Empathy has been inconsistently defined and inadequately measured. This research aimed to produce a new and rigorously developed questionnaire. Exploratory (n₁ = 640) and confirmatory (n₂ = 318) factor analyses were employed to develop the Questionnaire of Cognitive and Affective Empathy (QCAE). Principal components analysis revealed 5 factors (31 items). Confirmatory factor analysis confirmed this structure in an independent sample. The hypothesized 2-factor structure (cognitive and affective empathy) was tested and provided the best and most parsimonious fit to the data. Gender differences, convergent validity, and construct validity were examined. The QCAE is a valid tool for assessing cognitive and affective empathy.
Enhancement of serotonin neurotransmission plays an important role in the antidepressant response to agents presently available to treat depression. This response forms the major evidence for the role of serotonin in affective and social behaviour in humans. The present study investigated the effects of acute administration of the selective serotonin reuptake inhibitor (SSR1), citalopram (10 mg, i.v.) upon a measure of emotional processing in healthy female volunteers. Subjects completed a facial expression recognition task following infusion of citalopram or saline (between-subjects design, double-blind). Facial expressions associated with five basic emotionsFhappiness, sadness, fearfulness, anger and disgustFwere displayed. Each face had been 'morphed' between neutral (0%) and each emotional standard (100%) in 10% steps, leading to a range of emotional intensities. Mood and subjective experience were also monitored throughout the testing session. Volunteers receiving citalopram detected a higher number of facial expressions of fear and happiness, with reduced response times, relative to those given the placebo. By contrast, changes in the recognition of other basic emotions were not observed following citalopram. Notable differences in mood were also not apparent in these volunteers. These results suggest that acute administration of antidepressant drugs may affect neural processes involved in the processing of social information. This effect may represent an early acute effect of SSRIs on social and emotional processing that is relevant to their therapeutic actions.
The current evidence from randomised controlled trials suggests that drug treatment, especially with mood stabilisers and second-generation antipsychotics, may be effective for treating a number of core symptoms and associated psychopathology, but the evidence does not currently support effectiveness for overall severity of borderline personality disorder. Pharmacotherapy should therefore be targeted at specific symptoms.
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the beneficial and harmful effects of psychological therapies for people with borderline personality disorder (BPD). B A C K G R O U N D Description of the condition Borderline personality disorder (BPD) is a condition first recognised in the 20th century (Gunderson 2009). Historically, the term BPD was coined by Adolph Stern to describe a condition in the 'borderland' between psychosis and neurosis (Stern 1938). Subsequent psychoanalytic contributions (especially that of Kernberg 1975) have reaffirmed this distinction, emphasising that the capacity to test reality remains grossly intact but is subject to subtle distortions, especially under stress. According to current diagnostic criteria, BPD is characterised by a pervasive pattern of instability in affect regulation, impulse control , interpersonal relationships, and self-image (APA 2013; WHO 1993). Clinical hallmarks include emotional dysregulation, impulsive aggression, repeated self-injury, and chronic suicidal tendencies (Fonagy 2009; Lieb 2004). Whereas some authors have suggested that it is a variant of affective disorders (Akiskal 2004), others claim that it is only the causes of these diseases that partially overlap in BPD (Paris 2007). Despite the difficulties in defining and delimiting the condition, BPD is still being widely researched. Its importance stems from the considerable psychological suffering of the persons concerned (
Background Drugs are widely used in borderline personality disorder (BPD) treatment, chosen because of properties known from other psychiatric disorders (“off-label use”), mostly targeting affective or impulsive symptom clusters. Objectives To assess the effects of drug treatment in BPD patients. Search methods We searched bibliographic databases according to the Cochrane Developmental, Psychosocial and Learning Problems Group strategy up to September 2009, reference lists of articles, and contacted researchers in the field. Selection criteria Randomised studies comparing drug versus placebo, or drug versus drug(s) in BPD patients. Outcomes included total BPD severity, distinct BPD symptom facets according to DSM-IV criteria, associated psychopathology not specific to BPD, attrition and adverse effects. Data collection and analysis Two authors selected trials, assessed quality and extracted data, independently. Main results Twenty-eight trials involving a total of 1742 trial participants were included. First-generation antipsychotics (flupenthixol decanoate, haloperidol, thiothixene); second-generation antipsychotics (aripirazole, olanzapine, ziprasidone), mood stabilisers (carbamazepine, valproate semisodium, lamotrigine, topiramate), antidepressants (amitriptyline, fluoxetine, fluvoxamine, phenelzine sulfate, mianserin), and dietary supplementation (omega-3 fatty acid) were tested. First-generation antipsychotics were subject to older trials, whereas recent studies focussed on second-generation antipsychotics and mood stabilisers. Data were sparse for individual comparisons, indicating marginal effects for first-generation antipsychotics and antidepressants. The findings were suggestive in supporting the use of second-generation antipsychotics, mood stabilisers, and omega-3 fatty acids, but require replication, since most effect estimates were based on single studies. The long-term use of these drugs has not been assessed. Adverse event data were scarce, except for olanzapine. There was a possible increase in self-harming behaviour, significant weight gain, sedation and changes in haemogram parameters with olanzapine. A significant decrease in body weight was observed with topiramate treatment. All drugs were well tolerated in terms of attrition. Direct drug comparisons comprised two first-generation antipsychotics (loxapine versus chlorpromazine), first-generation antipsychotic against antidepressant (haloperidol versus amitriptyline; haloperidol versus phenelzine sulfate), and second-generation antipsychotic against antidepressant (olanzapine versus fluoxetine). Data indicated better outcomes for phenelzine sulfate but no significant differences in the other comparisons, except olanzapine which showed more weight gain and sedation than fluoxetine. The only trial testing single versus combined drug treatment (olanzapine versus olanzapine plus fluoxetine; fluoxetine versus fluoxetine plus olanzapine) yielded no significant differences in outcomes. Authors’ conclusions The available evidence indicat...
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