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Bräscher AK, Brähler E, Häuser W, Witthöft M. Further Evidence for a Dimensional Latent Structure of Health Anxiety: Taxometric Analyses of the Whiteley Index Based on Two German Representative Samples. Assessment 2024; 31:1324-1331. [PMID: 38159038 DOI: 10.1177/10731911231219802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Health anxiety is an intricate part of illness anxiety and somatic symptom disorder. Based on convenience samples, two out of three available studies indicate that it is a dimensional rather than a categorical construct. Using two representative datasets, this study investigates whether previous results can be clarified. Conventional taxometric analyses as well as comparison curve fit indices (CCFI) profile analyses (MAMBAC and MAXSLOPE procedures) were calculated with two datasets of the German adult population assessing the Whiteley Index (WI-14, N = 2,072; WI-7, N = 2,498). Mean CCFIs indicated a dimensional structure for both the WI-7 (mean CCFI = 0.42, mean CCFI profile = 0.40) and the WI-14 (mean CCFI = 0.44, mean CCFI profile = 0.32). The results support and extend previous findings by strongly suggesting a dimensional distribution of health anxiety in the general population. Implications for research and practice comprise the adoption of a dimensional description of psychopathology as well as transdiagnostic treatment approaches.
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Affiliation(s)
| | - Elmar Brähler
- University Medical Center of the Johannes Gutenberg University Mainz, Germany
- University of Leipzig Medical Center, Germany
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2
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Haywood D, Kotov R, Krueger RF, Wright AGC, Forbes MK, Dauer E, Baughman FD, Rossell SL, Hart NH. Reconceptualizing mental health in cancer survivorship. Trends Cancer 2024; 10:677-686. [PMID: 38890021 DOI: 10.1016/j.trecan.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/25/2024] [Accepted: 05/28/2024] [Indexed: 06/20/2024]
Abstract
Mental health for cancer survivors in both research and clinical applications has strongly adopted a traditional nosological approach, involving the classification of psychopathology into discrete disorders. However, this approach has recently faced considerable criticism due to issues such as high comorbidity and within-disorder symptom heterogeneity across populations. Moreover, there are additional specific issues impacting the validity of traditional approaches in cancer survivorship populations, including the physiological effects of cancer and its treatments. In response, we provide the case for the hierarchical dimensional approach within psycho-oncology, in particular the Hierarchical Taxonomy of Psychopathology (HiTOP). We discuss not only the potential utility of HiTOP to research and clinical applications within psycho-oncology, but also its limitations, and what is required to apply this approach within cancer survivorship.
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Affiliation(s)
- Darren Haywood
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia; Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia; Department of Psychiatry, Melbourne Medical School, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia.
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Aidan G C Wright
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA; Eisenberg Family Depression Center, University of Michigan, Ann Arbor, MI, USA
| | - Miriam K Forbes
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| | - Evan Dauer
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia; Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Frank D Baughman
- School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
| | - Susan L Rossell
- Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia; Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Nicolas H Hart
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia; Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia; Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia; Institute for Health Research, University of Notre Dame Australia, Perth, WA, Australia
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3
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Petzke TM, Weber K, Van den Bergh O, Witthöft M. Illustrating the pathway from affect to somatic symptom: the Affective Picture Paradigm. Cogn Emot 2024; 38:801-817. [PMID: 38411187 DOI: 10.1080/02699931.2024.2319273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 02/28/2024]
Abstract
High levels of somatic symptom distress represent a core component of both mental and physical illness. The exact aetiology and pathogenesis of this transdiagnostic phenomenon remain largely unknown. The Affective Picture Paradigm (APP) represents an innovative experimental paradigm to study somatic symptom distress. Based on the HiTOP framework and a population-based sampling approach, associations between facets of somatic symptom distress and symptoms induced by the APP were explored in two studies (N1 = 201; N2 = 254) using structural equation bi-factor models. Results showed that the APP effect was significantly positively correlated with general somatic symptom distress (PHQ-15, HiTOP), cardio-respiratory symptoms (PHQ-15), as well as difficulties identifying feelings. In conclusion, negative affective cues in the APP can elicit somatic symptoms, particularly in people with higher levels of somatic symptom distress. Difficulties identifying feelings might contribute to this phenomenon. Results are compatible with a predictive processing account of somatic symptom perception.
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Affiliation(s)
- Tara M Petzke
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes-Gutenberg-University Mainz, Mainz, Germany
| | - Kathrin Weber
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes-Gutenberg-University Mainz, Mainz, Germany
| | | | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes-Gutenberg-University Mainz, Mainz, Germany
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Carmichael J, Ponsford J, Gould KR, Tiego J, Forbes MK, Kotov R, Fornito A, Spitz G. A Transdiagnostic, Hierarchical Taxonomy of Psychopathology Following Traumatic Brain Injury (HiTOP-TBI). J Neurotrauma 2024. [PMID: 38970424 DOI: 10.1089/neu.2024.0006] [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: 07/08/2024] Open
Abstract
Psychopathology, including depression, anxiety, and post-traumatic stress, is a significant yet inadequately addressed feature of moderate-severe traumatic brain injury (TBI). Progress in understanding and treating post-TBI psychopathology may be hindered by limitations associated with conventional diagnostic approaches, specifically the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD). The Hierarchical Taxonomy of Psychopathology (HiTOP) offers a promising, transdiagnostic alternative to psychiatric classification that may more effectively capture the experiences of individuals with TBI. However, HiTOP lacks validation in the TBI population. To address this gap, we administered a comprehensive questionnaire battery, including 56 scales assessing homogeneous symptom components and maladaptive traits within HiTOP, to 410 individuals with moderate-severe TBI. We evaluated the reliability and unidimensionality of each scale and revised those with psychometric problems. Using a top-down, exploratory latent variable approach (bass-ackwards modeling), we subsequently constructed a hierarchical model of psychopathological dimensions tailored to TBI. The results showed that, relative to norms, participants with moderate-severe TBI experienced greater problems in the established HiTOP internalizing and detachment spectra, but fewer problems with thought disorder and antagonism. Fourteen of the 56 scales demonstrated psychometric problems, which often appeared reflective of the TBI experience and associated disability. The Hierarchical Taxonomy of Psychopathology Following Traumatic Brain Injury (HiTOP-TBI) model encompassed broad internalizing and externalizing spectra, splitting into seven narrower dimensions: Detachment, Dysregulated Negative Emotionality, Somatic Symptoms, Compensatory and Phobic Reactions, Self-Harm and Psychoticism, Rigid Constraint, and Harmful Substance Use. This study presents the most comprehensive empirical classification of psychopathology after TBI to date. It introduces a novel, TBI-specific transdiagnostic questionnaire battery and model, which addresses the limitations of conventional DSM and ICD diagnoses. The empirical structure of psychopathology after TBI largely aligned with the established HiTOP model (e.g., a detachment spectrum). However, these constructs need to be interpreted in relation to the unique experiences associated with TBI (e.g., considering the injury's impact on the person's social functioning). By overcoming the limitations of conventional diagnostic approaches, the HiTOP-TBI model has the potential to accelerate our understanding of the causes, correlates, consequences, and treatment of psychopathology after TBI.
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Affiliation(s)
- Jai Carmichael
- Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Jennie Ponsford
- Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Kate Rachel Gould
- Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Jeggan Tiego
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Miriam K Forbes
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Roman Kotov
- Stony Brook University, New York, New York, USA
| | - Alex Fornito
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Gershon Spitz
- Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, Australia
- Department of Neuroscience, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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Petzke TM, Witthöft M. The Association of Emotion Regulation and Somatic Symptoms. Psychosom Med 2024; 86:561-568. [PMID: 38598412 DOI: 10.1097/psy.0000000000001310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
OBJECTIVE People with functional somatic symptoms have difficulties in various stages of the emotion regulation (ER) process. As an adaptive and flexible use of ER strategies is a core tenet of emotional health, having difficulties in this area is often assumed to be the key mechanism behind functional somatic symptoms. Following a dimensional population-based sampling approach, we investigated ER abilities across a broad range of people and tested possible associations with somatic symptom reporting, habitual ER use, and various subclinical constructs (such as alexithymia and anxiety). METHODS In a sample of N = 254 persons, somatic symptom distress (Patient Health Questionnaire-15, Hierarchical Taxonomy of Psychopathology somatoform spectrum), trait ER facets (Emotion Regulation Questionnaire, Emotion Reactivity Scale), and the ER abilities (suppression and reappraisal) were assessed. Correlations (frequentist and Bayesian), ANOVAs, and structural equation models were used to analyze the data. RESULTS Correlational and structural equation model analyses revealed that general symptom severity (both on the somatoform Hierarchical Taxonomy of Psychopathology and Patient Health Questionnaire-15) was not significantly associated with ER effectiveness, general arousal, or general valence. The sensory components of pain symptoms ( r = -0.708, p = .023) and health anxiety ( r = -0.443, p = .028) were significantly negatively associated with effective ER. CONCLUSIONS ER effectiveness seems independent of general somatic symptom distress. We make recommendations for clinical interventions in light of these complex findings.
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Affiliation(s)
- Tara M Petzke
- From the Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes-Gutenberg-University Mainz, Mainz, Germany
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Vaysi A, Nazarpour P, Kiani Z, Maleki M, Hamzehei M, Amianto F, Sellbom M, Komasi S. Replicability of the five-factor structure of DSM-5 and ICD-11 trait systems and their associations with binge eating and bipolar spectrum psychopathology. Personal Ment Health 2024; 18:122-137. [PMID: 38031321 DOI: 10.1002/pmh.1600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/21/2023] [Accepted: 11/09/2023] [Indexed: 12/01/2023]
Abstract
Since the research on contemporary personality models-and psychopathology-mainly originate from the Western world, we aimed to test the factorial structure of two trait systems assessed with the Personality Inventory for DSM-5 (PID-5) in a non-Western sample and to compare the extracted models' relative associations with binge eating disorder (BED) and bipolar spectrum disorder (BSD) symptoms. A community sample (N = 516; 72% female) was administered the PID-5, which can operationalize both the DSM-5 and ICD-11 systems. The factor structures of both systems were tested using exploratory structural equation modeling (ESEM). The congruence coefficients of all factor loadings with international studies were calculated. The Binge Eating Scale (BES), Bipolar Spectrum Diagnostic Scale (BSDS), and Hypomania Checklist-32-Revised (HCL-32) were used to measure the criterion variables. Linear regression models were used for comparing the DSM-5 and ICD-11 systems in predicting the BED and BSD. The findings supported five-factor solutions for both trait systems. Both systems significantly predicted dimensional measures of both BED and BSD (all p < 0.001). The present findings support an acceptable five-factor structure for both personality systems in the non-Western sample. Different algorithms of maladaptive domains on both systems are related to binge eating and bipolar spectrum psychopathology.
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Affiliation(s)
- Anis Vaysi
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Parisa Nazarpour
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Zhaleh Kiani
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Mahtab Maleki
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Maryam Hamzehei
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Federico Amianto
- Department of Neurosciences, Psychiatry Section, Regional Pilot Centre for Eating Disorders, University of Torino, Torino, Italy
| | - Martin Sellbom
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Saeid Komasi
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
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Rezaei F, Rahmani K, Hemmati A, Komasi S. A head-to-head comparison of eight unique personality systems in predicting somatization phenomenon. BMC Psychiatry 2023; 23:912. [PMID: 38053166 PMCID: PMC10698954 DOI: 10.1186/s12888-023-05424-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/30/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND If somatization is an independent personality trait, it is not clear whether it is specific to the temperament or maladaptive spectrum of personality. We aimed at the head-to-head comparison of temperament and maladaptive systems and spectra of personality to predict both somatization and somatic symptom and related disorders (SSRD). METHODS The samples included 257 cases with SSRD (70.8% female) and 1007 non-SSRD (64.3% female) from Western Iran. The Personality Inventory for DSM-5 (PID-5), Personality Diagnostic Questionnaire-4 (PDQ-4), Temperament and Character Inventory (TCI), Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A), Affective and Emotional Composite Temperament Scale (AFECTS), and Positive Affect and Negative Affect Model (PANAS) was used to data collection. A somatization factor plus temperament and maladaptive spectra of personality were extracted using exploratory factor analysis. Several hierarchical linear and logistic regressions were used to test the predictive systems and spectra. RESULTS All personality systems jointly predict both somatization and SSRD with a slightly higher contribution for temperament systems. When the temperament and maladaptive spectra were compared, both spectra above each other significantly predicted both somatization (R2 = .407 versus .263) and SSRD (R2 = .280 versus .211). The temperament spectrum explained more variance beyond the maladaptive spectrum when predicting both the somatization factor (change in R2 = .156 versus .012) and SSRD (change in R2 = .079 versus .010). CONCLUSION All temperament and maladaptive frameworks of personality are complementary to predicting both somatization and SSRD. However, the somatization is more related to the temperament than the maladaptive spectrum of personality.
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Affiliation(s)
- Farzin Rezaei
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Khaled Rahmani
- Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Azad Hemmati
- Department of Psychology, University of Kurdistan, Sanandaj, Iran
| | - Saeid Komasi
- Neurosciences Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran.
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Gearhart MG, Brewerton TD. Psychogenic Nonepileptic Seizures Associated with an Eating Disorder and PTSD Are Responsive to Cognitive Processing Therapy. Case Rep Psychiatry 2023; 2023:5539951. [PMID: 38033475 PMCID: PMC10684327 DOI: 10.1155/2023/5539951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/05/2023] [Accepted: 11/06/2023] [Indexed: 12/02/2023] Open
Abstract
Objective Eating disorders (EDs) are often associated with prior histories of trauma, subsequent PTSD and related psychiatric comorbidities. There is a paucity of information about their relationship to somatic symptom disorders, specifically psychogenic nonepileptic seizures (PNES), a type of functional neurological symptom disorder or conversion disorder. Methods We report a case of a 39-year-old bisexual female with bulimia nervosa (BN), PTSD, recurrent major depressive disorder (MDD), cannabis use disorder, and PNES who responded to integrated trauma-focused treatment during residential ED treatment using cognitive processing therapy (CPT). Symptoms of ED, PTSD, major depression, and state-trait anxiety were measured using validated assessment instruments. Results During the course of CPT treatment, the patient's total scores on the PTSD Symptom Checklist for DSM-5 (PCL-5) went from 59 to 26, which is below the diagnostic threshold for PTSD. In addition, she demonstrated improvements in the Eating Disorder Examination Questionnaire (EDE-Q) Global Severity score, the Eating Disorder Inventory (EDI-2) total score, the Patient Health Questionnaire (PHQ-9) total score, the Spielberger State and Trait Anxiety Inventory scores, and the Eating Disorder Quality of Life (EDQOL) total score. Furthermore, her PNES also abated, and she remained seizure free for ∼1 year following discharge with the exception of one short seizure, per report of the patient. Conclusion The use of CPT as part of an integrated trauma-informed treatment approach during residential ED treatment was successful in a woman with PNES, BN, PTSD, MDD, and cannabis use disorder.
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Affiliation(s)
| | - Timothy D. Brewerton
- Monte Nido and Affiliates, Miami, FL, USA
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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Kennedy HL, Hitchman LM, Pettie MA, Bulik CM, Jordan J. Avoidant/restrictive food intake disorder (ARFID) in New Zealand and Australia: a scoping review. J Eat Disord 2023; 11:196. [PMID: 37932836 PMCID: PMC10629104 DOI: 10.1186/s40337-023-00922-9] [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: 06/19/2023] [Accepted: 10/31/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Avoidant/restrictive food intake disorder (ARFID) is an eating disorder that involves restrictive or avoidant eating behaviour not related to weight or body image concerns. It was first included in the Diagnostic and Statistical Manual of Mental Disorders-fifth edition (DSM-5) in 2013. ARFID frequently begins in childhood and can have serious psychosocial impacts and detrimental health consequences when nutritional and energy needs are persistently unmet. This systematic scoping review focuses on Australasia, synthesizing the current literature landscape on ARFID, and offering recommendations for targeted, actionable research directions for both funders and researchers. METHODS Online databases and university thesis repositories were systematically searched for studies examining ARFID in the New Zealand or Australian population since 2013. Database search results were exported to Rayyan software, and two independent reviewers screened all identified sources, prior to extraction of key data. RESULTS Twenty-nine studies and one thesis from 138 screened sources were eligible for inclusion. Frequent study types were treatment interventions and cross-sectional studies, with populations including individuals with ARFID, ED service populations, parents/caregivers, health professionals, and non-clinical populations. ARFID presents in a range of settings and is associated with poorer quality of life and significant functional impairment. Assessment of ARFID was varied, and no specific treatment guidelines for ARFID have been written as yet. CONCLUSION This review calls for more accurate prevalence estimates of ARFID in children and larger-scale studies in all ages using validated measures. It emphasizes the need for education and training of healthcare professionals, and interdisciplinary collaboration. Established interventions like behaviour analytics should be considered, and more comprehensive research is needed on interventions for ARFID, including controlled trials and longitudinal studies. Urgent research is needed to improve outcomes for those affected by ARFID.
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Affiliation(s)
- Hannah L Kennedy
- Department of Psychological Medicine, University of Otago - Christchurch, Christchurch, New Zealand.
| | - Leonie M Hitchman
- Department of Pathology and Biomedical Science, University of Otago - Christchurch, Christchurch, New Zealand
| | - Michaela A Pettie
- Department of Pathology and Biomedical Science, University of Otago - Christchurch, Christchurch, New Zealand
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jennifer Jordan
- Department of Psychological Medicine, University of Otago - Christchurch, Christchurch, New Zealand
- Specialist Mental Health Clinical Research Unit, Te Whatu Ora, Waitaha, Christchurch, New Zealand
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Hennemann S, Wenzel M, Van den Bergh O, Wessels M, Witthöft M. Emotion dynamics and somatic symptoms in everyday life: Ecological momentary assessment in somatic symptom disorder and healthy controls. J Psychosom Res 2023; 172:111429. [PMID: 37406416 DOI: 10.1016/j.jpsychores.2023.111429] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/23/2023] [Accepted: 06/24/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVE Negative affectivity (NA) is associated with the emergence and persistence of physical symptoms with unclear organic pathology. This study investigated the temporal dynamics of NA and somatic symptom burden using ecological momentary assessment (EMA) in adults with somatic symptom disorder (SSD) and healthy control participants (HC). METHODS Participants underwent a seven-day, smartphone-based EMA, with 6 randomly-stratified time points per day. NA was assessed using a five-item short form of the Positive and Negative Affectivity Scale (PANAS) and somatic symptom burden with two self-constructed items. 22 persons with SSD and 20 HCs were included in multilevel analyses. RESULTS Within-person analyses showed a significantly stronger (positive) association of concurrent NA with somatic symptom burden in participants with SSD than in HCs, β = 0.15, SE = 0.04, p = .001. Time-lagged analyses demonstrated that, across groups, NA at a previous time point t-1 significantly predicted somatic symptom burden at the subsequent timepoint t, β = 0.09, SE = 0.03, p = .005, but not in the other direction (somatic symptom burdent-1→ NAt, β = 0.01, SE = 0.04, p = .79). Between-person analyses showed that both inertia (i.e., persistence of negative affective states), d = 0.74, and instability (i.e., magnitude of moment-to-moment fluctuations), d = 0.76 of NA were significantly higher in participants with SSD than in HCs. CONCLUSIONS Our findings sustain the idea of (negative) affect-driven modulation in somatic signal processing and suggest that interoceptive and emotional differentiation training can advance the psychotherapeutic treatment of SSD.
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Affiliation(s)
- Severin Hennemann
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, University of Mainz, Germany.
| | - Mario Wenzel
- Department of Health Psychology, University of Mainz, Germany
| | | | - Marlene Wessels
- Department of Experimental Psychology, University of Mainz, Germany
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, University of Mainz, Germany
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11
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Komasi S, Hemmati A, Rahmani K, Rezaei F. Construct and criterion validity of the HiTOP spectra to predict dimensional and categorical somatization in a large non-western sample. Sci Rep 2023; 13:13197. [PMID: 37580386 PMCID: PMC10425466 DOI: 10.1038/s41598-023-40545-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 08/12/2023] [Indexed: 08/16/2023] Open
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a phenotypic data-driven framework for the classification of psychopathology. We tested the construct and criterion validity of the HiTOP spectra measured by the Personality Inventory for DSM-5 (PID-5) using exploratory structural equation modeling (ESEM) and hierarchical regressions both to predict somatic symptom and related disorders (SSRD) and a somatization factor. The case-control study used hierarchical logistic regressions to distinguish 257 cases with SSRD from 1007 healthy controls by both the maladaptive and the temperament factors. The extracted factors were also used in hierarchical linear regressions to predict the dimensional somatization factor. The seven temperament factors explained more variance above and beyond the five maladaptive factors when predicting SSRD (pseudo R2 = 0.169 to 0.266 versus 0.125 to 0.196; change in pseudo R2 = 0.055 to 0.087 versus 0.011 to 0.017). The temperament factors also explained more variance above and beyond the maladaptive factors when predicting the somatization factor (R2 = 0.392 versus 0.269; change in R2 = 0.146 versus 0.023). Although the HiTOP spectra measured by PID-5 are significant structures related to the categorical and dimensional measurements of somatoform, our findings highlight potential problems with both the construct and criterion validity of the HiTOP spectra.
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Affiliation(s)
- Saeid Komasi
- Neurosciences Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran.
| | - Azad Hemmati
- Department of Psychology, University of Kurdistan, Sanandaj, Iran
| | - Khaled Rahmani
- Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Farzin Rezaei
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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12
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Mirabella M, Muzi L, Franco A, Urgese A, Rugo MA, Mazzeschi C, Speranza AM, McWilliams N, Lingiardi V. From symptoms to subjective and bodily experiences: the contribution of the Psychodynamic Diagnostic Manual (PDM-2) to diagnosis and treatment monitoring in eating disorders. Eat Weight Disord 2023; 28:35. [PMID: 36997702 PMCID: PMC10063489 DOI: 10.1007/s40519-023-01562-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 03/17/2023] [Indexed: 04/01/2023] Open
Abstract
PURPOSE Atheoretical and descriptive conceptualizations of eating disorders (EDs) have faced substantial criticism due to their limited ability to assess patients' subjective characteristics and experiences, as needed to determine the most appropriate treatment options. The present article provides an overview of the clinical and empirical literature supporting the potential contribution of the Psychodynamic Diagnostic Manual (PDM-2) to both diagnostic assessment and treatment monitoring. METHODS Following a discussion of the most relevant shortcomings of current diagnostic models of EDs and a description of the rationale and structure of the PDM-2, evidence supporting the core PDM-2 dimensions of ED patients' subjective experiences (i.e., affective states, cognitive processes, relational patterns, somatic/bodily experiences and states) are examined, alongside their relevance to ED diagnosis and treatment. RESULTS Overall, the reviewed studies support the diagnostic importance of these patterns of subjective experiences in EDs, highlighting their potential role as either predisposing or maintaining factors to target in psychotherapy. A growing body of multidisciplinary evidence also shows that bodily and somatic experiences are central to the diagnosis and clinical management of ED patients. Moreover, there is evidence that a PDM-based assessment may enable closer monitoring of patient progress during treatment, with regard to both subjective experiences and symptom patterns. CONCLUSIONS The study suggests that current diagnostic frameworks for EDs would benefit from the addition of a person-centered perspective that considers not only symptoms, but also patients' full range of functioning-including their deep and surface-level emotional, cognitive, interpersonal, and social patterns-to improve patient-tailored interventions. LEVEL OF EVIDENCE Level V, narrative review.
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Affiliation(s)
- Marta Mirabella
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Laura Muzi
- Department of Philosophy, Social Sciences, Humanities and Education, University of Perugia, Perugia, Italy.
| | - Anna Franco
- Eating Disorder Clinic "Residenza Gruber", Bologna, Italy
| | - Alessia Urgese
- Eating Disorder Clinic "Residenza Gruber", Bologna, Italy
| | - Michele A Rugo
- Eating Disorder Clinic "Residenza Gruber", Bologna, Italy
| | - Claudia Mazzeschi
- Department of Philosophy, Social Sciences, Humanities and Education, University of Perugia, Perugia, Italy
| | - Anna Maria Speranza
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Nancy McWilliams
- Graduate School of Applied and Professional Psychology, Rutgers University, Lambertville, NJ, USA
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
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Komasi S, Jananeh M, Mahdavi S, Shademan T, Vaysi A, Shahlaee M, Mirani A, Chamandoust Z, Saeidi M. The maladaptive domains according to the alternative model of personality disorders (AMPD) criterion B in patients with affective disorders and temperamental triads related to these domains: two unique profiles. BMC Psychol 2023; 11:83. [PMID: 36978163 PMCID: PMC10053052 DOI: 10.1186/s40359-023-01122-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVES The study aimed to (i) compare the maladaptive domains and facets according to the Alternative Model of Personality Disorders (AMPD) Criterion B in patients with a type II bipolar disorder (BD-II) or major depressive disorder (MDD) with healthy controls (HCs), and (ii) investigating the relationship between affective temperaments and these domains and facets in the total sample. METHODS Outpatients diagnosed with current BD-II (n = 37; female 62.2%) or MDD (n = 17; female 82.4%) based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria and community HCs (n = 177; female 62.1%) in Kermanshah from July to October 2020 included this case-control study. All participants completed the Personality Inventory for DSM-5 (PID-5), the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A), and the second version of the Beck Depression Inventory (BDI-II). Data were analyzed using analysis of variance (ANOVA), Pearson correlation, and multiple regression. RESULTS The score of patients with BD-II in all five domains and those with MDD in three domains including negative affectivity, detachment, and disinhibition are significantly higher than the HCs (p < 0.05). Depressive temperament (related to negative affectivity, detachment, and disinhibition) and cyclothymic temperament (related to antagonism and psychoticism) were the most important correlates of the maladaptive domains. CONCLUSIONS Two unique profiles are proposed, including three domains of negative affectivity, detachment, and disinhibition associated with the depressive temperament for MDD, and two domains of antagonism and psychoticism related to cyclothymic temperament for BD-II.
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Affiliation(s)
- Saeid Komasi
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran.
| | - Minoo Jananeh
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran.
| | - Sahar Mahdavi
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Tahereh Shademan
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Anis Vaysi
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Mehrnoosh Shahlaee
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Atefeh Mirani
- Department of Psychology, University of Kurdistan, Sanandaj, Iran
| | - Zahra Chamandoust
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Mozhgan Saeidi
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
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14
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Wendt LP, Jankowsky K, Schroeders U, Nolte T, Fonagy P, Montague PR, Zimmermann J, Olaru G. Mapping established psychopathology scales onto the Hierarchical Taxonomy of Psychopathology (HiTOP). Personal Ment Health 2022; 17:117-134. [PMID: 36162810 DOI: 10.1002/pmh.1566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/18/2022] [Accepted: 08/23/2022] [Indexed: 11/05/2022]
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) organizes phenotypes of mental disorder based on empirical covariation, offering a comprehensive organizational framework from narrow symptoms to broader patterns of psychopathology. We argue that established self-report measures of psychopathology from the pre-HiTOP era should be systematically integrated into HiTOP to foster cumulative research and further the understanding of psychopathology structure. Hence, in this study, we mapped 92 established psychopathology (sub)scales onto the current HiTOP working model using data from an extensive battery of self-report assessments that was completed by community participants and outpatients (N = 909). Content validity ratings of the item pool were used to select indicators for a bifactor-(S-1) model of the p factor and five HiTOP spectra (i.e., internalizing, thought disorder, detachment, disinhibited externalizing, and antagonistic externalizing). The content-based HiTOP scales were validated against personality disorder diagnoses as assessed by standardized interviews. We then located established scales within the taxonomy by estimating the extent to which scales reflected higher-level HiTOP dimensions. The analyses shed light on the location of established psychopathology scales in HiTOP, identifying pure markers and blends of HiTOP spectra, as well as pure markers of the p factor (i.e., scales assessing mentalizing impairment and suspiciousness/epistemic mistrust).
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Affiliation(s)
- Leon P Wendt
- Department of Psychology, University of Kassel, Kassel, Germany
| | | | | | | | - Tobias Nolte
- Wellcome Trust Centre for Neuroimaging, University College London, London, UK.,Anna Freud National Centre for Children and Families, London, UK
| | - Peter Fonagy
- Anna Freud National Centre for Children and Families, London, UK.,Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - P Read Montague
- Wellcome Trust Centre for Neuroimaging, University College London, London, UK.,Fralin Biomedical Research Institute, Department of Psychology, Virginia Tech, Roanoke, Virginia, USA
| | | | - Gabriel Olaru
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
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