British Journal of Clinical Psychology最新文献

Objectives: Inflexibility of thought and behaviour is a transdiagnostic feature of many neuropsychiatric disorders and presents several empirical measurement challenges. Here, we developed and validated the Flexibility in Daily Life scale (FIDL); a novel, self-report questionnaire, which captures expressions of cognitive and behavioural flexibility in daily life and is sensitive to natural shifts in these processes across the adult lifespan.

Methods: The FIDL was developed using a deductive scale development approach, which aimed to capture common themes within the flexibility literature and across diagnoses (e.g. insistence on sameness, preference for routines). Following multidisciplinary consensus, an initial 37-item questionnaire was submitted for validation in an online sample of 295 healthy adult participants (19-78 years).

Results: Exploratory factor analysis produced a revised 21-item version comprising five factors, labelled: Repetition, Switching, Predictability/Control, Routine, and Thoughts/Beliefs. Internal consistency reliability was good-to-strong for the total FIDL score and moderate-to-strong for individual subscales. Convergent validity was established between the FIDL and an existing measure of cognitive flexibility. Critically, the FIDL total score evinced a U-shaped relationship with age, whereby flexibility was lower at the younger and older tails of the lifespan and greater in middle age. The same U-shaped trajectory emerged for the Repetition, Routine, and Thoughts/Beliefs factors.

Conclusions: Overall, the FIDL is a valid and reliable multidimensional measure of flexibility, which upholds a clearly defined factor structure and good psychometric properties. It promises to be a valuable clinical and research tool to assess the natural fluctuations in flexibility across the lifespan and departures thereof.

Objectives: Trauma-related conditions, such as post-traumatic stress disorder, are associated with high rates of impairment and distress. Evidence-based interventions for many trauma-related conditions exert robust effects on their primary outcomes. However, logistical, financial, geographic and stigma-related barriers to accessing these interventions exist.

Methods: Innovations that overcome barriers to access and engagement and increase the scalability of interventions for trauma-related conditions are sorely needed.

Results and conclusions: Here, we explore the following two potential avenues towards meeting this need: changes to the delivery model, including embedding interventions in settings which are already accessed by trauma-exposed individuals (e.g. schools, social care systems) and harnessing advancements in technology to provide truly accessible trauma-focussed interventions.

Background and objectives: According to current models of compulsive checking, memory confidence greatly contributes to the development and maintenance of checking behaviours. However, how to intervene in memory confidence in an evidence-based manner has not yet been fully understood. Thus, the purpose of the current paper was to identify the factors influencing memory confidence through the review of experimental evidence.

Methods: PubMed, Google Scholar, OpenGrey and ProQuest databases were searched by combining two sets of keywords related to memory confidence and checking. Our search yielded 24 experiments. Due to the considerable heterogeneity of the studies regarding questionnaires, tasks and paradigms used, data were synthesized using a narrative review approach.

Results: Six factors emerged from a thorough review of the literature, including negative memory belief, higher memory standard, inflated sense of responsibility, familiarization with the checked stimuli, number of checks and anxious valence of the checked stimuli.

Conclusion: The findings have important implications for the treatment of compulsive checking. We suggested general guidelines to translate these factors into a novel intervention to increase memory confidence in compulsive checkers.

Objectives: Emotion regulation plays an important role in the development and maintenance of psychopathology. However, the question whether specific ER skills are related to specific psychological symptoms has rarely been studied, but has important implications for targeted interventions. This analysis aims to explore potential differential associations between various ER skills and psychological symptoms using a network analysis approach.

Methods: Routine data from a transdiagnostic clinical sample of 716 patients (460 females, 256 males) from an outpatient clinic for psychotherapy were analysed. Nine ER skills were assessed with the Emotion Regulation Skills Questionnaire, and nine symptom dimension scores were obtained using the Brief Symptom Inventory. A regularized partial correlation network models including ER skills and individual symptom domains were calculated. Bridge expected influence was calculated to estimate the strength of association of each ER skill with psychological symptoms.

Results: Only the following ER skills were most strongly related to psychological symptoms (bridge expected influence): Tolerance, Confrontation and Modification. All other ER skills were indirectly connected to symptom severity through these four skills. The strongest direct edges between ER skills and symptoms were Modification-Depression, Confrontation-Obsession-Compulsion and Tolerance-Interpersonal Sensitivity, which were significantly stronger than the vast majority of other associations between ER skills and psychological symptoms.

Conclusions: These exploratory findings provide valuable targets for future studies to investigate specific associations between ER skills and psychological symptoms which could help to improve outcome monitoring and efficacy of interventions targeting ER.

Objective: Social anxiety is characterized by maladaptive self-schemas about being socially undesirable. Self-schemas are deeply held beliefs which are derived from negative autobiographical memories of painful social experiences. In contrast to the plethora of past research on negative memories in social anxiety, almost no research has investigated objectively positive social autobiographical memories. In this preregistered study, we examined the effects of social anxiety and self-schemas on the appraised impact and meaningfulness of retrieved positive versus negative social autobiographical memories.

Method: Participants recruited via Prolific (final n = 343) were randomized to one of two conditions in which they were instructed to retrieve, orally narrate, and appraise a positive or negative social autobiographical memory of a specific experience from their personal past where they felt either valued or unvalued, respectively.

Results: Results demonstrated that participants rated their positive memories as more impactful and meaningful than negative memories overall, but this effect was reversed for participants who endorsed having either stronger negative self-schemas or greater social anxiety symptoms, for whom negative memories were more impactful. Additionally, participants who endorsed having stronger positive self-schemas rated their negative memories as significantly less impactful and their positive memories as nearly more impactful.

Conclusion: Together, these results elucidate how self-schemas and social anxiety are related to autobiographical memory appraisals, paving the way for future research on memory-based therapeutic interventions for social anxiety disorder.

Objectives: Psychosis can be thought of as a threat-based experience. Compassion has been shown to be effective in reducing threat, although highly distressed individuals may struggle to be self-compassionate. This study explored the effects of compassionate interactions with staff on inpatients with psychosis.

Method: Experience Sampling Method (ESM) was used to investigate the relationships between compassion from staff and paranoia, voice hearing, distress related to psychosis experiences, affect and risk incidents in daily life. Twenty-two service users residing on inpatient mental health wards took part. Baseline measures of compassion, fears of compassion and affect were taken. Participants completed ESM assessments 10 times per day, over 6 days.

Results: Compassion from staff was associated with a small increase in voice hearing, but was not associated with paranoia, paranoia-related distress, voice-related distress, negative affect, positive affect, or risk incidents in daily life. Baseline fears of compassion moderated the relationships between compassion from staff and some of the service user outcomes. For inpatients scoring low on fears of compassion, compassionate interactions were associated with increased positive affect and lower paranoia. However, for those scoring high on fears of compassion, this relationship was reversed, and compassionate interactions were associated with higher paranoia and lower positive affect.

Conclusion: People with psychosis who have fears of compassion may benefit from receiving support to address these fears in order to experience the benefit from the compassion of staff. The results should be interpreted with caution due to the low number of observations and limited statistical power.

Objectives: We report the effect of quality of therapy delivery on outcomes in a randomized, controlled trial of behavioural activation (BA) and guided self-help (GSH) for depression in adults with intellectual disabilities.

Methods: A study specific measure of quality was used in a linear mixed effect model to determine the effects therapy and therapy quality on therapy outcome.

Results: There was a significant interaction between quality and treatment type, with lower quality therapy associated with better outcome for GSH but poorer outcome for BA, with little difference in outcomes at higher levels of therapy quality.

Conclusions: Factors suggesting high quality in individualized BA may indicate problematic engagement for GSH. More research into processes in therapy for people with intellectual disabilities is required.

Objectives: The accommodation of symptoms of obsessive-compulsive disorder (OCD) by loved ones is highly prevalent and impactful on treatment outcomes; however, little is known about factors that influence accommodation by romantic partners of OCD sufferers. The aim of this preliminary investigation was to explore such correlates.

Methods: A community sample of 50 patients self-identifying with OCD (M_age = 29.3; SD = 9.3; 74% female) and 20 individuals self-identifying as the partner of someone with OCD (M_age = 32.1; SD = 12.4; 65% female) participated in this study via an online questionnaire.

Results: Associations were found between partner accommodation of OCD and a range of obsessions and compulsions across the patient and partner samples, as well as patient-reported symptom severity, functional impairment and negative emotion states. Neuroticism was also positively associated with partner accommodation in the patient sample but did not contribute to its prediction over and above other known correlates of family accommodation. In the partner sample, extraversion was found to be a unique negative correlate of partner accommodation.

Conclusions: These findings highlight the vital role both patient and partner factors play in the accommodation of OCD behaviours by romantic partners and the importance of involving loved ones in the treatment of individuals with OCD.

Objective: Prior research has revealed impaired inhibitory control as a pivotal factor contributing to smokers' struggle to control smoking impulses. However, few studies focus on enhancing smokers' inhibitory control. This study investigates the potential of social rewards to bolster inhibitory control among smokers and elucidates the underlying mechanisms.

Methods: In Experiment 1, a reward-based Go/Nogo paradigm assessed error rates and reaction times for 30 smokers exposed to social reward and neutral feedback in distinct contexts (smoking-related and neutral). Experiment 2 used a modified paradigm, incorporating cognitive load manipulation, to investigate error rates, reaction times, N2, and P3 ERPs among 32 smokers facing social reward and neutral feedback under different cognitive loads (high and low).

Results: Smokers exhibit lower Nogo error rates with social reward feedback; higher error rates occur with smoking cues and high cognitive load; increased N2, P3 amplitudes under social reward versus neutral feedback; low cognitive load enhances P3 amplitude under social reward.

Conclusion: Social reward improves smokers' inhibitory control, but this effect weakens with exposure to smoking cues; higher cognitive load further diminishes the enhancement of smokers' inhibitory control by social reward under smoking cues.