Alexithymia is a personality trait characterized by difficulties identifying and describing feelings, an externally oriented style of thinking, and a reduced inclination to imagination. Previous ...research has shown deficits in the recognition of emotional facial expressions in alexithymia and reductions of brain responsivity to emotional stimuli. Using an affective priming paradigm, we investigated automatic perception of facial emotions as a function of alexithymia at the behavioral and neural level. In addition to self-report scales, we applied an interview to assess alexithymic tendencies.
During 3 T fMRI scanning, 49 healthy individuals judged valence of neutral faces preceded by briefly shown happy, angry, fearful, and neutral facial expressions. Alexithymia was assessed using the 20-Item Toronto Alexithymia Scale (TAS-20), the Bermond-Vorst Alexithymia Questionnaire (BVAQ) and the Toronto Structured Interview for Alexithymia (TSIA). As expected, only negative correlations were found between alexithymic features and affective priming. The global level of self-reported alexithymia (as assessed by the TAS-20 and the BVAQ) was found to be related to less affective priming owing to angry faces. At the facet level, difficulties identifying feelings, difficulties analyzing feelings, and impoverished fantasy (as measured by the BVAQ) were correlated with reduced affective priming due to angry faces. Difficulties identifying feelings (BVAQ) correlated also with reduced affective priming due to fearful faces and reduced imagination (TSIA) was related to decreased affective priming due to happy faces. There was only one significant correlation between alexithymia dimensions and automatic brain response to masked facial emotions: TAS-20 alexithymia correlated with heightened brain response to masked happy faces in superior and medial frontal areas.
Our behavioral results provide evidence that alexithymic features are related in particular to less sensitivity for covert facial expressions of anger. The perceptual alterations could reflect impaired automatic recognition or integration of social anger signals into judgemental processes and might contribute to the problems in interpersonal relationships associated with alexithymia. Our findings suggest that self-report measures of alexithymia may have an advantage over interview-based tests as research tools in the field of emotion perception at least in samples of healthy individuals characterized by rather low levels of alexithymia.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The loss of a child during pregnancy can be a traumatic event associated with long-lasting grief and psychological distress. This study examined the efficacy of an internet-based cognitive behavioral ...therapy program for mothers after pregnancy loss. In a randomized controlled trial with a waiting list control group, 83 participants who had lost a child during pregnancy were randomly allocated either to 5 weeks of internet therapy or to a 5-week waiting condition. Within a manualized cognitive behavioral treatment program, participants wrote ten essays on loss-specific topics. Posttraumatic stress, grief, and general psychopathology, especially depression, were assessed pretreatment, posttreatment, and at 3-month follow-up. Intention-to-treat analyses and completer analyses were performed. Relative to controls, participants in the treatment group showed significant improvements in posttraumatic stress, grief, depression, and overall mental health, but not in anxiety or somatization. Medium to large effect sizes were observed, and the improvement was maintained at 3-month follow-up. This internet-based cognitive behavioral therapy program represents an effective treatment approach with stable effects for women after pregnancy loss. Implementation of the program can thus help to improve the health care provision for mothers in this traumatic loss situation.
Background:
The high prevalence of mental disorders related to posttraumatic stress among Syrian refugees is often in contrast with their low utilization of mental health care in the host countries. ...Mental health self-stigma, i.e., internalized stigma of having a mental disorder, could prevent individuals from seeking mental health care. Therefore, we aimed to provide evidence on different aspects of mental health self-stigmatization among adult Syrian refugees with posttraumatic stress symptoms residing in Germany. Moreover, we investigated associations with sociodemographic and psychopathological variables in order to identify those at higher risk of self-stigmatization.
Material and Methods:
Overall, 133 participants with mild to moderate posttraumatic stress symptoms were recruited in the metropolitan areas of Leipzig, Dresden and Halle, Germany, using a multimodal approach. Mental health self-stigma was assessed using the Self-Stigma of Mental Illness Scale – Short Form (SSMIS-SF), consisting of four subscales (
Stereotype awareness, Stereotype agreement, Application to self
,
Harm to self-esteem
), each scoring from 5 (low) to 45 (high) points. Linear regression analysis was used to test associations of sociodemographic and psychopathological variables with self-stigma subscales.
Results:
On average, self-stigma ratings ranged from 16.5 (SD = 6.6) points on
Application to self
to 28.3 (SD = 7.5) points on
Stereotype awareness
. Results showed higher scores on
Application to self
for individuals who were younger (
t
= 2.65,
p
= 0.009) and single (
F
= 5.70,
p
= 0.004). Regression analyses yielded statistically significant associations between having multiple comorbidities and a higher
Application to self
stigma (β = 0.18,
p
= 0.044), controlling for sociodemographic covariates.
Discussion:
Mental health self-stigma was increased among Syrian refugees in Germany. Correlates of increased self-stigma could inform efforts to improve access to mental health care among Syrian refugees with mental ill-health. Longitudinal studies following an intersectional approach by concurrently examining multiple forms of public and internalized stigma could provide helpful insights for developing tailored stigma reduction efforts in this context.
Glutamate decarboxylases (GAD67/65; GAD1/GAD2) are crucially involved in gamma-aminobutyric acid (GABA) synthesis and thus were repeatedly suggested to play an important role in the pathogenesis of ...anxiety disorders. In the present study, DNA methylation patterns in the GAD1 and GAD2 promoter and GAD1 intron 2 regions were investigated for association with panic disorder, with particular attention to possible effects of environmental factors.
Sixty-five patients with panic disorder (f=44, m=21) and 65 matched healthy controls were analyzed for DNA methylation status at 38 GAD1 promoter/intron2 and 10 GAD2 promoter CpG sites via direct sequencing of sodium bisulfate treated DNA extracted from blood cells. Recent positive and negative life events were ascertained. Patients and controls were genotyped for GAD1 rs3762556, rs3791878 and rs3762555, all of which are located in the analyzed promoter region.
Patients with panic disorder exhibited significantly lower average GAD1 methylation than healthy controls (p<0.001), particularly at three CpG sites in the promoter as well as in intron 2. The occurrence of negative life events was correlated with relatively decreased average methylation mainly in the female subsample (p=0.01). GAD1 SNP rs3762555 conferred a significantly lower methylation at three GAD1 intron 2 CpG sites (p<0.001). No differential methylation was observed in the GAD2 gene.
The present pilot data suggest a potentially compensatory role of GAD1 gene hypomethylation in panic disorder possibly mediating the influence of negative life events and depending on genetic variation. Future studies are warranted to replicate the present finding in independent samples, preferably in a longitudinal design.
•Glutamate decarboxylases (GAD1/2) are involved in GABA synthesis and anxiety.•For the first time, GAD1/GAD2 DNA methylation was analyzed in panic disorder (PD).•PD patients showed lower GAD1 methylation than healthy controls (p<0.001).•Negative life events correlated with relatively decreased average GAD1 methylation.•A possibly compensatory role of GAD1 gene hypomethylation in PD is suggested.
Introduction: Individuals suffering from overweight or obesity frequently experience weight-based stigmatization. The widespread belief that weight is a matter of personal will and self-control ...results in various weight-based stereotypes (e.g., laziness, lack of self-discipline, or neglect). Objective: Based on the modified version of the Weight Bias Internalization Scale (WBIS-M), a short form for the economic assessment of weight bias internalization in the general population was compiled and validated. Methods: A three-item short form (WBIS-3) was derived based on data from a representative sample of the German population (n = 1,092). This new short form was validated in a second representative population sample (n = 2,513). Item characteristics and internal consistency were obtained. Measurement invariance was tested. Construct validity was established via the correlation with theoretically related constructs (depression, anxiety, eating behavior, discrimination, weight status). To establish scale validity, all analyses were performed for the whole sample as well as for the subsample of individuals with overweight. Age- and gender-specific population norms were provided. Results: The WBIS-3 exhibited excellent psychometric properties. Internal consistency was α = 0.92. Strong measurement invariance was confirmed regarding age, gender, discrimination, and weight status in both the whole sample as well as the overweight subsample. Conclusions: The WBIS-3 constitutes a valid and economical tool for the assessment of weight bias internalization in epidemiological contexts. Measurement invariance allows for an unbiased comparison of means, correlation coefficients, and path coefficients within structural equation modeling across groups.
Objectives: Identifying the underlying pathways between obesity and depression and which individuals with obesity are at risk for developing depressive symptoms is important for improving prevention ...and treatment efforts. The current study investigated appearance evaluation as a potential mediator of the relationship between obesity and depression. Methods: A total of 1,000 participants with a self-reported BMI greater than 30 kg/m2 were interviewed about their experiences with an elevated body weight and completed measures on appearance evaluation and depression. Results: A negative relationship between satisfaction with appearance and BMI and a negative association between satisfaction with appearance and depression was found in men and women. Men reported less depressive symptoms and higher satisfaction with appearance compared to women. While no mediation effect could be determined in women, satisfaction with appearance mediated the obesity-depression relationship in men. Conclusions: Efforts to reduce adverse effects of either obesity or depression need to take the reciprocal relationship between the two conditions into account. The current findings underscore the importance of appearance evaluation for treatment efforts in individuals with obesity. Interventions addressing body image might improve both, psychological distress and weight management efforts in general.
Complicated grief after perinatal loss Kersting, Anette; Wagner, Birgit
Dialogues in clinical neuroscience,
06/2012, Letnik:
14, Številka:
2
Journal Article
Odprti dostop
The loss of an infant through stillbirth, miscarriage, or neonatal death is recognized as a traumatic life event. Predictors of development of complicated grief after prenatal loss include lack of ...social support, pre-existing relationship difficulties, or absence of surviving children, as well as ambivalent attitudes or heightened perception of the reality of the pregnancy. Risk of complicated grief was found to be especially high after termination of a pregnancy due to fetal abnormality. Studies have revealed that men and women show different patterns of grief, potentially exacerbating decline in a relationship. Although it is clear that prenatal loss has a large psychological impact, it is concluded that there is a substantial lack of randomized controlled studies in this field of research,
Purpose
We examined whether multi-disciplinary stepped psycho-social care decreases financial problems and improves return-to-work in cancer patients.
Methods
In a university hospital, wards were ...randomly allocated to either stepped or standard care. Stepped care comprised screening for financial problems, consultation between doctor and patient, and the provision of social service. Outcomes were financial problems at the time of discharge and return-to-work in patients < 65 years old half a year after baseline. The analysis employed mixed-effect multivariate regression modeling.
Results
Thirteen wards were randomized and 1012 patients participated (
n
= 570 in stepped care and
n
= 442 in standard care). Those who reported financial problems at baseline were less likely to have financial problems at discharge when they had received stepped care (odds ratio (OR) 0.2, 95% confidence interval (CI) 0.1, 0.7;
p
= 0.01). There was no evidence for an effect of stepped care on financial problems in patients without such problems at baseline (OR 1.1, CI 0.5, 2.6;
p
= 0.82). There were 399 patients < 65 years old who were not retired at baseline. In this group, there was no evidence for an effect of stepped care on being employed half a year after baseline (OR 0.7, CI 0.3, 2.0;
p
= 0.52).
Trial registration
NCT01859429
Conclusions
Financial problems can be avoided more effectively with multi-disciplinary stepped psycho-social care than with standard care in patients who have such problems.
Individuals differ in their dispositional coping behavior when they are confronted with anxiety-provoking situations. Cognitive avoidance is characterized by a withdrawal from threatening ...information, whereas vigilance denotes the intensive search for threat-related information. Functional neuroimaging studies indicate alterations in brain responsivity to emotional stimuli as a function of cognitive avoidant and vigilant coping, but findings are partially discrepant. Studies on structural correlates of coping styles are scarce.
By using structural magnetic resonance imaging, the present study examined the relationship between brain gray matter volume and coping strategies in 114 healthy individuals. Individual differences in vigilance and cognitive avoidance were measured by the Mainz Coping Inventory.
Exploratory whole-brain analyses were conducted. Cognitive avoidant coping significantly predicted reduced gray matter volume in the bilateral thalamus, whereas vigilant coping was associated with volumetric increases in the bilateral thalamus. These relationships remained significant when controlling for a potential influence of age, sex, depressive symptoms, and trait anxiety.
Our findings indicate that dispositional strategies to deal with anxiety-provoking situations are related to volumetric alterations in the thalamus, a brain structure that has been implicated in the mediation of attentional processes and alertness, and the anticipation of harm. The dispositional tendency to monitor the environment for potential threats (i.e., vigilance), appears to be associated with volumetric increases in the thalamus, whereas the dispositional inclination to divert one's attention away from distressing stimuli (i.e., cognitive avoidance) seems to go along with reductions in thalamic gray matter density.
Among the functional neuroimaging studies on emotional face processing in schizophrenia, few have used paradigms with facial expressions of disgust. In this study, we investigated whether ...schizophrenia patients show less insula activation to macro-expressions (overt, clearly visible expressions) and micro-expressions (covert, very brief expressions) of disgust than healthy controls. Furthermore, departing from the assumption that disgust faces signal social rejection, we examined whether perceptual sensitivity to disgust is related to social alienation in patients and controls. We hypothesized that high insula responsiveness to facial disgust predicts social alienation.
We used functional magnetic resonance imaging to measure insula activation in 36 schizophrenia patients and 40 healthy controls. During scanning, subjects passively viewed covert and overt presentations of disgust and neutral faces. To measure social alienation, a social loneliness scale and an agreeableness scale were administered.
Schizophrenia patients exhibited reduced insula activation in response to covert facial expressions of disgust. With respect to macro-expressions of disgust, no between-group differences emerged. In patients, insula responsiveness to covert faces of disgust was positively correlated with social loneliness. Furthermore, patients' insula responsiveness to covert and overt faces of disgust was negatively correlated with agreeableness. In controls, insula responsiveness to covert expressions of disgust correlated negatively with agreeableness.
Schizophrenia patients show reduced insula responsiveness to micro-expressions but not macro-expressions of disgust compared to healthy controls. In patients, low agreeableness was associated with stronger insula response to micro- and macro-expressions of disgust. Patients with a strong tendency to feel uncomfortable with social interactions appear to be characterized by a high sensitivity for facial expression signaling social rejection. Given the associations of insula responsiveness to covert disgust expression with low agreeableness in healthy individuals, insula responsiveness to expressions of disgust might be in general a neural marker of the personality trait of agreeableness.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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