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Frontiers in Psychiatry 2023Mindfulness training among patients with major depressive disorder (MDD) reduces symptoms, prevents relapse, improves prognosis, and is more efficient for those with a...
Mindfulness training among patients with major depressive disorder (MDD) reduces symptoms, prevents relapse, improves prognosis, and is more efficient for those with a high level of trait mindfulness. Upon hospital admission, 126 MDD patients completed the Beck Depression Inventory (BDI), World Health Organization Quality of Life Brief, Five-Factor Mindfulness Questionnaire (FFMQ), and the Rumination Response Scale (RRS). The 65 patients that scored less than the median of all subjects on the FFMQ were placed into the low mindfulness level (LML) group. The other 61 patients were placed in the high mindfulness level (HML) group. All facet scores were statistically different between the mental health assessment scores of the HML and LML groups except for RRS brooding and FFMQ nonjudgement. Trait mindfulness level exhibited a negative and bidirectional association with MDD severity primarily through the facets of description and aware actions. Trait mindfulness was also related positively with age primarily through the facets of nonreactivity and nonjudgement. Being married is positively associated with trait mindfulness levels primarily through the facet of observation and by an associated increase in perceived quality of life. Mindfulness training prior to MDD diagnosis also associates positively with trait mindfulness level. Hospitalized MDD patients should have their trait mindfulness levels characterized to predict treatment efficiency, help establish a prognosis, and identify mindfulness-related therapeutic targets.
PubMed: 37496685
DOI: 10.3389/fpsyt.2023.1144989 -
Gastro Hep Advances 2023Patients with functional constipation (FC) are frequently dissatisfied with current treatment options which may be related to persistent, unaddressed symptoms. We...
BACKGROUND AND AIMS
Patients with functional constipation (FC) are frequently dissatisfied with current treatment options which may be related to persistent, unaddressed symptoms. We hypothesized that refractory FC may actually represent functional dyspepsia (FD) overlap. Among adults presenting with refractory FC, we sought to (1) identify the prevalence of concurrent FD and (2) identify the symptoms and presentations most frequently associated with concurrent FD and FC.
METHODS
We assembled a retrospective cohort of 308 patients sequentially presenting to a tertiary neurogastroenterology clinic for evaluation of refractory FC, defined as having failed first-line therapy. Using Rome IV criteria, trained raters identified the presence and characteristics of concurrent FD in addition to demographics, presenting complaints, and psychological comorbidities.
RESULTS
Among 308 patients presenting with refractory FC (average of 3.0 ± 2.3 constipation treatments tried unsuccessfully), 119 (38.6%) had concurrent FD. Aside from meeting FD criteria, the presence of concurrent FD was associated with patient complaints of esophageal symptoms (Odds ratio = 3.1; 95% confidence interval, 1.80-5.42) and bloating and distension (Odds ratio = 2.67; 95% confidence interval, 1.50-4.89). Patients with concurrent FD were more likely to have a history of an eating disorder (21.0% vs 12.7%) and were also more likely to present with current avoidant/restrictive food intake disorder-related symptoms (31.9% vs 21.7%).
CONCLUSION
Almost 40% of adult patients referred for refractory FC met criteria for concurrent FD in a tertiary-level cohort. The presence of both FC and FD was associated with greater esophageal symptoms and bloating/distention. Determining presence of concurrent FD may represent an additional therapeutic opportunity in refractory patients who may attribute symptoms to FC alone.
PubMed: 37389172
DOI: 10.1016/j.gastha.2023.01.004 -
Current Psychology (New Brunswick, N.J.) May 2023The current systematic review sought to identify quantitative empirical studies that focused on the transdiagnostic factors of intolerance of uncertainty, emotional...
The current systematic review sought to identify quantitative empirical studies that focused on the transdiagnostic factors of intolerance of uncertainty, emotional dysregulation and rumination, and their relation with depression and post-traumatic stress disorder (PTSD). The overall research aim was to examine the relationship between these transdiagnostic factors and their relation with depression and PTSD symptoms. The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Out of the 768 articles initially identified, 55 met the inclusion criteria for the current review. The results determined that intolerance of uncertainty is indirectly related to depression and PTSD symptoms, mainly through other factors including emotion dysregulation and rumination. Additionally, emotional dysregulation is a significant predictor of both depression and PTSD symptoms. Rumination is a robust factor related to depression and PTSD symptoms, this relationship was significant in cross-sectional and longitudinal studies. This review provides evidence on the transdiagnostic factors of intolerance of uncertainty, emotional dysregulation and rumination in the relationship with depression and PTSD symptoms.
PubMed: 37359653
DOI: 10.1007/s12144-023-04792-x -
Turk Psikiyatri Dergisi = Turkish... 2023Metacognitive beliefs operate through cognitive attentional syndrome, where attention concentrated on negative automatic thoughts results in rumination. This...
Metacognitive beliefs operate through cognitive attentional syndrome, where attention concentrated on negative automatic thoughts results in rumination. This perseverative thinking style manifesting in the form of rumination and worry intensifies depression. This study aims to assess the effect of cognitive behaviour therapy (CBT) on metacognitive beliefs, symptom severity, quality of life, and functionality. A pre-post study design comparing CBT-alone and CBT-with-medication was employed using purposive sampling to recruit 40 participants diagnosed with depressive disorders. All the participants received 10 sessions of CBT. Pre and post assessment measures were Beck Depression Inventory-II, Metacognitive Questionnaire-30, World Health Organization Quality of Life- Brief, and Global Assessment of Functioning. Paired t-test analysis revealed significant difference on outcome measures in both groups. Between-subject analysis revealed that the CBT-alone group was not significantly different in terms of improvement than CBT-withmedication group even when confounding variables were statistically controlled by way of testing analysis of covariance and propensity score match (nearest neighbour match). Keywords: Cognitive behaviour therapy, metacognition, depressive disorders, metacognitive beliefs, depression, quality of life.
Topics: Humans; Metacognition; Quality of Life; Cognitive Behavioral Therapy; Anxiety; Depressive Disorder
PubMed: 37357894
DOI: 10.5080/u26398 -
Journal of Behavior Therapy and... Dec 2023Mind-wandering, and specifically the frequency and content of mind-wandering, plays an important role in the psychological well-being of individuals. Repetitive negative...
BACKGROUND AND OBJECTIVES
Mind-wandering, and specifically the frequency and content of mind-wandering, plays an important role in the psychological well-being of individuals. Repetitive negative thinking has been associated with a high risk to develop and maintain Major Depressive Disorder. We here combined paradigms and techniques from cognitive sciences and experimental clinical psychology to study the transdiagnostic psychiatric phenomenon of repetitive negative thinking. This allowed us to investigate the adjustability of the content and characteristics of mind-wandering in individuals varying in their susceptibility to negative affect.
METHODS
Participants high (n = 42) or low (n = 40) on their vulnerability for negative affect and depression performed a Sustained Attention to Response Task (SART) after a single session of positive fantasizing and a single session of stress induction in a cross-over design. Affective states were measured before and after the interventions.
RESULTS
After stress, negative affect increased, while after fantasizing both positive affect increased and negative affect decreased. Thoughts were less off-task, past-related and negative after fantasizing compared to after stress. Individuals more susceptible to negative affect showed more off-task thinking after stress than after fantasizing compared to individuals low on this.
LIMITATIONS
In this cross-over design, no baseline measurement was included, limiting comparison to 'uninduced' mind-wandering. Inclusion of self-related concerns in the SART could have led to negative priming.
CONCLUSIONS
Stress-induced negative thinking underlying vulnerability for depression could be partially countered by fantasizing in a non-clinical sample, which may inform the development of treatments for depression and other disorders characterized by maladaptive thinking.
Topics: Humans; Affect; Depression; Depressive Disorder, Major; Emotions; Cross-Over Studies
PubMed: 37352732
DOI: 10.1016/j.jbtep.2023.101888 -
Frontiers in Psychiatry 2023Self-reported subjective cognitive difficulties (subjective deficits) and rumination are central residual cognitive symptoms following major depressive disorder (MDD)....
Improvement in self-reported cognitive functioning but not in rumination following online working memory training in a two-year follow-up study of remitted major depressive disorder.
Self-reported subjective cognitive difficulties (subjective deficits) and rumination are central residual cognitive symptoms following major depressive disorder (MDD). These are risk factors for more a severe course of illness, and despite the considerable relapse risk of MDD, few interventions target the remitted phase, a high-risk period for developing new episodes. Online distribution of interventions could help close this gap. Computerized working memory training (CWMT) shows promising results, but findings are inconclusive regarding which symptoms improve following this intervention, and its long-term effects. This study reports results from a longitudinal open-label two-year follow-up pilot-study of self-reported cognitive residual symptoms following 25 sessions (40 min), five times a week of a digitally delivered CWMT intervention. Ten of 29 patients remitted from MDD completed two-year follow-up assessment. Significant large improvements in self-reported cognitive functioning on the behavior rating inventory of executive function-adult version appeared after two-years ( = 0.98), but no significant improvements were found in rumination ( < 0.308) measured by the ruminative responses scale. The former showed moderate non-significant associations to improvement in CWMT both post-intervention ( 0.575) and at two-year follow-up ( 0.308). Strengths in the study included a comprehensive intervention and long follow-up time. Limitations were small sample and no control group. No significant differences between completers and drop-outs were found, however, attrition effects cannot be ruled out and demand characteristics could influence findings. Results suggested lasting improvements in self-reported cognitive functioning following online CWMT. Controlled studies with larger samples should replicate these promising preliminary findings.
PubMed: 37342173
DOI: 10.3389/fpsyt.2023.1163073 -
Nature Communications Jun 2023Rumination is a cognitive style characterized by repetitive thoughts about one's negative internal states and is a common symptom of depression. Previous studies have...
Rumination is a cognitive style characterized by repetitive thoughts about one's negative internal states and is a common symptom of depression. Previous studies have linked trait rumination to alterations in the default mode network, but predictive brain markers of rumination are lacking. Here, we adopt a predictive modeling approach to develop a neuroimaging marker of rumination based on the variance of dynamic resting-state functional connectivity and test it across 5 diverse subclinical and clinical samples (total n = 288). A whole-brain marker based on dynamic connectivity with the dorsomedial prefrontal cortex (dmPFC) emerges as generalizable across the subclinical datasets. A refined marker consisting of the most important features from a virtual lesion analysis further predicts depression scores of adults with major depressive disorder (n = 35). This study highlights the role of the dmPFC in trait rumination and provides a dynamic functional connectivity marker for rumination.
Topics: Adult; Humans; Depressive Disorder, Major; Magnetic Resonance Imaging; Prefrontal Cortex; Brain; Brain Mapping
PubMed: 37321986
DOI: 10.1038/s41467-023-39142-9 -
Journal of Affective Disorders Oct 2023Emotional inertia refers to the resistance to update or change an emotional state and is a hallmark of maladaptive emotional dynamics in psychopathology. Little is...
BACKGROUND
Emotional inertia refers to the resistance to update or change an emotional state and is a hallmark of maladaptive emotional dynamics in psychopathology. Little is known, however, about the role of emotion regulation in negative emotional inertia in dysphoria. The current study aimed to explore the association between inertia of discrete negative emotions, and emotion-specific emotion regulation strategy selection use and efficacy in dysphoria.
METHODS
The Center for Epidemiologic Studies Depression Scale (CESD) was used to divide university students into a dysphoria (N = 65) and non-dysphoria control (N = 62) group. Using an experience sampling approach delivered via a smartphone app, participants were queried semi-randomly regarding negative emotions and emotion regulation strategies 10 times a day for 7 consecutive days. Temporal network analysis was employed to estimate autoregressive connections for each discrete negative emotion (inertia of negative emotion) and the bridge connections between negative emotion and emotion regulation clusters.
RESULTS
Participants with dysphoria showed stronger inertia for anger and sadness in the context of the use of emotion-specific regulation strategies. Specifically, individuals with dysphoria displaying greater inertia of anger were more likely to ruminate about the past to cope with anger, and to ruminate on the past and future when experiencing sadness.
LIMITATIONS
Lack of a clinical depression patient group for comparison.
CONCLUSIONS
Our findings suggest an inflexibility to adaptively shift attention from discrete negative emotions in dysphoria and provide important insights for development of interventions to support wellbeing in this population.
Topics: Humans; Ecological Momentary Assessment; Emotions; Depressive Disorder, Major; Anger; Sadness
PubMed: 37315591
DOI: 10.1016/j.jad.2023.06.006 -
Ideggyogyaszati Szemle May 2023
Although rumination and schizotypal traits can be considered transdiagnostic phenomena and can occur within non-clinical population as well, a relatively small...
BACKGROUND AND PURPOSE
Although rumination and schizotypal traits can be considered transdiagnostic phenomena and can occur within non-clinical population as well, a relatively small number of research has been carried out on the topic involving both patient and non clinical participants. The aim of this study is to examine the relationship between schizotypal traits and rumination using a transdiagnostic approach, involving participants living with psychotic disorders and sine morbo individuals.
.METHODS
We recruited participants living with psychotic disorders (paranoid schizophrenia, hebephrenia, schizoaffective disorder, etc.) (n = 30) and controls who had not been diagnosed with any mental illnesses (n = 67). The connection between rumination and schizotypal traits was examined by self-report questionnaire method in a cross-sectional arrangement. The Oxford-Liverpool Inventory was used to measure schizotypal traits, and the Ruminative Thought Style Questionnaire was used to determine the level of rumination.
.RESULTS
Schizotypal symptoms (β = 0.575; p < 0.001), especially cognitive disorganization (β = 0.459; p < 0.001) and unusual experiences (β = 0.221; p = 0.029) significantly explained the degree of rumination.
.CONCLUSION
Our results support the hypothesis that the association between rumination and schizotypic traits is due to decreased cognitive inhibitory functions.
.Topics: Humans; Schizotypal Personality Disorder; Cross-Sectional Studies; Psychotic Disorders; Surveys and Questionnaires; Personality
PubMed: 37294028
DOI: 10.18071/isz.76.0149