Intolerance of uncertainty (IU) is characterized by a pervasive negative reaction to uncertainty. It is a transdiagnostic risk factor for various mental disorders. Since decisions often need to be made in the face of uncertainty, IU is associated with indecisiveness, a dispositional difficulty in making decisions. Indecisiveness is also linked to a range of mental disorders. While IU is seen as a causal factor in indecisiveness, experimental studies on this assumption are lacking.
Methods
In this pre-registered, adequately powered study (N = 301), IU was experimentally increased or decreased compared to a control group, and the effect on indecisiveness was observed. Indecisiveness was assessed in a situational context, focusing on two decisions that were personally relevant to participants.
Results
The manipulation successfully affected IU. As predicted, increased IU led to more indecisiveness across both decisions compared to decreased IU. Exploratory analyses found that situational IU mediated the effect of the experimental manipulation on indecisiveness.
Conclusions
The results are the first to demonstrate a causal effect of IU on indecisiveness, thus contributing to the explanation of indecisiveness and the role that uncertainty management plays in it. Moreover, they have implications for treating various mental disorders by highlighting the role of IU in the transdiagnostic phenomenon of indecisiveness.
{"title":"Intolerance of uncertainty causally affects indecisiveness","authors":"Helmut Appel, Alexander L. Gerlach","doi":"10.1111/bjc.12534","DOIUrl":"10.1111/bjc.12534","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Intolerance of uncertainty (IU) is characterized by a pervasive negative reaction to uncertainty. It is a transdiagnostic risk factor for various mental disorders. Since decisions often need to be made in the face of uncertainty, IU is associated with indecisiveness, a dispositional difficulty in making decisions. Indecisiveness is also linked to a range of mental disorders. While IU is seen as a causal factor in indecisiveness, experimental studies on this assumption are lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this pre-registered, adequately powered study (<i>N</i> = 301), IU was experimentally increased or decreased compared to a control group, and the effect on indecisiveness was observed. Indecisiveness was assessed in a situational context, focusing on two decisions that were personally relevant to participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The manipulation successfully affected IU. As predicted, increased IU led to more indecisiveness across both decisions compared to decreased IU. Exploratory analyses found that situational IU mediated the effect of the experimental manipulation on indecisiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results are the first to demonstrate a causal effect of IU on indecisiveness, thus contributing to the explanation of indecisiveness and the role that uncertainty management plays in it. Moreover, they have implications for treating various mental disorders by highlighting the role of IU in the transdiagnostic phenomenon of indecisiveness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"806-816"},"PeriodicalIF":3.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606748","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}
S. Arnáez, M. Roncero, J. López-Santiago, G. del Valle, E. Cabedo, G. Bottesi, G. García-Soriano
Background
Obsessive-compulsive disorder (OCD) is a disabling disorder, and self-stigma negatively impacts quality of life, symptom severity and self-esteem. esTOCma is a smartphone-based serious game developed to increase knowledge about OCD and reduce stigma. It features 10 missions using psychoeducation, indirect contact and cognitive restructuring. Players help 10 characters escape the OCD stigma monster. Aims: To explore, in individuals with a self-reported diagnosis of OCD, the feasibility, acceptability and preliminary effectiveness of esTOCma to change self-stigma and knowledge about OCD, OC severity, guilt, quality of life and self-esteem.
Materials and Methods
A single-arm pilot study with 130 participants who completed esTOCma and pre-, post- and 3-month follow-up assessments.
Results
Half of participants spent 9–10-days playing with the app and most of them found it useful/very useful and easy to use. Self-stigma was associated with higher OC symptoms, guilt and lower quality of life, self-esteem and knowledge about OCD. After using the app, participants showed lower levels of self-stigma, OC symptoms and guilt, and higher levels of quality of life, self-esteem and knowledge about OCD. Changes were maintained or increased at a 3-month follow-up.
Discussion
esTOCma is a feasible and acceptable app that could help people with OCD to increase their knowledge and understanding of the disorder, dismiss self-stigma and OC symptoms, and at the same time increase self-esteem and quality of life. A replication of the study with a control sample is needed to validate our findings.
Conclusion
Tools like the esTOCma app, accessible 24/7, offer a means to tackle self-stigma detrimental effects.
{"title":"Fighting against self-stigma in adults with self-reported diagnosis of OCD: A single-arm pilot study using a mobile app-based intervention","authors":"S. Arnáez, M. Roncero, J. López-Santiago, G. del Valle, E. Cabedo, G. Bottesi, G. García-Soriano","doi":"10.1111/bjc.12537","DOIUrl":"10.1111/bjc.12537","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Obsessive-compulsive disorder (OCD) is a disabling disorder, and self-stigma negatively impacts quality of life, symptom severity and self-esteem. esTOCma is a smartphone-based serious game developed to increase knowledge about OCD and reduce stigma. It features 10 missions using psychoeducation, indirect contact and cognitive restructuring. Players help 10 characters escape the OCD stigma monster. Aims: To explore, in individuals with a self-reported diagnosis of OCD, the feasibility, acceptability and preliminary effectiveness of esTOCma to change self-stigma and knowledge about OCD, OC severity, guilt, quality of life and self-esteem.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A single-arm pilot study with 130 participants who completed esTOCma and pre-, post- and 3-month follow-up assessments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Half of participants spent 9–10-days playing with the app and most of them found it useful/very useful and easy to use. Self-stigma was associated with higher OC symptoms, guilt and lower quality of life, self-esteem and knowledge about OCD. After using the app, participants showed lower levels of self-stigma, OC symptoms and guilt, and higher levels of quality of life, self-esteem and knowledge about OCD. Changes were maintained or increased at a 3-month follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>esTOCma is a feasible and acceptable app that could help people with OCD to increase their knowledge and understanding of the disorder, dismiss self-stigma and OC symptoms, and at the same time increase self-esteem and quality of life. A replication of the study with a control sample is needed to validate our findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tools like the esTOCma app, accessible 24/7, offer a means to tackle self-stigma detrimental effects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"788-805"},"PeriodicalIF":3.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597853","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}
Amelia S. Dev, Theresa Davison, Hannah C. Broos, Sheri L. Johnson, Kiara R. Timpano
Objectives
The interpersonal-psychological theory of suicide identifies three risk factors for suicidal behaviours: perceived burdensomeness, thwarted belongingness, and acquired capability. We sought to clarify relationships between the interpersonal-psychological risk factors and two individual difference factors, emotion-related impulsivity (ERI) and intolerance of uncertainty (IU).
Methods
In the current study, we analysed self-report scales from a large community sample (N = 169) that was oversampled for individuals with elevated suicidality. We considered two separate factors of ERI: Pervasive Influence of Feelings, which measures how much a person's emotions shape their worldview, and Feelings Trigger Action, which measures impulsive behavioural reactivity to emotions. We tested unique effects of ERI and IU and the interactions of ERI × IU on the three interpersonal-psychological risk factors using linear regression models.
Results
Pervasive Influence of Feelings correlated with higher perceived burdensomeness and thwarted belongingness, whereas Feelings Trigger Action correlated with higher perceived burdensomeness and acquired capability. Within the regression models, IU correlated significantly with lower acquired capability but not perceived burdensomeness or thwarted belongingness. Interactions of ERI × IU were not significant.
Conclusions
These results demonstrate the importance of considering both factors of ERI in understanding the risk for suicide. Our results also provide novel evidence that while IU may not impact risk factors such as perceived burdensomeness and thwarted belongingness, higher levels of IU may serve as some protection against individuals' acquired capability for suicidal action. Limitations and implications of findings are discussed.
{"title":"Emotion-related impulsivity factors and intolerance of uncertainty are uniquely associated with interpersonal-psychological risk factors for suicide","authors":"Amelia S. Dev, Theresa Davison, Hannah C. Broos, Sheri L. Johnson, Kiara R. Timpano","doi":"10.1111/bjc.12535","DOIUrl":"10.1111/bjc.12535","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The interpersonal-psychological theory of suicide identifies three risk factors for suicidal behaviours: perceived burdensomeness, thwarted belongingness, and acquired capability. We sought to clarify relationships between the interpersonal-psychological risk factors and two individual difference factors, emotion-related impulsivity (ERI) and intolerance of uncertainty (IU).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In the current study, we analysed self-report scales from a large community sample (<i>N</i> = 169) that was oversampled for individuals with elevated suicidality. We considered two separate factors of ERI: Pervasive Influence of Feelings, which measures how much a person's emotions shape their worldview, and Feelings Trigger Action, which measures impulsive behavioural reactivity to emotions. We tested unique effects of ERI and IU and the interactions of ERI × IU on the three interpersonal-psychological risk factors using linear regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pervasive Influence of Feelings correlated with higher perceived burdensomeness and thwarted belongingness, whereas Feelings Trigger Action correlated with higher perceived burdensomeness and acquired capability. Within the regression models, IU correlated significantly with lower acquired capability but not perceived burdensomeness or thwarted belongingness. Interactions of ERI × IU were not significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These results demonstrate the importance of considering both factors of ERI in understanding the risk for suicide. Our results also provide novel evidence that while IU may not impact risk factors such as perceived burdensomeness and thwarted belongingness, higher levels of IU may serve as some protection against individuals' acquired capability for suicidal action. Limitations and implications of findings are discussed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"773-787"},"PeriodicalIF":3.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524922","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}
Fears of recurrence and progression (FORP) in people with mental health conditions are understudied despite predicting poorer psychological outcomes and increased rates of relapse. However, there are no well-validated questionnaires that assess FORP in people with non-psychotic conditions. Moreover, it is not known whether FORP is empirically distinct from mental health anxiety.
Design
Online survey collected data at two time points.
Method
A 40-item FORP About Mental Health Questionnaire (FORP-MHQ) was derived from lived experience interviews. Analyses were conducted with a sample of 865 people with different mental health conditions. Exploratory factor analysis in a randomly split sub-sample (N = 432) yielded a 10-item, single-factor structure that measures FORP severity. Confirmatory factor analysis on these items was conducted in the remaining sample (N = 433). Discriminant and convergent validity, and reliability, analyses were conducted in the complete sample. Measurement invariance was assessed between men and women, those with and without a history of psychosis or mania, and those with and without diagnoses across different diagnostic categories.
Results
The 10-item FORP-MHQ demonstrated good structural, convergent and concurrent validity, internal consistency, and test–retest reliability. It was also empirically distinct from mental health anxiety with good discriminant validity. The FORP-MHQ was invariant between men and women, those with and without a history of psychosis or mania, and those with and without diagnoses across diagnostic categories.
Conclusion
The FORP-MHQ is a valid and reliable tool to assess FORP in people with a range of different mental health conditions, both psychotic and non-psychotic.
{"title":"Validation of a transdiagnostic measure of fears of recurrence and progression about mental health conditions","authors":"Daelin Coutts-Bain, Louise Sharpe, Caroline Hunt","doi":"10.1111/bjc.12536","DOIUrl":"10.1111/bjc.12536","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Fears of recurrence and progression (FORP) in people with mental health conditions are understudied despite predicting poorer psychological outcomes and increased rates of relapse. However, there are no well-validated questionnaires that assess FORP in people with non-psychotic conditions. Moreover, it is not known whether FORP is empirically distinct from mental health anxiety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Online survey collected data at two time points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A 40-item FORP About Mental Health Questionnaire (FORP-MHQ) was derived from lived experience interviews. Analyses were conducted with a sample of 865 people with different mental health conditions. Exploratory factor analysis in a randomly split sub-sample (<i>N</i> = 432) yielded a 10-item, single-factor structure that measures FORP severity. Confirmatory factor analysis on these items was conducted in the remaining sample (<i>N</i> = 433). Discriminant and convergent validity, and reliability, analyses were conducted in the complete sample. Measurement invariance was assessed between men and women, those with and without a history of psychosis or mania, and those with and without diagnoses across different diagnostic categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 10-item FORP-MHQ demonstrated good structural, convergent and concurrent validity, internal consistency, and test–retest reliability. It was also empirically distinct from mental health anxiety with good discriminant validity. The FORP-MHQ was invariant between men and women, those with and without a history of psychosis or mania, and those with and without diagnoses across diagnostic categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The FORP-MHQ is a valid and reliable tool to assess FORP in people with a range of different mental health conditions, both psychotic and non-psychotic.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"757-772"},"PeriodicalIF":3.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517102","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}
Emilia Robinson, Chloe Chapman, Faith Orchard, Clare Dixon, Mary John
Objectives
The aim of the paper was to describe referrals to a UK school-based mental health service for children and adolescents.
Methods
Children and young people (CYP) (N = 485, aged 4–18) were referred to two Mental Health Support Team sites in the South of England in 2021, for CBT-informed interventions for mild-to-moderate anxiety and depression. Child and parent reported outcome measures were completed pre-intervention, including measures of symptom severity and impact.
Results
Referrals consisted of 61% female, 57% secondary school age (12–18 years old) and 81% White British. Children of secondary school age self-reported significantly higher levels of anxiety (p = .003) and depression (p < .001) than children of primary age. Females self-reported significantly higher levels of anxiety (p < .001) and depression (p < .001) than males. The majority of CYP self-reported below or borderline threshold anxiety, depression and overall internalizing symptoms. The majority of caregiver-reported CYP difficulties met the clinical threshold for anxiety and overall internalizing symptoms, but not depression.
Conclusions
The findings have direct relevance to the transformation and delivery of school-based public mental health services for children and adolescents. There is a need to collect routine data from other services to assess the broader needs of CYP referred for low intensity early interventions across regions.
{"title":"Characteristics of young people referred for treatment of depression and anxiety in a school-based mental health service","authors":"Emilia Robinson, Chloe Chapman, Faith Orchard, Clare Dixon, Mary John","doi":"10.1111/bjc.12526","DOIUrl":"10.1111/bjc.12526","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of the paper was to describe referrals to a UK school-based mental health service for children and adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Children and young people (CYP) (<i>N</i> = 485, aged 4–18) were referred to two Mental Health Support Team sites in the South of England in 2021, for CBT-informed interventions for mild-to-moderate anxiety and depression. Child and parent reported outcome measures were completed pre-intervention, including measures of symptom severity and impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Referrals consisted of 61% female, 57% secondary school age (12–18 years old) and 81% White British. Children of secondary school age self-reported significantly higher levels of anxiety (<i>p</i> = .003) and depression (<i>p</i> < .001) than children of primary age. Females self-reported significantly higher levels of anxiety (<i>p</i> < .001) and depression (<i>p</i> < .001) than males. The majority of CYP self-reported below or borderline threshold anxiety, depression and overall internalizing symptoms. The majority of caregiver-reported CYP difficulties met the clinical threshold for anxiety and overall internalizing symptoms, but not depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings have direct relevance to the transformation and delivery of school-based public mental health services for children and adolescents. There is a need to collect routine data from other services to assess the broader needs of CYP referred for low intensity early interventions across regions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"744-756"},"PeriodicalIF":3.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504522","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}
The most successful psychological treatment for obsessive-compulsive disorder (OCD) is cognitive behavioural therapy (CBT). However, treatment success remains around 50% when refusal and dropout are considered. Purdon (Journal of Behavior Therapy and Experimental, Psychiatry, 2023, 78, 101773) argued that the CBT model is under-specified, suggesting that there may be important treatment targets that are not directly addressed. Based on emerging research, she identified insecure attachment and fear of compassion (FOC) as potentially important targets. Insecure attachment and FOC are associated with OCD symptoms, and past research suggests that FOC may explain the relationship between attachment insecurity and emotional distress. We reasoned that FOC may also be an important predictor of OCD symptom severity.
Methods
We conducted two preliminary, pre-registered online survey studies with undergraduate samples to explore potential theoretical relationships between attachment, FOC, and OCD.
Results
Study one (N = 329) revealed that the indirect effect of attachment anxiety on OCD symptom severity through fear of self-compassion was significant, even when controlling for trait self-compassion. A significant indirect effect of attachment avoidance predicting OCD severity, through fear of receiving compassion, also emerged. Study two (N = 340) replicated these findings and extended this research by controlling for depression.
Conclusions
Taken together, these findings suggest that FOC could be an important variable to consider when conceptualizing OCD. Further exploration is warranted to understand the directionality of these relationships and whether attachment and FOC could be valuable targets in OCD treatment.
目的：对强迫症（OCD）最成功的心理治疗是认知行为疗法（CBT）。然而，如果考虑到拒绝和退出，治疗成功率仍在50%左右。Purdon （Journal of Behavior Therapy and Experimental, Psychiatry, 2023, 78, 101773）认为，CBT模型没有明确规定，这表明可能存在没有直接解决的重要治疗目标。根据最新的研究，她确定了不安全依恋和同情恐惧（FOC）是潜在的重要目标。不安全依恋和FOC与强迫症症状有关，过去的研究表明FOC可以解释依恋不安全和情绪困扰之间的关系。我们推断FOC也可能是强迫症症状严重程度的重要预测因子。方法：我们对大学生样本进行了两项初步的、预先注册的在线调查研究，以探索依恋、FOC和强迫症之间潜在的理论关系。结果：研究一（N = 329）发现，即使在控制特质性自我同情的情况下，依恋焦虑通过对自我同情的恐惧对强迫症症状严重程度的间接影响也是显著的。通过害怕得到同情，依恋回避对强迫症严重程度的预测也产生了重要的间接影响。研究二（N = 340）重复了这些发现，并通过控制抑郁来扩展这项研究。结论：综上所述，这些发现表明FOC可能是概念化强迫症时需要考虑的一个重要变量。进一步的探索是必要的，以了解这些关系的方向性，以及依恋和FOC是否可以成为强迫症治疗的有价值的目标。
{"title":"A preliminary investigation of the relationships between attachment insecurity, fear of compassion, and OCD severity","authors":"Aliya McNeil, Christine Purdon","doi":"10.1111/bjc.12533","DOIUrl":"10.1111/bjc.12533","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The most successful psychological treatment for obsessive-compulsive disorder (OCD) is cognitive behavioural therapy (CBT). However, treatment success remains around 50% when refusal and dropout are considered. Purdon (<i>Journal of Behavior Therapy and Experimental, Psychiatry</i>, 2023, 78, 101773) argued that the CBT model is under-specified, suggesting that there may be important treatment targets that are not directly addressed. Based on emerging research, she identified insecure attachment and fear of compassion (FOC) as potentially important targets. Insecure attachment and FOC are associated with OCD symptoms, and past research suggests that FOC may explain the relationship between attachment insecurity and emotional distress. We reasoned that FOC may also be an important predictor of OCD symptom severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted two preliminary, pre-registered online survey studies with undergraduate samples to explore potential theoretical relationships between attachment, FOC, and OCD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Study one (<i>N</i> = 329) revealed that the indirect effect of attachment anxiety on OCD symptom severity through fear of self-compassion was significant, even when controlling for trait self-compassion. A significant indirect effect of attachment avoidance predicting OCD severity, through fear of receiving compassion, also emerged. Study two (<i>N</i> = 340) replicated these findings and extended this research by controlling for depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Taken together, these findings suggest that FOC could be an important variable to consider when conceptualizing OCD. Further exploration is warranted to understand the directionality of these relationships and whether attachment and FOC could be valuable targets in OCD treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"725-743"},"PeriodicalIF":3.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484550","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}
L. M. Smith, B. Barrett, S. Barnes, B. Oltean, L. Ige, C. Day, T. Tranah
Objectives
To evaluate an arts-enhanced dialectical behavioural therapy skills group for managing emotions and self-harm, implemented via an innovative public sector/third sector partnership to increase access to care.
Design
This is a pilot mixed-methods study.
Methods
To assess participant experience in the ‘Imagining Futures’ programme, we examined self-report questionnaires and qualitative focus group interviews using framework analysis. We collected recruitment, session attendance and programme completion rates. To explore impact, we also report on quantitative psychological outcome measures, including self-harm frequency and overall well-being.
Results
We recruited 45 young women (mean age: 15.9, s.d. = 1.24, range 13.9–18.0 years) with a history of emotional dysregulation, self-harm and other contextual risks who were not receiving support from statutory child and adolescent mental health services in the United Kingdom. Participants were 22% not in education, employment or training and 77% were from United Kingdom racially minoritized backgrounds. The overall completion rate was 62% (n = 28/45). Qualitative data analysed from respondents (n = 25/28 young people and n = 12 parents) suggested high levels of satisfaction with the project. Thirteen themes were identified which described service elements perceived to support engagement and observed impact. There was an important role for relationships and the creative components. Quantitative clinical data indicated reductions in the frequency of self-harming, significant reductions in the perceived impact of difficulties and increased perceived social support.
Conclusions
This novel delivery of a DBT skills group, incorporating blended psychology arts activities, has the potential to support engagement with psychological supports that improve mental well-being.
{"title":"Imagining Futures: Evaluation of a blended programme of dialectical behaviour therapy and the creative arts for young women with a history of self-harm","authors":"L. M. Smith, B. Barrett, S. Barnes, B. Oltean, L. Ige, C. Day, T. Tranah","doi":"10.1111/bjc.12528","DOIUrl":"10.1111/bjc.12528","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate an arts-enhanced dialectical behavioural therapy skills group for managing emotions and self-harm, implemented via an innovative public sector/third sector partnership to increase access to care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This is a pilot mixed-methods study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To assess participant experience in the ‘Imagining Futures’ programme, we examined self-report questionnaires and qualitative focus group interviews using framework analysis. We collected recruitment, session attendance and programme completion rates. To explore impact, we also report on quantitative psychological outcome measures, including self-harm frequency and overall well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We recruited 45 young women (mean age: 15.9, s.d. = 1.24, range 13.9–18.0 years) with a history of emotional dysregulation, self-harm and other contextual risks who were not receiving support from statutory child and adolescent mental health services in the United Kingdom. Participants were 22% not in education, employment or training and 77% were from United Kingdom racially minoritized backgrounds. The overall completion rate was 62% (<i>n</i> = 28/45). Qualitative data analysed from respondents (<i>n</i> = 25/28 young people and <i>n</i> = 12 parents) suggested high levels of satisfaction with the project. Thirteen themes were identified which described service elements perceived to support engagement and observed impact. There was an important role for relationships and the creative components. Quantitative clinical data indicated reductions in the frequency of self-harming, significant reductions in the perceived impact of difficulties and increased perceived social support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This novel delivery of a DBT skills group, incorporating blended psychology arts activities, has the potential to support engagement with psychological supports that improve mental well-being.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"702-724"},"PeriodicalIF":3.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460203","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}
Valentine Chirokoff, Arnaud Tessier, Fuschia Serre, Maud Dupuy, Marc Auriacombe, Sandra Chanraud, Sylvie Berthoz, Melina Fatseas, David Misdrahi
Background
Medication non-adherence is a leading cause of treatment failure in psychiatric populations. However, current studies highlight the lack of methodological guidance on medication assessments. Ecological Momentary Assessment (EMA), using smartphone-based evaluations, shows promise for real-time monitoring in everyday settings.
Aims
This study evaluated EMA's effectiveness in assessing medication adherence in patients with schizophrenia, depression, and substance use disorders (SUD), covering various treatment regimens.
Materials & Methods
A total of 133 participants (27 with schizophrenia, 20 with depression, 44 with SUDs, and 42 healthy controls) completed EMA via study-provided smartphones five times daily over 1 week. Treatment regimens, categorized by mono vs. polytherapy and single vs. multiple daily doses, were documented. EMA adherence was calculated from the completion rate of the assessments, while medication adherence was assessed daily for patients. Both mean medication adherence and adherence variation over time were analysed by diagnosis and treatment regimen.
Results
All groups demonstrated high mean EMA and medication adherence, with minor variations across treatment types. Importantly, patients showed improved adherence over time, independently of diagnosis or regimen.
Discussion
These findings indicate EMA's potential as an effective method for capturing medication adherence in psychiatric populations.
Conclusion
The approach's capacity for real-time, context-sensitive data collection could reveal adherence patterns and changes not detectable by conventional methods, offering valuable insights for clinical practice.
{"title":"Relevance of ecological momentary assessment for medication adherence in clinical settings: A precision psychiatry approach","authors":"Valentine Chirokoff, Arnaud Tessier, Fuschia Serre, Maud Dupuy, Marc Auriacombe, Sandra Chanraud, Sylvie Berthoz, Melina Fatseas, David Misdrahi","doi":"10.1111/bjc.12532","DOIUrl":"10.1111/bjc.12532","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Medication non-adherence is a leading cause of treatment failure in psychiatric populations. However, current studies highlight the lack of methodological guidance on medication assessments. Ecological Momentary Assessment (EMA), using smartphone-based evaluations, shows promise for real-time monitoring in everyday settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study evaluated EMA's effectiveness in assessing medication adherence in patients with schizophrenia, depression, and substance use disorders (SUD), covering various treatment regimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials & Methods</h3>\u0000 \u0000 <p>A total of 133 participants (27 with schizophrenia, 20 with depression, 44 with SUDs, and 42 healthy controls) completed EMA via study-provided smartphones five times daily over 1 week. Treatment regimens, categorized by mono vs. polytherapy and single vs. multiple daily doses, were documented. EMA adherence was calculated from the completion rate of the assessments, while medication adherence was assessed daily for patients. Both mean medication adherence and adherence variation over time were analysed by diagnosis and treatment regimen.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All groups demonstrated high mean EMA and medication adherence, with minor variations across treatment types. Importantly, patients showed improved adherence over time, independently of diagnosis or regimen.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>These findings indicate EMA's potential as an effective method for capturing medication adherence in psychiatric populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The approach's capacity for real-time, context-sensitive data collection could reveal adherence patterns and changes not detectable by conventional methods, offering valuable insights for clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"692-701"},"PeriodicalIF":3.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442329","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}
Jennifer U. Le, Regine M. Deguzman, Norman B. Schmidt, Nicole A. Short
Objectives
The Emotional Cascade Model posits that rumination is associated with impulsivity and risky behaviours such as substance use. Although trauma-exposed individuals often engage in rumination and problematic cannabis use, this model has not been tested on trauma-exposed cannabis users. Therefore, our study examines the direct and indirect effects between rumination and its subtypes with problematic cannabis use among trauma-exposed cannabis users. We also examine how these associations occur through impulsivity.
Methods
A cross-sectional sample of 56 trauma-exposed young adult cannabis users (Mage = 21 years, 59% female, 73% white) self-reported rumination, impulsivity, and cannabis-related problems. All participants provided written informed consent, and procedures were approved by the university's Institutional Review Board and pre-registered.
Results
Regression analyses indicated total and brooding rumination were related to greater cannabis-related problems, after covarying for number of traumas and cannabis use frequency. Rumination, specifically brooding, was incrementally associated with greater cannabis-related problems and had an indirect effect on cannabis-related problems through impulsivity. Consistent with hypothesis, rumination and impulsivity were incrementally associated with greater problematic cannabis use among trauma-exposed cannabis users.
Conclusion
The current study expands work on the Emotional Cascade Model by supporting the indirect effect of impulsivity in the association between rumination and problematic cannabis use.
{"title":"The role of impulsivity in the association between rumination and cannabis-related problems among trauma-exposed cannabis users","authors":"Jennifer U. Le, Regine M. Deguzman, Norman B. Schmidt, Nicole A. Short","doi":"10.1111/bjc.12530","DOIUrl":"10.1111/bjc.12530","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The Emotional Cascade Model posits that rumination is associated with impulsivity and risky behaviours such as substance use. Although trauma-exposed individuals often engage in rumination and problematic cannabis use, this model has not been tested on trauma-exposed cannabis users. Therefore, our study examines the direct and indirect effects between rumination and its subtypes with problematic cannabis use among trauma-exposed cannabis users. We also examine how these associations occur through impulsivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional sample of 56 trauma-exposed young adult cannabis users (<i>M</i><sub>age</sub> = 21 years, 59% female, 73% white) self-reported rumination, impulsivity, and cannabis-related problems. All participants provided written informed consent, and procedures were approved by the university's Institutional Review Board and pre-registered.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Regression analyses indicated total and brooding rumination were related to greater cannabis-related problems, after covarying for number of traumas and cannabis use frequency. Rumination, specifically brooding, was incrementally associated with greater cannabis-related problems and had an indirect effect on cannabis-related problems through impulsivity. Consistent with hypothesis, rumination and impulsivity were incrementally associated with greater problematic cannabis use among trauma-exposed cannabis users.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The current study expands work on the Emotional Cascade Model by supporting the indirect effect of impulsivity in the association between rumination and problematic cannabis use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"677-691"},"PeriodicalIF":3.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190570","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}
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