Various Types Of Psychopathology Research Articles

Parental rearing and substance related disorders—a multi‐factorial controlled study in a Swedish sample

AbstractDysfunctional parental rearing was investigated to evaluate cognitive self‐protective strategies in a high‐risk sample from the Methadone Maintenance Programme, Stockholm, Sweden, and healthy subjects respectively. The Bowlby‐Scale, the ASQ‐SWED, the Reciprocal Attachment Questionnaire, the Dysfunctional Attitudes Scale and the Dysfunctional Working Models Scale were used. Results confirm insecure attachment (types A, C, D) among addicts and secure attachment (type B) among controls. The influence of the pathological pattern Compulsive self‐reliance on the personality factor Confidence in self and others was 40.3 times higher (odds ratio) for addicts. The content of schemas in substance‐related disorders shows an individual vulnerability associated with a decreased social competence and a very high risk for the development of various types of psychopathology. On the other hand, findings obtained in control subjects attest to a ‘normal’ organization of self‐protective strategies and a pattern of behaviour mainly based on secure attachment. Copyright © 2004 John Wiley & Sons, Ltd.

The Harvard Twin Study of Substance Abuse: What We Have Learned

The Harvard Twin Study of Substance Abuse was carried out with the members of the Vietnam Era Twin (VET) Registry. The VET Registry comprises over 8000 male twins who served in the United States military between 1965 and 1975 and were subsequently interviewed regarding their use of licit and illicit substances, as well as various types of psychopathology. Our research has demonstrated significant influences by genetic, shared environmental, and unique environmental factors on the abuse of illicit substances. Multivariate analyses have indicated that the co-occurrence of abuse of various types of illicit drugs reflects a common vulnerability, influenced by both genetic and environmental factors, that cuts across all categories of illicit drugs. We have also demonstrated that some drugs have unique determinants, both genetic and environmental, that are not shared with other drugs. In part, the genetic influence on marijuana abuse is mediated by genetic influence on subjective effects in response to the drug. The determinants of transitions from one stage of drug use to another differ depending on which drug or which transition is examined. We determined significant genetic influences on several aspects of nicotine and alcohol use separately, as well as genetic influences shared by both substances. We found that the co-occurrence of illicit drug abuse and major depression is due to unique environmental influences. The phenotypic association between symptoms of conduct disorder and alcohol and marijuana dependence is due largely to shared environmental influences. Our results, thus far, indicate a complex pattern of genetic and environmental influences on substance use and abuse.

Relation between intelligence and psychopathology among preschoolers

Examined the relation between intelligence and psychopathology in a nonclinical sample of 510 children ages 2 to 5 years. Psychopathology was measured using both quantitative, dimensional methods (Child Behavior Checklist [CBCL]) and taxonomic methods (the Diagnostic and Statistical Manual of Mental Disorders [3rd. ed., Rev.; DSM-III-R; American Psychological Association, 1987]). IQ scores were derived from either the McCarthy Scales of Children's Abilities or the Bayley Scales of Mental Development. Based on quantitative, dimensional data, results support similar findings among older children and clinical populations that lower McCarthy general, verbal, and perceptual-performance IQ scores are associated with various types of psychopathology. Results were also consistent for the DSM-III-R data. Bayley IQ scores did not predict CBCL psychopathology or DSM-III-R Disruptive Disorders, but they did predict the presence of a DSM-III-R diagnosis. Early identification of intellectual deficits among preschoolers ages 3 to 5 may help to prevent later school difficulties and severe psychopathology.

Impulsivity and inhibitory control in normal development and childhood psychopathology.

Two experiments investigated the development and pathology of inhibitory control in children. Inhibitory control was investigated with the stop-signal paradigm, which is based on a formal theory of inhibition and directly measures the mechanism of inhibition. The ability to inhibit developed little after Grade 2, but subjects with attention deficit disorder with hyperactivity (ADDH) showed deficient inhibitory control. Their deficient inhibitory control was attributable to the subgroup of ADDH subjects with pervasive hyperactivity who had a more severe inhibitory deficit than did the situational hyperactive subgroup, the normal group, and the pathological controls. These studies reflect the utility of the stop-signal paradigm as a measure of inhibitory control. The concept of inhibitory control is central in theories of child development and in the definition and explanation of psychopathological disorders of childhood—in particular, of attention deficit disorder with hyperactivity (ADDH; Douglas, 1983; Kogan, 1983; Milich & Kramer, 1984). Inhibitory control is one of several processes that perform the executive functions of the cognitive system. These functions determine how various mental processes (e.g., encoding, recognition, retrieval) will work together in the performance of a task. Children need executive control to choose, construct, execute, and maintain optimal strategies for performing a task, as well as to inhibit strategies that become inappropriate when goals or task demands change or errors occur (Logan, 1985). Deficient inhibitory control is revealed by impulsive behaviors such as responding before the task is understood, answering before sufficient information is available, allowing attention to be captured by irrelevant stimuli (i.e, distractibility), or failing to correct obviously inappropriate responses. Poorly developed inhibitory control might account for impulsive behaviors of younger children and of children with various types of psychopathology. Despite the importance of inhibitory control in theories of child development and psychopathology, no widely accepted

Screening emergency room patients with atypical chest pain for depression and panic disorder.

In response to recent reports relating atypical chest pain to normal coronary arteries and to various types of psychopathology, we developed a pilot study to investigate 1) the prevalence of depression and panic disorder among patients presenting to an emergency room with atypical chest pain, and 2) what the likelihood is of an emergency room physician recognizing the psychosocial factor. Of forty-nine subjects screened, 39 percent scored positively for depressive syndrome on the Center for Epidemiological Studies-Depression rating scale, 43 percent met criteria for panic attack and 16 percent met criteria for panic disorder by DSM-III. Although thirty subjects (61%) screened positively for depression or panic attack, only one received a psychiatric diagnosis of any kind. This pilot study suggests: 1) that the relationship between chest pain and psychopathology in emergency room patients deserves further rigorous study; 2) that depression and panic attacks in association with atypical chest pain may be underdiagnosed by the emergency room physician; and 3) that self-report screening measures as an aid to diagnosis in this population need to be more closely investigated.

Application of a behavioral theory of motivation to the concepts of anxiety and impulsivity

Gray's model has been employed in attempts to formulate theories concerning the processes underlying various types of psychopathology. In the most direct application of his model, the dominant mood is assumed to reflect the strength of the underlying motivational system—i.e., strong anxiety with a strong behavioral inhibition system (BIS), strong positive affect with a strong behavioral activation system (BAS). This approach would predict strong anxiety to be associated with a dominance of passive avoidance and extinction and, similarly, strong positive affect with a dominance of impulsivity and other approach behaviors. The present paper has argued that these expectations are based on an implicit assumption that equally stressful environments are encountered—an assumption that would be undermined by individual differences in the very motivational systems under consideration. Examination of the approach-avoidance conflict paradigm supported the argument that, at least in the case of anxiety, one should not expect a strong association between behavior and motivational states. In particular, a weak behavioral inhibition system or strong behavioral activation system is likely to facilitate anxiety-producing impulsive behavior, whereas a strong behavioral inhibition system or weak behavioral activation system may facilitate anxiety-reducing cautious behavior. Other factors were also thought to promote independence of affective states and behavioral traits across individuals. On this argument, trait anxiety conceptualized as resulting from a strong BIS may not be highly correlated with frequent anxiety. Stating this another way, the behavioral correlates of a dominant BIS may be relatively independent of a trait involving a dominance of anxious mood. Using Tellegen's (1985) discussion of self-report measures of mood and personality traits, it was proposed that the trait factor of Constraint may be more strongly associated with behavioral consequences of the BAS and BIS, whereas the Negative Emotionality dimension is largely unrelated to the behavioral effects of the BIS. Since Negative Emotionality corresponds to the traditional anxiety/neuroticism factor, this proposal differs from the customary assumptions about the alignment of Gray's motivational systems and personality traits. The personality trait of Positive Emotionality (cf. extraversion) may be associated with individual differences in the strength of the BAS, with both affective and behavioral components. Thus, the hypothesis of motivational-behavioral uncoupling offers an alternative to the usual intepretations of the three major dimensions seen in most personality inventories. Unfortunately, it remains unclear as to how well the three major personality traits (Positive Emotionality, Negative Emotionality, and Constraint) are aligned with the hypothesized underlying motivational dimensions, and any hypotheses must be seen as extremely tentative. Finally, the question of the validity of self-report measures was discussed briefly. Of greatest interest is the possibility that a subset of subjects are unable to accurately report their emotional states, and that methods are available for identifying these individuals. If so, the validity of these self-report measures may be significantly improved, facilitating research on anxiety and impulsivity.

Reported effects of alcohol on the sexual feelings and behavior of women alcoholics and nonalcoholics.

Women alcoholics were more likely than nonalcoholics to report that they desire, engage in and enjoy sexual intercourse more after drinking. Reproductive dysfunction was more typical of women having various types of psychopathology (including alcoholism) than of normal women.

The family, language, and the transmission of schizophrenia

IT HAS long been my belief that our understanding of the nature and etiology of schizophrenia has been blocked by the deficiencies in our grasp of personality development and integration. At the recent international conference on the etiology of schizophrenia in Rochester, I tried to convey in broad outline an approach to both personality development and to the study of schizophrenia that seems-to me-to take into account our current knowledge and also provides hypotheses to direct future studies (Lidz, 1967). I do not wish to repeat what many at this Conference heard in Rochester. The essence of what I said is simple and may even seem obvious to some. For an infant to grow up-even one that is properly endowed genetically-and develop into a reasonably well-integrated and competent individual, he requires positive direction and guidance in a suitable interpersonal environment and social system. However, the developmental theories used in psychiatry, including psychoanalytic theory, implicitly or explicitly consider that a normal infant will develop into a functioning and reasonably stable adult as a concomitant of his physical maturation unless he receives very faulty nurturance in his first few years, or he is seriously traumatized. Indeed, innate sources of libidinal fixation-unknown and undemonstrated but readily hypothesized-are invoked as explanations of various types of psychopathology by analytically oriented psychiatrists as readily as other psychiatrists fall back on hypothetical genetic anomalies and metabolic impairments of brain functioning in schizophrenia. The extent and complexity of the positive forces required to mold the personality and equip the child with essential adaptive techniques have largely been overlooked because they are built into the institutions and mores of all societies which could not survive if they were not-and into the omnipresent family which everywhere has the implicit task of carrying out the basic socialization and enculturation of the new generation. Man’s biological make-up requires that he grow up in a family-or some planned substitute for it-not simply for his protection and nurture during his lengthy immaturity, but to be directed into an integrated person who possesses the techniques, knowledge, and roIes he requires for survival and for adaptation in that physical and social environment in which he happens to grow up. I discussed the requisites that the family must provide a child under four overlapping and somewhat arbitrary headings. 1. The parental nurturant functions: how parents must meet the child’s changing needs and supplement his immature capacities in a different manner at each phase of his development. The influence of the nature of the nurture on the individual’s emotional