Clinical Psychology in Europe (E-Journal)
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Only the Lonely: A Study of Loneliness Among University Students in Norway
Background: Loneliness is a major public health concern among college and university students, the evidence is inconsistent regarding whether there is an increasing trend or not. Furthermore, knowledge of the demographic determinants for loneliness are limited. The present study assesses recent trends of loneliness from 2014 to 2018, and explores demographic risk indicators of loneliness among students.
Method: Data was drawn from two waves of a national student health survey from 2014 and 2018 for higher education in Norway (the SHoT-study). In 2018, all 162,512 fulltime students in Norway were invited to participate and 50,054 students (69.1% women) aged 18-35 years were included (response rate = 30.8%). Loneliness was measured by “The Three-Item Loneliness Scale” (T-ILS) and one item from the Hopkins Symptom Checklist-25 (HSCL-25).
Results: Age showed a curvilinear association with loneliness, with the youngest and oldest students reporting the highest level of loneliness across all measures. Other significant demographic determinants of loneliness were being female, single and living alone. There was a considerable increase in loneliness from 2014 (16.5%) to 2018 (23.6%, p < .001), and the increase was particularly strong for males, for whom the proportion of feeling “extremely” lonely had more than doubled.
Conclusion: The high rate of loneliness and the increasing trends indicate the need for preventive interventions in the student population
A Response to Marvin Goldfried's Article on the Immaturity of the Psy-Professions
No abstract available
Intuitive Judgments in Depression and the Role of Processing Fluency and Positive Valence: A Preregistered Replication Study
Background: Recent preliminary evidence indicates that depression is associated with impaired intuitive information processing. The current study aimed at replicating these findings and to move one step further by exploring whether factors known as triggering intuition (positivity, processing fluency) also affect intuition in patients with depression. Method: We pre-registered and tested five hypotheses using data from 35 patients with depression and 35 healthy controls who performed three versions of the Judgment of Semantic Coherence Task (JSCT, Bowers et al., 1990). This task operationalizes intuition as the inexplicable and sudden detection of semantic coherence. Results: Results revealed that depressed patients and healthy controls did not differ in their general intuitive performance (Hypothesis 1). We further found that fluency did not significantly affect depressed patients’ coherence judgments (H2a) and that the assumed effect of fluency on coherence judgments was not moderated by depression (H2b). Finally, we found that triads positive in valence were more likely to be judged as coherent as compared to negative word triads in the depressed sample (H3a), but this influence of positive (vs. negative) valence on coherence judgments did not significantly differ between the two groups (H3b). Conclusion: Overall the current study did not replicate findings from previous research regarding intuitive semantic coherence detection deficits in depression. However, our findings suggest that enhancing positivity in depressed patients may facilitate their ability to see meaning in their environment and to take intuitive decision
Biased Perception of Physiological Arousal in Child Social Anxiety Disorder Before and After Cognitive Behavioral Treatment
Background: A biased perception of physiological hyperreactivity to social-evaluative situations is crucial for the maintenance of social anxiety disorder (SAD). Alterations in interoceptive accuracy (IAc) when confronted with social stressors may play a role for SAD in children. We expected a biased perception of hyperarousal in children with SAD before treatment and, consequently, a reduced bias after successful cognitive behavioral therapy (CBT).Method: In two centers, 64 children with the diagnosis of SAD and 55 healthy control (HC) children (both 9 to 13 years) participated in the Trier Social Stress Test for Children (TSST-C), which was repeated after children with SAD were assigned to either a 12-week group CBT (n = 31) or a waitlist condition (n = 33). Perception of and worry about physiological arousal and autonomic variables (heart rate, skin conductance) were assessed. After each TSST-C, all children further completed a heartbeat perception task to assess IAc.Results: Before treatment, children with SAD reported both a stronger perception of and more worry about their heart rate and skin conductance than HC children, while the objective reactivity of heart rate did not differ. Additionally, children with SAD reported heightened perception of and increased worry about trembling throughout the TSST-C compared to HC children, but reported increased worry about blushing only after the stress phase of the TSST-C compared to HC children. Children with and without SAD did not differ in IAc. Contrary to our hypothesis, after treatment, children in the CBT group reported heightened perception of physiological arousal and increased worry on some parameters after the baseline phase of the TSST-C, whereas actual IAc remained unaffected. IAc before and after treatment were significantly related.Conclusions: Increased self-reported perception of physiological arousal may play a role in childhood SAD and could be an important target in CBT. However, further studies should examine if this is an epiphenomenon, a temporarily occurring and necessary condition for change, or indeed an unwanted adverse intervention effect
Pre-Sleep Arousal and Fear of Sleep in Trauma-Related Sleep Disturbances: A Cluster-Analytic Approach
Background: Trauma-related sleep disturbances constitute critical symptoms of posttraumatic stress disorder (PTSD), but sleep symptoms often reside even after successful trauma-focused psychotherapy. Therefore, currently unattended factors – like fear of sleep (FoS) – might play a crucial role in the development and maintenance of residual sleep disturbances. However, it is unclear whether trauma-exposed individuals exhibit different symptomatic profiles of sleep disturbances that could inform individualized therapeutic approaches and eventually enhance treatment efficacy.Method: In a large online study, a two-step cluster analysis and a hierarchical cluster analysis using Ward’s method were performed to explore subgroups among trauma-exposed individuals (N = 471) in terms of FoS, different aspects of trauma-related sleep disturbances (e.g., insomnia symptoms, nightmares, arousal), and PTSD symptoms. These variables were compared between resulting clusters using ANOVAs and Scheffé’s post-hoc tests.Results: The hierarchical cluster analysis supported 3- and 4-cluster solutions. The 3-cluster solution consisted of one “healthy” (n = 199), one “subclinical” (n = 223), and one “clinical” (n = 49) cluster, with overall low, medium, and high symptomatology on all used variables. In the 4-cluster solution, the clinical cluster was further divided into two subgroups (n = 38, n = 11), where one cluster was specifically characterized by elevated somatic pre-sleep arousal and high levels of FoS.Conclusions: A subgroup of trauma-exposed individuals with PTSD and sleep disturbances suffers from increased pre-sleep arousal and FoS, which has been suggested as one possible explanation for residual sleep disturbances. In these patients, FoS might be a relevant treatment target
The Emerging Role of Clinical Pharmacopsychology
Background: Clinical pharmacopsychology is an area of clinical psychology that is concerned with the application of clinimetric methods to the assessment of psychotropic effects of drugs on psychological functioning, and the interaction of such drugs with specific or non-specific treatment ingredients. Clinical pharmacopsychology derives its data from observational and controlled studies on clinical populations and refers to the therapeutic use of medical drugs, not to the effects of substances used for other purposes.
Method: Domains and operational settings of clinical pharmacopsychology are illustrated.
Results: The domains of clinical pharmacopsychology extend over several areas of application which encompass the psychological effects of psychotropic drugs (with particular emphasis on subclinical changes), the characteristics that predict responsiveness to treatment, the vulnerabilities induced by treatment (i.e., side effects, behavioral toxicity, iatrogenic comorbidity), and the interactions between drug therapy and psychological variables. A service for clinical pharmacopsychology is here proposed as an example of the innovative role of clinical psychology in medical settings.
Conclusion: Clinical pharmacopsychology offers a unifying framework for the understanding of clinical phenomena in medical and psychiatric settings. Its aim is to provide a comprehensive assessment of the clinical important changes that are concerned with wanted and expected treatment effects; treatment-induced unwanted side effects; and the patient's own personal experience of a change in terms of well-being and/or quality of life. It is now time to practice clinical pharmacopsychology, creating ad hoc services in Europe
OK Computer? A Time Analysis of Google Searches About Symptoms
Background: Google searches are now a popular way for individuals to seek information about the significance of common symptoms and whether they should seek medical assistance. As analysis of search patterns may help understand the demand for medical care, we examined what times over a 24-hour period and on what days of the week people searched Google for information about common symptoms.
Method: We analysed Google searches for symptoms in the United Kingdom during the week from July 30 to August 5, 2018 using Google Trends. We recorded the time points with the highest search volume for 50 common symptoms relative to other searches, and the day of the week with the highest search peak for each particular symptom.
Results: All of the peak searches for the symptoms we examined occurred during the night between 10pm and 8am. The majority 32/50 (64%) occurred between 3am to 6am with 12/50 (24%) between midnight and 3am. Most symptom searches were more common during the week and lowest during the weekend. Typically, searches for a particular symptom peaked at a similar time each night over the week.
Conclusions: Searches for symptoms are significantly more common during night-time hours, and particularly between 3 and 6am. Symptom searches show relatively stable diurnal and weekly patterns
Anxiety and Depression in Cardiac Inherited Disease: Prevalence and Association With Clinical and Psychosocial Factors
Background: The small number of published studies indicate increased rates of anxiety and depression among patients with cardiac inherited diseases (CID). This study aimed to assess the prevalence of anxiety and depression in a New Zealand CID cohort and seek any associations with clinical and psychosocial factors.Method: Patients on a national CID register were sent a survey; 202 of 563 contactable patients participated (36% response rate). Ages ranged from 16 to 83 years (median 53). Most had Long QT Syndrome (43%) or Hypertrophic Cardiomyopathy (34%). Questionnaires collected demographic and psychological variables, including anxiety (GAD-7), depression (PHQ-9), illness perceptions, perceived risk and social support. The registry supplied clinical and genetic characteristics.Results: 80 participants (42%) reported features of anxiety and/or depression. 24 (13%) reached clinical levels of depression, a greater proportion than that found in the general population. Poorer perceived social support was associated with worse anxiety (p < .001) and depression (p < .001) scores. Reporting more physical symptoms (p = .001) (commonly not caused by the CID) was associated with poorer depression scores and greater perceived consequences of the CID was associated with greater anxiety scores (p < .05). Neither anxiety nor depression were associated with time since diagnosis, disease severity or type of disease.Conclusion: Forty percent of the CID population live with some degree of psychopathology but this did not correlate with disease severity, type of disease nor time since diagnosis. Correlating factors which may be modifiable include illness perceptions, various physical symptoms and social support
Evidence of a Media-Induced Nocebo Response Following a Nationwide Antidepressant Drug Switch
oai:journals.psychopen.eu:article/2361Background: In 2017, patients on a generic or branded antidepressant venlafaxine were switched to a new generic formulation (Enlafax). In February and April 2018, two major NZ media outlets ran stories about the new generic being less effective and causing specific side effects. This study aimed to examine the effect of the media coverage on drug side effects reported to the national Centre for Adverse Reactions Monitoring (CARM) and whether the specific symptoms reported in the media increased compared to side effects not reported in the media.Method: We analysed monthly adverse reaction reports for Enlafax to CARM from October 2017 to June 2018 and compared adverse reports, complaints of decreased therapeutic effect and specific symptom reports before and after the media coverage using an interrupted time series analysis.Results: We found the number of side effects and complaints of reduced therapeutic effect increased significantly following the media stories (interruption effect = 41.83, 95% CI [25.25, 58.41], p = .003; interruption effect = 15.49, 95% CI [7.01, 23.98], p = .012, respectively). The specific side effects mentioned in the media coverage, including suicidal thoughts, also increased significantly compared to other side effects not mentioned in the media.Conclusions: In the context of a drug switch, media reports of side effects appear to cause a strong nocebo response by increasing both the overall rate of side effect reporting and an increase in the specific side effects mentioned in the media coverage, including reduced drug efficacy and heightened suicidal thoughts
Overcoming Barriers and Limitations – Why This New Journal Is Needed
Highlights
Introducing the new journal Clinical Psychology in Europe (CPE).
Overcoming artificial barriers by focusing on evidence instead of traditions.
Bridging the gap from basic experimental to treatment-related research.
Supporting open science recommendations.
Covering a broad variety of research efforts.
Full open access but no publication fees