Psychosocial Impairment Research Articles

Links of Weight and Muscularity Teasing with Eating Disorder Symptomatology, Eating-related Psychosocial Impairment, and Intuitive Eating in Chinese Men: Teasing Directions and Combinations Matter

Empirical evidence, based on variable-centered approaches (e.g., correlation and regression analyses), shows robust links between weight and muscularity teasing and eating variables in men. However, limited research has considered the directions (i.e., high and low) of teasing or their combinations via person-centered approaches (e.g., latent class analysis). Thus, this study explored the relationships between four types of teasing (i.e., teasing for high weight, low weight, high muscularity, and low muscularity) and eating variables in 596 Chinese adult men using variable and person-centered approaches. Independent t-tests and regression analyses revealed that four types of teasing had unique associations with eating disorder (ED) symptomatology, eating-related psychosocial impairment, and intuitive eating. Latent Class Analysis identified four distinct teasing classes, including High Weight-Low Muscularity, Low Weight-Low Muscularity, Low Teasing, and High Weight-High Muscularity. Notably, individuals in the Low Teasing group consistently showed the lowest ED symptomatology and psychosocial impairment and the highest intuitive eating. Individuals in the High Weight-High Muscularity group exhibited the highest traditional ED symptomatology and the most severe psychosocial impairment. The findings highlight the importance of future research considering teasing directions and tailored interventions for adult men in certain subgroups at risk of eating disorder psychopathology (e.g., the High Weight-High Muscularity).

Engagement in Intermittent Fasting is Prospectively Associated With Higher Body Mass Index, Higher Eating Disorder Psychopathology, and Lower Intuitive Eating inChinese Adults.

This study examined cross-sectional and longitudinal associations of intermittent fasting (IF) engagement with body mass index (BMI), both thinness-oriented and muscularity-oriented eating disorder (ED) psychopathology, eating-related psychosocial impairment, and intuitive eating. Using a longitudinal design, 491 Chinese adults (Mage = 30.33 years, SD = 7.89) provided data regarding BMI, IF status, and eating variables at baseline (T1) and 8-month (T2) follow-up. One-way ANOVA was used to explore cross-sectional associations between IF engagement at T1 and study variables (i.e., BMI and eating variables) at T1. Cross-lagged regression analyses were used to examine the longitudinal associations between IF engagement at T1 and study variables at T2, after adjusting for covariates and study variables at T1. Cross-sectionally, compared with participants who never engaged in IF at T1, those with current or past engagement in IF at T1 exhibited significantly higher BMI, ED psychopathology, eating-related psychosocial impairment, and lower intuitive eating at T1. Longitudinally, relative to never engagement in IF at T1, both current and past engagement in IF at T1 were associated with higher ED psychopathology and greater eating-related psychosocial impairment at T2. Also, relative to never engagement in IF at T1, past engagement in IF at T1 was associated with higher BMI at T2 and lower unconditional permission to eat as a facet of intuitive eating at T2. The findings challenge the perception of IF as an effective approach for weight loss and also suggest IF might have enduring adverse impacts on eating behaviors, similar to traditional forms of dieting.

Relationships between personality factors and DC/TMD Axis II scores of psychosocial impairment among patients with pain related temporomandibular disorders

This cross-sectional analytical study aimed to assess the relationship between personality factors and the DC/TMD Axis II scores of psychosocial impairment among patients with pain related temporomandibular disorders (TMD). 120 participants (60 females and 60 males) who were diagnosed with pain related TMD according to the Axis I DC/TMD protocol were recruited. The participants were requested to complete four tests including the NEO Five Factor Inventory (NEO-FFI) to assess personality factors and three Axis II DC/TMD tools; the Graded Chronic Pain Scale (GCPS) Version 2.0 to assess TMD pain intensity and pain-related disability, Patient Health Questionnaire-4 (PHQ-4) to assess psychological distress due to TMD pain, and Generalized Anxiety Disorder-7 (GAD-7) to assess patients’ stress reactivity. Results showed that 49.2% of the participants experienced high intensity of characteristic pain, 14.2% reported pain related disability more than 30 days (grade 3 disability days) and had disability scores of 70 or above (grade 3 disability scores), 16.7% demonstrated severe distress, and 18.3% reported severe anxiety due to TMD pain. Females scored higher on all these variables than males (P < .05). Multiple regression analyses indicated that higher extraversion scores, higher agreeableness scores and being a female were associated with higher intensity of characteristic pain (p < .05). Also, higher neuroticism and agreeableness scores were associated with more disability days (p < .05). In addition, higher agreeableness scores were associated with higher disability scores and disability point values (p < .05). Furthermore, lower neuroticism scores and being a female were associated with higher PHQ total scores, while being a female and having a lower level of education were associated with higher GAD total scores (p < .05). In conclusion, personality profiles and gender significantly impact the DC/TMD Axis II scores of psychosocial impairment among patients with pain related TMD.

The Lived Experiences and Well-Being of Female Partners Following Discovery or Disclosure of Their Male Partner’s Compulsive Sexual Behaviours: An Australian Phenomenological Study

Abstract Introduction There has been an upsurge of research articles in the last two decades about sexual addiction (SA) and compulsive sexual behaviour (CSB). In the literature, SA/CSB is mainly presented as comparable to other behavioural addictions and similarly involves a problematic consumption model: loss of control, psychosocial impairments, and risky sexual activities. Despite this recent rise in research interest in this area, only a small number of studies have focused on the partners’ lived experiences and well-being. Methods This qualitative descriptive phenomenological investigation aimed to examine female partners’ lived experiences and well-being following the discovery or disclosure of their male partners’ SA/CSB. Individual in-depth semi-structured interviews were conducted (2020–2022) with primary participants (female partners; n = 12) and supplementary participants (counsellors; n = 15). Results The analysis reveals that this group has encountered several detrimental consequences of CSB-associated betrayal trauma (BT), including but not limited to suicidal thoughts and self-harm, compulsive self-comparisons with other women, physical and behavioural difficulties, and diminished self-esteem. Conclusions This empirical research is the first study in Australia to examine the voices and experiences of female partners upon learning of their mates’ CSBs. The findings contribute to the field of SA/CSB and enhance understanding of the multifarious consequences for the emotional, physical, sexual, spiritual and/or relational well-being of intimate female partners and their general outlook on life. Policy Implications Based on the results, there are strong indications with implications for policy that this population requires validation and multifaceted support systems to better navigate the challenging, complex, and stressful processes of discovery/disclosure and subsequent recovery.

21 Exploring the clinical presentation and health service utilization in autistic children and adolescents diagnosed with avoidant / restrictive food intake disorder: A descriptive study

Abstract Background Avoidant/restrictive food intake disorder (ARFID) is an eating disorder with much clinical variability, negatively impacting growth, nutrition, psychosocial functioning and overall well-being. ARFID is more frequently reported in neurotypical populations than in neurodivergent populations. Little is known about the clinical presentation and healthcare utilization of autistic individuals with ARFID. Objectives The purpose of this study was to understand the clinical presentation, laboratory abnormalities and health system utilization amongst autistic individuals diagnosed with ARFID within the community. Design/Methods We completed a comprehensive multidisciplinary assessment on autistic individuals less than18 years of age who were diagnosed with ARFID by their community physician. Recruitment period: June 2020-June 2021. Results Nineteen autistic individuals completed a comprehensive multidisciplinary assessment; of these, 42.1% (8/19) met criteria for Autism Spectrum Disorder (ASD) severity level 1. The onset of restrictive eating manifested at M(SD)= 2.5 (0.7) years, and the age of ASD diagnosis was 4.2 (3.8) years. Of these, 78.9% (15/19) had the onset of feeding difficulties either prior to or at the time of their ASD diagnosis (Figure 1). Dependence on enteral feeding or nutritional supplements (74%), psychosocial impairment (68%), and nutritional deficiencies (42%) were the criteria commonly met for ARFID. Sensory-based avoidance (100%) and lack of interest in food (89%) were the two most reported potential drivers for the dysfunctional feeding behaviour based on the Pica , ARFID, and Rumination Disorder Interview-AR-Q. Neurodevelopment disorder comorbidities included ADHD (26.3%), Anxiety (21.1%), and Intellectual Developmental Disability (15.8%). Constipation (68.4%) and nutritional deficits (63.15%) were the most common medical comorbidities recorded. Nutritional profile revealed Vitamin D deficit in 50% (8/16), Anaemia 21% (4/19), Vitamin B1 deficit 20% (2/10). Additionally, three participants (17.7%, 3/17) had deficits in Vitamin B12, Zinc, Vitamin C and low ferritin levels. Four autistic individuals (21.1%, 4/19) were hospitalized because of their restrictive eating. 68.4% (13/19) autistic individuals had involvement of at least one allied health professional (OT or SLP or BT). No participants had a prior multidisciplinary feeding assessment or intervention to address restrictive eating. Conclusion ARFID is an eating disorder observed within autistic individuals. Evidence suggests food related sensory sensitivities and lack of interest in food are potential drivers of ARFID in the context of ASD. A comprehensive multidisciplinary assessment is needed to elucidate factors driving restrictive eating to inform targeted evidence-based interventions.

Concurrent and prospective prediction of community-dwelling adults' psychosocial functioning with the Inventory of Depression and Anxiety Symptoms-II (IDAS-II).

Mood and anxiety disorders involve defining symptoms (e.g., dysphoria, anhedonia) that can impair psychosocial functioning (e.g., self-care, work, social relationships). The present study evaluated the validity of the Inventory of Depression and Anxiety Symptoms-II (IDAS-II; Watson et al., 2012) via convergence with a semistructured interview assessing mood and anxiety disorder symptoms and, moreover, prediction of psychosocial functioning. Community-dwelling adults (N = 601) completed the self-report IDAS-II, a semistructured diagnostic interview, and self-report and interview measures of psychosocial functioning. A retest subsample (ns = 497-501) completed the functioning measures again, on average 8 months later. Supporting our hypotheses, the IDAS-II converged robustly with interview-assessed symptoms and predicted psychosocial functioning significantly, both concurrently and prospectively. Moreover, the IDAS-II predicted functioning significantly better than did the diagnostic interview. These findings support use of the IDAS-II in research and clinical settings to assess mood and anxiety symptoms and their connections to psychosocial impairment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Impact of Body Contouring Following Bariatric Surgery: A Prospective Examination of Psychosocial and Medical Impairment.

Body contouring surgery (BCS) to remove loose skin is often desired following bariatric surgery. This study prospectively examined psychosocial and medical functioning based on BCS status after bariatric surgery. N=56 adults who sought a BCS consultation following bariatric surgery completed measures of impairment, depression, and medical (e.g., rashes, infections) and psychosocial concerns due to loose skin. Assessments were repeated at 1- and 3-month follow-ups. Most did not undergo BCS due to insurance coverage denial/finances; n = 24 (42.9%) underwent BCS. The groups with and without BCS did not differ significantly in BMI, weight loss, impairment, or depression at any assessment; however, a significantly greater proportion of non-BCS patients reported several medical and psychosocial concerns due to loose skin relative to BCS patients at follow-up assessments. Greater loose skin concerns were associated significantly with greater impairment and depression at all assessments. Over half who sought BCS did not undergo BCS, mostly due to insurance/financial reasons. The BCS group had significantly fewer medical and psychosocial concerns related to loose skin at follow-ups. Greater loose skin concerns were associated with heightened levels of broad psychosocial impairments suggesting that loose skin and psychological concerns warrant greater clinical attention after bariatric surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Prevalence of psychosocial findings and their correlation with TMD symptoms in an adult population sample

Background and aimSome studies suggested an association between Temporomandibular Disorders (TMD) and psychosocial status, but most of them are focused on samples of patients looking for treatment or present limits of sample representativeness. The aim of the present study was to evaluate the psychosocial status in a large sample of adult population, further than to assess its association to TMD symptoms, oral behaviours, and self-reported facial trauma.Resultsthe study sample included 4299 subjects older than 18 years randomly recruited from general population in public spaces during their daily life (1700 Males, 2599 Females mean ± SD age = 40.4 ± 18.1). Psychosocial status and pain-related disability were assessed by means of Patient Health Questionnaire 4 (PHQ-4) and Graded Chronic Pain Scale (GCPS). TMD symptoms were assessed by RDC/TMD and validated screening tools for TMD pain. Oral Behaviours Checklist was used to investigate on oral behaviours. Logistic regression model was used to evaluate the association of the psychosocial status, TMD symptoms, trauma, and oral behaviours. The association was tested using both univariate and multivariate models. The PHQ4 evaluation showed a severe impairment in 4.6% of our sample, moderate in 18.8% and mild in 32.5%. We found a Characteristic Pain Intensity (CPI) level and Interference Score greater that 30 respectively in 36.2% and 22.2% of the study sample. The GCPS status revealed a high disability with severe limitation in 2.5% of the sample, high disability with moderate limitation in 7.0%, low disability high pain intensity in 7.4% and low disability low pain intensity in 37.8%. Anxiety and depression’s levels were significantly associated with gender, TMD pain, coexistence of TMD Pain and sound, and oral behaviours. GCPS status was significantly associated with age, TMD Pain, coexistence of TMD pain and sound, trauma, and oral behaviours.ConclusionsIn the general population, psychosocial impairment is associated to TMD pain, female gender, and report of oral behaviours. Hence, in adults with TMD accompanied by pain, psychosocial status should also be evaluated.

12606 Gamification In The Management Of Children And Adolescents With Diabetes: A Systematic Review

Abstract Disclosure: L.C. Hespanhol: None. V. Lins de Menezes: None. P. Souto Maia: None. C.A. Balieiro: None. W. Oliveira Amador: None. R. Lira: None. Background: Educating children and adolescents with diabetes about their own condition presents a significant challenge. Gamification has been proposed as an innovative approach to ease the transition to self-care by engaging and empowering children and adolescents in their diabetes management. Purpose: The purpose of this systematic review is to examine published research on using gamification and technology within diabetes care for young patients. Methods: PubMed, Lilacs and EMBASE were systematically searched in January 2024 to include articles focusing on the use of new virtual technologies to improve the clinical and laboratory conditions of children and adolescents with diabetes. The protocol was registered in PROSPERO (ID: CRD42024499381) adhering to PRISMA recommendations. We assessed the risk of bias using RoB-2 and ROBINS-I. Results: A total of 24 studies were included, of which 7 were randomized trials. Age of participants ranged from 5 to 19 years. We identified five gamification strategies (i.e., applications, video games, minigame, robot, or web game) within seven clinical domains (i.e., psychosocial impairment, glycemic control, autonomy, reduced frequency of error, health lifestyle, nutrition, or knowledge about disease). 246 (27%) patients demonstrated reduced emotional distress and increased enjoyment. Reduction of errors such as hypoglycemia and emergency preparedness was identified in 354 (39%) of patients and improvement in glycemic control measured by HbA1c was described in 277 (30%) of patients. Conclusion: Our systematic review gamification has shown promise in fostering autonomy by providing tools that educate young individuals regarding glycemic control, lifestyle choices, injection practices, carbohydrate counting, and other pertinent aspects of diabetes management. Presentation: 6/1/2024

Assessment of adverse childhood experiences in adolescents from a rural agricultural community: Associations with depressive symptoms and psychosocial problems

The main goal of this study was to determine the prevalence of adverse childhood experiences (ACEs) among Latino adolescents from an agricultural community and to examine how it may impact their neuropsychiatric functioning. This research particularly assessed the association between ACEs and depression, as well as ACEs and psychosocial problems. The study sample consisted of 852 adolescents treated at a rural primary care clinic with a comprehensive ACE screening protocol that assesses for ACEs, depressed mood, and psychosocial functioning during every annual Well-Child Visit. Study results showed that ACEs were relatively common among participants with 64 % endorsing having experienced at least one ACE. Approximately 23 % of participants screened positive for depressed mood and 11 % for psychosocial problems. ACEs were found to have significant associations with both depression symptoms and with psychosocial problems. Males were found to have less depression symptoms than females among subjects with exposure to most ACE types, and older age was associated with lower psychosocial impairment. Study participants live in an agricultural community and are likely exposed to both chemical and non-chemical stressors. The exposure to ACEs and chemical environmental stressors may interact with pathological synergy to alter their biobehavioral development. Further research is needed to understand the “rules” for which stressors at what dose and at what stage of development place youth at greatest risk.

Association of Atrial Fibrillation and Cognitive Dysfunction: A Comprehensive Narrative Review of Current Understanding and Recent Updates.

Atrial fibrillation (AF) is the most common sustained arrhythmia in adults. The prevalence of both AF and dementia is steadily rising and is expected to rise further in the coming decades. There is increasing evidence to suggest an association between AF and various degrees of cognitive dysfunction, from mild cognitive impairment to severe dementia. In this review, we aimed to discuss the epidemiological aspects, pathophysiological mechanisms, role of neuroimaging, impact of treatment modalities, and clinical and socioeconomic impact of this association. Numerous observational studies and meta-analyses have revealed this association to exist in AF patients with and without a history of stroke, and the association also persists after adjusting for shared risk factors such as hypertension and diabetes mellitus. Various pathophysiological mechanisms have been proposed for this association, including silent cerebral infarcts, cerebral microbleeds, cerebral hypoperfusion, inflammation, and atherosclerosis. While neuroimaging findings have been utilized to suggest some of these pathophysiological mechanisms, more studies are needed to further elucidate this and to determine the potential role of neuroimaging in altering anticoagulation and other treatment decisions. Anticoagulants have shown effectiveness in reducing the rate of cognitive decline in AF patients; however, their role in low-risk AF patients remains under investigation. Even though AF patients receiving catheter ablation may have post-operative cognitive dysfunction in the short term, long-term follow-up studies have shown an improvement in cognitive function following ablation. Cognitive decline in AF patients often occurs with greater functional decline and other psychosocial impairments such as depression and anxiety and future research on this association must incorporate aspects of social determinants of health and associated outcomes.

Development and Management of Avoidant/Restrictive Food Intake Disorder and Food Neophobia in Pediatric Patients with Food Allergy: A Comprehensive Review.

Avoidant/Restrictive Food Intake Disorder (ARFID) and food neophobia present significant challenges in pediatric healthcare, particularly among children with food allergies (FAs). These eating disorders, characterized by the persistent avoidance or restriction of food, can lead to severe nutritional deficiencies and psychosocial impairments. The presence of FAs further complicates these eating behaviors, as the fear of allergic reactions exacerbates avoidance and restrictive patterns. This comprehensive review synthesizes current knowledge on ARFID and food neophobia, focusing on their definitions, characteristics, and the unique challenges they present in the context of FAs. The review explores the critical role of healthcare professionals, especially nurses, in integrating psychological and clinical care to improve outcomes for affected children. A multidisciplinary approach, including Cognitive Behavioral Therapy (CBT) and Family-Based Therapy (FBT), is emphasized as essential in addressing the complex needs of these patients. The review also highlights the need for standardized treatment protocols and further research on the long-term outcomes of these disorders, aiming to enhance therapeutic strategies and family support systems. Effective management of ARFID and food neophobia in the context of FAs requires a holistic and integrated approach to mitigate the profound impacts on a child's growth, development, and overall well-being.

The psychosocial and educational burden of obsessive-compulsive disorder in youth

BackgroundPediatric OCD is associated with functional impairment in multiple environments. However, relatively little is known about the impact of comorbid conditions, as well as OCD severity on psychosocial functioning in this population. Furthermore, most studies did not include a control sample, nor examined differences between children and adolescents. The goal of this investigation was to assess psychosocial functioning and its associations with age, symptom severity, and comorbid conditions in a large well characterized sample of pediatric OCD probands, and controls. MethodsParticipants included 117 pediatric OCD probands and 147 controls, that underwent a careful diagnostic process, and completed several questionnaires and interviews. ResultsResults revealed significant psychosocial impairments across multiple domains/settings, some of which were affected by symptom severity as well as by conduct related comorbidities and to a lesser extent affective disorders. In addition, different aspects of psychosocial impairments were found between children and adolescents. ConclusionThis study provides high resolution information regarding the types and extent of psychosocial dysfunction in youth with OCD, as well as its relationship with clinical and diagnostic correlates. It is recommended that evaluation and management of OCD in youth in research and clinical settings regularly include qualitative and semi-quantitative assessment of function across these domains.

The Relationships Between Psychosocial Factors and Short-Term Treatment Outcomes of Massage Therapy in Patients with Myogenic Temporomandibular Disorders: A Single-Arm Preliminary Study.

Massage therapy is included as part of a comprehensive treatment plan for patients with temporomandibular disorders (TMDs). However, it displayed varying degrees of success. Preexisting psychosocial impairments may be one of the possible factors affecting the treatment response. This preliminary study aimed to investigate the relationships between psychological factors and treatment outcomes of massage therapy in myogenous TMD patients. Twenty-two myogenous TMD patients were enrolled in this single-arm preliminary study. Baseline psychosocial assessment was done using self-report measures associated with chronic pain severity, depression, anxiety, and non-specific physical symptoms. Massage therapy including the intraoral and extraoral massage of the face and neck muscles was performed twice a week for 4 weeks. Pain intensity and quality of life related to oral health were evaluated as treatment outcomes before and immediately after eight sessions of massage therapy. Regression analyses showed a significant effect of depression on changes in the quality of life after massage (β = 0.35, p-value = 0.026). In addition, results showed a significant effect of chronic pain severity on changes in the pain intensity following massage (β = 1.50, p-value = 0.027). Our findings suggested that psychosocial characteristics of myogenous TMD patients should be considered as important factors that may adversely affect pain intensity reduction and quality-of-life improvement after short-term massage therapy.

Quality of Life and Psychosocial Outcomes Among Children With Cleft Differences.

Introduction Velopharyngeal insufficiency (VPI) and craniofacial differences can lead to diminished speech and swallowing function resulting in communication and social challenges throughout childhood. To monitor changes in patients' psychosocial health and velopharyngeal function, the Pediatric Symptom Checklist (PSC) and Velopharyngeal Insufficiency Effects on Life Outcomes (VELO) survey tools can be utilized. This study aimed to investigate the relationship between VPI quality-of-life outcomes and psychosocial disturbances through a comparative analysis of PSC and VELO parental surveys among children followed by a craniofacial team. Methods A retrospective chart review was completed using data from asingle, multidisciplinary cleft and craniofacial team. Previously completed parental survey responses between 2010 and 2022 were collated and resultswere analyzed using a Spearman's rank correlation test (rs). Results There were 89 subjects who completed both surveys on the same day (n = 148 survey pairs (s)). Patients aged three to five years old (s = 88) had a mean VELO of 17.9 (0-65) and a mean PSC of 7.9 (0-27), while patients aged six to eight years old (s = 60) had a mean VELO of 16.6 (0-74) and a mean PSC of 12.0 (0-37). The strongest correlation observed for both age groups was between the total PSC and VELO Speech Limitations sub-scores (three to five years old: rs = 0.537, p < 0.001; six to eight years old: rs = 0.330, p = 0.010). Similarly, children in the six- to eight-year-old group with cleft lip and palate showed a correlation between the total PSC and VELO Speech Limitations (rs = 0.583, p < 0.001). Conclusion This study suggests arelationship between PSC and VELO scores among childrenages three to eight years old with cleft differences and demonstrates that specific domains within theVELO questionnaireshould be considered as being associated with a higher riskfor psychosocial impairment. Specifically, higher VELO Speech Limitations sub-scores may portend a greater risk for poor psychosocial outcomes supporting the importance of early interventions in this group.

Examining the role of personality functioning in a hierarchical taxonomy of psychopathology using two years of ambulatory assessed data

The Hierarchical Taxonomy of Psychopathology (HiTOP) arranges phenotypes of mental disorders based on empirical covariation, ranging from narrowly defined symptoms to higher-order spectra of psychopathology. Since the introduction of personality functioning (PF) in DSM-5 and ICD-11, several studies have identified PF as a predictor of transdiagnostic aspects of psychopathology. However, the role of PF in the HiTOP classification system has not been systematically examined. This study investigates how PF can be integrated into HiTOP, whether PF accounts for transdiagnostic variance captured in higher-order spectra, and how its predictive value for future affective well-being (AWB) and psychosocial impairment (PSI) compares to the predictive value of specific psychopathology beyond PF. To this end, we examined two years of ambulatory assessed data on psychopathology, PF, PSI, and AWB of N = 27,173 users of a mental health app. Results of bass-ackwards analyses largely aligned with the current HiTOP working model. Using bifactor modeling, aspects of PF were identified to capture most of the internalizing, thought disorder, and externalizing higher-order factor variance. In longitudinal prediction analyses employing bifactor-(S-1) modeling, PF explained 58.6% and 30.6% of variance in PSI and AWB when assessed across one year, respectively, and 33.1% and 23.2% of variance when assessed across two years. Results indicate that personality functioning may largely account for transdiagnostic variance captured in the higher-order components in HiTOP as well as longitudinal outcomes of PSI and AWB. Clinicians and their patients may benefit from assessing PF aspects such as identity problems or internal relationship models in a broad range of mental disorders. Further, incorporating measures of PF may advance research in biological psychiatry by providing empirically sound phenotypes.

Comparing the new concept of impairment in personality functioning with borderline personality disorder: differential psychosocial and psychopathological correlates in a clinical adolescent sample.

Borderline personality disorder (BPD) is an established diagnosis in adolescence with high comorbidity and psychosocial impairment. With the introduction of the alternative model for personality disorders in DSM-5 (AMPD), personality functioning is operationalized using the Level of Personality Functioning Scale (LPFS), which has been shown to be associated with severity of personality pathology. The present study aimed at examining differential psychopathological and psychosocial correlates of LPFS and BPD. A total of 526 adolescent in- and outpatients were interviewed with the STiP-5.1 (LPFS) and the SCID-II. Mixed linear regression was used to investigate the associations between the two interviews with measures of psychopathology and psychosocial impairment. 11.4% met the diagnostic threshold of both interviews, 16.1% only of the LPFS, and 64.1% were below the diagnostic threshold in both interviews (no PD). The BPD only group was larger than expected-8.4% of patients who met criteria for BPD did not fulfill criteria for significant impairment in the LPFS. The highest burden was found in individuals concurrently showing significant impairment in LPFS and fulfilling BPD diagnosis (LPFS + BPD). Differences between the LPFS only group and the BPD only group were found in risk behavior and traumatic experiences, with higher prevalence in the BPD group. Findings confirm the high psychopathological burden and psychosocial impairment associated with both BPD and LPFS. Those exceeding the diagnostic threshold of LPFS in combination with a BPD diagnosis are characterized by greatest disability. Not all adolescents fulfilling formal BPD diagnosis showed a clinically significant impairment in LPFS, which may refer to a distinct diagnostic group.

Differences in Thinness- and Muscularity-Oriented Eating and Body Image Disturbances and Psychosocial Well-Being in Chinese Sexual Minority Men Reporting Top, Bottom, and Versatile Sexual Self-Labels.

In addition to describing sexual partner preferences, sexual self-labels in gay and bisexual (henceforth, sexual minority) men, such as top, bottom, and versatile, are associated with psychological characteristics (e.g., gendered personality traits). No research has explored the association between sexual self-labels and eating and body image disturbances in sexual minority men. Research in sexual minority men from China is particularly valuable and needed due to recent rises in rates of eating and body image disturbances and unique, minority-specific stressors experienced by Chinese sexual minority populations. We adopted an online, cross-sectional study in a sample of sexual minority men from China (N = 403; tops, n = 256, bottoms, n = 95, versatiles, n = 52). Bottoms reported higher thinness internalization, lower muscularity internalization, higher body fat dissatisfaction, and higher psychological distress than tops. Bottoms' weight bias internalization was higher than tops' and versatiles' reports and, compared to versatiles, bottoms also reported higher psychosocial impairment related to eating disorder psychopathology. Compared to versatiles, tops reported higher drive for muscularity and muscularity-oriented disordered eating. Adjusting for age, psychological distress, and psychosocial impairment, tops reported higher muscularity internalization than bottoms and higher drive for muscularity and muscularity-oriented disordered eating than both bottoms and versatiles. Findings suggested unique relations between sexual self-labels and eating and body image disturbances in Chinese sexual minority men. Replication and validation of the temporal order between sexual self-labels and eating and body image disturbances is needed, including assessment of social factors (e.g., femmephobia, minority stress) that may help explain the links between sexual self-labels and eating pathology.

Predictors of psychosocial impairment in a transdiagnostic sample: Unique effects of repetitive negative thinking

BackgroundRepetitive negative thinking (RNT) is a transdiagnostic process involving perseverative, unproductive, and uncontrollable thoughts. Although RNT may impede adaptive psychosocial functioning by prolonging negative mood states, strengthening cognitive biases, and preventing effective problem-solving, the extent to which RNT is associated with risk for poor psychosocial outcomes is unclear. Given that this has clear transdiagnostic treatment implications, the present study aimed to isolate the unique relationship of RNT with social functioning and life satisfaction in a mixed clinical and non-clinical sample. MethodsIn 201 mid-to-later life adult participants (27 with primary diagnoses of bipolar disorder, 84 with major depressive disorder, and 90 healthy volunteers), we measured RNT, social functioning, life satisfaction, trait rumination, DSM-5 diagnoses, depressive symptoms, manic symptoms, cognitive control performance, and global cognitive functioning. ResultsLinear regression models revealed that RNT, but not rumination, was significantly associated with poorer social functioning (β = 0.42 p < .001) and reduced life satisfaction (β = −0.42, p < .001) after controlling for clinical and cognitive covariates. LimitationsLimited demographic diversity, cross-sectional design, self-reporting of outcomes. ConclusionsResults suggest that RNT may confer risk for key psychosocial outcomes during middle to later adulthood, over and above the effects of clinical and cognitive variables and independent of diagnostic status. Findings lend support to the notion of RNT as a transdiagnostic process and suggest that RNT may be an important therapeutic target for adults with poor social functioning and/or reduced life satisfaction.

Childhood Trauma and Panic Disorder: The Impact of History of Child Abuse on Illness Severity and Treatment Response.

Patients who have experienced child abuse often have complex clinical presentations; whether a history of child abuse (HCA) affects psychotherapy outcomes is unclear. The authors examined relationships between HCA, clinical baseline variables, and change in these variables after three different psychotherapies for panic disorder (PD). Two hundred adults with PD (with or without agoraphobia) were randomly assigned to one of three treatments across two sites: panic-focused psychodynamic psychotherapy (PFPP), cognitive-behavioral therapy (CBT), or applied relaxation training (ART). Differences in demographic and clinical variables between those with and without HCA were compared. The primary analysis addressed odds of meeting clinical response criteria on the Panic Disorder Severity Scale (PDSS) between treatments, as moderated by HCA. This effect was examined via continuous outcomes on the PDSS and psychosocial functioning (Sheehan Disability Scale). Compared with patients without HCA (N=154), patients with HCA (N=46) experienced significantly more severe symptoms of PD (d=0.60), agoraphobia (d=0.47), and comorbid depression (d=0.46); significantly worse psychosocial impairment (d=0.63) and anxiety sensitivity (d=0.75); greater personality disorder burden (d=0.45)-particularly with cluster C disorders (d=0.47)-and more severe interpersonal problems (d=0.54). HCA significantly moderated the likelihood of clinical response, predicting nonresponse to ART (B=-2.05, 95% CI=-4.17 to -0.30, OR=0.13, z=-2.14, p=0.032) but not CBT or PFPP. HCA did not interact with treatment condition to predict slopes of PDSS change. The results of this study highlight the importance of HCA in formulating treatment recommendations. Increased awareness of HCA's effects on severity of PD and treatment responsiveness among patients with PD may improve outcomes.