29^th World Psychiatrists Meet December 07-08, 2017 Dubai, UAE

Biography:

Nasri Jacir M.D. Ahliya University Instructor, Private Practice: Clinician

Abstract:

A continuum paradigm of psychopathology: Narcissism as the core construct of mental illness

Nasri Jacir, Amjed Abojdei and Natasha Abaza

Ahliya University,Jordan

Abstract

Recommendations for DSM-V (2013) include complementing the current standard categorical approach with a dimensional approach. The paper proposes that the author’s development of the Narcissistic Spectrum Personality Questionnaire (NSPQ) based on Lowen’s (1985) definition of narcissism as the denial of the true self may potentially provide the framework for designing a measurement tool to assess psychiatric disorders on a continuum. The scale was not designed to assess extremes of narcissism where Narcissistic Personality Disorder (NPD-DSM-IV) lie, rather, the scale attempted to develop a quantification of continuous narcissism. The authors aimed to expand the definition of narcissism using self-psychology constructs inherent in the original mythological conceptualization. The NSPQ was given to a random outpatient clinic population. The sample included 112 patients referred to the clinic located in Amman, Jordan for initial assessment. The sample distribution according to their diagnosis were as follows, psychotic (6.3%), ADHD (18.8%), anxiety disorders (46.4%) and affective only or mixed affective and anxiety disorders (28.6%). Results found that, the internal validity for the NSPQ supported by corrected item total correlation as well as item difficulties according to one model item response theory. The construct validity was further supported by confirmatory factor analysis (CFA) and empirically validated by the 3 proposed sub-factors (self-denial, guilt, self-destructiveness) into the main construct (narcissism). Data revealed a trend towards supplementing axis I disorders where the NSPQ traversed across various axis I diagnosis in a linear and statistically significant differentiating pattern as revealed by the ANOVA result. The overall result of this research supports the concept of a continuum model that may be used in supplementing the current diagnostic categories of the DSM. The results were discussed and recommendations for implementation and further research were suggested.

Biography:

Professor WK Tang was appointed to professor in the Department of Psychiatry, the Chinese University of Hong Kong in 2011. His main research areas are Addictions and Neuropsychiatry in Stroke. Professor Tang has published over 100 papers in renowned journals, and has also contributed to the peer review of 40 journals. He has secured over 20 major competitive research grants, including Health and Medical Research Fund, reference number: 02130726. Health and Medical Research Fund, reference number: 01120376. National Natural Science Foundation of China, reference number: 81371460. General Research Fund, reference number: 474513. General Research Fund, reference number: 473712. He has served the editorial boards of five scientific journals. He was also a recipient of the Young Researcher Award in 2007, awarded by the Chinese University of Hong Kong.

Abstract:

Evidence of brain damage in chronic ketamine users: A brain imaging study

Wai Kwong Tang

The Chinese University of Hong Kong, Hong Kong

Abstract

Background & Objectives: The objectives of this study were to ascertain the pattern of grey and white matter volume reduction and regional metabolic and activation abnormalities in chronic ketamine users and to evaluate the correlations between these brain abnormalities and cognitive impairments in chronic ketamine users in Hong Kong.

Methods: It was a cross-sectional observational study and was done in counseling center for psychotropic substance abusers in Hong Kong. 136 participants were recruited from October 2011 to April 2014. The participants were divided into two groups: Ketamine users (79) and healthy controls (57). Psychiatric assessments included screening with self-rating questionnaires and face-to-face interviews. All of the participants completed a detailed cognitive battery that covered general intelligence, verbal and visual memory, executive functions, motor speed and language. All of the participants underwent magnetic resonance imaging of the brain.

Results: Many of the participants in the ketamine group also frequently used cocaine and cannabis. Among the ketamine users, 12.6% were diagnosed with a mood disorder and 8.9% with an anxiety disorder. The participants in the ketamine group had worse performance than the healthy controls on tests of general intelligence, verbal, visual and working memory and executive functioning. In terms of grey matter volumes, the right orbitofrontal cortex, right medial prefrontal cortex, left and right hippocampus and possibly the left orbitofrontal cortex were smaller in the ketamine group. In contrast, the volumes of the left basal ganglia, left putamen and possibly the left caudate were higher in the ketamine group. In terms of white matter volumes, the ketamine group had a lower periventricular white matter volume in the right hemisphere. The grey matter volumes of the left and right orbitofrontal cortex, right medial prefrontal cortex, left basal ganglia and left putamen, and right periventricular white matter volume were negatively correlated with the severity of ketamine dependence. The hippocampal volumes were correlated with performance on the arithmetic, information and digit span tests. The periventricular white matter volume also correlated with the information score. A functional connectivity examination of the default mode network revealed significantly decreased connectivity in the medial part of the bilateral superior frontal gyrus, left middle frontal gyrus, bilateral gyrus rectus, left superior temporal pole, left inferior temporal gyrus, bilateral angular gyrus and bilateral cerebellum crus II in the ketamine group. This group also displayed increased connectivity in the bilateral precuneus and right inferior occipital gyrus.

Conclusion: The results provide imaging evidence of brain damage in chronic ketamine users. Chronic ketamine use was associated with reduced grey and white matter volumes in certain regions of the brain. Chronic ketamine use was also associated with altered functional connectivity with the default mode network. Abnormal brain structures and altered functional organization of the brain network may underlie the hypersensitivity towards drug related cues but weakened cognitive control in those with ketamine addiction. Longitudinal or prospective studies would help to strengthen the evidence on the reversibility of the structural and functional brain damage caused by ketamine.

Biography:

Abstract: