ABSTRACT
The World Health Organization (WHO) has included complex post-traumatic stress disorder (C-PTSD) in the final draft of the 11th edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-11), which was published in June, 2018 and is scheduled to be submitted to WHO's World Health Assembly for official endorsement in 2019. Mental health providers will want to be informed about this diagnosis in order to provide effective treatment. Complex PTSD, or developmental PTSD as it is also called, refers to the constellation of symptoms that may result from prolonged, chronic exposure to traumatic experiences, especially in childhood, as opposed to PTSD which is more typically associated with a discrete traumatic incident or set of traumatic events. Although it has been a controversial diagnosis and is not included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), lines of evidence support its distinct profile and utility. In this case study, we elucidate and discuss some aspects of the diagnosis and its treatment.
Subject(s)
Adult Survivors of Child Adverse Events , International Classification of Diseases , Stress Disorders, Post-Traumatic/diagnosis , Female , Humans , Middle AgedABSTRACT
BACKGROUND AND OBJECTIVES: Emotion plays a significant role in schizophrenia. Emotional awareness (i.e., attention to and clarity of emotions) is associated with a wide range of outcomes. Given that individuals with schizophrenia and schizoaffective disorder differ in the significance of their mood symptoms, the present research examined whether the association between emotional awareness and delusions differs for these two groups of patients. METHODS: Emotional awareness (i.e., attention to and clarity of emotions) was measured with self-report in a sample of 44 individuals diagnosed with either schizophrenia or schizoaffective disorder. Clinical ratings of delusions were made using the Scale for the Assessment of Positive Symptoms. RESULTS: For the sample as a whole, individuals with higher levels of attention to emotion tended to have more severe delusions. In addition, diagnostic group significantly moderated the relation between emotional clarity and delusions. LIMITATIONS: Conclusions regarding causality cannot be drawn due to the cross-sectional design. Replication is particularly important given the small sample sizes. CONCLUSIONS: The present research indicates that emotional awareness is associated with delusions. The results raise the possibility that the emotional factors that contribute to delusional beliefs among individuals with schizophrenia differ in at least some ways from the emotional factors that contribute to delusional beliefs among individuals with schizoaffective disorder.
Subject(s)
Awareness , Delusions/psychology , Emotions , Psychotic Disorders/psychology , Schizophrenic Psychology , Adult , Cross-Sectional Studies , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Male , Middle Aged , Mood Disorders/complications , Mood Disorders/psychology , Psychiatric Status Rating Scales , Young AdultABSTRACT
Chinese patients have been largely ignored in the literature examining ethnic differences in schizophrenia. This study examined demographics and symptom profiles of Euro-, African-, Chinese-American, and Latino inpatients with schizophrenia. Chinese-American patients had fewer symptoms, hospitalizations, and least amount of education compared to other groups. Cultural and clinical implications are discussed.
Subject(s)
Schizophrenia/ethnology , Schizophrenia/physiopathology , Acute Disease , Black or African American , Analysis of Variance , Asian People , Cross-Cultural Comparison , Ethnicity , Female , Humans , Male , Psychiatric Status Rating Scales , Schizophrenia/diagnosis , White PeopleABSTRACT
RATIONALE: We recently found that muscarinic receptor (mAChR) stimulation in the ventral tegmental area (VTA) is involved in the acquisition of a feeding task. OBJECTIVE: To investigate the involvement of VTA mAChR and nicotinic receptors (nAChR) in the acquisition and performance of a food-rewarded lever-pressing task. METHODS: In experiment 1 (N=54), rats were trained under a fixed ratio 1 schedule of reinforcement and received bilateral intra-VTA microinjections of scopolamine (0, 2.5 or 5 microg/0.5 microl) or mecamylamine (0, 5 or 10 microg/0.5 microl) before each of the first four sessions. Before session 10, all rats that initially received a dose of either compound now received the vehicle and vice versa. In experiment 2 (N=14), rats were tested with scopolamine or mecamylamine while lever pressing under a progressive ratio schedule of reinforcement. RESULTS: In experiment 1, lever pressing by rats initially treated with any mecamylamine dose or the scopolamine vehicle rose to and stayed at maximal levels for the remaining sessions. Responding by rats initially treated with the 2.5- or 5-microg dose of scopolamine remained low, even after the cessation of scopolamine treatment, and gradually rose to maximal levels by the final sessions. Injections of scopolamine 1 to 2 mm dorsal to the VTA had no significant effect on responding. In experiment 2, neither of the compounds significantly affected break points. CONCLUSIONS: Stimulation of VTA mAChR, but not of nAChR, is necessary for the acquisition of a food-rewarded lever-pressing task and neither is necessary for the performance of the task.
