Showing papers in "Journal of Nervous and Mental Disease in 2005"
TL;DR: This study found that subjects who had previously played online games were predominantly male, and older age, lower self-esteem, and lower satisfaction with daily life were associated with more severe addiction among males, but not among females.
Abstract: The aim of this study was to evaluate the extent to which gender and other factors predict the severity of online gaming addiction among Taiwanese adolescents. A total of 395 junior high school students were recruited for evaluation of their experiences playing online games. Severity of addiction, behavioral characteristics, number of stressors, and level of satisfaction with daily life were compared between males and females who had previously played online games. Multiple regression analysis was used to explore gender differences in the relationships between severity of online gaming addiction and a number of variables. This study found that subjects who had previously played online games were predominantly male. Gender differences were also found in the severity of online gaming addiction and motives for playing. Older age, lower self-esteem, and lower satisfaction with daily life were associated with more severe addiction among males, but not among females. Special strategies accounting for gender differences must be implemented to prevent adolescents with risk factors from becoming addicted to online gaming.
481 citations
TL;DR: The validity of the diagnostic criteria proposed in this study was further confirmed by comparing the demographic and Internet-using characteristics between those with and without Internet addiction.
Abstract: The aims of the present study were to develop diagnostic criteria of Internet addiction for adolescents and to examine the discriminating potential and validity of diagnostic criteria by an empirical community study among adolescent populations. We developed 13 candidate diagnostic criteria for characteristic symptoms of Internet addiction in adolescents. A total of 468 adolescents completed the Chen Internet Addiction Scale (CIAS) and were systematically assessed for Internet-using behaviors by seven psychiatrists using the diagnostic interview schedule. The sensitivity, specificity, and diagnostic accuracy of the 13 candidate diagnostic criteria were analyzed with references to the interviewers' global clinical impressions and CIAS results. The cutoff point of the diagnostic criteria to differentiate the Internet-addicted subjects with nonaddicted ones was then determined by the best diagnostic accuracy and the receiver operating characteristic curve. This study selected nine of the 13 candidate diagnostic criteria to construct the diagnostic criteria of Internet addiction for adolescents, which were composed of three main criteria: characteristic symptoms of Internet addiction, functional impairment secondary to Internet use, and exclusive criteria. The diagnostic criteria had high diagnostic accuracy, specificity, negative predictive value, accepted sensitivity, and accepted positive predictive rate. The validity of the diagnostic criteria proposed in this study was further confirmed by comparing the demographic and Internet-using characteristics between those with and without Internet addiction. The diagnostic criteria for Internet addiction can provide health care professionals with a means to communicate and make comparisons of clinical cases.
309 citations
TL;DR: It is found that people with SMI are overall less physically active than the general population, although the proportion with recommended physical activity levels was equal.
Abstract: Although physical inactivity is a leading cause of death and the Surgeon General recommends regular moderate physical activity, many Americans are inactive. Because of their increased burden of obesity and diabetes, people with severe mental illness (SMI) especially may benefit from physical activity, yet little is known about the prevalence and types of physical activity in people with SMI. We surveyed outpatients with schizophrenia and affective disorders at two psychiatric centers in Maryland and compared physical activity patterns to an age-gender-race-matched national sample (National Health and Nutrition Examination Survey III) of the general population. We found that people with SMI are overall less physically active than the general population, although the proportion with recommended physical activity levels was equal. The participants with SMI were more likely to walk as their sole form of physical activity. Within the SMI group, those without regular social contact and women had higher odds of being inactive.
305 citations
TL;DR: Mental health workers should recognize the impact of postmigration living problems and consider focusing their treatment on coping with these problems instead of traumas from the past, and appeal to governments to shorten the asylum procedures, allow asylum seekers to work, and give preference to family reunion.
Abstract: In a previous community-based, national study among Iraqi asylum seekers, a long asylum procedure was found to have a higher risk for common psychiatric disorders than adverse life events in Iraq. In the present article, the postmigration period is considered in more detail and evaluated in relationship with psychiatric disorders. Respondents were interviewed with fully structured, culturally validated, translated questionnaires. With the use of a Postmigration Living Problems questionnaire, worries about all kinds of problems were gathered. Psychiatric (DSM-IV) disorders were measured with the Composite International Diagnostic Interview 2.1. Factor analysis was done on the postmigration living problems, and in univariate and multivariate analyses, associations with psychopathology were calculated. Results show that clusters of postmigration living problems could be identified: family issues, discrimination, asylum procedure, socioeconomic living conditions, socioreligious aspects, and work-related issues. There was a significant relationship between all clustered postmigration living problems and psychopathology, except for socioreligious aspects. Multivariate logistic regression showed that lack of work, family issues, and asylum procedure stress had the highest odds ratios for psychopathology. The findings appeal to governments to shorten the asylum procedures, allow asylum seekers to work, and give preference to family reunion. Mental health workers should recognize the impact of postmigration living problems and consider focusing their treatment on coping with these problems instead of traumas from the past.
283 citations
TL;DR: The robust association between PTSD and suicide attempts has important implications for psychiatric assessment of suicidal behavior and future research is required to investigate the mechanisms underlying the relationship between PTSDand suicidal behavior.
Abstract: This study examined the relationship between anxiety disorders and suicidal ideation or suicide attempts in a nationally representative sample (N = 5877; age, 15-54; response rate, 82.4%). A modified version of the Composite International Diagnostic Interview was used to make DSM-III-R mental disorder diagnoses. Two multivariate logistic regression analyses were performed with suicidal ideation (N = 754) and suicide attempts (N = 259) as dependent variables. In each regression, the independent variables entered were lifetime social phobia, panic disorder, agoraphobia, generalized anxiety disorder, simple phobia, and posttraumatic stress disorder (PTSD). Covariates in the analyses were sociodemographics, lifetime mood disorders, substance use disorders, nonaffective psychosis, antisocial personality disorder, and presence of three or more lifetime DSM-III-R diagnoses. PTSD was significantly associated with suicidal ideation (adjusted odds ratio = 2.79; p < 0.01) and suicide attempts (adjusted odds ratio = 2.67; p < 0.01). None of the other anxiety disorders were significantly associated with suicidal ideation or attempts. The robust association between PTSD and suicide attempts has important implications for psychiatric assessment of suicidal behavior. Future research is required to investigate the mechanisms underlying the relationship between PTSD and suicidal behavior.
276 citations
TL;DR: A theoretically informed phenomenological study that assessed the rates of four types of hypothesized association between traumas and hallucinations (direct, indirect, stress, and none) in 75 participants with nonaffective psychosis to report a theoretically informed study on the nature of the relationship between trauma and hallucinations.
Abstract: Recent research indicates that there may be phenomenological, symptom, and diagnostic associations between trauma and hallucinations. However, the nature of the relationship is poorly understood from a psychological perspective. We report a theoretically informed phenomenological study. From descriptions of reported traumas and hallucinations, we assessed the rates of four types of hypothesized association between traumas and hallucinations (direct, indirect, stress, and none) in 75 participants with nonaffective psychosis. In a subgroup who had experienced trauma (N = 40), 12.5% had hallucinations with similar themes and content to their traumas, 45% had hallucinations in which the themes were the same but not the content, and 42.5% had no identifiable associations between their hallucinations and previously experienced trauma. Traumas rated as intrusive were significantly associated with hallucinations rated as intrusive, although intrusive hallucinations were not associated with traumas in general. The traumas most likely to be associated with hallucinations were sexual abuse and bullying.
229 citations
TL;DR: Zero-order correlations and multilevel analysis revealed that only lack of premeditation was specifically linked to disadvantageous decisions on the Gambling Task, which suggests that premeditations is related to decision making influenced by somatic (or emotional) markers.
Abstract: :The purpose of the present study was to explore the links among the four facets of impulsivity (urgency, lack of premeditation, lack of perseverance, and sensation seeking) proposed by Whiteside and Lynam (2001) and decision-making processes. Thirty undergraduate students completed a self-r
205 citations
TL;DR: Prevention of new cases of mental disorders seems to be possible and may be an important way of reducing the enormous burden of these disorders.
Abstract: To assess the results of studies examining the effects of preventive interventions on the incidence of mental disorders, we conducted a systematic review. A literature search resulted in 13 high-quality randomized trials, six on depressive disorder (including postpartum depression), one on anxiety, one examining both anxiety and depression, three on posttraumatic stress disorders, one on psychosis, and one on any mental disorder. The overall relative risk (RR) was 0.73 (95% CI, 0.56-0.95), indicating a reduction of the risk to become a new case of a mental disorder. The seven studies on prevention of depressive disorder resulted in a RR of 0.72 (95% CI, 0.54-0.96). The risk of posttraumatic stress disorder was somewhat increased after debriefing, but not significantly (RR = 1.33), indicating a possible adverse effect. Prevention of new cases of mental disorders seems to be possible and may be an important way of reducing the enormous burden of these disorders.
182 citations
TL;DR: Comparisons across three trauma-exposed groups revealed that veterans in the subthreshold PTSD group did not use mental health services more often than those in the no PTSD group despite the presence of additional mental health diagnoses and worse functional status, indicating that clinicians may be overlooking a subset of individuals suffering from subsyndromal PTSD.
Abstract: The purpose of this study is to determine the prevalence of subthreshold posttraumatic stress disorder (PTSD) and its association with specific traumas, other psychiatric diagnoses, healthcare use, and functional status among 669 veterans in four VA Medical Centers. A cross-sectional, epidemiological design incorporating self-report measures, structured interviews, and chart reviews was used to obtain relevant information for analyses. Comparisons across three trauma-exposed groups (PTSD, subthreshold PTSD, no PTSD) revealed that veterans in the subthreshold PTSD group did not use mental health services more often than those in the no PTSD group despite the presence of additional mental health diagnoses and worse functional status. These data indicate that clinicians may be overlooking a subset of individuals suffering from subsyndromal PTSD, suggesting the need to detect and serve these individuals better within healthcare settings.
153 citations
TL;DR: Family environment, parental psychopathology, and history of abuse all independently predicted BPD symptoms in multiple regression analyses, although family environmental factors such as instability partially mediated the effect.
Abstract: A substantial body of research points to several variables relevant to the etiology of borderline personality disorder (BPD), notably childhood physical and sexual abuse, childhood family environment, and familial aggregation of both internalizing and externalizing disorders. However, these variables tend to be correlated, and few studies have examined them simultaneously. A national sample of randomly selected psychologists and psychiatrists described 524 adult patients with personality disorders. Family environment, parental psychopathology, and history of abuse all independently predicted BPD symptoms in multiple regression analyses. Sexual abuse contributed to the prediction of BPD symptoms over and above family environment, although family environmental factors such as instability partially mediated the effect. The results converge with recent studies using very different samples and methodologies.
146 citations
TL;DR: It is concluded that nonclinical paranoid thoughts are most closely associated with emotional disturbances and anomalous experiences and Extreme reasoning bias may particularly contribute to the development of clinical phenomena.
Abstract: A cognitive model of persecutory delusions is used to predict the occurrence of nonclinical paranoid thoughts in a virtual reality environment. Scorers across the range of paranoia entered a virtual reality scene populated by five computer characters programmed to behave neutrally (N = 30). Many appraisals of the computer characters were positive or neutral. However, there were also persecutory thoughts about the characters. Providing evidence of the validity of the experimental method, persecutory ideation was predicted by higher trait paranoia and a greater sense of presence in the environment. The psychological variables from the cognitive model that predicted persecutory ideation were anxiety, timidity, and hallucinatory predisposition. Further, hallucinatory predisposition distinguished the prediction of paranoid thoughts from social anxiety in virtual reality. It is concluded that nonclinical paranoid thoughts are most closely associated with emotional disturbances and anomalous experiences. Extreme reasoning bias may particularly contribute to the development of clinical phenomena.
TL;DR: Although being Latino was independently associated with less suicidal ideation, other suicidal behaviors held a stronger relationship to moral objections to suicide and survival and coping skills than to ethnicity, suggesting self-identification as Latino may be associated with espousing cultural constructs that mediate protective effects against suicidal behavior.
Abstract: Latinos appear to be relatively protected against suicidal behavior, but the factors that mediate this effect are not known. Some protective factors may be related to cultural constructs that provide a buffer against suicidal behavior in the face of psychiatric illness. We sought to determine whether the Reasons for Living Inventory (RFLI) might capture protective factors against suicidal behavior in Latinos and non-Latinos. Patients with major depression, bipolar disorder, or schizophrenia were interviewed regarding their depressive symptomatology and lifetime history of suicidal behavior. The RFLI, which measures protective factors against suicidal acts, was also administered. Multivariate analyses were used to assess the relationship between suicide measures, ethnicity, and selected clinical and demographic variables. Although Latinos and non-Latinos did not differ significantly in attempter status (attempter/nonattempter), number of attempts, or suicide intent, Latinos reported significantly less suicidal ideation and made less lethal attempts. On the RFLI, Latinos scored significantly higher on subscales regarding survival and coping beliefs, responsibility to family, and moral objections to suicide, possibly reflective of cultural norms endorsed by Latino groups. Multivariate analyses suggested that although being Latino was independently associated with less suicidal ideation, other suicidal behaviors held a stronger relationship to moral objections to suicide and survival and coping skills than to ethnicity. Self-identification as Latino may be associated with espousing cultural constructs that mediate protective effects against suicidal behavior. Constructs identified in the RFLI may protect Latinos from acting on suicidal thoughts, affecting moral objections to suicide and survival and coping beliefs. Further studies to elucidate the impact of these factors on suicidal behavior and their relationship to specific cultural constructs would be of interest.
TL;DR: It is concluded that religious involvement likely plays a significant role in modulating the pain experience of African American patients with SCD and may be an important factor for future study in other populations of chronically ill pain sufferers.
Abstract: Religion/spirituality has been identified by individuals with sickle cell disease (SCD) as an important factor in coping with stress and in determining quality of life. Research has demonstrated positive associations between religiosity/spirituality and better physical and mental health outcomes. However, few studies have examined the influence religiosity/spirituality has on the experience of pain in chronically ill patients. Our aim was to examine three domains of religiosity/spirituality (church attendance, prayer/Bible study, intrinsic religiosity) and evaluate their association with measures of pain. We studied a consecutive sample of 50 SCD outpatients and found that church attendance was significantly associated with measures of pain. Attending church once or more per week was associated with the lowest scores on pain measures. These findings were maintained after controlling for age, gender, and disease severity. Prayer/Bible study and intrinsic religiosity were not significantly related to pain in our study. Positive associations are consistent with recent literature, but our results expose new aspects of the relationship for African American patients. We conclude that religious involvement likely plays a significant role in modulating the pain experience of African American patients with SCD and may be an important factor for future study in other populations of chronically ill pain sufferers.
TL;DR: It is concluded that persons suffering from PTSD might need comprehensive aid in smoking cessation, and increased odds ratios for smoking and nicotine dependence in traumatized persons, independent of PTSD.
Abstract: :This study is aimed at investigating the association between trauma, posttraumatic stress disorder (PTSD), smoking, and nicotine dependence. Data were collected in a representative population sample of 4075 adults aged 18 to 64 with the Composite International Diagnostic Interview. Findings
TL;DR: The findings imply that conversion symptoms may be elicited by a complex of early and later negative life events and that traditional unifactorial trauma-theories of conversion disorder should be replaced by multifactorial stress models.
Abstract: Although the presence of psychological stress factors in the evolution of conversion symptoms forms an important criterion for the DSM-IV diagnosis of conversion disorder, little is known about the nature and timing of these stress factors. Fifty-four patients with conversion disorder and 50 control patients with an affective disorder were screened for life events experienced in the year before the symptom onset. Conversion patients did not differ from control patients in the number or severity of life events, but showed a significant relation between the recent life events and the severity of conversion symptoms. Especially life events with respect to work and relationships contributed to this effect. These results remained when controlling for the previously found effects of childhood traumatization on the severity of conversion symptoms. The findings imply that conversion symptoms may be elicited by a complex of early and later negative life events and that traditional unifactorial trauma-theories of conversion disorder should be replaced by multifactorial stress models.
TL;DR: Examination of changes in symptoms of PTSD, depression, and anxiety during treatment in traumatized refugees found emotional distress seems to be chronic for the majority of this population.
Abstract: Longitudinal studies of traumatized refugees are needed to study changes in mental health over time and to improve health-related and social interventions. The aim of this study was to examine changes in symptoms of PTSD, depression, and anxiety, and in health-related quality of life during treatment in traumatized refugees. The study group comprises 55 persons admitted to the Rehabilitation and Research Centre for Torture Victims in 2001 and 2002. Data on background, trauma, present social situation, mental symptoms (Hopkins Symptom Checklist-25, Hamilton Depression Scale, Harvard Trauma Questionnaire), and health-related quality of life (WHO Quality of Life-Bref) were collected before treatment and after 9 months. No change in mental symptoms or health-related quality of life was observed. In spite of the treatment, emotional distress seems to be chronic for the majority of this population. Future studies are needed to explore which health-related and social interventions are most useful to traumatized refugees.
TL;DR: Clinical factors were associated with individuals’ ability to achieve competitive jobs and to work 40 or more hours per month and poor self-rated functioning, negative psychiatric symptoms, and recent hospitalizations were most consistently associated with failure to achieve employment outcomes.
Abstract: Research has shown that supported employment programs are effective in helping psychiatric outpatients achieve vocational outcomes, yet not all program participants are able to realize their employment goals. This study used 24 months of longitudinal data from a multisite study of supported employment interventions to examine the relationship of patient clinical factors to employment outcomes. Multivariate random regression analysis indicated that, even when controlling for an extensive series of demographic, study condition (experimental versus control), and work history covariates, clinical factors were associated with individuals' ability to achieve competitive jobs and to work 40 or more hours per month. Poor self-rated functioning, negative psychiatric symptoms, and recent hospitalizations were most consistently associated with failure to achieve these employment outcomes. These findings suggest ways that providers can tailor supported employment programs to achieve success with a diverse array of clinical subpopulations.
TL;DR: The results showed that social phobia and panic disorder within the past year and lifetime, and generalized anxiety disorder withinThe past year, had an independent effect on quality of life when controlling for a number of sociodemographic variables, somatic health, and other DSM-III-R Axis I mental disorders.
Abstract: The study of quality of life has increased in importance in the area of mental disorders during the last decade. The aim of the present study was to investigate the effect of specific anxiety disorders on specific quality of life indicators in the common population. More than 2000 individuals between 18 and 65 years old were studied by means of structured interviews. The results showed that social phobia and panic disorder within the past year and lifetime, and generalized anxiety disorder within the past year, had an independent effect on quality of life when controlling for a number of sociodemographic variables, somatic health, and other DSM-III-R Axis I mental disorders. Specific phobias and obsessive compulsive disorder had only a small effect, and agoraphobia showed no effect. The effect was strongest for self-realization and contact with friends, but anxiety disorders also influenced subjective well-being, social support, negative life events, contact with family of origin, and neighborhood quality.
TL;DR: Among patients meeting criteria for comorbid somatoform with anxiety and/or depressive disorders, complementary assessment of patient-perceived causes, a key element of illness explanatory models, was related to levels of functional impairment and short-term prognosis.
Abstract: The assessment of somatoform disorders is complicated by persistent theoretical and practical questions of classification and assessment. Critical rethinking of professional concepts of somatization suggests the value of complementary assessment of patients' illness explanatory models of somatoform and other common mental disorders. We undertook this prospective study to assess medically unexplained somatic symptoms and their patient-perceived causes of illness and to show how patients' explanatory models relate to professional diagnoses of common mental disorders and how they may predict the short-term course of illness. Tertiary care patients (N=186) with prominent somatoform symptoms were evaluated with the Structured Clinical Interview for DSM-IV, a locally adapted Explanatory Model Interview to elicit patients' illness experience (priority symptoms) and perceived causes, and clinical self-report questionnaires. The self-report questionnaires were administered at baseline and after 6 months. Diagnostic overlap between somatoform, depressive, and anxiety disorders occurred frequently (79.6%). Patients explained pure somatoform disorders mainly with organic causal attributions; they explained pure depressive and/or anxiety disorders mainly with psychosocial perceived causes, and patients in the diagnostic overlap group typically reported mixed causal attributions. In this last group, among patients with similar levels of symptom severity, organic perceived causes were related to a lower physical health sum score on the MOS Short Form, and psychosocial perceived causes were related to less severe depressive symptoms, assessed with the Hospital Anxiety and Depression Scale at 6 months. Among patients meeting criteria for comorbid somatoform with anxiety and/or depressive disorders, complementary assessment of patient-perceived causes, a key element of illness explanatory models, was related to levels of functional impairment and short-term prognosis. For such patients, causal attributions may be particularly useful to clarify clinically significant features of common mental disorders and thereby contribute to clinical assessment.
TL;DR: A questionnaire survey of nonclinical paranoia designed to assess the theoretical model of paranoia found that paranoia was best explained by separation anxiety, depression, fragile inner self, hallucinatory experiences, discomfort with ambiguity, stress, self-focus, perceptual anomalies, and anxiety.
Abstract: Paranoia is a complex phenomenon that is likely to arise from a number of factors. In a recent cognitive model of persecutory delusions, three key factors are highlighted: anomalous experiences, emotion, and reasoning. In the first of two linked studies, we report a questionnaire survey of nonclinical paranoia designed to assess the theoretical model. A nonclinical population (N = 327) completed measures of paranoia, anomalous experiences (hallucinatory predisposition, perceptual anomalies), emotion (depression, anxiety, self-focus, stress, interpersonal sensitivity), and reasoning (need for closure). Paranoia was best explained by separation anxiety, depression, fragile inner self, hallucinatory experiences, discomfort with ambiguity, stress, self-focus, perceptual anomalies, and anxiety. The findings are consistent with the central predictions within the model of paranoia.
TL;DR: It is proposed that reliance on false knowledge represents a candidate mechanism for the emergence of fixed false beliefs (i.e., delusions) and was observed to be significantly greater in schizophrenic patients relative to controls for false-positive and false-negative judgments.
Abstract: In two previous studies, it was observed that schizophrenic patients display increased confidence in memory errors compared with controls. The patient group displayed an increased proportion of errors in their knowledge system, quantified as the percentage of high-confident responses that are errors. The latter phenomenon has been termed knowledge corruption and is put forward as a risk factor for the emergence of delusions. In the present study, knowledge corruption was analyzed separately for different aspects of memory errors. A source-monitoring task was used, for which participants (30 schizophrenic patients with past or current paranoid ideas and 15 healthy controls) were asked to provide associates for each of 20 prime words. Later, participants were required to recognize studied words among distractor words, judge the original source, and provide a confidence rating for the most recent decision. Schizophrenic patients displayed greater confidence in memory errors compared with controls. Knowledge corruption was observed to be significantly greater in schizophrenic patients relative to controls for false-positive and false-negative judgments. It is proposed that reliance on false knowledge represents a candidate mechanism for the emergence of fixed false beliefs (i.e., delusions).
TL;DR: Reported childhood abuse in schizophrenia spectrum disorders is linked with graver symptom levels and social dysfunction, and repeated-measures ANOVA revealed the abuse group had consistently higher levels of both symptom components and poorer participation in vocational rehabilitation.
Abstract: Cross-section research suggests reported childhood abuse in schizophrenia spectrum disorders is linked with graver symptom levels and social dysfunction. To examine this prospectively, we compared biweekly ratings of positive and emotional discomfort symptoms and weekly accounts of hours worked over 4 months of rehabilitation of 12 participants with schizophrenia or schizoaffective disorder and childhood sexual abuse history and 31 with schizophrenia or schizoaffective disorder and no childhood sexual abuse history. Repeated-measures ANOVA revealed the abuse group had consistently higher levels of both symptom components and poorer participation in vocational rehabilitation. A time by group effect was observed for hours of work, with the abuse group working increasingly fewer hours over time. Participants reporting abuse also were more likely to perform poorly on a test of executive function and to have particularly higher levels of hallucinations and anxiety over time. Clinical and theoretical implications are discussed.
TL;DR: Investigating differences in outcome based on a diagnosis of PCD (DSM-IV) versus PCS (ICD-10 clinical criteria) as to which criteria set might be preferred for clinical practice found no compelling evidence, based on these outcome domains, to suggest which of the two diagnostic criteria sets should be clinically preferred.
Abstract: Little is known about the characteristics and outcomes of patients diagnosed with postconcussional disorder (PCD) under the provisionally proposed criteria in the DSM-IV and how they differ from patients diagnosed with postconcussional syndrome (PCS) under the International Classification of Diseases, 10th edition clinical (ICD-10) criteria. This study investigated differences in outcome based on a diagnosis of PCD (DSM-IV) versus PCS (ICD-10 clinical criteria) as to which criteria set might be preferred for clinical practice. A consecutive series of adult patients with mild (N = 319) to moderate (N = 21) traumatic brain injury was assessed at 3 months postinjury with a brief neuropsychological battery and measures of specific outcome domains. In two separate series of analyses, patients with PCD were compared with those without PCD, and those with PCS were compared with those without PCS. Although the two criteria sets resulted in markedly different incidence rates, there was no substantial pattern of differences between the DSM-IV and ICD-10 in the outcome domains of psychiatric symptoms and disorders, social and community integration, health-related quality of life, or global outcome as measured by the Glasgow Outcome Scale-Extended. In spite of significant differences between the two diagnostic criteria sets and different incidence rates for PCD/PCS, outcome in all measured domains was very similar at 3 months postinjury. There is no compelling evidence, based on these outcome domains, to suggest which of the two diagnostic criteria sets should be clinically preferred.
TL;DR: This article critically reviews the reported neuropsychological impairments in BD and the methodological limitations facing such research and posits cortical-subcortical-limbic disruption in recovered euthymic patients that manifests as cognitive dysfunction.
Abstract: Bipolar disorder (BD) is a debilitating psychiatric illness that is uniquely characterized by switching between psychopathologically contrasting phases of mania and depression, often with intervening periods of euthymia. However, these periods of apparent clinical recovery (euthymia) are marked by subtle social, occupational, and cognitive impairments, profiled by recent neuropsychological investigations. Determining the cognitive changes across these three phases may help differentiate the disruptions that are mood state-dependent from those associated with underlying pathology. This article therefore critically reviews the reported neuropsychological impairments in BD and the methodological limitations facing such research. Integration of the available evidence, principally from the field of neuropsychology, when synthesized, implicates the prefrontal cortex in the etiopathogenesis of BD and posits cortical-subcortical-limbic disruption in recovered euthymic patients that manifests as cognitive dysfunction.
TL;DR: Findings suggest that psychological distress from natural disasters may be very long lasting and financial loss from the Bradyseism quakes was associated with higher distress across all measures.
Abstract: This report details relationships between earthquake exposures in 1980 and 1983 to 1984 and psychological distress reported in 1994. Participants are 555 Italian male factory workers from Naples, Italy. Those men who experienced damage from the 1980 quake reported higher levels of psychological distress (across several dimensions of the Symptom Checklist) than those without damage; additionally, 30% of these men reported symptoms of posttraumatic stress disorder (PTSD). While men evacuated as a result of the 1983 to 1984 Bradyseism earthquakes did not report higher distress levels (Symptom Checklist) than their nonevacuated colleagues, they did report more PTSD-like symptoms than those not evacuated. Financial loss from the Bradyseism quakes was associated with higher distress across all measures (seven Symptom Checklist dimensions and presence of PTSD symptoms). Additionally, social network disruptions following 1983 to 1984 evacuation were associated with greater distress (not all measures). These findings suggest that psychological distress from natural disasters may be very long lasting.
TL;DR: Examining depressed patients’ awareness of their own and other persons’ emotions in the course of an inpatient psychotherapeutic treatment program found that acute depressed patients seem not to be impaired in the complexity of their Own emotional experience, but they exhibit a reduced ability to empathize with other persons.
Abstract: The present study was conducted to examine depressed patients' awareness of their own and other persons' emotions in the course of an inpatient psychotherapeutic treatment program. To this aim, the Levels of Emotional Awareness Scale (LEAS) was administered twice, approximately 7 weeks apart, to 22 patients with a unipolar depression and 22 normal controls. From test 1 to test 2, severity of patients' depressive symptoms as measured by the Beck Depression Inventory improved significantly. Depressed patients did not differ from normal individuals on the LEAS-self score, but at time 1, they exhibited lower LEAS-other scores than normal controls. In the whole sample, LEAS-other scores increased significantly from time 1 to time 2. Acutely depressed patients seem not to be impaired in the complexity of their own emotional experience, but they exhibit a reduction in the ability to empathize with other persons.
TL;DR: For patients with schizophrenia, increasing perceptions of family cohesion was associated with less general emotional distress and fewer psychiatric symptoms and for family members of Latino and African American descent, greater self-reported family cohesion appeared to have a protective effect against emotional distress.
Abstract: This study included a sample of 57 Anglo-American, Latino American, and African American patients with schizophrenia and their family members. Findings indicate that for patients, as hypothesized, increasing perceptions of family cohesion was associated with less general emotional distress and fewer psychiatric symptoms. For family members of Latino and African American descent, greater self-reported family cohesion also appeared to have a protective effect against emotional distress, as hypothesized. However, no association was found between family cohesion and general emotional distress for Anglo-American family members. Interestingly, no relationship was found between patients' and their relatives' views of their family environment. Thus, researchers and clinicians working with families are encouraged to attain separate assessments of the family environment from each individual member. Contrary to expectations, religiosity was not associated with patient or family member emotional distress or with patient psychiatric symptoms. Study implications are discussed.
TL;DR: The results of the present study support the use of a lower cutoff on the HRSD than has been traditionally used to define remission, and the association between the breadth of the definition of remission and self-report ratings of global psychosocial functioning and quality of life.
Abstract: The Hamilton Rating Scale for Depression (HRSD) is the most frequently used measure of outcome in antidepressant efficacy trials. More than a decade ago, a consensus panel recommended that remission be defined on the 17-item version of the HRSD as a cutoff
TL;DR: These findings argue against PTSD patients being chronically inhibited and unresponsive to rewards, and the presence of disinhibition accompanying behavioral activation in these subjects may explain the impulsivity and aggression associated with PTSD.
Abstract: Posttraumatic stress disorder (PTSD) is characterized by anxiety symptoms and impulsivity and aggression, which are thought to represent examples of excessive behavioral inhibition and activation, respectively. PTSD and traumatized control subjects performed the Stop-Signal Task to assess behavioral activation and inhibition simultaneously. PTSD subjects showed no evidence of the generally increased behavioral inhibition expected to accompany anxiety, but exhibited progressively decreased behavioral activation during acquisition of the task. However, when behavior was facilitated using monetary rewards, both PTSD and traumatized control subjects showed increases in behavioral activation, whereas PTSD subjects also showed significant disinhibition. These findings argue against PTSD patients being chronically inhibited and unresponsive to rewards, and the presence of disinhibition accompanying behavioral activation in these subjects may explain the impulsivity and aggression associated with PTSD.