The effect of body dissatisfaction on disordered eating: The mediating role of self-esteem and negative affect in male and female adolescents

This study aimed to determine whether self-esteem and negative affect sequentially mediate the relationship between body dissatisfaction and disordered eating. A total of 806 adolescents (61.8% females) completed the Drive for Thinness, Bulimia, and Body Dissatisfaction subscales of the Eating Disorder Inventory-2, the Anxiety and Depression subscales of the General Health Questionnaire-28, and the Negative Self-beliefs subscale of the Eating Disorder Belief Questionnaire. Mediational analyses showed that body dissatisfaction had both direct and indirect effects through self-esteem and negative affect on disordered eating. It was also observed that negative self-esteem mediated-completely in boys and partially in girls-the relationship between body dissatisfaction and negative affect.

The effect of body dissatisfaction on disordered eating: The mediating role of self-esteem and negative affect in male and female adolescents

This study aimed to determine whether self-esteem and negative affect sequentially mediate the relationship between body dissatisfaction and disordered eating. A total of 806 adolescents (61.8% females) completed the Drive for Thinness, Bulimia, and Body Dissatisfaction subscales of the Eating Disorder Inventory-2, the Anxiety and Depression subscales of the General Health Questionnaire-28, and the Negative Self-beliefs subscale of the Eating Disorder Belief Questionnaire. Mediational analyses showed that body dissatisfaction had both direct and indirect effects through self-esteem and negative affect on disordered eating. It was also observed that negative self-esteem mediated-completely in boys and partially in girls-the relationship between body dissatisfaction and negative affect.

Current psychological therapeutic approaches for gambling disorder with psychiatric comorbidities: A narrative review

Background. Although the presence of a gambling disorder (GD) together with another mental disorder poses special treatment challenges, such as relapses, severe outcomes for patients and families, and increased number of hospitalizations, there are only a few critical reviews in the literature. Objective. To review empirical evidence of psychological approaches to cope specifically with these dual disorders. Method. A narrative review of the relevant bibliography on this topic was carried out. A systematic search of original articles (2010-October 2017) was conducted in MEDLINE and PsycInfo. Key terms were: 1. gambling/gamblers, 2. treatment/intervention/therapy/therapeutics, and 3. dual diagnosis/comorbidity. Results. Current treatment for GD involves a number of different options, including inpatient treatments, intensive outpatient therapy, individual and group cognitive-behavioral options (CBT), self-help groups, and pharmacotherapy. Inpatient care is generally limited to patients with severe acute crises, treatment failures, and severe comorbid disorders, particularly depression and attempted suicide. Treatment for GD with other mental disorder needs more research. CBT, motivational enhancement therapy and self-help groups have some empirical support when GD is comorbid with other addiction, mood disorder, or schizophrenia. Programs that combine pharmacotherapy and psychosocial treatments for GD into a single comprehensive package are most likely to have good treatment outcomes, at least with regard to treatment retention. Discussion and conclusion. Interventions should be tailored to the needs of the patients. Future research should be concerned about the statistical power of the studies, implement motivational strategies for patients with poor medication adherence, and design measures to study treatment fidelity in the CBT groups.

Comparison of methods for dealing with missing values in the EPV-R

BACKGROUND

The development of an effective instrument to assess the risk of partner violence is a topic of great social relevance. This study evaluates the scale of “Predicción del Riesgo de Violencia Grave Contra la Pareja” –Revisada– (EPV-R - Severe Intimate Partner Violence Risk Prediction Scale-Revised), a tool developed in Spain, which is facing the problem of how to treat the high rate of missing values, as is usual in this type of scale.

METHOD

First, responses to the EPV-R in a sample of 1215 male abusers who were reported to the police were used to analyze the patterns of occurrence of missing values, as well as the factor structure. Second, we analyzed the performance of various imputation methods using simulated data that emulates the missing data mechanism found in the empirical database.

RESULTS

The imputation procedure originally proposed by the authors of the scale provides acceptable results, although the application of a method based on the Item Response Theory could provide greater accuracy and offers some additional advantages.

CONCLUSIONS

Item Response Theory appears to be a useful tool for imputing missing data in this type of questionnaire.

Prediction of Relapse After Cognitive-Behavioral Treatment of Gambling Disorder in Individuals With Chronic Schizophrenia: A Survival Analysis

Gambling disorder (GD) in individuals with chronic schizophrenia is relevant because there are higher rates of GD in schizophrenic populations (10%) than in the nonschizophrenic population (1%-5%). In addition, these patients have more severe alcohol use disorder (i.e., meeting at least 6 of the DSM-5 11 criteria for diagnosis of this disorder), higher depression scores, a poor adherence to treatment, and more frequent use of outpatient mental health care. One of the main problems in GD is therapeutic failure (defined as three or more lapse episodes during treatment) or relapse (three or more lapse episodes in the follow-up period). Predicting a relapse of GD in individuals with chronic schizophrenia can be useful in targeting the patients for aftercare services. The main aim of this study was to estimate the time to a GD relapse (survival rate) and to evaluate some of the qualitative and quantitative variables related to a GD relapse by a survival analysis. The sample consisted of 35 patients with chronic schizophrenia and GD who were treated with pharmacological and cognitive-behavioral therapy. The therapeutic failure rate in the treatment period was 43%, and it was associated with the number of episodes of schizophrenia, the age of gambling onset, and the age of the patients. The relapse rate in the follow-up period was 32%, and it was associated with the patients' age, educational level, and weekly allowance. The implications of this study for future research are discussed.

Cognitive behavioral therapy program for cannabis use cessation in first-episode psychosis patients: study protocol for a randomized controlled trial

BACKGROUND

The high rate of cannabis use among patients with first-episode psychosis (FEP), as well as the associated negative impact on illness course and treatment outcomes, underlines the need for effective interventions in these populations. However, to date, there have been few clinical treatment trials (of pharmacological or psychological interventions) that have specifically focused on addressing comorbid cannabis use among these patients. The aim of this paper is to describe the design of a study protocol for a randomized controlled trial in which the objective is to assess the efficacy of a specific cognitive behavioral therapy program for cannabis cessation in patients with FEP compared to standard treatment (psychoeducation).

METHODS/DESIGN

This is a single-blind randomized study with 1 year of follow-up. Patients are to be randomly assigned to one of two treatments: (1) specific cognitive behavioral therapy for cannabis cessation composed of 1-hour sessions once a week for 16 weeks, in addition to pharmacological treatment scheduled by the psychiatrist, or (2) a control group (psychoeducation + pharmacological treatment) following the same format as the experimental group. Participants in both groups will be evaluated at baseline (pre-treatment), at 16 weeks (post-treatment), and at 3 and 6 months and 1 year of follow-up. The primary outcome will be that patients in the experimental group will have greater cannabis cessation than patients in the control group at post-treatment. The secondary outcome will be that the experimental group will have better clinical and functional outcomes than the control group.

DISCUSSION

This study provides the description of a clinical trial design based on specific cognitive behavioral therapy for cannabis cessation in FEP patients, aiming to improve clinical and functional outcome, as well as tackling the addictive disorder.

TRIAL REGISTRATION

NCT02319746 ClinicalTrials.gov Identifier. ClinicalTrials.gov Protocol and Results Registration System (PRS) Receipt Release Date: 15 December 2014.

Psychological Treatment of Slot Machine Pathological Gambling

In this article, treatment with stimulus control, exposure, and relapse prevention of a patient affected by pathological gambling is described. The patient, a 47-year-old woman, was suffering from this disorder for 5 years. Treatment consisted of nine individual sessions (five sessions of stimulus control and exposure and four sessions of relapse prevention) in a period of 10 weeks. At the end of 1-year follow-up, the patient was much improved, without gambling behavior or associated symptoms, as well as with a greater overall adaptation. Implications of this case for clinical research and practice are discussed.

Normal-weight and overweight female adolescents with and without extreme weight-control behaviours: Emotional distress and body image concerns

The objective of this study was to analyse emotional distress and concerns related to body image in 712 normal-weight and overweight adolescent girls. A total of 12.3 per cent of the normal-weight girls and 25 per cent of the overweight girls showed extreme weight-control behaviours. In normal-weight adolescents, their engagement in extreme weight-control behaviours was associated with high levels of somatic symptoms, a drive for thinness and control over eating. In overweight girls, high levels of drive for thinness and anxiety were associated with extreme weight-control behaviours. Finally, the implications for preventive and therapeutic programmes are discussed.

Substance abuse and crime: considerations for a comprehensive forensic assessment

There is a strong link between drug use and crime, but this relationship is complex. Drug use does not necessarily lead to an increase in crimes, such as theft, rape or assault, even among regular users or addicts. However, in cases of individuals who consume drugs excessively and commit crimes, both factors are linked. Poverty, personality disorders, social and cultural variables, relationships with other users and previous incarceration or drug use are all factors. These issues play an important role in understanding the risk of crime and drug use. Most addicts should be held liable for most criminal behaviour motivated by addiction, but that addiction can, in some cases, affect one's capacity for self-control over one's actions. This paper examines the current response of the Spanish Criminal Justice System to various aspects of drug abuse, focusing on court decisions related with the nature and enforcement of drug laws. It also addresses aspects of criminal responsibility for drug abuse and drug-related crimes and suggests legislation on drugs, sentencing alternatives for drug offenses, and drug treatment options. Expert evidence plays a crucial role in this area in the court.

The hybrid model for the classification of personality disorders in DSM-5: a critical analysis

A personality disorder can be considered to be a generalized pattern of behaviors, cognitions, and emotions that is enduring, begins in adolescence or early adulthood, remains stable over time, and generates stress or psychological damage. The current focus on personality disorders (PDs) is found in Section II of DSM-5 and is unchanged compared to DSMIV, except that the PDs were removed from the former Axis II of the DSM-IV and included in the central classification of disorders. However, an alternative model for further study is presented in Section III that aims to address the deficiencies in the current categorical model of PDs. The underlying idea is that PDs are an extreme version of the personality traits that everyone has. According to this approach, PDs are characterized by impaired personality functioning (areas of identity, self-direction, empathy, and intimacy) and pathological personality factors (negative affectivity, detachment, antagonism, disinhibition, and psychoticism). The diagnostic categories derived from this model include only antisocial, avoidant, borderline, narcissistic, obsessive-compulsive, and schizotypal PDs. This hybrid approach to the diagnosis of PDs is complex and requires more empirical evidence before it can be incorporated into clinical practice. The proposals of the draft ICD-11 for PDs, which are based primarily on severity and dominant personality traits, are also included.

Subclinical depressive symptoms and continued cannabis use: predictors of negative outcomes in first episode psychosis

Background

Although depressive symptoms in first episode psychosis have been associated with cannabis abuse, their influence on the long-term functional course of FEP patients who abuse cannabis is unknown. The aims of the study were to examine the influence of subclinical depressive symptoms on the long-term outcome in first episode-psychosis patients who were cannabis users and to assess the influence of these subclinical depressive symptoms on the ability to quit cannabis use.

Methods

64 FEP patients who were cannabis users at baseline were followed-up for 5 years. Two groups were defined: (a) patients with subclinical depressive symptoms at least once during follow-up (DPG), and (b) patients without subclinical depressive symptoms during follow-up (NDPG). Psychotic symptoms were measured using the Positive and Negative Syndrome Scale (PANSS), depressive symptoms using the Hamilton Depression Rating Scale (HDRS)-17, and psychosocial functioning was assessed using the Global Assessment of Functioning (GAF). A linear mixed-effects model was used to analyze the combined influence of cannabis use and subclinical depressive symptomatology on the clinical outcome.

Results

Subclinical depressive symptoms were associated with continued abuse of cannabis during follow-up (β= 4.45; 95% confidence interval [CI]: 1.78 to 11.17; P = .001) and with worse functioning (β = -5.50; 95% CI: -9.02 to -0.33; P = .009).

Conclusions

Subclinical depressive symptoms and continued cannabis abuse during follow-up could be predictors of negative outcomes in FEP patients.

Effectiveness of a psychological support program for relatives of people with mental disorders compared to a control group: a prandomized controlled trial

Families of people affected by mental illness may suffer an adverse effect on well-being. In this study, the effectiveness of a cognitive-behavioral treatment designed for relatives of people with mental health problems was evaluated. The sample comprised 50 individuals: 30 in the experimental group, who completed assessment measures in pre-posttreatment and 6 months later, and 20 participants in the control group, who were assessed at baseline and 6 months later. In the experimental group, significant improvements in well-being were observed following the treatment and 6 months later, when compared to the control group, which did not demonstrate any significant changes in outcomes between the baseline and the second assessment 6 months later. This program has proven to be effective as a treatment for the relatives of people with mental disorders. Finally, several topics that may contribute to future research are discussed.

Individual Versus Individual and Group Therapy Regarding a Cognitive-Behavioral Treatment for Battered Women in a Community Setting

The current study aimed to test the clinical effectiveness of a cognitive-behavioral therapy (CBT) program for battered women in a community setting and to find out whether effectiveness of individual therapy can be improved in conjunction with group therapy. One hundred sixteen treatment-seeking battered women were assigned either to CBT on an individual basis or an individual and group basis. Psychological treatment, focused on post-traumatic stress disorder (PTSD), emotional discomfort, and impaired functioning, comprised a 17-session program, including emotional expression, psychoeducation, trauma re-exposure, coping skills, and problem-solving training. Although most treated patients in both groups improved in all variables (PTSD, emotional discomfort, and impaired functioning) at all assessments, the combined individual and group therapy did better than the individual therapy regarding PTSD symptoms and impaired functioning at follow-up assessments. These findings partially support the beneficial effects of group CBT as adjunctive therapy to individual CBT. Implications of this study for clinical practice and future research in this field are commented on.

Piloting a cognitive-behavioral intervention for family members living with individuals with severe mental disorders

Living with a person who experiences mental health problems can have an adverse effect on well-being. The aim of this study is to evaluate the effectiveness of a psychological treatment for relatives of people with mental health problems, byusing an interrupted time-series design. The sample comprised 20 individuals, who completed assessment measures at baseline and 6 months later. Sixteen of these participants then received the treatment and were assessed again at the end of the program. There were no significant changes in outcomes between the baseline and the second assessments done 6 months later and there were significant improvements in well-being following treatment The program shows promise as a treatment for relatives of people with mental health problems and therefore warrants further evaluation in more controlled studies.

Risky eating behaviors and beliefs among adolescent girls

This study investigated the prevalence of weight control and binge eating behaviors in a sample of 767 adolescent girls aged 16–20 years, and the differences between adolescents with and without altered eating behaviors regarding anthropometric and body image variables and beliefs associated with eating disorders. Adolescents who engaged in unhealthy strategies were found to be at a higher risk of eating disorders, since these behaviors were accompanied by higher levels of drive for thinness and body dissatisfaction, as well as by beliefs associated with the importance of weight and body shape as a means of personal and social acceptance.