Clinical Psychology Review最新文献

Neurobiological information – including executive functioning – is increasingly relevant for forensic clinical practice, as well as for the criminal justice system. Previous meta-analyses report that antisocial populations show impaired performance on executive functioning tasks, but these meta-analyses are outdated, have limitations in their methodological approach, and are therefore in need of an update. The current multi-level meta-analysis including 133 studies (2008-2023) confirms impaired performance in executive functioning (d=.42), but studies are heterogeneous. Several moderator analyses showed that neuropsychological test used, type of executive function component, and control group characteristics moderated the overall effect. Specifically, matching psychiatric problems in the non-antisocial control group eliminated any differences in executive functioning between groups. No moderation effects were found for assessment quality, hot or cold executive functions, and various population characteristics. These results could indicate that the assessment of executive functioning in antisocial populations may be less relevant for recidivism risk assessment than thought, although this should first be assessed in prospective longitudinal studies. Executive functioning could potentially be used to identify or screen for individuals with certain treatment needs or be used as a responsivity factor, especially in disorders which are often underdiagnosed in criminal justice settings.

Children and adolescents with Autism Spectrum Disorder (ASD) often experience challenges in emotion regulation (ER) and emotion dysregulation (ED) which can interfere with their adaptive functioning. This study aimed to systematically review and meta-analyze the evidence on ER/ED in children and/or adolescents with ASD, examining its relationship with the following variables: internalizing and externalizing symptoms, cognitive function and social skills, and the effectiveness of non-pharmacological interventions addressing ER difficulties. Both electronic and manual searches were conducted to identify potential studies. Fifty-five studies were included in the meta-analysis. A statistically significant between-group difference was found, suggesting greater ER/ED challenges in the ASD group. Also, the ASD group showed more maladaptive ER strategies and fewer adaptive ER strategies compared to the non-ASD participants. Additionally, more severe ASD and poorer social skills were associated with greater ED and poorer ER skills, respectivelly. Furthermore, there was a significant correlation between internalizing symptomatology and both adaptive and maladaptive ER strategies. Studies of non-pharmacological interventions showed significant improvement in both ER and ED. These results imply that assessing ER/ED in children and adolescents with ASD should be part of the evaluation process, and it should also be a focal point for intervention in this population.

Parenting a child with a chronic illness presents a complex journey marked by various challenges, along with possible personal growth following these challenges. In this systematic review we present three meta-analyses, in order to examine the associations of post-traumatic growth (PTG) among parents of children with diverse chronic illnesses, and psychological distress, social support, and resilience. Analyzing 34 studies encompassing a total of 5328 parents, the results reveal several key findings. First, PTG was found to be prevalent among the parents. Second, there was no significant correlation between PTG and psychological distress, suggesting that these two processes may exist independently. Third, a positive correlation was observed between PTG and both social support and resilience-related factors, underscoring the role of these factors in fostering growth among parents of children with chronic illnesses. Additionally, illness type emerged as a moderator, affecting the strength of the above-mentioned correlations with PTG. Specifically, in the case of psychiatric illnesses, correlations of PTG with social support and resilience were stronger than in the context of other illnesses. Overall, this review emphasizes the significance of recognizing and addressing PTG correlates among parents of children with chronic illnesses, offering insights for clinical practice.

Callous-unemotional (CU) traits have been measured in a variety of sample-types (e.g., community or forensic) and from the perspective of different informants (e.g., self-report or parent-report) using the inventory of callous-unemotional traits total score (ICU-T). Although the positive association between CU traits and antisocial behavior is uncontroversial, the degree to which sample-types are different from each other has received little attention despite such knowledge being important for generalization and interpretation of research findings. To address this gap in the literature, we estimated the implied distribution of the ICU-T across sample-types, informants, and their interaction using meta-analytic models of sample means and variances. In unconditional models, we found that sample-type significantly moderated mean ICU-T scores but not variance, while informant significantly moderated the variance of ICU-T scores but not means. There was also a significant interaction between sample-type and informant. Mean parent-reported ICU-T scores were significantly lower than self-reported scores in community samples, but not significantly different in samples with elevated levels of antisocial behavior. Implications of our findings include improved research efficiency, the need for different ICU-T norms across informants, and greater understanding of informant biases.

Autistic adolescents are at increased risk of developing mental health problems. Improving psychological well-being could reduce the likelihood of such problems developing. Research has tended to prioritise the voices of non-autistic people and has neglected to consult autistic young people themselves. Our meta-synthesis aimed to systematically review qualitative research on the perspectives of autistic young people and their parents on the lived experience of psychological well-being. We conducted a pre-planned systematic search which identified 2552 papers, with 37 of those meeting full inclusion criteria. Included papers were published between 2008 and 2023, with three-quarters published since 2018. We extracted qualitative data from each paper pertaining to the lived experience of psychological well-being in autistic young people and conducted a thematic synthesis. We identified three themes; Walking a tightrope: the need for growth versus recharging through rest and familiarity; Developing a positive sense of self in the social world; Internally driven sources of happiness. Psychological interventions aiming to improve well-being in autistic young people should respect their autonomy and need for rest whilst encouraging growth and skills development, provide opportunities to understand social needs and differences, and promote opportunities to enjoy special interests.

Psychologists remain underrepresented in end-of-life care, and there is limited understanding of their role among healthcare professionals, patients, and caregivers. This systematic mixed-studies review, prospectively registered on PROSPERO (CRD42020215775), explored the role of psychologists, and the facilitators and barriers they experience, in supporting clients with illness-related dying and death. A search of six research databases was conducted in October 2023. Fifty-one studies, mainly qualitative and from the perspectives of psychologists, met inclusion criteria. Thematic synthesis highlighted how psychologists provided expertise across various contexts. They supported clients with preparing for death, and adjusting to dying, provided professional consultancy and support, and undertook leadership in enhancing psychological end-of-life care. Results illustrated the sustaining factors and ongoing challenges working in end-of-life care, namely, the unique nature of navigating the death space, recognition and awareness of psychologists' contribution, and the support, training and development required. Given the universality of dying and death, this review is relevant to psychologists working within and beyond more traditional end-of-life care contexts, such as employee assistance programs, private practice, schools, and other psychological services. Policy, clinical and research implications are discussed, including the need for greater engagement and training of psychologists in the dying and death space.

Background

Mentalizing, making sense of mental states, is hypothesized to have a central role in self-organization and social learning. Findings support this notion, but the extent of the association between mentalizing and various correlates has not been meta-analyzed. Furthermore, mentalizing presumably occurs with (explicit) and without (implicit) awareness but few studies have attempted to disentangle these aspects. We conducted a meta-analysis of implicit and explicit mentalizing in relation to the domains of attachment security, personality, affect, psychopathology, and functioning.

Methods

We searched for studies of adult mentalizing in PsycINFO and in related reviews. Overall, 511 studies (N = 78,733) met criteria and were analyzed using multi-level meta-analysis.

Results

Implicit (r = 0.19–0.29) and explicit (r = 0.26–0.40) mentalizing were moderately correlated with psychopathology, functioning, personality, affect, and attachment security. The correlations of implicit mentalizing were stronger with more objectively measured correlates (b = 0.02, p < .001) while the correlations of explicit mentalizing were not (b = −0.07, p = .21).

Conclusions

Mentalizing is associated with better intra- and interpersonal functioning. Implicit mentalizing is more strongly associated with objectively measured correlates. These findings underscore the importance of an integrative approach considering both implicit and explicit mentalizing.

Many youth experience mental health problems and digital games hold potential as mental health interventions. This systematic review provides an overview of randomised controlled studies assessing the effectiveness of digital applied and casual games for improving mental health in youth aged 6–24 years. A systematic search of PsycINFO, Web of Science and Pubmed yielded 145 eligible studies. Studies on (sub)clinical participant samples (n = 75) most often focused on attention-deficit/hyperactivity disorder (ADHD), autism and anxiety. Applied games were found most effective for improving social skills, verbal memory and anxiety, whereas casual games were found most effective for improving depression, anxiety and ADHD. Studies involving healthy youth (n = 70) were grouped into papers examining anxiety in medical settings, momentary effects on positive and negative affect, and papers employing a longitudinal design measuring mental health trait outcomes. Promising results were found for the use of games as distraction tools in medical settings, and for applied and casual games for improving momentary affect. Overall, our findings demonstrate the potential of digital games for improving mental health. Implications and recommendations for future research are discussed, such as developing evaluation guidelines, clearly defining applied games, harmonising outcome measures, including positive outcomes, and examining nonspecific factors that may influence symptom improvement as well.

Meta-analytic methods were used to examine global and domain-specific (i.e., academic, social, behavioral) self-esteem in children and adolescents with and without ADHD. Potential moderators of effect size heterogeneity were also examined via meta-regressions within a three-level approach. Findings from 49 aggregated global self-esteem effect sizes (ADHD_N = 2500, TD_N = 9448), 12 academic self-esteem effect sizes (ADHD_N = 386, TD_N = 315), 11 social self-esteem effect sizes (ADHD_N = 258, TD_N = 254), and 8 behavioral self-esteem effect sizes (ADHD_N = 231, TD_N = 211) suggest that children and adolescents with ADHD experience moderate global (ES = 0.46, p < .001), academic (ES = 0.60, p = .009), and social (ES = 0.67, p = .001) self-esteem impairments compared to children and adolescents without the disorder. The aggregated behavioral self-esteem effect size (ES = 0.20, p = .54), however, was not significant, and the global self-esteem effect size was markedly smaller compared to effect sizes for the academic and social domains. Further, examination of potential moderators of effect size heterogeneity indicated null effects for medication status, diagnostic complexity, informant, age, sex, comorbid psychopathology, and self-esteem dimension. Collectively, findings suggest that children and adolescents with ADHD do not hold a ubiquitous negative self-perception of difficulties across academic, social, and behavioral domains of functioning, and unexamined domains that are distal to ADHD may serve to bolster global self-esteem.