Robert J. Zhou, Brooklynn Bailey, Daniel R. Strunk
Background
Although the importance of sleep difficulties in emotional disorders has long been acknowledged, the nature of the potential reciprocal relationship between sleep and depressive symptoms is not yet well understood. The coronavirus disease 19 pandemic provided a unique opportunity to study the interrelation of these symptoms over a period marked by increases in sleep and psychological difficulties.
Methods
Using online data collection, we followed 1200 adults (59% male) through 1 year of the pandemic. Measures of sleep disturbance and depressive symptoms were assessed at eight time points. Factor analysis of the items from these two measures suggested separate insomnia and depressive symptom factors. A random intercept cross-lagged panel model was used to assess within-person relationships between factor analysis-informed subscales of insomnia and depressive symptoms.
Results
Depressive symptoms predicted subsequent changes in insomnia symptoms; however, insomnia did not predict changes in depressive symptoms.
Conclusions
Our findings suggest the impact of depressive symptoms on insomnia is evident, but the reverse is not. Implications of this finding along with the need for research addressing depressive symptoms and insomnia as treatment targets are discussed.
{"title":"Testing the reciprocal relationship between depressive symptoms and insomnia","authors":"Robert J. Zhou, Brooklynn Bailey, Daniel R. Strunk","doi":"10.1002/jclp.23670","DOIUrl":"10.1002/jclp.23670","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although the importance of sleep difficulties in emotional disorders has long been acknowledged, the nature of the potential reciprocal relationship between sleep and depressive symptoms is not yet well understood. The coronavirus disease 19 pandemic provided a unique opportunity to study the interrelation of these symptoms over a period marked by increases in sleep and psychological difficulties.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using online data collection, we followed 1200 adults (59% male) through 1 year of the pandemic. Measures of sleep disturbance and depressive symptoms were assessed at eight time points. Factor analysis of the items from these two measures suggested separate insomnia and depressive symptom factors. A random intercept cross-lagged panel model was used to assess within-person relationships between factor analysis-informed subscales of insomnia and depressive symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Depressive symptoms predicted subsequent changes in insomnia symptoms; however, insomnia did not predict changes in depressive symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest the impact of depressive symptoms on insomnia is evident, but the reverse is not. Implications of this finding along with the need for research addressing depressive symptoms and insomnia as treatment targets are discussed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.23670","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139972011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joseph M. Currier, Elizabeth M. Bounds, Hiroki Matsuo, Charlotte vanOyen Witvliet, Alexis D. Abernethy, Karl VanHarn, Sarah A. Schnitker
Background
Meaning in life is a benchmark indicator of flourishing that can likely mitigate the severity of depression symptoms among persons seeking mental healthcare. However, patients contending with serious mental health difficulties often experience a painful void or absence of ultimate meaning in their lives that might hinder recovery. This two-wave longitudinal study examined temporal associations between perceived presence of meaning in life, struggles with ultimate meaning, flourishing, and depression symptoms among adults in a spiritually integrated inpatient treatment program.
Methods
Of the 242 patients assessed at intake, 90% (N = 218; 40% Cisgender male; 57% Cisgender female; 3.0% nonbinary) completed validated measures of these meaning-related factors and mental health outcomes at discharge.
Results
Cross-sectional analyses revealed perceptions of meaning in life and ultimate meaning struggles were inversely linked with one another along with being associated with indices of positive and negative mental health in varying ways at the start and end of treatment. Drawing upon a two-wave cross-lagged panel design, longitudinal structural equation modeling analyses supported a Primary Meaning Model whereby having a subjective sense of meaning in life at intake was prospectively linked with lower levels of ultimate meaning struggles and greater flourishing at discharge. However, baseline levels of mental health outcomes were not predictive of the meaning-related factors in this sample.
Conclusion
Findings highlight the utility of assessing patients' perceived meaning in life and ultimate meaning struggles in spiritually integrated programs and for clinicians to be prepared to possibly address these meaning-related concerns in the treatment process.
{"title":"Temporal associations between meaning in life, ultimate meaning struggles, and mental health outcomes in a spiritually integrated inpatient program","authors":"Joseph M. Currier, Elizabeth M. Bounds, Hiroki Matsuo, Charlotte vanOyen Witvliet, Alexis D. Abernethy, Karl VanHarn, Sarah A. Schnitker","doi":"10.1002/jclp.23666","DOIUrl":"10.1002/jclp.23666","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Meaning in life is a benchmark indicator of flourishing that can likely mitigate the severity of depression symptoms among persons seeking mental healthcare. However, patients contending with serious mental health difficulties often experience a painful void or absence of ultimate meaning in their lives that might hinder recovery. This two-wave longitudinal study examined temporal associations between perceived presence of meaning in life, struggles with ultimate meaning, flourishing, and depression symptoms among adults in a spiritually integrated inpatient treatment program.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Of the 242 patients assessed at intake, 90% (<i>N</i> = 218; 40% Cisgender male; 57% Cisgender female; 3.0% nonbinary) completed validated measures of these meaning-related factors and mental health outcomes at discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Cross-sectional analyses revealed perceptions of meaning in life and ultimate meaning struggles were inversely linked with one another along with being associated with indices of positive and negative mental health in varying ways at the start and end of treatment. Drawing upon a two-wave cross-lagged panel design, longitudinal structural equation modeling analyses supported a Primary Meaning Model whereby having a subjective sense of meaning in life at intake was prospectively linked with lower levels of ultimate meaning struggles and greater flourishing at discharge. However, baseline levels of mental health outcomes were not predictive of the meaning-related factors in this sample.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings highlight the utility of assessing patients' perceived meaning in life and ultimate meaning struggles in spiritually integrated programs and for clinicians to be prepared to possibly address these meaning-related concerns in the treatment process.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139972010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peter J. Jankowski, Steven J. Sandage, Laura E. Captari, Sarah A. Crabtree, Elise J. Choe, Judy Gerstenblith
Objective
Treatment outcome monitoring typically emphasizes pathology. In contrast, we responded to the need to establish psychodynamic psychotherapy as evidence-based by modeling changes in gratitude and forgiveness.
Method
We utilized a practice-based research design involving non-manualized outpatient treatment. We employed a longitudinal mixture modeling approach to evaluate treatment effectiveness. We did so by testing the theorized role for relational virtues (i.e., gratitude, forgiveness) as signs of progress in psychodynamic treatment, with relational virtues referring to the application of character strengths to specific situations. We modeled clients' self-reported level on the virtues as a joint process over five time points, and examined the influence of early treatment alliance correspondence on patterns of change using a sample of outpatient clients (N = 185; Mage = 40.12; 60% female; 74.1% White).
Results
A 3-class solution best fit the data, with one class exhibiting growth in gratitude and forgiveness, improved symptoms, and a greater likelihood of symptom improvement relative to well-being gains. Alliance correspondence predicted the classes of change patterns, with greater similarity between clinicians' and clients' perceptions about the alliance predicting greater likelihood of belonging to the subgroup showing highest levels of virtues and well-being, lowest symptoms, and improved well-being.
Conclusion
Clinical implications involve monitoring gratitude and forgiveness as signs of progress and navigating the dialectic between implicit alliance processes and explicit virtue interventions. The former involves nurturing a strong alliance and repairing ruptures, whereas the latter involves direct in-session conversation and/or the practice of virtue interventions in and/or outside of session.
{"title":"A practice-based study of relational virtues and alliance correspondence in psychodynamic psychotherapy","authors":"Peter J. Jankowski, Steven J. Sandage, Laura E. Captari, Sarah A. Crabtree, Elise J. Choe, Judy Gerstenblith","doi":"10.1002/jclp.23669","DOIUrl":"10.1002/jclp.23669","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Treatment outcome monitoring typically emphasizes pathology. In contrast, we responded to the need to establish psychodynamic psychotherapy as evidence-based by modeling changes in gratitude and forgiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We utilized a practice-based research design involving non-manualized outpatient treatment. We employed a longitudinal mixture modeling approach to evaluate treatment effectiveness. We did so by testing the theorized role for relational virtues (i.e., gratitude, forgiveness) as signs of progress in psychodynamic treatment, with relational virtues referring to the application of character strengths to specific situations. We modeled clients' self-reported level on the virtues as a joint process over five time points, and examined the influence of early treatment alliance correspondence on patterns of change using a sample of outpatient clients (<i>N</i> = 185; <i>M</i><sub>age</sub> = 40.12; 60% female; 74.1% White).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A 3-class solution best fit the data, with one class exhibiting growth in gratitude and forgiveness, improved symptoms, and a greater likelihood of symptom improvement relative to well-being gains. Alliance correspondence predicted the classes of change patterns, with greater similarity between clinicians' and clients' perceptions about the alliance predicting greater likelihood of belonging to the subgroup showing highest levels of virtues and well-being, lowest symptoms, and improved well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Clinical implications involve monitoring gratitude and forgiveness as signs of progress and navigating the dialectic between implicit alliance processes and explicit virtue interventions. The former involves nurturing a strong alliance and repairing ruptures, whereas the latter involves direct in-session conversation and/or the practice of virtue interventions in and/or outside of session.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139972009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nonsuicidal self-injury (NSSI) is theorized to be caused by negative associations with the self, including low self-esteem, but the mechanisms explaining why low self-esteem is related to more severe NSSI are unclear. The current study aimed to address this limitation by evaluating a mediation model, proposing that low self-esteem would relate to more severe NSSI through increasing self-punishment motivations. Data came from 468 undergraduate students with a history of NSSI who completed an online survey measuring NSSI characteristics and functions, self-esteem, and self-punishment motivations for NSSI. Mediation was tested using a structural equation model using bootstrapped 95% percentile-corrected confidence intervals in which NSSI severity was modeled as a latent variable composed of NSSI frequency, recency, and versatility of methods. The total model was significant and the indirect effect of self-esteem on NSSI severity through self-punishment motives was significant. Self-esteem also retained significant direct effects on NSSI severity, indicating partial mediation. These results provide support for the benefits and barriers model of NSSI, suggesting that negative self-views increase risk for more severe NSSI through self-punishment motivations. Clinical interventions that emphasize self-compassion and focus on modifying self-punishment motivations may help reduce NSSI behavior.
{"title":"Negative self-perceptions and severity of NSSI: Testing the benefits and barriers model","authors":"Laura M. Nagy, Jennifer J. Muehlenkamp","doi":"10.1002/jclp.23667","DOIUrl":"10.1002/jclp.23667","url":null,"abstract":"<p>Nonsuicidal self-injury (NSSI) is theorized to be caused by negative associations with the self, including low self-esteem, but the mechanisms explaining why low self-esteem is related to more severe NSSI are unclear. The current study aimed to address this limitation by evaluating a mediation model, proposing that low self-esteem would relate to more severe NSSI through increasing self-punishment motivations. Data came from 468 undergraduate students with a history of NSSI who completed an online survey measuring NSSI characteristics and functions, self-esteem, and self-punishment motivations for NSSI. Mediation was tested using a structural equation model using bootstrapped 95% percentile-corrected confidence intervals in which NSSI severity was modeled as a latent variable composed of NSSI frequency, recency, and versatility of methods. The total model was significant and the indirect effect of self-esteem on NSSI severity through self-punishment motives was significant. Self-esteem also retained significant direct effects on NSSI severity, indicating partial mediation. These results provide support for the benefits and barriers model of NSSI, suggesting that negative self-views increase risk for more severe NSSI through self-punishment motivations. Clinical interventions that emphasize self-compassion and focus on modifying self-punishment motivations may help reduce NSSI behavior.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.23667","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139944194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Posttraumatic stress disorder symptoms (PTSS) and posttraumatic growth (PTG) are possible reactions to exposure to potentially traumatic events (PTEs) during military service. However, knowledge about patterns of both PTSS and PTG among female combat veterans is sparse. This study examines constellations of PTSS and PTG among Israeli female combat veterans, as well as military-related exposure and positive psychological correlates of these constellations.
Methods
A volunteer sample of Israeli women combat veterans (n = 885) responded to self-report questionnaires in a cross-sectional design study.
Results
Latent profile analysis (LPA) was used to identify four profiles characterized by unique constellations of PTSS and PTG: moderate PTSS and high PTG (33%), moderate PTSS and moderate PTG (30%), low PTSS and high PTG (30%), and low PTSS and PTG (5.5%). Higher levels of combat experiences were associated with higher odds of inclusion in the moderate PTSS and high PTG and moderate PTSS and moderate PTG profiles. Moreover, compared to the other classes, both low PTSS and high PTG and moderate PTSS and high PTG classes were associated with higher levels of satisfaction with life and happiness psychological outcomes.
Conclusion
The study's findings offer an overview of the complex pattern of associations between PTSS, PTG, and associated predictors and outcomes. Clinicians treating female veterans should be aware of the varying reactions to military service challenges, including the presence of moderate to high levels of PTG reactions in addition to PTSS.
{"title":"Constellations of posttraumatic stress symptoms and posttraumatic growth among Israeli female combat veterans: A latent profile analysis approach","authors":"Gadi Zerach","doi":"10.1002/jclp.23671","DOIUrl":"10.1002/jclp.23671","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Posttraumatic stress disorder symptoms (PTSS) and posttraumatic growth (PTG) are possible reactions to exposure to potentially traumatic events (PTEs) during military service. However, knowledge about patterns of both PTSS and PTG among female combat veterans is sparse. This study examines constellations of PTSS and PTG among Israeli female combat veterans, as well as military-related exposure and positive psychological correlates of these constellations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A volunteer sample of Israeli women combat veterans (<i>n</i> = 885) responded to self-report questionnaires in a cross-sectional design study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Latent profile analysis (LPA) was used to identify four profiles characterized by unique constellations of PTSS and PTG: <i>moderate PTSS and high PTG</i> (33%), <i>moderate PTSS and moderate PTG</i> (30%), <i>low PTSS and high PTG</i> (30%), and <i>low PTSS and PTG</i> (5.5%). Higher levels of combat experiences were associated with higher odds of inclusion in the moderate PTSS and high PTG and moderate PTSS and moderate PTG profiles. Moreover, compared to the other classes, both low PTSS and high PTG and moderate PTSS and high PTG classes were associated with higher levels of satisfaction with life and happiness psychological outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study's findings offer an overview of the complex pattern of associations between PTSS, PTG, and associated predictors and outcomes. Clinicians treating female veterans should be aware of the varying reactions to military service challenges, including the presence of moderate to high levels of PTG reactions in addition to PTSS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139944193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vesna Trenoska Basile, Toby Newton-John, Bethany M. Wootton
Generalized anxiety disorder (GAD) is a prevalent and chronic mental health condition, associated with considerable individual and economic burden. Despite the availability of effective treatments, many individuals do not access support. The current study explores treatment histories, barriers to help-seeking, and cognitive behavioral therapy (CBT) treatment preferences for individuals with clinically significant GAD symptoms. The utility of Health Belief Model (HBM) in predicting help-seeking is also examined. A cross-sectional design with 127 participants (Mage = 29.17; SD = 11.86; 80.3% female) was used. Sixty-two percent of participants reported previously seeking psychological treatment, and approximately 28% received CBT in the first instance. The most influential treatment barriers were a desire to solve the problem on one's own (M = 1.96, SD = 0.96), followed by affordability (M = 1.75, SD = 1.15) and feeling embarrassed or ashamed (M = 1.75, SD = 1.06). The most preferred treatment modes were in-person individual treatment (M = 7.59, SD = 2.86) followed by remote treatment via videoconferencing (M = 4.31, SD = 3.55). Approximately 38% of the variance in intention to seek treatment was associated with the HBM variables, with perceived benefit of treatment being the strongest predictor. Results have the potential to inform mental health service delivery by reducing treatment barriers and aligning public health campaigns with benefits of psychological treatments.
{"title":"Treatment histories, barriers, and preferences for individuals with symptoms of generalized anxiety disorder","authors":"Vesna Trenoska Basile, Toby Newton-John, Bethany M. Wootton","doi":"10.1002/jclp.23665","DOIUrl":"10.1002/jclp.23665","url":null,"abstract":"<p>Generalized anxiety disorder (GAD) is a prevalent and chronic mental health condition, associated with considerable individual and economic burden. Despite the availability of effective treatments, many individuals do not access support. The current study explores treatment histories, barriers to help-seeking, and cognitive behavioral therapy (CBT) treatment preferences for individuals with clinically significant GAD symptoms. The utility of Health Belief Model (HBM) in predicting help-seeking is also examined. A cross-sectional design with 127 participants (<i>M</i><sub>age</sub> = 29.17; SD = 11.86; 80.3% female) was used. Sixty-two percent of participants reported previously seeking psychological treatment, and approximately 28% received CBT in the first instance. The most influential treatment barriers were a desire to solve the problem on one's own (<i>M</i> = 1.96, SD = 0.96), followed by affordability (<i>M</i> = 1.75, SD = 1.15) and feeling embarrassed or ashamed (<i>M</i> = 1.75, SD = 1.06). The most preferred treatment modes were in-person individual treatment (<i>M</i> = 7.59, SD = 2.86) followed by remote treatment via videoconferencing (<i>M</i> = 4.31, SD = 3.55). Approximately 38% of the variance in intention to seek treatment was associated with the HBM variables, with perceived benefit of treatment being the strongest predictor. Results have the potential to inform mental health service delivery by reducing treatment barriers and aligning public health campaigns with benefits of psychological treatments.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.23665","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139931395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The network analysis method emphasizes the interaction between individual symptoms to identify shared or bridging symptoms between depression and anxiety to understand comorbidity. However, the network analysis and community detection approach have limitations in identifying causal relationships among symptoms. This study aims to address this gap by applying Bayesian network (BN) analysis to investigate potential causal relationships.
Method
Data were collected from a sample of newly enrolled college students. The network structure of depression and anxiety was estimated using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) Scale measures, respectively. Shared symptoms between depression and anxiety were identified through network analysis and clique percolation (CP) method. The causal relationships among symptoms were estimated using BN.
Results
The strongest bridge symptoms, as indicated by bridge strength, include sad mood (PHQ2), motor (PHQ8), suicide (PHQ9), restlessness (GAD5), and irritability (GAD6). These bridge symptoms formed a distinct community using the CP algorithm. Sad mood (PHQ2) played an activating role, influencing other symptoms. Meanwhile, restlessness (GAD5) played a mediating role with reciprocal influences on both anxiety and depression symptoms. Motor (PHQ8), suicide (PHQ9), and irritability (GAD6) assumed recipient positions.
Conclusion
BN analysis presents a valuable approach for investigating the complex interplay between symptoms in the context of comorbid depression and anxiety. It identifies two activating symptoms (i.e., sadness and worry), which serve to underscore the fundamental differences between these two disorders. Additionally, psychomotor symptoms and suicidal ideations are recognized as recipient roles, being influenced by other symptoms within the network.
{"title":"Investigating the network structure and causal relationships among bridge symptoms of comorbid depression and anxiety: A Bayesian network analysis","authors":"Yu Wang, Zhongquan Li, Xing Cao","doi":"10.1002/jclp.23663","DOIUrl":"10.1002/jclp.23663","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The network analysis method emphasizes the interaction between individual symptoms to identify shared or bridging symptoms between depression and anxiety to understand comorbidity. However, the network analysis and community detection approach have limitations in identifying causal relationships among symptoms. This study aims to address this gap by applying Bayesian network (BN) analysis to investigate potential causal relationships.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Data were collected from a sample of newly enrolled college students. The network structure of depression and anxiety was estimated using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) Scale measures, respectively. Shared symptoms between depression and anxiety were identified through network analysis and clique percolation (CP) method. The causal relationships among symptoms were estimated using BN.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The strongest bridge symptoms, as indicated by bridge strength, include sad mood (PHQ2), motor (PHQ8), suicide (PHQ9), restlessness (GAD5), and irritability (GAD6). These bridge symptoms formed a distinct community using the CP algorithm. Sad mood (PHQ2) played an activating role, influencing other symptoms. Meanwhile, restlessness (GAD5) played a mediating role with reciprocal influences on both anxiety and depression symptoms. Motor (PHQ8), suicide (PHQ9), and irritability (GAD6) assumed recipient positions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>BN analysis presents a valuable approach for investigating the complex interplay between symptoms in the context of comorbid depression and anxiety. It identifies two activating symptoms (i.e., sadness and worry), which serve to underscore the fundamental differences between these two disorders. Additionally, psychomotor symptoms and suicidal ideations are recognized as recipient roles, being influenced by other symptoms within the network.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139898093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel F. Gros, Jeffrey M. Pavlacic, Evangelia Argyriou, Ron Acierno, Melba A. Hernandez-Tejada
Objectives
Limited research exists that outlines the predictive relevance of the treatment components of prolonged exposure (PE) for post-traumatic stress disorder (PTSD) on PTSD and depression symptom outcomes. The goal of the present study was to investigate relations between participant completion of breathing retraining, in vivo exposure, and imaginal exposure exercises and symptom outcomes.
Methods
A total of 58 participants completed a trial of PE as part of a larger trial on peer involvement and treatment adherence. Diagnostic and self-report measures were completed throughout treatment. Participants also recorded weekly completion of breathing retraining, in vivo exposure, and imaginal exposure exercises. Pearson correlations and hierarchical regression analyses were used to investigate relations between average weekly treatment component completion and treatment outcomes, controlling for relevant variables.
Results
Although breathing retraining and in vivo exposures were associated with PTSD outcomes in the correlational findings, use of breathing retraining, in vivo exposures, and imaginal exposures were not reliably associated with PTSD symptom outcomes when controlling for other variables in the regression analysis. However, when investigating changes in comorbid symptoms of depression, greater use of breathing retraining was associated with decreased symptoms of depression at posttreatment.
Conclusions
Present findings demonstrate the differential relations between participation in various PE treatment components and posttreatment symptom outcomes. The importance of breathing retraining in addressing comorbid depressive symptoms is discussed, with emphasis on potentially increasing relaxation and positive activities more broadly to encourage further treatment benefits.
研究目的：关于创伤后应激障碍（PTSD）的长期暴露（PE）治疗内容对创伤后应激障碍和抑郁症状结果的预测相关性的研究十分有限。本研究的目的是调查参与者完成呼吸再训练、体内暴露和想象暴露练习与症状结果之间的关系：方法：共有 58 名参与者完成了 PE 试验，该试验是同伴参与和治疗依从性大型试验的一部分。在整个治疗过程中完成了诊断和自我报告测量。参与者还记录了每周完成呼吸再训练、体内暴露和想象暴露练习的情况。在控制相关变量的情况下，使用皮尔逊相关性和分层回归分析来研究平均每周治疗部分完成情况与治疗结果之间的关系：结果：尽管在相关性研究结果中，呼吸训练和体内暴露与创伤后应激障碍结果有关，但在回归分析中，当控制了其他变量后，呼吸训练、体内暴露和意象暴露的使用与创伤后应激障碍症状结果没有可靠的关联。然而，在调查合并抑郁症状的变化时，更多使用呼吸再训练与治疗后抑郁症状的减少有关：目前的研究结果表明，参与体育运动治疗的不同部分与治疗后的症状结果之间存在不同的关系。讨论了呼吸再训练在解决合并抑郁症状方面的重要性，并强调有可能更广泛地增加放松和积极活动，以鼓励进一步的治疗效果。
{"title":"Differential relations between breathing retraining, in vivo exposure, and imaginal exposure homework completion and treatment outcomes in veterans receiving prolonged exposure for PTSD","authors":"Daniel F. Gros, Jeffrey M. Pavlacic, Evangelia Argyriou, Ron Acierno, Melba A. Hernandez-Tejada","doi":"10.1002/jclp.23662","DOIUrl":"10.1002/jclp.23662","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Limited research exists that outlines the predictive relevance of the treatment components of prolonged exposure (PE) for post-traumatic stress disorder (PTSD) on PTSD and depression symptom outcomes. The goal of the present study was to investigate relations between participant completion of breathing retraining, in vivo exposure, and imaginal exposure exercises and symptom outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 58 participants completed a trial of PE as part of a larger trial on peer involvement and treatment adherence. Diagnostic and self-report measures were completed throughout treatment. Participants also recorded weekly completion of breathing retraining, in vivo exposure, and imaginal exposure exercises. Pearson correlations and hierarchical regression analyses were used to investigate relations between average weekly treatment component completion and treatment outcomes, controlling for relevant variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Although breathing retraining and in vivo exposures were associated with PTSD outcomes in the correlational findings, use of breathing retraining, in vivo exposures, and imaginal exposures were not reliably associated with PTSD symptom outcomes when controlling for other variables in the regression analysis. However, when investigating changes in comorbid symptoms of depression, greater use of breathing retraining was associated with decreased symptoms of depression at posttreatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Present findings demonstrate the differential relations between participation in various PE treatment components and posttreatment symptom outcomes. The importance of breathing retraining in addressing comorbid depressive symptoms is discussed, with emphasis on potentially increasing relaxation and positive activities more broadly to encourage further treatment benefits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139898092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aser Alba Coma Gonzalez, Elisabet Vilella, Alfonso Gutiérrez-Zotes
A significant number of borderline personality disorder (BPD) symptoms are manifested in the interpersonal context. This can be explained by the difficulties in attributing the mental states of oneself and others, which constitutes social cognition. Errors in social cognition are interrelated with the affective, cognitive, impulsive, and interpersonal areas of the person with BPD. The aims of this study was to analyze social cognition in women with BPD compared with a control group and to analyze social cognition in BPD based on BPD symptoms and its severity. To assess social cognition, we used a full range of social cognition categories provided by the Movie for the Assessment of Social Cognition (MASC): correct theory of mind (ToM); attribution of mental states (thoughts, emotions, or intentions); errors of mentalization; types of ToM; and attribution of mental states through perceptive or cognitive cues and through hot or cold emotions. The MASC has high ecological validity and has been validated in Spanish. The sample comprised 79 women, including 47 women with BPD and 32 healthy women. Worse social cognition performance was observed in women with BPD. More severe borderline symptoms were related to worse functioning in the correct ToM and to errors of no mentalization. Involvement of the cognitive area in borderline symptoms was associated with worse functioning in correct ToM and worse social cognition in cognitive areas as well as with hypermentalization. This is the first study that uses all the MASC categories and considers BPD heterogeneity and its severity to study social cognition.
{"title":"Social cognition in women with borderline personality disorder based on an exhaustive analysis of the Movie for Assessment of Social Cognition (MASC) categories","authors":"Aser Alba Coma Gonzalez, Elisabet Vilella, Alfonso Gutiérrez-Zotes","doi":"10.1002/jclp.23661","DOIUrl":"10.1002/jclp.23661","url":null,"abstract":"<p>A significant number of borderline personality disorder (BPD) symptoms are manifested in the interpersonal context. This can be explained by the difficulties in attributing the mental states of oneself and others, which constitutes social cognition. Errors in social cognition are interrelated with the affective, cognitive, impulsive, and interpersonal areas of the person with BPD. The aims of this study was to analyze social cognition in women with BPD compared with a control group and to analyze social cognition in BPD based on BPD symptoms and its severity. To assess social cognition, we used a full range of social cognition categories provided by the Movie for the Assessment of Social Cognition (MASC): correct theory of mind (ToM); attribution of mental states (thoughts, emotions, or intentions); errors of mentalization; types of ToM; and attribution of mental states through perceptive or cognitive cues and through hot or cold emotions. The MASC has high ecological validity and has been validated in Spanish. The sample comprised 79 women, including 47 women with BPD and 32 healthy women. Worse social cognition performance was observed in women with BPD. More severe borderline symptoms were related to worse functioning in the correct ToM and to errors of no mentalization. Involvement of the cognitive area in borderline symptoms was associated with worse functioning in correct ToM and worse social cognition in cognitive areas as well as with hypermentalization. This is the first study that uses all the MASC categories and considers BPD heterogeneity and its severity to study social cognition.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139746731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lauren Stavropoulos, Nancy Briggs, Jessica R. Grisham
Background
Mental images of feared events are overactive and intrusive in generalized anxiety disorder (GAD). Imagery rescripting involves integration of positive or neutral imagery and corrective information into images to facilitate emotional processing, reduce imagery intrusions, and re-structure underlying schema. Yet only one known study has applied the technique to treatment of worry. The present study aimed first to examine the relationship between trait worry and properties of future-oriented worry images, and second to examine the efficacy of a self-guided imagery rescripting intervention in improving individuals' response to their worries.
Methods
Participants recruited through Amazon Mechanical Turk (N = 365) identified their major worry and wrote the script of a worst-case scenario mental image. Participants were randomized to three conditions: re-writing the same worry image script (exposure), or writing scripts of either one or three positive alternative future-oriented images (rescripting conditions).
Results
In preliminary analyses, trait worry negatively predicted participants' ratings of worry images, including valence and ability to cope, and positively predicted distress, anticipated cost, and belief in their negative meaning. In experimental analyses, linear mixed-effects models revealed anxious response and cognitive appraisal of the threat were significantly lower among participants allocated to rescripting relative to exposure. There was no effect of rescripting type.
Conclusions
This investigation demonstrated the impact of a future-oriented imagery rescripting task on anxiety and cognitive biases associated with real worries in an unselected sample. Results may contribute to the development of imagery rescripting interventions for GAD.
背景：在广泛性焦虑症（GAD）患者中，恐惧事件的心理意象会过度活跃并具有侵扰性。意象重写包括将积极或中性的意象和纠正信息整合到意象中，以促进情绪处理，减少意象干扰，并重新构建潜在的模式。然而，只有一项已知的研究将该技术应用于担忧的治疗。本研究的目的首先是研究特质担忧与面向未来的担忧意象属性之间的关系，其次是研究自我指导的意象重写干预在改善个体对担忧的反应方面的效果：方法：通过 Amazon Mechanical Turk 招募的参与者（N = 365）确定了他们的主要担忧，并撰写了最坏情况下的心理图像脚本。参与者被随机分为三种情况：重新书写相同的担忧图像脚本（暴露），或书写一个或三个积极的替代性未来导向图像脚本（重写条件）：在初步分析中，特质担忧对参与者对担忧图像（包括情绪和应对能力）的评价有负面预测作用，而对困扰、预期成本和对其负面意义的信念有正面预测作用。在实验分析中，线性混合效应模型显示，相对于暴露，接受重述的参与者的焦虑反应和对威胁的认知评价明显较低。重述类型没有影响：这项调查证明了面向未来的意象重述任务对未经选择的样本中与真实担忧相关的焦虑和认知偏差的影响。研究结果可能有助于开发针对严重焦虑症的意象重述干预方法。
{"title":"Self-guided imagery rescripting for worry images: A preliminary experimental investigation","authors":"Lauren Stavropoulos, Nancy Briggs, Jessica R. Grisham","doi":"10.1002/jclp.23660","DOIUrl":"10.1002/jclp.23660","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mental images of feared events are overactive and intrusive in generalized anxiety disorder (GAD). Imagery rescripting involves integration of positive or neutral imagery and corrective information into images to facilitate emotional processing, reduce imagery intrusions, and re-structure underlying schema. Yet only one known study has applied the technique to treatment of worry. The present study aimed first to examine the relationship between trait worry and properties of future-oriented worry images, and second to examine the efficacy of a self-guided imagery rescripting intervention in improving individuals' response to their worries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants recruited through Amazon Mechanical Turk (<i>N</i> = 365) identified their major worry and wrote the script of a worst-case scenario mental image. Participants were randomized to three conditions: re-writing the same worry image script (exposure), or writing scripts of either one or three positive alternative future-oriented images (rescripting conditions).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In preliminary analyses, trait worry negatively predicted participants' ratings of worry images, including valence and ability to cope, and positively predicted distress, anticipated cost, and belief in their negative meaning. In experimental analyses, linear mixed-effects models revealed anxious response and cognitive appraisal of the threat were significantly lower among participants allocated to rescripting relative to exposure. There was no effect of rescripting type.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This investigation demonstrated the impact of a future-oriented imagery rescripting task on anxiety and cognitive biases associated with real worries in an unselected sample. Results may contribute to the development of imagery rescripting interventions for GAD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.23660","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139735365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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