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Cattarinussi G, Meda N, Miola A, Sambataro F. The functional connectivity of the right superior temporal gyrus is associated with psychological risk and resilience factors for suicidality. J Affect Disord 2024; 357:51-59. [PMID: 38653349 DOI: 10.1016/j.jad.2024.04.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 01/13/2024] [Accepted: 04/11/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION Suicide attempters show increased activation in the right superior temporal gyrus (rSTG). Here, we investigated the rSTG functional connectivity (FC) to identify a functional network involved in suicidality and its associations with psychological suicidality risk and resilience factors. METHODS The resting state functional magnetic resonance imaging data of 151 healthy individuals from the Human Connectome Project Young Adult database were used to explore the FC of the rSTG with itself and with the rest of the brain. The correlation between the rSTG FC and loneliness and purpose in life scores was assessed with the NIH Toolbox. The effect of sex was also investigated. RESULTS The rSTG had a positive FC with bilateral cortical and subcortical regions, including frontal, temporal, parietal, occipital, limbic, and cerebellar regions, and a negative FC with the medulla oblongata. The FC of the rSTG with itself and with the left central operculum were associated with loneliness scores. The within rSTG FC was also negatively correlated with purpose in life scores, although at a trend level. We did not find any effect of sex on FC and its associations with psychological factors. LIMITATIONS The cross-sectional design, the limited age range, and the lack of measures of suicidality limit the generalizability of our findings. CONCLUSIONS The rSTG functional network is associated with loneliness and purpose in life. Together with the existing literature on suicide, this supports the idea that the neural activity of rSTG may contribute to suicidality by modulating risk and resilience factors associated with suicidality.
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Affiliation(s)
- Giulia Cattarinussi
- Department of Neuroscience, University of Padova, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy
| | - Nicola Meda
- Department of Neuroscience, University of Padova, Padua, Italy; Padova University Hospital, Padua, Italy
| | - Alessandro Miola
- Department of Neuroscience, University of Padova, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy; Casa di Cura Parco dei Tigli, Padova, Italy
| | - Fabio Sambataro
- Department of Neuroscience, University of Padova, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy; Padova University Hospital, Padua, Italy.
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Orsolini L, Corona D, Cervelli AL, Ribuoli E, Longo G, Volpe U. The role of Theory of Mind in the transition towards suicidal attempts in youth NSSI: an exploratory pilot study. Front Psychiatry 2024; 15:1403038. [PMID: 38873534 PMCID: PMC11170150 DOI: 10.3389/fpsyt.2024.1403038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/22/2024] [Indexed: 06/15/2024] Open
Abstract
Non-suicidal self-injury (NSSI) can both precede and co-occur with suicidal attempts (SA). Underlying mechanisms/factors leading to the transition to SA in NSSI youths have been proposed (including the role of social cognition), despite they should be yet confirmed. Therefore, the study aims at exploring the role of the Theory of Mind in the differentiation of a sample of NSSI youngsters (aged 15-24) according to the presence of SA. We divided the sample into 4 groups using the Deliberate Self Harm Inventory (DSHI) and Columbia Suicide Severity Rating Scale (C-SSRS): control group (notNSSInotSA), NSSI without SA (NSSInotSA), NSSI with SA (NSSIplusSA), and SA without NSSI (SAonly). NSSIplusSA patients displayed higher Reading the Mind in the Eyes Test (RMET) scores (indicative of ToM abilities) than both the NSSInotSA (p=0.0016) and SAonly groups (p=0.0198), while SAonly patients showed lower RMET scores compared to the control group (p=0.0214). Multiple regression models used to differentiate NSSInotSA and NSSIplusSA found a significant association between RMET and LOSCS-CSC (Level Of Self-Criticism Scale-Comparative Self-Criticism) (pC=0.0802, pD=0.0016, pG=0.0053). Our findings supported the hypothesis that a hypertrophic affective ToM may possibly be associated with the occurrence of SA in youth NSSI. Further larger and longitudinal studies should confirm these preliminary findings, by exploring all social cognition dimensions.
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Shen Y, Chen D, Guo J, Zheng Y, Zhang J, Zhan S, You J. Co-developmental trajectories of suicidal ideation and non-suicidal self-injury among Chinese adolescents: Transdiagnostic predictors and association with suicide attempts. Suicide Life Threat Behav 2024. [PMID: 38529888 DOI: 10.1111/sltb.13074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 02/18/2024] [Accepted: 03/13/2024] [Indexed: 03/27/2024]
Abstract
INTRODUCTION Adolescent suicidal ideation (SI) and non-suicidal self-injury (NSSI) are crucial public health issues, yet their co-developmental trajectories during early adolescence and their associations with predictors and outcomes are unclear. This study aimed to (a) identify heterogeneous co-developmental trajectories of SI and NSSI, (b) explore associations between transdiagnostic predictors and trajectories, and (c) assess suicide attempt risk across trajectories. METHODS Four hundred fifty-three adolescents (Mage = 12.35 years, 48.3% boys) completed surveys at 6-month intervals across 2 years. At Time 1 (Nov 2020), participants completed surveys encompassing SI, and NSSI, along with family, peer, and individual predictors. Subsequent surveys (Times 2-4) measured SI and NSSI, with suicide attempts queried at Time 4. RESULTS Parallel process latent class growth models revealed three co-developmental groups (i.e., Stable low NSSI and SI; Moderate-NSSI and high-SI, parallel decreasing; High-NSSI and moderate-SI, parallel increasing). Multivariate logistic regression indicated that group membership was predicted by parental rejection, parental warmth, bullying victimization, depressive and anxiety symptoms, thwarted belongingness, and perceived burdensomeness. Adolescents in the "High-NSSI and moderate-SI, parallel increasing" group reported the highest suicide attempt frequency. CONCLUSION These findings underscore subgroup distinctions and transdiagnostic predictors in comprehending SI and NSSI progression, emphasizing the necessity of dynamic monitoring and tailored interventions for distinct subgroup characteristics.
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Affiliation(s)
- Yunhong Shen
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, China
| | - Danrui Chen
- Psychological Counseling Centre, Chang'an University, Xi'an, China
| | - Jiaqi Guo
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, China
| | - Yue Zheng
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, China
| | - Jiajing Zhang
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, China
| | - Shiting Zhan
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, China
| | - Jianing You
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, China
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Andreo-Jover J, Curto Ramos J, Bobes J, Bravo-Ortiz M, Cebria AI, Crespo-Facorro B, De la Torre-Luque A, Díaz-Marsa M, Fernández-Rodrigues V, Garrido-Torres N, Grande I, López Peña MP, Pemau A, Roberto N, Ruiz-Veguilla M, Saiz P, Rodríguez-Vega B, Pérez-Sola V. The mediating role of reflective functioning in the association between childhood trauma and suicide attempt. J Psychiatr Res 2024; 171:30-37. [PMID: 38241967 DOI: 10.1016/j.jpsychires.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/12/2023] [Accepted: 01/03/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND Childhood trauma is intimately related with suicidal behaviour. Patients who have suffered childhood trauma develop impaired Reflective Functioning (RF), which refers to the capacity to understand ourselves and others in terms of intentional mental states. An improvement in RF has been associated with a reduction in suicidal attempts, but the mediating role of RF between childhood trauma and suicidal behaviour has not been addressed so far. OBJECTIVE We aim to examine the potential mediating effect of RF among childhood trauma and suicide attempts. METHOD We included 748 patients who had attempted suicide at least once. They were asked to complete the Reflective Functioning Questionnaire (RFQ-8), the Columbia-Suicide Severity Rating scale (CSSRS), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). We conducted linear regressions by simple mediating model to examine the role of RF in the indirect association between childhood trauma and the number of suicide attempts. RESULTS Our results show significant indirect effects through hypo and hypermentalizing between Emotional Abuse (EA) and Sexual Abuse (SA) in childhood and the number of suicide attempts in lifetime. These results indicate that ineffective RF significantly mediates the association between childhood trauma and suicidality. CONCLUSION This is the first study supporting the mediational role of RF in the relationship between EA and SA, and the number of suicide attempt in lifetime. These findings have important implications for reducing suicide rates and preventing future re-attempts. Further studies analysing this mediating role and focusing efforts on increasing RF-based interventions are required.
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Affiliation(s)
- J Andreo-Jover
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - J Curto Ramos
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - J Bobes
- Department of Psychiatry, Universidad de Oviedo, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain; Mental Health Services of the Principality of Asturias (SESPA), Oviedo, Spain
| | - M Bravo-Ortiz
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain.
| | | | - B Crespo-Facorro
- Hospital Virgen del Rocio/IBIS, Sevilla, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Departamento de Psiquiatría, Universidad de Sevilla, Spain
| | - A De la Torre-Luque
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Departamento de Medicina Legal, Psiquiatría y Patología, Universidad Complutense de Madrid, Spain
| | | | - V Fernández-Rodrigues
- Departamento de Medicina Legal, Psiquiatría y Patología, Universidad Complutense de Madrid, Spain
| | - N Garrido-Torres
- Hospital Virgen del Rocio/IBIS, Sevilla, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Departamento de Psiquiatría, Universidad de Sevilla, Spain
| | - I Grande
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain
| | | | - A Pemau
- Departamento de Medicina Legal, Psiquiatría y Patología, Universidad Complutense de Madrid, Spain
| | - N Roberto
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain
| | - M Ruiz-Veguilla
- Hospital Virgen del Rocio/IBIS, Sevilla, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Departamento de Psiquiatría, Universidad de Sevilla, Spain
| | - P Saiz
- Department of Psychiatry, Universidad de Oviedo, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain; Mental Health Services of the Principality of Asturias (SESPA), Oviedo, Spain
| | - B Rodríguez-Vega
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - V Pérez-Sola
- Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain
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Malhi GS, Das P, Outhred T, Bryant RA, Calhoun VD. An fMRI examination of the neural basis of suicide attempts: The role of mentalizing in the context of mood. Bipolar Disord 2022; 24:806-816. [PMID: 36164959 PMCID: PMC10092483 DOI: 10.1111/bdi.13261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Facial emotion recognition (FER) deficits in depressed mood disorder patients contribute to suicidality. Prior research shows that intrinsic brain activity patterns are altered by attempting suicide. Therefore, we investigated in depressed patients whether differences in FER contribute to their clinical symptoms of suicide. METHODS Neural activity in response to an FER task was compared across three groups: healthy controls (HCs, N = 66), suicide non-attempter (SNA, N = 50), suicide attempter (SA, N = 25). Modulation of brain networks by the task and functional connectivity (FC) within (using spatial map, spectral power) and between (using functional network connectivity; FNC) were examined. The contribution of these differences to suicidal symptoms in each group was also examined. RESULTS Patient groups displayed impaired FC both within and between networks but differed in nature and networks involved. They also showed differential modulation of networks by task, such that compared with both HC and SNA, SA displayed impaired FC within the default-mode network (DMN) and also its task modulation. In the SA group, FC within the DMN and FNC between two lateral prefrontal networks, and its interaction with the basal ganglia network contributed significantly to the clinical symptoms of suicide. CONCLUSIONS This study affirms differences between SA and SNA brain activity patterns and suggests that suicidal activity probably emanates via different mechanisms in these patient groups. Perhaps, over-attribution of emotion impairs one's self-referential thought processes and coupled with diminished emotional control this makes depressed individuals vulnerable to suicide.
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Affiliation(s)
- Gin S Malhi
- Academic Department of Psychiatry, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,CADE Clinic, Royal North Shore Hospital, St Leonards, New South Wales, Australia.,ARCHI, Sydney Medical School Northern, The University of Sydney, Sydney, New South Wales, Australia.,Department of Psychiatry, University of Oxford, Oxford, UK
| | - Pritha Das
- Academic Department of Psychiatry, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,CADE Clinic, Royal North Shore Hospital, St Leonards, New South Wales, Australia.,ARCHI, Sydney Medical School Northern, The University of Sydney, Sydney, New South Wales, Australia
| | - Tim Outhred
- Academic Department of Psychiatry, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,CADE Clinic, Royal North Shore Hospital, St Leonards, New South Wales, Australia.,ARCHI, Sydney Medical School Northern, The University of Sydney, Sydney, New South Wales, Australia
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Vince D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Georgia, USA
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Abstract
OBJECTIVE Disturbances in interpersonal functioning are prevalent in individuals with suicidality. Foundational for interpersonal functioning is theory of mind (ToM), a social-cognitive ability that allows individuals to understand the thoughts and feelings of others. Recent work has begun to investigate ToM performance in individuals with suicidality, though no review has quantitatively aggregated findings from these varied studies. The current study investigated the relations between ToM and suicidality with meta-analysis. METHOD We identified and meta-analyzed 15 studies that presented data for 2,895 participants (617 of whom had reported at least one suicide attempt). RESULTS Results indicated a significant, negative relation between ToM and suicidality with a medium overall effect size (g = -.475). Moderator analyses revealed that this effect was consistent across age, sex, ToM content, and suicidal outcome. CONCLUSION Deficits in ToM associated with suicidality hold promise for risk-identification, treatment, and prevention work.HighlightsTheory of mind (ToM) abilities are critical for effective interpersonal functioning.Meta-analytics results indicate that ToM deficits are associated with suicidality.Identifying such suicidality-related ToM deficits may inform risk-identification, treatment, and prevention work.
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Stagaki M, Nolte T, Feigenbaum J, King-Casas B, Lohrenz T, Fonagy P, Montague PR. The mediating role of attachment and mentalising in the relationship between childhood maltreatment, self-harm and suicidality. CHILD ABUSE & NEGLECT 2022; 128:105576. [PMID: 35313127 PMCID: PMC10466023 DOI: 10.1016/j.chiabu.2022.105576] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 01/01/2022] [Accepted: 02/17/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Although the relationship between childhood maltreatment, self-harm and suicidality is well-established, less is known about the mediating mechanisms explaining it. Based on a developmental mentalisation-based theoretical framework, childhood adversity compromises mentalising ability and attachment security, which in turn increase vulnerability to later stressors in adulthood. OBJECTIVE This study aimed to investigate the role of attachment and mentalising as potential mechanisms in the relationship between childhood maltreatment, self-harm and suicidality. PARTICIPANTS AND SETTING We recruited 907 adults from clinical and community settings in Greater London. METHODS The study design was cross-sectional. Participants completed self-report questionnaires on retrospectively rated childhood trauma, and current attachment to the romantic partner, mentalising, self-harm, suicidal ideation and attempt. We used structural equation modelling to examine the data and conceptualized childhood maltreatment as a general factor in a confirmatory bifactor model. RESULTS The results showed that childhood maltreatment was both directly associated with self-harm and suicidality and indirectly via the pathways of attachment and mentalising. CONCLUSIONS These findings indicate that insecure attachment and impaired mentalising partially explain the association between childhood maltreatment, self-harm and suicidality. Clinically, they provide support for the potential of mentalisation-based therapy or other psychosocial interventions that aim to mitigate the risk of self-harm and suicidality among individuals who have experienced childhood maltreatment via increasing understanding of self and other mental states.
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Affiliation(s)
- Maria Stagaki
- Division of Psychiatry, University College London, London, United Kingdom.
| | - Tobias Nolte
- Wellcome Trust Centre for Neuroimaging, University College London, London, United Kingdom; Anna Freud National Centre for Children and Families, London, United Kingdom
| | - Janet Feigenbaum
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Brooks King-Casas
- Fralin Biomedical Research Institute, Department of Psychology, Virginia Tech, Roanoke, VA, United States of America
| | - Terry Lohrenz
- Fralin Biomedical Research Institute, Department of Psychology, Virginia Tech, Roanoke, VA, United States of America
| | - Peter Fonagy
- Anna Freud National Centre for Children and Families, London, United Kingdom; Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - P Read Montague
- Wellcome Trust Centre for Neuroimaging, University College London, London, United Kingdom; Fralin Biomedical Research Institute, Department of Psychology, Virginia Tech, Roanoke, VA, United States of America; Department of Physics, Virginia Tech, Blacksburg, VA, United States of America; Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Virginia Tech, Roanoke, VA, United States of America
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Depressive symptomatology and different dimensions of social support serially mediate the effect of negative automatic thoughts on suicidal ideation. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02974-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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McLaren V, Gallagher M, Hopwood CJ, Sharp C. Hypermentalizing and Borderline Personality Disorder: A Meta-Analytic Review. Am J Psychother 2022; 75:21-31. [PMID: 35099264 DOI: 10.1176/appi.psychotherapy.20210018] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE A hypermentalizing impairment, or tendency to overattribute mental states to others, has been identified among individuals with borderline personality disorder. However, associations between hypermentalizing and other disorders call into question the specificity of this impairment to borderline personality disorder. This study aimed to evaluate the relative strength of the association between hypermentalizing and borderline personality disorder compared with other disorders and to assess the impact of moderators on the relationship between hypermentalizing and psychopathology. METHODS The authors conducted a meta-analysis of 36 studies (N=4,188 people) to investigate the relative strength of the association between hypermentalizing and borderline personality disorder, compared with other disorders, and to assess the impact of moderators on this relationship. The Movie for the Assessment of Social Cognition, an ecologically valid experimental instrument, was used to measure hypermentalizing. RESULTS Results indicated support for an association between psychopathology and hypermentalizing (r=0.24, 95% confidence interval [CI]=0.17 to 0.31), but the association was not significantly stronger for borderline personality disorder (r=0.26, 95% CI=0.12 to 0.39) than for other disorders (r=0.24, 95% CI=0.14 to 0.33). Neither age nor gender significantly moderated the association between psychopathology and hypermentalizing. CONCLUSIONS Hypermentalizing may be related to psychopathology in general rather than borderline personality disorder in particular. The findings are discussed in view of the possibility that features of borderline personality disorder associated with other psychopathology may explain the overall association between psychopathology and hypermentalizing. Clinical implications for mentalization-based treatment and concerns that the measurement used for hypermentalization may be too narrow and not representative of variations in functioning across cultures and race-ethnicity also are discussed.
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Affiliation(s)
- Veronica McLaren
- Department of Psychology, University of Houston, Houston (McLaren, Gallagher, Sharp); Department of Psychology, University of California, Davis (Hopwood)
| | - Matthew Gallagher
- Department of Psychology, University of Houston, Houston (McLaren, Gallagher, Sharp); Department of Psychology, University of California, Davis (Hopwood)
| | - Chris J Hopwood
- Department of Psychology, University of Houston, Houston (McLaren, Gallagher, Sharp); Department of Psychology, University of California, Davis (Hopwood)
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston (McLaren, Gallagher, Sharp); Department of Psychology, University of California, Davis (Hopwood)
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Abdo MMM, Mohamed AS, Hammed MAE, Hashem RE, El Nagar ZM. Affective theory of the mind and suicide in women with borderline personality disorder and schizophrenia: a comparative study. MIDDLE EAST CURRENT PSYCHIATRY 2021. [DOI: 10.1186/s43045-021-00142-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Theory of mind (ToM) is one of the essential components of social cognition. Affective ToM enables us to interpret other’s feelings and behaviors. Borderline personality disorder (BPD) and schizophrenia are two distinct mental disorders, yet they have a mutual deficit in interpreting emotions, thoughts, and intentions which may lead to a higher incidence of suicidality. Studies that involved social cognition, particularly ToM in schizophrenia, or BPD have controversial results. Therefore, this study aimed at comparing affective ToM functioning in female patients with BPD, schizophrenia, and healthy controls. In addition, identifying the possible impact and any correlation exists between the affective ToM and liability for suicide in those patients. Sixty individuals were recruited from the Institute of Psychiatry, Ain Shams University, Cairo, Egypt, and assigned into 3 groups where group A involved 20 BPD patients, group B involved 20 schizophrenic patients, and group C were healthy persons as a control. Assessment of affective ToM was done using Reading the Mind in the Eyes Test (RMET), and probability of suicide was measured using Suicide Probability Scale (SPS).
Results
Regarding ToM, the three groups were assessed using RMET and the results revealed a significantly higher mean score (hypermentalization) in BPD patients than both schizophrenic patients and controls. While schizophrenic patients had significantly lower mean scores than the control group (hypomentalization). As well, BPD patients had a significantly higher suicide probability total score than Schizophrenic patients and in all subdomains except for the hostility subdomain that was significantly higher in schizophrenic patients. Interestingly, in BPD, the suicide probability total score was positively correlated with RMET.
Conclusions
BPD patients have enhanced affective ToM and hypermentalization that is significantly associated with increased suicide probability in those patients, while in schizophrenia, hypomentalization could not be linked to increased suicide probability. Rehabilitation and proper management of ToM abnormalities might be a crucial tool in suicide prevention in mental illnesses, particularly, BPD.
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The Interaction Effects of Suicidal Ideation and Childhood Abuse on Brain Structure and Function in Major Depressive Disorder Patients. Neural Plast 2021; 2021:7088856. [PMID: 34335734 PMCID: PMC8321745 DOI: 10.1155/2021/7088856] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/17/2021] [Indexed: 12/25/2022] Open
Abstract
Suicidal ideation (SI) is a direct risk factor for suicide in patients with depression. Regarding the emergence of SI, previous studies have discovered many risk factors, including childhood abuse as the major public problem. Previous imaging studies have demonstrated that SI or childhood abuse has effects on brain structure and function, respectively, but the interaction effects between them have not been fully studied. To explore the interaction effect between SI and childhood abuse, 215 patients with major depressive disorder completed the Childhood Trauma Questionnaire to evaluate childhood abuse and Beck's Scale for Suicidal Ideation to evaluate SI. Then, they completed magnetic resonance imaging (MRI) within one week after completing questionnaires. Respectively, we preprocessed the structural and functional images and analyzed gray matter volumes (GMV) and mean fractional amplitude of low-frequency fluctuation (mfALFF) values. Results showed that the changes of GMV in the cuneus, precuneus, paracentric lobule, inferior frontal gyrus, and caudate nucleus and local activity in cuneal and middle temporal gyrus are in relation with SI and childhood abuse. And in left caudate, SI and childhood abuse interact with each other on the influence of GMV. That is, the influence of SI in GMV was related to childhood abuse, and the influence of childhood abuse in GMV was also related to SI. Therefore, the combination of SI and childhood abuse based on imaging should help us better understand the suicide ideation developing mechanism and propose more effective targeted prevention strategies for suicide prevention.
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Fei X, Wang S, Zheng X, Liu K, Liang X. Global research on cognitive behavioural therapy for schizophrenia from 2000 to 2019: a bibliometric analysis via CiteSpace. Gen Psychiatr 2021; 34:e100327. [PMID: 33585791 PMCID: PMC7845669 DOI: 10.1136/gpsych-2020-100327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/26/2020] [Accepted: 12/08/2020] [Indexed: 11/12/2022] Open
Abstract
Background Cognitive behavioural therapy (CBT) is considered to be an effective treatment for schizophrenia. In recent years, researchers have published clinical research results on CBT for schizophrenia. However, there is currently a lack of bibliometric analysis on CBT for schizophrenia. Aims To understand the current situation and research trends of CBT for schizophrenia, and to provide valuable information for researchers in this field. Methods Literature was retrieved from the Web of Science Core Collection database. CiteSpace was used to visually analyse the current status of research on CBT for schizophrenia, as well as trends and points of general interest on this topic. Results A total of 1151 papers were retrieved. The annual number of publications has increased 417.65% from 2000 to 2019. Schizophrenia Research was the most active journal. McGorry enjoys considerable influence. The University of London is deemed to be the most active research institution. England and the USA retain the highest scientific productivity in this field. China and Norway might make more contributions to this field in the future. The most important research topics are randomised controlled trials of CBT for schizophrenia, meta-analysis, scale selection and research on the improvement of quality of life. Results from the following keywords ‘psychoeducation’, ‘insomnia’, ‘individual’, ‘mental illness’, ‘major depressive disorder’, ‘efficacy’, ‘internalised stigma’ and ‘remediation’ indicated new research frontiers in this field. Conclusions The field of CBT for schizophrenia is progressing and has great potential. The level and quality of research in this field is high. The proposal of research hotspots and frontiers serves as a direction for researchers in this field. Researchers around the world should strengthen their cooperation and communication to promote further development of this field.
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Affiliation(s)
- Xinxing Fei
- Psychiatry Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Shiqi Wang
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Xiaojiao Zheng
- Psychiatry Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Kezhi Liu
- Psychiatry Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Xuemei Liang
- Psychiatry Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
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Sumlin E, Wall K, Sharp C. The moderating role of dissociation in the relation between borderline features and factors of self-injury in adolescents. Personal Ment Health 2020; 14:215-226. [PMID: 32026619 DOI: 10.1002/pmh.1477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 10/11/2019] [Accepted: 01/20/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Self-injurious behaviours (SIB) occur frequently in individuals with borderline personality disorder (BPD). While multiple factors may explain the association between SIB and BPD, studies in adults have pointed to dissociation as factor worth considering. However, this relationship has not been examined in adolescents. AIMS The current study investigated the role of dissociation as a potential moderator between borderline features and SIB, with the expectation that this association would be stronger in the presence of dissociation. METHODS One hundred forty-four adolescent inpatients were compared on measures of BPD, non-suicidal self-injury (NSSI) and suicidal behaviour. The relationships between borderline features and self-injury outcomes were evaluated using linear and logistic regression with dissociation as a moderator. RESULTS Borderline features and dissociation were found to be significantly associated with history of NSSI, history of suicide attempt, suicidal ideation (SI) intensity and SI severity. However, dissociation was a significant moderator only in the relationship between borderline features and SI intensity. CONCLUSION Higher levels of dissociation were associated with more engagement with suicidal thoughts but did not necessarily contribute to SIB. Further research into differential patterns of association of self-injury in patients with BPD may investigate other models where dissociation may more strongly factor into outcomes. © 2020 John Wiley & Sons, Ltd.
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Affiliation(s)
- Eric Sumlin
- Department of Psychology, University of Houston, Houston, TX, 77204, USA
| | - Kiana Wall
- Department of Psychology, University of Houston, Houston, TX, 77204, USA
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, TX, 77204, USA.,University of the Free State, Bloemfontein, South Africa
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