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The American Journal of Hospice &... Jun 2024The experience of a patient's death on medical students is powerful and may entail distress and anxiety. We review the experience of death and dying as perceived by...
The experience of a patient's death on medical students is powerful and may entail distress and anxiety. We review the experience of death and dying as perceived by medical students. Students are exposed to death and dying while dissecting cadavers in pre-clinical years, following patient death in clinical years, and commonly as a result of personal exposure. Students report sadness and anger in response to patient death, particularly following their first experience. The patient's identity and the student's past exposure to death were found to influence the way students experience death and dying. Coping methods may include conversation, reflection, and religion as well as detachment and avoidance. Although time and resources are invested in preparing students for a patient's death, many of them feel inadequately prepared. Greater understanding of and investment in processing medical students' experience of patient death may be helpful in their personal and professional development.
PubMed: 38906091
DOI: 10.1177/10499091241264523 -
Frontiers in Psychiatry 2024Sensitivity plays a crucial role in parenting as it involves the ability to perceive and respond appropriately to children's signals. Childhood maltreatment and...
BACKGROUND
Sensitivity plays a crucial role in parenting as it involves the ability to perceive and respond appropriately to children's signals. Childhood maltreatment and depression can negatively impact adults' ability to recognize emotions, but it is unclear which of these factors has a greater impact or how they interact. This knowledge is central to developing efficient, targeted interventions. This paper examines the interaction between parents' depressive symptoms and childhood maltreatment and its influence on their ability to recognize the five basic emotions (happiness, anger, sadness, fear, and disgust) in children's faces.
METHOD
The sample consisted of 52 parents. Depressive symptoms were measured by the depression subscale of the Brief Symptom Inventory-18 (BSI-18), and maltreatment history was assessed by the Childhood Trauma Questionnaire (CTQ). Children's emotional stimuli were morphed images created using The Child Affective Facial Expression (CAFE) database.
RESULTS
Our findings indicate that depressive symptoms moderate the relationship between parents' history of childhood maltreatment and emotion recognition skills. Parents with higher depressive symptoms had lower emotion recognition accuracy when they had not experienced maltreatment. When childhood maltreatment was severe, emotion recognition skills were more consistent across all levels of depression. The relationship between depression and emotion recognition was primarily linked to recognizing sadness in children's faces.
CONCLUSION
These findings highlight how different experiences can affect parental abilities in emotion recognition and emphasize the need for interventions tailored to individual profiles to improve their effectiveness.
PubMed: 38903632
DOI: 10.3389/fpsyt.2024.1374872 -
Translational Psychiatry Jun 2024Whereas meta-analytical data highlight abnormal frontocortical macrostructure (thickness/surface area/volume) in Major Depressive Disorder (MDD), the underlying...
Whereas meta-analytical data highlight abnormal frontocortical macrostructure (thickness/surface area/volume) in Major Depressive Disorder (MDD), the underlying microstructural processes remain uncharted, due to the use of conventional MRI scanners and acquisition techniques. We uniquely combined Ultra-High Field MRI at 7.0 Tesla with Quantitative Imaging to map intracortical myelin (proxied by longitudinal relaxation time T) and iron concentration (proxied by transverse relaxation time T*), microstructural processes deemed particularly germane to cortical macrostructure. Informed by meta-analytical evidence, we focused specifically on orbitofrontal and rostral anterior cingulate cortices among adult MDD patients (N = 48) and matched healthy controls (HC; N = 10). Analyses probed the association of MDD diagnosis and clinical profile (severity, medication use, comorbid anxiety disorders, childhood trauma) with aforementioned microstructural properties. MDD diagnosis (p's < 0.05, Cohen's D = 0.55-0.66) and symptom severity (p's < 0.01, r = 0.271-0.267) both related to decreased intracortical myelination (higher T values) within the lateral orbitofrontal cortex, a region tightly coupled to processing negative affect and feelings of sadness in MDD. No relations were found with local iron concentrations. These findings allow uniquely fine-grained insights on frontocortical microstructure in MDD, and cautiously point to intracortical demyelination as a possible driver of macroscale cortical disintegrity in MDD.
Topics: Humans; Depressive Disorder, Major; Magnetic Resonance Imaging; Female; Male; Adult; Prefrontal Cortex; Gyrus Cinguli; Myelin Sheath; Middle Aged; Iron; Case-Control Studies
PubMed: 38902245
DOI: 10.1038/s41398-024-02976-y -
Cadernos de Saude Publica 2024This study aimed to evaluate the association between employment status and mental health, considering food insecurity as a mediator of this relation. A cross-sectional...
This study aimed to evaluate the association between employment status and mental health, considering food insecurity as a mediator of this relation. A cross-sectional population-based study was conducted with adults (≥ 18 and < 60 years) during the COVID-19 outbreak in two cities from Southern Brazil. Employment status was categorized into working, not working, and lost job. The mental health outcomes evaluated were depressive symptoms, perceived stress, and sadness. Food insecurity was identified by the short-form version of the Brazilian Food Insecurity Scale. Adjusted analyses using Poisson regression were performed to assess the association between employment status and mental health. Mediation analysis was performed to investigate the direct and indirect effects of employment status on mental health outcomes. In total, 1,492 adults were analyzed. The not working status was associated with 53% and 74% higher odds of perceived stress and of sadness, respectively. Being dismissed during the pandemic increased the odds of depressive symptoms, perceived stress, and sadness by 68%, 123%, and 128%, respectively. Mediation analyses showed that food insecurity was an important mediator of the association between employment status and depressive symptoms and sadness, but not of perceived stress. The complexity of these results highlights economic and nutritional aspects involved in mental health outcomes.
Topics: Humans; COVID-19; Brazil; Adult; Female; Cross-Sectional Studies; Male; Food Insecurity; Depression; Middle Aged; Mental Health; Pandemics; Young Adult; Employment; Stress, Psychological; Socioeconomic Factors; SARS-CoV-2; Unemployment; Adolescent
PubMed: 38896594
DOI: 10.1590/0102-311XEN110523 -
Frontiers in Psychiatry 2024Borderline Personality Disorder (BPD) symptoms include inappropriate control of anger and severe emotional dysregulation after rejection in daily life. Nevertheless,...
Borderline Personality Disorder (BPD) symptoms include inappropriate control of anger and severe emotional dysregulation after rejection in daily life. Nevertheless, when using the Cyberball paradigm, a tossing game to simulate social exclusion, the seven basic emotions (happiness, sadness, anger, surprise, fear, disgust, and contempt) have not been exhaustively tracked out. It was hypothesized that these patients would show anger, contempt, and disgust during the condition of exclusion versus the condition of inclusion. When facial emotions are automatically detected by Artificial Intelligence, "blending", -or a mixture of at least two emotions- and "masking", -or showing happiness while expressing negative emotions- may be most easily traced expecting higher percentages during exclusion rather than inclusion. Therefore, face videos of fourteen patients diagnosed with BPD (26 ± 6 years old), recorded while playing the tossing game, were analyzed by the FaceReader software. The comparison of conditions highlighted an interaction for anger: it increased during inclusion and decreased during exclusion. During exclusion, the masking of surprise; i.e., displaying happiness while feeling surprised, was significantly more expressed. Furthermore, disgust and contempt were inversely correlated with greater difficulties in emotion regulation and symptomatology, respectively. Therefore, the automatic detection of emotional expressions during both conditions could be useful in rendering diagnostic guidelines in clinical scenarios.
PubMed: 38895036
DOI: 10.3389/fpsyt.2024.1354762 -
Sensors (Basel, Switzerland) May 2024One of the biggest challenges of computers is collecting data from human behavior, such as interpreting human emotions. Traditionally, this process is carried out by...
One of the biggest challenges of computers is collecting data from human behavior, such as interpreting human emotions. Traditionally, this process is carried out by computer vision or multichannel electroencephalograms. However, they comprise heavy computational resources, far from final users or where the dataset was made. On the other side, sensors can capture muscle reactions and respond on the spot, preserving information locally without using robust computers. Therefore, the research subject is the recognition of the six primary human emotions using electromyography sensors in a portable device. They are placed on specific facial muscles to detect happiness, anger, surprise, fear, sadness, and disgust. The experimental results showed that when working with the CortexM0 microcontroller, enough computational capabilities were achieved to store a deep learning model with a classification store of 92%. Furthermore, we demonstrate the necessity of collecting data from natural environments and how they need to be processed by a machine learning pipeline.
Topics: Humans; Electromyography; Machine Learning; Facial Expression; Emotions; Facial Muscles; Male; Female; Adult
PubMed: 38894141
DOI: 10.3390/s24113350 -
PloS One 2024Major depressive disorder (MDD) is a common and debilitating mental illness characterized by persistent feelings of sadness, hopelessness, and a lack of interest in...
BACKGROUND
Major depressive disorder (MDD) is a common and debilitating mental illness characterized by persistent feelings of sadness, hopelessness, and a lack of interest in daily activities. The objective of this study was to investigate whether levels of macrophage inflammatory protein-1β (MIP-1β) and macrophage chemoattractant protein-2 (MCP-2) in the blood were associated with the pathophysiology and development of MDD compared to healthy controls (HCs).
METHODS
This case-control study was conducted involving 50 MDD patients and 38 HCs. We performed a comprehensive assessment to match age, sex, BMI, and socio-demographic profile between the groups. The study excluded participants with chronic infection, inflammatory diseases, coexisting psychiatric disorder, history of liver and kidney diseases, and individuals who are under antipsychotic medications. A professional psychiatrist diagnosed MDD patients and evaluated HCs based on the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) criteria. The severity of depression was assessed using the Hamilton Depression (Ham-D) rating scale. Commercially available enzyme-linked immunosorbent assay (ELISA) kits were used to quantify the serum MIP-1β and MCP-2 levels.
RESULTS
The results indicated elevated serum MIP-1β levels (207.73±24.24 pg/ml) in MDD patients compared to HCs (58.77±9.14 pg/ml). This difference in concentration is positively correlated with severity of disease symptoms (r = 0.451; p<0.001). Similarly, the levels of MCP-2 were found to be elevated in patients compared to controls (143.61±19.92 vs. 56.84±4.02 pg/ml; p = 0.003), with a positive correlation with the Ham-D scores (r = 0.373; p = 0.004).
CONCLUSION
According to this study, elevated levels of MIP-1β and MCP-2 may be associated with the pathophysiology and development of MDD. These increased serum MIP-1β and MCP-2 levels could be used as risk assessment tools for MDD. The present findings urge further research and the development of therapeutic and diagnostic approaches for depression.
Topics: Humans; Depressive Disorder, Major; Male; Female; Case-Control Studies; Adult; Chemokine CCL4; Chemokine CCL2; Middle Aged; Biomarkers
PubMed: 38889138
DOI: 10.1371/journal.pone.0305734 -
BMC Public Health Jun 2024Social support provided by a family member has been found to have a buffering effect on distress and is associated with better diabetes self-care. This study explores...
BACKGROUND
Social support provided by a family member has been found to have a buffering effect on distress and is associated with better diabetes self-care. This study explores the meaning of social support, as described by close family members of foreign-born people living with type 2 diabetes (PWDM) in Sweden. It also explores the support provided by family members, and the support they need to be able to support the PWDM.
METHODS
Qualitative explorative study, semi-structured interviews for data collection. Qualitative content analysis based on a theoretical framework on social support. Purposive sample of 13 family members, 18-52-years-old, born in countries in the Middle East, Africa, and Russia.
RESULTS
The meaning of support was described as social and emotional. Most participants described a stressful situation; feelings of sadness/worry about the risk of the PWDM developing complications added to a strained life situation from which one could not opt out. Frequent daily contacts in a family network were evident, particularly by children trained as healthcare professionals. Caring for a family member was considered a filial piety, but it was also a chance to reciprocate. The support provided was mainly informational (e.g., reminders about nutritional intake), but it was also instrumental/practical (administering medicines, helping with economy/logistics, planning/cooking meals, basic care) and emotional (sharing meals, thoughts, and activities). The support the family members needed was getting first-hand information by attending the physician visits, being able to book appointments themselves at suitable times, and preventing the withholding of important information about the PWDM. They also desired an open telephone-line, oral and written information, particularly on diet.
CONCLUSIONS
To family-members, supporting the PWDM was normal and a filial piety. Support provided and needed was not only informational but also instrumental/practical and emotional. In diabetes care, addressing foreign-born individuals, diabetes education needs to be developed, also including family members. Informational material, particularly on diet, and improved access to healthcare and information about the healthcare system have the potential to increase family members' control over the situation and prevent a negative trajectory in caregiving with perceived demands causing high levels of stress.
Topics: Humans; Diabetes Mellitus, Type 2; Qualitative Research; Female; Male; Middle Aged; Adult; Sweden; Social Support; Family; Young Adult; Adolescent; Interviews as Topic; Transients and Migrants; Emigrants and Immigrants; Middle East; Africa
PubMed: 38886671
DOI: 10.1186/s12889-024-19101-9 -
Women's Health (London, England) 2024Premenstrual dysphoric disorder is a depressive disorder affecting 5%-8% of people with menstrual cycles. Despite evidence that facial emotion detection is altered in...
BACKGROUND
Premenstrual dysphoric disorder is a depressive disorder affecting 5%-8% of people with menstrual cycles. Despite evidence that facial emotion detection is altered in depressive disorders, with enhanced detection of negative emotions (negativity bias), minimal research exists on premenstrual dysphoric disorder.
OBJECTIVES
The goal of this study was to investigate the effect of premenstrual dysphoric disorder symptoms and the premenstrual phase on accuracy and intensity at detection of facial emotions.
DESIGN
Cross-sectional quasi-experimental design.
METHOD
The Facial Emotion Detection Task was administered to 72 individuals assigned female at birth with no premenstrual dysphoric disorder ( = 30), and provisional PMDD ( = 42), based on a retrospective -based measure of premenstrual dysphoric disorder. Facial emotion detection was examined both irrespective of menstrual cycle phase, and as a function of premenstrual phase (yes, no). The task used neutral-to-emotional facial expression morphs (15 images/morph). Participants indicated the emotion detected for each image within the progressive intensity morph. For all six basic emotions (sad, angry, fearful, happy, disgust, and surprise), two scores were calculated: accuracy of responses and the intensity within the morph at which the correct emotion was first detected (image number).
RESULTS
Individuals reporting moderate/severe symptoms of premenstrual dysphoric disorder had more accurate and earlier detection of disgust, regardless of cycle phase. In addition, those with provisional premenstrual dysphoric disorder detected sad emotions earlier. A premenstrual dysphoric disorder group × cycle phase interaction also emerged: individuals reporting premenstrual dysphoric disorder symptoms were more accurate at detecting facial emotions during the premenstrual phase compared to the rest of the cycle, with a large effect size for sad emotions.
CONCLUSION
The findings suggest enhanced facial emotion processing in individuals reporting symptoms of premenstrual dysphoric disorder, particularly for sadness and disgust. However, replication is required with larger samples and prospective designs. This premenstrual dysphoric disorder premenstrual emotion detection advantage suggests an adaptive cognitive mechanism in premenstrual syndrome/premenstrual dysphoric disorder, and challenges stigma surrounding premenstrual experiences.
Topics: Humans; Female; Premenstrual Dysphoric Disorder; Cross-Sectional Studies; Emotions; Adult; Facial Expression; Menstrual Cycle; Young Adult; Premenstrual Syndrome
PubMed: 38877749
DOI: 10.1177/17455057241259176 -
BMC Psychiatry Jun 2024Self-harm and suicidal ideation are prevalent among adolescents, cause physical and psychosocial disability, and have potentially life-threatening consequences....
BACKGROUND
Self-harm and suicidal ideation are prevalent among adolescents, cause physical and psychosocial disability, and have potentially life-threatening consequences. Dialectical behavioral therapy for Adolescents (DBT-A) is an evidence-based intervention for reducing self-harm. However, few studies have investigated the effectiveness of DBT-A when delivered in routine clinical practice.
METHODS
A follow-up cohort study, based on data from a quality assessment register of DBT-A in child and adolescent mental health services including seven outpatient clinics. Inclusion criteria were ongoing or a history of self-harming behavior the last 6 months; current suicidal behavior; at least 3 criteria of DSM-IV Borderline personality disorder (BPD), or at least the self-destruction criterion of DSM-IV BPD, in addition to minimum 2 subthreshold criteria; and fluency in Norwegian. Participants received 20 weeks of DBT-A consisting of multifamily skills training groups and individual therapy sessions. Outcomes from 41 participants included frequency of self-harm, suicide attempts and hospitalizations caused by self-harm or suicide attempts, assessed pre-, during, and post-treatment by self-report and reviews of the patient's medical records. Suicidal ideation, urge to self-harm and perceived feelings of happiness and sadness were assessed by the patients' diary cards at week 1, 5, 10, 15 and 20 of the treatment program.
RESULTS
Participants attended an average of 17.9 (SD = 4.7) individual sessions, 14.7 (SD = 3.4) group-based skills training sessions and 4.6 (SD = 4.1) brief intersession telephone consultations. Moderate to large within-group effect sizes (ES) were found in self-harm from pre-treatment to 1-5 weeks (d = 0.64), 6-10 weeks (d = 0.84), 11-15 weeks (d = 0.99), 16-20 weeks (d = 1.26) and post-treatment (d = 1.68). Nine participants were admitted to hospitalization during DBT-A, whereas five had attempted suicide, but no suicides were completed. No statistically significant changes were found in suicidal ideation, urge to self-harm or perceived feelings of happiness or sadness from pre to post treatment.
CONCLUSION
The findings of the current study are promising as the participants reported considerably reduced self-harm behavior after DBT-A treatment in a child and adolescent mental health outpatient setting.
Topics: Humans; Adolescent; Female; Dialectical Behavior Therapy; Male; Self-Injurious Behavior; Suicidal Ideation; Suicide, Attempted; Borderline Personality Disorder; Treatment Outcome; Follow-Up Studies; Child
PubMed: 38877441
DOI: 10.1186/s12888-024-05876-z