Psychopathological Manifestations Research Articles

Daily manifestations of psychopathology in response to stress.

Psychological functioning is shaped by how people navigate their environment. Accordingly, psychopathology is often caused and maintained by patterns of responding to the environment that do not meet situational demands. In particular, psychopathology is often expressed in an inflexible or intense manner of coping with stressful situations. Prior research on psychopathology and daily life stress is limited by an overreliance on negative affect reactivity, which neglects the myriad responses that can create problems in a person's life. In this study, we assessed a broad range of daily manifestations of psychopathology to examine daily psychopathology-stress associations. We conceptualized individual differences in functioning as psychopathology traits and daily fluctuations in the interrelated thoughts, behaviors, and emotions as psychopathology states, with traits and states corresponding to the same domains of functioning (i.e., antagonism, detachment, disinhibition, negative affectivity, anankastia, psychoticism). Data have been taken from two samples enriched for psychopathology (N = 112, N = 294 participants) who completed daily assessments of stressors and psychopathological states (n = 9,201, n = 4,292 days). We used multilevel structural equation models to examine average, within-person associations between stressors and psychopathological states and correlations between psychopathological traits and stress responses. Results showed that (a) most people experience increases in psychopathological states when stressed and (b) psychopathological traits relate to more consistent and stronger increases in psychopathological states. Our study suggests that psychopathology reflects how people cope with stressful situations, and what distinguishes people with high-trait psychopathology from those who experience typical upticks in psychopathology when stressed is the consistency and extremity of their responses. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Mechanisms and Functions of the Cerebral-Cognitive Reserve in Patients with Alzheimer's Disease: A Narrative Review.

The need for scientific knowledge about aging is predicated on the demand of modern society to extend the active life of a person. To maintain intellectual longevity, it is necessary to take into account not only the pathological, but also compensatory mechanisms that arise during aging. The cerebral-cognitive reserve (CCR) influences the rate of transition from pre-phenomenological stages to the clinical stage of the disease, thereby changing the prognosis of Alzheimer's disease (AD). The aim of this work was to review meta-analyses from studies that have examined the principles and functions of the CCR in people with AD. The work included 83 scientific publications devoted to the issues of the CCR in neurodegenerative diseases such as AD. The Results and Discussion sections of this article provide reviews of the results of 12 meta-analyses published from 2012 to 2024 and selected from the PubMed and eLibrary databases using the following keywords in English and Russian: "cerebral reserve", "cognitive "reserve", and "Alzheimer's disease". The scope of the definition was not limited, since the goal here was to determine the terminological boundaries of the concepts of "cognitive reserve" and "single brain reserve". The modern understanding of AD as a biological continuum covering the preclinical, prodromal, and clinical phases of the disease makes it possible to infer that insufficiency of protective factors underlies the progression of AD. The cognitive reserve is involved in the sanogenetic protective mechanism during neurodegeneration. The cognitive reserve is a theoretical concept that reflects modern research's understanding of how the integrative functioning of the brain (cerebral) and cognitive reserves extend the period of active intellectual longevity through energy-saving mechanisms. It considers these mechanisms as central to healthy mental activity and in slowing the progression of neurodegenerative diseases. At some point, an increase in excess interneuronal activity that reflects the hypercompensatory function of the reserve would accelerate the depletion of brain structures and contribute to clinical and psychopathological manifestations of AD. The concept of the CCR puts the spotlight on the need to determine the compensatory indicators of cognitive deficit in AD, assess the architecture and volume of the reserve, and develop and follow protocols for its maintenance. It appears just as crucial to adopt measures to prevent the Reserve's depletion as early as at the preclinical stages of the disease. Elaborating protective and compensatory mechanisms that help to maintain the functional activity of the brain in conditions of neurodegeneration, that is, CCR, require further research and can form a conceptual basis for the prevention of AD, starting from the preclinical stages of the disease.

Cerebellar cognitive affective syndrome and vertebrobasilar ischemia. From cerebello-cerebral diaschisis to "dysmetria of thought"

Cerebellum, along with it' s role in coordinating motor functions, exercises a significant regulatory influence in fields of cognitive and affective functions. Therefore, studying the effect of cerebrovascular atherosclerotic pathology on mood and cognition should not be limited to stenotic dysfunctions of carotid arteries, but also extend its methodological framework to the consideration of the integrity of vertebrobasilar system (VBS), cerebellar perfusion and posterior cerebral circulation in general, as it has not been yet sufficiently addressed whether VBS insufficiency is associated with deterioration of patients' mental and emotional status and quality of life (QoL). Vertebrobasilar circulatory dysfunction has been pointed out, since decades, as a cause of progressive memory impairment and dementia, due to multiple infarcts in cerebral areas which are topographically critical for mental and emotional functions. Indicative of the pathophysiological and anatomic-functional association of VBS with these neuro-psychiatric domains are cerebellar cognitive-affective syndrome (CCAS) and crossed cerebello-cerebral diaschisis (CCCD). Mental and psychiatric components of CCAS, along with ataxic motor disability, constitute the conceptual hypothesis of "dysmetry of thought", while diagnostic significance of mental dysfunctions and psychopathological manifestations, in terms of symptoms preceding motor impairments that ascribe cerebellar malfunction in the epicenter of their pathophysiology, such as cerebellar ataxias, in which, early recognition of CCAS may facilitate therapeutic interventions aimed at improving QoL, reveal that cerebellar pathology, either of degenerative etiology or vascular substrate on the ground of vertebrobasilar insufficiency (VBI) or other surgical conditions of the posterior fossa, is associated with deterioration of patients' QoL which is related to significant impairments in their cognitive functions with (co)manifested emotional disorders. Studies in animal models also support these conclusions. Since VBI is responsible for a wide range of psychiatric and neurological symptoms, new findings concurred with current indications advocating that, without consideration of VBS disorders, it is impossible to clarify the connection of cerebral perfusion dysfunctions to neurocognitive deficits. The inclusion of cerebellar perfusion disorders in scientific research and clinical approaches to cognitive and affective disorders that may occur in patients with cerebrovascular lesions constitutes a paradigm of best clinical practices implementation and interdisciplinary convergence of neurosciences and vascular medicine.

The Resurgence of Exogenous Psychosis: A Phenomenological Examination of Substance-Induced Psychopathology.

The psychopathological manifestations associated with substance use, including induced psychotic experiences, are increasingly relevant but not well-understood within the medical community. Novel psychoactive substances and potentiated old compounds like cannabis and cocaine have emerged as a global concern, especially among adolescents and young adults. Transition rates from substance-induced psychosis (SIP) to persistent psychosis are significant, particularly in cases of cannabis-induced psychosis. Scientific inquiry into induced psychotic phenomena has revealed differences between SIP and primary psychotic disorders, highlighting the risk factors associated with each. The concept of exogenous psychosis, including its toxic variant known as lysergic psychoma, provides valuable insights into the role of external factors in psychosis development. A phenomenological approach characterizes this disruption in perception as a shift in temporal and spatial dimensions, leading to auditory and visual hallucinations. The "twilight state" of consciousness plays a crucial role in the transition from substance use to psychosis, with implications for spatiality, intersubjectivity, and temporality. This complex path to psychosis challenges traditional diagnostic models and underscores the need for a more nuanced understanding of substance-induced psychopathological experiences.

Decreased free D-aspartate levels in the blood serum of patients with schizophrenia.

Schizophrenia (SCZ) and autism spectrum disorder (ASD) are neurodevelopmental diseases characterized by different psychopathological manifestations and divergent clinical trajectories. Various alterations at glutamatergic synapses have been reported in both disorders, including abnormal NMDA and metabotropic receptor signaling. We conducted a bicentric study to assess the blood serum levels of NMDA receptors-related glutamatergic amino acids and their precursors, including L-glutamate, L-glutamine, D-aspartate, L-aspartate, L-asparagine, D-serine, L-serine and glycine, in ASD, SCZ patients and their respective control subjects. Specifically, the SCZ patients were subdivided into treatment-resistant and non-treatment-resistant SCZ patients, based on their responsivity to conventional antipsychotics. D-serine and D-aspartate serum reductions were found in SCZ patients compared to controls. Conversely, no significant differences between cases and controls were found in amino acid concentrations in the two ASD cohorts analyzed. This result further encourages future research to evaluate the predictive role of selected D-amino acids as peripheral markers for SCZ pathophysiology and diagnosis.

The predictivity role of affective temperaments in mood alteration

BackgroundThe affective temperaments are defined as the fundamental predisposition from which normal affective states originate or as the constitutional core of personality. Recently, researchers have started considering the role of affective temperament on the clinical expression of affective disorders. The aim of the study is to learn more about the role of affective temperaments on irritability, anxiety and depression symptoms. Methods748 subjects belonging to Italian population were included. Data were collected through an online survey including IDAS and TEMPS-A questionnaire. Two correlation analysis were performed to assess sex differences in the affective patterns. A linear regression analysis was performed to assess how age, sex and temperamental dimensions could play a role as predictors of depression, anxiety and irritability symptoms. ResultsThe correlation analysis shows that "Cyclothymic," "Depressive," "Irritable", and "Anxious" temperaments, in both genders, positively correlate with Anxiety, Depression, and Irritability. Hyperthymic temperament, instead, negatively correlates with Depression in men and with both Anxiety and Depression in women. Linear regression show that Cyclothymic, depressive and anxious temperaments are significant predictors of anxiety symptoms while depressive and cyclothymic temperaments are predictors of depressive symptoms. The irritability was found to be a significant predictor of depression and anxiety disorders. The results of the linear regression analysis show that the Cyclothymic and Irritable temperaments significantly predicted “Irritability”. Finally, female sex was found to be a predictor of anxiety (β = 0.090, t = 2.906, p = <0.004) ConclusionThe present study confirms the role of affective temperaments as possible risk factors in psychopathological manifestations. Further studies would be necessary in order to investigate the mechanisms of these observed associations.

Childhood Trauma, Mentalization and Obsessive Compulsive Symptoms in a Non-Clinical Sample: A Mediation Analysis Study.

Obsessive and compulsive symptoms (OCS) are cross-cutting psychopathological manifestations frequently detected in a variety of clinical and non-clinical samples. It has been suggested that impaired mentalization abilities and traumatic experiences during childhood may be relevant etiopathogenetic factors in the development of OCS. The purpose of the current study was to cross-sectionally assess these variables in a non-clinical sample, testing the mediational role of mentalization abilities in the association between childhood trauma (CT) and OCS. 667 participants (488 females; mean age= 29.76 ± 11.87 years; age range: 18-80) answered a survey including the Childhood Trauma Questionnaire, the Mentalization Questionnaire and the Obsession-Compulsion subscale of the Brief Symptom Inventory. The mediation model was significant for the total effect (p< .001), showing that CT was positively associated with OCS (95% CI: .006; .019) and that this association was mediated by reduced levels of mentalization capacity (95% CI: .003; .009). Such results were significant controlling for potential sociodemographic and clinical confounding variables. The findings contribute to elucidate the complex relationships between CT, mentalization capacity, and OCS, supporting the possibility that mentalization impairments, arising from CT, may affect top-down control mechanisms thus contributing to the development of OCS.

Body checking and avoidance among dancers

Dancers are at heightened risk for eating disorders (EDs) and have job and training demands that obscure ED assessment and likely impede treatment. Two behavioral manifestations of ED psychopathology that may present uniquely in a dance environment are body checking and body avoidance. The current study sought to provide a foundational understanding of the phenomenology of body checking and avoidance among dancers by assessing the reliability (i.e., internal consistency) of existing body checking and avoidance measures and the relationships, or convergent validity, between measures of body checking and avoidance and measures of related constructs. Eighty professional and pre-professional (i.e., conservatory level) dancers (78.8 % female) from seven dance genres completed self-report measures of body checking and avoidance, ED pathology, clinical perfectionism, depression, and anxiety. Across the dancer sample, body checking and avoidance measures demonstrated adequate internal consistency. More frequent body checking and body avoidance was strongly related to higher levels of ED pathology. There were moderate to strong correlations between body checking and body avoidance and clinical perfectionism, depression, and anxiety such that higher body checking and body avoidance was related to higher clinical perfectionism, depression, and anxiety. Exploratory analyses found no significant differences between ballet dancers and dancers of other dance genres; professional dancers scored in the normative range on measures of body checking and body avoidance. Dancers' qualitative descriptions of body checking and avoidance revealed behaviors not included in existing questionnaires, such as unique mirror use behaviors, technology-assisted body checking, and the checking and avoidance of body parts relevant to the dance-specific body ideal. Results support the inclusion of body checking and avoidance interventions in ED treatments for dancers (particularly pre-professional dancers) and emphasize the need for dancer-specific ED assessment methods.

Dissecting the polygenic contribution of attention-deficit/hyperactivity disorder and autism spectrum disorder on school performance by their relationship with educational attainment

Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) are strongly associated with educational attainment (EA), but little is known about their genetic relationship with school performance and whether these links are explained, in part, by the genetic liability of EA. Here, we aim to dissect the polygenic contribution of ADHD and ASD to school performance, early manifestation of psychopathology and other psychiatric disorders and related traits by their relationship with EA. To do so, we tested the association of polygenic scores for EA, ADHD and ASD with school performance, assessed whether the contribution of the genetic liability of ADHD and ASD to school performance is influenced by the genetic liability of EA, and evaluated the role of EA in the genetic overlap between ADHD and ASD with early manifestation of psychopathology and other psychiatric disorders and related traits in a sample of 4,278 school-age children. The genetic liability for ADHD and ASD dissected by their relationship with EA show differences in their association with school performance and early manifestation of psychopathology, partly mediated by ADHD and ASD symptoms. Genetic variation with concordant effects in ASD and EA contributes to better school performance, while the genetic variation with discordant effects in ADHD or ASD and EA is associated with poor school performance and higher rates of emotional and behavioral problems. Our results strongly support the usage of the genetic load for EA to dissect the genetic and phenotypic heterogeneity of ADHD and ASD, which could help to fill the gap of knowledge of mechanisms underlying educational outcomes.

PECULIARITIES OF ADAPTATION AND COURSE OF POST-TRAUMATIC STRESS DISORDER IN SERVICEMEN DEPLOYED TO INTENSE COMBAT ZONES

In the context of war, post-traumatic stress disorder (PTSD) emerges as one of the most prevalent psychological conditions, particularly among military personnel deployed in combat zones. The primary triggers for PTSD in military personnel often include the loss of comrades or the necessity to use lethal weapons, resulting in significant consequences. For PTSD to manifest, individuals must undergo a traumatic experience that exceeds normal human stress levels and leads to distress. The aim of this study is to investigate the course of PTSD in military personnel who have been exposed to intense combat operations and to explore their maladaptive manifestations. The study comprised 38 patients diagnosed with PTSD (F43.1) according to the ICD-10, who received treatment at the Regional Mental Health Care Institution for the Protection of the Armed Forces. All patients provided informed consent to participate in the study. A structured clinical diagnostic interview known as CAPS-DX was applied in this study. Developed based on the DSM-IV, this interview assesses the symptoms of posttraumatic stress disorder (PTSD), the duration of the disorder, and the degree of impairment of social functioning. The CAPS-DX scale provided insights into the presence of PTSD symptoms both currently and throughout the individual's life following psychotrauma. To diagnose psychosocial maladjustment and its characteristics, we employed the Psychosocial Maladjustment Scale by L. Herasymenko (2018). Clinical and anamnestic examinations revealed that 86% of servicemen had experienced multiple traumatic events, indicating a history of several psychotraumas. The study identified that the primary psychopathological manifestations of PTSD did not differ significantly from the traditional course of the disorder, but they were more intense and pronounced in this group of servicemen. The study has demonstrated that servicemen with combat experience and PTSD exhibited reduced levels of psychosocial adaptation. Their adaptive resources and capabilities, as well as their neuropsychological stability, were significantly diminished, along with a decrease in their communication abilities. Based on the overall level and quality of social and psychological adaptation, three levels of adaptation/maladaptation were distinguished among servicemen with combat-related PTSD: sufficient, partial, or maladaptation. It should be noted that the levels of adaptation were correlated with the severity of anxiety. Servicemen with sufficient adaptation typically exhibited low levels of anxiety, while those with partial adaptation showed an average level, and those with maladaptation displayed high levels of anxiety. The study revealed a spectrum of psychopathological manifestations in servicemen who were in the combat zone, ranging from semiotic complexes resembling panic attacks to psychogenic catalepsy. Furthermore, it was found that servicemen with combat experience and post-traumatic stress disorder had reduced levels of psychosocial adaptation, which correlated with the severity of anxiety.

Rethinking peer influence and risk taking: A strengths-based approach to adolescence in a new era.

The ways that psychopathology manifests in adolescence have shifted dramatically over the past twenty-five years, with rates of many externalizing behaviors declining substantially while rates of anxiety and depressive disorders have skyrocketed. This paper argues that understanding these changes requires rethinking the field's historically somewhat negative views of intense peer connections, peer influences, and adolescent risk-taking behavior. It is argued that intense peer connections are critical to development, and that peer influence and risk taking have important, often overlooked, adaptive components. The shift in observed manifestations of adolescent psychopathology over this period can be viewed at least partly in terms of a shift away from strong peer connections and toward greater risk aversion. Implications for research and intervention based on a focus on the adaptive aspects of peer influences and risk taking are discussed.

Awareness of the disease and attitude to treatment in patients with various mental disorders at the initial stages of the disease

IntroductionAn important aspect in providing effective psychiatric care and treatment is the formation of an adequate perception of their mental disorder in patients and awareness of the need for treatment, especially at the initial stages of the disease. Patients’ misunderstanding of their own psychopathological manifestations can act as a serious obstacle to their compliance and lead to an increase in the frequency of exacerbations and repeated hospitalizations.ObjectivesTo assess the attitude to the disease and treatment in patients with various mental disorders at the initial stages of the disease.MethodsClinical and psychopathological, psychological, statistical. The following scales were used: Drug Attitude Inventory (DAI, Hogan T.P. et al., 1983); Insight Scale for Psychosis (ISP, Birchwood M., 1994); Questionnaire “Style of self-regulation of behavior” (SSPM, V.I. Morosanova, 1988) and others. 17 patients with a diagnosis of bipolar disorder (BD, F31.xxx, ICD-10) were examined, the average age of patients was 25.52±4.55 years and 39 patients with a diagnosis of schizophrenia (F20.1xx and F23.1xx, ICD-10), the average age of patients was 29.29±9.71. The duration of the disorder in both groups of patients was 0.5-3 years.ResultsA comparative analysis of the average scores of the scale of attitude to the disease revealed significant differences in the groups (p≤0.01). Patients with schizophrenia had a lower awareness of their disease (2.31±0.91 points) than patients with bipolar disorder (3.59±0.76 points). Correlation analysis revealed reliable connections (p≤0.01) between the scales of attitude to the disease and drugs and the self-regulation questionnaire. In patients with schizophrenia, deeper violations were found in the links of self-regulation, such as programming and planning when assessing the presence of a mental disorder and deterioration of their condition due to discontinuation of medication (r=0.38 and r=0.36, respectively). The low level of self-regulation in general and the rigidity of negative attitudes in awareness of the disease and the need for treatment also have a negative impact on compliance with the medication regimen. No such correlations were found in patients with bipolar disorder: they were more aware of the presence of a mental disorder and the need for treatment, but the degree of compliance with the medication regimen was not high enough.ConclusionsThe treatment of patients with mental disorders requires an integrated approach with the mandatory inclusion of a psychoeducational component in order to form an adequate model of their disease and an understanding of the expected risks when therapy is discontinued. Psychoeducation is especially relevant in the early stages of the disease, both for patients with schizophrenia and with BD.Disclosure of InterestNone Declared

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

Clinical subtypes of postpsychotic depression in the first episode of schizophrenia: results of a cross-sectional observational study

BACKGROUND: Clinical diagnosis of depression in schizophrenia is difficult because of the dimensional overlap of a number of affective symptoms with negative manifestations of schizophrenia spectrum disorders. In the very first attack of schizophrenia, when the negative symptom complex is not yet clear enough, the difficulties of differential diagnosis become even more relevant, especially when depression occurs in the post-attack stage during the formation of remission and the manifestation of postpsychotic depression.&#x0D; AIM: To establish a diagnostic approach based on a combination of clinical-psychopathological and psychometric methods for the assessment of postpsychotic depression in patients with a first episode of schizophrenia.&#x0D; MATERIAL AND METHODS: We are examined 1112 patients who had suffered a first psychotic episode. Аfter introducing inclusion/exclusion criteria, two groups were formed in the final design: 243 patients with postpsychotic depression (PPD) and 119 patients without depression in partial remission. Clinical-psychopathological, psychometric (PANSS, CDSS, SCL-90-R scales), and statistical (descriptive, non-parametric statistics — significance level p 0.05) methods were used.&#x0D; RESULTS: Based on the concept of positive-negative affectivity, three types of PPD have been identified: with signs of positive affectivity — anxious, sensitive-psychasthenic, depersonalisation-hypochondriacal and melancholic-anergic subtypes; with signs of negative affectivity anhedonic, dysthymic-apathetic and dysphoric subtypes; formed due to psychopathological manifestations of the non-affective register — obsessive-ruminative, agoraphobic, paranoid-symbolic subtypes. Patients who were diagnosed with PPD with positive affectivity after an attack were predominat (p 0.05): 46.91% of the total number of depressed patients. PPD formed due to non-affective spectrum disorders is accompanied by the strongest subjective severity of suffering in patients, compared to patients diagnosed with PPD with positive affectivity. Subjectively, the easiest for patients is PPD with negative affectivity, which, however, does not mean that it can be considered as favourable from the standpoint of therapy and rehabilitation.&#x0D; CONCLUSION: PPD is detected in a significant number of patients with a first psychotic episode, even after excluding the group with pharmacogenic depression, both due to subjective complaints, nosogenic depressive experiences, and as a result of a psychometric assessment of the patients’ condition. The concept of “dissociated post-attack depression” is substantiated.

Features of the pathodynamics of psychosomatic pathology (based on the psoriasis model) under the influence of large-scale social crises

Background. Psychoemotional stress is a relevant factor in the recurrence of psoriasis. In recent years, the population of Ukraine has been experiencing strong social stress related to the COVID-19 pandemic and the war. Studying the influence of social stress on the recurrence of psoriasis allows for the personalization of therapeutic and preventive measures aimed at normalizing the psycho-emotional sphere in patients with psoriasis. Purpose – to investigate the relationship between the influence of stress and the pathodynamics of psychosomatic pathology (on the model of psoriasis) during periods of social upheavals, to determine, in the future, targets of medical and psychological support of the population during large-scale social crises. Objectives of the study: to determine the frequency of recurrence of psoriasis during the action of powerful social stress, their connection with social stress, and features of psychopathological manifestations during exacerbations taking into account the scale. Materials and Methods. 39 men and 44 women with psoriasis were examined using a specially developed online questionnaire. Results. It was found that 36.1% of patients had an exacerbation of psoriasis in the first year of the COVID-19 pandemic (38.6% of women and 33.3% of men), and the majority (63.3% of patients) associated this exacerbation with stress pandemic Exacerbation occurred insignificantly more often in refugees: 38.9% vs. 34.0% (p&gt;0.05); among local residents, the impact of stress was more often noted by women (66.7% vs. 57.1%, p&gt;0.05), and among refugees by men (66.7% vs. 62.5%, p&gt;0.05). The structure of psychopathological manifestations during an exacerbation during the COVID-19 pandemic was dominated by fear and anxiety (80.0%), low mood (66.7%), dyssomnias (50%), manifestations of asthenia (36.7%), emotional lability and irritability (33.3%), with the prevalence of all psychopathological symptoms being slightly higher among women. It was found that the stress of war was associated with a higher frequency of psoriasis exacerbations (49.4%) and a higher association with social stress (82.9%), more significantly in refugees (55.6% vs. 44.7%, p&gt;0, 05), and among men (51.3% vs. 47.7%, p&gt;0.05). This is a significant (p&lt;0.01) more than during the Covid-19 pandemic, the same differences are detected for men (p&lt;0.01) and women (p &lt;0.05). Statistically significant exacerbation occurred after the start of the war compared to the Covid-19 pandemic in IDPs in general (p &lt;0.05) and in men-IVPO (p &lt;0.05). Affected by psychopathological symptoms during exacerbations during wartime was also higher than the pandemic period: fear, anxiety – 97.6%, reduced mood – 92.7%, asthenisation – 51.2%, irritability – 39.0%. Moreover, men were greater than the prevalence of low mood and emotional lability. Conclusion. The determining factor of exacerbation of psychosomatic pathology (on the model of excerbation of psoriasis) is the content of stress factor and features of individual response to stress, while gender differences of response, and even the fact of forced resettle during large-scale social crises, are less significant. The prospects for further research are to study the role of large-scale social crises with the recurrence of psychosomatic pathology, and to develop on the basis of these personalized medical and psychological support measures.

Features of psychopathological response and coping in patients with malignant skin diseases with a low level of vital threat

Background. Malignant skin tumors are common oncological diseases that have a negative impact on the psyche; their nosological and clinical heterogeneity necessitates in-depth study and differential approaches to the elimination of psychopathological manifestations. Purpose: to study the features of psychopathological response and stress-overcoming behavior in patients with malignant skin tumors with a low level of vital threat. Objectives of the study: to determine the features of depressive manifestations, the structure and expressiveness of psychopathological symptoms and the coping repertoire of patients with malignant skin tumors with a low level of vital threat, as well as the relationship between psychopathological symptoms and stress-coping behavior. Materials and Methods. 24 men and 15 women with basal cell and squamous cell carcinoma were clinically and psychologically examined using the HRDS, HARS, SCL-90-R and the Coping Behavior questionnaire. Results. The presence of a clinically defined depressive disorder was established in 38.5% of patients with a predominance of low mood (69.2%), feeling tired (56.4%), anxious (71.8%), pessimistic (59.0%) and dyssomnic (56.4%) symptoms and elevated depression indicators (11.85±8.52 points). Predominance in psychopathological symptoms of somatization (2.55±0.35 points), anxiety (2.38±0.35 points) and depression (2.15±0.57 points) was established. Study of the coping of patients with malignant skin tumors with a low level of vital threat revealed a predominance of relatively constructive coping strategies of self-control (70.69±8.64 points), search for social support (67.23±13.84 points) and acceptance of responsibility (64.09±19.04 points) and significant direct correlations of medium strength between non-constructive coping and anxiety and hostility, and inverse correlations between constructive and conditionally constructive coping and depression and hostility. Conclusions. Patients with skin cancer with a low level of vital threat are characterized by a high susceptibility to depressive disorders, mainly vital and asthenodepressive forms, with pronounced somatization; the predominance in the coping repertoire of strategies of self-control, seeking social support, accepting responsibility, distancing and planning to solve the problem, which are correlated with anxiety, depression and hostility.

Couple-Level Manifestations of Posttraumatic Stress and Maternal and Paternal Postpartum Relationship Functioning

Objective. Posttraumatic stress disorder (PTSD) is linked with impaired intimate relationships in postpartum women, yet less is known about couple-level manifestations of posttraumatic psychopathology and potential associations with relationship functioning for mothers and fathers during this critical time. Method. In a predominately low-to-middle income sample of 867 mother-father couple dyads assessed six months following the birth of a child, two analytic methods—a data-driven dyadic latent profile analysis and hypothesis-driven a priori categorization approach—evaluated whether discrete subgroups of couples could be identified based on both partners’ PTSD symptoms. Structural equation models then tested associations between identified subgroups with (1) self-reported relationship quality and (2) interviewer-rated relationship stress. Results. Three couple-level PTSD symptom groupings were common to both methods: both low, mother low-father high, and mother high-father low. Dyad-level PTSD symptom patterns were differentially related to relationship dysfunction for mothers and fathers, although mixed findings emerged across methods regarding the relevance of which partner had elevated symptoms for relationship functioning in PTSD symptom-discordant couples. Individuals in dyads characterized by at least one partner with elevated PTSD symptoms consistently exhibited greater relationship dysfunction—indexed both subjectively and objectively—compared to dyads where both partners had low symptoms. Conclusions. Couple-level typologies of PTSD symptoms can be identified using data- and hypothesis-driven approaches, with generally concordant results. Dyadic patterns of PTSD symptoms are relevant to relationship functioning for both mothers and fathers during the postpartum period and may help to inform more targeted intervention efforts to support couples who are parenting.

How effective are mood stabilizers in treating bipolar patients comorbid with cPTSD? Results from an observational study

BackgroundMultiple traumatic experiences, particularly in childhood, may predict and be a risk factor for the development of complex post-traumatic stress disorder (cPTSD). Unfortunately, individuals with bipolar disorder (BP) are more likely to have suffered traumatic events than the general population. Consequently, cPTSD could be comorbid with BD, and this may negatively affect psychopathological manifestations. To date, no one has explored whether such comorbidity also affects the response to treatment with mood stabilizers in BD patients.ResultsHere, a cross-sectional study was carried out by comparing the response to treatment, measured by the Alda scale, in a cohort of 344 patients diagnosed with BD type I and II, screened for the presence (or absence) of cPTSD using the International Trauma Questionnaire. The main result that emerged from the present study is the poorer response to mood stabilizers in BD patients with comorbid cPTSD compared with BD patients without cPTSD.ConclusionsThe results collected suggest the need for an add-on therapy focused on trauma in BD patients. This could represent an area of future interest in clinical research, capable of leading to more precise and quicker diagnoses as well as suggesting better tailored and more effective treatments.

Psychometric Analysis of the Obsessive-Compulsive Spectrum Self-Report and Social Anxiety Spectrum Self-Report in the Korean Population.

The present study aimed to assess the psychometric properties of the Korean versions of the Obsessive-Compulsive Spectrum Self Report (OBS-SR) and the Social Anxiety Spectrum Self Report (SHY-SR) questionnaires, along with determining their optimal cut-off points in a Korean population. The study included outpatients with obsessive-compulsive disorder (OCD) (n=86), or social anxiety disorder (SAD) (n=52), those with major depressive disorder (MDD) (n=27), and 33 healthy controls. Participants were administered the Korean versions of the OBS-SR and SHY-SR questionnaires. Clinical symptoms were also assessed with several self-rating scales. The Korean versions of the OBS-SR and SHY-SR demonstrated good internal consistency, test-retest reliability, and convergent validity. Both questionnaires effectively differentiated between individuals with OCD or SAD and normal controls or those with MDD. Receiver-operating characteristic analyses of the OBS-SR and SHY-SR yielded area under the curve values of 0.89 and 0.96 for Diagnostic and Statistical Manual of Mental Disorders, Forth Edition diagnosis, respectively, and showed optimal threshold values of 50 and 44. The Korean versions of OBS-SR and SHY-SR demonstrate good reliability and validity in assessing manifestations of obsessive-compulsive and social anxiety psychopathology in Korean populations.

The nested hierarchical model of self and its non-relational vs relational posttraumatic manifestation: an fMRI meta-analysis of emotional processing.

Different kinds of traumatic experiences like natural catastrophes vs. relational traumatic experiences (e.g., sex/physical abuse, interpersonal partner violence) are involved in the development of the self and PTSD psychopathological manifestations. Looking at a neuroscience approach, it has been proposed a nested hierarchical model of self, which identifies three neural-mental networks: (i) interoceptive; (ii) exteroceptive; (iii) mental. However, it is still unclear how the self and its related brain networks might be affected by non-relational vs relational traumatic experiences. Departing from this background, the current study aims at conducting a meta-analytic review of task-dependent fMRI studies (i.e., emotional processing task) among patients with PTSD due to non-relational (PTSD-NR) and relational (PTSD-R) traumatic experiences using two approaches: (i) a Bayesian network meta-analysis for a region-of-interest-based approach; (ii) a coordinated-based meta-analysis. Our findings suggested that the PTSD-NR mainly recruited areas ascribed to the mental self to process emotional stimuli. Whereas, the PTSD-R mainly activated regions associated with the intero-exteroceptive self. Accordingly, the PTSD-R compared to the PTSD-NR might not reach a higher symbolic capacity to process stimuli with an emotional valence. These results are also clinically relevant in support of the development of differential treatment approaches for non-relational vs. relational PTSD.