Comprehensive psychiatry最新文献_第4页

Beyond criticism, hostility, and emotional overinvolvement: Development and psychometric validation of the Comprehensive Expressed Emotion Scale (CEES) in schizophrenia 超越批评、敌意和情绪过度投入：精神分裂症综合情绪表达量表（CEES）的开发和心理计量学验证。

IF 4.2 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2025-10-02 DOI: 10.1016/j.comppsych.2025.152638

Yingzhe He , Siu-Man Ng , Mao-Sheng Ran , Cong Wang , Yi-Yue Yang , Lie Zhou , Jia Cai

Background

Expressed Emotion (EE) is a well-established predictor of schizophrenia relapse, but concerns remain regarding the content validity of its traditional components—criticism, hostility, and emotional overinvolvement (EOI). Recent research suggests a covert EE dimension (disassociation, apathy) unmeasured by current scales. This study developed and validated a self-report EE scale, the Comprehensive Expressed Emotion Scale (CEES), to reconceptualize EE.

Methods

319 adults with schizophrenia in Mainland China completed CEES, relevant Family Environment Scale—Chinese Version (FES-CV) subscales, and SF-12. Ten patient–family dyads also underwent the Camberwell Family Interview (CFI). Exploratory and confirmatory factor analyses determined factor structure; reliability and validity were evaluated using established indices and correlations.

Results

EFA supported a three-factor model—overt (criticism, hostility), covert (disassociation, apathy), and EOI—explaining 64 % of variance. CFA confirmed strong loadings for overt and covert items (0.70–0.91 and 0.72–0.90; all p < 0.001), but weaker, mostly non-significant loadings for EOI items. The three-factor model showed good fit (χ²(402) = 657.17, CFI = 0.971, TLI = 0.968, RMSEA = 0.061, SRMR = 0.079). The total scale and overt and covert subscales showed high internal consistency and strong construct and concurrent validity; EOI subscale reliability was moderate.

Conclusions

CEES operationalizes covert EE in Chinese families, broadening EE assessment to include implicit conflict. It demonstrates strong psychometric properties and potential for targeted interventions, though EOI subscale reliability and generalizability remain limitations.

背景：情绪表达（EE）是一种公认的精神分裂症复发预测因子，但对其传统成分——批评、敌意和情绪过度投入（EOI）的内容效度仍然存在担忧。最近的研究表明，当前的量表无法测量一个隐蔽的情感表达维度（分离、冷漠）。本研究开发并验证了一种自我报告的情感表达量表，即综合表达情感量表（CEES），以重新定义情感表达。方法：319名中国大陆成人精神分裂症患者完成了CEES、相关家庭环境量表-中文版（FES-CV）子量表和SF-12。10名患者家属也进行了Camberwell家庭访谈（CFI）。探索性和验证性因子分析确定了因子结构；采用建立的指标和相关性评价信度和效度。结果：EFA支持三因素模型-公开（批评，敌意），隐蔽（分离，冷漠）和情绪波动-解释了64%的方差。CFA证实了显性和隐性项目的强负荷（0.70-0.91和0.72-0.90；所有p 2(402) = 657.17, CFI = 0.971, TLI = 0.968, RMSEA = 0.061, SRMR = 0.079）。总量表和内外隐量表具有较高的内部一致性，具有较强的构念效度和并发效度；EOI分量表信度中等。结论：CEES在中国家庭中实施了隐性情感表达，扩大了情感表达评估，将隐性冲突纳入其中。它显示了强大的心理测量特性和有针对性干预的潜力，尽管情绪情绪量表的可靠性和普遍性仍然存在局限性。

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引用次数: 0

The power of youth: Long-term differential effects of developmental functioning trajectory on social functioning, quality of life and personal recovery across the schizophrenia spectrum 青年的力量：精神分裂症谱系中发育功能轨迹对社会功能、生活质量和个人康复的长期差异影响。

IF 4.2 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2025-09-29 DOI: 10.1016/j.comppsych.2025.152637

Jiasi Hao , Richard Bruggeman , Wim Veling , Behrooz Z. Alizadeh

Background

Compromised developmental functioning is frequently observed in patients with schizophrenia spectrum disorder (SSD) and is associated with poor outcomes, which remains understudied in individuals at varying risk of SSD. This study aimed to investigate the course of developmental functioning and its relationship with long-term outcomes within a population across the vulnerability spectrum of SSD. We hypothesized that developmental functioning negatively correlated with SSD vulnerability, and was positively associated with worse outcomes, regardless of disease status.

Methods

We used data of 1119 patients, 1059 siblings, and 586 controls from the Dutch Genetic Risk and Outcome in Psychosis (GROUP) cohort. Group-based trajectory modelling and linear mixed models were employed to investigate the course of developmental functioning (measured by the Premorbid Adjustment Scale) and its associations with the outcomes, including social functioning (SF), personal recovery (PR), and quality of life (QoL).

Results

In the combined sample, six developmental trajectories were identified: normal-stable (12.4 %), normal-slow decrease (12.3 %), mild-stable (46.9 %), all dominated by controls and siblings; and mild-rapid decrease (5.1 %), moderate-stable (16.5 %), and severe-slow decrease (6.8 %) more prevalent in patients. Compared to normal-stable, all other trajectories in developmental functioning were correlated with decreased SF; mild-rapid decrease and severe-slow decrease were linked to lower QoL. No association with PR was observed.

Conclusion

Impaired developmental functioning variably lowers prolonged SF and QoL but not PR. Potentially influenced by factors encompassing environment, cognition, resilience and disease status, this finding demands screening for developmental deviance among youths and early preventive interventions to achieve normal functioning through a public health salutogenic approach.

背景：发育功能受损在精神分裂症谱系障碍（SSD）患者中经常观察到，并与不良预后相关，这在不同风险的SSD个体中仍未得到充分研究。本研究旨在调查SSD易损性人群的发育功能过程及其与长期预后的关系。我们假设，无论疾病状态如何，发育功能与SSD易感性呈负相关，而与更糟糕的结果呈正相关。方法：我们使用了来自荷兰精神病遗传风险和结局（组）队列的1119名患者、1059名兄弟姐妹和586名对照者的数据。采用基于群体的轨迹模型和线性混合模型来研究发育功能的过程（由病前适应量表测量）及其与社会功能（SF）、个人恢复（PR）和生活质量（QoL）等结果的关系。结果：在合并样本中，确定了6种发育轨迹：正常-稳定（12.4%），正常-缓慢下降（12.3%），轻度稳定（46.9%），均由对照和兄弟姐妹主导；轻-快速下降（5.1%）、中-稳定（16.5%）和严重缓慢下降（6.8%）在患者中更为普遍。与正常稳定相比，发育功能的所有其他轨迹都与SF下降相关；中速下降和慢速下降与较低的生活质量有关。与PR无关联。结论：发育功能受损对延长的SF和QoL有不同程度的影响，但对PR没有影响。这一发现可能受到环境、认知、恢复力和疾病状态等因素的影响，这一发现需要筛查青少年的发育异常，并通过公共健康有益的方法进行早期预防干预，以实现正常的功能。

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引用次数: 0

Gaming disorder among Swedish adolescents: Measurement, risk factors, and classification 瑞典青少年的游戏障碍：测量、危险因素和分类

IF 4.2 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2025-09-19 DOI: 10.1016/j.comppsych.2025.152635

Amir Pakpour , Marit Eriksson , Daniel Kwasi Ahorsu , Gunilla Björling , Anders Broström , Staffan Bengtsson , Malin Jakobsson , Karina Huus

Objectives

This study examined the 1) psychometric properties of an independently translated Swedish version of the gaming disorder test (GDT) among Swedish adolescents based on two psychometric theories, 2) measurement invariance across age (i.e., 15 vs 16–17), gender (i.e., males vs females), and gaming time (i.e., < 2 h vs ≥ 2 h), and 3) factors that predict gaming disorder. The findings will help researchers understand and ascertain the use of the GDT among Swedish adolescents.

Methods

A total of 5320 Swedish adolescents were recruited and responded to measures including gaming disorder, gaming duration, sleep duration, physical activity, mental well-being, and self-esteem. Statistical analyses were conducted using confirmatory factor analysis, regression analysis, latent class analysis, classical test theory, and Rasch analysis.

Results

Satisfactory and unidimensional psychometric properties for the independently translated Swedish version of the GDT were found. Specifically, the factor structure, internal consistencies, separation reliability and separation index were supported, but not the person separation reliability and index. Also, the GDT was invariant across ages but only partially so across gender and gaming time. The GDT can classify adolescents as having a high or low risk of gaming disorder. Lastly, factors that predicted gaming disorder were poorer mental well-being and longer gaming time among males and low physical activity and longer gaming time among females.

Conclusion

Due to its conciseness, researchers may use the independently translated Swedish version of the GDT for screening people for gaming issues even in busy settings like schools. Moreover, attention must be paid to males, those with poorer mental well-being, those who are physically inactive, and those with a longer gaming time to help curb gaming disorder. Future research may focus on examining the test-retest reliability and clinical validity of the GDT among adolescents.

本研究基于两种心理测量理论检验了1)瑞典青少年独立翻译的游戏障碍测试（GDT）的心理测量特性；2)不同年龄（即15岁vs 16-17岁）、性别（即男性vs女性）、游戏时间（即2小时vs≥2小时）的测量不变性；3)预测游戏障碍的因素。这些发现将有助于研究人员了解和确定瑞典青少年使用GDT的情况。方法共招募了5320名瑞典青少年，并对游戏障碍、游戏持续时间、睡眠时间、身体活动、心理健康和自尊进行了评估。统计分析采用验证性因子分析、回归分析、潜在类分析、经典检验理论和Rasch分析。结果独立翻译的瑞典语版GDT具有令人满意的单维心理测量特性。其中，因子结构、内部一致性、分离信度和分离指标得到支持，但不支持人的分离信度和分离指标。此外，GDT在不同年龄段是不变的，但在性别和游戏时间上是部分不变的。GDT可以将青少年分为高或低风险的游戏障碍。最后，预测游戏障碍的因素是男性较差的心理健康状况和较长的游戏时间，以及女性较少的身体活动和较长的游戏时间。由于GDT的简洁性，即使在学校等繁忙的环境中，研究人员也可以使用独立翻译的瑞典语GDT来筛查人们的游戏问题。此外，必须关注男性，那些心理健康状况较差的人，那些身体不活跃的人，以及那些玩游戏时间较长的人，以帮助遏制游戏障碍。未来的研究重点应放在青少年GDT的重测信度和临床效度上。

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引用次数: 0

An extended model of gambling motives: The first results with the long and short versions of the gambling motives questionnaire-revised 赌博动机的扩展模型：第一个结果与赌博动机问卷的长和短版本-修订。

IF 4.2 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2025-09-10 DOI: 10.1016/j.comppsych.2025.152633

Anna Magi , Zsolt Horváth , Cristina Villalba-García , Borbála Paksi , Andrea Eisinger , Katalin Felvinczi , Sherry H Stewart , Beáta Bőthe , Gyöngyi Kökönyei , Zsolt Demetrovics , Andrea Czakó

Background

Motives underlying addictions have been widely studied, using validated tools such as the Gambling Motives Questionnaire (GMQ) (Stewart and Zack, 2008). Nevertheless, subsequent studies have suggested the need to extend this model. The present paper aimed to identify potential additional factors, such as escapism, omnipotence, pleasure and financial motives, in addition to the social, enhancement and coping aspects already included.

Methods

A total of 40 motivational items (adding 25 additional items to the original GMQ items) were analysed within two datasets. Sample 1 was a player panel from a gambling service provider (N = 1829; mean age: 42.4 [SD = 13.3]; Females: 30 % [n = 548]), while Sample 2 consisted of a nationally representative sample of the Hungarian population (N = 437; mean age: 42.9 [SD = 13.55]; Females: 49.2 % [N = 215]).

Results

Exploratory Factor Analysis on Sample 1 identified four factors (including a total of 27 items): coping/escapism, social motives, enhancement/pleasure, and financial motives. The four-factor structure was confirmed on Sample 2 with confirmatory factor analysis showing adequate model fit (CFI = 0.987; TLI = 0.986; RMSEA[CI] = 0.047 [0.041–0.052]); however, high inter-factor correlations were evident in the general population sample. A shorter, 14-item version of the scale was also suggested.

Conclusions

Although the newly identified motives overlap with the original ones, the content of the factors enables the inclusion of certain aspects, like escapism within the coping factor, that proved to be the most important in relation to other potentially addictive behaviours. This suggests that examining the role of motives in gambling may be crucial in differentiating between problem gambling and recreational gambling.

背景：使用赌博动机问卷（GMQ）等有效工具（Stewart和Zack， 2008），对成瘾的动机进行了广泛的研究。然而，随后的研究表明需要扩展这一模型。本论文旨在找出潜在的其他因素，如逃避主义，全能，快乐和经济动机，除了社会，提高和应对方面已经包括。方法：在两个数据集中，共分析了40个动机项目（在原有GMQ项目的基础上增加了25个动机项目）。样本1是来自赌博服务提供商的玩家小组（N = 1829，平均年龄：42.4 [SD = 13.3]，女性：30% [N = 548]），而样本2是匈牙利人口的全国代表性样本（N = 437，平均年龄：42.9 [SD = 13.55]，女性：49.2% [N = 215]）。结果：对样本1进行探索性因子分析，确定了应对/逃避、社会动机、提升/愉悦和经济动机四个因素（共27个项目）。对样本2进行验证性因子分析，模型拟合良好（CFI = 0.987; TLI = 0.986; RMSEA[CI] = 0.047 [0.041 ~ 0.052]）；然而，在一般人群样本中，高因素间相关性是明显的。还有人建议采用较短的14项比额表。结论：虽然新发现的动机与最初的动机重叠，但这些因素的内容使某些方面得以纳入，如逃避主义，这被证明是与其他潜在成瘾行为相关的最重要的应对因素。这表明，检查赌博动机的作用可能是区分问题赌博和娱乐赌博的关键。

{"title":"An extended model of gambling motives: The first results with the long and short versions of the gambling motives questionnaire-revised","authors":"Anna Magi , Zsolt Horváth , Cristina Villalba-García , Borbála Paksi , Andrea Eisinger , Katalin Felvinczi , Sherry H Stewart , Beáta Bőthe , Gyöngyi Kökönyei , Zsolt Demetrovics , Andrea Czakó","doi":"10.1016/j.comppsych.2025.152633","DOIUrl":"10.1016/j.comppsych.2025.152633","url":null,"abstract":"<div><h3>Background</h3><div>Motives underlying addictions have been widely studied, using validated tools such as the Gambling Motives Questionnaire (GMQ) (Stewart and Zack, 2008). Nevertheless, subsequent studies have suggested the need to extend this model. The present paper aimed to identify potential additional factors, such as escapism, omnipotence, pleasure and financial motives, in addition to the social, enhancement and coping aspects already included.</div></div><div><h3>Methods</h3><div>A total of 40 motivational items (adding 25 additional items to the original GMQ items) were analysed within two datasets. Sample 1 was a player panel from a gambling service provider (<em>N</em> = 1829; mean age: 42.4 [SD = 13.3]; Females: 30 % [<em>n</em> = 548]), while Sample 2 consisted of a nationally representative sample of the Hungarian population (<em>N</em> = 437; mean age: 42.9 [SD = 13.55]; Females: 49.2 % [<em>N</em> = 215]).</div></div><div><h3>Results</h3><div>Exploratory Factor Analysis on Sample 1 identified four factors (including a total of 27 items): coping/escapism, social motives, enhancement/pleasure, and financial motives. The four-factor structure was confirmed on Sample 2 with confirmatory factor analysis showing adequate model fit (CFI = 0.987; TLI = 0.986; RMSEA[CI] = 0.047 [0.041–0.052]); however, high inter-factor correlations were evident in the general population sample. A shorter, 14-item version of the scale was also suggested.</div></div><div><h3>Conclusions</h3><div>Although the newly identified motives overlap with the original ones, the content of the factors enables the inclusion of certain aspects, like escapism within the coping factor, that proved to be the most important in relation to other potentially addictive behaviours. This suggests that examining the role of motives in gambling may be crucial in differentiating between problem gambling and recreational gambling.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152633"},"PeriodicalIF":4.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Psychometric properties of the 4-week version of the Borderline Personality Disorder Severity Index-5 边缘型人格障碍严重程度指数-5的4周版本的心理测量特性

IF 4.2 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2025-09-08 DOI: 10.1016/j.comppsych.2025.152634

Shanna van Trigt , Mariana Mendoza-Alvarez , Tanja van der Zweerde , Livia De Picker , Annemieke van Straten , Arnoud Arntz , Hein J.F. van Marle

This study evaluated the psychometric properties of a new version of the Borderline Personality Disorder Severity Index-5 that assesses BPD symptom severity over the course of 4 weeks instead of the standard 3 months: the BPDSI-5-4wk. Reliability and validity were evaluated in a mixed sample of patients with BPD (n = 92), patients with avoidant personality disorder (APD) as clinical control group (n = 16), and a non-patient control group (n = 20). The study demonstrated very high interrater agreement and test-retest reliability and acceptable to excellent internal consistencies of the BPDSI-5-4wk. Confirmatory factor analysis supported its assumed nine-factor structure. The BPDSI-5-4wk also showed very good construct (i.e. known-group) validity, as well as criterion-related (i.e. concurrent) validity when correlating the BPDSI-5-4wk with the BPDSI-5 (3-month version), the structured clinical interview for DSM personality disorders (SCID-5-P), and several other BPD- and other mental health-related self-report questionnaires. We additionally derived cut-off scores with high sensitivity and specificity for distinguishing BPD from clinical controls (21.02, 85 % sensitivity, 94 % specificity), from non-patient controls (10.50, 98 % sensitivity, 100 % specificity), and from both control groups combined (17.26, 93 % sensitivity, 92 % specificity). A reliable change criterion of 5.88 was established. Preliminary trial data additionally showed the BPDSI-5-4wk's sensitivity to change. The strong reliability and validity of the BPDSI-5-4wk support its value for detailed, dimensional assessment of BPD symptom severity over shorter time frames. This will facilitate frequent treatment response evaluations, rapid indication of follow-up treatment, and better alignment with shorter intervention and follow-up periods in clinical trials.

本研究评估了新版边缘型人格障碍严重程度指数-5的心理测量特性，该指数在4周内评估BPD症状的严重程度，而不是标准的3个月：bpdsi -5-4周。在BPD患者（n = 92）、逃避型人格障碍（APD）患者作为临床对照组（n = 16）和非患者对照组（n = 20）的混合样本中进行信度和效度评估。研究表明，BPDSI-5-4wk具有非常高的判读一致性和重测信度，并且具有良好的内部一致性。验证性因子分析支持其假设的九因子结构。当BPDSI-5-4wk与BPDSI-5（3个月版）、DSM人格障碍结构化临床访谈（SCID-5-P）以及其他一些BPD和其他心理健康相关自我报告问卷相关联时，BPDSI-5-4wk也显示出非常好的构念效度（即已知组），以及标准相关效度（即并发效度）。此外，我们还获得了区分BPD与临床对照组（21.02,85%敏感性，94%特异性）、非患者对照组（10.50,98%敏感性，100%特异性）以及两个对照组联合（17.26,93%敏感性，92%特异性）的高灵敏度和特异性的截止评分。建立了5.88的可靠变化判据。初步试验数据还显示了BPDSI-5-4wk对变化的敏感性。BPDSI-5-4wk的高可靠性和有效性支持其在较短时间内对BPD症状严重程度进行详细、维度评估的价值。这将促进频繁的治疗反应评估，快速指示后续治疗，并与临床试验中较短的干预和随访期更好地结合。

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引用次数: 0

Comparative effects of pharmacological treatment for weight gain in patients treated with antipsychotics. A systematic review and network meta-analysis 抗精神病药物治疗患者体重增加的药理治疗效果比较。系统回顾和网络荟萃分析

IF 4.2 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2025-09-01 DOI: 10.1016/j.comppsych.2025.152632

Zuzanna Goetz-Kundera , Bogusława Przekopińska , Patryk Walichniewicz , Maciej Niewada , Michał Lew-Starowicz

Background

Weight gain induced by antipsychotic treatment is a significant cardiometabolic risk factor associated with increased mortality.

Methods

Following PRISMA criteria Medline, Cochrane Central Register of Clinical Trials and Science Direct were systematically searched. Only randomised placebo-controlled trials evaluating pharmacological interventions to reduce antipsychotic drug-induced weight gain in adults were included.

Data on mean change in weight from baseline were extracted, together with parameters defining variability or dispersion. A fixed effects model and random effects mode were used. Treatments were ranked using SUCRA.

Outcomes

27 studies including 17 medications were included. The studies were divided into two groups with a time horizon of less or more than 12 weeks. A comparison of the short-term interventions showed significant advantages of nizatidine (MD -6,82; CI -13,36 to −0,55) and metformin (MD -4,17; CI -8,02 to −0,64) over placebo. For longer-term interventions, significant benefits were shown for liraglutide (MD -5,3; Cl −6,93 to −3,75), exenatide (MD -4,17; Cl −7,4 to −1,14), metformin (MD -2,08; Cl −2,86 to −1,35) and samidorphan (MD -1,91; CL −3,31 to −0,51) as compared to placebo. Liraglutide was superior to other drugs according to the SUCRA analysis.

Interpretation

Our network meta-analysis presents a comparison of pharmacological interventions to address weight gain associated with antipsychotic treatment. Metformin and liraglutide appear to have the strongest evidence for treating weight gain in the target group.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sector.

背景：抗精神病药物治疗引起的体重增加是与死亡率增加相关的重要心脏代谢危险因素。方法按照PRISMA标准系统检索Medline、Cochrane Central Register of Clinical Trials和Science Direct。仅纳入了评估药物干预以减少成人抗精神病药物引起的体重增加的随机安慰剂对照试验。从基线提取的平均体重变化数据，以及定义可变性或分散性的参数。采用固定效应模型和随机效应模型。采用SUCRA对治疗进行排序。结果纳入了27项研究，包括17种药物。这些研究分为两组，时间范围分别小于或大于12 周。短期干预的比较显示，与安慰剂相比，尼扎替丁（MD -6,82; CI -13,36至- 0,55）和二甲双胍（MD -4,17; CI -8,02至- 0,64）具有显著优势。对于长期干预，与安慰剂相比，利拉鲁肽（MD -5,3; Cl - 6,93至- 3,75）、艾塞那肽（MD -4,17; Cl - 7,4至- 1,14）、二甲双胍（MD -2,08; Cl - 2,86至- 1,35）和samidorphan （MD -1,91; Cl - 3,31至- 0,51）显示出显著的益处。根据SUCRA分析，利拉鲁肽优于其他药物。解释：我们的网络荟萃分析比较了药物干预与抗精神病药物治疗相关的体重增加。二甲双胍和利拉鲁肽在治疗目标人群体重增加方面似乎有最有力的证据。本研究未获得任何公共、商业或非营利部门的资助机构的特别资助。

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引用次数: 0

Aberrant anterior insula underlies interoceptive deficits in alexithymia among schizophrenia patients 异常前脑岛是精神分裂症患者述情障碍的内感受性缺陷的基础

IF 4.2 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2025-08-23 DOI: 10.1016/j.comppsych.2025.152630

Haoran Shen , Yaping He , Renjie Zeng , Likun Ge , Jingang Dai , Juanhua Li , Zezhi Li , Gao-Xia Wei

Objective

This study aims to investigate the unique neural mechanisms underpinning abnormal interoception in schizophrenia patients with comorbid alexithymia. The focus is on identifying aberrant activation patterns and functional connectivities of the insula cortex with regions involved in emotional processing.

Methods

Fifty schizophrenia patients were assessed using the Toronto Alexithymia Scale (TAS) and the Multidimensional Assessment of Interoceptive Awareness (MAIA). Task-based fMRI scans were conducted to observe brain activation patterns during interoceptive conditions.

Results

Alexithymic patients showed higher alexithymia and lower interoception compared to non-alexithymic patients. During the interoceptive task, alexithymic patients exhibited reduced activation in the anterior insula (AI), while no difference was observed in the posterior insula (PI). Functional connectivity analysis revealed reduced connectivity between the AI and the anterior cingulate cortex (ACC) as well as the superior frontal gyrus (SFG) in alexithymic patients. Moreover, the connection between the AI and the ACC mediated the relationship between interoception and alexithymia.

Conclusion

These results suggested that alexithymic schizophrenia patients struggle to integrate interoceptive afferents with emotional salience, and highlighted AI's role in the interplay between interoceptive awareness and emotional articulation in alexithymic schizophrenia, suggesting a potential neurobiological pathway for targeted interventions.

Trial registration: The research is registered with the China Clinical Trials Registry (CCTR), under the registration number ChiCTR2400080313 on January 15, 2024.

目的探讨精神分裂症合并述情障碍患者间感受异常的独特神经机制。重点是识别异常激活模式和脑岛皮层与参与情绪处理的区域的功能连接。方法采用多伦多述情障碍量表（TAS）和内感受意识多维度评估量表（MAIA）对50例精神分裂症患者进行评估。以任务为基础的功能磁共振成像（fMRI）扫描用于观察内感受状态下的大脑激活模式。结果与非述情障碍患者相比，述情障碍患者述情障碍程度较高，内感受程度较低。在内感受性任务中，述情障碍患者表现出前岛（AI）的激活减少，而后岛（PI）没有观察到差异。功能连通性分析显示，述情障碍患者的AI与前扣带皮层（ACC）以及额上回（SFG）之间的连通性降低。此外，AI和ACC之间的联系介导了内感受和述情障碍之间的关系。结论这些结果表明，述情精神分裂症患者难以将内感受性事件与情绪显著性相结合，并强调AI在述情精神分裂症患者的内感受性意识和情绪表达之间的相互作用中所起的作用，为有针对性的干预提供了潜在的神经生物学途径。试验注册：本研究已于2024年1月15日在中国临床试验注册中心（CCTR）注册，注册号为ChiCTR2400080313。

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引用次数: 0

An exploratory analysis of obsessive-compulsive personality traits, pathologic anger and quality of life among trauma-exposed veterans 创伤暴露退伍军人强迫症人格特征、病理性愤怒与生活质量的探索性分析

IF 4.2 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2025-08-20 DOI: 10.1016/j.comppsych.2025.152628

Meghan J. Kulak , Meghan A. Gonsalves , Timothy Y. Mariano , Anthony Pinto , Benjamin D. Greenberg , Jennifer Barredo , Zachary Kunicki , M. Tracie Shea

Introduction

Trauma exposure and post-traumatic stress disorder (PTSD) are associated with high rates of co-occurring personality pathology, including Obsessive Compulsive Personality Disorder (OCPD). OCPD is characterized by rigidity and perfectionism, leading to internalized distress, interpersonal difficulties, and lower quality of life (QOL). Individuals with OCPD often report high levels of anger, which may exacerbate distress and interpersonal issues. However, the relationship between OCPD, anger, and QOL in trauma-exposed Veterans remains understudied.

Materials and methods

92 Veterans with warzone trauma, hyperarousal symptoms, and moderate to severe problems with anger were recruited from a VA Medical Center for a study on cognitive-behavioral therapy for anger. Assessments included standardized interviews on demographics and trauma history, as well as self-reports on OCPD and borderline personality disorder (BPD) traits, anger, and QOL.

Results

OCPD scores were significantly correlated with higher state anger (r = 0.276, p = 0.013), trait anger (r = 0.275, p = 0.016), and lower social QOL (r = −0.344, p = 0.002). BPD scores were similarly associated with higher state (r = 0.242, p = 0.031) and trait anger (r = 0.291, p = 0.011), but had lower QOL in all domains.

Conclusion

In this exploratory analysis, OCPD traits in trauma-exposed Veterans were linked to higher anger and lower social QOL, with effect sizes comparable to BPD traits. This highlights the importance of screening for OCPD traits to inform treatment strategies and improve outcomes, especially given that OCPD traits receive less clinical attention than BPD traits.

创伤暴露和创伤后应激障碍（PTSD）与同时发生的人格病理（包括强迫性人格障碍（OCPD））的高发率相关。OCPD以僵化和完美主义为特征，导致内化痛苦、人际关系困难和较低的生活质量。患有OCPD的人通常会表现出高度的愤怒，这可能会加剧痛苦和人际关系问题。然而，创伤暴露退伍军人的OCPD、愤怒和生活质量之间的关系仍未得到充分研究。材料和方法从退伍军人医疗中心招募了92名有战区创伤、亢奋症状和中重度愤怒问题的退伍军人，进行愤怒的认知行为疗法研究。评估包括对人口统计学和创伤史的标准化访谈，以及OCPD和边缘型人格障碍（BPD）特征、愤怒和生活质量的自我报告。结果socpd得分与较高的状态性愤怒（r = 0.276, p = 0.013）、特质性愤怒（r = 0.275, p = 0.016）、较低的社会生活质量（r = - 0.344, p = 0.002）显著相关。BPD得分与较高的状态（r = 0.242, p = 0.031）和特质性愤怒（r = 0.291, p = 0.011）有相似的相关性，但在所有领域的生活质量都较低。结论创伤暴露退伍军人的OCPD特征与较高的愤怒和较低的社会生活质量相关，其效应量与BPD特征相当。这突出了筛查OCPD特征对制定治疗策略和改善结果的重要性，特别是考虑到OCPD特征比BPD特征得到的临床关注更少。

{"title":"An exploratory analysis of obsessive-compulsive personality traits, pathologic anger and quality of life among trauma-exposed veterans","authors":"Meghan J. Kulak , Meghan A. Gonsalves , Timothy Y. Mariano , Anthony Pinto , Benjamin D. Greenberg , Jennifer Barredo , Zachary Kunicki , M. Tracie Shea","doi":"10.1016/j.comppsych.2025.152628","DOIUrl":"10.1016/j.comppsych.2025.152628","url":null,"abstract":"<div><h3>Introduction</h3><div>Trauma exposure and post-traumatic stress disorder (PTSD) are associated with high rates of co-occurring personality pathology, including Obsessive Compulsive Personality Disorder (OCPD). OCPD is characterized by rigidity and perfectionism, leading to internalized distress, interpersonal difficulties, and lower quality of life (QOL). Individuals with OCPD often report high levels of anger, which may exacerbate distress and interpersonal issues. However, the relationship between OCPD, anger, and QOL in trauma-exposed Veterans remains understudied.</div></div><div><h3>Materials and methods</h3><div>92 Veterans with warzone trauma, hyperarousal symptoms, and moderate to severe problems with anger were recruited from a VA Medical Center for a study on cognitive-behavioral therapy for anger. Assessments included standardized interviews on demographics and trauma history, as well as self-reports on OCPD and borderline personality disorder (BPD) traits, anger, and QOL.</div></div><div><h3>Results</h3><div>OCPD scores were significantly correlated with higher state anger (<em>r</em> = 0.276, <em>p</em> = 0.013), trait anger (<em>r</em> = 0.275, <em>p</em> = 0.016), and lower social QOL (<em>r</em> = −0.344, <em>p</em> = 0.002). BPD scores were similarly associated with higher state (<em>r</em> = 0.242, <em>p</em> = 0.031) and trait anger (<em>r</em> = 0.291, <em>p</em> = 0.011), but had lower QOL in all domains.</div></div><div><h3>Conclusion</h3><div>In this exploratory analysis, OCPD traits in trauma-exposed Veterans were linked to higher anger and lower social QOL, with effect sizes comparable to BPD traits. This highlights the importance of screening for OCPD traits to inform treatment strategies and improve outcomes, especially given that OCPD traits receive less clinical attention than BPD traits.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152628"},"PeriodicalIF":4.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Blood-based DNA methylation profiles in major depressive disorder, bipolar disorder, and schizophrenia spectrum disorders 重度抑郁症、双相情感障碍和精神分裂症谱系障碍的血液DNA甲基化谱

IF 4.2 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2025-08-20 DOI: 10.1016/j.comppsych.2025.152629

Friederike S. David , Josef Frank , Frederike Stein , Susanne Meinert , Lea Zillich , Lea Sirignano , Fabian Streit , Eva C. Beins , Lisa Sindermann , Paula Usemann , Janik Goltermann , Elisabeth J. Leehr , Sugirthan Sivalingam , Stefan Herms , Per Hoffmann , Tim Hahn , Stephanie H. Witt , Nina Alexander , Tilo Kircher , Udo Dannlowski , Andreas J. Forstner

Alterations in DNA methylation (DNAm) profiles have been implicated in affective and psychotic disorders. However, no comprehensive understanding of peripheral DNAm profiles associated with diagnostic groups, course of illness, and other clinical variables has emerged yet. In particular, studies exploring commonalities and differences across diagnoses are lacking. Here we conducted a systematic epigenetic characterization of the transdiagnostic German FOR2107 cohort, including individuals with major depressive disorder (MDD, n = 342), bipolar disorder (BD, n = 99), or a schizophrenia spectrum disorder (SSD, n = 101) and healthy controls (HC, n = 339). For 183 MDD cases and 178 HC, we assessed additional DNAm data from the two-year follow-up study visit. To explore DNAm differences between and across diagnostic groups, case-control and case-case methylome-wide association studies were performed. Our sample was further characterized using methylation risk scores (MRS) for MDD and SSD. Finally, epigenetic age acceleration was examined and compared to a measure of brain age acceleration. We identified few methylome-wide significant associations with diagnostic groups. MRS for MDD did not differ between diagnostic groups, and an increase in MRS for SSD in SSD compared to HC did not remain significant when adjusting for smoking behavior and BMI. An increase in epigenetic age acceleration was most evident for SSD compared to HC, which did not remain significant when adjusting for covariates. No correlation between epigenetic and brain age acceleration was observed. Our findings emphasize the relevance of potential confounding factors in epigenetics research in psychiatry and contribute to a growing body of studies on DNAm profiles across affective and psychotic disorders.

DNA甲基化（DNAm）谱的改变与情感和精神障碍有关。然而，目前还没有全面了解与诊断组、病程和其他临床变量相关的外周dna谱。特别是，缺乏探索诊断之间的共性和差异的研究。在这里，我们对德国FOR2107的跨诊断队列进行了系统的表观遗传学表征，包括重度抑郁症（MDD, n = 342）、双相情感障碍（BD, n = 99）或精神分裂症谱系障碍（SSD, n = 101）和健康对照（HC, n = 339）。对于183例重度抑郁症和178例HC，我们评估了来自两年随访研究访问的额外DNAm数据。为了探索诊断组之间和诊断组之间的DNAm差异，进行了病例对照和病例甲基组全关联研究。我们的样本进一步使用甲基化风险评分（MRS）对MDD和SSD进行表征。最后，研究了表观遗传年龄加速，并将其与大脑年龄加速的测量结果进行了比较。我们发现很少有甲基组与诊断组有显著关联。MDD的MRS在诊断组之间没有差异，在调整吸烟行为和BMI后，SSD患者与HC患者相比，SSD患者的MRS增加也没有保持显著性。与HC相比，SSD的表观遗传年龄加速的增加最为明显，在调整协变量后，这一点并不显著。未观察到表观遗传与脑老化加速之间的相关性。我们的研究结果强调了精神病学表观遗传学研究中潜在混杂因素的相关性，并有助于在情感和精神障碍中进行越来越多的dna谱研究。

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引用次数: 0

Investigating attentional bias in low-dependence smokers with steady-state visual evoked potentials (SSVEPs): Linking wanting, liking, and neural responses 具有稳态视觉诱发电位（ssvep）的低依赖性吸烟者的注意偏倚研究：连接想要、喜欢和神经反应

IF 4.2 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2025-08-12 DOI: 10.1016/j.comppsych.2025.152627

Domonkos File , Bela Petro , Lili Kővári , Petia Kojouharova , Zsófia Anna Gaál , Zsolt Demetrovics , István Czigler

While traditional electrophysiological measures such as ERPs have been successfully used to study individual differences, their signal-to-noise ratio often limits the precision of single-subject analyses. To address this, the present study had two primary aims: (1) to explore the utility of steady-state visual evoked potential (SSVEP) method for investigating addiction-specific cognitive processes and (2) to examine the relationship between the imbalance of self-reported wanting and liking, and the neural correlates of tobacco smoking-related attentional bias. A total of 39 participants, including smokers (N = 22) and non-smokers (N = 17), were exposed to a passive visual oddball paradigm comprising rapidly flickering stimuli under two conditions: neutral (e.g., office tools) and smoking-related (e.g., cigarettes). Neural activity was recorded using EEG, and frequency-specific SSVEP responses were analyzed to assess attentional bias toward smoking-related stimuli. The results demonstrated that SSVEPs effectively captured the well-documented attentional bias effect between smokers and non-smokers. Furthermore, beyond group-level comparisons, SSVEPs proved suitable for examining attentional bias at the individual level, allowing for the investigation of correlations between neural responses to smoking cues and the difference between self-reported wanting and liking (WmL) imagined before, during and after smoking. A moderate to strong positive correlation was observed specifically for WmL-after and attentional-bias, supporting two conclusions: (1) SSVEPs represent a promising tool for assessing addiction-specific cognitive processes, and (2) self-reported assessments of incentive sensitization theory (IST) may be associated with attentional bias characteristic of addictive behaviors. These findings highlight the potential value of self-report measures in human IST research and underscore the need for further investigation.

虽然传统的电生理测量如erp已经成功地用于研究个体差异，但它们的信噪比往往限制了单受试者分析的精度。为了解决这个问题，本研究主要有两个目的：(1)探索稳态视觉诱发电位（SSVEP）方法在研究成瘾特异性认知过程中的应用；(2)研究自我报告的欲望和喜欢的不平衡与吸烟相关的注意偏倚的神经关联之间的关系。共有39名参与者，包括吸烟者（N = 22）和非吸烟者（N = 17），在两种条件下暴露于被动视觉怪异范式，包括快速闪烁的刺激：中性（例如办公工具）和吸烟相关（例如香烟）。使用脑电图记录神经活动，并分析频率特异性SSVEP反应以评估对吸烟相关刺激的注意偏倚。结果表明，ssvep有效地捕获了吸烟者和非吸烟者之间的注意偏倚效应。此外，除了群体水平的比较，ssvep被证明适用于在个体水平上检查注意偏差，允许研究吸烟线索的神经反应与吸烟前、吸烟中和吸烟后想象的自我报告的想要和喜欢（WmL）之间的差异之间的相关性。WmL-after和注意偏倚之间存在中强正相关，支持两个结论：(1)ssvep是评估成瘾特异性认知过程的一个有希望的工具；(2)自我报告的激励敏感化理论（IST）评估可能与成瘾行为的注意偏倚特征有关。这些发现突出了自我报告测量在人类IST研究中的潜在价值，并强调了进一步研究的必要性。

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引用次数: 0