Psychopathology最新文献

The article traces the hypotheses of the contemporary French psychiatrist Henri Grivois, concerning what he calls nascent psychosis. In a perspective close to descriptive phenomenology, Grivois tries to identify the alteration of subjective experience specific to the first moments of a psychosis. He thus describes the experiences of concernment and centrality as consisting in a disruption of the tacit mechanisms of mimesis and interindividual attunement. Using the common points between Grivois's aim and that of the phenomenological approach, the article puts these two conceptions of first-episode psychosis into dialog, questioning in particular the prereflexive register of experience. The notion of centrality questions the conditions of the constitution of intersubjectivity: it places the question of the bodily and gestural incarnation that founds the relationship to the other at the center of our understanding of psychosis. Grivois's hypotheses and the phenomenology of psychoses together contribute to the questioning of the therapeutic methods employed in the early stages of treatment. Centrality, in particular, questions the limits of verbal descriptions of psychotic experiences and invites us to think about methods that are based more on the anchoring and bodily attunement of the patient and the therapist.

Introduction: Mental health comorbidities such as depression and anxiety are common in epilepsy, especially among people with pharmacoresistant epilepsy who are candidates for epilepsy surgery. The Psychology Task Force of the International League Against Epilepsy advised that psychological interventions should be integrated into comprehensive epilepsy care.

Methods: To better understand the psychological impact of epilepsy and epileptic seizures in epilepsy surgery candidates, we analysed interviews with this subgroup of patients using Karl Jaspers' concept of limit situations, which are characterised by a confrontation with the limits and challenges of life. These are especially chance, randomness, and unpredictability, death and finitude of life, struggle and self-assertion, guilt, failure, and falling short of one's aspirations.

Results: In 43 interviews conducted with 15 people with drug-resistant epilepsy who were candidates for epilepsy surgery, we found that these themes are recurrent and have a large psychosocial impact, which can result in depression and anxiety. For some people, epileptic seizures appear to meet the criteria for traumatic events.

Conclusion: Understanding epilepsy and seizures as existential challenges complements the neurobiological explanations for psychological comorbidities and can help tailor psychological interventions to the specific needs of people with epilepsy, especially those who are candidates for surgical treatment.

Background: The majority of models on obsessive compulsive disorder (OCD) endorse a top-down perspective on the cognitive mechanisms underlying OCD functioning and maintenance, whereas a bottom-up perspective is rarely pursued.

Objectives: The aim of the study was to review the empirical literature on sensory phenomena (SP) and neurodevelopmental antecedents of OCD, which could support the conceptualization of an alternative, bottom-up perspective integrating neurodevelopmental and phenomenological levels of analysis on OCD.

Methods: A systematic review according to PRISMA guidelines was performed in PubMed/MEDLINE, PsycInfo, the Cochrane Library, and Excerpta Medica Database (EMBASE) and focused on SP and "neurodevelopmental antecedents" (operationalized in early risk factors, neuroimaging signs, neurological soft signs, and sensory responsivity). The time interval was from inception up to March 31, 2022.

Results: From the search in electronic databases, 48 studies were retained and reviewed. SP are highly prevalent in OCD patients and overrepresented in comparison with healthy controls. Similarly, OCD patients also present a higher prevalence of early environmental adversities and sensorimotor alterations in terms of neurological soft signs and sensory over-responsivity in the tactile and acoustic domains; additional findings included hypogyrification signs at neuroimaging. Both sensorimotor alterations and SP are associated with tic-related manifestations and poorer insight in OCD patients.

Conclusions: On the ground of established common subjective experience of SP and premorbid neurodevelopmental features, we hypothesized an explanatory model for OCD, which considers the possible pathophysiological role for altered corollary discharge and enhanced error detection in the neurodevelopment of SP and obsessions. SP may represent the subjective experiential resonance of an individual history of persistently inaccurate sensory predictions, whereas accompanying manifestations, such as the obsessive need for order and symmetry, may represent a compensatory attempt to mitigate SP. This neurodevelopmental-phenomenological bottom-up model, describing a dimensional gradient of sensorimotor alterations and related subjective experiences, may contribute to explain the dimensional affinity between OCD and schizophrenia spectrum disorders. Furthermore, this model could be useful for the early detection of subjects at higher risk of OCD.

Introduction: The aim of this study was to examine whether (a) cyberbullying has unique associations with mental health problems, risk-taking, and self-harm behavior in victims and perpetrators when compared to school bullying and (b) if cyberbullying is associated with an additional burden for students already involved in school bullying.

Methods: Data were collected from 6,561 students across 23 schools in Germany (grades 5-13). The sample was divided into the following four groups: cyber-only involvement (victims = 1.9%, perpetrators = 0.6%), school-only involvement (victims = 17.2%, perpetrators = 11.9%), dual involvement (victims = 5.7%, perpetrators = 2.9%), and noninvolvement (victims = 75.3%, perpetrators = 84.6%). Multilevel mixed-effects regression analysis was conducted to examine group differences in mental health (Strengths and Difficulties Questionnaire, KIDSCREEN-10), risk-taking, and self-harm behavior (e.g., substance use, suicide attempts).

Results: Cyber-only bullying had unique associations with mental health problems and risk-taking behavior in victims (lower levels of peer relationship problems: p < 0.001, greater substance use: p < 0.05) and perpetrators (higher levels of peer relationship problems: p < 0.05) when compared to school-only bullying. Dual victims and perpetrators reported significantly more mental health problems (victims: χ2(5) = 221.58, p < 0.001; perpetrators: χ2(5) = 116.40, p < 0.001) and were more likely to report risk-taking and self-harm behavior (victims: χ2(7) = 115.15, p < 0.001; perpetrators: χ2(7) = 38.79, p < 0.001) than students involved in school-only bullying.

Conclusion: Cyber-only bullying appears to be related to specific mental health issues beyond those associated with school-only bullying. Cyberbullying and school bullying go along with additive mental health problems, risk-taking, and self-harm behavior in both victims and perpetrators. Thus, bullying prevention and intervention programs should also target cyberbullying.

Introduction: Research has shown that people with mental illnesses (PMI) are found to show poorer lifestyle than the general population. Yet, the effect of their psychiatric symptoms in the association between gender difference, health-promoting behaviors, and quality of life have received little attention. The present study examined the association between symptom severity, health-promoting behaviors, and quality of life among PMI in Hong Kong. Gender difference on the association between these variables was also examined.

Method: A cross-sectional survey was conducted among 591 individuals with DSM-IV-TR Axis 1 diagnosis recruited from the community.

Results: Results from MANOVA showed that PMI with more severe psychiatric symptoms engaged in a significantly lower level of health-promoting behaviors and reported a lower level of quality of life. Results from structural equation modeling showed that health-promoting behaviors mediated the association between psychiatric symptoms and quality of life. Multigroup analyses showed that the association between psychiatric symptoms and health-promoting behaviors was stronger among female participants, while the association between health-promoting behaviors and quality of life was stronger among male participants.

Discussion/conclusion: Despite clear evidence suggesting symptom severity to be negatively correlated with quality of life, the underlying mechanism has been less clear. There is a need to promote health-promoting behaviors in order to improve the quality of life of PMI. Gender-specific interventions are warranted.

Borderline personality disorder (BPD) is a complex condition marked by heterogeneity. People with BPD have a profusion of symptoms spread across various levels of lived experience, such as identity, affectivity, and interpersonal relationships. Researchers and clinicians have often resorted to the structuring concept of Self to organize the fragmentation of their experience at the identity level. Notably, using the concept of the narrative self, Fuchs proposed to interpret BPD as a fragmentation of narrative identity. This interpretation of BPD, widely shared, has been challenged by Gold and Kyratsous, who have proposed a complementary understanding of the self through the idea of agency, and to which Schmidt and Fuchs in turn have countered. This article proposes to contribute to this discussion from a phenomenological perspective. First, we will briefly review the discussions around narrative interpretation of BPD. From the problems left unresolved by the discussion, we will then justify the necessity to proceed with a stratification of the self from a phenomenology method. Third, from the thought of the Hungarian phenomenologist László Tengelyi, we will continue with an archaeology of the self, in three layers - self-institution, self-formation, and minimal self - integrating Schmidt and Fuchs' concepts of self, in addition to those of Gold and Kyratsous, but also, to a lesser extent, those of Dan Zahavi. Finally, we will proceed with a phenomenological reconfiguration of the experiences and manifestations associated with the identity axis of BPD.

Introduction: We investigated the longitudinal course of self-, other-, and dual-harm in adolescents, focusing on the infliction of physical injury on oneself, another person, or both parties, respectively. We examined the within-person transitions between these types of harm and whether relationships with peers and teachers predict individual harm trajectories.

Methods: We used community-representative longitudinal data (N = 1,482; 52% male; 50% both parents born abroad). The participants self-reported self- and other-harm at 13, 15, 17, and 20 years. We assigned them to groups with self-, other-, dual- or no harm at specific assessments. Bullying victimization and relationship quality with classmates and teachers were assessed at 13 and 17. We estimated transition probabilities between the harm groups using latent Markov chain models.

Results: At age 13, 3% of the sample engaged in dual-harm, 10% in self-harm only, and 7% in other-harm only. These percentages decreased in late adolescence. Initial dual-harm was often followed by sex-specific single-harm: most of the female participants transitioned to self-harm, and male participants to other-harm. Those in the initial dual-harm group were less likely to stop harming than those in the initial single-harm groups (p < 0.05). Adverse relationship experiences generally predicted harm. A positive teacher-student bond was associated with the cessation of single-harm.

Conclusion: Single- and dual-harm in the form of physical injury typically emerge by mid-adolescence. After this point, adolescents commonly maintain harm, especially those who have presented with dual-harm. Helping adolescents cope with adverse relationship experiences and creating opportunities for positive relationship experiences could address these harmful behaviors.

Informal caregivers of individuals affected by psychotic disorder can play a key role in the recovery process. However, little research has been conducted on the lived experiences of carers and family members. We conducted a bottom-up (from lived experience to theory) review of first-person accounts, co-written between academics and experts by experience, to identify key experiential themes. First-person accounts of carers, relatives, and individuals with psychosis were screened and discussed in collaborative workshops involving individuals with lived experiences of psychosis, family members, and carers, representing various organizations. The lived experiences of family members and carers were characterized by experiential themes related to dealing with the unexpected news, the search for a reason behind the disorder, living with difficult and negative emotions, dealing with loss, feeling lost in fragmented healthcare systems, feeling invisible and wanting to be active partners in care, struggling to communicate with the affected person, fighting stigma and isolation, dealing with an uncertain future, and learning from one's mistakes and building resilience and hope. Our findings bring forth the voices of relatives and informal carers of people with psychosis, by highlighting some of the common themes of their lived experiences from the time of the initial diagnosis and throughout the different clinical stages of the disorder. Informal carers are key stakeholders who can play a strategic role, and their contributions in the recovery process merit recognition and active support by mental health professionals.

Introduction: Despite the similarities in poor social competence and clinical manifestations of poor social behavior, no study has compared the theory of mind performance between social anxiety disorder (SAD) and schizophrenia, considering the effect of social-evaluative anxiety and neurocognitive functions. In our study, we aimed to compare the theory of mind functions and social-evaluative anxiety between patients with SAD and schizophrenia and healthy controls and to examine the relationship between the theory of mind, neurocognitive skills, and social-evaluative anxiety.

Methods: Thirty-four consecutive patients with schizophrenia, 29 patients with SAD, and 30 controls matched by age, education level, and sex were enrolled in the study. Structured Clinical Interview for DSM, Beck Depression Inventory, Liebowitz Social Anxiety Scale, Theory of Mind measures (Reading the Mind in the Eyes Test, Hinting Task, Faux Pas Test), Social Appearance Anxiety Scale, Fear of Positive Evaluation Scale, Fear of Negative Evaluation Scale-Short Form, and neuropsychological tests were administered to all participants.

Results: A greater significant deterioration in theory of mind and neurocognitive functions was found in patients with schizophrenia compared to those with SAD and healthy controls. Social evaluation anxiety was highest in patients with SAD. Although social-evaluative anxiety was associated with the theory of mind function in schizophrenia, only fear of positive evaluation was associated with SAD. In all groups, neither theory of mind nor neurocognitive ability measures were correlated with social anxiety levels and related symptoms.

Conclusions: The impaired theory of mind functioning detected in our study is more prominent in the schizophrenia group and largely independent of anxiety in schizophrenia and SAD. Although social evaluation anxiety, as a transdiagnostic concept, seems to be independent of theory of mind function in general, fear of positive evaluation seems to be associated with hinting in both disorders.