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*Corresponding Author: Humberto García Penedo. Professor of the Faculty of Psychology/University of Havana (San Rafael No. 1168 between Mazón and Basarrate Vedado).
Citation: Katiusca Abrantes Sosa, Humberto García Penedo, Mabelín Serret Soto. (2023), Paroxysmal Emotionality in a Group of Adolescents with Behavioral Disorders, J Clinical Research and Reports, 13(4); DOI:10.31579/2690-1919/316
Copyright: © 2023, Humberto García Penedo. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 31 March 2023 | Accepted: 11 May 2023 | Published: 19 May 2023
Keywords: teenagers; negative affect; grau's modified experiential self-report; behavioral disorders
General Objective: Characterize the categorical and dimensional psychopathological spectrum of a group of adolescents Specific objectives: Describe the sociodemographic composition of the sample, characterize the psychopathological alterations of these adolescents and identify the negative emotions with clinical significance that characterize the group.
Methods: A quantitative-qualitative methodology, a descriptive exploratory study and a non-experimental cross-sectional design were assumed. We worked with a non-probabilistic intentional sample, which included 20 adolescents who met the study inclusion criteria. A Modified Grau Experiential Self-Report, a Sentence Completion and an in-depth interview were applied to them. Descriptive statistics of the evaluated constructs were performed.
Results: The initial diagnostic impression reflected that (50%) (n=20) have a Conduct Disorder, (30%) (n=20) have an Anxiety Disorder, (15%) (n=20) suffers from a Depressive Episode, while through the Self-report it was identified that 95% (n=20) have poor emotional regulation, 80% (n=20) suffer from anxiety, have tense emotional health and trait anger, the 75% (n=20) have depression and suffer possible Alexithymia, (70%) (n=20) are affected by psychological trauma.
Conclusions: the group was characterized by having an average age of 15 years, with a predominance of the male sex, a high school education and the white race. The psychopathological alterations that characterized the group were conduct disorders, anxiety and depressive episode, and in terms of dimensions, it was characterized by high negativity and low positivity. The paroxysmal negative emotions that characterize the group are anxiety, irritability, anger, impulsiveness, apathy, demotivation, and unpleasant emotion that they cannot define.
Emotionality is dimensional and is considered as negative affect [1] but it also includes positive affectivity, among which joy, optimism and good humor have been studied in association with good health and a better quality of life [2; 3]. Including the study of emotionality in adolescents implies a strategy to improve the psychopathological diagnosis that leads to a personalization of the treatments. In the present study, emotionality is understood in its entirety, that is, considering the negativity in its interrelation with the positivity of the individual. This relationship is known as the additive principle of emotions [4]. Its authors define it as follows:
“...when the individual experiences multiple sources of emotional stimulation, the emotions add up. If the emotions are negative the result will be a sum that is more intense than an emotional response alone. And if the emotions are positive, the sum will be more intense than one. If one source of emotion is positive and the other is negative, however, the emotions elicited will subtract from each other, resulting in the stronger of the two being experienced in a more attenuated form. (p.287).
To this principle is added the undo effect that positivity is recognized on the impact of negativity on health [5]. Due to these foundations, it is not appropriate to determine the psychopathological state of patients without considering this interrelationship mentioned above, in addition, the contributions of Positive Psychology to the understanding of the continuous health-disease process are considered [6;7]. On the other hand, the psychopathological diagnosis should never remain at the level of classical Nosology only, since several individual elements can always be identified which, due to their clinical significance, become the basis for personalizing the treatment of patients. The Research Problem is: What emotional comorbidities and paroxysmal negative emotions characterize the group of adolescents under study? The General Objective was established: To characterize the categorical and dimensional psychopathological spectrum of the group of adolescents studied, while as specific objectives: to describe the sociodemographic composition of the sample studied, to characterize the psychopathological alterations of the adolescents studied and to identify the paroxysmal emotions that characterize the adolescent. cluster.
Type of study: descriptive-exploratory and non-experimental cross-sectional design
Population: made up of 191 adolescents assisted in the Guillermo Barrientos De Llano Municipal Department of Mental Health in the period from January to August 2022
Sample: 20 patients (11 males and 9 females). Intentionally chosen based on meeting the inclusion criteria
Inclusion criteria:
Exclusion criteria:
The instruments used were the Modified Grau's Experiential Self-Report (MGESR) (Appendix No.1), a Completion of sentences focused on emotionality (Appendix No.2) and the in-depth interview, both to explore the presence of psychological trauma.
Ethical aspects: authorization was requested from the direction of the Municipal Department of Mental Health. Informed consent was used both with the patients and with the parents or guardians.
Characteristics and instrumental benefits of the Experiential Self-Report.
The test is the result of a modification to a previous version created by Doctor Jorge A. Grau in 1984, to which a construct and a concurrent validity were performed [8; 9]. It is based on the fact that normal emotionality is in itself a circumstantial, transitory phenomenon, but if it becomes very frequent and very intense, it is considered that it has been incorporated as a feature into the habitual way of reacting by the individual and being unpleasant (negative) emotions will then generate social dysfunction and represent a psychopathological disorder. Three positive components were added to the instrument that represent the universe of positivity, which are: good humor, optimism and joy. All three are often considered an individual's inner strengths and exert a favorable influence as a counterpart to negativity. Accounting is based on the additive principle of emotions [4] and the undoing effect of emotional positivity on the impact of negativity on cardiovascular health [5] subtraction operation between the negativity and positivity values, a calculation that generates the spectrum of test constructs mentioned above.
According to the data obtained in this instrument, opinions of six constructs will be obtained, which are: Emotional health, Emotional self-regulation, Psychological trauma, depression, anxiety, Alexithymia and trait anger. Paroxysmal emotions will also be defined.
Definitions of terms:
Emotional health: it is defined on the one hand by the amount of negative emotions with clinical significance, that is, that generate discomfort for the individual, by the amount of positivity, as well as by the capacity for emotional self-regulation. As operational definitions of this construct, there are the following levels (Ideal, Normal, Light, Moderate, Tense).
Emotional self-regulation: it is defined by the individual's ability to regulate their negative emotions based on their emotional balance and psychological well-being. As operational definitions of this construct, there are the following levels (Good, Regular and Bad).
Positivity: it is a concept that arises in positive Psychology; groups the set of attributes that make up the protective factors for health, quality of life and psychological well-being. Its operational definition consists of a value from 0 to 12, the closer to 12 that value is, the greater Positivity the individual possesses. Positivity can be considered a dimension from the Transdiagnostic paradigm.
Negativity: is a measure of the amount of negative emotions that have clinical significance. The greater the number of negative emotions are clinically significant, the greater the individual's negativity. Negativity can be considered a dimension from the Transdiagnostic paradigm, together with positivity.
Affective profile: reflects the dispersion of negative emotions (from left to right) according to their clinical significance (a combination of intensity and frequency) as well as a positivity value where 12 is the maximum value; both obtained by the individual through the Self-report.
Psychological trauma: its underlying presence is estimated when several negative emotions come together at the same time with the same frequency and high intensity, as usually happens with traumas and in Post-traumatic Stress Disorder (PTSD). Up to three are valued as Possible the presence of trauma, five or more are valued as "Very possible" the presence of trauma; but an interview will be required to clarify it after obtaining an opinion of clinical significance in this regard.
Depression: estimated from five specific items (sad, unmotivated, long-suffering, anguished, and apathetic). The following levels are used as operational definitions of this construct (Severe, Moderate, Mild and None).
Anxiety: estimated from three specific items (restless, insecure and anxious). The following levels are used as operational definitions of this construct (Severe, Moderate, Regular and Absent).
Alexithymia: although the disorder is more complex, it is estimated from two items (“Unpleasant emotion that I cannot define” and “Confusion”); if required, a specialized instrument is subsequently applied to confirm the opinion.
Trait anger: it is estimated from five specific items that are (irritable, impulsive, wrathful, contempt and resentful). The following levels are used as operational definitions of this construct (Severe, Moderate, Regular and Absent).
Paroxysmal emotions: are those reported by individuals as experienced by them with high frequency and intensity. When both qualities come together in an experience, it is then recognized that they have already become a trait, forming part of the emotional predispositions to react in a dysfunctional way. If an individual presents sequelae of a psychological trauma, it is easy to be detected by the confluence of more than four or five paroxysmal negative emotions forming a constellation.
Results
General characterization of the group according to clinical and sociodemographic variables
According to the data reflected in table No.1, it is significant that all have a Middle Schooling
| Patient | Age | Sex | Race | Scholar | Diagnosis | ||||||||
| W | M | B | S | HS | Tech | Behavioral disorders | Anxiety disorders | Depressive episode | Obsessive Compulsive Disorder | ||||
| 1 | DBT | 15 | M | 1 | 1 | 1 | |||||||
| 2 | LMG | 17 | M | 1 | 1 | 1 | |||||||
| 3 | YCG | 13 | M | 1 | 1 | 1 | |||||||
| 4 | CCV | 14 | M | 1 | 1 | 1 | |||||||
| 5 | MNP | 16 | M | 1 | 1 | 1 | |||||||
| 6 | GMB | 15 | M | 1 | 1 | 1 | |||||||
| 7 | FPD | 13 | F | 1 | 1 | 1 | |||||||
| 8 | OCG | 14 | F | 1 | 1 | 1 | |||||||
| 9 | MTL | 15 | F | 1 | 1 | 1 | |||||||
| 10 | LBC | 14 | F | 1 | 1 | 1 | |||||||
| 11 | YBM | 11 | F | 1 | 1 | 1 | |||||||
| 12 | KDV | 13 | F | 1 | 1 | 1 | |||||||
| 13 | DIP | 15 | F | 1 | 1 | 1 | |||||||
| 14 | NGA | 16 | F | 1 | 1 | 1 | |||||||
| 15 | MFS | 15 | F | 1 | 1 | 1 | |||||||
| 16 | RTN | 13 | M | 1 | 1 | 1 | |||||||
| 17 | MAR | 13 | M | 1 | 1 | 1 | |||||||
| 18 | DCD | 14 | M | 1 | 1 | 1 | |||||||
| 19 | EBS | 17 | M | 1 | 1 | 1 | |||||||
| 20 | SVQ | 18 | M | 1 | 1 | 1 | |||||||
| T | Av. | 14 | 13 | 3 | 4 | 14 | 4 | 2 | 10 | 6 | 3 | 1 | |
Source: authors file
Table 1: Brief psychosocial characterization of the studied group
| Anxiety | Severe | Moderate | Slight | None |
| Frequency | 3 | 7 | 6 | 4 |
| Average | 15% | 35% | 30% | 20% |
Source: authors file
Anxiety: 80% of the group is affected by clinically significant anxiety distributed equally as can be seen in table No.2
Table 2: Anxiety levels in the group
Trait anger: 80% of the cases present a tendency to anger, either high or moderate, as observed in figure No. 1.
Figure No.1: Trait anger in the group
Depression: 75% of the cases suffer from depression, distributed between the Severe, Moderate and Slight levels, as shown in figure No.2.
Figure No.2 Proportion of depression among assisted adolescents
Alexithymia: 75% of adolescents are affected by possible Alexithymia at some level of clinical significance as shown in Table No.3
| Alexithymia | Severe | Moderate | Slight | None |
| Frequency | 7 | 4 | 4 | 5 |
| Average | 35% | 20% | 20% | 25% |
Source: data from the authors
Table 3: Results of Alexithymia levels at the group level.
As can be seen in table No.4, 80% of adolescents have tense emotional health. 95% of their Self-regulation is bad, while 75% may be affected by at least one psychological trauma, with a greater possibility of 45%.
| Emotional Health | Emotional Self-Regulation | Psychological Trauma | ||||||
| Normal | Moderate | Tense | Good | Bad | No | Possible | Very Possible | |
Frequency | 1 | 3 | 16 | 1 | 19 | 6 | 5 | 9 |
| Average | 5% | 15% | 80% | 5% | 95% | 30% | 25% | 45% |
Source: data from the authors
Table No.4: Emotional Health, Emotional Self-Regulation and Psychological Trauma
Regarding the affective dimension (which contemplates negativity versus positivity), the affective profile of the Self-report was taken as a reference. 65% have problematic negativity, which means that they have a high number of negative emotions with some level of clinical significance and established as a trait, that is, paroxysmal. It can be seen that in the first two columns on the left side, 13 negative experiences without clinical significance at the group level are concentrated, on the other hand, with the highest clinical significance, an average of 5.2 emotions was obtained, which reflects the presence of psychological trauma in a part of adolescents, while the positivity reflected in the extreme right column is 5.7 on average compared to 12, which would be the ideal number.
Figure 3: Proportion of Negativity versus Positivity values at the group level (affective dimensionality)
As for the paroxysmal experiences, in table No.5 it can be seen that anxiety and irritability were the highest experiences followed by anger, impulsiveness, apathy among others that are decreasing in frequency. It must be taken into account that at the critical level the highest intensity of the experience converges with the highest frequency in which it is felt. The high frequency defines the character of this experience as a trait, that is, a component of the emotional predispositions of these adolescents, while the intensity highlights the clinical significance as a symptom and also very possibly the repercussion of this symptom in their interpersonal relationships. It should be remembered that there are related experiences, for example, "Unpleasant emotion that I can't define" and "Confusion" are two crucial attributes of Alexithymia, and in patients who declared these symptoms as a quick alternative to detect the possible presence of this disorder, the which requires to be confirmed with the specific test, which was not performed in this study.
| No. |
Negative emotions | Without Clinical significance | With Clinical significance | % With Clinical significance | |||
| 0 | Slight level | Half level | Critical level | ||||
| 1 | Anxiety | 2 | 3 | 5 | 10 | 75% | |
| 2 | Irritability | 3 | 2 | 3 | 12 | 75% | |
| 3 | Anger | 7 | 2 | 4 | 7 | 55% | |
| 4 | Impulsivity | 5 | 5 | 0 | 10 | 50% | |
| 5 | Apathetic | 8 | 2 | 5 | 5 | 50% | |
| 6 | Unmotivated | 5 | 6 | 6 | 3 | 45% | |
| 7 | Displeasing emotion that I can't define | 5 | 6 | 3 | 3 | 45% | |
| 8 | Guilty | 9 | 3 | 4 | 4 | 40% | |
| 9 | Ashamed | 8 | 4 | 0 | 8 | 40% | |
| 10 | Confusion | 7 | 5 | 5 | 3 | 40% | |
| 11 | Long-Suffering | 7 | 7 | 1 | 5 | 30% | |
| 12 | Insecurity | 9 | 5 | 3 | 3 | 30% | |
| 13 | Distrust | 9 | 5 | 1 | 5 | 30% | |
| 14 | Sadness | 6 | 9 | 3 | 2 | 25% | |
| 15 | Resentment | 13 | 2 | 3 | 2 | 25% | |
| 16 | Anguish | 11 | 4 | 2 | 3 | 25% | |
| 17 | Fear | 14 | 2 | 1 | 3 | 20% | |
| 18 | Shy | 13 | 3 | 2 | 2 | 20% | |
| 19 | Restlessness’ | 9 | 7 | 1 | 3 | 20% | |
| 20 | Jealousy | 11 | 6 | 0 | 3 | 15% | |
| 21 | Scorn | 15 | 3 | 1 | 1 | 10% | |
| 22 | Envy | 18 | 2 | 0 | 0 | 0% | |
Source: data from the authors
Table No. 5: Distribution of paroxysmal negative emotions collected in Grau's Experiential Self-report N=20
80% of the group presents trait anger, 50% impulsiveness and 75
Proportion of negative emotions through the Grau's Modified Emotional Self report (N=20)
Name _____________________ Age _____ Schooling _____________________
Instructions: To the left column there are a series of emotions that you could feel. To the right of each one there is a horizontal line whose left end indicates the weakest grade in that you feel these emotions, while the right end corresponds to the biggest intensity in that you may has felt them.
1.- You should check only one box per row where you think best reflects the intensity with which you have been feeling each emotion during the last few months. Please make sure to match the chosen intensity with the frequency in which it occurs.
0= seldom 1= sometimes 2= very often
With clinical significance
Appendix No.2
Completion of phrases / Most frequent emotions associated with personal experiences. (To identify past personal experiences associated to specific emotions)
Please complete the following sentences. Your sincerity will be your contribution to treatment.
Name: _________________ Age: ___ Reason for consultation: ___________________
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Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
