Cocaine use and post partum psychiatric symptoms.

The association of mental health symptoms with cocaine use was studied among post partum women. Gestational cocaine use was determined by confidential interview or urine assay. A structured Psychiatric Symptom Index was used to measure mental health symptoms. Among 155 women, 24 (15%) used cocaine. Cocaine-using women had less education, higher parity, less weight gain during pregnancy, and used more cigarettes, marijuana, and opiates in pregnancy than nonusers. High frequency of symptoms (standardized Psychiatric Symptom Index score greater than or equal to 20) was found in 71% of women for the Total Index score, 81% on depression, 61% on anxiety, 36% on cognitive disturbance, and 75% on anger. No differences in Psychiatric Symptom Index Total or factor scores were associated with cocaine use.     

Formalising social representation to explain psychiatric symptoms

Recent work in social cognition has moved beyond a focus on how people process social rewards to examine how healthy people represent other agents and how this is altered in psychiatric disorders. However, formal modelling of social representation has not kept pace with these changes, impeding our understanding of how core aspects of social cognition function, and fail, in psychopathology. Here, we suggest that belief-based computational models provide a basis for an integrated sociocognitive approach to psychiatry, with the potential to address important but unexamined pathologies of social representation, such as maladaptive schemas and illusory social agents.     

Examination of psychiatric symptoms in student athletes

In the present study, the authors examined the severity of psychiatric symptoms in undergraduate recreational (noncompetitive) athletes (n = 64) and National Collegiate Athletic Association (NCAA; competitive) athletes (n = 72). The results indicated that the 2 groups were similar in the severity of psychiatric symptoms. The recreational and NCAA athletes combined (n = 136) showed less severe global psychiatric symptoms when they were compared with an undergraduate control group (n = 435). The implications of the study are discussed in the context of those findings.     

情绪复杂性对精神症状的影响途径及干预技术

情绪复杂性指的是个体情绪体验的多样性和分化度。情绪复杂性影响了精神症状的形成, 它不仅通过改变情绪调节策略的频率和程度来影响精神症状, 而且会影响情绪调节策略和精神症状之间的关系。基于情绪复杂性的干预增加了暴露治疗的疗效。正念能提升情绪复杂性, 但两者的作用机制可能有所差别。情绪复杂性的多角度测量、作用条件及脑机制应成为今后在临床领域的研究方向。     

Uncontrollability, depression, and the construction of mental models.

Three studies examined mental model generation after preexposure to uncontrollability and in a depressive state. The purpose of the experiments was to test the implications of the cognitive exhaustion model, applying an explicit conceptualization of social mental models and a process-tracing method developed by U. von Hecker (1997). An experimental situation was created for observation of consecutive, rule-based construction steps as a function of input diagnosticity, and for the quality assessment of constructed mental models. The findings show that participants preexposed to uncontrollability, as well as depressed students, were able, as were controls, to identify rule-relevant information needed for model construction. However, they were less able than control participants to engage in a more cognitively demanding and generative step of processing (i.e., in integrating the pieces of input information into a coherent mental model of sentiment relations).     

Predicting psychiatric symptoms in rural community mental health clients

Using the Brief Symptom Inventory administered to 88 rural clients on Visit 1 and to 56 clients, 3 mo. later after Visit 3 with an evaluation of service, regression analyses suggested a 4-variable model, with fewer symptoms on Visit 1, higher income, lower anxiety, and younger age accounted for 70% of the total variance. Cross-validation is needed.     

Working memory, psychiatric symptoms, and academic performance at school

Previous studies of the relationship among working memory function, academic performance, and behavior in children have focused mainly on clinical populations. In the present study, the associations of the performance in audio- and visuospatial working memory tasks to teacher reported academic achievement and psychiatric symptoms were evaluated in a sample of fifty-five 6-13-year-old school children. Working memory function was measured by visual and auditory n-back tasks. Information on incorrect responses, reaction times, and multiple and missed responses were collected during the tasks. The children's academic performance and behavioral and emotional status were evaluated by the Teacher Report Form. The results showed that good spatial working memory performance was associated with academic success at school. Children with low working memory performance, especially audiospatial memory, were reported to have more academic and attentional/behavioral difficulties at school than children with good working memory performance. An increased number of multiple and missed responses in the auditory and visual tasks was associated with teacher reported attentional/behavioral problems and in visual tasks with teacher reported anxiety/depressive symptoms. The results suggest that working memory deficits may underlie some learning difficulties and behavioral problems related to impulsivity, difficulties in concentration, and hyperactivity. On the other hand, it is possible that anxiety/depressive symptoms affect working memory function, as well as the ability to concentrate, leading to a lower level of academic performance at school.     

Maternal postnatal psychiatric symptoms and infant temperament affect early mother-infant bonding

Postnatal mother-infant bonding refers to the early emotional bond between mothers and infants. Although some factors, such as maternal mental health, especially postnatal depression, have been considered in relation to mother-infant bonding, few studies have investigated the role of infant temperament traits in early bonding. In this study, the effects of maternal postnatal depressive and anxiety symptoms and infant temperament traits on mother-infant bonding were examined using both mother and father reports of infant temperament. Data for this study came from the first phase of the FinnBrain Birth Cohort Study (n = 102, father reports n = 62). After controlling for maternal symptoms of depression and anxiety, mother-reported infant positive emotionality, measured by infant smiling was related to better mother-infant bonding. In contrast, infant negative emotionality, measured by infant distress to limitations was related to lower quality of bonding. In regards to father-report infant temperament, only infant distress to limitations (i.e., frustration/anger) was associated with lower quality of mother-infant bonding. These findings underline the importance of infant temperament as one factor contributing to early parent-infant relationships, and counseling parents in understanding and caring for infants with different temperament traits.     

Uncontrollability versus perceived failure as determinants of subsequent performance deficits

An experiment is reported that attempted to dissociate the effects of uncontrollability from those of failure in the standard learned helplessness induction procedure involving instrumental tasks. The task was administered to both university and high school students. The primary finding was a grade by controllability interaction, whereby uncontrollability had a larger effect for university students who became much more helpless. Further analysis revealed that while controllability or uncontrollability was the main determinant of university student performance, the performance of the high school students depended primarily upon success or failure. Perhaps we have previously generalized too widely from a restricted subject population.     

Uncontrollability and unpredictability in post-traumatic stress disorder: an animal model.

The disturbances observed in animals subjected to unpredictable and uncontrollable aversive events resemble post-traumatic stress disorder (PTSD) symptoms and thus may constitute an animal model of this disorder. It is argued that the similarity between animals' symptoms and those of trauma victims may reflect common etiological factors. Relevant experiments in which animals exhibit generalized fear and arousal, discrete fear of a conditioned stimulus (CS), analgesia, and avoidance are reviewed with the view that these manifestations may be analogous to the PTSD symptom clusters of persistent arousal, reexperiencing, numbing, and avoidance, respectively. Finally, animal paradigms are suggested to test the validity of the model and specific hypotheses are derived from the animal literature regarding trauma variables that are predictive of particular PTSD symptom clusters.     

Violent and disruptive behavior among drug-involved prisoners: relationship with psychiatric symptoms

This study examines the relationship between psychiatric symptoms and violent/disruptive behavior among 192 inmates who participated in prison-based substance abuse treatment. Participants came from two sites able to provide narrative reports of disciplinary actions in the Criminal Justice Drug Abuse Treatment Studies' Co-Occurring Disorders Screening Instrument study. In multivariate logistic models, a lifetime history of thought insertion/control ideation (OR, 11.6; 95% CI, 1.8-75.2), antisocial personality disorder (OR, 3.3; 95% CI, 1.2-8.9), and disciplinary action related to possession of controlled substances or contraband (OR, 4.9; 95% CI, 1.9-12.3) were associated with increased risk for violent or disruptive behavior while in prison, whereas lifetime phobic symptoms (OR, 0.2; 95% CI, 0.1-0.54) and high school graduation (OR, 0.4; 95% CI, 0.2-1.0) were associated with a decreased risk of violence and disruptive behavior in general. We conclude that, among inmates in substance abuse treatment, symptoms that increase risk for violence or disruptive behavior include thought control/insertion ideation and disciplinary infractions related to controlled substances, contraband, or failure to participate in assigned programs, as well a history of antisocial personality disorder.     

Relationship of resilience to personality, coping, and psychiatric symptoms in young adults

Developing a comprehensive understanding of resilience across the lifespan is potentially important for mental health promotion, yet resilience has been vastly understudied compared to disease and vulnerability. The present study investigated the relationship of resilience to personality traits, coping styles, and psychiatric symptoms in a sample of college students. Measures included the Connor-Davidson Resilience Scale, NEO Five Factor Inventory, Coping Inventory for Stressful Situations, and Brief Symptom Inventory. Results supported hypotheses regarding the relationship of resilience to personality dimensions and coping styles. Resilience was negatively associated with neuroticism, and positively related to extraversion and conscientiousness. Coping styles also predicted variance in resilience above and beyond the contributions of these personality traits. Task-oriented coping was positively related to resilience, and mediated the relationship between conscientiousness and resilience. Emotion-oriented coping was associated with low resilience. Finally, resilience was shown to moderate the relationship between a form of childhood maltreatment (emotional neglect) and current psychiatric symptoms. These results augment the literature that seeks to better define resilience and provide evidence for the construct validity of the Connor-Davidson Resilience Scale.     

Cognitive deficits presenting as psychiatric symptoms in a patient with Moyamoya disease

The case of a middle-aged man who had intraventricular hemorrhages secondary to Moyamoya disease (MMD), and initially, presented with psychiatric symptoms which did not respond to treatment is described. Neuropsychological assessment showed underlying significant cognitive deficits, mostly of complex attention and speed of information processing, visuospatial and constructional abilities, verbal and nonverbal memory, and executive functions. These deficits remained stable or slightly improved in follow-up assessments. Cognitive dysfunction should be suspected in case of psychiatric or psychiatric-related symptoms in MMD patients. This case study in Greece highlights the range of preserved and impaired cognitive functions in adult MMD by means of repeated neuropsychological evaluations in which a broad range of cognitive abilities were assessed.     

The association between axis I and II psychiatric symptoms and high-risk sexual behavior during adolescence

This study was conducted to investigate the association between psychiatric disorders and high-risk sexual behavior among adolescent primary care patients. Interviews assessing anxiety, conduct, depressive, eating, substance use, and personality disorders (PDs), as well as histories of sexual behavior were administered to 119 male and 284 female adolescent primary care patients. Results indicated that, after co-occurring psychiatric disorders were controlled statistically, adolescents with elevated PD symptom levels were more likely than adolescents without elevated PD symptom levels to report a high number of sexual partners during the past year and during their lifetime. Adolescents with a history of conduct disorder were more likely than adolescents without such a history to report a high number of lifetime unsafe sexual partners. Elevated antisocial, dependent, and paranoid PD symptom levels were associated with high-risk sexual behavior after co-occurring psychiatric disorders were controlled. Further, certain specific antisocial, borderline, dependent, histrionic, narcissistic, obsessive-compulsive, paranoid, and schizotypal PD symptoms were independently associated with high-risk sexual behavior after co-occurring psychiatric disorders and overall PD symptom levels were controlled. The association between overall PD symptom levels and the number of sexual partners was significantly stronger among the females than among the males in the sample. Increased recognition and treatment of PDs, coupled with increased recognition of high-risk sexual behavior may facilitate the prevention of sexually transmitted diseases and teenage pregnancy among adolescents.     

Anxiety sensitivity as a specific and unique marker of anxious symptoms in youth psychiatric inpatients

We addressed several questions regarding the relation of anxiety sensitivity to anxious symptoms among 47 youth psychiatric inpatients (18 boys, 29 girls), ages 9–17 (M = 14.23, SD = 1.89). Participants completed measures of anxiety sensitivity, anxious and depressive symptoms, trait anxiety, and positive and negative affect; chart diagnoses were available. Consistent with hypotheses, we found that (a) anxiety sensitivity was associated with anxious symptoms, even controlling for trait anxiety and depressive symptoms; and (b) anxiety sensitivity displayed symptom specificity to anxious versus depressive symptoms (i.e., was associated with anxiety controlling for depression but not with depression controlling for anxiety). Furthermore, regarding factors of anxiety sensitivity, we obtained mixed support for our prediction that phrenophobia would be associated with both depression and anxiety, whereas fear of physical arousal would be associated with anxiety but not depression. Implications for the construct validity of anxiety sensitivity were discussed.     

Idiopathic physical symptoms: a common manifestation of psychiatric disorders in primary care

Worldwide, patients with common mental disorders, such as depression and anxiety, have a tendency to present first to primary care exhibiting idiopathic physical symptoms. Typically, these symptoms consist of pain and other physical complaints that remain medically unexplained. While in the past, traditional psychopathology emphasized the relevance of somatic presentations for disorders, such as depression, in the last few decades, the "somatic component" has been neglected in the assessment and treatment of psychiatric patients. Medical specialties have come up with a variety of "fashionable" labels to characterize these patients and the new psychiatric nomenclatures, such as the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, attempt to classify these patients into a separate "somatoform disorders" category. These efforts fall short, and revisionists are asking altogether for the elimination of "somatoform disorders" from future nomenclatures. This review emphasizes the importance of idiopathic physical symptoms to the clinical phenomenology of many psychiatric disorders, offers suggestions to the diagnostic conundrum, and provides some hints for the proper assessment and management of patients with these common syndromes.