Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review

Frontiers in Psychiatry, Год журнала: 2021, Номер 12

Опубликована: Окт. 25, 2021

Background: Emotional dysregulation (ED) is a transdiagnostic construct defined as the inability to regulate intensity and quality of emotions (such as, fear, anger, sadness), in order generate an appropriate emotional response, handle excitability, mood instability, overreactivity, come down baseline. Because ED has not been clinical entity, because plays major role child adolescent psychopathology, we decided summarize current knowledge on this topic based narrative review literature. Methods: This literature search peer-reviewed journals. We searched databases ERIC, PsycARTICLES, PsycINFO PSYNDEX June 2, 2020 for peer reviewed articles published between 2000 English language preschool, school, age (2-17 years) using following terms: "emotional dysregulation" OR "affect dysregulation," retrieving 943 articles. Results: The results are presented sections: relationship psychiatric disorders (ADHD, Mood Disorders, Psychological Trauma, Posttraumatic Stress Disorder, Non-suicidal Self-Injury, Eating Oppositional Defiant Conduct Disruptive Dysregulation Personality Substance Use Developmental Autism Spectrum Psychosis Schizophrenia, Gaming Disorder), prevention, treatment ED. Conclusion: Basic conditions genetic disposition, experience trauma, especially sexual or physical abuse, neglect childhood adolescence, personal stress. complex comprehensive concept, aggravating number various mental disorders. Differential mandatory individual social functioning.

Язык: Английский

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Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review

Current Neuropharmacology, Год журнала: 2023, Номер 22(4), С. 557 - 635

Опубликована: Май 3, 2023

Abstract: This narrative state-of-the-art review paper describes the progress in understanding and treatment of Posttraumatic Stress Disorder (PTSD). Over last four decades, scientific landscape has matured, with many interdisciplinary contributions to its diagnosis, etiology, epidemiology. Advances genetics, neurobiology, stress pathophysiology, brain imaging have made it apparent that chronic PTSD is a systemic disorder high allostatic load. The current state includes wide variety pharmacological psychotherapeutic approaches, which are evidence-based. However, myriad challenges inherent disorder, such as individual barriers good outcome, comorbidity, emotional dysregulation, suicidality, dissociation, substance use, trauma-related guilt shame, often render response suboptimal. These discussed drivers for emerging novel including early interventions Golden Hours, interventions, medication augmentation use psychedelics, well targeting nervous system. All this aims improve symptom relief clinical outcomes. Finally, phase orientation recognized tool strategize position step progression pathophysiology. Revisions guidelines systems care will be needed incorporate innovative treatments evidence emerges they become mainstream. generation well-positioned address devastating disabling impact traumatic events through holistic, cutting-edge efforts research.

Язык: Английский

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Developmental trauma: Conceptual framework, associated risks and comorbidities, and evaluation and treatment

Frontiers in Psychiatry, Год журнала: 2022, Номер 13

Опубликована: Июль 22, 2022

Children exposed to adverse childhood experiences (ACEs) and pervasive interpersonal traumas may go on develop PTSD and, in most cases, will further undergo a significant shift their developmental trajectory. This paper examines contemporary research Developmental Trauma (DT), which is inextricably linked disruptions social cognition, physiological behavioral regulation, parent-child attachments. trauma associated with early of abuse or neglect leads multi-faceted longstanding consequences underscores critical periods development, complex stress-mediated adaptations, multilevel, trans-theoretical influences the diagnostic formulation treatment traumatized children, adolescents, adults. Psychological medical correlates Disorder are considered, directions for future discussed.

Язык: Английский

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Validation of the International Trauma Interview (ITI) for the Clinical Assessment of ICD-11 Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) in a Lithuanian Sample

European journal of psychotraumatology, Год журнала: 2022, Номер 13(1)

Опубликована: Фев. 23, 2022

Background The 11th revision of the International Classification Diseases (ICD-11) includes a new diagnosis complex posttraumatic stress disorder (CPTSD). Trauma Interview (ITI) is novel clinician-administered diagnostic interview for assessment ICD-11 PTSD and CPTSD.Objective aim this study was to evaluate psychometric properties ITI in Lithuanian sample relation interrater agreement, latent structure, internal reliability, as well convergent discriminant validity.Method In total, 103 adults with history various traumatic experiences participated study. predominantly female (83.5%), mean age 32.64 years (SD = 9.36). For CPTSD, self-report Questionnaire (ITQ) were used. Mental health indicators, such depression, anxiety, dissociation, measured using questionnaires. structure evaluated confirmatory factor analysis (CFA). order test validity we conducted structural equation model (SEM).Results Overall, based on ITI, 18.4% participants fulfilled criteria 21.4% CPTSD. A second-order two-factor CFA disturbances self-organization (DSO) symptoms demonstrated good fit. associations mental indicators supported ITI. ITQ had poor moderate agreement across different symptom clusters.Conclusion reliable valid tool assessing diagnosing

Язык: Английский

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The memory and identity theory of ICD-11 complex posttraumatic stress disorder.

Psychological Review, Год журнала: 2023, Номер 130(4), С. 1044 - 1065

Опубликована: Июнь 20, 2023

The 11th version of the International Classification Diseases (ICD-11) includes complex posttraumatic stress disorder (CPTSD) as a separate diagnostic entity alongside (PTSD).ICD-11 CPTSD is defined by six sets symptoms, three that are shared with PTSD (reexperiencing in here and now, avoidance, sense current threat) (affective dysregulation, negative selfconcept, disturbances relationships) representing pervasive "disturbances self-organization" (DSO).There considerable evidence supporting construct validity ICD-11 CPTSD, but no theoretical account its development has thus far been presented.A theory needed to explain several phenomena especially relevant such role played prolonged repeated trauma exposure, functional independence between DSO heterogeneity following exposure.The memory identity states single multiple exposure occur context individual vulnerability which interact give rise intrusive, sensation-based traumatic memories identities which, together, produce symptoms define CPTSD.The model emphasizes two major related causal processes intrusive exist on continuum from prereflective experience full self-awareness.Theoretically derived implications for assessment treatment discussed, well areas future research testing.

Язык: Английский

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Proposition of a transdiagnostic processual approach of emotion dysregulation based on core triggers and interpersonal styles

Frontiers in Psychiatry, Год журнала: 2024, Номер 15

Опубликована: Фев. 7, 2024

Emotion dysregulation (ED) has primarily been described in patients suffering from borderline personality disorder (BPD) and is an integral part of this diagnosis, but it also a transdiagnostic construct that can be found several other psychiatric disorders. The strong relationships between ED BPD may lead clinicians to underestimate associated clinical contexts. This difficulties diagnostic treatment orientation, especially the context comorbidities. In article, after reviewing literature on development functioning emotion dysregulation, evidence for eight disorders (borderline disorder, pathological narcissism with/without narcissistic obsessive-compulsive antisocial bipolar autism spectrum complex post-traumatic stress adult attention deficit hyperactivity disorder), we present processual model based core triggers interpersonal styles try address issue provide simple technical tool help their assessment orientation. By focusing more typical patterns dynamics than only categories, believe contribute actual need improvement our current classifications, alongside well-studied under-used dimensional models psychopathology (e.g., HiTOP, AMPD), useful build specific frameworks ED.

Язык: Английский

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Metacognition and Dissociation as Mediators Between Childhood Trauma and Psychiatric Symptoms

European Journal of Trauma & Dissociation, Год журнала: 2025, Номер unknown, С. 100500 - 100500

Опубликована: Янв. 1, 2025

Язык: Английский

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Oxidative and Excitatory Neurotoxic Stresses in CRISPR/Cas9-Induced Kynurenine Aminotransferase Knockout Mice: A Novel Model for Despair-Based Depression and Post-Traumatic Stress Disorder

Frontiers in Bioscience-Landmark, Год журнала: 2025, Номер 30(1)

Опубликована: Янв. 20, 2025

Backgrounds: Memory and emotion are especially vulnerable to psychiatric disorders such as post-traumatic stress disorder (PTSD), which is linked disruptions in serotonin (5-HT) metabolism. Over 90% of the 5-HT precursor tryptophan (Trp) metabolized via Trp-kynurenine (KYN) metabolic pathway, generates a variety bioactive molecules. Dysregulation KYN metabolism, particularly low levels kynurenic acid (KYNA), appears be neuropsychiatric disorders. The majority KYNA produced by aadat (kat2) gene-encoded mitochondrial kynurenine aminotransferase (KAT) isotype 2. Little known about consequences deleting enzyme gene. Methods: In CRISPR/Cas9-induced knockout (kat2-/-) mice, we examined effects on emotion, memory, motor function, Trp its metabolite levels, activities plasma urine 8-week-old males compared wild-type mice. Results: Transgenic mice showed more depressive-like behaviors forced swim test, but not tail suspension, anxiety, or memory tests. They also had fewer center field corner entries, shorter walking distances, jumping counts open test. Plasma generally consistent with those urine: antioxidant KYNs, 5-hydroxyindoleacetic acid, indole-3-acetic were lower; KATs, kynureninase, monoamine oxidase/aldehyde dehydrogenase lower, 3-monooxygenase was higher; oxidative excitotoxicity indices higher. displayed depression-like behavior learned helplessness model, emotional indifference, deficits, coupled decrease KYNA, shift metabolism toward KYN-3-hydroxykynurenine partial gut microbial Trp-indole pathway metabolite. Conclusions: This first evidence that gene induces uniquely experiences despair, appear associated excitatory neurotoxic stresses. may lead development double-hit preclinical model despair-based depression, better understanding these complex conditions, effective therapeutic strategies elucidating relationship between PTSD pathogenesis.

Язык: Английский

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Mapping connections between complex post-traumatic stress disorder and psychotic-like experiences among adolescents: a Gaussian and Bayesian network study

Psychological Medicine, Год журнала: 2025, Номер 55

Опубликована: Янв. 1, 2025

Abstract Background Complex post-traumatic stress disorder (cPTSD) is a newly recognized condition characterized by core PTSD symptoms and disturbances in self-organization (DSO) that has been associated with psychotic-like experiences (PLEs). This study employs two psychopathology network approaches to identify which are related PLEs sample of late adolescents. We propose cPTSD play crucial role explaining the co-occurrence trauma PLEs. Methods A 1010 adolescents provided measures symptomatology estimated Gaussian graphical structure PTSD/cPTSD assessed their bridge centrality indices. Bayesian analysis was then used estimate directed acyclic graph (DAG). Gender set as moderator both models. Results show affect dysregulation, domain, presented highest connection PLE cluster. identified pathway going from items worthlessness relational paranoia social anxiety. Additionally, we found relevant gender differences connectivity, females showing higher connectivity compared males. Conclusions Our findings highlight central dysregulation negative self-concept linking symptoms, specific according gender. These insights underscore need for targeted, gender-sensitive prevention treatment among adolescents, emphasizing early intervention tailored strategies.

Язык: Английский

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Dissociation in Borderline Personality Disorder: Recent Experimental, Neurobiological Studies, and Implications for Future Research and Treatment

Current Psychiatry Reports, Год журнала: 2021, Номер 23(6)

Опубликована: Апрель 28, 2021

The aim of this review article is to give an overview over recent experimental neurobiological research on dissociation in borderline personality disorder (BPD), order inform clinicians and stimulate further research. First, we introduce basic definitions models that conceptualize from a transdiagnostic perspective. Then, discuss findings BPD.

Язык: Английский

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