Change in dysfunctional attitudes and attachment in interpersonal psychotherapy for depressed adolescents

Psychometric assessment of the 10-item Thai version of the Experience in Close Relationship-Revised for Adolescents (ECR-R-10-AD)

The 18-item version of the Experiences in Close Relationships-revised (ECR-R-18) is a valid and reliable scale used among Thai adolescents. However, it revealed problematic items that impacted the scale's internal consistency. The study aimed to achieve two objectives: (1) develop a new, shorter scale by retaining only highly loaded items equally between attachment anxiety and attachment avoidance, and (2) evaluate the psychometric properties of the shorter ECR-R version compared to the existing 18-item scale. Objective 1 was achieved through Study 1, involving 204 youths aged 16-18 years (64% female). All participants completed the 18-item ECR-R, and exploratory factor analysis was conducted to identify suitable items for the new ECR-R-AD. Objective 2 was fulfilled in Study 2, which included a total of 443 students in grades aged 15-18 years old (88% female) from Thai boarding schools in Northern Thailand. All participants completed both the 18-item ECR-R, and confirmatory factor analysis of both the existing 18-item and the new shorter scale was performed and compared. Additional measures including the Rosenberg Self-Esteem Scale, Perceived Stress Scale-10, and Relationship Questionnaire were completed alongside the ECR-R to assess convergent, discriminant, and criterion validity. The invariance test for the new ECR-R across genders was conducted using multigroup confirmatory factor analysis. For objective 1, Study 1 developed a new scale called "ECR-R-10-AD" with 10 items, comprising 5 for attachment anxiety and 5 for attachment avoidance. The McDonald's omega values were 0.866 for avoidance and 0.823 for anxiety subscales. The corrected correlation between the ECR-R-18 and ECR-R-10-AD was significant. For objective 2, Study 2 found that the first-order two-factor solution model fit the data best for the ECR-R-10-AD. Convergent, discriminant, and criterion validity with other measurements and invariance tests based on sex were established for the ECR-R-AD. The ECR-R-10-AD provided sufficient psychometric properties among Thai adolescents. Factorial validity, convergent validity, and measurement invariance were established. As the ECR-R-10-AD is brief, it can be administered with less burden. Limitations and future research were discussed.

Associations of dysfunctional attitudes, ruminations and metacognitive beliefs about rumination with pharmacological treatment response in patients with first episode of major depression

INTRODUCTION

The aim of this study is to investigate whether treatment with selective serotonin reuptake inhibitors (SSRI) has an effect on the ruminative response, ruminative beliefs and dysfunctional attitudes (DA), and to evaluate the effects of pre-treatment dysfunctional attitudes and rumination levels on treatment response in individuals diagnosed with the first episode of major depression (MD).

METHODS

110 patients with MD participated in this study. Participants were evaluated with the Hamilton Depression Rating Scale (HDRS), the Clinical Global Impression Scale (CGI), the Short Version of Ruminative Response Scale (RRS), the Positive Beliefs about Rumination Scale (PBRS), the Negative Beliefs about Rumination Scale (NBRS), and the Dysfunctional Attitude Scale form A (DAS-A) before receiving SSRI treatment and 2 months after the onset of treatment.

RESULTS

After two months of SSRI treatment, patients were divided into two groups, remission and non-remission groups. The decrease in RRS subscales and total scores, NBRS uncontrollability and danger of ruminations score, PBRS total score and DAS-A autonomous attitude scores were significantly higher in the remission group. RRS and DAS-A scores were found to be predictors of remission.

CONCLUSIONS

DA and ruminations may be associated with poor response to SSRI treatment in depression. KEY POINTSAfter treatment with selective serotonin reuptake inhibitors, ruminations, dysfunctional attitudes, and positive and negative metacognitions on ruminations significantly decreased in patients with a first episode of major depression.The decrease in ruminations, autonomous attitudes, the metacognitions on the uncontrollability and danger of ruminations, and positive metacognitions on ruminations was higher in remission group compared to the non-remission group.Ruminations and dysfunctional attitudes significantly predicted remission in first episode of major depression.

Dysfunctional Attitudes Mediate the Relationship Between Childhood Emotional Neglect and Anhedonia in Young Adult Major Depression Patients

BACKGROUND

Childhood traumas are well-established risk factors for major depressive disorder (MDD). However, the relationship between childhood traumas types and MDD symptoms is unclear. The present study tested the hypothesis that childhood traumas affect specific types of anhedonia in depression and the mediating role of dysfunctional attitude.

METHODS

Within this cross-sectional study, 310 young adult patients with MDD completed the PHQ-9, CTQ-SF, DAS, and SHAPS. The statistical analyses used the Mann-Whitney U test, Spearman's rank correlation, and multiple regression analysis. Mediation analyses were tested by the structural equation model (SEM).

RESULTS

Spearman's rank correlation analysis showed positive correlations between the SHAPS, CTQ-SF, and DAS total score (p < 0.05). The EA, EN, PN, and SHAPS scores were positively correlated (p < 0.05). Among the four factors of anhedonia, social interaction and interest/pastimes were positively correlated with EA, EN, and PN (p < 0.05), the sensory experience was positively correlated with EN (p < 0.01), and diet did not correlate with childhood traumas. Stepwise regression analysis showed that dysfunctional attitude and emotional neglect were the main influencing factors of sensory experience (p < 0.001) and social interaction (p < 0.001). Dysfunctional attitude and physical neglect were the main factors influencing interest/pastimes (p < 0.001). SEM analysis found that dysfunctional mediated between childhood traumas and anhedonia.

CONCLUSIONS

The degree of anhedonia was related to dysfunctional attitudes and childhood traumas. The childhood emotional neglect experience was the most important and was related to sensory and social anhedonia. Dysfunctional attitudes played a mediating role between childhood neglect and anhedonia. Early psychotherapy targeting young adult MDD patients with childhood emotional neglect may help decrease symptoms of anhedonia.