{"title":"Object relations moderate the relationship between emotion regulation and quality of life among psychiatric inpatients: A brief report.","authors":"John T Rucker, Alex Ray, Katrina A Rufino","doi":"10.1521/bumc.2026.90.1.42","DOIUrl":"10.1521/bumc.2026.90.1.42","url":null,"abstract":"<p><p>The ways a person manages emotional demands consequently influences their psychiatric distress and quality of life. The influence of object relations in the relationship between emotion regulation and quality of life is underemphasized, if not mostly speculative. This study represents an early attempt to empirically investigate if and how object relations moderate the relationship between emotion regulation and quality of life in a hospitalized psychiatric sample. One-hundred (N = 100) consecutively admitted inpatients were each administered the Bell Object Relations and Reality Testing Inventory, the Difficulties in Emotion Regulation Scale-Short Form, and the World Health Organization Quality of Life-Brief Version. Results indicated object relations moderated this relationship with distinct aspects of object relations functioning, insecure attachment and egocentricity, reaching the strongest moderation effects. The discussion situates these findings within the extant literature with ideas for future study. Limitations and clinical applications are offered.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"90 1","pages":"42-57"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Steffen Moritz, Antonia Meinhart, Franziska Miegel, Jannik Blömer, Kim M Rojahn
{"title":"Stepping into fear safely: A case study on mixed reality exposure in spider phobia.","authors":"Steffen Moritz, Antonia Meinhart, Franziska Miegel, Jannik Blömer, Kim M Rojahn","doi":"10.1521/bumc.2026.90.3.221","DOIUrl":"https://doi.org/10.1521/bumc.2026.90.3.221","url":null,"abstract":"<p><p>Arachnophobia is a common specific phobia, yet access to therapy is limited. This single-case study examined the use of a mixed reality exposure therapy (MRET) for spider phobia, enabling room-aware spatial mapping and passthrough vision for safety. Its core feature is a spider behavior system that simulates naturalistic, unpredictable movements animated procedurally for ecological validity. The study participant was a 56-year-old female patient with chronic spider phobia who had shown limited response to two previous cognitive behavioral treatments. Progress was assessed at nine time points over one year using the Spider Phobia Questionnaire (SPQ), Fear of Spiders Questionnaire (FSQ), and Patient Health Questionnaire (PHQ-9). Results showed a 48% reduction in FSQ scores. Decreases in the SPQ avoidance and vigilance subscale scores were notable. MRET produced substantial and lasting reductions in spider phobia severity over a period of 12 months, with improved tolerance, reduced avoidance, and stable mood. The approach was well accepted.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"90 3","pages":"221-243"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samantha N Hellberg, Heidi J Ojalehto, Caitlin M Pinciotti, Nathaniel Van Kirk, Jonathan S Abramowitz
{"title":"Understanding the co-occurrence of OCD and PTSD: A network approach.","authors":"Samantha N Hellberg, Heidi J Ojalehto, Caitlin M Pinciotti, Nathaniel Van Kirk, Jonathan S Abramowitz","doi":"10.1521/bumc.2026.90.3.187","DOIUrl":"https://doi.org/10.1521/bumc.2026.90.3.187","url":null,"abstract":"<p><p>Obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) often co-occur, complicating the presentation, severity, and treatment of these conditions. Relationships among the symptoms of these disorders may contribute to their co-occurrence. This study aimed to extend recent work on comorbid OCD+PTSD and to examine its network structure in a clinical sample of 137 treatment-seeking patients at two large healthcare institutions. Confirmatory factor analysis was used to examine the OCD+PTSD factor structure and the optimal solution subjected to network analysis. The best fitting factor solution, consistent with Pinciotti, Horvath, and colleagues (2022), included seven PTSD factors and two OCD factors. The strongest symptom-level associations were among: a) trauma-related intrusions and avoidance and b) obsessions and compulsions. Affective symptoms (e.g., dysphoric arousal) emerged as central bridge symptoms connecting obsessions/compulsions to trauma-related intrusions/avoidance symptoms. Findings converge with models suggesting these disorders are functionally related, albeit distinct, conditions.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"90 3","pages":"187-220"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patrick Galland, Frank Fischer, Berenike Steven, Johanna Seifert, Jörn Hilfrich, Alexandros Rahn
{"title":"Psychiatric and behavioral symptoms after pediatric herpes simplex virus type 1 encephalitis: An exploratory case series.","authors":"Patrick Galland, Frank Fischer, Berenike Steven, Johanna Seifert, Jörn Hilfrich, Alexandros Rahn","doi":"10.1521/bumc.2026.90.2.126","DOIUrl":"10.1521/bumc.2026.90.2.126","url":null,"abstract":"<p><strong>Aim: </strong>To exploratively describe long-term psychiatric and behavioral symptoms in pediatric survivors of herpes simplex virus type 1 encephalitis.</p><p><strong>Methods: </strong>In this retrospective descriptive case series conducted at two tertiary pediatric centers, admissions from 2000 to 2022 were screened for confirmed herpes simplex virus type 1 encephalitis. Eight families completed validated parentand self-report questionnaires assessing emotional and behavioral symptoms. Analyses were descriptive.</p><p><strong>Results: </strong>Mean age at disease onset was 5.4 years, and mean age at follow-up was 13.1 years. Seven of eight children exhibited persistent neurological sequelae. Clinically elevated emotional or behavioral symptoms were observed in a subset of children, including anxiety, depressive symptoms, and attention problems.</p><p><strong>Conclusions: </strong>Some pediatric survivors exhibited clinically relevant emotional and behavioral symptoms years after the acute illness. Although no conclusions regarding prevalence or disease-specific risk can be drawn, the findings underscore the importance of clinical awareness and mental health screening as part of long-term follow-up care.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"90 2","pages":"126-143"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Toward a double bind theory of borderline personality disorder.","authors":"Mark L Ruffalo, Jerold J Kreisman","doi":"10.1521/bumc.2026.90.2.168","DOIUrl":"10.1521/bumc.2026.90.2.168","url":null,"abstract":"<p><p>This article revisits the Bateson group's concept of the double bind, originally proposed as an etiological theory of schizophrenia, and reinterprets it as a central framework for understanding borderline personality disorder (BPD). We propose that paradoxical communication patterns in early development, characterized by contradictory and entrapping messages, become internalized and give rise to the structural and interpersonal paradoxes that define BPD. Drawing upon psychodynamic theory, empirical research, and contemporary object relations perspectives, we conceptualize BPD as a \"disorder of paradox\" in which love and fear, autonomy and dependence, approach and avoidance coexist in irresolvable tension. The double bind provides a unifying model linking developmental origins, phenomenology, and clinical manifestations of BPD, while illuminating the transference dilemmas encountered in psychotherapy. Understanding paradox as the organizing principle of BPD restores coherence and depth to the disorder's psychodynamic formulation and offers guidance for treatment.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"90 2","pages":"168-185"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kiefer D Cowie, Andrew M Scott, Malak Sadek, Karen Rowa
{"title":"Identifying factors associated with sleep disturbance among adults seeking outpatient psychiatric services for anxiety and related disorders.","authors":"Kiefer D Cowie, Andrew M Scott, Malak Sadek, Karen Rowa","doi":"10.1521/bumc.2026.90.2.87","DOIUrl":"10.1521/bumc.2026.90.2.87","url":null,"abstract":"<p><p>This study sought to characterize self-reported sleep disturbance and identify factors associated with sleep disturbance among treatment seeking adults with clearly diagnosed anxiety and related disorders. Four principal diagnostic groups were included: generalized anxiety disorder, obsessive-compulsive disorder, panic disorder/agoraphobia, and social anxiety disorder. Linear regression was conducted to identify main effects of psychiatric (diagnostic group, cannabis use, anxiety, depressive, and stress symptoms) and demographic (age and sex) variables on sleep quality and whether these effects were moderated by diagnostic group. The majority of participants reported clinically meaningful sleep disturbance with no difference across diagnostic presentation. Depression, stress, anxiety, and age demonstrated significant main effects on sleep quality while cannabis use and biological sex did not. No significant moderation effects were observed. These findings suggest that sleep disturbance is highly prevalent among treatment seeking individuals with anxiety and related disorders warranting further research. Clinical and research implications are discussed.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"90 2","pages":"87-108"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Camille F Villar, Robert J Zhou, Caitlin Perez-Stable, Annabel Merritt, Kendall Oh, Oyetewa Asempa
{"title":"Psychiatric comorbidities and treatment in adults with trichotillomania and excoriation disorder: A retrospective cohort study.","authors":"Camille F Villar, Robert J Zhou, Caitlin Perez-Stable, Annabel Merritt, Kendall Oh, Oyetewa Asempa","doi":"10.1521/bumc.2026.90.3.269","DOIUrl":"https://doi.org/10.1521/bumc.2026.90.3.269","url":null,"abstract":"<p><p>Trichotillomania (TTM) and excoriation disorder (ED) are body-focused repetitive behaviors (BFRBs) characterized by recurrent hair-pulling or skin-picking; they may present with psychiatric comorbidities worsening outcomes. While cross-sectional and case-control studies report high comorbidity rates, longitudinal analyses remain limited. We looked to determine incidence of new psychiatric diagnoses, psychopharmacologic prescriptions, and psychotherapy referrals following BFRB diagnosis compared with controls and assess whether psychiatric history modified outcomes. Adults with ICD-10 diagnoses of TTM or ED were matched to controls. Outcomes included new psychiatric diagnoses, psychiatric medications, and psychotherapy referrals within one year. Kaplan-Meier analyses and Cox regression were performed. Among 304 participants (102 BFRB, 202 controls), BFRB patients more frequently initiated psychiatric medications and received psychotherapy referrals after adjusting for prior psychiatric comorbidity. New psychiatric diagnoses did not differ significantly. Adults with BFRBs demonstrate substantial psychiatric treatment burden, underscoring the importance of routine psychiatric screening and coordinated psycho dermatologic care.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"90 3","pages":"269-290"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Multi-rater input and behavioral observations facilitate diagnoses of ADHD and anxiety: A case report.","authors":"Michael R Capawana","doi":"10.1521/bumc.2026.90.1.78","DOIUrl":"10.1521/bumc.2026.90.1.78","url":null,"abstract":"<p><p>Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent child-onset condition, spanning symptoms of inattention, hyperactivity, and/or impulsivity. Anxiety is a primary co-occurring issue that can further affect children and adolescents, thus contributing to functional impairment across settings. Information obtained from individuals other than the youth themselves is often prioritized in terms of rendering diagnostic impressions. While valuable, this method is not fully comprehensive as it does not consistently account for the youth's own opinions and interactions with the care provider. This article describes a case wherein comorbidity and atypical symptom presentation were apparent. It highlights potential variability among informants but nonetheless also the importance of multi-rater input, with recommendations for clinical practice.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"90 1","pages":"78-83"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fares Zine El Abiddine, Chung-Ying Lin, Ahmed Alduais, Musheer A Aljaberi, Mark D Griffiths
{"title":"The psychometric properties of the Arabic Satisfaction With Life Scale for Children (SWLS-C).","authors":"Fares Zine El Abiddine, Chung-Ying Lin, Ahmed Alduais, Musheer A Aljaberi, Mark D Griffiths","doi":"10.1521/bumc.2026.90.3.244","DOIUrl":"https://doi.org/10.1521/bumc.2026.90.3.244","url":null,"abstract":"<p><p>Life satisfaction is a key component of children's subjective well-being, yet validated tools for Arabic-speaking populations remain limited. The present study translated and validated the Arabic version of the Satisfaction With Life Scale for Children (SWLS-C). A cross-sectional sample of 300 children and adolescents completed the SWLS-C alongside measures of psychological well-being, affect, and happiness. The adaptation followed international guidelines, including translation, back-translation, expert review, and refinement. Confirmatory factor analysis supported a unidimensional structure (CFI = 0.982; TLI = 0.965; RMSEA = 0.059; SRMR = 0.034). Internal consistency was acceptable (α = .706; ω = 0.716). Multigroup CFA confirmed configural, metric, and scalar invariance across gender. Concurrent validity was supported by positive correlations with psychological well-being, positive affect, and happiness, and a negative correlation with negative affect (all p < .001). Overall, findings indicate the Arabic SWLS-C is a reliable and valid measure of life satisfaction among Arabic-speaking children and adolescents.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"90 3","pages":"244-268"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexandra C Volpacchio, Kimberly Glazier Leonte, Lydia Hardy, Brian D Ott
{"title":"Clinician use of ERP principles in conceptualization and response to OCD clients seeking reassurance.","authors":"Alexandra C Volpacchio, Kimberly Glazier Leonte, Lydia Hardy, Brian D Ott","doi":"10.1521/bumc.2026.90.1.58","DOIUrl":"10.1521/bumc.2026.90.1.58","url":null,"abstract":"<p><strong>Background: </strong>Exposure and response prevention (ERP) is the gold standard psychological treatment for obsessive-compulsive disorder (OCD). This study assessed if participants' response to a client with OCD, who is seeking reassurance, would follow ERP principles.</p><p><strong>Methods: </strong>2,550 American Psychological Association members were randomized to one of three OCD vignettes: contamination, sexual, and harm. Participants selected how they would respond to a client with OCD who was seeking reassurance.</p><p><strong>Results: </strong>499 participants completed the survey. Across the vignettes, participants (1) were least likely to select the ERP response (harm: 3.0%; sexual: 3.1%; contamination: 7.1%), (2) rated the ERP response as Very Non-Therapeutic or Non-Therapeutic (sexual: 89.6%; harm: 82.7%; contamination: 58.9%), and (3) did not agree that the ERP response (e.g., \"You may have stabbed someone\") was reflective of the theory and practice of ERP.</p><p><strong>Conclusions: </strong>Greater training and education regarding ERP for OCD among mental health professionals is needed.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"90 1","pages":"58-77"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}