Clinical psychology & psychotherapy最新文献

With gaming's increasing prevalence, understanding the psychological functioning of individuals across a range of internet gaming disorder (IGD) severity is crucial. This study replicates and extends Bonnaire and Baptista's (2019) research on DSM-5 IGD in European young adults, examining alexithymia, anxiety, maladaptive personality traits and interpersonal problems with a US sample. A diverse group of 205 young adults (mean age = 20.41, 73% female) completed an anonymous survey assessing IGD using the Internet Gaming Disorder Scale—Short Form (IGDS9-SF; Pontes and Griffiths 2015), gaming type, alexithymia, anxiety, maladaptive personality traits and interpersonal problems. IGDS9-SF effectively distinguished normal gamers (IGD criteria = 0) from risky gamers (IGD criteria = 1–6), with the latter showing significantly greater pathology across all measures (p < 0.01). While gaming type showed no overall significant differences, gamers who preferred more role-playing platforms trended toward reporting more interpersonal problems than gamers preferring action games (p = 0.059). Overall IGD severity was also significantly correlated with greater pathology on all measures (p < 0.001). Specifically, disinhibition (impulsivity and poor self-control) and socially avoidant interpersonal problems emerged as the strongest unique predictors of IGD severity, suggesting that interventions targeting impulsivity, interpersonal functioning and social skills may be particularly useful in the treatment of IGD issues. Findings underscore IGD's connections to emotional, personality and interpersonal factors, informing clinical assessment and treatment.

Diagnosing behavioural problems in adolescents often relies on subjective reports from parents or caregivers. Systemic theory emphasizes the need for multiple perspectives, including those of the adolescent. This study examined the alignment between adolescents' and parents' perceptions of behavioural problems in ADHD and non-ADHD groups and explored how family cohesion and flexibility explain the severity of externalizing and internalizing behaviours from both perspectives. Participants included 214 adolescents diagnosed with ADHD and their parents (adolescents: Mage = 11.24, SD = 0.91, 75.23% boys; parents: Mage = 41.92, SD = 6.43, 84.11% mothers) and 514 adolescents without ADHD and their parents (adolescents: Mage = 11.34, SD = 0.75, 51.56% boys; parents: Mage = 42.29, SD = 5.58, 87.55% mothers), from 18 cities in southern Poland. The variables were measured using the ASEBA instruments (Child Behaviour Checklist, Youth Self Report) and the Family Adaptation and Cohesion Evaluation Scales. Data were analysed using Actor–Partner Interdependence Models to examine actor and partner associations within adolescent–parent dyads. More boys were diagnosed with ADHD, showing slightly more externalizing problems than girls. Lower family flexibility predicted externalizing behaviours, with parent-rated flexibility linked to parent-rated behaviours, and adolescent-rated flexibility linked to adolescent-rated behaviours. Adolescent-rated family cohesion rated by adolescents predicted fewer externalizing behaviours as reported by parents in the ADHD group and by adolescents in the non-ADHD group. Internalizing behaviours were linked to family flexibility and cohesion, regardless of the actor (adolescent or parent). The predominance of actor effects indicates that each informant's perception of family functioning is uniquely linked to their own reports of symptoms; given only moderate parent-adolescent agreement, these perspectives appear complementary rather than redundant. Assessing behavioural problems requires data from both parents and adolescents, as family cohesion and flexibility significantly impact adolescent functioning.

Trial Registration: ClinicalTrials.gov identifier: NCT04574414.

The acceptability and effectiveness of the 12-week, mentalization-based, Lighthouse Parenting Programme (LPP) for parents of children with emotional and behavioural difficulties was assessed in an Irish primary care setting. Changes in child behavioural problems, parental stress, parental reflective functioning (PRF) and epistemic trust were examined. Twenty-seven parents participated. Significant reductions in child behavioural problems and parental stress were reported, with medium to large effect sizes reported. Epistemic trust also improved significantly, while PRF remained unchanged. These findings offer preliminary support for the LPP's value in primary care. Further research with larger samples and control conditions is needed.

Research into the differences across cognitive domains has been conducted to characterize the various presentations of schizophrenia-spectrum disorders. We aimed to identify distinct combined cognitive profiles with clinical relevance in patients with early psychosis (EP) by integrating neurocognition, social cognition and cognitive biases (CBs). Seventy-five outpatients attending an EP programme were assessed on neuropsychological performance, Theory of Mind (ToM), facial emotion recognition (FER), jumping to conclusions (JTC) bias and self-reported CBs through standardized tools. A two-step cluster analysis was performed to identify latent profiles. The optimal number of clusters was determined based on the Bayesian information criterion. Symptom dimensions, depression, global functioning, antipsychotic use, duration of untreated psychosis (DUP) and sociodemographic variables were compared across the resulting clusters. Two distinct profiles were identified. The first cluster (53.3%) was characterized by significant impairments in neurocognition, ToM and FER, as well as greater JTC and self-reported CBs. The second cluster (46.7%) was defined by relatively preserved performance across cognitive domains. Furthermore, the impaired cluster showed more severe positive, negative and disorganized symptoms, poorer functioning, lower premorbid intelligence and increased use of antipsychotics. No significant differences were found for depression, DUP or sociodemographic variables. Concluding, cognitive clustering revealed a clinically impaired subgroup of patients with more severe psychotic symptoms and poorer functioning. Our results may contribute to a better understanding of the distinct cognitive profiles of patients with EP. These findings may be relevant because several interventions targeting different cognitive domains have been shown to improve clinical and functional outcomes in EP.

Body Dysmorphic Disorder (BDD) is a condition characterised by intrusive thoughts of ugliness and deformity. The efficacy of cognitive behavioural therapy (CBT) in treating BDD remains debatable despite results from several randomised controlled trials (RCTs). This study evaluated the current evidence on the efficacy of CBT compared to placebo or other interventions for treating BDD. We conducted a systematic review and meta-analysis of RCTs. Following a database search, the quality effects (QE) model was used to synthesise standardised mean differences and 95% confidence intervals for outcomes including BDD symptoms, insight, depression, body image, anxiety, global functioning and quality of life. Stratified analyses were based on outcome scale, CBT delivery mode and modality, control group type and country. Heterogeneity was assessed using the I² statistic and publication bias using funnel and Doi plots and the LFK (Luis Furuya-Kanamori) index and the trim-and-fill analysis. Evidence quality was evaluated using the GRADE framework. The meta-analysis included 19 RCTs (978 participants), demonstrating that CBT significantly improved BDD symptoms (SMD = −1.17, CI: −1.92, −0.43, I² = 93.3%), body image (SMD = −1.90, CI: −4.22, −0.42, I² = 97.2%) and global functioning (SMD = 0.63, CI: 0.28, 0.98, I² = 65.0%). CBT showed non-significant effects on insight (SMD = −0.93, CI: −2.09, 0.22, I² = 96.7%), depression (SMD = −0.73, CI: −1.56, 0.10, I² = 94.8%) and quality of life (SMD = 0.87, CI: −0.35, 2.09, I² = 94.4%). In conclusion, CBT was efficacious in alleviating BDD symptoms, anxiety, body image concerns and improving global functioning. Face-to-face, online and non-specialised CBT for BDD were also efficacious; however, further investigation is needed to explore the sources of the observed heterogeneity.