Autonomy-connectedness mediates sex differences in symptoms of psychopathology.
ABSTRACT: This study aimed to examine if autonomy-connectedness, capacity for self-governance under the condition of connectedness, would mediate sex differences in symptoms of various mental disorders (depression, anxiety, eating disorders, antisocial personality disorder).Participants (N = 5,525) from a representative community sample in the Netherlands filled out questionnaires regarding the variables under study.Autonomy-connectedness (self-awareness, SA; sensitivity to others, SO; capacity for managing new situations, CMNS) fully mediated the sex differences in depression and anxiety, and partly in eating disorder -(drive for thinness, bulimia, and body dissatisfaction) and anti-social personality disorder characteristics. The mediations followed the expected sex-specific patterns. SO related positively to the internalizing disorder indices, and negatively to the anti-social personality disorder. SA related negatively to all disorder indices; and CMNS to all internalizing disorder indices, but positively to the anti-social personality disorder.Treatment of depression, anxiety, but also eating disorders and the antisocial personality disorder may benefit from a stronger focus on autonomy strengthening.
Project description:OBJECTIVE:To present current, nationally representative US findings on prevalence, correlates, psychiatric comorbidity, disability, and treatment of DSM-5 antisocial personality disorder (ASPD) and adulthood antisocial behavioral syndrome without conduct disorder before 15 years of age (AABS). METHOD:Face-to-face interviews were conducted with respondents (N = 36,309) in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. DSM-5 alcohol, nicotine, and specific drug use disorders and selected mood, anxiety, trauma-related, eating, and personality disorders were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5. RESULTS:Prevalences of ASPD and AABS were 4.3% and 20.3%, respectively, and were highest among male, white, Native American, younger, and unmarried respondents, those with high school or less education, lower incomes, and Western residence. Both antisocial syndromes were significantly associated with 12-month and lifetime substance use, dysthymia/persistent depressive, bipolar I, posttraumatic stress, and borderline and schizotypal personality disorders (odds ratios [ORs] = 1.2-7.0). ASPD was additionally associated with 12-month agoraphobia and lifetime generalized anxiety disorder (ORs = 1.3-1.6); AABS, with 12-month and lifetime major depressive and 12-month generalized anxiety disorders (ORs = 1.2-1.3). Both were associated with significant disability (P < .001 to .01). Most antisocial survey respondents were untreated. CONCLUSIONS:One in 4 US adults exhibits syndromal antisocial behavior, with similar sociodemographic and psychiatric correlates and disability regardless of whether onset occurred before 15 years of age, illustrating the clinical and public health significance of both ASPD and AABS. In addition to laying groundwork for estimates of social and economic costs, and further etiologic and nosologic research, these findings highlight the urgency of effectively preventing and treating antisocial syndromes, including investigation of whether treatment for comorbidity hastens symptomatic remission and improves quality-of-life outcomes.
Project description:Although links between childhood residential mobility and subsequently increased risks of psychopathology have been well documented, associations across the full spectrum of psychiatric disorders are unknown. We conducted a population-based study of all 1,439,363 persons born in Denmark during 1971-1997 to investigate relationships between childhood cross-municipality residential moves from year of birth to age 14 years and the development of a range of psychiatric disorders from mid-adolescence to early middle age. We examined: (1) Any substance misuse disorders; specifically alcohol misuse, and cannabis misuse; (2) Any personality disorders; specifically antisocial, and borderline personality disorders; (3) Schizophrenia and related disorders; specifically schizophrenia, and schizoaffective disorder; (4) Any mood disorders; specifically bipolar disorder, and depressive disorder; (5) Any anxiety and somatoform disorders; specifically obsessive compulsive disorder; (6) Any eating disorders; specifically anorexia nervosa. Childhood residential mobility was associated with elevated risks of developing most psychiatric disorders, even after controlling for potential confounders. The associations generally rose with increasing age at moving and were stronger for multiple moves in a year compared to a single move. Links were particularly strong for antisocial personality disorder, any substance misuse disorder, and cannabis misuse in particular, for which the highest increases in risks were observed if relocation occurred during adolescence. Childhood residential change was not linked to subsequent risk of developing an eating disorder. Frequent residential mobility could be a marker for familial adversities. Mental health services and schools need to be vigilant of the psychosocial needs of children, particularly adolescents, who have recently moved homes.
Project description:We examined the relationship between psychopathology and interpersonal problems in a sample of 825 clinical and community participants. Sixteen psychiatric diagnoses and five transdiagnostic dimensions were examined in relation to self-reported interpersonal problems. The structural summary method was used with the Inventory of Interpersonal Problems Circumplex Scales to examine interpersonal problem profiles for each diagnosis and dimension. We built a structural model of mental disorders including factors corresponding to detachment (avoidant personality, social phobia, major depression), internalizing (dependent personality, borderline personality, panic disorder, posttraumatic stress, major depression), disinhibition (antisocial personality, drug dependence, alcohol dependence, borderline personality), dominance (histrionic personality, narcissistic personality, paranoid personality), and compulsivity (obsessive-compulsive personality). All dimensions showed good interpersonal prototypicality (e.g., detachment was defined by a socially avoidant/nonassertive interpersonal profile) except for internalizing, which was diffusely associated with elevated interpersonal distress. The findings for individual disorders were largely consistent with the dimension that each disorder loaded on, with the exception of the internalizing and dominance disorders, which were interpersonally heterogeneous. These results replicate previous findings and provide novel insights into social dysfunction in psychopathology by wedding the power of hierarchical (i.e., dimensional) modeling and interpersonal circumplex assessment.
Project description:Alcohol use disorder (AUD) is among the most stigmatized health conditions and is frequently comorbid with mood, anxiety, and drug use disorders. Theoretical frameworks have conceptualized stigma-related stress as a predictor of psychiatric disorders. We described profiles of psychiatric comorbidity among people with AUD and compared levels of perceived alcohol stigma across profiles.Cross-sectional data were analyzed from a general population sample of U.S. adults with past-year DSM-5 AUD (n = 3,368) from the National Epidemiologic Survey on Alcohol and Related Conditions, which was collected from 2001 to 2005. Empirically derived psychiatric comorbidity profiles were established with latent class analysis, and mean levels of perceived alcohol stigma were compared across the latent classes while adjusting for sociodemographic characteristics and AUD severity.Four classes of psychiatric comorbidity emerged within this AUD sample, including those with: (i) high comorbidity, reflecting internalizing (i.e., mood and anxiety disorders) and externalizing (i.e., antisocial personality and drug use disorders) disorders; (ii) externalizing comorbidity; (iii) internalizing comorbidity; and (iv) no comorbidity. Perceived alcohol stigma was significantly higher in those with internalizing comorbidity (but not those with high comorbidity) as compared to those with no comorbidity or externalizing comorbidity.Perceived stigma, as manifested by anticipations of social rejection and discrimination, may increase risk of internalizing psychiatric comorbidity. Alternatively, internalizing psychiatric comorbidity could sensitize affected individuals to perceive more negative attitudes toward them. Future research is needed to understand causal and bidirectional associations between alcohol stigma and psychiatric comorbidity.
Project description:The authors sought to clarify the structure of the genetic and environmental risk factors for 22 DSM-IV disorders: 12 common axis I disorders and all 10 axis II disorders.The authors examined syndromal and subsyndromal axis I diagnoses and five categories reflecting number of endorsed criteria for axis II disorders in 2,111 personally interviewed young adult members of the Norwegian Institute of Public Health Twin Panel.Four correlated genetic factors were identified: axis I internalizing, axis II internalizing, axis I externalizing, and axis II externalizing. Factors 1 and 2 and factors 3 and 4 were moderately correlated, supporting the importance of the internalizing-externalizing distinction. Five disorders had substantial loadings on two factors: borderline personality disorder (factors 3 and 4), somatoform disorder (factors 1 and 2), paranoid and dependent personality disorders (factors 2 and 4), and eating disorders (factors 1 and 4). Three correlated environmental factors were identified: axis II disorders, axis I internalizing disorders, and externalizing disorders versus anxiety disorders.Common axis I and II psychiatric disorders have a coherent underlying genetic structure that reflects two major dimensions: internalizing versus externalizing, and axis I versus axis II. The underlying structure of environmental influences is quite different. The organization of common psychiatric disorders into coherent groups results largely from genetic, not environmental, factors. These results should be interpreted in the context of unavoidable limitations of current statistical methods applied to this number of diagnostic categories.
Project description:The traditional view that mental disorders are distinct, categorical disorders has been challenged by evidence that disorders are highly comorbid and exist on a continuum (e.g., Caspi et al., 2014; Tackett et al., 2013). The first objective of this study was to use structural equation modeling to model the structure of psychopathology in an adolescent community-based sample (N = 2,144) including conduct disorder, attention-deficit/hyperactivity disorder (ADHD), oppositional-defiant disorder (ODD), obsessive-compulsive disorder, eating disorders, substance use, anxiety, depression, phobias, and other emotional symptoms, assessed at 16 years. The second objective was to identify common personality and cognitive correlates of psychopathology, assessed at 14 years. Results showed that psychopathology at 16 years fit 2 bifactor models equally well: (a) a bifactor model, reflecting a general psychopathology factor, as well as specific externalizing (representing mainly substance misuse and low ADHD) and internalizing factors; and (b) a bifactor model with a general psychopathology factor and 3 specific externalizing (representing mainly ADHD and ODD), substance use and internalizing factors. The general psychopathology factor was related to high disinhibition/impulsivity, low agreeableness, high neuroticism and hopelessness, high delay-discounting, poor response inhibition and low performance IQ. Substance use was specifically related to high novelty-seeking, sensation-seeking, extraversion, high verbal IQ, and risk-taking. Internalizing psychopathology was specifically related to high neuroticism, hopelessness and anxiety-sensitivity, low novelty-seeking and extraversion, and an attentional bias toward negatively valenced verbal stimuli. Findings reveal several nonspecific or transdiagnostic personality and cognitive factors that may be targeted in new interventions to potentially prevent the development of multiple psychopathologies. (PsycINFO Database Record
Project description:Early descriptions of psychopathy emphasise fearlessness and a lack of nervousness or anxiety as key characteristics of the disorder. However, conflicting evidence suggests that anxiety may be positively correlated with some aspects of the psychopathy construct. This position may seem somewhat paradoxical when considered alongside impaired processing of fear related stimuli in psychopathic personality. The aim of the current paper was to examine the distinct relations of callous, egocentric, and antisocial psychopathic traits with measures of anxiety and social anxiety in samples of non-offenders (Study 1) and violent offenders (Study 2). In Study 2 we also used an emotion recognition task to examine fearful face recognition. In Studies 1 and 2 we showed distinct and opposite significant relationships of egocentric and antisocial psychopathic traits with trait anxiety. Thus, while trait anxiety was negatively predicted by egocentric traits, it was predicted in a positive direction by antisocial traits in both samples. In Study 2 we found that callous traits were predictive of greater impairments in fearful face recognition. These findings suggest that anxiety and fear are distinguishable constructs in relation to psychopathic personality traits, and are discussed in terms of potentially separable mechanisms for these two constructs.
Project description:BACKGROUND:The Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) is an interview that assesses psychiatric symptoms and diagnoses, including substance use disorders and anxiety and mood (i.e., internalizing) disorders. Although the SSAGA is widely used, there exists no overall internalizing characteristics scale based on items drawn from SSAGA's mood and anxiety disorder sections. OBJECTIVES:To design and assess a SSAGA-based measurement instrument capturing the overall internalizing dimension that underlies more specific internalizing conditions. METHODS:We developed, assessed, and characterized a new scale for measuring internalizing problematic characteristics derived from the SSAGA interview. All samples were drawn from the Collaborative Studies on the Genetics of Alcoholism, a prospective multi-site genetic study of families at high risk for alcohol use disorders. All participants taking part in the study between September 2005 and September 2017 were eligible (n = 904, 52.2% female). RESULTS:The scale had adequate internal consistency (ordinal ? = 0.85, 95% CI = [0.81, 0.89]). Construct validity was supported by its association with other measures of internalizing characteristics (Internalizing Scale from Achenbach Self Reports; Neuroticism Scale from the Neuroticism-Extraversion-Openness Five-Factor Personality Inventory). Several indices of alcohol, marijuana, and nicotine misuse were also positively associated with Internalizing Scale scores. CONCLUSIONS:The Internalizing Scale has very good psychometric properties and can be used in studies that incorporate the SSAGA interview to study the association between internalizing characteristics and problematic alcohol and other substance use. These associations can potentially be utilized to identify individuals at risk for substance problems and to design treatments targeting such individuals.
Project description:Internalizing disorders co-occur with alcohol use disorder (AUD) at a rate that exceeds chance and compromise conventional AUD treatment. The "vicious cycle" model of comorbidity specifies drinking to cope (DTC) as a link between these disorders that, when not directly addressed, undermines the effectiveness of conventional treatments. Interventions based on this model have proven successful but there is no direct evidence for how and to what extent DTC contributes to the maintenance of comorbidity. In the present study, we used network analysis to depict associations between syndrome-specific groupings of internalizing symptoms, alcohol craving, and drinking behavior, as well as DTC and other extradiagnostic variables specified in the vicious cycle model (e.g., perceived stress and coping self-efficacy). Network analyses of 362 individuals with comorbid anxiety and AUD assessed at the beginning of residential AUD treatment indicated that while internalizing conditions and drinking elements had only weak direct associations, they were strongly connected with DTC and perceived stress. Consistent with this, centrality indices showed that DTC ranked as the most central/important element in the network in terms of its "connectedness" to all other network elements. A series of model simulations-in which individual elements were statistically controlled for-demonstrated that DTC accounted for all the relationships between the drinking-related elements and internalizing elements in the network; no other variable had this effect. Taken together, our findings suggest that DTC may serve as a "keystone" process in maintaining comorbidity between internalizing disorders and AUD. (PsycINFO Database Record
Project description:Genetic and molecular mechanisms that play a causal role in mental illnesses are challenging to elucidate, particularly as there is a lack of relevant in vitro and in vivo models. However, the advent of induced pluripotent stem cell (iPSC) technology has provided researchers with a novel toolbox. We conducted a systematic review using the PRISMA statement. A PubMed and Web of Science online search was performed (studies published between 2006-2020) using the following search strategy: hiPSC OR iPSC OR iPS OR stem cells AND schizophrenia disorder OR personality disorder OR antisocial personality disorder OR psychopathy OR bipolar disorder OR major depressive disorder OR obsessive compulsive disorder OR anxiety disorder OR substance use disorder OR alcohol use disorder OR nicotine use disorder OR opioid use disorder OR eating disorder OR anorexia nervosa OR attention-deficit/hyperactivity disorder OR gaming disorder. Using the above search criteria, a total of 3515 studies were found. After screening, a final total of 56 studies were deemed eligible for inclusion in our study. Using iPSC technology, psychiatric disease can be studied in the context of a patient's own unique genetic background. This has allowed great strides to be made into uncovering the etiology of psychiatric disease, as well as providing a unique paradigm for drug testing. However, there is a lack of data for certain psychiatric disorders and several limitations to present iPSC-based studies, leading us to discuss how this field may progress in the next years to increase its utility in the battle to understand psychiatric disease.