Klara Olofsdotter Lauri, Kristina Aspvall, Ingvill Bagøien Hustad, Karin Malmqvist, Eva Serlachius, David Mataix-Cols, Christian Rück, Volen Ivanov, Erik Andersson
Objectives
The current study evaluated the feasibility of an internet-delivered cognitive therapy (I-CT) in a self-help format with minimal therapist support for patients with obsessive–compulsive disorder (OCD) with primary taboo obsessions. Specifically, the aims were to investigate (1) whether participants were able to grasp and apply the internet-delivered cognitive framework to their own situation; (2) whether they had clinically meaningful reductions of OCD symptom severity; and (3) whether reduced negative appraisals (hypothesized mechanism of change in CT) preceded reductions in OCD symptom severity.
Method
Nineteen OCD patients with primary taboo obsessions, recruited from an OCD clinic or self-referrals, received the I-CT intervention for 10 weeks. I-CT did not contain any systematic exposure or response prevention.
Results
Adherence and engagement with the intervention was high. Most participants (n = 13, 68%) understood and successfully applied the cognitive model to their own situation. Within-group analyses showed large reductions in OCD symptom severity at post-treatment (bootstrapped within group d = 1.67 [95% CI; 0.67 to 2.66]) measured with the Yale–Brown Obsessive–Compulsive Scale. The gains were maintained at the 6-month follow-up. Post-hoc analyses revealed that the large reductions in OCD symptom severity were driven by the participants who understood the cognitive model. Reductions in negative appraisals predicted subsequent reductions in OCD symptom severity during treatment.
Conclusion
It is possible to adapt a purely cognitive intervention to a digital guided self-help format and to achieve both cognitive change and meaningful symptom reduction. The results require confirmation in a randomized clinical trial.
{"title":"Initial evaluation of a therapist-supported online cognitive therapy self-help for patients with taboo obsessions","authors":"Klara Olofsdotter Lauri, Kristina Aspvall, Ingvill Bagøien Hustad, Karin Malmqvist, Eva Serlachius, David Mataix-Cols, Christian Rück, Volen Ivanov, Erik Andersson","doi":"10.1111/bjc.12369","DOIUrl":"10.1111/bjc.12369","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The current study evaluated the feasibility of an internet-delivered cognitive therapy (I-CT) in a self-help format with minimal therapist support for patients with obsessive–compulsive disorder (OCD) with primary taboo obsessions. Specifically, the aims were to investigate (1) whether participants were able to grasp and apply the internet-delivered cognitive framework to their own situation; (2) whether they had clinically meaningful reductions of OCD symptom severity; and (3) whether reduced negative appraisals (hypothesized mechanism of change in CT) preceded reductions in OCD symptom severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Nineteen OCD patients with primary taboo obsessions, recruited from an OCD clinic or self-referrals, received the I-CT intervention for 10 weeks. I-CT did not contain any systematic exposure or response prevention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Adherence and engagement with the intervention was high. Most participants (<i>n</i> = 13, 68%) understood and successfully applied the cognitive model to their own situation. Within-group analyses showed large reductions in OCD symptom severity at post-treatment (bootstrapped within group <i>d</i> = 1.67 [95% CI; 0.67 to 2.66]) measured with the Yale–Brown Obsessive–Compulsive Scale. The gains were maintained at the 6-month follow-up. Post-hoc analyses revealed that the large reductions in OCD symptom severity were driven by the participants who understood the cognitive model. Reductions in negative appraisals predicted subsequent reductions in OCD symptom severity during treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>It is possible to adapt a purely cognitive intervention to a digital guided self-help format and to achieve both cognitive change and meaningful symptom reduction. The results require confirmation in a randomized clinical trial.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"61 4","pages":"964-982"},"PeriodicalIF":3.1,"publicationDate":"2022-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/e2/BJC-61-964.PMC9790335.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10435750","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}
Although self-compassion has been shown to facilitate eating disorder (ED) remission, significant barriers to acquiring this skill have been identified. This is particularly true for tertiary care populations, where ED behaviours provide a valued identity and readiness issues are highly salient. In this research, the voices and perspectives of patients who have recovered as well as those in later stages of tertiary care treatment were captured using qualitative methods.
Methods
Seventeen individuals with a lengthy ED history (seven fully recovered, 10 currently in recovery-focused residential treatment) participated in audio recorded interviews. Using a visual timeline, participants described the development of their understanding of self-compassion, barriers to self-compassion and how these barriers were overcome.
Results
Three processes were identified, reflecting different levels of readiness. Challenging my beliefs involved overcoming cognitive barriers to the concept of self-compassion (i.e. coming to see self-compassion as helpful), and set the stage for dealing with the world around me and rolling up my sleeves, which reflected preparatory (i.e. freeing oneself from difficult life circumstances) and active (i.e. having the courage to do the work) change efforts, respectively.
Conclusions
These findings may help patients embarking on tertiary care treatment to envision a roadmap of supportive processes and help clinicians tailor interventions to patient level of readiness for self-compassion.
{"title":"Path to practising self-compassion in a tertiary eating disorders treatment program: A qualitative analysis","authors":"Josie Geller, Avarna Fernandes, Suja Srikameswaran, Rachelle Pullmer, Sheila Marshall","doi":"10.1111/bjc.12370","DOIUrl":"https://doi.org/10.1111/bjc.12370","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Although self-compassion has been shown to facilitate eating disorder (ED) remission, significant barriers to acquiring this skill have been identified. This is particularly true for tertiary care populations, where ED behaviours provide a valued identity and readiness issues are highly salient. In this research, the voices and perspectives of patients who have recovered as well as those in later stages of tertiary care treatment were captured using qualitative methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventeen individuals with a lengthy ED history (seven fully recovered, 10 currently in recovery-focused residential treatment) participated in audio recorded interviews. Using a visual timeline, participants described the development of their understanding of self-compassion, barriers to self-compassion and how these barriers were overcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three processes were identified, reflecting different levels of readiness. <i>Challenging my beliefs</i> involved overcoming cognitive barriers to the concept of self-compassion (i.e. coming to see self-compassion as helpful), and set the stage for <i>dealing with the world around me</i> and <i>rolling up my sleeves</i>, which reflected preparatory (i.e. freeing oneself from difficult life circumstances) and active (i.e. having the courage to do the work) change efforts, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings may help patients embarking on tertiary care treatment to envision a roadmap of supportive processes and help clinicians tailor interventions to patient level of readiness for self-compassion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"61 4","pages":"983-997"},"PeriodicalIF":3.1,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71954316","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}
Amy E. Joubert, Michelle L. Moulds, Aliza Werner-Seidler, Maria Sharrock, Bojana Popovic, Jill M. Newby
Objectives
Rumination and worry have been implicated in the onset, severity, maintenance and relapse risk of depression and anxiety disorders. Despite this, little research has examined individuals' personal experiences of these processes. This study investigates how individuals experience these processes, which will provide insight into these common features of mental disorders and inform the development of an online intervention specifically targeting rumination and worry.
Design
An online qualitative survey was conducted to gain insight into people's personal definitions, experiences with and understandings of rumination and worry.
Methods
Participants answered open- and close-ended questions about their personal understanding of rumination and worry, typical thought content, triggers, frequency, duration and coping strategies. Participant responses were coded into themes. Participants also completed self-report questionnaires of depression, anxiety and stress and repetitive negative thinking.
Results
Two hundred and seven adults completed the online survey (76% female; mean age = 28.2 years, range = 17–71), 51% of whom reported previously experiencing depression and anxiety. All participants were familiar with the concept of worry, whereas 28% of participants indicated they had never heard of rumination. Participants reported most commonly ruminating and/or worrying about personal relationships, past mistakes, negative experiences and conversations/social interactions. The most commonly reported triggers for rumination and/or worry were social situations/interpersonal interactions (25%) and negative events/experiences (24%). Distraction was the most common coping strategy (48%); however, 21% reported being unable to stop themselves from ruminating and/or worrying.
Conclusions
The results provide a unique insight into the personal experiences and understandings of rumination and worry of potential end users of treatment programs targeting these processes.
{"title":"Understanding the experience of rumination and worry: A descriptive qualitative survey study","authors":"Amy E. Joubert, Michelle L. Moulds, Aliza Werner-Seidler, Maria Sharrock, Bojana Popovic, Jill M. Newby","doi":"10.1111/bjc.12367","DOIUrl":"10.1111/bjc.12367","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Rumination and worry have been implicated in the onset, severity, maintenance and relapse risk of depression and anxiety disorders. Despite this, little research has examined individuals' personal experiences of these processes. This study investigates how individuals experience these processes, which will provide insight into these common features of mental disorders and inform the development of an online intervention specifically targeting rumination and worry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>An online qualitative survey was conducted to gain insight into people's personal definitions, experiences with and understandings of rumination and worry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants answered open- and close-ended questions about their personal understanding of rumination and worry, typical thought content, triggers, frequency, duration and coping strategies. Participant responses were coded into themes. Participants also completed self-report questionnaires of depression, anxiety and stress and repetitive negative thinking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred and seven adults completed the online survey (76% female; mean age = 28.2 years, range = 17–71), 51% of whom reported previously experiencing depression and anxiety. All participants were familiar with the concept of worry, whereas 28% of participants indicated they had never heard of rumination. Participants reported most commonly ruminating and/or worrying about personal relationships, past mistakes, negative experiences and conversations/social interactions. The most commonly reported triggers for rumination and/or worry were social situations/interpersonal interactions (25%) and negative events/experiences (24%). Distraction was the most common coping strategy (48%); however, 21% reported being unable to stop themselves from ruminating and/or worrying.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results provide a unique insight into the personal experiences and understandings of rumination and worry of potential end users of treatment programs targeting these processes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"61 4","pages":"929-946"},"PeriodicalIF":3.1,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/54/8f/BJC-61-929.PMC9790473.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10502924","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}
Lance L. Hawley, Lance M. Rappaport, Christine A. Padesky, Steven D. Hollon, Enza Mancuso, Judith M. Laposa, Karen Brozina, Zindel V. Segal
Objectives
This study examined whether ‘personality vulnerability’ (i.e., self-critical perfectionism or dependency) predicts the trajectory of change, as well as variability and instability (i.e., entropy) of symptoms, during cognitive behaviour therapy (CBT) for depression.
Design
Study participants were outpatients (N = 312) experiencing a primary mood disorder. Participants received CBT for depression group sessions over 15 weeks. Self-report measures of self-critical perfectionism, dependency, and depression were collected longitudinally.
Methods
A latent growth mixture modelling (LGMM) statistical approach was used to evaluate the presence of latent classes of individuals based on their longitudinal pattern of symptom change during CBT and to evaluate whether baseline self-critical perfectionism or dependency predicts class membership. A Latent Acceleration Score (LAS) model evaluated whether perfectionism or dependency led to variability in depression symptom change (e.g., velocity) by considering changes in velocity (e.g., acceleration and/or deceleration).
Results
LGMM indicated the presence of two latent classes that represent symptom improvement (N = 239) or minimal symptom improvement over time (N = 73). Elevated baseline self-critical perfectionism, but not dependency, predicted a greater likelihood of membership in the class of participants who demonstrated minimal symptom improvement over time. The second analysis examined whether baseline self-critical perfectionism also predicts depression symptom variability and instability. The LAS perfectionism model demonstrated that perfectionism accelerates depression symptom change during the first seven sessions of treatment, then has a decelerating effect on depression symptom change.
Conclusions
Results indicated that higher baseline self-critical perfectionism predicted higher variability and instability in depression symptoms and variability in acceleration and deceleration, over the course of treatment.
{"title":"Self-critical perfectionism, dependency and entropy during cognitive behavioural therapy for depression","authors":"Lance L. Hawley, Lance M. Rappaport, Christine A. Padesky, Steven D. Hollon, Enza Mancuso, Judith M. Laposa, Karen Brozina, Zindel V. Segal","doi":"10.1111/bjc.12366","DOIUrl":"https://doi.org/10.1111/bjc.12366","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study examined whether ‘personality vulnerability’ (i.e., self-critical perfectionism or dependency) predicts the trajectory of change, as well as variability and instability (i.e., entropy) of symptoms, during cognitive behaviour therapy (CBT) for depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Study participants were outpatients (<i>N </i>= 312) experiencing a primary mood disorder. Participants received CBT for depression group sessions over 15 weeks. Self-report measures of self-critical perfectionism, dependency, and depression were collected longitudinally.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A latent growth mixture modelling (LGMM) statistical approach was used to evaluate the presence of latent classes of individuals based on their longitudinal pattern of symptom change during CBT and to evaluate whether baseline self-critical perfectionism or dependency predicts class membership. A Latent Acceleration Score (LAS) model evaluated whether perfectionism or dependency led to variability in depression symptom change (e.g., velocity) by considering changes in velocity (e.g., acceleration and/or deceleration).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>LGMM indicated the presence of two latent classes that represent symptom improvement (<i>N </i>= 239) or minimal symptom improvement over time (<i>N </i>= 73). Elevated baseline self-critical perfectionism, but not dependency, predicted a greater likelihood of membership in the class of participants who demonstrated minimal symptom improvement over time. The second analysis examined whether baseline self-critical perfectionism also predicts depression symptom variability and instability. The LAS perfectionism model demonstrated that perfectionism accelerates depression symptom change during the first seven sessions of treatment, then has a decelerating effect on depression symptom change.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Results indicated that higher baseline self-critical perfectionism predicted higher variability and instability in depression symptoms and variability in acceleration and deceleration, over the course of treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"61 4","pages":"911-928"},"PeriodicalIF":3.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71928953","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}
Julie Marie Brandt, Nicoline Hemager, Maja Gregersen, Anne Søndergaard, Mette Falkenberg Krantz, Jessica Ohland, Martin Wilms, Sinnika Birkehøj Rohd, Carsten Hjorthøj, Lotte Veddum, Christina Bruun Knudsen, Anna Krogh Andreassen, Aja Greve, Katrine Søborg Spang, Camilla Austa Christiani, Ditte Ellersgaard, Birgitte Klee Burton, Ditte Lou Gantriis, Vibeke Bliksted, Ole Mors, Kerstin Jessica Plessen, Jens Richardt Møllegaard Jepsen, Merete Nordentoft, Anne Amalie Elgaard Thorup
Objectives
Childhood trauma increases the risk of developing mental illness as does being born to parents with schizophrenia or bipolar disorder. We aimed to compare prevalence of lifetime childhood trauma among 11-year-old children at familial high risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) compared with population-based controls (PBCs).
Design
The study is a longitudinal, prospective cohort study of children at FHR-SZ, FHR-BP, and PBCs.
Methods
A cohort of 512 children at FHR-SZ (N = 199), FHR-BP (N = 118), and PBCs (N = 195) were examined at baseline (mean age 7.8, SD 0.2) and 451 children at FHR-SZ (N = 172), FHR-BP (N = 104), and PBCs (N = 175) were examined at four-year follow-up (mean age 11.9, SD 0.2, retention rate 87.3%). Childhood trauma was measured with a semi-structured interview.
Results
Children at FHR-BP had an elevated risk of exposure to any lifetime trauma (age 0–11 years) compared with PBCs (OR 2.082, 95%CI 1.223–3.545, p = .007) measured with binary logistic regression. One-way ANOVA revealed that both FHR-groups had a higher lifetime prevalence of exposure to a greater number of types of trauma compared with PBCs (FHR-SZ: observed mean: 1.53, 95%CI 1.29–1.77; FHR-BP: observed mean: 1.56, 95%CI 1.26–1.85; PBCs: observed mean: 0.99, 95%CI 0.82–1.17; p < .001). Binary logistic regression showed that the lifetime risk of exposure to interpersonal trauma (age 0–11 years) was elevated for both FHR-groups (FHR-SZ: OR 3.773, 95%CI 2.122–6.710, p < .001; FHR-BP: OR 3.602, 95%CI 1.913–6.783, p < .001).
Conclusions
Children at FHR-SZ and FHR-BP are at increased risk for being exposed to childhood trauma compared with PBCs. This study underscores the need for early detection, support, and prevention of childhood trauma in children at FHR-SZ and FHR-BP.
童年创伤会增加患精神疾病的风险，父母患有精神分裂症或双相情感障碍也是如此。我们的目的是比较家族性精神分裂症(FHR-SZ)或双相情感障碍(FHR-BP)高风险的11岁儿童与基于人群的对照组(pbc)的终生儿童创伤患病率。本研究是一项纵向、前瞻性队列研究，研究对象为FHR-SZ、FHR-BP和pbc患儿。方法选取基线时FHR-SZ患儿512例(N = 199)、FHR-BP患儿118例(N = 118)、pbc患儿195例(平均年龄7.8岁，SD 0.2)， 4年随访时FHR-SZ患儿172例(N = 172)、FHR-BP患儿104例(N = 104)、pbc患儿175例(平均年龄11.9岁，SD 0.2，保留率87.3%)。儿童创伤是通过半结构化访谈来测量的。结果与PBCs相比，FHR-BP患儿暴露于任何终身创伤(0-11岁)的风险较高(OR 2.082, 95%CI 1.223-3.545, p = 0.007)。单因素方差分析显示，与PBCs相比，两个fhr组都有更高的终生暴露于更多类型创伤的患病率(FHR-SZ:观察平均值:1.53,95%CI 1.29-1.77;FHR-BP:观察平均值:1.56,95%CI 1.26-1.85;PBCs:观察平均值:0.99,95%CI 0.82-1.17;p & lt;措施)。二元logistic回归分析显示，两组儿童终生暴露于人际创伤(0 ~ 11岁)的风险均升高(FHR-SZ: OR 3.773, 95%CI 2.122 ~ 6.710, p <措施;FHR-BP: OR 3.602, 95%CI 1.913-6.783, p <措施)。结论:与PBCs相比，FHR-SZ和FHR-BP组儿童暴露于儿童创伤的风险更高。这项研究强调了在FHR-SZ和FHR-BP患儿中早期发现、支持和预防儿童创伤的必要性。
{"title":"Childhood trauma in children at familial high risk of schizophrenia or bipolar disorder: A longitudinal study. The Danish High Risk and Resilience Study – VIA 7 and VIA 11","authors":"Julie Marie Brandt, Nicoline Hemager, Maja Gregersen, Anne Søndergaard, Mette Falkenberg Krantz, Jessica Ohland, Martin Wilms, Sinnika Birkehøj Rohd, Carsten Hjorthøj, Lotte Veddum, Christina Bruun Knudsen, Anna Krogh Andreassen, Aja Greve, Katrine Søborg Spang, Camilla Austa Christiani, Ditte Ellersgaard, Birgitte Klee Burton, Ditte Lou Gantriis, Vibeke Bliksted, Ole Mors, Kerstin Jessica Plessen, Jens Richardt Møllegaard Jepsen, Merete Nordentoft, Anne Amalie Elgaard Thorup","doi":"10.1111/bjc.12364","DOIUrl":"10.1111/bjc.12364","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Childhood trauma increases the risk of developing mental illness as does being born to parents with schizophrenia or bipolar disorder. We aimed to compare prevalence of lifetime childhood trauma among 11-year-old children at familial high risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) compared with population-based controls (PBCs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>The study is a longitudinal, prospective cohort study of children at FHR-SZ, FHR-BP, and PBCs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cohort of 512 children at FHR-SZ (<i>N </i>= 199), FHR-BP (<i>N </i>= 118), and PBCs (<i>N </i>= 195) were examined at baseline (mean age 7.8, SD 0.2) and 451 children at FHR-SZ (<i>N </i>= 172), FHR-BP (<i>N </i>= 104), and PBCs (<i>N </i>= 175) were examined at four-year follow-up (mean age 11.9, SD 0.2, retention rate 87.3%). Childhood trauma was measured with a semi-structured interview.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Children at FHR-BP had an elevated risk of exposure to any lifetime trauma (age 0–11 years) compared with PBCs (OR 2.082, 95%CI 1.223–3.545, <i>p</i> = .007) measured with binary logistic regression. One-way ANOVA revealed that both FHR-groups had a higher lifetime prevalence of exposure to a greater number of types of trauma compared with PBCs (FHR-SZ: observed mean: 1.53, 95%CI 1.29–1.77; FHR-BP: observed mean: 1.56, 95%CI 1.26–1.85; PBCs: observed mean: 0.99, 95%CI 0.82–1.17; <i>p</i> < .001). Binary logistic regression showed that the lifetime risk of exposure to interpersonal trauma (age 0–11 years) was elevated for both FHR-groups (FHR-SZ: OR 3.773, 95%CI 2.122–6.710, <i>p</i> < .001; FHR-BP: OR 3.602, 95%CI 1.913–6.783, <i>p</i> < .001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Children at FHR-SZ and FHR-BP are at increased risk for being exposed to childhood trauma compared with PBCs. This study underscores the need for early detection, support, and prevention of childhood trauma in children at FHR-SZ and FHR-BP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"61 4","pages":"875-894"},"PeriodicalIF":3.1,"publicationDate":"2022-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40327622","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}
Oskar Flygare, Lina Lundström, Erik Andersson, David Mataix-Cols, Christian Rück
Objectives
Digital therapies such as internet-delivered cognitive behaviour therapy (ICBT) can improve treatment access for patients with common mental disorders, but are rarely used in the Improving Access to Psychological Therapies (IAPT) programme in the United Kingdom. The objective of this study was to evaluate an evidence-based ICBT intervention for obsessive-compulsive disorder (OCD-NET) in three IAPT services in an open trial.
Methods
Consecutively referred patients with a primary diagnosis of OCD (n = 474) were offered OCD-NET. Symptoms of OCD, depression, anxiety, and level of functioning were measured weekly throughout treatment.
Results
In the full intention to treat sample (n = 474), the intervention was associated with large reductions in self-reported OCD symptoms (d = 1.77), anxiety (d = 1.55) and depression (d = 0.8), as well as improvements in functional impairment (d = 0.51 to 0.72). Further, 35% of participants were in recovery at their last assessment, 25% achieved reliable improvement and 15% met criteria for both recovery and improvement. Among participants completing at least 4 modules (n = 261), corresponding to an adequate ‘dose’ of treatment, the rates of recovery (44%), reliable improvement (34%) and reliable recovery (21%) were higher. A majority of participants were satisfied with the online treatment and found the online materials helpful.
Conclusions
OCD-NET is an effective treatment when delivered in regular care within the IAPT system. Challenges associated with implementing ICBT in regular health care are discussed.
{"title":"Implementing therapist-guided internet-delivered cognitive behaviour therapy for obsessive–compulsive disorder in the UK’s IAPT programme: A pilot trial","authors":"Oskar Flygare, Lina Lundström, Erik Andersson, David Mataix-Cols, Christian Rück","doi":"10.1111/bjc.12365","DOIUrl":"10.1111/bjc.12365","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Digital therapies such as internet-delivered cognitive behaviour therapy (ICBT) can improve treatment access for patients with common mental disorders, but are rarely used in the Improving Access to Psychological Therapies (IAPT) programme in the United Kingdom. The objective of this study was to evaluate an evidence-based ICBT intervention for obsessive-compulsive disorder (OCD-NET) in three IAPT services in an open trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Consecutively referred patients with a primary diagnosis of OCD (<i>n </i>= 474) were offered OCD-NET. Symptoms of OCD, depression, anxiety, and level of functioning were measured weekly throughout treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the full intention to treat sample (<i>n </i>= 474), the intervention was associated with large reductions in self-reported OCD symptoms (<i>d</i> = 1.77), anxiety (<i>d</i> = 1.55) and depression (<i>d</i> = 0.8), as well as improvements in functional impairment (<i>d</i> = 0.51 to 0.72). Further, 35% of participants were in recovery at their last assessment, 25% achieved reliable improvement and 15% met criteria for both recovery and improvement. Among participants completing at least 4 modules (<i>n </i>= 261), corresponding to an adequate ‘dose’ of treatment, the rates of recovery (44%), reliable improvement (34%) and reliable recovery (21%) were higher. A majority of participants were satisfied with the online treatment and found the online materials helpful.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>OCD-NET is an effective treatment when delivered in regular care within the IAPT system. Challenges associated with implementing ICBT in regular health care are discussed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"61 4","pages":"895-910"},"PeriodicalIF":3.1,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9790702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10435261","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}
Melissa J. Green, Kirstie O’Hare, Kristin R. Laurens, Stacy Tzoumakis, Kimberlie Dean, Johanna C. Badcock, Felicity Harris, Richard J. Linscott, Vaughan J. Carr
<div> <section> <h3> Objectives</h3> <p>The detection of young people at high risk for psychotic disorders has been somewhat narrowly focused on overt symptom-based markers that reflect mild reality distortion (e.g., psychotic-like experiences), or prodromal syndromes that are proximal to psychosis onset. The concept of schizotypy represents a broader framework for investigating risk for schizophrenia (and other disorders) in childhood, before the onset of prodromal or overt symptoms. We sought to detect profiles of risk for psychosis (schizotypy) in a general population sample of 22,137 Australian children aged 11–12 years, and to determine early life risk factors associated with these profiles from data available in linked records (registers).</p> </section> <section> <h3> Methods</h3> <p>Fifty-nine self-reported items were used as indicators of schizotypy across six broad domains; <i>z</i>-scores for each domain were subjected to latent profile analyses (LPA). A series of multinomial logistic regressions was used to examine the association between resulting profile (class) membership and several childhood and parental risk factors, and the proportion of children with mental disorders among each schizotypy profile was examined.</p> </section> <section> <h3> Results</h3> <p>The LPA revealed three person-centred profiles referred to as <i>True Schizotypy</i> (<i>n</i> = 1,323; 6.0%), <i>Introverted Schizotypy</i> (<i>n</i> = 4,473; 20.2%), and <i>Affective Schizotypy</i> (<i>n</i> = 4,261; 19.2%), as well as a group of children showing no risk (<i>n</i> = 12,080; 54.6%). Prior exposure to perinatal and familial adversities including childhood maltreatment, as well as poor early childhood development and academic functioning, was variously associated with all risk groups. There was a higher proportion of childhood mental disorder diagnoses among children in the <i>True Schizotypy</i> group, relative to other profiles.</p> </section> <section> <h3> Conclusion</h3> <p>Subtle differences in the pattern of exposures and antecedents among schizophrenia liability profiles in childhood may reflect distinct pathogenic pathways to psychotic or other mental illness.</p> </section> <section> <h3> Practitioner points</h3> <div> <ul> <li>Children aged 11–12 years report characteristics of schizotypy which can be classified into three distinct profiles that may represent diff
{"title":"Developmental profiles of schizotypy in the general population: A record linkage study of Australian children aged 11–12 years","authors":"Melissa J. Green, Kirstie O’Hare, Kristin R. Laurens, Stacy Tzoumakis, Kimberlie Dean, Johanna C. Badcock, Felicity Harris, Richard J. Linscott, Vaughan J. Carr","doi":"10.1111/bjc.12363","DOIUrl":"https://doi.org/10.1111/bjc.12363","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The detection of young people at high risk for psychotic disorders has been somewhat narrowly focused on overt symptom-based markers that reflect mild reality distortion (e.g., psychotic-like experiences), or prodromal syndromes that are proximal to psychosis onset. The concept of schizotypy represents a broader framework for investigating risk for schizophrenia (and other disorders) in childhood, before the onset of prodromal or overt symptoms. We sought to detect profiles of risk for psychosis (schizotypy) in a general population sample of 22,137 Australian children aged 11–12 years, and to determine early life risk factors associated with these profiles from data available in linked records (registers).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty-nine self-reported items were used as indicators of schizotypy across six broad domains; <i>z</i>-scores for each domain were subjected to latent profile analyses (LPA). A series of multinomial logistic regressions was used to examine the association between resulting profile (class) membership and several childhood and parental risk factors, and the proportion of children with mental disorders among each schizotypy profile was examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The LPA revealed three person-centred profiles referred to as <i>True Schizotypy</i> (<i>n</i> = 1,323; 6.0%), <i>Introverted Schizotypy</i> (<i>n</i> = 4,473; 20.2%), and <i>Affective Schizotypy</i> (<i>n</i> = 4,261; 19.2%), as well as a group of children showing no risk (<i>n</i> = 12,080; 54.6%). Prior exposure to perinatal and familial adversities including childhood maltreatment, as well as poor early childhood development and academic functioning, was variously associated with all risk groups. There was a higher proportion of childhood mental disorder diagnoses among children in the <i>True Schizotypy</i> group, relative to other profiles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Subtle differences in the pattern of exposures and antecedents among schizophrenia liability profiles in childhood may reflect distinct pathogenic pathways to psychotic or other mental illness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practitioner points</h3>\u0000 \u0000 <div>\u0000 \u0000 <ul>\u0000 \u0000 \u0000 <li>Children aged 11–12 years report characteristics of schizotypy which can be classified into three distinct profiles that may represent diff","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"61 3","pages":"836-858"},"PeriodicalIF":3.1,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/bjc.12363","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71933176","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}
Monica Sood, Katherine B. Carnelley, Katherine Newman-Taylor
<div> <section> <h3> Background</h3> <p>The relationship between attachment and paranoia is now well established. There is good theoretical reason and evidence to indicate that attachment style affects cognitive, affective, and behavioural processes which, in turn, contribute to the maintenance of paranoia, but this research has not been integrated. We critically and systematically review research that examines relevant cognitive, affective, and behavioural processes, which may explain how attachment insecurity leads to paranoia and constitute key targets in psychotherapeutic interventions for people with psychosis.</p> </section> <section> <h3> Method</h3> <p>We conducted three systematic searches across six databases (PsycINFO, CINAHL, Medline, Web of Science, Embase, and Google Scholar), from inception to September 2021, to investigate key cognitive, affective, and behavioural processes in the attachment–paranoia association.</p> </section> <section> <h3> Results</h3> <p>We identified a total of 1930 papers and critically reviewed 16. The literature suggests that negative self- and other-beliefs, inability to defuse from unhelpful cognitions, and use of maladaptive emotion regulation strategies mediate the association between attachment insecurity and paranoia in people with psychosis/psychotic experience. Attachment-secure people with psychosis are more likely to seek help and engage with services than attachment-insecure people.</p> </section> <section> <h3> Conclusions</h3> <p>Attachment styles impact help-seeking behaviours in people with psychosis and are likely to influence paranoia via self- and other-beliefs, cognition fusion, and emotion regulation – these candidate mechanisms may be targeted in psychological therapy to improve clinical outcomes for people with psychosis, characterized by paranoia.</p> </section> <section> <h3> Practitioner points</h3> <div> <ul> <li>Insecure attachment is likely to lead to paranoia via negative beliefs about self and others, cognitive fusion, and use of maladaptive emotion regulation strategies. These mechanisms can be targeted in psychotherapeutic interventions for psychosis, such as cognitive behaviour therapy, to improve clinical and recovery outcomes.</li> <li>People with psychosis who are attachment-secure are more likely to seek help and engage
依恋和偏执之间的关系现在已经得到了很好的证实。有很好的理论依据和证据表明，依恋类型影响认知、情感和行为过程，而这些过程反过来又有助于偏执的维持，但这一研究尚未得到整合。我们批判性地、系统地回顾了有关认知、情感和行为过程的研究，这些研究可以解释依恋不安全感如何导致偏执，并构成精神病患者心理治疗干预的关键目标。方法:从成立到2021年9月，我们对六个数据库(PsycINFO, CINAHL, Medline, Web of Science, Embase和谷歌Scholar)进行了三次系统搜索，以调查依恋-偏执关联中的关键认知、情感和行为过程。结果我们共收录了1930篇论文，并对其中16篇进行了批判性审查。文献表明，消极的自我和他人信念，无法从无益的认知中解脱，以及使用适应不良的情绪调节策略介导了精神病/精神病经历患者依恋不安全感与偏执之间的联系。依恋安全型精神病患者比依恋安全型精神病患者更有可能寻求帮助和参与服务。结论依恋类型影响精神病患者的求助行为，并可能通过自我和他人信念、认知融合和情绪调节影响偏执，这些可能的机制可以作为心理治疗的目标，以改善偏执精神病患者的临床结果。从业人员指出，不安全依恋可能通过对自我和他人的消极信念、认知融合和使用适应不良的情绪调节策略而导致偏执。这些机制可以作为精神病心理治疗干预的目标，如认知行为治疗，以改善临床和康复结果。依恋安全型精神病患者比依恋安全型精神病患者(尤其是回避型精神病患者)更有可能寻求帮助并参与服务。依恋类型可以通过评估来预测精神病患者的服务投入和求助行为。依恋类型是精神病患者关键认知、情感和行为过程的重要预测因子。可以对这些过程进行评估，并将其纳入个体化方案，然后在治疗中进行针对性治疗，以实现心理治疗的改变。
{"title":"How does insecure attachment lead to paranoia? A systematic critical review of cognitive, affective, and behavioural mechanisms","authors":"Monica Sood, Katherine B. Carnelley, Katherine Newman-Taylor","doi":"10.1111/bjc.12361","DOIUrl":"10.1111/bjc.12361","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The relationship between attachment and paranoia is now well established. There is good theoretical reason and evidence to indicate that attachment style affects cognitive, affective, and behavioural processes which, in turn, contribute to the maintenance of paranoia, but this research has not been integrated. We critically and systematically review research that examines relevant cognitive, affective, and behavioural processes, which may explain how attachment insecurity leads to paranoia and constitute key targets in psychotherapeutic interventions for people with psychosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We conducted three systematic searches across six databases (PsycINFO, CINAHL, Medline, Web of Science, Embase, and Google Scholar), from inception to September 2021, to investigate key cognitive, affective, and behavioural processes in the attachment–paranoia association.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified a total of 1930 papers and critically reviewed 16. The literature suggests that negative self- and other-beliefs, inability to defuse from unhelpful cognitions, and use of maladaptive emotion regulation strategies mediate the association between attachment insecurity and paranoia in people with psychosis/psychotic experience. Attachment-secure people with psychosis are more likely to seek help and engage with services than attachment-insecure people.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Attachment styles impact help-seeking behaviours in people with psychosis and are likely to influence paranoia via self- and other-beliefs, cognition fusion, and emotion regulation – these candidate mechanisms may be targeted in psychological therapy to improve clinical outcomes for people with psychosis, characterized by paranoia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practitioner points</h3>\u0000 \u0000 <div>\u0000 \u0000 <ul>\u0000 \u0000 \u0000 <li>Insecure attachment is likely to lead to paranoia via negative beliefs about self and others, cognitive fusion, and use of maladaptive emotion regulation strategies. These mechanisms can be targeted in psychotherapeutic interventions for psychosis, such as cognitive behaviour therapy, to improve clinical and recovery outcomes.</li>\u0000 \u0000 \u0000 <li>People with psychosis who are attachment-secure are more likely to seek help and engage ","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"61 3","pages":"781-815"},"PeriodicalIF":3.1,"publicationDate":"2022-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9542899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39934576","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}
Lena Jelinek, Gloria Röhrig, Steffen Moritz, Anja S. Göritz, Ulrich Voderholzer, Anja Riesel, Amir H. Yassari, Franziska Miegel
<div> <section> <h3> Objective</h3> <p>Unrealistic pessimism (UP) is an aspect of overestimation of threat (OET) that has been associated with obsessive-compulsive disorder/symptoms (OCD/OCS). During the COVID-19 pandemic, UP may have played an important role in the course of OCD. To investigate the relationship, we conducted two longitudinal studies assuming that higher UP predicts an increase in OCS.</p> </section> <section> <h3> Method</h3> <p>In Study 1, we investigated UP in the general population (<i>N</i> = 1,184) at the start of the pandemic asking about overall vulnerability to infection with SARS-CoV-2 and UP regarding infection and outcome of severe illness. Further, OCS status (OCS+/−) was assessed at the start of the pandemic and 3 months later. In Study 2, we investigated UP in individuals with OCD (<i>N</i> = 268) regarding the likelihood of getting infected, recovering, or dying from an infection with SARS-CoV-2 at the start of the pandemic and re-assessed OCS 3 months later.</p> </section> <section> <h3> Results</h3> <p>In Study 1, UP was higher in the OCS+ compared to the OCS− group, and estimates of a higher overall vulnerability for an infection predicted a decrease in OCS over time. UP regarding severe illness predicted an increase in symptoms over time. In Study 2, UP was found for a recovery and death after an infection with SARS-CoV-2, but not for infection itself.</p> </section> <section> <h3> Conclusions</h3> <p>Exaggeration of one’s personal vulnerability rather than OET per se seems pivotal in OCD, with UP being associated with OCD/OCS+ as well as a more negative course of symptomatology over the pandemic in a nonclinical sample.</p> </section> <section> <h3> Practitioner points</h3> <div> <ul> <li>Unrealistic optimism, a bias common in healthy individuals, is thought to be a coping mechanism promoting well-being in the face of danger or uncertainty.</li> <li>The current study extends findings that its inversion, unrealistic pessimism, may play an important role in obsessive-compulsive disorder and may also be involved in the development of the disorder.</li> <li>This study highlights the importance that prevention programs during a pandemic should include targeting unrealistic pessimism.</li>
{"title":"Unrealistic pessimism and obsessive-compulsive symptoms during the COVID-19 pandemic: Two longitudinal studies","authors":"Lena Jelinek, Gloria Röhrig, Steffen Moritz, Anja S. Göritz, Ulrich Voderholzer, Anja Riesel, Amir H. Yassari, Franziska Miegel","doi":"10.1111/bjc.12362","DOIUrl":"10.1111/bjc.12362","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Unrealistic pessimism (UP) is an aspect of overestimation of threat (OET) that has been associated with obsessive-compulsive disorder/symptoms (OCD/OCS). During the COVID-19 pandemic, UP may have played an important role in the course of OCD. To investigate the relationship, we conducted two longitudinal studies assuming that higher UP predicts an increase in OCS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>In Study 1, we investigated UP in the general population (<i>N</i> = 1,184) at the start of the pandemic asking about overall vulnerability to infection with SARS-CoV-2 and UP regarding infection and outcome of severe illness. Further, OCS status (OCS+/−) was assessed at the start of the pandemic and 3 months later. In Study 2, we investigated UP in individuals with OCD (<i>N</i> = 268) regarding the likelihood of getting infected, recovering, or dying from an infection with SARS-CoV-2 at the start of the pandemic and re-assessed OCS 3 months later.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In Study 1, UP was higher in the OCS+ compared to the OCS− group, and estimates of a higher overall vulnerability for an infection predicted a decrease in OCS over time. UP regarding severe illness predicted an increase in symptoms over time. In Study 2, UP was found for a recovery and death after an infection with SARS-CoV-2, but not for infection itself.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Exaggeration of one’s personal vulnerability rather than OET per se seems pivotal in OCD, with UP being associated with OCD/OCS+ as well as a more negative course of symptomatology over the pandemic in a nonclinical sample.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practitioner points</h3>\u0000 \u0000 <div>\u0000 \u0000 <ul>\u0000 \u0000 \u0000 <li>Unrealistic optimism, a bias common in healthy individuals, is thought to be a coping mechanism promoting well-being in the face of danger or uncertainty.</li>\u0000 \u0000 \u0000 <li>The current study extends findings that its inversion, unrealistic pessimism, may play an important role in obsessive-compulsive disorder and may also be involved in the development of the disorder.</li>\u0000 \u0000 \u0000 <li>This study highlights the importance that prevention programs during a pandemic should include targeting unrealistic pessimism.</li>\u0000 ","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"61 3","pages":"816-835"},"PeriodicalIF":3.1,"publicationDate":"2022-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9111568/pdf/BJC-9999-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39806955","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}
<div> <section> <h3> Background</h3> <p>The COVID-19 pandemic has had a significant impact on mental health. Specifically, the stringent lockdown restrictions have heightened anxiety and depression. Therefore, monitoring and supporting the mental health of the population during these unprecedented times is an immediate priority.</p> </section> <section> <h3> Methods</h3> <p>In this systematic review and meta-analyses, articles that explored the prevalence of anxiety and depression during the first COVID-19 lockdown in the United Kingdom were included. We searched the databases Embase, Medline (PubMed), Web of Science, and PsycINFO for cross-sectional studies. We conducted meta-analyses of prevalence rates using a random-effects model, and the heterogeneity of studies was examined using the <i>I</i><sup>2</sup> index.</p> </section> <section> <h3> Results</h3> <p>Fourteen studies involving 46,158 participants were included in the review. The studies use clinical cut-off scores on anxiety and depression measures to define cases. While the prevalence of anxiety was 31.00% (95% CI = 26.00 to 35.00), the prevalence of depression was 32.00% (95% CI = 29.00 to 35.00). The prevalence of anxiety pre-pandemic was 4.65%, indicating a 26.35% increase. Whereas the prevalence of depression pre-pandemic was 4.12%, indicating a 27.88% increase. Moreover, participants experienced a slightly greater prevalence of depression than anxiety by 1.00%.</p> </section> <section> <h3> Conclusions</h3> <p>To conclude, the first COVID-19 lockdown in the United Kingdom increased the prevalence of anxiety and depression among the general population, compared to pre-pandemic data. Hence, it is vital that policymakers and mental health services maximize their efforts to monitor mental health and provide interventions to support those in need.</p> </section> <section> <h3> Practitioner points</h3> <div> <b>Clinical implications</b> <ul> <li>Awareness of the high prevalence of anxiety and depression during the first lockdown in the United Kingdom can inform policy development that substantial effort, time, and funding of mental health services are required to support those in need.</li> <li>Similarly, awareness of the prevalence of anxiety and depression in the United Kingdom can contribute to the development of n
2019冠状病毒病大流行对心理健康产生了重大影响。具体来说，严格的封锁限制加剧了焦虑和抑郁。因此，在这前所未有的时期监测和支持人口的心理健康是当务之急。方法在这项系统综述和荟萃分析中，纳入了探讨英国首次COVID-19封锁期间焦虑和抑郁患病率的文章。我们检索了Embase、Medline (PubMed)、Web of Science和PsycINFO数据库进行横断面研究。我们使用随机效应模型对患病率进行了荟萃分析，并使用I2指数检查了研究的异质性。结果14项研究共纳入46,158名受试者。这些研究使用焦虑和抑郁指标的临床分值来确定病例。焦虑的患病率为31.00% (95% CI = 26.00 ~ 35.00)，抑郁的患病率为32.00% (95% CI = 29.00 ~ 35.00)。大流行前的焦虑患病率为4.65%，比前增加26.35%。而大流行前抑郁症患病率为4.12%，增加了27.88%。此外，参与者的抑郁患病率略高于焦虑患病率1.00%。总而言之，与大流行前的数据相比，英国第一次COVID-19封锁增加了普通人群中焦虑和抑郁的患病率。因此，至关重要的是，政策制定者和精神卫生服务机构应最大限度地努力监测精神卫生并提供干预措施，以支持有需要的人。认识到英国第一次封锁期间焦虑和抑郁的高发率，可以告知政策制定，需要在精神卫生服务方面投入大量精力、时间和资金，以支持有需要的人。同样，认识到焦虑和抑郁在联合王国的普遍存在，有助于制定针对国家的干预措施和举措。目前的综述集中在英国的普通人群，这并不允许研究结果推广到全球人口。将当前流行率与从不同研究样本中获得的相应大流行前流行率进行间接比较，增加了个体差异，削弱了研究结果的可靠性。
{"title":"Investigating the prevalence of anxiety and depression during the first COVID-19 lockdown in the United Kingdom: Systematic review and meta-analyses","authors":"Luca Marie Dettmann, Sally Adams, Gemma Taylor","doi":"10.1111/bjc.12360","DOIUrl":"10.1111/bjc.12360","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The COVID-19 pandemic has had a significant impact on mental health. Specifically, the stringent lockdown restrictions have heightened anxiety and depression. Therefore, monitoring and supporting the mental health of the population during these unprecedented times is an immediate priority.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this systematic review and meta-analyses, articles that explored the prevalence of anxiety and depression during the first COVID-19 lockdown in the United Kingdom were included. We searched the databases Embase, Medline (PubMed), Web of Science, and PsycINFO for cross-sectional studies. We conducted meta-analyses of prevalence rates using a random-effects model, and the heterogeneity of studies was examined using the <i>I</i><sup>2</sup> index.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen studies involving 46,158 participants were included in the review. The studies use clinical cut-off scores on anxiety and depression measures to define cases. While the prevalence of anxiety was 31.00% (95% CI = 26.00 to 35.00), the prevalence of depression was 32.00% (95% CI = 29.00 to 35.00). The prevalence of anxiety pre-pandemic was 4.65%, indicating a 26.35% increase. Whereas the prevalence of depression pre-pandemic was 4.12%, indicating a 27.88% increase. Moreover, participants experienced a slightly greater prevalence of depression than anxiety by 1.00%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>To conclude, the first COVID-19 lockdown in the United Kingdom increased the prevalence of anxiety and depression among the general population, compared to pre-pandemic data. Hence, it is vital that policymakers and mental health services maximize their efforts to monitor mental health and provide interventions to support those in need.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practitioner points</h3>\u0000 \u0000 <div>\u0000 <b>Clinical implications</b>\u0000 \u0000 <ul>\u0000 \u0000 \u0000 <li>Awareness of the high prevalence of anxiety and depression during the first lockdown in the United Kingdom can inform policy development that substantial effort, time, and funding of mental health services are required to support those in need.</li>\u0000 \u0000 \u0000 <li>Similarly, awareness of the prevalence of anxiety and depression in the United Kingdom can contribute to the development of n","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"61 3","pages":"757-780"},"PeriodicalIF":3.1,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9111383/pdf/BJC-9999-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39778488","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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