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Psychological Medicine Apr 2024The DSM Level 1 Cross-Cutting Symptom Measure (DSM-XC) allows for assessing multiple psychopathological domains. However, its capability to screen for mental disorders...
BACKGROUND
The DSM Level 1 Cross-Cutting Symptom Measure (DSM-XC) allows for assessing multiple psychopathological domains. However, its capability to screen for mental disorders in a population-based sample and the impact of adverbial framings (intensity and frequency) on its performance are unknown.
METHODS
The study was based on cross-sectional data from the 1993 Pelotas birth cohort in Brazil. Participants with completed DSM-XC and structured diagnostic interviews ( = 3578, aged 22, 53.6% females) were included. Sensitivity, specificity, positive (LR+), and negative (LR-) likelihood ratios for each of the 13 DSM-XC domains were estimated for detecting five internalizing disorders (bipolar, generalized anxiety, major depressive, post-traumatic stress, and social anxiety disorders) and three externalizing disorders (antisocial personality, attention-deficit/hyperactivity, and alcohol use disorders). Sensitivities and specificities >0.75, LR+ > 2 and LR- < 0.5 were considered meaningful. Values were calculated for the DSM-XC's original scoring and for adverbial framings.
RESULTS
Several DSM-XC domains demonstrated meaningful screening properties. The anxiety domain exhibited acceptable sensitivity and LR- values for all internalizing disorders. The suicidal ideation, psychosis, memory, repetitive thoughts and behaviors, and dissociation domains displayed acceptable specificity for all disorders. Domains also yielded small but meaningful LR+ values for internalizing disorders. However, LR+ and LR- values were not generally meaningful for externalizing disorders. Frequency-framed questions improved screening properties.
CONCLUSIONS
The DSM-XC domains showed transdiagnostic screening properties, providing small but meaningful changes in the likelihood of internalizing disorders in the community, which can be improved by asking frequency of symptoms compared to intensity. The DSM-XC is currently lacking meaningful domains for externalizing disorders.
PubMed: 38639338
DOI: 10.1017/S0033291724000849 -
PloS One 2024Juvenile antisocial behavior can have long-lasting and devastating effects for juveniles themselves, victims, and society. Evidence-based treatment is vital. Forensic...
BACKGROUND
Juvenile antisocial behavior can have long-lasting and devastating effects for juveniles themselves, victims, and society. Evidence-based treatment is vital. Forensic Outpatient Systemic Therapy (Forensische Ambulante Systeem Therapie; FAST) is a promising treatment for juveniles showing severe antisocial behavior including aggression, (domestic) violence, and delinquent behavior. FAST has a flexible intensity and length, addresses individual and systemic risk and protective factors, and is responsive to the abilities of the client (system), intervention characteristics all considered crucial for effective treatment. The current study will investigate whether FAST is effective in reducing aggression of the juvenile, reaching client formulated subgoals, and improving family functioning. Processes of change will be examined, as well as mediation by reaching client formulated subgoals and improved family functioning.
METHODS
A Multiple Case Experimental Design (MCED) with an ABC design will be performed (A = baseline, B = intervention, and C = follow-up). Juveniles with primary aggression and/or anger problems (N = 15) and their caregiver(s) will be recruited. Data collection will consist of self-report questionnaires and case file analysis. Participants fill out frequent short self-report questionnaires (twice a week during phase A, every other week during phase B, and every week during phase C) and two main questionnaires at the start of the intervention and immediately after intervention end, thereby covering a period of 5 to 11 months. Both visual and statistical analyses will be performed.
DISCUSSION
This study will generate robust knowledge and inform clinical practice on the effectiveness, processes of change, and mediating mechanisms of FAST, aiming to improve the treatment of future families within youth forensic care.
TRIAL REGISTRATION
This trial was registered at ClinicalTrials.gov on 28/08/2023, protocol ID 60-63600-98-1138a.
Topics: Adolescent; Humans; Aggression; Antisocial Personality Disorder; Outpatients; Research Design; Treatment Outcome
PubMed: 38635676
DOI: 10.1371/journal.pone.0298057 -
JAMA Psychiatry Jul 2024Several factors may place people with mental health disorders, including substance use disorders, at increased risk of experiencing homelessness and experiencing... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Several factors may place people with mental health disorders, including substance use disorders, at increased risk of experiencing homelessness and experiencing homelessness may also increase the risk of developing mental health disorders. Meta-analyses examining the prevalence of mental health disorders among people experiencing homelessness globally are lacking.
OBJECTIVE
To determine the current and lifetime prevalence of mental health disorders among people experiencing homelessness and identify associated factors.
DATA SOURCES
A systematic search of electronic databases (PubMed, MEDLINE, PsycInfo, Embase, Cochrane, CINAHL, and AMED) was conducted from inception to May 1, 2021.
STUDY SELECTION
Studies investigating the prevalence of mental health disorders among people experiencing homelessness aged 18 years and older were included.
DATA EXTRACTION AND SYNTHESIS
Data extraction was completed using standardized forms in Covidence. All extracted data were reviewed for accuracy by consensus between 2 independent reviewers. Random-effects meta-analysis was used to estimate the prevalence (with 95% CIs) of mental health disorders in people experiencing homelessness. Subgroup analyses were performed by sex, study year, age group, region, risk of bias, and measurement method. Meta-regression was conducted to examine the association between mental health disorders and age, risk of bias, and study year.
MAIN OUTCOMES AND MEASURES
Current and lifetime prevalence of mental health disorders among people experiencing homelessness.
RESULTS
A total of 7729 citations were retrieved, with 291 undergoing full-text review and 85 included in the final review (N = 48 414 participants, 11 154 [23%] female and 37 260 [77%] male). The current prevalence of mental health disorders among people experiencing homelessness was 67% (95% CI, 55-77), and the lifetime prevalence was 77% (95% CI, 61-88). Male individuals exhibited a significantly higher lifetime prevalence of mental health disorders (86%; 95% CI, 74-92) compared to female individuals (69%; 95% CI, 48-84). The prevalence of several specific disorders were estimated, including any substance use disorder (44%), antisocial personality disorder (26%), major depression (19%), schizophrenia (7%), and bipolar disorder (8%).
CONCLUSIONS AND RELEVANCE
The findings demonstrate that most people experiencing homelessness have mental health disorders, with higher prevalences than those observed in general community samples. Specific interventions are needed to support the mental health needs of this population, including close coordination of mental health, social, and housing services and policies to support people experiencing homelessness with mental disorders.
Topics: Ill-Housed Persons; Humans; Mental Disorders; Prevalence; Adult; Substance-Related Disorders
PubMed: 38630486
DOI: 10.1001/jamapsychiatry.2024.0426 -
Physiology & Behavior Jun 2024This study investigated the relationship between psychopathy, as assessed by the Levenson Self-Report Psychopathy (LSRP) scale, and cerebral laterality. EEG recordings...
This study investigated the relationship between psychopathy, as assessed by the Levenson Self-Report Psychopathy (LSRP) scale, and cerebral laterality. EEG recordings from frontal cortex (L3 and L4) were taken during both resting conditions and while viewing a video of an emergency field amputation, used as an empathic challenge. The ratio of alpha power from the two recording site was taken as an index of relative activity in the two hemispheres. Eighty three students from the University subject pool were recruited as participants. Male participants had a significantly higher mean LSRP score than did female participants. While LSRP scores were unrelated to cerebral laterality under resting conditions, there was both a significant linear and quadratic negative relationship between LSRP scores and relative left-hemisphere alpha activity. As alpha activity has been reported to be inversely related to brain or mental activity, a negative relationship can be inferred between LSRP scores and right hemisphere neural activity. The female participants had a much stronger quadratic relationship than did the combined sample, while the male sample showed only weak, non-significant relationships. Our data suggest that the relationship between psychopathy and cerebral laterality may be sexually dimorphic.
Topics: Humans; Male; Female; Functional Laterality; Empathy; Sex Characteristics; Young Adult; Electroencephalography; Adult; Antisocial Personality Disorder; Adolescent; Alpha Rhythm; Self Report
PubMed: 38614417
DOI: 10.1016/j.physbeh.2024.114535 -
Law and Human Behavior Apr 2024Borderline and antisocial personality disorders are characterized by pervasive psychosocial impairment, disproportionate criminal justice involvement, and high mental...
Prison or treatment? Gender, racial, and ethnic inequities in mental health care utilization and criminal justice history among incarcerated persons with borderline and antisocial personality disorders.
OBJECTIVE
Borderline and antisocial personality disorders are characterized by pervasive psychosocial impairment, disproportionate criminal justice involvement, and high mental health care utilization. Although some evidence suggests that systemic bias may contribute to demographic inequities in criminal justice and mental health care among persons experiencing these mental health conditions, no research to date has explicitly examined such differences.
HYPOTHESES
Women and White persons would be more likely to endorse internalizing symptoms and have a more extensive history of mental health service utilization, whereas men, persons from minoritized racial groups, and persons identifying as Hispanic/Latino would be more likely to endorse externalizing symptoms and have more extensive histories of involvement with the criminal justice system.
METHOD
This study examined gender, racial, and ethnic differences in symptom presentation, criminal justice history, and mental health care utilization in a sample of 314 adults with comorbid borderline and antisocial personality disorders enrolled in prison-based substance use treatment programs in the United States.
RESULTS
Results suggested that men with these personality disorders were more likely to have early extensive criminal justice involvement, whereas women and White people had more extensive mental health treatment histories. Women were also more likely to endorse a range of internalizing symptoms, and White and non-Hispanic participants were more likely to endorse a history of reckless behavior. Notably, however, many associations-particularly, racial differences in symptom presentation and mental health utilization history and gender differences in symptom presentation-did not persist after we controlled for preincarceration employment and educational attainment.
CONCLUSION
Results highlight a range of gender, racial, and ethnic inequities in criminal justice involvement and mental health utilization among this high-risk high-need population. Findings attest to the likely impact of societal, structural, and systemic factors on trajectories of persons affected by this comorbidity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Topics: Adult; Female; Humans; Male; Antisocial Personality Disorder; Criminal Law; Mental Disorders; Patient Acceptance of Health Care; Prisoners; Prisons; Racial Groups; United States; Minority Groups; White; Hispanic or Latino
PubMed: 38602804
DOI: 10.1037/lhb0000557 -
Psychopharmacology Bulletin Apr 2024Zolpidem is a widely used hypnotic. Dependence on zolpidem due to the induction of euphoria is a rare condition, while intranasal misuse of zolpidem is a rather new...
Zolpidem is a widely used hypnotic. Dependence on zolpidem due to the induction of euphoria is a rare condition, while intranasal misuse of zolpidem is a rather new phenomenon. We present the first case of a patient who developed zolpidem dependence, which was associated with the prompt onset of euphoria exclusively following intranasal use. Mr. A was a 51-year-old polydrug abuser with antisocial personality disorder and a physical dependence on zolpidem. Over several years, he consumed 500 mg of the drug daily, usually divided into 30 mg doses, exclusively via the nasal route because unlike the oral administration of the same dose of the drug, intranasal administration induced euphoria. Euphoric effects manifested 3-5 minutes after taking the drug, and pronounced withdrawal symptoms (i.e., profuse sweating, tremors, nausea, vomiting, diarrhea, and inability to drink and eat), present 7-8 hours after the use could disappear within 3-5 minutes upon drug re-administration. The dependence was managed through a slow tapering of the zolpidem use. Clinicians should be aware that intranasal use of zolpidem could be associated with euphoric effects and the development of addiction. The potential for misuse of zolpidem via the nasal route may be of interest for future research.
Topics: Male; Humans; Middle Aged; Zolpidem; Pyridines; Administration, Intranasal; Hypnotics and Sedatives; Substance-Related Disorders
PubMed: 38601832
DOI: No ID Found -
Scientific Reports Apr 2024Social decisions are influenced by a person's social preferences. High psychopathy is defined by antisocial behaviour, but the relationship between psychopathy and...
Social decisions are influenced by a person's social preferences. High psychopathy is defined by antisocial behaviour, but the relationship between psychopathy and social preferences remains unclear. In this study, we used a battery of economic games to study social decision-making and social preferences in relation to psychopathy in a sample of 35 male prison inmates, who were arrested for sexual and severe violent offenses (mean age = 39 years). We found no evidence for a relationship between social preferences (measured with the Dictator and Ultimatum Games, Social Value Orientation, and one-shot 2 × 2 games) and psychopathy (measured by the overall Hare Psychopathy Checklist-Revised score and both factors). These results are surprising but also difficult to interpret due to the small sample size. Our results contribute to the ongoing debate about psychopathy and social decision-making by providing crucial data that can be combined with future datasets to reach large sample sizes that can provide a more nuanced understanding about the relationship between psychopathy and social preferences.
Topics: Humans; Male; Adult; Antisocial Personality Disorder; Pilot Projects; Prisoners; Aggression; Social Behavior Disorders
PubMed: 38594328
DOI: 10.1038/s41598-024-59066-8 -
Journal of Personality Disorders Apr 2024Two studies examined the consistency of associations between specific components of psychopathy and two indices of drug use: (a) abstinence and (b) severity (i.e.,...
Two studies examined the consistency of associations between specific components of psychopathy and two indices of drug use: (a) abstinence and (b) severity (i.e., counts) of lifetime substance use disorder (SUD) symptoms. Participants were 418 male county jail inmates in Illinois (Study One) and 354 male state prison inmates in New Mexico (Study Two). Across samples, lifestyle and antisocial trait ratings were associated with a reduced likelihood of abstinence from most substances. Lifestyle traits were also uniquely associated with severity of substance dependence ratings. Consistent with prior research, interpersonal traits were uniquely related to cocaine indices in both samples. Furthermore, analyses revealed negative associations between the affective features of psychopathy and alcohol dependence in one sample (Study Two), and illicit substance use across samples. These findings demonstrate the robustness of the associations between the interpersonal and affective features of psychopathy and specific aspects of substance (mis)use.
Topics: Humans; Male; Antisocial Personality Disorder; Prisoners; Substance-Related Disorders
PubMed: 38592911
DOI: 10.1521/pedi.2024.38.2.138 -
Law and Human Behavior Feb 2024The Minnesota Multiphasic Personality Inventory (MMPI) instruments have a long history with respect to the assessment of psychopathic personality traits. The most recent...
OBJECTIVE
The Minnesota Multiphasic Personality Inventory (MMPI) instruments have a long history with respect to the assessment of psychopathic personality traits. The most recent version, the MMPI-3, should be in a good position to continue this tradition, and the aim of the current research was to evaluate its scales for this purpose. We examined, on the basis of previous research, how well conceptually relevant MMPI-3 scales mapped onto dominant contemporary psychopathy models: the traditional three-factor model and triarchic psychopathy model.
HYPOTHESES
We hypothesized that MMPI-3 markers of internalizing would be negatively correlated with boldness, whereas broad and specific markers of externalizing proclivities would be associated with disinhibition and antisociality. We also hypothesized that egocentricity and callousness would be associated with MMPI-3 scales measuring various features of externalizing, interpersonal aggression/antagonism, and grandiosity.
METHOD
We used archival samples of male prison inmates (n = 452), community members with externalizing proclivities (n = 205), and university students (n = 645). These participants completed the Expanded Levenson Self-Report Psychopathy Scale and the Triarchic Psychopathy Measure.
RESULTS
Zero-order correlation analyses indicated support for many of our hypotheses across samples, with notable exceptions. Regression and dominance analyses yielded information about the most potent MMPI-3 predictors of each psychopathy domain, with consistency across the three samples. Boldness was associated with low scores on Emotional/Internalizing Dysfunction, Low Positive Emotions, Shyness, and Negative Emotionality/Neuroticism and high scores on Self-Importance and Dominance. For meanness and disinhibition, we found substantial overlap with MMPI-3 scales (e.g., Behavioral/Externalizing Dysfunction, Antisocial Behavior). Meanness was indicated by high Aggression, Cynicism, Aggressiveness, and Disaffiliativeness; disinhibition/antisociality was primarily marked by high Antisocial Behavior, Hypomanic Activation, Impulsivity, and Disconstraint; and Anger Proneness, Aggression, and Cynicism were secondary indicators.
CONCLUSIONS
These findings provide support for using the MMPI-3 in clinical assessments to corroborate other sources of information regarding psychopathy as well as generate hypotheses for further consideration. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Topics: Humans; Male; MMPI; Universities; Aggression; Anger; Antisocial Personality Disorder
PubMed: 38573701
DOI: 10.1037/lhb0000552