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This work investigates the perception of eight different mental disorders within the Stereotype Content Model (SCM). The presented study (N = 297) includes a sample representative for the German population in terms of age and gender. Results reveal distinct warmth and competence evaluations for people with different mental disorders, e.g., people with alcohol dependence were seen as less warm and less competent than people with depression or phobia. Future directions and practical implications are discussed.

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INTRODUCTION: Recent research has focused on the relationship between shame and psychopathology. It has been shown that shame predicts depressive and anxious symptoms, as well as substance abuse, non-suicidal self-injury, and aggression. However, it remains unclear, how one emotion can influence psychiatric symptoms of such a broad spectrum. It is assumed that as shame is such an intense and painful emotion, it needs to be coped with and that the coping-strategies influence the effect shame has on psychopathologies. The Compass of Shame Scale (CoSS) is a questionnaire measuring 4 shame coping-strategies (withdrawal, avoidance, attacking others, and attacking the self) and the ability to adapt to shame. METHODS: In this article, a German version of the CoSS (CoSS-d) is validated in a community sample and is used to predict psychopathology in a clinical and non-clinical sample. RESULTS: The CoSS-d shows a 4-factorial structure, good reliability, and validity and is stable over time. The 4 poles of shame-coping show an impact on depressive symptoms, aggression, and self-injury. CONCLUSION: The CoSS serves as a reliable and unique measurement of trait shame-coping. Shame-coping styles are associated with psychopathology.

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A large body of research revealed that shame is associated with adaptive and maladaptive correlates. The aim of this work was to validate a new dimensional instrument (SHAME), which was developed to disentangle adaptive and maladaptive dimensions of shame proneness. Confirmatory factor analyses supported the three-factorial structure (bodily, cognitive, and existential shame) in American (n = 502) and German (n = 496) community samples, using invariance testing. Bifactor model analyses exhibited distinct associations of adaptive (bodily and cognitive shame) and maladaptive (existential shame) dimensions of shame with psychopathology and social functioning. Network analyses highlighted the role of existential shame in psychopathology, especially for a clinical sample of patients with Borderline Personality Disorder (n = 92). By placing shame pronenesss into a network of similar and dissimilar constructs, the current findings serve as a foundation for drawing conclusions about the adaptive and maladaptive nature of shame.

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Shame is related to several mental disorders. We assume that facets of shame, namely bodily, cognitive and existential shame, may occur in typical patterns in mental and personality disorders. An excessive level of shame may lead to psychopathological symptoms. However, a lack of shame may also lead to distress, for instance as it may facilitate violation of social norms and thus may promote interpersonal problems. In this study we investigated facets of shame in females suffering from various mental disorders and personality disorders presumably associated with specific aspects of shame. Women suffering from borderline personality disorder (BPD, n=92), attention deficit hyperactivity disorder (ADHD, n=86), major depressive disorder (MDD, n=17), social anxiety disorder (SAD, n=33), and a community sample (COM, n=290) completed the SHAME questionnaire, which is a newly developed instrument to assess adaptive and maladaptive aspects of shame. BPD patients reported the highest level of existential shame compared to all other groups. Compared to the controls, SAD patients displayed stronger bodily and cognitive shame, and ADHD showed lower bodily shame. As assumed, specific aspects of shame were found in different patient groups. It may be important to specifically address these specific aspects of shame in psychotherapy.

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OBJECTIVE: Tobacco smoking and ADHD frequently co-occur. So far, the bulk of research on the ADHD-smoking comorbidity has been done in children with ADHD and nonclinical adult samples. To assess smoking habits in adults with ADHD, the authors used the Fagerström test for nicotine dependence (FTND). METHOD: In 60 adult outpatients, with an ADHD diagnosis according to Diagnostic and statistical manual of mental disorders (4th ed.; DSM-IV) criteria and 60 age- and gender-matched controls, smoking habits were assessed with the FTND. RESULTS: The authors replicated earlier findings in children confirming a higher rate of smokers in the ADHD group. The adult smokers with ADHD suffered from more severe nicotine dependence and smoked significantly more often when being sick. Females with ADHD smoked significantly more often and started smoking at an earlier age. CONCLUSION: Applying the FTND, the authors confirmed a high rate of highly dependent smokers among adult ADHD patients. The authors' findings point to a higher vulnerability for the development of nicotine dependence in women with ADHD.

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Social anxiety is associated with an attentional bias toward angry and fearful faces, along with an enhanced processing of faces per se. However, little is known about the processing of gaze direction, a subtle but important social cue. Participants with high or low social anxiety (HSA/LSA) observed eye pairs with direct or averted gaze while subjective ratings and event-related potentials (ERPs) were measured. Behaviorally, all participants rated averted gaze as more unpleasant than direct gaze. Neurally, only HSA participants showed a trend for higher P100 amplitudes to averted gaze and significantly enhanced processing at late latencies (Late positive potential [LPP]), indicative of a specific processing bias for averted gaze. Furthermore, HSA individuals showed enhanced processing of both direct and averted gaze relative to the LSA group at intermediate latencies (Early posterior negativity [EPN]). Both general and specific attentional biases play a role in social anxiety. Averted gaze--potential sign of disinterest--deserves more attention in the attentional bias literature.

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Some evidence points to an increased rate of cluster B and C personality disorders (PDs) in adult ADHD patients. In order to assess axis II disorders comprehensively we used the diagnostic instrument of the WHO. In sixty adult out-patients with ADHD according to DSM-IV criteria PDs were assessed with the International PD Examination (IPDE) and severity of childhood ADHD with the Wender-Utah-Rating Scale (WURS). We found at least one PD in 25% of cases. Cluster C PDs were most common (36.6%) followed by Cluster B (23.3%) and A (8.3%). Avoidant (21.7%) and borderline (18.3%) were the most frequent single PD entities. ADHD patients with PD suffered from significantly more severe childhood ADHD compared to those without co-occurring PD. Applying the IPDE we confirmed a high number of PDs among adult ADHD patients. Our findings point to a higher vulnerability for the development of PDs in patients with severe childhood ADHD.

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BACKGROUND: In this study we compared the effect of different emotion regulation strategies on positive and negative emotions in patients with borderline personality disorder. METHODS: Emotion regulation strategies were a distracting task, individual positive memory imagery, individual soothing imagery, and a neutral comparison condition. During two separate sessions, 17 participants watched either neutral or negative movie segments before using these strategies. RESULTS: All three strategies influenced emotions into a favorable direction as compared to the neutral comparison condition. The positive memory image increased positive emotions significantly stronger than counting colors and distracting. DISCUSSION: Different strategies seem to have similar effects in decreasing negative emotions. Positive emotions may be affected in particular by positive and soothing imagery techniques.

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Emotional dysregulation is hypothesized to be a core feature of borderline personality disorder (BPD). In this study, we investigated the course of emotions in response to standardized emotion inductions in BPD. A total of 26 female BPD patients, 28 matched healthy control subjects, and 15 female patients with major depressive disorder listened to short stories inducing an angry, joyful, or neutral mood. Before and immediately after each story as well as 3 and 6 minutes later, participants rated their current anger, joy, anxiety, shame, and sadness. All 3 groups showed the same increase and decrease of emotions. However, strong group differences in the general level of all negative emotions occurred. While sadness was stronger both in BPD and major depressive disorder as compared with healthy controls, all other negative emotions were significantly increased in BPD only independent of comorbid depression. Extreme negative affectivity may be a more appropriate description of BPD-related emotional problems than emotional hyperreactivity.

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Adult attention deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) share several clinical features, e.g. emotional lability and impulsivity. This study aimed to delineate differences and similarities between ADHD and BPD with respect to borderline typical symptomatology and gender specifics. Borderline symptomatology was assessed in 60 adult patients with ADHD with the borderline symptom list (BSL) and compared to both 60 gender- and age-matched BPD patients and control subjects. The BSL is a standardized instrument including 95 items on 7 subscales (self-perception, affect regulation, self-destruction, dysphoria, loneliness, intrusions and hostility). Adult ADHD patients showed significantly higher BSL total scores and all of the seven subscales compared to healthy controls (p < 0.001) but lower scores than BPD patients (p < 0.001). With respect to the seven subscales, the largest differences between ADHD and BPD patients were found with respect to self-destruction (d = 1.12) and affect dysregulation (d = 0.90), whereas the smallest difference was found with respect to loneliness (d = 0.36). In females, the BSL subscales "loneliness" and "hostility" did not differentiate between BPD and ADHD. Borderline typical symptoms are common in adult patients with ADHD but seem to be less pronounced than in patients with BPD. Females with ADHD and BPD share more clinical features than males. However, symptoms of self-destruction and affect dysregulation appear to be more severe in BPD patients.

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Borderline personality disorder (BPD) is characterized by emotional dysregulation including strong emotional reactions to emotional stimuli and a slow return to baseline emotions. Difficulties controlling anger are particularly prominent in BPD. To experimentally test emotional dysregulation with a special focus on anger, we investigated whether a standardized anger induction by a short story caused stronger and prolonged anger reactions in women with BPD (n=27) as compared to female healthy controls (n=26) and whether other emotions were affected by the anger induction. Although the anger reaction was not stronger in the BPD group, it was significantly prolonged. The BPD group showed also stronger negative emotions over the whole experiment. The study is the first to demonstrate prolonged anger reactions in BPD patients in an experimental setting.

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Attention deficit hyperactivity disorder (ADHD) is a serious mental disorder that often persists in adulthood. In a pilot study, a structured skills training group program for adult ADHD led to significant symptomatic improvements. The present study evaluated the program's effectiveness, feasibility, and patient acceptability in a multicenter setting. Seventy-two adult ADHD patients were assigned to 13 two-hour weekly sessions at 4 different therapy sites. The therapy was well tolerated and led to significant improvements of ADHD, depressive symptoms, and personal health status (p < 0.001). The factors treatment site and medication did not contribute to the overall improvement. Patients regarded the program topics "behavioral analyses," "mindfulness," and "emotion regulation" as the most helpful. In this multicenter study, the therapy program showed therapist-independent effects and seemed to be disorder-specific. This warrants the effort of organizing further controlled studies.

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