Journal of psychopathology and clinical science最新文献

Heightened sensitivity to costs during decision making consistently has been related to substance use. However, no work in this area has manipulated cost information to examine how people evaluate and compare multiple costs. Furthermore, limited work has examined how affective motivations for substance use modulate the evaluation of cost information. We administered a loss-frame variant of the Effort Expenditure for Rewards Task in a diverse community sample (N = 126). Individuals who use substances to avoid negative affect allocated comparable effort across varying likelihoods of loss and computational modeling parameters indicated that they did not systematically consider cost information, which ultimately led these individuals to exert effort when it was disadvantageous to do so. Individuals who use substances to enhance positive affect allocated effort when loss magnitudes were small, suggesting that they effectively compared costs and worked to minimize those costs. Motivations for substance use differentially relate to the comparison of costly information, ultimately influencing effective decision making. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Suicide attempts (SAs) are commonly assessed by asking patients and study participants face-valid questions about whether an individual has engaged in any self-injurious behavior with the intent to die within a given timeframe. Unfortunately, for most clinical and scientific endeavors, only information about the presence vs. absence of a SA is documented and analyzed. In this Viewpoint, we discuss how such a dichotomous operationalization of SAs obscures important heterogeneity among those who have attempted suicide. There are several facets of SAs, beyond the simple presence vs. absence, that are important to consider because they have implications regarding acute and long-term clinical outcomes. These facets include the level of intent to die, the means used and associated risk for death, the actual medical consequences of the attempt, and the chronicity of the behavior. We discuss how considering these SA facets-in theory testing and refinement, the design, analysis, and interpretation of research findings, and clinical practice-will improve the impact of scientific findings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Hierarchical Taxonomy of Psychopathology (HiTOP) framework offers the potential to better understand how neurobiological mechanisms relate to psychopathology. The P300 is an event-related potential component that indexes attention, stimulus evaluation, and categorization. A blunted P300 has been associated with psychiatric disorders across externalizing, internalizing, and thought disorder domains. However, there has been little research investigating whether the P300 is related to higher-order dimensions of psychopathology. In a sample of 225 adults aged 18-35 years (M_age = 23.09, SD = 3.83, 82.2% female) who were oversampled for psychopathology, the present study examined the associations between the P300 and both psychopathology spectra and a general factor. Participants completed multiple experimental tasks, while electroencephalography was recorded to measure the P300 elicited by auditory, tactile, and visual stimuli. Participants also completed the self-report Comprehensive Assessment of Traits Relevant to Personality Disorder to assess pathological personality dimensions. We used structural equation modeling to examine the relationship between a latent P300 factor and both psychopathology spectra (negative emotionality, detachment, psychoticism, disinhibition, and antagonism) and a general factor. The results indicated that the P300 was inversely related to the general factor. Further analyses revealed no relationships between the P300 and any individual spectrum when accounting for the general factor. Overall, the present study indicates that the P300 is associated with the general factor of psychopathology, which might explain its association with multiple categorical disorders. The study also demonstrates the potential importance of neuroscience-informed dimensional systems to understand clinical phenomena. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Borderline personality disorder (BPD) is highly comorbid with eating disorders (EDs), and comorbid ED-BPD is associated with a worse clinical presentation and treatment outcomes. Understanding how BPD symptoms manifest in the daily lives of those with EDs and predict momentary ED symptoms has important treatment implications. This study: (a) compared the nine BPD symptoms, assessed across 14 days, in individuals with comorbid ED-BPD, only an ED, and no ED; and (b) examined average and momentary relationships between BPD symptoms and specific ED symptoms (i.e., binge eating, purging, restriction, and maladaptive exercise) in women with EDs. Individuals with comorbid ED-BPD (n = 60), only an ED (n = 114), and controls (n = 47) completed 14 days of ecological momentary assessment. All BPD symptoms except affective instability were more common in individuals with comorbid ED-BPD than those with only an ED. Affective instability and paranoia/dissociation had the largest effect sizes, indicating the greatest differences across groups. Individuals with more frequent abandonment avoidance, anger, identity disturbance, paranoia/dissociation, and self-harm over the 14 days engaged in more frequent binge eating, while those with greater emptiness engaged in more frequent restriction and maladaptive exercise. Momentary affective instability predicted an increased likelihood of binge eating, while momentary interpersonal difficulties predicted a decreased likelihood of binge eating, at the next prompt. This study highlights the importance of considering BPD symptoms in the treatment of individuals with EDs to improve their clinical outcomes and quality of life. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Ketamine has shown promise in rapidly improving symptoms of depression and most notably treatment-resistant depression (TRD). However, given the heterogeneity of TRD, biobehavioral markers of treatment response are necessary for the personalized prescription of intravenous ketamine. Heterogeneity in depression can be manifested in discrete patterns of functional connectivity (FC) in default mode, ventral affective, and cognitive control networks. This study employed a data-driven approach to parse FC during positive mood processing to characterize subgroups of patients with TRD prior to infusion and determine whether these connectivity-based subgroups could predict subsequent antidepressant response to ketamine compared to saline infusion. 152 adult patients with TRD completed a baseline assessment of FC during positive mood processing and were randomly assigned to either ketamine or saline infusion. The assessment utilized Subgroup-Group Iterative Multiple Model Estimation to recover directed connectivity maps and applied Walktrap algorithm to determine data-driven subgroups. Depression severity was assessed pre- and 24-hr postinfusion. Two connectivity-based subgroups were identified: Subgroup A (n = 110) and Subgroup B (n = 42). We observed that treatment response was moderated by an infusion type by subgroup interaction (p = .040). For patients receiving ketamine, subgroup did not predict treatment response (β = -.326, p = .499). However, subgroup predicted response for saline patients. Subgroup B individuals, relative to A, were more likely to be saline responders at 24-hr postinfusion (β = -2.146, p = .007). Thus, while ketamine improved depressive symptoms uniformly across both subgroups, this heterogeneity was a predictor of placebo response. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Most studies aimed at understanding suicidal behavior have focused on quantifying the associations between putative risk factors and suicidal behavior in comparative studies of cases and controls. The current study, in comparison, exclusively focused on cases-89 Army soldiers presenting for hospital care following a suicide attempt-and attempted to reveal the antecedents of, reasons for, and consequences of suicide attempts. This mixed-methods study using qualitative interviews and self-report surveys/interviews revealed that in most cases, the most recent onset of suicidal thoughts began shortly before the suicide attempt and were not disclosed to others, limiting opportunities for intervention via traditional approaches. The primary reason given for attempting suicide was to escape from psychologically aversive conditions after concluding that no other effective strategies or options were available. Participants reported both negative (e.g., self-view, guilt) and positive (e.g., learning new skills, receiving support) consequences of their suicide attempt-and described things they believe would have prevented them from making the attempt. These findings provide new insights into the motivational and contextual factors for suicidal behavior and highlight several novel directions for prevention and intervention efforts. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

This article discusses the concept of "experience" in experience sampling. A central challenge of clinical science is understanding psychopathological constructs and their manifestations. In conventional definitions and measures of psychopathology, subjective experience of mental disorder is often lost. The authors argue for an integration of phenomenology-or prioritization of subjectivity-in psychopathological construct definition and measurement, particularly through experience sampling methods (ESMs). ESMs capture idiographic, contextual, and longitudinal elements of lived experience that can expand our current conceptualizations and classifications of psychopathology. The authors propose three novel applications and extensions: (a) leveraging ESM for subjective construct definition (i.e., phenomena detection), (b) mixed-methods approaches, like cognitive interviewing, to improve the validity of ESM measures and (c) incorporation of novel ESM approaches (e.g., audiovisual data capturing) to expand understanding of subjective, daily experience of psychopathology. Merging phenomenological tradition with ESM serves to expand our understanding of psychopathology and bring "experience" back into experience sampling. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Problematic pornography use (PPU) is the most common manifestation of the newly introduced compulsive sexual behavior disorder diagnosis in the 11th revision of the International Classification of Diseases. Research related to PPU has proliferated in the past two decades, but most prior studies were characterized by several shortcomings (e.g., using homogenous, small samples), resulting in crucial knowledge gaps and a limited understanding concerning empirically based risk factors for PPU. This study aimed to identify the most robust risk factors for PPU using a preregistered study design. Independent laboratories' 74 preexisting self-report data sets (N_participants = 112,397; N_countries = 16) were combined to identify which factors can best predict PPU using an artificial intelligence-based method (i.e., machine learning). We conducted random forest models on each data set to examine how different sociodemographic, psychological, and other characteristics predict PPU, and combined the results of all data sets using random-effects meta-analysis with meta-analytic moderators (e.g., community vs. treatment-seeking samples). Predictors explained 45.84% of the variance in PPU scores. Out of the 700+ potential predictors, 17 variables emerged as significant predictors across data sets, with the top five being (a) pornography use frequency, (b) emotional avoidance pornography use motivation, (c) stress reduction pornography use motivation, (d) moral incongruence toward pornography use, and (e) sexual shame. This study is the largest and most integrative data analytic effort in the field to date. Findings contribute to a better understanding of PPU's etiology and may provide deeper insights for developing more efficient, cost-effective, empirically based directions for future research as well as prevention and intervention programs targeting PPU. (PsycInfo Database Record (c) 2024 APA, all rights reserved).