Psychiatric Quarterly最新文献

This study aims to examine the effectiveness of ACT-based positive psychology intervention on young people's mental health and well-being. Existing literature offers limited insights into the impacts of ACT-based PPIs, particularly concerning young people. The study explores the potential of this intervention to enhance positive psychological outcomes such as subjective well-being, self-compassion, and optimism, while reducing negative psychological outcomes like pessimism, anxiety, depressive symptoms, and somatic symptoms, and improving resilience. Conducted at a state university, the study involved 42 participants between the ages of 19 and 23 who were assigned to experimental (n = 20) and control (n = 22) group. The experimental group participated in an 8-week ACT-based PPI program. Employing a longitudinal experimental design, the study included a pre-test, post-test, and a follow-up test approximately two years later. Results indicated that the experimental group experienced significant improvements in positive psychological outcomes and reductions in negative outcomes, with the effects sustained during the follow-up period. Notably, long-term enhancements in resilience and self-compassion were observed. Overall, this study provides important evidence of the effectiveness of ACT-based PPI in promoting young people's long-term outcomes, with implications for developing intervention programs to support their mental health and well-being.

This study aimed to determine the pathways linking cognitive flexibility to fatigue through the serial mediation effect of sleep quality and sleepiness in 564 healthy adults using various scales, including the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Chalder Fatigue Scale, and Cognitive Flexibility Inventory. Analysis was performed using two mediating variables (sleep quality and sleepiness) with age and gender as covariates. The simple mediation effect was evaluated using the Causal Step. The indirect effect was examined using bootstrap method and Sobel test. The total and direct effects of cognitive flexibility on fatigue were both found to be statistically significant. The research model revealed three significant indirect effects: cognitive flexibility affecting fatigue through sleep quality, cognitive flexibility affecting fatigue through sleepiness and cognitive flexibility affecting fatigue through both sleep quality and sleepiness. Additionally, serial mediation analysis showed that the relationship between cognitive flexibility and fatigue is sequentially mediated by sleep quality and sleepiness (B = -0.064, SE = 0.013, 95% CI: -0.070 to -0.017). All effects were confirmed through the 95% confidence intervals, which did not include zero, and with significant p values. These findings highlight the role of sleep quality and sleepiness as serial mediators of the relationship between cognitive flexibility and fatigue. The study's major contribution is to provide insight on the independent and serial mediating role of sleep quality and sleepiness in the relationship between cognitive flexibility to fatigue.

This study was aimed at exploring students' psychological condition (operationalized through psychological distress and perceived loneliness) one year after the COVID-19 lockdown and testing its role in predicting academic motivation. The possible mediating role of emotional regulation in this relationship was also investigated. A non-random sample of university students completed a cross-sectional online survey assessing their psychological distress, feelings of loneliness, emotion regulation strategies, and academic motivation. Structural equation modeling multi-group analysis was used to examine the relation between variables. The final sample comprised 479 students (62.8% female, Mage = 22.16 ± 2.79 years) from several degree courses attending Italian universities. Of these, 56.6% and 41.5% of the participants showed high levels of psychological distress and perceived loneliness, respectively. Psychological distress and loneliness were positively associated with problems with emotion-regulation abilities and negatively associated with academic motivation. The lack of emotional awareness, in turn, reduced their academic motivation levels. Analysis of the indirect effects showed that psychological distress affected academic motivation via awareness (β = -.02, p < .05 and β = -.03, p < .05 in males and females, respectively). Overall, the model was able to predict academic motivation in university students, explaining a reasonable percentage of the variance (14% for males and 17% for females). These results indicate a meaningful effect of students' psychological condition on academic motivation. Implications for the definition and implementation of actions to support students in managing psychological problems and feelings of loneliness and to foster students' psychological health in university settings are discussed.

Psychological suffering of healthcare professionals, during War times, is ignored in literature. While struggling to provide ultimate care, HCP need support and psychological counseling. The purpose of this study was to examine the moderation effect of resilience on the relationship between life satisfaction, depression, and PTSD controlling for the sociodemographic and personal characteristics among on-duty healthcare professionals in Gaza. A convenience sample of 150 on-duty healthcare professionals filled out an online survey. The sample targeted a convenience sample of HCWs who are currently on duty in Gaza. Data collected regrading satisfaction with life, PTSD, depression, and resilience. Data collected from August to end of Sept 2024. Of the sample, 94.7% (n = 146) met criteria of PTSD, 85.3% (n = 128) reported a severe form of depression, 59.3% (n = 89) have a low level of resilience, and 74.7% (n = 112) reported that they are dissatisfied with their life. The analysis showed that resilience has no significant moderation effect on the relationship between psychological factors and PTSD controlling for demographic and personal characteristics as the R² change of 0.011 in the model was not statistically significant (p = 0.09). Years of experience, age and having mental illness were significant risk factors to develop PTSD. There is a need to provide an urgent psychological counselling to healthcare professionals in Gaza. Online and face-to-face help groups and peer to peer support need to be established.

Systematic reviews have confirmed that home treatment (HT) is an appropriate alternative to conventional inpatient treatment. So far, research on predictors for treatment outcomes of HT has been rather inconsistent, and potential predictors have not been systematically investigated yet. This exploratory study has a prospective naturalistic design with repeated measurements of symptoms, well-being, and self-efficacy at baseline, at post-assessment (discharge from HT) and at follow-up. Repeated measures analysis of variance (ANOVA) was carried out to measure changes between assessment points. Changes in emotion regulation were analysed between baseline and post-assessment using t-tests. Potential predictor variables were assessed at baseline. Linear regression models were estimated with post scores of symptoms, well-being, self-efficacy and emotion regulation as dependent variables and potential predictors as independent variables. 58 patients participated in the study. Significant differences between baseline and post-assessment were found for psychiatric symptoms, well-being, self-efficacy and emotion regulation. No significant changes were found at follow-up. Of the investigated potential predictors, three significantly predicted outcome of HT: Patients with former treatments in a psychiatric institution had significantly higher post-assessment in symptoms (β = .26, p = .04) and lower well-being (β = -.28, p = .02) compared to patients without former treatment in a psychiatric institution. Furthermore, hope for change and symptoms of anxiety were found to be predictors of outcome. General improvement in symptoms and well-being indicate that HT was effective. Previous psychiatric history, hope of improvement and anxiety were identified as predictors of treatment outcome.

Detailed evaluation of changes in patient retention in psychiatric care as a result of the onset of the COVID-19 pandemic have not been studied. Here, we present a retrospective analysis of aggregate data from a large academic health system (n = 16,701 patients) to examine if there were differences in patients leaving psychiatric care from the pre-COVID-19 period to the first 12 months of the COVID-19 pandemic. Demographic, clinical, and behavioral factors were studied using logistic regressions to determine significant associations in leaving psychiatric care during COVID-19 and in the 12 months immediately prior to the pandemic. Factors identified with a higher odds of leaving psychiatric care during COVID-19 that were not associated with leaving care prior to COVID-19 included demographic (male sex, uninsured (self-pay) status), behavioral (inactive patient health portal), and diagnostic (anxiety and trauma stressor disorders, pervasive and specific developmental disorders, and disorders of childhood) factors. These results highlight that the reasons patients left care during the period immediately after the COVID-19 pandemic may have been multifactorial in nature, although certain patterns seem to have appeared. Further study is needed to elucidate why these specific factors may have driven patients to leave psychiatric treatment during the COVID-19 pandemic.

Dysfunctional grief was not addressed adequately during the COVID-19 pandemic. This study aimed to develop a dysfunctional pandemic grief model specific to healthcare workers who experienced patient deaths during the COVID-19 pandemic. We conducted an anonymous online survey among 568 nursing professionals who had experienced a patient's death while working at three tertiary-level hospitals. We further assessed psychological status using the Pandemic Grief Scale (PGS) for Healthcare Workers, Pandemic Grief Risk Factors (PGEF), Utrecht Grief Rumination Scale (UGRS), Grief Support HealthCare Scale (GSHCS), Patient Health Questionnaire-9 (PHQ-9), and Stress and Anxiety in Viral Epidemic-9 (SAVE-9). PGS correlated with PGRF, UGRS, GSHCS, PHQ-9, and SAVE-9 (all p < 0.01). Linear regression analysis revealed that PGRF (𝛽=0.44, p < 0.001), UGRS (𝛽=0.24, p < 0.001), GSHCS (𝛽=-0.09, p = 0.004), and PHQ-9 (𝛽=0.23, p < 0.001) expected pandemic dysfunctional grief. Mediation analysis showed that PGRF directly influenced PGS; UGRS and GSHCS positively and negatively mediated the relationship between PGRF and PGS, respectively. The dysfunctional pandemic grief model shows that it is important to address grief risk factors, manage rumination, and provide effective psychological support to healthcare workers.

Voice-hearing experiences (VHEs), commonly known as auditory verbal hallucinations, can range from mild to severe, rare to frequent, and negative to positive. There has been a significant increase in studies focusing on non-clinical voice-hearing experiences as compared with clinical groups. However, not many studies have investigated these experiences occurring solely in non-clinical populations. Studies investigating voice-hearing experiences in the non-clinical population were reviewed in the present study as an attempt to examine how these experiences are understood and interpreted in healthy voice-hearing groups. Four electronic databases were searched for empirical papers from 2010 onwards for voice-hearing experiences in the non-clinical population resulting in the selection of 7 papers at the end. As a result of the review, it was found that VHEs in this population are more likely to have positive voice content with voices perceived as more benevolent, a better relationship is found between the voice and the voice-hearer, an explanatory framework to situate one's experiences to understand and ultimately accept them, and therefore, no or minimal related distress. The findings of this present review may have broad implications for clinical practice, awareness and understanding of mental health in the general population.

Childhood psychological maltreatment has psychological, behavioral, and emotional repercussions on individuals in adulthood. These reflections play a role in both the internal distress of individuals and the deterioration of their interpersonal relationships. The aim of this study was to examine the serial mediating role of psychological flexibility and family conflict in the relationship between childhood psychological maltreatment and subjective happiness. The study was conducted with 493 university students (61.7% female, 38.3% male), with ages ranging from 18 to 53 years (M_age = 24.02, SD = 6.342). The data of this research was analyzed using structural equation modeling. The findings of the study indicate that psychological flexibility and family conflict have a serial mediating role in the relationship between childhood psychological maltreatment and subjective happiness. The results demonstrated that to improve the subjective happiness of people who have been psychologically abused as children, it is necessary to make them more psychologically flexible and teach them how to deal with family conflict. Overall, these findings emphasize the importance of fostering psychological flexibility and conflict resolution skills as key intervention targets to mitigate the long-term negative effects of childhood psychological maltreatment on subjective happiness. The findings of the study were discussed and interpreted in detail in the light of the relevant literature.

Schizophrenia is a chronic mental illness that affects daily functioning and quality of life. Many patients experience internalized stigma, which worsens symptoms and quality of life. Psychological flexibility may help reduce stigma's negative effects. This study explores how psychological flexibility, internalized stigma, and illness knowledge relate to symptom severity in schizophrenia. We hypothesized that internalized stigma mediates the link between psychological flexibility and symptoms, and that greater illness knowledge leads to lower stigma and better outcomes. This cross-sectional study included patients diagnosed with schizophrenia at a Community Mental Health Center (CMHC) in Turkey. 253 participants completed standardized scales of psychological flexibility(AAQ-II), internalized stigma(ISMI), knowledge about schizophrenia(KASQ), and symptom severity(PANSS). Mediation analysis was performed using the PROCESS macro for SPSS to assess the indirect effects of stigma and illness knowledge on symptom severity. Psychological flexibility was significantly associated with lower levels of internalized stigma (β = -1.046, p < 0.001). Internalized stigma mediated the relationship between psychological flexibility and symptom severity(β = 0.506, p < 0.001), whereas illness knowledge had a protective effect on symptom severity(β = -1.582, p < 0.001). However, illness knowledge did not significantly mediate the relationship between psychological flexibility and stigma. The findings highlight the critical role of psychological flexibility in mitigating the negative impact of internalized stigma, suggesting that interventions aimed at enhancing flexibility could improve clinical outcomes. Psychoeducation programs may further reduce symtom severity by increasing ilness knowledge. Future research should explore longitudinal interventions targeting stigma reduction and psychological flexibility to enhance functional recovery in schizophrenia.