Effective Psychotherapeutic Interventions Research Articles

The influence of gender in cognitive insight and cognitive bias in people with first-episode psychosis: an uncontrolled exploratory analysis.

Previous studies have investigated the role of gender in clinical symptoms, social functioning, and neuropsychological performance in people with first-episode psychosis (FEP). However, the evidence of gender differences for metacognition in subjects with FEP is still limited and controversial. The aim of the present study was to explore gender differences in cognitive insight and cognitive biases in this population. Cross-sectional study was carried out in a sample of 104 patients with FEP (35 females and 69 males) recruited from mental health services. Symptoms were assessed with the Positive and Negative Syndrome Scale, cognitive insight with the Beck Cognitive Insight Scale, and cognitive bias by the Cognitive Biases Questionnaire for Psychosis. The assessment also included clinical and sociodemographic characteristics. After controlling for potential confounders (level of education, marital status, and duration of psychotic illness) analysis of covariance revealed that males presented greater self-reflectiveness (p = 0.004) when compared to females. However, no significant differences were found in self-certainty and composite index of the cognitive insight scale, as in the cognitive biases assessed. Gender was an independent influence factor for self-reflectiveness, being better for males. Self-reflectiveness, if shown to be relatively lacking in women, could contribute to the design of more gender-sensitive and effective psychotherapeutic treatments, as being able to self-reflect predicts to better treatment response in psychosis.

Understanding how online solution–focused hypnotherapy can support the wellbeing of police personnel and treat symptoms of anxiety and depression

Background: The mental health and wellbeing of police personnel has received increased attention over the last 5 years and rates of mental illness amongst employees are high. Anxiety and depression are the most common mental illnesses within the police force, yet little is known about how effective psychotherapeutic interventions are in treating the symptoms of these mental illnesses in police personnel, that is, how many police personnel recover from anxiety and depression after completing a course of psychotherapy. In the psychotherapy outcome literature, recovery rates for anxiety and depression in clinical samples following treatment are low, between 37% and 47%, suggesting similar outcomes can be expected within the police force using current therapy models. Further research into new or unused interventions is therefore needed to improve recovery rates within the police force. Method: This pilot study explored how a new type of psychotherapy, online Solution Focused Hypnotherapy (SFH), can support the wellbeing of police personnel and effectively treat symptoms of anxiety and depression. A quantitative design was used to measure changes in anxiety (GAD-7) and depression (PHQ-9) symptom severity at pre- and post-intervention and measure changes in wellness using a rating scale (Life Wellness Indicator Tool) at the end of each session. Results: A total of 42 police personnel, both officers and staff, participated in the study and 20 qualified SFH therapists delivered the online intervention. The main finding was that 78% of police personnel who completed a course of SFH and started with clinically significant symptoms of anxiety and/or depression had recovered from their illness following the intervention (i.e. scored below 5 on at least one outcome measure). A total of 97.2% of participants achieved ‘wellness’ after the intervention, compared to 19% at pre-intervention and no participants experienced an increase in symptom scores after completing the intervention. Conclusion: Online Solution Focused Hypnotherapy (SFH) can support the wellbeing of both police officers and staff and effectively treat the symptoms of anxiety and depression. Our findings suggest that SFH is an effective, well liked and safe intervention to use within the police force and provides support for more resources into a larger randomised controlled trial.

Understanding the Nature and Condition of Adolescents with General Anxiety Disorder

The study aimed to recognize and categorize the characteristics of adolescents with Generalized Anxiety Disorder (GAD). This study is qualitative research utilizing the multiple case study design to determine the common symptoms of ten (10) individual cases with GAD from each of their psychologists. Interview guide question was developed to set a direction in gathering the clients’ nature and condition. A thematic analysis using Braun and Clarke’s (2006) method was used to formulate relevant extracts' themes to understand their common symptoms. The findings revealed that adolescents who are diagnosed with GAD have manifestations of physiological, cognitive, and behavioral symptoms. This study posits an easier understanding of their symptoms in the context of a Filipino setting through their psychologists' transcriptions. With the findings, a better understanding of the perspective of adolescents with GAD can be conveyed to the community in preventing public nd self-stigma amongst them. This is also a step forward in designing effective psychotherapeutic interventions tailored to their needs. A program for their mental health protection and promotion is also recommended for further studies.

Understanding the Nature and Condition of Adolescents with General Anxiety Disorder

The study aimed to recognize and categorize the characteristics of adolescents with Generalized Anxiety Disorder (GAD). This study is qualitative research utilizing the multiple case study design to determine the common symptoms of ten (10) individual cases with GAD from each of their psychologists. Interview guide question was developed to set a direction in gathering the clients’ nature and condition. A thematic analysis using Braun and Clarke’s (2006) method was used to formulate relevant extracts' themes to understand their common symptoms. The findings revealed that adolescents who are diagnosed with GAD have manifestations of physiological, cognitive, and behavioral symptoms. This study posits an easier understanding of their symptoms in the context of a Filipino setting through their psychologists' transcriptions. With the findings, a better understanding of the perspective of adolescents with GAD can be conveyed to the community in preventing public nd self-stigma amongst them. This is also a step forward in designing effective psychotherapeutic interventions tailored to their needs. A program for their mental health protection and promotion is also recommended for further studies.

Effect of Training on Beliefs About Exposure Therapy in Experienced Therapists

Exposure therapy is an effective psychotherapeutic intervention for anxiety disorders, obsessive-compulsive disorder, and acute or posttraumatic stress disorder. Despite its effectiveness, exposure therapy is underutilized in situations in which it could be beneficial for patients. Negative beliefs about exposure therapy in therapists may partly explain this. This study therefore investigated the effect of a one-day training in exposure therapy on beliefs about exposure therapy in 81 experienced therapists with mostly cognitive behavioral orientations. In addition, anxiety sensitivity and intolerance of uncertainty were tested as predictors of this effect. Results showed that a one-day training had a significant moderate positive effect on therapist beliefs about exposure therapy. The magnitude of this effect was not predicted by anxiety sensitivity or intolerance of uncertainty in therapists. Further research is needed that includes control conditions and longer posttest intervals, investigates the effect of exposure training in therapists with different theoretical orientations, and examines if changes in beliefs about exposure therapy mediate the effect of exposure training on actual therapist behaviors.

Epileptiform Discharges in Patients with Psychogenic Non-Epileptic Attacks: A Case Series (P1-1.009)

<h3>Objective:</h3> We present a small case series of patients with psychogenic non-epileptic attacks (PNEA), who were misdiagnosed with “refractory epilepsy” based on the presence of epileptiform discharges (EDs), particularly generalized spike-and-wave, on their EEG. This diagnosis was reversed after admission to the epilepsy monitoring unit for spell characterization, where all stereotypical events of interest were captured and were deemed non-epileptic. <h3>Background:</h3> Over the past decade, there was an increased emphasis on the need to correctly diagnose patients with PNEA to avoid unnecessary treatment with anti-seizure drugs and initiate psychotherapy to attain good clinical outcome. Misdiagnosing PNEA with “refractory epilepsy” could be due to misinterpreted EEG as “abnormal with epileptiform discharges” or co-existence of PNEA with EDs in the absence of clinical seizures. Although, PNEA is seen in up to 12% of epilepsy patients, there are rare cases where PNEA only occurs without confirmed epilepsy despite the presence of EDs. <h3>Design/Methods:</h3> We identified seven patients with only PNEA and EDs admitted to Epilepsy Monitoring Unit for “refractory epilepsy” and retrospectively reviewed their records including their EEG. <h3>Results:</h3> None of the stereotypical events captured on video-EEG was associated with ictal EEG correlates. Six had generalized spike-and-wave discharges (GSW) without clinical accompaniments. Of patients who initiated psychotherapy, 60% had ≥ 50% reduction in frequency of PNEA. <h3>Conclusions:</h3> EDs can occur in “PNEA-only” patients and shouldn’t delay PNEA diagnosis or effective psychotherapeutic treatment. <b>Disclosure:</b> Dr. Afify has nothing to disclose. The institution of Dr. Tolchin has received research support from C.G. Swebilius Trust. The institution of Dr. Altalib has received research support from UCB. The institution of Dr. Altalib has received research support from Eisai. The institution of Dr. Altalib has received research support from Sunovian. The institution of Dr. Altalib has received research support from DEPARTMENT OF DEFENSE - CONGRESSIONALLY DIRECTED MEDICAL RESEARCH PROGRAMS. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Aquestive. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Hirsch has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for marinus. Dr. Hirsch has received personal compensation in the range of $0-$499 for serving as a Consultant for Medtronic. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Hirsch has received personal compensation in the range of $0-$499 for serving as a Consultant for Accure. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neuropace. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurelis. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Rafa Laboratories, Ltd. Dr. Hirsch has received publishing royalties from a publication relating to health care. Dr. Hirsch has received publishing royalties from a publication relating to health care. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Neuropace. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Natus. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a speaker with UCB. Dr. Herlopian has nothing to disclose.

Transformation of Cognitive Behavior Therapy as a Psychotherapeutic Intervention in Contemporary Health Care: A Review

Cognitive behavior therapy (CBT) is an evidence-based intervention in contemporary clinical health care services. CBT was developed as a psychotherapy to overcome the deficits of psychoanalysis and behaviorism by Aron T. Beck. However, after 63 years, CBT has transformed from its early framework. In comparison to other psychotherapies, cognitive behavior therapy has rapidly changed and developed as an evidence-based clinical intervention. Therefore, this study explored the evolution of cognitive behavior therapy by focusing on its origin, development, limitations, clinical application, third waves, and future directions. Early CBT therapeutic framework has developed as a cognitive model of depression and developed as an intervention to address the negative core belief of individuals and rationalize maladaptive behaviors, thoughts, and emotions. However, clinicians have experienced several limitations and scholars have recognized theoretical limitations in CBT. Later, scholars on CBT have overcome these deficits and developed disorder-specific CBT therapies. Then, clinicians empirically evaluate those therapeutic frameworks and transform CBT into an evidence-based clinical intervention. Further, CBT has strength in integrating third-wave therapies. In the future, CBT will therapeutically further transform with technology, integrating advanced theories of pathology, and clinical demand of the present health care services. Therefore, as a psychotherapeutic intervention, cognitive behavior therapy has transformed from its early framework, and at present, it has developed empirically. Further, in the future, it will transform into a more effective psychotherapeutic intervention.

Quand aider devient nuire : une compréhension des implications de l’accommodation familiale sur l’efficacité des interventions psychologiques dans le TOC

The objective of this article is to present a review of current knowledge of the consequences and determinants of family accommodation in adults, children and adolescents. Family accommodation can be defined as the changes in behavior adopted by family members of a relative suffering from a mental disorder in order to reduce the associated suffering and distress (e.g., participating in OCD rituals or helping with avoidance). This phenomenon is particularly frequent since it is observed in from 70 to 97% of the relatives interviewed in the studies, whether the patients are adults or children. To present this mechanism, this article will discuss the underlying theoretical models in obsessive-compulsive disorder (OCD) as well as outline the epidemiology, consequences and maintaining factors of family accommodation. The second part of this article will deal with the principal programs and methods of treatment of family accommodation. To this end, a review of the literature regarding family accommodation was conducted using the following databases: PubMed, Google Scholar, ScienceDirect, and PsycINFO, without date limitation. Sixty-seven articles were selected to explore the question of family accommodation in OCD, both in child and adult populations. The data in the literature clearly show that family accommodation is an important factor in the perpetuation of OCD and anxiety symptomatology. Indeed, this accommodation would seem to impede attempts to learn new functional behavior by not allowing the person to perceive the negative consequences of his or her symptomatic behavior or by preventing him or her from experiencing habituation to anxiety-provoking stimuli. In addition, several studies have shown a moderate correlation between the intensity of OCD and family accommodation, as well as the negative effects on the quality of the relationship in couples, or an increase in the perceived burden for the relative. Another finding that seems relevant to clinical practice is that family accommodation is negatively associated with the effectiveness of psychotherapeutic interventions. Indeed, it has been shown that a high level of family accommodation is positively correlated with a low response to psychotherapeutic and pharmacological treatments. Family accommodation has been shown to be a factor in the failure of psychotherapies by distorting the learning achieved in therapy, as well as by leading to greater functional deterioration in the patient. This accommodation is also a predictor of non-spontaneous recovery. These data, therefore, indicate the importance of considering this mechanism in the treatment of patients suffering from OCD, regardless of their age or sex. In the second part of the article, we discuss many proposals for interventions, based on CBT models, which have emerged in recent years in order to maximize the effectiveness of therapies for OCD and anxiety disorders. Their aim is to integrate the family member into the therapy so that he or she can understand the interest in changing his or her reinforcing behavior. In addition to understanding the importance of change, they can be helped by the therapist. Most of these programs are for children only, but some do exist for relatives of adult patients. These propositions for the treatment of family accommodation seem to demonstrate interesting evidence in favor of their effectiveness. However, considering the small number of existing programs, and the small sample sizes that have led to their validation, further research is needed on this topic in order to highlight key interventions that can lead to a decrease in family accommodation. In conclusion, despite an acceleration of research during the last decade, family accommodation remains relatively insufficiently studied, particularly in adults. Recently, family accommodation has been demonstrated in cases of depression, all anxiety disorders, autism spectrum disorders, eating disorders and in chronic pain. There is still a lack of evidence for the existence of this process in certain disorders such as schizophrenia or bipolarity, but it is easy to hypothesize that a change in behavior can be found in the relatives of people suffering from these types of pathologies. In consideration of these results and of the negative impact of family accommodation on the treatment of mental pathologies, a better understanding of family accommodation and its consideration in all psychiatric pathologies seems essential in the future in order to increase the effectiveness of treatment proposals.

Depressive and anxiety disorders in the cardiological conditions: psychological interventions

Cardiovascular disease (CVD) remains a leading cause of mortality worldwide, despite diagnostic and pharmacological advances. These adverse effects lead to the search for new etiological factors and effective ways to prevent, treat and rehabilitate CVD. The impact of psychological factors on the development of CVD has gained scientific recognition. Mental and mood disorders, such as depressive disorders, anxiety disorders, and post-traumatic stress disorder (PTSD), can contribute to CVD and significantly affect the quality of life and prognosis of a CVD patient, often contributing to premature death. Therefore, it is essential to study the socio-demographic and psychosocial factors that are most likely to support pro-health behaviour and identify effective psychotherapeutic interventions for CVD patients. These findings result in new interventions, such as meta-cognitive therapy and mindfulness-based training, which promote healthy behaviours and improve clinical conditions and prognosis in CVD patients.

A Retrospective Observational Study of Psychosocial Determinants and Psychiatric Diagnoses of Mass Shooters in the United States.

Our aim was to better understand the underlying psychiatric, psychosocial, and psychodynamic aspects of mass shootings in the United States (US). The Mother Jones database of 115 mass shootings from 1982-20119 was used to study retrospectively 55 shooters in the US. After developing a psychiatric-assessment questionnaire, psychiatric researchers gathered multiple psychosocial factors and determined diagnoses and treatment by evaluating the clinical evidence obtained by interviewing forensic psychiatrists, who had assessed the assailant, and/or by reviewing psychiatric evaluations conducted during the judicial proceedings. All 35 surviving-assailant cases were selected. Additionally, 20 cases where the assailant died at the time of the shootings were randomly selected from the remaining 80 cases. The majority of assailants (87.5%) had misdiagnosed and incorrectly treated or undiagnosed and untreated psychiatric illness. Most of the assailants also experienced profound estrangement not only from families, friends, and classmates but most importantly from themselves. Being marginalized and interpersonally shunned rendered them more vulnerable to their untreated psychiatric illness and to radicalization online, which fostered their violence. While there are complex reasons that a person is misdiagnosed or not diagnosed, there remains a vital need to decrease the stigma of mental illness to enable those with severe psychiatric illness to be more respected, less marginalized, and encouraged to receive effective psychotherapeutic and pharmacologic treatments.

A Retrospective Observational Study of Psychosocial Determinants and Psychiatric Diagnoses of Mass Shooters in the United States.

Our aim was to better understand the underlying psychiatric, psychosocial, and psychodynamic aspects of mass shootings in the United States (US). The Mother Jones database of 115 mass shootings from 1982-2019 was used to study retrospectively 55 shooters in the US. After developing a psychiatric-assessment questionnaire, psychiatric researchers gathered multiple psychosocial factors and determined diagnoses and treatment by evaluating the clinical evidence obtained by interviewing forensic psychiatrists, who had assessed the assailant, and/or by reviewing psychiatric evaluations conducted during the judicial proceedings. All 35 surviving-assailant cases were selected. Additionally, 20 cases where the assailant died at the time of the shootings were randomly selected from the remaining 80 cases. The majority of assailants (87.5%) had misdiagnosed and incorrectly treated or undiagnosed and untreated psychiatric illness. Most of the assailants also experienced profound estrangement not only from families, friends, and classmates but most importantly from themselves. Being marginalized and interpersonally shunned rendered them more vulnerable to their untreated psychiatric illness and to radicalization online, which fostered their violence. While there are complex reasons that a person is misdiagnosed or not diagnosed, there remains a vital need to decrease the stigma of mental illness to enable those with severe psychiatric illness to be more respected, less marginalized, and encouraged to receive effective psychotherapeutic and pharmacologic treatments.

Mental Health in Athletes: Where Are the Treatment Studies?

In recent years, athletes’ mental health has gained interest among researchers, sport practitioners, and the media. However, the field of sport psychology lacks empirical evidence on the effectiveness of psychotherapeutic interventions for mental health problems and disorders in athletes. Thus far, intervention research in sport psychology has mainly focused on performance enhancement using between-subject designs and healthy athlete samples. In the current paper, we highlight three interrelated key issues in relation to treating mental health problems and disorders in athletes. (i) How are mental health and mental health problems and disorders defined in the sport psychology literature? (ii) How are prevalence rates of mental health problems and disorders in athletes determined? (iii) What is known about psychotherapeutic interventions for mental health problems and disorders in athletes? We conclude that the reliance on different definitions and assessments of mental health problems and disorders contributes to heterogeneous prevalence rates. In turn, this limits our understanding of the extent of mental health problems and disorders in athletes. Furthermore, knowledge of the effectiveness of psychotherapeutic interventions for athletes with mental health problems and disorders is scarce. Future research should include athletes with established mental health problems and disorders in intervention studies. We also propose an increased use of N-of-1 trials to enhance the knowledge of effective psychotherapeutic interventions in this population.

The effectiveness of mindfulness based stress reduction and sama vritti pranayama on reducing blood pressure, improving sleep quality and reducing stress levels in the elderly with hypertension

Introduction: Increasing age has the potential to cause hardening of the arteries. Hypertension is also related to sleep quality and stress levels. Hypertension can be controlled with non-pharmacological therapy using Mindfulness Based Stress Reduction (MBSR) and samavriti pranayama. Samavriti pranayama increases the oxygen supply to the brain, lungs and lowers the heart rate. The purpose of this study was to determine the effectiveness of MBSR and samavriti pranayama for lowering blood pressure, improving sleep quality, and reducing stress levels. Methods: This study utilized a cross-sectional model. Elders analyzed with hypertension were surveyed for qualification. A add up to of 40 seniors were randomized into the mediation and control bunches. Both bunches gotten schedule care. Eight sessions of MBSR and samavritti pranayama were conducted within the intercession bunch, whereas the control gather gotten no mental intercession. Elders were surveyed with respect to diminished hypertension, uneasiness, and rest quality at two unmistakable stages: some time recently and after the mediation. Results: There were no significant differences in sociodemographic and clinical parameters between the intercession and control bunches at standard. The mediation program essentially lightened mental and physiological complications in elderly with hypertension. Particularly, the consider uncovered that 8 weeks of the combined MBSR and samavritti pranayama mediation viably decreased lower hypertension and uneasiness scores and made strides the quality of rest in elderly. Conclusion: The conclusion MBSR combined with samavritti pranayama significantly alleviated clinical symptoms, and could be considered a new, effective psychotherapeutic intervention for Elderly with Hypertension.

A Retrospective Observational Study of Psychosocial Determinants and Psychiatric Diagnoses of Mass Shooters in the United States.

Our aim was to better understand the underlying psychiatric, psychosocial, and psychodynamic aspects of mass shootings in the United States (US). The Mother Jones database of 115 mass shootings from 1982-2019 was used to study retrospectively 55 shooters in the US. After developing a psychiatric-assessment questionnaire, psychiatric researchers gathered multiple psychosocial factors and determined diagnoses and treatment by evaluating the clinical evidence obtained by interviewing forensic psychiatrists, who had assessed the assailant, and/or by reviewing psychiatric evaluations conducted during the judicial proceedings. All 35 surviving-assailant cases were selected. Additionally, 20 cases where the assailant died at the time of the shootings were randomly selected from the remaining 80 cases. The majority of assailants (87.5%) had misdiagnosed and incorrectly treated or undiagnosed and untreated psychiatric illness. Most of the assailants also experienced profound estrangement not only from families, friends, and classmates but most importantly from themselves. Being marginalized and interpersonally shunned rendered them more vulnerable to their untreated psychiatric illness and to radicalization online, which fostered their violence. While there are complex reasons that a person is misdiagnosed or not diagnosed, there remains a vital need to decrease the stigma of mental illness to enable those with severe psychiatric illness to be more respected, less marginalized, and encouraged to receive effective psychotherapeutic and pharmacologic treatments.

Interventions Used in the Psychotherapeutic Treatment of Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD), a highly prevalent psychopathological condition, results from exposure to a traumatic event that evokes fear, helplessness and horror. However, effective psychotherapeutic interventions have been developed that allow for the relief of symptoms and improvements associated with the functioning of patients diagnosed with this condition. The purpose of this review of clinical reports, published between 2014 and 2019 in journals indexed in the Online Library of Knowledge (B-on), was to provide an overview of the interventions that were used, by psychologists or other health professionals, in the psychotherapeutic treatment of the aforementioned disorder. Fifty one publications that met the inclusion criteria were identified and there was a predominance of the cognitive-behavioural approach, with strategies and procedures derived from the Cognitive-Behavioural Model of Learning. The results were later discussed.

Review: Unaccompanied refugee minors' perception of mental health services and professionals: a systematic review of qualitative studies.

Unaccompanied refugee minors (URMs) are a population at risk of mental health problems and a population with whom the therapeutic alliance can be difficult to set up. The therapeutic alliance's quality can impact the result and effectiveness of psychotherapeutic interventions. The aim of the present study was to gather URMs' points of view about mental health services and mental health professionals (MHP) in the host country. A summary of interviews conducted with URMs will allow a better understanding of their perception and expectations. Seven databases were searched with English and French keywords. In the end, nine studies were selected. The review of the interviews shows that URMs do not have a clear perception of MHP - it seems difficult for them to trust MHP, but also to understand the value of sharing past painful experiences to reduce current symptoms. They can have a negative perception of mental health and consider that this is not a priority. URMs prefer to focus on day-to-day problems, do activity-based interventions and do group sessions to value social interactions. Clinical and methodological implications are discussed. The development of an instrument to evaluate therapeutic care for URMs could be interesting for future research and for clinicians.

Development and validation of a self-report measure of epistemic trust.

Epistemic trust (ET) refers to trust in communicated knowledge. This paper describes the development and validation of a new self-report questionnaire, the Epistemic Trust, Mistrust and Credulity Questionnaire (ETMCQ). We report on two studies (Study 1, n = 500; Study 2, n = 705) examining the psychometric properties of the ETMCQ and the relationship between EMTCQ scores (i.e., an individual’s epistemic stance) and exposure to adverse childhood experiences, mental health symptoms, attachment, mentalizing and general self-efficacy. The factor structure of the ETMCQ was examined using Exploratory and Confirmatory Factor Analyses, and its reliability and test-retest reliability were tested. Both studies yielded three correlated yet distinct factors–Trust, Mistrust and Credulity–and confirmed the reliability and validity of the ETMCQ. Preregistered hypotheses were confirmed and replicated across both studies. Main findings suggest intriguing links between the ETMCQ and developmental psychopathology constructs and are consistent with thinking on the role of epistemic stance in undermining adaptation and increasing the developmental risk of mental health problems. Mistrust and Credulity scores were associated with childhood adversity and higher scores on the global psychopathology severity index and both factors partially mediated the link between early adversity and mental health symptoms. Mistrust and Credulity were positively associated with difficulties in understanding mental states and insecure attachment styles. Post-hoc analysis identified that different attachment styles were associated with differences in epistemic stance. In addition, Trust was not associated with reduced levels of mental health symptoms and did not moderate the impact of childhood adversity–findings are congruent with the suggestion that the reduction of mistrust and credulity may be crucial common factors in promoting resilience and the effectiveness of psychotherapeutic interventions. This investigation and the ETMCQ provide an empirical measure of what until now has been largely a theoretical concept and open new avenues for future research.

Cognitive-Behavioral Model of Generalized Anxiety Disorder Psychotherapy

Among the variations of anxiety disorders, generalized anxiety disorder is considered to be one of the most problematic. In times of intense social transformation, the issue of mental health of the youth, in particular the prevalence of tendencies to generalized anxiety disorder among young people arises. For this reason, the purpose of the article is to investigate the propensity of young students to excessive experiences and propose a model of understanding and treatment of generalized anxiety disorder. Cognitive-behavioral methodology is used while the study for understanding generalized anxiety disorder, PSWQ experience questionnaire, WWS-II experience value scale, and two survey items. The results of the study show that 18% of the youth surveyed have a high level of anxiety. Such young people can be considered a risk group for generalized anxiety disorder. The results of the study indicate that respondents with a high level of worry are statistically more likely to perceive worries as those helping them to solve problems, motivate them to act and are able to prevent negative results. Such positive beliefs about the experience may reduce the perceived need to seek help from psychologists and psychotherapists. A description of the clinical case is given and the effectiveness of psychotherapeutic interventions is demonstrated. An algorithm for working with clients is proposed, which is based on a modern protocol for the treatment of generalized anxiety disorder. It includes: qualified examination; reassessment of the usefulness of the worry; assistance in a realistic understanding of ambiguous situations as such that are not clearly threatening; rethinking attitudes to situations of uncertainty; use of exposures for the purpose of deeper processing of the stimulus in a nonverbal way; skills of overcoming negative emotions without avoiding them. An attempt to combine the clinical paradigm and the scientific position is made in the article. Nowadays there are very few studies based on cognitive-behavioral methodology in Ukraine.

Effects of non-invasive brain stimulation in children and young people with psychiatric disorders: a protocol for a systematic review

BackgroundMost psychiatric disorders have their onset in childhood or adolescence, and if not fully treated have the potential for causing life-long psycho-social and physical sequelae. Effective psychotherapeutic and medication treatments exist, but a significant proportion of children and young people do not make a full recovery. Thus, novel, safe, brain-based alternatives or adjuncts to conventional treatments are needed. Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are non-invasive brain stimulation (NIBS) techniques which have shown clinical benefits in adult psychiatric conditions. However, in children and young people their efficacy is not well established. The objective of this study will be to systematically evaluate the evidence on clinical effects of NIBS in children and young people with psychiatric disorders, assessing disorder-specific symptoms, mood and neurocognitive functions.MethodsWe designed and registered a study protocol for a systematic review. We will include randomised and non-randomised controlled trials and observational studies (e.g. cohort, case-control, case series) assessing the effects of NIBS in children and young people (aged ≤ 24 years old) for psychiatric disorders. The primary outcome will be reduction of disorder-specific symptoms. Secondary outcomes will include effects on mood and cognition. A comprehensive search from database inception onwards will be conducted in MEDLINE, EMBASE and PsycINFO. Grey literature will be identified through searching multiple clinical trial registries. Two reviewers will independently screen all citations, full-text articles and abstract data. The methodological quality of the studies will be appraised using appropriate tools. We will provide a narrative synthesis of the evidence and according to heterogeneity will conduct an appropriate meta-analysis. Additional analyses will be conducted to explore the potential sources of heterogeneity.DiscussionThis systematic review will provide a broad and comprehensive evaluation of the evidence on clinical effects of NIBS in children and young people with psychiatric disorders. Our findings will be reported according to the PRISMA guidelines and will be of interest to multiple audiences (including patients, researchers, healthcare professionals and policy-makers). Results will be published in a peer-reviewed journal.Systematic review registrationPROSPERO CRD42019158957

Feasibility and effectiveness of Dialectical-Behavior Therapy for patients with borderline personality disorder in Italian mental health services: a preliminary study.

Dialectical-Behavior Therapy (DBT) is an evidence-based effective psychotherapeutic intervention for patients with Borderline Personality Disorder (BPD). There is a paucity of empirical evidences on the feasibility and the effectiveness of DBT in real-world Italian mental health services. This study aimed at reporting preliminary data on the implementation of DBT for adult patients with BPD attending an Italian mental health service. 28 BPD patients attending a mental health service underwent a 16-session DBT program. Effects of DBT were measured with the Difficulties in Emotion Regulation Scale (DERS) and the Barratt Impulsiveness Scale (BIS-11). 17 patients completed the DBT program, reporting reduced levels of emotion dysregulation and impulsiveness at follow up in comparison with baseline. Higher emotional dysregulation was a risk factor for dropout. In conclusion, this preliminary pilot study suggests that DBT is feasible and effective for BPD patients in Italian adult mental health services.