Few Gender Differences Exist Between Women and Men with Chronic Fatigue Syndrome

Chronic fatigue syndrome (CFS) is generally considered to be a women's health issue, but the illness occurs also in men. The research objective of this study was to determine if illness patterns and functional status differed between the sexes. Because our own data showed that women with CFS have significantly more comorbid fibromyalgia or multiple chemical sensitivity than men, we eliminated patients with these comorbid conditions from our evaluation. Women with CFS were quite similar to men with CFS in terms of demographics, psychiatric status, functional status, and assessments of disability. Women reported more infectious/flu-like symptoms (represented by a factor derived from factor analysis) than men, but these differences were insignificant after controlling for other variables. Cluster analysis revealed that women were more likely than men to fall in the cluster characterized by symptom severity. Differences found were those of degree rather than of type; strikingly different illness patterns—suggestive of different pathophysiological processes between the sexes—were not found.     

Overgeneral autobiographical memory predicts higher prospective levels of depressive symptoms and intrusions in borderline patients

Overgeneral memory (OGM), the tendency to retrieve categories of events from autobiographical memory instead of single events, is found to be a reliable predictor for future mood disturbances and post-traumatic symptom severity. Patients with borderline personality disorder (BPD) often report co-morbid episodes of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). Therefore, we investigated whether OGM would predict depression severity and (post-traumatic) stress symptoms in BPD patients. At admission (N?=?54) and at six-month follow-up (N?≥?31), BPD patients completed the Structured Clinical Interview for DSM-IV Disorders, the Assessment of DSM-IV Personality Disorders, the Autobiographical Memory Test, the Beck Depression Inventory—2nd edition (BDI-II), and the Impact of Event Scale. OGM at baseline predicted (a) higher levels of depressive symptoms at follow-up and (b) more intrusions related to a stressful event over and above baseline levels of borderline symptoms, depressive symptoms, and intrusions, respectively. No association was found between memory specificity and event-related avoidance at follow-up. Despite previous findings suggesting that OGM in BPD is less robust than in MDD and PTSD, our results suggest that memory specificity in BPD patients may have some relevance for the course of depressive and stress symptomatology in BPD.     

Internal Validity of the Disruptive Behavior Disorder Symptoms: Implications from Parent Ratings for a Dimensional Approach to Symptom Validity

A dimensional approach was used to evaluate the internal validity of the DSM-III-R ADHD-inattention, ADHD-hyperactivity/impulsivity, oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms (i.e., whether a symptom has a stronger correlation with its own dimension than the other three). Parents rated 4,019 children between the ages of 2 and 19 on these symptoms. The results showed that 5 of the 6 inattention symptoms, 3 of the 4 hyperactivity symptoms, 1 of the 4 impulsivity symptoms, 6 of the 9 oppositional defiant disorder symptoms, and 8 of the 11 CD symptoms had significant internal validity. Confirmatory factor analysis (CFA) found support for inattention, hyperactivity/impulsivity, oppositional defiant, and conduct disorder dimensions. Multiple-group CFA also found support for factor pattern and loading invariance across gender. The implications of these results as well as the merits of the dimensional approach to symptom validity are discussed in the context of the DSM-IV changes in ADHD, ODD, and CD.     

Detecting the malingering of cognitive deficits: An update

There has recently been a dramatic increase of empirical studies that investigate methods for detecting malingering of cognitive deficits. The present review focuses on a comparison of simulated and suspected malingerers in the malingering literature, and critiques the numerous approaches to the detection of malingering. The approaches that are reviewed include detection of floor effects, discrepancies of information, response bias, neuropsychological tests and batteries, symptom validity testing, and anomalous performance on memory tests. The latter approach has only recently been proposed by researchers and may show the most promise.     

儿童中期亲子依恋与焦虑症状的交叉滞后分析

以Kerns依恋安全性量表、Spence儿童焦虑量表为研究工具,对2所普通小学的472名三年级学生进行为期1年的追踪,考察儿童中期亲子依恋和焦虑症状的发展变化,以及亲子依恋与焦虑症状之间的关系。结果发现:(1)儿童中期的亲子依恋和焦虑症状在1年内较为稳定,分离焦虑、社交恐惧、恐慌障碍和强迫冲动障碍表现出一定的发展变化。(2)亲子依恋与焦虑症状呈显著负相关,依恋越安全,儿童的焦虑水平越低。(3)交叉滞后分析显示,亲子依恋在更大程度上影响儿童焦虑;母子依恋只具有同时性的影响,父子依恋既有同时性也有继时性的影响。(4)安全型父子依恋能够有效缓解不安全母子依恋的消极影响,安全型母子依恋对不安全父子依恋的补偿作用较小。     

Relationship quality of persons with obstructive sleep apnoea syndrome

In the field of sleep disorders, the quality of couple relationship is arousing increasing attention, given its implications for quality of life and treatment adherence. The aim of the present study was to evaluate relationship quality in a sample of treated or untreated patients with Obstructive Sleep Apnoea Syndrome. Eighty-seven patients were recruited in a hospital-based Centre for Sleep Medicine. Subjects were administered the Dyadic Adjustment Scale (DAS) to evaluate relationship quality, and the Epworth Sleepiness Scale (ESS). Apnoea-hypopnoea indexes (AHI) were collected through nocturnal polysomnography or home testing with a portable monitoring device. Although the DAS average scores were similar to local normative values, relationship quality was significantly lower in the untreated patients when compared with the ones treated. The ESS scores showed a negative correlation with many DAS scores, whereas no significant correlation emerged for AHI. Such data suggest a significant impact of perceived sleep apnoea symptoms on marital satisfaction, even though in the absence of striking differences between the whole sample and the general population.     

The symbol in the body: the un-doing of a dissociation through Embodied Active Imagination in Jungian analysis

Jung understood dissociation as a natural state of the psyche, capable of turning defensive through development. Based on this premise, and its conception on the equivalence between psyche and matter, the present work describes the un-doing of a dissociation expressed through a chronic enterocolitis disorder. When the symbol remains closer to the body and its most instinctive manifestations, we need to descend to that level in order to let the vertical axis connection be gradually restored through the therapeutic relationship – the horizontal axis. In other words, this un-doing requires that patient and analyst follow the unconscious path proposed by symbolic expressions that gradually emerge through the patient’s body and active imagination. Movement is our most primitive and fundamental experience. Many authors (Stern, Panksepp, Gallese) have agreed that, in addition to being first in terms of development, movement continues to have primacy over any other experience throughout life. This means that emotions, bodily concepts and, later, speech, evolve from a somatic basis. In the light of such neuroscientific findings, Jung’s vision of the correspondence of psyche and matter will be revisited in order to portray how the analytic bond provides a context for the re-establishment of the linking/creative function of the archetype, and allows the restoring of the ego-Self axis connection by including non-verbal approaches, such as body-based active imagination, also known as Authentic Movement. Authentic Movement is an amplification of Jung’s active imagination method that enables a dialogue between the ego and the diverse configurations of the unconscious. When such dialogue is grounded in the body, there is an easier access to the affective dimension stored in implicit memory. That which was relived through the body can gradually be remembered, and affects hitherto rejected, find other symbolic ways of being expressed and contained in the analytic vas.     

心理病理学网络理论、方法与挑战

对于精神障碍这一概念的理解, 传统DSM-ICD分类诊断系统和研究领域标准RDoC均基于潜变量视角, 认为精神障碍的症状由其潜在共同原因所致。这2种观点都忽略了症状间的相互作用。不同于分类和维度视角, Borsboom在2008年对精神障碍的概念化提出了的全新视角——心理病理学网络理论。此理论的核心观点是症状之间的动态因果关系构成了精神障碍。基于心理病理学网络理论的网络分析方法, 主要以结合EBIC的glasso算法估计症状间的偏相关网络, 并通过网络中节点中心性与网络连接性等指标, 来考查精神障碍症状的不同特性。近几年来, 研究者发现心理病理学网络分析方法在对症状间因果关系的推断、核心症状的识别和网络结构的可靠性与可重复性方面仍面临一些挑战。这些挑战为心理病理学网络理论与方法指明了未来可能的发展方向。     

Neurocognitive functioning in patients with conversion disorder/functional neurological disorder

Neurocognitive symptoms are common in individuals with somatic symptom and related disorders (SSRD), but little is known about the specific impairments in neurocognitive domains in patients with conversion disorder (CD)/functional neurological disorder (FND). This study examines neurocognitive functioning in patients with CD/FND compared to patients with other SSRD. The sample consisted of 318 patients. Twenty-nine patients were diagnosed with CD/FND, mean age 42.4, standard deviation (SD) = 13.8 years, 79.3% women, and 289 patients had other SSRD (mean age 42.1, SD = 13.3, 60.2% women). Patients completed a neuropsychological test battery that addressed a broad range of neurocognitive domains, including information processing speed, attention and executive functioning. Patients with CD/FND had clinically significant neurocognitive deficits in all neurocognitive domains based on normative data comparison. Patients with CD/FND also performed significantly worse than patients with other SSRD on information processing speed (Digit Symbol Substitution Test (V = .115, p = .035), Stroop Color–Word Test (SCWT) card 1 (V = .190, p = .006), and SCWT card 2 (V = .244, p < .001). No CD/FND vs. other SSRD differences were observed in other neurocognitive domains. These findings indicate the patients with CD/FND perform worse on information processing speed tests compared to patients with other SSRD.     

Am I Abnormal? Relative Rank and Social Norm Effects in Judgments of Anxiety and Depression Symptom Severity

Overdetection and underdetection of depression and anxiety in primary care are common and may partly reflect individuals' misperceptions of the severity of symptoms they experience. Here, we explore how people's judgments about the severity of their own symptoms are influenced by their beliefs about the distribution of symptoms experienced by the rest of the population. We apply the rank‐based decision by sampling cognitive model of judgment to symptom severity. The model proposes that judgments depend on the relative rank of an item within a mental sample of comparable items. It is predicted that judgments of symptom severity will be context dependent and more specifically that an individual's judgments will be invalid to the extent that the individual has inaccurate beliefs about the relevant social context. Two studies found that participants' assessments of symptom severity were rank based. Study 1 elicited participants' beliefs about the social distribution of symptoms and found that participants' judgments of whether they were depressed or anxious were mainly predicted not by their symptoms' objective severity but rather by where participants ranked the severity of their symptoms in comparison with the believed symptoms of others. Study 2 varied symptom distributions experimentally and again found relative rank effects as predicted. It is concluded that the real‐world application of contextual models of judgment requires investigation of individual differences in participants' background beliefs. Copyright © 2012 John Wiley & Sons, Ltd.