Background: Previous studies of insomnia focused mainly on the improvement of sleep condition and ignored the effects of sleep-related psychological activity and daytime function after pharmacological and behavioral treatments. We compared the clinical effects of both therapies on sleep condition, sleep-related psychological activity and daytime function in chronic insomnia. Methods: Seventy-one patients with chronic insomnia were randomly divided into 4 groups and either received cognitive-behavior therapy (CBT, n = 19), pharmacological therapy (PCT, n = 17), CBT plus medication (Combined, n = 18) or placebo (n = 17). The treatments lasted for 8 weeks with follow-ups conducted at 3 and 8 months. On the day after treatment ended, all patients were assessed using a polysomnogram (PSG), a sleep diary and a psychological assessment. Results: The three active treatments were more effective than placebo at the time the treatments were completed. Subjective sleep-onset latency, sleep efficacy and total sleep time were better in the PCT group than in the CBT group. At the 3-month follow-up, subjective and objective sleep-onset latency, sleep efficacy and total sleep time were better in the CBT group than in both the PCT and the Combined group. At the 8-month follow-up, the CBT group showed a steady comfortable sleep state, while the PCT and Combined groups were gradually returning to the pre-treatment condition. The Combined group showed a variable long-term effect. On the other hand, pre-sleep arousal at nighttime, dysfunctional beliefs about sleep as well as daytime functioning in the CBT group not only improved, but was better than in the other active treatment groups. Conclusion: Medication and Combined therapy produced a short-term effect on chronic insomnia while CBT had a long-term effect of improved sleep-related psychological activity and daytime functioning.
Aim: To explore the effect of melatonin on PC12 cell death induced by 1-methyl-4-phenylpyridinium (MPP +
This study aimed to investigate whether a multivariate association between alexithymia and coping styles is affected by self-inconsistency and whether the association contributed to obsessive-compulsive symptoms in 34 patients with obsessive-compulsive disorder (OCD) and 53 healthy participants. Alexithymia, coping styles, self-inconsistency, and obsessive-compulsive symptoms were evaluated using the Toronto Alexithymia Scale-20, the Coping Style Questionnaire, the Self-Consistency and Congruence Scale, and the Vancouver Obsessive-Compulsive Inventory, respectively. We found that self-inconsistency partially mediated the association between alexithymia and immature coping styles in the OCD patients but fully mediated the association in the healthy participants. Moreover, in the two groups, the alexithymia-coping coupling was related to contamination, obsession, indecisiveness, and ritualization, but not the checking symptom dimension. The findings suggest that the disturbance in identifying and describing feelings is associated with immature coping styles through disharmony between self-recognition and experience. The mechanism of the checking symptom seems to be distinct from other obsessive-compulsive symptoms.
Aims: This cross-sectional study aimed to test the path relations between alexithymia, ego-dystonicity, anxiety, depression and obsessive-compulsive (OC) symptoms in obsessive-compulsive disorder (OCD) and healthy individuals. Methods: Fifty-eight patients with OCD (mean age 35.5 years) and 54 healthy participants (mean age 33.5 years) completed an assessment via a structured clinical interview. All of them completed the Toronto Alexithymia Scale (TAS-20), the Vancouver Obsessive-Compulsive Inventory (VOCI), the Self-Consistency and Congruence Scale (SCCS), the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). The data were analyzed using partial least squares structural equation modeling (PLS-SEM). Results: In the OCD patients, alexithymia (a linear combination of difficulty identifying and describing emotions in the self) was associated with the OC symptoms either with or without the presence of ego-dystonicity (a profile of self-inconsistency and self-stereotype). In the heathy participants, alexithymia was associated with the OC symptoms only through ego-dystonic experiences. Conclusion: This study provides evidence that ego-dystonicity partially affects the association between alexithymia and obsessive-compulsions. Alexithymia and ego-dystonicity have a synergistic effect on the symptoms of OCD. Alexithymia in healthy participants associates to the OC symptoms only through ego-dystonicity. Targeting ego-dystonicity dimensions in psychotherapy would help improve the symptoms of OCD.
Transgender women are an important subgroup of the transgender umbrella and have their own unique gender identity. This article aimed to understand and measure the latent concept of gender identity among Chinese transgender women from a multi-dimensional perspective. Through a two-phase, iterative scale development process, we developed the Gender Identity Scale for Transgender Women (GIS-TW) in Chinese. Literature reviews, expert consultations, and focus groups constitute phrase 1 of the study, which resulted in the first version of GIS-TW with 30 items. In phrase 2, exploratory factor analysis on a sample of 244 Chinese transgender women revealed a six-factor solution across the 22 items. The Bem Sex Role Inventory was included to test for convergent validity, and the Rosenberg Self-Esteem Scale was used to test discriminant validity. Then we conducted the confirmatory factor analysis with an independent sample of 420 Chinese transgender women, which produced the final version of GIS-TW with 21 items. The internal consistency (Cronbach’s alpha = 0.71–0.87) and test-retest stability (r = 0.73–0.87) of each factor was good. In conclusion, the GIS-TW is a reliable and valid psychometric tool for the assessment of Chinese transgender women’s gender identity. Future application of the scale will help transgender women obtain better gender confirmative interventions.
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