British Journal of Clinical Psychology最新文献_第7页

Editorial acknowledgement 社论承认

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-02-05 DOI: 10.1111/bjc.12521

引用次数: 0

The role of impulsivity in the association between rumination and cannabis-related problems among trauma-exposed cannabis users 在创伤暴露的大麻使用者中，冲动在反刍和大麻相关问题之间的关联中的作用。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-02-05 DOI: 10.1111/bjc.12530

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 (M_age = 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.

研究目的情绪级联模型认为，反刍与冲动和药物使用等危险行为有关。虽然遭受创伤的人经常会产生反刍和使用问题大麻，但这一模型尚未在遭受创伤的大麻使用者身上进行过测试。因此，我们的研究探讨了反刍及其亚型对受创伤影响的大麻使用者使用问题大麻的直接和间接影响。我们还研究了这些关联是如何通过冲动性发生的：56名受创伤的年轻成人大麻使用者（年龄=21岁，59%为女性，73%为白人）自我报告了反刍、冲动和大麻相关问题。所有参与者都提供了书面知情同意书，研究程序获得了大学机构审查委员会的批准，并进行了预先登记：回归分析表明，在与创伤次数和大麻使用频率相关联后，总遐想和忧郁遐想与大麻相关问题的增加有关。反刍，特别是沉思，与大麻相关问题的增加呈递增关系，并通过冲动性对大麻相关问题产生间接影响。与假设一致的是，反刍和冲动与受到创伤的大麻使用者使用大麻的问题更多呈递增关系：本研究通过支持冲动在反刍与问题性吸食大麻之间的关联中的间接作用，扩展了情绪级联模型的研究工作。

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引用次数: 0

Negative interpretation bias and repetitive negative thinking as mechanisms in the association between insomnia and depression in young adults. 消极解释偏见和重复消极思维是年轻人失眠和抑郁之间的关联机制。

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-01-15 DOI: 10.1111/bjc.12529

Isabel Clegg, Lies Notebaert, Amy Whittle-Herbert, Cele Richardson

Objectives: Despite evidence supporting sleep's role in the development and maintenance of depression, mechanisms underlying this association in young people are less established. Negative interpretation bias (the tendency to interpret ambiguous situations negatively) and repetitive negative thinking (RNT) are important candidate mechanisms. Whilst negative interpretation bias is implicated in depression development, it is a transdiagnostic process and may result from insomnia. Yet, research relating to these constructs is lacking. RNT is another transdiagnostic process implicated in association between negative interpretation bias, depression and insomnia. However, an elaborated model that includes both mechanisms is yet to be tested. It was hypothesised that negative interpretation bias and RNT would sequentially mediate the relationship between sleep/insomnia and depressive symptoms in young people.

Design: The associations predicted by this hypothesis were tested via cross-sectional mediation in a sample of 214 participants (M_age = 19.19 years, SD = 1.67, Range_age = 17-24 years, 20% male).

Methods: Participants completed questionnaire measures of insomnia symptoms, depression symptoms and RNT, an ambiguous scenarios task and a 1-week sleep diary.

Results: Results were consistent with negative interpretation bias and RNT as sequential mechanisms which partially account for the relationship between sleep (i.e., insomnia severity and sleep parameters) and depression.

Conclusions: This study supports negative interpretation bias and RNT as mechanisms linking insomnia and depression in young people, as the predicted associations between these variables were observed. Future research should investigate the causal/directional associations. However, results support theoretical models, and suggest sleep, interpretation bias and RNT may be important processes to target in preventing and treating depression.

目的：尽管有证据支持睡眠在抑郁症的发展和维持中所起的作用，但在年轻人中这种关联的机制尚不明确。负性解释偏差（消极解读模棱两可情境的倾向）和重复性消极思维（RNT）是重要的候选机制。虽然负面解释偏差与抑郁症的发展有关，但它是一个跨诊断过程，可能由失眠引起。然而，与这些结构相关的研究是缺乏的。RNT是另一个与负性解释偏差、抑郁和失眠相关的跨诊断过程。然而，一个包含这两种机制的详细模型还有待检验。假设负性解释偏差和RNT会依次介导年轻人睡眠/失眠与抑郁症状之间的关系。设计：通过横断面中介在214名参与者（Mage = 19.19岁，SD = 1.67, age = 17-24岁，20%为男性）的样本中检验该假设预测的关联。方法：参与者完成失眠症状、抑郁症状和RNT的问卷测量、模糊情景任务和为期一周的睡眠日记。结果：研究结果与负解释偏倚和RNT作为顺序机制一致，部分解释了睡眠（即失眠严重程度和睡眠参数）与抑郁之间的关系。结论：本研究支持负解释偏倚和RNT作为联系年轻人失眠和抑郁的机制，因为这些变量之间的预测关联被观察到。未来的研究应探讨因果/定向关联。然而，研究结果支持理论模型，并提示睡眠、解释偏差和RNT可能是预防和治疗抑郁症的重要目标过程。

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引用次数: 0

Correlates of suicidal ideation and suicide attempts among bisexual+, gay/lesbian, and heterosexual young adults 双性恋+、男同性恋/女同性恋和异性恋年轻人自杀意念和自杀企图的相关性

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-01-13 DOI: 10.1111/bjc.12525

Erik M. Benau, Matthew R. Hanna, Felix Yirdong, Lillian Polanco-Roman

Introduction

Compared to their exclusively gay/lesbian or heterosexual identifying peers, young people identifying as bisexual+ (e.g. bisexual, pansexual, asexual, queer or questioning) are at elevated risk for suicidal ideation (SI) and attempts (SA). The present study aimed to establish whether the prevalence of, and psychosocial risk factors for, SI and SA vary as a function of sexual identity.

Methods

Young adults (N = 274; 18–29 years old) were recruited via online crowdsourcing. They completed questionnaires assessing adverse childhood experiences (ACEs), emotion dysregulation, impulsivity, depression symptoms and lifetime history of SI and SA. Spearman correlations, Kruskal-Wallis H-tests and binomial logistic regression models were used.

Results

No variable was associated with SI. Bisexual+ individuals reported greater SA than the heterosexual group, though statistically similar to the gay/lesbian group. A similar pattern emerged for ACEs. The bisexual+ group reported greater depression symptoms than the gay/lesbian group. Impulsivity and emotion dysregulation did not vary by sexual identity. Controlling for these psychosocial and sociodemographic variables did not alter results: bisexual+ individuals were almost three times more likely to report SA than heterosexual individuals, OR = 2.93 95% CI [1.16, 7.44]; gay/lesbian and heterosexual individuals had a statistically similar likelihood of reporting SA, OR = 1.09, 95% CI [0.27, 4.37].

Conclusion

This is the first study to establish that young adults identifying as bisexual+ are at greater risk for SA after controlling for well-established psychosocial correlates; this was not the case for SI. Further work is needed to establish the aetiology of this risk.

引言：与他们的纯同性恋或异性恋同龄人相比，被认定为双性恋+的年轻人（如双性恋、泛性恋、无性恋、酷儿或有疑问的人）有更高的自杀意念（SI）和企图（SA）的风险。本研究旨在确定SI和SA的患病率及其社会心理风险因素是否随性别认同而变化。方法：青壮年(N = 274；18-29岁)通过网络众包招募。他们完成了评估童年不良经历（ace）、情绪失调、冲动、抑郁症状以及SI和SA的终生史的问卷调查。采用Spearman相关、Kruskal-Wallis h检验和二项logistic回归模型。结果：没有与SI相关的变量。双性恋+个体报告的SA高于异性恋组，尽管统计上与男同性恋/女同性恋组相似。ace也出现了类似的模式。双性恋+组报告的抑郁症状比男同性恋/女同性恋组更严重。冲动和情绪失调并没有因性别而异。控制这些社会心理和社会人口学变量并没有改变结果：双性恋+个体报告SA的可能性几乎是异性恋个体的三倍，OR = 2.93 95% CI [1.16, 7.44]；男女同性恋者和异性恋者报告SA的可能性在统计学上相似，OR = 1.09, 95% CI[0.27, 4.37]。结论：这是第一个在控制了已确立的社会心理相关因素后，确定为双性恋+的年轻人患SA的风险更高的研究；SI不是这样的。需要进一步的工作来确定这种风险的病因。

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引用次数: 0

A systematic review of predictors and moderators of treatment response in psychological interventions for persisting forms of depression 对持续性抑郁症心理干预治疗反应的预测因子和调节因子的系统回顾。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-12-31 DOI: 10.1111/bjc.12513

Margaret Lyons, Jaime Delgadillo

Background

Although psychological interventions can be effective for the treatment of major depressive disorder, some patients' symptoms persist or rapidly recur after therapy. This study aimed to synthesize research findings on predictors and moderators of treatment response for persisting forms of depression, such as chronic, recurrent, and treatment-resistant depression.

Methods

A systematic review of studies investigating predictors and moderators of response to outpatient psychological treatment for adults with persisting forms of depression was conducted by searching Web of Science, Scopus, and PsycInfo. A total of 23 eligible studies were included, assessed for risk of bias, and summarized using a narrative synthesis.

Results

Sixty-five predictor and moderator variables were examined across studies, categorized into sociodemographic, clinical, interpersonal/personality, psychological, and treatment variables. Most variables were only examined in single studies, which were rarely adequately powered for predictor and moderator analyses. Among variables studied more frequently (age, gender, baseline depression severity, childhood trauma), only baseline depression severity was found to be a replicated and consistent predictor of poorer treatment response. Risk of bias was low to medium for the majority of studies.

Limitations

Meta-analysis could not be done due to methodological heterogeneity among studies.

Conclusion

Our current understanding of significant predictors and moderators for persisting forms of depression is limited. A high level of baseline severity of depressive symptoms is so far the only variable consistently associated with poorer treatment response in this clinical population.

背景：虽然心理干预对重度抑郁症的治疗是有效的，但一些患者的症状在治疗后持续存在或迅速复发。本研究旨在综合有关慢性、复发性和难治性抑郁症治疗反应的预测因子和调节因子的研究结果。方法：通过检索Web of Science、Scopus和PsycInfo，系统回顾了调查持续形式抑郁症成人门诊心理治疗反应的预测因素和调节因素的研究。共纳入23项符合条件的研究，评估偏倚风险，并采用叙事综合法进行总结。结果：65个预测变量和调节变量在研究中被检查，分类为社会人口学、临床、人际/人格、心理和治疗变量。大多数变量仅在单个研究中进行了检查，很少有足够的预测和调节分析能力。在更频繁研究的变量（年龄、性别、基线抑郁严重程度、童年创伤）中，只有基线抑郁严重程度被发现是较差治疗反应的重复和一致的预测因子。大多数研究的偏倚风险为低至中等。局限性：由于研究方法的异质性，不能进行meta分析。结论：我们目前对持续形式抑郁的重要预测因子和调节因子的理解是有限的。到目前为止，高水平的基线抑郁症状严重程度是与该临床人群较差的治疗反应一致相关的唯一变量。

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引用次数: 0

Trauma in the courtroom: The role of prior trauma exposure and mental health on stress and emotional responses in jurors 法庭上的创伤：先前的创伤暴露和心理健康对陪审员压力和情绪反应的作用。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-12-23 DOI: 10.1111/bjc.12522

Matthew Brooks, Jessica Glynn, Hannah Fawcett, Aminah Barnes, Rachael Carew, David Errickson, Maria Livanou

Objectives

Prior research indicates that jury duty can be distressing for some jurors. This study examined: (1) the influence of prior trauma characteristics (type, exposure, time since trauma), medical fear and mental health difficulties on stress and emotional responses during a mock trial and 1 week later; and (2) associations between early stress reactions during a trial on subsequent stress and emotional reactivity after exposure to skeletal evidence and 1 week later.

Methods

Mock jurors (n = 180) completed baseline self-report mental health measures, read a summary of a murder case and were then exposed to graphic skeletal evidence. Stress and/or emotional responses were collected at baseline, after reading the case summary, before and after viewing the skeletal evidence and 7 days post-trial.

Results

Participants reported a wide range of prior traumatic experiences, with nearly half reporting pre-existing mental health difficulties. Average traumatic stress symptoms tripled from baseline to follow-up, with 44% of participants meeting PTSD-type criteria 7 days later. Medical fear and mental health difficulties were positively associated with some stress and/or emotional responses throughout the trial, with mixed findings concerning trauma characteristics, stress and emotional reactivity. Initial stress and emotional responses to case evidence were linked to later stress and emotional reactions, after accounting for pre-existing trauma and mental health characteristics.

Conclusions

Past trauma experiences, mental health difficulties and immediate stress responses during a trial can exacerbate emotional and stress reactions. Addressing the psychological impacts of pre-existing trauma symptoms could improve juror well-being during this important civic duty.

目的：先前的研究表明，陪审员的义务可能是痛苦的一些陪审员。本研究考察：(1)在模拟审判期间和1周后，先前的创伤特征（类型、暴露、创伤后时间）、医疗恐惧和心理健康困难对应激和情绪反应的影响；(2)早期应激反应与暴露于骨骼证据后和1周后的后续应激反应之间的关系。方法：模拟陪审员（n = 180）完成基线自我报告心理健康测量，阅读谋杀案摘要，然后接触图形骨骼证据。在基线、阅读病例摘要后、观察骨骼证据前后和审判后7天收集压力和/或情绪反应。结果：参与者报告了广泛的先前创伤经历，近一半的人报告了先前的心理健康问题。从基线到随访，平均创伤压力症状增加了两倍，7天后44%的参与者符合ptsd类型标准。在整个试验过程中，医疗恐惧和心理健康困难与一些压力和/或情绪反应呈正相关，在创伤特征、压力和情绪反应方面的发现好坏参半。在考虑了先前的创伤和心理健康特征后，对案件证据的最初压力和情绪反应与后来的压力和情绪反应有关。结论：过去的创伤经历、心理健康问题和试验期间的即时应激反应可加剧情绪和应激反应。解决先前存在的创伤症状的心理影响可以改善陪审员在履行这一重要公民义务时的幸福感。

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引用次数: 0

Feared self and morality in obsessive-compulsive phenomena 在强迫现象中恐惧自我和道德。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-12-22 DOI: 10.1111/bjc.12527

Yoon-Hee Yang, Tess Jaeger, Richard Moulding

Background: Recent studies have shown that individuals with obsessive-compulsive disorder (OCD) tend to endorse a feared self that they perceive to be immoral, insane and/or dangerous. The current study investigated the relationship between morality-related feared self, self-relevance and OC-related cognitions and behaviours such as moral deliberation, threat interpretation bias, discomfort, urge to act and likelihood of acting in OC-relevant situations in a non-clinical sample. Method: A total of 78 participants (27 female, M_age = 29.85, SD = 9.8) underwent a priming study. Participants had their feared-self primed firstly via an unscrambling task in either a feared self or neutral condition and secondly via a writing task about moral transgressions. The response time for these tasks was recorded as a measurement of moral deliberation. Further, self-relevance was primed by having half of the participants' complete tasks that referenced their actions, whereas half of the participants completed tasks that referenced others' actions. Results: It was found that participants' pre-existing level of feared self was linked to threat interpretation bias, discomfort and urge to act in OC-relevant situations. A primed sense of feared self and self-relevance also demonstrated significant links to changes in OC-relevant symptoms. Conclusion: These results indicate that environmental cues related to morality may lead to OC-related symptoms.

背景：最近的研究表明，患有强迫症（OCD）的个体倾向于认可一个他们认为不道德、疯狂和/或危险的恐惧自我。本研究以非临床样本为研究对象，探讨了道德相关的恐惧自我、自我关联与强迫症相关的认知和行为之间的关系，如道德考虑、威胁解释偏见、不适、行动冲动和在强迫症相关情境下行动的可能性。方法：78名被试（女性27名，Mage = 29.85, SD = 9.8）进行启动研究。参与者首先在恐惧的自我或中立的条件下通过一项解读任务来启动他们的恐惧自我，然后通过一项关于道德犯罪的写作任务来启动他们的恐惧自我。这些任务的反应时间被记录下来，作为衡量道德思考的一项指标。此外，有一半的参与者完成了与自己的行为相关的任务，而有一半的参与者完成了与他人的行为相关的任务，从而启动了自我关联。结果：研究发现，被试的恐惧自我存在水平与威胁解释偏差、不适和行动冲动有关。启动的恐惧自我和自我相关感也显示出与oc相关症状变化的显著联系。结论：这些结果提示与道德相关的环境线索可能导致强迫症相关症状。

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引用次数: 0

Reasons for seeking internet-delivered treatment for individuals with obsessive-compulsive disorder 为强迫症患者寻求互联网治疗的原因。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-12-11 DOI: 10.1111/bjc.12524

Maral Melkonian, Sarah McDonald, Eyal Karin, Nickolai Titov, Blake F. Dear, Bethany M. Wootton

Objectives

Patients with obsessive-compulsive disorder (OCD) face multiple barriers when accessing treatment and rarely receive best-practice cognitive behaviour therapy (CBT) when they seek help. Remote treatments, such as internet-delivered CBT (ICBT), enhance access to evidence-based treatments. To date, no known studies have examined the reasons individuals seek remote treatment over traditional in-person treatment for OCD. Thus, the aim of the current study was to examine the treatment histories of individuals who completed ICBT for OCD and their reasons for seeking ICBT.

Methods

One hundred and sixty-six participants (M_age = 33.88; SD = 13.41, 71.7% female) were included in the study.

Results

Almost three-quarters of the sample had previously spoken to a health professional about their OCD symptoms. General practitioners were the most frequently consulted health professionals initially (41.7%), while psychologists were the most frequently consulted overall (81.7%). Supportive counselling (74.2%) and medication (72.5%) were the most common forms of treatment ever received. Of those who had received CBT for OCD, only 20.0% (12.5% of the overall sample) likely received best-practice CBT. The most frequently endorsed reasons for seeking ICBT over in-person treatment related to having no access to face-to-face treatment in the community (25.9%) and having found previous face-to-face treatment unhelpful (24.1%). Group differences in reasons for seeking ICBT over face-to-face treatment emerged based on geographical location, OCD severity and presence of comorbid depressive symptoms.

Conclusions

Evidence-based treatment for OCD is underutilized in the community highlighting the need to develop and disseminate evidence-based remote treatments for OCD.

目的：强迫症（OCD）患者在寻求治疗时面临多重障碍，并且在寻求帮助时很少接受最佳实践认知行为疗法（CBT）。远程治疗，如互联网提供的CBT (ICBT)，提高了获得循证治疗的机会。迄今为止，没有已知的研究调查了强迫症患者寻求远程治疗而不是传统的面对面治疗的原因。因此，本研究的目的是检查因强迫症而完成ICBT的个体的治疗史以及他们寻求ICBT的原因。方法：166名受试者(Mage = 33.88；SD = 13.41, 71.7%为女性)纳入研究。结果：近四分之三的样本之前曾向健康专业人士谈论过他们的强迫症症状。全科医生是最常被咨询的健康专业人员（41.7%），而心理学家是最常被咨询的整体（81.7%）。支持性咨询（74.2%）和药物治疗（72.5%）是最常见的治疗形式。在那些接受CBT治疗强迫症的患者中，只有20.0%（占总样本的12.5%）可能接受了最佳实践CBT。与面对面治疗相比，寻求ICBT最常见的原因与无法在社区获得面对面治疗有关（25.9%），并且发现以前的面对面治疗没有帮助（24.1%）。在寻求ICBT而非面对面治疗的原因上，群体差异基于地理位置、强迫症严重程度和是否存在共病抑郁症状。结论：基于证据的OCD治疗在社区中未得到充分利用，需要开发和推广基于证据的OCD远程治疗。

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引用次数: 0

Patient experiences of behavioural therapy for bipolar depression: A qualitative study 双相抑郁症行为治疗的患者体验：一项定性研究。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-12-10 DOI: 10.1111/bjc.12515

Sakir Yilmaz, Anna Hancox, Molly Price, Jemma Regan, Barney Dunn, Heather O'Mahen, Kim Wright

Background

Although multiple qualitative studies have explored participants' experiences of behavioural activation (BA) for unipolar depression, none have investigated the experiences of BA in people with bipolar depression. This is of particular interest because qualitative studies concerning the experience of receiving therapy can help inform the theory of change underpinning the intervention.

Aim

The purpose of this study was to explore the experiences and perspectives of individuals with bipolar disorder who received a course of one-to-one BA for bipolar depression. We sought to explore participants' experience of the effects of BA therapy, both proximally and distally.

Method

Semi-structured interviews were conducted with nine individuals meeting research diagnostic criteria for bipolar I or II disorder who had received up to 20 sessions of BA adapted for bipolar depression. Thematic analysis using a framework approach was used to explore and describe the experiences of participants.

Results

Participants' perspectives on the impact of therapy were categorized under four subthemes: client behaviour inside and outside sessions, changes in clients' perspectives, the impact on symptoms and impact on life and functioning.

Conclusions

Participants' accounts of the impact of therapy were broadly consistent with the theory underpinning a behavioural approach. Participants described a central role for perspective change, and particularly increased acceptance of the self and mood states, as facilitating behavioural changes and more distal benefits. Process evaluations embedded in future trials may include quantitative measures of key processes described by our participants, as well as those clearly implied by the behavioural theory of depression.

背景：虽然有多项定性研究探讨了参与者在单极抑郁症中的行为激活（BA）体验，但尚未有研究调查双相抑郁症患者的行为激活体验。这是特别有趣的，因为关于接受治疗经验的定性研究可以帮助告知支持干预的变化理论。目的：本研究的目的是探讨双相情感障碍患者接受一对一BA治疗双相抑郁的经历和观点。我们试图探索参与者对近端和远端BA治疗效果的体验。方法：对9名符合双相I或II型障碍研究诊断标准的患者进行了半结构化访谈，这些患者接受了多达20次适用于双相抑郁症的BA治疗。使用框架方法的主题分析用于探索和描述参与者的经验。结果：参与者对治疗影响的看法分为四个子主题：治疗内外的客户行为、客户观点的变化、对症状的影响以及对生活和功能的影响。结论：参与者对治疗影响的描述与支撑行为方法的理论大体一致。参与者描述了观点改变的核心作用，特别是对自我和情绪状态的接受度的提高，有助于行为改变和更多的长远利益。在未来的试验中嵌入的过程评估可能包括参与者描述的关键过程的定量测量，以及抑郁症行为理论明确暗示的过程。

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引用次数: 0

Direct and indirect effects of childhood adversity on psychopathology: Investigating parallel mediation via self-concept clarity, self-esteem and intolerance of uncertainty 童年逆境对精神病理的直接和间接影响：通过自我概念清晰、自尊和不确定性不容忍的平行中介研究。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-12-08 DOI: 10.1111/bjc.12523

Lindsey Sharratt, Nathan Ridout

Objectives

The aim was to extend previous work on the identity disruption model (IDM) of adult psychological distress. According to the IDM, aversive childhood experiences (ACEs) disrupt the development of identity, resulting in an unclear sense of self and a reliance on external sources of self-definition, leading to psychological distress in adulthood. In line with this model, self-concept clarity (SCC) in parallel with self-esteem (SE) and intolerance of uncertainty (IU) has been shown to mediate the relationship between childhood adversity and depression and anxiety. The current study examined if SCC, SE and IU mediated the influence of childhood adversity on depression, anxiety and hypomania.

Methods

A community sample of 159 adults completed online measures of childhood adversity, self-esteem, self-concept clarity, intolerance of uncertainty, depression, anxiety and hypomania. Structured equation modelling using bias corrected bootstrapping was used to test the mediation model.

Results

Direct effects of childhood adversity were found for depression and anxiety, but not hypomania. The influence of ACEs on depression and anxiety was mediated by self-concept clarity and self-esteem. Self-concept clarity also mediated the influence of ACEs on hypomania, which is an important novel finding. The indirect effect of childhood adversity via intolerance of uncertainty was limited to anxiety.

Conclusions

Results suggest that the identity disruption model generalizes to hypomania. The clinical implications are that interventions to improve clarity of the self-concept might be useful in reducing psychopathology.

目的：扩展成人心理困扰的身份破坏模型（IDM）。根据IDM的说法，令人厌恶的童年经历（ace）破坏了身份的发展，导致自我意识不清，依赖外部来源的自我定义，导致成年后的心理困扰。根据该模型，自我概念清晰（SCC）、自尊（SE）和不确定性不耐受（IU）在童年逆境与抑郁和焦虑之间的关系中起中介作用。本研究考察SCC、SE和IU是否介导童年逆境对抑郁、焦虑和轻躁的影响。方法：以社区为样本，共159名成年人完成了童年逆境、自尊、自我概念清晰度、对不确定性的不容忍、抑郁、焦虑和轻躁狂的在线测量。采用纠偏自举的结构方程模型对中介模型进行检验。结果：童年逆境对抑郁和焦虑有直接影响，对轻躁无直接影响。ace对抑郁和焦虑的影响受自我概念清晰和自尊的中介作用。自我概念清晰也介导了ace对轻躁狂的影响，这是一项重要的新发现。童年逆境对不确定性的不容忍所产生的间接影响仅限于焦虑。结论：结果表明认同破坏模型可推广到轻躁狂。临床意义是，提高自我概念清晰度的干预措施可能有助于减少精神病理。

{"title":"Direct and indirect effects of childhood adversity on psychopathology: Investigating parallel mediation via self-concept clarity, self-esteem and intolerance of uncertainty","authors":"Lindsey Sharratt, Nathan Ridout","doi":"10.1111/bjc.12523","DOIUrl":"10.1111/bjc.12523","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim was to extend previous work on the identity disruption model (IDM) of adult psychological distress. According to the IDM, aversive childhood experiences (ACEs) disrupt the development of identity, resulting in an unclear sense of self and a reliance on external sources of self-definition, leading to psychological distress in adulthood. In line with this model, self-concept clarity (SCC) in parallel with self-esteem (SE) and intolerance of uncertainty (IU) has been shown to mediate the relationship between childhood adversity and depression and anxiety. The current study examined if SCC, SE and IU mediated the influence of childhood adversity on depression, anxiety and hypomania.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A community sample of 159 adults completed online measures of childhood adversity, self-esteem, self-concept clarity, intolerance of uncertainty, depression, anxiety and hypomania. Structured equation modelling using bias corrected bootstrapping was used to test the mediation model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Direct effects of childhood adversity were found for depression and anxiety, but not hypomania. The influence of ACEs on depression and anxiety was mediated by self-concept clarity and self-esteem. Self-concept clarity also mediated the influence of ACEs on hypomania, which is an important novel finding. The indirect effect of childhood adversity via intolerance of uncertainty was limited to anxiety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Results suggest that the identity disruption model generalizes to hypomania. The clinical implications are that interventions to improve clarity of the self-concept might be useful in reducing psychopathology.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 2","pages":"539-552"},"PeriodicalIF":3.1,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjc.12523","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796167","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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