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Psychiatric Quarterly

, Volume 86, Issue 4, pp 459–469 | Cite as

Specificity of the Relationships Between Dysphoria and Related Constructs in an Outpatient Sample

  • Vladan Starcevic
  • David Berle
  • Kirupamani Viswasam
  • Anthony Hannan
  • Denise Milicevic
  • Vlasios Brakoulias
  • Erin Dale
Original Paper

Abstract

Dysphoria has recently been conceptualized as a complex emotional state that consists of discontent and/or unhappiness and a predominantly externalizing mode of coping with these feelings. The Nepean Dysphoria Scale (NDS) was developed on the basis of this model of dysphoria and used in this clinical study to ascertain the specificity of the relationships between dysphoria and relevant domains of psychopathology. Ninety-six outpatients completed the NDS, Symptom Checklist 90-Revised (SCL-90R) and Depression, Anxiety, Stress Scales, 21-item version (DASS-21). The scores on the NDS subscales (Discontent, Surrender, Irritability and Interpersonal Resentment) and total NDS scores correlated significantly with scores on the DASS-21 scales and relevant SCL-90R subscales. Multiple regression analyses demonstrated the following: DASS-21 Depression and Stress each had unique relationships with NDS Discontent and Surrender; DASS-21 Anxiety had a unique relationship with NDS Discontent; SCL-90R Hostility and Paranoid Ideation and DASS-21 Stress each had unique relationships with NDS Irritability; and SCL-90R Paranoid Ideation and DASS-21 Stress, Depression and Anxiety each had unique relationships with NDS Interpersonal Resentment. These findings support the notion that dysphoria is a complex emotional state, with both non-specific and specific relationships with irritability, tension, depression, paranoid tendencies, anxiety, hostility and interpersonal sensitivity. Conceptual rigor when referring to dysphoria should be promoted in both clinical practice and further research.

Keywords

Dysphoria Depression Irritability Nepean Dysphoria Scale 

Notes

Disclaimer

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in this article. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties. No writing assistance was utilized in the production of this article.

References

  1. 1.
    Musalek M, Griengl H, Hobl B, Sachs G, Zoghlami A: Dysphoria from a transnosological perspective. Psychopathology 33:209–214, 2000.CrossRefGoogle Scholar
  2. 2.
    Starcevic V: Dysphoric about dysphoria: Towards a greater conceptual clarity of the term. Australasian Psychiatry 15:9–13, 2007.CrossRefPubMedGoogle Scholar
  3. 3.
    Starcevic V, Monti MR, D’Agostino A, Berle D: Will DSM-5 make us feel dysphoric? Conceptualisation(s) of dysphoria in the most recent classification of mental disorders. Australian and New Zealand Journal of Psychiatry 47:954–955, 2013.CrossRefGoogle Scholar
  4. 4.
    Sandberg R: Zur Psychopathologie der chronischen Paranoia. Allgemeine Zeitschrift für Psychiatrie und Psychisch-Gerichtliche Medizin 52:619–654, 1896.Google Scholar
  5. 5.
    Specht G: Über den pathologischen Affekt in der chronischen Paranoia. Festschrift der Erlanger Universität. Leipzig, Böhme, 1901.Google Scholar
  6. 6.
    Berner B, Musalek M, Walter H: Psychopathological concepts of dysphoria. Psychopathology 20:93–100, 1987.CrossRefGoogle Scholar
  7. 7.
    American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Washington, DC, Author, 2000.Google Scholar
  8. 8.
    American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Washington, DC, Author, 2013.Google Scholar
  9. 9.
    Sadock BJ, Sadock VA (Eds): Kaplan & Sadock’s comprehensive textbook of psychiatry. 7th ed. Philadelphia, Lippincott Williams & Wilkins, 2000.Google Scholar
  10. 10.
    Sims ACP: Symptoms in the mind: An introduction to descriptive psychopathology. 3rd ed. London/Philadelphia, Saunders, 2003.Google Scholar
  11. 11.
    Gabriel E: Dysphoric mood in paranoid psychoses. Psychopathology 20:101–106, 1987.CrossRefGoogle Scholar
  12. 12.
    Dayer A, Aubry J-M, Roth L, Ducrey S, Bertschy G: A theoretical reappraisal of mixed states: Dysphoria as a third dimension. Bipolar Disorders 2:316–324, 2000.CrossRefPubMedGoogle Scholar
  13. 13.
    Pazzagli A, Monti MR: Dysphoria and aloneness in borderline personality disorder. Psychopathology 33:220–226, 2000.CrossRefGoogle Scholar
  14. 14.
    Andreasen NC, Black DW: Introductory textbook of psychiatry. 3rd ed. Washington, DC, American Psychiatric Publishing, 2001.Google Scholar
  15. 15.
    Simms LJ, Watson D, Doebbeling BN: Confirmatory factor analysis of posttraumatic stress symptoms in deployed and nondeployed veterans of the Gulf War. Journal of Abnormal Psychology 111:637–647, 2002.CrossRefPubMedGoogle Scholar
  16. 16.
    Bertschy G, Gervasoni N, Favre S, Liberek C, Ragama-Pardos E, Aubry J-M, et al: Phenomenology of mixed states: A principal component analysis study. Bipolar Disorders 9:907–912, 2007.CrossRefPubMedGoogle Scholar
  17. 17.
    Elhai JD, Biehn TL, Armour C, Klopper JJ, Frueh BC, Palmieri PA: Evidence for a unique PTSD construct represented by PTSD’s D1-D3 symptoms. Journal of Anxiety Disorders 25:340–345, 2011.CrossRefPubMedGoogle Scholar
  18. 18.
    Cassidy F, Ahearn E, Murry E, Forest K, Carroll BJ: Diagnostic depressive symptoms of the mixed bipolar episode. Psychological Medicine 30:403–411, 2000.CrossRefPubMedGoogle Scholar
  19. 19.
    Zoellner LA, Pruitt LD, Farach FJ, Jun JJ: Understanding heterogeneity in PTSD: Fear, dysphoria, and distress. Depression and Anxiety 31:97–106, 2014.PubMedCentralCrossRefPubMedGoogle Scholar
  20. 20.
    Singh MM, Smith JM: Dysphoric response to neuroleptic treatment in schizophrenia and its prognostic significance. Diseases of the Nervous System 37:191–196, 1976.PubMedGoogle Scholar
  21. 21.
    Wu HE, Okusaga OO: Antipsychotic medication-induced dysphoria: Its meaning, association with typical vs. atypical medications and impact on adherence. Psychiatric Quarterly 2015. doi: 10.1007/s11126-014-9319-1.PubMedGoogle Scholar
  22. 22.
    Liebowitz MR, Klein DF: Hysteroid dysphoria. Psychiatric Clinics of North America 2:555–575, 1979.Google Scholar
  23. 23.
    Williamson DA, Barker SE, Bertman LJ, Gleaves DH: Body image, body dysphoria, and dietary restraint: Factor structure in nonclinical subjects. Behaviour Research and Therapy 33:85–93, 1995.CrossRefPubMedGoogle Scholar
  24. 24.
    Stanghellini G: Dysphoria as a nosographical dis-organizer. European Psychiatry 13(Suppl 4):153s, 1998.CrossRefGoogle Scholar
  25. 25.
    Berle D, Starcevic V: Preliminary validation of the Nepean Dysphoria Scale. Australasian Psychiatry 20:322–326, 2012.CrossRefPubMedGoogle Scholar
  26. 26.
    Derogatis LR: Symptom Checklist-90-R: Administration, scoring and procedures manual. Minneapolis, NCS Pearson, 1994.Google Scholar
  27. 27.
    Lovibond SH, Lovibond PF: Manual for the Depression, Anxiety, Stress Scales. 2nd ed. Sydney, Psychological Foundation, 1995.Google Scholar
  28. 28.
    Peveler RC, Fairburn CG: Measurement of neurotic symptoms by self-report questionnaire: Validity of the SCL-90R. Psychological Medicine 20:873–879, 1990.CrossRefPubMedGoogle Scholar
  29. 29.
    Horowitz LM, Rosenberg SE, Baer BA, Ureno G, Villasenor VS: Inventory of interpersonal problems: Psychometric properties and clinical applications. Journal of Consulting and Clinical Psychology 56:885–892, 1988.CrossRefPubMedGoogle Scholar
  30. 30.
    Antony MM, Bieling PJ, Cox BJ, Enns MW, Swinson RP: Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales (DASS) in clinical groups and a community sample. Psychological Assessment 10:176–181, 1998.CrossRefGoogle Scholar
  31. 31.
    Henry JD, Crawford JR: The 21-item version of the Depression Anxiety Stress Scales (DASS-21): Normative data and psychometric evaluation in a large non-clinical sample. British Journal of Clinical Psychology 44:227–39, 2005.CrossRefPubMedGoogle Scholar
  32. 32.
    Faul F, Erdfelder E, Buchner A, Lang A-G: Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods 41:1149–1160, 2009.CrossRefPubMedGoogle Scholar
  33. 33.
    Caspi A, Houts RM, Belsky DW, Goldman-Mellor SJ, Harrington H, Israel S, et al: The p factor: One general psychopathology factor in the structure of psychiatric disorders? Clinical Psychological Science 2:119–137, 2014.PubMedCentralCrossRefPubMedGoogle Scholar
  34. 34.
    Schanda H: Paranoia and dysphoria: Historical developments, current concepts. Psychopathology 33:204–208, 2000.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Vladan Starcevic
    • 1
  • David Berle
    • 2
    • 3
  • Kirupamani Viswasam
    • 4
  • Anthony Hannan
    • 5
  • Denise Milicevic
    • 5
  • Vlasios Brakoulias
    • 1
  • Erin Dale
    • 5
  1. 1.Discipline of Psychiatry, Sydney Medical School – NepeanUniversity of SydneyPenrithAustralia
  2. 2.School of PsychiatryUniversity of New South WalesRandwickAustralia
  3. 3.St John of God Healthcare, Richmond HospitalNorth RichmondAustralia
  4. 4.Department of PsychiatryNepean HospitalPenrithAustralia
  5. 5.Nepean Anxiety Disorders Clinic, Nepean Blue Mountains Local Health DistrictPenrithAustralia

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