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Frontiers in Psychiatry 2021The global dissemination of COVID-19 creates confusion and ambiguity in nearly every aspect of life, including fear of contagion, heightened awareness of the mortality...
The global dissemination of COVID-19 creates confusion and ambiguity in nearly every aspect of life, including fear of contagion, heightened awareness of the mortality of self and family members, lack of power, and distrust of experts and decision-makers. In this stressful situation, the question arises as to what mechanisms distinguish between adaptive and maladaptive self-regulation. The theory of Motivated Cue-Integration (MCI) is a novel theory of self-regulation that provides a new perspective on the effect of COVID-19 on self-regulation deficiency as an example of psychological distress. Inspired by predictive coding, social cognition, embodied cognition, and experiential approach, MCI suggests that self-regulation is based on interaction between (1) high-level values and goals, (2) low-level interoceptive and exteroceptive signals, and (3) trust in epistemic authority or a significant other. Motivated Cue-Integration posits that individuals create meaning by making moment-to-moment predictions that affect their interpretation of the experience of ambiguity influenced by their relationship with epistemic authority. According to MCI, deficiency in self-regulation during COVID-19 could result either from over-sensitivity or under-sensitivity to low-level interoceptive and exteroceptive cues; rigidity or ambiguity of high-level goals, poor integration between the two levels of processing as well as distrust in epistemic authority. According to MCI, variations of these deficiencies may occur in various clinical phenomena such as alexithymia and somatization, as well as in social phenomena such as goal radicalization. Based on this reasoning, MCI claims that the mentalization of the relationship between interoceptive cues, exteroceptive cues, goals, and psychological needs of the person, as well as the improvement of confidence in epistemic authority, can promote adaptive self-regulation. Psychological intervention can foster trust in epistemic authority, increase the mentalization of interoceptive and exteroceptive cues, and their association with adaptive goals. As such, the integration of these elements in a way that facilitates incentives pathways and insight fosters a more integrated subjective experience, higher clarity of emotion, and positive internal dialogue which promotes action tendency.
PubMed: 34177640
DOI: 10.3389/fpsyt.2021.631758 -
Environmental Research Mar 2022Early, chronic, low-level fluoride exposure has been linked to attention-deficit hyperactivity disorder (ADHD) and learning deficits in children. Rodent studies suggest...
BACKGROUND
Early, chronic, low-level fluoride exposure has been linked to attention-deficit hyperactivity disorder (ADHD) and learning deficits in children. Rodent studies suggest a link between fluoride exposure and internalizing behaviors. No human studies have examined the impact of fluoride on internalizing behaviors during adolescence.
OBJECTIVE
Evaluate the relationship between urinary fluoride and early adolescent internalizing symptoms in the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS).
METHODS
Participants in CCAAPS provided non-fasting spot urine samples at age 12 years (n = 286). Urine samples were analyzed using a microdiffusion method to determine childhood urinary fluoride (CUF) concentrations and were log-transformed for analyses. Caregivers of CCAAPS participants completed the Behavior Assessment System for Children-2 (BASC-2) at the age 12 study visit to assess internalizing symptoms (e.g., anxiety, depression, somatization), and a composite score of the three domains; T-scores ≥ 60 were used to identify adolescents in a clinically "at-risk" range. Race, age of the adolescent, household income, maternal age at birth, caregiver depression, caregiver-child relationships, and age 12-year serum cotinine concentrations were considered covariates in regression models. Sex-specific effects of fluoride exposures were investigated through the inclusion of interaction terms.
RESULTS
Higher CUF concentrations were significantly associated with increased somatization (β = 3.64, 95% CI 0.49, 6.81) and internalizing composite T-scores in a clinically "at-risk" range (OR = 2.9, 95% CI 1.24, 6.9). Compared to females, males with higher CUF concentrations had more internalizing (p = 0.04) and somatization symptoms (p = 0.02) and were nearly seven times more likely to exhibit "at-risk" internalizing symptomology. CUF concentrations were not significantly associated with depression or anxiety symptoms.
CONCLUSIONS
This is the first study to link fluoride exposure and internalizing symptoms, specifically somatization. Somatization represents an interface of physical and psychological health. Continued follow-up will help shed light on the sex-specific relationship between fluoride and mental health and the role of somatization.
Topics: Adolescent; Air Pollution; Anxiety; Attention Deficit Disorder with Hyperactivity; Child; Female; Fluorides; Humans; Male; Mental Health
PubMed: 34755609
DOI: 10.1016/j.envres.2021.112296 -
Frontiers in Psychology 2020To investigate whether chronic pain (CP) patients with somatization reported higher alexithymic traits than those without somatization and to study the different...
OBJECTIVE
To investigate whether chronic pain (CP) patients with somatization reported higher alexithymic traits than those without somatization and to study the different relationships between psychological characteristics, pain, health-related quality of life (HRQL), and somatization.
METHOD
A consecutive sample of 134 CP treatment-seeking outpatients were evaluated for alexithymia (TAS-20), somatization (PHQ-15), distress (HADS), HRQL (SF-12), and pain (BPI).
RESULTS
Patients with somatization (37.04%) reported significantly higher TAS-20 total scores ( < 0.001) and difficulty in identifying feelings (DIF) ( < 0.001) than those without somatization. The somatizer group had also a significantly higher disease duration, severity and interference of pain, distress, and lower HRQL than the non-somatizer group. Hierarchical regression analysis showed that although distress, pain interference and the mental HRQL component are closely related to somatization ( = 0.55), DIF was the strongest predictor of severity of somatization (β = 0.31). A sequential indirect effect from DIF to somatization via distress symptoms and pain interference turned out to be significant [95% CI (0.01, 0.09)]. Support was also found for sequential mediation paths from DIF to somatization via distress and mental HRQL [95% CI (0.01, 0.11)].
CONCLUSIONS
Our results pointed-out that alexithymia, particularly DIF, may be major factor for somatization risk in CP patients. Longitudinal observations are needed for evaluating the role of alexithymia in clinical outcomes.
PubMed: 33192791
DOI: 10.3389/fpsyg.2020.545881 -
Journal of Preventive Medicine and... Dec 2019Today mental disorders are important concerns of health care system in all countries. Among different mental disorders; depression, anxiety, and somatization are more...
INTRODUCTION
Today mental disorders are important concerns of health care system in all countries. Among different mental disorders; depression, anxiety, and somatization are more frequent. This manuscript was conducted to evaluate the frequency of somatization symptoms, its related factors and the correlation between somatization symptoms and anxiety and depression disorders in Iranian population.
METHODS
The cross-sectional study was conducted in Kerman, Iran, 2017. Participants were selected from patients who referred to the Clinics of Educational Hospitals using convenience sampling method. The PHQ-15 and HADS questionnaire were used to assess the somatization and depression and anxiety, respectively. The univariate and multivariate logistic regression was used to determine the predictive factors of somatization symptoms. The correlations between each PHQ-15 item score and anxiety and depression score were expressed.
RESULTS
The frequency of mild, moderate and severe levels of somatization was 66.3%, 20.5% and 13.1%, respectively. Considering multivariate logistic regression analysis; age was associated with somatic symptoms, significantly. The risk of somatic symptoms was 3.4 times more in Divorced/Widowed participants than single ones (p-value: 0.035). There were significant positive correlations between anxiety and depression scores. Each additional score of anxiety and depression were associated with 1.14 times more likely (p-value: < 0.001) and 1.11 times less likely (p-value: 0.003) of having somatic symptoms, respectively.
CONCLUSION
The burden of somatization, depression and anxiety is high in Iranian population. Psychologists and policy-makers should consider these predictive factors for primary prevention of somatization at the personal and community level, respectively.
Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Anxiety; Child; Cross-Sectional Studies; Depression; Divorce; Female; Humans; Iran; Logistic Models; Male; Marital Status; Middle Aged; Multivariate Analysis; Patient Health Questionnaire; Prevalence; Risk Factors; Somatoform Disorders; Widowhood; Young Adult
PubMed: 31967099
DOI: 10.15167/2421-4248/jpmh2019.60.4.1006 -
Brain Communications 2020With the creation of the Somatic Symptom and Related Disorders category of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition in 2013, the... (Review)
Review
With the creation of the Somatic Symptom and Related Disorders category of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition in 2013, the functional neurological (symptom) disorder diagnostic criteria underwent transformative changes. These included an emphasis on 'rule-in' physical examination signs/semiological features guiding diagnosis and the removal of a required proximal psychological stressor to be linked to symptoms. In addition, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition somatization disorder, somatoform pain disorder and undifferentiated somatoform disorder conditions were eliminated and collapsed into the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition somatic symptom disorder diagnosis. With somatic symptom disorder, emphasis was placed on a cognitive-behavioural (psychological) formulation as the basis for diagnosis in individuals reporting distressing bodily symptoms such as pain and/or fatigue; the need for bodily symptoms to be 'medically unexplained' was removed, and the overall utility of this diagnostic criteria remains debated. A consequence of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition restructuring is that the diagnosis of somatization disorder that encompassed individuals with functional neurological (sensorimotor) symptoms prominent other bodily symptoms, including pain, was eliminated. This change negatively impacts clinical and research efforts because many patients with functional neurological disorder experience pain, supporting that the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition would benefit from an integrated diagnosis at this intersection. We seek to revisit this with modifications, particularly since pain (and a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition somatization disorder comorbidity, more specifically) is associated with poor clinical prognosis in functional neurological disorder. As a first step, we systematically reviewed the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition somatization disorder literature to detail epidemiologic, healthcare utilization, demographic, diagnostic, medical and psychiatric comorbidity, psychosocial, neurobiological and treatment data. Thereafter, we propose a preliminary revision to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition allowing for the specifier functional neurological disorder 'with prominent pain'. To meet this criterion, core functional neurological symptoms (e.g. limb weakness, gait difficulties, seizures, non-dermatomal sensory loss and/or blindness) would have 'rule-in' signs pain (>6 months) impairing social and/or occupational functioning would also be present. Two optional secondary specifiers assist in characterizing individuals with cognitive-behavioural (psychological) features recognized to amplify or perpetuate pain and documenting if there is a pain-related comorbidity. The specifier of 'with prominent pain' is etiologically neutral, while secondary specifiers provide additional clarification. We advocate for a similar approach to contextualize fatigue and mixed somatic symptoms in functional neurological disorder. While this preliminary proposal requires prospective data and additional discussion, these revisions offer the potential benefit to readily identify important functional neurological disorder subgroups-resulting in diagnostic, treatment and pathophysiology implications.
PubMed: 33426523
DOI: 10.1093/braincomms/fcaa156 -
Agri : Agri (Algoloji) Dernegi'nin... Jul 2022Psychiatric disorders including somatization impact pain severity and chronicity. This study aimed to determine sleep quality and the presence of psychiatric disorders...
OBJECTIVES
Psychiatric disorders including somatization impact pain severity and chronicity. This study aimed to determine sleep quality and the presence of psychiatric disorders in patients with chronic lateral epicondylitis (LE) and to investigate the effect of these comorbidities on pain levels.
METHODS
This study included 46 patients diagnosed with chronic LE and 46 healthy controls. Visual analog scale (VAS) was used for the assessment of pain intensity. The prevalence of depression and other psychological factors was examined using Beck Depression Inventory (BDI) and the Symptom Checklist-90-Revised test (SCL-90-R). Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality.
RESULTS
The mean BDI (p<0.001), all subdivisions of SCL-90-R including somatization (p<0.001), and the mean global PSQI scores (p=0.002) were found to be significantly higher in patients with chronic LE than those in the control group. The presence of depression according to BDI was 41.3% in the patient group. About 60.8% of the patients had somatization and 71.7% had poor sleep quality. VAS scores were significantly higher in the patients with depression, somatization, and low sleep quality indicating a low positive linear relationship (r=0.357, r=0.360, and r=0.463, respectively, and all p<0.05).
CONCLUSION
Psychiatric disorders and poor sleep quality are frequently observed in patients with chronic LE. These comorbidities negatively affect pain levels and may be linked to pain chronicity. Therefore, the potential coexistence of psychiatric disorders should be kept in mind when determining the treatment protocols for patients with chronic LE and adjunctive treatment should be given if necessary.
Topics: Humans; Mental Disorders; Pain; Sleep Quality; Sleep Wake Disorders; Tennis Elbow
PubMed: 35792693
DOI: 10.14744/agri.2021.24119 -
Journal of Immigrant and Minority Health Dec 2020Many studies reveal the effectiveness of different psychological interventions on the adult refugees reporting mental health distress. Aim of this metanalysis was to... (Meta-Analysis)
Meta-Analysis Review
Many studies reveal the effectiveness of different psychological interventions on the adult refugees reporting mental health distress. Aim of this metanalysis was to test the efficacy of different psychological treatments on the depressive, anxiety and somatization symptoms on refugees and asylum seekers. Fifty-two studies, since 1997 to 2019, were included in the systematic review and 27 of those were included in the metanalysis. Studies providing a pre and post treatment methodological design were included. All treatments reported significant effects on the three outcomes. Qualitative observations showed a probability to have a significant pre-post treatment effects on trials with outcome of depression (56%), anxiety (44%), and somatization (42%). Cognitive behavioral treatment resulted the most effective treatment. The status of refugee compared to the status of asylum seeker seems to have a great effect on the effectiveness of the treatment.
Topics: Adult; Anxiety; Depression; Humans; Psychosocial Intervention; Refugees; Stress Disorders, Post-Traumatic; Transients and Migrants
PubMed: 32712851
DOI: 10.1007/s10903-020-01055-w -
Journal of Clinical Hypertension... Jul 2023To explore the moderating effect of mindfulness on the relationship between anxiety and somatization symptoms in middle-aged and elderly female patients with...
To explore the moderating effect of mindfulness on the relationship between anxiety and somatization symptoms in middle-aged and elderly female patients with hypertension and provide a foundation for the development of more effective mindfulness intervention strategies. A total of 109 middle-aged and elderly female patients with hypertension participated in this cross-sectional study from April to July 2022 and provided valid responses to the Five Facet Mindfulness Questionnaire (FFMQ), the Hospital Anxiety and Depression Scale (HADS), and the Somatization Symptom Self-rating Scale (SSS). The moderating effect of mindfulness was determined using multiple linear regression. The participants' average scores were as follows: mindfulness: 123.86 ± 10.49; anxiety: 7.41 ± 3.62; and somatization symptoms: 41.2 ± 9.44. The anxiety (P = .000) and somatization symptoms (P = .001) of participants with high mindfulness were significantly reduced. Anxiety was positively correlated with somatization symptoms (r = 0.606, P = .000), while mindfulness was negatively correlated with both anxiety (r = -0.468, P = .000) and somatization symptoms (r = -0.439, P = .000). Moreover, mindfulness had a significant moderating effect on the relationship between anxiety and somatization symptoms (n = 109) (B = -0.166, t = -2.125, P = .036). The effect of mindfulness on anxiety and somatization symptoms was more significant in participants with low mindfulness levels (n = 56) (B = 0.144, t = 2.805, P = .008) than in participants with high mindfulness levels (n = 53) (B = -0.037, t = -0.864, P = .393). The moderating effect analysis based on regression analysis showed that mindfulness had a significant moderating effect on anxiety and somatization symptoms, especially in participants with low mindfulness levels.
Topics: Middle Aged; Aged; Humans; Female; Mindfulness; Cross-Sectional Studies; Depression; Hypertension; Anxiety
PubMed: 37254882
DOI: 10.1111/jch.14670 -
Healthcare (Basel, Switzerland) Jun 2022Somatization and number of diseases are interrelated variables, whose association with stress-coping strategies, according to sex, has not been investigated. Therefore,...
Somatization and number of diseases are interrelated variables, whose association with stress-coping strategies, according to sex, has not been investigated. Therefore, the aim of this study was to investigate such association in a sample of the Mexican general population. The general population was invited to answer an electronic questionnaire via the social networks-e-mail, WhatsApp and Facebook-by the research team. A sample of 1008 adults was obtained, of which 62.2% were women, in whom we detected higher levels of negative psychological variables, somatization and number of diseases and lower levels of sleep quality. Positive moderate correlations were found between depresion, anxiety and stress with somatization, on one hand, and with the number of diseases, on the other, and negative moderate correlations were found between sleep quality and the two dependent variables. As for the coping strategies, self-blame, behavioral disengagement, denial, self-distraction and substance use were positively correlated with somatization. Of these, self-blame, substance use, and self-distraction also showed a positive correlation with number of diseases in both sexes. Negative correlations were detected for active coping and the two dependent variables in men and for religion and planning with somatization in women. In conclusion, the coping strategies showed significant correlations with somatization and number of diseases in both sexes.
PubMed: 35742099
DOI: 10.3390/healthcare10061048 -
Cureus Oct 2022Somatization refers to the condition in which psychological distress is shown in the form of somatic symptoms such as persistent headache, nausea, gastrointestinal... (Review)
Review
Somatization refers to the condition in which psychological distress is shown in the form of somatic symptoms such as persistent headache, nausea, gastrointestinal discomfort, etc. Various predisposing factors, including familial such as high expressed emotion, poor parental care, genetic, biological, and demographic which includes age and gender, cognitive such as learning disabilities, psychiatric such as depression, anxiety, post-traumatic stress disorder, social, etc., play an essential role in saturation of the disease. During the time of the COVID-19 pandemic, psychological distress increased in the patients infected with the coronavirus due to some the factors such as social distancing from loved ones, lack of physical exercise, loss of income, loneliness due to quarantine, etc. Therefore, management and treatment of the disorder became essential, especially in coronavirus-infected patients, as it may lead to an increase in complications of the disease. Many studies have been conducted to identify the proper way to manage the condition. Treatments include pharmacological therapy and psychosocial interventions. Pharmacological therapy includes using various antidepressants, hypnotics, and sedatives such as benzodiazepines. For the treatment, mirtazapine is a secure and reliable antidepressant. Another drug, trizolobenzodiazepine adinazolam, was also very useful in treating patients. In some randomized experiments, alprazolam significantly outperformed amitryptiline in reducing the symptoms. Psychosocial interventions include sessions such as cognitive behavioral therapy (CBT), mindfulness-based cognitive therapy, relaxation training, meditation, and psychological interventions such as enhancing multidimensional social help, modifying cognitive assessment, directing positive coping, and inspiring positive emotions.
PubMed: 36381919
DOI: 10.7759/cureus.30262