Psychopathology最新文献

{"title":"Cyberbullying and School Bullying Are Related to Additive Adverse Effects among Adolescents.","authors":"Fanny Carina Ossa,&nbsp;Vanessa Jantzer,&nbsp;Franziska Neumayer,&nbsp;Lena Eppelmann,&nbsp;Franz Resch,&nbsp;Michael Kaess","doi":"10.1159/000523992","DOIUrl":"https://doi.org/10.1159/000523992","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to examine whether (a) cyberbullying has unique associations with mental health problems, risk-taking, and self-harm behavior in victims and perpetrators when compared to school bullying and (b) if cyberbullying is associated with an additional burden for students already involved in school bullying.</p><p><strong>Methods: </strong>Data were collected from 6,561 students across 23 schools in Germany (grades 5-13). The sample was divided into the following four groups: cyber-only involvement (victims = 1.9%, perpetrators = 0.6%), school-only involvement (victims = 17.2%, perpetrators = 11.9%), dual involvement (victims = 5.7%, perpetrators = 2.9%), and noninvolvement (victims = 75.3%, perpetrators = 84.6%). Multilevel mixed-effects regression analysis was conducted to examine group differences in mental health (Strengths and Difficulties Questionnaire, KIDSCREEN-10), risk-taking, and self-harm behavior (e.g., substance use, suicide attempts).</p><p><strong>Results: </strong>Cyber-only bullying had unique associations with mental health problems and risk-taking behavior in victims (lower levels of peer relationship problems: p < 0.001, greater substance use: p < 0.05) and perpetrators (higher levels of peer relationship problems: p < 0.05) when compared to school-only bullying. Dual victims and perpetrators reported significantly more mental health problems (victims: χ2(5) = 221.58, p < 0.001; perpetrators: χ2(5) = 116.40, p < 0.001) and were more likely to report risk-taking and self-harm behavior (victims: χ2(7) = 115.15, p < 0.001; perpetrators: χ2(7) = 38.79, p < 0.001) than students involved in school-only bullying.</p><p><strong>Conclusion: </strong>Cyber-only bullying appears to be related to specific mental health issues beyond those associated with school-only bullying. Cyberbullying and school bullying go along with additive mental health problems, risk-taking, and self-harm behavior in both victims and perpetrators. Thus, bullying prevention and intervention programs should also target cyberbullying.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":"56 1-2","pages":"127-137"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9094805","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":"The Mediating Role of Health-Promoting Behaviors on the Association between Symptom Severity and Quality of Life among Chinese Individuals with Mental Illness: A Cross-Sectional Study.","authors":"Phoenix K H Mo,&nbsp;Georgina Y K So,&nbsp;Zhihui Lu,&nbsp;Winnie W S Mak","doi":"10.1159/000525495","DOIUrl":"https://doi.org/10.1159/000525495","url":null,"abstract":"<p><strong>Introduction: </strong>Research has shown that people with mental illnesses (PMI) are found to show poorer lifestyle than the general population. Yet, the effect of their psychiatric symptoms in the association between gender difference, health-promoting behaviors, and quality of life have received little attention. The present study examined the association between symptom severity, health-promoting behaviors, and quality of life among PMI in Hong Kong. Gender difference on the association between these variables was also examined.</p><p><strong>Method: </strong>A cross-sectional survey was conducted among 591 individuals with DSM-IV-TR Axis 1 diagnosis recruited from the community.</p><p><strong>Results: </strong>Results from MANOVA showed that PMI with more severe psychiatric symptoms engaged in a significantly lower level of health-promoting behaviors and reported a lower level of quality of life. Results from structural equation modeling showed that health-promoting behaviors mediated the association between psychiatric symptoms and quality of life. Multigroup analyses showed that the association between psychiatric symptoms and health-promoting behaviors was stronger among female participants, while the association between health-promoting behaviors and quality of life was stronger among male participants.</p><p><strong>Discussion/conclusion: </strong>Despite clear evidence suggesting symptom severity to be negatively correlated with quality of life, the underlying mechanism has been less clear. There is a need to promote health-promoting behaviors in order to improve the quality of life of PMI. Gender-specific interventions are warranted.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":"56 3","pages":"194-205"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9303648","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":"Personal Identity and Narrativity in Borderline Personality Disorder: A Phenomenological Reconfiguration.","authors":"Cassandre Bois,&nbsp;István Fazakas,&nbsp;Juliette Salles,&nbsp;Tudi Gozé","doi":"10.1159/000526222","DOIUrl":"https://doi.org/10.1159/000526222","url":null,"abstract":"<p><p>Borderline personality disorder (BPD) is a complex condition marked by heterogeneity. People with BPD have a profusion of symptoms spread across various levels of lived experience, such as identity, affectivity, and interpersonal relationships. Researchers and clinicians have often resorted to the structuring concept of Self to organize the fragmentation of their experience at the identity level. Notably, using the concept of the narrative self, Fuchs proposed to interpret BPD as a fragmentation of narrative identity. This interpretation of BPD, widely shared, has been challenged by Gold and Kyratsous, who have proposed a complementary understanding of the self through the idea of agency, and to which Schmidt and Fuchs in turn have countered. This article proposes to contribute to this discussion from a phenomenological perspective. First, we will briefly review the discussions around narrative interpretation of BPD. From the problems left unresolved by the discussion, we will then justify the necessity to proceed with a stratification of the self from a phenomenology method. Third, from the thought of the Hungarian phenomenologist László Tengelyi, we will continue with an archaeology of the self, in three layers - self-institution, self-formation, and minimal self - integrating Schmidt and Fuchs' concepts of self, in addition to those of Gold and Kyratsous, but also, to a lesser extent, those of Dan Zahavi. Finally, we will proceed with a phenomenological reconfiguration of the experiences and manifestations associated with the identity axis of BPD.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":"56 3","pages":"183-193"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9698242","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":"Developmental Trajectories of Self-, Other-, and Dual-Harm across Adolescence: The Role of Relationships with Peers and Teachers.","authors":"Annekatrin Steinhoff,&nbsp;Denis Ribeaud,&nbsp;Manuel Eisner,&nbsp;Lilly Shanahan","doi":"10.1159/000525296","DOIUrl":"https://doi.org/10.1159/000525296","url":null,"abstract":"<p><strong>Introduction: </strong>We investigated the longitudinal course of self-, other-, and dual-harm in adolescents, focusing on the infliction of physical injury on oneself, another person, or both parties, respectively. We examined the within-person transitions between these types of harm and whether relationships with peers and teachers predict individual harm trajectories.</p><p><strong>Methods: </strong>We used community-representative longitudinal data (N = 1,482; 52% male; 50% both parents born abroad). The participants self-reported self- and other-harm at 13, 15, 17, and 20 years. We assigned them to groups with self-, other-, dual- or no harm at specific assessments. Bullying victimization and relationship quality with classmates and teachers were assessed at 13 and 17. We estimated transition probabilities between the harm groups using latent Markov chain models.</p><p><strong>Results: </strong>At age 13, 3% of the sample engaged in dual-harm, 10% in self-harm only, and 7% in other-harm only. These percentages decreased in late adolescence. Initial dual-harm was often followed by sex-specific single-harm: most of the female participants transitioned to self-harm, and male participants to other-harm. Those in the initial dual-harm group were less likely to stop harming than those in the initial single-harm groups (p < 0.05). Adverse relationship experiences generally predicted harm. A positive teacher-student bond was associated with the cessation of single-harm.</p><p><strong>Conclusion: </strong>Single- and dual-harm in the form of physical injury typically emerge by mid-adolescence. After this point, adolescents commonly maintain harm, especially those who have presented with dual-harm. Helping adolescents cope with adverse relationship experiences and creating opportunities for positive relationship experiences could address these harmful behaviors.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":"56 1-2","pages":"138-147"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10840400","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":"The Lived Experiences of Family Members and Carers of People with Psychosis: A Bottom-Up Review Co-Written by Experts by Experience and Academics.","authors":"Andrés Estradé,&nbsp;Juliana Onwumere,&nbsp;Jemma Venables,&nbsp;Lorenzo Gilardi,&nbsp;Ana Cabrera,&nbsp;Joseba Rico,&nbsp;Arif Hoque,&nbsp;Jummy Otaiku,&nbsp;Nicholas Hunter,&nbsp;Péter Kéri,&nbsp;Lily Kpodo,&nbsp;Charlene Sunkel,&nbsp;Jianan Bao,&nbsp;David Shiers,&nbsp;Ilaria Bonoldi,&nbsp;Elizabeth Kuipers,&nbsp;Paolo Fusar-Poli","doi":"10.1159/000528513","DOIUrl":"10.1159/000528513","url":null,"abstract":"<p><p>Informal caregivers of individuals affected by psychotic disorder can play a key role in the recovery process. However, little research has been conducted on the lived experiences of carers and family members. We conducted a bottom-up (from lived experience to theory) review of first-person accounts, co-written between academics and experts by experience, to identify key experiential themes. First-person accounts of carers, relatives, and individuals with psychosis were screened and discussed in collaborative workshops involving individuals with lived experiences of psychosis, family members, and carers, representing various organizations. The lived experiences of family members and carers were characterized by experiential themes related to dealing with the unexpected news, the search for a reason behind the disorder, living with difficult and negative emotions, dealing with loss, feeling lost in fragmented healthcare systems, feeling invisible and wanting to be active partners in care, struggling to communicate with the affected person, fighting stigma and isolation, dealing with an uncertain future, and learning from one's mistakes and building resilience and hope. Our findings bring forth the voices of relatives and informal carers of people with psychosis, by highlighting some of the common themes of their lived experiences from the time of the initial diagnosis and throughout the different clinical stages of the disorder. Informal carers are key stakeholders who can play a strategic role, and their contributions in the recovery process merit recognition and active support by mental health professionals.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"371-382"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10568611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10612720","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":"Comparison of Social-Evaluative Anxiety and Theory of Mind Functions in Social Anxiety Disorder, Schizophrenia, and Healthy Controls.","authors":"Gorkem Yilmaz, Ejder Akgun Yildirim, Abdulkadir Sencer Tabakcı","doi":"10.1159/000529880","DOIUrl":"10.1159/000529880","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the similarities in poor social competence and clinical manifestations of poor social behavior, no study has compared the theory of mind performance between social anxiety disorder (SAD) and schizophrenia, considering the effect of social-evaluative anxiety and neurocognitive functions. In our study, we aimed to compare the theory of mind functions and social-evaluative anxiety between patients with SAD and schizophrenia and healthy controls and to examine the relationship between the theory of mind, neurocognitive skills, and social-evaluative anxiety.</p><p><strong>Methods: </strong>Thirty-four consecutive patients with schizophrenia, 29 patients with SAD, and 30 controls matched by age, education level, and sex were enrolled in the study. Structured Clinical Interview for DSM, Beck Depression Inventory, Liebowitz Social Anxiety Scale, Theory of Mind measures (Reading the Mind in the Eyes Test, Hinting Task, Faux Pas Test), Social Appearance Anxiety Scale, Fear of Positive Evaluation Scale, Fear of Negative Evaluation Scale-Short Form, and neuropsychological tests were administered to all participants.</p><p><strong>Results: </strong>A greater significant deterioration in theory of mind and neurocognitive functions was found in patients with schizophrenia compared to those with SAD and healthy controls. Social evaluation anxiety was highest in patients with SAD. Although social-evaluative anxiety was associated with the theory of mind function in schizophrenia, only fear of positive evaluation was associated with SAD. In all groups, neither theory of mind nor neurocognitive ability measures were correlated with social anxiety levels and related symptoms.</p><p><strong>Conclusions: </strong>The impaired theory of mind functioning detected in our study is more prominent in the schizophrenia group and largely independent of anxiety in schizophrenia and SAD. Although social evaluation anxiety, as a transdiagnostic concept, seems to be independent of theory of mind function in general, fear of positive evaluation seems to be associated with hinting in both disorders.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"440-452"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9310781","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":"Delusional Misidentification Syndromes in Postpartum Psychosis: A Systematic Review.","authors":"Gabriella Lewis,&nbsp;Lucy Blake,&nbsp;Gertrude Seneviratne","doi":"10.1159/000526129","DOIUrl":"https://doi.org/10.1159/000526129","url":null,"abstract":"<p><strong>Introduction: </strong>Delusional misidentification syndromes (DMS) are a group of psychopathological experiences occurring in psychosis, involving the misidentification of a person or place. DMS are often accompanied by hostility towards the object of delusional misidentification. This is of a particular concern in perinatal mental illness due to the potential disruption of the mother-infant bond, and risk of neglect, violence, or infanticide towards a misidentified child. This review aimed to collate all published cases of DMS in postpartum psychosis to further understand how these syndromes present in perinatal mental illness.</p><p><strong>Methods: </strong>In August 2021, an online database search was conducted using PubMed, MEDLINE, PsycINFO, CINAHL, and Embase to identify all publications reporting DMS in the perinatal period.</p><p><strong>Results: </strong>Nine papers were included in the review involving 8 case reports of Capgras syndrome and one case series involving 4 cases of Fregoli syndrome. Three cases identified organic pathology, which may have contributed to the presentation. The most common subject of misidentification was the patient's husband (n = 7), followed by their baby (n = 6), hospital staff (n = 4), other family members (n = 3), and self (n = 1). Five cases remark on the impact of perinatal illness on the maternal-infant bond, of which four result in the mother being unwilling to care for the infant as the result of their delusional beliefs.</p><p><strong>Conclusion: </strong>This is the first systematic review of the literature in this field. Although small in number, these cases reveal several important learning points including that DMS can occur with or without underlying organic disease. Active exploration of the nature of delusions in postpartum psychosis is required to mitigate the risk of harm to the infant and mother-infant bond. It may also uncover that these syndromes are more common in postpartum psychosis than previously realized.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":"56 4","pages":"285-294"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9555760","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":"Do Proximal Risk Factors Mediate the Impact of Affect on Symptoms of Generalized Anxiety Disorder and Major Depressive Disorder? An Extension of the Hierarchical Model of Cognitive Vulnerability.","authors":"Brandon Koscinski,&nbsp;Nicholas P Allan","doi":"10.1159/000527300","DOIUrl":"https://doi.org/10.1159/000527300","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are among the most prevalent forms of psychopathology. The hierarchical model of cognitive vulnerability proposes that higher order risk factors explain co-occurrence among internalizing disorders, whereas lower order risk factors explain discordance.</p><p><strong>Methods: </strong>Participants (N = 646; mean age = 38.50, SD = 10.00; 49.2% female) were recruited from Amazon MTurk to complete self-report questionnaires related to psychopathology in the summer of 2020. Structural equation modeling was used to examine the relations that negative affect (NA) and positive affect (PA) share with MDD and GAD, through rumination and intolerance of uncertainty (IU), cross-sectionally.</p><p><strong>Results: </strong>When modeling both IU and depressive rumination together as explaining the indirect effects from affect to psychopathology, the association between NA and symptoms of MDD was explained by depressive rumination. There were no indirect effects from PA to MDD or GAD symptoms. When modeled separately, both risk factors explained the associations NA shared with MDD and GAD symptoms.</p><p><strong>Conclusions: </strong>The present study extends the hierarchical model of cognitive vulnerability by finding that depressive rumination explains the association between NA and symptoms of MDD, even when controlling for IU.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":"56 4","pages":"258-267"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9556259","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":"Transactional Relations between Child Functioning and Parenting Stress in the First Years of Life: A Longitudinal Study among Psychosocially Burdened Families.","authors":"Oliver Evers,&nbsp;Anna Katharina Georg,&nbsp;Charlotte Wegener,&nbsp;Anna Sidor,&nbsp;Svenja Taubner","doi":"10.1159/000524101","DOIUrl":"https://doi.org/10.1159/000524101","url":null,"abstract":"<p><strong>Introduction: </strong>Previous research reported transactional relations between child functioning and parenting stress. There is limited evidence whether a transactional developmental model also fits children below the age of 12 months, especially in psychosocially burdened families. This study aims to test the fit of a transactional model during the first 3 years of life and examines whether the model differs between families with low and high psychosocial burden.</p><p><strong>Methods: </strong>A total of 302 psychosocially burdened families were observed over 3 years at age 4, 12, 24, and 36 months. Child behavioral problems and parenting stress were assessed via self-report while psychosocial burden was assessed via external rating at baseline. Cross-lagged panel analysis was used to investigate the fit of a transactional model.</p><p><strong>Results: </strong>A transactional model fitted the data significantly better (Δχ2 = 81.87, p < 0.001) than an autoregressive model reaching acceptable to good fit indices (CFI = 0.96, RMSEA = 0.09). The model indicated moderate stability within and reciprocal effects between child behavioral problems and parenting stress from age 12 to 36 months. From age 4 to 12 months, parenting stress predicted child behavioral problems but not vice-versa. Model fit indices and transactional relations did not substantially differ between families with low and high psychosocial burden, except for child effects on parenting stress during the first year of life, which were only evident in higher burdened families.</p><p><strong>Conclusion: </strong>Transactional relations among child and parent variables are evident in the first 3 years of life. Child effects in the first year of life may be restricted to highly psychosocially burdened families. Future research may focus on potential mediating variables such as parental sensitivity or contextual variables like significant life events. Targeted prevention strategies should be adapted to the level of psychosocial burden to account for the differing transactional relations.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":"56 1-2","pages":"29-40"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10843826","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":"How to Improve Training in Descriptive Psychopathology for Psychiatry Residents: A Delphi Study.","authors":"Jon-Inaki Etxeandia-Pradera,&nbsp;Jon Landeta,&nbsp;Jose Gonzalez-Such,&nbsp;Eduardo-Jesus Aguilar","doi":"10.1159/000525691","DOIUrl":"https://doi.org/10.1159/000525691","url":null,"abstract":"<p><strong>Purpose: </strong>Descriptive psychopathology (DP) is the language of psychiatry and is dedicated to the description of mental symptoms. Despite its core importance, a systematic review identified a series of shortcomings in its training. This Delphi study seeks to provide guidance for better didactic and clinical training in DP.</p><p><strong>Method: </strong>The authors used the Delphi method in order to gather, pool, and optimize the knowledgeable opinion of a highly qualified panel of international experts on how to improve DP training. A preliminary phase with open-ended questions was the basis to elaborate a Delphi questionnaire consisting of 14 questions on didactic and clinical training, which was then used in two successive Delphi rounds. Twenty-nine international experts in DP participated throughout the study.</p><p><strong>Results: </strong>A series of hierarchical lists on how to improve DP training were elaborated. Regarding didactic training, the experts valued the contents and educational methods, as well as recommended authors and texts. Regarding clinical training, the experts valued educational methods, desirable characteristics in clinical supervisors, how to improve the supervisors' expertise, useful aspects and facilitating questions for direct supervision, and the suitability of including other evaluators besides the supervisor. In the final survey, 94% of the experts considered that the Delphi method had been effective to obtain and improve their opinions.</p><p><strong>Conclusions: </strong>Insufficient direct supervision in live interviews was considered the most important problem. A series of general measures were proposed to improve DP training: (i) adapting DP training throughout residency, with introductory and advanced levels; (ii) making DP training compulsory in psychiatry curricula; (iii) assessing residents' DP knowledge and clinical use; and (iv) training the trainers/supervisors in both content (DP) and form (how to train/supervise residents). Within didactic training, epistemology of DP and contemporary and classic authors/texts were the highest rated contents, while supervised discussions based on cases, videos, or readings were the highest rated methods. Within clinical training, 8 aspects of DP that could guide the supervisor were highly rated: mental state examination, dialogue, empathy and understanding, attitude/willingness, knowledge-practice bridge, mental symptom formation, implications for decision-making, and the written report of the encounter.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":"56 3","pages":"206-219"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9249610","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}