Pub Date : 2025-06-23DOI: 10.1016/j.comppsych.2025.152617
Jiajia Jin , Xinyi Zhu , Wen Lian , Lu Fan
Objective
Body language plays a vital role in emotion perception, yet the involuntary neural mechanisms through which individuals with social anxiety process these signals remain unclear. This research investigates these mechanisms by analyzing visual components such as P3a, P1, and N190 within a three-stimulus oddball paradigm.
Method
Participants were classified into high social anxiety (HSA, n = 31) and low social anxiety (LSA, n = 26) groups using the Liebowitz Social Anxiety Scale (LSAS). The paradigm employed custom-designed distractors depicting positive, negative, and neutral body expressions to examine the involuntary processing of these stimuli.
Results
The findings indicate that individuals with high social anxiety (HSA) showed significantly higher P3a amplitudes than those with low social anxiety (LSA), especially for positive body expressions. In contrast, negative expressions elicited the weakest amplitudes. The N190 component responded most strongly to positive expressions and least to negative ones, while the P1 component showed uniform responses across all types.
Conclusions
HSA individuals process body expressions more intensely and are highly sensitive to them, regardless of valence. This insight can inform interventions targeting their cognitive and emotional biases.
肢体语言在情绪感知中起着至关重要的作用，但社交焦虑个体处理这些信号的非自愿神经机制尚不清楚。本研究通过在三刺激古怪范式中分析P3a、P1和N190等视觉成分来探讨这些机制。方法采用Liebowitz社交焦虑量表（LSAS）将被试分为高社交焦虑组（HSA, n = 31）和低社交焦虑组（LSA, n = 26）。该范式采用定制设计的描绘积极、消极和中性身体表情的干扰物来检查这些刺激的非自愿加工。结果高社交焦虑（HSA）个体的P3a波幅显著高于低社交焦虑（LSA）个体，尤其是对积极的身体表达。相反，消极表达引起的振幅最弱。N190组分对积极表达的响应最强烈，对消极表达的响应最小，而P1组分在所有类型中表现出一致的响应。结论shsa个体对身体表达的加工更强烈，且对其高度敏感，无论其价态如何。这种见解可以为针对他们的认知和情感偏见的干预提供信息。
{"title":"Unraveling the neurophysiological underpinnings of social anxiety through body language: An ERP study","authors":"Jiajia Jin , Xinyi Zhu , Wen Lian , Lu Fan","doi":"10.1016/j.comppsych.2025.152617","DOIUrl":"10.1016/j.comppsych.2025.152617","url":null,"abstract":"<div><h3>Objective</h3><div>Body language plays a vital role in emotion perception, yet the involuntary neural mechanisms through which individuals with social anxiety process these signals remain unclear. This research investigates these mechanisms by analyzing visual components such as P3a, P1, and N190 within a three-stimulus oddball paradigm.</div></div><div><h3>Method</h3><div>Participants were classified into high social anxiety (HSA, <em>n</em> = 31) and low social anxiety (LSA, <em>n</em> = 26) groups using the Liebowitz Social Anxiety Scale (LSAS). The paradigm employed custom-designed distractors depicting positive, negative, and neutral body expressions to examine the involuntary processing of these stimuli.</div></div><div><h3>Results</h3><div>The findings indicate that individuals with high social anxiety (HSA) showed significantly higher P3a amplitudes than those with low social anxiety (LSA), especially for positive body expressions. In contrast, negative expressions elicited the weakest amplitudes. The N190 component responded most strongly to positive expressions and least to negative ones, while the P1 component showed uniform responses across all types.</div></div><div><h3>Conclusions</h3><div>HSA individuals process body expressions more intensely and are highly sensitive to them, regardless of valence. This insight can inform interventions targeting their cognitive and emotional biases.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152617"},"PeriodicalIF":4.3,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144492175","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}
Pub Date : 2025-06-15DOI: 10.1016/j.comppsych.2025.152614
Philippa Ditton-Phare , Tina Fox , Kristen Vallender , Jose Cuenca , Sally Fitzpatrick
Introduction
Paramedics experience disproportionately high rates of mental health concerns, often relying on informal support from family and friends. While this support is vital, it can impose significant strain on family and friends, who frequently lack the necessary resources and skills for their role. To address this, a novel online program, Minds Together, was developed specifically for family and friends to enhance their ability to support the mental health of paramedics while prioritizing their own mental health and wellbeing.
Methods
The feasibility and acceptability of the program was evaluated through a pilot study involving 53 participants randomized to either program or waitlist groups. Data collection included pre- and post-intervention surveys, program usage metrics, post-project surveys, and feedback from user testing. The Global Impact Analytics Framework (GIAF) guided analysis of planning, pre-engagement, pre-readiness, usability, dissemination, adoption, and contextual factors.
Results
Participants valued the program for its lived-experience content and self-paced format. Broad dissemination reached over one million individuals, and usability and relevance were rated highly. However, low engagement and completion rates reflected challenges common to online interventions. Barriers included limited access duration, participants' time constraints, and difficulties in reaching the target audience. Suggestions included flexible access, advanced content options, and targeted outreach strategies.
Conclusion
Minds Together shows promise as a scalable intervention for family and friends of paramedics. Future research will address barriers, explore long-term outcomes, and refine the program to better meet family and friends' diverse needs, improving mental health support for paramedics and their support network.
{"title":"Pilot implementation of an online program for family and friends supporting the mental health of paramedics in Australia: Lessons learned.","authors":"Philippa Ditton-Phare , Tina Fox , Kristen Vallender , Jose Cuenca , Sally Fitzpatrick","doi":"10.1016/j.comppsych.2025.152614","DOIUrl":"10.1016/j.comppsych.2025.152614","url":null,"abstract":"<div><h3>Introduction</h3><div>Paramedics experience disproportionately high rates of mental health concerns, often relying on informal support from family and friends. While this support is vital, it can impose significant strain on family and friends, who frequently lack the necessary resources and skills for their role. To address this, a novel online program, <em>Minds Together,</em> was developed specifically for family and friends to enhance their ability to support the mental health of paramedics while prioritizing their own mental health and wellbeing.</div></div><div><h3>Methods</h3><div>The feasibility and acceptability of the program was evaluated through a pilot study involving 53 participants randomized to either program or waitlist groups. Data collection included pre- and post-intervention surveys, program usage metrics, post-project surveys, and feedback from user testing. The Global Impact Analytics Framework (GIAF) guided analysis of planning, pre-engagement, pre-readiness, usability, dissemination, adoption, and contextual factors.</div></div><div><h3>Results</h3><div>Participants valued the program for its lived-experience content and self-paced format. Broad dissemination reached over one million individuals, and usability and relevance were rated highly. However, low engagement and completion rates reflected challenges common to online interventions. Barriers included limited access duration, participants' time constraints, and difficulties in reaching the target audience. Suggestions included flexible access, advanced content options, and targeted outreach strategies.</div></div><div><h3>Conclusion</h3><div><em>Minds Together</em> shows promise as a scalable intervention for family and friends of paramedics. Future research will address barriers, explore long-term outcomes, and refine the program to better meet family and friends' diverse needs, improving mental health support for paramedics and their support network.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152614"},"PeriodicalIF":4.3,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307302","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}
Pub Date : 2025-06-13DOI: 10.1016/j.comppsych.2025.152615
Jessica L. Campbell , Josh Darby , Paul Oswald , Lisa Mackay , Grant Schofield
Background
Firefighters are regularly exposed to potentially psychologically traumatic events (PPTEs), significantly increasing their risk of mental ill-health. Organizational factors such as leadership, support, and workload also influence these outcomes.
Purpose
This study evaluates the Whanaungatanga Program, a participatory initiative designed to address organizational factors affecting firefighter well-being, focusing on early changes in sentiment.
Methods
We conducted a qualitative analysis of open-text responses from two surveys (embedded within broader mental health questionnaires) with firefighters and commanders, and semi-structured interviews with commanders. Thematic and sentiment analyses explored perceptions of organizational interventions and the emotional tone in responses across two time points.
Main Findings
In the pilot region receiving interventions, organizational sentiment shifted substantially: positive sentiment increased from 13 % to 48 %, negative sentiment decreased over 20 % (from 66 % to 40 %), and themes such as improved leadership visibility emerged, reflecting rapid cultural progress.
Conclusions
The results highlight the effectiveness of targeted, participatory interventions in fostering positive organizational change. Marked improvements in sentiment indicate that even in high-stress environments, well-designed interventions can lead to substantial benefits in employee sentiment and organizational culture.
{"title":"Shifting organizational sentiment: Qualitative insights from a mental ill-health prevention program for New Zealand firefighters","authors":"Jessica L. Campbell , Josh Darby , Paul Oswald , Lisa Mackay , Grant Schofield","doi":"10.1016/j.comppsych.2025.152615","DOIUrl":"10.1016/j.comppsych.2025.152615","url":null,"abstract":"<div><h3>Background</h3><div>Firefighters are regularly exposed to potentially psychologically traumatic events (PPTEs), significantly increasing their risk of mental ill-health. Organizational factors such as leadership, support, and workload also influence these outcomes.</div></div><div><h3>Purpose</h3><div>This study evaluates the Whanaungatanga Program, a participatory initiative designed to address organizational factors affecting firefighter well-being, focusing on early changes in sentiment.</div></div><div><h3>Methods</h3><div>We conducted a qualitative analysis of open-text responses from two surveys (embedded within broader mental health questionnaires) with firefighters and commanders, and semi-structured interviews with commanders. Thematic and sentiment analyses explored perceptions of organizational interventions and the emotional tone in responses across two time points.</div></div><div><h3>Main Findings</h3><div>In the pilot region receiving interventions, organizational sentiment shifted substantially: positive sentiment increased from 13 % to 48 %, negative sentiment decreased over 20 % (from 66 % to 40 %), and themes such as improved leadership visibility emerged, reflecting rapid cultural progress.</div></div><div><h3>Conclusions</h3><div>The results highlight the effectiveness of targeted, participatory interventions in fostering positive organizational change. Marked improvements in sentiment indicate that even in high-stress environments, well-designed interventions can lead to substantial benefits in employee sentiment and organizational culture.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152615"},"PeriodicalIF":4.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298138","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}
Pub Date : 2025-06-13DOI: 10.1016/j.comppsych.2025.152611
Mathew Varidel , Ian B. Hickie , Victor An , Sally Cripps , Roman Marchant , Jo Robinson , Louise La Sala , William Capon , Ashlee Turner , Alexander Tashevski , Elizabeth Scott , Frank Iorfino
Background
Suicidal thoughts and behaviours (STBs) have a profound impact on individuals, communities, and healthcare systems. A wide range of factors have been shown to be associated with STBs. Within prior research it is also common to distinguish between proximal and distal factors, usually by distinction of short compared to long-term prediction.
Objective
We aimed to learn the proximal and distal factors of suicidal ideation for young people engaged in mental health care using the inferred structure of probabilistic graphical models (PGMs).
Methods and materials
We used cross-sectional data from a sample of 1020 help-seeking individuals aged 12–25 years from Australia that while engaged in mental health care, contributed data to a digital platform. The posterior distribution of the dependency structure assuming both undirected PGMs and Bayesian networks (BNs) was inferred. Causal effects were then estimated using a counterfactual query of the Bayesian networks.
Results
Depressed mood, functional impairment, poor social connection, and psychosis-like experiences were proximal factors. Whereas experiencing a traumatic event, anxiety, insomnia, and unrefreshed sleep were distal factors. Proximal factors had the greatest effect on suicidal ideation, while anxiety symptoms and experiencing a traumatic event were the most influential distal factors.
Conclusions
These relative timings of events and their effects on suicidal ideation could be used to understand the future likelihood of suicidal ideation, and aid planning of targeted interventions.
{"title":"Pathways to suicidal ideation for young people engaged in mental health care","authors":"Mathew Varidel , Ian B. Hickie , Victor An , Sally Cripps , Roman Marchant , Jo Robinson , Louise La Sala , William Capon , Ashlee Turner , Alexander Tashevski , Elizabeth Scott , Frank Iorfino","doi":"10.1016/j.comppsych.2025.152611","DOIUrl":"10.1016/j.comppsych.2025.152611","url":null,"abstract":"<div><h3>Background</h3><div>Suicidal thoughts and behaviours (STBs) have a profound impact on individuals, communities, and healthcare systems. A wide range of factors have been shown to be associated with STBs. Within prior research it is also common to distinguish between proximal and distal factors, usually by distinction of short compared to long-term prediction.</div></div><div><h3>Objective</h3><div>We aimed to learn the proximal and distal factors of suicidal ideation for young people engaged in mental health care using the inferred structure of probabilistic graphical models (PGMs).</div></div><div><h3>Methods and materials</h3><div>We used cross-sectional data from a sample of 1020 help-seeking individuals aged 12–25 years from Australia that while engaged in mental health care, contributed data to a digital platform. The posterior distribution of the dependency structure assuming both undirected PGMs and Bayesian networks (BNs) was inferred. Causal effects were then estimated using a counterfactual query of the Bayesian networks.</div></div><div><h3>Results</h3><div>Depressed mood, functional impairment, poor social connection, and psychosis-like experiences were proximal factors. Whereas experiencing a traumatic event, anxiety, insomnia, and unrefreshed sleep were distal factors. Proximal factors had the greatest effect on suicidal ideation, while anxiety symptoms and experiencing a traumatic event were the most influential distal factors.</div></div><div><h3>Conclusions</h3><div>These relative timings of events and their effects on suicidal ideation could be used to understand the future likelihood of suicidal ideation, and aid planning of targeted interventions.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152611"},"PeriodicalIF":4.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144492174","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}
Adolescents with attachment anxiety can compensate via gaming for their unmet needs of closeness, reassurance, and emotion regulation. However, individual factors linking attachment anxiety to compensation via gaming are still unclear. In this two-wave longitudinal study (Wave 1, W1 = baseline; Wave 2, W2 = 6 months later), we aimed to determine whether intolerance of uncertainty (IU) mediates the link between attachment anxiety and gaming behaviours (gaming compensation, gaming frequency, and problematic gaming). Online questionnaires were administered to Italian adolescent gamers (N = 570; Mage = 15.60; SDage = 1.56; 68.8 % males). First, via path analyses, we tested whether attachment anxiety towards mother and father (W1) and IU (W1) would predict gaming behaviours (W2). Second, we tested whether IU would mediate the link between attachment anxiety and gaming compensation specifically. Multigroup analysis was used to explore gender differences. We found that attachment anxiety towards the mother and father was positively associated with IU, whereas attachment anxiety towards only the mother predicted gaming compensation at W2 both directly and via IU. Moreover, IU positively predicted gaming compensation and problematic gaming at W2. Multigroup analysis further revealed that for females, attachment anxiety towards the mother positively predicted gaming compensation at W2. Findings revealed small/modest effect sizes. Overall, attachment anxiety and IU may boost individuals to compensate via gaming, increasing the risk of problematic gaming. These results hold implications for future prevention interventions, emphasizing the quality of the parent-child relationship and IU as potential targets to foster adaptive coping strategies in adolescence.
{"title":"The role of attachment anxiety and intolerance of uncertainty in gaming during adolescence: A two-wave longitudinal study","authors":"Camilla Gregorini , Claudia Marino , Alessandro Giardina , Joël Billieux , Gioia Bottesi , Chiara Sacchi , Erika Pivetta , Alessio Vieno , Natale Canale","doi":"10.1016/j.comppsych.2025.152613","DOIUrl":"10.1016/j.comppsych.2025.152613","url":null,"abstract":"<div><div>Adolescents with attachment anxiety can compensate via gaming for their unmet needs of closeness, reassurance, and emotion regulation. However, individual factors linking attachment anxiety to compensation via gaming are still unclear. In this two-wave longitudinal study (Wave 1, W1 = baseline; Wave 2, W2 = 6 months later), we aimed to determine whether intolerance of uncertainty (IU) mediates the link between attachment anxiety and gaming behaviours (gaming compensation, gaming frequency, and problematic gaming). Online questionnaires were administered to Italian adolescent gamers (<em>N</em> = 570; M<sub>age</sub> = 15.60; SD<sub>age</sub> = 1.56; 68.8 % males). First, via path analyses, we tested whether attachment anxiety towards mother and father (W1) and IU (W1) would predict gaming behaviours (W2). Second, we tested whether IU would mediate the link between attachment anxiety and gaming compensation specifically. Multigroup analysis was used to explore gender differences. We found that attachment anxiety towards the mother and father was positively associated with IU, whereas attachment anxiety towards only the mother predicted gaming compensation at W2 both directly and via IU. Moreover, IU positively predicted gaming compensation and problematic gaming at W2. Multigroup analysis further revealed that for females, attachment anxiety towards the mother positively predicted gaming compensation at W2. Findings revealed small/modest effect sizes. Overall, attachment anxiety and IU may boost individuals to compensate via gaming, increasing the risk of problematic gaming. These results hold implications for future prevention interventions, emphasizing the quality of the parent-child relationship and IU as potential targets to foster adaptive coping strategies in adolescence.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152613"},"PeriodicalIF":4.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279344","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}
Pub Date : 2025-06-06DOI: 10.1016/j.comppsych.2025.152612
Alexandra Pham-Scottez , Isabelle Sabbah-Lim , Jean Chambry , Valérie Dao , Raphael Gourevitch , David Barruel Ing , Valérie Dauriac-Le Masson
Although psychiatrists working with adolescents know that sometimes they need to be hospitalised in emergency, few studies have described the hospitalisation of adolescents in adult psychiatric wards. We aimed to estimate the prevalence of adolescents hospitalised in adult psychiatric wards (characteristics, gender comparison, subtypes).
We conducted a monocentric retrospective study in the largest psychiatric hospital in France. All patients aged 15 to <18 years hospitalised in adult psychiatric wards were included, with different variables: socio-demographic and family information, history of inpatient / outpatient treatment, clinical data (like ICD-10 diagnoses, care pathway before / after hospitalisation…).
We included 332 hospitalisations (70 % girls), representing 2.8 % of all psychiatric hospitalisations. For 37 hospitalisations (11.1 %), this was the first psychiatric contact; for 54.2 %, patients had no previous psychiatric hospitalisation, for 87.3 %, patients had previous outpatient treatment. Mood disorders was the diagnosis for 47 % of the admissions, suicide attempts and suicidal ideation accounted for 69 % of the clinical situations leading to hospitalisation. Boys and girls differed significantly on many variables. Cluster analyses revealed two subgroups: cluster 1 patients (62 %) more frequently were girls, had previous hospitalisations in child psychiatry, came from home, had suicide attempts / suicidal ideation, had personality disorders, whereas cluster 2 patients (38 %) more frequently had substance use disorders, psychotic episodes, clastic crisis / hetero-aggression, longer hospital stays. Emergency admission of an adolescent with psychiatric issues to an adult psychiatric ward is not uncommon, especially in the context of a suicidal crisis or psychotic episode. Our results suggest the need for establishing unscheduled hospital beds for such adolescents.
{"title":"Characteristics of adolescents hospitalised in adult psychiatric units. Retrospective study in the largest psychiatric hospital in France","authors":"Alexandra Pham-Scottez , Isabelle Sabbah-Lim , Jean Chambry , Valérie Dao , Raphael Gourevitch , David Barruel Ing , Valérie Dauriac-Le Masson","doi":"10.1016/j.comppsych.2025.152612","DOIUrl":"10.1016/j.comppsych.2025.152612","url":null,"abstract":"<div><div>Although psychiatrists working with adolescents know that sometimes they need to be hospitalised in emergency, few studies have described the hospitalisation of adolescents in adult psychiatric wards. We aimed to estimate the prevalence of adolescents hospitalised in adult psychiatric wards (characteristics, gender comparison, subtypes).</div><div>We conducted a monocentric retrospective study in the largest psychiatric hospital in France. All patients aged 15 to <18 years hospitalised in adult psychiatric wards were included, with different variables: socio-demographic and family information, history of inpatient / outpatient treatment, clinical data (like ICD-10 diagnoses, care pathway before / after hospitalisation…).</div><div>We included 332 hospitalisations (70 % girls), representing 2.8 % of all psychiatric hospitalisations. For 37 hospitalisations (11.1 %), this was the first psychiatric contact; for 54.2 %, patients had no previous psychiatric hospitalisation, for 87.3 %, patients had previous outpatient treatment. Mood disorders was the diagnosis for 47 % of the admissions, suicide attempts and suicidal ideation accounted for 69 % of the clinical situations leading to hospitalisation. Boys and girls differed significantly on many variables. Cluster analyses revealed two subgroups: cluster 1 patients (62 %) more frequently were girls, had previous hospitalisations in child psychiatry, came from home, had suicide attempts / suicidal ideation, had personality disorders, whereas cluster 2 patients (38 %) more frequently had substance use disorders, psychotic episodes, clastic crisis / hetero-aggression, longer hospital stays. Emergency admission of an adolescent with psychiatric issues to an adult psychiatric ward is not uncommon, especially in the context of a suicidal crisis or psychotic episode. Our results suggest the need for establishing unscheduled hospital beds for such adolescents.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152612"},"PeriodicalIF":4.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298091","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}
Pub Date : 2025-06-06DOI: 10.1016/j.comppsych.2025.152610
Harin Chung, Gyumyoung Kim, Da-In Kim, Ji-Won Hur
Background
While low distress tolerance has been widely studied as a risk factor for nonsuicidal self-injury (NSSI), recent attention has shifted toward distress overtolerance—an individual's excessive endurance to distress despite severe adverse effects. Understanding this double-edged nature of distress tolerance is critical for developing effective intervention strategies to address the growing burden of NSSI. This study investigated the role of distress overtolerance in NSSI pathology.
Methods
The study comprised 1818 female participants, including 918 and 900 participants with and without a history of NSSI, respectively. Binary logistic regression models were utilized to analyze distress overtolerance as a predictor of NSSI engagement, versatility, and frequency while controlling for demographic variables, depression, anxiety, and emotion dysregulation. Among the participants with a history of NSSI, Pearson's correlation analyses were conducted to identify the functions of NSSI that were the most associated with distress overtolerance.
Results
Distress overtolerance was identified as a significant predictor of NSSI engagement, versatility, and frequency even after controlling for other risk factors. Distress overtolerance was most strongly linked to self-punishment function in individuals with a history of NSSI.
Conclusions
Distress overtolerance is a distinct and significant risk factor for NSSI, highlighting the need for its inclusion in mechanisms and intervention models for NSSI. Addressing distress overtolerance in therapeutic settings to achieve an optimal balance in distress regulation could provide innovative and more effective strategies for the treatment of NSSI.
{"title":"The double-edged sword of distress tolerance: Exploring the role of distress overtolerance in nonsuicidal self-injury","authors":"Harin Chung, Gyumyoung Kim, Da-In Kim, Ji-Won Hur","doi":"10.1016/j.comppsych.2025.152610","DOIUrl":"10.1016/j.comppsych.2025.152610","url":null,"abstract":"<div><h3>Background</h3><div>While low distress tolerance has been widely studied as a risk factor for nonsuicidal self-injury (NSSI), recent attention has shifted toward distress overtolerance—an individual's excessive endurance to distress despite severe adverse effects. Understanding this double-edged nature of distress tolerance is critical for developing effective intervention strategies to address the growing burden of NSSI. This study investigated the role of distress overtolerance in NSSI pathology.</div></div><div><h3>Methods</h3><div>The study comprised 1818 female participants, including 918 and 900 participants with and without a history of NSSI, respectively. Binary logistic regression models were utilized to analyze distress overtolerance as a predictor of NSSI engagement, versatility, and frequency while controlling for demographic variables, depression, anxiety, and emotion dysregulation. Among the participants with a history of NSSI, Pearson's correlation analyses were conducted to identify the functions of NSSI that were the most associated with distress overtolerance.</div></div><div><h3>Results</h3><div>Distress overtolerance was identified as a significant predictor of NSSI engagement, versatility, and frequency even after controlling for other risk factors. Distress overtolerance was most strongly linked to self-punishment function in individuals with a history of NSSI.</div></div><div><h3>Conclusions</h3><div>Distress overtolerance is a distinct and significant risk factor for NSSI, highlighting the need for its inclusion in mechanisms and intervention models for NSSI. Addressing distress overtolerance in therapeutic settings to achieve an optimal balance in distress regulation could provide innovative and more effective strategies for the treatment of NSSI.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"141 ","pages":"Article 152610"},"PeriodicalIF":4.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144239686","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}
Pub Date : 2025-05-23DOI: 10.1016/j.comppsych.2025.152609
Guifeng Li , Mengya Li , Xin Xu , Junhong Zhang , Qifang Li , Qing Cai
Objective
While outpatient cognitive behavioral therapy for insomnia (CBT-I) represents the most efficacious delivery method, approximately 50 % of patients are unable to achieve clinical remission. There is a pressing need to develop more effective approaches to CBT-I delivery. This study assessed the comparative efficacy of one-week inpatient CBT-I and eight-week standard outpatient CBT-I.
Methods
A randomized controlled trial was conducted with 200 adults with chronic insomnia disorder. These participants were randomly allocated to either the inpatient group (n = 100) or the outpatient group (n = 100). The inpatient group underwent a one-week intensive inpatient CBT-I followed by weekly follow-ups program. The outpatient group participated in a standard outpatient CBT-I program conducted on an individual basis over an eight-week period. The primary outcome was the insomnia severity index score at 9 weeks after the start of intervention. Linear mixed effects model was employed for the intention-to-treat analysis.
Results
At the 9-week assessment, the inpatient CBT-I group demonstrated a mean change in insomnia severity index score of −13.31 (95 % confidence interval [CI], −14.47 to −12.16; Cohen's d = −3.18; P < .001). The outpatient group showed a mean change of −11.14 (95 % CI, −12.30 to −9.98; Cohen's d = −2.66; P < .001). The mean difference between groups was −2.03 (95 % CI, −3.21 to −0.85; Cohen's d = −0.48; P < .001), indicating a statistically significant improvement in the inpatient group compared to the outpatient group.
Conclusions
This study demonstrated that inpatient CBT-I exhibited superior efficacy compared to outpatient CBT-I in alleviating insomnia severity.
{"title":"Inpatient vs outpatient cognitive behavioral therapy for insomnia: A two-arm parallel randomized controlled trial","authors":"Guifeng Li , Mengya Li , Xin Xu , Junhong Zhang , Qifang Li , Qing Cai","doi":"10.1016/j.comppsych.2025.152609","DOIUrl":"10.1016/j.comppsych.2025.152609","url":null,"abstract":"<div><h3>Objective</h3><div>While outpatient cognitive behavioral therapy for insomnia (CBT-I) represents the most efficacious delivery method, approximately 50 % of patients are unable to achieve clinical remission. There is a pressing need to develop more effective approaches to CBT-I delivery. This study assessed the comparative efficacy of one-week inpatient CBT-I and eight-week standard outpatient CBT-I.</div></div><div><h3>Methods</h3><div>A randomized controlled trial was conducted with 200 adults with chronic insomnia disorder. These participants were randomly allocated to either the inpatient group (<em>n</em> = 100) or the outpatient group (n = 100). The inpatient group underwent a one-week intensive inpatient CBT-I followed by weekly follow-ups program. The outpatient group participated in a standard outpatient CBT-I program conducted on an individual basis over an eight-week period. The primary outcome was the insomnia severity index score at 9 weeks after the start of intervention. Linear mixed effects model was employed for the intention-to-treat analysis.</div></div><div><h3>Results</h3><div>At the 9-week assessment, the inpatient CBT-I group demonstrated a mean change in insomnia severity index score of −13.31 (95 % confidence interval [CI], −14.47 to −12.16; Cohen's <em>d =</em> −3.18; <em>P</em> < .001). The outpatient group showed a mean change of −11.14 (95 % CI, −12.30 to −9.98; Cohen's <em>d</em> = −2.66; <em>P</em> < .001). The mean difference between groups was −2.03 (95 % CI, −3.21 to −0.85; Cohen's <em>d</em> = −0.48; <em>P</em> < .001), indicating a statistically significant improvement in the inpatient group compared to the outpatient group.</div></div><div><h3>Conclusions</h3><div>This study demonstrated that inpatient CBT-I exhibited superior efficacy compared to outpatient CBT-I in alleviating insomnia severity.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"141 ","pages":"Article 152609"},"PeriodicalIF":4.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154929","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}
Psychiatric comorbidity is a prevalent phenomenon that imposes a significant burden on patients, healthcare systems, and society. However, current research on psychiatric comorbidity is often limited to single disorders or partial associations. This study aims to utilize network analysis methods to construct a psychiatric comorbidity network and explore the network structural characteristics under different network weight definitions.
Method
Based on the psychiatric outpatient data from Changhua Christian Hospital in Taiwan from January 1, 2016, to June 30, 2024, the ICD-10 diagnostic codes (F00-F99) of all patients that appeared at least three times were extracted. Three different comorbidity networks were constructed using co-occurrence counts, Jaccard index, and partial correlation coefficient estimated by the mixed graphical model (MGM) as the weights of the network edges. Network structure was analyzed using indicators such as degree centrality, modularity, and community detection.
Results
The dataset included 16,954 patients. The comorbidity frequency network showed that mood disorders (F34) and anxiety disorders (F41) had the highest weighted degree centrality. In the Jaccard coefficient network, the weighted degree centrality of developmental disorders (F8x) increased. The MGM network highlighted the central role of substance use disorders (F1x).
Conclusion
Our findings suggested the roles and interrelationships of different disease categories in the comorbidity network. The results provide new perspectives and data support for clinical practice and future research.
{"title":"Mapping psychiatric comorbidity network: A pilot multi-method weighted network analysis with a focus on key disorders","authors":"Yu Chang , Si-Sheng Huang , Wen-Yu Hsu , Yi-Chun Liu","doi":"10.1016/j.comppsych.2025.152608","DOIUrl":"10.1016/j.comppsych.2025.152608","url":null,"abstract":"<div><h3>Background</h3><div>Psychiatric comorbidity is a prevalent phenomenon that imposes a significant burden on patients, healthcare systems, and society. However, current research on psychiatric comorbidity is often limited to single disorders or partial associations. This study aims to utilize network analysis methods to construct a psychiatric comorbidity network and explore the network structural characteristics under different network weight definitions.</div></div><div><h3>Method</h3><div>Based on the psychiatric outpatient data from Changhua Christian Hospital in Taiwan from January 1, 2016, to June 30, 2024, the ICD-10 diagnostic codes (F00-F99) of all patients that appeared at least three times were extracted. Three different comorbidity networks were constructed using co-occurrence counts, Jaccard index, and partial correlation coefficient estimated by the mixed graphical model (MGM) as the weights of the network edges. Network structure was analyzed using indicators such as degree centrality, modularity, and community detection.</div></div><div><h3>Results</h3><div>The dataset included 16,954 patients. The comorbidity frequency network showed that mood disorders (F34) and anxiety disorders (F41) had the highest weighted degree centrality. In the Jaccard coefficient network, the weighted degree centrality of developmental disorders (F8x) increased. The MGM network highlighted the central role of substance use disorders (F1x).</div></div><div><h3>Conclusion</h3><div>Our findings suggested the roles and interrelationships of different disease categories in the comorbidity network. The results provide new perspectives and data support for clinical practice and future research.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"141 ","pages":"Article 152608"},"PeriodicalIF":4.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139535","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}
Pub Date : 2025-05-18DOI: 10.1016/j.comppsych.2025.152607
M.W. Stratmann , J. Heeg , M. Härter , L. Kriston , U. Verthein , C. Lindemann
Background and aims
We aimed to assess the accuracy for the German version of the Benzodiazepine Dependence Self-Report Questionnaire (Bendep-SRQ-GV) as a possible screening instrument for benzodiazepine or Z-drug substance use disorder.
Method
This study includes a convenience sample of adults who had used benzodiazepines or Z-drugs at least once in the last year. Participants were recruited through notice boards, social media, newspaper, and a digital health information platform. All participants answered the Bendep-SRQ-GV and were assessed for benzodiazepine or Z-drug substance use disorder using the Structured Clinical Interview for DSM-5 Disorders – Clinical Version. We performed receiver operating characteristics curve analyses and calculated the area under the curve (AUC).
Results
42 out of 60 participants fulfilled the criteria for benzodiazepine or Z-drug substance use disorder according to Structured Clinical Interview. AUCs varied among the 4 subscales of the Bendep-SRQ-GV: Problematic Use (0.893 [0.819–0.975]), Preoccupation (0.751 [0.609–0.892]), Lack of Compliance (0.804 [0.699–0.919]), Withdrawal (0.743 [0.622–0.864]) and Total Score (0.860 [0.762–0.963]). For Problematic Use and Total Score selected cut-offs (5.5 and 16.5) showed best results: sensitivity (83 % [71–93 %] and 79 % [67–90 %]), high specificity (83 % [61–100 %] and 83 % [67–100 %], positive predictive value (92 % [84–100 %] and 92 % [83–100 %]), and negative predictive value (68 % [54–85 %] and 63 % [50–77 %]).
Discussion
The subscale Problematic Use and the Total Score seem promising for detecting benzodiazepine or Z-drug substance use disorder in adults. Precise cut-offs should be determined with a larger sample. The Bendep-SRQ-GV could be of great value as a screening questionnaire in clinical settings, counselling sites, and for scientific purposes.
{"title":"Screening accuracy of the German version of the benzodiazepine self-report questionnaire","authors":"M.W. Stratmann , J. Heeg , M. Härter , L. Kriston , U. Verthein , C. Lindemann","doi":"10.1016/j.comppsych.2025.152607","DOIUrl":"10.1016/j.comppsych.2025.152607","url":null,"abstract":"<div><h3>Background and aims</h3><div>We aimed to assess the accuracy for the German version of the Benzodiazepine Dependence Self-Report Questionnaire (Bendep-SRQ-GV) as a possible screening instrument for benzodiazepine or <em>Z</em>-drug substance use disorder.</div></div><div><h3>Method</h3><div>This study includes a convenience sample of adults who had used benzodiazepines or <em>Z</em>-drugs at least once in the last year. Participants were recruited through notice boards, social media, newspaper, and a digital health information platform. All participants answered the Bendep-SRQ-GV and were assessed for benzodiazepine or <em>Z</em>-drug substance use disorder using the Structured Clinical Interview for DSM-5 Disorders – Clinical Version. We performed receiver operating characteristics curve analyses and calculated the area under the curve (AUC).</div></div><div><h3>Results</h3><div>42 out of 60 participants fulfilled the criteria for benzodiazepine or <em>Z</em>-drug substance use disorder according to Structured Clinical Interview. AUCs varied among the 4 subscales of the Bendep-SRQ-GV: Problematic Use (0.893 [0.819–0.975]), Preoccupation (0.751 [0.609–0.892]), Lack of Compliance (0.804 [0.699–0.919]), Withdrawal (0.743 [0.622–0.864]) and Total Score (0.860 [0.762–0.963]). For Problematic Use and Total Score selected cut-offs (5.5 and 16.5) showed best results: sensitivity (83 % [71–93 %] and 79 % [67–90 %]), high specificity (83 % [61–100 %] and 83 % [67–100 %], positive predictive value (92 % [84–100 %] and 92 % [83–100 %]), and negative predictive value (68 % [54–85 %] and 63 % [50–77 %]).</div></div><div><h3>Discussion</h3><div>The subscale Problematic Use and the Total Score seem promising for detecting benzodiazepine or <em>Z</em>-drug substance use disorder in adults. Precise cut-offs should be determined with a larger sample. The Bendep-SRQ-GV could be of great value as a screening questionnaire in clinical settings, counselling sites, and for scientific purposes.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"141 ","pages":"Article 152607"},"PeriodicalIF":4.3,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107116","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}
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