Emotional Disorders Research Articles

Recurrent negative autobiographical memories and mental health

BackgroundRecurrent symptom-relevant negative autobiographical memories are common in patients with emotional disorders such as anxiety and depression, even among those without a trauma-related diagnosis. Recurrent negative autobiographical memories may also contribute to distress in non-clinical populations. MethodsTo examine the prevalence of recurrent negative autobiographical memories and associated psychological features, we recruited a student sample (n = 101) and a treatment-seeking sample of patients with emotional disorders (n = 123). We hypothesized that recurrent negative autobiographical memories would be associated with higher levels of psychological symptoms and rumination. We also conducted exploratory analyses of participants’ most bothersome memory. ResultsIn each sample, individuals who endorsed recurrent negative autobiographical memories had significantly higher depression, anxiety, and stress symptoms as well as greater rumination. In the treatment-seeking sample, where memories also had to be identified by patients as symptom-relevant, those who endorsed memories also had significantly higher clinician-rated symptom severity for their primary diagnosis. The majority of participants in each sample endorsed moderate or greater re-experiencing (sample 1: 79 %, sample 2: 66 %) and avoidance symptoms (sample 1: 78 %, sample 2: 58 %) related to their most bothersome memory. ConclusionRecurrent negative autobiographical memories relate to mental health symptoms in both clinical and non-clinical samples. Further research should explore whether targeting such memories reduces distress or improves wellbeing in these populations.

The familial transmission of suicide and non-suicidal self-injury in different income levels in town.

Prior researches have established that suicide and non-suicidal self-injury (NSSI) exhibit familial transmission patterns. However, the extent to which these patterns vary across different income levels remains unclear, as well as the specific factors that influence them. This study aimed to explore these questions. We analyzed data from 13,988 parent-child pairs in Chongqing, China, where the children were aged from 7 to 12 years old. Six income levels were considered, and the children's depression and anxiety symptoms were assessed using standardized scales (the Center for Epidemiological Studies Depression Scale for Children, [CES-DC], and the Screen for Child Anxiety Related Emotional Disorders [SCARED], respectively). Binary logistic regression analysis was employed to examine the transmission of suicide and NSSI across different income levels. Familial transmission of suicide was significant difference in all income levels except the highest, while familial transmission of NSSI was significant difference in all income levels except the lowest. Notably, in both low- and high-income levels, suicide and NSSI transmissions primarily occurred among male children, mothers with higher education, and children who spent long time with their mothers. Additionally, the transmissions were mediated partially or entirely by children's depression and anxiety symptoms. Future studies should investigate the separate effects of fathers' and mothers' suicide and NSSI histories on familial transmission patterns. The familial transmissions of suicide and NSSI exhibited distinct patterns across different income levels.

Implementation and Outcomes of Outdoor Science Education in an Urban Setting on Primary and Intermediate Level Students with Emotional and Behavioral Disorders

The term nature deficit disorder describes the “human costs of alienation from nature” (Louv, 2019). While not meant to be a medical diagnosis, Louv argues that the condition has, “profound implications, not only for the health of future generations but for the health of the earth itself” (Louv, 2008). Children most at risk are those who live or go to school in an urban setting, as well as students diagnosed with Emotional and Behavioral Disorders (EBD). Students diagnosed with EBD are often kept indoors as their teachers and caretakers are frequently trained in the indoor use only of behavior management techniques (Riden et al., 2022). This means that during professional development training, any that pertain to behavior management techniques, procedure, or protocol are routinely taught inside of a classroom, conference room, or recently home office, using an indoor scenario (classroom, auditorium, cafeteria, etc.) as an example of when and how to use these behavior management tools. Outdoor professional development, equipping students with natural tools that can help improve not only their physical but also their mental health, as well as connecting students with nature in a way that teaches them to advocate for the health of the earth, thus becoming citizen stewards are all themes that are part of the massive, currently dysfunctional system that is outdoor education in schools. This study shows that when students are encouraged to interact with nature on their own terms on-task behaviors and motivation increase. Students also retained lesson information and asked follow-up questions after the lesson when taught outside using hands-on activities.

Amygdala structural and functional reorganization as an indicator of affective dysfunction in patients with tinnitus.

The aim of this study was to systematically investigate structural and functional alterations in amygdala subregions using multimodal magnetic resonance imaging (MRI) in patients with tinnitus with or without affective dysfunction. Sixty patients with persistent tinnitus and 40 healthy controls (HCs) were recruited. Based on a questionnaire assessment, 26 and 34 patients were categorized into the tinnitus patients with affective dysfunction (TPAD) and tinnitus patients without affective dysfunction (TPWAD) groups, respectively. MRI-based measurements of gray matter volume, fractional anisotropy (FA), fractional amplitude of low-frequency fluctuations (fALFF), regional homogeneity (ReHo), degree centrality (DC), and functional connectivity (FC) were conducted within 14 amygdala subregions for intergroup comparisons. Associations between the MRI properties and clinical characteristics were estimated via partial correlation analyses. Compared with that of the HCs, the TPAD and TPWAD groups exhibited significant structural and functional changes, including white matter integrity (WMI), fALFF, ReHo, DC, and FC alterations, with more pronounced WMI changes in the TPAD group, predominantly within the left auxiliary basal or basomedial nucleus (AB/BM), right central nucleus, right lateral nuclei (dorsal portion), and left lateral nuclei (ventral portion containing basolateral portions). Moreover, the TPAD group exhibited decreased FC between the left AB/BM and left middle occipital gyrus and right superior frontal gyrus (SFG), left basal nucleus and right SFG, and right lateral nuclei (intermediate portion) and right SFG. In combination, these amygdalar alterations exhibited a sensitivity of 65.4% and specificity of 96.9% in predicting affective dysfunction in patients with tinnitus. Although similar structural and functional amygdala remodeling were observed in the TPAD and TPWAD groups, the changes were more pronounced in the TPAD group. These changes mainly involved alterations in functionality and white matter microstructure in various amygdala subregions; in combination, these changes could serve as an imaging-based predictor of emotional disorders in patients with tinnitus.

Personality and Pain Outcomes in Rheumatic Disease: The Mediating Role of Psychological Flexibility.

Chronic pain is associated with increased disability and vulnerability to emotional disorders. Personality and psychological flexibility (PF) describe interindividual differences that shape the adjustment to chronic pain. Specifically, PF was found to be associated with pain, fatigue, anxiety, and depression intensity. Although previous studies established strong correlations between personality and pain outcomes, evidence on the nature of this relationship is scarce. Therefore, the objective of this study is to explore the mediating effect of PF on the relationship between personality and distress. This transversal study included 108 participants (age M = 56.7, SD = 11.3) diagnosed with musculoskeletal chronic pain. Self-reported measures were administered by the medical care team. Multiple mediation models were performed for estimating the indirect effects on each outcome variable. After controlling for age and gender covariates, we found that PF completely mediated the relationship between personality traits and all pain outcomes and partially mediated the impact of extraversion on anxiety. In addition, emotional stability also had an indirect effect on anxiety through PF. Personality traits and PF are significant predictors of pain outcomes. PF represents a core process mediating the impact of personality traits on the perceived intensity of pain, fatigue, anxiety, and depression in patients with rheumatic disease. These results could facilitate the application of individualized psychological interventions in clinical contexts targeting the reduction of emotional avoidance and in chronic pain patients.

Supporting Transition-Readiness Skills for Adolescents With Emotional and Behavioral Disorders Using Check-In/Check-Out

Check-in/check-out (CICO) is an evidence-based practice for addressing the behavioral needs of students with and without disabilities from kindergarten through the 12th grade. The CICO intervention is easily adapted to address other areas of need, beyond behavior, including academics and social integration, making CICO appealing for all school grade levels and differing student needs. Recently, transition skills have been targeted and integrated into CICO for adolescents with disabilities. Building from the transition-focused applications of CICO, adaptations and intensifications specific to high school students with emotional and behavioral disorders related to transition-readiness skills of self-monitoring, social skills, and vocational training are provided.

Looking at the Mental Health of Children and Adolescents with Cleft Lip and/or Palate through Neuroticism and Emotional Regulation Strategies: A Case-Controlled Observational Study.

Background: Children and adolescents with cleft lip and/or palate (CL/P) are at an increased risk of developing emotional disorders. This study aims to explore this question in greater depth by addressing three objectives: (1) the presence of neuroticism as an indicator of emotional symptomatology, (2) the use of adaptive and non-adaptive emotional regulation strategies, and (3) the relationship between these strategies and neuroticism. Methods: A case-control correlational methodology was employed, with 60 children and adolescents with CL/P (mean age = 12.80 years; 33 females) and 60 non-clinical equivalent children and adolescents. Results: The CL/P group has higher scores on neuroticism (t = -7.74; p ≤ 0.001, d Cohen = 1.43) and lower scores in almost all emotional regulation strategies. The presence of CL/P moderated the relationship between neuroticism and self-blame (Beta = -0.46, t = -2.81, p = 0.005), rumination (Beta = -0.49, t = -3.73, p < 0.001), catastrophizing (Beta = -0.61, t = -4.26, p < 0.001), and blaming others (Beta = -0.45, t = -2.84, p = 0.005). This model predicted a significant variance of neuroticism (all p < 0.005), which ranged from 39% to 41%. Conclusions: The CL/P group has worse mental health indicators. Particularly novel results about the CL/P group are the lower scores on regulation strategies (both adaptive and non-adaptive) and the fact that non-adaptive strategies contribute, contrary to their effect in the general population, to a decrease in neuroticism. It supports the need to incorporate mental health indicators in the diagnosis and treatment of children and adolescents with CL/P.

NOSOLOGICAL STRUCTURE OF IN-PATIENT PSYCHIATRIC CARE PROVISION IN THE POLTAVA REGION IN 2023

Introduction. The importance of safeguarding mental health and providing high-quality psychiatric care became increasingly urgent following the onset of full-scale war in Ukraine. Currently, a strategy to transfer psychiatric care from specialized institutions to primary care is being implemented. Therefore, analyzing the nosological distribution of referrals to a psychiatric hospital during martial law is an extremely urgent issue. The aim of this study is to investigate the nosological structure of hospitalizations at the Communal Enterprise “Regional Institution of Mental Psychiatric Care of the Poltava Regional Council” in 2023. Results and their discussion. Schizophrenia remains the leading diagnosis among patients receiving inpatient psychiatric care. The second place is taken by neurotic, stress-related, and somatoform disorders. In third place are organic, including symptomatic, mental disorders, with vascular dementia being the leading primary diagnosis among patients with organic, including symptomatic, mental disorders. Among the substances causing mental and behavioral disorders due to the use of psychoactive substances, alcohol ranks first. Paranoid schizophrenia is the leading diagnosis in patients with schizophrenia, schizotypal states, and delusional disorders. Recurrent depressive disorder is the most common among affective disorders. Adjustment disorders occupy the first place in the structure of the incidence of neurotic, stress-related, and somatoform disorders. Among the behavioral syndromes associated with physiological disturbances and physical factors, anorexia nervosa is the most common. Emotionally unstable personality disorder is most common among patients with disorders of adult personality and behavior. Mild mental retardation is more common than others. Childhood autism has the largest share in the incidence structure of disorders of psychological development. Among behavioral and emotional disorders with onset usually occurring in childhood and adolescence, the most common are mixed disorders of conduct and emotions. Conclusion. The obtained results can be used in planning and forecasting the provision of inpatient psychiatric care to patients during the wartime.

Emotional experiences and gender roles of men with fibromyalgia syndrome: a cross-cultural qualitative study.

Gender roles may impact men with fibromyalgia, causing a high number of negative emotional states and affective disorders. There are few studies that detect men's high emotional suffering. This study examined the emotional experience of men with fibromyalgia. A qualitative cross-cultural study utilized inductive thematic analysis was performed at the Fibromyalgia and Chronic Fatigue Unit Santa Maria University Hospital in Spain, the Fibromyalgia and Chronic Fatigue Clinic at Mayo Clinic in the US, and volunteers from the Winneshiek County in the US A total of 17 participants, 10 men from Spain and 7 men from the US were included. Three themes related to feelings/emotions emerged: (1) psychological level; (2) social level; and (3) physical level. Men with fibromyalgia from Spain and the US experienced many negative emotions. Men often experience negative emotions that are worsened by common misunderstandings and social biases/stigma about their condition. A proper assessment of emotions when evaluating the global health of men with fibromyalgia as well as the provision of emotional support would improve their mental health and therefore their overall physical health. Emotional management should be incorporated into all treatment protocols for fibromyalgia, especially for men given the gender stigma. Health policies designed by legislators, policymakers, and support agencies must be accompanied by education in gender role concepts to improve the emotions of men with FMS. The mass media will be essential for the disclosure of the emotional suffering of male patients so that society might better understand them.

Effects of Chronic Stress Stimulation on the Occurrence and Development of Tumors and the Regulatory Role of Chinese Medicine

Chronic stress refers to the continuous non-specific adaptive response of the body caused by the activation of the classic hypothalamic-pituitary-adrenal axis neuroendocrine system and sympathetic nervous system, which not only affects sleep quality, appetite, and gastrointestinal function, but also increases the risk of atherosclerosis, cardiovascular disease, mental disorders, and tumors. Notably, chronic stress has been confirmed to induce tumorigenesis and promote tumor evolution, especially on the immune function of the body and the remodeling of the tumor microenvironment. Therefore, it is essential and important to improve the emotional disorders caused by chronic stress stimulation in cancer patients. Many studies have proved that traditional Chinese medicine and compound regulation can significantly improve anxiety, depression and tumor development in patients. In this article, the mechanism of CUMS affecting tumor and the therapeutic effect of traditional Chinese medicine compound are reviewed, so as to provide reference for the adjuvant treatment of cancer by traditional Chinese medicine.

Systematic Review and Meta-analysis of the Efficacy and Effectiveness of the Unified Protocol for Emotional Disorders in Group Format for Adults

AbstractLittle is known about the efficacy and effectiveness of the Unified Protocol for Emotional Disorders in group format. A systematic review of the research of this intervention (UP) was conducted, and a meta-analysis of the efficacy and effectiveness was made. We searched for studies in the databases Web of Science, PubMed, PsycInfo, PSICODOC, Scholar Google, EBSCOhost, SpringerLink, and Sage Publications. We used a fixed effects model. Effect sizes were measured using Hedges’ g (adjusted), and heterogeneity was calculated using Cochran’s Q and I2. The psychological variables on which we assessed the effect of the intervention were anxiety and depressive symptoms, positive and negative affect, quality of life, and social adjustment. We located 115 studies that applied the UP, including 7 studies for the efficacy analysis (randomized controlled trial (RCT) studies) and 24 for the effectiveness analysis (RCT and non-RCT studies). The analyses suggest that the UP presents high efficacy reducing anxiety (1.29) and depressive (1.54) symptoms, as well as high effectiveness in decreasing negative affect (0.78), anxiety (1.08), and depressive (1.02) symptoms and increasing quality of life (1.01), social adjustment (0.62), and positive affect (0.59). We found heterogeneity in the analyses performed. This heterogeneity could be explained by the differences between the heterogeneous studies and the rest of the studies. The UP in group format for adults represents a highly effective and efficient alternative for treating emotional problems.

Exploring the psychometric properties of the premonitory urge for tics scale (PUTS) and its association with psychiatric symptoms in Chinese children with tic disorders

BackgroundThe Premonitory Urge for Tics Scale (PUTS) is a common self-report measure of premonitory urges for patients with tic disorders. This study aims to evaluate the Chinese version of the PUTS (PUTS-C) and to explore its association with psychiatric symptoms in Chinese children diagnosed with tic disorders.MethodsThe psychometric evaluation involved 204 outpatients with tic disorders, aged 7–16 years, who were divided into two age groups: (7–10 years, n = 103; 11–16 years, n = 95).ResultsThe PUTS-C demonstrated good internal consistency (McDonald’sω = 0.84) and two-week test-retest reliability (0.76). We observed a statistically significant correlation between the total PUTS-C score and various Yale Global Tic Severity Scale (YGTSS) subscales and total tic severity scores. The PUTS-C score also showed significant correlations with the Children Yale-Brown Obsessive Compulsive Scale (CY-BOCS), Screening Child Anxiety-Related Emotional Disorders (SCARED), and Children’s Depression Inventory (CDI). Notably, premonitory urges independently predicted tic severity, beyond the influence of comorbid symptoms. A two-factor structure of the PUTS-C was identified in the total sample through factor analysis.ConclusionsThe PUTS-C possesses acceptable validity and good reliability. It appears that premonitory urges in Chinese patients with tic disorders are associated with obsessive-compulsive symptoms, anxiety, and depression, but can independently predict tic severity. Specific PUTS-C factors possibly related to motor and vocal tics. Future research should continue to investigate age-related differences and the association with tics and other sensory symptoms.

Coding of Childhood Psychiatric and Neurodevelopmental Disorders in Electronic Health Records of a Large Integrated Health Care System: Validation Study.

Mental, emotional, and behavioral disorders are chronic pediatric conditions, and their prevalence has been on the rise over recent decades. Affected children have long-term health sequelae and a decline in health-related quality of life. Due to the lack of a validated database for pharmacoepidemiological research on selected mental, emotional, and behavioral disorders, there is uncertainty in their reported prevalence in the literature. We aimed to evaluate the accuracy of coding related to pediatric mental, emotional, and behavioral disorders in a large integrated health care system's electronic health records (EHRs) and compare the coding quality before and after the implementation of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding as well as before and after the COVID-19 pandemic. Medical records of 1200 member children aged 2-17 years with at least 1 clinical visit before the COVID-19 pandemic (January 1, 2012, to December 31, 2014, the ICD-9-CM coding period; and January 1, 2017, to December 31, 2019, the ICD-10-CM coding period) and after the COVID-19 pandemic (January 1, 2021, to December 31, 2022) were selected with stratified random sampling from EHRs for chart review. Two trained research associates reviewed the EHRs for all potential cases of autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD), major depression disorder (MDD), anxiety disorder (AD), and disruptive behavior disorders (DBD) in children during the study period. Children were considered cases only if there was a mention of any one of the conditions (yes for diagnosis) in the electronic chart during the corresponding time period. The validity of diagnosis codes was evaluated by directly comparing them with the gold standard of chart abstraction using sensitivity, specificity, positive predictive value, negative predictive value, the summary statistics of the F-score, and Youden J statistic. κ statistic for interrater reliability among the 2 abstractors was calculated. The overall agreement between the identification of mental, behavioral, and emotional conditions using diagnosis codes compared to medical record abstraction was strong and similar across the ICD-9-CM and ICD-10-CM coding periods as well as during the prepandemic and pandemic time periods. The performance of AD coding, while strong, was relatively lower compared to the other conditions. The weighted sensitivity, specificity, positive predictive value, and negative predictive value for each of the 5 conditions were as follows: 100%, 100%, 99.2%, and 100%, respectively, for ASD; 100%, 99.9%, 99.2%, and 100%, respectively, for ADHD; 100%, 100%, 100%, and 100%, respectively for DBD; 87.7%, 100%, 100%, and 99.2%, respectively, for AD; and 100%, 100%, 99.2%, and 100%, respectively, for MDD. The F-score and Youden J statistic ranged between 87.7% and 100%. The overall agreement between abstractors was almost perfect (κ=95%). Diagnostic codes are quite reliable for identifying selected childhood mental, behavioral, and emotional conditions. The findings remained similar during the pandemic and after the implementation of the ICD-10-CM coding in the EHR system.

Special Series Part II: Supporting Teachers of Students with Emotional and Behavioral Disorders

Special Series Part II: Supporting Teachers of Students with Emotional and Behavioral Disorders

Structured Peer Observation and Targeted Training to Increase Consistency of Classroom Practices in a Self-Contained School for Students with Emotional and Behavioral Disorders

ABSTRACT Consistency, predictability, and structure have been identified as key components of recommended supports for students with Emotional and Behavioral Disorders (EBD). This study describes an intervention implemented during behavioral school consultation aimed at increasing consistency in the use of classroom practices by teacher and paraprofessional participants in a self-contained school for students with EBD. A classroom observation form was developed with school personnel to measure key classroom practices, and participants then used this form to conduct structured peer observations in each other’s classes. This was followed by a single training targeting the practices that were least consistently used across classes during preceding phases of the intervention. Peer observations increased the consistency of the use of measured practices across classes, including the proper use of the school’s reward point system. The targeted training further increased the use of the least consistently used practices. These changes were maintained up to two months after the end of intervention. Data from the district’s Student Climate Survey were analyzed to evaluate the effects of the intervention from the perspectives of students. The benefits of targeting consultee observational skills as a goal during behavioral school consultation are discussed.

Attentional bias to uncertainty-based information: a conceptual replication of Fergus et al. (2013)

Attentional biases to negative information are often observed in emotional disorders such as anxiety and depression. Recently, Fergus et al. (Cognitive Therapy and Research 37:735-741, 2013) demonstrated that participants scoring high in Intolerance of Uncertainty (IU), a transdiagnostic risk factor for emotional disorders, were faster at identifying targets with uncertainty-based information (e.g., word stimuli such as ‘maybe’), relative to neutral information (e.g. word stimuli related to household items). Moreover, this effect was specific to IU over other anxious traits such as worry. This report aimed to conceptually replicate the results of Fergus et al. (Cognitive Therapy and Research 37:735-741, 2013). The current experiment was conducted with a student sample (n = 126). As in the original study, a visual search task with uncertainty-based and neutral information (e.g., word stimuli) was used. Reaction times were collected. IU and trait anxiety was measured via self-report. We partially replicated the results of Fergus et al. (Cognitive Therapy and Research 37:735-741, 2013). We found that higher IU was significantly associated with faster identification of uncertainty-based information, relative to neutral information. However, we also observed a similar pattern of results for trait anxiety. Additionally, we observed no specificity of IU or trait anxiety in predicting faster identification of uncertainty-based information, relative to neutral information. Despite the lack of specificity of IU or trait anxiety in predicting attentional bias to uncertainty-based information, these findings highlight that negative emotionality may be generally associated with attentional biases to uncertainty-based information in the absence of direct threat.

Efficacy and safety of Piwei Peiyuan Prescription in the treatment of chronic atrophic gastritis: A multicenter, double-blind, double-simulated, randomized, controlled clinical trial.

The incidence of chronic atrophic gastritis (CAG) is on the rise due to the growing pressure in modern social life, increasing bad living habits and emotional disorders (such as anxiety and depression), and the aging of the population. Of note, digestive system diseases are the dominant diseases in the field of traditional Chinese medicine (TCM). Therefore, this study evaluated the efficacy and safety of Piwei Peiyuan Prescription, a TCM prescription, in the treatment of CAG through a multicenter, double-blind, randomized, controlled design. This research was organized by the Second Affiliated Hospital of Anhui University of TCM and simultaneously performed in 6 centers. A total of 120 CAG patients were included and randomized into 2 groups: group A (treatment with Piwei Peiyuan granules plus Weifuchun Simulant) and Group B (treatment with Weifuchun Tablets plus Piwei Peiyuan Simulant). These 2 groups were compared in terms of gastroscopy scores, TCM syndrome scores, and serological indicators at baseline and within 12 weeks after treatment. According to endoscopic biopsy for pathological observation, atrophy (2.56 ± 1.08 vs 3.00 ± 1.00, P = .028) and intestinal epithelial hyperplasia (1.00 ± 1.43 vs 1.69 ± 1.80, P = .043) scores were lower in group A than in group B. For the more, group A had higher effective rates for inflammation, atrophy, and intestinal metaplasia (IM) in various regions of the stomach, especially for atrophy/IM of the gastric angle (64%, P = .034) and atrophy/IM of the lesser curvature of gastric antrum (63%, P = .042) than group B. According to TCM syndrome scores, Piwei Peiyuan Prescription improved the scores of gastric distension (2.30 ± 1.13 vs 2.80 ± 0.99, P = .022), preference for warmth and pressure (1.44 ± 1.06 vs 1.36 ± 1.10, P = .041), and poor appetite and indigestion (0.78 ± 0.66 vs 1.32 ± 0.72, P = .018). GAS, MTL, and PGE2 expression was significantly elevated after treatment with Piwei Peiyuan Prescription (P < .001). Piwei Peiyuan Prescription is effective for CAG treatment with high safety.

Diagnostic accuracy and clinical utility of the PHQ-2 and GAD-2: a comparison with long-format measures for depression and anxiety.

Anxiety and depression are highly prevalent and often comorbid mental disorders that are encompassed within the broad category of emotional disorders. The frequent comorbidity of anxiety and depression can pose challenges for accurate diagnosis and treatment which, in turn, highlights the need for reliable measurements that are simultaneously responsive to change and prevent non-response bias. Brief measures of anxiety and depression can potentially increase response rates due to their brevity and ease of administration. This study evaluates the psychometric characteristics, discriminative accuracy, and sensitivity to change of the Generalized Anxiety Disorder 2-item scale (GAD-2) and the Patient Health Questionnaire 2-item scale (PHQ-2) within a clinical population. The sample comprised treatment-seeking participants (n = 3,411), screened (n = 2,477) to receive an internet-based psychotherapeutic intervention (cognitive-behavioral, psychodynamic, or waitlist). Brief measures can effectively detect individuals who may be eligible for a diagnosis of depression and anxiety, not only prior to but also during and following the completion of psychological treatment. The discriminative ability of the GAD-2 was significantly greater during active treatment and at post-assessment compared with pre-treatment screening, although no such differences were found for the PHQ-2. Finally, endorsing the most severe response option on the GAD-2 and PHQ-2 was associated with a high probability of presenting with clinically relevant anxiety and depressive symptoms. Brief measures of anxiety and depression are viable instruments to screen for and monitor anxiety and depressive symptoms. ClinicalTrials.gov, identifier NCT05016843.

Impulsivity, emotional disorders and cognitive distortions in the general population: highlighting general interaction profiles.

Cognitive distortions, defined as erroneous information-processing, are involved in the emergence and maintenance of various mental and emotional disorders, including anxiety and depression. On the other hand, several studies highlight the existence of links between these states and the dimensions of impulsivity. We therefore studied the links between cognitive distortions, anxiety and depressive symptomatology, and impulsivity. Two hundred and forty adults (aged 18-60years, 101 men, 139 women) completed the French version of the Impulsive Behavior Scale, the Cognitive Distortions Scale for Adults and the Hospital Anxiety and Depression Scale. The results obtained highlight the existence of a cognitive distortion specific profile regarding the urgency dimension. Negative maximization, disqualification of the positive, negative-focused dichotomous reasoning, positive arbitrary focus, and neutral omission in favour of the negative are thus the distortions most associated with the level of urgency of subjects. The results also show, a moderating effect of the level of urgency on the interaction between anxiety and negative focused dichotomous reasoning. As well as on the interaction between depression and positive minimization, and between depression and positive maximization. The discussion of the results focuses on the interpretation of the data regarding the anxiety-depressive states in general population.

Efficacy of a transdiagnostic internet-based program for adolescents with emotional disorders: A randomized controlled trial

ObjectiveThe Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) is a well-established transdiagnostic cognitive-behavioral therapy (T-CBT) intervention. The aim of the present study was to examine the efficacy of the program Learn to Manage your Emotions [Aprende a Manejar tus Emociones] (AMtE), a self-applied transdiagnostic internet-delivered program based on the Spanish version of the UP-A. This is the first transdiagnostic internet-based program designed for the treatment of emotional disorders in adolescents. MethodA sample of Spanish adolescents with a primary diagnosis of an anxiety and/or depressive disorder (n = 58; age range = 12–18 years; 78.3% girls; 90% Caucasian) were randomly allocated to receive AMtE (n = 28) or the UP-A via videocall (n = 30). Pre-treatment, post-treatment and 3-month follow-up data were collected using self-reports and clinician-rated measures of anxiety, depression, positive and negative affect, anxiety sensitivity and emotional avoidance. ResultsBased on generalized estimating equations (GEE) models, both intervention programs were effective in significantly reducing self-reported anxiety and depressive disorder symptoms and clinician-rated severity of anxiety and depression, as well as self-reported transdiagnostic outcome variables. ConclusionsData provide empirical support for the efficacy of AMtE as a transdiagnostic online CBT treatment for anxiety and depressive disorders in adolescents. No marked nor consistent differences were observed between the UP-A and AMtE, highlighting the potential usefulness of the online self-administered AMtE program.