The role of emotion regulation strategies and dissociation in non-suicidal self-injury for women with borderline personality disorder and comorbid eating disorder

Different dysfunctional emotion regulation strategies are observed in patients with borderline personality disorder (BPD) and comorbid eating disorders (EDs) who report non-suicidal self-injury (NSSI). The objective of this study was to investigate the relationship of two well-defined emotion regulation strategies (i.e. expressive suppression and cognitive reappraisal) and dissociation with NSSI. The participants were sixty-eight women diagnosed with BPD and comorbid ED. A cross-sectional research design was used, and clinical interviews and self-report questionnaires were administered to collect data. Multiple regression was conducted to analyze the relationship of two emotion regulation strategies and dissociation with NSSI. According to the results, for low cognitive reappraisal scores, an increase in dissociation leads to an increase in NSSI; however, as cognitive reappraisal increases, higher dissociation is associated with fewer NSSI. When expressive suppression is low, an increase in cognitive reappraisal is associated with a decrease in NSSI; however, as suppression increases, a higher cognitive reappraisal has less effect on decreasing NSSI. These findings indicate that cognitive reappraisal reduces the harmful effects that dissociation has on NSSI, and that expressive suppression interferes with the beneficial effects of cognitive reappraisal on NSSI. Therefore, targeting expressive suppression before cognitive reappraisal is conducted may enhance treatment outcomes for patients with BPD and comorbid ED.The research presented in this paper was funded by Ministerio de Economía y Competitividad, Spain, proyectos de investigacion fundamental no orientada (PSI2010-21423/PSIC), Plan de Formación de la investigacion en la Universitat Jaume I (P11B2005-32), and Generalitat Valenciana, Redes de Excelencia ISIC (ISIC/2012/012)

The half-painted picture: Reviewing the mental health impacts of cancer screening

Peer reviewe

Social trauma and its association with posttraumatic stress disorder and social anxiety disorder

Publisher's version (útgefin grein)The key characteristic of a traumatic event as defined by the Diagnostic and Mental Manual of Mental Disorders (DSM) seems to be a threat to life. However, evidence suggests that other types of threats may play a role in the development of PTSD and other disorders such as social anxiety disorder (SAD). One such threat is social trauma, which involves humiliation and rejection in social situations. In this study, we explored whether there were differences in the frequency, type and severity of social trauma endured by individuals with a primary diagnosis of SAD (n = 60) compared to a clinical control group of individuals with a primary diagnosis of obsessive compulsive disorder (OCD, n = 19) and a control group of individuals with no psychiatric disorders (n = 60). The results showed that most participants in this study had experienced social trauma. There were no clear differences in the types of experiences between the groups. However, one third of participants in the SAD group (but none in the other groups) met criteria for PTSD or suffered from clinically significant PTSD symptoms in response to their most significant social trauma. This group of SAD patients described more severe social trauma than other participants. This line of research could have implications for theoretical models of both PTSD and SAD, and for the treatment of individuals with SAD suffering from PTSD after social trauma.The authors would like to thank Anna Kristin Cartesegna and TomasPall Thorvaldsson for their assistance in collecting data for this studyPeer Reviewe

Appraisals of Social Trauma and Their Role in the Development of Post-Traumatic Stress Disorder and Social Anxiety Disorder

Funding Information: ASB receives funding from the Icelandic Research Fund (185323). Funders were not involved in study design, data collection, data analysis, report writing, or submission process. Publisher Copyright: © 2023 by the authors.Cognitive theories of post-traumatic stress disorder (PTSD) feature appraisal of trauma as a critical factor in the development and maintenance of the disorder. Here we explored appraisals of social trauma (severe rejection or humiliation). Participants were outpatients with social anxiety disorder (SAD) and clinically significant PTSD symptoms (PTSS) after social trauma (n = 15); two clinical control groups of either SAD (n = 32) or obsessive-compulsive disorder (OCD; n = 13); and a control group with no diagnoses (n = 38). Measures included a clinical interview to assess social trauma and related open-ended appraisals and the Posttraumatic Cognitions Inventory (PTCI). Raters blind to group assignment performed content analyses of appraisals. Results showed that the PTSS group scored significantly higher than either clinical group on the PTCI SELF subscale. Only the SELF subscale predicted a diagnosis of both PTSS and SAD. All but one PTSS participant reported primarily negative beliefs about their social trauma, and the most common categories were flawed self and others are critical or cruel. Post-traumatic appraisals implicated in the course of PTSD are significant in how individuals respond to social trauma, with negative self-cognitions linked to both PTSS and SAD.Peer reviewe

Iceland screens, treats, or prevents multiple myeloma (iStopMM): a population-based screening study for monoclonal gammopathy of undetermined significance and randomized controlled trial of follow-up strategies.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadMonoclonal gammopathy of undetermined significance (MGUS) precedes multiple myeloma (MM). Population-based screening for MGUS could identify candidates for early treatment in MM. Here we describe the Iceland Screens, Treats, or Prevents Multiple Myeloma study (iStopMM), the first population-based screening study for MGUS including a randomized trial of follow-up strategies. Icelandic residents born before 1976 were offered participation. Blood samples are collected alongside blood sampling in the Icelandic healthcare system. Participants with MGUS are randomized to three study arms. Arm 1 is not contacted, arm 2 follows current guidelines, and arm 3 follows a more intensive strategy. Participants who progress are offered early treatment. Samples are collected longitudinally from arms 2 and 3 for the study biobank. All participants repeatedly answer questionnaires on various exposures and outcomes including quality of life and psychiatric health. National registries on health are cross-linked to all participants. Of the 148,704 individuals in the target population, 80 759 (54.3%) provided informed consent for participation. With a very high participation rate, the data from the iStopMM study will answer important questions on MGUS, including potentials harms and benefits of screening. The study can lead to a paradigm shift in MM therapy towards screening and early therapy.Black Swan Research Initiative by the International Myeloma Foundation Icelandic Centre for Research European Research Council (ERC) University of Iceland Landspitali University Hospita

Áhrif táknbundinnar styrkingar á vinnusemi og truflandi hegðun drengs með AMO og ODD

Fylgst var með hegðun 10 ára drengs í skóla á höfuðborgarsvæðinu með beinu áhorfi. Drengurinn hafði nýlega verið greindur með athyglisbrest og ofvirkni (AMO) og mótþróaþrjóskuröskun (ODD). Einnig sýndi greindarpróf mikinn misstyrk og mat á aðlögunarfærni leiddi í ljós vandkvæði í boðskiptum og félagslegri aðlögun. Drengurinn hafði verið í lyfjameðferð, tekið inn örvandi lyf sem heitir Concerta, en þeirri meðferð var hætt áður en mælingar hófust. Markmið rannsóknarinnar var að auka vinnusemi og minnka tíðni truflandi hegðunar í kennslustundum en rannsóknin fór bæði fram í almennri kennslu og sérkennslu. Notast var við marghliða grunnlínusnið yfir aðstæður og byrjaði inngripið í almennri kennslu og þar eftir í sérkennslu. Til að breyta hegðun drengsins voru notaðar fyrirbyggjandi aðgerðir, hegðunarsamningar, sjálfsmat og táknbundið styrkingarkerfi (token economy). Styrkingarkerfið fólst í því að drengurinn fékk stig fyrir hverja kennslustund og ef þau náðu ákveðnum fjölda í lok skóladags fékk hann íshokkíleikmann í verðlaun. Fengi hann leikmann gat hann valið sér verðlaun þegar hann kom heim úr skólanum af lista sem hafði verið útbúinn út frá viðtölum við drenginn og foreldra hans. Drengurinn gat einnig fengið helgarverðlaun en til þess þurfti hann að ná ákveðnum fjölda leikmanna yfir kennsluvikuna. Til að koma í veg fyrir að drengurinn gæti hagað sér illa eftir að hafa náð þeim stigafjölda sem hann þurfti til að standast kröfur dagsins gat hann fengið auka íshokkíleikmann í lok hverrar kennsluviku. Stæðist hann kröfurnar tvær vikur í röð fékk hann bónusverðlaun helgina eftir að seinni kennsluvikan var liðin. Kennarar voru beðnir um að hrósa og veita athygli fyrir viðeigandi hegðun en hunsa óviðeigandi hegðun og drengnum voru kenndar viðeigandi leiðir til að ná athygli jafnaldra og kennara. Frumbreytur rannsóknarinnar voru fyrirbyggjandi aðgerðir, viðeigandi leiðir til ná athygli, hegðunarsamningar, sjálfsmat nemandans, táknbundið styrkingarkerfi og viðbrögð kennara og samnemanda/enda við viðeigandi og óviðeigandi hegðun drengsins. Fylgibreyturnar voru tíðni truflandi hegðunar og hlutfall þess tíma sem var varið í vinnusemi á áhorfstíma. Vinnusemi jókst í almennri kennslu úr 48,52% í 79,82% en í sérkennslu úr 65,50% í 91,67%. Tíðni truflandi hegðunar minnkaði úr um 14,44 í 2,68 í almennri kennslu en úr 10 í 1,17 í sérkennslu

Measuring biases of visual attention: A comparison of 4 tasks

Observers typically attend preferentially to stimuli with emotional content over emotionally neutral ones. For some this attentional pull is abnormally strong, and such attention biases may play a role in the development and maintenance of anxiety disorders. The assessment of potential biases is constrained by measurement methods. The tasks most commonly used to measure preferential attentional orienting to emotional stimuli, the dot-probe and spatial cueing tasks, have yielded mixed results. We assessed the sensitivity of 4 visual attention tasks (dot-probe, spatial cueing, visual search with irrelevant distractor and attentional blink tasks) to differences in attentional processing between threatening and neutral faces in 33 outpatients with a primary diagnosis of social anxiety disorder (SAD) and 26 healthy controls. The dot-probe and cueing tasks did not reveal any differential processing of neutral and threatening faces nor between the SAD and control groups. The irrelevant distractor task showed some sensitivity to differential processing of facial expression in the SAD group, but the attentional blink task was uniquely sensitive to such differences in both groups, and also revealed processing differences between the SAD and control groups. The attentional blink task revealed interesting temporal dynamics of attentional processing of emotional stimuli and may provide a uniquely nuanced picture of attentional response to emotional stimuli. The task may, therefore, be more suitable to measuring preferential attending to emotional stimuli and treating dysfunctional attention patterns than the more commonly used dot-probe and cueing tasks

Measuring biases of visual attention: A comparison of 4 tasks

Observers typically attend preferentially to stimuli with emotional content over emotionally neutral ones. For some this attentional pull is abnormally strong, and such attention biases may play a role in the development and maintenance of anxiety disorders. The assessment of potential biases is constrained by measurement methods. The tasks most commonly used to measure preferential attentional orienting to emotional stimuli, the dot-probe and spatial cueing tasks, have yielded mixed results. We assessed the sensitivity of 4 visual attention tasks (dot-probe, spatial cueing, visual search with irrelevant distractor and attentional blink tasks) to differences in attentional processing between threatening and neutral faces in 33 outpatients with a primary diagnosis of social anxiety disorder (SAD) and 26 healthy controls. The dot-probe and cueing tasks did not reveal any differential processing of neutral and threatening faces nor between the SAD and control groups. The irrelevant distractor task showed some sensitivity to differential processing of facial expression in the SAD group, but the attentional blink task was uniquely sensitive to such differences in both groups, and also revealed processing differences between the SAD and control groups. The attentional blink task revealed interesting temporal dynamics of attentional processing of emotional stimuli and may provide a uniquely nuanced picture of attentional response to emotional stimuli. The task may, therefore, be more suitable to measuring preferential attending to emotional stimuli and treating dysfunctional attention patterns than the more commonly used dot-probe and cueing tasks

Psychometric properties of the Icelandic translations of the Sheehan Disability Scale, Quality of Life Scale and the Patient Health Questionnaire

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadVirkniskerðing, skert lífsgæði og þunglyndi hafa mikil áhrif á líf fólks og því er mikilvægt fyrir meðferðaraðila og rannsakendur á Íslandi að geta reitt sig á áreiðanleg og réttmæt mælitæki sem meta þessa þætti. Í þessari rannsókn voru próffræðilegir eiginleikar þriggja sjálfsmatskvarða í íslenskri þýðingu metnir. Þetta eru Sheehan Disability Scale (SDS), sem mælir virkniskerðingu, Quality of Life Scale (QOLS), sem mælir lífsgæði, og Patient Health Questionnaire (PHQ-9), sem mælir fjölda og alvarleika þunglyndiseinkenna. Þátttakendur rannsóknarinnar voru alls 110, þar af 56 í klínísku úrtaki einstaklinga með félagsfælni sem megingreiningu og 54 í almennu úrtaki einstaklinga án geðraskana. Tvö greiningarviðtöl voru lögð fyrir þátttakendur, The Mini International Neuropsychiatric Interview (MINI) og Body Dysmorphic Disorder Diagnostic Module (BDD-DM). Samleitniréttmæti kvarðanna SDS, QOLS og PHQ-9 var metið með tilliti til félagsfælnigreiningar á MINI en samleitniréttmæti PHQ-9 var einnig athugað miðað við þunglyndisgreiningu á MINI. Innri áreiðanleiki SDS var viðunandi (α = 0,7) fyrir klíníska úrtakið en góður (α = 0,81) fyrir almenna úrtakið, viðunandi (α = 0,76) fyrir QOLS í klíníska úrtakinu en góður (α = 0,86) í almenna úrtakinu, góður (α = 0,87) fyrir PHQ-9 í klíníska úrtakinu en sæmilegur (α = 0,66) í almenna úrtakinu. Samleitniréttmæti kvarðanna var mjög gott sem kom fram í því að félagsfælnigreining á MINI tengdist hærri stigafjölda á SDS og PHQ-9 en lægri stigafjölda á QOLS. Einnig spáði hærri stigafjöldi á PHQ-9 fyrir um hærra hlutfall einstaklinga með þunglyndisgreiningu á MINI. Helstu niðurstöður eru þær að próffræðilegir eiginleikar kvarðanna haldast að mestu leyti í íslenskri þýðingu. Félagsfælni virðist draga úr lífsgæðum, auka líkurnar á þunglyndiseinkennum og hafa mikil og neikvæð áhrif á virkni fólks sem greinist með hana.It is imperative for clinicians and researchers in Iceland to have good measures of functioning, quality of life and depression symptoms. In this study, the psychometric properties of the translations of three well-known measures of these variables were assessed. These were the Sheehan Disability Scale (SDS), a measure of the impact of psychiatric symptoms on functioning, the Quality of Life Scale (QOLS), and the Patient Health Questionnaire (PHQ-9), which is a measure of depression symptoms and their severity. There were 110 participants, 56 participants had a primary diagnosis of social anxiety disorder (SAD; SAD group), and 54 participants had no clinical diagnoses (comparison group). All participants were interviewed with two diagnostic interviews, the Mini International Neuropsychiatric Interview (MINI) and the Body Dysmorphic Disorder Diagnostic Module (BDD-DM). The convergent validity of the SDS, QOLS and PHQ-9 was assessed with reference to a diagnosis of SAD on the MINI, and the convergent validity of PHQ-9 was also assessed with reference to a diagnosis of major depressive disorder on the MINI. The internal consistency of the SDS was acceptable (α = 0,7) for the SAD group, but good (α = 0,81) for the control group, the internal consistency of the the QOLS was acceptable (α = 0,76) for the SAD group but good (α = 0,86) for the control group, and the internal consistency of the PHQ-9 was good (α = 0,87) for the SAD group but questionable (α = 0,66) for the control group. The convergent validity of the scales was good in that a diagnosis of SAD was associated with higher scores on the SDS, lower scores on the QOLS and higher scores on the PHQ-9. In addition, higher scores on the PHQ- 9 predicted a greater likelihood of being diagnosed with major depressive disorder on the MINI. The main findings were that the psychometric properties of these self-report scales mostly carried over to the Icelandic translations. Social anxiety disorder appears to reduce quality of life, increase the likelihood of depression symptoms and negatively impact functioning

Icelandic translation and reliability data on the DSM-5 version of the schedule for affective disorders and schizophrenia for school-aged children - present and lifetime version (K-SADS-PL).

To access publisher's full text version of this article click on the hyperlink belowBackground: The Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) is a semi-structured interview based on the Diagnostic and Statistical Manual of Mental Disorders (DSM), and assesses past and present symptoms in children aged 6-18 years old. It has been translated into more than 20 languages and is widely used in clinical work. The K-SADS-PL has recently been revised by adopting new DSM-5 disorders and modifying probes accordingly. However, research on this revision is critically limited. The objective of this study was to examine the inter-rater reliability of the DSM-5 K-SADS-PL when administered by postgraduate students after receiving thorough training and supervision. Method: The DSM-5 K-SADS-PL was applied in a clinical sample of two outpatient units: The outpatient unit of the Department of Child and Adolescent Psychiatry at the Landspítali University Hospital in Reykjavík, Iceland and The Icelandic Anxiety Centre for Children, Adolescents and Young Adults. Results: Fourty-one (80%) consecutive patients aged 6-18 years consented and were included. Cohen's κ was calculated to estimate inter-rater reliability, with estimates ranging from fair to excellent (κ = 0.57-0.90), with most diagnoses in the excellent range (κ > 0.75). Conclusions: These results indicate that the Icelandic translation of the DSM-5 K-SADS-PL can be reliably administered by postgraduate students. Keywords: Inter-rater reliability; K-SADS-PL; clinical sample; paediatric.1)Reykjavík Municipal Service Centre for Breiðholt, Reykjavík, Iceland. 2)Child and Adolescent Psychiatric Unit, Akureyri Hospital, Akureyri, Iceland. 3)Department of School and Leisure, Reykjavík, Iceland. 4)Reykjavík Municipal Service Centre for Laugadalur and Háaleiti, Reykjavík, Iceland