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2,648 result(s) for "Compulsions"
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Compra compulsiva: revisión bibliométrica de la productividad científica desde 1985 hasta 2020
En la sociedad de consumo, los deseos se transforman en necesidades y esto incide en la emergencia de compra compulsiva y sus efectos negativos a nivel personal y social. Por ello se requiere un esfuerzo de análisis y síntesis sobre el conocimiento científico existente, que mejore nuestra comprensión del área. El objetivo es analizar el desarrollo de la producción científica –artículos empíricos individuales y revisiones- sobre la compra compulsiva, hasta el año 2020 en cualquier idioma. Mediante un análisis bibliométrico con criterios PRISMA, se localizaron 971 publicaciones en las bases de datos Web of Science, ScopusyPsycINFO. Los resultados señalan un aumento de la productividad desde 2005; al inglés como idioma prevalente; EE. UU. es el país predominante; la palabra clave más frecuente es compulsive buying. Se identifican tres equipos de investigación principales, con un análisis de contenido de sus publicaciones. Se reportan los artículos más citados. Se concluye que existe poca precisión investigativa, pese al incremento de productividad anual.
Prevalence of personality disorders in the general adult population in Western countries: systematic review and meta-analysis
Personality disorder is a severe health issue. However, the epidemiology of personality disorders is insufficiently described and surveys report very heterogeneous rates.AimsWe aimed to conduct a meta-analysis on the prevalence of personality disorders in adult populations and examine potential moderators that affect heterogeneity. We searched PsycINFO, PSYNDEX and Medline for studies that used standardised diagnostics (DSM-IV/-5, ICD-10) to report prevalence rates of personality disorders in community populations in Western countries. Prevalence rates were extracted and aggregated by random-effects models. Meta-regression and sensitivity analyses were performed and publication bias was assessed. The final sample comprised ten studies, with a total of 113 998 individuals. Prevalence rates were fairly high for any personality disorder (12.16%; 95% CI, 8.01-17.02%) and similarly high for DSM Clusters A, B and C, between 5.53 (95% CI, 3.20-8.43%) and 7.23% (95% CI, 2.37-14.42%). Prevalence was highest for obsessive-compulsive personality disorder (4.32%; 95% CI, 2.16-7.16%) and lowest for dependent personality disorder (0.78%; 95% CI, 0.37-1.32%). A low prevalence was significantly associated with expert-rated assessment (versus self-rated) and reporting of descriptive statistics for antisocial personality disorder. Epidemiological studies on personality disorders in community samples are rare, whereas prevalence rates are fairly high and vary substantially depending on samples and methods. Future studies investigating the epidemiology of personality disorders based on the DSM-5 and ICD-11 and models of personality functioning and traits are needed, and efficient treatment should be a priority for healthcare systems to reduce disease burden.Declaration of interestNone.
Obsessive-compulsive disorder
[...]OCD is often hidden, as patients believe that their own intrusive thoughts or images are too shameful.What is important in recognising and understanding OCD is not the behaviour but the intended aim of the behaviour.[...]the intended aim of a compulsion in OCD is to verify whether a threat exists (for example, a checking ritual) or to get rid of a threat by \"undoing\" it (for example, by compulsive washing or replacing a thought).[...]the family may seek help for the patient, who may be unwilling to take this step him or herself.For those patients for whom SSRIs and cognitive behavioural therapy have been ineffective, the evidence for adjunctive antipsychotic drugs in the short term is weak and an increased risk of adverse events is seen in the long term.[...]a recent controlled trial of patients resistant to one SSRI found that cognitive behavioural therapy was more effective than either risperidone or a placebo. 31 Meta-analyses show no significant benefit for augmentation with quietapine or olanzapine, a small effect size for risperidone, and a modest effect size for aripiprazole. 32 Antipsychotics are thus recommended only in patients who are refractory to cognitive behavioural therapy and SSRIs.
Cognitive deficits in problematic internet use: meta-analysis of 40 studies
Excessive use of the internet is increasingly recognised as a global public health concern. Individual studies have reported cognitive impairment in problematic internet use (PIU), but have suffered from various methodological limitations. Confirmation of cognitive deficits in PIU would support the neurobiological plausibility of this disorder. To conduct a rigorous meta-analysis of cognitive performance in PIU from case-control studies; and to assess the impact of study quality, the main type of online behaviour (for example gaming) and other parameters on the findings. A systematic literature review was conducted of peer-reviewed case-controlled studies comparing cognition in people with PIU (broadly defined) with that of healthy controls. Findings were extracted and subjected to a meta-analysis where at least four publications existed for a given cognitive domain of interest. The meta-analysis comprised 2922 participants across 40 studies. Compared with controls, PIU was associated with significant impairment in inhibitory control (Stroop task Hedge's g = 0.53 (s.e. = 0.19-0.87), stop-signal task g = 0.42 (s.e. = 0.17-0.66), go/no-go task g = 0.51 (s.e. = 0.26-0.75)), decision-making (g = 0.49 (s.e. = 0.28-0.70)) and working memory (g = 0.40 (s.e. = 0.20-0.82)). Whether or not gaming was the predominant type of online behaviour did not significantly moderate the observed cognitive effects; nor did age, gender, geographical area of reporting or the presence of comorbidities. PIU is associated with decrements across a range of neuropsychological domains, irrespective of geographical location, supporting its cross-cultural and biological validity. These findings also suggest a common neurobiological vulnerability across PIU behaviours, including gaming, rather than a dissimilar neurocognitive profile for internet gaming disorder. S.R.C. consults for Cambridge Cognition and Shire. K.I.'s research activities were supported by Health Education East of England Higher Training Special interest sessions. A.E.G.'s research has been funded by Innovational grant (VIDI-scheme) from ZonMW: (91713354). N.A.F. has received research support from Lundbeck, Glaxo-SmithKline, European College of Neuropsychopharmacology (ECNP), Servier, Cephalon, Astra Zeneca, Medical Research Council (UK), National Institute for Health Research, Wellcome Foundation, University of Hertfordshire, EU (FP7) and Shire. N.A.F. has received honoraria for lectures at scientific meetings from Abbott, Otsuka, Lundbeck, Servier, Astra Zeneca, Jazz pharmaceuticals, Bristol Myers Squibb, UK College of Mental Health Pharmacists and British Association for Psychopharmacology (BAP). N.A.F. has received financial support to attend scientific meetings from RANZCP, Shire, Janssen, Lundbeck, Servier, Novartis, Bristol Myers Squibb, Cephalon, International College of Obsessive-Compulsive Spectrum Disorders, International Society for Behavioral Addiction, CINP, IFMAD, ECNP, BAP, the World Health Organization and the Royal College of Psychiatrists. N.A.F. has received financial royalties for publications from Oxford University Press and payment for editorial duties from Taylor and Francis. J.E.G. reports grants from the National Center for Responsible Gaming, Forest Pharmaceuticals, Takeda, Brainsway, and Roche and others from Oxford Press, Norton, McGraw-Hill and American Psychiatric Publishing outside of the submitted work.
Bisexuality, Minority Stress, and Health
Purpose of Review Bisexual individuals are at increased risk for negative health outcomes compared to heterosexual individuals and often compared to gay/lesbian individuals as well. The goal of this article is to summarize the current evidence-base on bisexual health disparities, to describe factors that influence them, and to review interventions designed to improve the health of bisexual individuals. Recent Findings Based on our review of the literature, we conclude that there is strong evidence that bisexual individuals are at increased risk for mental health and substance use problems. These disparities are evident across dimensions of bisexuality (identity, attraction, and behavior), but there are important nuances to these findings. There is also evidence that bisexual men are at increased risk for sexually transmitted infections (STIs) compared to heterosexual men and that bisexual women are at increased risk for STIs compared to both lesbians and heterosexual women. Although there are numerous causes of these disparities, a leading contributor is stress related to stigma and discrimination. Most of the interventions that have been developed for bisexual individuals are HIV prevention programs for behaviorally bisexual men of color. Despite less attention to mental health and substance use interventions for bisexual individuals, recent developments show promise in their potential application to this population. Summary Bisexual individuals are at increased risk for mental health, substance use, and sexual health problems, and this is due, in part, to stigma and discrimination. Future research should continue to examine how different dimensions of bisexuality relate to health disparities and factors that influence them. There is also an urgent need to develop, test, and disseminate interventions to improve the health of bisexual individuals..
Co-morbid obsessive–compulsive disorder and depression: a Bayesian network approach
Obsessive-compulsive disorder (OCD) is often co-morbid with depression. Using the methods of network analysis, we computed two networks that disclose the potentially causal relationships among symptoms of these two disorders in 408 adult patients with primary OCD and co-morbid depression symptoms. We examined the relationship between the symptoms constituting these syndromes by computing a (regularized) partial correlation network via the graphical LASSO procedure, and a directed acyclic graph (DAG) via a Bayesian hill-climbing algorithm. The results suggest that the degree of interference and distress associated with obsessions, and the degree of interference associated with compulsions, are the chief drivers of co-morbidity. Moreover, activation of the depression cluster appears to occur solely through distress associated with obsessions activating sadness - a key symptom that 'bridges' the two syndromic clusters in the DAG. Bayesian analysis can expand the repertoire of network analytic approaches to psychopathology. We discuss clinical implications and limitations of our findings.
Revisiting the Role of Impulsivity and Compulsivity in Problematic Sexual Behaviors
Impulsivity and compulsivity are transdiagnostic features associated with clinically relevant aspects of psychiatric disorders, including addictions. However, little research has investigated how impulsivity and compulsivity relate to hypersexuality and problematic pornography use. Thus, the aims of the present study were to investigate (a) self-reported impulsivity and compulsivity with respect to hypersexuality and problematic pornography use and (b) the similarities and possible differences between hypersexuality and problematic pornography use in these domains. Utilizing structural equation modeling (SEM) in a large community sample (N = 13,778 participants; female = 4,151, 30.1%), results indicated that impulsivity (β = .28, β = .26) and compulsivity (β = .23, β = .14) were weakly related to problematic pornography use among men and women, respectively. Impulsivity had a stronger relationship (β = .41, β = .42) with hypersexuality than did compulsivity (β = .21, β = .16) among men and women, respectively. Consequently, impulsivity and compulsivity may not contribute as substantially to problematic pornography use as some scholars have proposed. On the other hand, impulsivity might have a more prominent role in hypersexuality than in problematic pornography use. Future research should examine further social and situational factors associated with problematic pornography use.
The Effectiveness of Virtual Reality Exposure–Based Cognitive Behavioral Therapy for Severe Anxiety Disorders, Obsessive-Compulsive Disorder, and Posttraumatic Stress Disorder: Meta-analysis
In recent years, virtual reality exposure-based cognitive behavioral therapy (VRE-CBT) has shown good treatment results in (subclinical) anxiety disorders and seems to be a good alternative to exposure in vivo in regular cognitive behavioral therapy (CBT). However, previous meta-analyses on the efficacy of VRE-CBT on anxiety disorders have included studies on specific phobias and subthreshold anxiety; therefore, these results may not be generalizable to patients with more severe and disabling anxiety disorders. The objective of our study is to determine the efficacy of VRE-CBT on more severe anxiety disorders, excluding specific phobias and subthreshold anxiety disorders. Meta-analyses will be conducted to examine the efficacy of VRE-CBT versus waitlist and regular CBT. Our secondary objectives are to examine whether the efficacy differs according to the type of anxiety disorder, type of recruitment, and type of VRE-CBT (virtual reality exposure either with or without regular CBT). Furthermore, attrition in VRE-CBT and CBT will be compared. Studies published until August 20, 2020, were retrieved through systematic literature searches in PubMed, PsycINFO, and Embase. We calculated the effect sizes (Hedges g) for the difference between the conditions and their 95% CIs for posttest and follow-up measurements in a random effects model. A separate meta-analysis was performed to compare attrition between the VRE-CBT and CBT conditions. A total of 16 trials with 817 participants were included. We identified 10 comparisons between VRE-CBT and a waitlist condition and 13 comparisons between VRE-CBT and a CBT condition. With regard to risk of bias, information on random sequence generation, allocation concealment, and risk of bias for selective outcome reporting was often absent or unclear. The mean effect size of VRE-CBT compared with waitlist (n =10) was medium and significant, favoring VRE-CBT (Hedges g=-0.490, 95% CI -0.82 to -0.16; P=.003). The mean effect size of VRE-CBT compared with CBT (n =13) was small and nonsignificant, favoring CBT (Hedges g=0.083, 95% CI -0.13 to 0.30; P=.45). The dropout rates between VRE-CBT and CBT (n =10) showed no significant difference (odds ratio 0.79, 95% CI 0.49-1.27; P=.32). There were no indications of small study effects or publication bias. The results of our study show that VRE-CBT is more effective than waitlist and as effective as CBT in the treatment of more severe anxiety disorders. Therefore, VRE-CBT may be considered a promising alternative to CBT for patients with more severe anxiety disorders. Higher-quality randomized controlled trials are needed to verify the robustness of these findings.
Intolerance of Uncertainty as a Transdiagnostic Mechanism of Psychological Difficulties: A Systematic Review of Evidence Pertaining to Causality and Temporal Precedence
Intolerance of uncertainty (IU) is proposed to be a transdiagnostic causal mechanism of psychological difficulties. The systematic review sought to evaluate the status of evidence pertaining to IU’s proposed causal influence upon symptoms of psychological conditions. The review collated evidence from studies involving experimental manipulation and assessment of temporal precedence to ensure direct assessment of causality. The search strategy and eligibility screening identified 12 articles, detailing 15 eligible studies (experimental manipulations: n = 10; temporal precedence studies: n = 5). Available evidence comprised symptoms of anxiety- and mood-related conditions, including obsessive–compulsive disorder (OCD). The greatest support for IU as a causal mechanism was evident for anxiety-related difficulties and, to a lesser extent, negative affect; limited support was found for OCD-related difficulties. However, notable inconsistency across study findings for all difficulty types precludes absolute conclusions. Implications and recommendations are discussed.
Effects of parental mental illness on children's physical health: systematic review and meta-analysis
Children of parents with mental disorder face multiple challenges. To summarise evidence about parental mental disorder and child physical health. We searched seven databases for cohort or case-control studies quantifying associations between parental mental disorders (substance use, psychotic, mood, anxiety, obsessive-compulsive, post-traumatic stress and eating) and offspring physical health. Studies were excluded if: they reported perinatal outcomes only (<28 days) or outcomes after age 18; they measured outcome prior to exposure; or the sample was drawn from diseased children. A meta-analysis was conducted. The protocol was registered on the PROSPERO database (CRD42017072620). Searches revealed 15 945 non-duplicated studies. Forty-one studies met our inclusion criteria: ten investigated accidents/injuries; eight asthma; three other atopic diseases; ten overweight/obesity; ten studied other illnesses (eight from low-and middle-income countries (LMICs)). Half of the studies investigated maternal perinatal mental health, 17% investigated paternal mental disorder and 87% examined maternal depression. Meta-analysis revealed significantly higher rates of injuries (OR = 1.15, 95% CI 1.04-1.26), asthma (OR = 1.26, 95% CI 1.12-1.41) and outcomes recorded in LMICs (malnutrition: OR = 2.55, 95% CI 1.74-3.73; diarrhoea: OR = 2.16, 95% CI 1.65-2.84). Evidence was inconclusive for obesity and other atopic disorders. Children of parents with mental disorder have health disadvantages; however, the evidence base is limited to risks for offspring following postnatal depression in mothers and there is little focus on fathers in the literature. Understanding the physical health risks of these vulnerable children is vital to improving lives. Future work should focus on discovering mechanisms linking physical and mental health across generations. None.