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情绪波动

维基百科,自由的百科全书

情绪波动是指情绪的极端或突然变化,[1]或具有破坏性。

与双极性情感障碍和循环性精神障碍相比,情绪波动的图形比较

当情绪波动严重时,可能会被归类为精神疾病的一部分,例如躁郁症。不稳定和破坏性的情绪波动是其典型特征。 [2]

情绪波动可以在任何时间、任何地点发生 [3]。情绪波动可能会持续几天,甚至几周[4]

此外,情绪波动不仅在躁狂和忧郁之间波动,而且在某些情况下还涉及焦虑。[5][6]

术语

情绪波动”、“情绪不稳定”、“情感激动”或“情绪激动”的定义通常相似,都描述情绪或情感的波动或振荡。但每个术语都有独特的特征,用于描述特定的现象或振荡模式,尽管有些人将它们视为同义词。[7][8]与情绪或影响不同,[9]

情绪与不知道原因(不知道)的情绪反应有关。[10][11]由于情绪的动态变化,长时间的情绪模式通常是不稳定的,[12][13]或不稳定,也称为情绪正常。[14]虽然情绪波动这个术语并不具体,但它可以用来描述情绪在特定时期立即从正价下降到负价(没有基线延迟)的模式。[15]并且通常也具有非周期性模式。[16][17]描是因为情绪动态受到各种因素的影响,这些因素可以放大或减少波动,[18]例如期望何时成为现实例如期望何时成为现实。[19]

概述

情绪波动可能随时随地发生,从双极性情感障碍的微观波动到剧烈波动不等,[20] 因此可以追溯到围绕自尊的正常斗争,透过循环性精神障碍,直至忧郁症的连续统一体。[21] 然而,大多数人的情绪波动仍处于轻度至中度的情绪起伏范围内。[22] 双极性情绪波动的持续时间也各不相同。它们可能会持续几个小时(超快)或持续数天(超快):临床医生坚持认为,只有当连续四天的轻躁狂或连续七天的躁狂发生时,才可以诊断双相情感障碍。[23]在这种情况下,情绪波动可能会持续数天,甚至几周:这些发作可能包括忧郁和欣快感之间的快速交替。[24]

特征

Man running a marathon
精力充沛的人
Man sleep on the desk
情绪低落的人
  • 在不知道原因或外界刺激的情况下情绪上下变化,[25]有不同程度、持续时间和频率,从情绪高涨(快乐、高涨、恼怒)到情绪低落(悲伤、沮丧)。[26]
  • 有时它是混合的,[27] 躁狂和忧郁症状的组合[28] 或类似的苦乐参半的经历持续一天。[29][30]
  • 正常人的情绪波动表现为轻度至中度的“气候变迁”。[7][31] 因此,除非发生中等程度或以上,否则有些人需要较高的情绪智商[32]才能辨识自己的情绪变化。[33]
  • 精神疾病中的情绪波动可以简单地用基于情绪动态(表征波动的模式)的广义复杂性来描述[34] 如强度(轻度、中度、重度)、持续时间(天、周、年) 、平均情绪和其他特征,如:[35][36]
  1. 循环性精神障碍的情绪波动:情绪波动在 2 年内或更长时间内间歇性、非周期性地发生,程度中等且频繁。[37] 其特征是与焦虑、持续性、快速转变、强烈、冲动并存,[38] 因对外部刺激的敏感性和反应性而增强。[39]
  2. 双极性情感障碍 II的情绪波动:间歇性、[40] 轻躁症(严重程度)发作持续 4 天,[28] 忧郁症发作持续数周,[41] 有时在发作之间出现中等程度的不稳定发作。[42]
  3. 双极 I的情绪波动:间歇性,[40] 躁症发作(严重程度)连续发生 7 天,[28] 忧郁症发作持续数周,[43][44] 以及有时在发作之间中等程度的不稳定发作。[28] 双极 I 型和 II 型的变化可能是快速循环的,这意味著情绪的变化在一年内发生 4 次或更多次。[45] 双极 I 型和双极 II 型躁症和轻躁症发作的症状相似,只是强度程度不同。[46]
  4. 经前症状(PMS)的情绪波动:在月经期间间歇性地从轻微到严重程度,逐渐或迅速发生,[47]在月经前7天开始并在月经开始时减少。[48] 以愤怒爆发、忧郁、焦虑、困惑、易怒或社交退缩为特征。[49]
  5. 边缘型人格疾患 (BPD) 的情绪波动:情绪随偶发性情绪波动而变化无常。[50] 情绪波动会在数小时或数天内快速变化,而不是因外部刺激而持续、敏感和加剧的负面情绪(例如烦躁)。[51][52] 情绪表现为高度烦躁、[53] 和中度忧郁(其特征为敌意、对自己的愤怒、孤独、孤立、与人际关系有关、空虚)或无聊)。[54][55]
  6. 注意力不足过动症 (ADHD) 的情绪波动:情绪变化不规律,情绪波动是间歇性的,有时一天会发生几次快速变化。[56][57] 征是轻度至中度的烦躁,[58]与环境有关,冲动(急于获得奖励)。[59] 在成人注意力不足过动症中,情绪高涨表现为兴奋,情绪低落则表现为无聊。[56]
  7. 精神分裂症的情绪波动:尽管精神分裂症情绪平淡,[60]Margrethe Collier 等人在 2021 年基于 ALS-SF 测量的一项研究发现,精神分裂症的评分模式与双相 I 相似。[61] 与双相情感障碍相关的改变对于妄想或幻觉,[62] 内部发生的情绪变化可能难以在外部表达(钝性影响),[63] 并因外部刺激而加剧。[64]
  8. 重度忧郁症 (MDD) 的情绪波动:各种情绪模式,[65] 和情绪变化不规则。[35] 情绪波动是间歇性的,在中度情绪高涨和严重情绪低落之间波动。.[66][67] 其特征是大多数时候都有很高的负面情绪(坏心情),特别是在忧郁亚型。[68]还有正向的情绪昼夜变化(早上心情不好,晚上心情好),[69] 对负刺激的敏感度和某些人的混合症状等[70][71]
  9. 创伤后压力症候群(PTSD)中的情绪波动:情绪变化不规律[72] 在复原过程中情绪波动加剧。[73][74]表现为负面情绪(焦虑、烦躁、羞耻、内疚)和自尊的暂时波动,对环境提醒做出反应,[75] 难以控制情绪,[76]度兴奋症状等[77][78]

原因

情绪波动的原因可能有很多。有些情绪波动可以归类为正常/健康反应,例如悲伤处理、物质/药物的副作用或睡眠不足的结果。在没有外部触发因素或压力源的情况下,情绪波动也可能是精神疾病的征兆。

一个人的能量水平、睡眠模式、自尊、性功能、注意力、药物或酒精使用的变化可能是即将出现情绪障碍的迹象。[79]

情绪波动的其他主要原因(除了双相情感障碍和重度忧郁症)包括干扰神经系统功能的疾病/失调。注意力不足过动症(ADHD)、癫痫[ 和自闭症谱系就是三个这样的例子。[80][81]

过动症有时伴随注意力不集中、冲动和健忘,是与过动症相关的主要症状。因此,众所周知,过动症通常会带来短暂的(尽管有时是剧烈的)情绪波动。与自闭症相关的沟通困难以及相关的神经化学变化也被认为会导致自闭症发作(自闭症情绪波动)。与癫痫相关的癫痫发作涉及大脑电放电的变化,因此也可能带来显著且剧烈的情绪波动。[82] 如果情绪波动与情绪障碍无关,治疗就更难分配。然而,最常见的是,情绪波动是处理日常生活中的压力和/或意外情况的结果。

人类中枢神经系统的退化性疾病,如帕金森氏症、阿兹海默症、多发性硬化症和亨廷顿舞蹈症也可能导致情绪波动。[83] 如果情绪波动与情绪障碍无关,治疗就更难分配。然而,最常见的是,情绪波动是处理日常生活中的压力和/或意外情况的结果。

类中枢神经系统的退化性疾病,如帕金森氏症阿兹海默症多发性硬化症亨廷顿舞蹈症也可能导致情绪波动。[84] 乳糜泻也会影响神经系统,并可能出现情绪波动。[85]

不按时吃饭会造成影响,或吃太多糖,会造成血糖波动,进而造成情绪波动。[86][87]

脑化学

如果一个人的大脑中一种或几种某些神经传导物质(NT)水平异常,可能会导致情绪波动或情绪障碍。[88] 血清素是一种与睡眠、情绪和情绪状态有关的神经传导物质。NT 的轻微失衡可能会导致忧郁症。去甲肾上腺素是一种神经传导物质,与学习、记忆和身体唤醒有关。与血清素一样,去甲肾上腺素的不平衡也可能导致忧郁症。[89]

已知会导致情绪波动的情况

  • 双极性情感障碍或循环性精神障碍:躁郁症是一种情绪障碍,其特征是从轻躁症或躁症到忧郁的情绪波动。而循环性精神障碍是一种较低程度的双极性情感障碍。[90]2022年,ENIGMA双极性情感疾患工作小组发现,躁郁症患者的皮质下体积较小,皮质厚度较低,白质完整性改变,[91][92] 其中功能之一是情绪处理。[93]
  • 合成代谢类固醇滥用:[94] 合成代谢类固醇是睾固酮的合成衍生物。用于治疗男性性腺功能减退症或青春期延迟,[95] 刺激肌肉生长,[96] 阳痿爱滋病[97] 研究发现,过度使用合成代谢雄性激素类固醇会导致情绪波动、冲动和攻击行为。[98] 这种行为与情绪调节系统的减弱有关,例如额叶皮质、颞叶顶叶枕叶[99] 研究也发现,使用合成代谢雄性激素类固醇会导致下视丘-脑下垂体-性腺轴神经元变化和死亡,进而出现睡眠和情绪障碍的症状。[100]
  • 注意力不足过动症(ADHD):ADHD 被称为一种难以控制注意力、过动、频繁改变焦点和失去兴趣的疾病[101] 以及在做一些有趣或愉快的任务时注意力过度集中的疾病。[102] 专注于愉快的任务时分心可能会导致情绪失调。[103][104] 情绪波动的另一个原因是前额叶皮质(PFC)、[105] 眶额皮质(OFC)的大脑活动降低,[106] 在某些人中,海马体尺寸增大,杏仁核尺寸减小。[107] 脑这些部位的异常会导致注意力、动机、情绪和行为抑制的失调。[108]
  • 自闭症或其他广泛性发展障碍:自闭症是一种神经和发展障碍,其症状包括缺乏社交、重复行为受限、对感觉输入反应过度或反应低下等。[109] 感觉处理异常是情绪波动的原因之一在自闭症。[110] 2015 年的研究发现,自闭症患者的大脑边缘区域、初级感觉皮质和眶额皮质(OFC) 变得过度活跃,这些区域负责情绪和感觉处理。研究也发现,自闭症患者的大脑杏仁核和腹外侧前额叶皮质之间的连结性降低,杏仁核反应性增加,前额叶反应减少,进而导致情绪失调。[111][112]
  • 边缘性人格障碍:理论上,边缘性人格障碍源自于缺乏忍受、学习[113] 和克服负面事件的能力。[114] 边缘性人格障碍患者通常在人际关系方面有困难,[115]与愤怒爆发、判断力[116] 或期望他人行为的倾向有关。[117] 绪失调可能是由于缺乏人际沟通能力所造成的,例如情绪知识以及如何控制情绪,尤其是在情绪强烈的情况下。[118]大多数情况下,边缘性人格障碍患者会使用适应不良的情绪调节方式,如自我批评、思想压抑、回避和酗酒,这可能会引发更多的情绪紊乱。[119][120][121]
  • 痴呆症,包括阿兹海默症、帕金森氏症和亨廷顿舞蹈症:痴呆症是一种影响老年人的脑功能下降疾病。[122]在阿兹海默症中,情绪调节失调可能是由于情绪调节、突出性、胆碱能、GABA能和多巴胺能功能下降而引起的。[122] 帕金森氏症会产生情绪波动和情绪失调,例如由认知和身体问题引起的忧郁、自我价值感低落、羞耻和对未来的担忧。[123] 在亨丁顿舞蹈症中,常见的情绪波动是由于社会心理、认知缺陷、神经精神和生物因素所造成的。[124]
  • 多巴胺失调症候群:多巴胺失调症候群是滥用帕金森氏症药物减少运动和非运动症候群的结果,导致躁狂、暴力行为和停药时忧郁。[125]多巴胺失调症候群引起的情绪失调是由于神经传导物质系统的变化(例如多巴胺能奖励系统的紊乱)引起的。[126][125]
  • 癫痫:癫痫是一种以癫痫发作为特征的脑部活动异常疾病。癫痫发作的发生是因为神经元的超同步和过度兴奋,换句话说,神经活动和兴奋同时发生过多。[127]情绪波动通常出现在癫痫发作之前、期间、之后、治疗期间。[128] 研究发现,由于海马体杏仁核神经发生异常以及神经元连接受损,癫痫发作会导致情绪和情绪处理功能下降。[127] 癫痫发作可能会导致因忧郁、焦虑或担心生命受到威胁而引起的情绪波动。情绪变化的另一个来源来自治疗癫痫的抗惊厥药物,例如用于增加大脑抑制剂的苯巴比妥或用于减少大脑活动的抗谷氨酸药,从而导致抑郁、认知功能障碍、镇静或情绪不稳定。[129]
  • 甲状腺功能减退症甲状腺功能亢进症:甲状腺功能减退症和甲状腺功能亢进症是由甲状腺激素分泌过少或过多引起的内分泌疾病。甲状腺激素异常会影响情绪[130] ,尽管甲状腺激素与情绪障碍之间的相关性仍不清楚。[131]
  • 间歇性爆发性障碍:间歇性爆发性障碍是自发性、不受控制、不成比例且不持久的频繁愤怒。[132][133] 这种短暂的情绪交替以对人或财产进行言语或身体攻击的形式出现,有时在可能产生抑郁症状的行为后会出现后悔、羞耻和内疚。[134] IED 中的冲动行为可能与调节和情绪表达的大脑区域过度活跃有关,例如杏仁核、岛叶和眶额区域。[135]
  • 更年期:[136] 女性更年期通常发生在 52 岁。造成情绪困扰的因素之一是环境荷尔蒙的波动[137] 括性类固醇、生长荷尔蒙、压力荷尔蒙等。[138][139]
  • 重度忧郁症:重度忧郁症是一种具有悲伤、兴趣丧失、空虚等症状的疾病[140] ,对某些人来说,还伴随烦躁、精神过度活跃行为过度活跃[141]烦躁或愤怒的发展可能是由于自恋等人格特质或避免看起来悲伤、无价值或沮丧的因应策略所致。[142]
  • 强迫症:强迫症的特征是对某些导致生活困扰和功能障碍的事物的强迫和强迫。[143] 侵入性想法、恐惧、冲动、[144]和幻想可能会导致情绪变化和感觉不适,例如羞耻、内疚或焦虑。[145]
  • 创伤后压力症候群:创伤后压力症候群是一种与经常受到闪回记忆困扰以及被过去的恐惧和恐怖感觉困扰有关的疾病。这会导致创伤事件发生后情绪的改变,例如忧郁、愤怒的爆发、自毁行为和羞耻感。[146][147]
  • 怀孕:女性在怀孕期间和产后通常会经历情绪波动。荷尔蒙的变化、压力和担忧可能是情绪变化的原因。[148]
  • 经前症候群:[149] 女性会在经期的几天至两周内经历不同强度的经前综合症,如身体疼痛、情绪波动、烦躁或抑郁[150] 在经期的几天到两周内以不同的强度进行。[151] 此外,4% 至 14% 的女性患有严重的经前症候群或经前焦虑症 (PMDD),这会降低生活品质。[152]尽管经前症候群情绪失调的原因尚不清楚,但研究发现情绪失调与黄体素浓度下降、血清素能传递中断、GABA能、压力、体重指数和创伤事件有关。[151]
  • 分裂情感障碍:分裂情感性疾患的情绪波动是由精神分裂症和情绪障碍之间的混合症状引起的。[153]
  • 精神分裂症:精神分裂症是一种具有妄想、幻觉、情绪失调等症状的疾病。[154] 幻觉和妄想可能会产生情绪变化[155] ,导致愤怒、[156][157] 偏执,[158] 和羞耻.[159]
  • 季节性情感障碍:季节性情感障碍是在某些季节(通常在冬季)发生的忧郁症,然后在其他季节出现躁狂或轻躁症发作,并且每年都会发生。[160] 这些波动的情绪以愤怒发作和忧郁的形式出现[161] ,并且随季节变化,也称为季节性情绪波动[162]
  • XXYY 症候群:XXYY 症候群是一种罕见的性染色体非整倍体 (SCAs) 类型。XXYY 症候群会导致神经发育异常和精神疾病,进而导致情绪障碍。[163][164]

治疗

这是由各种因素引起的人性情绪起伏的一部分。[165]个人力量、[166][167] 应对技巧或适应能力、[168]社会支持[169] 或其他恢复模式可能决定情绪波动是否会对生活造成干扰。[170][171]

认知行为疗法建议使用情绪抑制剂来打破躁症或忧郁情绪波动的自我强化倾向。[172] 动、款待、寻求小的(且容易实现的)胜利以及利用阅读或看电视等替代性干扰,是人们在打破抑郁波动时经常使用的技巧之一。[173]

学会将自己从浮夸的心态中拉下来,或从夸张的羞耻状态中拉起来,是采取积极主动的方法来管理自己的情绪和不同的自尊感的一部分。[174]

行为活化是 CBT 的一个组成部分,它可以打破这个循环(忧郁导致不活动,不活动导致忧郁)。[175] 这可能依靠个人优势来“冷启动”奖励制度。[176]

辩证行为疗法(DBT):情绪波动的另一个表现是烦躁,这可能导致兴高采烈、愤怒或攻击性。[177] DBT有许多因应技巧可用于情绪调节失调,例如用“明智的头脑”进行正念[178] 或用相反的行动进行情绪调节。[179][180]

情绪调节疗法(ERT)具有一整套正念情绪调节技能(例如,注意力调节技能、后设认知调节技能等),当情绪波动发生时,这些技能可以派上用场。[181]

当情绪波动频繁、扰乱生活节奏时,可以采用人际和社会节奏疗法来调节生活节奏。[182] 情绪障碍的发作通常会打乱睡眠时间表、社交互动、[183][184]或工作并导致昼夜节律不规律,从而使人们从日常生活中解放出来。[185]

接受与承诺疗法(ACT)具有透过学习评估当前经历或保持正念、接受内部或外部的一切、采取行动以实现个人康复等来提高心理灵活性的功能。[186]

参考文献

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  7. ^ 7.0 7.1 Manjunatha, Narayana; Khess, Christoday Raja Jayant; Ram, Dushad. The conceptualization of terms: 'Mood' and 'affect' in academic trainees of mental health. Indian Journal of Psychiatry. 2009, 51 (4): 285–288. ISSN 1998-3794. PMC 2802377可免费查阅. PMID 20048455. doi:10.4103/0019-5545.58295可免费查阅. One would conclude from the above italic sentences of Fish that affect is a sudden exacerbation of emotion, and mood is also the emotional state prevailing at any given time, in other words, both mood and affect are short-term emotional tone (However, these confusing lines are deleted in the new edition of Fish's clinical psychopathology). 
  8. ^ APA Dictionary of Psychology. dictionary.apa.org. [2023-08-18]. (原始内容存档于2023-07-15) (英语). Moods differ from emotions in lacking an object; for example, the emotion of anger can be aroused by an insult, but an angry mood may arise when one does not know what one is angry about or what elicited the anger. 
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  35. ^ 35.0 35.1 van Genugten, Claire. (2022). Measurement innovation: studies on smartphone-based ecological momentary assessment in depression页面存档备份,存于互联网档案馆). VU Research Portal.ISBN 978-94-93270-96-1."Mood dynamics are the patterns that characterize fluctuations in a person's mood [64]. Mood dynamics are often operationalized by a combination of "mood variability" and "emotional inertia" [65,66].
  36. ^ van Genugten, Claire R.; Schuurmans, Josien; Hoogendoorn, Adriaan W.; Araya, Ricardo; Andersson, Gerhard; Baños, Rosa M.; Berger, Thomas; Botella, Cristina; Cerga Pashoja, Arlinda; Cieslak, Roman; Ebert, David D.; García-Palacios, Azucena; Hazo, Jean-Baptiste; Herrero, Rocío; Holtzmann, Jérôme. A Data-Driven Clustering Method for Discovering Profiles in the Dynamics of Major Depressive Disorder Using a Smartphone-Based Ecological Momentary Assessment of Mood. Frontiers in Psychiatry. 2022-03-17, 13: 755809. ISSN 1664-0640. PMC 8968132可免费查阅. PMID 35370856. doi:10.3389/fpsyt.2022.755809可免费查阅. 
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  38. ^ Rhoads, J. (2021). Clinical Consult to Psychiatric Mental Health Management for Nurse Practitioners. Amerika Serikat: Springer Publishing Company."Mood changes in cyclothymic disorder can be abrupt and unpredictable, of short duration, and with infrequent euthymic episodes."
  39. ^ Perugi, Giulio; Hantouche, Elie; Vannucchi, Giulia. Diagnosis and Treatment of Cyclothymia: The "Primacy" of Temperament. Current Neuropharmacology. 2017, 15 (3): 372–379. ISSN 1875-6190. PMC 5405616可免费查阅. PMID 28503108. doi:10.2174/1570159X14666160616120157. Cyclothymia is characterized by early onset, persistent, spontaneous and reactive mood fluctuations, associated with a variety of anxious and impulsive behaviors, resulting in a very rich and complex clinical presentation. Current diagnostic criteria for cyclothymic disorder (DSM-5 and ICD-10), emphasizing only episodic mood symptoms, may be misleading both from diagnostic and therapeutic point of views. 
  40. ^ 40.0 40.1 Holmes, E A; Bonsall, M B; Hales, S A; Mitchell, H; Renner, F; Blackwell, S E; Watson, P; Goodwin, G M; Di Simplicio, M. Applications of time-series analysis to mood fluctuations in bipolar disorder to promote treatment innovation: a case series. Translational Psychiatry. 2016-01-26, 6 (1): e720. ISSN 2158-3188. PMC 5068881可免费查阅. PMID 26812041. doi:10.1038/tp.2015.207. A time-series approach allows comparison of mood instability pre- and post-treatment. Figure 1 
  41. ^ Tondo, Leonardo; Vázquez, Gustavo H.; Baldessarini, Ross J. Depression and Mania in Bipolar Disorder. Current Neuropharmacology. 2017, 15 (3): 353–358. ISSN 1875-6190. PMC 5405618可免费查阅. PMID 28503106. doi:10.2174/1570159X14666160606210811. As expected, episodes of depressions were much longer than manias, but episode-duration did not differ among BD diagnostic types: I, II, with mainly mixed-episodes (BD-Mx), or with psychotic features (BD-P)...A total of 56.8% of subjects could be characterized for major course-patterns as either DMI or MDI, which occurred in similar proportions for each type. As expected, depressive episodes averaged 5.2 months 
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  43. ^ Last, C. G. (2009). When Someone You Love Is Bipolar: Help and Support for You and Your Partner. Ukraina: Guilford Publications."Research indicates that bipolar II depressions persist for longer periods of time than bipolar I depressions, nearly twice as long (1 year versus 6 months)."
  44. ^ Solomon, David A.; Fiedorowicz, Jess G.; Leon, Andrew C.; Coryell, William; Endicott, Jean; Li, Chunshan; Boland, Robert J.; Keller, Martin B. Recovery from multiple episodes of bipolar I depression. The Journal of Clinical Psychiatry. 2013, 74 (3): e205–211. ISSN 1555-2101. PMC 3837577可免费查阅. PMID 23561241. doi:10.4088/JCP.12m08049. The median duration of major depressive episodes was 14 weeks, and over 70% recovered within 12 months of onset of the episode. The median duration of minor depressive episodes was 8 weeks, and approximately 90% recovered within 6 months of onset of the episode...An early report from this study examined 66 participants with bipolar I followed for up to 5 years, and found that the median time to recovery from the first two prospectively observed episodes of major depression was 20 weeks and 24 weeks.16 A subsequent report described 82 participants with bipolar I followed for 10 years; the median duration of major and minor depressive episodes were 12 and 5 weeks, respectively.17 
  45. ^ Fink, C., Kraynak, J. (2011). Bipolar Disorder For Dummies. Amerika Serikat: Wiley."Rapid cycling isn't a separate type of bipolar disorder, but your doctor may use the label to describe a particular subtype of Bipolar I or II. To qualify as a rapid-cycling sufferer, you must experience the following: You must ..."
  46. ^ Clinical Handbook for the Management of Mood Disorders. (2013). Amerika Serikat: Cambridge University Press."While both mania and hypomania are phenomenologically similar in that they occur as discrete episodes ... "
  47. ^ admin. PMS. Women's International Pharmacy. [2023-08-20]. (原始内容存档于2023-10-21) (美国英语). In PMS: Solving the Puzzle, Linaya Hahn identifies five patterns of symptoms, occurring primarily within the luteal phase but varying in timing and intensity (see Patterns of PMS Symptoms) 
  48. ^ Bowen, Rudy; Bowen, Angela; Baetz, Marilyn; Wagner, Jason; Pierson, Roger. Mood Instability in Women With Premenstrual Syndrome. Journal of Obstetrics and Gynaecology Canada. 2011, 33 (9): 927–934. ISSN 1701-2163. PMID 21923990. doi:10.1016/s1701-2163(16)35018-6. (graph PMS pattern)...Key characteristics of PMS include a lack of symptoms during the follicular phase, a peak of symptoms during the late luteal or premenstrual phase, and a sudden decrease of symptoms with the onset of menses. 
  49. ^ Dilbaz, Berna; Aksan, Alperen. Premenstrual syndrome, a common but underrated entity: review of the clinical literature. Journal of the Turkish German Gynecological Association. 2021-05-28, 22 (2): 139–148. ISSN 1309-0399. PMC 8187976可免费查阅. PMID 33663193. doi:10.4274/jtgga.galenos.2021.2020.0133. The ACOG definition involves the presence of at least one of the six affective symptoms (angry outbursts, depression, anxiety, confusion, irritability and social withdrawal) and one of the four somatic… 
  50. ^ Southward, Matt & Semcho, Stephen & Stumpp, Nicole & MacLean, Destiney & Sauer, Shannon. (2020). A Day in the Life of Borderline Personality Disorder: A Preliminary Analysis of Within-Day Emotion Generation and Regulation页面存档备份,存于互联网档案馆). Journal of Psychopathology and Behavioral Assessment. 42. 702-713. 10.1007/s10862-020-09836-1页面存档备份,存于互联网档案馆)."Graph页面存档备份,存于互联网档案馆)"
  51. ^ Bertsch, Katja; Back, Sarah; Flechsenhar, Aleya; Neukel, Corinne; Krauch, Marlene; Spieß, Karen; Panizza, Angelika; Herpertz, Sabine C. Don't Make Me Angry: Frustration-Induced Anger and Its Link to Aggression in Women With Borderline Personality Disorder. Frontiers in Psychiatry. 2021, 12: 695062. ISSN 1664-0640. PMC 8195331可免费查阅. PMID 34122197. doi:10.3389/fpsyt.2021.695062可免费查阅. Individuals with BPD report more negative emotions and a greater intensity of negative emotions than healthy individuals throughout the day (9). However, recent data suggest a particular relevance of anger, a negative emotion that is closely related to reactive aggression, in BPD. Using e-diaries, Kockler et al. (10) found that individuals with BPD exhibit anger more frequently in their daily life than healthy as well as clinical control groups and feelings of anger accounted for more distress than pure emotional intensity. 
  52. ^ Reich Brad.(2012).Affective Instability in Borderline Personality Disorder页面存档备份,存于互联网档案馆).McLean Hospital."Graph"
  53. ^ Koenigsberg, Harold W.; Harvey, Philip D.; Mitropoulou, Vivian; Schmeidler, James; New, Antonia S.; Goodman, Marianne; Silverman, Jeremy M.; Serby, Michael; Schopick, Frances; Siever, Larry J. Characterizing Affective Instability in Borderline Personality Disorder. American Journal of Psychiatry. 2002, 159 (5): 784–788 [2024-01-09]. ISSN 0002-953X. PMID 11986132. doi:10.1176/appi.ajp.159.5.784. (原始内容存档于2023-10-21). The results of this study suggest that the presence of greater lability in terms of anger, anxiety, and depression/anxiety oscillation characterizes borderline personality disorder, while suggesting that the subjective sense of high affective intensity is present in this population but does not explain these other affective phenomena. 
  54. ^ Beatson, Josephine A.; Rao, Sathya. Depression and borderline personality disorder. Medical Journal of Australia. 2013-10-29, 199 (6): S24–7 [2024-01-09]. ISSN 0025-729X. PMID 25370280. S2CID 22836499. doi:10.5694/mja12.10474可免费查阅. (原始内容存档于2023-11-13). Depressive symptoms that occur as part of BPD are usually transient and related to interpersonal stress (eg, after an event arousing feelings of rejection). Such "depression" usually lifts dramatically when the relationship is restored. Depressive symptoms in BPD may also serve to express feelings (eg, anger, frustration, hatred, helplessness, powerlessness, disappointment) that the patient is not able to express in more adaptive ways. 
  55. ^ Köhling, Johanna; Ehrenthal, Johannes C.; Levy, Kenneth N.; Schauenburg, Henning; Dinger, Ulrike. Quality and severity of depression in borderline personality disorder: A systematic review and meta-analysis. Clinical Psychology Review. 2015-04-01, 37: 13–25. ISSN 0272-7358. PMID 25723972. doi:10.1016/j.cpr.2015.02.002. Moderator analyses revealed lower depression severity in BPD patients without comorbid DeDs, but higher severity in BPD patients with comorbid DeDs compared to depressed controls...some authors labeled the depression experienced in BPD "borderline-depression", characterized by distinct feelings of loneliness and isolation (Adler and Buie, 1979, Grinker et al., 1968), emptiness or boredom (Gunderson, 1996), high dependency and fears of abandonment (Masterson, 1976), as well as intense anger and hate toward the self and others (Hartocollis, 1977, Kernberg, 1975, Kernberg, 1992). 
  56. ^ 56.0 56.1 FW, Reimherr & Marchant, Barrie & Olsen, John & C, Halls & Kondo, Douglas & ED, Lyon & Robison, Reid. (2010). Emotional dysregulation as a core feature of adult ADHD: Its relationship with clinical variables and treatment response in two methylphenidate trials页面存档备份,存于互联网档案馆). Journal of ADHD and Related Disorders. 1. 53-64. "Graph页面存档备份,存于互联网档案馆)"
  57. ^ Skirrow, Caroline; Asherson, Philip. Emotional lability, comorbidity and impairment in adults with attention-deficit hyperactivity disorder. Journal of Affective Disorders. 2013-05-01, 147 (1): 80–86. ISSN 0165-0327. PMID 23218897. doi:10.1016/j.jad.2012.10.011. This study replicates research showing that adults with ADHD report heighted emotional lability (EL), which contributes to impairments in their daily life. 
  58. ^ J. Rosen, Paul; N. Epstein, Jeffery. A pilot study of ecological momentary assessment of emotion dysregulation in children (PDF). Journal of ADHD & Related Disorder. 2010, 1 (4): 49 [2024-01-09]. (原始内容存档 (PDF)于2018-11-03) –通过semantic scholar. This pattern is consistent with the pattern of dysregulation demonstrated by the ADHD-EDr child in the present study, as he demonstrated generally low positive affect along with 10 single time-point ratings of mild to moderate irritability over the 4 weeks. 
  59. ^ Winstanley, Catharine A.; Eagle, Dawn M.; Robbins, Trevor W. Behavioral models of impulsivity in relation to ADHD: translation between clinical and preclinical studies. Clinical Psychology Review. 2006, 26 (4): 379–395. ISSN 0272-7358. PMC 1892795可免费查阅. PMID 16504359. doi:10.1016/j.cpr.2006.01.001. However, common themes include decreased inhibitory control, intolerance of delay to rewards and quick decision-making due to lack of consideration, as well as more universal deficits such as poor attentional ability. 
  60. ^ Ciompi, Luc. The key role of emotions in the schizophrenia puzzle. Schizophrenia Bulletin. 2015, 41 (2): 318–322. ISSN 1745-1701. PMC 4332953可免费查阅. PMID 25481397. doi:10.1093/schbul/sbu158. Kraepelin1 and Bleuler2 had already mainly focused on "flat" or "inappropriate" emotions as core features of the illness. 
  61. ^ Høegh, Margrethe Collier; Melle, Ingrid; Aminoff, Sofie R.; Haatveit, Beathe; Olsen, Stine Holmstul; Huflåtten, Idun B.; Ueland, Torill; Lagerberg, Trine Vik. Characterization of affective lability across subgroups of psychosis spectrum disorders. International Journal of Bipolar Disorders. 2021, 9 (1): 34. ISSN 2194-7511. PMC 8566621可免费查阅. PMID 34734342. doi:10.1186/s40345-021-00238-0可免费查阅 (英语). There were no statistically significant differences between individuals with BD-I and SZ for any ALS-SF dimension and these two groups had very similar score patterns throughout. This suggests that despite the overlap in core affective symptom profiles of BD-I and BD-II, the BD-I group is more similar to SZ than it is to BD-II concerning levels of affective lability. 
  62. ^ van Rossum, Inge; Dominguez, Maria-de-Gracia; Lieb, Roselind; Wittchen, Hans-Ulrich; van Os, Jim. Affective dysregulation and reality distortion: a 10-year prospective study of their association and clinical relevance. Schizophrenia Bulletin. 2011, 37 (3): 561–571. ISSN 1745-1701. PMC 3080695可免费查阅. PMID 19793794. doi:10.1093/schbul/sbp101. Evidence from multiple domains indicates that affective dysregulation is strongly associated with reality distortion.1,2 Genetic epidemiological studies have demonstrated that the liabilities for bipolar disorder and schizophrenia are correlated. 
  63. ^ Kilian, Sanja; Asmal, Laila; Goosen, Anneke; Chiliza, Bonginkosi; Phahladira, Lebogang; Emsley, Robin. Instruments measuring blunted affect in schizophrenia: a systematic review. PLOS ONE. 2015, 10 (6): e0127740. Bibcode:2015PLoSO..1027740K. ISSN 1932-6203. PMC 4452733可免费查阅. PMID 26035179. doi:10.1371/journal.pone.0127740可免费查阅. Blunted affect, also referred to as emotional blunting, is a prominent symptom of schizophrenia. Patients with blunted affect have difficulty in expressing their emotions [1], characterized by diminished facial expression, expressive gestures and vocal expressions in reaction to emotion provoking stimuli [1–3]. However, patients' reduced outward emotional expression may not mirror subjective internal emotional experiences [4] suggesting a disconnect in what patients experience, perceive and express when interpreting emotional stimuli [5] due to problems associated with emotional processing [6–7]. 
  64. ^ Docherty, Nancy M.; St-Hilaire, Annie; Aakre, Jennifer M.; Seghers, James P. Life events and high-trait reactivity together predict psychotic symptom increases in schizophrenia. Schizophrenia Bulletin. 2009, 35 (3): 638–645. ISSN 0586-7614. PMC 2669571可免费查阅. PMID 18245057. doi:10.1093/schbul/sbn002. There is evidence that the occurrence of stressful life events3,6–8 or the presence of social relationship stressors such as high levels of familial "expressed emotion9–11" are associated with subsequent exacerbation of psychotic symptoms in patients as a group. 
  65. ^ Thompson, Renee J.; Mata, Jutta; Jaeggi, Susanne M.; Buschkuehl, Martin; Jonides, John; Gotlib, Ian H. The everyday emotional experience of adults with major depressive disorder: Examining emotional instability, inertia, and reactivity. Journal of Abnormal Psychology. 2012, 121 (4): 819–829. ISSN 1939-1846. PMC 3624976可免费查阅. PMID 22708886. doi:10.1037/a0027978. Whether depressed individuals and healthy controls will differ in their instability of PA is less clear. As we noted above, depressed individuals have been found to have blunted emotional responses to valenced stimuli in the laboratory (Bylsma, et al., 2008) and decreased responsivity to reward (e.g., Pizzagalli, Iosifescu, Hallett, Ratner, & Fava, 2009)... 
  66. ^ Bowen, Rudy; Peters, Evyn; Marwaha, Steven; Baetz, Marilyn; Balbuena, Lloyd. Moods in Clinical Depression Are More Unstable than Severe Normal Sadness. Frontiers in Psychiatry. 2017, 8: 56. ISSN 1664-0640. PMC 5388683可免费查阅. PMID 28446884. doi:10.3389/fpsyt.2017.00056可免费查阅. He noted that people with melancholia could become over-talkative and manic but did not adequately explain why this is so." & "On the VAS ratings, the depressed group experienced more severe low moods and less severe high moods than the non-depressed group, as would be expected given the selection criteria. This is consistent with reports of more severe negative emotions and variable positive emotions in ecological momentary assessment studies of patients with major depression (12, 33, 53). 
  67. ^ Christensen, Michael Cronquist; Ren, Hongye; Fagiolini, Andrea. Emotional blunting in patients with depression. Part I: clinical characteristics. Annals of General Psychiatry. 2022-04-04, 21 (1): 10. ISSN 1744-859X. PMC 8981644可免费查阅. PMID 35379283. doi:10.1186/s12991-022-00387-1可免费查阅. Emotional effects of depression and treatment vary, but may include, for example, feeling emotionally "numbed" or "blunted" in some way; lacking positive emotions or negative emotions; feeling detached from the world around you... 
  68. ^ Sperry, Sarah Havens; Walsh, Molly A.; Kwapil, Thomas Richard. Emotion Dynamics Concurrently and Prospectively Predict Mood Psychopathology. Journal of Affective Disorders. 2019-09-30, 261: 67–75 [2023-08-25]. PMID 31600589. S2CID 242802425. doi:10.31234/osf.io/n7xza. Major depressive disorder is characterized by high mean NA and low mean PA (e.g., Watson et al., 1988).... Note that major depressive disorder generally is unassociated with instability of NA or PA (Köhling et al., 2016; Koval et al., 2013). 
  69. ^ Murray, Greg. Diurnal mood variation in depression: A signal of disturbed circadian function?. Journal of Affective Disorders. Depression and Anxiety in Women across Cultures. 2007-09-01, 102 (1): 47–53 [2024-01-09]. ISSN 0165-0327. PMID 17239958. doi:10.1016/j.jad.2006.12.001. (原始内容存档于2018-07-03). Diurnal variation in mood is a prominent symptom of depression, and is typically experienced as positive mood variation (PMV — mood being worse upon waking and better in the evening). 
  70. ^ Loas, Gwenolé; Salinas, Eliseo; Pierson, Annick; Guelfi, Julien D.; Samuel-Lajeunesse, Bertrand. Anhedonia and blunted affect in major depressive disorder. Comprehensive Psychiatry. 1994-09-01, 35 (5): 366–372. ISSN 0010-440X. PMID 7995029. doi:10.1016/0010-440X(94)90277-1. The depressives are more sensitive to displeasure and more anhedonic than controls. 
  71. ^ Faedda, Gianni L.; Marangoni, Ciro; Reginaldi, Daniela. Depressive mixed states: A reappraisal of Koukopoulos׳criteria. Journal of Affective Disorders. 2015-05-01, 176: 18–23. ISSN 0165-0327. PMID 25687279. doi:10.1016/j.jad.2015.01.053. The mixed depressive syndrome is not a transitory state but a state of long duration, which may last weeks or several months. The clinical picture is characterized by dysphoric mood, emotional lability, psychic and/or motor agitation, talkativeness, crowded and/or racing thoughts, rumination, initial or middle insomnia. 
  72. ^ Wonderlich, Stephen A.; Rosenfeldt, Steven; Crosby, Ross D.; Mitchell, James E.; Engel, Scott G.; Smyth, Joshua; Miltenberger, Raymond. The effects of childhood trauma on daily mood lability and comorbid psychopathology in bulimia nervosa. Journal of Traumatic Stress. 2007, 20 (1): 77–87 [2024-01-09]. PMID 17345648. doi:10.1002/jts.20184. (原始内容存档于2023-10-21) (英语). Emotional abuse was associated with average daily mood and mood lability. 
  73. ^ Power, Mick J.; Fyvie, Claire. The Role of Emotion in PTSD: Two Preliminary Studies. Behavioural and Cognitive Psychotherapy. 2013, 41 (2): 162–172. ISSN 1352-4658. PMID 22452905. S2CID 33989429. doi:10.1017/S1352465812000148 (英语). The results showed that less than 50% of PTSD cases presented with anxiety as the primary emotion, with the remainder showing primary emotions of sadness, anger, or disgust rather than anxiety 
  74. ^ Price, Matthew; Legrand, Alison C.; Brier, Zoe M. F.; Gratton, Jennifer; Skalka, Christian. The short-term dynamics of posttraumatic stress disorder symptoms during the acute posttrauma period. Depression and Anxiety. 2020, 37 (4): 313–320. ISSN 1520-6394. PMC 8340953可免费查阅. PMID 31730736. doi:10.1002/da.22976. Taken together, these results indicate that PTSD development is a dynamic process in which symptoms interact over time (Gelkopf et al., 2017). As hypothesized, intrusions and AAR symptoms may be more important early on and lead to other symptoms in the disorder. 
  75. ^ Shalev, Arieh Y. Posttraumatic stress disorder and stress-related disorders. The Psychiatric Clinics of North America. 2009, 32 (3): 687–704. ISSN 1558-3147. PMC 2746940可免费查阅. PMID 19716997. doi:10.1016/j.psc.2009.06.001. Chronic PTSD most often co-occurs with mood, anxiety and substance use disorders. It is highly reactive to environmental reminders of the traumatic event and to renewed life-stressors, and thus may have a fluctuating course (23). 
  76. ^ Newton, Tamara; Ho, Ivy. Posttraumatic Stress Symptoms and Emotion Experience in Women: Emotion Occurrence, Intensity, and Variability in the Natural Environment. Journal of Psychological Trauma. 2008-12-04, 7 (4): 276–297 [2024-01-09]. ISSN 1932-2887. S2CID 144129832. doi:10.1080/19322880802492237. (原始内容存档于2023-10-26) (英语). Posttraumatic stress symptom severity was uniquely correlated with greater intensity and variability, but not occurrence, of certain negative emotions, and with less frequent occurrence but greater variability of joy/happiness. Intrusive reexperiencing was uniquely associated with greater variability of both anxiety and joy/happiness. Results suggest that women with more severe posttraumatic stress symptoms do not experience more episodes of negative emotion but, once emotion occurs, they have difficulty modulating its intensity. 
  77. ^ Yehuda, Rachel; LeDoux, Joseph. Response Variation following Trauma: A Translational Neuroscience Approach to Understanding PTSD. Neuron. 2007-10-04, 56 (1): 19–32 [2024-01-09]. ISSN 0896-6273. PMID 17920012. S2CID 25239428. doi:10.1016/j.neuron.2007.09.006可免费查阅. (原始内容存档于2023-12-23). Reexperiencing symptoms describe spontaneous, often insuppressible intrusions of the traumatic memory in the form of images or nightmares that are accompanied by intense physiological distress...Hyperarousal symptoms reflect more overt physiological manifestations, such as insomnia, irritability, impaired concentration, hypervigilance, and increased startle responses. 
  78. ^ Schoenleber, Michelle; Berghoff, Christopher R.; Gratz, Kim L.; Tull, Matthew T. Emotional lability and affective synchrony in posttraumatic stress disorder pathology. Journal of Anxiety Disorders. 2018, 53: 68–75. ISSN 1873-7897. PMC 5748357可免费查阅. PMID 29197703. doi:10.1016/j.janxdis.2017.11.006. Kleim, Graham, Bryant, and Ehlers (2013) asked a sample of trauma-exposed individuals to report state levels of various unpleasant emotions (i.e., fear, helplessness, anger, guilt, and shame) following naturally occurring intrusive memories over the course of a week. 
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  91. ^ Ching, Christopher R. K.; Hibar, Derrek P.; Gurholt, Tiril P.; Nunes, Abraham; Thomopoulos, Sophia I.; Abé, Christoph; Agartz, Ingrid; Brouwer, Rachel M.; Cannon, Dara M.; de Zwarte, Sonja M. C.; Eyler, Lisa T.; Favre, Pauline; Hajek, Tomas; Haukvik, Unn K.; Houenou, Josselin. What we learn about bipolar disorder from large-scale neuroimaging: Findings and future directions from the ENIGMA Bipolar Disorder Working Group. Human Brain Mapping. 2022, 43 (1): 56–82. ISSN 1097-0193. PMC 8675426可免费查阅. PMID 32725849. doi:10.1002/hbm.25098. Findings and future directions from the ENIGMA Bipolar Disorder Working Group. Hum Brain Mapp. 2022 Jan;43(1):56-82."Initial BD Working Group studies reveal widespread patterns of lower cortical thickness, subcortical volume and disrupted white matter integrity associated with BD. Findings also include mapping brain alterations of 
  92. ^ Jain, Ankit; Mitra, Paroma, Bipolar Disorder, StatPearls (Treasure Island (FL): StatPearls Publishing), 2023 [2023-08-05], PMID 32644424, (原始内容存档于2023-03-23), Currently, the etiology of BD is unknown but appears to be due to an interaction of genetic, epigenetic, neurochemical, and environmental factors. Heritability is well established.[3][4][5] Numerous genetic loci have been implicated as increasing the risk of BD; the first was noted in 1987 with "DNA markers" on the short arm of chromosome 11. Since then, an association has been made between at least 30 genes and an increased risk of the condition.[6] 
  93. ^ Benoit, M.; Robert, P.H., Behavior, Neural Basis of, Encyclopedia of the Neurological Sciences, Elsevier: 364–369, 2003 [2023-07-29], ISBN 9780122268700, doi:10.1016/b0-12-226870-9/00418-4, mesial limbic system (nucleus accumbens, amygdala, and hippocampus) and the entire prefrontal cortex. They play a determining role in emotional expression and motivation. For example, a reduction in the activity of the mesocortical pathway will result in a paucity of affect and loss of motivation and planning 
  94. ^ Su, Tung-Ping. Neuropsychiatric Effects of Anabolic Steroids in Male Normal Volunteers. JAMA: The Journal of the American Medical Association. 1993-06-02, 269 (21): 2760–2764. ISSN 0098-7484. PMID 8492402. doi:10.1001/jama.1993.03500210060032. 
  95. ^ Lenko, Iil; Mäenpää, J.; Mäkitie, O.; Perheentupa, J. Low Dose Testosterone Treatment of Delayed Growth. Pediatric Research. 1988, 23 (1): 124 [2024-01-09]. ISSN 1530-0447. S2CID 6016824. doi:10.1203/00006450-198801000-00139可免费查阅. (原始内容存档于2023-10-21) (英语). Anabolic steroids are used to accelerate the growth of normal boys with constitutional, delay of growth and puberty 
  96. ^ Mottram, David R.; George, Alan J. Anabolic steroids. Best Practice & Research Clinical Endocrinology & Metabolism. 2000-03-01, 14 (1): 55–69. ISSN 1521-690X. PMID 10932810. doi:10.1053/beem.2000.0053 (英语). The anabolic effects are considered to be those promoting protein synthesis, muscle growth and crythopoiesis 
  97. ^ Newshan, Gayle; Leon, Wade. The use of anabolic agents in HIV disease. International Journal of STD & AIDS. 2001-03-01, 12 (3): 141–144 [2024-01-09]. ISSN 0956-4624. PMID 11231865. S2CID 6055905. doi:10.1258/0956462011916893. (原始内容存档于2023-10-26) (英语). Anabolic steroids and other agents are fast becoming part of the standard of care for HIV disease, gaining acceptance in reversing loss of lean body mass... 
  98. ^ Piacentino, Daria; Kotzalidis, Georgios D.; Del Casale, Antonio; Aromatario, Maria Rosaria; Pomara, Cristoforo; Girardi, Paolo; Sani, Gabriele. Anabolic-androgenic steroid use and psychopathology in athletes. A systematic review. Current Neuropharmacology. 2015, 13 (1): 101–121. ISSN 1570-159X. PMC 4462035可免费查阅. PMID 26074746. doi:10.2174/1570159X13666141210222725. High doses of AASs can lead to serious physical and psychological complications, such as hypertension, atherosclerosis, myocardial hypertrophy and infarction, abnormal blood clotting, hepatotoxicity and hepatic tumors, tendon damage, reduced libido, and psychiatric/behavioral symptoms like aggressiveness and irritability 
  99. ^ Hauger, Lisa E.; Westlye, Lars T.; Fjell, Anders M.; Walhovd, Kristine B.; Bjørnebekk, Astrid. Structural brain characteristics of anabolic-androgenic steroid dependence in men. Addiction. 2019, 114 (8): 1405–1415. ISSN 1360-0443. PMC 6767448可免费查阅. PMID 30955206. doi:10.1111/add.14629. AAS users who fulfilled the criteria for AAS‐dependence had significantly thinner cortex in frontal, temporal, parietal, occipital and pre‐frontal regions compared to non‐dependent users 
  100. ^ SANTOS, JOÃO PEDRO BELCHIOR; LACERDA, FRANCIELLY BAÊTA; OLIVEIRA, LEANDRO ALMEIDA DE; FIALHO, BRENDA BORCARD; ASSUNÇÃO, ISADORA NOGUEIRA; SANTANA, MARCOS GONÇALVES; GOMIDES, LINDISLEY FERREIRA; CUPERTINO, MARLI DO CARMO. NEUROLOGICAL CONSEQUENCES OF ABUSIVE USE OF ANABOLIC-ANDROGENIC STEROIDS (PDF). Brazilian Journal of Surgery and Clinical Research – BJSCR. 2020, 32 (2): 52–58 [2024-01-09]. eISSN 2317-4404. (原始内容存档 (PDF)于2023-12-16) –通过BJSCR. As a result, it was observed that at NS, these stimulants actuate through a complex signaling systems that include the neuroendocrine alteration of the hypothalamic pituitary-gonadal axis, modification of neurotransmitters and their receptors, as well as the induction of neuronal death by apoptosis in several pathways 
  101. ^ Koutsoklenis, Athanasios; Honkasilta, Juho. ADHD in the DSM-5-TR: What has changed and what has not. Frontiers in Psychiatry. 2023-01-10, 13. ISSN 1664-0640. PMC 9871920可免费查阅. PMID 36704731. doi:10.3389/fpsyt.2022.1064141可免费查阅. ADHD is a neurodevelopmental disorder defined by impairing levels of inattention, disorganization, and/or hyperactivity-impulsivity. Inattention and disorganization entail inability to stay on task, seeming not to listen, and losing materials necessary for tasks, at levels that are inconsistent with age or developmental level. 
  102. ^ Ashinoff, Brandon K.; Abu-Akel, Ahmad. Hyperfocus: the forgotten frontier of attention. Psychological Research. 2021-02-01, 85 (1): 1–19. ISSN 1430-2772. PMC 7851038可免费查阅. PMID 31541305. doi:10.1007/s00426-019-01245-8 (英语). Ozel-Kizil et al. (2013; also see Ozel-Kizil et al., 2014) defined hyperfocusing as being “characterized by intensive concentration on interesting and non-routine activities accompanied by temporarily diminished perception of the environment”. 
  103. ^ Can ADHD Cause Mood Swings?. Psych Central. 2022-08-12 [2023-07-27]. (原始内容存档于2023-08-11) (英语). ADHD-induced mood shifts may be a result of being distracted, comorbid conditions like depression or bipolar disorder, or a side effect of certain medications. 
  104. ^ McDonagh, Tracey; Travers, Áine; Bramham, Jessica. Do Neuropsychological Deficits Predict Anger Dysregulation in Adults with ADHD?. International Journal of Forensic Mental Health. 2019-07-03, 18 (3): 200–211 [2024-01-09]. ISSN 1499-9013. S2CID 149490018. doi:10.1080/14999013.2018.1508095. (原始内容存档于2023-08-11) (英语). Shifting attention was more significantly associated with trait anger and anger out than response inhibition, which was significantly related to anger control 
  105. ^ Arnsten, Amy F.T. ADHD and the Prefrontal Cortex. The Journal of Pediatrics. 2009, 154 (5): I–S43. PMC 2894421可免费查阅. PMID 20596295. doi:10.1016/j.jpeds.2009.01.018 (英语). Studies have found that ADHD is associated with weaker function and structure of prefrontal cortex (PFC) circuits, especially in the right hemisphere. 
  106. ^ Itami, Shouichi; Uno, Hiroyuki. Orbitofrontal cortex dysfunction in attention-deficit hyperactivity disorder revealed by reversal and extinction tasks. NeuroReport. 2002-12-20, 13 (18): 2453–2457 [2024-01-09]. ISSN 0959-4965. PMID 12499848. S2CID 23189353. doi:10.1097/00001756-200212200-00016. (原始内容存档于2022-02-06). ADHD subjects indeed showed a performance deficit in the tasks, supporting OFC dysfunction in ADHD. Furthermore, a discriminat analysis using the task performance variables correctly classified 89.7% of the participants among ADHD patients and normal controls. 
  107. ^ Perlov, Evgeniy; Philipsen, Alexandra; Tebartz van Elst, Ludger; Ebert, Dieter; Henning, Juergen; Maier, Simon; Bubl, Emanuel; Hesslinger, Bernd. Hippocampus and amygdala morphology in adults with attention-deficit hyperactivity disorder. Journal of Psychiatry & Neuroscience. 2008, 33 (6): 509–515. ISSN 1488-2434. PMC 2575764可免费查阅. PMID 18982173. We conclude that the findings of interest (i.e., hippocampus enlargement and amygdala volume loss) are not very stable across different samples of patients with ADHD and that the different and contradictory findings may be related to the different locations of alterations along the complex circuits responsible for the different symptoms of ADHD. 
  108. ^ Arnsten, Amy P.T. The Emerging Neurobiology of Attention Deficit Hyperactivity Disorder: The Key Role of the Prefrontal Association Cortex. Journal of Pediatrics. May 1, 2009, 154 (5): I–S43. PMC 2894421可免费查阅. PMID 20596295. doi:10.1016/j.jpeds.2009.01.018. The prefrontal association cortex plays a crucial role in regulating attention, behavior, and emotion, with the right hemisphere specialized for behavioral inhibition. 
  109. ^ Hodges, Holly; Fealko, Casey; Soares, Neelkamal. Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation. Translational Pediatrics. 2020, 9 (S1): S55–S65. ISSN 2224-4336. PMC 7082249可免费查阅. PMID 32206584. doi:10.21037/tp.2019.09.09可免费查阅. Table 1 :Changes in ASD criteria from the DSM-IV to DSM-5 
  110. ^ MacLennan, K.; O’Brien, S.; Tavassoli, T. In Our Own Words: The Complex Sensory Experiences of Autistic Adults. Journal of Autism and Developmental Disorders. 2022, 52 (7): 3061–3075. ISSN 0162-3257. PMC 9213348可免费查阅. PMID 34255236. doi:10.1007/s10803-021-05186-3 (英语). Difficulties with sensory input was described to impact mood, causing stress and agitation: 
  111. ^ Green, Shulamite A.; Hernandez, Leanna; Tottenham, Nim; Krasileva, Kate; Bookheimer, Susan Y.; Dapretto, Mirella. Neurobiology of Sensory Overresponsivity in Youth With Autism Spectrum Disorders. JAMA Psychiatry. 2015, 72 (8): 778–786. ISSN 2168-6238. PMC 4861140可免费查阅. PMID 26061819. doi:10.1001/jamapsychiatry.2015.0737. The authors found that youth with ASDs had overactivation in limbic areas, primary sensory cortices, and orbitofrontal cortex (OFC) compared with typically developing (TD) control subjects in response to mildly aversive visual and auditory stimuli." & "Finally, Green et al10 found that SOR symptoms correlated with hyperactivity in the amygdala and OFC.  
  112. ^ Ibrahim, Karim; Eilbott, Jeffrey A.; Ventola, Pamela; He, George; Pelphrey, Kevin A.; McCarthy, Gregory; Sukhodolsky, Denis G. Reduced Amygdala–Prefrontal Functional Connectivity in Children With Autism Spectrum Disorder and Co-occurring Disruptive Behavior. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. 2019, 4 (12): 1031–1041. ISSN 2451-9022. PMC 7173634可免费查阅. PMID 30979647. doi:10.1016/j.bpsc.2019.01.009. Children with ASD and disruptive behavior showed reduced amygdala–vlPFC connectivity compared with children with ASD without disruptive behavior. 
  113. ^ Fonagy, Peter; Luyten, Patrick; Allison, Elizabeth; Campbell, Chloe. What we have changed our minds about: Part 1. Borderline personality disorder as a limitation of resilience. Borderline Personality Disorder and Emotion Dysregulation. 2017, 4 (1): 11. ISSN 2051-6673. PMC 5389119可免费查阅. PMID 28413687. doi:10.1186/s40479-017-0061-9可免费查阅. In BPD, the appraisal mechanisms are at fault, in large part because of mentalizing difficulties (e.g. in the mistaken appraisal of threat at the moment of its presentation) or a breakdown in epistemic trust, which damages the capacity to relearn different ways of mentalizing – or appraising – situations (i.e. the inability to change our understanding of the threat after the event). 
  114. ^ Chapman, Jennifer; Jamil, Radia T.; Fleisher, Carl, Borderline Personality Disorder, StatPearls [Internet] (StatPearls Publishing), 2022-10-25 [2023-08-07], PMID 28613633, (原始内容存档于2023-03-17) (英语), There are many theories about the development of borderline personality disorder. In the mentalizing model of Peter Fonagy and Anthony Bateman, borderline personality disorder is the result of a lack of resilience against psychological stressors. In this framework, Fonagy and Bateman define resilience as the ability to generate adaptive re-appraisal of negative events or stressors;... 
  115. ^ Lazarus, Sophie A.; Choukas-Bradley, Sophia; Beeney, Joseph E.; Byrd, Amy L.; Vine, Vera; Stepp, Stephanie D. Too Much Too Soon?: Borderline Personality Disorder Symptoms and Romantic Relationships in Adolescent Girls. Journal of Abnormal Child Psychology. 2019, 47 (12): 1995–2005. ISSN 1573-2835. PMC 7045362可免费查阅. PMID 31240430. doi:10.1007/s10802-019-00570-1. Core symptoms that comprise the disorder are often explicitly interpersonal in nature (e.g., tumultuous romantic relationships and frantic efforts to avoid abandonment) or are expressed in reaction to interpersonal stressors (e.g., affective instability, paranoid ideation, suicidal behavior 
  116. ^ Nicol, Katie; Pope, Merrick; Sprengelmeyer, Reiner; Young, Andrew W.; Hall, Jeremy. Social Judgement in Borderline Personality Disorder. PLOS ONE. 2013-11-06, 8 (11): e73440. Bibcode:2013PLoSO...873440N. ISSN 1932-6203. PMC 3819347可免费查阅. PMID 24223110. doi:10.1371/journal.pone.0073440可免费查阅 (英语). Individuals with a diagnosis of BPD have difficulty making appropriate social judgements about others from their faces. Judging more faces as unapproachable and untrustworthy indicates that this group may have a heightened sensitivity to perceiving potential threat, and this should be considered in clinical management and treatment 
  117. ^ Balsis, Steve; Loehle-Conger, Evan; Busch, Alexander J.; Ungredda, Tatiana; Oltmanns, Thomas F. Self and informant report across the borderline personality disorder spectrum. Personality Disorders. 2018, 9 (5): 429–436. ISSN 1949-2723. PMC 6082732可免费查阅. PMID 28857585. doi:10.1037/per0000259. Individuals with BPD features often have distorted cognitions. Specifically, they often make simplified judgments about people and situations. 
  118. ^ Carpenter, Ryan W.; Trull, Timothy J. Components of emotion dysregulation in borderline personality disorder: a review. Current Psychiatry Reports. 2013, 15 (1): 335. ISSN 1535-1645. PMC 3973423可免费查阅. PMID 23250816. doi:10.1007/s11920-012-0335-2. Following Linehan’s biosocial model, we conceptualize emotion dysregulation in borderline personality disorder (BPD) as consisting of four components: emotion sensitivity, heightened and labile negative affect, a deficit of appropriate regulation strategies, and a surplus of maladaptive regulation strategies. 
  119. ^ Salgó, Ella; Szeghalmi, Liliána; Bajzát, Bettina; Berán, Eszter; Unoka, Zsolt. Emotion regulation, mindfulness, and self-compassion among patients with borderline personality disorder, compared to healthy control subjects. PLOS ONE. 2021-03-17, 16 (3): e0248409. Bibcode:2021PLoSO..1648409S. ISSN 1932-6203. PMC 7968662可免费查阅. PMID 33730065. doi:10.1371/journal.pone.0248409可免费查阅. In comparison to a healthy control group, BPD patients show deficits in the following areas: mindfulness, self-compassion and adaptive emotion-regulation strategies. 
  120. ^ Dixon-Gordon, Katherine L.; Peters, Jessica R.; Fertuck, Eric A.; Yen, Shirley. Emotional Processes in Borderline Personality Disorder: An Update for Clinical Practice. Journal of Psychotherapy Integration. 2017, 27 (4): 425–438. ISSN 1053-0479. PMC 5842953可免费查阅. PMID 29527105. doi:10.1037/int0000044. BPD features are also associated with self-criticism, thought suppression, avoidance, and alcohol use as strategies for regulating emotions (Aldao & Dixon-Gordon, 2014). 
  121. ^ Murray, Clara V.; Jacobs, Juno Irma-Louise; Rock, Adam J.; Clark, Gavin I. Attachment style, thought suppression, self-compassion and depression: Testing a serial mediation model. PLOS ONE. 2021, 16 (1): e0245056. Bibcode:2021PLoSO..1645056M. ISSN 1932-6203. PMC 7808589可免费查阅. PMID 33444358. doi:10.1371/journal.pone.0245056可免费查阅. Studies of the general population indicate that attempts to suppress thoughts typically result in a heightened accessibility of suppressed thoughts (e.g., a rebound effect) together with increases in emotional and physiological arousal [27]. 
  122. ^ 122.0 122.1 Lanctôt, Krista L.; Amatniek, Joan; Ancoli-Israel, Sonia; Arnold, Steven E.; Ballard, Clive; Cohen-Mansfield, Jiska; Ismail, Zahinoor; Lyketsos, Constantine; Miller, David S.; Musiek, Erik; Osorio, Ricardo S.; Rosenberg, Paul B.; Satlin, Andrew; Steffens, David; Tariot, Pierre. Neuropsychiatric signs and symptoms of Alzheimer's disease: New treatment paradigms. Alzheimer's & Dementia: Translational Research & Clinical Interventions. 2017, 3 (3): 440–449. PMC 5651439可免费查阅. PMID 29067350. doi:10.1016/j.trci.2017.07.001 (英语). ...NPSs based on neurobiological dimensions and behaviors rather than clinical syndromes, grouping them into five domains: (1) negative valence; (2) positive valence; (3) cognitive systems; (4) processes for social systems; and (5) arousal or regulatory systems [13]. Yet here, too, there is tremendous overlap. For example, impairment of cognitive systems may manifest in delusions, hallucinations, agitation, aggression, depression or dysphoria, anxiety, elation or euphoria, apathy, disinhibition, irritability, motor disturbance, sleep disorder, appetite disorder, aberrant vocalization, and ruminative, repetitive, and somatoform behaviors. 
  123. ^ Sjödahl Hammarlund, C., Westergren, A., Åström, I., Edberg, A. K., & Hagell, P. (2018). The Impact of Living with Parkinson's Disease: Balancing within a Web of Needs and Demands. Parkinson's disease, 2018, 4598651. https://doi.org/10.1155/2018/4598651.PMCID: PMC6087577.PMID: 30151098页面存档备份,存于互联网档案馆)."Psychological symptoms and mood swings were intertwined with cognitive and physical problems, adding to the struggle of managing the demands of everyday life. The participants felt depressed, low-spirited, and were worried about the future. Some held dark and destructive thoughts and considered intentionally ending their lives. In a previous study, suicidal and death ideation was present among one-third of persons with PD [25]. "
  124. ^ Jauhar, S., & Ritchie, S. (2010). Psychiatric and behavioural manifestations of Huntington's disease页面存档备份,存于互联网档案馆). Advances in Psychiatric Treatment, 16(3), 168-175. doi:10.1192/apt.bp.107.005371."Cognitive deficits combined with neuropsychiatric symptoms often cause the greatest difficulties in behaviour, for example anergia, lack of initiative, blunted affect, egocentricity, constant demands, irritation and threatening behaviour."
  125. ^ 125.0 125.1 De la Casa-Fages, Beatriz; Grandas, Francisco. Dopamine dysregulation syndrome and deep brain stimulation of the subthalamic nucleus in Parkinson's disease. Neurology Research International. 2011, 2011: 759895. ISSN 2090-1860. PMC 3216377可免费查阅. PMID 22135744. doi:10.1155/2011/759895可免费查阅. (d) impairment in social or occupational functioning: fights, violent behaviour, loss of friends, absence from work, loss of job, legal difficulties, arguments or difficulties with family; (e) development of hypomaniac, maniac, or cyclothymic affective syndrome in relation to DRT; (f) development of a withdrawal state characterized by dysphoria, depression, irritability, and anxiety on reducing the level of DRT; (g) duration of disturbance of at least 6 months." & "Patients with DDS develop an addictive pattern of DRT use, self-administering doses of dopaminergic drugs in excess of those required to control their motor symptoms. 
  126. ^ Drew, Daniel S; Muhammed, Kinan; Baig, Fahd; Kelly, Mark; Saleh, Youssuf; Sarangmat, Nagaraja; Okai, David; Hu, Michele; Manohar, Sanjay; Husain, Masud. Dopamine and reward hypersensitivity in Parkinson's disease with impulse control disorder. Brain. 2020-08-01, 143 (8): 2502–2518. ISSN 0006-8950. PMC 7447523可免费查阅. PMID 32761061. doi:10.1093/brain/awaa198. However, the findings argue against a simple relationship between dopamine level and reward sensitivity. Many PD+ICD patients were also found to experience behavioural apathy and impulsivity comorbidly, suggesting that aberrant reward sensitivity is just one component of a dysfunctional system which may incorporate functional changes in other neurotransmitter systems. 
  127. ^ 127.0 127.1 Chauhan, Pradip; Philip, Shalom Elsy; Chauhan, Girish; Mehra, Simmi; Mehra, S. The Anatomical Basis of Seizures. Epilepsy. 2022-04-02: 15–23 [2024-01-09]. ISBN 9780645332049. PMID 35605083. doi:10.36255/exon-publications-epilepsy-anatomical-basis. (原始内容存档于2023-10-21) (英语). Hyperexcitability of neurons and hypersynchrony of neural networks are the hallmarks of seizures." & "Seizures have been known to cause abnormal neurogenesis in the hippocampus and form faulty circuits that disrupt its function (11). 
  128. ^ Heilman, Kenneth M., Emotion and mood disorders associated with epilepsy, Disorders of Emotion in Neurologic Disease, Handbook of Clinical Neurology 183, Elsevier: 169–173, 2021 [2023-07-28], ISBN 978-0-12-822290-4, PMID 34389116, S2CID 237009046, doi:10.1016/b978-0-12-822290-4.00008-6 ."Epilepsy is a disorder characterized by recurrent seizures. Epilepsy can alter mood and emotions. Treatments for epilepsy can also alter mood and emotions."
  129. ^ Salpekar, Jay. Mood Disorders in Epilepsy. FOCUS. 2016, 14 (4): 465–472. ISSN 1541-4094. PMC 6519597可免费查阅. PMID 31975826. doi:10.1176/appi.focus.20160017. Mood disorder may represent the most common, and likely the most worrisome, psychiatric manifestation associated with epilepsy. Depression is frequently associated, although anxiety and bipolar disorder may also co-occur with epilepsy 
  130. ^ Hage, Mirella P.; Azar, Sami T. The Link between Thyroid Function and Depression. Journal of Thyroid Research. 2011-12-14, 2012: e590648. ISSN 2090-8067. PMC 3246784可免费查阅. PMID 22220285. doi:10.1155/2012/590648可免费查阅 (英语). Today, it is well recognized that disturbances in thyroid function may significantly affect mental status including emotion and cognition. Both excess and insufficient thyroid hormones can cause mood abnormalities including depression... 
  131. ^ Kuś, Aleksander; Kjaergaard, Alisa D.; Marouli, Eirini; Del Greco M., Fabiola; Sterenborg, Rosalie B.T.M.; Chaker, Layal; Peeters, Robin P.; Bednarczuk, Tomasz; Åsvold, Bjørn O.; Burgess, Stephen; Deloukas, Panos; Teumer, Alexander; Ellervik, Christina; Medici, Marco. Thyroid Function and Mood Disorders: A Mendelian Randomization Study. Thyroid. 2021, 31 (8): 1171–1181. ISSN 1050-7256. PMC 7612998可免费查阅. PMID 33899528. doi:10.1089/thy.2020.0884. Variations in normal-range TSH and FT4 levels have no effects on the risk of MDD and its subtypes, and neither on minor depressive symptoms. This indicates that depressive symptoms should not be attributed to minor variations in thyroid function 
  132. ^ Coccaro, Emil F. DSM-5 intermittent explosive disorder: Relationship with Disruptive Mood Dysregulation Disorder. Comprehensive Psychiatry. 2018, 84: 118–121. ISSN 0010-440X. PMID 29753187. S2CID 21679528. doi:10.1016/j.comppsych.2018.04.011. These data indicate that inter-outburst anger in those with IED is relatively brief and that such individuals do not generally display the kind of persistent anger that is a diagnostic feature of DMDD. 
  133. ^ Scott, K. M.; de Vries, Y. A.; Aguilar-Gaxiola, S.; Al-Hamzawi, A.; Alonso, J.; Bromet, E. J.; Bunting, B.; Caldas-de-Almeida, J. M.; Cía, A.; Florescu, S.; Gureje, O.; Hu, C.-Y.; Karam, E. G.; Karam, A.; Kawakami, N. Intermittent explosive disorder subtypes in the general population: association with comorbidity, impairment and suicidality. Epidemiology and Psychiatric Sciences. 2020-06-23, 29: e138. ISSN 2045-7979. PMC 7327434可免费查阅. PMID 32638683. doi:10.1017/S2045796020000517. A prominent bimodal conceptualisation of aggression classifies it as either: (i) spontaneous (referred to as reactive or impulsive aggression), or (ii) planned (referred to as proactive, premediated or instrumental aggression) (Babcock et al., 2014; Wrangham, 2018)." & "...DSM-5 is the occurrence of repeated episodes of impulsive aggression resulting in verbal or physical assaults or property destruction." & "DSM-IV criterion B for IED requires that the aggressiveness is ‘grossly out of proportion to any precipitating psychosocial stressor’. 
  134. ^ Tilghman-Osborne, Carlos; Cole, David A.; Felton, Julia W.; Ciesla, Jeffrey A. Relation of Guilt, Shame, Behavioral and Characterological Self-Blame to Depressive Symptoms in Adolescents Over Time. Journal of Social and Clinical Psychology. October 2008, 27 (8): 809–842. ISSN 0736-7236. PMC 4238306可免费查阅. PMID 25419043. doi:10.1521/jscp.2008.27.8.809. Results suggest that shame and CSB converge into a common construct, significantly related to depressive symptoms and cognitions. Convergence of guilt and BSB, however, was limited to particular pairs of measures. 
  135. ^ Seok, Ji-Woo; Cheong, Chaejoon. Gray Matter Deficits and Dysfunction in the Insula Among Individuals With Intermittent Explosive Disorder. Frontiers in Psychiatry. 2020-05-20, 11: 439. ISSN 1664-0640. PMC 7251158可免费查阅. PMID 32508687. doi:10.3389/fpsyt.2020.00439可免费查阅. We found hyperreactivity in brain regions involved in both, emotional expression, and regulation. 
  136. ^ Sengupta, A. The emergence of the menopause in India. Climacteric. January 2003, 6 (2): 92–95. ISSN 1369-7137. PMID 12841878. S2CID 22273563. doi:10.1080/cmt.6.2.92.95. 
  137. ^ Freeman, Ellen W.; Sammel, Mary D.; Lin, Hui; Nelson, Deborah B. Associations of Hormones and Menopausal Status With Depressed Mood in Women With No History of Depression. Archives of General Psychiatry. 2006-04-01, 63 (4): 375–382. ISSN 0003-990X. PMID 16585466. doi:10.1001/archpsyc.63.4.375可免费查阅 (英语). Transition to menopause and its changing hormonal milieu are strongly associated with new onset of depressed mood among women with no history of depression. 
  138. ^ Hankinson, S. E., & Tworoger, S. S. (2011). Assessment of the hormonal milieu. IARC scientific publications, (163), 199–214."The hormonal milieu has been hypothesized to play a role in a range of human diseases, and therefore has been a topic of much epidemiologic investigation. Hormones of particular interest include: sex steroids; growth hormones; insulin-like growth factors; stress hormones, such as cortisol; and hormones produced by the adipose tissue, termed adipokines."
  139. ^ Gava, Giulia; Orsili, Isabella; Alvisi, Stefania; Mancini, Ilaria; Seracchioli, Renato; Meriggiola, Maria Cristina. Cognition, Mood and Sleep in Menopausal Transition: The Role of Menopause Hormone Therapy. Medicina (Kaunas, Lithuania). 2019-10-01, 55 (10): 668. ISSN 1648-9144. PMC 6843314可免费查阅. PMID 31581598. doi:10.3390/medicina55100668可免费查阅. Sex steroids are able to modify several functions including behavior, cognition and memory, sleep, mood, pain and coordination, amongst others. 
  140. ^ Li, Zezhi; Ruan, Meihua; Chen, Jun; Fang, Yiru. Major Depressive Disorder: Advances in Neuroscience Research and Translational Applications. Neuroscience Bulletin. 2021-02-13, 37 (6): 863–880. ISSN 1673-7067. PMC 8192601可免费查阅. PMID 33582959. doi:10.1007/s12264-021-00638-3. Major depressive disorder (MDD) also referred to as depression, is one of the most severe and common psychiatric disorders across the world. It is characterized by persistent sadness, loss of interest or pleasure, low energy, worse appetite and sleep, and even suicide, disrupting daily activities and psychosocial functions. 
  141. ^ Benazzi, Franco. Various forms of depression. Dialogues in Clinical Neuroscience. 2006-06-30, 8 (2): 151–161. ISSN 1958-5969. PMC 3181770可免费查阅. PMID 16889102. doi:10.31887/dcns.2006.8.2/fbenazzi. The most common DSM-IV-TR manic/hypomanic symptoms of mixed depression are irritability, mental overactivity (flight of ideas, racing thoughts, crowded thoughts), and behavioral overactivity (psychomotor agitation, overtalkativeness). Different frequencies of mixed depression have been reported, which may be related to treated versus untreated samples... 
  142. ^ Busch, Fredric N. Anger and depression. Advances in Psychiatric Treatment. July 2009, 15 (4): 271–278. ISSN 1355-5146. doi:10.1192/apt.bp.107.004937可免费查阅 (英语). Anger in people with depression often stems from narcissistic vulnerability, a sensitivity to perceived or actual loss or rejection. These angry reactions cause intrapsychic conflicts through the onset of guilt and the fear that angry feelings will disrupt relationships 
  143. ^ Soomro, G. Mustafa. Obsessive compulsive disorder. BMJ Clinical Evidence. 2012-01-18, 2012: 1004. ISSN 1752-8526. PMC 3285220可免费查阅. PMID 22305974. Obsessive compulsive disorder (OCD) involves obsessions, compulsions, or both, that are not caused by drugs or by a physical disorder, and which cause significant personal distress or social dysfunction. 
  144. ^ Bowen, Rudy; Rahman, Hiba; Dong, Lisa Yue; Khalaj, Sara; Baetz, Marilyn; Peters, Evyn; Balbuena, Lloyd. Suicidality in People With Obsessive-Compulsive Symptoms or Personality Traits. Frontiers in Psychiatry. 2018, 9: 747. ISSN 1664-0640. PMC 6339952可免费查阅. PMID 30692943. doi:10.3389/fpsyt.2018.00747可免费查阅. Recurring thoughts of death and suicide (27) and aggression (28, 29) are common features of OCD. The most prevalent obsession was the fear of harming oneself in the DSM-IV field trials of 431 patients diagnosed with OCD (30, 31). 
  145. ^ Mason, Katherine A. Blenders, Hammers, and Knives: Postpartum Intrusive Thoughts and Unthinkable Motherhood. Anthropology and Humanism. 2022, 47 (1): 117–132. ISSN 1548-1409. PMC 9435669可免费查阅. PMID 36061237. doi:10.1111/anhu.12379. These thoughts can include horrific flashes of violence involving one’s baby and frequently lead to shame and fear on the mother’s part, but rarely result in real-world violence. 
  146. ^ Mann, Sukhmanjeet Kaur; Marwaha, Raman, Posttraumatic Stress Disorder, StatPearls (Treasure Island (FL): StatPearls Publishing), 2023 [2023-08-03], PMID 32644555, (原始内容存档于2023-03-14) ."The symptoms of PTSD include persistently re-experiencing the traumatic event, intrusive thoughts, nightmares, flashbacks, dissociation(detachment from oneself or reality), and intense negative emotional (sadness, guilt) and physiological reaction on being exposed to the traumatic reminder." & "Once people develop PTSD, the recurrent unbidden reliving of the trauma in visual images, emotional states, or nightmares produces a constant reexposure to the terror of the trauma" & "Negative alterations in mood and cognition that began or worsened after the traumatic event..."
  147. ^ van der Kolk, B. Posttraumatic stress disorder and the nature of trauma. Dialogues in Clinical Neuroscience. 2000, 2 (1): 7–22. ISSN 1294-8322. PMC 3181584可免费查阅. PMID 22034447. doi:10.31887/DCNS.2000.2.1/bvdkolk. The DSM-TV Field Trial8 demonstrated that it was not the prevalence of PTSD symptoms themselves, but depression, outbursts of anger, self-destructive behaviors, and feelings of shame, self-blame, and distrust that distinguished a treatment-seeking... 
  148. ^ Altshuler, Lori L.; Hendrick, Victoria; Cohen, Lee S. An Update on Mood and Anxiety Disorders During Pregnancy and the Postpartum Period. Primary Care Companion to the Journal of Clinical Psychiatry. 2000, 2 (6): 217–222. ISSN 1523-5998. PMC 181144可免费查阅. PMID 15014632. doi:10.4088/pcc.v02n0604. Marital discord, stressful life events, and ambivalence about the pregnancy are risk factors not only for depression during pregnancy but also for postpartum depression 
  149. ^ Theisler, Charles, Premenstrual Syndrome/Premenstrual Dysphoric Disorder, Adjuvant Medical Care (New York: CRC Press), 2022-05-17: 288–289 [2022-09-20], ISBN 9781003291381, doi:10.1201/b22898-286 
  150. ^ Kwan, Irene; Onwude, Joseph Loze. Premenstrual syndrome. BMJ Clinical Evidence. 2015-08-25, 2015: 0806. ISSN 1752-8526. PMC 4548199可免费查阅. PMID 26303988. Psychological symptoms of PMS include irritability, depression, crying/tearfulness, and anxiety. Physical symptoms of PMS include abdominal bloating, breast tenderness, and headaches. 
  151. ^ 151.0 151.1 Yonkers, Kimberly Ann; O'Brien, P. M. Shaughn; Eriksson, Elias. Premenstrual syndrome. Lancet. 2008-04-05, 371 (9619): 1200–1210. ISSN 1474-547X. PMC 3118460可免费查阅. PMID 18395582. doi:10.1016/S0140-6736(08)60527-9. The length of symptom expression varies between a few days and 2 weeks (figure 1). Symptoms often worsen substantially 6 days before, and peak at about 2 days before, menses start. " & “Such an enhanced tendency to have disphoria as a result of the effects of sex steroids on the brain might be heritable, as suggested by twin studies.56–58 Other possible risk factors for PMS are high body-mass index,59 stress,7 and traumatic events.60” “ & ”…various indices of serotonergic trans mission are reported to be aberrant in women with PMS.75,80–89” & “Another neurotransmitter that has been linked to PMS is the inhibitory aminoacid GABA. This theory gains support from an imaging study,90” 
  152. ^ Firoozi, Reihane; Kafi, Mousa; Salehi, Iraj; Shirmohammadi, Maryam. The Relationship between Severity of Premenstrual Syndrome and Psychiatric Symptoms. Iranian Journal of Psychiatry. 2012, 7 (1): 36–40. ISSN 2008-2215. PMC 3395966可免费查阅. PMID 23056116. Premenstrual syndrome (PMS) is characterized by a cluster of mild to severe physical or emotional symptoms that mainly begin during the luteal phase of the menstrual cycle. Symptoms should disappear within 4 days of the onset of menses and be severe enough to interfere with normal and daily function. The severe form of PMS is the Premenstrual Dysphoric Disorder (PMDD), which differs from PMS in respect to intensity of symptoms, predominance of mood symptoms, and the significant function impairment. (1, 2, 3). The most common symptoms are tension, irritability, hostility, depression, anxiety, mood swings, sleep changes, breast tenderness, and abdominal bloating (4). 
  153. ^ Wy, Tom Joshua P.; Saadabadi, Abdolreza, Schizoaffective Disorder, StatPearls (Treasure Island (FL): StatPearls Publishing), 2023 [2023-08-09], PMID 31082056, (原始内容存档于2023-03-14) ."Because of criteria that encompass both psychotic and mood symptoms, schizoaffective disorder is easy to mistake for other mental disorders."
  154. ^ Patel, Krishna R.; Cherian, Jessica; Gohil, Kunj; Atkinson, Dylan. Schizophrenia: overview and treatment options. P & T: A Peer-Reviewed Journal for Formulary Management. 2014, 39 (9): 638–645. ISSN 1052-1372. PMC 4159061可免费查阅. PMID 25210417. Schizophrenia is a complex, chronic mental health disorder characterized by an array of symptoms, including delusions, hallucinations, disorganized speech or behavior, and impaired cognitive ability. 
  155. ^ Upthegrove, Rachel; Marwaha, Steven; Birchwood, Max. Depression and Schizophrenia: Cause, Consequence or Trans-diagnostic Issue?. Schizophrenia Bulletin. 2016-07-15, 43 (2): 240–244 [2024-01-09]. ISSN 0586-7614. PMC 5605248可免费查阅. PMID 27421793. doi:10.1093/schbul/sbw097. (原始内容存档于2022-08-02) (英语). ...phenomenology of depression in schizophrenia, however, has not often been interrogated in phenomenological terms. Some of our recent evidence suggests self-stigma, shame, difficulty in regaining trust in ones own thoughts after recovery from delusional beliefs, and poor motivation are core features rather than other more “biological” symptoms such as early morning wakening, diurnal variation in mood or loss of appetite.14 
  156. ^ Yan, Wenhua; Ji, Weidong; Su, Chen; Yu, Yunhan; Yu, Xiaoman; Chen, Liangliang. Anger Experience and Anger Expression Through Drawing in Schizophrenia: An fNIRS Study. Frontiers in Psychology. 2021-09-01, 12: 721148. ISSN 1664-1078. PMC 8441178可免费查阅. PMID 34539522. doi:10.3389/fpsyg.2021.721148可免费查阅. Studying anger is important for schizophrenia because this disease is often associated with angry and hostile behavior (Volavka, 1999) 
  157. ^ Maurizio Pompili, M. D.; Andrea Fiorillo, M. D. Aggression and Impulsivity in Schizophrenia. Psychiatric Times. Vol 32 No 7. 2015-07-23, 32 (7) [2024-01-09]. (原始内容存档于2023-09-24) (英语). Although the neurobiological aspects of aggression in patients with schizophrenia are still not well understood, impulsivity and aggression may correlate with frontal and temporal brain abnormalities.2 Psychotic symptoms, such as delusions and hallucinations, with subsequent suspiciousness and hostility, may result in aggressive behavior. Or, aggression may be impulsive and caused by an environmental frustrating event. Patients may be more aggressive and violent during acute episodes.3 
  158. ^ Pinkham, Amy E.; Harvey, Philip D.; Penn, David L. Paranoid individuals with schizophrenia show greater social cognitive bias and worse social functioning than non-paranoid individuals with schizophrenia. Schizophrenia Research: Cognition. 2016, 3: 33–38. ISSN 2215-0013. PMC 5156478可免费查阅. PMID 27990352. doi:10.1016/j.scog.2015.11.002. Paranoia is the most commonly reported delusion among individuals diagnosed with schizophrenia spectrum illnesses (Bentall et al., 2009) 
  159. ^ Keen, Nadine; George, Darren; Scragg, Peter; Peters, Emmanuelle. The role of shame in people with a diagnosis of schizophrenia. British Journal of Clinical Psychology. 2017-01-19, 56 (2): 115–129. ISSN 0144-6657. PMID 28105670. S2CID 1453778. doi:10.1111/bjc.12125. Both the schizophrenia and depression groups exhibited higher levels of external shame, or seeing others as shaming, than the medical group 
  160. ^ Foster, P. M. (2017). The Real Guide to Teenage Depression: Handling Teen Depression A book about what matters most for teen boys and teen girls. Amerika Serikat: PatriceMFoster.com."Seasonal depression, or seasonal affective disorder, is a type of depression that affects a person every year around the same time. It is almost always observed during the winter months, particularly in places where it gets dark and ..."
  161. ^ Winkler, Dietmar; Pjrek, Edda; Konstantinidis, Anastasios; Praschak-Rieder, Nicole; Willeit, Matthäus; Stastny, Jürgen; Kasper, Siegfried. Anger attacks in seasonal affective disorder. The International Journal of Neuropsychopharmacology. 2005-07-08, 9 (2): 215–219 [2024-01-09]. ISSN 1461-1457. PMID 16004620. doi:10.1017/S1461145705005602可免费查阅. (原始内容存档于2022-03-14) (英语). SAD patients were also more likely to report a larger number of accompanying symptoms during the anger attacks, suggesting that they experience the anger attacks as particularly intense. 
  162. ^ Basco, M. R. (2015). The Bipolar Workbook: Tools for Controlling Your Mood Swings. Amerika Serikat: Guilford Publications."Seasonal Mood Swings Sometimes mood swings occur at predictable times. Common examples are depressions that occur during the winter months and manias that occur in the spring. In this case the shifting seasons can serve as triggers for ..."
  163. ^ Razali, Nur Atikah; Mohd Daud, Tuti Iryani; Woon, Luke Sy-Cherng; Mohamed Saini, Suriati; Muhammad, Noor Azimah; Sharip, Shalisah. Case report: Bipolar disorder in 48,XXYY syndrome. Frontiers in Psychiatry. 2023-01-11, 13. ISSN 1664-0640. PMC 9874087可免费查阅. PMID 36713919. doi:10.3389/fpsyt.2022.1080698可免费查阅. 48,XXYY is one of the most under-studied and rare types of sex chromosome aneuploidies (SCAs). In male births, 48,XXYY incidence occurs with an estimated prevalence of 1 in 18,000–40,000 (1). The SCAs can influence the neurodevelopment of an individual and are associated with impairment in executive function, verbal skills, working memory, sustained attention, mental flexibility, and inhibition by altering the basic differentiation process of the neurons, encoding proteins, and synaptic transmission (2). 
  164. ^ Tartaglia, Nicole; Davis, Shanlee; Hench, Alison; Nimishakavi, Sheela; Beauregard, Renee; Reynolds, Ann; Fenton, Laura; Albrecht, Lindsey; Ross, Judith; Visootsak, Jeannie; Hansen, Robin; Hagerman, Randi. A new look at XXYY syndrome: medical and psychological features. American Journal of Medical Genetics. Part A. 2008-06-15, 146A (12): 1509–1522. ISSN 1552-4833. PMC 3056496可免费查阅. PMID 18481271. doi:10.1002/ajmg.a.32366. Behavioral and psychiatric symptoms including hyperactivity, attention problems, impulsivity, aggression, mood instability, and “autistic-like” behaviors have also been described [Schlegel et al., 1965; Sorensen et al., 1978; Fryns et al., 1995; Hagerman, 1999]. 
  165. ^ Sekhon, Sandeep; Gupta, Vikas, Mood Disorder, StatPearls (Treasure Island (FL): StatPearls Publishing), 2023 [2023-08-13], PMID 32644337, (原始内容存档于2023-03-06), Neurotransmitters that play an important function in mood disorders are serotonin and...." & "Stressful life changes (death of significant other, parents, siblings, etc.) traumatic events and childhood abuse have been found to be major risk factors for the development of mood disorder later on in life.... 
  166. ^ Peterson, Christopher; Park, Nansook; Seligman, Martin E. P. Greater strengths of character and recovery from illness. The Journal of Positive Psychology. 2006, 1 (1): 17–26 [2024-01-09]. ISSN 1743-9760. S2CID 143660204. doi:10.1080/17439760500372739. (原始内容存档于2023-10-26) (英语). A retrospective web-based study of 2087 adults found small but reliable associations between a history of physical illness and the character strengths of appreciation of beauty, bravery, curiosity, fairness, forgiveness, gratitude, humor, kindness, love of learning, and spirituality. 
  167. ^ Xie, Huiting. Strengths-based approach for mental health recovery. Iranian Journal of Psychiatry and Behavioral Sciences. 2013, 7 (2): 5–10. ISSN 1735-8639. PMC 3939995可免费查阅. PMID 24644504. Findings from the literature have shown that individuals’ strengths are related to mental health improvement. These strengths can bring about positive outcomes in various aspects of life as satisfaction, functional status or health status, and have the potential to aid mental health recovery. 
  168. ^ Crowe, Marie. Recovery and mood disorders. Journal of Psychiatric and Mental Health Nursing. 2017, 24 (8): 561–562 [2024-01-09]. PMID 28802085. doi:10.1111/jpm.12418可免费查阅. (原始内容存档于2023-10-21) (英语). Personal recovery involves developing the skills to live well and is a very individual process that the consumer can undertake on their own, with peers and family or through disorder-specific psychotherapies. Personal recovery can be contrasted with clinical and functional recovery and refers to the process of individual psychological adaptation to the disorder rather than the reduction of psychiatric symptoms, relapse prevention and addressing functional impairment (Tse et al., 2014) 
  169. ^ Chan, Kevin Ka Shing; Yip, Charles Chiu Hung; Tsui, Jack Ka Chun. Self-Compassion Mediates the Impact of Family Support on Clinical and Personal Recovery Among People with Mental Illness. Mindfulness. 2023-02-27, 14 (3): 720–731. ISSN 1868-8527. S2CID 257243921. doi:10.1007/s12671-023-02088-6可免费查阅. Our findings indicate that people with mental illness who receive greater support from the family are better able to have self-caring attitudes...They may also have more positive experiences and perceptions of recovery and attain greater levels of life satisfaction and enjoyment. 
  170. ^ Concerto, Carmen; Rodolico, Alessandro; Mineo, Ludovico; Ciancio, Alessia; Marano, Leonardo; Romano, Carla Benedicta; Scavo, Elisa Vita; Spigarelli, Riccardo; Fusar-Poli, Laura; Furnari, Rosaria; Petralia, Antonino; Signorelli, Maria Salvina. Exploring Personal Recovery in Schizophrenia: The Role of Mentalization. Journal of Clinical Medicine. 2023-06-16, 12 (12): 4090. ISSN 2077-0383. PMC 10299717可免费查阅. PMID 37373783. doi:10.3390/jcm12124090可免费查阅. It encompasses various elements, such as spirituality, empowerment, embracing the illness actively, finding hope, restoring a positive identity, creating meaning in life, combating stigma, taking charge of one’s own life, and cultivating supportive relationships [4]. PR concerns the individuals’ perceived capacity to manage mental illness, their sense of purpose, and their confidence in their ability to lead a fulfilling life, irrespective of the disorder’s severity [5] 
  171. ^ O’Keeffe, Donal; Sheridan, Ann; Kelly, Aine; Doyle, Roisin; Madigan, Kevin; Lawlor, Elizabeth; Clarke, Mary. A qualitative study exploring personal recovery meaning and the potential influence of clinical recovery status on this meaning 20 years after a first episode psychosis. Social Psychiatry and Psychiatric Epidemiology. 2021-06-18, 57 (3): 473–483. ISSN 0933-7954. PMC 8934321可免费查阅. PMID 34143247. doi:10.1007/s00127-021-02121-w. For many, recovery is their preferred term to describe the continuing experience of living with, managing, or overcoming mental health difficulties [5]. 
  172. ^ Gilbert, Paul. Overcoming Depression. Basic Books. 1999: 63. ISBN 978-0-465-01508-5. 
  173. ^ Goleman, pp. 73-4
  174. ^ Terence Real. I Don't Want to Talk About It. Newleaf. 1997: 279. ISBN 978-0717127108. . 
  175. ^ Elfrey, Mary Kate; Ziegelstein, Roy C. The "inactivity trap". General Hospital Psychiatry. 2009, 31 (4): 303–305. ISSN 1873-7714. PMC 2752478可免费查阅. PMID 19555788. doi:10.1016/j.genhosppsych.2009.05.001. It is the unfortunate result of the bidirectional relationship between depression and inactivity: depression leads to a reduced activity level, and depressive symptoms then become more severe. Berlin, et al. 
  176. ^ Mazzucchelli, Trevor G.; Kane, Robert T.; Rees, Clare S. Behavioral activation interventions for well-being: A meta-analysis. The Journal of Positive Psychology. 2010, 5 (2): 105–121. ISSN 1743-9760. PMC 2882847可免费查阅. PMID 20539837. doi:10.1080/17439760903569154. By intentional activity, the authors meant discrete actions or practices that individuals must choose to engage in and that require some effort to enact. This might include adopting new behaviors such as an exercise program, changing one's cognitive attitudes or practices such as practicing forgiveness, or volitional activity such as pursuing personal goals. 
  177. ^ Vidal-Ribas, Pablo; Brotman, Melissa A.; Valdivieso, Isabel; Leibenluft, Ellen; Stringaris, Argyris. The Status of Irritability in Psychiatry: A Conceptual and Quantitative Review. Journal of the American Academy of Child and Adolescent Psychiatry. 2016, 55 (7): 556–570. ISSN 1527-5418. PMC 4927461可免费查阅. PMID 27343883. doi:10.1016/j.jaac.2016.04.014. Irritability describes proneness to anger... Irritability is a mood in the sense that young people can remain in states of proneness to anger for very long times and sometimes for no apparent reason, as discussed below... irritability shares a negative valence with anxiety and depression but denotes approach and is therefore linked to elation in mania. 
  178. ^ Elices, Matilde; Soler, Joaquim; Feliu-Soler, Albert; Carmona, Cristina; Tiana, Thais; Pascual, Juan C.; García-Palacios, Azucena; Álvarez, Enric. Combining emotion regulation and mindfulness skills for preventing depression relapse: a randomized-controlled study. Borderline Personality Disorder and Emotion Dysregulation. 2017, 4 (1): 13. ISSN 2051-6673. PMC 5497384可免费查阅. PMID 28690851. doi:10.1186/s40479-017-0064-6可免费查阅. The first session provided an overview of the training goals and an explanation of the differences between the three states of mind (i.e., emotional mind, rational mind and wise mind)...In DBT, ER skills training is oriented to encouraging behavioral activation (BA) by training patients in “opposite action” (OA) to depressive symptoms. 
  179. ^ Frazier, Savannah N.; Vela, Jamie. Dialectical behavior therapy for the treatment of anger and aggressive behavior: A review. Aggression and Violent Behavior. 2014, 19 (2): 156–163. ISSN 1359-1789. doi:10.1016/j.avb.2014.02.001. DBT was designed to treat emotional dysregulation (i.e., mood disturbance, affective liability, uncontrolled anger) and the behavioral difficulties..." & "Research has shown that there are potentially clinically significant results when using DBT to treat anger and aggression in various samples. Findings from this review suggest that treatments, even when modified show a positive impact on the reduction of anger and aggressive behaviors. 
  180. ^ Jones, Brett D. M.; Umer, Madeha; Kittur, Mary E.; Finkelstein, Ofer; Xue, Siqi; Dimick, Mikaela K.; Ortiz, Abigail; Goldstein, Benjamin I.; Mulsant, Benoit H.; Husain, Muhammad I. A systematic review on the effectiveness of dialectical behavior therapy for improving mood symptoms in bipolar disorders. International Journal of Bipolar Disorders. 2023-02-05, 11 (1): 6. ISSN 2194-7511. PMC 9899872可免费查阅. PMID 36739574. doi:10.1186/s40345-023-00288-6可免费查阅. While they also experienced more improvement in depressive symptoms and in their ability to control emotional states, the difference between the two groups did not reach statistical significance. 
  181. ^ Renna, Megan E.; Fresco, David M.; Mennin, Douglas S. Emotion Regulation Therapy and Its Potential Role in the Treatment of Chronic Stress-Related Pathology Across Disorders. Chronic Stress (Thousand Oaks, Calif.). 2020, 4: 2470547020905787. ISSN 2470-5470. PMC 7219947可免费查阅. PMID 32440604. doi:10.1177/2470547020905787. ...first phase of treatment focusing on increasing momentary clarity of motivational responses during emotional episodes and the cultivation of mindful emotion regulation skills with the goal of promoting counteractive responding to intense emotional experiences. Skills are presented in a specific order focusing on less cognitively elaborative skills (e.g., attention regulation skills) followed by more cognitively elaborative skills (e.g., metacognitive regulation skills). 
  182. ^ Frank, Ellen; Swartz, Holly A; Kupfer, David J. Interpersonal and social rhythm therapy: managing the chaos of bipolar disorder. Biological Psychiatry. 2000-09-15, 48 (6): 593–604. ISSN 0006-3223. PMID 11018230. S2CID 7926489. doi:10.1016/S0006-3223(00)00969-0. Interpersonal and social rhythm therapy is a manual-based psychotherapy (E. Frank et al, unpublished data, 1999) focusing on 1) the link between mood and life events, 2) the importance of maintaining regular daily rhythms as elucidated by the SRM, 3) the identification and management of potential precipitants of rhythm dysregulation with special attention to interpersonal triggers, 4). 
  183. ^ Boland, Elaine M.; Bender, Rachel E.; Alloy, Lauren B.; Conner, Bradley T.; Labelle, Denise R.; Abramson, Lyn Y. Life events and social rhythms in bipolar spectrum disorders: an examination of social rhythm sensitivity. Journal of Affective Disorders. 2012, 139 (3): 264–272. ISSN 1573-2517. PMC 3368102可免费查阅. PMID 22381951. doi:10.1016/j.jad.2012.01.038. Shen, Alloy, Abramson, and Sylvia provided further evidence of social rhythm irregularities in bipolar spectrum disorder (2008). In a sample of 414 undergraduates, those diagnosed with either cyclothymia or bipolar II disorder reported significantly fewer regular activities than normal controls. 
  184. ^ Bullock, Ben; Judd, Fiona; Murray, Greg. Social rhythms and vulnerability to bipolar disorder. Journal of Affective Disorders. 2011, 135 (1–3): 384–388. ISSN 0165-0327. PMID 21708409. doi:10.1016/j.jad.2011.06.006. As well as being strongly associated with the clinical manifestation of BD, reduced social rhythmicity has also been demonstrated in some populations with increased risk for BD. 
  185. ^ Murray, Greg; Gottlieb, John; Swartz, Holly A. Maintaining Daily Routines to Stabilize Mood: Theory, Data, and Potential Intervention for Circadian Consequences of COVID-19. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie. 2021, 66 (1): 9–13. ISSN 1497-0015. PMC 7890582可免费查阅. PMID 32909832. doi:10.1177/0706743720957825. More than 30 years ago, it was observed that major life events associated with mood disorder (divorce, loss of job, life transitions) are not just psychologically challenging but also cause significant change to daily routines.10 Unemployment, for example, may be associated not just with challenges to self-esteem but also with less regular bed-, wake- and mealtimes. This instability of daily routines, in turn, may have circadian impact through weakened zeitgeber information. 
  186. ^ Bai, Zhenggang; Luo, Shiga; Zhang, Luyao; Wu, Sijie; Chi, Iris. Acceptance and Commitment Therapy (ACT) to reduce depression: A systematic review and meta-analysis. Journal of Affective Disorders. 2020, 260: 728–737. ISSN 0165-0327. PMID 31563072. S2CID 203466750. doi:10.1016/j.jad.2019.09.040. ...To foster psychological flexibility, according to Grégoire et al. (2017), ACT relies on six interrelated and overlapping processes: acceptance (i.e., willingness to open fully to unwanted experiences such as difficult thoughts, memories, or emotions), contact with the present moment (i.e., being mindful and aware of one's experiences), self as context (i.e., maintaining perspective about oneself within one's experiences), cognitive defusion (i.e., being able to step back from unwanted experiences without getting stuck in them), committed action (i.e., engaging in actions that move toward important aspects of life), and values (i.e., staying connected to personal values or areas of life that are important).