Papers by Vladan Starcevic
Australian and New Zealand Journal of Psychiatry, Apr 1, 2012
Psychiatry Research-neuroimaging, Mar 1, 2021
The aims of this study were to investigate the prevalence of anxiety and related disorders (e.g.,... more The aims of this study were to investigate the prevalence of anxiety and related disorders (e.g., obsessive-compulsive disorder [OCD]) and major depressive disorder (MDD) at any time during pregnancy and during each pregnancy trimester and ascertain the proportions of women with an onset of these disorders during pregnancy. Several questionnaires and the Mini International Neuropsychiatric Interview were administered to 200 women at each pregnancy trimester. Complete data were obtained from 148 participants. The most prevalent anxiety disorder at any time during pregnancy was panic disorder (PD), followed by generalised anxiety disorder (GAD) and OCD. Unlike all the other disorders, the prevalence rates of OCD increased steadily from the first to the third trimester. Approximately one half of women with OCD and about one third of women with PD, GAD and MDD at any time during pregnancy had an onset of these disorders during pregnancy. Pregnancy may be a risk factor for an onset of OCD and to a lesser extent, for an onset of PD, GAD and MDD. Absence of remission of OCD during pregnancy despite treatment may suggest treatment resistance of OCD at this time. These findings have implications for recognition, prevention and treatment of anxiety disorders during pregnancy.
Australian and New Zealand Journal of Psychiatry, May 1, 2013
Journal of Psychiatric Research, Nov 1, 2021
Cyberchondria is a clinical entity of excessive and repetitive online health-related searches, as... more Cyberchondria is a clinical entity of excessive and repetitive online health-related searches, associated with health anxiety, obsessive-compulsive symptoms and intolerance of uncertainty. Its relationships with depressive and somatic symptoms have not yet received much attention. The purpose of this study was to examine the individual and comparative effects of several psychopathology constructs on the severity of cyberchondria. Through an online platform, participants (N = 749) completed specific self-report measures assessing the severity of cyberchondria, anxiety, intolerance of uncertainty, depressive, somatic, and obsessive-compulsive symptoms. Standard and hierarchical multiple regression analyses were used to assess how well the independent variables influenced the levels of cyberchondria, before and after controlling for age, education, and sex. When measures of all constructs were included in the analysis, all were significant predictors of cyberchondria levels, except for anxiety. Health anxiety made the strongest contribution. When age, education and sex were controlled for, all measures except for anxiety were also significant predictors of cyberchondria severity. Our study confirms that health anxiety, obsessive-compulsive symptoms and intolerance of uncertainty are all associated with cyberchondria severity, with health anxiety making the strongest unique contribution. Depression and somatic symptoms also predicted cyberchondria severity. These findings have important implications for research and clinical practice.
Current Opinion in Psychiatry, 2019
Purpose of review The purpose of this article is to review the most recent literature on psychoti... more Purpose of review The purpose of this article is to review the most recent literature on psychotic symptoms in borderline personality disorder (BPD). Recent findings Both auditory hallucinations and delusional ideation (especially paranoid delusions) are relatively common in individuals with BPD. It is still difficult to distinguish these and related phenomena in BPD from the corresponding experiences in psychotic disorders and schizophrenia, despite numerous attempts to do so. The terminology introduced to help with this effort has not been particularly useful. The presence of auditory hallucinations may affect the course of BPD negatively. Psychotic symptoms in BPD seem to be significantly related to the context (usually stressful events) and appear or intensify in response to situational crisis. The role of certain co-occurring disorders in increasing the risk of psychotic symptoms in BPD remains uncertain.
Journal of Obsessive-Compulsive and Related Disorders, 2023
European Psychiatry, Mar 1, 2015
ABSTRACT Introduction. Dysphoria is a very complex emotional state that seems to be present in ma... more ABSTRACT Introduction. Dysphoria is a very complex emotional state that seems to be present in many psychiatric disorders (especially in BPD), but whose psychopathological core is still surrounded by a halo of vagueness, so that measuring its construct empirically is difficult and suitable tests to do that do not exist in Italy. Objectives. To analyze the psychometric properties of the Italian version of the Nepean Dysphoria Scale (NDS; Berle & Starcevic, 2012), a self-report questionnaire that measures dysphoria, reflecting its multidimensional nature. Aims. To validate the Italian version of the NDS for a future use in routine clinical practice and, more generally, to assess dysphoria in a more conceptually coherent way. Methods. The NDS was administered to 132 university students, along with other conceptually similar (Beck Depression Inventory II, Dysfunctional Attitude Scale – Form A and Toronto Alexithymia Scale) and conceptually distinct (Anxiety Sensitivity Index – 3) instruments. Then, its characteristics (internal consistency, factor structure, convergent and divergent validity) were examined, comparing them with those of the original version. Results. The 22-item NDS demonstrated excellent internal consistency (alpha = 0.949). A four-factor solution was confirmed, with factors pertaining to irritability, discontent, surrender and interpersonal resentment. There were medium to strong correlations with the Beck Depression Inventory II, and weaker but still significant correlations with Dysfunctional Attitude Scale – Form A, Toronto Alexithymia Scale and Anxiety Sensitivity Index – 3. Conclusions. The Italian version of the NDS shows good psychometric properties, maintaining a high equivalence with the original version. Further research on clinical samples is needed.
European Psychiatry, Apr 1, 2017
Australian and New Zealand Journal of Psychiatry, Oct 16, 2020
Background: There is a growing realisation that anxiety symptoms and disorders during pregnancy a... more Background: There is a growing realisation that anxiety symptoms and disorders during pregnancy are associated with various negative outcomes. The aims of this study were to identify latent classes of anxiety symptom trajectories during pregnancy, compare anxiety levels between pregnancy trimesters and ascertain the predictors of anxiety symptom trajectories. Methods: Two hundred pregnant women in their first trimester who attended obstetric clinics at the local hospital were recruited. Three self-report questionnaires assessing anxiety levels were administered at three time points during pregnancy. Latent class growth analysis was used to identify anxiety symptom trajectories, and logistic regression analysis was performed to ascertain the predictors of latent class membership. Results: Data for analyses were available for 188 women. Two anxiety symptom trajectories were identified: a 'highanxiety' trajectory (13.3% of participating women) and 'low-anxiety' trajectory (86.7%). This finding was consistent across all the anxiety measures used in the study. Overall, anxiety levels gradually decreased during pregnancy, with a significant decrease between the first and second trimesters on some measures. Past mental disorders and significant stressors in the preceding 6 months predicted membership in the 'high-anxiety' trajectory group. Conclusions: These findings support an early assessment of anxiety in pregnant women. If untreated, a high level of anxiety in the first trimester is likely to persist throughout pregnancy, although it may decrease somewhat. An early recognition of pathological anxiety during pregnancy allows its timely treatment and prevention of unfavourable outcomes.
General Hospital Psychiatry, 2020
Addictive Behaviors, Dec 1, 2022
Australian and New Zealand Journal of Psychiatry, Apr 16, 2014
Objectives: This study aims to examine the characteristics of obsessive compulsive disorder (OCD)... more Objectives: This study aims to examine the characteristics of obsessive compulsive disorder (OCD) associated with high levels of schizotypy. Methods: Using the Schizotypal Personality Questionnaire (SPQ) with 177 individuals with OCD, patients with OCD and high levels of schizotypy (OCD-HS) were compared to patients with OCD and low levels of schizotypy (OCD-LS) on a range of clinical characteristics. Self-report and clinician-administered instruments were used. Results were adjusted for the severity of OCD symptoms, age, marital status and comorbidity using logistic regression. Results: Patients with OCD-HS were younger and less likely to have been married. OCD-HS was associated with higher rates of symmetry/order obsessions, ordering/arranging compulsions, checking compulsions, co-occurring major depression, post-traumatic stress disorder, substance use disorders and greater general psychopathology. Previously reported associations, such as higher total scores on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) were not significant when adjusted for differences in demographic variables and comorbidity. Conclusions: Patients with OCD-HS were associated with specific OCD symptoms and comorbid conditions and may warrant a specific treatment approach.
Current Psychology, May 13, 2022
Cyberchondria refers to excessive and repeated online health-related searching, which is associat... more Cyberchondria refers to excessive and repeated online health-related searching, which is associated with increased distress and anxiety. The Cyberchondria Severity Scale (CSS) is the most widely used measure for assessment of cyberchondria, and its shortened version (CSS-12) has recently been developed. The aim of the present study was to develop the Spanish version of the CSS-12 and test its psychometric properties. A community sample of 432 Spanish-speaking adults (67.6% women; mean age = 36.00 ± 15.22 years) completed the Spanish translation of CSS-12 along with measures of health anxiety, obsessivecompulsive, anxiety and depressive symptoms. The Spanish version of the CSS-12 comprises a general cyberchondria factor and four specific factors ('excessiveness', 'compulsion', 'distress', and 'reassurance'). Multi-group confirmatory factor analysis indicated measurement invariance across gender groups. Internal consistency values for the total score and subscales were good to excellent. The CSS-12 showed strong correlations with health anxiety, and moderate to low correlations with anxiety, obsessive-compulsive and depressive symptoms, supporting the convergent and divergent validity of the CSS-12, respectively. In conclusion, these results show that the CSS-12 is a valid and reliable tool for measuring cyberchondria in both genders in the general Spanish population.
European Psychiatry, Mar 1, 2016
IntroductionOver the past decade, emotion dysregulation has become a very popular term in the psy... more IntroductionOver the past decade, emotion dysregulation has become a very popular term in the psychiatric and clinical psychology literature and it has been described as a key component in a range of mental disorders. For this reason, it has been recently called the “hallmark of psychopathology” (Beauchaine et al., 2007). However, many issues make this concept controversial.ObjectivesTo explore emotion dysregulation, focusing on problems related to its definition, meanings and role in many psychiatric disorders.AimsTo clarify the psychopathological core of emotion dysregulation and to discuss potential implications for clinical practice.MethodsA literature review was carried out by examining articles published in English between January 2003 and June 2015. A search of the databases PubMed, PsycINFO, Science Direct, Medline, EMBASE and Google Scholar was performed to identify the relevant papers.ResultsAlthough, there is no agreement about the definition of emotion dysregulation, the following five overlapping, not mutually exclusive dimensions were identified: decreased emotional awareness, inadequate emotional reactivity, intense experience and expression of emotions, emotional rigidity and cognitive reappraisal difficulty. These dimensions characterise a number of psychiatric disorders in different proportions, with borderline personality disorder and eating disorders seemingly more affected than other conditions.ConclusionsThis review highlights a discrepancy between the widespread clinical use of emotion dysregulation and inadequate conceptual status of this construct. Better understanding of the various dimensions of emotion dysregulation has implications for treatment. Future research needs to address emotion dysregulation in all its multifaceted complexity.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Comprehensive Psychiatry, Aug 1, 2022
Official Journal of the Italian Society of Psychopathology, May 23, 2016
Objectives Dysphoria is a complex emotional state that is prevalent in the clinical setting but v... more Objectives Dysphoria is a complex emotional state that is prevalent in the clinical setting but very vague in its precise meaning. The aim of this study was to develop and validate the Italian version of the Nepean Dysphoria Scale (NDS-I), a self-report questionnaire developed to measure the severity of dysphoria. Methods The NDS was translated into Italian and subjected to a crosscultural adaptation process according to standard guidelines. The scale was then administered to 132 psychology students, together with other conceptually similar (Beck Depression Inventory II, Dysfunctional Attitude Scale-Form A, Toronto Alexithymia Scale) and conceptually different (Anxiety Sensitivity Index-3) instruments. Results The NDS-I demonstrated excellent internal consistency (Cronbach α = 0.949). Factor analysis confirmed four factors related to irritability, discontent, interpersonal resentment and surrender. There were medium to strong correlations between the scores on the NDS-I and its subscales and the scores on the Beck Depression Inventory II, and weak to medium but still significant correlations with the scores on the other instruments. Conclusions The NDS-I has good psychometric properties, thus supporting the validity of the original scale. Further research in clinical samples is needed to test it as a tool for routine clinical practice.
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Papers by Vladan Starcevic