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Narrative Review of Paraphilias: An Indian Perspective 副性癖的叙述性评论:印度视角
IF 2.8 Q3 PSYCHIATRY Pub Date : 2024-08-02 DOI: 10.1177/02537176241256885
Manish Roshan Thakur, Ravi Yadav, Rajvardhan Singh Bhanwar
Introduction:Paraphilias, encompassing a diverse range of atypical sexual interests and behaviors, have been a subject of profound interest and scrutiny throughout history. These sexual interests are a matter of debate with the changing society and also with the changing world view. The rise in awareness about abnormal sexual interests also poses difficulty in adding to the existing list.Objectives:This article aims to provide a comprehensive exploration of the historical underpinnings, current diagnostic criteria, legal considerations in India, and treatment approaches available for paraphilias.Methodology:Electronic searches were done on PubMed, Science Direct, Web of Science, and Google Scholar. Search term included were “paraphilias,” “history,” “nosology,” “legislation,” “law,” “treatment guidelines,” and “treatment recommendations” in various combinations. An independent online search was also conducted for historical and legal aspects of India.Results:The classification and understanding of paraphilias have evolved over time, with some being removed from criminalized groups and laws and legislation changing based on societal norms. ICD and DSM have become more structured, but need constant updating. India's laws need to be more specific and streamlined, and guidelines have not been assessed for effectiveness. Paraphilias has been treated as a foster child in psychiatry, raising concerns about treatment options.
导言:奸淫癖包括各种非典型的性兴趣和性行为,在历史上一直是人们深感兴趣和关注的话题。随着社会的变迁和世界观的改变,这些性趣也成为人们争论的焦点。目的:本文旨在全面探讨副性妄想症的历史基础、现行诊断标准、印度的法律考虑因素和治疗方法。方法:在 PubMed、Science Direct、Web of Science 和 Google Scholar 上进行电子检索。搜索关键词包括 "性变态"、"历史"、"分类学"、"立法"、"法律"、"治疗指南 "和 "治疗建议 "的各种组合。结果:随着时间的推移,对恋物癖的分类和理解也在发生变化,有些恋物癖已从犯罪群体中删除,法律和立法也根据社会规范发生了变化。ICD 和 DSM 已变得更加系统化,但仍需不断更新。印度的法律需要更加具体和简化,而且尚未对指导方针的有效性进行评估。性变态在精神病学中一直被视为寄养儿童,引起了人们对治疗方案的关注。
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引用次数: 0
Childhood Trauma, Emotional Regulation, Alexithymia, and Psychological Symptoms Among Adolescents: A Mediational Analysis 青少年的童年创伤、情绪调节、亚历山大症和心理症状:中介分析
IF 2.8 Q3 PSYCHIATRY Pub Date : 2024-08-02 DOI: 10.1177/02537176241258251
Prerna Sharma, Mahadev Singh Sen, Uday Kumar Sinha, Deepak Kumar
Background:Adolescents’ mental health is influenced by childhood trauma, emotional regulation, and psychological symptoms. This study aimed to explore these interconnections among adolescents attending a child and adolescent clinic.Method:Adolescents aged 13-19 from a city were recruited through purposive sampling. Data were collected using the Child Behavior Checklist (CBCL), Childhood Trauma Questionnaire-Short Form (CTQ), Difficulties in Emotion Regulation Scale (DERS), and Toronto Alexithymia Scale-20. Adolescents with severe mental or physical illnesses were excluded.Results:A total of 100 participants were recruited aged 13-19. The CTQ scores positively correlated with DERS Scores ( r = 0.246, P < .05) and Internalizing scores ( r = 0.325, P < .01). DERS Scores strongly correlated with alexithymia ( r = 0.624, P < .001) and Internalizing scores( r = 0.556, P < .001). Regression analyses revealed CTQ, Alexithymia, and DERS scores significantly predicted Internalizing scores ( R2 = 0.37). Mediation analysis showed that emotional regulation partially mediated the relationship between child trauma and Internalizing scores ( B = 0.059, 95% confidence interval [CI] = 0.011 to 0.133, t = 1.92, P = .01), as well as the relationship between Alexithymia and Internalizing scores( B = 0.255, 95% CI = 0.129 to 0.465, t = 3.31, P < .001).Conclusion:Findings highlight the importance of emotional regulation as a mediator in the connections between childhood trauma, alexithymia, and psychological symptoms among adolescents. This complementary mediation underscores the dual impact of direct and indirect effects on psychological well-being. The findings reveal intricate links between childhood trauma, emotional regulation, and alexithymia in adolescents with psychological symptoms. Emotional regulation proved to have a pivotal role in influencing psychological well-being. These results emphasize the importance of considering emotional regulation when assessing and maintaining mental health in adolescents, further contributing to understanding treatment needs.
背景:青少年的心理健康受到童年创伤、情绪调节和心理症状的影响。本研究旨在探讨在儿童和青少年诊所就诊的青少年中存在的这些相互联系。方法:通过有目的的抽样调查从某市招募 13-19 岁的青少年。使用儿童行为检查表(CBCL)、童年创伤问卷-简表(CTQ)、情绪调节困难量表(DERS)和多伦多亚历山大症量表-20收集数据。结果:共招募了 100 名 13-19 岁的参与者。CTQ得分与DERS得分(r = 0.246, P <.05)和内化得分(r = 0.325, P <.01)呈正相关。DERS 评分与情感淡漠(r = 0.624,P <.001)和内化评分(r = 0.556,P <.001)密切相关。回归分析表明,CTQ、Alexithymia 和 DERS 分数可显著预测内化分数 ( R2 = 0.37)。中介分析显示,情绪调节部分中介了儿童创伤与内化得分之间的关系(B = 0.059,95% 置信区间 [CI] = 0.011 至 0.133,t = 1.92,P = .01),以及亚历山大症与内化得分之间的关系(B = 0.255,95% CI = 0.129 to 0.465,t = 3.31,P <.001)。结论:研究结果凸显了情绪调节作为青少年童年创伤、亚历山大症和心理症状之间联系的中介的重要性。这种互补性调解强调了直接和间接效应对心理健康的双重影响。研究结果揭示了有心理症状的青少年童年创伤、情绪调节和情感障碍之间错综复杂的联系。事实证明,情绪调节在影响心理健康方面起着举足轻重的作用。这些结果强调了在评估和维护青少年心理健康时考虑情绪调节的重要性,进一步有助于了解治疗需求。
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引用次数: 0
Perspectives on the Journey Through the Early Exposure Psychiatry Enrichment Program 2023 透视早期接触精神病学强化计划的历程 2023 年
IF 2.8 Q3 PSYCHIATRY Pub Date : 2024-08-01 DOI: 10.1177/02537176241261196
Adityaraj Patidar, Debprosit Karmakar, Kanishka Tenguriya, Snehil Gupta
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引用次数: 0
Chemsex and Beyond: A Study of Factors Associated with Substance Use Among Men Who Have Sex with Men and Transgender Women in Southern Vietnam to Develop Informed HIV and STI Prevention and Intervention Programs 化学性行为及其他:研究越南南部男男性行为者和变性妇女使用药物的相关因素,以制定知情的 HIV 和 STI 预防和干预计划
IF 2.8 Q3 PSYCHIATRY Pub Date : 2024-08-01 DOI: 10.1177/02537176241258715
Vu Thi Tuong Vi, Vo Van Tam, Le Huynh Thi Cam Hong, Nguyen Viet Ngoc, Nguyen Thi Ngoc Diep, Nguyen Nhu Trang, Kevin P. Mulvey, Do Van Dung, Yatan Pal Singh Balhara
Background:Amphetamine-type stimulant (ATS) use is a major public health concern among men who have sex with men (MSM) and transgender women (TGW) in communities worldwide and in Vietnam.Methods:A cross-sectional study was conducted on 1000 adult MSM and TGW from 9 community-based organizations in southern Vietnam from March to August 2019. Data on demographics, sexual behaviors, STIs, HIV infection, and substance use were collected with a self-administered questionnaire including the ASSIST tool. Blood and urine samples were collected for HIV and ATS testing.Results:The prevalence of lifetime ATS use in the previous three months was 50.5% and 49.4%, respectively. Multivariable analyses showed that ATS use was significantly associated with sex with a transactional partner (aOR [29] = 3.06, 95% CI = 2.13–4.39) who engaged in sex and got paid for it (aOR = 2.78, 95% CI = 1.64–4.73), and purchasing sex (aOR = 2.34, 95% CI = 1.06–5.16). The role in sex with a partner with significant association was ‘insertive and receptive equally vs. insertive only’ (aOR = 1.78, 95% CI = 1.14–2.76).Conclusion:ATS use is associated with many sexual behaviors that could be associated with an increased risk of HIV transmission among MSM and TGW populations.
背景:安非他明类兴奋剂(ATS)的使用是全球和越南社区中男男性行为者(MSM)和变性女性(TGW)的一个主要公共卫生问题。方法:2019 年 3 月至 8 月,对越南南部 9 个社区组织的 1000 名成年 MSM 和 TGW 进行了横断面研究。通过自填式问卷(包括 ASSIST 工具)收集了有关人口统计学、性行为、性传播感染、HIV 感染和药物使用的数据。结果:前三个月终生使用苯丙胺类兴奋剂的比例分别为 50.5%和 49.4%。多变量分析表明,使用苯丙胺类兴奋剂与与交易性伴侣发生性行为(aOR [29] = 3.06,95% CI = 2.13-4.39)、从事性行为并获得报酬(aOR = 2.78,95% CI = 1.64-4.73)和购买性行为(aOR = 2.34,95% CI = 1.06-5.16)显著相关。结论:安非他明类兴奋剂的使用与许多性行为有关,而这些性行为可能与 MSM 和 TGW 群体中 HIV 传播风险的增加有关。
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引用次数: 0
Solution-focused Brief Psychological Intervention in Alteration of Compulsive Buying Behavior in an Individual with Compulsive Buying Disorder: A Case Report 在改变强迫性购买障碍患者强迫性购买行为过程中进行以解决方案为重点的简短心理干预:病例报告
IF 2.8 Q3 PSYCHIATRY Pub Date : 2024-08-01 DOI: 10.1177/02537176241259709
Trusha Shanbhag, Debaleena Ghosh, Priyanka Lenka
Background:Compulsive buying (CB) presents itself with uncontrollable or excessive urges and preoccupations with behaviors related to spending money that have detrimental consequences. Compulsive buying disorder (CBD) can result in remorse and regret over purchases, guilt, shame, issues with finances, and interpersonal difficulties. Despite the growing understanding of the phenomenology of CBD, only some evidence-based therapies have been developed that cater to the concerns within a limited time frame.Aim:This study aimed to assess the effectiveness of solution-focused brief therapy for CBD.Methods:This study explored compulsive buying behavior (CBB) and evaluated the clinical effectiveness of a single case intervention study of a 21-year-old male with a CBD. The patient was assessed using the Yale-Brown Obsessive Compulsive Scale for Compulsive Buying (Y-BOCS). The data were collected at baseline, treatment termination, and follow-up. The intervention was initiated in October 2022 and continued for two weeks. The intervention was conducted in three phases: psychoeducation, goal setting, solution-building, and relapse prevention.Results:The data analysis showed a decrease in scores on CB between baseline (24), treatment termination (8), and one-year follow-up (4), indicating a significant reduction in the symptoms.Conclusion:The study results suggested the clinical relevance of solution-focused brief therapy for the treatment of CB in obsessive compulsive disorder (OCD). Future studies are needed to develop therapy guidelines for solution-focused brief therapy as a medium of intervention for treating OCD. It is important to establish the effectiveness of a larger sample or case series on a clinically adequate sample size.
背景:强迫性购买(CB)表现为无法控制或过度的冲动,以及对与花钱有关的行为的先入为主,这些行为会产生有害的后果。强迫性购买障碍(CBD)可导致对购买行为的悔恨和遗憾、内疚、羞愧、财务问题和人际交往障碍。方法:本研究探讨了强迫性购买行为(CBB),并评估了对一名患有强迫性购买障碍的 21 岁男性患者进行的单例干预研究的临床效果。该患者使用雅礼-布朗强迫性购买行为量表(Y-BOCS)进行评估。数据收集时间为基线、治疗终止和随访。干预于 2022 年 10 月开始,持续两周。结果:数据分析显示,在基线(24分)、治疗终止(8分)和一年随访(4分)期间,强迫症的CB得分均有所下降,表明症状明显减轻。未来的研究需要制定治疗指南,将以解决方案为中心的简短疗法作为治疗强迫症的干预手段。重要的是要在临床上足够大的样本量上确定更大样本或病例系列的有效性。
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引用次数: 0
A Qualitative Study on Lived Experiences of Psychotherapists Working with Trauma 关于心理治疗师处理创伤的生活经验的定性研究
IF 2.8 Q3 PSYCHIATRY Pub Date : 2024-08-01 DOI: 10.1177/02537176241260849
Tanmayee Baruah, Soma Pramanik, Deepshikha Ray
Background:Psychotherapists, while treating clients with a history of traumatic experiences, are exposed to vicarious trauma, which affects their mental health as well as their quality of caregiving. The present research tries to gain an insight into the lived experiences of psychotherapists while treating clients with traumatic experiences.Methods:In-depth individual interviews were conducted with five psychotherapists (two males and three females) with a minimum duration of continuous professional practice of 3.5 years and all of them above 30 years of age. The interviews were conducted for 30–45 minutes and recorded after taking informed consent from the participants. The data was analyzed and interpreted using the interpretative phenomenological analysis. Investigator triangulation was done to ensure the trustworthiness of the research.Results:The analysis reveals that the participants have experienced vicarious trauma from their therapeutic interaction with their clients on their traumatic issues, particularly during the initial phases of their career as a psychotherapist. Some of them feel that such experiences, despite being distressing, have also empowered them psychologically. The participants have reported using constructive coping strategies to deal with such vicarious trauma, such as emotional distancing, journaling, seeking personal therapy and social support, reading, physical exercise, and self-care activities.
背景:心理治疗师在治疗有创伤经历的求助者时,会受到替代性创伤的影响,从而影响他们的心理健康和护理质量。本研究试图深入了解心理治疗师在治疗有创伤经历的求助者时的生活经历。方法:本研究对五名心理治疗师(两男三女)进行了深入的个人访谈,他们的连续从业时间至少为 3.5 年,年龄均在 30 岁以上。访谈时间为 30-45 分钟,在征得参与者知情同意后进行记录。采用解释性现象分析法对数据进行分析和解释。结果:分析表明,参与者在与客户就其创伤问题进行治疗互动时,尤其是在其心理治疗师职业生涯的初始阶段,经历了替代性创伤。他们中的一些人认为,这些经历虽然令人痛苦,但也增强了他们的心理能力。参与者报告说,他们采用了建设性的应对策略来处理这种替代性创伤,如情感疏远、写日记、寻求个人治疗和社会支持、阅读、体育锻炼和自我保健活动。
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引用次数: 0
Artificial Intelligence for Psychotherapy: A Review of the Current State and Future Directions 人工智能用于心理治疗:现状与未来方向综述
IF 2.8 Q3 PSYCHIATRY Pub Date : 2024-07-29 DOI: 10.1177/02537176241260819
Mirza Jahanzeb Beg, Mohit Verma, Vishvak Chanthar K. M. M., Manish Kumar Verma
Background:Psychotherapy is crucial for addressing mental health issues but is often limited by accessibility and quality. Artificial intelligence (AI) offers innovative solutions, such as automated systems for increased availability and personalized treatments to improve psychotherapy. Nonetheless, ethical concerns about AI integration in mental health care remain.Aim:This narrative review explores the literature on AI applications in psychotherapy, focusing on their mechanisms, effectiveness, and ethical implications, particularly for depressive and anxiety disorders.Methods:A review was conducted, spanning studies from January 2009 to December 2023, focusing on empirical evidence of AI’s impact on psychotherapy. Following PRISMA guidelines, the authors independently screened and selected relevant articles. The analysis of 28 studies provided a comprehensive understanding of AI’s role in the field.Results:The results suggest that AI can enhance psychotherapy interventions for people with anxiety and depression, especially chatbots and internet-based cognitive-behavioral therapy. However, to achieve optimal outcomes, the ethical integration of AI necessitates resolving concerns about privacy, trust, and interaction between humans and AI.Conclusion:The study emphasizes the potential of AI-powered cognitive-behavioral therapy and conversational chatbots to address symptoms of anxiety and depression effectively. The article highlights the importance of cautiously integrating AI into mental health services, considering privacy, trust, and the relationship between humans and AI. This integration should prioritize patient well-being and assist mental health professionals while also considering ethical considerations and the prospective benefits of AI.
背景:心理治疗对于解决心理健康问题至关重要,但往往受到可及性和质量的限制。人工智能(AI)提供了创新的解决方案,例如提高可用性的自动化系统和改善心理治疗的个性化治疗。目的:这篇叙述性综述探讨了人工智能在心理治疗中的应用,重点关注其机制、有效性和伦理影响,尤其是对抑郁症和焦虑症的影响。方法:我们对2009年1月至2023年12月期间的研究进行了综述,重点关注人工智能对心理治疗影响的实证证据。按照 PRISMA 指南,作者独立筛选了相关文章。结果:研究结果表明,人工智能可以加强对焦虑症和抑郁症患者的心理治疗干预,尤其是聊天机器人和基于互联网的认知行为疗法。结论:该研究强调了人工智能驱动的认知行为疗法和会话聊天机器人在有效解决焦虑和抑郁症状方面的潜力。文章强调了谨慎地将人工智能融入心理健康服务的重要性,同时考虑到了隐私、信任以及人类与人工智能之间的关系。这种整合应优先考虑患者的福祉并协助心理健康专业人员,同时还要考虑道德因素和人工智能的预期效益。
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引用次数: 0
Balancing Regulation and Autonomy: NCAHP Act and the Psychology Profession in India. 平衡监管与自主:NCAHP法案与印度心理学专业
IF 1.9 Q3 PSYCHIATRY Pub Date : 2024-07-01 Epub Date: 2023-07-06 DOI: 10.1177/02537176231179920
Chinchu C
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引用次数: 0
Technology-based Interventions to Reduce the Treatment Gap for Common Perinatal Mental Disorders in Low- and Middle-income Countries (LMICs): Challenges and the Way Forward. 基于技术的干预措施,缩小中低收入国家(LMICs)常见围产期精神障碍的治疗差距:挑战与前进之路》。
IF 1.9 Q3 PSYCHIATRY Pub Date : 2024-07-01 Epub Date: 2024-02-11 DOI: 10.1177/02537176231225649
Arpana Pokharel, Rodrigo Ramalho, Bipul Kumar Das, Lungan Rongmei, Chonnakarn Jatchavala, Ahmet Gürcan, Ramdas Ransing
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引用次数: 0
Barriers to Seek Professional Help for Mental Health Scale: Development and Psychometric Validation 寻求心理健康专业帮助的障碍量表:开发与心理测量验证
IF 2.8 Q3 PSYCHIATRY Pub Date : 2024-06-23 DOI: 10.1177/02537176241256480
Prachi Sanghvi, Seema Mehrotra, Sumit Kumar Das, Manoj Kumar Sharma
Background:Mental health conditions are highly prevalent, and both supply- and demand-side factors drive a high treatment gap. There is a dearth of socio-culturally appropriate measures to assess barriers to professional help-seeking in distressed non-treatment seekers. This study aimed to develop and validate the Barriers to Seek Professional Help for Mental Health Scale for distressed, non-treatment-seeking young adults experiencing common mental health concerns in the Indian context.Methods:The study was conducted in three phases: Phase I: development of initial measure; Phase II: scale try-out ( N = 190); and Phase III: validating the factor structure ( N = 172). Distressed, non-treatment-seeking young adults (20–35 years old) were recruited for the present study. Exploratory factor analysis (EFA) was used to identify the factor structure, and confirmatory factor analysis (CFA) was conducted to validate it.Results:EFA showed that a five-factor structure best fits the data, namely, stigma and minimization, instrumental barriers, problem perception, self-efficacy in service utilization, and negative service expectancies. CFA revealed that the model was a reasonably good fit. The scale was finalized into a 24-item measure. Internal consistency reliabilities of the scale and subscales were satisfactory. Correlation patterns of barriers subscales with help negation, help-seeking inclination, and distress support its convergent validity.Conclusion:The Barriers to Seek Professional Help for Mental Health Scale was developed, and preliminary evidence supports its reliability, construct, and convergent validity. The scale could prove valuable for assessing barriers to seeking professional help for mental health in the Indian context, developing help-seeking interventions, and examining their effectiveness in increasing the uptake of mental health services.
背景:精神疾病的发病率很高,供需两方面的因素导致治疗缺口很大。目前还缺乏适合社会文化背景的测量方法来评估非治疗者在寻求专业帮助时遇到的障碍。本研究旨在开发并验证针对印度常见心理健康问题的受困、不寻求治疗的年轻成年人的心理健康专业求助障碍量表:第一阶段:开发初始量表;第二阶段:量表试用(N = 190);第三阶段:验证因子结构(N = 172)。本研究招募了情绪低落、不寻求治疗的年轻人(20-35 岁)。结果:探索性因素分析(EFA)显示,五因素结构最适合数据,即污名化和最小化、工具性障碍、问题感知、利用服务的自我效能感和消极服务期望。CFA 显示,该模型的拟合效果相当不错。量表最终确定为 24 个项目。量表和分量表的内部一致性信度令人满意。障碍子量表与求助否定、求助倾向和痛苦的相关模式支持其收敛效度。结论:心理健康求助障碍量表已经编制完成,初步证据支持其信度、建构效度和收敛效度。该量表可用于评估在印度寻求心理健康专业帮助的障碍,制定寻求帮助的干预措施,以及研究这些措施在提高心理健康服务利用率方面的有效性。
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引用次数: 0
期刊
Indian Journal of Psychological Medicine
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