American Psychiatric Association Research Articles

Stranger in the Mirror: Exploring Somatic Defamiliarization

This study explores the centrality of the senses for the maintenance or disruption of people’s commonsensical familiarity with the world. Drawing from in-depth interviews with people affected by depersonalization/derealization, which the American Psychiatric Association defines as a dissociative condition in which people perceive the world as dream-like, I conceptualize what I term somatic defamiliarization. I define somatic defamiliarization as a process whereby people experience previously unquestioned sensory phenomena, such as mundane objects or their bodies, as unfamiliar. Building on Berger and Luckmann’s work, I contend that somatic defamiliarization is a perpetual, albeit latent, condition of social life that threatens reality maintenance. I discuss how the concept of somatic defamiliarization can be applied to explore the somatic qualities of experiential ruptures that people may undergo in various circumstances, such as immigration or war.

Psychiatric disorder in prolonged post-concussive syndrom : clinical assessment, physiopathology and management review of the literature

IntroductionAccording to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), post concussive syndrome (PCS) is given a diagnosis of either major or mild neurocognitive disorder (NCD) due to traumatic brain injury TBI. However Persistent post-concussion symptoms (PPCS) are more complex, and typically involve multidisciplinary assessment and management. The symptoms are varied, non-specific and the therapeutic process is defiant for psychiatrist.ObjectivesTo investigate the semiology of persistent post-concussion syndrome (PPCS) and the therapeutic challenges it poses.MethodsA literature review was made on Pubmed, Google Scholar and Cochrane library using keywords: “post-concussive syndrome”,”psychiatric disorder”, “depression”,”post-traumatic stress disorder”,”treatment”, “physiopathology”.ResultsThe physiopathology of persistent PCS is controversy.The Symptoms are due to the Concept of “Symptom Generators” which results from the alterations in neurophysiology and neuropathology secondary to the injury, and pre- or post-injury psychological factors physiological concussion. The Global cerebral metabolic disturbance, the autonomic nervous system dysfunction and the cerebral blood flow dysregulation induce biochemical cascade,excitotoxic reaction and immunotoxicity.Clinical diagnoses associated with PPCS are:Major depressive disorder,Post traumatic stress disorder,Anxiety disorder,Substance abuse disorder,Psychotic disorder and Antisocial personality disorder. For the non pharmacological management: A systematically early information and a graded physical exercise in addition to other treatment are essential.Antidepressant, benzodiazepine and mood-stabilizer are the most recommended treatments for psychiatric symptoms. Atypical neuroleptics are indicated in delirant disorder, behavior disorder and antisocial personality disorder.Some studies suggest the methylphenidate and biperiden to treat several cognitive impairment and severe behavior disorder.Conclusions(PPCS) is far from being a subjective complaint by patients. It is a complex clinical entity that groups symptoms that overlap with other psychiatric diagnoses, such as depression, post-traumatic stress disorder, and mood disorders. Early neuropsychiatric assessment and personalized pharmacological and psychotherapeutic treatment are essential factors in the prognosis of the disease.Disclosure of InterestNone Declared

Gaming Addiction: Investigation of Motivation to Play PUBG Game

American Psychiatric Association (APA) states that gaming addiction is an irresistible and compulsive drive by a person to be involved in a video game. We are going to find out what is the motive of a PUBG player to play for the game. This involves two hypotheses of the study. One is about whether religiosity level has any relationship with gaming addiction or not. The other is about motivation to play PUBG games. A survey technique was employed to collect the data. The Pearson correlation is -0.192. This value signifies a negative correlation between religion level and gaming addiction. A negative correlation suggests that as one variable (in this case, religion level) increases, the other variable (gaming addiction) tends to decrease, and vice versa. The magnitude of -0.192 indicates that the association is not extremely strong, but it is statistically significant. A strong association was observed between a high cultivation effect and a high motivation level.

An Antidote to the Pathologizing of Grief: Applying the Power–Threat–Meaning Framework

Emerging theories of grief over the last 30 years have represented a shift from the healing of pathology to a focus on the adaptation to loss. Recently, however, there has been an alarming resurgence for a medicalized model of grief, most saliently evident in the removal of the bereavement exclusion from the diagnosis of major depressive disorder in theDiagnostic and Statistical Manual of Mental Disorders(5th ed.;DSM-5; American Psychiatric Association [APA], 2013) and the inclusion of prolonged grief disorder in theDiagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision(DSM-5-TR; APA, 2022). These have predictably opened up opportunities for the pursuit of pharmacological treatment including antidepressants and medication usually offered for recovery from alcohol and drug addiction. A pathologizing approach to grief can have a significant and detrimental impact on individuals and compromises the core humanistic values that underpin my professional identity as a counselling psychologist. I propose that we need a radically different lens, and the power–threat–meaning framework (PTMF), an alternative to psychiatric diagnosis developed by psychologists in the United Kingdom, offers us such an opportunity. Consideration is given to how the PTMF may be applied to grief therapy where it can embrace the uniqueness of grief responses and reframe it as an entirely understandable response to trauma and loss.

Effect of biophilic shopping environments featuring Christmas trees on perceived attentional and mental fatigue: A national study

The Mayo Clinic and the American Psychiatric Association recognize that many people experience stress around the holidays. For example, households with children, people living alone, etc. during the Christmas holiday might be feeling mentally fatigued or maybe they simply want to improve their mental state. We aimed to investigate the extent to which Christmas tree shopping environments that include real trees in the outdoors (a common type of biophilic store design) provide opportunities to help them recover from mental and attentional fatigue (derived from Attention Restoration Theory) when compared to artificial indoor tree displays. A nationwide online survey (n=1208, 45 questions, and two video evaluations) was used to compare real-time and post video evaluations of outdoor displays of real Christmas trees with indoor displays of artificial Christmas trees using two measures of overall perceived restorative quality. The key finding indicates that real/outdoor trees have a higher perceived restorative quality (real-time video evaluation p <.05 and post-video evaluation p <.001). Although the fascination ratings for artificial/indoor tree ratings were significantly higher (p <.01), it had a much weaker effect than real trees (less than half) on overall restorative quality. That is, although indoor artificial trees were more fascinating, it appears to be the kind of “hard” fascination that does not contribute nearly as much to restoration when compared to the “softer” fascination associated with real trees. The positive effect of coherence (e.g., orderly tree displays) and scope (e.g., perception of depth and spaciousness) on overall restorative quality that was perceived by respondents was greater for real/outdoor tree displays. These larger effects were measured in a multivariate multiple regression model but also identified in most of the peak restorative moments during the video evaluation.

In Case You Haven't Heard…

Body dysmorphic disorder (BDD), defined as an excessive preoccupation with perceived flaws in personal appearance, affects almost two in every 100 teens, according to a report in the Journal of the American Academy of Child and Adolescent Psychiatry. The report also found that BDD is much more common in girls than boys, according to an American Psychiatric Association news alert. Moreover, children and adolescents with BDD are highly likely to have other psychiatric disorders — especially depression and anxiety — and to experience psychosocial problems, self‐harm and/or suicide attempts. “The researchers analyzed data from 7,654 children and young people aged 5‐19 who completed the 2017 Mental Health of Children and Young People in England survey with their parents/guardians. Among all children and teens aged 5‐19, the prevalence of BDD was 1%. BDD was more common among teens ages 12‐19 (1.9%) than among children ages 5‐11 (0.1%). Across all ages, BDD was also more common in girls (1.8%) than boys (0.3%).

The effectiveness of school-based child sexual abuse prevention programmes among primary school-aged children: A systematic review

This systematic review provides a comprehensive overview of child sexual abuse prevalence globally, along with an examination of the effectiveness of school-based prevention education programmes for primary school-aged children. These prevention programmes utilise social cognitive learning theories to teach children the importance of identifying and responding to abusive situations. A total of 676 papers were evaluated with 13 Randomised Controlled Trial (RCT) or cluster RCT design studies identified as meeting the study's inclusion criteria. These studies were published in English between January 2000 and May 2022, and focus on outcomes of school-based prevention programmes designed for primary school-aged children (5–12 years old). To ensure a comprehensive and academically rigorous analysis, the following databases were included: Science Direct, Web of Science, Scopus, the American Psychiatric Association (APA) PsycINFO, Ovid Medline, and Embase. The studies reviewed aim to evaluate the effectiveness of various child sexual abuse prevention programmes in improving children's knowledge and recognition of, and response to potentially unsafe situations. In terms of outcomes and results, the interventions have significantly impacted knowledge, skills, confidence, and awareness in the short and long term. These studies used different intervention methods, including mobile applications, personal safety programmes, and protective behaviour programmes, delivered in various formats such as web-based, textbooks, and in-person sessions. This systematic review highlights the importance of child sexual abuse prevention programmes in schools and the need for further research.

From Siege to Survival: Exploring the Multi-Faceted Traumas of Meranao Internally Displaced Persons

The 2017 Marawi Siege in the southern Philippines resulted not only in a city’s physical devastation but also in a profound psychological impact on its internally displaced residents, mainly from the Meranao community. This research aims to understand the trauma endured by these Meranao IDPs, linking it with paradigms of forced migration, cultural displacement, and post-conflict collective memory. Using the American Psychiatric Association’s definition of trauma and Herman’s Trauma Theory as a guiding framework, six IDP survivors from the Sagonsongan area were interviewed. The study adopted the Interpretative Phenomenological Analysis (IPA) approach to explore the participants’ experiences. This qualitative method involves a detailed examination of personal lived experiences, attempting to understand how individuals make sense of their major life experiences. The IPA approach was particularly suitable for this study as it allowed the researchers to examine the personal stories of trauma, providing a rich and detailed first-person account of the psychological struggles faced by the Meranao IDPs. The data collection involved in-depth, semi-structured interviews that enabled the participants to share their stories in a flexible yet comprehensive manner. The interviews were transcribed verbatim and analyzed following the principles of IPA, which involve a cyclical process of reading and re-reading the transcripts, coding for themes, and looking for connections between themes across the different narratives. The researchers remained cognizant of their preconceptions and engaged in a reflective process to minimize bias. The findings revealed several themes, such as the traumatic implications of familial dislocation, economic hardships, persistent trauma, feelings of exhaustion, and a compromised sense of safety. These findings not only intersect with established theories but also provide unique insights into the Meranao community’s post-siege challenges. The trauma narratives contributed to a nuanced account of the Meranao IDPs’ psychological struggles after the siege. Keywords: Meranao community, internally displaced persons, Marawi Siege, trauma

Comparing psychopathological symptoms, life satisfaction, and personality traits between the WHO and APA frameworks of gaming disorder symptoms: A psychometric investigation.

The inclusion of Internet Gaming Disorder (IGD) in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association and Gaming Disorder in the 11th revision of the International Classification of Diseases (ICD-11) by the World Health Organization requires consistent psychological measures for reliable estimates. The current study aimed to investigate the psychometric properties of the Gaming Disorder Test (GDT), the Ten-Item Internet Gaming Disorder Test (IGDT-10), and the Five-Item Gaming Disorder Test (GDT-5) and to compare the WHO and the APA frameworks of gaming disorder symptoms in terms of psychopathological symptoms, life satisfaction, and personality traits. A sample of 723 Swedish gamers was recruited (29.8% women, 68.3% men, 1.9% other, Mage = 29.50 years, SD = 8.91). The results indicated notable differences regarding the estimated possible risk groups between the two frameworks. However, the association between gaming disorder symptoms and personality traits, life satisfaction, and psychopathological symptoms appeared consistent across the two frameworks. The results showed excellent psychometric properties in support of the one-factor model of the GDT, IGDT-10, and GDT-5, including good reliability estimates (McDonald's omega) and evidence of construct validity. Additionally, the results demonstrated full gender and age measurement invariance of the GDT, IGDT-10, and GDT-5, indicating that gaming disorder symptoms are measured equally across the subgroups. These findings demonstrate that the IGDT-10, GDT-5, and GDT are appropriate measures for assessing gaming disorder symptoms and facilitating future research in Sweden.

In Case You Haven't Heard…

The transition into menopause by itself does not appear to raise the risk of depression in women, according to a review in The Lancet, the American Psychiatric Association News Alert reported. However, a subset of women with a history of depression and/or certain menopause‐related risk factors may be vulnerable to depressive symptoms during this period. “Clinicians should not assume that psychological symptoms during the menopause transition are always attributable to hormonal changes,” wrote Lydia Brown, Ph.D., M.Psych., of the University of Melbourne and colleagues. “Potential misattribution of psychological distress and psychiatric disorders to menopause could harm women by delaying accurate diagnosis and the initiation of effective psychotropic treatments, and by creating negative expectations for people approaching menopause.” Brown and colleagues analyzed 12 prospective studies reporting depressive symptoms, major depressive disorder, or both for more than 25,000 women during the menopause transition. Among their recommendations, Brown and colleagues said individuals should be provided with evidence‐based information about menopause, including clear statements that most individuals are not at risk of mental health problems.

The Unconscious as Cinematographic Form: A Psychoanalytic Reading of Inception

Freud’s “unconscious,” a lauded seminal psychological contribution, has transitioned into an efficacious narrative device in cinema, evolving into a paradigmatic relationship. This article scrutinizes Inception (2010), a quintessential psychoanalytical film written and directed by Christopher Nolan. It explicates the director’s linkage to psychoanalysis and reveals how he demystifies the unconscious through its utilization both as a cinematic form and thematic device, manifested in discernible dream layers. It is ascertained that these layers perform a bifunctional role as cinematic and narrative elements. Intriguingly, this multifaceted structure extends to character development as well, exploiting the complexities of the characters’ pathologies. Since the filmic structure leverages the pathologies exhibited by the characters, they constitute secondary data for the analysis. The pathologies are aligned with the mental disorder classifications the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TRTM) (American Psychiatric Association, 2013). Pertinent character data are analysed in the Statistical Package for the Social Sciences (SPSS). The findings, subsequently subjected to psychoanalytic film analysis, enrich a deeper understanding and fuller appreciation of the representation of the unconscious in the cinematic domain.

The availability of dialectical behavior therapy in partial hospitalization and residential services for borderline personality disorder: An exploratory longitudinal study of the National Mental Health Services Survey from 2014 to 2021.

Treatment guidelines on borderline personality disorder (BPD) recommend day-hospital or residential treatments for patients with BPD who cannot tolerate outpatient treatment (American Psychiatric Association, 2010; National Health & Medical Research Council, 2013). However, the current literature suggests that evidence-based treatment for BPD may be difficult to access (Lohman et al., 2017). The present study aims to characterize the accessibility of dialectical behavioral therapy (DBT) in day-treatment and residential programs in the United States in the last 7 years and examines whether day-treatment and residential programs that accept state benefits (i.e., Medicaid) are significantly less likely to offer DBT. Using mixed logistic regression, we examined trends in the National Mental Health Services Survey data from 2014 to 2021, a survey of U.S. mental health facilities which tracks whether facilities provide DBT. We found that the likelihood that a residential or day-hospital facility offers DBT has been growing over time at the national level (ORday-treatment = 1.07, SE = .03, z = 1.90, p = .05; ORresidential = 1.08, SE = .05, z = 1.77, p = .08). We also found significant variability in these trends at the state level. In addition, we found that facilities accepting state benefits were less likely to offer DBT (ORday-treatment = .66, SE = .021, z = -1.93, p = .05; ORresidential = .67, SE = .21, z = -1.91, p = .06). Consistent with previous literature, our study suggests that these programs are very scarce across the United States and difficult to access for those with Medicaid.guidelines on borderline personality disorder (BPD) recommend day-hospital or residential treatments for patients with BPD who cannot tolerate outpatient treatment (American Psychiatric Association, 2010; National Health & Medical Research Council, 2013). However, the current literature suggests that evidence-based treatment for BPD may be difficult to access (Lohman et al., 2017). The present study aims to characterize the accessibility of dialectical behavioral therapy (DBT) in day-treatment and residential programs in the United States in the last 7 years and examines whether day-treatment and residential programs that accept state benefits (i.e., Medicaid) are significantly less likely to offer DBT. Using mixed logistic regression, we examined trends in the National Mental Health Services Survey data from 2014 to 2021, a survey of U.S. mental health facilities which tracks whether facilities provide DBT. We found that the likelihood that a residential or day-hospital facility offers DBT has been growing over time at the national level (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Fifty Years of Change: A Shared Journey.

The author shares a personal account of 50 years of experience practicing psychodynamic psychiatry and psychoanalysis after migrating from Argentina to the United States. Her career developed in parallel as a clinician and as an academic psychiatrist, with leadership roles in the American Psychiatric Association, the Association of Women Psychiatrists, and the American Academy of Psychodynamic Psychiatry and Psychoanalysis. After describing what constitutes the essence, substance, and form of psychoanalysis, she reviews the historic shift within psychoanalysis in the United States from intrapsychic dyadic practice with selected patients to the application of psychodynamic concepts to everyday psychiatric care of patients with complex morbidities in multiple clinical settings.

The American Psychiatric Association Publishing Textbook of Geriatric Psychiatry, Sixth Edition.

The American Psychiatric Association Publishing Textbook of Geriatric Psychiatry, Sixth Edition.

THE REPRESENTATION OF NARCISSISTIC PERSONALITY DISORDER OF BARONESS IN THE MOVIE OF “CRUELLA” DIRECTED BY CRAIG GILLESPIE

The purposes of this research are: (1) To examine the character of Narcissistic Personality Disorder on Baroness (2) To show the impacts of Baroness’s Narcissistic Personality Disorder to people around her. This research found out the characterization of Narcissistic Personality Disorder on Baroness the villain on Cruella (2021) movie. In studying of Narcissistic Personality Disorder, the researchers use Qualitative research methodology and use psychological approach to examine the psychology aspect on Baroness. This research also uses two main books from American Psychiatry Association DSM – V to know the characterization of Narcissistic Personality Disorder and book The Everything : Guide to Narcissistic Personality Disorder by Goodman, Lechan Cynthia and Leff, Barbara to describe the impact of Baroness’s Narcissistic Personality Disorder to people around her. The researchers found the significant characterization which is the Grandiose of Self – Importance on Baroness’s Narcissistic Personality Disorder and the significant impacts are Narcissistic as Co – Worker and Narcissistic as Boss.

Mental health awareness initiative to support Black males

Creating new, psychologically safe opportunities for Black men and boys to normalize seeking out mental health care when they need it is the objective behind a new initiative announced Feb. 15 that supports their mental health — at a time when suicide rates for Black males aged 10 to 19 have risen faster than any other racial group in the past two decades, according to the American Psychiatric Association Foundation (APAF).

Is trypophobia real?

Approximately 10-18% of the adult population experience some form of anxiety when viewing clusters of small holes. 'Trypophobia' has been the subject of much discussion within the peer-reviewed literature, news outlets, health-related websites and social media. However, there is some scepticism surrounding the phenomenon. It is often stated that the condition is not recognised by the American Psychiatric Association, and not listed as a phobia in the DSM-5. It has also been claimed that trypophobia is no more than a particularly successful internet meme. In this editorial, I argue that such criticisms are misplaced. There is, for instance, no list of phobias in the DSM-5; only criteria that determine phobia classification. Using these criteria, as well as personal testimonials, trypophobia is clearly a phobia. Furthermore, the meme hypothesis cannot account for the fact that the phenomenon existed long before the internet.

Associated Factors with Premenstrual Dysphoric Disorder among Undergraduate Medical Students of a Teaching Hospital

Introduction: Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome in women which adversely affects social, academic, or work performance. The mechanisms underlying PMDD are still insufficiently known, the findings indicate a multifactorial genesis. Prevalence data of PMDD and its potential associated risk factors is sparse in Nepal. This study aimed to determine the associated factors with PMDD among undergraduate medical students of a teaching hospital in Nepal. Methods: This was a cross sectional study conducted among unmarried female medical students at KIST medical college and teaching hospital from 1st June to 30th July, 2023. Students were assigned from each of the four MBBS years (First, Second, Third, and Final) through random sampling till the desired sample size was achieved. Questionnaires about socio-demographic, menstrual, lifestyle variables and questionnaire for diagnosis of PMDD were administered. PMDD was diagnosed from the Diagnostic and Statistical Manual – fifth edition (DSM-5) of the American Psychiatric Association (APA). Data Analysis was performed using SPSS version 16. Data calculated as frequencies, mean, standard deviation and chi square test, independent t test with p-value of &lt; 0.05 was considered as statistically significant. Results: The prevalence of PMDD according to DSM-V criteria was 41 (36.28%). PMDD was significantly associated with dysmenorrhea (P=0.030) and with intake of caffeinated beverages (P=0.034). Conclusion: PMDD is prevalent among medical students in Nepal. The potential associated risk factors are dysmenorrhea and intake of caffeinated beverages.

APA Healthy Minds poll finds 1 in 3 adults lonely every week

Thirty percent of adults said that they have experienced feelings of loneliness at least once a week over the past year, while 10% said they are lonely every day, according to the latest Healthy Minds Monthly Poll from the American Psychiatric Association (APA) released last week. The APA poll found that only 9% connect to a therapist or counselor to combat feelings of loneliness.

Examining the Authenticity of Autistic Portrayals in US Adult and Children's Television Shows Using Medical and Social Models of Disability.

Television programs have introduced viewers to characters on the autism spectrum (e.g., Sesame Street, The Good Doctor), impacting audiences' knowledge and attitudes. Thus, it is essential that character representations convey accurate health information. This study explores how autistic portrayals across six adult and children's television programs align with the medical (e.g., American Psychiatric Association in Diagnostic and statistical manual of mental disorders, 5th ed., text rev., 2022, https://doi.org/10.1176/appi.books.9780890425787 ) and social models of disability. A content analysis methodology was used to investigate defining characteristics of autism (i.e., medical model) and how characters navigated their environment (i.e., social model) in 252 scenes (across six characters in 22 episodes). Measures included the frequency with which autism characteristics (e.g., social-communicative difficulties, restrictive repetitive behaviors) were present across autistic portrayals and the valence (e.g., positive, negative, neutral) with which characters interacted with their environment (e.g., character and neurodiversity affirming valence). Findings indicate that (a) television portrayals depict social-communication difficulties significantly more than behavioral characteristics, (b) children's programming portrays autistic characters with significantly more positive personal attributes (i.e., character valence) than adult programs, and (c) the majority of programs portray characters navigating autism in positive or neutral ways (i.e., neurodiversity affirming valence). Results offer stakeholders (e.g., writers, advocates, neurodiverse community) insight into how autistic characters are portrayed on television, adding to a growing body of literature examining how such representations impact public knowledge, attitudes, and behaviors towards individuals on the autism spectrum. Collectively, such studies highlight how changes in diagnostic criteria, legal protections, and social inclusivity are presented to viewers, who are seeking entertainment but gaining public health information.