Associations between amygdala nuclei volumes, psychosis, psychopathy, and violent offending.

The amygdala is involved in fear perception and aggression regulation, and smaller volumes have been associated with psychotic and non-psychotic violence. We explored the relationship between amygdala nuclei volumes in violent offenders with and without psychosis, and the association to psychopathy traits. 3T MRI scans (n = 204, males, 18-66 years) were obtained from psychotic violent offenders (PSY-V, n = 29), non-psychotic violent offenders (NPV, n = 19), non-violent psychosis patients (PSY-NV, n = 67), and healthy controls (HC, n = 89). Total amygdala and 9 amygdala nuclei volumes were obtained with FreeSurfer. Psychopathy traits were measured with the Psychopathy Checklist-revised (PCL-R). Multivariate analyses explored diagnostic differences in amygdala nuclei volumes and associations to psychosis, violence, and psychopathy traits. PSY-V had a smaller basal nucleus, anterior amygdaloid area, and cortical amygdalar transition area (CATA), whereas PSY-NV had a smaller CATA than HC. Volumes in NPV did not differ from HC, and there were no associations between PCL-R total or factor scores and any of the nuclei or whole amygdala volumes. The lower volumes of amygdala nuclei involved in fear modulation, stress responses, and social interpretation may point towards some mechanisms of relevance to violence in psychosis, but the results warrant replication in larger subject samples.

Sexually destroyed or empowered? Silencing female genital cutting in close relationships.

Based on fieldwork among Kurdish-Norwegian migrants, this study explored how female genital cutting (FGC) was a silenced topic between mothers and daughters, and between men and women. The silence was often broken when FGC was discussed as a practice that needed to be rejected. The main reasons for rejecting FGC were to support women's rights and to recognise the negative ways in which FGC affected women's sexuality. This way of breaking the silence on FGC was particularly helpful to some husbands and wives in their discussion of how FGC might have affected their sexual relationships. Using theories of migrant women's sexual agency and embodiment, this study examined how the silencing of FGC in close relationships can be interpreted both as a sign of oppression and as a sign of empowerment. The analysis suggests that the stigmatisation that circumcised women can experience from condemnatory public discourse on FGC may sometimes lead to the negotiation of assertive female sexuality.

Undoing female genital cutting: perceptions and experiences of infibulation, defibulation and virginity among Somali and Sudanese migrants in Norway.

This paper explores the dynamics of change in meaning-making about female genital cutting among migrants from Somalia and Sudan residing in Norway. In both countries, female genital cutting is almost universal, and most women are subjected to the most extensive form - infibulation - which entails the physical closure of the vulva. This closure must later be re-opened, or defibulated, to enable sexual intercourse and childbirth. Defibulation can also ease other negative health consequences of the practice. In Norway, surgical defibulation is provided on demand by the public health services, also beyond the traditional contexts of marriage and childbirth. This study explores experiences and perceptions of premarital defibulation. It explores whether Somali and Sudanese men and women understand defibulation as a purely medical issue or whether their use of the services is also affected by the cultural meaning of infibulation. This study analyses data from in-depth interviews with 36 women and men of Somali and Sudanese origin as well as participant observation conducted in various settings during 2014-2015. It reports that although all of the informants displayed negative attitudes towards infibulation, cultural meanings associated with virginity and virtue constitute a significant barrier to the uptake of premarital defibulation.

Personality traits, interpersonal problems and therapeutic alliance in early schizophrenia spectrum disorders.

BACKGROUND: The quality of the therapeutic alliance is associated with engagement in- and thus important to the outcome of- treatment in schizophrenia. In non-psychotic disorders, general personality traits and individual patterns of interpersonal problems have been linked to the formation and quality of the therapeutic alliance. The role of these factors in relation to therapeutic alliance has not previously been explored in schizophrenia spectrum disorders. AIM: To investigate associations between personality traits, interpersonal problems and the quality of the therapeutic alliance in early schizophrenia spectrum disorders. METHODS: Demographic and clinical characteristics including Positive and Negative Syndrome Scale (PANSS) scores were assessed in 42 patients. Personality traits and interpersonal problems were assessed with the NEO Five factor Inventory (NEO-FFI) and the circumplex model of the Inventory of Interpersonal Problems (IIP-64C). Therapeutic alliance was measured with the Working Alliance Inventory - short form (WAI-S). RESULTS: Patient WAI-S scores were predicted by IIP-64C Submissive/Hostile interpersonal problems, age and PANSS excitative symptoms. Therapist WAI-S scores were predicted by NEO-FFI Agreeableness and the PANSS insight item. CONCLUSION: Core traits of personality and dimensions of interpersonal problems are associated with both patients' and therapists' perceptions of the quality of the working alliance.

Therapeutic alliance in early schizophrenia spectrum disorders: a cross-sectional study.

BACKGROUND: The therapeutic alliance is related to better course and outcome of treatment in schizophrenia. This study explores predictors and characteristics of the therapeutic alliance in recent-onset schizophrenia spectrum disorders including the agreement between patient and therapist alliance ratings. METHODS: Forty-two patients were assessed with demographic, neurocognitive, and clinical measures including the Positive and Negative Syndrome Scale (PANSS). The therapeutic alliance was measured with the Working Alliance Inventory - Short Form (WAI-S). RESULTS: Patient WAI-S total scores were predicted by age and PANSS excitative symptoms. Therapist WAI-S total scores were predicted by PANSS insight. Patient and therapist WAI-S total scores were moderately associated. Neurocognition was not associated with working alliance. CONCLUSION: Working alliance is associated with specific demographic and symptom characteristics in patients with recent-onset schizophrenia spectrum disorders. There is moderate agreement between patients and therapists on the total quality of their working alliance. Findings highlight aspects that may increase therapists' specificity in the use of alliance-enhancing strategies.

Cognitive and clinical factors are associated with service engagement in early-phase schizophrenia spectrum disorders.

We examined how neurocognition contributes to adherence with treatment in early-phase schizophrenia spectrum disorders, in context with clinical symptoms. A total of 148 patients were assessed with a broad neurocognitive test battery and clinical assessments including the Positive and Negative Syndrome Scale (PANSS); service engagement was measured by the Service Engagement Scale (SES). Patients' ability to conceptualize (measure: Wechsler Abbreviated Scale of Intelligence similarities) substantially influenced service engagement. Verbal fluency scores (measure: Delis-Kaplan Executive Functioning System semantic set shift) were significantly different between patients with high and low SES scores. Positive and excitative symptoms (measure: PANSS) contributed significantly in explaining service engagement. In the SES availability subscore, 18% of the variance resulted from PANSS positive and PANSS excitative symptoms and Wechsler Abbreviated Scale of Intelligence conceptualizing ability. Some of the relationship between cognitive deficits and clinical outcome can be mediated by patients' ability to engage in arranging appointments, thereby benefiting from professional mental health care.