Diagnostic and Statistical Manual of Mental Disorders
... In 2019, 17.3 million of the 41.9 million global cases of eating disorders were attributed to BED, accounting for one-fifth of the total Disability-Adjusted Life Years (DALYs) due to eating disorders [2]. BED is characterized by recurrent episodes of consuming large quantities of food, accompanying feelings of loss of control and distress [3]. Often leading to weight gain and health problems related to obesity, including type 2 diabetes, cardiovascular disease, and other psychiatric illnesses such as anxiety and depression [4]. ...
Background
Binge-eating disorder (BED) is the most common eating disorder with university students being particularly vulnerable. The study aimed to investigate the association between binge eating and Internet addiction (IA), body shape (BS) concerns, and body mass index (BMI) among university students.
Methods
In this cross-sectional study, 448 university students (221 males and 227 females) aged between 18 and 25 years were recruited. A multicomponent questionnaire included socio-demographic information, and validated scales such as the International Physical Activity Questionnaire (IPAQ), Binge-Eating Disorder Screener-7 (BEDS-7), Internet Addiction Test (IAT), and Body Shape Questionnaire (BSQ). Anthropometric measurements [weight, height, and waist circumference (WC)] were recorded, and BMI was calculated.
Results
The findings reported that approximately 31% of the participants were at risk of BED, 24.3% had moderate/severe IA, 27.8% were moderate/marked concerned about their BS, and 41.1% were overweight/obese. The risk of BED was significantly associated with IA (OR = 1.06, 95%CI: 0.34–0.93; p < 0.005), BS concerns (OR = 1.39, 95%CI:0.90–2.16; p < 0.001), BMI (OR = 1.74, 95%CI:1.16–2.60; p < 0.005), and WC (OR = 1.78, 95%CI: 1.16–2.75; p < 0.006). Regression analysis showed that the risk of BED had a highly significant positive association with WC, BSQ, and IA with the WC identified as the strongest predictor for risk of BED (β = 0.23, p < 0.001).
Conclusions
This study underscores the need for targeted national initiatives and awareness programs that promote balanced food consumption, healthy internet use, and increased physical activity among young adults of both sexes. By fostering these healthy habits, such interventions can reduce the risk of binge eating disorder and support overall mental and physical well-being in this population.
... As a result, written work is often illegible or difficult to read. An impairment in writing skills significantly interferes with academic achievement or activities of daily living that require the composition of written text (APA, 2013) 18 . ...
Kindergarten writing involves acquiring fundamental skills, such as letter formation, phonemic awareness, and the gradual use of written language to express ideas. In this context, tablet-based curriculum assessments present new opportunities for teaching and evaluating these early writing abilities. To the best of our knowledge, there is currently no tool with these features available for Spanish-speaking children. Therefore, the primary objective of this study was to present a tablet-based protocol for screening at-risk young writers. This tablet-based protocol is specifically designed for kindergarten-level education and serves as a curriculum-based assessment tool that focuses on evaluating early writing skills in young learners. This user-friendly application incorporates interactive tasks and exercises, including assessments of phonological awareness, name writing, alphabet letter copying fluency, and oral narrative skills. These comprehensive evaluations cover various aspects of writing. This application is meticulously aligned with kindergarten curriculum objectives, ensuring that assessments adhere to educational standards. By providing educators with a digital platform to assess and enhance students' writing skills, this tool empowers them to make data-driven decisions for effective instruction during the early stages of writing development. Moreover, it functions as a curriculum-based measurement (CBM), offers valuable support for identifying potential writing challenges in young learners and continuously monitoring their progress. This feature enables early intervention and tailored instruction to optimize writing skill development.
... The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) [25] broadened the conceptualization of addictive disorders to formally recognize a behavioral addiction for the first time (i.e., gambling disorder) [10]. These features include persistent urges and a lack of control that can lead to disruptive and problematic behavior. ...
Background
Rates of ultraviolet radiation (UVR)-emitting tanning bed use have declined in the United States over the past decade. However, many young adults continue to indoor tan at rates that put them at risk for melanoma. There is evidence that UVR may impact addiction pathways and some people who use tanning beds experience urges to tan and diminished control over tanning which may be evidence of a behavioral addiction. However, studies have not adequately explored whether excessive tanning continues despite concerns and problems that would be expected with behavioral addiction. This represents an important gap since behavioral persistence in the face of such negative experiences is a hallmark of behavioral addiction. Further, there is a dearth of research exploring change perceptions of excessive tanners.
Methods
We administered a cross-sectional online survey to women between 18 and 34 years old who reported frequent indoor tanning (at least 10 times) in the past 12 months. Participants completed the 7-item Behavioral Addiction Indoor Tanning Screener (BAITS). T- and chi-square tests were used to compare the association of theoretically informed correlates from conceptual models of behavioral addiction (e.g., concerns and problems) and tanning change/quit perceptions with results from the BAITS (i.e., a positive or negative screen for tanning addiction symptoms).
Results
Participants were 280 non-Hispanic White women (mean age = 27.5 years (SD = 4.3)) from across the United States (mean number of past 12-month indoor tanning sessions = 40.1 (SD = 42.5)). Frequent indoor tanners with a positive BAITS score had higher mean scores for negative affect, greater worry about getting skin cancer, and more tanning-related problems compared to those with a negative score. A positive BAITS score was also associated with more perceived barriers to quitting tanning, increased interest in getting help to reduce tanning, and a higher number of quit attempts.
Conclusions
Our findings provide unique evidence for tanning as a behavioral addiction by demonstrating an association between tanning behavioral addiction symptoms with skin cancer concerns, tanning-related problems, and unsuccessful attempts to change. These findings have implications for the design of interventions and support the need for additional research to support the conceptualization of indoor tanning as a behavioral addiction.
... Therefore, speech-language pathologists (SLPs) frequently face pragmatic impairments in children and should make clinical decisions about the nature of the deficit or the need for intervention. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM5-TR), pragmatic impairment is the core problem of communication in some neurodevelopmental disorders, such as ASD and SCD (Social Communication Disorder) [5]. Other disorders leading to pragmatic deficits are language disorders caused by Hearing Impairment (HI) [6,7], intellectual disabilities [8][9][10], and late-talking [11][12][13]. ...
Background
Pragmatic language assessment is a necessary component of evaluation in language impairments. Some procedures are applied to assess pragmatic abilities in childhood. Parent-report questionnaires are among the most useful instruments for evaluating pragmatics in real situations. This study aimed to translate and adapt the Language Use Inventory (LUI) into Persian and examine its psychometric properties.
Method
It was a methodological and cross-sectional study. We pursued the steps of translation and adaptation of this questionnaire into Persian according to a standard guideline. Then, 348 parents/caregivers of three groups of children consisting of typically developing (TD), late-talking children, and ones with autism spectrum disorders (ASD) 18-47-month-old Persian-speaking children completed the adapted version of the LUI. The participants were recruited into study by convenience sampling. Next, different psychometric properties including item analysis, validity (content, face, and construct), and reliability (test-retest and internal consistency) were investigated.
Results
Translation, adaptation, and item analysis led to the deletion of 7 Items. Differential validity for age revealed the noticeably different performance among different age groups (p < 0.001). Also, Given the clinical validity, TD and ASD children performed differently in this measure(p < 0.001). In addition, the evidence of the discriminant validity was confirmed by a significant difference between TD and late-talking children (p < 0.001). Concurrent validity was also established by a moderate and positive value of the correlation between total scores of the LUI-Persian and Newsha developmental scale (r = 0.54, p = 0.01). Exploratory factor analysis (EFA) indicated that the Language Use Inventory-Persian had 2 factors of verbal and nonverbal use of language. Also, the evidence for the confirmatory factor analysis (CFA) was attained (all the values of factor load were higher than 0.40). The internal consistency (α = 0.99) and test-retest reliability (r = 0.97) proved adequate values.
Conclusions
The Language Use Inventory-Persian with 173 items revealed the acceptable psychometric attributes for assessing pragmatics in 18-47-month-old Persian-speaking children; however, for screening pragmatic impairments, it may need further studies on clinical populations with a larger sample size to see whether the LUI items are appropriate or possible changes in the items are required.
Phubbing, or prioritising smartphone use during face-to-face interactions, is an increasingly common behaviour with detrimental effects on mental well-being. This cross-sectional study aimed to explore the relationships between basic psychological needs, psychological distress, the fear of missing out (FoMO), self-compassion and phubbing. A total of 774 university students ( M age = 28.3, 74% women) completed an online questionnaire assessing these variables. After accounting for dysfunctional personality traits, age, gender, and years of smartphone ownership, partial correlations revealed that reduced psychological needs were significantly associated with increased FoMO ( r = .27, p < .001), psychological distress ( r = .42, p < .001), phubbing severity ( r = .17, p = .01), and showed a significant negative relationship with self-compassion ( r = - .46, p < .001). FoMO, but not self-compassion, was found to partially mediate the relationship between psychological needs and phubbing. The findings highlight the critical influence of FoMO on phubbing.
Anorexia nervosa (AN) remains one of the most lethal mental health disorders and is poorly understood from a neurobiological perspective. The most widely used animal model of AN is activity‐based anorexia (ABA) where scheduled food presentation leads to a spontaneous maladaptive increase in running‐wheel activity and rapid weight loss in rodents, recapitulating specific aspects of AN. Research using the ABA paradigm to probe the role of hedonic and homeostatic circuits has indicated that the hypothalamic proopiomelanocortin (POMC) system may play a role in both the increased activity and reduced food intake observed. Previous work has shown that Pomc mRNA and its peptide product beta‐endorphin (β‐end) are increased during the onset of ABA. β‐end is reinforcing and increases locomotor activity, and mice lacking the mu opioid receptor (MOR), the primary target of β‐end, display blunted food‐anticipatory activity in the ABA paradigm. Thus, the current work was designed to determine if aspects of ABA would be diminished in mice lacking β‐end. We did not find any significant differences in wheel‐running, food intake, or body weight loss in β‐end knockout mice of either sex during ABA compared to wild‐type littermates. Therefore, we conclude that the development of ABA does not require β‐end.
Objectives
Incontrovertible evidence surrounds the need to support healthcare professionals after patient safety incidents (PSIs). However, what characterises effective organisational support is less clearly understood and defined. This review aims to determine what support healthcare professionals want for coping with PSIs, what support interventions/approaches are currently available and which have evidence for effectiveness.
Design
Systematic research review with narrative synthesis.
Data sources
Medline, Scopus, PubMed and Web of Science databases (from 2010 to mid-2021; updated December 2022), reference lists of eligible articles and Connected Papers software.
Eligibility criteria for selecting studies
Empirical studies (1) containing information about support frontline healthcare staff want before/after a PSI, OR addressing (2) support currently available, OR (3) the effectiveness of support to help prevent/alleviate consequences of a PSI. Study quality was appraised using the Quality Assessment for Diverse Studies tool.
Results
Ninety-nine studies were identified. Staff most wanted: peer support (n=28), practical support and guidance (n=27) and professional mental health support (n=21). They mostly received: peer support (n=46), managerial support (n=23) and some form of debrief (n=15). Reports of poor PSI support were common. Eleven studies examined intervention effectiveness. Evidence was positive for the effectiveness of preventive/preparatory interventions (n=3), but mixed for peer support programmes designed to alleviate harmful consequences after PSIs (n=8). Study quality varied.
Conclusions
Beyond peer support, organisational support for PSIs appears to be misaligned with staff desires. Gaps exist in providing preparatory/preventive interventions and practical support and guidance. Reliable effectiveness data are lacking. Very few studies incorporated comparison groups or randomisation; most used self-report measures. Despite inconclusive evidence, formal peer support programmes dominate. This review illustrates a critical need to fund robust PSI-related intervention effectiveness studies to provide organisations with the evidence they need to make informed decisions when building PSI support programmes.
PROSPERO registration number
CRD42022325796.
Following a traumatic injury, individuals are at higher risk for the development of psychological and physical health problems, such as posttraumatic stress, while the incidence and precipitating factors that lead to these negative outcomes continue to be a popular area of research. By contrast, an estimated two-thirds of survivors remain unaffected by these outcomes and are qualified as “resilient.” Despite its prevalence, significantly less is known about factors associated with resilience following traumatic injury, including the development of posttraumatic growth (PTG), a unique outcome associated with experiencing positive outcomes. Although prior reviews have documented the incidence and unique ways in which PTG manifests in other trauma samples, less is known about PTG in traumatic injury survivors. Here, a scoping review was conducted: four databases of peer-reviewed articles available in English were queried, and 31 articles describing PTG in traumatic injury samples were reviewed. This scoping review summarizes the incidence of PTG in traumatic injury survivors and describes its associated sociodemographic and injury factors, qualitative findings, relationship with psychopathology, quality of life, coping strategies, and treatment outcomes. In addition, we call attention to affective and cognitive processes associated with PTG as it manifests specifically to traumatic injury survivors. Implications for future research and clinical application are discussed.
The prevalence of autism, especially in children, calls for professionals to develop more effective therapies for treatment. Music therapy has been used for the treatment of Autism Spectrum Disorders (ASDs) since 1940s, although its treatment effect remains to be discussed. The current review aims to investigate the techniques used by literatures in this domain and to determine the evidence base for music therapy in intervention for children with ASD. After searching relevant database, a total of 217 articles were identified and 17 of them met the review’s inclusion criterion. DSP method is wildly used in music therapy, with various ways to include the musical elements in treatment. In general, music interventions were found to have treatment effect in areas of communication, socialization and behavior of children with ASD. The implications of these findings in terms of the use of music interventions, issues related to generalization and future direction are discussed.
Experts call for the application of positive psychological interventions (PPIs) to bolster treatment for people with substance use disorders. However, there remains a gap in developing PPIs that promote positive dispositions important to people with substance problems from collectivist societies. In this study, we developed a PPI that can promote well-being and recovery by boosting the locus-of-hope of people with substance use disorders in a therapeutic community. Using a double-blind, randomized controlled trial with pre-treatment, post-treatment, and 1-month follow-up design, we tested the efficacy and mechanisms of the Locus-of-Hope Enhancement Program (LEAP) for Well-being and Recovery, a PPI that fosters cognitive hope. One hundred thirty-eight participants were randomly assigned to LEAP (n = 73) or a stress management control (n = 65). Outcomes were measured using the Locus-of-Hope Scale, Flourishing Scale, Brief Assessment of Recovery Capital, Dimensions of Change Instrument, and the Group Working Alliance Inventory. Results show that participants who received LEAP reported better internal locus-of-hope, external-peer locus-of-hope, community process experience, and group working alliance than the control group across time, but not on external-family locus-of-hope, external-spiritual locus-of-hope, psychological well-being, and recovery capital. LEAP indirectly boosted psychological well-being and recovery capital through community process experience and group working alliance post-treatment. LEAP’s indirect effect was sustained for recovery capital but not for psychological well-being at the 1-month follow-up. The current study provides initial evidence of the efficacy and mechanisms of a PPI for people with substance use disorders that promotes hope, leading to better well-being and recovery.
This study highlights the critical role of structured play in enhancing the development of children with Autism Spectrum Disorder (ASD) and underscores the necessity of equipping specialists with effective strategies for implementation. Understanding and applying structured play not only improve children's social and cognitive skills but also contribute to the advancement of specialized education and intervention programs.This study aimed to assess the level of awareness and application of the Structured Play Strategy among specialists working with children with ASD in daycare centers within the Riyadh region. The study sample consisted of 219 specialists, including 26 males and 193 females, who work with children with ASD in these centers. To achieve the study's objectives, the researchers employed a descriptive research method. The results indicated that the specialists' awareness of the structured play strategy was high, with 86% demonstrating familiarity with the approach, a finding consistent with previous research. Additionally, the professionals' application of the strategy was also high, with an application rate of 84%. However, the study identified several obstacles that may hinder the effective implementation of the structured play strategy, including the lack of a stimulating environment and difficulties in managing large groups of children. Furthermore, no statistically significant differences were found in the application of the strategy based on variables such as gender, years of experience, or educational qualifications. The study concludes with recommendations for future research.
Closed religious communities cultivate a robust communal identity, shared faith, values, and norms among their members, providing them with social and emotional support. Deviance carries significant consequences, specifically disintegrating members’ sense of belonging. Gambling disorder (GD) is characterized by harmful gambling behaviors that negatively affect individuals’ lives. While gambling is a prevalent recreational activity, within closed religious communities, addiction, including GD, is viewed as a violation of religious teachings, values, and communal norms. This study explores GD's impact on the sense of belonging of Jewish Ultra‐Orthodox men and their spouses in Israel. This research employed constructivist grounded theory, interviewing twenty‐two men with GD and eleven spouses and uncovered two complementary themes. The first, “Depleting versus replenishing of the personal aspects of sense of belonging,” elucidates GD's different effects on the men and spouses’ sense of belonging. The second, “Paying the toll,” illuminates the emotional experiences and actions of the men and the spouses in reaction to societal conditional negative regard directed at them, disintegrating the sense of belonging of the men, but also that of the spouses who did not deviate from communal norms. The paper introduces the novel concept of “an empty pool/pull,” portraying these individuals’ limbo state. The “empty pool” represents the depletion of faith, adherence to religious commandments, and communal values for the men, while the “empty pull” signifies the inclination of the men and the spouses to conform amid the community's unfulfilled promise of protection. The study advocates for further research and offers clinical insights for therapists.
While most research concerning trauma has been conducted in adults, many children and adolescents are confronted with one or more potentially traumatic events while growing up and are at risk of developing a trauma-related disorder such as acute stress disorder (ASD), post-traumatic stress disorder (PTSD) or complex PTSD. This chapter provides an overview of estimates and relevant predictors of trauma exposure and trauma-related disorders among children and adolescents. Age, gender, externalising behaviour and stressors in the home environment appear to predict trauma exposure. While empirical findings for ASD and complex PTSD among children and adolescents are fairly scarce, the main predictors of PTSD appear to involve the nature of the trauma (with interpersonal trauma being related to higher rates of PTSD), acute stress levels, cognitive factors and family or broader social support factors. Low- and middle-income countries and young children are underrepresented in research into exposure and trauma-related disorders.
There is a large body of evidence showing that young children and adolescents can develop mental health problems after experiencing traumatic events, and studies are consistently documenting the differential effects of trauma on children and their development (Danese and Widom, JAMA Psychiatry 80:1009–1016, 2023; Lewis et al., Lancet Psychiatry 6:247–256, 2019; Straussner and Calnan, Clin Soc Work J 42:323–335, 2014; Teicher and Samson, J Child Psychol Psychiatry 57:241–266, 2016). However, in the revisions of the DSM and ICD classification systems, little attention is dedicated to developmental aspects. Hopefully, as the field moves forward, future studies on the validity of these diagnostic categories and criteria for children and adolescents will evolve. In this chapter, we discuss some developmental aspects of trauma exposure and present the latest revisions of the ICD-11 and DSM-5 diagnostic criteria for acute stress, posttraumatic stress disorder (PTSD), complex PTSD, attachment disorders, and the new disorder of prolonged grief.
This study questioned whether knowledge of the employment situation of a person with an intellectual disability affected stigmatising attitudes towards that individual among a sample of 507 people who did not have intellectual disabilities. A hypothetical individual with a mild intellectual disability was described as either (i) in paid employment, or (ii) living entirely on state social security benefits. Sample members, none of whom were themselves intellectually disabled, unemployed, or living on social security benefits, completed a questionnaire concerning their attitudes towards the person. Many participants who were informed that a person with an intellectual disability worked for a living exhibited more positive attitudes towards the individual than participants advised that the person relied on welfare. The results suggest the existence of a “welfare slur” among some sample members. The level of an observer’s self-reported social status impacted on the favorability of certain attitudes.
Children with autism spectrum disorder (ASD) often exhibit social communication impairments and restricted, repetitive behaviors (RRB). Previous studies have shown that children with ASD prefer observing repetitive movements over random movements, reflecting RRB symptoms, but the developmental timeline of this preference remains unclear. New evidence suggests that children with ASD may develop predictive processing abilities for repeated behaviors, providing insight into how they recognize and respond to predictable patterns. This study employed a preferential-looking paradigm to examine whether children with potential ASD demonstrated longer observation durations for predictable movements compared to typically developing (TD) children. Participants were presented with pairs of stimuli featuring predictable and unpredictable movements, which they freely observed side-by-side. Results showed that children with potential ASD spent significantly more time observing predictable movements, particularly during the latter part of the stimulus presentation. These findings suggest that a gradual increase in attention to predictable movements may reflect difficulties in learning cause-and-effect relationships between movement trajectories and the anticipation of complete shapes. This study highlights the potential utility of predictable movement stimuli as a behavioral marker for early ASD screening. It underscores the essential need for further research into predictive processing in children with ASD.
Objective: Knowledge about transdiagnostic factors associated with global symptom severity among patients diagnosed with various mental disorders remains limited. This study examined the cross-sectional associations between transdiagnostic processes including global emotion regulation and specific emotion regulation strategies (i.e., amount of physical activity and sedentary behaviour, repetitive negative thinking and sleep routines) with global symptom severity, while controlling for sociodemographic data (age, gender, employment status, relationship status, and educational level) and fear of the coronavirus.
Methods: Data from 401 outpatients, aged 42.08 years on average (SD = 13.26; 71.3% female), diagnosed with depressive disorders, non-organic primary insomnia, agoraphobia, panic disorder and/or post-traumatic stress disorder were examined. This study is a secondary analysis of a randomized controlled trial. Data were collected from 10 different study sites between March 2021 and May 2022 for cross-sectional analysis. The influence of predictors of global symptom severity was determined using three-step hierarchical multiple regression: (1) control variables, (2) global emotion regulation and (3) specific emotion regulation strategies. Global symptom severity was measured using the Global Severity Index, derived from the Brief Symptom Inventory-18. Predictors were measured using validated scales, and physical activity was additionally assessed via accelerometer-based sensors.
Results: In the first step, control variables accounted for 4% of variance in global symptom severity. The inclusion of global emotion regulation in the second step explained 26% of the outcome variance, and the incorporation of specific emotion regulation strategies in the third step increased the explained variance to 37%. Significant predictors included global emotion regulation (β = 0.28), repetitive negative thinking (β = 0.26) and sleep routines (β = 0.25).
Conclusion: Global emotion regulation along with repetitive negative thinking and sleep routines as specific emotion regulation strategies are identified as transdiagnostic psychological processes that may serve as treatment targets for evidence-based interventions designed to enhance emotion regulation, particularly in transdiagnostic samples of stress-related disorders. Additional prospective longitudinal studies with transdiagnostic samples are necessary to explore possible causal relationships.
Understanding the impact of eye gaze on social interactions may mitigate some risks for adolescents who are either currently justice-involved or at risk of contacting the justice system. At present, there are no universally accepted assessments for determining age-appropriate levels of eye gaze for adolescents during social interactions. One way to evaluate an individual’s sensitivity to eye gaze is to determine if they can detect different levels of eye gaze in other people. Bush et al. Developmental Neurorehabilitation, 25 , 263–273, (2021) created three videos (profiles) of an actor displaying three different levels of eye gaze (directed toward an off-screen interviewer) and then asked college students to rate the actor in the three profiles using six statements. Bush et al. found college students provided the most favorable ratings for the profile with a high, but not the highest, level of eye gaze. This study used the same three video profiles of a speaker and six statements to assess ratings by two groups: non-justice-involved adolescents and justice-involved adolescents. Results indicate both groups rated the three speaker profiles differently for some statements. In particular, both groups rated the low eye gaze profile less favorably than the other two profiles. Analyses also revealed (1) non-justice-involved adolescents rated the high eye gaze profile as less attentive but more likely to get an important job than the justice-involved group and (2) justice-involved adolescents rated the “socially valid” profile as less likely to have friends than non-justice-involved adolescents. Implications and next steps are discussed.
This book seeks to distinguish empirically-based knowledge from widespread misconceptions in the fields of legal and forensic psychology. Across ten chapters, leading scholars contribute different perspectives on their areas of expertise within the fields of legal and forensic psychology, providing a comprehensive overview of the historical context and defining characteristics of these two disciplines. The first section of the book is dedicated to legal psychology, exploring issues such as pseudoscience in lie detection, the use of polygraphs, and the reliability of eyewitness testimony and memory reports in legal settings. The second focuses on forensic psychology, addressing topics such as the relationship between criminal behavior and psychopathology, symptom validity assessment, risk assessment, and the treatment of forensic patients. As such, this vital book will serve as an excellent starting point for those seeking to educate themselves about these disciplines.
Este estudo aborda o Transtorno do Espectro Autista (TEA), uma condição neuro comportamental complexa da qual é frequentemente associada a diversas comorbidades. Objetivo: identificar e sintetizar as principais condições que ocorrem concomitantemente com o TEA, explorando suas características, incidências e implicações para a prática clínica. Método: Foi realizada uma revisão integrativa conduzida nas bases de dados PubMED, Biblioteca Virtual em Saúde (BVS) e SciELO, com base na questão norteadora: “Quais são as doenças, comorbidades e condições que ocorrem associadamente em pacientes diagnosticados com Transtorno do Espectro Autista?”. Artigos dos últimos cinco anos foram incluídos sem restrição de idioma. Utilizando-se do software Rayyan para exclusão de duplicatas e análise de título e resumo, foram escolhidos 35 documentos para a elaboração deste trabalho. Resultados e Discussão: Uma ampla gama de comorbidades, incluindo transtornos de ansiedade, TDAH, depressão, distúrbios do sono, epilepsia, condições gastrointestinais e alergias, são associadas ao TEA. Evidências apontam que essas condições compartilham mecanismos com o autismo, como alterações genéticas, neurobiológicas e inflamatórias. Além disso, fatores como a sensibilidade sensorial exacerbada do autismo e desafios na regulação emocional foram identificados como agravantes de desfechos comportamentais adversos. Conclusão: A elevada carga de comorbidades no TEA exige uma abordagem clínica integrada para melhorar a qualidade de vida dos pacientes e otimizar o uso dos sistemas de saúde.
Background and aims
Smartphones have been so widely adopted that many consider them essential for modern life. However, some people use their phone excessively, which can cause functional impairment or harm, termed problematic smartphone use (PSU). Smartphone use motives may help explain why users engage in general smartphone use and PSU, but existing measures may not capture certain motives which research suggests are important to smartphone use. To address this, across two studies, we constructed and validated a Motives for Smartphone Use Questionnaire (MSUQ) among young adults.
Methods and results
In Study 1, the Delphi method was used, whereby engagement with a panel of 23 international academic experts resulted in a pool of 62 smartphone use motives items that measure 11 proposed motives. In Study 2, the 62 items were administered to 680 young adults aged 18–25 years ( M age = 22.50, SD = 2.16). Results from exploratory and confirmatory factor analyses found that the MSUQ has a seven-factor structure, assessing smartphone use to cope, pass time, socialize, obtain social comfort, feel safe, fulfil social obligations, and seek information. These motives differentially influenced PSU and smartphone usage.
Conclusions
The MSUQ is a valid measure of motives for smartphone use. It was developed specifically for smartphone use and it includes motives not captured in prior measures.
Transitioning from high school to college can be a stressful experience for young adults. While some stress is necessary to successfully adapt during the transition from adolescence to adulthood, many college students may have difficulty adapting and be more prone to significant emotional distress that impacts daily life. Grounded theory methodology was used to examine the process of managing self-identified depression during the first year of college. Purposive sampling was used to recruit first-semester sophomore students who self-identified as being depressed during their freshman year. Thirty-five interviews were completed, each began with one open-ended question: "What was the experience of your freshman year in college?" Participants described the social context of depression during their freshman year. Analysis was completed by four experienced researchers using NVivo. Four themes emerged to form the grounded theory of Managing Self-identified Depression during the Freshman Year of College. These themes included: navigating the day-to-day context; making and maintaining meaningful connections; living with emotions, behaviors, and history of depression; and coping to manage depressive symptoms. As the mental health issues continue to increase in this population, grounded theory provides a better understanding of the needs of students living with depression during their freshman year in college.
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that adversely affects children's academic performance, classroom behaviour, social interactions, and daily life. Despite its prevalence, symptoms of ADHD often go unnoticed by parents/guardians and teachers. This study examines the knowledge of ADHD among parents and teachers and the role of educational qualifications in shaping awareness. A cross-sectional design was employed, with 150 participants conveniently selected from six private schools in Lagos, Nigeria. Standardized questionnaires with open-and closed-ended questions were used to collect data. Results showed limited ADHD knowledge among participants, with 75.4% reporting no prior awareness of the disorder, while 24.6% claimed some awareness. Half of the respondents could accurately distinguish ADHD traits in children, and 32.2% recognized that adults could also be diagnosed with ADHD. Educational qualification significantly influenced knowledge of ADHD [F(3,114) = 6.210, p < .05]. These findings highlight the need for private schools in Lagos to organize educational seminars during Parents and Teachers' Forums (PTFs). Such initiatives should address ADHD's prevalence, presentation, and management, particularly targeting knowledge gaps linked to varying educational backgrounds. By doing so, schools can better equip parents and teachers to identify and support children with ADHD, fostering improved academic and social outcomes.
Research indicates that treatment-resistant depression is common in clinical practice. Although there are several reasons why depression can be difficult to ameliorate, one common reason stems from comorbid personality disorders. Research has shown that not only are personality disorders commonly comorbid among those with depression, but their presence negatively affects the course and outcome in the treatment of depression. This implies that careful assessment of comorbid personality pathology is of critical importance in the case conceptualization of treatment-resistant depression and may be essential for planning treatments that most benefit patients. In the following article, we illustrate the value of transference-focused psychotherapy (TFP), an evidence-based approach for treatment of personality disorders, in addressing treatment-resistant depression when there is a comorbid personality disorder. To do this, we discuss the evidence regarding the comorbidity of treatment-resistant depression and personality disorders and the implications for treatment approaches. We make an argument for treatments such as TFP. We then explicate the TFP model of treatment, including TFP’s model of personality pathology in the development of treatment-resistant depression. In doing so, we also describe the evidence base behind TFP and its mechanisms of change. Clinical vignettes are also used to give clear examples of how TFP assesses and treats treatment-resistant depression in the context of personality pathology.
Background/Objectives: Dysregulation of Mood, Energy, and Social Rhythms Syndrome (DYMERS) characterizes the poor regulation of biological (sleep/waking), social, and behavioral rhythms that affected the level of burnout in healthcare professionals during the pandemic in particular. The aim is to provide an initial scoping review of publications on this topic. Methods: The keywords “Stress Rhythms Dysregulation Bipolar Disorder Burnout DYMERS Healthcare professionals COVID-19” were searched on 9 December 2024 following PRISMA 2020 guidelines, using five primary databases (OVID, ProQuest, PubMed, Scopus, Web of Science), one register (Cochrane COVID-19 register), and one supplementary database (Google Scholar). Included were peer-reviewed publications. Excluded were duplicates, reports lacking either a research study or any keywords, or including irrelevant information regarding them. Results: The returns for all the databases were (n = 0) except for ProQuest (n = 4) and Google Scholar (n = 14). Of these, three ProQuest returns were duplicates of the Google Scholar search. The remaining report contained irrelevant information on healthcare professionals. The Google Scholar search results produced two relevant reports—neither duplicated with ProQuest. The excluded contained a duplicate in the search itself, three that did not mention healthcare professionals, two that contained irrelevant information concerning them, four returns that were not a research study, and three that were not peer-reviewed. Conclusions: The two studies published on this topic are by various members of the same investigating institution. DYMERS has provided valuable insights regarding burnout in healthcare professionals. The suggestion is for further DYMERS research by this team and others, anticipating future pandemics.
Autism Spectrum Disorder (ASD) is a neurodevelopmental condition with rising prevalence. Traditional diagnostic approaches often lack biological markers, making precision in diagnosis challenging. This study explores the role of array Comparative Genomic Hybridization (aCGH) in improving diagnostic accuracy for ASD. Five clinical vignettes of children diagnosed with ASD via DSM-5 or ADOS-2 were evaluated at a child and adolescent psychiatry clinic. Genome-wide oligonucleotide aCGH analysis was conducted using the Human Genome CGH Microarray kit (OGT), containing approximately 180,000 probes with 30–37 kb spacing based on the GRCh37 build. Fragile X syndrome was excluded using the Asuragen Amplidex PCR/CE FMR1 kit. The case series included boys aged 8–11 from diverse ethnic backgrounds (Asian, African, and Qatari), all presenting with varying degrees of ASD. Genetic analyses revealed significant chromosomal changes affecting eight genes, SHOX, HNF1B, COH1, AHNAK, DOCK8, TIAM1, TBL1XR1, and ALKBH8, highlighting diverse genetic contributions to ASD. These findings encompassed both chromosomal gains and losses, as well as variants of uncertain significance (VUS). The aCGH analyses provided valuable genetic insights, refining the diagnostic process and informing personalized management strategies for ASD. This suggests that aCGH is a useful tool in identifying clinically relevant genetic variations, particularly in settings with limited resources, where other diagnostic modalities may be less accessible.
O Transtorno Bipolar (TB) se manifesta por meio de episódios maníacos, hipomaníacos e depressivos, diagnosticado em pacientes que apresentam tais sintomas ao longo da vida. O Diagnóstico Diferencial (DD) é a investigação precisa de fatores biopsicossociais, comportamentais e uma avaliação clínica do histórico do paciente. Neste contexto, foi realizada uma revisão integrativa com o objetivo de analisar estudos brasileiros sobre as contribuições da psicologia para o DD do TB. Foram critérios de inclusão: artigos completos em português, disponíveis no Portal Regional da BVS (Biblioteca Virtual em Saúde), Portal Capes Periódicos e na Scielo Brazil (Scientific Eletronic Libraly Online), publicados entre 2019 e 2023. Foram selecionados três artigos que destacaram a dificuldade do DD do TB, as altas taxas de suicídio e o papel da família no processo de investigação como resultados significativos. Além disso, foi ressaltada a importância da precisão e da individualização no tratamento pelos profissionais de saúde, após o diagnóstico ser corretamente estabelecido.
The hypothalamus-pituitary-adrenal (HPA) and gut-brain axes are vital biological pathways in depression. The HPA axis regulates the body's stress response, and chronic stress can lead to overactivation of the HPA axis, resulting in elevated cortisol levels that contribute to neuronal damage, particularly in regions such as the hippocampus and prefrontal cortex, both of which are involved in mood regulation and mental disorders. In parallel, the gut-brain axis, a bidirectional communication network between the gut microbiota and the central nervous system, influences emotional and cognitive functions. Imbalances in gut microbiota can affect the HPA axis, promoting inflammation and increasing gut permeability. This allows endotoxins to enter the bloodstream, contributing to neuroinflammation and altering neurotransmitter production, including serotonin. Since the majority of serotonin is produced in the gut, disruptions in this pathway may be linked to depressive symptoms. This review explores the interplay between the HPA axis and the gut-brain axis in the context of depression.
Purpose
This study examines the connection between infections and the abrupt onset or exacerbation of anorexia nervosa (AN) in the context of PANS (Pediatric Acute–Onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections).
Methods
The authors conducted a literature review and present a case study of a 17-year-old girl treated at the University of Turin Eating Disorder Unit, whose AN presented with an abrupt onset following an infection and was characterized by a rapid and favorable course.
Results
The review includes 30 cases derived from six studies, suggesting that AN can manifest as PANS/PANDAS, with subjects, mainly adolescents, experiencing sudden or exacerbated eating restrictions alongside obsessive–compulsive behaviors. Some cases improved with antibiotics or standard psychiatric treatments, although age, symptom severity, and diagnostic markers like D8/17 varied across studies. Data on treatment follow-up also varied.
The report refers to the case of V., a 17-year-old girl who developed AN following an intestinal infection. After significant weight loss and amenorrhea, she was hospitalized for 29 days, receiving psychiatric care, nutritional rehabilitation, and pharmacological treatment. Over 2 months of residential care and ongoing outpatient therapy, she improved notably, though mild body dysmorphophobia persisted.
Conclusions
While evidence suggests a possible link between infections and AN, research is still limited and inconsistent. Infections may trigger AN through autoimmune mechanisms or by initiating weight loss, particularly in younger patients. Although further studies are needed to clarify this relationship, infections should be considered in AN diagnosis, especially in pediatric cases.
Level of Evidence: Level V, a narrative review and a case report.
Objective
While research supports differentiating anorexia nervosa into binge–purge (AN‐BP) vs. restricting (AN‐R) subtypes, DSM‐5‐TR does not provide a specific threshold of binge and/or purge episodes that constitutes an AN‐BP vs. AN‐R diagnosis. Our review of the literature suggests that cutoffs used for defining AN subtypes are rarely reported and, when reported, are highly heterogeneous. Inconsistent subtyping protocols limit generalizability and understanding of AN‐R and AN‐BP differences.
Method
The present study used structural equation modeling (SEM) trees to empirically determine the frequency of binge eating and/or purging that best differentiates AN subtypes. We then compared empirically determined groups on characteristics frequently found to differ between subtypes. Participants were 731 adolescents and adults with AN (94% female, M age = 20, 72% clinically diagnosed with AN‐R) in a partial hospitalization program who completed assessments of AN and comorbid symptoms at intake.
Results
SEM tree analyses yielded four subgroups: past‐month binge/purge frequency 0 (AN‐R; n = 396); frequency 1–3 (AN‐BP1; n = 101); frequency 4–15 (AN‐BP2; n = 130); and frequency > 16 (AN‐BP3; n = 98). AN‐R differed from higher frequency groups on 14/22 clinical characteristics, AN‐BP1 differed from higher frequency groups on 11/22 clinical characteristics, and AN‐BP2 differed from higher frequency groups on 2/22 clinical characteristics.
Conclusions
Findings suggest that one binge eating and/or purge episode in the past month provides adequate distinction between subtypes. These findings indicate that the DSM's definition of AN‐BP may need to be revised to specify that the presence of any binge eating or purging, rather than “recurrent” binge eating or purging, is sufficient for subtyping AN.
Background/Objectives: Sleep and cognitive alterations are common symptoms associated with child Post-traumatic stress disorder (PTSD) and depression (DEP). This study aims to investigate the relationship between sleep disturbances and cognitive alterations in PTSD and DEP. Methods: Using a quantitative, cross-sectional exploratory design, we examined 130 students (106 girls and 24 boys) aged 11 to 16 years (mean age = 12.9, SD = 1.35) from 6th to 8th grade. Twenty-eight participants met the criteria for PTSD, 15 met the criteria for DEP, 43 met the criteria for both PTSD+/DEP+, and 44 served as the control group. Comparative analyses were conducted using the MANOVA and multiple one-way ANOVA tests. Results: The MANOVA test indicated an interaction between cognitive and sleep alterations. Post hoc analysis revealed that sleep patterns were significantly altered among the groups with PTSD, DEP, and PTSD+/DEP+ (F(3, 126) = 16.98, p = 0.001). In contrast, cognitive alterations were most pronounced in PTSD and PTSD+/DEP+ (F(3, 126) = 63.97, p < 0.001). Conclusions: These findings emphasize the impact of PTSD and DEP on cognition and sleep. Potential clinical implications suggest the need for interventions targeting sleep and cognitive alterations. This study underscores the complex relationship among traumatic experiences, depression, and cognitive/sleep alterations.
Posttraumatic stress symptoms have been closely linked with the use of harsh parenting practices in veteran families. This study was aimed at assessing the potential added importance of parent mentalization in predicting the use of corporal punishment among US veterans. A hypothesized hierarchical regression model in which parent mentalization dimensions (i.e., prementalizing, over‐certainty, and interest and curiosity) were examined as predictors of corporal punishment was analysed in monoracial ( n = 318) and multiracial ( n = 182) US veteran families. For veteran parents in both monoracial and multiracial families, parent mentalization emerged as a significant predictor of corporal punishment, even after accounting for parent posttraumatic stress. While the prementalizing dimension of mentalization was associated with greater corporal punishment among veteran parents in both monoracial and multiracial families, the over‐certainty dimension was associated with greater corporal punishment exclusively in multiracial families. The present findings clarify dimensions of parent mentalization that confer risk for the use of corporal punishment in US veteran families, above and beyond the predictive role of posttraumatic stress. Implications of the present findings for social workers working with monoracial and multiracial veteran families are discussed.
Catatonia is a psychomotor syndrome that can present secondary to mood and psychotic disorders, other medical conditions, antipsychotic use, and alcohol withdrawal (Rasmussen et al., World Journal of Psychiatry, 6:391–398, 2016). In addition, acute and chronic trauma are increasingly recognized as a substrate for catatonia (Dhossche et al., Acta Psychiatrica Scandinavica, 125:25–32, 2012). Catatonia is a clinical diagnosis that relies on standardized examination of the patient. The Pediatric Catatonia Rating Scale (PCRS) was modified from the Bush Francis Catatonia Rating Scale and validated in children and adolescents (Benarous et al., Schizophrenia Research, 176:378–386, 2016). Changes included the addition of urinary incontinence, schizophasia and acrocyanosis; and withdrawal was separated into refusal to eat or drink and social withdrawal (Benarous et al., Schizophrenia Research, 176:378–386, 2016). In both pediatric and adult patients, catatonia must be differentiated from other movement disorder emergencies such as serotonin syndrome and neuroleptic malignant syndrome, which can also present with altered mental status and autonomic dysfunction (Rajan et al., Seminars in Neurology, 39:125–136, 2019). In pediatric patients, catatonia may be the genuine diagnosis in cases of Resignation Syndrome and Pervasive Refusal Syndrome (Sallin et al., Frontiers in Behavioral Neuroscience, 10(7), 2016; Ngo and Hodes, Clinical Child Psychology and Psychiatry, 25:227–241, 2019). The literature on pediatric catatonia is scarce but nevertheless expanding. Herein, we contribute to the literature by reporting four complex cases of pediatric catatonia that appear to have been triggered by a traumatic event and further reviewing the role of acute and chronic trauma in the presentation of pediatric catatonia.
Purpose
Extending research on adverse childhood experiences (ACEs), this study examined the occurrence, co-occurrence, and associated outcomes of adverse adult experiences (AAEs). We also explored subgroup differences in the effects of AAEs and responses to the Adult Experiences Survey, a seminal assessment of AAEs.
Method
Survey data were collected between October 2021 and May 2023 from more than 2,000 Wisconsin adults who enrolled in the Strong and Stable Families Study, a prospective investigation of risk and resilience in families with children. Descriptive analyses produced sample prevalence estimates of AAEs overall and by race/ethnicity, income, and gender. Analyses were performed to test bivariate associations among AAEs and to calculate the mean number of additional adversities associated with each AAE. Multivariate regressions were conducted to test associations between AAE scores and indicators of mental health and well-being along with the moderating effects of race/ethnicity, income, and gender. A multigroup confirmatory factor analysis with an alignment optimization procedure was used to assess measurement invariance by race/ethnicity, income, and gender.
Results
More than 75% of participants reported at least one AAE, and more than 25% reported four or more AAEs. Higher levels of cumulative adversity were reported by non-White than White adults, women than men, and adults from lower-income than higher-income backgrounds. All 10 AAEs were significantly intercorrelated, and specific AAEs such as sexual abuse, violent crime victimization, and homelessness were linked to especially high levels of cumulative adversity. Adult adversity scores were positively associated with depression and anxiety symptoms and negatively associated with quality of life and life satisfaction ratings. Significant adversity-by-race and adversity-by-income interaction effects were observed. Response patterns to AAE questions were similar across racial/ethnic, income, and gender subgroups, providing support for measurement invariance of the Adult Experiences Survey.
Conclusions
Like ACEs, AAEs are common, correlated, and consequential events and conditions. The findings are discussed in light of their significance for research on life course and intergenerational adversity and their implications for practice and policy.
While psychotherapy is effective for treating depression, men are less likely than women to attend and more likely to drop out. The value of alternative therapeutic approaches for men needs to be investigated. In this randomised pilot trial, we investigated the feasibility and preliminary efficacy of outdoor ‘walk‐and‐talk’ therapy compared to conventional indoor therapy for 37 men with low mood (mean [SD] PHQ‐9 score = 11.4 [5.0]; mean [SD] age = 44.1 [15.8] years). Over 6 weeks at the University of Newcastle participants received weekly 60‐min sessions delivered (i) while walking along a 4‐km route on campus or (ii) indoors in a psychology clinic, delivered by provisional psychologists using non‐directive supportive counselling. Outcomes included validated measures of depression, anxiety, stress and overall psychological distress, male‐type depression, mental well‐being, behavioural activation and therapeutic alliance. At post‐intervention, all pre‐registered feasibility benchmarks were exceeded including recruitment capability, retention (89%), average attendance (walk‐and‐talk: 91%, indoor: 89%), proportion of sessions delivered in intended setting (walk‐and‐talk: 100%, indoor: 98%) and overall perceived acceptability of the therapy (walk‐and‐talk: 4.4/5, indoor: 4.2/5, where 1 = poor and 5 = excellent ). Linear mixed model analysis demonstrated both groups achieved similar improvements in depressive symptoms ( d = −0.02), but the walk‐and‐talk group reported greater improvements in overall psychological distress ( d = −0.5), anxiety ( d = −0.4) and stress ( d = −0.7). In contrast, male‐type depression improved more in the conventional indoor group ( d = 0.6). Other outcomes were comparable between groups. Results indicate that walk‐and‐talk therapy may be acceptable and effective for men with depression. A powered trial to interrogate these effects and identify moderators of effectiveness is warranted.
Trial Registration: Australian New Zealand Clinical Trials Registry number: ACTRN12622001318774.
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that is characterized by limitations in social communication and interaction, self-repetitive behaviors, and the presence of limited interests. The prevalence of ASD, which typically emerges in the first years of life, is increasing at an alarming rate due to multiple factors, including the broadening of diagnostic criteria, heightened public awareness, and more frequent diagnoses among women and adults. Over the years, experts have invested considerable time and effort in developing educational scenarios for children with ASD. However, they have faced challenges replicating certain scenarios—such as emergencies, crowded public transportation, or restaurant environments—because recreating these exact conditions in real-world settings is difficult or cost-prohibitive. This has consequently compelled experts to seek out supplementary intervention methods that are more suitable and accessible. Virtual reality (VR), which has the capacity to integrate the physical and virtual realms, represents one such alternative intervention method. In this study, a systematic review of studies employing VR technology in social skills interventions for individuals with ASD was conducted, and 31 studies were included. The findings indicate the potential benefits of VR applications focusing on the social skills of individuals with ASD. Additionally, this research elucidates the limitations of the studies and offers suggestions for future research.
Attention deficit hyperactivity disorder (ADHD) confers greater risk of alcohol and substance use disorders, which may be linked to altered compulsivity and impulsivity within the condition. However, no study has investigated the link between these constructs and behavioural addictions in ADHD. The aim of this study was to investigate whether individuals with ADHD show increased impulsivity, compulsivity, and associated distress, as well as addictive behaviour for gambling, exercise, and internet use, and to assess the relationship between these factors. Adults with and without ADHD were recruited from across the UK and completed an online survey measuring impulsivity, compulsivity, gambling, internet use and exercise addiction. Three hundred and forty-six adults took part (Healthy control = 137, ADHD-medicated = 110, ADHD-unmedicated = 99). Those declaring a diagnosis of ADHD reported greater internet use problems and greater withdrawal from exercise. Medicated individuals also reported higher exercise continuance and were more likely be symptomatic for exercise dependency. Individuals identifying with ADHD had greater levels of impulsivity and compulsivity, with impulsivity correlated with all behavioural addictions, whilst compulsivity correlated only with exercise and internet use. Regression analyses indicated that the distress caused by impulsivity and compulsivity was associated with internet use. Although further research is needed, this study indicates that the greater risk of behavioural addictions found in those with ADHD may relate to impulsivity and compulsivity, and that this should be considered when managing ADHD.
EEG microstates are brief, stable topographical configurations of brain activity that provide insights into alterations in brain function and connectivity. Anomalies in microstates are associated with different neuropsychiatric conditions, especially schizophrenia. Recent advances in both EEG techniques and machine learning point to the potential role of microstates as diagnostic markers for psychotic disorders. This systematic review aims to gather current knowledge on machine learning applied to EEG microstate analysis in psychotic disorders. Following PRISMA guidelines, we searched Scopus, PubMed, and Scholar databases, including 10 studies. Overall results show that EEG microstates can be used to accurately classify diagnoses within the psychosis spectrum, across all stages, outperforming models based on conventional EEG measures, with a prominent role of microstate D. One study also suggests that microstate anomalies may be directly linked to symptom severity. Integrating EEG microstates with machine learning shows promise in improving our understanding of psychotic disorders and developing more precise diagnostic tools.
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