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How are irritability and anhedonia symptoms linked? A network approach 易怒和失神症状之间有何联系？网络方法
IF 3 3区 心理学 Q2 PSYCHOLOGY, CLINICAL
Journal of Clinical Psychology
Pub Date : 2024-03-18 DOI: 10.1002/jclp.23679
Sonia Sistiaga, Wan-Ling Tseng, Lanting Zhang, Mandy Rossignol, Nellia Bellaert

Background

Anhedonia and irritability are two prevalent symptoms of major depressive disorder (MDD) that predict greater depression severity and poor outcomes, including suicidality. Although both symptoms have been proposed to result from paradoxical reward processing dysfunctions, the interactions between these symptoms remain unclear. Anhedonia is a multifaceted symptom reflecting impairments in multiple dimensions of reward processing (e.g., pleasure, desire, motivation, and effort) across distinct reward types (e.g., food, sensory experiences, social activities, hobbies) that may differentially interact with irritability. This study investigated the complex associations between anhedonia and irritability using network analysis.

Method

Participants (N = 448, Mage = 33.29, SD = 14.58) reported their symptoms of irritability on the Brief Irritability Test (Holtzman et al., 2015) and anhedonia (i.e., pleasure, desire, motivation, and effort dimensions across four reward types) on the Dimensional Anhedonia Rating Scale (Rizvi et al., 2015). A regularized Gaussian Graphical Model was built to estimate the network structure between items.

Results

Irritability was negatively related to willingness to expand effort to obtain food/drinks (estimate = −0.18), social activities (−0.13), and hobbies (−0.12) rewards. Irritability was positively associated with a desire for food/drinks (0.12).

Limitations

Only a small proportion (5.8%) of our sample was clinical and the study design was cross-sectional.

Conclusion

A specific link between irritability and the effort dimension of the hedonic response across three reward types was identified. Investigating effort expenditure deficits with experimental paradigms may help us understand the mechanisms underlying the comorbidity between irritability and anhedonia in the context of MDD.

背景：失乐症和易激惹是重度抑郁障碍（MDD）的两种常见症状，可预示抑郁的严重程度和不良后果，包括自杀倾向。虽然这两种症状被认为是奖赏处理功能障碍的矛盾结果，但这些症状之间的相互作用仍不清楚。失乐症是一种多方面的症状，反映了不同奖赏类型（如食物、感官体验、社交活动、业余爱好）的奖赏加工在多个方面（如快乐、欲望、动机和努力）的障碍，这些障碍可能会与易激惹产生不同程度的相互作用。本研究利用网络分析法研究了失乐症与易怒之间的复杂关联：参与者（N = 448，Mage = 33.29，SD = 14.58）在简易易怒测试（Brief Irritability Test，Holtzman等人，2015年）中报告了他们的易怒症状，并在维度失乐症评分量表（Dimensional Anhedonia Rating Scale，Rizvi等人，2015年）中报告了他们的失乐症（即四种奖励类型中的快乐、欲望、动机和努力维度）。我们建立了一个正则化高斯图形模型来估计项目之间的网络结构：易激惹性与为获得食物/饮料（估计值=-0.18）、社交活动（-0.13）和业余爱好（-0.12）而付出更多努力的意愿呈负相关。烦躁与对食物/饮料的渴望呈正相关（0.12）：局限性：我们的样本中只有一小部分（5.8%）是临床样本，而且研究设计是横断面的：结论：在三种奖赏类型中，易怒与享乐反应的努力维度之间存在特定联系。通过实验范式来研究努力支出的缺陷，可能有助于我们了解在 MDD 的背景下，易激惹和失乐症之间的共病机制。
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引用次数: 0
Evolving policies, enduring impacts: Cross-sectional surveys of mental health, risk-related perceptions, and coping behaviors throughout China's U-turn in its stringent zero-COVID policy 不断变化的政策，持久的影响：在中国严格的 "零婴儿出生缺陷 "政策发生转变的整个过程中，对心理健康、风险相关认知和应对行为的横断面调查。
IF 3 3区 心理学 Q2 PSYCHOLOGY, CLINICAL
Journal of Clinical Psychology
Pub Date : 2024-03-15 DOI: 10.1002/jclp.23676
Shuguang Zhao, Jue Zhou, Ting Wang

Objective

China's early encounter with COVID-19 and protracted prevention policies, presents an ideal case to study psychological changes during a prolonged and evolving crisis. This study aims to examine the shifts in mental health symptoms, risk-related perceptions, and associated coping behaviors within two large-scale samples of Chinese respondents, spanning from the pandemic's onset to the relaxation of the zero-COVID policy. Moreover, the study strives to identify protective factors that could potentially mitigate the pandemic's impact.

Methods

Two online surveys were conducted during China's initial pandemic phase (February 25–28, 2020) and the relaxation of the zero-COVID policy (March 30–April 18, 2023). Participants' mental health indicators, risk-related perceptions, and coping behaviors were assessed using the Depression, Anxiety, and Stress Scale-21 Items, the 9-item Bergen Burnout Inventory, and other adopted scales. Multivariable linear models were employed to examine the enduring psychological impact of the pandemic and identify potential protective factors.

Results

Analysis of two datasets comprising 1946 and 1878 participants from the onset and the remission of China's COVID-19 pandemic revealed an upward trend in various mental health indicators of Chinese respondents between 2020 and 2023. Similarly, risk-related perceptions, encompassing perceived severity, susceptibility, and self-efficacy, and risk-related information sharing witnessed an increase. Being female, single, residing in rural areas, having higher education, and lacking acquaintances with COVID-19 are protective factors against mental health risks. Additionally, being female, married, over 30, living in big cities, having higher education, and lacking personal or acquaintances' infection history are associated with engaging in protective behaviors and reduced information avoidance.

Conclusion

The study investigated the changes in mental health symptoms, risk-related perceptions, and coping behaviors of Chinese respondents between 2020 and 2023 and identified protective factors against the pandemic's impact, including demographic (gender, age), social (education, marital status, residence), and exposure (infection history) elements. Understanding these fluctuations and protective elements is crucial for policymakers, as it can inform the development of targeted strategies to alleviate negative psychological impacts while effectively managing future pandemics.

目的：中国与 COVID-19 的早期接触以及旷日持久的预防政策，为研究长期和不断演变的危机中的心理变化提供了一个理想的案例。本研究旨在通过两个大规模的中国受访者样本，研究从疫情爆发到零COVID政策放松期间，受访者心理健康症状、风险相关认知以及相关应对行为的变化。此外，本研究还试图找出可能减轻疫情影响的保护性因素：方法：在中国大流行初期（2020 年 2 月 25-28 日）和零感染率政策放宽期间（2023 年 3 月 30 日至 4 月 18 日）进行了两次在线调查。采用抑郁、焦虑和压力量表-21 项、卑尔根职业倦怠量表 9 项以及其他采用的量表对参与者的心理健康指标、风险相关认知和应对行为进行了评估。采用多变量线性模型来研究大流行病的持久心理影响，并确定潜在的保护因素：对中国 COVID-19 大流行爆发期和缓解期的 1946 名和 1878 名受访者组成的两个数据集进行分析后发现，在 2020 年至 2023 年期间，中国受访者的各项心理健康指标呈上升趋势。同样，包括严重性、易感性和自我效能感在内的风险相关认知以及风险相关信息共享也呈上升趋势。女性、单身、居住在农村地区、受过高等教育以及缺乏与 COVID-19 相关的熟人是抵御心理健康风险的保护因素。此外，女性、已婚、30 岁以上、居住在大城市、受过高等教育、没有个人或熟人感染史也与参与保护行为和减少信息回避有关：本研究调查了 2020 年至 2023 年期间中国受访者的心理健康症状、风险相关认知和应对行为的变化，并确定了抵御大流行影响的保护性因素，包括人口（性别、年龄）、社会（教育、婚姻状况、居住地）和暴露（感染史）因素。了解这些波动和保护性因素对政策制定者来说至关重要，因为这有助于制定有针对性的策略，在有效管理未来大流行病的同时减轻负面心理影响。
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引用次数: 0
I'm Great! I'm no good….: A case illustration of drama therapeutic work with a male offender of domestic violence in a forensic outpatient setting 我很棒我不是好....：在法医门诊环境中对一名家庭暴力男性罪犯进行戏剧治疗的案例说明。
IF 3 3区 心理学 Q2 PSYCHOLOGY, CLINICAL
Journal of Clinical Psychology
Pub Date : 2024-03-12 DOI: 10.1002/jclp.23674
Elsa van den Broek

Treating perpetrators of aggressive behavior, like verbal aggression, intimidation, and bullying behavior resulting in aggressive incidents with others, is difficult. This group is often diagnosed with personality disorders and when legal measures applied, they are more often treated in a forensic setting for their problems. This article presents the case of a 54-year-old man, diagnosed with Borderline personality disorder, narcissistic and antisocial traits, mild depressive symptoms, and loss and grief, who has voluntarily had treatment in a forensic outpatient center to reduce aggression and change destructive patterns in relationships. Hating, judging, and self-defeating were the main reasons why the patient found himself ending up in the same situation repeatedly. The client received individual drama therapy sessions. The drama therapeutic approach included schema therapeutic elements, such as schema mode work with cards, as well as roleplay, imagery (with rescripting), improvisation, and psycho drama elements. As a result of drama therapy, the client reported less (active) aggression, less aggression in his relationships (partners/children/friends), but also an increased level of loneliness, and mild depressive symptoms. The client was more in touch with his vulnerability and was able to behave in a more adequate healthy way in relationships. Although self-esteem was still building up, there was a decrease of aggression and less conflict-seeking behavior as a result. Risk assessment tools (FARE-2 & HONOS) and Schema therapy scales (YSQ and SMI) were used pre- and posttreatment confirming the improvements. This case promotes the use of dramatherapy in forensic outpatient care to be valuable in lowering risk recidivism and changing deeply rooted behavioral patterns.

治疗攻击性行为（如语言攻击、恐吓和欺凌行为）的实施者是很困难的，因为这些行为会导致与他人发生攻击性事件。这类人群通常被诊断为人格障碍，在适用法律措施时，他们的问题更多是在法医环境下进行治疗。本文介绍了一名 54 岁男子的病例，他被诊断为边缘型人格障碍、自恋和反社会特征、轻度抑郁症状以及失落和悲伤，他自愿在法医门诊中心接受治疗，以减少攻击行为并改变人际关系中的破坏性模式。憎恨、批判和自我否定是该患者发现自己反复陷入相同处境的主要原因。患者接受了个人戏剧治疗课程。戏剧治疗方法包括图式治疗元素，如用卡片进行图式模式工作，以及角色扮演、想象（重写剧本）、即兴表演和心理剧元素。戏剧治疗的结果是，当事人的（主动）攻击行为减少了，人际关系（伴侣/子女/朋友）中的攻击行为也减少了，但孤独感和轻度抑郁症状也增加了。求助者更加了解自己的弱点，能够在人际关系中采取更适当、更健康的行为方式。虽然自尊心仍在建立中，但攻击性有所减少，寻求冲突的行为也随之减少。治疗前后使用的风险评估工具（FARE-2 和 HONOS）和模式疗法量表（YSQ 和 SMI）证实了治疗效果的改善。本案例促进了戏剧疗法在法医门诊治疗中的应用，对降低再犯风险和改变根深蒂固的行为模式具有重要价值。
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引用次数: 0
Determining the MMPI-3 SUI scale's cross-sectional and prospective utility in suicide risk assessment 确定 MMPI-3 SUI 量表在自杀风险评估中的横断面效用和前瞻性效用
IF 3 3区 心理学 Q2 PSYCHOLOGY, CLINICAL
Journal of Clinical Psychology
Pub Date : 2024-03-11 DOI: 10.1002/jclp.23664
Cole S. Morris, Megan A. Keen, Chloe White, Paul B. Ingram, Sean M. Mitchell, Sarah E. Victor

Objective

In-depth suicide risk assessments are particularly important to long-term suicide prevention. Broadband measures of psychopathology, such as the Minnesota Multiphasic Personality Inventory (MMPI) instruments, assess suicide risk factors and various mental health comorbidities. With the recent release of the MMPI-3, the Suicidal/Death Ideation (SUI) scale underwent revisions to improve its construct validity and detection of suicide risk factors. Thus, we hypothesized the MMPI-3 SUI scale would demonstrate medium to large associations with suicidal experience and behaviors, future ideation, and interpersonal risk factors of suicide.

Methods

A sample of 124 college students screened for elevated depressive symptoms completed a brief longitudinal study. Participants completed a baseline session including the MMPI-3 and criterion measures and three brief follow-ups every 2 weeks.

Results

SUI scores were most robustly associated with increased risk for past suicidal ideation, planning, and perceived burdensomeness. Prospectively assessed suicidal ideation was also meaningfully associated with SUI. SUI scale elevations indicate an increased risk of suicide-related risk factors.

Conclusion

The MMPI-3 is a valuable tool to inform long-term suicide prevention for those experiencing elevated depressive symptoms as the SUI scale can assess past, current, and future suicide-related risk factors, including suicidal ideation and behaviors.

深入的自杀风险评估对于长期预防自杀尤为重要。明尼苏达多相人格量表（MMPI）等宽带精神病理学测量工具可以评估自杀风险因素和各种精神健康合并症。随着最近 MMPI-3 的发布，自杀/死亡意念量表（SUI）也进行了修订，以提高其构造效度和对自杀风险因素的检测。因此，我们假设 MMPI-3 SUI 量表将与自杀经历和行为、未来意念以及自杀的人际关系风险因素表现出中等至较大的关联。
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引用次数: 0
Examining cognitive disengagement syndrome in a psychiatric outpatient sample: Psychometric support and associations with internalizing symptoms and sleep problems 在精神病门诊病人样本中研究认知脱离综合征：心理计量学支持以及与内化症状和睡眠问题的关联。
IF 3 3区 心理学 Q2 PSYCHOLOGY, CLINICAL
Journal of Clinical Psychology
Pub Date : 2024-03-11 DOI: 10.1002/jclp.23678
Bengu Yucens, Omer Basay, Ahmet Buber, Selim Tumkaya, Burge Kabukcu Basay, Busra Erdem, Stephen P. Becker, G. Leonard Burns

Objective

The internal (structural) and external validity of a self-report measure of cognitive disengagement syndrome (CDS, formerly sluggish cognitive tempo) relative to a self-report measure of attention-deficit/hyperactivity disorder-inattention (ADHD-IN) was evaluated with adults from university outpatient psychiatric clinics in Turkey.

Methods

A total of 274 outpatients (75.9% women; ages 18–64 years; Mage = 31.06; SDage = 10.84; 50.4% anxiety disorders; 41.6% depressive disorders; 2.9% ADHD; 1.5% sleep disorders; 0.7% eating disorders; 2.9% no mental disorder) completed self-report measures of CDS, ADHD-IN, ADHD-hyperactivity/impulsivity (HI), sleep problems, depression, and stress.

Results

All 15 CDS symptoms measured by the Adult Concentration Inventory (ACI) showed convergent (moderate to high loadings on the CDS factor) and discriminant (loading close to zero on the ADHD-IN factor) validity. CDS also showed stronger first-order and unique associations than ADHD-IN with sleep problems, depression, anxiety, and stress, whereas ADHD-IN showed stronger first-order and unique associations than CDS with ADHD-HI.

Conclusion

This is the first study to provide support for the scores from this 15 item self-report measure of CDS by the ACI in a clinical sample of adults, with findings consistent with previous studies examining parent and teacher rating scale measures with the same 15 CDS symptoms. These findings provide additional support for usefulness of these 15 CDS symptoms as measured by the ACI to study CDS across various cultures.

目的以土耳其大学精神科门诊的成年人为研究对象，评估了认知脱离综合征（CDS，原认知节奏迟缓）自我报告测量法与注意力缺陷/多动障碍-注意力（ADHD-IN）自我报告测量法的内部（结构）和外部有效性：共有 274 名门诊患者（75.9% 为女性；年龄 18-64 岁；Mage = 31.06；SDage = 10.84；50.4% 患有焦虑症；41.6% 患有抑郁症；2.9% 患有多动症；1.5% 患有睡眠障碍；0.7% 患有饮食障碍；2.9% 无精神障碍）完成了 CDS、ADHD-IN、ADHD-多动/冲动（HI）、睡眠问题、抑郁和压力的自我报告测量：通过成人注意力集中量表（ACI）测量的所有 15 个 CDS 症状均显示出收敛性（在 CDS 因子上有中等至较高的负荷）和判别性（在 ADHD-IN 因子上的负荷接近零）。CDS还比ADHD-IN与睡眠问题、抑郁、焦虑和压力表现出更强的一阶和独特关联，而ADHD-IN则比CDS与ADHD-HI表现出更强的一阶和独特关联：这是第一项支持 ACI 在临床成人样本中对 15 项 CDS 症状进行自我报告测量的研究，其结果与之前对家长和教师对同样 15 项 CDS 症状进行评分的研究结果一致。这些研究结果为 ACI 测量的这 15 项 CDS 症状在研究不同文化背景下的 CDS 方面的实用性提供了更多支持。
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引用次数: 0
A brief mindfulness-based intervention, sleep quality, sleep duration, and fatigue among nurses: A randomized controlled trial 基于正念的简短干预、护士的睡眠质量、睡眠时间和疲劳：随机对照试验。
IF 3 3区 心理学 Q2 PSYCHOLOGY, CLINICAL
Journal of Clinical Psychology
Pub Date : 2024-03-08 DOI: 10.1002/jclp.23677
Mohammed Munther Al-Hammouri, Jehad A. Rababah

Aims

The purpose of the current study was to investigate the effectiveness of a mindfulness-based intervention in improving sleep duration, sleep quality, and fatigue among Jordanian nurses.

Design and Methods

A randomized controlled trial was used to conduct this study. Data from 123 nurses (60 nurses in the interventional group and 63 nurses in the control group) were collected and analyzed. The primary outcome measures were compared between the intervention and control groups using repeated measure MANOVA to assess changes in sleep duration, sleep quality, and fatigue over time.

Results

The results showed that there was a statistically significant multivariate effect of the intervention on the linear combination of the dependent variables (sleep duration, sleep quality, and fatigue) (V = 0.23, F (3, 119) = 12.02, p < .001) with Partial η2 of 0.23. Follow-up analysis showed that the intervention group had lower sleep disturbances (Mean difference = −6.53, CI = −7.79 to −5.26) and less fatigue (Mean difference = −13.36, CI = −17.24 to −9.47) than the control group.

Conclusions

The current study showed that the mindfulness-based intervention effectively addresses sleep quality and fatigue in nurses, which in turn is expected to positively impact the health care system.

Clinical Relevance

Mindfulness-based interventions effectively address sleep quality and fatigue associated with nurses' job performance and outcomes. Implementing brief mindfulness-based interventions is crucial as they can be self-implemented and fit into nurses' busy schedules.

目的：本研究旨在调查正念干预对改善约旦护士睡眠时间、睡眠质量和疲劳程度的有效性：本研究采用随机对照试验的方法。收集并分析了 123 名护士（干预组 60 名，对照组 63 名）的数据。使用重复测量 MANOVA 对干预组和对照组的主要结果进行比较，以评估睡眠时间、睡眠质量和疲劳程度随时间的变化：结果表明，干预对因变量（睡眠时间、睡眠质量和疲劳）的线性组合有显著的多变量影响（V = 0.23，F (3, 119) = 12.02，p < .001），部分η2 为 0.23。后续分析表明，与对照组相比，干预组的睡眠障碍更低（平均差异 = -6.53，CI = -7.79 至 -5.26），疲劳感更少（平均差异 = -13.36，CI = -17.24 至 -9.47）：本研究表明，正念干预能有效解决护士的睡眠质量和疲劳问题，从而有望对医疗保健系统产生积极影响：基于正念的干预能有效解决与护士工作表现和结果相关的睡眠质量和疲劳问题。实施简短的正念干预措施至关重要，因为这些措施可以自行实施，并适合护士繁忙的日程安排。
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引用次数: 0
Social problem-solving in intimate partner violence victims: Exploring the relative contributions of shame and PTSD symptoms 亲密伴侣暴力受害者的社会问题解决：探索羞耻感和创伤后应激障碍症状的相对作用。
IF 3 3区 心理学 Q2 PSYCHOLOGY, CLINICAL
Journal of Clinical Psychology
Pub Date : 2024-03-06 DOI: 10.1002/jclp.23675
J. Gayle Beck, Elizabeth L. Griffith, Rimsha Majeed, Melissa S. Beyer, Mya E. Bowen, Bre'Anna L. Free

Objective

This study examined the contributions of shame and posttraumatic stress disorder (PTSD) symptoms to two dimensions of social problem-solving.

Method

A sample of 426 women who were seeking mental health assistance following experiences of intimate partner violence completed self-report and clinician measures. Separate path analyses were conducted for problem orientation and problem-solving styles.

Results

In the model examining problem orientation, higher levels of shame were significantly associated with lower levels of positive problem orientation (f2 = 0.32) and higher levels of negative problem orientation (f2 = 0.92), with large effects noted. PTSD symptoms were significantly, positively associated with negative problem orientation (f2 = 0.3, large effect). When examining problem-solving styles, shame showed a significant negative association with rational style (f2 = 0.08, small effect) and significant positive associations with impulsive style (f2 = 0.45, large effect) and avoidant style (f2 = 0.48, large effect). PTSD symptoms did not return significant associations with any of the three problem-solving styles.

Conclusion

Results indicate that shame holds notable associations with both dimensions of social problem-solving, relative to PTSD symptoms, and are discussed in light of current models of post-trauma functioning. Implications for clinical care and early intervention efforts are highlighted.

目的：本研究探讨了羞耻感和创伤后应激障碍（PTSD）症状对解决社会问题的两个方面的影响：本研究探讨了羞耻感和创伤后应激障碍（PTSD）症状对社会问题解决两个维度的影响：抽样调查了 426 名因遭受亲密伴侣暴力而寻求心理健康帮助的女性，她们完成了自我报告和临床医生测量。对问题导向和问题解决方式分别进行了路径分析：在研究问题取向的模型中，较高的羞耻感与较低的积极问题取向（f2 = 0.32）和较高的消极问题取向（f2 = 0.92）显著相关，且影响较大。创伤后应激障碍症状与消极问题取向有明显的正相关（f2 = 0.3，大效应）。在研究解决问题的风格时，羞耻感与理性风格呈显著负相关（f2 = 0.08，小效应），与冲动风格（f2 = 0.45，大效应）和回避风格（f2 = 0.48，大效应）呈显著正相关。创伤后应激障碍症状与三种问题解决方式均无明显关联：结果表明，相对于创伤后应激障碍症状而言，羞耻感与社会问题解决的两个维度都有明显的关联，并根据创伤后功能的现有模型进行了讨论。本文还强调了临床护理和早期干预工作的意义。
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引用次数: 0
Clinical characteristics of treatment-seeking youth with misophonia 寻求治疗的失音症青少年的临床特征。
IF 3 3区 心理学 Q2 PSYCHOLOGY, CLINICAL
Journal of Clinical Psychology
Pub Date : 2024-03-02 DOI: 10.1002/jclp.23672
Adam B. Lewin, Lauren Milgram, Sandra L. Cepeda, Sarah Dickinson, Morgan Bolen, Kelly Kudryk, Cassidy Bolton, Ashley R. Karlovich, Hannah L. Grassie, Aileen Kangavary, Sherelle L. Harmon, Andrew Guzick, Jill Ehrenreich-May

Objective

Misophonia is a psychiatric condition characterized by strong emotional and/or behavioral responses to auditory stimuli, leading to distress and functional impairment. Despite previous attempts to define and categorize this condition, misophonia is not currently included in the Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases. The lack of formal diagnostic consensus presents challenges for research aimed at assessing and treating this clinical presentation.

Methods

The current study presents clinical characteristics of youth (N = 47) with misophonia in the largest treatment-seeking sample to date. We examined demographic characteristics of the sample, frequency of comorbid disorders, frequency of specific misophonia symptoms (i.e., triggers, emotional and behavioral responses, and impairments), and caregiver-child symptom agreement. Misophonia symptoms were evaluated using a multimodal assessment including clinician, youth, and caregiver reports on empirically established misophonia measures, and concordance among measures was assessed.

Results

Youth seeking treatment for misophonia presented with marked misophonia symptoms and an array of comorbid conditions. Youth and caregivers identified various triggers of misophonia symptoms (e.g., chewing sounds, breathing sounds), as well as a wide range of emotional (e.g., anger, annoyance, disgust) and behavioral (e.g., aggression, avoidance) responses to triggers. Youth and caregivers exhibited high agreement on misophonia triggers but lower agreement on symptom severity and associated impairment. Compared to younger children (aged 8−13), older children (aged 14+) appeared to report symptom severity and associated impairment more reliably.

Conclusion

Misophonia is a heterogenous and impairing clinical condition that warrants future investigation and evidence-based treatment development.

目的：失音症是一种精神疾病，其特征是对听觉刺激产生强烈的情绪和/或行为反应，从而导致痛苦和功能障碍。尽管以前曾试图对这种病症进行定义和分类，但目前失音症并未被纳入《精神疾病诊断与统计手册》或《国际疾病分类》。缺乏正式的诊断共识给旨在评估和治疗这种临床表现的研究带来了挑战：本研究介绍了迄今为止最大的寻求治疗样本中患有失声症的青少年（N = 47）的临床特征。我们研究了样本的人口统计学特征、合并症的频率、特定失音症状（即诱因、情绪和行为反应以及障碍）的频率以及照顾者与儿童症状的一致性。嗜睡症症状的评估采用多模式评估，包括临床医生、青少年和照顾者对经验确立的嗜睡症测量方法的报告，并对测量方法之间的一致性进行评估：结果：寻求失音治疗的青少年有明显的失音症状和一系列合并症。青少年和照护者发现了引发失音症状的各种诱因（如咀嚼声、呼吸声），以及对诱因的各种情绪（如愤怒、恼怒、厌恶）和行为（如攻击、回避）反应。青少年和照护者对误咽症诱因的认同度较高，但对症状严重程度和相关障碍的认同度较低。与年龄较小的儿童（8-13 岁）相比，年龄较大的儿童（14 岁以上）对症状严重程度和相关障碍的报告似乎更可靠：失认症是一种异质性的临床损伤性疾病，值得在未来进行研究并开发循证治疗方法。
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引用次数: 0
The Brief Evaluation of Adolescents and Children Online (BEACON): Psychometric development of a mental health screening measure for school students 青少年和儿童在线简要评估（BEACON）：针对在校学生的心理健康筛查量表的心理计量学开发。
IF 3 3区 心理学 Q2 PSYCHOLOGY, CLINICAL
Journal of Clinical Psychology
Pub Date : 2024-02-29 DOI: 10.1002/jclp.23673
Ronald M. Rapee, Rebecca Kuhnert, Susan H. Spence, Ian Bowsher, John Burns, Jennifer Coen, Julie Dixon, Pauline Kotselas, Catherine Lourey, Lauren F. McLellan, Cathrine Mihalopoulos, Lorna Peters, Traci Prendergast, Tiffany Roos, Danielle Thomas, Viviana Wuthrich

This paper describes the development and psychometric evaluation of a brief self-report measure (BEACON) to inform universal mental health screening in schools. Items assess symptoms and impairment associated with anxiety and attention/hyperactivity problems (grades 4–11) as well as depression and eating difficulties (grades 6–11), with optional items for suicidality and self-harm (grades 7–11). Initial item examination based on Item Response Theory (IRT) and classical test theory involved 3844 students in grades 4 through 11 (Study 1) and identified 18 items for grades 4–5 and 31 items for grades 6–11 that fulfilled pre-set criteria. Study 2 extended testing with 10,479 students in grades 4–11 and added an additional four items assessing impairment associated with eating difficulties for older students (grades 6–11) creating a total of 35 items for grades 6–11. All items, for both grade-level versions, met the pre-set criteria for IRT and classical test theory analysis supporting their strength in the measurement of the dimensions of concern. The measure showed good reliability (subscale alphas .87 to .95). Validity was also demonstrated against standard symptom measures, school grades, school absenteeism, and help-seeking. The BEACON appears to be a psychometrically sound measure to use in the first stage of school-based screening for mental health problems.

本文介绍了一种简短的自我报告测量方法（BEACON）的开发和心理测量评估，为在学校普及心理健康筛查提供参考。项目评估与焦虑和注意力/多动问题（4-11 年级）以及抑郁和进食困难（6-11 年级）相关的症状和障碍，并可选择自杀和自残项目（7-11 年级）。以项目反应理论（IRT）和经典测验理论为基础，对 3844 名四年级至十一年级的学生进行了初步的项目检查（研究 1），发现四至五年级有 18 个项目、六至十一年级有 31 个项目符合预设标准。研究 2 对 10,479 名 4-11 年级的学生进行了扩展测试，并为高年级学生（6-11 年级）增加了 4 个评估与进食困难相关的障碍的项目，从而为 6-11 年级增加了总共 35 个项目。两个年级版本的所有项目均符合 IRT 和经典测验理论分析的预设标准，支持其在测量关注维度方面的优势。测量结果显示了良好的信度（子量表信度为 0.87 至 0.95）。此外，它还与标准症状测量、学校成绩、旷课情况和求助情况进行了比对，证明了其有效性。BEACON 似乎是一种心理测量方法，可用于学校心理健康问题筛查的第一阶段。
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引用次数: 0
Temporal associations between meaning in life, ultimate meaning struggles, and mental health outcomes in a spiritually integrated inpatient program 精神综合住院计划中人生意义、终极意义挣扎与心理健康结果之间的时间关联。
IF 3 3区 心理学 Q2 PSYCHOLOGY, CLINICAL
Journal of Clinical Psychology
Pub Date : 2024-02-26 DOI: 10.1002/jclp.23666
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.

背景：人生意义是衡量一个人生活是否富足的基准指标，它有可能减轻寻求心理保健者抑郁症状的严重程度。然而，面临严重心理健康问题的患者往往会体验到痛苦的空虚感，或者在他们的生活中缺乏终极意义，这可能会阻碍他们的康复。这项分为两个阶段的纵向研究考察了接受精神综合住院治疗项目的成年人在感知生命意义的存在、与终极意义的抗争、蓬勃发展和抑郁症状之间的时间关联：在入院时接受评估的 242 名患者中，90%（N = 218；40% 顺性别男性；57% 顺性别女性；3.0% 非二元性）完成了这些意义相关因素和出院时心理健康结果的有效测量：横截面分析表明，在治疗开始和结束时，生活意义感和终极意义挣扎之间存在反向联系，并以不同方式与积极和消极心理健康指数相关联。利用两波交叉滞后面板设计，纵向结构方程建模分析支持 "主要意义模型"（Primary Meaning Model），即入院时对生活意义的主观感知与出院时较低的终极意义挣扎水平和较高的蓬勃发展水平相关联。然而，心理健康结果的基线水平并不能预测该样本中与意义相关的因素：研究结果凸显了在精神整合项目中评估患者感知到的生命意义和终极意义挣扎的实用性，临床医生应做好准备，以便在治疗过程中解决这些与意义相关的问题。
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