1,721,412 research outputs found
Digital hazards for feeding and eating: what we know and what we don't.
No full textPurpose of review: We aimed to accrue recent evidence exploring effects of modern online activities (e.g. Internet use) on feeding and eating disorder symptoms, and related traits. We examined available evidence to ascertain any direct influences from online activities on feeding and eating disorders, thereby shedding light on putative mechanisms by which those influences may occur. Recent findings: Many facets of problematic usage of the internet correlate cross sectionally with eating disorder and related psychopathology. There is evidence to suggest that significant effects do exist in the direction of specific internet activities contributing to eating disorder symptoms, viewed dimensionally. Putative mechanisms are discussed. However a significant number of eating disorder phenotypes and internet-related activities remain under-researched. Summary: Specific facets of engagement with the online environment appear to confer risk for feeding and eating problems, evidence being strongest for non-clinical studies using dimensional measures. More research is required to rigorously confirm causal effects, including in patients meeting formal diagnostic criteria for eating disorders. We also highlight the need for high quality evidence to explore how eating disorder phenotypes are commonly as well as uniquely affected by different online activities. Such research is needed in order that scientific understanding in this area can be translated to protect those most at risk of disordered eating, including through changes in public health approaches and clinical practice. <br/
Modafinil, inhibitory control, and alcoholism
No full textCommentary on L. Schmaal et al, 'Effects of Modafinil on Neural Correlates of Response Inhibition in Alcohol-Dependent Patients' Biological Psychiatry, Volume 73, Issue 3, 1 February 2013, pp 211-21
Lack of deleterious effects of buspirone on cognition in healthy male volunteers (Journal of Psychopharmacology 21, 2, DOI: 10.1177/0269881107068066)
No full textAttentional problems occur across multiple psychiatric disorders and are not specific for ADHD
No full textObjective: Attentional problems are common and have been associated with multiple psychiatric disorders. This study examined problems of sustained attention across a range of psychiatric disorders using a validated computerized trans-diagnostic attentional paradigm (a Continuous Performance Task). We hypothesized that multiple psychiatric disorders, particularly ADHD, would be associated with pronounced attentional problems in young adults versus controls. Methods: 576 non-treatment seeking participants (aged 18-29 years) were enrolled from general community settings, and provided information regarding demographic variables and underwent clinical assessments to detect a range of mental health disorders. Each participant underwent the Rapid Visual Information Processing (RVP) task, a previously validated computerized test measuring sustained attention. The two measures of sustained attention were the sensitivity index, and target detection (proportion of targets detected). The profile of attentional deficits was examined across different disorders using z-scores relative to controls. Results: Participants with social phobia, OCD, bulimia nervosa, and intermittent explosive disorder showed the greater impairment in target sensitivity, all with effect sizes of at least 0.8. Target detection was impaired across multiple disorders, with OCD and binge eating disorder exhibiting the most pronounced impairment. PTSD and compulsive sexual behavior were associated with particularly spared performance on both measures. Discussion: These data indicate that impaired attention is non-specific for ADHD and in fact several other disorders are associated with markedly larger deficits. Instead of clinicians assuming sustained attention problems are due to ADHD, a variety of disorders should be screened for when people report attentional problems. Future work should examine the contribution of comorbidities and psychoactive substances (prescribed or illicit) to the profiles identified. <br/
Personality traits and their clinical associations in trichotillomania and skin picking disorder
Full text linkBackground: Despite being discussed in the psychiatric literature for decades, very little is known about personality features associated with trichotillomania and skin picking disorder (known as body focused repetitive behavior disorders, BFRBs); and the contribution of personality traits to their clinical presentations. Aim: The present study assessed personality traits in a large and well-characterized sample of adults with either trichotillomania or skin picking disorder or both. Methods: Adults (n = 98, aged 18–65 years), with trichotillomania (n = 37), skin picking disorder (n = 32), both trichotillomania and skin picking disorder (n = 10), and controls (n = 19) were enrolled. Participants completed self-report questionnaires to quantify personality (NEO Personality Inventory), as well as extent/severity of picking/pulling symptoms, mood and anxiety, impulsive and perfectionistic tendencies, and neurocognitive functioning. Group differences were characterized and correlations with other measures were examined. Results: In comparison to controls, BFRBs had elevated neuroticism scores (p < 0.001), lower extraversion scores (p = 0.023), and lower conscientiousness scores (p = 0.007). Neuroticism was significantly related to both hair pulling (r = 0.24, p < 0.001) and skin picking severity (r = 0.48, p < 0.001), as well as elevated perceived stress, worse anxiety and depressive symptoms, and poorer quality of life. Introversion (i.e. lower extraversion) was significantly associated with worse picking severity, higher perceived stress, and higher depression. Lack of conscientiousness was significantly associated with more depression, impulsivity, and perceived stress. Discussion: Personality traits of neuroticism, introversion, and lack of conscientiousness are heightened in individuals with BFRBs and show strong associations with a number of clinically relevant features of illness. The holistic understanding and treatment of these disorders is likely to require consideration of dimensional traits such as these.</p
Endophenotypes of obsessive-compulsive disorder: Rationale, evidence and future potential
No full textObsessive-compulsive disorder (OCD) is a heritable and debilitating neuropsychiatric condition. Attempts to delineate genetic contributions have met with limited success, and there is an ongoing search for intermediate trait or vulnerability markers rooted in the neurosciences. Such markers would be valuable for detecting people at risk of developing the condition, clarifying etiological factors and targeting novel treatments. This review begins with brief coverage of the epidemiology of OCD, and presents a hierarchical model of the condition. The advantages of neuropsychological assessment and neuroimaging as objective measures of brain integrity and function are discussed. We describe the concept of endophenotypes and examples of their successful use in medicine and psychiatry. Key areas of focus in the search for OCD endophenotypes are identified, such as measures of inhibitory control and probes of the integrity of orbitofrontal and posterior parietal cortices. Finally, we discuss exciting findings in unaffected first-degree relatives of patients with OCD that have led to the identification of several candidate endophenotypes of the disorder, with important implications for neurobiological understanding and treatment of this and related conditions.</p
Monoamine oxidase inhibitors (MAOIs) for trichotillomania: a case series
No full textPurpose/Background Despite several decades of research, there are no US Food and Drug Administration-approved medications for trichotillomania or medications generally approved in other geographical jurisdictions. Monoamine oxidase inhibitors show efficacy in the treatment of depression and some possible promise for obsessive compulsive disorder. Methods/Procedures We present new data from a case series collected in a specialty clinical practice over a 4-year period. Findings/Results In 5 treatment-resistant patients whose trichotillomania had not improved with at least 1 course of cognitive behavior therapy and trials of n-acetyl cysteine, an antipsychotic, and a serotonin selective reuptake inhibitor, 2 had marked clinical improvement (>40% improvement) on phenelzine, 1 improved on tranylcypromine, and 2 showed no improvement (<10%) on phenelzine. In 2 of the 3 patients who experienced improvement, there was co-occurring depression. Implications/Conclusions Monoamine oxidase inhibitors in trichotillomania may deserve large-scale randomized controlled trials, particularly in specialist settings where first-line interventions have proven inadequate to manage severe symptoms.</p
Gambling disorder in minority ethnic groups
No full textBackground: Although the data on racial/ethnic associations with gambling disorder are limited, studies suggest that ethnicity may have associations with both symptom severity and psychosocial impairment linked to gambling disorder. Based on the current literature, we hypothesized that there would be a difference in gambling symptom severity, and co-occurring disorders, as a function of racial-ethnic group. Methods: 475 adults (mean age = 47.6 (±11.6) years; 54.3 % females) with gambling disorder who had participated in clinical trials on pharmacotherapy or psychotherapy were included. Participants were assessed for gambling severity, comorbidities, health issues, quality of life and psychosocial functioning. Participants who self-identified as Black, Asian or Minority Ethnic (BAME) were compared to those who self-identified as white Caucasian (non-BAME). Significance was defined as p < 0.01. Results: The BAME group had significantly earlier age of first gambling. The two groups did not differ significantly in terms of age when gambling first became problematic, disability, current gambling disorder symptom severity, previous suicide attempt(s), quality of life, percent of salary in past year lost to gambling, or likelihood of having received treatment for gambling disorder in the past, nor in terms of having used Gamblers Anonymous. Conclusions: These data show that having gambling disorder and being from a minority racial-ethnic group was associated with significantly earlier age at first gambling, in clinical trial settings. Future work should further examine differences in the clinical features of gambling disorder in different minority groups in larger sample sizes, ideally also longitudinally, across a range of settings. Identification of the reasons/mechanisms for differences in earlier age of first gambling may lead to new public health and treatment targets to minimize gambling harms.</p
Phenomenology and epidemiology of trichotillomania
No full textTrichotillomania is a psychiatric disorder characterized by recurrent hair pulling, leading to hair loss and functional impairment. This chapter reviews the phenomenology and epidemiology of trichotillomania, and considers its relationship with putative obsessive-compulsive spectrum conditions and other body-focused repetitive behaviors. Salient animal models of the disorder, along with findings in human patients using neuroimaging and cognitive probes, are summarized. A brain-based model of trichotillomania is formulated, focusing on affect dysregulation, addiction, and impulse dyscontrol. Finally, the chapter flags cardinal questions for the attention of future clinical and research scrutiny.</p
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