British Journal of Clinical Psychology最新文献

{"title":"A scoping review of service user experiences of potential harm in early intervention in psychosis services in the UK","authors":"Georgie Hudson,&nbsp;India Francis-Crossley,&nbsp;Craig S. Mackie,&nbsp;Rachel Hiller,&nbsp;James B. Kirkbride,&nbsp;Claire Powell","doi":"10.1111/bjc.70057","DOIUrl":"10.1111/bjc.70057","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Early intervention in psychosis (EIP) services provide care for individuals experiencing first-episode psychosis and are considered both clinically and cost-effective. While many have positive experiences of EIP, there have also been reports of perceived harm. This scoping review synthesized qualitative evidence on service user perspectives of potential harm in EIP services in the UK, to consider how services may continue to improve practice to meet the needs of their service users.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a scoping review following a pre-registered protocol. Systematic searches were performed in PsycINFO, Web of Science Core Collection, Scopus, Embase, CINAHL Plus and Medline on 9th October 2024, and updated searches on 12th January 2026. We included peer-reviewed qualitative studies exploring service user experiences in EIP services in the UK. Data on reported harms from eligible studies were thematically analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirteen studies met inclusion criteria. We identified four main themes: (1) Intersection of stigma and lack of cultural awareness; (2) Inappropriate or inadequate support; (3) Poor relationships and communication; and (4) Challenges in the discharge process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While EIP services offer the current gold standard of care for first-episode psychosis, our review highlighted some areas where harm was perceived to have arisen. Such information presents potential targets for service improvement. Strengthening communication and enhancing information sharing may help mitigate potential harms and optimize service user experiences. Further research to quantify the prevalence of harms within EIP services is needed to inform best practices and ensure equitable, person-centred care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"65 4","pages":"1015-1039"},"PeriodicalIF":2.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjc.70057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700197","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":"Developmental trajectories of social responsiveness and theory of mind in adolescent offspring at familial high-risk of schizophrenia or bipolar disorder and population-based controls—The Danish High Risk and Resilience Study, VIA 15","authors":"Lotte Veddum,&nbsp;Andreas Færgemand Laursen,&nbsp;Anette Faurskov Bundgaard,&nbsp;Nicoline Hemager,&nbsp;Maja Gregersen,&nbsp;Mette Falkenberg Krantz,&nbsp;Anja Vaskinn,&nbsp;Jens Richardt Møllegaard Jepsen,&nbsp;Anne Søndergaard,&nbsp;Sinnika Birkehøj Rohd,&nbsp;Martin Wilms,&nbsp;Marta Schiavon,&nbsp;Doris Helena Bjarnadóttir Streymá,&nbsp;Anne Amalie Elgaard Thorup,&nbsp;Merete Nordentoft,&nbsp;Ole Mors,&nbsp;Aja Neergaard Greve","doi":"10.1111/bjc.70054","DOIUrl":"10.1111/bjc.70054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aimed to investigate the developmental trajectories of social responsiveness and theory of mind (ToM) from childhood to adolescence in offspring at familial high risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) and population-based controls (PBC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>The Danish High Risk and Resilience Study is a longitudinal cohort study investigating offspring at FHR-SZ (<i>n</i> = 202) or FHR-BP (<i>n</i> = 120) and PBC (<i>n</i> = 200), assessed at age 7, 11 and 15.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Social responsiveness was measured with The Social Responsiveness Scale, Second Edition, completed by a teacher and the primary caregiver, and ToM was assessed using the Animated Triangles Task. Developmental differences and cross-sectional between-group differences were ascertained with multi-level mixed effects linear regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found non-significantly different development of social responsiveness and ToM across groups. At age 15, offspring at FHR-SZ displayed social responsiveness impairments compared with PBC, both according to teachers and primary caregivers. Offspring at FHR-BP only displayed social responsiveness impairments compared with PBC according to the primary caregivers. Significantly more offspring at FHR-SZ displayed clinically significant impairments in social responsiveness compared with PBC. We found no significant between-group difference in ToM at age 15.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Especially offspring at FHR-SZ, but also offspring at FHR-BP, show developmental deficits in social responsiveness and normal ToM development from childhood to adolescence, indicating that social responsiveness impairments may constitute a vulnerability marker. Additional studies are needed to validate our findings and to investigate the long-term impact of social responsiveness impairments in offspring at FHR-SZ or FHR-BP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"65 4","pages":"1075-1093"},"PeriodicalIF":2.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjc.70054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724637","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":"Therapeutic effectiveness of group psychotherapy incorporating cognitive and goal management training in substance use disorder patients under deferred prosecution","authors":"Po-Chih Liu,&nbsp;Jui-Chien Huang,&nbsp;Kao Chin Chen,&nbsp;Rwei-Ling Yu","doi":"10.1111/bjc.70061","DOIUrl":"10.1111/bjc.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to evaluate the effectiveness of a structured group psychotherapy program integrating cognitive training (CT) and goal management training (GMT) across neuropsychological, coping and behavioural levels in patients with substance use disorder (SUD) under deferred prosecution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Utilizing a pre–post design, this study analysed data from 35 patients under deferred prosecution who were enrolled in a compulsory addiction treatment programme consisting of 10-session group psychotherapy incorporating CT and GMT. Patients were primarily addicted to heroin, methamphetamine or cannabis. Neuropsychological assessments were conducted before and after the intervention, including the Stroop Colour-Word Test (SCWT) to assess inhibition, the Tower of London-DX (ToL-DX) to assess planning and the Wisconsin Card Sorting Test (WCST) to assess cognitive flexibility. Additionally, participants completed the Daily Executive Behaviours Scale and substance use was tracked via urine tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant improvements were observed in the SCWT colour-word score (<i>t</i> = −2.78, <i>p</i> = .009, <i>r</i>_<i>t</i> = 0.43), ToL-DX execution time (<i>t</i> = 2.40, <i>p</i> = .02, <i>r</i>_<i>t</i> = 0.38) and rule violation metrics (<i>Z</i> = −3.34, <i>p</i> &lt; .001, <i>r</i>_<i>z</i> = 0.57), as well as WCST perseverative errors (<i>Z</i> = −3.00, <i>p</i> = .003, <i>r</i>_<i>z</i> = 0.51); however, no significant changes were found in self-reported assessments or urine tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The combined CT and GMT intervention significantly improved cognitive functions, although it did not lead to a notable reduction in substance use. This approach was associated with measurable improvements in executive functions, while highlighting the limits of short-term cognitive enhancement in altering substance use behaviour.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"65 4","pages":"1128-1141"},"PeriodicalIF":2.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786081","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":"High dental anxiety among adults worldwide: A systematic review and meta-analysis using the MDAS","authors":"Marta Leśna,&nbsp;Krystyna Górna,&nbsp;Jakub Kwiatek","doi":"10.1111/bjc.70049","DOIUrl":"10.1111/bjc.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Dental anxiety can significantly influence both oral health and overall quality of life. The present review aimed to estimate how common high dental anxiety is among adults worldwide, based on studies that used the Modified Dental Anxiety Scale (MDAS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis were carried out following predefined eligibility criteria. We searched studies published between 2000 and 2025 that reported the proportion of adults scoring ≥19 on the MDAS. Primarily cross-sectional observational surveys, as well as selected clinical observational studies, were included. Using a random effects model, we calculated pooled prevalence estimates with 95% confidence intervals (CIs) and conducted subgroup and sensitivity analyses to explore variation by time period and study setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nineteen studies, involving a total of 9267 participants, met the inclusion criteria. The pooled prevalence of high dental anxiety was 18% (95% CI: 0.10–0.30), with substantial between-study heterogeneity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High dental anxiety may affect a substantial proportion of adults, depending on study context. These results emphasize the importance of prevention and intervention strategies aimed at reducing dental anxiety and promoting better oral health outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"65 4","pages":"907-924"},"PeriodicalIF":2.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576029","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":"What are the experiences of people with psychosis, their carers and staff in inpatient mental healthcare services in the United Kingdom? A systematic review and meta-ethnography","authors":"Lewis A. MacDonald-Winship,&nbsp;Thomas A. Schröder,&nbsp;Stephanie Lane","doi":"10.1111/bjc.70051","DOIUrl":"10.1111/bjc.70051","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>UK inpatient mental healthcare services face ongoing challenges of safety and staff shortages. People experiencing psychosis account for around half of admissions, with over half readmitted within 7 years. Care is organized around the therapeutic alliance between patients, their carers and staff, yet no systematic review has synthesized the views of all three groups within UK inpatient settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>(i) To identify and appraise qualitative studies examining experiences of inpatient mental healthcare from the perspectives of patients with psychosis, carers and staff; (ii) To synthesize findings to deepen understanding of these experiences:</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A systematic search of three databases identified 21 relevant studies. All were appraised using an adapted Critical Appraisal Skills Programme (CASP) tool. Data were extracted and synthesized using meta-ethnography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Study quality varied. Three key constructs emerged: (1) Power and Control in the Inpatient Setting; (2) Atmospheres of Care and (3) Connection and Recovery. Patients, carers and staff described multifaceted challenges within conflict-laden environments. Experiences ranged from confusion, disconnection, and threat to safety, understanding, and recovery, shaped by relational and communicative practises. Where patients felt informed, carers included and staff supported, experiences were more positive. Conversely, institutional routines may function as defences against emotional strain, risking relational detachment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Inpatient services support individuals experiencing acute distress and risk, underscoring the emotional intensity of these settings. Despite policy emphasis on deinstitutionalization, inpatient care remains essential. Future research should further explore staff and carer experiences to inform relationally attuned service design.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"65 4","pages":"1040-1074"},"PeriodicalIF":2.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718469","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 effect of an integrated application-supported mindfulness-based cognitive therapy programme on depression among adolescents with non-suicidal self-injury: A randomized controlled trial.","authors":"Russunan Jantarapakdee, Ratchaneekorn Upasen, Penpaktr Uthis, Jojo Yan Yan Kwok","doi":"10.1111/bjc.70101","DOIUrl":"https://doi.org/10.1111/bjc.70101","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the effectiveness of an integrated, application-supported mindfulness-based cognitive therapy (MBCT) programme in reducing depressive symptoms among adolescents with non-suicidal self-injury (NSSI).</p><p><strong>Methods: </strong>An open-label, two-arm randomized controlled trial was conducted in two public secondary schools in Thailand. The schools were randomly allocated to the intervention or usual-care control condition, with eligible participants pair-matched by sex and baseline depressive symptom severity (n = 48 persons/group). The blended school-based and application-supported MBCT programme was evaluated at baseline, 2 weeks post-intervention, and 1-month follow-up using repeated-measures ANOVA.</p><p><strong>Results: </strong>There was a significant time × group interaction, F (1.73, 162.17) = 62.59, p < .001, ηp² = .40, indicating differential changes in depressive symptoms between groups. Significant main effects of time, F (1.73, 162.17) = 203.59, p < .001, ηp² = .68 and group, F (1, 94) = 15.74, p < .001, ηp² = .14, were also observed, with lower depressive symptom scores overall in the intervention group.</p><p><strong>Conclusions: </strong>The integrated application-supported MBCT programme effectively reduced depressive symptoms among adolescents with NSSI. NSSI was used to define the target population and was not a treatment outcome; therefore, effects on NSSI cannot be interpreted.</p>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138767","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":"Social media exposure and anxiety and depression in young people: A systematic review and meta-analysis of longitudinal and experimental studies.","authors":"William Peachey, Stefan Piantella, Sue M Cotton, John F M Gleeson","doi":"10.1111/bjc.70100","DOIUrl":"https://doi.org/10.1111/bjc.70100","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the current review was to comprehensively synthesize the evidence for the relationship between social media use and anxiety and depression symptoms in young people using data from robust methodological designs, namely, longitudinal and experimental studies.</p><p><strong>Methods: </strong>PsycINFO, Web of Science, MEDLINE, Embase and Scopus databases were searched for peer-reviewed, English-language, longitudinal and experimental studies. Included studies measured SMU in terms of time or frequency of use, mainly via self-report, used standardized measures of depression and anxiety, and recruited samples ranging from 10 to 24 years of age.</p><p><strong>Results: </strong>Screening retrieved 37 eligible studies that included 36 longitudinal observational studies and one experiment. Twelve studies examined depression outcomes (pooled r = .08, 95% CIs [0.04, 0.11]), and five studies examined anxiety (pooled r = 0.093, 95% CIs [0.059, 0.126]), showing very small linear effects. There were no moderating effects for year of publication, duration of follow-up or mean age of sample for the depression effects.</p><p><strong>Conclusions: </strong>Given the very weak relationships between SMU and the severity of anxiety and depression symptoms, SMU is unlikely to account for the contemporary youth mental health crisis. Further longitudinal research designed to examine potential non-monotonic relationships between SMU and adverse mental health outcomes is required, along with attention to other potential causes of increased prevalence of mental health problems in young people.</p>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128925","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":"Finding salvage in standardization? Structural and longitudinal evaluation of the patient health questionnaire anxiety and depression scale in a UK representative sample.","authors":"Joshua James Crawford, Gary Adamson","doi":"10.1111/bjc.70103","DOIUrl":"https://doi.org/10.1111/bjc.70103","url":null,"abstract":"<p><strong>Objectives: </strong>Some research funders mandate the use of the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) as independent measures of depression and anxiety. This study examined their independence in a UK representative sample by testing the structural validity, external validity, longitudinal measurement invariance and growth trajectories of the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS).</p><p><strong>Methods: </strong>Data from Waves 1 (N = 2025), 2 (N = 1406) and 3 (N = 1166) of the COVID-19 Psychological Research Consortium Study were analysed. Confirmatory factor analysis and exploratory structural equation modelling were used to compare PHQ-ADS models. Structural equation modelling examined associations with Cybernetic Big Five Theory traits, intolerance of uncertainty and mental health treatment status. Longitudinal measurement invariance was tested across waves, and curve-of-factors models examined change over time.</p><p><strong>Results: </strong>A bifactor model with a correlated residual produced interpretable factors. Auxiliary bifactor statistics supported a composite PHQ-ADS score, whereas PHQ-9 and GAD-7 summed scores showed little reliable unique variance after accounting for the general factor. Stability and Neuroticism were associated with the general factor (p < .001), Conscientiousness with the PHQ-9 group-factor (p < .001) and Agreeableness with the GAD-7 group-factor (p = .003). Intolerance of uncertainty was associated with the general and GAD-7 group-factors (p < .001). Mental health treatment status was primarily associated with the general factor. Residual invariance was supported after inclusion of a trait-factor, and growth trajectories differed across factors.</p><p><strong>Conclusions: </strong>Although the PHQ-9 and GAD-7 showed some tentative uniqueness within latent models, their summed scores would largely reflect general distress. These findings suggest caution when interpreting PHQ-9 and GAD-7 total scores as distinct indicators, warranting reconsideration of measurement standardization.</p>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128843","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":"Mapping the network of theory of mind in paranoid schizophrenia: Preliminary investigation of the role of attachment, emotional empathy and emotion recognition.","authors":"Milica Mitrović, Nikola Ćirović","doi":"10.1111/bjc.70102","DOIUrl":"https://doi.org/10.1111/bjc.70102","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to examine the underlying dynamics between theory of mind (ToM), attachment, emotional empathy and facial emotion recognition (FER) in individuals with paranoid schizophrenia (PaSch) and healthy controls.</p><p><strong>Methods: </strong>Using network analysis, we investigated patterns of associations and compared the structural organization of these constructs across two matched samples (N = 60).</p><p><strong>Results: </strong>Results indicated that unresolved family traumatization emerged as the most central node in both networks, suggesting its key role in linking attachment-related vulnerabilities with socio-cognitive functioning. Network comparison analyses revealed no significant differences between the PaSch and control groups in global structure and overall connectivity, suggesting potentially isomorphic relationships among the constructs studied across clinical and non-clinical populations. However, exploratory graph analysis identified meaningful differences in the organization of constructs. In healthy controls, attachment variables were relatively distinct from ToM and empathy. In contrast, in the PaSch group, these domains were more intertwined, particularly with negative self-representation clustering alongside ToM measures. Additionally, in the extended network including persecutory ideation, the most central nodes were unresolved family traumatization, negative model of others and persecutory ideation, supporting theoretical accounts linking insecure attachment and early adverse experiences with positive psychotic symptoms.</p><p><strong>Conclusion: </strong>These findings suggest that, although the overall structure of relationships may be similar, the functional integration of attachment and socio-cognitive processes differs in schizophrenia. The study highlights the importance of early relational experiences in understanding socio-cognitive impairments and psychotic symptomatology. Limitations include a small sample size and limited generalizability, warranting further research.</p>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116758","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":"Effectiveness of cognitive behavioural therapy on anxiety and depression symptoms in naturalistic settings for patients with and without personality disorders.","authors":"Gabriele Caselli, Silvia Grazioli, Rossana Piron, Marta Fanfoni, Simona Giuri, Simona Scaini, Giovanni Maria Ruggiero, Sandra Sassaroli","doi":"10.1111/bjc.70097","DOIUrl":"https://doi.org/10.1111/bjc.70097","url":null,"abstract":"<p><strong>Objectives: </strong>Personality disorders (PD) are often considered a negative prognostic factor for cognitive behavioural therapy (CBT) in anxiety and depression, yet evidence from real-world settings with rigorous diagnostic assessment remains limited. This study examined whether PD diagnosis influences CBT outcomes using data from inTHERAPY, an Italian CBT service integrating systematic outcome monitoring with structured diagnostic assessment (SCID-5).</p><p><strong>Methods: </strong>Patients receiving CBT for anxiety and/or depression were classified according to the presence or absence of a PD and assessed on anxiety, depression, and psychosocial functioning. Treatment effectiveness was evaluated through symptom change, reliable and clinically significant improvement (RCSI), and recovery rates. Mixed-effects growth curve models examined outcome trajectories, and regression analyses tested the role of PD diagnosis, treatment exposure, and dropout status.</p><p><strong>Results: </strong>CBT was associated with a RCSI rate of 50%, with moderate-to-large pre-post effect sizes for anxiety (d = .77), depression (d = .76), and functioning (d = .63). Although patients with PD presented with higher baseline severity and lower recovery rates, PD diagnosis did not independently predict outcomes when baseline severity, dropout status, and number of sessions were controlled for. Symptom trajectories were nonlinear and largely comparable across groups. Notably, patients with PD who dropped out late showed greater functional impairment at discharge than late dropouts without PD.</p><p><strong>Conclusions: </strong>These findings suggest that standard disorder-specific CBT is effective for patients with comorbid PD in real-world practice. Apparent poorer outcomes primarily reflect greater initial severity, underscoring the importance of adequate treatment duration and strategies to prevent late dropout.</p>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082582","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}