Textbook of Psychiatry First Edition, Draft 2

This multi-authored collaborative textbook on psychiatry, originally created on Wikibooks, discusses a range of psychiatric disorders, including psychotic, mood and and anxiety disorders, amongst many others. It covers other aspects of psychiatric care such as diagnosis, neurobiology, psychopharmacology, treatment methods, and dealing with agitated or violent patients

Examining the Unique Roles of Disgust Constructs in Co-Occurring Posttraumatic Stress and Obsessive-Compulsive Symptoms

This study examined the distinct roles of disgust propensity (DP) and disgust sensitivity (DS) as mechanisms for obsessive-compulsive (OC) and posttraumatic stress (PTS) symptoms via both self-report and implicit measurement. Undergraduates completed self-report questionnaires assessing negative affect, disgust constructs, mental contamination (MC), OC symptoms, lifetime trauma exposure, and PTS symptoms. Participants who endorsed a lifetime traumatic event and whose reported PTS symptoms approximated DSM-5 diagnostic criteria were invited into the laboratory to complete additional assessments of disgust with the Implicit Relational Assessment Procedure (IRAP), with tasks assessing DP and DS. Partial correlation and linear regression analyses controlling for gender and negative affect examined associations between disgust constructs (as measured both by self-report and IRAP), OC symptom severity, and PTS symptom severity. Results showed that self-reported DP and DS were each uniquely, significantly predictive of OC symptom severity in a general trauma-exposed sample with a range of symptom levels, and that DS was uniquely, significantly correlated with PTS symptoms in a sample of individuals meeting for PTSD caseness. Additionally, DP and DS each significantly predicted OC symptoms in a model also containing gender, negative affect, and PTS symptoms, and DP had unique predictive effects when accounting for construct overlap with DS. Although the delivery of the IRAP tasks appeared to successfully replicate past applications based on descriptive statistics, the disgust IRAPs failed to show any significant associations with or predictions of study outcome variables. Exploratory analyses showed MC to be superior to disgust in predicting OC symptoms in the above model, and post hoc tests showed that DP and DS interacted to predict MC. Exploratory partial correlation analyses revealed differential patterns of association between disgust and OC symptom domains amongst participants reporting various types of traumatic events. Taken together, these findings provide preliminary evidence for a model of how OC symptoms may emerge in the context of trauma, in which DP and DS interact to contribute to MC, which in turn influences OC symptoms

Comprehensive Distancing: A Novel Approach to Reducing Moral Disgust, Shame, and Guilt in Posttraumati Stress Reactions

Abstract not availabl

Pediatric Obsessive-Compulsive Disorder: An Illustration of Intensive Family-Based Treatment Delivered via Web Camera

Effective treatment for childhood obsessive-compulsive disorder (OCD) is available, including exposure with response prevention and other cognitive-behavioral interventions. However, many children with OCD reside in locations in which few providers have adequate training to implement these procedures correctly. Family accommodation of childhood OCD symptoms further complicates the delivery of existing treatments. The advent of web camera technology has created the opportunity to provide therapy to individuals who otherwise could not access expert care. This case illustrates the treatment of an 8-year-old child with severe OCD who lived in a remote region of the United States. Treatment was administered twice daily for 5 days via web camera. At a 3-month follow-up, the child showed significant improvement in her OCD symptoms and in overall disability. Other symptoms (anxiety and anxiety sensitivity) were reduced, but not at a statistically significant level. The implications for treatment are considered

Shared Cognitive Features of Posttraumatic Cognitions and Obsessive-Compulsive Symptoms

Obsessive–compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) frequently co-occur. However, the shared features of these conditions have been under-examined. Evaluation of the common aspects of posttraumatic and obsessive–compulsive (OC) symptoms could improve treatment responsivity for individuals with comorbid PTSD and OCD, for whom outcome is typically poorer than for those with either disorder alone. This study examined intolerance of uncertainty, inflated responsibil- ity, and a global measure of posttraumatic cognitions as potential shared cognitive constructs that moderate distress associated with OC symptoms. A total of 211 undergrad- uate students reporting significant trauma histories partic- ipated. All participants completed measures of obsessive– compulsive symptoms and beliefs, as well as posttraumatic cognitions. Results indicated that posttraumatic cognitions moderated the relationship between inflated responsibility and intolerance of uncertainty, which in turn predicted all domains of obsessive–compulsive symptom distress (all bs [ 0.41, all zs [ 3.44). Further, posttraumatic cognitions alone significantly predicting OC symptoms related to doubting, obsessions, and neutralizing. These findings suggest that shared cognitive constructs play a role in co- occurring posttraumatic stress and OC symptoms, and thus may be a relevant treatment target when these disorders present simultaneously

Change in disgust reactions following cognitive-behavioral therapy for childhood anxiety disorders

La asco, además del miedo, es un estado emocional prominente asociado con la evitación de estímulos perturbadores. Aunque la mayoría de la investigación se ha llevado a cabo en relación con el trastorno obsesivo-compulsivo (TOC), datos recientes han implicado la asco en la etiología de trastornos de ansiedad en general. Se ha demostrado que la disminución de la asco es clave para la reducción de los síntomas en personas con TOC. Sin embargo, son escasos los trabajos que exploren si estas intervenciones son eficaces en trastornos de ansiedad en la infancia con componentes prominentes de asco. Este estudio examinó cómo la propensión a la asco en niños con trastornos de ansiedad responde a la terapia cognitivo-conductual (TCC) con énfasis en la exposición. Cuarenta y un niños de 7 a 17 años, con trastornos de ansiedad, fueron evaluados en la propensión a la asco y tratados semanalmente con TCC intensiva. Se encontró que los niveles de asco disminuyeron tras el tratamiento en todos los diagnósticos de trastorno de ansiedad, siendo los niños con TOC primario los que mostraron reducciones significativamente mayores. Se discuten las implicaciones clínicas y sugerencias para futuras investigaciones sobre el tratamiento de la asco en relación con los trastornos de ansiedad infantil

Disgust as a Unique Affective Predictor of Mental Contamination Following Sexual Trauma

Mental contamination has been described as an internal experience of dirtiness that can arise and per- sist in the absence of contact with observable physical contaminants. Recent research has examined mental contamination specifically related to unwanted physical contact and sexual trauma. This study evaluated the degree to which disgust propensity and both self-focused and perpetrator-focused peri- traumatic disgust were associated with mental contamination in a sample of women who experienced sexual trauma (n = 72). Results showed that peritraumatic self-focused disgust, but not peritraumatic perpetrator-focused disgust or fear, was significantly associated with mental contamination. Addition- ally, disgust propensity contributed significantly to the incremental validity of the model. These findings support the nascent literature showing that disgust plays a significant role in mental contamination, particularly following sexual trauma. Future research directions, and clinical/theoretical implications of these results are discussed

Alleviation of Moral Disgust, Shame, and Guilt in Posttraumatic Stress Reactions: An Evaluation of Comprehensive Distancing

Research suggests that moral disgust, shame, and guilt are present in posttraumatic psychopathology. However, it is unclear that these emotional states are responsive to empirically supported interventions for posttraumatic stress symptoms (PTSS). This study explored the relations among moral disgust, shame, guilt, and PTSS, and examined comprehensive distancing (CD) as a novel intervention for these emotional states in undergraduates with elevated PTSS. Participants were randomly assigned to use a CD or a cognitive challenge task in response to personalized scripts of a traumatic event. Both interventions were associated with decreases in disgust, moral disgust, shame, and guilt. Contrary to predictions, there were no significant differences between the exercises in the reduction of negative emotions. In addition, PTSS severity was correlated with trauma-related guilt as well as state guilt and shame, but not trait or state measures of disgust or moral disgust. This proof of concept project sets the stage for further research examining CD as an alternative or adjunctive intervention for posttraumatic stress reactions with strong features of moral disgust, shame, and guilt