Psychiatric Quarterly最新文献

Major depressive disorder (MDD) patients' personality traits and illness representations are linked to MDD severity. However, the associations between personality and illness representations in MDD and the mediating role of illness representations between personality and MDD severity have not been investigated. This study aimed to prospectively investigate the aforementioned associations and the possible mediating role of illness representations between personality and MDD severity. One hundred twenty-five patients with a MDD diagnosis, aged 48.18 ± 13.92 (84% females), participated in the study. Personality traits were measured with the Traits Personality Questionnaire at baseline. Illness representations were measured with the Illness Perception Questionnaire-Mental Health about five months later (mean = 5.08 ± 1.14 months). MDD severity was measured about 10 months after the baseline assessment (mean = 9.53 ± 2.36 months) with the Beck Depression Inventory. SPSS 29 and AMOS 27 were used to conduct correlational and parallel mediation analyses. According to the results, Neuroticism was positively and Extraversion was negatively linked to MDD severity. Negative MDD impact representations fully mediated these associations. Neuroticism and Extraversion are linked to future MDD severity through patients' representations of MDD's impact. Restructuring maladaptive representations about MDD's impact can be a promising way to reduce symptom severity in patients with high Neuroticism and low Extraversion levels.

Background: Military veterans often encounter multiple obstacles to mental health care, such as stigma, practical barriers (e.g., high cost), and negative beliefs about mental health care. To date, however, nationally representative data on the prevalence and key correlates of these barriers to care are lacking. Such data are critical to informing population-based efforts to reduce barriers and promote engagement in mental health treatment in this population.

Methods: Data were analyzed from the National Health and Resilience in Veterans Study, which surveyed 4,069 US veterans, 531 (weighted 15.0%) of whom screened positive for a mental disorder but never received mental health treatment. Multivariable logistic regression and relative importance analyses were conducted to identify key predisposing, enabling, and need-based factors associated with endorsement of stigma, instrumental barriers, and negative beliefs about mental health care.

Results: A total 47.1% of veterans endorsed any barrier to care, with 38.7% endorsing instrumental barriers to care, 28.8% perceived stigma, and 22.0% negative beliefs about mental health care. Lower purpose in life, grit, and received social support were most consistently associated with these barriers to care.

Conclusions: Nearly half of US veterans with psychiatric need and no history of mental health treatment report barriers to care. Modifiable characteristics such as a low purpose in life, grit, and received support were associated with endorsement of these barriers. Results may help inform resource allocation, as well as prevention, psychoeducation, and treatment efforts to help reduce barriers and promote engagement with mental health services in this population.

COPD is one of the leading causes of death in the United States and results in increased healthcare costs and disability. Smoking is the main determinant of COPD development and continued use increases mortality as compared to those who have stopped smoking. Research has indicated that cigarette smoking may play a role in attempts to regulate distressing emotional experiences and thus, may be an important transdiagnostic process underlying continued smoking behavior among adults with COPD. The current study investigated the role of ER difficulties in relation to smoking status and cigarettes smoked per day among adults with COPD. This cross-sectional study included a sample was adults with COPD (N = 320). Participants self-reported current smoking status, daily smoking, and the Difficulties in Emotion Regulation Scale. All analyses were adjusted for age, sex, probable depression, probable anxiety, and dyspnea severity. DERS total scores were associated with greater odds of current smoking. With the exception of impulsivity, all other dimensions of emotion regulation were significantly associated with current smoking. Greater difficulties in emotional awareness were associated with greater cigarettes smoked per day. However, neither the DERS total score nor any other dimensions of emotional regulation were significantly associated with cigarettes smoked per day. The present study provides preliminary data linking ER difficulties to smoking behavior among adults with COPD. If corroborated by future research, these findings suggest that ER might be a potential target for smoking cessation programs among adults with COPD.

The current paper aimed to investigate the network structure and centrality indexes of hypersensitive narcissism using the hypersensitive Narcissism Scale (HSN). Additionally, we aimed to explore its relationships with dark triad personality aspects. A globally diverse sample of "53,981" participants (47.9% non-United States responders) completed the HSN and Dark Triad Dirty Dozen scale (DTD). We estimated the network structure across genders to determine the core characteristics of hypersensitive narcissism. Additionally, bridge and central nodes (characteristics) were identified. All analyses were performed using R-Studio programming software. The network comparison test indicated significant differences in the network structures between males and females (Network-Invariance: 0.0489, P < 0.01; Global Strength Invariance: 0.101, P < 0.01). In the network of HSN for male participants, characteristics with the highest strength centrality were "Highly affected by criticism" (HSN.2, strength = 1.08) and "Self-absorbed in personal pursuits" (HSN.8, strength = 1.28). For female participants, "Self-absorbed in personal pursuits" (HSN.8, strength = 1.32) and "privately annoyed by others' needs" (HSN.10, strength = 1.21) were the highest central characteristics. The assessment of bridge strength indicated that nodes HSN.2 (Highly sensitive to criticism), scoring 0.42, and DTD.1 (Tendency to manipulate for gain, a component of Machiavellianism), scoring 0.428, showed the highest bridge strength values. The current study identified core characteristics of hypersensitive narcissism and its correlation with dark triad personality, revealing gender-specific patterns and bridging symptoms between the two constructs. These findings showed that focusing on these core characteristics may be advantageous in treating individuals exhibiting elevated levels of narcissism.

This study assessed the relationship between daily life changes and mental health in Korean adolescents during the COVID-19 pandemic. Data from middle and high school students who responded to the relevant survey items the 2021 Korea Youth Risk Behavior Survey were analyzed (n = 53,868). The survey assessed changes in economic status, physical activity, skipping breakfast, drinking, smoking, and mental health, including stress, depression, generalized anxiety disorder, and suicidal ideation, due to the COVID-19 pandemic. The overall prevalence of perceived stress, depression, generalized anxiety disorder, and suicidal ideation was 38.6%, 26.4%, 12.2%, and 12.4%. Adolescents whose economic status worsened due to COVID-19 had a higher risk of perceived stress, depression, generalized anxiety disorder, and suicidal ideation. Changes in physical activity and breakfast consumption due to the COVID-19 pandemic were significantly associated with increases in perceived stress, depression, generalized anxiety disorder, and suicidal ideation. Adolescents who increased their alcohol consumption had the highest risk of perceived stress, depression, generalized anxiety disorder, and suicidal ideation. Changes in economic status and health behaviors caused by the COVID-19 pandemic had a negative effect on the mental health of Korean adolescents. These results can be used to identify adolescents at high risk of developing mental health problems.

School bullying and depression are both serious social and public health problems among adolescents. Prior studies indicated a correlation between bullying and depression. However, the potential moderators remain largely unexplored. This study aimed to identify the mediating effect of Internet addiction and the moderating effect of living in urban or rural areas in the relationship between school bullying victimization and depression symptoms among Chinese adolescents. This cross-sectional study of adolescents was conducted using two-stage random cluster sampling of students in urban and rural public high schools in China. A moderated mediation model was constructed to uncover the underlying mechanism of school bullying victimization and depression symptoms. A total of 2,376 adolescents (52.65% females, mean age ± SD a 14.69 ± 1.76 years) were included in the study. The prevalence of clinical depression symptoms with a cut-off value of 16 on the Center for Epidemiological Studies Depression Scale (CES-D) was 21.76% (95% CI: 20.15, 23.46), and with a cut-off value of 20 on the CES-D was 13.85% (95% CI: 12.51, 15.30) for overall. Our findings indicated a significant positive association between school bullying victimization and depression symptoms (p < 0.01) and a significant mediating effect of Internet addiction in the association between school bullying victimization and depression symptoms (indirect effect = 1.143, 95% CI: 0.677, 1.609; percentage of mediation: 16.7%, 95% CI: 10.3, 23.1). This indirect relationship was partially moderated by the living in urban or rural areas in the mediation process. Specifically, the effect of school bullying victimization on Internet addiction was greater among urban adolescents (simple slope: 0.774, 95% CI: 0.524, 1.024, p < 0.01) than among rural adolescents (simple slope: 0.337, 95% CI: 0.132, 0.543, p < 0.01), but moderating effect of urban-rural areas was not significant on the relationship between Internet addiction and depression symptoms. These findings highlight the mediating role of Internet addiction and the moderating role of living areas in school bullying victimization and adolescents' depression symptoms, which provide evidence for social work, mental health services, and policy interventions for adolescents in China.

Despite the substantial disease burden of anxiety disorders, only limited or conflicting data on prognostic factors is available. Most studies include patients in the secondary healthcare sector thus, the generalizability of findings is limited. The present study examines predictors of symptom reduction and remission in patients with anxiety disorders in a primary care setting. 214 patients with anxiety disorders, recruited as part of the Collabri Flex trial, were included in secondary analyses. Data on potential predictors of anxiety symptoms at 6-month follow-up was collected at baseline, including patient characteristics related to demography, illness, comorbidity, functional level, life quality, and self-efficacy. The outcomes were symptom reduction and remission. Univariate and multivariate linear and logistic regression analyses were conducted to assess the associations between predictor variables and the outcome, and machine-learning methods were also applied. In multiple linear regression analysis, anxiety severity at baseline (β = -6.05, 95% CI = -7.54,-4.56, p < 0.001) and general psychological problems and symptoms of psychopathology (SCL-90-R score) (β = 2.19, 95% CI = 0.24,4.14, p = 0.028) were significantly associated with symptom change at 6 months. Moreover, self-efficacy was associated with the outcome, however no longer significant in the multiple regression model. In multiple logistic regression analysis, anxiety severity at baseline (OR = 0.54, 95% CI = -1.13,-0.12, p = 0.018) was significantly associated with remission at 6 months. There was no predictive performance of the machine-learning models. Our study contributes with information that could be valuable knowledge for managing anxiety disorders in primary care.

Internet gaming disorder (IGD) is multifaceted and can have significant negative consequences. The present study examined the contribution of cognitive, metacognitive, motivational, and emotional factors as predictors for IGD severity. In a cross-sectional study, 703 Iranian adolescents (36.8% females, mean age = 16.98 years [SD = 1.23]) completed an online survey. Hierarchical regression analysis showed that the cognitive, metacognitive, motivational, and emotional factors predicted 7.8%, 17.4%, 1.4%, and 1.9% of the variance in IGD symptoms, respectively. The findings indicated that the cognitive factors including some maladaptive cognitions, such as cognitive salience, regret, and perfectionism, and metacognitive factors including some maladaptive metacognitions (negative metacognitions regarding the uncontrollability of online gaming and negative metacognitions regarding the dangers of online gaming) were significant predictors of IGD severity, highlighting their importance in understanding and predicting problematic gaming behaviors. Although contributing to the variance in IGD, motivational factors (escape, coping, and skill development) and emotional factors including emotion regulation (especially reappraisal) played relatively smaller roles compared to cognitive and metacognitive factors. Of the examined predictive factors, metacognitions were the most important predictor of IGD severity. Exploratory moderator analyses showed significant interactions between three predictors of IGD (reappraisal, negative metacognitions, and cognitive salience) with loneliness, stress, anxiety, and depressive symptoms. Reappraisal was the most frequent predictor and had a significant interaction with these variables. Other predictors independently impacted IGD irrespective of the level of loneliness, stress, anxiety, or depressive symptoms. Based on these findings, special attention to metacognitive, cognitive, emotional, and motivational factors is suggested in the treatment of IGD.

Introduction: The current study aimed to utilize a network perspective to identify the core symptoms of Relationship Obsessive-Compulsive Disorder (ROCD), encompassing both partner-focused and relationship-centered presentations. Additionally, we examined the interaction between ROCD symptoms and personality traits.

Method: 493 participants were included in the current study. The Personality Inventory for DSM-5 - short form (PID-5-SF), NEO Five-Factor Inventory, Partner-Related Obsessive-Compulsive Symptoms Inventory (PROCSI), and Relationship Obsessive-Compulsive Inventory (ROCI) were used to estimate the network structure. Specifically, we computed network structure, bridge expected influence (BEI), and Exploratory Graph Analysis (EGA) for ROCD scales.

Results: In the ROCI network, items 1 and 11 (ROCI.1: "The idea that my affection for my partner is not genuine troubles me," ROCI.7: Thoughts that something is "off" in my relationship significantly disturb me.) emerged as the most important nodes (ROCI.1: Betweenness:1.777, Closeness:1.025, Strength: .872; ROCI.11" Betweenness: 1.097, Closeness:0.457, strength:.699). Additionally, ROCI.7 stands out with significant Betweenness and Expected Influence, emphasizing its importance in facilitating communication and influencing information flow. Conversely, in the PROCI network, item 2 (PROCI.2: "I am constantly questioning whether my partner is deep and intelligent enough") was identified as the most crucial node (Betweenness: 2.568, Closeness: 2.528, Strength: 1.905). Neuroticism is highly influential in the interaction of personality traits with the ROCI scale (BEI: .3781), connecting non-maladaptive traits, while Negative affect, a maladaptive trait, has a significant impact (Bridge Value: .283).

Conclusion: The present study provided a detailed examination of the psychological dynamics within romantic relationships, highlighting key cognitive processes and personality trait.

Procrastination is the deliberate, unjustified postponing of an intended course of action despite its costs or unfavorable effects. The present study used a self-report online survey and collected data from a large convenience sample of the general adult population (N = 2,076; females = 55.73%; M_age = 35.1 years [SD ± 12.7]) with diverse demographics. Following the ring-curve distribution, the results indicated a 15.4% prevalence rate of procrastination among the Iranian community, which was significantly higher among women and divorced individuals and lower among nomadic individuals and those with higher academic degrees. A latent profile analysis demonstrated two distinct profiles, one for procrastinators (high scores on chronic procrastination, psychological distress, neuroticism, and extraversion; and low scores on general self-efficacy, self-esteem, satisfaction with life, openness, agreeableness, and conscientiousness) and one for non-procrastinators (demonstrating a reverse pattern compared to procrastinators). Moreover, additional network analysis suggested that the examined networks were invariant across procrastination status and gender. The results indicate that procrastination differs by demographic characteristics and is associated with a unique psychological profile. However, none of the aforementioned key study variables were considered a potential vulnerability for procrastinators due to the finding that all variables were peripheral and none were central in the examined networks. Therefore, relying on the differences in mean scores on psychometric scales does not appear to be an optimal way of determining the most important variables in a therapeutic context when treating procrastination.