Psychopathology最新文献

{"title":"Delusional Misidentification Syndromes in Postpartum Psychosis: A Systematic Review.","authors":"Gabriella Lewis,&nbsp;Lucy Blake,&nbsp;Gertrude Seneviratne","doi":"10.1159/000526129","DOIUrl":"https://doi.org/10.1159/000526129","url":null,"abstract":"<p><strong>Introduction: </strong>Delusional misidentification syndromes (DMS) are a group of psychopathological experiences occurring in psychosis, involving the misidentification of a person or place. DMS are often accompanied by hostility towards the object of delusional misidentification. This is of a particular concern in perinatal mental illness due to the potential disruption of the mother-infant bond, and risk of neglect, violence, or infanticide towards a misidentified child. This review aimed to collate all published cases of DMS in postpartum psychosis to further understand how these syndromes present in perinatal mental illness.</p><p><strong>Methods: </strong>In August 2021, an online database search was conducted using PubMed, MEDLINE, PsycINFO, CINAHL, and Embase to identify all publications reporting DMS in the perinatal period.</p><p><strong>Results: </strong>Nine papers were included in the review involving 8 case reports of Capgras syndrome and one case series involving 4 cases of Fregoli syndrome. Three cases identified organic pathology, which may have contributed to the presentation. The most common subject of misidentification was the patient's husband (n = 7), followed by their baby (n = 6), hospital staff (n = 4), other family members (n = 3), and self (n = 1). Five cases remark on the impact of perinatal illness on the maternal-infant bond, of which four result in the mother being unwilling to care for the infant as the result of their delusional beliefs.</p><p><strong>Conclusion: </strong>This is the first systematic review of the literature in this field. Although small in number, these cases reveal several important learning points including that DMS can occur with or without underlying organic disease. Active exploration of the nature of delusions in postpartum psychosis is required to mitigate the risk of harm to the infant and mother-infant bond. It may also uncover that these syndromes are more common in postpartum psychosis than previously realized.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":"56 4","pages":"285-294"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9555760","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":"Do Proximal Risk Factors Mediate the Impact of Affect on Symptoms of Generalized Anxiety Disorder and Major Depressive Disorder? An Extension of the Hierarchical Model of Cognitive Vulnerability.","authors":"Brandon Koscinski,&nbsp;Nicholas P Allan","doi":"10.1159/000527300","DOIUrl":"https://doi.org/10.1159/000527300","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are among the most prevalent forms of psychopathology. The hierarchical model of cognitive vulnerability proposes that higher order risk factors explain co-occurrence among internalizing disorders, whereas lower order risk factors explain discordance.</p><p><strong>Methods: </strong>Participants (N = 646; mean age = 38.50, SD = 10.00; 49.2% female) were recruited from Amazon MTurk to complete self-report questionnaires related to psychopathology in the summer of 2020. Structural equation modeling was used to examine the relations that negative affect (NA) and positive affect (PA) share with MDD and GAD, through rumination and intolerance of uncertainty (IU), cross-sectionally.</p><p><strong>Results: </strong>When modeling both IU and depressive rumination together as explaining the indirect effects from affect to psychopathology, the association between NA and symptoms of MDD was explained by depressive rumination. There were no indirect effects from PA to MDD or GAD symptoms. When modeled separately, both risk factors explained the associations NA shared with MDD and GAD symptoms.</p><p><strong>Conclusions: </strong>The present study extends the hierarchical model of cognitive vulnerability by finding that depressive rumination explains the association between NA and symptoms of MDD, even when controlling for IU.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":"56 4","pages":"258-267"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9556259","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":"Transactional Relations between Child Functioning and Parenting Stress in the First Years of Life: A Longitudinal Study among Psychosocially Burdened Families.","authors":"Oliver Evers,&nbsp;Anna Katharina Georg,&nbsp;Charlotte Wegener,&nbsp;Anna Sidor,&nbsp;Svenja Taubner","doi":"10.1159/000524101","DOIUrl":"https://doi.org/10.1159/000524101","url":null,"abstract":"<p><strong>Introduction: </strong>Previous research reported transactional relations between child functioning and parenting stress. There is limited evidence whether a transactional developmental model also fits children below the age of 12 months, especially in psychosocially burdened families. This study aims to test the fit of a transactional model during the first 3 years of life and examines whether the model differs between families with low and high psychosocial burden.</p><p><strong>Methods: </strong>A total of 302 psychosocially burdened families were observed over 3 years at age 4, 12, 24, and 36 months. Child behavioral problems and parenting stress were assessed via self-report while psychosocial burden was assessed via external rating at baseline. Cross-lagged panel analysis was used to investigate the fit of a transactional model.</p><p><strong>Results: </strong>A transactional model fitted the data significantly better (Δχ2 = 81.87, p < 0.001) than an autoregressive model reaching acceptable to good fit indices (CFI = 0.96, RMSEA = 0.09). The model indicated moderate stability within and reciprocal effects between child behavioral problems and parenting stress from age 12 to 36 months. From age 4 to 12 months, parenting stress predicted child behavioral problems but not vice-versa. Model fit indices and transactional relations did not substantially differ between families with low and high psychosocial burden, except for child effects on parenting stress during the first year of life, which were only evident in higher burdened families.</p><p><strong>Conclusion: </strong>Transactional relations among child and parent variables are evident in the first 3 years of life. Child effects in the first year of life may be restricted to highly psychosocially burdened families. Future research may focus on potential mediating variables such as parental sensitivity or contextual variables like significant life events. Targeted prevention strategies should be adapted to the level of psychosocial burden to account for the differing transactional relations.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":"56 1-2","pages":"29-40"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10843826","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":"How to Improve Training in Descriptive Psychopathology for Psychiatry Residents: A Delphi Study.","authors":"Jon-Inaki Etxeandia-Pradera,&nbsp;Jon Landeta,&nbsp;Jose Gonzalez-Such,&nbsp;Eduardo-Jesus Aguilar","doi":"10.1159/000525691","DOIUrl":"https://doi.org/10.1159/000525691","url":null,"abstract":"<p><strong>Purpose: </strong>Descriptive psychopathology (DP) is the language of psychiatry and is dedicated to the description of mental symptoms. Despite its core importance, a systematic review identified a series of shortcomings in its training. This Delphi study seeks to provide guidance for better didactic and clinical training in DP.</p><p><strong>Method: </strong>The authors used the Delphi method in order to gather, pool, and optimize the knowledgeable opinion of a highly qualified panel of international experts on how to improve DP training. A preliminary phase with open-ended questions was the basis to elaborate a Delphi questionnaire consisting of 14 questions on didactic and clinical training, which was then used in two successive Delphi rounds. Twenty-nine international experts in DP participated throughout the study.</p><p><strong>Results: </strong>A series of hierarchical lists on how to improve DP training were elaborated. Regarding didactic training, the experts valued the contents and educational methods, as well as recommended authors and texts. Regarding clinical training, the experts valued educational methods, desirable characteristics in clinical supervisors, how to improve the supervisors' expertise, useful aspects and facilitating questions for direct supervision, and the suitability of including other evaluators besides the supervisor. In the final survey, 94% of the experts considered that the Delphi method had been effective to obtain and improve their opinions.</p><p><strong>Conclusions: </strong>Insufficient direct supervision in live interviews was considered the most important problem. A series of general measures were proposed to improve DP training: (i) adapting DP training throughout residency, with introductory and advanced levels; (ii) making DP training compulsory in psychiatry curricula; (iii) assessing residents' DP knowledge and clinical use; and (iv) training the trainers/supervisors in both content (DP) and form (how to train/supervise residents). Within didactic training, epistemology of DP and contemporary and classic authors/texts were the highest rated contents, while supervised discussions based on cases, videos, or readings were the highest rated methods. Within clinical training, 8 aspects of DP that could guide the supervisor were highly rated: mental state examination, dialogue, empathy and understanding, attitude/willingness, knowledge-practice bridge, mental symptom formation, implications for decision-making, and the written report of the encounter.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":"56 3","pages":"206-219"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9249610","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":"Changes in Eating Attitudes and Risk for Developing Disordered Eating Behaviors in College Students with Subthreshold Eating Disorders: A Cohort Study.","authors":"Yoshie Miyake,&nbsp;Yuri Okamoto,&nbsp;Koki Takagaki,&nbsp;Masaharu Yoshihara","doi":"10.1159/000527604","DOIUrl":"https://doi.org/10.1159/000527604","url":null,"abstract":"<p><strong>Introduction: </strong>The number of young adults with eating disorders or subthreshold eating disorders has increased recently. Although disordered eating behaviors persist once they appear, there have been relatively few studies on factors that might cause disordered eating behaviors. The purpose of this study was to investigate how the eating attitudes of young adults change over time and the risk factors that increase disordered eating behaviors.</p><p><strong>Methods: </strong>A total of 1,141 college students, 639 males and 502 females, participated. We investigated changes in eating attitudes (using EAT-26 and BITE), depressive symptoms (using BDI-II), and stress coping (using CISS, which has three subscales) between 2 time points: at college entrance and in the fourth year of college. We divided the students into three groups (clinical, subthreshold, and healthy) based on EAT-26 scores and compared their BDI-II and CISS scores. Next, we identified students who developed disordered eating behaviors, both clinical and subthreshold, during their time at college (exacerbated students) and compared depressive symptoms and stress coping styles between exacerbated students and healthy students (unchanged students).</p><p><strong>Results: </strong>The students in the subthreshold group (both males and females) scored significantly higher on the BDI-II and emotion-oriented coping (CISS-E) than the students in the healthy group at college entrance. Additionally, the exacerbated students (both males and females) scored significantly higher on the CISS-E in the fourth year than unchanged students. The female exacerbated students scored significantly higher on the BDI-II than female unchanged students at both time points.</p><p><strong>Conclusions: </strong>Our results show that depressive symptoms and nonadaptive stress coping are associated with an increased risk of disordered eating behaviors. This study suggests that early intervention may be necessary for both the clinical and subthreshold groups. The key to early intervention may be to manage not only eating behaviors but also depressive symptoms and stress coping.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":"56 4","pages":"276-284"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9557593","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":"Behavioral Apophenia and Dimensions of Psychoticism in Adolescents with and without Mood Disorders.","authors":"Michael Reinke, Julia M Longenecker, Lamisa Chowdhury, Michelle Thai, Erin Begnel, Nathan Horek, Cheryl Olman, Kathryn R Cullen, Bonnie Klimes-Dougan","doi":"10.1159/000529796","DOIUrl":"10.1159/000529796","url":null,"abstract":"<p><p>Apophenia is the tendency to falsely detect meaningful relationships and may indicate susceptibility to more extreme expressions on the psychotic spectrum. This pilot investigated the fragmented ambiguous object task (FAOT), a new measure designed to assess apophenia behaviorally in a sample of adolescents with and without mood disorders using an image recognition task. Our primary hypothesis was that increased image recognition would be associated with PID-5 psychoticism. Participants were 33 (79% female) adolescents with (n = 18) and without (n = 15) mood disorders. Consistent with predictions, increased recognition of ambiguous images correlated positively with psychoticism. There was also moderate evidence for long-term stability of FAOT apophenia scores over time (mean interval of approximately 10 months). These findings offer preliminary evidence that the FAOT may be reflective of underlying psychoticism in our target population.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"473-477"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9132713","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":"Peripheral Inflammatory Markers in Subtypes and Core Features of Depression: A Systematized Review.","authors":"Pavel Křenek,&nbsp;Jana Hořínková,&nbsp;Elis Bartečků","doi":"10.1159/000528907","DOIUrl":"10.1159/000528907","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this work was to summarize relationships between two subtypes of major depressive disorder (melancholic and atypical) and four core features of depression that reflect the domains identified consistently in previous studies of major depressive disorder endophenotypes (exaggerated reactivity to negative information, altered reward processing, cognitive control deficits, and somatic symptoms) on the one hand and selected peripheral inflammatory markers (C-reactive protein [CRP], cytokines, and adipokines) on the other.</p><p><strong>Methods: </strong>A systematized review was conducted. The database used for searching articles was PubMed (MEDLINE).</p><p><strong>Results: </strong>According to our search, most peripheral immunological markers associated with major depressive disorder are not specific to a single depressive symptom group. The most evident examples are CRP, IL-6, and TNF-α. The strongest evidence supports the connection of peripheral inflammatory markers with somatic symptoms; weaker evidence indicates a role of immune changes in altered reward processing. The least amount of evidence was found for the role of peripheral inflammatory markers in exaggerated reactivity to negative information and cognitive control deficits. Regarding the depression subtypes, a tendency for higher CRP and adipokines was observed in atypical depression; increased IL-6 was found in melancholic depression.</p><p><strong>Conclusion: </strong>Somatic symptoms of depression could be a manifestation of a specific immunological endophenotype of depressive disorder. Melancholic and atypical depression may be characterized by different profiles of immunological markers.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"403-416"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10568602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10755266","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":"The Development and Validation of the First German Open Scale of Social Information Processing.","authors":"Sophie Charlotte Niestroj,&nbsp;Sarah Steden,&nbsp;Maren Boecker,&nbsp;Edward Stuart Brodkin,&nbsp;Kerstin Konrad","doi":"10.1159/000525950","DOIUrl":"https://doi.org/10.1159/000525950","url":null,"abstract":"<p><strong>Introduction: </strong>This study introduces the first German Open Scale of Social Information Processing (GOSSIP) and evaluates its psychometric properties. Even though social information processing (SIP) and its important role in developmental psychopathology is a rising field of interest, model-based standardized assessment tools are still scarce.</p><p><strong>Methods: </strong>GOSSIP was developed to assess SI processes in boys and girls aged eight to 21 years. First, 61 vignettes (combinations of pictures and short written descriptions of the situation depicted) were evaluated by an expert group and piloted with 48 healthy participants (aged 8-21). The best-rated vignettes were then implemented in a Web-based application. 191 participants completed GOSSIP. Of those, 76 answered additional questionnaires to assess their social skills and psychopathology. Internal consistencies for the emotional and cognitive GOSSIP scales were determined. Latent profile analysis (LPA) was used to identify subgroups of children and adolescents characterized by specific SIP profiles (i.e., patterns of emotional, cognitive, and behavioral responses to the GOSSIP). Furthermore, the external validity of the participants' attribution tendencies in GOSSIP was evaluated in real life by smartphone-based Ecological Momentary Assessments (EMA).</p><p><strong>Results: </strong>The internal consistencies for the emotional and cognitive scales (angry, ashamed, physical aggression, pro-social response, revenge, and outcome expectancy) were good to excellent. The scales of hostile interpretation, relation aggression, sadness, and exclusion showed borderline/acceptable internal consistency. Correlation analysis confirmed convergent validity with self-reported social skills and external validity with ratings of aggressive and pro-social behaviors. The LPA revealed three profiles as the best fit of the data. The first group is named \"aggressors,\" the second \"social-emotional group,\" and a third named \"ashamed-internalizing group.\" However, no significant association was found between the attribution tendencies derived from GOSSIP and EMA data.</p><p><strong>Discussion/conclusion: </strong>GOSSIP is the first model-based German Web-based assessment for several SIP mechanisms that showed overall adequate psychometric properties. GOSSIP can be used to classify individuals into SIP profiles that differ in terms of their cognitive and emotional response tendencies and therefore could contribute to the development of targeted interventions. Integrating assessments of emotional responses into GOSSIP revealed an important role of \"shame\" in SIP and the development of psychopathology. Furthermore, the lack of external validity between GOSSIP and EMA calls into question how attribution tendencies are best assessed in future studies.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":"56 1-2","pages":"52-63"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10843862","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":"Gaming Disorder and Psychotic Disorders: A Scoping Review.","authors":"Maxime Huot-Lavoie, Mina Gabriel-Courval, Laurent Béchard, Olivier Corbeil, Sébastien Brodeur, Charles Massé, Émilien Fournier, Anne Marie Essiambre, Elizabeth Anderson, Audrey Cayouette, Isabelle Giroux, Yasser Khazaal, Marie-France Demers, Marc-André Roy","doi":"10.1159/000527143","DOIUrl":"10.1159/000527143","url":null,"abstract":"<p><strong>Background: </strong>There is a growing interest in understanding the impact of video games in the clinical field, given that their excessive use could be associated with health issues. Particularly, gaming disorder (GD) is considered as an addictive behavioral disorder. Clinicians widely recognize the comorbidity of gaming and psychotic disorders (PDs). Furthermore, association between addictive (i.e., substance use disorders) and PDs are well recognized by clinicians. It seems of high interest to explore GD among people with PDs. To this day, little is known about the consequences of GD in vulnerable populations.</p><p><strong>Objectives: </strong>The aim of this scoping review was to summarize the available research on the comorbidity between GD and PD and to identify the knowledge gaps in this field.</p><p><strong>Methods: </strong>We used Levac's six-stage methodology for scoping review. Two-hundred and forty-two articles from seven databases were identified. Eight articles respected our inclusion and exclusion criteria.</p><p><strong>Results: </strong>No available study has assessed the prevalence or incidence of GD among patients with PDs. The cases reported highlight the possibility that excessive video gameplay or abrupt gaming disruption could trigger psychosis in some patients.</p><p><strong>Conclusion: </strong>The results highlight a significant lack of knowledge concerning PDs associated with GD as only a few reported cases and one empirical study exposed the potential association between those conditions.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":"56 4","pages":"315-323"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9557549","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":"\"As If There Are Two of Us\": The Battle of Borderline Personality Disorder Diagnosis in Lived Time.","authors":"Anna Sterna,&nbsp;Marcin Moskalewicz","doi":"10.1159/000527028","DOIUrl":"https://doi.org/10.1159/000527028","url":null,"abstract":"<p><strong>Background: </strong>Although the experience of reception of borderline personality disorder (BPD) diagnosis was previously researched, the process of mental adjustment to this diagnosis remains both empirically and theoretically unexplored. Theoretical concepts describing the structure of lived time in borderline patients, which underlies adjustment to diagnosis, living with the diagnosis, and recovery from the disorder, namely, immediacy and instantaneity are not empirically verified.</p><p><strong>Aim: </strong>This study aimed to phenomenologically describe the process of mental adjustment to the diagnosis of BPD and to uncover its underlying temporal structure.</p><p><strong>Methods: </strong>Semi-structured phenomenological interviews based on Giorgi's descriptive phenomenological psychological method and Cottle's Circles Test. The participants were 10 white, adult women diagnosed with BPD aged 20-32 years.</p><p><strong>Results: </strong>The process of adjustment to BPD diagnosis comprises three following stages: (1) a cumulative feeling of inadequacy preceding the diagnosis, (2) the outburst of diagnosis, (3) a battle of Self fragments while adjusting to the diagnosis. Simultaneously, the diagnosis modifies the relationship between the self and illness in a way that previously scattered problematic issues become inscribed into the self as symptoms. At the same time, these symptoms are relatively separated from its \"healthy\" part. The temporal structure underlying this process is discontinuous. Particular temporal dimensions are distanced from one another, and the inner images of the past and present consist of unconnected, emotional peaks. The present resembles waking up from the lethargy of the past, while the future consists of two colliding scenarios - either being free of or in control of symptoms.</p><p><strong>Conclusion: </strong>Clinicians should pay more attention to the pathway of identification with BPD diagnosis and its underlying temporality. This is crucial for recovery and may allow adjusting therapeutic interventions to the patients' needs. Treatment should aim to enhance the patients' abilities to reflect upon their temporal experience to merge their fragmented narrative identity and better situate them in the recovery process.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":"56 4","pages":"239-250"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9913312","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}