Clinical psychology & psychotherapy最新文献

Coronavirus disease-19 (COVID-19) has led to the demise of millions of people worldwide; additionally, it has resulted in a significant economic and mental health burden. Since the onset of the COVID-19 pandemic, various measures have been constructed to evaluate pandemic-related fear and anxiety. The COVID-19 Anxiety Syndrome Scale (C-19ASS) is a promising measure that assesses coping strategies (e.g., avoidance, checking, worrying and threat monitoring), termed ‘COVID-19 Anxiety Syndrome’, in response to COVID-19 fear and anxiety. The measure has been broadly welcomed, leading to its use in Brazil (Portuguese), China, Greece, Indonesia, the Philippines, Iran (Farsi), Italy, Saudi Arabia (Arabic), Turkey, the United Kingdom and the United States. To gain a better understanding of the relevance of the COVID-19 Anxiety Syndrome, we conducted a systematic review and meta-analysis to explore the psychological correlates and psychometric properties of the C-19ASS. Through the analysis of a total of 17,789 individuals (age range 19–70; female = 33%–85%), the C-19ASS demonstrated a consistent factor structure, measurement invariance across gender and acceptable reliabilities. Furthermore, a significant association with COVID-19 anxiety, depressive symptoms, generalized anxiety, health anxiety, psychological distress and functional impairment (work and social adjustment) during the COVID-19 pandemic was observed. When considering the Big Five personality traits, the C-19ASS and its subscales were only significantly and negatively associated with extraversion; only the total score on the measure was associated with neuroticism. The observed effect sizes ranged from very small to medium. Given that all included studies (K = 24) were cross-sectional, and due to the nature of the COVID-19 Anxiety Syndrome, which may well persist after the pandemic ends, it is recommended to continue screening society for the persistence of this syndrome.

Access to psychotherapy is critical to improving mental health, but only a small proportion of refugees receive treatment in the regular psychotherapeutic care system in high-income countries. In previous research, outpatient psychotherapists reported several barriers to more frequent treatment of refugee patients. However, it is unclear to what extent these perceived barriers contribute to the poor provision of services to refugees. In a survey of N = 2002 outpatient psychotherapists in Germany, we collected data on perceived treatment barriers and on the integration of refugees into regular psychotherapeutic practice. Half of the psychotherapists reported that they do not treat refugee patients. In addition, therapies provided for refugees were, on average, 20% shorter than for other patients. Regression analyses showed direct negative associations between psychotherapists' overall perception of barriers with the number of refugees treated and the number of sessions offered to refugee patients, even when controlling for sociodemographic and workload-related characteristics. Correlation analyses on the level of specific types of barriers further revealed that particularly language-related barriers and lack of contact with the refugee population are negatively correlated with the number of refugees treated and the number of sessions for refugees. Our findings indicate that the integration of refugees into regular psychotherapeutic care could be improved by measures to connect psychotherapists with refugee patients as well as professional interpreters and to ensure coverage of costs for therapy, interpreters and related administrative tasks.

Personality traits underlying both anxiety disorders and depression are more malleable than previously presumed. This study examined associations between changes in personality traits (i.e. negative affectivity and detachment) and alleviation of anxiety and depression symptoms following cognitive behaviour therapy (CBT). We hypothesized that decreases in negative affectivity would predict alleviation of depression and anxiety symptoms and decreases in detachment would predict decreases in depression and, to a lesser degree, anxiety symptoms. Data (N = 156) were collected in a randomized controlled trial comparing transdiagnostic and diagnosis-specific group CBT for patients with major depressive disorder, social anxiety disorder, panic disorder or agoraphobia. We assessed personality traits using the Personality Inventory for DSM-5 (PID-5) and symptoms with the Hopkins Symptom Checklist 25-item scale (SCL). Prediction was based on regression analyses. We found that decreases in negative affectivity predicted lower levels of depression and anxiety symptoms while decreases in detachment only predicted lower levels of depression symptoms. The findings substantiate current efforts to explicate the dynamic interplay between personality traits and symptoms and support the existing focus on targeting negative affectivity and detachment in therapy for anxiety disorders and depression.

The trial is registered at clinicaltrials.gov (ID NCT02954731).

The ICD-11 features a new group of disorders specifically associated with stress, which are interlinked by various symptoms, such as intrusive memory symptoms. Although research interest in these new ICD-11 diagnoses is growing rapidly, so far, no studies have systematically investigated the transdiagnostic distribution of stress-associated symptoms in these disorders. In the present study, 447 individuals completed a series of online questionnaires, which measured various stress-associated symptoms, e.g., flashbacks, preoccupation or yearning. Findings showed that the majority of correlations between the measured psychopathological constructs was between 0.30 and 0.60. Furthermore, with regard to specific diagnostic groups, a complex variation of stress-associated symptoms was observed, with preoccupation as a predominant symptom in all disorders. Results demonstrate that stress-associated symptoms are inherently interconnected yet possess an individual variation in different disorders. Furthermore, findings illustrate that preoccupation represents a major feature in all stress-associated disorders.

Sudden gains, defined as large and stable improvements in symptom severity during psychological treatment, have consistently been found to be associated with better outcomes across treatments and diagnoses. Yet, insights on coherent predictors of sudden gains and on emotional changes around sudden gains in post-traumatic stress disorder (PTSD) are lacking. We aimed at replicating a measure of intraindividual variability as a predictor for sudden gains and testing its independence from change during treatment. Furthermore, we expected changes in emotions of guilt, shame and disgust prior to sudden gains to predict sudden gains. Data from a pre-registered randomized controlled trial (RCT) of eye-movement desensitization and reprocessing (emdr) and Imagery Rescripting (ImRs) for PTSD in 155 adult survivors of childhood abuse were used. Intraindividual variability of PTSD symptoms in both treatments did not predict sudden gains status and was not independent of change during treatment. In the EMDR condition, levels of shame during treatment predicted sudden gains and shame decreased shortly before a sudden gain in both treatments. Reductions in all emotions during sudden gains were significantly higher for participants with sudden gains than for comparable intervals in non-sudden gainers. Our findings do not support the predictive validity of intraindividual variability for sudden gains. The decrease of guilt, shame and disgust during sudden gains warrants further research on their role as a mechanism of treatment change for PTSD.