Psychopathology

A recent factor analysis oftheMultiple AffectAdjective check List (MAACL) changed the Anxiety, Depression, and Hostility scales from bipolar to unipolar scales and added two new scales: Positive Affect and Sensation Seek-ing. Internal reliability of the MAACL-R scales, ...

"The role that the involvement of parents may play in the treatment outcome of their
children with anxiety disorders is still under debate. Some studies dealing with other
disorders have examined the role that the expressed emotion (EE) construct (parental
overinvolvement, criticism and hostility) may play in treatment outcome and relapse.
Given that some of these aspects have been associated with social anxiety for a long time,
it was hypothesized that EE may be associated with lower treatment outcome. The sample
was composed of 16 adolescents who benefited from a school-based, cognitive-behavioural
intervention aimed at overcoming social anxiety. Then, parents were classified with
high or low EE. The results revealed that the adolescents whose parents had low EE
showed a statistically significant reduction of their social anxiety scores at posttest, as
opposed to adolescents of parents with high expressed emotion. These findings suggest
that parental psychopathology (parents with high EE) should be taken into consideration
to prevent poor adolescent treatment outcome."

In this afterword to an important collection of essays that address the clinical aspects of the new phenomenology's concept of "atmospheres" in terms of psychopathology, I consider whether gestalt therapy may be an hospitable modality for these concerns.  I approach gestalt therapy as a clinical phenomenology and, as such, see many possible ways for the new phenomenology and gestalt therapy to critically engage one another. 

Please cite: Dan Bloom, D. (2019). Neither from the “Inside” Looking “Out” nor from the “Outside” Looking “In.” In G. Francesetti & T. Griffero (Eds.), Psychopathology and Atmospheres, neither inside nor outside (pp. 178–190). Cambridge Scholars Publishing.

The article develops the concept of sensus communis in order to describe the fundamentally interactive and socially embedded nature of human experience. In the introduction, we focus on the historical relevance of phenomenological psychiatry for social psychiatry, especially in Germany, and give a short outline of the philosophy of common sense. The concept of sensus communis is then considered under three aspects: (1) as a fundamental intermodal capacity of sensing oneself and the world through the medium of the lived body; (2) as a social sense, derived from primary social interactions with others, and enabling a habitual, pre-reflective and confident relation with the social world; (3) as ‚common sense‘, that means, the capacity to perceive and think in accordance with intersubjectively shared, self-evident rules, and to apply them to specific situations. All three aspects must be considered as mutually interwoven. On this basis, psychopathological implications of sensus communis as well as socio-epidemiological findings on the connection between social environment and mental disorders will be taken into account. Finally, the paper points out possible applications of the concept to therapeutic approaches such as assertive community treatment and open dialogue.

The Nephilim were said to be a race or a group of people that had distinct physical characteristics of large size and great strength.  They are first mentioned in Genesis chapter 6 as the progeny of the “sons of God” and the “daughters of men.”  Although the psychological characteristics of the Nephilim are not specifically described in the Bible, they are pictured in the Second Temple writings as being very belligerent, sexually aggressive, and prone to conflict.  Immediately after they are mentioned, Genesis goes on to discuss how the heart and minds of people became continually evil, and God’s flood judgement in response.  But the Bible indicates that the Nephilim reappeared after presumably being killed off in the Flood.  How could that have happened? 

This paper explores a possibility that may not have been previously considered – that the wife of Ham (one of the sons of Noah), who was one of the individuals present on the ark, was born from Nephilim stock.  She would therefore have passed her DNA to some of her children (especially to her son Canaan) and later descendants, so that individuals of large size and/or psychopathic behavior could therefore reappear later in history.  Also considered is the possibility that the Biblical Nimrod, a descendant of Ham, was the Sumerian king Gilgamesh, and that he also was genetically Nephilim.

This milestone text provides a comprehensive and state-of-the art overview of perfectionism theory, research, and treatment from the past 25 years, with contributions from the leading researchers in the field. The book examines new theories and perspectives including the social disconnection model of perfectionism and the 2 × 2 model of perfectionism. It also reviews empirical findings, with a special focus on stress, vulnerability, and resilience, and examines perfectionism in specific populations. Finally, it considers how perfectionism relates to physical health and psychophysiological processes and introduces new approaches to effective prevention and treatment. By increasing our understanding of perfectionism as a complex personality disposition and providing a framework for future explorations, this landmark publication aims to promote further research in this field. It will be invaluable reading for academics, students, and professionals in personality psychology, clinical and counselling psychology, applied psychology and related disciplines.

Mark Haddon’s Polar Bears (2010) and Nick Payne’s Constellations (2012) are two recent plays of the British stage exploring the minds of women suffering from a psychological or neurological disorder: in Haddon’s play, Kay, an artist, is bipolar; in Payne’s play, Marianne, a scientist, has a brain tumour. Both pieces question the protagonists’ freedom of self-determination and highlight our sense of reality as a construct, using poetic structures which break with the traditional dramatic linearity of the conventional play. Indeed, instead of providing a chronological succession of scenes, they allow the drama to emerge from a random alternation of parallel scenarios to be read as probabilities. The contradictory, disordered fragments that make up the plays thus invite the reader-spectator, in a suggestive way, to imagine the dramatic possibilities of a story which is never set or decided, instead of merely registering a given narrative. As a result, in providing structural metaphors for the female characters’ pathological states, these plays not only reflect on the tentative process of their own writing, they also encourage us to question our perception of reality as a unique object – a view contradicted by the paradigm shift of quantum physics. While Marianne explains the scientific theory that "In the quantum universe, every choice, every decision you’ve ever and never made exists in an unimaginable vast ensemble of parallel universes", Kay seems to experience Everett’s many-worlds interpretation from a first-person perspective, exclaiming, "We think there’s only one world. […] But there are so many worlds, aren’t there, one laid over the other. […] It’s so beautiful it makes me want to cry." This study aims to look at how these two plays, as instances of a “Theatre of Possibilities”, to use Jean-Pierre Sarrazac’s expression, explore mind and brain disorders to open a dramatic space which allows for a subversive form of realism to develop, based on the quantum principle of uncertainty. They resort to tropes – quantum principles and phenomena used as thematic and structural metaphors – as a means to portray our cognitive processes and, more specifically, to conjure up the hidden reality of pathological subjective experience, paralleled by the most mind-blowing theories of modern science. I argue that in Payne’s and Haddon’s plays, the dramatic space becomes a place where quantum descriptions of reality and psychopathological distortions of reality tend to converge to form a consistent landscape/mindscape, making room for theatrical realism to be reinvented from the very matter of what should intuitively appear as the most delusional imaginings.

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Polar Bears de Mark Haddon (2010) et Constellations de Nick Payne (2012) sont deux pièces britanniques récentes qui explorent la psyché de personnages féminins souffrant soit d’un trouble psychiatrique soit d’une maladie neurologique : dans la pièce de Haddon, Kay, une artiste, est bipolaire ; dans la pièce de Payne, Marianne, une scientifique, déclare une tumeur cérébrale. En faisant dialoguer santé mentale, fonctionnement cognitif et mécanique quantique, les deux pièces interrogent la liberté et la capacité des protagonistes à s’autodéterminer malgré la maladie et, à travers la mise à mal des fonctions cognitives, mettent en lumière notre perception de la réalité comme construction subjective en utilisant des structures poétiques qui rompent avec la linéarité traditionnelle du drame conventionnel. En effet, au lieu de proposer un enchaînement chronologique de scènes déterminantes dont le déroulé crée progressivement l’univers de la fiction sur le mode indicatif, Polar Bears et Constellations se tissent toutes deux autour d’une alternance aléatoire de scénarios parallèles qui s’appréhendent sur un mode conditionnel comme autant de probabilités décrochées de la flèche du temps. Les fragments contradictoires et désordonnés qui les constituent invitent ainsi le lecteur-spectateur, par touches suggestives et non successives, à imaginer les possibilités d’une histoire sans résolution, qui n’est jamais fixée ou déterminée, au lieu d’enregistrer simplement les avancées d’un récit donné. Cet article vise à montrer que les hésitations et oscillations qui s’élaborent autour des états pathologiques des personnages féminins (et dont elles sont le résultat et le symptôme) mettent non seulement en abyme le processus même d’écriture (dimension métadramatique), elles nous encouragent également à interroger notre rapport au réel (dimension philosophique) non pas tant comme objet unique et extérieur au sujet qui l’observe, mais comme onde de probabilités ou écosystème d’états superposés dans lequel l’observateur lui-même joue un rôle déterminant. Ce changement de paradigme introduit par la physique quantique rencontre ainsi l’instabilité ou l’indécidabilité psychologique. Tandis que, dans Constellations, Marianne explique la théorie scientifique selon laquelle « dans l’univers quantique, chaque choix que l’on fait, chaque décision que l’on prend existe dans un ensemble infiniment vaste d’univers parallèles », dans Polar Bears Kay semble faire l’expérience directe, à la première personne, de la théorie des mondes multiples d’Everett (many-worlds interpretation) lorsqu’elle s’exclame, en proie à une phase maniaque : « On croit qu’il n’existe qu’un seul monde. […] Mais il existe tellement de mondes (so many worlds), n’est-ce pas, empilés les uns sur les autres. […] C’est si beau que ça me donne envie de pleurer. » Ce travail s’intéresse à la manière dont ces deux pièces illustrent ce que l’on pourrait appeler, avec Jean-Pierre Sarrazac, un « Théâtre des Possibilités » et explorent les maladies de l’esprit et du cerveau pour ouvrir un espace dramatique dans lequel se développe une forme subversive de réalisme postdramatique fondé sur le principe quantique d’incertitude (Heisenberg). Les tropes qui s’y déploient – principes et phénomènes quantiques utilisés comme métaphores thématiques et structurelles – permettent de rendre compte de nos processus cognitifs et, plus précisément, de la réalité cachée de l’expérience intime de la maladie, tout en mettant ces expériences en relation avec les théories les plus révolutionnaires de la science moderne. Chez Payne comme chez Haddon, l’espace dramatique devient le lieu où les descriptions quantiques et les distorsions psychopathologiques de la réalité tendent à converger pour former un paysage étonnamment cohérent dans sa relativité et permettre au réalisme théâtral de se refonder à partir de cela-même qui s’apparente intuitivement aux délires d’une imagination malade et à des dysfonctionnements cognitifs, pour finalement poser la question essentielle de notre libre-arbitre.

This article presents an approach to obsessive–compulsive disorder based on Gestalt therapy theory, Gestalt psychology, and psychiatric phenomenology. After establishing a diagnostic framework, the experiences of clients are explored, starting from the experience of space and time, of the relationship between details and the whole, of boundaries, and of materiality. In the light of the Gestalt theory of perception, the obsessive– compulsive symptom is framed as a creative adjustment able to protect the client from much worse suffering, in a situation in which the bodily sensorial ground is permeated with terror. After describing how the obsessive–compulsive field is aesthetically actualised in therapy, a number of issues and passages are highlighted that can help therapists in their journey with the sufferers.

Background: During the COVID-19 pandemic, a decrease in well-being and an increase in mental health problems were registered in medical and psychotherapeutic practices, counseling centers, and clinics. According to previous stud- ies, younger people and women seemed to be particularly affected. The aim of this study was to describe mental health problems of students and to draw consequences for the fur- ther handling of pandemics and other crises. Method: Stu- dents at the University of Heidelberg, a typical German “full university,” were surveyed online using internationally com- parable screening instruments like the Well-Being Index (WHO-5) and the Patient Health Questionnaire (PHQ). In ad- dition, the students had the opportunity to describe in a nar- rative form their well-being and to make suggestions how to improve their situation. Results: Out of a population of 27,162 students who were contacted by email, 2,137 stu- dents completed the questionnaire. The salient finding is that according to the WHO-5 Well-Being Index, 72.2% of the
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respondents feel seriously impaired in their well-being. This corresponds to the finding that 75.8% of the respondents in the PHQ-D show indications of at least one syndrome diag- nosis. Depression was found in 41.8% of the respondents in the PHQ-D. Indications of moderate to severe and severe de- pressive syndromes were present in 31.8%. Signs of somato- form syndromes are found in 25.4% and of anxiety syn- dromes in 20.0%. 1,089 students gave narrative reports on how they were feeling and made suggestions for improve- ment. About 75% reported severely reduced well-being. Their main complaints were loneliness and depression and lack of recognition for their specific academic and life situa- tion during the pandemic. By far, the largest proportion of students supposed that their mental health issues were caused and/or intensified by the pandemic-related social contact restrictions. The vast majority of them made reason- able suggestions for controlled relaxation of contact restric- tions. Conclusions: Students suffer severely from the pan- demic-related social restriction. In respect to future pandem- ic outbreaks or other crises leading to social isolation, the dramatic consequences of social lockdowns should be taken into account. Under pandemic conditions, we especially should support persons lacking social networks.

The aim of this paper is to develop a phenomenological analysis of those psychopathologies which involve an intersubjective disruption, such as schizophrenia or autistic spectrum disorder. After briefly summarizing the contemporary debate about intersubjectivity, I will emphasize the importance of the living body in the development of our understanding of otherness, and I will show two qualitative tools I have personally developed: a " phenomenological test " that takes into account specific phenomenological notions and is aimed at the analysis of the so-called existentialia (self, other, time, space, body); and a form of therapy focused on the fortification of intercorporeality and of bodily awareness.

This paper is written in the spirit of a collaborative approach to the diagnosis and treatment of depression. It points toward a integrative Gestalt methodology, which is informed by he psychopathological perspective yet firmly rooted in a Phenomenological and Relational Field Perspective which honours the diversity of experience across the continuum of depression.

People abused by angry discipline as children, may tend to abuse or overly punish other people or themselves for perceived wrongs in their adult life. In some individuals, aggressive personality traits may be genetically inherited. The aggressive personality may feel weakened by having guidelines or boundaries for anger. Anger is a normal human emotion, and these guidelines can help express anger in a healthy way.

International literature has shown that adolescents represent the population most at risk of fatal and nonfatal motor vehicle collisions (MVCs). Adolescents’ alexithymic traits and significant use of immature defense strategies have been seen to play a key role. This study aimed to investigate the possible mediation role played by defense strategies use in the relationship between alexithymia and MVCs. Our sample consisted of 297 adolescents divided into four subgroups, based on the number of visits to the emergency department due to an MVC. We assessed adolescents’ alexithymic traits and defense strategies use through self-report instruments. Results showed that males reported a higher rate of MVCs than females. Higher rates of MVCs are associated with more alexithymic traits and maladaptive defense strategies use. Adolescents’ Acting Out and Omnipotence use significantly mediated the relationship between alexithymia and MVCs. Our findings suggest the recidivism of MVCs as an attem...

Background Few studies have examined the psychopathological profiles of child offspring of bipolar parents. Such investigations are useful as a first step to identifying potential prodromal manifestations of bipolar disorder. Methods The presence of psychopathology ...

AIMS The aims of this study were to evaluate the association between obesity and socio-demographic and psychopathological variables in a clinical sample of patients referred to a center for the diagnosis and treatment of obesity, compared with a homogeneous sample of normal-weight subjects. METHODS In the context of a research project regarding obesity and psychopathology, a multivariate logistic regression analysis was used to examine the association between obesity and the demographic and clinical variables, on the basis of the dataset of a consecutive sample of 293 obese patients (48 males, 245 females, mean age: 45.41±13.55, mean body mass index [BMI] 35.6±6.2)compared with a control group of 293 non-obese subjects (48 males, 245 females, mean age 45.66±13.86, mean BMI 21.8±2.06). All subjects were assessed by structured clinical interview, the Structured Clinical Interview for Diagnosis for axis I DSM-IV (SCID-I) and for axis II DSM-IV(SCID-II). RESULTS Multivariate statistical...

Perfectionists have shown increased negative affect after failure compared to nonperfectionists. However, little is known about how perfectionists react to repeated failure. This study investigated the effects of two forms of perfectionism—self-oriented perfectionism and socially prescribed perfectionism—on 100 university students’ reactions to repeated failure (versus repeated success) examining three negative emotions: anxiety, depression, and anger. Results showed that socially prescribed perfectionism predicted increased anxiety, depression, and anger after initial failure and further increased anger after repeated failure. In contrast, self-oriented perfectionism predicted increased anxiety, but only after repeated failure. The findings suggest that both self-oriented and socially prescribed perfectionism are vulnerability factors predisposing individuals to react with increased negative affect after repeated failure.

ADHD is characterized by inattention, hyperactivity, and disinhibition, including the inability to screen out distracting stimuli. Prepulse inhibition (PPI) of startle indexes a related gating process and is enhanced during attended compared to ignored stimuli. We predicted that PPI during attended stimuli would be enhanced by the stimulant methylphenidate (MPH) and that this effect would be moderated by baseline PPI. Children with ADHD (n=36) completed a baseline day and a randomized, double-blind medication trial (placebo vs. sustained release MPH). Bilateral startle eyeblink EMG was measured during a tone discrimination task. MPH enhanced PPI during attended, but not during ignored stimuli. Extending findings that pretreatment functioning moderates stimulant effects on PPI, this effect tended to be inversely related to baseline PPI. These data fit with the clinical literature on ADHD and the hypothesis that MPH enhances interference control for important environmental stimuli.

The reliability and validity of traditional taxonomies are limited by arbitrary boundaries between psychopathology and normality, often unclear boundaries between disorders, frequent disorder co-occurrence, heterogeneity within disorders, and diagnostic instability. These taxonomies went beyond evidence available on the structure of psychopathology and were shaped by a variety of other considerations, which may explain the aforementioned shortcomings. The Hierarchical Taxonomy Of Psychopathology (HiTOP) model has emerged as a research effort to address these problems. It constructs psychopathological syndromes and their components/subtypes based on the observed covariation of symptoms, grouping related symptoms together and thus reducing heterogeneity. It also combines co-occurring syndromes into spectra, thereby mapping out comorbidity. Moreover, it characterizes these phenomena dimensionally, which addresses boundary problems and diagnostic instability. Here, we review the develop...