Prevalence of excessive internet use and its correlation with associated psychopathology in 11th and 12th grade students

Background Globally, the number of internet users has crossed the three-billion mark, while in India users grew over 17% in the first 6 months of 2015 to 354 million. This study presented a background on internet use and the existence of excessive internet use. Aim To study the extent of internet use in 11th and 12th grade students and the psychopathology, if any, associated with excessive internet use. Methods 426 students who met the inclusion criteria were recruited from 11 th and 12th grade classes from Kendriya Vidyalaya, New Delhi, India, and were assessed by Young's Internet Addiction Test and the Strength and Difficulties Questionnaire. Results Among the 426 students, the mean internet addiction total score was 36.63 (20.78), which indicated mild level of internet addiction. 1.41%(six students) was diagnosed as excessive internet users, while 30.28% and 23.94% were classified as moderate and mild internet users, respectively. The prevalence of internet addiction between gender was 58.22% in males and 41.78% in females. While both positive (prosocial) and negative (hyperactivity, emotional, conduct and peer problem) impacts of internet use were reported by students, in the current study excessive use of internet had a negative impact on students' lives as compared with positive impact, which was statistically significant (p<0.0001). Conclusion Excessive internet use led to abnormal behaviours which cause negative consequences to users. Early diagnosis of risk factors related to excessive internet use, provides education about responsible use and supervision of students by family members.

Alexithymia, Psychopathology and Alcohol Misuse in Adolescence: A Population Based Study on 3556 Teenagers

Objectives: To analyze the association between alexithymia and alcohol intake during adolescence, also in relation to psychopathology, in order to identify psychological risk factors for alcohol misuse. Method: 3556 students [mean age (range) 14.5 years (11-18)] were recruited in the Padua area. Each was administered a set of three questionnaires: the Toronto Alexithymia Scale for children (TAS-20) to measure alexithymia, the Questionnaire Adolescent Saturday evening (QAS) to estimate of alcohol intake, and the Youth Self-Report (YSR 11-18) to value psychopathology. Results: Externalizing problems appeared to increase with age and with the amount of alcohol consumed, unlike internalizing problems. The prevalence of alexithymia was 18%, decreasing with age, and it was not associated with alcohol consumption, and used except in younger subjects (≤13), for whom a positive correlation was observed between alexithymia, internalizing problems and alcohol intake. Conclusions: Younger adolescents are more psycho-emotionally vulnerable (internalizing problems and alexithymia) and at a greater risk of alcohol misuse.

Impact of adolescent complex regional pain syndrome on the psychopathology of young men ahead of military service: A retrospective cohort analysis of Korean conscription data

Background: The relationship between physical and psychopathological features in complex regional pain syndrome(CRPS) has been a subject of constant interest, but no data are available in adolescents. Therefore, we aimed to identify the factors associated with psychopathology in adolescents with CRPS ahead of military service.Methods: We retrospectively reviewed all conscription examinees who had completed a Military Personality Inventory(MPI) during a period between February 2013 and December 2016. A total of 63 persons with a history of CRPS(19-years of age for all) were enrolled. Basic demographic and pain-related data were analyzed to examine their association with MPI results. The mean FGR score as well as the 8 subdomain scores were compared between those with pain duration at <15 months(n=30) vs. ≥15 months(n=33). Binary MPI results(normal-abnormal) were also compared between the two groups.Results: In multivariate analysis, abnormal MPI was associated with pain duration, with an odds ratio(OR) at 1.05 for every 1-month increase [95% confidence interval(CI) 1.02–1.08;P=0.002]. Subjects with pain duration at ≥15 months have lower faking good response score(P<0.001 vs. those with pain duration at <15 months), and higher abnormal MPI result rate, faking bad response, inconsistency, anxiety, depression, somatization, paranoid, personality disorder cluster A, and personality disorder cluster B scores(P<0.05). Pain duration was significantly associated with the MPI variables.Conclusions: Pain duration is associated with psychopathology in adolescents with CRPS. Psychopathologic features increased as the disease duration increased. A comprehensive understanding of time-dependent psychopathological factors could support the planning of multimodal approaches for managing adolescent CRPS.

Social skills and psychopathology are associated with autonomic function in children:a cross-sectional observational study

In recent years,the increase of psychopathological disorders in the population has become a health emergency,leading to a great effort to understand psychological vulnerability mechanisms.In this scenario,the role of the autonomic nervous system(ANS)has become increasingly important.This study investigated the association between ANS,social skills,and psychopathological functioning in children.As an ANS status proxy,we measured heart rate variability(HRV).Infants admitted to the neonatal intensive care unit of the University Hospital of Padova because of preterm birth or neonatal hypoxic-ischemic encephalopathy were sequentially recruited from January 2011 to June 2013 and followed long-term up to school age in this cross-sectional observational study.We recorded 5 minutes of HRV immediately before measuring performance in social abilities tasks(affect recognition and theory of mind,NEPSY-II)in 50 children(mean age 7.4±1.4 years)with and without risk factors for developing neuropsychiatric disorders due to pre-/perinatal insults without major sequelae.Children also completed extensive cognitive,neuropsychological,and psychosocial assessment.Parents were assessed with psychopathological interviews and a questionnaire(CBCL 6-18).Analysis in a robust Bayesian framework was used to unearth dependencies between HRV,social skills,and psychopathological functioning.Social task scores were associated with HRV components,with high frequency the most consistent.HRV bands were also associated with the psychopathological questionnaire.Only normalized HRV high frequency was able to distinguish impaired children in the affect recognition task.Our data suggest that ANS may be implicated in social cognition both in typical and atypical developmental conditions and that HRV has cross-disease sensitivity.We suggest that HRV parameters may reflect a neurobiological vulnerability to psychopathology.The study was approved by the Ethics Committee of the University Hospital of Padova(Comitato Etico per la Sperimentazione,Azienda Opedaliera di Padova,approval No.1693 P).

Association between resting energy expenditure, psychopathology and HPA-axis in eating disorders

AIM: To investigate the complex relationships between resting energy expenditure(REE), eating psychopathology, and Hypothalamus Pituitary Adrenal axis functioning in patients with eating disorders. METHODS: The study was designed as a crosssectional survey, and it was planned by the Clinic for Eating Disorders of the University of Florence(Italy). The protocol was approved by the Ethics Committee of the Institution. Twenty two anorexia nervosa and twenty one Bulimia Nervosa patients were assessed by means of a clinical interview and the structured clini-cal interview for diagnostic and statistical manual of mental disorders, fourth edition. Eating attitudes and behaviour were specifically investigated by means of the eating disorder examination questionnaire(EDE-Q). Patients were also evaluated by means of the symptom checklist(SCL 90-R), REE was measured by means of indirect calorimetry, and blood cortisol morning levels were evaluated. RESULTS: Both anorexia nervosa and bulimia nervosa patients showed a reduced REE as compared with predicted REE. Body mass index(BMI) was positively associated with resting energy expenditure in Bulimics, whereas a strong, negative association between BMI and REE was observed in Anorectics. The pattern of associations between variables supported a mediation model, where shape concern accounted for variations in REE and cortisol levels(mediator), and variations in the mediator significantly accounted for variations in REE. When these associations where taken into account together, the relationship between shape concern and REE was no longer significant, whereas the association between cortisol levels and REE retained its significance, showing strong evidence for a single, dominant mediator. Anorectics and Bulimics showed an opposite pattern of association between BMI and REE. In Anorectics only, a higher REE was associated with a more severe eating disorder specific psychopathology, and cortisol levels represent a possible mediating factor for this relationship. CONCLUSION: The data supported a mediation model where cortisol levels mediated the relationship between eating psychopathology(concern about body shape) and REE.

Pregnancy-related psychopathology:A comparison between pre-COVID-19 and COVID-19–related social restriction periods

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic impacted in a still undefined way pregnant women’s mental health.There are reports of mood and affect changes in the general population and the suggestion that similar changes occur also in the pregnant population.The greater vulnerability of women during the COVID-19 restriction period may translate into a greater risk for mental disorders in the gestational period.We hypothesised that pregnant women in the prepandemic period would have less psychopathology and more psychological support than pregnant women during the pandemic restriction period.AIM To compare pregnant women for anxiety,prenatal depression,psychopathology,and social support before and after the awareness of the pandemic.METHODSWe administered to women willing to participate in their 2nd-3rd trimesters of pregnancy theEdinburgh Postnatal Depression Scale(EPDS),the State-Trait Anxiety Inventory Form Y(STAI-Y),and the Symptom CheckList-90-Revised(SCL-90R);we further collected sociodemographicvariables and explored women’s social support.The comparison was cross-sectional.The firstsample was termed nonCOVID-19 because data were gathered before the COVID-19 outbreak(January 2020-February 2020)was declared,and the second sample termed COVID-19 becauseparticipants were already subjected to the COVID-19-related restrictive measures(January 2021-February 2021).Since normal distribution was not met(Shapiro-Wilk test applied),we appliednonparametric Mann-Whitney’s U-test to compare psychometric tests.Ethical standards were met.RESULTSThe nonCOVID-19 group reported higher support from partners only,while the COVID-19 groupreported multiple support(χ^(2)=9.7181;P=0.021);the nonCOVID-19 group scored higher than theCOVID-19 group only on state anxiety among psychometric scales[STAI-Y1,nonCOVID-19median=39(95%CI:39.19-51.10)vs COVID-19 median=32(95%CI:30.83-38.90);Mann-Whitney’sU=117.5,P=0.00596].Other measures did not differ meaningfully between the two groups.Scoreson the EPDS,the state and trait subscales of the STAI-Y,and most SCL-90R subscales intercorrelatedwith one another.The anxiety component of the EPDS,EPDS-3A,correlated poorlywith other measures,while it was the Global Symptom Index of the SCL-90-R that correlated moststrongly with most measures.Our results are at odds with most literature and do not confirmincreased depression and anxiety rates in pregnant women during the pandemic.CONCLUSIONThe ability of pregnant women to deal with novel generalised threats involves mobilization ofinner resources.Increasing sources of social support may have produced anxiolysis in the COVID-19 sample.

Interpersonal distances, coping strategies and psychopathology in patients with depression and schizophrenia

AIM: To explore(1) intergroup differences in comfortable interpersonal distances(CIDs) and the use of coping strategies;(2) the association of these parameters with individual symptomatology; and(3) the interplay between CIDs and coping styles in patients with depression and schizophrenia. METHODS: The parameters of interest were assessed by means of standardized questionnaires: CID and Coping Inventory for Stressful Situations. Psychopathology was evaluated with the Beck Depression Inventory and Positive and Negative Syndromes Scale. ANOVA, Pearson's correlations and multiple regression analyses were used to examine relationships among the variables.RESULTS: Compared with controls, depressed patients were more distanced from family members, significant others and self-images, whereas patients with schizophrenia were less distanced from neutral and threatrelated stimuli. Distancing from self-images was mostly associated with depression severity in depressed patients, whereas distancing from hostile and threat-related stimuli with the severity of psychotic and affective symptoms in patients with schizophrenia. Both patient groups used more emotion-oriented than task-oriented and avoidance-oriented coping strategies. Self-distancing among patients with schizophrenia was positively associated with the use of the social diversion coping, implying social support seeking. CONCLUSION: Patients with depression and schizophrenia use different maladaptive emotion- regulation strategies to cope with their symptoms and related distress. Training in stress management might provide these patients with skills for more effective emotion regulation.

Treatment outcome,cognitive function,and psychopathology in methamphetamine users compared to other substance users

BACKGROUND The rising number of people using methamphetamine leads to an increasing need for treatment options for this patient group.Evidence-based research on the efficacy of treatment programs for methamphetamine users is limited.Due to specific characteristics of methamphetamine users,the question arises whether established treatment methods for individuals using other substances can be effective for the treatment of methamphetamine dependence as well.We hypothesize that there are significant differences between the two groups that may affect the effectiveness of treatment and worsen the prognosis of treatment outcomes for methamphetamine users compared to consumers of other substances.AIM To investigate potential differences in cognitive functioning and psychopathology between methamphetamine users and other substance users and possible correlations with treatment outcomes.METHODS A total of 110 subjects were recruited for an observational,longitudinal study from a German inpatient addiction treatment center:55 patients with methamphetamine dependence and 55 patients with dependence of other substances(“OS group”).Both groups were examined at beginning(baseline)and end of treatment(after 6 mo)with regard to treatment retention,craving,cognitive functioning,psychosocial resources,personality traits,depression,and other psychiatric symptoms.Instruments used were Raven’s IQ test,Mannheimer craving scale,cognitrone cognitive test battery,NEO personality factors inventory,Hamilton depression scale,Becks depression inventory,and a symptom checklist.The statistical methods used were χ^(2)-test,t-test and multiple mixed ANOVAs.RESULTS A total drop-out rate of 40%(methamphetamine-group:36.4%;OS-group:43.6%)was observed without significant differences between groups.At baseline,methamphetamine-group subjects significantly differed from OS-group individuals in terms of a lower intelligence quotient,fewer years of education,slower working speed,and decreased working accuracy,as well as less cannabinoid and cocaine use.Methamphetamine-group subjects further showed a significantly lower score of conscientiousness,depressive,and psychiatric symptoms than subjects from the OSgroup.In both groups,a reduction of craving and depressive symptoms and an improvement of working speed and working accuracy was noted after treatment.CONCLUSION There are differences between methamphetamine users and users of other drugs,but not with regard to the effectiveness of treatment in this inpatient setting.There are differences in cognitive function and psychopathology between methamphetamine and other drugs users.The existing treatment options seem to be an effective approach in treating methamphetamine dependence.

Experiencing, Psychopathology, and the Tripartite Mind

The philosopher Eugene Gendlin argues that a distinctive mode of reasoning, called experiencing, is necessary for working through personally salient problems such as are encountered in psychotherapy. We review supporting empirical support. It is now possible to consider Gendlin’s ideas from a neurological perspective. Work directed at understanding the neurological underpinnings of consciousness and self-related processing, as well as comparative neuroanatomical work, are all consistent with and elucidated by Gendlin’s experiencing construct. We argue from this data that the human mind is composed of three interacting systems that are unique to or enhanced in humans compared to other primates. Two are dedicated to “hot and cold” cognition. The most important, least well-studied third system is dedicated to mediating between these forms of cognition. We outline how interactions between these systems define different forms of psychopathology and what they suggest about the structure of the human mind.

Developmental psychopathology:A primer for clinical pediatrics

Developmental psychopathology(DP),broadly defined as the scientific discipline that has as its primary goal the integration of developmental science and psychopathology into a coherent approach to explanatory models for psychopathological development,has become the dominant approach in the past decade for understanding the origins of mental disorders among children and adolescents.Hence,it is incumbent upon those working in the field of clinical pediatrics to have at least a basic understanding of its core principles of DP.This article provided such an understanding(i.e.,a primer) in an exposition of the four principles that are generally considered be core elements of with examples illustrative of each of the principles.

Explosion of research on psychopathology and social media use after COVID-19:A scientometric study

BACKGROUND Despite advances in research on psychopathology and social media use,no comprehensive review has examined published papers on this type of research and considered how it was affected by the coronavirus disease 2019(COVID-19)outbreak.AIM To explore the status of research on psychopathology and social media use before and after the COVID-19 outbreak.METHODS We used Bibliometrix(an R software package)to conduct a scientometric analysis of 4588 relevant studies drawn from the Web of Science Core Collection,PubMed,and Scopus databases.RESULTS Such research output was scarce before COVID-19,but exploded after the pandemic with the publication of a number of high-impact articles.Key authors and institutions,located primarily in developed countries,maintained their core positions,largely uninfluenced by COVID-19;however,research production and collaboration in developing countries increased significantly after COVID-19.Through the analysis of keywords,we identified commonly used methods in this field,together with specific populations,psychopathological conditions,and clinical treatments.Researchers have devoted increasing attention to gender differences in psychopathological states and linked COVID-19 strongly to depression,with depression detection becoming a new trend.Developments in research on psychopathology and social media use are unbalanced and uncoordinated across countries/regions,and more indepth clinical studies should be conducted in the future.CONCLUSION After COVID-19,there was an increased level of concern about mental health issues and a changing emphasis on social media use and the impact of public health emergencies.

Community Needs Assessment for a Professional University Health Counselling Course in Cambodia

Developing health and counselling professionals remains an important part of supporting mental health services in Cambodia.This paper aims to identify how the key stakeholders and mental health experts in Cambodia consider how a university level health counselling course could contribute to addressing the needs/treatment gap for mental health services in Cambodia.In order to do this,the study consists of semi-structured interviews with stakeholders,community needs assessment,and community resource mapping.The data were drawn from 15 NGOs,various profit and not-for-profit organizations as well as two key government stakeholders.The participants were invited to take part in a stakeholders/expert semi-structured interview that lasted between 30-60 minutes at the participants’organizations.The findings revealed that all participants believe that a university level health counseling course was crucial in Cambodia to address pressing mental health issues in the country.Most participants believed that a graduate or post-graduate level program such as a B.A.or M.A.was necessary to train qualified counsellors.The program should be internationally benchmarked,with a Cambodian context.Topics should include psychopathology,professional ethics and competencies,counselling theories and interventions,trauma treatment,as well as emotional intelligence and addiction.Other topics might need to include parenting,support system for suicidal patients,self-care,staff wellbeing programs,and school counselor programs.

Associated factors of self-reported psychopathology and health related quality of life among men who have sex with men (MSM) with HIV/AIDS in Dalian, China: a pilot study

Background:Despite the availability of Anti-Retroviral Therapy(ART),the health-related quality of life(HRQoL)among HIV-positive men who have sex with men(HIVMSM)in China remains poor.This study aimed to explore the relationship between self-reported psychopathology and HRQoL among HIVMSM in Dalian,China.Methods:A cross-sectional study was conducted in 112 HIVMSM.Symptom check list 90(SCL 90):a measure of psychopathology and World Health Organization quality of life in HIV infection(WHOQOL-HIV-Bref):a measure of HRQoL were used.Correlation and multiple regression analysis were employed to explore the association between self-reported psychopathology and HRQoL in HIVMSM.Results:Out of the total 112 HIVMSM cases,9(8%)cases were homosexuals and 103(92%)ones were bisexuals.The participants who had low family income(P=0.001),perceived discrimination(P=0.001)and lack of regular attendance in medical follow-ups(P=0.014)reported poorer HRQoL than their counterparts.Somatization,obsession,depression,phobia and overall SCL 90 scores in self-reported psycholpathology had a negative impact on the domains of HRQoL among HIVMSM.Conclusions:Total quality of life was predicted by family income,perceived discrimination,and medical follow-up attendance.Self-reported psychopathology was negatively correlated with HRQoL in HIVMSM.The Strategies that target MSM focusing on linking and engaging HIV-positive patients in medical care is the key step to improve their HRQoL.More emphasis is needed on the newly diagnosed HIVMSM in Dalian in order to develop a more targeted intervention to prevent perceived discrimination and lack of proper medical follow-up services.Trial registration:The trial registration number does not require for this manuscript.The study is cross-sectional design that do not involve intervention at all,it is not a clinical trial.

Sexual Assault and Its Psychopathological Repercussions in the Life of Female Students in Northeastern Benin (2023)

Objective: The aim of the present study was to investigate the psychic repercussions of sexual assault among female students in Parakou in 2023. Methods: Descriptive cross-sectional study conducted from December 2022 to July 2023 among all students at the University of Parakou. The sampling technique was stratified non-proportional at two levels. The dependent variable was self-reported sexual assault. The psychopathological repercussions linked to sexual assault and explored in these students were: post-traumatic stress disorder assessed with the Post Traumatic Stress Disorder Checklist-5 (PCL-5) scale;and current depression screened with the Patient Health Questionnaire-9 (PHQ-9) scale. Results: A total of 376 female students from the University of Parakou meeting the inclusion criteria were surveyed. The average age of the subjects surveyed was 20.56 ± 2.46 years, with extremes of 16 and 32 years. A predominance of subjects under 25 was observed. The prevalence of sexual assault among female students at the University of Parakou was 10.63%. The types of aggression suffered were mostly rape (18 people;45%) and sexual touching (16 people;40%), and the aggressors were mainly friends/boyfriends (13;32.5%), family members (12;30.0%) and people from the house/neighborhood (9;22.5%). Psychological repercussions included depression in 72.5% (29) of cases, with mild depression in 30% (12), moderate depression in 37.5% (15) and severe depression in 5% (2). Anxiety disorders were present in 27.50% (11) of victims. The risk factors associated with sexual assault in these students were gravidity (p = 0.014;OR = 15.32), unhappy life events (p = 0.01;OR = 17.24), and age of first sexual intercourse (p = 0.016;OR = 4.608). Conclusion: One in ten female students in Parakou has been sexually assaulted. Once again, preventive action through effective sex education is a means of fighting the problem that should be prioritized for every girl and boy from an early age. Psychological support by specialists should be offered to any victim discovered without delay. Communication on the subject should be multiplied in all family and academic educational environments, from the lowest to the highest levels.

Operational definitions and measurement of externalizing behavior problems:An integrative review including research models and clinical diagnostic systems

Measurement of externalizing disorders such as antisocial disorders,attentiondeficit/hyperactivity disorder or borderline disorder have relevant implications for the daily lives of people with these disorders.While the Diagnostic and Statistical Manual of Mental Disorders(DSM)and the International Classification of Diseases(ICD)have provided the diagnostic framework for decades,recent dimensional frameworks question the categorical approach of psychopathology,inherent in traditional nosotaxies.Tests and instruments develop under the DSM or ICD framework preferentially adopt this categorical approach,providing diagnostic labels.In contrast,dimensional measurement instruments provide an individualized profile for the domains that comprise the externalizing spectrum,but are less widely used in practice.Current paper aims to review the operational definitions of externalizing disorders defined under these different frameworks,revise the different measurement alternatives existing,and provide an integrative operational definition.First,an analysis of the operational definition of externalizing disorders among the DSM/ICD diagnostic systems and the recent Hierarchical Taxonomy of Psychopathology(HiTOP)model is carried out.Then,in order to analyze the coverage of operational definitions found,a description of measurement instruments among each conceptualization is provided.Three phases in the development of the ICD and DSM diagnosis systems can be observed with direct implications for measurement.ICD and DSM versions have progressively introduced systematicity,providing more detailed descriptions of diagnostic criteria and categories that ease the measurement instrument development.However,it is questioned whether the DSM/ICD systems adequately modelize externalizing disorders,and therefore their measurement.More recent theoretical approaches,such as the HiTOP model seek to overcome some of the criticism raised towards the classification systems.Nevertheless,several issues concerning this model raise mesasurement challenges.A revision of the instruments underneath each approach shows incomplete coverage of externalizing disorders among the existing instruments.Efforts to bring nosotaxies together with other theoretical models of psychopathology and personality are still needed.The integrative operational definition of externalizing disorders provided may help to gather clinical practice and research.

Childhood stressful events, HPA axis and anxiety disorders

Anxiety disorders are among the most common of all mental disorders and their pathogenesis is a major topic in psychiatry, both for prevention and treatment. Early stressful life events and alterations of hypothalamic pituitary adrenal(HPA) axis function seem to have a significant role in the onset of anxiety. Existing data appear to support the mediating effect of the HPA axis between childhood traumata and posttraumatic stress disorder. Findings on the HPA axis activity at baseline and after stimuli in panic disordered patients are inconclusive, even if stressful life events may have a triggering function in the development of this disorder. Data on the relationship between stress, HPA axis functioning and obsessive-compulsive disorder(OCD) are scarce and discordant, but an increased activity of the HPA axis is reported in OCD patients. Moreover, normal basal cortisol levels and hyperresponsiveness of the adrenal cortex during a psychosocial stressor are observed in social phobics. Finally,abnormal HPA axis activity has also been observed in generalized anxiety disordered patients. While several hypothesis have attempted to explain these findings over time, currently the most widely accepted theory is that early stressful life events may provoke alterations of the stress response and thus of the HPA axis, that can endure during adulthood, predisposing individuals to develop psychopathology. All theories are reviewed and the authors conclude that childhood life events and HPA abnormalities may be specifically and transnosographically related to all anxiety disorders, as well as, more broadly, to all psychiatric disorders.

The Criticism and Amendment for the Dual-Factor Model of Mental Health: From Chinese Psychological Suzhi Research Perspectives

Aiming at the limitations of psychopathology (PTH), the dual-factor model of mental health (DFM) was proposed as a new mental health concept and methodology under the background of positive psychology trend. In this paper we propose giving an overview of DFM, and doubt, criticize, and modify DFM from the perspective of Chinese psychological suzhi research. The available literature from 1983 to 2012 that is related to DFM and concerning psychological suzhi research in the past 20 years has been reviewed. In addition, we also absorbed the idea of positive psychology and Traditional Chinese Medicine (TCM) Constitution theory to develop theoretically the relationship model between psychological suzhi and mental health. The relationship model between psychological suzhi and mental health modifies and transcends PTH and DFM. It will be the new research area of mental health research.

Tattoos as a window to the psyche:How talking about skin art can inform psychiatric practice

Tattooing the skin as a means of personal expression is a ritualized practice that has been around for centuries across many different cultures.Accordingly,the symbolic meaning of tattoos has evolved over time and is highly individualized,from both the internal perspective of the wearer and the external perspective of an observer.Within modern Western societies through the 1970 s,tattoos represented a cultural taboo,typically associated with those outside of the mainstream such as soldiers,incarcerated criminals,gang members,and others belonging to marginalized and counter-cultural groups.This paper aims to review the more recent epidemiology of tattoos in Western culture in order to establish that tattooing has become a mainstream phenomenon.We then review psychological and psychiatric aspects of tattoos,with a goal of revising outmoded stigmas about tattooing and helping clinicians working with tattooed patients to facilitate an exploration of the personal meaning of skin art and self-identity.We suggest that as a kind of augmentation of the physical exam,looking at and talking to patients about their tattoos can provide a valuable window into the psyche,informing clinical practice.

How does the‘environment’come to the person?The‘ecology of the person’and addiction

Currently,psychiatry lacks a field that can be called“theoretical psychiatry”,which uses theoretical concepts and explanatory models:The main stream of research is to collect data of all kinds in the hope that the computational Big Data approach will shed a bright light on the black box of mental disorders.Accordingly,the biology-based Research Domain Criteria of the National Institute of Mental Health have been established.However,as philosophical analyses of concepts and methods have shown,several epistemological gaps stand in the way of a consistent multilevel understanding of mental disorders.Also,the implicit ontological problems in the biological reduction of the psychosocial level and in the integration of so-called hard and soft disciplines are mostly left out.As a consequence,a non-reductive psychological theory of mental disorders is sought that also integrates correlating biological and sociological issues.In this context,one example of promising nonreductive psychiatric research is the option of systems/network psychopathology.The possibilities for integrating different psychological perspectives are highlighted for the field of addiction research and treatment,where pragmatic behaviorist approaches dominate over the theorybased practice of psychoanalysis.In comparing the theoretical constructs of these two approaches,the relevance of the concept of“(social)environment”as the wealth of influential sociocultural factors is discussed at levels superior to the interpersonal micro-level,namely the organizational meso-and societal macro level,which is not sufficiently considered in current biopsychiatry.On this basis of argumentation,the usefulness of grounding and framing psychiatry through the field of ecological sciences,especially human ecology,is demonstrated.Finally,to this end,an outline of an ecological model of mental health and illness is presented.

Psychosocial aspects of hematopoietic stem cell transplantation

Hematopoietic stem cell transplantation(HSCT)has become a conventional and potentially curative treatment for various hematological diseases.As more sophisticated procedures have been developed and mortality rates have decreased,attention has shifted to the psychosocial challenges associated with transplantation.The psychosocial difficulties accompanying transplantation are addressed in the context of both quality of life(QOL)and psychopathological research.Among the psychiatric comorbidities of HSCT,anxiety,depression,sleep and sexual disorders,delirium and post-traumatic stress disorder are the most studied conditions.Recently,more attention has been focused on the psychosocial burden of caregivers.Devising recommendations for the management of psychiatric symptoms and psychosocial interventions in HSCT sufferers and close relatives is a major concern to consultation–liaison psychiatrists and transplant teams.This review synthesizes and critically evaluates the current literature on the psychosocial aspects of HSCT and appraises the clinical significance of these outcomes.Issues of QOL assessment;psychosocial functioning and QOL in the course of HSCT;impact of graft-versus-host disease and other predictors of QOL and psychosocial functioning;comorbid psychiatric disorders;and interventions to maintain or improve QOL and reduce psychopathology and psychosocial burden on family members are presented.