Bulletin of the Menninger Clinic最新文献

Although much is known about how intrusive thoughts become obsessions, the factors that determine which particular thoughts do so is not. The degree to which intrusions are personally significant may be such a determinant. Obsessive-compulsive disorder (OCD) is heterogeneous; thus, it is possible that contradictions of personal values may play a varying role in the development of obsessions depending on which OCD symptoms manifest and may change differentially following treatment. Archival data were examined. Patients with a diagnosis of OCD (N = 62) reported their most upsetting obsession and the degree to which it violated values both pre- and postparticipation in group cognitive-behavioral therapy for OCD. At pretreatment, contradiction ratings differed across symptom domains, such that participants with primary symptoms of obsessions/checking exhibited contradiction ratings that were significantly greater than did participants with other primary symptoms. Contradiction ratings did not change posttreatment. Implications for the conceptualization of OCD are discussed.

This study evaluated COVID-19-related intrusive thoughts and associated ritualistic behaviors (CITRB). From March to May 2020, 1,118 Chinese high school students, college students, psychiatric outpatients, and community members completed a survey assessing CITRB, generalized anxiety, depression, somatization, obsessive-compulsive symptoms, and pandemic-related disruptions. Overall, participants reported mild to moderate CITRB, although certain thoughts/behaviors were more frequently endorsed, such as repeatedly telling others to take precautions against COVID-19 and checking COVID-19-related news. Being male, younger, a health-care worker, or in isolation/quarantine was associated with CITRB severity in community members. Obsessive-compulsive symptom severity, depression, somatic symptoms, and anxiety were associated with CITRB severity, although only obsessive-compulsive symptoms were uniquely associated with CITRB. This study provided evidence for the construct of CITRB, which may help mental health providers identify the nature and sources of COVID-19-related distress for some individuals as well as serve as a framework for evaluating obsessive-compulsive symptoms specific to large-scale crises.

Individual cognitive-behavioral therapy (CBT) is the recommended first-line psychological treatment for young people with obsessive-compulsive disorder (OCD), with good outcomes. However, because some young people only partially respond to CBT, it is necessary to improve treatment outcomes. This is the first study to explore the acceptability and satisfaction of a new multifamily therapy (MFT). Three groups were attended by 16 young people with OCD, their parents, and siblings. Parents and young people completed questionnaires and focus groups. Thematic analysis was applied to transcripts of focus groups. The majority of young people and parents (93.9%) were satisfied or very satisfied. Thematic analysis identified benefits, including increased understanding of OCD, support from the group, and a feeling of not being alone. Further research is required to establish the group's effectiveness on OCD symptom severity and to identify the factors that MFT addresses. MFT shows promise as an acceptable and satisfactory treatment.

School-based instruction and services can effectively support both reproductive and mental health for youth, complementing family and community efforts. Though favored by a large majority of families, school-based sex education can engender controversy, and recently, mental health advocates have begun to face similar challenges around topics such as social-emotional learning and school-based counseling services. This article provides an overview of the emerging trend of opposition to school-based mental health instruction and services, which shares many similarities with opposition to sexual health instruction. In light of these trends, cross-sectoral partnerships in support of health education become all the more crucial. Additionally, the mental health community can benefit from lessons learned by sex education advocates.

Multiple studies have demonstrated a relationship between risk factors for sexually transmitted infections (STIs) and mental health needs. This "syndemic" phenomenon suggests that while many patients with mental health conditions are at higher risk for STI acquisition, the relationship also works in the opposite direction: Patients diagnosed with STIs are more likely to have mental health issues. The purposes of this review article are to examine the overlap between mental health and STIs, to provide mental health providers the tools to identify individuals with behavioral health concerns who may be at increased risk for STI acquisition, to discuss how STI diagnosis can affect mental health, and to review interventions to mitigate these risks, such as cognitive-behavioral therapy and motivational interviewing-based behavioral interventions. Integrating primary health care and mental health care for sexual health needs may also help improve delivery of both of these services.

We present a model of disgust-induced avoidant processing of autobiographical memories contributing to the persistence of psychopathology. Following the model, autobiographical memory retrieval is biased toward disgust-related experiences. Critically, disgust promotes the avoidance of specific autobiographical memories by reactively aborting the processing of those memories or by strategically preventing access to them, making disgust appraisals immune to corrective information. In the context of eating disorders/body image, studies provided consistent evidence for a bias toward disgust-related memories of their own body in women with a more negative body image. Although the current research casts doubt on disgust-induced strategic avoidant retrieval of body-related memories, it provided initial evidence for reactive avoidance of such memories. Insight into the role of disgust-induced avoidant memory processing as a transdiagnostic mechanism may help in understanding the refractoriness of disgust-relevant psychopathologies (including depressive and trauma-related disorders) and point to the necessity of therapeutic strategies to address disgust-induced avoidance.

While clinical research on disgust relies on nonclinical research, the framework of disgust as an immune mechanism is not as central in clinical research. The immune framework for disgust may be integrated into clinical research by acknowledging the role of the self as the critical element protected by the immune system. In this review, we offer the premise that at the center of all disgust-related behaviors, thoughts, and cognitions is an attempt to protect the self (i.e., "disgust is self-centered" or DISC). We offer evidence in support of DISC and explore the relevance of DISC to clinical research for several disgust-related psychopathologies (obsessive-compulsive disorder, posttraumatic stress disorder, anorexia nervosa, and self-disgust). We then offer future directions for DISC research into disgust-related psychopathologies.