Clinical psychology & psychotherapy最新文献

Objective

The aim of the study was to estimate the prevalence of eating disorders (EDs) across the borderline personality disorder (BPD) population.

Method

After protocol registration (number = CRD42023415721), we systematically searched PubMed/MEDLINE, PsycINFO and Web of Science for articles that allowed the assessment of the proportion of at least one ED in a sample of patients with BPD. Risk of bias was estimated using the Joanna Briggs Institute (JBI) checklist for studies reporting prevalence data, and we used a random-effects meta-analytic model. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) statement.

Results

A total of 34 articles were included, with 20 reports (N = 4107) related to EDs without distinction, and 20 (n = 3901), 20 (n = 4369), seven (n = 766), and six (n = 1773) reports related to anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and eating disorder not otherwise specified (EDNOS), respectively. The overall frequency of EDs in BPD was estimated to be 29.7% (95% CI = [21.6%, 38.4%]), while the frequencies of AN, BN, BED, and EDNOS were estimated to be 9.98% (95% CI = [5.6%, 15.3%]), 16.3% (95% CI = [12.1%, 21.1%]), 16.3% (95% CI = [6%, 30%]) and 18.8% (95% CI = [10.6%, 28.6%]), respectively. The overall risk of bias was moderate, there was no publication bias, and the certainty levels of our evidence were low.

Discussion

This meta-analytic review highlights the high frequency of EDs in BPD. It could serve as a basis for exploring the determinants of these comorbidities.

Conclusions

Through this systematic review and meta-analysis, we found a high prevalence of EDs and their subtypes in patients with BPD.

Background

The Israeli–Gaza conflict has re-erupted on October 7th, and the unique events of that day presented unprecedented challenges to first responders (FRs). Notwithstanding, while there is empirical evidence regarding the long-term psychological consequences of FRs, little is known regarding the immediate mental health consequences, as well as personal resources, as events continued to unfold on a daily basis.

Objective

The current study examined the relationship between traumatic stress symptoms (TSS) and psychological flexibility (PF) levels among FRs and controls during the first weeks of the Iron Swords war.

Method

Data were collected during the first month of the Iron Swords war from 295 participants living in Southern Israel, of whom 55 (19%) were FRs. All participants filled out scales assessing TSS and PF and provided relevant background information.

Results

Overall, high TSS levels were associated with low PF. In addition, FRs showed higher levels of TSS, whereas no group differences were found in PF. Most importantly, a significant interaction of study group × PF was observed, revealing that while the PF–TSS link connection was significant for both FRs and non-FRs, it was significantly stronger among FRs.

Conclusions

The findings highlight the importance of targeting specific tailored interventions in the mentioned population. Clinical interventions aimed towards FRs should focus on the extent to which they are able to use PF as a resource, as this appears to be an important parameter in their ability to cope with traumatic stress symptomatology.

Objective

Traditional treatment approaches in cocaine use disorder (CUD) still report high rates of poor outcomes. Emotion regulation (ER) is a transdiagnostic factor that may contribute to the initiation and maintenance of CUD, strengthening addiction severity. A deeper understanding of ER in this population is crucial for improving treatment outcomes. This study explores whether ER difficulties at treatment entry predict addiction severity and withdrawal symptom severity after discharge in patients with CUD. Secondarily, it examines whether withdrawal symptom severity mediates the relationship between ER difficulties and relapse.

Methods

A total of 70 CUD patients underwent a 14-day inpatient detoxification. At admission, cocaine use–related variables and ER questionnaires (DERS and ERQ) were registered. After discharge, addiction severity (SDS), craving (WCS), cocaine withdrawal symptom severity (CSSA) and relapse were recorded. Multiple linear regression and mediation analysis were conducted to address the primary and secondary aims, respectively. This study draws on data from a larger randomized clinical trial.

Results

Impulse control difficulties and nonacceptance of emotional responses predicted SDS, and nonacceptance of emotional responses predicted CSSA. However, mediation analyses showed no indirect effect of DERS total score on relapse through the effect of the mediating variable CSSA.

Conclusion

ER screening at hospitalization admission may optimize treatment by identifying high-risk CUD patients. Third-generation therapies targeting ER skills may enhance outcomes by helping patients manage emotional distress, potentially reducing addiction severity and withdrawal symptoms. Because of mixed results and the exploratory nature of this study, further research on the ER role in this context is needed.

Trial Registration: ClinicalTrials.gov; ID: NCT05207228.

Background

Schizotypy provides a theoretically grounded framework for investigating psychosis proneness, reflecting a multidimensional structure that parallels the positive, negative and disorganized symptoms of schizophrenia. Alexithymia, a trait characterized by difficulties in identifying (DIF) and describing feelings (DDF) and a tendency towards externally oriented thinking (EOT), has been robustly linked to schizophrenia. Despite these associations, the relationship between alexithymia and schizotypy remains underexplored. Moreover, given that both constructs are closely associated with negative affect, it is critical to account for this potential confound to estimate their associations accurately.

Method

We employed a cross-sectional design in a non-clinical sample to examine the associations among the dimensions of alexithymia, negative affect and schizotypy. Network models were estimated using Spearman correlations and the EBICglasso method to capture conditionally independent associations.

Results

The sample (N = 420) was predominantly female (n = 314), with ages ranging from 18 to 37 years (M = 28.72, SD = 4.52). More than half (n = 232) reported receiving mental health treatment, and 127 participants self-reported a personal history of psychosis. DIF and negative schizotypy emerged as central to different clusters in the network. Specifically, DIF served as a bridge linking positive and disorganized schizotypy dimensions to anxiety and stress, whereas negative schizotypy was a central bridge connecting DDF and EOT to depression. These estimates were psychometrically stable.

Conclusion

Our findings suggest DIF and negative schizotypy as plausible mechanisms of change facilitating emotional attunement and resilience against distress due to unusual self-experiences.

Background

The study investigated the relationship between early maladaptive schemas (EMS), gaming disorder (GD) and alcohol use disorder (AUD) symptoms. Previous studies did not address the possible relationship between AUD and GD symptoms, which could lead to an incomplete understanding of the relationship between EMS and these disordered behaviours. The current study addressed this research gap by testing the relationship between AUD, GD symptoms and EMS.

Methods

The study included 1054 participants (565 females, M = 22.96 years, SD = 2.52) who reported playing video games and consuming alcohol within the past 12 months. Participants completed the Young Schema Questionnaire (YSQ-S3), Gaming Disorder Test (GDT) and Problem Drinking Scale (PDS). Seemingly Unrelated Regression (SUR) analysis was used to model the relationships between EMS, GD and AUD symptoms while controlling for gender, age, gaming hours and alcohol consumption frequency.

Results

AUD symptoms were positively associated with dependence/incompetence, vulnerability to harm or illness, self-punitiveness and entitlement/grandiosity schemas and negatively related to social isolation/alienation and insufficient self-control/self-discipline schemas. GD symptoms were positively related to enmeshment and subjugation schemas and negatively associated with unrelenting standards and pessimism/negativism schemas. Significant differences were found between GD and AUD symptoms in their associations with specific EMS, suggesting distinct psychological pathways.

Conclusions

The findings highlighted the differential roles of EMS in AUD and GD symptoms. The results suggest that EMS contribute uniquely to addictive behaviours and underscore the importance of considering schema-based interventions. Future research should further explore the mediating role of parenting styles in the development of AUD and GD symptoms.

Objectives

The time perspective dimensions and balanced time perspective (BTP) may play a crucial role in the therapeutic process of individuals with schizophrenia spectrum disorders (SSDs). This study aimed to investigate the relationship between BTP, working alliance (WA) and psychiatric symptomatology in individuals with SSD.

Methods

A total of 313 residential patients with SSD were recruited from 98 residential facilities in Italy. Clinicians completed the Brief Psychiatric Rating Scale (BPRS) and the Brief Negative Symptom Scale (BNSS), while patients completed the Zimbardo Time Perspective Inventory (ZTPI) and the Working Alliance Inventory–Short Form (WAI). Deviation from Balanced Time Perspective–revised (DBTP-r) was applied as an estimate of unbalanced TP. Statistical analyses included Pearson correlations and mediation models. Age, sex, illness duration and years of education were controlled in mediation analyses.

Results

DBTP-r showed significant negative correlations with WAI total and positive correlations with BPRS and BNSS. ZTPI-Present Fatalistic negatively correlated with WAI-Goal. The WAI partially mediated the effect of DBTP-r on both BPRS and BNSS, while DBTP-r partially mediated the impact of WAI on both BPRS and BNSS.

Conclusions

BTP played a dual role, acting both as a contributing factor to and a result of the WA. The present-fatalistic TP emerged as a key factor in shaping WA concerning therapeutic goals. Findings underscore the importance of considering (B)TP as both a potential resource and a therapeutic target in treating SSD.