transdiagnostic
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Background: Although trauma exposure is universally prevalent, the ways in which individuals respond to potentially traumatic events vary. Between-country differences have been identified as affecting the development and manifestation of transdiagnostic psychological symptoms, but it remains unclear how stress and trauma-related transdiagnostic symptoms and risk patterns differ based on geographic region.Objective: To explore whether there are distinct classes of stress and trauma-related transdiagnostic symptoms and to determine predictors of class membership in a global sample.Method: Participants (N = 8675) from 115 different countries were recruited online between 2020-2022 and completed the Global Psychotrauma Screen, which assesses stress and trauma exposure, related symptoms, and risk factors. A latent class analysis (LCA) was used to identify classes of stress and trauma-related symptoms per world region (African States, Asia-Pacific States, Eastern European States, Latin American and Caribbean States, Western European and Other States, and North America) and the total sample. Likelihood of class membership was assessed based on demographics, characteristics of the potentially traumatic event, and potential risk factors across the world regions.Results: Similar class compositions were observed across regions. A joint latent class analysis identified three classes that differed by symptom severity (i.e. high, moderate, low). Multinomial logistic regression analyses revealed several factors that conferred greater risk for experiencing higher levels of symptoms, including geographic region, gender, and lack of social support, among others.Conclusions: Stress and trauma-related symptoms seem to be similarly transdiagnostic across the world, supporting the value of a transdiagnostic assessment.
- MeSH
- analýza latentních tříd MeSH
- lidé MeSH
- posttraumatická stresová porucha * diagnóza epidemiologie psychologie MeSH
- rizikové faktory MeSH
- sociální opora MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Asie MeSH
Characterizing patterns of mental phenomena in epidemiological studies of adolescents can provide insight into the latent organization of psychiatric disorders. This avoids the biases of chronicity and selection inherent in clinical samples, guides models of shared aetiology within psychiatric disorders and informs the development and implementation of interventions. We applied Gaussian mixture modelling to measures of mental phenomena from two general population cohorts: the Avon Longitudinal Study of Parents and Children (ALSPAC, n = 3018) and the Neuroscience in Psychiatry Network (NSPN, n = 2023). We defined classes according to their patterns of both positive (e.g. wellbeing and self-esteem) and negative (e.g. depression, anxiety, and psychotic experiences) phenomena. Subsequently, we characterized classes by considering the distribution of diagnoses and sex split across classes. Four well-separated classes were identified within each cohort. Classes primarily differed by overall severity of transdiagnostic distress rather than particular patterns of phenomena akin to diagnoses. Further, as overall severity of distress increased, so did within-class variability, the proportion of individuals with operational psychiatric diagnoses. These results suggest that classes of mental phenomena in the general population of adolescents may not be the same as those found in clinical samples. Classes differentiated only by overall severity support the existence of a general, transdiagnostic mental distress factor and have important implications for intervention.
- MeSH
- dítě MeSH
- lidé MeSH
- longitudinální studie MeSH
- mladiství MeSH
- rodiče MeSH
- úzkost * diagnóza epidemiologie psychologie MeSH
- úzkostné poruchy * diagnóza epidemiologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- Publikační typ
- časopisecké články MeSH
1st ed. x, 365 s.
Addressing global mental health is a major 21st-century challenge. Current treatments have recognized limitations; in this context, new ones that are prophylactic and effective across diagnostic boundaries would represent a major advance. The view that there exists a core of transdiagnostic overlap between psychiatric disorders has re-emerged in recent years, and evidence that psychedelic therapy holds promise for a range of psychiatric disorders supports the position that it may be transdiagnostically effective. Here, we propose that psychedelic therapy's core, transdiagnostically relevant action lies in its ability to increase neuronal and mental plasticity, thus enhancing the potential for change, which we consider to be a key to its therapeutic benefits. Moreover, we suggest that enhanced plasticity via psychedelics, combined with a psychotherapeutic approach, can aid healthy adaptability and resilience, which are protective factors for long-term well-being. We present candidate neurological and psychological markers of this plasticity and link them with a predictive processing model of the action of psychedelics. We propose that a model of psychedelic-induced plasticity combined with an adequate therapeutic context has prophylactic and transdiagnostic potential, implying that it could have a broad, positive impact on public health.
- Publikační typ
- časopisecké články MeSH
Teorie menšinového stresu v současnosti představuje uznávaný interpretační rámec, kterým můžeme porozumět faktorům, jež negativně ovlivňují duševní zdraví neheterosexuálních lidí. V tomto přehledovém příspěvku představím základní východiska tohoto přístupu a diskutuji tři klíčové proximální menšinové stresové procesy - internalizovanou homonegativitu, motivaci ke skrývání sexuální identity a citlivost k odmítnutí. Na závěr poukáži na aktuální praxi v oblasti transdiagnostických intervencí.
Minority stress theory is now a recognised interpretive framework through which we can understand the factors that negatively affect the mental health of non-heterosexual people. In this review paper, I introduce the basic premises of this approach and discuss three key proximal minority stress processes - internalized homonegativity, motivation to conceal sexual identity, and rejection sensitivity. I conclude by highlighting current practice in transdiagnostic interventions.
Duševní onemocnění představují významný problém současné společnosti. Klinické výzkumy psychedelik přinášejí rostoucí množství evidence o jejich terapeutickém potenciálu. Zajímavá pro tuto skupinu látek je skutečnost, že stejné substance se ukazují jako účinné v léčbě různých psychických symptomů a duševních onemocnění napříč diagnostickými kategoriemi. Psychedelika se tak ukazují mít univerzálnější využití než tradiční psychofarmaka, která působí zejména na konkrétní symptomy. Jejich terapeutické podání předpokládá přítomnost zkušeného odborníka během akutní fáze účinku a širší rámec zahrnující přípravná a následná sezení. Psychedelická terapie může ovlivňovat vybrané psychologické fenomény a charakteristiky i u zdravých dobrovolníků – např. zvyšovat jejich well-being, otevřenost, kapacitu všímavosti nebo mentální flexibilitu. Tyto fenomény jsou zároveň významnými koreláty duševního zdraví. Na základě dostupné evidence se lze domnívat, že klíčovým mechanismem účinku psychedelik je jejich působení na psychologickou flexibilitu, která by mohla představovat základní sjednocující faktor pro vysvětlení terapeutického účinku psychedelik na různé duševní obtíže z psychologické perspektivy. Na základě transdiagnostické povahy tohoto mechanismu by psychedelická terapie mohla najít uplatnění nejen v léčbě nejrůznějších poruch, ale potenciálně sloužit i v rámci širší péče o duševní zdraví, popř. prevence duševních onemocnění u zdravých lidí. Psychedelická terapie poutá pozornost autorů směrem k multifaktoriální etiologii duševních onemocnění, transdiagnostickým procesům, významu psychoterapie při jejich léčbě i extrafarmakologickým proměnným. V tomto článku je reflektován význam, který by mohlo mít využití psychedelik v péči o duševní zdraví, jejich mechanismus účinku a potenciální rizika i způsoby, jakými by bylo možné jim předcházet.
Mental health problems constitute a major issue in contemporary society. Meanwhile, the evidence of the therapeutic potential of psychedelics obtained in clinical trials is continuing to grow. One of the remarkable characteristics of this class of substances is the fact that they appear to be effective in the treatment of a variety of psychological symptoms and mental illnesses across diagnostic categories. Psychedelics thus seem to have a wider range of usefulness than traditional psychopharmaceuticals, which generally tend to target specific symptoms. The administration of psychedelics includes the presence of an experienced professional until the acute effects subside. Moreover, these substances should be administered as part of a broader, more comprehensive programme, including preparatory and follow-up sessions. Psychedelic therapy can also have an effect on certain psychological phenomena and processes even in healthy volunteers, e.g. increase their well-being, openness, mindfulness capacities and mental flexibility. These phenomena are important correlates of mental health. The available evidence seems to indicate that the key psychological mechanism of the therapeutic effect of psychedelics is their impact on psychological flexibility. This could be the common underlying factor explaining the therapeutic efficacy of psychedelics in the treatment of various mental health disorders across diagnostic categories. The transdiagnostic nature of this mechanism suggests that psychedelic therapy could potentially prove useful, apart from the treatment of various pathologies, also as a tool for general mental health promotion and prevention of mental illness in healthy people. Psychedelic therapy brings the attention to the multifactorial etiology of mental disorders, the importance of the psychotherapy component in healthcare, and the role of transdiagnostic processes and non-pharmacological variables. In this review article, the potential of psychedelics in mental health care, their mechanisms of action, and possible risks as well as risk-prevention strategies is discussed.
Purpose: Obsessive compulsive disorder (OCD) is a debilitating mental disorder that often takes a chronic course. One of the factors influencing the treatment effectiveness in anxiety and depressive disorders is the self-stigma. This study focused on the relationship between the self-stigma, symptomatology, and therapeutic outcomes in patients with OCD. Patients and Methods: Ninety-four inpatients with OCD, who did not sufficiently respond to at least one selective serotonin reuptake inhibitor trial, participated in the study. They attended a six-week therapeutic program consisting of exposure and response prevention, transdiagnostic group cognitive behavioral therapy, individual sessions, mental imagery, relaxation, sport, and ergotherapy. The participants completed several scales: the Internalized Stigma of Mental Illness Scale (ISMI), the self-report Yale-Brown Obsessive Compulsive Scale (Y-BOCS-SR), Beck Anxiety Scale (BAI), Beck Depression Scale-II (BDI-II), and Dissociative Experiences Scale (DES). A senior psychiatrist filled in the Clinical Global Impression (CGI-S). Results: The average scales' scores considerably declined in all measurements except for DES. The self-stigma positively correlated with all psychopathology scales. It was also higher in patients with a comorbid personality disorder (PD). The higher self-stigma predicted a lower change in compulsion, anxiety, and depressive symptoms but not the change of obsessions or the overall psychopathology. Conclusion: The self-stigma presents an important factor connected to higher severity of OCD. It is also a minor predictor of a lower change in symptomatology after combined treatment.
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Maladaptive responses to negative affective stimuli are pervasive, including clinically ill and healthy people, and men and women respond differently at neural and hormonal levels. Inspired by the Research Domain Criteria initiative, we used a transdiagnostic approach to investigate the impact of sex and dysphoric mood on neural-hormonal responses to negative affective stimuli. METHODS: Participants included 99 individuals with major depressive disorder, psychosis and healthy controls. Functional magnetic resonance imaging (fMRI) was complemented with real-time acquisition of hypothalamo-pituitary-adrenal (HPA) and -gonadal (HPG) hormones. fMRI data were analyzed in SPM8 and task-related connectivity was assessed using generalized psychophysiological interaction. RESULTS: Across all participants, elevated cortisol response predicted lower brain activity in orbitofrontal cortex and hypothalamus-amygdala connectivity. In those with worse dysphoric mood, elevated cortisol response predicted lower activity in hypothalamus and hippocampus. In women, elevated cortisol response was associated with lower activity in medial prefrontal cortex and low hypothalamo-hippocampal connectivity. In women with high dysphoric mood, elevated cortisol response was associated with low hypothalamo-hippocampal connectivity. There were no interactions with diagnosis or medication. LIMITATIONS: There was limited power to correct for multiple comparisons across total number of ROIs and connectivity targets; cortisol responses were relatively low. CONCLUSIONS: We conclude that the pathophysiology in neural-hormonal responses to negative affective stimuli is shared across healthy and clinical populations and varies as a function of sex and dysphoric mood. Our findings may contribute to the development of hormonal adjunctive therapeutics that are sex-dependent, underscoring the importance of one's sex to precision medicine.
- MeSH
- afekt fyziologie MeSH
- amygdala patofyziologie MeSH
- depresivní porucha unipolární diagnostické zobrazování patofyziologie psychologie MeSH
- dospělí MeSH
- hipokampus patofyziologie MeSH
- hydrokortison fyziologie MeSH
- hypothalamus patofyziologie MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mladý dospělý MeSH
- prefrontální mozková kůra patofyziologie MeSH
- psychotické poruchy diagnostické zobrazování patofyziologie psychologie MeSH
- sexuální faktory * MeSH
- systém hypofýza - nadledviny fyziologie MeSH
- systém hypotalamus-hypofýza fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: The Overall Anxiety Severity and Impairment Scale (OASIS) is a transdiagnostic measure that assesses severity and impairment associated with anxiety disorders. However, its psychometric properties were primarily examined in English-speaking or western countries. Therefore, this study aims to examine its psychometric parameters in the Czech Republic. METHODS: A large representative sample (n = 1738), a clinical sample (n = 57) and a retest sample (n = 20) were used. In addition to the OASIS, conventional measures of anxiety, depression, personality traits, self-esteem, life satisfaction, and other scales were also administered. Moreover, we examined the latent structure, reliability, validity, and the cut-off score for the Reliable Change Index (RCI) and the Clinically Significant Change Index (CSI). RESULTS: Higher anxiety was found in females, religious non-church members, and students. The Confirmatory Factor Analysis supported the adequate fit of the unidimensional solution: x2(4) = 3.20; p < 0.525; CFI = 1.000; TLI = 1.000;RMSEA = 0, SRMR = 0. The measurement equivalence examination indicated that the OASIS measures anxiety invariantly between males and females. The validity of the OASIS was supported by positive associations with neuroticism, depression, perceived stress, guilt, shame, and the established anxiety measures. The internal consistency was excellent (Cronbach's alpha = 0.96, McDonald's omega = 0.96). The test-retest reliability was acceptable (r = 0.66). The cut-off for the CSI is 6 and the RCI is 5.32. CONCLUSIONS: The OASIS represents a reliable and valid instrument for assessing anxiety in adults. Due to its shortness, excellent psychometric properties, and percentile norms, it is especially useful for short and accurate screening of anxiety and mapping therapeutic changes in clinical practice.
- MeSH
- dospělí MeSH
- lidé MeSH
- průzkumy a dotazníky MeSH
- psychiatrické posuzovací škály MeSH
- psychometrie metody MeSH
- referenční standardy MeSH
- reprodukovatelnost výsledků MeSH
- úzkost * diagnóza MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
... Interventions 211 -- Bruce E Chorpita, Jeanne Miranda, and Adam Bernstein -- Part Three • Unified and Transdiagnostic ...
Oxford library of psychology
Update ed. xix, 945 s. : il., tab. ; 26 cm
- MeSH
- klinická psychologie klasifikace metody MeSH
- psychologie metody MeSH
- psychoterapie metody MeSH
- Publikační typ
- příručky MeSH
- Konspekt
- Psychologie
- NLK Obory
- psychologie, klinická psychologie
