Ambivalence over emotional expression and symptom attribution are associated with self‐reported somatic symptoms in Singaporean school adolescents

Although somatization is common across cultures, its meanings may differ as culture shapes emotional experience. Thus, instead of treating somatization as a form of psychopathology, it is more useful to conceptualize it as an idiom of distress, and how complaints of somatic symptoms are related to social relationships, patterns of emotional expression and symptom attribution in a cultural context. This study seeks to explore whether ambivalence over emotional expression and causal attribution would shed light on the meanings of somatization among Asian adolescents. Three hundred secondary school adolescents in Singapore participated in this study. The main results show that emotional ambivalence, biomedical and Traditional Chinese Medicinal causal beliefs, and magical attribution contributed to additional variance in somatic symptoms over and above the variance explained by emotional distress. These findings are discussed from both psychological and cultural perspectives.     

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.     

5·12汶川地震后灾区教师主观幸福感的变化趋势及中介效应分析

·12汶川地震发生两个月后,对508名灾区的幼儿园、中小学教师进行测量,结合他们对地震前状况的回忆,考察其地震后主观幸福感的变化情况及其影响因素。结果表明：（1）与回忆得到的地震前感受相比,地震后灾区教师体验到主观幸福感水平显著降低。（2）极重灾区教师体验到的主观幸福感降低程度大于重灾区和轻灾区教师。（3）教师遭受的客观损失严重程度能显著预测其体验到的主观幸福感降低;而创伤后身心症状在其中起完全中介的作用,即创伤事件引发教师创伤后身心症状,而这些症状日趋严重,使其体验到的消极情感增加、主观幸福感降低。     

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.     

Violent obsessions are associated with suicidality in an OCD analog sample of college students

The picture of suicide in obsessive-compulsive disorder (OCD) is unclear because previous research did not uniformly control for depressive symptoms when examining the relationship between OCD and suicidality. Specific links between OC symptom dimensions and suicidality were also not adequately studied. As such, we investigated specific associations between OC symptom dimensions and suicidality, beyond the contribution of depressive symptoms, in an OCD analog sample of college students, a group traditionally at risk for suicide. One hundred and forty-six college students (103 females; 43 males) who exceeded the clinical cut-off for OC symptoms on the Obsessive-Compulsive Inventory, Revised (OCI-R) were recruited. Participants completed an online questionnaire containing measures that assessed suicidality and OC and depressive symptom severity. Total OC symptom severity, unacceptable thoughts, and especially violent obsessions exhibited significant positive zero-order correlations with suicidality. However, analyses of part correlations indicated that only violent obsessions had a significant unique association with suicidality after controlling for depressive symptoms. Our findings support the hypothesis that violent obsessions have a specific role in suicidality beyond the influence of depressive symptoms in an OCD analog sample of college students. A strong clinical focus on suicide risk assessment and safety planning in college students reporting violent obsessions is therefore warranted. Future related research should employ longitudinal or prospective designs and control for other possible comorbid symptoms in larger and more representative samples of participants formally diagnosed with OCD in order to verify the generalizability of our findings to these groups.     

自然自明性的失落——Blankenburg精神分裂理论述评

传统的精神分裂研究,关注的主要是精神分裂的妄想症候群。因为精神分裂中相对特殊的症状,在妄想形式中可以得到最轻易的把握。Blankenburg则认为:精神分裂的本质结构变异是先于妄想的。因此,他致力于在精神分裂的症状贫乏型(主要是青春型和单纯型)中,寻找精神分裂的本质变异。他发现:精神分裂异常中的核心缺损是自然自明性的失落。根据胡塞尔的超越现象学,自然自明性失落有四个原因:与世界关系的改变、时间建构的改变、自我建构的改变、交互主体性的改变。Blankenburg的精神分裂理论,作为二十世纪有关精神分裂的最重要工作之一,对于今天的精神分裂研究仍然有极其重要的意义。     

Avoidance behavior associated with depressive symptoms in patients with implantable cardioverter defibrillators

Objective: Many patients with implantable cardioverter defibrillators experience depressive symptoms. In addition, avoidance behavior is a common problem among patients with implantable cardioverter defibrillators. We examined the association between avoidance behaviors and depressive symptoms in patients with implantable cardioverter defibrillators. Method: We conducted a single-center, cross-sectional study with self-completed questionnaires between May 2010 and March 2011. We measured avoidance behaviors (avoidance of places, avoidance of objects, and avoidance of situations) and depressive symptoms (using the Beck Depression Inventory, Version II) in 119 participants. An avoidance behaviors instrument was developed for this study and we confirmed its internal consistency reliability. Results: Ninety-two (77.3%) patients were aged older than 50 years, and 86 (72.3%) were men. Fifty-one (42.9%) patients reported “avoidance of places”, 34 (28.6%) reported “avoidance of objects”, and 63 (52.9%) reported “avoidance of activity”. Avoidance behavior was associated with increased odds for the presence of depressive symptoms (OR 1.31; 95% CI 1.06–1.62). Conclusions: This was the first study to identify the relationship between avoidance behavior and depressive symptoms among patients with implantable cardioverter defibrillators; however, there are a few methodological limitations.     

大一新生网络心理问题调查研究

采用自编网络心理问卷研究了669名大一新生在情绪反应、动机冲突、现实疏离、躯体症状四个维度上的性别、家庭来源、家庭气氛、父母教养方式上的差异。结果表明．大一新生网络使用的负性心理总体上不严重;在情绪反应和现实疏离上存在极其显著的家庭气氛主效应;在动机冲突和躯体症状上存在极显著的家庭气氛与父母教养方式交互作用。     

焦虑症状的绘画评定研究

目的:利用回归分析探讨绘画测验对焦虑状态的评定作用。方法：对290名被试实施了房子-树-人绘画投射测验和Scl90焦虑分量表测验,结果：在所考察的11种绘画特征中,有5种对焦虑具有预测性。可以建立绘画特征对焦虑进行预测的回归方程,方程具有中等程度的解释水平。两名主试评价的Kappa一致性系数均达到较高水平。结论：可以通过绘画测验评定和预测焦虑,焦虑症状的绘画测验方法具有较好的评分者信度。