Search

Background: Borderline personality disorder (BPD) is the prototypical disorder of emotion dysregulation. We have previously shown that patients with BPD are impaired in their capacity to engage cognitive reappraisal, a frequently employed adaptive emotion regulation strategy., Methods: Here, we report on the efficacy of longitudinal training in cognitive reappraisal to enhance emotion regulation in patients with BPD. Specifically, the training targeted psychological distancing, a reappraisal tactic whereby negative stimuli are viewed dispassionately as though experienced by an objective, impartial observer. At each of 5 sessions over 2 weeks, 22 participants with BPD (14 female) and 22 healthy control participants (13 female) received training in psychological distancing and then completed a widely used picture-based reappraisal task. Self-reported negative affect ratings and functional magnetic resonance imaging data were acquired at the first and fifth sessions. In addition to behavioral analyses, we performed whole-brain pattern expression analyses using independently defined patterns for negative affect and cognitive reappraisal implementation for each session., Results: Patients with BPD showed a decrease in negative affect pattern expression following reappraisal training, reflecting a normalization in neural activity. However, they did not show significant change in behavioral self-reports., Conclusions: To our knowledge, this study represents the first longitudinal functional magnetic resonance imaging examination of task-based cognitive reappraisal training. Using a brief, proof-of-concept design, the results suggest a potential role for reappraisal training in the treatment of patients with BPD., (Published by Elsevier Inc.)

Background: Basic self-disturbance, or anomalous self-experiences (ASEs), is a core feature of the schizophrenia spectrum. We propose a novel method of natural language processing to quantify ASEs in spoken language by direct comparison to an inventory of self-disturbance, the Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE). We hypothesized that there would be increased similarity in open-ended speech to the IPASE items in individuals with early-course psychosis (PSY) compared with healthy individuals, with clinical high-risk (CHR) individuals intermediate in similarity., Methods: Open-ended interviews were obtained from 170 healthy control participants, 167 CHR participants, and 89 PSY participants. We calculated the semantic similarity between IPASE items and "I" sentences from transcribed speech samples using S-BERT (Sentence Bidirectional Encoder Representation from Text). Kolmogorov-Smirnov tests were used to compare distributions across groups. A nonnegative matrix factorization of cosine similarity was performed to rank IPASE items., Results: Spoken language of CHR individuals had the greatest semantic similarity to IPASE items when compared to both healthy control (s = 0.44, p < 10 -14 ) and PSY (s = 0.36, p < 10 -6 ) individuals, while IPASE scores were higher among PSY than CHR group participants. In addition, the nonnegative matrix factorization approach produced a data-driven domain that differentiated the CHR group from the others., Conclusions: We found that open-ended interviews elicited language with increased semantic similarity to the IPASE by participants in the CHR group compared with patients with psychosis. This demonstrates the utility of these methods for differentiating patients from healthy control participants. This complementary approach has the capacity to scale to large studies investigating phenomenological features of schizophrenia and potentially other clinical populations., (Copyright © 2023 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.)

Background: Rotator cuff repairs (RCRs) are one of the most commonly performed shoulder surgeries in the United States. Psychological health has been shown to influence postoperative outcomes in orthopedic procedures. The purpose of this study is to evaluate the relationship between depression and anxiety (DA) and psychotropic medication and postoperative outcomes following RCR., Methods: A single institution retrospective observational cohort study of 816 patients undergoing arthroscopic RCR from January 2014 to October 2020 was conducted. Univariate statistics were used to assess differences in demographics, operative characteristics, and postoperative outcomes; multivariate analysis was used to evaluate risk factors for postoperative complications., Results: Patients with DA were more likely to have a higher first (3.60 vs. 3.00, P  = .004) and last (1.23 vs. 0.96, P  = .042) postoperative pain scores, lower first (18.67 vs. 21.85, P  = .008) and last (61.87 vs. 64.71, P  = .014) Upper Extremity Functional Score (UEFS), more likely to experience an emergency department visit postoperatively (9.1 vs. 5.0%, P  = .028), have a symptomatic recurrent tear (8.2 vs. 3.3%, P  = .003), and persistent pain (4.3 vs. 1.2%, P  = .011). After controlling for age, sex, body mass index, American Society of Anesthesiologists score, diabetes, smoking, coronary artery disease, asthma, hypertension, psychotropic medication and DA, having DA at the time of surgery was independently predictive of any complication (odds ratio, 2.033; P  = .028) and persistent pain (odds ratio, 8.232; P  ≤ .001). Patients with and without DA showed significant improvement in postoperative pain and UEFS from the first to the last measurement ( P  < .001)., Conclusion: DA is not a deterrent for RCR but targeted interventions may be needed to decrease the occurrence of complications., (© 2022 The Authors.)

Increasingly, data-driven methods have been implemented to understand psychopathology. Language is the main source of information in psychiatry and represents "big data" at the level of the individual. Language and behavior are amenable to computational natural language processing (NLP) analytics, which may help operationalize the mental status examination. In this review, we highlight the application of NLP to schizophrenia and its risk states as an exemplar of its use, operationalizing tangential and concrete speech as reductions in semantic coherence and syntactic complexity, respectively. Other clinical applications are reviewed, including forecasting suicide risk and detecting intoxication. Challenges and future directions are discussed, including biomarker development, harmonization, and application of NLP more broadly to behavior, including intonation/prosody, facial expression and gesture, and the integration of these in dyads and during discourse. Similar NLP analytics can also be applied beyond humans to behavioral motifs across species, important for modeling psychopathology in animal models. Finally, clinical neuroscience can inform the development of artificial intelligence., (Copyright © 2020 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.)