Τρίτη, 30 Ιουλίου 2019

Daily Functioning in Schizophrenia: Is There Room for Anxiety?
imageThe present study aims at evaluating the impact of anxiety on functional outcome in patients with schizophrenia, also taking into account the other main predictors of functioning identified by literature, to disentangle specific subcomponents which contribute to functional outcome. One hundred five patients with DSM-IV-TR schizophrenia were recruited and underwent a broad functional, psychopathological, and clinical-neuropsychological battery. A forward stepwise regression model was used to assess the predictive effect of anxiety and other factors on daily functioning, showing significant results only for global neurocognitive status and anxiety. These results confirm the role of neurocognition and are also in line with the hypothesis that trait anxiety has a direct impact on functional outcome. Overall, the findings support the role of anxiety as a core feature of schizophrenia pathology, with important implications for both research and clinical settings.
Cognitive and Behavioral Differentiation of Those With Borderline Personality Disorder and Bipolar Disorder
imageThe current study sought to identify features offering differentiation of borderline personality disorder (BPD) from bipolar disorder (BP). Participants were clinically assessed and assigned diagnoses based on the Diagnostic and Statistical Manual of Mental Disorders criteria. A 113-item self-report questionnaire was completed, comprising cognitive and behavioral constructs weighted to a borderline personality style. A total of n = 53 participants were assigned to BPD, n = 83 to BP, with comorbid participants excluded. Twenty items were highly endorsed (>95%) by the BPD group, with most of the features capturing emotional dysregulation (ED) and identity disturbance; however, many items were also highly endorsed by the participants with BP. Thirty-eight items offered differentiation of BPD from BP, with identity disturbance overrepresented. The study findings indicate that the transdiagnostic nature of ED (a feature of both conditions) means it is less useful for diagnostic decisions, whereas identity disturbance is both intrinsic to BPD and offers specificity in differentiation from BP.
A Randomized Controlled Trial Assessing the Efficacy of Group Psychological First Aid
imageA randomized controlled trial assessed the efficacy of group psychological first aid (PFA) by comparing the Johns Hopkins RAPID-PFA model with a group conversation condition in 119 participants using the state version of State Trait Anxiety Scale and the Positive and Negative Affect Schedules. Both groups showed similar baseline scores, and after watching a distressing 5-minute video, both groups showed similar significant increases in state anxiety scores and negative affect scores, as well as similar decreases in positive affect scores. However, compared with the group conversation condition, the RAPID-PFA group evidenced significantly lower state anxiety scores at postintervention and at 30-minute delay. RAPID-PFA, compared with the group conversation condition, was also more effective in lowering negative affect scores postintervention, and significantly increasing positive affect scores at 30-minute delay. These results support the two primary goals of PFA, which are mitigating acute distress and instilling hope.
Total and Differential White Blood Cell Counts, Cocaine, and Marijuana Use in Patients With Schizophrenia
imageSchizophrenia is associated with blood inflammatory marker abnormalities. Illicit drug use, which is common in schizophrenia, may modulate inflammatory marker levels. We examined effects of marijuana and cocaine use on white blood cell (WBC) counts in acutely ill, hospitalized patients with schizophrenia using a within-subjects and between-groups design. Mean total and differential WBC counts were first compared in acutely ill patients with schizophrenia for hospitalizations with and without either marijuana (n = 18) or cocaine (n = 24) use. Mean total and differential WBC counts were then compared between patients with schizophrenia with either marijuana or cocaine use and patients with a negative urine drug screen (UDS; n = 43). Patients with schizophrenia had significantly higher total WBC, lymphocytes, and monocytes during hospitalizations with (vs. without) cocaine use. Patients with cocaine use also had significantly higher monocytes and eosinophils than those with a negative UDS. Our findings suggest that substance use, particularly of cocaine, may modulate inflammatory marker levels in acutely ill, hospitalized patients with schizophrenia.
Investigating the Relationship Between Weight-Related Self-Stigma and Mental Health for Overweight/Obese Children in Hong Kong
imageThis study aimed to test the differences of weight-related self-stigma and mental health conditions between overweight (OW) and non-OW children in Hong Kong. The correlations between weight-related self-stigma and mental health conditions were also investigated. Children aged 8 to 12 years (n = 367; 198 boys) completed questionnaires on weight-related self-stigma (Weight Bias Internalization Scale [WBIS] and Weight Self-Stigma Questionnaire [WSSQ]) and mental health conditions (Brief Symptom Rating Scale-5 [BSRS-5]). Compared with non-OW children (n = 241; 143 boys), OW children (n = 114; 55 boys) had higher weight-related self-stigma in the WBIS (26.49 ± 8.68 vs. 21.58 ± 7.54; p < 0.001) and WSSQ scores (26.36 ± 8.98 vs. 21.91 ± 8.71; p < 0.001). No significant difference was found between OW and non-OW children in mental health conditions as reflected by the BSRS-5 score (4.29 ± 4.35 vs. 4.44 ± 4.16; p = 0.761). BSRS-5 was significantly associated with the WBIS. OW children tended to have a higher level of self-stigma; those having a higher level of weight-related self-stigma presented with more mental health problems.
Burnout and Its Relationships With Alexithymia, Stress, Self-Esteem, Depression, Alcohol Use Disorders, and Emotional Intelligence: Results From a Lebanese Cross-Sectional Study
imageOur aim was to assess the relationship between personality and psychological traits, and burnout among the Lebanese population. A questionnaire-based cross-sectional study was conducted with multiple validated scales used to measure burnout and other characteristics. A cluster analysis was then performed to split the population into mutually exclusive groups with different profiles according to the burnout scales using the K-mean method. A multivariate analysis of covariance was carried out to compare multiple measures between the cluster groups under comparison. The study, conducted between November 2017 and March 2018, enrolled 789 participants. The results showed that 100 (14.0%) had high emotional work fatigue, whereas 443 (62.5%) and 680 (95.4%) had high mental and physical work fatigue, respectively. People with high physical work fatigue (cluster 1) had lower alcohol dependence (β = −2.78), alexithymia (β = −3.16), depression (β = −7.20), anxiety (β = −6.99), perceived stress (β = −2.53), social phobia (β = −11.49), suicidal ideation (β = −0.35), emotional awareness (β = −4.54), emotional managament (β = −1.71), social emotional awareness (β = −9.27), and relationship management (β = −9.12). People with high emotional work fatigue (cluster 2) had higher alcohol dependence (β = 2.11), alexithymia (β = 6.51), depression (β = 2.48), anxiety (β = 4.11), perceived stress (β = 4.30), and lower emotional awareness (β = −6.68), emotional management (β = −7.80), social emotional awareness (β = −3.71), and relationship management (β = −3.05). Higher levels of burnout were found to be associated with multiple psychological factors. The results would help understand the burnout dimensions and their correlated factors in the Lebanese population.
Heart-Focused Anxiety Among Latinxs in Primary Care: Relations to Anxiety, Depression, Pain, and Functional Impairment
imageThere is a public health need to better characterize the individual-based differences that may be involved in the expression and maintenance of psychological and related health problems among Latinx individuals. One individual difference factor that may be relevant to the nexus of psychological and physical concerns is heart-focused anxiety. The current study sought to evaluate the potential explanatory relevance of heart-focused anxiety as an important individual difference factor for anxiety, depression, pain experience, and functional impairment. Participants included 158 Latinx adults (Mage = 39.26, SD = 13.19; 85.4% female) from a primary health clinic. Results indicated that heart-focused anxiety was significantly related to anxious arousal, pain intensity, pain disability, and functional impairment. However, no significant effects were evident for depressive symptoms. These data indicate that heart-focused anxiety may be an underrecognized cognitive factor relevant to better understanding anxiety and pain among Latinx adults in primary care.
For Better or Worse: Facebook Use and Wellbeing Among Community Mental Health Care Clients
imageOnline social networking is ubiquitous, but research regarding its relationship to wellbeing has yielded contradictory results. This study examined the relationship between Facebook use and wellbeing among community mental health service clients. Twenty-six clients from a community mental health service provided access to their Facebook page. Seven aspects of 3674 Facebook posts were coded, and cross-lagged multilevel models were estimated over three periods to establish the relationship between Facebook use and wellbeing over time. Some aspects of Facebook use were related to wellbeing within the same period, although this pattern of relationships did not emerge longitudinally. Although Facebook has the potential to forge social connections for those who are socially isolated, Facebook use was neither helpful nor harmful over time among people with mental health problems. Given the prevalence of social networking, a clearer understanding of its impact on wellbeing is critical for mental health providers.
Association of Psychache and Alexithymia With Suicide in Patients With Schizophrenia
imageSuicide is a leading cause of death in patients with schizophrenia. Previous studies have mostly investigated the association between suicide and sociodemographics, positive and negative symptoms, and depressive symptoms. This study evaluated psychache and alexithymia in patients with schizophrenia, which have both been associated with suicide attempts and thoughts in patients with other psychiatric disorders. Positive and Negative Syndrome Scale (PANSS), Psychache Scale (PAS), Beck Scale for Suicidal Ideation (BSSI), Calgary Depression Scale for Schizophrenia (CDSS), and Toronto Alexithymia Scale (TAS) scores were obtained in 113 patients with schizophrenia, including 50 with suicide attempts. PANSS positive symptoms and general psychopathology subscale, CDSS, BSSI, TAS, and PAS scores were significantly higher in patients with suicide attempts. In multivariate logistic regression analysis, only the PAS score was an independent predictor of attempted suicide. Mediation analysis demonstrated that psychache (both directly and indirectly) and alexithymia (indirectly) might be associated with the risk of suicide in these patients.
Refining Psychological, Substance Use, and Sociodemographic Predictors of Suicide Ideation and Attempts in a National Multiethnic Sample of Adults, 2008–2013
imageThe purpose of this study was to examine psychological, substance use, and sociodemographic predictors of 12-month suicide ideation and attempts across six US racial/ethnic groups—white, Latino/a, Black, Asian or Pacific Islander (A/PI), American Indian or Alaska Native (AI/AN), and multiracial adults. Multiple logistic regression analyses were conducted for 218,765 adults who participated in the 2008–2013 National Survey on Drug Use and Health. Overall, commonly cited factors were associated with increased risk for suicide ideation and attempt for some racial/ethnic groups, but not for others. As one example, 12-month depression was associated with 12-month suicide attempt for A/PI, AI/AN, Latino/a, and white, but not for Black or multiracial adults. Alcohol abuse and dependence were also associated with suicide attempt for AI/AN, Black, and white respondents but not for other racial/ethnic groups. Risk factors for suicide ideation and attempt may not increase risk universally. More theoretically supported research is needed.

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