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PubMed2004

Serotonin transporter polymorphism and depressive-related symptoms in schizophrenia.

A role for the serotonin transporter (5-HTT) gene polymorphism in mental illnesses and anxiety-traits has been implicated. The contribution of genetic factors in personality traits and the manifestation of specific symptoms in psychiatric illnesses have yet to be elucidated. Anxious-depressive symptoms are a significant component in a pattern of schizophrenic symptoms. This study focused on the relation between 5-HTT polymorphism and clinical presentations of schizophrenia, specifically those related to the affective spectrum. Using clinical and psychological analyses, we tested the genetic association between the 5-HTTLPR polymorphism (5-HTT gene-linked polymorphic region) and anxiety- and depressive-related symptoms emerged in schizophrenia. In 260 patients with an ICD-10 diagnosis of schizophrenia (broad definition), we studied the 5-HTTLPR genotype (insertion-deletion polymorphism), the Positive and Negative Syndrome Scale (PANSS), and self-rated inventories (EPI, MMPI, STAI) scores. Patients with the "ss" genotype (deletion variant) scored significantly higher on "Guilt feelings" and "Depression" items, as compared with those of the "ll" genotype (insertion variant) (P = 0.016, 0.039, respectively). The frequency of the "ss" genotype was reduced in patients with no depression or guilt feelings, or in those patients exhibiting questionable symptoms. In contrast, the "ss" genotype carriers prevailed among the patients with mild, moderate, or severe ratings of the symptoms. The scores on all anxiety- and depression-related traits, self-rated by the patients, did not significantly differ by genotype. Our finding may contribute to understanding of molecular genetic features underlying an appearance of psychopathological symptoms emerged in schizophrenia.

Adult↗

PubMed2003

The verdict on jury trials for juveniles: the effects of defendant's age on trial outcomes.

With the progression to more adult-like policies and procedures for youth in the justice system, the right to a jury trial has been extended to young offenders. These youth would not be tried by a jury of their peers, however, but by a jury of adults. The concern is that adult jurors may hold negative attitudes about youth that might influence their decision making in a case involving a young defendant. Two studies examined whether and under what conditions defendant's age affects jurors' decisions about the guilt and sentencing of an accused. In study 1, data were gathered from two samples of jury eligible adults: one university sample and one public sample. Mock jurors read written transcripts of a trial involving a defendant who was presented as either 13, 17, or 25 years of age. Results indicated that the defendant's age had no effect on mock jurors' verdict or their ratings of defendant guilt. However, younger defendants were granted shorter sentences than the adult defendants. In study 2, mock jurors read the same trial presented in study 1 but were asked to deliberate about the case and render group verdicts. These group verdicts did not differ significantly by defendant's age. Age-related themes that emerged from group deliberations were identified, and results indicated that age tended to be used as a mitigating factor in favor of youth rather than against them. These findings are discussed in terms of their implications for youth justice policy and practice.

Adolescent↗

PubMed1995

Statistical issues in DNA evidence.

Some of the statistical issues involved in the interpretation of DNA evidence in courts, particularly focusing on the adversarial process as seen in the UK and the USA, are discussed. The appropriate way to consider the use of DNA evidence in courts is through the use of a likelihood ratio. In this, the relative likelihoods of the DNA evidence are calculated under two hypotheses, respectively that the subject is or is not the source of a DNA sample found at the scene-of-crime. This formulation allows, using Bayes' theory, the prior probability of guilt, based on the other evidence in a case, to be incorporated in a formal way into calculation of a final, or posterior, probability of guilt. The most controversial aspect of DNA evidence has concerned the calculation of the probability of a match between an innocent suspect and DNA from the scene-of-crime. The calculation is affected by subdivision within the population and the possibility of relatedness between the suspect and the true source of the scene-of-crime DNA. The qualitative importance of these effects will be discussed. In addition to the scientific questions concerning the likelihood ratio, there have been a number of other concerns about the use of DNA evidence, and other evidence presented in a statistical form, in courts. These include the question whether accurate or conservative values of the likelihood ratio should be presented, and the abilities of juries to deal with quantitative evidence.

DNA↗

PubMed1993

Studies in feminine psychology 6: Kundry.

The problem of feminine rage, feminine psychology, and feminine self-destruction must be understood as multiply determined and not merely an appropriate manifestation of social inequality in a male-dominated culture. This is illustrated by a study of pathological and borderline women, in the present paper represented by Wagner's creation from Parsifal, Kundry. Kundry suffers from pathological splitting, in which she oscillates from mature nurturing service to hatred, seduction, and destruction of men. What is most emphasized is her misery and guilt, which is a consequence of her reality testing being sufficiently intact for her to be aware of this splitting and its consequences for her. She receives no understanding from the men around her; even the hero or "pure fool" Parsifal at first attempts to strangle her like an animal. But Wagner's intuition emphasizes her conflict and guilt rather than the splitting and deficits, making her redemption possible. This approach to borderline psychopathology has a more hopeful prognosis, given the presence of a dedicated, determined, and competent psychoanalytic psychotherapist.

Borderline Personality Disorder↗

PubMedDate not supplied

Role of emotional factors in diabetes.

As an approach to the emotional attitude of diabetic patients, the attitude examination devised by Dunn et al. in 1986 (ATT39 test) was applied. Thirty-nine points were analyzed on the basis of 6 factors in order to assess the stress relating to the diabetes, the adaptation, the guilt feelings, the alienation, the awareness of the disease and the tolerance on the Likert scale. Analysis of the results of 128 diabetic patients demonstrated that, besides the appearance of stress, the emotional attitude of the subject to diabetes is characterized by good ability to cooperate, appropriate awareness of the disease, adaptive tolerance and slight guilt feelings. The data were also evaluated with respect to the quality of metabolic control, age, sex, duration of disease, educational level and type of diabetes. Contrary to expectations, quality of control and duration of disease did not influence the emotional attitude towards diabetes, but this attitude was correlated to type of diabetes, complications and sex of the patients. The results of the attitude examination of 34 type I diabetic patients were compared with the data from other pyschological surveys (personality and performance tests), and a good correlation was found between emotional characteristics and results of the personality tests. It was concluded that the attitude examination can readily be carried out, and provides a basis that can be appropriately utilized in the care of diabetic patient.

Attitude to Health↗

PubMed2003

Hospital and community-based care for patients with chronic schizophrenia in Hong Kong--quality of life and its correlates.

BACKGROUND: There have been few studies on the impact of de-institutionalization on psychiatric patients' lives in Chinese culture. The objectives of the present study were: (1) to compare quality of life (QOL) of Chinese patients with schizophrenia living in three different treatment settings (hospital, long-stay care home and half-way house) in Hong Kong, and (2) to identify factors associated with patients' subjective well-being. METHOD: A matched-group design was used. Subjects (n = 204) living in the three treatment settings were matched according to age, sex, educational level, marital status, length of psychiatric illness and number of previous psychiatric admissions. Multiple measures for the evaluation of QOL included the Satisfaction With Life Scale (SWLS), WHO Quality of Life Measure-Abbreviated version-Hong Kong (WHOQOL-BREF-HK), Life Event List (LEL) and the Global Assessment Scale (GAS). Psychiatric symptoms were evaluated with the Brief Psychiatric Rating Scale (BPRS). RESULTS: Significant differences in objective QOL indices (global level of functioning, number of life events and income) between subjects staying in hospital and community-based residential services were found in favour of the less restrictive community settings. However, with respect to global life satisfaction, subjects preferred the more secure settings despite their restrictiveness. Predictors of subjective well-being were educational level, negative life events and the BPRS items of somatic concern, anxiety and guilt feelings. The impact of negative life events on subjective well-being decreased over time. CONCLUSION: In a cohort of Chinese patients with chronic schizophrenia, community-based treatment settings had a positive impact on objective QOL indices but not on subjective well-being. Negative life events, education level, and the BPRS items of somatic concern, anxiety and guilt feelings were predictors of subjective well-being which seemed to adapt to external circumstances over time.

Adult↗

PubMed2006

Hearsay versus children's testimony: Effects of truthful and deceptive statements on jurors' decisions.

Researchers and courts are focusing increasing attention on the reliability of children's out-of-court statements, especially in relation to trials of child sexual abuse. The main goal of this study was to investigate the effects of presentation of children's out-of-court statements (e.g., hearsay) on jurors' perceptions of witness credibility and defendant guilt, and on jurors' abilities to reach the truth. Child participants experienced either a mock crime or were coached to say they experienced the crime when in fact they had not. During elaborate mock trials involving community member jurors, children's testimony was presented either: (1) live, (2) on videotape, or (3) via a social worker. Analyses revealed that testimony format directly influenced jurors' perceptions of child and social worker credibility (e.g., children were perceived as less likely to provide false statements if they testified live) as well as jurors' sympathy toward the child, all of which then predicted jurors' confidence in defendant guilt. Jurors had difficulty discerning accurate from deceptive child statements regardless of testimony format. Implications for psychology and the legal system are discussed.

Adult↗

PubMed2006

The court of public opinion: lay perceptions of polygraph testing.

We sampled a total of 411 participants and randomly assigned them one of three brief trial vignettes that contained either no-polygraph evidence, evidence of a passed polygraph test, or evidence of a failed polygraph test. Participants rendered guilt judgments and answered a series of questions concerning the trial in particular, and polygraph tests in general. Similar to previous studies on the impact of polygraph evidence on jurors' guilt judgments, this sample of jury-eligible adults indicated that they did not find polygraph test evidence to be persuasive. Moreover, it mattered little to participants whether the results indicated the defendant passed a polygraph test, or that he failed a polygraph test. However, when our findings are compared to those of previous surveys involving experts in the field of psychophysiology, they differ in a number of important respects. The implications for decisions regarding admissibility (e.g., U.S. v. Alexander, 1975 and U.S. v. Scheffer, 1998) are discussed.

Adolescent↗

PubMed1994

Personality traits in subclinical and non-obsessive-compulsive volunteers and their parents.

Theorists from a variety of perspectives have asserted that obsessive compulsives are more risk-aversive, perfectionistic and guilt-ridden than non-obsessive compulsives, and that these characteristics are central features of the disorder. Furthermore, several have hypothesized that the parents of obsessive compulsives are characterized by risk-aversion, perfectionism, and high levels of criticism. Little research exists which corroborates these hypotheses, however. The present investigation examined these hypotheses among subclinical obsessive compulsives. In two different samples, subclinical obsessive compulsives were found to be more risk-aversive, perfectionistic, and guilt-ridden. Subclinical obsessive compulsives also perceived their parents to be more overprotective. The findings regarding other parental traits were less clear. There was some support for the hypothesis that the parents of subclinical obsessive compulsives are more risk-aversive, and that fathers are more critical and perfectionistic.

Female↗

PubMed1995

Perceived responsibility: structure and significance.

Given the postulated significance of inflated responsibility in obsessive compulsive disorder (OCD), there is a need for clarification of the concept itself and a means for measuring such responsibility. Two psychometric studies were conducted in order to develop a reliable self-report scale. In the first study 291 students completed the specially constructed Responsibility Appraisal Questionnaire (RAQ). Four factors emerged: responsibility for harm, responsibility in social contexts, a positive outlook towards responsibility, and thought-action fusion (TAF). In the second study, 234 students completed a revised RAQ. Four comparable factors emerged, and the TAF subscale correlated significantly with measures of obsessionality, guilt, and depression. The correlations between TAF and obsessionality and guilt remained significant even after BDI scores were controlled. It is concluded that the broad concept of inflated responsibility needs to be qualified; the connection between inflated responsibility and OCD appears to be situation-specific and idiosyncratic. There is more inflated responsibility than there is OCD. The measured concept of inflated responsibility is multifactorial (harm, social, positive, and TAF), not unitary. The TAF factor appears to be particularly significant in OCD.

Adult↗

PubMed1994

Factors associated with the development of posttraumatic stress disorder among child victims of sexual abuse.

This study examined the relationship between the development of PTSD and selected victim and event characteristics. The sample consisted of 69 girls and 21 boys (mean age = 12.4 years) who had been referred to a child witness preparation program following documentation of sexual abuse. Comparisons of PTSD positive (N = 44) and PTSD negative (N = 46) subgroups found significant differences on variables of age, sex, duration of the abuse, and the use of violence or coercion by the offender. Comparisons on psychological test data indicated that the PTSD subgroup significantly differed from the non-PTSD subgroup on the basis of children's abuse-related fears, anxiety, depression, and feelings of guilt related to the abuse. Hierarchical multiple regression analysis indicated that factors related to the nature and severity of the abuse and the child's self-report of guilt feelings each contributed significantly to explaining 37% of the variance in PTSD symptoms, even after the variables of receptive language ability, age, and sex were controlled. Discriminant function analysis correctly classified 78.4% of the respondents. The importance of considering PTSD in relation to child sexual abuse is discussed, along with limitations of the current study.

Adolescent↗

PubMed1983

Pain as a symptom in depressive disorders. II. Relationship to personality traits as assessed by means of KSP.

The series included 140 hospitalized patients with depressive disorders, who were rated by means of the Comprehensive Psychopathological Rating Scale (CPRS). Furthermore, a personality inventory, KSP, was completed when the patients had improved markedly. Forty-six per cent of the patients were found to have pain as a symptom. The patients with pain were found to have more somatic anxiety, more muscular tension, more psychasthenia and more inhibition of aggression but no significant differences were found in guilt. Thus pain as a symptom in depressive disorders seems to be linked to muscular tension and the patients seem to have more introjected aggression while no evidence emerges indicating that pain could serve to relieve the feelings of guilt.

Adult↗

PubMed2006

[Evaluation of a group intervention using a feminist approach for women experiencing sexual abuse].

OBJECTIVE: The present study evaluates a group intervention using a feminist approach for women experiencing sexual abuse in childhood or adulthood in order to measure changes associated with participation in a group intervention and verifies whether effects are maintained over time. The present study relates effects of the group intervention in terms of psychological distress, depression symptoms, post-traumatic stress symptoms and feelings of guilt and helplessness. METHOD: The sample consists of 26 women participating in a group intervention offered by sexual assault centers in Quebec (CALACS - Centre d'aide et de lutte contre les agressions à caractère sexuel). RESULTS: Results show significant differences between pretest and post-test scores obtained one week following the end of the group intervention and gains are maintained at follow-up 3 months later. CONCLUSION: The findings suggest that participation in the group intervention is associated with a reduction of psychological distress, depression symptoms, post-traumatic stress symptoms and feelings of guilt and helplessness in adult women reporting sexual abuse.

Adult↗

PubMed2005

Mood stabilizer augmentation in apparently "unipolar" MDD: predictors of response in the naturalistic French national EPIDEP study.

BACKGROUND: Mood stabilizers (MS), especially Lithium, are used in augmentation strategies for resistant depression. However the broader bipolar spectrum (depressions with brief [i.e. 2 days] hypomania, cyclothymic and hyperthymic temperaments) has rarely been explored in such strategies. The aim of the current report is to search for predictive factors for response to mood stabilizers when used as augmentation therapy after excluding clear-cut hypomania and focusing on DSM-IV major depressive disorder (UP-MDD), which is best designated as apparently "unipolar". METHOD: From the total sample of 452 major depressives (MDE) included in the French National study EPIDEP, 256 were classified as UP-MDD after eliminating DSM-IV bipolar II (> or =4 days of hypomania); conservatively, we also excluded MDD with hypomania associated with antidepressants. Lifetime treatment history of UP-MDD revealed that 59 (23.3%) had received at least one MS (lithium, valpromide [French variant of divalproex], and carbamazepine) in the past; from this sub-population, 18 were considered retrospectively as good responders (30%, GR) versus 41 poor responders (70%, PR) to MS augmentation on the basis of the clinical judgment of the treating psychiatrist. RESULTS: Comparative analyses between patients who received MS and those who did not, revealed the former group as having higher levels on the hypomania checklist and cyclothymic and depressive temperaments. The delay to MS installation was significantly longer in the PR versus GR. The profile of GR could be described as follows: younger current age, higher education; symptom-free interval between major episodes; and fewer prior depressive episodes and hospitalizations; and higher rate of MS prescription. However, no significant differences were obtained from hypomania assessment and affective temperament ratings (cyclothymic, hyperthymic, depressive). During the index (most recent) depressive episode, we obtained a significantly higher rating of "suicidal thoughts" associated with higher levels of "sadness-guilt," psychomotor agitation, and lower "retardation-fatigue" (all from the HAM-D) in the PR group; better and faster response to current treatment (as prospectively assessed) were also observed in the GR. At this time, overall severity of depression was not linked to the quality of response to the MS. LIMITATIONS AND CONCLUSION: Despite its retrospective design, these analyses have important implications in the management of difficult or resistant "unipolar" depression by using MSs as augmentation strategy. Clinicians appeared to have used "subtle" hypomanic and cyclothymic features as a justification for augmentation. However, these features per se were not predictive of response to such augmentation. Instead, the profile of augmentation response to failed antidepressants appears to be an "activated depression" (significantly less retardation and withdrawal and higher agitation associated with greater intensity of painful and guilt-ridden sadness with suicidality), and the significantly higher rate of and earlier prescription of MSs in the course of recurrent MDD. These data suggest that resistant depressives should not stay on antidepressant or antidepressant combination for too long; MS augmentation must be instituted without much delay.

Adult↗

PubMed2005

Bipolar II vs. unipolar depression: psychopathologic differentiation by dimensional measures.

BACKGROUND: Clinical presentations of depression in bipolar disorder are varied, inconsistent and often confusing. Most previous studies have focused on bipolar I (BP-I). Given that bipolar II (BP-II) is the more common bipolar phenotype, which is often confused with unipolar (UP), the aim of the current analyses is to delineate the symptomalogic differences between BP II vs. UP MDD in a large national sample. METHODS: The data derived from the French National EPIDEP study (n = 452 DSM-IV major depressives), subdivided into BP-II (n = 196) and UP (n = 256). The BP II group included major depressives with both spontaneous and antidepressant-associated hypomania based on our finding of similarity in rates of familial bipolarity in the two subgroups. At index presentation, depression was assessed by the clinician (using HAM-D and the Rosenthal Atypical Depression Scale) and by the patient (using the Multi-Visual Analog Scale of Bipolarity, MVAS-BP). Principal component analyses (PCA with varimax rotation) were conducted on HAM-D and MVAS-BP in the total population and separately in BP-II and UP. We performed inter-group comparative tests (UP vs. BP-II) on factorial scores derived from PCAs and correlation tests between these factorial scores. RESULTS: The PCA on "HAM-D + Rosenthal scale" showed the presence of nine major factors: F1-2 "weight changes", F3-4 "sleep disturbances", F5 "sadness-guilt", F6 "retardation-fatigue", F7 "somatic", F8 "diurnal variation" and F9 "insight-delusion". The PCA on MVAS-BP revealed the presence of eight principal components: F1 "psychomotor retardation", F2 "central pain", F3 "somatic", F4 "social contact", F5 "worry", F6 "loss of interest", F7 "guilt" and F8 "anger". Despite uniformity in global intensity of depression, significant differences were observed as follows: higher score on "psychomotor retardation" (p = 0.03), "loss of interest" (p = 0.057) and "insomnia" (p = 0.05) in the UP group, and higher score on "hypersomnia" (p = 0.008) in the BP-II group. Correlation analyses between clinician- and self-rating revealed the presence of higher number of significant coefficients in the UP vs. BP-II group (p < or =0.001). LIMITATION: A three-way comparison between BP-I, BP-II and UP may have yielded somewhat different results. CONCLUSION: Our data indicate greater psychomotor retardation, stability and uniformity in the clinical picture of strictly defined UP depression. By contrast, bipolar II depression appeared to be characterized, despite the hypersomnic tendency, by psychomotor activation. This would indicate greater mixed features than those observed in UP. Moreover, in BP-II, there was less agreement between clinician vs. self-rating on the presence of various features of depression. Taken together, these findings explain why BP-II depression is missed by clinicians as a genuine depression.

Antidepressive Agents↗

PubMed2006

Sex offenders and confessions: how to overcome their resistance during questioning.

A confession, when properly and fairly obtained, is powerful evidence against a suspect and will generally guarantee a conviction. There are a number of theoretical models that explain why suspects confess to crimes they have committed. In this chapter, the key models and the relevant empirical evidence are discussed. The evidence shows that sex offenders, and particularly child molesters, sometimes have a strong need to talk about their crimes due to the feelings of guilt and this gives the police an advantage. However, sex offenders also find it difficult to be open, honest and complete when interrogated due to the feelings of shame, which act to inhibit their motivation to confess. They are therefore torn between feelings of guilt, which encourages them to confess, and feelings of shame, which inhibit them from confessing. As a consequence, feelings of shame need to be overcome during the interrogation, which means that sex offenders need to be interviewed sensitively and skillfully. Any challenges need to be presented in a 'softly' fashion and with understanding of the perpetrator's perspective and emotional needs.

Criminal Psychology↗

PubMed2004

One method of coping: resident debriefing after the death of a patient.

OBJECTIVE: To describe residents' exposure and reactions to pediatric deaths, their debriefing experiences, and factors associated with debriefing. STUDY DESIGN: Cross-sectional survey completed at the end of residency. The survey reflected experiences from the prior 18 months concerning number, type, and setting of deaths; resident reactions; whether resident debriefed and with whom after a patient's death. RESULTS: Seventy-four residents (84%) completed the survey over 4 academic years accounting for 363 deaths; 59% were inpatient deaths of patients with chronic diseases, 22% were inpatient, 18% were emergency department (ED) deaths of previously healthy patients, and 1% were deaths of patients with chronic diseases who died in the ED or in their home. Mean number of deaths experienced per resident was 4.6 (range, 0-19). Thirty-one percent of residents expressed guilt, and 74% stated they had debriefed at least one time, but debriefings took place after only 30% of deaths. Resident debriefing was associated with an inpatient death of a previously healthy child, OR 5.3 (95% CI: 1.31, 22.3), P=.01, whereas there was not an association with number of previous deaths, acute outpatient or chronic inpatient deaths, or resident guilt. CONCLUSIONS: Pediatric residents were involved in a small number but varying types of death experiences. Debriefing took place after a minority of deaths. Future research needs to investigate the potential benefits of debriefing.

Adaptation, Psychological↗

PubMed2004

Psychosocial correlates of the impact of road traffic accidents among South African drivers and passengers.

The aim of the study was to investigate the psychosocial consequences and coping strategies among accident victims in South Africa. Participants (138 drivers and 141 passengers) who had been involved in a road traffic accident were approached and interviewed in public places. In both groups the median age group was between 25 years and 34 years. In 34 accidents (12.2%) a family member was killed, in 68 accidents (24.4%) a non-family member was killed in the accident. In 272 accidents 197 (72.4%) persons (both drivers and passengers) were injured and 168 (61.7%) were hospitalized. Eighty-seven drivers (63%) did not perceive themselves at fault and 51 (37%) did. Following the road traffic accident both drivers and passengers showed a significant decline of their well-being. Drivers who perceived themselves to be at fault did not cope better than those not perceiving themselves at fault. Passengers related to the drivers showed more decline in their well-being than those not related. Path analysis for drivers found that holding oneself responsible had a direct, and mediated by self-blame, guilt and family distress, negative effect on personal well-being. In the passengers group, holding the driver or others responsible led, mediated by increased self-blame, feelings of guilt, and family distress, to lower psychological well-being (PWB). Findings have relevant implications for the development of coping strategies to aid victims of road traffic accidents in dealing with their trauma in this African context, which may differ to those in Western societies.

Accidents, Traffic↗