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Lawlor, Caroline; Hepworth, Claire; Smallwood, Jane; Carter, Ben; Jolley, Suzanne
doi: 10.1002/cpp.2408pmid: 31661593
Emotions play a key role in the development and experience of psychosis, yet there are important gaps in our understanding of how individuals with psychosis understand and respond to their emotions. This systematic review investigated self‐reported emotion regulation difficulties in individuals with psychosis compared with non‐clinical controls. An electronic database search was conducted in Medline, PsychINFO, and Embase and supplemented by searches of reference lists and citations. Seventeen studies were included. A narrative synthesis was conducted because contextual diversity was present across the studies and outcomes. Individuals with psychosis reported greater difficulties in (i) emotional clarity (specifically with identifying, describing, and understanding their emotions), (ii) emotional acceptance, (iii) engaging in goal‐directed behaviours when experiencing negative emotions, and (iv) willingness to experience emotional distress in the pursuit of meaningful activities in life. Evidence pertaining to other self‐reported emotion regulation difficulties was less clear. Effect sizes were generally large in magnitude but there were few studies on some self‐reported emotion regulation difficulties, and all studies were at moderate to high risk of bias. Further research is needed to clarify the nature of emotion regulation difficulties in individuals with psychosis to inform the provision of targeted clinical interventions.
Goldfinger, Corrie; Green, Sheryl M.; Furtado, Melissa; McCabe, Randi E.
doi: 10.1002/cpp.2413pmid: 31746496
Prevalence of perinatal anxiety disorders continues to grow, with estimates greater than those of postpartum depression. Generalized anxiety disorder (GAD) is the most commonly reported perinatal anxiety disorder, yet very little is known about the worry content experienced during the perinatal period in those with GAD. This study investigated worry content and frequency in a sample of perinatal women (n = 20) and age‐matched nonperinatal women (n = 20) diagnosed with GAD. Participants completed the Penn State Worry Questionnaire (PSWQ) to assess worry severity, in addition to providing their current top worries. Mean scores on the PSWQ in both samples exceeded a clinical cut‐off score of 65, and thematic analyses revealed that perinatal women experienced significantly greater parental‐themed worries compared with the nonperinatal GAD sample (p < .05). Capturing the unique content of worry for perinatal woman will assist clinicians in identifying treatment targets and may enhance treatment outcome.
Palmier‐Claus, Jasper; Wright, Kim; Mansell, Warren; Bowe, Samantha; Lobban, Fiona; Tyler, Elizabeth; Lodge, Christopher; Jones, Steve
doi: 10.1002/cpp.2415pmid: 31830342
Behavioural experiments are an important component of cognitive–behavioural therapy. However, there exists little up‐to‐date guidance on how to conduct these in people with a diagnosis of bipolar disorder. This paper provides recommendations on how to conduct behavioural experiments in this population. The aim is to upskill and empower clinicians to conduct behavioural experiments. The paper combines the expertise of senior clinicians working in the United Kingdom. The article starts by providing general advice on conducting behavioural experiments in people with bipolar disorder. It then offers specific examples of behavioural experiments targeting cognitions around the uncontrollability and danger of affective states, and related behavioural strategies, which have been implicated in the maintenance of bipolar mood swings. The article finishes by providing examples of behavioural experiments for non‐mood related difficulties that commonly occur with bipolar experiences including perfectionistic thinking, need for approval, and intrusive memories. Behavioural experiments offer a useful therapeutic technique for instigating cognitive and behavioural change in bipolar disorder. Conducted sensitively and collaboratively, in line with people's recovery‐focused goals, behavioural experiments can be used to overcome mood‐ and non‐mood related difficulties.
Kadur, Jennifer; Lüdemann, Jonas; Andreas, Sylke
doi: 10.1002/cpp.2416pmid: 31837282
This systematic review summarizes articles that examined the effects of the psychotherapist's statements on the outcome of the patient and the therapeutic alliance.
Jones, Lauren Stephanie; Anderson, Emma; Loades, Maria; Barnes, Rebecca; Crawley, Esther
doi: 10.1002/cpp.2417pmid: 31840339
Comorbid depression is common in adolescents with chronic illness. We aimed to design and test a linguistic coding scheme for identifying depression in adolescents with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), by exploring features of e‐consultations within online cognitive behavioural therapy treatment. E‐consultations of 16 adolescents (aged 11–17) receiving FITNET‐NHS (Fatigue in teenagers on the interNET in the National Health Service) treatment in a national randomized controlled trial were examined. A theoretically driven linguistic coding scheme was developed and used to categorize comorbid depression in e‐consultations using computerized content analysis. Linguistic coding scheme categorization was subsequently compared with classification of depression using the Revised Children's Anxiety and Depression Scale published cut‐offs (t‐scores ≥65, ≥70). Extra linguistic elements identified deductively and inductively were compared with self‐reported depressive symptoms after unblinding. The linguistic coding scheme categorized three (19%) of our sample consistently with self‐report assessment. Of all 12 identified linguistic features, differences in language use by categorization of self‐report assessment were found for “past focus” words (mean rank frequencies: 1.50 for no depression, 5.50 for possible depression, and 10.70 for probable depression; p < .05) and “discrepancy” words (mean rank frequencies: 16.00 for no depression, 11.20 for possible depression, and 6.40 for probable depression; p < .05). The linguistic coding profile developed as a potential tool to support clinicians in identifying comorbid depression in e‐consultations showed poor value in this sample of adolescents with CFS/ME. Some promising linguistic features were identified, warranting further research with larger samples.
Rupp, Christian; Gühne, Daniela; Falke, Charlotte; Doebler, Philipp; Andor, Fabian; Buhlmann, Ulrike
doi: 10.1002/cpp.2418pmid: 31881096
Ecological momentary assessment (EMA) has been shown to be a valid and sensitive measure of treatment effects in obsessive‐compulsive disorder (OCD). As part of a clinical trial, this EMA study deals with a comparison of two treatment conditions, that is, cognitive restructuring (CR) and detached mindfulness (DM). EMA data from n = 39 OCD patients were available from a randomized clinical trial on the effectiveness of CR and DM. Smartphone‐based EMA sampling spread over 4 days each before and after treatment, with 10 random prompts per day and a 2‐week intervention of either CR or DM. We tracked CR strategies (e.g., questioning an appraisal by re‐evaluating risk), DM strategies (e.g., allowing one's thoughts to come and go), and application of newly learned strategies during Post‐Treatment EMA. Although there was a trend towards DM strategies being applied more often during Pre‐Treatment EMA than CR strategies, we did not find differences during Post‐Treatment EMA between CR and DM regarding frequency or difficulty of application and experienced relief. As expected, we found a clear pre‐post increase for all CR and DM behaviours except for one DM item. However, we did not find a treatment‐specific increase of CR and DM behaviours; that is, both interventions equally well promoted a seemingly general treatment effect. Despite the ecological validity of EMA, however, social desirability effects cannot be ruled out, so that this conclusion must be handled cautiously. Further research is needed to replicate and generalize our results.
Han, Jiwon; Seo, Yesul; Hwang, Hyunchan; Kim, Sun Mi; Han, Doug Hyun
doi: 10.1002/cpp.2419pmid: 31881100
Cognitive behavioural therapy (CBT) is considered to be an effective treatment for internet gaming disorder (IGD). This study examined the effectiveness of CBT in treating impulsivity, anxiety, avoidance, and family and environmental problems in patients. A total of 101 patients completed the CBT programme, and 104 completed the supportive therapy. The CBT programme consisted of fourteen 90‐min sessions with one therapist and four to five patients, once or twice a week. The supportive therapy group visited a psychiatric outpatient department once or twice a week until they completed 14 visits. Outcomes were measured in terms of improvement in IGD, psychological symptoms, and social interaction. The CBT group (improvement: 67 [66.3%] versus non‐improvement: 34 [33.7%]) showed more improvement in IGD compared with the supportive therapy group. The CBT group also showed a greater decrease in internet addiction, anxiety, impulsivity, and social avoidance. In the CBT group, among patients who improved, the greatest improvements were in internet addiction, attention, depression, anxiety, impulsivity, social avoidance, and family cohesion. Our CBT programme may be more effective than supportive therapy with regard to improvement in IGD symptoms by controlling anxiety, impulsivity, and social avoidance. In addition, CBT‐related improvements in patients with IGD could be enhanced by controlling anxiety, social avoidance, and family cohesion.
Lamela, Diogo; Figueiredo, Bárbara; Morais, Ana; Matos, Paula; Jongenelen, Inês
doi: 10.1002/cpp.2420pmid: 31881102
Marital satisfaction (MS) is a key indicator of mental and physical health. Factor structure of MS measures in individuals with clinical levels of depression as well as their measurement invariance across groups with different levels of depressive symptoms were not yet explored. The lack of evidence of measurement invariance might compromise valid comparisons between individuals with elevated and minimal depressive symptoms in MS. This study examined the factor structure of the Couple Satisfaction Index‐4 (CSI‐4) among women with clinical levels of depression, tested the CSI‐4 measurement invariance across depression levels groups, and investigated CSI‐4 convergent and divergent validity. Participants were 891 heterosexual married/cohabiting women who were assigned into one of two groups based on assessment of their levels of depressive symptoms. Participants completed the CSI‐4 and self‐reported measures used to examine convergent and divergent validity. Support was found for the factor structure of the CSI‐4 for the total sample and both elevated depressive symptoms and minimal depressive symptoms groups. Subsequent multigroup confirmatory factor analyses supported the measurement invariance of the CSI‐4 across depression levels groups. The CSI‐4 revealed excellent values of internal consistency and convergent and divergent validity. Our findings suggest that CSI‐4 produces comparable response patterns across depression groups and thus meaningful comparisons between groups can be performed.
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