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Archives of Sexual Behavior Jul 2023Gender transition is undertaken to improve the well-being of people suffering from gender dysphoria. However, some have argued that the evidence supporting medical...
Gender transition is undertaken to improve the well-being of people suffering from gender dysphoria. However, some have argued that the evidence supporting medical interventions for gender transition (e.g., hormonal therapies and surgery) is weak and inconclusive, and an increasing number of people have come forward recently to share their experiences of transition regret and detransition. In this essay, I discuss emerging clinical and research issues related to transition regret and detransition with the aim of arming clinicians with the latest information so they can support patients navigating the challenges of regret and detransition. I begin by describing recent changes in the epidemiology of gender dysphoria, conceptualization of transgender identification, and models of care. I then discuss the potential impact of these changes on regret and detransition; the prevalence of desistance, regret, and detransition; reasons for detransition; and medical and mental healthcare needs of detransitioners. Although recent data have shed light on a complex range of experiences that lead people to detransition, research remains very much in its infancy. Little is known about the medical and mental healthcare needs of these patients, and there is currently no guidance on best practices for clinicians involved in their care. Moreover, the term detransition can hold a wide array of possible meanings for transgender-identifying people, detransitioners, and researchers, leading to inconsistences in its usage. Moving forward, minimizing harm will require conducting robust research, challenging fundamental assumptions, scrutinizing of practice patterns, and embracing debate.
Topics: Humans; Transgender Persons; Transsexualism; Gender Identity; Uncertainty; Gender Dysphoria; Emotions
PubMed: 37266795
DOI: 10.1007/s10508-023-02626-2 -
JAMA Jun 2023Prior studies have suggested that transgender individuals may be a high-risk group with respect to suicide attempt and mortality, but large-scale, population-based...
IMPORTANCE
Prior studies have suggested that transgender individuals may be a high-risk group with respect to suicide attempt and mortality, but large-scale, population-based investigations are lacking.
OBJECTIVE
To examine in a national setting whether transgender individuals have higher rates of suicide attempt and mortality than nontransgender individuals.
DESIGN, SETTING, AND PARTICIPANTS
Nationwide, register-based, retrospective cohort study on all 6 657 456 Danish-born individuals aged 15 years or older who lived in Denmark between January 1, 1980, and December 31, 2021.
EXPOSURE
Transgender identity was determined through national hospital records and administrative records of legal change of gender.
MAIN OUTCOMES AND MEASURES
Suicide attempts, suicide deaths, nonsuicidal deaths, and deaths by any cause during 1980 through 2021 were identified in national hospitalization and causes of death registers. Adjusted incidence rate ratios (aIRRs) with 95% CIs controlling for calendar period, sex assigned at birth, and age were calculated.
RESULTS
The 6 657 456 study participants (50.0% assigned male sex at birth) were followed up during 171 023 873 person-years. Overall, 3759 individuals (0.06%; 52.5% assigned male sex at birth) were identified as transgender at a median age of 22 years (IQR, 18-31 years) and followed up during 21 404 person-years, during which 92 suicide attempts, 12 suicides, and 245 suicide-unrelated deaths occurred. Standardized suicide attempt rates per 100 000 person-years were 498 for transgender vs 71 for nontransgender individuals (aIRR, 7.7; 95% CI, 5.9-10.2). Standardized suicide mortality rates per 100 000 person-years were 75 for transgender vs 21 for nontransgender individuals (aIRR, 3.5; 95% CI, 2.0-6.3). Standardized suicide-unrelated mortality rates per 100 000 person-years were 2380 for transgender vs 1310 for nontransgender individuals (aIRR, 1.9; 95% CI, 1.6-2.2), and standardized all-cause mortality rates per 100 000 person-years were 2559 for transgender vs 1331 for nontransgender individuals (aIRR, 2.0; 95% CI, 1.7-2.4). Despite declining rates of suicide attempts and mortality during the 42 years covered, aIRRs remained significantly elevated in recent calendar periods up to and including 2021 for suicide attempts (aIRR, 6.6; 95% CI, 4.5-9.5), suicide mortality (aIRR, 2.8; 95% CI, 1.3-5.9), suicide-unrelated mortality (aIRR, 1.7; 95% CI, 1.5-2.1), and all-cause mortality (aIRR, 1.7; 95% CI, 1.4-2.1).
CONCLUSIONS AND RELEVANCE
In this Danish population-based, retrospective cohort study, results suggest that transgender individuals had significantly higher rates of suicide attempt, suicide mortality, suicide-unrelated mortality, and all-cause mortality compared with the nontransgender population.
Topics: Adolescent; Adult; Humans; Male; Young Adult; Denmark; Hospitalization; Retrospective Studies; Suicide, Attempted; Transgender Persons; Gender Identity; Registries; Suicide; Female
PubMed: 37367977
DOI: 10.1001/jama.2023.8627 -
Neuroscience and Biobehavioral Reviews Jul 2023Animal personality, consistent individual differences in behaviour, is an important concept for understanding how individuals vary in how they cope with environmental... (Review)
Review
Animal personality, consistent individual differences in behaviour, is an important concept for understanding how individuals vary in how they cope with environmental challenges. In order to understand the evolutionary significance of animal personality, it is crucial to understand the underlying regulatory mechanisms. Epigenetic marks such as DNA methylation are hypothesised to play a major role in explaining variation in phenotypic changes in response to environmental alterations. Several characteristics of DNA methylation also align well with the concept of animal personality. In this review paper, we summarise the current literature on the role that molecular epigenetic mechanisms may have in explaining personality variation. We elaborate on the potential for epigenetic mechanisms to explain behavioural variation, behavioural development and temporal consistency in behaviour. We then suggest future routes for this emerging field and point to potential pitfalls that may be encountered. We conclude that a more inclusive approach is needed for studying the epigenetics of animal personality and that epigenetic mechanisms cannot be studied without considering the genetic background.
Topics: Animals; Behavior, Animal; Personality; Individuality; Epigenesis, Genetic; Biological Evolution
PubMed: 37094740
DOI: 10.1016/j.neubiorev.2023.105194 -
Psychoneuroendocrinology Jul 2023An aging-related immune phenotype (ARIP) has been defined as a decrease in naïve T cells (T) relative to the accumulation of memory T cells (T). Recent research...
An aging-related immune phenotype (ARIP) has been defined as a decrease in naïve T cells (T) relative to the accumulation of memory T cells (T). Recent research implicates ARIP measures, such as CD4 +T/T and CD8 +T/T ratios, in multimorbidity and mortality. This study examined whether psychological dispositions that assess how people think, feel, and behave are related to CD4 +T/T and CD8 +T/T. Participants were adults aged 50-104 years (N = 4798; 58% women, Mean Age= 67.95, SD= 9.56) from the Health and Retirement Study. Data on CD4 +T/T and CD8 +T/T were obtained in 2016. Data on personality, demographic factors, and potential clinical (body mass index, disease burden), behavioral (smoking, alcohol, physical activity), psychological (depressive symptoms, stress), and biological (cytomegalovirus IgG antibodies) mediating factors were obtained in 2014/2016. Controlling for demographic factors, higher conscientiousness was related to higher CD4 +T/T and CD8 +T/T. To a lesser extent, higher neuroticism and lower extraversion were associated with lower CD4 +T/T Physical activity, and to a lesser extent BMI and disease burden, were the most robust mediators between personality and ARIP measures. Cytomegalovirus IgG level mediated the association between conscientiousness and both CD4 +T/T and CD8 +T/T. This study provides novel evidence that personality is related to ARIP. Higher conscientiousness and, to a lesser extent, higher extraversion may be protective against age-related immunophenotype change, whereas neuroticism may be a risk factor.
Topics: Female; Male; Humans; Personality; Personality Disorders; Neuroticism; Immunoglobulin G
PubMed: 37120948
DOI: 10.1016/j.psyneuen.2023.106113 -
Current Opinion in Psychology Feb 2024We give an overview of what age stereotypes (AS) are, how they are acquired and change across the lifespan, and how they shape development in old age. AS reflect complex... (Review)
Review
We give an overview of what age stereotypes (AS) are, how they are acquired and change across the lifespan, and how they shape development in old age. AS reflect complex beliefs and expectations that vary on the following dimensions: They differ in content and valence, depending on the life-domain to which they are applied (context), they refer to different age-groups (reference), to older people or to oneself as an old person (direction of relevance), and they either describe how older people are or prescribe how they should be (modality). AS are acquired early, and later taint beliefs about one's own aging (internalization). Once they are part of the self-concept, AS act as self-fulfilling prophecies that shape the actual aging process (stereotype embodiment).
Topics: Humans; Aged; Aging; Stereotyping; Self Concept; Longevity
PubMed: 38035656
DOI: 10.1016/j.copsyc.2023.101747 -
Cancer Metastasis Reviews Dec 2023Some relevant emerging properties of intelligent systems are "adaptation to a changing environment," "reaction to unexpected situations," "capacity of problem solving,"... (Review)
Review
Some relevant emerging properties of intelligent systems are "adaptation to a changing environment," "reaction to unexpected situations," "capacity of problem solving," and "ability to communicate." Single cells have remarkable abilities to adapt, make adequate context-dependent decision, take constructive actions, and communicate, thus theoretically meeting all the above-mentioned requirements. From a biological point of view, cancer can be viewed as an invasive species, composed of cells that move from primary to distant sites, being continuously exposed to changes in the environmental conditions. Blood represents the first hostile habitat that a cancer cell encounters once detached from the primary site, so that cancer cells must rapidly carry out multiple adaptation strategies to survive. The aim of this review was to deepen the adaptation mechanisms of cancer cells in the blood microenvironment, particularly referring to four adaptation strategies typical of animal species (phenotypic adaptation, metabolic adaptation, niche adaptation, and collective adaptation), which together define the broad concept of biological intelligence. We provided evidence that the required adaptations (either structural, metabolic, and related to metastatic niche formation) and "social" behavior are useful principles allowing putting into a coherent frame many features of circulating cancer cells. This interpretative frame is described by the comparison with analog behavioral traits typical of various animal models.
Topics: Animals; Neoplasms; Intelligence; Tumor Microenvironment
PubMed: 37540301
DOI: 10.1007/s10555-023-10123-0 -
Journal of the American Medical... Oct 2023Clinical observations and studies of retrospective observer ratings point to changes in personality in persons with cognitive impairment or dementia. The timing and... (Observational Study)
Observational Study
OBJECTIVES
Clinical observations and studies of retrospective observer ratings point to changes in personality in persons with cognitive impairment or dementia. The timing and magnitude of such changes, however, are unclear. This study used prospective self-reported data to examine the trajectories of personality traits before and during cognitive impairment.
DESIGN
Longitudinal observational cohort study.
SETTING AND PARTICIPANTS
Older adults from the United States in the Health and Retirement Study were assessed for cognitive impairment and completed a measure of the 5 major personality traits every 4 years from 2006 to 2020 (N = 22,611; n = 5507 with cognitive impairment; 50,786 personality and cognitive assessments).
METHODS
Multilevel modeling examined changes before and during cognitive impairment, accounting for demographic differences and normative age-related trajectories.
RESULTS
Before cognitive impairment was detected, extraversion (b = -0.10, SE = 0.02), agreeableness (b = -0.11, SE = 0.02), and conscientiousness (b = -0.12, SE = 0.02) decreased slightly; there was no significant change in neuroticism (b = 0.04, SE = 0.02) or openness (b = -0.06, SE = 0.02). During cognitive impairment, faster rates of change were found for all 5 personality traits: neuroticism (b = 0.10, SE = 0.03) increased, and extraversion (b = -0.14, SE = 0.03), openness (b = -0.15, SE = 0.03), agreeableness (b = -0.35, SE = 0.03), and conscientiousness (b = -0.34, SE = 0.03) declined.
CONCLUSIONS AND IMPLICATIONS
Cognitive impairment is associated with a pattern of detrimental personality changes across the preclinical and clinical stages. Compared with the steeper rate of change during cognitive impairment, the changes were small and inconsistent before impairment, making them unlikely to be useful predictors of incident dementia. The study findings further indicate that individuals can update their personality ratings during the early stages of cognitive impairment, providing valuable information in clinical settings. The results also suggest an acceleration of personality change with the progression to dementia, which may lead to behavioral, emotional, and other psychological symptoms commonly observed in people with cognitive impairment and dementia.
Topics: Humans; Aged; Retrospective Studies; Prospective Studies; Personality; Cognitive Dysfunction; Dementia
PubMed: 37330217
DOI: 10.1016/j.jamda.2023.05.011 -
Psychological Medicine Jan 2024Psilocybin Therapy (PT) is being increasingly studied as a psychiatric intervention. Personality relates to mental health and can be used to probe the nature of PT's... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Psilocybin Therapy (PT) is being increasingly studied as a psychiatric intervention. Personality relates to mental health and can be used to probe the nature of PT's therapeutic action.
METHODS
In a phase 2, double-blind, randomized, active comparator controlled trial involving patients with moderate-to-severe major depressive disorder, we compared psilocybin with escitalopram, over a core 6-week trial period. Five-Factor model personality domains, Big Five Aspect Scale Openness aspects, Absorption, and Impulsivity were measured at Baseline, Week 6, and Month 6 follow-up.
RESULTS
PT was associated with decreases in neuroticism ( = -0.63), introversion ( = -0.38), disagreeableness ( = -0.47), impulsivity ( = -0.40), and increases in absorption ( = 0.32), conscientiousness ( = 0.30), and openness ( = 0.23) at week 6, with neuroticism ( = -0.47) and disagreeableness ( = -0.41) remaining decreased at month 6. Escitalopram Treatment (ET) was associated with decreases in neuroticism ( = -0.38), disagreeableness ( = -0.26), impulsivity ( = -0.35), and increases in openness ( = 0.28) at week 6, with neuroticism ( = -0.46) remaining decreased at month 6. No significant between-condition differences were observed.
CONCLUSIONS
Personality changes across both conditions were in a direction consistent with improved mental health. With the possible exception of trait absorption, there were no compelling between-condition differences warranting conclusions regarding a selective action of PT ( ET) on personality; however, post-ET changes in personality were significantly moderated by pre-trial positive expectancy for escitalopram, whereas expectancy did not moderate response to PT.
Topics: Humans; Psilocybin; Escitalopram; Depressive Disorder, Major; Depression; Personality; Neuroticism
PubMed: 37264814
DOI: 10.1017/S0033291723001514 -
Schizophrenia Research Jul 2024Despite the historically consolidated psychopathological perspective, on the one hand, contemporary organicistic psychiatry often highlights abnormalities in... (Review)
Review
Despite the historically consolidated psychopathological perspective, on the one hand, contemporary organicistic psychiatry often highlights abnormalities in neurotransmitter systems like dysregulation of dopamine transmission, neural circuitry, and genetic factors as key contributors to schizophrenia. Neuroscience, on the other, has so far almost entirely neglected the first-person experiential dimension of this syndrome, mainly focusing on high-order cognitive functions, such as executive function, working memory, theory of mind, and the like. An alternative view posits that schizophrenia is a self-disorder characterized by anomalous self-experience and awareness. This view may not only shed new light on the psychopathological features of psychosis but also inspire empirical research targeting the bodily and neurobiological changes underpinning this disorder. Cognitive neuroscience can today address classic topics of phenomenological psychopathology by adding a new level of description, finally enabling the correlation between the first-person experiential aspects of psychiatric diseases and their neurobiological roots. Recent empirical evidence on the neurobiological basis of a minimal notion of the self, the bodily self, is presented. The relationship between the body, its motor potentialities and the notion of minimal self is illustrated. Evidence on the neural mechanisms underpinning the bodily self, its plasticity, and the blurring of self-other distinction in schizophrenic patients is introduced and discussed. It is concluded that brain-body function anomalies of multisensory integration, differential processing of self- and other-related bodily information mediating self-experience, might be at the basis of the disruption of the self disorders characterizing schizophrenia.
Topics: Humans; Schizophrenia; Self Concept; Ego; Schizophrenic Psychology; Body Image; Brain
PubMed: 38815468
DOI: 10.1016/j.schres.2024.05.014 -
Reviews in the Neurosciences Feb 2024Even though the number of studies aiming to improve comprehension of ADHD pathology has increased in recent years, there still is an urgent need for more effective... (Review)
Review
Even though the number of studies aiming to improve comprehension of ADHD pathology has increased in recent years, there still is an urgent need for more effective studies, particularly in understanding adult ADHD, both at preclinical and clinical levels, due to the increasing evidence that adult ADHD is highly distinct and a different entity from childhood ADHD. This review paper outlines the symptoms, diagnostics, and neurobiological mechanisms of ADHD, with emphasis on how adult ADHD could be different from childhood-onset. Data show a difference in the environmental, genetic, epigenetic, and brain structural changes, when combined, could greatly impact the behavioral presentations and the severity of ADHD in adults. Furthermore, a crucial aspect in the quest to fully understand this disorder could be through longitudinal analysis. In this way, we will determine if and how the pathology and pharmacology of ADHD change with age. This goal could revolutionize our understanding of the disorder and address the weaknesses in the current clinical classification systems, improving the characterization and validity of ADHD diagnosis, specifically those in adults.
Topics: Adult; Humans; Child; Attention Deficit Disorder with Hyperactivity; Brain; Motivation
PubMed: 37813870
DOI: 10.1515/revneuro-2023-0071