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Emotion Regulation and Mentalization in Patients With Depression and Anxiety 抑郁症和焦虑症患者的情绪调节和心智化。
IF 3.6 3区 心理学 Q2 Psychology Pub Date : 2024-05-09 DOI: 10.1002/cpp.2995
Anne Bryde Christensen, Stig Poulsen, Trine Munk Højberg, Stine Bech Jessen, Nina Reinholt, Morten Hvenegaard, Anita Eskildsen, Mikkel Arendt, Sidse Arnfred

Objective

Theoretical conceptualizations of emotion and affect regulation have a considerable common ground. However, mentalization theory considers the ability to regulate affects as being contingent on the ability to mentalize. The aim of the present study is to examine the association between emotion regulation and mentalization, operationalized as reflective functioning, in a sample of patients with depression and/or anxiety.

Methods

The study used data from the TRAns-diagnostic Cognitive behavioural Therapy versus standard cognitive behavioural therapy (TRACT-RCT) trial. Patients with depression and/or anxiety (N = 291; 64.4% female; Mage = 32.2; SD = 11.0) completed the Emotion Regulation Strategies Questionnaire (ERSQ) and the Reflective Functioning Questionnaire (RFQ-6). Correlation and regression analyses were performed to determine associations of the measures of ERSQ and RFQ-6 in relation to the outcome variables, global well-being (World Health Organization Well-being Index; WHO-5) and social functioning (Work and Social Adjustment Scale; WSAS).

Results

Overall, the patients had a reduced level of emotion regulation (MERSQ_Total = 1.77; SD = 0.59). However, only mildly impaired reflective functioning was found (MRFQ-6 = 3.57; SD = 1.26). ERSQ correlated significantly with RFQ-6 (r = −0.31), that is, more frequent use of emotion regulation strategies was associated with less hypomentalization. ERSQ was a stronger predictor of well-being and social function than RFQ-6.

Conclusion

In patients with anxiety and/or depression, hypomentalization as measured by the RFQ-6 is not a major problem, but emotion regulation is. It seems that these two, theoretically related constructs, do not necessarily co-occur. Alternatively, the RFQ-6 scale might not capture the mentalization construct in a valid way. Emotion regulation strategies are highly related to symptomatology; therefore, they are likely to be an important target for psychotherapy.

目的:情绪和情感调节的理论概念有相当多的共同点。然而,心智化理论认为情绪调节能力取决于心智化能力。本研究旨在对抑郁症和/或焦虑症患者样本中的情绪调节与心智化(操作化为反思功能)之间的关联进行研究:本研究使用了TRAns诊断认知行为疗法与标准认知行为疗法(TRACT-RCT)试验的数据。抑郁症和/或焦虑症患者(N = 291;64.4%为女性;Mage = 32.2;SD = 11.0)填写了情绪调节策略问卷(ERSQ)和反思功能问卷(RFQ-6)。研究人员对ERSQ和RFQ-6的测量结果进行了相关性和回归分析,以确定它们与结果变量--全球幸福感(世界卫生组织幸福指数;WHO-5)和社会功能(工作和社会适应量表;WSAS)--的关系:结果:总体而言,患者的情绪调节能力下降(MERSQ_Total = 1.77; SD = 0.59)。然而,患者的反思功能只有轻度受损(MRFQ-6 = 3.57; SD = 1.26)。ERSQ与RFQ-6有明显的相关性(r = -0.31),也就是说,更频繁地使用情绪调节策略与较少的低意念化有关。与 RFQ-6 相比,ERSQ 对幸福感和社会功能的预测作用更强:结论:在焦虑症和/或抑郁症患者中,RFQ-6 测定的意念减退不是主要问题,但情绪调节却是。看来,这两个理论上相关的概念并不一定同时存在。或者说,RFQ-6 量表可能并没有以有效的方式捕捉到心智化结构。情绪调节策略与症状学高度相关,因此很可能成为心理治疗的重要目标。
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引用次数: 0
Imagery-Focused Therapy for Visual Hallucinations: A Case Series 视觉幻觉的意象聚焦疗法:病例系列。
IF 3.6 3区 心理学 Q2 Psychology Pub Date : 2024-05-09 DOI: 10.1002/cpp.2993
Georgie Paulik, Christopher D. J. Taylor

Introduction

Visual hallucinations (VH) are more common than previously thought and are linked to higher levels of distress and disability in people with a psychotic illness. Despite this, scant attention has been given to VHs in the clinical literature, and the few therapy case series of cognitive behavioural therapy (CBT) published to date have not demonstrated reliable change. In other areas of clinical research, problematic mental imagery has been found to be more strongly related to negative affect in psychological disorders than negative linguistic thinking, and imagery focused techniques have commonly been found to improve the outcomes in CBT trials. Given VHs have many similarities with visual mental imagery and many of the distressing beliefs associated with VHs targeted in CBT are maintained by accompanying mental imagery (i.e., imaging a hallucinated figure attacking them), it seems plausible that an imagery-focused approach to treating VHs may be most effective.

Methods

The current study is a multiple baseline case series (N = 11) of a 10-session imagery-focused therapy for VH in a transdiagnostic sample.

Results

The study had good attendance and feedback, no adverse events and only one [seemly unrelated] drop-out, suggesting good feasibility, safety and acceptability. The majority of clients reported reduction on both full-scale measures (administered at 3 baselines, midtherapy, posttherapy and 3-month follow-up) and weekly measures of VH severity and distress, ranging from medium to large effect sizes.

Conclusions

The case series suggests that an imagery-focused approach to treating VHs may be beneficial, with a recommendation for more rigorous clinical trials to follow.

简介视幻觉(VH)比以前想象的更为常见,它与精神病患者更高的痛苦和残疾程度有关。尽管如此,临床文献中对视幻觉的关注却很少,迄今为止发表的认知行为疗法(CBT)的少数治疗病例系列也未显示出可靠的改变。在其他领域的临床研究中,有问题的心理想象比消极的语言思维与心理障碍中的消极情绪有更密切的关系,以想象为重点的技术通常被认为可以改善 CBT 试验的结果。鉴于VHs与视觉心理想象有许多相似之处,而且CBT所针对的许多与VHs相关的痛苦信念都是通过伴随的心理想象(即想象一个幻觉人物攻击他们)来维持的,因此以想象为重点的方法来治疗VHs可能是最有效的:本研究是一项多基线病例系列研究(N = 11),在跨诊断样本中对 VH 进行了为期 10 次的以意象为重点的治疗:该研究的出勤率和反馈情况良好,无不良事件发生,仅有一人[似乎与此无关]退出,这表明该疗法具有良好的可行性、安全性和可接受性。大多数客户报告说,他们在全面测量(3 次基线测量、治疗中期测量、治疗后测量和 3 个月随访测量)和每周测量 VH 严重程度和痛苦程度方面都有所减轻,效果大小从中等到较大不等:该系列病例表明,以意象为重点的方法可能对治疗颅内高压有益,建议随后进行更严格的临床试验。
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引用次数: 0
Psychological Group Interventions for Reducing Distress Symptoms in Healthcare Workers: A Systematic Review 减少医护人员压力症状的心理团体干预:系统回顾
IF 3.6 3区 心理学 Q2 Psychology Pub Date : 2024-05-05 DOI: 10.1002/cpp.2980
Sandra Sanz, Carmen Valiente, Regina Espinosa, Almudena Trucharte

Healthcare workers exposed to emergencies and chronic stressors are at high risk of developing mental health problems. This review synthesized existing studies of group psychological therapy to reduce distress symptoms in healthcare workers (i.e., as complex and heterogeneous emotional states, characterized by the presence of symptoms associated with post-traumatic stress disorder, burnout, anxiety, depression and moral injury). Searches were conducted using PRISMA guidelines and databases such as PubMed, PsycINFO, Medline and Web of Science, along with manual searches of reference lists of relevant articles. The search returned a total of 1071 randomized trials, of which 23 met the inclusion criteria. Of the total studies, nine were mindfulness interventions, seven were cognitive behavioural programmes, one was a programme based on acceptance and commitment therapy, one was an EMDR protocol and two focused on systemic and art therapy. Most studies aimed to reduce burnout, anxiety and depression; only three focused on post-traumatic stress disorder, and no studies were found that addressed moral injury. The results suggested that group interventions could be an effective tool to improve the mental health of healthcare workers and reduce their symptoms of distress, although many of the studies have methodological deficiencies. Limitations and future directions are discussed.

医护人员面临突发事件和长期压力,极有可能出现心理健康问题。本综述综合了现有的关于团体心理疗法减轻医护人员痛苦症状的研究(即复杂而多变的情绪状态,其特点是存在与创伤后应激障碍、职业倦怠、焦虑、抑郁和精神伤害相关的症状)。检索采用了 PRISMA 准则和 PubMed、PsycINFO、Medline 和 Web of Science 等数据库,并对相关文章的参考文献列表进行了人工检索。搜索共检索到 1071 项随机试验,其中 23 项符合纳入标准。在所有研究中,有九项是正念干预,七项是认知行为方案,一项是基于接受和承诺疗法的方案,一项是 EMDR 方案,两项侧重于系统疗法和艺术疗法。大多数研究旨在减少职业倦怠、焦虑和抑郁;只有三项研究侧重于创伤后应激障碍,没有发现针对精神伤害的研究。研究结果表明,尽管许多研究在方法上存在缺陷,但团体干预可以成为改善医护人员心理健康和减轻其痛苦症状的有效工具。本文讨论了研究的局限性和未来发展方向。
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引用次数: 0
A Self-Reported Study on Explanatory Variables of Stress in Multiple Sclerosis Patients: Exploring the Effect of Physical Conditions and Emotion Regulation Processes 多发性硬化症患者压力解释变量的自述研究:探索身体状况和情绪调节过程的影响
IF 3.6 3区 心理学 Q2 Psychology Pub Date : 2024-05-05 DOI: 10.1002/cpp.2992
Teresa Carvalho, Andreia Sousa-Mendes, Luís Benedito, Carolina Gomes, Carolina da Motta

Background

Multiple sclerosis (MS)-linked stress is frequent, multidetermined and facilitates the onset/exacerbation of MS. However, few explanatory models of stress analysed the joint explanatory effect of emotion regulation and clinical outcomes of MS in those patients.

Objective

This study explored whether self-reported MS-related conditions (number of relapses, fatigue and global disability) and specific emotion regulation processes (experiential avoidance and self-compassion) explain stress symptoms in MS patients.

Methods

The MS sample comprised 101 patients with MS diagnosis receiving treatment in hospitals and recruited through the Portuguese MS Society. The no-MS sample included 134 age-, sex- and years of education-matched adults without MS recruited from the general Portuguese population. Both samples did not report other neurological disorders. Data were collected using self-response measures.

Results

All potential explanatory variables differed significantly between samples, with higher scores found in MS patients. In MS clinical sample, those variables and years of education correlated with stress symptoms and predicted stress symptoms in simple linear regression models. These results allowed their selection as covariates in a multiple linear regression model. Years of education, the number of relapses, fatigue and experiential avoidance significantly predicted 51% of stress symptoms' total variance.

Conclusions

This study provides preliminary evidence on the importance of clinicians and researchers considering the simultaneous contribution of years of education, the number of perceived relapses, fatigue and experiential avoidance as factors that can increase vulnerability to stress in MS patients. Psychological intervention programmes that tackle these factors and associated stress symptomatology should be implemented.

背景与多发性硬化症(MS)相关的压力是一种常见的、多因素的压力,并会促进多发性硬化症的发病/加重。然而,很少有压力解释模型分析多发性硬化症患者情绪调节和临床结果的共同解释作用。 目的 本研究探讨了自我报告的多发性硬化症相关情况(复发次数、疲劳和全身残疾)和特定情绪调节过程(体验性回避和自我同情)是否能解释多发性硬化症患者的压力症状。 方法 多发性硬化症样本包括通过葡萄牙多发性硬化症协会招募的 101 名在医院接受治疗的多发性硬化症患者。非多发性硬化症样本包括从葡萄牙普通人群中招募的 134 名年龄、性别和受教育年限匹配的非多发性硬化症成人。两个样本均未报告其他神经系统疾病。数据收集采用自应答方法。 结果 所有潜在的解释变量在样本之间都有显著差异,多发性硬化症患者的得分更高。在多发性硬化症临床样本中,这些变量和受教育年限与压力症状相关,并在简单线性回归模型中预测压力症状。这些结果允许在多元线性回归模型中选择它们作为协变量。教育年限、复发次数、疲劳和经验性回避显著预测了应激症状总方差的 51%。 结论 本研究提供了初步证据,说明临床医生和研究人员同时考虑教育年限、感知到的复发次数、疲劳和经验回避等因素的重要性,这些因素可能会增加多发性硬化症患者的应激易感性。应实施针对这些因素和相关压力症状的心理干预计划。
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引用次数: 0
Assessment of Voice Content for Voice Hearers: Psychometric Evaluation of the Perth Voice Content Questionnaire 评估听音者的语音内容:珀斯语音内容问卷的心理计量评估
IF 3.6 3区 心理学 Q2 Psychology Pub Date : 2024-05-05 DOI: 10.1002/cpp.2991
Erica Salt, Petra Skeffington, Caitlin Reddyhough, Georgie Paulik

The experience of hearing voices is common to an estimated 7% of the general population, with the presence of negative content being the best predictor of whether individuals will require clinical support. Whilst largely neglected in the literature to date, there are calls to consider the significance of voice content for reducing voice-related distress. However, no quantitative and comprehensive measure of voice content with suitability for research and clinical use exists. This pilot study aimed to demonstrate preliminary psychometric properties of a newly developed measure, the Perth Voice Content Questionnaire (PVCQ), designed to measure the intensity and themes of positively and negatively valenced voice content, primarily of the dominant voice. The PVCQ and measures of voice severity and related beliefs were completed by 47 voice-hearing participants. The measure was found to be internally consistent, loaded onto two distinct factors of positive and negative content, and these factors were associated with voice-related distress and negative beliefs about voices and positive beliefs about voices, respectively, indicating good validity. The PVCQ offers the first self-report measure of voice content, with preliminary psychometric properties indicating its suitability for clinical and research use.

据估计,7% 的普通人群都会有幻听的经历,而负面内容的出现则是个人是否需要临床支持的最佳预测指标。迄今为止,虽然大部分文献都忽视了这一点,但仍有学者呼吁考虑声音内容对减少声音相关困扰的重要性。然而,目前还没有适合研究和临床使用的语音内容量化综合测量方法。本试验研究旨在展示新开发的测量方法--珀斯嗓音内容问卷(PVCQ)的初步心理测量特性,该方法旨在测量积极和消极嗓音内容的强度和主题,主要是主导嗓音的强度和主题。47 名嗓音听力参与者完成了 PVCQ 以及嗓音严重程度和相关信念的测量。结果表明,该量表具有内部一致性,包含积极和消极内容的两个不同因子,这些因子分别与嗓音相关困扰、对嗓音的消极信念和对嗓音的积极信念相关,表明该量表具有良好的有效性。PVCQ是首个自我报告嗓音内容的测量方法,其初步的心理测量特性表明它适合临床和研究使用。
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引用次数: 0
Goal-Directed Treatment of Patients With Anxiety and Mood Disorders in a Regular Curative Mental Health Care Setting 在常规治疗性精神保健机构中对焦虑症和情绪障碍患者进行目标导向治疗
IF 3.6 3区 心理学 Q2 Psychology Pub Date : 2024-05-05 DOI: 10.1002/cpp.2984
Paulette Regina van Santen-Bauer, Edwin de Beurs, Mathijs Deen, Kees Korrelboom, Colin van der Heiden

This study examined whether goal-directed treatment leads to improved treatment outcomes for patients with a primary mood or anxiety disorder and whether beneficial outcomes are achieved sooner compared to treatment as usual. In a quasi-experimental controlled study with a nested design, 17 therapists received training in goal-directed treatment and treated 105 patients with anxiety or mood disorders using principles of goal-directed treatment. Treatment results on a generic self-report instrument were compared with two control groups: a historical control group consisting of 16 of the 17 participating therapists, who provided treatment as usual to 97 patients before having received training in goal-directed treatment, and a parallel control group consisting of various therapists, who provided treatment as usual to 105 patients. Symptom reduction on a self-report measure was compared using multilevel analysis. A survival analysis was performed to assess whether a satisfactory end state had been reached sooner after goal-directed treatment. The results of this study show that goal-directed treatment only led to a significantly better overall treatment outcome compared to the parallel treatment as usual group. Furthermore, goal-directed treatment was significantly shorter than both treatment as usual groups. In conclusion, this research suggest that goal-directed treatment led to a similar or better treatment outcome in a shorter amount of time.

本研究探讨了目标导向疗法是否能改善原发性情绪或焦虑障碍患者的治疗效果,以及与常规治疗相比,是否能更快地取得有益效果。在一项采用嵌套设计的准实验对照研究中,17 名治疗师接受了目标导向治疗培训,并运用目标导向治疗原则治疗了 105 名焦虑症或情绪障碍患者。研究人员将通用自我报告工具的治疗结果与两个对照组进行了比较:一个是历史对照组,由 17 名参与研究的治疗师中的 16 人组成,他们在接受目标导向治疗培训之前为 97 名患者提供了常规治疗;另一个是平行对照组,由不同的治疗师组成,他们为 105 名患者提供了常规治疗。通过多层次分析比较了自我报告测量的症状减轻情况。研究还进行了生存分析,以评估目标导向治疗后是否能更快达到满意的最终状态。研究结果表明,与平行的常规治疗组相比,目标导向治疗的总体治疗效果明显更好。此外,目标引导治疗组的治疗时间明显短于常规治疗组。总之,这项研究表明,目标导向治疗能在更短的时间内取得相似或更好的治疗效果。
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引用次数: 0
The Effects of Patient Preference on Clinical Outcome, Satisfaction and Adherence Within the Treatment of Anxiety and Depression: A Meta-Analysis 患者偏好对焦虑症和抑郁症治疗的临床效果、满意度和依从性的影响:元分析
IF 3.6 3区 心理学 Q2 Psychology Pub Date : 2024-05-05 DOI: 10.1002/cpp.2985
Eline Eigenhuis, Vanessa E. M. van Buuren, Rosa E. Boeschoten, Anna D. T. Muntingh, Neeltje M. Batelaan, Patricia van Oppen

Background

Taking patient preference into consideration has received increased attention in the last decades. We conducted a meta-analysis to estimate the effects of patient preference on clinical outcome, satisfaction and adherence regarding treatment of depression and anxiety.

Methods

Pubmed, Embase, PsycINFO and Scopus were searched for (cluster) randomized controlled trials. Twenty-six randomized controlled clinical trials were included, comprising 3670 participants, examining the effect of patient preference regarding treatment of anxiety and depression on clinical outcome, satisfaction and/or adherence.

Results

No effect of patient preference was found on clinical outcome [d = 0.06, 95% CI = (−0.03, 0.15), p = 0.16, n = 23 studies]. A small effect of patient preference was found on treatment satisfaction [d = 0.33, 95% CI = (0.08, 0.59), p = 0.01, n = 6 studies] and on treatment adherence [OR = 1.55, 95% CI = (1.28, 1.87), p < 0.001, n = 22 studies].

Limitations

Patient preference is a heterogeneous concept, future studies should strive to equalize operationalization of preference. Subgroup analyses within this study should be interpreted with caution because the amount of studies per analysed subgroup was generally low. Most studies included in this meta-analysis focused on patients with depression. The small number of studies (n = 6) on satisfaction, prevents us from drawing firm conclusions.

Conclusions

While this meta-analysis did not find a positive effect of considering patient preference on clinical outcome, it was associated with slightly better treatment satisfaction and adherence. Accommodating preference of patients with anxiety and depression can improve treatment.

Trial Registration

PROSPERO: CRD42020172556

背景 在过去的几十年中,考虑患者的偏好已受到越来越多的关注。我们进行了一项荟萃分析,以估计患者偏好对抑郁症和焦虑症治疗的临床结果、满意度和依从性的影响。 方法 在 Pubmed、Embase、PsycINFO 和 Scopus 上检索(群组)随机对照试验。共纳入 26 项随机对照临床试验,共有 3670 人参与,研究了患者对焦虑症和抑郁症治疗的偏好对临床结果、满意度和/或依从性的影响。 结果 未发现患者偏好对临床结果有影响[d = 0.06,95% CI = (-0.03,0.15),p = 0.16,n = 23 项研究]。发现患者偏好对治疗满意度[d = 0.33,95% CI = (0.08,0.59),p = 0.01,n = 6项研究]和治疗依从性[OR = 1.55,95% CI = (1.28,1.87),p < 0.001,n = 22项研究]有微小影响。 局限性 患者偏好是一个不同的概念,今后的研究应努力实现偏好操作的均等化。本研究中的亚组分析应谨慎解释,因为每个分析亚组的研究数量普遍较少。本荟萃分析所包含的大多数研究都侧重于抑郁症患者。关于满意度的研究较少(6 项),因此我们无法得出确切的结论。 结论 虽然本荟萃分析未发现考虑患者偏好对临床结果有积极影响,但这与治疗满意度和依从性略有提高有关。考虑焦虑症和抑郁症患者的偏好可以改善治疗效果。 试验注册 PROSPERO: CRD42020172556
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引用次数: 0
The Perceived Functions and Phenomenological Characteristics of Future Thinking and Clinically Significant Generalized Anxiety Disorder Symptoms 未来思维的感知功能和现象特征与临床显著的广泛焦虑症症状
IF 3.6 3区 心理学 Q2 Psychology Pub Date : 2024-05-05 DOI: 10.1002/cpp.2978
David J. Hallford, Mohammad Seydavi, Mehdi Akbari

Current research indicates that anxiety disorders and elevated levels of trait anxiety are associated with biases and impairments when thinking of personally relevant future events, that is, future thinking. However, to date, little research has been conducted into how people with symptoms of clinical anxiety perceive the functions of future thinking. The current study presents a cross-sectional survey comparing individuals with elevated symptoms of generalized anxiety disorder (GAD) and related functional impact (N = 51, 43.1% female, Mage = 33.1, SD = 10.2) matched on age and gender with individuals with no clinically significant symptoms of GAD (N = 51, 43.1% female, Mage = 33.3, SD = 10.1) on self-reported functions of future thinking and a battery of items assessing the phenomenological characteristics. The results indicated various significant differences in the perceived functions of future thinking and its phenomenological characteristics in those with elevated GAD symptoms. Broadly, they indicate more frequent future thinking and more commonly for self-distraction or processing negatively valenced future events, and generally less adaptive mental representations that support current thinking on the psychopathological process of increased worry, anxious arousal and maladaptive cognition in clinical anxiety symptoms.

目前的研究表明,焦虑症和特质焦虑水平的升高与在思考与个人相关的未来事件(即未来思维)时出现的偏差和障碍有关。然而,迄今为止,有关临床焦虑症状患者如何看待未来思维功能的研究还很少。本研究进行了一项横断面调查,比较了广泛性焦虑症(GAD)症状升高并受到相关功能影响的人(51 人,女性占 43.1%,平均年龄 33.1 岁,标准差 10.2 岁)与无显著 GAD 临床症状的人(51 人,女性占 43.1%,平均年龄 33.3 岁,标准差 10.1 岁)在自我报告的未来思维功能和一系列现象学特征评估项目上的差异。结果表明,在 GAD 症状升高的人群中,未来思维的感知功能及其现象特征存在各种明显差异。大体上,这些结果表明,未来思维更频繁,更常见于自我疏远或处理负面情绪的未来事件,适应性较差的心理表征通常支持当前关于临床焦虑症状中担忧增加、焦虑唤醒和适应不良认知的心理病理学过程的思考。
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引用次数: 0
Unmet Needs, Minority Stress and Mental Health Outcomes Among Transgender Individuals: The Mediating Role of Schema Domains 变性人中未满足的需求、少数群体压力和心理健康结果:模式域的中介作用
IF 3.6 3区 心理学 Q2 Psychology Pub Date : 2024-05-05 DOI: 10.1002/cpp.2983
George Radford, Jamie E. M. Byrne, Petra K. Staiger, Gery C. Karantzas

Exposure to gender-related minority stressors, the negative experiences and beliefs that stem from anti-trans stigma increases transgender and gender diverse (TGD) people's vulnerability to experiencing poor mental health outcomes. This study examined if the relationships between experiences of minority stress and mental health outcomes were mediated by early maladaptive schemas: mental representations shaping the way people view themselves, others and the world. Drawing from a schema therapy perspective, the study additionally examined if caregivers' failure to meet TGD people's core emotional needs was associated with mental health outcomes and if schemas similarly mediated these relationships. A total of 619 TGD adults completed an online survey about early maladaptive schemas, core emotional needs, gender-related minority stress and psychological distress and wellbeing. Causal mediation analyses indicated that caregivers who did not meet TGD people's core emotional needs and greater experiences of minority stress were associated with increased distress and lower wellbeing. These relationships were mediated by schema severity, particularly the disconnection and rejection and impaired autonomy domains. These findings provide empirical support for the schema therapy model's assumption that unmet core emotional needs are associated with schema formation. For TGD people, maladaptive beliefs about the self, others and world can form in response to manifestations of anti-trans stigma within the individual, their interpersonal relationships, community and broader society. Caregivers' failure to meet needs, plus experiences of minority stress throughout the individual's system, leads to greater distress and lower wellbeing; however, clinical interventions targeting schemas may improve outcomes for this at-risk group.

暴露在与性别相关的少数群体压力下,反变性污名所产生的负面经历和信念会增加变性者和性别多元化者(TGD)的脆弱性,使其心理健康状况不佳。本研究探讨了少数群体压力体验与心理健康结果之间的关系是否受到早期不良图式的影响:这种心理表征塑造了人们看待自己、他人和世界的方式。从图式疗法的角度出发,该研究还考察了照顾者未能满足少数民族核心情感需求是否与心理健康结果有关,以及图式是否同样对这些关系起中介作用。共有 619 名成年同性恋、双性恋和变性者完成了一项在线调查,内容涉及早期适应不良模式、核心情感需求、与性别相关的少数群体压力以及心理困扰和幸福感。因果中介分析表明,照顾者不能满足同性恋、双性恋和变性者的核心情感需求以及更多的少数群体压力体验与心理困扰增加和幸福感降低有关。这些关系受到模式严重性的调节,尤其是断开与拒绝和自主性受损领域。这些发现为图式治疗模式的假设提供了实证支持,即核心情感需求得不到满足与图式的形成有关。对于 TGD 患者来说,由于个人、人际关系、社区和更广泛的社会中出现的反变性污名,他们会形成对自我、他人和世界的不适应信念。照顾者未能满足需求,再加上在整个个人系统中经历的少数群体压力,导致了更大的痛苦和更低的幸福感;然而,针对图式的临床干预可能会改善这一高风险群体的结果。
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引用次数: 0
A Cluster Analysis of Neuropsychological Impairment in Borderline Personality Disorder: Identifying a Neurocognitive Subtype Linked to Attention Deficit Hyperactivity Disorder 边缘型人格障碍神经心理学损害的聚类分析:确定与注意缺陷多动障碍相关的神经认知亚型
IF 3.6 3区 心理学 Q2 Psychology Pub Date : 2024-05-02 DOI: 10.1002/cpp.2979
J. M. López-Villatoro, M. Diaz-Marsá, W. Ayad-Ahmed, A. Rico-Pérez, I. Perez-Diez, A. Galvez-Merlin, C. Prittwitz, J. L. Carrasco

Introduction

Cognitive impairment associated with borderline personality disorder (BPD) has been consistently demonstrated. However, a specific neuropsychological profile has not yet been established for this disorder, maybe due to the heterogeneity of BPD. The aim of this work is the search for distinct neuropsychological subtypes among patients with BPD and for the association of neuropsychological subgroups with specific clinical characteristics.

Methodology

One hundred fifteen patients with BPD diagnosis received an extensive neuropsychological evaluation assessing attentional, memory and executive functions indexes. For subtyping strategies, a cluster analysis of neuropsychological BPD distribution was performed. Central clinical dimensions of BPD were measured and analysed in relation with the obtained neuropsychological clusters.

Results

Two clusters were found: Cluster 1 showed a significantly lower score on the working memory index, and Cluster 2 had significantly worse overall executive performance, response inhibition and planning abilities. Patients in the neurocognitive Cluster 2 showed significantly higher clinical deficits of attention as measured with subscales of the CAARS attention deficit hyperactivity disorder (ADHD) index (F = 2.549, p < 0.005, d = 11.49).

Conclusions

Two neuropsychological clusters of patients were found in the BPD sample: Cluster 1 patients showed greater impairment in working memory, while Cluster 2 patients had greater deficits of executive functioning, particularly for response inhibition and planning. In addition, BPD patients with greater executive deficits presented greater levels of ADHD clinical features. These findings might also facilitate earlier diagnosis of severe BPD patient profiles and to establish more personalized treatment based on neurocognitive stimulation.

导言:与边缘型人格障碍(BPD)相关的认知障碍已被证实。然而,也许是由于边缘型人格障碍的异质性,目前还没有为这种障碍建立起特定的神经心理学特征。这项工作的目的是在 BPD 患者中寻找独特的神经心理学亚型,并寻找神经心理学亚型与特定临床特征之间的关联。 方法 对 15 名确诊为 BPD 的患者进行了广泛的神经心理学评估,评估内容包括注意力、记忆力和执行功能指数。为制定亚型分析策略,对 BPD 神经心理学分布进行了聚类分析。测量并分析了 BPD 的核心临床指标与神经心理学聚类的关系。 结果 发现了两个聚类:群组 1 的工作记忆指数得分明显较低,群组 2 的整体执行能力、反应抑制和计划能力明显较差。根据 CAARS 注意力缺陷多动障碍(ADHD)指数的分量表,神经认知群组 2 的患者表现出明显较高的临床注意力缺陷(F = 2.549,p < 0.005,d = 11.49)。 结论 在 BPD 样本中发现了两个神经心理学患者群:第 1 组患者的工作记忆能力受损更严重,而第 2 组患者的执行功能受损更严重,尤其是反应抑制和计划能力。此外,执行功能缺陷更严重的 BPD 患者表现出更多的多动症(ADHD)临床特征。这些发现可能有助于更早地诊断严重的 BPD 患者,并在神经认知刺激的基础上制定更个性化的治疗方案。
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引用次数: 0
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Clinical psychology & psychotherapy
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