Psychiatry-Interpersonal and Biological Processes最新文献

ObjectiveChildhood maltreatment is a well-established risk factor for the development of mental disorders. Interpretation bias has been proposed as a potential mechanism mediating the relationship between childhood maltreatment and subsequent psychopathology. This study investigated differences in interpretation bias and psychopathology symptoms based on experiences of childhood abuse and neglect. It also examined whether interpretation bias mediates the relationship between childhood maltreatment and symptoms of psychopathology using network analysis. Methods: A cross-sectional sample of 123 university students aged 19 to 25 participated. Childhood maltreatment was assessed using the Childhood Maltreatment Experiences Scale, and psychopathological symptoms were measured with the Symptom Checklist-90-Revised. Interpretation bias was assessed using a facial emotion judgment task involving morphed anger-happiness and anger-sadness expressions presented at varying intensity levels. Results: Participants with a history of abuse were more likely to interpret ambiguous anger-happiness expressions as anger, especially at the most ambiguous levels, and reported higher symptoms across all domains of psychopathology compared to those without maltreatment experiences. Participants with a history of neglect showed elevated depression and paranoid ideation but did not show significant interpretation bias. Network analysis revealed that abuse was directly connected to interpretation bias, somatization, and phobic anxiety. Interpretation bias and somatization served as bridge nodes, with anxiety emerging as the most central symptom. Conclusions: Interpretation bias may serve as a transdiagnostic factor linking childhood abuse to various forms of psychopathology, highlighting its importance for early identification and intervention in individuals with childhood abuse histories.

Objective: Non-suicidal self-injury (NSSI) has been identified as a prevalent behavior among adolescents, particularly those with major depressive disorder (MDD). The present study sought to examine differences in neurocognition, social cognition, negative urgency (NU)-the tendency to act impulsively in response to negative emotions-and anxiety among adolescents with MDD and NSSI, MDD without NSSI, and healthy controls.

Method: A total of 204 adolescents (aged 11-17 years; 161 girls [78.9%], 43 boys [21.1%]) were divided into three groups: (1) MDD with NSSI, (2) MDD without NSSI, and (3) healthy controls. Participants completed psychiatric assessments, computerized neurocognitive tests, emotion recognition tasks, and self-report measures of NU and anxiety. Data were analyzed using SPSS 22. Descriptive statistics included frequencies for categorical variables and medians for continuous variables. Group comparisons were performed using chi-square-based tests and the Kruskal-Wallis test. Logistic regression identified predictors of NSSI, with significance set at p < .05.

Results: Adolescents with MDD exhibited significant deficits in executive function and episodic memory, as well as elevated NU and anxiety, compared to healthy controls. Furthermore, adolescents with MDD and NSSI reported significantly higher levels of anxiety (particularly panic symptoms) and NU compared to those with MDD alone.

Conclusion: These findings suggest that emotional difficulties, particularly impulsivity and panic symptoms, play a crucial role in NSSI among adolescents with MDD rather than cognitive disturbance, highlighting potential targets for prevention and intervention efforts.

Background: Military personnel and active combatants are known to be at risk for perpetrating or witnessing acts that violate their moral code. These events, termed potentially morally injurious events (PMIEs), were found to be associated in cross-sectional studies with an increased risk of mental and behavioral health problems, such as depression and anxiety symptoms. However, the longitudinal contribution of deployment-related PMIEs and moral injury (MI) outcomes to depression and anxiety symptoms among veterans remain unclear, particularly during their initial years following discharge. Method: Participants were 169 Israeli combat veterans who participated in a six-year longitudinal study with four measurement points (T1: 12 months before enlistment, T2: Six months following enlistment - pre-deployment, T3: 18 months following enlistment - post-deployment, and T4: 28 months following discharge). Participants' characteristics were assessed between 2019-2024 via semi-structured interviews (T1) and validated self-report measures (T2-T4). Results: Exposure to PMIE-Self (i.e. self-perpetrated potentially morally injurious events) at T3 predicted severity of depressive symptoms (T4), and MI-outcomes of shame and trust-violation (T4) predicted both severity of depressive and anxiety symptoms (T4), above and beyond the pre-enlistment personal characteristics (T1), depressive and anxiety symptoms (T2 and T3), personality risk factors (T2) and combat exposure (T3). Conclusions: Deployment-related PMIE experiences, especially PMIE-Self experiences, and MI outcomes, were found to be valid predictors of higher severity of depression and anxiety symptoms following discharge. Routine screening and targeted interventions should be available to combatants upon their discharge from the military, a transition identified as vulnerable to the consequences of moral injury.

Objective: Chronic pain can result in psychological distress. In addition, sleep disturbance is associated with both chronic pain and psychological distress. However, no study has comprehensively investigated the roles of sleep disturbance in the associations between pain and psychological distress in the general population. Our study aims to explore the mediating as well as the moderating effects of sleep disturbance between chronic pain and psychological distress in a national Canadian sample. Methods: Data were analyzed from the Canadian Community Health Survey-Mental Health (CCHS-MH), a national cross-sectional study comprised of adult respondents who provided information on chronic pain, sleep and psychological distress (N = 25,113). The 10-item Kessler Psychological Distress Scale (K-10) was used to assess psychological distress. Structural equation modeling (SEM) was used to measure the mediating and moderating effects of sleep disturbance on the relationships between chronic pain and psychological distress. Results: Our findings indicated that sleep disturbance had both direct and indirect effects on psychological distress. Sleep disturbance partially mediated the relationships between chronic pain and psychological distress (β = 0.10, p < .05). The model accounts for 30.3% of the variance in psychological distress. Sleep disturbance also played a moderating role in the relationships between chronic pain and psychological distress. The pronounced moderation effect was found in the "no sleep disturbance group" (β = 0.20, p < .05). Conclusions: These results revealed that addressing sleep problems should be one of the targets of intervention and prevention for psychological distress among those individuals suffering from chronic pain.

Objective: Although the relationship between childhood maltreatment (CM) and obsessive-compulsive disorder (OCD) is well known, no studies to date have examined the potential mediating roles of thought-action fusion (TAF) and schizotypal traits in the relationship between CM and OCD. In this study, we investigated whether TAF and/or schizotypal traits mediate the association between CM subtypes and OCD.

Method: This study was conducted in 83 patients (18-65 years) with OCD. Participants completed Yale Brown Obsessive-Compulsive Scale (YBOCS) Childhood Trauma Questionnaire-Short Form (CTQ-SF), Thought-Action Fusion Scale (TAFS), and Schizotypal Personality Questionnaire-Brief (SPQ-B). Descriptive, correlational, and mediation analyses were used to determine the extent of the relationship between CM and OCD.

Results: The YBOCS scores showed significant correlations with SPQ-B total and SPQ-B interpersonal traits. Positive correlations were found between the YBOCS scores and emotional abuse, physical abuse, and emotional neglect. Emotional abuse was associated with cognitive, perceptual, and disorganized traits and TAF subscales. Emotional neglect was significantly associated with SPQ-B total, interpersonal, and cognitive-perceptual traits, as well as TAF likelihood-self. The mediation analysis indicated that the SPQ-B total significantly mediated the relationship between emotional abuse and emotional neglect and the YBOCS total.

Conclusions: Contrary to expectations, neither moral nor the likelihood dimensions of TAF were significantly associated with OCD severity. As hypothesized, the indirect effects of emotional abuse and emotional neglect on OCD through total schizotypy were significant. Clinicians treating individuals who develop new or worsening OCD following maltreatment exposure should consider the role of schizotypal traits for treatment.

Objective: Digital social technologies, such as social media and online multiplayer video games (MVGs), have ushered in an era of peer relationships that evolve online, in addition to in person. This report reviews existing research about the dual role of social media and MVGs in shaping youth social connectedness, recognizing both their potential benefits and their associated risks on youth mental health. By providing evidence-based insights, it aims to inform strategies that optimize these technologies' advantages while safeguarding youth mental health and well-being.

Method: This report reviews peer-reviewed literature, clinical recommendations, reports, and surveys that assess youth usage of social media and MVGs and their associated psychological and physical health outcomes.

Results: Social media provides many opportunities for peer connection, including self-expression and social support, fostering positive social development and well-being. MVGs combine entertainment with collaboration, further strengthening social bonds. However, the use of these technologies has also been linked to negative outcomes, including social isolation, depression, anxiety, and sleep disorders. Publically-available, evidence-based resources can provide caregivers and professionals with guidance and clinical recommendations regarding youth social media and MVG use.

Conclusions: Digital social technologies have become increasingly user-specific and immersive as the internet evolves and social media algorithms become more powerful. Additional research is required to understand how current youth usage of these technologies impacts physical and psychological outcomes. Future research should also investigate the differences in usage, outcomes, and the efficacy of treatments across youth sex and age.

Objective: To investigate the relationships between insight, cognition, and daily living functions in patients with schizophrenia.

Method: Fifty-six clinically stable patients with schizophrenia were evaluated for clinical symptoms using the Positive and Negative Syndrome Scale (PANSS) and Apathy Evaluation Scale (AES). Self-rated insight was assessed using the Insight Scale for Psychosis (ISP), while the interviewer-rated insight was determined by the PANSS item G12 score. The MATRICS Consensus Cognitive Battery (MCCB) and the University of California San Diego Performance-based Skills Assessment (UPSA) were used to assess participants' cognitive and daily living functions. We also performed correlation and linear regression analyses.

Results: The MCCB's social cognition domain and several UPSA components-communication, comprehension/planning, household skills, and total score-correlated significantly with interviewer-rated insight. In the linear regression analysis, communication and comprehension/planning domains of UPSA significantly predicted interviewer-rated insight after adjusting for additional variables.

Conclusions: This study demonstrated significant correlations between insight and both cognitive and daily living functions in patients with schizophrenia. Social cognition, communication, and comprehension abilities were associated with insight and should be factored in when implementing rehabilitation, including psychoeducation.

ObjectiveThis study sought to identify independent factors influencing short-term treatment responses in schizophrenia, covering both positive and negative symptoms, and developed a validated nomogram prediction model. Method: The study examined clinical data from 446 schizophrenia patients diagnosed between 2019 and 2023, focusing on health status, admission vital signs, and initial lab results. Participants were split into training and validation groups (6:4 ratio) and classified as improvers or non-improvers based on a ≥ 30% symptom score reduction. LASSO and multivariable logistic regression analyzed the data, with a nomogram illustrating the prediction model. The Bootstrap method generated the ROC curve, and the AUC was calculated. Calibration and clinical decision curves evaluated the model's discrimination, calibration, and clinical utility. Results: The study involved 446 schizophrenia patients, divided into 267 for training and 179 for validation. Of these, 122 improved in psychiatric symptoms, while 324 did not. Key factors linked to improvement- gender, age, smoking, LDL, homocysteine, and folic acid, were identified using LASSO and logistic regression. These factors formed a predictive model, visualized with nomograms. The model's performance, tested with 1000 Bootstrap iterations, had a C-index of 0.7817. ROC analysis showed an AUC of 0.814 for the training group and 0.7863 for the validation group. Conclusion: Gender, age, smoking habits, LDL, homocysteine, and folic acid independently influence the improvement of psychiatric symptoms in schizophrenia. Predictive models using these factors are effective and clinically valuable, with the resulting nomogram serving as a practical tool for evaluating potential symptom improvement in patients.

Objective: We assessed the impact of the COVID-19 pandemic on the implementation of a peer-integrated enhancement of integrated clinical care intervention to address the mental health needs of 450 patients undergoing treatment for a physical injury.

Methods: Qualitative data were collected by 7 clinician investigators of a randomized controlled trial acting as participant observers in a trauma care setting of a major U.S. metropolitan hospital and analyzed in collaboration with an external mixed methods specialist.

Results: The pandemic created or exacerbated several implementation barriers, including increased risk of infection, homelessness, hospitalizations and comorbid conditions such as fentanyl overdoses that increased demand on emergency department and Trauma Center services, imposition of safety measures to reduce risk of infection in clinical settings, transition from face-to-face to virtual interactions with study patients, shortages of specialty mental health providers, suspension of recruitment of patients into the study, scheduling calls with patients, and an increased workload for the study clinical interventionists. Peer specialists perceived the transition to virtual interactions with patients reduced their effectiveness; however, this was not reflected in assessments of patient satisfaction with services received and may have inadvertently increased adoption by Trauma Center staff. Reduction in reach of the intervention to target population was temporary.

Conclusions: The COVID-19 pandemic exacerbated existing barriers and created new barriers to successfully implementing evidence-based practices in trauma care settings, resulting in an attenuation of their effectiveness. However, the shift from face-to-face to virtual services delivery may have actually led to improved implementation outcomes.

Trial registration: ClinicalTrials.gov identifier: NCT03569878. Registered June 15, 2018.