Psychology and Psychotherapy-Theory Research and Practice最新文献

Objectives: This study used a network approach to examine gender differences in adolescents regarding unresolved attachment styles, COVID-19 PTSD symptoms, comorbid psychiatric symptoms, and contamination fear. The rationale for the study stems from the suggestion that parents' relationships with adolescents (i.e., attachment) can influence how adolescents cope with distress during COVID-19. Since attachment is linked to gender differences, these differences should also be considered. Furthermore, while much has been documented on secure or insecure attachment, little is known about whether the impact of unresolved attachment can influence psychological distress in adolescents.

Methods: Adolescents (n = 1715; 803 females, 912 males) from five Hong Kong secondary schools completed measures assessing unresolved attachment, contamination-related fears, PTSD symptoms, and general psychological disorders.

Results: No significant gender differences were observed in network density or global strength. However, network structure analysis revealed weaker connections among males compared to females. For males, all unresolved attachment aspects were linked to COVID-19 PTSD and comorbid psychiatric symptoms, while for females, only perceived failed protection correlated with depression. Both genders showed associations between PTSD, comorbid symptoms, and contamination fear.

Conclusions: While trauma and psychological reactions were shared, gender differences emerged in how unresolved attachment influenced distress. Males exhibited broader attachment-related distress links, whereas females showed more specific associations. These findings enhance understanding of adolescent psychotherapy needs during crises.

Objective: This study aimed to evaluate the effectiveness of cognitive behavioural therapy (CBT), parent training programm (PTPs), and their combination as adjunctive interventions to medication in reducing core ADHD symptoms and functional difficulties in children aged 7-11 who had been receiving pharmacological treatment. The goal was to examine whether these psychosocial approaches could enhance treatment outcomes beyond medication alone.

Method: Forty-two mother-child dyads were randomly assigned to one of four groups: (1) medication (M) plus cognitive behavioural therapy (CBT), (2) M plus parent training programme (PTP), (3) M plus both CBT and PTP (combined), and (4) M only (control). Families completed the sociodemographic data form, the Turgay DSM-IV ADHD Assessment Scale, and the Strengths and Difficulties Questionnaire (SDQ) before and after the intervention period. Data were analysed using Kruskal-Wallis H, Mann-Whitney U, Bonferroni correction, Wilcoxon signed-rank, and Chi-square tests, with a significance level set at p < .05.

Results: Significant reductions in attention deficit, hyperactivity, and impulsivity were observed in the M + CBT, M + PTP, and combined groups, as measured by the Turgay DSM-IV ADHD Assessment Scale. According to the SDQ, all three groups also showed significant decreases in SDQ impact scores, suggesting improved functional outcomes. In contrast, the control group showed improvement only in attention deficit, despite a notable increase in SDQ impact scores, indicating worsened overall functioning.

Conclusion: Adjunctive CBT, parent training, and their combination were more effective than medication alone in reducing core ADHD symptoms and improving children's functioning. These findings support the integration of psychosocial interventions into routine ADHD treatment, especially in school and family settings where behavioural support is essential. However, the small sample size limits generalizability, and further research with larger samples, extended follow-up, and placebo-controlled designs is needed to confirm these results and guide evidence-based policy and practice.

Objective: Adolescent depression is a significant public health concern, with emotional neglect and psychoticism identified as key risk factors. This study investigated their longitudinal effects on adolescent depression within a unified framework.

Method: A total of 1894 Italian adolescents (M = 15.46, SD = 1.10) participated in a three-wave longitudinal study, with assessments conducted at baseline (T1), six months (T2) and twelve months (T3). A cross-lagged panel design was applied to examine the bidirectional relationships and mediation effects among study variables over time.

Results: Emotional neglect was associated with higher levels of psychoticism and depression one year later. Psychoticism, in turn, predicted increases in depression one year later. Mediation analyses showed that emotional neglect indirectly contributed to later depression through its effects on psychoticism. Overall, these findings support cumulative developmental risk models, underscoring the psychological and clinical relevance of these pathways in adolescence.

Conclusions: These results suggested that adolescents experiencing emotional neglect are at heightened risk for depression, with psychoticism compounding this risk. Interventions focusing on emotional support and addressing psychotic tendencies may help mitigate depression and improve adolescent mental health outcomes.

Objective: As part of a task-sharing strategy, clinical psychologists are becoming increasingly expected to offer therapy training for staff in health care services to develop psychological mindedness to increase access and provision of psychological support for clients. The current study explored how 10 staff working in health care settings experienced Solution-Focused Brief Therapy (SFBT) training and how they subsequently used it.

Methods: One-to-one semi-structured interviews were conducted with 10 participants; a constructivist grounded theory (GT) approach was used to generate a model based on the participants' reflections after the training.

Results: Staff shared how they felt they needed evidence of SFBT effectiveness in order to believe that learning a new model would be worth the required investment. They also found realistic role modelling that was relevant to their context to be particularly convincing as well as regular support from their peers and multidisciplinary meetings. Participants also shared some barriers to using SFBT in practice, including time-restricted clinics, service pressures and challenging clients.

Conclusion: The model describes a complex dynamic between personal, interpersonal and systemic factors that influenced the staff members' individual decision to abandon the more familiar medical model that represented a sense of comfort and safety. The study includes recommendations for how clinical psychologists can address the identified facilitators and barriers to facilitate more effective training programmes and training transfer.

Aims: This qualitative study explored the subjective experiences of psychologists in terms of the establishment and development of the therapeutic relationship with adults with intellectual disabilities (ID). It placed a particular focus on the psychologist's own process in their work.

Method: Sixteen psychologists took part in semi-structured interviews. Psychologists were asked to reflect on the process of developing a therapeutic relationship in addition to other relevant factors such as their attitudes, biases and the transferential relationship. The interviews were analysed using reflexive thematic analysis (RTA).

Results: Two main themes were developed including: (1) the relationship is key-a desire for friendship, balancing formality with informality and (2) letting go of what you know-psychologist's biases and the transferential relationship.

Discussion: The results highlighted the importance of the psychologist's process in the work with adults with ID, and the need for future research with adults with ID themselves to ascertain their views on the therapeutic relationship.

Objectives: To evaluate cognitive analytic therapy-guided self-help (CAT-GSH) for depression in terms of outcomes and acceptability.

Design: A parallel mixed methods case series with session-by-session outcome measurement supplemented by patient and staff interviewing.

Methods: Four psychological well-being practitioners (PWPs) delivered CAT-GSH to N = 11 patients in an NHS talking therapies service, and these patients were followed up at 1 month. Acceptability of CAT-GSH was assessed via treatment refusal and dropout rates, sessional attendance and qualitative interviewing of PWPs and patients. Outcomes were assessed by comparing group means at screening, termination and follow-up on sessional measures, calculating the case-by-case recovery rate and benchmarking against relevant research.

Results: All 11 patients offered CAT-GSH accepted; one patient dropped out, all completers attended the full 6 sessions, and 7/10 were in reliable recovery at follow-up. Treatment gains were maintained over the follow-up period, and outcomes appeared equivalent when benchmarked against the evidence base. Patients found CAT-GSH to be a mostly acceptable intervention, and this was due to mood improvements, better recognition skills and implementation of 'exits'. CAT-GSH improved the diversity of the treatment offer for PWPs and provided professional development opportunities.

Conclusions: CAT-GSH holds promise as a low-intensity treatment for depression, but clearly more controlled research is needed.

Objectives: Dissociation is a well-established mediator of the relationship between trauma and psychosis. Despite identified phenomenological similarities, there is limited research regarding the nature of the relationship between dissociation and delusions. The study aimed to identify dissociative experiences within delusions and examine whether these are associated with childhood trauma and its psychological sequelae.

Methods: Sixty-four young people were recruited from an early psychosis service and completed a cross-sectional assessment of childhood trauma, psychosis, PTSD and dissociation. A coding frame was developed to identify dissociative detachment and compartmentalisation within descriptions of delusions. Group comparisons were conducted to examine differences in the severity and frequency of trauma, PTSD, dissociation and psychosis between those with and without dissociative delusions.

Results: Thirty-four participants (59%) had at least one delusion that clearly included dissociative content. Compartmentalisation was identified in the descriptions of delusions for 25 participants (43%), and detachment was identified in the descriptions of delusions for 12 participants (21%). Three participants (5%) described a delusion that contained both compartmentalisation and detachment. All participants described at least one delusion without compartmentalisation or detachment. Those with dissociative delusions had a significantly higher frequency of PTSD diagnoses (χ²(1) = 5.32, p = .02, ϕ_c = 0.31).

Conclusion: Dissociative experiences are prevalent amongst those with early psychosis and can be reliably identified in the descriptions of delusions. It is likely that dissociation is phenomenologically important for the experience of some delusions.

Objective: Talking about the present-moment quality of a therapy relationship-sometimes termed immediacy or working in the here and now-has been recommended as a technique to enhance the therapeutic alliance and treatment outcome. The aim of the present study was to compare perceptions of therapy when the discussion was of the client's relationship with the therapist or with someone else.

Method: In the study, undergraduate participants were presented with an audio recording of a therapist and client discussing their relationship and another recording in which the discussion was of the client's relationship with someone else. For approximately half the participants, the relationships discussed were both positive; for the other participants, both relationships were problematic. After listening to each recording, participants rated the therapeutic bond and treatment credibility.

Results: Results revealed that the effect of discussing the therapy relationship depended on the relationship valence: When the valence was positive, participants rated the therapeutic bond and treatment credibility higher for discussions of the therapy relationship; when the valence was negative, ratings were higher for discussions of an outside relationship.

Conclusion: These findings suggest that focusing the therapy discussion on the therapeutic relationship may be more helpful when the relationship is positive than when it is negative.

Objectives: Research consistently reports an association between auditory hallucinations and traumatic experiences, yet the psychological mechanisms underpinning this relationship remain poorly understood. Empirical evidence suggests that enduring dispositions, including early maladaptive schemas, interact with immediate stressors to elicit auditory hallucinations. The inner critic represents the activation of such enduring dispositions and concurs with common themes in auditory hallucinations. This study aimed to investigate the effect of the inner critic on speech illusions and the emotional valence of perceived words.

Design: A quasi-experimental design was utilised.

Methods: Forty-two non-clinical participants (67.40% female, M_age = 29.63) completed self-report questionnaires measuring predisposition to hallucination-like experiences, self-criticism and demanding and punitive parent schema modes. Participants then completed an auditory perception task, the Babble Task, inducing speech illusions before and after an inner critic imagery manipulation.

Results: A mixed factorial analysis of variance revealed a significant main effect of the inner critic manipulation on speech illusions, with participants reporting more speech illusions after the manipulation. Participants scoring high on the demanding parent mode reported more speech illusions overall. Linguistic analysis of speech illusions demonstrated an increase in negative tone across groups following the inner critic manipulation.

Conclusions: While acknowledging concerns regarding the convergent validity of the Babble Task, these findings add nuance to existing theories by suggesting that an activated inner critic impairs source monitoring and shapes the content of ensuing auditory intrusions. Additionally, the findings indicate the inner critic as a potential target for treatment in distressing auditory hallucinations.