Psychopathology最新文献

Introduction: Individuals with borderline personality disorder (BPD) are thought to experience specific biosocial vulnerabilities that give rise to a maladaptive negativity bias in the perception and expression of emotions. However, while this negative bias has been identified in adults with full threshold BPD or high BPD features, it is unclear whether it is evident earlier in the course of the disorder - that being, young persons with first-presentation BPD meeting three or more BPD features, as defined by early intervention models.

Methods: The current study compared patterns of facial responding in individuals aged 15-25 years first presenting to a specialist outpatient service with three or more BPD features (n = 32) to age-matched healthy controls (n = 46). Facial electromyography was used to assess muscle activity associated with positive (zygomaticus major) and negative (corrugator supercilii) expression while participants viewed happy, angry, and neutral facial expressions.

Results: The data revealed that negative facial emotional reactivity for the BPD group did not significantly differ from the control group. However, the results for positive emotional reactivity were more nuanced, indicating that while there was not an overall between-group difference, there might be an effect of time suggestive of a slower positive emotional reaction to happy faces by the BPD group.

Conclusions: These data provide initial evidence that negatively biased emotional expression, when responding with negative facial expressions to neutral, happy, or angry faces, is not evident in young persons first presenting to a specialist outpatient service for treatment of BPD. However, a bias may be demonstrated by what appears to be a slower positive affective response to happy faces. The implications of these findings are discussed, particularly in relation to factors associated with chronicity of illness that might potentially contribute to the development of a more pronounced negativity bias later in the course of the illness. We encourage further examination of negativity biases in the developmental sequelae of BPD via longitudinal design or cross-sectional designs that include BPD participants across the course of illness, as well as further research to explore the possibility that positive affective reactions in this group might not be grossly blunted but rather delayed.

Background: Psychopharmacology is currently plagued by reductionism since it is understood as the treatment of biological and behavioural symptoms of mental disorders without taking into account the subjective life of the self in relation to others. Psychopharmacological interventions, such as antidepressants and antipsychotics, must be situated and discussed within the embodied context of the organism-environment.

Summary: In this paper, we present a framework for understanding the effects of psychopharmacological treatments that move beyond the traditional reductive, biochemical perspective by putting forward an embodied and enactive approach to psychopharmacology that integrates phenomenology, neuroscience, and physiology. This approach explores how medications impact not only symptoms but also patients' lived experiences, existential feelings, and embodied sense of self.

Key messages: Psychotropic drugs interact with the entire lived body, influencing emotional processing, perception, and the embodied self, determining emotional blunting, changing affect, temperamental dispositions, and altering motor function and sensory experience. This fundamentally shapes patients' embodied engagement with their environment, which reciprocally influences the entire embodied system, thereby promoting a more nuanced understanding of treatment effects that account for physiological and experiential dynamics. We emphasize the importance of the clinician as a mediator of embodied change, moving beyond the mere management of symptoms to supporting patients in navigating the complex shifts in self-perception and relationality induced by pharmacotherapy. We advocate for the development of phenomenological profiles of psychopharmacological drugs, as well as tailored, patient-centred psychopharmacological interventions that take into account not only clinical efficacy but also the subjective and embodied changes these treatments induce, and how they interact with the patients' unique phenomenological profiles.

Objective: Borderline personality disorder (BPD) is characterized by instability in self-image, emotions, and relationships. Features such as (auto)aggression, devaluation, and impulsivity indicate proximity to narcissistic traits, especially antagonistic aspects. While its links to grandiose and vulnerable narcissism are established, the role of antagonistic narcissism (AN) remains unclear. This study investigates AN in BPD by comparing female BPD patients with a diagnostically heterogeneous clinical control group without personality disorders and by examining its associations with symptom severity, self-harm, aggression, interpersonal problems, and empathy.

Methods: 51 female BPD patients and 51 clinical control patients completed the Narcissistic Admiration and Rivalry Questionnaire and measures of borderline symptomatology, aggression, interpersonal problems, and empathy. Group comparisons were conducted using analyses of covariance, and Spearman correlations examined relationships between clinical characteristics. Interpersonal tendencies of AN were analyzed via the Structural Summary Method (SSM).

Results: BPD patients showed higher levels of AN compared to the control group (η2 = 0.04), though this difference was only marginally significant (p = 0.050). AN correlated positively with overall aggression (r = 0.34, p < 0.05), particularly verbal aggression (r = 0.43, p < 0.01). SSM analysis positioned AN within the domineering-vindictive quadrant of the interpersonal circumplex, characterized by high dominance and low affiliation. No significant correlation was found with empathy.

Conclusion: Findings suggest a potential elevation of AN in females with BPD and its associations with aggression and interpersonal dysfunction, highlighting the complexity of narcissistic traits in BPD and the need for further research.

Introduction: Misophonia is an increasingly recognized disorder characterized by negative emotional and sensory reactions to specific noises. Although misophonia most often begins in childhood, there has been minimal research on its clinical presentation in youth. This qualitative study explored cognitive behavioral processes that are involved in misophonia and its associated functional impairment in young people and their families.

Methods: Focused interviews were conducted with 20 youth with misophonia (ages 10-17) and their parents. Thematic analyses of these interviews using a cognitive behavioral theoretical framework were conducted.

Results: A number of themes were identified, which included internalizing and externalizing cognitive behavioral processes at the individual level (e.g., hypervigilance, anticipatory anxiety, escape, automatic negative attributions), secondary emotional and functional consequences (e.g., negative perception of self, guilt, anxiety, depression, emotional exhaustion, concentration difficulties at school), as well as significant impacts to school, social life, and particularly to family life (e.g., conflict/tension, anger and resentment, family accommodation). These themes are integrated in a proposed theoretical model.

Discussion: Misophonia is characterized by several transdiagnostic cognitive behavioral processes, including avoidance, maladaptive cognitions, emotional reactivity, and family communication difficulties, as well as significant functional impairment. Developing treatments that target these processes has the potential to help youth overcome misophonia and improve the quality of life of youth and their families.

Background: Cannibalism is a practice based on the assimilation of the enemy, characterized by different ritual phases. The cultural anthropologist Francesco Remotti provides insight into this practice, stating that the Tupinamba tribes - an ethnic group living along the Eastern Atlantic coast of Brazil - use it to demonstrate their superiority over the defeated group. After capturing a prisoner, the assimilation process begins, which prepares the prisoner for the cannibalistic act through a specific sequence of steps.

Summary: Remotti's research on cannibalism is applicable to the world of narcissism. The way a narcissistic individual relates to others is a paradigmatic example of cannibalistic rituals. This study aimed to catch the structural components of the narcissistic relationship, rooted in Remotti's anthropological perspective, and to explore the associated phenomenological and psychopathological characteristics.

Key message: We present a new perspective for understanding the interpersonal relationship characteristic of a narcissistic person, which we have termed "identity cannibalism."

Background: Schizophrenia is a psychiatric disorder that has long been regarded as irreversibly degenerative. However, the recent improvements in treatment and prognosis and the trend towards person-centred care have reversed this fatalistic tendency, and encouraged the development of theoretical and clinical tools to support these people as closely as possible to their concerns.

Summary: In this article, we look at how bibliotherapy, namely care assisted by the reading of literary fictions, might be conceived in relation to the classic psychotherapeutic framework. To circumscribe the definition of this approach for people with schizophrenia, we will refer to the work of Giovanni Stanghellini, and in particular to two of his works: the Phenomenology, Hermeneutics and Psychodynamics model, and his epistemological theory of Images. Thus, we shall see that the clinical particularities of bibliotherapy could assist a person-centred psychotherapy by promoting the unfolding of people's phenomenological experiences, opening them up to other ways of interpreting them, and re-establishing the dialogue between the self and its existence.

Key messages: Bibliotherapy could hence participate in the contemporary movements of clinical hermeneutic phenomenology, medical humanities, and personal recovery.

Introduction: In terms of the risk of developing depressive symptoms, adolescents are a heterogeneous group according to their characteristics and environment. However, the effect of the heterogeneity on depressive symptoms remains unclear. Although the effects of parental psychological control, harsh parenting, and adolescent psychological resilience (as a trait in this article) have been well documented, these factors are generally examined separately, while little is known about their interactive effects on adolescent mental health. The goal of this study was to explore latent profiles of parenting and adolescent psychological resilience and to compare the corresponding levels of depressive symptoms in adolescents.

Methods: Self-reported data from 1,049 adolescents (M_age = 14.2 ± 1.7, N_boy = 432) were used in latent profile analysis to categorize participants based on parental psychological control, harsh parenting, and adolescent psychological resilience. Multinomial logistic regression was employed to examine the associations between latent profiles and adolescent depressive symptoms.

Results: Three distinct profiles emerged, each associated with different levels of adolescent depressive symptoms after adjusting for covariates: supportive and resilient profile (n = 308, 29.4%; reference), struggling and vulnerable profile (n = 463, 44.1%; odds ratio [OR], 2.31; 95% CI, 1.96-2.71), and pressured but adaptive profile (n = 278, 26.5%; OR, 4.44; 95% CI, 3.75-5.25).

Conclusion: Individuals with highest level of depressive symptoms were more likely to be classified into pressured but adaptive profile. Parents should avoid psychological control and harsh parenting in the process of raising children.

Background: The question of the role of personal values in the constitution of and recovery from mental illness is a divisive subject discussed in contemporary psychopathology. This article critically examines the psychopathological theories and contributions of Antoni Kępiński - a seminal yet internationally under-recognized Polish psychiatrist.

Summary: Drawing upon a multilayered framework incorporating biological, affective-emotional, and sociocultural dimensions, Kępiński posited mental disorders as disturbances in the energy and information metabolism with the environment leading to an increase in entropy. Kępiński's work also contributes to a richer understanding of schizophrenia (whose essence he metaphorically described as the plasma membrane rupture) and the complexities inherent in the decision-making processes of patients. In a quasi-phenomenological vein, Kępiński encouraged to re-evaluate delusions and hallucinations as opportunities to access unfiltered insights into reality. He also argued for the potential for moral growth within psychiatric treatment.

Key messages: Kępiński's theories anticipated many concepts now foundational in neuroscientific research and clinical psychiatry, showcasing his role as a forward-thinking figure in the history of the profession.

Background: Mental health problems are highly prevalent among adolescents. This study aimed to investigate the interrelations among depressive, anxiety, and stress-related symptoms in Chinese adolescents using a symptom network approach.

Methods: A cross-sectional survey was conducted in October 2022 in Tianjin, China. Symptoms of depression, anxiety, and stress were assessed using the 21-item Depression Anxiety Stress Scales (DASS-21). Network analysis was employed to examine centrality, stability, and predictability of symptoms. Network Comparison Tests (NCTs) were used to assess structural differences across gender and residential status. In addition, a flow network analysis was performed to identify symptoms most strongly associated with stress.

Results: A total of 660 Chinese adolescents participated in the study. The most central symptom in the network was "feeling down," followed by "palpitations," "nervousness," "agitation," and "difficulty relaxing." Key bridge symptoms included "worrying," "feeling down," "near panic," and "nervousness." NCT results indicated no significant differences in the network structures by gender or residence. In the flow network, "feeling down" demonstrated the strongest direct association with stress.

Conclusion: Specific central and bridge symptoms may play a pivotal role in the onset and maintenance of depression, anxiety, and stress among Chinese adolescents. These findings highlight potential targets for early intervention and prevention efforts in this population.