Clinical psychology & psychotherapy最新文献

Turkey experienced two devastating earthquakes, which resulted in more than 50,000 deaths and millions of injured and homeless individuals. The negative influence of direct exposure to trauma has been proven, but the impact of indirect exposure remains unclear. In this study, we focused on indirect types of trauma exposure: the loss of someone in the earthquake and the exposure to disaster media. We aimed to explore the influence of these dimensions on psychological states, including earthquake trauma severity, post-traumatic stress disorder (PTSD) symptoms, depression, anxiety, hopelessness and life satisfaction and temporal-psychological measures, such as intertemporal decision-making tendencies and time perspectives. The sample (N = 215) consisted of Turkish individuals who experienced the earthquakes through two types of indirect exposure: having lost someone and being exposed to disaster media. Findings showed that having a loss in the earthquake was related to high levels of trauma, anxiety, hopelessness and a past-negative time perspective. Repetitive exposure to disaster media was linked to higher levels of trauma, PTSD symptoms, depression, anxiety, stress and a past-negative time perspective. Importantly, the amount of traumatization in case of losing someone was modulated by the frequency of disaster-media exposure. Even indirect exposure to the disaster substantially disturbs many processes, and the media magnifies such disturbances.

This cross-sectional study investigated the relationship between the presence and impact of ACEs with both reactive and proactive aggression, and the possible moderating role of mentalization (operationalized as reflective functioning) in these expected relationships. Sixty-five inpatient and outpatient adults with any kind of antisocial behaviour completed the Dutch version of the Traumatic Experiences Checklist, the Reactive-Proactive Aggression Questionnaire, and the Adult Attachment Interview with the use of the Reflective Functioning Scale. Preliminary analysis showed a remarkably high level of ACEs, and a relatively high reported impact of these experiences. We found a positive relationship between the total presence of ACEs (including childhood maltreatment and adverse household factors), and both reactive and proactive aggression. We also found positive relationships between the experienced impact of these ACEs and both reactive and proactive aggression. Regarding childhood maltreatment in family of origin, we did not find a correlation between the presence of these experiences and respectively reactive and proactive aggression. However, we found a correlation between the impact of childhood maltreatment and reactive aggression. These results suggest that in addition to the cumulative experience of ACEs, the subjective burden of these experiences on individuals must not be underestimated in case of aggression. Additional moderation analysis showed no differences in these relationships in case of less developed versus medium-high developed reflective functioning. The findings substantiate the importance of early prevention and treatment programs with focus on ACEs to possibly reduce aggression.

In routine outcome monitoring, psychotherapists receive feedback from their clients about their self-reported progress during therapy. This practice is based on research indicating that therapists overestimate their effectiveness and cannot detect and predict negative client change. However, this assumption is based on only a few studies. This study aimed to investigate whether trainee therapists could estimate client deterioration after each session and after therapy and whether they, from session to session, could predict client post-therapy outcomes. Fifty-three postgraduate trainee therapists at a university clinic treated 105 clients, with an average of 13.1 sessions. A questionnaire was developed to measure the therapists' estimation of client change at each session and their session-by-session prediction of client post-therapy outcomes. The 10-item version of the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE-OM) was used to measure clients' self-reported change at each session. The data included 96 (91.5%) therapist estimations of client post-therapy outcomes, 1015 (87.8%) estimations of client change from the second to the penultimate session, and 1140 predictions of post-therapy outcomes. The study found that at post-therapy, the therapists were only able to identify one out of eight clients who showed deterioration on the CORE-10. Additionally, during therapy, they could accurately estimate only six out of 83 sessions in which clients had experienced deterioration on the CORE-10, and they failed to predict any of the eight clients who ended therapy with deterioration. In conclusion, therapists cannot rely on their clinical judgement alone to assess client progress and outcomes and will depend on routine outcome monitoring to detect client deterioration.

The aim of the study was to investigate the mediating roles of resilience, posttraumatic growth (PTG) and religiosity between the impact of hurricane trauma and psychological distress. Using a cross-sectional design, the study involved 101 Libyan participants with an average age of 30.43 years (SD = 9.59), of whom 72% were women. Participants completed validated tests, including the Impact of Event Scale (IES), Brief Resilience Scale, Muslim Religiosity Scale and Patient Health Questionnaire (PHQ). The results indicated that posttraumatic stress symptoms (PTSS) were not associated with PTG (r = 0.04, p > 0.05) or religiosity (r = 0.02, p > 0.05) but were negatively associated with resilience (r = −0.39, p < 0.001) and positively associated with psychological distress including anxiety (r = 0.72, p < 0.001) and depression (r = 0.69, p < 0.001). Structural equation modelling (SEM) revealed that only resilience positively mediated the association between PTSS and anxiety (indirect effect = 0.04, p = 0.031), while PTSS positively predicted psychological distress (β = 0.037, p < 0.001). Network analysis identified parent loss is strongly connected with intrusion (r = 0.121), as most central node, while partner loss was associated with hyperarousal (r = 0.063), irritability (r = 0.036) and both share the same connection with numbing, while interestingly partner and friends loss share connection with resilience (r = 0.177). The study concludes that urgent clinical interventions, such as trauma-focused cognitive behavioural therapy, are required for the affected individuals, with a focus on enhancing resilience as a protective factor against PTSS.