Psychopathology最新文献

{"title":"A Network Analysis of Depression, Anxiety, and Stress Symptoms in Chinese Adolescents.","authors":"Ying Hu, Lingfeng Wang, Xinyi Tang, Qihan Zhang, Qiang Wang, Haibo Yang","doi":"10.1159/000547479","DOIUrl":"10.1159/000547479","url":null,"abstract":"<p><strong>Background: </strong>Mental health problems are highly prevalent among adolescents. This study aimed to investigate the interrelations among depressive, anxiety, and stress-related symptoms in Chinese adolescents using a symptom network approach.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted in October 2022 in Tianjin, China. Symptoms of depression, anxiety, and stress were assessed using the 21-item Depression Anxiety Stress Scales (DASS-21). Network analysis was employed to examine centrality, stability, and predictability of symptoms. Network Comparison Tests (NCTs) were used to assess structural differences across gender and residential status. In addition, a flow network analysis was performed to identify symptoms most strongly associated with stress.</p><p><strong>Results: </strong>A total of 660 Chinese adolescents participated in the study. The most central symptom in the network was \"feeling down,\" followed by \"palpitations,\" \"nervousness,\" \"agitation,\" and \"difficulty relaxing.\" Key bridge symptoms included \"worrying,\" \"feeling down,\" \"near panic,\" and \"nervousness.\" NCT results indicated no significant differences in the network structures by gender or residence. In the flow network, \"feeling down\" demonstrated the strongest direct association with stress.</p><p><strong>Conclusion: </strong>Specific central and bridge symptoms may play a pivotal role in the onset and maintenance of depression, anxiety, and stress among Chinese adolescents. These findings highlight potential targets for early intervention and prevention efforts in this population.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-12"},"PeriodicalIF":2.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691289","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":"Personality Organization, Childhood Adversity, and Paranoid Thinking: Moderating and Mediating Pathways.","authors":"Jürgen Fuchshuber, Maria Gruber, Karin Feichtinger, Miriam Klauser, Karoline Parth, Nestor Kapusta, Stephan Doering, Victor Blüml","doi":"10.1159/000547518","DOIUrl":"10.1159/000547518","url":null,"abstract":"<p><strong>Objectives: </strong>The study investigated the relationship between personality organization, childhood trauma, and paranoid thinking. It is hypothesized that personality organization mediates as well as moderates the link between paranoia and childhood adversity.</p><p><strong>Methods: </strong>A mixed sample of patients and control participants (N = 119; 76% psychiatric patients; 71% female) was diagnostically assessed according to psychopathology (SCID I and II, BSI-53), personality organization (STIPO), and childhood trauma (CTQ). Mediation effects were analyzed within a Bayesian path modeling approach. We assessed potential moderation effects of personality organization by estimating interaction effects in the SPSS PROCESS macro.</p><p><strong>Results: </strong>Significant positive correlations were found between childhood trauma, personality organization, and paranoid thinking (all p < 0.001). Mediation analysis showed that personality organization partially mediated the relationship between childhood trauma and paranoid thinking (indirect effect, B = 0.14, 95% CrI [0.07, 0.23], p < 0.01), however, only if not corrected for general psychiatric symptom load. In contrast, moderation analysis indicated that personality organization moderated the relationship (ΔR2 = 0.02, F(6,112) = 4.93, p < 0.05), if controlled for unspecific psychopathology, with stronger personality dysfunction intensifying the link between childhood trauma and paranoid thinking.</p><p><strong>Conclusions: </strong>The study generally supports the hypothesis that personality organization plays a critical role in linking childhood trauma to paranoid thinking, acting as both mediator and moderator. This suggests that deficits in personality structure partly explain and modulate the association of childhood adversity with paranoid ideation. The complex role of general psychopathology in this relationship is discussed.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-12"},"PeriodicalIF":2.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691290","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":"Which Mechanism Kicks in When? Temporal Changes in the Effect of Transtheoretical Factors on Symptom Distress over the Course of Therapy.","authors":"Brian Schwartz, Danilo Moggia, Jay Lawrynowicz, Julian A Rubel, Wolfgang Lutz","doi":"10.1159/000546285","DOIUrl":"10.1159/000546285","url":null,"abstract":"<p><strong>Introduction: </strong>The mechanisms of change in psychological therapies have not yet been sufficiently empirically validated. In particular, the time course of their effects on patients' symptom distress is unknown. Therefore, the aims of the present study were (1) to examine the effects of 4 patient experiences, namely, interpersonal experience (IE), coping experience (CE), affective experience (AE), and resource-related experience (RE), on symptom distress within and between patients; (2) to consider the temporal development of the within-patient effects; and (3) to examine their associations with the final treatment outcome.</p><p><strong>Methods: </strong>Within- and between-patient effects of IE, CE, AE, and RE on session-level symptom distress were calculated for n = 2,208 outpatients treated by n = 253 therapists. Patient experiences were measured after each session using session reports, and outcome was assessed with the HSCL-11 at the beginning of each session and with the OQ-30 after treatment. Linear mixed models (LMMs) were used to examine the within- and between-patient associations. Temporal changes in the within-patient effects were modeled using rolling windows and three-level LMMs (sessions nested in windows and patients).</p><p><strong>Results: </strong>Within-patient components of all 4 patient experiences were significantly associated with symptom distress (b = -0.006 to b = -0.057), while none of the between-patient components were. The effects of all 4 patient experiences diminished over time (b = 0.000 to b = 0.001). The effects of IE, CE, and RE remained negative and significant, but the effect of AE crossed zero and became significantly positive with an increasing window number. A greater decrease in the within-patient effects of IE (b = -0.001) and CE (b = -0.001) on HSCL-11 was associated with better final treatment outcomes.</p><p><strong>Conclusion: </strong>The results suggest that all four change factors are drivers of successful therapy, particularly in the early sessions. Over the course of treatment, their impact on symptom distress diminishes, which appears to be beneficial for the final treatment outcome. In the future, differences between patients in the temporal dynamics of change factors should be investigated to inform transtheoretical and process-based treatments that support therapists in personalizing their treatments to individual patients.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-14"},"PeriodicalIF":2.2,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554314","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":"From Experience to Symptoms: A Multilayer Hierarchy of Psychopathological Dimensions in Schizophrenia.","authors":"Stephan Lechner, Karl Erik Sandsten, Dusan Hirjak, Jonas Daub, Stefan Fritze, Geva A Brandt, Filipe Arantes-Gonçalves, Angelika Wolman, Riccardo Stefanelli, Julian Gojer, Sanjiv Gulati, Hasan Hersi, Josef Parnas, Georg Northoff","doi":"10.1159/000547153","DOIUrl":"10.1159/000547153","url":null,"abstract":"<p><strong>Introduction: </strong>The psychopathology of schizophrenia is a complex amalgamation of features that span across different dimensions. These dimensions range from the experience of altered time and space through self-disorders to perceptual, positive, and negative symptoms. The relationship between these different psychopathological dimensions remains unclear. Addressing this gap was the aim of our study.</p><p><strong>Methods: </strong>We collected data on schizophrenia spectrum disorder at three medical expert centers, via semi-structured phenomenological interviews, consisting of the Scale for Space and Time Experience in Psychosis (STEP), the Positive and Negative Syndrome Scale for Schizophrenia (PANSS) and, for a subset of these data, the Examination of Anomalous Self-Experience (EASE), and the perceptual domain of the Bonn Scale for the Assessment of Basic Symptoms (BSABS or BONN). Various state-of-the-art statistical methods, including network and mediation analyses, were used to investigate the relationships between these psychopathological dimensions.</p><p><strong>Results: </strong>We found a relationship between altered time and space experiences (STEP) and both general symptoms (PANSS) and the basic self-disorders (EASE).</p><p><strong>Conclusion: </strong>Our various network and mediation analyses show that the basic self-disturbance is a key node in mediating the impact of the more fundamental time and space disturbances on both perceptual changes, and negative, positive, and general symptoms.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-19"},"PeriodicalIF":2.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529353","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":"EAIE Scale: The Examination of Autistic Intersubjective Experiences - A Qualitative Tool to the Exploration of Sociality.","authors":"Valeria Bizzari, Valeria Bizzari, Tim Schnitzler, Thomas Fuchs","doi":"10.1159/000545919","DOIUrl":"10.1159/000545919","url":null,"abstract":"<p><strong>Introduction: </strong>The Examination of Autistic Intersubjective Experiences is a semi-structured interview aimed at a phenomenological exploration of experiential and subjective ways of dealing with sociality.</p><p><strong>Methods: </strong>As a qualitative study, this work can be understood in continuity with Examination of Anomalous Self-Experience (EASE) and Examination of Anomalous World Experience (EAWE). While these models focus on anomalies of selfhood and experience of the external world, respectively, this semi-structured interview focuses instead on the divergent ways dealing with intersubjective experience and on the difficulties that people with a diagnosis of autism experience in the social domain.</p><p><strong>Conclusion: </strong>The advantages are both theoretic and practical: from a philosophical perspective, it will be interesting to observe how intersubjectivity works. From a clinical perspective, the collected data will be useful both for clinicians and caregivers, allowing them to better understand and cope with the autistic subject, and favor the communication between different social styles.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"334-346"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053624","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":"Prevalence and Associations of Anxiety Symptoms among Young Overweight or Obese Patients with Major Depressive Disorder.","authors":"Ting Wang, Yu Tang, Sanrong Xiao, Xiangyang Zhang","doi":"10.1159/000546692","DOIUrl":"10.1159/000546692","url":null,"abstract":"<p><strong>Introduction: </strong>Overweight or obesity often co-occurs with depression among young adults. Major depressive disorder (MDD) frequently occurs alongside anxiety; nevertheless, research exploring the interaction between anxiety symptoms and MDD in young adults with overweight or obesity is limited. This study aimed to investigate the prevalence and clinical characteristics of comorbid anxiety among young adults with overweight/obesity concomitant with MDD. Additionally, it aimed to identify predictors of anxiety within this demographic.</p><p><strong>Methods: </strong>This cross-sectional study involved 523 young adults with overweight/obesity concomitant with MDD (age 18-35 years). Their demographic characteristics, clinical variables, and fasting biochemical parameters were collected utilizing the Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS).</p><p><strong>Results: </strong>The prevalence of anxiety symptoms was 50.8%. Correlation analysis suggested strong associations between total HAMD scores and various factors, including total HAMA scores, body mass index, suicidal tendencies, and psychotic symptoms. Binary regression identified four clinical variables, namely, HAMD scores, thyroid-stimulating hormone levels, excitement levels, and fasting blood glucose, as significant risk factors for anxiety within this demographic.</p><p><strong>Conclusion: </strong>In summary, this research highlights a substantial prevalence of anxiety symptoms among young adults with overweight/obesity concomitant with MDD. Furthermore, it elucidates four risk factors associated with concurrent anxiety symptoms among this demographic. These findings have significant clinical implications.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"315-322"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199859","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}