Psychopathology最新文献

{"title":"One-way Love. The paradox of loving without expectation between existential assurance and the missed encounter with the Other.","authors":"Giovanni Stanghellini","doi":"10.1159/000548794","DOIUrl":"https://doi.org/10.1159/000548794","url":null,"abstract":"<p><strong>Background: </strong>The phenomenon of love is an important task for the psychopathologist since love experience is the site in which the Self is formed and potentially dismantled. This paper explores \"one-way love\"-an autotelic form of love that persists independently of return. It may serve as a way for the person to sustain a sense of autonomy finding fulfilment in the act of loving itself - a paradoxical affirmation of identity, existence, and autonomy.</p><p><strong>Summary: </strong>The analysis unfolds three central functions of one-way love: (1) it frees the person from dependency on the Other's love; (2) it preserves the integrity of the lover's own desire protecting it from the confrontation with the Other's desire; (3) it offers the lover a heroic and noble self-image rooted in fidelity to feeling. One-way lovers may appear as dependent on a beloved who does not reciprocate, but they are firmly convinced that they are performing a radical act of freedom: loving not to be loved in return, but to assert their own existence as a person fully capable of loving.</p><p><strong>Message: </strong>One-way love is a strategy in which desire and fear intersect, sustaining the beloved at a distance and affirming the lover's capacity to love without dependence. Yet, this autonomy carries a cost: it prevents genuine intimacy with the Other. By avoiding the vulnerability required to share private aspects of the Self, one-way lovers evade the very encounter with otherness that is essential to the ongoing development and transformation of the Self.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Embodied Mind as Pharmacological Target: Towards a Phenomenology of Psychopharmacological Interventions.","authors":"Stefan Jerotić, Janko Nešić, Vuk Vuković, Luis Madeira","doi":"10.1159/000548625","DOIUrl":"https://doi.org/10.1159/000548625","url":null,"abstract":"<p><p>Psychopharmacology is currently plagued by reductionism since it is understood as the treatment of biological and behavioral symptoms of mental disorders without taking into account the subjective life of the self in relation to others. Psychopharmacological interventions, such as antidepressants and antipsychotics, must be situated and discussed within the embodied context of the organism-environment. To overcome this inadequacy, we present a framework for understanding the effects of psychopharmacological treatments that move beyond the traditional reductive, biochemical perspective by putting forward an embodied and enactive approach to psychopharmacology that integrates phenomenology, neuroscience, and physiology. This approach explores how medications impact not only symptoms but also patients' lived experiences, existential feelings, and embodied sense of self. Psychotropic drugs interact with the entire lived body, influencing emotional processing, perception, and the embodied self, determining emotional blunting, changing affect, temperamental dispositions, and altering motor function and sensory experience. This fundamentally shapes patients' embodied engagement with their environment, which reciprocally influences the entire embodied system, thereby promoting a more nuanced understanding of treatment effects that account for physiological and experiential dynamics. We also emphasize the importance of the clinician as a mediator of embodied change, moving beyond the mere management of symptoms to supporting patients in navigating the complex shifts in self-perception and relationality induced by pharmacotherapy. We advocate for the development of phenomenological profiles of psychopharmacological drugs, as well as tailored, patient-centered psychopharmacological interventions that take into account not only clinical efficacy but also the subjective and embodied changes these treatments induce, and how they interact with the patients' unique phenomenological profiles.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-16"},"PeriodicalIF":2.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who are people with psychosis delusional about? A study of social agents in the phenomenology of delusions.","authors":"Elisavet Pappa, Nichola Raihani, Vaughan Bell","doi":"10.1159/000548611","DOIUrl":"https://doi.org/10.1159/000548611","url":null,"abstract":"<p><strong>Introduction: </strong>Delusions frequently involve strong beliefs about, or interactions with, illusory social agents. Although such agents have been systematically described in hallucinations, few studies have investigated their nature and identity in delusions.</p><p><strong>Methods: </strong>We identified 205 electronic mental health records describing the content of delusions from the Clinical Record Interactive Search (CRIS) platform at South London and Maudsley NHS Foundation Trust. Delusional content was classified as non-social, implicitly social, or explicitly social. Descriptions of illusory social agents from explicitly social delusions were extracted and categorized using an upward coding analysis. A hierarchical cluster analysis identified distinct groupings of illusory social agents.</p><p><strong>Results: </strong>Most delusions (83.4%) contained explicit references to illusory social agents. Across 238 instances, we identified 220 distinct agent identities, with a mean of 1.17 agents per record. The majority were humans (85.1%), most often identified as family members (31.0%), followed by acquaintances (17.2%), religious figures (13.2%), unnamed persons (12.8%), professionals (11.8%), and cultural figures (10.9%). Hierarchical clustering revealed two distinct groups: one including socially proximate agents and the other more socially distant agents. These findings indicate a social gradient in delusions.</p><p><strong>Conclusion: </strong>Social content predominates in delusions, with patients experiencing delusions about socially closer individuals more frequently. We discuss the extent to which social gradient may not be unique to delusional misidentification syndromes but may instead represent a general feature of delusions. Better characterization of social agents in delusions could inform mechanistic accounts of these symptoms and, in clinical practice, guide family support and risk assessment.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-19"},"PeriodicalIF":2.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Felt-Presence and Psychosis-Risk in the General Population.","authors":"Tatiana Baxter, Sohee Park","doi":"10.1159/000548612","DOIUrl":"https://doi.org/10.1159/000548612","url":null,"abstract":"<p><strong>Objective: </strong>Felt presence (FP) is the experience that another entity is present in one's proximal environment, despite no sensory evidence. Occurrence of FP is linked to psychosis-risk, but qualities of FP in the context of psychosis are not well-understood. We conducted an online, exploratory survey assessing qualities of FP in relation to psychosis-risk in the general population.</p><p><strong>Method: </strong>Three-hundred and seventy-six participants completed an anonymous online survey consisting of validated measures of sensed presence, psychosis-risk, loneliness, trauma, resilience and general mental health. They also responded to questions about perceptual qualities of FP. We investigated the role of the presence and qualities of FP in predicting psychosis-risk, and the qualities of FP in relation to psychosis-risk. We also examined the relationships between qualities of FP, psychosis-risk, and psychosocial variables.</p><p><strong>Results: </strong>FP and anxiety significantly predicted elevated psychosis-risk. FP experience in the high-risk group was more frequent, distressing, vivid, and multisensory than in the low-risk group. Specifically, distress during FP significantly predicted psychosis-risk status over and above demographic and psychiatric covariates (including anxiety). Cumulative trauma was linked with total number of FP experiences as well as increased frequency, distress, vividness, and understandings of FP's identity. Depression, anxiety, and stress were associated with more physiological sensations and increased distress during FP, as well as knowledge of FP's identity. Resilience was associated with more frequent and vivid FPs.</p><p><strong>Conclusions: </strong>These results demonstrate strong links between FP and psychosis-risk in the general population and provide preliminary evidence of qualitative markers that differentiate FP from psychosocial factors in the context of psychosis-risk. Assessment and clinical conceptualizations of risk for schizophrenia should consider including experiences of bodily self-disturbance, such as FP.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-29"},"PeriodicalIF":2.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal hallucinations in Muslim patients with severe psychotic disorders: The entity experience revisited.","authors":"Anastasia Lim, Hans W Hoek, Jan Dirk Blom","doi":"10.1159/000548607","DOIUrl":"https://doi.org/10.1159/000548607","url":null,"abstract":"<p><strong>Introduction: </strong>In biomedicine, entity experiences are conceptualised as compound hallucinations featuring living beings. The term 'experience' suggests that these have an objective basis in reality, as those perceiving them may maintain. So-called jinn encounters, typically described by Muslims with and without a psychiatric diagnosis, involve the multimodal perception of a spirit that, as described in the Qur'an, was created by Allah.</p><p><strong>Methods: </strong>We conducted a phenomenological investigation among Muslim patients residing at Parnassia Psychiatric Institute, The Hague, mostly diagnosed with a schizophrenia spectrum disorder. To inquire specifically into multimodal hallucinations featuring jinn or related entities, we used the Hallucination Attribution List (HAL), a tailor-made, semi-structured questionnaire.</p><p><strong>Results: </strong>Of the 42 interviewees, 35 described multimodal hallucinations of which 22 fulfilled the criteria of entity experiences involving two to six sensory modalities simultaneously. Twelve participants (54.5%) were fully convinced they were dealing with jinn; the others left some room for doubt. Although we did not quantitatively assess the levels of jinn-associated distress, all participants characterised their experiences as impressive and impactful.</p><p><strong>Conclusion: </strong>Multimodal hallucinations may involve full-blown entity experiences, which in Muslim patients typically take the form of jinn encounters. The way in which these entity experiences are mediated is as yet uncertain. However, since visual, auditory, and tactile hallucinations in our sample were described substantially more frequently than somatic, olfactory, and gustatory ones, we hypothesise that the processes underlying the hallucinations may be driven by a stochastic mechanism in that the first three sensory modalities need to have been engaged before the latter three can be recruited. We highlight several biological models of potential underlying mechanisms as well as two overarching models that may help place the mechanisms in the wider context of personal, social, cultural, religious, philosophical, and evolutionary factors that, conceivably, all play a role in their mediation.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Dual Diagnoses: Psychopathological Characteristics in the Co-Occurrence of Schizophrenia and Addiction: A scoping review.","authors":"Stefania Chiappini, Alessio Mosca, Andrea Miuli, Giacomo D Apos Andrea, Clara Cavallotto, Francesco Semeraro, Tommaso Piro, Maria Chiara Vicinelli, Rolando Tucci, Concetta Conidi, Alessia Santeusanio, Mauro Pettorruso, Giovanni Martinotti","doi":"10.1159/000547322","DOIUrl":"https://doi.org/10.1159/000547322","url":null,"abstract":"<p><strong>Background: </strong>The co-occurrence of schizophrenia and substance use disorders (SUDs), referred to as dual diagnosis, represents a significant challenge in psychiatric research and clinical practice. The interplay between these conditions complicates symptomatology, diagnosis, and treatment, necessitating an integrated approach to care.</p><p><strong>Summary: </strong>This scoping review systematically examines the available literature on the psychopathological characteristics of individuals with dual diagnosis, emphasizing symptomatologic clusters associated with different substances. A systematic search was conducted in Medline and Scopus databases to identify original research articles published in the last 20 years. Studies examining psychosis-related symptoms in individuals with SUDs were included, excluding non-original research, non-English articles, and studies not focusing on dual diagnosis. A total of 129 studies were included, with cannabis being the most frequently studied substance, followed by alcohol, stimulants, and opioids. The most commonly reported symptoms were positive symptoms (hallucinations, delusions, paranoia, disorganized thinking), cognitive impairments, and negative symptoms (social withdrawal, anhedonia). Emotional dysregulation, impulsivity, and aggression were also frequently documented. Substance-induced psychosis was found to differ from primary psychotic disorders in symptom severity, age of onset, and associated comorbidities.</p><p><strong>Key messages: </strong>The psychopathology of dual diagnosis is multifaceted, with overlapping and complex symptom presentations. Substance use can exacerbate or trigger psychotic symptoms, making differential diagnosis challenging. These findings highlight the need for integrative treatment strategies that address both psychotic and substance-related symptoms. Further research is needed to develop standardized diagnostic criteria and targeted interventions for dual diagnosis patients.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-54"},"PeriodicalIF":2.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Data-Driven Decomposition of Anxiety.","authors":"Andreas Buchmann, Adrian Hase, Christopher Johannes Ritter, Sabrina Theresia Müller, Melanie Haynes, Sylvia Huber, Carmen Ghisleni, Ruth O Apos Gorman Tuura, Gregor Hasler","doi":"10.1159/000548258","DOIUrl":"https://doi.org/10.1159/000548258","url":null,"abstract":"<p><strong>Introduction: </strong>The present paper identified key components of anxiety and fear based on a large community sample of 387 psychiatrically healthy or depressed participants.</p><p><strong>Methods: </strong>Subfactors were defined based on a principal component analysis with promax rotation and characterized via correlations with other psychiatric as well as physiological and volumetric indicators collected in this large study.</p><p><strong>Results: </strong>The key components were labelled \"discomfort\", \"fright\", \"nervousness\", \"lack of self-confidence\", and \"worry\". We discuss the components according to their organizational complexity, but also in terms of their affective and motivational content.</p><p><strong>Conclusion: </strong>The components may be useful for future research, as they are based on three of the most-used psychiatric questionnaires assessing anxiety and fear symptoms.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-24"},"PeriodicalIF":2.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revising the Standard Definition of Hallucination: Delirium and Schizophrenia.","authors":"Kasper Møller Nielsen, Julie Nordgaard, Søren Overgaard, Mads Gram Henriksen","doi":"10.1159/000548200","DOIUrl":"https://doi.org/10.1159/000548200","url":null,"abstract":"<p><strong>Background: </strong>According to the standard definition, a hallucination is 1) a perceptual experience occurring in the absence of a relevant perceptual object, 2) it has the sense of reality of a veridical perception, and 3) it is unwilled and not under voluntary control of the hallucinator. This definition is supposed to encompass all hallucinations, across mental disorders and experiential modalities.</p><p><strong>Summary: </strong>In this article, we examine the standard definition's validity by comparing visual hallucinations in delirium and auditory verbal hallucinations (AVHs) in schizophrenia, focusing especially on the definition's second criterion, i.e., the sense of reality criterion. Our analysis reveals stark differences between these two disorders, their concomitant experiential structures, and the experience of hallucinations. While hallucinated objects are experienced as real in both disorders, they are typically not experienced as real in the same sense of the term. In delirium, hallucinatory objects are experienced as real in the way perceptual objects are, and they often are indistinguishable from such objects. In schizophrenia, by contrast, hallucinatory objects are often not experienced as real in the way perceptual objects are, and they often are distinguishable from such objects.</p><p><strong>Key message: </strong>An appreciation of the different kinds of sense of reality of hallucinations is relevant for developing more precise psychopathological concepts, clinical care, and empirical research. Based on our findings, we offer a revision of the standard definition of hallucination, making it valid for the variety of hallucinations that are found across mental disorders.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Phenomenological Reappraisal of Dynamical Systems in Psychopathology.","authors":"Evan J Kyzar, George H Denfield, Jasper Feyaerts, Louis Sass, Barnaby Nelson","doi":"10.1159/000548025","DOIUrl":"10.1159/000548025","url":null,"abstract":"<p><strong>Background: </strong>Dynamical systems theory (DST) has recently gained traction as a framework to describe and predict the progression of psychopathology. However, a number of challenges to the application of DST to psychopathology have arisen, including the heterogeneity of symptom measures and the lack of theoretical underpinnings to describe the temporal unfolding of psychiatric illnesses.</p><p><strong>Summary: </strong>In this article, we aim to show how the integration of methods from phenomenology may strengthen the application of DST in psychopathology research. We explore how phenomenological psychopathology can improve DST-based investigations in two key ways: (1) by specifying the core symptoms of interest in psychopathological states in a more precise manner by focusing on subjective experiences, and (2) by deepening our theoretical understanding of how these symptoms evolve in severity over time. We show how incorporating phenomenologically informed measures of experience can complement DST using clinical high risk (CHR) for psychosis as a test case, and we demonstrate the utility of combining phenomenologically informed theory and DST by examining the ipseity-disturbance model (IDM) of psychosis development. We close by offering a vision for the broader integration of DST and phenomenological research methods within psychopathological research.</p><p><strong>Key messages: </strong>Phenomenological investigations can synergize with and advance the use of DST to better understand and predict psychiatric disorders and transitions in states of mental health.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"For a Choreography of Emotions: Spatiotemporal Phenomenology.","authors":"Giovanni Stanghellini, Veronica Boniotti, Angelika Wolman, Helene Cæcilie Mørck, Georg Northoff","doi":"10.1159/000547559","DOIUrl":"10.1159/000547559","url":null,"abstract":"<p><strong>Background: </strong>Emotions are a key feature of human life. Despite intensive research, we still do not have a full grasp of the complexity of emotions, such as their peculiar combination of emotional feeling and behavioral motor manifestation. We also lack translational research that links the phenomenal (experiential) with the pre-phenomenal (neurological) levels.</p><p><strong>Summary: </strong>Operating within the framework of embodiment on experiential and neural levels, we characterize different emotions by their different movements as well as by their distinct experiences of time and space, rather than externally observable behavior. This leads literally to a choreography of emotions and spatiotemporal phenomenology, that is, a characterization of emotions in terms of corporeality, particularly how persons feel that their body moves in space and time and interacts with its environment. That is complemented by an outlook of linking such views of emotions to the brain through what has recently been introduced as \"Spatiotemporal Neuroscience,\" whose theoretical background is briefly sketched and outlined. This is accompanied by an example of the temporal changes, with abnormal slowness being shared by both, experience and brain, as their \"common currency\" during sadness.</p><p><strong>Key message: </strong>We here introduce the outline of a choreography of emotions as a descriptive framework that makes reference to the direction and timing of the way persons experience their bodily movement, as well as to the matching of bodily movements and the surrounding lived space, which carries high potential of being directly linked to the brain in a non-reductive way through spatiotemporal neuroscience.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-19"},"PeriodicalIF":2.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}