Clinical Psychology in Europe (E-Journal)
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Growing (Up) in Times of Multiple Crises – A Call for Mental Health (Research) Action
No abstract available
Implicit Attitudes Toward Psychotherapy and Explicit Barriers to Accessing Psychotherapy in Youths and Parent–Youth Dyads
Background: Few studies have investigated implicit and explicit attitudes toward psychotherapy in youths (Study 1), although information about attitudes would improve interventions that aim to decrease barriers to accessing psychotherapy including parents (Study 2), who facilitate the help-seeking process of youths. Method: The Study 1 sample comprised 96 youths (14–21 years) and the Study 2 sample 38 parent–youth dyads. Differences in implicit attitudes regarding psychotherapy and a medical treatment were measured with the Implicit Association Test, and psychotherapy knowledge and self-reported barriers to psychotherapy were assessed with questionnaires. The actor-partner interdependence model was used to test the dyadic effects of implicit attitudes on explicit attitudes in parents and youths. Results: We did not find evidence for an implicit bias toward psychotherapy compared to a medical treatment, neither in youths, nor in parents. Self-reported barriers were a predictor for lower help-seeking intentions. Deficits in psychotherapy knowledge were more relevant in younger participants. Having a prior or current experience with psychotherapy and having a friend or family member with a prior or current experience with psychotherapy were predictors for better psychotherapy knowledge, but was not for lower barriers to accessing psychotherapy. Partner effects (degree to which the individual’s implicit attitudes are associated with explicit attitudes of the other dyad’s member) were not found. Conclusion: Specific deficits in psychotherapy knowledge should be addressed in interventions to lower barriers accessing psychotherapy. Parents should be included in interventions as a valuable resource to support youths in seeking psychotherapy for mental disorders
What Is the Common Ground for Modern Psychotherapy? A Discussion Paper Based on EACLIPT’s 1st Webinar
Psychotherapy as it is implemented today, can be seen as the composition of unconnected groups of practitioners and scientists pursuing different theories. The idea of finding a common “umbrella” for all evidence-based treatments in the field of psychotherapy is gaining more interest. Based on this background, experts in clinical psychology from various backgrounds led a fundamental discussion about modern psychotherapy and its basic mechanisms. Process-Based Therapy (PBT) was presented by Stefan Hofmann as a possible novel approach to clinical research and practice. In this article we present the different perspectives of the four panelists on PBT and in how far the model builds a common ground for different treatment approaches. Learning mechanisms and the therapeutic alliance were almost unanimously considered as indispensable factors in a global model of psychotherapy. In conclusion, the panelists emphasized a much-needed focus on characteristics and competencies of therapists themselves e.g., in communication, listening and empathy. These core competencies should be trained and promoted independently of the therapeutic approach
Personality Disorder Diagnoses in ICD-11: Transforming Conceptualisations and Practice
Background: Until the advent of the ICD-11, classification of personality disorders was based on categorical prototypes with a long history. These prototypes, whilst familiar, were not based in the science of personality. Prototypical classifications were also complex to administer in non-specialist settings requiring knowledge of many signs and symptoms. Method: This article introduces the new structure of ICD-11 for personality disorders, describing the different severity levels and trait domain specifiers. Case studies illustrate the main aspects of the classification. Results: The new ICD-11 system acknowledges the fundamentally dimensional nature of personality and its disturbances whilst requiring clinicians to make categorical decisions on the presence or absence of personality disorder and severity (mild, moderate or severe). The connection between normal personality functioning and personality disorder is established by identifying five trait domain specifiers to describe the pattern of a person’s personality disturbance (negative affectivity, detachment, dissociality, disinhibition, and anankastia) that connect to the Big 5 personality traits established in the broader study of personality. Conclusions: Whilst new assessment measures have been and are in development, the success of the new system will rely on clinicians and researchers embracing the new system to conceptualise and describe personality disturbances and to utilise the classification in the investigation of treatment outcome
Meaningful and Lasting Change – Psychotherapy in the Light of Evolutionary Processes
No abstract available
Fear of Becoming Infected and Fear of Doing the Wrong Thing – Cross-Cultural Adaptation and Further Validation of the Multidimensional Assessment of COVID-19-Related Fears (MAC-RF)
Background: With the COVID-19 infection speeding around the world, many experience fear and anxiety. To detect those at risk of psychopathology and provide treatment, valid instruments are needed. The aim of this study was to cross-culturally validate the theory-based instrument Multidimensional Assessment of COVID-19-Related Fears (MAC-RF) in Croatian and to further examine the scale’s validity by exploring its relationship with relevant constructs. Method: A total of 477 participants completed an online survey during a rapid rise in new daily COVID-19 cases in Croatia and while new restrictions were being imposed. Results: MAC-RF had a stronger association with health anxiety, cyberchondria, and anxiety sensitivity compared to depression, attesting to its convergent and divergent validity. However, a 2-factor structure was revealed in this sample: Fear of infection and Fear of using an inadequate strategy in dealing with pandemic. Fear of infection had a stronger association with health anxiety and COVID-19 anxiety and was a better predictor of COVID-19 related protective health behaviors. Fear of choosing an inadequate strategy had a stronger association with cyberchondria, fear of consequences of the epidemic on mental health, as well as financial consequences, and loss of civil liberties. Conclusion: Fear of infection captures negative emotional states due to feared consequences on personal somatic health and the health of loved ones, while Fear of choosing an inadequate strategy in dealing with the pandemic reflects a metacognitive aspect. Treatments may have to target both aspects of COVID-19 related fear
Open-Label Placebo Effects on Psychological and Physical Well-Being: A Conceptual Replication Study
Background: Contrary to traditional placebos, open-label placebos (OLP) abstain from deception, i.e., participants are openly informed to receive an inert substance. Studies in clinical and healthy samples evidence the efficacy of OLPs. This study aims to conceptually replicate and expand findings of a recent OLP study in healthy participants while implementing a within-subject design and daily instead of retrospective assessments. Additionally, the effect of a brand name on the medicine container is tested and possible predictors of the OLP effects are explored. Method: Healthy participants (N = 75) received OLP and no placebo for 5 days each (randomized sequence) and answered daily questionnaires on sleep quality, bodily symptoms, mental well-being, and psychological distress. The medicine container of half the participants had a brand name, the remaining did not. Different personality traits and situational factors were assessed. Results: Mental and physical well-being did not differ between OLP and control phase, i.e., overall, no OLP effect emerged. Contrast analysis indicated that an OLP effect emerged for sleep quality and psychological distress when no brand name was present. Further, an OLP effect emerged in persons with higher expectations for bodily symptoms (r = .23, p = .046) and psychological distress (r = .24, p = .037). Conclusions: Methodological differences to the original study are discussed as an explanation for the failure to induce overall OLP effects. Future studies should continue to replicate previous findings and determine the exact conditions of successful implementation of OLP effects in healthy as well as clinical samples
Shame Mediates the Relationship Between Negative Trauma Attributions and Posttraumatic Stress Disorder (PTSD) Symptoms in a Trauma Exposed Sample
Background: Theoretical models of self-conscious emotions indicate that shame is elicited through internal, stable, and global causal attributions of the precipitating event. The current study aimed to investigate whether these negative attributions are related to trauma-related shame and PTSD symptom severity. Method: A total of 658 participants aged 18 to 89 (M = 33.42; SD = 12.17) with a history of trauma exposure completed a range of self-report measures assessing trauma exposure, negative trauma-related attributions, shame, and PTSD symptoms. Results: Higher levels of internal, stable, and global trauma-related attributions were significantly associated with shame and PTSD. Shame mediated the association between trauma-related attributions and PTSD symptom severity, even after controlling for the effects of number of trauma exposures, worst index trauma and depression. Conclusions: The present results suggest that negative attributions are a critical cognitive component related to shame and in turn, PTSD symptom severity. Future research should aim to replicate these findings in a clinical sample and extend these findings using prospective designs
External Locus of Control but not Self-Esteem Predicts Increasing Social Anxiety Among Bullied Children
Background: Elevated social anxiety is more likely among bullied children than those who have not been bullied but it is not inevitable and may be influenced by cognitive factors. Lower self-esteem and more external locus of control are associated with bullying and social anxiety but the impact of these factors over time among bullied children is less clear.
Method: Children from the UK Avon Longitudinal Study of Parents and Children (ALSPAC) reported bullying experiences at age 8 (n = 6,704) and were categorized according to level of bullying exposure. The impact of self-esteem and locus of control on social anxiety was assessed up to age 13 across the bullying exposure groups using multi-group latent growth curve analysis. Complete data was available for 3,333 participants.
Results: More external locus of control was associated with a steeper increase in social anxiety among severely bullied children [B = .249, p = .025]. Although self-esteem at age 8 was associated with existing social anxiety it did not predict later increases in social anxiety.
Conclusion: These results indicate that beliefs about lack of personal control among severely bullied children may contribute to increasing social anxiety over time. Exploring related cognitions may be helpful in this potentially vulnerable group
The Influence of Alcohol on Rumination and Metacognitions in Major Depressive Disorder
Background and Objectives: Comorbidity between major depressive disorder (MDD) and alcohol use disorder (AUD) is highly prevalent but reasons for this association are unclear. Rumination may activate metacognitive beliefs that contribute to the development and maintenance of rumination and depression. Negative metacognitions can further lead to other dysfunctional coping strategies (i.e., consumption of alcohol). We examined whether alcohol reduces (state) metacognitions, rumination and other disorder-specific processes in a group of individuals suffering from MDD. Method: In an experiment with three randomized conditions we investigated whether the consumption of alcohol, placebo or no alcohol (orange juice) affects (meta-)cognitions, depressive symptoms and / or psychophysiological variables while participants ruminate. Results: Voluntary rumination increased self-reported sadness, tension and rumination, tensed facial muscles and increased heart rate, but did not affect (state) metacognitions and heart rate variability. The consumption of alcohol did not influence rumination, metacognitions, depressive or psychophysiological measures. Limitations: We recruited a depressed population but excluded pathological alcohol use due to ethical considerations. Conclusions: We found no evidence that alcohol consumption affects rumination, metacognitions and other disorder-specific processes in MDD. However, rumination had a negative effect on various depression-specific processes, although it did not activate (negative state) metacognitions