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Polat H, Karakaş SA, Erçel Ş, Taşci G. Alexithymia and Forgiveness Levels of Forensic Psychiatric Patients. J Psychosoc Nurs Ment Health Serv 2024; 62:27-35. [PMID: 37879088 DOI: 10.3928/02793695-20231018-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
The current cross-sectional study was performed to examine levels of alexithymia and forgiveness in forensic psychiatric patients. Data were collected between March 2022 and August 2022 at a high-security forensic psychiatric hospital affiliated with a city hospital in Turkey. A personal information form prepared by the researchers, the Toronto Alexithymia Scale, and the Heartland Forgiveness Scale were used to obtain data. Participants comprised 132 forensic psychiatric patients who agreed to participate in the study. A significant negative correlation was found between alexithymia and forgiveness levels of participants (p < 0.01, r = -0.259). In other words, as alexithymia levels increased, participants were found to be less forgiving. In addition, results suggest that forensic psychiatric patients are susceptible to alexithymia and higher levels of forgiveness. Determining forgiveness and alexithymia levels of forensic psychiatric patients will contribute to the structuring of care to be offered to these patients. [Journal of Psychosocial Nursing and Mental Health Services, 62(6), 27-35.].
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Burghart M, Sahm AHJ, Schmidt S, Bulla J, Mier D. Understanding empathy deficits and emotion dysregulation in psychopathy: The mediating role of alexithymia. PLoS One 2024; 19:e0301085. [PMID: 38718018 PMCID: PMC11078418 DOI: 10.1371/journal.pone.0301085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 03/09/2024] [Indexed: 05/12/2024] Open
Abstract
Psychopathy is a severe personality disorder marked by a wide range of emotional deficits, including a lack of empathy, emotion dysregulation, and alexithymia. Previous research has largely examined these emotional impairments in isolation, ignoring their influence on each other. Thus, we examined the concurrent interrelationship between emotional impairments in psychopathy, with a particular focus on the mediating role of alexithymia. Using path analyses with cross-sectional data from a community sample (N = 315) and a forensic sample (N = 50), our results yielded a statistically significant mediating effect of alexithymia on the relationship between psychopathy and empathy (community and forensic) and between psychopathy and emotion dysregulation (community). Moreover, replacing psychopathy with its three dimensions (i.e., meanness, disinhibition, and boldness) in the community sample revealed that boldness may function as an adaptive trait, with lower levels of alexithymia counteracting deficits in empathy and emotion dysregulation. Overall, our findings indicate that psychopathic individuals' limited understanding of their own emotions contributes to their lack of empathy and emotion dysregulation. This underscores the potential benefits of improving emotional awareness in the treatment of individuals with psychopathy.
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Affiliation(s)
- Matthias Burghart
- Department of Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Alexander H. J. Sahm
- Department of Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Sergej Schmidt
- Department of Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Jan Bulla
- Forensic Psychiatry and Psychotherapy, Reichenau Psychiatric Center, Reichenau, Germany
- Department of Forensic Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | - Daniela Mier
- Department of Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
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Rubenzer SJ. Ruling out feigned crime-related amnesia? A response to Acklin (2022). BEHAVIORAL SCIENCES & THE LAW 2023; 41:207-223. [PMID: 37071040 DOI: 10.1002/bsl.2623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 01/22/2023] [Accepted: 03/21/2023] [Indexed: 06/19/2023]
Abstract
In a recent paper, Acklin discussed a case of possible amnesia for a murder in terms of neurobiology, psychoanalysis, and personality assessment. Acklin accepted the defendant's claim of amnesia for the crime as genuine. The considerable literature that takes a skeptical view of crime-related amnesia was not cited, and the possibility of feigning or malingering was "ruled out" with a single sentence that does not withstand scrutiny. A review of the literature on feigned amnesia suggests that it may not be possible to rule out malingering even if the best available tools are used: There has been minimal investigation of most validity tests and estimates of base rates of feigned amnesia for a crime vary widely and make estimates of Negative Predictor Power highly unreliable. Although one cannot know from the information presented if Acklin's defendant legitimately experienced amnesia, feigning could not be ruled out using an interview and the test data cited by Acklin. I call for a moratorium on publication of further articles on crime specific amnesia that do not conscientiously examine other potential explanations and do not use current best practices for assessing negative response bias.
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Boskovic I, Akca AYE. Presenting the consequences of feigning: Does it diminish symptom overendorsement? An analog study. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-10. [PMID: 35287519 DOI: 10.1080/23279095.2022.2044329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Feigning causes personal and societal consequences, in both civil and criminal context. We investigated whether presenting the consequences of feigning can diminish symptom endorsement in feigned Posttraumatic Stress Disorder (PTSD). We randomly allocated non-native English speaking undergraduates (N = 145) to five conditions: 1) Truth tellers (n = 31), 2) Civil context feigners (n = 27), 3) Civil context warned feigners (n = 26), 4) Criminal context feigners (n = 29), and 5) Criminal context warned feigners (n = 32). All feigning groups received a vignette depicting a situation in which claiming PTSD would be beneficial. One vignette referred to the personal injury claim, whereas the second was about the aggravated assault charges. Additionally, one feigning group from each setting received information about the consequences of feigning (i.e., warned feigners). After receiving the instructions, all participants were administered the Self-Report Symptom Inventory (SRSI), a measure of symptom endorsement. Truth tellers endorsed fewer symptoms than all feigning groups, which mostly did not differ. Yet, criminal warned feigners (59%) were significantly less frequently detected on the SRSI as overreporters than other feigning groups (86.2%-89%). Hence, emphasizing the negative consequences of overreporting may diminish symptom endorsement, but only in high-stake situations. The implications and limitations (e.g., online measure administration) of this work are discussed.
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Affiliation(s)
- Irena Boskovic
- Erasmus University Rotterdam, Rotterdam, the Netherlands
- Maastricht University, Maastricht, the Netherlands
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Abstract
AbstractAre personality traits related to symptom overreporting and/or symptom underreporting? With this question in mind, we evaluated studies from 1979 to 2020 (k = 55), in which personality traits were linked to scores on stand-alone validity tests, including symptom validity tests (SVTs) and measures of socially desirable responding (SDR) and/or supernormality. As to symptom overreporting (k = 14), associations with depression, alexithymia, apathy, dissociation, and fantasy proneness varied widely from weak to strong (rs .27 to .79). For underreporting (k = 41), inconsistent links (rs − .43 to .63) were found with narcissism, whereas alexithymia and dissociation were often associated with lower SDR tendencies, although effect sizes were small. Taken together, the extant literature mainly consists of cross-sectional studies on single traits and contexts, mostly offering weak correlations that do not necessarily reflect causation. What this field lacks is an overarching theory relating traits to symptom reporting. Longitudinal studies involving a broad range of traits, samples, and incentives would be informative. Until such studies have been done, traits are best viewed as modest concomitants of symptom distortion.
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Alimoradi Z, Majd NR, Broström A, Tsang HWH, Singh P, Ohayon MM, Lin CY, Pakpour AH. Is alexithymia associated with sleep problems? A systematic review and meta-analysis. Neurosci Biobehav Rev 2021; 133:104513. [PMID: 34958823 DOI: 10.1016/j.neubiorev.2021.12.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 12/03/2021] [Accepted: 12/21/2021] [Indexed: 02/08/2023]
Abstract
Alexithymia, a difficulty identifying and expressing emotions experienced by oneself or others, measurably harms quality of sleep. Research has observed the association between alexithymia and sleep problems; however, the cumulative effect of this association is still unknown. Therefore, this systematic review and meta-analysis was conducted to present scientific evidence regarding the relationship between alexithymia and sleep quality. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, and using relevant keywords, we searched six databases: Scopus, PubMed Central, ProQuest, ISI Web of Knowledge, EMBASE, and Science Direct. We selected observational studies on the association between alexithymia and sleep. We conducted meta-analysis using a random-effect model to calculate the effect size (ES) with Fisher's z transformation. Eligible studies (N = 26) in 24 papers included 7546 participants from 12 countries. The entire ES for the association between alexithymia and sleep was 0.44 (95 % CI: 0.31, 0.56). Additionally, patient populations had a larger ES (ES = 0.55; 95 % CI: 0.30, 0.79) than healthy populations (ES = 0.30; 95 % CI: 0.20, 0.41). The results of the present systematic review and meta-analysis revealed a significant association between alexithymia and sleep problems, especially among people with any medical condition.
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Affiliation(s)
- Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin 3419759811, Iran.
| | - Nilofar Rajabi Majd
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin 3419759811, Iran
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jönköping University, 55111 Jönköping, Sweden; Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
| | - Hector W H Tsang
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong; Graduate Research Assistant at the Pennsylvania State University, USA.
| | - Parmveer Singh
- P. G. Department of Agriculture, Khalsa College Amritsar, Punjab, India.
| | - Maurice M Ohayon
- Stanford Sleep Epidemiology Research Center (SSERC), School of Medicine, Stanford University, CA, USA.
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin 3419759811, Iran; Department of Nursing, School of Health and Welfare, Jönköping University, 55111 Jönköping, Sweden.
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Shura RD, Ord AS, Worthen MD. Structured Inventory of Malingered Symptomatology: a Psychometric Review. PSYCHOLOGICAL INJURY & LAW 2021. [DOI: 10.1007/s12207-021-09432-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Emotional Intelligence: Relevance and Implications for Addiction. CURRENT ADDICTION REPORTS 2021. [DOI: 10.1007/s40429-021-00356-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mollayeva T, Sharma B, Vernich L, Mantis S, Lewko J, Gibson B, Liss G, Kontos P, Grigorovich A, Colantonio A. Sleep before and after work-related concussion: Sex differences in effects and functional outcomes. Work 2020; 67:927-938. [PMID: 33325439 DOI: 10.3233/wor-203343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Recent studies have started disentangling components of disturbed sleep as part of the post-concussive syndrome, but little is known about the workers with an injury' perspectives on post-injury sleep changes or what causes these changes. OBJECTIVES To determine the effects of work-related concussion/mild traumatic brain injury (wr-mTBI) on perceptions of refreshing sleep in workers with an injury and to identify the relevant factors responsible for sleep changes. METHODS We studied post-concussive changes in sleep in 66 adults (50% male workers, 42% aged 30-50 years, median post-injury days: 155) who had sustained wr-mTBI and experienced functional limitations long after the injury. We collected sociodemographic, occupational and health status data and identified variables related to post-concussive changes in refreshing sleep. RESULTS Forty-seven workers with wr-mTBI (79% of male workers, 64% of female workers) perceived their sleep as being refreshing before injury and unrefreshing afterwards (χ2 = 67.70 for change, χ2 = 27.6 for female and χ2 = 41.1 for male workers, p < 0.0001). Post-concussive losses in refreshing sleep were associated with socio demographic, occupational, and health status data variables. Sex stratification revealed differences between male and female workers. CONCLUSIONS Workers with wr-mTBI experience clinically meaningful changes in refreshing sleep that are associated with modifiable variables. The observed differences in functional outcomes between male and female workers warrant further study.
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Affiliation(s)
- Tatyana Mollayeva
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,KITE Toronto Rehabilitation Institute University Health Network, Toronto Rehabilitation Institute University Health Network, Toronto, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada.,Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Bhanu Sharma
- KITE Toronto Rehabilitation Institute University Health Network, Toronto Rehabilitation Institute University Health Network, Toronto, Canada
| | - Lee Vernich
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Steve Mantis
- Ontario Network of Injured Workers Groups, Research Action Committee, Toronto, Canada
| | - John Lewko
- School of Rural and Northern Health, Laurentian University, Sudbury, Canada
| | - Brian Gibson
- Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Gary Liss
- Division of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Pia Kontos
- KITE Toronto Rehabilitation Institute University Health Network, Toronto Rehabilitation Institute University Health Network, Toronto, Canada.,Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Alisa Grigorovich
- KITE Toronto Rehabilitation Institute University Health Network, Toronto Rehabilitation Institute University Health Network, Toronto, Canada.,Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,KITE Toronto Rehabilitation Institute University Health Network, Toronto Rehabilitation Institute University Health Network, Toronto, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada.,Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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van Minnen A, van Dalen B, Voorendonk EM, Wagenmans A, de Jongh A. The effects of symptom overreporting on PTSD treatment outcome. Eur J Psychotraumatol 2020; 11:1794729. [PMID: 33029329 PMCID: PMC7473171 DOI: 10.1080/20008198.2020.1794729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND It is often assumed that individuals with posttraumatic stress disorder (PTSD) who overreport their symptoms should be excluded from trauma-focused treatments. OBJECTIVE To investigate the effects of a brief, intensive trauma-focused treatment programme for individuals with PTSD who are overreporting symptoms. METHODS Individuals (n = 205) with PTSD participated in an intensive trauma-focused treatment programme consisting of EMDR and prolonged exposure (PE) therapy, physical activity and psycho-education. Assessments took place at pre- and post-treatment (Structured Inventory of Malingered Symptomatology; SIMS, Clinician Administered PTSD Scale for DSM-5; CAPS-5). RESULTS Using a high SIMS cut-off of 24 or above, 14.1% (n = 29) had elevated SIMS scores (i.e. 'overreporters'). The group of overreporters showed significant decreases in PTSD-symptoms, and these treatment results did not differ significantly from other patients. Although some patients (35.5%) remained overreporters at post-treatment, SIMS scores decreased significantly during treatment. CONCLUSION The results suggest that an intensive trauma-focused treatment not only is a feasible and safe treatment for PTSD in general, but also for individuals who overreport their symptoms.
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Affiliation(s)
- Agnes van Minnen
- Behavioural Science Institute (BSI), Radboud University Nijmegen, Nijmegen, The Netherlands.,Research Department, Research Department PSYTREC, Bilthoven, The Netherlands
| | - Birgit van Dalen
- Research Department, Research Department PSYTREC, Bilthoven, The Netherlands
| | - Eline M Voorendonk
- Behavioural Science Institute (BSI), Radboud University Nijmegen, Nijmegen, The Netherlands.,Research Department, Research Department PSYTREC, Bilthoven, The Netherlands
| | - Anouk Wagenmans
- Research Department, Research Department PSYTREC, Bilthoven, The Netherlands
| | - Ad de Jongh
- Research Department, Research Department PSYTREC, Bilthoven, The Netherlands.,Academic Centre for Dentistry Amsterdam (ACTA, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.,School of Health Sciences, Salford University, Manchester, UK.,Institute of Health and Society, University of Worcester, Worcester, UK.,School of Psychology, Queen's University, Belfast, Northern Ireland
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Lynn SJ, Maxwell R, Merckelbach H, Lilienfeld SO, Kloet DVHVD, Miskovic V. Dissociation and its disorders: Competing models, future directions, and a way forward. Clin Psychol Rev 2019; 73:101755. [DOI: 10.1016/j.cpr.2019.101755] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 06/20/2019] [Accepted: 07/15/2019] [Indexed: 12/18/2022]
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Antisocial and Borderline Personality Disorders in the Emergency Department: Conceptualizing and Managing “Malingered” or “Exaggerated” Symptoms. Curr Behav Neurosci Rep 2019. [DOI: 10.1007/s40473-019-00183-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Merckelbach H, Dandachi-FitzGerald B, van Helvoort D, Jelicic M, Otgaar H. When Patients Overreport Symptoms: More Than Just Malingering. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2019. [DOI: 10.1177/0963721419837681] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Mental-health patients may report more symptoms than they actually experience. Experts and laypeople often view this overreporting as a sign of malingering. We show that there are multiple pathways to symptom overreporting: carryover effects from previous tests that lower the threshold for answering affirmatively to symptom items, suggestive misinformation that escalates symptom reports, inattentive responding that promotes indiscriminate endorsement of symptoms, and personality traits that bias symptom reports in an upward direction. A one-sided focus on malingering may distract from a research agenda that may contribute to knowledge accumulation in this domain.
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Affiliation(s)
| | | | | | | | - Henry Otgaar
- Forensic Psychology Section, Maastricht University
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