Mentalizing—holding in mind, appraising and reappraising mental states—is evidenced across research disciplines as a key psychological capacity of developmental and clinical importance. Due to this interdisciplinary context, there are a broad range of mentalizing measures available. The primary aim of this review was to systematically review existing mentalizing measures. MEDLINE, PSYCHINFO, HAPI and PSYCHTESTS were searched to identify English-language, text-based, general adult population mentalizing measures.
Mentalizing is established as a multidimensional concept that varies across relational contexts. However, explicit dimensional definition and systematic contextualisation of mentalizing measures is rare. The secondary aim of the review was to develop and pilot a novel framework for classifying the mentalizing dimensions and relational context operationalised by each measure. Following reference to the literature and expert discussion, a dimensional construct framework of mentalizing with 18 components was proposed and applied to existing instruments.
57 text-based measures were identified by the review. Inter-rater agreement using the novel framework was 75%. No measures completely overlapped on dimensions and relational context. Relational contexts of measures were largely mentalizing the self (52) and/or hypothetical unspecified others (33). The review demonstrates that measures of mentalizing can be compared on the basis of dimensions operationalised and relational context, increasing utility in measure selection. Divergent construct validity highlights a need for careful selection of appropriate measures on the basis of mentalizing components of interest. Increased clarity of construct validity could be used to illuminate conflicting findings in the mentalizing literature and to advance the development of new assessment instruments.
{"title":"Measurement of mentalizing: A systematic review and development of a construct validity framework","authors":"Hannah Hawksdale , Beichen Meng , Janet Feigenbaum , Peter Fonagy , Tobias Nolte","doi":"10.1016/j.cpr.2025.102657","DOIUrl":"10.1016/j.cpr.2025.102657","url":null,"abstract":"<div><div>Mentalizing—holding in mind, appraising and reappraising mental states—is evidenced across research disciplines as a key psychological capacity of developmental and clinical importance. Due to this interdisciplinary context, there are a broad range of mentalizing measures available. The primary aim of this review was to systematically review existing mentalizing measures. MEDLINE, PSYCHINFO, HAPI and PSYCHTESTS were searched to identify English-language, text-based, general adult population mentalizing measures.</div><div>Mentalizing is established as a multidimensional concept that varies across relational contexts. However, explicit dimensional definition and systematic contextualisation of mentalizing measures is rare. The secondary aim of the review was to develop and pilot a novel framework for classifying the mentalizing dimensions and relational context operationalised by each measure. Following reference to the literature and expert discussion, a dimensional construct framework of mentalizing with 18 components was proposed and applied to existing instruments.</div><div>57 text-based measures were identified by the review. Inter-rater agreement using the novel framework was 75%. No measures completely overlapped on dimensions and relational context. Relational contexts of measures were largely mentalizing the self (52) and/or hypothetical unspecified others (33). The review demonstrates that measures of mentalizing can be compared on the basis of dimensions operationalised and relational context, increasing utility in measure selection. Divergent construct validity highlights a need for careful selection of appropriate measures on the basis of mentalizing components of interest. Increased clarity of construct validity could be used to illuminate conflicting findings in the mentalizing literature and to advance the development of new assessment instruments.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"122 ","pages":"Article 102657"},"PeriodicalIF":12.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145311767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-10-03DOI: 10.1016/j.cpr.2025.102655
Elad Zlotnick, Jonathan D. Huppert
“Core threats” are the ultimate feared consequences motivating avoidance behaviors and underpinning surface-level fears. For example, the surface fear of contamination may stem from core threats such as death, suffering, or harming loved ones. Whereas traditional models of anxiety recognize the role of motivation, they have not emphasized how global motivations shape threat appraisal and avoidance. We distinguish core threats from core beliefs: while core beliefs describe how individuals view themselves, others, and the world (which typically influence the likelihood of core threats), core threats specify why outcomes matter emotionally—what makes them motivating (i.e., why are they individually costly). Core threats provide the motivational structure that organizes diverse fears across anxiety disorders and beyond. They help explain generalization, persistence, and relapse. Phenomenologically, core threats are highly individualized, reflecting personal values over diagnostic categories. Contemporary models of treatment of anxiety often emphasize metacognitive regulation processes while treating fear content as interchangeable or secondary. We propose a complementary perspective: motivationally guided appraisals determine what becomes threatening and why. We formalize this perspective in a computational framework that distinguishes motivational drivers of avoidance, including core threats, distress intolerance, and exaggerated duration. Just as categories are organized around central exemplars, fear structures are organized around motivationally central threats. Conditioning research mirrors this principle: fear generalizes more strongly from central exemplars and remains sensitive to the value of the underlying outcome. Targeting core threats—the motivational focus of fear—offers a pathway to engage broader fear networks, improve generalization, reduce relapse, and guide personalized interventions.
{"title":"The motivational anatomy of fear: A closer look at core threats","authors":"Elad Zlotnick, Jonathan D. Huppert","doi":"10.1016/j.cpr.2025.102655","DOIUrl":"10.1016/j.cpr.2025.102655","url":null,"abstract":"<div><div>“Core threats” are the ultimate feared consequences motivating avoidance behaviors and underpinning surface-level fears. For example, the surface fear of contamination may stem from core threats such as death, suffering, or harming loved ones. Whereas traditional models of anxiety recognize the role of motivation, they have not emphasized how global motivations shape threat appraisal and avoidance. We distinguish core threats from core beliefs: while core beliefs describe how individuals view themselves, others, and the world (which typically influence the likelihood of core threats), core threats specify why outcomes matter emotionally—what makes them motivating (i.e., why are they individually costly). Core threats provide the motivational structure that organizes diverse fears across anxiety disorders and beyond. They help explain generalization, persistence, and relapse. Phenomenologically, core threats are highly individualized, reflecting personal values over diagnostic categories. Contemporary models of treatment of anxiety often emphasize metacognitive regulation processes while treating fear content as interchangeable or secondary. We propose a complementary perspective: motivationally guided appraisals determine what becomes threatening and why. We formalize this perspective in a computational framework that distinguishes motivational drivers of avoidance, including core threats, distress intolerance, and exaggerated duration. Just as categories are organized around central exemplars, fear structures are organized around motivationally central threats. Conditioning research mirrors this principle: fear generalizes more strongly from central exemplars and remains sensitive to the value of the underlying outcome. Targeting core threats—the motivational focus of fear—offers a pathway to engage broader fear networks, improve generalization, reduce relapse, and guide personalized interventions.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"122 ","pages":"Article 102655"},"PeriodicalIF":12.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-08-14DOI: 10.1016/j.cpr.2025.102642
Celia Bähr , David Phan , Natalia Murawska , Julia Gerber , Annie Jordan , Kyra Hoffmann , Claudia Calvano
Transdiagnostic group interventions address the limitations of youth mental health care services, including the disorder-specific nature of existing treatments and the limited capacity of individual psychotherapies. This review synthesizes the 1) characteristics, applications, parental involvement, patient and public involvement (PPI), and 2) data on efficacy, adherence, safety and treatment satisfaction evidence of transdiagnostic group interventions for children and adolescents. Following PRISMA guidelines, a preregistered systematic literature search identified 6845 publications on transdiagnostic in-person group-based interventions for children and adolescents (mean age ≤ 18 years). Two reviewers independently screened for inclusion, extracted data, and assessed risk of bias using the RoB-2 and ROBINS-I tool. The review examined 80 studies encompassing 4152 participants (Mage = 12.81 years), mostly conducted in high-income countries. Cognitive behavioural therapy was the most commonly used approach (κ = 59), with the core components mindfulness, emotion regulation, and cognitive restructuring. Interventions averaged 11 sessions and 52 % involved parents. 22 studies targeted anxiety and depression jointly with positive pre-post effects. Significant reductions in symptom severity were also reported for other disorders, though outcome measures highly varied and group comparisons with active control conditions or treatment-as-usual were often non-significant. Few studies examined disorder-unspecific outcomes like psychosocial functioning, quality of life, or reported remission rates, treatment satisfaction or applied a PPI framework. While a large number of different transdiagnostic group interventions for youth have been developed and evaluated, the lack of rigorous reporting and high risk of bias highlight the need for better-quality research to strengthen evidence and improve clinical implementation.
{"title":"Together and beyond: A systematic review on characteristics and efficacy of transdiagnostic psychotherapeutic group-based interventions for children and adolescents","authors":"Celia Bähr , David Phan , Natalia Murawska , Julia Gerber , Annie Jordan , Kyra Hoffmann , Claudia Calvano","doi":"10.1016/j.cpr.2025.102642","DOIUrl":"10.1016/j.cpr.2025.102642","url":null,"abstract":"<div><div>Transdiagnostic group interventions address the limitations of youth mental health care services, including the disorder-specific nature of existing treatments and the limited capacity of individual psychotherapies. This review synthesizes the 1) characteristics, applications, parental involvement, patient and public involvement (PPI), and 2) data on efficacy, adherence, safety and treatment satisfaction evidence of transdiagnostic group interventions for children and adolescents. Following PRISMA guidelines, a preregistered systematic literature search identified 6845 publications on transdiagnostic in-person group-based interventions for children and adolescents (mean age ≤ 18 years). Two reviewers independently screened for inclusion, extracted data, and assessed risk of bias using the RoB-2 and ROBINS-I tool. The review examined 80 studies encompassing 4152 participants (<em>M</em><sub>age =</sub> 12.81 years), mostly conducted in high-income countries. Cognitive behavioural therapy was the most commonly used approach (<em>κ</em> = 59), with the core components mindfulness, emotion regulation, and cognitive restructuring. Interventions averaged 11 sessions and 52 % involved parents. 22 studies targeted anxiety and depression jointly with positive pre-post effects. Significant reductions in symptom severity were also reported for other disorders, though outcome measures highly varied and group comparisons with active control conditions or treatment-as-usual were often non-significant. Few studies examined disorder-unspecific outcomes like psychosocial functioning, quality of life, or reported remission rates, treatment satisfaction or applied a PPI framework. While a large number of different transdiagnostic group interventions for youth have been developed and evaluated, the lack of rigorous reporting and high risk of bias highlight the need for better-quality research to strengthen evidence and improve clinical implementation.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"121 ","pages":"Article 102642"},"PeriodicalIF":12.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-09-06DOI: 10.1016/j.cpr.2025.102646
Jessilyn M. Froelich, Emily D. Gerstein
Psychopathology research and clinical practice have historically relied on traditional diagnostic approaches, though there is a growing body of evidence suggesting these methods are likely outdated and are not suited for capturing the nuance and complexity of mental health symptomatology. Transdiagnostic approaches to psychopathology have been proposed as an alternative to traditional nosology, such as the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Diseases and their corresponding versions. The postpartum period may be a time when transdiagnostic approaches could be useful, as it has both normative and maladaptive psychological challenges with clear overlapping risk, protective, and maintenance factors related to its psychopathology. The benefits of taking a transdiagnostic approach in the postpartum period are vast – examining postpartum psychopathology transdiagnostically can help identify common thematic elements experienced by new mothers, thus leading to improved screening, further assessment, and targeted treatment. This paper reviews the current diagnostic approaches to postpartum psychopathology, the benefits of a transdiagnostic approach in the postpartum period, relevant biopsychosocial factors, and proposes ways to incorporate this transdiagnostic approach in a way that works to benefit new mothers. Additionally, potential challenges and barriers to implementation are explored.
{"title":"Towards a transdiagnostic approach to psychopathology in the postpartum period","authors":"Jessilyn M. Froelich, Emily D. Gerstein","doi":"10.1016/j.cpr.2025.102646","DOIUrl":"10.1016/j.cpr.2025.102646","url":null,"abstract":"<div><div>Psychopathology research and clinical practice have historically relied on traditional diagnostic approaches, though there is a growing body of evidence suggesting these methods are likely outdated and are not suited for capturing the nuance and complexity of mental health symptomatology. Transdiagnostic approaches to psychopathology have been proposed as an alternative to traditional nosology, such as the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Diseases and their corresponding versions. The postpartum period may be a time when transdiagnostic approaches could be useful, as it has both normative and maladaptive psychological challenges with clear overlapping risk, protective, and maintenance factors related to its psychopathology. The benefits of taking a transdiagnostic approach in the postpartum period are vast – examining postpartum psychopathology transdiagnostically can help identify common thematic elements experienced by new mothers, thus leading to improved screening, further assessment, and targeted treatment. This paper reviews the current diagnostic approaches to postpartum psychopathology, the benefits of a transdiagnostic approach in the postpartum period, relevant biopsychosocial factors, and proposes ways to incorporate this transdiagnostic approach in a way that works to benefit new mothers. Additionally, potential challenges and barriers to implementation are explored.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"121 ","pages":"Article 102646"},"PeriodicalIF":12.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-08-15DOI: 10.1016/j.cpr.2025.102643
Fangqing Liu , Xiaoshan Yin
This systematic review and meta-analysis aimed to synthesise global data on the prevalence, determinants, and moderators of Intermittent Explosive Disorder (IED). Analysing 29 studies (N = 182,112 participants across 17 countries), pooled lifetime and 12-month prevalence estimates were 5.1 % (95 % CI: 3.4–7.5 %) and 4.4 % (95 % CI: 2.9–6.7 %), respectively. Prevalence varied significantly across subgroups, with higher rates in clinical (10.5 %), refugee (8.5 %), and adolescent populations. Male gender (OR = 3.39), younger age, trauma exposure, and psychiatric comorbidities (mood, anxiety, and substance use disorders) emerged as robust risk factors. Studies using DSM-5 criteria reported lower prevalence than DSM-IV. Regional disparities were notable, with elevated rates in conflict-affected and Global South regions. Heterogeneity was partially explained by population type, diagnostic criteria, and sociocultural context. Findings underscore the multifactorial etiology of IED, shaped by biological vulnerabilities, trauma, and structural adversities. A tiered intervention framework integrating universal prevention, targeted therapies, and policy advocacy is therefore proposed to address its global burden.
{"title":"Angry without Borders: Global prevalence and factors of intermittent explosive disorder: A systematic review and meta-analysis","authors":"Fangqing Liu , Xiaoshan Yin","doi":"10.1016/j.cpr.2025.102643","DOIUrl":"10.1016/j.cpr.2025.102643","url":null,"abstract":"<div><div>This systematic review and meta-analysis aimed to synthesise global data on the prevalence, determinants, and moderators of Intermittent Explosive Disorder (IED). Analysing 29 studies (<em>N</em> = 182,112 participants across 17 countries), pooled lifetime and 12-month prevalence estimates were 5.1 % (95 % CI: 3.4–7.5 %) and 4.4 % (95 % CI: 2.9–6.7 %), respectively. Prevalence varied significantly across subgroups, with higher rates in clinical (10.5 %), refugee (8.5 %), and adolescent populations. Male gender (OR = 3.39), younger age, trauma exposure, and psychiatric comorbidities (mood, anxiety, and substance use disorders) emerged as robust risk factors. Studies using DSM-5 criteria reported lower prevalence than DSM-IV. Regional disparities were notable, with elevated rates in conflict-affected and Global South regions. Heterogeneity was partially explained by population type, diagnostic criteria, and sociocultural context. Findings underscore the multifactorial etiology of IED, shaped by biological vulnerabilities, trauma, and structural adversities. A tiered intervention framework integrating universal prevention, targeted therapies, and policy advocacy is therefore proposed to address its global burden.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"121 ","pages":"Article 102643"},"PeriodicalIF":12.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-09-11DOI: 10.1016/j.cpr.2025.102645
Iana Wong , Thomas F. Denson
Little is known about why insecure attachment is related to greater perpetration and victimization of intimate partner violence (IPV). Many studies have examined the underlying mechanisms, but no studies have integrated them. The present article aimed to systematically identify and quantify the magnitude of the mediators between anxious and avoidant attachment and IPV perpetration and victimization. We used two meta-analytic methods (two-stage structural equation modelling and multi-level meta-analyses) to accomplish this goal. After screening 5087 records, 63 eligible studies were identified. The mediators were reviewed using the framework of the I3 model. We meta-analyzed seven categories of mediators, including: 1) jealousy, anger, distrust, and perceived partner's infidelity, 2) dysfunctional beliefs, 3) maladaptive personality traits, 4) relationship dissatisfaction, 5) dominance and need for control, 6) destructive communication, and 7) emotion dysregulation. Results showed that interpersonal instigating (jealousy, anger, distrust, and perceived partner's infidelity), interpersonal impelling (relationship dissatisfaction, dominance and need for control, destructive communication), and personal disinhibiting (emotion dysregulation) factors significantly mediated the attachment-IPV relationships. The indirect effects of most instigating, impelling, and disinhibiting factors had small effect sizes, but interpersonal impelling factors such as dominance/need for control and relationship dissatisfaction had medium effect sizes in the anxiety-IPV and avoidance-IPV links respectively. Moreover, some mediators between avoidance and IPV were significant without having significant direct effects. An additional 26 mediators were presented in the Systematic Review section. The findings suggest IPV interventions should consider addressing attachment insecurity along with the relevant mediators, especially interpersonal impellance for avoidant attachment.
{"title":"Understanding the mechanisms underlying the association between insecure attachment and intimate partner violence (IPV): Meta-analyses using two meta-analytical methods and a systematic review of mediators","authors":"Iana Wong , Thomas F. Denson","doi":"10.1016/j.cpr.2025.102645","DOIUrl":"10.1016/j.cpr.2025.102645","url":null,"abstract":"<div><div>Little is known about why insecure attachment is related to greater perpetration and victimization of intimate partner violence (IPV). Many studies have examined the underlying mechanisms, but no studies have integrated them. The present article aimed to systematically identify and quantify the magnitude of the mediators between anxious and avoidant attachment and IPV perpetration and victimization. We used two meta-analytic methods (two-stage structural equation modelling and multi-level meta-analyses) to accomplish this goal. After screening 5087 records, 63 eligible studies were identified. The mediators were reviewed using the framework of the I<sup>3</sup> model. We meta-analyzed seven categories of mediators, including: 1) jealousy, anger, distrust, and perceived partner's infidelity, 2) dysfunctional beliefs, 3) maladaptive personality traits, 4) relationship dissatisfaction, 5) dominance and need for control, 6) destructive communication, and 7) emotion dysregulation. Results showed that interpersonal instigating (jealousy, anger, distrust, and perceived partner's infidelity), interpersonal impelling (relationship dissatisfaction, dominance and need for control, destructive communication), and personal disinhibiting (emotion dysregulation) factors significantly mediated the attachment-IPV relationships. The indirect effects of most instigating, impelling, and disinhibiting factors had small effect sizes, but interpersonal impelling factors such as dominance/need for control and relationship dissatisfaction had medium effect sizes in the anxiety-IPV and avoidance-IPV links respectively. Moreover, some mediators between avoidance and IPV were significant without having significant direct effects. An additional 26 mediators were presented in the Systematic Review section. The findings suggest IPV interventions should consider addressing attachment insecurity along with the relevant mediators, especially interpersonal impellance for avoidant attachment.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"121 ","pages":"Article 102645"},"PeriodicalIF":12.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-08-13DOI: 10.1016/j.cpr.2025.102639
Samantha M. Margherio , Hannah Brockstein , Azadeh Bakhtiari , Steven W. Evans
Objective
We sought to ascertain the representativeness of psychosocial treatment trials for youth with ADHD in terms of parent education (PE) and race and to determine whether these study characteristics moderated treatment outcomes.
Method
High-quality randomized controlled trials (RCTs) of psychosocial treatments for children and adolescents with ADHD conducted in the U.S. and published between 2007 and 2025 were included in this study if they reported PE (% of parents with a college degree or higher) and race/ethnicity.
Results
A total of 46 studies were included, representing 5837 participants. Between 48 % and 52 % of parents had a college degree or higher, compared to 38 % in the U.S. population. Two-thirds of studies overrepresented highly educated parents. Samples were generally representative of diverse races and ethnicity, although this appeared driven by the 35 % of studies that oversampled racially minoritized youth whereas 26 % underrepresented racially minoritized youth. Subgroup meta-analyses indicated treatment was only superior to control conditions in reducing ADHD symptoms in samples with highly educated parents. For race, treatment was only associated with significant effects on hyperactivity/impulsivity symptoms among racially-representative samples who also had high PE.
Conclusion
These findings question the effectiveness of psychosocial interventions for youth with ADHD for families of diverse educational backgrounds. There is a dire need to recruit more diverse samples in terms of PE, and to develop interventions that are effective for families across all educational backgrounds.
{"title":"Underrepresentation and moderation of parent education levels in ADHD psychosocial treatment trials: A meta-analysis","authors":"Samantha M. Margherio , Hannah Brockstein , Azadeh Bakhtiari , Steven W. Evans","doi":"10.1016/j.cpr.2025.102639","DOIUrl":"10.1016/j.cpr.2025.102639","url":null,"abstract":"<div><h3>Objective</h3><div>We sought to ascertain the representativeness of psychosocial treatment trials for youth with ADHD in terms of parent education (PE) and race and to determine whether these study characteristics moderated treatment outcomes.</div></div><div><h3>Method</h3><div>High-quality randomized controlled trials (RCTs) of psychosocial treatments for children and adolescents with ADHD conducted in the U.S. and published between 2007 and 2025 were included in this study if they reported PE (% of parents with a college degree or higher) and race/ethnicity.</div></div><div><h3>Results</h3><div>A total of 46 studies were included, representing 5837 participants. Between 48 % and 52 % of parents had a college degree or higher, compared to 38 % in the U.S. population. Two-thirds of studies overrepresented highly educated parents. Samples were generally representative of diverse races and ethnicity, although this appeared driven by the 35 % of studies that oversampled racially minoritized youth whereas 26 % underrepresented racially minoritized youth. Subgroup meta-analyses indicated treatment was only superior to control conditions in reducing ADHD symptoms in samples with highly educated parents. For race, treatment was only associated with significant effects on hyperactivity/impulsivity symptoms among racially-representative samples who also had high PE.</div></div><div><h3>Conclusion</h3><div>These findings question the effectiveness of psychosocial interventions for youth with ADHD for families of diverse educational backgrounds. There is a dire need to recruit more diverse samples in terms of PE, and to develop interventions that are effective for families across all educational backgrounds.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"121 ","pages":"Article 102639"},"PeriodicalIF":12.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-08-08DOI: 10.1016/j.cpr.2025.102638
Wencke Donath , Robin Van der Linde , Bruno Verschuere , John J.B. Allen , Richard J. McNally , Rafaele J.C. Huntjens
{"title":"Does meta-analytic evidence support inter-identity amnesia in dissociative identity disorder? A commentary and corrected analysis for Beker et al. (2024)","authors":"Wencke Donath , Robin Van der Linde , Bruno Verschuere , John J.B. Allen , Richard J. McNally , Rafaele J.C. Huntjens","doi":"10.1016/j.cpr.2025.102638","DOIUrl":"10.1016/j.cpr.2025.102638","url":null,"abstract":"","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"121 ","pages":"Article 102638"},"PeriodicalIF":12.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-09-05DOI: 10.1016/j.cpr.2025.102648
Ryan Van Patten , Kyler Mulhauser , Tara A. Austin , John A. Bellone , Erica Cotton , Lawrence Chan , Elizabeth W. Twamley , Kelsey Sawyer , W. Curt LaFrance Jr.
The relationship between subjective (self-reported) and objective (performance-based) cognitive functioning has significant clinical implications across neuropsychiatric syndromes. We performed an umbrella review examining literature on the association between subjective and objective cognition from a transdiagnostic perspective. Eligible studies were full reports of review papers examining the relationship between subjective and objective cognition in humans across the lifespan. Risk of bias was evaluated using a modified version of the AMSTAR rating scale. Of 7329 initial reports screened, 50 reviews of mostly cross-sectional data were included. Review size ranged from 4 to 488 studies and demographic factors aside from age were rarely reported. Risk of bias was mixed. A narrative synthesis across more than 20 neuropsychiatric and neuromedical conditions found an inconsistent relationship between subjective and objective cognition, with effect sizes ranging from null to weak. Mental health factors such as depression and anxiety were more reliably and strongly related to subjective cognition than were objective cognitive test scores. In a second-order meta-analysis (10 reviews; N = 92,606), the pooled correlation between overall objective and subjective cognition was 0.14 (95 % CI [0.08, 0.21]; p = 0.001, Q(9) = 179.50, τ = 0.09, I2 = 95.00, <2 % variance shared). Subjective and objective cognition are largely non-overlapping constructs, reflecting unique and complementary aspects of overall cognitive functioning regardless of the specific population investigated or assessment method used. Researchers and clinicians should not expect to find concordance between concurrent self-reported cognition and neuropsychological testing, and simple discrepancies between subjective and objective cognition are so common as to be diagnostically unhelpful.
{"title":"The association between subjective and objective cognitive functioning from a transdiagnostic perspective: An umbrella review and meta-analysis","authors":"Ryan Van Patten , Kyler Mulhauser , Tara A. Austin , John A. Bellone , Erica Cotton , Lawrence Chan , Elizabeth W. Twamley , Kelsey Sawyer , W. Curt LaFrance Jr.","doi":"10.1016/j.cpr.2025.102648","DOIUrl":"10.1016/j.cpr.2025.102648","url":null,"abstract":"<div><div>The relationship between subjective (self-reported) and objective (performance-based) cognitive functioning has significant clinical implications across neuropsychiatric syndromes. We performed an umbrella review examining literature on the association between subjective and objective cognition from a transdiagnostic perspective. Eligible studies were full reports of review papers examining the relationship between subjective and objective cognition in humans across the lifespan. Risk of bias was evaluated using a modified version of the AMSTAR rating scale. Of 7329 initial reports screened, 50 reviews of mostly cross-sectional data were included. Review size ranged from 4 to 488 studies and demographic factors aside from age were rarely reported. Risk of bias was mixed. A narrative synthesis across more than 20 neuropsychiatric and neuromedical conditions found an inconsistent relationship between subjective and objective cognition, with effect sizes ranging from null to weak. Mental health factors such as depression and anxiety were more reliably and strongly related to subjective cognition than were objective cognitive test scores. In a second-order meta-analysis (10 reviews; <em>N</em> = 92,606), the pooled correlation between overall objective and subjective cognition was 0.14 (95 % CI [0.08, 0.21]; <em>p</em> = 0.001, Q(9) = 179.50, τ = 0.09, I<sup>2</sup> = 95.00, <2 % variance shared). Subjective and objective cognition are largely non-overlapping constructs, reflecting unique and complementary aspects of overall cognitive functioning regardless of the specific population investigated or assessment method used. Researchers and clinicians should not expect to find concordance between concurrent self-reported cognition and neuropsychological testing, and simple discrepancies between subjective and objective cognition are so common as to be diagnostically unhelpful.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"121 ","pages":"Article 102648"},"PeriodicalIF":12.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-09-10DOI: 10.1016/j.cpr.2025.102647
Serena Bruno, Gaia Cichetti, Patrizia Velotti PhD
Background
The relationship between suicide-related outcomes and dissociation is a critical issue. In recent years, research has focused on understanding dissociation as an acquired capacity factor for suicide attempts. Moreover, meta-analysis findings demonstrate the relationship between dissociation and suicidal ideation. To unravel the role of dissociation in the development of suicidal ideation and attempt, this study adopts a multidimensional perspective, that conceptualizes a complex construct comprising distinct but related domains which reflects disruptions in perception, cognition, emotion, and somatic experience.
Methods
We conducted systematic research on the main databases (PubMed, Medline, APA PsycInfo, Scopus, Web of Science, APA PsycArticles), collecting the literature of the last 30 years. A total of 84 studies (Ntotalsample = 129.582) studies were included in the systematic review. Of these, 68 studies were included in the meta-analysis. The analyses are based on the Pearson correlation coefficient as the effect size for the relationship between suicide-related outcomes and dissociation domains. The outcome variables included suicidal ideation, suicide attempts, and suicide risk - a composite or dimensional construct reflecting the likelihood of suicidal thoughts or behaviors, as well as specific psychological factors associated with the emergence of suicidal outcomes, as reported in the selected studies.
We used a random effects model, conducted moderation analyses to explain the heterogeneity of study variance, controlled for publication bias, and assessed the methodological quality of the included studies.
Results
General dissociation was significantly correlated with suicidal risk (r = 0.29; p < .001), suicidal ideation (r = 0.25; p < .001), and suicide attempts (r = 0.27; p < .001). A positive and significant relationship was found between suicidal ideation and detachment (r = 0.31; p < .001), as well as with maladaptive daydreaming (r = 0.27; p < .001). A statistically significant but small association was also observed between suicide attempts and somatoform dissociation (r = 0.02; p < .001), whereas a stronger connection was found with suicidal ideation (r = 0.31; p < .001). Moderator effects related to sample characteristics, sociocultural factors, and methodological quality of studies were identified with no evidence of publication bias.
Conclusions
These findings support the importance of a multidimensional approach to examining dissociation and suicide-related outcomes, revealing differential relationships based on the specific domains assessed. The resulting clinical implications and future directions are discussed.
{"title":"Multidimensional perspective of dissociation and suicide-related outcomes: A Meta-analysis and systematic review","authors":"Serena Bruno, Gaia Cichetti, Patrizia Velotti PhD","doi":"10.1016/j.cpr.2025.102647","DOIUrl":"10.1016/j.cpr.2025.102647","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between suicide-related outcomes and dissociation is a critical issue. In recent years, research has focused on understanding dissociation as an acquired capacity factor for suicide attempts. Moreover, meta-analysis findings demonstrate the relationship between dissociation and suicidal ideation. To unravel the role of dissociation in the development of suicidal ideation and attempt, this study adopts a multidimensional perspective, that conceptualizes a complex construct comprising distinct but related domains which reflects disruptions in perception, cognition, emotion, and somatic experience.</div></div><div><h3>Methods</h3><div>We conducted systematic research on the main databases (PubMed, Medline, APA PsycInfo, Scopus, Web of Science, APA PsycArticles), collecting the literature of the last 30 years. A total of 84 studies (N<sub>totalsample</sub> = 129.582) studies were included in the systematic review. Of these, 68 studies were included in the meta-analysis. The analyses are based on the Pearson correlation coefficient as the effect size for the relationship between suicide-related outcomes and dissociation domains. The outcome variables included suicidal ideation, suicide attempts, and suicide risk - a composite or dimensional construct reflecting the likelihood of suicidal thoughts or behaviors, as well as specific psychological factors associated with the emergence of suicidal outcomes, as reported in the selected studies.</div><div>We used a random effects model, conducted moderation analyses to explain the heterogeneity of study variance, controlled for publication bias, and assessed the methodological quality of the included studies.</div></div><div><h3>Results</h3><div>General dissociation was significantly correlated with suicidal risk (<em>r</em> = 0.29; <em>p < .001</em>), suicidal ideation (<em>r</em> = 0.25; <em>p < .001</em>), and suicide attempts (<em>r</em> = 0.27; <em>p < .001</em>). A positive and significant relationship was found between suicidal ideation and detachment (<em>r</em> = 0.31; <em>p < .001</em>), as well as with maladaptive daydreaming (<em>r</em> = 0.27; <em>p < .001</em>). A statistically significant but small association was also observed between suicide attempts and somatoform dissociation (<em>r</em> = 0.02; <em>p < .001</em>), whereas a stronger connection was found with suicidal ideation (<em>r</em> = 0.31; <em>p < .001</em>). Moderator effects related to sample characteristics, sociocultural factors, and methodological quality of studies were identified with no evidence of publication bias.</div></div><div><h3>Conclusions</h3><div>These findings support the importance of a multidimensional approach to examining dissociation and suicide-related outcomes, revealing differential relationships based on the specific domains assessed. The resulting clinical implications and future directions are discussed.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"121 ","pages":"Article 102647"},"PeriodicalIF":12.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145089177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}