Clinical Neuropsychiatry最新文献

Objective: Research on the psychological impact of the COVID-19 pandemic has pointed out that lockdowns had small effects on the overall mental health, despite considerable heterogeneity among studies is present. Psychological resilience may be responsible for an amount of variance in individual reactions to the pandemic, despite the fact that its longitudinal associations with mental health symptoms remain unclear. This study sought to investigate changes in resilience and its relationships with depression, anxiety, and stress during the COVID-19 pandemic.

Method: A total of 814 participated in this longitudinal study via an online survey during the first lockdown consequent to the COVID-19 pandemic (T1) and during the third wave (T2). The Resilience Scale and the Depression Anxiety Stress Scales - 21 were administered. Sociodemographic data and COVID-19 related information were also collected.

Results: Psychological resilience decreased during the third wave of the pandemic, whereas depression and stress increased. Moreover, psychological resilience had a direct effect only on depression during the third wave, while its effect on anxiety and stress is mediated by the mental health during the first lockdown.

Conclusions: The mental health symptoms worsened during the third wave, while protective factors such as resilience decreased. Individuals showing high resilience experienced lower depression, anxiety, and stress over time. Psychological intervention that enhances resilience should be embraced in the action of health care authorities to reduce the impact of pandemic.

Objective: Online shopping has been described by the scientific literature both for its benefits and the potential risks when excessive usage is involved. Indeed, compulsive online shopping is commonly conceptualized as a potential behavioural addiction that substantially impacts the lives of individuals afflicted by it. In light of this, the present research aimed at exploring the association between possible risk and protective factors for compulsive online shopping, by specifically exploring the role of adult attachment, affect dysregulation, and dissociation.

Method: 285 participants (75% females, 25% males; M_age = 31.57, SD = 11.379) were involved in the research and completed an online survey. The collected data was analysed implementing a path analysis model.

Results: Results showed significant total effects in the relationship between secure/fearful attachment patterns and compulsive online shopping. Such associations were significantly mediated by the sequential effect of affect dysregulation and dissociation.

Conclusions: The present study provides useful information to guide tailored interventions concerning both preventive activity and clinical practice.

Objective: It is known from earlier literature that substance use is associated with diminished executive functioning and decreased quality of life (QoL). The study extended this knowledge by assessing whether selective executive function components would mediate the association between age and QoL domains in young men with substance use disorder and whether family history of substance use would moderate these mediated associations.

Method: A sample of 212 young inpatient men with substance use disorder (105 positive family history and 107 negative family history of substance use disorder) was selected from drug units/wards of government sector hospitals.

Results: The participants with positive family history compared to those with negative family history scored significantly lower on all QoL domains except physical QoL. Mediation analyses revealed that only inhibition but not flexibility mediated the negative association of age with psychological, social, and environmental QoL. Furthermore, family history of substance use moderated all the significant mediated associations with stronger indirect negative associations in participants having a family history of substance use disorder compared to those with no such history.

Conclusions: It is concluded that inhibitory control, which is vulnerable to aging, substance use, and family history of substance use, is an important factor related to QoL in young substance abuser men.

Objective: Transference is a psychological process where feelings and attitudes towards a familiar person are unconsciously redirected to another. This phenomenon can be activated by physical resemblance, including facial features. Despite its potential therapeutic significance, little research has investigated transference processes in individuals with psychiatric conditions. Here, we explored how patients with borderline personality disorder (BPD)-characterized, among other features, by unstable relationships, self-damaging impulsivity, and suicidal ideation-would exhibit transference of negative and positive attributes.

Method: We performed an experiment where BPD participants and a control group with no prior psychiatric history completed a face-rating task. The task involved an evaluation of images of strangers who resembled significant others in terms of facial features.

Results: Our results indicated that transference effects were elicited in both groups. Notably, there were significant differences in ratings assigned to significant others, whereby participants with BPD displayed transference of negative attributes more and positive attributes less intensely than healthy controls, which, in part, correlated with attachment anxiety.

Conclusions: Our findings align with the tendency in BPD to perceive interpersonal relationships and emotions more negatively. They have potential implications for psychotherapeutic approaches in treating patients with BPD and our understanding of underlying pathophysiological mechanisms of BPD itself.

Objective: Resilience is a complex process of adaptation to new conditions that would permit a positive outcome after adversities, traumas or other sources of stress. However, despite the growing interest in this topic, there is no universally accepted definition and no comprehensive bio-behavioural model. This systematic review aims to provide an overview of the main biological models that have been theorized to date, with a focus on new alternative theories to improve our understanding of the mechanisms underlying the development and strengthening of resilience, with potential implications for the prevention of some psychopathological disorders.

Method: This review was conducted according to PRISMA guidelines and includes 185 studies published in English in PubMed and Embase up to December 2023.

Results: Most studies use the stress-related model, which conceptualizes resilience as the absence of symptoms after the stressful event and mainly deal with the differences between stress-prone and resilient phenotypes in animals exposed to stress. However, the results of this search seem to suggest that resilience might be an independent construct with biological bases rooted in the stress system and the social brain, and widely sculptured by individual and environmental factors, especially early life events and affiliation.

Conclusions: This work contributes to ongoing efforts to understand the intricate mechanisms of resilience, while highlighting the potential of improving social relationships since our birth to promote coping strategies towards stress and traumas, and even a peaceful world.

Objective: The negative effects of Problematic Instagram Use (PIU) on self-evaluations of one's appearance (i.e., body-image satisfaction-dissatisfaction) are well-known, whereas less explored is its role on body-image investment dimensions. By adopting the Social Comparison and the Self-discrepancies theories as the framework, the present study hypothesized that PIU negatively affects body investment and appearance management behaviours through the serial mediating role of actual appearance comparison on Instagram (IG) and the need to conceal body flaws. Gender, age and trait appearance comparison were controlled for.

Method: A convenience sample of 323 participants (F = 70.3%; M= 28.92 + 10.96) was recruited, and well-known self-report measures were administered online.

Results: The structural model produced good fit indices [χ2/df = 2.36, RMSEA = 0.065 (0.053 - 0.077), CFI = 0.962, SRMR = 0.038], and the variables accounted for 79% and 32% of the variance in body investment and appearance management behaviours, respectively. PIU was associated with body investment both directly and indirectly, whereas it affected appearance management behaviours only via appearance comparison on Ig. The tested alternative model has a poorer fit than the hypothesized model, and the former fitted significantly worse than the proposed one.

Conclusions: The present study represents a step toward a better understanding of the psychological mechanisms underlying the link between PIU and body image investment dimensions.

Objective: Fear of moral guilt and conseque:nt increased attention to personal actions and intentions are the main ingredients of the self-criticism in patients suffering from obsessive-compulsive disorder (OCD). This pathogenic attitude takes shape in a typical guilt-inducing self-talk.The purpose of this work is to describe in detail a novel cognitive therapeutic procedure for OCD called "Dramatized Socratic Dialogue" (DSD).

Method: DSD is a theory-oriented intervention that combine elements of Socratic dialogue, chairwork, and cognitive acceptance strategies derived from Mancini's model, which posits that obsessive-compulsive (OC) symptoms stem from a fear of deontological guilt.

Results: DSD appears to have many strengths, being a theory-oriented treatment and focusing, as a therapeutic target, on the cognitive structures that determine pathogenic processes and OC symptoms. Furthermore, it is a short, flexible and tailor-made intervention.

Conclusions: Detailed description of the intervention could foster future research perspectives and thus be used in evidence-based effectiveness studies to establish whether DSD reduces OC symptoms and to investigate its mechanism of action.

Objective: Post-traumatic stress disorder (PTSD) is an enduring condition characterized by a chronic course and impairments across several areas. Despite its significance, treatment options remain limited, and remission rates are often low. Ketamine has demonstrated antidepressant properties and appears to be a promising agent in the management of PTSD.

Method: A systematic review was conducted in PubMed/MEDLINE, Cochrane Library, Clinicaltrials.gov, Lilacs, Scopus, and Embase, covering studies published between 2012 and December 2022 to assess the effectiveness of ketamine in the treatment of PTSD. Ten studies, consisting of five RCTs, two crossover trials, and three non-randomized trials, were included in the meta-analysis.

Results: Ketamine demonstrated significant improvements in PCL-5 scores, both 24 hours after the initial infusion and at the endpoint of the treatment course, which varied between 1 to 4 weeks in each study. Notably, the significance of these differences was assessed using the Two Sample T-test with pooled variance and the Two Sample Welch's T-test, revealing a statistically significant effect for ketamine solely at the endpoint of the treatment course (standardized effect size= 0.25; test power 0.9916; 95% CI = 0.57 to 17.02, p=0.0363). It is important to note that high heterogeneity was observed across all analyses.

Conclusions: Our findings suggest that ketamine holds promise as an effective treatment option for PTSD. However, further trials are imperative to establish robust data for this intervention.