RESUMO
INTRODUCTION: Growing, albeit heterogenous evidence questions whether attention deficit/hyperactivity disorder (ADHD) is associated with socio-cognitive impairments, especially beyond childhood. This study focuses on mentalizing - the socio-cognitive ability to attribute and reason in terms of mental states. We aimed to characterize mentalizing performance in terms of correct scores and types of errors in adolescents and young adults with ADHD. METHODS: Forty-nine adolescents and adults with ADHD and 49 healthy controls matched for age and gender completed a computerized naturalistic mentalizing task, the Movie for Assessment of Social Cognition (MASC). Repeated measures analyses of variance examined the effects of age group and ADHD diagnosis on MASC performance. Additionally, associations between mentalizing scores, the severity of attention problems, and the presence of comorbidity were explored in the ADHD group. RESULTS: Results showed an increased prevalence of hypomentalizing errors in adolescents with ADHD. Lower mentalizing scores in adolescents with ADHD were correlated with indices of inattentiveness, impulsivity, and vigilance problems. Hypomentalizing errors in adolescents showed to be particularly associated with inattentiveness, after controlling for age and comorbidity. In contrast, adults with ADHD performed similarly to controls and their scores on the mentalizing task were not correlated to attention problems. CONCLUSION: These findings highlight potential developmental differences in mentalizing abilities in ADHD youths and their association with attentional impairments.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtornos Cognitivos , Mentalização , Humanos , Adolescente , Adulto Jovem , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Comportamento Impulsivo , Cognição , Transtornos Cognitivos/psicologiaRESUMO
Neuroanatomical abnormalities have been reported along a continuum from at-risk stages, including high schizotypy, to early and chronic psychosis. However, a comprehensive neuroanatomical mapping of schizotypy remains to be established. The authors conducted the first large-scale meta-analyses of cortical and subcortical morphometric patterns of schizotypy in healthy individuals, and compared these patterns with neuroanatomical abnormalities observed in major psychiatric disorders. The sample comprised 3004 unmedicated healthy individuals (12-68 years, 46.5% male) from 29 cohorts of the worldwide ENIGMA Schizotypy working group. Cortical and subcortical effect size maps with schizotypy scores were generated using standardized methods. Pattern similarities were assessed between the schizotypy-related cortical and subcortical maps and effect size maps from comparisons of schizophrenia (SZ), bipolar disorder (BD) and major depression (MDD) patients with controls. Thicker right medial orbitofrontal/ventromedial prefrontal cortex (mOFC/vmPFC) was associated with higher schizotypy scores (r = 0.067, pFDR = 0.02). The cortical thickness profile in schizotypy was positively correlated with cortical abnormalities in SZ (r = 0.285, pspin = 0.024), but not BD (r = 0.166, pspin = 0.205) or MDD (r = -0.274, pspin = 0.073). The schizotypy-related subcortical volume pattern was negatively correlated with subcortical abnormalities in SZ (rho = -0.690, pspin = 0.006), BD (rho = -0.672, pspin = 0.009), and MDD (rho = -0.692, pspin = 0.004). Comprehensive mapping of schizotypy-related brain morphometry in the general population revealed a significant relationship between higher schizotypy and thicker mOFC/vmPFC, in the absence of confounding effects due to antipsychotic medication or disease chronicity. The cortical pattern similarity between schizotypy and schizophrenia yields new insights into a dimensional neurobiological continuity across the extended psychosis phenotype.
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Transtorno Bipolar , Transtornos Psicóticos , Esquizofrenia , Transtorno da Personalidade Esquizotípica , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Transtornos Psicóticos/diagnóstico por imagem , Transtorno da Personalidade Esquizotípica/diagnóstico por imagemRESUMO
The existing literature suggests that individual differences in attachment may be associated with differential trajectories of structural brain development. In addition to maturation during infancy and childhood, developmental trajectories are characteristic of adolescence, a period marked by increasingly complex interpersonal relationships and significant neurostructural and functional plasticity. It remains to be examined whether attachment prospectively relates to neurostructural developmental trajectories during adolescence. In this longitudinal study, we investigated whether self-reported attachment dimensions of anxiety (AX) and avoidance (AV) could predict elements of cortical thickness (CT) and subcortical volume (SV) trajectories in 95 typically developing adolescents (12-19 years old at study baseline). Self-reported scores of AX and AV were obtained at study baseline, and neurostructural development was assessed at baseline and three timepoints over the four following years. Self-reported AX and AV were associated with steeper CT decreases in prefrontal cortical and cortical midline structures as well as anterior temporal cortex, particularly in participants younger at study baseline. Regarding SV, preliminary differential associations were observed between developmental trajectories and attachment dimensions. Our study suggests that interindividual differences in attachment contribute to shaping neurodevelopmental trajectories for several cortical and subcortical structures during adolescence and young adulthood.
Assuntos
Imageamento por Ressonância Magnética , Apego ao Objeto , Humanos , Adolescente , Adulto Jovem , Adulto , Criança , Estudos Longitudinais , Autorrelato , Imageamento por Ressonância Magnética/métodosRESUMO
INTRODUCTION: The mirror-gazing task (MGT) is an experimental paradigm inducing anomalous perceptions and anomalous experiences of self-face (ASEs) in the general population, ranging from changes in light and color, to face deformation, to experiencing one's specular image as another identity. Subclinical ASEs have been related to the emergence of the risk for developing psychotic disorders, and inducing such states in the general population could shed light on the factors underlying interindividual differences in proneness to these phenomena. We aimed to examine the influence of schizotypal personality traits on proneness to experiencing induced ASEs from a developmental perspective, from childhood to adulthood. METHODS: Two hundred and sixteen children, adolescents, and young adults participated in the MGT, and their schizotypal personality traits were assessed with the Schizotypal Personality Questionnaire. Statistical analyses assessed the relationship between schizotypy dimensions and induced ASEs, and we further tested their dynamic relationship as function of age (from childhood to adulthood). RESULTS: Results confirmed the developmental trajectory of the different schizotypy dimensions, with scores peaking during adolescence, and proneness to induced ASEs seemed to follow a similar developmental trajectory. Moreover, positive (p = 0.001) and disorganized (p = 0.004) dimensions were found to contribute to the proneness to experiencing induced ASEs. Finally, the developmental model showed that positive schizotypy (p = 0.035) uniquely distinguished between experiencing other-identity phenomena between childhood and adulthood. CONCLUSION: This study has the potential to inform research on early detection of psychosis through a developmental approach and links the concept of schizotypy with processes of perceptual self-distortions.
Assuntos
Transtornos Psicóticos , Transtorno da Personalidade Esquizotípica , Adolescente , Adulto , Criança , Humanos , Personalidade , Autorrelato , Inquéritos e Questionários , Adulto JovemRESUMO
BACKGROUND: The 22q11.2 deletion syndrome (22q11DS) is a genetic syndrome that results in a highly variable profile of affected individuals of which impairments in the social domain and increased psychopathology are the most prominent. Notably, 25-30% of affected individuals eventually develop schizophrenia/psychosis, predisposing persons with the syndrome to increased risk for this disorder. Because social cognition is considered to underlie social behavior and to be related to psychopathology, this systematic review investigated social cognition in individuals with 22q11DS and examined reported links across its domains with psychopathology and social outcomes. This can provide the basis for a closer understanding of the path from risk to disorder and will inform on the specific domains that can be targeted with preventive intervention strategies. METHOD: Systematic literature review of studies that reported the links between social cognitive domains and psychopathology and/or social outcomes in individuals with 22q11DS. Electronic databases searched were PubMed and PsycINFO. RESULTS: Defined eligibility criteria identified a total of ten studies to be included in the present review. Selected studies investigated links between two domains of social cognition (emotion processing and theory of mind (ToM)) and psychopathology and/or social outcomes. With respect to the links to psychopathology, two aspects of social cognition were related primarily to negative symptoms. Results regarding the associations to positive and emotional symptoms (anxiety/depression) are limited and require further investigation. Even though both aspects of social cognition were associated with social outcomes, several studies also found no links between these two domains. Both reports invite for an additional examination of reported results and specific considerations regarding chosen constructs. CONCLUSION: Although equivocal, results of the present review provide sufficient evidence that social cognition is a useful domain for the closer elucidation of clinical outcomes and social difficulties in this population. At the same time, longitudinal studies and consideration of other variables are also necessary for a timely understanding of affected persons in this respect.
Assuntos
Síndrome de DiGeorge , Teoria da Mente , Cognição , Síndrome de DiGeorge/complicações , Síndrome de DiGeorge/genética , Humanos , Psicopatologia , Comportamento Social , Cognição SocialRESUMO
Externalizing behaviors (EBs) pertain to a diverse set of aggressive, antisocial, and potentially destructive behaviors directed toward the external environment. They range from nonclinical to clinical in severity, associated with opposition, aggression, hyperactivity, or impulsivity, and are considered a risk factor for the emergence of psychopathology later in adulthood. Focusing on community adolescents (N = 102; 49 female and 53 male adolescents; age range 12-19 years), this study aimed to explore the relations between EBs and the cortical thickness of regions of interest as well as to identify possible risk markers that could improve understanding of the EB construct. Using a mixed cross-sectional and prospective design (1-year follow-up), we report specific associations with cortical thickness of the left insular, right orbitofrontal, and left anterior cingulate cortex. Specifically, thinner left insular and right orbitofrontal cortex was associated with higher EBs, and thinner left anterior cingulate cortex predicted less reduction in EBs 1 year later. In addition, further examination of the aggression and rule-breaking subscales of the Youth/Adult Self-Report, used to assess EBs, revealed specific associations with insular subregions. Findings suggest that cortical structure morphology may significantly relate to the expression and maintenance of EBs within the general population of adolescents.
Assuntos
Comportamento do Adolescente/psicologia , Córtex Cerebral , Imageamento por Ressonância Magnética , Adolescente , Córtex Cerebral/diagnóstico por imagem , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Córtex Pré-Frontal/diagnóstico por imagem , Estudos Prospectivos , Adulto JovemRESUMO
Introduction: Disruptions in self-monitoring processes represent key cognitive factors associated with schizophrenia spectrum disorders. In the current study, we assessed the effects of age and cognitive effort on self-monitoring for speech in adolescence, as well as its associations with personality dimensions pertaining to schizotypy and impulsivity.Methods: 121 community adolescents undertook a self-monitoring task that assesses the capacity to discriminate between self-generated overt and silent speech, for items requiring different levels of cognitive effort. Self-report measures were used to assess trait dimensions of schizotypy and impulsivity.Results: Cognitive effort, but not age, contributed to the overall rate of self-monitoring errors. Contrary to clinical psychosis and high risk samples, increased cognitive effort in healthy adolescents led to more internalising than externalising self-monitoring errors. Higher scores on the interpersonal dimension of schizotypy were associated with increases in the total rate of self-monitoring errors. No associations were found between positive schizotypy and externalising self-monitoring misattributions. Finally, trait impulsivity dimensions were not associated with self-monitoring performance.Conclusions: The present findings suggest that self-monitoring confusions may be linked to trait-risk for psychosis in adolescence. Future studies can prospectively assess whether the association between negative schizotypal traits and self-monitoring represents a distal marker of psychosis vulnerability.
Assuntos
Cognição/fisiologia , Comportamento Impulsivo/fisiologia , Transtorno da Personalidade Esquizotípica/psicologia , Autorrelato , Fala/fisiologia , Adolescente , Fatores Etários , Criança , Feminino , Humanos , Masculino , Desempenho Psicomotor/fisiologia , Leitura , Transtorno da Personalidade Esquizotípica/diagnóstico , Transtorno da Personalidade Esquizotípica/fisiopatologiaRESUMO
Reflective functioning (RF) refers to the understanding of one's own and others' behaviors in terms of mental states, whereas empathy entails the abilities to understand (cognitive empathy) and to share (affective empathy) the emotions of others. Low RF and low empathy have been previously related to externalizing behaviors, such as aggression and rule breaking. However, few longitudinal studies have simultaneously examined the relationships between these variables during adolescence. The aim of the present study is to investigate the longitudinal effects of both RF and empathy on potential changes in externalizing behaviors over time, in a group of 103 adolescents and young adults from the general population assessed repeatedly up to four times. We conducted multilevel analysis in order to examine the effects of RF and empathy on the initial levels and the trajectories of externalizing behaviors over time, while accounting for other variables previously associated with externalizing behaviors, such as age, gender, internalizing problems, and cognitive abilities. The results suggest that the ability to reflect on behaviors in terms of mental states predicted a sharper decrease in externalizing behaviors over time. Moreover, externalizing behaviors at the first assessment were associated with RF impairments and low affective empathy. Age, gender, cognitive abilities, and cognitive empathy were not associated with externalizing behaviors. We discuss how our results, based on a typically developing population, might inform primary or indicated prevention strategies for externalizing behaviors by focusing on socio-cognitive processes such as RF and affective empathy.
Assuntos
Agressão/psicologia , Emoções/fisiologia , Empatia/fisiologia , Teoria da Mente/fisiologia , Adolescente , Comportamento do Adolescente/psicologia , Criança , Cognição/fisiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Testes Neuropsicológicos , Adulto JovemRESUMO
INTRODUCTION: Adolescence is a critical period for the development of mentalizing - the imaginative capacity to understand one's own and others' behaviour in terms of underlying mental states. Yet, factors and mechanisms underlying individual differences in adolescent mentalizing remain poorly understood. This exploratory study examined whether and how a) age and gender and b) psychological difficulties correlate with mentalizing performance in adolescents from the general population. METHODS: 89 adolescents from Geneva, Switzerland (54 females, age 12-17 years) completed a computerized task of mentalizing and a self-report measure of psychopathology. RESULTS: Mentalizing performance improved with age. Males showed lower scores on the mentalizing task and made more hypermentalizing errors than females. The main findings revealed a negative association between mentalizing performance and self-reported attention problems. Post-hoc analyses further demonstrated that self-reported attentional difficulties were particularly associated with weaker scores on items requiring mentalizing about intentions, while self-reported withdrawal/depression symptoms were particularly associated with weaker scores on items requiring mentalizing about emotions and thoughts. CONCLUSION: The present study highlights a negative association between attentional difficulties and mentalizing performance in community adolescents. Moreover, it provides preliminary evidence suggesting that age, gender and psychological difficulties can be distinctively associated with patterns of correct and incorrect mentalizing in community adolescents. Implications for future research and clinical practice are discussed.
Assuntos
Atenção , Depressão/psicologia , Mentalização/fisiologia , Adolescente , Fatores Etários , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Psicologia do Adolescente , Autorrelato , Fatores Sexuais , SuíçaRESUMO
INTRODUCTION: Antisocial individuals present behaviours that violate the social norms and the rights of others. In the present study, we examine whether biases in monitoring the self-generated cognitive material might be linked to antisocial manifestations during adolescence. We further examine the association with psychopathic traits and conduct problems (CPs). METHODS: Sixty-five incarcerated adolescents (IAs; M age = 15.85, SD = 1.30) and 88 community adolescents (CAs; M age = 15.78, SD = 1.60) participated in our study. In the IA group, 28 adolescents presented CPs (M age = 16.06, SD = 1.41) and 19 did not meet the diagnostic criteria for CPs (M age = 15.97, SD = 1.20). Source monitoring was assessed through a speech-monitoring task, using items requiring different levels of cognitive effort; recognition and source-monitoring bias scores (internalising and externalising biases) were calculated. RESULTS: Between-group comparisons indicate greater overall biases and different patterns of biases in the source monitoring. IA participants manifest a greater externalising bias, whereas CA participants present a greater internalising bias. In addition, IA with CPs present different patterns of item recognition. CONCLUSIONS: These results indicate that the two groups of adolescents present different types of source-monitoring bias for self-generated speech. In addition, the IAs with CPs present impairments in item recognition. Future studies may examine the developmental implications of self-monitoring biases in the perseverance of antisocial behaviours from adolescence to adulthood.
Assuntos
Transtorno da Conduta/diagnóstico , Transtorno da Conduta/psicologia , Prisioneiros/psicologia , Desempenho Psicomotor/fisiologia , Adolescente , Transtorno da Personalidade Antissocial/diagnóstico , Transtorno da Personalidade Antissocial/psicologia , Viés , Feminino , Humanos , Masculino , AutorrelatoRESUMO
One of teenagers' key developmental tasks is to engage in new and meaningful relationships with peers and adults outside the family context. Attachment-derived expectations about the self and others in terms of internal attachment working models have the potential to shape such social reorientation processes critically and thereby influence adolescents' social-emotional development and social integration. Because the neural underpinnings of this developmental task remain largely unknown, we sought to investigate them by functional magnetic resonance imaging. We asked n = 44 adolescents (ages 12.01-18.84 years) to evaluate positive and negative adjectives regarding either themselves or a close other during an adapted version of the well-established self-other trait-evaluation task. As measures of attachment, we obtained scores reflecting participants' positive versus negative attachment-derived self- and other-models by means of the Relationship Questionnaire. We controlled for possible confounding factors by also obtaining scores reflecting internalizing/externalizing problems, schizotypy, and borderline symptomatology. Our results revealed that participants with a more negative attachment-derived self-model showed increased brain activity during positive and negative adjective evaluation regarding the self, but decreased brain activity during negative adjective evaluation regarding a close other, in bilateral amygdala/parahippocampus, bilateral anterior temporal pole/anterior superior temporal gyrus, and left dorsolateral prefrontal cortex. These findings suggest that a low positivity of the self-concept characteristic for the attachment anxiety dimension may influence neural information processing, but in opposite directions when it comes to self- versus (close) other-representations. We discuss our results in the framework of attachment theory and regarding their implications especially for adolescent social-emotional development and social integration.
Assuntos
Encéfalo/fisiopatologia , Emoções/fisiologia , Retroalimentação Psicológica/fisiologia , Autoimagem , Adolescente , Adulto , Ansiedade/fisiopatologia , Mapeamento Encefálico/métodos , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Percepção/fisiologia , Adulto JovemRESUMO
In the past few years, there has been an increased and widespread interest for Mentalization-Based Therapies (MBTs). Although originally developed by Anthony Bateman and Peter Fonagy for the treatment of Borderline Personality Disorder (BPD), the scope of MBTs has now been broadened and is relevant in liaison psychiatry, not only to cope with personality disorders or phenomena such as emotional dysregulation and suicidal behaviours, but also because being ill and expericencieng a dependency-laden relationship with health workers tend to reduce mentalization capacities, thereby increasing the probability of misunderstandings, conflicts, treatment drop-outs or medical errors. We provide clinicians with clues to identify failures and reboot the mentalization process among their patients and colleagues.
Les thérapies basées sur la mentalisation (TBM), développées pour le trouble borderline, ont connu ces dernières années un essor important. Les techniques des TBM pourraient être utiles en psychiatrie de liaison au-delà des troubles de la personnalité et de phénomènes comme la dérégulation émotionnelle ou les conduites suicidaires. En effet, le vécu de la maladie et la relation de soin, qui activent puissamment les représentations d'attachement, affaiblissent les capacités de mentalisation du patient et du soignant et, de ce fait, augmentent le risque de malentendus, de conflits, d'interruptions de traitements ou d'erreurs médicales. Nous proposons aux cliniciens quelques pistes pour déceler les failles et restaurer le processus de mentalisation dans le contexte de la psychiatrie de liaison.
Assuntos
Psiquiatria , Teoria da Mente , HumanosRESUMO
INTRODUCTION: The main purpose of this study was to analyze the psychometric properties of the State-Trait Anxiety Inventory (STAI1). Previous studies have indicated different factor solutions. Nevertheless, there is still a lack of consensus about the best dimensional model of STAI scores. METHOD: The sample consisted of 417 participants, composed of 387 (29.71% male) healthy participants (comparison group: M=35.5 years; SD=8.40), and 30 (36.66% male) patient (clinical group M=35.8 years; SD=12.94). RESULTS: The internal consistency evaluated through Ordinal Alpha was good, 0.98 and 0.94 in the non-clinical and the clinical samples, respectively. Test-retest reliability (two weeks) for Total Score was 0.81 for the non-clinical subsample, and 0.93 for the clinical subsample. Confirmatory factor analyses supported both a four factor model and bifactor model. Also, STAI scores showed statistically significant correlations with Burns Anxiety Inventory (Burns-A) scores. Furthermore, results showed statistically significant differences in the mean scores of the STAI between the clinical and the non-clinical subsamples. CONCLUSIONS: The psychometric properties of the STAI were adequate. The present study contributes to better understand the STAI structure through the comparison of new approaches in the study of the STAI internal structure. The results found may contribute in the efforts to improve the evaluation and identification of anxiety symptoms and disorders.
Assuntos
Escala de Ansiedade Frente a Teste , Adulto , Feminino , Humanos , Masculino , PsicometriaRESUMO
Neuroscience literature increasingly suggests a conceptual self composed of interacting neural regions, rather than independent local activations, yet such claims have yet to be investigated. We, thus, combined task-dependent meta-analytic connectivity modeling (MACM) with task-independent resting-state (RS) connectivity analysis to delineate the neural network of the self, across both states. Given psychological evidence implicating the self's interdependence on social information, we also delineated the neural network underlying conceptual other-processing. To elucidate the relation between the self-/other-networks and their function, we mined the MACM metadata to generate a cognitive-behavioral profile for an empirically identified region specific to conceptual self, the pregenual anterior cingulate (pACC), and conceptual other, posterior cingulate/precuneus (PCC/PC). Mining of 7,200 published, task-dependent, neuroimaging studies, using healthy human subjects, yielded 193 studies activating the self-related seed and were conjoined with RS connectivity analysis to delineate a differentiated self-network composed of the pACC (seed) and anterior insula, relative to other functional connectivity. Additionally, 106 studies activating the other-related seed were conjoined with RS connectivity analysis to delineate a differentiated other-network of PCC/PC (seed) and angular gyrus/temporoparietal junction, relative to self-functional connectivity. The self-network seed related to emotional conflict resolution and motivational processing, whereas the other-network seed related to socially oriented processing and contextual information integration. Notably, our findings revealed shared RS connectivity between ensuing self-/other-networks within the ventromedial prefrontal cortex and medial orbitofrontal cortex, suggesting self-updating via integration of self-relevant social information. We, therefore, present initial neurobiological evidence corroborating the increasing claims of an intricate self-network, the architecture of which may promote social value processing.
Assuntos
Encéfalo/fisiologia , Processos Mentais/fisiologia , Autoimagem , Adulto , Mapeamento Encefálico/métodos , Mineração de Dados , Bases de Dados Factuais , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Vias Neurais/fisiologia , Testes Neuropsicológicos , Tomografia por Emissão de Pósitrons , DescansoRESUMO
The clinical picture associated with 22q11.2 deletion syndrome (22q11DS) includes mild mental retardation and an increased risk of schizophrenia. While the clinical phenotype has been related to structural brain network alterations, there is only scarce information about functional connectivity in 22q11DS. However, such studies could lead to a better comprehension of the disease and reveal potential biomarkers for psychosis. A connectivity decoding approach was used to discriminate between 42 patients with 22q11DS and 41 controls using resting-state connectivity. The same method was then applied within the 22q11DS group to identify brain connectivity patterns specifically related to the presence of psychotic symptoms. An accuracy of 84 % was achieved in differentiating patients with 22q11DS from controls. The discriminative connections were widespread, but predominantly located in the bilateral frontal and right temporal lobes, and were significantly correlated to IQ. An 88 % accuracy was obtained for identification of existing psychotic symptoms within the patients group. The regions containing most discriminative connections included the anterior cingulate cortex (ACC), the left superior temporal and the right inferior frontal gyri. Functional connectivity alterations in 22q11DS affect mostly frontal and right temporal lobes and are related to the syndrome's mild mental retardation. These results also provide evidence that resting-state connectivity can potentially become a biomarker for psychosis and that ACC plays an important role in the development of psychotic symptoms.
Assuntos
Síndrome da Deleção 22q11/fisiopatologia , Encéfalo/fisiopatologia , Transtornos Psicóticos/diagnóstico , Síndrome da Deleção 22q11/complicações , Adolescente , Adulto , Biomarcadores , Mapeamento Encefálico , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Modelos Neurológicos , Descanso/fisiologia , Adulto JovemRESUMO
22q11.2 deletion syndrome (22q11DS) is associated with increased risk for schizophrenia. Better identifying risk factors for the emergence of psychotic symptoms in this population is needed to improve clinical assessment and early interventions. Schizophrenia spectrum disorders, hallucinations and delusions were characterized in an original sample of 104 individuals with 22q11DS. Further analysis of positive and negative symptoms was performed in a subsample of 59 individuals. Finally, longitudinal data available in 56 patients were used to explore the developmental trajectories of psychotic symptoms as well as the associations between psychotic symptoms and cognitive functioning. Schizophrenia spectrum disorders and psychotic symptoms were frequent in adolescent and adults with 22q11DS. The severity of hallucinations and non-persecutory delusional ideas discriminated patients at ultra-high risk for conversion to psychosis. Whereas approximately one-third of patients experienced an emergence of psychotic symptoms during a 4-year interval, 20 % displayed transient symptoms. Individuals with psychotic symptoms were characterized by a lower cognitive functioning in the context of the 22q11DS. The present study adds important data on the characteristics and developmental trajectory of psychotic symptoms in this population. This information may ultimately help clinicians dealing with these patients to reduce the duration of untreated psychosis and improve outcome.
Assuntos
Síndrome de DiGeorge/psicologia , Transtornos Psicóticos/diagnóstico , Adolescente , Adulto , Criança , Cognição/fisiologia , Estudos Transversais , Delusões , Feminino , Alucinações , Humanos , Estudos Longitudinais , Masculino , Fatores de Risco , Esquizofrenia , Adulto JovemRESUMO
Adult attention deficit hyperactivity disorder (ADHD) is often associated with personality pathology. However, only few studies have been conducted on the link between ADHD and pathological narcissism (PN), with or without a diagnosis of narcissistic personality disorder (NPD). In order to fill this gap, PN and NPD were assessed in 164 subjects suffering from ADHD, with several other measures including ADHD severity, quality of life, depression, anxiety, impulsivity, and emotion dysregulation (ED). We found that a significant proportion of ADHD patients suffered from NPD, and that both narcissistic grandiosity and vulnerability were associated with ADHD hyperactivity and impulsivity symptoms, but not with inattentive symptoms. These two dimensions seemed to be negatively associated with well-being and positively associated with most of the other studied psychiatric dimensions except ED, the latter being only associated with vulnerability, even after adjustment on borderline symptoms. Overall, despite important limitations that limit the generalizability of our findings to the overall ADHD population (notably linked to selection bias), we believe that this exploratory study sheds light on the potential clinical relevance of narcissistic pathology in adult ADHD patients.
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Transtorno do Deficit de Atenção com Hiperatividade , Narcisismo , Transtornos da Personalidade , Humanos , Adulto , Masculino , Feminino , Transtornos da Personalidade/epidemiologia , Estudos Retrospectivos , Escalas de Graduação Psiquiátrica , Adulto Jovem , Pessoa de Meia-Idade , Qualidade de Vida , Comportamento Impulsivo/fisiologia , Transtorno da Personalidade NarcisísticaRESUMO
BACKGROUND: The transdiagnostic approach to psychopathology has emerged as an alternative to traditional taxonomic approaches. The Multidimensional Emotional Disorders Inventory (MEDI) is a specifically designed self-report to measure the transdiagnostic dimensions proposed by Brown and Barlow (2009). This study aims to analyse the psychometric properties of the MEDI scores in adolescents with subthreshold anxiety and depression. METHOD: The sample consisted of a total of 476 students. The mean age was 13.77 years (SD = 1.43) (range 10 to 18 years), 73.9 % were females. Several questionnaires assessing positive affect, negative affect, mental health difficulties, and quality of life were used. RESULTS: The original 9-factor structure of the MEDI was confirmed with good fit indices. Satisfactory levels of internal consistency were observed in most of the MEDI scores using McDonald's Omega, ranging from 0.58 to 0.87. The MEDI dimensions were associated with psychopathology, positive affect, negative affect, and quality of life. LIMITATIONS: Reliance on self-reported data, a cross-sectional design limiting temporal assessment, and a 73.9 % female gender imbalance. CONCLUSION: The MEDI scores showed adequate psychometric properties among adolescents with subclinical emotional symptoms. The results found might have potential clinical implications for conceptualization, assessment, intervention, and prevention of emotional disorders at both clinical and research levels.
Assuntos
Psicometria , Humanos , Adolescente , Feminino , Masculino , Criança , Qualidade de Vida/psicologia , Depressão/diagnóstico , Depressão/psicologia , Ansiedade/diagnóstico , Ansiedade/psicologia , Reprodutibilidade dos Testes , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Inquéritos e Questionários/normas , Estudos Transversais , Autorrelato , Escalas de Graduação Psiquiátrica/normas , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/psicologiaRESUMO
Pathological narcissism (PN) is a common psychopathological issue leading to maladaptive strategies to cope with self-esteem threats, including self-enhancement and exploitation (grandiose strategies) or internalized shame, depression, and social withdrawal (vulnerable strategies). Mentalizing is a key process for regulating self and other representations and their associated emotions. Patients with PN further struggle with emotion dysregulation (ED), which during development is intertwined with the growing capacity to mentalize. We seek to contribute to emerging empirical data documenting the associations between PN and ED and between PN and mentalizing, and to provide information on the nature of their mutual relationships. In the present study, we assessed PN, ED, and three mentalizing dimensions (mentalizing self, other, and motivation to mentalize) in 183 patients consulting in our outpatient unit specialized in ED. We found that narcissistic vulnerability was negatively associated with self-mentalizing and positively associated with overall ED, both even after adjustment for borderline and attention deficit hyperactivity disorder (ADHD) symptoms. However, the association with ED was not maintained after further adjustment for self-mentalizing or overall-mentalizing, which suggests that mentalizing may play a mediating role in this relationship. On the other hand, narcissistic grandiosity was positively associated with other-mentalizing and ED and negatively associated with self-mentalizing in bivariate analyses, but these last two associations were not maintained after adjustment for comorbid borderline and/or ADHD symptomatology. This study provides new information on the link between PN and ED and on key mentalizing dimensions meaningfully relating to PN, notably through a potential role of self-mentalizing processes between PN and ED.
Assuntos
Regulação Emocional , Transtorno da Personalidade Narcisística , Autoimagem , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Sintomas Afetivos , Transtorno do Deficit de Atenção com Hiperatividade , Regulação Emocional/fisiologia , Mentalização/fisiologia , Transtorno da Personalidade Narcisística/psicologiaRESUMO
While significant differences in male and female brain structures have commonly been reported, only a few studies have focused on the sex differences in the way the cortex matures over time. Here, we investigated cortical thickness maturation between the age of 6 to 30 years, using 209 longitudinally-acquired brain MRI scans. Significant sex differences in the trajectories of cortical thickness change with age were evidenced using non-linear mixed effects models. Similar statistical analyses were computed to quantify the differences between cortical gyrification changes with age in males and females. During adolescence, we observed a statistically significant higher rate of cortical thinning in females compared to males in the right temporal regions, the left temporoparietal junction and the left orbitofrontal cortex. This finding is interpreted as a faster maturation of the social brain areas in females. Concomitantly, statistically significant sex differences in cortical folding changes with age were observed only in one cluster of the right prefrontal regions, suggesting that the mechanisms underlying cortical thickness and gyrification changes with age are quite distinct. Sexual dimorphism in the developmental course of the cortical maturation may be associated with the different age of onset and clinical presentation of many psychiatric disorders between males and females.