Mood instability contributes to impulsivity, non-suicidal self-injury, and binge eating/purging in people with anxiety disorders

Role of lifestyle factors in mediating the effect of mood swings on cardiovascular diseases: A mediation Mendelian randomization study

It has been found that individuals with psychiatric illnesses are predisposed to an elevated risk of cardiovascular diseases (CVDs). Mood swing is a clinically relevant characteristic linked to psychiatric disorders. This study examined the possible relationship between genetically predicted mood swings and CVDs risk. In this mediation Mendelian randomization (MR) study, we compiled data from genome-wide association studies examining mood swings (n = 451,619) and 5 CVDs among Europeans, including coronary artery disease (CAD) (n = 547,261), major coronary heart disease events (MCEs) (n = 361,194), all-cause heart failure (AHF) (n = 218,208), atrial fibrillation (n = 1030,836), and stroke (n = 446,696). The inverse variance weighting method was considered the primary assessment approach in MR analysis, and several sensitivity analyses were performed to evaluate the reliability of the results. Furthermore, the mediating effect of lifestyle factors including smoking, alcohol intake, walking, and waist-hip ratio was explored by using a two-step MR. According to our MR analysis, mood swings were genetically associated with a higher risk of CAD (OR, 2.101; 95% CI, 1.200-3.679; P = .009), AHF (OR, 2.761; 95% CI, 1.312-5.810; P = .007), and MCE (OR, 1.048; 95% CI, 1.022-1.076; P < .001). In the two-step MR analysis, smoking may mediate the causal pathways from mood swings to CAD (27%), MCE (18%), and AHF (26%). Our MR study revealed a potential causal relationship between mood swings and CVDs, smoking may play an important role in it, highlighting the need for regulating mood stability and build a healthy lifestyle to prevent the onset of CVDs. However, due to the limitations of MR, further research is needed to confirm these associations and clarify the underlying mechanisms.

A meta-analysis of the relationship between anxiety and non-suicidal self-injury based on knowledge graphs

Objective

The existing research on the relationship between anxiety and non-suicidal self-injury (NSSI) is inconsistent, and there is no systematic review on this area. This study aims to explore the relationship between anxiety and NSSI, in order to provide evidence-based medicine evidence for the early identification of preventable occurrence factors of NSSI.

Methods

The semantic query (i.e. SPARQL) method was used to retrieve the anxiety- related literature on the Knowledge graph of NSSI, which consist of the metadata and semantic annotation data of English literature related to non-suicidal self-injury in PubMed by June 2023. Two researchers strictly followed the inclusion and exclusion criteria for independent literature screening. After evaluating the quality of the included studies, the selected data was subjected to meta-analysis using RevMan5.3 software.

Results

A total of 14 studies met the inclusion criteria of the meta-analysis, including 44064 subjects. The results showed that the proportion of anxiety in the NSSI group was significantly higher than that in the non-NSSI group, and the difference between the groups was statistically significant (OR=3.60, 95% Cl=2.08-6.22, p<0.01).

Conclusion

There is a significant correlation between anxiety and NSSI, which is a possible risk factor for NSSI. However, due to limitations of the design type, quantity, and quality of the included study, further research is needed on the causal relationship between anxiety and NSSI. Furthermore, we show that using knowledge graphs is an effective approach to retrieve literature for meta-analysis.

Negative Affect and Impulsivity in Adolescents with Non-Suicidal Self-Injury: The Moderating and Mediating Roles of Perceived Social Support

BACKGROUND

Negative affective states and impulsivity have been found to be closely associated with non-suicidal self-injury (NSSI), but how negative affect contributes to impulsivity in NSSI adolescents and the role of perceived social support remain unclear.

METHODS

In Study 1, the Barratt Impulsiveness Scale (BIS-11) was administered on 225 NSSI adolescents and 225 healthy volunteers to determine the characteristics of impulsivity in the patients. In Study 2, 102 of the patients were randomly selected to further complete the Zung Self-rating Anxiety Scale (SAS), Zung Self-rating Depression Scale (SDS), and Multidimensional Scale of Perceived Social Support (MSPSS) to clarify the relationships between negative affect, perceived social support, and impulsivity in these patients.

RESULTS

In Study 1, NSSI adolescents scored higher than volunteers on almost all factors of BIS-11 except for Cognitive Instability. In Study 2, Support from significant others mediated the association between SAS and BIS-11 Self-control. Moreover, Support from significant others and family moderated the prediction of SAS score on their BIS-11 Cognitive Complexity.

CONCLUSION

Compared to healthy adolescents, NSSI individuals were more impulsive, while perceived support from family and significant others prevented the anxious NSSI adolescents from lower cognitive complexity. Therefore, more social support should be available to NSSI adolescents with high anxiety to reduce their risk of self-harm due to high impulsivity.

Bulimia nervosa selectively reshapes the structure and intrinsic function of anterior insula subregions associated with cognition-emotion integration

BACKGROUND

Existing evidence suggests that anterior insula plays a crucial role in cognitive control and emotional regulation and is implicated in the onset and maintenance of bulimia nervosa (BN). However, it remains unclear how structural and functional abnormalities in specific subregions of anterior insula contribute to BN.

METHODS

In this study, we analyzed structural MRI and resting-state functional MRI data from 54 BN patients and 56 healthy controls (HCs). We conducted voxel-based morphometry, amplitude of low frequency fluctuation (conventional band: 0.01-0.08 Hz, slow-5: 0.01-0.027 Hz) and seed-based whole-brain functional connectivity (FC) analysis of the anterior insula subregions for both groups. Additionally, we investigated the correlation between neuroimaging findings and clinical characteristics in the BN group.

RESULTS

Our findings revealed that BN patients exhibited reduced gray matter volume in the right dorsal anterior insula (dAI) and bilateral ventral anterior insula (vAI) and demonstrated decreased ALFF in slow-5 band of bilateral dAI. The BN group also showed increased FC between bilateral dAI and precuneus or right superior frontal gyri which significantly correlated with the severity of BN or its key symptom. In addition, the decreased FC between bilateral vAI and anterior cingulate and paracingulate gyri and/or median cingulate and paracingulate gyri were both significantly correlated with the severity and its restrained eating behavior.

CONCLUSIONS

Our findings further indicate that the functional separation of anterior insula subregions may underlie the pathophysiology of BN. Notably, the vAI associated with emotional processing may serve as a promising neuroimaging biomarker which could inform therapeutic strategy.

Personality traits and self-control: The moderating role of neuroticism

Self-control is important for mental and physical health, and personality traits are vital antecedents for self-control. Previous studies suggest that conscientiousness and extraversion enhance self-control, whereas neuroticism hampers it. However, the link between personality and self-control has mostly been studied using a narrow conceptualization of self-control, as the ability to resist impulses, thus excluding initiatory self-control. Also, no studies have examined whether and how personality traits interact with one another to increase, or reduce, self-control. Data were collected on two occasions from 480 military cadets (31.04% female) to examine the relationship between the Big Five personality traits and self-control (general, inhibitory, and initiatory self-control). Furthermore, the study investigated the moderating role of neuroticism, as a trait and as individual facets, on the relationship between the other personality traits and self-control. Although neuroticism correlated negatively with all self-control dimensions, there were unique relations only with general and inhibitory self-control. Extraversion correlated positively with all self-control dimensions but was only uniquely related to initiatory self-control. Conscientiousness correlated positively with all self-control dimensions and this pattern persisted when we assessed the unique effects. Openness to experience and agreeableness correlated positively with general and inhibitory self-control but had no unique effects on any of the self-control dimensions. Neuroticism negatively moderated the relationship between extraversion and both general and inhibitory self-control, and the relationship between conscientiousness and both general and initiatory self-control. The facet-level analysis confirmed the general patterns and provided further detail on which facets of neuroticism were the most influential as moderators. In conclusion, the study highlights the critical role of different types of self-control, and that neuroticism plays a cardinal role for the effects of conscientiousness and extraversion on self-control.

The use and misuse of the SCOFF screening measure over two decades: a systematic literature review

PURPOSE

The SCOFF questionnaire was designed as a simple, memorable screening tool to raise suspicion that a person might have an eating disorder. It is over 20 years since the creation of the SCOFF, during which time it has been widely used. Considering this, we wish to review the use of the SCOFF in peer-reviewed scientific journals, and to assess whether it is being used appropriately in the manner in which it was originally devised and tested.

METHODS

The Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines were followed, and all search strategies and methods were determined before the onset of the study. PubMed and Wiley Online Library were searched using the terms SCOFF and eating. Two reviewers were involved in the reviewing process. Criteria for appropriate use of the SCOFF were formalised with the tool's original authors.

RESULTS

180 articles were included in the final review. 48 articles had used the SCOFF appropriately, 117 articles inappropriately and 15 articles had been mixed in the appropriateness of their use.

CONCLUSION

This systematic review highlights the inappropriate use of the SCOFF in diverse languages and settings. When used correctly the SCOFF has made a significant contribution to the understanding of eating disorders and its simplicity has been applauded and led to widespread use. However in over two-thirds of studies, the use of the SCOFF was inappropriate and the paper highlights how and in what way it was misused, Guidelines for the appropriate use of the SCOFF are stated. Future validation and avenues of research are suggested.

LEVEL OF EVIDENCE

Level I.

Distress tolerance and lifetime frequency of non-suicidal self-injury (NSSI): A systematic review and meta-analysis

NSSI has recently been recognized as a significant health issue given its documented association with psychopathology and across a broad spectrum of psychiatric disorders. It has been found that individuals experiencing heightened emotions, which is referred to as an emotional cascade, are more likely to engage in self-injury behaviour due to low levels of distress tolerance (DT). The current meta-analysis using PRISMA guidelines sought to quantify the strength of the association between DT and lifetime frequency of NSSI using 22 eligible studies (N = 14,588; F = 60.7%; age = 23.35 ± 7.30), mainly from the United States. The correlation between emotional DT and NSSI was a small negative correlation (r = -.14), and it was non-significant for behavioural DT and NSSI (r = .02). Also, the effect-size was significant for studies that used interview-based measure of NSSI (r = -.24), and it was non-significant when self-report measures of NSSI (r = -.11) utilized. The association between DT and NSSI was significant and negative across the general population (r = -.47), university students (r = -.17), and inpatients (r = -.27); surprisingly, it was significant and positive among adolescents or high school students (r = .17). The observed effect-sizes were independent of publication year, mean age and its standard deviation, study quality, female proportion, DT, NSSI measures reliability, and clinical status. Future studies on NSSI should consider DT as a spectrum from distress intolerance to distress over-tolerance, given that it seems it has different functions when different samples (e.g., adolescents) are studied.

A cross-sectional study of non-suicidal self-injury in a Chinese adolescent inpatient cohort

Background

Non-suicidal self-injury (NSSI) is a significant predictor of completed suicide and is increasingly recognized as a serious public health concern. Multiple factors, including social, familial, mental, and genetic factors could influence the occurrence of this behavior. Identifying the early risk factors is important for screening and preventing this behavior.

Methods

Here, we recruited a total of 742 adolescent inpatient participants from a mental health center and conducted a series of diagnostic interviews and questionnaires to assess NSSI behavior and other events. Bivariate analysis was used to detect differences between groups in NSSI and non-NSSI. Then, binary logistic regression was fitted to identify predictors of NSSI as a function of these questionnaire scores.

Results

Of the 742 adolescents examined, a total of 382 (51.5%) participants engaged in NSSI. Bivariate analysis showed that age, gender, depression, anxiety, insomnia, and childhood trauma was significantly associated with NSSI. Logistic regression results suggested that females had 2.43 higher odds of engaging in NSSI when compared to their male counterparts (OR = 3.43, 95%CI = 2.09-5.74, p = 1.70 × 10^-6). Depression was a primary risk predictor for NSSI with each additional increase in symptoms of depression increasing the odds of engaging in NSSI by 18% (OR = 1.18, 95%CI = 1.12-1.25, p = 2.25 × 10^-8).

Conclusion

More than half of the adolescent inpatients with psychiatric disorders have NSSI experience. Depression and gender were the risk factors for NSSI. Age at a specific range had a high prevalence of NSSI.

The relationship between social anxiety and self-injury of junior high school students: Mediation by intolerance of uncertainty and moderation by self-esteem

Objective

The problem of adolescents' self-injury has gradually attracted social attention, however, a lack of research exists on the internal mechanism between social anxiety and self-injury. This study explored the relationship between social anxiety and self-injury in Chinese junior high school students.

Method

An adolescent self-injury questionnaire, social anxiety scale, intolerance of uncertainty questionnaire and self-injury questionnaire were used to survey 614 junior high school students.

Results

The results showed that: (1) social anxiety had a significant positive predictive effect on self-injury; (2) intolerance of uncertainty had a significant mediating effect between social anxiety and self-injury; and (3) self-esteem had a significant moderating effect on the mediating effect of intolerance of uncertainty.

Conclusion

The study suggested that social anxiety in junior high school students has an impact on self-injury through mediation of intolerance of uncertainty and modulation of self-esteem.

High-risk group and functional subtypes of non-suicidal self-injury in young adults with mental disorders

BACKGROUND

Identifying high-risk groups of non-suicidal self-injury (NSSI) with multiple risk factors and different functional subtypes contribute to implementing person-centered interventions.

METHODS

We investigated NSSI profiles among a sample of 258 psychiatric inpatients aged 18-25 years. All participants completed well-validated measures of internal personal and external environmental characteristics. One-hundred and ninety patients reported a lifetime history of NSSI and completed an additional NSSI assessment. A k-means cluster analysis was conducted to extract characteristics of risk factors and functional subtypes. Independent sample t-test, analysis of variance and χ 2 test were used to test the difference of demographic statistical factors, risk factors and functional scores among groups with different frequency of NSSI.

RESULTS

The clustering of risk factors analyses supported 4-clusters. The proportion of repeat NSSI patients was the highest (67.1%) in the group with unfavorable personal and unfavorable environmental characteristics. Functional subtype clustering analyses supported 5-clusters. Among patients with repeated NSSI, those with depression were mainly accompanied by the "Sensation Seeking" subtype (39.7%), bipolar disorder mainly supported the "Anti-suicide" subtype (37.9%), and eating disorders were mostly "Social Influence" subtype (33.3%). There was an interaction between functional subtypes and mental disorders.

LIMITATIONS

All participants were in treatment in a psychiatric service and the results may not be generalizable to a community sample. The data included retrospective self-report which may be inaccurate due to recall bias.

CONCLUSION

It is necessary to identify high-risk groups of NSSI who with unfavorable personal and environmental characteristics and clinical interventions need to consider the heterogeneity of patients' functional subtypes of NSSI.

One size does not fit all: Exploring how the five-factor model facets predict disordered eating behaviours among adolescent and young adult males and females

There is a wealth of research that has highlighted the relationship between personality and eating disorders. It has been suggested that understanding how subclinical disordered eating behaviours are uniquely associated with personality can help to improve the conceptualization of individuals with eating disorders. This study aimed to explore how the facets of the Five-Factor Model (FFM) predicted restrictive eating, binge eating, purging, chewing and spitting, excessive exercising and muscle building among males and females. An online survey assessing disordered eating behaviours, FFM and general psychopathology was completed by 394 females and 167 males aged between 16 and 30 years. Simultaneous equations path models were systematically generated for each disordered eating behaviour to identify how the FFM facets, body dissatisfaction and age predicted behaviour. The results indicated that each of the six disordered behaviours were predicted by a unique pattern of thinking, feeling and behaving. Considerable differences between males and females were found for each path model, suggesting differences between males and females in the personality traits that drive disordered eating behaviours. It was concluded that it is important to take personality into account when treating males and females who engage in disordered eating behaviours.

Understanding the inverse relationship between age and psychotic symptoms: The role of borderline personality traits

OBJECTIVE

There is a well-established inverse relationship between age and positive psychotic symptoms, both in patients with psychotic disorders and in general population samples with psychotic experiences. The reason for this inverse relationship is unclear. We hypothesized that life-course developmental changes in borderline personality traits, which also typically decline with age, might explain the inverse relationship between age and positive psychotic symptoms.

METHODS

We tested this hypothesis with data from 19,980 adults who completed 2000, 2007, and 2014 UK Adult Psychiatric Morbidity Survey studies. Hallucinations and delusions were assessed with the Psychosis Screening Questionnaire. Borderline features were assessed with the Structured Clinical Interview for DSM-IV Axis II Personality Disorders Screening Questionnaire. Logistic regression models with effect decompositions were used to conduct the analyses.

RESULTS

As expected, age was negatively associated with hallucinations and delusions. These effects were wholly or mostly reduced after controlling for borderline features. Similar results were found in a subgroup of participants with a probable psychotic disorder. Repeating the analysis with a broad index of psychopathology severity instead of borderline features did not produce comparable results. Borderline factor scores reflecting identity/relationship disturbance, mood instability/anger, and self-harm/suicidality were created, all of which appeared to explain part of the inverse relationship between age and psychotic experiences.

CONCLUSION

Declining borderline traits throughout adulthood may account for the reduced prevalence of positive psychotic symptoms in both clinical and non-clinical populations. Future research might evaluate the impact of treatments that target borderline traits on positive psychotic symptoms.

Associations between anxiety disorders and diet quality in a Swiss cohort study

OBJECTIVES

Anxiety disorders are common in the general population and can have a major impact on a person's behavior. These disorders may also affect shopping and cooking habits, which may lead to a less healthy diet. Thus, we aimed to assess whether any current anxiety disorder or current specific anxiety disorders were associated with diet quality.

METHODS

Data of 6392 observations of 3993 participants were retrieved from 2 data waves of a population-based prospective cohort study conducted in an urban area in Switzerland. To assess the associations of anxiety status with diet quality measured by the Alternate Healthy Eating Index (AHEI), we performed cross-sectional multilevel random-effects linear regression analyses, which accounted for potential repeated participation and a series of potential confounders.

RESULTS

We observed an association between the presence of any current anxiety disorder and lower diet quality. For the most conclusive model, the AHEI was 1.2 points lower among those with current anxiety disorders compared to those participants with no anxiety disorder (p = 0.016). When specific anxiety disorders were included separately into the model, panic disorder was associated with lower diet quality in the fully adjusted model (p = 0.037).

CONCLUSIONS

Our findings of reduced diet quality in people with any current anxiety disorder suggest that practical support is needed when it comes to buying and processing food. This might be systematically addressed in psychotherapy and external interdisciplinary support (e.g. occupational therapy and dietary counselling) should be involved. However, further data is needed to strengthen the findings of the present study.

Mapping the landscape and structure of global research on binge eating disorder: Visualization and bibliometric analysis

BACKGROUND

Binge-eating disorder (BED) is a clinical syndrome and is considered the most common type of eating disorder. However, our understanding of the global performance and progress of BED research is limited.

AIM

To describe and perform a bibliometric analysis of the state of BED research.

METHODS

The term 'Binge eating' was searched in the title throughout the previous year's up to December 31, 2020. We searched the Scopus and Reference Citation Analysis for publications on Binge eating. The VOSviewer software version 1.6.17 was used to produce the network visualization map of the most frequent author, collaborative relationships between countries/regions, and to determine the hotspots related to binge eating research. In addition, conventional bibliometric indicators were generated.

RESULTS

The search strategy found 2713 total articles and an average of 62 articles per year. Among them, 'Article' represented 82.49% of the publications (n = 2238 articles) and was the most frequent type, followed by reviews (n = 243; 8.96%). The number of publications increased steadily during the last decade of the study period. One hundred and thirty-two countries contributed to binge eating research, with 1495 (55.11%) articles published in the United States, followed by Italy with 256 (9.44%), the United Kingdom with 183 (6.75%), and Germany with 182 (6.71%). Currently, the main hot topics related to BED are 'type of treatment and management and treatment provided to BED"; "processes and pathways to binge eating"; and 'diagnosis, signs and symptoms, comorbidities and prevalence and associated factors with BED'.

CONCLUSION

The number of publications has increased noticeably during the previous decade. There are indeed relatively few publications on BED from low-and middle-income nations, so much is to be learned from the experience of all countries. Studies on this topic are critical in all countries to discover risk factors and effective intervention measures. Although our findings are preliminary, they imply that the future prospects for interventions aimed at BED management are bright, focusing on complex models of care and long-term maintenance of therapeutic gains.

[Non-suicidal self-injurious behavior in adolescents]

OBJECTIVE

To compare the motives of non-suicidal self-injurious behavior (NSSI) in terms of nosological affiliation, gender and age group.

MATERIAL AND METHODS

Ninety-one patients, 80 women and 11 men, aged 13-24 years old, who independently applied to the SPbSPMU consulting center, were selected. The patients were examined clinically as well as using the Russian-language adapted version of the Inventory of Statements about Self-injury. The younger subgroup consisted of 54 people under the age of 18, another group of age above 18 numbered 37 participants. At the preliminary stage, patients with schizophrenia, organic mental disorders, etc were excluded. Based on the clinical and psychopathological assessment, 3 clinical groups were identified. The first group (n=50) consisted of patients under 18 years old with different subtypes of pubertal behavioral disorders (ICD-10 F91) and patients with emotionally unstable personality disorder (F60.3). The second group is represented by patients with mild or moderate depressive episodes (F32). The third group included patients with various eating disorders.

RESULTS

The selected groups did not differ by the age of patients, the age of onset of self-injurious behavior and its duration. There were also no differences in the leading types of NSSI depending on gender, age subgroup, or clinical diagnosis, which confirms the currently prevailing view on NSSI as a transnosological phenomenon. The motives of NSSI also did not differ depending on the nosological form. Gender and age differences in the motives of NSSI were revealed. In male patients, the motive of «sensations seeking» (p=0.037) and «peer-bonding» (p=0.036) significantly prevailed. In the younger age subgroup, the motives of «self-punishment» (p=0.032) and «peer-bonding» (p=0.026) prevail.

CONCLUSIONS

The nosological non-specificity of NSSI, which is manifested in the similarity of the age of onset, duration, types of NSSI and motives for committing them in different disorders, allows us to consider this phenomenon as a separate dimensional characteristic of a mental illness, more dependent on internal patterns, gender and age characteristics than on its nosological affiliation.

Relationship among self-injury, experiential avoidance, cognitive fusion, anxiety, and depression in Chinese adolescent patients with nonsuicidal self-injury

OBJECTIVE

To explore relationship among self-injury behavior, experiential avoidance, cognitive fusion, anxiety, and depression in Chinese adolescent patients with nonsuicidal self-injury (NSSI).

METHODS

Cognitive fusion questionnaire (CFQ), Acceptance and Action Questionnaire-2nd edition (AAQ-II), adolescent nonsuicidal self-injury behavior questionnaire (ANSAQ), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) were used as research tools to investigate 120 subjects with NSSI and 130 healthy controls.

RESULTS

The scores of CFQ and AAQ-II in the NSSI group were significantly higher than those in the healthy control group (p < .001). The results of regression analysis showed that the experiential avoidance score of patients with NSSI could predict the score of self-injury questionnaire (β = 0.585, p < .001); when predicting anxiety, only CFQ (β = 0.361, p < .001) entered the equation, with an explanatory variation of 12.3%; when predicting depression, CFQ (β = 0.287, p < .01) entered the equation, with an explanatory variation of 7.4%.

CONCLUSION

A high level of cognitive fusion and experiential avoidance may be important factors for the maintenance of self-injury behavior in patients with NSSI.

Lisdexamfetamine and binge-eating disorder: A systematic review and meta-analysis of the preclinical and clinical data with a focus on mechanism of drug action in treating the disorder

Binge-Eating Disorder (BED) is the most common eating disorder in the United States. Lisdexamfetamine (LDX) was approved in 2015 by the FDA for treatment of BED and is the only drug approved for treating the disorder. There has been no systematic evaluation of the published clinical and preclinical evidence for efficacy of LDX in treating BED and the mechanisms responsible for the therapeutic action of the drug. To address this gap, we conducted a systematic review and meta-analysis using PRISMA guidelines. Fourteen clinical and seven preclinical articles were included. There is consistent evidence from clinical studies that LDX is an effective treatment for BED and that the drug reduces the BED symptoms and body weight of patients with the disorder. There is also consistent evidence from preclinical studies that LDX reduces food intake but no consistent evidence for a preferential reduction of palatable food consumption by the drug in rodents. The evidence on mechanism of action is more limited and suggests LDX may reduce binge eating by a combination of effects on appetite/satiety, reward, and cognitive processes, including attention and impulsivity/inhibition, that are mediated by catecholamine and serotonin mechanisms in the brain. There is an urgent need for adequately powered, placebo-controlled, behavioural and neuroimaging studies with LDX (recruiting patients and/or individuals with subclinical BED symptoms) to further investigate the mechanism of action of the drug in treating BED. An improved understanding of the behavioural and neurochemical mechanisms of action of LDX could lead to the development of improved drug therapies to treat BED.

Phenotyping mental health: Age, community size, and depression differently modulate COVID-19-related fear and generalized anxiety

INTRODUCTION

When the first COVID-19 infections were reported in Germany, fear and anxiety spread faster than the pandemic itself. While moderate amounts of fear of a COVID-19 infection may be functional, generalized anxiety and the potentially resulting distress and psychopathology may possibly be detrimental to people's health. Authorities need to avoid a countrywide panic, on the one hand, but foster a realistic awareness of the actual threat, on the other hand.

OBJECTIVES

The current cross-sectional study aimed to investigate psychological reactions in response to the real or perceived infection threats. In particular, the analysis should reveal whether COVID-19-related fear and generalized anxiety in times of COVID-19 have distinct correlates.

METHODS

A nationwide study was conducted from March 10th to May 4th 2020 in Germany (n = 15,308; 10,824 women, 4433 men, 51 other). Generalized anxiety was assessed using the GAD-7, while COVID-19-related fear was measured using a self-generated item. Both outcome variables were entered into linear regression models. Demographic information, depressive symptoms, trust in governmental interventions, subjective level of information regarding COVID-19 and media use were used to predict generalized anxiety and COVID-19-related fear.

RESULTS

The data revealed distinct correlates of COVID-19-related fear and generalized anxiety. Although COVID-19-related fear and generalized anxiety had overlapping predictors, such as neuroticism, they most prominently differed in age distribution and direction of an urban-rural disparity: generalized anxiety decreases with age, but COVID-19-related fear is most pronounced in elderly participants. Generalized anxiety is also more prevalent in rural communities, but COVID-19-related fear is elevated in metropoles. Furthermore, the presence of a risk disease increases COVID-19-related fear, but not generalized anxiety.

CONCLUSION

These results suggest that COVID-19-related fear is often justified considering the individual risk of infection or complication due to infection. Some of the characteristics that predict COVID-19-related fear leave generalized anxiety unaffected or show divergent predictive directions. The present findings hint toward two related, but discriminant constructs.

Predicting factors for non-suicidal self-injury in patients with schizophrenia spectrum disorders and the role of substance use

Non-suicidal self-injury (NSSI) has been shown as a characteristic feature in many clinical populations in recent years and schizophrenia is one of the most common psychiatric disorders which is associated with NSSI. In this study, we aimed to investigate predictors of NSSI in patients with schizophrenia spectrum disorders (SSD) and the role of lifetime substance use disorder (SUD). A sample of 165 patients with a diagnosis of SSD who were in remission participated in the study. Lifetime NSSI was assessed using the Inventory of Statements About Self-injury (ISAS). Lifetime SUD were evaluated. Logistic regression analysis was conducted to predict NSSI. SUD was found to be related to NSSI in patients with SSD, and it was associated with an approximately fourfold increase in the risk of NSSI. The rates of lifetime SUD in our sample and in the NSSI (+) group were 38.2 % and 55.6 %, respectively. The most commonly abused substances among patients with NSSI were cannabis and synthetic cannabinoids. The prevalence of NSSI was 43.6 % in our sample. 'Self-cutting' was the most common type and 'affect regulation' was the most common function of NSSI. One of the most significant risk factors for NSSI was a previous history of suicide attempts. SUD appears to be a significant predictor of NSSI in patients with SSD. Further investigation of treatable risk factors such as SUD which are related to NSSI is needed. It is also essential to screen SSD patients for NSSI due to the probable relation to high risk of suicide.

Mood Instability and Trait Anxiety as Distinct Components of Eysenckian Neuroticism With Differential Relations to Impulsivity and Risk Taking

This article presents the results of 2 studies that investigated mood instability in the Eysenck neuroticism scales and its relationship to trait impulsivity and risk taking. In Study 1 we examined the relationship between a mood instability factor in the Eysenck Personality Inventory and impulsivity (i.e., rapid unplanned behavior) in a general population sample of 6,066 adults. The mood instability factor was positively correlated with impulsivity. The remaining factors, largely reflecting trait anxiety, were also positively correlated with impulsivity, although these correlations disappeared when mood instability was included in the same regression model. In Study 2 we factor analyzed the short form of the revised Eysenck Personality Questionnaire to isolate mood instability and trait anxiety factors and explore their associations with risk taking in a general population sample of 394,170 adults 40 to 69 years old. The mood instability factor was positively associated with risk taking, whereas the association for the trait anxiety factor was negative. Taken together, the results suggest that mood instability and trait anxiety are separable components of Eysenckian neuroticism and that mood instability is the main component that is positively associated with trait impulsivity and risk taking. Further research is needed to clarify the factor structure of Eysenckian neuroticism.

Negative Affect Mediates Impulsivity in Generalized Anxiety Disorder

INTRODUCTION

Although anxiety and impulsivity are intuitively thought to be inversely correlated, increased impulsivity has been associated both with generalized anxiety disorder (GAD) diagnosis and GAD symptoms in non-clinical samples. The emotional dysregulation model of GAD posits that patients experience more frequent and intense negative emotions while having poor regulatory control over emotional states and greater negative reactivity to their emotions. We hypothesized that poor regulatory control in the presence of negative emotions might explain the increased impulsivity found in GAD patients. In this study, we examined if negative affect mediates the relationship between GAD and impulsivity.

METHODS

Thirty-four GAD patients and 35 healthy controls were included, and evaluated with measurements of impulsivity, negative and positive emotions, the severity of worrying and GAD symptoms, depression, and 5-factor personality traits.

RESULTS

Global impulsivity scores and the attentional facet of impulsivity were higher in the patient group when compared to the controls. Negative affect was correlated with global impulsivity in the patient group only and explained impulsivity in our regression model while worrying and depressive symptoms did not. An indirect relationship was found between diagnosis and impulsivity through negative affect.

CONCLUSION

Our study showed that the cardinal symptom of GAD - worrying - was not independently related to impulsivity in our sample. Increased impulsivity in GAD seems to be mediated by the increased presence of negative emotions, as it is common in mood and impulse-control disorders, indicating an unspecific shared vulnerability factor to psychopathology.