Psychopathology最新文献

{"title":"Antagonistic Narcissism in Women with Borderline Personality Disorder: A Case-Control Study.","authors":"Philipp Wülfing, Nikolaus Krämer, Claas-Hinrich Lammers, Carsten Spitzer","doi":"10.1159/000545761","DOIUrl":"10.1159/000545761","url":null,"abstract":"<p><strong>Objective: </strong>Borderline personality disorder (BPD) is characterized by instability in self-image, emotions, and relationships. Features such as (auto)aggression, devaluation, and impulsivity indicate proximity to narcissistic traits, especially antagonistic aspects. While its links to grandiose and vulnerable narcissism are established, the role of antagonistic narcissism (AN) remains unclear. This study investigates AN in BPD by comparing female BPD patients with a diagnostically heterogeneous clinical control group without personality disorders and by examining its associations with symptom severity, self-harm, aggression, interpersonal problems, and empathy.</p><p><strong>Methods: </strong>51 female BPD patients and 51 clinical control patients completed the Narcissistic Admiration and Rivalry Questionnaire and measures of borderline symptomatology, aggression, interpersonal problems, and empathy. Group comparisons were conducted using analyses of covariance, and Spearman correlations examined relationships between clinical characteristics. Interpersonal tendencies of AN were analyzed via the Structural Summary Method (SSM).</p><p><strong>Results: </strong>BPD patients showed higher levels of AN compared to the control group (η2 = 0.04), though this difference was only marginally significant (p = 0.050). AN correlated positively with overall aggression (r = 0.34, p < 0.05), particularly verbal aggression (r = 0.43, p < 0.01). SSM analysis positioned AN within the domineering-vindictive quadrant of the interpersonal circumplex, characterized by high dominance and low affiliation. No significant correlation was found with empathy.</p><p><strong>Conclusion: </strong>Findings suggest a potential elevation of AN in females with BPD and its associations with aggression and interpersonal dysfunction, highlighting the complexity of narcissistic traits in BPD and the need for further research.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity of Self-Rating Questionnaires Used for Assessing Self-Disorders? A Systematic Review.","authors":"Helena Cobanovic, Julie Nordgaard, Jonas Berge, Mads Gram Henriksen","doi":"10.1159/000545364","DOIUrl":"10.1159/000545364","url":null,"abstract":"<p><strong>Introduction: </strong>Self-disorders designate a group of nonpsychotic, trait-like, anomalous self-experiences. The \"gold standard\" for assessing self-disorders is largely considered to be the Examination of Anomalous Self-Experience (EASE). The EASE must be conducted as a semistructured interview, and it requires substantial knowledge of psychopathology and excellent interviewing skills. To bypass these demands, self-rating questionnaires are regularly used to assess self-disorders in research. However, it is not clear if these self-rating questionnaires are valid measures of self-disorders. The purpose of this systematic review was to assess the validity of self-rating questionnaires used for assessing self-disorders.</p><p><strong>Methods: </strong>Following the PRISMA guidelines, we searched PubMed, Embase, and PsycInfo for studies that had used or developed self-rating questionnaires for assessing self-disorders.</p><p><strong>Results: </strong>Twenty-nine studies had used or developed self-rating questionnaires to assess self-disorders, involving a total of 8 different self-rating questionnaires. None of these self-rating questionnaires have been properly validated to measure self-disorders in relation to EASE.</p><p><strong>Conclusion: </strong>Despite being frequently used in research, only 1 (IPASE: The Inventory of Psychotic-Like Anomalous Self-Experiences) of the 8 self-rating questionnaires has been attempted validated in relation to the EASE. Though a strong correlation was found between IPASE and EASE, the result cannot be considered valid because of profound methodological issues. We recommend that efforts to validate self-rating questionnaires are prioritized if they are to be used in research, and that results from studies using self-rating questionnaires are separated from those of EASE-based research as long as the self-rating questionnaires have not been properly validated in relation to the EASE.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-13"},"PeriodicalIF":1.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Do We Risk to SQuEASE by Making Psychiatric Phenomenology Too Efficient?","authors":"Florestan Delcourt, Jérôme Englebert","doi":"10.1159/000545169","DOIUrl":"10.1159/000545169","url":null,"abstract":"","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-4"},"PeriodicalIF":1.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bibliotherapy and Schizophrenia: A Stanghellinian Perspective.","authors":"Florestan Delcourt, Jérôme Englebert, Bernard Pachoud","doi":"10.1159/000545471","DOIUrl":"10.1159/000545471","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia is a psychiatric disorder that has long been regarded as irreversibly degenerative. However, the recent improvements in treatment and prognosis and the trend towards person-centred care have reversed this fatalistic tendency, and encouraged the development of theoretical and clinical tools to support these people as closely as possible to their concerns.</p><p><strong>Summary: </strong>In this article, we look at how bibliotherapy, namely care assisted by the reading of literary fictions, might be conceived in relation to the classic psychotherapeutic framework. To circumscribe the definition of this approach for people with schizophrenia, we will refer to the work of Giovanni Stanghellini, and in particular to two of his works: the Phenomenology, Hermeneutics and Psychodynamics model, and his epistemological theory of Images. Thus, we shall see that the clinical particularities of bibliotherapy could assist a person-centred psychotherapy by promoting the unfolding of people's phenomenological experiences, opening them up to other ways of interpreting them, and re-establishing the dialogue between the self and its existence.</p><p><strong>Key messages: </strong>Bibliotherapy could hence participate in the contemporary movements of clinical hermeneutic phenomenology, medical humanities, and personal recovery.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Contribution of Phenomenology to the Assessment of Severe Non-Psychotic Forms of Psychopathological Conditions in Transitional Age Youth: Two Case Studies.","authors":"Matteo Ballabio, Giovanni Stanghellini","doi":"10.1159/000544720","DOIUrl":"10.1159/000544720","url":null,"abstract":"<p><strong>Background: </strong>In recent times, adolescents with severe forms of psychopathology that do not unambiguously fit into a precise diagnostic category have come to clinical observation. The diagnoses attributed to these young patients range from borderline personality disorder, to affective disorders, ADHD, and others. These diagnoses are mainly based on behavioural abnormalities (e.g., social withdrawal, aggressiveness, self-injuring behaviour), but fail to capture the experiential core of their suffering.</p><p><strong>Summary: </strong>Research in psychopathology, particularly that with a phenomenological approach, has long been committed to identifying early markers of schizophrenia in clinical pictures that precede the full onset of this pathology. In this paper, two case studies in transitional age youth (TAY) and additional material taken from our own clinical practice are presented where self-disorders and anomalies of common sense - originally developed to phenomenologically characterise the schizophrenic spectrum phenotype, and especially non-delusional forms of schizophrenia - are used to complement standard nosographic assessments.</p><p><strong>Key message: </strong>We propose that using some of these phenomenological constructs can shed light on certain TAY pictures, in particular the most serious ones, helping us grasp their psychopathological core, and provide further elements for a fine-grained characterization and in-depth understanding. We propose as a work-in-progress a set of tentative criteria to differentiate such phenomena in TAY patients as compared to patients with a diagnosis of schizophrenia.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-13"},"PeriodicalIF":1.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mothers of Young Children during the COVID-19 Pandemic: Depressive Symptoms and Perceived Stress.","authors":"Christian F J Woll-Weber, Corinna Reck, Anton K G Marx, Su Mevsim Küçükakyüz, Mitho Müller, Alexandra von Tettenborn, Nora Nonnenmacher, Anna-Lena Zietlow","doi":"10.1159/000543715","DOIUrl":"10.1159/000543715","url":null,"abstract":"<p><strong>Objective: </strong>Due to the COVID-19 pandemic, psychosocial well-being of families and parents worldwide has been impaired. As part of a larger online survey, we analyzed maternal depressive symptoms and perceived stress.</p><p><strong>Method: </strong>A total of 666 mothers from Germany with young children (mostly aged 0-3 years) filled out the Edinburgh Postnatal Depression Scale (EPDS) and the Perceived Stress Scale (PSS) at 2 time points during the pandemic (T1: summer/fall 2020; T2: early spring 2021). We (1) calculated prevalence rates of a risk for depression and high perceived stress levels, (2) analyzed differences between time points via paired t tests, and (3) examined the reciprocal relation between the two constructs via cross-lagged panel modeling.</p><p><strong>Results: </strong>Considering cut-off values of the EPDS (≥10) and PSS (≥27), 33.8% carried a risk for depression and 15.2% high levels of stress at T1, whereas, respectively, 55.1% and 26.0% did so at T2. Depressive symptom severity and perceived stress levels significantly differed between measurement points with higher values at T2 (p < 0.001). Our cross-lagged panel analysis revealed large correlations (p < 0.001) within as well as small to medium (i.e., [0.21, 0.47]) auto-regressive (p < 0.001) and reciprocal (p < 0.001) predictions across time points between the severity of depressive symptoms and perceived stress.</p><p><strong>Conclusions: </strong>This work demonstrates how severely mothers of infants were affected by depressive symptoms and perceived stress in a time of pandemic crisis. Psychosocial support should focus on screening and treating mothers as early as possible to mitigate the risk for subsequent depressive symptoms and perceived stress. Aiming attention at both depressive symptom reduction and stress relief most successfully promotes maternal well-being.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-14"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allostatic Load as a Mediator and Perceived Chronic Stress as a Moderator in the Association between Maternal Mental Health and Preterm Birth: A Prospective Cohort Study of Pregnant Women in Pakistan.","authors":"Shahirose Sadrudin Premji, Sharifa Lalani, Farooq Ghani, Sidrah Nausheen, Ntonghanwah Forcheh, Geoffrey Omuse, Nicole Letourneau, Neelofur Babar, Salima Sulaiman, Musana Wangira, Shahnaz Shahid Ali, Nazneen Islam, Aliyah Dosani, Ilona S Yim","doi":"10.1159/000540579","DOIUrl":"10.1159/000540579","url":null,"abstract":"<p><strong>Introduction: </strong>The complex biopsychosocial pathways linking maternal mental health with preterm birth (PTB) are not well understood. This study aimed to explore allostatic load (AL) as a mediator and perceived chronic stress as a moderator in the pathway linking maternal mental health and PTB.</p><p><strong>Methods: </strong>A cohort study of pregnant women (n = 1,567) recruited at clinic visits within 10-19 weeks of gestation was assessed for maternal mental health (i.e., pregnancy-related anxiety, state anxiety, depressive symptoms) and perceived chronic stress. Blood pressure and levels of cortisol, total cholesterol, C-reactive protein, and glycosylated hemoglobin were used to create a composite measure of AL.</p><p><strong>Results: </strong>AL had the most significant effect on PTB (odds ratio (OR) = 1.84, 95% CI = 1.26-12.67, p = 0.001), while systolic blood pressure emerged as the only significant individual marker using variable selection (OR = 22%, 95% CI = 1.06-1.40, p < 0.001) in multiple logistic regression analysis. A mediation analysis revealed that maternal mental health did not have a significant direct effect on PTB (p = 0.824), but its indirect effect mediated by AL was significant (z = 2.33, p < 0.020). Low and high levels of perceived chronic stress, relative to the mean, moderated this indirect effect (z = 3.66, p < 0.001).</p><p><strong>Conclusions: </strong>AL has a significant direct influence on PTB and mediates the effect of maternal mental health on PTB; however, the indirect effect of AL is indistinguishable between women with higher or lower levels of perceived chronic stress than normal.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"13-32"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward Centrality Evaluation of Yearning Symptoms for Prolonged Grief Disorder: A Cross-Cultural Approach.","authors":"Amelie Mazza, Andreas Maercker, Simon Forstmeier, Mario Müller, Clare Killikelly","doi":"10.1159/000541321","DOIUrl":"10.1159/000541321","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The new ICD-11 diagnosis of prolonged grief disorder (PGD) is characterized by the prominent role of yearning as hallmark symptom. A secondary analysis of eight international datasets on PGD was conducted to evaluate this assumption. Additionally, cross-cultural comparison explored whether the centrality of yearning differs across world regions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Primary studies originated from German-speaking countries (n = 4 samples), other European countries and Israel (n = 3 samples), as well as China (n = 1 samples). Different PGD measures were used, including yearning and longing as symptoms. For the centrality assessment of yearning, PGD symptoms were ranked by their factor loadings from confirmatory factor analyses, followed by statistical testing to determine significant differences between yearning and other symptoms of PGD in their factor loading estimates. Subsequently, ranking positions of yearning in three world regions (German-speaking, other Europe-Israel, and China) were compared. Finally, proxy thresholds for individuals at high-risk states for PGD were defined for the different datasets, and sensitivity-specificity analyses of yearning were performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Yearning was ranked high in five out of 12 models tested. In the German-speaking region, it was predominantly ranked among the most central symptoms; in the other Europe-Israel region as well as China, it tended to fall into the middle or lower rankings of symptom centrality. Sensitivity values were consistently high, while specificity values indicated moderate levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;In line with previous research on the general outcomes of grief, the present study showed that yearning may be subject to a culture-specific distribution. Other central symptoms such as feeling as if a part of oneself died have also been shown to potentially play a central role in PGD across world regions. On the other hand, the sensitivity-specificity analyses revealed that yearning can be considered a significant (diagnostically highly sensitive) symptom for individuals in high-risk states for PGD, although it has only moderate specificity (i.e., its absence does not necessarily indicate individuals experiencing normative grief). Nonetheless, a culture-sensitive approach to psychopathology should consider the cultural differences in the centrality of this symptom group. More research is needed to better understand the role of yearning and its determinants across world regions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The new ICD-11 diagnosis of prolonged grief disorder (PGD) is characterized by the prominent role of yearning as hallmark symptom. A secondary analysis of eight international datasets on PGD was conducted to evaluate this assumption. Additionally, cross-cultural comparison explored whether the centrality of yearning differs across world regions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Primary studies ori","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"69-79"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in the Prevalence and Correlates of Suicide Attempts in Patients with First-Episode and Drug-Naïve Psychotic Major Depression.","authors":"Weijian Liu, Chunyu Yang, Xiangyang Zhang","doi":"10.1159/000542844","DOIUrl":"10.1159/000542844","url":null,"abstract":"<p><strong>Purpose: </strong>Sex differences play an important role in depression prevalence, symptom profile, treatment response, and disease course. However, sex differences in factors associated with suicide attempts (SAs) in first-episode and drug-naïve (FEDN) patients with psychotic major depression (PMD) remain unclear.</p><p><strong>Methods: </strong>In this study, 171 patients with FEDN PMD were recruited. Patients' symptoms were assessed using the Hamilton Rating Scale for Depression (HAMD), Hamilton Anxiety Rating Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) positive subscale. In addition, metabolic parameters and thyroid hormone levels were measured.</p><p><strong>Results: </strong>The prevalence of SA was remarkably high in both male and female PMD patients (53.19% vs. 50.81%), without significant differences between the two groups. In male PMD patients, the combination of marital status and thyroid-stimulating hormone (TSH) levels was found to effectively distinguish between SA and non-SA cases, with an AUC value of 0.87. In addition, the HAMD score and diastolic blood pressure (BP) were significantly associated with the frequency of SAs in this subgroup. For female PMD patients, the combination of positive score, diastolic BP, TSH, and antithyroglobulin was found to be an effective discriminator between SA and non-SA cases, with an AUC of 0.91. Furthermore, duration of illness, positive score, systolic BP, and thyroid peroxidase antibody were found to be significantly associated with the frequency of SAs in this subgroup.</p><p><strong>Conclusions: </strong>Our results indicate a high incidence of SAs in both men and women with PMD. Several clinically relevant factors, metabolic parameters, and thyroid hormone function contribute to sex differences in SAs in FEDN PMD patients.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"199-210"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142953926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"More than Meets the \"I\": A Panoramic View of Epistemic Trust in Psychotherapy.","authors":"Shimrit Fisher, Peter Fonagy, Sigal Zilcha-Mano","doi":"10.1159/000541667","DOIUrl":"10.1159/000541667","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Epistemic trust (ET), the authenticity and personal relevance we assign to interpersonally transmitted knowledge, is considered an essential component of any effective therapy. Despite its clinical significance, comprehensive empirical support is still lacking regarding whether ET is an inherent characteristic of the patient or acts as a catalyst for therapeutic change. Consequently, unlike other critical components, a clear distinction between its aspects - the patient's attributes, the therapist's contribution, and their unique therapeutic relationship - remains elusive, leaving our understanding incomplete. The current study examines the constituents of ET in therapy and its related effects through three distinct lenses: a blended snapshot lens, a prognostic lens, and a lens focusing on state-like changes. The constituents of ET were measured as follows: patient attributes were measured using attachment orientation and interpersonal functioning scales; therapist contribution was evaluated through scales assessing the therapist's use of techniques; and the patient-therapist therapeutic relationship was gauged using the working alliance scale.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We collected and analyzed data from 116 patients who participated in manualized psychodynamic psychotherapy sessions to investigate the trait-like and state-like components of ET.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The results offer a comprehensive panoramic view with small to medium, but meaningful, correlations between ET and patients' attributes (ranging from 0.18 to -0.26); therapists' contributions (ranging between 0.15 and 0.28); and the patient-therapist therapeutic relationship (ranging between 0.17 and 0.23).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;While some findings were consistent with our expectations, others were contrary, highlighting the necessity of considering the variations between and within patients as they have distinct theoretical, clinical, and empirical implications. Employing these three distinct lenses helps therapists gain a better understanding of the clinical picture reflected by the patient over different treatment periods. This broad perspective is of prognostic importance and encourages clinicians to adjust the treatment focus to meet the evolving needs of their patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Epistemic trust (ET), the authenticity and personal relevance we assign to interpersonally transmitted knowledge, is considered an essential component of any effective therapy. Despite its clinical significance, comprehensive empirical support is still lacking regarding whether ET is an inherent characteristic of the patient or acts as a catalyst for therapeutic change. Consequently, unlike other critical components, a clear distinction between its aspects - the patient's attributes, the therapist's contribution, and their unique therapeutic relationship - remains elusive, leaving our understanding incomplete. Th","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"80-93"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}