Journal Of Clinical Psychology[JOURNAL]
Sun
200 papers
Profiles of Early Life Stress and Their Interaction With Proximal Stress in Early Adulthood: A Person-Centered Approach.
Park J, Freeman C, Hong S … +1 more , Weinberg A
J Clin Psychol · 2026 Jul · PMID 42400332 · Publisher ↗
OBJECTIVE: Adverse effects of early life stress (ELS) exposure are well-documented, but the joint effects of multiple exposures to different types of ELS (e.g., abuse, neglect, family dysfunction, maladaptive parenting)...
OBJECTIVE: Adverse effects of early life stress (ELS) exposure are well-documented, but the joint effects of multiple exposures to different types of ELS (e.g., abuse, neglect, family dysfunction, maladaptive parenting) and their interaction with more proximal stress in adulthood remains less understood. To bridge this gap, we used a person-centered approach to identify distinct patterns of exposure to ELS (i.e., ELS profiles) and examined whether they interact with proximal stress to explain variability in mental health outcomes. METHODS: 367 young adults completed questionnaires assessing their exposure to ELS (i.e., abuse, neglect, family dysfunction, maladaptive parenting), proximal stress (COVID-19-related stressors), and stress-related mental health outcomes (e.g., mood and posttraumatic stress symptoms, alcohol use). We conducted latent profile analyses to uncover ELS profiles and regression-based moderation analyses to examine their interactions with COVID-19 stress. RESULTS: We identified three profiles: Profile 1 (n = 286) with low ELS exposure; Profile 2 (n = 66) with high emotional maltreatment and elevated physical maltreatment, family dysfunction, and parental affectionless control; and Profile 3 (n = 15) with extremely high childhood maltreatment (particularly sexual abuse), parental affectionless control, and normative family dysfunction. These profiles interacted with COVID-19 stress to explain variability in mood symptoms and alcohol use, suggesting sensitizing effects of ELS. CONCLUSIONS: The identified profiles and their interaction with COIVD-19 stress shed light on the cumulative and interactive effects of exposure to multiple stressors across the lifespan that could help identify vulnerabilities for stress-related psychological problems.
Single Versus Multiple Intimate Partner Violence Relationships: Current Severity of Psychological Distress Among Romantic Partners.
Hurd JA, Giff ST, Hall E … +3 more , Thomas M, Noblejas-Guloy R, Flanagan JC
J Clin Psychol · 2026 Jul · PMID 42400312 · Publisher ↗
OBJECTIVE: Experiencing multiple relationships with intimate partner violence (IPVRs) in one's lifetime is linked to poorer mental health outcomes. However, associations among multiple IPVRs, depression symptoms, and pos...
OBJECTIVE: Experiencing multiple relationships with intimate partner violence (IPVRs) in one's lifetime is linked to poorer mental health outcomes. However, associations among multiple IPVRs, depression symptoms, and posttraumatic stress symptoms (PTSS) have primarily been tested with individual women. The present study examines whether experiencing multiple physical IPVRs, compared to a singular physical IPVR, is associated with greater severity of depression symptoms and PTSS among a sample of romantic couples. We also explored whether gender or current physical IPV victimization severity moderates these associations. METHODS: A subsample of 116 romantic partners reporting at least one physical IPVR was drawn from a larger study of dyads reporting alcohol use disorder and IPV in their current relationship. Two multilevel models tested associations among multiple physical IPVRs, gender, and current IPV victimization severity with depression symptoms and PTSS while controlling for the interdependence of the dyadic sample and alcohol problem severity. RESULTS: Experiencing multiple physical IPVRs, compared to a singular physical IPVR, was related to greater depression symptoms and PTSS, respectively. Alcohol problem severity was also related to greater PTSS. There were no significant associations among gender or current physical IPV severity with depression symptoms or PTSS, nor any significant interactions between these variables and single versus multiple physical IPVRs with depression symptoms or PTSS. CONCLUSION: These findings emphasize the value of examining physical IPV and psychological outcomes in a dyadic context. Prevention and intervention efforts for those who experience multiple physically violent relationships may be valuable for both men's and women's psychological health. CLINICAL TRIAL REGISTRATION: NCT03046836 (https://clinicaltrials.gov/study/NCT03046836).
Psychological Distress Profiles in Women With Recurrent Pregnancy Loss During Subsequent Early Pregnancy and Their Association With Sleep Characteristics: A Latent Profile Analysis.
Ma B, Mu F, Wang C … +2 more , Han Z, Wang F
J Clin Psychol · 2026 Jul · PMID 42400297 · Publisher ↗
OBJECTIVE: This study aimed to explore psychological distress (PD) patterns in pregnant women with recurrent pregnancy loss (RPL) during early pregnancy and to examine the association between sleep characteristics and th...
OBJECTIVE: This study aimed to explore psychological distress (PD) patterns in pregnant women with recurrent pregnancy loss (RPL) during early pregnancy and to examine the association between sleep characteristics and these patterns. METHODS: A total of 203 pregnant women with RPL were recruited between October 2022 and April 2023 at the study hospital. The patients' PD was assessed using the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder 7-Item Questionnaire. The Pittsburgh Sleep Quality Index (PSQI) was employed to measure the sleep conditions. Latent profile analysis and multivariable logistic regression were used to identify the patterns of PD in RPL women and connections between their sleep characteristics and these identified patterns. RESULTS: Three PD patterns were identified in participants, including "mild PD" (57.15%), "moderate PD" (36.45%), and "severe PD" (6.40%). Subjective sleep quality, sleep disturbance, sleep efficiency, diurnal dysfunction, and PSQI score in patients varied significantly among the different PD patterns (p < 0.05). Compared with "mild PD," poor subjective sleep quality (Moderate: aOR= 2.76, 95%CI 1.37-5.56; Severe: aOR= 7.19, 95%CI 1.99-25.98) and diurnal dysfunction (Moderate: aOR= 3.1, 95%CI 1.62-5.97; Severe: aOR= 25.16, 95%CI 5.57-113.61) were significantly associated with "moderate" or "severe" PD. Addtionally, low sleep efficiency markedly increased the risk of "severe PD" (aOR= 28.76, 95%CI 1.09-759.02). CONCLUSIONS: This study identified three distinct patterns of PD (mild, moderate, and severe) among women with RPL during early pregnancy. Specific sleep characteristics, including poor subjective sleep quality, diurnal dysfunction, and low sleep efficiency, were significantly associated with moderate/severe PD.
Personality Traits in Borderline Personality Disorder: A Cluster Analysis Based on the Millon Test Scores.
Lopez-Villatoro JM, Diaz-Marsa M, Perez-Diez I … +3 more , Galvez-Merlin A, Prittwitz C, Carrasco JL
J Clin Psychol · 2026 Jul · PMID 42400289 · Publisher ↗
INTRODUCTION: The complexity of the treatment of borderline personality disorder (BPD) is largely due to its heterogeneity. The aim of this study is to identify empirically derived patterns of co-occurring personality tr...
INTRODUCTION: The complexity of the treatment of borderline personality disorder (BPD) is largely due to its heterogeneity. The aim of this study is to identify empirically derived patterns of co-occurring personality traits in individuals with primary BPD and to examine their clinical correlates. METHODS: Millon's personality traits (MCMI-IV) of 97 BPD patients were assessed and a cluster analysis of these traits was performed. Patients were evaluated on different clinical dimensions of BPD and compared between the different clusters found. RESULTS: Three trait-pattern clusters were obtained. Pattern 1 showed higher scores for borderline, histrionic, narcissistic and antisocial traits. Pattern 2 had higher scores for borderline, dependent and avoidant traits. Pattern 3 had lower levels of all the traits. Patients in patterns 1 and 2 showed greater scores on anxious-depressive scales. Pattern 1 also showed greater scores for anger expression. Pattern 3 patients were characterized for receiving more pharmacological treatment. CONCLUSIONS: Findings provide evidence for three patterns of co-occurring traits within BPD, consistent with dimensional conceptualizations and longstanding categorical overlap. These patterns align with externalizing-leaning, internalizing-leaning, and attenuated configurations and may help generate hypotheses for early characterization and treatment personalization.
Exploring Reasoning Biases Associated With Psychosis in Borderline Personality Disorder Using Self-Report and Objective Measures.
Krishnakumar S, Kumar D
J Clin Psychol · 2026 Jul · PMID 42398047 · Publisher ↗
Jumping to Conclusions (JTC) and Bias Against Disconfirmatory Evidence (BADE) are interrelated cognitive biases implicated in psychosis. Individuals diagnosed with Borderline Personality Disorder (BPD) may experience psy...
Jumping to Conclusions (JTC) and Bias Against Disconfirmatory Evidence (BADE) are interrelated cognitive biases implicated in psychosis. Individuals diagnosed with Borderline Personality Disorder (BPD) may experience psychotic symptoms, raising the question of whether they also exhibit these biases. However, research investigating the presence of these biases in individuals with BPD remains limited. Existing studies are marked by significant methodological shortcomings, including overreliance on self-report measures and the lack of clinical comparison groups. The present study examined JTC and BADE, using both objective and self-report measures, in individuals with BPD (N = 20), healthy controls (N = 20), and individuals with schizophrenia (N = 20). A serial disambiguation task and a multi-trial beads task were utilized as objective measures of BADE and JTC, respectively, while the Davos Assessment of Cognitive Biases Scale (DACOBS) served as the self-report measure. On the disambiguation task, individuals with BPD showed greater BADE than healthy controls but less than those with schizophrenia. On the beads task, 90% of the schizophrenia group and 65% of the BPD group exhibited JTC bias, compared to only 5% of the control group. There were no significant differences between the two clinical groups on JTC and draws to a decision. On the DACOBS, the BPD group reflected higher levels of belief inflexibility (a self-report index related to BADE) than healthy controls, but lower than those with schizophrenia. In contrast, on the jumping to conclusions scale, the BPD group did not differ from either the schizophrenia or the healthy control groups. Scores on self-report and objective measures did not correlate overall.
Maladaptive Perfectionism and Adolescent Nonsuicidal Self-Injury: A Longitudinal Moderated Mediation Model of Hopelessness and Self-Concept Clarity.
Gu H, Xiao Y, Ai X … +2 more , Fan M, Xia T
J Clin Psychol · 2026 Jun · PMID 42376892 · Publisher ↗
OBJECTIVE: The Benefits and Barriers Model of nonsuicidal self-injury (NSSI) suggests that individuals with maladaptive perfectionism may be prone to negative self-views when facing failure, which may be associated with...
OBJECTIVE: The Benefits and Barriers Model of nonsuicidal self-injury (NSSI) suggests that individuals with maladaptive perfectionism may be prone to negative self-views when facing failure, which may be associated with lowered psychological barriers to NSSI. Based on this framework, the present three-wave longitudinal study examined whether hopelessness mediated the association between maladaptive perfectionism and later NSSI, and whether this indirect association varied as a function of self-concept clarity. METHODS: A sample of 786 Chinese adolescents (51.8% girls; M = 13.27, SD = 0.74) participated in a three-wave longitudinal study with 6-month intervals. Maladaptive perfectionism and NSSI were assessed at baseline, hopelessness and self-concept clarity at the 6-month follow-up, and NSSI again at the 12-month follow-up. RESULTS: After controlling for gender, age, baseline hopelessness, and baseline NSSI, baseline maladaptive perfectionism was indirectly associated with NSSI at the 12-month follow-up through hopelessness at the 6-month follow-up. The hopelessness-later NSSI association varied by self-concept clarity and was weaker among adolescents with higher self-concept clarity. CONCLUSION: These findings suggest that hopelessness may be relevant to understanding later NSSI among adolescents, and that self-concept clarity may help identify variability in the strength of the hopelessness-later NSSI association. Any prevention or intervention implications involving self-concept clarity should be considered tentative until future longitudinal, experimental, or intervention research determines whether changes in self-concept clarity precede changes in NSSI risk or produce downstream improvements in self-injury-related outcomes.
Evaluating the Impact of Transcendental Meditation on Trauma Symptoms, Depression, Anxiety, and Sleep Problems Among Israeli Civilians Post-October 7, 2023: A Pilot Study.
Walter O, Nidich S, Shahrokhi K
J Clin Psychol · 2026 Jun · PMID 42371680 · Publisher ↗
OBJECTIVE: The mass evacuation of Israeli residents from conflict zones after the events of October 7, 2023, coupled with ongoing security threats, has taken a substantial psychological toll, with many individuals exhibi...
OBJECTIVE: The mass evacuation of Israeli residents from conflict zones after the events of October 7, 2023, coupled with ongoing security threats, has taken a substantial psychological toll, with many individuals exhibiting symptoms of post-traumatic stress disorder (PTSD), anxiety, and sleep problems. This pilot study examined the feasibility and preliminary within-group changes associated with participation in transcendental meditation (TM), a non-pharmacological program, in relation to PTSD symptoms, depression, anxiety, and sleep problems among 39 Israeli civilians evacuated after October 7. METHOD: In an 8-week intervention, we examined changes in psychological well-being using the PTSD Checklist for DSM-5 (PCL-5), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder scale (GAD-7), and Insomnia Severity Index (ISI). Changes in PTSD symptoms, depression symptoms, anxiety, and sleep problems were analyzed using dependent t-tests. Additional analyses of baseline, 4-week, and 8-week post-test data used repeated-measures analysis of variance. RESULTS: Participants showed statistically significant within-group decreases from baseline to post-test in PTSD symptoms, depression, anxiety, and sleep problems. CONCLUSION: Findings provide preliminary support for the feasibility and acceptability of TM in trauma-exposed civilians and suggest that participation in the program was associated with improvements in psychological symptoms over time. Given the uncontrolled pilot design, these results should be interpreted cautiously and require confirmation in randomized controlled trials.
Longitudinal Associations Between Emotional Abuse, Family Functioning, and Depressive Symptoms in Adolescence.
Calaresi D, Saladino V, Giordano F … +1 more , Verrastro V
J Clin Psychol · 2026 Jun · PMID 42330248 · Publisher ↗
Adolescence is a critical period for mental health, during which family dynamics and emotional experiences shape psychological well-being. Emotional abuse (EA) is associated with depressive symptoms (DS), yet its longitu...
Adolescence is a critical period for mental health, during which family dynamics and emotional experiences shape psychological well-being. Emotional abuse (EA) is associated with depressive symptoms (DS), yet its longitudinal processes remain unclear. This study examined longitudinal associations among EA, family functioning (FF), and DS in adolescents. A sample of 1887 Italian adolescents (Mage = 15.44, SD = 1.09) was recruited. Data were collected at baseline (T1), 6 months later (T2), and 12 months later (T3) to assess changes over time. Structural equation modeling was used to analyze bidirectional relationships and mediation effects. Results showed that emotional abuse at T1 and T2 was associated with poorer family functioning and higher depressive symptoms at later waves, whereas family functioning at T1 and T2 was associated with later depressive symptoms. No longitudinal effects were observed from family functioning to emotional abuse or from depressive symptoms to the other variables. Exploratory mediation analyses suggested indirect associations of T1 emotional abuse and family functioning with T3 depressive symptoms through T2 measures. These findings highlight a possible role of FF in the link between EA and DS, underscoring how dysfunctional family dynamics are related to higher levels of mental health challenges. These findings suggest that family relationships and communication may represent potentially relevant targets for future prevention and intervention research in adolescent mental health.
Familial Risk and Resilience Moderate the Association Between Intolerance of Uncertainty and Youth Suicidal Ideation.
House A, Toleson S, Jenkins KC … +4 more , Kreutzer K, Allan N, Phan KL, Gorka S
J Clin Psychol · 2026 Jun · PMID 42319955 · Publisher ↗
BACKGROUND: Intolerance of uncertainty (IU), defined as a trait-like tendency to respond to uncertain situations with negative cognitive, behavioral, and/or physiological reactions, is associated with increased risk for...
BACKGROUND: Intolerance of uncertainty (IU), defined as a trait-like tendency to respond to uncertain situations with negative cognitive, behavioral, and/or physiological reactions, is associated with increased risk for suicidal ideation (SI). Theory and research suggest that family-level risk and resilience factors may shape how vulnerability traits such as IU relate to SI; however, few studies have tested these associations. The current study therefore examined the unique and interactive effects of IU and familial risk and resilience factors on SI severity in youth. METHODS: A total of 184 individuals, ages 16-19, at elevated risk for escalation in alcohol use, completed self-report measures of IU and current SI severity. The Family Risk and Protective Factors questionnaire was used to create two composites: familial risk and familial resilience. A series of hierarchical linear regressions were used to test the study hypotheses. Biological sex, trauma exposure, and legal minor status were all included in the models as covariates. RESULTS: There were main effects of IU, familial risk, and resilience on SI. At high levels of familial risk, but not low levels, greater IU was associated with greater SI severity. Meanwhile at low levels of familial resilience, but not high levels, greater IU was associated with greater SI severity. CONCLUSIONS: Results revealed that the link between IU and SI is particularly robust in the context of low familial resilience and high familial risk. Targeting family-level factors may be one pathway for altering the negative mental health consequences associated with high IU.
Examining the Measurement and Validity of the Difficulties in Emotion Regulation Scale and Its Short Forms.
Faulkenberry RS, Hicks AD, Byllesby BM
J Clin Psychol · 2026 Jun · PMID 42304804 · Publisher ↗
Emotion regulation is a transdiagnostic development and maintenance factor for internalizing and externalizing psychopathology, and one popular measure of emotion dysregulation is the 36-item Difficulties in Emotion Regu...
Emotion regulation is a transdiagnostic development and maintenance factor for internalizing and externalizing psychopathology, and one popular measure of emotion dysregulation is the 36-item Difficulties in Emotion Regulation Scale (DERS). Due to psychometric issues and concerns with length, research with the DERS has produced multiple short forms of the scale. The present study, using a convenience sample of 618 college students with measures administered online, aimed to examine and compare all DERS versions to identify the best fitting model. Each of the five versions of the DERS was examined using a series of confirmatory factor analyses (CFA), including both correlated factors models and bifactor models, as appropriate. The bifactor DERS-18 model was determined to be the best fitting model, and it was retained for subsequent analyses. In keeping with similar studies, findings indicated that the awareness factor was not well defined. Next, the specific factors and the general factor of the DERS-18 were correlated with the scale scores of the MMPI-3 to examine the relationships with psychopathology. The specific factors, but not the general factor alone, were related to internalizing MMPI-3 scale scores; however, the DERS-18 factors had low or nonsignificant correlations with externalizing scales. Results suggested that in a large non-clinical sample, the DERS-18 was primarily associated with internalizing psychopathology at the latent level, so it may be more appropriate for use in assessing internalizing distress rather than associations with external behaviors.
Music Playlist Use in Clinical Trials of Psychedelic Assisted Psychotherapy: A Systematic Review.
Cruz L, Beserra FR, Freind JMK … +2 more , Rodrigues SE, Mograbi DC
J Clin Psychol · 2026 Jun · PMID 42296474 · Publisher ↗
Recent studies have shown promising results for psychedelics in the treatment of psychiatric disorders. Both in clinical and recreational settings, contextual elements, such as music, can influence the experience of user...
Recent studies have shown promising results for psychedelics in the treatment of psychiatric disorders. Both in clinical and recreational settings, contextual elements, such as music, can influence the experience of users and may be linked to positive outcomes. This systematic review identifies how music is being selected and used in psychedelisc-assisted psychotherapy (PAP). The search adopted PRISMA criteria and was conducted using PubMed, PsycNet, Web of Science, Scopus and Cochrane as databases. The use of music in PAP was compared, considering aspects such as the creation of a playlist, playlist features and characteristics of the setting. A total of 36 articles were found, with 25 articles mentioning the use of music, predominantly addressing depressive disorders and post-traumatic stress disorder using psilocybin and 3,4-methylenedioxymethamphetamine (MDMA). There was considerable variation in terms of procedures, mostly because studies explored different disorders and substances, but also because there was no standardized protocol regarding music. Understanding which aspects are being privileged when choosing music for use in PAP may orient future clinical and research efforts.
Role of Depression and Anxiety in Eating Disorder Symptomatology in Higher Levels of Care for Girls With Anorexia Nervosa.
Ghannadpour J, Dieste S, Buerkert S … +1 more , Stewart SM
J Clin Psychol · 2026 Jun · PMID 42263255 · Publisher ↗
OBJECTIVES: Although the prevalence of affective comorbidities with eating disorders (ED) has been well established, the three-way relation between ED, depression, and anxiety symptoms has not been explored in an intensi...
OBJECTIVES: Although the prevalence of affective comorbidities with eating disorders (ED) has been well established, the three-way relation between ED, depression, and anxiety symptoms has not been explored in an intensive adolescent treatment setting. METHODS: This study analyzed data from a sample of teenage girls with anorexia nervosa in higher levels of care (n = 457) to assess the relations between changes in ED symptoms, depression, and anxiety over the course of ED treatment. RESULTS: This study demonstrated that improvements in depression and anxiety are significantly associated with improvement in ED symptoms. CONCLUSION: Findings support the importance of routine assessments for depression and anxiety among adolescents with anorexia nervosa in higher levels of care and a transdiagnostic approach to treatment that addresses shared underlying mechanisms. Future research that aims to uncover mediators and moderators of these relations is warranted to enhance clinical efforts.
Sense of Coherence in the Perinatal Period: A Longitudinal Growth Mixture Modeling Analysis.
Perrykkad K, Watson S, Lewis AJ … +2 more , Van IJzendoorn M, Galbally M
J Clin Psychol · 2026 Jun · PMID 42250253 · Publisher ↗
OBJECTIVES: Previous studies have established that higher Sense of Coherence (SoC) predicts lower pregnancy-specific distress, fewer delivery complications, and increased birth satisfaction. However, less is known about...
OBJECTIVES: Previous studies have established that higher Sense of Coherence (SoC) predicts lower pregnancy-specific distress, fewer delivery complications, and increased birth satisfaction. However, less is known about how SoC typically changes over pregnancy, birth, and postnatally and the risk factors and protective factors contributing to SoC trajectory during the perinatal period. In this study, we aim to describe and predict common trajectories of SoC in the perinatal period. METHODS: 680 women in the Mercy Pregnancy and Emotional Wellbeing Study completed measures of SoC on four occasions across pregnancy and the postpartum. Predictors included history of childhood trauma, expectations and outcomes from birth and the postpartum, and postpartum social support. Depression was assessed by structured clinical interview in early pregnancy. Growth mixture modeling was used to classify participants into trajectories of SoC, and multinomial logistic regression models predicted class membership. RESULTS: Four trajectories were identified: (1) High (67%), (2) Low (21%), (3) Rising (8%), (4) Falling (3%). The strongest predictors of class were depression diagnosis, associated with Low and Rising trajectories, and a history of childhood trauma, associated with Low and Falling trajectories. CONCLUSION: Childhood trauma was thus predictive of a poor SoC at 12 months postpartum, suggesting that pregnancy and birth have a negative impact on women's resilience resources, whereas depression in early pregnancy is more predictive of poorer starting point of SoC. Targeted mental health support in the perinatal period may ensure individuals have adequate coping resources.
The Effect of Intolerance of Uncertainty on Indecisiveness in Anxiety and Obsessive-Compulsive Disorders.
Appel H, Mattes A, Gerlach AL
J Clin Psychol · 2026 Jun · PMID 42247665 · Publisher ↗
OBJECTIVES: Intolerance of uncertainty (IU) describes a dispositional aversion to uncertainty. Recent research has identified IU as a causal contributor to pervasive decision difficulties (indecisiveness). Given that IU...
OBJECTIVES: Intolerance of uncertainty (IU) describes a dispositional aversion to uncertainty. Recent research has identified IU as a causal contributor to pervasive decision difficulties (indecisiveness). Given that IU and indecisiveness occur across mental disorders, understanding whether IU's causal role in indecisiveness extends to clinical populations is critical. This study therefore tested the effect of IU on indecisiveness in a clinical sample. METHODS: In this pre-registered experiment, N = 154 individuals with formally diagnosed obsessive-compulsive and/or anxiety disorders were randomly assigned to a condition aimed at either increasing or decreasing IU. Subsequently, participants reported their current levels of (situational) IU and their indecisiveness regarding two personally relevant decisions. RESULTS: While the manipulation had no main effect on indecisiveness, it influenced situational IU levels, which were positively associated with indecisiveness. Mediation analysis indicated a significant indirect effect of the experimental condition on indecisiveness via situational IU. LIMITATIONS: Compared to preceding research, effect sizes were small and the effect of IU on indecisiveness only manifested itself indirectly. More robust interventions may be necessary to induce more pronounced changes in IU within clinical populations. The reliance on a heterogeneous sample with various diagnoses limits the disorder-specificity of the findings. CONCLUSIONS: These results tentatively extend the causal role of IU in indecisiveness to mental disorders. The findings suggest IU as a potential approach for addressing clinically relevant indecisiveness if future research corroborates the evidence.
Psychometric Evaluation of the Norwegian Difficulties in Emotion Regulation Scale in a Multi-Site Sample of Patients With Personality Disorders and Personality Problems.
Pedersen G, Hummelen B, Gulbrandsen S … +8 more , Leitemo K, Oftedal E, Tenebroso A, Morken KTE, Lindberget K, Ulvestad DA, Wilberg T, Kvarstein EH
J Clin Psychol · 2026 Jun · PMID 42247633 · Publisher ↗
OBJECTIVE: The validity and psychometric qualities of the Difficulties in Emotion Regulation Scale (DERS) in populations with a broader range of personality disorders (PDs) are still unclear. The aim of the current study...
OBJECTIVE: The validity and psychometric qualities of the Difficulties in Emotion Regulation Scale (DERS) in populations with a broader range of personality disorders (PDs) are still unclear. The aim of the current study was to analyze the factor structure and validity of DERS and two of its short-forms (DERS-SF and DERS-18), their relation to PD features and personality functioning, gender differences, and the overlap between concepts of alexithymia and emotion regulation. METHOD: Data were extracted from a multi-site clinical sample of patients with PDs or personality related problems referred to specialist mental health services (n = 2093). Confirmatory factor analyses (CFA)-specifically first-order correlated and bifactor analysis, as well as analysis of measurement invariance-were applied. Linear associations and group differences were investigated by correlational analysis and independent samples t-tests. DERS and its shortforms were validated through associations with PD features (PD criteria), measures of personality functioning (LPFS-BF), and alexithymia (TAS-20). RESULTS: CFA of the short forms revealed good model fit, while the full version of DERS showed poorer fit. None of the bifactor analyses supported a strong general factor. Gender differences were prominent, and substantial associations were found between DERS and PD criteria, LPFS-BF, and TAS-20. CONCLUSION: DERS and its short forms demonstrated acceptable reliability and validity in a sample of patients with PDs and personality related problems. Without support for a general factor, interpretation of the total scores of DERS should be conducted with care, especially if the subscales Awareness and Clarity are included. Given the advantages of the short forms, the selection of one version over another seems to be of limited consequence.
Development and Initial Validation of the Response to Suicidal Ideation Inventory (RSII).
Yeo SN, Stewart JG
J Clin Psychol · 2026 Jun · PMID 42246059 · Publisher ↗
OBJECTIVES: Young adults (18-29 years old) often report difficulties coping during suicide crises. However, the responses that young adults employ to manage suicidal ideation (SI) are underexplored. This study developed...
OBJECTIVES: Young adults (18-29 years old) often report difficulties coping during suicide crises. However, the responses that young adults employ to manage suicidal ideation (SI) are underexplored. This study developed a new measure to quantify how young adults with a history of suicidal thoughts and behaviors (STBs) respond to their SI, and conducted an initial evaluation of the measure's psychometric properties. METHODS: Using inductive and deductive approaches, we developed a preliminary item set (n = 79) for the Response to Suicide Ideation Inventory (RSII). Thereafter, 491 participants (M = 22.0, SD = 3.3, 18-29 years old), completed the RSII, as well as questionnaires assessing the RSII's content validity, general coping, emotion dysregulation, history of STBs, reasons for living, and future expectations of engaging in STBs. RESULTS: Results from an exploratory factor analysis indicated that a 43-item, seven-factor solution was an appropriate fit to the data. The RSII and its subscales showed acceptable reliability, as well as preliminary content validity. The RSII's subscales also demonstrated medium-sized positive correlations with measures of general coping, and weak associations with emotion dysregulation, suicide resilience, and expectations of future STBs. CONCLUSIONS: Our results point to some important directions for refining the RSII. Exploring the range and types of responses young adults engage in to manage their SI may improve our understanding of, and ability to predict, fluctuations in SI severity.
"Back to the Future": Testing the "Individual Problems and Strengths" Scale With a Stepwise Confirmatory Factor Analysis Approach.
Zahl-Olsen R, Gausel N, Håland ÅT … +1 more , Tilden T
J Clin Psychol · 2026 Jun · PMID 42244454 · Publisher ↗
Routine Outcome Monitoring systems have been developed to monitor how clients' lives change over the course of therapy. However, for such systems to be effective, they must possess sufficient construct validity and scale...
Routine Outcome Monitoring systems have been developed to monitor how clients' lives change over the course of therapy. However, for such systems to be effective, they must possess sufficient construct validity and scale-reliability to warrant their use. In this study, using a sample of 841 Norwegian clients, we performed the first independent test of the construct validity and scale-reliability of the "Individual Problems and Strengths" (IPS) scale, a subsection of the "Systemic Therapy Inventory of Change." We used a stepwise Confirmatory Factor Analysis approach specifically designed to test the construct validity of the measurement scales. We found satisfactory support for the construct validity of the original "8-factor" version of the IPS; however, its scale reliability received poor to mixed support. Furthermore, we failed to find support for all other previously or recently suggested factorial alternatives to the original 8-factor model. Our analysis leads us to conclude that the developers of the IPS should return "back to the future" by refining their original 8-factor structure of the IPS, while disregarding other proposed versions. TRIAL REGISTRATION: The data stems from an RCT study registered at ClinicalTrials.gov (NCT01873742) as well as from a prior pilot study (Tilden et al. 2015).
Commentary: Making Patient Data Count-Opportunities and Challenges for Open Science in Clinical Psychology.
Cwik JC, Cludius B, Bentz D … +13 more , Riehle M, Ehrenthal JC, Haberkamp A, Clamor A, Blackwell SE, Kämpf MS, Nazarenus E, Rahal RM, Möllmann A, Fink-Lamotte J, Burghardt J, Boehnke JR, Hilbert K
J Clin Psychol · 2026 Jun · PMID 42244393 · Publisher ↗
Open science practices-such as preregistration, data and material sharing, and open-access dissemination-are increasingly promoted across psychology, yet their specific value for clinical psychology has often been overlo...
Open science practices-such as preregistration, data and material sharing, and open-access dissemination-are increasingly promoted across psychology, yet their specific value for clinical psychology has often been overlooked. This commentary argues that open science is particularly crucial for clinical psychology, where studies rely on small, hard-to-recruit patient samples, ethically sensitive data, and complex psychotherapeutic interventions. However, applying open science practices in one's research can be challenging. And yet, it is becoming increasingly necessary to take a stance on this. To support our colleagues in clinical psychology to take a stance on open science practices and to motivate them to apply these practices in their research, we describe here how the use of open science practices benefits or can benefit clinical psychology science and practice and provide some perspective on why we believe that the increasing use of open science practices is consistent with good scientific practice and the ethical standards of our profession. In addition, we discuss how calls for increased implementation of open science practices in psychological research can be reconciled with some of the challenges, concerns, and conflicts that can arise around open science practices, especially in clinical psychology. Finally, we extend open science's inclusive and collaborative stance to include "experts by experience" in the research process. Including our research topics in the research process is a specific facet of the open science approach in clinical psychology that has been overlooked.
Predicting Change in Brief Treatment for BPD: The Role of Defensive Functioning and Pervasiveness in Relationship Patterns.
Yılmaz M, Grandjean L, Beuchat H … +5 more , Ranjbar S, de Roten Y, Felici C, Lingiardi V, Kramer U
J Clin Psychol · 2026 Jun · PMID 42228959 · Publisher ↗
BACKGROUND: Borderline personality disorder (BPD) is marked by unstable relationships and maladaptive defense mechanisms. This study examined whether defensive functioning and the pervasiveness of core conflictual relati...
BACKGROUND: Borderline personality disorder (BPD) is marked by unstable relationships and maladaptive defense mechanisms. This study examined whether defensive functioning and the pervasiveness of core conflictual relationship themes (CCRT) predict symptom change following 10-session General Psychiatric Management (GPM) versus Treatment as Usual (TAU) in patients with BPD. METHOD: Sixty patients with BPD (75% female, mean age 29.6) in a randomized controlled trial completed the Relationship Anecdote Paradigm at pretreatment. Interviews were coded using the Defense Mechanisms Rating Scale-Q-sort and the CCRT method. Symptom severity change was assessed using the Zanarini Rating Scale for BPD as post-pre score differences for total and subscale measures. Multiple linear regressions were used for analysis. RESULTS: Neither overall defensive functioning (ODF) (b = -1.59, p = 0.36) nor overall CCRT pervasiveness (OCP) (b = 2.10, p = 0.46) predicted change in borderline symptom severity. However, the interaction between OCP and treatment was significant for affective disturbance (b = 13.55, p = 0.03): patients with low OCP ( < 70%) improved more under GPM, while those with high OCP benefited more from TAU. In TAU, low OCP ( < 50%) was associated with worsening affective symptoms. CONCLUSIONS: Patients with BPD whose relational patterns were less pervasive and who primarily seek relief from affective distress may particularly benefit from GPM. The preliminary findings further suggest that heightened caution may be warranted when providing TAU to patients with low CCRT pervasiveness. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03717818.
An Ecological Momentary Assessment Study of the Influence of Psychic Pain on Suicidal Ideation and Planning.
Lewis KC, Cain NM, Meehan KB … +2 more , Roche MJ, Jobes DA
J Clin Psychol · 2026 May · PMID 42216800 · Publisher ↗
Psychic pain (PsyPn) refers to intense emotional suffering that is experienced as both unbearable and irreversible. PsyPn has been shown in cross-sectional studies to be associated with greater depression, distress, and...
Psychic pain (PsyPn) refers to intense emotional suffering that is experienced as both unbearable and irreversible. PsyPn has been shown in cross-sectional studies to be associated with greater depression, distress, and suicide risk. Although PsyPn is frequently discussed as a primary driver of suicide, few studies have evaluated its short-term predictive value for detecting changes in risk, and few have examined how PsyPn influences risk in interaction with other established factors, such as hopelessness. To address these gaps, the current study utilized ecological momentary assessment (EMA) to identify links between PsyPn, well-established psychosocial risk factors for suicide (hopelessness, loneliness, and burdensomeness), and the short-term emergence of suicidal ideation (SI) and planning. Thirty-nine adults across three clinical sites enrolled in the study after being identified during prescreen as being at elevated suicide risk. Subjects completed a baseline measure of vulnerability to PsyPn (Psychic Pain Scale), followed by an EMA protocol evaluating negative mental states, PsyPn, and SI and planning six times daily over a 14-day period. Multilevel modeling was used to estimate both within-and between-person associations between PsyPn, negative mental states, and SI and planning. Across suicide-related outcomes and timescales, PsyPn was associated with increased suicide risk, and greater PsyPn at both baseline and near-term levels amplified the influence of other daily living risk factors on suicide-related outcomes. The implications of these findings for suicide risk assessment and intervention are discussed, particularly in terms of informing specific targets and timescales of interventions.
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