Does it exist?: "a psychopathology of deafness"

This work aims to study the relationship between psychopathology and deafness. These results show that the most frequent diagnosis among the deaf are disorders of mood and post-traumatic syndrome. Psychotic disorders and mental retardation, once widely diagnosed among deaf populations, are less frequent. The accuracy of these findings results from studies conducted by a team that is specialized in the care of the deaf and that also masters the socio-linguistic aspects of the deaf culture. The high prevalence of erroneous diagnosis posed by non-specialist teams in support of deaf persons, shows the need for the establishment of a bio-psycho-socio-specific language for the deaf.     

Disability as a risk factor? Development of psychopathology in children with disabilities

Empirical research has established that children with disabilities are more likely to develop psychopathology than children without disabilities. But too little is known about the association between disability and psychopathology. The aim of this article is to discuss developmental psychopathological models that conceptualise the connection between childhood disability and psychopathology. Empirical studies of psychopathology among children with a congenital hearing impairment and children with cerebral palsy will be reviewed, representing in-depth examples of association between disability and psychopathology. Both a congenital hearing impairment and cerebral palsy were found to be dominating risk factors for all types of psychopathology, but no relationship was identified between degree of disability and risk of psychopathology. The higher risk cannot be explained by biological impairments alone. To explain the contradictory findings, developmental models of disability and psychopathology are applied. Within a multi-factorial developmental psychopathological perspective and a dialectical model of disability (Vygotsky, 1993), it is suggested that disability can be understood as an incongruence between the individual development of the child and demands and expectations in the specific relations and institutions in which the child participates. This incongruence creates and strengthens negative factors for the child with disability and results in a higher risk of psychopathology.     

Design fluency subsequent to onset of aphasia: a distinct pattern of executive function difficulties?

ABSTRACT

Background: Executive function problems commonly co-occur with aphasia and influence language and communication performance as well as aphasia treatment outcomes and prognosis. Prior research, however, has focused on a restricted set of executive skills.

Aims: This study examined further the integrity of executive functioning and its relationship to language performance in individuals with aphasia by utilising a design fluency measure, which assesses executive skills like initiation, planning, and cognitive flexibility. To examine domain-general versus domain-specific executive problems and determine the distinctiveness of the aphasic group’s performance pattern, adults with right hemisphere brain damage (RHD) were included. The hypotheses examined were: (a) compared to adults with no brain damage, the aphasic and RHD groups would display design fluency impairments; (b) the design fluency performances of aphasic and RHD groups would be quantitatively but not qualitatively similar; and (c) the design fluency performances of the aphasic and RHD groups would be related to their language abilities, as well as their performance of other executive and cognitive measures.

Methods and Procedures: Participants with aphasia, RHD, or no brain damage completed the Ruff Figural Fluency Test (RFFT; Ruff, 1996), the results of which were quantitatively (i.e., number of unique designs, a perseverative error ratio) and qualitatively analysed (i.e., number and maximum length of orderly patterns, design complexity, number, and types of non-repetition errors), along with a formal cognitive-linguistic test battery and a verbal fluency task.

Outcomes and Results: The traditional, quantitative RFFT scores of the aphasia, and RHD groups were significantly lower than those of the control group. Only the RHD group significantly differed from the control group when qualitative RFFT variables were analysed. RFFT performances correlated with language and other cognitive test scores, with some differences in the number and nature of these associations across the aphasic and RHD groups.

Conclusions: The current design fluency findings indicated that executive function deficits involving initiation, planning, self-monitoring, and cognitive flexibility commonly co-occur with aphasia. These results supported previous research by identifying executive function impairments in many, however, not all individuals with aphasia, and by confirming influential associations between executive function and language, and communication measures. Inclusion of individuals with RHD indicated that such executive function difficulties and a potent relationship between executive functioning and language skills are not only unique to those with aphasia but also prevalent in other patient populations and consistent with the contribution of domain-general factors in acquired cognitive impairments.     

Does dissociation offer a useful explanation for psychopathology?

BACKGROUND: Dissociation is often conceptualised as an altered state of consciousness, a trance-like state in which normal barriers between conscious and unconscious memories, desires and beliefs break down and other amnestic barriers emerge. This review explores whether it is likely that there is a neurophysiology of pathological dissociative processes that will elucidate management. METHOD: A critical reading of current research, sourced through Medline and Psychinfo searches from 1990 to 2002, using subject headings: dissociative disorders, hypnosis and stress disorder (post-traumatic), as well as keywords: dissociation, hypnosis and trance. RESULTS: Current knowledge does not support the notion of dissociation as a discrete brain state or process. CONCLUSIONS: Psychiatric and neurophysiological research and theory development are better directed towards individual components that contribute to dissociative experience.     

How specific is a deficit of executive functioning for attention-deficit/hyperactivity disorder?

A selective review of research in the executive functioning (EF) is given for attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), higher functioning autism (HFA) and Tourette syndrome. The review is restricted due to changes in the classification of the disorder in recent years and secondly the heterogeneity of EF is restricted to five key areas of concern, inhibition, set shifting, working memory, planning, and fluency. The review makes clear that there are strong differences between child psychopathological groups and controls on these EFs. However, future research will be needed to identify an EF deficit or profile, which is specific for these disorders.     

Self-harm: a transdiagnostic marker of psychopathology and suicide risk during the COVID-19 pandemic?

There is a growing number of young people, diagnosed with an autism-spectrum disorder (ASD), transitioning to adulthood. Among this number, individuals without an intellectual disability have significant adaptive deficits and need individualized care and support services to better target vocational, social, and educational prospects and outcomes. Group-based interventions, including patient education, social-skills training, and cognitive–behavioral therapy, are widely used in clinical settings to improve the daily life and prospects of ASD individuals facing the challenge of transitioning to adulthood. We performed a systematic review of studies concerning the efficiency of group-based educational interventions with a focus on the transition to adulthood for young, ASD individuals without intellectual disability (ID). As a result of this systematic search, 21 studies out of 163 were found to be eligible for inclusion. We observed considerable heterogeneity across the studies, in terms of effect sizes and intervention design, delivery, and the comparison of controls. Strong evidence was found in favor of social-skills training and cognitive–behavioral therapy interventions. Professionals should consider group-based psychoeducational intervention to be an appropriate and relevant service for young subjects with ASD without ID transitioning to adulthood. Further research is needed on larger samples using multicentric designs to validate efficacy before generalization.

     

Emotion regulation deficits in eating disorders: a marker of eating pathology or general psychopathology?

Preliminary evidence indicates that individuals with eating disorders (ED) show emotion regulation (ER) difficulties. However, it is yet unclear whether different types of ED differ in their ER profile and whether certain ER difficulties are specific for ED or rather a transdiagnostic factor. Twenty women with anorexia nervosa (AN), 18 with bulimia nervosa (BN), 25 with binge eating disorder (BED), 15 with borderline personality disorder (BPD), 16 with major depressive disorder (MDD) and 42 female healthy controls (HC) were administered the Emotion Regulation Questionnaire, the Inventory of Cognitive Affect Regulation Strategies, the Difficulties in Emotion Regulation Scale and the Affect Intensity Measure. The ED groups reported significantly higher levels of emotion intensity, lower acceptance of emotions, less emotional awareness and clarity, more self-reported ER problems as well as decreased use of functional and increased use of dysfunctional emotion regulation strategies when compared to HC. No significant differences between the ED groups emerged for most ER variables. However, there were indications that the BED group may show a slightly more adaptive pattern of ER than the two other ED groups. As a whole, all clinical groups performed very similar on most ER variables and reported more difficulties regulating their emotions than HC. The findings suggest that ER difficulties are not linked to a particular diagnostic category. Instead, ER difficulties appear to be a transdiagnostic risk and/or maintenance factor rather than being disorder-specific.     

Hypothyroidism and major depression: a common executive dysfunction?

Little is known about the possible link between the cognitive disorders associated with hypothyroidism and those encountered in depression. This study examines attentional and executive functions as well as the intensity of anxiety and depressive symptoms in hypothyroidism and major depression and the possible link between these symptoms and cognitive disturbances. This study confirms the existence of psychomotor slowing associated with attentional and executive disturbance in major depression as well as in hypothyroidism. However, while depressed subjects manifested a conscious bias with material of negative emotional valence, no such bias was found in the hypothyroid subjects. While the hypothyroid state is accompanied by anxiety/depressive symptoms, it seems that the latter are too discrete for an attentional bias to be observed with material with a negative emotional valence.     

Prevalence and trajectory of psychopathology among child and adolescent survivors of disasters: a systematic review of epidemiological studies across 1987–2011

Aims

The goal of this paper was to systematically review evidence on (1) the potential magnitude of the psychopathological impacts of community-wide disasters on child and adolescent survivors, and (2) the long-term course or trajectory of disaster-induced psychopathology among children and adolescents.

Methods

The PubMed/MEDLINE and PsycINFO databases were searched from their respective inception through December 2011. All of the resulting epidemiological studies of child and adolescent survivors following community-wide disasters were examined.

Results

Sixty cross-sectional studies and 25 longitudinal or long-term follow-up studies were identified. The estimated rates of posttraumatic stress disorder (PTSD) and depression among child and adolescent survivors varied greatly across the included studies, ranging from 1.0 to 95 % and 1.6 to 81 %, respectively, while the reported rates of diagnosable PTSD according to the DSM-IV criteria and diagnosable depression ranged from 1.0 to 60 % and 1.6 to 33 %, respectively. The long-term courses of psychopathology among youthful survivors were summarized. Methodological issues with those studies were discussed.

Conclusions

The empirical findings summarized in this review highlight the importance of psychosocial intervention at early postdisaster stages for child and adolescent survivors. The methodological flaws revealed by this review indicate the need for continued attempts to better understand the epidemiology and trajectory of psychopathological problems among youthful survivors.     

Five-factor model of schizophrenic psychopathology: how valid is it?

Aim of the study was to examine the consistency of the five-factor model of schizophrenic symptoms, assess its validity and evaluate its dimensional factor structure using confirmatory factor (CFA) analysis. A sample of 258 randomly assigned DSM-III R patients with schizophrenic disorders were studied by means of the structured clinical interview for the Greek validated Positive and Negative Syndrome Scale (PANSS) and were rated on its 30 items. Patients' scores were subjected to principal component analysis (PCA) with varimax rotation. Internal consistency for each of the components was determined by the use of Cronbach's alpha. External validity of the model derived was investigated by searching for possible relationships between the components and sociodemographic characteristics with the aid of canonical correlation analysis. Confirmatory factor analysis (CFA) was also performed. Using the scree plot criterion PCA revealed a five-factor model. These factors were interpreted as representing--in a decreasing order of relative importance--the following dimensions of schizophrenic psychopathology: negative, excitement, depression, positive and cognitive impairment. The model was comparable with six previous factor analytic studies. Internal consistency was quite satisfactory whereas external validity was found to be not so powerful. CFA did not show that the proposed model yields an adequate factor structure.     

Is there an association between the level of grandiose narcissism severity of psychopathology?

Background: Narcissism is a personality trait associated with both psychological health and resilience as well as with aggression and interpersonal problems. Aim: This study compares levels of total narcissism and subscale scores in inpatients, outpatients and a community sample. Methods: Inpatients (N = 186) were recruited from consecutively admitted patients to two closed units, and the outpatient group (N = 144) consisted of patients attending a psychiatric outpatient clinic. The patients and a normative community sample (N = 437) all filled in the Narcissistic Personality Inventory questionnaire (NPI-29). Results: The NPI total and subscales scores showed considerable gender differences. Among men only the Uniqueness/Entitlement subscale showed significant group differences, with inpatients showing higher mean score than the two other groups. Among women three factors, Leadership/Power, Superiority/Arrogance, and Uniqueness/ Entitlement, showed significant differences between the different levels of psychopathology. The outpatient female group regularly had the lowest group mean scores. The NPI-29 scores of the normative group showed weak internal consistencies. Conclusion: Our hypothesis of a significant association between mean levels of total narcissism and subscale scores and severity of psychopathology was not supported.     

Assessment and classification of psychopathology in epidemiological research of children 0–3 years of age

Abstract The research of psychopathology in children 0–3 years of age is dominated by clinical case studies and theoretical reflections, and epidemiological studies are few. This paper reviews methods to assess and classify psychopathology in children 0–3 years old in an epidemiological context. Diagnostic assessments of children 0–3 years of age are based on information from different sources and investigation of several domains of mental functioning, and the rapid developmental changes and the relationship context are taken into account. The reviewed literature shows a range of methods to assess and classify psychopathology in children 0–3 years of age: screening instruments with established psychometric properties, such as the Child Behaviour Checklist (CBCL) and the Checklist for Autism in Toddlers (CHAT), and methods of in-depth assessment known from both clinical practice and research: developmental tests, such as the Bayley Scales, and relationship assessments, such as the Early Relational Assessment (ERA). The classification of psychopathology in young children can be approved by the Diagnostic Classification 0–3. The reliability and validity of DC 0–3 have not yet been established, but preliminary results seem promising. The demands made on diagnostic assessment procedures in epidemiological research of children 0–3 years of age can be met by a combination of well-established research instruments, such as the CBCL, with in-depth clinical assessment procedures, such as the Bayley Scales and the ERA, and diagnostic classification by DC 0–3.     

Are mental states a useful concept? Neurophilosophical influences on phenomenology and psychopathology

Recent trends in neurophilosophy question the validity of conceptions as to the nature of mental states and of "folk psychology" (FP) in general. One school of thought, the "eliminative materialistics," see FP as a misdirected and scientifically redundant approach to the mind which should be discarded; the "functionalists," in contrast, consider FP categories, such as belief, to be essential. Between these extremes other neurophilosophical positions affect the way we view mental life. This paper extends the debate to include a consideration of abnormal mental states. It is argued that approaches to phenomenology and psychopathology cannot be immune from any conceptual reconfiguration of normal mental life which might occur. The manner and extent to which psychiatric theory and practice may be affected as a result of these developments is discussed.     

Reduced specificity of autobiographical memory and aging: Do the executive and feature binding functions of working memory have a role?

Autobiographical memory (AM) is built up from various kinds of knowledge, from general to specific, via generative processes. Aging seems to particularly affect the episodic autobiographical information while preserving information that is more semantic. However, the mechanism of this deficit has not yet been thoroughly tested in relation to working memory. This study is designed to investigate, in a group of 100 subjects, the relationships between age, accessibility to different levels of AM specificity, and two main components of working memory: the central executive and the episodic buffer. We used a new task composed of four embedded verbal autobiographical fluencies (VAF) - from low to highest specificity levels - exploring lifetime periods, general events, specific events, and details, plus tasks exploring free recall of episodic AM and updating, shifting, inhibition, and feature binding in working memory. The results demonstrate that age-related difficulties increase with level of specificity of autobiographical knowledge, i.e., from semantic to episodic aspects. Moreover, regression analyses mainly show that increase in age-related deficit with level of specificity of AM is largely mediated by performance on executive functions (updating and inhibition) and to a lesser extent feature binding in working memory. The results confirm in episodic AM the executive/working memory aging hypothesis, and for the first time highlight the role of episodic buffer in associating the various different details of specific events that elicit the conscious recollection.