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Rabl L, Maerz J, Viviani R, Labek K. The dark side of personality functioning: associations between antisocial cognitions, personality functioning (AMPD), empathy and mentalisation. Front Psychiatry 2024; 15:1377177. [PMID: 38863611 PMCID: PMC11165144 DOI: 10.3389/fpsyt.2024.1377177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/16/2024] [Indexed: 06/13/2024] Open
Abstract
Introduction With the introduction of the new psychiatric diagnostic manuals, personality functioning has gained new prominence. Several studies have reported consistent findings that individual showing high levels of antisocial features are associated with alterations in interpersonal functioning domains such as empathy and mentalisation. The focus of the current study (N = 198) is to examine antisocial cognitions, as measured by the Scrambled Sentences Task (SST), and to what extent this approach can help to better understand the relationship between antisocial traits and personality functioning/empathy. Method We implemented a hypothesis-driven approach using logistic regression and a data-driven approach using machine learning to examine distinct but related measures of personality functioning as predictors of antisocial cognitions. Results Antisocial cognitions were associated with low interpersonal functioning as expected, but only when not adjusting for antisocial traits, which accounted for almost all the association. The data-driven analysis revealed that individual items assessing empathic concern in personality functioning scales (as opposed to the whole scores) explained low antisocial cognitions even when adjusting for antisocial traits. Discussion Antisocial cognitions appear to be associated to two distinct traits, the antisocial and a specific type of personality functioning. This finding is discussed in terms of the possible distinction between two motivational forces: to harm others/prioritize one's advantage, and to help suffering others.
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Affiliation(s)
- Luna Rabl
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Jeff Maerz
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Roberto Viviani
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
- Dept. of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany
| | - Karin Labek
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
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Frommelt T, Bäumler L, Rohleder N, Schulte-Körne G, Platt B. Study protocol for a randomized controlled trial investigating the effect of online interpretation bias intervention on stress reactivity in the children of parents with depression: the CoCo study. BMC Psychiatry 2023; 23:378. [PMID: 37254177 DOI: 10.1186/s12888-023-04803-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 04/19/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Current preventive interventions for the children of parents with depression demonstrate modest effects on depression incidence. This may be because existing interventions tend to comprise general psychotherapeutic tools, rather than targeting the specific mechanisms underlying familial transmission. Improved theoretical models of familial transmission could enhance the development of targeted interventions. Although existing models assume that cognitive and biological vulnerability factors influence one another, the precise mechanisms are unknown. This project is the first to experimentally test whether negative interpretation bias has an impact on cortisol response in children of parents with depression. This study protocol reports a randomised controlled trial of an interpretation bias intervention which aims to shift participants' interpretation bias in a more positive direction and thereby alter their stress response. METHODS Children aged 10-14 years who have i) one parent with a current or previous depression diagnosis, with at least one episode occurring during the child's lifetime and ii) do not have a current or previous psychiatric diagnosis themselves, will be assigned to one of two conditions: an interpretation bias intervention (n = 50) or a structurally similar placebo intervention (n = 50). The interpretation bias intervention consists of a short lab-based cognitive reappraisal of interpretations training, a four-week app-based Cognitive Bias Modification of Interpretations intervention and interpretation bias specific if-then plans. Interpretation bias will be assessed before and after the intervention using the Scrambled Sentences Task. The effect of the intervention on participants' stress response will be assessed by salivary cortisol collected at five different time points: from immediately before until 45 min after administering the Trier Social Stressor Test for Children. Stress reactivity will be measured via baseline to peak cortisol and stress recovery will be measured via the 45 min cortisol marker. We hypothesise that children who participate in the interpretation bias intervention will display a positive shift in interpretation bias and this, in turn, will alter their stress response. Children who receive the placebo intervention are expected to show a smaller positive shift in interpretation bias and stress reactivity. DISCUSSION The findings of the present study will contribute to models of familial depression transmission as well as informing preventive interventions. If training a more positive interpretation bias subsequently alters participants' stress response, then incorporating such tools may increase the efficacy of existing preventive interventions. TRIAL REGISTRATION Deutsches Register Klinischer Studien DRKS00028842. Registered August 19, 2022.
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Affiliation(s)
- Tonya Frommelt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital Munich, Nussbaumstr. 5, 80336, Munich, Germany.
| | - Leonie Bäumler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital Munich, Nussbaumstr. 5, 80336, Munich, Germany
| | - Nicolas Rohleder
- Department of Psychology, Chair of Health Psychology, Friedrich-Alexander-University Erlangen-Nürnberg, Nägelsbachstr. 49a, 91052, Erlangen, Germany
| | - Gerd Schulte-Körne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital Munich, Nussbaumstr. 5, 80336, Munich, Germany
| | - Belinda Platt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital Munich, Nussbaumstr. 5, 80336, Munich, Germany
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Kroener J, Greiner A, Sosic-Vasic Z. Cognitive bias modification for interpretation (CBM-I) for post-traumatic stress disorder: study protocol of an app-based randomised controlled trial. BMJ Open 2023; 13:e069228. [PMID: 36797017 PMCID: PMC9936272 DOI: 10.1136/bmjopen-2022-069228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
INTRODUCTION Previous studies indicate that computerised trainings implementing cognitive bias modification (CBM) for interpretation bias might be promising treatments for trauma-related cognitive distortions and symptoms. However, results are mixed, which might be related to the implemented task (sentence completion task), setting, or training duration. Within the present study, we aim to evaluate the efficacy and safety of an app-based intervention for interpretation bias using standardised imagery audio scripts, which is designed as a standalone treatment. METHODS AND ANALYSIS The study is a randomised controlled trial, implementing two parallel arms. 130 patients diagnosed with post-traumatic stress disorder (PTSD) will be allocated to either the intervention group or the waiting-list control group receiving treatment as usual. The intervention consists of 3 weeks of an app-based CBM training for interpretation bias using mental imagery, with three training sessions (20 min) per week. Two months after the last training session, 1 week of booster CBM treatment will be implemented, consisting of three additional training sessions. Outcome assessments will be conducted pretraining, 1 week post-training, 2 months post-training, as well as 1 week after the booster session (approximately 2.5 months after initial training termination). The primary outcome is interpretation bias. Secondary outcomes include PTSD-related cognitive distortions and symptom severity, as well as negative affectivity. Outcome assessment will be conducted by intention-to-treat analysis, as well as per-protocol analysis using linear mixed models. ETHICS AND DISSEMINATION The study was approved by the Ethics Committee of the State Chamber of Physicians in Baden-Wuerttemberg, Germany (number of approval: F-2022-080). Scientific findings will be published in peer-reviewed journals informing future clinical studies, which focus on the reduction of PTSD-related symptoms using CBM. TRIAL REGISTRATION NUMBER German Clinical Trials Register (DRKS00030285; https://drks.de/search/de/trial/DRKS00030285).
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Affiliation(s)
- Julia Kroener
- Department of Applied Psychotherapy and Psychiatry, Christophsbad GmbH & Co Fachkrankenhaus KG, Goppingen, Germany
- University of Ulm, Ulm, Germany
| | - Alexander Greiner
- Department of Applied Psychotherapy and Psychiatry, Christophsbad GmbH & Co Fachkrankenhaus KG, Goppingen, Germany
- University of Ulm, Ulm, Germany
| | - Zrinka Sosic-Vasic
- Department of Applied Psychotherapy and Psychiatry, Christophsbad GmbH & Co Fachkrankenhaus KG, Goppingen, Germany
- University of Ulm, Ulm, Germany
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Krahé C, Meeten F, Hirsch CR. Development and psychometric evaluation of a scrambled sentences test specifically for worry in individuals with generalised anxiety disorder. J Anxiety Disord 2022; 91:102610. [PMID: 36029530 DOI: 10.1016/j.janxdis.2022.102610] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 07/11/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022]
Abstract
The tendency to draw negative conclusions from ambiguous information (interpretation bias) is prevalent across emotional disorders and plays a key role in the development and maintenance of pathological worry and anxious mood. Assessing interpretation bias using valid and reliable measures is central to empirical research. A commonly used measure of interpretation bias is the scrambled sentences test (SST), originally relating to depression. Given the association between interpretation bias and worry, we aimed to develop and psychometrically evaluate a new version of the SST with items pertaining to common worry domains for use in worry and anxiety research. In Studies 1-3 (analogue samples, combined N = 288), the new worry SST showed excellent construct validity (moderate-to-strong associations with worry and anxiety-related measures), and reliability (split-half and test-retest reliability). We confirmed construct validity in Study 4 (N = 215 individuals with generalised anxiety disorder). Furthermore, we demonstrated version specificity in analogue and clinical samples: the worry SST was associated with trait worry but not trait rumination, while the original depression SST largely showed the opposite pattern. Overall, the new worry SST is a psychometrically robust measure that may be especially useful for research into cognitive processes underpinning worry and anxiety.
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Affiliation(s)
- Charlotte Krahé
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Frances Meeten
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Colette R Hirsch
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Würtz F, Zahler L, Blackwell SE, Margraf J, Bagheri M, Woud ML. Scrambled but valid? The scrambled sentences task as a measure of interpretation biases in psychopathology: A systematic review and meta-analysis. Clin Psychol Rev 2022; 93:102133. [PMID: 35219928 DOI: 10.1016/j.cpr.2022.102133] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 11/18/2021] [Accepted: 02/13/2022] [Indexed: 11/21/2022]
Abstract
The Scrambled Sentences Task (SST) is frequently used to assess interpretation biases (IBs). However, neither the range of its applications nor the quality of the empirical evidence it provides has been systematically examined. This systematic review investigates the types of samples and disorders in which the SST has been applied and evaluates its psychometric properties via a meta-analysis. The databases PubMed and EBSCOhost (including PsycINFO, PsycARTICLES, PSYNDEX, MEDLINE) were examined (last search: September 2021) and 93 studies from 91 manuscripts were included. Results showed that the SST has been applied predominantly in unselected samples or those with elevated levels of subsyndromal symptoms, with about a third of the studies employing the SST in a clinical population. While the SST was initially developed to assess depression-related IBs, it has now been extended to other disorders, in particular anxiety disorders. Results of the meta-analyses indicated good convergent validity and reliability across disorders, albeit in the context of substantial heterogeneity. Findings concerning divergent validity were mixed with high correlations across disorders between the SST and trait anxiety in particular, questioning its specificity. Future research should consider developing standardized SST versions and investigating its relationships with other measures of IB.
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Affiliation(s)
- Felix Würtz
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany.
| | - Lisa Zahler
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Simon E Blackwell
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Mahdi Bagheri
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Marcella L Woud
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
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O'Connor CE, Everaert J, Fitzgerald A. Interpreting ambiguous emotional information: Convergence among interpretation bias measures and unique relations with depression severity. J Clin Psychol 2021; 77:2529-2544. [PMID: 34101175 DOI: 10.1002/jclp.23186] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 04/07/2021] [Accepted: 05/08/2021] [Indexed: 12/30/2022]
Abstract
This study aimed to examine the convergence among interpretation bias measures and their associations with depressive symptom severity. Research into interpretation biases employs measures of interpretation bias interchangeably, however, little is known about the relationship between these measures. Participants (N = 82 unselected undergraduate students; 59 female) completed four computer-based interpretation bias tasks in a cross-sectional design study. Indirect measures, based on participants' reaction times, were not correlated with each other and had poor split-half reliability. Direct measures were more strongly correlated with depressive symptoms than indirect measures, but only the Scrambled Sentences Task explained a reliable unique portion of the variance in depressive symptoms. Interpretation bias tasks may not measure the same cognitive process and may differ in the extent to which they are a cognitive marker of depression-linked interpretation bias. These findings help to improve the measurement of and theory underlying interpretation bias and depressive symptoms.
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Affiliation(s)
| | - Jonas Everaert
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Does Approach-Avoidance Behavior in Response to Ambiguous Cues Reflect Depressive Interpretation Bias? Related but Distinct. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10133-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Zahler L, Sommer K, Reinecke A, Wilhelm FH, Margraf J, Woud ML. Cognitive Vulnerability in the Context of Panic: Assessment of Panic-Related Associations and Interpretations in Individuals with Varying Levels of Anxiety Sensitivity. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10103-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Abstract
Background
Cognitive models of panic disorder (PD) highlight the role of panic-related associations and interpretations. However, results are mixed and rely on specific measures. This study examined panic-related associations and interpretations using established and new paradigms in individuals varying on anxiety sensitivity (AS).
Methods
Associations were measured using a priming task and a novel Single Target Implicit Association Test (STIAT); interpretations were assessed using the Interpretation Bias Questionnaire (IBQ) and a novel Scrambled Sentences Task (SST). Symptoms were assessed via a provocation task (Straw Breathing Task, SBT).
Results
Panic-related interpretations correlated with AS and other PD-related measures. Of the association tasks, only the priming task correlated with one of the other PD-related measures. Panic-related interpretations assessed via the SST, but not priming, STIAT, and IBQ, predicted SBT reactivity. The relationship between AS and SBT reactivity was mediated by panic-related interpretations.
Conclusions
Our data provide support for panic-related interpretations as an important cognitive mechanism.
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Biondolillo M, Epstein L. Constructing a Performance Measure of Future Time Orientation. J Pers Assess 2020; 103:278-288. [DOI: 10.1080/00223891.2019.1705843] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Mathew Biondolillo
- Division of Behavioral Medicine, State University of New York at Buffalo
| | - Leonard Epstein
- Division of Behavioral Medicine, State University of New York at Buffalo
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