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Clinical Psychology & Psychotherapy Jan 2022The metacognitive model of post-traumatic stress disorder (PTSD) implicates metacognitive beliefs, meta-memory beliefs and metacognitive control strategies in... (Review)
Review
The metacognitive model of post-traumatic stress disorder (PTSD) implicates metacognitive beliefs, meta-memory beliefs and metacognitive control strategies in perpetuating and maintaining symptoms of PTSD. Despite this expanding area of research, the evidence for the metacognitive model of PTSD has not been reviewed. A systematic review according to the PRISMA statement was conducted. Searches across MEDLINE, PubMed and PsycNET, as well as reference lists of the included studies (2004 to March 2020), yielded 221 records. Two independent reviewers screened articles, which were included where the impact of the constructs of interest on PTSD symptoms was investigated within the framework of the metacognitive model for PTSD. Eighteen articles were included in the review. Eleven studies were determined to have good methodological robustness. Metacognitive therapy for PTSD demonstrated reductions in symptoms from pretreatment to post-treatment, which were maintained at follow-up. Predictors of greater PTSD symptom severity included metacognitive beliefs, meta-memory beliefs, and worry, punishment, thought suppression, experiential avoidance, and rumination. Overall, support was found for the validity of the metacognitive model of PTSD.
Topics: Anxiety; Humans; Metacognition; Stress Disorders, Post-Traumatic
PubMed: 34155731
DOI: 10.1002/cpp.2633 -
Frontiers in Psychology 2018Major Depressive Disorder (MDD) is a highly prevalent, recurrent, and potentially chronic disorder. Identifying risk factors and underlying mechanisms to inform...
Major Depressive Disorder (MDD) is a highly prevalent, recurrent, and potentially chronic disorder. Identifying risk factors and underlying mechanisms to inform preventive and therapeutic interventions is therefore imperative. Emotion regulation is a proposed factor in the development and maintenance of MDD. The aim of the present review was to summarize and synthesize research on self-reported emotion regulation strategy use and emotion regulation abilities in adults diagnosed with current and remitted MDD. Seventy-two eligible studies were retrieved from databases through a systematic literature search. Group differences between individuals with current MDD, remitted MDD, and healthy controls were calculated using meta-analytic procedures. Meta-regression analyses investigated potential moderator effects on emotion regulation difficulties. Results indicated that individuals with current MDD report higher maladaptive emotion regulation strategy use for avoidance (Hedges' = 1.3), rumination ( = 2.1), and suppression ( = 1.1) compared to healthy controls. Also, they reported lower adaptive emotion regulation strategy use for acceptance ( = -1.0), problem solving ( = -1.0), and reappraisal ( = -0.7). Individuals with current MDD reported limited general emotion regulation abilities, indicated by higher alexithymia ( = 1.45), lower emotional awareness ( = -0.95), emotional clarity ( = -1.50) and emotional tolerance ( = -1.89). Similar results were found in individuals with remitted MDD for avoidance ( = 1.0), rumination ( = 1.1), suppression ( = 0.6), and general emotion regulation abilities. However, no difference was found between individuals with remitted MDD and healthy controls for adaptive emotion regulation strategies. Meta-regression analyses suggest that age of illness onset, comorbid anxiety and duration of remission influence emotion regulation. The present review and meta-analysis indicates that individuals with current and remitted MDD have difficulties with emotion regulation compared to individuals who have never been depressed. Although depressive symptoms improve, emotion regulation difficulties may continue, and could be a contributing factor to relapse. Our findings inform future research on emotion regulation and psychotherapeutic interventions.
PubMed: 29867700
DOI: 10.3389/fpsyg.2018.00756 -
Journal of Affective Disorders May 2015Mixed states have been a fundamental part of Kraepelin׳s conceptualization of the manic-depressive illness. However, after Kraepelin, the study of mixed states was not... (Review)
Review
BACKGROUND
Mixed states have been a fundamental part of Kraepelin׳s conceptualization of the manic-depressive illness. However, after Kraepelin, the study of mixed states was not of great interest, until the publication of the RDC criteria (1978) and then the DSM-III edition (1980), where criteria for mixed manic states were operationalized. The most notable victims of DSM nosology were depressive mixed states, in particular depression with flight of ideas and excited (agitated) depression.
METHODS
We briefly review the clinical work of Athanasios Koukopoulos on depressive mixed states (in particular agitated depression) pointing out the diagnostic and therapeutic contributions, especially in the lights of Koukopoulos׳ first description of depressive mixed syndrome in 1992.
RESULTS
The mixed depressive syndrome is not a transitory state but a state of long duration, which may last weeks or several months. The clinical picture is characterized by dysphoric mood, emotional lability, psychic and/or motor agitation, talkativeness, crowded and/or racing thoughts, rumination, initial or middle insomnia. Impulsive suicidal attempts may be frequent. The family observes incessant complaints, irritability, occasional verbal outbursts, occasional physical aggression, and occasional hypersexuality. Treatment with antipsychotics and ECT is very effective; antidepressants can worsen the clinical picture.
LIMITATIONS
Selective but not systematic review of the literature on depressive mixed states. Relatively little research data is currently available for validation of the criteria proposed by Koukopoulos.
CONCLUSIONS
Koukopoulos׳ proposal of mixed depression, besides its diagnostic implications, clearly identifying it as manifestations of bipolar disorder, allows for better clinical characterization of cases and improves treatment decisions.
Topics: Adult; Age of Onset; Antidepressive Agents; Bipolar Disorder; Depression; Depressive Disorder, Major; Diagnosis, Differential; Diagnostic and Statistical Manual of Mental Disorders; Female; Genetic Diseases, X-Linked; Humans; Irritable Mood; Psychomotor Agitation
PubMed: 25687279
DOI: 10.1016/j.jad.2015.01.053 -
HSS Journal : the Musculoskeletal... Oct 2020Unanticipated severe injury to part of the musculoskeletal system, referred to as orthopedic trauma, can be debilitating. It can also be accompanied by equally... (Review)
Review
BACKGROUND
Unanticipated severe injury to part of the musculoskeletal system, referred to as orthopedic trauma, can be debilitating. It can also be accompanied by equally debilitating psychological distress, but little is known about the effective interventions for psychological sequelae of orthopedic trauma.
QUESTIONS/PURPOSES
We sought to determine the effectiveness of interventions on psychological outcomes, such as post-traumatic stress disorder (PTSD), depression, and pain catastrophizing (feelings of helplessness, excessive rumination, and exaggerated description of pain), after major orthopedic trauma.
METHODS
Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement as guidelines, we systematically searched Scopus, PubMed, and Google Scholar. Studies included for review were English-language interventional studies in an orthopedic trauma population that included assessment of post-injury psychological distress or disability as either a primary or secondary aim.
RESULTS
Twelve studies were identified, including six randomized trials, three prospective cohort studies, and three retrospective cohort studies. Study sample sizes ranged from 48 to 569 patients, the mean age ranged from 29 to 52.8 years, and the percentage of male patients ranged from 38 to 90%. We examined four categories of interventions. Peer group treatment (one study) significantly reduced rates of depression but had low participation rates. Brief interventions to teach coping and self-efficacy skills (two studies) decreased depression, pain catastrophizing, and anxiety scores while increasing self-efficacy on short-term follow-up. Individualized counseling and rehabilitation (four studies) resulted in a consistent reduction in the risk of PTSD. Early amputation was found to result in lower rates of PSTD than limb salvage in US military personnel (four studies). One study examined surgeons' confidence in dealing with possible psychological distress; surgeons who participated in a program on collaborative care were significantly more confident that they could help their patients with such issues.
CONCLUSION
Interventional strategies, including group interventions, brief individual interventions, longitudinal counseling, and consideration of early amputation in selected populations have proved effective in reducing negative psychological sequelae of major orthopedic trauma. Further research that determines the effects of interventions in this population is needed.
PubMed: 33088239
DOI: 10.1007/s11420-019-09731-w -
Clinical Psychology & Psychotherapy Jan 2018This review investigated whether unhelpful metacognitive coping strategies, such as attentional biases, worry, rumination, and thought control, are associated with... (Review)
Review
This review investigated whether unhelpful metacognitive coping strategies, such as attentional biases, worry, rumination, and thought control, are associated with experiences of psychosis. These processes, known collectively as the Cognitive Attentional Syndrome (CAS), form a central tenet of the Self-Regulatory Executive Function model. Three research questions based on assumptions underlying the CAS were addressed. It was predicted that processes of (a) self-focused processing, (b) negative perseverative thinking (worry and rumination), and (c) counterproductive thought control would be associated with experiences of psychosis. A comprehensive search of the literature identified 51 eligible studies: 17 investigated self-focused attention, 25 investigated perseverative processing (worry: n = 18; rumination: n = 10), and 9 investigated thought control strategies. Findings indicated that unhelpful metacognitive coping strategies associated with the CAS are related to experiences of psychosis and appear to share important relationships with distress. Implications for future research and clinical practice are discussed.
Topics: Adaptation, Psychological; Attentional Bias; Humans; Metacognition; Psychotic Disorders; Rumination, Cognitive
PubMed: 28833863
DOI: 10.1002/cpp.2132 -
Neuroscience and Biobehavioral Reviews Jan 2024Prior studies reported mixed effects of the COVID-19 pandemic on the mental health of children and adolescents with ADHD, but they were mainly cross-sectional and... (Review)
Review
Prior studies reported mixed effects of the COVID-19 pandemic on the mental health of children and adolescents with ADHD, but they were mainly cross-sectional and without controls. To clarify the impact, we searched Web of Science, EMBASE, Medline, and PsychINFO until 18/11/2023 and conducted a systematic review of controlled longitudinal cohort studies (Prospero: CRD42022308166). The Newcastle-Ottawa scale was used to assess quality. We identified 6 studies. Worsening of mental health symptoms was more evident in ADHD or control group according to symptom considered and context. However, those with ADHD had more persistent elevated symptoms and remained an at-risk population. Sleep problems deteriorated more significantly in those with ADHD. Lower pre-COVID emotion regulation skills and greater rumination were associated with worse mental health outcomes, and longer screen time with poorer sleep. Quality was rated as low in most studies, mainly due to self-report outcome measures and no information on attrition rates. Despite these limitations, results suggest a predominantly negative impact on youths with ADHD and may guide clinical practice and policy.
Topics: Child; Humans; Adolescent; Attention Deficit Disorder with Hyperactivity; Mental Health; COVID-19; Longitudinal Studies; Pandemics; Cross-Sectional Studies; Cohort Studies
PubMed: 38065419
DOI: 10.1016/j.neubiorev.2023.105502 -
International Journal of Environmental... Apr 2020Transdiagnostic causal variables have been identified that have allowed understanding the origin and maintenance of psychopathologies in parsimonious explanatory models...
Transdiagnostic causal variables have been identified that have allowed understanding the origin and maintenance of psychopathologies in parsimonious explanatory models of antisocial disorders. However, it is necessary to systematize the information published in the last decade. The aim of the study was to identify through a systematic review, the structural, emotional and cognitive transdiagnostic variables in antisocial disorders of adolescence and youth. Recommendations for systematic reviews and meta-extraction and analysis of information according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), the Cochrane Collaboration and Campbell were followed. We found 19 articles from 110 reviewed documents. The results indicated that at a structural level there is a general psychopathological factor (psychopathy or externalizing), non-emotional callousness and impulsivity from behavioral inhibition and activation systems, and negative affect traits as base structures. In the emotional level, the study found a risk component from emotional dysregulation and experiential avoidance. In the cognitive level, a key role of anger-rumination and violent ideation as explanatory variables of antisocial disorders. We concluded that the interaction of these identified variables makes it possible to generate an evidence-based transdiagnostic model.
Topics: Adolescent; Anger; Antisocial Personality Disorder; Child; Cognition; Emotions; Female; Humans; Male; Quality of Life; Young Adult
PubMed: 32349315
DOI: 10.3390/ijerph17093036 -
Journal of Pediatric Gastroenterology... Apr 2024Rumination syndrome (RS) is a complex functional disorder characterized by recurrent, repetitive regurgitation of recently swallowed food. RS may have medical and... (Review)
Review
Rumination syndrome (RS) is a complex functional disorder characterized by recurrent, repetitive regurgitation of recently swallowed food. RS may have medical and psychosocial implications, compromising the quality of life and causing high rates of school absenteeism. Pediatric RS has been poorly studied and little evidence regarding its treatment is available. This systematic review aims to evaluate the literature on the nonpharmacological treatment of RS in childhood. A systematic literature search was conducted on MEDLINE/PubMed, CINAHL, Cochrane Library, PsycINFO, and PEDro, from 2000 to 2023. The methodological quality of the publications was assessed by applying the guidelines proposed by the Equator network, according to the different designs of study, and the risk of bias was evaluated with the Risk Of Bias In Non-Randomized Studies of Interventions (ROBINS-I). Five hundred ninety-six studies were screened, and 7 studies were included in the review. Diaphragmatic breathing was the most used nonpharmacological treatment, and it was always combined with other therapeutic strategies. The vast heterogeneity of the physical or mental comorbidities and the methodology adopted in the publications did not allow a comparative analysis of the different treatments. Regardless of the type of treatment, high-intensity therapeutic programs and specific operators' training emerged as the most influencing factors for patients' outcomes. According to the available evidence, there is not enough high-quality evidence to suggest a defined therapeutic strategy. Large observational studies on selected patients accounting for possible confounders, with adequate follow-up times, and with clearly defined treatment regimens are needed to identify the best therapeutic approach.
Topics: Humans; Child; Quality of Life; Rumination Syndrome; Comorbidity
PubMed: 38268062
DOI: 10.1002/jpn3.12038 -
Journal of Affective Disorders Jan 2022Researches have highlighted communication deficits between resting-state brain networks in major depressive disorder (MDD), as reflected in abnormal functional... (Review)
Review
RATIONALE/IMPORTANCE
Researches have highlighted communication deficits between resting-state brain networks in major depressive disorder (MDD), as reflected in abnormal functional connectivity (FC). However, it is unclear whether impaired FC is associated with MDD pathology or is simply incidental to MDD symptoms. Moreover, there is no generalized theory to analyze the impact of treatment modalities on MDD.
OBJECTIVES
To address the issues, we conducted a systematic review of 49 eligible papers to provide insight into the pathological mechanisms of MDD patients by summarizing resting-state FC alterations involving mood and cognitive abnormalities and the effects of medications on them.
RESULTS
Mood disorders in MDD were characterized by abnormal FC between the amygdala, insula, anterior cingulate cortex (ACC), and prefrontal cortex (PFC). Cognitive impairment manifests as deficits in executive function, attention, memory, and rumination, primarily modulated by dysfunction between the fronto-parietal network and default mode network. Especially, we proposed the set of core abnormal FC (CA-FC) contributing to mood and cognitive impairment in MDD, currently including ACC-left precuneus/amygdala, rostral ACC-left dorsolateral PFC, left subgenual ACC-left cerebellar, left PFC- anterior subcallosal, and left precuneus-left pulvinar. After treatment, patients with normalized CA-FC showed remission of depressive symptoms.
CONCLUSIONS
We propose a CA-FC set for possible causative principle of MDD, which unifies the FC results from specific, difficult-to-analyze conditions into one outcome set for screening. Furthermore, CA-FC varies from person to person, and the low success rate of a single treatment may be due to the inability to cover too many CA-FC.
Topics: Antidepressive Agents; Brain; Brain Mapping; Depressive Disorder, Major; Gyrus Cinguli; Humans; Magnetic Resonance Imaging
PubMed: 34688026
DOI: 10.1016/j.jad.2021.09.074 -
Journal of Pediatric Gastroenterology... Apr 2016Functional disorders of the upper gastrointestinal tract are frequently diagnosed in children. Four different clinical entities are addressed by the Rome III committee:... (Review)
Review
OBJECTIVES
Functional disorders of the upper gastrointestinal tract are frequently diagnosed in children. Four different clinical entities are addressed by the Rome III committee: functional dyspepsia (FD), cyclic vomiting syndrome (CVS), adolescent rumination syndrome (ARS), and aerophagia. Management of these disorders is often difficult leading to a wide variety in therapeutic interventions. We hypothesize that definitions and outcome measures in these studies are heterogeneous as well. Our aim is to systematically assess how these disorders and outcomes are defined in therapeutic randomized controlled trials (RCTs).
STUDY DESIGN
CENTRAL, Embase, and MEDLINE/PubMed were searched from inception to February 25, 2015. Search terms were FD, CVS, ARS, and aerophagia. Therapeutic RCTs, or systematic reviews of RCTs, in English language including subjects ages 4 to 18 years (0-18 years for CVS) were evaluated. Quality was assessed using the Delphi list.
RESULTS
A total of 1398 articles were found of which 8 articles were included. Seven concerned FD and 1 concerned CVS. In all of the studies, Rome criteria or similar definitions were used; all the studies however used different outcome measures. Seventy-five percent of the trials were of good methodological quality. Only 57% used validated pain scales.
CONCLUSIONS
Different outcome measures are used in therapeutic trials on functional disorders of the upper gastrointestinal tract. There is a clear paucity of trials evaluating different treatment regimens regarding CVS, ARS, and aerophagia. Uniform definitions, outcome measures, and validated instruments are needed to make a comparison between intervention studies possible.
Topics: Adolescent; Aerophagy; Child; Dyspepsia; Evidence-Based Medicine; Feeding and Eating Disorders of Childhood; Humans; Infant; Outcome Assessment, Health Care; Pediatrics; Practice Guidelines as Topic; Quality of Life; Randomized Controlled Trials as Topic; Upper Gastrointestinal Tract; Vomiting
PubMed: 26348686
DOI: 10.1097/MPG.0000000000000973