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情绪波动

情绪波動是指情绪的極端或突然變化，[1]或具有破壞性。

與雙極性情感障礙和循環性精神障礙相比，情緒波動的圖形比較

當情緒波動嚴重時，可能會被歸類為精神疾病的一部分，例如躁鬱症。不穩定和破壞性的情緒波動是其典型特徵。 [2]

情绪波動可以在任何時間、任何地點發生 [3]。情绪波動可能會持續幾天，甚至幾周[4]。

此外，情緒波動不僅在躁狂和憂鬱之間波動，而且在某些情況下還涉及焦慮。[5][6]

術語

“情緒波動”、“情緒不穩定”、“情感激動”或“情緒激動”的定義通常相似，都描述情緒或情感的波動或振盪。但每個術語都有獨特的特徵，用於描述特定的現象或振盪模式，儘管有些人將它們視為同義詞。[7][8]與情緒或影響不同，[9]

情緒與不知道原因（不知道）的情緒反應有關。[10][11]由於情緒的動態變化，長時間的情緒模式通常是不穩定的，[12][13]或不穩定，也稱為情緒正常。[14]雖然情緒波動這個術語並不具體，但它可以用來描述情緒在特定時期立即從正價下降到負價（沒有基線延遲）的模式。[15]並且通常也具有非週期性模式。[16][17]描是因為情緒動態受到各種因素的影響，這些因素可以放大或減少波動，[18]例如期望何時成為現實例如期望何時成為現實。[19]

概述

情緒波動可能隨時隨地發生，從雙極性情感障礙的微觀波動到劇烈波動不等,[20] 因此可以追溯到圍繞自尊的正常鬥爭，透過循環性精神障礙，直至憂鬱症的連續統一體。[21] 然而，大多數人的情緒波動仍處於輕度至中度的情緒起伏範圍內。[22] 雙極性情緒波動的持續時間也各不相同。它們可能會持續幾個小時（超快）或持續數天（超快）：臨床醫生堅持認為，只有當連續四天的輕躁狂或連續七天的躁狂發生時，才可以診斷雙相情感障礙。[23]在這種情況下，情緒波動可能會持續數天，甚至幾週：這些發作可能包括憂鬱和欣快感之間的快速交替。[24]

特徵

Man running a marathon
精力充沛的人
Man sleep on the desk
情緒低落的人
  • 在不知道原因或外界刺激的情況下情緒上下變化，[25]有不同程度、持續時間和頻率，從情緒高漲（快樂、高漲、惱怒）到情緒低落（悲傷、沮喪）。[26]
  • 有時它是混合的，[27] 躁狂和憂鬱症狀的組合[28] 或類似的苦樂參半的經歷持續一天。[29][30]
  • 正常人的情緒波動表現為輕度至中度的「氣候變遷」。[7][31] 因此，除非發生中等程度或以上，否則有些人需要較高的情緒智商[32]才能辨識自己的情緒變化。[33]
  • 精神疾病中的情緒波動可以簡單地用基於情緒動態（表徵波動的模式）的廣義複雜性來描述[34] 如強度（輕度、中度、重度）、持續時間（天、週、年） 、平均情緒和其他特徵，如：[35][36]
  1. 循環性精神障礙的情緒波動：情緒波動在 2 年內或更長時間內間歇性、非週期性地發生，程度中等且頻繁。[37] 其特徵是與焦慮、持續性、快速轉變、強烈、衝動並存，[38] 因對外部刺激的敏感性和反應性而增強。[39]
  2. 雙極性情感障礙 II的情緒波動：間歇性、[40] 輕躁症（嚴重程度）發作持續 4 天，[28] 憂鬱症發作持續數週，[41] 有時在發作之間出現中等程度的不穩定發作。[42]
  3. 雙極 I的情緒波動：間歇性，[40] 躁症發作（嚴重程度）連續發生 7 天，[28] 憂鬱症發作持續數週，[43][44] 以及有時在發作之間中等程度的不穩定發作。[28] 雙極 I 型和 II 型的變化可能是快速循環的，這意味著情緒的變化在一年內發生 4 次或更多次。[45] 雙極 I 型和雙極 II 型躁症和輕躁症發作的症狀相似，只是強度程度不同。[46]
  4. 經前症狀（PMS）的情緒波動：在月經期間間歇性地從輕微到嚴重程度，逐漸或迅速發生，[47]在月經前7天開始並在月經開始時減少。[48] 以憤怒爆發、憂鬱、焦慮、困惑、易怒或社交退縮為特徵。[49]
  5. 邊緣型人格疾患 (BPD) 的情緒波動：情緒隨偶發性情緒波動而變化無常。[50] 情緒波動會在數小時或數天內快速變化，而不是因外部刺激而持續、敏感和加劇的負面情緒（例如煩躁）。[51][52] 情緒表現為高度煩躁、[53] 和中度憂鬱（其特徵為敵意、對自己的憤怒、孤獨、孤立、與人際關係有關、空虛）或無聊）。[54][55]
  6. 注意力不足過動症 (ADHD) 的情緒波動：情緒變化不規律，情緒波動是間歇性的，有時一天會發生幾次快速變化。[56][57] 徵是輕度至中度的煩躁，[58]與環境有關，衝動（急於獲得獎勵）。[59] 在成人注意力不足過動症中，情緒高漲表現為興奮，情緒低落則表現為無聊。[56]
  7. 精神分裂症的情緒波動：儘管精神分裂症情緒平淡，[60]Margrethe Collier 等人在 2021 年基於 ALS-SF 測量的一項研究發現，精神分裂症的評分模式與雙相 I 相似。[61] 與雙相情感障礙相關的改變對於妄想或幻覺，[62] 內部發生的情緒變化可能難以在外部表達（鈍性影響），[63] 並因外部刺激而加劇。[64]
  8. 重度憂鬱症 (MDD) 的情緒波動：各種情緒模式，[65] 和情緒變化不規則。[35] 情緒波動是間歇性的，在中度情緒高漲和嚴重情緒低落之間波動。.[66][67] 其特徵是大多數時候都有很高的負面情緒（壞心情），特別是在憂鬱亞型。[68]還有正向的情緒晝夜變化（早上心情不好，晚上心情好），[69] 對負刺激的敏感度和某些人的混合症狀等[70][71]
  9. 創傷後壓力症候群（PTSD）中的情緒波動：情緒變化不規律[72] 在復原過程中情緒波動加劇。[73][74]表現為負面情緒（焦慮、煩躁、羞恥、內疚）和自尊的暫時波動，對環境提醒做出反應，[75] 難以控制情緒，[76]度興奮症狀等[77][78]

原因

情緒波動的原因可能有很多。有些情緒波動可以歸類為正常/健康反應，例如悲傷處理、物質/藥物的副作用或睡眠不足的結果。在沒有外部觸發因素或壓力源的情況下，情緒波動也可能是精神疾病的徵兆。

一個人的能量水平、睡眠模式、自尊、性功能、注意力、藥物或酒精使用的變化可能是即將出現情緒障礙的跡象。[79]

情緒波動的其他主要原因（除了雙相情感障礙和重度憂鬱症）包括幹擾神經系統功能的疾病/失調。注意力不足過動症（ADHD）、癲癇[ 和自閉症譜係就是三個這樣的例子。[80][81]

過動症有時伴隨注意力不集中、衝動和健忘，是與過動症相關的主要症狀。因此，眾所周知，過動症通常會帶來短暫的（儘管有時是劇烈的）情緒波動。與自閉症相關的溝通困難以及相關的神經化學變化也被認為會導致自閉症發作（自閉症情緒波動）。與癲癇相關的癲癇發作涉及大腦電放電的變化，因此也可能帶來顯著且劇烈的情緒波動。[82] 如果情緒波動與情緒障礙無關，治療就更難分配。然而，最常見的是，情緒波動是處理日常生活中的壓力和/或意外情況的結果。

人類中樞神經系統的退化性疾病，如帕金森氏症、阿茲海默症、多發性硬化症和亨廷頓舞蹈症也可能導致情緒波動。[83] 如果情緒波動與情緒障礙無關，治療就更難分配。然而，最常見的是，情緒波動是處理日常生活中的壓力和/或意外情況的結果。

類中樞神經系統的退化性疾病，如帕金森氏症、阿茲海默症、多發性硬化症和亨廷頓舞蹈症也可能導致情緒波動。[84] 乳糜瀉也會影響神經系統，並可能出現情緒波動。[85]

不按時吃飯會造成影響，或吃太多醣，會造成血糖波動，進而造成情緒波動。[86][87]

腦化學

如果一個人的大腦中一種或幾種某些神經傳導物質(NT)水平異常，可能會導致情緒波動或情緒障礙。[88] 血清素是一種與睡眠、情緒和情緒狀態有關的神經傳導物質。NT 的輕微失衡可能會導致憂鬱症。去甲腎上腺素是一種神經傳導物質，與學習、記憶和身體喚醒有關。與血清素一樣，去甲腎上腺素的不平衡也可能導致憂鬱症。[89]

已知會導致情緒波動的情況

  • 雙極性情感障礙或循環性精神障礙：躁鬱症是一種情緒障礙，其特徵是從輕躁症或躁症到憂鬱的情緒波動。而循環性精神障礙是一種較低程度的雙極性情感障礙。[90]2022年，ENIGMA雙極性情感疾患工作小組發現，躁鬱症患者的皮質下體積較小，皮質厚度較低，白質完整性改變，[91][92] 其中功能之一是情緒處理。[93]
  • 合成代謝類固醇濫用：[94] 合成代謝類固醇是睪固酮的合成衍生物。用於治療男性性腺功能減退症或青春期延遲，[95] 刺激肌肉生長，[96] 陽痿和愛滋病。[97] 研究發現，過度使用合成代謝雄性激素類固醇會導致情緒波動、衝動和攻擊行為。[98] 這種行為與情緒調節系統的減弱有關，例如額葉皮質、顳葉、頂葉和枕葉。[99] 研究也發現，使用合成代謝雄性激素類固醇會導致下視丘-腦下垂體-性腺軸神經元變化和死亡，進而出現睡眠和情緒障礙的症狀。[100]
  • 注意力不足過動症（ADHD）：ADHD 被稱為一種難以控制注意力、過動、頻繁改變焦點和失去興趣的疾病[101] 以及在做一些有趣或愉快的任務時注意力過度集中的疾病。[102] 專注於愉快的任務時分心可能會導致情緒失調。[103][104] 情緒波動的另一個原因是前額葉皮質(PFC)、[105] 眶額皮質(OFC)的大腦活動降低，[106] 在某些人中，海馬體尺寸增大，杏仁核尺寸減小。[107] 腦這些部位的異常會導致注意力、動機、情緒和行為抑制的失調。[108]
  • 自閉症或其他廣泛性發展障礙：自閉症是一種神經和發展障礙，其症狀包括缺乏社交、重複行為受限、對感覺輸入反應過度或反應低下等。[109] 感覺處理異常是情緒波動的原因之一在自閉症。[110] 2015 年的研究發現，自閉症患者的大腦邊緣區域、初級感覺皮質和眶額皮質(OFC) 變得過度活躍，這些區域負責情緒和感覺處理。研究也發現，自閉症患者的大腦杏仁核和腹外側前額葉皮質之間的連結性降低，杏仁核反應性增加，前額葉反應減少，進而導致情緒失調。[111][112]
  • 邊緣性人格障礙：理論上，邊緣性人格障礙源自於缺乏忍受、學習[113] 和克服負面事件的能力。[114] 邊緣性人格障礙患者通常在人際關係方面有困難，[115]與憤怒爆發、判斷力[116] 或期望他人行為的傾向有關。[117] 緒失調可能是由於缺乏人際溝通能力所造成的，例如情緒知識以及如何控制情緒，尤其是在情緒強烈的情況下。[118]大多數情況下，邊緣性人格障礙患者會使用適應不良的情緒調節方式，如自我批評、思想壓抑、迴避和酗酒，這可能會引發更多的情緒紊亂。[119][120][121]
  • 癡呆症，包括阿茲海默症、帕金森氏症和亨廷頓舞蹈症：癡呆症是一種影響老年人的腦功能下降疾病。[122]在阿茲海默症中，情緒調節失調可能是由於情緒調節、突出性、膽鹼能、GABA能和多巴胺能功能下降而引起的。[122] 帕金森氏症會產生情緒波動和情緒失調，例如由認知和身體問題引起的憂鬱、自我價值感低落、羞恥和對未來的擔憂。[123] 在亨丁頓舞蹈症中，常見的情緒波動是由於社會心理、認知缺陷、神經精神和生物因素所造成的。[124]
  • 多巴胺失調症候群：多巴胺失調症候群是濫用帕金森氏症藥物減少運動和非運動症候群的結果，導致躁狂、暴力行為和停藥時憂鬱。[125]多巴胺失調症候群引起的情緒失調是由於神經傳導物質系統的變化（例如多巴胺能獎勵系統的紊亂）引起的。[126][125]
  • 癲癇：癲癇是一種以癲癇發作為特徵的腦部活動異常疾病。癲癇發作的發生是因為神經元的超同步和過度興奮，換句話說，神經活動和興奮同時發生過多。[127]情緒波動通常出現在癲癇發作之前、期間、之後、治療期間。[128] 研究發現，由於海馬體和杏仁核神經發生異常以及神經元連接受損，癲癇發作會導致情緒和情緒處理功能下降。[127] 癲癇發作可能會導致因憂鬱、焦慮或擔心生命受到威脅而引起的情緒波動。情緒變化的另一個來源來自治療癲癇的抗驚厥藥物，例如用於增加大腦抑制劑的苯巴比妥或用於減少大腦活動的抗谷氨酸藥，從而導致抑鬱、認知功能障礙、鎮靜或情緒不穩定。[129]
  • 甲狀腺功能減退症或甲狀腺功能亢進症：甲狀腺功能減退症和甲狀腺功能亢進症是由甲狀腺激素分泌過少或過多引起的內分泌疾病。甲狀腺激素異常會影響情緒[130] ，儘管甲狀腺激素與情緒障礙之間的相關性仍不清楚。[131]
  • 間歇性爆發性障礙：間歇性爆發性障礙是自發性、不受控制、不成比例且不持久的頻繁憤怒。[132][133] 這種短暫的情緒交替以對人或財產進行言語或身體攻擊的形式出現，有時在可能產生抑鬱症狀的行為後會出現後悔、羞恥和內疚。[134] IED 中的衝動行為可能與調節和情緒表達的大腦區域過度活躍有關，例如杏仁核、島葉和眶額區域。[135]
  • 更年期:[136] 女性更年期通常發生在 52 歲。造成情緒困擾的因素之一是環境荷爾蒙的波動[137] 括性類固醇、生長荷爾蒙、壓力荷爾蒙等。[138][139]
  • 重度憂鬱症：重度憂鬱症是一種具有悲傷、興趣喪失、空虛等症狀的疾病[140] ，對某些人來說，還伴隨煩躁、精神過度活躍和行為過度活躍。[141]煩躁或憤怒的發展可能是由於自戀等人格特質或避免看起來悲傷、無價值或沮喪的因應策略所致。[142]
  • 強迫症：強迫症的特徵是對某些導致生活困擾和功能障礙的事物的強迫和強迫。[143] 侵入性想法、恐懼、衝動、[144]和幻想可能會導致情緒變化和感覺不適，例如羞恥、內疚或焦慮。[145]
  • 創傷後壓力症候群：創傷後壓力症候群是一種與經常受到閃回記憶困擾以及被過去的恐懼和恐怖感覺困擾有關的疾病。這會導致創傷事件發生後情緒的改變，例如憂鬱、憤怒的爆發、自毀行為和羞恥感。[146][147]
  • 懷孕：女性在懷孕期間和產後通常會經歷情緒波動。荷爾蒙的變化、壓力和擔憂可能是情緒變化的原因。[148]
  • 經前症候群:[149] 女性會在經期的幾天至兩週內經歷不同強度的經前綜合症，如身體疼痛、情緒波動、煩躁或抑鬱[150] 在經期的幾天到兩週內以不同的強度進行。[151] 此外，4% 至 14% 的女性患有嚴重的經前症候群或經前焦慮症 (PMDD)，這會降低生活品質。[152]儘管經前症候群情緒失調的原因尚不清楚，但研究發現情緒失調與黃體素濃度下降、血清素能傳遞中斷、GABA能、壓力、體重指數和創傷事件有關。[151]
  • 分裂情感障礙：分裂情感性疾患的情緒波動是由精神分裂症和情緒障礙之間的混合症狀引起的。[153]
  • 精神分裂症：精神分裂症是一種具有妄想、幻覺、情緒失調等症狀的疾病。[154] 幻覺和妄想可能會產生情緒變化[155] ，導致憤怒、[156][157] 偏執,[158] 和羞恥.[159]
  • 季節性情感障礙：季節性情感障礙是在某些季節（通常在冬季）發生的憂鬱症，然後在其他季節出現躁狂或輕躁症發作，並且每年都會發生。[160] 這些波動的情緒以憤怒發作和憂鬱的形式出現[161] ，並且隨季節變化，也稱為季節性情緒波動。[162]
  • XXYY 症候群：XXYY 症候群是一種罕見的性染色體非整倍體 (SCAs) 類型。XXYY 症候群會導致神經發育異常和精神疾病，進而導致情緒障礙。[163][164]

治療

這是由各種因素引起的人性情緒起伏的一部分。[165]個人力量、[166][167] 應對技巧或適應能力、[168]社會支持[169] 或其他恢復模式可能決定情緒波動是否會對生活造成乾擾。[170][171]

認知行為療法建議使用情緒抑制劑來打破躁症或憂鬱情緒波動的自我強化傾向。[172] 動、款待、尋求小的（且容易實現的）勝利以及利用閱讀或看電視等替代性幹擾，是人們在打破抑鬱波動時經常使用的技巧之一。[173]

學會將自己從浮誇的心態中拉下來，或從誇張的羞恥狀態中拉起來，是採取積極主動的方法來管理自己的情緒和不同的自尊感的一部分。[174]

行為活化是 CBT 的一個組成部分，它可以打破這個循環（憂鬱導致不活動，不活動導致憂鬱）。[175] 這可能依靠個人優勢來「冷啟動」獎勵制度。[176]

辯證行為療法（DBT）：情緒波動的另一個表現是煩躁，這可能導致興高采烈、憤怒或攻擊性。[177] DBT有許多因應技巧可用於情緒調節失調，例如用「明智的頭腦」進行正念[178] 或用相反的行動進行情緒調節。[179][180]

情緒調節療法（ERT）具有一整套正念情緒調節技能（例如，注意力調節技能、後設認知調節技能等），當情緒波動發生時，這些技能可以派上用場。[181]

當情緒波動頻繁、擾亂生活節奏時，可以採用人際和社會節奏療法來調節生活節奏。[182] 情緒障礙的發作通常會打亂睡眠時間表、社交互動、[183][184]或工作並導致晝夜節律不規律，從而使人們從日常生活中解放出來。[185]

接受與承諾療法（ACT）具有透過學習評估當前經歷或保持正念、接受內部或外部的一切、採取行動以實現個人康復等來提高心理靈活性的功能。[186]

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  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."
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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 
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  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 
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  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 
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  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.
    ASIN 0717127109
    .     
  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). 
Index: pl ar de en es fr it arz nl ja pt ceb sv uk vi war zh ru af ast az bg zh-min-nan bn be ca cs cy da et el eo eu fa gl ko hi hr id he ka la lv lt hu mk ms min no nn ce uz kk ro simple sk sl sr sh fi ta tt th tg azb tr ur zh-yue hy my ace als am an hyw ban bjn map-bms ba be-tarask bcl bpy bar bs br cv nv eml hif fo fy ga gd gu hak ha hsb io ig ilo ia ie os is jv kn ht ku ckb ky mrj lb lij li lmo mai mg ml zh-classical mr xmf mzn cdo mn nap new ne frr oc mhr or as pa pnb ps pms nds crh qu sa sah sco sq scn si sd szl su sw tl shn te bug vec vo wa wuu yi yo diq bat-smg zu lad kbd ang smn ab roa-rup frp arc gn av ay bh bi bo bxr cbk-zam co za dag ary se pdc dv dsb myv ext fur gv gag inh ki glk gan guw xal haw rw kbp pam csb kw km kv koi kg gom ks gcr lo lbe ltg lez nia ln jbo lg mt mi tw mwl mdf mnw nqo fj nah na nds-nl nrm nov om pi pag pap pfl pcd krc kaa ksh rm rue sm sat sc trv stq nso sn cu so srn kab roa-tara tet tpi to chr tum tk tyv udm ug vep fiu-vro vls wo xh zea ty ak bm ch ny ee ff got iu ik kl mad cr pih ami pwn pnt dz rmy rn sg st tn ss ti din chy ts kcg ve
Prefix: a b c d e f g h i j k l m n o p q r s t u v w x y z 0 1 2 3 4 5 6 7 8 9

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