Clinical phenomenology of anxiety disorders in internally displaced persons

In recent years, reports from international organizations have focused on the mental health of internally displaced persons and the provision of timely medical care. Involuntary resettlement is accompanied by transformation of the entire system of socio- psychological relations, including interpersonal, family, parental, labor and leads to a significant strain on pathopsychological mechanisms, which ultimately contributes to the formation of anxiety disorders. In examined patients from main group, along with mood depression and anxiety, there were various fears and anxieties, asthenic manifestations and autonomic paroxysms, as well as against the background of anxious symptoms, they noted presence of isolated obsessive fears, closely related to anxious thinking about assessments in the eyes of others, short-term violent reactions to minor emotional events, mismatch of the strength of emotional reactions to the situation. At the same time, patients of the control group showed sensitization to external stimuls, especially during sleep and in the process of falling asleep.

Sensory Processing and Intolerance in Obsessive-Compulsive Disorder

Patients with obsessive-compulsive disorder often exhibit abnormal sensitivity to sensory stimuli and a reduced ability to screen out stimuli that most do not find bothersome. This chapter reviews the literature to date investigating these sensory experiences, first describing studies examining behavioral and psychophysiological responses to external sensory stimuli (exteroception) that use neuroscience and clinical frameworks. Results from these studies suggest that patients with obsessive-compulsive disorder show greater sensory sensitivity than healthy controls. In addition to abnormal exteroception, many patients with obsessive-compulsive disorder experience abnormal sensations that appear to be “internally generated,” including not-just-right experiences, incompleteness, and physical urges. These sensations, termed “sensory phenomena,” cause significant distress and impairment in daily functioning and may require different treatments than fear-based obsessions. The chapter discusses the clinical phenomenology of these sensory phenomena and describes the literature on their epidemiology and neural correlates, concluding with a brief discussion of directions for future research that may provide further insight into the nature of sensory symptoms in obsessive-compulsive disorder as well as potential treatments.

Networks in the Field of Tourette Syndrome

Gilles de la Tourette syndrome (TS) is a neuropsychiatric neurodevelopmental disorder with the cardinal clinical features of motor and phonic tics. Clinical phenomenology can be complex since, besides tics, there are other features including premonitory urges preceding tics, pali-, echo-, and coprophenomena, hypersensitivity to external stimuli, and symptom dependency on stress, attention, and other less well-defined factors. Also, the rate of comorbidities, particularly attention deficit hyperactivity disorder and obsessive-compulsive disorder, is high. Mirroring the complexities of the clinical course and phenomenology, pathophysiological findings are very diverse, and etiology is disputed. It has become clear, though, that abnormalities in the basal ganglia and their connections with cortical areas are key for the understanding of the pathophysiology and as regards etiology, genetic factors are crucial. Against this background, both adequate clinical management of TS and TS-related research require multidisciplinary preferably international cooperation in larger groups or networks to address the multiple facets of this disorder and yield valid and useful data. In particular, large numbers of patients are needed for brain imaging and genetic studies. To meet these requirements, a number of networks and groups in the field of TS have developed over the years creating an efficient, lively, and supportive international research community. In this review, we will provide an overview of these groups and networks.

Sketch of clinical phenomenology of the lived experience in the COVID-19 pandemic in Northeastern Brazil

The clinical practice in clinical phenomenology, be it psychiatric or psychological, is based on the philosophical inspiration adopted by the clinician. In my case, I see the world ambiguously and Merleau-Ponty is my philosopher of inspiration. Through these lenses, I see the phenomenon I study as a researcher or the way I relate to my patient as a psychotherapist. I also look through these lenses to write this essay about my lived experience in the pandemic of COVID-19 in 2020. COVID-19 reminds us that we are human and vulnerable. Assuming this vulnerability in its full existential meaning can be empowering, considering vulnerability in its intrinsic sense as a place in life with its ethical and political meanings. In the case of the lived experience of the COVID-19 pandemic in northeastern Brazil, contact with vulnerability, in many situations, is confused with precariousness, which has a more social nature. I also mention that the quarantine imposed by the COVID-19 pandemic required us to communicate with our families and work at home exclusively through video and audio on our computers. Under these circumstances, it is worth reflecting on the changes that we are experiencing in our own functioning, in our lived space and lived body. On the other hand, the lack of fluidity in our existential movement in the lived time is concerning as it affects the structural core of the human being and existential continuity. In this context, I finally present some preliminary thoughts about on-online psychotherapy through phenomenological lens.

CLINICAL PHENOMENOLOGY OF DEPRESSIVE BEHAVIOR DISORDER IN ADOLESCENTS: DIAGNOSIS, THERAPY, PREVENTION

The informativeness of behavioral patterns of depressive behavior disorder in adolescents in the age and gender aspect is determined. It is proved that many variants of behavioral disorders in adolescents with depressive disorders indicate the complex nature of relationships formation of behavioral disorders presence, which is the practical value for the development of specific preventive therapeutic programs.

Clinical phenomenology of the prodrome for psychosis

More than 100 years of retrospective studies show that psychosis is usually preceded by a prodrome. Nonspecific symptoms such as anxiety and depression precede more specific negative and attenuated positive symptoms. Prospective diagnostic criteria have been developed based on the retrospective work. The prospective criteria have shown high reliability in the research context, and follow-up studies demonstrate that those assessed as at clinical high risk (CHR) are five to seven times more likely to progress to psychosis as those who are not. Functional and cognitive impairment and distress accompany the increased risk. CHR diagnosis rates in general epidemiology studies are low, supporting validity, but rates in clinical epidemiology studies are substantially higher, suggesting that CHR constitutes an important but often overlooked clinical entity. Despite this importance, several areas in need of additional research effort are identified.

Correlates and clinical implications of tic suppressibility

Purpose of review: Tic disorders are common in the pediatric population and are differentiated from other movement disorders by tic suppressibility. Understanding the mechanism of tic suppression may provide new insights to the pathophysiology of tic disorders. This article highlights clinical phenomenology and neuronal correlates of tic suppressibility. Recent findings: Recent studies suggest that tic suppressibility exists in children shortly after onset of their tics. Moreover, those who are better able to suppress their tics have better tic outcomes. Interoceptive awareness and automatic action inhibition may be involved in tic suppression. Summary: We illustrate a possible underlying mechanism of tic suppressibility and its clinical correlations and implications. New concepts such as interoceptive awareness and action inhibition may help explain tic disorders. Further study will be useful to fill remaining knowledge gaps.

Trauma or Drama: A Predictive Processing Perspective on the Continuum of Stress

The notion of trauma has been liberally used both in clinical literature and general discourse. However, no consensus exists on its exact meaning and definition. Whereas traditionally trauma has been mostly associated with criterion A of acute and post-traumatic stress disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders, many researchers find this definition too constraining and not accounting for the complexity and many aspects of psychological trauma. This touched off a quest for a broader more accommodating trauma concept, and a dimensional view of trauma has been suggested with PTSD as its extreme manifestation. The dimensional view also has its detractors arguing that a “conceptual bracket creep” may undermine the category’s utility. Both categorical and dimensional views mostly rely on trauma’s clinical phenomenology and lack a unified theoretical basis. In an attempt to reconcile this contradiction, a hybrid categorical-dimensional model of trauma based on the general theory of stress has been recently proposed (Krupnik, 2019). In this report, we explore the categorical boundary of the trauma concept, as posited by the model, within the predictive processing framework (PPF). We integrate the PPF view with the theory of stress. In conclusion, we briefly discuss how the proposed model of trauma may guide clinical practice.