Aberrant adapting of beliefs under stress: a mechanism relevant to the formation of paranoia?

2021 ◽  
pp. 1-10
Author(s):  
Katarina Krkovic ◽  
Ulrike Nowak ◽  
Mathias K. Kammerer ◽  
Antonia Bott ◽  
Tania M. Lincoln
Keyword(s):  
Psychotic Disorder ◽  
Cognitive Processes ◽  
Stress Condition ◽  
Multilevel Models ◽  
Psychotic Symptoms ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
New Information ◽  
The Face ◽  
Central Symptom

Abstract Background Difficulties in the ability to adapt beliefs in the face of new information are associated with psychosis and its central symptom – paranoia. As cognitive processes and psychotic symptoms are both known to be sensitive to stress, the present study investigated the exact associations between stress, adapting of beliefs [reversal learning (RL), bias against disconfirmatory evidence (BADE), and jumping to conclusions (JTC)] and paranoia. We hypothesized that paranoia would increase under stress and that difficulties in adapting of beliefs would mediate or moderate the link between stress and paranoia. Furthermore, we hypothesized that the investigated effects would be strongest in the group of individuals diagnosed with a psychotic disorder. Methods We exposed 155 participants (38 diagnosed with a psychotic disorder, 40 individuals with attenuated psychotic symptoms, 39 clinical controls diagnosed with an obsessive-compulsive disorder, and 38 healthy controls) to a control condition and a stress condition, in which we assessed their levels of paranoia and their ability to adapt beliefs. We applied multilevel models to analyze the data. Results Paranoia was higher in the stress condition than in the control condition, b = 1.142, s.e. = 0.338, t(150) = 3.381, p < 0.001. RL, BADE, and JTC did not differ between conditions and did not mediate or moderate the association between stress and paranoia (all ps > 0.05). Conclusions The results support the assumption that stress triggers paranoia. However, the link between stress and paranoia does not seem to be affected by the ability to adapt beliefs.

scholarly journals Likely Exacerbation of Psychological Disorders from Covid-19 Response

2021 ◽  
Vol 12 ◽  
pp. 215013272110167
Author(s):  
Tara Rava Zolnikov ◽  
Tanya Clark ◽  
Tessa Zolnikov
Keyword(s):  
Psychological Disorders ◽  
Emotional Reactions ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Current State ◽  
The Face ◽  
Adults And Children ◽  
Post Traumatic ◽  
Anxiety Depression

Anxiety and fear felt by people around the world regarding the coronavirus pandemic is real and can be overwhelming, resulting in strong emotional reactions in adults and children. With depressive and anxiety disorders already highly prevalent in the general population (300 million worldwide), depression and/or anxiety specifically because of the pandemic response is likely. Moreover, the current state of panic in the face of uncertainty is apt to produce significant amounts of stress. While this situation has the potential to cause psychological disorders in previously unaffected populations, perhaps more impactful is the exacerbation of symptoms of many existing disorders including anxiety, depression, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and hoarding disorder.

scholarly journals Psychopathology and urine toxicology in methadone patients

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Gamal Sadek ◽  
Zack Cernovsky ◽  
Simon Chiu
Keyword(s):  
Psychotic Symptoms ◽  
Social Self ◽  
Check List ◽  
Obsessive Compulsive ◽  
Paranoid Ideation ◽  
Compulsive Disorder ◽  
Self Confidence ◽  
Urine Toxicology ◽  
Symptom Check List ◽  
Methadone Patients

Several studies reported high rates of psychiatric commorbidity among methadone patients. We examined the relationships of measures of psychopathology to outcomes of screening urine tests for cocaine, opiates, and benzodiazepines in a sample of 56 methadone patients. They also completed the Symptom Check List-90-Revised (SCL-90-R). The highest scales in the SCL-90-R profile of our patients were those indicating somatic discomfort, anger, phobic anxiety, paranoid ideation, and also obsessive-compulsive disorder symptoms (scores above the 39th percentile). The only significant correlations between urine tests and SCL-90-R psychopathology were those involving benzodiazepines: patients with urine tests positive for benzodiazepines had lower social self-confidence (r=0.48), were more obsessive-compulsive (r=0.44), reported a higher level of anger (r=0.41), of phobic tendencies (r=40), of anxiety (r=0.39), and of paranoid tendencies (r=0.38), and also reported more frequent psychotic symptoms (r=0.43).

scholarly journals Schizophrenia-spectrum psychopathology in obsessive–compulsive disorder: an empirical study

2019 ◽  
Vol 270 (8) ◽  
pp. 993-1002 ◽  
Author(s):  
Andreas Rosén Rasmussen ◽  
Julie Nordgaard ◽  
Josef Parnas
Keyword(s):  
Diagnostic Criteria ◽  
Obsessive Compulsive Disorder ◽  
Psychotic Symptoms ◽  
Main Diagnosis ◽  
Schizophrenia Spectrum Disorders ◽  
Obsessive Compulsive ◽  
Main Research ◽  
Compulsive Disorder ◽  
Diagnostic Potential ◽  
Schizophrenia Spectrum

Abstract The differential diagnosis of obsessive–compulsive disorder (OCD) and schizophrenia-spectrum disorders can be difficult. In the current diagnostic criteria, basic concepts such as obsession and delusion overlap. This study examined lifetime schizophrenia-spectrum psychopathology, including subtle schizotypal symptomatology and subjective anomalies such as self-disorders, in a sample diagnosed with OCD in a specialized setting. The study also examined the differential diagnostic potential of the classic psychopathological notions of true obsession (‘with resistance’) and pseudo-obsession. The study involved 42 outpatients diagnosed with OCD at two clinics specialized in the treatment of OCD. The patients underwent semi-structured, narrative interviews assessing a comprehensive battery of psychopathological instruments. The final lifetime research-diagnosis was based on a consensus between a senior clinical psychiatrist and an experienced research clinician. The study found that 29% of the patients fulfilled criteria of schizophrenia or another non-affective psychosis as main, lifetime DSM-5 research-diagnosis. Another 33% received a research-diagnosis of schizotypal personality disorder, 10% a research-diagnosis of major depression and 29% a main research-diagnosis of OCD. Self-disorders aggregated in the schizophrenia-spectrum groups. True obsessions had a specificity of 93% and a sensitivity of 58% for a main diagnosis of OCD. In conclusion, a high proportion of clinically diagnosed OCD patients fulfilled diagnostic criteria of a schizophrenia-spectrum disorder. The conspicuous obsessive–compulsive symptomatology may have resulted in a disregard of psychotic symptoms and other psychopathology. Furthermore, the differentiation of obsessions from related psychopathological phenomena is insufficient and a conceptual and empirical effort in this domain is required in the future.

scholarly journals The Role of Self-Talk in Predicting Death Anxiety, Obsessive-Compulsive Disorder, and Coping Strategies in the Face of Coronavirus Disease (COVID-19)

2020 ◽  
Author(s):  
Esmaeil Sadri Damirchi ◽  
Arezoo Mojarrad ◽  
Saeed Pireinaladin ◽  
Andrej M M Grjibovski
Keyword(s):  
Coping Strategies ◽  
Obsessive Compulsive Disorder ◽  
Coping Style ◽  
Death Anxiety ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Self Talk ◽  
The Face ◽  
And Coping

Objective: Nowadays, the outbreak of Coronavirus (COVID-19) is one of the most stressful resources that has led to the rise of different levels of psychological crisis. In addition to the countries affected by the COVID-19, such as China, European and American countries, Iran has appeared as one of the most affected countries with high infected cases and deaths. Thus, the purpose of this study was to investigate the role of self-talk in predicting death anxiety, obsessive-compulsive disorder, and coping strategies in the face of COVID-19. Method: This descriptive and correlational study was conducted on 354 adults living in Ardabil, Iran, who were selected using cluster sampling from 21 January to 19 March 2020. Self-Talk questionnaires, Coping Strategies, Death Anxiety, and Obsessive-Compulsive questionnaires were used for data collection. Descriptive statistics, Pearson correlation, and multiple linear regression were used for data analysis. Results: The findings revealed a significant positive relationship between self-talk and problem-centered coping style. Also, significant negative relationships were found between self-talk and emotional coping style, death anxiety, and obsessive-compulsive disorder. Furthermore, based on the results of the regression test, self-talk predicted problem-centered style, emotional-coping style, death anxiety, and obsessive-compulsive disorder. Conclusion: The results of this study emphasize the need for psychological crisis intervention during the COVID-19 outbreak. Also, this study provides an important step in shifting attention to self-talk skills from sport psychology fields toward clinical psychology, especially about the mental impacts of COVID-19.

scholarly journals Atypical action updating in a dynamic environment associated with adolescent obsessive-compulsive disorder

2021 ◽  
Author(s):  
Aleya A Aziz Marzuki ◽  
Matilde Vaghi ◽  
Anna Conway-Morris ◽  
Muzaffer Kaser ◽  
Akeem Sule ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Young Patients ◽  
Dynamic Environment ◽  
Prediction Errors ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Error Related Negativity ◽  
The Face ◽  
Cognitive Information ◽  
Confidence Ratings

Background Computational research had determined that adults with obsessive-compulsive disorder (OCD) display heightened action updating in response to noise in the environment and neglect meta-cognitive information (such as confidence) when making decisions. These features are proposed to underlie patients compulsions despite knowledge they are irrational. Nonetheless, it is unclear whether this extends to adolescents with OCD as research in this population is lacking. Thus, this study aimed to investigate the interplay between action and confidence in adolescents with OCD. Methods Twenty-seven adolescents with OCD and 46 controls completed a predictive-inference task, designed to probe how subjects actions and confidence ratings fluctuate in response to unexpected outcomes. We investigated how subjects update actions in response to prediction errors (indexing mismatches between expectations and outcomes) and used parameters from a Bayesian model to predict how confidence and action evolve over time. Confidence-action association strength was assessed using a regression model. We also investigated the effects of serotonergic medication. Results Adolescents with OCD showed significantly increased learning rates, particularly following small prediction errors. Results were driven primarily by unmedicated patients. Confidence ratings appeared equivalent between groups, although model-based analysis revealed that patients confidence was less affected by prediction errors compared to controls. Patients and controls did not differ in the extent to which they updated actions and confidence in tandem. Conclusions Adolescents with OCD showed enhanced action adjustments, especially in the face of small prediction errors, consistent with previous research establishing just-right compulsions, enhanced error-related negativity, and greater decision-uncertainty in paediatric-OCD. These tendencies were ameliorated in patients receiving serotonergic medication, emphasising the importance of early intervention in preventing disorder-related cognitive deficits. Confidence ratings were equivalent between young patients and controls, mirroring findings in adults OCD research.

Obsessive–compulsive symptoms in schizophrenia: a review

2018 ◽  
Vol 31 (2) ◽  
pp. 63-73 ◽  
Author(s):  
Sandeep Grover ◽  
Swapnajeet Sahoo ◽  
Indu Surendran
Keyword(s):  
Psychotic Symptoms ◽  
Limited Data ◽  
Behaviour Therapy ◽  
Obsessive Compulsive ◽  
Initial Attempt ◽  
Compulsive Disorder ◽  
Symptom Profile ◽  
Cognitive Behaviour ◽  
Obsessive Compulsive Symptom ◽  
At Risk Mental State

AbstractObjectiveTo review the available literature on obsessive–compulsive symptom (OCS)/obsessive–compulsive disorder (OCD) in patients with schizophrenia.MethodologyElectronic searches were carried out to locate studies reporting various aspects of OCS/OCD in patients with schizophrenia.ResultsAvailable evidence suggests that prevalence of OCS/OCD in patients with schizophrenia is much higher than prevalence in general population and it is seen in all the stages of schizophrenia, starting from at risk mental state to chronic/stabilisation/deficit phases. Symptom profile of OCS/OCD in schizophrenia is similar to that seen in patients with OCD only. Presence of OCS/OCD is associated with higher severity of symptoms of schizophrenia and more negative outcome. At present there is very limited data on the efficacy/effectiveness of various pharmacological measures and psychological interventions, for management of OCS/OCD in patients with schizophrenia. There is some evidence pointing towards beneficial effect of certain antipsychotics, antidepressants and cognitive behaviour therapy. Management of OCS/OCD in patients with schizophrenia involves proper assessment. If the OCS/OCD is related to use of particular antipsychotic use, initial attempt must be made to reduce the dose of antipsychotics, however, if this is not effective, than addition of a selective serotonin reuptake inhibitor (SSRIs) must be considered. If the OCS/OCD is not related to the use of antipsychotic medication, than depending up on the severity of psychotic symptoms, addition of SSRIs must be considered.ConclusionThis review suggests that OCS/OCD is highly prevalent among patients with schizophrenia and there is limited good quality evidence to make any specific recommendations for management.

The Expanding Role of Antipsychotics

CNS Spectrums ◽  
2004 ◽  
Vol 9 (S1) ◽  
pp. 7-12
Author(s):  
Philip G. Janicak
Keyword(s):  
Bipolar Disorder ◽  
Manic Episode ◽  
Acute Mania ◽  
Psychotic Symptoms ◽  
Primary Therapy ◽  
Obsessive Compulsive ◽  
Stabilizing Agent ◽  
Compulsive Disorder ◽  
Bipolar Patients

Antipsychotics have been utilized in the treatment of bipolar disorder for many decades and were the mainstay of treatment before lithium was reintroduced in the late 1960s. Today, many bipolar patients who present with psychotic features are misdiagnosed and prescribed an antipsychotic for another disorder. Estimates of psychotic symptoms in bipolar disorder, particularly during a manic episode, are ≥50% by clinical assessment and even higher by individual reports. Thus, antipsychotics are frequently used: as first treatment for psychosis not recognized as bipolar disorder, and as an adjunct to a mood-stabilizing agent in bipolars with psychotic symptoms.Most recently, antipsychotics have been examined for their mood-stabilizing properties as well (Slide 9). One may conceptualize using a selective serotonin reuptake inhibitor (SSRI) antidepressant for disorders such as panic disorder or obsessive-compulsive disorder, and using an antiepileptic as a mood-stabilizing agent; however, it is more difficult to accept that an agent approved for treatment of psychosis can be a primary therapy for bipolar disorder. Data from the monotherapy trials suggest that second-generation antipsychotics (SGAs) are at least as effective as lithium and valproic acid for acute mania. There is a very large database indicating that SGAs can be utilized as monotherapy for acute mania. However, there is limited data on the role of these agents in prevention of relapse and recurrence and in their efficacy for depression in the context of bipolar disorder. More studies will be needed to clarify whether SGAs should be used as monotherapy or whether they would be best used as augmenting agents in severe and psychotically manic or depressed patients.

Potential Misdiagnosis of Bipolar Disorder

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
D. Correia ◽  
L. Correia ◽  
T. Gandra ◽  
F. Silva
Keyword(s):  
Bipolar Disorder ◽  
Seasonal Pattern ◽  
Large Fraction ◽  
Review Literature ◽  
Mood Stabilizers ◽  
Psychotic Symptoms ◽  
Obsessive Compulsive ◽  
Clinical Indicators ◽  
Compulsive Disorder

Background:Several reports indicate that Bipolar Disorder (BD) is frequently underdiagnosedleading to overuse of antidepressants and underuse of mood stabilizers.Aims and methods:The aim is to review literature concerning this subject published since 2000.Results:BD seems to be frequently underdiagnosed. Several studies, as EPIDEP and NEMESIS, reveal insufficiencies on the diagnosis of this disorder, suggesting that clinicians miss this diagnosis about half of the times, and that about three quarters of these patients are not receiving appropriate treatment, respectively.BD is often misdiagnosed as Major Depression Disorder (MDD), with approximately 40% of BD patients being initially diagnosed as MDD. On the other hand, a large fraction of patients initially diagnosed as MDD will change diagnosis to BD during follow-up, with some authors presenting values as high as 67%. Studies comparing the depressive features of MDD and BD point to some strong clinical indicators of bipolarity in patients presenting with depression, such as family history, seasonal pattern, postpartum onset, psychotic symptoms, younger age, suicidal behaviours, among others.To a lesser extent, BD can also be misdiagnosed as: substance abuse, borderline personality, obsessive-compulsive disorder, among others.It is also important to consider that a large fraction of patients with BD diagnosis will change diagnosis during the follow-up period.Conclusion:BD patients with the diagnosis may represent only a fraction of the subjects with this disorder, and the true epidemiological extent of this problem needs further investigation.

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