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Background: While Tourette syndrome (TS) and attention-deficit/hyperactivity disorder (ADHD) often co-occur, the nature of the relationship between their symptoms is not well understood. Network analysis of psychopathology allow for detailed examinations of symptom interactions, providing an effective approach to explore the patterns of comorbidity between TS and ADHD symptoms. Methods: This study included 3,958 participants (male/female = 3,004/954, age mean ± SD = 8.60 ± 2.25 years). We collected data on TS symptoms using the Motor Tic, Obsessions and Compulsions, Vocal Tic Evaluation Survey (MOVES), and ADHD symptoms using the Swanson, Nolan, and Pelham Rating Scale-IV (SNAP-IV). Network analysis was employed to construct a combined network of TS and ADHD symptoms at the symptom level. We utilized the expected influence (EI) and bridge EI metrics to explore the core and bridge symptoms within the network. Results: The network structure demonstrated a moderate number of non-zero connections between TS and ADHD symptoms, constituting 23.06% of all potential connections. Core symptoms in the comorbidity network included "Often has difficulty sustaining attention in tasks or play activities," "Certain bad words or thoughts keep going through my mind," and "Words come out that I can't stop or control." Bridging symptoms identified were "Words come out that I can't stop or control," "I do certain things like jumping or clapping over and over," "I can't control all my movements," and "Often talks excessively." Conclusion: The core and bridging symptoms identified in this study serve as potential therapeutic targets for the treatment of TS and ADHD comorbidity in clinical children and adolescents. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusions Emotion regulation plays an important role in the development and maintenance of psychopathology. However, the question whether specific ER skills are related to specific psychological symptoms has rarely been studied, but has important implications for targeted interventions. This analysis aims to explore potential differential associations between various ER skills and psychological symptoms using a network analysis approach.Routine data from a transdiagnostic clinical sample of 716 patients (460 females, 256 males) from an outpatient clinic for psychotherapy were analysed. Nine ER skills were assessed with the Emotion Regulation Skills Questionnaire, and nine symptom dimension scores were obtained using the Brief Symptom Inventory. A regularized partial correlation network models including ER skills and individual symptom domains were calculated. Bridge expected influence was calculated to estimate the strength of association of each ER skill with psychological symptoms.Only the following ER skills were most strongly related to psychological symptoms (bridge expected influence): Tolerance, Confrontation and Modification. All other ER skills were indirectly connected to symptom severity through these four skills. The strongest direct edges between ER skills and symptoms were Modification—Depression, Confrontation—Obsession‐Compulsion and Tolerance—Interpersonal Sensitivity, which were significantly stronger than the vast majority of other associations between ER skills and psychological symptoms.These exploratory findings provide valuable targets for future studies to investigate specific associations between ER skills and psychological symptoms which could help to improve outcome monitoring and efficacy of interventions targeting ER. [ABSTRACT FROM AUTHOR]

Identifying patients at risk for a suicide attempt (SA) is critical in adolescents with mental disorders. The current study aimed to 1) examine whether personality dysfunction (PD) is associated with previous SA, 2) explore the incremental utility of PD over psychiatric disorders in modeling previous SA. The sample comprised of n = 498 adolescent patients (mean age = 15.41 years, 79.12 % females, inpatient 48.8 %, outpatient 51.2 %). SA in the past year, PD according to the alternative DSM-5 model for personality disorders, and psychiatric diagnoses were assessed using semi-structured interviews. Logistic regression and principal component analysis examining the associations and specific patterns of PD and SA in the past year were conducted. Hierarchical (stepwise) logistic regression was applied to investigate the incremental utility of PD over that of psychiatric diagnoses to identify individuals with SA in the past year. Including all facets of PD revealed a significant model with SA in the past year as outcome (χ 2 (12) = 106.65, McFaddens Pseudo- R 2 = 0.17, p < 0.01). Adding PD to the model explained a significant amount of variance in past SA over that of psychiatric diagnoses (Pseudo- R 2 = 0.18, Wald χ 2 = 43.05, p < 0.01). As we only studied past SA and due to the cross-sectional design, no conclusion regarding the prediction of future SA can be drawn. PD should routinely be assessed in adolescent patients since individuals with PD are more likely to have attempted suicide even when controlling for comorbid psychiatric disorders. PD may represent an important target for intervention in those with suicidal thoughts and behaviors. • Personality dysfunction and past suicide attempts in adolescent patients were studied. • Personality dysfunction predicted past suicide attempts above psychiatric diagnosis. • Impaired self-functioning was associated with higher odds for past suicide attempts. • In teens at risk for suicide attempts personality dysfunction should be assessed. • Future studies should address implications for the prevention of suicide attempts. [ABSTRACT FROM AUTHOR]

Comorbidity in mental disorders is prevalent among adolescents, with evidence suggesting a general psychopathology factor ("p" factor) that reflects shared mechanisms across different disorders. However, the association between the "p" factor and protective factors remains understudied. The current study aimed to explore the "p" factor, and its associations with psycho-social functioning, in Chinese adolescents. 2052 students, aged 9–17, were recruited from primary and secondary schools in Shanghai, China. Multiple rating scales were used to assess psychological symptoms and psycho-social functioning. Confirmatory factor analysis was conducted to verify the fit of models involving different psychopathology domains such as externalizing, internalizing, and the "p" factor. Subsequently, structural equation models were used to explore associations between the extracted factors and psycho-social functioning, including emotion regulation, mindful attention awareness, self-esteem, self-efficacy, resilience, and perceived support. The bi-factor model demonstrated a good fit, with a "p" factor accounting for 46 % of symptom variation, indicating that the psychological symptoms of Chinese adolescents could be explained by internalizing, externalizing, and the "p" factor. Psychologically, a higher "p" was positively correlated with emotion suppression and negatively correlated with mindful attention awareness, emotion reappraisal, self-esteem, and resilience. Socially, a higher "p" was associated with decreased perceived support. Only common symptoms were included as this study was conducted at school. Furthermore, the cross-sectional design limited our ability to investigate causal relationships. A "p" factor exists among Chinese adolescents. Individuals with higher "p" factor levels were prone to experience lower levels of psycho-social functions. • This study aimed to explore the "p" factor and its associations with psycho-social functioning in Chinese adolescents. • The psychological symptoms of Chinese adolescents could be explained by internalizing, externalizing, and the "p" factor. • Individuals with higher "p" factor levels were prone to experiencing lower psycho-social functioning. • This study highlights the "p" factor's role in protective factors and identifies variables for trans-diagnostic interventions. [ABSTRACT FROM AUTHOR]

The present study focused on the emotional experience of anger among individuals with and without social anxiety disorder (SAD). Eighty-eight participants took part in the study, half (n = 44) met diagnostic criteria for SAD and half (n = 44) did not meet criteria for SAD. Participants completed a 21-day experience sampling measurement (ESM) in which they reported on daily social interactions and emotions. Using multilevel linear modeling we found that individuals with SAD experienced more anger compared to individuals without SAD. We also found a Diagnosis × Social Context interaction such that interactions with distant others were associated with elevated anger compared to interactions with close others for individuals with SAD but not for individuals without SAD. Finally, we found that for individuals with SAD (but not those without SAD) anger on a given day (day t) was associated with elevated anxiety on the following day (day t + 1), above and beyond previous anxiety, sadness and guilt (i.e. anxiety, sadness and guilt reported on day t). This suggests that anger may play a unique role in maintaining or exacerbating anxiety among individuals with SAD. Additional implications of our findings for models of psychopathology and for treatment of SAD are discussed. [ABSTRACT FROM AUTHOR]

Adolescence poses significant challenges for emotion regulation (ER) and is thus a critical phase in the emergence of various mental disorders, specifically internalising disorders such as anxiety and depression. Affective control, defined as the application of cognitive control in affective contexts, is crucial for effective ER. However, the relationship between ER and affective control is unclear. This study examined the predictive role of ER strategies and difficulties in affective control, measured as the congruency effect and error rate on an Emotional Stroop task (EST), in a sample of adolescents and young adults (aged 14–21, M = 17.28, 22% male). It was hypothesised that participants with internalising disorders would show higher congruency effects and error rates on the EST than healthy controls after a psychosocial stress induction, indicating lower affective control. Surprisingly, our findings revealed no significant differences in these measures between the groups. However, higher depression scores were associated with increased EST errors. While ER strategies and difficulties did not predict affective control, exploratory analyses unveiled associations between depression scores and ER strategy repertoire, perceived ER success and the ER strategy Acceptance. These findings underscore the importance of implicit ER facets, particularly perceived ER success and flexibility to change between applied strategies for adolescents and young adults with elevated depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: Parental psychological distress is a well-known risk factor for developmental psychopathology, with longer term parental distress associated with worse youth mental health. Neurotoxicant exposure during pregnancy is a risk factor for both poor maternal and youth mental health. The impact of one class of pollutant, polycyclic aromatic hydrocarbons (PAH), on long-term trajectories of maternal distress and youth self-reported mental health symptoms in adolescence has been understudied. Methods: PAH exposure was measured by DNA adducts in maternal blood sampled during the third trimester of pregnancy. Maternal distress, operationalized as maternal demoralization, was measured at 11 timepoints (prenatal to child age 16). Adolescent mental health symptoms were measured at age 13–15. Follow up analyses examined a subset of measures available at age 15–20 years. Structural equation modeling examined associations between PAH exposure during pregnancy and latent growth metrics of maternal distress, and between maternal distress (intercept and slope) and youth mental health symptoms in a prospective longitudinal birth cohort (N = 564 dyads). Results: Higher prenatal PAH exposure was associated with higher concurrent maternal distress. Prenatal maternal distress was associated with adolescent's self-reported anxiety, depression, and externalizing problems. On average, maternal distress declined over time; a slower decline in mother's distress across the course of the child's life was associated with greater self-reported anxiety and externalizing problems in youth. Conclusions: Our findings are consistent with an intergenerational framework of environmental effects on mental health: PAH exposure during pregnancy affects maternal mental health, which in turn influences mental health outcomes for youth well into adolescence. Future research is necessary to elucidate the possible social and biological mechanisms (e.g., parenting, epigenetics) underlying the intergenerational transmission of the negative effects of pollution on mental health in caregiver-child dyads. [ABSTRACT FROM AUTHOR]

Background: Childhood adversity has been associated with alterations in threat-related information processing, including heightened perceptual sensitivity and attention bias towards threatening facial expressions, as well as hostile attributions of neutral faces, although there is a large degree of variability and inconsistency in reported findings. Methods: Here, we aimed to implicitly measure neural facial expression processing in 120 adolescents between 12 and 16 years old with and without exposure to childhood adversity. Participants were excluded if they had any major medical or neurological disorder or intellectual disability, were pregnant, used psychotropic medication or reported acute suicidality or an ongoing abusive situation. We combined fast periodic visual stimulation with electroencephalography in two separate paradigms to assess the neural sensitivity and responsivity towards neutral and expressive, i.e. happy and angry, faces. Linear mixed effects models were used to assess the impact of childhood adversity on facial expression processing. Results: Sixty-six girls, 53 boys and one adolescent who identified as 'other', between 12 and 16 years old (M = 13.93), participated in the current study. Of those, 64 participants were exposed to childhood adversity. In contrast to our hypotheses, adolescents exposed to adversity show lower expression-discrimination responses for angry faces presented in between neutral faces and higher expression-discrimination responses for happy faces presented in between neutral faces than unexposed controls. Moreover, adolescents exposed to adversity, but not unexposed controls, showed lower neural responsivity to both angry and neutral faces that were simultaneously presented. Conclusions: We therefore conclude that childhood adversity is associated with a hostile attribution of neutral faces, thereby reducing the dissimilarity between neutral and angry faces. This reduced threat-safety discrimination may increase risk for psychopathology in individuals exposed to childhood adversity. [ABSTRACT FROM AUTHOR]

Background: Understanding the interplay between psychopathology of alcohol withdrawal syndrome (AWS) in alcohol use disorder (AUD) patients may improve the effectiveness of relapse interventions for AUD. Network theory of mental disorders assumes that mental disorders persist not of a common functional disorder, but from a sustained feedback loop between symptoms, thereby explaining the persistence of AWS and the high relapse rate of AUD. The current study aims to establish a network of AWS, identify its core symptoms and find the bridges between the symptoms which are intervention target to relieve the AWS and break the self-maintaining cycle of AUD. Methods: Graphical lasso networkwere constructed using psychological symptoms of 553 AUD patients. Global network structure, centrality indices, cluster coefficient, and bridge symptom were used to identify the core symptoms of the AWS network and the transmission pathways between different symptom clusters. Results: The results revealed that: (1) AWS constitutes a stable symptom network with a stability coefficient (CS) of 0.21-0.75. (2) Anger (Strength = 1.52) and hostility (Strength = 0.84) emerged as the core symptom in the AWS network with the highest centrality and low clustering coefficient. (3) Hostility mediates aggression and anxiety; anger mediates aggression and impulsivity in AWS network respectively. Conclusions: Anger and hostility may be considered the best intervention targets for researching and treating AWS. Hostility and anxiety, anger and impulsiveness are independent but related dimensions, suggesting that different neurobiological bases may be involved in withdrawal symptoms, which play a similar role in withdrawal syndrome. [ABSTRACT FROM AUTHOR]

Objective: Despite increasing evidence of high psychopathological vulnerability in people with Autism Spectrum Disorder (ASD) and/or Intellectual disability (ID), comprehensive data on prevalence and presentation of psychiatric disorders (PD) in people with significant cognitive and communication impairment are lacking. The extent to which PD can present with behavioral/observable symptoms and include Problem Behaviors (PB) has also been scarcely evaluated through population-based studies. The paper presents the protocol of a cross-sectional study aimed at filling these gaps, referred to a large multicentric Italian population-based sample of adolescents and adults. Methods: A battery of validated scales, SPAIDD, DASH-II, DiBAS-R, and STA-DI, is used to support and control for clinical diagnoses of PD. Study population is stratified according to different independent variables such as the severity of ID and ASD, gender, age group, and source of recruitment. A network analysis will be carried out to identify the most central behavioral symptoms for the various PD and their relationship with PB. Overlap between psychiatric symptoms and ASD and ID phenotypes is also addressed. Results and Conclusion: This study should provide valuable insight into better diagnostic accuracy, leading to well-informed interventions to improve the quality of life of people with ASD and/or ID. [ABSTRACT FROM AUTHOR]

Mary Main’s operationalization of infant attachment disorganization contributed to our understanding of attachment and psychopathology. Her exploration of attachment patterns at age 6 with Jude Cassidy laid the foundations for studying attachment post-infancy. They found remarkable correspondence from age 1 to age 6 in the disorganization spectrum and documented the emergence of role-reversal. This study proposes a person-centered approach to explore classes of children with respect to attachment disorganization at four time points between infancy and late preschool. Participants (n = 205) were recruited in the UK and formed a socioeconomically diverse community sample of mother–child dyads. We identified three classes of children: 1) a stable organized group; 2) an unstable group becoming organized; and 3) an unstable group becoming disorganized. Results show that major loss predicts membership of the third class of children. These findings contribute to our understanding of disorganization across multiple periods, and thus to Mary Main’s legacy. [ABSTRACT FROM AUTHOR]

ObjectiveMethodResultsConclusionSystemic Therapy conceives mental health symptoms in the context of social systems. Previous meta-analyses on Systemic Therapy focused on symptoms. This meta-analysis aims to focus on family system functioning while including all types of outcomes.We conducted a systematic literature research in multiple databases (PsycInfo, PubMed, Embase, Cochrane Central). We included RCT-studies on adults with psychiatric diagnoses, which compared Systemic Therapy with active psychosocial control. The literature research resulted in 171 coded effect sizes of 32 RCTs. We conducted a random-effects three-level meta-analysis. We categorized outcomes into symptoms of patients, family system functioning, further secondary outcomes of patients, and psychopathology of family members.The results show a small significant overall effect size of g = .30 (CI: .15–.45, p < .001, k = 171, s = 32) for all outcomes. Systemic Therapy revealed small effect sizes with regard to family system functioning (g = .34, z = 3.51, p = .0004, k = 26, s = 12), symptoms (g = .30, z = 3.74, p = .0002, k = 73, s = 29), and further secondary outcomes (g = .32, z = 3.83, p = .0001, k = 63, s = 19). The effect sizes for psychopathology of family system members were reported rarely (k = 9, s = 6).This meta-analysis shows the potential relevance of investigating family system functioning as a primary outcome for Systemic Therapy. [ABSTRACT FROM AUTHOR]

Professionals are encouraged to include multiple symptom validity tests (SVTs) and multiple performance validity tests (PVTs) to assess the credibility of clinical and forensic presentations. Combining the Inventory of Problems–29 (IOP-29, an SVT) with its Memory module (IOP-M, a PVT), referred to here as ‘IOP-29-M’, may be especially beneficial, as it allows for rapid assessment of both symptom and performance validity. Accordingly, the present study aimed at ‘stress testing’ the IOP-29-M by examining base rates of failure (BRFail) in 109 patients with schizophrenia spectrum psychopathology, both with and without criminal convictions. In the overall sample, BRFail were low: 13.8% and 8.3%, respectively, for the standard (≥ .50) and conservative (≥ .65) cutoffs of the IOP-29, and 12.8% and 9.2%, respectively, for the standard (≤ 29) and conservative (≤ 28) cutoffs of the IOP-M. Importantly, very few individuals, less than 5%, failed both components of the IOP-29-M. [ABSTRACT FROM AUTHOR]

AbstractBackgroundAimMethodsResultsConclusionsAsthma, a chronic inflammatory condition affecting the airways, significantly impacts both respiratory function and quality of life. Recent studies have highlighted the psychological dimensions of chronic diseases like asthma. Despite growing evidence linking asthma with various psychopathological conditions, comprehensive data remains scarce.This study aims to explore the psychopathological status of asthma patients and identify demographic and clinical factors associated with higher levels of psychopathological symptoms.Data were collected from 42 asthma patients attending the Asthma Outpatient Clinic at the University of Thessaly, Greece. Participants completed a detailed questionnaire on demographics and clinical parameters, along with the Symptoms Checklist-90 (SCL-90) to assess psychological symptoms.The sample included patients with varying asthma severity: 38% with severe asthma and 62% with mild-moderate asthma, with a mean age of 60.8 ± 15.6 years. Results indicated that 23.8% exhibited somatization symptoms, 23.8% showed compulsive behaviors, 33.8% reported interpersonal sensitivity, and 38.1% experienced depression and 38.1% aggressiveness. Additionally, 45.2% struggled with fearful anxiety, 4.8% showed paranoid ideation, and 11.9% had traits of psychoticism. Women had significantly higher psychopathology scores than men. Factors such as longer disease duration, uncontrolled asthma, severe asthma, and comorbid conditions like atopy and gastroesophageal reflux disease (GERD) were linked to higher psychopathological scores.The study found a high prevalence of psychopathological symptoms among asthma patients. Female gender, prolonged asthma duration, persistent symptoms, comorbid diseases (GERD, atopy) and greater disease severity were significantly associated with higher psychopathology, underscoring the need for integrated mental health care in asthma management. [ABSTRACT FROM AUTHOR]

Background: Psychological and trauma-related factors are associated with many diseases and mortality. However, a comprehensive assessment of the association between psycho-trauma exposures and aging acceleration is currently lacking. Methods: Using data from 332,359 UK Biobank participants, we calculated biological aging acceleration, indexed by the presence of leukocyte telomere length (LTL) deviation (i.e., the difference between genetically determined and observed LTL > 0). The acceleration of facial aging (i.e., looking older than the chronological age) was assessed using a self-report question. Then, we estimated the associations of each psycho-trauma factor with biological and facial aging acceleration, using logistic regression models adjusted for multiple important covariates. Furthermore, restricted to 99,180 participants with complete psychological and trauma-related data, we identified clusters of individuals with distinct psycho-trauma patterns using the latent class analysis method and assessed their associations with aging acceleration using similar models. Results: We observed most of the studied psycho-trauma factors were associated with biological and facial aging acceleration. Compared to the "Absence of trauma and psychopathology" cluster, the "adverse childhood experiences (ACEs) with psychopathology" cluster showed strong associations with those aging measurements (odds ratio [OR] = 1.13 [1.05 − 1.23] for biological and 1.52 [1.18 − 1.95] for facial aging acceleration), while no such association was observed for the "ACEs without psychopathology" cluster (1.04 [0.99 − 1.09] and 1.02 [0.84 − 1.24]. Conclusions: Our study demonstrated significant associations of psycho-trauma factors with both biological and facial aging acceleration. The differential aging consequences observed among ACEs exposed individuals with and without psychopathology prompt interventions aimed to improve individuals' psychological resilience to prevent aging acceleration. [ABSTRACT FROM AUTHOR]

Objective Method Results Discussion Motivation to change is an important predictor for treatment outcomes in individuals with anorexia nervosa (AN), however, the existence and clinical relevance of distinct motivational dimensions are understudied. This study aimed to structurally validate the AN Stage of Change Questionnaire (ANSOCQ) in the Italian adult AN population to identify separate motivational dimensions and their association with clinical variables and outcomes.Inpatients and outpatients with AN (N = 300) completed the ANSOCQ and measures assessing eating and depressive psychopathology. Unique Variable Analysis and Exploratory Graph Analysis were employed to identify dimensions in the network structure of ANSOCQ. Cross‐sectional associations with clinical variables were assessed in the whole sample. Predictive value on weight and psychopathology was assessed in inpatients.Two dimensions were identified, one comprising items relative to weight gain, and the second items regarding attitudes towards eating, body, and emotional problems. Feelings associated with eating resulted as most central in the network. Higher scores in the first dimension and ANSOCQ total predicted weight gain during hospitalisation. No significant predictors emerged for changes in eating psychopathology.These findings confirm the robust psychometric properties of ANSOCQ and provide support for the use of its subdimensions in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Anorexia nervosa (AN) and obesity (OB) are relevant concerns in adolescence. Despite their contrasting phenotypes, they share common pathogenic origins and may be present in the same individual at different times. We explored the psychopathology and attachment features of adolescents with AN who did (AN-ow) or did not (AN-nw) have previous overweight, compared with OB adolescents and healthy control (HC) adolescents. Method: In total, 148 female adolescents referred to an outpatient clinic for an eating disorder (66 for AN and 42 for OB) and 40 HCs were assessed using self-administered instruments that measured parenting, attachment, eating, and general psychopathology. Group differences were tested by analysis of covariance, and correlations between variables were examined. Results: AN-ow, AN-nw, and OB adolescents had greater interpersonal distrust and avoidance of relationships, compared with HC adolescents. AN-nw and AN-ow adolescents displayed a higher need for approval and a drive to thinness and interpersonal distrust, compared with HC adolescents. AN-ow adolescents displayed lower paternal care and higher ineffectiveness, asceticism, social insecurity, and depression, compared with HC adolescents. Compared with AN-nw adolescents, AN-ow adolescents felt more ineffective and more ascetic. The dynamics linking the psychopathological features clearly distinguished the four groups. Conclusions: AN-ow is a well-identified subtype of AN, with specific features that differ from AN-nw; some of these features are shared with OB. A therapeutic approach tailored to AN-ow adolescents should consider these features. [ABSTRACT FROM AUTHOR]

Theoretically, purpose serves as a basic dimension of healthy psychological functioning and an important protective factor from psychopathology. Theory alone, however, is insufficient to answer critical questions about human behavior and functioning; we require empirical evidence that explores the parameters of purpose with respect to measurement, prediction, and modification. Here, we provide empirically supported insights about how purpose can operate as a beneficial outcome (e.g., marker of well-being), a predictor or mechanism that accounts for benefits that a person derives (such as from an intervention), or a moderator that offers insight into when benefits arise. Advancing the study of purpose requires careful consideration of how purpose is conceptualized, manipulated, and measured across the lifespan. Our aim is to help scientists understand, specify, and conduct high-quality studies of purpose in life. Public Significance Statement: This article reviews and synthesizes what is known about the nature and benefits of human beings possessing and working toward a purpose in life. We detail the various ways that a purpose can serve a person and the specific ways that psychologists and other mental health professionals can study and target this highly desirable psychological resource. [ABSTRACT FROM AUTHOR]

This study analyzed the mediating role that implicit theories of intelligence and academic self-efficacy may play in the relationship between psychopathology and mathematical performance. The sample consisted of 838 students from first and second year of high school. A numerical calculation test was applied, followed by psychopathology self-report scales, implicit theories of intelligence, and academic self-efficacy. Serial multiple mediation models were tested. The results showed a complete mediation of the effect of psychopathology on mathematical performance through implicit theories of intelligence and academic self-efficacy. The effect of entity theories of intelligence on mathematical performance was both direct and through academic self-efficacy, whereas the effect of incremental theories of intelligence was only through academic self-efficacy. Identifying the variables that mediate the relationship in question is crucial to develop targeted interventions to prevent the development of a vicious circle between psychopathology and poor school performance. [ABSTRACT FROM AUTHOR]

The co-occurrence between gambling disorder (GD) and problematic pornography use (PPU) has not yet been explored. Therefore, the present study compared (a) sociodemographic variables, (b) GD-related factors, (c) substance use, (d) psychopathology, (e) personality features, (f) impulsivity, and (g) emotion regulation between individuals with GD (GD group) and those with co-occurring GD and PPU (GD+PPU group). The sample consisted of 359 treatment-seeking individuals with GD: n = 332 individuals had GD only (GD group) and n = 37 individuals had GD and co-occurring PPU (GD+PPU group). GD severity, impulsivity, psychopathology, personality, emotion regulation, and other sociodemographic and clinical variables were assessed. No between-group differences in sociodemographic measures were observed. The GD+PPU group demonstrated greater GD severity and a higher likelihood of substance use compared to those without PPU. Furthermore, the presence of PPU was associated with worse psychopathology, higher impulsivity (except for lack of premeditation and positive urgency), more difficulties in emotion regulation (except for non-acceptance of emotions and limited access to emotions), and a personality profile characterized by lower levels of self-directedness and cooperativeness. The co-occurrence of GD and PPU seems associated with a more dysfunctional clinical profile. [ABSTRACT FROM AUTHOR]

The sense of agency, our felt sense of authorship for our actions, is a difficult concept to define, yet its faltering stands at the heart of psychopathology. Historically undertheorized by psychoanalysis and typically positioned opposite relatedness by clinical psychology, Jeremy Safran conceived of agency and relatedness as paradoxically related. This paper pays tribute to Safran's ideas by taking his writings on agency as a starting point to elaborate how agency forms, and goes awry, in the relational crucible of early life. In doing so, the paper draws on the developmental theory of Winnicott, empirical research on embodied agency from adjacent fields of study, and Safran's clinical phenomenology. [ABSTRACT FROM AUTHOR]

Centering the perspectives of youth with lived experience (YWLE) in psychopathology is critical to engaging in impactful clinical research to improve youth mental health outcomes. Over the past decade there has been a greater push in clinical science to include community members, and especially community members with lived experience, in all aspects of the research process. The goal of this editorial is to highlight the need for and importance of integrating YWLE into every stage of clinical science research, from idea generation to interpretation and dissemination of research findings. We identify five key problems associated with pursuing research on adolescent mental health without involvement of YWLE and propose strategies to overcome barriers to youth engagement in clinical science research. We conclude with a call to action, providing guidance to clinical scientists, institutions, and funding agencies in conducting research on youth psychopathology with YWLE. [ABSTRACT FROM AUTHOR]

Schizophrenia is a neurodevelopmental disorder associated with deficits in cognitive development and childhood psychopathology. Previous studies have focused on older children and the few studies of early childhood have yielded inconsistent findings. We studied cognitive development and psychopathology in children at familial high risk (FHR) of schizophrenia and matched controls from 1 to 6 years and hypothesized that FHR children would show consistent deficits across cognitive and behavioral measures in early childhood. Cognitive development in children at high familial risk for schizophrenia or schizoaffective disorder (n = 33) and matched healthy controls (n = 66) was assessed at 1 and 2 years with the Mullen Scales of Early Learning, and at 4 and 6 years with the Stanford Binet Intelligence Scales, BRIEF-P/BRIEF and CANTAB. Psychopathology was assessed at 4 and 6 years with the BASC-2. General linear models were used to examine differences on outcome scores, and chi-square analyses were used to explore differences in the proportion of "at risk" or "below average" score profiles. FHR children scored significantly lower than controls on Mullen Composite at age 2, and demonstrated broad deficits in IQ, executive function and working memory and 4 and 6 years. FHR children were also rated as significantly worse on most items of the BASC-2 at ages 4 and 6. Children at FHR for schizophrenia demonstrate abnormal cognitive development and psychopathology at younger ages than previously detected, suggesting that early detection and intervention needs to be targeted to very early childhood. [ABSTRACT FROM AUTHOR]

Paranoia is a common delusion type found in clinical and non-clinical populations. A hierarchical, dimensional model of paranoia in the general population has been proposed, with four categories representing increasing levels of paranoia: interpersonal sensitivity (IP), mistrust (M), ideas of reference (IR), persecutory ideas (PI). What is currently lacking and could provide insights into etiology is a comprehensive clinical characterization of the lower end of the paranoia spectrum, psychological domains that are associated with symptom severity, and how paranoia and its structure fluctuate over time. This study conducted both cross-sectional and longitudinal surveys with 802 participants from the German population assessing paranoia and general psychopathology. Data was collected through Ecological Momentary Assessment (EMA). Several statistical approaches were used including confirmatory factor analysis (CFA), latent class analysis (LCA) and mixed modelling analyses (ME). Paranoid experiences appear to be a common phenomenon that occur in people with and without mental illness. Subjects clustered into four paranoia severity subgroups (IP, M, IR, PI) and showed significant associations in various psychological domains like increased psychiatric symptoms and maladaptive coping. Paranoia fluctuates over time in all four severity subgroups, but the hierarchical subgrouping was stable. Both persecutory ideations and interpersonal sensitivity were significant predictors of paranoia. Findings provide important insights into the architecture of paranoia in the German population by characterizing their hierarchical, dimensional, and dynamic structure and its link to psychopathology. [ABSTRACT FROM AUTHOR]

Measurement tools from which valid interpretations can be made are critical for assessing early emerging depressive symptoms, as depressive symptoms in childhood are associated with increased risk for early-onset depressive disorder, recurrence, suicidality, and other psychopathology. The Depression Self-Rating Scale for Children (DSRS) is a widely used self-report scale assessing youth depressive symptoms. The relatively few studies investigating the DSRS' latent structure have yielded mixed results, and measurement invariance (MI) based on sex and age has not been examined. We examined the factor structure and MI of the DSRS across sex and age in a community sample of 6–9-year-olds (N = 352; Mage = 7.57 years, SD =.70). Consistent with the largest prior structural study of the DSRS, a two-factor structure, with factors reflecting elevated negative affect (NA) and low positive affect (PA), showed strong model fit. Although this structure was consistent across sex and age (i.e., configural invariance), loadings of DSRS items varied across sex and age (i.e., metric noninvariance). Allowing the loadings of items contributing to noninvariance to vary across groups improved model fit. Implications for the clinical and research utility of the DSRS and suggestions for future research are discussed. Public Significance Statement: We examined factors underlying children's responses on the Depression Self-Rating Scale for Children (DSRS) and the structure of scores across sex and age. DSRS items reflect low positive affect and high negative affect. Although this was consistent across sex and age, how much individual items related to these factors differed across sex and age. As a result, we may not be able to meaningfully compare scores across sex and age. [ABSTRACT FROM AUTHOR]

Access to parenthood is not always easy, and various difficulties can sometimes emerge. Often underdiagnosed, these peri- and post-partum disorders have a major impact on the quality of early interactions. Prevention and fast care are fundamental. In Nancy, France, a mobile perinatal psychiatry team (EMPPer) was created in September 2021 with the aim of "reaching out" to these vulnerable populations with care access difficulties. A clinical case combining precariousness, migration, maternal psychopathological disorders, baby's psycho-affective and psychomotor development trouble is exposed. This article aims to present the multidisciplinary network intervention of EMPPer. [ABSTRACT FROM AUTHOR]

While psychopathy has been a topic of interest in the psychological field for a long time, it is still unclear which developmental factors are related to its onset. Theories have suggested that experiencing trauma in childhood may contribute to the development of psychopathic traits. Experiencing trauma may also contribute to the development of an insecure attachment style, which in turn might cause the emergence of psychopathic traits. The current study investigated links between experiencing childhood trauma and the three psychopathy domains of the Extended Levenson Self-Report Psychopathy scale (E-LSRP; Egocentricity, Callousness, and Antisocial), and whether these links were mediated by the four insecure attachment dimensions of the Attachment Style Questionnaire (ASQ; Need for Approval, Preoccupation with Relationships, Relationships as Secondary, and Discomfort with Closeness), in a large sample of non-clinical participants (N = 2023, Mage = 32.7, 70.0% female). The results suggested that Relationships as Secondary, but not Discomfort with Closeness, positively mediated the relationship between childhood trauma and the three domains of psychopathy, while Need for Approval negatively mediated this relationship. Preoccupation with Relationships was a significant mediator in the links between childhood trauma and both the Egocentricity and Antisocial domains, but not the Callousness domain. The current findings suggested that there might be both shared and differential mechanisms linking childhood trauma and psychopathic traits through insecure attachment styles. These findings can guide further investigations in longitudinal research. [ABSTRACT FROM AUTHOR]

Background: Generalized anxiety disorder (GAD)–characterised by excessive and uncontrollable worry–is the most frequently diagnosed anxiety disorder during pregnancy and the postpartum period. Identification of GAD often relies on assessment of its cardinal feature, pathological worry. The Penn State Worry Questionnaire (PSWQ) is the most robust measure of pathological worry to date but has not been extensively evaluated for use during pregnancy and the postpartum period. This study evaluated the internal consistency, construct validity, and diagnostic accuracy of the PSWQ in a sample of pregnant and postpartum women with and without a principal GAD diagnosis. Methods: One hundred forty-two pregnant and 209 postpartum women participated in this study. Sixty-nine pregnant and 129 postpartum participants met criteria for a principal diagnosis of GAD. Results: The PSWQ demonstrated good internal consistency and converged with measures assessing similar constructs. Pregnant participants with principal GAD scored significantly higher on the PSWQ than those with no psychopathology and postpartum participants with principal GAD scored significantly higher than those with principal mood disorders, other anxiety and related disorders, and no psychopathology. A cut-off score of 55 and 61 or greater was determined for detecting probable GAD during pregnancy and the postpartum period, respectively. Screening accuracy of the PSWQ was also demonstrated. Conclusions: This study underscores the robustness of the PSWQ as a measure of pathological worry and probable GAD and supports its use in the detection and monitoring of clinically significant worry symptoms during pregnancy and postpartum period. [ABSTRACT FROM AUTHOR]

L'objectif de l'article est de questionner aux niveaux théorique et clinique les thérapies d'affirmation de genre. Elles sont en effet présentées dans le DSM-5-TR comme les seules thérapies possibles de la dysphorie de genre, et nous démontrons que cela est discutable du point de vue de l'interaction entre l'activité médicale et la clinique du sujet, ainsi que du point de vue de l'évolution des modèles psychopathologiques de traitement des problématiques liées au genre, cela notamment au regard des données psychanalytiques (diagnostics, processus et thérapeutiques associés). Notre méthode articule une analyse de la littérature et deux cas cliniques. D'abord, nous étudions les évolutions diagnostiques du transsexualisme à la dysphorie de genre dans le champ de la psychopathologie et de la psychanalyse. Ensuite, nous présentons deux cas cliniques de patients ayant envisagé ou engagé une transition. Puis, nous étudions l'activité médicale impliquée dans les thérapies d'affirmation de genre, à partir des thèses de Canguilhem. Le DSM-5-TR a une conception réductrice et contradictoire de la dysphorie : il en situe implicitement la cause et la solution dans le milieu social, sans prendre en compte l'interaction avec le patient. Les théories psychanalytiques ont au contraire maximisé les potentialités de cette interaction, permettant ainsi d'argumenter l'intérêt psychothérapeutique de la réassignation (ou affirmation) de genre, mais aussi d'en démontrer les limites, en tenant compte notamment de la position subjective du sujet dans sa structure psychique. La réassignation se présente comme une normativation de la dysphorie par les traitements médicaux. Or, la normativation doit plutôt être comprise comme le processus par lequel le sujet établit une norme de genre qui lui est spécifique et qui lui permet de traiter sa dysphorie, en faisant un usage singulier des protocoles médicaux de réassignation. Du fait de l'interaction entre le sujet et son milieu, la normativation n'est pas une adaptation à la réalité extérieure ou sociale, mais implique que le second soit aussi modifié par le premier. On ne peut donc souscrire à la thèse du DSM-5-TR selon laquelle la dysphorie n'aurait qu'une seule thérapeutique possible prédéfinie, systématique et généraliste. La dimension clinique interne à l'activité médicale suppose en effet que la souffrance des patients précède la formalisation qui peut en être faite, et que les dispositifs médicaux sont conçus et appliqués secondairement à une diversité de configurations psychopathologiques. C'est d'ailleurs ce que démontrent les cas et l'histoire des idées et des pratiques présentés. La normativation des patients s'applique à leur environnement incluant les thérapeutiques, lesquelles sont donc appelées à être modifiées et diversifiées. The objective of this article is to question gender-affirming therapies at the theoretical and clinical levels. They are, in fact, presented in the DSM-5-TR as the only possible therapies for gender dysphoria; we demonstrate that this is questionable from the point of view of the interaction between medical activity and clinical practice with the subject, as well as from the point of view of the evolution of psychopathological models of treatment of gender-related issues, particularly with regard to psychoanalytic data (diagnoses, associated processes and therapies). Our method combines an analysis of the literature and two clinical cases. First, we study diagnostic developments from transsexualism to gender dysphoria in the field of psychopathology and psychoanalysis. Next, we present two clinical cases of patients who have considered or initiated a transition. Then, we study the medical activity involved in gender-affirming care, based on Canguilhem's theses. The DSM-5-TR has a reductive and contradictory conception of dysphoria: it implicitly locates the cause and the solution in the social environment, without taking into account the interaction with the patient. Psychoanalytic theories have, on the contrary, maximized the potential of this interaction, thus making it possible to argue the psychotherapeutic interest of gender reassignment (or affirmation), but also to demonstrate its limits, in particular by taking into account the subjective position of the subject in its psychic structure. Reassignment presents itself as a normativation of dysphoria by medical treatments. However, normativation must rather be understood as the process by which subjects establish gender norms that are specific to them and which allow them to treat their dysphoria, by making specific use of medical reassignment protocols. Due to the interaction between subject and environment, normativation is not an adaptation to external or social reality, but implies that the latter is also modified by the former. We cannot therefore subscribe to the thesis of the DSM-5-TR according to which dysphoria has only one possible predefined, systematic, and general treatment. The internal clinical dimension of medical activity assumes that the suffering of patients precedes the formalization that can be made of it, and that medical tools are designed and applied secondarily to a diversity of psychopathological configurations. This is also what the cases and the history of the ideas and practices presented demonstrate. The standardization of patients applies to their environment including therapies, which therefore should be modified and diversified. [ABSTRACT FROM AUTHOR]

Cette étude présente une réflexion sur l'habitation d'un lieu et la constitution d'un « Soi territorial », dans le contexte de la vie et du travail « paysan ». L'hypothèse est alors posée d'une possible « psychopathologie de la (dé-) territorialisation », selon laquelle un « non-lieu », générateur de non-sens, peut se trouver impliqué dans une dynamique suicidaire en lien spécifique avec la dimension territoriale du Soi et l'habitation impossible d'un lieu. Les aspects cliniques et psychopathologiques sont appréhendés dans la perspective du lien entre certains « paysans de tradition » et leur lieu de vie, au regard de l'empreinte réciproque entre psychisme et territoire. Cette réflexion exploratoire permet d'orienter des recherches cliniques auprès d'agriculteurs en souffrance en marge des « troubles psycho-sociaux » habituellement recensés. Les limitations et impasses induites par des processus dissociatifs, ou mélancoliques sont rapportés soit à une défaillance de la Présence, compromettant la construction d'un monde habitable, c'est-à-dire territorialisable, soit à l'hostilité d'un monde réfractaire à la dynamique d'un processus de territorialisation, et donc inapte à permettre d'y séjourner. Ces considérations ouvrent une perspective originale de recherches qualitatives visant à appréhender les rapports entre altération des assises territoriales du Soi et intentionnalité suicidaire. This study presents a reflection on the inhabitation of a place and the constitution of a territorial Self,' in the context of 'country' life and work. The hypothesis is then put forward of a possible 'psychopathology of (de-)territorialization,' according to which a 'non-place,' generator of meaninglessness, may be involved in a suicidal dynamics specifically linked to the territorial dimension of the Self and the impossible inhabitation of a place. The clinical and psychopathological aspects are examined from the perspective of the link between certain 'traditional farmers' and the place where they live, with regard to the reciprocal imprint between psyche and territory. This exploratory study will provide guidance for clinical research into the suffering of farmers who fall outside the scope of commonly identified 'psycho-social disorders.' The limitations and impasses induced by dissociative or melancholic processes are related either to a failure of Presence, compromising the construction of a habitable world, i.e. one that can be territorialized, or to the hostility of a world that is resistant to the dynamics of a territorialization process, and therefore unfit to allow us to dwell in it. These considerations open up an original perspective for qualitative research aimed at understanding the relationships between alteration of the territorial foundations of the Self and suicidal intentionality. [ABSTRACT FROM AUTHOR]

This article discusses the new phenomenon of a significant increase in requests for social and even medical transition, mainly from adolescents who identify as trans and often feel uncomfortable in their bodies. In France, as in all industrialized countries, this exponential increase is linked to the use of digital social networks. This phenomenon of transidentification, which we distinguish from gender dysphoria, contrasts with the previous descriptions affecting mainly adult men (who have transitioned in adulthood). We will try to understand this important increase in requests and we will try to understand the meaning of the trans identification of these adolescents. First, in order to understand the emergence and the context of appearance of gender dysphoria in the psychological organization of young people, we will rely on studies that have highlighted the psychopathological comorbidities of transidentification. Then, we will present an analysis of certain invariants identified in our clinical practice, based on a group of 26 adolescents, around psychological history, psychic structure, and family functioning. These elements will allow us to discuss "transidentification," which is more a process of identification with the signifier "trans" than a fixed identity and which seems to be a solution to pubertal malaise. We will conclude on the types of psychotherapeutic treatments that seem relevant to these adolescents. What psychotherapeutic care should be given to these young people? How can we listen to the request for a sex change in a hyper-connected society where images flow in a present time disconnected from history? Transidentification is a concept that seems to us to be heuristic to think about the significant and recent increase of adolescents who present a dysphoria that seems more linked to puberty itself than to gender. [ABSTRACT FROM AUTHOR]

Self-injurious thoughts and behaviors (SITB) among preteen children have risen to the attention of researchers, practitioners, and policymakers. To shed light on potential treatment/prevention targets, we sought to identify empirically derived emotional and behavioral problem profiles of preteens with SITB, and to determine whether these profiles differ by age, gender and society. Caregivers of 46,719 children aged 6 to 12 years from 42 societies across the world completed the Child Behavior Checklist for ages 6-18 (CBCL/6-18). There were 1,656 children whose caregivers indicated that their child experienced SITB. We conducted a latent profile analysis (LPA) using scores from eight CBCL/6-18 problem scales to derive problem profiles of children with SITB. Multilevel modelling was used to estimate differences in the profiles by SITB, society, sex, and age. A 4-profile model provided the best fit to the data, with profiles reflecting low problems (39.7%), mild problems (42.6%), moderate problems (15.4%), and rule-breaking/thought problems (2.3%). The low problems profile had CBCL problem scale scores nearly indistinguishable from those of children without SITB. Children in the rule-breaking/thought problems group were mostly female, whereas children in the other profile groups were mostly male. Children with the rule-breaking/thought problems profile also were most likely to have both suicidal thoughts and self-harm behaviors. In this study, authors analyzed emotional and behavioral profile of preteens who experienced self-injurious thoughts and behaviors (SITB). Caregivers of over 46,000 children aged 6-12 from 42 countries completed the Child Behavior Checklist. The authors found that most preteens with SITB had low levels of other mental health problems. This study highlights the needs to screen all children for SITBs, not just those who have have significant mental health problems. Problem profiles of preteens with SITB are heterogeneous, with most having relatively low levels of other psychopathology. Selectively screening only children with clinically significant mental health problems for suicidal thoughts and self-harm behaviors (eg, asking about suicidal thoughts only among children with depression) risks missing many children experiencing SITB. [ABSTRACT FROM AUTHOR]

Background: Depressive moods and behaviors are developmentally normative, yet potentially impairing, in preschool‐aged children. In addition to frequency, duration of behavior is an important parameter to consider when characterizing risk for worsening mood dysregulation. The goal of this study was to identify the duration and severity of depressive moods and behaviors and associations with impairment in a large community sample of preschool‐aged children using an online parent‐report daily diary. Methods: Primary caregivers (N = 900) of 3–5‐year‐old children reported the daily duration of each instance of seven depressive moods and behaviors for 14 days. We used item response theory analyses to examine duration item characteristics. Results: Moods and behaviors occurred at specific durations to be considered psychometrically severe/rare; for example, instances of sadness had to last an average total of 32 min per day or more, irritability at least 38 min, tantrums at least 30 min, and tearfulness/sensitivity at least 35 min. Longer durations of mood and behavior were associated with daily impairment, as well as older child age and less parental education. Conclusions: To our knowledge, this is the first study to delineate specific duration ranges for depressive moods and behaviors in preschool‐aged children. These data, coupled with information about the frequency of mood‐related behaviors, can assist child practitioners in differentiating normative patterns from less normative mood problems to evaluate which children may be at risk. Future work should identify the duration of depressive moods and behaviors in early childhood that predict clinically significant psychopathology over time. [ABSTRACT FROM AUTHOR]

Distress intolerance—a broad band dispositional variable has been shown to serve as a transdiagnostic risk factor for psychopathology. We investigated the predictive validity of the physical and emotional subscales of the Distress Tolerance Inventory (DTI) on behavioral responding (immersion time) and moment-to-moment subjective distress ratings to the Cold-Pressor Test. College students (N = 134) completed self-report questionnaires indexing physical and emotional distress tolerance and then completed a cold pressor challenge. The DTI displayed convergent validity with several well-established self-report measures assessing distress tolerance (i.e. DTS, PCS, DIS). Participants' scores on the DTI physical subscale (but not the DTS or DTI emotional subscale) predicted participants' immersion time on the cold pressor challenge, thus supporting the construct validity of the DTI physical distress subscale. The DIS also predicted immersion time, though its internal consistency was marginal. These data suggest that the DTI is a valid measure for both emotional and physical distress tolerance and should be considered as a viable alternative to the DTS, especially for investigative domains involving physical distress such as chronic pain, or screening personnel for physically demanding tasks. [ABSTRACT FROM AUTHOR]

The complex interplay of fear, attention, and behavior toward bodily sensations with psychopathological symptoms and how they mutually influence and potentially reinforce one another remains to be fully elucidated. In this study, we used a network analytical approach to unravel these complex interactions. Specifically, we aimed to identify central symptoms and etiologically relevant factors that might be associated with anxiety and depressive core symptoms. To this end, the following clusters were assessed in 791 adults: interoceptive fear, interoceptive attention, maladaptive behaviors related to bodily sensations, and core symptoms of anxiety and depression. This network was modeled using a Gaussian Graphical Model. Central variables (nodes) were identified using centrality indices and bridge analysis. Self-examination and attention to bodily sensations emerged as central nodes. Moreover, time spent paying attention to bodily sensations, fear of anxiety-related sensations, and self-examination were identified as central bridge nodes, that is, central nodes connecting psychopathologically relevant symptom clusters. The present study indicates that fear of bodily sensations, the amount of attention and time spent focusing on somatic sensations, and self-examination are central factors. The findings suggest potential targets for future longitudinal studies on the impact of these factors for the escalation of anxiety and depressive symptoms. Central variables were identified through centrality indices and bridge analysis Attention to bodily sensations and self-examination were identified as central nodes Fear of bodily sensations and self-examination emerged as central bridge nodes Time spent paying attention to body sensations also emerged as central bridge node Results suggest possible targets for future experimental and longitudinal research [ABSTRACT FROM AUTHOR]

Clozapine-induced myocarditis (CIM) is among the most important adverse events limiting the use of clozapine as the most effective treatment for schizophrenia. CIM necessitates the immediate termination of clozapine, often resulting in its permanent discontinuation with considerable detrimental effects on patients' psychopathology and long-term outcome. Consequently, a clozapine re-challenge after CIM is increasingly regarded as a viable alternative, with published reports indicating a success rate of approximately 60%. However, published cases of re-challenges after CIM remain limited. Here, we provide a narrative review of the current state of research regarding the epidemiology, pathophysiology, risk factors, diagnosis and clinical management of CIM as well as a synthesis of current recommendations for re-challenging patients after CIM. This includes a step-by-step guide for this crucial procedure based on the current evidence regarding the pathophysiology and risk factors for CIM. Slow dose titration regimes and addressing risk factors including concomitant valproate and olanzapine are crucial both to prevent CIM and to ensure a safe and successful re-challenge. Furthermore, we discuss the utility of C-reactive protein, troponin, N-terminal-pro hormone and brain natriuretic peptide, therapeutic drug-monitoring and cardiac magnetic resonance imaging for CIM screening and diagnosis as well as for post-CIM re-challenges. [ABSTRACT FROM AUTHOR]

• Mealtime anxiety predicted increased emotional avoidance at the next meal. • When considering concurrent guilt, anxiety did not predict emotional avoidance. • Mealtime guilt and physical discomfort predicted emotional avoidance. • These affective processes may differentially relate to eating disorder symptoms. • Guilt should be considered in conceptualizing the anxiety–avoidance cycle. The relationship between negative emotions and avoidance is widely theorized as a bidirectional cycle implicated in a range of psychopathology. Historically, research on this cycle has examined one type of negative emotion: anxiety. Yet, a broader range of internal experiences may be implicated in the maintenance of unhealthy avoidance cycles in psychopathology. This study examines prospective relationships among anxiety, guilt, physical discomfort, and experiential avoidance during mealtimes for individuals with eating disorders (EDs). Participants (N = 108) completed ecological momentary assessments four times a day for 25 days. We computed multilevel models to examine between- and within-person effects of negative emotions and physical discomfort on experiential avoidance. When including guilt and anxiety in one model, guilt, but not anxiety, explained the significant variance in experiential avoidance at the next meal. Mealtime physical discomfort and experiential avoidance evidenced reciprocal prospective relationships. Future research should test whether interventions targeting experiential avoidance and physical discomfort at mealtimes disrupt guilt. [ABSTRACT FROM AUTHOR]

Objective Resistance management in psychotherapy remains a foundational skill that is associated with positive client outcomes (Westra, H. A., & Norouzian, N. (2018). Using motivational interviewing to manage process markers of ambivalence and resistance in cognitive behavioral therapy. Cognitive Therapy and Research, 42(2), 193–203). However, little is known about which therapist characteristics contribute to successful management of resistance. Research has suggested that psychotherapy performance does not improve with experience (Goldberg, S. B., Rousmaniere, T., Miller, S. D., Whipple, J., Nielsen, S. L., Hoyt, W. T., & Wampold, B. E. (2016). Do psychotherapists improve with time and experience? A longitudinal analysis of outcomes in a clinical setting. Journal of Counseling Psychology, 63(1), 1–11), that psychotherapists lack humility (Macdonald, J., & Mellor-Clark, J. (2015). Correcting psychotherapists' blindsidedness: Formal feedback as a means of overcoming the natural limitations of therapists. Clinical Psychology & Psychotherapy, 22(3), 249–257), and that difficult therapeutic moments may dysregulate therapist emotions (Muran, J. C., & Eubanks, C. F. (2020). Therapist performance under pressure: Negotiating emotion, difference, and rupture. American Psychological Association). This study aimed to 1) identify whether psychotherapy experience (i.e., training versus no training and number of years of psychotherapy experience) was associated with resistance management skill, and 2) identify whether humility and difficulties regulating emotions among trained individuals were each associated with resistance management. Method: A sample of 76 trained and 98 untrained participants were recruited for the present study. All participants completed the Comprehensive Intellectual Humility Scale (CIHS, Krumrei-Mancuso, E. J., & Rouse, S. V. (2016). The development and validation of the comprehensive intellectual humility scale. Journal of Personality Assessment, 98(2), 209–221), the Difficulties in Emotion Regulation Scale (DERS; Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54), and the Resistance Vignette Task (RVT; Westra, H. A., Nourazian, N., Poulin, L., Hara, K., Coyne, A., Constantino, M. J., Olson, D., & Antony, M. M. (2021). Testing a deliberate practice workshop for developing appropriate responsivity to resistance markers: A randomized clinical trial. Psychotherapy, 58, 175–185) which was used to assess resistance management skill. Results: Trained individuals performed significantly better on resistance management than untrained individuals; however, years of experience within the trained sample were not associated with resistance management. Conversely, lower humility and greater difficulties regulating emotions were each associated with significantly poorer resistance management in trained individuals. Conclusion: These findings suggest the possibility of improving training to focus on key skills, like resistance management, through supporting humility and emotion regulation in training, as opposed to simply acquiring more experience. [ABSTRACT FROM AUTHOR]

Health anxiety is an intricate part of illness anxiety and somatic symptom disorder. Based on convenience samples, two out of three available studies indicate that it is a dimensional rather than a categorical construct. Using two representative datasets, this study investigates whether previous results can be clarified. Conventional taxometric analyses as well as comparison curve fit indices (CCFI) profile analyses (MAMBAC and MAXSLOPE procedures) were calculated with two datasets of the German adult population assessing the Whiteley Index (WI-14, N = 2,072; WI-7, N = 2,498). Mean CCFIs indicated a dimensional structure for both the WI-7 (mean CCFI = 0.42, mean CCFI profile = 0.40) and the WI-14 (mean CCFI = 0.44, mean CCFI profile = 0.32). The results support and extend previous findings by strongly suggesting a dimensional distribution of health anxiety in the general population. Implications for research and practice comprise the adoption of a dimensional description of psychopathology as well as transdiagnostic treatment approaches. [ABSTRACT FROM AUTHOR]

The traits of the dark triad (narcissism, psychopathy, and Machiavellianism) capture the individual differences in the aversive personality. The dark triad has shown significant relations with behaviors that affect people's lives. One of the best-known instruments to assess the dark triad is the Dirty Dozen. However, controversy continues over the use of one general dark triad score or, conversely, three different scores. This study aimed to investigate the factor structure of the Dirty Dozen across eight global regions. There were 11,477 participants in 49 countries grouped into eight regions. Different factor structures were studied using confirmatory factor analyses. Both the three-dimensional models and the bifactor models (symmetrical or traditional and non-symmetrical or bifactor-[S – 1]) showed a good fit to the data. The bifactor-(S – 1) models (with psychopathy or Machiavellianism as the reference factors) show adequate fit to the data, supported by the coherence of the factorial loadings and the bifactor indices. Regarding measurement invariance for both models, configural, metric, and scalar invariance were satisfied. The results indicate that it is not clear whether a psychopathy or Machiavellianism reference factor predominates in the Dirty Dozen. For both models, templates are provided to obtain standardized scores for applied researchers in the eight studied world regions until future studies offer a greater amount of validity evidence for this instrument. [ABSTRACT FROM AUTHOR]

Establishing normative data for questionnaires is essential for the accurate interpretation of scores, given that these norms can vary according to different subpopulations and treatment contexts. The purpose of this study was to establish norms for the Eating Disorder Examination-Questionnaire (EDE-Q) among adults receiving higher levels of care (HLOCs) for the treatment of eating disorders. Participants were 2,283 people receiving treatment at the inpatient, residential, partial hospitalization, or intensive outpatient levels of care. The EDE-Q was completed at admission. Patients with anorexia nervosa—restricting subtype (AN-R) had the lowest EDE-Q Global scores when compared with all other eating disorder diagnoses. When compared with intensive outpatient care, only those in residential treatment had higher EDE-Q Global scores. This study is among the first to describe norms for the EDE-Q in a large sample of adults receiving various HLOCs. Programs utilizing the EDE-Q to assess treatment outcomes can use these findings to aid people in interpreting their scores. [ABSTRACT FROM AUTHOR]

This paper theoretically examines how the psycho-pathological concept of hysteria has evolved since its emergence in antiquity, what causes contributed to it and how nowadays meaning-making systems of clinical psychology are mirrored through it. As has been shown, the transformation of hysteria is more closely related to the cultural psychology of feminism than any other disease before it. The 20th century in particular marked a significant change in the conceptualization of hysteria. From a highly sexist and paternalistic it became a political diagnose and finally was used, after getting banished from the psychological dictionary as an everyday pejorative personality adjective. It underwent a transformation within its gender classification, which was initially limited exclusively to women. Later, it became a psychiatric diagnosis, which was no longer durable nowadays and has finally changed into the concept of histrionic today. The analysis shows how, on the one hand, medical and biopsychological findings and, on the other hand, especially political movements and their cultural psychological processes of change form the basis of psychopathological concepts. It will be shown to what extent hysteria is exceptionally exemplary for this change in psychological meaning-making. In this context, the close connection between hysteria and the emancipatory development of our society could be emphasized. [ABSTRACT FROM AUTHOR]

Clinical instruments that use a filter/follow-up response format often produce data with excess zeros, especially when administered to nonclinical samples. When the unidimensional graded response model (GRM) is then fit to these data, parameter estimates and scale scores tend to suggest that the instrument measures individual differences only among individuals with severe levels of the psychopathology. In such scenarios, alternative item response models that explicitly account for excess zeros may be more appropriate. The multivariate hurdle graded response model (MH-GRM), which has been previously proposed for handling zero-inflated questionnaire data, includes two latent variables: susceptibility, which underlies responses to the filter question, and severity, which underlies responses to the follow-up question. Using both simulated and empirical data, the current research shows that compared to unidimensional GRMs, the MH-GRM is better able to capture individual differences across a wider range of psychopathology, and that when unidimensional GRMs are fit to data from questionnaires that include filter questions, individual differences at the lower end of the severity continuum largely go unmeasured. Practical implications are discussed. [ABSTRACT FROM AUTHOR]

Background: Attachment theory has served as an influential framework for understanding psychopathology, partly due to reliable assessment methodology. The influence of insecure attachment on attitudes toward the body and the impact this might have for the development of psychopathology is however less well elucidated. Method: A total of 123 adolescents (35 with borderline personality disorder or BPD, 25 with other personality disorders [OPD] and 63 comprising a normative control group) were interviewed with the Adult Attachment Interview (AAI) and the Mirror Interview (MI). The MI questions respondents about how they feel about their bodies, as they look in the mirror. Results: The AAIs from the Borderline group were predominantly insecure‐preoccupied and unresolved. These adolescents had significantly lower levels of a positive and integrated sense of self and body than the other groups. Regression results revealed a high loving relationship with fathers, low involving anger with father, high coherence of mind, slight derogation of mother & low levels of unresolved loss uniquely and additively predicted 55% of variance in the summary score assigned to MI responses, that is, the summary score for a Positive and Integrated Body Representation (PIBR). Conclusion: Unfavorable attachment experiences and current states of mind regarding attachment may give rise to problems with establishing PIBRs, and thus play a role in the development of psychopathology, especially BPD. [ABSTRACT FROM AUTHOR]

Monozygotic twins share the same genotype; however, they can be phenotypically discordant on various traits. Studying discordant monozygotic twins allows the investigation of differences in associations between symptoms and psychopathological risk factors, controlled for shared genetic liability. The network approach to psychopathology suggests that depressive symptoms, along with risk and protective factors (e.g., cognition, daily activities), form a complex system of mutually interacting components. We compared monozygotic twins discordant for lifetime depression on their respective extended networks of depressive symptoms, cognitive functions and daily activities (intellectual, physical, social), and evaluated if these networks differ in their associations between variables and in the role of each variable within the network. Regularized partial correlations investigated the networks' composition in 147 monozygotic twin pairs discordant for depression from the Danish Twin Registry. Affected twins had stronger overall associations within their network of depressive symptoms, cognitive functions and daily activities than their unaffected co-twins, while the importance of the network components' associations did not differ between the co-twins. In affected twins, decreased frequency in experiencing happiness had the strongest association with remaining variables (i.e., the most influence in activating other network elements). Also, variables from different groups were significantly associated (e.g., loneliness with delayed memory, pessimism with low social activities, verbal learning with intellectual activities). In unaffected twins, both mood symptoms and cognitive functions were important, but between-groups associations were quasi-absent. These results suggest that external events affecting the ability to feel happiness likely trigger the psychopathological process (depression network activation), independently from the genetic predisposition to depression. [ABSTRACT FROM AUTHOR]

The aim of this pre-registered (NCT05051462), randomized controlled trial was to investigate the efficacy and safety of a pandemic-adjusted version of family/systemic constellation therapy in the general population. Altogether, 80 individuals were randomized (85% retained; 67.6% women, M age = 41.9 ± 9.2 years) and followed up 1- and 6 months after participation in the single-day intervention. Numerous indicators of psychopathology and addiction as well as wellbeing were assessed. Members of the intervention group improved significantly in terms of the a priori primary outcome (overall psychopathology: d 1-month = 0.41, p 1-month = 0.003; d 6-month = 0.31, p 6-month = 0.028) as well as numerous secondary outcomes (obsession-compulsion, interpersonal sensitivity, anxiety, hostility, phobic anxiety, and paranoid ideation). However, the magnitude of improvements was small and mostly disappeared by 6-months. Further, no significant treatment benefit emerged considering time x group interactions regarding any of the outcomes (although statistical power was low). Due to the significant, pandemic-related deviations from the protocol of the intervention, these results may not be generalizable to systemic constellation interventions in general; instead – considering the previous, more favorable data regarding efficacy/effectiveness and tolerability – they rather call attention to the importance of process-related factors regarding this intervention specifically as well as the potential disadvantages of pandemic-related treatment modifications of in-person (non-virtual) group interventions in general. [ABSTRACT FROM AUTHOR]

The role of fear of COVID-19 in prospectively predicting changes in psychopathological symptoms during the COVID-19 pandemic remains unclear. The present data were obtained from a longitudinal non-probability sample in Germany, initially assessed at the beginning of the COVID-19 pandemic in Germany (April–May 2020) and reassessed after two years (n = 846; 83% female; mean age: 44.59 years, SD = 12.32; response rate: 19.5%). Multiple linear regressions were used to examine associations of fear of COVID-19 at baseline with depressive symptoms, anxiety, health anxiety, psychosocial distress, and loneliness controlling for (a) the respective symptom measure, and (b) all psychopathological symptoms at baseline. The data were weighted to minimize attrition and representativeness biases. Overall, loneliness decreased from the beginning of the COVID-19 pandemic until the two-year follow-up, whereas all other symptoms did not change. Fear of COVID-19 at the beginning of the pandemic predicted an increase in anxiety symptoms, health anxiety, psychosocial distress, and loneliness two years later. In addition, fear of COVID-19 predicted higher health anxiety, depressive symptoms, psychosocial distress, and loneliness, but not anxiety symptoms when controlling for all baseline symptom measures at once. Fear of COVID-19 seems to play a central role in predicting negative mental health outcomes, emphasizing the necessity of indicated prevention and intervention to decrease worry and manage anxiety, thereby reducing the negative impact on mental health caused by fear during future pandemics. • Loneliness decreased over two years. • Anxiety, depression, health anxiety, and psychosocial distress remained unchanged. • Fear of COVID-19 was associated with increases in these psychopathological symptoms. • Fear of COVID-19 is a central predictor of adverse mental health outcomes. [ABSTRACT FROM AUTHOR]

Cognitive impairment is recognized as a risk factor for suicide in schizophrenia (SZ) patients. Despite empathy being an important aspect of social cognition, the association between suicidal behavior and empathy has received little attention. We aimed to compare empathy and neurocognition in SZ patients with and without suicide attempts (SAs), and to explore the relationship between empathy, neurocognition, and clinical symptoms in SZ patients with and without SAs. Data on SAs and socio-demographic characteristics were collected from 628 chronic SZ patients. The patients' symptomatology was measured by the Positive and Negative Syndrome Scale (PANSS). Empathy and neurocognition were assessed with the Interpersonal Reactivity Index (IRI) and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), respectively. Patients with SAs performed better on all IRI domains (except for Perspective Taking) and total scores. Regression results showed that negative symptoms, positive symptoms, and duration of illness were independently associated with IRI total score in patients without SAs (adjusted R2 = 0.048). In patients without SAs, negative symptoms, general psychopathology, education, age, and sex were independently associated with RBANS total score (adjusted R2 = 0.265), while in patients with SAs, education, PANSS total score, and age at onset were independently associated with RBANS total score (adjusted R2 = 0.456). Our results show that SZ patients with SAs may have better empathic performance than patients without SAs. In chronic SZ patients, negative and positive symptoms may have different effects on cognition in the SAs and non-SAs groups. [ABSTRACT FROM AUTHOR]

Although psychotic disorders are characterized by an impaired ability to discriminate internal and external worlds, the role of interoceptive and exteroceptive perceptions in determining this alteration is still unclear. This observational study aimed at investigating (a) increases/decreases in interoceptive and exteroceptive perceptions in patients with psychosis (PSY) compared to healthy controls (HC); (b) the association between interoception and exteroception in HC and PSY. Two hundred and ten HC and 72 PSY completed the Multidimensional Assessment of Interoceptive awareness (MAIA, 8 domains) and the Adolescent-Adult Sensory Profile (AASP, 4 domains). MAIA/AASP differences were evaluated with MANOVA, Kruskal–Wallis and Mann–Whitney tests. MAIA and AASP scores were correlated to quantify the interoceptive–exteroceptive coupling as Spearman's rho coefficients. Subgroup analyses were performed dividing PSY in schizophrenia/schizoaffective versus other psychosis. Compared to HC, PSY showed increased mean scores in four MAIA and two AASP domains (Bonferroni-p < 0.01). The interoceptive–exteroceptive coupling followed two correlation patterns in HC. A first pattern displayed negative correlations between MAIA not-worrying and AASP sensory sensitivity/sensation avoidance, while the second pattern highlighted positive correlations between MAIA scores and AASP sensation seeking. The two correlation patterns between HC and other-PSY subgroup were similar. However, schizophrenia/schizoaffective PSY did not show positive correlations in the second pattern, rather displaying negative correlations between MAIA scores and AASP domains related to passive behavioral responses. Correlation values were more extreme in PSY subgroups, indicating stronger interoceptive–exteroceptive coupling compared to HC. This study demonstrates that interoception and exteroception are atypical and excessively coupled in psychosis compared to the general population. Clinical Trials Registration: Protocol Number 20210003663 (Pavia, Ethical Committee IRCCS Policlinico San Matteo). [ABSTRACT FROM AUTHOR]

There is increasing evidence that sex differences exist in many clinical manifestations of patients with schizophrenia, including suicidal ideation (SI) and neurocognitive function. The present study was performed to explore the sex differences in the association between SI and neurocognitive function in Chinese patients with schizophrenia. A total of 1188 inpatients with schizophrenia were recruited from multicenter psychiatric hospitals. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was utilized to evaluate the neurocognitive function of all patients. The Positive and Negative Syndrome Scale (PANSS) was utilized to assess the psychopathology of patients. The Beck Scale for Suicide Ideation (BSSI) was used to assess the severity of SI. In male patients, the suicide risk score was significantly associated with PANSS negative symptoms (r = 0.167, p = 0.043), visuospatial subscale (r = − 0.261, p = 0.001), and RBANS total scores (r = − 0.172, p = 0.037). Furthermore, multivariate linear regression analysis showed that the visuospatial subscale (β = − 0.490, t = − 3.273, p = 0.001) was independently associated with the suicide risk score in male patients. In female patients, the suicide risk score was significantly correlated with PANSS positive symptoms (r = 0.249, p = 0.021), negative symptoms (r = 0.394, p < 0.001), general psychopathology (r = 0.276, p = 0.01) and PANSS total score (r = 0.365, p = 0.001). Multivariate linear regression analysis showed that PANSS negative symptoms (β = 1.849, t = 3.933, p = 0.001) were significantly associated with suicide risk scores in female patients. Our findings indicate that there are sex differences in the association between SI and neurocognitive function in patients with schizophrenia. Based on the findings of our study, gender-specific prevention and intervention strategies may make a difference in reducing SI in Chinese schizophrenia patients. [ABSTRACT FROM AUTHOR]