Aberrant Salience among Young Healthy Postgraduate University Students: The Role of Cannabis Use, Psychotic-Like Experiences, and Personality

Aberrant salience (AS) is an anomalous world experience which plays a major role in psychotic proneness. In the general population, a deployment of this construct – encompassing personality traits, psychotic-like symptoms, and cannabis use – could prove useful to outline the relative importance of these factors. For this purpose, 106 postgraduate university students filled the AS Inventory (ASI), the Community Assessment of Psychic Experiences (CAPE), the Temperament and Character Inventory (TCI), and the Symptom Checklist 90-Revised (SCL-90-R). Lifetime cannabis users (<i>n</i> = 56) and individuals who did not use cannabis (<i>n</i> = 50) were compared. The role of cannabis use and psychometric indexes on ASI total scores was tested in different subgroups (overall sample, cannabis users, and nonusers). The present study confirmed that cannabis users presented higher ASI scores. The deployment of AS proved to involve positive symptom frequency (assessed through CAPE), character dimensions of self-directedness and self-transcendence (TCI subscales), and cannabis use. Among nonusers, the role of personality traits (assessed through the TCI) was preeminent, whereas positive psychotic-like experiences (measured by means of CAPE) had a major weight among cannabis users. The present study suggests that pre-reflexive anomalous world experiences such as AS are intertwined with reflexive self-consciousness, personality traits, current subclinical psychotic symptoms, and cannabis use. In the present study, subthreshold psychotic experiences proved to play a major role among cannabis users, whereas personality appeared to be more relevant among nonusers.

How Social Exclusion, Embitterment, and Conspiracy Beliefs Mediate Individual’s Intention to Vaccination against COVID-19: Results from a Moderated Serial Mediation Analysis

<b><i>Introduction:</i></b> As Switzerland faced the “second wave” of COVID-19 incidences, a discussion of a potential vaccine against the virus emerged. While some individuals accept vaccines, others challenge or refuse to be vaccinated, a phenomena called <i>vaccine hesitancy</i>. Here, trust plays a vital role in vaccination intention. Embitterment not only goes along with the sense of being treated unjust but also innates a distrust in others. Thus, embitterment may influence individuals’ vaccination intention against COVID-19. In the present study, we investigate how feelings of being socially excluded and the perceived negative impact of the pandemic are associated with embitterment and in turn, how embitterment is related to individuals’ vaccination intention and the tendency to hold COVID-19-related conspiracy beliefs (CCBs). This is in regard of the perceived communication style by the government. <b><i>Method:</i></b> A convenience sample of 281 individuals completed an online survey developed on Qualtrics. In this cross-sectional, nonexperimental designed study, indirect effects of a moderated serial mediation were analyzed using <i>Jamm</i> (Jamovi, Version 0.9; 2019). <b><i>Results:</i></b> Results indicated that embitterment went along with increased feelings of social exclusion (β = 0.45, <i>p</i> &#x3c; 0.001). Further, individuals high in embitterment generally indicated a higher vaccination intention against COVID-19 (β = 0.15, <i>p</i> &#x3c; 0.01). However, embittered individuals holding CCBs had a decreased vaccination intention against COVID-19 (β = −0.71, <i>p</i> &#x3c; 0.001). Thus, whether or not embittered individuals develop CCBs might be a crucial determinant for their vaccination intention. Noteworthy, the relationship between embitterment and the tendency to hold CCBs was reinforced by the notion of an unsatisfactory style of communication by the government. <b><i>Conclusion:</i></b> Taken together, results suggest that embitterment not only plays a relevant role in vaccination intention against COVID-19 but also for the susceptibility to engage in conspiracy beliefs.

Four Core Concepts in Psychiatric Diagnosis

In the present article, we aimed at describing the diagnostic process in Psychiatry through a phenomenological perspective. We have identified 4 core concepts which may represent the joints of a phenomenologically oriented diagnosis. The “tightrope walking” attitude refers to the psychiatrist’s ability to swing between 2 different and sometimes contrasting tendencies (e.g., engagement and disengagement). The “holistic experience” includes all those intuitive, nonverbal, and pre-thematic elements that emerge in the early stages of the clinical encounter as an emanation of the atmospheric quality of the intersubjective space. The “co-construction of symptoms” regards the hermeneutic process behind psychiatric symptoms, involving both the patient as a self-interpreting agent and the clinician as a translator of his/her experience. Finally, by the “evolving typification” we mean that the closer the relationship becomes with the patient, the more specific and nuanced becomes the typification behind psychiatric diagnosis. Each of these concepts will be accompanied by an extract from a clinical case deriving from one of the authors’ most recent clinical experiences.

Toward Understanding of Suicidality in a Spanish Clinical Population: Validation of the European Spanish Version of the Interpersonal Needs Questionnaire

<b><i>Introduction:</i></b> Suicidal ideation (SI) represents one of the most prominent predictors of suicidal behavior (SB). The Interpersonal Needs Questionnaire (INQ) was developed from the Interpersonal Theory of Suicide (ITS) to assess the 2 core drivers of SI proposed by the theory. Despite the relevance of suicide-related ideations and ITS, there is a lack of psychometric measures validated in clinical Spanish population that adequately evaluate SI components of ITS. Thus, the main aim of the study was to validate INQ-10 in a Spanish clinical sample including the genuine cultural and linguistic characteristics of European Spanish. <b><i>Methods:</i></b> 315 participants were included in the analyses; 149 of them consulted mental health services for the presence of suicide-related behaviors. A series of exploratory and confirmatory factor analyses were carried out to identify the factor solution. Bivariate and multivariate analyses were used to analyze psychometric properties. Finally, sensitivity and specificity properties were explored through receiver-operating characteristic analyses which also provided the cut-off values of the questionnaire. <b><i>Results:</i></b> An 8-item version demonstrated a good fit to the 2-factor solution. Likewise, this 8-item version showed good psychometric properties. Sensitivity and specificity indices of the version validated as well as the calculated cut-off points were excellent. <b><i>Conclusions:</i></b> The current results demonstrate the utility of an 8-item INQ European Spanish version as a valid measure of the current SI in Spanish clinical population. In addition, the validated form reflects the theoretical framework on which it was built.

A Developmental Study of Mirror-Gazing-Induced Anomalous Self-Experiences and Self-Reported Schizotypy from 7 to 28 Years of Age

<b><i>Introduction:</i></b> The mirror-gazing task (MGT) is an experimental paradigm inducing anomalous perceptions and anomalous experiences of self-face (ASEs) in the general population, ranging from changes in light and color, to face deformation, to experiencing one’s specular image as another identity. Subclinical ASEs have been related to the emergence of the risk for developing psychotic disorders, and inducing such states in the general population could shed light on the factors underlying interindividual differences in proneness to these phenomena. We aimed to examine the influence of schizotypal personality traits on proneness to experiencing induced ASEs from a developmental perspective, from childhood to adulthood. <b><i>Methods:</i></b> Two hundred and sixteen children, adolescents, and young adults participated in the MGT, and their schizotypal personality traits were assessed with the Schizotypal Personality Questionnaire. Statistical analyses assessed the relationship between schizotypy dimensions and induced ASEs, and we further tested their dynamic relationship as function of age (from childhood to adulthood). <b><i>Results:</i></b> Results confirmed the developmental trajectory of the different schizotypy dimensions, with scores peaking during adolescence, and proneness to induced ASEs seemed to follow a similar developmental trajectory. Moreover, positive (<i>p</i> = 0.001) and disorganized (<i>p</i> = 0.004) dimensions were found to contribute to the proneness to experiencing induced ASEs. Finally, the developmental model showed that positive schizotypy (<i>p</i> = 0.035) uniquely distinguished between experiencing other-identity phenomena between childhood and adulthood. <b><i>Conclusion:</i></b> This study has the potential to inform research on early detection of psychosis through a developmental approach and links the concept of schizotypy with processes of perceptual self-distortions.

Borderline We-Space? The Phenomenology of the Background of Safety in Borderline Personality Disorder

Borderline personality disorder (BPD) is a severe psychiatric condition characterized by instability in identity, relationships, and affect. Individuals, with BPD typically lack a coherent sense of self, are highly sensitive to interpersonal stressors, experience intense fluctuations in mood, and frequently engage in impulsive and self-destructive behaviors. Although both empirical research and development of effective psychotherapy have evidently progressed over the past years, many aspects regarding the structure of experience and the life-world typical for persons with BPD are not yet fully understood. Somewhat surprisingly, phenomenological psychopathology has only recently started to pay more attention to the disorder. A comprehensive elaboration of the phenomenology of BPD is therefore still lacking. This article aimed to contribute to such a phenomenological understanding by focusing on what we think is an essential aspect that has yet not been sufficiently addressed: the background of safety. To clarify what this means, we depart from Sandler’s [<i>Int J Psychoan</i>. 1960;41:352–6] psychoanalytic concept and elaborate on it phenomenologically. This leads us to argue that the development of a background of safety requires a particular embodied presence of others, which, in turn, contributes to the constitution of a safe we-space, a shared and familiar environment providing a matrix for the experience of a stable world. However, even when established, the background of safety remains in need of a continuous reconfirmation through corresponding experiences within a sufficiently reliable and controllable environment. The background of safety is vulnerable and open to (interpersonal) disruptions like trauma or neglect. In BPD, we suggest 3 aspects regarding the phenomenology of the background of the safety need to be considered: first, typically, patients with BPD did not develop a robust background of safety in infancy; second, weakening of the background of safety gives rise to symptoms and dynamics typical for BPD; third, these symptoms and dynamics further undermine the possible development of a background of safety in adult life and thus gravitate toward a petrification of the borderline condition, a “stable instability.” To conclude, we examine whether this concept should be understood as a <i>trouble générateur</i> and, last, consider its clinical implications.

Social and Nonsocial Autism Symptom Domains in Children and Adolescents with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder: Insights into Their Symptomatological Interplay

<b><i>Introduction:</i></b> Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) share overlapping symptomatology, particularly with regard to social impairments (including peer relationship difficulties), and they frequently co-occur. However, the nature of their co-occurrence remains unclear. Therefore, the current study aimed to examine the nature of the transdiagnostic link between ASD and ADHD from a symptomatological point of view measured with the Autism Diagnostic Observation Schedule (ADOS Module 3) and the Autism Diagnostic Interview-Revised (ADI-R). <b><i>Methods:</i></b> We analyzed the social and nonsocial ASD symptom domain scores from both diagnostic instruments in 4 clinically referred groups (i.e., ASD, ADHD, ASD + ADHD, and no psychiatric diagnosis) without other co-occurring mental disorders using a two-by-two full-factorial MANOVA design with the factors ASD (yes/no) and ADHD (yes/no). <b><i>Results:</i></b> We found no ASD by ADHD interaction effects across all symptom domain scores of ADOS and ADI-R, except for ADOS <i>imagination/creativity</i>. There were only main effects of the factor ASD but no main effects of ADHD. Follow-up contrasts showed that exclusively, ASD had an impact on the measured symptomatology in case of co-occurring ASD + ADHD. <b><i>Conclusion:</i></b> Overall, the results support an additive model of the symptomatology across areas of communication, social interaction, and stereotyped behaviors and restricted interests in case of the co-occurrence of ASD and ADHD when assessed with ADOS/ADI-R. Thus, one can assume that the phenotypic overlap of ASD + ADHD may be less complicated than suspected – at least with regard to ASD symptomatology – and that in the presence of ADHD, ASD symptomatology is generally well measurable with best-practice diagnostic instruments.

Scale for Space and Time Experience in Psychosis: Converging Phenomenological and Psychopathological Perspectives

<b><i>Introduction:</i></b> Abnormalities in the experience of space and time are fundamental to understanding schizophrenia spectrum disorders, but the precise relation between such abnormalities and psychopathological symptoms is still unclear. Therefore, the aim of our study was to introduce a novel scale for space and time experience in psychosis (STEP), specifically devised to assess schizophrenia spectrum disorders. <b><i>Methods:</i></b> The STEP scale is a semiquantitative instrument developed on the basis of several items from previous scales and phenomenological reports addressing the experience of space and time. We applied the STEP scale to three groups of subjects (patients with schizophrenia spectrum disorders, patients with predominant affective symptoms, and healthy control subjects), to whom we also applied other more general psychopathological scales, such as the Positive and Negative Syndrome Scale and the Ego-Psychopathology Inventory. <b><i>Results:</i></b> Patients with schizophrenia spectrum disorders scored significantly higher on general psychopatho<X00_Del_TrennDivis>­-</X00_Del_TrennDivis>logical scales relative to subjects belonging to the other groups. The STEP scale provided good psychometric properties regarding reliability. We also tested convergent and divergent validity of the STEP scale and found that space and time subscale scores of STEP significantly correlated with each other, as well as with the remaining general psychopathological scores. <b><i>Discussion/Conclusion:</i></b> We introduced the STEP scale as a novel instrument for the assessment of experience of space and time. Its psychometric properties showed high validity and reliability to identify psychopathological symptoms and enabled to differentiate patients with predominantly psychotic symptoms from those with predominantly affective symptoms. The STEP scale provides a standardized measure for assessing disturbances in the experience of space and time. Furthermore, it probably represents a leap forward toward the establishment of an additional dimension of symptoms proposed as “spatiotemporal psychopathology.”

Psychobiological Correlates of Aggression in Female Adolescents with Borderline Personality Disorder

<b><i>Introduction:</i></b> Aggressive behavior in reaction to threats, frustration, or provocation is prevalent in borderline personality disorder (BPD). This study investigated aggressive behavior and its biological correlates in adolescents with BPD. <b><i>Methods:</i></b> Twenty-one female adolescents with a DSM-IV BPD diagnosis and 25 sex- and age-matched healthy controls participated in the Taylor Aggression Paradigm (TAP), a laboratory-based experiment measuring aggressive behavior in the interpersonal context. Heart rate was measured and saliva samples were taken throughout the experiment. <b><i>Results:</i></b> Multilevel mixed-effects linear regression analyses revealed no significant group difference in aggressive behavior induced by the TAP. Additionally, the two groups did not differ in cortisol, testosterone, and heart rate responses to the aggression induction. The BPD group showed a significant cortisol increase in the time preceding the start of the TAP in contrast to the healthy control group, in whom a significant heart rate increase from baseline to the first block of the TAP was observed. <b><i>Discussion:</i></b> There was no evidence, either at the phenomenological or the biological level, of increased task-induced aggression in adolescents with BPD. The results may indicate that adolescents with BPD experienced fearful stress in anticipation of the experimental task in contrast to healthy controls who showed an adaptive response of the autonomic nervous system necessary to deal with the upcoming demand.

Introducing a Group Therapy Program (PLAN D) for Young Outpatients with Derealization and Depersonalization: A Pilot Study

Depersonalization and derealization (DD) cause significant distress and are associated with poor role and social functional outcomes. Despite the relatively high prevalence of DD symptoms and the chronic course in those suffering from a DD disorder, there still exists a need for effective interventions. Preliminary evidence indicates that cognitive behavioral therapy (CBT) delivered in an individual setting demonstrates some positive intervention effects for patients with DD regarding their symptom levels. By considering DD-specific treatment needs, a group therapy program was developed as an add-on therapy based on CBT techniques called PLAN D comprising the following elements: psychoeducation, lifestyle interventions, acceptance and mindfulness training, and new patterns of DD-related cognitions. In a pilot study, we present an 8-week group intervention for adolescents and young adults with DD disorder. To our knowledge, no standardized group intervention program for DD exists so far. Thus, this novel intervention represents a promising opportunity to positively influence long-term outcomes and course of DD.