Psychopathology最新文献_第7页

Mentalizing in Adolescents and Young Adults with Attention Deficit Hyperactivity Disorder: Associations with Age and Attention Problems. 患有注意力缺陷多动障碍的青少年的心理治疗：与年龄和注意力问题的关系。

IF 3.6 3区医学

Psychopathology Pub Date : 2024-01-01 Epub Date: 2023-08-16 DOI: 10.1159/000531512

Elena Poznyak, Jessica Lee Samson, Juan Barrios, Halima Rafi, Roland Hasler, Nader Perroud, Martin Debbané

{"title":"Mentalizing in Adolescents and Young Adults with Attention Deficit Hyperactivity Disorder: Associations with Age and Attention Problems.","authors":"Elena Poznyak, Jessica Lee Samson, Juan Barrios, Halima Rafi, Roland Hasler, Nader Perroud, Martin Debbané","doi":"10.1159/000531512","DOIUrl":"10.1159/000531512","url":null,"abstract":"Introduction: Growing, albeit heterogenous evidence questions whether attention deficit/hyperactivity disorder (ADHD) is associated with socio-cognitive impairments, especially beyond childhood. This study focuses on mentalizing - the socio-cognitive ability to attribute and reason in terms of mental states. We aimed to characterize mentalizing performance in terms of correct scores and types of errors in adolescents and young adults with ADHD.Methods: Forty-nine adolescents and adults with ADHD and 49 healthy controls matched for age and gender completed a computerized naturalistic mentalizing task, the Movie for Assessment of Social Cognition (MASC). Repeated measures analyses of variance examined the effects of age group and ADHD diagnosis on MASC performance. Additionally, associations between mentalizing scores, the severity of attention problems, and the presence of comorbidity were explored in the ADHD group.Results: Results showed an increased prevalence of hypomentalizing errors in adolescents with ADHD. Lower mentalizing scores in adolescents with ADHD were correlated with indices of inattentiveness, impulsivity, and vigilance problems. Hypomentalizing errors in adolescents showed to be particularly associated with inattentiveness, after controlling for age and comorbidity. In contrast, adults with ADHD performed similarly to controls and their scores on the mentalizing task were not correlated to attention problems.Conclusion: These findings highlight potential developmental differences in mentalizing abilities in ADHD youths and their association with attentional impairments.","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"91-101"},"PeriodicalIF":3.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10997248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10016672","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}

引用次数: 0

Exploring the Association between Depression, Suicidality, and Serum Brain-Derived Neurotrophic Factor, FAM19A5, Total Antioxidant Status, Total Oxidant Status, Oxidative Stress Index, and Cytokine Levels: A Case-Control Study of Drug-Naive Adolescents with First-Episode Major Depressive Disorder. 探索抑郁、自杀与血清脑源性神经营养因子、FAM19A5、总抗氧化状态、总氧化状态、氧化应激指数和细胞因子水平之间的关联：一项针对患有首发重度抑郁障碍的药物过敏青少年的病例对照研究。

IF 1.9 3区医学

Psychopathology Pub Date : 2024-01-01 Epub Date: 2024-06-27 DOI: 10.1159/000539695

Aylin Deniz Uzun Çakir, Burak Çakir, Şermin Yalin Sapmaz, Öznur Bilaç, Fatma Taneli, Hasan Kandemir

{"title":"Exploring the Association between Depression, Suicidality, and Serum Brain-Derived Neurotrophic Factor, FAM19A5, Total Antioxidant Status, Total Oxidant Status, Oxidative Stress Index, and Cytokine Levels: A Case-Control Study of Drug-Naive Adolescents with First-Episode Major Depressive Disorder.","authors":"Aylin Deniz Uzun Çakir, Burak Çakir, Şermin Yalin Sapmaz, Öznur Bilaç, Fatma Taneli, Hasan Kandemir","doi":"10.1159/000539695","DOIUrl":"10.1159/000539695","url":null,"abstract":"Introduction: Considering the importance of neuroinflammation and neurodegeneration in the pathophysiology of major depressive disorder (MDD), peripheral blood biomarkers are promising for the prediction of diagnosis and treatment outcomes. We aimed to elucidate the neuroinflammatory pathophysiology of depression by evaluating serum levels of FAM19A5 as a new biomarker of inflammatory activation, proinflammatory cytokines, brain-derived neurotrophic factor (BDNF), and oxidative stress parameters.Methods: Adolescents diagnosed with first-episode drug-naive MDD (n = 35) were compared neurobiologically healthy control group (n = 33). Serum FAM19A5 levels, cytokine levels, BDNF and oxidative stress parameters were evaluated using the enzyme-linked immunoassay method. All participants were assessed with the Level-2 Depression Severity Scale, Sleep Disturbance Scale, Somatic Symptom Scale.Results: BDNF levels were significantly higher in the patient group compared to the control group. While BDNF showed a positive correlation with all scale scores; BDNF was significantly higher in the suicide risk groups than the control group. IL-1β levels displayed a negative correlation with the severity of sleep disturbances.Conclusions: In adolescents with MDD, inflammatory and oxidative stress markers were not raised in peripheral blood, unlike in adults. However, BDNF levels, which typically decrease in neurodegenerative conditions, were higher in those with MDD.","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"451-458"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141458934","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}

引用次数: 0

Circadian Activity Rhythms and Psychopathology in Major Depressive Episodes. 重度抑郁发作的昼夜活动节律与精神病理学

IF 3.6 3区医学

Psychopathology Pub Date : 2024-01-01 Epub Date: 2023-07-27 DOI: 10.1159/000530768

Paola Salvatore, Premananda Indic, Harimandir K Khalsa, Mauricio Tohen, Ross J Baldessarini, Carlo Maggini

{"title":"Circadian Activity Rhythms and Psychopathology in Major Depressive Episodes.","authors":"Paola Salvatore, Premananda Indic, Harimandir K Khalsa, Mauricio Tohen, Ross J Baldessarini, Carlo Maggini","doi":"10.1159/000530768","DOIUrl":"10.1159/000530768","url":null,"abstract":"Background: Identifying suicidal risk based on clinical assessment is challenging. Suicidal ideation fluctuates, can be downplayed or denied, and seems stigmatizing if divulged. In contrast, vitality is foundational to subjectivity in being immediately conscious before reflection. Including its assessment may improve detection of suicidal risk compared to relying on suicidal ideation alone. We hypothesized that objective motility measures would be associated with vitality and enhance assessment of suicidal risk.Methods: We evaluated 83 adult-psychiatric outpatients with a DSM-5 bipolar (BD) or major depressive disorder (MDD): BD-I (n = 48), BD-II (20), and MDD (15) during a major depressive episode. They were actigraphically monitored continuously over 3 weekdays and self-rated their subjective states at regular intervals. We applied cosinor analysis to actigraphic data and analyzed associations of subjective psychopathology measures with circadian activity parameters.Results: Actigraphic circadian mesor, amplitude, day- and nighttime activity were lower with BD versus MDD. Self-rated vitality (wish-to-live) was significantly lower, self-rated suicidality (wish-to-die) was higher, and their difference was lower, with BD versus MDD. There were no other significant diagnostic differences in actigraphic sleep parameters or in self-rated depression, dysphoria, or anxiety. By linear regression, the difference between vitality and passive suicidal ideation was strongly positively correlated with mesor (p < 0.0001), daytime activity (p < 0.0001), and amplitude (p = 0.001).Conclusions: Higher circadian activity measures reflected enhanced levels of subjective vitality and were associated with lesser suicidal ideation. Current suicidal-risk assessment might usefully include monitoring of motility and vitality in addition to examining negative affects and suicidal thinking.","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-9"},"PeriodicalIF":3.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9883563","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}

引用次数: 0

Methylation of the Glucocorticoid Receptor Gene (NR3C1) in Adolescents with a History of Childhood Adversity Engaging in Non-Suicidal Self-Injury. 有童年逆境史的青少年非自杀性自伤行为中糖皮质激素受体基因（NR3C1）的甲基化。

IF 3.6 3区医学

Psychopathology Pub Date : 2024-01-01 Epub Date: 2023-08-02 DOI: 10.1159/000531253

Nicole Hammann, Michael Kaess, Dan Rujescu, Romuald Brunner, Annette M Hartmann, Corinna Reichl

{"title":"Methylation of the Glucocorticoid Receptor Gene (NR3C1) in Adolescents with a History of Childhood Adversity Engaging in Non-Suicidal Self-Injury.","authors":"Nicole Hammann, Michael Kaess, Dan Rujescu, Romuald Brunner, Annette M Hartmann, Corinna Reichl","doi":"10.1159/000531253","DOIUrl":"10.1159/000531253","url":null,"abstract":"Introduction: Non-suicidal self-injury (NSSI) is a large phenomenon among adolescents, and adverse childhood experiences (ACEs) are a major risk factor in its development. Malfunctioning of the hypothalamus-pituitary-adrenal (HPA) axis has been repeatedly reported for ACE as well as for NSSI. The glucocorticoid receptor (GR) is essential for the correct functioning of the HPA axis, thus alterations in the expression of the GR through altered methylation of the GR gene (NR3C1) (and more specifically exon 1F) might contribute to the development of NSSI in individuals with a history of ACEs, as has been reported for different other mental disorders.Methods: In this case-control study, we compared the methylation levels of exon 1F of the GR gene (NR3C1-1F) in adolescents with engagement in NSSI (n = 67) and a healthy control group (HC; n = 47). We preserved buccal swabs and used a mass spectrometry-based method called EpiTYPER for analyzing mean methylation of NR3C1-1F.Results: Adolescents in the NSSI group reported significantly more ACEs. The mean methylation level was about 3% in both groups with no significant group differences. Furthermore, no significant relation was found between ACE and methylation of NR3C1-1F, neither in the overall sample nor in the NSSI or HC group.Conclusion: Our results are contradictory to previous research showing an increased methylation in individuals with ACE. Regarding relations between methylation of NR3C1-1F and mental disorders, previous studies reported inconsistent findings. Our study points to NSSI being either unrelated to methylation of NR3C1-1F or to yet not identified moderators on relations between methylation of NR3C1-1F and engagement in NSSI during adolescence.","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"81-90"},"PeriodicalIF":3.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9927253","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}

引用次数: 0

Network Analysis of Borderline Personality Features in Adolescence Using a Screening Tool in a Chinese Community Sample. 在中国社区样本中使用筛查工具对青春期边缘型人格特征进行网络分析。

IF 1.9 3区医学

Psychopathology Pub Date : 2024-01-01 Epub Date: 2024-01-16 DOI: 10.1159/000535586

Qian Wang, Zirong Li, Jie Zhong

{"title":"Network Analysis of Borderline Personality Features in Adolescence Using a Screening Tool in a Chinese Community Sample.","authors":"Qian Wang, Zirong Li, Jie Zhong","doi":"10.1159/000535586","DOIUrl":"10.1159/000535586","url":null,"abstract":"Introduction: This study investigated the structure of the borderline personality features (BPFs) network and the most central BPF in adolescence.Methods: Cross-sectional self-report data from 4,866 Chinese adolescents (M = 13.96, SD = 1.64; 61.3% girls) were included in the network analysis models. BPFs were assessed with the McLean Screening Instrument for Borderline Personality Disorder.Results: Identity disturbance and affective instability emerged as the most central BPF in the current adolescent sample. In addition, chronic emptiness was also found with high centrality. The general networks of BPF were very similar between adolescent boys and girls, although some differences were detected.Discussion: This study further supports the necessity of BPD assessment and diagnosis in adolescence and identifies the distinctive importance of identity and affective dysregulation in the early development of BPD. The findings provide empirical insights into the interconnections of BPF, which resonate with therapeutic mechanisms of evidence-based treatments for BPD. However, the research was limited in its use of a screening measurement rather than a diagnostic tool. Future studies can further explore BPD psychopathology in adolescence with longitudinal data and clinical interviews.","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"182-191"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11152012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139478820","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}

引用次数: 0

Anxiety Disorders: The Relationship between Insight and Metacognition. 焦虑症：洞察力与元认知之间的关系。

IF 1.9 3区医学

Psychopathology Pub Date : 2024-01-01 Epub Date: 2024-03-27 DOI: 10.1159/000538096

Asala Halaj, George Konstantakopoulos, Nassir S Ghaemi, Anthony S David

{"title":"Anxiety Disorders: The Relationship between Insight and Metacognition.","authors":"Asala Halaj, George Konstantakopoulos, Nassir S Ghaemi, Anthony S David","doi":"10.1159/000538096","DOIUrl":"10.1159/000538096","url":null,"abstract":"Background: The exploration of metacognition in relation to anxiety has received considerable attention in recent decades. Research indicates that it plays a role in the development and maintenance of anxiety disorders while also providing benefits, including the ability to assess situations, modify behaviors, and make informed decisions.Summary: We propose that having an awareness of a disorder, also known as insight, is related to metacognition in anxiety. This relationship stems from the ability it provides individuals to recognize their mental state through reflection on personal experiences. We discuss the impact of insight and metacognition on decision-making, treatment-seeking behaviors, and coping strategy selection.Key messages: Understanding the concept of insight in anxiety disorders, as compared to other mental disorders like psychosis, requires exploring its complexities while carefully considering the balance of harms and benefits. While the medicalization of symptoms in psychosis is widely regarded as clearly beneficial, evaluating the role of insight in anxiety disorders demands a more nuanced understanding. Gaining a fuller perspective on patients' beliefs can impact their behaviors and decision-making. Clinicians can achieve this by encouraging active self-reflection to increase awareness, which includes evaluating both severity and impact on daily functioning. This also involves expressing experiences and exploring attributions of anxiety. This practical approach enables clinicians to understand engagement and treatment-seeking behaviors, allowing them to tailor treatment plans and develop effective coping and management strategies. Ultimately, this knowledge promotes a deeper comprehension of insight into anxiety disorders.","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"434-443"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140306631","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}

引用次数: 0

What Is It Like to Be in Alcohol Addiction Recovery? A Dialectical Phenomenological Analysis. 酗酒戒毒是一种怎样的体验？辩证现象学分析》。

IF 1.9 3区医学

Psychopathology Pub Date : 2024-01-01 Epub Date: 2024-05-16 DOI: 10.1159/000538267

Victor Monteiro, Lucas Bloc, Guilherme Messas

{"title":"What Is It Like to Be in Alcohol Addiction Recovery? A Dialectical Phenomenological Analysis.","authors":"Victor Monteiro, Lucas Bloc, Guilherme Messas","doi":"10.1159/000538267","DOIUrl":"10.1159/000538267","url":null,"abstract":"Introduction: Currently, there is no scientific consensus on the concept of alcohol addiction recovery beyond substance use control. This conceptual issue challenges the implementation of therapeutic strategies and mental health policies that are unrestricted to symptomatic remission. Aiming to contribute to its definition, this study aimed to examine the recovery experience of individuals with alcohol addiction using dialectical phenomenological psychopathology (DPP) as a theoretical and methodological framework.Methods: A dialectical phenomenological analysis was conducted through an examination of online interviews with eight Brazilian, São Paulo state citizens who were self-declared to be undergoing alcohol addiction recovery (or who declared that they had completely recovered).Results: Participants' reports generated eight categories that were subdivided into two groups. The first group indicated experiential elements of recovery, such as changes in self-relation, changes in interpersonal relations, and changes in time relations, giving new meanings to suffering and alcohol use, and recovery as a continuous process. The second group referred to how the participants interpreted recovery according to their worldviews: as a spiritual experience, moral reformation, and mentality change.Conclusion: These categories can be understood through the lens of DPP as a process of change in the subjects' being in the world, characterized by the continued management of their existential imbalances in the dimensions of spatiality, temporality, selfhood, and intersubjectivity. The results are preliminary when it comes to conceptualizing recovery but may help future studies to develop recovery-oriented therapeutic strategies.","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"377-388"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959161","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}

引用次数: 0

Temperament Traits in Pediatric Obsessive-Compulsive Disorder in Relation to Tourette Syndrome and Attention-Deficit Hyperactivity Disorder. 小儿强迫症的气质特征与图雷特综合征和注意力缺陷多动障碍的关系。

IF 1.9 3区医学

Psychopathology Pub Date : 2024-01-01 Epub Date: 2024-01-29 DOI: 10.1159/000535658

Jessica Szu-Chi Cheng, Elissa Khalil, Masoud Salehi, Lauren Mulcahy, Isabella Yiru Xie, Hasti Hadizadeh, Marco A Grados

{"title":"Temperament Traits in Pediatric Obsessive-Compulsive Disorder in Relation to Tourette Syndrome and Attention-Deficit Hyperactivity Disorder.","authors":"Jessica Szu-Chi Cheng, Elissa Khalil, Masoud Salehi, Lauren Mulcahy, Isabella Yiru Xie, Hasti Hadizadeh, Marco A Grados","doi":"10.1159/000535658","DOIUrl":"10.1159/000535658","url":null,"abstract":"Introduction: Pediatric obsessive-compulsive disorder (OCD), attention-deficit hyperactivity disorder (ADHD), and Tourette syndrome (TS) are often concurrent. This study explores the temperament profile of complex OCD phenotypes.Methods: A clinical registry recorded demographic data, psychiatric diagnoses, and temperament traits, including novelty seeking (exploratory behaviors), harm avoidance (fear of uncertainty), reward dependence (sentimentality), and persistence (perseverance). Temperament data were accrued from the Junior Temperament and Character Inventory (JTCI). Participants were divided into (1) OCD only; (2) OCD+ADHD or TS; and (3) OCD+ADHD+TS to compare temperament.Results: Participants include 126 youths with OCD (61.9% male, 88.9% white) between the ages 6 and 18 years (12.7 ± 3.1). Among the three groups, the complex neurodevelopmental disorder group OCD+ADHD+TS expresses the highest novelty seeking and lowest persistence. Harm avoidance is increased in all groups compared to reference controls, irrespective of concurrent ADHD or TS. For the OCD+ADHD+TS group, contamination and washing symptoms have higher novelty seeking (p < 0.01), while counting and ordering have lower novelty seeking (p < 0.05). Harm avoidance is increased with aggressive, somatic, and checking symptoms in OCD only (p < 0.01), while persistence is increased with repeating and counting symptoms in the comorbid groups (OCD+ADHD or TS, OCD+ADHD+TS).Discussion/conclusion: The complex subtype, OCD+ADHD+TS, is associated with high novelty seeking and low persistence, while high harm avoidance is linked to pediatric OCD irrespective of ADHD or TS co-occurrence. In sum, pediatric OCD with ADHD and TS confers a unique temperament profile, further refining complex phenotypes of pediatric OCD for future research.","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"192-201"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11147693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576163","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}

引用次数: 0

Disembodiment and Affective Resonances in Esketamine Treatment of Depersonalized Depression Subtype: Two Case Studies. Esketamine 治疗人格解体抑郁症亚型中的非人格化和情感共振：两个案例研究。

IF 1.9 3区医学

Psychopathology Pub Date : 2024-01-01 Epub Date: 2024-08-22 DOI: 10.1159/000539714

Pietro Sarasso, Martina Billeci, Irene Ronga, Fabiola Raffone, Vassilis Martiadis, Gilberto Di Petta

{"title":"Disembodiment and Affective Resonances in Esketamine Treatment of Depersonalized Depression Subtype: Two Case Studies.","authors":"Pietro Sarasso, Martina Billeci, Irene Ronga, Fabiola Raffone, Vassilis Martiadis, Gilberto Di Petta","doi":"10.1159/000539714","DOIUrl":"10.1159/000539714","url":null,"abstract":"Introduction: Dissociative experiences are considered undesirable ketamine's adverse events. However, they might be crucial for ketamine's antidepressant effects, at least in some depression subtypes. Current understandings of ketamine's therapeutic potentials converge on the so-called \"relaxed prior hypothesis,\" suggesting that glutamatergic blockage up-weights bottom-up surprising somatosensory/affective states. As a result, ketamine improves short-term plasticity in depression by enhancing sensitivity to interoceptive signals.Methods: We selected 2 case studies for their paradigmatic description of \"depersonalized depression\" (Entfremdungsdepression) symptoms. Patients were included in a 6-month-long esketamine program for treatment resistant depression, during which we collected their spontaneous experience with esketamine. According to a neurophenomenological approach, we combined subjective reports from unstructured clinical interviews and the review of previous objective neuroimaging results and neurocomputational models to unveil the relation between esketamine antidepressant effects and interoceptive sensitivity.Results: According to our clinical observations, esketamine-induced dissociation might be particularly effective in the depersonalized depression subtype, in which interoceptive awareness and interaffectivity are particularly compromised. Ketamine and esketamine's dissociative effects and particularly disembodiment might suspend previously acquired patterns of feeling, sensing, and behaving.Conclusions: Coherently with previous research, we suggest that esketamine-induced disembodiment allows for a transient window of psychological plasticity and enhanced sensitivity, where the body recovers its permeability to affective affordances.","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"480-491"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036761","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}

引用次数: 0

Are Traumatic Disintegration, Detachment, and Dissociation Separate Pathogenic Processes Related to Attachment Trauma? A Working Hypothesis for Clinicians and Researchers 创伤性解体、分离和解离是与依恋创伤相关的独立致病过程吗？临床医生和研究人员的工作假设

IF 3.6 3区医学

Psychopathology Pub Date : 2023-12-08 DOI: 10.1159/000535191

B. Farina, Claudio Imperatori

{"title":"Are Traumatic Disintegration, Detachment, and Dissociation Separate Pathogenic Processes Related to Attachment Trauma? A Working Hypothesis for Clinicians and Researchers","authors":"B. Farina, Claudio Imperatori","doi":"10.1159/000535191","DOIUrl":"https://doi.org/10.1159/000535191","url":null,"abstract":"Background: Despite its high prevalence in all psychiatric disorders and its widely demonstrated clinical relevance as a marker of both clinical severity and poorer treatment response, a scientifically validated definition of dissociation remains controversial, and the understanding of its pathogenesis is still somewhat lacking. Furthermore, although most clinicians commonly refer to dissociation as a single unitary concept, the empirical evidence strongly supports the paucity of a one-dimensional approach to dissociation. Summary: Resonating with the clinical and neuroscientific data on this topic, this article aimed to provide a working hypothesis, suggesting that the wide variety of psychopathological phenomena that are currently improperly lumped into the category of dissociation are in fact produced by at least three different pathogenic processes involved in developmental trauma, namely, traumatic disintegration, detachment responses, and dissociation. Key Messages: This hypothesis should, therefore, be considered a starting point for a better understanding of the complex manifestations and processes that currently overly, attributed to dissociation per se.","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":"58 34","pages":""},"PeriodicalIF":3.6,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138588218","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}

引用次数: 0