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What Does It Take to Make an Incel: The Role of Paranoid Thinking, Depression, Anxiety, and Attachment Patterns 怎样才能成为乱伦者?偏执思维、抑郁、焦虑和依恋模式的作用
IF 4.7 2区 医学 Q1 Psychology Pub Date : 2024-06-20 DOI: 10.1155/2024/5512878
Lilybeth Fontanesi, Daniela Marchetti, Giulia Cosi, Erika Limoncin, Emmanuele A. Jannini, Maria Cristina Verrocchio, Giacomo Ciocca

Background. The term “incel” (involuntary celibate) refers to the members of an online subculture, mainly composed of heterosexual men. These individuals find it difficult or impossible to have a romantic and/or sexual partner, and they express extreme anger and resentment toward women, as they hold them accountable for their “inceldom.” In recent years, online and offline acts of violence have been perpetrated by incels, raising concern at social and political levels. This study aims to understand the personal, psychological, and psychopathological variables that may contribute to developing incel traits. Materials and Methods. A total of 800 Italian heterosexual cisgender men were recruited by a link to the survey forwarded on social networks. Participants have completed a sociodemographic questionnaire and a set of psychometric tests to assess incels’ personality traits, attachment patterns, paranoia, anxiety, and depression. Results. Positive correlations among incel personality traits and psychopathological symptoms and insecure attachment were found. Hierarchical regression analysis showed the significant role of paranoid thinking, insecure attachment, depression, and anxiety symptoms in the presence of incels’ personality traits. Conclusion. Therefore, the assessment of these psychopathological aspects could help clinicians, parents, and teachers to early identify young males that can be caught in the inceldom and to develop specific intervention programs to prevent violence.

背景。非自愿独身者"(incel)一词是指一种网络亚文化的成员,主要由异性恋男性组成。这些人认为很难或不可能有恋爱和/或性伴侣,他们对女性表示极度的愤怒和怨恨,因为他们认为女性要对他们的 "不忠 "负责。近年来,"乱伦者 "在网上和网下实施的暴力行为引起了社会和政治层面的关注。本研究旨在了解可能导致 "乱伦者 "特质形成的个人、心理和精神病理学变量。材料与方法。通过在社交网络上转发调查链接,共招募了 800 名意大利同性异性恋男性。参与者完成了一份社会人口调查问卷和一套心理测试,以评估乱伦者的人格特质、依恋模式、偏执、焦虑和抑郁。研究结果结果发现,不伦教徒的人格特质与精神病理症状和不安全依恋之间存在正相关。分层回归分析表明,妄想症、不安全依恋、抑郁和焦虑症状在乱伦者的人格特质中起着重要作用。结论因此,对这些心理病理学方面的评估有助于临床医生、家长和教师及早发现可能陷入不伦恋的年轻男性,并制定具体的干预方案来预防暴力。
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引用次数: 0
The Effects of Various Types of Physical Exercise on Health Outcomes in Older Adults with Depression: A Systematic Review and Meta-Analysis of Controlled Trials 各种体育锻炼对患有抑郁症的老年人健康结果的影响:对照试验的系统回顾和元分析
IF 7.4 2区 医学 Q1 Psychology Pub Date : 2024-06-19 DOI: 10.1155/2024/9363464
Samaher Alowaydhah, Ishanka Weerasekara, Sarah Walmsley, Jodie Marquez

Background and Purpose. The number of older adults and the occurrence of concomitant health issues continue to grow. One of the most prevalent mental health issues in this population is depression. Physical exercise (PE) is widely acknowledged as a method to alleviate the associated health burdens of aging, including depression; however, there is no collated evidence regarding the effectiveness of specific types of exercise on a range of health outcomes. To address this, we conducted a systematic review to evaluate exercise benefits for this specific subgroup. Methods. An electronic search of five databases was used to retrieve controlled studies investigating health-related outcomes associated with any type of PE, in adults over 65 years with depression. Where possible, data were analyzed in meta-analyses or else reported narratively. Results and Discussion. Fifteen studies were included in the review. All 15 studies had data available for meta-analysis, yet heterogeneity in exercise types and outcome measures limited synthesis. When data for all types of exercise were pooled together, significant improvements were found in depression (SMD = 0.52; CI = 0.07, 0.97; p = 0.02), physical health and function (SMD = 0.44, CI = 0.14, 0.74; p = 0.004), anxiety (SMD = 0.23; CI = 0.04, 0.42; p = 0.02), and self-efficacy (SMD = 0.97; CI = 0.32, 1.61; p = 0.003). When data were pooled according to exercise type, positive effects were demonstrated for aerobic exercise on depression (SMD = 0.49; CI = −0.16, 0.8; p = 0.003), tai chi/qigong on depression (SMD = 0.89; CI = −0.14, 1.63; p = 0.02), and self-efficacy (SMD = 6.70; CI = −0.90, 12.50; p = 0.02) and multicomponent exercise demonstrated positive effects on physical function (SMD = 0.49; CI = 0.12, 0.87; p = 0.009) and the physical health component of quality of life (SMD = 0.88; CI = 0.10, 1.65; p = 0.03). No health-related benefits were revealed from the combined findings of the two studies investigating strengthening exercises. Conclusion. Lack of consistency regarding exercise types, dosage, and outcomes presents challenges in the evidence. In general, exercise is beneficial across a range of health-related variables. Multicomponent, aerobic, and tai chi forms of exercise appear most likely to reap benefits in depressed older adults; however, the type of benefit is determined by the type of exercise and should be considered when recommending a regime. This trial is registered with CRD42020173465.

背景和目的。老年人的数量和伴随的健康问题不断增加。在这一人群中,最普遍的心理健康问题之一就是抑郁症。人们普遍认为体育锻炼(PE)是减轻包括抑郁症在内的老龄化带来的相关健康负担的一种方法;然而,关于特定类型的锻炼对一系列健康结果的有效性,目前还没有经过整理的证据。针对这一问题,我们进行了一项系统性研究,以评估运动对这一特定亚群体的益处。研究方法我们使用电子方式搜索了五个数据库,检索了针对 65 岁以上患有抑郁症的成年人进行的对照研究,这些研究调查了与任何类型的体育锻炼相关的健康结果。在可能的情况下,对数据进行了荟萃分析或其他叙述性报告。结果与讨论。15 项研究被纳入综述。所有 15 项研究都有数据可供进行荟萃分析,但运动类型和结果测量的异质性限制了荟萃分析的进行。将所有运动类型的数据汇总后发现,抑郁(SMD = 0.52;CI = 0.07,0.97;P = 0.02)、身体健康和功能(SMD = 0.44,CI = 0.14,0.74;P = 0.004)、焦虑(SMD = 0.23;CI = 0.04,0.42;P = 0.02)和自我效能(SMD = 0.97;CI = 0.32,1.61;P = 0.003)均有显著改善。当根据运动类型汇总数据时,有氧运动对抑郁(SMD = 0.49;CI = -0.16,0.8;P = 0.003)、太极拳/气功对抑郁(SMD = 0.89;CI = -0.14,1.63;P = 0.02)和自我效能(SMD = 6.70; CI = -0.90, 12.50; p = 0.02)和多组分运动对身体功能(SMD = 0.49; CI = 0.12, 0.87; p = 0.009)和生活质量的身体健康部分(SMD = 0.88; CI = 0.10, 1.65; p = 0.03)有积极影响。两项加强锻炼研究的综合结果均未显示出与健康相关的益处。结论运动类型、剂量和结果缺乏一致性,这给证据带来了挑战。总的来说,运动对一系列健康相关变量都有益处。多成分运动、有氧运动和太极拳似乎最有可能使抑郁的老年人受益;但是,受益的类型取决于运动的类型,在推荐运动方式时应加以考虑。本试验的注册号为 CRD42020173465。
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引用次数: 0
Knowledge, Attitudes, and Practices among Healthcare Workers regarding Depression Care in Two Medium-Sized Hospitals in Kenya 肯尼亚两家中型医院医护人员对抑郁症护理的认识、态度和做法
IF 7.4 2区 医学 Q1 Psychology Pub Date : 2024-06-07 DOI: 10.1155/2024/4756962
Millicent Muthoni Muriuki, Peterson Mwangi, Ezra Kombo Osoro, Miriam Miima

Introduction. Depression is the most common mental health disorder worldwide with a lifetime prevalence of approximately 10% in the general population. Our objective was to assess the knowledge, attitudes, and practices among healthcare workers (HCWs) regarding depression care. Methods. We conducted a cross-sectional study among consenting healthcare workers in two medium-sized hospitals in Kenya. Data on demographic characteristics, knowledge, attitude, and practice of depression were collected through a self-administered structured questionnaire. The Revised Depression Attitude Questionnaire was incorporated into the questionnaire. Knowledge and attitude scores were computed, where higher scores suggested higher knowledge or more positive attitudes. Descriptive and regression analyses were used to assess associations, and a p value of < 0.05 was considered significant. Results. Among the 316 HCWs approached, 303 (95.9%) consented and were enrolled. Almost two-thirds (64.0%) of the respondents were female, and 58.4% were between 18 and 29 years old. HCWs were categorised into three: nurses, clinicians (doctors/clinical officers), and nonclinicians (other healthcare workers). The median knowledge score among respondents was 9 out of 10. Nonclinicians scored significantly lower (β = −0.5, p < 0.011) on the knowledge score compared to clinicians. Only 9.3% of the respondents strongly agreed or agreed that they were confident in assessing the risk of suicide in patients with depression. The median attitude score among respondents was 65 out of 110. The attitude score was positively associated with the knowledge score (β = 0.78, p = 0.001), and respondents with professional experience of 5-14 years had higher attitude scores compared (β = 1.7, p = 0.023) to those with fewer than 5 years. Among clinicians and nurses, 40.3% reported that they rarely or have never been screened for depression. Conclusions. HCWs demonstrated good knowledge of depression’s symptoms and causes but lacked confidence in pharmacological management, with gaps in regular screening and comprehensive care practices, particularly among nonclinicians and less experienced staff. Focused training for these groups could enhance the early detection and treatment of depressed patients.

简介抑郁症是全球最常见的精神疾病,在普通人群中的终生患病率约为 10%。我们的目的是评估医护人员(HCWs)在抑郁症护理方面的知识、态度和实践。研究方法我们对肯尼亚两家中型医院中征得同意的医护人员进行了横断面研究。通过自填式结构化问卷收集了有关抑郁症的人口统计学特征、知识、态度和实践的数据。问卷中加入了修订版抑郁症态度问卷。计算了知识和态度得分,得分越高,表明知识越丰富或态度越积极。使用描述性分析和回归分析来评估相关性,P 值在 0.05 以下为显著。结果。在接触的 316 名医护人员中,有 303 人(95.9%)同意并加入了调查。近三分之二(64.0%)的受访者为女性,58.4%的受访者年龄在 18-29 岁之间。医护人员分为三类:护士、临床医生(医生/临床官员)和非临床医生(其他医护人员)。受访者的知识得分中位数为 9 分(满分 10 分)。与临床医生相比,非临床医生的知识得分明显较低(β = -0.5,p < 0.011)。只有 9.3% 的受访者非常同意或同意他们有信心评估抑郁症患者的自杀风险。受访者态度得分的中位数为 65 分(满分 110 分)。态度得分与知识得分呈正相关(β = 0.78,p = 0.001),与工作年限少于 5 年的受访者相比,工作年限在 5-14 年的受访者的态度得分更高(β = 1.7,p = 0.023)。在临床医生和护士中,40.3%的人表示很少或从未接受过抑郁症筛查。结论医护人员对抑郁症的症状和病因有很好的了解,但对药物治疗缺乏信心,在定期筛查和综合护理实践方面存在差距,尤其是非临床医生和经验较少的医护人员。对这些群体进行有针对性的培训可以加强对抑郁症患者的早期发现和治疗。
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引用次数: 0
Allostatic Load and Metabolic Syndrome in Depressed Patients: A Cross-Sectional Analysis 抑郁症患者的代谢负荷和代谢综合征:横断面分析
IF 7.4 2区 医学 Q1 Psychology Pub Date : 2024-06-05 DOI: 10.1155/2024/1355340
Francis Osei, Pia-Maria Wippert, Andrea Block

Allostatic load (AL) is the cumulative wear and tear on the body due to the chronic adverse physical or psychosocial situations. The acute stress response activates the primary mediators of AL, which include cortisol, epinephrine (EPI), norepinephrine (NE), and dehydroepiandrosterone sulfate (DHEA-S). Secondary outcomes, such as metabolic syndrome (MetS), cardiovascular, and immune system changes, can result from long-term stress responses. Given these complex reactions to an acute stressor, a multidimensional stress assessment is required when investigating individual stress reactivity in an experimental setting. This study is aimed at examining the association between the primary mediators of AL and MetS in major depressive disorder (MDD) patients. MDD patients (n = 164, age = 18–65 years old) with MetS+ (n = 46, weight = 93.10 ± 16.43 kg) and without MetS- (n = 118, weight = 73.08 ± 15.22 kg) were analyzed cross-sectionally. Stepwise binary regression and Welch’s t-test were used to find the associations and differences between the two groups. The regression analysis was fully adjusted for age, sex, and the Beck Depression Inventory-II score. In unadjusted model, cortisol (b = −0.003, p = 0.034) was inversely associated with MetS. In fully adjusted model, EPI (b = −0.006, p = 0.007) was inversely associated with MetS. However, significant differences (p = 0.005) were observed for cortisol between MDD patients without MetS- (410.13 ± 144.63 nmol/l) and MDD patients with MetS+ (340.90 ± 132.98 nmol/l) with a small effect size (Cohen’s d of 0.489). Significant differences (p = 0.001) were observed for EPI between MDD patients without MetS- (185.67 ± 124.44 pg/ml) and MDD patients with MetS+ (124.95 ± 84.38 pg/ml) with a moderate effect size (Cohen’s d of 0.530). These observations are of clinical importance for the management of MDD patients.

静态负荷(Allostatic load,AL)是指长期不良的生理或社会心理状况对身体造成的累积性磨损。急性应激反应会激活 AL 的主要介质,包括皮质醇、肾上腺素(EPI)、去甲肾上腺素(NE)和硫酸脱氢表雄酮(DHEA-S)。长期应激反应可导致代谢综合征(MetS)、心血管和免疫系统变化等次要结果。鉴于对急性应激源的这些复杂反应,在实验环境中调查个体应激反应时需要进行多维度的应激评估。本研究旨在探讨重度抑郁症(MDD)患者体内 AL 的主要介质与 MetS 之间的关联。研究人员对患有 MetS+(46 人,体重为 93.10 ± 16.43 千克)和未患有 MetS-(118 人,体重为 73.08 ± 15.22 千克)的 MDD 患者(164 人,年龄为 18-65 岁)进行了横截面分析。采用逐步二元回归和韦尔奇 t 检验来发现两组之间的关联和差异。回归分析对年龄、性别和贝克抑郁量表-II 评分进行了充分调整。在未经调整的模型中,皮质醇(b = -0.003,p = 0.034)与 MetS 呈反向关系。在完全调整模型中,EPI(b = -0.006,p = 0.007)与 MetS 成反比。然而,在皮质醇方面,未患 MetS- 的 MDD 患者(410.13 ± 144.63 nmol/l)和患 MetS+ 的 MDD 患者(340.90 ± 132.98 nmol/l)之间存在明显差异(p = 0.005),但影响较小(Cohen's d 为 0.489)。未患 MetS- 的 MDD 患者(185.67 ± 124.44 pg/ml)和患 MetS+ 的 MDD 患者(124.95 ± 84.38 pg/ml)之间的 EPI 存在显著差异(p = 0.001),效应大小适中(Cohen's d 为 0.530)。这些观察结果对 MDD 患者的管理具有重要的临床意义。
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引用次数: 0
Young Adults with Anxiety Disorders Show Reduced Inhibition in the Dorsolateral Prefrontal Cortex at Higher Trait Anxiety Levels: A TMS-EEG Study 患有焦虑症的年轻成年人在特质焦虑水平较高时,背外侧前额叶皮层的抑制作用会减弱:TMS-EEG研究
IF 7.4 2区 医学 Q1 Psychology Pub Date : 2024-05-30 DOI: 10.1155/2024/2758522
Lena Pokorny, Lea Biermann, Eva Breitinger, Tomasz Antoni Jarczok, Daniel Wagner, Jasper Vöckel, Stephan Bender

Background. The neuropathology of anxiety disorders, including specific phobias, social phobias, and generalized anxiety disorders (GAD), has been believed to be rooted in a reduced inhibition of limbic areas by the dorsolateral prefrontal cortex (DLPFC). Trait anxiety has been linked to insufficient recruitment of DLPFC mechanisms for attentional control. Despite limited research on individuals with anxiety disorders, our study utilized transcranial magnetic stimulation to assess DLPFC cortical activity and emotional states using the N100 as an indicator of GABA-B-mediated cortical inhibition. Additionally, we aimed to correlate trait anxiety scores with cortical activity. Methods. A total of 20 subjects with social phobia and GAD and 21 subjects with specific phobia were compared to 24 control subjects regarding their inhibitory N100 in the DLPFC. Therefore, TMS was applied on the left and right DLPFC during an emotional task with fearful, angry, and neutral faces and a rest condition. Results. Smaller N100 amplitudes after DLPFC stimulation were found in subjects with social phobia, GAD, and social phobias compared to the control group. Furthermore, a correlation between trait anxiety scores and smaller N100 amplitudes, independent of group effects, was found. Conclusion. There appears to be a decrease in GABA-B-mediated cortical inhibition in the DLPFC in subjects with anxiety disorders. The correlation between trait anxiety and N100 amplitudes suggests a trait-related modulation of cortical inhibition.

背景。焦虑症(包括特异性恐惧症、社交恐惧症和广泛性焦虑症(GAD))的神经病理学根源被认为是背外侧前额叶皮层(DLPFC)对边缘区的抑制作用减弱。特质性焦虑与 DLPFC 的注意控制机制招募不足有关。尽管对焦虑症患者的研究有限,但我们的研究利用经颅磁刺激来评估 DLPFC 皮层的活动和情绪状态,使用 N100 作为 GABA-B 介导的皮质抑制指标。此外,我们还旨在将特质焦虑评分与皮质活动相关联。研究方法我们将 20 名社交恐惧症和 GAD 受试者以及 21 名特殊恐惧症受试者与 24 名对照组受试者的 DLPFC 抑制性 N100 进行了比较。因此,在完成一项包含恐惧、愤怒和中性面孔的情绪任务以及休息状态时,对左右DLPFC施加TMS。结果显示与对照组相比,社交恐惧症、GAD和社交恐惧症患者在刺激DLPFC后的N100振幅较小。此外,还发现特质焦虑评分与较小的 N100 波幅之间存在相关性,这与群体效应无关。结论在焦虑症患者的 DLPFC 中,GABA-B 介导的皮质抑制似乎有所下降。特质焦虑与 N100 波幅之间的相关性表明,皮质抑制作用的调节与特质有关。
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引用次数: 0
Suicide among Reproductive-Age Women in Northwest Ethiopia: A Community-Based Cross-Sectional Study 埃塞俄比亚西北部育龄妇女中的自杀现象:基于社区的横断面研究
IF 7.4 2区 医学 Q1 Psychology Pub Date : 2024-05-22 DOI: 10.1155/2024/1735716
Techilo Tinsae, Biruk Fanta Alemayehu, Wondale Getinet Alemu

Background. Suicide is one of the global burdens of morbidity and mortality in all reproductive-age women population groups across the world. It is one of the most significant contributors to the global burden of illness and a cause of morbidity. This study is aimed at finding out how it occurred and what risk factors were related to suicidal ideation and attempts among women in the reproductive-age group. Methods. A community-based cross-sectional study design was conducted using a multistage cluster sampling technique to get a total of 590 study participants from March to April 2021. Data were entered into EpiData version 3.1 and analyzed in bivariate and multivariable logistic regression models using Statistical Package for Social Science (SPSS) version 20. Variables with a p value <0.05 were declared to be associated risk factors with the outcome variable. Results. A total of 590 of the 598 sampled women participated, with a response rate of 98.7%. A one-month prevalence of suicidal ideation and attempt was 2.9% (95% CI: 1.5%, 4.4%) and 2.5% (95% CI: 1.4%, 3.7%), respectively. Intimate partner violence (AOR = 4.69, 95% CI: 1.53, 14.45), depression (AOR = 3.11, 95% CI: 1.11, 9.85), and history of mental illness (AOR = 5.18, 95% CI: 1.55, 17.32) were associated risk factors for suicide ideation. Anxiety (AOR = 3.55, 95% CI: 1.17, 10.81), being unmarried (AOR = 4.39, 95% CI: 1.49, 12.87), and history of mental illness (AOR = 7.95, 95% CI: 2.42, 26.15) were associated risk factors for suicide attempts. Conclusion. SI and SA are prevalent in reproductive-age women. Intimate partner violence, depression, anxiety, a history of mental illness, and being single were associated factors. This implies that providing relevant information, education, and continuing support is very crucial for reproductive-age group women to decrease the incidence and risk factors of suicide.

背景。自杀是造成全球所有育龄妇女群体发病和死亡的负担之一。它是造成全球疾病负担的最重要因素之一,也是发病的原因之一。本研究旨在了解育龄妇女自杀的发生原因以及与自杀意念和企图自杀有关的风险因素。研究方法采用多阶段群组抽样技术,在 2021 年 3 月至 4 月期间进行了一项基于社区的横断面研究设计,共获得 590 名研究参与者。数据被输入 EpiData 3.1 版,并使用社会科学统计软件包(SPSS)20 版进行双变量和多变量逻辑回归模型分析。P值小于0.05的变量被视为与结果变量相关的风险因素。结果在 598 名抽样妇女中,共有 590 人参与了调查,回复率为 98.7%。一个月内自杀意念和企图自杀的发生率分别为 2.9% (95% CI: 1.5%, 4.4%) 和 2.5% (95% CI: 1.4%, 3.7%)。亲密伴侣暴力(AOR=4.69,95% CI:1.53,14.45)、抑郁(AOR=3.11,95% CI:1.11,9.85)和精神病史(AOR=5.18,95% CI:1.55,17.32)是自杀意念的相关风险因素。焦虑(AOR=3.55,95% CI:1.17,10.81)、未婚(AOR=4.39,95% CI:1.49,12.87)和精神病史(AOR=7.95,95% CI:2.42,26.15)是自杀未遂的相关风险因素。结论SI和SA在育龄妇女中普遍存在。亲密伴侣暴力、抑郁、焦虑、精神病史和单身是相关因素。这意味着,为育龄妇女提供相关信息、教育和持续支持对于降低自杀发生率和风险因素至关重要。
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引用次数: 0
Enough Terror to Belong: The Nonlinear Association of Death Anxiety with Group Identification 足够恐怖才能归属:死亡焦虑与群体认同的非线性关联
IF 7.4 2区 医学 Q1 Psychology Pub Date : 2024-05-21 DOI: 10.1155/2024/3699789
Chao Li, Jianning Dang, Li Liu

Death anxiety is presumed to be positively associated with group identification; however, recent evidence of a null correlation between the two constructs raises questions regarding this assumption. In contrast to the traditional linear perspective, we proposed and tested a J-shaped curvilinear association that only death anxiety beyond a certain threshold predicts group identification. Using two-wave longitudinal data from the UK, study 1 (N = 1,402) revealed that only after reaching a moderate-to-high level could death anxiety measured during the COVID-19 pandemic positively predict later identification with the community, one’s country, and all humanity. Furthermore, using World Values Survey data, study 2 (N = 56,871) found that death-related anxiety (i.e., worry about a terrorist attack) was only positively associated with perceived closeness to one’s village, county, and country after reaching a moderate-to-high level. Our findings provide a novel insight into the process of managing terror and the replication failure of the mortality salience effect.

据推测,死亡焦虑与群体认同呈正相关;然而,最近有证据表明这两个概念之间的相关性为零,这就对这一假设提出了质疑。与传统的线性观点不同,我们提出并检验了一种 J 型曲线关联,即只有超过一定临界值的死亡焦虑才会预测群体认同。利用英国的两波纵向数据,研究 1(N=1,402)显示,只有在 COVID-19 大流行期间测得的死亡焦虑达到中度到高度水平后,才能积极预测日后对社区、国家和全人类的认同。此外,研究 2(N=56,871)利用世界价值观调查的数据发现,与死亡有关的焦虑(即对恐怖袭击的担忧)只有在达到中度到高度水平后,才会与感知到的与村庄、县城和国家的亲密程度呈正相关。我们的研究结果为管理恐怖事件的过程提供了一个新的视角,也为死亡突出效应的复制失败提供了一个新的视角。
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引用次数: 0
Brain Connectomics Improve the Prediction of High-Risk Depression Profiles in the First Year following Breast Cancer Diagnosis 脑连接组学能更好地预测乳腺癌诊断后第一年的高风险抑郁特征
IF 7.4 2区 医学 Q1 Psychology Pub Date : 2024-05-17 DOI: 10.1155/2024/3103115
Mu Zi Liang, Peng Chen, Ying Tang, Xiao Na Tang, Alex Molassiotis, M. Tish Knobf, Mei Ling Liu, Guang Yun Hu, Zhe Sun, Yuan Liang Yu, Zeng Jie Ye

Background. Prediction of high-risk depression trajectories in the first year following breast cancer diagnosis with fMRI-related brain connectomics is unclear. Methods. The Be Resilient to Breast Cancer (BRBC) study is a multicenter trial in which 189/232 participants (81.5%) completed baseline resting-state functional magnetic resonance imaging (rs-fMRI) and four sequential assessments of depression (T0-T3). The latent growth mixture model (LGMM) was utilized to differentiate depression profiles (high vs. low risk) and was followed by multivoxel pattern analysis (MVPA) to recognize distinct brain connectivity patterns. The incremental value of brain connectomics in the prediction model was also estimated. Results. Four depression profiles were recognized and classified into high-risk (delayed and chronic, 14.8% and 12.7%) and low-risk (resilient and recovery, 50.3% and 22.2%). Frontal medial cortex and frontal pole were identified as two important brain areas against the high-risk profile outcome. The prediction model achieved 16.82-76.21% in NRI and 12.63-50.74% in IDI when brain connectomics were included. Conclusion. Brain connectomics can optimize the prediction against high-risk depression profiles in the first year since breast cancer diagnoses.

背景。利用与 fMRI 相关的脑连接组学预测乳腺癌确诊后第一年的高危抑郁轨迹尚不明确。研究方法乳腺癌复原力(BRBC)研究是一项多中心试验,189/232 名参与者(81.5%)完成了基线静息态功能磁共振成像(rs-fMRI)和四次连续抑郁评估(T0-T3)。利用潜在增长混合模型(LGMM)来区分抑郁特征(高风险与低风险),然后进行多象素模式分析(MVPA)来识别不同的大脑连接模式。此外,还估算了大脑连接组学在预测模型中的增量价值。结果共识别出四种抑郁特征,并将其分为高风险(延迟型和慢性型,分别占 14.8% 和 12.7%)和低风险(复原型和恢复型,分别占 50.3% 和 22.2%)。额叶内侧皮层和额极被确定为与高风险特征结果相对应的两个重要脑区。如果将大脑连接组学包括在内,预测模型在 NRI 和 IDI 中的预测率分别为 16.82%-76.21% 和 12.63%-50.74%。结论脑连接组学可以优化对乳腺癌确诊后第一年高风险抑郁特征的预测。
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引用次数: 0
Meta-Analysis of Brain Volumetric Abnormalities in Patients with Remitted Major Depressive Disorder 缓解型重度抑郁症患者脑容量异常的 Meta 分析
IF 7.4 2区 医学 Q1 Psychology Pub Date : 2024-05-15 DOI: 10.1155/2024/6633510
Xin Xu, Qian Zhou, Fei Wen, Mingzhe Yang

Although patients with major depressive disorder (MDD) achieve remission after antidepressant treatment, >90% of those in remission have at least one residual depressive symptom, which may be due to neural damage linked with MDD. To better understand the structural impairments in patients with remitted MDD, we conducted a meta-analysis comparing grey matter volume (GMV) abnormalities between patients with remitted MDD and healthy controls (HCs). There were 11 cross-sectional datasets that investigated 275 patients with remitted MDD versus 437 HCs, and 7 longitudinal datasets that investigated 167 patients with remitted MDD. We found that GMV in the left insula, inferior parietal gyri, amygdala, and right superior parietal gyrus was decreased in patients with remitted MDD than in HCs. Additionally, patients with remitted MDD had lower GMV in the bilateral gyrus rectus than those in the nonremission state. Moreover, increased GMV in the bilateral anterior cingulate cortex, right striatum, middle temporal gyrus, and superior frontal gyrus was observed in patients with remitted MDD than in HCs. Furthermore, patients with remitted MDD had a larger GMV in the bilateral median cingulate/paracingulate gyri, left striatum, putamen, amygdala, hippocampus, and parahippocampal gyrus at follow-up than at baseline. Based on the brain morphological abnormalities in patients with remitted MDD after electroconvulsive therapy and pharmacological treatment, we proposed a schematic diagram of targeted intervention approaches for residual symptoms. In summary, our findings provide neurobiology-based evidence for multitarget treatment of depression to reduce residual symptoms and improve social function in patients with MDD.

尽管重度抑郁症(MDD)患者在接受抗抑郁治疗后病情得到缓解,但90%以上的缓解期患者至少有一种抑郁症状残留,这可能是与MDD相关的神经损伤所致。为了更好地了解缓解型多发性抑郁症患者的结构损伤,我们对缓解型多发性抑郁症患者和健康对照组(HCs)的灰质体积(GMV)异常进行了荟萃分析。共有 11 个横断面数据集调查了 275 名 MDD 缓解期患者和 437 名健康对照者,另有 7 个纵向数据集调查了 167 名 MDD 缓解期患者。我们发现,与普通人相比,缓解型 MDD 患者左侧岛叶、顶叶下回、杏仁核和右侧顶叶上回的 GMV 有所下降。此外,缓解型 MDD 患者双侧直肌回的 GMV 也低于非缓解型患者。此外,在双侧扣带回前皮层、右侧纹状体、颞中回和额上回中观察到 MDD 缓解期患者的 GMV 比 HCs 增加。此外,与基线时相比,缓解型 MDD 患者随访时双侧扣带回/旁回、左侧纹状体、普坦门、杏仁核、海马和海马旁回的 GMV 更大。根据电休克治疗和药物治疗后缓解的 MDD 患者的大脑形态异常,我们提出了针对残余症状的干预方法示意图。总之,我们的研究结果为抑郁症的多靶点治疗提供了基于神经生物学的证据,以减少残余症状并改善 MDD 患者的社会功能。
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引用次数: 0
Predictive Models for Suicide Attempts in Major Depressive Disorder and the Contribution of EPHX2: A Pilot Integrative Machine Learning Study 重度抑郁障碍患者自杀未遂的预测模型及 EPHX2 的贡献:一项试验性综合机器学习研究
IF 7.4 2区 医学 Q1 Psychology Pub Date : 2024-05-09 DOI: 10.1155/2024/5538257
Shuqiong Zheng, Weixiong Zeng, Qianyun Wu, Weimin Li, Zilong He, Enze Li, Chong Tang, Xiang Xue, Genggeng Qin, Bin Zhang, Honglei Yin

Suicide is a major public health problem caused by a complex interaction of various factors. Major depressive disorder (MDD) is the most prevalent psychiatric disorder associated with suicide; therefore, it is essential to prioritize suicide prediction and prevention within this population. Integrated information from different dimensions, including personality, cognitive function, and social and genetic factors, is necessary to improve the performance of predictive models. Besides, recent studies have indicated the critical roles for EPHX2/P2X2 in the pathophysiology of MDD. Our previous studies found an association of EPHX2 and P2X2 with suicide in MDD. This study is aimed at (1) establishing predictive models with integrated information to distinguish MDD from healthy volunteers, (2) estimating the suicide risk of MDD, and (3) determining the contribution of EPHX2/P2X2. This cross-sectional study was conducted on 472 prospectively collected participants. The machine learning (ML) technique using Extreme Gradient Boosting (XGBoost) classifier was employed to evaluate the performance and relative importance of the extracted characteristics in recognising patients with MDD and depressed suicide attempters (DSA). In independent validation set, the model with clinical and cognitive information could recognise MDD with an area under the receiver operating characteristic curve (AUC) of 0.938 (95% confidence interval (CI), 0.898–0.977), and genetic information did not improve classification performance. The model with clinical, cognitive, and genetic information resulted in a significantly higher AUC of 0.801 (95% CI, 0.719–0.884) for identifying DSA than the model with only clinical information, in which the three single nucleotide polymorphisms of EPHX2 showed important roles. This study successfully established step-by-step predictive ML models to estimate the risk of suicide attempts in MDD. We found that EPHX2 can help improve the performance of suicidal predictive models. This trial is registered with NCT05575713.

自杀是一个重大的公共卫生问题,由各种因素的复杂相互作用造成。重度抑郁障碍(MDD)是与自杀相关的最普遍的精神疾病;因此,必须优先考虑这一人群的自杀预测和预防工作。要提高预测模型的性能,就必须整合来自不同方面的信息,包括人格、认知功能、社会和遗传因素。此外,最近的研究表明,EPHX2/P2X2 在 MDD 的病理生理学中起着关键作用。我们之前的研究发现 EPHX2 和 P2X2 与 MDD 患者自杀有关。本研究旨在:(1)建立综合信息的预测模型,以区分 MDD 和健康志愿者;(2)估计 MDD 的自杀风险;(3)确定 EPHX2/P2X2 的贡献。这项横断面研究的对象是 472 名前瞻性收集的参与者。研究采用了极端梯度提升(XGBoost)分类器的机器学习(ML)技术,以评估提取的特征在识别 MDD 患者和抑郁自杀企图者(DSA)方面的性能和相对重要性。在独立验证集中,包含临床和认知信息的模型可以识别 MDD,其接收者工作特征曲线下面积(AUC)为 0.938(95% 置信区间(CI),0.898-0.977),而遗传信息并没有提高分类性能。与仅有临床信息的模型相比,包含临床、认知和遗传信息的模型在识别DSA方面的AUC明显更高,为0.801(95% CI,0.719-0.884),其中EPHX2的三个单核苷酸多态性显示了重要作用。本研究成功地建立了逐步预测 MDD 患者自杀未遂风险的 ML 模型。我们发现,EPHX2有助于提高自杀预测模型的性能。该试验已在 NCT05575713 上注册。
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引用次数: 0
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Depression and Anxiety
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