ObjectivesPersonalized symptom networks are emerging as a tool to enhance psychiatric case conceptualizations. However, applications of the approach have so far focused on illness-causing (pathogenic) factors and their relationships with each other, whereas it is possible that a useful case conceptualization needs to include health-promoting (salutogenic) factors. The aim of this study was to investigate adolescents' and clinicians' evaluations of pathogenic and salutogenic idiographic networks.MethodsNetworks were created for nine adolescent women by using the PECAN (Perceived Causal Networks) method. For every participant two networks were produced: one consisted of symptoms, such as “stuck in negative thoughts” as nodes (pathogenetic), the other health-promoting factors, such as “can let go of negative thoughts” as nodes (salutogenic). The same nine adolescents (Study I) and twenty therapists (Study II) evaluated these networks.ResultsAdolescents evaluated their salutogenic networks as easier to define and create, but their pathogenic network as more useful. Therapists considered both methods to be clinically useful, but in general rated the salutogenic networks to be more informative. Both adolescents and therapists stressed the complementary use of salutogenic and pathogenic networks.ConclusionsFuture studies should explore ways to integrate pathogenic and salutogenic nodes in the same network, and compare whether patients collecting longitudinal data might be differentially impacted by a focus on either symptoms or strengths.Practice implicationsPerson-specific networks could complement traditional case conceptualization by integrating both symptoms and resilience factors.

No abstract

No abstract

No abstract

Adolescence is characterized by large bodily changes and a heightened body-focus. It is also a sensitive period for the onset of various forms of psychopathology. Previous longitudinal studies have shown that body dissatisfaction is a predictor of disordered eating, non-suicidal self-injury (NSSI), and depression among adolescents. Body dissatisfaction, however, only represents one aspect of bodily self-experience. Another aspect is embodiment, defined as the anchoring of one's identity in bodily self-experience. Research in this area, however, has been hampered by the lack of a psychometrically sound measure of embodiment that can be administered to adolescents. The purpose of the present study was to develop a brief measure of embodiment suitable for young adolescents. A 12-item Embodiment Scale (ES-12) was developed and underwent confirmatory factor analysis and tests of internal consistency, test-retest reliability, measure invariance, subscale inter-correlations, and construct validity. Incremental validity was analyzed to see if the ES-12 could predict disordered eating, non-suicidal self-injury, depression, and anxiety, above and beyond that of a measure of body dissatisfaction. The ES-12 was found to exhibit robust psychometric properties, such as a distinct three-factor structure, strong internal consistency, and good test-retest reliability. It demonstrated good convergent and divergent validity, indicating that its three subscales-Harmonious Body, Disharmonious Body, and Body for Others-are significantly associated with a range of psychological health issues in adolescents. In addition, the ES-12 demonstrated consistent incremental validity by predicting disordered eating, NSSI, depression, and anxiety, beyond that of a measure of body dissatisfaction. The results suggest that ES-12 is a useful instrument in research on the experience of embodiment among adolescents.

The aim of this study was to explore factors psychotherapists believe influence their choice of theory, method, and techniques when doing therapeutic work. Semi-structured interviews were conducted with six certified psychotherapists and one psychotherapist in training. The interviews were analyzed using Interpretative Phenomenological Analysis (IPA), a qualitative methodology which explores how individuals make sense of their experiences. With the help of that methodology, we identified four main themes: Congruence, Responsibility, Context, and Flexibility. Our results indicated that practical and theoretical knowledge needs to be synchronized with the individual practitioner's basic personality. This enables the psychotherapists to experience themselves as professionals, as well as being their authentic self. When the professional and personal identity is joined together, a space is created for greater flexibility in the use of methods and techniques. The study also indicated the existence of a habitus among the psychotherapists embodied in a common language, derived from professional training, supervision and collegial discussions. There was also a consensus among the psychotherapists that they, as professionals, need to be independent and autonomous when doing therapeutic work. Permissive and supportive organizations were seen as an important asset, as well as access to colleagues and networks. The participants in the present study characterized their attitudes to clinical work using keywords such as curiosity, presence, and co-creation. It is suggested that therapists constantly walk a fine line between being an expert and at the same time bracketing their professional knowledge to meet the needs of their clients. A main limitation of the present study was that almost all participants belonged to one therapeutic orientation within the field of psychotherapy (family therapy).

Fear of cancer recurrence (FCR) is defined as "fear, worry, or concern relating to the possibility that cancer will come back or progress". After cancer treatment, 20% of patients suffer from clinical fear of cancer recurrence (FCR), warranting specialized treatment. While intrusive catastrophic scenarios are clinical symptoms of FCR, they are rarely the key focus in current FCR treatments. Eye Movement Desensitization Reprocessing (EMDR) including the flash forward procedure explicitly addresses these intrusions. The present study explored whether EMDR is effective in treating clinical FCR. A sequentially replicated, randomized single-case experimental design was used among six cancer survivors with clinical levels of FCR. During an 84-day period, participants daily registered their FCR level. The Fear of Recurrence Inventory was administered at baseline, EMDR start, EMDR completion and study completion. The start of EMDR was randomized. All participants commented positively on the effect of EMDR during the semi-structured interviews: EMDR helped decrease intrusions and face death anxiety. Visual analysis of daily FCR were in line with these comments. Regression analysis showed a significant decrease of daily FCR in two participants, while the randomization test showed no effects. FCRI scores decreased below clinical levels in all participants, which was considered a reliable change in four participants. There was no drop-out. In light of these mixed findings, EMDR appears a promising treatment for FCR. Further research needs to establish its effectiveness and explore whether diminishing the emotional load of intrusions constitutes the working mechanism of EMDR in FCR.

Several researchers have argued that disturbances in embodiment play an important role in the development of psychological health problems among adolescents. The purpose of the present study was to use the 12-item Embodiment Scale (ES-12), with its three subscales Harmonious Body (HB), Disharmonious Body (DB), and Body for Others (BO), (1) to identify subgroups of adolescents with different profiles on the ES-12 scales, and (2) to see how these profiles are associated with patterns of psychological health problems. The participants were 530 adolescents with a mean age of 14 years (SD = 0.89), who filled out the ES-12 and measures of disordered eating, non-suicidal self-injury (NSSI), anxiety, and depression. Hierarchical cluster analysis was used to divide the sample into (1) subgroups with different profiles of HB, DB and BO and (2) subgroups with different psychological health profiles. Cross-tabulation was used to study associations between different embodiment profiles and different patterns of psychological health problems. Five different profiles of embodiment were identified: Strong Embodiment, Average Embodiment, Weak Embodiment, Body for Others, and Low Body Harmony. Five different psychological health profiles were identified: Multiple Problems, Multiple Problems without NSSI, Disordered Eating Only, Average Psychological Health, and a Healthy profile. Cross-tabulation showed that individuals with a Strong Embodiment profile were over-represented among adolescents in the Healthy cluster, and that individuals with the Weak Embodiment profile were over-represented in both Multiple Problems clusters. Individuals with a Body for Others profile were overrepresented among adolescents with a Disordered Eating Only profile but not among adolescents with Multiple Problems profiles. These findings align with theoretical frameworks which emphasize the importance of embodiment for the understanding of psychological health problems. At the same time, the results go against theories that attribute a central role to high levels of experienced Body for Others for the development of psychological health problems.

Lienert's (1973) original approach to comparing groups with Configural Frequency Analysis (CFA) cannot straightforwardly be generalized to the comparison of multiple groups. The present article proposes a new base model for group comparison with CFA. This model allows researchers to compare multiple groups, to evaluate overall model fit, to take covariates into account, and to conduct exploratory and confirmatory analyses. In confirmatory group comparisons, base models need to be specified in which particular configurations are blanked out, and other configurations are explicitly set equal. Reference is made to existing base models, e.g., the configural model of axial symmetry. Data examples are provided in which individuals are compared. Extensions of the new models are discussed.

Ecological momentary assessment (EMA) of affect, cognition and behavior aims to provide a 'window into a person's daily life'. But what should we look for through this window? In this paper, we compare a statistical perspective, grounded in probability theory, with a dynamic pattern perspective, grounded in complexity theory, on two common phenomena in EMA data: non-stationarity and outlying values. From a statistical perspective, these phenomena are considered nuisances that should be dealt with. From a dynamic pattern perspective, in contrast, non-stationarity may signal transitions from one dynamic pattern to another (e.g., a transition from a neutral to a persistent sad mood), whereas outlying values may signal recovery from perturbations (e.g., stressful life events). We evaluated the dynamic pattern view with a triangulation study of multiple single cases that took part in the Track your Mood EMA study, where participants reported on their emotions and daily events for 60 days. We found that non-stationarity was indeed related to a pattern transition, whereas outlying values were related to recovery after perturbations. These findings show that person-oriented EMA research would benefit from a dynamic pattern perspective that can identify highly meaningful and clinically relevant phenomena that are otherwise at risk of being missed. Complementing EMA time series with contextual information and qualitative data will be essential to genuinely understand these phenomena.