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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
Low frustration tolerance (LFT), or "short-term hedonism" is a concept utilized to describe the inability to tolerate unpleasant feelings or stressful situations. It stems from the feeling that reality should be as wished, and that any frustration should be resolved quickly and easily. People with low frustration tolerance experience emotional disturbance when frustrations are not quickly resolved. Behaviors are then directed towards avoiding frustrating events which, paradoxically, leads to increased frustration and even greater mental stress.
In REBT the opposite construct is "high frustration tolerance".
The concept was originally developed by psychologist Albert Ellis who theorized that low frustration tolerance is an evaluative component in dysfunctional and irrational beliefs. His theory of REBT proposes that irrational beliefs and the avoidance of stressful situations is the origin of behavioral and emotional problems. As humans, we tend to seek for instant gratification to avoid pain, ignoring the fact that evading a situation now, will make it more problematic later.
Psychiatrist Kantor suggests a treatment approach using psychodynamic, supportive, cognitive, behavioral and interpersonal therapeutic methods. These methods apply to both the Passive–aggressive person and their target victim.
Emotional dysregulation (ED) is a term used in the mental health community to refer to an emotional response that is poorly modulated, and does not fall within the conventionally accepted range of emotive response.
Possible manifestations of emotional dysregulation include angry outbursts or behavior outbursts such as destroying or throwing objects, aggression towards self or others, and threats to kill oneself. These variations usually occur in seconds to minutes or hours. Emotional dysregulation can lead to behavioral problems and can interfere with a person's social interactions and relationships at home, in school, or at place of employment.
Emotional dysregulation can be associated with an experience of early psychological trauma, brain injury, or chronic maltreatment (such as child abuse, child neglect, or institutional neglect/abuse), and associated disorders such as reactive attachment disorder. Emotional dysregulation may present in people with psychiatric disorders such as attention deficit hyperactivity disorder, bipolar disorder, borderline personality disorder, narcissistic personality disorder, and complex post-traumatic stress disorder. ED is also found among those with autism spectrum disorders. In such cases as borderline personality disorder, hypersensitivity to emotional stimuli causes a slower return to a normal emotional state. This is manifested biologically by deficits in the frontal cortices of the brain.
Treatment is attempted through both cognitive behavioral therapy and psychotropic medication regimens, though the pharmaceutical options have shown limited success. Therapy aids in helping the patient recognize the impulses in hopes of achieving a level of awareness and control of the outbursts, along with treating the emotional stress that accompanies these episodes. Multiple drug regimens are frequently indicated for IED patients. Cognitive Relaxation and Coping Skills Therapy (CRCST) has shown preliminary success in both group and individual settings compared to waitlist control groups. This therapy consists of 12 sessions, the first three focusing on relaxation training, then cognitive restructuring, then exposure therapy. The final sessions focus on resisting aggressive impulses and other preventative measures.
Tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, fluvoxamine, and sertraline appear to alleviate some pathopsychological symptoms. GABAergic mood stabilizers and anticonvulsive drugs such as gabapentin, lithium, carbamazepine, and divalproex seem to aid in controlling the incidence of outbursts. Anxiolytics help alleviate tension and may help reduce explosive outbursts by increasing the provocative stimulus tolerance threshold, and are especially indicated in patients with comorbid obsessive-compulsive or other anxiety disorders. However, certain anxiolytics are known to "increase" anger and irritability in some individuals, especially benzodiazepines.
Early experiences with caregivers can lead to differences in emotional regulation. The responsiveness of a caregiver to an infant's signals can help an infant regulate their emotional systems. Caregiver interaction styles that overwhelm a child or that are unpredictable may undermine emotional regulation development. Effective strategies involve working with a child to support developing self-control such as modeling a desired behavior rather than demanding it.
The richness of environment that a child is exposed to helps development of emotional regulation. An environment must provide appropriate levels of freedom and constraint. The environment must allow opportunities for a child to practice self-regulation. An environment with opportunities to practice social skills without over-stimulation or excessive frustration helps a child develop self-regulation skills.
The fear of crime refers to the fear of being a victim of crime as opposed to the actual probability of being a victim of crime.
The fear of crime, along with fear of the streets and the fear of youth, is said to have been in Western culture for "time immemorial". While fear of crime can be differentiated into public feelings, thoughts and behaviors about the personal risk of criminal victimization, distinctions can also be made between the tendency to see situations as fearful, the actual experience while in those situations, and broader expressions about the cultural and social significance of crime and symbols of crime in people's neighborhoods and in their daily, symbolic lives.
Importantly, feelings, thoughts and behaviors can have a number of functional and dysfunctional effects on individual and group life, depending on actual risk and people's subjective approaches to danger. On a negative side, they can erode public health and psychological well-being; they can alter routine activities and habits; they can contribute to some places turning into 'no-go' areas via a withdrawal from community; and they can drain community cohesion, trust and neighborhood stability. Some degree of emotional response can be healthy: psychologists have long highlighted the fact that some degree of worry can be a problem-solving activity, motivating care and precaution, underlining the distinction between low-level anxieties that motivate caution and counter-productive worries that damage well-being.
Factors influencing the fear of crime include the psychology of risk perception, circulating representations of the risk of victimization (chiefly via interpersonal communication and the mass media), public perceptions of neighborhood stability and breakdown, the influence of neighbourhood context, and broader factors where anxieties about crime express anxieties about the pace and direction of social change. There are also some wider cultural influences. For example, some have argued that modern times have left people especially sensitive to issues of safety and insecurity.
Impulsive behavior, and especially impulsive violence predisposition has been correlated to a low brain serotonin turnover rate, indicated by a low concentration of 5-hydroxyindoleacetic acid (5-HIAA) in the cerebrospinal fluid (CSF). This substrate appears to act on the suprachiasmatic nucleus in the hypothalamus, which is the target for serotonergic output from the dorsal and median raphe nuclei playing a role in maintaining the circadian rhythm and regulation of blood sugar. A tendency towards low 5-HIAA may be hereditary. A putative hereditary component to low CSF 5-HIAA and concordantly possibly to impulsive violence has been proposed. Other traits that correlate with IED are low vagal tone and increased insulin secretion. A suggested explanation for IED is a polymorphism of the gene for tryptophan hydroxylase, which produces a serotonin precursor; this genotype is found more commonly in individuals with impulsive behavior.
IED may also be associated with lesions in the prefrontal cortex, with damage to these areas, including the amygdala, increasing the incidence of impulsive and aggressive behavior and the inability to predict the outcomes of an individual's own actions. Lesions in these areas are also associated with improper blood sugar control, leading to decreased brain function in these areas, which are associated with planning and decision making. A national sample in the United States estimated that 16 million Americans may fit the criteria for IED.
Another example of treatment besides coding is Functional Ideographic Assessment Template. The functional ideographic assessment template, also known as FIAT, was used as a way to generalize the clinical processes of functional analytic psychotherapy. The template was made by a combined effort of therapists and can be used to represent the behaviors that are a focus for this treatment. Using the FIAT therapists can create a common language to get stable and accurate communication results through functional analytic psychotherapy at the ease of the client; as well as the therapist.
Philophobia: The fear of falling in love or emotional attachment. The risk is usually when a person has confronted any emotional turmoil relating to love but also can be chronic phobia. This affects the quality of life and pushes a person away from commitment. The worst aspect of fear of being in love and falling in love is that it keeps a person in solitude. It can also evolve out of religious and cultural beliefs that prohibit love.It represents certain guilt and frustration towards the reaction coming from inside.
Stir crazy is a phrase that dates to 1908 according to the Oxford English Dictionary and the online Etymology Dictionary. Used among inmates in prison, it referred to a prisoner who became mentally unbalanced because of prolonged incarceration. The term "stir crazy" is based upon the slang "stir" (1851) to mean prison. It is now used to refer to anyone who becomes restless or anxious from feeling trapped and even somewhat claustrophobic in an environment perceived to be more static and unengaging than they can any longer continue to hold interest, meaning, and value to and for them.
"Stir crazy" could be classified as a more specific form of boredom, but combined with elevated and often increasing levels of anxiety, frustration, agitation, fidgeting, bipolar type mood swings, and accessory episodes of acting out impulsively or otherwise antisocially on those feelings, the longer the unengaging non-stimulating environment is persisted in.
Treatment is often prompted by depression associated with dissolved romantic relationships. Medication does little to affect the personality disorder, but may be helpful with symptoms such as depression. Treatment for HPD itself involves psychotherapy, including cognitive therapy.
Passive–aggressive disorder may stem from a specific childhood stimulus (e.g., alcohol/drug addicted parents, bullying, abuse) in an environment where it was not safe to express frustration or anger. Families in which the honest expression of feelings is forbidden tend to teach children to repress and deny their feelings and to use other channels to express their frustration. For example, if physical and psychological punishment were to be dealt to children who express anger, they would be inclined to be passive aggressive.
Children who sugarcoat hostility may have difficulties being assertive, never developing better coping strategies or skills for self-expression. They can become adults who, beneath a "seductive veneer," harbor "vindictive intent," in the words of US congressman/psychologist Timothy F. Murphy, and writer/practicing therapist Loriann Oberlin. Alternatively individuals may simply have difficulty being as directly aggressive or assertive as others. Martin Kantor suggests three areas that contribute to Passive–aggressive anger in individuals: conflicts about dependency, control, and competition, and that a person may be termed Passive–aggressive if they behave so to few people on most occasions.
Murphy and Oberlin also see passive aggression as part of a larger umbrella of hidden anger stemming from ten traits of the angry child or adult. These traits include making one's own misery, the inability to analyze problems, blaming others, turning bad feelings into angry ones, attacking people, lacking empathy, using anger to gain power, confusing anger with self-esteem, and indulging in negative self-talk. Lastly, the authors point out that those who hide their anger can be nice when they wish to be.
Emotional and behavioral disorders (EBD; sometimes called emotional disturbance or serious emotional disturbance) refer to a disability classification used in educational settings that allows educational institutions to provide special education and related services to students that have poor social or academic adjustment that cannot be better explained by biological abnormalities or a developmental disability.
The classification is often given to students that need individualized behavior supports to receive a free and appropriate public education, but would not be eligible for an individualized education program under another disability category of the Individuals with Disabilities Education Act (IDEA).
Mystical psychosis is a term coined by Arthur J. Deikman in the early 1970s to characterize first-person accounts of psychotic experiences that are strikingly similar to reports of mystical experiences. According to Deikman, and authors from a number of disciplines, psychotic experience need not be considered pathological, especially if consideration is given to the values and beliefs of the individual concerned. Deikman thought the mystical experience was brought about through a "deautomatization" or undoing of habitual psychological structures that organize, limit, select, and interpret perceptual stimuli. There may be several causes of deautomatization—exposure to severe stress, substance abuse or withdrawal, and mood disorders.
A first episode of mystical psychosis is often very frightening, confusing and distressing, particularly because it is an unfamiliar experience. For example, researchers have found that people experiencing paranormal and mystical phenomena report many of the symptoms of panic attacks.
On the basis of comparison of mystical experience and psychotic experience Deikman came to a conclusion that mystical experience can be caused by "deautomatization" or transformation of habitual psychological structures which organize, limit, select and interpret perceptional incentives that is interfaced to heavy stresses and emotional shocks. He described usual symptoms of mystical psychosis which consist in strengthening of a receptive mode and weakening of a mode of action.
People susceptible to mystical psychosis become much more impressible. They feel a unification with society, with the world, God, and also feel washing out the perceptive and conceptual borders. Similarity of mystical psychosis to mystical experience is expressed in sudden, distinct and very strong transition to a receptive mode. It is characterized with easing the subject—object distinction, sensitivity increase and nonverbal, lateral, intuitive thought processes.
Deikman's opinion that experience of mystical experience in itself can't be a sign to psychopathology, even in case of this experience at the persons susceptible to neurophysiological and psychiatric frustration, in many respects defined the relation to mystical experiences in modern psychology and psychiatry.
Deikman considered that all-encompassing unity opened in mysticism can be all-encompassing unity of reality.
Some researchers have suggested that DES is mislabelled as a syndrome because it is possible for the symptoms to exist on their own. Also, there is not a distinct pattern of damage that leads to the syndrome. Not all patients with frontal lobe damage have DES and some patients with no damage at all to the frontal lobe exhibit the necessary pattern of symptoms. This has led research to investigate the possibility that executive functioning is broken down into multiple processes that are spread throughout the frontal lobe. Further disagreement comes from the syndrome being based on Baddeley and Hitch's model of working memory and the central executive, which is a hypothetical construct.
The vagueness of some aspects of the syndrome has led researchers to test for it in a non-clinical sample. The results show that some dysexecutive behaviours are part of everyday life, and the symptoms exist to varying degrees in everyone. For example, absent-mindedness and lapses in attention are common everyday occurrences for most people. However, for the majority of the population such inattentiveness is manageable, whereas patients with DES experience it to such a degree that daily tasks become difficult.
There is no cure for individuals with DES, but there are therapies to help them cope with their symptoms. DES can affect a number of functions in the brain and vary from person to person. Because of this variance, it is suggested that the most successful therapy would include multiple methods. Researchers suggest that a number of factors in the executive functioning need to be improved, including self-awareness, goal setting, planning, self-initiation, self-monitoring, self-inhibition, flexibility, and strategic behaviour.
One method for individuals to improve in these areas is to help them plan and carry out actions and intentions through a series of goals and sub-goals. To accomplish this, therapists teach patients a three-step model called the General Planning Approach. The first step is Information and Awareness, in which the patients are taught about their own problems and shown how this affects their lives. The patients are then taught to monitor their executive functions and begin to evaluate them. The second stage, Goal Setting and Planning, consists of patients making specific goals, as well as devising a plan to accomplish them. For example, patients may decide they will have lunch with a friend (their goal). They are taught to write down which friend it may be, where they are going for lunch, what time they are going, how they will get there, etc. (sub-goals). They are also taught to make sure the steps go in the correct order. The final stage, named Initiation, Execution, and Regulation, requires patients to implement their goals in their everyday lives. Initiation can be taught through normal routines. The first step can cue the patient to go to the next step in their plan. Execution and regulation are put into action with reminders of how to proceed if something goes wrong in the behavioural script. This treatment method has resulted in improved daily executive functioning, however no improvements were seen on formal executive functioning tests.
Since planning is needed in many activities, different techniques have been used to improve this deficit in patients with DES. Autobiographical memories can be used to help direct future behaviour. You can draw on past experiences to know what to do in the future. For example, when you want to take a bus, you know from past experience that you have to walk to the bus stop, have the exact amount of change, put the change in the slot, and then you can go find a seat. Patients with DES seem to not be able to use this autobiographical memory as well as a normal person. Training for DES patients asks them to think of a specific time when they did an activity previously. They are then instructed to think about how they accomplished this activity. An example includes "how would you plan a holiday". Patients are taught to think of specific times they went on a holiday and then to think how they may have planned these holidays. By drawing on past experiences patients were better able to make good decisions and plans.
Cognitive Analytic Therapy (CAT) has also been used to help those with DES. Because individuals with this syndrome have trouble integrating information into their actions it is often suggested that they have programmed reminders delivered to a cell phone or pager. This helps them remember how they should behave and discontinue inappropriate actions. Another method of reminding is to have patients write a letter to themselves. They can then read the letter whenever they need to. To help patients remember how to behave, they may also create a diagram. The diagram helps organize their thoughts and shows the patient how they can change their behaviour in everyday situations.
The use of auditory stimuli has been examined in the treatment of DES. The presentation of auditory stimuli causes an interruption in current activity, which appears to aid in preventing "goal neglect" by increasing the patients' ability to monitor time and focus on goals. Given such stimuli, subjects no longer performed below their age group average IQ.
Malignant narcissism is a psychological syndrome comprising an extreme mix of narcissism, antisocial behavior, aggression, and sadism. Often grandiose, and always ready to raise hostility levels, the malignant narcissist undermines organizations in which they are involved, and dehumanizes the people with whom they associate.
Malignant narcissism is a hypothetical, experimental diagnostic category. Narcissistic personality disorder is found in the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-IV-TR), while malignant narcissism is not. As a hypothetical syndrome, malignant narcissism could include aspects of narcissistic personality disorder as well as paranoia. The importance of malignant narcissism and of projection as a defense mechanism has been confirmed in paranoia, as well as "the patient's vulnerability to malignant narcissistic regression".
The IDEA requires that a student must exhibit one or more of the following characteristics over a long duration, and to a marked degree that adversely affects their educational performance, to receive an EBD classification:
- Difficulty to learn that cannot be explained by intellectual, sensory, or health factors.
- Difficulty to build or maintain satisfactory interpersonal relationships with peers and teachers.
- Inappropriate types of behavior (acting out against self or others) or feelings (expresses the need to harm self or others, low self-worth, etc.) under normal circumstances.
- A general pervasive mood of unhappiness or depression.
- A tendency to develop physical symptoms or fears associated with personal or school problems.
The term "EBD" includes students diagnosed with schizophrenia, but does not apply to students who are "socially maladjusted", unless it is determined that they also meet the criteria for an EBD classification.
The core aspect of fear of crime is the range of emotions that is provoked in citizens by the possibility of victimization. While people may feel angry and outraged about the extent and prospect of crime, surveys typically ask people "who they are afraid of" and "how worried they are". Underlying the answers that people give are (more often than not) two dimensions of 'fear': (a) those everyday moments of worry that transpire when one feels personally threatened; and (b) some more diffuse or 'ambient' anxiety about risk. While standard measures of worry about crime regularly show between 30% and 50% of the population of England and Wales express some kind of worry about falling victim, probing reveals that few individuals actually worry for their own safety on an everyday basis. One thus can distinguish between fear (an emotion, a feeling of alarm or dread caused by an awareness or expectation of danger) and some broader anxiety. However it should be noted that some people may be more willing to admit their worries and vulnerabilities than others.
Comedown or crashing is the deterioration in mood that happens as a psychoactive drug, typically a stimulant, is either decreasing or is cleared from the blood and thus the cerebral circulation. The improvement and deterioration of mood (euphoria and dysphoria) are represented in the cognitive as high and low elevations; thus, after the drug has "elevated" the mood (a state known as a high), there follows a period of "coming back down," which often has a distinct character from withdrawal in stimulants. Generally, a comedown ("down", "low", sometimes "crash") can happen to anyone as a transient symptom, but in people who are dependent on the drug (especially those addicted to it), it is an early symptom of withdrawal and thus can be followed by others. Various drug classes, most especially stimulants and to a lesser degree opioids and sedatives, are subject to comedowns. A milder analogous mood cycle can happen even with blood sugar levels (thus sugar highs and sugar lows), which is especially relevant to people with diabetes mellitus and to parents and teachers managing children's behavior, as well as in adults with ADHD. Stimulant comedowns are unique in that they often appear very abruptly after a period of focus or high, and are typically the more intensely dysphoric phase of withdrawal than that following complete elimination from the bloodstream. Besides general dysphoria, this phase can be marked by frustration, anger, anhedonia, social withdrawal, and other symptoms characteristic to a milder mixed episode in bipolar disorder. Alertness and other general stimulant effects are still present.
According to one hypothesis, "POIS is caused by Type-I and Type-IV allergy to the males' own semen". Specifically,
POIS could also be caused by an auto-immune reaction not to semen itself, but to another substance that is released during ejaculation, such as to cytokines.
The allergy hypothesis has been disputed. According to one study, "IgE-mediated semen allergy in men may not be the potential mechanism of POIS".
The cause of POIS is unknown. Some doctors hypothesize that POIS is caused by an auto-immune reaction. Other doctors suspect a hormone imbalance as the cause. While other causes have been proposed as well, none of the proposed causes seem to fully explain the disease.
While narcissists are common, malignant narcissists are less common. A notable difference between the two is the feature of sadism, or the gratuitous enjoyment of the pain of others. A narcissist will deliberately damage other people in pursuit of their own selfish desires, but may regret and will in some circumstances show remorse for doing so, while a malignant narcissist will harm others and enjoy doing so, showing little empathy or regret for the damage they have caused.
In examining the published studies on opioid-induced hyperalgesia (OIH), Reznikov "et al" criticize the methodologies employed on both humans and animals as being far-removed from the typical regimen and dosages of pain patients in the real world. They also note that some OIH studies were performed on drug addicts in methadone rehabilitation programs, and that such results are very difficult to generalize and apply to medical patients in chronic pain. In contrast, a study of 224 chronic pain patients receiving 'commonly-used' doses of oral opioids, in more typical clinical scenarios, found that the opioid-treated patients actually experienced no difference in pain sensitivity when compared to patients on non-opioid treatments. The authors conclude that opioid-induced hyperalgesia may not be an issue of any significance for normal, medically-treated chronic pain patients at all.
Opioid-induced hyperalgesia has also been criticized as overdiagnosed among chronic pain patients, due to poor differential practice in distinguishing it from the much more common phenomenon of opioid tolerance. The misdiagnosis of common opioid tolerance (OT) as opioid-induced hyperalgesia (OIH) can be problematic as the clinical actions suggested by each condition can be contrary to each other. Patients misdiagnosed with OIH may have their opioid dose mistakenly decreased (in the attempt to counter OIH) at times when it is actually appropriate for their dose to be increased or rotated (as a counter to opioid tolerance).
The suggestion that chronic pain patients who are diagnosed as experiencing opioid-induced hyperalgesia ought to be completely withdrawn from opioid therapy has also been met with criticism. This is not only because of the uncertainties surrounding the diagnosis of OIH in the first place, but because of the viability of rotating the patient between different opioid analgesics over time. Opioid rotation is considered a valid alternative to the reduction or cessation of opioid therapy, and multiple studies demonstrate the rotation of opioids to be a safe and effective protocol.