Psychopathology最新文献

{"title":"Distressing Experiences of Felt Presence in Child and Adolescent Mental Health Services: Early Observations from the ChUSE Trial and the Challenges of Assessment.","authors":"Sarah Parry, Sarah Carr, Ben Alderson-Day","doi":"10.1159/psp/aelag004","DOIUrl":"10.1159/psp/aelag004","url":null,"abstract":"<p><strong>Introduction: </strong>Felt presence (FP) is an emerging field of clinical research, and to our knowledge, there are no studies exploring the phenomenon within children and young people. The current study aims to address this by reporting the experiences of FP from a clinical sample of young people involved in the ChUSE trial, a feasibility and acceptability RCT looking at supporting young people with distressing sensory experiences (DSEs) within CAMHS services in the NHS.</p><p><strong>Methods: </strong>Self-reported experiences of FP were collected at baseline assessment alongside other DSEs for 50 young people aged 8-16 years. Qualitative analysis of therapeutic sessions that young people received as part of the ChUSE trial was used to identify themes relating to FPs.</p><p><strong>Results: </strong>Rates of reporting during the baseline assessment of feeling watched or followed were high (88%) with 28% reporting that they were most distressed by this experience alongside other DSEs. Over half the young people (63.8%) who received therapy as part of the trial reported regularly experiencing and feeling distressed in relation to a FP. Six themes were identified and FP was often associated with a sense of threat, physical sensations of closeness, and a visceral sense of being observed.</p><p><strong>Conclusion: </strong>FP is potentially more common and distressing for young people in CAMHS than previously recognised and routine assessment should be considered alongside assessment of other DSEs. There were limitations in the current study in relation to how FP was assessed and future research should include a more robust measure of FP. More broadly, there is a need to include a more diverse sample of young people in any future research in this emerging field to get a better understanding of this phenomenology within a developmental context.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841017","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":"Imaginative Vulnerability and Symbolic Mediation: A Phenomenological Analysis in Schizophrenia-Spectrum Conditions.","authors":"Birgit Bundesen, Keld Stehr Nielsen, Bo Ærenlund Sørensen, Sebastian Porsdam Mann, Allan Køster","doi":"10.1159/psp/aelag005","DOIUrl":"10.1159/psp/aelag005","url":null,"abstract":"<p><strong>Introduction: </strong>Imagination depends on symbolic mediation that sustains an as-if mode of experience. In schizophrenia-spectrum conditions, this mediation is structurally vulnerable, rendering imaginative activity unstable under intensified activation. Arts-based interventions have rarely specified the conditions under which imaginative activity remains symbolically mediated rather than becoming overwhelming. The present study examines how imaginative vulnerability is regulated in group-based creative writing.</p><p><strong>Methods: </strong>The analysis draws on retrospective phenomenological interviews with 50 participants with schizophrenia-spectrum diagnoses from the REWRITALIZE programme and applies a phenomenologically grounded qualitative approach organised around three conditions of symbolic mediation: aesthetic distance, relational holding, and the as-if frame.</p><p><strong>Results: </strong>Destabilisation emerges as a structural possibility when symbolic mediation becomes insufficiently coordinated across form, relation, and frame. Four modes of destabilisation are identified: affective flooding, boundary permeability, frame slippage, and cognitive or social overload. These configurations reflect strain within a shared symbolic and relational field in which imaginative material loses its mediating function and acquires immediacy or intrusiveness. When aesthetic distance, holding, and the as-if frame remain sufficiently coordinated, imaginative activity retains a representational character and enables articulation, modulation, and continuity while maintaining difficulty.</p><p><strong>Conclusion: </strong>Creative writing functions as a phenomenological amplifier of imaginative vulnerability and symbolic stability alike. The study contributes to phenomenological psychopathology by showing that destabilisation reflects not a deficit of imagination, but a failure of symbolic mediation under intensified activation, and by clarifying how symbolic and relational conditions regulate imaginative processes in schizophrenia-spectrum conditions.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840982","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":"What Is Phenomenology For? Applications in Autism Mental Health and a Pragmatist Criterion of Success.","authors":"Themistoklis Pantazakos","doi":"10.1159/psp/aelag003","DOIUrl":"10.1159/psp/aelag003","url":null,"abstract":"<p><strong>Background: </strong>Phenomenological approaches have gained increasing traction in autism mental health studies, yet what phenomenology specifically contributes, beyond a general orientation toward lived experience, has received little scrutiny. This paper asks two questions: why phenomenology, rather than other ways of attending to experience, is needed in autism mental health research and clinical practice, and what, concretely, it is for. Throughout, it adopts the neurodiversity-affirming stance that autism is not a deficit at the level of the condition, while treating what serves a given person as open, facet by facet, to empirical inquiry.</p><p><strong>Summary: </strong>The paper makes two contributions. The first is a pragmatist criterion of phenomenological success, according to which an interpretation earns credibility through the predictions and interventions it allows - in the clinical case, its capacity to facilitate outcomes the service user values. However, left unqualified and because it reaches beneath what a person can by themselves articulate, this kind of inquiry risks re-enacting the displacement of autistic voices a neurodiversity-affirming stance opposes. In response, two safeguards are developed to keep interpretation answerable to the person it concerns. The second contribution identifies three sites in autism mental health where phenomenology does work other methods cannot: assessment and formulation, where it surfaces the experiential structure a presenting symptom obscures; evaluation of outcomes, where it supplies the register in which success can be judged at all; and the therapeutic relationship. Illustrations are drawn from a recent qualitative study with autistic psychotherapy clients.</p><p><strong>Key messages: </strong>Phenomenology's contribution to autism mental health is distinctive and non-substitutable, not merely a general orientation toward lived experience. A pragmatist criterion judges a phenomenological interpretation by its capacity to facilitate outcomes the service user values. Phenomenology does uniquely important work at three sites: assessment and formulation, evaluation of outcomes, and the therapeutic relationship.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841020","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":"Contiguity and the Genesis of Autistic Experience: What Psychoanalysis Contributes to Phenomenology.","authors":"Sofie Boldsen, Joona Taipale","doi":"10.1159/psp/aelag002","DOIUrl":"10.1159/psp/aelag002","url":null,"abstract":"<p><strong>Background: </strong>While contemporary phenomenologists have highlighted the central role of sensory differences in autism, such differences have rarely been phenomenologically interrogated in their own right. The psychoanalytic approach to autism offers an underexplored resource for addressing this gap. Focusing on Thomas Ogden's concept of contiguity, this paper investigates how autistic sensory experience may be fundamentally structured through a \"touch-like\" mode of relating to self and world.</p><p><strong>Summary: </strong>Drawing on Ogden's suggestion that autism is characterized by contiguity as a norm for the experience of self and world, we argue that contiguity presents as a mode of generating sensory experience in autism across a broad range of phenomena commonly grouped under the heading of sensory differences. Illustrating this point through an integrative reading of autistic autobiographical writings, we emphasize how autistic sensory experiences and behaviors may often serve to manage a felt porousness of bodily boundaries. As we show, this does not render autism pathological but accounts for autistic experience in terms of an accentuation of an indispensable dimension of human experience. In conclusion, we briefly discuss how Ogden's psychoanalytic theorization may pave the way for a genetic phenomenology of autism.</p><p><strong>Key messages: </strong>We argue that Ogden's concept of contiguity allows for a radical rearticulation of autistic experience in terms of a felt permeability to the world and others rather than an increased detachment from them. In doing so, we highlight the value of bringing psychoanalysis into dialogue with phenomenology for interdisciplinary autism research.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813721","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":"Frozen Instants and Gestalt Words: Toward a Phenomenology of Autistic Language and Temporality.","authors":"Yiğit Özaydın, Buket Canlan Özaydın","doi":"10.1159/psp/aelag001","DOIUrl":"10.1159/psp/aelag001","url":null,"abstract":"<p><strong>Background: </strong>Autistic patterns of language use, including echolalia, gestalt language processing, and formulaic repetition, have been theorized largely within behavioral and developmental frameworks. Such accounts have documented the functional range of these phenomena in valuable detail, yet their experiential structure has received little attention.</p><p><strong>Summary: </strong>This paper develops a phenomenological account of autistic language and temporality. We argue that echolalia and gestalt language are best understood not as deficient approximations of normative speech but as expressions of a distinctly structured temporal consciousness. Drawing on Husserl's analysis of inner time-consciousness and Merleau-Ponty's account of bodily intentionality, we propose that autistic temporal experience may be marked by a heightened density of the present moment, a configuration in which retention and protention are differently weighted and in which the instant attains a relative closure that canonical phenomenological accounts do not anticipate. We name this configuration the weighted present. Gestalt language, read in this light, appears less as a failure of analytic decomposition than as a mode of meaning-making that preserves semantic wholes rooted in bodily-affective memory.</p><p><strong>Key messages: </strong>The argument carries implications for both phenomenological theory and clinical practice. It questions the assumption of a universal temporal substrate underlying language acquisition, and it motivates a clinical reorientation from suppressing echolalia toward interpreting it. The clinical question accordingly shifts from how to reduce echoed speech toward what a given echoed utterance discloses about the temporal and affective character of the moment in which it appears.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763411","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":"Validation of the Examination of Autistic Intersubjective Experiences.","authors":"Tim Schnitzler, Miriam Feix, Valeria Bizzari, Thomas Fuchs","doi":"10.1159/000552698","DOIUrl":"10.1159/000552698","url":null,"abstract":"<p><strong>Introduction: </strong>In the past 2 decades, phenomenological interviews have been used in psychopathological research, mostly in schizophrenia, demonstrating how psychopathology and psychiatry can benefit from phenomenology. For autism spectrum condition, there was no such an interview, which is why we designed the Examination of Autistic Intersubjective Experience (EAIE).</p><p><strong>Methods: </strong>In the present study, we conducted the EAIE with 20 autistic and 20 non-autistic individuals.</p><p><strong>Results: </strong>Our results showed considerable differences between the two study groups in the total score and in each domain. For the total EAIE scores, we found good internal consistency, but this was insufficient for the individual domains, with two exceptions. Interrater reliability was almost 0.9, while intrarater reliability was 0.6 after repeating the interview almost 2 years later.</p><p><strong>Conclusion: </strong>We demonstrated the viability of utilizing the EAIE to assess, quantify, and investigate subjective anomalies in the experience of intersubjectivity among autistic individuals. Due to the low internal consistency, we recommend focusing predominantly on the total scores if EAIE is intended for quantitative assessment of deviations in social interaction rather than for qualitative evaluation.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-10"},"PeriodicalIF":3.1,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382506","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":"Childhood Maltreatment and Psychopathology: The Mediating Roles of Mentalizing and Attachment Styles.","authors":"Calliope Amy Chen, Klara Selén, Sophie Raymont, Chris MacGregor, Rob Saunders, Tobias Nolte, Peter Fonagy","doi":"10.1159/000553373","DOIUrl":"10.1159/000553373","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence suggests that childhood maltreatment is associated with adult psychopathology, including borderline personality disorder (BPD). Mentalizing and attachment styles (anxiety and avoidance) are implicated in psychopathology development and maintenance of psychopathology, and may serve as treatment targets.</p><p><strong>Methods: </strong>This study investigated (1) associations between childhood maltreatment (severity and multiplicity) and adult psychopathology (psychological distress and BPD symptoms), and (2) indirect effects of mentalizing, anxious attachment style, and avoidant attachment style. Using structural equation modeling and network analysis, we tested these relationships in a cross-sectional sample of 340 participants.</p><p><strong>Results: </strong>Results supported a dose-response relationship between maltreatment and adult psychopathology, with both severity and multiplicity significantly associated with increased psychological distress. Mentalizing exhibited a partial indirect effect in this association, as lower mentalizing was related to higher levels of psychopathology. Attachment anxiety demonstrated an indirect effect across the maltreatment-psychopathology relationship, whereas attachment avoidance was not found to be a meaningful indirect pathway. Notably, mentalizing difficulties emerged as the strongest indirect pathway across all models, highlighting mentalizing interventions as promising transdiagnostic approaches for mitigating the psychological impacts of childhood trauma. Exploratory network analysis broadly converged with these findings, showing that mentalizing and attachment anxiety were uniquely associated with psychopathology after controlling for all other variables in the network, whereas attachment avoidance occupied a peripheral position.</p><p><strong>Conclusion: </strong>Overall, these results enhance understanding of mechanisms linking early adversity to adult psychopathology, emphasizing the importance of interventions addressing transdiagnostic risk factors such as mentalizing difficulties and heightened attachment anxiety.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-17"},"PeriodicalIF":3.1,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382563","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":"Tourette Syndrome and Rage Attacks: A Longitudinal and Cross-Sectional Study.","authors":"Ida Cintin, Camilla Groth, Liselotte Skov, Nanette Mol Debes","doi":"10.1159/000553160","DOIUrl":"10.1159/000553160","url":null,"abstract":"<p><strong>Introduction: </strong>Rage attacks (RA) are prevalent in patients with Tourette syndrome (TS) and affect their quality of life severely. Due to TS's relationship with attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD), a genetic reason or an increased level of irritability from early in life could be hypothesized. This longitudinal study aimed to examine the correlation between tic severity and comorbidities and RA at baseline and 6 years later. We hypothesize that a higher symptom load of TS and comorbidities results in more RA.</p><p><strong>Methods: </strong>We examined 314 patients with TS (age 5-19) at baseline and re-examined 227 patients 6 years later together with a matched control group using various instruments to assess the severity of tics, ADHD, OCD, and the presence of RA.</p><p><strong>Results: </strong>Patients experienced more RA than control subjects at both time points. Patients with RA at baseline had more compulsions and higher ADHD scores at baseline than patients without RA, but this difference was not seen at follow-up. Patients with RA at follow-up had higher ADHD scores at baseline. Tic severity was worse in patients with RA at both time points but was lower in the group who had developed RA at T2.</p><p><strong>Conclusion: </strong>Patients with TS had significantly more RA than control subjects. The severity of compulsions and ADHD correlated with the presence of RA, and higher ADHD scores early in life correlated with the presence of RA in adolescence. This suggests that it is important to screen for the presence of RA in patients with TS - especially in patients who also have comorbid ADHD and/or OCD.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-10"},"PeriodicalIF":3.1,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376787","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":"Involuntary Hospitalization for Treatment: Triangulation of Perspectives of Patients, Relatives, and Professionals.","authors":"Sara Kærn Linstow, Katrine Schepelern Johansen, Mads Gram Henriksen, Julie Nordgaard, Annick Urfer-Parnas","doi":"10.1159/000552615","DOIUrl":"10.1159/000552615","url":null,"abstract":"<p><strong>Background: </strong>An involuntary hospitalization (IH) for treatment purpose is initiated when a person refuses admission while clinicians consider them severely mentally ill and in urgent need of treatment to improve their condition. Qualitative studies of IH patients show that patients later describe mixed experiences and consequences of IH. No study has examined in-depth with views from different perspectives what the disagreement on need of care consists of.</p><p><strong>Aim: </strong>This study wants to explore convergences and divergences in perspectives within triads of patients with non-affective psychosis involuntarily hospitalized for treatment purpose, their relatives, and professionals involved in the same IH focusing on the period prior to IH, experiences of hospitalization, and the outcome of IH.</p><p><strong>Method: </strong>Qualitative interviews were conducted when the patients were in a stabilized phase. The description of each patient's condition in the chart was discussed with the patient in question. Interviews were thematically analyzed, and the three different perspectives were triangulated.</p><p><strong>Results: </strong>We found divergences within triads on the need for and outcome of IH, the notion of illness, and the expectations of the hospital treatment. Most patients did not feel ill or in need of treatment. Most professionals and relatives deemed IH necessary, but many relatives were dissatisfied with the outcome. All participants emphasized the hospital's lack of capacity.</p><p><strong>Conclusion: </strong>This triangulation study on IH highlights the complexity of this intervention, revealing a fundamental divergence between the perspectives of patients, experiencing their psychotic condition as meaningful, the hospital system responding primarily with a medical perspective, and the relatives desiring a more personalized approach.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-11"},"PeriodicalIF":3.1,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376805","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":"Depressing Temporal Experiences: The COVID-19 Pandemic Lockdown in Victoria, Australia.","authors":"Jack Reynolds, Sarah W Pinto, Andrew Singleton","doi":"10.1159/000553378","DOIUrl":"10.1159/000553378","url":null,"abstract":"<p><strong>Introduction: </strong>Various governments around the world implemented stay-at-home orders, colloquially known as lockdowns, in response to the COVID-19 pandemic. Existing research suggests that these lockdowns had significant impacts upon the lived experiences of temporality of many people, with widespread reports of anomalous experiences of temporal passage and difficulties with judgements of temporal duration.</p><p><strong>Methods: </strong>We conducted a phenomenologically framed online survey of 830 people in the state of Victoria, Australia, focused on temporal experiences of the state's COVID-19 pandemic lockdowns in 2020 and 2021. This survey used an adjusted version of the Transdiagnostic Assessment of Temporal Experience (TATE) scale to get clearer about the frequency of the temporal anomalies and disruptions of these lockdowns.</p><p><strong>Results: </strong>Our survey results confirm much of the existing research regarding the widespread prevalence of anomalous temporal experiences. In particular, we found that around half of our participants reported slowness, feeling out of sync (with others and the world), and persistent worry about the future during the lockdowns, with these reported disruptions falling sharply after restrictions ended in late 2021.</p><p><strong>Conclusion: </strong>By juxtaposing these survey results with existing work in the phenomenology of depression, we contend that many people experienced depressive-like temporal experiences under lockdown. We also outline the need for further phenomenologically informed research of this kind, which conjoins both qualitative and quantitative methods.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-12"},"PeriodicalIF":3.1,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376755","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}