Journal Of Clinical Psychology[JOURNAL]
Sun
200 papers
Using CBT-E in the Treatment of Anorexia Nervosa With Comorbid Obsessive-Compulsive Personality Disorder and Clinical Perfectionism.
Sand L, Shafran R
J Clin Psychol · 2025 Aug · PMID 40279666 · Full text
OBJECTIVE: Several studies and clinical vignettes emphasize the association between eating disorders and maladaptive personality traits that should be targeted in treatment to strengthen the therapeutic prognosis and out...
OBJECTIVE: Several studies and clinical vignettes emphasize the association between eating disorders and maladaptive personality traits that should be targeted in treatment to strengthen the therapeutic prognosis and outcome. The aim of this paper is to present a single case study with a patient showing comorbid Anorexia Nervosa (AN) and Obsessive-Compulsive Personality Disorder (OCPD) with perfectionistic traits, using Cognitive Behavioral Therapy for Eating disorders (CBT-E) and Perfectionism (CBT-P). METHODS: The patient, a young girl aged 17 years, was underweight when entering therapy and received an enhanced version of CBT-E with 40 sessions as recommended in the manual. The treatment was adjusted for adolescents with a heightened focus on motivation, therapeutic alliance, and parental involvement. The clinical interventions were structured in accordance with CBT-E for adolescents with six added sessions targeting clinical perfectionism based on CBT-P focusing on over-evaluation of achievements in addition to weight and shape. RESULTS: The patient showed a gradual decrease in eating disorder symptoms and perfectionism through the 1-year treatment. She was normal weight by the end of therapy, enjoyed varied food, was more socially engaged and balanced clinical perfectionism with more healthy strivings and standards. She was also able to express her need for boundaries and rest to family, friends and her sports team. At the final assessment, she did not fulfill diagnostic criteria for AN or OCPD with perfectionistic traits, but she showed some symptoms in achievement situations that was targeted by information and preventive interventions. CONCLUSION: In accordance with the manual for CBT-E, perfectionism should be targeted as part of the treatment for eating disorders when in the clinical range. This was done in the present case with AN and perfectionistic traits within a comorbid OCPD, using elements of CBT-P that showed positive results and meaningful changes for the patient.
«Scaringly Safe»: Therapeutic Processes in Longstanding Eating Disorders With Comorbid Avoidant Personality Disorders in the Recovered Case of Jade.
Eielsen HP, Vrabel K, Olofsson ME
J Clin Psychol · 2025 Aug · PMID 40267178 · Publisher ↗
Personality disorders (PD) are highly prevalent among patients with eating disorders (ED) and are often associated with unfavorable treatment outcomes. This may be due to poor engagement in therapy, interpersonal difficu...
Personality disorders (PD) are highly prevalent among patients with eating disorders (ED) and are often associated with unfavorable treatment outcomes. This may be due to poor engagement in therapy, interpersonal difficulties hampering the treatment alliance, and emotional instability overshadowing the ED symptoms. However, the patients' perspectives on these processes are understudied. To illustrate the potential of addressing personality vulnerabilities and relational issues in ED treatment, we present the case of Jade, a 29-year-old female with longstanding bulimia nervosa, major depressive disorder, and posttraumatic stress disorder following childhood maltreatment. Jade had been diagnosed with multiple PD such as paranoid, borderline, and avoidant PD, and at the time of treatment, she fulfilled the diagnostic criteria for the latter. Jade participated in a 12-week Cognitive Behavioral Therapy (CBT) inpatient program in a specialized ED unit. The treatment focused on the complex symptom interplay, specifically connecting early memories to current reactions, coping strategies, and relationship patterns. Jade normalized her eating patterns and trauma symptoms decreased. She highlighted being able to trust the staff and the treatment program as a prerequisite for ED improvement. Her narrative was triangulated with real-time self-report data examining ED symptoms (EDE-Q), interpersonal patterns (IIP-64), and trauma symptoms (PSS-SR) at assessment, admission, discharge, and 1-year follow-up. Jade was fully recovered from the ED at 1-year follow-up, however, the avoidant PD persisted. Considering the frequent ED-PD co-occurrence, the patient perspective may provide valuable insight to reduce long-term suffering by guiding tailored treatment approaches to improve outcomes for these difficult-to-treat patients. Trial Registration: NCT02649114.
"When Standard Treatments Are Not Enough" - Showcasing Schema Therapy for the Treatment of Anorexia Nervosa and Borderline Personality Disorder.
Hepworth NS, Simpson SG
J Clin Psychol · 2025 Aug · PMID 40265219 · Publisher ↗
Whilst standard cognitive and behavioural treatments lead to clinical improvement for approximately half of the people with eating disorders, preliminary evidence indicates that complex comorbidity, including personality...
Whilst standard cognitive and behavioural treatments lead to clinical improvement for approximately half of the people with eating disorders, preliminary evidence indicates that complex comorbidity, including personality difficulties, insecure attachment patterns and Posttraumatic stress disorder, may hinder treatment engagement and outcomes. Such comorbidities tend to be associated with increased emotional dysregulation, rigidity of beliefs, and dissociation. Schema Therapy is a transdiagnostic approach that interweaves the treatment of current eating disorder symptomatology and comorbid presentations through addressing early maladaptive schemas linked to unmet attachment needs and traumas. The goals are to promote integration, coherence, and resilience of self, whilst reducing reliance on the eating disorder as a means of self-regulation and substitute identity. In this case example, we follow a 27-year-old woman with an eating disorder (Anorexia Nervosa) and comorbid personality disorder (Borderline Personality Disorder), illustrating how Schema Therapy can effectively treat both conditions by healing the underlying schemas. This case study highlights the ways in which the therapeutic 'limited reparenting' approach is used to interweave cognitive, experiential, and behavioural techniques that address clients' chronically unmet emotional needs, and the importance of enhancing the individual's Healthy Adult mode to facilitate self-regulation and the client's capacity to effectively manage their own psychological needs in the future.
Metacognitive Interpersonal Therapy-Eating Disorder (MIT-ED) in the Case of a Woman With Binge Eating Disorder and Avoidant and Obsessive-Compulsive Personality Disorders.
Fioravanti G, Popolo R, Dimaggio G
J Clin Psychol · 2025 Aug · PMID 40253676 · Publisher ↗
Binge Eating Disorder (BED) needs more effective empirically supported treatments, given problems with attrition from and response to available options. One avenue to improve adherence and response is considering comorbi...
Binge Eating Disorder (BED) needs more effective empirically supported treatments, given problems with attrition from and response to available options. One avenue to improve adherence and response is considering comorbid personality disorders, given their impact on the therapy relationship and on patients' capacities to comply with homework, for example, regularizing eating habits or abstaining from bingeing. We describe here the case of a woman in her thirties suffering from BED, and avoidant and obsessive-compulsive personality disorders, treated with Metacognitive Interpersonal Therapy for Eating Disorders (MIT-ED), a psychotherapy that has begun to gather empirical support. Silvia is a 34 year old married woman with two children. She begins psychotherapy to lose weight but she oscillates between restriction and daily binges, in the last 2 years she has gained 30 kg. During 20 sessions of MIT-ED Silvia realized that she tended to binge because she thought she was unworthy and unable to put boundaries to her mother's criticism and intrusions. The therapist helped her realize that following psychoeducation about eating made her feeling controlled, and that was the reason for initial noncompliance with behavioral tasks. During the therapy she formed more adaptive ideas of herself as worthy and autonomous and become able to put boundaries to her mother. At the end of the therapy, Silvia no longer suffered from BED as evident from Eating Disorder Examination Questionnaire (Fairburn and Beglin 2008) and from the Binge Eating Scale (Gormally et al. 1982). Implications for further application of MIT-ED across ED are discussed.
Treating Patients With Comorbid Eating Disorders and Personality Disorders: A Rationale.
Fioravanti G, Dimaggio G, Sand L
J Clin Psychol · 2025 Aug · PMID 40253619 · Publisher ↗
Eating disorders (ED) have heightened risk for both psychiatric and medical complications, and they require more effective psychological interventions, in light of evidence saying that treatment response is often incompl...
Eating disorders (ED) have heightened risk for both psychiatric and medical complications, and they require more effective psychological interventions, in light of evidence saying that treatment response is often incomplete, and attrition is significant. One possible avenue to improve treatment effectiveness is address the frequent co-occurrence with personality disorders (PD). When persons suffer from both ED and PD they would present with complex manifestations and serious interpersonal problems. In parallel, their capacity to form a solid working alliance can be limited. They are likely to have difficulty trusting clinicians and engaging in the necessary work needed to counteract their maladaptive ideas about food, weight and body image, and to change their problematic eating habits. This introduction of the issue of the Journal of Clinical Psychology: In Session devoted to treating patients with comorbid ED and PD describe the rationale for why it is necessary to assess and treat PD symptoms integrated with appropriate ED focused treatment.
Age Disparities in the Association Between Leisure-Time Physical Activity and Depression Among American Adults.
Yang J, Zheng X, Wang Y … +2 more , Wang H, Song G
J Clin Psychol · 2025 Aug · PMID 40253596 · Publisher ↗
BACKGROUND: This study aims to investigate the association between leisure-time physical activity (LTPA), age, and depressive symptoms. METHODS: We included and analyzed data from 18,052 participants (age ≥ 20 years) fro...
BACKGROUND: This study aims to investigate the association between leisure-time physical activity (LTPA), age, and depressive symptoms. METHODS: We included and analyzed data from 18,052 participants (age ≥ 20 years) from the cross-sectional National Health and Nutrition Examination Survey (NHANES) (2007-2014). Multivariable logistic regression was employed to assess the independent associations between physical activity and household income with depressive symptoms. Restricted cubic spline plots were utilized to analyze the non-linear relationship between LTPA and depression. RESULTS: Among the 18,052 participants, 1,676 (9.28%) were defined as having depressive symptoms. We found: 1. Age exhibits a non-linear relationship with depression, with a turning point around 40 years. 2. Compared to those with no LTPA, individuals with higher levels of LTPA (Q3) in both younger and older age groups experienced the lowest risk of depression, with risk reductions of 53% (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.33-0.67) and 74% (OR 0.26, 95% CI 0.14-0.50), respectively. Conversely, in the middle-aged group, those with the highest level of LTPA (Q4) experienced the greatest reduction in depression risk, by 67% (OR 0.33, 95% CI 0.21-0.53). 3. A U-shaped relationship between LTPA and depression risk was observed in younger and older age groups. CONCLUSION: The risk of depression peaks around the age of 40 in adults. For middle-aged individuals, greater engagement in LTPA is associated with reduced depression risk. Conversely, higher levels of LTPA in younger and older adults may not confer additional protective effects.
Self-Ambivalence Is Indirectly Associated With Obsessive-Compulsive and Eating Disorder Symptoms Through Different Feared Self-Themes.
Wilson S, Mesli N, Mehak A … +1 more , Racine SE
J Clin Psychol · 2025 Jul · PMID 40227164 · Full text
OBJECTIVES: Uncertainty regarding the self and fear of self have been independently identified as relevant to both obsessive-compulsive disorder (OCD) and eating disorders (EDs). The present study aimed to examine self-a...
OBJECTIVES: Uncertainty regarding the self and fear of self have been independently identified as relevant to both obsessive-compulsive disorder (OCD) and eating disorders (EDs). The present study aimed to examine self-ambivalence (an indicator of uncertainty regarding the self often characterized by conflicting self-beliefs) as a potential transdiagnostic factor associated with both OCD and EDs and to determine whether differences in the thematic content of the feared self may be linked to the experience of symptoms of one disorder over another despite common co-occurrence and shared processes. METHODS: Undergraduate and community women (N = 138) completed a battery of questionnaires, which included measures of self-ambivalence, fear of self (assessing three feared self-themes: feared corrupted self, feared culpable self, and feared unattractive self), and OCD and ED symptoms. RESULTS: A path analysis revealed that self-ambivalence was directly associated with OCD and ED symptoms. Self-ambivalence was also indirectly associated with OCD symptoms via the feared corrupted self and with ED symptoms via the feared unattractive self. There was no indirect path through the feared culpable self. CONCLUSION: Self-ambivalence warrants additional investigation as a factor associated with multiple forms of psychopathology, representing a potentially valuable target for both intervention and prevention efforts. Differences in the content of the feared self may contribute to our understanding of divergent trajectories (why one individual may develop an ED while another develops OCD). Overall, research of this kind contributes to the development and improvement of transdiagnostic models of psychopathology integrating the self.
Exposure and Response Prevention in OCD: A Framework to Capitalize Change.
Faustino D, Gonçalves MM, Braga R … +2 more , Faria MJ, Oliveira JT
J Clin Psychol · 2025 Jul · PMID 40215475 · Publisher ↗
Exposure and response prevention (ERP) constitutes the first-line treatment for obsessive-compulsive disorder (OCD). Despite robust empirical evidence supporting its efficacy, ERP has challenges, including high attrition...
Exposure and response prevention (ERP) constitutes the first-line treatment for obsessive-compulsive disorder (OCD). Despite robust empirical evidence supporting its efficacy, ERP has challenges, including high attrition rates and difficulty sustaining engagement. Research suggests that focusing on clients' strengths while addressing their difficulties can enhance therapy effectiveness. The present article details the case of a young adult with OCD characterized by sexual obsessions and mental compulsions, who initially underwent 12 sessions of cognitive-behavioral therapy (CBT) with limited progress. A subsequent transition to ERP throughout nine sessions resulted in positive treatment outcomes. The article illustrates how ERP may be coupled with a framework that capitalizes change using Innovative Moments (IMs)-changes in clients' discourse that reflect progress in therapy as manifested by new and adaptive ways of acting, feeling, or thinking. Therapists can be attentive, detect, and explore these moments to expand and promote further change. By attuning to and reinforcing IMs during ERP, the therapist assisted the client in disengaging from compulsions, increasing exposure tolerance, and consolidating therapeutic gains. This case underscores a practical strategy for clinicians: therapists can leverage naturally occurring change markers to enhance motivation and deepen learning in ERP rather than solely correcting dysfunctional patterns. The recognition and expansion of IMs have the potential to assist clients in maintaining engagement, tolerating distress, and cultivating more flexible responses to intrusive thoughts, which are all pivotal factors in the effective treatment of OCD.
The Therapeutic Community Integrated With a DBT Skills Training Program for Substance Use Disorders: The Initial Efficacy for the Treatment of Impulsivity and Related Dimensions.
Cavicchioli M, Mambreani J, Conti G … +3 more , Mazoli S, Galli F, Begarani M
J Clin Psychol · 2025 Jul · PMID 40215471 · Publisher ↗
OBJECTIVES: This study aims at investigating the initial efficacy of a 6-month therapeutic community (TC) intervention integrated with a standard Dialectical Behavior Therapy Skills Training (DBT-ST) program (DBT-ST-TC)...
OBJECTIVES: This study aims at investigating the initial efficacy of a 6-month therapeutic community (TC) intervention integrated with a standard Dialectical Behavior Therapy Skills Training (DBT-ST) program (DBT-ST-TC) for treating impulsivity among patients with SUDs. METHODS: Impulsivity was assessed through self-report (UPPS-P) and neuropsychological (Attentional Network Test [ANT]-conflict monitoring, Go/No-Go, Iowa Gambling Task) measures. Furthermore, mindfulness (FFMQ, MAAS) emotion dysregulation (DERS) and distress tolerance (DTS) were evaluated. Intention-to-treat analysis was performed to evaluate pre- post-treatment changes controlling for baseline levels. Pre- and post-treatment results of the DBT-ST-TC group were also compared to baseline levels of variables of interest measured in two control groups (i.e., untreated outpatient with SUDs; healthy controls [HCs]). RESULTS: Sixty-eight patients with SUDs were screened and admitted to the DBT-ST-TC. Thirty-eight (55.9%) patients completed the first cycle of DBT-ST-TC. The clinical control group included 41 untreated individuals with SUDs. The HC group was composed of 53 participants. DBT-ST-TC patients reported pre- post-treatment improvements of emotion dysregulation (t = -2.10; p = 0.04), positive urgency (t = -3.27; p = 0.002) and sensation seeking (t = -2.08; p = 0.04). The improvement of ANT-conflict monitoring performances was the most relevant pre- posttreatment change (t = -2.98; p = 0.005): no significant differences between posttreatment performances of the DBT-ST-TC group and HCs were detected. CONCLUSION: The DBT-ST-TC might be a promising intervention for treating patients with SUDs. Future long-term outcomes are needed to corroborate and extend these provisional results.
Client Attraction to Therapists - A Mixed Methods Study of Therapist Experiences.
Rabasco A, Jessup SC, Mariaskin A … +1 more , McKay D
J Clin Psychol · 2025 Jul · PMID 40183174 · Publisher ↗
OBJECTIVES: There is a paucity of qualitative and quantitative work exploring characteristics of client attraction towards therapists (CATT) and strategies for handling those situations. The present study aimed to explor...
OBJECTIVES: There is a paucity of qualitative and quantitative work exploring characteristics of client attraction towards therapists (CATT) and strategies for handling those situations. The present study aimed to explore CATT using mixed methods, including providing updated rates of client attraction in the therapeutic relationship and examining characteristics of CATT. METHODS: A sample of 204 therapists (74% female; M = 36.74) completed an online survey with multiple-choice and open-ended questions on therapist demographics and experiences with clients endorsing attraction (including client disclosure, therapist emotional reaction, strategies for addressing, conceptualization, and supervision). 77% of respondents reported a cognitive-behavioral (CBT) theoretical orientation. RESULTS: 54% (n = 111) of respondents had a client express CATT, and anxiety was the most commonly reported emotional reaction. Qualitative results suggested that CATT was complex and multifaceted, that therapist and client identities played a key role in CATT, and that therapists often feel uncomfortable and/or unequipped to manage the situation. Therapist respondents reported using a variety of strategies to address the disclosure (e.g., normalization, setting boundaries). Supervision was reported to be useful, but at times insufficient. CONCLUSION: The present research showed that CATT was a common clinical experience; yet therapists often feel anxious or unequipped to manage the situation. This study highlights the importance of clinical training on managing client attraction, especially from a CBT perspective. Directions for future research include further exploration of the intersection of client and therapist cultural and identity factors in the development and characteristics of CATT.
Mechanisms of Action of Combination Motivational Interviewing-Cognitive Behavior Therapy for Reversing Medication Non-Adherence in Patients With Multiple Sclerosis.
Schoor R, Bruce JM, Staggs VS … +4 more , Fox AT, Bruce A, Lynch S, Catley D
J Clin Psychol · 2025 Jul · PMID 40176571 · Publisher ↗
OBJECTIVE: Despite disease modifying therapies' (DMT) demonstrated efficacy for treating relapsing MS, around 40% of patients discontinue use. This study aimed to understand the mechanism of action of Motivational Interv...
OBJECTIVE: Despite disease modifying therapies' (DMT) demonstrated efficacy for treating relapsing MS, around 40% of patients discontinue use. This study aimed to understand the mechanism of action of Motivational Interviewing plus cognitive behavioral therapy (MI-CBT) in a previously conducted randomized controlled trial in which the MI-CBT intervention successfully promoted DMT re-initiation of participants compared to a treatment as usual (TAU) condition. METHODS: This secondary analysis (N = 91) explored changes in motivation (a single item motivation "ruler" [Mot∆], and the Brief Motivation Scale [BMS∆]), autonomous motivation (AR∆), personal control (PC∆), treatment control (TC∆), and confidence to reinitiate (Con∆) as potential mediators of the treatment effect, using logistic regression. RESULTS: Logistic regression analysis including all potential mediators as predictors of initiation indicated the BMS∆ was the only statistically significant predictor (OR = 1.61, p = 0.010). When BMS∆ was removed Mot∆ (OR = 1.22, p = 0.002) and PC∆ (OR = 1.67, p = 0.002) were statistically significant predictors of initiation. CONCLUSION: The MI-CBT intervention appeared to work primarily by increasing motivation to initiate DMT.
Test Anxiety and Trait Anxiety in Adolescence: Same or Different Structures?
Liu P, Bai S, Li M … +1 more , Zhou R
J Clin Psychol · 2025 Jul · PMID 40176481 · Publisher ↗
OBJECTIVES: Test anxiety is positively correlated with trait anxiety. However, the precise relationship between the two is not clear. Are they two independent constructs that share a high degree of comorbidity, or the sa...
OBJECTIVES: Test anxiety is positively correlated with trait anxiety. However, the precise relationship between the two is not clear. Are they two independent constructs that share a high degree of comorbidity, or the same construct manifesting in different situations (e.g., test anxiety as a special type of trait anxiety)? METHODS: The present study employed two advanced analysis tools (latent profile analysis and network analysis) to evaluate the connectivity pattern between test anxiety and trait anxiety in a sample of adolescent students (N = 475, Mean age = 13.49). RESULTS: The latent profile analysis revealed that all participants could be classified into three groups (low-risk, moderate-risk, and high-risk) based on their scores on two scales measuring test anxiety and trait anxiety, indicating a high degree of comorbidity between test and trait anxiety. The network analysis found that test anxiety and trait anxiety formed two relatively distinct communities, suggesting that they are two independent structures. CONCLUSIONS: Together, this study provides a novel insight into the structural relationship between test anxiety and trait anxiety, indicating that while they are distinct constructs, they frequently coexist. The clinical implications for our understanding of the etiology, diagnosis and treatment of test and trait anxiety are discussed.
The Unique Associations of Thin-Ideal Internalization and Internalized Weight Stigma With Body Dissatisfaction Across Body Sizes.
Harris ER, Hahn SL, Jean Forney K
J Clin Psychol · 2025 Jul · PMID 40138659 · Full text
OBJECTIVES: The internalization of socioculturally influenced body ideals, including thin-ideal internalization and internalized weight stigma, is consistently associated with body dissatisfaction. However, the independe...
OBJECTIVES: The internalization of socioculturally influenced body ideals, including thin-ideal internalization and internalized weight stigma, is consistently associated with body dissatisfaction. However, the independent contributions of thin-ideal internalization and internalized weight stigma to body dissatisfaction and the extent to which these two body ideals are distinct are unknown. The current study examined whether internalized weight stigma contributes to body dissatisfaction above and beyond the effects of thin-ideal internalization. To further investigate the independence of these two cultural processes, the current study also tested if body size moderates the association between thin-ideal internalization and internalized weight stigma. METHODS: Data come from 430 university students (80.7% female, 87.7% white) who completed surveys for partial course credit. RESULTS: Both thin-ideal internalization (β = 0.202, p < 0.001) and internalized weight stigma (β = 0.638, p < 0.001) were associated with body dissatisfaction in a mutually adjusted regression model. However, the association between thin-ideal internalization and internalized weight stigma did not differ by body size (β = 0.054, p = 0.79). CONCLUSIONS: Thin-ideal internalization and internalized weight stigma are independent correlates of body dissatisfaction, regardless of weight status. As distinct constructs, both thin-ideal internalization and internalized weight stigma should be targeted in the prevention and treatment of body dissatisfaction.
Internalized Stigma Is a Predictor of Mental Health Secrecy and Loneliness in Young People With Clinical Depression Symptoms: A Longitudinal Study.
Prizeman K, McCabe C, Weinstein N
J Clin Psychol · 2025 Jul · PMID 40138634 · Full text
Young people with depression experience loneliness and internalized stigma. Stigma might make disclosing depression to others difficult, thus increasing loneliness and reducing the opportunity for treatment. Knowing whet...
Young people with depression experience loneliness and internalized stigma. Stigma might make disclosing depression to others difficult, thus increasing loneliness and reducing the opportunity for treatment. Knowing whether internalized stigma predicts loneliness and secrecy reinforces the need for stigma reduction efforts. The aim of this research was to examine the independent effects of internalized stigma and clinical depression on loneliness and mental health secrecy in young people with a range of depressive symptoms (Mood and Feelings Questionnaire score ≥ 27). A total of 275 young people (M = 20.53, SD = 2.17) were recruited and completed the Internalized Stigma of Mental Illness Inventory, the 5-Item Link's Secrecy Scale, and the UCLA Loneliness Scale at baseline and again at 1-month follow-up (N = 172, M = 20.40, SD = 2.00). Results showed that internalized stigma was associated with baseline loneliness (β = 0.57, 95% CI: 7.87-11.75, p < 0.001), baseline secrecy (β = 0.40, 95% CI: 0.23-0.45, p < 0.001), and secrecy over time (β = 0.20, 95% CI: 0.04-0.30, p = 0.009). This work highlights the need to develop targeted interventions to reduce stigma and encourage mental health disclosure and help-seeking behaviors among young people with depression.
The Intrinsic Association of Posttraumatic Stress Symptoms Among Chinese Police Officers During COVID-19: Evidence From Network Perspective.
Jin J, An Y, Li X … +1 more , An D
J Clin Psychol · 2025 Jun · PMID 40130821 · Publisher ↗
BACKGROUND: The current study aimed to identify the core posttraumatic stress symptoms (PTSS) and to explore the longitudinal predictive relationships of these symptoms among Chinese police officers during COVID-19. Iden...
BACKGROUND: The current study aimed to identify the core posttraumatic stress symptoms (PTSS) and to explore the longitudinal predictive relationships of these symptoms among Chinese police officers during COVID-19. Identifying the important symptoms of PTSS could help with informing future research to alleviate police officers' psychological problems. METHODS: In this study, a two-wave on-line investigation (4 months interval; T1 and T2) was conducted with a sample of 891 Chinese police officers who completed the Chinese version of PTSD Checklist for DSM-5 (PCL-5). Cross-sectional network and cross-lagged panel network (CLPN) analyses were adopted. RESULTS: The results showed that: (1) The most central nodes all belonged to the hyper-arousal and the negative cognition and emotion alteration clusters in both T1 and T2. (2) The strongest positive predictive paths were apparent from symptoms in hyper-arousal cluster to symptoms in negative cognition and emotion alteration cluster and intrusions cluster. CONCLUSIONS: Hyperarousal is the core symptom cluster among police officers during COVID-19, and it positively predict negative cognition and emotion alteration symptoms and intrusions symptoms over time. Future research could focus more on these symptoms and examine their role in the onset and development of PTSS in police officers following traumatic events.
Identification of Borderline Personality Disorder in Adolescents: Psychometric Properties and Diagnostic Efficiency of a Juvenile Version of the Impulsivity and Emotion Dysregulation Scale (IES-27-J).
Brede M, Dippold B, Bender S … +2 more , Kröger C, Krischer M
J Clin Psychol · 2025 Jul · PMID 40130807 · Full text
OBJECTIVE: The diagnostic efficiency of screening instruments for adolescents with Borderline Personality Disorder (BPD)-that are applicable to its new classification in DSM-5 and ICD-11-has not yet been sufficiently stu...
OBJECTIVE: The diagnostic efficiency of screening instruments for adolescents with Borderline Personality Disorder (BPD)-that are applicable to its new classification in DSM-5 and ICD-11-has not yet been sufficiently studied. METHODS: We examined the reliability and diagnostic efficiency of the juvenile version of the Impulsivity and Emotion Dysregulation Scale (IES-27-J) in a German-speaking sample of inpatient 12-19-year-old adolescents (N = 220, including n = 88 with BPD and n = 132 with other mental disorders). Using a receiver operating characteristic (ROC) analysis, optimal cutoff values were determined for this self-report instrument. Analyses were conducted for two different diagnostic thresholds with at least four and five BPD diagnostic criteria, respectively, in accordance with the semi-structured clinical interview International Personality Disorder Examination (IPDE). RESULTS: Results indicate that the IES-27-J is a reliable and valid instrument with moderate to high discriminative ability (areas under the curve [AUC] = 0.77 and 0.80, respectively). Using the preferred cutoff values, sensitivity (71% and 83%) and specificity (76% and 67%) turned out to be moderate. CONCLUSION: The application of the IES-27-J can be considered favorable in a two-stage approach, using a lower cutoff value in a first step to miss fewer patients with BPD, and conducting a clinical interview in a second step to confirm the diagnosis. More studies in different settings, including direct comparisons with other screening instruments, are necessary to further assess the clinical utility of the IES-27-J.
Enhancing Body Image in Chronic Pain: A Case Study Utilizing Virtual Reality.
Navarro Moreno V, Herrero R, Zamora Á … +2 more , Miragall M, Baños RM
J Clin Psychol · 2025 Jun · PMID 40119646 · Publisher ↗
OBJECTIVE: This case study aims to provide data regarding the acceptability of CLEVER, a positive body image-based intervention supported by the use of virtual reality to improve body image and other pain-related variabl...
OBJECTIVE: This case study aims to provide data regarding the acceptability of CLEVER, a positive body image-based intervention supported by the use of virtual reality to improve body image and other pain-related variables in people with chronic low back pain. METHOD: The intervention consists of four sessions: Psychoeducation about pain and its impact on the body, Body Awareness, Acceptance of the body with pain, and Appreciation and gratitude toward the body. A daily monitoring and an interview were conducted to assess the intervention. RESULTS: John (fictitious name) is a 48-year-old man who has been suffering from low back pain for 5 years as a result of an accident at work. Before starting the intervention, the patient presented a considerable level of kinesiophobia, fear of pain, and emotional distress and he also reported body image problems due to pain. After the intervention, data showed a moderate effect on pain interference, kinesiophobia, a reduction of emotional distress and a questionable effect on pain catastrophizing and pain intensity. Regarding Positive Body Image variables, results showed a moderate improvement in Appreciation of Body Functionality and a questionable effect on Pain Acceptance and Body Awareness. The patient also showed good adherence to the treatment and good acceptability of the intervention and the virtual environments. CONCLUSIONS: CLEVER-BODY is the first positive body image-based intervention using Virtual Reality that has shown improvements in variables related to pain and body image. Nonetheless, further studies will be necessary to evaluate the effectiveness of the intervention in a larger sample.
Deliberate Practice Supervision in Action: The Sentio Supervision Model.
Brand J, Miller-Bottome M, Vaz A … +1 more , Rousmaniere T
J Clin Psychol · 2025 Jun · PMID 40110761 · Publisher ↗
Deliberate Practice (DP) is gaining consensus by researchers as a potentially promising method to increase therapist's effectiveness. While many clinicians and trainers now support DP's potential benefits, there is still...
Deliberate Practice (DP) is gaining consensus by researchers as a potentially promising method to increase therapist's effectiveness. While many clinicians and trainers now support DP's potential benefits, there is still a lack of guidelines, research, and training on implementing DP in clinical supervision. Recently, Vaz and Rousmaniere have proposed the Sentio Supervision Model as a method to integrate three major supervision-enhancing contributions: the use of routine outcome monitoring, the use of therapy recordings, and the use of DP skills training. We present a case study focusing on one client's treatment progress and their therapist's engagement in weekly supervision following the Sentio Supervision Model. The client had been identified by the outcome measure as being at risk of deterioration, and after DP supervision showed recovery and became on track for a good treatment outcome. Annotated transcripts provide a closer look into the clinical and supervisory process and how the latter influenced the former. We highlight the potential benefits and challenges inherent to this novel Supervision Model.
Mentalizing Oneself and Others in Anorexia Nervosa: From Subjective Evaluation to Performance.
Auger E, Nandrino JL, Doba K
J Clin Psychol · 2025 Jul · PMID 40106173 · Full text
OBJECTIVE: The present study examined impairment in two main dimensions of mentalizing (self-other and emotional-cognitive) in patients with anorexia nervosa (AN) by combining self-reported measures with performance-base...
OBJECTIVE: The present study examined impairment in two main dimensions of mentalizing (self-other and emotional-cognitive) in patients with anorexia nervosa (AN) by combining self-reported measures with performance-based tasks. METHOD: Forty-five patients with AN recruited from an eating disorder unit and 45 healthy controls (HCs) recruited from the general population completed the Mentalization Scale and the Movie for Assessment of Social Cognition. RESULTS: The results revealed that in self-reported evaluations of their mentalization process, patients with AN hypo-mentalized about themselves and others' mental states. However, they used more hyper-mentalizing than HCs when mentalizing others' emotional and cognitive mental states in performance-based tasks. Finally, the severity of eating symptoms in patients with AN was associated with higher levels of perceived hypo-mentalizing about their own mental states and lower levels of perceived hypo-mentalizing of others' mental states. No associations were found between the severity of eating symptoms and mentalizing performance. CONCLUSIONS: This study emphasizes the importance of mentalizing impairment in patients with AN, which should be considered via a multidimensional approach that considers both emotional and cognitive dimensions and the ability to assess patients' competences.
Alexithymia in Schizophrenia and Psychosis Vulnerability: A Systematic Review and Meta-Analysis.
Ozdemir E, Xiao Z, Griffiths H … +1 more , MacBeth A
J Clin Psychol · 2025 Jun · PMID 40105143 · Full text
AIMS: Disturbances involving impairments in experience and expression of affect are frequently identified in schizophrenia samples. Alexithymia underlies cognitive impairments in identification and expression of affect,...
AIMS: Disturbances involving impairments in experience and expression of affect are frequently identified in schizophrenia samples. Alexithymia underlies cognitive impairments in identification and expression of affect, further implicated in affect dysregulation. The current review aimed to systematically review the literature and estimate the strength of associations between alexithymia and schizophrenia phenomenology. METHOD: A systematic review and meta-analysis identified 67 studies involving measures of alexithymia in psychosis. All studies were assessed for quality and publication bias. Overall, data from 47 studies were suitable for meta-analysis. RESULTS: Alexithymia and schizophrenia were consistently positively associated with a large effect size (k = 11). Compared to control groups, a schizophrenia diagnosis was positively associated with large magnitude effects for difficulties in identifying feelings (k = 18) and moderate effect sizes for difficulties in describing feelings (k = 17) and externally oriented thinking (k = 11). Data from community samples indicated moderate associations between subclinical negative symptoms and difficulties in identifying and describing feelings (k = 4) and a small association between positive symptoms and difficulties in identifying feelings (k = 5). CONCLUSIONS: Alexithymia and schizophrenia are strongly associated. However, methodological issues limit the establishment of directionality in these associations. The majority of studies use cross-sectional designs reliant on self-report assessments which may result in over-estimation of the reported effect sizes. Future research could conceptualize alexithymia as a stress-reactive multidimensional construct, and modeling dynamic relationships between alexithymia, psychological distress, and schizophrenia phenomenology should incorporate confounders such as gender, age, and neurocognition.
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