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}
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 (Mage = 19.19 years, SD = 1.67, Rangeage = 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。
{"title":"Negative interpretation bias and repetitive negative thinking as mechanisms in the association between insomnia and depression in young adults.","authors":"Isabel Clegg, Lies Notebaert, Amy Whittle-Herbert, Cele Richardson","doi":"10.1111/bjc.12529","DOIUrl":"https://doi.org/10.1111/bjc.12529","url":null,"abstract":"<p><strong>Objectives: </strong>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.</p><p><strong>Design: </strong>The associations predicted by this hypothesis were tested via cross-sectional mediation in a sample of 214 participants (M<sub>age</sub> = 19.19 years, SD = 1.67, Range<sub>age</sub> = 17-24 years, 20% male).</p><p><strong>Methods: </strong>Participants completed questionnaire measures of insomnia symptoms, depression symptoms and RNT, an ambiguous scenarios task and a 1-week sleep diary.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014254","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}
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.
{"title":"Correlates of suicidal ideation and suicide attempts among bisexual+, gay/lesbian, and heterosexual young adults","authors":"Erik M. Benau, Matthew R. Hanna, Felix Yirdong, Lillian Polanco-Roman","doi":"10.1111/bjc.12525","DOIUrl":"10.1111/bjc.12525","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Young adults (<i>N</i> = 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 <i>H</i>-tests and binomial logistic regression models were used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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].</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"657-676"},"PeriodicalIF":3.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972834","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}
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。
{"title":"A systematic review of predictors and moderators of treatment response in psychological interventions for persisting forms of depression","authors":"Margaret Lyons, Jaime Delgadillo","doi":"10.1111/bjc.12513","DOIUrl":"10.1111/bjc.12513","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Limitations</h3>\u0000 \u0000 <p>Meta-analysis could not be done due to methodological heterogeneity among studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"623-656"},"PeriodicalIF":3.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907854","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}
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.
{"title":"Trauma in the courtroom: The role of prior trauma exposure and mental health on stress and emotional responses in jurors","authors":"Matthew Brooks, Jessica Glynn, Hannah Fawcett, Aminah Barnes, Rachael Carew, David Errickson, Maria Livanou","doi":"10.1111/bjc.12522","DOIUrl":"10.1111/bjc.12522","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Mock jurors (<i>n</i> = 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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"603-622"},"PeriodicalIF":3.1,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877899","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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