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Rambod M, Pasyar N, Mazarei Z, Soltanian M. The predictive roles of parental stress and intolerance of uncertainty on psychological well-being of parents with a newborn in neonatal intensive care unit: a hierarchical linear regression analysis. BMC Pediatr 2023; 23:607. [PMID: 38037025 PMCID: PMC10691133 DOI: 10.1186/s12887-023-04420-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/14/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Hospitalization of newborns in neonatal intensive care units (NICU) exposes parents to considerable stress. This study aimed to determine the predictive role of parental stress and intolerance of uncertainty on the psychological well-being of parents with a newborn in NICU using hierarchical linear regression analysis. METHODS This cross-sectional study included 130 parents of newborns hospitalized in the NICU. Data were collected using Parental Stress Scale, Intolerance of Uncertainty Scale, and Psychological Wellbeing Scale. The data were analyzed in SPSS v.26 using hierarchical linear regression analysis. RESULTS The mean scores of the parents' psychological well-being, parental stress, and intolerance of uncertainty were 79.08 (SD = 11.70), 63.06 (SD = 26.71), and 75.38 (SD = 19.40), respectively. The result of the hierarchical linear regression analysis revealed that, in step 1, academic education had a significant proportion of the variance of parents' psychological well-being (β = 0.26, P = 0.005). In step 2, it was shown that academic education (β=-0.25, P = 0.006) and parental stress (β=-0.25, P = 0.006) had a significant proportion of the variance of parents' psychological well-being. According to step 2, education levels, parental stress, and intolerance of uncertainty explained 22% of the changes in parents' psychological well-being. CONCLUSION There was a significant association between the parents' psychological well-being and education levels, intolerance of uncertainty, and parental stress. Academic education and parental stress were the predictors of parents' psychological well-being. Based on these findings, early detection of parents' education and stress are important for their psychological well-being.
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Affiliation(s)
- Masoume Rambod
- Community Based Psychiatric Care Research Center, Nursing and Midwifery School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nilofar Pasyar
- Community Based Psychiatric Care Research Center, Nursing and Midwifery School, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Zeinab Mazarei
- Student Research Committee of Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mitra Soltanian
- Community Based Psychiatric Care Research Center, Nursing and Midwifery School, Shiraz University of Medical Sciences, Shiraz, Iran
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2
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Brennan SN, Rossell SL, Rehm I, Thomas N, Castle DJ. A qualitative exploration of the lived experiences of Body Dysmorphic Disorder. Front Psychiatry 2023; 14:1214803. [PMID: 37854447 PMCID: PMC10580279 DOI: 10.3389/fpsyt.2023.1214803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 09/06/2023] [Indexed: 10/20/2023] Open
Abstract
Body Dysmorphic Disorder (BDD) is characterized by an intense preoccupation with one or more perceived "defects" in physical appearance. Despite the distress and impairment associated with BDD, the disorder remains understudied and poorly understood. In particular, there are limited studies available which give voice to those with firsthand experiences of the disorder. A qualitative approach was employed to study lived experience of BDD. In-depth semi-structured interviews were conducted with 12 participants with BDD, aiming to understand their subjective experiences of the disorder. Data was analyzed using Interpretative Phenomenological Analysis (IPA). The results identified three superordinate themes; (1) consumed by the disorder, (2) the flawed self, and (3) intolerance of uncertainty about appearance. The qualitative findings of this study are discussed in relation to current conceptual understandings of BDD, including the cognitive behavioral model.
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Affiliation(s)
- Sarah N. Brennan
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
- Gatehouse Centre, Royal Children’s Hospital, Melbourne, VIC, Australia
| | - Susan L. Rossell
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
- Department of Psychiatry, St. Vincent’s Hospital, Melbourne, VIC, Australia
| | - Imogen Rehm
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
- Institute of Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Neil Thomas
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - David J. Castle
- Department of Psychiatry, St. Vincent’s Hospital, Melbourne, VIC, Australia
- Department of Psychiatry, University of Tasmania, Hobart, TAS, Australia
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3
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Wiese AD, Lim SL, Filion DL, Kang SS. Intolerance of uncertainty and neural measures of anticipation and reactivity for affective stimuli. Int J Psychophysiol 2023; 183:138-147. [PMID: 36423712 DOI: 10.1016/j.ijpsycho.2022.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 10/31/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022]
Abstract
Intolerance of uncertainty (IU) is a transdiagnostic construct referring to the aversive interpretation of contexts characterized by uncertainty. Indeed, there is a growing body of research examining individual differences in IU and how these are associated with emotional anticipation and reactivity during periods of certainty and uncertainty, however, how these associations are reflected via neurophysiological indices remain understudied and poorly understood. The present study examined the relationship between self-reported IU and neurophysiological measures of emotional anticipation and reactivity, namely stimulus preceding negativity (SPN) and late positive potential (LPP), and self-report measures of emotional experiences. These measures were captured during an S1-S2 picture viewing tasks in which participants were presented with cues (S1) that either indicated the affective valence of upcoming picture (S2) or provided no information about the valence. Findings here provide evidence for significant associations between SPN amplitude and IU scores during uncertain and certain-positive cueing conditions, and significant associations between LPP amplitude and IU scores during both certain- and uncertain-negative picture viewing conditions that appear driven by prospective IU sub-scores. These positive associations between IU and SPN amplitude are suggestive of heightened emotional anticipation following S1 cues, while positive associations between IU and LPP are suggestive of heightened emotional reactivity following S2 images. These findings are discussed in detail relative to existing IU literature, and potential implications of these findings.
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Affiliation(s)
- Andrew D Wiese
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, United States of America
| | - Seung-Lark Lim
- Department of Psychology, University of Missouri - Kansas City, United States of America
| | - Diane L Filion
- Department of Psychology, University of Missouri - Kansas City, United States of America
| | - Seung Suk Kang
- Department of Biomedical Sciences, University of Missouri - Kansas City, United States of America.
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YIĞMAN F, FİDAN S. Transdiagnostik Faktör Olarak Belirsizliğe Tahammülsüzlük. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2021. [DOI: 10.18863/pgy.827416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Opladen V, Vivell MB, Vocks S, Hartmann AS. Revisiting the Postulates of Etiological Models of Eating Disorders: Questioning Body Checking as a Longer-Term Maintaining Factor. Front Psychiatry 2021; 12:795189. [PMID: 35095608 PMCID: PMC8792988 DOI: 10.3389/fpsyt.2021.795189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/10/2021] [Indexed: 11/29/2022] Open
Abstract
Body checking (BC) is not only inherent to the maintenance of eating disorders but is also widespread among healthy females. According to etiological models, while BC serves as an affect-regulating behavior in the short term, in the longer term it is assumed to be disorder-maintaining and also produces more negative affect. The present study therefore aimed to empirically examine the proposed longer-term consequences of increased BC. In an online study, N = 167 women tracked their daily amount of BC over a total of 7 days: Following a 1-day baseline assessment of typical BC, participants were asked to check their bodies in an typical manner for 3 days and with a 3-fold increased frequency for 3-days. Before and after each BC episode, the impact of BC on affect, eating disorder symptoms, general pathology and endorsement of different functions of BC was assessed. Participants showed longer-term consequences of increased BC in terms of increased negative affect and general pathology, while eating disorder symptoms remained unaffected. In the case of typical BC, participants showed decreased general pathology and anxiety. Furthermore, the endorsement of a higher number of BC functions led to increased negative affect and an increased amount of typical BC. The findings support the theoretically assumed role of maladaptive BC in maintaining negative emotion in the longer term. However, though requiring replication, our finding of positive effects of typical BC calls into question the overall dysfunctionality of BC among non-clinical women who are not at risk of developing an eating disorder.
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Affiliation(s)
- Vanessa Opladen
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Maj-Britt Vivell
- Department of Psychology, Experimental Clinical Psychology, University of Konstanz, Konstanz, Germany
| | - Silja Vocks
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Andrea S Hartmann
- Department of Psychology, Experimental Clinical Psychology, University of Konstanz, Konstanz, Germany
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Understanding Relations Between Intolerance of Uncertainty, Social Anxiety, and Body Dissatisfaction in Women. J Nerv Ment Dis 2020; 208:833-835. [PMID: 33002940 DOI: 10.1097/nmd.0000000000001208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Body dissatisfaction (BD) is highly prevalent among young females and is associated with negative mental health outcomes. Social anxiety (SA) has been identified as an important determinant of BD; however, potential factors underlying SA-related BD remain unstudied. Research indicates that intolerance of uncertainty (IU), the tendency to respond negatively to uncertainty, may be critical for developing and maintaining SA. The current study investigated whether IU is associated with SA and whether SA, in turn, is related to BD. In a cross-sectional study, 139 women completed an online survey measuring IU, SA, and BD. Correlation analyses showed that IU, SA, and BD were strongly positively associated. A mediation analysis revealed that higher levels of IU were indirectly related to more BD through higher levels of SA. A direct effect of IU on BD was also found. These findings suggest that individuals with SA-related BD may benefit from interventions targeting IU.
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The impact of methodological and measurement factors on transdiagnostic associations with intolerance of uncertainty: A meta-analysis. Clin Psychol Rev 2019; 73:101778. [PMID: 31678816 DOI: 10.1016/j.cpr.2019.101778] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 08/04/2019] [Accepted: 08/20/2019] [Indexed: 01/12/2023]
Abstract
Intolerance of uncertainty is a dispositional trait associated with a range of psychological disorders, but the influence of methodological factors on theses associations remains unknown. The first aim of this meta-analysis was to quantify the strengths of the association between IU and symptoms of generalised anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, obsessive compulsive disorder, depression, and eating disorders. The second aim was to assess the influence of methodological factors on these relationships, including clinical (vs. non-clinical) status, age group, sex, IU measure, and symptom measure. We extracted 181 studies (N participants = 52,402) reporting 335 independent effect sizes (Pearson's r). Overall, there was a moderate association between IU and symptoms (r = 0.51, 95% CI = 0.50-0.52), although heterogeneity was high (I2 = 83.50, p < .001). Some small but significant moderator effects emerged between and within disorders. Effect sizes were not impacted by sample size. The results indicate that IU has robust, moderate associations with a range of disorder symptoms, providing definitive evidence for the transdiagnostic nature of IU.
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Mohajerin B, Bakhtiyar M, Olesnycky OS, Dolatshahi B, Motabi F. Application of a transdiagnostic treatment for emotional disorders to body dysmorphic disorder: A randomized controlled trial. J Affect Disord 2019; 245:637-644. [PMID: 30445389 DOI: 10.1016/j.jad.2018.11.058] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/14/2018] [Accepted: 11/03/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Body dysmorphic disorder (BDD) is a common disorder which is associated with a high rate of comorbidity and functional impairment. Although research shows that cognitive-behavioral therapy can be an efficacious treatment for BDD, there is growing evidence that dysregulated emotion is a core deficit. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP) is a transdiagnostic, emotion focused cognitive-behavioral therapy protocol that has been developed to target emotion regulation processes that play an important role in the development and maintenance of many emotional disorders METHODS: : In the present study, 128 patients meeting criteria for BDD were randomized to either the UP (n = 64) or waitlist/treatment-as-usual (WL/TAU) condition. Diagnoses were determined using semi-structural interviews and patients also completed the Brown Assessment of Beliefs Scale (BABS), the Appearance Anxiety Inventory (AAI), the Difficulties in Emotion Regulation Scale (DERS), the Beck Depression Inventory (BDI) and the Clinical Global Impression (CGI). RESULTS Repeated measure ANOVA indicated that the UP significantly decreased depression, BDD symptoms and body-related anxiety, as well as significantly improving emotional regulation all with large effect sizes compared to the TAU/WL condition. Treatment gains as well as remission of comorbid conditions were maintained at the three-month follow-up. LIMITATIONS Our study limitations include restricted follow-up periods and excluding participants who were actively suicidal. CONCLUSIONS To our knowledge, this is the first examination of the UP for BDD, and results suggest that this disorder shares common mechanisms with other disorders of emotion, and that the UP may be an additional efficacious treatment for this condition.
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Affiliation(s)
- Banafsheh Mohajerin
- Department of Clinical Psychology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Maryam Bakhtiyar
- Department of Clinical Psychology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Olenka S Olesnycky
- Center for Anxiety and Related Disorders, Boston University, Massachusetts, USA
| | - Behrouz Dolatshahi
- Department of Psychology, Iranian Research Center for Substance Abuse and Dependence, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fereshteh Motabi
- Family Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Hartmann AS, Cordes M, Hirschfeld G, Vocks S. Affect and worry during a checking episode: A comparison of individuals with symptoms of obsessive-compulsive disorder, anorexia nervosa, bulimia nervosa, body dysmorphic disorder, illness anxiety disorder, and panic disorder. Psychiatry Res 2019; 272:349-358. [PMID: 30599438 DOI: 10.1016/j.psychres.2018.12.132] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 12/04/2018] [Accepted: 12/23/2018] [Indexed: 11/27/2022]
Abstract
Checking behavior (CB) occurs in a variety of disorders such as obsessive-compulsive (OCD), body dysmorphic (BDD), illness anxiety (IA), and panic disorder (PD), as well as anorexia (AN) and bulimia nervosa (BN). Etiological models of these disorders - with the exception of those for PD - postulate that CB mainly occurs in situations characterized by negative affect and serves to regulate it. We aimed to test these assumptions: N = 386 individuals with a self-reported diagnosis of one of the disorders rated their affect at baseline, directly before a remembered CB episode, during, immediately afterwards, and 15 and 60 minutes afterwards, and rated their endorsement of different functions of CB. The results show that transdiagnostically negative affect is significantly higher before CB compared to baseline, and is significantly reduced from before CB to all post-CB assessments. Reduction of negative affect and Attainment of certainty were the sole functions predicting the affective course during CB, and most prominently reported transdiagnostically. Assumptions of the etiological models were confirmed, suggesting that exposure and ritual prevention should be examined across disorders. As attainment of certainty seems to be predictive for the course of CB, this might be targeted in cognitive interventions.
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Affiliation(s)
- Andrea S Hartmann
- Faculty of Human Sciences, Department of Psychology, Division of Clinical Psychology and Psychotherapy, Osnabrück University, Knollstr. 15, 49069 Osnabrück, Germany.
| | - Martin Cordes
- Faculty of Human Sciences, Department of Psychology, Division of Clinical Psychology and Psychotherapy, Osnabrück University, Knollstr. 15, 49069 Osnabrück, Germany
| | - Gerrit Hirschfeld
- Faculty of Economics and Health, Department of Applied Psychology, Division of Research Methods and Diagnostics, University of Applied Sciences Bielefeld, Interaktion 1, 33619 Bielefeld, Germany
| | - Silja Vocks
- Faculty of Human Sciences, Department of Psychology, Division of Clinical Psychology and Psychotherapy, Osnabrück University, Knollstr. 15, 49069 Osnabrück, Germany
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Matheny NL, Summers BJ, Macatee RJ, Harvey AM, Okey SA, Cougle JR. A multi-method analysis of distress tolerance in body dysmorphic disorder. Body Image 2017; 23:50-60. [PMID: 28826046 DOI: 10.1016/j.bodyim.2017.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 07/21/2017] [Accepted: 07/24/2017] [Indexed: 11/18/2022]
Abstract
Distress tolerance (DT) is a transdiagnostic construct linked to multiple psychiatric disorders. We conducted three studies using different methods to investigate the relationship between DT and body dysmorphic disorder (BDD). Study 1 found a significant relationship between low DT and more severe BDD symptoms in an adult community sample (N=81). In Study 2, we found a similar relationship between lower DT and greater BDD symptoms in a student sample (N=192). Furthermore, we found a unique relationship between greater BDD symptoms and lower self-reported tolerance of anger and sadness mood induction tasks. Greater BDD symptoms were not significantly associated with lower self-reported tolerance of a fear mood induction task. In Study 3, a clinical sample of individuals with BDD (N=40) reported lower DT than a sample of healthy controls (N=36). Findings suggest that low DT is a broad vulnerability factor related to BDD.
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Affiliation(s)
- Natalie L Matheny
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Berta J Summers
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Richard J Macatee
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Ashleigh M Harvey
- Department of Psychology, University of Wisconsin - Milwaukee, Milwaukee, WI, USA
| | - Sarah A Okey
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Jesse R Cougle
- Department of Psychology, Florida State University, Tallahassee, FL, USA.
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Mathes BM, Oglesby ME, Short NA, Portero AK, Raines AM, Schmidt NB. An examination of the role of intolerance of distress and uncertainty in hoarding symptoms. Compr Psychiatry 2017; 72:121-129. [PMID: 27816711 DOI: 10.1016/j.comppsych.2016.10.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 09/14/2016] [Accepted: 10/08/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Hoarding disorder (HD) is a common and debilitating disorder characterized by an accumulation of and failure to discard one's possessions. The identification and examination of underlying factors that may contribute to hoarding symptoms are needed to elucidate the nature of the disorder and refine existing treatments. Two transdiagnostic vulnerability factors that have been associated with hoarding symptoms are distress intolerance (DI) and intolerance of uncertainty (IU). OBJECTIVES This study examined the relationships between DI, IU, and symptoms of hoarding in two samples consisting of outpatients and individuals recruited from Amazon's Mechanical Turk. We hypothesized that DI and IU would show unique and interactive associations with hoarding symptoms. RESULTS Across both samples, DI and IU were significantly associated with hoarding symptoms. However, DI and IU did not interact in their prediction of symptoms, and only IU remained a significant predictor, when accounting for relevant covariates. CONCLUSIONS Results suggest that IU is a robust predictor of hoarding symptoms and may be a promising and novel treatment target for HD.
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Affiliation(s)
- Brittany M Mathes
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, USA
| | - Mary E Oglesby
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, USA
| | - Nicole A Short
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, USA
| | - Amberly K Portero
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, USA
| | - Amanda M Raines
- Southeast Louisiana Veterans Health Care System, 3500 Canal Street, New Orleans, LA, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, USA.
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12
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Modifying interpretation biases in body dysmorphic disorder: Evaluation of a brief computerized treatment. Behav Res Ther 2016; 87:117-127. [DOI: 10.1016/j.brat.2016.09.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 09/03/2016] [Accepted: 09/12/2016] [Indexed: 11/20/2022]
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