Clinical psychology & psychotherapy最新文献

{"title":"Experiential Avoidance as a Transdiagnostic Mediator in the Relationship Between Intolerance of Uncertainty, Maladaptive Perfectionism, and Psychiatric Symptoms: Structural and Causal Mediation Analyses in a Clinical Sample","authors":"Gizem Gerdan, Ebru Salcioglu","doi":"10.1002/cpp.70102","DOIUrl":"https://doi.org/10.1002/cpp.70102","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Anxiety- and depression-related disorders rank among the most prevalent psychological conditions globally. Intolerance of uncertainty (IU), perfectionism, and experiential avoidance (EA) are recognized as transdiagnostic factors contributing to the development and maintenance of these emotional disturbances. However, their interplay remains insufficiently understood and has not been examined within a single research design across clinical samples with varying psychiatric diagnoses. Investigating the relationships and clinical significance of these key transdiagnostic processes in the maintenance of psychiatric symptoms represents a research priority. This study examined the mediating role of EA in the relationship between IU, maladaptive perfectionism (MP), and psychiatric symptoms (PS) using structural equation modeling (SEM) and causal mediation analyses. The sample included 221 participants (18–65 years) with a range of anxiety- and depression-related diagnoses. SEM results showed that EA fully mediated the relationships between IU, MP, and PS. Increased IU and MP were linked to heightened EA, which, in turn, was associated with greater symptom severity. The model explained 54.5% of the variance in EA and 62.5% in PS. Causal mediation analyses showed that EA fully mediated the relationships between IU and PS and MP and PS in two separate models. EA explained 1.254 standard deviations in the IU-PS relationship and 0.871 standard deviations in the MP-PS relationship. Sensitivity analyses (<i>ρ</i> = −0.1) supported the robustness of these effects against potential confounders. These findings underscore the potential utility of assessments and interventions targeting EA to more effectively address the relationship between MP, IU, and anxiety- and depression-related disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Summary</h3>\u0000 \u0000 <div>\u0000 \u0000 <ul>\u0000 \u0000 \u0000 <li>This study is among the first to examine the role of EA in the relationship between intolerance of uncertainty (IU), MP, and PS in individuals with anxiety- and depression-related disorders.</li>\u0000 \u0000 \u0000 <li>IU and MP are associated with psychiatric PS severity through EA.</li>\u0000 \u0000 \u0000 <li>Causal mediation analyses confirmed EA as a key mechanism linking IU and MP to PS, with results remaining robust after controlling for potential confounders.</li>\u0000 \u0000 \u0000 <li>Avoidance behaviors appear to contribute to the maintenance and reinforcement of MP traits and IU, as their direct associations with PS were fully mediated by EA, resulting in increased symptom burden.</li>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.70102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315379","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":"Schizotypy, Schizotypal Personality Disorder and Eating Disorders: A Systematic Review","authors":"Haoyu Guo,&nbsp;Mingyue Xiao,&nbsp;Jiawen Tian,&nbsp;Bruce K. Christensen,&nbsp;Hong Chen","doi":"10.1002/cpp.70079","DOIUrl":"https://doi.org/10.1002/cpp.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This systematic review aims to explore the comorbidity of schizotypy and schizotypal personality disorder (SPD) with eating disorders (EDs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four databases (Cochrane Library, PubMed, PsycINFO and Web of Science) were searched for empirical studies published through 2023. Eligible studies underwent data extraction, risk of bias assessment and subsequent analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 11 studies with 2236 patients were included in the present review. The three main types of EDs—anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED)—along with their subtypes were involved. Patients with AN and both anorexia and bulimia nervosa exhibited more obvious schizotypal manifestations, whereas those with BN showed less severe schizotypal levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EDs are closely linked with schizotypy and SPD. Schizotypal manifestations vary across different types of EDs. The cognitive and social deficits highlighted by schizotypy and SPD and their associated neurobiological dysfunction may be related to abnormal and pathological eating behaviours. Future research should further investigate their comorbid relationships, especially potential transdiagnostic indicators.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315374","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":"Parental Stress and Coping in Autism Spectrum Disorder: A Network Analysis of Internalizing and Externalizing Symptoms in Children With Autism Spectrum Disorder","authors":"Mahmoud Gharaibeh,&nbsp;Mohammad Nayef Ayasrah,&nbsp;Ayoub Hamdan Al-Rousan,&nbsp;Yusra Jadallah Abed Khasawneh,&nbsp;Mohamad Ahmad Saleem Khasawneh","doi":"10.1002/cpp.70100","DOIUrl":"https://doi.org/10.1002/cpp.70100","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Parental stress and coping strategies play a pivotal role in shaping mental health outcomes for children with Autism Spectrum Disorder (ASD). While traditional research has examined linear relationships, network analysis offers a novel lens to uncover dynamic interactions between parental factors and child psychopathology. This study employs advanced network modeling to map how specific stress dimensions and coping mechanisms differentially associate with internalizing (e.g., anxiety) and externalizing (e.g., aggression) symptoms. Our findings provide clinically actionable insights into targeted intervention points within the parent–child stress-coping system.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Method&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Parents of children aged 6–12 years (age &lt;sub&gt;mean ± SD&lt;/sub&gt; 8.84 ± 1.86, with 78 female participants (41.94%)) with the ASD diagnosis completed online questionnaires that incorporated the Autism Parenting Stress Index (APSI), the Child Behavior Checklist (CBCL), and the Brief COPE scale. Network modeling techniques were employed, utilizing a Multivariate Gaussian Model (MGM) with a gLASSO regularization parameter (&lt;i&gt;γ&lt;/i&gt; = 0.1) and bootstrapping with 1000 resamples to ensure the precision of edge weights and centrality indices.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The network analysis revealed a significant edge weight of 0.332 between core autism-related stress (APSI.T1) and affective problems (CBCL1) and a robust connection of 0.414 between conduct problems (CBCL4) and oppositional defiant behaviors (CBCL5). Notably, adaptive coping strategies (C.1) exhibited high centrality values (betweenness = 1.537; closeness = 1.552; strength = 1.297), indicating their pivotal role in buffering the impact of parental stress on psychiatric outcomes. In contrast, maladaptive coping strategies (C.2) demonstrated negative centrality measures (betweenness = −1.132; closeness = −1.899; strength = −1.677), suggesting a limited protective effect.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Adaptive coping strategies served as protective factors, while maladaptive ones intensified the stress cycle. These findings emphasize the need for targeted interventions focusing on both symptom management and strengthening parental resilience.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Summary&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 \u0000 &lt;li&gt;Emotional regulation skill development through techniques like CBT and mindfulness should be the primary focus of interventions for childre","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281472","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":"Characterizing Therapy Experiences in Youth With Depression and Suicide Via the Depression Treatment Experiences Questionnaire","authors":"Kendall N. Drummond,&nbsp;Andrew G. Guzick,&nbsp;Samuel D. Spencer,&nbsp;Caitlin M. Pinciotti,&nbsp;Emily J. Bivins,&nbsp;Abu Minhajuddin,&nbsp;Holli Slater,&nbsp;April Gorman,&nbsp;Lynnel C. Goodman,&nbsp;Rachel A. Walker,&nbsp;Sarah M. Wakefield,&nbsp;Tianyi Wang,&nbsp;Caitlin Chanoi,&nbsp;Jacquelyn M. LaGrone,&nbsp;Jair C. Soares,&nbsp;Matt Smith,&nbsp;Francesca Lambie,&nbsp;Jennifer L. Hughes,&nbsp;Shane A. Snyder,&nbsp;Wayne K. Goodman,&nbsp;Madhukar H. Trivedi,&nbsp;Eric A. Storch","doi":"10.1002/cpp.70088","DOIUrl":"https://doi.org/10.1002/cpp.70088","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;p&gt;Depression and suicidality are prevalent mental health issues among adolescents in the United States. There are multiple evidence-based practices (EBPs) for depression and/or suicidality, including cognitive behavioural therapy (CBT), dialectical behavioural therapy (DBT) and interpersonal therapy for adolescents (IPT-A), though youth seeking psychotherapeutic treatment in community settings may not consistently receive these EBPs. This study aims to characterize therapy experiences among youth aged 8–20 years with depression and/or suicidal behaviour who were in treatment using the Depression Treatment Experiences Questionnaire (DTEQ), as well as to provide initial construct validity and test–retest reliability of this new measure. Of the first 1000 participants in the Texas Youth Depression and Suicide Research Network (TX-YDSRN), 585 were currently receiving psychotherapy for their depression and/or suicidality. Almost half of the participants engaged in therapy reported receiving some form of CBT (&lt;i&gt;n&lt;/i&gt; = 237, 42.4%). The DTEQ showed a two-factor structure, including a 12-item ‘Evidence-Based Practice’ factor that demonstrated strong internal consistency and test–retest reliability and a two-item ‘Parental Involvement’ factor that showed acceptable internal consistency and test–retest reliability. Participants receiving psychotherapy generally endorsed being exposed to techniques aligned with EBPs. Additional non-therapeutic elements, such as exercise (&lt;i&gt;n =&lt;/i&gt; 276, 47.1%) and changing sleep habits (&lt;i&gt;n =&lt;/i&gt; 191, 32.6%), were frequently endorsed as being received by participants in psychotherapy. These results describe the therapy experiences of youth engaged in psychotherapy for depression and/or suicidality and propose a new assessment tool that can be used to characterize these experiences.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Key Practitioner Messages&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 \u0000 &lt;li&gt;Youth in psychotherapy for depression or suicidality frequently engage in evidence-based techniques (e.g., problem-solving, cognitive restructuring), yet nearly half are unaware of the type of therapy they are receiving—highlighting a gap in patient-provider communication and psychoeducation.&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;The DTEQ is a promising tool for assessing therapy content and structure and may help practitioners assess that evidence-based components are being implemented and understood by clients.&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;Many adolescents supplement treatment with lifestyle changes like exercise and sleep adjustments—indicating the importance of integrating behavioural health recommendations into therapy for holistic care.&lt;/li&gt;\u0000 &lt;/ul&gt;\u0000 ","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256034","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":"Interplay Between Childhood Maltreatment, Alexithymia, Negative Affect and Cognitive Bias in Relation to Psychotic Symptoms and Psychotic-Like Experiences","authors":"Vahid Khosravani,&nbsp;Seyed Mehdi Samimi Ardestani,&nbsp;Nika Eskandari,&nbsp;Farangis Sharifibastan,&nbsp;Morteza Aghaeimazraji,&nbsp;Michael Berk,&nbsp;Azra Mohammadpanah Ardakan,&nbsp;Mina Shirmohammadali","doi":"10.1002/cpp.70096","DOIUrl":"https://doi.org/10.1002/cpp.70096","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;p&gt;Prior research has individually examined childhood maltreatment, alexithymia, negative affect and cognitive biases in the context of psychosis. This study investigated the interplay among these factors in relation to psychotic symptoms and psychotic-like experiences (PLEs) among three groups (&lt;i&gt;n&lt;/i&gt; = 1383): hospitalized individuals with schizophrenia (&lt;i&gt;n&lt;/i&gt; = 302) and nonclinical individuals at high (&lt;i&gt;n&lt;/i&gt; = 205) and at low risk for psychosis (&lt;i&gt;n&lt;/i&gt; = 876). Both self-report and clinician-rated scales were conducted. Individuals with schizophrenia and those at high risk exhibited higher measures of cognitive bias, alexithymia, childhood maltreatment and negative affect than those at low risk. Within each group, participants reporting childhood maltreatment and alexithymia also demonstrated elevated cognitive bias, negative affect, psychotic symptoms, schizotypy or PLEs than people without such reports. The same result was replicated across the entire sample regarding cognitive bias and negative affect, with the most adverse profile observed in individuals with both alexithymia and childhood maltreatment. Further, specific dimensions of cognitive bias facets behaved differently in their mediating roles in the links of childhood maltreatment, alexithymia and negative affect to psychotic symptoms and PLEs. The study highlights childhood maltreatment, alexithymia, negative affect and cognitive bias facets as significant risk factors along the psychosis continuum. Additionally, the study emphasizes the role of cognitive bias facets in linking childhood maltreatment, alexithymia and negative affect to psychotic symptoms and PLEs.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Key Practitioner Messages&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 \u0000 &lt;li&gt;Individuals with schizophrenia and those at high and low risk for psychosis were evaluated for childhood maltreatment, alexithymia, negative affect, psychotic symptoms and PLEs.&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;The high-risk and schizophrenia groups scored higher on several variables than those at low risk group.&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;In each group, people with childhood maltreatment and alexithymia differed from those without.&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;In the total sample, people with childhood maltreatment and alexithymia showed significant differences, with individuals having both alexithymia and childhood maltreatment demonstrating the most adverse profile.&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;Specific cognitive biases linked childhood maltreatment, alexithymia and negative affect to psychotic symptoms and PLEs.&lt;/li&gt;\u0000 &lt;/ul&gt;\u0000 &lt;/div&gt;","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256110","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":"Culturally Adapted Manual-Assisted Psychological Intervention (CaMaPI) for Adolescents/Young People With a History of Self-Harm and Suicidal Ideation in Nigeria: A Randomised Controlled Feasibility Trial","authors":"Dung Ezekiel Jidong,&nbsp;Tarela Juliet Ike,&nbsp;Maigari Yusufu Taru,&nbsp;Juliet Y. Pwajok,&nbsp;Charles Nnaemeka Nwoga,&nbsp;John Ezekiel Jidong,&nbsp;Shadrack B. Mwankon,&nbsp;Christopher Francis,&nbsp;Nusrat Husain","doi":"10.1002/cpp.70098","DOIUrl":"https://doi.org/10.1002/cpp.70098","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Globally, suicide is the second leading cause of death for adolescents/young people aged 15–30-years old. The mainstream care for these affected persons is mostly unsuccessful due to limited culturally appropriate care.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This is a mixed-methods randomised controlled feasibility trial design. A culturally adapted manual-assisted psychological intervention (CaMaPI) was utilised to treat adolescents/young people with histories of self-harm and suicidal ideation. CaMaPI is a manualised intervention consisting of 10 sessions, grounded in psychoeducation and cognitive behavioural therapy. Participants aged 18–29 were screened for self-harm and suicidal ideation. &lt;i&gt;N&lt;/i&gt; = 20 participants were randomised into CaMaPI (&lt;i&gt;n&lt;/i&gt; = 10) or Treatment as Usual (TaU) (&lt;i&gt;n&lt;/i&gt; = 10) groups. One focus group with &lt;i&gt;n&lt;/i&gt; = 8 participants, and &lt;i&gt;n&lt;/i&gt; = 3 individual interviews were conducted with the experimental group.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Result&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Satisfaction with intervention (CaMaPI, 100%; TaU, 50%). Reduction in self-harm and suicidal ideation was higher in CaMaPI on the suicide and self-harm scale at Md = 1.00 with z = −2.264, compared to TaU, Md = 3.00 with z = −0.378. Both groups showed no significant reduction in hopelessness. Emerging themes from the qualitative findings showed acceptance of self-harm and suicidal ideation as a treatable condition, mood management and behaviour modification, alongside cultural appropriateness and positive experience of the CaMaPI.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;CaMaPI is feasible, culturally appropriate and acceptable in reducing self-harm and suicidal ideation in adolescents/young people with histories of self-harm and suicidal ideation in Nigeria. A fully powered randomised control trial is recommended to evaluate the clinical and cost-effectiveness of CaMaPI compared with TAU.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;&lt;b&gt;Trial Registration:&lt;/b&gt; ClinicalTrials.gov (No. NCT06440031)&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Key Practitioner Message&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 \u0000 &lt;li&gt;Suicide is one of the leading causes of death among 15- to 29-year-olds globally.&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;Seventy-three percent of all suicides and self-harm happen in low- and middle-income countries, i","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.70098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256213","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":"Bidirectional Associations Between Defense Mechanisms and Therapeutic Techniques in Psychotherapies for Panic Disorder","authors":"Serena Z. Chen,&nbsp;Nili Solomonov,&nbsp;Mary V. Minges,&nbsp;Kevin S. McCarthy,&nbsp;Fredrik Falkenström,&nbsp;Dianne L. Chambless,&nbsp;Barbara Milrod,&nbsp;Jacques P. Barber","doi":"10.1002/cpp.70081","DOIUrl":"https://doi.org/10.1002/cpp.70081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The current study investigated bidirectional associations between defense mechanisms and therapeutic techniques in two different psychotherapies for panic disorder (PD). Identifying how technique use facilitates and is facilitated by change in defenses might guide adaptation and improvement of therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Patient defense mechanisms and use of therapeutic techniques were measured at early, mid, and late-treatment for 101 patients receiving panic-focused psychodynamic psychotherapy (PFPP) and cognitive behavioral therapy (CBT). Time-lagged associations between use of techniques and psychological defenses were examined using random-intercept cross-lagged panel models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In PFPP, less-organized defense use at mid-treatment predicted higher therapist focus on the patient's moment-to-moment experience and affect at late-treatment. In CBT, greater therapist focus on the patient's thoughts and cognitions at early-treatment predicted use of more adaptive defenses at mid-treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Results underscore differential treatment effects in the relationship between techniques and change in defensive functioning over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Messages</h3>\u0000 \u0000 <div>\u0000 \u0000 <ul>\u0000 \u0000 \u0000 <li>In cognitive behavioral therapy, therapists could focus on patients' thoughts and cognitions to foster adaptive defensive functioning like intellectualization and rationalization.</li>\u0000 \u0000 \u0000 <li>In panic-focused psychodynamic psychotherapy, therapists might increase affect-focused interventions to target when patients persist in using lower adaptive defenses.</li>\u0000 \u0000 \u0000 <li>Broadly, therapists can also be aware that their use of therapeutic interventions may be influenced by their patient's defensive functioning.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244250","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":"Aspects of Attachment in Relation to Early Maladaptive Schemas in Children Residing in Child Care Facilities","authors":"George Tsouvelas,&nbsp;Roza Laious,&nbsp;Michaila Chondrokouki,&nbsp;Xenia Antoniou,&nbsp;George Nikolaidis","doi":"10.1002/cpp.70095","DOIUrl":"https://doi.org/10.1002/cpp.70095","url":null,"abstract":"<div>\u0000 \u0000 <p>This study examines the relationship between attachment styles and early maladaptive schemas (EMS) in 66 children aged 8–18 living in institutional care in Greece. Attachment was evaluated using three methods: (1) self-reports on peer relationships through the Attachment Questionnaire for Children, (2) therapist evaluations of parental attachment via Attachment Style Prototypes and (3) self-reports on caregiver relationships using the Experiences in Close Relationships Scale–Revised Child version. Using a multimethod approach—including self- and therapist-reported measures—findings revealed that insecure attachment, particularly avoidant patterns with caregivers, was strongly associated with EMS in the Disconnection/Rejection domain. The analysis revealed notably elevated EMS scores, most prominently in Vulnerability to Harm, Unrelenting Standards, Emotional Inhibition and Self-Sacrifice. Among the assessed attachment patterns, avoidant attachment to caregivers emerged as more prevalent than anxiety-based attachment. In contrast, secure attachment was most frequently reported in peer relationships, whereas therapist evaluations of parental attachment indicated a predominance of preoccupied and disorganised styles. Notably, avoidant attachment was strongly associated with specific schemas, such as Emotional Deprivation and Self-Sacrifice. Significant variations in EMS were identified across attachment styles, with avoidant children displaying more pronounced maladaptive patterns. The findings underscore the imperative of fostering secure attachment within institutional care environments and support the implementation of targeted interventions aimed at mitigating attachment-related difficulties and preventing the emergence of EMS in this high-risk population.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144206436","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":"Validation of the Executive Functioning Scale (EFS) in Children With Neurodevelopmental Disorders and Their Typically Developing Peers: Psychometric Properties, Factor Structure and Measurement Invariance","authors":"Mohammadreza Kordbagheri,&nbsp;Hasti Samsam,&nbsp;Amal Zayed,&nbsp;Alireza Kordbagheri","doi":"10.1002/cpp.70093","DOIUrl":"https://doi.org/10.1002/cpp.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The current study was aimed at translating and validating the Persian version of the 52-item Executive Functioning Scale (EFS) for Iranian children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The Persian EFS was administered online to a total of 600 Iranian children aged 2–17 years and their parents (48 with autism spectrum disorder, 162 with other neurodevelopmental/functional disorders and 390 typically developing). Construct validity was evaluated via confirmatory factor analysis (CFA) and exploratory structural equation modelling (ESEM) using the weighted least squares estimator. Four competing models were compared: a first-order six-factor model, a higher order model, a bifactor model and a six-factor ESEM model with target rotation. Measurement invariance across gender and age was tested. Reliability was assessed using Cronbach's α, McDonald's ω and 3-week test–retest intraclass correlations. Convergent and discriminant validity were examined through composite reliability (CR), average variance extracted (AVE) and correlations with the Behaviour Rating Inventory of Executive Function (BRIEF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The six-factor ESEM model provided the best fit (CFI = 0.974; TLI = 0.951; RMSEA = 0.059; WRMR = 0.717), outperforming the first-order (CFI = 0.903; TLI = 0.897) and bifactor solutions (CFI = 0.947; TLI = 0.926). Full configural, metric and scalar invariance held across gender and age (ΔCFI &lt; 0.01). Subscale internal consistencies ranged from <i>α</i> = 0.70 to 0.84 and <i>ω</i> = 0.71 to 0.84; test–retest ICCs exceeded 0.80 for all scales. CR values exceeded 0.79, AVE values ranged from 0.41 to 0.56 and EFS–BRIEF correlations supported convergent and discriminant validity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The Persian EFS demonstrates robust factorial validity, measurement invariance, reliability and convergent/discriminant validity in Iranian samples.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190945","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":"The Role of Alexithymia, Borderline Personality Traits and Resilience in Suicidal and Nonsuicidal Self-Harm Behaviours Among Adolescents With Major Depressive Disorder","authors":"Ibrahim Adak,&nbsp;Oğuz Bilal Karakuş,&nbsp;Özalp Ekinci,&nbsp;Omar Alomari,&nbsp;Alper Çalışkan,&nbsp;Elif Burcu Bağçeli,&nbsp;İpek Süzer Gamlı","doi":"10.1002/cpp.70094","DOIUrl":"https://doi.org/10.1002/cpp.70094","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Depression is a significant health issue among adolescents, often associated with decreased academic performance, self-harm and increased suicide attempts. Suicidal and self-harm behaviours are particularly concerning and are influenced by multiple factors beyond depression. This study aims to examine the factors contributing to suicidal behaviour and nonsuicidal self-harm in adolescents diagnosed with major depressive disorder (MDD).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Materials and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This prospective study included adolescent patients aged 12–18 years diagnosed with MDD according to DSM-5 criteria, referred to our Child and Adolescent Psychiatry Clinic between 1 February 2023 and 1 August 2023. Participants with intellectual disability, autism spectrum disorder, schizophrenia or other psychotic disorders were excluded. Data collection tools included the Sociodemographic Data Form, Inventory of Statements About Self-Injury, Child Depression Inventory, Borderline Personality Inventory (BPI), Toronto Alexithymia Scale and Child and Youth Resilience Measure-12 (CYRM-12). Data were analysed using SPSS25.0.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Out of the 185 participants initially screened, 153 completed the study and were evenly divided into three groups: those who had never engaged in self-harm or attempted suicide (&lt;i&gt;n&lt;/i&gt; = 51), those who had engaged in self-harm at least once but had not attempted suicide (&lt;i&gt;n&lt;/i&gt; = 51) and those who had both engaged in self-harm and attempted suicide (&lt;i&gt;n&lt;/i&gt; = 51). There were no significant differences in sociodemographic variables among the groups. Cutting was identified as the most common method of self-harm (84.3%), followed by scratching (72.5%). In terms of resilience, measured by the CYRM-12, the group with no history of self-harm or suicide attempts had significantly higher scores (M = 36.55) than the self-harm only group (M = 32.83) and the self-harm plus suicide attempt group (M = 31.03) (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). For the BPI, the highest scores were observed in the group that had both engaged in self-harm and attempted suicide (M = 29.28), followed by the self-harm only group (M = 24.91) and the no self-harm or suicide group (M = 19.26) (&lt;i&gt;p&lt;/i&gt; &lt; 0.001).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Adolescents with MDD who exhibit suicidal or self-harm behaviours have higher borderline personality traits and alexithymia levels, and lower resilience compared to their counterparts without such behaviours. These findings suggest the importan","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.70094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190982","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}