Prospective and Concurrent Affective Dynamics in Self-Injurious Thoughts and Behaviors: An Examination in Young Adult Women

Affective dynamics, assessed using ecological momentary assessment (EMA), provide a nuanced understanding of within-person fluctuations of negative affect (NA) and positive affect (PA) in daily life. NA and PA dynamics have been associated with psychopathology and response to psychological treatments. NA and PA dynamics have been rarely studied concurrently in association with self-injurious thoughts and behaviors (SITB), transdiagnostic difficulties encountered regularly in clinical and community settings. Here we present EMA data from a large, diverse sample of young adult women with high rates of SITB to examine NA and PA dynamics (mean intensity, variability, and inertia). Specifically, we considered the prospective associations between past-year suicidal thoughts and past-year nonsuicidal self-injury and affective dynamics, as well as the concurrent associations between affective dynamics, EMA-reported suicidal thoughts, and EMA-reported urges for nonsuicidal self-injury. Results demonstrate that elevated mean NA and NA variability are robustly associated with all types of SITB assessed prospectively or concurrently. Interestingly, these associations were weakest for past-year nonsuicidal self-injurious behaviors, relative to past-year and concurrent suicidal or nonsuicidal self-injurious thoughts. Past-year suicidal thoughts further predicted increased NA inertia. Decreased PA inertia was associated with past-year nonsuicidal self-injury behavior, as well as concurrent EMA suicidal thoughts. We found no associations (prospective or concurrent) between SITB and mean PA intensity or PA variability. These results highlight the importance of understanding affective processes to develop real-world interventions to prevent nonsuicidal self-injury and suicidal behavior in daily life.     

Childhood Maltreatment,Emotional Response Inhibition,and Suicide in Psychiatric Inpatients

Childhood abuse and/or neglect adversely influences development of neurocognitive systems that regulate affect and behavior. Poor inhibitory control over emotional reactions is thus one potential pathway from maltreatment to suicide. Adult psychiatric inpatients completed the Childhood Trauma Questionnaire and an emotional stop-signal task indexing negative emotional action termination (NEAT): the ability to inhibit ongoing motor reactions to aversive stimuli triggered by negative affect. Clinical interviews assessed suicidal thoughts and behaviors during hospitalization (n = 131) and at follow-up assessments 6 months later (n = 87). Our primary aim was to examine whether maltreatment history and NEAT explain overlapping variance in suicidal behaviors (1) retrospectively and (2) 6 months following hospital discharge. Contrary to prediction, childhood maltreatment was unrelated to history of suicidal behaviors. However, NEAT was consistently associated with prior suicidal acts, even controlling for suicidal ideation and demographic covariates. NEAT similarly contributed to the prediction of post-discharge suicidal behaviors, whereas we found no effect of maltreatment history. The present study suggests that NEAT captures suicide risk independently of childhood maltreatment. Results implicated NEAT impairment specifically, rather than broader response inhibition deficits (e.g., to positive stimuli), in past and future suicidal behaviors. These findings provide preliminary support for NEAT as a behavioral vulnerability marker for suicide, with implications for understanding links between maltreatment history and suicidal acts.     

Collaborative competence,social capital,and mental health: A cross‐sectional analysis of a community‐based intervention for older adults

Social capital interventions for the mental health of older adults have been inconclusive to date, and have rarely investigated the psychological resources that are important to having social capital. This study focused on the “Neighborhoods in Solidarity” (NS), which are a series of Swiss community‐based interventions that aim to empower older adults to participate in their communities. Our goal was to understand whether the NS were associated with collaborative competence, social capital, and subsequently, symptoms of depression. Cross‐sectional data were collected from 947 individuals aged 55 and over (M_age = 68.66, SD = 9.04) in 10 Swiss neighbourhoods (five with the NS [n = 479] and five control neighbourhoods [n = 468]). Structural equation modelling was used to model the relationship between the NS intervention, collaborative competence, cognitive and structural dimensions of social capital, and symptoms of depression (measured by the CESD‐R‐10). Individual participation in the NS had total and indirect effects on symptoms of depression via collaborative competence and both social capitals. These findings suggest that existing community‐based interventions can be indirectly associated with better mental health outcomes in the ageing population.     

Interpersonal Psychotherapy—Adolescent Skills Training With Youth From Asian American and Immigrant Families: Cultural Considerations and Intervention Process

Although research has identified effective evidence-based depression prevention interventions for diverse youth, little is known about how the intervention process unfolds with immigrant family youth. This study utilized a qualitative approach to explore cultural and clinical differences in the implementation of Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST) in two schools, one serving youth from primarily immigrant, Asian American families and the second, youth from mostly nonimmigrant, non-Hispanic White families. A total of 131 IPT–AST sessions were audio recorded, transcribed, and coded for presence and patterns of cultural and clinical constructs. Results revealed that sessions with immigrant family youth were more likely to contain discussions of interpersonal problems characterized by estrangement, goals of spending time together with important others, mentions of emotion suppression and academic achievement expectations, conversations about acculturation, differences in value orientation, and discomfort with implementing new intervention skills. Dialogue from interventionist and youth exchanges is presented to illustrate how these themes emerged and were addressed by interventionists in a culturally responsive manner. The study highlights how IPT–AST with immigrant family and Asian American youth may unfold differently compared to youth from nonimmigrant families. Implications of findings for providers are discussed.     

Brief Cognitive-Behavioral Therapy for Suicidal Inpatients

Suicide risk is elevated in psychiatric patients following discharge from inpatient care. Despite this vulnerability, there has been limited research investigating suicide prevention protocols that take into account the unique system characteristics of this setting (e.g., short lengths of stay, crisis stabilization treatment model, multidisciplinary team coordination). Cognitive-behavioral therapy (CBT) has demonstrated efficacy for improving suicide risk in outpatients, but has not been validated with inpatients. The current study was a treatment development and pilot feasibility open trial that modified brief cognitive-behavioral therapy (BCBT) for an inpatient setting (BCBT-I). Key treatment modifications included administering up to 10 sessions (depending on patient length of stay), daily, and in a standardized order, with core crisis management skills introduced during the first three sessions. In addition, coordination with the inpatient treatment team was included in BCBT-I implementation. Six adult inpatients with a recent suicide attempt enrolled and completed an average of 4.67 BCBT-I sessions (SD = 1.36). The treatment was highly acceptable (Client Satisfaction Questionnaire total score M = 3.49, SD = 0.73). Pre- to posttreatment effect sizes demonstrated improvements in suicidal ideation (d = 0.97), depression (d = 1.33), and suicidal implicit associations (d = 1.28). All but one of the participants (83%) completed follow-up assessments 1-, 2-, and 3-months postdischarge. Over follow-up, two participants reported suicidal ideation (both without intent), and none reported suicide attempts, preparatory acts or behaviors, or nonsuicidal self-injury. This study provided preliminary evidence supporting the feasibility of CBT to treat suicidal inpatients. Future research is needed to validate BCBT-I in a larger, randomized controlled trial to determine whether BCBT-I reduces suicide risk beyond that afforded by inpatient treatment alone.     

The effectiveness of cognitive behavioral group intervention on depression and anxiety in patients with type II diabetes

IntroductionDepression and anxiety are important risk factors for diabetes and high blood pressure.ObjectiveThis study investigated the effectiveness of the Cognitive-Behavioral Group Intervention for Diabetes Disease (CBGI-DD) in reducing depression and anxiety in female patients with type 2 diabetes (T2D).MethodThe CBGI-DD program includes 12 weekly 2.5 h sessions, spread weekly over the course of 3 months. The present study was semi-experimental and controlled, with assessments at pre-test and post-test. It included diagnostic criteria for the diagnosis of T2D in the patient's medical records by a diabetes specialist. Participants (62 female volunteers aged 25 to 75 years) were randomly allocated to a control or test group. Both groups responded to the Second edition of the Beck Depression Inventory (BDI-II) and the Beck Anxiety Inventory (BAI) before (pretest) and immediately after the intervention (posttest). Participants in the test group received CBGI-DD (from April up to the end of September 2018) at Mashhad Diabetes Center. The control group received only medical care during this period.ResultsAn analysis of covariance showed that compared to the control group, the test group had a significant reduction in anxiety and depression from pre-test to post-test (p < 0.05). It was compared post-test scores between the two groups, controlling for pre-test scores.ConclusionThe CBGI-DD program seems to be effective in reducing anxiety and depression in female patients with T2D. However, further research exploring the potential for long-term improvements in depression and anxiety is needed.     

拖延行为的发展认知机制及神经基础

拖延是指尽管预见到拖延会带来不利后果, 人们仍自愿推迟开始或完成某一计划好的任务。研究表明, 不同文化背景下有15%~20%的成年人存在慢性拖延, 超过70%的学生承认自己存在学业拖延, 部分学生还会形成特质性拖延。严重的拖延不仅影响人们的学业、工作和生活, 甚至还会危害到人们的身心健康。鉴于目前对于拖延产生的核心机制、形成的关键期以及发展认知神经机制还不是很清楚, 本项目拟从拖延的时间决策理论出发, 首先系统探明拖延决策的核心机制, 尤其是远期价值评估、延迟折扣和自我控制能力等在拖延决策过程中的认知加工机制和神经基础; 其次结合行为-环境变量-脑的多模态数据, 从发展角度探究拖延形成的关键期(敏感期)、影响因素以及发展认知神经机制; 最后从行为干预和脑的可塑性角度出发, 试图制定各关键年龄阶段拖延预防与干预的临床方案。本研究的开展对于把握拖延形成的认知机制、神经基础及其发展规律具有重要的科学价值, 对于拖延行为的预防和干预也具有直接的现实意义。     

寻找镜中的自我：精神分裂症患者的视觉观点采择

精神分裂症患者的视觉观点采择影响其必要的社交活动和生活质量。本文通过对精神分裂症患者视觉观点采择的研究进行梳理,总结出相关的心理特点：精神分裂症患者的视觉观点采择过程受损,表现出自我中心性和他人中心性。在神经生理上表现出与视觉观点采择相关的脑区激活减弱。可能的原因是患者认知功能中反应抑制能力和心理旋转能力的受损所致,建议采用认知干预疗法可能会改善患者的视觉观点采择能力。目前的研究论证了精神分裂症患者视觉观点采择过程的损伤,对于不同水平的视觉观点采择下精神分裂症患者的认知模式还未有明确的定论,未来的研究可以从该角度入手,更加明确精神分裂症患者不同水平视觉观点采择的特点和神经生理活动。     

A review of attachment-based parenting interventions: Recent advances and future considerations

Research evidence has shown that in childhood, a secure attachment to a reliable caregiver is important for future mental health and well-being. The theoretical and research basis for attachment theory continues to grow. As attachment theory has become more widely adopted there are challenges and opportunities both theoretically and in terms of its clinical use. Disordered attachment has been linked to psychopathology including internalising and externalising disorders. However, there are ongoing implications for researchers and clinicians as only the most extreme forms of attachment disorders are included in the current diagnostic systems. A wide range of reliable and validated observational assessments to classify attachment are available. Owing to the growing popularity of attachment-based interventions there is a need to develop assessments which are practical for use in clinical settings. The use of attachment-based parenting interventions in clinical settings is increasing as they have been found to be effective and relevant. This growth presents opportunities to further refine these interventions, so they are easy to deliver in clinical practice and tailored to different populations. Attachment-based interventions are being widely used in Australia, and this has led to a need to understand and adapt the theory, assessments, and interventions to this context. Attachment-based interventions demonstrate the importance of relationships and provide an important tool to support children and families. For psychologists here in Australia there are many opportunities to develop measures and interventions based on attachment theory that fit into the Australia context.