Elevated shame appears to be a feature of anorexia (AN) and bulimia nervosa (BN). Shame appears to fluctuate with the occurrence of eating disordered behaviours like binging, purging or restricted eating. Guilt is less consistently linked to AN and BN presentations. Interventions directed at shame may be helpful for these populations. A lack of longitudinal data means the temporal features of these relationships are still unclear.

The review supports the suggestion that those who identify as belonging to an alternative subculture may be at a higher risk of self-harm and suicidal behaviour. It also presents preliminary evidence that alternative affiliation predicts self-harm over time, and that this effect holds whilst adjusting for a number of likely confounders. The findings highlight the importance of increasing the awareness of the victimization and potential risk that these groups hold and suggests areas for intervention in health, educational, and social services. The review does not, however, indicate specifically what it is about alternative subculture affiliation (or alternative music preference) that could contribute to the risk of self-harm. Consequently, studies with a greater focus on mechanisms are needed. Methodological limitations (e.g., cross-sectional studies, small sample of 'alternative' participants, westernized samples) restricted the reliability and validity of the results which impacted on the extent to which the findings could be generalized more widely.

No abstract

Background:There is a pressing need to understand more about the psychological experience in patients with Behçet’s Disease (BD). The presence of poor wellbeing, low mood and anxiety may affect the ability to both manage and cope with this complex disorder and also impact upon the perception and experience of disease activity1,2,3.Objectives:Our aim was to investigate the relationship between patient rating of disease activity and their psychological experience (anxiety, low mood, illness perception and coping style) in a UK Centre of Excellence for BD.Methods:This study had full UK research ethics approval.A 12-month prospective observational study of a cohort of patients diagnosed with BD according to the International Criteria for BD(ICBD) under surveillance in the BD Centre of Excellence Liverpool, UK. All patients that agreed to a psychological evaluation were included. Participants were described for demographics and clinical presentation. BD Current Activity Form 2006 and a clinician’s and patient’s visual analogue scale (VAS) were recorded. Participants completed validated self-reported measures: Brief COPE, IPQ-R, PHQ-9, GAD-7 and WEMWBS. Spearman Rank correlations, multivariate regression analysis and mediation analysis were used to investigate the relationship between patient perception of disease activity, coping mechanisms and mood. For data analysis Excel and SPSS were used.Results:86 patients were selected (24 males, 68 females; mean age at time of evaluation 43.58 years ±11.8 SD; mean disease duration 9.76years ±10.01). The correlation between Clinician’s VAS and Patient’s VAS was strong 0.754 (p<0.005). Strong correlations were also observed between Patient’s VAS and low mood (PHQ-9) r=0.533 (p<0.005), anxiety (GAD-7) r=0.433(p<0.05), illness perception- emotional representation (IPQ-R) r=0.377 (p<0.05) and emotion-focused coping (COPE) r=0.320 (p<0.05).The results of the mediation analysis indicated that patient’s perception of disease activity was a significant predictor for Dysfunctional Coping Strategies (b=1.5,se=0.57, p<0.05). Dysfunctional Coping Strategies had a mediating impact on the relationship between patient perception of disease activity (VAS) and mood 0.645(CE: 0.68-1.389).Conclusion:Psychological experience plays an important part in the patient evaluation and experience of disease activity. Patient coping strategies and psychological representation of illness experience influence their perception of disease activity and their mood. This highlights the need of patients for psychological support and for improving coping mechanisms in order to obtain a better disease control and a higher quality of life.References:[1] RJ Moots, S Campbell, Is Psychological Status Related to Symptom Experience in Behçet’s Syndrome? 2014 ACR/ARHP Annual Meeting[2] IM Atay,I Erturan, A Demirdas, GB Yaman, VA Yürekli The impact of personality on quality of life and disease activity in patients with Behcet’s disease: a pilot study Compr Psychiatry. 2014 Apr;55(3):511-7[3] MA Melikoglu,M Melikoglu The rel...