Psychopathology最新文献

There are indications for a raise in embitterment during the COVID-19 pandemic. As embitterment is related to felt social exclusion, pessimism, and a proneness toward COVID-19-related conspiracy beliefs, embitterment may be a key factor to consider in the current pandemic. However, perceived social support (PSS), which is associated with hope during the COVID-19 pandemic could serve as an important resilience factor for bitterness. We therefore investigated the effects of PSS on embitterment in aftermath of the second wave of the COVID-19 pandemic. 52 individuals participated in our follow-up online study in October 2020 (T1) and May 2021 (T2). Embitterment (measured with the Berne Embitterment Inventory) and PSS were repeatedly assessed at T1 and T2. A double moderation analysis was conducted, using the PROCESS macro to examine the effects of embitterment, PSS, and age on embitterment 6 months later. The results suggest that the prediction of embitterment at T2 by embitterment at T1 was altered by changes in PSS. Here, in particular participants with high embitterment at T1 and a gain in PSS had higher embitterment scores at T2, whereas participants with low embitterment were found to have lower embitterment scores. This interaction effect was further influenced by the age of the participants, where the effects were more pronounced among middle-aged participants than younger participants. As embittered individuals seem to grow in bitterness with a gain in PSS, support is found for the notion that embittered individuals seeking allies supporting their mindset.

Introduction: The fear of scrutiny central in social anxiety disorder (SAD) points to a problem of the interpersonally perceivable body. Whereas the predominant cognitive-behavioral (CBT) account of the disorder understands this as a problem of excessive self-focused attention, the phenomenological literature reveals it as a sign of a fundamental transformation of body experience. The lived body absent from experience becomes the object body at the forefront of it. The present paper contributes to this literature by refining and grounding these notions in first-person descriptions of concrete experiences of social anxiety.

Method: Repeated interviews were conducted with eight informants struggling with social anxiety and collected personal diaries. The interviews were informed by phenomenological concepts and a specific line of inquiry on body experiences. The analysis tested iteratively a set of phenomenologically grounded hypotheses of altered body experience against the first-person descriptions.

Results: A concept of bodily instrumentalization is developed which accounts for the tendency of self-directed attention and behavior central to the disorder. That is, the socially anxious patient experiences their body as entrapped by the Other and thus unable to act freely among them. This felt bodily self-enslavement for the Other shows itself in efforts to conceal the body from the others and to puppeteer it for them.

Discussion: The notion of bodily enslavement captures a central aspect of the suffering experienced by patients with SAD that exceeds the capability of the CBT language. Additionally, the social nature of the bodily instrumentalization that is constitutive of this suffering means that psychotherapy should not treat SAD as a cognitive disorder, but rather as an interpersonal disorder. Specifically, psychotherapy should offer patients shared interpersonal experiences in which they forget their bodily presence.

Introduction: Embitterment may occur after stressful but normal life events, such as job loss, divorce, or unjust events. Embitterment is a normal affect, but it may become clinically relevant in case it becomes very strong and long-lasting, and impairs daily functioning.

Objective: Until now, no epidemiological data on the frequency of high embitterment in the general population have been available.

Methods: A national representative survey of 2,531 people was carried out in Germany in 2019. The participants gave ratings for their embitterment due to perceived events (Posttraumatic Embitterment Scale), their psychological capacity profile (Mini-ICF-APP-S), sick leave duration, and sociodemographics.

Results: About 11.7% of the investigated representative population report moderate embitterment, and another 3.8% high embitterment. Embitterment was only low correlated with other psychopathology, here work anxiety (r = 0.281**). There are no differences between embittered and nonembittered in respect to age, sex, household members, and professional distribution. Those with the highest embitterment have been unemployed more often and have lower income. At least 7.2% of those with high embitterment have a severe psychological capacity impairment and are in need of support by thirds to fulfill daily duties. In 55% of the 802 who reported a stressful event, injustice by an important person has been reported. Injustice by an institution (14%) or societal injustice (12%) was least often reported as a relevant stressful event.

Conclusion: Physicians, therapists, and public health must be aware of embitterment as a specific mental health problem which occurs frequently and may become chronic with work and life participation problems.

Objective: The current study explored the role of maternal depressive symptoms in the intergenerational transmission of childhood maltreatment and developmental psychopathology. Based on the sensitive window hypothesis, the effects of earlier versus later maternal depression symptoms on child development were analysed.

Method: Ninety-nine mother-child dyads, 65% of which had high-risk teenage mothers, participated in a longitudinal study with three assessments in the first 18 months of the child's life (T1-T3) and a 4th reassessment (T4) at the child's preschool age. Using serial mediation analyses, we tested whether the relationship between the mother's own maltreatment history (Childhood Experience of Care and Abuse Questionnaire) and the child's psychopathological outcome at preschool age was mediated in a causal effect chain by maternal depression in the first 2 years of life, by current maternal depression (Beck Depression Inventory-II) and by current maternal child abuse potential (Child Abuse Potential Inventory). The children's emotional problems and externalizing symptoms were assessed at preschool age by parent or teacher Strengths and Difficulties Questionnaire ratings.

Results: The results indicated that especially later maternal depression mediated the relationship between maternal childhood maltreatment and negative developmental outcomes in the next generation. The effects of maltreatment type on maternal depression were rather nonspecific. However, mental abuse affected existing risk factors more directly over time compared to physical and sexual abuse. Additionally, the impact of early life maltreatment and maternal depression on child psychopathology varied by rater. The pathway to externalizing symptoms was significant only in teacher ratings and for the pathway to emotional problems only in maternal ratings.

Conclusions: The present findings suggest that early maternal depression followed by ongoing maternal depression plays a mediating role in the intergenerational cycle of maltreatment. Therefore, in the future, interventions should be offered at an early stage, but also extend well beyond the first 2 years of a child's life, addressing maternal depression and trauma.

Considering the growing sense of ambivalence about the merits of the DSM, the time seems right for the re-evaluation of nosological attempts and efforts in the pre-DSM era. One example of these attempts is the CHAM system developed by the Dutch psychiatrist R.M. Silbermann (1932-1976). This system is intended as a simple classification with 20 "psychiatric states," which are classified based on the presence of one of 12 hierarchically arranged core symptoms or key characteristics, while all "hierarchically higher" symptoms are excluded without inference about the "hierarchically lower" symptoms. Its scientific evidence is, as yet, insufficiently substantiated. However, disqualifying the CHAM system as an outdated Dutch folklore is like throwing out the baby with the bathwater. The CHAM system emerges as clinically straightforward, didactically fruitful, and consistent with more modern initiatives in descriptive psychopathology. Studying pre-DSM attempts such as Silbermann's CHAM system can stimulate psychopathological thinking and serve as a source of inspiration for future phenomenological research in psychiatry.

Introduction: Research has consistently demonstrated that the COVID-19 pandemic, and resulting sudden shift to online learning (OL), had detrimental impacts on the motivation and mental health of university students. To date however this research has been cross-sectional and quantitative.

Method: This study employed a mixed-methods design to examine the experiences of students at a large national Australian University both at the outset of the pandemic in 2020 (n = 824) and again 6 months later (n = 254) at the conclusion of their academic year.

Results: Key findings from this study highlighted that despite quantitative findings suggesting poorer attitudes toward learning during the pandemic, qualitatively students perceived both positives and negatives to studying online. The qualitative results further highlighted that this experience was not the same for all and suggests the need to reconsider the standard approaches to offering support for students.

Conclusion: Students reported poor mental health in both time points, but outlined avenues which improved not only their mental health but also their motivation for studying such as increased peer engagement and self-care activities. Students reported that OL negatively impacted on both their engagement with studies and their mental health, highlighting the need for universities to prioritize supporting their students' mental health as much as their development of academic skills.

Introduction: Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) share overlapping symptomatology, particularly with regard to social impairments (including peer relationship difficulties), and they frequently co-occur. However, the nature of their co-occurrence remains unclear. Therefore, the current study aimed to examine the nature of the transdiagnostic link between ASD and ADHD from a symptomatological point of view measured with the Autism Diagnostic Observation Schedule (ADOS Module 3) and the Autism Diagnostic Interview-Revised (ADI-R).

Methods: We analyzed the social and nonsocial ASD symptom domain scores from both diagnostic instruments in 4 clinically referred groups (i.e., ASD, ADHD, ASD + ADHD, and no psychiatric diagnosis) without other co-occurring mental disorders using a two-by-two full-factorial MANOVA design with the factors ASD (yes/no) and ADHD (yes/no).

Results: We found no ASD by ADHD interaction effects across all symptom domain scores of ADOS and ADI-R, except for ADOS imagination/creativity. There were only main effects of the factor ASD but no main effects of ADHD. Follow-up contrasts showed that exclusively, ASD had an impact on the measured symptomatology in case of co-occurring ASD + ADHD.

Conclusion: Overall, the results support an additive model of the symptomatology across areas of communication, social interaction, and stereotyped behaviors and restricted interests in case of the co-occurrence of ASD and ADHD when assessed with ADOS/ADI-R. Thus, one can assume that the phenotypic overlap of ASD + ADHD may be less complicated than suspected - at least with regard to ASD symptomatology - and that in the presence of ADHD, ASD symptomatology is generally well measurable with best-practice diagnostic instruments.

This paper sheds light on some aspects of what contemporary clinical theory calls "borderline" condition providing a description of a key figure of late-modern culture that I will call Homo dissipans (from Latin dissipatio, -onis = scattering, dispersion). Homo dissipans is the opposite of Homo œconomicus, the form that "narcissism" takes on in contemporary "achievement society," solely concerned with rational action aimed to utility and production. In order to define Homo dissipans, I follow French philosopher, anthropologist, and novelist Georges Bataille's descriptions of two core phenomena: "excess" and "expenditure." The former can be defined as a surplus of energy that according to Bataille characterizes human existence, animated by a general movement of exudation and dilapidation and an inexhaustible drive to "pour out" of oneself, especially outside the limits of composure and reasonableness. The latter is an ethical attitude which gives its approval to excess and to its metamorphic and destructive power. The Homo dissipans' credo is to profitlessly dissipate the surplus of energy, escape into a world of pure intensities in which all forms - including identity - dissolve and surrender themselves to transformation. I argue that Bataille's ideas about "dissipation" can help us reconsider two features attributed to borderline personality disorder which have been extensively described and sometimes stigmatized - "identity diffusion" and "stable instability" - and to better recognize, understand, and make sense of their phenomenology in the clinical context.

Introduction: Individuals with schizotypy can experience a number of cognitive biases that may increase their risk in developing schizophrenia-spectrum psychopathology. However, cognitive biases are also present in mood and anxiety disorders, and it is currently unclear which biases are specific to schizotypy and which may be a result of comorbid depression and/or anxiety.

Methods: 462 participants completed measures of depression, anxiety, cognitive biases, cognitive schemas, and schizotypy. Correlation analyses were conducted to examine the relationship between these constructs. Three hierarchical regression analyses were conducted to examine if schizotypy, depression, and anxiety explained a statistically significant amount of variance in cognitive biases after controlling for depression and anxiety, schizotypy and anxiety, and schizotypy and depression, respectively. Moderated regression analyses were also conducted to investigate the moderating role of biological sex and ethnicity in the association between cognitive biases and schizotypy.

Results: Self-referential processing, belief inflexibility, and attention for threat were associated with schizotypy. The belief inflexibility bias and social cognition problems were specifically associated with schizotypy after controlling for depression and anxiety and were not directly associated with either depression or anxiety. These associations were not moderated by biological sex or ethnicity.

Conclusion: The belief inflexibility bias may be an important cognitive bias underlying schizotypal personality, and further research will be important to determine whether this bias is also associated with an increased likelihood of transitioning to psychosis.

The progressively improving understanding of the borderline personality disorder (BPD) has led to an increased interest in the better clarification of the integrated role of biological and psychosocial factors in the underlying pathophysiology of this condition. The influence of early childhood interactions and stress exposure in shaping our personalities during adulthood cannot be emphasized enough. In this review, we discuss the critical role of parenting-related factors including maladaptive parenting, parenting styles, and parenting psychopathology as early childhood influences in the developmental psychopathology of BPD. Protective factors that may impact the development of this disorder and possible preventive interventions are also briefly reviewed.