Nomophobia: Dependency on virtual environments or social phobia?

Background

The increasing use of new technologies and virtual communication involving personal computers (PCs), tablets and mobile phones are causing changes in individuals’ daily habits and behavior. We report the case of an individual with social phobia who developed a dependency on communication through virtual environments (i.e., nomophobia), and used a PC as a form of relating to the outside world to reduce stress and to avoid direct social relations. Nomophobia refers to the discomfort or anxiety caused by the non-availability of a mobile phone, PC or any another virtual communication device. Social phobia is described as an anxiety disorder of chronic evolution.

Objective

To study nomophobia as a manifest behavior that might serve as an indication of a possible anxiety disorder.

Methodology

The treatment consisted of the use of medication, cognitive-behavioral therapy (CBT) and the application of evaluation tools (interviews, scales, inventories and questionnaires).

Results

The individual responded satisfactorily to medication and CBT treatment, which reduced his time using the PC and increased his exposure to real-life situations.

Conclusion

Nomophobic behavior produces changes in daily habits and can reveal other aspects to be investigated, such as the presence of comorbid mental disorders.     

Screening for principal versus comorbid conditions in psychiatric outpatients with the Psychiatric Diagnostic Screening Questionnaire.

In examining the performance of screening scales, a distinction should be made between principal and additional diagnoses. The Psychiatric Diagnostic Screening Questionnaire (PDSQ) is a brief, psychometrically strong self-report scale designed to screen for the most common Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) Axis I disorders encountered in outpatient mental health settings. In the present report, the authors compared the performance of the PDSQ in identifying principal and comorbid disorders. Seven hundred ninety-nine psychiatric outpatients completed the PDSQ and were interviewed with the Structured Clinical Interview for DSM-IV. The sensitivity and negative predictive values of the PDSQ subscales were similar for principal and additional diagnoses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Item response theory analysis of diagnostic criteria for alcohol and cannabis use disorders in adolescents: Implications for DSM-V.

Item response theory (IRT) has advantages over classical test theory in evaluating diagnostic criteria. In this study, the authors used IRT to characterize the psychometric properties of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV; American Psychiatric Association, 1994) alcohol and cannabis use disorder symptoms among 472 clinical adolescents. For both substances, DSM-IV symptoms fit a model specifying a unidimensional latent trait of problem severity. Threshold (severity) parameters did not distinguish abuse and dependence symptoms. Abuse symptoms of legal problems and hazardous use, and dependence symptoms of tolerance, unsuccessful attempts to quit, and physical-psychological problems, showed relatively poor discrimination of problem severity. There were gender differences in thresholds for hazardous use, legal problems, and physical-psychological problems. The results illustrate limitations of DSM-IV criteria for alcohol and cannabis use disorders when applied to adolescents. The development process for the fifth edition (DSM-V) should be informed by statistical models such as those used in this study. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reliability of DSM-IV anxiety and mood disorders: Implications for the classification of emotional disorders.

The reliability of current and lifetime Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) anxiety and mood disorders was examined in 362 outpatients who underwent 2 independent administrations of the Anxiety Disorders Interview Schedule for DSM-IV: Lifetime version (ADIS-IV–L). Good to excellent reliability was obtained for the majority of DSM-IV categories. For many disorders, a common source of unreliability was disagreements on whether constituent symptoms were sufficient in number, severity, or duration to meet DSM-IV diagnostic criteria. These analyses also highlighted potential boundary problems for some disorders (e.g., generalized anxiety disorder and major depressive disorder). Analyses of ADIS-IV–L clinical ratings (0–8 scales) indicated favorable interrater agreement for the dimensional features of DSM-IV anxiety and mood disorders. The findings are discussed in regard to their implications for the classification of emotional disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of What works for whom? A critical review of psychotherapy research.

Reviews the book, What works for whom? A critical review of psychotherapy research by Anthony Roth and Peter Fonagy (see record 1996-98691-000). This book presents a comprehensive review of the status of psychotherapy research. The authors look at the evidence dealing with both efficacy and effectiveness of psychotherapy for the more common DSM-IV disorders. All of the chapters are geared toward the goal of providing the practitioner with a list of treatments for which there is empirical support. The reviewer notes that the amount of information covered in this text is extensive and provides sufficient evidence for the efficacy of psychotherapy for many of the diagnostic categories. Despite an overemphasis on cognitive/behavioral treatments, the authors do present the best of the research in psychodynamic therapy. The reviewer recommends this volume to both to researchers and practitioners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

DSM-IV criteria for generalized anxiety disorder in older adults: Distinguishing the worried from the well.

This study compared 36 older adults with generalized anxiety disorder (GAD), 22 older adults with subsyndromal anxiety symptoms, and 32 normal controls on criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) for GAD. GAD patients reported more frequent and uncontrollable worry, somewhat different worry content, higher prevalence of most associated symptoms, and more distress or impairment than the subsyndromal group or normal controls. Individuals with subsyndromal anxiety reported more excessive, frequent, and uncontrollable worry than asymptomatic individuals, along with more sleep disturbance, fatigue, and distress or impairment. Results indicate that the key features of late-life GAD are distress and impairment, frequency and uncontrollability of worry, muscle tension, and sleep disturbance and that clinicians treating older adults with GAD should monitor and treat residual symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How should we revise diagnostic criteria for substance use disorders in the DSM-V?

This article reviews literature on the validity and performance characteristics of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) diagnostic criteria for substance use disorders (SUDs) and recommends changes in these criteria that should be considered for the next edition of the DSM (DSM-V). Substantial data indicate that DSM-IV substance abuse and substance dependence are not distinct categories and that SUD criteria are best modeled as reflecting a unidimensional continuum of substance-problem severity. The conceptually and empirically problematic substance abuse diagnosis should be abandoned in the DSM-V, with substance dependence defined by a single set of criteria. Data also indicate that various individual SUD criteria should be revised, dropped, or considered for inclusion in the DSM-V. The DSM-V should provide a framework that allows the integration of categorical and dimensional approaches to diagnosis. Important areas for further research are noted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relational diagnosis--A brief historical overview: Comment on the special section.

Various mental health disciplines have attempted to bring the significance of relational interaction and dysfunction to the attention of the entire field. Over the past 20 years, these efforts have been initiated and developed both independently and collaboratively, and although progress has been made, results have been incremental and insufficient. The inclusion of the Global Assessment of Relational Functioning (GARF) as an option on Axis IV of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) was a milestone but fell short of recognition as a major disorder on Axis I. This article summarizes and provides a background for the historical efforts that have occurred and suggests possibilities for greater prominence of relational disorders in DSM-V. Renewed interest by coalitions of researchers and practitioners in recent years indicates a positive prognosis for greater acceptance of a classification of couple and family dysfunction in the mental health professions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward a cognitive process model of ethnic/racial biases in clinical judgment.

The purpose of the present article is to discuss approaches to the development of cognitive process models of misdiagnosis of African Americans, with particular emphasis on structured clinical interviews. Two basic approaches to cognitive process models are discussed. The first is cognitive bias based on prototype models of information processing. The second approach involves using the structured clinical interview to see how and when the decision-making process may be flawed, or where cognitive shifts are made in considering one diagnosis over another. Although routine training in structured clinical interviews may nullify cognitive biases associated with clinician judgment, it does not address cultural biases in the diagnostic system. It is concluded that a comprehensive approach to training in clinical decision making for mental health professionals is needed which include courses in the administration of the Structured Clinical Interview for DSM-IV, sociocultural case formulation, and cross-cultural sensitivity in making psychodiagnostic judgments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Axis I and II comorbidity in adults with ADHD.

Ongoing debate over the validity of the attention-deficit/hyperactivity disorder (ADHD) construct in adulthood is fueled in part by uncertainty regarding implications of potentially extensive yet incompletely described comorbid Axis I and II psychopathology. Three hundred sixty-three adults ages 18 to 37 completed semistructured clinical interviews; informants were also interviewed, and best estimate diagnoses were obtained. Results were as follows: First, ADHD combined type (ADHD-C) had an excess of externalizing and internalizing Axis I disorders, suggesting a gradient-of-severity relationship between it and ADHD inattentive type (ADHD-I). Second, ADHD-C and ADHD-I did not differ in frequency of Axis II disorders. Third, however, ADHD overall was associated with increased rates of Axis II disorders, compared with rates in non-ADHD control participants, including both Cluster B (primarily borderline personality disorder) and Cluster C disorders. Fourth, ADHD incrementally accounted for clinician-rated global assessment of functioning scores above and beyond comorbid conditions or symptoms on either Axis I or Axis II. Results further inform nosology of ADHD in adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)