Emotional Problems Research Articles

Clinical significance of echocardiographic signs of right heart dysfunction in patients with chronic heart failure with preserved left ventricular ejection fraction

Aim: To analyze the features of clinical signs, quality of life and psycho-emotional state in patients with heart failure with preserved left ventricular ejection fraction (HFpEF) and non-obstructive atherosclerosis of the coronary arteries, depending on the presence of echocardiographic criteria for dysfunction of the right heart.Material and Methods. Patients underwent an extended protocol of echocardiography with an assessment of the structure and function of the right heart; ultrasound examination of the lungs with the determination of the number of B-lines; a six-minute walk test, a test for the presence of a symptom of bendopnea with the determination of blood oxygen saturation (SpO2) before and during the test. In addition, quality of life was assessed using the Minnesota questionnaire and the SF-36 questionnaire (The Short Form-36); the psycho-emotional state of patients was analyzed according to the HADS (Hospital Anxiety and Depression Scale), the level of adherence to treatment was analyzed according to the Morisky – Green questionnaire. Patients were divided into two groups depending on signs of right heart dysfunction: Tei index more than 0.54, tricuspid annulus systolic excursion (TAPSE) less than 17 mm, tricuspid annulus systolic velocity (RV S’) less than 9,5 cm/sec.Results. Echocardiographic signs of right heart dysfunction in patients with HFpEF was associated with lower quality of life indicators according to the SF-36 questionnaire, in particular, general health status (p = 0.008) and role limitations due to emotional problems (p = 0.03). During the bendopnea test (p = 0.04), the majority of patients with signs of dysfunction of the right heart (66.7%) had a decrease in SpO2, while in the comparison group the proportion of such patients was 36.7% (p = 0.04). The psycho-emotional state according to the HADS scale and adherence to treatment did not differ in both groups (p > 0.05). The frequency of detection of B-lines according to lung ultrasound was also comparable.

Solution-Focused Group Counseling on Mental States in Hemodialysis Patients with Anxiety.

Hemodialysis patients usually suffer from anxiety due to physical and social factors, which belongs to a kind of psychological disorder, easily contributing to the decrease of patients' adherence to the treatment, and seriously affecting the patients' health status and quality of life. Solution-focused group counseling (SFGC) is a kind of psychotherapy proven to improve emotional problems in many fields. Still, the application of this therapy is rare in medical situations. This retrospective study aims to analyze the application of SFGC and probe into the effects on mental states in hemodialysis patients with anxiety. From January 2022 to February 2023, 212 patients with hemodialysis and anxiety admitted to our hospital were selected, and 9 patients who did not meet the inclusion criteria were excluded. Finally, 203 patients were included in this retrospective study. According to different clinical management methods, 102 patients receiving routine management were classified as the control group (CG), and 101 patients receiving SFGC on the basis of routine management were included in the observation group (OG). The scores of the self-perceived burden scale (SPBS), medical coping modes questionnaire (MCMQ), and self-rating anxiety scale (SAS) of the two groups were collected. The data collected were calculated and processed by software SPSS 26.0, and the effects of different managements on the mental states of patients with hemodialysis and anxiety were compared. After management, the scores of SPBS in both groups were lower than those before management, and the score in OG was significantly lower than the CG (p < 0.001). After management, the confrontation scores increased, the avoidance and resignation scores decreased in the MCMQ of the two groups, and the scores in the OG changed significantly (p < 0.001). The SAS scores of the two groups after management were significantly lower than those before management, and the OG score was significantly lower than the CG (p < 0.001). SFGC has a positive effect on the mental states of patients with hemodialysis and anxiety, which is worthy of further clinical study.

Emotional and relational problems of adolescents with and without a migrant background in Europe: a systematic review.

Mental health of migrant adolescents is a topic that has been widely studied in the past decades. Emotional and behavioural problems are amongst the most explored areas; however, little attention has been paid to the relational sphere, which represents another key aspect of mental health and is paramount during adolescence. This systematic review analysed the available evidence on emotional and relational problems comparing adolescents with and without a migrant background in Europe between 2010 and 2021. The search was conducted in four databases using a common search strategy composed of terms addressing adolescence, migrant population, and emotional and relational problems. Three rounds of screening produced 36 eligible studies. Factors affecting both types of problems were identified and categorised using thematic synthesis, dividing them into factors affecting both types of problems jointly or separately and analysing them according to three systemic levels affecting the adolescents' lives (intrapersonal, interpersonal and external). Critical analysis of the results pointed to mixed findings, with a mild tendency in migrant-background adolescents to portray more emotional problems than their native peers and a stronger tendency for relational problems in the same direction. Several limitations were identified and, along with the conclusions, point to suggestions for future research focusing on studying relational problems as a key component of mental health and its link to emotional problems. Further suggestions entail designing studies that target adolescents with different migrant-background profiles and cultural origins to establish differences between them and identify additional factors affecting emotional and relational problems during the pre-migration and transit phases of the migratory journey to help prevent the onset of these problems.

Exploring the impact of lifestyle and environmental exposures on appetite hormone levels in children and adolescents: An observational study

BackgroundAppetite hormones are considered a promising target in fighting obesity as impaired appetite hormone levels have already been associated with obesity. However, further insights in the drivers of appetite hormone levels are needed. ObjectivesIn this study, we investigated the associations of fasting appetite hormone levels with lifestyle and environmental exposures in children and adolescents. MethodsA total of 534 fasting blood samples were collected from children and adolescents (4-16y,50% boys) and appetite hormone levels (glucagon-like peptide-1 (GLP-1), peptide YY (PYY), pancreatic polypeptide (PP), leptin and ghrelin) were measured. Exposures included dietary quality (fiber-rich food intake, sugar propensity, fat propensity), psychosocial stress (happiness, negative emotions, negative life events and emotional problems), sleep duration, physical activity and environmental quality (long term black carbon (BC), particulate matter <2.5 μM (PM2.5), nitrogen dioxide (NO2) exposure, and green space in a 100 m and 2000 m radius around the residence). A multi-exposure score was calculated to combine all the exposures at study in one measure. Associations of individual exposures and multi-exposure score with appetite hormone levels were evaluated using linear mixed regression models adjusting for sex, age, socioeconomic status, waist-to-height ratio and multiple testing. ResultsGLP-1 was associated with air pollution exposure (NO2 β* = -0.13, BC β* = -0.15, PM2.5 β* = -0.16, all p < 0.001). Leptin was associated with green space in a 100 m radius around the residence (β* = -0.11; p = 0.002). Ghrelin was associated with negative emotions (active ghrelin β* = -0.16; p = 0.04, total ghrelin β* = -0.23; p = 0.0051) and happiness (active ghrelin β* = 0.25; p < 0.001, total ghrelin β* = 0.26; p < 0.001). Furthermore, total ghrelin levels were associated with the multi-exposure score, reflecting unhealthy exposures and lifestyle (β* = -0.22; p = 0.036). DiscussionOur findings provide new insights into the associations of exposures with appetite hormone levels, which are of high interest for preventive obesity research. Further research is crucial to reveal the underlying mechanisms of the observed associations.

Prenatal particulate matter exposure is linked with neurobehavioural development in early life

BackgroundEarly life exposure to ambient particulate matter (PM) may negatively affect neurobehavioral development in children, influencing their cognitive, emotional, and social functioning. Here, we report a study on prenatal PM2.5 exposure and neurobehavioral development focusing on different time points in the first years of life. MethodsThis study was part of the ENVIRONAGE birth cohort that follows mother-child pairs longitudinally. First, the Neonatal Behavioral Assessment Scale (NBAS) was employed on 88 newborns aged one to two months to assess their autonomic/physiological regulation, motor organisation, state organisation/regulation, and attention/social interaction. Second, our study included 393 children between the ages of four and six years, for which the Strengths and Difficulties Questionnaire (SDQ) was used to assess the children's emotional problems, hyperactivity, conduct problems, peer relationship, and prosocial behaviour. Prenatal PM2.5 exposure was determined using a high-resolution spatial-temporal method based on the maternal address. Multiple linear and multinomial logistic regression models were used to analyse the relationship between prenatal PM2.5 exposure and neurobehavioral development in newborns and children, respectively. ResultsA 5 μg/m³ increase in first-trimester PM2.5 concentration was associated with lower NBAS range of state cluster scores (−6.11%; 95%CI: −12.00 to −0.23%; p = 0.04) in one-to-two-month-old newborns. No other behavioural clusters nor the reflexes cluster were found to be associated with prenatal PM2.5 exposure. Furthermore, a 5 μg/m³ increment in first-trimester PM2.5 levels was linked with higher odds of a child experiencing peer problems (Odds Ratio (OR) = 3.89; 95%CI: 1.39 to 10.87; p = 0.01) at ages four to six. Additionally, a 5 μg/m³ increase in second-trimester PM2.5 concentration was linked to abnormal prosocial behaviour (OR = 0.49; 95%CI: 0.25 to 0.98; p = 0.04) at four to six years old. No associations were found between in utero PM2.5 exposure and hyperactivity or conduct problems. ConclusionsOur findings suggest that prenatal exposure to PM may impact neurobehavioural development in newborns and preschool children. We identified sensitive time windows during early-to-mid pregnancy, possibly impacting stage changes in newborns and peer problems and prosocial behaviour in children.

Substance use and adolescent mental health during the COVID-19 pandemic in Brazil: a longitudinal approach

ObjectiveTo describe the changes in alcohol and drug use by Brazilian adolescents during the COVID-19 pandemic (April-August 2021), and to analyze the relationship between alcohol use changes and psychiatric symptomatology. MethodsA secondary analysis with a longitudinal approach was performed with data from a cluster-randomized controlled trial, conducted in 73 public middle schools in three Brazilian cities, to evaluate the effectiveness of a drug use prevention program. The sample included 535 students (61% girls; Mage = 15.2 years). Data were collected pre-intervention (February-March 2019), after 9 months (November-December 2019), and after 26 months (April-August 2021), when the students were in their first year of high school. The authors analyzed drug use prevalence (alcohol, binge drinking, tobacco, inhalants, marijuana, cocaine, and crack) in a lifetime, past year, and past month periods, and the association between alcohol use change subsamples with psychiatric symptoms. Logistic regressions were adjusted by sex, age, socioeconomic status, city, and group (control and intervention). ResultsThe present findings suggest that the COVID-19 pandemic led to a decrease in past-year substance use and in past-month substance use frequency, despite the gradually increased (but decelerating) prevalence of lifetime use. However, some adolescents initiated, maintained, or increased the frequency of their alcohol use. Mainly, they were more likely to present behavioral problems, as well as symptoms of inattentive hyperactivity, and peer and emotional problems. ConclusionsDespite the extensive decline in substance use during the pandemic period, these results suggest an association between previous mental health conditions and behavioral risk factors, leading to increased alcohol consumption and behavioral disorders manifestations.

The development of ability emotional intelligence during adolescence

This study aimed to examine the development of ability emotional intelligence (EI) in the adolescent population with a Spanish performance-based instrument of EI: Botín Foundation's Emotional Intelligence Test for Adolescents (TIEFBA), which assesses the respondent's ability to solve emotional problems for each of the four emotional skills of the Mayer and Salovey EI model. With a large cross-sectional sample of Spanish adolescents (N = 5377; girls, 50.9 %) aged from 10 to 17 years (M = 13.57), the authors examined the progression of ability EI across the adolescent period, as well as the effects of gender. The results revealed that girls scored higher than boys on both the total EI and its four branches. Moreover, total EI increased throughout adolescence, but only in girls. Regarding EI branches, while using and understanding emotions increased with age in both girls and boys, managing emotions increased only in girls and perceiving emotions decreased in boys. These findings represent a significant advance that helps us define the evolution of emotional skills in adolescence, providing empirical support for using this performance measure of ability EI.

Emotional Skills with Homogeneity Psycho Cognition Strategy: A Study of Physical Education in Elementary Schools

The emotional skills of elementary school students in physical education subjects are still minimal. Therefore, a deeper exploration in this study was conducted to uncover it. This study aims to analyze the relationship of emotional intelligence with homogeneity psycho cognition strategies in physical education students in elementary schools. This study aims to analyze the relationship between emotional skills and homogeneity psycho cognition strategies in the physical education of elementary school students. The results showed a relationship between emotional skills and homogeneity psycho cognition strategies in physical education subjects. Some factors cause the absence of a relationship between physical education and homogeneity psycho cognition strategies of elementary school students. The results showed a relationship between emotional skills and homogeneity psycho cognition supported by adequate collaboration and emotional by all students. Other factors are reduced or limited interaction between students and the learning environment, aggravated by an economic burden that causes parents' emotional problems that impact children's emotions. Therefore, homogeneity psycho cognition can be recommended in physical education learning to improve the emotional skills of elementary school students. Key words: Emotional Skills; HPC; Physical education; Elementary schools

The role of loneliness and general health in predicting life satisfaction

Students are one of society’s most important groups, and their health and well-being are among every nation’s priorities. Satisfaction with life, as one of the effective components of well-being, is related to mental and physical health; throughout time, the feeling of satisfaction with one’s life faces some ups and downs. This descriptive study investigated the relationship between loneliness, general health, and student satisfaction and was carried out using correlational designs on the statistical population of Sistan and Baluchistan University students in 2023. Furthermore, 106 people were selected among male and female students by the convenience sampling method, and they were asked to complete satisfaction questionnaires: Huebner’s life, Goldberg’s general health scale, and Russell’s loneliness questionnaire. The collected data were analyzed using SPSS 22 software through Pearson’s correlation coefficient and step-by-step regression model. The findings indicated a significant relationship between life satisfaction, general health, and loneliness (p&lt;0/001). Also, the step-by-step regression analysis showed that loneliness can predict life satisfaction (p&lt;0/001). It seems that the developments and conditions of the student period and the distance of most students from their families pose serious challenges, including the unpleasant feeling of loneliness, which overshadows life satisfaction and, consequently, the psychological well-being of this young group, ultimately reducing their efficiency. Their social and educational skills are adequate; therefore, self-care behaviors, creating and developing stable social interactions in academic environments, and seeking help for mental and emotional health problems are emphasized. Considering the limitations of the current research and its cross-sectional nature, longitudinal studies in this field are recommended.

How discrimination experiences relate to racial/ethnic identity and mental health across first- and second-generation Vietnamese American adolescents.

Racial/ethnic discrimination has been linked to behavioral and emotional problems in youth from marginalized groups. However, the psychological experience associated with discrimination may differ between immigrant and nonimmigrant youth. Race-based discrimination may impact an adolescent's view of their own group (private regard) and/or their sense of how others view their group (public regard). Owing to differences in racialization, immigrant adolescents may be affected differently by experiences of discrimination than their U.S.-born peers. The present study examined whether nativity moderated the paths from racial/ethnic discrimination to private and public regard to mental health problems among Vietnamese American youth. Surveys were completed by 718 Vietnamese American 10th and 11th graders (Mage = 15.54 years, 61.4% female, 38.6% male). In this sample, 21.2% were first-generation (i.e., born outside of the United States) and 78.8% were second-generation (i.e., born in the United States with at least one parent born outside of the United States). Multigroup path analysis tested the direct and indirect effects of racial/ethnic discrimination on behavioral and emotional problems via private and public regard and whether associations differed for first- versus second-generation youth. Racial/ethnic discrimination was associated with lower public regard, but not private regard, for both first- and second-generation Vietnamese American youth. Public regard was negatively associated with behavioral and emotional problems only among second-generation youth. No indirect effects were significant. Findings suggest differences in racialized experiences, as well as opportunities to support second-generation Vietnamese American and other marginalized youth from immigrant families from the mental health impacts of discrimination. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Somatic Representation of Emotional Problems among Native Kyrgyz Speakers

IntroductionThe somatization problem has been one of the most acute in mental health for half a century (Kirmayer, L., 2000). Patients with somatic complaints turn to specialists in various fields but rarely to psychologists and psychiatrists, although the connection between bodily suffering and psychological difficulties sometimes lies on the surface (Molchanova E., 2016). In the last twenty years, the mechanisms of somatization have been considered by several disciplines, one of which is cultural psychiatry, which has become relevant.Unfortunately, most of the research focuses on the cultural characteristics of migrants living in the United States (Groleau, D. and Kirmayer, L. 2004). There needs to be more research on the cultural features of somatization in Kyrgyz culture.ObjectivesThe goal of the study is to discover the distinctive features of the process of somatization in Kyrgyz cultureThe objectives are:To create a vocabulary of somatic phrases and idioms used to represent somatic problems to find the most commonly used somatic idioms for emotional complaints by native speakers of the Kyrgyz language.To describe the mechanism of transformation of the emotional symptom into a specifically located and presented somatic complaint.MethodsThe research used a mixed, qualitative, and quantitative design.The first stage is qualitative, including ten semi-structured interviews with linguists, culturologists, historians, and specialists in folk art.The second stage included four focus groups (12 people in each group) with a follow-up analysis. The recruitment of respondents was carried out through social networks, announcements, and the snowball method.The third stage was quantitative. With the help of the dictionary compiled at the first stage, 250 participants ranked the frequency of somatic idioms, which were used to express the emotional problemsResultsThere have been found more than 200 somatic idioms, which are used to present emotional problems. The most frequent ones describe the heart, liver, and joints. Heart metaphors are associated with despair and anxiety, joints - with depression, and liver metaphors - with some personality characteristics, such as conformity and kindness. The created map of somatic representation of emotional problems shows the most frequent localization of somatic symptoms in disorders featuring somatic symptoms in native Kyrgyz speakers.ConclusionsThere is a culturally shaped specifics of somatic representations of emotional problems among native Kyrgyz speakers. More research needs to be conducted to interpret the nature of people’s emotional problems represented by somatic symptoms.Disclosure of InterestNone Declared

A Systematic Review and Meta-analysis: Paternal Anxiety and the Emotional and Behavioral Outcomes in Their Offspring

Anxiety disorders are highly prevalent worldwide; however, the literature lacks a meta-analytic quantification of the risk posed by fathers' anxiety for offspring development. This systematic review and meta-analysis aimed to provide a comprehensive estimate of the magnitude of the association between paternal anxiety and emotional and behavioral problems of offspring. In February 2022, Web of Science, Ovid (Embase, MEDLINE, PsycINFO), Trip Database, and ProQuest were searched to identify all quantitative studies that measured anxiety in fathers and emotional and/or behavioral outcomes in offspring. No limits were set for offspring age, publication language, or publication year. Summary estimates were extracted from the primary studies. Meta-analytic random-effects 3-level models were used to calculate correlation coefficients. Quality was assessed using the Newcastle-Ottawa Scale. The study protocol was preregistered with PROSPERO (CRD42022311501) and adhered to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) reporting guidelines. Of 11,746 records identified, 98 were included in the meta-analysis. Small but significant associations were found between paternal anxiety and offspring emotional and behavioral problems overall (r= 0.16, 95% CI [0.13, 0.19]) and behavioral (r= 0.19, 95% CI [0.13, 0.24]), emotional (r= 0.15, 95% CI [0.12, 0.18]), anxiety (r= 0.13, 95% CI [0.11, 0.16]), and depression (r= 0.13, 95% CI [0.03, 0.23]) problems. Some significant moderators were identified. Paternal mental health is associated with offspring development, and the offspring of fathers with anxiety symptoms or disorders are at increased risk of negative emotional and behavioral outcomes, in line with the principles of multifinality and pleiotropy. The substantial heterogeneity among studies and the overrepresentation of White European American groups in this literature highlight the need for further research. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list.

Changes in psychosocial distress and the number and types of problems reported by patients with cancer when routine screening is integrated within cancer services

Abstract Background: The impact of patient-reported outcome measures on patient outcomes in longitudinal clinical studies is poorly understood. This observational study explored longitudinal changes in distress and problems reported by cancer patients screened and managed in accordance with a clinical pathway for anxiety and depression (ADAPT CP), implemented over 12 months. Methods: Patients reported distress using the Distress Thermometer and indicated reasons for distress using the 39-item Problem List across five domains: practical, social, emotional, spiritual/religious, and physical. Repeat screening occurred on average 3 monthly (quarterly). Results: Six hundred sixty patients from 10 participating services completed 1,256 screening events over 12 months, reporting 8,645 problems. On average, more emotional (27–34%) and physical (19–22%) issues were reported across all quarters than practical (7–9%) and social (8–9%) issues. Distress and emotional, physical, practical, and social problems reduced from initial to follow-up screens, although the decrease in emotional problems over time was not significantly different than that of the other problems. Worry, fatigue, sleep difficulties, health of family members, and insurance/finances were more persistent problems. Conclusions: Although distress and the change in the number of emotional concerns over time did not differ from other problems, rescreening is recommended within oncology settings to allow patients to indicate new or persistent problems and hospital staff to monitor and assess needs. Emotional concerns are high in oncology patients, suggesting the need for the prioritization of psychosocial care. These problems can persist over time due to their clinically challenging nature or because access to, or implementation of, evidence-based interventions are not yet widespread.

Cultivating young minds: Exploring the relationship between child socio-emotional competence, early childhood education and care quality, creativity and self-directed learning

Creativity and self-directed learning (SDL) have been identified as two key skills that children need to develop for success in the 21st century. As such, developing such skills has become a priority. High quality early childhood education and care (ECEC) can play a pivotal role in supporting a myriad of children's developmental outcomes. This study uses multi-level modeling on 484 children between 30 and 75 months of age (Mean age = 48) across 87 ECEC classrooms in Toronto. We tested associations between two skills (creativity and SDL), children's social and emotional competence (hyperactivity, prosocial behaviour, and emotional problems) and ECEC quality (professional development, ratios and emotional support). We found significant relationships between children's social and emotional outcomes and their creativity skills, but not their SDL. In addition, the proportion of professional development opportunities conducted onsite was positively associated with children's creativity. Implications for future research, policy and practice are discussed. Educational relevance statementThis study contributes to the understanding of how to support two skills needed in the wake of the fourth industrial revolution. First, we examine the relationship between children's social and emotional development and their creativity and self-directed learning. We then examine the role played by the quality of their early childhood education and care (ECEC) settings as contexts to learn these important skills when accounting for their children's social and emotional development. Finally, we test the robustness of these associations by controlling for important contextual factors (age, months in the program, family income, and maternal education).

Clinical and psychopathological features of parents of patients with anorexia nervosa.

IntroductionAnorexia nervosa (AN) is a widespread chronic mental disorder with severe negative medical and social consequences. Treating patients with AN is a complex and time-consuming process, as persistent forms are often encountered. The studies’ results indicate a possible influence of psychoemotional state and/or existing psychopathological manifestations in parents on AN development.ObjectivesTo investigate the clinical and psychopathological characteristics of parents of patients with AN based on the study of emotional regulation, alexithymia, depression, and anxiety.MethodsThe study population (N=110) consisted of fathers (N=47 (42.7%)) and mothers (N=63 (57.3%) of patients with AN. The mean age was M=44.90 (SD=5.9; SE=0.567). All participants completed the emotional regulation scale (DERS), Toronto Alexithymia Scale (TAS-26), Hospital Anxiety and Depression Scale (HADS).ResultsAccording to DERS: “rejection” - 21.86 (SD=5.675; SE=0.541); “goals” - 19.13 (SD=2.028; SE=0.193); “impulse” - 24.17 (SD=4.908; SE=0.468); “awareness” - 21.93 (SD=1.999; SE=0.191); “strategies” - 30.75 (SD=2.173; SE=0.207); “clarity” - 18.58 (SD=1.486; SE=0.142). The sum was 136.42 (SD=8.119; SE=0.774). The TAS results of the study group were 80.45 (SD=13.699), which characterizes the average personality type as alexithymic. According to HADS, the average values were distributed: the anxiety scale M=7.96 (SD=1.347) the depression scale M=7.95 (SD=1.442). These indicators can be considered as the extreme limit of the norm or subclinically expressed anxiety and depression. The next step was to find statistically significant relationships between the DERS methodology and the HADS and TAS for the study group. According to Spearman’s correlation coefficient, there is a direct stable relationship between the variables “anxiety” and “impulse” (r=0.257), awareness (r=0.255), and the total score of emotional regulation according to “DERS” (r=0.246); A direct correlation was found between the indicators “depression” and “rejection” (r=0.151), “goals” (r=0.233), “awareness” (r=0.138); Alexithymia, in turn, has a direct correlation with the “goals” scale and an inverse correlation with the “strategies” scale (r=-0.141)ConclusionsParents of patients with AN have various manifestations of psychoemotional disturbances, namely subclinical levels of depression and anxiety, high levels of alexithymia, and emotional regulation problems. The correlation analysis showed that the anxiety score for parents of patients with AN is higher if difficulties with impulse control, emotional awareness, and general emotional regulation are problematic. Depressive tendencies are also associated with the subjects’ rejection of emotional reactions and problems with goal-directed behavior. The inverse correlation indicates that the higher the index of alexithymia, the less limited access to emotion regulation strategies, and vice versa.Disclosure of InterestNone Declared

A patient`s trajectory with autism spectrum disorder leading to forensic psychiatric institutionalisation

IntroductionAutism-spectrum-disorder (ASD) is a heterogenous neurodevelopmental condition with a wide range of symptoms. Typical deficits, such as impairment in social communication and interactions, can lead to violent behaviours. However, ASD is often underdiagnosed and little is known about patients with ASD in forensic institutions.ObjectivesTo highlight the diagnostic challenges and offending behaviour of people with ASD in the context of the criminal justice system (CJS) through a case report.MethodsThe case report is based on exploration, third party anamnesis, medical documentations and court filesResults A 25-year-old man was placed in detention in 2021 after having committed a dangerous threat to unknown persons and was considered not guilty by reason of insanity. Since early childhood the patient presented with extreme mood swings and impulsive-aggressive outbursts that led to criminal mischief later on. During elementary school he developed concentration problems as well as specific learning deficits. Due to his deviant social behaviour, he was rejected from his peer group. Over the course of the years, he showed no significant responses to different psychopharmacological treatment approaches. His social anxiety grew and ultimately, he started experimenting with various drugs and drinking excessive amounts of alcohol, which induced multiple psychotic episodes. Due to the psychotic exacerbations, he was repeatedly admitted to psychiatric units for acute treatment, however the autistic disorder remained untreated. At the time of the crime an independent psychiatric assessor diagnosed schizophrenia simplex and multiple drug abuse. The patient had been in psychiatric treatment since the age of 5 and received multiple diagnoses such as combined personality disorder, different subtypes of schizophrenia, ADHD, Tourette syndrome, depressive disorder and ASD at the age of 14. Nevertheless, prior to his detention he had never received a complex therapy focusing on his ASD. According to the verdict he was admitted to a medium secure forensic ward in Lower Austria, where he was treated with antipsychotic and anxiolytic medication. Furthermore, he participated in the day-structuring treatment program ensuring routine.Conclusions Neurodevelopmental disorders such as ASD often impose a diagnostic challenge, particularly without intellectual disability. This can lead to under- and misdiagnosis, inadequate treatment or even criminal behaviour. Impaired theory of mind, poor emotional regulation and problems with moral reasoning should be recognized and treated specifically early on to prevent further damage to both the individual and society.Disclosure of InterestNone Declared

IJCM_390A: A study to assess body weight perception, weight control practices, and their association with menstruation among adolescent girls in the rural field practice area of Bangalore medical college and research institute

Background: Adolescent girls are concerned about their weight, physical appearance, and how society perceives them. The identities they seek and create in this phase influence society and their peers. In this process, a lot of Emotional, Biological, and Social problems are faced by them. One such problem is Menstrual disorders. Keeping this rationale in mind, the above study was undertaken to Assess Body weight perception, Weight control practices, and their association with Menstruation among Adolescent girls. Objective: 1. To assess Body weight perception and Weight Control Practices, among Adolescent girls 2. To compare Body weight perception and Weight control practices among Adolescent girls with normal and abnormal Menstrual cycles Methodology: A Cross-sectional study was conducted among Adolescent girls residing in the rural field practice area of Bangalore Medical College and Research Institute, Bengaluru. A Sample size of 192 was determined based on a previous study done by Bhurtun DD et al, and Simple random sampling was used for participant recruitment. Data collection utilized a pre-tested structured questionnaire. Data analyzed using SPSS 21.0 Results: Among the 192 participants, based on Body mass index (BMI), 13(6.7%) were Overweight and the rest of the participants 135(70.3%) were of Normal weight. Out of 118(61.5%) respondents reported trying to lose weight, reducing fat intake 100(84.7%) was the most common method. The majority of the Adolescent girls had a positive perception of weight control but had problems accepting their body image as healthy. Body weight perception and Weight control practices affected normal menstrual cycles as well as girls with Menstrual disorders. Conclusion: The findings revealed Body weight perception affected the girls with Normal Menstruation as well as with Menstrual disorders. Therefore, Adolescent girls need to be educated on the need for a Healthy body image as well as a Healthy lifestyle.

Emotional and behavioural problems of orphan and non-orphan adolescents

Emotional and behavioural problems of orphan and non-orphan adolescents

Experiences of Patients with Unilateral Vocal Fold Paralysis: A Mixed-Methods Study of the Insider’s Perspective

ObjectiveUnilateral vocal fold paralysis (UVFP) is often characterized by severe dysphonia and has a significant impact on a patient’s communication in daily and vocational situations. Having a better understanding of how UVFP influences quality of life and patient experiences can help improve patient-centered care in this population. Therefore, the purpose of this study was to explore the lived experiences of patients with UVFP. MethodsTwenty-five adults with UVFP (age range: 39 – 84 years) participated in the study. Quantitative data were collected from 22 participants, using the Voice Handicap Index (VHI), Dysphonia Severity Index (DSI), and Acoustic Voice Quality Index (AVQI). Qualitative data were collected from 25 individual semi-structured interviews, which were recorded, transcribed, and analyzed with the software program NVivo. The interviews were coded using an inductive thematic approach. ResultsQuantitative results showed a mean DSI of -1.6, mean AVQI of 3.80, and mean VHI of 45.8 in the participant group. A statistically significant, moderate (positive) correlation was found between VHI and time after onset (in years). From the qualitative analysis of the interviews, four main themes were identified: emotional impact, psychosocial impact, physical complaints, and coping strategies. Voice problems caused by UVFP generally had a negative impact on patients’ emotional and psychological well-being, with considerable effects on participation, self-identity, and professional activity. Participants demonstrated a combination of problem-focused and emotion-focused coping strategies to accommodate to these issues. Half of the participant group also showed avoidance as a coping style. VHI scores were significantly higher in participants who reported experiencing current emotional and participation problems due to UVFP, and who had not yet accepted their new voice. ConclusionThe themes from this study emphasize the importance of focused anamnesis and emotive counseling in practice, with specific attention to the psychosocial and emotional impact of UVFP. Data Availability StatementData is available from the authors upon request due to privacy reasons.

Early Infant Prefrontal Cortical Microstructure Predicts Present and Future Emotionality

BackgroundHigh levels of infant negative emotionality (NE) and low positive emotionality (PE) predict future emotional and behavioral problems. The prefrontal cortex (PFC) supports emotional regulation, with each PFC subregion specializing in specific emotional processes. Neurite orientation dispersion and density imaging estimates microstructural integrity and myelination via the neurite density index (NDI) and dispersion via the orientation dispersion index (ODI), with potential to more accurately evaluate microstructural alterations in the developing brain. Yet, no study has used these indices to examine associations between PFC microstructure and concurrent or developing infant emotionality. MethodsWe modeled PFC subregional NDI and ODI at 3 months with caregiver-reported infant NE and PE at 3 months (n = 61) and at 9 months (n = 50), using multivariable and subsequent bivariate regression models. ResultsThe most robust statistically significant findings were positive associations among 3-month rostral anterior cingulate cortex (ACC) ODI and caudal ACC NDI and concurrent NE, a positive association between 3-month lateral orbitofrontal cortex ODI and prospective NE, and a negative association between 3-month dorsolateral PFC ODI and concurrent PE. Multivariate models also revealed that other PFC subregional microstructure measures, as well as infant and caregiver sociodemographic and clinical factors, predicted infant 3- and 9-month NE and PE. ConclusionsGreater NDI and ODI, reflecting greater microstructural complexity, in PFC regions supporting salience perception (rostral ACC), decision making (lateral orbitofrontal cortex), action selection (caudal ACC), and attentional processes (dorsolateral PFC) might result in greater integration of these subregions with other neural networks and greater attention to salient negative external cues, thus higher NE and/or lower PE. These findings provide potential infant cortical markers of future psychopathology risk.