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Identifying central symptoms of eating disorders among ethnic and racial minority women. 确定少数民族和种族妇女饮食失调的主要症状。
IF 4.6 1区 心理学 Q1 Medicine Pub Date : 2021-10-01 Epub Date: 2021-09-13 DOI: 10.1037/abn0000695
Marisol Perez, Victoria Perko, Kimberly Y Yu, Juan C Hernández, Tara K Ohrt, Jenna Stadheim

Experiencing eating disorder symptoms is associated with maladaptive outcomes and impairment in functioning. A paucity of research exists examining eating disorder symptoms among ethnic/racial minority women. Using a network analysis, we evaluated core symptoms of eating disorder psychopathology and the degree of association between eating disorder symptoms in a sample of ethnic/racial minority women. Participants were 296 Black, 261 Hispanic, and 261 Asian American women recruited across the United States to complete an online survey. Inclusionary criteria yielded a sample with high eating disorder psychopathology. The Network Comparison Test was used to identify differences in networks between groups and yielded no significant differences between the three ethnic/racial groups. Thus, one network analysis on the entire sample was conducted in the main analyses. However, separate group analyses are presented in the online supplemental materials. Consistent with the transdiagnostic theory of eating disorders, weight concerns (i.e., strong desire to lose weight and fear of weight gain) emerged as central symptoms. Discrepant from findings with predominantly White samples, purging emerged as a central symptom as well, while shape concerns did not. Interestingly, having to weigh oneself weekly, having a flat stomach, fasting, and compulsive exercising were on the periphery of the network. Findings are discussed in terms of clinical implications and comparative similarities and differences when addressing the existing literature. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

经历饮食失调症状与适应不良结果和功能损害有关。关于少数民族/种族妇女饮食失调症状的研究很少。使用网络分析,我们评估了少数民族/种族妇女样本中饮食失调精神病理学的核心症状和饮食失调症状之间的关联程度。参与者是296名黑人、261名西班牙裔和261名亚裔美国女性,她们在美国各地被招募来完成一项在线调查。纳入标准产生了高饮食失调精神病理的样本。使用网络比较测试来确定群体之间的网络差异,三个民族/种族群体之间没有显着差异。因此,在主要分析中对整个样本进行了一次网络分析。然而,在线补充材料中提供了单独的组分析。与进食障碍的跨诊断理论一致,体重担忧(即强烈的减肥欲望和对体重增加的恐惧)成为中心症状。与主要是白色样本的研究结果不同,排便也是一个中心症状,而形状问题则不是。有趣的是,每周称一次体重、腹部平坦、禁食和强迫性锻炼都在社交网络的边缘。在处理现有文献时,研究结果在临床意义和比较异同方面进行了讨论。(PsycInfo Database Record (c) 2021 APA,版权所有)。
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引用次数: 3
Intrusive memories following disaster: Relationship with peritraumatic responses and later affect. 灾难后的侵入性记忆:与创伤周围反应和后来的影响的关系。
IF 4.6 1区 心理学 Q1 Medicine Pub Date : 2021-10-01 Epub Date: 2021-08-26 DOI: 10.1037/abn0000694
Alessandro Massazza, Helene Joffe, Chris R Brewin

Cognitive theories of posttraumatic stress disorder (PTSD) suggest that intrusive memories result from disrupted information processing during traumatic memory encoding and are characterized by fear, helplessness, and horror at recall. Existing naturalistic studies are limited by the absence of direct comparisons between specific moments that do and do not correspond to intrusive memories. We tested predictions from cognitive theories of PTSD by comparing peritraumatic responses during moments experienced as intrusive memories versus distressing moments of the same traumatic event from the same individual not experienced as intrusive memories. A further comparison was with highly distressing moments experienced during the same event by individuals without intrusive memories. We utilized a psychometrically generated model to distinguish different peritraumatic reactions. Moments experienced as intrusive memories were characterized by higher peritraumatic distress, immobility, cognitive overload, and somatic dissociation when compared both to distressing moments from the same individual that did not intrude and to the most distressing memories of individuals without intrusions. Exploratory analyses indicated that at recall, intrusive memories were characterized by higher levels of primary traumatic emotions such as anxiety, fear, and helplessness in comparison with nonintrusive memories. Findings from this novel naturalistic design support predictions made by cognitive theories of PTSD and have implications for research and preventative interventions targeting intrusive memories. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

创伤后应激障碍(PTSD)的认知理论认为,侵入性记忆是由于创伤记忆编码过程中信息加工的中断而产生的,其特征是对回忆的恐惧、无助和恐惧。现有的自然主义研究受到缺乏直接比较特定时刻与侵入性记忆相对应或不相对应的限制。我们通过比较来自同一个体的创伤性事件在经历侵入性记忆时的创伤周围反应和来自同一个体的非侵入性记忆时的痛苦时刻,来测试PTSD认知理论的预测。进一步的比较是,没有侵入性记忆的人在同一事件中经历了非常痛苦的时刻。我们使用心理测量生成的模型来区分不同的创伤周围反应。与未被侵入的个体的痛苦时刻和未被侵入的个体的最痛苦记忆相比,作为侵入性记忆经历的时刻具有更高的创伤周围痛苦、不动、认知超载和躯体分离的特征。探索性分析表明,在回忆时,与非侵入性记忆相比,侵入性记忆的特点是具有更高水平的初级创伤情绪,如焦虑、恐惧和无助。这种新颖的自然主义设计的发现支持了PTSD认知理论的预测,并对针对侵入性记忆的研究和预防性干预具有启示意义。(PsycInfo Database Record (c) 2021 APA,版权所有)。
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引用次数: 4
Adolescent cannabis use and adult psychoticism: A longitudinal co-twin control analysis using data from two cohorts. 青少年大麻使用和成人精神病:使用两个队列数据的纵向双胎对照分析。
IF 4.6 1区 心理学 Q1 Medicine Pub Date : 2021-10-01 DOI: 10.1037/abn0000701
Jonathan D Schaefer, Seon-Kyeong Jang, Scott Vrieze, William G Iacono, Matt McGue, Sylia Wilson

Observational studies have repeatedly linked cannabis use and increased risk of psychosis. We sought to clarify whether this association reflects a causal effect of cannabis exposure or residual confounding. We analyzed data from two cohorts of twins who completed repeated, prospective measures of cannabis use (N = 1544) and cannabis use disorder symptoms (N = 1458) in adolescence and a dimensional measure of psychosis-proneness (the Personality Inventory for DSM-5 Psychoticism scale) in adulthood. Twins also provided molecular genetic data, which were used to estimate polygenic risk of schizophrenia. Both cumulative adolescent cannabis use and use disorder were associated with higher Psychoticism scores in adulthood. However, we found no evidence of an effect of cannabis on Psychoticism or any of its facets in co-twin control models that compared the greater-cannabis-using twin to the lesser-using co-twin. We also observed no evidence of a differential effect of cannabis on Psychoticism by polygenic risk of schizophrenia. Although cannabis use and disorder are consistently associated with increased risk of psychosis, the present results suggest this association is likely attributable to familial confounds rather than a causal effect of cannabis exposure. Efforts to reduce the prevalence and burden of psychotic illnesses thus may benefit from greater focus on other therapeutic targets. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

观察性研究一再将大麻使用与精神病风险增加联系起来。我们试图澄清这种关联是否反映了大麻暴露或残留混淆的因果效应。我们分析了来自两组双胞胎的数据,这些双胞胎在青春期完成了大麻使用(N = 1544)和大麻使用障碍症状(N = 1458)的重复前瞻性测量,并在成年期完成了精神病倾向的维度测量(DSM-5精神病量表的人格清单)。双胞胎还提供了分子遗传数据,用于估计精神分裂症的多基因风险。青少年大麻的累积使用和使用障碍都与成年后较高的精神病得分有关。然而,我们没有发现大麻对精神病或其任何方面的影响的证据,在同卵双胞胎控制模型中,比较大麻使用量较大的双胞胎和较少使用的双胞胎。我们也没有观察到大麻对精神分裂症多基因风险的不同影响的证据。虽然大麻的使用和紊乱一直与精神病风险增加有关,但目前的结果表明,这种联系可能归因于家族混杂,而不是大麻暴露的因果效应。因此,努力减少精神疾病的患病率和负担可能会受益于更多地关注其他治疗目标。(PsycInfo Database Record (c) 2021 APA,版权所有)。
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引用次数: 3
More by stick than by carrot: A reinforcement learning style rooted in the medial frontal cortex in anorexia nervosa. 更多的是大棒而不是胡萝卜:一种根植于厌食症神经的内侧额叶皮层的强化学习方式。
IF 4.6 1区 心理学 Q1 Medicine Pub Date : 2021-10-01 DOI: 10.1037/abn0000690
Fabio Bernardoni, Joseph A King, Daniel Geisler, Franziska Ritschel, Sarah Schwoebel, Andrea M F Reiter, Tanja Endrass, Veit Rössner, Michael N Smolka, Stefan Ehrlich

Anorexia nervosa (AN) is characterized by a relentless pursuit of thinness, despite serious implications for health and social relations. In a previous study wielding the power of computational psychiatry, we found alterations in learning from negative feedback and in neural activity in the posterior medial frontal cortex (pMFC) in young acutely underweight AN patients (acAN). Here we ask whether these abnormalities are merely a state-related consequence of the illness or whether they might constitute a trait marker predisposing individuals to AN. To address this question, we employed the same reinforcement learning paradigm during fMRI with 31 female former AN patients after complete weight-recovery (recAN) and 31 age-matched healthy volunteers (15-28 years). Participants performed a decision task that required adaptation to changing reward contingencies. Data were analyzed within a hierarchical Gaussian filter model, which captures interindividual variability in feedback learning and decision-making under uncertainty. Similar to acute patients, individuals recovered from AN appear to emphasize negative over positive feedback when updating expectations regarding changing reward-punishment contingencies (difference in learning rate between punished and rewarded trials was increased in recAN: p = .006, d = .70. This behavioral pattern was mirrored in hyperactivation of the pMFC following negative feedback (FWE p < .001). Because the previously observed alterations in acANs are also evident after recovery and do not correlate with state variables like weight, altered feedback learning might be a trait marker of AN. The neural underpinnings of these alterations may lie in the pMFC. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

神经性厌食症(AN)的特点是不顾对健康和社会关系的严重影响,坚持不懈地追求苗条。在之前的一项利用计算精神病学的研究中,我们发现急性体重不足的年轻AN患者(acAN)从负反馈中学习和后内侧额叶皮层(pMFC)的神经活动发生了变化。在这里,我们想知道这些异常是否仅仅是疾病的一种状态相关的后果,或者它们是否可能构成一个性状标记,使个体易患AN。为了解决这个问题,我们对31名体重完全恢复(recAN)的女性前AN患者和31名年龄匹配的健康志愿者(15-28岁)在fMRI期间采用了相同的强化学习范式。参与者完成了一项决策任务,该任务需要适应不断变化的奖励偶然性。采用分层高斯滤波模型对数据进行分析,该模型捕捉了不确定条件下反馈学习和决策过程中的个体差异性。与急性患者相似,从AN中恢复过来的个体在更新关于变化的奖惩偶发事件的期望时,似乎更强调消极反馈而不是积极反馈(在recAN中,惩罚和奖励试验之间的学习率差异增加:p = 0.006, d = 0.70)。这种行为模式反映在负反馈后pMFC的过度激活(FWE p < .001)。由于先前观察到的acANs的变化在恢复后也很明显,并且与体重等状态变量无关,因此改变的反馈学习可能是AN的特征标记。这些变化的神经基础可能在于pMFC。(PsycInfo Database Record (c) 2021 APA,版权所有)。
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引用次数: 0
Volatility of subliminal haptic feedback alters the feeling of control in schizophrenia. 阈下触觉反馈的不稳定性改变了精神分裂症患者的控制感。
IF 4.6 1区 心理学 Q1 Medicine Pub Date : 2021-10-01 DOI: 10.1037/abn0000703
François R Foerster, Sébastien Weibel, Patrick Poncelet, André Dufour, Yvonne N Delevoye-Turrell, Antonio Capobianco, Laurent Ott, Anne Giersch

It has been proposed that agency disorders found in schizophrenia rely on aberrant processing of prediction error. Overreactivity to nonpertinent prediction errors may lead to the attribution of one's own actions to an external source. When applied to perception, this could explain hallucinations. However, experiments in motor control or perception have mainly suggested deficient prediction errors. Using a novel approach based on the manipulation of temporal delays, 23 patients with schizophrenia, 18 patients with bipolar disorder, and 22 healthy participants performed a pointing task with a haptic device that provided haptic feedback without or with delays, which were processed consciously (65 ms) or unconsciously (15 ms). The processing of prediction errors was measured via the adaptation of the hand trajectory, that is, the deceleration in anticipation of the surface, and its modulation as a function of recent history (stable or unstable sensory feedback). Agency was evaluated by measuring the participants' feeling of controlling the device. Only patients with schizophrenia reported a decrease in the feeling of control following subliminally delayed haptic feedback and adapted deceleration durations following subliminally delayed haptic feedback. This effect was correlated with positive symptoms. The overreactivity to subliminal delays was present only when delays occurred repeatedly in an unpredictable way, that is, with a volatile distribution. The results suggest that small temporal uncertainties that should be held as negligible, trigger an aberrant overreactivity which could account for hallucinations and alterations of the patients' conscious feeling of control. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

有人提出,精神分裂症患者的代理障碍依赖于对预测误差的异常处理。对不相关的预测错误反应过度可能导致将自己的行为归因于外部因素。当应用于感知时,这可以解释幻觉。然而,在运动控制或感知方面的实验主要表明预测误差不足。采用一种基于时间延迟操纵的新方法,23名精神分裂症患者、18名双相情感障碍患者和22名健康参与者使用触觉装置执行指向任务,该触觉装置提供无延迟或有延迟的触觉反馈,这些触觉反馈被有意识地(65 ms)或无意识地(15 ms)处理。预测误差的处理是通过手轨迹的自适应来测量的,即预期表面的减速,以及它作为最近历史(稳定或不稳定的感官反馈)的函数的调制。通过测量参与者控制设备的感觉来评估代理。只有精神分裂症患者报告了潜意识延迟触觉反馈后控制感的下降和潜意识延迟触觉反馈后适应的减速持续时间。这种效应与阳性症状相关。只有当延迟以不可预测的方式反复发生时,即具有波动性分布时,才会出现对阈下延迟的过度反应。结果表明,时间上的微小不确定性可以忽略不计,却会引发异常的过度反应,从而导致幻觉和患者意识控制感的改变。(PsycInfo Database Record (c) 2021 APA,版权所有)。
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引用次数: 7
Neural responses to reward and pleasant pictures prospectively predict remission from depression. 对奖励和愉快图片的神经反应可以预测抑郁症的缓解。
IF 4.6 1区 心理学 Q1 Medicine Pub Date : 2021-10-01 Epub Date: 2021-09-13 DOI: 10.1037/abn0000696
Julia Klawohn, C J Brush, Greg Hajcak

Reduced neural responses to reward and pleasant stimuli-indicators of anhedonia and reduced emotional reactivity, respectively-have been reported among individuals with depressive disorders. The current study examined whether these neural measures could prospectively predict the course of depression among a community-based sample of 83 participants diagnosed with a depressive disorder. At initial assessment, participants performed both a guessing task to elicit the reward positivity (RewP) and a picture viewing paradigm with neutral and pleasant pictures to measure the late positive potential (LPP)-both event-related brain potentials (ERPs) independently related to diagnosis of depression. After approximately 9 months, 53 of those participants returned to the lab for a clinical assessment of current symptoms and course of disorder during the follow-up period. We found a more intact (i.e., larger) RewP and LPP at baseline among participants who achieved an episode of full remission from depression at any point during the follow-up period. In multiple logistic regression models, the RewP and LPP were both independent predictors of remission status; moreover, the RewP, but not the LPP, remained a significant predictor after accounting for other clinical variables that predicted remission. These data provide initial evidence for the clinical utility of ERPs from reward and picture viewing tasks within depressed individuals to predict disease course prospectively, which could be further leveraged to improve intervention approaches and parse the heterogeneity of depression. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

据报道,在抑郁症患者中,对奖励和愉悦刺激的神经反应减少(分别是快感缺乏和情绪反应减少的指标)。目前的研究考察了这些神经测量是否能在83名被诊断为抑郁症的社区样本中前瞻性地预测抑郁症的病程。在最初的评估中,参与者执行猜测任务以诱发奖励积极性(RewP),并使用中性和愉快的图片观看范式来测量晚期积极电位(LPP)——这两种事件相关脑电位(ERPs)都与抑郁症的诊断独立相关。大约9个月后,这些参与者中的53人回到实验室,在随访期间对当前症状和疾病过程进行临床评估。我们发现,在随访期间的任何时候,在抑郁完全缓解的参与者中,基线时的RewP和LPP更完整(即更大)。在多元logistic回归模型中,RewP和LPP都是缓解状态的独立预测因子;此外,在考虑了其他预测缓解的临床变量后,RewP,而不是LPP,仍然是一个重要的预测因子。这些数据为抑郁症患者奖励和图片观看任务的erp在预测病程方面的临床应用提供了初步证据,可以进一步利用这些数据来改进干预方法和分析抑郁症的异质性。(PsycInfo Database Record (c) 2021 APA,版权所有)。
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引用次数: 11
The dyadic effects of subclinical paranoia on relationship satisfaction in roommate relationships and college adjustment. 亚临床偏执对室友关系满意度和大学适应的双重影响。
IF 4.6 1区 心理学 Q1 Medicine Pub Date : 2021-10-01 Epub Date: 2021-08-16 DOI: 10.1037/abn0000689
Cassi R Springfield, Robert A Ackerman, Amy E Pinkham

Subclinical paranoia is associated with negative psychological and general health consequences including poorer social functioning. Despite extensive research on the outcomes of individuals with greater paranoia, the consequences of interacting with someone who is paranoid are less clear. As social functioning involves interactions between individuals, investigating associations between paranoia and relationship outcomes from a dyadic perspective may aid in elucidating the mechanisms underlying social dysfunction in subclinical paranoia. This study examined the trajectory of new roommate relationships over the course of the college semester. One hundred three same-sex roommate dyads were assessed on pathological personality traits at the beginning of the semester and on roommate relationship satisfaction and college adjustment at 2-week intervals. Individuals who were more paranoid reported lower satisfaction in their roommate relationship and poorer overall college adjustment. Importantly, individuals who lived with a more paranoid roommate also reported lower satisfaction in their roommate relationship. In contrast, elevated psychoticism, in either the individual or their roommate, was not associated with lower roommate relationship satisfaction. These findings demonstrate that the effects of subclinical paranoia extend beyond the paranoid individual to social partners as well. Further, poorer relationship satisfaction appears specifically related to paranoia and does not seem to be associated with increased psychoticism. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

亚临床妄想症与负面的心理和一般健康后果有关,包括较差的社会功能。尽管对偏执狂患者的后果进行了广泛的研究,但与偏执狂患者互动的后果尚不清楚。由于社会功能涉及个体之间的相互作用,从二元视角研究偏执与关系结果之间的联系可能有助于阐明亚临床偏执中社会功能障碍的潜在机制。这项研究考察了大学一学期新室友关系的发展轨迹。本研究在学期开始时对103名同性室友进行病态人格特征评估,并每隔两周对室友关系满意度和大学适应性进行评估。偏执狂越强的人对室友关系的满意度越低,对大学生活的整体适应也越差。重要的是,与偏执狂室友一起生活的人对室友关系的满意度也较低。相比之下,个体或其室友的精神状态升高与较低的室友关系满意度无关。这些发现表明,亚临床偏执狂的影响不仅限于偏执狂个人,还会影响到社会伙伴。此外,较差的关系满意度似乎与偏执狂特别相关,而似乎与精神病的增加无关。(PsycInfo Database Record (c) 2021 APA,版权所有)。
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引用次数: 2
Functional assessment of restrictive eating: A three-study clinically heterogeneous and transdiagnostic investigation. 限制性进食的功能评估:三项临床异质性和跨诊断研究。
IF 4.6 1区 心理学 Q1 Medicine Pub Date : 2021-10-01 DOI: 10.1037/abn0000700
Shirley B Wang, Kathryn R Fox, Chelsea Boccagno, Jill M Hooley, Patrick Mair, Matthew K Nock, Ann F Haynos

Restrictive eating is common and associated with negative psychological outcomes across the life span and eating disorder (ED) severity levels. Little is known about functional processes that maintain restriction, especially outside of narrow diagnostic categories (e.g., anorexia nervosa). Here, we extend research on operant four-function models (identifying automatic negative, automatic positive, social negative, and social positive reinforcement functions) that have previously been applied to nonsuicidal self-injury (NSSI), binge eating, and purging to restricting. We assessed restrictive eating functions in three samples: clinically heterogeneous adolescents (Study 1: N = 457), transdiagnostic adults (Study 2: N = 145), and adults with acute or recently weight-restored anorexia nervosa (Study 3: N = 45). Study 1 indicated the four-function model was a good fit for restricting (root mean square error of approximation [RMSEA] = .06, Tucker-Lewis index [TLI] = .88). This factor structure replicated in Study 2 (comparative fit index [CFI] = .97, RMSEA = .07, TLI = .97, standardized root mean square residual [SRMR] = .09). Unlike NSSI, binge eating, and purging, which have been found to primarily serve automatic negative reinforcement functions, all three present studies found automatic positive reinforcement was most highly endorsed (by up to 85% of participants). In Studies 1 and 3, automatic functions were associated with poorer emotion regulation (ps < .05). In Study 1, social functions were associated with less social support (ps < .001). Across studies, automatic functions were associated with greater restriction ps < .05). Functions varied slightly by ED diagnosis. Across ED presentation, severity, and developmental stage, restrictive eating may be largely maintained by automatic positive reinforcement, with some variability across presentations. Continued examination of restrictive eating functions will establish processes that maintain restriction, allowing more precise treatment targeting for these problematic behaviors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

限制性进食是一种常见现象,与整个生命周期和进食障碍(ED)严重程度的负面心理结果相关。人们对维持限制性饮食的功能过程知之甚少,尤其是在狭隘的诊断类别(如神经性厌食症)之外。在此,我们将操作性四功能模型(识别自动消极、自动积极、社会消极和社会积极强化功能)的研究扩展到限制性进食上,该模型之前曾应用于非自杀性自伤(NSSI)、暴饮暴食和清除。我们在三个样本中评估了限制性进食功能:临床异质性青少年(研究 1:457 人)、跨诊断成人(研究 2:145 人)以及急性或近期体重恢复的神经性厌食症成人(研究 3:45 人)。研究 1 表明,四功能模型非常适合限制(均方根近似误差 [RMSEA] = 0.06,塔克-刘易斯指数 [TLI] = 0.88)。研究 2 复制了这一因子结构(比较拟合指数 [CFI] = 0.97,RMSEA = 0.07,TLI = 0.97,标准化均方根残差 [SRMR] = 0.09)。研究发现,NSSI、暴饮暴食和清食主要起到自动负强化的作用,与之不同的是,目前的三项研究都发现自动正强化的认可度最高(高达 85% 的参与者)。在研究 1 和研究 3 中,自动功能与较差的情绪调节能力有关(PS < 0.05)。在研究 1 中,社会功能与较少的社会支持有关(PS < .001)。在所有研究中,自动功能与更大的限制有关 ps < .05)。功能因 ED 诊断而略有不同。在不同的 ED 表现、严重程度和发育阶段,限制性进食在很大程度上可能是通过自动正强化来维持的,但在不同的表现形式下会有一些差异。对限制性进食功能的继续研究将确定维持限制性进食的过程,从而对这些问题行为进行更精确的针对性治疗。(PsycInfo Database Record (c) 2021 APA,保留所有权利)。
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引用次数: 0
Structural stigma and sexual minority men's depression and suicidality: A multilevel examination of mechanisms and mobility across 48 countries. 结构性耻辱和性少数群体男性抑郁和自杀:对48个国家机制和流动性的多层次检查。
IF 4.6 1区 心理学 Q1 Medicine Pub Date : 2021-10-01 DOI: 10.1037/abn0000693
John E Pachankis, Mark L Hatzenbuehler, Richard Bränström, Axel J Schmidt, Rigmor C Berg, Kai Jonas, Michal Pitoňák, Sladjana Baros, Peter Weatherburn

Sexual minority men are at greater risk of depression and suicidality than heterosexuals. Stigma, the most frequently hypothesized risk factor for this disparity, operates across socioecological levels-structural (e.g., laws), interpersonal (e.g., discrimination), and individual (e.g., self-stigma). Although the literature on stigma and mental health has focused on interpersonal and individual forms of stigma, emerging research has shown that structural stigma is also associated with adverse mental health outcomes. However, there is limited data on whether changes in structural stigma, such as when a stigmatized person moves to a lower stigma context, affect mental health, and on the mechanisms underlying this association. To address these questions, we use data from the 2017/18 European Men-who-have-sex-with-men Internet Survey (n = 123,428), which assessed mental health (i.e., Patient Health Questionnaire) and psychosocial mediators (i.e., sexual orientation concealment, internalized homonegativity, and social isolation). We linked these data to an objective indicator of structural stigma related to sexual orientation-including 15 laws and policies as well as aggregated social attitudes-in respondents' countries of origin (N = 178) and receiving countries (N = 48). Among respondents who still live in their country of birth (N = 106,883), structural stigma was related to depression and suicidality via internalized homonegativity and social isolation. Among respondents who moved from higher-to-lower structural stigma countries (n = 11,831), longer exposure to the lower structural stigma environments of their receiving countries was associated with a significantly: 1) lower risk of depression and suicidality; 2) lower odds of concealment, internalized homonegativity, and social isolation; and 3) smaller indirect effect of structural stigma on mental health through these mediators. This study provides additional evidence that stigma is a sociocultural determinant of mental health. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

性少数男性比异性恋者更容易抑郁和自杀。耻辱感是造成这种差异的最常见的假设风险因素,它在社会生态层面上起作用——结构(如法律)、人际(如歧视)和个人(如自我耻辱感)。尽管关于耻辱和心理健康的文献主要集中在人际和个体形式的耻辱上,但新兴研究表明,结构性耻辱也与不良的心理健康结果有关。然而,关于结构性耻辱感的变化(例如当被耻辱感的人转移到耻辱感较低的环境时)是否会影响心理健康以及这种关联的机制的数据有限。为了解决这些问题,我们使用了2017/18年欧洲男性网络调查(n = 123,428)的数据,该数据评估了心理健康(即患者健康问卷)和心理社会中介(即性取向隐藏、内化同性恋消极情绪和社会孤立)。我们将这些数据与受访者原籍国(N = 178)和接收国(N = 48)与性取向相关的结构性耻辱的客观指标联系起来,包括15项法律和政策以及总体社会态度。在仍然生活在其出生国的受访者中(N = 106,883),结构性耻辱通过内化的同性恋消极和社会孤立与抑郁和自杀有关。在从结构污名较高的国家迁移到结构污名较低的国家的受访者中(n = 11,831),在接收国的结构污名较低的环境中暴露时间越长,其抑郁和自杀风险越低;2)较低的隐蔽性、内化同性负性和社会孤立几率;3)结构性耻感通过这些中介对心理健康的间接影响较小。这项研究提供了额外的证据,表明耻辱是心理健康的社会文化决定因素。(PsycInfo Database Record (c) 2021 APA,版权所有)。
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引用次数: 7
Supplemental Material for Increased Inflammation Predicts Nine-Year Change in Major Depressive Disorder Diagnostic Status 炎症增加的补充材料预测严重抑郁症诊断状态的九年变化
IF 4.6 1区 心理学 Q1 Medicine Pub Date : 2021-09-27 DOI: 10.1037/abn0000716.supp
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引用次数: 0
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Journal of abnormal psychology
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