Structured Clinical Interview For DSM Research Articles

Algorithm-based modular psychotherapy vs. cognitive-behavioral therapy for patients with depression, psychiatric comorbidities and early trauma: a proof-of-concept randomized controlled trial.

Effect sizes of psychotherapies currently stagnate at a low-to-moderate level. Personalizing psychotherapy by algorithm-based modular procedures promisesimproved outcomes, greater flexibility, and a better fit between research and practice. However, evidence for the feasibility and efficacy of modular-based psychotherapy, using a personalized treatment algorithm, is lacking. This proof-of-concept randomized controlled trial was conducted in 70 adult outpatients with a primary DSM-5 diagnosis of major depressive disorder, a score higher than 18 on the 24-item Hamilton Rating Scale for Depression (HRSD-24), at least one comorbid psychiatric diagnosis according to the Structured Clinical Interview for DSM-5 (SCID-5), a history of at least "moderate to severe" childhood maltreatment on at least one domain of the Childhood Trauma Questionnaire (CTQ), and exceeding the cut-off value on at least one of three measures of early trauma-related transdiagnostic mechanisms: the Rejection Sensitivity Questionnaire (RSQ), the Interpersonal Reactivity Index (IRI), and the Difficulties in Emotion Regulation Scale-16 (DERS-16). Patients were randomized to 20 sessions of either standard cognitive-behavioral therapy alone (CBT) or CBT plus transdiagnostic modules according to a mechanism-based treatment algorithm (MoBa), over 16 weeks. We aimed to assess the feasibility of MoBa, and to compare MoBa vs. CBT with respect to participants' and therapists' overall satisfaction and ratings of therapeutic alliance (using the Working Alliance Inventory - Short Revised, WAI-SR), efficacy, impact on early trauma-related transdiagnostic mechanisms, and safety. The primary outcome for efficacy was the HRSD-24 score at post-treatment. Secondary outcomes included, among others, the rate of response (defined as a reduction of the HRSD-24 score by at least 50% from baseline and a score <16 at post-treatment), the rate of remission (defined as a HRSD-24 score ≤8 at post-treatment), and improvements in early trauma-related mechanisms of social threat response, hyperarousal, and social processes/empathy. We found no difficulties in the selection of the transdiagnostic modules in the individual patients, applying the above-mentioned cut-offs, and in the implementation of MoBa. Both participants and therapists reported higher overall satisfaction and had higher WAI-SR ratings with MoBa than CBT. Both approaches led to major reductions of depressive symptoms at post-treatment, with a non-significant superiority of MoBa over CBT. Patients randomized to MoBa were nearly three times as likely to experience remission at the end of therapy (29.4% vs. 11.4%; odds ratio, OR = 3.2, 95% CI: 0.9-11.6). Among mechanism-based outcomes, MoBa patients showed a significantly higher post-treatment effect on social processes/empathy (p<0.05) compared to CBT patients, who presented an exacerbation on this domain at post-treatment. Substantially less adverse events were reported for MoBa compared to CBT. These results suggest the feasibility and acceptability of an algorithm-based modular psychotherapy complementing CBT in depressed patients with psychiatric comorbidities and early trauma. While initial evidence of efficacy was observed, potential clinical advantages and interindividual heterogeneity in treatment outcomes will have to be investigated in fully powered confirmation trials.

Personality and psychopathological characteristics in functional movement disorders.

Aim of the present study was to assess personality and psychopathological characteristics in patients with functional movement disorders (FMDs) compared to patients with other neurological disorders (OND). In this cross-sectional study, patients affected by clinically established FMDs and OND who attended the Neurologic Unit of the University-Hospital "Policlinico-San Marco" of Catania from the 1st of December 2021 to the 1st of June 2023 were enrolled. Personality characteristics were assessed with the Rorschach test coded according to Exner's comprehensive system and the Structured Clinical Interview for DSM-5 (SCID-II). Thirty-one patients with FMDs (27 women; age 40.2±15.5 years; education 11.7±3.2 years; disease duration 2.3±2.5 years) and 24 patients affected by OND (18 women; age 35.8±16.3 years; education 11.9±2.9 years; disease duration 3.4±2.8 years) were enrolled. At the Rorschach, FMDs presented a significantly higher frequency of Popular (P) and sum of all Human content codes (SumH>5) responses and avoidant coping than OND. FMDs presented "conformity behaviors", excessive interest in others than usual a maladaptive avoidant style of coping and a difficulty in verbalizing emotional distress. These psychopathological characteristics may favor the occurrence of FMDs.

ØCD: protocol for the development and evaluation of a cognitive-behavioral prevention program for obsessive-compulsive disorder

BackgroundObsessive-compulsive disorder (OCD) imposes significant burdens on individuals, families, and healthcare systems and the COVID-19 pandemic appears to have exacerbated OCD symptoms. Currently, there are no validated prevention programs for OCD, highlighting a critical gap in mental health services. This study aims to develop and validate the first ØCD prevention program, for at-risk adults, utilizing cognitive-behavioral therapy (CBT) and exposure response prevention (ERP) techniques.MethodsA single-blind, randomized controlled trial comparing the ØCD prevention program to a waitlist control group will be conducted. Participants, at-risk adults (18–65 years) with subclinical OCD symptoms (OCI-R score ≥ 12), will be recruited for the study. The ØCD prevention program compresise of six online group sessions incorporating CBT and ERP techniques over three modules. The primary outcomes are OCD symptom severity (measured by the Obsessive-Compulsive Inventory- revised form; OCI-R), depression symptoms (measured by the Patient Health Questionnaire; PHQ-9), and anxiety symptoms (measured by the Generalised Anxiety Disorder 7-item; GAD-7). Secondary outcomes include OCD-related beliefs, experiential avoidance, resilience, quality of life, uncertainty intolerance, automatic thoughts, and distress. Outcome measures will be collected at baseline, at completion of the intervention, and one year later (follow-up). At follow-up, we will also analyze the OCD diagnostic incidence, using the Structured Clinical Interview for DSM-5. We will employ a multivariate analysis of variance (MANOVA) to explore whether significant differences exist between groups across dependent variables. To compare the OCD incidence levels from the pre-test to the follow-up we will use the chi-squared test.DiscusionThe present study may contribute novel data on the efficacy of OCD prevention approaches, leading to the development of an evidence-based OCD prevention program that could alleviate individual and societal burdens associated with OCD.Trial registrationThis trial was approved by the University Ethical Review Authority (937/ 28.11.2023) at Babeș-Bolyai University and is registered on clinicaltrials.gov (ID: NCT06262464).

Psychometric evaluation of the PCL-5: assessing validity, diagnostic utility, and bifactor structures

ABSTRACT Background: The changes DSM-5 brought to the diagnostic criteria for posttraumatic stress disorder (PTSD) resulted in revising the most widely used instrument in assessing PTSD, namely the Posttraumatic Checklist for DSM-5 (PCL-5). Objective: This study examined the psychometric properties of the Romanian version of the PCL-5, tested its diagnostic utility against the Structured Clinical Interview for DSM-5 (SCID-5), and investigated the latent structure of PTSD symptoms through correlated symptom models and bifactor modelling. Method: A total sample of 727 participants was used to test the psychometric properties and underlying structure of the PCL-5 and 101 individuals underwent clinical interviews using SCID-5. Receiver operating characteristic curve (ROC) analyses were performed to test the diagnostic utility of the PCL-5 and identify optimal cut-off scores based on Youden's J index. Confirmatory Factor Analyses (CFAs) and bifactor modelling were performed to investigate the latent structure of PTSD symptoms. Results: Estimates revealed that the PCL-5 is a valuable tool with acceptable diagnostic accuracy compared to SCID-5 diagnoses, indicating a cut-off score of >47. The CFAs provide empirical support for Anhedonia, Hybrid, and bifactor models. The findings are limited by using retrospective, self-report data and the high percentage of female participants. Conclusions: The PCL-5 is a psychometrically sound instrument that can be useful in making provisional diagnoses within community samples and improving trauma-informed practices.

Course of avoidant/restrictive food intake disorder: Emergence of overvaluation of shape/weight

BackgroundAvoidant/restrictive food intake disorder (ARFID) is a feeding/eating disorder characterized by avoidance/restriction of food intake by volume and/or variety. The emergence of shape/weight-related eating disorder symptoms in the longitudinal course of ARFID is an important clinical phenomenon that is neither robustly documented nor well understood. We aimed to characterize the emergence of eating disorder symptoms among adults with an initial diagnosis of ARFID who ultimately developed other eating disorders.MethodThirty-five participants (94% female; Mage = 23.17 ± 5.84 years) with a history of ARFID and a later, separate eating disorder completed clinical interviews (i.e., Structured Clinical Interview for DSM-5 – Research Version and Longitudinal Interval Follow-Up Evaluation) assessing the period between ARFID and the later eating disorder. Participants used calendars to aid in recall of symptoms over time. Descriptive statistics characterized the presence, order of, and time to each symptom. Paired samples t-tests compared weeks to emergence between symptoms.ResultsMost participants (71%) developed restricting eating disorders; the remainder (29%) developed binge-spectrum eating disorders. Cognitive symptoms (e.g., shape/weight concerns) tended to onset initially and were followed by behavioral symptoms. Shape/weight-related food avoidance presented first, objective binge eating, fasting, and excessive exercise occurred next, followed by subjective binge eating and purging.ConclusionsDiagnostic crossover from ARFID to another (typically restricting) eating disorder following the development of shape/weight concerns may represent the natural progression of a singular clinical phenomenon. Findings identify potential pathways from ARFID to the development of another eating disorder, highlighting possible clinical targets for preventing this outcome.

Examining Factors Influencing Length of Stay for Inpatients at Alcohol and Substance Addiction Treatment Center

Objective: The aim of this study is to determine the impact of impulsivity, treatment motivation, anxiety, and cognitive distortions on the duration of inpatient treatment for substance use.&#x0D; Methods: The sample for the study consisted of 200 volunteer patients receiving inpatient treatment at the Alcohol and Substance Addiction Treatment Center. Participants underwent a general psychopathological evaluation using the Structured Clinical Interview for DSM-5 (SCID-5) administered by the clinician. All participants were given the Case Report Form prepared by the clinician along with the Barratt Impulsivity Scale-11 Short Form (BIS), Automatic Thoughts Scale (ATS), State and Trait Anxiety Inventory (STAI-I, STAI-II) and Treatment Motivation Questionnaire (TMQ).&#x0D; Results: A significant distinction was noted in discharge statuses when comparing scores on the Barratt Impulsiveness Scale and nonplaning impulsiveness subscale, and the State and Trait Anxiety Inventory and Automatic Thoughts Scale. Those who were discharged with remission had notably lower scores compared to those who left voluntarily or were discharged due to rule violation (p&lt; 0.001). Negative significant correlations were found between length of stay and Barratt Impulsiveness Scale and its subscales [BIS-T (p

Allostatic overload in the medically ill patients: Results from an observational study

The present study aimed at evaluating the prevalence of allostatic overload (AO) among subjects with different medical diseases and explore whether medically ill patients with or without AO differ for specific clinical features (i.e., co-occurring mental or psychosomatic disorders). An observational cross-sectional study was carried out. Outpatients with a diagnosis of blood cancer, systemic sclerosis, or migraine received a clinical assessment which included the Mini International Neuropsychiatric Interview or the Structured Clinical Interview for DSM-5 and the Diagnostic Criteria for Psychosomatic Research-Revised Semi-Structured Interview (DCPR-R SSI). Four hundred and thirty-nine outpatients were enrolled. Among them, 39 (8.9%) had a diagnosis of blood cancer, 200 (45.5%) had a diagnosis of systemic sclerosis, and 200 (45.5%) had a diagnosis of migraine. A total of 104 (23.7%) patients had a DCPR-R diagnosis of AO. Patients with a diagnosis of blood cancer, migraine, or systemic sclerosis did not differ for DCPR-R AO prevalence (P = 0.082). Based on multiple regression analysis, medically ill patients with DCPR-R AO were more likely to satisfy the diagnosis of DCPR-R illness denial (odds ratio [OR] = 2.99, 95% confidence interval [CI] = 1.04 &amp;ndash; 8.58), conversion symptoms (OR = 5.32, 95% CI = 1.16 &amp;ndash; 24.38), or demoralization (OR = 2.57, 95% CI = 1.08 &amp;ndash; 6.11) and a DSM-5 diagnosis of major depressive episode/disorder (OR = 1.90, 95% CI = 1.03 &amp;ndash; 3.50), if compared to those without DCPR-R AO. DCPR-R AO is a clinically useful transdiagnostic feature potentially associated with other psychosomatic syndromes and mental disorders that may contribute to the disease burden and the poor global health conditions of medically ill patients.

Inflammatory markers in world trade center workers with asthma: Associations with post traumatic stress disorder.

Post-traumatic stress disorders (PTSD) is associated with worse asthma outcomes in individuals exposed to the World Trade Center (WTC) site. Do WTC workers with coexisting PTSD and asthma have a specific inflammatory pattern that underlies the relationship with increased asthma morbidity? We collected data on a cohort of WTC workers with asthma recruited from the WTC Health Program. Diagnosis of PTSD was ascertained with a Structured Clinical Interview for DSM-5 (Diagnostic and Statistical Manuel of Mental Disorders) and the severity of PTSD symptoms was assessed with the PTSD Checklist 5. We obtained blood and sputum samples to measure cytokines levels in study participants. Of the 232 WTC workers with diagnosis of asthma in the study, 75 (32%) had PTSD. PTSD was significantly associated with worse asthma control (p = 0.002) and increased resource utilization (p = 0.0002). There was no significant association (p>0.05) between most blood or sputum cytokines with PTSD diagnosis or PCL-5 scores both in unadjusted and adjusted analyses. Our results suggest that PTSD is not associated with blood and sputum inflammatory markers in WTC workers with asthma. These findings suggest that other mechanisms likely explain the association between PTSD and asthma control in WTC exposed individuals.

The Relationship Between Early Term Birth and the Risk of Later Childhood Mental Disorders Within a Pregnancy Cohort.

This study examines whether gestational age, birth weight, and early term birth is associated with childhood mental disorders in 342 pregnant women recruited at less than 20weeks gestation and were then followed up until 4years postpartum, including 93 children born at early term. Women were assessed at recruitment using the Structured Clinical Interview for DSM. At 4years of age their children were assessed using the Preschool Age Psychiatric Assessment (PAPA) and the Child Behavior Checklist (CBCL). This study found earlier birth predicted an increased risk for anxiety disorders and demonstrated a significant interaction between gestational age and lower birthweight. The risk for ADHD increased with lower gestational age independent of birthweight. In contrast, gestational age was not associated with Oppositional Defiant Disorder, Conduct Disorder, internalizing or externalizing symptoms. These findings highlight the important differences in the association of early term birth and vulnerability for specific mental disorders.

Validation of the EDDS-5 self-report survey against the SCID-5 diagnostic interview in US veterans

The aim of our study was to validate the Eating Disorder Diagnostic Scale (EDDS-5) updated for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) with a diverse veteran population against a clinician-administered interview based on the Structured Clinical Interview for DSM-5 (SCID-5). Our sample included 343 veterans, 18–75 years, recruited April 2019 to December 2022 who completed the EDDS-5 as well as other eating disorder and mental health measures. A subsample of these veterans received clinical interviews (n = 166), which were used to validate the EDDS-5. We found that despite multiple proposed modifications, the EDDS-5 performed poorly at correctly identifying diverse veterans who were diagnosed as having eating disorders through clinician-administered interviews. The sensitivity was very low, indicating that using the EDDS-5 did not identify many true positives and may also over diagnose those without true eating disorders. The EDDS-5 may not be the best for screening or diagnostic purposes among diverse samples like veterans.

Exploring Overlooked Anxiety Disorders: A Study on the Prevalence of Adult Separation Anxiety Disorder and Specific Phobia in the General Population

Objective: The current study aimed to investigate the prevalence of adult separation anxiety disorder and specific phobia in the general population, along with identifying the factors associated with these two disorders. Material and Method: The study was carried out in the Selçuklu district, encompassing 28 of the 34 family health centers selected through a simple random sampling method. The study sample included 1,218 individuals over 18, chosen using a systematic sampling approach by skipping one resident from each neighborhood covered by the family health unit. After collecting the sociodemographic data, face-to-face diagnostic interviews were performed using the Structured Clinical Interviews for Separation Anxiety Symptoms (SCI-SAS) for ASAD and the Structured Clinical Interview for DSM-5 (SCID-5) for specific phobia assessment. Results: The study revealed that the lifetime prevalence of ASAD was 5.9%, with a point prevalence of 1.5%, while the lifetime prevalence of specific phobia was 11.3%. The application rates for the treatment of both disorders were very low and clinicians demonstrated limited recognition of ASAD. ASAD was correlated with female gender, low income, childhood traumatic experiences, migraine presence, and family history of serious illness. On the other hand, specific phobia was associated with female gender and family history of psychiatric disease. Conclusion: Despite the high prevalence of both disorders, the alarming rates of clinical recognition and treatment underscore the need to develop health policies and awareness programs aimed at promoting early diagnosis and treatment.

An empirical investigation of definitions of subthreshold posttraumatic stress disorder.

Subthreshold posttraumatic stress disorder (PTSD) has long been recognized as an important construct that identifies a subgroup of individuals who report significant PTSD symptoms and associated disability but do not endorse enough symptoms to meet the criteria for a full PTSD diagnosis. Different investigators have defined subthreshold PTSD in various ways, making it difficult to interpret findings across studies. To address this problem, we systematically compared individuals who met criteria for nine different subthreshold PTSD definitions with individuals diagnosed with either full PTSD or no PTSD (i.e., failed to meet the criteria for a subthreshold definition) with respect to prevalence and associated clinical outcomes of interest. Participants were 1,082 veterans enrolled in the Veterans After DischargeLongitudinalRegistry. PTSD and subthreshold PTSD diagnostic status were determined using the Structured Clinical Interview for DSM-5 (SCID-5) and validated self-report instruments were used to assess clinical outcomes. Across outcomes, subthreshold definitions generally identified a group of participants that was distinguishable from participants in both the PTSD and no PTSD groups, rs = .02-.47. We discuss the benefits and drawbacks of various subthreshold definitions and highlight the need for additional work evaluating these definitions across additional outcomes and samples. In the interim, we propose a working case definition of subthreshold PTSD as meeting any three of the four DSM-5 symptom criteria (i.e., Criteria B, C, D, and E) along with Criterion A and Criteria F-H. The results suggest subthreshold PTSD is a clinically meaningful construct.

Efficacy and safety of TV-46000, a long-acting, subcutaneous, injectable formulation of risperidone, for schizophrenia: a randomised clinical trial in the USA and Bulgaria

TV-46000 is a long-acting, subcutaneous, antipsychotic agent that combines risperidone and an innovative, copolymer-based drug delivery technology in a suspension that was approved in April, 2023 for subcutaneous use. The aim of the phase 3 Risperidone Subcutaneous Extended-release (RISE) study was to evaluate the efficacy of TV‑46000 in schizophrenia. The RISE study consisted of two treatment stages: a 12-week, open-label stabilisation phase with oral risperidone (stage 1), and an open-ended, randomised, double-blind, placebo-controlled, relapse-prevention phase with subcutaneous TV-46000 (stage 2) done at 69 clinical sites across the USA and Bulgaria. Patients diagnosed with schizophrenia more than 1 year before screening by DSM-5 criteria and confirmed at screening by the Structured Clinical Interview for DSM-5 and who had at least one relapse within 24 months before screening were eligible for enrolment. Patients who were outpatients and stabilised in stage 1 continued to stage 2 and were randomly assigned 1:1:1 by a computer-generated randomisation list to receive either subcutaneous TV-46000 once monthly, TV-46000 once every 2 months, or placebo until relapse, early discontinuation, or the study was stopped because the prespecified stopping criterion of at least 90 relapse events was met. The primary endpoint was time to impending relapse of the intention-to-treat patient population in stage 2. This study is registered with ClinicalTrials.gov, number NCT03503318, and is complete. The study enrolled the first patient on June 1, 2018, and the last patient completed on Dec 3, 2020. 1267 patients were screened, 863 enrolled, and 544 (male, n=332 [61%], female, n=212 [39%]; mean [SD] age, 49·3 [10·98] years; Black or African American, n=322 [59%]; White, n=206 [38%]; Asian, n=7 [1%]; Native Hawaiian or other Pacific Islander, n=2 [<1%]; race not reported, n=3 [<1%]; other race, n=4 [<1%]; Hispanic or Latinx, n=117 [22%]) randomly assigned to subcutaneous TV-46000 once monthly (n=183), TV-46000 once every 2 months (n=180), or placebo (n=181). Time to impending relapse was significantly prolonged by 5·0 times with TV-46000 once monthly (hazard ratio, 0·200 [95% CI 0·109-0·367]; p<0·0001) and by 2·7 times with TV-46000 once every 2 months (0·375 [0·227-0·618]; p<0·0001) versus placebo. Most frequently reported treatment-related adverse events (ie, ≥5% of patients in either TV-46000 group) that occurred more often in patients receiving TV-46000 (once monthly or once every 2 months) versus placebo were injection site nodules (7% for TV-46000 once monthly, 7% for TV-46000 once every 2 months, 3% for placebo), weight increased (4%, 6%, 2%, respectively), and extrapyramidal disorder (5%, 3%, 0% respectively). Serious adverse events were reported for eight (4%) patients in the TV-46000 once-monthly group, ten (6%) patients in the TV-46000 once-every-2-months group, and 14 (8%) patients in the placebo group. The safety profile of TV-46000 was consistent with other approved formulations of risperidone. No new safety signals were identified. In patients with schizophrenia, subcutaneous TV-46000 once monthly and once every 2 months significantly delayed impending relapse versus placebo. TV-46000 is an effective long-acting, subcutaneous, antipsychotic agent treatment option in adult patients with schizophrenia, with a favourable benefit-risk profile. Teva Branded Pharmaceutical Products R&D.

Prevalence of Comorbidities of Psychotic Disorders in Patients with Substance Use Disorders in Iran Psychiatric Hospital in Tehran, Iran

Background: Substance use disorders are highly prevalent among psychotic patients and are associated with poorer clinical outcomes. Objective: This study aimed to investigate the prevalence of psychotic disorders in substance users and the epidemiological features of this population. Material&amp;Methods: In a cross-sectional study, we investigated 455 outpatient and inpatient participants with SUD referred to the Iran psychiatric hospital from April, 2020, to March, 2021. All participants were substance users, referred to Iran psychiatric center to follow up on their comorbidities and psychiatric disorders. The Structured Clinical Interview for DSM-5 (SCID) was used for psychotic disorders and substance use disorder diagnoses. Finally, gathered data were analyzed by SPSS-25. Results: A total of 455 patients were involved in the study. The mean age was 34.66 years, of which 89.7% were men. The most common main substances include methamphetamine (39.1%) and heroin (27%). The prevalence of psychotic disorder was 36.7%, and the most common type was substance-induced psychotic disorder (26.4%) and schizophrenia (8.4%). There was a significant association between methamphetamine and opium use and the presence of substance-induced psychotic disorder and schizophrenia, respectively (p˂ 0.001). Conclusion: The most common type of substance use was methamphetamine, and the most common type of psychotic disorder was substance-induced psychotic disorder. There was a significant association between methamphetamine and opium use and the presence of substance- induced psychotic disorder and schizophrenia, respectively. It should be noted that this was a sample of individuals hospitalized for substance abuse. It was not a general population sample and was very biased toward substance use.

The Nepean Belief Scale (NBS) as a tool to investigate the intensity of beliefs in anorexia nervosa: psychometric properties of the Italian version

BackgroundPeople with anorexia nervosa (AN) show a peculiar impairment of insight regarding their condition, often manifesting a denial of extreme emaciation and sometimes hiding or underreporting socially undesirable abnormal eating patterns. Sometimes the intensity of the beliefs held by patients with AN reach a delusional intensity.ObjectivesIn this study, the Italian version of the Nepean Belief Scale was applied to a sample of patients diagnosed with AN to investigate the intensity of their beliefs and convictions and its clinical correlates.MethodsThe Nepean Belief Scale (NBS) was translated and adapted to Italian and applied to a sample of patients diagnosed with AN based on the Structured Clinical Interview for DSM-5 (SCID-5).ResultsThe Italian version of the 5-item NBS showed excellent reliability. Convergent validity was proved by negative association with levels of insight measured with the Schedule for the Assessment of Insight in Eating Disorders. Beliefs of delusional intensity were reported by 10% of participants. Those with a greater intensity of beliefs, either overvalued or delusional ideas, were more likely to report poorer general cognitive performances on the Montreal Cognitive Assessment. No association was observed between NBS score and age, body mass index, symptoms of eating disorders, body dissatisfaction, or levels of depression. Fear of weight gain and control seeking were the most often reported themes at the NBS.ConclusionsThe Italian version of the NBS is a reasonably reliable, valid, and usable tool for the multidimensional assessment of insight in AN.Level of evidence Level III, Evidence obtained from well-designed cohort or case–control analytic studies.

The Relationship Between Childhood Traumatic Experiences and Obsessive Beliefs in Alcohol Use Disorder

Objective: Based on the pathophysiological similarities between alcohol use disorder (AUD) and obsessive compulsive spectrum disorders, as well as the close association between traumatic experiences and addiction, the goal of this study was to assess the relationship between obsessive beliefs and childhood traumas in patients with alcohol use disorder by comparing them with the control group.&#x0D; Material and Method: The data of 60 AUD cases who applied to the Alcohol and Substance Treatment Center (AMATEM) outpatient clinic consecutively and 56 healthy control groups were evaluated. Structured Clinical Interview for DSM-5 (SCID-5), Obsessive Beliefs Questionnaire (OBS), Childhood Trauma Questionnaire (CTS), Hamilton Anxiety Inventory (HAM-A), and Hamilton Depression Inventory (HAM-D) were applied to both groups. The Addiction Profile Index, which evaluates the severity of addiction, was applied to the patient group. Data were evaluated with SPPS 22.&#x0D; Results: Obsessive beliefs, traumatic experiences, depression and anxiety scores were found to be significantly higher in AUD cases than in the control group. No significant relationship was found between traumatic experiences and obsessive beliefs. The most important predictors of obsessive beliefs were found to be anxiety and depression scores.&#x0D; Conclusion: The current study is valuable because it is the first study to evaluate the relationship between obsessive beliefs and childhood traumas in alcohol use disorder patients. Further analyzes in a larger sample in this area will be helpful in identifying risk factors and creating preventive interventions for AUD, a disorder that is difficult to treat and recurs.

Exploring Deviation from Time Perspective in Patients with Major Depressive Disorder, Obsessive Compulsive Disorder, and Generalized Anxiety Disorder: A Comparative Analysis in the Clinical Context.

Objective: A growing body of research stresses the effect of time perspective (TP) on the genesis and maintenance of psychological disorders. However, the variations in the TP configuration of individuals with different disorders have not yet been completely investigated. We aimed to compare the differences in TP among patients with three common psychiatric disorders. Method : We recruited 30 patients with major depressive disorder (MDD), 30 with generalized anxiety disorder (GAD), and 30 with obsessive-compulsive disorder (OCD). Participants completed Zimbardo's Time Perspective Inventory, Beck Depression Inventory, Generalized Anxiety Disorder Scale, Maudsley Obsessive Compulsive Inventory, and Structured Clinical Interview for DSM-5 (SCID-5). The one-way MANOVA was utilized for the comparison of TP dimensions among the three disordered groups. Results: The results showed that TP was significantly affected in all three clinical groups. The effect of the disorder on time perspective was significant for Past Negative (PN) (F (2, 84) = 11.86, P < 0.01), Past Positive (PP) (F (2, 84) = 6.66, P < 0.01), Present Fatalistic (PF) (F (2, 84) = 7.08, P < 0.01) and Future (F) (F (2, 84) = 26.40, P < 0.01), but not for Present Hedonistic (PH). The findings revealed that the MDD group scored the highest on PN, with the GAD group scoring higher than the OCD group. The GAD and OCD groups reported higher PP than the MDD group. In addition, the MDD group scored higher than both the GAD and OCD groups on PF. Finally, the GAD patients reported higher scores than both the MDD and OCD patients on the F dimension, while the OCD patients scored higher than the MDD patients. Conclusion: Individuals with MDD tend to obtain higher scores in PN and PF time perspective, whereas those with GAD and OCD showed higher PP and F scores. These findings demonstrate the significance of examining TP in clinical patients and prompt further research into the association between TP and the disorders being studied. Perspectives on therapy are also explored.

A comparison of schema modes and self-beliefs related to social anxiety in individuals with subclinical social anxiety disorder and without social anxiety disorder: a preliminary finding

ABSTRACT Social anxiety disorder (SAD) is the most common anxiety disorder and has serious negative effects on multiple areas of life. The possibility of comorbidity with other disorders and malfunction in different domains of life exists in both full-blown and subclinical social anxiety. This study aimed to compare the schema modes and self-beliefs related to social anxiety in individuals with subclinical social anxiety disorder and without social anxiety disorder. Multistage cluster random and purposive sampling methods were used to select 100 students, 50 with and 50 without symptoms of social anxiety disorder. Participants were evaluated in regard to schema modes, self-beliefs related to social anxiety, social anxiety, depression, and generalized anxiety disorder. They were then evaluated clinically through Structured Clinical Interview for DSM-5 (SCID-5). Data analysis was performed by Multivariate Analysis of Variance (MANOVA) which showed that there was a significant difference between the groups of individuals with and without symptoms of social anxiety in schema modes and self-beliefs related to social anxiety (p < 0.001). The obtained results can contribute to a deeper understanding of the dimensions of vulnerability underlying subclinical social anxiety disorder in the relationship between symptoms of subclinical social anxiety disorder and schema modes.

New progress in an old debate? Applying the DSM-5 criteria to assess traumatic events and stressor-related disorders in cancer survivors.

The rather broad definition of medical trauma within DSM-IV has contributed to long-lasting debates on the applicability of Posttraumatic Stress Disorder (PTSD) in oncological patients and its differentiation from Adjustment Disorder (AjD) which results from non-traumatic critical life events. The DSM-5 criteria have introduced a narrower definition of medical traumatization. However, studies on updated prevalence rates in cancer patients are missing. Within a cross-sectional study, we assessed hematological cancer survivors using the Structured Clinical Interview for DSM-5. We investigated (i) the frequency and type of cancer-related stressors, (ii) the proportion of stressors qualifying as traumatic according to DSM-5 (i.e., an event of sudden and catastrophic character) and (iii) the prevalence of PTSD, AjD and cancer-related PTSD according to DSM-5. 291 patients participated (response rate: 58%). Mean age was 54years, 60% were male. 168 patients (59%) reported cancer-related stressors, with the most frequent being cancer diagnosis disclosure (n=58, 27%). Eight percent of reported stressors qualified as traumatic events according to DSM-5. Five (1.8%), 15 (5.3%) and 20 (7.0%) cancer survivors met DSM-5 criteria for current PTSD, lifetime PTSD and AjD, respectively. Among all PTSD cases, three were cancer-related (1.1%). In addition, seven patients (2.5%) metall symptoms for cancer-related PTSD, but not the DSM-5 criterion for medical trauma. Considering receiving the cancer diagnosis as traumatic event, which is debatable according to DSM-5, 38% of stressors qualified as traumatic and six patients (2.1%) met criteria for cancer-related PTSD. DSM-5 criteria enable a clear identification of traumatic events in the context of cancer. This change may inform discussions on the appropriateness of PTSD in cancer patients and facilitates its differentiation from AjD. Larger studies need to validate our findings.

Screening for cannabis use disorder among young adults: Sensitivity, specificity, and item-level performance of the Cannabis Use Disorders Identification Test – Revised

The Cannabis Use Disorders Identification Test Revised (CUDIT-R) is a widely used screening tool. However, its utility in screening for cannabis use disorder (CUD) among young adults requires further investigation. The current study evaluated the accuracy of the CUDIT-R in distinguishing between young adults with and without CUD. We also examined the individual item properties of the CUDIT-R in this sample. A community sample of young adults (N = 153, ages 19–26 years) who reported at least one lifetime period of regular cannabis use (i.e., twice or more per month for at least six months) completed the CUDIT-R and the Structured Clinical Interview for DSM-5 (SCID-5) Substance Use Module. The CUDIT-R showed good accuracy in distinguishing between young adults with and without CUD as determined by the SCID-5 (area under the receiver operating characteristic curve = 0.84). A cut-point of nine yielded 87.80 % sensitivity and 70.42 % specificity, with positive and negative predictive values of 77.42 % and 83.33 %, respectively. Item response theory analyses revealed that CUDIT-R items assessing impaired control, failure to meet expectations, time devoted to use, and memory and concentration problems displayed high discrimination and were relatively difficult, whereas items assessing frequency of use and attempts to reduce use showed moderate discrimination and relatively low difficulty. Items assessing hours high and use with potential for physical hazard displayed poor discrimination. The CUDIT-R appears to validly distinguish between young adults with and without CUD and may be useful in screening for CUD in this high-risk population. Further research considering individual item properties is needed to refine the CUDIT-R for use among young adults.