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Wegner's seminal investigations of effects of thought suppression on later thought frequency have had a significant impact on recent approaches to understanding emotional disorders characterized by the occurrence of persistent, repetitive, unwanted thoughts. Thought suppression has now been implicated as a etiological and/or maintaining factor in depression, generalized anxiety disorder, specific phobia, posttraumatic stress disorder and obsessive-compulsive disorder. These developments are fairly new, and it has not been until recently that studies have investigated the effects of suppressing thoughts that are actually analogous to problematic thoughts characteristic of emotional disorder. This paper provides a review of this body of work, including the findings and their relevance for existing models of specific disorders. Directions for future research are suggested.
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PMID:Thought suppression and psychopathology. 1050 Mar 19

We report about a five year-old patient suffering from tics and ADHD (attention deficit hyperkinetic disorder), aggressions, depression and emotional disorder. Furthermore, an epileptic focus and perinatal encephalopathy were diagnosed. Lofexidine (Britlofex) medication did not reduce Tic symptomatology, but showed remarkable sedative effects. Family therapy and Clonidine (Catapressan) medication reduced symptomatology significantly.
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PMID:[Therapy of tic disorders apparently of organic origin in a multi-morbid 5-year-old patient with lofexidine (Britlofex) and clonidine (Catapressan)]. 1158 98

Stroke represents a major health problem in the United States and most European and Asian countries. Depression is probably the most common and serious emotional disorder following stroke. Post-stroke depression (PSD) has frequently been overlooked and left untreated. Prevention of PSD or successful intervention in the early phase may prevent premature deaths as well as facilitate rehabilitation, reduce costs, and improve quality of life. Stroke is clearly a risk factor for depression, and recent evidence suggests that depression increases the risk for stroke, although the mechanisms by which depression leads to stroke remain to be clarified. Once PSD has developed, numerous studies have documented its adverse effect on cognitive recovery, physical recovery, and mortality. Taken together, these studies support the necessity of identifying and treating this condition.
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PMID:Stroke-related depression. 1205 81

The aim of the study was to estimate the emotional state and the prediction of the emotional disorder of the patients who suffer from tinnitus. The General Health Questionnaire by Goldberg (GHQ) was used to this study. The study was performed in 129 patients aged 20-78 years who had been suffering from tinnitus for more than 3 months. Based on the results of the examination the patients were divided into two groups. The first group consisted of 58 patients without any emotional disorders. The second group consisted of 71 patients who would be supposed to suffer from the emotional disorders in the future. There were no statistical significant differences in the gender, age and the result of the audiometric tests between the groups of the patients. An analysis showed that the results of the GHQ were the statistical significant higher in the second group especially in the part where the symptoms of a depression were estimated.
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PMID:[Impact of tinnitus on emotional state of patients according to General Health Questionnaire by Goldberg]. 1560 1

Announcement of schizophrenia diagnostic to the patients is a topical issue in France. The evolution in clinical practices, a better efficiency in therapeutic procedures and the fundamental right of the patient to obtain information have initialised the discussion of its interest. Spontaneous claim for information from the patient is rarely observed although awareness troubles might be reported at the instauration of the mental disorder or during its evolution. Methodological studies concerning the diagnostic announcement are limited. Except the Bayle studies recently published, only a few publications are available in France about the knowledge of their pathology and their need to be clearly informed. French scientific literature deals generally about medico-legal aspects of this information and consisted of survey about diagnostic announcement. International literature is more abundant and presents positive and negative aspects of the announcement. An information procedure of schizophrenia announcement to the patient has been developed in our hospitalisation unit of psychiatry. This procedure has taken place on the basis of the literature data, our specificity and our clinical experiences. For some Anglo-American psychiatrists who have proceeded to semi-structured interview in order to announce the diagnostic, information to the patients might improve the clinical relationship. Thus, compliance to the treatment is significantly increased. The ability of the patient to recognise the symptoms of the disease and to accept their consequences and the treatments is associated to a better social prognosis, daily activities and response to the treatment. The announcement impact justifies the prescription of neuroleptics, treatment that is notoriously perceived as prejudicial by the patients themselves or more commonly in the basic population. To obtain compliance to the treatment, a satisfactory acceptance of the mental disorder is required. Compliance is based on satisfactory information in order to gain the cooperation of the patient and its relative (10). Atkinson has classified four main types of arguments, the ethical principle to be informed, talk to explain and give sense to the symptoms, reduce the feeling of guilt perceived by the patient and his relative and enhance the collaboration between the patient and the nursing staff. According to Ferreri and Bayle studies French psychiatrists reluctance to announce schizophrenia diagnostic are the following: lack of request or of interrogations asked by the patient about their disease, diagnostic and prognosis uncertainty and irreversibility of the disease, complexity of the pathology and its origin which hinder an accessible explanation, cognitive disorders frequently observed with schizophrenic patients which may be associated with difficulties of understanding information, destabilization of the patient-nursing staff relationship and social stigmatisation risks. Other arguments like reluctance to give a "label" to the disease, too abstract diagnostic, a negative social vision and the possibility of discouragement for the relative are classically retrieved in French literature. In fact, divulgation of the term schizophrenia involves a panel of negative representations and is hindered by the confusion in the social imagination of such a term related with lost of control, quintessence of madness, dangerous behaviour possibilities, evil and incurability. Some psychiatrists do not transmit information arguing that significant obstruction of the future may be consecutive to the information. They prefer to use vague terms more socially acceptable like "nervous breakdown or depression, atypical or emotional disorder, dissociative troubles...". Information to the patient about his mental disorder is more frequent in psychiatry for affective, anxious and additive troubles than for schizophrenia. Our procedure of diagnostic announcement has been elaborated after preliminary discussion with the medical and nursing staff. Diagnostic of schizophrenia announcement has been presented by weighing the pros and cons according to the intemational literature. It clearly appeared that benefits for the patients prevail on the drawbacks. Nevertheless, inclusion and clinical supervision have to be carefully precised in particular to verify the ability to receive information. Short term objectives: deliver progressively information to the patient about his disease by means of an active and educational process with hope and optimism using a accessible language (explanation of each terms used with the intention of being well understood); quantify the impact of diagnostic announcement on the schizophrenic patient using clinical rating scales during a period of one month (clinical interview at day 1, day 7 and day 28). Mid term objectives: improve the global supervision and autonomy of schizophrenic by means of a therapeutic project helping the patient to become an active partner in the monitoring of his mental disorder; enhance a psycho-educational program after the procedure of announcement in order to optimise the observance of his treatment, increase his quality of life and answer to the requests of his relative; 45 patients (age 29.3 +/- 8.8 years old) have been included to be informed on their diagnostic since the elaboration of this procedure during a time period of 24 months. Time interval between the beginning of their pathology and the delivering of this information was 4.7 years. Most of them (56%) presented a paranoid type of schizophrenia. In most of the cases, the patients did not know their diagnostic or declared suffering from a diagnostic, which was erroneous; 80% of the 45 patients have complied with the procedure until its end. On more than 24 of following after the instauration of the diagnostic announcement procedure, these patients ha ve presented satisfactory observance to the medical supervision (medical consultation and drug intake); 60% of the patients were regularly present to their medical appointment. The number of patients included (45 patients) appears small compared to the time interval of the study (24 months) but was significant according to the great changes in our clinical approach. Thus, this procedure was not systematically applied, in particular the patients who did not want to be informed on their disease. Is it clinically relevant or not to announce diagnostic of schizophrenia to the patient? This issue remains questioned according to the few studies published at the present time, any consensus has been clearly presented on formal indications or contra-indications. If on an ethical side, this information appears logical, the medical and nursing staff should require special care. Special care must be taken before delivering information to the patients; each situation must be evaluated in order not to comply with an ideology of total and inadequate information, which could have serious consequences. Nevertheless, it appeared clearly that information must be given to stabilized patients with satisfactory insight. Moreover, psychotherapeutic projects become easier because patients awareness and understanding towards pathological symptoms are greatly improved. Partnership between patient and medical staff is the key of this dynamic and psycho-educative procedure, which opens new horizons in our therapeutic prospect.
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PMID:[Schizophrenia diagnostic announcement in a French psychiatric unit]. 1638 12

Negativity biases, i.e., tendencies for negative features and interpretations to predominate over positive, are known to play a role in the etiology and maintenance of emotional disorders. Both depression and anxiety have been associated with such negative cognitive styles. Recently, Fazio, R.H., Eiser, J.R., and Shook, N.J. [(2004). Attitude formation through exploration: Valence asymmetries. Journal of Personality and Social Psychology, 87, 293-311] have observed similar valence asymmetries in the domain of attitude formation and generalization. The present research examined the possibility that the extent to which individuals display a learning bias in attitude formation is related to negative cognitive style and emotional disorder symptoms. Participants played a computer game that required learning whether novel stimuli produced positive or negative outcomes. Poorer learning was associated with more negative cognitive style, greater depression, and a tendency toward greater anxiety. Interestingly, these relations were most evident with respect to the learning of the positive stimuli, suggesting that an under-appreciation of positive objects and events may underlie vulnerability to emotional disorders. The potential value of various indices of negativity bias that can be assessed when examining attitude formation and generalization is discussed.
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PMID:Negativity bias in attitude learning: a possible indicator of vulnerability to emotional disorders? 1710 Nov 16

The temporal stability and directional relations among dimensions of temperament (e.g., neuroticism) and selected Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) disorder constructs (depression, generalized anxiety disorder, social phobia) were examined in 606 outpatients with anxiety and mood disorders, assessed on 3 occasions over a 2-year period. Neuroticism/behavioral inhibition (N/BI) and behavioral activation/positive affect (BA/P) accounted for the cross-sectional covariance of the DSM-IV constructs. Although N/BI evidenced the most change of the constructs examined, initial levels of N/BI predicted less improvement in 2 of the 3 disorder constructs. Unlike the DSM-IV disorder constructs, the temporal stability of N/BI increased as a function of initial severity. Moreover, N/BI explained all the temporal covariation of the DSM-IV disorder constructs. The results are discussed in regard to conceptual models of temperament that define N/BI and BA/P as higher order dimensions accounting for the course and covariation of emotional disorder psychopathology.
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PMID:Temporal course and structural relationships among dimensions of temperament and DSM-IV anxiety and mood disorder constructs. 1751 64

In offspring of depressed parents a second parent with emotional problems is likely to increase risk of emotional disorder. This effect may however differ between sons and daughters and between offspring of depressed fathers and offspring of depressed mothers. In adolescent and young-adult offspring of parents with major depressive disorder, this study examined the effects of a second affected parent, offspring gender, gender of the depressed parent and their interactions on risk of depression and anxiety disorder. We found that daughters had a higher risk of depression and anxiety than sons and that offspring of depressed mothers had a higher risk of anxiety than offspring of depressed fathers. In addition to these main effects, we found an interaction between parent and offspring gender inasmuch that sons of depressed fathers had the lowest risk of depression and anxiety relative to the other groups. A second affected parent tended to increase risk of depression and significantly increased risk of anxiety. However, this effect of a second affected parent on offspring anxiety was most prominent in daughters when the second affected parent was the father, whereas risk in sons did not increase if the father was affected as well. Our results indicate that paternal and maternal depression similarly and additively increase daughters' risk of emotional disorder, but that sons' risk only increases with maternal depression. Intergenerational transmission of emotional disorder seems strongest when the female gender is involved, either in the form of a daughter or a depressed mother.
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PMID:Risk of emotional disorder in offspring of depressed parents: gender differences in the effect of a second emotionally affected parent. 1794 Oct 98

Chronic daily headaches are an increasingly recognized neurologic issue in children. Frequent headaches can be a source of significant disability and family discord with work/school absenteeism. Medication overuse and emotional disorder would significantly impact treatment and progression. This study examined the frequency of emotional and behavioral problems in children and adolescents with chronic daily headache compared with age-related healthy controls. Prevalence of medication overuse in this chronic daily headache group was evaluated. Otherwise healthy children and adolescents with chronic daily headache (according to International Classification of Headache Disorders-II criteria) were enrolled from the Headache Clinic. Healthy controls were prospectively enrolled from physician offices. Multiple psychological rating scales, headache diaries, presence of medication overuse, and disability surveys (Pediatric Migraine Disability Assessment Survey) were completed. A total of 57 healthy controls and 70 patients were studied. The sample consisted largely of females, many of whom (60%) had medication overuse before medical treatment. Headache patients had significantly more symptoms of anxiety, depression, and somatization compared with controls. Patients with chronic daily headache were at higher risk for emotional disorders, and medication overuse was a significant occurrence, suggesting a need for multisystem treatment approach.
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PMID:Emotional problems and prevalence of medication overuse in pediatric chronic daily headache. 1817 51

It has been suggested that overgeneral memory (OGM) represents a vulnerability marker for depression [Williams, J. M. G., Barnhofer, T., Crane, C., Hermans, D., Raes, F., Watkins, E., et al. (2007). Autobiographical memory specificity and emotional disorder. Psychological Bulletin, 133, 122-148]. One important underlying mechanism involved is rumination [e.g., Watkins, E., & Teasdale, J. D. (2001). Rumination and overgeneral memory in depression: Effects of self-focus and analytic thinking. Journal of Abnormal Psychology, 110, 353-357; Watkins, E., & Teasdale, J. D. (2004). Adaptive and maladaptive self-focus in depression. Journal of Affective Disorders, 82, 1-8]. It is as yet unclear to what extent the relationship between rumination and OGM also applies to nonclinical groups. The present study investigated this relationship in a nonclinical student sample, using an innovative sentence completion procedure to assess OGM. As hypothesized, the experimental induction of a concrete, process-focused (or non-ruminative) thinking style (n=102) led to less OGMs as compared to the experimental induction of an abstract, evaluative (or ruminative) thinking style (n=93). The present results add to the accumulating body of evidence that abstract, evaluative (or ruminative) thinking is a crucial underlying process of OGM, and expand prior literature by extending this idea to nonclinical individuals and by using a new procedure to assess OGM.
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PMID:Non-ruminative processing reduces overgeneral autobiographical memory retrieval in students. 1845 42


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