Made by DATEXIS (Data Science and Text-based Information Systems) at Beuth University of Applied Sciences Berlin
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
The prevalence of scrupulosity is speculative. Available data do not permit reliable estimates, and available analyses mostly disregard associations with age or with gender, and have not reliably addressed associations with geography or ethnicity. Available data suggest that the prevalence of obsessive–compulsive disorder does not differ by culture, except where prevalence rates differ for all psychiatric disorders. No association between OCD and depth of religious beliefs has been demonstrated, although data are scarce. There are large regional differences in the percentage of OCD patients who have religious obsessions or compulsions, ranging from 0–7% in countries like the U.K. and Singapore, to 40–60% in traditional Muslim and orthodox Jewish populations.
MSbP is rare. A recent systematic study in Italy found that in a series of over 700 patients admitted to a pediatric ward, 4 cases met the diagnostic criteria for MSbP (0.53%). In this study, stringent diagnostic criteria were used, which required at least one test outcome or event that could not possibly have occurred without deliberate intervention by the MSbP person.
One study showed that in 93 percent of MSbP cases, the abuser is the mother or another female guardian or caregiver. This may be attributed to the prevalent socialization pattern that places females in the primary care-taking role. Of course, it could also be a gender trait rooted in genetics, as it is easy to see how females who seek attention as victims could gain an evolutionary advantage, while men seeking the same would be unfavoured for physical protection and mating. A psychodynamic model of this kind of maternal abuse exists.
MSbP may be more prevalent in the parents of those with a learning difficulty or mental incapacity, and as such the apparent patient could, in fact, be an adult.
Fathers and other male caregivers have been the perpetrators in only 7% of the cases studied. When they are not actively involved in the abuse, the fathers or male guardians of MSbP victims are often described as being distant, emotionally disengaged, and powerless. These men play a passive role in MSbP by being frequently absent from the home and rarely visiting the hospitalized child. Usually, they vehemently deny the possibility of abuse, even in the face of overwhelming evidence or their child's pleas for help.
Overall, male and female children are equally likely to be the victim of MSbP. In the few cases where the father is the perpetrator, however, the victim is three times more likely to be male.
Risk factors for mental illness include genetic inheritance, such as parents having depression, or a propensity for high neuroticism or "emotional instability".
In depression, parenting risk factors include parental unequal treatment, and there is association with high cannabis use.
In schizophrenia and psychosis, risk factors include migration and discrimination, childhood trauma, bereavement or separation in families, and abuse of drugs, including cannabis, and urbanicity.
In anxiety, risk factors may include family history (e.g. of anxiety), temperament and attitudes (e.g. pessimism), and parenting factors including parental rejection, lack of parental warmth, high hostility, harsh discipline, high maternal negative affect, anxious childrearing, modelling of dysfunctional and drug-abusing behaviour, and child abuse (emotional, physical and sexual).
Environmental events surrounding pregnancy and birth have also been implicated. Traumatic brain injury may increase the risk of developing certain mental disorders. There have been some tentative inconsistent links found to certain viral infections, to substance misuse, and to general physical health.
Social influences have been found to be important, including abuse, neglect, bullying, social stress, traumatic events and other negative or overwhelming life experiences. For bipolar disorder, stress (such as childhood adversity) is not a specific cause, but does place genetically and biologically vulnerable individuals at risk for a more severe course of illness. The specific risks and pathways to particular disorders are less clear, however. Aspects of the wider community have also been implicated, including employment problems, socioeconomic inequality, lack of social cohesion, problems linked to migration, and features of particular societies and cultures.
Survivor guilt (or survivor's guilt; also called survivor syndrome or survivor's syndrome) is a mental condition that occurs when a person believes they have done something wrong by surviving a traumatic event when others did not. It may be found among survivors of murder, terrorism, combat, natural disasters, epidemics, among the friends and family of those who have died by suicide, and in non-mortal situation. The experience and manifestation of survivor's guilt will depend on an individual's psychological profile. When the "Diagnostic and Statistical Manual of Mental Disorders IV" (DSM-IV) was published, survivor guilt was removed as a recognized specific diagnosis, and redefined as a significant symptom of post traumatic stress disorder (PTSD).
Underlying causes may include:
- Han (a Korean culture-related depressive sentiment related to hard life and social unfairness resulting not only from a tragic collective national history, but also from personal traumas)
- prior instances of major depressive disorder
- prior instances of anxiety disorder
- prior instances of adjustment disorder
- prior instances of other somatoform disorders
- repression of feelings of anger/resentment arising from past events
Triggering causes are typically external events, including:
- familial stressors, e.g. spousal infidelity or conflict with in-laws
- witnessing acts/actions/phenomena that conflict with one's own moral and/or ethical principles
The syndrome itself is believed to be the result of the continued repression of feelings of anger without addressing their source. In holistic medicine the containment of anger in hwabyung disturbs the balance of the five bodily elements, resulting in the development of psychosomatic symptoms such as panic, insomnia, and depression after a long period of repressed feelings.
It is possible that hormonal imbalances such as those around the time of menopause may also be an underlying cause of hwabyung in middle-aged women, the most often-diagnosed demographic.
Rape trauma syndrome (RTS) is the psychological trauma experienced by a rape victim that includes disruptions to normal physical, emotional, cognitive, and interpersonal behavior. The theory was first described by psychiatrist Ann Wolbert Burgess and sociologist Lynda Lytle Holmstrom in 1974.
RTS is a cluster of psychological and physical signs, symptoms and reactions common to most rape victims immediately following and for months or years after a rape. While most research into RTS has focused on female victims, sexually abused males (whether by male or female perpetrators) also exhibit RTS symptoms. RTS paved the way for consideration of complex post-traumatic stress disorder, which can more accurately describe the consequences of serious, protracted trauma than posttraumatic stress disorder alone. The symptoms of RTS and post-traumatic stress syndrome overlap. As might be expected, a person who has been raped will generally experience high levels of distress immediately afterward. These feelings may subside over time for some people; however, individually each syndrome can have long devastating effects on rape victims and some victims will continue to experience some form of psychological distress for months or years. It has also been found that rape survivors are at high risk for developing substance use disorders, major depression, generalized anxiety disorder, obsessive-compulsive disorder, and eating disorders.
In scrupulosity, a person's obsessions focus on moral or religious fears, such as the fear of being an evil person or the fear of divine retribution for sin. Although it can affect nonreligious people, it is usually related to religious beliefs. In the strict sense, not all obsessive–compulsive behaviors related to religion are instances of scrupulosity: strictly speaking, for example, scrupulosity is not present in people who repeat religious requirements merely to be sure that they were done properly.
A study by Farrington of a sample of London males followed between age 8 and 48 included studying which factors scored 10 or more on the PCL:SV at age 48. The strongest factors included having a convicted parent, being physically neglected, low involvement of the father with the boy, low family income, and coming from a disrupted family. Other significant factors included poor supervision, harsh discipline, large family size, delinquent sibling, young mother, depressed mother, low social class, and poor housing. There has also been association between psychopathy and detrimental treatment by peers. However, it is difficult to determine the extent of an environmental influence on the development of psychopathy because of evidence of its strong heritability.
Genetically informed studies of the personality characteristics typical of individuals with psychopathy have found moderate genetic (as well as non-genetic) influences. On the PPI, fearless dominance and impulsive antisociality were similarly influenced by genetic factors and uncorrelated with each other. Genetic factors may generally influence the development of psychopathy while environmental factors affect the specific expression of the traits that predominate. A study on a large group of children found more than 60% heritability for "callous-unemotional traits" and that conduct problems among children with these traits had a higher heritability than among children without these traits.
Traumatic grief or complicated mourning are conditions where both trauma and grief coincide. There are conceptual links between trauma and bereavement since loss of a loved one is inherently traumatic. If a traumatic event was life-threatening, but did not result in death, then it is more likely that the survivor will experience post-traumatic stress symptoms. If a person dies, and the survivor was close to the person who died, then it is more likely that symptoms of grief will also develop. When the death is of a loved one, and was sudden or violent, then both symptoms often coincide. This is likely in children exposed to community violence.
For C-PTSD to manifest, the violence would occur under conditions of captivity, loss of control and disempowerment, coinciding with the death of a friend or loved one in life-threatening circumstances. This again is most likely for children and stepchildren who experience prolonged domestic or chronic community violence that ultimately results in the death of friends and loved ones. The phenomenon of the increased risk of violence and death of stepchildren is referred to as the Cinderella effect.
Correlations of mental disorders with drug use include cannabis, alcohol and caffeine, use of which appears to promote anxiety. For psychosis and schizophrenia, usage of a number of drugs has been associated with development of the disorder, including cannabis, cocaine, and amphetamines. There has been debate regarding the relationship between usage of cannabis and bipolar disorder.
RTS identifies three stages of psychological trauma a rape survivor goes through: the acute stage, the outer adjustment stage, and the renormalization stage.
A 2007 study found that 78% of a clinical sample of OCD patients had intrusive images. Most people who suffer from intrusive thoughts have not identified themselves as having OCD, because they may not have what they believe to be classic symptoms of OCD, such as handwashing. Yet, epidemiological studies suggest that intrusive thoughts are the most common kind of OCD worldwide; if people in the United States with intrusive thoughts gathered, they would form the fourth-largest city in the US, following New York City, Los Angeles, and Chicago.
The prevalence of OCD in every culture studied is at least 2% of the population, and the majority of those have obsessions, or bad thoughts, only; this results in a conservative estimate of more than 2 million sufferers in the United States alone (as of 2000). One author estimates that one in 50 adults have OCD and about 10–20% of these have sexual obsessions. A recent study found that 25% of 293 patients with a primary diagnosis of OCD had a history of sexual obsessions.
Warning signs of the disorder include:
- A child who has one or more medical problems that do not respond to treatment or that follow an unusual course that is persistent, puzzling, and unexplained.
- Physical or laboratory findings that are highly unusual, discrepant with patient's presentation or history, or physically or clinically impossible.
- A parent who appears medically knowledgeable, fascinated with medical details and hospital gossip, appears to enjoy the hospital environment and expresses interest in the details of other patients' problems.
- A highly attentive parent who is reluctant to leave their child's side and who themselves seem to require constant attention.
- A parent who appears unusually calm in the face of serious difficulties in their child's medical course while being highly supportive and encouraging of the physician, or one who is angry, devalues staff and demands further intervention, more procedures, second opinions, and transfers to other more sophisticated facilities.
- The suspected parent may work in the health care field themselves or profess an interest in a health-related job.
- The signs and symptoms of a child's illness may lessen or simply vanish in the parent's absence (hospitalization and careful monitoring may be necessary to establish this causal relationship).
- A family history of similar or unexplained illness or death in a sibling.
- A parent with symptoms similar to their child's own medical problems or an illness history that itself is puzzling and unusual.
- A suspected emotionally distant relationship between parents; the spouse often fails to visit the patient and has little contact with physicians even when the child is hospitalized with a serious illness.
- A parent who reports dramatic, negative events, such as house fires, burglaries, or car accidents, that affect them and their family while their child is undergoing treatment.
- A parent who seems to have an insatiable need for adulation or who makes self-serving efforts for public acknowledgment of their abilities.
- A patient who inexplicably deteriorates whenever discharge is planned.
Complex post-traumatic stress disorder (C-PTSD; also known as complex trauma disorder) is a psychological disorder thought to occur as a result of repetitive, prolonged trauma involving harm or abandonment by a caregiver or other interpersonal relationships with an uneven power dynamic. C-PTSD is associated with sexual, emotional or physical abuse or neglect in childhood, intimate partner violence, victims of kidnapping and hostage situations, indentured servants, victims of slavery, sweatshop workers, prisoners of war, victims of bullying, concentration camp survivors, and defectors of cults or cult-like organizations. Situations involving captivity/entrapment (a situation lacking a viable escape route for the victim or a perception of such) can lead to C-PTSD-like symptoms, which include prolonged feelings of terror, worthlessness, helplessness, and deformation of one's identity and sense of self.
Some researchers argue that C-PTSD is distinct from, but similar to PTSD, somatization disorder, dissociative identity disorder, and borderline personality disorder, with the main distinction being that it distorts a person's core identity, especially when prolonged trauma occurs during childhood development . It was first described in 1992 by Judith Herman in her book "Trauma & Recovery" and an accompanying article. Though peer-reviewed journals have published papers on C-PTSD, the category is not yet adopted by either the American Psychiatric Association's (APA) "Diagnostic and Statistical Manual of Mental Disorders", 5th Edition (DSM-5), or in the World Health Organization's (WHO) "International Statistical Classification of Diseases and Related Health Problems", 10th Edition (ICD-10). However, it is proposed for the ICD-11, to be finalized in 2018.
Hedonophobia is an excessive fear or aversion to obtaining pleasure. The purported background of some such associated feelings may be due to an egalitarian-related sentiment, whereby one feels a sense of solidarity with individuals in the lowest Human Development Index countries. For others, a recurring thought that some things are too good to be true has resulted in an ingrainedness that they are not entitled to feel too good. The condition is relatively rare. Sometimes, it can be triggered by a religious upbringing wherein asceticism is propounded.
Hedonophobia is formally defined as the fear of experiencing pleasure. 'Hedon' or 'hedone' comes from ancient Greek, meaning 'pleasure' + fear: 'phobia'. Hedonophobia is the inability to enjoy pleasurable experiences, and is often a persistent malady. Diagnosis of the condition is usually related to the age of 'maturity' in each country where the syndrome exists. For instance, in the US a person must be 18 years old to be considered an adult, whereas in Canada he or she must be 18 or 19 years old, depending on the province of residence. Globally, the ages range from (+/-) 12 to 24 years and are mainly determined by traditional ethical practices from previous societies. High anxiety, panic attacks, and extreme fear are symptoms that can result from anticipating pleasure of any kind. Expecting or anticipating pleasure at some point in the future can also trigger an attack.
Hedonophobics have a type of guilt about feeling pleasure or experiencing pleasurable sensations, due to a cultural background or training (either religious or cultural) that eschews pleasurable pursuits as frivolous or inappropriate. Oftentimes, social guilt is connected to having fun while others are suffering, and is common for those who feel undeserving or have self-worth issues to work through. Also, there is a sense that they shouldn't be given pleasures due to their lack of performance in life, and because they have done things that are deemed "wrong" or "undeserving."
To determine the depth of the diagnosis for those who suffer from hedonophobia, background is crucial. For example, when a child is taught that a strong work ethic is all that makes them worthy of the good things in life, guilt becomes a motivator to move away from pleasure when they begin to experience it. The individual learns that pleasures are bad, and feeling good is not as sanctified as being empathetic towards those who suffer.
C.B.T. (Cognitive Behavioral Therapy) is an effective approach to the resolution of past beliefs that infiltrate and affect the sufferer's current responses to various situations. Medication is only necessary when there is an interference in the person's normal daily functioning. Various techniques are used by those afflicted with the condition to hide, camouflage or mask their aversion to pleasure.
Any relationship that includes things that are pleasurable is re-established when the sufferer learns that he is not worthy of anything pleasurable, or that he only deserves the opposite of those things which are pleasurable. A disconnect is necessary to determine the sufferer's lack of ability to intervene in the overall process.
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.
Primarily cognitive obsessive-compulsive disorder (also commonly called "primarily obsessional OCD", purely obsessional OCD, Pure-O, OCD without overt compulsions or with covert compulsions) is a lesser-known form or manifestation of OCD. For people with primarily obsessional OCD, there are fewer observable compulsions, compared to those commonly seen with the typical form of OCD (checking, counting, hand-washing, etc.). While ritualizing and neutralizing behaviors do take place, they are mostly cognitive in nature, involving mental avoidance and excessiverumination. Primarily obsessional OCD often takes the form of intrusive thoughts of a distressing or violent nature.
Unwanted thoughts by mothers about harming infants are common in postpartum depression. A 1999 study of 65 women with postpartum major depression by Katherine Wisner "et al." found the most frequent aggressive thought for women with postpartum depression was causing harm to their newborn infants. A study of 85 new parents found that 89% experienced intrusive images, for example, of the baby suffocating, having an accident, being harmed, or being kidnapped.
Some women may develop symptoms of OCD during pregnancy or the postpartum period. Postpartum OCD occurs mainly in women who may already have OCD, perhaps in a mild or undiagnosed form. Postpartum depression and OCD may be comorbid (often occurring together). And though physicians may focus more on the depressive symptoms, one study found that obsessive thoughts did accompany postpartum depression in 57% of new mothers.
Wisner found common obsessions about harming babies in mothers experiencing postpartum depression include images of the baby lying dead in a casket or being eaten by sharks; stabbing the baby; throwing the baby down the stairs; or drowning or burning the baby (as by submerging it in the bathtub in the former case or throwing it in the fire or putting it in the microwave in the latter). Baer estimates that up to 200,000 new mothers with postpartum depression each year may develop these obsessional thoughts about their babies; and because they may be reluctant to share these thoughts with a physician or family member, or suffer in silence and fear they are "crazy", their depression can worsen.
Intrusive fears of harming immediate children can last longer than the postpartum period. A study of 100 clinically depressed women found that 41% had obsessive fears that they might harm their child, and some were afraid to care for their children. Among non-depressed mothers, the study found 7% had thoughts of harming their child—a rate that yields an additional 280,000 non-depressed mothers in the United States with intrusive thoughts about harming their children.
Survivor guilt was first identified during the 1960s. Several therapists recognized similar if not identical conditions among Holocaust survivors. Similar signs and symptoms have been recognized in survivors of traumatic situations including combat, natural disasters, terrorist attacks, air-crashes and wide-ranging job layoffs. A variant form has been found among rescue and emergency services personnel who blame themselves for doing too little to help those in danger, and among therapists, who may feel a form of guilt in the face of their patients' suffering.
Stephen Joseph, a psychologist at the University of Warwick, has studied the survivors of the capsizing of the MS "Herald of Free Enterprise" which killed 193 of the 459 passengers. His studies showed that 60 percent of the survivors suffered from survivor guilt. Joseph went on to say: "There were three types: first, there was guilt about staying alive while others died; second, there was guilt about the things they failed to do – these people often suffered post-traumatic 'intrusions' as they relived the event again and again; third, there were feelings of guilt about what they did do, such as scrambling over others to escape. These people usually wanted to avoid thinking about the catastrophe. They didn't want to be reminded of what really happened.
Sufferers sometimes blame themselves for the deaths of others, including those who died while rescuing the survivor or whom the survivor tried unsuccessfully to save.
Many people with sexual obsessions are alarmed that they seem to lose their sex drive. People with OCD may see this as evidence that they no longer have normal sexual attractions and are in fact deviant in some way. Some may wonder if medication is the answer to the problem. Medication is a double-edged sword. Drugs specifically for erectile dysfunction (i.e. Viagra, Cialis) are not the answer for people with untreated OCD. The sexual organs are working properly, but it is the anxiety disorder that interferes with normal libido.
Medications specifically for OCD (typically SSRI medications) will help alleviate the anxiety but will also cause some sexual dysfunction in about a third of patients. For many the relief from the anxiety is enough to overcome the sexual problems caused by the medication. For others, the medication itself makes sex truly impossible. This may be a temporary problem, but if it persists a competent psychiatrist can often adjust the medications to overcome this side-effect.
Hwabyeong or Hwabyung is a Korean somatization disorder, a mental illness which arises when people are unable to confront their anger as a result of conditions which they perceive to be unfair.
Hwabyung is a colloquial and somewhat inaccurate name, as it refers to the etiology of the disorder rather than its symptoms or apparent characteristics. Hwabyung is known as a culture-bound syndrome. The word hwabyung is composed of "hwa" (the Sino-Korean word for "fire" which can also contextually mean "anger") and "byung" (the Sino-Korean word for "syndrome" or "illness"). In South Korea, it may also be called "ulhwabyeong" (), literally "depression anger illness". In one survey, 4.1% of the general population in a rural area in Korea were reported as having hwabyung. Another survey shows that about 35% of Korean workers are affected by this condition at some time.
It is during the years of young adulthood (20 to 40 years of age) that death anxiety most often begins to become prevalent. However, during the next phase of life, the middle age adult years (40–64 years of age), death anxiety peaks at its highest levels when in comparison to all other age ranges throughout the lifespan. Surprisingly, levels of death anxiety then slump off in the old age years of adulthood (65 years of age and older). This is in contrast with most people’s expectations, especially regarding all of the negative connotations younger adults have about the elderly and the aging process (Kurlychek & Trenner, 1982).
Predatory death anxiety arises from the fear of being harmed. It is the most basic and oldest form of death anxiety, with its origins in the first unicellular organisms’ set of adaptive resources. Unicellular organisms have receptors that have evolved to react to external dangers, along with self-protective, responsive mechanisms made to guarantee survival in the face of chemical and physical forms of attack or danger. In humans, predatory death anxiety is evoked by a variety of danger situations that put one at risk or threaten one's survival. These traumas may be physical, psychological, or both. Predatory death anxiety mobilizes an individual’s adaptive resources and leads to a fight-or-flight response: active efforts to combat the danger or attempts to escape the threatening situation.
According to Professor Emily Simonoff of the Institute of Psychiatry, Psychology and Neuroscience, "childhood hyperactivity and conduct disorder showed equally strong prediction of antisocial personality disorder (ASPD) and criminality in early and mid-adult life. Lower IQ and reading problems were most prominent in their relationships with childhood and adolescent antisocial behaviour."