An Internet-Based Compassion-Focused Intervention for Increased Self-Criticism: A Randomized Controlled Trial

Increased levels of self-criticism and a lack of self-compassion have been associated with the development and maintenance of a range of psychological disorders. In the current study, we tested the efficacy of an online version of a compassion-focused intervention, mindfulness-based compassionate living (MBCL), with guidance on request. A total of 122 self-referred participants with increased levels of self-criticism were randomly assigned to care as usual (CAU) or the intervention group (CAU + online intervention). Primary endpoints were self-reported depressive, anxiety and distress symptoms (DASS-21) and self-compassion (SCS) at 8 weeks. Secondary endpoints were self-criticism, mindfulness, satisfaction with life, fear of self-compassion, self-esteem, and existential shame. At posttreatment, the intervention group showed significant changes with medium to large effect sizes compared to the control group regarding primary outcomes (Cohen’s d: 0.79 [DASS] and -1.21 [SCS]) and secondary outcomes (Cohen’s ds: between 0.40 and 0.94 in favor of the intervention group). The effects in the intervention group were maintained at 6-months postrandomization. Adherence measures (number of completed modules, self-reported number of completed exercises per week) predicted postintervention scores for self-compassion but not for depressive, anxiety, and distress symptoms in the intervention group. The current study shows the efficacy of an online intervention with a transdiagnostic intervention target on a broad range of measures, including depressive and anxiety symptoms and self-compassion.     

Exploring correlations between positive psychological resources and symptoms of psychological distress among hematological cancer patients: a cross-sectional study

Hematological cancer patients experience high levels of psychological distress during diagnoses and intensive treatments. The aim of the present study is to explore the effects of positive psychological resources on depressive and anxiety symptoms in hematological cancer patients. This survey was conducted in a hospital during the period from July 2013 to April 2014. A total of 300 inpatients were recruited and finally 227 of them completed the questionnaires. Questionnaires included demographic and clinical variables, the Center for Epidemiologic Studies Depression Scale, the Self-Rating Anxiety Scale, the Life Orientation Scale-Revised, the General Perceived Self-Efficacy Scale, and the Resilience Scale-14. Results showed that the prevalence of depressive and anxiety symptoms was 66.1 and 45.8%, respectively. Both optimism (β = ?.479, p < .001) and resilience (β = ?.174, p < .05) were negatively associated with depressive symptoms, and optimism (β = ?.393, p < .001) was negatively associated with anxiety symptoms. However, resilience (β = ?.133, p > .05) was not significantly associated with anxiety symptoms, and self-efficacy was not significantly associated with depressive (β = ?.032, p > .05) or anxiety symptoms (β = ?.055, p > .05). The results suggest that hematological cancer patients who possess high levels of positive psychological resources may have fewer symptoms of psychological distress. The findings indicate that enhancing positive psychological resources can be considered in developing intervention strategies for decreasing depressive and anxiety symptoms.     

Comorbidity and Internet-Delivered Transdiagnostic Cognitive Behavioural Therapy for Anxiety Disorders

Internet-delivered transdiagnostic anxiety interventions aim to reduce symptoms across several anxiety disorders using one treatment protocol. However, it is unclear whether comorbidity affects outcomes of such treatment. This study re-examined data from a recent randomised controlled trial (N = 129) that evaluated the efficacy of an Internet-delivered transdiagnostic cognitive behavioural therapy (iCBT) intervention for participants with principal diagnoses of generalised anxiety disorder (GAD), social phobia (SP) panic disorder and agoraphobia (PDA), of whom 72% met criteria for a comorbid anxiety disorder or depression. Participants were divided into two groups based on whether or not they had a comorbid disorder before treatment. Participants with comorbid conditions reported higher symptom levels at pre-treatment, post-treatment, and follow-up across a range of measures. Both groups showed significant reductions in symptoms over treatment; however, participants with comorbid disorders showed greater reductions in measures of GAD, PDA, SP, depression, and neuroticism. In addition, treatment significantly reduced the number of comorbid diagnoses at follow-up. These results indicate transdiagnostic iCBT protocols have the potential to reduce comorbidity.     

Effects of Mindfulness-Based Stress Reduction on Psychological Symptoms and Telomere Length: A Randomized Active-Controlled Trial

Much research has demonstrated the beneficial effects of mindfulness-based stress reduction (MBSR) on psychological and physical health, but it is not known whether MBSR may impact cellular aging in healthy populations. Further, little research has evaluated MBSR against an active control condition, which precludes strong conclusions regarding the unique effects of mindfulness on psychological functioning. The present study examined the effects of MBSR versus music therapy–based stress reduction (MTSR) on trait mindfulness, self-compassion, and several psychological health outcomes, as well as leukocyte telomere length (LTL). One hundred and fifty eight Singaporean Chinese adults were recruited and randomly assigned to an eight-week MBSR or MTSR course. Participants provided blood samples and completed a battery of self-report measures pre- and post-intervention. Analyses showed that participants in the MBSR condition demonstrated significantly greater improvements in depressive symptoms, trait mindfulness, and self-compassion compared to the control condition. Treatment condition did not predict changes in LTL, anxiety, stress, or happiness, though there was a trend for duration of home mindfulness practice to predict increases in LTL. Overall, the study demonstrated MBSR’s unique effects in reducing depressive symptoms. Improvements in trait mindfulness and self-compassion correspond with theorized mechanisms of change underlying mindfulness training. The lack of intervention effect with regards to LTL suggests that a more intensive intervention may be required for mindfulness to exert noticeable impact on aging at the cellular level, or that the effect may only emerge over a longer term.     

Impact of a brief auditory attention training on a modified colour-word Stroop task in a high anxiety and worry sample

Poor attentional control leads to attentional biases that are implicated in psychological distress. Attention Training Technique (ATT) is an auditory intervention designed to strengthen attentional control. Research indicates that ATT alleviates anxiety and depressive symptoms. This study is a randomised control trial with repeated measures that tested if a lab-based, single-exposure of ATT strengthened attentional control. Forty-six nonclinical, high anxiety/worry participants received either ATT or a sham control intervention. Attentional control was assessed using the standard and a modified version of the colour-word Stroop task. The modified version incorporated tactile interference to increase perceptual load. A series of mixed effects models, simple contrasts, and z-tests were used to evaluate if cross-modal interference worsened, and whether ATT was beneficial to, attentional control. Tactile interference increased reaction times but, when Stroop interference was controlled for, this was only true on incongruent trials. The impact of ATT was greatest under high perceptual load.     

Sense of purpose and food insecurity during the COVID-19 pandemic

The COVID-19 pandemic brought new attention to the issues of food insecurity faced by individuals throughout the United States, a stressor exacerbated by disruptions to work status and supply chains. The burden of food insecurity likely carries consequences for whether individuals feel capable of pursuing their broad goals and life engagements; put differently, food insecurity may pose a threat to people perceiving a sense of purpose in life. The current study tested this claim across three samples taken during 2020 (n = 2009), 2021 (n = 1666), and 2022 (n = 1975). Participants completed inventories for perceived food insecurity, sense of purpose, depressive symptoms, and anxiety, among other measures. Results found consistent negative associations between food insecurity and sense of purpose across all three samples. In addition, food insecurity moderated associations between sense of purpose and depressive or anxiety symptoms. Sense of purpose was more strongly negatively associated with depressive and anxiety symptoms for those participants who reported no food insecurity. That said, sense of purpose remained negatively associated with psychological distress even among those reporting food insecurity.     

Implementation of a mindfulness-based stress reduction (MBSR) program to reduce stress,anxiety, and depression and to improve psychological well-being among retired Iranian football players

ObjectivesTo test whether a mindfulness-based stress reduction (MBSR) program could reduce symptoms of anxiety, stress, and depression, and increase psychological well-being among retired Iranian football players compared to an active control group.DesignRandomized controlled trial, with an 8-week MBSR intervention (16 group sessions, 90 min each) and an active control group. Three data assessments were performed at baseline, eight weeks later after completion of the intervention, and again twelve weeks later at follow-up.MethodsForty male retired football players (M_age = 34.05, SD = 1.72) were randomly assigned either to the MBSR intervention or the active control condition. All participants completed questionnaires on perceived stress, anxiety, depression, and psychological well-being. Repeated measures analyses of variance were used to assess time by group interactions.ResultsSignificant time by group interaction effects were found for all outcomes. In the MBSR group, psychological well-being improved and symptoms of stress, anxiety, and depression decreased over time from baseline to intervention completion and to follow-up. In the active control group, the outcomes remained relatively stable across time.ConclusionsThe present findings suggest that among male retired Iranian football players, a MBSR intervention has the potential to reduce symptoms of stress, anxiety, and depression, and to increase their psychological well-being. Potential (underlying) mechanisms were not assessed in the present study. In future investigations, researchers should try to gain a deeper understanding of the mechanisms which may explain the observed effects.     

Group acceptance and commitment therapy (ACT) for bipolar disorder and co-existing anxiety – an open pilot study

Previous studies have supported acceptance and commitment therapy (ACT) for reducing impairment related to various chronic conditions. ACT may possibly be beneficial for bipolar disorder (BD) with co-existing anxiety, which is associated with a poorer treatment outcome. Efforts are needed to identify suitable psychological interventions for BD and co-existing anxiety. In this open clinical trial, we included 26 patients with BD type 1 or 2 at an outpatient psychiatric unit specializing in affective disorders. The intervention consisted of a 12-session manualized group treatment that included psychoeducation, mindfulness, engaging in values-based behaviour, cognitive defusion, acceptance and relapse prevention modules. Participants completed four self-report questionnaires covering anxiety symptoms (Beck Anxiety Inventory - BAI), depressive symptoms (Beck Depression Inventory - BDI-II), quality of life (Quality of Life Inventory - QOLI) and psychological flexibility (Acceptance and Action Questionnaire - AAQ-2) before, during and after the treatment. At post-treatment, the participants reported significant improvements in all outcome measures, with large effects (Cohen’s d between 0.73 and 1.98). The mean reduction in anxiety symptoms was 45%. At post-treatment, 96% of the patients were classified as responders on at least one of the outcome measures. A limitation is that the trial is uncontrolled. The results suggest that ACT has the potential to be an effective treatment for BD patients with co-existing anxiety. Further randomized studies are warranted.     

Writing content predicts benefit from written expressive disclosure: Evidence for repeated exposure and self-affirmation

Expressive disclosure regarding a stressful event improves psychological and physical health, yet predictors of these effects are not well established. The current study assessed exposure, narrative structure, affect word use, self-affirmation and discovery of meaning as predictors of anxiety, depressive and physical symptoms following expressive writing. Participants (N = 50) wrote on four occasions about a stressful event and completed self-report measures before writing and three months later. Essays were coded for stressor exposure (level of detail and whether participants remained on topic), narrative structure, self-affirmation and discovery of meaning. Linguistic Inquiry and Word Count software was used to quantify positive and negative affect word use. Controlling for baseline anxiety, more self-affirmation and detail about the event predicted lower anxiety symptoms, and more negative affect words (very high use) and more discovery of meaning predicted higher anxiety symptoms three months after writing. Findings highlight the importance of self-affirmation and exposure as predictors of benefit from expressive writing.     

Efficacy of guided self-help behavioural activation and physical activity for depression: a randomized controlled trial

Behavioural activation and physical activity have received empirical support that highlight their efficacy in reducing depression. Even though both behavioural activation and physical activity share the common goal of reactivating the individual, limited research has directly compared these interventions, and more research is required to evaluate their efficacy when offered in low-intensity formats. The present study involves a randomized controlled clinical trial comparing the efficacy of two guided self-help interventions for the treatment of depression: behavioural activation and physical activity. Fifty-nine participants presenting mild-to-moderate symptoms of depression were randomized either to a behavioural activation intervention (n = 20), a physical activity intervention (n = 19) or a wait-list control group (n = 20). All participants completed symptom measure pre-, mid- and post-intervention, as well as at a two-month follow-up. Mixed-model analyses of variance revealed that both interventions were significantly more efficacious in reducing depressive symptoms in comparison with the control group. Physical activity involved significantly less time-investment compared to the behavioural activation condition (less than half the amount of time). These results indicate that physical activity and behavioural activation both effectively reduce depressive symptoms and are favourably applicable in low-intensity formats. Implications of these results and avenues for future research are discussed.     

A Positive Psychology Intervention for Patients with an Acute Coronary Syndrome: Treatment Development and Proof-of-Concept Trial

Positive psychological constructs are associated with superior outcomes in cardiac patients, but there has been minimal study of positive psychology (PP) interventions in this population. Our objective was to describe the intervention development and pilot testing of an 8-week phone-based PP intervention for patients following an acute coronary syndrome (ACS). Initial intervention development and single-arm proof-of-concept trial, plus comparison of the PP intervention to a subsequently-recruited treatment as usual (TAU) cohort. PP development utilized existing literature, expert input, and qualitative interview data in ACS patients. In the proof-of-concept trial, the primary outcomes were feasibility and acceptability, measured by rates of exercise completion and participant ratings of exercise ease/utility. Secondary outcomes were pre-post changes in psychological outcomes and TAU comparisons, measured using effect sizes (Cohen’s d). The PP intervention and treatment manual were successfully created. In the proof-of-concept trial, 17/23 PP participants (74 %) completed at least 5 of 8 exercises. Participants rated the ease (M = 7.4/10; SD = 2.1) and utility (M = 8.1/10, SD = 1.6) of PP exercises highly. There were moderate pre-post improvements (ds = .46–.69) in positive affect, anxiety, and depression, but minimal effects on dispositional optimism (d = .08). Compared to TAU participants (n = 22), PP participants demonstrated greater improvements in positive affect, anxiety, and depression (ds = . 47–.71), but not optimism. A PP intervention was feasible, well-accepted, and associated with improvements in most psychological measures among cardiac patients. These results provide support for a larger trial focusing on behavioral outcomes.     

Outcome of the Psychological Intervention Program: Internet Use for Youth

The prevalence of problematic Internet use (PIU) is reportedly higher in South East Asian adolescent populations. The exacerbation of problematic adolescent behaviors has been found to associate significantly with PIU and is expected to worsen with age. Cognitive Behavioural Therapy (CBT)-integrated therapy has been shown to significantly reduce in the presence of psychological symptoms such as depression and social anxiety. The Psychological Intervention Program-Internet Use for Youth (PIP-IU-Y) is a CBT-based program designed for adolescents and comprises of a series of interpersonal skills to improve their face-to-face interaction. It focuses on taking preventative measures against Internet addiction before it develops by addressing the participant’s PIU as a negative coping style and incorporating positive psychological techniques. A total of 157 participants between the ages of 13 and 18 completed the program which consisted of eight weekly, 90 min sessions in a group format. Treatment outcomes were measured using mean change at the end of the program and 1 month post-treatment. The majority of the participants showed improvement after the eight weekly sessions of PIP-IU-Y and continued symptom maintenance at the 1 month follow-up. An overwhelming majority of participants were able to manage PIU symptoms after the intervention program, reinforcing the efficacy of the PIP-IU-Y. Not only did it addresses the PIU behaviour but also helped in reducing social anxiety and increasing social interaction. Further research could investigate treatment differences among the various subtypes of PIU (e.g., online gaming and pornography) in order to see if treatment differences exist.     

The effect of group psychological counselling in Greek university students’ anxiety,depression, and self-esteem

Objective: During the last decades there has been a marked increase in both the number of students with severe psychological problems on campus and the number of students seeking counselling services. The present study measured the effect of a group psychological counselling program on university students’ anxiety, depression, and self-esteem. Design: Data were derived from six separate groups and a total of 53 participants (19 male, 34 female). The intervention was based on Cognitive-Behavioural Group Therapy (CBGT) and included cognitive and behavioural techniques in eight, two-hour weekly sessions. The quasi-experimental longitudinal study used a pretest/posttest group design. The participants completed the Spielberger's State–Trait Anxiety Inventory (STAI), the Beck Depression Inventory (BDI), and the Rosenberg Self-esteem Scale (RSE) before and after the intervention. Data were analyzed using t-tests. Results: The results indicated the existence of meaningful differences in terms of state and trait anxiety, depression and self-esteem from pre-treatment to post-treatment. Conclusion: The program was effective in decreasing significantly participants’ anxiety and depressive symptoms, as well as increasing their self-esteem. These are encouraging results demonstrating an effective form of the intervention on student population.     

Longitudinal evaluation of anhedonia as a mediator of fear of positive evaluation and other depressive symptoms

ABSTRACT

Fear of positive evaluation (FPE) is experiencing dread during real or potential praise. FPE is associated with social anxiety, but its relation to depressive symptoms is unclear. Anhedonia is a core symptom of depression related to symptoms of anxiety in cross-sectional research. The current study investigated the indirect effect of FPE on depressive symptoms via anhedonia over time. One-hundred ninety-six participants completed three waves of questionnaires over a total timespan of approximately four months via Amazon’s Mechanical Turk, including measures of FPE, depressive symptoms, and anticipatory and consummatory anhedonia. Findings indicated that anticipatory anhedonia at Time 2 mediated the relationship between FPE at Time 1 and depressive symptoms at Time 3. Consummatory anhedonia, however, did not. Each model was contextualised by accounting for prospective covarying relationships, such as depressive symptoms predicting the same symptoms at later waves. The constellation of findings is considered within a reward devaluation framework.     

Differences in panic psychopathology between smokers with and without asthma

Cigarette smoking is more common among individuals with asthma compared to those without, resulting in increased risk of morbidity and mortality. However, there has been little exploration of psychological factors that differ between smokers with and without asthma. Thus, the aim of the current study was to examine differences between smokers with and without asthma in terms of anxiety sensitivity, panic symptoms, lifetime history of panic attacks, and lifetime history of panic disorder. Participants were 115 smokers with asthma (55.3% male, M_age = 38.4 years, SD = 11.9) and 120 smokers without asthma (70.6% male, M_age = 37.0 years, SD = 12.8) who were administered a structured diagnostic interview and completed self-report measures. As hypothesized, after controlling for the effects of cigarettes per day, gender, race, and education, smokers with asthma reported higher levels of anxiety sensitivity and panic symptoms and were at an increased risk for having a lifetime history of panic attacks (OR = 3.01) and panic disorder (OR = 2.96) compared to smokers without asthma. Further, group differences in anxiety sensitivity and panic symptoms remained even after removing participants with a lifetime history of panic attacks or panic disorder. These findings suggest that smokers with asthma are a particularly ‘at-risk’ population for panic psychopathology and likely in need of specialized smoking-related prevention and intervention efforts.     

Effect of the Healthy MOMs Lifestyle Intervention on Reducing Depressive Symptoms Among Pregnant Latinas

Depression during the prenatal and postpartum periods is associated with poor maternal, perinatal and child outcomes. This study examines the effectiveness of a culturally and linguistically tailored, social support-based, healthy lifestyle intervention led by trained community health workers in reducing depressive symptoms among pregnant and early postpartum Latinas. A sample of 275 pregnant Latinas was randomized to the Healthy MOMs Healthy Lifestyle Intervention (MOMs) or the Healthy Pregnancy Education (control) group. More than one-third of participants were at risk for depression at baseline. MOMs participants were less likely than control group participants to be at risk for depression at follow-up. Between baseline and 6 weeks postpartum, MOMs participants experienced a significant decline in depressive symptoms; control participants experienced a marginally significant decline. For MOMs participants, most of this decline occurred during the pregnancy intervention period, a time when no change occurred for control participants. The change in depressive symptoms during this period was greater among MOMs than control participants (“intervention effect”). From baseline to postpartum, there was a significant intervention effect among non-English-speaking women only. These findings provide evidence that a community-planned, culturally tailored healthy lifestyle intervention led by community health workers can reduce depressive symptoms among pregnant, Spanish-speaking Latinas.     

Daily Hassles and African American Adolescent Females�� Psychological Functioning: Direct and Interactive Associations with Gender Role Orientation

Given that stressors may accumulate across the life span, the extent to which daily hassles are associated with African American females?? psychological functioning during the adolescent years remains an important question. Understanding the potential impact of daily hassles is important due to indications that African American women report greater daily hassles and have higher incidence rates of stress-related disorders. The current study examines the relationship between daily hassles and psychological functioning (e.g., depression and anxiety symptoms) among 103 U.S. African American adolescent females (M?=?15.50; SD?=?1.70) residing in a moderately-sized Midwestern city. Additionally, this investigation explores gender role orientation as a moderator of this relationship. Results indicated that increased daily hassles were associated with greater depressive and anxiety symptoms. Also, this investigation provides some support for the direct and moderating role of gender role orientation. A greater feminine or androgynous role orientation was associated with fewer depressive and anxiety symptoms. In addition, although not directly associated, this investigation indicated that a masculine role orientation moderated the association between daily hassles and girls?? psychological outcomes. Specifically, among African American adolescent females with a greater masculine role orientation, increased daily hassles were associated with reduced psychological functioning (e.g., greater depressive and anxiety symptoms). Neither feminine nor androgynous role orientation, however, moderated the relationship between daily hassles and psychological functioning (e.g., depressive and anxiety symptoms). Implications of findings are discussed.     

Long-Term Outcome of a Cluster-Randomized Universal Prevention Trial Targeting Anxiety and Depression in School Children

The present study concerns a 3-year follow-up of a universal prevention trial targeting anxiety and depressive symptoms in school children. In addition to evaluating the long-term effect of the prevention program, we also examined attrition and its effect on the outcome. High rates of attrition have commonly been observed in studies in the field. However, the role of attrition is not sufficiently understood regarding internal and external validity biases. The current study comprised 695 children (aged 8–11 at baseline) from 17 schools in Sweden. Schools were cluster-randomized to either the intervention or control condition. Children completed measures of anxiety and depressive symptoms and parents completed measures of their child’s anxiety and general mental health. We found no evidence of long-term effects of the prevention program, except for a small effect regarding parent reports of child anxiety. However, that effect was not found to be of clinical significance. Regarding attrition, children with missing data at the 3-year follow-up displayed higher levels of psychiatric symptoms at baseline and increasing symptoms across time. Furthermore, children in the control condition with missing follow-up data were found to be significantly deteriorated across time compared to the corresponding children in the intervention condition regarding depressive symptoms and total difficulties. In other words, attrition served as a moderator of the effect, which suggests that the overall result was biased toward a null-result. Our study highlights that large and nonrandom attrition severely limits the validity of the results. Further, given the common problem of retaining participants in long-term evaluations of school-based prevention trials, previous studies may suffer from the same limitations as the current study.     

Life outcomes influenced by war-related experiences during the Gulf crisis

This study examined the life outcomes of children exposed to the Gulf crisis in 1990–1991. We expected war-trauma exposure and psychological distress symptoms to predict poorer educational and occupational outcomes. Participants were 151 Kuwaiti citizens who were assessed during childhood (in 1993; M age = 10.6 years), and who were reassessed 10 years later in young adulthood (in 2003; M age = 21.2 years). Participants completed measures of intelligence, war-trauma exposure, posttraumatic stress symptoms, anxiety symptoms, depressive symptoms, intervening life events, and life outcomes. Results indicated that war-trauma exposure negatively impacted children's educational and occupational outcomes as young adults. Boys with higher levels of war-trauma exposure were less likely to attend University. Posttraumatic stress and anxiety symptoms also predicted poorer educational and occupational outcomes. However, this relationship was not significant when we accounted for children's intelligence. Depressive symptoms were not predictive of children's educational or occupational outcomes. Results suggest that war-trauma exposure may have life-altering effects on children. Tailored, early interventions are needed for children exposed to war traumas.     

The Role of Perfectionism in Relation to an Intervention to Reduce Anxious and Depressive Symptoms in Children

Research has demonstrated an association between perfectionism and depressive and anxious symptoms in children. We examined whether a school-based program targeting anxious and depressive symptoms would reduce perfectionism, and whether perfectionism would interfere with intervention outcomes. The participants were 78 school-age children identified as at-risk for anxiety and/or depression. At-risk children took part in a randomized controlled trial of a school-based intervention program. Levels of perfectionism, depression, and anxiety were assessed at pre-treatment (Time 1) and again at post-treatment (Time 2) after participating in either a cognitive behavioral group or a structured activity group. Participation in either group was associated with significant reductions in overall levels of self-oriented perfectionism, anxious symptoms, and depressive symptoms. Supplementary analyses indicated that pre-treatment self-oriented perfectionism influenced post-treatment depression scores, suggesting that perfectionism interferes with treatment outcome. Perfectionism in children appeared amenable to group-based intervention, and identifying perfectionism may be important for treating children with depressive symptoms.