Maladaptive Beliefs Research Articles

Evaluation of maladaptive beliefs in patients with migraine: measurement properties for three versions (TSK-11, TSK-13, and TSK-17) of the Tampa Scale for Kinesiophobia

BackgroundThe Tampa Scale for Kinesiophobia (TSK) is one of the most frequently employed instruments for assessing maladaptive beliefs about pain, injury, and movement in patients with chronic musculoskeletal pain. However, the measurement properties of this tool have so far not been tested for individuals with migraine. ObjectiveTo evaluate the structural, construct, and criterion validity, and the internal consistency for three versions (TSK-11, TSK-13, and TSK-17) of the TSK for patients with migraine. MethodsA total of 113 individuals aged between 18 and 55 years old with migraine diagnosis were included. All participants completed the TSK with 17 items, the Fear-Avoidance Beliefs Questionnaire, the Headache Impact Test, and the Pain Catastrophizing Scale questionnaires. Confirmatory factor analysis was used to assess the structural validity of the TSK, and Cronbach's α was used to assess internal consistency. For construct and criterion validity, the Spearman's correlation was calculated. ResultsThe TSK structure with one factor and the 17, 13, or 11 items versions were suitable, with suitable values in all fit indices related to structural validity. The three versions showed acceptable internal consistency (α = 0.75). All TSK versions showed moderate positive correlation with the other questionnaires (rho range= 0.31–0.63), confirming most of the predefined hypothesis for the construct validity. Also, the criterion validity of the 13-item and 11-item versions was confirmed (rho=0.95 and rho=0.94, respectively). ConclusionAll versions of the TSK demonstrated good measurement properties in the assessment of maladaptive beliefs about pain, injury, and movement in individuals with migraine.

Coping motives as a mediator of the relationship between child maltreatment and substance use problems in south African adolescents

BackgroundEvidence suggests that adults with a history of child maltreatment (CM) engage in substance misuse driven by ‘coping motives’: maladaptive beliefs that substances help them cope with negative emotions. However, the specificity of this risk pathway is under-researched in younger and non-Western cohorts. ObjectiveThe present study aimed to determine whether coping motives play a distinct role compared to other motives for substance use in mediating the relationship between CM and problematic alcohol and marijuana use in a sample of South African adolescents. Participants and settingA sample of 688 high school students (M age = 15.03 years; 62.5 % female) in Cape Town, South Africa, completed a cross sectional survey. MethodsParticipants completed self-report measures of CM exposure, motives for using alcohol and marijuana (coping, enhancement, social and conformity), and alcohol and marijuana related problems. Participants who endorsed using alcohol (N = 180) or marijuana (N = 136) were included in analysis. A parallel mediation model was conducted for each substance (alcohol and marijuana, respectively) to assess which motives mediated the relationship between CM exposure and substance-related problems. ResultsCM exposure predicted both alcohol-and marijuana related problems. The relationship between CM exposure and alcohol-related problems was partially mediated by coping motives (p < .001, 95%CI 0.028, 0.115) and, to a lesser extent, conformity motives (p < .01, 95%CI 0.001, 0.041), but not by social motives or enhancement motives. The relationship between CM exposure and marijuana-related problems was partially mediated by coping motives (p < .001, 95%CI 0.004, 0.037), but not by conformity, social or enhancement motives. ConclusionsThe findings support the importance of coping motives as a mediator between CM and problematic substance use across different substances of abuse in South African adolescents, and the role of conformity motives in problematic alcohol use. Future research should explore whether these findings hold across other sociocultural contexts, and the utility of interventions to address coping motives for substance use in adolescence.

‘Specialist before physiotherapist’: physicians’ and physiotherapists’ beliefs and management of chronic low back pain in Ghana – A qualitative study

Purpose This study provides an understanding of the chronic low back pain (CLBP) beliefs and management practices of physicians/doctors and physiotherapists in Ghana, and the mechanisms underlying their beliefs and practices. Materials/Methods Thirty-three individual semi-structured interviews, involving eighteen physio­therapists and fifteen physicians involved with CLBP management, were carried out. Interviews were audio recorded, transcribed, and analysed using Straussian grounded theory principles and critical realist philosophy. Results Five categories were derived: The predominance of bio-medical/mechanical beliefs, maladaptive beliefs, maladaptive practices, limited involvement of physiotherapists and other healthcare professionals (HCPs) and evidence-based beliefs and practices. The predominant mechanisms underlying the HCPs beliefs and practices were: the healthcare environment (professional roles/identity hinged around paternalistic and biomedical care, fragmented CLBP management, limited physiotherapy/HCPs’ knowledge) and sociocultural environment (sociocultural/patients’ expectations of passive therapy and paternalism). Conclusion The CLBP beliefs and practices of HCPs involved with CLBP in Ghana is modelled around a professional identity that is largely hinged on paternalism and bio-medical/mechanical understandings. Lack of collaboration and sociocultural expectations also play a significant role. There is the need for a reconstitution of Ghanaian HCPs’ CLBP beliefs and management approaches to align with evidenced-based approaches (e.g., imaging should not be universally prescribed, biopsychosocial and patient-centred care).

Trajectories of Perceived Parental Psychological Control and the Longitudinal Associations with Chinese Adolescents' School Adjustment across High School Years.

Past research supports the detrimental effects of parental psychological control on adolescent school adjustment in both emotional and academic domains. However, how psychological control changes during adolescence, and how such developmental course is related to adolescent psychological well-being and academic functioning are unclear. The direction of effects between parenting and child behaviors is also inconclusive. This 3-year longitudinal study addressed these research gaps by using five waves of survey data on 710 Chinese adolescents of high school ages (Mean age at T1 = 15.54 years, SD = 0.45, 50% males). Using latent growth curve models and latent class growth analysis, the majority of adolescents (about 63%) reported gradual increases of parental psychological control in the first 2 years of high school but a slight decline afterwards, while the other 37% perceived low and stable levels. Results from parallel latent growth modeling suggested that trajectories of psychological control were positively related to developmental trends of internalizing problems (i.e., depression and anxiety) and maladaptive academic functioning, but negatively associated with the trajectory of adaptive academic functioning, as indexed by intercept-intercept and slope-slope associations. The random-intercept cross-lagged models further revealed that psychological control was predictive of adolescent anxiety and lower adaptive academic functioning, and bidirectionally associated with maladaptive academic-related beliefs and behaviors at the within-person level. Taken together, these findings highlight the crucial role of parental psychological control on adolescent school adjustment in the Chinese cultural context and support the reciprocal model of parent-child interactions.

PAINFUL VS NON-PAINFUL EXERCISE IN PEOPLE WITH KNEE OSTEOARTHRITIS: A FEASIBILITY STUDY

INTRODUCTION &amp; AIMS Painful exercise reduces pain in the short-term compared to non-painful exercise in people with chronic pain. However, integration of painful exercise into knee osteoarthritis (OA) treatment is contentious among clinicians, with the clinical implications unknown. This study aimed to explore the feasibility of painful versus non-painful exercise in people with knee OA. METHODS Participants were randomised into a painful (INT; RPE 5-6) or non-painful (CON; RPE 4-5) who performed exercise twice per week for 6 weeks. Both groups also received standardised education. The primary outcomes were feasibility, assessed using participant recruitment, retention, adherence, and compliance rates. Secondary outcomes included pain, function, strength, pressure pain thresholds, psychosocial measures and adverse events. Immediate pre- and post-exercise pain were also measured. RESULTS 21 people with knee OA (66 ± 9 years old; BMI: 29.4 ± 8.1) completed the study. Feasibility was achieved and supported by high rates of recruitment (INT = 89%, CON 89%), retention (INT = 91%, CON = 100%), adherence (INT = 91%, CON = 92%), and compliance (INT = 72%, CON = 81%). Pain reduced in both groups (mean difference [95% CI]; INT = -0.7 [-1.8 to 0.4]; CON = -1.5 [-2.7 to 0.4]), and strength (1-RM leg press) improved with a moderate effect in favour of INT (12.8 [0.2 to 25.9], d = 0.97, p = 0.046). CONCLUSION Incorporating painful exercise into treatment for individuals with knee OA is feasible. Several potential benefits include positive changes in maladaptive beliefs and behaviours and enhanced systemic benefits associated with higher intensity exercise. Future research comparing the efficacy of painful versus non-painful exercise in knee OA and other chronic musculoskeletal conditions is warranted.

Unmet Needs, Minority Stress and Mental Health Outcomes Among Transgender Individuals: The Mediating Role of Schema Domains.

Exposure to gender-related minority stressors, the negative experiences and beliefs that stem from anti-trans stigma increases transgender and gender diverse (TGD) people's vulnerability to experiencing poor mental health outcomes. This study examined if the relationships between experiences of minority stress and mental health outcomes were mediated by early maladaptive schemas: mental representations shaping the way people view themselves, others and the world. Drawing from a schema therapy perspective, the study additionally examined if caregivers' failure to meet TGD people's core emotional needs was associated with mental health outcomes and if schemas similarly mediated these relationships. A total of 619 TGD adults completed an online survey about early maladaptive schemas, core emotional needs, gender-related minority stress and psychological distress and wellbeing. Causal mediation analyses indicated that caregivers who did not meet TGD people's core emotional needs and greater experiences of minority stress were associated with increased distress and lower wellbeing. These relationships were mediated by schema severity, particularly the disconnection and rejection and impaired autonomy domains. These findings provide empirical support for the schema therapy model's assumption that unmet core emotional needs are associated with schema formation. For TGD people, maladaptive beliefs about the self, others and world can form in response to manifestations of anti-trans stigma within the individual, their interpersonal relationships, community and broader society. Caregivers' failure to meet needs, plus experiences of minority stress throughout the individual's system, leads to greater distress and lower wellbeing; however, clinical interventions targeting schemas may improve outcomes for this at-risk group.

Trends in the dose-response relationship between adverse childhood experiences and maladaptive metacognitive beliefs: A cross-sectional study

BackgroundSince the publication of the major research on adverse childhood experiences (ACE) at the turn of the millennium, our knowledge about the prevalence and physical and mental consequences of childhood adversities has increased substantially. In parallel, research on metacognition, which plays an important role in understanding our mental functioning, has also been on the rise. Although the adverse effects of ACEs on mental processes and the role of metacognitive deficits in the development of mental disorders are widely known, hardly any research into the interaction between these two areas has been conducted; this is what triggered our investigation. MethodsOur research was carried out as a cross-sectional study on a sample of 304 members of the general population. We measured ACEs with the 10-item Adverse Childhood Experiences Questionnaire and maladaptive metacognitions—positive and negative metacognitive beliefs, cognitive confidence, cognitive self-consciousness, and need to control thoughts— using the Meta-Cognitions Questionnaire.The closeness of the relationship between the ACE score and metacognitions was measured using Pearson's linear correlation coefficient, while the association of ACE accumulation with metacognitive beliefs was assessed using generalized linear models. ResultsThe most common ACE in our sample turned out to be emotional neglect (44.74%). All the examined maladaptive metacognitive beliefs correlate mildly to moderately with the number of suffered ACEs (r = 0.13–0.34), with an increase in the ACE score leading to a rise in the salience of maladaptive metacognitive beliefs. Moreover, a dose-response relationship was seen between increases in ACE scores and the overall values of metacognition, negative metacognitive beliefs, and the maladaptive metacognitive belief of the need to control thoughts. ConclusionsOur results suggest that the more ACEs were experienced in childhood, the more pronounced the dysfunctional metacognitive beliefs are. Therefore, our findings emphasize the importance of further research into the topic.

Misconceptions and Beliefs Related to Diabetes Care and Their Effect on A1C Values in People With Type 2 Diabetes.

Despite recent therapeutic advances, diabetes remains the seventh leading cause of death in the United States. Clinicians caring for people with diabetes often find that low health literacy interferes with diabetes care. The aim of this cross-sectional study was to determine which diabetes-related misunderstandings or potentially maladaptive health beliefs were present among people at a low-income community clinic in Harris County, TX, and to determine the effect of such misconceptions on A1C values.

Belief revision in psychotherapy

According to the cognitive model of psychopathology, maladaptive beliefs about oneself, others, and the world are the main factors contributing to the development and persistence of various forms of mental suffering. Therefore, the key therapeutic process of Cognitive Behavioral Therapy (CBT)—a therapeutic approach rooted in the cognitive model—is cognitive restructuring, i.e., a process of revision of such maladaptive beliefs. In this paper, I examine the philosophical assumptions underlying CBT and offer theoretical reasons to think that the effectiveness of belief revision in psychotherapy is very limited. This is the case, I argue, because the cognitive model wrongly assumes that our body of beliefs is unified, while it is in fact fragmented.

Development and feasibility of a mindfulness-based dance/movement therapy intervention for chronic low back pain.

Responding to the need for innovative, multi-modal, non-pharmacological strategies in chronic low back pain (cLBP) care, this article presents the development and a mixed methods feasibility trial of a manualized Mindfulness-based Dance/Movement Therapy (M-DMT) program for cLBP. The 12-week program is designed as a group therapy, integrating mindfulness principles, creative/expressive dance and movement, and psychoeducational content focused on cLBP management. This holistic program seeks to cultivate nonjudgmental awareness of pain experiences, challenge maladaptive pain-related beliefs, enhance emotional well-being, foster social support, and promote effective coping strategies for the daily challenges associated with cLBP. The 12-week M-DMT intervention was administered to individuals with non-specific cLBP (N = 18, aged 51.7 ± 13.9 years, 72% female, 55% Black and 39% White). We assessed feasibility and acceptability through monitoring enrollment and retention rates, attendance, and adverse events. Moreover, we measured the intervention's credibility/expectancy, participants' perception of changes, and overall satisfaction. Additionally, we collected qualitative data, capturing participants' perspectives on the intervention's usefulness and perceived benefits. Specific benchmarks were established to gauge the successful feasibility and acceptability of the program. The adherence rate stood at 80%, with a perfect retention rate of 100%. The study successfully met the benchmarks for treatment acceptability and satisfaction criteria, with 61% of participants reporting "feeling better" or a "great deal better" after the intervention. No adverse events were observed. Participants found the intervention enjoyable and reported that it provided effective tools for cLBP and related symptoms. Notably, participants reported a decrease in fear-avoidance behaviors, increased motivation for physical activity, and a boost in self-efficacy for pain management. These encouraging findings establish a strong basis for considering the M-DMT intervention as a promising approach for cLBP management, warranting further investigation in larger-scale studies.

Psychopathological symptoms and social networking sites addiction in Poland and Germany: The role of fear of missing out and preference for online social interaction

Psychopathological symptoms, especially depression and anxiety, can contribute to the development of addictive tendencies offline and online. The present cross-national study aims to verify whether Fear of Missing Out (FoMO) and Preference for Online Social Interactions (POSI) could explain the relationship between psychopathological symptoms (i.e., depression and anxiety symptoms) and Social Networking Sites (SNS) addiction. We tested our hypothesis in two samples from Poland (N = 1163) and Germany (N = 781) using self-report measures of psychopathological symptoms, FoMO, POSI, and SNS addiction. In both countries, we found the same result pattern. Depression and anxiety symptoms were positively related to SNS addiction. Moreover, FoMO and POSI partially mediated the relationship between psychopathological symptoms and addictive SNS use. Notably, the relationship between psychopathological symptoms is significantly more robust via FoMO as it is an essential predictor of SNS addiction in both countries. Our findings show that ineffective emotional regulation, as well as maladaptive thoughts and beliefs about one's Internet use among persons with psychopathological symptoms, might increase the risk for SNS addiction.

The Emotion Beliefs Questionnaire: Psychometric properties, norms, and links to affective outcomes

BackgroundThe Emotion Beliefs Questionnaire was recently developed to measure beliefs about the controllability and usefulness of negative and positive emotions. These are beliefs that have been theorised to be influential for emotion regulation and psychological outcomes. However, to date there are few studies utilising large, representative samples to examine the EBQ's psychometric properties and affective correlates. Our aim was to fill this gap by examining the EBQ's psychometric properties and exploring associations between emotion beliefs, emotion regulation, and affective disorder symptoms. MethodsA sample of 1175 adults recruited from the general population in the United States completed measures of emotion beliefs, emotion regulation, and affective disorder symptoms. ResultsConfirmatory factor analyses supported the EBQ's intended subscale structure, where controllability and usefulness beliefs were separated by valence. This structure was invariant across gender, age, and education categories. The EBQ correlated in expected ways with other measures, demonstrating good validity, and had good to excellent levels of internal consistency reliability. LimitationsThis study used a non-clinical sample that was predominantly White. Future work should utilise clinical and cross-cultural samples to maximise generalisability of findings. ConclusionsOur findings indicate that the EBQ is a psychometrically sound tool for measuring the multidimensional emotion belief construct. The EBQ may have clinical utility in the conceptualisation, assessment, and treatment of maladaptive emotion beliefs. Furthermore, our results highlight the importance of considering the potential influence of maladaptive emotion beliefs in emotion dysregulation and affective disorder symptoms.

The Mediating Role of Maladaptive Metacognitive Beliefs between Adverse Childhood Experiences and Trait Anxiety

IntroductionAdverse childhood experiences (ACE) have a significant negative impact on health. ACEs lead to more pronounced trait anxiety, among others, which serves as a basis for various mental and somatic symptoms. Recent findings suggest that the fact that individuals with more ACEs also have more maladaptive metacognitive beliefs may contribute to the development of these symptoms.ObjectivesWe aim to study the possible mediating role of maladaptive metacognitive beliefs, resulting from adverse childhood experiences, on trait anxiety.MethodsData was collected online, anonymously, in a non-clinical population of adults over 18 years of age. The sample consisted of 304 subjects (84.21 % women, 15.79 % men). The applied questionnaires included a demographic questionnaire, the Adverse Childhood Experiences Questionnaire 10 item version, the Meta-Cognitions Questionnaire, and the Spielberger Trait Anxiety Questionnaire. The system of correlations between the examined variables was explored using structural equation modeling (SEM). The study was carried out with ethical approval and in accordance with the Declaration of Helsinki.ResultsOur results confirm that ACEs have a significant impact on all the measured dimensions of maladaptive metacognitive beliefs. The direct effect of ACEs on adult trait anxiety is also significant. The results of the study on indirect effects support the joint mediating role of the five metacognitive dimensions. The strongest significant mediating effect was found for the uncontrollability and dangerousness of negative beliefs about worry. Both the direct and indirect effects of cognitive self-consciousness on adult trait anxiety are negative, which means that the more the cognitive self-consiousness is characteristic of someone, the lower the degree of trait anxiety in adulthood is.ConclusionsOur results confirm the mediating effect of metacognitive beliefs on trait anxiety in the context of adverse childhood experiences, which points to the importance of further research on metacognition among the population that suffered early adversities. One of the limitations of the study roots in online data collection: the examined sample is not representative. Moreover, to extend the results, it is recommended to repeat the study on a clinical population. This would enable us to compare our results with those of the clinical population, which could provide further important results in the field of metacognition and adverse childhood experiences.Disclosure of InterestNone Declared

Exploring the Role of Attachment Styles, Life Scripts, and Parental Mandates in Suicidal Behavior: Implications for Prevention and Intervention

Introduction The scientific literature widely acknowledges the multitude of factors contributing to suicide, emphasizing the intricate and dynamic interplay among genetic, biological, psychological, and social dimensions (Van Heeringen, 2001). Despite this consensus, each suicide case is unique, shaped by an exclusive combination of these factors. One relatively underexplored risk factor in the realm of suicidal behavior is attachment style. As posited by attachment theorists, avoidant and anxious/insecure attachment styles may hold predictive value for suicide attempts (Sheftall et al., 2014).ObjectivesThis study undertakes a comprehensive review of the relationships between attachment styles, life scripts, parental mandates, and suicidal behavior.MethodsThis study delves into the interconnections between attachment styles, life scripts, parental mandates, and suicide, drawing from an extensive body of research and theory. A comprehensive review of existing literature was conducted to elucidate the intricate relationships among these variables and their potential influence on suicidal behavior.Results The synthesis of existing research highlights a compelling link between attachment styles, life scripts, and parental mandates. Attachment styles, formed in early life, profoundly influence an individual’s interpersonal relationships, emotional regulation, and sense of self-worth. These attachment patterns lay the foundation for the development of life scripts—internalized narratives that dictate one’s beliefs, values, and expectations regarding their life course. Parental mandates, often transmitted explicitly or implicitly during childhood, further shape these life scripts by imposing conditions or constraints on the individual’s choices and aspirations.Crucially, within this framework, suicidal behavior emerges as a possible outcome. Individuals with maladaptive attachment styles, burdened by parental mandates that discourage autonomous living or impose conditional acceptance, may perceive suicide as a way to escape perceived unmet expectations or alleviate emotional distress.ConclusionsThis study underscores the intricate interplay between attachment styles, life scripts, parental mandates, and suicidal behavior. Understanding these complex relationships is pivotal in both prevention and intervention efforts. Recognizing the significance of family history, parental approaches, maladaptive beliefs, attachment patterns, and early caregiver interactions can inform the development of targeted strategies aimed at mitigating suicide risk in diverse contexts, including schools, communities, and clinical settings. By identifying these factors and their influence on suicidal behavior, practitioners and researchers alike can contribute to more effective prevention and intervention initiatives tailored to individual needs.Disclosure of InterestNone Declared

Family Cancer Caregiver Use of and Benefit from an Internet-delivered Insomnia Intervention: Results from a Single-Group Feasibility Trial.

Cancer caregivers are more likely to report clinically significant symptoms of insomnia than cancer patients and the general population, yet research has been limited regarding cognitive-behavioral therapy for insomnia (CBT-I) among this population. To better understand cancer caregivers' engagement with and benefit from CBT-I, cancer caregivers were enrolled in a nonrandomized pilot feasibility trial of an evidence-based Internet-delivered insomnia program. Thirteen caregivers completed mixed-methods assessments prior to receiving the insomnia program and after the nine-week intervention period. Compared to the five caregivers who did not complete any intervention Cores, the eight caregivers who completed at least one of the intervention Cores tended to report more sleep impairment (insomnia symptom severity; minutes of sleep onset latency and wake after sleep onset), less physical and emotional strain from caregiving, and less maladaptive sleep beliefs at the baseline assessment. These caregivers who used the program also showed large improvements in their insomnia symptoms. Caregivers' qualitative feedback about their experience with the program identified potential areas that might be modified to improve caregivers' engagement with and benefit from Internet-delivered insomnia programs. Findings suggest that family cancer caregivers can use and benefit from a fully-automated Internet-delivered CBT-I program, even without caregiving-specific tailoring. Further rigorous research is needed to better understand whether and how program modifications may allow more caregivers to initiate and engage with this program.

Deep CANALs: a deep learning approach to refining the canalization theory of psychopathology.

Psychedelic therapy has seen a resurgence of interest in the last decade, with promising clinical outcomes for the treatment of a variety of psychopathologies. In response to this success, several theoretical models have been proposed to account for the positive therapeutic effects of psychedelics. One of the more prominent models is "RElaxed Beliefs Under pSychedelics," which proposes that psychedelics act therapeutically by relaxing the strength of maladaptive high-level beliefs encoded in the brain. The more recent "CANAL" model of psychopathology builds on the explanatory framework of RElaxed Beliefs Under pSychedelics by proposing that canalization (the development of overly rigid belief landscapes) may be a primary factor in psychopathology. Here, we make use of learning theory in deep neural networks to develop a series of refinements to the original CANAL model. Our primary theoretical contribution is to disambiguate two separate optimization landscapes underlying belief representation in the brain and describe the unique pathologies which can arise from the canalization of each. Along each dimension, we identify pathologies of either too much or too little canalization, implying that the construct of canalization does not have a simple linear correlation with the presentation of psychopathology. In this expanded paradigm, we demonstrate the ability to make novel predictions regarding what aspects of psychopathology may be amenable to psychedelic therapy, as well as what forms of psychedelic therapy may ultimately be most beneficial for a given individual.

Meta-emotion therapy for complex trauma and binge eating: A case study.

There is a lack of evidence guiding treatment guidelines for individuals with comorbid complex posttraumatic stress disorder (C-PTSD) and binge eating disorder (BED). The article aims to present preliminary evidence to support the proof of concept of novel therapy termed meta-emotion therapy (MET) that targeted maladaptive beliefs about emotions, for this specific comorbidity. The single case study design involved a 35-year-old woman with a comorbid diagnosis of C-PTSD and BED, stemming from a history of childhood maltreatment, receiving 14 sessions of MET. Outcome measures related to PTSD symptoms, posttraumatic cognitions, BED cognitions and behavior, distress, and negative beliefs about emotions were assessed at initial assessment (baseline), pretreatment, posttreatment, and 1-month follow-up. The participant had a reliable and significant decrease in PTSD symptoms, posttraumatic cognitions, disordered eating symptoms, distress, and negative beliefs about emotions at posttreatment. Participant feedback supported the positive perception of the treatment. The findings of this study provide promising evidence to support the potential effectiveness of MET as an intervention for adults with comorbid C-PTSD and BED. Further research in the form of larger intervention trials is warranted to investigate the efficacy and long-term outcomes of MET in this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effect of high-risk sleep apnea on treatment-response to a tailored digital cognitive behavioral therapy for insomnia program: a quasi-experimental trial

IntroductionTherapist-delivered Cognitive Behavioral Therapy for Insomnia (CBTi) is an effective but largely inaccessible treatment for people with Co-Morbid Insomnia and Sleep Apnea (COMISA). To increase CBTi access for COMISA, we aimed to develop a self-guided interactive 5-session digital CBTi program that is appropriate for people with insomnia-alone and COMISA, and compare its effectiveness between people with insomnia-alone, vs. comorbid insomnia and high-risk sleep apnea.MethodsData from 62 adults with insomnia symptoms were used. High-risk sleep apnea was defined as a score of ≥5 on the OSA50. Participants self-reported symptoms of insomnia (ISI), depression, anxiety, sleepiness (ESS), fatigue, and maladaptive sleep-related beliefs (DBAS-16) at baseline, 8-week, and 16-week follow-up. ESS scores were additionally assessed during each CBTi session. Intent-to-treat mixed models and complete-case chi2 analyses were used.ResultsThere were more participants with insomnia-alone [n = 43, age M (sd) = 51.8 (17.0), 86.1% female] than suspected COMISA [n = 19, age = 54.0 (14.8), 73.7% female]. There were no between-group differences in baseline questionnaire data, or rates of missing follow-up data. There were no significant group by time interactions on any outcomes. Main effects of time indicated moderate-to-large and sustained improvements in insomnia (d = 3.3), depression (d = 1.2), anxiety (d = 0.6), ESS (d = 0.5), fatigue (d = 1.2), and DBAS-16 symptoms (d = 1.2) at 16-weeks. ESS scores did not increase significantly during any CBTi session.ConclusionThis interactive digital CBTi program is effective in people with insomnia-alone, and people with co-morbid insomnia and high-risk sleep apnea. Further research is required to determine the effectiveness, safety and acceptability of digital CBTi in people with insomnia and confirmed sleep apnea.Clinical Trial RegistrationThis trial was prospectively registered on the Australian and New Zealand Clinical Trials Registry (ANZCTR, ACTRN12621001395820).

Effect of Adolescents’ Perceived Parental Blame on Learned Helplessness: The Sequential Mediating Effects of Maladaptive Metacognitive Beliefs and Rumination

This study aimed to examine the effect of adolescents’ perceived parental blame (criticism) on learned helplessness and to examine whether maladaptive metacognitive beliefs and rumination sequentially mediate the relationship between parental blame and learned helplessness. The participants were 316 adolescents (&lt;i&gt;Mean age&lt;/i&gt; =16.7, &lt;i&gt;SD&lt;/i&gt; =0.75; 137 male, 179 female) attending grades 1&lt;sup&gt;st&lt;/sup&gt; and 2&lt;sup&gt;nd&lt;/sup&gt; in high school in South Korea. The participants were selected using a snowball sampling method, while the data was collected via an online selfreport questionnaire. This survey was completed by the participants and analyzed using SPSS 28.0, Amos 26.0 (IBM Co., Armonk, NY), and PROCESS macro version 4.2 (Model 6; Hayes, 2022). The main results are summarized as follows. Firstly, the adolescents’ perceived paternal and maternal blame indicated significant direct effects on learned helplessness. Secondly, rumination mediated the effect of paternal and maternal blame on learned helplessness. Lastly, paternal and maternal blame significantly affected learned helplessness through the sequential mediating effects of maladaptive metacognitive beliefs and rumination. This study elucidates the causal structure among the various factors influencing learned helplessness in adolescents, focusing on parental blame, maladaptive metacognitive beliefs, and rumination. Furthermore, considering the verified sequential mediating effects of maladaptive metacognitive beliefs and rumination in the relationship between adolescents’ perceived parental blame and learned helplessness, these findings suggest that modifying maladaptive metacognitive beliefs may help to reduce learned helplessness among adolescents who perceive high levels of parental blame.

Worriers of the Pandemic: How People with Mental Disorders Cope with COVID-19 Restrictions

Objective: The aim of the study was to investigate the level of anxiety as well as the attitude toward disease and mitigation strategies in people with non-psychotic mental disorders and healthy controls. Methods: A case-control study (1:4) was conducted during a self-isolation regimen in Moscow. Cases were adult patients with NPMD admitted to the Moscow Research and Clinical Center for Neuropsychiatry. Sex and age-matched controls (individuals who have never sought psychiatric help) were selected from a cohort of 7498 Moscow residents who participated in a large cross-sectional survey delivered via social networks and popular Russian web platforms. Fisher's exact test, Mann-Whitney U test, and General linear modelling were used as statistic methods. Results: In the univariate analysis, patients with NPMD had a lower level of education and were less likely to be married. The level of the trait but not state anxiety was higher in people with NPMD. People with mental disorders were significantly more often concerned about the negative impact of the COVID-19 pandemic on their lives, were more likely to be confident that they would contract the coronavirus and their disease would be severe, showed suboptimal adherence to mitigation strategies, were dissatisfied with the amount of information they received about the COVID-19 disease, and were more concerned about becoming a victim of domestic violence. Marital status, education, use of information resources, dissatisfaction with information about COVID-19, use of public transport, paying attention to the need of others and domestic violence assessment remained significant in the general linear model. All the factors included in the multivariate model accounted for 36.4% of the variance. Conclusion: People with NPMD have a higher level of trait anxiety and are prompted to develop a constellation of maladaptive beliefs toward a pandemic. These beliefs, along with the lack of reliable information on coronavirus infection, can lead to misunderstanding and disregard of sanitary and self-isolation recommendations. Educational programs and vaccination campaigns should be sensitive to these features of people with NPMD.