The CORE‐10: A short measure of psychological distress for routine use in the psychological therapies

Background: There is a need for a generic, short, and easy‐to‐use assessment measure for common presentations of psychological distress in UK primary care mental health settings. This paper sets out the development of the CORE‐10 in response to this need. Method: Items were drawn from the CORE‐OM and 10 items were selected according to a combination of usefulness, coverage of item clusters, and statistical procedures. Three CORE‐OM datasets were employed in the development phase: (1) a primary care sample, (2) a sample from an MRC platform trial of enhanced collaborative care of depression in primary care, and (3) a general population sample derived from the Office of National Statistics Psychiatric Morbidity Follow‐up survey. A fourth dataset comprising a sample from an occupational health setting was used to evaluate the CORE‐10 in its standalone format. Results: The internal reliability (alpha) of the CORE‐10 was .90 and the score for the CORE‐10 correlated with the CORE‐OM at .94 in a clinical sample and .92 in a non‐clinical sample. The clinical cut‐off score for general psychological distress was 11.0 with a reliable change index (90% CI) of 6. For depression, the cut‐off score for the CORE‐10 was 13 and yielded sensitivity and specificity values of .92 (CI=.83–1.0) and 0.72 (CI=.60–.83) respectively. Conclusion: The CORE‐10 is an acceptable and feasible instrument that has good psychometric properties and is practical to use with people presenting with common mental health problems in primary care settings.     

Space-based and object-based capacity limitations in visual search

Space-based accounts of visual attention assume that we select a limited spatial region independent of the number of objects it contains. In contrast, object-based accounts suggest that we select objects independent of their location. We investigated the boundary conditions on the selection modes of attention in a series of tachistoscopic visual search tasks, where the nature of capacity limitations on search was examined. Observers had to search for a horizontally oriented target ellipse among differently oriented distractor ellipses. Across four experiments, we orthogonally manipulated target-distractor (TD) similarity and distractor-distractor (DD) similarity. Each experiment consisted of a two-way design: Firstly, with a central cue, we indicated the spatial extent of the relevant search area. Secondly, we varied the number and spatial proximity of items in the display. Performance could be accounted for in terms of capacity limited object-based attention, assuming also that the spatial proximity of items enhances performance when there is high DD-similarity (and grouping). In addition, the cueing effect interacted with spatial proximity when DD-similarity was high, suggesting that grouping was influenced by attention. We propose that any capacity limits on visual search are due to object-based attention, and that the formation of perceptual objects and object groups is also subject to attentional modulation.     

Die stationäre Behandlung von Zwangsstörungen mit multimodaler Verhaltenstherapie

The results of a 1-year-follow-up study concerning the treatment of 30 in-patients suffering from obsessive-compulsive disorder (OCD) are presented. This prospective study was carried out at the Psychosomatic Hospital Windach. Beside a multimodal setting the central treatment component was flooding and response prevention. Group analysis showed significant improvements in all measures (BDI, STAI-X1, Y-BOCS and self-ratings). The results of the follow-up indicate, that more than 70% of the patients maintained their positive treatment response over 1 year (symptom improvement >30%). The average reduction of symptoms was 42%. Average treatment duration was 12 weeks. A high initial depression score (BDI >18) predicted a worse outcome.     

Dynamic integration: affect, cognition, and the self in adulthood

Positive self- and emotional development is often measured by optimization of happiness, but a second aspect of positive development—the ability to tolerate tension and negativity in the interest of maintaining objective representations—needs to be integrated with this hedonic emphasis. The integration of these two aspects, optimization and differentiation, reflects a dynamic balance. Such integration is possible when emotional activation or arousal is moderate, but is impaired at very high levels of activation. From youth to middle adulthood, the capacity for integration increases, but later in life, limitations or poor regulation strategies foster compensatory processes that compromise integration.     

Measurement Invariance of Personal Well-Being Index (PWI-8) Across 26 Countries

This report examines the measurement invariance of the Personal Well-being Index with 8 items (PWI-8). University students (N = 5731) from 26 countries completed the measure either through paper and pencil or electronic mode. We examined uni-dimensional structure of PWI and performed a Multi-group CFA to assess the measurement invariance across the 26 countries, using conventional approach and the alignment procedure. The findings provide evidence of configural and partial metric invariance, as well as partial scalar invariance across samples. The findings suggest that PWI-8 can be used to examine correlates of life satisfaction across all included countries, however it is impossible to compare raw scores across countries.     

Alexithymia,Defenses, and Ego Strength: Cross-Sectional and Longitudinal Relationships with Psychological Well-Being and Depression

Affect regulation is important to mental health. A deficit in one’s ability to identify and express emotions (alexithymia), cognitive styles of regulating emotional conflict (defenses), and the capacity for integrative and complex self-other understanding (ego strength or maturity) need to be studied to understand how they relate to each other as well as to mental health and well-being. A sample of 415 community-dwelling adults from a major metropolitan area in the Midwest U.S., stratified for gender, age, and ethnicity, completed three methodologically different measures of affect regulation along with measures of well-being and depression. Six years later, 49 % of the sample again reported their well-being and depression. At baseline, ego strength and the defenses of principalization and reversal correlated negatively with alexithymia and the other defenses (turning against self, turning against object and projection), even after controlling for negative affect. Cross-sectionally, relationships were largely as hypothesized, with low alexithymia, use of mature defenses, and greater ego strength correlating with less depression and greater well-being, although some of these relationships were attenuated after controlling for negative affect. Prospectively, each of the affect regulation measures predicted hypothesized changes in well-being after 6 years, after controlling for baseline well-being, but affect regulation did not predict changes in depression. These findings illuminate similarities and differences among these affect regulation constructs, suggest the importance of differentiating well-being from depression, and reveal that affect regulation uniquely predicts changes in long-term well-being.     

The Association Between Elevated Maternal Panic-Like and Depression Symptoms and Separation-Related Interpretive Biases in Offspring

We explored the association between maternal panic-like and depression symptoms with the offspring’s separation-related interpretive bias in a community sample. Separation anxiety has been found to be a precursor of panic disorders; therefore we focused on children and adolescents’ (aged 7–14 years) interpretive bias tapping into separation concerns using a story-based task. We collected self-reports and maternal reports of the levels of separation anxiety in the offspring. To assess maternal panic-like symptoms, we measured interoceptive and agoraphobic fears; as they have been found to increase the likelihood of experiencing panic disorders. The results showed that elevated levels of maternal interoceptive fears and agoraphobia co-occurring with depression were associated with an interpretive bias that related to separation anxiety concerns in children and adolescents. Offspring whose mothers experienced elevated panic-like symptoms together with depression did not show an interpretive bias linked to generalized anxiety concerns, suggesting the bias is content specific. The clinical significance of these findings stems from giving insight as to what extent separation interpretive biases would be influenced by maternal mental health variables, as these biases could constitute a vulnerability factor for later psychopathology. Further research is merited to address the findings with a longitudinal approach.