Psychotherapists’ psychological well-being: The role of epistemic orientation and emotion regulation

Psychotherapists’ mental health has been traditionally associated with the harmful consequences of clinical practice. In contrast to this dominant model, a growing body of research in positive psychology has sparked an interest in therapists’ positive well-being. The main objective of this study was to examine the relations between therapists’ epistemic orientation modes, emotion regulation strategies and psychological well-being (PWB). This was a cross-sectional study in which participants were 674 therapists (78.5% women), with a mean age of 42.02 years (SD = 13.06). Therapists completed an online questionnaire containing self-report measures of all study variables. Structural equation modelling using latent variables was performed to test the study hypotheses. Results revealed no significant direct effects of epistemic orientation on PWB. Up- and downregulation strategies had the most substantial direct effects on total PWB. Furthermore, emotion regulation mediated the association between therapists’ epistemic orientation modes and PWB, accounting for 57% of the variance in the outcome variable. Implications for training, practice and therapist self-care are discussed.     

Acceptance and commitment therapy (ACT) for people with dementia experiencing psychological distress: A hermeneutic single-case efficacy design (HSCED) series

Introduction

People with dementia have a high prevalence of psychological distress but are underserved with evidence-based psychological interventions. To promote choice and improve clinical outcomes, there is a necessity to test different psychological intervention options for this population.

Purpose

This study aimed to investigate the effectiveness and acceptability of acceptance and commitment therapy (ACT) for people with dementia, considering carer-supported, remote delivery and necessary therapy adaptations.

Methods

A hermeneutic single-case efficacy design series was used to analyse the therapy process and change for three clients with dementia and psychological distress. A matrix of quantitative and qualitative data was collated (“rich case records”) and subject to critical analyses by three independent psychotherapy experts (“judges”) who identified change processes and determined the outcome for each client.

Results

Adjudication concluded that one client made positive changes, specifically reliable reductions in psychological distress, which were largely attributable to ACT. Two clients remained unchanged.

Discussion/Conclusion

Where change was achieved, the ACT-specific processes of values, committed action and acceptance, in combination with non-specific therapy factors, including a strong client–carer relationship, existing client interests and individualised therapy adaptations, were facilitative. Hence, ACT may be a feasible and effective vehicle for therapeutic change by helping carers to better meet the needs of their loved ones. Future research to optimise ACT delivery in this population may be beneficial. Furthermore, the assessment of carer factors (e.g., their psychological flexibility and the client–carer relationship) may strengthen the evidence base for systemic ACT use.     

The impact of living in a bio-secure bubble on mental health: An examination in elite cricket

The COVID-19 pandemic has had a profound impact on many people’s lives, including the use of bio-secure environments to facilitate the continuation of professional sport. Although it is well documented that the pandemic has negatively impacted mental health, the impact of bio-bubbles on mental health is yet to be investigated. In the present study we sought to identify the impact of bio-bubbles on the mental health of those residing within, and then to explore the underlying mechanism of any such impact. Individuals (n = 68) who resided in England and Wales Cricket Board (ECB) created bio-bubbles between March 2020 and April 2021 provided data, regarding their time inside and outside of bio-bubbles, on measures of mental health and basic psychological need satisfaction and frustration. Analysis revealed that bio-bubbles increased anxiety and depression and reduced wellbeing. Additionally, MEMORE mediation analyses revealed that autonomy frustration mediated the relationship between bubble status and all mental health markers. Furthermore, compared to men, women were more likely to experience elevated levels of anxiety and depression inside the bubble. The findings suggest that bio-bubbles negatively impact mental health and further suggest that satisfaction and frustration of basic psychological needs is a contributing factor. Findings suggest organizations tasked with creating bio-bubbles would do well to tailor their environment with an awareness of the importance of basic psychological needs and sex differences in relation to mental health. To the best of our knowledge, this research represents the first investigation of the impact of bio-bubbles on mental health.     

注意缺陷多动障碍-发展性阅读障碍共患儿童的干预效果及其内在机理

注意缺陷多动障碍和发展性阅读障碍是两类常见的儿童神经发育障碍, 二者共患率高达25%~48%。共患问题不仅使儿童自身面临着严重的认知、行为和心理损害, 还给家庭、学校和社会带来了沉重的负担, 对共患儿童的干预是极为必要且重要的。以共患病理机制假说为基础, 可将既往共患儿童的干预研究划分为以下两大类：(1)基于表型假说的干预方案, 如药物干预、阅读干预以及二者联合干预, 相应方案干预效果的迁移性和稳定性均有待深入考究; (2)基于共同缺陷假说的干预方案, 如针对核心共同认知缺陷之一的加工速度问题的干预已初显成效, 但相关研究较少, 干预效果需更多研究进一步系统性地考察。最后就共患儿童的干预方案现状进行了反思和展望。     

Openness relates to COVID-19 vaccination rates across 48 United States but politics trump personality

Does geographic variation in personality across the United States relate to COVID-19 vaccination rates? To answer this question, we combined multiple state-level datasets: (a) Big Five personality averages (i.e., extraversion, agreeableness, conscientiousness, neuroticism, and openness; Rentfrow et al., 2008), (b) COVID-19 full-vaccination rates (CDC, 2021a), (c) health-relevant demographic covariates (population density, per capita gross domestic product, and racial/ethnic data; Webster et al., 2021), and (d) political and religiosity data. Analyses showed openness as the strongest correlate of full-vaccination rates (r = 0.51). Controlling for other traits, demographic covariates, and spatial dependence, openness remained significantly related to full-vaccination rates (r_p = 0.55). Adding political and religiosity data to this model diminished openness effects for full-vaccination rates to non-significance (r_p = 0.26); however, extraversion emerged as a significant correlate of full-vaccination rates (r_p = 0.37). Although politics are paramount, we suspect that states with higher average openness scores are more conducive to novel thinking and behavior—dispositions that may be crucial in motivating people to take newly-developed vaccines based on new technologies to confront a novel coronavirus.     

Change in Seasonal Beliefs Mediates the Durability Advantage of Cognitive-Behavioral Therapy Over Light Therapy for Winter Depression

In treating an acute episode of winter depression, cognitive-behavioral therapy for seasonal affective disorder (CBT-SAD) and light therapy are comparably efficacious, with improvement in depression symptoms during CBT-SAD mediated by reduced seasonal beliefs (i.e., maladaptive thoughts about the seasons, light availability, and weather). Here, we tested whether the enduring benefit of CBT-SAD over light therapy following treatment is associated with offsetting seasonal beliefs during CBT-SAD. Currently depressed adults with Major Depression, Recurrent with Seasonal Pattern (N = 177) were randomized to 6 weeks of light therapy or group CBT-SAD and followedup one and two winters after treatment. Outcomes measured during treatment and at each follow-up included depression symptoms on the Structured Clinical Interview for the Hamilton Rating Scale for Depression—SAD Version and Beck Depression Inventory—Second Edition. Candidate mediators measured at pre-, mid-, and posttreatment were SAD-specific negative cognitions (Seasonal Beliefs Questionnaire; SBQ); general depressogenic cognitions (Dysfunctional Attitudes Scale; DAS); brooding rumination (Ruminative Response Scale-Brooding subscale; RRS-B); and chronotype (Morningness-Eveningness Questionnaire; MEQ). Latent growth curve mediation models found a significant positive path from treatment group to the slope of SBQ during treatment, with CBT-SAD showing larger improvements in seasonal beliefs with overall change in seasonal beliefs in the medium-effect range, and significant positive paths from SBQ slope to depression scores at the first and second winter follow-ups, indicating greater change towards more flexible seasonal beliefs during active treatment was associated with less severe depression symptoms following treatment. Estimated indirect effects (treatment group → SBQ change * SBQ change → outcome) were also significant at each follow-up for each outcome with β_indirect ranging from .091 to .162. Models also found significant positive paths from treatment group to the slope of MEQ and RRS-B during treatment, with light therapy showing a greater increase in “morningness” and CBT-SAD showing a greater decrease in brooding during active treatment; however, neither construct emerged as a mediator of follow-up depression scores. Change in seasonal beliefs during treatment mediates both the acute antidepressant and long-term effects of CBT-SAD and explains lower depression severity following CBT-SAD relative to light therapy.     

Factors Associated With Treatment Response in an Internet-Based Intervention for Prolonged Grief Disorder After Cancer Bereavement

Internet-based psychological interventions have proven effective in the treatment of prolonged grief disorder (PGD). Yet, some patients do not benefit from treatment in a clinically significant way. We aimed to examine predictors of symptom reduction in an Internet-based intervention for PGD after cancer bereavement, in order to identify possible treatment mechanisms and discern directions for future intervention design. A secondary analysis of data from a randomized wait-list controlled trial on an Internet-based intervention for PGD after cancer bereavement was conducted. Multiple regression models were used (1) to test for the influence of pretreatment PGD, working alliance, avoidance and gender on PGD symptom reduction; and (2) to explore further predictors of treatment success with a best subset selection protocol. The regression models explained 18% (Model 1) and 34% (Model 2) of variance in symptom reduction. Participants with more favorable symptom change had more severe pretreatment PGD scores and better working alliance. Those with lower social support and less posttraumatic growth experienced more PGD symptom change. In conclusion, therapeutic alliance is an important factor that should be monitored and fostered. Findings regarding social support and posttraumatic growth need further replication and clarification.     

A Pilot Open Trial of a Digital Mindfulness-Based Intervention for Anorexia Nervosa

Anorexia nervosa (AN) is a chronic and debilitating psychiatric disorder. Unfortunately, current treatments are lacking, with only 30-50% of individuals with AN recovering after treatment. We developed a beta-version of a digital mindfulness-based intervention for AN called Mindful Courage-Beta, which includes: (a) one foundational multimedia module; (b) 10 daily meditation mini-modules; (c) emphasis on a core skill set called the BOAT (Breathe, Observe, Accept, Take a Moment); and (d) brief phone coaching for both technical and motivational support. In this open trial, we aimed to evaluate (1) acceptability and feasibility; (2) intervention skill use and its association with state mindfulness in daily life; and (3) pre-to-post changes in target mechanisms and outcomes. Eighteen individuals with past-year AN or past-year atypical AN completed Mindful Courage-Beta over 2 weeks. Participants completed measures of acceptability, trait mindfulness, emotion regulation, eating disorder symptoms, and body dissatisfaction. Participants also completed ecological momentary assessment of skill use and state mindfulness. Acceptability ratings were good (ease-of-use: 8.2/10, helpfulness: 7.6/10). Adherence was excellent (100% completion for foundational module and 96% for mini-modules). Use of the BOAT in daily life was high (1.8 times/day) and was significantly associated with higher state mindfulness at the within-person level. We also found significant, large improvements in the target mechanisms of trait mindfulness (d = .96) and emotion regulation (d = .76), as well as significant, small-medium to medium-large reductions in eating disorder symptoms (ds = .36–.67) and body dissatisfaction (d = .60). Changes in trait mindfulness and emotion regulation had medium-large size correlations with changes in global ED symptoms and body dissatisfaction (rs = .43 – .56). Mindful Courage-Beta appears to be promising and further research on a longer, refined version is warranted.     

Evaluating the integration hypothesis: A meta-analysis of the ICSEY project data using two new methods

The Integration Hypothesis states that acculturating migrants who adopt the integration strategy (i.e. being doubly engaged, in both their heritage culture and in the larger national society) will have better psychological and socio-cultural adaptation than those who adopt any other strategy (Assimilation, Separation or Marginalization). This hypothesis was supported in the original evaluation of the ICSEY project data, using the mean adaptation scores for individuals in the four acculturation clusters. This conclusion was further supported by an analysis that used scores that were derived from the two underlying dimensions. This paper further evaluates this hypothesis meta-analytically using two new methods: Cultural Involvement and Cultural Preference; and Euclidean Distance. The results showed that these two methods provided support for the integration hypothesis, for both psychological adaptation and socio-cultural adaptation. The pattern of relationships was stronger for positive than for negative indicators of adaptation. Theoretical and practical implications of the results are discussed.