Clinical psychology & psychotherapy最新文献

{"title":"Development of the Turkish Short Form of the Parental Trauma Reactions Questionnaire and Evaluation of Its Validity and Reliability","authors":"Fatmanur Çimen,&nbsp;İsmail Seçer,&nbsp;Sarah Halligan,&nbsp;Richard Meiser-Stedman,&nbsp;Tim Dalgleish,&nbsp;Victoria Williamson","doi":"10.1002/cpp.70341","DOIUrl":"10.1002/cpp.70341","url":null,"abstract":"<div>\u0000 \u0000 <p>Considering the buffering role of parents in children's post-trauma adjustment, the availability of a valid and reliable measure that captures parental cognitions and coping responses is essential for both clinical practice and research. Although the Parental Trauma Reactions Questionnaire (PTRQ), developed to assess parents' evaluations of and support for their children's coping processes following childhood trauma, provides an important foundation in this field, the lack of model fit evaluation and cross-cultural validation has limited its broader applicability. This study aimed to examine the psychometric properties of the PTRQ, adapt it to the Turkish cultural context and develop a brief version to facilitate its use in both clinical and research settings. The research was carried out in two sequential studies. Study 1 re-examined the psychometric structure of the original PTRQ using the dataset from the initial development study, which included 365 parents. Factor structure and model fit were evaluated to determine whether the long forms retained an adequate structure. Study 2 focused on the cultural adaptation and validation of the Turkish version, conducted with 155 parents of trauma-exposed children aged 7–17 years. The CFA generally supported the multidimensional structure of the PTRQ-SF. Internal consistency assessed using Cronbach's alpha and McDonald's omega indicated acceptable reliability. Associations between parental trauma-related responses and child post-traumatic stress symptoms were broadly consistent with theoretically expected relationships, providing preliminary evidence for the theoretical relevance of the constructs assessed by the PTRQ-SF. However, the findings should be interpreted cautiously given the elevated RMSEA for the MAF-SF and the observed estimation issues. The findings provide preliminary support for the validity and reliability of the Turkish PTRQ-SF. Compared with the original long forms, the newly developed short forms demonstrated improved psychometric performance and offered a brief, practical instrument for assessing parental trauma-related responses in research and clinical settings.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imagery Rescripting for Pathological Affective Dependence in Intimate Partner Violence (ImRs-PAD): An In-Person Proof-of-Concept Study","authors":"Erica Pugliese,&nbsp;Allison Uvelli,&nbsp;Maria Grazia Foschino Barbaro,&nbsp;Carolina Papa,&nbsp;Federica Visco-Comandini,&nbsp;Francesco Mancini,&nbsp;Arnold A. P. van Emmerik","doi":"10.1002/cpp.70339","DOIUrl":"10.1002/cpp.70339","url":null,"abstract":"<p>This study evaluated the feasibility and preliminary effects of in-person Imagery Rescripting for Pathological Affective Dependence (ImRs-PAD), a trauma-focused and mechanism-based intervention for survivors of intimate partner violence (IPV). ImRs-PAD targets trauma-related relational dynamics—specifically Pathological Affective Dependence (PAD)—together with the related relational processes that may contribute to difficulties disengaging from abusive relationships. PAD is conceptualized as a relational constraint rooted in trauma, rather than individual pathology or responsibility. This study employed an exploratory single-arm repeated-measures proof-of-concept design conducted in Italy. Eighteen adult women survivors of IPV received a 13-session ImRs-PAD intervention, delivered within anti-violence services by supervised psychotherapy trainees. Primary outcomes included state and trait levels of PAD, relational commitment and intention to return to the abusive relationship, which were conceived as different, although potentially overlapping self-report indicators of relational entrapment. Secondary outcomes assessed complex trauma symptoms, psychological well-being and resilience. Participants were assessed at baseline/pre-treatment, mid-treatment, post-treatment and 1-month follow-up. Significant reductions were observed in PAD, relational commitment and intention to return over the course of the intervention. Improvements were also noted in trauma-related symptoms, psychological well-being and resilience from baseline to post-treatment. At 1-month follow-up, changes in the primary relational outcomes and resilience were largely maintained, whereas trauma-related symptoms showed slight attenuation but remained significantly improved relative to baseline. ImRs-PAD appears to be a feasible and promising intervention in real-world anti-violence centre settings, specifically targeting unmet relational needs implicated in IPV-related entrapment. Changes in the primary relational outcomes were more consistently maintained at follow-up than improvements in trauma-related symptoms after treatment termination, suggesting the potential importance of integrating such interventions within broader systems of psychosocial support.</p><p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT06670326</p>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.70339","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotional Labour in Psychotherapy: A Scoping Review of How Therapists Regulate Emotions in Clinical Practice","authors":"Judith Velasco,&nbsp;Francisco J. Sanmartín","doi":"10.1002/cpp.70344","DOIUrl":"10.1002/cpp.70344","url":null,"abstract":"<div>\u0000 \u0000 <p>Emotional labour is an integral yet conceptually underexamined feature of psychotherapeutic work. This scoping review mapped how emotional labour has been conceptualized and operationalized among psychotherapists, along with the associated outcomes and factors linked to greater emotional burden, and potential protective resources. Following JBI and PRISMA-ScR guidance, PsycINFO, Web of Science and Scopus were searched in August 2025 and updated in April 2026 for peer-reviewed studies on emotional labour among professionals delivering psychotherapy published in English or Spanish. Two reviewers independently screened and charted records. Fourteen sources met inclusion criteria, comprising both quantitative and qualitative research. Emotional labour was most commonly conceptualized as the regulation of emotional experience and expression to meet professional expectations. Operationalizations ranged from surface and deep acting to multidimensional models incorporating emotional dissonance. Therapists described emotional labour as intrinsic, emotionally ambivalent and capable of extending beyond the therapy room. Surface acting and emotional dissonance were most consistently linked to exhaustion, burnout and secondary traumatic stress, whereas self-compassion, psychological flexibility and professional identity were associated with more favourable responses to emotional demands. Emotional labour thus appears structurally embedded in psychotherapeutic practice, although the predominantly cross-sectional evidence limits conclusions about temporal and causal relationships, underscoring the need for longitudinal and intervention research.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Cultural Adaptation and Psychometric Evaluation of the Suicidal Intrusions Attributes Scale (SINAS) in Iranian Adolescents With Suicidal Ideation","authors":"Mohammad Javad Bagian Koulemarzi,&nbsp;Moslem Rajabi","doi":"10.1002/cpp.70340","DOIUrl":"10.1002/cpp.70340","url":null,"abstract":"<div>\u0000 \u0000 <p>Suicidal intrusive thoughts are unwanted, recurrent mental images of suicide that carry considerable weight in suicide-risk evaluation. Yet, few brief screening instruments exist for assessing them in high-risk groups. This study examined the psychometric properties and cross-cultural adaptation of the Suicidal Intrusions Attributes Scale (SINAS) for evaluating the severity and characteristics of these thoughts in adolescents. The sample comprised 623 Iranian adolescents (aged 14–19 years) with current suicidal ideation, drawn from 12,000 students in Lorestan Province who were first screened with the Suicide Probability Scale and then selected through random cluster and purposive sampling. Instruments included the 10-item SINAS, the Suicide Probability Scale, the Beck Hopelessness Scale, the Hospital Anxiety and Depression Scale, a brooding-rumination measure, and a fearlessness-about-death measure. We examined age and gender as grouping variables to evaluate measurement invariance. Data were analysed in SPSS 26/27 and JASP 0.19.1. Exploratory factor analysis (<i>n</i> = 323) identified a single-factor structure explaining 50.48% of the variance; confirmatory factor analysis (<i>n</i> = 300) supported this one-factor structure with good fit. Internal consistency was satisfactory (Cronbach's α = 0.91; McDonald's ω = 0.89) and convergent and discriminant validity were acceptable. SINAS also discriminated well between adolescents with suicidal ideation and those with a history of a suicide attempt (AUC = 0.876). Convergent validity was supported by significant positive correlations between SINAS scores and suicide probability (<i>r</i> = 0.724), hopelessness (<i>r</i> = 0.698), anxiety (<i>r</i> = 0.663), rumination (<i>r</i> = 0.578), depression (<i>r</i> = 0.569) and fearlessness about death (<i>r</i> = 0.167; all <i>p</i> &lt; 0.001). CFA confirmed a unidimensional structure, with measurement invariance across gender and age. These findings indicate that the SINAS demonstrates acceptable reliability and validity among Iranian adolescents with suicidal ideation and represents a suitable instrument for screening suicidal intrusive thoughts in research and clinical settings.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Positive Schemas and Symptom Severity in Depressive and Anxiety Disorders: The Mediating Role of Schema Modes","authors":"Büşra Altuntaş,&nbsp;Ahmet Gül,&nbsp;Mustafa Şahan Uyanık,&nbsp;Veysel Eren Bulut,&nbsp;Kutalp Köroğlu,&nbsp;Fatih Yığman","doi":"10.1002/cpp.70337","DOIUrl":"10.1002/cpp.70337","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to examine patients diagnosed with depressive disorder and anxiety disorder from a transdiagnostic perspective, compare them with healthy controls with respect to positive schemas and schema modes and investigate the parallel mediating role of schema modes in the effect of positive schemas on symptom severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A total of 164 participants were included, comprising 110 patients diagnosed with depressive or anxiety disorder and 54 healthy volunteers. Psychiatric diagnoses were confirmed using the Structured Clinical Interview for DSM-5 Disorders–Clinician Version (SCID-5-CV). Participants completed the Young Positive Schema Questionnaire (YPSQ), the Schema Mode Inventory–Short Form (SMI-SF) and the Depression Anxiety Stress Scale (DASS-21). The simultaneous mediating role of four schema mode factors (dysfunctional child modes, dysfunctional parent modes, coping modes and healthy modes) in the effect of positive schemas on DASS total scores was tested using path analysis and bootstrap methodology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Positive schema and healthy mode scores were significantly lower in the clinical group compared with controls, whereas dysfunctional child, dysfunctional parent and coping mode scores were significantly elevated (all <i>p</i> &lt; 0.001; Cohen's <i>d</i> = 1.10–2.12). In the parallel mediation model constructed for the clinical group, the direct effect of positive schemas on DASS total scores was non-significant (β = −0.055, <i>p</i> = 0.634), whereas indirect effects operating through dysfunctional child modes (IE = −0.310), dysfunctional parent modes (IE = −0.117) and healthy modes (IE = −0.199) remained significant, indicating a full mediation pattern (<i>R</i>² = 0.520). In the control group, this four-path mediation mechanism was largely inoperative.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The association between positive schemas and lower symptom severity appears to be mediated not through a direct pathway but through schema modes, suggesting that this mechanism may act as a protective factor in the presence of a psychopathological substrate. These findings support the view that positive schemas warrant consideration as independent and functional components in clinical assessment and treatment planning.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Undoing Self-Contempt in Borderline Personality Disorder: A Controlled Test of Change in Emotion Processing in Psychotherapy","authors":"Ueli Kramer,&nbsp;Loris Grandjean,&nbsp;Hélène Beuchat,&nbsp;Stéphane Kolly","doi":"10.1002/cpp.70335","DOIUrl":"10.1002/cpp.70335","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Emotion processing has been discussed as a mechanism of change in several forms of psychotherapy for a broad range of psychological disorders. The general conclusions of the field do not allow for a step-by-step granularity of relevant emotional experiences in clients. This is particularly important for personality disorders, especially borderline personality disorder (BPD). Using a controlled out-of-therapy assessment, we assume that the lessening of expressed self-contempt by clients gives way to proportionally more expressions of self-compassion and assertive anger after a brief psychiatric intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The present secondary analysis of a randomized controlled trial includes <i>N</i> = 79 participants (<i>n</i> = 27 clients with BPD in the active treatment following the principles of good psychiatric management [GPM]; <i>n</i> = 23 clients with BPD in the treatment as usual [TAU]; <i>n</i> = 29 healthy controls). Both treatments—GPM and TAU—lasted 4 months. All participants underwent out-of-therapy experiential two-chair dialogues focusing on self-criticism at two time points. The participants' emotional expressions were assessed using the video-rated Classification of Affective Meaning States and the Self-Contempt Rating Scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results indicated that the intensity of out-of-session observed self-contempt as part of a person-relevant self-criticism decreased in clients with BPD undergoing GPM, with a large effect, similar to healthy controls. A medium-sized effect was found for reduction in self-contempt in clients undergoing TAU. The results also indicated that the proportion of individuals with BPD undergoing GPM accessing self-compassion and assertive anger increased, which was not the case for healthy controls nor clients in TAU.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Undoing self-contempt may be an elusive, yet central task in psychotherapy for clients with BPD. The present study explored the client process of change of undoing self-contempt and moving towards self-compassion and assertive anger. These conclusions bear important clinical and research implications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.70335","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Personality Style and Diagnostic Characteristics With Therapeutic Process Variables of Adults With Eating Disorders","authors":"Evangeline Giannopoulos,&nbsp;Mark Hilsenroth,&nbsp;Robert Bornstein,&nbsp;Susan Farella-Busch,&nbsp;Giorgio A. Tasca","doi":"10.1002/cpp.70331","DOIUrl":"10.1002/cpp.70331","url":null,"abstract":"<div>\u0000 \u0000 <p>The prevalence and severity of eating disorders (EDs) have been increasing globally, and better understanding the role of different personality styles that occur in adults with EDs may optimize diagnosis and treatment. This study therefore aimed to investigate the relationship between personality styles, diagnostic characteristics, therapeutic techniques and therapeutic alliance in the treatment of adults with EDs. It is the first known study to directly explore personality styles and therapeutic alliance specifically with an ED sample. Data was collected via an online survey from 126 licenced therapists who reported on their treatment of an adult with an ED. Therapists provided ED diagnostic information (diagnosis and symptoms); rated their patients on three personality prototypes (emotionally dysregulated, constricted and high-functioning/perfectionistic); their use of cognitive-behavioural (CB), psychodynamic-interpersonal (PI) and adjunctive (AT) ED interventions utilized in treatment; and their therapeutic alliance with a randomly selected patient. Results reveal that patients who have both more constricted and more dysregulated features have more challenging diagnostic profiles. In addition, patients with more dysregulated features, in particular, elicit the integrative technique use from therapists with diverse primary theoretical orientations and pose more difficulty in forming a strong therapeutic alliance. In all, our findings have direct clinical application in the treatment of adults with EDs with differing personality features, such as emphasizing conceptualization and treatment planning for patients with more constricted and dysregulated features, integrating techniques outside of a clinician's primary theoretical orientation and emphasizing alliance formation for patients with more dysregulated features.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative War-Related Resource Loss and Multidimensional Quality of Life in Gaza: The Mediating Role of Psychological Distress","authors":"Belal Aldabbour,&nbsp;Alaa E. Elshafee,&nbsp;Mohammed E. Hammad,&nbsp;Ahmad Abdaljaber Alkhaldi,&nbsp;Yahia Maher Mezied,&nbsp;Mohammed Z. Alshaikhali,&nbsp;Tareq A. Mkadmh,&nbsp;Hassan Ahmed Abudan,&nbsp;Mohammed Tammem Alaqad,&nbsp;Awad Mohammed Alnjjar,&nbsp;Mahmoud Fares Attaallah,&nbsp;Latefa Ali Dardas","doi":"10.1002/cpp.70338","DOIUrl":"https://doi.org/10.1002/cpp.70338","url":null,"abstract":"<div>\u0000 \u0000 <p>Beyond direct trauma, armed conflicts generate cumulative structural losses, including repeated displacement, housing destruction and economic collapse. Although prior research has linked trauma exposure to impaired quality of life (QoL), the pathways through which cumulative war-related losses affect domain-specific QoL remain underexamined. We conducted a cross-sectional survey in August 2025 among 894 adults across the Gaza Strip. Participants completed the Arabic WHOQOL-BREF and the PHQ-4, and QoL domain scores were transformed to a 0–100 scale. Multivariable linear regression identified independent predictors of overall and domain-specific QoL, and mediation analyses assessed whether psychological distress mediated the associations between cumulative resource loss (housing damage, forced relocations and loss of income source) and QoL outcomes. QoL scores were markedly low across domains, particularly in the environmental (mean: 25.91) and psychological (mean: 35.60) domains, with an overall QoL mean of 37.46. Psychological distress was highly prevalent (mean PHQ-4 = 6.9), with 94.3% scoring above the normal range, 64.9% screening positive for probable anxiety and 65.5% for probable depression. In multivariable models, psychological distress was the strongest and most consistent predictor of reduced QoL across all domains (<i>β</i> range: −1.67 to −2.28 per 1-point increase in PHQ-4; all <i>p</i> &lt; 0.001). Forced relocations were independently associated with lower QoL across all four domains, whereas housing destruction and income loss showed domain-specific effects, particularly on psychological and environmental QoL. Mediation analyses showed that psychological distress partially mediated the association between cumulative resource loss and QoL, accounting for 26% of the association with overall QoL and 29%–41% of the association with domain-specific outcomes, indicating both direct structural and indirect mental health pathways. QoL impairment during the current war in Gaza appears more severe than previously documented in the area and lower than that reported in other recent conflict settings. Cumulative resource loss has both direct and indirect effects on QoL, with psychological distress serving as a key explanatory pathway. Integrated humanitarian responses that address both structural restoration and scalable mental health interventions are urgently needed.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does More Mean Better? Treatment Intensity and Predictors of Clinically Significant Change in Suicidal Ideation During Dialectical Behaviour Therapy","authors":"Maya E. Amestoy,&nbsp;Nathan Kolla,&nbsp;Judith Levy-Ajzenkopf,&nbsp;Ryan Klein,&nbsp;Amanda A. Uliaszek","doi":"10.1002/cpp.70336","DOIUrl":"10.1002/cpp.70336","url":null,"abstract":"<p>This study examined whether DBT treatment intensity predicts clinically significant change (CSC) in suicidal ideation, whether maladaptive personality traits moderate this relationship and whether early symptom improvements in suicidal ideation from baseline to midtreatment predicted CSC at post-treatment, above and beyond the effects of treatment intensity and personality traits. Adults (<i>n</i> = 105) in a hospital-based DBT day treatment programme were triaged into three DBT intensity tracks over 12 weeks: low intensity (weekly DBT skills group), mid intensity (weekly skills group plus individual therapy) and high intensity (two weekly skills groups, individual therapy). Suicidal ideation was assessed using the Beck Scale for Suicidal Ideation (BSSI), and maladaptive personality traits were assessed using the Personality Inventory for ICD-11 at baseline, Week 6 and Week 12. Early symptom improvement was operationalized as change in BSSI scores from baseline to Week 6. CSC at Week 12 was defined as a reliable improvement from baseline to Week 12 and a BSSI score of ≤ 6 at Week 12. Suicidal ideation decreased significantly over time, with no differences across treatment intensity levels or maladaptive personality traits. Early symptom improvement predicted higher odds of achieving CSC at Week 12, whereas Disinhibition predicted lower odds of achieving CSC. Suicidal ideation improved across DBT intensity levels, with early reductions in suicidal ideation and Disinhibition, but not treatment intensity, emerging as key predictors of clinically significant recovery at post-treatment.</p>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.70336","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Metacognition and Mindfulness Across Social Anxiety Disorder, Panic Disorder and Healthy Controls","authors":"Fikret Poyraz Çökmüş,&nbsp;Zeynep Tiftikçi,&nbsp;Osman İyilikçi,&nbsp;Orkun Aydın","doi":"10.1002/cpp.70334","DOIUrl":"10.1002/cpp.70334","url":null,"abstract":"<div>\u0000 \u0000 <p>Metacognition and mindfulness are central to contemporary accounts of anxiety, yet their comparative profiles across social anxiety disorder (SAD) and panic disorder (PD) remain insufficiently defined. The objective of this study is to compare metacognition and mindfulness across SAD, PD and healthy controls (HC) and to examine how these processes predict disorder specific severity. Adults with SAD (<i>n</i> = 47), PD (<i>n</i> = 50) and HC (<i>n</i> = 50) participated, for a total of 147 individuals. Participants completed the Metacognitions Questionnaire 30 (MCQ-30), the Five Facet Mindfulness Questionnaire Short Form (FFMQ-SF) and disorder-specific severity measures. Group differences were tested, followed by multiple linear regressions predicting severity within each clinical group from MCQ-30 subscales and FFMQ-SF facets. Metacognitive dysfunction was higher in SAD and PD than in HC, with the clearest separations in cognitive self-consciousness and the need to control thoughts. Mindfulness was lowest in SAD, intermediate in PD and highest in HC. In regression analyses, only mindfulness variables predicted severity in SAD, with higher observing and higher nonjudging associated with lower symptom levels. In PD, the need to control thoughts was the sole metacognitive predictor positively associated with severity; other metacognitive and mindfulness facets were not significant. Metacognition and mindfulness index a shared liability across anxiety but show disorder-specific signatures. In SAD, mindfulness facets related to observing and nonjudging are most relevant for severity, whereas in PD, control-oriented metacognitive beliefs are most relevant. These patterns identify focused targets for future longitudinal and experimental studies and may inform disorder-sensitive intervention strategies.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}