We examined the unique predictive strength of anxiety sensitivity (AS) and the role of expectancy, credibility, and therapeutic alliance (TA) as predictors and mediators of cognitive-behavioral ...treatment (CBT) outcomes in obsessive-compulsive disorder (OCD).
The current study is a prospective cohort study. Participants (N = 116) were treatment-seeking individuals with a primary diagnosis of OCD. Independent raters assessed patients on Yale-Brown Obsessive-Compulsive Scale (YBOCS) and Anxiety Sensitivity Index-3 at baseline, post-intervention, and three-month follow-up. Participants responded to the Credibility and Expectancy questionnaire and Working Alliance Inventory-Short revised at baseline, first-session, and mid-session.
The individual addition of AS, end-of-first-session credibility and expectancy, mid-session credibility and expectancy, and therapeutic alliance predicted significant CBT outcomes. There was a moderate positive correlation between baseline OCD severity and the global score of AS, but a weak one with AS dimensions. Both expectancy and credibility significantly improved from baseline to end-of-first-session treatment. End-of-first and third-session outcome expectancies, not credibility, have significant, indirect effects on OCD CBT outcomes.
AS, within-session credibility and expectancies and TA independently predict CBT outcomes. Within-sessions outcome expectancies mediate CBT outcomes in OCD, not credibility. Expectancy and credibility both include state-like elements that can be influenced to enhance the outcomes of CBT. Proposals for reducing treatment barriers in CBT for OCD are offered.
•We looked into the specific role that predictors and mediators had in the effectiveness of CBT for OCD.•Expectancies and credibility each have a unique contribution to CBT outcomes and are not a proxy for each other.•End-of-first-session expectancies, not baseline expectancy or credibility at any stage, mediate CBT outcomes in OCD.•Expectancy and credibility can be manipulated to bring favorable CBT outcomes.•Anxiety sensitivity was moderately associated with baseline OCD severity but not its dimensions.
PURPOSE OF REVIEWThe present review examines the recent advances in psychological interventions for two major lifestyle disorders in adults namely, type 2 diabetes mellitus and cardiovascular ...disorders. The review summarizes findings from studies carried out between the years 2015 and 2017.
RECENT FINDINGSThe effectiveness of psychological interventions in the management of lifestyle disorders has been examined with respect to adaptation, self-care, adherence, negative emotions and improving quality of life. There is an increasing recognition that psychological interventions are important for prevention of lifestyle disorders and promotion of health. Key psychological interventions include self-management and educational interventions based on learning and motivational principles, patient empowerment, cognitive behaviour therapy, behavioural skills and coaching. Recent developments also include the use of information technology to deliver these interventions through internet, mobile applications and text messages. Another significant development is that of mindfulness-based interventions within the third-generation behaviour therapy approaches to reduce distress and increase acceptance. In addition, family and couples interventions have also been emphasised as necessary in maintenance of healthy behaviours.
SUMMARYStudies examining psychological interventions in cardiovascular and type 2 diabetes mellitus support the efficacy of these interventions in bringing about changes in biochemical / physiological parameters and in psychological outcomes such as self-efficacy, knowledge, quality of life and a sense of empowerment.
Cognitive behaviour therapy is a structured, time limited, psychological intervention that has is empirically supported across a wide variety of psychological disorders. CBT for addictive behaviours ...can be traced back to the application of learning theories in understanding addiction and subsequently to social cognitive theories. The focus of CBT is manifold and the focus is on targeting maintaining factors of addictive behaviours and preventing relapse. Relapse prevention programmes are based on social cognitive and cognitive behavioural principles. Interventions for preventing relapse include, behavioural strategies to decrease the valence of addictive behaviours, coping skills to deal with craving, arousal, negative mood states, assertiveness skills to manage social pressures, family psychoeducation and environmental manipulation and cognitive strategies to enhance self-efficacy beliefs and modification of outcome expectancies related to addictive behaviours. More recent developments in the area of managing addictions include third wave behaviour therapies. Third wave behaviour therapies are focused on improving building awareness, and distress tolerance skills using mindfulness practices. These approaches have shown promise, and more recently the neurobiological underpinnings of mindfulness strategies have been studied. The article provides an overview of cognitive behavioural approaches to managing addictions.
Background:
Research indicates that help seeking for mental health is low and often delayed. Understanding pathways to care is crucial to facilitate mental health referrals and reduce the time to ...consultation.
Methods:
In the present study, 63 individuals were assessed on illness severity, attitudes towards help-seeking and pathways-to-care.
Results:
Multiple pathways for therapy were noted, a delayed-pathway, two-step referral pathway and a direct-pathway. Most prominent pathway was the delayed-pathway. The direct-pathway had least treatment delay, contributed by timely recognition of symptoms by the patient. As first point of contact, patients preferred psychiatrists and popularly sought information about treatment via media.
Conclusions:
There are multiple pathways to consultations, often leading to treatment delay in care received. Timely recognition of symptoms was associated a direct pathway and the least delay. These findings have implications for strengthening routes to mental health specialists at early stages and increasing awareness about treatment available.
•We tested the effect of Unified Protocol on neuroticism, symptoms, and emotion regulation skills.•A multiple baseline design, with 2,3, and 4-week baseline was adopted.•There was a greater reliable ...change in emotion regulation skills than neuroticism.•Change in slope, and level of anxiety observed across participants.•UP is a promising intervention that can address neuroticism and emotion regulation skills.
There has been a shift from single disease protocols to interventions that address shared vulnerabilities across disorders with high comorbidity. Unified Protocol (UP) is an emotion-focused transdiagnostic intervention that addresses neuroticism, a shared mechanism identified in emotional disorders by enhancing emotion regulation skills. In this study, we attempted to understand the effect of the (UP) on symptom severity, emotion regulation, and neuroticism.
A non-concurrent multiple baseline design was adopted. Six clients with a primary diagnosis of an anxiety disorder were randomly assigned to a 2, 3, or 4-week baseline period, following medication stabilization for 4 weeks. Following the baseline period, UP was delivered over 15–18 sessions. Neuroticism and emotion regulation were assessed at baseline, post, and follow-up. Anxiety severity was measured weekly by both an independent rater and on self-report.
Of the 6 clients randomized, 3 completed the intervention. Visual analysis was used to examine changes in symptom severity and Reliable Change Index (RCI) was used to examine changes in scores on neuroticism and emotion regulation across time points for the 3 completers. Reliable change was observed in 1 out of 3 clients for neuroticism and in 2 out of 3 clients for emotion regulation skills. Change in slope, and level of symptom severity was observed across participants.
UP is a parsimonious approach to addressing co-morbidities. Our findings support the role of emotion regulation skills in the management of anxiety. A larger sample is required to establish these findings more robustly and support generalization of findings.
Adult ADHD is a prevalent yet underdiagnosed and undertreated condition. Assessment of ADHD is critical to understanding and managing ADHD comprehensively.
Method:
Scholarly articles on adult ADHD ...between 1996 and 2022 were reviewed using the PRISMA guidelines. ADHD rating scales with multiple citations were selected and their psychometric properties and symptom coverage were analyzed.
Results:
Ten rating scales, with sound psychometric properties, were identified. Out of those reviewed two (BADDS and BAARS-IV) load on the inattentive domain of ADHD, while the rest focus on a comprehensive assessment of ADHD. Only one scale (BARRS-IV) incorporates an assessment of functional impairment. Some scales though widely utilized have not been adequately examined for their sensitivity.
Conclusions:
Rating scales are reliable and valid, in the assessment of adult ADHD. We present a review of recent scales, with an expanded focus, to help clinicians make informed decisions on diagnosis, identifying targets and planning interventions accordingly.
New-wave behavioral therapies in obsessive-compulsive disorders (OCDs) comprise of third-wave therapies and newer cognitive therapies (CTs). This review covers outcome studies published in English ...until December 2017. A total of forty articles on mindfulness-based CT, metacognitive therapy, acceptance and commitment therapy, and danger ideation reduction therapy in the form of single-case studies, case series, open-label trials, two-group comparison studies, and randomized controlled studies were included. Results show that studies on these therapies are limited in number. Methodological limitations including lack of active control groups, randomized controlled trials, small sample sizes, and short follow-up periods were also noted. However, the available literature demonstrates the feasibility and utility of these therapies in addressing the issues unresolved by exposure and response prevention (ERP) and cognitive behavior therapy (CBT). These therapies were often combined with traditional ERP and CBT based on the profile and response of the client; hence, it is unclear whether they can be used as standalone therapies in the larger segment of the OCD population. Supplementary use of these strategies alongside established therapies could provide better utilization of resources. In view of the need for such integration, further research is warranted. The use of sound methodologies and establishing the mechanism of action of these therapies would assist in choosing the techniques for integration.
There is evidence for non-specific factors impacting treatment outcomes, with pragmatic concerns regarding the need to popularize briefer formats of cognitive behavioral therapy (CBT). The need to ...have more culturally suitable and acceptable forms of CBT is also indicated. We evaluated the feasibility and efficacy of a brief 5 session CBT (bCBT) in participants (N = 4) with panic disorder (PD) and agoraphobia, using a non-concurrent multiple baseline design. In this case series, efforts were made to maximize non-specific factors of psychotherapy in bringing about treatment outcomes. Reliable and significant treatment effects were observed at post-intervention and follow-up assessments. The present study offers preliminary evidence of a bCBT protocol that comprises the efforts to maximize the non-specific factors in psychotherapy such as credibility, expectancy, and the therapeutic alliance in bringing treatment outcomes; however, further controlled evaluation is warranted. We also discuss the mechanisms contributing to these treatment outcomes in the present protocol.
•The present protocol delineated the steps to maximize the non-specific factors in bCBT.•The studied non-specific factors were credibility, expectancy, and the therapeutic alliance.•The potential role of metaphors in conceptualization, credibility, expectancy, and adherence were discussed.•Importance of objectifying functional goals, agreement to tasks, and a regular feedback system for bCBT outcomes are mentioned.
Background: Emotion processing has received significant research attention in persons with schizophrenia. However, some aspects of this construct, such as emotion awareness, are less researched. In ...addition, there is limited work on metacognitive awareness and social functioning in persons with schizophrenia. Methods: Our sample comprised of 27 participants with schizophrenia- and 26 nonclinical controls. The clinical group was assessed on Scale for Assessment of Positive Symptoms, Scale for Assessment of Negative Symptoms, Tool for Recognition of Emotions in Neuropsychiatric Disorders, Toronto Alexithymia Scale, Metacognitive Assessment Scale, self-reflectiveness subscale of Beck's Cognitive Insight Scale, Scale S and Scale U subscales of the Metacognitive Assessment Scale, and Groningen's Social Dysfunction Scale. Results and Conclusion: Participants with schizophrenia had greater deficits in emotion recognition than nonclinical controls (P = 0.05, df = 51). There was no significant correlation between emotion recognition and metacognition in the clinical group. The presence of negative symptoms was significantly associated with social functioning in persons with schizophrenia.
BackgroundWork, a central aspect of human life, serves vital economic and social functions. There is a burgeoning interest in positive emotions in the workplace, which can enhance creativity, foster ...social connections, and improve problem-solving abilities. These emotions are pivotal in key organizational outcomes, including employee performance and health. Despite the extensive examination of factors like job satisfaction and workplace stressors, a knowledge gap exists regarding the everyday workplace events that influence emotions and their contribution to overall workplace emotional health. The present study introduces the Workplace Affective Events Survey (WAES), a new tool that can facilitate the advancement of research in this field.PurposeThis study aimed to develop a tool to assess daily workplace events that lead to positive or negative emotional responses and the intensities of such responses. The study also examined the relationship between these events and the associated affect-intensities with trait affect, and social companionship at work for convergent validation.MethodologyThe tool development entailed a multi-phase approach which encompassed item generation, content validation, pre-pilot trials, and pilot testing of the WAES. Participants were entry and mid-level service sector employees aged 25-55 years. Themes generated using focus group discussions and one-to-one interviews were mapped against a known taxonomy of workplace affective events. Expert validation and pre-pilot trials helped in refining the final items. The main phase engaged 300 individuals from nine service industries across 29 organizations in an urban metropolitan city in India. WAES was administered alongside standardized measures of trait-affect and workplace social companionship.ResultsWAES subscales demonstrated acceptable reliability. Participants reported positive daily affective events more often than negative ones, with the average intensity of positive emotions surpassing that of negative emotions. Notably, trait affect scores and social companionship exhibited significant correlations with daily affective events and their intensity.ConclusionsThe WAES offers a novel tool to investigate daily emotional experiences in the workplace. The data suggest that a within-person disposition such as trait-affect might play a lesser role in generating positive affective events than contextual factors. These findings underscore the value of creating work environments that consistently nurture positive emotional experiences.
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