Schizophrenia in the World: Arguments for a Contextual Phenomenology of Psychopathology

2020 ◽  
Vol 51 (2) ◽  
pp. 184-206
Author(s):  
Elizabeth Pienkos
Keyword(s):  
Risk Factors ◽  
Social Context ◽  
Life Events ◽  
Stressful Life Events ◽  
Strong Relationship ◽  
Phenomenological Research ◽  
Explanatory Models ◽  
Contextual Approach ◽  
The World ◽  
Phenomenological Psychopathology

Abstract Traditionally, phenomenological theories of schizophrenia have emphasized disturbances in self-experience, with relatively little acknowledgement of the surrounding world. However, epidemiological research consistently demonstrates a strong relationship between traumatic and stressful life events and the development of schizophrenia, suggesting that encounters in the world are highly relevant for many people diagnosed with this disorder. This paper reviews foundational texts in phenomenology and phenomenological psychopathology on the nature of subjectivity and its disturbances, finding support for broadening contemporary phenomenological models of schizophrenia to incorporate world events and their subjective meaning as essential aspects of this disorder. This contextual approach to phenomenology emphasizes the relationship between self and world, one that is especially unstable, unclear, and untrustworthy in schizophrenia. Both epidemiological and phenomenological research can benefit from this approach: in epidemiology, researchers might consider the ways that various risk factors are experienced by persons vulnerable to schizophrenia, while phenomenologists are encouraged to inquire about the environmental and social context in which altered experiences occur and incorporate these considerations into their explanatory models.

scholarly journals PATIENTS WITH CONVERSION DISORDER

2010 ◽  
Vol 17 (04) ◽  
pp. 715-720
Author(s):  
NIAZ MAQSOOD ◽  
BUSHRA AKRAM ◽  
WAJID ALI
Keyword(s):  
Life Events ◽  
Stressful Life Events ◽  
Case Series ◽  
Strong Relationship ◽  
Conversion Disorder ◽  
Stressful Life ◽  
Psychosocial Stressors ◽  
Medical College ◽  
Case Series Study ◽  
Series Study

Objectives: To assess the frequency of the various psychosocial stressors and stressful life events in patients presenting with conversion disorder. Study Design: Case series study. Place & Duration of Study: The study was conducted in the Department of Psychiatry & Behavioural Sciences, Bahawal Victoria Hospital & Quaid-e-Azam Medical College, Bahawalpur from January, 2009 to March, 2009. Subjects & Methods: The sample consisted of 100 in-patients (89 Female, 11 Male) with Conversion Disorder. They were interviewed andresults were analysed from the entries in a Performa. Results: Stressors were clearly identified in 100 patients. In all patients, we found more than one stressor. Among patients, there were (24%) In-laws problems, (23%) Love problems, (21%) Relationship problems with family, (20%) exam/study stress, (15%) marriage against will, (13%) demanding and pampered child, (11%) Issue less, (10%) sexual abuse, (8%) demand of marriage, (6%) overage in wait of marriage, (4%) death of partner, (3%) husband abroad and (3%) patient’s engagement break. Conclusions: We concluded that stressors and life events were present in all conversion disorder’s patients and these stressful life events are important causal factors for Conversion Disorder. Conversion Disorder has strong relationship with psychosocial stressors. 

scholarly journals Genetic and environmental determinants of stressful life events and their overlap with depression and neuroticism

2019 ◽  
Vol 3 ◽  
pp. 11 ◽  
Author(s):  
Toni-Kim Clarke ◽  
Yanni Zeng ◽  
Lauren Navrady ◽  
Charley Xia ◽  
Chris Haley ◽  
...  
Keyword(s):  
Risk Factors ◽  
Life Events ◽  
Stressful Life Events ◽  
Family Health ◽  
Stressful Life ◽  
Risk Scores ◽  
Health Study ◽  
Phenotypic Variance ◽  
Polygenic Risk ◽  
Genetic Overlap

Background: Stressful life events (SLEs) and neuroticism are risk factors for major depressive disorder (MDD). However, SLEs and neuroticism are heritable and genetic risk for SLEs is associated with risk for MDD. We sought to investigate the genetic and environmental contributions to SLEs in a family-based sample, and quantify genetic overlap with MDD and neuroticism. Methods: A subset of Generation Scotland: the Scottish Family Health Study (GS), consisting of 9618 individuals with information on MDD, past 6 month SLEs, neuroticism and genome-wide genotype data was used in the present study. We estimated the heritability of SLEs using GCTA software. The environmental contribution to SLEs was assessed by modelling familial, couple and sibling components. Using polygenic risk scores (PRS) and LD score regression (LDSC) we analysed the genetic overlap between MDD, neuroticism and SLEs. Results: Past 6-month life events were positively associated with lifetime MDD status (β=0.21, r2=1.1%, p=2.5 x 10-25) and neuroticism (β =0.13, r2=1.9%, p=1.04 x 10-37) at the phenotypic level.  Common SNPs explained 8% of the phenotypic variance in personal life events (those directly affecting the individual) (S.E.=0.03, p= 9 x 10-4). A significant effect of couple environment was detected accounting for 13% (S.E.=0.03, p=0.016) of the phenotypic variation in SLEs. PRS analyses found that reporting more SLEs was associated with a higher polygenic risk for MDD (β =0.05, r2=0.3%, p=3 x 10-5), but not a higher polygenic risk for neuroticism. LDSC showed a significant genetic correlation between SLEs and both MDD (rG=0.33, S.E.=0.08 ) and neuroticism (rG=0.15, S.E.=0.07). Conclusions: These findings suggest that SLEs should not be regarded solely as environmental risk factors for MDD as they are partially heritable and this heritability is shared with risk for MDD and neuroticism. Further work is needed to determine the causal direction and source of these associations.

Life events and psychosocial factors in elderly suicides – a case–control study

2001 ◽  
Vol 31 (7) ◽  
pp. 1193-1202 ◽  
Author(s):  
E. RUBENOWITZ ◽  
M. WAERN ◽  
K. WILHELMSON ◽  
P. ALLEBECK
Keyword(s):  
Risk Factors ◽  
Mental Disorder ◽  
Life Events ◽  
Stressful Life Events ◽  
Significant Risk ◽  
Stressful Life ◽  
Elderly Persons ◽  
Somatic Illness ◽  
Family Discord ◽  
Population Controls

Background. Stressful life events, such as family conflicts, separation, bereavement, somatic illness and financial problems are common antecedents of suicide. Studies on suicide among younger persons dominate the literature, despite the fact that a large proportion of suicides occur among elderly persons.Methods. The occurrence of stressful life events was investigated among elderly suicide cases and population controls. The study was conducted in the southwestern part of Sweden and included 85 persons (46 males and 39 females) 65 years and above who had committed suicide from January 1994 to May 1996. Population controls (84 males and 69 females) were randomly selected. Interviews were carried out with the controls and with informants for the suicide cases. Questions on sociodemographic background, mental and somatic health status, and life events (0–6, 7–12 and 13–24 months preceding suicide/interview) were included in the interviews.Results. Somatic illness, family discord and financial trouble were significant risk factors during all three time periods. Other risk factors were mental disorder, lower education, feelings of loneliness and previous suicide in the family. Factors associated with a decreased risk included active participation in organizations and having a hobby. Variables that remained in the multivariate logistic regression model were mental disorder (men, odds ratio (OR) = 62·4, 95% CI 17·9–217·5; women, OR = 55·9, 95% CI 14·1–222·3) and family discord (men, OR = 10·0, 95% CI 1·7–59·8; women, OR = 9·2, 95% CI 1·9–44·8).Conclusions. Mental disorder and family discord were the two major risk factors for suicide among elderly men and women.

scholarly journals Predicting Future Harm from Gambling over a Five-Year period in a General Population Sample: A Survival Analysis

2020 ◽  
Author(s):  
Shawn Currie ◽  
David Hodgins ◽  
Robert Williams ◽  
Kirsten Fiest
Keyword(s):  
Risk Factors ◽  
Problem Gambling ◽  
Life Events ◽  
Stressful Life Events ◽  
Low Risk ◽  
Modifiable Risk Factors ◽  
Electronic Gaming Machines ◽  
Risk Gambling ◽  
Gaming Machines ◽  
Over Time

Abstract Background. There is little longitudinal evidence on the cumulative risk of harm from gambling associated with excess spending and frequency of play. The present study sought to assess the risk of gambling problems over a five-year period in adults who exceed previously derived low-risk gambling limits compared to those who remain within the limits after controlling for other modifiable risk factors. Methods. Participants were adults (N = 4212) drawn from two independent Canadian longitudinal cohort studies who reported gambling in the past year and were free of problem gambling at time 1. Multivariate Cox regression was employed to assess the impact over time of gambling above low-risk gambling thresholds (frequency ≥ 8 times per month; expenditure ≥ 75CAD per month; percent of household income spent on gambling ≥ 1.7%) on developing moderate harm and problem gambling. Covariates included presence of a DSM5 addiction or mental health disorder at time 1, irrational gambling beliefs, number of stressful life events in past 12 months, number of game types played each year, and playing electronic gaming machines or casino games. Results. In both samples, exceeding the low-risk gambling limits at time 1 significantly increased the risk of moderate harm (defined as ≥ 2 consequences on the Problem Gambling Severity Index [PGSI]) within five years after controlling for other modifiable risk factors. Other significant predictors of harm were presence of a mental disorder at time 1, cognitive distortions about gambling, stressful life events, and playing electronic gaming machines or casino games. In one sample, the five-year cumulative survival rate for moderate harm among individuals who stayed below all the low-risk limits was 95% compared to 83% among gamblers who exceeded all limits. Each additional low-risk limit exceeded increased the cumulative probability of harm by 30%. Similar results were found in models when the outcome was problem gambling.Conclusions. Level of gambling involvement represents a highly modifiable risk factor for later harm. Staying below empirically derived safe gambling thresholds reduces the risk of harm over time.

scholarly journals Genetic and environmental determinants of stressful life events and their overlap with depression and neuroticism

2018 ◽  
Vol 3 ◽  
pp. 11 ◽  
Author(s):  
Toni-Kim Clarke ◽  
Yanni Zeng ◽  
Lauren Navrady ◽  
Charley Xia ◽  
Chris Haley ◽  
...  
Keyword(s):  
Risk Factors ◽  
Life Events ◽  
Stressful Life Events ◽  
Family Health ◽  
Stressful Life ◽  
Risk Scores ◽  
Health Study ◽  
Phenotypic Variance ◽  
Polygenic Risk ◽  
Genetic Overlap

Background: Stressful life events (SLEs) and neuroticism are risk factors for major depressive disorder (MDD). However, SLEs and neuroticism are heritable and genetic risk for SLEs is correlated with risk for MDD. We sought to investigate the genetic and environmental contributions to SLEs in a family-based sample, and quantify genetic overlap with MDD and neuroticism. Methods: A subset of Generation Scotland: the Scottish Family Health Study (GS), consisting of 9618 individuals with information on MDD, past 6 month SLEs, neuroticism and genome-wide genotype data was used in the present study. We estimated the heritability of SLEs using GCTA software. The environmental contribution to SLEs was assessed by modelling familial, couple and sibling components. Using polygenic risk scores (PRS) and LD score regression (LDSC) we analysed the genetic overlap between MDD, neuroticism and SLEs. Results: Past 6-month life events were positively correlated with lifetime MDD status (β=0.21, r2=1.1%, p=2.5 x 10-25) and neuroticism (β =0.13, r2=1.9%, p=1.04 x 10-37) at the phenotypic level.  Common SNPs explained 8% of the phenotypic variance in personal life events (those directly affecting the individual) (S.E.=0.03, p= 9 x 10-4). A significant effect of couple environment was detected accounting for 13% (S.E.=0.03, p=0.016) of the phenotypic variation in SLEs. PRS analyses found that reporting more SLEs was associated with a higher polygenic risk for MDD (β =0.05, r2=0.3%, p=3 x 10-5), but not a higher polygenic risk for neuroticism. LDSC showed a significant genetic correlation between SLEs and both MDD (rG=0.33, S.E.=0.08 ) and neuroticism (rG=0.15, S.E.=0.07). Conclusions: These findings suggest that SLEs should not be regarded solely as environmental risk factors for MDD as they are partially heritable and this heritability is shared with risk for MDD and neuroticism. Further work is needed to determine the causal direction and source of these associations.

scholarly journals Depression is more than the sum score of its parts: individual DSM symptoms have different risk factors

2013 ◽  
Vol 44 (10) ◽  
pp. 2067-2076 ◽  
Author(s):  
E. I. Fried ◽  
R. M. Nesse ◽  
K. Zivin ◽  
C. Guille ◽  
S. Sen
Keyword(s):  
Risk Factors ◽  
Life Events ◽  
Stressful Life Events ◽  
Disease Model ◽  
Work Hours ◽  
Stressful Life ◽  
Childhood Stress ◽  
Dsm 5 ◽  
Patient Health ◽  
Sum Scores

BackgroundFor diagnostic purposes, the nine symptoms that compose the DSM-5 criteria for major depressive disorder (MDD) are assumed to be interchangeable indicators of one underlying disorder, implying that they should all have similar risk factors. The present study investigates this hypothesis, using a population cohort that shifts from low to elevated depression levels.MethodWe assessed the nine DSM-5 MDD criterion symptoms (using the Patient Health Questionnaire; PHQ-9) and seven depression risk factors (personal and family MDD history, sex, childhood stress, neuroticism, work hours, and stressful life events) in a longitudinal study of medical interns prior to and throughout internship (n = 1289). We tested whether risk factors varied across symptoms, and whether a latent disease model could account for heterogeneity between symptoms.ResultsAll MDD symptoms increased significantly during residency training. Four risk factors predicted increases in unique subsets of PHQ-9 symptoms over time (depression history, childhood stress, sex, and stressful life events), whereas neuroticism and work hours predicted increases in all symptoms, albeit to varying magnitudes. MDD family history did not predict increases in any symptom. The strong heterogeneity of associations persisted after controlling for a latent depression factor.ConclusionsThe influence of risk factors varies substantially across DSM depression criterion symptoms. As symptoms are etiologically heterogeneous, considering individual symptoms in addition to depression diagnosis might offer important insights obfuscated by symptom sum scores.

Sign in / Sign up

Export Citation Format

Share Document