Blunted Affect Research Articles

The structure stability of negative symptoms: longitudinal network analysis of the Brief Negative Symptom Scale in subjects with schizophrenia

IntroductionNegative symptoms (NS) represent an unmet need of treatment in schizophrenia (SCZ). As a result, these symptoms pose a significant burden on patients, their families, and the health care system. In the last decade, the conceptualization model that has received the most support from the literature has described 2 domains of NS: the expressive deficit (EXP), which includes blunted affect and alogia, and the motivational deficit (MAP), which includes avolition, asociality, and anhedonia. However, different confirmatory factor-analytic studies suggest that the bi-dimensional model may not capture the complexity of this construct, which could be better defined by the 5-factor model. To date no study exploiting innovative tools and state of the art assessment instruments has yet been conducted to evaluate the NS structure stability over time.ObjectivesThe aim of this study was to investigate the stability of the latent structure of NS in subjects with SCZ.MethodsNS were assessed in 612 subjects with SCZ using the Brief Negative Symptom Scale (BNSS) at the baseline and after 4-year follow-up. A network invariance analysis was conducted for the data collected longitudinally.ResultsResults showed that the BNSS’ items aggregated to form 5 distinct domains (avolition, asociality, blunted affect, alogia and anhedonia). The result of the network invariance test indicated that the network structure remained unchanged over time (network invariance test = 0.13; p = 0.169) while its overall strength decreased significantly (6.28 baseline, 5.79 at follow-up; global strength invariance test = 0.48; p = 0.016).ConclusionsThe results of this study show how the construct of NS can be better explained by the 5 individual negative symptoms and that this model is almost stable over time. Therefore the 2-dimensional model may be insufficient to describe the characteristics of NS. This data is of important relevance with consequent implications in the study of pathophysiological mechanisms and the development of targeted treatments for NS.Disclosure of InterestNone Declared

Sociality, wellbeing, and emotions in children during the pandemic. The case of Pompei

Our objective in this work was to show how the pandemic and mitigation efforts affected the physical and emotional well-being of parents and children in our research context through early March of 2020. The methods used in our research include the analysis of children's drawings, as well as interviews with teachers and family members. During this period of the restriction, our research verified the presence of reduced physical activities, eating disorders, increased requests for and reliance on video games, and screen time for entertainment, all fears related to isolation, restlessness dreams, emotional withdrawal, and sadness/depression.

Searching for bridges between psychopathology and real-world functioning in first-episode psychosis: a network analysis from the OPTiMiSE trial

IntroductionNetwork analysis has been used to explore the interplay between psychopathology and functioning in psychosis, but no study has used dedicated statistical techniques to focus on the bridge symptoms connecting these domains.ObjectivesThe current study aims to estimate the network of depressive, negative, and positive symptoms, general psychopathology, and real-world functioning in people with first-episode schizophrenia or schizophreniform disorder, focusing on bridge nodes.MethodsBaseline data from the OPTiMiSE trial were analysed. The sample included 446 participants (age 40.0±10.9 years, 70% males). The network was estimated with a Gaussian graphical model (GGM), using scores on individual items of the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS), and the Personal and Social Performance (PSP) scale. Stability, strength centrality, expected influence (EI), predictability, and bridge centrality statistics were computed. The top 20% scoring nodes on bridge strength were selected as bridge nodes.ResultsNodes from different rating scales assessing similar psychopathological and functioning constructs tended to cluster together in the estimated network (Fig. 1). The most central nodes (EI) were Delusions, Emotional Withdrawal, Depression, and Depressed Mood. Bridge nodes included Depression, Conceptual Disorganisation, Active Social Avoidance, Delusions, Stereotyped Thinking, Poor Impulse Control, Guilty Feelings, Unusual Thought Content, and Hostility. Most of the bridge nodes belonged to the general psychopathology subscale of the PANSS. Depression (G6) was the bridge node with the highest value.Image:ConclusionsThe current study provides novel insights for understanding the complex phenotype of psychotic disorders and the mechanisms underlying the development and maintenance of comorbidity and functional impairment after psychosis onset.Disclosure of InterestNone Declared

Psychiatric Symptoms & Misdiagnosis Of Frontotemporal Dementia: A Case Report

IntroductionFrontotemporal dementia (FTD) is the second most common type of dementia seen between 45-65 years of age and affects the frontal and/or temporal lobes. FTD is clinically characterized by progressively the change in behavior, personality, and language dysfunctions. Clinical features of FTD include restlessness, disinhibition, apathy, blunted affect, avolition, social withdrawal, impulsiveness, and loss of executive function. Most patients with FTD act as socially inappropriate behaviors, not talking much, compulsive-like acts, poor insight, and psychiatric features including hallucinations and paranoid delusions. According to symptoms, the diagnosis of FTD may be confused with depression, mania, or schizophrenia.ObjectivesIn this case report, we wanted to draw attention that FTD should be considered in the differential diagnosis of late-onset psychosis.MethodsA 53-year-old female, married, uneducated, and not having children patient has applied to our clinic with complaints, that started a year ago, about social withdrawal, activity, decreased sense of purpose, neglecting personal hygiene, not eating well, and acting inappropriately and impulsively.The patient reported that she was walking out of the house for hours, having profanity speeches, and forgetfulness.She was admitted to the psychiatry hospital a year ago and discharged with a diagnosis of bipolar disorder.Brain MRI showed atrophy of frontal and anterior temporal structures bilaterally. PET scan demonstrated left frontal, parietal, and temporal hypo perfusion of the brain.In our clinical observation, she had apathy, inappropriate jokes, lack of eye contact, flat affect, lack of gesturing when communicating, unable to respond to questions, and visual hallucinations.ResultsDue to the similarity of the clinical resemblance of BPAD and FTD, the diagnosis of FTD can be confusing. In this case, amnesia and sudden onset of the symptoms with rapid destruction may help the diagnosis of FTD.Psychosis symptoms in our clinical observation also suggested the diagnosis of psychosis. However, its atypical course and early-onset psychosis symptoms brought us closer to organic pathology. Investigations of structural and functional brain imaging may help support the diagnosis.Image:Image 2:ConclusionsPsychiatric symptoms in FTD may cause misdiagnosis. Organic pathologies should be kept in mind, especially in late and sudden onset symptoms.Disclosure of InterestNone Declared

Reviewing the consistency of Dissociative Identity Disorder: a case report.

IntroductionWe present the case of a 22-year-old patient who has been followed up in a daytime hospital for personality disorders since June 2022. Of note is the presence of multiple personalities (in total of more than 20 have been identified), each of which has distinct physical and psychological characteristics.ObjectivesThe objective is to present a clinical case of dissociative identity disorder and to review the existence of scientific evidence supporting this diagnosis.MethodsLiterature review of scientific papers over the last years and classic textbooks on the issue. We included references in English and Spanish languages.ResultsNumerous studies support that dissociative disorders are the result of psychological traumas that generally begin in childhood. This is a difficult category to diagnose, since they present symptoms that also appear in other disorders such as those of the schizophrenic spectrum.One or more dissociative parts of the subject’s personality avoid the traumatic memories while others become fixed to these traumatic experiences and manifest symptoms. In the case of our patient, there are dissociative episodes with subsequent amnesia and auditory, visual and olfactory hallucinations, as well as impulsive behaviors in the form of self-injury and a flattened affect, with significant emotional distancing.Conclusions-The prevalence of dissociative identity disorder is higher than traditionally thought.-Some theories develop how trauma essentially produces a degree of dissociation of the psychobiological systems that constitute the subject’s personality.Disclosure of InterestNone Declared

The Brief Negative Symptom Scale: external validation of symptom domains with clinical, cognitive and functioning-related variables in subjects with schizophrenia

IntroductionNegative symptoms (NS) represent a heterogeneous construct of schizophrenia, whose conceptualization is still to be clarified. In the last decade, the conceptualization model that has received the most support from the literature has described 2 NS domains: the expressive deficit (EXP), which includes blunted affect and alogia, and the motivational deficit (MAP), which includes avolition, asociality, and anhedonia. However, different confirmatory factor-analytic studies suggest that the bi-dimensional model may not capture the complexity of this construct, which could be better defined by a 5-factor model (5 individual negative symptoms) or a hierarchical model (5 individual negative symptoms as first-order factors, and the 2 domains, MAP and EXP domains, as second-order factors). However, to our knowledge, no study has investigated associations between negative symptom models with social cognition and functional capacity, which are largely documented to correlate with negative symptoms, nor the associations with external validators over time, looking at the potential stability of negative symptom models validity through the course of the illness.ObjectivesIn the light of this observations, we investigated, the external validity of the five-factor model and the hierarchical model of the BNSS in subjects with schizophrenia, looking at associations with cognition, social cognition, functioning and functional capacity at baseline and at four years follow-up.MethodsNS were assessed in 612 subjects with schizophrenia using the Brief Negative Symptom Scale at the baseline and after 4-year follow-up. State of the art assessment instruments were used to assess cognitive and functioning related variables. Structural equation models (SEM) that included the NS models and 4 external variables were used to our aim.ResultsAccording to recent multicenter studies, our results confirmed the validity of the 5-factor- and the hierarchical-model of negative symptoms. In particular, these 2 models proved to be equivalent in terms of fit to the data at baseline and follow-up. As regard to the relationship of the two BNSS models with external variables, we found that there was a similar pattern of associations at the two time points despite minor variations.ConclusionsThe five factor and the hierarchical models provide an optimal conceptualization of negative symptoms in relation to external variables. The similar pattern of associations with external variables of the two models at the two time points despite minor variations, suggests that the simple and widely used 5-factor solution provides the best balance between parsimony and granularity to summarize BNSS structure. This data is of important relevance with consequent implications in the study of pathophysiological mechanisms and the development of targeted treatments for NS.Disclosure of InterestNone Declared

Особливості психотерапевтичного супроводу в структурі паліативної допомоги хворим, які страждають на злоякісні новоутворення

Palliative medicine is aimed at achieving the best possible in a particular situation the level of quality of life of the patient. Purpose - to investigate that the grief reaction is one of the strongest and most painful human experiences. Materials and methods. There were 120 cancer patients observed. The reaction of grief consists of 4 stages: shock and protest - numbness, disbelief and acute dysphoria; absorption - acute longing, search and anger; disorganization - a sense of despair and acceptance of loss and decision. Results. The initial reaction of grief - shock, emotional numbness and disbelief. The excitement is most pronounced within about two weeks, followed by symptoms of depression, which reach its peak 4-6 weeks. Eventually, the former intense pain of severe loss begins to subside. In addition to the reaction of grief, there is a pathological, which is divided into suppressed (inhibited), delayed (delayed) and chronic. The role of the psychotherapist at this stage is to provide psychological support and assistance to both the patient and his environment to cope with this situation. Conclusions. The principle of the concept of palliative care is the need to ensure the psychological comfort of the patient. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

The impact of subtle language and communication difficulties on the daily lives of autistic children without intellectual disability: Parent perspectives.

Autistic children without intellectual disability will likely experience higher level language and communication difficulties. These may appear subtle, in that they are not immediately evident to those who do not know the child well and may not manifest in all environments. Because of this, the impact of such difficulties may be underestimated. This phenomenon has similarly attracted little research attention, meaning the extent to which subtle language and communication difficulties contribute to the needs of autistic individuals without intellectual disability may be underspecified in clinical services. To offer a detailed exploration of how relatively subtle language and communication difficulties impact on autistic children without intellectual disability and what strategies parents recognize can mediate those negative effects. Twelve parents of autistic children from the target group (aged 8-14 years, attending mainstream school) were interviewed about how subtle language and communication difficulties impact their autistic child. Rich accounts were derived then analysed using thematic analysis. Eight of the children discussed had previously been interviewed independently in a parallel study. Comparisons are discussed in this paper. Parents reported heterogeneous but pervasive higher level language and communication difficulties which universally impacted key areas of the children's function: peer relationships, developing independence and performance in education. Communication difficulties were also universally associated with negative emotional responses, social withdrawal and/or negative self-perceptions. While parents identified a range of ad hoc strategies and naturally occurring opportunities that improved outcomes, there was little mention of the means to address primary language and communication difficulties. The current study showed a number of parallels with child accounts, demonstrating the benefits of collecting data from both sources in clinical and research investigations. However, parents were more concerned about longer term implications of language and communication difficulties and highlighted their impact on the child developing functional independence. Subtle language and communication difficulties, typically identified in this higher ability autistic group, can impact significantly on key areas of childhood function. Support strategies seem to be parent generated and inconsistently applied across individuals, without the benefit of coherent specialist services. Dedicated provision and resources targeting areas of functional need may be beneficial to the group. In addition, the commonly reported association between subtle language and communication difficulties and emotional well-being indicates the need for greater exploration using empirical methods, and joined-up clinical working between speech and language therapy and mental health services. What is already known on the subject There is now a wide understanding of how language and communication difficulties can impact the individual. However, where those difficulties are relatively subtle, for example, in children without intellectual disability and where difficulties are not immediately evident, less is known. Research has often speculated on how identified differences in higher level structural language and pragmatic difficulties might impact on the function of autistic children. However, to date dedicated exploration of this phenomenon is limited. The current author group explored first-hand accounts of children. Corroborative evidence from parents of the same children would add further weight to understanding this phenomenon. What this paper adds to the existing knowledge This study provides a detailed exploration of parents' perspective relating to the impact of language and communication difficulties on autistic children without intellectual disability. It provides corroborative detail that support child accounts of the same phenomenon, indicating the impact on peer relationships, school outcomes and emotional well-being. Parents also report functional concerns around the child's ability to develop independence and this paper demonstrates how parents and children might deviate in their accounts, with parents reporting increased concerns around the longer term implications of early language and communication difficulties. What are the potential or actual clinical implications of this work? Relatively subtle language and communication difficulties can have a significant impact on the lives of autistic children without intellectual disability. Greater service provision for this group is therefore indicated. Interventions could focus on areas of functional concern where language is implicated, for example, peer relationships, developing independence and school success. Additionally, the relationship between language and emotional well-being points to further integration between speech and language therapy and mental health services. Differences found between parental and child reports highlight the need to collect data from both parties during clinical investigations. Parental strategies may offer benefits for the wider population.

Relationship Between Attachment Behaviors and Marital Trust Among Nurses With the Mediating Role of Covert Aggression

Background: Marital trust as a fiduciary relationship is very important for ensuring the continuity of married life, and identifying its factors are critical. Female nurses are prone to marital problems due to involvement in stressful jobs with different work shifts and long working hours. Accordingly, the present study aimed to investigate the mediating role of covert aggression in relationships between attachment behaviors and marital trust in female nurses. Methods: This correlational study was conducted using structural equation modeling (SEM) from March to June 2021. The statistical population consisted of all married female nurses (aged 25-55 years) working in hospitals in Shiraz City, Iran. Of whom, 310 were selected as the sample through two-stage cluster random sampling. The research instruments included the Trust in Close Relationships scale, the brief accessibility, responsiveness, and engagement (BARE) scale, and the couples relational aggression and victimization scale (CRAViS). The proposed model was evaluated by SEM, and indirect relationships were examined using the Bootstrap method in AMOS-24. The significance level was considered to be 0.05. Results: The results showed that both indirect paths of dimensions of attachment behaviors and a marital trust, mediated by covert aggression (destruction of social image and emotional withdrawal), were statistically significant (P<0.05). In addition, the results demonstrated a significant and direct relationship between dimensions of attachment behaviors and marital trust (P<0.01). Conclusion: The study results show the acceptable goodness of fit of the proposed model. Therefore, policymakers, family consultants, and psychiatric nurses are recommended to pay special attention to the effects of attachment behaviors and covert aggression on the marital trust of female nurses.

Four reasons why we should screen for dissociation in competitive sports

Four reasons why we should screen for dissociation in competitive sports

Self-injury and the embodiment of solitary confinement among adult men in Louisiana prisons

Solitary confinement is a harrowing human rights and public health problem that is currently inflicted as a routine punishment for a litany of prison rule violations, a reactionary tactic to quell resistance to prison conditions, and as a destination of last resort for people serious mental illnesses (SMI) who are especially vulnerable to its harms. An extensive body of research has documented clusters of psychiatric symptoms—emotional distress, cognitive deficits, social withdrawal, anxiety, paranoia, sleeplessness, and hallucinations—linked to solitary confinement that often manifest in decompensating behaviors, which include self-injury and suicide. This study summarizes the historical evolution of solitary confinement, recaps its linkages to self-injury and suicidality, and offers a theoretical framework grounded in ecosocial theory, and supplemented with concepts from theories of dehumanization and carceral geography. Findings bolster extant evidence on the harms of solitary confinement by focusing on whether and how exertions of power by prison staff to deploy mechanisms of dehumanization—as a pathway between SMI and self-injury among a cross section of adult men (n = 517) exposed to solitary confinement in Louisiana prisons in 2017. Findings reinforce the need for structural interventions that diffuse forms of carceral power and practices that continue to subject people to isolation, dehumanization, and violence.

The underlying mechanisms by which PTSD symptoms are associated with cardiovascular health in male UK military personnel: The ADVANCE cohort study

Post-Traumatic Stress Disorder (PTSD) has been identified as an independent risk factor for cardiovascular disease, but the mechanisms of this relationship are not well understood. This study investigates the associations between PTSD symptom clusters (hyperarousal, intrusive thoughts, avoidance behaviours and emotional numbing) and mechanisms of cardiovascular disease including cardiometabolic effects, inflammation, and haemodynamic functioning. In the ADVANCE study cohort of UK male military personnel, 1111 participants were assessed for PTSD via questionnaire and cardiovascular risk via venous blood sampling, pulse wave analysis and dual energy x-ray absorptiometry between 2015 and 2020. Variable selection procedures were conducted to assess which of the symptom clusters if any were associated with cardiovascular risk outcomes. Associations were confirmed via robust regression modelling. Avoidance behaviours were associated with greater systolic Blood Pressure (BP) (Adjusted Coefficient (AC) 0.640 (95% Confidence Interval (CI) 0.065, 1.149). Emotional numbing was associated with greater estimated glucose disposal rate (AC -0.021 (95%CI -0.036, −0.005). Hyperarousal was associated with greater levels of (log)triglycerides (exponentiated-AC 1.009 (95%CI 1.002, 1.017). Intrusive thoughts were associated with greater visceral adipose tissue (AC 0.574 (95%CI 0.020, 1.250). Nonlinear relationships were observed between emotional numbing with heart rate and intrusive thoughts with systolic BP. Limited evidence is present for symptom associations with lipoproteins and pulse wave velocity. No associations were observed between PTSD symptom clusters and high sensitivity c-reactive protein, diastolic BP, total cholesterol, or haemoglobin fasting glucose. In conclusion, symptom clusters of PTSD were associated with increased cardiovascular risk via cardiometabolic and haemodynamic functioning mechanisms, but not inflammation.

Burnout Syndrome Present in the Process of Rehabilitation in Teachers at the Primary Level

The purpose of this research work is to determine the Burnout Syndrome present in the rehabilitation process in teachers at the primary level after the Covid-19 pandemic in Mexico, being a quantitative, cross-sectional, analytical study and its universe. It was made up of basic level teachers, a sociodemographic questionnaire was applied, teachers were evaluated with a self-application instrument on organizational climate, mental health and finally fatigue. Where it was found that 85% that teachers notice alterations and refers to the fact that they are usually noticed in a different, strange or uncomfortable way in difference with other colleagues, it is important to point out the manifestations of apathy that exist among co-workers given the labor characteristics, these sensations continue to appear continuously or never completely disappear. Teachers are affected by their ability to function, in any of their personal and social roles, and they may be considered to suffer from depersonalization-derealization disorder. It is important to point out that they manifest a feeling of not being able to control their movements or that they simply feel like a robot, having little coordination when doing exercises with the students and also that it manifests itself in communication with other teachers. They manifest having emotional and physical numbness in response to living with the world around them. Fear of the social environment under normal characteristics causes emotional exhaustion, a high level of stress and poor mental health, which is why 80% of teachers at the time of the study are considered to have Bournout syndrome.

Dorsomedial prefrontal hypoexcitability underlies lost empathy in frontotemporal dementia

Empathic function is essential for the well-being of social species. Empathy loss is associated with various brain disorders and represents arguably the most distressing feature of frontotemporal dementia (FTD), a leading form of presenile dementia. The neural mechanisms are unknown. We established an FTD mouse model deficient in empathy and observed that aged somatic transgenic mice expressing GGGGCC repeat expansions in C9orf72, a common genetic cause of FTD, exhibited blunted affect sharing and failed to console distressed conspecifics by affiliative contact. Distress-induced consoling behavior activated the dorsomedial prefrontal cortex (dmPFC), which developed profound pyramidal neuron hypoexcitability in aged mutant mice. Optogenetic dmPFC inhibition attenuated affect sharing and other-directed consolation in wild-type mice, whereas chemogenetically enhancing dmPFC excitability rescued empathy deficits in mutant mice, even at advanced ages when substantial cortical atrophy had occurred. These results establish cortical hypoexcitability as a pathophysiological basis of empathy loss in FTD and suggest a therapeutic strategy.

Emotional numbing: A key construct in the assessment of mental health during COVID-19 pandemic

Emotional numbing is a debilitating response to traumatic stress, but no scale has yet to be validated for use among Chinese populations. The aim of the study is to revise and validate a brief measurement of emotional numbing and test the clinical significance of emotional numbing among Chinese adults. A total of 3,230 participants enrolled in this study during a city-wide lockdown caused by the COVID-19 pandemic in Shanghai, China. The general subscale of the Emotional Reactivity and Numbing Scale (ERNS) was used to assess emotional numbing. Cronbach's αs were calculated to examine each item’s contribution to the measurement reliability. A unidimensional graded response model was estimated to evaluate the item-level performance and validity from an item-response theory (IRT) perspective. Informed by the reliability test and the IRT analysis, a four-item ENRS-C scale was found to be a reliable and valid measurement. Regression models were used to examine pandemic-related stressors and mental health correlates of emotional numbing. Emotional numbing was associated with intimate partner violence, bereavement, stressful life events and mental health outcomes including self-reported depression symptoms, anxiety symptoms, psychological well-being, and sleeping problems. This study highlights emotional numbing as a mental health condition associated with major life stressors and has significant clinical and functional implications. Additional studies are needed to investigate how emotional numbing in China is shaped by sociocultural contexts that discourage the expression of socially disruptive emotions.

Solitary Confinement and Prison Personnel: Emotional numbing as a response to work in extended restrictive housing*

Drawing on prior theory and research, this study develops and tests hypotheses about the potential for work in extended restrictive housing (ERH), which entails solitary confinement, to contribute to emotional numbing among personnel. It draws on a mixed-methods approach using data from a large-scale survey and from focus groups and interviews with correctional personnel. As compared to work in general population housing (GPH), ERH work was reported to be associated with greater emotional numbing due in part to unique aspects of this work. The numbing effects, then, may have adverse consequences for personnel's mental and physical health and relationships. Implications for understanding the punitive era and social order in prisons are discussed.

Post-traumatic stress disorder and associated factors among adults exposed to stress in Ethiopia: A meta-analysis and systematic review.

Post-traumatic stress disorder is a complex psychiatric disorder that develops after exposure to traumatic events, such as violent physical assaults, accidents, rape, natural disasters, and conflicts, stranger than usual human experiences. The typical presentation of intrusive thoughts, the persistence of the trauma, the avoidance of pertinent stimuli, emotional numbness, and physiological hyperarousal are the characteristics of this anxiety symptom. Despite the presence of a study conducted on this problem, the pooled effect, particularly in Ethiopia, is not known; therefore, this study assessed the allover burden of post-traumatic stress disorder. The available study was extracted and conducted on post-traumatic stress disorder and its associated factors in Ethiopia by three independent authors. The data were analyzed by using STATA version 11 after extraction was done on a Microsoft Excel spreadsheet. The random-effect model was used to estimate the pooled effect size of post-traumatic stress disorder and its effect in the previous studies with 95% confidence intervals. Funnel plots analysis and Egger regression tests were conducted to detect the presence of publication bias. A subgroup analysis and a sensitivity analysis were done. Thirteen (13) studies were included with a total of 5874 study participants in this meta-analysis and systematic reviews. The pooled prevalence of post-traumatic stress disorder in Ethiopia was 39.28% with a 95% confidence interval (26.54, 52.01). Poor social support (adjusted odds ratio = 2.86; 95% confidence interval (1.81, 4.53)), being female (adjusted odds ratio = 1.89; 95% confidence interval (1.53, 2.34)), presence of previous mental illness (adjusted odds ratio = 4.72; 95% confidence interval (2.62, 8.36)), and witness (adjusted odds ratio = 2.01; 95% confidence interval (1.30, 3.11)) were associated with post-traumatic stress disorder. The burden of post-traumatic stress disorder in this meta-analysis and systematic review is high; therefore, immediate intervention is needed for those specific traumatized individuals.

Variations in Sleep Architecture among Different Subtypes of Schizophrenia: A Cross-sectional Study

Introduction: Schizophrenia is a severe mental disorder characterised by positive symptoms such as delusions and hallucinations, as well as negative symptoms including anhedonia, asociality, avolition, and affective blunting. It may also be associated with cognitive deficits. Sleep disturbances are commonly encountered in schizophrenia, and there may be variations in sleep patterns among its different subtypes. These differences in sleep patterns could have prognostic implications for the various subtypes of schizophrenia. Effective management of sleep disturbances could contribute to the recovery and wellbeing of individuals diagnosed with schizophrenia. Aim: To compare the differences in sleep architecture between the various subtypes of schizophrenia and to compare them with socio-demographically matched healthy volunteers. Materials and Methods: A cross-sectional study was conducted at the Institute of Psychiatry-Centre of Excellence, Kolkata, West Bengal, India over a duration of one year (May 2016 to June 2017). The study included 60 medication-naïve patients diagnosed with schizophrenia according to International Classification of Diseases (ICD)-10 criteria, and a control group of 30 demographically matched healthy volunteers. All study participants were aged between 18 and 60 years and free from any co-morbid illnesses. Patients with schizophrenia were further classified into four groups based on the ICD-10 subtypes: paranoid, hebephrenic, catatonic, and undifferentiated. Overnight polysomnography was performed to assess sleep parameters, including total record time, total sleep time, sleep onset latency, Rapid Eye Movement (REM), sleep latency, sleep efficiency, durations of Total Non Rapid Eye Movement (NREM) Sleep, Total REM sleep, and the different phases of NREM sleep. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 20.0. Analysis of Variance (ANOVA), Chi-square, and t-test were used as applicable, with a p-value <0.05 considered statistically significant. Results: The results showed a decrease in sleep efficiency, total sleep time, and shorter duration of mean N1, N2, and N3 sleep in schizophrenia patients compared to the control group. There was a significant difference in N3 sleep duration, reduced duration of total NREM and REM sleep, reduced REM latency, increased sleep onset latency, and the number of awakenings during sleep in schizophrenia patients. Statistically significant differences (p-values <0.05) were also noted in some sleep parameters among the various subtypes of schizophrenia. The paranoid subtype had the shortest REM latency, while the catatonic subtype had the longest. The hebephrenic subtype had the lowest percentage of REM sleep and sleep efficiency, while the catatonic subtype had the highest. The duration of Slow Wave Sleep (SWS) was lowest in the undifferentiated subtype and highest in the catatonic subtype. Conclusion: This study reveals significant differences in sleep patterns between patients with schizophrenia and the control group, as well as among the various subtypes of schizophrenia. These distinctions provide insight into the relationship between schizophrenia subtypes, sleep irregularities, and clinical consequences. Further investigation is necessary to explore differences in sleep architecture among the various subtypes of schizophrenia and yield clinically meaningful results.

Linguistic marker of schizotypy: a study on nominal reference

Semantic impairments are considered linguistic identifiers of schizotypal personality disorder. Particularly, failures in building reference of nominal expressions have been said to distinguish schizophrenia, high-schizotypy and control groups, and these failures reflect difficulties in using linguistic contextual cues. Our experimental study investigated covariances between schizotypal traits, in a nonclinical population, and interpretations of definite singular nominal expressions as referring either to kinds of objects (generic reading) or to specific objects (specific reading). The experiment was conducted in Brazilian Portuguese, where specific reading is the strong/default meaning of definite singular nominals, while generic reading is the weak meaning, being dependent on contextual information. Results indicate associations between interpretation of definite singular nominals and two schizotypal traits: constricted affect (a negative trait) and unusual perceptual experiences (a positive trait). Speakers in general had preference for assigning specific interpretations to definite singular nominals. Those with higher measurements of constricted affect and lower traits of unusual perceptual experiences, however, showed significant higher preference for this reading with an additive effect in discourse-contexts containing cues for specificity. This suggests that schizotypal traits might manifest themselves within language as a tendency to hold onto strong meaning.

BIOPOLITICS OF BODY IN ALDOUS HUXLEY’S BRAVE NEW WORLD

Aldous Huxley is a well-known English writer who has had a major influence on the subsequent writers directly or indirectly. A prolific writer of a variety of books including novels, short stories, essays, screenplays, and travel books, Huxley is especially famous for the novel Brave New World (1932). The novel depicts the World State in 632 A. F. (after Ford); it is controlled by Mustapha Mond, and people are born through artificial wombs. Since the novel was published, it has attracted much attention not only in the field of literature but also in the field of biology. Hailed as one of the most outstanding dystopian novels, the novel provides precise delineations of a racist and totalitarian regime, the World State, characterized by the advanced biotechnology, overpowering hedonism as well as deliberately devised emotional numbness. It is obvious that life, especially the biological existence of people, becomes not only the cornerstone but also the prey of politics—biopolitics. Michel Foucault’s term, biopolitics, is the basis of the biopolitical frame, within which, Brave New World is closely examined in this paper. The novel reflects a biopolitical aim which is to shelter and improve life through the biological regulation with advanced bio-science as well as biotechnology. In this respect, this study intends to carry out a detailed analysis of biopolitics reflected in Brave New World, represented by biological regulation pertaining to life making and setting, medicalization, and sexuality.