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  Subjects -> PSYCHOLOGY (Total: 889 journals)
Showing 1 - 174 of 174 Journals sorted alphabetically
Acción Psicológica     Open Access   (Followers: 3)
Acta Colombiana de Psicología     Open Access   (Followers: 4)
Acta Comportamentalia     Open Access   (Followers: 3)
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Psychologica     Hybrid Journal   (Followers: 24)
Activités     Open Access   (Followers: 1)
Actualidades en Psicologia     Open Access   (Followers: 2)
Ad verba Liberorum : Journal of Linguistics & Pedagogy & Psychology     Open Access   (Followers: 8)
Addictive Behaviors Reports     Open Access   (Followers: 6)
ADHD Attention Deficit and Hyperactivity Disorders     Hybrid Journal   (Followers: 22)
ADHD Report The     Full-text available via subscription   (Followers: 8)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 43)
Advances in Mental Health     Hybrid Journal   (Followers: 74)
Advances in Physiotherapy     Hybrid Journal   (Followers: 58)
Advances in Psychology     Full-text available via subscription   (Followers: 62)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 30)
African Journal of Cross-Cultural Psychology and Sport Facilitation     Full-text available via subscription   (Followers: 5)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 417)
Aggressive Behavior     Hybrid Journal   (Followers: 15)
Aging, Neuropsychology, and Cognition     Hybrid Journal   (Followers: 34)
Ágora - studies in psychoanalytic theory     Open Access   (Followers: 3)
Aletheia     Open Access   (Followers: 1)
American Behavioral Scientist     Hybrid Journal   (Followers: 18)
American Imago     Full-text available via subscription   (Followers: 3)
American Journal of Applied Psychology     Open Access   (Followers: 38)
American Journal of Community Psychology     Hybrid Journal   (Followers: 24)
American Journal of Health Behavior     Full-text available via subscription   (Followers: 24)
American Journal of Orthopsychiatry     Hybrid Journal   (Followers: 4)
American Journal of Psychoanalysis     Hybrid Journal   (Followers: 22)
American Psychologist     Full-text available via subscription   (Followers: 200)
Anales de Psicología     Open Access   (Followers: 2)
Análise Psicológica     Open Access   (Followers: 1)
Análisis y Modificación de Conducta     Open Access   (Followers: 2)
Analysis     Full-text available via subscription   (Followers: 4)
Annual Review of Clinical Psychology     Full-text available via subscription   (Followers: 70)
Annual Review of Organizational Psychology and Organizational Behavior     Full-text available via subscription   (Followers: 30)
Annual Review of Psychology     Full-text available via subscription   (Followers: 228)
Anuario de Psicología / The UB Journal of Psychology     Open Access   (Followers: 1)
Anuario de Psicología Jurídica     Open Access   (Followers: 1)
Anxiety, Stress & Coping: An International Journal     Hybrid Journal   (Followers: 24)
Applied and Preventive Psychology     Hybrid Journal   (Followers: 14)
Applied Cognitive Psychology     Hybrid Journal   (Followers: 70)
Applied Neuropsychology : Adult     Hybrid Journal   (Followers: 34)
Applied Neuropsychology : Child     Hybrid Journal   (Followers: 20)
Applied Psychological Measurement     Hybrid Journal   (Followers: 19)
Applied Psychology     Hybrid Journal   (Followers: 206)
Applied Psychology: Health and Well-Being     Hybrid Journal   (Followers: 49)
Applied Psychophysiology and Biofeedback     Hybrid Journal   (Followers: 8)
Archive for the Psychology of Religion / Archiv für Religionspychologie     Hybrid Journal   (Followers: 21)
Archives of Clinical Neuropsychology     Hybrid Journal   (Followers: 27)
Archives of Scientific Psychology     Open Access   (Followers: 4)
Arquivos Brasileiros de Psicologia     Open Access   (Followers: 1)
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 8)
Asia-Pacific Psychiatry     Hybrid Journal   (Followers: 4)
Asian American Journal of Psychology     Full-text available via subscription   (Followers: 5)
Asian Journal of Business Ethics     Hybrid Journal   (Followers: 7)
Assessment     Hybrid Journal   (Followers: 11)
Attachment: New Directions in Psychotherapy and Relational Psychoanalysis     Full-text available via subscription   (Followers: 16)
Attention, Perception & Psychophysics     Full-text available via subscription   (Followers: 11)
Australian and Aotearoa New Zealand Psychodrama Association Journal     Full-text available via subscription  
Australian Educational and Developmental Psychologist, The     Full-text available via subscription   (Followers: 7)
Australian Journal of Psychology     Hybrid Journal   (Followers: 18)
Australian Psychologist     Hybrid Journal   (Followers: 12)
Autism Research     Hybrid Journal   (Followers: 36)
Autism Research and Treatment     Open Access   (Followers: 28)
Autism's Own     Open Access   (Followers: 1)
Autism-Open Access     Open Access   (Followers: 5)
Avaliação Psicológica     Open Access  
Avances en Psicologia Latinoamericana     Open Access   (Followers: 1)
Aviation Psychology and Applied Human Factors     Hybrid Journal   (Followers: 19)
Balint Journal     Hybrid Journal   (Followers: 3)
Barbaroi     Open Access  
Basic and Applied Social Psychology     Hybrid Journal   (Followers: 37)
Behavior Analysis in Practice     Full-text available via subscription   (Followers: 7)
Behavior Analysis: Research and Practice     Full-text available via subscription   (Followers: 2)
Behavior Analyst     Hybrid Journal   (Followers: 4)
Behavior Modification     Hybrid Journal   (Followers: 10)
Behavior Research Methods     Hybrid Journal   (Followers: 18)
Behavior Therapy     Hybrid Journal   (Followers: 49)
Behavioral Development Bulletin     Full-text available via subscription  
Behavioral Interventions     Hybrid Journal   (Followers: 9)
Behavioral Neuroscience     Full-text available via subscription   (Followers: 53)
Behavioral Sciences & the Law     Hybrid Journal   (Followers: 24)
Behavioral Sleep Medicine     Hybrid Journal   (Followers: 7)
Behaviormetrika     Hybrid Journal  
Behaviour     Hybrid Journal   (Followers: 12)
Behaviour Research and Therapy     Hybrid Journal   (Followers: 17)
Behavioural and Cognitive Psychotherapy     Hybrid Journal   (Followers: 131)
Behavioural Processes     Hybrid Journal   (Followers: 8)
Biofeedback     Hybrid Journal   (Followers: 4)
BioPsychoSocial Medicine     Open Access   (Followers: 6)
BMC Psychology     Open Access   (Followers: 17)
Body, Movement and Dance in Psychotherapy: An International Journal for Theory, Research and Practice     Hybrid Journal   (Followers: 10)
Boletim Academia Paulista de Psicologia     Open Access  
Boletim de Psicologia     Open Access  
Brain Informatics     Open Access  
British Journal of Clinical Psychology     Full-text available via subscription   (Followers: 140)
British Journal of Developmental Psychology     Full-text available via subscription   (Followers: 37)
British Journal of Educational Psychology     Hybrid Journal   (Followers: 33)
British Journal of Health Psychology     Full-text available via subscription   (Followers: 43)
British Journal of Mathematical and Statistical Psychology     Full-text available via subscription   (Followers: 21)
British Journal of Psychology     Full-text available via subscription   (Followers: 58)
British Journal of Psychotherapy     Hybrid Journal   (Followers: 67)
British Journal of Social Psychology     Full-text available via subscription   (Followers: 33)
Burnout Research     Open Access   (Followers: 8)
Cadernos de psicanálise (Rio de Janeiro)     Open Access  
Cadernos de Psicologia Social do Trabalho     Open Access  
Canadian Art Therapy Association     Hybrid Journal  
Canadian Journal of Behavioural Science     Full-text available via subscription   (Followers: 5)
Canadian Journal of Experimental Psychology     Full-text available via subscription   (Followers: 15)
Canadian Psychology / Psychologie canadienne     Full-text available via subscription   (Followers: 14)
Case Studies in Sport and Exercise Psychology     Hybrid Journal   (Followers: 1)
Cendekia : Jurnal Kependidikan dan Kemasyarakatan     Open Access  
Child Development Perspectives     Hybrid Journal   (Followers: 28)
Child Development Research     Open Access   (Followers: 16)
Ciencia Cognitiva     Open Access   (Followers: 2)
Ciencia e Interculturalidad     Open Access   (Followers: 1)
Ciências & Cognição     Open Access  
Ciencias Psicológicas     Open Access  
Clínica y Salud     Open Access  
Clinical Medicine Insights : Psychiatry     Open Access   (Followers: 10)
Clinical Practice in Pediatric Psychology     Full-text available via subscription   (Followers: 10)
Clinical Psychological Science     Hybrid Journal   (Followers: 12)
Clinical Psychologist     Hybrid Journal   (Followers: 18)
Clinical Psychology & Psychotherapy     Hybrid Journal   (Followers: 71)
Clinical Psychology and Special Education     Open Access   (Followers: 2)
Clinical Psychology Review     Hybrid Journal   (Followers: 40)
Clinical Psychology: Science and Practice     Hybrid Journal   (Followers: 21)
Clinical Schizophrenia & Related Psychoses     Full-text available via subscription   (Followers: 8)
Coaching Psykologi - The Danish Journal of Coaching Psychology     Open Access   (Followers: 1)
Coaching | Theorie & Praxis     Open Access  
Cogent Psychology     Open Access  
Cógito     Open Access  
Cognition & Emotion     Hybrid Journal   (Followers: 40)
Cognitive Behaviour Therapy     Hybrid Journal   (Followers: 15)
Cognitive Neuropsychology     Hybrid Journal   (Followers: 29)
Cognitive Psychology     Hybrid Journal   (Followers: 65)
Cognitive Research : Principles and Implications     Open Access   (Followers: 2)
Consciousness and Cognition     Hybrid Journal   (Followers: 30)
Construção Psicopedagógica     Open Access  
Consulting Psychology Journal : Practice and Research     Full-text available via subscription   (Followers: 4)
Contagion : Journal of Violence, Mimesis, and Culture     Full-text available via subscription   (Followers: 7)
Contemporary Educational Psychology     Hybrid Journal   (Followers: 23)
Contemporary School Psychology     Hybrid Journal   (Followers: 4)
Contextos Clínicos     Open Access  
Counseling Outcome Research and Evaluation     Hybrid Journal   (Followers: 11)
Counseling Psychologist     Hybrid Journal   (Followers: 16)
Counseling Psychology and Psychotherapy     Open Access   (Followers: 10)
Counselling and Psychotherapy Research : Linking research with practice     Hybrid Journal   (Followers: 24)
Counselling and Values     Hybrid Journal   (Followers: 3)
Counselling Psychology Quarterly     Hybrid Journal   (Followers: 11)
Couple and Family Psychoanalysis     Full-text available via subscription   (Followers: 1)
Couple and Family Psychology : Research and Practice     Full-text available via subscription   (Followers: 6)
Creativity Research Journal     Hybrid Journal   (Followers: 23)
Creativity. Theories - Research - Applications     Open Access   (Followers: 3)
Criminal Justice Ethics     Hybrid Journal   (Followers: 8)
Cuadernos de Neuropsicología     Open Access   (Followers: 1)
Cuadernos de Psicologia del Deporte     Open Access  
Cuadernos de Psicopedagogía     Open Access  
Cultural Diversity and Ethnic Minority Psychology     Full-text available via subscription   (Followers: 14)
Cultural-Historical Psychology     Open Access   (Followers: 1)
Culturas Psi     Open Access  
Culture and Brain     Hybrid Journal   (Followers: 4)
Current Addiction Reports     Hybrid Journal   (Followers: 12)
Current Behavioral Neuroscience Reports     Hybrid Journal   (Followers: 2)
Current Directions In Psychological Science     Hybrid Journal   (Followers: 53)
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 3)
Current Opinion in Psychology     Hybrid Journal   (Followers: 5)
Current Psychological Research     Hybrid Journal   (Followers: 13)
Current Psychology     Hybrid Journal   (Followers: 15)
Current psychology letters     Open Access   (Followers: 2)
Current Research in Psychology     Open Access   (Followers: 20)
Cyberpsychology, Behavior, and Social Networking     Hybrid Journal   (Followers: 15)
Decision     Full-text available via subscription   (Followers: 3)
Depression and Anxiety     Hybrid Journal   (Followers: 17)
Depression Research and Treatment     Open Access   (Followers: 14)
Developmental Cognitive Neuroscience     Open Access   (Followers: 18)
Developmental Neuropsychology     Hybrid Journal   (Followers: 17)
Developmental Psychobiology     Hybrid Journal   (Followers: 9)
Developmental Psychology     Full-text available via subscription   (Followers: 46)
Diagnostica     Hybrid Journal   (Followers: 2)
Dialectica     Hybrid Journal   (Followers: 1)
Discourse     Full-text available via subscription   (Followers: 9)
Diversitas: Perspectivas en Psicologia     Open Access  
Drama Therapy Review     Hybrid Journal   (Followers: 1)
Dreaming     Full-text available via subscription   (Followers: 11)
Drogues, santé et société     Full-text available via subscription  
Dynamics of Asymmetric Conflict: Pathways toward terrorism and genocide     Hybrid Journal   (Followers: 15)
Ecopsychology     Hybrid Journal   (Followers: 6)
ECOS - Estudos Contemporâneos da Subjetividade     Open Access  
Educational Psychology Review     Hybrid Journal   (Followers: 28)
Educational Psychology: An International Journal of Experimental Educational Psychology     Hybrid Journal   (Followers: 50)
Educazione sentimentale     Full-text available via subscription  
Electronic Journal of Research in Educational Psychology     Open Access   (Followers: 7)
Elpis - Czasopismo Teologiczne Katedry Teologii Prawosławnej Uniwersytetu w Białymstoku     Open Access  
Emotion     Full-text available via subscription   (Followers: 36)
Emotion Review     Hybrid Journal   (Followers: 21)
En-Claves del pensamiento     Open Access   (Followers: 1)
Enseñanza e Investigacion en Psicologia     Open Access  
Epiphany     Open Access   (Followers: 3)

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Journal Cover Clinical Psychology & Psychotherapy
  [SJR: 1.171]   [H-I: 51]   [71 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1063-3995 - ISSN (Online) 1099-0879
   Published by John Wiley and Sons Homepage  [1589 journals]
  • How does routinely delivered cognitive–behavioural therapy for gambling
           disorder compare to “gold standard” clinical trial'
    • Authors: David P. Smith; A. Kate Fairweather-Schmidt, Peter W. Harvey, Malcolm W. Battersby
      Abstract: Currently, it is unknown whether treatment outcomes derived from randomized controlled trials (RCTs) of cognitive–behavioural therapy (CBT) for problem gamblers still hold when applied to patients seen in routine practice. Thus, data from an RCT of cognitive therapy versus exposure therapy for problem gambling versus patients of a gambling help service were compared. Assessments of problem gambling severity, psychosocial impairment, and alcohol use were undertaken at baseline and post-treatment and evaluated within a counterfactual framework. Findings showed that the contrast between routine CBT for pokies and horse betting had a significant effect, indicative of a 62% lower gambling urge score if routine CBT recipients had all been horse/track betters opposed to gambling with “pokies.” However, the majority of contrasts indicated therapeutic outcomes achieved in routine CBT treatments were of equivalent robustness relative to RCT conditions. The present findings infer routine practice treatment outcomes are as efficacious as those generated in RCT contexts.
      PubDate: 2017-12-11T04:54:07.556334-05:
      DOI: 10.1002/cpp.2163
  • Metacognitive beliefs as a predictor of health anxiety in a self-reporting
           Italian clinical sample
    • Authors: Gabriele Melli; Robin Bailey, Claudia Carraresi, Andrea Poli
      Abstract: Research has supported the specific role that anxiety sensitivity, health-related dysfunctional beliefs, and metacognitive beliefs may play in the development and maintenance of health anxiety symptoms. However, the role of metacognitive beliefs in health anxiety has only been explored in analogue samples. The aim of this study was to explore for the first time the association between metacognitive beliefs and health anxiety symptoms in a sample of participants who reported having received a diagnosis of severe health anxiety (hypochondriasis) or illness anxiety disorder and test whether these beliefs are significant predictors of health anxiety after controlling for anxiety, depression, anxiety sensitivity, and dysfunctional beliefs. A series of dimensional self-report measures were administered to a large Italian sample (N = 458). At a bivariate level, Beliefs that Thoughts are Uncontrollable had a stronger association with health anxiety than any of the dysfunctional beliefs and anxiety sensitivity subscales. Results from hierarchical multiple regression analysis indicated that Beliefs that Thoughts are Uncontrollable predicted health anxiety symptoms over-and-above depression, general anxiety, anxiety sensitivity, and health-related dysfunctional beliefs. Despite many important limitations, this study supported the hypothesis that metacognition may have an important role in health anxiety in clinical samples.KEY PRACTITIONER MESSAGEThe role of metacognitive beliefs in health anxiety is underexploredWe investigated their role over-and-above anxiety sensitivity and cognitive beliefsBeliefs that Thoughts are Uncontrollable seems to play the most important roleTargeting such a metacognitive belief may result in a reduction of health anxiety
      PubDate: 2017-12-11T01:43:09.11771-05:0
      DOI: 10.1002/cpp.2159
  • Late-adoptions in adolescence: Can attachment and emotion regulation
           influence behaviour problems' A controlled study using a moderation
    • Authors: Cecilia Serena Pace; Simona Di Folco, Viviana Guerriero
      Abstract: A growing body of research suggests that, compared to normative adolescence, adoptive adolescence could be considered a specific risk condition characterized by more psychiatric problems, attachment insecurity, and emotional regulation difficulties as consequences of negative experiences in preadoption relationships. The current study explores (a) a moderation model of adoption status on the association between attachment representations (secure, dismissing, preoccupied, and disorganized) and behavioural problems and (b) a moderation model of adoption status on the association between emotion regulation processes (cognitive reappraisal and expressive suppression) and behavioural problems. Both the moderation models were controlled for verbal skills. Forty-six adopted adolescents and a control group of 34 nonadopted peers (12–16 years old) living with both their biological parents were assessed using the Friends and Family Interview, the Emotion Regulation Questionnaire for Children and Adolescents, the Child Behaviour Check List 6–18, and the verbal subtests of the Wechsler Intelligence Scale for Children, the latter as control measure. Results showed that adoption status (but not attachment) positively predicted externalizing and total behaviour problems, whereas attachment disorganization (but not adoption status) positively predicted internalizing problems in both group. Moreover, low cognitive reappraisal had a negative impact on externalizing problems only for adopted adolescents, but not for nonadopted youths. The clinical implications of these findings are discussed in order to enhance effective intervention with adopted adolescents and their parents.Key Practitioner MessageThe adoption status (but not attachment representations) was found to be predictive of externalizing and total behaviour problems, suggesting that attachment itself is not the only variable to take into account in explaining possible maladaptive outcomes in late-adopted adolescents. Nevertheless, disorganized attachment positively predicted internalizing problems, being a risk factor for both adopted and nonadopted adolescents.Only for late-adopted adolescents, higher cognitive reappraisal was negatively related with externalizing problems, suggesting that the functional and positive ability to cognitively restructure negative situations may help them to reduce impulsive negative reactions towards others. Both increasing cognitive reappraisal and decreasing expressive suppression may be considered as valuable goals of therapy with adopted adolescents and their parents.Late-adopted adolescents, compared to nonadopted peers, reported lower somatic complaints, suggesting that they may not allow themselves to show physical vulnerability as consequence of their early affective experiences of severe deprivation.Late-adopted adolescents, compared to nonadopted ones, reported higher level of expressive suppression strategies, which may be considered as an attempt to be compliant with the environment's requests in order to be loved, accepted, and nurtured
      PubDate: 2017-11-28T23:45:31.1199-05:00
      DOI: 10.1002/cpp.2158
  • What psychologists need to know about psychotropic medications
    • Authors: Elena Tomba; Jenny Guidi, Giovanni A. Fava
      Abstract: Despite the fact that today most of the patients with psychological disturbances assume some form of psychotropic drug treatment, clinical psychologists may have little familiarity with psychopharmacology and are substantially unaware of subtle and yet pervasive potential effects of medications in clinical presentations. In their training, psychologists are generally exposed, at best, to some general principles of drug action. Standard psychopharmacology textbooks tend to omit the subtle psychological changes that may occur during psychotropic drug treatment.Clinical pharmacopsychology consists of the application of clinical psychology to the full understanding of pharmacological effects. The domains of clinical pharmacopsychology encompass the clinical benefits of psychotropic drugs, the characteristics that predict responsiveness to treatment, the vulnerabilities induced by treatment (side effects, behavioural toxicity, iatrogenic comorbidity), and the interactions between drug treatment and psychological variables.The DSM-5 refers to a patient population that no longer exists: subjects who display various manifestations of psychological distress who do not receive any form of drug treatment for it.Any type of psychotropic drug treatment, particularly after long-term use, may increase the risk of experiencing additional psychopathological problems that do not necessarily subside with discontinuation of the drug. The changes may be persistent and not limited to a short phase, such as in the case of withdrawal reactions, and cannot be subsumed under the generic rubrics of adverse events or side effects.
      PubDate: 2017-11-23T05:50:21.07005-05:0
      DOI: 10.1002/cpp.2154
  • The relationship between perceived organisational threat and compassion
           for others: Implications for the NHS
    • Authors: Lauren Elizabeth Henshall; Tim Alexander, Philip Molyneux, Eric Gardiner, Ashleigh McLellan
      Abstract: The National Health Service (NHS) is known to be a challenging place to work, with financial and performance targets placing increasing pressure on the organisation. This study aimed to investigate whether these pressures and threats might be detrimental to the quality of care and the compassion that the NHS strives to deliver. Quantitative data were collected via self-report questionnaires from healthcare professionals across 3 NHS trusts in England in order to measure Self-compassion; Compassion for Others; Perceived Organisational Threat; and Perceived Organisational Compassion. Qualitative data were also collected to explore the threats considered most pertinent to healthcare professionals at present. The key findings suggest that an increase in Perceived Organisational Threat may reduce an individual's ability to give compassion to others; however, Self-compassion and Perceived Organisational Compassion were better predictors of Compassion for Others. This highlights the need to consider compassion at a systemic level, providing interventions and training not only to cultivate self-compassion in healthcare professionals, but also to encourage compassion across the NHS more generally. In promoting self-compassion and increasing the level of compassion that employees feel they receive at work, healthcare professionals may be better able to maintain or improve their level of compassion for service users and colleagues.Key Practitioner MessageIncreases in Perceived Organisational Threat were found to be related to a decrease in healthcare professionals' level of Compassion for Others.However, Self-compassion and Perceived Organisational Compassion were significantly better predictors of level of Compassion for Others than was Perceived Organisational Threat; an increase in Self-compassion and Perceived Organisational Compassion related to an increase in Compassion for Others.Healthcare service development and staff interventions may benefit from greater focus on cultivating and promoting self-compassion and on systemic interventions promoting compassion across all levels of an organisation.Future research should examine the feasibility and effectiveness of compassion-focussed interventions amongst professionals in healthcare organisations and would benefit from further investigation into the impact this may have for service users.
      PubDate: 2017-11-23T05:15:46.779961-05:
      DOI: 10.1002/cpp.2157
  • If it is absurd, then why do you do it' The richer the obsessional
           experience, the more compelling the compulsion
    • Authors: Steffen Moritz; Christine Purdon, Lena Jelinek, Brenda Chiang, Marit Hauschildt
      Abstract: Mounting evidence suggests that obsessive intrusions are often accompanied and amplified by perceptual experiences of different modalities (e.g., feeling dirt on one's skin while experiencing intrusive thoughts about contamination). Pilot studies conducted online with individuals endorsing mild obsessive–compulsive symptoms have linked the co-occurrence of perceptual experiences and obsessions to the severity of subsequent compulsive behaviour as well as low insight. However, it is presently unclear whether sensory experiences accompany all types of obsessional thoughts or are restricted to certain preoccupations (e.g., contamination and aggression). The present study examined a clinical inpatient and outpatient sample with a formally diagnosed obsessive–compulsive disorder (N = 34). Perceptual properties of intrusive thoughts were assessed with the Sensory Properties of Obsessions Questionnaire. The prevalence of perception-laden obsessive thoughts was comparable with prior studies (73.5%), but the intensity was significantly greater. No association was observed between perceptual experiences and expert-rated insight. However, the severity of perception-laden obsessions predicted the frequency of and impairment associated with compulsive behaviour. This was particularly strong for obsessions about contamination. The present study confirms the high prevalence and clinical relevance of perceptual experiences that accompany obsessions and further challenges the traditional trichotomy splitting mental phenomena into thoughts, intrusions, and hallucinations.Key Practitioner MessageObsessive thoughts are often accompanied by perceptual experiences such as feeling dirt on one's skin or seeing blood before one's inner eye.Sensory experiences have been associated with decreased insight in obsessive–compulsive disorder.We found that 75% of obsessive–compulsive disorder patients have such sensory experiences.The severity of perceptual obsessions predicted low control over compulsions.Clinicians should not confuse sensory experiences with hallucinations and psychosis, respectively.
      PubDate: 2017-11-20T05:10:21.351111-05:
      DOI: 10.1002/cpp.2155
  • Convergent, incremental, and criterion-related validity of multi-informant
           assessments of adolescents' fears of negative and positive evaluation
    • Authors: Jeremy N. Karp; Bridget A. Makol, Lauren M. Keeley, Noor Qasmieh, Danielle E. Deros, Justin W. Weeks, Sarah J. Racz, Melanie F. Lipton, Tara M. Augenstein, Andres De Los Reyes
      Abstract: Adolescents who experience social anxiety tend to hold fears about negative evaluations (e.g., taunting) and may also hold fears about positive evaluations (e.g., praise from a teacher). The Brief Fear of Negative Evaluation (BFNE) scale and Fear of Positive Evaluation Scale (FPES) are 2 widely used measures of adults' evaluative concerns. Yet we know little about their psychometric properties when assessing adolescents. In a mixed clinical/community sample of 96 adolescents (66.7% female; M = 14.50 years, SD = 0.50; 63.3% African American), we examined both self-report and parent report versions of the BFNE and FPES. Adolescents and parents also provided reports about adolescents on survey measures of social anxiety and depressive symptoms. Adolescents participated in multiple social interactions in which they self-reported their state arousal before and during the tasks. Adolescent and parent BFNE and FPES reports distinguished adolescents who displayed elevated social anxiety from those who did not. Both informants' reports related to survey measures of adolescent social anxiety, when accounting for domains that commonly co-occur with social anxiety (i.e., depressive symptoms). Further, both the BFNE and FPES displayed incremental validity in relation to survey measures of adolescent social anxiety, relative to each other. However, only adolescents' BFNE and FPES reports predicted adolescents' self-reported arousal within social interactions, and only adolescents' FPES displayed incremental validity in predicting self-reported arousal, relative to their BFNE. Adolescent and parent BFNE and FPES reports display convergent validity and in some cases incremental and criterion-related validity. These findings have important implications for evidence-based assessments of adolescents' evaluative concerns.
      PubDate: 2017-11-17T07:35:37.583197-05:
      DOI: 10.1002/cpp.2156
  • The Pregnancy Related Beliefs Questionnaire (PRBQ): An examination of the
           psychometric properties in perinatal samples
    • Authors: Dawn M. Leach; Philip Terry, Ana V. Nikčević
      Abstract: BackgroundIdentifying vulnerability to perinatal depression is an important public health issue. Risk factors include general and maternal-specific dysfunctional attitudes. Scales of maternal attitudes have a number of shortcomings. Further, it is not known whether antenatal maternal attitudes predict post-natal depression, independently of general dysfunctional attitudes (GDA). The aim of the current study was to examine the psychometric properties of the Pregnancy Related Beliefs Questionnaire (PRBQ) and to establish, prospectively, the utility of the revised PRBQ in predicting the symptoms of post-natal depression.MethodIn Study 1, a cross-sectional sample of 344 participants, who were either pregnant or in the post-natal period, completed a battery of questionnaires assessing background factors, GDA, attitudes specific to motherhood (PRBQ), and depression. In Study 2, a sample of 210 women completed a battery of questionnaires, including a measure of GDA, the PRBQ-8, and depression, on two occasions: early in the second trimester of pregnancy and post-natally.ResultsExploratory and confirmatory factor analyses supported a one-factor, eight-item measure of maladaptive attitudes specific to motherhood (PRBQ-8). The PRBQ-8 was found to have good convergent, concurrent, and predictive validity and high internal and test–retest reliability. A hierarchical regression analysis revealed that antenatal PRBQ-8 scores predict the severity of post-natal depression symptoms, after controlling for background factors, antenatal depression, and GDA.ConclusionsThe PRBQ-8 is a psychometrically sound measure of maternal attitudes that can be used antenatally to identify women at risk of post-natal depression.Key Practitioner MessageThe PRBQ-8 is a valid and reliable measure of maladaptive maternal attitudes.The PRBQ-8 can help perinatal practitioners identify women who hold unhelpful beliefs regarding the maternal role.Assessing maladaptive maternal attitudes during pregnancy can help identify women who may be at risk of developing postnatal depression.
      PubDate: 2017-11-02T05:15:23.904195-05:
      DOI: 10.1002/cpp.2149
  • The Anaclitic–Introjective Depression Assessment: Development and
           preliminary validity of an observer-rated measure
    • Authors: Felicitas Rost; Patrick Luyten, Peter Fonagy
      Abstract: BackgroundThe two-configurations model developed by Blatt and colleagues offers a comprehensive conceptual and empirical framework for understanding depression. This model suggests that depressed patients struggle, at different developmental levels, with issues related to dependency (anaclitic issues) or self-definition (introjective issues), or a combination of both.AimsThis paper reports three studies on the development and preliminary validation of the Anaclitic–Introjective Depression Assessment, an observer-rated assessment tool of impairments in relatedness and self-definition in clinical depression based on the item pool of the Shedler–Westen Assessment Procedure.MethodStudy 1 describes the development of the measure using expert consensus rating and Q-methodology. Studies 2 and 3 report the assessment of its psychometric properties, preliminary reliability, and validity in a sample of 128 patients diagnosed with treatment-resistant depression.ResultsFour naturally occurring clusters of depressed patients were identified using Q-factor analysis, which, overall, showed meaningful and theoretically expected relationships with anaclitic/introjective prototypes as formulated by experts, as well as with clinical, social, occupational, global, and relational functioning.ConclusionTaken together, findings reported in this paper provide preliminary evidence for the reliability and validity of the Anaclitic–Introjective Depression Assessment, an observer-rated measure that allows the detection of important nuanced differentiations between and within anaclitic and introjective depression.
      PubDate: 2017-10-23T02:30:24.592352-05:
      DOI: 10.1002/cpp.2153
  • Impaired emotion processing and a reduction in trust in patients with
           somatic symptom disorder
    • Authors: Maja Erkic; Josef Bailer, Sabrina C. Fenske, Stephanie N. L. Schmidt, Jörg Trojan, Annette Schröder, Peter Kirsch, Daniela Mier
      Abstract: There is accumulating evidence for deficits in the perception and regulation of one's own emotions, as well as the recognition of others' emotions in somatic symptom disorder (SSD). However, investigations of SSD focusing on specific aspects of emotion processing and how these might interact are missing. We included 35 patients with SSD and 35 healthy controls who completed questionnaires on the perception and regulation of their own emotions, as well as experimental investigations of emotion recognition and trust. In line with previous studies, our results show that SSD patients in comparison to healthy controls have difficulties in the identification and description of own feelings (ηp2 = .381 and ηp2 = .315). Furthermore, we found that patients apply less cognitive reappraisal (ηp2 = .185) but tend to use more expressive suppression (ηp2 = .047). In contrast to previous studies, we found SSD patients to perform superior in emotion recognition, in particular for anger (d = 0.40). In addition, patients with SSD invested less in a trust game (d = 0.73). These results point to a higher sensitivity for negative emotions and less trust in others. Further, these findings suggest a dissociation between the ability to recognize one's own emotions versus others' emotions in SSD. Future interventions targeting emotion processing in SSD might focus on the identification of one's own emotions, prior to the training of emotion regulation.
      PubDate: 2017-10-18T03:25:34.236356-05:
      DOI: 10.1002/cpp.2151
  • Corrective emotional experience in an integrative affect-focused therapy:
           Building a preliminary model using task analysis
    • Authors: Kaori Nakamura; Shigeru Iwakabe
      Abstract: ObjectiveThe present study constructed a preliminary process model of corrective emotional experience (CEE) in an integrative affect-focused therapy.MethodTask analysis was used to analyse 6 in-session events taken from 6 Japanese clients who worked with an integrative affect-focused therapist. The 6 events included 3 successful CEEs and 3 partially successful CEEs for comparison.ResultsA rational–empirical model of CEE was generated, which consisted of two parallel client change processes, intrapersonal change and interpersonal change, and the therapist interventions corresponding to each process. Therapist experiential interventions and therapist affirmation facilitated both intrapersonal and interpersonal change processes, whereas his relational interventions were associated with the interpersonal change process. The partially successful CEEs were differentiated by the absence of the component of core painful emotions or negative beliefs in intrapersonal change process, which seemed crucial for the interpersonal change process to develop.ConclusionsCEE is best represented by a preliminary model that depicts two parallel yet interacting change processes. Intrapersonal change process is similar to the sequence of change described by the emotional processing model (Pascual-Leone & Greenberg, ), whereas interpersonal change process is a unique contribution of this study. Interpersonal change process was facilitated when the therapist's active stance and use of immediacy responses to make their relational process explicit allowed a shared exploration. Therapist affirmation bridged intrapersonal change to interpersonal change by promoting an adaptive sense of self in clients and forging a deeper emotional connection between the two.Key Practitioner MessageIn-session corrective emotional experience consists of intrapersonal and interpersonal change processes.The intrapersonal change process involved experiencing adaptive emotions such as grief.The interpersonal change process involved the processing of the relational experience in which the therapist and the client explicitly discussed the immediate feelings towards each other and the meaning of a new relational experience in the here and now.Therapist active stance as well as therapist affirmation responses that validate and support client resilience and strength facilitated both intrapersonal and interpersonal change.
      PubDate: 2017-10-16T00:01:03.663716-05:
      DOI: 10.1002/cpp.2150
  • Continuity between DSM-5 Section II and Section III personality traits for
           obsessive–compulsive personality disorder
    • Authors: Jacqueline Liggett; Martin Sellbom, Bo Bach
      Abstract: ObjectiveObsessive–compulsive personality disorder (OCPD) is formally operationalized in Section II of the DSM-5 by a heterogeneous collection of 8 categorical criteria. Section III contains an alternative model operationalizing personality disorders via dimensional personality traits and associated impairment. The extent to which the personality traits used to define OCPD in Section III correspond with the Section II operationalization of the disorder is contested. The current study aims to contribute to the evidence base necessary to solidify the optimal trait profile for this disorder via a more fine-tuned examination of OCPD.MethodThe research questions were examined using a clinical sample of 142 Danish adults who completed the Structured Clinical Interview for DSM-IV Axis II Disorders and the Personality Inventory for DSM-5 to index both the Sections II and III (personality traits) operationalizations of OCPD, respectively.ResultsBivariate correlations supported Rigid Perfectionism and Perseveration as traits relevant to OCPD; however, hierarchical regression analyses indicated that of the 4 traits used in the Section III operationalization of OCPD, only Rigid Perfectionism uniquely predicted OCPD (p 
      PubDate: 2017-10-11T06:35:48.868566-05:
      DOI: 10.1002/cpp.2147
  • Anger and depressive ruminations as predictors of dysregulated behaviours
           in borderline personality disorder
    • Authors: Francesca Martino; Gabriele Caselli, Jessica Di Tommaso, Sandra Sassaroli, Marcantonio M. Spada, Barbara Valenti, Domenico Berardi, Anna Sasdelli, Marco Menchetti
      Abstract: BackgroundAnger and depressive ruminations have recently received empirical attention as processes related to borderline personality disorder (BPD). The Emotional Cascade Model (Selby, Anestis, & Joiner, 2008) suggests that negative affect (such as anger and sadness) may trigger rumination, which in turn may increase the duration and extent of negative affect, leading to dysregulated behaviours aimed at reducing such intense and unpleasant emotions.AimThe aim of this study is to explore the relationships between emotional dysregulation, anger and depressive ruminations, and their role in predicting dysregulated behaviours (such as aggression and self-harm) in a clinical sample of patients with BPD.MethodsNinety-one patients with a diagnosis of BPD were recruited from three outpatient community mental health centres and asked to complete a comprehensive assessment for personality disorder symptoms, emotion dysregulation, anger and depressive ruminations, aggression, and self-harm.ResultsAnger and depressive ruminations were found to be significantly associated to, respectively, self-harm and aggression, beyond the variance accounted by emotional dysregulation.ConclusionsRumination may act as a mediator between emotional dysregulation and dysregulated behaviours in BPD. Future research should examine whether clinical techniques aimed at reducing rumination may be helpful in reducing dysregulated behaviours in patients with BPD.
      PubDate: 2017-10-11T06:25:25.937098-05:
      DOI: 10.1002/cpp.2152
  • Therapeutic alliance in psychological therapy for people with
           schizophrenia and related psychoses: A systematic review
    • Authors: Lucy Shattock; Katherine Berry, Amy Degnan, Dawn Edge
      Abstract: Therapeutic alliance is a key predictor of therapy outcomes. Alliance may be particularly pertinent for people with schizophrenia as this group often have a history of interpersonal trauma and relationship difficulties including difficult relationships with mental health staff. This review aimed to determine (a) the quality of therapeutic alliance between people with schizophrenia and their therapists; (b) whether alliance predicts therapeutic outcomes; and (c) variables associated with alliance. Databases were searched from inception up to April 2015. The search yielded 4,586 articles, resulting in 26 eligible studies, involving 18 independent samples. Weighted average client and therapist Working Alliance Inventory-Short Form total scores were 64.51 and 61.26, respectively. There was evidence that alliance predicts overall psychotic symptomatic outcomes and preliminary evidence for alliance predicting rehospitalization, medication use, and self-esteem outcomes. There was evidence for specific client-related factors being linked to different perspectives of alliance. For example, poorer insight and previous sexual abuse were associated with worse client-rated alliance, whereas baseline negative symptoms were associated with worse therapist-rated alliance. Therapist and therapy-related factors, including therapists' genuineness, trustworthiness, and empathy were associated with better client-rated alliance, whereas suitability for therapy, homework compliance, and attendance were associated with better therapist-rated alliance. Key clinical implications include the need to consider alliance from both client and therapist perspectives during therapy and training and supervision to enhance therapist qualities that foster good alliance. Future research requires longitudinal studies with larger samples that include pan-theoretical, well-validated alliance measures to determine causal predictor variables.
      PubDate: 2017-09-29T11:32:43.034935-05:
      DOI: 10.1002/cpp.2135
  • Fluctuations in alliance and use of techniques over time: A bidirectional
           relation between use of “common factors” techniques and the
           development of the working alliance
    • Authors: Nili Solomonov; Kevin S. McCarthy, Jack R. Keefe, Bernard S. Gorman, Mark Blanchard, Jacques P. Barber
      Abstract: ObjectiveThe aim of this study was twofold: (a) Investigate whether therapists are consistent in their use of therapeutic techniques throughout supportive–expressive therapy (SET) and (b) Examine the bi-directional relation between therapists' use of therapeutic techniques and the working alliance over the course of SET.MethodThirty-seven depressed patients were assigned to 16 weeks of SET as part of a larger randomized clinical trial (Barber, Barrett, Gallop, Rynn, & Rickels, ). Working Alliance Inventory-Short Form (WAI-SF) was collected at Weeks 2, 4, and 8. Use of therapeutic interventions was rated by independent observers using the Multitheoretical List of Therapeutic Interventions (MULTI). Intraclass correlation coefficients assessed therapists' consistency in use of techniques. A cross-lagged path analysis estimated the working alliance inventory- Multitheoretical List of Therapeutic Interventions bidirectional relation across time.ResultsTherapists were moderately consistent in their use of prescribed techniques (psychodynamic, process-experiential, and person-centred). However, they were inconsistent, or more flexible, in their use of “common factors” techniques (e.g., empathy, active listening, hope, and encouragements). A positive bidirectional relation was found between use of common factors techniques and the working alliance, such that initial high levels of common factors (but not prescribed) techniques predicted higher alliance later on and vice versa.ConclusionTherapists tend to modulate their use of common factors techniques across treatment. Additionally, when a strong working alliance is developed early in treatment, therapists tend to use more common factors later on. Moreover, high use of common factors techniques is predictive of later improvement in the alliance.
      PubDate: 2017-09-29T10:49:54.134812-05:
      DOI: 10.1002/cpp.2143
  • Children's psychosocial functioning and parents' quality of life in
           paediatric short stature: The mediating role of caregiving stress
    • Authors: Neuza Silva; Monika Bullinger, Rachel Sommer, Anja Rohenkohl, Stefanie Witt, Julia Quitmann
      Abstract: ObjectivesOn the basis of the multidimensional model of the caregiving process, this study aimed (a) to compare the levels of quality of life (QoL) and psychological problems of children with short stature and the levels of caregiving stress and QoL of their parents, between diagnostic, treatment, and current height deviation groups, and (b) to examine the direct and indirect links, via caregiving stress, between children's psychosocial functioning and their parents' QoL.MethodThe sample was collected in 5 European countries and comprised 238 dyads of 8- to 18-year-old children and adolescents with a clinical diagnosis of growth hormone deficiency or idiopathic short stature and one of their parents. The children completed self-report measures of height-related QoL (Quality of Life in Short Stature Youth Core Module) and psychological problems (Strengths and Difficulties Questionnaire); the parents reported on their own QoL (EUROHIS-QOL-8 Index) and caregiving stress (Quality of Life in Short Stature Youth Effects on Parents subscale).ResultsChildren who were treated and who achieved normal height reported better QoL compared to those untreated and with current short stature. Parents of children with idiopathic short stature and current short stature presented greater caregiving stress than parents of children with growth hormone deficiency and achieved normal height. Children's better psychosocial functioning was indirectly associated with parents' better QoL, via less caregiving stress, and these links were invariant across diagnoses, treatment status, and current height deviation.ConclusionsThese results suggest that, along with growth hormone treatments, multidisciplinary interventions in paediatric endocrinology should be family-centred, by targeting both the children's psychosocial functioning and the parents' stress, in order to improve individual and family adaptation.Key Practitioner MessageHeight-related quality of life impairments and more internalizing problems in children and adolescents with short stature increase caregiving stress, which in turn has a negative impact on parents' quality of life, independently of patients' diagnosis, treatment status, and current height deviation.In addition to growth hormone treatment, multidisciplinary interventions in the context of paediatric short stature should target the children's and adolescents' psychosocial functioning, as well as provide the parents with cognitive and behavioural strategies to manage their child's physical, emotional, social, and behavioural problems.Caregiving stress should be routinely assessed and selected as a strategic intervention target for family-centred psychosocial interventions aimed at promoting parents' adaptation outcomes (e.g., quality of life).Psychosocial interventions should prioritize the children and adolescents who had never been treated with growth hormone and who have current short stature, as well as the parents of children with idiopathic short stature and current short stature.
      PubDate: 2017-09-27T03:22:01.129245-05:
      DOI: 10.1002/cpp.2146
  • Exploring the paths between dysfunctional attitudes towards motherhood and
           postpartum depressive symptoms: The moderating role of self-compassion
    • Authors: Ana Fonseca; Maria Cristina Canavarro
      Abstract: Better understanding how cognitive processes operate to influence women's depressive symptoms during the postpartum period is crucial for informing preventive and treatment approaches. The present study aimed to examine the relationship between women's dysfunctional attitudes towards motherhood and depressive symptoms, considering the mediating role of negative automatic thoughts and the moderating role of self-compassion. A sample of 387 women in the postpartum period cross-sectionally answered a set of questionnaires to assess dysfunctional attitudes towards motherhood, negative automatic thoughts (general and postpartum-specific), depressive symptoms, and self-compassion. Women with clinically significant depressive symptoms presented more dysfunctional attitudes towards motherhood, more frequent negative thoughts, and lower self-compassion. More dysfunctional beliefs about others' judgments and about maternal responsibility were associated with higher depressive symptoms, and this effect occurred through both general and postpartum-specific thoughts related to the metacognitive appraisal of the thought content. Moreover, these relationships occurred only when women presented low or moderate levels of self-compassion. These results highlight the need to comprehensively assess women's cognitive variables during the postpartum period with appropriate measures, for the early identification of women with more dysfunctional beliefs about motherhood, who may be at higher risk of depression. Moreover, preventive/treatment approaches should aim not only to challenge women's preexisting dysfunctional beliefs but also to promote a more self-compassionate attitude towards themselves.
      PubDate: 2017-09-27T02:00:23.169327-05:
      DOI: 10.1002/cpp.2145
  • Does an emotion-focused two-chair dialogue add to the therapeutic effect
           of the empathic attunement to affect'
    • Authors: Jan Reidar Stiegler; Helge Molde, Elisabeth Schanche
      Abstract: An increasing amount of research suggests that it is beneficial to work explicitly with emotions in psychotherapy. Emotion-focused therapy (EFT) utilizes interventions that are thought to enhance the evocativeness of emotional processing and facilitate explorations of new meaning. The purpose of this study was to examine the effect of such an intervention on therapeutic outcome. The intervention, a two-chair dialogue drawn from emotion-focused therapy, was added to the treatment conditions that consisted of empathically following the clients' emotional processes. The treatment comprised 2 phases. Using a multiple baseline design, 21 self-critical clients (15 women and 6 men) with clinically significant symptoms of depression and/or anxiety first received 5, 7, or 9 sessions of a baseline treatment focused on alliance building, empathic attunement to affect, and therapeutic presence and genuineness. A two-chair dialogue intervention was then added for 5 sessions. The symptoms were measured before each session using Beck's Depression Inventory, Beck's Anxiety Index, and Forms of Self-Criticizing/Attacking and Self-Reassuring Scale. An analysis using Hierarchical Linear Modelling revealed that the phase with the two-chair dialogue had a larger impact on symptoms of anxiety and depression when compared to the baseline phase. On BDI-II, there was a greater impact on somatic-affective components than cognitive components. Self-criticism was reduced when we used time as a predictor for both phases but not significantly more after introducing the intervention. The results corroborate that the two-chair dialogue intervention is associated with change beyond what is shown when relationship conditions alone are being provided. Implications and limitations are discussed.
      PubDate: 2017-09-27T01:55:24.474286-05:
      DOI: 10.1002/cpp.2144
  • Developments on committed action: Validity of the CAQ-8 and analysis of
           committed action's role in depressive symptomatology in breast cancer
           patients and healthy individuals
    • Authors: Inês A. Trindade; Joana Marta-Simões, Cláudia Ferreira, José Pinto-Gouveia
      Abstract: Committed action, a process of acceptance and commitment therapy's psychological flexibility model, is considered an understudied construct that currently can only be measured by one instrument, the Committed Action Questionnaire (CAQ-8). This study aims at analysing the psychometric properties of the CAQ-8 in healthy individuals and breast cancer patients. This study also aims to explore the specific meditational role of committed action in the well-established relationship between experiential avoidance and depression symptoms.The healthy sample comprised 294 adults from the general population, and the breast cancer samples comprised 82 participants. Both groups completed the validated self-report measures. CAQ-8's robustness was examined through validity analyses, confirmatory factor analyses, and multigroup analysis. The meditational model was conducted using structural equation modelling.The CAQ-8 presented good internal consistency and construct, convergent, concurrent, and divergent validity in both samples. Further, the CAQ-8 showed incremental validity over a measure of engaged living. Findings also demonstrated measurement invariance between healthy individuals and breast cancer patients. Regarding the conducted meditational model that was also invariant between the two analysed groups, it was demonstrated that part of the effect that experiential avoidance holds on depressive symptomatology is explained by committed action.This study suggests that the CAQ-8 is adequate for use in healthy and cancer populations. Moreover, it provides novel, empirical support regarding the links between committed action, experiential avoidance, and depressed mood, being also the first investigation to particularly study committed action in a cancer population. Implications for theory and practice are discussed.
      PubDate: 2017-09-27T01:45:46.392333-05:
      DOI: 10.1002/cpp.2125
  • Body image and nonsuicidal self-injury: Validation of the Body Investment
           Scale in participants with eating disorders
    • Authors: J. H. Marco; M. Cañabate, J. García-Alandete, G. Llorca, M. Real-López, M. Beltrán, S. Pérez
      Abstract: The Body Investment Scale (BIS) assesses body image feelings, body care, protection of the body, and comfort in touch, in order to identify and distinguish participants with self-harming and self-destructive tendencies. However, the psychometric properties of the BIS were not analysed in participants diagnosed with eating disorders. The main objective of the present study is to confirm the factor structure of the Spanish version of the BIS and analyse its psychometric properties in a sample composed of women diagnosed with eating disorders. Participants were 250 Spanish women between 12 and 60 years old (M = 26.05, SD = 11.97) diagnosed with eating disorders. A confirmatory factor analysis showed a poor fit of the original BIS. The final model showed an acceptable 4-factor structure (Body Feelings, α = .88; Body Touch, α = .82; Body Protection, α = .77; Body Care, α = .68), with a good fit to the data (SBχ2(246) = 393.21, CFI = .906, IFI = .908, RMSEA = .049). The relationships between the BIS and both the Purpose-In-Life Test—10 Items and Beck Hopelessness Scale were analysed, as well as differences in the BIS score according to nonsuicidal self-injuries and suicidal ideation in the past year. The BIS is an appropriate instrument to assess the body investment dimension of body image in women with eating disorders.
      PubDate: 2017-09-18T20:45:47.381934-05:
      DOI: 10.1002/cpp.2142
  • Does assimilation of problematic experiences predict a decrease in symptom
    • Authors: Isabel Morais Basto; William B. Stiles, Daniel Rijo, João Salgado
      Abstract: The assimilation model describes therapeutic change as an integration of experiences that had previously been problematic, distressing, avoided, or warded off. This study assessed whether assimilation was associated with treatment outcome in a sample of psychotherapeutic treatments for depression. Further, it assessed the direction of the association—whether increasing assimilation predicted decreases in symptom intensity or decreasing symptom intensity predicted increases in assimilation.MethodParticipants were 22 clients with mild to moderate depression drawn from a clinical trial comparing cognitive behavioral therapy with emotion-focused therapy. The direction of prediction between assimilation progress and changes in self-reported symptom intensity was assessed.ResultsThe assimilation progress was shown to be a better predictor of decreases in symptom intensity than the reverse.ConclusionThe results supported the assimilation model's suggestion that assimilation progress promotes decreases in symptom intensity in the treatment of clients with major depressive disorder.
      PubDate: 2017-09-10T23:15:31.180668-05:
      DOI: 10.1002/cpp.2130
  • Do therapists' subjective variables impact on psychodynamic psychotherapy
           outcomes' A systematic literature review
    • Authors: Vittorio Lingiardi; Laura Muzi, Annalisa Tanzilli, Nicola Carone
      Abstract: BackgroundDespite growing attention to the general therapist effects in a wide range of clinical settings, little is known about the individual, cross-situational, and therapy–nonspecific variables that impact on the differential effectiveness of clinicians. The current study is a systematic review of the evidence relating to the influence of therapist's subjective characteristics on outcomes of psychodynamic psychotherapies.MethodA multistage and systematic search of articles published between 1987 and 2017 identified 30 relevant studies, which were organized into 6 areas according to the specific therapist's variable considered.ResultsTherapists' interpersonal functioning and skills showed the strongest evidence of a direct effect on treatment outcomes. Furthermore, there were preliminary evidence that therapists' attachment styles, their interpersonal history with caregivers, and their self-concept might affect outcomes through interaction effects with other constructs, such as technical interventions, patient's pathology, and therapeutic alliance. The high variability between studies on therapists' overall reflective or introspective abilities and personality characteristics suggested the need for more systematic research in these areas, whereas therapists' values and attitudes showed small effects on therapeutic outcome.ConclusionsThe present review clarifies how a deep examination of the contribution of therapists' subjective characteristics can help elucidate the complex association between relational and technical factors related to the outcome of psychodynamic treatments.
      PubDate: 2017-09-05T08:46:28.890889-05:
      DOI: 10.1002/cpp.2131
  • Analysing phase progression in Susan's case
    • Authors: Joana F. Ferreira; António B. Vasco, Michael Basseches, Andreia Santos, João M. Ferreira
      Abstract: This study adds a phase-by-phase perspective to the case of Susan, with the aim of better understanding the processes of change in this therapeutic case. A team of 3 raters integrated the sequential phases of the Paradigmatic Complementarity Metamodel with a moment-by-moment tracking method—the Developmental Analysis of Psychotherapy Process method—to analyse this therapeutic process and clarify what happened throughout that may explain phase gains and how the therapist facilitated them. The results suggest that Susan evolved in accordance with the sequence of phases proposed by the Paradigmatic Complementarity Metamodel. We illustrate and explain this with therapeutic interactions representative of Susan's development within the evolving therapeutic process. This case study is the third of a series intended to contribute towards the optimization of clinical decisions in therapeutic processes by identifying markers of phase progression and assessing the value of the therapeutic interventions offered.
      PubDate: 2017-08-31T04:05:41.701605-05:
      DOI: 10.1002/cpp.2110
  • Preschool children's response to behavioural parent training and parental
           predictors of outcome in routine clinical care
    • Authors: Lianne Veen-Mulders; Pieter J. Hoekstra, Maaike H. Nauta, Barbara J. Hoofdakker
      Abstract: ObjectiveTo investigate the effectiveness of behavioral parent training (BPT) for preschool children with disruptive behaviours and to explore parental predictors of response.MethodsParents of 68 preschool children, aged between 2.7 and 5.9 years, participated in BPT. We evaluated the changes in children's behaviour after BPT with a one group pretest–posttest design, using a waiting period for a double pretest. Outcome was based on parents' reports of the intensity and number of behaviour problems on the Eyberg Child Behavior Inventory. Predictor variables included parents' attention-deficit/hyperactivity disorder symptoms, antisocial behaviours, and alcohol use, and maternal parenting self-efficacy and disciplining.ResultsMother-reported child behaviour problems did not change in the waiting period but improved significantly after BPT (d = 0.63). High levels of alcohol use by fathers and low levels of maternal ineffective disciplining were each associated with somewhat worse outcome.ConclusionsBPT under routine care conditions clearly improves disruptive behaviours in preschool children. Mothers who consider themselves as inadequate in disciplining and mothers whose partners do not consume high levels of alcohol report the largest improvements.Key practitionerDisruptive behaviours in referred preschool children improve when parents follow behavioural parent training under routine care conditions.Behavioural parent training is useful to help parents experience fewer behaviours as troublesome.About one third of the parents for whom behavioural parent training was indicated never started the treatment.Clinicians are recommended to put additional effort in motivating and facilitating parents to actually participate in behavioural parent training.It may be useful to assess and treat problematic alcohol use in fathers before behavioural parent training.Behavioural parent training may be particularly effective when mothers perceive themselves as inadequate in disciplining.
      PubDate: 2017-08-30T22:00:23.295421-05:
      DOI: 10.1002/cpp.2117
  • Comparing the acceptability of a positive psychology intervention versus a
           cognitive behavioural therapy for clinical depression
    • Authors: Irene Lopez-Gomez; Covadonga Chaves, Gonzalo Hervas, Carmelo Vazquez
      Abstract: There is growing evidence on the efficacy of positive psychology interventions (PPI) to treat clinical disorders. However, very few studies have addressed their acceptability. The present study aimed to analyse 2 key components of acceptability (i.e., client satisfaction and adherence to treatment) of a new PPI programme, the Integrative Positive Psychological Intervention for Depression (IPPI-D), in comparison to a standard cognitive behavioural therapy (CBT) programme in the treatment of clinical depression. One hundred twenty-eight women with a DSM-IV diagnosis of major depression or dysthymia were allocated to a 10-session IPPI-D or CBT group intervention condition. Results showed that both interventions were highly acceptable for participants. Attendance rates were high, and there were no significant differences between conditions. However, the IPPI-D condition showed significantly higher client satisfaction than the CBT condition. Moreover, acceptability did not differ based on participants' severity of symptoms, regardless of condition. These findings encourage further investigations of the applicability of PPI in clinical settings in order to broaden the range of acceptable and suitable therapies for depressed patients.Key Practitioner MessageThis study sheds light on the client satisfaction and adherence to a positive intervention.For participants, positive psychology interventions (PPI) may be more satisfactory than CBT as PPI are framed within a positive mental health model and, consequently, may reduce the risk of stigmatizationBecause acceptability of treatments and preferences may affect the efficacy of treatments, this study provides an excellent opportunity to offer professionals more therapeutic options to tailor treatments to clients' needs and expectations
      PubDate: 2017-08-30T21:55:26.298585-05:
      DOI: 10.1002/cpp.2129
  • Different aspects of emotional intelligence of borderline personality
    • Authors: Mathell Peter; Arnoud R. Arntz, Theo Klimstra, Ad J.J.M. Vingerhoets
      Abstract: ObjectivesThe present study investigated deficiencies in different components of emotional intelligence in borderline personality disorder (BPD).MethodThe Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT) and the Emotional Quotient Inventory (EQ-i) were used to assess EI dimensions. BPD patients (N = 85; 69 women; M = 33.6 years) were compared with Cluster C personality disorder (PD) patients (N = 39; 23 women; M = 36.6 years) and nonpatients (N = 69; 44 women; M = 35.6 years).ResultsCompared to the Cluster C PD patients and the nonpatient group, BPD patients displayed only deficits in their ability to understand emotions as measured with the Mayer–Salovey–Caruso Emotional Intelligence Test. The Emotional Quotient Inventory only revealed deficits in stress management in BPD patients compared to Cluster C PD patients.ConclusionsOur findings suggest that BPD patients have the ability to regulate emotions effectively, but they subjectively experience deficits in emotion regulation and therefore may not use this ability when they need it.
      PubDate: 2017-08-30T21:40:23.934087-05:
      DOI: 10.1002/cpp.2126
  • How do women's partners view perinatal mental health services' A
           qualitative meta-synthesis
    • Authors: Billie Lever Taylor; Jo Billings, Nicola Morant, Sonia Johnson
      Abstract: ObjectivesPerinatal mental health difficulties are prevalent among women and can adversely affect their partners too. There is also increasing recognition that a woman's partner can play a vital role in relation to her perinatal mental health and should be supported and involved in decisions about her care. Yet it is unclear how services are experienced by the partners of women with perinatal mental health difficulties. This study aimed to synthesize qualitative evidence of partners' views of perinatal mental health care.MethodsA systematic search of 5 electronic databases identified 20 studies that met the inclusion criteria. The findings of these studies were synthesized using an approach based on meta-ethnography.ResultsSix themes were identified, namely, the marginalization and neglect of women's partners, an unmet need for information, partners' ambivalence about involvement and support, practical barriers to involvement, views about support for women's partners, and the impact on partners of the care women received.ConclusionsGiven the importance of women's partners in relation to perinatal mental health as well as to women's engagement with support and treatment outcomes, greater consideration should be given to their needs to ensure they feel well informed and involved in perinatal mental health care, rather than marginalized. However, professionals also need to challenge the barriers to involvement and support that women's partners face and consider the ways in which services may reinforce these barriers.KEY PRACTITIONER MESSAGEPartners of women with perinatal mental health difficulties play a vital role.However, they often feel uninformed and marginalized by services and professionals.They also face significant barriers to accessing support themselves or being more involved.Services and professionals may reinforce these barriers and need to challenge them.Further consideration must be given to the needs of women's partners.
      PubDate: 2017-08-30T21:30:29.648295-05:
      DOI: 10.1002/cpp.2133
  • Improving functional outcome in bipolar disorder: A pilot study on
           metacognitive training
    • Authors: Paula Haffner; Esther Quinlivan, Jana Fiebig, Lene-Marie Sondergeld, Elisa Sophie Strasser, Mazda Adli, Steffen Moritz, Thomas Josef Stamm
      Abstract: BackgroundEffective group psychological interventions in bipolar disorder are rare. In this study, we present “metacognitive training (MCT) for bipolar disorder”—an adaption of a group intervention that has proven effective in other severe psychiatric disorders. MCT is a structured, interactive approach that addresses cognitive biases, social cognition, and self-esteem. In this pilot study, we investigated psychosocial functioning as primary outcome measure, as well as the feasibility of MCT and its acceptance among bipolar patients.MethodsThirty-four outpatients with bipolar disorder were recruited. Inclusion criteria were euthymia and psychosocial functioning with a score >11 assessed by the Functional Assessment Short Test. The subjects received eight weekly MCT sessions. Before and after the intervention, psychosocial functioning, quality of life (QoL), and patient views were assessed.ResultsPatients improved significantly in global psychosocial functioning, with a large effect size from baseline to post-treatment. Over the intervention period, patient QoL improved significantly in terms of their physical health, however not for other QoL subdomains. Treatment adherence was 80%, and patients' appraisal of the training was positive.LimitationsAs this study lacks a control group, it is not possible to ascertain whether the positive treatment effects are attributable to MCT. Additionally, it is unclear whether gains in psychosocial functioning would have been maintained long term.ConclusionsThis pilot trial conclusively shows that MCT is feasible and provides preliminary evidence for both the acceptance and efficacy of MCT. Further studies with larger samples and control condition will be necessary to build on these findings.
      PubDate: 2017-08-30T21:25:36.03683-05:0
      DOI: 10.1002/cpp.2124
  • Tracking and understanding phase progression in Lisa's case
    • Authors: Joana F. Ferreira; António B. Vasco, Michael Basseches, Nuno Conceição, Catarina Vaz-Velho, Rhonda Goldman
      Abstract: This study adds a phase-by-phase perspective to the well-known, and thoroughly analysed on a moment-by-moment basis, case of Lisa. The aim is to see whether this phase-by-phase analysis adds anything valuable to the understanding of the processes of change in this case and the therapeutic processes in general.In this good-outcome case study, a team of raters integrated the temporal sequencing phase component of the Paradigmatic Complementarity Metamodel (PCM) with a moment-by-moment tracking method—the Developmental Analysis of Psychotherapy Process Method (DAPP)—to analyse what occurred along the process that could explain the phase transitions and consolidations observed and how the therapist facilitated them.We illustrate and explain the therapeutic progression with therapeutic interactions from the dyad. The results suggest that Lisa evolved in accordance with the sequence of phases proposed by the PCM until phase 4 (out of 7). However, only phase 2 gains show evidence of structural consolidation.The sequence of phases proposed by the PCM seems to represent a natural progression for patients throughout the therapeutic process, and the consideration of a phase-by-phase map in analysing and thinking of therapeutic cases may be a valuable tool regarding clinical decision making.
      PubDate: 2017-08-30T00:55:55.170242-05:
      DOI: 10.1002/cpp.2111
  • Resilience to suicide ideation: A cross-cultural test of the buffering
    • Authors: Paula Siegmann; Tobias Teismann, Nathalie Fritsch, Thomas Forkmann, Heide Glaesmer, Xiao Chi Zhang, Julia Brailovskaia, Jürgen Margraf
      Abstract: Depression and suicide ideation are common in student populations across the world. The present study investigated factors buffering the association between depression and suicide ideation. A total of 2,687 Chinese students and 601 German students took part in the investigation. Social support, satisfaction with life, self-efficacy, psychosocial stress resistance, and positive mental health were considered as resilience factors moderating the association between depressive symptoms and suicide ideation within both samples. Positive mental health moderated the impact of depressive symptoms on suicide ideation in German and Chinese students. Life satisfaction moderated the impact of depressive symptoms on suicide ideation in German students. Social support moderated the impact of depressive symptoms on suicide ideation in Chinese students. No interaction effects were found for self-efficacy and psychosocial stress resistance. Positive mental health, satisfaction with life, and perceived social support seem to confer resilience and should be taken into account, when assessing individuals for suicide risk.
      PubDate: 2017-08-29T20:15:28.160669-05:
      DOI: 10.1002/cpp.2118
  • Effectiveness of bereavement counselling through a community-based
           organization: A naturalistic, controlled trial
    • Authors: Catherine Newsom; Henk Schut, Margaret S. Stroebe, Stewart Wilson, John Birrell, Mirjam Moerbeek, Maarten C. Eisma
      Abstract: This controlled, longitudinal investigation tested the effectiveness of a bereavement counselling model for adults on reducing complicated grief (CG) symptoms. Participants (N = 344; 79% female; mean age: 49.3 years) were adult residents of Scotland who were bereaved of a close relation or partner, experiencing elevated levels of CG, and/or risks of developing CG. It was hypothesized that participants who received intervention would experience a greater decline in CG levels immediately following the intervention compared to the control participants, but the difference would diminish at follow-up (due to relapse). Data were collected via postal questionnaire at 3 time points: baseline (T), post-intervention (T + 12 months), and follow-up (T + 18 months). CG, post-traumatic stress, and general psychological distress were assessed at all time points. Multilevel analyses controlling for relevant covariates were conducted to examine group differences in symptom levels over time. A stepwise, serial gatekeeping procedure was used to correct for multiple hypothesis testing. A main finding was that, contrary to expectations, counselling intervention and control group participants experienced a similar reduction in CG symptoms at postmeasure. However, intervention participants demonstrated a greater reduction in symptom levels at follow-up (M = 53.64; d = .33) compared to the control group (M = 62.00). Results suggest community-based bereavement counselling may have long-term beneficial effects. Further longitudinal treatment effect investigations with extensive study intervals are needed.Key Practitioner MessagesBereavement counselling for elevated- and high-risk bereaved persons has a beneficial effect on grief symptoms over 18 months.Preliminary indications suggest no marked difference in the effectiveness of bereavement counselling for elevated versus high levels of complicated grief.Professionally trained volunteer counselling by a non-profit organization complements professional services.
      PubDate: 2017-08-29T03:01:20.893904-05:
      DOI: 10.1002/cpp.2113
  • The Music Therapy Session Assessment Scale (MT-SAS): Validation of a new
           tool for music therapy process evaluation
    • Authors: Alfredo Raglio; Marco Gnesi, Maria Cristina Monti, Osmano Oasi, Marta Gianotti, Lapo Attardo, Giulia Gontero, Lara Morotti, Sara Boffelli, Chiara Imbriani, Cristina Montomoli, Marcello Imbriani
      Abstract: BackgroundMusic therapy (MT) interventions are aimed at creating and developing a relationship between patient and therapist. However, there is a lack of validated observational instruments to consistently evaluate the MT process.AimThe purpose of this study was the validation of Music Therapy Session Assessment Scale (MT-SAS), designed to assess the relationship between therapist and patient during active MT sessions.MethodsVideotapes of a single 30-min session per patient were considered. A pilot study on the videotapes of 10 patients was carried out to help refine the items, define the scoring system and improve inter-rater reliability among the five raters. Then, a validation study on 100 patients with different clinical conditions was carried out. The Italian MT-SAS was used throughout the process, although we also provide an English translation.ResultsThe final scale consisted of 7 binary items accounting for eye contact, countenance, and nonverbal and sound–music communication. In the pilot study, raters were found to share an acceptable level of agreement in their assessments. Explorative factorial analysis disclosed a single homogeneous factor including 6 items (thus supporting an ordinal total score), with only the item about eye contact being unrelated to the others. Moreover, the existence of 2 different archetypal profiles of attuned and disattuned behaviours was highlighted through multiple correspondence analysis.ConclusionsAs suggested by the consistent results of 2 different analyses, MT-SAS is a reliable tool that globally evaluates sonorous–musical and nonverbal behaviours related to emotional attunement and empathetic relationship between patient and therapist during active MT sessions.
      PubDate: 2017-08-25T02:55:20.081629-05:
      DOI: 10.1002/cpp.2115
  • The predictive value of early maladaptive schemas in paranoid responses to
           social stress
    • Authors: Johanna Sundag; Leonie Ascone, Tania M. Lincoln
      Abstract: BackgroundSocial stress and negatively valenced cognitive representations of the self (self-schemas) play an important role in the formation of delusions. However, it has not been investigated whether and which self-schemas explain paranoid responses to social stress. Building on the framework of schema theory, the aim of this study was thus to investigate whether more pronounced early maladaptive schemas (EMSs) were associated with increased paranoid ideation after a social stress induction in patients with persecutory delusions (PD).MethodPatients with PD (n = 20) and healthy controls (n = 40) were assessed for EMSs with the Young Schema Questionnaire. They were then exposed to a social stress situation in which they were socially excluded in a Cyberball paradigm. Prior to and after the social stress induction, paranoid symptoms were assessed.ResultsPatients with PD responded with a stronger increase in paranoia and revealed a significantly higher EMS total score compared to the healthy controls. As expected, higher increases in paranoia following the social stress were accounted for by higher EMS total scores. Exploratory analyses showed that particularly the specific EMSs Defectiveness/Shame and Enmeshment/Undeveloped Self were associated with the increase in paranoia.ConclusionsEMSs are associated with stress-related symptom increases in patients with PD. It thus seems worthwhile to further investigate the relevance of specific schemas for paranoia. The findings also suggest that addressing EMSs in psychological treatment of patients with PD holds potential.
      PubDate: 2017-08-25T02:30:23.079623-05:
      DOI: 10.1002/cpp.2128
  • Social cognition and metacognition in social anxiety: A systematic review
    • Authors: Styliani Gkika; Anja Wittkowski, Adrian Wells
      Abstract: Cognitive–behavioural and metacognitive approaches to emotional disorder implicate beliefs in social anxiety, but the types of beliefs differ across these perspectives. Cognitive models suggest that social beliefs about the self (i.e., high standards and conditional and unconditional beliefs) are central. In contrast, the metacognitive model gives centre stage to metacognitive beliefs (i.e., positive and negative beliefs about thinking) as main contributors to the maintenance of the disorder. Despite an expanding research interest in this area, the evidence for such contributions has not yet been reviewed. This study set out to systematically review relevant cross-sectional, longitudinal, and experimental investigations of the direct and indirect (through cognitive processes, such as anticipatory processing, self-focused attention, the post-mortem, and avoidance) relationships of social and metacognitive beliefs with social anxiety. Clinical and nonclinical samples were included, and correlation and regression coefficients as well as results from group comparisons (e.g., t tests and analyses of variance) were extracted. Overall, 23 papers were located, through PsycINFO, PubMed, and Web of Science, and reviewed using narrative synthesis. The results showed a robust positive relationship between social beliefs and social anxiety that appeared to be mediated by cognitive processes. Specific metacognitive beliefs were found to positively contribute to social anxiety both directly and indirectly, through cognitive processes. The study's findings are limited to 2 models of social anxiety and other minor limitations (e.g., grey literature was excluded). With these accounted for, the results are discussed in terms of the conceptualization and treatment of social anxiety and suggestions for future research are made.KEY PRACTITIONERS MESSAGESHigh standards and conditional and unconditional beliefs positively and significantly correlated with social anxiety.These relationships appeared to be affected by cognitive processes, such as anticipatory processing, self-focused attention, and post-mortem processing.Positive and negative metacognitive beliefs and beliefs about the need to control thoughts positively and significantly correlated with social anxiety.Metacognitive beliefs showed both direct and indirect (via cognitive processes) effects on social anxiety.The general methodological quality of the papers was moderate to very good.
      PubDate: 2017-08-24T03:25:28.243326-05:
      DOI: 10.1002/cpp.2127
  • Reducing the time until psychotherapy initiation reduces sick leave
           duration in participants diagnosed with anxiety and mood disorders
    • Authors: Sandra Alonso; José H. Marco, Joaquín Andani
      Abstract: BackgroundSick leave in patients with a mental disorder is characterized by having a long duration. Studies suggest that the time until a patient on sick leave for a common mental health disorder initiates evaluation and treatment by a healthcare professional is an important factor in the duration of the sick leave. However, in these studies, the intervention was not performed by a mental health specialist. The aim of this study was to find out whether the length of sick leave was associated with the time before initiating psychotherapy, age, time until returning to work after psychotherapy ends, and duration of psychotherapy. In a further analysis, we examined whether the model composed of age, duration of psychotherapy, and time before initiating psychotherapy predicted the length of sick leave.MethodThe sample consisted of 2,423 participants, 64.1% (n = 1,554) women and 35.9% (n = 869) men, who were on sick leave for anxiety disorders or depressive disorder.ResultsThe total duration of the sick leave of participants diagnosed with depression and anxiety was positively associated with the time before beginning psychotherapy. Time before beginning psychotherapy predicted the length of sick leave when the variables age and duration of psychotherapy were controlled.ConclusionIt is necessary to reduce the time until beginning psychotherapy in people on sick leave for common mental disorders.
      PubDate: 2017-08-23T02:40:23.193359-05:
      DOI: 10.1002/cpp.2134
  • Are experiences of psychosis associated with unhelpful metacognitive
           coping strategies' A systematic review of the evidence
    • Authors: Rachel Sellers; Adrian Wells, Anthony P. Morrison
      Abstract: This review investigated whether unhelpful metacognitive coping strategies, such as attentional biases, worry, rumination, and thought control, are associated with experiences of psychosis. These processes, known collectively as the Cognitive Attentional Syndrome (CAS), form a central tenet of the Self-Regulatory Executive Function model. Three research questions based on assumptions underlying the CAS were addressed. It was predicted that processes of (a) self-focused processing, (b) negative perseverative thinking (worry and rumination), and (c) counterproductive thought control would be associated with experiences of psychosis. A comprehensive search of the literature identified 51 eligible studies: 17 investigated self-focused attention, 25 investigated perseverative processing (worry: n = 18; rumination: n = 10), and 9 investigated thought control strategies. Findings indicated that unhelpful metacognitive coping strategies associated with the CAS are related to experiences of psychosis and appear to share important relationships with distress. Implications for future research and clinical practice are discussed.Key Practitioner MessageThe unhelpful coping strategies postulated by the Self-Regulatory Executive Function model, may have an important role in distressing experiences of psychosis.
      PubDate: 2017-08-23T02:35:40.894678-05:
      DOI: 10.1002/cpp.2132
  • Early maladaptive schemas associated with dimensional and categorical
           psychopathology in patients with borderline personality disorder
    • Authors: Álvaro Frías; Sara Navarro, Carol Palma, Núria Farriols, Ferrán Aliaga, Ana Salvador, Elena Aluco, Bárbara Martínez, Laia Solves
      Abstract: ObjectiveTo ascertain the foundations for a schema-focused therapy model for the treatment of borderline personality disorder.MethodsThe sample consisted of 102 borderline personality disorder outpatients. Dimensional psychopathology was assessed using the Scale for Suicidal Ideation, the Aggression Questionnaire, and the Symptom CheckList Revised. Categorical psychopathology was measured using the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders, Patient Edition. Stepwise linear/logistic multiple regression analyses were used to determine the predictive role of the schema domains tested by the Young Schema Questionnaire on both types of psychopathology. Receiver operating characteristic curves were calculated for those binary outcomes.ResultsRegarding dimensional psychopathology, disconnection/rejection predicted greater suicidal ideation (β = .39, p = .002), physical/overt aggressiveness (β = .27, p = .05), and psychotic-like symptoms, such as paranoid ideation (β = .35, p = .003). Other-directedness predicted greater anger/inner aggressiveness (β = .22, p = .05) and internalizing symptoms, such as phobic anxiety (β = .39, p = .001). Regarding categorical psychopathology, disconnection/rejection significantly predicted the presence of lifetime comorbidities with eating disorders (adjusted odds ratio [AOR] = 1.12, 95% CI = 0.99–1.24) and posttraumatic stress disorder (AOR = 1.2, 95% CI = 1.04–1.3), resulting in a good balance of sensitivity/specificity, respectively (.97/.96 and .88/.89). Other-directedness significantly predicted the absence of lifetime comorbidity with substance-use disorders (AOR = .74, 95% CI = 0.57–0.95). These relationships remained significant after controlling for confounders (e.g., comorbidity with other personality disorders, clinical global severity).ConclusionsTwo schema domains, disconnection/rejection and other-directedness, were directly associated with dimensional and categorical psychopathology among borderline personality disorder patients. These findings provide further information about the foundations and target interventions when implementing schema-focused therapy on this population.
      PubDate: 2017-08-17T20:25:38.790612-05:
      DOI: 10.1002/cpp.2123
  • Ambivalence and guilt feelings: Two relevant variables for understanding
           caregivers' depressive symptomatology
    • Authors: Andrés Losada; María Márquez-González, Carlos Vara-García, Laura Gallego-Alberto, Rosa Romero-Moreno, Karl Pillemer
      Abstract: Providing care for a relative with dementia is considered to be a chronic stressor that has been linked to negative mental health consequences for caregivers. A theoretical model was developed and tested to assess the degree to which ambivalence and guilt feelings contribute to caregivers' depressive symptomatology. Participants included 212 dementia family caregivers. In addition to ambivalence and guilt feelings, sociodemographic characteristics, behavioural and psychological symptoms of dementia, and depressive symptomatology were assessed. Hypotheses derived from the stress and coping model were tested using path analysis. The analysed model showed an excellent fit to the data. In total, 35% of the variance in depressive symptomatology was explained by the assessed variables. Although significant correlations were obtained between frequency and appraisal of behavioural and psychological symptoms of dementia and depression, the obtained model suggests that this effect was mediated through ambivalence. In addition, ambivalence had an indirect effect on depression. The association of ambivalence with depression was explained through feelings of guilt; that is, respondents who reported ambivalent feelings were more likely to experience guilt, leading in turn to greater depressive symptomatology. The findings suggest that dementia caregivers' ambivalence and guilt feelings are relevant for understanding their depressive symptomatology. These factors should be addressed in psychological interventions with caregivers.
      PubDate: 2017-08-14T23:55:26.361213-05:
      DOI: 10.1002/cpp.2116
  • Confirming the mechanisms behind cognitive-behavioural therapy
           effectiveness in chronic pain using structural equation modeling in a
           sample of patients with temporomandibular disorders
    • Authors: Estrella Durá-Ferrandis; Maite Ferrando-García, Mª José Galdón-Garrido, Yolanda Andreu-Vaillo
      Abstract: ObjectiveTo evaluate whether therapeutic mechanisms assumed to explain the effect of cognitive behavioural therapy (CBT) concerning temporomandibular symptoms are confirmed by structural equation modelling.MethodPatients were randomly assigned to either an experimental group receiving CBT (N = 41) or a standard therapy control group (N = 31). Subjects were assessed before and after intervention using mediator variables hypothesized according to the CBT model, as well as outcome variables and other socio-demographic and clinical measures.ResultsThe results confirm that the effect of treatment on pain intensity was partially mediated by distress, catastrophizing, perceived control, distraction, and mental self-control. The self-medication frequency was partially mediated by distraction. Pain interference was partially mediated by distress, distraction, and mental self-control. Reduction in the number of painful points on palpation was partially explained by distress, although in this case, there was a significant direct effect of treatment not mediated by other variables.ConclusionsThe results could set the principles for the development of more efficient and effective cognitive behavioural interventions for chronic pain.Key Practitioner MessageCognitive-behavioural models fundamentals for chronic pain interventions (and concretely in TMD patients) are tested and partially confirmed, providing experts and professionals with specific knowledge to be transferred to clinical practice.The article provide key messages for the psychologists (and other professionals) working on pain management, identifying those strategies directly linked with the improvement of outcome measures.The results provide evidence-based orientations for the future application of the CBT to chronic pain, thereby making interventions more efficient as they would only be focused on the most effective technique.
      PubDate: 2017-08-14T03:54:53.080725-05:
      DOI: 10.1002/cpp.2114
  • The role of feared possible selves in obsessive–compulsive and related
           disorders: A comparative analysis of a core cognitive self-construct in
           clinical samples
    • Authors: Frederick Aardema; Richard Moulding, Gabriele Melli, Adam S. Radomsky, Guy Doron, Jean-Sebastien Audet, Magali Purcell-Lalonde
      Abstract: Increasingly, cognitive-behavioural models have been considering the role of beliefs about the self in the development and maintenance of obsessive–compulsive disorder (OCD), including sensitive domains of self-concept and feared self-perceptions. This has led to the development of the Fear of Self Questionnaire (FSQ; Aardema et al., ), which has shown strong internal consistency, divergent and convergent validity, and found to be a major predictor of unwanted thoughts and impulses (i.e., repugnant obsessions). The current study aimed to investigate fear of self-perceptions using the FSQ in an OCD sample (n = 144) and related psychological disorders (eating disorders, n = 57; body dysmorphic disorder, n = 33) in comparison to a non-clinical (n = 141) and clinical comparison group (anxiety/depressive disorders, n = 27). Following an exploratory factor analysis of the scale in the OCD sample, the results showed that participants with OCD in general did not score significantly higher on fear of self-perceptions than did the clinical comparison participants. However, consistent with previous findings, fear of self was highly characteristic among OCD patients with unwanted repugnant thoughts and impulses. In addition, fear of self-perceptions were significantly more elevated in those with eating or body dysmorphic disorders relative to the other non-clinical and clinical groups. The construct of a “feared possible self” may be particularly relevant in disorders where negative self-perception is a dominant theme, either involving concerns about one's inner self or concerns related to perceived bodily faults.
      PubDate: 2017-08-09T01:47:24.380563-05:
      DOI: 10.1002/cpp.2121
  • A collaborative care skills workshop for carers: Can it be delivered in
           1 day'
    • Authors: Paul E. Jenkins; Sonia Bues, Julie Cottrell, Joel Hawkins, Laura Pinder, Susan Price, Anne Stewart
      Abstract: Carers of individuals with eating disorders (EDs) report high levels of burden and distress and describe a number of unmet needs. As a result, a number of interventions have been designed to support carers, including the “Maudsley eating disorder collaborative care skills workshops,” which comprise six 2-hr workshops delivered over 3 months for parents and carers of people with EDs. The current study aimed to test a proof-of-concept that this workshop could be effectively delivered in 1 day. An additional aim was to assess whether the workshop had direct effects on carer skills. A nonexperimental repeated measures research design was employed, giving measures before and after a 1-day workshop. Results suggested significant increases in carer self-efficacy and carer skills, with moderate to large effect sizes. Qualitative analyses supported these results whilst also generating ideas to improve the 1-day workshop.
      PubDate: 2017-08-07T04:35:22.090659-05:
      DOI: 10.1002/cpp.2119
  • Beyond Ryff's scale: Comprehensive measures of eudaimonic well-being in
           clinical populations. A systematic review
    • Authors: Martina Brandel; Francesca Vescovelli, Chiara Ruini
      Abstract: Eudaimonic well-being that protects mental and physical health has received increasing attention. This investigation aimed to review which comprehensive instruments for measuring eudaimonic well-being were applied with clinical populations (reporting mental or physical illnesses), beyond Ryff's Psychological Well-Being Scale.Articles citing at least 1 of the measures of eudaimonic well-being identified by previous theoretical work were extracted from medical and psychological electronic databases and screened. Only investigations involving clinical populations were included and reviewed.An initial screening identified 5,065 articles using eudaimonic well-being measures, out of which only 28 articles encompassed clinical populations and could be included. Sixteen involved patients with mental disorders and 12 populations with medical conditions. In these articles, only 4 measures of eudaimonic well-being were used (Mental Health Continuum, Flourishing Scale, General Causality Orientations Scale, and Orientations to Happiness Subscales), out of the 12 currently available in literature. The Mental Health Continuum was the most used instrument, particularly in adults with depression, whose levels of eudaimonic well-being are impaired, but may be improved by specific interventions. Autonomy appeared to influence patients' motivation to treatment, both in mental and physical disorders.The need for a larger consensus regarding specific measures of eudaimonic well-being for clinical populations emerged. The importance of including assessment of positive functioning as an indicator of recovery in clinical domains is discussed.Key Pratictioner MessageEudaimonic well-being protects health, but few studies involved clinical samples, and no consensus on its definitions emerged.Only 4 measures of eudaimonic well-being were used in clinical populations (the Mental Health Continuum, The Flourishing Scale, the General Causality Orientations Scale, and the Orientation to Happiness Subscales), out of the 12 analyzed in the present review.Eudaimonic well-being is impaired in clinical populations and can be improved by acceptance and commitment therapy or other positive interventions, including yoga and mind/body treatments.Autonomy may play a crucial role in influencing patients' motivation to treatment.The restoration of eudaimonic well-being should be considered as a clinical indicator of recovery.
      PubDate: 2017-08-02T21:50:49.723095-05:
      DOI: 10.1002/cpp.2104
  • A randomized controlled trial comparing EMDR and CBT for
           obsessive–compulsive disorder
    • Authors: Zoe Marsden; Karina Lovell, David Blore, Shehzad Ali, Jaime Delgadillo
      Abstract: BackgroundThis study aimed to evaluate eye movement desensitization and reprocessing (EMDR) as a treatment for obsessive–compulsive disorder (OCD), by comparison to cognitive behavioural therapy (CBT) based on exposure and response prevention.MethodThis was a pragmatic, feasibility randomized controlled trial in which 55 participants with OCD were randomized to EMDR (n = 29) or CBT (n = 26). The Yale-Brown obsessive–compulsive scale was completed at baseline, after treatment and at 6 months follow-up. Treatment completion and response rates were compared using chi-square tests. Effect size was examined using Cohen's d and multilevel modelling.ResultsOverall, 61.8% completed treatment and 30.2% attained reliable and clinically significant improvement in OCD symptoms, with no significant differences between groups (p > .05). There were no significant differences between groups in Yale-Brown obsessive–compulsive scale severity post-treatment (d = −0.24, p = .38) or at 6 months follow-up (d = −0.03, p = .90).ConclusionsEMDR and CBT had comparable completion rates and clinical outcomes.
      PubDate: 2017-07-28T03:25:46.399028-05:
      DOI: 10.1002/cpp.2120
  • What approaches for promoting shared decision-making are used in child
           mental health' A scoping review
    • Authors: Helen Cheng; Daniel Hayes, Julian Edbrooke-Childs, Kate Martin, Louise Chapman, Miranda Wolpert
      Abstract: ObjectiveWhilst the benefits of shared decision-making (SDM) have been promoted across different health settings, its implementation is complex, particularly for children and young people with mental health difficulties. The aim of this scoping review was to identify and describe SDM approaches (tools, techniques, and technologies) used in child and youth mental health.MethodElectronic databases and grey literature were searched. Papers were included if they satisfied these criteria: English language; described an SDM approach (tool, technique, or technology); included sufficient detail on the SDM approach for quality assessment; did not use only a questionnaire to provide feedback on SDM or related concepts (e.g., therapeutic alliance) without another SDM approach; child or adolescent population (up to 18 years); carers of children or adolescents; and mental health setting. Screening and data extraction were performed by two co-authors, and each included record was quality assessed against a set of essential ingredients of SDM identified by previous studies.ResultsOf the 8,153 initial results, 22 were eligible for final inclusion. These could be grouped into six approaches: therapeutic techniques, psychoeducational information, decision aids, action planning or goal setting, discussion prompts, and mobilizing patients to engage. The quality of approaches identified ranged from one to seven of the nine essential elements of SDM.ConclusionEvidence suggests that a range of approaches are being developed to support SDM in child and youth mental health. Rigorous research evaluating the effectiveness of these approaches is urgently needed, particularly from the perspective of children and young people.Key practitioner messageThis scoping review is the first to categorise and outline different shared decision-making (SDM) approaches (tools, techniques, and technologies) as suggested by The Health Foundation and has identified six distinct approaches used in child and youth mental healthEach of the six extant SDM approaches has been qualitatively assessed using a most comprehensive list of essential elements of SDM available so far in the areaWhilst evidence suggests that a range of approaches is being developed to support SDM in child and youth mental health, rigorous research evaluating the effectiveness of these approaches is largely lackingThe current review may serve as a useful guideline for those institutions and health service organisations that are keen to implement an SDM approach for children and young people in their careFurther research is urgently needed to establish the effect of SDM on clinical outcomes, as well as whether such approaches are cost effective
      PubDate: 2017-07-28T03:21:58.68065-05:0
      DOI: 10.1002/cpp.2106
  • An evaluation of the effectiveness of psychological therapy in reducing
           general psychological distress for adults with autism spectrum conditions
           and comorbid mental health problems
    • Authors: Sarah H. Blainey; Freya Rumball, Louise Mercer, Lauren Jayne Evans, Alison Beck
      Abstract: ObjectiveTo investigate the effectiveness of psychological therapy in reducing psychological distress for adults with autism spectrum conditions (ASC) and co-morbid mental health conditions in routine clinical practice. To explore the effect of individual characteristics and service factors on change in general distress.MethodIn a specialist psychological therapies service for adults with ASC, the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) self-report questionnaire of psychological distress is completed by clients at start and end of therapy. Change over time and reliable and clinical change was assessed for 81 of a total of 122 clients (66.4%). Factors which may influence change over time were explored using available clinical information.ResultsOverall, there was a significant reduction in CORE-OM score during therapy with a small effect size. Most clients showed an improvement in psychological distress over therapy (75.4% improved, with 36.9% of these showing reliable changes). Significant and comparable reductions from pre-therapy to post-therapy were seen across the sample, showing that individual differences did not mediate therapy effectiveness. CORE-OM scores mediate the association between age of ASD diagnosis and hours of therapeutic input required, with greater age at diagnosis and higher distress associated with longer therapy duration.ConclusionsOur preliminary findings suggest that psychological therapy may be effective in reducing general distress for clients with ASC and co-morbid mental health conditions and should be routinely offered. Individuals who are diagnosed with ASD in adulthood are likely to require a longer course of therapy when their general distress scores are high.Key Practitioner MessageCo-morbid mental health conditions are common in adults on the autism spectrum, but there is little evidence for what might be helpful in reducing rates of mental health conditions in this population.This study demonstrates that adapted psychological therapy offered in a specialist adult ASC service was somewhat effective in reducing distress for adults with autism.Individual characteristics and service factors did not influence the extent of change in general distress over the course of therapy; significant and comparable reductions in general distress from pre-therapy to post-therapy were seen across the sample.Individuals who are diagnosed with ASD in adulthood are likely to require a longer course of therapy when their pre-therapy general distress scores are high.Adaptations that may need to be made to services and to therapy delivery are discussed.
      PubDate: 2017-07-26T20:20:33.394501-05:
      DOI: 10.1002/cpp.2108
  • Four years comparative follow-up evaluation of community-based, step-down,
           and residential specialist psychodynamic programmes for personality
    • Authors: Marco Chiesa; Antonella Cirasola, Peter Fonagy
      Abstract: Although the fulcrum of service provision for personality disorder (PD) has shifted from hospital-based to psychodynamically- and cognitively-oriented outpatient programmes, very few studies have attempted to compare specialist moderate intensity outpatient programmes with specialist high-intensity residential models, or to explore whether a period of inpatient treatment may be necessary to improve outcome and prognosis. In this article, we prospectively compare changes over a 4-year period in 3 groups of patients with personality disorders (N = 162) treated in a specialist community-based (CBP, N = 30), a step-down (RT-CBP, N = 87), and a specialist residential programme (RT, N = 45) in psychiatric distress, deliberate self-injury, and suicide attempt using multilevel modelling and multivariate logistic regression analyses. The results showed that percentages of early-dropout were significantly different (p = .0001) for the 3 programmes (CBP = 13.4%, RT-CBP = 10.2%, and RT = 41.4%). A significant interaction between treatment model and time was found for psychiatric distress (p = .001), with CBP and RT-CBP achieving more marked changes (g = 1.20 and g = 0.68, respectively) compared to RT (g = 0.30) at 48-month follow-up. CBP and RT-CBP were found to significantly reduce impulsive behaviour (deliberate self-injury and suicide attempt) compared to RT. Severity of presentation was not found to be a significant predictor of outcome. Long-term RT showed no advantage over long-term CBP, either as stand-alone or as step-down treatment. Replication may be needed to confirm generalizability of results, and a number of limitations in the study design may moderate the inferences that can be drawn from the results.
      PubDate: 2017-07-26T20:15:42.2546-05:00
      DOI: 10.1002/cpp.2109
  • Differences in clinical intrusive thoughts between obsessive–compulsive
           disorder, generalized anxiety disorder, and hypochondria
    • Authors: Pablo Romero-Sanchiz; Raquel Nogueira-Arjona, Antonio Godoy-Ávila, Aurora Gavino-Lázaro, Mark H. Freeston
      Abstract: Differences and similarities between intrusive thoughts typical of obsessive–compulsive disorder, generalized anxiety disorder, and hypochondriasis are relevant for their differential diagnosis, formulation, and psychological treatment. Previous research in non-clinical samples pointed out the relevance of some process variables, such as responsibility, guilt, or neutralization strategies. This research is aimed to investigate the differences and similarities between clinical obsessions, worries, and illness intrusions in some of these process variables. A second aim is to identify models based on these variables that could reliably differentiate between them. Three groups of patients with obsessive–compulsive disorder (n = 35; 60% women, mean age 38.57), generalized anxiety disorder (n = 36; 61.1% women, mean age 41.50), and hypochondriasis (n = 34; 70.6% women, mean age 31.59) were evaluated using the Cognitive Intrusions Questionnaire—Transdiagnostic Version (Romero-Sanchiz, Nogueira-Arjona, Godoy-Ávila, Gavino-Lázaro, & Freeston, ). The results showed that some appraisals (e.g., responsibility or egodystonicity), emotions (e.g., guilt or insecurity), neutralization strategies, and other variables (e.g., verbal content or trigger from body sensation) are relevant for the discrimination between obsessions, worries, and illness intrusions. The results also showed 3 stable models based on these variables for the discrimination between these thoughts. The implication of these results in the diagnosis, formulation, and psychological treatment of obsessive–compulsive disorder, generalized anxiety disorder, and hypochondriasis is discussed.Key Pratictioner MessageThe current study provides evidence about the discrimination between clinical obsessions, worries, and illness intrusions from a transdiagnostic perspective.The differentiation between them is crucial for the diagnosis, formulation, and psychological treatment of obsessive–compulsive disorder, generalized anxiety disorder, and hypochondriasis.Appraisals such as responsibility or egodystonicity, emotions such as guilt or insecurity, and other variables such as frequency, neutralization strategies or verbal form were found relevant for the discrimination between these types of thoughts.Three stable binary logistic models including these variables were developed for the discrimination between these thoughts.
      PubDate: 2017-07-26T02:40:21.074567-05:
      DOI: 10.1002/cpp.2107
  • Animal-assisted psychotherapy for young people with behavioural problems
           in residential care
    • Authors: Alexander Muela; Nekane Balluerka, Nora Amiano, Miguel Angel Caldentey, Jone Aliri
      Abstract: The aim of this study was to evaluate the impact of an animal-assisted psychotherapy (AAP) programme on clinical symptoms, personal adjustment, and adaptive skills in a group of adolescents in residential care who had experienced childhood trauma and who presented mental health problems and difficulties adapting to the care home environment. The 87 participants (Mage = 15.17, SD = 1.53) were divided into two groups: a treatment group (25 girls and 27 boys; Mage = 15.00, SD = 1.55) and a control group (9 girls and 26 boys; Mage = 15.42, SD = 1.50). The programme consisted of 34 sessions involving both group (23 sessions) and individual (11 sessions) AAP. The Behaviour Assessment System for Children was used to evaluate clinical and adaptive dimensions of behaviour and personality. The results indicated that, in comparison with controls, the young people who took part in the AAP programme reported a significant improvement on two measures of internalizing symptoms, namely, depression and sense of inadequacy. Although no significant differences were observed in relation to externalizing symptoms, the adolescents who received the AAP programme showed improved social skills in terms of their ability to interact satisfactorily with peers and adults in the care home environment, as well as a more positive attitude towards teachers at school. These results suggest that AAP may be a promising treatment for young people who have experienced childhood trauma and who subsequently find it difficult to adapt to the residential care setting.
      PubDate: 2017-07-20T22:40:24.47208-05:0
      DOI: 10.1002/cpp.2112
  • Experiencing health-related quality of life in paediatric short stature
           – a cross-cultural analysis of statements from patients and parents
    • Authors: Rachel Sommer; Monika Bullinger, John Chaplin, Ju-ky Do, Mick Power, Andreas Pleil, Julia Quitmann
      Abstract: ObjectivesDirect assessment of the patient perspective is necessary to thoroughly understand patients' experiences of disease. We aimed to examine information from children with short stature on their perceived HrQoL within 5 European countries.MethodsPatients, identified through clinical databases, were approached by their clinicians according to the inclusion criteria regarding a diagnosis of growth hormone deficiency or idiopathic short stature and age requirements. A focus group methodology was applied in 84 children and 112 parents. Based on a category system, individual statements were allocated to domains. To evaluate the emerging topics, qualitative content analysis was conducted. Domains and respective coding frequencies per category were compared across countries and respondents.ResultsThe highest number of statements produced by the children and parents were related to social (29%) and emotional needs and concerns (28%). In particular, children stressed their experience of social exclusion but also their perception of social support. Regarding emotional needs, they stated mainly the desire to be taller in order to be less teased by peers. National differences were identified, for example, Swedish (22%) and British (16%) children and their parents (Sweden 26%; Britain 23%) stressed physical HrQoL aspects, whereas German children (21%) strongly focused on treatment aspects, mainly the benefit of treatment.ConclusionComprehensive knowledge of the impact of a chronic condition such as short stature on wellbeing is an important precondition of effective treatment. Because socioemotional topics were rated in all the countries to be most important, interventions aimed at improving HrQoL should target social and emotional responses to short stature.Key Practitioner MessagesFocus group discussions have been shown to be a useful method for children with short stature and their parents to describe, communicate, prioritize and present aspects of health-related quality of life to health care professionals.Social and emotional aspects of living with short stature are the most frequently discussed topics by children as well as by parents across countries; these topics provide important objectives for tailoring appropriate psychosocial interventions.Clinicians should consider both child and parent concerns, include psychosocial screening tools and propose appropriate referral options for patients and family members.
      PubDate: 2017-07-04T02:40:19.844969-05:
      DOI: 10.1002/cpp.2105
  • Intensive Short-Term Dynamic Psychotherapy for generalized anxiety
           disorder: A pilot effectiveness and process-outcome study
    • Authors: Peter Lilliengren; Robert Johansson, Joel M. Town, Steve Kisely, Allan Abbass
      Abstract: The objective of this study was to evaluate the clinical- and cost-effectiveness of Intensive Short-Term Dynamic Psychotherapy (ISTDP) for generalized anxiety disorder (GAD). We further aimed to examine if a key clinical process within the ISTDP framework, termed the level of mobilization of unprocessed complex emotions (MUCE), was related to outcome. The sample consisted of 215 adult patients (60.9% female) with GAD and comorbid conditions treated in a tertiary mental health outpatient setting. The patients were provided an average of 8.3 sessions of ISTDP delivered by 38 therapists. The level of MUCE in treatment was assessed from videotaped sessions by a rater blind to treatment outcome. Year-by-year healthcare costs were derived independently from government databases. Multilevel growth models indicated significant decreases in psychiatric symptoms and interpersonal problems during treatment. These gains were corroborated by reductions in healthcare costs that continued for 4 years post-treatment reaching normal population means. Further, we found that the in-treatment level of MUCE was associated with larger treatment effects, underlining the significance of emotional experiencing and processing in the treatment of GAD. We conclude that ISTDP appears to reduce symptoms and costs associated with GAD and that the ISTDP framework may be useful for understanding key therapeutic processes in this challenging clinical population. Controlled studies of ISTDP for GAD are warranted.
      PubDate: 2017-07-04T01:50:51.456885-05:
      DOI: 10.1002/cpp.2101
  • In-session behaviours and adolescents' self-concept and loneliness: A
           psychodrama process–outcome study
    • Authors: Hod Orkibi; Bracha Azoulay, Sharon Snir, Dafna Regev
      Abstract: As adolescents spend many hours a day in school, it is crucial to examine the ways in which therapeutic practices in schools promote their well-being. This longitudinal pilot study examined the contribution of school-based psychodrama group therapy to the self-concept dimensions and perceived loneliness of 40 Israeli adolescents (aged 13–16, 60% boys) in public middle schools. From a process–outcome perspective, we also examined the understudied trajectory of adolescents' in-session behaviours (process variables) and its associations with changes in their self-concepts and loneliness (outcome variables). Psychodrama participants reported increases in global, social, and behavioural self-concepts and a decrease in loneliness compared to the control group. In-session productive behaviours increased and resistance decreased throughout the therapy, but varied process–outcome relationships were found. The study suggests that conducting further research into the process–outcome relationships in psychodrama group therapy is warranted to pinpoint specific mechanisms of change. Suggestions for future studies are provided.
      PubDate: 2017-06-27T02:17:41.245649-05:
      DOI: 10.1002/cpp.2103
  • Attachment and dissociation as mediators of the link between childhood
           trauma and psychotic experiences
    • Authors: Josie Pearce; Jane Simpson, Katherine Berry, Sandra Bucci, Andrew Moskowitz, Filippo Varese
      Abstract: Exposure to childhood trauma has been implicated in the development of paranoia and hearing voices, but the mechanisms responsible for these associations remain unclear. Understanding these mechanisms is essential for ensuring that targeted interventions can be developed to better support people experiencing distress associated with paranoia and voices. Recent models have proposed that dissociation may be a mechanism specifically involved in the development of voices and insecure attachment in the development of paranoia. Recent theoretical proposals have added to this and argued that fearful attachment could also lead to increased vulnerability for voices. This study was the first to examine whether dissociation and insecure attachment styles mediated the relationship between childhood trauma and these psychotic experiences. One hundred and twelve participants experiencing clinical levels of psychosis completed measures of dissociation, childhood trauma, attachment, voices, and paranoia. Results revealed positive associations between fearful (but not dismissive and anxious) attachment, dissociation, trauma, and psychotic experiences. Mediation analyses indicated that dissociation, but not fearful attachment, significantly mediated the relationship between trauma and voices. Conversely, both dissociation and fearful attachment significantly mediated the relationship between trauma and paranoia. The findings suggest that insecure attachment might be more strongly related to paranoia than hallucinations and suggest that fearful attachment may be a more promising mechanism to explain this relationship. Furthermore, the findings suggest that the impact of dissociation on psychotic experiences may extend to paranoia. Future research is required to replicate these findings using interview-based attachment measures.Key practitioner messagesDissociation is a robust mediator of the link between childhood trauma and experiences of psychosis, and as such, clinicians should routinely enquire about the presence of dissociation.Clinicians should consider dissociation when formulating clients' difficulties and include dissociation as a possible therapeutic target for psychological interventions in psychosis.Fearful attachment is robustly associated with paranoia and should be taken into account throughout assessment, formulation, and intervention.
      PubDate: 2017-06-27T02:12:36.680813-05:
      DOI: 10.1002/cpp.2100
  • Change in attachment states of mind of women with binge-eating disorder
    • Authors: Hilary Maxwell; Giorgio A. Tasca, Renee Grenon, Kerri Ritchie, Hany Bissada, Louise Balfour
      Abstract: Insecure and unresolved/disorganized attachment states of mind may impact affect regulation and interpersonal functioning that contribute to binge eating in women with binge-eating disorder (BED). Group psychological treatment may facilitate changes from insecure to secure and from unresolved–disorganized to non-unresolved/disorganized attachment states of mind. This study used attachment theory to understand better the psychopathology of BED and co-morbid overweight status and to understand better the treatment response of patients with BED who receive group psychotherapy. Women with BED attended group psychodynamic interpersonal psychotherapy and completed the Adult Attachment Interview pretreatment and 6 months posttreatment. Matched samples of overweight women without BED and normal-weight women without BED completed the Adult Attachment Interview at 1 time point. Women with BED had significantly higher rates of preoccupied and unresolved/disorganized attachment states of mind compared to normal-weight women without BED and had similar rates of insecure and unresolved/disorganized attachment states of mind compared to overweight women without BED. Of the women with BED who had an insecure and/or unresolved/disorganized attachment states of mind at pretreatment, about 60% demonstrated clinically relevant changes to secure and to non-unresolved/disorganized states of mind at 6 months post group psychodynamic interpersonal psychotherapy. Results indicated that some women with BED may benefit from interventions that help them regulate hyperactivated affect and create coherent narratives. Both women with BED and overweight women without BED may benefit from treatments that help them develop more adaptive affect regulation strategies related to unresolved/disorganized attachment states of mind.Key Practitioner MessagesA preoccupied attachment state of mind may be an underlying and maintaining factor for women with binge-eating disorderTime-limited psychodynamic and interpersonal group psychotherapies, like Group Psychodynamic Interpersonal Psychotherapy, may help those with binge-eating disorder to process and organize their attachment memories which may lead to improved affect regulation and interpersonal functioningPsychological theories and treatment for binge-eating disorder and overweight may benefit from considering the current impact of insecure and unresolved/disorganized attachment states of mind
      PubDate: 2017-06-21T21:25:32.609585-05:
      DOI: 10.1002/cpp.2095
  • An exploration of the relationship between use of safety-seeking
           behaviours and psychosis: A systematic review and meta-analysis
    • Authors: Sarah Tully; Adrian Wells, Anthony P. Morrison
      Abstract: Safety-seeking behaviours are responses employed to protect against perceived threat. In relation to anxiety disorders, safety-seeking behaviours have been implicated in both the formation and maintenance of distress. Several studies have highlighted similar findings in relation to psychosis; however, this literature has not yet been synthesized. This review is, therefore, being conducted in order to synthesize the literature on safety seeking in people with psychosis to increase the understanding of this relationship. A systematic search identified and included 43 studies comprising 2,592 participants, published between 1995 and 2015. The results indicated that people experiencing psychosis commonly respond to their experiences with behavioural and cognitive strategies intended to manage their difficulties. In relation to safety seeking, avoidance, and resistance, there was a pattern that these responses are associated with increased distress and appraisals of threat. The results relating to engagement response styles showed the opposite pattern. These results provide support for cognitive models of safety seeking and psychosis with many of the meta-analyses reported here showing a clear pattern of association between behavioural responses and distress. However, the results reported within individual studies are mixed. This appears to be particularly true with the response style of distraction, with our analyses unable to clarify this relationship. It is possible that the mixed results could reflect the complexities in defining safety seeking and distinguishing it from coping in this population. The clinical implications of this are discussed.Key practitioner messagePeople experiencing psychosis commonly respond to their unusual experiences with behavioural and cognitive strategies intended to manage their difficulties.In general, reducing safety seeking behaviours, including avoidance and resistance, seems likely to be helpful in the longer term reduction of distress associated with psychosis.However, it should not be assumed that certain responses are always unhelpful. The clinician should work with each individual to find out what each response style means to them and help them to assess its function and purpose.Formal evaluation of current and historical advantages and disadvantages of specific strategies could also be helpful.
      PubDate: 2017-06-21T06:01:09.095686-05:
      DOI: 10.1002/cpp.2099
  • The role of guilt sensitivity in OCD symptom dimensions
    • Authors: Gabriele Melli; Claudia Carraresi, Andrea Poli, Donatella Marazziti, Antonio Pinto
      PubDate: 2017-06-13T00:25:20.601591-05:
      DOI: 10.1002/cpp.2097
  • Does the severity of psychopathology of Italian students receiving
           counselling services increase over time' A 5-year analysis and a
           comparison with a clinical and non-clinical sample
    • Authors: Maria Grazia Strepparava; Marco Bani, Federico Zorzi, Umberto Mazza, Francesca Barile, Giorgio Rezzonico
      Abstract: Psychological problems—from the most minor such as exams anxiety to the more severe such as personality disorders—are not rare in young adults. University Counselling Services often present the only opportunity for undergraduates to meet health professionals and to be confronted with their difficulties in a non-clinical setting or—in cases of more severe psychopathology—to be referred to mental health services. Recent research attests to the increasing severity of psychological problems among undergraduate and graduate university students. The question necessarily arises as to whether this trend is replicated in the general population being referred to mental health services and, if such is the case, whether there are differences between the two populations. This paper analyses the change in the severity of self-reported symptoms in a sample of 194 students attending a University Counselling Service over a course of 5 years (2010–2014). Clinical severity was assessed in both groups by Symptoms Check List 90-Revised, Clinical Outcome in Routine Evaluation-Outcome Measure, and Emotion Regulation Questionnaire scores. Results show a substantial stability in severity level across time, and a comparison with an age-matched sample of patients referred to a public hospital clinical psychology service shows overlapping data with respect to disease severity level. As the mental health of university students is an important public health issue, the implications for the organization and structure of university counselling services and the connection with public mental health hospital centres are discussed.Key Practitioner MessageThe severity of distress and symptoms in Italian students who access psychological counselling service remained stable across a 5-year period.The level of severity of distress and symptoms in students who access psychological counselling service was higher and similar to that of a mental health service.The results suggest to develop multilevel interventions to address the broader well-being needs of university students providing both low- and high-intensity interventions and develop a network with mental health services.
      PubDate: 2017-06-13T00:00:37.402676-05:
      DOI: 10.1002/cpp.2096
  • On the relationships between DSM-5 dysfunctional personality traits and
           social cognition deficits: A study in a sample of consecutively admitted
           Italian psychotherapy patients
    • Authors: Andrea Fossati; Antonella Somma, Robert F. Krueger, Kristian E. Markon, Serena Borroni
      Abstract: This study aims at testing the hypothesis that the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) alternative model of personality disorder (AMPD) traits may be significantly associated with deficits on 2 different social cognition tasks, namely, the Reading the Mind in the Eyes Test and the Movie for the Assessment of Social Cognition, in a sample of consecutively admitted inpatients and outpatients. The sample was composed of 181 consecutively admitted participants (57.5% women; mean age = 38.58 years). Correlation coefficients and partial correlation coefficients were computed in order to assess the associations among social cognition tasks, DSM-5 AMPD traits, and dimensionally assessed DSM-5 Section II personality disorders. Specific maladaptive traits listed in the DSM-5 AMPD were significantly associated with Reading the Mind in the Eyes Test scores and Movie for the Assessment of Social Cognition scores, even when the effect of selected DSM-5 Section II personality disorders was controlled for. Our results support the relevance of studying social cognitive functioning in subjects suffering from personality disorders.
      PubDate: 2017-05-11T05:10:22.486377-05:
      DOI: 10.1002/cpp.2091
  • Sudden gains in exposure-focused cognitive-behavioral group therapy for
           panic disorder
    • Authors: Raquel Nogueira-Arjona; Martí Santacana, María Montoro, Silvia Rosado, Roser Guillamat, Vicenç Vallès, Miquel A. Fullana
      Abstract: In the context of psychological treatment, a sudden gain is a large and enduring improvement in symptom severity that occurs between two single therapy sessions. The influence of sudden gains on long-term outcomes and functional impairment in anxiety disorders is not well understood, and little is known with regard to panic disorder in particular. In addition, previous research on patients with anxiety disorders has produced inconsistent results regarding the relationship between sudden gains and cognitive change. We examined the incidence of sudden gains in a large sample (n = 116) of panic disorder patients undergoing exposure-focused cognitive-behavioral group therapy, and compared panic severity, functional impairment, and cognitive change in patients with and without sudden gains at posttreatment and 6-month follow-up. Participants who experienced sudden gains displayed lower levels of panic severity and functional impairment at posttreatment and 6-month follow-up than those who did not experience sudden gains. However, we observed no difference in cognitive changes between groups, either at posttreatment or at follow-up. Our results demonstrate that the beneficial effects of sudden gains on therapeutic outcomes not only extend to long-term and functional outcome measures but are also evident in less cognitive (i.e., exposure-focused) forms of psychological treatment.Key Practitioner MessageSudden gains are common in panic disorder patients undergoing exposure-based cognitive-behavioral group therapy.Sudden gains during exposure-focused therapy are linked to greater improvement in panic disorder severity and functional impairment.The positive impact of sudden gains on panic disorder severity and functional impairment is maintained in the long term.
      PubDate: 2017-05-11T05:05:31.243724-05:
      DOI: 10.1002/cpp.2093
  • Insecure attachment and maladaptive schema in disordered eating: The
           mediating role of rejection sensitivity
    • Authors: Tara De Paoli; Matthew Fuller-Tyszkiewicz, Isabel Krug
      Abstract: AimThe current study aimed to assess insecure attachment and the disconnection and rejection domain of maladaptive schema in the context of disordered eating. Rejection sensitivity (RS) was proposed as a mediator between maladaptive schema and disordered eating.MethodThe sample consisted of 108 female participants with a lifetime eating disorder diagnosis and 508 female control participants. Participants were asked to complete a number of self-report measures related to insecure attachment (anxious and avoidant), maladaptive schema (emotional deprivation, abandonment, mistrust, social isolation, and defectiveness), RS (interpersonal and appearance-based), and disordered eating.ResultsPath analysis indicated that anxious attachment was associated with disordered eating through multiple pathways involving emotional deprivation, abandonment, interpersonal RS, and appearance-based RS. Avoidant attachment was not related to disordered eating behaviours.ConclusionThe results indicate that both interpersonal and appearance-based RS are important mediators for the relationships between insecure attachment, maladaptive schema, and disordered eating.Key Practitioner MessageThe results from the current study suggest that insecure attachment leads to maladaptive schema, which in turn leads to sensitivity to rejection and subsequent disordered eating behaviour.Attachment anxiety, but not attachment avoidance, was related to greater endorsement of all five schemas in the disconnection and rejection domain.Path analysis revealed that, of the schema in the disconnection and rejection domain, only emotional deprivation and abandonment were related to disordered eating.Interpersonal and appearance-based rejection sensitivity were significant mediators of the relationship between emotional deprivation and disordered eating as well as the relationship between abandonment and disordered eating.Differentiating between schemas within schema domains has clinical value in further understanding the pathway to disordered eating.The schemas of emotional deprivation and abandonment are implicated in disordered eating, suggesting the need to target these schemas in schema therapy.
      PubDate: 2017-05-09T21:50:26.573347-05:
      DOI: 10.1002/cpp.2092
  • The development of a change model of “exits” during cognitive analytic
           therapy for the treatment of depression
    • Authors: Sundeep Kaur Sandhu; Stephen Kellett, Gillian Hardy
      Abstract: Objectives“Exits” in cognitive analytic therapy (CAT) are methods that change unhelpful patterns or roles during the final “revision” phase of the therapy. How exits are conceived and achieved is currently poorly understood. This study focussed on the revision stage to explore and define how change is accomplished in CAT.MethodsQualitative content analysis studied transcripts of sessions 6 and 7 of a protocol delivered 8-session CAT treatment for depression. Eight participants met the study inclusion criteria, and therefore, 16 sessions were analysed.ResultsThe exit model developed contained 3 distinct (but interacting) phases: (a) developing an observing self via therapist input or client self-reflection, (b) breaking out of old patterns by creating new roles and procedures, and (c) utilisation of a range of methods to support and maintain change. Levels of interrater reliability for the exit categories that formed the model were good.ConclusionsThe revision stage of CAT emerged as a complex and dynamic process involving 3 interacting stages. Further research is recommended to understand how exits relate to durability of change and whether change processes differ according to presenting problem.Key Practitioner MessagesExit work in cognitive analytic therapy is a dynamic process that requires progression through stages of insight, active change, and consolidation.Development of an “observing self” is an important foundation stone for change, and cognitive analytic therapists need to work within the client's zone of proximal development.A number of aspects appear important in facilitating change, such as attending to the process and feelings generated by change talk.
      PubDate: 2017-05-03T00:10:27.634452-05:
      DOI: 10.1002/cpp.2090
  • The impact of childhood maltreatment on the differential efficacy of CBASP
           versus escitalopram in patients with chronic depression: A secondary
    • Authors: Paul Bausch; Thomas Fangmeier, Ingo Zobel, Dieter Schoepf, Sarah Drost, Knut Schnell, Henrik Walter, Mathias Berger, Claus Normann, Elisabeth Schramm
      Abstract: Childhood maltreatment (CM) has been indicated as a predictor of a differential response to antidepressant treatment with psychotherapy compared to medication. In this secondary analysis, we investigated whether the presence of CM results in a differential indication for the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) or escitalopram plus clinical management (ESC). Sixty patients with chronic depression were randomized to either 22 sessions of CBASP or ESC over the course of 8 weeks of acute and 20 weeks of extended treatment at 2 German treatment sites. CM was assessed using the Childhood Trauma Questionnaire and the clinician rated Early Trauma Inventory. Intention-to-treat analyses were used to examine the impact of CM on depression, global functioning, and quality of life. The presence of CM did not result in significant differences in treatment response to CBASP or ESC on any outcome measure after 28 weeks of treatment independent of the type of CM assessment. After 8 weeks, a significant CM × treatment interaction was found for scores on the Montgomery-Asberg Depression Rating Scale. Patients with a history of CM receiving CBASP had a significantly lower response rate compared to patients without CM and to those receiving ESC after 8 weeks. Conclusively, CBASP and ESC are equally effective treatment options for the difficult to treat subgroup of patients with chronic depression and a history of CM. CM may be a predictor of a longer latency of treatment response in the case of psychotherapy.Key Practitioner MessageCBASP and escitalopram are equally effective treatment options for chronic depression.Both treatments are also equally effective for the difficult to treat subgroup of patients with chronic depression and a history of childhood maltreatment.Childhood maltreatment may result in a longer latency of treatment response in the case of psychotherapy.
      PubDate: 2017-03-21T22:32:12.730378-05:
      DOI: 10.1002/cpp.2081
  • Information order effects in clinical psychological diagnoses
    • Authors: Jan Christopher Cwik; Jürgen Margraf
      Abstract: Despite the wide application and long history of diagnostic systems, several sources of diagnostic errors remain in the criterion-based diagnosing of mental disorders. The aim of this study was to investigate whether the presentational order of diagnosis-relevant information and pretreatment reports predict diagnostic errors. One hundred twenty psychotherapists participated in the present online study. The study employed a 2 (symptom presentation: core symptoms at vignette's beginning vs. core symptoms at the end of the case vignette) × 2 (pretreatment report: receiving a pretreatment report with an incongruent diagnosis to the case vignette vs. receiving no pretreatment report) between-subjects experimental design, with random assignment. Participants were asked to make diagnoses after reading three case vignettes describing patients with different disorder constellations. Additionally, participants rated their confidence in the diagnoses and their estimation of the severity of each diagnosed condition. Results indicated that order of symptom descriptions predicted the correctness of diagnostic decisions, with a recency effect causing more fully correct diagnostic decisions in cases where diagnostic information was presented last. Receiving incongruent pretreatment reports was predictive for diagnostic errors. In conclusion, the results of this study indicate that diagnoses of mental disorders can depend on the way symptoms are presented or reported.Key Practitioner Message:Therapists' diagnostic decisions are not influenced by pretreatment reports.Diagnostic decisions are affected by information order effects.Diagnostic accuracy of psychotherapists is debatable.High rate of misdiagnoses in case vignette with comorbid disorders.
      PubDate: 2017-03-09T01:00:29.188535-05:
      DOI: 10.1002/cpp.2080
  • Preventing intimate partner violence via the Internet: A randomized
           controlled trial of emotion-regulation and conflict-management training
           for individuals with aggression problems
    • Authors: Hugo Hesser; Sandra Axelsson, Victoria Bäcke, Jonna Engstrand, Tina Gustafsson, Elin Holmgren, Ulrika Jeppsson, Maria Pollack, Kjell Nordén, Dan Rosenqvist, Gerhard Andersson
      Abstract: ObjectiveThe aim of this randomized controlled trial was to investigate the effect of an Internet-delivered cognitive behaviour therapy (iCBT), which incorporated emotion-regulation and conflict-resolution techniques, on intimate partner violence (IPV). Another aim was to test the theoretical underpinnings of the treatment model using mediation analysis.MethodSixty-five participants with aggression problems in intimate adult relationships were recruited from the community and were randomly assigned to iCBT or to a monitored waitlist control. Participants were assessed with standardized self-report measures of IPV or aggression (Multidimensional Measure of Emotional Abuse, Revised Conflict Tactics Scale, and Aggression Questionnaire), relationship quality (Dyadic Adjustment Scale), anxiety or depression symptomatology (Patient Health Questionnaire; Generalized Anxiety Disorder Screener), at pretreatment, posttreatment (8 weeks), and 1-year follow-up. Process variables (subscales of Dysfunctional and Emotional Regulation Scale and Anger Rumination Scale) were assessed weekly over the active treatment phase.ResultsRobust linear regression analysis of all randomized participants showed significant treatment effects on emotional abuse relative to control at postassessment. Mediation analysis using growth curve modeling revealed that the treatment effect was partially mediated by changes in emotion-regulation ability. Controlled effects on secondary outcomes were also observed. Analyses of uncontrolled effects indicted that gains on IPV were maintained at 1-year follow-up.ConclusionsiCBT focusing on enhancing conflict-resolution skills and emotion-regulation ability has the potential to reduce IPV among self-recruited individuals with mild forms of abusive behaviour in intimate relationships. Emotion-regulation ability is potentially a key therapeutic process of change.Key Practitioner MessageInternet-delivered clinician-guided cognitive behaviour therapy is a viable treatment option for reducing intimate partner violence among self-recruited individuals with mild forms of abusive behaviour.For persons who display patterns of frequent and severe violence, other treatments are most likely needed.Emotion-regulation training is potentially a key therapeutic component that ought to be incorporated in interventions targeting IPV.
      PubDate: 2017-03-06T02:20:30.319076-05:
      DOI: 10.1002/cpp.2082
  • Validation of the psychometric properties of cognitive fusion
           questionnaire. A study of the factorial validity and factorial invariance
           of the measure among osteoarticular disease, diabetes mellitus, obesity,
           depressive disorder, and general populations
    • Authors: Joana Alexandra Costa; João Marôco, José Pinto-Gouveia
      Abstract: BackgroundThe cognitive fusion questionnaire (CFQ) is a self-report questionnaire that assesses the extent to which individuals are psychologically entangled with, and dominated by the form–content of their thoughts. The aim of this study was to replicate the factor structure of CFQ in osteoarticular disease, diabetes mellitus, obesity, depressive disorder, and normative population. It further examined the factorial invariance of the CFQ across these 5 groups.MethodData from 299 participants (N General Population = 67, N Osteoarticular Disease = 73, N Diabetes Mellitus = 47, N Depressive Disorder = 45, and N Obesity = 60) were subjected to confirmatory factorial analysis (CFA) to replicate the structural model of CFQ dimensionality.ResultsCFA supported a 1-factor structure with good internal consistency and construct related validity. The 1-factor solution was also supported by a second independent data set, which showed a configural, strict measurement, and structural invariance of the 1-factor solution proposed. Multigroup CFA showed the configural invariance, strict measurement invariance, and structural invariance of CFQ across the 5 groups under study.ConclusionsThe unidimensional model has both similar meanings and the same structure, but the measurement model across the groups was not the same. The study provides the first approach to CFQ to Portuguese population, as a reliable tool of general cognitive fusion. Furthermore, results indicated that CFQ has a coherent structure across multiple samples and clinical utility, as it discriminate individuals with psychological distress from those who do not.
      PubDate: 2017-02-14T22:45:27.025811-05:
      DOI: 10.1002/cpp.2077
  • Mindfulness-based cognitive therapy as an augmentation treatment for
           obsessive–compulsive disorder
    • Authors: Brenda L. Key; Karen Rowa, Peter Bieling, Randi McCabe, Elizabeth J. Pawluk
      Abstract: A significant number of obsessive–compulsive disorder (OCD) patients continue to experience symptoms that interfere with their functioning following cognitive behavioural therapy (CBT). Providing an additional augmentation treatment following CBT could help reduce these residual symptoms. Mindfulness interventions that facilitate less reactivity to thoughts and feelings may be helpful for patients suffering from residual OCD symptoms. The purpose of the current randomized waitlist control trial was to evaluate the feasibility and impact of providing an 8-week mindfulness-based cognitive therapy (MBCT) intervention following completion of a CBT intervention to OCD patients who continued to suffer from significant symptoms. Results indicated that compared to the waitlist control group, MBCT participants reported decreases in OCD symptoms (d = 1.38), depression symptoms (d = 1.25), anxiety symptoms (d = 1.02), and obsessive beliefs (d = 1.20) along with increases in self-compassion (d = 0.77) and mindfulness skills (d = 0.77). Additionally, participants reported high levels of satisfaction with the MBCT intervention. The results suggest that the use of MBCT for OCD as an augmentation therapy is acceptable to patients who continue to suffer from OCD symptoms after completing CBT and provides some additional relief from residual symptoms.Key Practitioner MessageMindfulness interventions teach skills that facilitate disengaging from cognitive routines and accepting internal experience, and these skills may be valuable in treating obsessive–compulsive disorder (OCD), as individuals describe getting “stuck” in repetitive thoughts and consequent rituals.The results of this study suggest that teaching mindfulness skills using an 8-week mindfulness-based cognitive therapy (MBCT) intervention provides an added benefit (decreases in OCD, depression, and anxiety symptoms) for patients with OCD who have completed a cognitive behavioural therapy intervention and continued to suffer from significant symptoms.Participation in MBCT was also associated with increases in mindfulness skills including increased ability to be nonjudgmental and nonreactive. By fostering a nonjudgmental stance towards intrusive thoughts, mindfulness may discourage suppression and avoidance of thoughts and this could lead to increased habituation and a decreased reliance on compulsions.The use of MBCT as an augmentation treatment should be further explored to elucidate whether this treatment is beneficial for preventing relapse of OCD and could be compared against further cognitive behavioural therapy to see if offering participants a different and theoretically compelling intervention, such as MBCT, would outperform “more of the same” for individuals with OCD.
      PubDate: 2017-02-13T21:55:33.98302-05:0
      DOI: 10.1002/cpp.2076
  • Change in self-esteem predicts depressive symptoms at follow-up after
           intensive multimodal psychotherapy for major depression
    • Authors: Ulrike Dinger; Johannes C. Ehrenthal, Christoph Nikendei, Henning Schauenburg
      Pages: 1040 - 1046
      Abstract: Reduced self-esteem is a core symptom of depression, but few studies have investigated within-treatment change of self-esteem as a predictor of long-term outcome in depression. This study investigated change in self-esteem during 8 weeks of multimodal, psychodynamically oriented psychotherapy for 40 depressed patients and tested whether it would predict outcome 6 months after termination. Data was drawn from a randomized clinical pilot trial on day-clinic versus inpatient psychotherapy for depression. Findings supported the association between change in self-esteem and follow-up depression severity, even when controlling for within-treatment symptom change. Change in self-esteem was not related to overall symptoms and interpersonal problems at follow-up. Thus, change in self-esteem may be an important variable in preventing relapse for depression.Key Practitioner MessageSelf-esteem is related to depressive symptoms and interpersonal problems.Improvement of self-esteem during psychotherapy correlates with improvements of symptoms and interpersonal problems.Change of self-esteem during psychotherapy predicts depressive symptoms 6 months after termination of therapy.When treating depressed patients, psychotherapists should work towards an improvement of self-esteem in order to prevent relapse.
      PubDate: 2017-01-08T19:55:23.646969-05:
      DOI: 10.1002/cpp.2067
  • A proposed model of psychodynamic psychotherapy linked to Erik Erikson's
           eight stages of psychosocial development
    • Authors: Zelda Gillian Knight
      Pages: 1047 - 1058
      Abstract: Just as Freud used stages of psychosexual development to ground his model of psychoanalysis, it is possible to do the same with Erik Erikson's stages of development with regards to a model of psychodynamic psychotherapy. This paper proposes an eight-stage model of psychodynamic psychotherapy linked to Erik Erikson's eight stages of psychosocial development. Various suggestions are offered. One such suggestion is that as each of Erikson's developmental stages is triggered by a crisis, in therapy it is triggered by the client's search. The resolution of the search often leads to the development of another search, which implies that the therapy process comprises a series of searches. This idea of a series of searches and resolutions leads to the understanding that identity is developmental and therapy is a space in which a new sense of identity may emerge. The notion of hope is linked to Erikson's stage of Basic Trust and the proposed model of therapy views hope and trust as essential for the therapy process. Two clinical vignettes are offered to illustrate these ideas.Key Practitioner MessagePsychotherapy can be approached as an eight-stage process and linked to Erikson's eight stages model of development.Psychotherapy may be viewed as a series of searches and thus as a developmental stage resolution process, which leads to the understanding that identity is ongoing throughout the life span.
      PubDate: 2017-01-25T20:05:25.305993-05:
      DOI: 10.1002/cpp.2066
  • Indirect exposure to client trauma and the impact on trainee clinical
           psychologists: Secondary traumatic stress or vicarious traumatization'
    • Authors: Rakhee Makadia; Rachel Sabin-Farrell, Graham Turpin
      Pages: 1059 - 1068
      Abstract: ObjectivesThe study investigated the relationship between exposure to trauma work and well-being (general psychological distress, trauma symptoms, and disrupted beliefs) in trainee clinical psychologists. It also assessed the contribution of individual and situational factors to well-being.DesignA Web-based survey was employed.MethodsThe survey comprised the General Health Questionnaire, Secondary Traumatic Stress Scale, Trauma and Attachment Belief Scale, Trauma Screening Questionnaire, and specific questions about exposure to trauma work and other individual and situational factors. The link to the online survey was sent via email to trainee clinical psychologists attending courses throughout the UKResultsFive hundred sixty-four trainee clinical psychologists participated. Most trainees had a caseload of one to two trauma cases in the previous 6 months; the most common trauma being sexual abuse. Exposure to trauma work was not related to general psychological distress or disrupted beliefs but was a significant predictor of trauma symptoms. Situational factors contributed to the variance in trauma symptoms; level of stress of clinical work and quality of trauma training were significant predictors of trauma symptoms. Individual and situational factors were also found to be significant predictors of general psychological distress and disrupted beliefs.ConclusionsThis study provides support for secondary traumatic stress but lacks evidence to support belief changes in vicarious traumatization or a relationship between exposure to trauma work and general psychological distress. The measurement and validity of vicarious traumatization is discussed along with clinical, theoretical implications, and suggestions for future research.Practitioner PointsSecondary traumatic stress is a potential risk for trainee clinical psychologists.Training courses should (a) focus on quality of trauma training as it may be protective; (b) advocate coping strategies to reduce stress of clinical work, as the level of stress of clinical work may contribute to trauma symptoms.Limitations includeExposure to trauma work only uniquely explained a small proportion of variance in trauma symptoms.The study was cross-sectional in nature therefore cannot imply causality.
      PubDate: 2017-01-25T20:16:07.138545-05:
      DOI: 10.1002/cpp.2068
  • Effect of an art brut therapy program called go beyond the schizophrenia
           (GBTS) on prison inmates with schizophrenia in mainland China—A
           randomized, longitudinal, and controlled trial
    • Authors: Hong-Zhong Qiu; Zeng-Jie Ye, Mu-Zi Liang, Yue-Qun Huang, Wei Liu, Zhi-Dong Lu
      Pages: 1069 - 1078
      Abstract: Creative arts therapies are proven to promote an interconnection between body and mind, but there are major obstacles for providing therapeutic services in prisons due to inmates' inherent mistrust for verbal disclosure and rigid self-defenses, especially among inmates with schizophrenia. Thus, we developed a structured and quantitative art brut therapy program called go beyond the schizophrenia to actually measure the benefits of art therapy on prison inmates in mainland China. Upon completion of the program, the intervention group reported a decrease in anxiety, depression, anger, and negative psychiatric symptoms and showed better compliance with rules, socialization with peers, compliance with medications, and regular sleeping patterns after 16 weekly sessions of go beyond the schizophrenia. This article concludes that the art brut therapy was effective for the inmates with schizophrenia in mainland China and provides encouraging data on how to enhance mental health for inmates with schizophrenia.Key practitioner messageArt brut therapy can reduce emotional distress and negative psychiatric symptoms among Chinese inmates.Arts brut therapy can enhance Chinese inmates' compliance with rules, socialization with peers, compliance with medicines, and regular sleeping patterns.Arts brut therapy in conjunction with medication is highly recommended for recovery of Chinese inmates with schizophrenia, especially for patients with negative symptoms.
      PubDate: 2017-01-12T03:35:39.36157-05:0
      DOI: 10.1002/cpp.2069
  • The role of guilt sensitivity in OCD symptom dimensions
    • Authors: Gabriele Melli; Claudia Carraresi, Andrea Poli, Donatella Marazziti, Antonio Pinto
      Pages: 1079 - 1089
      Abstract: Although some studies have found that guilt may precede, motivate, or be a consequence of obsessive–compulsive disorder (OCD), the relationship between guilt and OCD has been under investigated. The studies that explored the role of trait guilt (guilt propensity) in OCD reported inconsistent findings and failed to support its predictive role. Since it has been suggested that OCD patients perceive guilt in a more threatening manner, it might also be relevant to test to what extent they negatively evaluate the experience of guilt (i.e., guilt sensitivity; GS). Study 1 investigated the psychometric properties of a new 10-item Italian measure developed to assess GS—named Guilt Sensitivity Questionnaire—in a nonclinical sample (N = 473). Results from exploratory factor analyses supported the unidimensionality of the scale. It also showed excellent internal consistency and good discriminant validity. Study 2 investigated the role of GS in OCD symptoms, in particular with regard to responsibility for harm obsessions and checking compulsions, using a heterogeneous OCD sample (N = 61) and a control group of patients with anxiety disorders (N = 47). GS was the unique significant predictor of checking related OCD symptoms independent of negative mood states and obsessive beliefs. Guilt Sensitivity Questionnaire scores of patients with responsibility for harm concerns were significantly higher than those of patients with other kinds of obsessive concerns and with anxiety disorders. Findings supported the hypothesis that GS plays a relevant role in OCD symptoms when checking rituals are primarily involved. Implications for current cognitive behavioral models are discussed.Key practitioner message:Guilt sensitivity may play a role in checking-related OCD symptoms.We developed a psychometrically sound unidimensional 10-item scale to assess guilt sensitivity.Guilt sensitivity was a unique predictor of checking-related OCD symptoms.Targeting beliefs about the intolerability/dangerousness of experiencing guilt may be useful.Acceptance-based approaches may be helpful as they promote the acceptance of guilt.
      PubDate: 2017-01-16T23:55:29.60713-05:0
      DOI: 10.1002/cpp.2071
  • BEfree: A new psychological program for binge eating that integrates
           psychoeducation, mindfulness, and compassion
    • Authors: José Pinto-Gouveia; Sérgio A. Carvalho, Lara Palmeira, Paula Castilho, Cristiana Duarte, Cláudia Ferreira, Joana Duarte, Marina Cunha, Marcela Matos, Joana Costa
      Pages: 1090 - 1098
      Abstract: Binge eating disorder (BED) is associated with several psychological and medical problems, such as obesity. Approximately 30% of individuals seeking weight loss treatments present binge eating symptomatology. Moreover, current treatments for BED lack efficacy at follow-up assessments. Developing mindfulness and self-compassion seem to be beneficial in treating BED, although there is still room for improvement, which may include integrating these different but complimentary approaches. BEfree is the first program integrating psychoeducation-, mindfulness-, and compassion-based components for treating women with binge eating and obesity.ObjectiveTo test the acceptability and efficacy up to 6-month postintervention of a psychological program based on psychoeducation, mindfulness, and self-compassion for obese or overweight women with BED.DesignA controlled longitudinal design was followed in order to compare results between BEfree (n = 19) and waiting list group (WL; n = 17) from preintervention to postintervention. Results from BEfree were compared from preintervention to 3- and 6-month follow-up.ResultsBEfree was effective in eliminating BED; in diminishing eating psychopathology, depression, shame and self-criticism, body-image psychological inflexibility, and body-image cognitive fusion; and in improving obesity-related quality of life and self-compassion when compared to a WL control group. Results were maintained at 3- and 6-month follow-up. Finally, participants rated BEfree helpful for dealing with impulses and negative internal experiences.ConclusionsThese results seem to suggest the efficacy of BEfree and the benefit of integrating different components such as psychoeducation, mindfulness, and self-compassion when treating BED in obese or overweight women.Key Practitioner MessageThe current study provides evidence of the acceptability of a psychoeducation, mindfulness, and compassion program for binge eating in obesity (BEfree);Developing mindfulness and self-compassionate skills is an effective way of diminishing binge eating, eating psychopathology and depression, and increasing quality of life in women with obesity;Integrating psychoeducation, mindfulness, and compassion seem to be effective in diminishing binge eating, with results maintained up to 6-month postintervention.
      PubDate: 2017-01-25T22:15:27.657302-05:
      DOI: 10.1002/cpp.2072
  • A qualitative investigation in the role of the baby in recovery from
           postpartum psychosis
    • Authors: Charlene Plunkett; Sarah Peters, Angelika Wieck, Anja Wittkowski
      Pages: 1099 - 1108
      Abstract: Psychosis after childbirth is a rare but severe type of mental health difficulty experienced by perinatal women. Research has explored mothers' experiences of onset and recovery from psychosis after childbirth. This study explored the role of the baby in 12 mothers' experiences of recovery. A thematic analysis of the data identified three core themes that described the role of the baby in the mothers' recovery from psychosis after childbirth. Findings revealed that the baby was central to recovery, experienced by mothers as both helpful and unhelpful. The baby interacted with the mother, increasing self-efficacy, and reducing emotional distress. Findings also showed that the baby could act as a barrier to recovery by increasing the women's emotional distress and hindering access to help and self-care. The findings of the study add to the existing evidence based on recovery from psychosis after childbirth. The research and clinical implications of these findings are discussed with reference to the existing literature.Key Practitioner MessageThe baby has an important role in recovery from psychosis after childbirth.The baby can be perceived by mothers to both hinder and help their recovery.Interacting with the baby can be helpful for the mothers' recovery by improving their self-efficacy and reducing emotional distress.Specialist interventions offered by a mother and baby unit can provide practical support that facilitates mother–baby interactions, which helps move women forward in the recovery process.
      PubDate: 2017-01-31T02:35:46.717274-05:
      DOI: 10.1002/cpp.2074
  • The Counseling Center Assessment of Psychological Symptoms (CCAPS-62):
           Acceptance, feasibility, and initial psychometric properties in a UK
           student population
    • Authors: Emma Broglia; Abigail Millings, Michael Barkham
      Pages: 1178 - 1188
      Abstract: BackgroundThe burden and severity of student mental health continue to increase in parallel with increasing financial pressures on students and services alike. There is a need for a student-specific measure of distress that acknowledges their unique context. This study examined the feasibility, acceptance, and initial psychometric properties of a US measure, the Counseling Center Assessment of Psychological Symptoms (CCAPS), in a UK student sample.MethodsA sample of 294 UK help-seeking students from two universities completed the CCAPS-62 and Clinical Outcomes in Routine Evaluation (CORE-10) as a comparator. The factor solution and reliability of the CCAPS-62 were examined. Correlations and clinical boundaries were determined between the CCAPS-62 subscales and CORE-10, and comparisons were made with US published norms.ResultsThe CCAPS-62 demonstrated a strong factor solution that matched the intended subscales. All subscales had good reliability and correlated significantly with the CORE-10. The agreement on caseness between the two measures was 92.8% with 86.3% reaching clinical threshold on both the CCAPS-62 and CORE-10. Severity was most noticeable for academic distress, depression, anxiety, and social anxiety. Compared to US data, UK students showed higher clinical severity for all psychological symptoms.ConclusionsThe CCAPS-62 is a reliable and psychometrically valid assessment measure to use with UK students without revision. The overall distress indicated is similar to that of the CORE-10, but the individual subscales are more informative of specific student concerns including academic distress, social anxiety, and substance abuse. Potential benefits of administering a student-focused assessment measure in student counselling services are discussed.Key Practitioner MessageUniversity students attending counselling in the UK demonstrate clinical severity for academic distress, depression, anxiety, and social anxiety.Compared to university students in the US, UK students present with higher clinical severity on all contextual measures of student psychological distress.It is advantageous for university counselling services to administer a student-specific clinical measure over measures intended for the general clinical population.CCAPS-62 is an acceptable, feasible, and psychometrically valid measure of student psychological distress that can be used in the UK without revision.It is important for university counselling services to continue to provide support from therapists that are trained and experienced in the university context over services intended for the general clinical population.
      PubDate: 2017-01-25T20:00:35.382765-05:
      DOI: 10.1002/cpp.2070
  • Development and validation of a new Italian short measure of disgust
           propensity: The Disgust Propensity Questionnaire (DPQ)
    • Authors: Gabriele Melli; Carlo Chiorri, Eleonora Stopani, Francesco Bulli, Claudia Carraresi
      Pages: 1189 - 1204
      Abstract: Although a few measures of disgust propensity are available in Italy, most of them take a long time to administer and/or have not shown replicable and sound psychometric properties. In the current study, the authors developed an Italian nine-item self-report measure of disgust propensity (particularly of pathogen disgust)—the Disgust Propensity Questionnaire (DPQ)—to address the limitations of currently available measures. In Study 1, the DPQ was developed through exploratory and confirmatory factor analyses from an initial pool of 33 items that were administered to 784 nonclinical participants. The DPQ showed evidence of an adequate factorial and construct validity as well as internal consistency and temporal stability. In Study 2, additional evidence of the sound psychometric properties of the DPQ was provided by analyzing an independent sample of 315 nonclinical participants and a sample of 208 patients with obsessive–compulsive disorder. This study also showed that the DPQ can discriminate between obsessive–compulsive disorder patients with and without contamination-related concerns, patients with anxiety disorders, and nonclinical participants.Key Practitioner MessageAn Italian nine-item self-report disgust propensity measure was developed to address the limitations of currently available tools.The Disgust Propensity Questionnaire (DPQ) was evaluated using two independent studies in nonclinical and clinical samples.The DPQ showed adequate factorial and construct validity, internal consistency, and temporal stability.It could discriminate between patients with obsessive–compulsive disorder with contamination-related concerns and all other groups.It is a very short and psychometrically sound measure to assess disgust propensity in Italian samples.
      PubDate: 2017-02-08T22:05:30.722721-05:
      DOI: 10.1002/cpp.2073
  • Psychometric properties of the Dutch version of the Treatment Support
           Measure (TSM) parent and youth form
    • Authors: Maartje A. M. S. Sonsbeek; Catharina J. M. Holtmaat, Bea G. Tiemens, Giel J. M. Hutschemaekers, Kim Jong
      Pages: 1205 - 1218
      Abstract: The Treatment Support Measure (TSM) Parent and Youth were created to help clinicians with actionable feedback when youths are not making sufficient progress in treatment. This study examined the psychometric properties of the Dutch TSM Parent and TSM Youth. Parents (n = 172) and youth (n = 122) were recruited at 2 outpatient mental health care institutions. Children of participating parents (50.6% boys) had a mean age of 11.9 years (SD = 3.46; range 4–18). Participating youth (30.3% boys) had a mean age of 15.68 years (SD = 1.75; range 12–18). Participants were asked to complete the TSM and questionnaires measuring related constructs once during treatment. Responses to the TSM Parent items were explained by 9 instead of 5 subscales, and responses to the TSM Youth items were explained by 8 instead of 4 subscales. The internal consistency reliability of both the TSM Parent and the TSM Youth scales was generally good. The convergent validity of the TSM Parent and the TSM Youth was also good, although the divergent validity was less convincing. The criterion validity was inconclusive; the TSM Parent was not able to differentiate between problematic and nonproblematic treatments, but multiple scales of the TSM Youth were able to differentiate between these groups. The TSM Parent and TSM Youth have potential to be helpful tools in clinical practice. They could signal potential barriers to youth progress and direct the conversation between the clinician and youth and parents about adaptation of treatment.Key practitioner messageThis is the first study to investigate the psychometric properties of the Treatment Support Measure (TSM) Parent and Youth versions, which are created to help clinicians with actionable feedback when youths are not making sufficient progress in treatment.The Dutch TSM Parent and TSM Youth have moderate to good psychometric properties.The Dutch TSM Parent and TSM Youth might be helpful tools for use in clinical practice: they contain variables that are related to youth outcome, can signal potential barriers to youth progress, and can direct the conversation between the clinician and the youth and parents about adaptation of treatment.The Dutch TSM Parent and TSM Youth could be added to the regular ROM to facilitate both routine monitoring of outcome and direct and concrete aid to the here-and-now relational processes in treatment.
      PubDate: 2017-02-08T23:55:34.465405-05:
      DOI: 10.1002/cpp.2075
  • Issue Information
    • Pages: 1220 - 1220
      Abstract: No abstract is available for this article.
      PubDate: 2017-10-03T01:26:37.732681-05:
      DOI: 10.1002/cpp.2148
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