Sample Of Psychiatric Inpatients Research Articles

Prolonged grief disorder in an inpatient psychiatric sample: psychometric properties of a new clinical interview and preliminary prevalence.

Prolonged Grief Disorder (PGD) was newly included in the ICD-11 and DSM-5-TR. It is not yet part of the standard assessments in many healthcare systems, including psychiatric wards. Because disordered grief is associated with suicidality, sleep problems and substance use disorders, an investigation into PGD in psychiatric inpatients is warranted. We interviewed N = 101 psychiatric inpatients who were admitted to the open psychiatric wards and the day hospital of a German psychiatric hospital and who had lost a person close to them. Assessments comprised clinical interviews and self-report instruments covering PGD and other mental disorders. We specifically developed the International Interview for Prolonged Grief Disorder according to ICD-11 (I-PGD-11) for the study and examined its psychometric properties. The prevalence rate of PGD among bereaved patients according to ICD-11 was 16.83% and according to DSM-5-TR 10.89%. The I-PGD-11 showed good psychometric properties (Mc Donald's ω = 0.89, ICC = 0.985). Being female, having lost a child or spouse, and unnatural or surprising circumstances of the death were associated with higher PGD scores. Approval was obtained by the ethics committee of the of the Goethe University Frankfurt (2021-62, 2023-17) and the Chamber of Hessian Physicians (2021-2730-evBO). The study was preregistered ( https://doi.org/10.17605/OSF.IO/K98MF ). We only assessed inpatients of one psychiatric clinic in Germany, limiting the generalizability of our findings. The present study underlines the importance of exploring loss and grief in psychiatric inpatients and including PGD in the assessments. Given that a significant minority of psychiatric inpatients has prolonged grief symptoms, more research into inpatient treatment programs is needed.

An evaluation of emotion recognition, emotion reactivity, and emotion dysregulation as prospective predictors of 12-month trajectories of non-suicidal self-injury in an adolescent psychiatric inpatient sample

BackgroundLittle is known about trajectories of NSSI. We aimed to identify NSSI trajectories in adolescent psychiatric inpatients and emotional processes that differentiate between trajectories. MethodsParticipants were 180 adolescents (71.7 % female; mean age of 14.89 years, SD = 1.35) from a psychiatric inpatient facility. NSSI was assessed at their index hospitalization, as well as 6, and 12 months after discharge. Emotion recognition, emotion reactivity, and emotion dysregulation were assessed at baseline. Latent class mixture modeling was used to identify different NSSI trajectories and ANOVAs were used to evaluate predictors of the trajectories. ResultsAnalyses yielded three NSSI trajectories. These included a stable low-frequency class (90.53 % of sample), a stable moderate-frequency class, and a class characterized by high-frequency NSSI at baseline but that largely resolves by 6-month follow-up. After adjustments for multiple comparisons were made, only emotion regulation at baseline differentiated between the trajectories, with greater overall emotion dysregulation and greater emotional non-acceptance (a facet of emotion dysregulation) characterizing the initially high-frequency class and the stable moderate-frequency class more than the stable low-frequency class (ps < .05). Difficulties engaging in goal-directed behavior when distressed characterized the stable moderate-frequency NSSI class more than the stable low-frequency class (p < .05).LimitationsThe study sample consists predominantly of female and White adolescents and thus may not generalize to other demographic groups. ConclusionsThe current findings suggest that interventions involving emotion regulation with adolescents who engage in NSSI would particularly benefit from a focus on increasing acceptance of emotional experiences.

Prevalence of Somatic Symptoms and Somatoform Disorders among a German Adolescent Psychiatric Inpatient Sample.

Somatoform disorders (SD), commencing during adolescence, represent a major problem in health care systems. While literature underlines the high presence of mental health problems among children and adolescents afflicted by somatic symptoms in the general population, limited evidence is available on the prevalence of comorbid somatic symptoms in child and adolescent psychiatric populations. We assessed the prevalence of somatic symptoms, depression, and anxiety by validated questionnaires in an inpatient cohort. We further screened for the presence of SD. Out of 434 inpatients aged 11-17 years, 371 were included and a total of n = 288 (77.6%) children and adolescents participated in the study. A total of 93.8% of the inpatients reported somatic symptoms within the past six months and still almost half (45.7%) of the sample reported at least one somatic symptom within the last seven days prior to inquiry. Relating to the past six months, 59.5% were positively screened for SD, and 44.6% reported symptoms eligible for positive screening within the past seven days prior to the survey. Somatoform symptomatology was highly associated with anxiety and depression scores, but functional decline was amenable to the number of somatic symptoms only. We provide evidence that somatic symptoms are frequent in children and adolescents being treated in child and adolescent psychiatry and are relevant to everyday functioning. Screening for somatic symptoms should be introduced in the routine diagnostic procedures for early detection of SD in the commencing stages.

Difficulties in emotion regulation moderates the relationship between mood symptoms and nightmares in an inpatient psychiatric sample

BackgroundEmotional processing and regulation of affect are often impaired in psychiatric patients. Nightmares could be considered a manifestation of problems with this process. In the present study, we examined how depression, anxiety and suicidal risk related to difficulties in emotion regulation and nightmares over the course of inpatient treatment. We also explored whether emotion regulation problems moderated the relationship between changes in depression, anxiety, and suicide risk to changes in nightmares from admission to discharge. MethodsThe present study included 1215 adults admitted to an inpatient psychiatric hospital ranging from 18 to 87 years of age (M = 37.18, SD = 16.14). Mood symptoms, emotion regulation difficulties, nightmares and suicide risk were assessed at admission and discharge. Moderation analyses were calculated using Model 1 of the PROCESS Macro (Hayes, 2013). ResultsModeration analyses showed the associations between depression and nightmares (b = 0.25, p < .001) and suicide and nightmares (b = 0.34, p < .001) were strongest when patients had high levels of emotion regulation difficulties. Emotion regulation difficulties did not, however, moderate the relationship between anxiety and nightmares. Furthermore, improvement in depression and nightmares was significantly related to improvement in emotion regulation difficulties. LimitationsThe homogeneity of the sample limits the generalizability of the results. Furthermore, the use of self-report measures, especially sleep related assessments, can bias the data more than objective measures. ConclusionsThese findings provide clinical implications when treating psychiatric patients such as a need for emotion regulation skills building.

B - 88 The Role of Cognitive Functioning on Trauma and Suicidality in Inpatient Cisgender and Gender-Minority Youth.

This study aimed to examine how executive functioning (EF) and processing speed (PS) moderate the relationship between adverse childhood experiences (ACE's) and suicidality in cisgender and gender-minority youth (GMY) in an inpatient setting. We hypothesized that neurocognitive domains will moderate the relationship between ACE's and suicidality in GMY. An inpatient psychiatric sample of 43 GMY and 43 cisgender adolescents ages 13-19 (M = 15.02, SD = 1.57) participated in this study. Participants completed the ACEs to measure cumulative trauma exposure, and the Millon Adolescent Clinical Inventory that assessed suicidality. EF and PS composite scores were used as moderators. Two regression models were conducted to examine how EF, PS, ACEs, and the ACEs*EF and ACEs*PS interactions predicted suicidality for cisgender and GMY respectively. For cisgender adolescents, no significance was found in the regression model (F(5,36) = 1.11, p = 0.370) or interactions between ACEs and EF (b = -2.24, p = 0.122) or PS (b = 2.14, p = 0.390). Although the regression model was not significant (F(5,37) = 1.52, p = 0.207) for GMY, there were significant crossover interactions between ACEs and EF (b = -3.50, p = 0.013; 95%CI = -6.20, -0.80), and PS (b = -3.67, p = 0.027; 95%CI = 0.44, 6.90) on suicidality. These results suggest that EF and PS meaningfully attenuate the relationship between ACEs and suicidality for GMY in an inpatient setting whereas this attenuation is not seen in their cisgender counterparts. Such findings can lead to better indicators and interventions for GMY in inpatient settings.

Interpersonal Needs, Mental Pain, and Hopelessness in Psychiatric Inpatients with Suicidal Ideation.

Suicide is a leading cause of death worldwide and models may help the understanding of the phenomenon and ultimately reduce its burden through effective suicide prevention strategies. The Interpersonal Theory of Suicide and Shneidman's Model have tried to describe different unmet needs related to suicidal ideation. The study aims to assess the association between thwarted belongingness, perceived burdensomeness, and suicidal ideation in a sample of psychiatric inpatients and the mediating role of hopelessness and mental pain in this association. 112 consecutive adult psychiatric inpatients were administered the Columbia Suicide Severity Rating Scale (C-SSRS), the Italian version of the Interpersonal Needs Questionnaire-15-I (INQ-15-I), the Physical and Psychological Pain Scale, and the Beck Hopelessness Scale (BHS). Mediation models indicated a significant indirect effect of perceived burdensomeness (with thwarted belongingness as covariates) on suicidal ideation intensity with hopelessness as a mediator. When thwarted belongingness (controlling for perceived burdensomeness as a covariate) was included in a model as an independent variable, direct and indirect effects on suicidal ideation intensity were not significant. Psychosocial interventions focusing on identifying and decreasing the perception of being a burden for others and the feeling hopeless could represent a powerful pathway for reducing suicidal ideation. Moreover, the attention toward unmet interpersonal needs may help increase and focus clinical discussions on risk factors, which may help engagement toward psychiatric care and downsize the stigma related to suicide. Raising awareness toward mental health topics is a goal of healthcare services globally.

Emotion dysregulation – A bridge between ACE and aggressive antisocial behavior

PurposeForensic populations have high prevalence rates of adverse childhood experiences (ACE), but specific pathways from childhood victimization to adult victimizing behavior remain unclear. Difficulties in emotion regulation may prove to be a more proximal risk factor that functions as a pathway between ACE and aggressive antisocial behavior (AAB). In this study, we investigated concurrent associations between ACE, AAB, and difficulties in emotion regulation and tested the mediational role of emotion dysregulation. MethodsA forensic psychiatric inpatient sample (N = 97) was recruited from a maximum-security forensic psychiatric hospital in Sweden. Data were collected through file reviews and self-reports and analyzed with mediation and correlation analyses. ResultsWidespread bivariate associations among the study variables emerged, with small to moderate effect sizes. Distinct emotion regulation difficulties had unique relations to ACE and to different forms of AAB respectively. Evidence of significant indirect effects was limited and inconsistent across different types of analyses. ConclusionsDeficits in emotion regulation might be an important target of change in efforts to reduce AAB in forensic psychiatric patients with past ACE exposure. Attention to different dimensions of emotion regulation is crucial to deliver comprehensive interventions.

Moral injury in psychiatric patients with personality and other clinical disorders: development, psychometric properties, and validity of the Moral Injury Events Scale–Civilian Version

ABSTRACT Background: Moral injury emerges when someone perpetrates, fails to prevent, or witnesses acts that violate their own moral or ethical code. Nash et al. [(2013). Psychometric evaluation of the moral injury events scale. Military Medicine, 178(6), 646–652] developed a short measure, the Moral Injury Events Scale (MIES) to facilitate the empirical study of moral injury in the military. Our study aimed to develop a civilian version of the measure (MIES–CV) and examine its psychometric properties in a sample of psychiatric inpatients . Methods: In this cross-sectional study, the sample comprised 240 adult patients (71.7% female) with a mean age of 31.57 (SD = 11.69). The most common diagnoses in the sample were anxiety disorders (58.3%), depressive disorders (53.8%), and borderline personality disorder (39.6%). Participants were diagnosed using structured clinical interviews and filled out psychological questionnaires. Results: Exploratory factor analysis suggested that Nash et al.’s model (Perceived Transgressions, Perceived Betrayals) represents the data well. This two-factor solution showed an excellent fit in the confirmatory factor analysis, as well. Meaningful associations were observed between moral injury and psychopathology dimensions, shame, reflective functioning, well-being, and resilience. The Perceived Betrayals factor was a significant predictor of bipolar disorders, PTSD, paranoid personality disorder, borderline personality disorder, and avoidant personality disorder. Conclusions: Our study demonstrated that this broad version of the MIES is a valid measure of moral injury that can be applied to psychiatric patients.

Relationship between parental attachment styles and suicide in adolescents and adults admitted to an inpatient psychiatric hospital

BackgroundSuicide is among one of the leading causes of death in the United States affecting individuals of all ages. MethodsWe examined the relationship between suicide risk and parental attachment among an inpatient psychiatric sample of 690 adolescents and 1000 adults. Participants completed self-report measures of suicide risk and attachment. ResultsWe found that both adolescents and adults with insecure (i.e., preoccupied, dismissive, fearful) maternal and paternal attachment are at a significantly higher risk of suicide compared to those with secure maternal and paternal attachment. Adolescents who endorsed a previous suicide attempt (27.2 %) were less likely to have a secure maternal attachment, while adults who endorsed a previous suicide attempt (28.9 %) were less likely to have secure paternal attachment. LimitationsOur sample had limited racial and ethnic diversity which may limit the generalizability of the results to a broader population. ConclusionsThe present study provides evidence of the importance of parental attachment styles as a predictor of suicide-related behaviors across both adolescents and adults who are admitted inpatient. This suggests the importance of utilizing family-based interventions in order to reduce the risk of suicide.

Moral Injury and Shame Mediate the Relationship Between Childhood Trauma and Borderline Personality Disorder, PTSD, and Complex PTSD Symptoms in Psychiatric Inpatients.

Moral injury (MI) has received increased research attention in the past decades. However, despite its detrimental mental health consequences, MI has not been studied in psychiatric patients. We aimed to establish the relationship between childhood trauma, MI, and borderline personality disorder (BPD), posttraumatic stress disorder (PTSD), and disturbances in self-organization symptoms (DSO), a core diagnostic criterion of complex PTSD besides PTSD symptoms, and shame as a moral emotion in an inpatient psychiatric sample (N = 240). We found that the impact of childhood trauma on present BPD, PTSD, and DSO symptoms was mediated by MI and shame; the models accounted for up to 31% of variance in symptomatology. To our knowledge, this study is the first to investigate MI in a psychiatric sample, and our results highlight the importance of considering MI as a critical factor of patient experiences in relation to childhood trauma that potentially contributes to the development of psychiatric symptoms.

Exploring the psychometric properties of the externalizing spectrum inventory-brief form in a Swedish forensic psychiatric inpatient sample

BackgroundThe Externalizing Spectrum Inventory-Brief Form (ESI-BF) [1] is a 160-item self-report instrument designed for the assessment of externalizing psychopathology, yet few studies to date have evaluated its psychometric properties, structural fit, and criterion validity in forensic psychiatric settings.MethodsHere, we investigated these aspects in a sample of forensic psychiatric inpatients (n = 77) from a maximum-security forensic psychiatric hospital in Sweden. We firstly investigated the reliability. Secondly, using confirmatory factor analysis, the structure of the ESI-BF. And thirdly, using a Bayesian approach, assessed how the three ESI-BF subfactors relate to criterion measures of antisocial behaviors, substance use, and lifetime externalizing spectrum diagnoses.ResultsThe ESI-BF demonstrated good to adequate reliability and internal consistency, with all but four facet scales exhibiting α and ω values ≥ 0.80. Average inter-item correlations for the facet scales ranged from 0.31 to 0.74. However, all structural models exhibited poor to mediocre fit, with model fit values for the CFI being 0.66, 0.79 and 0.87 and RMSEA values of 0.14, 0.12 and 0.09. for the unidimensional correlated factors and bifactor model, respectively. Regarding criterion validity, all subscales of the item-based ESI-BF three-factor model exhibited robust correlations with the Life History of Aggression total, aggression and antisocial/consequences subscales, with correlations ranging from 0.29 to 0.55. All ESI-BF subfactors demonstrated robust associations, yet with different externalizing outcomes, lending tentative support to its criterion validity.ConclusionDespite remaining ambiguities regarding its structural fit, the ESI-BF may be promising for assessing externalizing psychopathology in forensic psychiatric populations. However, further investigation of the ESI-BF is needed before any firm conclusions can be drawn about its appropriateness in forensic psychiatric settings.

Adverse childhood experiences do not moderate the association between aggressive antisocial behavior and general disinhibition in a forensic psychiatric inpatient sample.

Adverse childhood experiences (ACE) and high levels of disinhibition have been associated with a variety of negative outcomes such as aggressive antisocial behavior (AAB). However, forensic psychiatric populations remain an understudied group in this field of research. This study aimed to fill that gap by investigating associations between ACE, AAB, and disinhibition in a forensic psychiatric sample. Furthermore, we aimed to explore such findings by investigating whether ACE might have a moderating effect on the association between disinhibition and AAB. A sample of forensic psychiatric patients (n = 89) was recruited from a high-security forensic psychiatric facility in Sweden. All study variables were moderately to strongly related to each other, although we found no moderating effect of ACE. Post hoc analysis indicated that our ACE items had differential effects on AAB scores, with placement outside the family home, absent parents, and parental drug abuse producing the largest effect on AAB levels. Our findings are in line with previous research demonstrating a significant and robust relationship between ACE, AAB, and disinhibition. Forensic psychiatric populations are exposed to high levels of both self-reported and documented ACE. This calls for trauma-informed care and highlights the importance of considering ACE in risk assessment, preventive work, and policy making.

C-Reactive Protein as a Potential Peripheral Biomarker for High-Lethality Suicide Attempts.

The aim of the present study was to identify a cut-off of c-reactive protein (c-RP) potentially predictive of high-lethality suicide attempts (SA) in an inpatient psychiatric sample. After attempting suicide, subjects were admitted to the emergency ward of the IRCCS Ospedale Policlinico San Martino and later to the section of Psychiatry from 1 August 2013 to 31 July 2018. C-reactive protein was measured. The Area Under the Receiver Operating Characteristic (ROC_AUC) was used to assess the discriminative capacity of c-RP for high- vs. low-lethality SA, and a logistic regression was performed to detect the odds ratio, adjusted for age and sex. High-lethality suicide attempters were 133 (30.8%), while low-lethality suicide attempters were 299 (69.2%). The optimal cut-off threshold (and corresponding sensitivity and specificity values) for c-RP was 4.65 mg/L (68/71%). This cut-off corresponds to an AUC of 73.5%. An odds ratio of 4.70 was generated for current high-lethality SA after a logistic regression, adjusted for age and sex. Research on social and biological factors underlying the lethality of SA is crucial for a better understanding of this complex phenomenon. Identifying potential predictors of SA, especially those at high lethality, is essential to implement personalized preventive strategies.

2.133 Adverse Childhood Experiences Moderate the Relationship Between Minoritized Status and Engaging in Substance Use Among Adolescent Psychiatric Inpatients

Adverse childhood experiences (ACEs; parental death, bullying) are linked to developing psychiatric disorders and substance use. Individuals with a minoritized status due to race, ethnicity, sexuality, or gender identity often have more ACEs. ACEs are linked to substance use, hypothesized due to coping. The study objective was to test whether the relationship between minoritized status and ever using a substance depends on ACEs in a sample of adolescent psychiatric inpatients.

Neuroleptic Malignant Syndrome: Typical Antipsychotic Drugs Versus Atypical Antipsychotic Medications

Introduction: Neuroleptic malignant syndrome is an idiosyncratic reaction and a severe disorder caused by an adverse reaction to drugs with dopamine receptor- antagonist properties and is characterized by a tetrad of rigidity, fever, altered mental status, and autonomic instability. In the present assessment, typical or conventional antipsychotics have been contrasted with atypical antipsychotics with respect to recorded cases of neuroleptic malignant syndrome among a sample of nonwestern psychiatric inpatients. Methods: For assessment, all the cases with a diagnosis of neuroleptic malignant syndrome during the last sixty-two months, after exclusion of other conceivable differential diagnoses, were incorporated in the current retrospective, record-based evaluation. The clinical diagnosis was based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. The valuation of independent variables was analyzed by ‘Compression of proportions. Statistical significance is defined as p value ≤0.05. Results: Amongst 19814 psychiatric inpatients, in the course of sixty-two months, eighteen cases received the diagnosis of neuroleptic malignant syndrome. As said by the findings, neuroleptic malignant syndrome was meaningfully more frequent among males, in comparison with females, and it was importantly more prevalent among cases suffering from schizophrenia, in comparison with bipolar disorder. Also, the highest risk of neuroleptic malignant syndrome was found in the age group of 30-39. In the current assessment, only one of the patients, who had received haloperidol, died due to aspiration pneumonia and respiratory failure, and the most prevalent symptom was fever, which was observable in one hundred percent of cases. In addition to a similar clinical profile, ‘Compression of proportions’ did not show any significant difference between the conventional (typical) antipsychotics versus the atypical antipsychotic medications with respect to the occurrence of neuroleptic malignant syndrome. Conclusion: As said by the findings, no significant difference was evident between the typical antipsychotic drugs versus the atypical antipsychotic medications, with respect to incidence and clinical profile of neuroleptic malignant syndrome.

Reversal of Amnesia for Trauma in a Sample of Psychiatric Inpatients with Dissociative Identity Disorder and Dissociative Disorder Not Otherwise Specified

ABSTRACT The authors interviewed 118 highly dissociative inpatients in a Trauma Program with the Dissociative Disorders Interview Schedule, the Dissociative Experiences Scale and the Adverse Childhood Experiences questionnaire; of the 118 participants 42 met DSM-5 criteria for dissociative identity disorder and 52 for other specified dissociative disorder. The average score on the Dissociative Experiences Scale in the sample of 118 participants was 44.7. The authors also conducted semi-structured interviews inquiring about the circumstances and triggers for reversal of amnesia for childhood trauma in the participants. Only a small minority of the reversal of amnesia took place in therapy sessions, and 24 different triggers for remembering were described. Childhood sexual abuse was by far the most common type of trauma for which amnesia was reversed. The findings are inconsistent with the view that amnesia for childhood sexual abuse is reversed primarily during psychotherapy.

Translation and validation of the SCRAM questionnaire in a German adolescent inpatient sample

ABSTRACT Sleep, depressive symptoms and circadian preference are highly interconnected processes. Evidence suggests that, especially in adolescence, all processes should be considered in the assessment and treatment of patients with clinically relevant psychopathology. The SCRAM (Sleep, Circadian Rhythms, and Mood) questionnaire was developed and validated in a student sample as a promising tool to conjointly measure and separate sleep, circadian preference and depression symptomatology. The present study aims to validate a German version of the SCRAM questionnaire in an adolescent psychiatric inpatient sample. A two-step analytic strategy consisting of an exploratory factor analysis EFA followed by confirmatory factor analyses (CFA) was conducted. The EFA was run in the first half of the sample (n = 422, M = 14.92, SD = 1.67). To validate the factor structure of the EFA and the original study, two CFA`s were performed in the second half of the adolescent sample (n = 438, M = 15.07, SD = 1.68). The EFA analysis revealed a 4-factor model with 12 items. Two Sleep items and one Morningness item had cross-factor loadings. The fit indices in the CFA were good using the factor model of the original study, whereas the 4-factor model of the EFA did not converge. The German SCRAM factor model seems structurally sound in an adolescent inpatient sample, but questions remain regarding the role of diagnosis, gender, external correlates, and examining the change scores of the SCRAM scores with treatment. Before this application, further research is needed to replicate the factor structure, investigate test–retest reliability, predictive and discriminant validity and test in more generalizable samples.

Are Women Really Different? Comparison of Men and Women in a Sample of Forensic Psychiatric Inpatients.

BackgroundWomen in detention remain a widely understudied group. Although the number of studies in women in prison has grown in the past decade, research on female forensic psychiatric inpatients has not increased, and women are in the minority in forensic psychiatry not only as patients but also as examinees. Consequently, most treatment manuals and risk assessments were developed in male samples and apply to male offenders. However, the same treatment and risk assessment rationale can be applied in male and female mentally ill offenders only if evidence shows that no relevant sex differences exist.AimsThe aim of the present study was to examine a sample of male and female forensic psychiatric inpatients with substance use disorders and to compare the socio-demographic, legal, and clinical characteristics between the sexes.MethodsThe sample included 115 male and 61 female patients. All patients were in mandatory inpatient forensic psychiatry treatment according to section 64 of the German penal code.ResultsWe found no significant differences between men and women in terms of educational status and vocational training. However, women were more often single and less likely to be employed full time, and they reported adverse childhood experiences more often than men. Regarding clinical variables, women appeared to be less likely to have a substance use disorder due to alcohol use and had more previous psychiatric treatments than men. Male patients were significantly younger on first conviction and detention, had more criminal records and served longer total penalties than female patients. Furthermore, men committed more violent crimes and women, more narcotics-related crimes.ConclusionsThe study identified sex-specific differences in forensic psychiatric patients that should be considered in the context of forensic therapy.

Personality trait domains predict psychiatric symptom and functional outcomes.

A review of high intensity, high dose mentalization-based inpatient psychiatric treatment indicated large effect-size reductions in symptoms of depression, anxiety, somatization, and improving emotion-regulation functioning (Allen et al., 2017). This study examined the impact of pathological personality traits has on baseline symptoms and functioning, as well as their impact on the longitudinal course in a large cohort of adult inpatient psychiatric sample (N = 804). The Personality Inventory for DSM-5 (PID-5; Krueger et al., 2012) was used to assess trait domains impact on longitudinal outcomes (anxiety, depression, somatic symptoms, and functional impairment) using hierarchical repeated measures modeling. Results indicate Negative Affectivity and Detachment were related to higher admission severity in all four outcome domains. Psychoticism was related to somatic symptoms, while Antagonism and Disinhibition were related to functional impairment. Paradoxically, when symptoms were plotted over 2-week intervals during hospitalization, patients with higher admission PID-5 trait scores exhibited greater improvement over time. The PID-5 appears to contribute to prediction of treatment outcome response above and beyond demographic and burden of illness. Importantly, the findings add to a growing body of literature indicating that impairments in personality traits do not preclude positive treatment response, particularly when treatments target pathological personality features. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Gender-Specific Aspects of Suicide-Related Communication in a High Risk Sample of Psychiatric Inpatients

Background: In addition to help-seeking behavior in a professional context, suicide-related communication (SRC) with that discloses suicidal thoughts and plans to relatives and significant others play a major role in suicide prevention. While studies revealed gender differences in help-seeking behavior in case of suicidal thoughts and intent in a professional context, the empirical evidence on SRC and gender is limited. The present study aims to examine gender-specific aspects of prevalence, recipients, pathways, and content of SRC in a high-risk sample of psychiatric inpatients. Results may provide information for the development of gender-specific suicide prevention measures. Methods: This study considered data on SRC among individuals who had been admitted to a psychiatric ward due to suicide attempt or to an increased suicide risk and have previously attempted suicide. In this high-risk sample of 219 psychiatric inpatients (56.2% female: n = 123), SRC was assessed using the Suicide Attempt Self Injury Interview (SASII) and was analyzed with a mixed-method design. Results: There are no significant differences (Chi2 (4, n = 219) = 3.189, p = 0.074) in the frequencies of SCR between men and women. 34.4% (n = 33) of men and 46.3% (n = 57) of women reported SRC. Differences were found regarding the recipients. No differences in oral/written and explicit/implicit communication are evident. The most frequently addressed themes in SRC in men are exhaustion, resignation, and listlessness. For women, the suicide method is the most common topic, followed by the topics mentioned among men. Conclusions: A high proportion of participants reported having engaged in SRC. In contrast, the themes addressed are very ambiguous and not clearly suicide-related, especially among men. This can lead to difficulties in the interpretation of the statements by the recipients. Women seem to communicate more often with recipients who may provide assistance. These aspects ought to be considered for developing gender specific suicide prevention measures.