1
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Strand ER, Nordahl H, Hjemdal O, Nordahl HM. Metacognitive beliefs predict interpersonal problems in patients with social anxiety disorder. Scand J Psychol 2023; 64:819-824. [PMID: 37365879 DOI: 10.1111/sjop.12943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 06/28/2023]
Abstract
Patients with Social Anxiety Disorder (SAD) typically report interpersonal problems, and these are important targets in treatment beyond social anxiety symptoms as they impair quality of life, maintain emotion symptoms and effect on social functioning. What factors contribute to interpersonal problems? In the current study we set out to explore the role of metacognitive beliefs as correlates of interpersonal problems in patients treated for SAD when controlling for the effect of social phobic cognitions and symptoms. The sample consisted of 52 patients with a primary diagnosis of SAD participating in a randomized controlled trial comparing cognitive therapy, paroxetine, pill placebo, or the combination of cognitive therapy and paroxetine in treating SAD. Two hierarchical multiple linear regression analyses were conducted to explore change in metacognitions as predictors of change in interpersonal problems when controlling for change in social phobic cognitions and social anxiety. Change in metacognitions accounted for unique variance in interpersonal problems improvement beyond change in cognitions. Furthermore, change in cognitions overlapped with change in social anxiety symptoms, and when controlling the overlap between these three predictors, only change in metacognitions was uniquely associated with improvement in interpersonal problems. This finding indicates that metacognitions are linked to interpersonal problems in patients with SAD with the implication that treatment should aim to modify metacognitive beliefs to alleviate interpersonal dysfunction.
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Affiliation(s)
- Eivind R Strand
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- St. Olav's Hospital, Nidaros DPS, Trondheim, Norway
| | - Henrik Nordahl
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Hans M Nordahl
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- Division of Psychiatry, St. Olav's Hospital, Trondheim, Norway
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2
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Wang GY, Crook-Rumsey M, Sumich A, Dulson D, Gao TT, Premkumar P. The relationships between expressed emotion, cortisol, and EEG alpha asymmetry. Physiol Behav 2023:114276. [PMID: 37364671 DOI: 10.1016/j.physbeh.2023.114276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/29/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023]
Abstract
Families can express high criticism, hostility and emotional over-involvement towards a person with or at risk of mental health problems. Perceiving such high expressed emotion (EE) can be a major psychological stressor for individuals, especially those at risk of mental health problems. To reveal the biological mechanisms underlying the effect of EE on health, this study investigated physiological response (salivary cortisol, frontal alpha asymmetry (FAA)) to verbal criticism and their relationship to anxiety and perceived EE. Using a repeated-measures design, healthy participants attended three testing sessions on non-consecutive days. On each day, participants listened to one of three types of auditory stimuli, namely criticism, neutral or praise, and Electroencephalography (EEG) and salivary cortisol were measured. Results showed a reduction in cortisol following criticism but there was no significant change in FAA. Post-criticism cortisol concentration negatively correlated with perceived EE after controlling for baseline mood. Our findings suggest that salivary cortisol change responds to criticism in non-clinical populations might be largely driven by individual differences in the perception of criticism (e.g., arousal and relevance). Criticisms expressed by audio comments may not be explicitly perceived as an acute emotional stressor, and thus, physiological change responds to criticisms could be minimum.
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Affiliation(s)
- Grace Y Wang
- School of Psychology and Wellbeing, University of Southern Queensland, Australia; Centre for Health Research, University of Southern Queensland, University of Southern Queensland, Australia.
| | | | | | - Deb Dulson
- School of Biomedical, Nutritional and Sport Sciences, Newcastle University, UK; Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, New Zealand
| | - Terry T Gao
- Morton Bay Regional Council, Queensland, Australia
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3
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Mordeno IG, Bigcas JD, Mordeno ER. Examining the Latent Dimensions of Social Anxiety Disorder. Psychol Rep 2023:332941231156815. [PMID: 36773037 DOI: 10.1177/00332941231156815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
While the body of literature has investigated the latent dimensions of Social Anxiety Disorder (SAD), only few have directly anchored in the DSM-5 SAD symptoms. Similarly, a continuing issue on measuring mental health disorders pertains to whether a symptom's frequency, intensity, or both, are appropriate and sufficient indicators of severity. To address this gap, the present study developed and validated a DSM-5-based measurement tool, the Social Anxiety Symptom Severity Inventory (SASSI), which assesses both the intensity (intensity of disturbance) and frequency (frequency of occurrence) of SAD symptoms. In study 1 (n = 6458, college students), the results revealed a two-factor structure using exploratory structural equation modeling. In study 2 (n = 425, left-behind emerging adults), confirmatory factor analysis, measurement invariance testing, and latent class analysis were used. Findings demonstrated the importance of using both frequency and intensity of symptoms in assessing SAD severity. Moreover, a five-class solution best fitted the sample. Studies 1 and 2 demonstrated the good psychometric properties of SASSI and filled an important gap among available measures in assessing SAD severity through symptom frequency and intensity.
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Affiliation(s)
- Imelu G Mordeno
- Department of Professional Education, College of Education, 69330Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines
| | - Jimayma D Bigcas
- School of Graduate Studies, College of Education, 69330Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines
| | - Emelyn R Mordeno
- Department of Psychology, College of Arts and Social Sciences, 69330Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines
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4
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Li K, Ren L, Zhang L, Liu C, Zhao M, Zhan X, Li L, Luo X, Feng Z. Social anxiety and depression symptoms in Chinese left-behind children after the lifting of COVID-19 lockdown: A network analysis. Int J Soc Psychiatry 2022:207640221141784. [PMID: 36511138 PMCID: PMC9749067 DOI: 10.1177/00207640221141784] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Returning to social life after the lifting of COVID-19 lockdown may increase risk of social anxiety, which is highly co-morbid with depression. However, few studies have reported the association between them. AIMS To explore the complex relationship between social anxiety and depression symptoms in left-behind children after the lifting of the COVID-19 lockdown. METHODS A cross-sectional survey was conducted 6 months after the lockdown removal. A total of 3,107 left-behind children completed the survey with a mean age of 13.33 and a response rate of 87.77%. Depression and social anxiety severity were assessed by the DSM-5 Patient Health Questionnaire for Adolescents and the DSM-5 Social Anxiety Disorder Questionnaire, respectively. The symptom-level association between the two disorders was examined using network analysis. RESULTS After the lifting of COVID-19 lockdown, the prevalence of depression and social anxiety in left-behind children was 19.57% and 12.36%, respectively, with a co-morbidity rate of 8.98%. Network analysis showed that "Social tension" and "Social avoidance" had the greatest expected influence; "Humiliation" and "Motor" were bridge symptom nodes in the network. The directed acyclic graph indicated that "Social fright" was at the upstream of all symptoms. CONCLUSION Attention should be paid to social anxiety symptoms in left-behind children after the lifting of COVID-19 lockdown. Prevention and intervention measures should be taken promptly to reduce the comorbidity of social anxiety and depression symptoms in the left-behind children after the lifting of lockdown.
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Affiliation(s)
- Kuiliang Li
- Department of Medical English, School of Basic Medical Sciences, Army Medical University, Chongqing, China.,School of Psychology, Army Medical University, Chongqing, China
| | - Lei Ren
- Department of Military Medical Psychology, Fourth Military Medical University, Xi' an, China
| | - Lei Zhang
- Department of Medical English, School of Basic Medical Sciences, Army Medical University, Chongqing, China
| | - Chang Liu
- BrainPark, Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Australia
| | - Mengxue Zhao
- School of Psychology, Army Medical University, Chongqing, China
| | - Xiaoqing Zhan
- Department of Medical English, School of Basic Medical Sciences, Army Medical University, Chongqing, China
| | - Ling Li
- College of General Education, Chongqing Water Resources and Electric Engineering College, Chongqing, China
| | - Xi Luo
- Department of Medical English, School of Basic Medical Sciences, Army Medical University, Chongqing, China
| | - Zhengzhi Feng
- School of Psychology, Army Medical University, Chongqing, China
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5
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Zhao W, Zhang X, Zhou X, Song X, Zhang Z, Xu L, Zhou F, Kendrick KM. Depression mediates the association between insula-frontal functional connectivity and social interaction anxiety. Hum Brain Mapp 2022; 43:4266-4273. [PMID: 35596617 PMCID: PMC9435016 DOI: 10.1002/hbm.25952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/28/2022] [Accepted: 05/06/2022] [Indexed: 11/25/2022] Open
Abstract
High rates of comorbidity between depression and anxiety are frequently observed. However, few studies have investigated the relationship between depression and social interaction anxiety using a dimensional approach. The current study aimed to explore the associations between depression and social interaction anxiety with a multivariate approach in a comparably large dataset (n = 194, 95 males). All participants completed a structural and a resting‐state functional magnetic resonance imaging (fMRI) scan and self‐report measures of depression via Beck's Depression Inventory II and social interaction anxiety by social interaction anxiety scale. Voxel‐based morphometry (VBM) results first identified grey matter volumes of insula were positively correlated with depression dimension scores. Next, whole brain seed‐to‐voxel analyses were conducted using a VBM‐identified insula as a seed region to examine associations between depression/social anxiety and functional connectivity. The results suggested that a significant positive effect of depression/social anxiety was found on the connectivity between insula and dorsal lateral prefrontal cortex (dlPFC). Moreover, variations in depression meditated the association between insula‐dlPFC connectivity and social interaction anxiety. Overall, the results indicate that individual differences in depression relate more to insula‐dlPFC coupling compared to social interaction anxiety.
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Affiliation(s)
- Weihua Zhao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaolu Zhang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xinqi Zhou
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Xinwei Song
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhao Zhang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Lei Xu
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Feng Zhou
- Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality, Ministry of Education, China
| | - Keith M Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
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6
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Nordahl H, Anyan F, Hjemdal O, Wells A. Metacognition, cognition and social anxiety: A test of temporal and reciprocal relationships. J Anxiety Disord 2022; 86:102516. [PMID: 34972051 DOI: 10.1016/j.janxdis.2021.102516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 12/06/2021] [Accepted: 12/21/2021] [Indexed: 11/26/2022]
Abstract
Cognitive models of social anxiety give prominence to dysfunctional schemas about the social self as the key underlying factors in maladaptive self-processing strategies and social anxiety symptoms. In contrast, the metacognitive model argues that beliefs about cognition represent a central belief domain underlying psychopathology and cognitive schemas as products of a thinking style regulated by metacognition. The present study therefore evaluated the temporal and reciprocal relations between metacognitive beliefs, social self-beliefs, and social anxiety symptoms to shed light on possible causal relationships among them. Eight hundred and sixty-eight individuals gathered at convenience participated in a four-wave online survey with each measurement wave 6 weeks apart. Using autoregressive cross-lagged panel models, we found significant temporal and reciprocal relations between metacognition, social self-beliefs (schemas), and social anxiety. Whilst social self-beliefs prospectively predicted social anxiety this relationship was reciprocal. Metacognitive beliefs prospectively predicted both social interaction anxiety and social self-beliefs, but this was not reciprocal. The results are consistent with metacognitive beliefs causing social anxiety and social self-beliefs and imply that negative social self-beliefs might be a product of metacognition. The clinical implications are that metacognitive beliefs should be the central target in treatments of social anxiety.
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Affiliation(s)
- Henrik Nordahl
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Frederick Anyan
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Adrian Wells
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom; Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
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7
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Zangani C, Giordano B, Stein H, Bonora S, D'Agostino A, Ostinelli EG. Efficacy of amisulpride for depressive symptoms in individuals with mental disorders: A systematic review and meta-analysis. Hum Psychopharmacol 2021; 36:e2801. [PMID: 34727399 PMCID: PMC8596405 DOI: 10.1002/hup.2801] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 05/15/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Depressive symptoms occur in several psychiatric disorders, often in the absence of a formal diagnosis of depression. We aimed to evaluate the efficacy and the tolerability of amisulpride, both alone and as augmentation therapy, in the treatment of depressive symptoms in individuals with any major psychiatric disorder. METHODS We searched PubMed, Embase, PsycINFO, GreyLit, OpenGrey and ProQuest up to March 2020 for randomised controlled trials focussing on the treatment of an acute depressive episode in any major psychiatric disorder. A random-effect meta-analysis was performed to synthesize the findings on depressive symptoms (primary outcome), response rate and tolerability. RESULTS We retrieved 11 studies including 2065 patients with a diagnosis of dysthymia (eight studies), major depression (one study) or schizophrenia (two studies). Amisulpride 50 mg/day was associated with a larger reduction of depressive symptoms compared to placebo (standardised mean difference [SMD] = -0.70, CI 95% -0.92, -0.49; I2 = 0.0%), and was found to be comparable to selective serotonin reuptake inhibitors (SSRIs; SMD = -0.08, CI 95% -0.23, 0.06, I2 = 0.0%), amineptine, imipramine and amitriptyline in the treatment of dysthymia (three studies, not pooled). In individuals with schizophrenia, amisulpride administered at higher doses (>400 mg/day) was comparable to olanzapine and risperidone (two studies, not pooled). In terms of tolerability, amisulpride was superior to placebo for dysthymia (odds ratio [OR] = 3.94, CI 95% 1.07, 14.48; I2 = 0.0) and comparable with SSRIs (OR = 0.94, CI 95% 0.55, 1.62; I2 = 0.0%). CONCLUSION Treatment with amisulpride could be a valid choice for selected individuals with dysthymia or depressive symptoms in the context of schizophrenia. More studies on the efficacy and tolerability of amisulpride are needed to draw firm conclusions on its potential benefits in other psychiatric disorders.
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Affiliation(s)
- Caroline Zangani
- Oxford Health NHS Foundation Trust, Warneford HospitalOxfordUK,Department of PsychiatryUniversity of OxfordOxfordUK,Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research CentreOxfordUK,Department of Health SciencesUniversity of MilanMilanItaly
| | | | | | - Stefano Bonora
- Department of Health SciencesUniversity of MilanMilanItaly
| | | | - Edoardo Giuseppe Ostinelli
- Oxford Health NHS Foundation Trust, Warneford HospitalOxfordUK,Department of PsychiatryUniversity of OxfordOxfordUK,Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research CentreOxfordUK
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8
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Metacognitive Beliefs Predict Cognitive Behavioral Therapy Outcome in Children with Anxiety Disorders. Int J Cogn Ther 2021. [DOI: 10.1007/s41811-021-00119-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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9
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Chen J, Tan Y, Cheng X, Peng Z, Qin C, Zhou X, Lu X, Huang A, Liao X, Tian M, Liang X, Huang C, Zhou J, Xiang B, Liu K, Lei W. Maladaptive metacognitive beliefs mediated the effect of intolerance of uncertainty on depression. Clin Psychol Psychother 2021; 28:1525-1534. [PMID: 33780079 DOI: 10.1002/cpp.2589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/16/2021] [Accepted: 03/22/2021] [Indexed: 01/20/2023]
Abstract
Both elevated intolerance of uncertainty (IU) and maladaptive metacognitive beliefs (MBs) were associated with depression. However, the relationship between MBs and IU in clinical depression is unclear. The current study aimed to investigate the putative impairment of MBs and IU in major depressive disorder (MDD) and explore the relationship between these two factors with depressive symptoms. Metacognition Questionnaire-30 Items (MCQ-30), Intolerance of Uncertainty Scale-Short Form (IUS-12) and clinical rating scales were administered to 53 patients with MDD and 56 healthy controls (HCs). Stepwise regressions were performed to explore independent contributions of MBs and IU on depression. Mediation analysis was used to examine associations among variables. Patients with MDD reported higher IUS-12 and MCQ-30 scores than HCs. Stepwise regressions revealed a unique contribution of negative MBs concerning the consequences of not controlling thoughts (MCQ-NC) on depression symptoms while controlling the effects of age, gender, anxiety symptoms and IU. MCQ-NC and negative MBs concerning the uncontrollability and danger of negative thinking (MCQ-NEG) completely mediated the effects of IU on depression and anxiety symptoms. Our results provided clear evidence that maladaptive negative MBs are directly associated with depression symptoms, and mediated the effect of IU on depression and anxiety symptoms, suggesting that IU and MBs influence clinical symptoms in a hierarchical manner.
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Affiliation(s)
- Jing Chen
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Youguo Tan
- Zigong Mental Health Center, Zigong, China
| | - Xiaotong Cheng
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Zhenlei Peng
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Cheng Qin
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xinyi Zhou
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xingzi Lu
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Anqi Huang
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xiaoyuan Liao
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Mingyuan Tian
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xuemei Liang
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Chaohua Huang
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jia Zhou
- School of Humanities and Management Science, Southwest Medical University, Luzhou, China
| | - Bo Xiang
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Kezhi Liu
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Wei Lei
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
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10
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Mei S, Hu Y, Sun M, Fei J, Li C, Liang L, Hu Y. Association between Bullying Victimization and Symptoms of Depression among Adolescents: A Moderated Mediation Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3316. [PMID: 33806969 PMCID: PMC8005068 DOI: 10.3390/ijerph18063316] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/06/2021] [Accepted: 03/19/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Bullying victimization and its effect on symptoms of depression have received attention from researchers, but few studies have considered the potential mechanism. The aim of this study was to examine a moderated mediation model for the association between bullying victimization and depressive symptoms in terms of it being mediated by social anxiety, and investigated whether sleep duration would show moderating effects in this relationship. METHODS In this study, there were 2956 students, who completed three questionnaires, including a bullying victimization scale, as well as a social anxiety and epidemiologic studies depression scale. RESULTS Bullying victimization's effects on depressive symptoms were mediated by social anxiety. Furthermore, sleep duration moderated the relationship between bullying victimization and depressive symptoms. CONCLUSIONS The research contributes by clarifying the mechanisms underlying the relationship between bullying victimization and depressive symptoms.
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Affiliation(s)
- Songli Mei
- Department of Child and Adolescent Health, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China;
| | - Yueyang Hu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China; (Y.H.); (J.F.); (C.L.); (L.L.)
| | - Mengzi Sun
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China;
| | - Junsong Fei
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China; (Y.H.); (J.F.); (C.L.); (L.L.)
| | - Chuanen Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China; (Y.H.); (J.F.); (C.L.); (L.L.)
| | - Leilei Liang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China; (Y.H.); (J.F.); (C.L.); (L.L.)
| | - Yuanchao Hu
- Department of Child and Adolescent Health, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China;
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11
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Abstract
Background. Schizotypy is a multidimensional construct that is linked to the vulnerability for psychosis. Positive schizotypy includes having paranormal beliefs. Negative schizotypy includes social anhedonia. Disorganized schizotypy includes social anxiety and communication disorder. Schizotypy relates to depression and aggression. Family stress from high expressed emotion (EE; a rating of criticism, hostility, and emotional overinvolvement in a close relative toward a person showing signs of mental disorder) may mediate the link between schizotypy, depression and aggression. This study tested, using path analyses, the hypotheses that schizotypy predicts depression and aggression through high perceived EE as criticism and irritability (hypothesis 1) and praise and intrusiveness in a close relative (hypothesis 2). Methods. One hundred and four healthy participants listened to and rated the self-relevance of standard criticism and standard praise that denote EE. Participants rated their level of schizotypy, depression, aggression, and perceived EE in self-report questionnaires. Two path models tested the hypotheses. Results. Disorganized schizotypy, more than positive schizotypy, predicted the path to depression and aggression when perceived criticism and perceived EE-irritability were mediators. Disorganised schizotypy, more than negative schizotypy, predicted the path to depression and aggression when perceived praise and perceived EE-intrusiveness were mediators. Conclusions. Greater perceived criticism and less perceived praise in family communication explain the path from disorganized schizotypy (more so than positive or negative schizotypy) to depression and aggression. These findings indicate a need to consider the thought disorder-EE link as a potential contributor to depression and aggression in people with schizophrenia.
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Affiliation(s)
- Preethi Premkumar
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Elizabeth Kuipers
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.,NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Veena Kumari
- Centre for Cognitive Neuroscience, College of Life and Health Sciences, Brunel University London, Uxbridge, United Kingdom
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12
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Neufeld CB, Palma PC, Caetano KA, Brust-Renck PG, Curtiss J, Hofmann SG. A randomized clinical trial of group and individual Cognitive-Behavioral Therapy approaches for Social Anxiety Disorder. Int J Clin Health Psychol 2019; 20:29-37. [PMID: 32021616 PMCID: PMC6994736 DOI: 10.1016/j.ijchp.2019.11.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 11/29/2019] [Indexed: 12/27/2022] Open
Abstract
To compare the effectiveness of two Cognitive-Behavioral Therapy (CBT) interventions-an individual and a group intervention-in Social Anxiety Disorder therapy. We compared the two treatment groups against a waitlist condition in a randomized clinical trial with 86 young adults. The individual CBT intervention was Trial-Based Cognitive Therapy (TBCT) developed by De-Oliveira, a novel technique in which the therapist engages the patient in a simulated judicial trial with the goal of identifying and changing core dysfunctional beliefs. The group intervention consisted of exposition therapy based on the Hofmann and Otto protocol (Group CBT) to restructure negative and dysfunctional cognitions regarding social situations. Both interventions reduced psychiatric symptoms from pre- to post-test and primary social anxiety and depression symptoms relative to waitlist controls. The interventions were recently introduced in Brazil, and this is the first randomized control trial to compare TBCT and this Group CBT, which were effective in assessing changes in social anxiety symptoms as well as co-occurring psychiatric symptoms.
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Affiliation(s)
- Carmem Beatriz Neufeld
- Universidade de São Paulo, Brazil
- Corresponding author. Departamento de Psicologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900, 14040-901, Ribeirão Preto, SP, Brazil.
| | | | - Kátia A.S. Caetano
- Universidade de São Paulo, Brazil
- Boston University, United States of America
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13
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Nordahl H, Ødegaard IH, Hjemdal O, Wells A. A test of the goodness of fit of the generic metacognitive model of psychopathology symptoms. BMC Psychiatry 2019; 19:288. [PMID: 31533677 PMCID: PMC6751802 DOI: 10.1186/s12888-019-2266-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 08/29/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Common mental disorders such as depression and anxiety frequently co-occur and may share etiological mechanisms. The metacognitive model is based on the principle that there are common pathological mechanisms across disorders that account for comorbidity and therefore can be conceptualized in one generic model. A central prediction of the model is that particular metacognitive beliefs concerning the value of worry, and the uncontrollability and danger of cognition are positively correlated with psychopathology symptoms. In the present study, we set out to test the overall fit of this model by assessing generic metacognitive beliefs and judgements of attention control capacity as predictors of common and frequently co-occurring emotional distress symptoms. METHODS In a cross-sectional design, 645 participants gathered at convenience completed a battery of self-report questionnaires. RESULTS Structural equation modelling indicated a good model fit for the generic metacognitive model, and the predictors accounted for 93% of the variance in distress consisting of depression-, generalized- and social anxiety symptoms. CONCLUSIONS This finding supports the generic model and the implication that it can be used as a basis to formulate and treat multiple presenting problems.
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Affiliation(s)
- Henrik Nordahl
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway. .,St. Olavs Hospital, Division of Psychiatry, Trondheim University Hospital, Trondheim, Norway.
| | | | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Adrian Wells
- School of Psychological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Prestwich, UK
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Wang W, Xie X, Wang X, Lei L, Hu Q, Jiang S. Cyberbullying and depression among Chinese college students: A moderated mediation model of social anxiety and neuroticism. J Affect Disord 2019; 256:54-61. [PMID: 31158716 DOI: 10.1016/j.jad.2019.05.061] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/25/2019] [Accepted: 05/27/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cyberbullying is a serious social issue that can cause a number of psychological and behavioral problems for perpetrators and victims. Previous studies have shown that adolescent victims of cyberbullying are more likely to exhibit depressive symptoms. However, few studies have investigated the relationship between the perpetration of cyberbullying and depression, or the mediating and moderating mechanisms underlying this relationship. METHODS A questionnaire survey was conducted among 476 college students to investigate the relationships between cyberbullying perpetration and depression, the mediating role of social anxiety, and the moderating role of neuroticism. RESULTS The results showed that cyberbullying perpetration had a significant and positive predictive effect on depression. Social anxiety partially mediated this relationship. The direct predictive effect of cyberbullying perpetration on depression, and the relation between social anxiety and depression, were both moderated by neuroticism. Cyberbullying perpetration had a greater impact on depression for college students with lower levels of neuroticism and the predictive function of social anxiety on depression was stronger for individuals with low levels of neuroticism too. But neuroticism did not moderate the association between cyberbullying perpetration and social anxiety. LIMITATIONS This study focused only on the individual variables influencing the relationship between cyberbullying perpetration and depression, and did not examine interpersonal or environmental variables. Also, the cross-sectional research design means that causality cannot be deduced from the results. CONCLUSIONS Cyberbullying perpetration can predict depression directly, and also indirectly via the mediating role of social anxiety. Neuroticism moderates the relation both between cyberbullying and depression, and between social anxiety and depression. These findings provide new perspectives for the treatment and prevention of depression among college students.
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Affiliation(s)
- Wei Wang
- Department of Psychology, Shanxi Datong University, Datong 037009, China
| | - Xiaochun Xie
- School of Psychology, Northeast Normal University, Changchun 130024, China
| | - Xingchao Wang
- School of Education Science, Shanxi University, No. 92 Wucheng Road, Taiyuan 030006, China
| | - Li Lei
- Department of Psychology, Renmin University of China, Beijing 100872, China
| | - Qian Hu
- School of Foreign Languages, Wenzhou Medical University, Wenzhou 325035, China
| | - Suo Jiang
- Department of Applied Psychology in College of Psychiatry, Wenzhou Medical University, Wenzhou 325035, China.
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Nordahl H, Wells A. Metacognitive Therapy for Social Anxiety Disorder: An A-B Replication Series Across Social Anxiety Subtypes. Front Psychol 2018; 9:540. [PMID: 29706924 PMCID: PMC5906593 DOI: 10.3389/fpsyg.2018.00540] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 03/29/2018] [Indexed: 12/03/2022] Open
Abstract
Cognitive behavioural therapy (CBT) is the treatment of choice for Social anxiety disorder (SAD). However, factors additional to those emphasised in CBT are the primary cause of psychological disorder according to the metacognitive model. Metacognitive Therapy (MCT) aims to target a perseverative thinking style named the cognitive attentional syndrome and its underlying metacognitive beliefs (beliefs about cognition). The present study aimed to explore the effects of generic MCT for SAD. Treatment related effects were evaluated using direct replication single case (A–B) methodology across three patients with different subtypes of SAD; performance type, generalised and generalised plus avoidant personality disorder, representing increasing SAD severity/complexity. All patients responded during treatment and achieved substantial symptom reductions which were largely maintained at 6 months’ follow-up. Metacognitive therapy appears to be a suitable treatment and was associated with positive outcomes for patients with different presentations of SAD.
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Affiliation(s)
- Henrik Nordahl
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.,St. Olavs Hospital, Nidaros DPS, Trondheim University Hospital, Trondheim, Norway
| | - Adrian Wells
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Prestwich, United Kingdom
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