Background Despite common dissatisfaction with the syndromic heterogeneity of major depression, investigations into its symptom structure are scarce. Self-worthlessness/inadequacy is a distinctive and consistent symptom of major depression across cultures. Aims We investigated whether self-worthlessness is associated with self-blaming attribution-related symptoms or is instead an expression of reduced positive feelings overall, as would be implied by reduced positive affect accounts of depression. Methods 44,161 undergraduate students in Study 1, and 215 patients with current Major Depressive Disorder (MDD) and 237 age-matched healthy control participants in Study 2 completed the well-validated Symptom Check List-90. Depression-relevant items were used to construct regularized partial correlation networks with bootstrap estimates of network parameter variability. Results Worthlessness co-occurred more strongly with other symptoms linked to self-blaming attributions (hopelessness, and self-blame), displaying a combined edge weight with these symptoms which was significantly stronger than the edge weight representing its connection with reduced positive emotion symptoms (such as reduced pleasure/interest/motivation, difference in edge weight sum in Study 1 = 2.95, in Study 2 = 1.64; 95% confidence intervals: Study 1: 2.6–3.4; Study 2: 0.02–3.5; Bonferroni-corrected p < 0.05). Conclusions This confirms the prediction of the revised learned helplessness model that worthlessness is most strongly linked to hopelessness and self-blame. In contrast, we did not find a strong and direct link between anhedonia items and a reduction in self-worth in either study. This supports worthlessness as a primary symptom rather than resulting from reduced positive affect.
The aim of the study was to create an understanding of the different dimensions of subjective ill health through discovering the essence of ill health, based on the individual experience. A philosophical, phenomenological method has been employed, and in-depth interviews were conducted with 25 individuals. The findings showed that the essence of ill health is powerlessness, which is made by a self-image of worthlessness, a sense of being imprisoned in one's life situation, and emotional suffering. The individual views her/himself as worthless, based on societal norms, attitudes and human models. Incapability and a sense of worthlessness cause the individual to distrust her/himself and others. She/he is imprisoned in her/his own life situation due to limited choices and ability. Such a situation gives rise to apathy. Destructive feelings of alienation, anguish, shame and guilt take over, and the individual's autonomy and existence are threatened. Stigmatization results from suffering and a sense of worthlessness. The informants compensated for their vulnerability by means of human support, intimacy with others, a society adapted to disability, living in the present and awareness.
OBJECTIVE: To establish which symptoms of major depressive episode (MDE) predict postremission suicide attempts in complicated single-episode cases. METHOD: Using the nationally representative two-wave National Epidemiologic Survey on Alcohol and Related Conditions data set, we identified wave 1 lifetime single-episode MDE cases in which the episode remitted by the beginning of the wave 2 three-year follow-up period (N = 2791). The analytic sample was further limited to 'complicated' cases (N = 1872) known to have elevated suicide attempt rates, defined as having two or more of the following: suicidal ideation, marked role impairment, feeling worthless, psychomotor retardation, and prolonged (>6 months) duration. RESULTS: Logistic regression analyses showed that, after controlling for wave 1 suicide attempt which significantly predicted postremission suicide attempt (OR = 10.0), the additional complicated symptom 'feelings of worthlessness' during the wave 1 index episode significantly and very substantially predicted postremission suicide attempt (OR = 6.96). Neither wave 1 psychomotor retardation nor wave 1 suicidal ideation nor any of the other wave 1 depressive symptoms were significant predictors of wave 2 suicide attempt. CONCLUSION: Among depressive symptoms during an MDE, feelings of worthlessness is the only significant indicator of elevated risk of suicide attempt after the episode has remitted, beyond previous suicide attempts.
BACKGROUND: The prevalent co-occurrence between parental stress and depression has been established prior to and during the COVID-19 pandemic outbreak. However, no studies to date have identified the connections through which these symptom domains interact with each other to emerge into a complex and detrimental mental health state, along with the plausible mechanistic variables that may play key roles in maintaining parental stress and depression. The aim of this research is to uncover these interactions in a period where parents experience heightened demands and stress because of the strict social distancing protocols. METHODS: Network analysis is utilized to examine parental stress and depressive symptoms during the COVID-19 pandemic in a large cross-sectional study (N = 2,868) of parents. Two graphical Gaussian graphical network models were estimated, one in which only parental stress and depression symptoms were included, and another in which several mechanistic variables were added. RESULTS: Expected influence and bridge expected influence revealed that feeling worthless was the most influential node in the symptoms network and bridged the two psychological states. Among the mechanistic variables, worry and rumination was specifically relevant in the depressive cluster of symptoms, and self-criticism was connected to both constructs. CONCLUSION: The study displays that the co-occurrence of parental stress and depression has specific pathways, was manifested through feelings of worthlessness, and has specific patterns of connection to important mechanisms of psychopathology. The results are of utility when aiming to avoid the constellation of co-occurring parental stress and depressive symptoms during the pandemic.
BACKGROUND: Cognitive models predict that vulnerability to major depressive disorder (MDD) is due to a bias to blame oneself for failure in a global way resulting in excessive self-blaming emotions, decreased self-worth, hopelessness and depressed mood. Clinical studies comparing the consistency and coherence of these symptoms in order to probe the predictions of the model are lacking. METHODS: 132 patients with remitted MDD and no relevant lifetime co-morbid axis-I disorders were assessed using a phenomenological psychopathology-based interview (AMDP) including novel items to assess moral emotions (n=94 patients) and the structured clinical interview-I for DSM-IV-TR. Cluster analysis was employed to identify symptom coherence for the most severe episode. RESULTS: Feelings of inadequacy, depressed mood, and hopelessness emerged as the most closely co-occurring and consistent symptoms (≥90% of patients). Self-blaming emotions occurred in most patients (>80%) with self-disgust/contempt being more frequent than guilt, followed by shame. Anger or disgust towards others was experienced by only 26% of patients. 85% of patients reported feelings of inadequacy and self-blaming emotions as the most bothering symptoms compared with 10% being more distressed by negative emotions towards others. LIMITATIONS: Symptom assessment was retrospective, but this is unlikely to have biased patients towards particular emotions relative to others. CONCLUSIONS: As predicted, feelings of inadequacy and hopelessness were part of the core depressive syndrome, closely co-occurring with depressed mood. Self-blaming emotions were highly frequent and bothering but not restricted to guilt. This calls for a refined assessment of self-blaming emotions to improve the diagnosis and stratification of MDD.
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This book critically examines the socio-cultural role of achievement within education, arguing that the increasingly global demand for measurable standards of academic achievement is an expression of
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Fifteen years ago, radiofrequency ablation of the saphenous vein was introduced as a new and minimally invasive modality for the treatment of superficial venous insufficiency. Three years later, it was followed by endovenous laser ablation. These procedures have revolutionized the treatment of superficial venous insufficiency and have caused a dramatic shift from a highly invasive and morbid inpatient procedure, to a minimally invasive and ambulatory office procedure. Soon after their introduction, a new clinical entity was identified: endothermal heat-induced thrombosis (EHIT). This terminology, a classification system, and treatment strategies were introduced by Kabnick in 2005. Subsequently, advances in technique, along with the discovery of associated risk factors and a better understanding of the pathophysiologic process of endothermal coagulum formation, have reduced the current incidence of EHIT classes 2-4 to between 1%-2%. Still, a paucity of data exists regarding the true incidence of clinically significant pulmonary embolism secondary to EHIT. The authors believe that the rate is less than 0.01%. Furthermore, successful thermal saphenous ablation efficacy in the perioperative period approaches 99%. Despite these excellent numbers, the standard of care is to obtain a duplex ultrasound to evaluate for the presence of EHIT within the first 1-2 weeks post endovenous thermal ablation. Given this information, the authors believe that performing duplex ultrasound in the perioperative period is wasteful and an inefficacious use of limited health-care resources. Thus, the authors advocate against routine duplex to evaluate treatment efficacy and EHIT presence during the perioperative period in asymptomatic patients.
This paper investigates the price discovery relationships between FTT Token, issued by the cryptocurrency exchange FTX, and a set of assets and liabilities held by FTX amid a period of catastrophic financial decline by applying novel information flow measurement techniques. Results indicate that during key phases associated with the collapse of FTX, FTT Token had an informational lead over multiple assets, including cryptocurrencies such as Ethereum. Furthermore, we identify significant interactions between the FTT Token and both Robinhood shares and the token Serum, raising concerns about the direct influence of permissionless, technically valueless tokens on other assets and the potential challenges to market stability and investor protection. Our findings underscore the need for stronger policy-making, regulatory, and ethical considerations in cryptocurrency markets.
Abstract Introduced as a quantum extension of Maxwell's classical theory, quantum electrodynamic (QED) has been the first example of a quantum field theory (QFT). Eventually, QFT has become the framework for the discussion of all fundamental interactions at the microscopic scale except, possibly, gravity. More surprisingly, it has also provided a framework for the understanding of second order phase transitions in statistical mechanics. In fact, as hopefully this work illustrates, QFT is the natural framework for the discussion of most systems involving an infinite number of degrees of freedom with local couplings. These systems range from cold Bose gases at the condensation temperature (about ten nanokelvin) to conventional phase transitions (from a few degrees to several hundred) and high energy particle physics up to a TeV, altogether more than twenty orders of magnitude in the energy scale. Therefore, although excellent textbooks about QFT had already been published, I thought, many years ago, that it might not be completely worthless to present a work in which the strong formal relations between particle physics and the theory of critical phenomena are systematically emphasized. This option explains some of the choices made in the presentation. A formulation in terms of field integrals has been adopted to study the properties of QFT. The language of partition and correlation functions has been used throughout, even in applications of QFT to particle physics. Renormalization and renormalization group (RG) properties are systematically discussed. The notion of effective field theory (EFT) and the emergence of renormalizable theories are described. The consequences for fine-tuning and triviality issue are emphasized. This fifth edition has been updated and fully revised.
So‐called highly ‘evaluative’ personality judgments (e.g. describing someone as exceptional, odd, or vile,) are an integral component of people's daily judgments of themselves and others. However, little is known about the conceptual structure, psychological function, and personality‐relevance of these kinds of attribution. Two studies were conducted to explore the internal (i.e. implicit) and external (i.e. self‐report) structure of highly evaluative terms. Factor analyses of semantic‐similarity sortings and self‐reports on several representative samples of highly evaluative personality adjectives yielded internal and external structures that were very similar. Both types of structure included five dimensions representing distinction, worthlessness, depravity, unconventionality, and stupidity. The robustness of the uncovered dimensions across the two studies suggests that typically excluded highly evaluative personality terms, far from being behaviorally ambiguous and psychologically uninformative, allude to meaningful dispositions that people both implicitly understand and possess to different degrees. These findings also suggest that highly evaluative personality judgments are organized around the basic domains of morality (i.e. depravity), power (distinction and worthlessness), peculiarity (unconventionality), and intelligence (stupidity). We discuss the implications of our findings for the study of self‐ and other‐esteem processes, personality perception, and the Big Seven factor model of personality. Copyright © 2002 John Wiley & Sons, Ltd.
PURPOSE: To determine the level of anti-fat bias in health professionals specializing in obesity and identify personal characteristics that correlate with both implicit and explicit bias. RESEARCH METHODS AND PROCEDURES: The Implicit Associations Test (IAT) and a self-report questionnaire assessing explicit attitudes, personal experiences with obesity, and demographic characteristics was administered to clinicians and researchers attending the opening session of an international obesity conference (N = 389). The IAT was used to assess overall implicit weight bias (associating "obese people" and "thin people" with "good" vs. "bad") and three ranges of stereotypes: lazy-motivated, smart-stupid, and valuable-worthless. The questionnaire assessed explicit bias on the same dimensions, along with personal and professional experiences with obesity. RESULTS: Health professionals exhibited a significant pro-thin, anti-fat implicit bias on the IAT. In addition, the subjects significantly endorsed the implicit stereotypes of lazy, stupid, and worthless using the IAT. Level of bias was associated with several personal characteristics. Characteristics significantly predictive of lower levels of implicit anti-fat bias include being male, older, having a positive emotional outlook on life, weighing more, having friends who are obese, and indicating an understanding of the experience of obesity. DISCUSSION: Even professionals whose careers emphasize research or the clinical management of obesity show very strong weight bias, indicating pervasive and powerful stigma. Understanding the extent of anti-fat bias and the personal characteristics associated with it will aid in developing intervention strategies to ameliorate these damaging attitudes.
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The distinction between reactive mesothelial cells (RMC), malignant mesothelioma (MM), and metastatic adenocarcinoma (ACA) in pleural effusions may be impossible based on morphology alone. E-cadherin, N-cadherin, and calretinin are newly described immunocytochemical markers which can potentially be utilized for facilitating this distinction. E-cadherin and N-cadherin are calcium-dependent intercellular adhesion molecules expressed in epithelial cells and mesenchymal/mesothelial cells, respectively. The differential expression of E-cadherins in epithelial cells and N-cadherins in mesothelial cells has been utilized to differentiate reactive mesothelial cells, MMs and ACAs. Calretinin is a calcium-binding protein within the family of EF-hand proteins. It is abundantly expressed in peripheral and central nervous tissues, and has been shown to consistently immunoreact with mesothelial cells. We studied cell block sections from 77 pleural effusions (22 RMC, 26 MM, and 29 ACA) to investigate the potential immunocytochemical use of anti-E-cadherin, anti-N-cadherin, and anti-calretinin antibodies for differentiating between RMC, MM, and ACA in pleural effusions. A modified avidin-biotin peroxidase complex (ABC) method was used. E-cadherin immunostaining was observed in 14% of RMC, 46% of MMs, and 97% of ACAs. A distinct membrane staining pattern was seen in ACAs. The pattern of staining was cytoplasmic in all reactive RMC and varied from membrane to cytoplasmic in MMs. Anti-N-cadherin immunoreacted with 77% of RMC, 35% of MMs, and 48% of ACAs. Twenty-seven percent of RMC, 58% of MMs, and 31% of ACAs immunoreacted with anti-calretinin. Based on these results, we conclude that anti-E-cadherin is a potentially useful marker in the distinction of ACA cells from RMC. However, it is not as useful for the distinction of ACA and MM. Anti-N-cadherin and anti-calretinin did not reliably distinguish between reactive mesothelial, MM, and ACA cells in pleural effusions.