Clinical Psychology in Europe最新文献

Background: After almost three decades of ICD-10 use for diagnostic purposes, the World Health Organization has conducted a systematic and elaborate evaluation to revise the classification of mental disorders in this system. This revision resulted in the 11th version (ICD-11), introduced in 2022. As one new feature, the ICD-11 forms a new grouping of mental disorders specifically associated with stress.

Method: The current review presents an overview of the diagnostic features and cultural specifications of disorders specifically associated with stress. This grouping includes posttraumatic stress disorder and complex posttraumatic stress disorder, prolonged grief disorder, adjustment disorder, as well as two diagnoses for children, reactive attachment disorder and disinhibited social engagement disorder.

Results: Overall, there is evidence for the improved clinical utility and applicability of these disorders. The disorders have been defined in a parsimonious way by few features, but they suffice for scientific purposes as well.

Conclusion: However, more research is needed to evaluate assessments for the diagnoses and diagnostic features in the ICD-11.

Background: The new revision of the ICD came into effect on January 1st, 2022, and significant changes have been introduced in the section related to substance use disorders.

Method: In the present work we describe the new ICD-11 section "Disorders due to Substance Use and Addictive Behaviors" and outline the innovations in classification and diagnosis introduced, with a view to addressing the most important issues in terms of new opportunities for identifying and caring for people in need of treatment.

Results: The main innovations introduced in the ICD-11 chapter of interest are the expanded classes of psychoactive substances, the introduction of single episodes of substance use, the introduction of harmful patterns of substance use and severity qualifiers for substance intoxication. Furthermore, the new category "Disorders due to addictive behaviors" has been added, including "Gambling disorder" and the new diagnostic category "Gaming disorder".

Conclusions: ICD-11 calls for renewed public health response and policies fostering the multi-professional and multidisciplinary management of alcohol and substance abuse treatment, giving to these forms of addiction new chances also towards the reaching of the UN 2030 Agenda Sustainable Development Goals.

Background: In the 10th revision of the International Classification of Diseases and Related Health Problems (ICD-10), chronic pain was not represented adequately. Pain was left undefined and not recognized as a biopsychosocial phenomenon. Instead, a flawed dualism between psychological and somatic factors was implied. Individual diagnoses were ill-defined and scattered randomly through different chapters. Many patients received diagnoses in remainder categories devoid of meaningful clinical information.

Method: The International Association for the Study of Pain launched a Task Force to improve the diagnoses for the 11th revision of the ICD and this international expert team worked from 2013-2019 in cooperation with the WHO to develop a consensus based on available evidence and to improve the diagnoses.

Results: A new chapter on chronic pain was created with a biopsychosocial definition of pain. Chronic pain was operationalized as pain that persists or recurs longer than three months and subdivided into seven categories: Chronic primary pain and six types of chronic secondary pain. All diagnoses were based on explicit operationalized criteria. Optional extension codes allow coding pain-related parameters and the presence of psychosocial aspects together with each pain diagnosis.

Conclusion: First empirical studies demonstrated the integrity of the categories, the reliability, clinical utility, international applicability and superiority over the ICD-10. To improve reliability and ease of diagnosis, a classification algorithm is available. Clinical psychologists and other clinicians working with people with chronic pain should watch the national implementation strategies and advocate for multimodal and interdisciplinary treatments and adequate reimbursement for all providers involved.

Background: Until the advent of the ICD-11, classification of personality disorders was based on categorical prototypes with a long history. These prototypes, whilst familiar, were not based in the science of personality. Prototypical classifications were also complex to administer in non-specialist settings requiring knowledge of many signs and symptoms.

Method: This article introduces the new structure of ICD-11 for personality disorders, describing the different severity levels and trait domain specifiers. Case studies illustrate the main aspects of the classification.

Results: The new ICD-11 system acknowledges the fundamentally dimensional nature of personality and its disturbances whilst requiring clinicians to make categorical decisions on the presence or absence of personality disorder and severity (mild, moderate or severe). The connection between normal personality functioning and personality disorder is established by identifying five trait domain specifiers to describe the pattern of a person's personality disturbance (negative affectivity, detachment, dissociality, disinhibition, and anankastia) that connect to the Big 5 personality traits established in the broader study of personality.

Conclusions: Whilst new assessment measures have been and are in development, the success of the new system will rely on clinicians and researchers embracing the new system to conceptualise and describe personality disturbances and to utilise the classification in the investigation of treatment outcome.

Background: The present study investigated differences in symptom perceptions between individuals with functional disorders (FD), major health conditions, and FDs + major health conditions, respectively, and a group of healthy individuals. Furthermore, it investigated the relevance of FDs among other health-related and psychological correlates of symptom perceptions in the framework of the Common Sense Model of Self-Regulation (CMS).

Method: This cross-sectional study used epidemiological data from the Danish Study of Functional Disorders part two (N = 7,459 participants, 54% female, 51.99 ± 13.4 years). Symptom perceptions were assessed using the Brief Illness Perception Questionnaire (B-IPQ) and compared between the four health condition groups. Multiple regression analyses were performed to examine associations between symptom perceptions, FDs, and other health-related and psychological correlates from the CMS framework.

Results: Individuals with FDs (n = 976) and those with FDs + major health conditions (n = 162) reported less favorable symptom perceptions compared to the other two groups, particularly regarding perceived consequences, timeline, and emotional representations (effect size range Cohen's d = 0.12-0.66). The presence of a FD was significantly associated with all B-IPQ items, even in the context of 16 other relevant health-related and psychological correlates from the CMS framework, whereas symptom presence last year or last week was not.

Conclusion: In the general population, symptom perceptions seem to play a more salient role in FD than in individuals with well-defined physical illness. Symptom perceptions should therefore be targeted in both primary and secondary interventions for FDs.

Psychotherapies can lead to meaningful and lasting change.Evolutionary theory is relevant for understanding psychotherapy.Process-based approaches to conceptualizing psychotherapy can help organize clinical knowledge.Process-based approaches may be more useful than competitions between psychotherapy schools.

Background: Theoretical models of self-conscious emotions indicate that shame is elicited through internal, stable, and global causal attributions of the precipitating event. The current study aimed to investigate whether these negative attributions are related to trauma-related shame and PTSD symptom severity.

Method: A total of 658 participants aged 18 to 89 (M = 33.42; SD = 12.17) with a history of trauma exposure completed a range of self-report measures assessing trauma exposure, negative trauma-related attributions, shame, and PTSD symptoms.

Results: Higher levels of internal, stable, and global trauma-related attributions were significantly associated with shame and PTSD. Shame mediated the association between trauma-related attributions and PTSD symptom severity, even after controlling for the effects of number of trauma exposures, worst index trauma and depression.

Conclusions: The present results suggest that negative attributions are a critical cognitive component related to shame and in turn, PTSD symptom severity. Future research should aim to replicate these findings in a clinical sample and extend these findings using prospective designs.

Background: Quarantine and physical distancing represent the two most important non-pharmaceutical actions to contain the COVID-19 pandemic. Comparatively little is known about possible adverse consequences of these behavioural measures in Germany. This study aimed at investigating potential early adverse effects associated with quarantine and physical distancing at the beginning of the countrywide lockdown in Germany in March 2020.

Method: Using a cross-sectional online survey (N = 4,268), adverse consequences attributed to physical distancing, symptoms of psychopathology, and sociodemographic variables were explored in the total sample as well as in high-risk groups (i.e., people with a physical or mental condition).

Results: The most frequently reported adverse effects were impairment of spare time activities, job-related impairment, and adverse emotional effects (e.g., worries, sadness). Participants with a mental disorder reported the highest levels of adverse consequences (across all domains) compared to participants with a physical disease or participants without any mental or physical condition. No significant association between the duration of the behavioural protective measures and the severity of adverse mental health effects was observed.

Conclusion: Results showed that non-pharmaceutical actions were associated with adverse effects, particularly in people with mental disorders. The findings are of relevance for tailoring support to special at-risk groups in times of behavioural preventive strategies.