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1.
J Psychopathol Clin Sci ; 133(3): 257-272, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38619461

RESUMO

Women and men are at different risk for posttraumatic stress disorder (PTSD). It is unclear, however, how studies on PTSD risk factors integrate this knowledge into their research. Moreover, the temporal development of women's higher PTSD risk is unknown. In this systematic review and meta-analysis, we examine how prospective studies on PTSD development (k = 47) consider sex and gender across four domains (samples, terminology, analyses, and reporting). Further, we differentially analyze sex/gender differences within five time intervals from 1 month to 5 years posttrauma. PTSD prevalence (OR = 1.72 [1.27-2.34]) and severity (g = 0.31 [0.09, 0.53]) were increased for women relative to men at 1 month posttrauma already, that is, at the first timepoint of a possible PTSD diagnosis. PTSD severity was elevated for women compared to men across all time intervals, but evidence for increased PTSD prevalence for women relative to men was less stable with longer follow-ups. Despite women's higher PTSD burdens, they were clearly underrepresented in samples (68.3% male, 31.7% female participants). Only 5.0% of studies explained or described their understanding of sex and gender, and only 2.6% used sex as discovery variable, that is, investigating sex-dependent risk mechanisms. Sex and gender aspects in design, data, and discussion were considered by only one-third of studies each. Trauma research falls short of its potential to adequately consider sex and gender. Sex- and gender-sensitive practices can advance rigor, innovation, and equity in psychopathology research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Conhecimento , Psicopatologia , Humanos , Feminino , Masculino , Estudos Prospectivos , Bases de Dados Factuais , Fatores de Risco
2.
Cortex ; 172: 14-37, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38154375

RESUMO

In behavioral, cognitive, and social sciences, reaction time measures are an important source of information. However, analyses on reaction time data are affected by researchers' analytical choices and the order in which these choices are applied. The results of a systematic literature review, presented in this paper, revealed that the justification for and order in which analytical choices are conducted are rarely reported, leading to difficulty in reproducing results and interpreting mixed findings. To address this methodological shortcoming, we created a checklist on reporting reaction time pre-processing to make these decisions more explicit, improve transparency, and thus, promote best practices within the field. The importance of the pre-processing checklist was additionally supported by an expert consensus survey and a multiverse analysis. Consequently, we appeal for maximal transparency on all methods applied and offer a checklist to improve replicability and reproducibility of studies that use reaction time measures.


Assuntos
Lista de Checagem , Projetos de Pesquisa , Humanos , Reprodutibilidade dos Testes , Tempo de Reação , Inquéritos e Questionários
3.
Artigo em Inglês | MEDLINE | ID: mdl-37784203

RESUMO

BACKGROUND: Instability in self-esteem and instability in affect are core features of borderline personality disorder (BPD). For decades, researchers and theorists have been interested in the temporal dynamics between these constructs. Some hypothesize that changes in affective states should precede changes in self-esteem (Linehan, Cognitive-behavioral treatment of borderline personality disorder. Diagnosis and treatment of mental disorders, 1993), while others suggest that changes in self-esteem should precede changes in affective states (Kernberg, Borderline conditions and pathological narcissism, 1975). METHODS: In this study, we investigated the temporal relations between negative affective arousal states and current self-esteem in daily life. Patients with BPD (n = 42) or depressive disorders (DD; n = 40), and non-clinical controls (NCC; n = 40) were assessed every 15 min for 13 h. RESULTS: As expected, dynamic structural equation modeling showed higher levels of average daily negative affective arousal and lower levels of average daily self-esteem in the BPD group compared with the NCC group, and scores in the DD group were in-between the BPD and the NCC groups. In line with predictions based on Linehan's (Cognitive-behavioral treatment of borderline personality disorder. Diagnosis and treatment of mental disorders, 1993) model of affective dysregulation in BPD, negative affective arousal (t) and subsequent self-esteem (t+ 1) were significantly linked only in the BPD group, implying that higher negative affective arousal is followed by lower current self-esteem in the next measurement (ca. 15 min later). Importantly, self-esteem (t) and subsequent negative affective arousal (t + 1) were not significantly related (Kernberg, Borderline conditions and pathological narcissism, 1975). CONCLUSIONS: Our findings suggest close dynamic temporal relations between affective instability and self-esteem instability in BPD, which highlights the importance of providing patients with means to effectively modulate high negative affective arousal states.

4.
Eur J Psychotraumatol ; 14(2): 2225153, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37401356

RESUMO

Background: Pre-and post-traumatic hypothalamic-pituitary-adrenal (HPA) axis markers have been studied to predict posttraumatic stress disorder (PTSD) risk, but its acute reactivity cannot be measured in real-life settings. Experimental paradigms can depict the cortisol response to stimuli that simulate traumatic events.Objective: To review experimental studies on the cortisol response to traumatic stimuli and the correlation between cortisol and PTSD symptoms.Method: Experimental, (un-)published studies in German or English from any year were eligible if they confronted non-traumatized humans with traumatic stimuli, assessed cortisol before, during or after stimulus presentation and subsequent PTSD symptoms. The literature was searched via PubMed, PubPsych, PsychINFO, PsycArticle, Web of Science, EMBASE, ProQuest and ClinicalTrials.gov up to 16th February 2021. Risk of bias was assessed with the Cortisol Assessment List. Multilevel-meta-analyses were conducted under the random effects model. The standardized mean change (dSMC) indicated the cortisol response. Coefficient r indicated the correlations between cortisol and PTSD symptoms.Results: 14 studies, investigating 1004 individuals, were included. A cortisol response was successfully induced between 21 and 40 min post-presentation onset (kobservations = 25, dSMC = 0.15 [.03; .26]). Cortisol was not associated with overall or cluster-level PTSD symptoms. On a symptom-level, higher pre-presentation onset cortisol was correlated with lower state tension (k = 8, r = -.18 [-.35; -.01]), higher state happiness (k = 8, r = -.34 [-.59; -.03], variable inverted) and lower state anger (k = 9, r = -.14 [-.26; -.01]). Higher post-presentation onset cortisol was correlated with higher state happiness (k = 16, r = -.20 [-.33; -.06]) and lower state sadness (k = 17, r = -.16 [-.25; -.05]), whereas cortisol response was positively correlated with state anxiety (k = 9, r = .16 [0.04; 0.27]).Conclusions: Experimental paradigms effectively induce a cortisol response. Higher basal cortisol, higher cortisol, as measured after traumatic stimulus presentation, and a lower cortisol response were associated with more adaptive emotional reactions. These markers did not predict longer-term PTSD symptoms.


Experimental trauma paradigms successfully induced a cortisol response.Cortisol was predictive for single state, emotion-related symptoms, but not overall PTSD symptoms.Trauma paradigms shed light into the immediate post-trauma period that is hard to capture in real life, but the gap between experimental and naturalistic settings is difficult to overcome.


Assuntos
Transtornos de Estresse Pós-Traumáticos , Humanos , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Hidrocortisona/análise , Sistema Hipófise-Suprarrenal/química , Transtornos de Ansiedade , Ansiedade
5.
Psychol Trauma ; 2023 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-37126047

RESUMO

OBJECTIVE: Affective dysregulation is a core feature of borderline personality disorder (BPD), and some patients report dissociative symptoms. The present study investigated temporal dynamic relations between affective states and current experiences of depersonalization and derealization in daily life to test key theoretical premises of trauma models of dissociation. METHOD: Patients with BPD (n = 42) or depressive disorders (n = 40), and nonclinical controls (n = 39) were assessed every 15 min for 13 hr within a single day using smartphone-based diaries. RESULTS: As expected, dynamic structural equation modeling results show the highest levels of average daily affective arousal, negative affective valence, and dissociation in the BPD group. As hypothesized, arousal and subsequent dissociation were significantly linked only in the BPD group, implying that momentary arousal above a person's daily average is followed by higher dissociation in the next measurement (∼15 min later). In addition, some patients with BPD reported less negative affective valence following dissociation. CONCLUSIONS: Our findings suggest that changes in affective states play an important role at the onset of dissociation in patients with BPD. Subsequent relief from distress may explain maintenance. We recommend that clinicians provide means to regulate affect when dealing with dissociation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

6.
Psychoneuroendocrinology ; 152: 106082, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36989562

RESUMO

INTRODUCTION: Psychotherapeutic interventions for major depressive disorder (MDD) have been suggested to be associated with a normalization of biological stress system (i.e., the hypothalamic-pituitary-adrenal axis and the autonomic nervous system) dysregulation. Furthermore, pre-intervention cortisol parameters have been identified as prescriptive biological markers of treatment success. However, evidence of treatment effects on the biological stress systems is still sparse, and results are heterogeneous. The current study examined the effect of an internet-based intervention for MDD on salivary cortisol and alpha-amylase as well as hair cortisol concentrations. Moreover, the prescriptive capacity of pre-intervention cortisol and alpha-amylase concentrations on treatment response was explored. METHODS: Thirty-eight participants suffering from mild to moderate MDD collected saliva and hair samples throughout the intervention. Biological outcome parameters were salivary cortisol and alpha-amylase (awakening response, total diurnal output, diurnal slope) and hair cortisol concentrations. Treatment response was indicated by change in depression severity and perceived chronic stress. RESULTS: Treatment response on depression scores or chronic stress was not associated with changes in any of the cortisol or alpha-amylase parameters. Exploratory analysis indicated that non-responders showed a steeper alpha-amylase slope pre-intervention. DISCUSSION: The results indicate that changes in depressive symptoms did not correspond to changes of the biological stress systems, contradicting the suggested normalization of dysregulated hypothalamic-pituitary-adrenal axis or autonomic nervous system activity through a psychotherapeutic intervention. However, the results point to a potential role of pre-intervention alpha-amylase slope as a prescriptive marker of treatment response for depression.


Assuntos
Transtorno Depressivo Maior , Intervenção Baseada em Internet , Humanos , Hidrocortisona , alfa-Amilases/metabolismo , Transtorno Depressivo Maior/terapia , Sistema Hipotálamo-Hipofisário/metabolismo , Depressão/terapia , Sistema Hipófise-Suprarrenal/metabolismo , Saliva/metabolismo , Estresse Psicológico/terapia
7.
PLoS One ; 18(3): e0281387, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36920983

RESUMO

BACKGROUND AND OBJECTIVES: Current cognitive models of social anxiety disorder (SAD) propose that individual, situation-specific self-beliefs are central to SAD. However, the role of differences in the degree to which individuals with social anxiety are convinced of self-beliefs, in particular positive ones, is still not fully understood. We compared how much high and low socially anxious individuals agree with their own negative and positive self-beliefs. Furthermore, we investigated whether agreeing with one's self-belief can explain the relation between negative affect in response to self-beliefs and social anxiety. Specifically, we were interested whether social anxiety increases negative affect in response to self-beliefs through an increase in agreement. METHODS: We developed a new experimental self-belief task containing positive and negative semi-idiosyncratic, situation specific self-beliefs typical of high social anxiety and included a direct measure of agreement with these beliefs. Using extreme group sampling, we a-priori selected high (n = 51) and low (n = 50) socially anxious individuals. By multi-level mediation analysis, we analyzed agreement with self-beliefs in both groups and its association with affect. RESULTS: High and low socially anxious individuals chose similar self-beliefs. However, high socially anxious individuals (HSA) agreed more with negative self-beliefs and less with positive self-beliefs compared to low socially anxious individuals (LSA). HSA individuals reported increased negative affect after both, exposition to negative and positive self-beliefs compared to LSA. We found that social anxiety increases affective responses towards negative-self beliefs through an increase in agreeing with these self-beliefs. CONCLUSIONS: These findings suggest that cognitive models of social anxiety can be improved by including not only the content of a self-belief but also the strength of such a belief. In addition, they emphasize the relevance of positive self-beliefs in social anxiety, which has frequently been overlooked.


Assuntos
Medo , Fobia Social , Humanos , Medo/psicologia , Ansiedade/psicologia , Fobia Social/psicologia , Escalas de Graduação Psiquiátrica
8.
Personal Disord ; 14(1): 50-61, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36848073

RESUMO

Studies using experimental paradigms have been paramount in research on psychopathological processes in personality disorders (PDs). We review 99 articles that report experimental paradigms and that were published between 2017 and 2021 in 13 peer-reviewed journals. We structure the study content according to the National Institute of Mental Health Research Domain Criteria (RDoC), and report details on demographic variables, experimental design, sample size, and statistical analyses. We discuss unequal representation of the RDoC domains, representativeness of the recruited clinical groups, and a lack of sample diversity. Finally, we review issues regarding statistical power and the data analytic designs that were used. Based on the literature review, we draw implications for future experimental PD research, encouraging researchers to increase the breadth of represented RDoC constructs, the representativeness and diversity of the recruited samples, the statistical power to detect between-person effects, the reliability of estimators, the adequacy of statistical methods, and the transparency of experimental research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Transtornos da Personalidade , Psicopatologia , Estados Unidos , Humanos , Reprodutibilidade dos Testes , Projetos de Pesquisa , Grupo Social
9.
Front Psychiatry ; 13: 848645, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35492687

RESUMO

The COVID-19 pandemic and its preventive measures had adverse consequences for mental health. However, knowledge of mental health trajectories across the pandemic is limited. This study investigated the mental health levels and changes among university students during the pandemic and lockdown in Germany, as well as their associated factors. We surveyed students' mental health (N = 363, 68% female) with the patient health questionnaire (PHQ-8) and the generalized anxiety disorder scale (GAD-7) during the first easing phase (July 2020; time 1) and the second lockdown (November 2020; time 2). Cut-off scores from the GAD-7 and PHQ-8 were used to determine clinically relevant symptoms and to define trajectory groups. Sociodemographic and pandemic-related data were assessed (e.g., coping with academic life, social contacts) as well as loneliness, stress, repetitive negative thinking, quality of life, and perceived social support. Paired t-test, multiple regression, and repeated-measures ANOVA were applied. Means and prevalence rates for symptoms of depression (38.8%) and anxiety (25.6%) did not differ between time 1 and time 2, and most students were asymptomatic on the PHQ-8 (44.4%) and the GAD-7 (56.3%) across the pandemic. Feelings of loneliness significantly increased from time 1 to time 2, d = -0.30, [-0.47, -0.13], with higher symptom levels in symptomatic groups at time 2 and greater increases in the asymptomatic groups. Levels of stress, repetitive negative thinking, quality of life, and social support did not differ during the pandemic. At time 1, loneliness and repetitive negative thinking were associated with anxiety and depressive symptoms. Anxiety and depressive symptoms were prevalent among students, and increased levels of loneliness during the pandemic were associated with elevated symptoms and differing trajectories. Further research using representative and larger samples should determine the long-term impact of the pandemic on mental health and loneliness to identify vulnerable students and offer adequate support.

10.
Front Neuroendocrinol ; 66: 100998, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35597328

RESUMO

Differential HPA axis function has been proposed to underlie sex-differences in mental disorders; however, the impact of fluctuating sex hormones across the menstrual cycle on HPA axis activity is still unclear. This meta-analysis investigated basal cortisol concentrations as a marker for HPA axis activity across the menstrual cycle. Through a systematic literature search of five databases, 121 longitudinal studies were included, summarizing data of 2641 healthy, cycling participants between the ages of 18 and 45. The meta-analysis showed higher cortisol concentrations in the follicular vs. luteal phase (dSMC = 0.12, p =.004, [0.04 - 0.20]). Comparisons between more precise cycle phases were mostly insignificant, aside from higher concentrations in the menstrual vs. premenstrual phase (dSMC = 0.17, [0.02 - 0.33], p =.03). In all included studies, nine samples used established cortisol parameters to indicate HPA axis function, specifically diurnal profiles (k = 4) and the cortisol awakening response (CAR) (k = 5). Therefore, the meta-analysis highlights the need for more rigorous investigation of HPA axis activity and menstrual cycle phase.


Assuntos
Hidrocortisona , Sistema Hipotálamo-Hipofisário , Adolescente , Adulto , Feminino , Humanos , Hidrocortisona/análise , Sistema Hipotálamo-Hipofisário/fisiologia , Ciclo Menstrual/fisiologia , Pessoa de Meia-Idade , Sistema Hipófise-Suprarrenal/fisiologia , Saliva/química , Adulto Jovem
11.
Personal Disord ; 13(6): 597-608, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35389669

RESUMO

Borderline personality disorder (BPD) is characterized by high levels of arousal and perceived rejection by others. The temporal relation between these constructs, however, remains largely unclear. Based on predictions derived from the dynamic affect model and the rejection sensitivity model, we expected increases in arousal and perceived rejection to predict subsequent increases in perceived rejection and arousal, respectively. To investigate this topic, we assessed current self-reported affective arousal and perceived rejection in patients with BPD (n = 42), patients with depressive disorders (DDs; n = 43), and healthy controls (HCs; n = 40) for 52 times within 13 hr (ca. every 15 min). In line with previous studies, dynamic structural equation model results indicate significantly higher trait levels of arousal and perceived rejection in patients with BPD compared with participants in the DD and HC groups. In addition, we found substantial autoregressive and cross-lagged effects for arousal and perceived rejection. Other than expected, the magnitude of these effects did not significantly differ across diagnostic groups. Our findings suggest close temporal relations between arousal and perceived rejection. In patients with BPD, these effects unfold against the background of substantially elevated trait levels of arousal and perceived rejection. Future experience sampling studies should provide additional context information (e.g., through monitoring rejection events) to investigate how patients with BPD perceive rejection in everyday life and how this affects subsequent levels of arousal. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Assuntos
Transtorno da Personalidade Borderline , Transtorno Depressivo , Humanos , Transtorno da Personalidade Borderline/psicologia , Avaliação Momentânea Ecológica , Nível de Alerta , Autorrelato
12.
J Pers Disord ; 35(3): 447-468, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-31887103

RESUMO

Based on typical everyday trust situations, a short and ecologically valid self-report instrument for the assessment of interpersonal trust was developed (Interpersonal Trust Scenario Questionnaire [ITSQ]). Data from 1,359 clinical and nonclinical participants were analyzed to examine psychometric properties and group differences. The authors assessed interpersonal trust in patients with borderline personality disorder (BPD), patients with major depressive disorder, and patients with social anxiety disorder. Lastly, the relationship between interpersonal trust and the perceived quality of the therapeutic alliance was examined. The ITSQ showed satisfactory reliability (Cronbach's α = 0.72). Convergent validity and discriminant validity were obtained for correlations with a hypothetical trust game, another interpersonal trust scale (KUSIV-3), risk propensity, optimism and pessimism, and the HEXACO-60. Patients with BPD showed the lowest interpersonal trust scores of all groups. Interpersonal trust and the perceived quality of the therapeutic alliance were significantly associated only in the group of patients with BPD.


Assuntos
Transtorno da Personalidade Borderline , Transtorno Depressivo Maior , Transtorno da Personalidade Borderline/diagnóstico , Humanos , Reprodutibilidade dos Testes , Autorrelato , Confiança
13.
J Psychiatr Res ; 132: 131-135, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33091687

RESUMO

Borderline Personality Disorder (BPD) is characterized by difficulties in social cognition and social interactions, which exacerbate under stress. A previous study found better facial emotion recognition (FER) in patients with personality disorders and healthy controls (HC) after stress. We recently reported that emotional empathy scores, i.e. the emotional response to another person's emotional state, were significantly lower in BPD patients than in HC after psychosocial stress. Cognitive empathy scores remained unaltered. The present study aims to further investigate the effect of psychosocial stress induced by the Trier Social Stress Test (TSST) on FER as part of social cognition in patients with BPD. We randomized 43 women with BPD and 46 female HC to either the TSST or a placebo condition. Afterwards, participants were asked in an emotion recognition test to identify emotions in faces showing anger or sadness at low and high intensity. Both groups recognized emotions better at high intensity compared with low intensity. There was no effect of stress on FER performance and we found no difference between groups. This is in line with prior research on social cognition in BPD patients demonstrating that the ability to understand another person's perspective might be unaffected by acute stress.


Assuntos
Transtorno da Personalidade Borderline , Reconhecimento Facial , Emoções , Expressão Facial , Feminino , Humanos , Estresse Psicológico
14.
J Abnorm Psychol ; 129(5): 480-491, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32437207

RESUMO

Biased social cognition toward an enhanced processing of negative social information might contribute to instability in interpersonal relationships. Such interpersonal dysfunctions are important for the understanding of several mental disorders, among them borderline personality disorder (BPD). To experimentally test enhanced memory retrieval of negative social information, using a newly developed variant of a looking-at-nothing paradigm, 45 BPD patients and 36 healthy women learned positive and negative personality traits of different target persons. In a translational memory test, participants were asked to use the learned information to evaluate statements about the target person. In addition to behavioral measures of memory performance, we investigated eye gaze patterns to decompose memory retrieval processes. We hypothesized that BPD patients would retrieve negative as compared to positive person information more accurately than healthy controls, and show increased eye gaze toward spatial locations where negative information was provided during the learning phase. Results pointed to a more accurate retrieval of negative person attributes in the patient group as compared with healthy controls, thereby corroborating a negativity bias in social cognition in an exemplary sample of patients with interpersonal problems. Interestingly, the observed negativity bias for person memory was associated with BPD severity, stronger expectancies to be rejected by others, and social detachment. No group differences regarding eye fixation behavior were found. We propose that enhanced retrieval of negative person information might be associated with dysfunctional cognitive schemas as well as reduced behavioral trust, and be of relevance for mental disorders characterized by interpersonal difficulties. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Transtorno da Personalidade Borderline/psicologia , Emoções/fisiologia , Relações Interpessoais , Memória/fisiologia , Percepção Social , Confiança , Adulto , Feminino , Humanos , Comportamento Social , Adulto Jovem
15.
Sci Rep ; 9(1): 332, 2019 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-30674987

RESUMO

Borderline personality disorder (BPD) is characterized by impairments in the cognitive control of negative information. These impairments in cognitive control are presumably due to blunted activity of the dorsolateral prefrontal cortex (dlPFC) along with enhanced activations of the limbic system. However, the impact of an excitatory stimulation of the dlPFC still needs to be elucidated. In the present study, we therefore assigned 50 patients with BPD and 50 healthy controls to receive either anodal or sham stimulation of the right dlPFC in a double-blind, randomized, between-subjects design. Participants performed a delayed working memory task with a distracter period during which a grey background screen, or neutral, or negative stimuli were presented. This experimental paradigm was first evaluated in a pilot study with 18 patients with BPD and 19 healthy controls. In both studies, patients with BPD showed an impairment of cognitive control when negative distracters were presented in the delay period of a working memory task. However, excitatory stimulation of the right dlPFC did not ameliorate cognitive control of negative stimuli in BPD, which raises questions about the specific role of the right dlPFC for the understanding of BPD psychopathology. Methodological limitations are discussed.


Assuntos
Transtorno da Personalidade Borderline/terapia , Cognição/efeitos da radiação , Estimulação Transcraniana por Corrente Contínua/métodos , Adulto , Método Duplo-Cego , Feminino , Humanos , Masculino , Resultado do Tratamento , Adulto Jovem
16.
Artigo em Inglês | MEDLINE | ID: mdl-30581154

RESUMO

BACKGROUND: Borderline personality disorder (BPD), major depressive disorder (MDD), and posttraumatic stress disorder (PTSD) are prominent examples of mental disorders with affective disturbances. Notably, all three disorders share a generally heightened negative affect, which is presumably the result of shared neural abnormalities in affective processing. In this meta-analysis, we aimed to identify transdiagnostic and disorder-specific abnormalities during the processing of negative compared with neutral stimuli. METHODS: We synthesized neuroimaging findings of affect processing in BPD, MDD, and PTSD and calculated combined coordinate- and image-based meta-analyses. The analysis comprised 70 distinct study samples with a total of 31 unthresholded statistical parametric maps. Twenty-four studies had a focus on BPD (431 individuals with BPD, 436 healthy control subjects [HCs]), 32 studies on MDD (789 individuals with current MDD, 870 HCs), and 14 studies on PTSD (247 individuals with PTSD, 245 HCs). RESULTS: Findings showed limbic hyperactivations in BPD and PTSD compared with limbic activation of HCs. In contrast, patients with MDD showed blunted amygdala activation in comparison with that of HCs. Additionally, the calculation of overlapping brain abnormalities in BPD, MDD, and PTSD highlighted transdiagnostic hyperactivation of the right median cingulate gyri and hypoactivation of the right middle frontal gyrus and the right middle occipital gyrus. Finally, disorder-specific comparisons also illustrate unique abnormalities for each mental disorder. CONCLUSIONS: The present results support shared and disorder-specific neural abnormalities in patients with affective disturbances.


Assuntos
Afeto , Transtorno da Personalidade Borderline/fisiopatologia , Transtorno da Personalidade Borderline/psicologia , Encéfalo/fisiopatologia , Transtorno Depressivo Maior/fisiopatologia , Transtorno Depressivo Maior/psicologia , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Mapeamento Encefálico , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino
17.
BMJ Open ; 8(10): e022694, 2018 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-30282684

RESUMO

INTRODUCTION: Affective disturbances and difficulty in affect regulation are core features of major depressive disorder (MDD) as well as borderline personality disorder (BPD). Whereas depressed individuals are characterised by affective inertia, individuals with BPD are characterised by affective instability. Both groups have been found to use more maladaptive affect regulation strategies than healthy controls. Surprisingly, however, there have been hardly any studies directly comparing these two disorders to disentangle shared and disorder-specific deficits in affective dynamics and affect regulation.Furthermore, theoretical models link deficits in affect regulation to deficits in cognitive control functions. Given that individuals with MDD or BPD are both characterised by impairments in cognitive control, the present study will further examine the link between individual differences in cognitive control and disturbances in affect dynamics and regulation in the daily life of individuals with MDD or BPD. METHODS AND ANALYSES: We will use a smartphone application to assess negative and positive affect as well as affect regulation strategies at eight times a day for 7 days. We will further employ four computerised tasks to assess two cognitive control functions, namely interference control and discarding irrelevant information from working memory. Our hypotheses will be tested using a multimethod approach. Power analyses determined a sample size of 159 (53 MDD, 53 BPD, 53 controls) to detect medium effect sizes. ETHICS AND DISSEMINATION: Ethics approval has been obtained from the Freie Universität Berlin. Data collection started in January 2017 and will last until the end of 2018. Results will be disseminated to relevant psychotherapeutic and patient communities in peer-reviewed journals, and at scientific conferences.


Assuntos
Afeto/fisiologia , Assistência Ambulatorial , Transtorno da Personalidade Borderline/fisiopatologia , Transtorno da Personalidade Borderline/psicologia , Cognição/fisiologia , Transtorno Depressivo Maior/fisiopatologia , Transtorno Depressivo Maior/psicologia , Projetos de Pesquisa , Adulto , Berlim/epidemiologia , Transtorno da Personalidade Borderline/epidemiologia , Estudos Transversais , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Social , Teoria da Mente , Adulto Jovem
18.
Clin Psychol Rev ; 63: 56-65, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29913351

RESUMO

Individuals who experience recurrent negative thoughts are at elevated risk for mood and anxiety disorders. It is thus essential to understand why some individuals get stuck in recurrent negative thinking (RNT), whereas others are able to disengage eventually. Theoretical models propose that individuals high in recurrent negative thinking suffer from deficits in controlling the contents of working memory. Empirical findings, however, are inconclusive. In this meta-analysis, we synthesize findings from 94 studies to examine the proposed association between RNT and deficits in cognitive control. We included numerous effect sizes not reported in the primary publications. Moderator analyses tested the influence of variables, such as stimuli valence, cognitive control function (e.g., shifting, discarding), or type of RNT (i.e., rumination or worry). Results demonstrated an association between repetitive negative thinking and deficits in only one specific cognitive control function, namely difficulty discarding no longer relevant material from working memory (r = -0.20). This association remained significant after controlling for level of psychopathology. There was no substantial association between RNT and deficits in any other cognitive control function. All other moderators were not significant. We discuss limitations (e.g., primary sample sizes, reliability of paradigms) and highlight implications for future research and clinical interventions.


Assuntos
Transtornos de Ansiedade/psicologia , Ansiedade/psicologia , Pessimismo/psicologia , Ruminação Cognitiva/fisiologia , Humanos , Memória de Curto Prazo/fisiologia
19.
Cogn Emot ; 31(6): 1234-1242, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-27279528

RESUMO

Cognitive models propose that both, negative interpretations of ambiguous social situations and ruminative thoughts about social events contribute to the maintenance of social anxiety disorder. It has further been postulated that ruminative thoughts fuel biased negative interpretations, however, evidence is rare. The present study used a multi-method approach to assess ruminative processing following a social interaction (post-event processing by self-report questionnaire and social rumination by experience sampling method) and negative interpretation bias (via two separate tasks) in a student sample (n = 51) screened for high (HSA) and low social anxiety (LSA). Results support the hypothesis that group differences in negative interpretations of ambiguous social situations in HSAs vs. LSAs are mediated by higher levels of post-event processing assessed in the questionnaire. Exploratory analyses highlight the potential role of comorbid depressive symptoms. The current findings help to advance the understanding of the association between two cognitive processes involved in social anxiety and stress the importance of ruminative post-event processing.


Assuntos
Fobia Social/psicologia , Pensamento , Adulto , Depressão/complicações , Depressão/psicologia , Feminino , Humanos , Relações Interpessoais , Masculino , Fobia Social/complicações , Adulto Jovem
20.
Psychopharmacology (Berl) ; 233(18): 3405-15, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27422567

RESUMO

RATIONALE: Selective attention toward emotional cues and emotion recognition of facial expressions are important aspects of social cognition. Stress modulates social cognition through cortisol, which acts on glucocorticoid (GR) and mineralocorticoid receptors (MR) in the brain. OBJECTIVES: We examined the role of MR activation on attentional bias toward emotional cues and on emotion recognition. METHODS: We included 40 healthy young women and 40 healthy young men (mean age 23.9 ± 3.3), who either received 0.4 mg of the MR agonist fludrocortisone or placebo. A dot-probe paradigm was used to test for attentional biases toward emotional cues (happy and sad faces). Moreover, we used a facial emotion recognition task to investigate the ability to recognize emotional valence (anger and sadness) from facial expression in four graded categories of emotional intensity (20, 30, 40, and 80 %). RESULTS: In the emotional dot-probe task, we found a main effect of treatment and a treatment × valence interaction. Post hoc analyses revealed an attentional bias away from sad faces after placebo intake and a shift in selective attention toward sad faces compared to placebo. We found no attentional bias toward happy faces after fludrocortisone or placebo intake. In the facial emotion recognition task, there was no main effect of treatment. CONCLUSIONS: MR stimulation seems to be important in modulating quick, automatic emotional processing, i.e., a shift in selective attention toward negative emotional cues. Our results confirm and extend previous findings of MR function. However, we did not find an effect of MR stimulation on emotion recognition.


Assuntos
Atenção/efeitos dos fármacos , Sinais (Psicologia) , Emoções , Reconhecimento Facial/efeitos dos fármacos , Fludrocortisona/farmacologia , Receptores de Mineralocorticoides/agonistas , Adulto , Ira , Face , Expressão Facial , Feminino , Felicidade , Voluntários Saudáveis , Humanos , Masculino , Percepção Social , Adulto Jovem
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