Comprehensive psychiatry最新文献

{"title":"The role of attachment anxiety and intolerance of uncertainty in gaming during adolescence: A two-wave longitudinal study","authors":"Camilla Gregorini ,&nbsp;Claudia Marino ,&nbsp;Alessandro Giardina ,&nbsp;Joël Billieux ,&nbsp;Gioia Bottesi ,&nbsp;Chiara Sacchi ,&nbsp;Erika Pivetta ,&nbsp;Alessio Vieno ,&nbsp;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_age = 15.60; SD_age = 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":"2025-10-01","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}

{"title":"Navigating the challenges of substance use and psychopathology in depression, bipolar disorder, and schizophrenia","authors":"Stefania Chiappini ,&nbsp;Alessio Mosca ,&nbsp;Francesco Semeraro ,&nbsp;Andrea Amerio ,&nbsp;Isabella Berardelli ,&nbsp;Laura Cremaschi ,&nbsp;Ilaria Di Bernardo ,&nbsp;Mauro Pettorruso ,&nbsp;Gianluca Serafini ,&nbsp;Bernardo Dell'Osso ,&nbsp;Giovanni Martinotti","doi":"10.1016/j.comppsych.2025.152616","DOIUrl":"10.1016/j.comppsych.2025.152616","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Dealing with Substance use disorders (SUDs) in conjunction with psychopathological conditions such as Major Depressive Disorder (MDD), bipolar disorder (BD), and schizophrenia - often referred to as &lt;em&gt;dual diagnosis&lt;/em&gt; or &lt;em&gt;co-occurring disorders&lt;/em&gt; - poses significant challenges for both patients and clinicians, requiring integrated treatment approaches that simultaneously tackle both substance use and psychopathology.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aim and methods&lt;/h3&gt;&lt;div&gt;The objective of this systematic review is to analyse and summarize the existing research on the various pharmacological treatments for dual diagnosis, providing a comprehensive understanding of their effectiveness and identifying areas requiring further exploration. The systematic review was structured in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered on the International Prospective Register of Systematic Reviews (PROSPERO) with the id number CRD 42024500114.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The analysis of the available literature identified 66 articles, 29 related to SUDs &amp; schizophrenia, 20 focused on SUDs &amp; MDD, and 17 on SUDs &amp; BD. Overall, most manuscripts recording SUDs concerned the following drugs: alcohol (&lt;em&gt;N&lt;/em&gt; = 26), cannabis (&lt;em&gt;N&lt;/em&gt; = 19), opioids (&lt;em&gt;N&lt;/em&gt; = 10), cocaine (N = 10), and amphetamine (&lt;em&gt;N&lt;/em&gt; = 3), while several studies described SUDs in general (&lt;em&gt;N&lt;/em&gt; = 12). Findings were presented thematically based on the type of intervention for each of the main conditions recorded. In the case of psychotic symptoms and SUDs, aripiprazole appeared to be the most used medication in the maintenance therapy not only for its effectiveness but also for its safety profile. Alternatively, despite the side effects, clozapine showed a good efficacy in the management of symptoms and in terms of relapse prevention. Moreover, long-acting medications might be an effective option in the control of impulsivity and psychotic symptoms, but also in first-episode psychosis, reducing relapse and rehospitalization. With regard to the treatment of MDD/BD and SUDs, there are mixed findings regarding the best medication for symptom control; notably, different degrees of efficacy were recorded if added to psychological/behavioural interventions, or combined with specific SUD treatments, such as opioid receptor agonist/antagonist therapies or the anti-glutamatergic drugs acamprosate/memantine, etc.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The current body of evidence includes mixed findings in terms of which medication is superior in controlling symptoms, according to the specific psychopathology, the specific SUD involved, the treatment setting, and the primary objective of care. Overall, pharmacological treatments for dual diagnosis are complex and require personalized approaches considering the heterogeneity of the population. Future research shoul","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152616"},"PeriodicalIF":4.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611879","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}

{"title":"Personality, motivations, and gaming disorder symptoms: A large-scale comparative study of esports players, highly engaged gamers, and recreational players.","authors":"Harshdeep S. Mangat ,&nbsp;Róbert Urbán ,&nbsp;Patrik Koncz ,&nbsp;Zsolt Demetrovics ,&nbsp;Andrea Czakó ,&nbsp;Mark D. Griffiths ,&nbsp;Orsolya Király","doi":"10.1016/j.comppsych.2025.152623","DOIUrl":"10.1016/j.comppsych.2025.152623","url":null,"abstract":"<div><h3>Background and aims</h3><div>Esports playing (i.e., competitive videogaming) is an ever-growing activity but has a variety of risks or harms associated with problematic consumption. The aim of the present study was to investigate the extent to which esports is associated with different indicators of problematic consumption and how motivations for playing videogames reflect differences between esports players, recreational players, and highly engaged gamers.</div></div><div><h3>Methods</h3><div>Self-report data were collected regarding personality, psychopathological symptoms, and gaming behavior among 14,727 gamers (mean age = 24.1 years [SD = 7.0]; 89.3 % male) comprising 557 esports players (mean age = 21.5 years [SD = 6.5]; 95.9 % male), 5101 recreational players (mean age = 26.1 years [SD = 7.5]; 87.8 % male), and 9069 highly engaged gamers (mean age = 23.2 years [SD = 6.4]; 89.7 % male).</div></div><div><h3>Results</h3><div>Comparing all three groups, esports players were more likely to be male, younger in age, and were more likely to have a competitive personality. When compared to highly engaged gamers with regard to gaming motivation, esports players showed lower mastery, stimulation, and escapism motives. Highly engaged gamers displayed higher sensation seeking, higher negative affectivity, and lower sociability compared to the other two groups.</div></div><div><h3>Conclusion</h3><div>Esports players tend to have a balanced psychological profile, which indicates that esports themselves are not necessarily associated with problematic use characteristics. Highly engaged gamers showed potentially harmful characteristics in terms of higher perceived stress and depression, and motivations to play (escapism). Interventions are encouraged to protect and support this group of gamers.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152623"},"PeriodicalIF":4.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665776","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}

{"title":"Interoceptive sensibility: links with insomnia symptoms, anxiety, and depression in the general population","authors":"Faccini Julie ,&nbsp;Joshi Vrutti ,&nbsp;Del-Monte Jonathan","doi":"10.1016/j.comppsych.2025.152625","DOIUrl":"10.1016/j.comppsych.2025.152625","url":null,"abstract":"<div><h3>Background</h3><div>Diurnal and nocturnal symptoms of insomnia are strongly associated with anxiety and depression. Interoception provides a new reading window for understanding the development and maintenance of psychopathology and sleep disorders. While previous studies have provided preliminary insights into the relationships between depression, anxiety, insomnia, and interoceptive sensibility, to our knowledge, no study has comprehensively examined these relationships.</div></div><div><h3>Methods</h3><div>We used mediation and network analyses to investigate the associations between interoceptive sensibility, diurnal and nocturnal symptoms of insomnia, anxiety, and depression in a sample of 542 individuals from the general population. The Multidimensional Assessment of Interoceptive Awareness, the Sleep Condition Indicator, and the Hospital Anxiety and Depression Scale were used for the assessment.</div></div><div><h3>Results</h3><div>The results showed that the dimensions “trust” and “attention regulation” of interoceptive sensibility are central nodes in the interrelationship network. The “trust” dimension is strongly and negatively related to depression and anxiety. Nocturnal symptoms are more strongly related to anxiety, and diurnal symptoms are more strongly related to depression. Mediation analyses highlight the predominant mediating role of the “trust” dimension in the relationships between insomnia symptoms and clinical variables.</div></div><div><h3>Conclusions</h3><div>These findings suggest that interoceptive sensibility plays a critical role in bridging the relationship between both nocturnal and diurnal insomnia symptoms and anxiety-depressive symptomatology.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152625"},"PeriodicalIF":4.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680722","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}

{"title":"Inpatient vs outpatient cognitive behavioral therapy for insomnia: A two-arm parallel randomized controlled trial","authors":"Guifeng Li ,&nbsp;Mengya Li ,&nbsp;Xin Xu ,&nbsp;Junhong Zhang ,&nbsp;Qifang Li ,&nbsp;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> &lt; .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> &lt; .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> &lt; .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":"2025-08-01","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}

{"title":"Mapping the pathway to anabolic-androgenic steroids (AAS) use","authors":"Nora M. Laskowski ,&nbsp;Christopher Zaiser ,&nbsp;Roland Müller ,&nbsp;Gerrit Brandt ,&nbsp;Georgios Paslakis","doi":"10.1016/j.comppsych.2025.152602","DOIUrl":"10.1016/j.comppsych.2025.152602","url":null,"abstract":"<div><div>This short communication introduces a model for the use of anabolic-androgenic steroids (AAS), with body dissatisfaction as the central factor, shaped by sociocultural, psychological, and behavioral influences. Media-driven body ideals, gender, and sexual orientation may significantly influence body image, while low self-esteem and certain personality traits also contribute to dissatisfaction. Disordered eating behaviors (DEB) and intense physical exercise act as indirect contributors, particularly in fitness communities, where “conventional” body modification methods (i.e., exercise and diet) may fail to meet internalized ideals.</div><div>The model highlights a vicious cycle: body dissatisfaction drives AAS use, which, in turn, worsens dissatisfaction. Social media amplify this cycle by promoting unrealistic standards, while marginalized groups, including LGBTQI+ populations, face additional pressures to conform to heteronormative beauty norms. The overlap between body dissatisfaction, DEB, and intense physical exercise underscores the need for nuanced research to disentangle these inferences.</div><div>The model predominantly reflects Western body ideals, limiting its applicability across cultures. Addressing body dissatisfaction through early interventions targeting both societal standards and individual vulnerabilities is critical. Also, approaches accounting for aspects of sex and gender diversity are essential to promote body acceptance and reduce the risk of AAS use and DEB.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"141 ","pages":"Article 152602"},"PeriodicalIF":4.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071475","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}

{"title":"The LEADING guideline: Reporting standards for expert panel, best-estimate diagnosis, and longitudinal expert all data (LEAD) methods","authors":"Veerle C. Eijsbroek ,&nbsp;Katarina Kjell ,&nbsp;H. Andrew Schwartz ,&nbsp;Jan R. Boehnke ,&nbsp;Eiko I. Fried ,&nbsp;Daniel N. Klein ,&nbsp;Peik Gustafsson ,&nbsp;Isabelle Augenstein ,&nbsp;Patrick M.M. Bossuyt ,&nbsp;Oscar N.E. Kjell","doi":"10.1016/j.comppsych.2025.152603","DOIUrl":"10.1016/j.comppsych.2025.152603","url":null,"abstract":"<div><div>Accurate assessments of symptoms and illnesses are essential for health research and clinical practice but face many challenges. The absence of a single error-free measure is currently addressed by assessment methods involving experts reviewing several sources of information to achieve a <em>best-estimate assessment</em>. This assessment method is called the <em>Expert Panel</em> method in medicine, and the <em>Best-Estimate Diagnosis</em> or <em>Longitudinal Expert All Data</em> (LEAD) method in psychiatry and psychology. However, due to poor reporting of the assessment methods, the quality of pro-claimed best-estimate assessments is typically difficult to evaluate, and when the method is reported, the reporting quality varies substantially. To tackle this gap, we have developed a reporting guideline following a four-stage approach: 1) drafting reporting standards accompanied by empirical evidence, which were further developed with a patient organization for depression, 2) incorporating expert feedback through a two-round Delphi procedure, 3) refining the guideline based on an expert consensus meeting, and 4) testing the guideline by i) having researchers test it and ii) applying it to previously published studies. The last step also provides evidence for the need for the guideline: 10–63 % (Mean 33 %) of the standards were not reported across thirty randomly selected published studies. The result is the LEADING guideline comprising 20 reporting standards in four groups: the <em>Longitudinal design</em>, the <em>Appropriate data</em>, the <em>Evaluation – experts, materials and procedures</em>, and the <em>Validity</em> group. We hope that the LEADING guideline will assist researchers in planning, conducting, reporting, and evaluating research aiming to achieve best-estimate assessments.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"141 ","pages":"Article 152603"},"PeriodicalIF":4.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213296","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}

{"title":"A comparative evaluation of 23 projects on mental health and wellbeing for veterans and first responders","authors":"S. Lukersmith ,&nbsp;C. Woods ,&nbsp;L. Salvador-Carulla ,&nbsp;T. Niyonsenga ,&nbsp;I. Mohanty ,&nbsp;M.R. Gutierrez-Colosia ,&nbsp;D. Diaz-Milanes ,&nbsp;C.R. Garcia-Alonso ,&nbsp;C.J. Büsst","doi":"10.1016/j.comppsych.2025.152599","DOIUrl":"10.1016/j.comppsych.2025.152599","url":null,"abstract":"<div><h3>Background</h3><div>Veterans and First Responders (VFR) are at risk of developing a range of mental health disorders because of cumulative exposure to critical incidents at work. Two Philanthropic organisations funded 15 organisations, which collectively implemented 23 highly heterogeneous and international early intervention mental ill-health and suicide prevention Projects. The aim was identify and collaborate with Projects with a multi-project evaluation. The evaluation examined multiple domains including intervention effectiveness but critically the implementation processes impacts for potential replication or scale up. This paper reports on the methods and evaluation results of implementation processes, impact analysis and sustainability.</div></div><div><h3>Method</h3><div>The evaluation involved ecosystems and complex systems approaches using novel methods and tools. There was multiple preparatory evaluation steps including developing indices for complexity and context. The Global Impact Analytics Framework (GIAF) toolkit was used to evaluate the implementation processes. Methodological tools included qualitative analysis, descriptive statistics, GIAF ladders/scales and checklists (qualitative and quantitative data).</div></div><div><h3>Results</h3><div>We provide the results on characteristics (organisational, Project and participants), GIAF process components (planning, pre-engagement, pre-readiness/readiness, dissemination/diffusion, usability/sustainability, adoption and uptake). All Project interventions were assessed as usable, adoptable and have capacity to be sustained, with financial resources. Uptake of the intervention was mostly high.</div></div><div><h3>Conclusion</h3><div>Complex multi-project evaluation of highly heterogenous Projects implemented in the real world across different countries is possible and provides valuable information and learnings. The evaluation results establish benchmarks including Project pre-engagement with potential end-users, continuous, frequent collaboration between Project and evaluation teams, adequate contract duration for sufficient recruitment and intervention.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"141 ","pages":"Article 152599"},"PeriodicalIF":4.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928331","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}

{"title":"Screening accuracy of the German version of the benzodiazepine self-report questionnaire","authors":"M.W. Stratmann ,&nbsp;J. Heeg ,&nbsp;M. Härter ,&nbsp;L. Kriston ,&nbsp;U. Verthein ,&nbsp;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":"2025-08-01","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}

{"title":"The double-edged sword of distress tolerance: Exploring the role of distress overtolerance in nonsuicidal self-injury","authors":"Harin Chung,&nbsp;Gyumyoung Kim,&nbsp;Da-In Kim,&nbsp;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":"2025-08-01","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}