Clinical psychology & psychotherapy最新文献

Adolescence is a critical developmental period during which obsessive-compulsive disorder (OCD) frequently emerges. This study examined cognitive models of OCD, the associations between stressful life events (SLEs) and symptom severity, and the unique challenges faced by adolescents living with OCD symptoms. Two indirect pathways were tested: one involving SLEs and the other perceived stress, with both pathways including inferential confusion and obsessional beliefs as mediators. A sample of adolescents presenting with OCD symptoms completed validated measures assessing stress, obsessive beliefs, inferential confusion, and symptom severity. Results indicated that inferential confusion showed a significant indirect association between perceived stress and OCD symptom severity, whereas obsessional beliefs did not emerge as significant mediators. These findings suggest that inferential confusion represents an important cognitive factor associated with OCD symptoms in youth and may be especially salient under conditions of elevated stress. They also underscore the value of further investigating interventions that address inferential confusion in early OCD-focused treatments for adolescents.

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.