Blunted Affect Research Articles

FOOD SELECTION OF CHILDREN WITH AUTISM SPECTRUM DISORDER ENROLLED IN NATEA CAETÉS

Introduction: Autism Spectrum Disorder (ASD) is understood as a neurological disorder characterized by behavioral heterogeneity, affective blunting, and stereotypical behaviors. Objective: To understand the eating habits of children with Autism Spectrum Disorder and the main foods and restrictions regarding the child's diet. Methodology: This is an observational, cross-sectional study with a qualitative descriptive approach, since the objective is to observe and delve deeper into the food selectivity of autistic children. The target population will be mothers of children with autism spectrum disorder registered with NATEA in the city of Capanema. Results: The sample consisted of 42 participants, of which 85.71% were male, reflecting the male predominance frequently observed in ASD diagnoses. The most represented age group was 5 to 12 years (61.90%), and the majority of participants identified as brown (85.72%). Regarding diagnosis, 64.29% of children were diagnosed between 1 and 5 years of age, and support levels ranged from mild (33.33%), moderate (40.48%) to intense (26.19%). Regarding feeding, 80.49% of children presented food selectivity, with a greater preference for carbohydrates and sweets, and low acceptance of vegetables and fats. Mealtimes were challenging for caregivers, with 70.97% reporting greater difficulty at the beginning of meals, suggesting initial resistance to food engagement. In addition, 80% of participants reported difficulties with food consistency, highlighting the importance of adapted nutritional interventions. Conclusion: The results indicate the need for integrated strategies to improve food acceptance and provide emotional support to caregivers. It is concluded that the demographic profile, associated with food selectivity and socioeconomic difficulties, reinforces the importance of multidisciplinary support programs to promote a balanced diet and well-being for this population.

The Daydream Spectrum: The Role of Emotional Dysregulation, Internalized Stigma and Self-Esteem in Maladaptive Daydreaming Among Adults With ADHD, ASD, and Double Diagnosis.

Maladaptive daydreaming (MD) is characterized by vivid, excessive fantasy activity that becomes prioritized over other activities and may result in avoidant coping strategies. Little is known about the relationship between MD and internalized stigma in the neurodivergent sample. The current study aimed to examine emotional dysregulation, escapism and self-perception (self-esteem and internalized stigma) as potential determinants of MD in three groups: adults on the autism spectrum, with ADHD, and both diagnoses ("AuDHD"), including their neurodivergent symptoms (autistic traits, empathizing, ADHD symptoms). A sample of 293 persons (139 with ADHD, 74 on the autism spectrum, and 80 with both diagnoses) completed self-report scales concerning ADHD symptoms, autism spectrum symptoms, empathizing, self-esteem, daydreaming as escapism, emotional dysregulation, maladaptive daydreaming, and internalized stigma. A correlation analysis was implemented. Additionally, a group comparison and quantile regression for the 25th, 50th, and 75th percentile of maladaptive daydreaming in the three groups were executed. The results showed that internalized stigma, emotional dysregulation, escapism, and self-esteem have significant associations with MD in the neurodiverse sample. The ADHD group achieved the lowest scores in emotional dysregulation, discrimination experience, and social withdrawal. The groups did not vary in MD rates, stereotype endorsement, stigma resistance, nonacceptance of emotional responses, and impulse control difficulties. The AuDHD group achieved higher results than the ASD group only in the ADHD symptoms. Quantile regression revealed differences in the predictors of maladaptive daydreaming in the three groups. ADHD symptoms and self-suppression escapism were significant predictors for the higher levels of MD in persons with singular autism or ADHD diagnosis. The results showed no differences in MD rates, although there were significant variations in predictive features among the three samples. The role of internalized stigma and self-esteem was highlighted in the results as significant associates of MD prevalence. These outcomes expand the current knowledge in the context of maladaptive daydreaming, internalized stigma, self-esteem and emotional dysregulation in a neurodiverse sample and allow for proposing clinical applications and further research directions.

Cardiometabolic Morbidity (Obesity and Hypertension) in PTSD: A Preliminary Investigation of the Validity of Two Structures of the Impact of Event Scale-Revised.

Background: Posttraumatic stress disorder (PTSD) and/or specific PTSD symptoms may evoke maladaptive behaviors (e.g., compulsive buying, disordered eating, and an unhealthy lifestyle), resulting in adverse cardiometabolic events (e.g., hypertension and obesity), which may implicate the treatment of this complex condition. The diagnostic criteria for PTSD have lately expanded beyond the three common symptoms (intrusion, avoidance, and hyperarousal). Including additional symptoms such as emotional numbing, sleep disturbance, and irritability strengthens the representation of the Impact of Event Scale-Revised (IES-R), suggesting that models with four, five, or six dimensions better capture its structure compared to the original three-dimensional model. Methods: Using a convenience sample of 58 Russian dental healthcare workers (HCWs: mean age = 44.1 ± 12.2 years, 82.8% females), this instrumental study examined the convergent, concurrent, and criterion validity of two IES-R structures: IES-R3 and IES-R6. Results: Exploratory factor analysis uncovered five factors, which explained 76.0% of the variance in the IES-R. Subscales of the IES-R3 and the IES-R6 expressed good internal consistency (coefficient alpha range = 0.69-0.88), high convergent validity (item total correlations r range = 0.39-0.81, and correlations with the IES-R's total score r range = 0.62-0.92), excellent concurrent validity through strong correlations with the PTSD Symptom Scale-Self Report (PSS-SR: r range = 0.42-0.69), while their criterion validity was indicated by moderate-to-low correlations with high body mass index (BMI: r range = 0.12-0.39) and the diagnosis of hypertension (r range = 0.12-0.30). In the receiver-operating characteristic (ROC) curve analysis, all IES-R models were perfectly associated with the PSS-SR (all areas under the curve (AUCs) > 0.9, p values < 0.001). The IES-R, both hyperarousal subscales, and the IES-R3 intrusion subscale were significantly associated with high BMI. Both avoidance subscales and the IES-R3 intrusion subscale, not the IES-R, were significantly associated with hypertension. In the two-step cluster analysis, five sets of all trauma variables (IES-R3/IES-R6, PSS-SR) classified the participants into two clusters according to their BMI (normal weight/low BMI vs. overweight/obese). Meanwhile, only the IES-R, PSS-SR, and IES-R3 dimensions successfully classified participants as having either normal blood pressure or hypertension. Participants in the overweight/obese and hypertensive clusters displayed considerably higher levels of most trauma symptoms. Input variables with the highest predictor importance in the cluster analysis were those variables expressing significant associations in correlations and ROC analyses. However, neither IES-R3 nor IES-R6 contributed to BMI or hypertension either directly or indirectly in the path analysis. Meanwhile, age significantly predicted both health conditions and current smoking. Irritability and numbing were the only IES-R dimensions that significantly contributed to current smoking. Conclusions: The findings emphasize the need for assessing the way through which various PTSD symptoms may implicate cardiometabolic dysfunctions and their risk factors (e.g., smoking and the intake of unhealthy foods) as well as the application of targeted dietary and exercise interventions to lower physical morbidity in PTSD patients. However, the internal and external validity of our tests may be questionable due to the low power of our sample size. Replicating the study in larger samples, which comprise different physical and mental conditions from heterogenous cultural contexts, is pivotal to validate the results (e.g., in specific groups, such as those with confirmed traumatic exposure and comorbid mood dysfunction).

“Our American Optimism”: Race, Recognition, and Belonging in Claudia Rankine’s Don’t Let Me Be Lonely: An American Lyric

This paper explores Claudia Rankine’s representation of the feelings of racialisation in her 2004 poetry collection Don’t Let Me Be Lonely: An American Lyric. Contextualising this work within wider debates in Afropessimist philosophy, it considers how the poet’s portrayal of emotional pain, depression, and numbness exemplify a form of ‘social death’ instigated by the ubiquitous violence of antiblackness. Through close readings of select sequences, it argues that Rankine frames death as an ongoing structure of African American experience, rather than a singular event. In turn, this paper also considers how her innovative and hybrid “American Lyric” form functions to create a new grammar for Black self-expression in an ostensibly ‘post-race’ culture that obfuscates contemporary systems of racial inequality. It argues that Rankine’s collection cultivates an ethics of attention to the experiences and pain of others, offering poetry as a form of “exhausted hope” to challenge the dehumanising force of White supremacy.

8230 Adrenal Crisis, Unrevealing the Impact of Immigration on Central Adrenal Insufficiency

Abstract Disclosure: D.H. Sacoto: None. K. Madani: None. D. Patel: None. A. De Rosairo: None. G. Rai: None. R. Belokovskaya: None. A.A. Franco-Akel: None. Introduction: Even though patients with secondary adrenal insufficiency (AI) may go through life without an episode of adrenal crisis, there is a 50% chance of developing it. Around 90% have a known precipitating, with infections and surgery being frequent causes. However, emotional stress is unrecognized. With the recent increase in worldwide immigration, it is important to recognize these as potential triggers in those with AI. Here, we present a case of adrenal crisis triggered by immigration. Case presentation: A 41-year-old female diagnosed eighteen years ago with Sheehan syndrome, with unknown replacement therapy status, is brought to ED for altered mental status. One week before, she crossed the Mexican-US border as an illegal immigrant and was hospitalized in Arizona after developing mutism and mood lability. She was initiated and discharged on hormone replacement therapy. She arrived in New York confused with flat affect and impaired recent memory. She was hypotensive (BP: 92/64 mmHg), hyponatremic (Na: 133 mEq/L), and anemic (Hb: 10.6 g/dL). She had an inappropriate normal ACTH of 25 pg/mL (7.2-63.3 pg/mL). MRI findings confirmed empty sella, suggestive of central AI. Additional studies revealed central hypothyroidism (low normal TSH (1.36 uIU/mL), low-normal Free T4 (1.4 ng/dL), gonadotroph dysfunction with low FSH (2.7 IU/L), and low estrogen levels (20 pg/mL) for her age, and low normal prolactin (4.6 ng/mL). After initiating a stress dose of IV hydrocortisone and IV levothyroxine, her affect, memory, mental status, and vital signs (BP: 128/80 mmHg) improved. She was educated regarding the need for maintenance doses as an outpatient. At the one-month follow-up, she continued with a positive response. Discussion: Patients with chronic AI are unable to produce sufficient cortisol and are at risk of acute adrenal crisis when under stress. Stressful situations, including accidents, job interviews, or death in the family, have been described. However, with almost doubling the number of people entering the US without prior authorization between 2022 and 2023, immigration, which poses physical and emotional stress, certainty will become a matter of importance for those with AI. Guidelines to manage cortisol replacement in times of fever, infections, trauma, surgery, or severe pain are available. However, it is more difficult to define how emotional and psychological challenges affect the stress response, mainly because each challenge is unique. Therefore, it is important to advocate for policies to provide medical alert bracelets to immigrants with known AI in addition to providing education about emergency injection kits in cases of impending crisis. Presentation: 6/3/2024

A generalisability theory approach to quantifying changes in psychopathology among ultra-high-risk individuals for psychosis

Distinguishing stable and fluctuating psychopathological features in young individuals at Ultra High Risk (UHR) for psychosis is challenging, but critical for building robust, accurate, early clinical detection and prevention capabilities. Over a 24-month period, 159 UHR individuals were assessed using the Positive and Negative Symptom Scale (PANSS). Generalisability Theory was used to validate the PANSS with this population and to investigate stable and fluctuating features, by estimating the reliability and generalisability of three factor (Positive, Negative, and General) and five factor (Positive, Negative, Cognitive, Depression, and Hostility) symptom models. Acceptable reliability and generalisability of scores across occasions and sample population were demonstrated by the total PANSS scale (Gr = 0.85). Fluctuating symptoms (delusions, hallucinatory behaviour, lack of spontaneity, flow in conversation, emotional withdrawal, and somatic concern) showed high variability over time, with 50–68% of the variance explained by individual transient states. In contrast, more stable symptoms included excitement, poor rapport, anxiety, guilt feeling, uncooperativeness, and poor impulse control. The 3-factor model of PANSS and its subscales showed robust reliability and generalisability of their assessment scores across the UHR population and evaluation periods (G = 0.77–0.93), offering a suitable means to assess psychosis risk. Certain subscales within the 5-factor PANSS model showed comparatively lower reliability and generalisability (G = 0.33–0.66). The identified and investigated fluctuating symptoms in UHR individuals are more amendable by means of intervention, which could have significant implications for preventing and addressing psychosis. Prioritising the treatment of fluctuating symptoms could enhance intervention efficacy, offering a sharper focus in clinical trials. At the same time, using more reliable total scale and 3 subscales can contribute to more accurate assessment of enduring psychosis patterns in clinical and experimental settings.

Mapping a psychosocial syndemic among methamphetamine-using sexual minority men living with HIV.

While research with sexual minority men (SMM) has focused on disparities related to HIV, substance use and mental health, synergistic psychosocial pathways driving these epidemics remain underexplored. We used syndemic theory to assess how psychosocial factors sustain methamphetamine use and hinder recovery efforts for SMM living with HIV. A triangulation of network analyses and constructivist grounded theory approaches is utilised to elucidate pathways through which psychosocial factors influence methamphetamine use among this population. Survey data (N = 129) are used for quantitative analyses and a purposive sub-sample (n = 24) was recruited for semi-structured interviews for qualitative analyses. The network analysis revealed two statistically significant bivariate associations: between post-traumatic stress disorder and depression symptoms (b = 0.37, SD = 0.07, 95% confidence interval [0.23, 0.49]) and between depression symptoms and negative affect (b = 0.26, SD = 0.07, 95% confidence interval [0.12, 0.38]). Findings from the constructivist grounded theory analysis supplement the network analysis by offering a nuanced take on how negative affect, post-traumatic stress disorder, and depression symptoms operate synergistically to promote methamphetamine use and impede recovery efforts. Participants relay experiences of using methamphetamine to cope with these psychosocial factors through avoidance, escapism, mood elevation, and numbing of emotions. Findings suggest that centring these psychosocial factors may inform more effective, holistic interventions for this high-priority population.

Blunted reward-related activation to food scenes distinguishes individuals with alcohol use disorder in a pilot case-control fMRI pilot study.

Alcohol use disorder (AUD) is thought to bias the neurocircuitry underlying reward processing and motivation to preferentially attend to conditioned alcohol cues over natural rewards. The present case-control pilot study evaluated this hypothesis using novel natural reward paradigms. Twenty-eight participants (AUD, n = 14, light drinkers, n = 14) were recruited-AUD participants reported 44.0% heavy drinking days (%HDD) and 4.67 drinks/day over the preceding 90 days. Functional magnetic resonance imaging (fMRI) data were acquired during the administration of three separate picture-viewing paradigms of alcohol cues, food scenes, and social reward, respectively. Independent samples t-tests were performed to compare groups' fMRI data and exploratory correlation analyses were performed to examine associations with clinical characteristics of AUD. Food scenes elicited abnormally low reward-related activation, within the superior frontal gyrus and caudate bilaterally, among AUD participants. Lower activation to food scenes within the superior frontal gyrus was, in turn, associated with higher levels of past-month %HDD among AUD participants, specifically, along with craving and alcohol dependence severity when examined across the full sample. Contrasting reward types (e.g., alcohol cues vs. food scenes) did not reveal "preferential" activation to differentiate groups. Heavy drinking appears associated with reduced responsivity to natural rewards, specifically food rather than social cues. Neural mechanisms underlying the high prevalence of malnutrition among individuals with AUD may involve some combination of blunted approach-related affect and reduced craving-related motivation to eat when food is present, resulting in limited engagement of cortico-striato-thalamic motor circuitry supporting food acquisition. However, given the preliminary nature of this pilot study, such formulations remain tentative until larger follow-up studies can be conducted. From a potential translational standpoint, the ability of promising therapeutics to demonstrate increased responsivity to natural rewards, specifically nutritive reward may serve as a valuable complementary efficacy indicator for future clinical neuroimaging trials in AUD.

Employing Expressive Art to Explore Mexican Americans’ Grief Experiences of Loss Due to COVID-19

The COVID-19 pandemic changed people’s lives and resulted in tremendous pain, loss and suffering. The Rio Grande Valley (RGV), in the state of Texas in the U.S., was one of the regions with the highest number of infections and deaths during the pandemic. However, individuals’ bereavement in the RGV is rarely addressed. In this qualitative study, a snowball sample of 47 individuals who had lost their loved ones during the years 2020–2021 were interviewed and invited to engage in an art activity. The findings revealed four themes: peculiar funeral, grieving confusion, loved ones’ memories, and connection to self and the lost one through art. Results indicate that the collective aspect of the funeral was disrupted during the pandemic and created emotional numbness and denial. The intensity of grieving did not decrease with time. The participants mainly relied on their family support and rarely sought professional help. A culturally adapted intervention is needed to address long-term bereavement in this community. Analysis of the art activities indicated that all participants had a feeling of peace and relief afterward, especially male participants who had difficulty expressing their emotions. The participants reported that the artwork positively affected their grievances and that the process was satisfying.

Amygdala Cannabinoid 1 Receptor, Pain Response, and Emotional Numbing in Trauma-Exposed Individuals.

This case-control study assesses associations of amygdala cannabinoid 1 receptor availability with amygdala response to shock-induced pain and severity of emotional numbing symptoms of veterans with posttraumatic stress disorder.

Dynamics of symptom network in patients with first-episode schizophrenia: Insight from the CNFEST project

BackgroundSchizophrenia is a heterogeneous psychotic disorder. Recent theories have emphasized the importance of interactions among psychiatric symptoms in understanding the pathological mechanisms of schizophrenia. In the current study, we examined the symptom network in patients with first-episode schizophrenia (FES) at four time points during a six-month follow-up period. MethodsIn total, 565 patients with FES were recruited from the Chinese First-Episode Schizophrenia Trial (CNFEST) project. Clinical symptoms were measured using the Positive and Negative Syndrome Scale (PANSS) at baseline and follow-up (514 patients at one month, 429 at three months, and 392 at six months). We used a network analysis approach to estimate symptom networks with individual symptoms as nodes and partial correlation coefficients between symptoms as edges. A cross-lagged panel network (CLPN) model was used to identify predictive pathways for clinical symptoms. ResultsWe found stable and strongly connected edges in patients across the time points, such as links between delusions and suspiciousness/persecution (P1:P6), and emotional withdrawal and passive/apathetic social withdrawal (N2:N4). Emotional withdrawal (N2), poor rapport (N3), and passive/apathetic social withdrawal (N4) had high centrality estimates across all four time points. CLPN analysis showed that negative symptoms, including emotional withdrawal (N2), poor rapport (N3), and passive/apathetic social withdrawal (N4), and stereotyped thinking (N7) may have predictive effects for negative and general symptoms at follow-ups. ConclusionsThe symptom network of schizophrenia may be dynamic as treatment progresses. Negative symptoms remain the central and stable symptoms of schizophrenia. Negative symptoms may be potential therapeutic targets that predict other symptoms.

A Phenomenological Study On The Social Isolation Experiences Of Elderly Living Alone In Korea

Background: The purpose of this study is to identify the social isolation process of seniors living alone. Methods: Data collection was conducted over a total of 8 days from July 8, 2024 to July 15, 2024. The participants in this study were elderly people living alone and aged 65 or older. 11 subjects participated in the final interview. All interviews were recorded with recorder and transcribed for analyzing by Van Kaam method of phenomenology. Results: Demographic characteristics (Sex, age, job, education, housing status, religion, and economic condition) were derived from the raw data, and these were grouped into 14 sub-themes and four categories: ‘economic deprivation,’ ‘physical difficulties,’ ‘social relationships,’ and ‘emotional withdrawal.’ Conclusion: Based on the results of this study, it is believed that counseling and program development are necessary to address the social isolation of elderly people living alone

The Impact of Peer and Cyberbullying on Elementary School Children in the Republic of Serbia

This study examines the prevalence of various forms of peer bullying among elementary school children, with a particular focus on the rising issue of cyberbullying. Utilizing a specially constructed Likert scale, the research gathered data from a sample of 98 children, composed of 51 boys and 47 girls, across grades five to eight. The findings reveal that verbal abuse, such as name-calling, mocking, and insulting, is the most common form of bullying experienced by children. Physical bullying behaviors like hitting, pushing, and kicking are also prevalent. Furthermore, the study highlights the significant presence of cyberbullying, characterized by malicious online messaging and social media interactions, which often result in emotional distress and withdrawal from social activities. The reliability and internal consistency of the measurement scale were confirmed by a Cronbach’s Alpha coefficient of 0.775. The results underscore the importance of addressing both traditional and cyber forms of bullying to ensure a safer school environment. The study advocates for comprehensive educational programs that promote digital literacy and empathy among children to mitigate the negative impacts of bullying. Additionally, the research suggests implementing effective intervention strategies that include prompt responses to reported bullying incidents and providing support to victims. This study contributes to the growing body of literature on bullying by offering insights into the dynamics of peer and cyberbullying, emphasizing the need for continuous monitoring and preventive measures within educational settings.

Response styles to positive affect during a positive psychology intervention for veterans with PTSD and moral injury: Preliminary results from a moral elevation intervention pilot trial.

Veterans with posttraumatic stress disorder (PTSD) or moral injury are at risk of maladaptive response styles to positive emotions, such as emotional numbing. A potential pathway to target problematic responses to positive affect is a positive psychology intervention that elicits moral elevation-feeling inspired after witnessing someone perform a virtuous act. This study aims to examine responses to positive affect in a pilot trial of a web-based moral elevation intervention titled, MOVED: Moral Elevation Online Intervention for Veterans Experiencing Distress Related to PTSD and Moral Injury. Method: Veterans who reported moral injury distress and probable PTSD were randomized into an intervention or control condition (n = 48). We examined repeated measures data during the trial and focused on three subscales of the Response to Positive Affect Questionnaire: rumination on positive mood and somatic experiences (emotion-focus), rumination on positive aspects of the self and pursuit of relevant goals (self-focus), and efforts to dampen positive moods (dampening). Three multilevel models were fitted with time and condition as predictors and subscale scores as outcomes. Qualitative data reported at intervention sessions was also reviewed and coded based on the three subscales. Veterans in the MOVED condition reported more positive rumination than the control condition for both emotion-focus (b = 2.70, p = .023) and self-focus styles (b = 2.90, p = .003). There was no group difference in the dampening style. Qualitative responses after elevation-eliciting exercises and session-based goals were most frequently coded as including emotion-focused positive rumination, followed by dampening, then self-focused rumination. These results provide preliminary evidence that a moral elevation intervention might contribute to positive responses to positive affect in a sample predisposed to emotional numbing. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Vicarious trauma and the COVID-19 pandemic: The role of organisations.

Vicarious trauma (VT) is an occupational challenge incurred through hearing about traumatic experiences of others such as child maltreatment, mass casualties, and others while serving in helping professions. Without sufficient resources and support, long-term exposure can lead to symptoms such as intrusion, avoidance, arousal, emotional numbing, anxiety, and decline in one's ability to work. Organisations can mitigate VT's impact by addressing the needs of staff through 5 evidence-informed areas of occupational health. This project explored the impact of VT-informed practices on organisational responses to the COVID-19 pandemic. We compared responses from 50 organisations on strengths and weaknesses in core areas of being VT-informed to how those organisations responded to the COVID-19 pandemic. Subscales of the VT Organizational Readiness Guide (VT-ORG) were utilized as the exposure variables and 4 new COVID-19 questions served as the outcome. We ran a series of multilevel linear regression models with clustering controlled for at the organisational level. Staff ratings on 4 of the 5 pillars of the VT-ORG were positively associated with the organisation's responsiveness to the pandemic. Various demographic factors of the employees were negatively associated with organisations' responsiveness to the pandemic. While this study contributes to the growing research on VT, it also provides justification for helping organisations to become VT-informed; it provides evidence that being prepared for VT can also be useful to support workers and their communities during emergencies such as the COVID-19 pandemic.

Bolstering family therapy: Assimilating EMDR into ABFT in youth residential treatment.

The psychotherapy field has a long history of integration to improve treatment effectiveness. One type, assimilative integration, offers innovative opportunities to family therapy to incorporate the clinical and research contributions of different approaches. This paper contributes to the literature on integration by exploring how Eye Movement Desensitization and Reprocessing (EMDR) can be assimilated into Attachment-Based Family Therapy (ABFT) for youth in residential psychiatric treatment. ABFT seeks to improve attachment security to parental figures by asking adolescents and young adults to discuss attachment ruptures. This process, specially designed for patients with internalizing disorders, can provoke anxiety, particularly for a patient population that commonly has a history of trauma and adverse life experiences. EMDR is a first-line therapy for post-traumatic stress disorder and has the potential to be effective in treating various other mental health conditions. When patient emotional withdrawal or dysregulation due to breaches in trust between child and parent emerges in ABFT, EMDR may help desensitize associated memories and bolster the family therapy process. The authors provide an overview of both models, and a detailed case study as an example. The paper concludes with a discussion on implications, integration efforts, and limitations.

Distinguishing genuine from simulated dissociative identity disorder using the Morel Emotional Numbing Test.

Few studies have identified validity tests that are appropriate for use in individuals with dissociative identity disorder (DID). This study investigated whether the Morel Emotional Numbing Test (MENT) could distinguish between genuine and simulated DID. Thirty-five participants with DID diagnosed via a semistructured interview were compared to 88 participants taking an abnormal psychology course who were instructed to simulate DID. Group comparison analyses were conducted to examine differences in the MENT errors. Univariate logistic regression and receiver operating characteristic curve analyses examined how well the MENT errors discriminated between groups and identified a cutoff optimizing sensitivity while maintaining high specificity. Simulators had significantly more errors across all three MENT sets compared to genuine DID participants. The total number of MENT errors across sets most strongly and significantly predicted genuine versus simulated DID groups. Receiver operating characteristic curve analyses indicated that the MENT could discriminate between genuine and simulated DID with outstanding classification accuracy (area under the curve = .95). A cutoff of ≥ 10 total errors on the MENT yielded an optimal balance of sensitivity (.86) and specificity (.94). However, the previously defined cutoff of ≥ 8 total errors also demonstrated high sensitivity (.87) and specificity (.89). Findings provide preliminary evidence for the MENT as a validity test for DID populations. Although the commonly used cutoff of ≥ 8 errors on the MENT demonstrated excellent psychometric properties, we recommend using a cutoff of ≥ 10 errors for individuals with DID to minimize the risk of false positives while maintaining strong sensitivity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Disentangling negative and positive symptoms in schizophrenia and autism spectrum disorder

Autism spectrum disorder (ASD) and schizophrenia (SZ) share traits, especially in social skills and negative symptoms, and to a lesser degree positive symptoms. Differential diagnosis can be challenging and discerning expressive and experiential negative symptoms may provide knowledge with potential diagnostic and functional relevance that can guide treatment. Two exploratory factor analyses (EFA) were conducted to reveal the underlying dimensions of negative and positive symptoms using the Positive and Negative Syndrome Scale (PANSS), the Scale for the Assessment of Positive Symptoms & Negative Symptoms (SAPS/SANS) and the Autism Diagnostic Observation Schedule-Generic (ADOS-G). Three factors emerged from the negative symptom EFA (70.5 % variance): NF1) Expressive Negative; NF2) Experiential Negative; and NF3) Preoccupation, Absorption & Expressive Affective Flattening. Three positive factors emerged (68.6 % variance): PF1) Hallucinations-Delusions; PF2) Grandiosity; and PF3) Thought Disorder-ADOS positive Symptoms. SZ showed higher PF1 scores, and ASD had higher PF3 scores. No differences between groups were observed in the negative factors. Across groups, all negative factors were inversely associated with quality of life. Only NF1 and NF2 and PF1 were detrimentally related to social functioning. A discriminant function analysis using all factors classified correctly 84.4 % of participants, with PF1, NF1 followed by NF2 being the best predictors of diagnosis. Expressive negative followed by Experiential negative symptoms are of diagnostic value independent of and beyond SZ-related positive symptoms and are related with detrimental functioning. Findings confirm the need to distinctively target negative symptoms, and specific SZ-related and ASD-related positive symptoms, and especially the use of several assessment tools for diagnostic classification.

A CONCEPTUAL MODEL FOR DESIGNING TEACHER-CENTERED PROFESSIONAL DEVELOPMENT

Educators often experience significant levels of stress in the workplace that impact their enthusiasm about the profession and longevity in the field of education. Some personal impacts of stress on educators may include emotional numbing, feeling shut down, loss of energy, and increased illness or fatigue. Recently, some schools and districts have begun investing in programming to support educator well-being; however, these initiatives are rarely developed and co-led by educators themselves, and they do not address systemic issues within schools that may serve as barriers to teachers’ well-being. In this paper we draw upon existing theories and research, Critical Professional Engagement, Healing-Centered Engagement, and Critical Love Praxis, to explore the development and use of a conceptual framework to support the design of teacher-centered and justice-oriented professional development.

Withdrawal interference scale: a novel measure of withdrawal-related life disruption in opioid use disorder and alcohol use disorder

ABSTRACT Background: Hyperkatifeia describes amplified emotional and motivational withdrawal due to addiction-related sensitization of brain-stress-systems. Hyperkatifeia has been proposed as a target for addiction treatment development. However, translation of basic research in this area will require new tools designed to measure hyperkatifeia and related phenomena outside of laboratory settings. Objectives: We define a novel concept, withdrawal interference, and introduce a new tool – the Withdrawal Interference Scale (WIS) – which measures the impact of withdrawal on daily life among individuals with OUD or AUD. Methods: Described are the combined results of three separate cross-sectional studies. The structural validity, convergent validity, construct validity, trans-diagnostic (AUD/OUD) configural, metric, and scalar invariance, internal consistency, and composite reliability of WIS was tested among three independent samples of 1) treatment-seeking adults with OUD (n = 132), 2) treatment-seeking adults with AUD (n = 123), and 3) non-treatment-seeking adults with OUD (n = 140). Males numbered 218 and females were 163. Results: WIS exhibited structural validity (1 factor), convergent validity (average variance extracted .670–.676), construct validity, trans-diagnostic configural (χ2/df = 2.10), metric (Δχ2 = 5.70, p = .681), and scalar invariance (Δχ2 = 12.34, p = .338), internal consistency (α .882–928), and composite reliability (.924–.925). Conclusion: These results suggest WIS is a valid and reliable instrument for measuring withdrawal-related life disruption in AUD and OUD. Further, given our findings of transdiagnostic measurement invariance, WIS scores of individuals with AUD and OUD can be meaningfully compared in future statistical analyses.