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Edge D, Watkins E, Newbold A, Ehring T, Frost M, Rosenkranz T. Evaluating the Effects of a Self-Help Mobile Phone App on Worry and Rumination Experienced by Young Adults: Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e51932. [PMID: 39137411 DOI: 10.2196/51932] [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: 09/15/2023] [Revised: 04/25/2024] [Accepted: 05/06/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Delivery of preventative interventions via mobile phone apps offers an effective and accessible way to address the global priority of improving the mental health of adolescents and young adults. A proven risk factor for anxiety and depression is elevated worry and rumination, also known as repetitive negative thinking (RNT). OBJECTIVE This was a prevention mechanism trial that aimed to investigate whether an RNT-targeting self-help mobile phone app (MyMoodCoach) reduces worry and rumination in young adults residing in the United Kingdom. A secondary objective was to test whether the app reduces symptoms of anxiety and depression and improves well-being. METHODS A web-based, single-blind, 2-arm parallel-group randomized controlled trial was conducted with 236 people aged between 16 and 24 years, who self-reported high levels of worry or rumination. Eligible participants were randomized to an active intervention group (usual practice, plus up to 6 weeks of using the RNT-targeting mobile app, n=119) or a waitlist control group (usual practice with no access to the app until after 6 weeks, n=117). The primary outcome was changes in worry and rumination 6 weeks after randomization. Secondary outcomes included changes in well-being and symptoms of anxiety and depression after 6 weeks and changes in all measures after 12 weeks. RESULTS Participants randomly allocated to use the RNT-targeting self-help app showed significantly lower levels of rumination (mean difference -2.92, 95% CI -5.57 to -0.28; P=.03; ηp2=0.02) and worry (mean difference -3.97, 95% CI -6.21 to -1.73; P<.001; ηp2=0.06) at 6-week follow-up, relative to the waitlist control. Similar differences were observed for well-being (P<.001), anxiety (P=.03), and depression (P=.04). The waitlist control group also showed improvement when given access to the app after 6 weeks. Improvements observed in the intervention group after 6 weeks of using the app were maintained at the 12-week follow-up point. CONCLUSIONS The MyMoodCoach app had a significant positive effect on worry and rumination, well-being, anxiety, and depression in young adults, relative to waitlist controls, providing proof-of-principle that an unguided self-help app can effectively reduce RNT. This app, therefore, has potential for the prevention of anxiety and depression although longer-term effects on incidence need to be directly evaluated. TRIAL REGISTRATION ClinicalTrials.gov NCT04950257; https://www.clinicaltrials.gov/ct2/show/NCT04950257. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12888-021-03536-0.
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Affiliation(s)
- Daniel Edge
- Mood Disorders Centre, School of Psychology, University of Exeter, Exeter, United Kingdom
| | - Edward Watkins
- Mood Disorders Centre, School of Psychology, University of Exeter, Exeter, United Kingdom
| | - Alexandra Newbold
- Mood Disorders Centre, School of Psychology, University of Exeter, Exeter, United Kingdom
| | - Thomas Ehring
- Department of Psychology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | | | - Tabea Rosenkranz
- Department of Psychology, Ludwig-Maximilians-University of Munich, Munich, Germany
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Hirsig A, Häfeli XA, Schmidt SJ. Efficacy of a transdiagnostic Internet prevention approach in adolescents (EMPATIA study): study protocol of a randomized controlled trial. Trials 2024; 25:530. [PMID: 39118136 PMCID: PMC11308397 DOI: 10.1186/s13063-024-08241-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 06/10/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Most mental disorders have their onset in adolescence. Preventive interventions during this period are important; however, help-seeking behavior is generally poor in this age group resulting in low treatment rates. Internet interventions are expected to be an effective, low-threshold, and scalable approach to overcome barriers to help-seeking, particularly for individuals experiencing subclinical symptoms. Internet-delivered indicated prevention seems promising as it targets individuals with minimal symptoms of mental disorders who might need care but are not help-seeking yet. Previous indicated prevention-approaches have mainly targeted specific risk-syndromes. However, this contradicts the increasing recognition of emerging psychopathology as a complex system characterized by co-occurrence and rapid shifts of subclinical symptoms cutting across diagnostic categories. Therefore, this study will investigate the efficacy, mediators, moderators, and core symptomatic changes of a transdiagnostic Internet-delivered indicated prevention program (EMPATIA program) for adolescents. METHODS This randomized controlled trial (RCT) will be conducted in a general population sample (planned n = 152) of adolescents aged 12-18 years with subclinical symptoms but without any current or past mental disorder. Participants will be randomly assigned to the EMPATIA program or a care as usual (CAU) control condition. The 8-week guided EMPATIA program encompasses 8 modules targeting the following transdiagnostic mechanisms: repetitive negative thinking, self-perfectionism, emotion regulation, intolerance of uncertainty, rejection sensitivity, and behavioral avoidance. Participants will be asked to answer online self-report questionnaires at baseline, after 8 weeks, and at 6-, 9-, and 12-month follow-up. Diagnostic telephone interviews will be conducted at baseline and at 12-month follow-up. Additionally, intervention-specific constructs (motivation, alliance, negative effects, satisfaction, adherence) will be assessed during and after the EMPATIA program. The level of self-reported general psychopathology post-intervention is the primary outcome. DISCUSSION Results will be discussed considering the potential of Internet interventions as a scalable, low-threshold option for indicated prevention in adolescents experiencing subclinical symptoms. The EMPATIA program introduces a novel Internet prevention program targeting six transdiagnostic mechanisms associated with various mental health outcomes. Thereby, this trial pursues a very timely and important topic because it may contribute to narrow the current care gap for adolescents, to prevent mental health problems and related negative consequences, and to promote mental health in the long-term. TRIAL REGISTRATION The trial was approved by Swissmedic (Registration Number: 10001035, 08/22/2022) and the Ethics Committee of Bern (Registration Number: 2022-D0036, 08/22/2022). The trial was registered at ClinicalTrials.gov NCT05934019 on 07-03-2023.
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Affiliation(s)
- Anja Hirsig
- Division of Clinical Child and Adolescent Psychology, University of Bern, Fabrikstrasse 8, Bern, 3012, Switzerland.
| | - Xenia Anna Häfeli
- Division of Clinical Child and Adolescent Psychology, University of Bern, Fabrikstrasse 8, Bern, 3012, Switzerland
| | - Stefanie Julia Schmidt
- Division of Clinical Child and Adolescent Psychology, University of Bern, Fabrikstrasse 8, Bern, 3012, Switzerland
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Verreault MD, Granger É, Neveu X, Delage JP, Bastien CH, Vallières A. The effectiveness of stimulus control in cognitive behavioural therapy for insomnia in adults: A systematic review and network meta-analysis. J Sleep Res 2024; 33:e14008. [PMID: 37586843 DOI: 10.1111/jsr.14008] [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: 04/30/2023] [Revised: 07/10/2023] [Accepted: 07/13/2023] [Indexed: 08/18/2023]
Abstract
Stimulus control is part of the widely used cognitive behavioural therapy for insomnia. However, there is a lack of knowledge about its mechanisms of action and effectiveness when used alone. This systematic review with network meta-analysis aimed to evaluate stimulus control efficacy when used alone compared with cognitive behavioural therapy for insomnia or its components. The review also documented stimulus control mechanisms of action proposed by the authors. A search was conducted in several bibliographic databases (MEDLINE, PsycINFO, Embase, CINAHL, Psychology Behavioural Sciences Collection, Web of Science, and Cochrane Library) and in two registers from 1972 to June 2022. Randomised studies with adult participants presenting a diagnosis of insomnia and including at least one stimulus control instruction in a treatment group were included. Risk of bias was assessed with the Quality Assessment of Controlled Intervention Studies. Twenty-three studies were included and three network meta-analyses were conducted. The quality of included studies was generally poor. Results indicate that stimulus control is an effective intervention to improve insomnia compared with control conditions. Not all stimulus control instructions seem essential, especially those known to recondition the bedroom for sleep. The review challenges the classical conditioning hypothesis. Results should be interpreted cautiously given the small number of studies included, bias risk, and inconsistencies in the network meta-analysis. Rigorous research is needed in evaluating stimulus control efficacy and mechanisms.
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Affiliation(s)
- Mikael Demers Verreault
- École de psychologie, Université Laval, Québec, QC, Canada
- Centre de recherche CERVO, Québec, QC, Canada
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | | | - Xavier Neveu
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Julia Pizzamiglio Delage
- École de psychologie, Université Laval, Québec, QC, Canada
- Centre de recherche CERVO, Québec, QC, Canada
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Célyne H Bastien
- École de psychologie, Université Laval, Québec, QC, Canada
- Centre de recherche CERVO, Québec, QC, Canada
| | - Annie Vallières
- École de psychologie, Université Laval, Québec, QC, Canada
- Centre de recherche CERVO, Québec, QC, Canada
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
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Hitchcock PF, Frank MJ. From Tripping and Falling to Ruminating and Worrying: A Meta-Control Account of Repetitive Negative Thinking. Curr Opin Behav Sci 2024; 56:101356. [PMID: 39130377 PMCID: PMC11314892 DOI: 10.1016/j.cobeha.2024.101356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Repetitive negative thinking (RNT) is a transdiagnostic construct that encompasses rumination and worry, yet what precisely is shared between rumination and worry is unclear. To clarify this, we develop a meta-control account of RNT. Meta-control refers to the reinforcement and control of mental behavior via similar computations as reinforce and control motor behavior. We propose rumination and worry are coarse terms for failure in meta-control, just as tripping and falling are coarse terms for failure in motor control. We delineate four meta-control stages and risk factors increasing the chance of failure at each, including open-ended thoughts (stage 1), individual differences influencing subgoal execution (stage 2) and switching (stage 3), and challenges inherent to learning adaptive mental behavior (stage 4). Distinguishing these stages therefore elucidates diverse processes that lead to the same behavior of excessive RNT. Our account also subsumes prominent clinical accounts of RNT into a computational cognitive neuroscience framework.
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Affiliation(s)
- Peter F. Hitchcock
- Department of Psychology, Emory University, Atlanta, GA
- Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI
| | - Michael J. Frank
- Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI
- Carney Institute for Brain Science, Brown University, Providence, RI
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Giles S, Hughes EK, Castle D, Jenkins Z, Phillipou A, Rossell S, Urbini G, Fuller-Tyszkiewicz M, Krug I. A new network analysis model in anorexia nervosa patients based on self-reported eating disorder symptoms, psychological distress, and cognitive flexibility. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2024; 63:118-134. [PMID: 38071465 DOI: 10.1111/bjc.12451] [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: 04/28/2023] [Revised: 10/30/2023] [Accepted: 11/29/2023] [Indexed: 02/09/2024]
Abstract
OBJECTIVES Cognitive flexibility and psychological distress, such as depression and anxiety, have been implicated in the aetiology of Anorexia Nervosa (AN). Despite the known associations between eating disorder (ED) symptoms, depression, anxiety, and cognitive flexibility, the specific pathways that connect these constructs are unclear. We therefore used network analysis to examine the relationship between these symptoms in an AN sample. METHODS One hundred and ninety-three treatment-seeking individuals diagnosed with AN (95.6% female, M = 26.89 [SD = 9.45] years old) completed self-report measures assessing depression, anxiety, cognitive flexibility, and ED symptoms. To determine each symptom's influence in the network, we calculated the expected influence. RESULTS The two relationships with the greatest edges were those between (1) weight/shape concerns and eating/dietary restraint and (2) weight/shape concerns and psychological distress (a measure that combined depression and anxiety). Cognitive flexibility was not connected to weight/shape concerns but had negative partial associations with eating concerns/dietary restraint and psychological distress. There was also a slight, non-zero connection between eating concerns/dietary restraint and psychological distress. CONCLUSIONS The findings underscore the importance of weight/shape, eating/dietary concerns, and psychological distress in the AN network and suggest that addressing cognitive flexibility may be a useful target for eating concerns/dietary restraint and psychological distress. Future studies assessing the longitudinal course of psychopathology within the AN network structure may help in identifying whether specific symptoms function as risk factors or maintaining factors for this co-occurrence.
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Affiliation(s)
- Sarah Giles
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Elizabeth K Hughes
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - David Castle
- Centre for Mental Health Service Innovation, University of Tasmania, Hobart, Tasmania, Australia
| | - Zoe Jenkins
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia
- Iverson Institute, Swinburne University of Technology, Melbourne, Victoria, Australia
- Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andrea Phillipou
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Susan Rossell
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Gemma Urbini
- Body Image & Eating Disorders Treatment & Recovery Service, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Centre for Social and Early Emotional Development, Deakin University, Melbourne, Victoria, Australia
| | - Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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Rashtbari A, Taylor DL, Saed O, Malekizadeh H. Psychometric Properties of the Iranian Version of Contrast Avoidance Questionnaires: Could Contrast Avoidance Be a New Transdiagnostic Construct? J Pers Assess 2023; 105:820-837. [PMID: 36719952 DOI: 10.1080/00223891.2023.2169153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 01/05/2023] [Indexed: 02/02/2023]
Abstract
The contrast avoidance model (CAM) hypothesizes that individuals with chronic worry recruit worry to create and maintain a negative emotional state to avoid sudden increases in negative emotions. Preliminary evidence using the contrast avoidance questionnaires (CAQs) suggests that there might be a similar mechanism across mood and other anxiety disorders. To continue to assess the CAQs, they should be adapted for other languages and evaluated across multiple symptom domains. The present study aimed to develop the Persian versions of the CAQs and examine the transdiagnostic nature of CAM across two studies. A large Persian-speaking college student sample (Total n = 1438) was used to evaluate the factor structure of the CAQs (Study 1) and the psychometric properties of CAQs (Study 2). Results supported the two-factor structure of the CAQ-W (worry) and CAQ-GE (general emotion). Results showed that CAQ-W was a significant predictor of anxiety-related measures. However, CAQ-GE and IUS-12 significantly predicted depressive and other symptoms over the CAQ-W. Results demonstrated excellent psychometric properties. They indicate that contrast avoidance, measured via CAQ-GE, could be a transdiagnostic construct, and CAQ-W may be more sensitive to anxiety-specific contrast avoidance among Persian speaking and/or Iranian individuals.
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Affiliation(s)
- Alireza Rashtbari
- Department of Clinical Psychology, School of Medicine, Zanjan University of Medical Science, Zanjan, Iran
| | - Danielle L Taylor
- Ralph H. Johnson VA Medical Center, Charleston, South Carolina
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Omid Saed
- Department of Clinical Psychology, School of Medicine, Zanjan University of Medical Science, Zanjan, Iran
| | - Hossein Malekizadeh
- Department of Clinical Psychology, School of Medicine, Zanjan University of Medical Science, Zanjan, Iran
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Koscinski B, Accorso C, Albanese B, Schmidt NB, Allan NP. A replication and extension of bifactor modelling of perseverative thought in an at-risk community sample: Exploring sex differences in the structure of PT. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2023; 62:717-730. [PMID: 37493004 DOI: 10.1111/bjc.12434] [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: 12/29/2022] [Revised: 06/19/2023] [Accepted: 06/28/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Perseverative thought (PT) is a transdiagnostic construct associated with internalizing disorders. Bifactor models have shown that PT can be split into a general PT factor and lower-order factors for specific forms of PT, such as rumination and worry. No bifactor study to date has investigated if the structure of PT differs across sexes. METHODS The study consisted of 280 individuals recruited for a larger study targeting risk factors for suicidal ideation and behaviours. Participants completed a diagnostic interview and self-report questionnaires. RESULTS A two-factor model of PT fit best in males, whereas a bifactor model fit best in females. In a structural equation model, worry was associated with generalized anxiety disorder diagnoses in females, but not males. Rumination was associated with depressive disorder diagnoses in females, but not males. CONCLUSIONS The present study contributes to a growing literature on PT; we found that dimensionality of PT varied by sex. We also found that relations between PT factors and generalized anxiety disorder differed by sex. Sex differences in the internalizing spectrum and related risk factors need to be considered when examining the structure and function of risk factors.
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Affiliation(s)
| | | | - Brian Albanese
- Department of Psychology, Auburn University, Auburn, Alabama, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Nicholas P Allan
- Department of Psychology, Ohio University, Athens, Ohio, USA
- VA Center of Excellence for Suicide Prevention, VA Finger Lakes Health Care System, Finger Lakes, New York, USA
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Tichenor SE, Gerwin KL, Walsh B. Repetitive Negative Thinking in Adolescents Who Stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:3290-3306. [PMID: 37494925 PMCID: PMC10558142 DOI: 10.1044/2023_jslhr-23-00147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE Repetitive negative thinking (RNT) is the process of engaging in negatively valenced and habitual thought patterns. RNT is strongly associated with mental health conditions and often affects quality of life. This study explored RNT in older school-age children and adolescents who stutter to quantify the relationship between RNT and self-reported anxiety characteristics. An additional aim was to describe how individual differences in an adolescent's goal when speaking influences the frequency they engage in RNT. METHOD Ninety-nine children and adolescents who stutter aged 9-18 years completed a measurement of the frequency/severity of RNT, a screener of anxiety characteristics, and a measure of adverse impact related to stuttering. Children aged 10 years and above also answered questions about their goal when speaking. RESULTS Individual differences in RNT significantly predicted Overall Assessment of the Speaker's Experience of Stuttering (OASES) Total Scores more so than a child or adolescent's age. Higher generalized or social anxiety scores were significantly correlated with more frequent RNT and higher OASES Total Scores. Individual differences in goal when speaking (i.e., whether or not to stutter openly) were found to predict RNT. Finally, 22 children and adolescents (22.2%) also screened positive for generalized anxiety disorder and 32 (32.3%) screened positive for social anxiety disorder. DISCUSSION These data provide strong evidence that (a) many children and adolescents who stutter engage in RNT; (b) children and adolescents who engage more frequently in RNT or who have higher OASES Total Scores may be at increased risk for more characteristics of generalized or social anxiety; and (c) individual differences in goal when speaking can predict the degree to which an adolescent engages in RNT. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23713296.
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Zagaria A, Vacca M, Cerolini S, Terrasi M, Bacaro V, Ballesio A, Baglioni C, Spinhoven P, Lombardo C. Differential Associations of Cognitive Emotion Regulation Strategies with Depression, Anxiety, and Insomnia in Adolescence and Early Adulthood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105857. [PMID: 37239583 DOI: 10.3390/ijerph20105857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/05/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023]
Abstract
While difficulties with emotion regulation (ER) are consistently linked to poor mental health in adulthood, findings in adolescence have been more mixed. Cognitive ER strategies, which involve the ability to manage emotions through mental processes, may be particularly important during different stages of development due to age-specific adjustments. We conducted two exploratory and cross-sectional studies to examine the relationships between cognitive ER strategies and mental health (i.e., depressive, anxiety, and insomnia symptoms) in two samples: 431 young adults (Mage = 20.66 ± 2.21; 70% women and 30% men) and 271 adolescents (Mage = 14.80 ± 0.0.59; 44.6% girls and 55.4% boys). The participants completed a group of questionnaires, including the Cognitive Emotion Regulation Questionnaire, the Insomnia Severity Index, the Beck Depression Inventory-II, the State-Trait Anxiety Inventory, and the Youth Self Report. We employed hierarchical multiple regressions to assess the unique contribution of cognitive ER strategies to mental health outcomes. Maladaptive strategies (such as rumination and catastrophizing) were consistently associated with impaired mental health in both samples, while adaptive strategies (such as positive refocusing and positive reappraisal) were only associated with better mental health in young adults. These findings support the importance of cognitive ER strategies as potential risk factors for psychopathology and suggest that interventions aimed at improving emotion regulation may be beneficial. The age-specific differences in the relationship between cognitive ER strategies and mental health may reflect the refinement of emotion regulation abilities across the lifespan.
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Affiliation(s)
- Andrea Zagaria
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Silvia Cerolini
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Michela Terrasi
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Valeria Bacaro
- Department of Psychology, University of Bologna, 40136 Bologna, Italy
| | - Andrea Ballesio
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Chiara Baglioni
- Department of Human Sciences, University of Rome Guglielmo Marconi, 00193 Rome, Italy
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, 79098 Freiburg, Germany
| | - Philip Spinhoven
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Institute of Psychology, Leiden University, 2333 AK Leiden, The Netherlands
| | - Caterina Lombardo
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
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Do perfectionists show negative, repetitive thoughts facing uncertain situations? CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04409-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2023]
Abstract
Abstract
Perfectionism, intolerance of uncertainty and repetitive negative thinking are all psychological traits, which are treated as transdiagnostic phenomena for the development and the maintenance of psychopathology. The aim of the current work was to investigate the associations between repetitive negative thinking and the multidimensional aspects of perfectionism (perfectionistic strivings and perfectionistic concerns) and intolerance of uncertainty (prospective and inhibitory) in one model. Two studies were conducted in which participants (N1 = 227; N2 = 148) completed questionnaires in an online survey. The first study measured rumination and worry separately as repetitive negative thinking processes. The second study measured repetitive negative thinking as an underlying construct of rumination and worry using a single questionnaire. We applied hierarchical regression analyses and mediation analyses in both studies. The mediation analyses in both studies showed that inhibitory intolerance of uncertainty significantly partially mediated the relationship between perfectionistic concerns and repetitive negative thinking (as well as worry and rumination). Perfectionistic concerns seem to be the more crucial perfectionism aspect for transdiagnostic considerations, particularly in association with a heighten inhibitory intolerance of uncertainty and repetitive negative thinking. Both studies strongly affirm the necessity to use the multidimensional aspects of perfectionism and intolerance of uncertainty in psychological research.
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Chen N, Xi J, Fan X. Correlations among Psychological Resilience, Cognitive Fusion, and Depressed Emotions in Patients with Depression. Behav Sci (Basel) 2023; 13:bs13020100. [PMID: 36829329 PMCID: PMC9951929 DOI: 10.3390/bs13020100] [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: 11/21/2022] [Revised: 12/15/2022] [Accepted: 01/18/2023] [Indexed: 01/27/2023] Open
Abstract
Background: More than 300 million people worldwide suffer from depression, which is a significant contributor to the global burden of disease. This study investigated the factors influencing psychological resilience and cognitive fusion in patients with depression and the relationships of psychological resilience and cognitive fusion with depression. Methods: This study enrolled 172 participants (65.8% of them were female). Psychological resilience, cognitive fusion, and depression were assessed with the psychological resilience scale, the cognitive fusion questionnaire, the Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), and Zung Self-rating Depression Scale (SDS), respectively. Furthermore, the relationships of psychological resilience and cognitive fusion with depression were investigated. Results: The psychological resilience and cognitive fusion scores of patients with depression varied significantly among different education levels, and HAMA, HAMD, and SDS scores were significantly negatively correlated with psychological resilience but positively correlated with cognitive fusion. Conclusions: Depression levels in patients with depression are closely related to psychological resilience and cognitive fusion. Therefore, anxiety and depression could be alleviated by improving the psychological resilience or reducing the cognitive fusion of patients with depression.
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Affiliation(s)
- Ning Chen
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai 200124, China
- College of Arts, Humanities and Social Sciences, University of Edinburgh, Edinburgh EH8 9YL, UK
| | - Juzhe Xi
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
- Correspondence: (J.X.); (X.F.)
| | - Xiwang Fan
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai 200124, China
- Correspondence: (J.X.); (X.F.)
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Bell IH, Marx W, Nguyen K, Grace S, Gleeson J, Alvarez-Jimenez M. The effect of psychological treatment on repetitive negative thinking in youth depression and anxiety: a meta-analysis and meta-regression. Psychol Med 2023; 53:6-16. [PMID: 36373473 PMCID: PMC9875014 DOI: 10.1017/s0033291722003373] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/14/2022] [Accepted: 10/07/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Depression and anxiety are prevalent in youth populations and typically emerge during adolescence. Repetitive negative thinking (RNT) is a putative transdiagnostic mechanism with consistent associations with depression and anxiety. Targeting transdiagnostic processes like RNT for youth depression and anxiety may offer more targeted, personalised and effective treatment. METHODS A meta-analysis was conducted to examine the effect of psychological treatments on RNT, depression and anxiety symptoms in young people with depression or anxiety, and a meta-regression to examine relationships between outcomes. RESULTS Twenty-eight randomised controlled trials examining 17 different psychological interventions were included. Effect sizes were small to moderate across all outcomes (Hedge's g depression = -0.47, CI -0.77 to -0.17; anxiety = -0.42, CI -0.65 to -0.20; RNT = -0.45, CI -0.67 to -0.23). RNT-focused and non-RNT focused approaches had comparable effects; however, those focusing on modifying the process of RNT had significantly larger effects on RNT than those focusing on modifying negative thought content. Meta-regression revealed a significant relationship between RNT and depression outcomes only across all intervention types and with both depression and anxiety for RNT focused interventions only. CONCLUSION Consistent with findings in adults, this review provides evidence that reducing RNT with psychological treatment is associated with improvements in depression and anxiety in youth. Targeting RNT specifically may not lead to better outcomes compared to general approaches; however, focusing on modifying the process of RNT may be more effective than targeting content. Further research is needed to determine causal pathways.
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Affiliation(s)
- Imogen H. Bell
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Wolfgang Marx
- Deakin University, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Katherine Nguyen
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Sally Grace
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - John Gleeson
- Healthy Brain and Mind Research Centre and School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Mario Alvarez-Jimenez
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
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13
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Bottesi G, Iannattone S, Carraro E, Lauriola M. The assessment of Intolerance of uncertainty in youth: An examination of the Intolerance of Uncertainty Scale-Revised in Italian nonclinical boys and girls. Res Child Adolesc Psychopathol 2023; 51:209-222. [PMID: 35779168 PMCID: PMC9867688 DOI: 10.1007/s10802-022-00944-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2022] [Indexed: 01/26/2023]
Abstract
Intolerance of Uncertainty (IU) is a transdiagnostic factor involved in several psychological disorders. Adolescence is characterized by elevated uncertainty and psychopathological vulnerability, but insufficient attention has been paid to IU at this age. This study aimed to investigate the factor structure and psychometric properties of the Intolerance of Uncertainty Scale-Revised (IUS-R) in Italian preadolescents and adolescents. 862 Italian students (57.3% girls) aged 11-17 (M = 14.8 ± 1.91) completed the IUS-R and measures of internalizing and externalizing symptoms, and psychological well-being. To test the factor structure of the IUS-R, one-factor, two-factor, and bifactor models were compared; measurement invariance, reliability, and validity were also addressed. Results showed that the bifactor model outperformed alternative factor models, and a general factor was needed to model the IUS-R. Bifactor model indices supported using the total score to assess IU reliably. Configural and metric invariance by age and sex were fully supported, while the IUS-R achieved partial scalar invariance. Significant correlations emerged for the IUS-R total score with psychopathological constructs, while no relationships with psychological well-being were found. Compared to adult normative data, higher total IUS-R scores were detected, suggesting that IU may be a phase-specific characteristic of adolescence. Our findings support using the IUS-R to measure IU across the lifespan. The recommended use of the total score and its associations with psychopathological dimensions highlight the transdiagnostic nature of IU in adolescence. Therefore, including IU when implementing interventions to prevent maladaptive outcomes in teenagers would be beneficial.
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Affiliation(s)
- Gioia Bottesi
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy
| | - Sara Iannattone
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy
| | - Eleonora Carraro
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy
| | - Marco Lauriola
- grid.7841.aDepartment of Psychology of Developmental and Socialisation Processes, Sapienza University of Rome, via dei Marsi 78, 00185, Rome, Italy
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14
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Habibi Asgarabad M, Doos Ali Vand H, Salehi Yegaei P, Hooman F, Ahmadi R, Baglioni C, Moradi S. The contribution of transdiagnostic vulnerability factors in patients with chronic insomnia. Front Psychiatry 2023; 14:1162729. [PMID: 37077275 PMCID: PMC10106755 DOI: 10.3389/fpsyt.2023.1162729] [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: 02/09/2023] [Accepted: 03/14/2023] [Indexed: 04/21/2023] Open
Abstract
Introduction Various transdiagnostic factors have been associated with insomnia severity. The current study aimed to predict insomnia severity based on a group of transdiagnostic factors including neuroticism, emotion regulation, perfectionism, psychological inflexibility, anxiety sensitivity, and repetitive negative thinking after controlling for depression/anxiety symptoms and demographic characteristics. Methods Two hundred patients with chronic insomnia disorder were recruited from a sleep disorder clinic. Participants completed the Insomnia Severity Index (ISI), Clinical Perfectionism Questionnaire (CPQ), Acceptance and Action Questionnaire-II (AAQ-II), Anxiety Sensitivity Index-3 (ASI-3), Repetitive Thinking Questionnaire (RTQ-10), Big Five Inventory (BFI-10), Emotion Regulation Questionnaire (ERQ), and Depression Anxiety Stress Scale (DASS-21). Results After controlling for the confounding variables (depression/anxiety symptoms and demographic characteristics), hierarchical multiple linear regression suggested the significant association of neuroticism (BFI), cognitive reappraisal (ERQ), personal standards (CPQ), evaluative concerns (CPQ), physical concerns (ASI), cognitive concerns (ASI), and repetitive negative thinking (RTQ) with insomnia severity. Discussion The findings support the role of transdiagnostic factors, especially physical concerns, repetitive negative thinking, and neuroticism in chronic insomnia. Future research using longitudinal designs is required to verify the causal status of transdiagnostic variables.
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Affiliation(s)
- Mojtaba Habibi Asgarabad
- Health Promotion Research Center, Iran University of Medical Science, Tehran, Iran
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Health Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
- Positive Youth Development Lab, Human Development & Family Sciences, Texas Tech University, Texas, TX, United States
- Center of Excellence in Cognitive Neuropsychology, Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Hoda Doos Ali Vand
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pardis Salehi Yegaei
- Health Promotion Research Center, Iran University of Medical Science, Tehran, Iran
| | - Farzaneh Hooman
- Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
| | - Reza Ahmadi
- Health Promotion Research Center, Iran University of Medical Science, Tehran, Iran
- Department of Clinical Psychology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Chiara Baglioni
- Human Sciences Department, University of Rome Guglielmo Marconi Rome, Rome, Italy
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Shahram Moradi
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway, Porsgrunn, Norway
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15
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Wang J, Wang C, Gu X, Sun Y. Lockdown in Chinese university dormitories: Significant increase in negative feelings and time perception distortion. PSYCHOLOGY IN THE SCHOOLS 2022; 60:PITS22833. [PMID: 36718134 PMCID: PMC9877836 DOI: 10.1002/pits.22833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/11/2022] [Accepted: 11/20/2022] [Indexed: 12/04/2022]
Abstract
The COVID-19 pandemic has led to a global crisis resulting in lockdowns worldwide. Studies found that these could amplify negative affects predictive of disturbances in time perception. However, all existing studies on this topic concentrated on the general population during a lockdown at home. There was no research on university students living in dormitories. This study fills a gap in the literature by investigating the affective states and awareness of the passage of time of Chinese university students during an exceptional dormitory lockdown. Using a snowball sampling approach, this web-based study recruited 225 volunteers (136 girls, 17-27 years old) during a dormitory lockdown. The online survey consisted of questions on demographic information, affective states (the Chinese version of the depression anxiety stress scales-21 (DASS-21) on depression, anxiety, and stress), and sense of the passage of time (the translated version of the assessment of passage of time over daily, weekly and yearly periods). The researchers shared the questionnaire link via the social media application WeChat. The study applied descriptive statistics and column charts to represent students' affective states and sense of the passage of time under extreme conditions and Pearson's correlation analysis to examine the impact of affective states on their sense of time. The study's results indicate that the dormitory lockdown caused a significant increase in all depression, anxiety, and stress categories of the DASS-21, as well as a distortion of the sense of time passing. However, the direction of the distortion differed from that in previous studies. Moreover, a Pearson correlation analysis showed that none of the three negative affects could be associated with students' sense of time. The findings of this study indicate an increased vulnerability of students due to the lockdown. Their emotions were strongly affected, requiring particular interventions to preserve their mental well-being. In addition, they showed a different distortion direction of time passage. Finally, they differed in the correlations between negative affect and the sense of passage of time compared to the general population in lockdown at home. This shows a need to investigate the impact of psychological states on students' routines and quality of life in emergencies. This study's scope should be expanded by incorporating additional factors pertaining to the passage of time and by integrating cross-cultural comparisons.
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Affiliation(s)
- Juanjuan Wang
- School of English Teacher EducationXi'an International Studies UniversityXi'anChina
| | - Chen Wang
- School of English Teacher EducationXi'an International Studies UniversityXi'anChina
| | - Xiaoming Gu
- School of English Teacher EducationXi'an International Studies UniversityXi'anChina
| | - Yi Sun
- Center for Linguistics and Applied LinguisticsGuangdong University of Foreign StudiesGuangzhouChina
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16
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Akbar SA, Mattfeld AT, Laird AR, McMakin DL. Sleep to Internalizing Pathway in Young Adolescents (SIPYA): A proposed neurodevelopmental model. Neurosci Biobehav Rev 2022; 140:104780. [PMID: 35843345 PMCID: PMC10750488 DOI: 10.1016/j.neubiorev.2022.104780] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/28/2022] [Accepted: 07/12/2022] [Indexed: 01/28/2023]
Abstract
The prevalence of internalizing disorders, i.e., anxiety and depressive disorders, spikes in adolescence and has been increasing amongst adolescents despite the existence of evidence-based treatments, highlighting the need for advancing theories on how internalizing disorders emerge. The current review presents a theoretical model, called the Sleep to Internalizing Pathway in Young Adolescents (SIPYA) Model, to explain how risk factors, namely sleep-related problems (SRPs), are prospectively associated with internalizing disorders in adolescence. Specifically, SRPs during late childhood and early adolescence, around the initiation of pubertal development, contribute to the interruption of intrinsic brain networks dynamics, both within the default mode network and between the default mode network and other networks in the brain. This interruption leaves adolescents vulnerable to repetitive negative thought, such as worry or rumination, which then increases vulnerability to internalizing symptoms and disorders later in adolescence. Sleep-related behaviors are observable, modifiable, low-stigma, and beneficial beyond treating internalizing psychopathology, highlighting the intervention potential associated with understanding the neurodevelopmental impact of SRPs around the transition to adolescence. This review details support for the SIPYA Model, as well as gaps in the literature and future directions.
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Affiliation(s)
- Saima A Akbar
- Department of Psychology, Florida International University, Miami, FL, USA.
| | - Aaron T Mattfeld
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, USA
| | - Dana L McMakin
- Department of Psychology, Florida International University, Miami, FL, USA
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17
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Smith AR, Jones EL, Subar AR, Do QB, Kircanski K, Leibenluft E, Brotman MA, Pine DS, Silk JS. The role of anxiety and gender in anticipation and avoidance of naturalistic anxiety‐provoking experiences during adolescence: An ecological momentary assessment study. JCPP ADVANCES 2022. [DOI: 10.1002/jcv2.12084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Ashley R. Smith
- National Institute of Mental Health, Emotion and Development Branch Bethesda Maryland USA
| | - Emily L. Jones
- Department of Psychology University of Denver Denver Colorado USA
| | - Anni R. Subar
- Department of Psychology University of Denver Denver Colorado USA
| | - Quyen B. Do
- Department of Psychology University of Pittsburgh Pittsburgh Pennsylvania USA
| | - Katharina Kircanski
- National Institute of Mental Health, Emotion and Development Branch Bethesda Maryland USA
| | - Ellen Leibenluft
- National Institute of Mental Health, Emotion and Development Branch Bethesda Maryland USA
| | - Melissa A. Brotman
- National Institute of Mental Health, Emotion and Development Branch Bethesda Maryland USA
| | - Daniel S. Pine
- National Institute of Mental Health, Emotion and Development Branch Bethesda Maryland USA
| | - Jennifer S. Silk
- Department of Psychology University of Pittsburgh Pittsburgh Pennsylvania USA
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18
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Rogiers R, Van Parys H, Baeken C, Van den Abbeele D, Remue J, De Raedt R, Lemmens GMD. Treatment experiences during a cognitive behaviour therapy group intervention targeting repetitive negative thinking: A qualitative study. Psychol Psychother 2022; 95:447-466. [PMID: 34936174 DOI: 10.1111/papt.12378] [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: 07/14/2021] [Accepted: 12/09/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Treatment of repetitive negative thinking (RNT) focuses rather on individual than group cognitive behaviour therapy (CBT) treatment. Additionally, little is known on how clients experienced these interventions. This study investigates clients' experiences on participating in a CBT group intervention targeting RNT (RNT-G). DESIGN Of the 80 participants, 11 were randomly selected for an in-depth, semi-structured interview after treatment. Interviews focused on what participants experienced as important on group aspects, offered interventions, homework tasks, and possible changes. METHODS All participants were adults, diagnosed with major depressive disorder and/or generalized anxiety disorder and being currently in mental health care treatment. After transcribing the interviews, analyses were performed according to the guidelines of thematic analysis. RESULTS Four major themes were identified. First, the group format itself was experienced as an important factor of change. The experiences about the different offered interventions during the group formed a second theme. A third theme related to changes in family or professional life and dealing with RNT as a result of the intervention. Finally, group participation, social interactions, and mental health care treatment were experienced as mutually influencing during the intervention. CONCLUSIONS The results of this study shed some light on which treatment interventions were perceived as beneficial during the RNT-G and should therefore be emphasized in treatment. Further, they indicate that the treatment in a group format was experienced as helpful by the participants. Finally, a positive mutual influence between the group intervention and the ongoing individual treatment was experienced.
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Affiliation(s)
- Roland Rogiers
- Department of Psychiatry, Center for Anxiety and Mood Disorders, Ghent University Hospital, Ghent, Belgium.,Department of Head and Skin - Psychiatry, Ghent University, Ghent, Belgium
| | - Hanna Van Parys
- Department of Psychiatry, Center for Anxiety and Mood Disorders, Ghent University Hospital, Ghent, Belgium.,Department of Head and Skin - Psychiatry, Ghent University, Ghent, Belgium
| | - Chris Baeken
- Department of Head and Skin - Psychiatry, Ghent University, Ghent, Belgium.,Department of Psychiatry, University Hospital (UZ Brussel), Brussels, Belgium.,Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium
| | - Dirk Van den Abbeele
- Department of Psychiatry, Center for Anxiety and Mood Disorders, Ghent University Hospital, Ghent, Belgium
| | - Jonathan Remue
- Department of Psychiatry, Center for Anxiety and Mood Disorders, Ghent University Hospital, Ghent, Belgium.,Department of Head and Skin - Psychiatry, Ghent University, Ghent, Belgium
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Gilbert M D Lemmens
- Department of Psychiatry, Center for Anxiety and Mood Disorders, Ghent University Hospital, Ghent, Belgium.,Department of Head and Skin - Psychiatry, Ghent University, Ghent, Belgium
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19
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Coussement C, De Longueville X, Heeren A. Attentional networks in co-occurring generalized anxiety disorder and major depression disorder: Towards a staging approach to the executive control deficits. Compr Psychiatry 2022; 113:152294. [PMID: 34942482 DOI: 10.1016/j.comppsych.2021.152294] [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: 07/06/2021] [Revised: 11/29/2021] [Accepted: 12/17/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Major Depression Disorder (MDD) and Generalized Anxiety Disorder (GAD) often co-occur, but the neurocognitive mechanisms of this co-occurrence remain unknown. Prominent views have pointed to attentional processes as potent mechanisms at play in MDD and GAD, respectively. Yet uncertainty remains regarding the very nature of attentional impairments in patients with co-occurring MDD and GAD. METHODS Inspired by contemporary models of attentional networks, we compared the three main attentional networks, namely the orienting, alerting, and executive networks of the Attention Network Task's model, in four groups of patients with, respectively, co-occurring DSM-5 MDD and GAD (n = 30), DSM-5 MDD only (n = 30), DSM-5 GAD only (n = 30), or free from any DSM-5 diagnosis (n = 30). To capture the multivariate nature of our data, we examined between-group differences in the attentional networks through a multivariate analysis of variance. RESULTS Patients with co-occurring MDD and GAD exhibited more severe impairments in the executive control network than those with only one of the disorders. Although patients with MDD or GAD solely did not differ in terms of attentional impairments, both groups showed significantly more impairments in the executive control network than those free from any DSM-5 diagnosis (all Bonferonni-corrected post-hoc ps < 0.05). CONCLUSIONS Our findings align with a longstanding staging approach to comorbidity whereby, via synergistic effects, co-occurring disorders produce more damages than the sum of each disorder. Here, for the first time, we extended this approach to the executive network of attention in the context of the co-occurrence between MDD and GAD.
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Affiliation(s)
- Charlotte Coussement
- Psychological Sciences Research Institute, UCLouvain, Belgium; Le Beau Vallon - Psychiatric Hospital, Belgium
| | - Xavier De Longueville
- Department of Adult Psychiatry, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Alexandre Heeren
- Psychological Sciences Research Institute, UCLouvain, Belgium; Institute of Neuroscience, UCLouvain, Belgium.
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20
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Do Metacognitions of Children and Adolescents with Anxiety Disorders Change after Intensified Exposure Therapy? CHILDREN 2022; 9:children9020168. [PMID: 35204889 PMCID: PMC8869889 DOI: 10.3390/children9020168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 11/17/2022]
Abstract
Metacognitive beliefs have repeatedly proven to play a role in anxiety disorders in children and adolescents, but few studies have investigated whether they change after cognitive behavioral therapy. This longitudinal intervention study explores whether positive and negative metacognitive beliefs in particular change after exposure-focused treatment, and if metacognitive changes predict reductions in anxiety symptoms. A sample of 27 children between 8 and 16 years of age with a primary diagnosis of specific phobia, separation-anxiety disorder or social phobia completed assessments of anxiety symptoms, metacognitive beliefs, worry and repetitive negative thoughts before and after 11 sessions of intensified exposure treatment. Metacognitive beliefs did not change significantly after intensified exposure, but post-hoc power analysis revealed a lack of power here. Change in negative metacognitive beliefs correlated with a change in anxiety symptoms, but did not independently contribute as a predictor variable. Differences between subsamples showed that patients with separation-anxiety disorder scored higher on negative metacognitive beliefs than those with specific or social phobia. Consideration of metacognition, and negative metacognitive beliefs in particular could help us further improve the understanding and treatment of anxiety disorders in children and adolescents and should therefore receive more attention in psychotherapy research.
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21
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Hu Z, Yu H, Zou J, Zhang Y, Lu Z, Hu M. Relationship among self-injury, experiential avoidance, cognitive fusion, anxiety, and depression in Chinese adolescent patients with nonsuicidal self-injury. Brain Behav 2021; 11:e2419. [PMID: 34816613 PMCID: PMC8671785 DOI: 10.1002/brb3.2419] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/17/2021] [Accepted: 10/12/2021] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To explore relationship among self-injury behavior, experiential avoidance, cognitive fusion, anxiety, and depression in Chinese adolescent patients with nonsuicidal self-injury (NSSI). METHODS Cognitive fusion questionnaire (CFQ), Acceptance and Action Questionnaire-2nd edition (AAQ-II), adolescent nonsuicidal self-injury behavior questionnaire (ANSAQ), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) were used as research tools to investigate 120 subjects with NSSI and 130 healthy controls. RESULTS The scores of CFQ and AAQ-II in the NSSI group were significantly higher than those in the healthy control group (p < .001). The results of regression analysis showed that the experiential avoidance score of patients with NSSI could predict the score of self-injury questionnaire (β = 0.585, p < .001); when predicting anxiety, only CFQ (β = 0.361, p < .001) entered the equation, with an explanatory variation of 12.3%; when predicting depression, CFQ (β = 0.287, p < .01) entered the equation, with an explanatory variation of 7.4%. CONCLUSION A high level of cognitive fusion and experiential avoidance may be important factors for the maintenance of self-injury behavior in patients with NSSI.
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Affiliation(s)
- Zhizhong Hu
- Department of Psychosomatic MedicineThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxi ProvinceChina
- School of Public AdministrationNanchang UniversityNanchangJiangxi ProvinceChina
| | - Huijuan Yu
- Department of Psychosomatic MedicineThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxi ProvinceChina
| | - Jingzhi Zou
- Department of Psychosomatic MedicineThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxi ProvinceChina
| | - Yanyan Zhang
- Department of Psychosomatic MedicineThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxi ProvinceChina
- School of Public AdministrationNanchang UniversityNanchangJiangxi ProvinceChina
| | - Zihang Lu
- Department of Psychosomatic MedicineThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxi ProvinceChina
- School of Public AdministrationNanchang UniversityNanchangJiangxi ProvinceChina
| | - Maorong Hu
- Department of Psychosomatic MedicineThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxi ProvinceChina
- School of Public AdministrationNanchang UniversityNanchangJiangxi ProvinceChina
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22
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Chahal R, Weissman DG, Hallquist MN, Robins RW, Hastings PD, Guyer AE. Neural connectivity biotypes: associations with internalizing problems throughout adolescence. Psychol Med 2021; 51:2835-2845. [PMID: 32466823 PMCID: PMC7845761 DOI: 10.1017/s003329172000149x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Neurophysiological patterns may distinguish which youth are at risk for the well-documented increase in internalizing symptoms during adolescence. Adolescents with internalizing problems exhibit altered resting-state functional connectivity (RSFC) of brain regions involved in socio-affective processing. Whether connectivity-based biotypes differentiate adolescents' levels of internalizing problems remains unknown. METHOD Sixty-eight adolescents (37 females) reported on their internalizing problems at ages 14, 16, and 18 years. A resting-state functional neuroimaging scan was collected at age 16. Time-series data of 15 internalizing-relevant brain regions were entered into the Subgroup-Group Iterative Multi-Model Estimation program to identify subgroups based on RSFC maps. Associations between internalizing problems and connectivity-based biotypes were tested with regression analyses. RESULTS Two connectivity-based biotypes were found: a Diffusely-connected biotype (N = 46), with long-range fronto-parietal paths, and a Hyper-connected biotype (N = 22), with paths between subcortical and medial frontal areas (e.g. affective and default-mode network regions). Higher levels of past (age 14) internalizing problems predicted a greater likelihood of belonging to the Hyper-connected biotype at age 16. The Hyper-connected biotype showed higher levels of concurrent problems (age 16) and future (age 18) internalizing problems. CONCLUSIONS Differential patterns of RSFC among socio-affective brain regions were predicted by earlier internalizing problems and predicted future internalizing problems in adolescence. Measuring connectivity-based biotypes in adolescence may offer insight into which youth face an elevated risk for internalizing disorders during this critical developmental period.
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Affiliation(s)
- Rajpreet Chahal
- Department of Human Ecology, University of California, Davis, One Shields Avenue, Davis, CA 95618
- Center for Mind and Brain, University of California, Davis, 267 Cousteau Place, Davis, CA 95616
| | | | - Michael N. Hallquist
- Department of Psychology, Pennsylvania State University, 309 Moore Building, University Park, PA 16802
| | - Richard W. Robins
- Department of Psychology, University of California, Davis, One Shields Avenue, Davis, CA 95618
| | - Paul D. Hastings
- Center for Mind and Brain, University of California, Davis, 267 Cousteau Place, Davis, CA 95616
- Department of Psychology, University of California, Davis, One Shields Avenue, Davis, CA 95618
| | - Amanda E. Guyer
- Department of Human Ecology, University of California, Davis, One Shields Avenue, Davis, CA 95618
- Center for Mind and Brain, University of California, Davis, 267 Cousteau Place, Davis, CA 95616
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23
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Jolly ATW, Garratt-Reed D, McEvoy PM. Does repetitive negative thinking mediate the relationship between perfectionistic concerns and cognitive test anxiety? ANXIETY STRESS AND COPING 2021; 35:662-672. [PMID: 34719295 DOI: 10.1080/10615806.2021.1994142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Test anxiety, particularly cognitive test anxiety, is negatively associated with academic performance. Previous research has demonstrated that higher levels of perfectionistic concerns predict higher levels of cognitive test anxiety but has not explored potential mediators of this relationship. This study investigated whether repetitive negative thinking mediated the relationship between perfectionistic concerns and cognitive test anxiety in a non-clinical, academic sample. METHODS Participants were Australian university students (N = 129, 32 male, 94 female, 3 non-binary), aged between 18 and 53 (M = 23.96; SD = 6.88), recruited through convenience and snowball sampling. Participants completed an online questionnaire assessing demographics, repetitive negative thinking, perfectionistic concerns, and cognitive test anxiety. RESULTS Mediation analysis yielded a total model accounting for 43.5% of variance in cognitive TA. Perfectionistic concerns significantly accounted for 10.6% of variance direction (F(1, 127) = 12.21, p < .001, R2 = .106), and 32.5% indirectly through RNT (F(2,126) = 30.81, p < .001, R2 = .329). CONCLUSIONS Findings demonstrate that RNT significantly mediates the relationship between perfectionistic concerns and cognitive test anxiety in this sample. Importantly, these findings may direct future studies towards investigating the effectiveness of targeting repetitive negative thinking in interventions to mitigate levels of cognitive test anxiety.
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Affiliation(s)
- Alex T W Jolly
- School of Population Health, Curtin University, Perth, Australia
| | | | - Peter M McEvoy
- School of Population Health, Curtin University, Perth, Australia.,Centre for Clinical Interventions, Perth, Australia
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Demnitz-King H, Göehre I, Marchant NL. The neuroanatomical correlates of repetitive negative thinking: A systematic review. Psychiatry Res Neuroimaging 2021; 316:111353. [PMID: 34390952 DOI: 10.1016/j.pscychresns.2021.111353] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 07/30/2021] [Accepted: 07/30/2021] [Indexed: 12/18/2022]
Abstract
Repetitive negative thinking (RNT) is a cognitive process characterised by intrusive, repetitive, and difficult-to-disengage-from negative thoughts. Heightened RNT levels are prevalent across clinical disorders and have been associated with ill-health (e.g. cardiovascular disease), even at lower, non-clinical levels. Identifying the neuroanatomical correlates of RNT could help characterise structural alterations that transcend diagnostic boundaries and further understanding of the pathogenesis of clinical disorders. We therefore conducted a systematic review to investigate associations between RNT and brain morphology. Following title/abstract and full-text screening, 24 studies were included. We found evidence that RNT severity is associated with grey and white matter volumes/microstructure, particularly in the dorsolateral prefrontal cortex, anterior cingulate cortex and superior longitudinal fasciculus, regions heavily implicated in cognitive control, and emotional processing and regulation. However, inconsistent associations, potentially due to the heterogeneity of included studies (e.g. methodological differences, type of RNT assessed), preclude specific conclusions being reached regarding any one region's association with RNT. Further, given the defuse nature of thoughts, it may be that RNT is associated with distributed brain regions operating within large-scale networks, rather than with a single structure. High quality longitudinal studies, investigating structural networks, are required to confirm the neuroanatomical basis of RNT and elucidate the direction of relationships.
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Affiliation(s)
- Harriet Demnitz-King
- Division of Psychiatry, Faculty of Brain Sciences, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, United Kingdom.
| | - Isabelle Göehre
- Division of Psychiatry, Faculty of Brain Sciences, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, United Kingdom; Division of Clinical Psychology and Psychological Treatment, Department of Psychology, Ludwig-Maximilians-University Munich, Leopoldstr. 13, 80802, Munich, Germany
| | - Natalie L Marchant
- Division of Psychiatry, Faculty of Brain Sciences, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, United Kingdom
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25
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Hitchcock C, Brown RL, Cobham VE. Validation of the Child version of the Perseverative Thinking Questionnaire of repetitive negative thinking in young people with diagnosed depressive and anxiety disorders. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 61:242-254. [PMID: 34617301 PMCID: PMC9292182 DOI: 10.1111/bjc.12336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/28/2021] [Indexed: 12/02/2022]
Abstract
This paper sought to provide the first validation of a transdiagnostic measure of repetitive negative thinking – the Perseverative Thinking Questionnaire‐Child version (PTQ‐C) – in young people diagnosed with anxiety and depressive disorders. Participants (N = 114) were 11‐ to 17‐year‐olds with complex and comorbid presentations seeking treatment through Child and Adolescent Mental Health Services. Confirmatory factor analyses best supported a three‐factor model for the PTQ‐C; however, hypotheses of both perfect and close fit were rejected, and a subsequent bifactor model suggested minimal unique variance for each subscale. Results demonstrated good internal consistency, convergent validity and divergent validity for the total score and three PTQ‐S subscales: core characteristics, perceived unproductiveness, and consumed mental capacity of negative repetitive thinking. PTQ‐C scores did not account for additional variance in anxiety symptoms once worry was considered, indicating that retention of a content‐specific measure may be warranted in clinical samples. Findings emphasize the importance of validating clinically relevant measures which were developed with subclinical populations in samples with diagnosed mental health disorders.
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Affiliation(s)
- Caitlin Hitchcock
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK.,Melbourne School of Psychological Sciences, University of Melbourne, UK
| | - Renee L Brown
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Vanessa E Cobham
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia.,Children's Health Queensland, Child and Youth Mental Health Service, Brisbane, Queensland, Australia
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26
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Deng W, Gadassi Polack R, Creighton M, Kober H, Joormann J. Predicting Negative and Positive Affect During COVID-19: A Daily Diary Study in Youths. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2021; 31:500-516. [PMID: 34448307 PMCID: PMC8646745 DOI: 10.1111/jora.12646] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
The COVID-19 pandemic has the potential to profoundly affect youths' mental health. Understanding predictors of affective responding to the pandemic is critical for prevention and intervention efforts. This study examines emotion regulation as an important predictor of youth's changes in positive and negative affect. The present study of 115 participants (62 girls, Mage = 11.77) explores the relation between pre-existing emotion regulation strategies, as measured by multi-week daily diaries pre-COVID, and youths' mean positive and negative affect levels and variability during a 28-day period amidst the pandemic, while including COVID-related worries and isolation as important moderators. The findings provide important insight into interactions between pre-existing vulnerabilities and COVID-related stressors in predicting affective adjustment in youth.
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27
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Torrente F, Yoris A, Low D, Lopez P, Bekinschtein P, Manes F, Cetkovich M. Sooner than you think: A very early affective reaction to the COVID-19 pandemic and quarantine in Argentina. J Affect Disord 2021; 282:495-503. [PMID: 33422827 PMCID: PMC8529255 DOI: 10.1016/j.jad.2020.12.124] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/28/2020] [Accepted: 12/24/2020] [Indexed: 11/24/2022]
Abstract
The unique circumstances created by the COVID-19 pandemic pose serious challenges to mood stability and emotional regulation at all ages. Although many people tend to react resiliently to stress, others appear to display emotional anxiety and depression-related symptoms. In this study, we carried out a survey (N = 10,053) during the first week of the general lockdown (quarantine) in Argentina to measure early affective reactions in Argentine adults. Respondents showed substantial anxious and depressive symptoms, with 33% and 23% of participants reporting possible depressive and anxious syndromes, respectively, with the youngest group (18 to 25 y.o.) showing the highest prevalence of symptoms. Even if prior mental health problems predisposed or aggravated the reaction, participants without prior complaints showed signs of psychological impact. Using linear regression, the most important independent variables related to depressive symptoms were the feeling of loneliness followed by daily stress. In the case of anxious states, the strongest variables were negative repetitive thinking and feeling of loneliness. Other psychological, economic, and social factors are discussed. This study is in line with previous literature that highlight the importance of the psychological impact of pandemics, but additionally demonstrates that these reactions are present at a large scale immediately after the start of quarantine with very low infectious rates as an early anticipatory adaptive reaction leading to potential negative outcomes from adjustment disorders to major disorders. In addition, the present results provide potentially relevant information about sudden environmental impacts on affective states and specific pathways for anxiety and depression to be expressed. We end by discussing implications for public policy based on considering the most vulnerable groups.
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Affiliation(s)
- F. Torrente
- Institute of Neuroscience and Public Policy, INECO Foundation, Argentina,Institute of Cognitive and Translational Neurosciences, (INECO Foundation-Favaloro University-CONICET), Argentina,Corresponding author
| | - A. Yoris
- Institute of Neuroscience and Public Policy, INECO Foundation, Argentina,Institute of Cognitive and Translational Neurosciences, (INECO Foundation-Favaloro University-CONICET), Argentina
| | - D.M. Low
- Program in Speech and Hearing Bioscience and Technology, Harvard Medical School & MIT, USA
| | - P. Lopez
- Institute of Neuroscience and Public Policy, INECO Foundation, Argentina,Institute of Cognitive and Translational Neurosciences, (INECO Foundation-Favaloro University-CONICET), Argentina
| | - P. Bekinschtein
- Institute of Neuroscience and Public Policy, INECO Foundation, Argentina,Institute of Cognitive and Translational Neurosciences, (INECO Foundation-Favaloro University-CONICET), Argentina
| | - F. Manes
- Institute of Neuroscience and Public Policy, INECO Foundation, Argentina,Institute of Cognitive and Translational Neurosciences, (INECO Foundation-Favaloro University-CONICET), Argentina
| | - M. Cetkovich
- Institute of Neuroscience and Public Policy, INECO Foundation, Argentina,Institute of Cognitive and Translational Neurosciences, (INECO Foundation-Favaloro University-CONICET), Argentina
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28
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Graham BM, Weiner S, Li SH. Gender differences in avoidance and repetitive negative thinking following symptom provocation in men and women with spider phobia. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2020; 59:565-577. [PMID: 32955767 DOI: 10.1111/bjc.12267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 08/04/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Women's greater prevalence of anxiety disorders compared to men is widely assumed to be partly due to gender differences in cognitive and behavioural factors that perpetuate anxiety, such as repetitive negative thinking (RNT) and avoidance. However, past studies assessing this assumption have not controlled for gender differences in baseline symptom severity, the type of stressful life experiences against which RNT and avoidance are measured, or emotional reactivity to these experiences. DESIGN Using a two-group design, the present study controlled for these confounds by comparing avoidance and RNT in relation to a controlled symptom provocation task in spider phobic men and women with equivalent spider fear severity on the Fear of Spiders Questionnaire. METHODS Participants engaged in a behavioural approach test (BAT) involving a live spider, during which they were assessed for avoidance (physical proximity to the spider) and subjective distress. Two weeks later, participants reported on their levels of negative affect and RNT experienced during the preceding weeks in relation to the BAT. RESULTS Women exhibited greater avoidance and reported greater RNT than men, despite reporting comparable distress and negative affect. Gender remained a significant predictor of avoidance when accounting for distress and also remained a significant predictor of RNT when accounting for depressive symptoms and negative affect. CONCLUSIONS These results provide in vivo evidence that heightened avoidance and RNT may perpetuate anxiety symptoms in women independently of gender differences in symptom severity, daily experiences, or emotional reactivity. PRACTITIONER POINTS Following symptom provocation, men and women with spider phobia differ in cognitive and behavioural coping responses. Women exhibit greater avoidance and repetitive negative thinking than men, and these differences are not attributable to gender differences in symptom severity or emotional reactivity. These findings provide novel evidence for gender differences in maintaining factors that perpetuate anxiety disorders whilst accounting for confounding factors present in prior research.
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Affiliation(s)
- Bronwyn M Graham
- School of Psychology, The University of New South Wales, Sydney, New South Wales, Australia
| | - Shelley Weiner
- School of Psychology, The University of New South Wales, Sydney, New South Wales, Australia
| | - Sophie H Li
- School of Psychology, The University of New South Wales, Sydney, New South Wales, Australia
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29
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Jones EJ, Howell JA, Tonta KE, Egan SJ, Hasking PA, Boyes ME, McEvoy PM, Mazzucchelli TG. Guided Internet-delivered cognitive behaviour therapy for perfectionism in a non-clinical sample of adolescents: A study protocol for a randomised controlled trial. Internet Interv 2020; 21:100342. [PMID: 32868991 PMCID: PMC7449979 DOI: 10.1016/j.invent.2020.100342] [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: 04/20/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Perfectionism is elevated across a range of psychopathologies and has been shown to impede treatment outcomes. There is also evidence suggesting elevated perfectionism may contribute to the onset and maintenance of non-suicidal self-injury. There is a growing body of evidence suggesting that Internet-delivered cognitive-behavioural therapy for perfectionism reduces perfectionism and symptoms of psychological disorders and that reductions are maintained at 3-month and 6-month follow-up. There may also be reductions in non-suicidal self-injury, although no study has investigated this potential benefit. Given that associations between perfectionism and psychopathology are observed across both adults and adolescents, the need for the development of interventions targeting adolescents is essential for early intervention and prevention. METHODS The present study will employ a randomised controlled trial to examine the efficacy of 8-week guided Internet-delivered cognitive-behavioural therapy for perfectionism in adolescents compared to a waitlist control group. The primary outcome is perfectionism, and secondary outcomes include symptoms of psychological disorders, well-being, and non-suicidal self-injury. Outcomes will be assessed at pre-intervention, post-intervention, 1-month follow-up, 3-month follow-up, and 6-month follow-up. A minimum of 240 participants will be recruited online through social media, Australian universities, and schools across Australia. Generalised linear mixed models will be used to test for changes in outcomes between the intervention group and the waitlist control. DISCUSSION The outcomes of this trial will contribute to the literature on perfectionism and psychopathology in adolescents, as well as the efficacy of guided Internet-delivered interventions for adolescents. TRIAL REGISTRATION The trial was registered on the 20th of June 2019 at the Australia New Zealand Clinical Trials Registry (ACTRN12619000881134). TRIAL STATUS This is protocol version 1.0. Participant recruitment began on 31 July 2019 and is still actively running with an anticipated completion date in the fourth quarter of 2020.
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Affiliation(s)
- Emily J. Jones
- School of Psychology, Curtin University, Western Australia,Corresponding author at: School of Psychology, Curtin University, GPO Box U1987, Perth, WA 6845, Australia.
| | - Joel A. Howell
- School of Psychology, Curtin University, Western Australia
| | - Kate E. Tonta
- School of Psychology, Curtin University, Western Australia
| | - Sarah J. Egan
- School of Psychology, Curtin University, Western Australia
| | | | - Mark E. Boyes
- School of Psychology, Curtin University, Western Australia
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30
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Thorslund J, McEvoy PM, Anderson RA. Group metacognitive therapy for adolescents with anxiety and depressive disorders: A pilot study. J Clin Psychol 2020; 76:625-645. [PMID: 31916590 DOI: 10.1002/jclp.22914] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE(S) The metacognitive model suggests that beliefs about cognition maintain repetitive negative thinking (RNT), a transdiagnostic process that underlies commonly comorbid, emotional disorders. To date, there has been the limited application of metacognitive therapy (MCT) to adolescents. This study aimed to evaluate a six-session group transdiagnostic MCT program for adolescents with anxiety and/or depressive disorders. METHOD Participants (N = 10; 3 male, 7 female; average age 15.2 years) completed measures of metacognition and RNT at assessment, baseline period, during treatment, and at 1- and 3-month follow-ups. RESULTS Nine participants attended all six treatment sessions and one discontinued after four sessions. At posttreatment and follow-ups, the majority of participants no longer met diagnostic criteria for anxiety or depressive disorders and evidenced a clinically significant or reliable change in metacognitions and RNT. CONCLUSIONS Results suggest that group MCT is promising in terms of acceptability and effectiveness for adolescents with anxiety and/or depressive disorders.
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Affiliation(s)
| | - Peter M McEvoy
- School of Psychology, Curtin University, Perth, Australia.,Centre for Clinical Interventions, Perth, Australia
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31
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Mitchell C, Reese E, Salmon K, Jose P. Narrative coherence, psychopathology, and wellbeing: Concurrent and longitudinal findings in a mid-adolescent sample. J Adolesc 2019; 79:16-25. [PMID: 31877482 DOI: 10.1016/j.adolescence.2019.12.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Research with adults and older adolescents has found that people exhibiting higher narrative coherence in life stories also report higher psychological wellbeing; however, this link has not been investigated longitudinally. The current study investigated concurrent and longitudinal relationships in mid-adolescence between narrative coherence (causal and thematic coherence) of turning point narratives and psychopathology (depressive symptoms and rumination) and psychological wellbeing (life satisfaction). Hypothesis one was that in concurrent analyses, narrative coherence would be negatively associated with psychopathology and positively associated with wellbeing. Hypothesis two was that higher narrative coherence would predict lower psychopathology and greater wellbeing over time. METHOD A sample of 132 adolescents (ages 14-18 years) wrote a narrative about a turning point event in their life and completed psychopathology and psychological wellbeing measures twice, approximately one year apart. RESULTS Partial correlations on concurrent data showed that only causal coherence was associated with lower psychopathology and higher wellbeing. Longitudinal regressions showed that causal coherence predicted higher wellbeing one year later. CONCLUSIONS These findings suggest that causal coherence in life stories may play a causal role in increased life satisfaction over time for adolescents. Experimental research is required to further investigate this possibility.
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Affiliation(s)
| | | | | | - Paul Jose
- Victoria University of Wellington, New Zealand
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32
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Christian C, Brosof LC, Vanzhula IA, Williams BM, Shankar Ram S, Levinson CA. Implementation of a dissonance-based, eating disorder prevention program in Southern, all-female high schools. Body Image 2019; 30:26-34. [PMID: 31085488 DOI: 10.1016/j.bodyim.2019.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 05/05/2019] [Accepted: 05/05/2019] [Indexed: 10/26/2022]
Abstract
Adolescence represents a high-risk period for eating disorder development, and there is great need for effective prevention programs targeted at this population. The Body Project, a dissonance-based eating disorder prevention program, has robust literature showing reductions in body dissatisfaction and eating disorder symptoms. However, many additional factors (i.e., comorbid symptoms, transdiagnostic factors) have not yet been examined in relation to the Body Project. Additionally, there is little known about how to most effectively and broadly disseminate this intervention. The current study (N = 332 adolescents) examines eating disorder symptoms, comorbidities, and transdiagnostic risk factors pre- and post-Body Project and at 1-month follow-up. This study is the first examination of the effectiveness of the Body Project implemented within school programming in southern, all-female high schools. Social appearance anxiety, physical and social anxiety sensitivity, rumination, worry, perfectionism, and guilt, but not depression, cognitive anxiety sensitivity, shame, or exercise dependence, decreased pre- to post-intervention and/or 1-month follow-up. These results support the effectiveness of the Body Project in addressing eating disorder symptoms and suggest it may aid in the prevention of comorbid conditions. Additionally, the effectiveness of the intervention was comparable to past investigations, supporting its use in schools across the United States.
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Affiliation(s)
- Caroline Christian
- University of Louisville, Department of Psychological & Brain Sciences, United States.
| | - Leigh C Brosof
- University of Louisville, Department of Psychological & Brain Sciences, United States
| | - Irina A Vanzhula
- University of Louisville, Department of Psychological & Brain Sciences, United States
| | - Brenna M Williams
- University of Louisville, Department of Psychological & Brain Sciences, United States
| | - Shruti Shankar Ram
- University of Louisville, Department of Psychological & Brain Sciences, United States
| | - Cheri A Levinson
- University of Louisville, Department of Psychological & Brain Sciences, United States
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Gilbert KE, Tonge NA, Thompson RJ. Associations between depression, anxious arousal and manifestations of psychological inflexibility. J Behav Ther Exp Psychiatry 2019; 62:88-96. [PMID: 30273794 PMCID: PMC6252139 DOI: 10.1016/j.jbtep.2018.09.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 06/27/2018] [Accepted: 09/18/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Psychological inflexibility exhibits across multiple facets of functioning, including thinking styles, personality, cognitive shifting, emotion, and physiology, with many of these manifestations showing associations with depression. As such, these facets might be part of an overarching latent construct of psychological inflexibility that explains associations with depression. We predicted that (1) five facets of inflexibility (perseverative thinking, personality rigidity, attention-shifting, negative emotional inertia, and low respiratory sinus arrhythmia reactivity) would load onto a unique latent construct of psychological inflexibility. Further, we hypothesized this latent construct of psychological inflexibility would be (2) significantly associated with higher depression; and (3) associated with depression to a greater extent than anxious arousal. METHODS Seventy-five adult community participants completed measures assessing the five indices of inflexibility and self-report measures of depression and anxious arousal. RESULTS Structural equation modeling identified a latent inflexibility construct reflected by perseverative thinking, personality rigidity, and emotional inertia, but did not include attention-shifting or RSA reactivity. The inflexibility construct was positively associated with depression and anxious arousal, but more strongly associated with depression than with anxious arousal. LIMITATIONS Limitations included a small sample size, cross-sectional approach, and dimensional measures of depression and anxious arousal. CONCLUSIONS Findings provide preliminary support that multiple facets of inflexibility may emerge from a broader overarching vulnerability for internalizing psychopathology. This overarching inflexibility construct may have stronger associations with depression than with anxious arousal.
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Affiliation(s)
- Kirsten E Gilbert
- Department of Psychiatry, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, United States
| | - Natasha A Tonge
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States
| | - Renee J Thompson
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States.
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Bottesi G, Noventa S, Freeston MH, Ghisi M. Seeking certainty about Intolerance of Uncertainty: Addressing old and new issues through the Intolerance of Uncertainty Scale-Revised. PLoS One 2019; 14:e0211929. [PMID: 30742694 PMCID: PMC6370219 DOI: 10.1371/journal.pone.0211929] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 01/24/2019] [Indexed: 01/30/2023] Open
Abstract
Intolerance of Uncertainty is a trans-diagnostic process that spans a range of emotional disorders and it is usually measured through the Intolerance of Uncertainty Scale-12. The current study aims at investigating some issues in the assessment of Intolerance of Uncertainty (IU) through the Italian Intolerance of Uncertainty Scale-Revised, a measure adapted from the Intolerance of Uncertainty Scale-12 to assess IU across the lifespan. In particular we address the factor structure among a large community sample, measurement invariance across gender, age, and over time, together with reliability and validity of the overall scale and its subscales. The questionnaire was administered to community (N = 761; mean age = 35.86 ± 14.01 years) and undergraduate (N = 163; mean age = 21.16 ± 2.64 years) participants, together with other self-report measures assessing constructs theoretically related to IU. The application of a bifactor model shows that the Italian Intolerance of Uncertainty Scale-Revised possesses a robust general factor, thus supporting the use of the unit-weighted total score of the questionnaire as a measure of the construct. Furthermore, measurement invariance across gender, age, and over time is supported. Finally, the Italian Intolerance of Uncertainty Scale-Revised appears to possess adequate reliability and validity. These findings support the unidimensionality of the measure, a conceptually reasonable result in line with the trans-diagnostic nature of Intolerance of Uncertainty. In addition, this study and comparison with published factor structures of the Intolerance of Uncertainty Scale-12 and of the Intolerance of Uncertainty Scale-Revised identify some issues for the internal structure of the measure. In particular, concern is expressed for the Prospective IU subscale. In light of the promising psychometric properties, the use of the Italian Intolerance of Uncertainty Scale-Revised as a univocal measure is encouraged in both research and clinical practice.
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Affiliation(s)
- Gioia Bottesi
- Department of General Psychology, University of Padova, Padova, Italy
| | | | - Mark H. Freeston
- School of Psychology, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Marta Ghisi
- Department of General Psychology, University of Padova, Padova, Italy
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Gavazzeni JA, Andersson T, Sörman K, Kristiansson M. Psychometric Properties of the Swedish Version of the Brief Repetitive Thinking Questionnaire (RTQ-10): An Internet-Based Study on Degrees of Affective Symptoms and Levels of Distress. Psychopathology 2019; 52:256-264. [PMID: 31480069 DOI: 10.1159/000502388] [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: 04/15/2019] [Accepted: 07/28/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Repetitive negative thinking (RNT) is reported in a wide variety of emotional disorders, although it is most often associated with either depression or anxiety disorders, assessed as symptoms of rumination and worry. Early detection of indicators for RNT across disorders is needed. To this end we explored the psychometric properties of a transdiagnostic measure, i.e., the Swedish version of the brief Repetitive Thinking Questionnaire (RTQ-10), in adults (n = 674, age: 18 years or older). METHODS Participants completed an online battery of questionnaires measuring RNT, anxiety, depression and levels of positive and negative affect, satisfaction with life, metacognitive beliefs, and sick leave. Reliability and validity were evaluated with Cronbach's α, item and scale correlations, factor analysis (including multigroup analysis), and multiple linear regression analysis. Principal component analysis and exploratory factor analysis were first carried out to identify the number of latent factors. Confirmatory factor analysis was then used to assess the model fit of a single latent factor. RESULTS Analyses supported a single-factor solution. Results showed that the reliability was excellent. The single-factor model was robust, except across levels of distress that did not support scalar invariance. Negative metacognitive beliefs, negative affect, and anxiety were strong covariates demonstrating convergent validity. Negative and weaker correlations with life satisfaction, positive affect, and physical symptoms contributed to the discriminant validity. CONCLUSION This study showed that the instrument is robust in a population with various degrees of affective symptoms and distress. These results provide additional psychometric support for the RTQ-10 as a transdiagnostic measure. It can be administered online to assess RNT as a risk factor for emotional disorders.
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Affiliation(s)
- Joakim A Gavazzeni
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden,
| | - Tom Andersson
- Cognitive Science (LUCS), Lund University, Lund, Sweden
| | - Karolina Sörman
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Marianne Kristiansson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,National Board of Forensic Medicine, Stockholm, Sweden
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Wijnen BF, Lokman S, Leone S, Evers SM, Smit F. Complaint-Directed Mini-Interventions for Depressive Symptoms: A Health Economic Evaluation of Unguided Web-Based Self-Help Interventions Based on a Randomized Controlled Trial. J Med Internet Res 2018; 20:e10455. [PMID: 30274958 PMCID: PMC6231789 DOI: 10.2196/10455] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/30/2018] [Accepted: 07/22/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Depression prevention and early intervention have become a top priority in the Netherlands, but with considerable room for improvement. To address this, Web-based complaint-directed mini-interventions (CDMIs) were developed. These brief and low-threshold interventions focus on psychological stress, sleep problems, and worry, because these complaints are highly prevalent, are demonstrably associated with depression, and have substantial economic impact. OBJECTIVE The objective of this economic evaluation was to examine the added value of Web-based, unguided, self-help CDMIs compared with a wait-listed control group with unrestricted access to usual care from both a societal and a health care perspective. METHODS This health economic evaluation was embedded in a randomized controlled trial. The study entailed 2 arms, in which 3 Web-based CDMIs were compared with a no-intervention waiting-list control group (which received the intervention after 3 months). We conducted measurements at baseline, and at 3 and 6 months. The primary outcome was the rate of responders to treatment on depressive symptoms as measured by the Inventory of Depressive Symptomatology Self-Report (IDS-SR). We estimated change in quality of life by calculating effect sizes (Cohen d) for individual pre- and posttreatment IDS-SR scores using a conversion factor to map a change in standardized effect size onto a corresponding change in utility. We calculated incremental cost-effectiveness ratios using bootstraps (5000 times) of seemingly unrelated regression equations and constructed cost-effectiveness acceptability curves for the costs per quality-adjusted life-year (QALY) gained. RESULTS Of 329 study participants, we randomly assigned 165 to the CDMI group. At 3 months, the rate of responders to treatment was 13.9% (23/165) in the CDMI group and 7.3% (12/164) in the control group. At 3 months, participants in the CDMI group gained 0.15 QALYs compared with baseline, whereas participants in the control group gained 0.03 QALYs. Average total costs per patient at 3 months were €2094 for the CDMI group and €2230 for the control group (excluding baseline costs). Bootstrapped seemingly unrelated regression equations models resulted in a dominant incremental cost-effectiveness ratio (ie, lower costs and a higher rate of responders to treatment) for the CDMI group compared with the control group at 3 months, with the same result for the costs per QALY gained. Various sensitivity analyses attested to the robustness of the findings of the main analysis. CONCLUSIONS Brief and low-threshold Web-based, unguided, self-help CDMIs have the potential to be a cost-effective addition to usual care for adults with mild to moderate depressive symptoms. The CDMIs improved health status, while reducing participant health care costs, and hence dominated the care-as-usual control condition. As intervention costs were relatively low, and the internet is readily available in the Western world, we believe CDMIs can be easily implemented on a large scale. TRIAL REGISTRATION Netherlands Trial Register NTR4612; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4612 (Archived by WebCite at http://www.webcitation.org/6n4PVYddM).
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Affiliation(s)
- Ben Fm Wijnen
- Centre for Economic Evaluation, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands.,Department of Health Services Research, Care and Public Health Research Institute School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| | - Suzanne Lokman
- Department of Public Mental Health, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
| | - Stephanie Leone
- Department of Public Mental Health, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
| | - Silvia Maa Evers
- Centre for Economic Evaluation, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands.,Department of Health Services Research, Care and Public Health Research Institute School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| | - Filip Smit
- Centre for Economic Evaluation, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands.,Department of Clinical Psychology, Faculty of Behavioural and Movement Sciences, VU University, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, Netherlands
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Gladwin TE, Vink M. Freeze or Forget? Virtual Attack Effects in an Emotional Sternberg Task. EUROPES JOURNAL OF PSYCHOLOGY 2018; 14:342-358. [PMID: 30008950 PMCID: PMC6016026 DOI: 10.5964/ejop.v14i2.1473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 12/16/2017] [Indexed: 11/24/2022]
Abstract
Emotionally salient stimuli have the ability to disrupt cognitive processing. This kind of disruption involves effects on working memory and may be related to mental health problems. To explore the nature of such emotional interference on working memory, a Virtual Attack Emotional Sternberg Task (VAEST) was used. Neutral faces were presented as distractors and warning signals, which were sometimes followed by a virtual attack, created by having the neutral face turn angry while the image was enlarged. The attack was hypothesized to have one of two effects: to disrupt cognitive processing and thereby increase interference effects, or to terminate a state of freezing and thereby reduce interference effects. The task was successfully completed online by a sample of 59 students. Results clearly show that the virtual attack caused a reduction of interference relative to no-attack trials. The apparent cognitive disruption caused by emotional distractors may thus reflect freezing, which can be reversed by a freeze-terminating stimulus.
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Affiliation(s)
- Thomas Edward Gladwin
- Department of Psychology and Counseling, University of Chichester, Chichester, United Kingdom
| | - Matthijs Vink
- Department of Psychiatry, Brain Center Rudolf Magnus, Utrecht University Medical Center, Utrecht, The Netherlands.,Departments of Developmental and Experimental Psychology, Utrecht University, Utrecht, The Netherlands
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McEvoy PM, Hyett MP, Ehring T, Johnson SL, Samtani S, Anderson R, Moulds ML. Transdiagnostic assessment of repetitive negative thinking and responses to positive affect: Structure and predictive utility for depression, anxiety, and mania symptoms. J Affect Disord 2018; 232:375-384. [PMID: 29510356 DOI: 10.1016/j.jad.2018.02.072] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 01/22/2018] [Accepted: 02/25/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND Repetitive negative thinking (RNT) is a cognitive process that is repetitive, passive, relatively uncontrollable, and focused on negative content, and is elevated in emotional disorders including depression and anxiety disorders. Repetitive positive thinking is associated with bipolar disorder symptoms. The unique contributions of positive versus negative repetitive thinking to emotional symptoms are unknown. The first aim of this study was to use confirmatory factor analyses to evaluate the psychometrics of two transdiagnostic measures of RNT, the Repetitive Thinking Questionnaire (RTQ-10) and Perseverative Thinking Questionnaire (PTQ), and a measure of repetitive positive thinking, the Responses to Positive Affect (RPA) Questionnaire. The second aim was to determine incremental predictive utility of these measures. METHOD All measures were administered to a sample of 2088 undergraduate students from the Netherlands (n = 992), Australia (n = 698), and America (n = 398). RESULTS Unidimensional, bifactor, and three-factor models were supported for the RTQ-10, PTQ, and RPA, respectively. A common factor measured by all PTQ items explained most variance in PTQ scores suggesting that this measure is essentially unidimensional. The RNT factor of the RTQ-10 demonstrated the strongest predictive utility, although the PTQ was also uniquely although weakly associated with anxiety, depression, and mania symptoms. The RPA dampening factor uniquely predicted anxiety and depression symptoms, suggesting that this scale is a separable process to RNT as measured by the RTQ-10 and PTQ. LIMITATIONS Findings were cross-sectional and need to be replicated in clinical samples. CONCLUSIONS Transdiagnostic measures of RNT are essentially unidimensional, whereas RPA is multidimensional. RNT and RPA have unique predictive utility.
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Affiliation(s)
- Peter M McEvoy
- Centre for Clinical Interventions, Perth, Western Australia, Australia; School of Psychology, Curtin University, Perth, Western Australia, Australia.
| | - Matthew P Hyett
- School of Psychology, Curtin University, Perth, Western Australia, Australia
| | | | - Sheri L Johnson
- Department of Psychology, University of California Berkeley, Berkeley, CA, USA
| | - Suraj Samtani
- School of Psychology, The University of New South Wales, UNSW Sydney, New South Wales, Australia
| | - Rebecca Anderson
- School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - Michelle L Moulds
- School of Psychology, The University of New South Wales, UNSW Sydney, New South Wales, Australia
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Psychometric Qualities of Turkish Version of Perseverative Thinking Questionnaire (PTQ). JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2018. [DOI: 10.1007/s10942-018-0285-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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