Chanchan Shen

Development of a Body Image Concern Scale using both exploratory and confirmatory factor analyses in Chinese university students

Background The body dysmorphic disorder is prevalent in general population and in psychiatric, dermatological, and plastic-surgery patients, but there lacks a structure-validated, comprehensive self-report measure of body image concerns, which is established through both exploratory and confirmatory factor analyses. Methods We have composed a 34-item matrix targeting the body image concerns and trialed it in 328 male and 365 female Chinese university students. Answers to the matrix dealt with treatments including exploratory factor analyses, reserve of qualified items, and confirmatory factor analyses of latent structures. Results Six latent factors, namely the Social Avoidance, Appearance Dissatisfaction, Preoccupation with Reassurance, Perceived Distress/Discrimination, Defect Hiding, and Embarrassment in Public, were identified. The factors and their respective items have composed a 24-item questionnaire named as the Body Image Concern Scale. Each factor earned a satisfactory internal reliability, and the intercorrelations between these factors were in a median level. Women scored significantly higher than men did on the Appearance Dissatisfaction, Preoccupation with Reassurance, and Defect Hiding. Conclusion The Body Image Concern Scale has displayed its structure validation and gender preponderance in Chinese university students.

Inhibitory brainstem reflexes under external emotional-stimuli in bipolar I and II disorders

BackgroundBipolar disorder types I (BD I) and II (BD II) might present different dysfunctions of the cortex and brainstem, as reflected by the second exteroceptive suppression period of temporalis muscle activity (ES2) under different stimuli of external emotions.MethodsThis study included 30 BD I and 20 BD II patients, and 40 healthy volunteers. All participants were invited to answer the Mood Disorder Questionnaire, the Hypomania Checklist-32, and the Plutchik-van Praag Depression inventory, as well as to undergo the ES2 test under external emotional-stimuli (emotional pictures plus sounds) of Disgust, Erotica, Fear, Happiness, and Sadness.ResultsThe scale scores were elevated in both patient groups, but were not correlated with ES2 parameters. Compared to healthy controls, BD I showed prolonged ES2 latency under Erotica, and their perceived happiness and sadness intensities were negatively correlated with the respective ES2 durations, while BD II showed prolonged ES2 latencies under Disgust and Happiness, and shortened ES2 durations under Disgust, Happiness and Sadness. Moreover, ES2 duration under Sadness was significantly shorter in BD II than that in BD I.ConclusionsThe cortico-brainstem inhibitory dysfunctions in BD I and BD II was different, and this difference was independent of the patient’s ongoing emotions. Our study thus provides some hints to distinguish the two types of bipolar disorders.

Genetic and Neuroimaging Features of Personality Disorders: State of the Art

Personality disorders often act as a common denominator for many psychiatric problems, and studies on personality disorders contribute to the etiopathology, diagnosis, and treatment of many mental disorders. In recent years, increasing evidence from various studies has shown distinctive features of personality disorders, and that from genetic and neuroimaging studies has been especially valuable. Genetic studies primarily target the genes encoding neurotransmitters and enzymes in the serotoninergic and dopaminergic systems, and neuroimaging studies mainly focus on the frontal and temporal lobes as well as the limbic-paralimbic system in patients with personality disorders. Although some studies have suffered due to unclear diagnoses of personality disorders and some have included few patients for a given personality disorder, great opportunities remain for investigators to launch new ideas and technologies in the field.

Intensity Dependence of Auditory Evoked Potentials in Primary Dysmenorrhea

Some studies suggest that women with primary dysmenorrhea have distinct emotional or personality features. For example, they might exaggerate their responses to external stimuli, such as to intensity-increasing auditory stimuli. Fifteen women with primary dysmenorrhea and 15 healthy women were invited to undergo tests of the intensity dependence of auditory evoked potentials (IDAEP), the Functional and Emotional Measure of Dysmenorrhea, and the Plutchik-van Praag Depression Inventory. Study participants with dysmenorrhea showed higher Functional and Emotional scale scores and stronger IDAEP. Regarding the IDAEP generation, the source inversion of N1 and P2 disclosed the activated bilateral superior temporal gyri, medial and superior prefrontal gyri in all participants, and additionally, the middle frontal gyri in dysmenorrhea patients. We report a pronounced IDAEP in primary dysmenorrhea, which indicates the decreased cerebral serotonergic innervations and points to increased activations in the prefrontal and frontal areas in the disorder. PERSPECTIVE Using an IDAEP technique, the authors found decreased serotonergic innervation and altered cerebral activation in women with primary dysmenorrhea, which might offer some pharmacotherapeutic clues for the disorder.

Headache symptoms from migraine patients with and without aura through structure-validated self-reports

BackgroundHeadache symptoms self-reported by migraine patients are largely congruent with the clinician-used diagnostic criteria, but not always so. Patients’ self-reports of headache symptoms might offer additional clues to characterize migraine with (MA) and without (MO) aura more precisely.MethodsFirstly, we invited 324 participants with a life-long headache attack to answer an item-matrix measuring symptoms of primary headaches, then we performed both exploratory and confirmatory factor analyses to their answers and refined a headache symptom questionnaire. Secondly, we applied this questionnaire to 28 MA and 52 MO patients.ResultsIn participants with a life-long headache, we refined a 27-item, structure-validated headache symptom questionnaire, with four factors (scales) namely the Somatic /Aura Symptoms, Gastrointestinal and Autonomic Symptoms, Tightness and Location Features, and Prodromal/Aggravating Symptoms. Further, we found that MA patients reported higher than did MO patients on the Somatic/Aura Symptoms and Tightness and Location Features scales.ConclusionsCompared to MO, MA was conferred with more prominent tightness and location features besides its higher somatic or aura symptoms. Patients’ self-reports of headache symptoms might offer more clues to distinguish two types of migraine besides their clinician-defined criteria.

Narrations of Personality Disorders in a Famous Chinese Novel of the Eighteenth Century - A Dream of Red Mansions

Background: Traditional Chinese culture, such as the paternalism, male dominance and collectivism, contribute to normal and disordered personality traits, and the influence might be traced back to an ancient epoch. As a compendium of Chinese culture, the novel, A Dream of Red Mansions (up to first 80 chapters) written in the 18th century, might be a vector of these traces. Methods: We selected and voted on the personality-descriptive terms (adjective)/phrases, and sentences/ paragraphs in the novel, and compared them with the dimensional classification criteria of Section III of the Diagnostic and Statistical Manual of Mental Disorder-Version 5. Results: Some characters in the novel, Jia Baoyu, Wang Xifeng, Lin Daiyu, Xue Baochai, Xue Pan, Jia Yucun, Concubine Zhao, Jia Rui, Miaoyu, and Jia Jing, with their impairments in personality functioning and pathological traits, might be diagnosed as antisocial, borderline, narcissistic, obsessive-compulsive, or schizotypal personality disorder, or a trait-specified. In each character, the personality disorders or traits had their family, societal and religious (Taoism or Buddhism) connections. Conclusion: Our study indicates that Chinese culture has contributed to personality disorders or traits at least from 18th century on, and has disclosed the disadvantages of Taoism, Buddhism, and hierarchy, male dominance and collectivism under the influence of Confucianism in the development of personality disorder. Our findings might provide treatment hints for personality disorders at the root of culture, for patients in China, Japan, Singapore, South Korea, Thailand, and other neighboring countries in Asia, who have been emerged from the Chinese culture.

Electrocardiographic and Electrooculographic Responses to External Emotions and Their Transitions in Bipolar I and II Disorders

Bipolar disorder has two main types, bipolar I (BD I) and II (BD II), which present different affective states and personality characteristics, they might present different modes of emotional regulation. We hypothesized that the electrocardiogram and electrooculogram to external emotions are different in BD I and BD II. We asked 69 BD I and 54 BD II patients, and 139 healthy volunteers to undergo these tests in response to disgust, erotica, fear, happiness, neutral, and sadness, and their transitions. Their affective states were also measured. The heart rate in BD I was significantly higher under background fear after target neutral. The eyeball movement was quicker in BD I under target happiness after background disgust; in BD I under target sadness after background disgust; and in BD I under background disgust after target neutral. Some electrocardiographic and electrooculographic changes were correlated with affective states in patients. BD I and BD II had different physiological responses to external emotions and their transitions, indicating different pathophysiologies and suggesting different emotional-therapies for BD I and BD II.

Nightmare experience in bipolar I and II disorders.

Some patients with bipolar disorder have traumatic experience, sleep disturbance, and emotional variations, which are related to nightmare reports in clinics. We hypothesized that the nightmare experience might present some uniqueness in different types of bipolar disorder. We invited 200 healthy volunteers and 141 bipolar disorder I (BD I) and 78 bipolar disorder II (BD II) patients who had at least one nightmare lifelong to undergo tests of the Nightmare Experience Questionnaire (NEQ) and the questionnaires measuring mania, hypomania, and depression. Compared with healthy controls, both BD I and BD II patients displayed their abnormal affective states and scored significantly higher on NEQ Meaning Interpretation; BD I patients, in addition, scored higher on NEQ Horrible Stimulation. Hypomania was correlated with Horrible Simulation in BD II patients, and depression was correlated with Physical Effect and Horrible Stimulation in healthy controls. We found some NEQ scales were elevated in bipolar disorder, but these abnormalities failed to differentiate BD I from BD II. However, these results help explain the cognitive and emotional disturbances of bipolar disorder in general.

Relationship between hypnosis and personality trait in participants with high or low hypnotic susceptibility

Background The relationship between normal personality and hypnotic susceptibility is important for understanding mental processing and mental disorders, but it is less consistent in normal people or in patients with a psychiatric disorder. We have hypothesized that the correlation exists but varies in individuals with different levels of hypnotizability. Participants and methods We invited 72 individuals with high (HIGH group) and 47 individuals with low (LOW group) hypnotic susceptibilities to undertake tests of NEO-PI-R and the Stanford Hypnotic Susceptibility Scale, Form C (SHSSC). Results The HIGH group scored significantly higher than the LOW group did on openness to experience and its facet openness to feelings. In the LOW group, SHSSC total was positively predicted by openness to ideas; age regression was positively predicted by openness to experience and negatively predicted by extraversion; anosmia to ammonia was negatively predicted by agreeableness; and negative visual hallucination was positively predicted by openness to experience. In the HIGH group, hallucinated voice was positively predicted by openness to experience and negatively predicted by agreeableness, and posthypnotic amnesia was positively predicted by extraversion and negatively predicted by openness to experience. Conclusion The associations between normal personality traits and hypnotic susceptibility items were weak and different in the two groups, which imply that managing mental or somatoform disorders might be through adjusting hypnotizability and mobilizing personality functions.

Group cognitive–behavioral therapy in insomnia: a cross-sectional case-controlled study

Background Group cognitive–behavioral therapy (GCBT) might meet the considerable treatment demand of insomnia, but its effectiveness needs to be addressed. Participants This study recruited 27 insomnia patients treated with 16-weeks of zolpidem (zolpidem group), 26 patients treated with 4-weeks of zolpidem and also treated with 12-weeks of GCBT (GCBT group), and 31 healthy control volunteers. Methods Before treatment and 16 weeks after intervention, participants were evaluated using the Patient Health Questionnaires (Patient Health Questionnaire-9 [PHQ-9] and Patient Health Questionnaire-15 [PHQ-15]), the Dysfunctional Beliefs and Attitudes about Sleep-16 (DBAS-16), and the Pittsburgh Sleep Quality Index (PSQI). Results Compared to the zolpidem and healthy control groups, the scale scores of PHQ-9, PHQ-15, DBAS-16 and PSQI were significantly reduced after intervention in the GCBT group. Regarding the score changes, there were correlations between PSQI, DBAS-16, PHQ-9, and PHQ-15 scales in the zolpidem group, but there were limited correlations between PSQI and some DBAS-16 scales in the GCBT group. Conclusion Our results indicate that GCBT is effective to treat insomnia by improving sleep quality and reducing emotional and somatic disturbances; thus, the study supports the advocacy of applying group psychotherapy to the disorder.