Obituary Notices

Yolande Cantù
Arwind Vasavada
Dr Marie–Louise von Franz
Dr Roland Cahen     

Health anxiety and hypochondriasis in the light of DSM-5

Background: In the DSM-5, the diagnosis of hypochondriasis was replaced by two new diagnositic entities: somatic symptom disorder (SSD) and illness anxiety disorder (IAD). Both diagnoses share high health anxiety as a common criterion, but additonal somatic symptoms are only required for SSD but not IAD. Design: Our aim was to provide empirical evidence for the validity of these new diagnoses using data from a case–control study of highly health-anxious (n = 96), depressed (n = 52), and healthy (n = 52) individuals. Results: The individuals originally diagnosed as DSM-IV hypochondriasis predominantly met criteria for SSD (74%) and rarely for IAD (26%). Individuals with SSD were more impaired, had more often comorbid panic and generalized anxiety disorders, and had more medical consultations as those with IAD. Yet, no significant differences were found between SSD and IAD with regard to levels of health anxiety, other hypochondriacial characteristics, illness behavior, somatic symptom attributions, and physical concerns, whereas both groups differed significantly from clinical and healthy controls in all of these variables. Conclusion: These results do not support the proposed splitting of health anxiety/hypochondriasis into two diagnoses. Further validation studies with larger samples and additional control groups are warranted to prove the validity of the new diagnoses.     

The Hospital Anxiety and Depression Scale: a pilot study to examine its latent structure and the link between psychological state and symptom severity in transient ischaemic attack patients

Transient ischaemic attack (TIA) is often associated with anxiety and depression, which may precipitate secondary stroke and interfere with treatment. The Hospital Anxiety and Depression Scale (HADS) is widely used to assess these states and to inform the management of any associated psychological problems, but there is considerable debate about what it actually measures. The HADS scores from a range of different clinical groups have been reviewed in order to assess its psychometric properties, but so far, no research has examined either its latent structure when used with TIA patients, or the association between symptom severity and the test’s validity. The aims of this study, therefore, were to investigate: (a) the underlying structure of the HADS when used with TIA patients; and (b) the impact of symptom severity on the validity of the HADS. The HADS and a functional capacity measure were administered by post to a sample of 542 confirmed TIA patients. Exploratory factor analysis was conducted on the HADS scores to establish its underlying structure for this clinical group, and then, sub-sample correlations were undertaken between the anxiety/depression scores for different levels of functional capacity. Two factors emerged, with 13 of the 14 HADS items loading significantly on both, suggesting there is a common affective state underlying the standard anxiety and depression scales. Further data-exploration indicated that convergence between these affective states increased as functional capacity deteriorated. The results suggest firstly that the HADS measures general subjective distress when used with TIA patients, and secondly that the higher reported symptom severity in this clinical group may be associated with reduced affective differentiation. As the ability to retain clear affective discrimination is associated with health and well-being, this could provide a focus for post-TIA rehabilitation.     

On the Integration of Need‐related Autobiographical Memories among Late Adolescents and Late Adults: The Role of Depressive Symptoms and Self‐congruence

Within self‐determination theory, integration denotes the process through which people accept past and present experiences and harmonize these experiences within their sense of self. We investigated associations between indicators of successful and poor integration of need‐related memories and memory‐related affect. We also examined the role of depressive symptoms and self‐congruence as antecedents of these indicators. Moreover, we investigated whether late adults, compared with late adolescents, were better capable of integrating need‐frustrating memories through higher levels of self‐congruence. Participants were 132 late adolescents (Mage = 17.83) and 147 late adults (Mage = 76.13), who reported on their level of depressive symptoms and self‐congruence. Next, participants generated a need‐satisfying and need‐frustrating memory and reported on the memories' integration (in terms of acceptance, connection and rumination) and associated affect. Whereas depressive symptoms related mainly to the poor integration of need‐frustrating memories, self‐congruence related positively to the integration of both need‐satisfying and need‐frustrating memories. In turn, integration was related to more positive and less negative affect. Late adults scored higher than late adolescents on the integration of need‐frustrating memories, an effect that was partly accounted for by late adults' elevated self‐congruence. Results suggest that self‐congruence, depressive symptoms and age play a role in the integration of need‐based autobiographical memories. Copyright © 2016 European Association of Personality Psychology     

Out of our skulls: How the extended mind thesis can extend psychiatry

The thesis that mental states extend beyond the skull, otherwise known as the extended mind thesis (ExM), has attracted considerable philosophical attention and support. It has also been accused of lacking practical import. At the same time, the field of psychiatry has remained largely unacquainted with ExM, tending to rely instead upon what ExM proponents would consider to be outdated models of the mind. ExM and psychiatry, therefore, have much to offer one another, but the connection between the two has remained largely unexplored. Here, I consider what implications ExM may have for psychiatry and, in so doing, reveal how psychiatry may lend practical import to ExM. First, I detail the possibility of the extension of one mental state relevant to psychiatry. I augment this example by surveying other possibilities for extension in the context of psychiatric diagnoses. I then consider ways in which such extensions might alter psychiatric diagnosis and treatment. Overall, I argue that recognition of the truth of ExM could alter the diagnostic status of certain individuals by correcting both false positives and false negatives, re-conceptualize certain aspects of treatment, help us re-envision psychiatric research, and potentially increase empathy towards those individuals considered to be mentally disordered or mentally different.     

《价值观念冲突问卷》的编制及信度和效度检验

为评估不同受教育程度和文化水平的个体是否存在中国传统价值观念冲突的压力,编制价值观念冲突问卷,用以筛查价值观念冲突的压力对个体自杀行为的影响.通过对240例农村青年自杀死亡者及正常对照者的心理解剖访谈研究,验证此问卷具有较好的信度和效度,可用于甄别高应激群体价值观念冲突的压力,是自杀研究和干预的实用筛查工具.     

Aggressive Children and Effective Communication

Testing a component of a theoretical model which postulates that low levels of communication effectiveness accompany the social and affective problems presented by aggressive children, the study compared the communication skills of a group of aggressive (n = 49) and nonaggressive (n = 49) elementary school children (selected on the basis of teacher ratings) in a structured and cooperative communication task. Based on direct observational measures of communication effectiveness and aggression, and on teacher, peer, and self-rating measures of peer rejection and depressive symptoms, results showed that (a) aggressive children exhibited less effective communication skills and more disruptive communication skills than nonaggressive peers; (b) aggressive children experienced higher levels of peer rejection and depressive symptoms than nonaggressive peers; and (c) group differences in communication effectiveness could not be accounted for by differences in observed aggression and remained significant, even after controlling for differences in peer status and affective functioning. These findings highlight the role that ineffective communication may play in the development and maintenance of aggression and have important theoretical and applied implications, which are briefly discussed. © 1994 Wiley-Liss, Inc.     

Simulation of Preference Information in an Interactive Reference Point‐Based Method for the Bi‐Objective Inventory Routing Problem

In the research area of multiple criteria decision making, very few publications exist that explicitly design the simulation of a decision maker (DM) in an interactive approach. For this reason, we outline some methods widely used in the literature to identify common assumptions of simulating the DM's responses and the required input preference information. Our paper aims at covering the identified gap by introducing experimental concepts. Such concepts are used for theoretical analyses of a combined search‐and‐decision‐making procedure. Simulating the DM is a fruitful idea because the algorithm can be tested without integrating a human decision maker. Finally, we conduct experiments based on the proposed settings for a multiobjective inventory routing problem, which is a relevant and challenging logistic problem. Copyright © 2014 John Wiley & Sons, Ltd.     

On the dark side of work: a longitudinal analysis using self-determination theory

As the nature of work has changed in recent decades, employees are increasingly exposed to psychological demands in the workplace, which have associated consequences for employees, organizations, and society. Using self-determination theory, this study examined the dark side of work, in which frustration of basic psychological needs is associated with higher levels of work-related stress. In this model, work-related stress is associated with higher levels of somatic symptom burden, which in turn is associated with higher levels of emotional exhaustion, turnover intention, and absenteeism. Results of a longitudinal analysis using data from four time points over 15 months supported these predictions. Taken together, this study advances the literature towards an understanding of the (potential) detrimental impact that need-thwarting work contexts can have on employee wellness and work-related outcomes.