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Schizophrenia Bulletin Nov 2023Impaired social functioning is a major, but under-elucidated area of schizophrenia. It's typically understood as consequential to, eg, negative symptoms, but... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Impaired social functioning is a major, but under-elucidated area of schizophrenia. It's typically understood as consequential to, eg, negative symptoms, but meta-analyses on the subject have not examined psychopathology in a broader perspective and there's severe heterogeneity in outcome measures. To enhance functional recovery from schizophrenia, a more comprehensive understanding of the nature of social functioning in schizophrenia is needed.
STUDY DESIGN
In this systematic review and meta-analysis, we searched PubMed, PsycInfo, and Ovid Embase for studies providing an association between psychopathology and social functioning. Meta-analyses of the regression and correlation coefficients were performed to explore associations between social functioning and psychopathology, as well as associations between their subdomains.
STUDY RESULTS
Thirty-six studies with a total of 4742 patients were included. Overall social functioning was associated with overall psychopathology (95% CI [-0.63; -0.37]), positive symptoms (95% CI [-0.39; -0.25]), negative symptoms (95% CI [-0.61; -0.42]), disorganized symptoms (95% CI [-0.54; -0.14]), depressive symptoms (95% CI [-0.33; -0.11]), and general psychopathology (95% CI [-0.60; -0.43]). There was significant heterogeneity in the results, with I2 ranging from 52% to 92%.
CONCLUSIONS
This is the first systematic review and meta-analysis to comprehensively examine associations between psychopathology and social functioning. The finding that all psychopathological subdomains seem to correlate with social functioning challenges the view that impaired social functioning in schizophrenia is mainly a result of negative symptoms. In line with classical psychopathological literature on schizophrenia, it may be more appropriate to consider impaired social functioning as a manifestation of the disorder itself.
Topics: Humans; Schizophrenia; Social Interaction; Social Adjustment; Psychopathology; Outcome Assessment, Health Care
PubMed: 37260350
DOI: 10.1093/schbul/sbad075 -
The American Psychologist Dec 2018Impulsiveness has been studied as an aspect of personality and psychopathology for generations. There are longstanding disagreements about how to define it and whether... (Review)
Review
Impulsiveness has been studied as an aspect of personality and psychopathology for generations. There are longstanding disagreements about how to define it and whether it should be viewed as one construct or several. This article begins by briefly reviewing some earlier and some more recent work on impulsiveness. Several approaches have recently converged to focus on a distinction between impulsive reactions to emotion and impulsive properties that are not initiated by emotion. From this review, we turn to psychopathology. It is well known that impulsiveness is related to externalizing psychopathology, but some have concluded that a similar relation does not exist for internalizing psychopathology. A recent literature is described that challenges the latter conclusion, linking impulsive reactivity to emotion to both externalizing and internalizing aspects of psychopathology. Discussion then turns to emotion-related impulsiveness and other constructs to which it is conceptually and empirically related, reexamining whether other conceptual targets should be added to the discussion. The article closes with a consideration of how important it is to continue to remain open to new conceptual perspectives. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Topics: Emotions; Humans; Impulsive Behavior; Inhibition, Psychological; Mental Disorders; Personality; Psychopathology
PubMed: 30525782
DOI: 10.1037/amp0000387 -
La Clinica Terapeutica 2018The uncertainty regarding the scientific status of psychiatry arises from psychiatry's involvement with some unsolved problems, or put in another way, from its... (Review)
Review
INTRODUCTION
The uncertainty regarding the scientific status of psychiatry arises from psychiatry's involvement with some unsolved problems, or put in another way, from its enmeshment in certain points of transition of contemporary science. There is, in primis, the unsolved problem of the relationship between the mind and the body and, moreo- ver, the intricate relationship of connection/disjunction among biology, social science, anthropology, philosophy, etc. To speak about what psychopathology can expect from philosophy is, above all, to immerse oneself in a debate about the conditions of possibility of psychiatry as a science. This debate is especially concerned with the models of knowledge that have, until now, been proposed to psychiatry. Those models oscillate between the Dilthey's paradigms of the "Science of Nature" and the "Science of Spirit".
METHODS
It is certain that psychopathology, as already indicated by Jaspers, is a discipline which is among the most involved regard- ing the use of the two different cognitive strategies. The first strategy concerns the concept of "explanation" and its rigid approach to the objective and ultimate cause of the phenomenon. The second strategy is the "comprehensive" approach. This model, which the hermeneutic thought defines "interpretative", theorizes the provisional character, the subjectiveness and the finiteness of every cognitive project.
RESULTS
The interest of the authors is orientated towards the hermeneutic side (comprehensive-interpretative) of psychiatry, that which deals with the specificity of every clinical history, with the continuity of sense, and with intrinsic narrative intelligibility of every human event, psychopathological or not.
CONCLUSIONS
This approach to psychopathology is based on the statement: "a clinical history is a text which must be interpreted". From this perspective, every clinical history should be perceived as a text to decipher but, above all, as a "text" to listen to, in the persevering expectation that it could disclose its particular "project of world". When speaking about psychiatry, we always face a problem which dominates all the others: the unsolved problem of the relation- ship between typicalness and singularity of subjective events. B.B. Mandelbrot, theorist of "fractals", sums this dilemma up clearly. He suggests that the innumerable variety of the configurations of Nature is a challenge to investigate the morphology of that which is "irregu- lar" in order to discover in it, as far as possible, a rule.
Topics: Humans; Knowledge; Philosophy; Psychiatry; Psychopathology
PubMed: 29938746
DOI: 10.7417/T.2018.2068 -
Tijdschrift Voor Psychiatrie 2022Background Psychiatry and psychology have struggled since their earliest development with the question whether psychopathology manifests itself identically around...
Background Psychiatry and psychology have struggled since their earliest development with the question whether psychopathology manifests itself identically around the world, and whether a disorder can be better understood from a biological or a socio-cultural perspective. Aim To describe the culture and psychopathology debate based on recent developments in ICD and DSM, illustrated with depression and PTSD. Method Clinical experience, previous publications in other languages, and a recent PubMed search on culture and psychopathology. Results There is some consensus in worldwide studies on the universal manifestation of these two disorders. On the other hand, there is broad criticism due to three forms of bias: poor construct validity, looping effects and category truncation. DSM has developed concepts and tools that can enhance cultural competence in practice and in research. Conclusion Researchers and practitioners should develop phenomenological skills to describe and incorporate the local expression of psychological problems into practice. And take into account the three forms of bias mentioned.
Topics: Humans; Mental Disorders; Psychiatry; Psychopathology
PubMed: 36117487
DOI: No ID Found -
Psychology of Addictive Behaviors :... May 2023The causes of substance use disorders (SUDs) are largely unknown and the effectiveness of their treatments is limited. One crucial impediment to research and treatment... (Review)
Review
OBJECTIVE
The causes of substance use disorders (SUDs) are largely unknown and the effectiveness of their treatments is limited. One crucial impediment to research and treatment progress surrounds how SUDs are classified and diagnosed. Given the substantial heterogeneity among individuals diagnosed with a given SUD (e.g., alcohol use disorder [AUD]), identifying novel research and treatment targets and developing new study designs is daunting.
METHOD
In this article, we review and integrate two recently developed frameworks, the National Institute on Drug Abuse's Phenotyping Assessment Battery (NIDA PhAB) and the Hierarchical Taxonomy of Psychopathology (HiTOP), that hope to accelerate progress in understanding the causes and consequences of psychopathology by means of deep phenotyping, or finer-grained analysis of phenotypes.
RESULTS AND CONCLUSIONS
NIDA PhAB focuses on addiction-related processes across multiple units of analysis, whereas HiTOP focuses on clinical phenotypes and covers a broader range of psychopathology. We highlight that NIDA PhAB and HiTOP together provide deep and broad characterizations of people diagnosed with SUDs and complement each other in their efforts to address widely known limitations of traditional classification systems and their diagnostic categories. Next, we show how NIDA PhAB and HiTOP can be integrated to facilitate optimal rich phenotyping of addiction-related phenomena. Finally, we argue that such deep phenotyping promises to advance our understanding of the neurobiology of SUD and addiction, which will guide the development of personalized medicine and interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Humans; Psychopathology; Substance-Related Disorders; Behavior, Addictive; Research Design
PubMed: 36174150
DOI: 10.1037/adb0000878 -
Psychopathology 2019Recently, there has been renewed interest in Schneider's first-rank symptoms (FRS) of schizophrenia, thanks in part to a meta-analysis of their diagnostic accuracy,... (Meta-Analysis)
Meta-Analysis Review
Recently, there has been renewed interest in Schneider's first-rank symptoms (FRS) of schizophrenia, thanks in part to a meta-analysis of their diagnostic accuracy, which deserves much credit for its methodological rigor. Conceptualising FRS as a diagnostic test whose performance can be measured in terms of sensitivity and specificity involves some issues that require reflection. First, the full adequacy of sensitivity as a measure of diagnostic accuracy for FRS might be questioned. However, it is conceptually acceptable, though FRS are at a disadvantage as compared with many other psychiatric "diagnostic tests" that should have perfect sensitivity under ideal conditions. Also, from a psychopathological perspective it may well be argued that FRS cannot be conceptualised as a simple, inexpensive diagnostic test suitable for screening purposes; however, the history of the concept reveals some reasons why it may be legitimate to view them this way. While no other relevant study has appeared after the publication of the meta-analysis, data on a further 166 patients from a study that could not be included due to incompletely reported data were located. This brought the total to 4,236 patients from 17 studies on the ability of FRS to differentiate schizophrenia from other psychoses. The resulting summary estimates of sensitivity, specificity and positive and negative likelihood ratios are 60.2%, 75.9%, 2.50, and 0.52, respectively. FRS have a kind of double nature, as they can be legitimately considered as belonging to both a sophisticated framework grounded in phenomenological psychopathology and an eminently pragmatic framework grounded in clinical epidemiology. When FRS are conceptualised as simple clinical indicators that require low levels of inference, the available estimates of their diagnostic accuracy are a fairly valid appraisal of their performance and usefulness, and suggest that FRS have some value in differential diagnosis. However, when FRS are conceptualised as profoundly anomalous experiences that can be properly identified and evaluated only by using a phenomenological approach, these estimates can hardly be seen as a valid evaluation of their diagnostic significance. Phenomenologically informed studies are needed to address this research gap.
Topics: Female; Humans; Male; Psychopathology; Psychotic Disorders; Schizophrenia
PubMed: 31610542
DOI: 10.1159/000503152 -
Psychopathology 2018Despite the development and widespread diffusion of modern nosographic systems, the diagnosis of schizophrenia continues to raise several epistemological issues. To... (Review)
Review
Despite the development and widespread diffusion of modern nosographic systems, the diagnosis of schizophrenia continues to raise several epistemological issues. To address these issues, a number of researchers are currently pursuing the possibility of an integration between reliable, objective approaches and the intersubjective perspective in the clinical encounter. In the present article, we discuss Rümke's popular concept of praecox feeling, as introduced in 1941 and re-elaborated over the following 20 years. Our aim was to thoroughly analyze the author's original formulation and to identify the connections between his thinking and certain psychopathological developments, epistemological issues, and research perspectives on schizophrenia. The praecox feeling is presented by Rümke as a sensitive diagnostic tool for schizophrenia that is rooted in the peculiar subjective experience of the clinician when encountering a schizophrenic patient. This experience seems to be characterized by two essential dimensions: a subjective one, which reflects the failure of a clinician's empathic effort due to a fundamental alteration of the intersubjective space, a phenomenon related to schizophrenic autism, and a gestaltic, objective one, which is grounded in the clinician's implicit typifying process as a consequence of collecting recurrent clinical observations over the course of his/her professional experience. According to Rümke, the diagnostic use of the praecox feeling should be limited to the acute phases of the schizophrenic process, as the clinician's experience of an intersubjective struggle is attenuated in interactions with older, chronic patients. The multifaceted nature of Rümke's proposal seems to have contributed to some theoretical critiques and to inconclusive results from empirical investigations, leading to a progressive devaluation of the scientific and diagnostic validity of praecox feeling. The present analysis of the original concept suggests that a renewed research interest in the role of the clinician's subjective experience with regard to the schizophrenic patient could be helpful.
Topics: Female; Humans; Male; Psychopathology; Schizophrenia
PubMed: 30380532
DOI: 10.1159/000494088 -
Current Psychiatry Reports Jan 2021In current review, we evaluate the current literature examining the role of disgust in eating disorders (EDs), and provide a theoretical model designed to inform the... (Review)
Review
PURPOSE OF REVIEW
In current review, we evaluate the current literature examining the role of disgust in eating disorders (EDs), and provide a theoretical model designed to inform the study and treatment of disgust-based symptoms in EDs.
RECENT FINDINGS
Findings from this review suggest that aberrant disgust-conditioning processes represent promising but understudied mechanisms that may contribute to the risk and maintenance of core eating disorder (ED) psychopathology. In addition, preliminary evidence supports the use of interventions designed to target aversive disgust cues and disrupt maladaptive disgust-based conditioning that may maintain eating pathology. However, experimental studies designed to elucidate the role of disgust and aversive learning processes remain limited. Disgust is a promising risk and maintenance factor in EDs. Future systematic investigation is needed to examine disgust-based processes at a mechanistic level in order to better understand the links between disgust, avoidance behaviors, and EDs. Further investigation of the mechanistic role of disgust in EDs is warranted.
Topics: Affect; Avoidance Learning; Disgust; Feeding and Eating Disorders; Humans; Psychopathology
PubMed: 33404776
DOI: 10.1007/s11920-020-01217-5 -
European Archives of Psychiatry and... Apr 2012
Topics: Humans; Mental Disorders; Psychopathology
PubMed: 22450356
DOI: 10.1007/s00406-012-0307-x -
Dialogues in Clinical Neuroscience Sep 2018A crisis of confidence was triggered by the disappointment that diagnostic validity, an important goal, was not achieved with the publication of . The Research Domain... (Review)
Review
A crisis of confidence was triggered by the disappointment that diagnostic validity, an important goal, was not achieved with the publication of . The Research Domain Criteria (RDoC) project, which provides a framework for neuroscientific research, was initially conceptualized as an alternative to . However, RDoC and are complementary rather than mutually exclusive. From a historical perspective, this article argues that the debate opposing psychology and brain in psychiatric classification is not new and has an air of déjà vu. We go back to the first classifications based on a scientific taxonomy in the late 18th century with Boissier de Sauvages, which were supposed to describe diseases as they really existed in nature. Emil Kraepelin successfully associated psychopathology and brain research, prefiguring the interaction between and RDoC. DSM symptoms remain valuable because they are the only data that are immediately and directly observable. Computational science is a promising instrument to interconnect psychopathological and neuroscientific data in the future.
Topics: Diagnostic and Statistical Manual of Mental Disorders; History, 18th Century; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Mental Disorders; Neurosciences; Psychiatry; Psychopathology
PubMed: 30581284
DOI: 10.31887/DCNS.2018.20.3/macrocq