Clinical Psychology in Europe (E-Journal)
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Loneliness and Distress in the Aftermath of the COVID-19 Pandemic: A Cross-Sectional Study of German University Students
No full textBackground: Characterized by uncertainty and recurring periods of social isolation, the COVID-19 pandemic resulted in increases of loneliness and distress in young adults, such as university students. Despite the lifting of the last restrictions in Germany in April 2023, the state of mental health in vulnerable groups after the three-year global crisis remains to be investigated. Therefore, we aimed to assess university students’ mental health after the pandemic. Method: Between April and July 2023, N = 886 university students throughout Germany participated in a fully anonymous cross-sectional online survey. Psychological distress (BSI; Brief Symptom Inventory), loneliness (LS-SOEP; Loneliness Scale), and emotion regulation strategies (ERQ; Emotion Regulation Questionnaire) were assessed by standardized questionnaires, and mental health was compared to a survey of students in April 2020 (N = 1,062). Results: Unexpectedly, we found higher levels of distress in 2023 than in 2020. Overall, R2adj = 41% of variance in psychological distress was accounted for in a multiple linear regression, with loneliness emerging as the most important predictor. Additionally, emotion regulation, gender identity, and health behaviors such as keeping daily routines, sufficient sleep, and regular exercise were significant predictors. Analyses of variance (ANOVAs) revealed that students with past or present mental health conditions were significantly lonelier than those without. Conclusion: These findings highlight the ongoing mental health challenges of university students in the aftermath of the COVID-19 pandemic, identifying non-binary and female students, as well as students with current or past mental health conditions as particularly lonely and distressed
The Context of COVID-19 at 18 Months in Relation to Depression, Anxiety, Insomnia: The Emerging Role of Post COVID-19 Symptoms
No full textBackground: The COVID-19 pandemic naturally raised concerns about mental health and wellbeing around the world. As time passed, persisting physical and mental symptoms of post COVID-19, referred to as Post COVID Condition (PCC), have become an increasing concern. The aim of this study was to investigate the stability of symptoms of mental ill health in Sweden in the late phase of the pandemic and the prevalence of persistent symptoms post COVID-19 and interrelations between them. Method: We measured depression, anxiety, and insomnia, through a one-time online survey in Sweden (n = 1,482, mean age 47.6 years; 89.5% women) and used correlation and regression analysis to study potential predictors and their interrelations with PCC symptoms. Results: Compared to our previous study during the pandemic (May – June 2020), a marginal decrease was found for depression (27% versus 30%), a larger decrease for anxiety (16% vs 24%), and an increase for insomnia (45% vs 38%). Persistent symptoms were frequently reported, with 84.5% reporting at least one symptom, and 49.7% attributing one or more of these to COVID-19 infection. A history of poor mental health and COVID-19 related worry appeared as the strongest risk factors for mental ill health. Persistent symptoms also predicted these outcomes. Conclusions: Based on comparison with pre-pandemic rates, it appears that the pandemic continued to exert a negative impact on mental health in Sweden. Persistent symptoms, associated with COVID-19 exposure, appear common and may represent a vulnerability factor for mental ill health, along with other factors, including history of a mental ill health and specific pandemic worries
Associations and Interactions Between Neuroticism, Adverse Life Events and Health Anxiety: Results From a Large Representative Cohort
No full textPurpose: Adverse life events and neuroticism have been shown to be associated with health anxiety (HA), but their interaction has not been studied. This study aimed to examine the separate associations as well as the possible interaction effect of neuroticism and adverse life events with HA. Method: Cross-sectional self-report data originated from a representative Danish population cohort (DanFunD) (N = 7,493, 18-72 years, 53% females). Primary measures were HA (Whiteley Index 6 revised), neuroticism (NEO personality Inventory Revised short form), and adverse life events (Cumulative Lifetime Adversity Measure, CLAM). The CLAM was split into illness/death related life events (IDE) and other adverse life events (OAE) to test the specificity of IDEs. Results: Adjusted ordinal logistic regression models showed positive associations with HA for IDEs (OR = 1.05, CI [1.03, 1.08]), OAEs (OR = 1.05, CI [1.03, 1.07]) and neuroticism (OR = 1.08, CI [1.07, 1.09]). A Wald's test revealed no difference in association with HA for IDEs and OAEs (p = .82). Adjusted models showed an interaction effect for neuroticism*IDEs (OR = 1.002, CI [1.000, 1.004]), but not for neuroticism*OAEs (OR = 0.999, CI [0.996, 1.002]). Conclusion: Associations with HA were found for both adverse life events and neuroticism. Size of association did not differ for IDEs and OAEs. Only IDEs interacted with neuroticism
International Prolonged Grief Disorder Scale Addendum for Refugees and Displaced People (IPGDS-ARD): A Study of Arabic-Speaking Bereaved Refugees
No full textBackground: Prolonged grief disorder (PGD) is a new and significant addition to the ICD-11 WHO disease classification system and the DSM 5-TR. As a new disorder, it stands to improve diagnostic precision, enhance communication among health professionals and patients, provide better access to care and lead to effective treatments and intervention. However, it remains to be determined if the new diagnostic criteria for PGD are applicable to different cultural groups. Method: Here we sought to adapt the International Prolonged Grief Disorder Scale for refugees and displaced people. We conducted two focus groups with clinicians and health care workers and six cognitive interviews with bereaved Arabic-speaking refugees. Results: This formative research resulted in an addendum (comprised of three new scales) to the IPGDS aimed to aid with treatment planning: the 42 item Addendum for Refugees and Displaced people (IPGDS-ARD). Here we present the steps for scale augmentation based on cultural considerations, a detailed description of clinical utility, feasibility and content validity established at each step, and an analysis of the percent of change in content at each step. Conclusion: We conclude that the presented method of scale augmentation is a feasible and efficient approach that led to a culturally relevant, clinically useful addendum to an existing PGD questionnaire
Attitudes and Expectations Towards Mental Health Interventions in the General Population: Comparing Face-to-Face Counseling, Blended Counseling, and Digital or On-Paper Self-Help
No full textBackground: Digital interventions are supported by a growing evidence base and have the potential to contribute to accessible and personalized mental healthcare services. When individuals seek help for mental health problems, various intervention options are available in a digital, face-to-face or on-paper format. However, it is important to understand what individuals find important for intervention selection and how they perceive different intervention options. Method: The study recruited 232 individuals for a cross-sectional online survey on (1) the relevance of 12 evaluation dimensions for mental health support, (2) whether self-help books, digital interventions, face-to-face counseling, and blended interventions would meet expectations, and (3) self-reported likelihood of use. Results: The most important dimensions for intervention selection were helpfulness, personal support, motivates to get better, and credibility. Face-to-face counseling was evaluated favorably for dimensions linked to intervention content (e.g., helpfulness), while self-help approaches were rated more positively for practical aspects (e.g., waiting time). Blended counseling received fairly similar dimension ratings as face-to-face counseling. Self-reported likelihood of use differed significantly between modalities despite large individual differences. Face-to-face interventions were most likely to be used, followed by blended counseling, with digital and on-paper self-help options sharing third place. Conclusion: The findings suggests that mere self-help (online or on paper) does not sufficiently meet the needs and is not the preferred choice for handling mental health problems for most individuals. If presented with the choice, individuals still prefer face-to-face counseling. Nevertheless, blended interventions can be a promising treatment option for the future
Letter to the Editor: On the Critical Nature of Psychosomatics in Clinical Practice
No full textNo abstract available
EACLIPT Statement on the Importance of Science and Evidence-Based Treatment for Mental Health
No full textNo abstract available
Translation and Validation of the German 12-Item Obsessive-Compulsive Inventory (OCI-12) in Clinical and Non-Clinical Samples
No full textBackground: The Obsessive-Compulsive Inventory-Revised (OCI-R) is widely used to assess symptoms of Obsessive-Compulsive Disorder (OCD). Despite its consistent factor structure, criticism on its syndromal validity has been raised. With the recent update of the commonly used diagnostic manuals, hoarding symptoms are now better captured by the diagnosis “pathological hoarding”. Furthermore, the neutralising scale suffers from relatively low psychometric properties. Consequently, a 12-item version of the scale (OCI-12), excluding hoarding and neutralising items was recently developed in English. The current study examined the psychometric properties of the German version of the OCI-12. Method: The psychometric properties of the translated German version of the OCI-12 were investigated in a German-speaking sample, consisting of 102 participants with OCD, 69 participants with an anxiety-related disorder, and 248 non-clinical controls. Results: The German version of the OCI-12 replicated the four-factor structure of the original English version, with a higher order factor of general OCD symptoms. In addition, similar to the original version, the German OCI-12 showed good internal consistency and test-retest reliability, moderate-to-good construct validity, and good-to-excellent diagnostic accuracy. Conclusion: The German version of the OCI-12 represents a syndromally valid and reliable inventory for assessing OCD symptoms. Psychometric properties are good-to-excellent and comparable to the original English version. The diagnostic sensitivity is good-to-excellent and further supports using the OCI-12 in clinical and research settings
Structured Diagnostic Interviews in Psychotherapy Training: Trainees’ Beliefs About Interviews and Their Relationship to Overall Interview Satisfaction
No full textBackground: Structured diagnostic interviews (SDIs) are frequently used in science and are highly recommended for diagnosing mental disorders in clinical practice. However, the actual SDI familiarity and use among psychotherapy practitioners is limited. To identify opportunities for training improvement and ensure a frequent SDI application by future practitioners, data on SDI experiences and beliefs among current psychotherapy trainees is essential. Method: N = 233 psychotherapy trainees completed an online survey that included questions about their SDI experiences, use, beliefs, and their estimation of patient SDI satisfaction and acceptance. In addition, adherence to psychotherapeutic orientation and personality factors were assessed. Correlation between SDI satisfaction and familiarity was computed. Multiple linear regression analysis was performed to predict trainees’ SDI satisfaction by beliefs about SDIs. Exploratory correlations between SDI satisfaction, adherence to psychotherapeutic orientations, and personality factors were analyzed. Results: SDI familiarity was significantly related to trainees’ overall SDI satisfaction. Both positive (e.g., “SDIs are efficient”) and negative (e.g., “SDIs disturb the relationship to patients”) beliefs about SDIs predicted trainees’ overall satisfaction. Small relationships were found between SDI satisfaction and adherence to psychotherapeutic orientation, but none to personality factors. Conclusion: Psychotherapy training programs should provide sufficient opportunity for SDI practice to promote trainee satisfaction. Training providers should address trainees’ beliefs and concerns, underline advantages of SDIs, and inform about actual SDI acceptance among patients to resolve prejudice. Trainees’ personality appears to be less relevant to SDI satisfaction, but further investigations are needed. The findings have important implications for overcoming barriers to the use of structured diagnostic interviews
I’m Still Standing: Body Sway, Interpersonal Distance, and Social Anxiety – A Proof of Principle
No full textBackground and Objectives: Cognitive models suggest that individuals with high degrees of social anxiety (SAs) tend to incorrectly interpret (ambiguous) social cues as negative evaluations and thus justifying their fears. It is assumed that subtle behaviors of SAs may give rise to factual negative evaluations, but it is unclear which kind of behaviors that may be. We tested whether automatic motivational behavior becomes disrupted when degree of social anxiety increases, expecting higher social anxiety to be associated with more threat-related ‘freezing’ (reduction of body sway) and backward leaning (avoidance). Method: Of 87 participants with varying degrees of social anxiety, body sway was recorded by means of a stabilometric platform, while a fe-/male experimenter was gradually approaching. Results: Higher levels of social anxiety were related to an increase of body sway at an interpersonal distance of 260 to 120cm. No avoidant backward-leaning occurred. Limitations: Predictability of set-up and knowledge of escape options may have undermined participants’ experience of the situation as highly socially threatening. Unease-, rather than fear-related behavior may have been the result. Conclusions: The results indicate that SAs seem to show an increase in uneasy, nervous movement when approached by strangers. Whether that provokes the negative evaluation SAs fear most, still needs to be investigated