Dysphoric Persons Research Articles

The effect of rumination on recall of emotional words: comparison of dysphoric individuals with and without a history of nonsuicidal self-injury

ABSTRACTPrior research and theory has suggested that rumination plays a role in nonsuicidal self-injury (NSSI), and rumination increases recall of negative autobiographical information in dysphoric individuals. Across two studies, we investigated whether rumination (versus distraction) differentially influences the recall of emotional words among dysphoric persons with and without a history of NSSI. Participants encoded unpleasant, neutral, and pleasant words and then were randomly assigned to either focus on the meaning and consequences of their emotions (i.e. rumination) or unrelated thoughts (i.e. distraction) before they were asked to recall encoded words. Across the two studies, we did not find a significant effect of rumination on memory for emotional words among dysphoric people with (Studies 1 and 2) or without a history of NSSI (Study 1). We did find that people were more likely to remember neutral words as opposed to unpleasant or pleasant words across studies, regardless of rumination condition. Together, results from these two well-powered studies provide fairly compelling evidence that rumination after encoding has little to no effect on recall for emotional words in people elevated on symptoms of depression or with NSSI history. These findings can be used to refine theories of rumination and NSSI.

Changes in regional body fat, lean body mass and body shape in trans persons using cross-sex hormonal therapy: results from a multicenter prospective study.

Cross-sex hormonal therapy (CHT) in trans persons affects their total body fat and total lean body mass. However, it is unknown how separate body regions are affected and whether these changes alter body shape. Therefore, the aim of this study was to determine the effects on body fat and lean body mass in separate body regions and on body shape after one year of CHT. In a multicenter prospective study at university hospitals, 179 male-to-female gender dysphoric persons, referred to as transwomen, and 162 female-to-male gender dysphoric persons, referred to as transmen, were included. All underwent whole-body dual-energy X-ray absorptiometry and anthropometric measurements before and after one year of CHT. In transwomen, increases in body fat ranged from +18% (95% CI: 13%;23%) in the android region to +42% (95% CI: 37%;46%) in the leg region and +34% (95% CI: 29%;38%) in the gynoid region. In transmen, changes in body fat ranged from -16% (95% CI: -19;-14%) in the leg region and -14% in the gynoid region (95% CI: -16%;-12) to no change in the android region (+1%, 95% CI: -3%;5%). Waist-to-hip ratio (WHR) decreased in transwomen (-0.03, 95% CI: -0.04;-0.02) mainly due to an increase in hip circumference (+3.2 cm, 95% CI: 2.3;4.0). Transmen have a decrease in hip circumference (-1.9 cm, 95% CI: -3.1;-0.7) resulting in an increase in WHR (+0.01, 95% CI: 0.00;0.02). CHT causes a more feminine body fat distribution and a lower WHR in transwomen and a more masculine body fat distribution with a lower hip circumference in transmen.

A Dimensional perspective on sexual orientation and gender

Gender identity - the subjective experience of membership to a gender - is generally taken for granted by most of the persons. It is part of our general identity, and provides a sense of continuity of the self, and interrogative on this aspect of our life are barely present in our consciousness. Exceptions are represented by stages of development such as adolescence or some categories of persons who do not identify themselves into the dichotomous world of men/female. The debate on gender identity recently has broken into the consciousness for Psychopathology, rising interrogatives from different perspectives, including Medicine, Phycology, Anthropology, and Ethic.In the present symposium we resume the historical trajectory of gender definition, emphasizing the importance of a different perspective on gender than the common definition provided by western culture. We propose a phenomenological perspective on the components of sexual identity, which includes anatomical sex, gender identity, sexual orientation, and gender role. The phenomenological approach is coherent with the dimensional view on sexual identity proposed by the DSM board, as well as by LGBT movements. This position considers Gender Dysphoria and transsexualism as a pole of gender variants continuum. Phenomenology looks at the comprehension of subjective gender heterogeneity, and the subjective world of gender dysphoric persons as the only way to take care of them; every psychological medical or surgical treatment should come as consequences. The phenomenological perspective on gender dysphoria may be useful to understand and partially explain the different subjective satisfaction to common hormonal and surgical treatment.Disclosure of interestThe author has not supplied his declaration of competing interest.

Dysphoria: a Desperate Vitality

‘Dysphoria’ is often used as the most generic word for any kind of negative emotion. It can be better defined as an unmotivated and quasi-ineffable constellation of feelings that convey a nebula of vague sensations and impulses, an uncomfortable feeling characterized by being sorrowful and indignant. The intentional structure that characterizes much of human emotional experience is absent in dysphoria. Emotions are fluxes of intentionality that innervate the flesh and connect it to the world. Dysphoria is an emotional state saturated with a brimming constellation of feelings without any explicit object or target, a state of tension that may lead to spontaneously vigorous outbursts as well as to pale stagnation or emotional depletion. Dysphoria is empty intentionality devoid of the moderating power of language and representation which fragments the person’s representations of herself and of others and inducing painful experiences of incoherence and inner emptiness, threatening feeling of uncertainty and inauthenticity in interpersonal relationships, and excruciating sense of insignificance, futility and inanity of life. Dysphoric persons experience their own self as dim and fuzzy, and feel deprived of a defined identity and unable to be steadily involved in a given life project or social role. But it also entails a sense of vitality, although am aimless and explosive one – a desperate vitality . Dysphoria is felt as a disordered, overwhelming flux which is at the same time a disorganizing and compelling source of vitality. Dysphoria is felt as creative and destructive – a vigour that brings life as well as annihilation: a violent spasm that takes control of the body and a power that expresses vitality in touch with the source of all sensations.

Bioethical challenges and contraversis of the interdisciplinary treatment of gender dysphoric persons

Gender dysphoria is a complex phenomenological entity in various aspects. One if them is interdisciplinary treatment approach which carries numerous bioethical questions: timing and the extend of offered therapeutic options, right of mental health professionals to offer and conduct partial treatment etc. Term 'partial' is however contraversal and in colision with elementary bioethical principles regarding patient's fundamental right to obtain complete treatment allways. Bioethical challenges proceedes in postoperative clinical experiences related to reconversions and bioethical reasonablenes as sometimes it's caused by poor differential diagnosis and unrecognised motives? De-transition case reports and long term follow-up's could contribute to clarification of clinical indicators pointing out the non/validity of reversal transition. Accepted professional ethics of mental health professionals prescribe obligation to treat gender incogruent/dysphoric children and adoelscents. Bioethical accuracy of gender dysphoric prepubertal children treatment includes necessity of clear definitions and complete diagnostic procedure reliability. Important questions are child maturity, capacity and capability to adapt to extreme transitional hormonal body changes. Prepubertal period impose question of adequate patient's informing consent fully satisissfying legal criteria of informing and competency. Expert's opinion differs from critisized considering inappropriateness of parents imposing personal standards to their children to affirmative considering parents as most appropriate reference group to give social value judgement after consultation with doctors. Health professions included in the treatment of gender dysphoric patients have equal ethical obligation to guarantee happy and productive life to children by medical or any other intreventions. Discussion on fertility preservation in some fields of clinical medicine is routine, but contraversal in gender dysphoria on expert and general public level. Such discrimination deeply undermines patient's basic bioethical rights as informing and counseling of transgender persons on contemporary opportunities of reproductive techologies is an imperative. Posttransitional parenthood has specificity in reversal parents identities and roles which makes this question much more contraversal.

Autogynephilia

Gender identity disorder is a sexual disorder characterized by strong identification with the opposite gender, followed by unpleasant feeling dueto the birth given gender. Longstanding clinical experience with transgender population has brought new knowledge and better understanding of gender identity and gender identity disorders. Initial knowledge referred to sexual orientation of gender dysphoric persons such as homosexual, heterosexual, bisexual and asexual.The contemporary literature dealing with transgenderism and transsexualism brings out the concept of autogynephilia (from Greek "love oneself as a woman") which is the subject of numerous controversies among the experts in this field as well as in the transgender community. The concept of autogynephilia gained importance in Blanchard's work and his attempts to improve diagnostic categories of gender identity disorders and implement efficient strategies in the management of adult male patients. The main topic of this paper refers to the evolution of the autogynephilia concept, which most prominent authors within the field elaborate as a type of male paraphillic tendency of a person to be sexually by the idea of a phantasy or an image of oneself as a woman, naming these persons "nonhomosexual transsexuals" or "autogynephilic transsexuals".

On the feeling of doing: Dysphoria and the implicit modulation of authorship ascription

The experience of authorship arises when we feel that observed effects (e.g., the onset of a light) are caused by our own actions (e.g., pushing a switch). This study tested whether dysphoric persons’ authorship ascription can be modulated implicitly in a situation in which the exclusivity of the cause of effects is ambiguous. In line with the idea that depressed individuals’ self-schemata include general views of uncontrollability, in a subliminal priming task we observed that dysphoric (compared with nondysphoric) participants experienced lower authorship of action effects when the self-concept was primed. Priming the potential effects of an action just prior to their occurrence, however, increased experiences of authorship in all participants and eliminated the effect of self-concept priming on dysphoric participants’ authorship experiences. These findings suggest that the human mental system seizes on a match between primed and actual action effect to establish a sense of authorship, even in a state of depression when persons have weak self-views of causing behavioral outcomes.

It’s All About Me: Self-Focused Attention and Depressed Mood

The present study examined self-focused attention in dysphoria under various mood conditions. Participants were randomly assigned to either a positive, negative, or neutral writing condition. Results indicated that dysphoric participants displayed significantly greater self-focused attention across all conditions relative to the non-dysphoric participants. Taken together, these findings indicate that heightened self-focused attention is a pervasive pattern in dysphoric persons that may contribute to maintenance of a dysphoric mood state.

Looking at facial expressions: Dysphoria and facial EMG

Previous research on interpersonal deficits among dysphoric individuals has been equivocal, with some studies finding that dysphoric persons show an increase in negative behavior and other studies finding no group differences. Most studies in this area have employed self-report instruments and behavioral coding systems to examine interpersonal displays. Using a different approach, we examined facial electromyography (EMG) reactivity to pictures of happy and unhappy expressions among dysphoric persons. Dysphoric and non-dysphoric persons viewed happy and unhappy facial expressions while zygomatic EMG and corrugator EMG activity was recorded. Results indicated that both groups showed the appropriate increase in corrugator EMG to unhappy expressions; however, dysphoric persons did not show the expected increase in zygomatic EMG activity to happy expressions while the control participants did show this response. Unexpectedly, the dysphoric group displayed an increase in corrugator EMG activity (e.g. frown response) to the happy facial expressions. These findings indicate that dysphoric persons have impaired interpersonal reactivity that is specific to happy facial displays.

Think aloud statements and solutions of dysphoric persons on a social Problem-Solving task

The purpose of the present study was to examine the self-statements of dysphoric (n=13) and nondysphoric subjects (n=15) during an interpersonal problem-solving task. After completing the Problem Solving Inventory (PSI; Heppner & Petersen, 1982), subjects were individually shown a brief videotape depicting an interpersonal problem and asked to solve the problem while thinking aloud. Frequencies of five self-statement categories were recorded: task-facilitating, task-inhibiting, emotion-focused, problem-focused, and periods of silence. Although the dysphoric subjects rated themselves more negatively on the PSI with regard to their problem-solving abilities, they were actually able to generate as many, and as effective, solutions as the nondysphoric subjects. During problem solving, however, the dysphoric subjects used fewer problem-focused statements and more emotion-focused statements. The frequencies of task-inhibiting and emotion-focused self-statements correlated negatively with the socially validated score of solution effectiveness.

Dependency and self-criticism as moderators of interpersonal and achievement stress: The role of initial dysphoria

Previous research has suggested that dependency and self-criticism may increase adverse reactions to interpersonal and achievement negative life events. However, there has been insufficient attention to the rival hypothesis that these effects may result from preexisting symptoms. What appears to be a stress-enhancing effect for dependency or self-criticism may actually be a stress-enhancing effect for prior distress. This research was a prospective investigation of the role of preexisting dysphoria, dependency, and self-criticism in increasing negative reactions to interpersonal and achievement negative life events. Controlling for initial dysphoria in a prospective design, dependent subjects displayed greater increases in dysphoria following interpersonal events, but not achievement events. Highly self-critical subjects also exhibited greater increases in dysphoria following interpersonal events and displayed a trend for achievement events. However, dysphoric persons displayed greater increases in dysphoria following interpersonal, but not achievement events, suggesting that some of the observed effects for dependency and self-criticism could result from prior dysphoria. When the greater vulnerability of dysphoric persons to interpersonal events was controlled statistically, the ability of cognitive variables to predict reactivity to interpersonal events was reduced substantially.

Dysphoria and Vulnerability to Subsequent Life Events

Two prospective studies examined whether high levels of dysphoria placed persons at risk for experiencing certain types of negative events and vulnerability to increased dysphoria in response to life events. In both samples, more dysphoric persons reported more negative events in the domains of academics, finances, health, and relationship problems. However, they were not more likely to report unwanted termination of relationships, sexual events, or events experienced by close friends or relatives. Further, dysphoric persons continued to report more negative events even when analyses were restricted to events that were consensually negative. In instances in which persons reported experiencing the same type of event, more dysphoric persons were not more likely to rate these events as negative. These findings are consistent with the hypothesis that dysphoric persons are at greater risk for the actual occurrence of negative events. Nonetheless, the relation between negative events and increases in dysphoria remained when initial symptoms were controlled statistically. There was some evidence that dysphoric persons were more likely to experience worsening of symptoms in response to negative and neutral events, as well as improvement of symptoms following positive events. However, these results were not robust across samples. Results were discussed in terms of implications for understanding the reciprocal relation between dysphoria and life events.