Clinical psychology & psychotherapy最新文献

Hoarding disorder is a debilitating psychological disorder that is difficult to treat. Poor treatment response to current interventions indicates that new perspectives are needed. This systematic review examines qualitative and case study research on patient-centred strategies for reducing hoarding disorder symptoms and improving wellbeing. We conducted a comprehensive search of PsycInfo, Medline Complete, CINAHL, SocINDEX and Scopus in May 2025 to identify peer-reviewed qualitative research and case studies, published in English that examined hoarding disorder patients' first-hand experiences with strategies that improved their symptoms and wellbeing. We excluded papers that examined animal or digital hoarding, hoarding in the context of another disorder, hoarding in children or animals and papers with perspectives from only service providers or carers. The quality of studies was assessed using the Critical Appraisal Checklist for Qualitative Research Studies. Results were synthesized using thematic analysis. Twenty-one studies were included for review. Thematic analysis identified five key themes: interconnection, recognition of individuality and autonomy, self-care and acceptance, cognitive and behaviour change, and practical help. The papers included descriptions of therapeutic strategies (e.g., discarding tasks) and other factors identified as beneficial (e.g., meditation). Interconnection was the strongest theme, emphasizing the pivotal role trusted relationships play in helping individuals with hoarding disorder. The review indicates that individuals with HD may benefit from personalized care that focuses on interpersonal relationships, emotion regulation strategies, self-care, and in-home help for managing their symptoms and improving wellbeing.

Shame experience and regulation are of crucial importance in the study of emotion and psychopathology. Considering the variety of conceptualizations and operationalization methods in the shame literature, the present review aimed to provide a meta-synthesis of current knowledge. First, we examined how shame and shame regulation are conceptualized. Second, we aimed to identify the most used measures of shame experience and regulation. Third, we gauged the literature for levels of consistency between conceptualization and methods of operationalization. An umbrella review of recent (2018–2023) systematic reviews and meta-analyses was conducted: 17 studies were included, integrating data from a total of 748 samples and approximately 166,172 participants. Data on title, authors, journal, aims of the review, conceptualization and measures of shame and shame regulation, and main findings were extracted. A relative majority of studies (roughly 63%) conceptualized shame as a multidimensional construct, and the most used measure was the TOSCA (Test of Self-Conscious Affect) in 76% of cases. Only partial coherence between conceptualization and measurements of the constructs of interest was detected in the retrieved literature. Most measures capture different dimensions of shame, but these were not always leveraged in favour of ‘total score’ considerations. Notably, several reviews referred to shame regulation, but only two included measures of shame regulation. These findings stress the importance of increased consistency between conceptual and methodological levels when studying shame and, in particular, shame regulation, in order to aid integration across studies and increase the theoretical solidity and applied usefulness of empirical findings.

Although empirical studies have shown that interpersonal distress is related to mental health indicators in depression, there are no previous meta-analyses evaluating this association. We performed a systematic review and meta-analytic study to estimate the association between interpersonal distress and non-relational mental health indicators (NR-MHI) in depression. Following PRISMA criteria, we performed a systematic search on PubMed and PsycINFO. We conducted multilevel meta-analytic (i.e., random-effects) models to estimate a pooled correlation coefficient representing the strength of the association between interpersonal distress and NR-MHI. Thirty-eight studies (reporting 88 effect sizes) met inclusion criteria. The models showed a significant correlation between interpersonal distress and NR-MHI (r = 0.41, p < 0.001), with moderate heterogeneity, Q(87) = 710.38, p < 0.001. A funnel plot did not present evidence of publication bias. We found no significant moderation effects of specific depressive diagnoses, type of study or levels of interpersonal distress. This study is the first to report a meta-analytic synthesis of the association between interpersonal distress and NR-MHI in depression, showing that in individuals with depression, NR-MHI was positively associated with interpersonal distress, presenting a medium-to-large pooled effect size.

Current studies on intimate partner violence (IPV) conclude that IPV perpetrators are a heterogeneous group, with substantially different profiles and different relevant clinical variables, with a differential response to the psychological treatment programmes that they take part in, measured through criminal recidivism. However, most studies look only at these offenders' short-term recidivism. The aim of this longitudinal study was, on the one hand, to replicate a typology based on the risk of recidivism in a sample of 484 court-referred partner-violent men and, on the other hand, to analyse long-term criminal recidivism in these aggressors, depending on the typology found. For this purpose, a 15-year longitudinal follow-up was conducted on 484 court-referred partner-violent men after they had participated in a cognitive-behavioural psychological treatment programme. The results corroborated the existence of three subtypes of aggressors: those with high risk, medium risk and low risk, as well as different patterns of recidivism depending on the profile identified at the beginning of the treatment. It was concluded that recidivism was higher in the first year of follow-up, as well as the fact that the aggressors at greatest risk were the subgroup with the highest level of long-term recidivism. These results highlight the heterogeneity existing in this type of aggressor, as well as the need to adapt psychological treatment programmes in line with the initial characteristics of the participants.

Schema therapy (ST) is an effective psychotherapy for personality disorders in (older) adults. There is an increasing awareness of the imbalance in the ST community because of the emphasis on negative schemas versus attention to positive schemas. This study aimed to evaluate the effectiveness of an adapted ST approach that integrates positive schemas. Using a multiple baseline design, the study assessed 10 older adults (aged > 60) with Cluster C personality disorders through 1 year of weekly individual ST sessions, followed by a 6-month follow-up. Baseline consisted of 4–8 weeks without intervention. Primary outcomes were credibility of positive and negative core beliefs; secondary measures examined symptomatic distress, schema modes, early maladaptive and positive schemas. Results showed mixed individual outcomes. Positive core beliefs significantly improved in 38% of participants during treatment and 50% at follow-up, whereas negative core beliefs decreased significantly for 25% of participants during treatment and 67% at follow-up. At the group level, significant increases with very large effect sizes were observed in positive core beliefs in baseline versus follow-up and reductions in negative beliefs in baseline versus treatment and versus follow-up. Secondary outcomes revealed significant reductions in symptomatic distress and PD criteria, alongside increased positive schemas. No significant changes were found for schema modes or maladaptive schemas. This first study underscores the potential of integrating positive schemas into ST for older adults, suggesting preliminary efficacy. Further research is essential to generalize findings across different age groups and diagnoses and to identify which aspects of positive schemas enhance therapy outcomes.