Distress In Response Research Articles

More 911 calls may get a mental health co‐responder in Denver

Since it launched in 2020, Denver's Support Team Assisted Response (STAR) mental distress response unit has expanded exponentially. After starting with a skeleton crew and just one van, it now has a fleet of eight vans and responds to nonviolent crises citywide, Denverite reported Oct. 22. The police alternative is set to expand again in 2025, thanks to a grant from an external group and a bump in city funding, although Mayor Mike Johnston has denied a request for additional money beyond that. STAR started four years ago as advocates across the city called for police reform. Through STAR, paramedics and mental health professionals are sent to respond to nonviolent crises, especially people who are in distress or experiencing a mental health issue. Staff are trained in medical assessment, crisis intervention and de‐escalation. The new $1.5 million grant will help STAR continue its partnerships for one year with the nonprofits Servicios de la Raza and WellPower, which help to operate the program. The one‐year grant will allow WellPower to hire a behavioral health clinical supervisor and “create a more organized, responsive and effective operational structure for STAR,” among other things. The grants have averaged roughly $650,000 a year, so this year's grant represents a significant expansion. The Denver City Council approved the grant last week. STAR officials said they could increase their response rates through more funding, which would allow the service to hire more staff, purchase more vehicles for its fleet and become a 24/7 service.

Two-Step Screening for Depression and Anxiety in Patients with Cancer: A Retrospective Validation Study Using Real-World Data

Background: Although screening for distress is recommended by many cancer care guidelines, the uptake of such screening in cancer centers remains limited. Improving the acceptability of screening programs in cancer centers requires a reduction in clinical burden and an improved detection of distress. The purpose of this study was to validate the performance of the two-step screening algorithm used in the Distress Assessment and Response Tool (DART) for identifying cases of anxiety and depression. Methods: This retrospective validation study consisted of patients at the Princess Margaret Cancer Centre (PM) who completed the DART, which includes the Edmonton Symptom Assessment System depression (ESAS-D) and anxiety (ESAS-A) items, the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder (GAD-7). We evaluated the performance of a two-step screening approach, which modeled the ESAS-D, followed by the PHQ-9 and ESAS-A, then the GAD-7 for predicting a diagnosis of depression and anxiety disorders, respectively. A clinical psychiatric assessment was used as the gold standard reference. Results: A total of 172 patients with cancer were included in this study. A total of 59/172 (34%) and 39/172 (23%) were diagnosed with a depression or anxiety disorder, respectively. The sequential administration of the PHQ-9 ≥15 following the ESAS-D (>2) significantly increased the post-test probability of depression from 37% to 60% and improved the performance of predicting depression compared to both the ESAS-D or the PHQ-9 as standalone tests. The sequential administration of the GAD-7 after the ESAS-A did not improve the predictability of an anxiety diagnosis beyond the performance of the ESAS-A or the GAD-7 as standalone tests. Conclusions: The present study is among the first to demonstrate that a two-step screening algorithm for depression may improve depression screening in cancer using real-world data. Further research on optimal screening approaches for anxiety in cancer is warranted.

Heterogeneous empathic reactions and their associations with adherence and prosocial behaviors during a pandemic

AbstractThe present research utilized the backdrop of the COVID-19 pandemic as a case study to explore the motives driving individuals to adhere to recommended health standards. One month into the first lockdown and eight months before the availability of vaccinations, a large sample of 1,263 individuals completed measures of empathic concern and personal distress in response to a person who contracted the virus. In addition, we measured their COVID-related behaviors, relating to benefitting another person (i.e., donation), the self (i.e., physical hygiene), or both self and other (i.e., physical distancing). Consistent with the Empathy-Altruism Hypothesis (Batson et al., 2015), we found that individuals who experience higher empathic concern, maintain greater physical distance and physical hygiene and act more generously. We further found that individuals who experienced high personal distress were less likely to act generously, albeit more likely to maintain personal hygiene and physical distance. These findings suggest that compliance with health recommendations can be encouraged by eliciting empathic concern or personal distress. Yet, compliance per se is not prosocial behavior. Any intervention aiming to increase prosocial motivation should focus on enhancing empathic concern while minimizing personal distress.

Participation experiences of indirect victims of child sexual homicide in parole proceedings.

Few studies have examined victim participation in parole processes, particularly in countries that have specific procedures for hearing victims' statements in post-conviction proceedings. This study, through in-depth interviews, explores the experiences of seven indirect victims of child sexual homicide, identifying their needs and expectations in a justice system lacking formal mechanisms for their involvement. Results emphasize the necessity for official information for families and the consequent frustration from the absence of formal participation. Parole application becomes a new challenge to the ongoing grieving process, leading to distress responses that may require specialized care. Recommendations about formal mechanisms for victim notification, participation and support during the parole process are noted to acknowledge their experience and emotional impact.

Exploring the psychological and emotional burden of compulsory acquisition: a case study of New Akrade-Mpakadan, Ghana

PurposeThis paper aims to explore the psychological, emotional and equity implications of compulsory acquisition, evaluate the adequacy of compensation in mitigating those consequences and assess the sustainability of cash compensation for future generations.Design/methodology/approachA case study approach was operationalised to investigate the experiences of 40 project-affected persons (PAPs) four years after a compulsory acquisition project in Ghana’s New Akrade-Mpakadan region for the construction of a railway line. These perspectives were analysed through descriptive statistics and thematic analyses using the NVivo software. Figures and a holistic framework were adopted to report the identified issues.FindingsOverall, only 25% of PAPs received formal communication prior to the acquisition, and only 10.3% have been fully compensated four years later. Despite the acquiring body initiating the marking of properties and compensation assessment in 2019, no payments were made until 2021. This induced emotional responses of distress, loss, uncertainty, stress and sadness, which was further exacerbated by feelings of hopelessness because there was no platform to voice concerns or pursue arbitration. Although PAPs were only offered compensation in the form of single monetary payments, a third would have preferred re-settlement.Research limitations/implicationsBy exploring the emotional and psychological effects of compulsory land acquisition, the study adds a new dimension to understanding its consequences. This may spark more interest, debate and discourse amongst researchers and policymakers and lead to the creation or enhancement of existing policy and legal measures to address the needs of PAPs in compulsory acquisition projects in developing countries.Originality/valueThe financial consequences of eminent domain are well documented, but this study explored the psychological, emotional and equity implications of the practice under conditions of weak regulatory frameworks. The adequacy of single lump-sum compensations was also explored to highlight preferred alternatives to ensure fairness for generations unborn.

Association between pretreatment emotional distress and immune checkpoint inhibitor response in non-small-cell lung cancer

Emotional distress (ED), commonly characterized by symptoms of depression and/or anxiety, is prevalent in patients with cancer. Preclinical studies suggest that ED can impair antitumor immune responses, but few clinical studies have explored its relationship with response to immune checkpoint inhibitors (ICIs). Here we report results from cohort 1 of the prospective observational STRESS-LUNG study, which investigated the association between ED and clinical efficacy of first-line treatment of ICIs in patients with advanced non-small-cell lung cancer. ED was assessed by Patient Health Questionnaire-9 and Generalized Anxiety Disorder 7-item scale. The study included 227 patients with 111 (48.9%) exhibiting ED who presented depression (Patient Health Questionnaire-9 score ≥5) and/or anxiety (Generalized Anxiety Disorder 7-item score ≥5) symptoms at baseline. On the primary endpoint analysis, patients with baseline ED exhibited a significantly shorter median progression-free survival compared with those without ED (7.9 months versus 15.5 months, hazard ratio 1.73, 95% confidence interval 1.23 to 2.43, P = 0.002). On the secondary endpoint analysis, ED was associated with lower objective response rate (46.8% versus 62.1%, odds ratio 0.54, P = 0.022), reduced 2-year overall survival rate of 46.5% versus 64.9% (hazard ratio for death 1.82, 95% confidence interval 1.12 to 2.97, P = 0.016) and detriments in quality of life. The exploratory analysis indicated that the ED group showed elevated blood cortisol levels, which was associated with adverse survival outcomes. This study suggests that there is an association between ED and worse clinical outcomes in patients with advanced non-small-cell lung cancer treated with ICIs, highlighting the potential significance of addressing ED in cancer management. ClinicalTrials.gov registration: NCT05477979.

Background and Rationale for a Transitional Intervention for Debilitating Hyperacusis.

This report provides the experimental, clinical, theoretical, and historical background that motivated a patented transitional intervention and its implementation and evaluation in a field trial for mitigation of debilitating loudness-based hyperacusis (LH). Barriers for ameliorating LH, which is differentiated here from other forms of hyperacusis, are delineated, including counterproductive management and treatment strategies that may exacerbate the condition. Evidence for hyper-gain central auditory processes as the bases for LH and the associated LH-induced distress and stress responses are presented. This presentation is followed by an overview of prior efforts to use counseling and therapeutic sound as interventional tools for recalibrating the hyper-gain LH response. We also consider previous efforts to use output-limiting sound-protection devices in the management of LH. This historical background lays the foundation for our transitional intervention protocol and its implementation and evaluation in a field trial. The successful implementation and evaluation of a transitional intervention, which we document in the outcomes of a companion proof-of-concept field trial in this issue, build on our prior efforts and those of others to understand, manage, and treat hyperacusis. These efforts to overcome significant barriers and vexing long-standing challenges in the management and treatment of LH, as reviewed here, are the pillars of the transitional intervention and its primary components, namely, counseling combined with protective sound management and therapeutic sound, which we detail in separate reports in this issue.

From memory to motivation: Probing the relationship between episodic simulation, empathy, and helping intentions.

Research has documented a strong link between constructing episodic simulations-vivid imaginations of specific events-and empathy. To date, most studies have used episodic simulations of helping someone to facilitate affective empathy and promote helping intentions, but have not studied how episodic simulations of another's distressing situation affect empathy. Moreover, affective empathy encompasses both personal distress (i.e., an egocentric experience of distress in response to another's circumstances) and empathic concern (i.e., compassion for another), but we do not know how episodic simulations affect each component. To address these questions, we ran three experiments testing how different episodic simulations influenced personal distress and empathic concern, and thereby willingness to help. In Experiment 1 (N = 216), we found that participants who constructed episodic simulations of another's situation reported increased personal distress (but not empathic concern) and increased helping intentions compared to a control group; additional analyses revealed that personal distress mediated the simulation effect on helping. Furthermore, in Experiment 2 (N = 213), we contrasted episodic simulation of helping versus the distressing scenario; we found no differences in personal distress or helping intentions, but simulating helping led to higher empathic concern. Experiment 3 (N = 571) included both simulation conditions and a control condition; we fully replicated our findings, additionally showing that simulating a helping interaction increased personal distress, empathic concern, and helping intentions relative to the control condition, which consisted of prior work. Taken together, our work illustrates how distinct forms of episodic simulation differentially guide empathic responding and highlights the importance of personal distress in motivating helping. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Social Determinants and Mental Health in Newly Arrived Young Migrants in Spain

IntroductionResearch has shown that factors related with the migratory process (such as travelling alone, living away from family, and discrimination after arrival) considerably increase the risk of mental health problems in young migrants. Moreover, they are among the most vulnerable migration groups with a high risk of social exclusion.ObjectivesTo identify coping strategies and behavioural changes used to deal with perceived discrimination and its impact on the emotional well-being and mental health of newly arrived young migrants in Spain.MethodsA subsample of 15 audio-recorded in-depth qualitative interviews were analysed from the national action-research Migrasalud project (II IN 190517 EN 162 FA 01). The interviews were transcribed, translated from Arabic to Spanish, and analysed through content analysis.ResultsMost participants were males (93.3%; n=14), ranging from 18 to 20 years, and from Morocco (93.3%; n=14). All participants were from foster care placements in Barcelona and arrived to Spain as minors. Newly arrived young migrants reported that they perceived themselves as being healthy before the migratory process. Adverse experiences during the journey and discrimination after arrival impacted their well-being and mental health. Specifically, they reported perceived discrimination in their daily life due to culture, language, or origin. This negatively impacted their well-being and mental health, increasing their emotional distress response and ‘undervalued or inferior’ and ‘vulnerable’ feelings about themselves. Concerning coping with discrimination, they reported using internalised coping strategies such as ‘ignoring’ or ‘not responding’ for fear of having their legal documents revoked or not obtaining them. Their behavioural changes often occurred when they perceived unfair treatment or prejudice towards their migrant status or their socioeconomics, culture or religion. These changes were motivated by being more accepted by the local community by ‘westernisation or cultural assimilation’ and by ‘creating a good image’ of oneself and its culture.ConclusionsFindings establish that the cumulative experience of post-migration stressors (such as discrimination) negatively impacts their mental health and well-being in the long term. This suggests the need for specific policies and services to address this population’s effects of post-migration risk factors. Further research is needed to explore the causes and effects of perceived discrimination on mental health more closely and to develop more targeted and effective interventions.Disclosure of InterestNone Declared

Developmental trajectories of adolescent internalizing symptoms and parental responses to distress.

Parents' responses to their children's negative emotions are a central aspect of emotion socialization that have well-established associations with the development of psychopathology. Yet research is lacking on potential bidirectional associations between parental responses and youth symptoms that may unfold over time. Further, additional research is needed on sociocultural factors that may be related to the trajectories of these constructs. In this study, we examined associations between trajectories of parental responses to negative emotions and adolescent internalizing symptoms and the potential role of youth sex and racial identity. Adolescents and caregivers (N = 256) completed six assessments that spanned adolescent ages 13-18 years. Multivariate growth models revealed that adolescents with higher internalizing symptoms at baseline experienced increasingly non-supportive parental responses over time (punitive and distress responses). By contrast, parental responses did not predict initial levels of or changes in internalizing symptoms. Parents of Black youth reported higher minimization and emotion-focused responses and lower distress responses compared to parents of White youth. We found minimal evidence for sex differences in parental responses. Internalizing symptoms in early adolescence had enduring effects on parental responses to distress, suggesting that adolescents may play an active role in shaping their emotion socialization developmental context.

Applying the power threat meaning framework to the UK education system

ABSTRACT The Power Threat Meaning Framework (PTMF; Johnstone & Boyle, 2018a, 2018b) has fundamentally changed both the practice of clinical psychology and the understanding of mental health since its conception in 2018. However, to date the PTMF (Johnstone & Boyle, 2018a, 2018b) has had little application to other contexts, despite being of clear relevance. Once such absence of application is to the educational context. The context of power within education has been outlined before by philosophers such as Michel Foucault, however, the PTMF (Johnstone & Boyle, 2018a, 2018b) elaborates further about how negative power operations create threat and therefore lead to responses of psychological distress. Thus, the PTMF (Johnstone & Boyle, 2018a, 2018b) could elaborate on Foucault’s theories and offer more understanding on the role of power and psychological distress in the field of education. Therefore, this paper will seek to outline the PTMF (Johnstone & Boyle, 2018a, 2018b) and highlight the ways in which the PTMF can apply to education through reference to the school structure, teachers, parents and students.

A Prospective Cohort Study of Acute Pain and In-Hospital Opioid Consumption After Cardiac Surgery: Associations With Psychological and Medical Factors and Chronic Postsurgical Pain.

Understanding the association of acute pain intensity and opioid consumption after cardiac surgery with chronic postsurgical pain (CPSP) can facilitate implementation of personalized prevention measures to improve outcomes. The objectives were to (1) examine acute pain intensity and daily mg morphine equivalent dose (MME/day) trajectories after cardiac surgery, (2) identify factors associated with pain intensity and opioid consumption trajectories, and (3) assess whether pain intensity and opioid consumption trajectories are risk factors for CPSP. Prospective observational cohort study design conducted between August 2012 and June 2020 with 1-year follow-up. A total of 1115 adults undergoing cardiac surgery were recruited from the preoperative clinic. Of the 959 participants included in the analyses, 573 completed the 1-year follow-up. Main outcomes were pain intensity scores and MME/day consumption over the first 6 postoperative days (PODs) analyzed using latent growth mixture modeling (GMM). Secondary outcome was 12-month CPSP status. Participants were mostly male (76%), with a mean age of 61 ± 13 years. Three distinct linear acute postoperative pain intensity trajectories were identified: "initially moderate pain intensity remaining moderate" (n = 62), "initially mild pain intensity remaining mild" (n = 221), and "initially moderate pain intensity decreasing to mild" (n = 251). Age, sex, emotional distress in response to bodily sensations, and sensitivity to pain traumatization were significantly associated with pain intensity trajectories. Three distinct opioid consumption trajectories were identified on the log MME/day: "initially high level of MME/day gradually decreasing" (n = 89), "initially low level of MME/day remaining low" (n = 108), and "initially moderate level of MME/day decreasing to low" (n = 329). Age and emotional distress in response to bodily sensations were associated with trajectory membership. Individuals in the "initially mild pain intensity remaining mild" trajectory were less likely than those in the "initially moderate pain intensity remaining moderate" trajectory to report CPSP (odds ratio [95% confidence interval, CI], 0.23 [0.06-0.88]). No significant associations were observed between opioid consumption trajectory membership and CPSP status (odds ratio [95% CI], 0.84 [0.28-2.54] and 0.95 [0.22-4.13]). Those with moderate pain intensity right after surgery are more likely to develop CPSP suggesting that those patients should be flagged early on in their postoperative recovery to attempt to alter their trajectory and prevent CPSP. Emotional distress in response to bodily sensations is the only consistent modifiable factor associated with both pain and opioid trajectories.

CD38 genetic variation is associated with increased personal distress to an emotional stimulus

Genetic variation in CD38—a putative oxytocin pathway gene—has been linked to higher oxytocin levels, empathy, and sensitive parenting, but also to more negative interpersonal outcomes (e.g., alienation from friends and family, poorer romantic relationship quality). To reconcile these seemingly contradictory findings, we drew upon the idea that CD38 variation may heighten social-emotional sensitivity and, consequently, make individuals prone to negative emotions in distressing interpersonal situations. To test this hypothesis, we performed a secondary analysis of a dataset including participants’ (n = 171; 94 females) empathic concern (“sympathetic”) and distress-related (“anxious”) responses to an emotional video. Distress responses were higher for the CD38 rs3796863 AA/AC group vs. the CC group (p = 0.03, η2 = 0.027); however, there was no significant effect of genotype for empathic concern responses to the video or for indices of trait empathy. These findings provide preliminary evidence that, in the face of an interpersonal stressor, CD38 genetic variation may predict more self-focused, aversive emotional reactions. More broadly, this finding highlights the need to adopt a more nuanced perspective in which the influence of oxytocin system variation (assessed by oxytocin-related genetic variation) should be considered in light of the social context.

HOCl sensitivity associates with a reduced p53 transcriptional network and calreticulin expression in 25 human cancer cell lines

Reactive oxygen species (ROS) play roles in physiological processes and pathological conditions. Higher ROS levels induce oxidative distress and cytotoxic responses, such as chronic inflammatory conditions and cancer. While the cellular responses of various cell types to cytotoxic pro-oxidative conditions have been well studied in the past decades, much less is known about the cellular gene and expression profiles that are a priori associated with subsequent cellular demise to oxidative stress. To this end, we used 25 human cancer cell lines of different origins and established the inhibitory concentration (IC25) of hypochlorous acid (HOCl), an oxidant readily produced by neutrophils frequently present in many inflamed tissues, including cancer. The HOCl sensitivity varied throughout the 25 cell lines investigated, showing a more than 5-fold difference between the most sensitive and resistant types. In parallel, we investigated untreated cells and their basal gene expression using transcriptomic microarray and performed correlation analyses to HOCl IC25 values of all cell lines. Transcriptomic analyses and functional classification of significant correlating genes revealed reduced expression of tumor protein p53 signaling network members, including BAX, CDKN1A (p21), and BTG2, as well as the p53 gene (TP53) itself to associate with cell line sensitivity to HOCl toxicity. Further, baseline surface membrane expression analysis of 33 inflammation- and redox-related molecules identified nitric oxide (NO) synthase 2 and the ER-stress-associated chaperone calreticulin to correlate significantly with HOCl resistance. We identified targets associated with HOCl sensitivity. Nevertheless, further studies are needed to map gene and protein expression patterns associated with oxidative stress-induced cytotoxicity.

Conspiracies and contagion: Two patterns of COVID-19 related beliefs associated with distinct mental symptomatology

The COVID-19 pandemic brought about unique challenges, leading to a simultaneous decline in global mental well-being and an increase in perceived social threats. The present study explores the interplay between COVID-19 beliefs and mental health symptoms in a multinational sample of 1523 individuals primarily from Canada, the US and Mexico. Between May 2020 and February 2021, participants completed an online survey assessing somatic symptoms, anxiety, depression, alexithymia, and psychotic-like symptoms, along with the newly developed COVID-19 beliefs questionnaire (CBQ). The CBQ consisted of a series of statements corresponding to different beliefs about the origins and consequences of the virus and it revealed two dimensions through Exploratory Factor Analysis: Fear of contagion of COVID-19 (FC) and COVID-19 denial/conspiratorial ideation (CI).Correlation analyses and linear regressions revealed a negative correlation between these two belief patterns as well their distinct associations with mental health symptoms. Fear of contagion was positively predicted by somatic symptoms and anxiety. In contrast, COVID-19 denial/conspiratorial ideation was positively predicted by positive psychotic-like experiences, alexithymia, and depression, and negatively predicted by negative psychotic-like symptoms. Furthermore, the relationship between positive psychotic-like symptoms and CI was mediated negatively by negative psychotic-like symptoms, suggesting that individuals with higher self-reported delusional ideation and bizarre experiences but lower avolition during the pandemic were the most likely to endorse COVID-19 related conspiracy theories.We provide an interpretation of these results according to which these two profiles represent distinct doxastic threat responses, shaped by the interaction between the non-specific pandemic distress response and individual proneness to mental health symptomatology.

Clinical impact of a multifaceted intervention aimed at decreasing distress in people living with dementia: evaluating the Reconnect program.

To better meet the needs of people living with advanced dementia, Orchard Care Homes, United Kingdom have established an enhanced person focused program, namely the Reconnect program, which provides an enriched psycho-social care to enhance peoples' quality of life and well-being. Here we aimed to review the impact of this program on people living with dementia. In this study the implementation of the Reconnect program was evaluated for two six-month periods (April-September 2020 and April-September 2021). The focus of this evaluation was on three key interventions: increasing meaningful occupation and engagement; improving pain identification and management, and reducing constipation. The Reconnect program was conducted in a single for-profit care home. It involved residents with complex dementia needs who previously not responded to support in alternative settings or found previous care ineffective in relieving their distress and reducing risks they pose to themselves or others. A total of 24 people participated in the program during this evaluation. We observed a substantial increase in engagement in meaningful activity per person, including an increase of outdoor access to fresh air. Pain management improved as evidenced by more standardized pain assessments using the PainChek system and coverage of people with either regular and/or "when required" pain management. Constipation relief also improved. For the two comparison periods, distress responses per resident reduced from 14.5 to 10.6 events and use of regular pain relief increased from 21.7 to 48.1%. Use of "when required" benzodiazepine halved from 6 months average of 46 to 23.2 doses given. Benzodiazepine dose reductions increased from 13.3 to 31.8%, while cessations increased from 20 to 50%. We also observed a reduction from 76.3 to 56.3% in antipsychotic use. Their dose reductions increased from 8.3 to 40% and drug cessation was made in 30% of people using antipsychotics (compared to the first period in which no medication cessation was observed). A 91.7% reduction (i.e., from 36 to 3 events) in safeguarding events related to behaviors was also observed. Introduction of the Reconnect program, through its interventions focused on meaningful activity engagement, pain management and constipation relief resulted in substantial improvements related to people's distress, safeguarding and psychotropic use.

Screening for post-traumatic stress disorder following childbirth using the Peritraumatic Distress Inventory

BackgroundPost-traumatic stress disorder (PTSD) following traumatic childbirth may undermine maternal and infant health, but screening for maternal childbirth-related PTSD (CB-PTSD) remains lacking. Acute emotional distress in response to a traumatic experience strongly associates with PTSD. The Peritraumatic Distress Inventory (PDI) assesses acute distress in non-postpartum individuals, but its use to classify women likely to endorse CB-PTSD is unknown. Methods3039 women provided information about their mental health and childbirth experience. They completed the PDI regarding their recent childbirth event, and a PTSD symptom screen to determine CB-PTSD. We employed Exploratory Graph Analysis and bootstrapping to reveal the PDI's factorial structure and optimal cutoff value for CB-PTSD classification. ResultsFactor analysis revealed two strongly correlated stable factors based on a modified version of the PDI: (1) negative emotions and (2) bodily arousal and threat appraisal. A score of 15+ on the modified PDI produced high sensitivity and specificity: 88 % with a positive CB-PTSD screen in the first postpartum months and 93 % with a negative screen. LimitationsIn this cross-sectional study, the PDI was administered at different timepoints postpartum. Future work should examine the PDI's predictive utility for screening women as closely as possible to the time of childbirth, and establish clinical cutoffs in populations after complicated deliveries. ConclusionsBrief self-report screening concerning a woman's emotional reactions to childbirth using our modified PDI tool can detect those likely to endorse CB-PTSD in the early postpartum. This may serve as the initial step of managing symptoms to ultimately prevent chronic manifestations.

Neurological Underpinnings of Psychological Factors Distinguishing Obsessive-Compulsive Disorder From Misophonia

Several studies have suggested that misophonia should be categorized as an obsessive-compulsive disorder (OCD) due to similar neural manifestations, such as impairments in limbic structures, and psychological features, such as perfectionism and disgust sensitivity. However, the two disorders may differ in the domains of disgust sensitivity. In OCD, the domain of pathogen disgust has been studied extensively as per the contamination subtype. In misophonia, pathogen disgust has not been reported. We hypothesized that moral disgust may better characterize individuals with misophonia, as studies indicate that people with misophonia view their triggers as morally unacceptable. Furthermore, neuroimaging has shown anterior cingulate cortex (ACC) activation particularly during exposure to misophonic triggers, which is an area associated with moral assessment of stimuli. Another psychological factor that may point to the two disorders being discrete is intolerance of uncertainty (IU), an aversion to undetermined events. IU has been well documented in OCD: It has been found to be positively associated with striatal volume and dysfunction in the ACC—both of which are common findings in OCD. We expected people with misophonia not to exhibit IU since they experience distress in response to specific triggers and, unlike individuals with OCD, do not experience preemptive anxiety. Multivariate logistic regression analysis run on survey-gathered data revealed IU as a significant predictor of OCD symptoms and moral disgust as a significant predictor of misophonia. Consistent with our hypotheses, our findings suggest that IU and moral disgust and the associated neural underpinnings differentiate misophonia from OCD. [ Psychiatr Ann . 2023;53(12):570–580.]

Alterations in attentional processing in youth with misophonia: A phenotypical cross-comparison with anxiety patients

BackgroundMisophonia is a complex condition characterized by extreme emotional distress in response to specific sounds or specific visual stimuli. Despite a growing body of clinical and neuroscientific literature, the etiology of this condition remains unclear. Hyperarousal, that is, a state of heightened alertness and disinhibition, as a core feature of misophonia is supported by behavioral and neuroimaging literature and might represent a viable clinical target for the development of both behavioral and pharmacological interventions. The aim of this study was to investigate how hyperarousal might be linked to neurocognitive processes associated with vigilance and stimulus discrimination in youth with misophonia. MethodsWe compared 72 children and adolescents with misophonia (13.74 ± 2.44 years) (64 % female) and 89 children and adolescents with anxiety (12.35 ± 2.57 years) (58.4 % female) on behavioral and signal detection performance of the immediate memory task (IMT). Anxiety patients were used as a clinical control group to distinguish attentional processes specific for misophonia. ResultsBoth groups demonstrated similar behavioral performance, including response rate and reaction time. However, misophonia was associated with elevated stimulus discrimination (d prime), which in turn was positively correlated with the severity of misophonia trigger reports. ConclusionsOur findings are in line with previous cognitive and neuroimaging studies, and support an arousal-based model of misophonia, where individuals with misophonia experience a state of heightened vigilance, being more aware of stimuli in the environment. Our findings provide a neurocognitive basis for future study of neurochemical imaging that might further progress towards clinical targets.

The network structure of psychopathological and resilient responses to the pandemic: A multicountry general population study of depression and anxiety.

Commonly identified patterns of psychological distress in response to adverse events are characterized by resilience (i.e., little to no distress), delayed (i.e., distress that increases over time), recovery (i.e., distress followed by a gradual decrease over time), and sustained (i.e., distress remaining stable over time). This study aimed to examine these response patterns during the COVID-19 pandemic. Anxiety and depressive symptom data collected across four European countries over the first year of the pandemic were analyzed (N = 3,594). Participants were first categorized into groups based on the four described patterns. Network connectivity and symptom clustering were then estimated for each group and compared. Two thirds (63.6%) of the sample displayed a resilience pattern. The sustained distress network (16.3%) showed higher connectivity than the recovery network (10.0%) group, p = .031; however, the resilient network showed higher connectivity than the delayed network (10.1%) group, p = .016. Regarding symptom clustering, more clusters emerged in the recovery network (i.e., three) than the sustained network (i.e., two). These results replicate findings that resilience was the most common mental health pattern over the first pandemic year. Moreover, they suggest that high network connectivity may be indicative of a stable mental health response over time, whereas fewer clusters may be indicative of a sustained distress pattern. Although exploratory, the network perspective provides a useful tool for examining the complexity of psychological responses to adverse events and, if replicated, could be useful in identifying indicators of protection against or vulnerability to future psychological distress.