Medicine › Psychiatry and Mental health

Psychosomatic Disorders and Their Treatments

Works Count: 62794

Wikipedia

Description

This cluster of papers focuses on the study of interoception, the sense of the internal state of the body, and its association with somatic symptoms, including alexithymia, health anxiety, psychogenic nonepileptic seizures, and depersonalization disorder. The papers also explore the relationship between interoception, emotion regulation, and various mental health conditions such as anxiety and dissociation.

Keywords

Interoception; Somatic Symptoms; Alexithymia; Health Anxiety; Psychogenic Nonepileptic Seizures; Emotion Regulation; Medically Unexplained Symptoms; Depersonalization Disorder; Anxiety; Dissociation

Interoceptive predictions in the brain

2015-05-28

Lisa Feldman Barrett , W. Kyle Simmons

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Scale for the Assessment of Negative Symptoms

1982-01-01

Nancy C. Andreasen

Somatization: the concept and its clinical application

1988-11-01

Z. J. Lipowski

Somatization, a tendency to experience and communicate somatic distress in response to psychosocial stress and to seek medical help for it, poses a major medical, social, and economic problem. It … Somatization, a tendency to experience and communicate somatic distress in response to psychosocial stress and to seek medical help for it, poses a major medical, social, and economic problem. It is most often associated with depressive and anxiety disorders and constitutes the core of somatoform disorders. Its persistent form is especially costly and difficult to prevent and manage. The author discusses the prevalence, clinical manifestations, etiology, and treatment of somatization and presents a critical review of somatoform disorders.

Neuroticism, Somatic Complaints, and Disease: Is the Bark Worse than the Bite?

1987-06-01

Paul T. Costa , Robert R. McCrae

Perhaps because negative emotions are frequently expressed in physiological reactions, psychosomatic theories have often identified Neuroticism and its component traits (including anxiety, anger, and depression) as causal influences on the … Perhaps because negative emotions are frequently expressed in physiological reactions, psychosomatic theories have often identified Neuroticism and its component traits (including anxiety, anger, and depression) as causal influences on the development of disease. These views are apparently supported by correlations between physical symptom reports and measures of Neuroticism in males. Data from 347 adult women in the Baltimore Longitudinal Study of Aging replicate this finding for total physical complaints and for most body systems. However, analyses of mortality in the literature and in the present article show no influence of Neuroticism, suggesting that symptom reporting may be biased by Neuroticism-related styles of perceiving and reporting physiological experiences. Researchers in this area are urged to employ objective measures of medical status, and to be alert to possible biases of self-selection and selective perception in interpreting associations between Neuroticism and disease.

The Multidimensional Assessment of Interoceptive Awareness (MAIA)

2012-11-01

Wolf Mehling , Cynthia Price , Jennifer Daubenmier +3 more

This paper describes the development of a multidimensional self-report measure of interoceptive body awareness. The systematic mixed-methods process involved reviewing the current literature, specifying a multidimensional conceptual framework, evaluating prior … This paper describes the development of a multidimensional self-report measure of interoceptive body awareness. The systematic mixed-methods process involved reviewing the current literature, specifying a multidimensional conceptual framework, evaluating prior instruments, developing items, and analyzing focus group responses to scale items by instructors and patients of body awareness-enhancing therapies. Following refinement by cognitive testing, items were field-tested in students and instructors of mind-body approaches. Final item selection was achieved by submitting the field test data to an iterative process using multiple validation methods, including exploratory cluster and confirmatory factor analyses, comparison between known groups, and correlations with established measures of related constructs. The resulting 32-item multidimensional instrument assesses eight concepts. The psychometric properties of these final scales suggest that the Multidimensional Assessment of Interoceptive Awareness (MAIA) may serve as a starting point for research and further collaborative refinement.

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The Health Anxiety Inventory: development and validation of scales for the measurement of health anxiety and hypochondriasis

2002-07-01

Paul M. Šalkovskis , Katharine A. Rimes , Hilary M. C. Warwick +1 more

A self-rated measure of health anxiety should be sensitive across the full range of intensity (from mild concern to frank hypochondriasis) and should differentiate people suffering from health anxiety from … A self-rated measure of health anxiety should be sensitive across the full range of intensity (from mild concern to frank hypochondriasis) and should differentiate people suffering from health anxiety from those who have actual physical illness but who are not excessively concerned about their health. It should also encompass the full range of clinical symptoms characteristic of clinical hypochondriasis. The development and validation of such a scale is described.Three studies were conducted. First, the questionnaire was validated by comparing the responses of patients suffering from hypochondriasis with those suffering from hypochondriasis and panic disorder, panic disorder, social phobia and non-patient controls. Secondly, a state version of the questionnaire was administered to patients undergoing cognitive-behavioural treatment or wait-list in order to examine the measure's sensitivity to change. In the third study, a shortened version was developed and validated in similar types of sample, and in a range of samples of people seeking medical help for physical illness.The scale was found to be reliable and to have a high internal consistency. Hypochondriacal patients scored significantly higher than anxiety disorder patients, including both social phobic patients and panic disorder patients as well as normal controls. In the second study, a 'state' version of the scale was found to be sensitive to treatment effects, and to correlate very highly with a clinician rating based on an interview of present clinical state. A development and refinement of the scale (intended to reflect more fully the range of symptoms of and reactions to hypochondriasis) was found to be reliable and valid. A very short (14 item) version of the scale was found to have comparable properties to the full length scale.The HAI is a reliable and valid measure of health anxiety. It is likely to be useful as a brief screening instrument, as there is a short form which correlates highly with the longer version.

Measuring empathy: reliability and validity of the Empathy Quotient

2004-07-01

Emma Lawrence , Philip Shaw , Dustin Baker +2 more

Background. Empathy plays a key role in social understanding, but its empirical measurement has proved difficult. The Empathy Quotient (EQ) is a self-report scale designed to do just that. This … Background. Empathy plays a key role in social understanding, but its empirical measurement has proved difficult. The Empathy Quotient (EQ) is a self-report scale designed to do just that. This series of four studies examined the reliability and validity of the EQ and determined its factor structure. Method. In Study 1, 53 people completed the EQ, Social Desirability Scale (SDS) and a non-verbal mental state inference test, the Eyes Task. In Study 2, a principal components analysis (PCA) was conducted on data from 110 healthy individuals and 62 people reporting depersonalisation (DPD). Approximately 1 year later, Study 3, involved the re-administration of the EQ ( n =24) along with the Interpersonal Reactivity Index (IRI; n =28). In the last study, the EQ scores of those with DPD, a condition that includes a subjective lack of empathy, were examined in depth. Results. An association was found between the Eyes task and EQ, and only three EQ items correlated with the SDS. PCA revealed three factors: (1) ‘cognitive empathy’; (2) ‘emotional reactivity’, and (3) ‘social skills’. Test–retest reliability was good and moderate associations were found between the EQ and IRI subscales, suggesting concurrent validity. People with DPD did not show a global empathy deficit, but reported less social competence. Conclusions. The EQ is a valid, reliable scale and the different subscales may have clinical applications.

Common symptoms in ambulatory care: Incidence, evaluation, therapy, and outcome

1989-03-01

Kurt Kroenke , A. David Mangelsdorff

The Prevalence of ‘Alexithymic’ Characteristics in Psychosomatic Patients

1973-01-01

Peter E. Sifneos

An attempt is made in this paper to investigate the prevalence among patients who suffer from various psychosomatic diseases, of a relative constriction in emotional functioning, poverty of fantasy life, … An attempt is made in this paper to investigate the prevalence among patients who suffer from various psychosomatic diseases, of a relative constriction in emotional functioning, poverty of fantasy life, and inability to find appropriate words to describe their emotions. For lack of a better term, I call these characteristics 'alexithymic'. Twenty-five psychosomatic patients outnumbered 25 control patients by better than two to one as far as possession of these 'alexithymic' characteristics. The question is raised whether these defects are due to biological or developmental factors, and the conclusion is reached that patients with these characteristics may not be good candidates for dynamic psychotherapy.

Individuals with sociopathic behavior caused by frontal damage fail to respond autonomically to social stimuli

1990-12-14

André Damásio

Manic-depressive illness

1991-01-01

Demetrios Papageorgis

The Revised Illness Perception Questionnaire (IPQ-R)

2002-01-01

Rona Moss‐Morris , John Weinman , Keith J. Petrie +3 more

This paper presents a revised version of the Illness Perception Questionnaire (IPQ-R), a recently developed and widely used quantitative measure of the five components of illness representations in Leventhal's self-regulatory … This paper presents a revised version of the Illness Perception Questionnaire (IPQ-R), a recently developed and widely used quantitative measure of the five components of illness representations in Leventhal's self-regulatory model. The revised version stemmed from a need to deal with minor psychometric problems with two subscales, and to include additional subscales, assessing cyclical timeline perceptions, illness coherence, and emotional representations. Item selection was determined by principal components analyses which verified the factorial structure of the questionnaire in a sample of 711 patients from 8 different illness groups. Further analysis provided good evidence for both the internal reliability of the subscales and the short (3 week) and longer term (6 month) retest reliability. The IPQ-R also demonstrated sound discriminant, known group and predictive validity. While it is possible that the new subscales will vary in their applicability in different patient groups, the IPQ-R provides a more comprehensive and psychometrically acceptable assessment of the key components of patients' perceptions of illness.

International experiences with the Hospital Anxiety and Depression Scale-A review of validation data and clinical results

1997-01-01

Christoph S. Herrmann

Magical ideation as an indicator of schizotypy.

1983-01-01

Mark Eckblad , Loren J. Chapman

Dissociation and the fragmentary nature of traumatic memories: Overview and exploratory study

1995-10-01

Bessel A. van der Kolk , Rita E. Fisler

Since trauma arises from an inescapable stressful event that overwhelms people's coping mechanisms, it is uncertain to what degree the results of laboratory studies of ordinary events are relevant to … Since trauma arises from an inescapable stressful event that overwhelms people's coping mechanisms, it is uncertain to what degree the results of laboratory studies of ordinary events are relevant to the understanding of traumatic memories. This paper reviews the literature on differences between recollections of stressful and of traumatic events. It then reviews the evidence implicating dissociation as the central pathogenic mechanism that gives rise to posttraumatic stress disorder (PTSD). A systematic exploratory study of 46 subjects with PTSD indicated that traumatic memories were retrieved, at least initially, in the form of dissociated mental imprints of sensory and affective elements of the traumatic experience: as visual, olfactory, affective, auditory, and kinesthetic experiences. Over time, subjects reported the gradual emergence of a personal narrative that can be properly referred to as "explicit memory." The implications of these findings for understanding the nature of traumatic memories are discussed.

How do you feel — now? The anterior insula and human awareness

2008-12-19

A. D. Craig

The twenty-item Toronto Alexithymia scale—II. Convergent, discriminant, and concurrent validity

1994-01-01

R. Michael Bagby , Graeme J. Taylor , James D. A. Parker

Is schizophrenia a neurodevelopmental disorder?

1988-01-02

Robin M. Murray , Shôn Lewis

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Knowing your own heart: Distinguishing interoceptive accuracy from interoceptive awareness

2014-11-20

Sarah N. Garfinkel , Anil K. Seth , Adam B. Barrett +2 more

Interoception refers to the sensing of internal bodily changes. Interoception interacts with cognition and emotion, making measurement of individual differences in interoceptive ability broadly relevant to neuropsychology. However, inconsistency in … Interoception refers to the sensing of internal bodily changes. Interoception interacts with cognition and emotion, making measurement of individual differences in interoceptive ability broadly relevant to neuropsychology. However, inconsistency in how interoception is defined and quantified led to a three-dimensional model. Here, we provide empirical support for dissociation between dimensions of: (1) interoceptive accuracy (performance on objective behavioural tests of heartbeat detection), (2) interoceptive sensibility (self-evaluated assessment of subjective interoception, gauged using interviews/questionnaires) and (3) interoceptive awareness (metacognitive awareness of interoceptive accuracy, e.g. confidence-accuracy correspondence). In a normative sample (N = 80), all three dimensions were distinct and dissociable. Interoceptive accuracy was only partly predicted by interoceptive awareness and interoceptive sensibility. Significant correspondence between dimensions emerged only within the sub-group of individuals with greatest interoceptive accuracy. These findings set the context for defining how the relative balance of accuracy, sensibility and awareness dimensions explain cognitive, emotional and clinical associations of interoceptive ability.

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The twenty-item Toronto Alexithymia scale—I. Item selection and cross-validation of the factor structure

1994-01-01

R. Michael Bagby , James D. A. Parker , Graeme J. Taylor

Psychiatric Illness in General Practice: A Detailed Study Using a New Method of Case Identification

1970-05-23

David Goldberg , B Blackwell

A self-administered questionary (the General Health Questionnaire) aimed at detecting current psychiatric disturbance was given to 553 consecutive attenders to a general practitioner9s surgery. A sample of 200 of these … A self-administered questionary (the General Health Questionnaire) aimed at detecting current psychiatric disturbance was given to 553 consecutive attenders to a general practitioner9s surgery. A sample of 200 of these patients was given an independent assessment of their mental state by a psychiatrist using a standardized psychiatric interview. Over 90% of the patients were correctly classified as “well” or “ill” by the questionary, and the correlation between questionary score and the clinical assessment of severity of disturbance was found to be +0·80. The “conspicuous psychiatric morbidity” of a suburban general practice assessed by a general practitioner who was himself a psychiatrist and validated against independent psychiatric assessment was found to be 20%. “Hidden psychiatric morbidity” was found to account for one-third of all disturbed patients. These patients were similar to patients with “conspicuous illnesses” in terms both of degree of disturbance and the course of their illnesses at six-month follow-up, but were distinguished by their attitude to their illness and by usually presenting a physical symptom to the general practitioner. When 87 patients who had been assessed as psychiatric cases at the index consultation were called back for follow-up six months later, two-thirds of them were functioning in the normal range. Frequency of attendance at the surgery in the six months following index consultation was found to have only a modest relationship to severity of psychiatric disturbance. It is argued that minor affective illnesses and physical complaints often accompany each other and usually have a good prognosis.

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The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review

2010-05-08

Kurt Kroenke , Robert L. Spitzer , Janet B. W. Williams +1 more

Willed action and the prefrontal cortex in man: a study with PET

1991-06-22

Chris Frith , Karl Friston , Peter F. Liddle +1 more

We used positron emission tomography to contrast changes in cerebral blood flow associated with willed and routine acts. In the six tasks used, volunteers had to make a series of … We used positron emission tomography to contrast changes in cerebral blood flow associated with willed and routine acts. In the six tasks used, volunteers had to make a series of responses to a sequence of stimuli. For the routine acts, each response was completely specified by the stimulus. For the willed acts, the response was open-ended and therefore volunteers had to make a deliberate choice. Willed acts in the two response modalities studied (speaking a word, or lifting a finger) were associated with increased blood flow in the dorsolateral prefrontal cortex (Brodmann area 46). Willed acts were also associated with decreases in blood flow, but the location of these decreases was modality dependent.

Life Events and Depression

1969-12-01

Eugene S. Paykel

AN extensive literature exists regarding the relationship of life events and depression. The largest group of studies has concerned the descriptive characterization of those events occurring at the onset of … AN extensive literature exists regarding the relationship of life events and depression. The largest group of studies has concerned the descriptive characterization of those events occurring at the onset of depression. There has been particular emphasis on actual or symbolic losses,<sup>1-4</sup>including loss of self-esteem.<sup>5</sup>Others have been concerned with the general presence or absence of stress at onset and have attempted to define a group of endogenous depressions, occurring in the absence of stress, and showing characteristic clinical features.<sup>6-8</sup>Although it has been generally assumed that most depressions are reactions to events, some dissent has been expressed. Hudgens<sup>9</sup>and his colleagues found events uncommon in the six months prior to onset of illness in 40 patients hospitalized with affective disorders. Winokur and Pitts<sup>10</sup>reported reactive depressions to be infrequent and threw doubt on the validity of

An International Study of the Relation between Somatic Symptoms and Depression

1999-10-28

Gregory E. Simon , Michael VonKorff , Marco Piccinelli +2 more

Patients with depression, particularly those seen by primary care physicians, may report somatic symptoms, such as headache, constipation, weakness, or back pain. Some previous studies have suggested that patients in … Patients with depression, particularly those seen by primary care physicians, may report somatic symptoms, such as headache, constipation, weakness, or back pain. Some previous studies have suggested that patients in non-Western countries are more likely to report somatic symptoms than are patients in Western countries.

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Meta-analytic evidence for common and distinct neural networks associated with directly experienced pain and empathy for pain

2010-10-13

Claus Lamm , Jean Decety , Tania Singer

Manic-Depressive Insanity and Paranoia.

1921-08-13

Emil Kraepelin

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Development, Reliability, and Validity of a Dissociation Scale

1986-12-01

E. M. Bernstein , Frank W. Putnam

Dissociation is a lack of the normal integration of thoughts, feelings, and experiences into the stream of consciousness and memory. Dissociation occurs to some degree in normal individuals and is … Dissociation is a lack of the normal integration of thoughts, feelings, and experiences into the stream of consciousness and memory. Dissociation occurs to some degree in normal individuals and is thought to be more prevalent in persons with major mental illnesses. The Dissociative Experiences Scale (DES) has been developed to offer a means of reliably measuring dissociation in normal and clinical populations. Scale items were developed using clinical data and interviews, scales involving memory loss, and consultations with experts in dissociation. Pilot testing was performed to refine the wording and format of the scale. The scale is a 28-item self-report questionnaire. Subjects were asked to make slashes on 100-mm lines to indicate where they fall on a continuum for each question. In addition, demographic information (age, sex, occupation, and level of education) was collected so that the connection between these variables and scale scores could be examined. The mean of all item scores ranges from 0 to 100 and is called the DES score. The scale was administered to between 10 and 39 subjects in each of the following populations: normal adults, late adolescent college students, and persons suffering from alcoholism, agoraphobia, phobic-anxious disorders, posttraumatic stress disorder, schizophrenia, and multiple personality disorder. Reliability testing of the scale showed that the scale had good test-retest and good split-half reliability. Item-scale score correlations were all significant, indicating good internal consistency and construct validity. A Kruskal-Wallis test and post hoc comparisons of the scores of the eight populations provided evidence of the scale's criterion-referenced validity.(ABSTRACT TRUNCATED AT 250 WORDS)

The Mini-Mental State Examination

1983-07-01

Marshal F. Folstein , Lee N. Robins , John E. Helzer

<h3>To the Editor.—</h3> In response (Archives1982;39:1443-1445) to a letter by Ganguli and Saul (Archives1982;39:1442-1443), Robins and Helzer noted that the Mini-Mental State Examination,<sup>1</sup>incorporated into the Diagnostic Interview Schedule (DIS) to … <h3>To the Editor.—</h3> In response (Archives1982;39:1443-1445) to a letter by Ganguli and Saul (Archives1982;39:1442-1443), Robins and Helzer noted that the Mini-Mental State Examination,<sup>1</sup>incorporated into the Diagnostic Interview Schedule (DIS) to assess cognitive impairment, had been reported by Folstein et al to differentiate between pseudodementia and true organic brain syndromes. We would like to make that statement more specific. The Mini-Mental State Examination was designed as a clinical method for grading cognitive impairment. It produces a score that can be used to follow the course of patients or as a case detection technique after cutoff scores are established. In a clinical psychiatric setting, a low Mini-Mental score can be associated with many disorders including mental retardation, delirium, manicdepressive disorder, and schizophrenia, as illustrated by Folstein et al in their pre-<i>DSM-III</i>article in 1975.<sup>1,2</sup>However, on a medical unit like the one from which Ganguli and

Neural systems supporting interoceptive awareness

2004-01-18

Hugo Critchley , Stefan Wiens , Pia Rotshtein +2 more

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Assessing Psychiatric Impairment in Primary Care with the Sheehan Disability Scale

1997-06-01

Andrew C. Leon , Mark Olfson , Laura Portera +2 more

Several recent studies have documented that substantial functional impairment is associated with many of the mental disorders seen in primary care. However, brief measures of mental health-related functional impairment are … Several recent studies have documented that substantial functional impairment is associated with many of the mental disorders seen in primary care. However, brief measures of mental health-related functional impairment are not commonly applied in primary care settings. The Sheehan Disability Scale (SDS), a three-item instrument for assessing such impairment, is evaluated in this study.A psychometric analysis of the SDS was conducted with a sample of 1001 primary care patients at Kaiser Permanente In Oakland, California. The SDS and the Symptom Driven Diagnostic System for Primary Care assessments were completed.The internal consistency reliability of the SDS is high, with coefficient alpha of 0.89. The construct validity was substantiated in two ways. A one-factor model fit the data quite well. Furthermore, patients with each of six psychiatric disorders had significantly higher impairment scores than those who did not. Finally, over 80 percent of the patients with mental disorder diagnoses had an elevated SDS score and nearly 50 percent of those with elevated SDS scores had at least one disorder.The psychometric properties of the SDS were evaluated in primary care. The internal consistency reliability was high. The analyses also lend empirical support for the construct validity. The scale is a sensitive tool for identifying primary care patients with mental health-related functional impairment, who would warrant a diagnostically-oriented mental health assessment.

Emotion Modulation in PTSD: Clinical and Neurobiological Evidence for a Dissociative Subtype

2010-04-02

Ruth A. Lanius , Eric Vermetten , Richard J. Loewenstein +4 more

In this article, the authors present evidence regarding a dissociative subtype of PTSD, with clinical and neurobiological features that can be distinguished from nondissociative PTSD. The dissociative subtype is characterized … In this article, the authors present evidence regarding a dissociative subtype of PTSD, with clinical and neurobiological features that can be distinguished from nondissociative PTSD. The dissociative subtype is characterized by overmodulation of affect, while the more common undermodulated type involves the predominance of reexperiencing and hyperarousal symptoms. This article focuses on the neural manifestations of the dissociative subtype in PTSD and compares it to those underlying the reexperiencing/hyperaroused subtype. A model that includes these two types of emotion dysregulation in PTSD is described. In this model, reexperiencing/hyperarousal reactivity is viewed as a form of emotion dysregulation that involves emotional undermodulation, mediated by failure of prefrontal inhibition of limbic regions. In contrast, the dissociative subtype of PTSD is described as a form of emotion dysregulation that involves emotional overmodulation mediated by midline prefrontal inhibition of the same limbic regions. Both types of modulation are involved in a dynamic interplay and lead to alternating symptom profiles in PTSD. These findings have important implications for treatment of PTSD, including the need to assess patients with PTSD for dissociative symptoms and to incorporate the treatment of dissociative symptoms into stage-oriented trauma treatment.

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Detecting Awareness in the Vegetative State

2006-09-07

Adrian M. Owen , Martin R. Coleman , Mélanie Boly +3 more

We used functional magnetic resonance imaging to demonstrate preserved conscious awareness in a patient fulfilling the criteria for a diagnosis of vegetative state. When asked to imagine playing tennis or … We used functional magnetic resonance imaging to demonstrate preserved conscious awareness in a patient fulfilling the criteria for a diagnosis of vegetative state. When asked to imagine playing tennis or moving around her home, the patient activated predicted cortical areas in a manner indistinguishable from that of healthy volunteers.

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The 20-Item Toronto Alexithymia Scale

2003-09-01

James D. A. Parker , Graeme J. Taylor , R. Michael Bagby

A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects

1997-03-01

PH. SPINHOVEN , Johan Ormel , Peter P.A. Sloekers +3 more

Background. Research on the dimensional structure and reliability of the Hospital Anxiety and Depression Scale (HADS) and its relationship with age is scarce. Moreover, its efficacy in determining the presence … Background. Research on the dimensional structure and reliability of the Hospital Anxiety and Depression Scale (HADS) and its relationship with age is scarce. Moreover, its efficacy in determining the presence of depression in different patient groups has been questioned. Methods. Psychometric properties of the HADS were assessed in six different groups of Dutch subjects ( N = 6165): (1) a random sample of younger adults (age 18–65 years) ( N = 199); (2) a random sample of elderly subjects of 57 to 65 years of age ( N = 1901); (3) a random sample of elderly subjects of 66 years or older ( N = 3293); (4) a sample of consecutive general practice patients ( N = 112); (5) a sample of consecutive general medical out-patients with unexplained somatic symptoms ( N = 169); and (6) a sample of consecutive psychiatric out-patients ( N = 491). Results. Evidence for a two-factor solution corresponding to the original two subscales of the HADS was found, although anxiety and depression subscales were strongly correlated. Homogeneity and test–retest reliability of the total scale and the subscales were good. The dimensional structure and reliability of the HADS was stable across medical settings and age groups. The correlations between HADS scores and age were small. The total HADS scale showed a better balance between sensitivity and positive predictive value (PPV) in identifying cases of psychiatric disorder as defined by the Present State Examination than the depression subscale in identifying cases of unipolar depression as defined by ICD-8. Conclusions. The moderate PPV suggests that the HADS is best used as a screening questionnaire and not as a ‘case-identifier’ for psychiatric disorder or depression.

Pharmacological interventions for somatoform disorders in adults

2014-11-07

Maria Kleinstäuber , Michael Witthöft , Andrés Steffanowski +3 more

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Interoception: the sense of the physiological condition of the body

2003-07-16

AD Craig

An Insular View of Anxiety

2006-06-15

Martin P. Paulus , Murray B. Stein

Meditation experience is associated with increased cortical thickness

2005-11-07

Sara W. Lazar , Catherine E. Kerr , Rachel H. Wasserman +7 more

Previous research indicates that long-term meditation practice is associated with altered resting electroencephalogram patterns, suggestive of long lasting changes in brain activity. We hypothesized that meditation practice might also be … Previous research indicates that long-term meditation practice is associated with altered resting electroencephalogram patterns, suggestive of long lasting changes in brain activity. We hypothesized that meditation practice might also be associated with changes in the brain's physical structure. Magnetic resonance imaging was used to assess cortical thickness in 20 participants with extensive Insight meditation experience, which involves focused attention to internal experiences. Brain regions associated with attention, interoception and sensory processing were thicker in meditation participants than matched controls, including the prefrontal cortex and right anterior insula. Between-group differences in prefrontal cortical thickness were most pronounced in older participants, suggesting that meditation might offset age-related cortical thinning. Finally, the thickness of two regions correlated with meditation experience. These data provide the first structural evidence for experience-dependent cortical plasticity associated with meditation practice.

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Visceral Influences on Brain and Behavior

2013-02-01

Hugo Critchley , Neil A. Harrison

The Hospital Anxiety And Depression Scale.

2003-01-01

R. P. Snaith

There is a need to assess the contribution of mood disorder, especially anxiety and depression, in order to understand the experience of suffering in the setting of medical practice. Most … There is a need to assess the contribution of mood disorder, especially anxiety and depression, in order to understand the experience of suffering in the setting of medical practice. Most physicians are aware of this aspect of the illness of their patients but many feel incompetent to provide the patient with reliable information. The Hospital Anxiety And Depression Scale, or HADS, was designed to provide a simple yet reliable tool for use in medical practice. The term 'hospital' in its title suggests that it is only valid in such a setting but many studies conducted throughout the world have confirmed that it is valid when used in community settings and primary care medical practice. It should be emphasised that self-assessment scales are only valid for screening purposes; definitive diagnosis must rest on the process of clinical examination.

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The PHQ-15: Validity of a New Measure for Evaluating the Severity of Somatic Symptoms

2002-03-01

Kurt Kroenke , Robert L. Spitzer , Janet B. W. Williams

Objective Somatization is prevalent in primary care and is associated with substantial functional impairment and healthcare utilization. However, instruments for identifying and monitoring somatic symptoms are few in number and … Objective Somatization is prevalent in primary care and is associated with substantial functional impairment and healthcare utilization. However, instruments for identifying and monitoring somatic symptoms are few in number and not widely used. Therefore, we examined the validity of a brief measure of the severity of somatic symptoms. Methods The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-15 comprises 15 somatic symptoms from the PHQ, each symptom scored from 0 ("not bothered at all") to 2 ("bothered a lot"). The PHQ-15 was administered to 6000 patients in eight general internal medicine and family practice clinics and seven obstetrics-gynecology clinics. Outcomes included functional status as assessed by the 20-item Short-Form General Health Survey (SF-20), self-reported sick days and clinic visits, and symptom-related difficulty. Results As PHQ-15 somatic symptom severity increased, there was a substantial stepwise decrement in functional status on all six SF-20 subscales. Also, symptom-related difficulty, sick days, and healthcare utilization increased. PHQ-15 scores of 5, 10, 15, represented cutoff points for low, medium, and high somatic symptom severity, respectively. Somatic and depressive symptom severity had differential effects on outcomes. Results were similar in the primary care and obstetrics-gynecology samples. Conclusions The PHQ-15 is a brief, self-administered questionnaire that may be useful in screening for somatization and in monitoring somatic symptom severity in clinical practice and research.

Psychosomatic Medicine in Germany: More Timely than Ever

2016-01-01

Stephan Zipfel , Wolfgang Herzog , Johannes Kruse +1 more

In Germany, psychosomatic medicine is not a subspecialty of psychiatry, although it has clear connections in terms of shared models, methods, and overlapping care for patients.At some places, most prominently … In Germany, psychosomatic medicine is not a subspecialty of psychiatry, although it has clear connections in terms of shared models, methods, and overlapping care for patients.At some places, most prominently in Heidelberg and Tübingen, departments of psychosomatic medicine are part of overarching departments for internal medicine.The institutional independence of psychosomatic medicine in Germany is largely due to German psychiatry resisting the integration of psychotherapy as a core method.Hence, psychosomatic medicine developed independently as an institutional and academic basis for psychotherapy in medicine and later for integrated care models.The clinical core competency of German psychosomatic medicine is centered on integrated care for the following disorders: somatoform/functional disorders, eating disorders, somatopsychic disorders (including psycho-oncology, psychocardiology, neuropsychosomatics, and psychodiabetology), and psychotraumatology.An overlap with psychiatry exists in the fields of depressive, anxiety, and personality disorders.The following presents a brief overview of the current state of institutionalization, research, and teaching in the field of German psychosomatic medicine.

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Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

2019-03-14

Valery L. Feigin , Emma Nichols , Shazia Alam +7 more

<h2>Summary</h2><h3>Background</h3> Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study … <h2>Summary</h2><h3>Background</h3> Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders. <h3>Methods</h3> We estimated prevalence, incidence, deaths, and disability-adjusted life-years (DALYs; the sum of years of life lost [YLLs] and years lived with disability [YLDs]) by age and sex for 15 neurological disorder categories (tetanus, meningitis, encephalitis, stroke, brain and other CNS cancers, traumatic brain injury, spinal cord injury, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, motor neuron diseases, idiopathic epilepsy, migraine, tension-type headache, and a residual category for other less common neurological disorders) in 195 countries from 1990 to 2016. DisMod-MR 2.1, a Bayesian meta-regression tool, was the main method of estimation of prevalence and incidence, and the Cause of Death Ensemble model (CODEm) was used for mortality estimation. We quantified the contribution of 84 risks and combinations of risk to the disease estimates for the 15 neurological disorder categories using the GBD comparative risk assessment approach. <h3>Findings</h3> Globally, in 2016, neurological disorders were the leading cause of DALYs (276 million [95% UI 247–308]) and second leading cause of deaths (9·0 million [8·8–9·4]). The absolute number of deaths and DALYs from all neurological disorders combined increased (deaths by 39% [34–44] and DALYs by 15% [9–21]) whereas their age-standardised rates decreased (deaths by 28% [26–30] and DALYs by 27% [24–31]) between 1990 and 2016. The only neurological disorders that had a decrease in rates and absolute numbers of deaths and DALYs were tetanus, meningitis, and encephalitis. The four largest contributors of neurological DALYs were stroke (42·2% [38·6–46·1]), migraine (16·3% [11·7–20·8]), Alzheimer's and other dementias (10·4% [9·0–12·1]), and meningitis (7·9% [6·6–10·4]). For the combined neurological disorders, age-standardised DALY rates were significantly higher in males than in females (male-to-female ratio 1·12 [1·05–1·20]), but migraine, multiple sclerosis, and tension-type headache were more common and caused more burden in females, with male-to-female ratios of less than 0·7. The 84 risks quantified in GBD explain less than 10% of neurological disorder DALY burdens, except stroke, for which 88·8% (86·5–90·9) of DALYs are attributable to risk factors, and to a lesser extent Alzheimer's disease and other dementias (22·3% [11·8–35·1] of DALYs are risk attributable) and idiopathic epilepsy (14·1% [10·8–17·5] of DALYs are risk attributable). <h3>Interpretation</h3> Globally, the burden of neurological disorders, as measured by the absolute number of DALYs, continues to increase. As populations are growing and ageing, and the prevalence of major disabling neurological disorders steeply increases with age, governments will face increasing demand for treatment, rehabilitation, and support services for neurological disorders. The scarcity of established modifiable risks for most of the neurological burden demonstrates that new knowledge is required to develop effective prevention and treatment strategies. <h3>Funding</h3> Bill & Melinda Gates Foundation.

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Interoception and Mental Health: A Roadmap

2017-12-28

Sahib S. Khalsa , Ralph Adolphs , Oliver G. Cameron +7 more

Interoception refers to the process by which the nervous system senses, interprets, and integrates signals originating from within the body, providing a moment-by-moment mapping of the body's internal landscape across … Interoception refers to the process by which the nervous system senses, interprets, and integrates signals originating from within the body, providing a moment-by-moment mapping of the body's internal landscape across conscious and unconscious levels. Interoceptive signaling has been considered a component process of reflexes, urges, feelings, drives, adaptive responses, and cognitive and emotional experiences, highlighting its contributions to the maintenance of homeostatic functioning, body regulation, and survival. Dysfunction of interoception is increasingly recognized as an important component of different mental health conditions, including anxiety disorders, mood disorders, eating disorders, addictive disorders, and somatic symptom disorders. However, a number of conceptual and methodological challenges have made it difficult for interoceptive constructs to be broadly applied in mental health research and treatment settings. In November 2016, the Laureate Institute for Brain Research organized the first Interoception Summit, a gathering of interoception experts from around the world, with the goal of accelerating progress in understanding the role of interoception in mental health. The discussions at the meeting were organized around four themes: interoceptive assessment, interoceptive integration, interoceptive psychopathology, and the generation of a roadmap that could serve as a guide for future endeavors. This review article presents an overview of the emerging consensus generated by the meeting.

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Manic Depressive Insanity and Paranoia

1921-04-01

Emil Kraepelin

Renal interoception: form, function, and open questions

2025-06-25

Rose Z. Hill | Current Opinion in Neurobiology

Oscillatory markers of interoceptive attention: beta suppression as a neural signature of heartbeat processing

2025-06-25

Kristina I. Pultsina , Tiina Parviainen , Suvi Karjalainen | bioRxiv (Cold Spring Harbor Laboratory)

Interoceptive attention - the ability to selectively focus on internal bodily signals - has been linked to distinct neural responses, yet the contribution of oscillatory dynamics to this process remains … Interoceptive attention - the ability to selectively focus on internal bodily signals - has been linked to distinct neural responses, yet the contribution of oscillatory dynamics to this process remains underexplored. This study investigates the neural mechanisms underlying interoceptive attention by examining beta-band power suppression during heartbeat and auditory discrimination tasks. Fifty-one healthy participants engaged in interoceptive (heartbeat detection) and exteroceptive (auditory discrimination) tasks while their brain activity was measured using magnetoencephalography (MEG). The results revealed significant beta suppression time-locked to the R-peak in the somatosensory cortex, anterior cingulate cortex, mid-cingulate cortex, and dorsolateral prefrontal cortex from 310 to 530 ms post-R-peak. Beta suppression was more pronounced during interoceptive attention, correlating positively with interoceptive accuracy. The findings support the notion that beta suppression in fronto-cingulo-somatosensory network may serve as a neural marker of interoceptive processing, contributing to predictive coding models of interoception. This study highlights the potential for using beta suppression as an objective measure of interoceptive accuracy and suggests that neural oscillations play a critical role in the brain's regulation of heartbeat-related information. Furthermore, the study proposes that interoceptive attention involves a top-down mechanism that dynamically adjusts the brain's response to cardiac afferent signals, enhancing the precision of interoceptive processing. These findings have implications for understanding how the brain integrates interoceptive signals and may provide insights into clinical applications targeting interoceptive dysfunctions.

Psychosocial correlates of seizure severity in adults with functional/dissociative seizures (FDS): A systematic review

2025-06-25

Laura Whitaker , Gregg H. Rawlings , C. J. Gaskell +2 more | Epilepsy & Behavior

Perth Alexithymia Questionnaire-Short Form: Validity and Reliability Study for Turkish Population

2025-06-25

Azmi Çağlar , Yusuf Akyıl , Mehmet Fatih ŞİRAZ | Eğitim Bilimleri Dergisi

The aim of the study was to examine the reliability and validity of The Perth Alexithymia Questionnaire-Short Form (PAQ-S) in Turkish population. The study was conducted with a total of … The aim of the study was to examine the reliability and validity of The Perth Alexithymia Questionnaire-Short Form (PAQ-S) in Turkish population. The study was conducted with a total of 490 participants, 298 women and 192 men. In the Turkish adaptation process, language validity study was conducted first and then confirmatory factor analysis was conducted to examine construct validity. The fit values were found as the χ2/df ratio (χ2/df = 4.04 ≤ 5), SRMR (.040 ≤ .08), RMSEA (.079 ≤ .08), GFI (.977 ≥ .90), NFI (.919 ≥ .90), IFI (.938 ≥ .90), and CFI (.937 ≥ .90). Within the scope of criterion validity, the relationships between loneliness and resilience were examined. Reliability analyses revealed that McDonald's ω was .832, Cronbach's α was .830, and Guttman's λ6 was .824. In conclusion, according to the findings obtained from the validity and reliability studies of the Perth Alexithymia Questionnaire -Short Form, the scale can be used in Turkish culture and is a psychometrically valid and reliable tool for determining the alexithymia levels of individuals.

The Development and Initial Validation of the Very Short Form of the Short Dark Tetrad Scale: Its Links to Alexithymia, and Internet Trolling

2025-06-25

Muhammed Akat | Studia Psychologica

Neurophysiological Testing to Diagnose Stiff‐Person Spectrum Disorder

2025-06-25

Karlo J. Lizárraga , Petra Pavelekova , Robert Chen +1 more | Movement Disorders Clinical Practice

Psicologias integrativas baseadas em evidência, neuropsicologia e neuromodulação: reduzindo a recorrência no transtorno depressivo maior

2025-06-24

José Fernando de Souza Silva | Caderno Pedagógico

A depressão atinge cerca de 280 milhões de pessoas no mundo, todos os anos (WORLD HEALTH ORGANIZATION-WHO, 2023); considerada como incapacitante, causa prejuízo nas relações familiares, sociais e de trabalho, … A depressão atinge cerca de 280 milhões de pessoas no mundo, todos os anos (WORLD HEALTH ORGANIZATION-WHO, 2023); considerada como incapacitante, causa prejuízo nas relações familiares, sociais e de trabalho, além de potencializar o risco de suicídio (WHO, 2024a). O Brasil é o país da América Latina com maior prevalência de Depressão (GOV, 2022). Geralmente, o primeiro tratamento é medicamentoso e o gasto público e privado com medicamentos antidepressivos vem aumentando a cada ano no Brasil (Mattos, 2020). O Transtorno Depressivo Maior é multifatorial, com vários estágios, de manejo clínico complexo, podendo acarretar abandono do tratamento ou repetição dos episódios depressivos. Existem evidencias de que a utilização de biomarcadores, instrumentos de rastreio, testes neuropsicológicos e mapeamento por eletroencefalografia-EEG contribui para mensuração da depressão. A neuromodulação se apresenta como técnica coadjuvante promissora, porém seu acesso é limitado por custo e falta de neuroterapeutas treinados. A terapia com maior número de evidências é a terapia cognitivo-comportamental-TCC. As terapias cognitivo-comportamental, chamadas de terceira onda, são integrativas e buscam suprir lacunas da TCC tradicional. Dentre os fatores que levam a depressão, se encontram as experiencias adversas na infância e exposição a situações traumáticas. Para tratamento de estresse pós-traumático, a WHO recomenda utilização da terapia de dessensibilização e reprocessamento através dos movimentos oculares-EMDR e TCC (WHO 2024b). Esse estudo sugere integração das técnicas, novas pesquisas empíricas, treinamento universitário e convênio das universidades com o poder público e privado como forma de ampliar o acesso às melhores técnicas de combate a depressão e sua recorrência.

Subjective Sleep Gains in Empty Nose Syndrome: A Cautionary Note on the Need for Objective Validation

2025-06-24

Xiao Yu , Yidan Zhang , Hui Wang | International Forum of Allergy & Rhinology

Exploring Differential Patterns of Dissociation: Severity and Dimensions Across Diverse Trauma Experiences and/or Attention-Deficit/Hyperactivity Disorder Symptoms

2025-06-24

Rosario Esposito , Eduardo Maria Schettino , Veronica Buonincontri +3 more | Behavioral Sciences

Dissociative symptoms may result from both neurobiological conditions, such as Attention-Deficit/Hyperactivity Disorder (ADHD), and traumatic events/exposure, such as Post-Traumatic Stress Disorder (PTSD) and Adverse Childhood Experiences (ACEs). However, identifying whether … Dissociative symptoms may result from both neurobiological conditions, such as Attention-Deficit/Hyperactivity Disorder (ADHD), and traumatic events/exposure, such as Post-Traumatic Stress Disorder (PTSD) and Adverse Childhood Experiences (ACEs). However, identifying whether dissociative manifestations are associated with ADHD symptoms or trauma-related manifestations may drive clinicians to select the most effective intervention. Four hundred participants from the general population completed an online survey and were classified based on the presence of PTSD, ACEs, or ADHD symptoms. We compared the severity of dissociation and its dimensions across groups using the Dissociative Experiences Scale-II (DES-II) and explored its association with ADHD symptoms, PTSD manifestations, and ACEs. Dissociative symptoms were more pronounced in individuals with combined ADHD and PTSD or ACEs, but a hierarchical pattern of dissociation severity was also observed in isolated symptoms: ADHD > PTSD > ACEs. More specifically, participants who reported ADHD symptoms obtained higher scores on the Amnesia dimension of the DES-II than PTSD and more severe Absorption subscores than individuals reporting ACEs. Correlational analyses confirmed that DES-II scores were mostly associated with the scale evaluating the severity of ADHD symptoms rather than those evaluating trauma-related manifestations. These findings suggest that neurodevelopmental vulnerabilities, such as ADHD, may play a more significant role in dissociative symptomatology than trauma-related disorders.

Somatisation, Chronic Stress and The BodyMind Approach

2025-06-24

Helen Payne , Susan Brooks | Routledge eBooks

Efficacy of the Matrix Rhythm Therapy for Post Traumatic Trismus

2025-06-24

Ujjwal Joshi | International Journal of Oral and Maxillofacial Surgery

The role of sensory attenuation in symptomatic and healthy individuals: a scoping review

2025-06-23

Luca Rossi , Francesco Cerritelli , Michael Thacker +1 more | Frontiers in Neuroscience

Background Persistent physical symptoms (PPS), including functional neurological disorders (FND), chronic pain, and other neurological conditions [e.g., Parkinson’s disease (PD), Huntington’s disease (HD), autism spectrum disorder (ASD), and psychosis], present … Background Persistent physical symptoms (PPS), including functional neurological disorders (FND), chronic pain, and other neurological conditions [e.g., Parkinson’s disease (PD), Huntington’s disease (HD), autism spectrum disorder (ASD), and psychosis], present substantial challenges for healthcare systems due to their complex and multifaceted nature. These disorders often involve maladaptive sensory processing and heightened sensory perception, contributing to disability and psychological distress. Sensory attenuation (SA) is a neurophysiological mechanism that helps differentiate self-generated from external sensory stimuli, filtering irrelevant sensory input. Altered SA has been implicated in the pathophysiology of FND, chronic pain, and PPS, where impaired sensory modulation contributes to symptom persistence. Aims This scoping review aimed to explore the role of SA in healthy individuals and those with FND, neurological disorders, and chronic pain. A secondary objective was to examine SA measurement techniques and their clinical relevance. Methods Following the Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidelines, a comprehensive search of PubMed, ScienceDirect, and Google Scholar identified studies published between 2013 and 2023. Inclusion criteria encompassed investigations of SA in both symptomatic and healthy populations, focusing on FND, neurological disorders, and chronic pain. Data extraction highlighted SA mechanisms, assessment methods, and clinical implications for manual therapy and musculoskeletal (MSK) care. Results A total of 62 studies involving 3,344 participants were included. Findings indicated that SA is essential for sensorimotor integration and the sense of agency in healthy individuals. However, disruptions in SA were consistently observed in FND, chronic pain, and neurological disorders, leading to sensory hypersensitivity, impaired motor control, and a distorted sense of agency. SA was assessed using methods such as the force-matching paradigm, electroencephalography (EEG), event-related potentials (ERPs), and functional magnetic resonance imaging (fMRI), providing insights into neurophysiological alterations. Conclusion This review highlights the critical role of SA in adaptive sensory processing and its disruption in conditions like FND and chronic pain. Integrating SA-based interventions, such as sensorimotor retraining and affective touch, into manual therapy and MSK care may help recalibrate sensory processing and improve patient outcomes. Future research should focus on standardizing SA assessments and exploring its modulation in clinical settings to enhance person-centered therapeutic approaches.

From Inner Sense to Outer Action: Interoception and Impulsive Compulsive Behavior Disorders in Parkinson's Disease

2025-06-23

Chiara Baiano , Francesca Morgante , Diana Goeta +7 more | Movement Disorders Clinical Practice

Abstract Background Impulsive‐compulsive behavior disorders (ICBDs) in Parkinson's disease (PD) include impulse control disorders (ICDs) and compulsive behaviors, often linked to dopaminergic treatment and altered reward processing. Interoception, the perception … Abstract Background Impulsive‐compulsive behavior disorders (ICBDs) in Parkinson's disease (PD) include impulse control disorders (ICDs) and compulsive behaviors, often linked to dopaminergic treatment and altered reward processing. Interoception, the perception of internal bodily signals, plays a key role in emotional regulation and decision‐making. Neuroimaging studies suggest that alterations in interoceptive and reward‐related brain circuits may underlie ICDs in PD. However, the relationship between interoception and ICDs remains underexplored. Objective To investigate the relationship between impulse control disorders (ICD) severity and interoceptive abilities—specifically interoceptive accuracy, insight, and self‐reported interoception—in PD patients. Methods Fifty‐one participants were assessed using the Questionnaire for Impulsive‐Compulsive Disorders in Parkinson's Disease Rating Scale (QUIP‐RS) alongside measures of interoceptive performance, anxiety, depression, and apathy. Results Higher ICD severity predicted increased interoceptive insight and sensibility. No significant link was found between ICD severity and interoceptive accuracy. Additionally, higher Levodopa Equivalent Daily Dose (LEDD) was related to lower interoceptive insight, suggesting a potential modulatory effect of dopaminergic therapy on meta‐cognitive interoception. Conclusions These findings highlight the complex interplay between ICDs and interoception, suggesting that heightened self‐reported interoception and interoceptive insight may reinforce impulsive behaviors in PD via enhanced bodily signal salience. This study contributes to understanding the characteristics of ICDs in PD, implicating reward‐related circuits such as the insula and anterior cingulate cortex.

Rumination and Cognitive Distortion Levels in Temporal Lobe Epilepsy, Psychogenic Non-epileptic Seizures and Healthy Control Groups

2025-06-23

Yaren Bozkurt , Füsun Ferda Erdoğan , Duygu Kurt Gök | Archives of Epilepsy

Gaze fixation stability is a transdiagnostic marker of major psychiatric disorders: A high-density family-based study

2025-06-23

Swarna Buddha Nayok , Vanteemar S. Sreeraj , Sonika Nichenmetla +7 more

Abstract Background Eye movement tracking non-invasively captures subtle cognitive and neural differences. Fixation stability, the ability to maintain steady visual fixation, may serve as a transdiagnostic marker in major psychiatric … Abstract Background Eye movement tracking non-invasively captures subtle cognitive and neural differences. Fixation stability, the ability to maintain steady visual fixation, may serve as a transdiagnostic marker in major psychiatric disorders. This study evaluates fixation stability as a potential transdiagnostic endophenotype in families with multiple affected individuals. Methods Monocular eye tracking data was recorded using infrared cameras while participants fixed their gaze on a stimulus in trials with and without distractors. The fixation stability (FS) performance was compared across 449 individuals affected with major psychiatric disorders (26 Alzheimer’s Dementia (AD), 89 schizophrenia (SCZ), 116 bipolar disorder (BD), 98 obsessive-compulsive disorder (OCD), and 120 substance-use disorder (SUD)), 442 unaffected first degree relatives (FDRs) along with 145 healthy controls (HC). FS performance was compared across groups using a linear mixed effects model controlling for familiality, age and sex. Result Affected individuals performed significantly poorly (fixation frequency(F=6.37, p cor =0.003), median fixation duration(F=4.79, p cor =0.009), saccade frequency(F=7.74, p cor <0.001), mean saccade amplitude(F=4.92, p cor =0.009), mean scanpath length(F=6.83, p cor =0.003)) in the trials with distractors when compared to FDRs and HC. The performance of FDRs and HC did not differ significantly from that of the other. Furthermore, in a cross-diagnostic comparison, impaired performance was observed only in SCZ and BD, with both performing significantly worse than SUD, OCD, and HC. Conclusions FS performance was impaired in major psychiatric disorders compared to FDRs and HC. Instead of an endophenotype, FS measures serve as illness markers. SCZ and BD showed the greatest deficits, highlighting the strong impact of psychotic conditions on visuoperceptual processing.

Forum: Die Begleitung von Menschen mit Dissoziativer Identitätsstörung

2025-06-23

Cornelia Jakob-Krieger | körper – tanz – bewegung

<mb:p>Auf der Grundlage theoretischer Konzepte der Integrativen Therapie, dem Leibkonzept, der Intersubjektiven Ko-respondenz und dem komplexen Bewegungsbegriff werden in diesem Beitrag der Stellenwert der therapeutischen Beziehung und eine exemplarische Vorgehensweise … <mb:p>Auf der Grundlage theoretischer Konzepte der Integrativen Therapie, dem Leibkonzept, der Intersubjektiven Ko-respondenz und dem komplexen Bewegungsbegriff werden in diesem Beitrag der Stellenwert der therapeutischen Beziehung und eine exemplarische Vorgehensweise des Beziehungsaufbaus und der Beziehungsgestaltung in der Begleitung von Menschen mit einer Dissoziativen Identitätsstörung (DIS) aus der Sicht der Integrativen Leib- und Bewegungstherapie (IBT) beschrieben.</mb:p>

Fachbeitrag: Dissoziative Störungen

2025-06-23

| körper – tanz – bewegung

<ul:p>Dissoziative Störungen (DS) treten als eigene Erkrankung sowie als Symptom in Kombination mit Posttraumatischen Belastungsstörungen, Persönlichkeitsstörungen und als komorbide Störungen bei anderen psychischen Erkrankungen auf. Häufig liegen sehr frühe Traumatisierungen … <ul:p>Dissoziative Störungen (DS) treten als eigene Erkrankung sowie als Symptom in Kombination mit Posttraumatischen Belastungsstörungen, Persönlichkeitsstörungen und als komorbide Störungen bei anderen psychischen Erkrankungen auf. Häufig liegen sehr frühe Traumatisierungen zugrunde. Körperpsychotherapie hat sich in deren Behandlung mit verschiedenen Methoden seit Wilhelm Reich über fast 100 Jahre bewährt, insbesondere in der Arbeit mit Säuglingen und Eltern und mit Menschen mit Frühstörungen (z.B. Marlock/Weiss 2006, Harms 2017, Geuter 2015, Kuhfuß et al. 2021). Die Wirksamkeit der Funktionellen Entspannung in der Behandlung von Menschen mit DS konnte in einer randomisiert kontrollierten Studie nachgewiesen werden. Bewegungen, indirekt mit dem Atemrhythmus verbunden, regen die Selbstwahrnehmung an, die Selbstregulation von Patient:innen und Therapeut:innen wird aktiviert. Resonanzvorgänge, gegenseitige Regulation und verbaler Austausch darüber werden genutzt, um heute einen selbstfürsorglichen Umgang zu entwickeln und Traumatisierung zu transformieren.</ul:p>

Spor Bilimleri Alanında Deprem ve Depremin Psikososyal Etkileri Üzerine Türkiye’de Yapılan Araştırmaların Sistematik İncelemesi

2025-06-22

Günseli Duman , Çilem Bulut , Savaş Duman | Adnan Menderes Üniversitesi Sosyal Bilimler Enstitüsü Dergisi

TTürkiye, aktif fay hatları üzerinde yer alması nedeniyle tarih boyunca birçok yıkıcı deprem yaşamış ve bu afetler, bireylerin fiziksel ve psikososyal iyi oluşları üzerinde önemli etkiler bırakmıştır. Son yıllarda, spor … TTürkiye, aktif fay hatları üzerinde yer alması nedeniyle tarih boyunca birçok yıkıcı deprem yaşamış ve bu afetler, bireylerin fiziksel ve psikososyal iyi oluşları üzerinde önemli etkiler bırakmıştır. Son yıllarda, spor bilimleri alanında yapılan araştırmalar, depremin bireyler üzerindeki psikososyal etkilerini anlamaya ve sporun bu süreçte nasıl bir iyileştirici rol oynadığı göstermektedir. Bu bağlamda mevcut araştırmada, sistematik derleme modeli tercih edilmiştir. Araştırma kapsamında tercih edilen bu model doğrultusunda, Türkiye’de spor bilimleri alanında deprem ve depremin psikososyal etkileri üzerine gerçekleştirilen toplam 16 araştırma sistematik bir şekilde incelenmiştir. Çalışmaların ele aldığı temel konuların; depremin bireyler üzerindeki psikolojik etkileri, travmatik deneyimler, boş zaman aktivitelerinin stresle başa çıkma sürecine katkıları ve fiziksel aktivitenin ruh sağlığı üzerindeki olumlu etkileri üzerine olduğu görülmüştür. Yapılan incelemeler neticesinde; fiziksel aktivitenin ve sporun, depremden etkilenen bireylerde travma sonrası stres düzeyini azaltmada, psikolojik iyi oluşu desteklemede ve sosyal uyumu artırmada önemli bir rol oynadığı tespit edilmiştir. Ayrıca, boş zaman etkinliklerine katılımın stresle başa çıkma sürecinde etkili olduğu ve spor yapmayan bireylerin depremin olumsuz etkilerini daha yoğun hissettikleri belirlenmiştir. hissettikleri belirlenmiştir.

Fear of Physical Sensations and Metacognitions About Health Anxiety Mediate the Relationship Between Negative Affect and Health Anxiety

2025-06-22

Tiffany D. Carmichael , Alexander M. Penney | Journal of Rational-Emotive & Cognitive-Behavior Therapy

Alexithymia in Functional Defecation Disorder: The Incidence and the Effect on Treatment

2025-06-20

Sai Nan Shi , Bo Zhu , Mei Feng Wang +2 more | Journal of Digestive Diseases

ABSTRACT Objective We aimed to investigate the prevalence of alexithymia in patients with functional defecation disorder (FDD) and its impact on treatment outcomes. Methods FDD patients who underwent high‐resolution anorectal … ABSTRACT Objective We aimed to investigate the prevalence of alexithymia in patients with functional defecation disorder (FDD) and its impact on treatment outcomes. Methods FDD patients who underwent high‐resolution anorectal manometry and balloon expulsion test were enrolled. Symptoms, anorectal function, and treatment efficacy were assessed at baseline and after 4‐week medication. Results Alexithymia was present in 29.5% of all 129 FDD patients. Compared to the non‐alexithymia group, the alexithymia group had higher baseline scores for the Patient Assessment of Constipation‐Symptoms (PAC‐SYM) (19.0 vs. 15.0, p = 0.03), Patient Assessment of Constipation‐Quality of Life (PAC‐QOL) (67.0 vs. 26.0, p < 0.001), Zung's Self‐Rating Anxiety Scale (SAS) (44.5 vs. 30.0, p < 0.001), and Self‐Rating Depression Scale (SDS) (48.0 vs. 33.0, p < 0.001). Moreover, the improvements in post‐treatment complete spontaneous bowel movements (CSBMs) (0.0 vs. 1.5, p = 0.041), PAC‐SYM (0.0 vs. −11.5, p < 0.001), PAC‐QOL (0.0 vs. −16.0, p < 0.001), SAS (0.0 vs. −1.0, p < 0.001), and SDS (0.0 vs. −3.0, p < 0.001) scores were less significant in the alexithymia group than in the non‐alexithymia group. A high Toronto Alexithymia Scale‐20 score was an independent risk factor for drug therapy failure in FDD patients (odds ratio 0.949, 95% confidence interval 0.919–0.980, p = 0.001). Conclusion Alexithymia is prevalent in FDD patients and significantly affects symptom severity, quality of life, mental state, and treatment outcomes.

Cyberchondria Levels and Influencing Factors in Families of Asthma Patients

2025-06-20

Tuğçe Tatar Arık , Ahmet Kan , Masum Öztürk | Dicle Medical Journal / Dicle Tip Dergisi

Objective: Asthma is one of the most common chronic diseases in childhood. The term cyberchondria emphasizes excessive online health searches associated with increased distress or anxiety. Parents, especially pediatric patients, … Objective: Asthma is one of the most common chronic diseases in childhood. The term cyberchondria emphasizes excessive online health searches associated with increased distress or anxiety. Parents, especially pediatric patients, are responsible for managing the disease process. In this study, we examined the level of cyberchondria in families of asthmatic children and the factors affecting this level. Methods: Sixty asthma patients and their parents, aged 1-18 years, followed up with a diagnosis of asthma in the Pediatric Allergy and Immunology outpatient clinic between 14.04.2022 and 01.01.2023, were included. In addition, 60 parents of healthy children without chronic disease were also included as a control group. The parents’ cyberchondria severity levels of both groups were compared. Results: The median age of the asthma group was seven years. 45.6% of the patients were male. The mean cyberchondria severity score of the patient group was statistically significantly higher than that of the control group participants (p=0.02). A low-medium significant relationship was found between cyberchondria severity and the frequency of weekly internet access (p=0.009, r=0.35). In addition, there was a significant statistical correlation between cyberchondria severity and mother's education level (r=0.21, p=0.02) and father's education level (r=0.19, p=0.04). The cyberchondria severity score was higher in the group who wanted medical examinations other than the physician's recommendation (p=0.005). Conclusions: Parents with high cyberchondria severity experience more distress during chronic disease. If the parents' cyberchondria severity can be evaluated and determined promptly, their anxiety levels may be reduced with the necessary psychosocial support. Thus, trust in the physician and compliance with the treatment process can be increased. For this reason, the cyberchondria severity levels of parents with asthmatic children should be determined in time, and necessary psychosocial support should be provided.

Interoceptive Dysfunction in Psychiatric Disorders and Non-invasive Neuromodulation for Improving Interoception

2025-06-19

HuiRu Cui , Jijun Wang , Chunbo Li | Neuroscience Bulletin

Factors related to the occurrence of mass psychogenic illness in schools: a systematic review

2025-06-19

Aram Halimi , Alireza Mosavi Jarrahi , Naghmeh Kian +6 more | Social Psychiatry and Psychiatric Epidemiology

Psychological and behavioral correlates of health anxiety and other anxiety phenomena in adolescence—A cross‐sectional study in the Copenhagen Child Cohort 2000

2025-06-19

Charlotte Steen Duholm , Davíð R.M.A. Højgaard , Kaare Bro Wellnitz +4 more | JCPP Advances

Abstract Background Health anxiety (HA) is characterized by impairing worry about being or becoming seriously ill. This cross‐sectional study aimed to explore psychological and behavioral correlates of HA compared to … Abstract Background Health anxiety (HA) is characterized by impairing worry about being or becoming seriously ill. This cross‐sectional study aimed to explore psychological and behavioral correlates of HA compared to other anxiety phenomena in adolescents, that is, with respect to depression, physical symptoms, bodily dissatisfaction, health‐related quality of life (HRQoL) and healthcare utilization. Methods This study was pre‐registered at https://doi.org/10.17605/OSF.IO/YNBJG . We employed data from the 16/17‐year follow‐up ( N = 2438, 16/17 years old) from the general population‐based Copenhagen Child Cohort 2000. Health anxiety, anxiety, depression, physical symptoms, bodily dissatisfaction, and HRQoL were assessed using self‐report questionnaires, and linked to register data on healthcare utilization. Latent profile and latent class analyses were applied to explore if specific HA related profiles/classes could be detected. These analyses did not support the idea of HA being independent of other anxieties. Instead, four groups were created based on levels of HA and anxiety symptoms. Differences between the four groups regarding the various health‐related aspects were examined using relevant statistics. Results The four groups were: no anxieties ( N = 1822; 74.7%), high other anxiety ( N = 364; 14.9%), high HA ( N = 111; 4.6%), and both high HA and other anxiety ( N = 141; 5.8%). The high HA group reported fewer depressive symptoms, more physical symptoms, and higher healthcare utilization than those with high other anxiety. Compared to those without anxieties, both HA groups had worse scores on all psychological and behavioral correlates. Adolescents with both high HA and other anxiety symptoms reported most depressive and physical symptoms, highest bodily dissatisfaction, the lowest HRQoL and the highest healthcare utilization. Conclusion HA symptoms often co‐occur with additional anxiety symptoms but is specifically associated with significantly higher healthcare utilization, highlighting the importance of early recognition and intervention in youth to reduce its clinical impact.

The Diagnostic Odyssey of Dissociative Identity Disorder: A Case Report of Prolonged Misrecognition

2025-06-18

Eunsung Lim , Chi Eung Danforn Lim | Cureus

Dissociative identity disorder (DID) is characterised by two or more distinct personality states, often resulting from severe childhood trauma. The disorder is frequently misdiagnosed as depression, anxiety, or borderline personality … Dissociative identity disorder (DID) is characterised by two or more distinct personality states, often resulting from severe childhood trauma. The disorder is frequently misdiagnosed as depression, anxiety, or borderline personality disorder. This case study is regarding a 28-year-old Caucasian woman with mental health challenges since primary school, including a bullying and domestic violence history, who received multiple incorrect diagnoses (depression, anxiety, panic disorder) given by various psychiatrists, psychologists and general practitioners over several years. Patient treatment with tricyclic antidepressants, selective serotonin reuptake inhibitors, and serotonin-norepinephrine reuptake inhibitors failed to produce any improvements. At age 16, a specialist general practitioner considered the former diagnoses were incorrect and recognised the need for multidisciplinary assessment, leading to referral to a specific psychiatry diagnostic service at a tertiary teaching hospital, where she was correctly diagnosed with DID. Psychologists with a special interest in DID provided the patient with intensive psychotherapy sessions. Her 12-year journey through therapy resulted in significant mental health recovery in addition to finishing her university degree and obtaining a job. This case highlights the importance of recognising DID, challenges in differential diagnosis, and the need for specialised multidisciplinary care.

How to integrate physiological data from wearables in treatment of personality disorders: a narrative review

2025-06-18

Luuk Lans , K.M.L. Huijbregts , Gerben J. Westerhof +3 more | Frontiers in Psychiatry

In recent years, stress-monitoring innovations using wearable technology have entered the market. One innovation is biocueing, a process where patients receive real-time feedback on passive monitoring of significant changes in … In recent years, stress-monitoring innovations using wearable technology have entered the market. One innovation is biocueing, a process where patients receive real-time feedback on passive monitoring of significant changes in their physiological data, such as (additional) heart rate, heart rate variability or skin conductance. This technology offers potential for patients with borderline personality disorder, as they often report severe stress, difficulties in emotion regulation and low levels of emotional- and body awareness. Yet, currently there is no clear direction on when and how to fit these technologies, and physiology in general, into treatments for borderline personality disorder. We provide a comprehensive review on how and to what extent evidence-based treatments (Transference Focused Psychotherapy, Mentalization Based Treatment, Schema Therapy, Dialectical Behavior Therapy), and their underpinning theories provide guidance and predictions for integrating these technologies. Only Dialectical Behavior Therapy provide a theoretical framework that includes physiology, as well as interventions that actively target physiological data, whereas the other evidence-based treatments largely disregard physiology. Other promising developments are Creative Arts and Psychomotor Therapies and the Polyvagal theory, as they target bodily sensations and physiology more directly. Four avenues for future research and integration of psychophysiological theory and wearable technology in treatment are discussed: abandoning physiological data and technology, keeping a human in the loop, machine-learning biocueing interventions, or biomonitoring devices as long-term (mental) health monitors.

Defense mechanisms in immune-mediated diseases: a cross-sectional study focusing on Severe Allergic Asthma and Hymenoptera Venom Anaphylaxis patients

2025-06-18

Gabriella Martino , Mariagrazia Di Giuseppe , Orlando Silvestro +7 more | Frontiers in Psychology

Background Chronic immune-mediated diseases, such as Severe Allergic Asthma (SAA) and Hymenoptera Venom Anaphylaxis (HVA), significantly impact quality of life. Defense mechanisms, as implicit emotion-regulation strategies, shape an individual’s adaptation … Background Chronic immune-mediated diseases, such as Severe Allergic Asthma (SAA) and Hymenoptera Venom Anaphylaxis (HVA), significantly impact quality of life. Defense mechanisms, as implicit emotion-regulation strategies, shape an individual’s adaptation to chronic stressors. This cross-sectional study explored the relationship among defensive functioning, psychological symptoms, and perceived physical and mental health in patients with SAA and HVA. Methods To explore the role of defensive functioning in perceived physical and mental health 34 patients with SAA and 32 with HVA were assessed with the Short-Form Health Survey, the Beck Depression Inventory, the Hamilton Anxiety Rating Scale, the Toronto Alexithymia Scale, and the Defense Mechanisms Rating Scales Self Report-30; between-group differences, and mediation analyses were performed. Results Defensive functioning was positively associated with mental health and negatively related to depressive symptoms, anxiety and alexithymia. Males reported significantly higher physical and psychological health than females. Patients with SAA exhibited significantly higher defensive functioning but worse physical health than HVA patients. Mediation analysis revealed that defensive functioning correlated with disease type and physical health, accounting for 39% of the explained variances. Moreover, defensive functioning independently predicted mental health. Conclusion This study highlights the influence of implicit emotional regulation on psychophysiological well-being in patients with chronic immune-mediated disorders. Despite reporting lower perceived physical health, patients with SAA exhibited higher defensive functioning, suggesting that chronic conditions may shape distinct psychological adaptation processes. These findings support the importance of defence mechanisms assessment to tailor psychological interventions promoting well-being in patients with chronic diseases.

The association between alexithymia and internet addiction disorder in a large sample of Chinese undergraduates: the role of sexual assault experiences

2025-06-18

Fangxinrui Qiu , Wanjie Tang , Tao Hu +3 more | Frontiers in Public Health

Objective While a positive association between alexithymia and Internet Addiction Disorder (IAD) has been established, previous studies are often limited by small sample sizes, lack of representative populations, and insufficient … Objective While a positive association between alexithymia and Internet Addiction Disorder (IAD) has been established, previous studies are often limited by small sample sizes, lack of representative populations, and insufficient attention to intra-group differences, such as the impact of experiences like sexual assault. Method Anonymous questionnaires assessing alexithymia and IAD were distributed to approximately 11,000 university students across six institutions in Southwest China, resulting in 7,890 valid responses. In addition to measures of alexithymia and IAD, data were also collected on experiences of sexual assault, psychological distress, and a range of sociodemographic variables. Results Alexithymia was directly associated with IAD ( r = 0.40), and past experiences of sexual assault were found to exacerbate the negative impact of alexithymia on IAD symptoms, even after controlling for psychological distress and gender. Individuals who had experienced sexual assault reported significantly higher levels of alexithymia, psychological distress, and IAD compared to those who had not. Conclusion To address the high prevalence of IAD among college students, it is essential to screen for difficulties in emotional identification and expression, and to provide support for improving these skills. Targeted interventions are especially important for vulnerable groups, such as survivors of sexual assault, to help reduce the risk of IAD. Future longitudinal studies are needed to further explore these relationships.

Cyberchondria and The Psychological Effects of Health Information Online

2025-06-18

Lidia Sandra | Syntax Literate Jurnal Ilmiah Indonesia

Many people today experience both higher levels of health anxiety and difficulties with their emotional well-being due to an excessive reliance on the internet to gather health information. This study … Many people today experience both higher levels of health anxiety and difficulties with their emotional well-being due to an excessive reliance on the internet to gather health information. This study aims to investigate how excessive health-related internet research impacts anxiety and the need for constant reassurances in adults who use the internet. The goal of this study is to understand how engaging with health information online affects emotions and to determine if digital health literacy plays any role in these relationships. We evaluated associations between cyberchondria, anxiety, and compulsive reassurance-seeking by having 350 participants complete the CSS-15, GAD-7, and a digital health literacy questionnaire. It was found that people with higher levels of cyberchondria often experience more severe health anxiety (β = .56, p < .001) as well as the need for frequent reassurance from others. Those with less digital health literacy experience markedly increased anxiety following their use of internet health resources (p < .01). Having better skills and knowledge to interpret online health information helps to reduce the negative mental health outcomes linked to spending too much time searching for health details online. The results highlight the importance of promoting digital literacy and responsible online health information seeking among the public. Encouraging proper knowledge and counsel for cyberchondria reduces anxiety levels and the burden on healthcare services. This research reveals the influence the internet has over people’s online health-seeking behaviors as well as the associated impact on their psychological well-being.

Developing an Outpatient Transdisciplinary Functional Movement Disorder Program: 1‐Year Experience

2025-06-18

Gabriela S. Gilmour , Kayla Fritz , Joanne Stephen +7 more | Movement Disorders Clinical Practice

Exploring alexithymia with the French Perth alexithymia questionnaire: latent structure, profiles, and links with affective outcomes

2025-06-17

Carole Fantini‐Hauwel , Cassandra Gois , Olivier Luminet +4 more | Frontiers in Psychology

Introduction Alexithymia is of high clinical interest and its measurement remains an important evolving area of research. The Perth Alexithymia Questionnaire (PAQ) is a self-report measure designed to enable facet-level … Introduction Alexithymia is of high clinical interest and its measurement remains an important evolving area of research. The Perth Alexithymia Questionnaire (PAQ) is a self-report measure designed to enable facet-level and valence-specific assessments of alexithymia. Here we aimed to introduce a French version of the PAQ, examine its psychometric performance, and use the PAQ to further explore the nature of the alexithymia construct. Method Participants in Belgium ( N = 481) completed the PAQ and other self-report measures. Factor structure, reliability, and concurrent/discriminant validity were assessed, as well as an exploration of alexithymia profiles with latent profile analysis (LPA). Results Confirmatory factor analysis confirmed the PAQ had a theoretically congruent factor structure. All PAQ scores had high reliability and showed good concurrent validity with other measures of alexithymia, emotion regulation, and psychopathology. Sound discriminant validity was also established. Our LPA extracted eight profiles, highlighting the value of facet-level and valence-specific analysis of alexithymia. Some profiles had difficulties in all facets of alexithymia and both valence domains, whereas others had difficulties only in the appraisal of negative emotions. Conclusion Overall, our results indicate that the French PAQ has strong psychometric properties, and that facet-level and valence-specific assessments can be valuable in further understanding the alexithymia construct.

The low-flow mask oxygen could be a more effective, comfortable, and easy-to-follow treatment for psychogenic hyperventilation syndrome: A double-blind, randomized controlled trial

2025-06-17

linhe yang , Dongmei Yuan , Zhenyu Luo +2 more | International Emergency Nursing

Unraveling functional neurological disorder in pediatric populations: A systematic review of diagnosis, treatment, and outcomes

2025-06-16

Mohammed Al‐Beltagi , Nermin Kamal Saeed , Adel Salah Bediwy +2 more | World Journal of Clinical Pediatrics

BACKGROUND Functional neurological disorder (FND) in children is a complex and multifaceted condition characterized by neurological symptoms that cannot be explained by organic pathology. Despite its prevalence, FND in pediatric … BACKGROUND Functional neurological disorder (FND) in children is a complex and multifaceted condition characterized by neurological symptoms that cannot be explained by organic pathology. Despite its prevalence, FND in pediatric populations remains under-researched, with challenges in diagnosis and management AIM To synthesize the current literature on FND in children, focusing on clinical presentation, diagnostic approaches, treatment strategies, and outcomes. METHODS A comprehensive literature search was conducted across multiple databases, including PubMed, Scopus, and Web of Science, for articles published up to August 2024. Studies were included if they addressed FND in pediatric populations, specifically focusing on review articles, research articles, systematic reviews, meta-analyses, case reports, guidelines, expert opinions, and editorials. Data extraction and quality assessment were performed according to PRISMA guidelines. A total of 308 articles were included in the final analysis. RESULTS The analysis included 189 review articles, 57 research articles, 3 systematic reviews and meta-analyses, 5 case reports, 2 guidelines, 5 expert opinions, and 2 editorials. Key findings revealed a broad spectrum of symptoms, including motor and sensory disturbances and psychological factors contributing to the onset and persistence of FND. Diagnostic challenges were frequently highlighted, emphasizing the need for interdisciplinary approaches. Treatment strategies varied, with cognitive-behavioral therapy (CBT) and multidisciplinary care emerging as the most effective approaches. The outcomes varied, with early intervention being critical for a better prognosis. CONCLUSION Early diagnosis and multidisciplinary care, including CBT, are critical for improving outcomes in pediatric FND. Standardized diagnostic criteria and treatment protocols are needed to enhance clinical management.

Pimavanserin safety in adult and elderly patients with neuropsychiatric symptoms related to neurodegenerative disease: An open-label extension study

2025-06-16

Wiesław Jerzy Cubała , Ana Berrio , Katherine Chi-Burris +3 more | Journal of Alzheimer s Disease

Background An 8-week, phase 3b, randomized, placebo-controlled trial demonstrated that pimavanserin, a selective 5HT 2A inverse agonist, is generally well tolerated in elderly patients with neuropsychiatric symptoms related to neurodegenerative … Background An 8-week, phase 3b, randomized, placebo-controlled trial demonstrated that pimavanserin, a selective 5HT 2A inverse agonist, is generally well tolerated in elderly patients with neuropsychiatric symptoms related to neurodegenerative disease (NDD). Objective This open-label extension (OLE) study assessed the long-term safety and tolerability of pimavanserin. Methods Patients from the antecedent double-blind (DB) trial who were treated with oral pimavanserin (34 mg/day) or placebo were enrolled. The safety analysis population included all patients who received ≥1 dose of pimavanserin. The primary endpoint was treatment-emergent adverse events (TEAEs). Exploratory endpoints included change from baseline in Extrapyramidal Symptom Rating Scale-Abbreviated (ESRS-A), Mini-Mental State Examination (MMSE), Clinical Global Impression-Severity (CGI-S), EuroQoL 5-Dimension 5-Level (EQ-5D-5L), and Sleep Disorders Inventory (SDI) scores. Results Patients (N = 595; mean age, 72.2 years) received pimavanserin treatment (mean exposure, 312.4 days). Most patients (95.3%) had dementia (68.7% of whom had Alzheimer's disease), and 70.6% were concomitantly treated with anti-dementia drugs. TEAEs occurred in 238 (40.0%) patients, and 37 (6.2%) had a serious TEAE; 1 (0.2%) was pimavanserin-related. TEAEs resulted in treatment discontinuation in 39 (6.6%) patients. Fatal TEAEs occurred in 11 (1.8%) patients (none considered related to pimavanserin). The mean (standard error) change from DB baseline to OLE Week 52 in MMSE, ESRS-A, CGI-S, EQ-5D-5L, and SDI scores was +0.9 (0.21), −0.3 (0.22), −1.0 (0.05), + 10.7 (0.87), and −0.9 (0.07), respectively. No patients reported suicidal behavior. Conclusions Pimavanserin was generally well tolerated in frail older adults and elderly patients with neuropsychiatric symptoms related to NDD for up to 52 weeks of treatment.

Prevalence of the anti-CASPR2 autoantibody in patients with somatic symptom disorder accompanied by medically unexplained pain

2025-06-16

Shingo Katayama , Gayatri Nayanar , Takayuki Suga +6 more | Brain Behavior & Immunity - Health

Neural Insights

2025-06-16

Jannavi Srinivasan , R. Vijayalakshmi , Arash Adel +4 more | Advances in computational intelligence and robotics book series

This research study aims to conduct a real-time analysis of employee involvement in the workplace by examining the possible applications of brain-computer interfaces, or BCIs. Brain-computer interfaces (BCIs) provide a … This research study aims to conduct a real-time analysis of employee involvement in the workplace by examining the possible applications of brain-computer interfaces, or BCIs. Brain-computer interfaces (BCIs) provide a novel means of monitoring employee engagement by directly detecting brain activity. As such, there is no longer a need to depend exclusively on the already employed self-reporting techniques, which may be arbitrary and inaccurate. This study aims to assess whether brain-computer interfaces or BCIs, can be integrated into employee monitoring systems that already exist. More precisely, how real-time neural data may improve the precision of engagement assessments is the main area of interest. Some of the most important issues that are now being addressed include the processing of brain impulses, ensuring the ethical use of such technology, and maintaining user comfort. Based on the results, it seems that BCI-based engagement analysis offers deeper insights into employees' states, which helps companies react more quickly to changes in employee engagement.

The relevance of cardiac and gastric interoception for disordered eating behavior

2025-06-16

A. Tiemann , Julie Ortmann , Marius Rubo +4 more | Journal of Eating Disorders

Abstract Background Gastric interoception (i.e., the perception of gastrointestinal signals such as hunger, satiety or nausea) in the context of eating has recently gained increasing research attention. Nevertheless, it remains … Abstract Background Gastric interoception (i.e., the perception of gastrointestinal signals such as hunger, satiety or nausea) in the context of eating has recently gained increasing research attention. Nevertheless, it remains poorly understood how different interoceptive dimensions (e.g., self-report) and organ systems (e.g., cardiac, gastric) relate to each other and to disordered eating behaviors such as emotional, external and restrained eating. We assessed multiple dimensions (behavioral, self-reported, and physiological) in the cardiac domain (interoceptive accuracy, interoceptive self-report, interoceptive insight and objective physiological state) and in the gastric domain (gastric interoceptive sensitivity, gastric attribution of interoceptive sensations, interoceptive self-report, interoceptive insight and objective physiological state). The first goal of this study was to examine the relationship between cardiac and gastric interoception measured via multiple dimensions (behavioral, self-reported, and physiological). The second goal was to investigate whether multidimensional gastric interoception was a more important predictor of emotional, external and restrained eating than multidimensional cardiac interoception. Methods Our sample ( n = 128) was predominantly female ( n = 116), included healthy individuals ( n = 87) and individuals with an eating disorder or sub-clinical eating disorder ( n = 41). Instruments included a heartbeat counting task, the two-step Water Load Test, electrocardiogram, electrogastrogram and the Dutch-Eating Behaviour Questionnaire. We used correlation analysis, multiple regressions, and LASSO regressions. The final sample included in the multiple regression and LASSO regressions resulted in N = 89. Results Results showed cardiac and gastric interoception to be distinguishable, yet not to be entirely independent processes. Results further suggest gastric and not cardiac interoception to be the most important predictor of emotional, external and restrained eating. Specifically gastric attribution of interoceptive sensations played the most important role in all disordered eating behaviors. Conclusions Our findings highlight the importance of the gastric system in the assessment and targeted treatment of disordered eating behaviors. Future research should consider adding additional interoceptive dimensions.

The Role of the Psychotherapist’s Interoception in the Therapeutic Alliance

2025-06-16

Satu Halonen , Aarno Laitila , Tiina Parviainen +1 more | Journal of Contemporary Psychotherapy

Abstract How therapists’ interoceptive accuracy or awareness affects the therapy process, and especially the therapeutic alliance, has not been previously studied. In this paper, data on objectively defined interoceptive accuracy … Abstract How therapists’ interoceptive accuracy or awareness affects the therapy process, and especially the therapeutic alliance, has not been previously studied. In this paper, data on objectively defined interoceptive accuracy and subjectively assessed interoceptive awareness were collected from forty Finnish psychotherapists. Interoceptive accuracy was measured with a heartbeat discrimination task and interoceptive awareness using the Multidimensional Assessment of Interoceptive Awareness, version 2, questionnaire. The therapists and their clients evaluated their experience of the alliance and provided written descriptions of each session in the study period. Using mixed methods, we then examined the associations between interoception and the therapeutic alliance and client wellbeing, as well as how psychotherapists used their internal bodily sensations as a source of information. The key result of this study showed that the therapists’ interoceptive accuracy and awareness were positively correlated with their experience of the alliance. Through thematic analysis, we identified five sub-themes that illustrate how bodily sensations serve as a source of information for the psychotherapist. However, the therapists’ interoceptive accuracy or awareness were not associated with the clients’ experiences of alliance or their wellbeing. In conclusion, a psychotherapist’s increased interoceptive accuracy and high level of interoceptive awareness enhance the therapist’s own experience of therapeutic alliance with the client. In addition, their increased awareness of internal bodily sensations also brings more elaborated information to the therapeutic process.

“They Said It Was All in My Head”: Bioethical Reflections on Misdiagnosis in Functional Neurological Disorder

2025-06-16

Ioannis Mavroudis , Alexiou Pavlina , Foivos Petridis +1 more | Research Square (Research Square)

<title>Abstract</title> Background: Functional Neurological Disorder (FND) is frequently associated with diagnostic uncertainty, stigma, and dismissal by healthcare providers. These experiences raise significant ethical concerns that extend beyond clinical error, impacting … <title>Abstract</title> Background: Functional Neurological Disorder (FND) is frequently associated with diagnostic uncertainty, stigma, and dismissal by healthcare providers. These experiences raise significant ethical concerns that extend beyond clinical error, impacting trust, identity, and patient well-being. Objective: This study aimed to explore the bioethical dimensions of misdiagnosis and clinical dismissal in FND by analyzing patient narratives shared publicly on Reddit. Methods: A qualitative narrative bioethics approach was applied to 704 Reddit posts from the r/FND subreddit. Posts were coded thematically and interpreted using the four principles of biomedical ethics—autonomy, beneficence, non-maleficence, and justice—alongside the concept of epistemic injustice. Sentiment and lexical analyses supported ethical interpretation. Results: Three core themes were identified: (1) Epistemic marginalization and loss of autonomy, (2) Harm and diagnostic drift, and (3) Struggles for ethical recognition and justice. Patients described feeling dismissed, misdiagnosed, and morally invalidated. Sentiment analysis revealed high emotional distress. Ethical failures included lack of informed dialogue, stigmatizing assumptions, and systemic disparities in access and credibility. Conclusion: Misdiagnosis in FND entails not only clinical misjudgment but also bioethical harm. To improve patient care, ethical literacy must be integrated into diagnostic processes, emphasizing epistemic humility, collaborative decision-making, and patient-centered recognition.

Decoding the Enigmatic Link Between Sensory Impairment and Organic Mental Disorders: Insights From Biological Aging and Social Support in a Population Cohort Study

2025-06-16

Ce Liu , Li He , Ya Xiao +7 more | Journal of the American Medical Directors Association