Interoceptive Abnormalities and Suicidality: A Systematic Review

Dysfunction of interoception (i.e., difficulties sensing the physiological state of one's own body) is increasingly linked to different mental health disorders and suicidal outcomes. The aim of this study was to systematically review the literature on the association between suicidality and interoception, as well as identify potential confounders and mediators of the relationship. We conducted a systematic review of four databases, allowing for critical examination of the role of different measures of interoception (accuracy, sensibility, awareness, cognitive/emotional evaluation) across the suicide continuum (ideation, plans, attempts, deaths). The search strategy identified 22 studies (14,988 participants). Preliminary but limited evidence was found for impaired interoceptive accuracy among those reporting suicide attempt histories. We found evidence of interoceptive sensibility disturbances across the suicide continuum, including experiences of not trusting one’s own body sensations and impaired abilities to sustain and control attention to such sensations. Consistent evidence was also reported for disturbances related to cognitive and emotional evaluations of interoceptive sensations. The latter was particularly pronounced for those reporting suicide attempts, relative to those reporting suicidal thinking or planning alone. Overall, this review’s results suggest that interoceptive abnormalities are potentially important indicators of risk for suicidal thinking, intentions, and behaviors. However, due to the inconsistent adjustment for variables of interest, and cross-sectional designs, it is unclear whether interoceptive changes and disturbances have a direct role, or whether the association is explained and mediated by key third variables (e.g. depression, disordered eating, emotional dysregulation). We discuss the implications with respect to suicidal risk and therapeutic interventions.     

Maternal postpartum depressive symptoms and infant externalizing and internalizing behaviors

Maternal postpartum depression has been shown to be one of the main predictors of externalizing and internalizing behaviors in toddlers and adolescents. Research suggests that presence of such behaviors can be observed as early as infancy. The current study uses longitudinal data from 247 mothers to examine the relationship between postpartum depressive symptoms at 8 weeks and the infant's externalizing and internalizing behaviors at 12 months. In unadjusted linear regression models, there were associations between postpartum depressive symptoms and infant externalizing behaviors (β = 0.082, SE = 0.032, p = 0.012) and internalizing behaviors (β = 0.111, SE = 0.037, p = 0.003). After controlling for potential confounding factors, including maternal age, race, education, home ownership, smoking status in the postpartum period, marital status, parenting stress, and happiness from becoming a parent, the associations between postpartum depressive symptoms and infant externalizing (β = 0.051, SE = 0.034, p = 0.138) and internalizing behaviors (β = 0.077, SE = 0.040, p = 0.057) were reduced and became non-significant. Furthermore, in these models the total amount of variance explained was 17.2% (p < 0.0001) for externalizing behaviors and 10.5% (p < 0.01) for internalizing behaviors; the only significant predictor of externalizing behaviors was maternal age (β = −0.074, SE = 0.030, p = 0.014), and of internalizing behaviors was white non-Hispanic ethnicity (β = −1.33, SE = 0.378, p = 0.0005). A combined effect of the confounding factors seems to explain the finding of no significant independent association between postpartum depressive symptoms and infant externalizing and internalizing behaviors.     

Mentoring for Mental Health within a University: A psychodynamic approach

This paper explores the role of mentoring in a British University for students with mental health issues and is written from the perspective of the Mentor who is also a Psychodynamic Psychotherapist. Psychodynamic theory is applied to two case studies in order to understand the conscious and unconscious factors when considering these students’ particular learning difficulties and motivation for entering a learning environment. In the first case study, it is suggested that the student hopes to find his lost father within the containing bricks of the institution. When confronted with frustration and disappointment, he mobilises schizoid defences, precipitating a psychotic episode. The second case study formulates the student’s chronic procrastination, which verges on academic sabotage, as a defence against the unbearable guilt concerning his abilities and achievements in contrast with his unsuccessful and disabled siblings. The challenge of helping these students is explored, including the approaches taken by the Mentor, given her remit and the particular issues presented by the students.     

大连市抑郁障碍的现况调查

了解大连市18岁以上人群抑郁障碍的患病率和分布特点。采用多阶段分层整群随机抽样方法,以复合性国际诊断交谈检查量表(CIDI3.0)对大连市5062名≥18岁城乡居民进行了调查。抑郁障碍的患病率为4.30%,其中男性为3.40%,女性为5.00%,女性高于男性(P0.01);重度抑郁障碍的男性患病率为2.90%,女性为4.40%,女性高于男性(P0.01)。城乡间患病率无显著性差异。不同收入水平的患病率存在差异,收入处于中等水平的人群患病率低于低、高收入者。目前抑郁障碍已经成为迫切需要解决的重大公共卫生问题,关注女性,关注低收入群体,进行健康宣传,提供支持,以便促进家庭及社会的和谐。了解大连市18岁以上人群抑郁障碍的患病率和分布特点。采用多阶段分层整群随机抽样方法,以复合性国际诊断交谈检查量表(CIDI3.0)对大连市5062名≥18岁城乡居民进行了调查。抑郁障碍的患病率为4.30%,其中男性为3.40%,女性为5.00%,女性高于男性(P0.01);重度抑郁障碍的男性患病率为2.90%,女性为4.40%,女性高于男性(P0.01)。城乡间患病率无显著性差异。不同收入水平的患病率存在差异,收入处于中等水平的人群患病率低于低、高收入者。目前抑郁障碍已经成为迫切需要解决的重大公共卫生问题,关注女性,关注低收入群体,进行健康宣传,提供支持,以便促进家庭及社会的和谐。     

Destructive and reparative transference in multiple levels of group psychotherapy

Group members are challenged to form psychologically meaningful relationships with therapists, other members, and the group as a whole. The way in which individuals perceive this challenge is based on their past experiences. Early relationships establish a perceptual frame in which fears of being hurt and concern about hurting others coexist. Balance between these two ways of generating meaning enables individuals to form relatively healthy relationships. Imbalance in this perceptual frame results in distorted perceptions and maladaptive patterns emerging as transference manifestations. Working through involves repeatedly addressing distortions as members relate to therapists, others and the group as a whole.     

父母冲突对儿童青少年抑郁情绪的影响：有调节的中介模型

采用方便取样法选取山西、河南两省的2823名中小学生为被试,使用问卷法考察父母冲突与儿童青少年抑郁情绪之间的关系及机制。结果表明：（1）父母冲突、亲子关系、自尊均与抑郁呈显著相关;（2）父母冲突可以正向预测抑郁,亲子关系在其中起部分中介作用;（3）父母冲突影响抑郁的有调节的中介模型成立,其中自尊在前半段和后半段路径中均起调节作用,但作用有所不同。     

Factor Structure of the Parenting Scale in a Low-Income African American Sample

We evaluated the relative goodness-of-fit of two factor structures of the Parenting Scale (Arnold, O'Leary, Wolf, {&} Acker, 1993) among two samples of low-income African American families. Participants included 271 mother-child dyads from urban and rural areas in the southern and southeastern US, who completed the Parenting Scale along with other measures of parenting style and dyadic relationship. Confirmatory Factor Analyses (CFA) indicated that a two-factor solution, comprising Laxness and Overreactivity dimensions, was the better fit to the data. Some direct evidence for convergent validity was provided by a correlation between the Laxness factor of the Parenting Scale and the Firm/Lax Control subscale of the Children's Report of Parenting Behavior Inventory (CRPBI). Results are discussed in term of Brody and Flor's (1998) “no nonsense” parenting style.     

High-functioning depression among women in South Africa: An exploratory study

The study estimated the prevalence and trends of chronic depressive symptoms among women in South Africa from the National Income Dynamics Study (NIDS) data collection waves (2008, 2010, 2012, 2014/2015). NIDS utilised the Center for Epidemiological Studies Depression (CES-D) scale to assess depressive symptoms among adults. From the trend analysis, we observed a decrease in self-reported significant depressive symptoms over the eight-year period in black women (2.66%), followed by mixed-race (coloured) women (1.15%). Across race, significant depressive symptoms were associated with socioeconomic status variables such as income, education, and occupational status. Within race, prevalence rates were higher among individuals with low socioeconomic status (lower income, less educated, and less skilled occupations). Black women were at a higher risk of exhibiting high-functioning depression due to their overrepresentation among low socioeconomic status individuals. Symptom prevalence may be explained largely by psychosocial stressors in patriarchal legacy communities.     

SPONTANEOUS REMISSIONS: NORMAN REIDER'S FORGOTTEN PAPER,PART I

Almost sixty years ago, Norman Reider published a paper about spontaneous “remissions” he had observed. He discussed the manner in which psychoanalytic theory provided a way to partially explain these otherwise mysterious remissions or improvements in symptoms, some without benefit of either psychoanalysis or psychotherapy. Especially important were his comments about the negligible role of interpretation or insight in these examples. His conjectures reflected controversies that were current at the time and that remain unsettled. Of special interest is his introduction of some highly original ways to think of applying psychoanalytic ideas to supportive psychotherapy. But few analysts today have heard of this paper. A reconsideration of his paper allows us to be vividly reminded about our enduring and profound confusion about exactly what constitutes a “cure” at all. Spontaneous shifts in the severity of symptoms may be viewed as experiments of nature that we have neglected to investigate as valuable restraints on our immodest therapeutic claims.     

Growth in emotional intelligence. Psychotherapy with a learning disabled girl

This paper describes the once-weekly psychoanalytic psychotherapy of a girl, called Ellie, aged eight at the start of her treatment. Ellie had a learning disability and displayed difficult behaviour at school and at home. In her therapy, Ellie grew in emotional intelligence, more in touch with and able to express her feelings. Her behaviour improved and so did her capacity to learn. In the therapy there were certain limitations to progress and this is discussed in terms of how Ellie's disability affected the basic achievements of emotional development, including a mind with a solid ‘reality ego’, able to contain anxiety, and able to maintain depressive functioning. The importance of parallel parent work, to share observations and understanding of the child's functioning is discussed. Difficulties for both child and parents in dealing with the pain of difference and how this limits emotional intelligence are discussed. The author hopes that this paper will encourage the offering of psychoanalytic psychotherapy to children and young people with learning disabilities, who are significantly more likely to suffer from mental health problems than their peers.