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Saur R, Fourel E, Dos Santos S, Kosinski T, Tapia G, Besche-Richard C, Carré A, Courtois R, Bortolon C, Baeyens C, Marteau-Chasserieau F, Romo L, Morvan Y, Vancappel A. Integrative models of psychopathology and psychotherapy: A PRISMA-based scoping review. L'ENCEPHALE 2025:S0013-7006(25)00097-1. [PMID: 40413067 DOI: 10.1016/j.encep.2025.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2025] [Revised: 03/05/2025] [Accepted: 03/08/2025] [Indexed: 05/27/2025]
Abstract
INTRODUCTION Since the 1970s there has been increasing interest in integrative approaches to psychopathology. Within this framework, numerous models have been developed. The aim of this manuscript is to inventory these models, provide a critical evaluation of them, and offer recommendations for their further development. METHOD We conducted a scoping review based on PRISMA guidelines. The search strategy included keywords related to psychotherapy and/or psychopathology, one keyword related to models or conceptualizations, and one keyword associated with the integrative notion. The selected studies focused exclusively on integrative models of psychopathology and/or psychotherapy. The research was carried out using PsycInfo, PubMed, and EMBASE databases. RESULTS A total of 61 manuscripts were included in the systematic review. We identified a broad range of conceptual proposals, which can be categorized into three main types of models: 1) Models proposing a general framework for understanding psychopathology, 2) Models focusing on common factors in psychotherapy and 3) Models suggesting that a specific psychotherapy is inherently integrative. CONCLUSIONS Many of these identified models face criticism for their lack of clear methodological development, limited empirical evidence, and/or restricted applicability to psychotherapeutic interventions. Future models should aim to address these limitations in order to advance the field.
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Affiliation(s)
- Rodolphe Saur
- University of Tours, Department of psychology, QualiPsy, Tours, France
| | - Eva Fourel
- University of Tours, Department of psychology, QualiPsy, Tours, France
| | | | - Thierry Kosinski
- University Lille, ULR 4072-PSITEC-psychologie: interactions temps émotions cognition, 59000 Lille, France
| | - Géraldine Tapia
- University Bordeaux, LabPsy, UR 4139, 33000 Bordeaux, France
| | | | - Arnaud Carré
- University Grenoble Alpes, University Savoie Mont Blanc, LIP/PC2S, 38000 Grenoble, France
| | - Robert Courtois
- University of Tours, Department of psychology, QualiPsy, Tours, France
| | - Catherine Bortolon
- University Grenoble Alpes, University Savoie Mont Blanc, LIP/PC2S, 38000 Grenoble, France; Institut Universitaire de France (IUF), Paris, France; Centre référent réhabilitation psychosociale et remédiation cognitive (C3R), centre hospitalier Alpes Isère, 38000 Grenoble, France
| | - Céline Baeyens
- University Grenoble Alpes, University Savoie Mont Blanc, LIP/PC2S, 38000 Grenoble, France
| | - Fanny Marteau-Chasserieau
- Équipe VCR école de psychologues praticiens de l'institut Catholique de Paris, UR Religion, culture et société, EA 7403, 75006 Paris, France
| | - Lucia Romo
- Université Paris Nanterre, UR 4430 CLIPSYD, Paris, France; Hopital Universitaire Raymond-Poicaré (AP-HP), Inserm CESP 1018, Paris France
| | - Yannick Morvan
- Université Paris Nanterre, UR 4430 CLIPSYD, Paris, France
| | - Alexis Vancappel
- University Lille, ULR 4072-PSITEC-psychologie: interactions temps émotions cognition, 59000 Lille, France.
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Faustino B. Biopsychosocial and contextual pressures: Contributions to a metatheoretical disorder theory from neuroscience, evolutionary, developmental, and ecological perspectives. APPLIED NEUROPSYCHOLOGY. ADULT 2025:1-14. [PMID: 40094438 DOI: 10.1080/23279095.2025.2469249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2025]
Abstract
Human internal and external pressures that drive cognition, emotion, motivation, and interpersonal behavior are critical aspects of clinical psychology and psychotherapy's perspectives on psychopathology. Different theoretical orientations suggest that difficulties with emotional needs, interpersonal motivations, psychosocial stages, and maturational tasks lie at the core of psychopathology. From an evolutionary and neurobiological perspective, several affective systems were shaped through the interaction between genetic and environmental pressures and can be described as the neural basis for several emotion-based behavioral tendencies. However, efforts to integrate these constructs from basic neural science, evolutionary psychology, and clinical psychology have been sparse. In this sense, the present article aims to briefly review the literature on such clinically relevant constructs and make a proposal in a coherent metatheoretical perspective to integrate and make sense of these phenomena as an unified rationale. From affective neuroscience to evolutionary psychology, developmental psychopathology, and ecological systems perspectives, biopsychosocial and contextual pressures are suggested as a heuristic for a contemporary, coherent, and transtheoretical theory of the disorder.
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Affiliation(s)
- Bruno Faustino
- HEI-Lab: Digital Human-Environment Interaction Labs, Lusófona University, Lisbon, Portugal
- Faculdade de Psicologia da, Universidade de Lisboa, Lisboa, Portugal
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Schultz KR, McGrath S, Keary TA, Meng CK, Batchos E, Evans L, Fields D, Cummings A, Fornalski N. A multidisciplinary approach to assessment and management of long COVID cognitive concerns. Life Sci 2024; 357:123068. [PMID: 39299386 DOI: 10.1016/j.lfs.2024.123068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 09/16/2024] [Accepted: 09/16/2024] [Indexed: 09/22/2024]
Abstract
Cognitive dysfunction is a commonly reported feature of Long COVID (LC). With the overlap of assessment and treatment for cognitive concerns across multiple disciplines, coupled with current guidelines supporting interdisciplinary care, the aim of this clinically focused article is to provide a review of current guidelines and research related to assessment and interventions to address LC-related cognitive concerns within clinical practice from a multidisciplinary perspective, incorporating best practices for collaboration among Clinical Neuropsychologists, Rehabilitation Psychologists, and Speech-Language Pathologists. Current guidelines for assessment and interventions for cognitive functioning are provided, with clinical suggestions for best practices offered. Additional considerations related to diversity and variable patient presentations are identified. This article provides guidance based on current research and practice standards regarding the utilization of a multidisciplinary, collaborative approach to provide comprehensive assessment and treatment for individuals with LC-related cognitive concerns.
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Affiliation(s)
- Katlin R Schultz
- Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus, OH, United States of America.
| | - Shana McGrath
- Outpatient Rehabilitation, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America
| | - Therese Anne Keary
- Memory and Psychological Services, Inc., Brecksville, OH, United States of America
| | - Chelsea K Meng
- Memory and Psychological Services, Inc., Brecksville, OH, United States of America
| | - Elisabeth Batchos
- Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus, OH, United States of America
| | - Lauren Evans
- Outpatient Rehabilitation, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America
| | - Danelle Fields
- Memory and Psychological Services, Inc., Brecksville, OH, United States of America
| | - Annie Cummings
- Outpatient Rehabilitation, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America
| | - Nicole Fornalski
- Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus, OH, United States of America
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Sabey AK, Lafrance A, Furrow J, Diamond G, Hughes D. A family reunion of "clinical cousins": Attachment and emotion in four family-oriented therapy models. FAMILY PROCESS 2024; 63:1119-1144. [PMID: 38649331 DOI: 10.1111/famp.13001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 04/25/2024]
Abstract
Attachment theory and the science of emotion provide a strong foundation for intervention at the family system level. Four therapeutic models in particular, Attachment-Based Family Therapy, Emotion-Focused Family Therapy, Dyadic Developmental Psychotherapy, and Emotionally Focused Family Therapy, demonstrate how a broad and accurate view of attachment relationships and emotion can be utilized to effectively intervene for a variety of presenting problems in a relational and empathic way for all involved. This paper continues a conversation that began at the Summit for Attachment and Emotion in Family Therapy in 2021 and aims to foster openness, collaboration, and affirmation between four different models of family therapy with shared theoretical roots. The presenters at the Summit and the authors of this paper view similarities across these models as validating and differences as opportunities to serve more families in unique ways, learning from one another's creativity to promote healing within families in the most effective and efficient ways possible. The paper frames the value of attachment theory and emotion science for family therapy, discusses the importance of learning from a variety of models with shared theoretical roots, presents brief summaries of the four models presented at the Summit, compares the models for similarities and complementarities, and shares highlights from each of the presenters from the Summit.
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Affiliation(s)
- Allen K Sabey
- The Family Institute at Northwestern University, Evanston, Illinois, USA
| | | | - James Furrow
- School of Arts and Sciences, Seattle University, Seattle, Washington, USA
| | - Guy Diamond
- Pearlman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Adaralegbe N, Oyelakin A, Omotayo O. Shared Delusion: Impact on the Parent-Child Relationship. Cureus 2024; 16:e67548. [PMID: 39310464 PMCID: PMC11416830 DOI: 10.7759/cureus.67548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Accepted: 08/16/2024] [Indexed: 09/25/2024] Open
Abstract
Folie à famille, also known as shared psychotic disorder among family members, is a rare and underdiagnosed psychiatric condition. This disorder, seldom discussed in the literature, is particularly notable for its impact on clinical management and parent-child relationships. The few reported cases have predominantly focused on adult populations, leaving a significant gap in understanding how this condition manifests and affects younger individuals and family dynamics. One area that remains largely unexplored in the literature is the intersection between attachment patterns and shared psychosis, particularly in the context of parent-child relationships. Understanding this intersection is crucial, as it can provide insights into the development and perpetuation of shared delusions within families. This article presents a case study of a school-aged female with autism spectrum disorder who exhibits a multi-generational shared delusion. This unique case highlights the complexities of diagnosing and managing shared psychotic disorders in children, especially when compounded by other developmental conditions. The treatment implications are profound, requiring a careful and nuanced approach to pharmacological and psychotherapeutic interventions.
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Affiliation(s)
- Ngozi Adaralegbe
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston McGovern Medical School, Houston, USA
| | - Ayotomide Oyelakin
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston McGovern Medical School, Houston, USA
| | - Omobusayo Omotayo
- Department of Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
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Rafaeli E, Rafaeli AK. Needs, Modes, and Stances: Three Cardinal Questions for Psychotherapy Practice and Training. CLINICAL PSYCHOLOGY IN EUROPE 2024; 6:e12753. [PMID: 39118654 PMCID: PMC11303924 DOI: 10.32872/cpe.12753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/29/2023] [Indexed: 08/10/2024] Open
Abstract
Background Advances in motivational science (Dweck, 2017), personality dynamics (Lazarus & Rafaeli, 2023), and process-based psychotherapy (Hofmann & Hayes, 2019) converge into a pragmatic, integrative, and transtheoretical model of practice and training. Method The model comprises three elements: a formulation centered on clients' psychological needs which provides guidance regarding the goals and processes most profitable to pursue; a recognition that such pursuit frequently requires contending with a multiplicity of clients' internal self-states (i.e., modes); and an enumeration of pragmatic therapeutic stances likely to help address clients' need-related goals in light of their modes. Results We distill these elements into three cardinal questions: What needs does this client have that are not currently met, and what are the most profitable ways of remedying that frustration? What mode or modes does this client manifest - both generally and at this very moment? and What stance should I adopt in response to the client's current mode? We suggest that clinicians should be trained to continually pose these questions and seek to answer them collaboratively with their clients. Conclusion This model - illustrated here using schema therapy terms - offers a process-based approach which serves as a theoretically integrative starting point but is general enough to provide an assimilative integration roadmap for therapists anchored in most primary orientations. Integrative or assimilative therapists trained to attend to needs, modes, and stances are likely to be (and be perceived as) particularly responsive, and thus, to enact "common factor" practices known to be conducive to therapeutic alliance and gains.
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Affiliation(s)
- Eshkol Rafaeli
- Department of Psychology and Gonda Center for Neuroscience, Bar-Ilan University, Ramat-Gan, Israel
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Zhu H, Ma S, Ding Y, Xia H. Associations between employment and mental health of older workers with disparate conditions: Evidence from China. Geriatr Nurs 2024; 56:244-251. [PMID: 38387148 DOI: 10.1016/j.gerinurse.2024.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 02/03/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
PURPOSE This study aimed to examine associations between the employment of older people and mental health across demographic characteristics, socioeconomic conditions, and health status, with a focus on pensions. METHODS This study included 4,512 participants aged 60-69 from the CLASS in 2014. A multiple linear regression was conducted to investigate the association between employment and mental health. A causal forest model was applied to estimate the heterogeneous treatment effects. RESULTS Employed individuals (n = 1,295) reported better mental health than their non-employed counterparts. This association displayed significant heterogeneity, primarily attributed to pensions. Those with lower pensions may be compelled to work due to financial reasons, thus offsetting the health-promotion effect of employment. CONCLUSION Employment may benefit the mental health of older adults, which has a more significant marginal effect on those who are men, older, urban residents, without a spouse, below primary education, receiving more pensions, and less family and friend support.
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Affiliation(s)
- Huoyun Zhu
- School of Public Administration and Emergency Management, Institute of Common Prosperity and National Governance, Jinan University, Guangzhou, China.
| | - Shilong Ma
- School of Public Administration and Emergency Management, Jinan University, Guangzhou, China
| | - Yu Ding
- School of Public Affaris, Xiamen University, Xiamen, China
| | - Huiqin Xia
- College of Political Science and Law, Jiangxi Normal University, Nanchang, China
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Lucre K, Ashworth F, Copello A, Jones C, Gilbert P. Compassion Focused Group Psychotherapy for attachment and relational trauma: Engaging people with a diagnosis of personality disorder. Psychol Psychother 2024. [PMID: 38305507 DOI: 10.1111/papt.12518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 12/28/2023] [Accepted: 01/16/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVES The research aimed to evaluate an exploratory Compassion Focused Group Psychotherapy Programme and the impact on participants' experiences of self-criticism, usage of services and general wellbeing. Participants included patients with a history of complex attachment and relational trauma (A&RT), who might attract a diagnosis of personality disorder. DESIGN This study utilised a quasi-experimental non-randomised within subject controlled design for the evaluation of the efficacy of the programme. METHODS Participants were recruited from tertiary care services. The programme consisted of a 12-week Preparation and Engagement intervention (PEG) which was Compassionate Mind Training and Psychoeducation, followed by a 40-week Compassion Focused Trauma Group intervention. The cohort was then followed up after 12 months during which period they received treatment as usual. A comprehensive selection of self-report measures was administered at various points during the therapeutic process and following completion of the group interventions. RESULTS The results of the research showed that the provision of a long-term, slow-paced, Compassion Focused Group Psychotherapy intervention, resulted in significant changes across all measures which were maintained at 12-month follow-up. These significant results were maintained following intention to treat and reliable change analyses. These data were supported by a significant reduction in service usage and a significant increase in engagement in employment and education. CONCLUSIONS This study has identified that within Compassion Focused Group Psychotherapy, there is a therapeutic process of establishing group-based safeness as a necessary precursor to cultivating compassion and reworking early shame-based trauma memories.
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Affiliation(s)
- Kate Lucre
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | | | - Alex Copello
- School of Psychology University of Birmingham & Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - Chris Jones
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Paul Gilbert
- Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby, UK
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Demirel Y, Çağatay HT, Ertuğrul B, Başaran E, Salimoğlu S. The effect of the compassion levels of healthcare workers on their psychological well-being. Work 2024; 77:253-262. [PMID: 37638464 DOI: 10.3233/wor-230035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND A sense of compassion has a core importance in health service delivery. Research on the psychological impact of being compassionate on healthcare workers is limited. OBJECTIVE This research aims to examine the effect of compassion levels of healthcare workers on their psychological well-being. METHODS This was a cross-sectional and descriptive study. The population of the research consists of health personnel working throughout Ankara, the capital. The study was carried out with 414 healthcare workers. A personal information form, compassion scale and psychological well-being scale were used in the research questionnaire. RESULTS A positive and significant relationship was found between compassion and psychological well-being scores. It was determined that compassion positively affected psychological well-being levels. The level of compassion showed that there was a significant difference between the groups according to the variables of gender, family structure, job satisfaction and whether they would choose the same profession again. The level of psychological well-being was found to be significantly different between the groups in education, job satisfaction and making the same profession choice again. CONCLUSION It is a professional requirement that health professionals in patient care have a sense of compassion and reflect this feeling in their conduct. Research shows that the greater the compassion, the higher the psychological well-being. Therefore, undertaking training initiatives to make healthcare workers more compassionate can contribute to patient care and at the same time to the psychological well-being of healthcare workers.
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Affiliation(s)
- Yüksel Demirel
- Department of Medical Services and Techniques, Vocational School of Health Services, Başkent University, Ankara, Turkey
| | - Hüseyin Tolga Çağatay
- Department of Medical Services and Techniques, Vocational School of Health Services, Başkent University, Ankara, Turkey
| | - Bekir Ertuğrul
- Department of Medical Services and Techniques, Vocational School of Health Services, Başkent University, Ankara, Turkey
| | - Esin Başaran
- Department of Medical Services and Techniques, Vocational School of Health Services, Başkent University, Ankara, Turkey
| | - Serap Salimoğlu
- Department of Medical Services and Techniques, Vocational School of Health Services, Başkent University, Ankara, Turkey
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Kloos N, Kraiss J, Ten Klooster P, Bohlmeijer E. First validation of the model of sustainable mental health: Structural model validity and the indirect role of adaptation. J Clin Psychol 2023; 79:2650-2667. [PMID: 37543726 DOI: 10.1002/jclp.23574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/22/2023] [Accepted: 07/16/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVES There is a growing interest in mental well-being as a vital outcome in clinical practice in addition to mental illness. The model of sustainable mental health (SMH) was recently introduced to delineate how interventions can improve mental health by targeting barriers and resources of adaptation to life stressors, improving the ability to adapt and thereby reducing mental illness and improving mental well-being. The aim of the current study is to empirically validate the conceptual model of SMH as well as the assumed indirect role of ability to adapt. METHODS This study used an existing dataset of the general population with self-reported reduced well-being due to the corona crisis (n = 849, mean age 53 years, SD = 15). Measurements of mental illness (depression and anxiety), mental well-being, ability to adapt, a specific barrier for adaptation (i.e., repetitive negative thinking), and a specific resource for adaptation (i.e., positive reframing) were included. Structural equation modeling was used to assess both the structural validity of the model and the indirect effect of ability to adapt. RESULTS An acceptable to good fit was found for the model of SMH and all paths between the proposed elements of the model were significant and in the hypothesized direction. Ability to adapt served as an indirect pathway trough which repetitive negative thinking (B = 0.149, 95% confidence interval [CI] = 0.016-0.028) and positive reframing (B = 0.163, 95% CI = 0.065-0.123) were linked with mental illness and mental well-being. CONCLUSION The current study provides the first empirical support of the internal validity of the model of SMH in a sample of the general population with reduced well-being, suggesting that barriers and resources to adaptation have an effect on mental illness and mental well-being through the ability to adapt. The model of SMH may therefore be a good model to use in research and clinical practice for developing, implementing, and evaluating a balanced treatment approach targeting both barriers and resources for adaptation.
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Affiliation(s)
- Noortje Kloos
- Centre for eHealth and Well-Being Research, Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
- Radboud Alzheimer Center, Department of Primary and Community Care, Radboudumc, Nijmegen, The Netherlands
- School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
| | - Jannis Kraiss
- Centre for eHealth and Well-Being Research, Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Peter Ten Klooster
- Centre for eHealth and Well-Being Research, Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Ernst Bohlmeijer
- Centre for eHealth and Well-Being Research, Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
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Gilbert P, Basran JK, Plowright P, Gilbert H. Energizing compassion: using music and community focus to stimulate compassion drive and sense of connectedness. Front Psychol 2023; 14:1150592. [PMID: 37868612 PMCID: PMC10586219 DOI: 10.3389/fpsyg.2023.1150592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/23/2023] [Indexed: 10/24/2023] Open
Abstract
Objectives The last 20 years have seen considerable research on the nature and biopsychosocial impacts of compassion training on self and others. This training is usually focused on calming and slowing the mind and body and on individual imagery practices and mantras. This study explored the effects of three variations: 1. The impact of using energizing music to generate activation and "drive" for compassion; 2. To focus on imagining "breathing in and breathing out a white light or mist of compassion" to bring compassion to the world; and 3. While listening to energizing music, participants were guided to imagining connecting to the compassion (Sangha) community, imagining oneself as linking with others as part of communities seeking to help the world. Methods From approximately 1,600 members of the Compassionate Mind discussion list, participants were invited to take part in a new energizing focused self-practice study. The study involved listening to recorded guidance on the evolutionary model of compassion and the need to address the potentially harmful side of our nature. This was followed by a 4 1/2-min tonglen-informed guided practice of breathing in and breathing out compassion accompanied by energizing music. Forty-three participants completed several self-report scales measuring compassion orientation, wellbeing, social safeness, and positive affect before and following 2 weeks of practice. Participant experiences were recorded from 6 open explorative questions. Results Self-report measures taken before and following 2 weeks of practice revealed significant increases in self-compassion, compassion to others, openness to compassion from others, activated positive affect, safe positive affect, social safeness, and wellbeing, with the largest effect size relating to compassion for the self (d = -0.76). In addition, qualitative data revealed that the participants had experienced the practice as energizing, inspiring, and felt socially connected and that it had significant impacts on other aspects of their lives. Some participants noted that engaging with suffering also stimulated sadness. Conclusion This study found that pairing energizing music with breathing practices and specific compassion visualizations, focusing on the desire to bring compassion to the world and be part of a compassionate community, was well-accepted and had a range of significant positive impacts. This study indicates the potential value of exploring energizing in comparison to the more standard soothing and settling practices as ways of stimulating the biopsychosocial processes of compassion.
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Affiliation(s)
- Paul Gilbert
- Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby, United Kingdom
- The Compassionate Mind Foundation, Derby, United Kingdom
| | - Jaskaran Kaur Basran
- Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby, United Kingdom
- The Compassionate Mind Foundation, Derby, United Kingdom
| | | | - Hannah Gilbert
- The Compassionate Mind Foundation, Derby, United Kingdom
- University of Roehampton, London, United Kingdom
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Eder J, Dom G, Gorwood P, Kärkkäinen H, Decraene A, Kumpf U, Beezhold J, Samochowiec J, Kurimay T, Gaebel W, De Picker L, Falkai P. Improving mental health care in depression: A call for action. Eur Psychiatry 2023; 66:e65. [PMID: 37534402 PMCID: PMC10486253 DOI: 10.1192/j.eurpsy.2023.2434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/20/2023] [Accepted: 06/29/2023] [Indexed: 08/04/2023] Open
Abstract
Depressive disorders have one of the highest disability-adjusted life years (DALYs) of all medical conditions, which led the European Psychiatric Association to propose a policy paper, pinpointing their unmet health care and research needs. The first part focuses on what can be currently done to improve the care of patients with depression, and then discuss future trends for research and healthcare. Through the narration of clinical cases, the different points are illustrated. The necessary political framework is formulated, to implement such changes to fundamentally improve psychiatric care. The group of European Psychiatrist Association (EPA) experts insist on the need for (1) increased awareness of mental illness in primary care settings, (2) the development of novel (biological) markers, (3) the rapid implementation of machine learning (supporting diagnostics, prognostics, and therapeutics), (4) the generalized use of electronic devices and apps into everyday treatment, (5) the development of the new generation of treatment options, such as plasticity-promoting agents, and (6) the importance of comprehensive recovery approach. At a political level, the group also proposed four priorities, the need to (1) increase the use of open science, (2) implement reasonable data protection laws, (3) establish ethical electronic health records, and (4) enable better healthcare research and saving resources.
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Affiliation(s)
- Julia Eder
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
- Graduate Program “POKAL - Predictors and Outcomes in Primary Care Depression Care” (DFG-GrK 2621), Munich, Germany
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Philip Gorwood
- Université Paris Cité, GHU Paris (Sainte Anne hospital, CMME) & INSERM UMR1266, Paris, France
| | - Hikka Kärkkäinen
- Global Alliance of Mental Illness Advocacy Networks-Europe, Brussels, Belgium
| | - Andre Decraene
- EUFAMI, the European Organisation representing Families of persons affected by severe Mental Ill Health, Leuven, Belgium
| | - Ulrike Kumpf
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Julian Beezhold
- Norfolk and Suffolk NHS Foundation Trust, Norwich, UK, University of East Anglia, Norwich, UK
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Tamas Kurimay
- North-Central Buda Center, New Saint John Hospital and Outpatient Clinic, Buda Family Centered Mental Health Centre, Department of Psychiatry and Psychiatric Rehabilitation, Teaching Department of Semmelweis University, Budapest, Hungary
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, WHO Collaborating Centre DEU-131, Germany
| | - Livia De Picker
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
- Graduate Program “POKAL - Predictors and Outcomes in Primary Care Depression Care” (DFG-GrK 2621), Munich, Germany
- Max-Planck Institute of Psychiatry, Munich, Germany
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13
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Abstract
Evolutionary biology provides a crucial foundation for medicine and behavioral science that has been missing from psychiatry. Its absence helps to explain slow progress; its advent promises major advances. Instead of offering a new kind of treatment, evolutionary psychiatry provides a scientific foundation useful for all kinds of treatment. It expands the search for causes from mechanistic explanations for disease in some individuals to evolutionary explanations for traits that make all members of a species vulnerable to disease. For instance, capacities for symptoms such as pain, cough, anxiety and low mood are universal because they are useful in certain situations. Failing to recognize the utility of anxiety and low mood is at the root of many problems in psychiatry. Determining if an emotion is normal and if it is useful requires understanding an individual's life situation. Conducting a review of social systems, parallel to the review of systems in the rest of medicine, can help achieve that understanding. Coping with substance abuse is advanced by acknowledging how substances available in modern environments hijack chemically mediated learning mechanisms. Understanding why eating spirals out of control in modern environments is aided by recognizing the motivations for caloric restriction and how it arouses famine protection mechanisms that induce binge eating. Finally, explaining the persistence of alleles that cause serious mental disorders requires evolutionary explanations of why some systems are intrinsically vulnerable to failure. The thrill of finding functions for apparent diseases is evolutionary psychiatry's greatest strength and weakness. Recognizing bad feelings as evolved adaptations corrects psychiatry's pervasive mistake of viewing all symptoms as if they were disease manifestations. However, viewing diseases such as panic disorder, melancholia and schizophrenia as if they are adaptations is an equally serious mistake in evolutionary psychiatry. Progress will come from framing and testing specific hypotheses about why natural selection left us vulnerable to mental disorders. The efforts of many people over many years will be needed before we will know if evolutionary biology can provide a new paradigm for understanding and treating mental disorders.
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Affiliation(s)
- Randolph M Nesse
- Departments of Psychiatry and Psychology, University of Michigan, Ann Arbor, MI, USA
- Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA
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14
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Gómez-Carrillo A, Kirmayer LJ. A cultural-ecosocial systems view for psychiatry. Front Psychiatry 2023; 14:1031390. [PMID: 37124258 PMCID: PMC10133725 DOI: 10.3389/fpsyt.2023.1031390] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 03/08/2023] [Indexed: 05/02/2023] Open
Abstract
While contemporary psychiatry seeks the mechanisms of mental disorders in neurobiology, mental health problems clearly depend on developmental processes of learning and adaptation through ongoing interactions with the social environment. Symptoms or disorders emerge in specific social contexts and involve predicaments that cannot be fully characterized in terms of brain function but require a larger social-ecological view. Causal processes that result in mental health problems can begin anywhere within the extended system of body-person-environment. In particular, individuals' narrative self-construal, culturally mediated interpretations of symptoms and coping strategies as well as the responses of others in the social world contribute to the mechanisms of mental disorders, illness experience, and recovery. In this paper, we outline the conceptual basis and practical implications of a hierarchical ecosocial systems view for an integrative approach to psychiatric theory and practice. The cultural-ecosocial systems view we propose understands mind, brain and person as situated in the social world and as constituted by cultural and self-reflexive processes. This view can be incorporated into a pragmatic approach to clinical assessment and case formulation that characterizes mechanisms of pathology and identifies targets for intervention.
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Affiliation(s)
- Ana Gómez-Carrillo
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, QC, Canada
- Culture and Mental Health Research Unit, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - Laurence J. Kirmayer
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, QC, Canada
- Culture and Mental Health Research Unit, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
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15
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Garvey L, Benson AC, Benger D, Short T, Banyard H, Edward KL. The perceptions of mental health clinicians integrating exercise as an adjunct to routine treatment of depression and anxiety. Int J Ment Health Nurs 2023; 32:502-512. [PMID: 36369663 DOI: 10.1111/inm.13089] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2022] [Indexed: 11/15/2022]
Abstract
Individuals with depressive symptoms often experience changes in physical activity and lifestyle factors. Despite the benefits of exercise, mental health clinicians often do not refer for or prescribe exercise as part of traditionally accepted models of care for consumers with depression and anxiety. The aims were to investigate: (i) mental health clinicians' understanding of the relationship between exercise and mental health, (ii) if and how exercise is used by mental health clinicians in treatment for depression and anxiety, and (iii) the barriers to prescription of exercise. A descriptive qualitative method was used, and data were collected via individual semi-structured interviews. Ten mental health clinicians with varying backgrounds participated in this study. The data driven inductive analysis of participants views identified three themes: (i) knowing and not knowing, (ii) consumer comorbidities - the risk and benefit dilemma, and (iii) protecting vulnerable consumers. Enhancing clinicians' knowledge of the beneficial role of exercise in treatment for consumers' experiencing depression and anxiety is an important step. Mental health services can support integration of exercise by implementing policies and training for staff to support exercise prescription, and the role and referral of exercise and physical activity specialists, as part of routine care to improve clinical outcomes for consumers. Additional considerations should be given to fiscal support to access exercise as an adjunct therapy.
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Affiliation(s)
- Loretta Garvey
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Amanda Clare Benson
- Department of Health and Biostatistics, School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Debra Benger
- Access Health and Community, Melbourne, Victoria, Australia
| | - Tamsin Short
- Access Health and Community, Melbourne, Victoria, Australia
| | - Harry Banyard
- Department of Health and Biostatistics, School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Karen-Leigh Edward
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
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16
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Affective neurobiological systems underlie emotional needs, interpersonal motivations and life themes from a biopsychosocial and contextual perspective. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-04125-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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17
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Shan YN, Yu Y, Zhao YH, Tang LL, Chen XM. Three-dimensional psychological guidance combined with evidence-based health intervention in patients with liver abscess treated with ultrasound. World J Clin Cases 2022; 10:8196-8204. [PMID: 36159547 PMCID: PMC9403680 DOI: 10.12998/wjcc.v10.i23.8196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/23/2022] [Accepted: 06/30/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Liver abscess is a common clinical liver disease mainly caused by suppurative bacteria or amoebae, with early clinical signs of chills, high fever, jaundice, and other symptoms. Establishing its early diagnosis is difficult, which may lead to misdiagnosis.
AIM To observe the effects of psychological guidance combined with evidence-based health intervention in patients with liver abscess treated with ultrasound.
METHODS A total of 120 patients with bacterial liver abscess admitted to our hospital from May 2018 to February 2021 were selected and divided into groups according to their intervention plan.
RESULTS After the intervention, Self-Rating Depression Scale, Self-Rating Anxiety Scale, Self-Perceived Burden Scale (SPBS), and quality of life scores (physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, mental health) were lower than before the intervention in the two groups. The observation group had lower negative sentiment, SPBS, and quality of life scores than the control group. In the observation group, 31 and 24 patients had good and general compliance, respectively, with a compliance rate of 91.67%, which was significantly higher than that in the control group. The observation group had significantly lower total incidence of incision infection, abdominal abscess, hemorrhage, and severe abdominal pain than the control group.
CONCLUSION Three-dimensional psychological guidance combined with evidence-based health intervention in treating liver abscess can reduce patients’ burden and negative emotions, improve patient compliance and quality of life, and reduce complications.
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Affiliation(s)
- Ya-Nan Shan
- Department of Infectious Diseases, First Hospital of Qinhuangdao, Qinhuangdao 066000, Hebei Province, China
| | - Ying Yu
- Department of Infectious Diseases, First Hospital of Qinhuangdao, Qinhuangdao 066000, Hebei Province, China
| | - Yi-Han Zhao
- Department of Infectious Diseases, First Hospital of Qinhuangdao, Qinhuangdao 066000, Hebei Province, China
| | - Lian-Lian Tang
- Nursing Department, First Hospital of Qinhuangdao, Qinhuangdao 066000, Hebei Province, China
| | - Xiao-Min Chen
- Nursing Department, First Hospital of Qinhuangdao, Qinhuangdao 066000, Hebei Province, China
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18
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Gilbert P, Basran JK, Raven J, Gilbert H, Petrocchi N, Cheli S, Rayner A, Hayes A, Lucre K, Minou P, Giles D, Byrne F, Newton E, McEwan K. Compassion Focused Group Therapy for People With a Diagnosis of Bipolar Affective Disorder: A Feasibility Study. Front Psychol 2022; 13:841932. [PMID: 35936292 PMCID: PMC9347420 DOI: 10.3389/fpsyg.2022.841932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/01/2022] [Indexed: 11/21/2022] Open
Abstract
Background Compassion focused therapy (CFT) is an evolutionary informed, biopsychosocial approach to mental health problems and therapy. It suggests that evolved motives (e.g., for caring, cooperating, competing) are major sources for the organisation of psychophysiological processes which underpin mental health problems. Hence, evolved motives can be targets for psychotherapy. People with certain types of depression are psychophysiologically orientated towards social competition and concerned with social status and social rank. These can give rise to down rank-focused forms of social comparison, sense of inferiority, worthlessness, lowered confidence, submissive behaviour, shame proneness and self-criticism. People with bipolar disorders also experience elevated aspects of competitiveness and up rank status evaluation. These shift processing to a sense of superiority, elevated confidence, energised behaviour, positive affect and social dominance. This is the first study to explore the feasibility of a 12 module CFT group, tailored to helping people with a diagnosis of bipolar disorder understand the impact of evolved competitive, status-regulating motivation on their mental states and the value of cultivating caring and compassion motives and their psychophysiological regulators. Methods Six participants with a history of bipolar disorder took part in a CFT group consisting of 12 modules (over 25 sessions) as co-collaborators to explore their personal experiences of CFT and potential processes of change. Assessment of change was measured via self-report, heart rate variability (HRV) and focus groups over three time points. Results Although changes in self-report scales between participants and across time were uneven, four of the six participants consistently showed improvements across the majority of self-report measures. Heart rate variability measures revealed significant improvement over the course of the therapy. Qualitative data from three focus groups revealed participants found CFT gave them helpful insight into: how evolution has given rise to a number of difficult problems for emotion regulation (called tricky brain) which is not one's fault; an evolutionary understanding of the nature of bipolar disorders; development of a compassionate mind and practices of compassion focused visualisations, styles of thinking and behaviours; addressing issues of self-criticism; and building a sense of a compassionate identity as a means of coping with life difficulties. These impacted their emotional regulation and social relationships. Conclusion Although small, the study provides evidence of feasibility, acceptability and engagement with CFT. Focus group analysis revealed that participants were able to switch from competitive focused to compassion focused processing with consequent improvements in mental states and social behaviour. Participants indicated a journey over time from 'intellectually' understanding the process of building a compassionate mind to experiencing a more embodied sense of compassion that had significant impacts on their orientation to (and working with) the psychophysiological processes of bipolar disorder.
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Affiliation(s)
- Paul Gilbert
- Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby, United Kingdom
- The Compassionate Mind Foundation, Derby, United Kingdom
| | - Jaskaran K. Basran
- Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby, United Kingdom
- The Compassionate Mind Foundation, Derby, United Kingdom
| | - Joanne Raven
- The Compassionate Mind Foundation, Derby, United Kingdom
| | - Hannah Gilbert
- The Compassionate Mind Foundation, Derby, United Kingdom
- Department of Psychology, University of Roehampton, London, United Kingdom
| | - Nicola Petrocchi
- Department of Economics and Social Sciences, John Cabot University, Rome, Italy
- Compassionate Mind ITALIA, Rome, Italy
| | - Simone Cheli
- School of Human Health Sciences, University of Florence, Florence, Italy
| | - Andrew Rayner
- The Compassionate Mind Foundation, Derby, United Kingdom
| | - Alison Hayes
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, United Kingdom
| | - Kate Lucre
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, United Kingdom
| | - Paschalina Minou
- Department of Philosophy, University College London, London, United Kingdom
- College of Health, Psychology and Social Care, University of Derby, Derby, United Kingdom
| | - David Giles
- Lattice Coaching and Training, Chesterfield, United Kingdom
| | - Frances Byrne
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, United Kingdom
| | - Elizabeth Newton
- College of Health, Psychology and Social Care, University of Derby, Derby, United Kingdom
| | - Kirsten McEwan
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, United Kingdom
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19
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Nagae A, Asano K, Kotera Y. Moderating Effects of Striving to Avoid Inferiority on Income and Mental Health. Front Psychol 2022; 13:838991. [PMID: 35719576 PMCID: PMC9204202 DOI: 10.3389/fpsyg.2022.838991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/17/2022] [Indexed: 11/25/2022] Open
Abstract
Many people experience feelings of inferiority in their life. The concept of striving to avoid inferiority is a belief associated with the unwanted fear of being overlooked, missing out on opportunities for advancement, and active rejection. This study examined the effect of striving to avoid inferiority on mental health and well-being. We hypothesized that striving to avoid inferiority would modify the relationship among socioeconomic status, mental health, and well-being, therefore examined the effect of striving to avoid inferiority on the relationship between annual income, mental health, and well-being. The participants were 491 adults (241 men and 250 women). The results indicated that insecure striving (IS) in competition with others positively correlated with depression, anxiety, and stress, whereas secure non-striving (SNS) in acceptance of inferiority positively correlated with the satisfaction with life and negatively correlated with depression. The effect of striving to avoid inferiority on the relationship among annual income, mental health, and well-being indicated that SNS affected the relationships between annual income and well-being, annual income and depression, income and anxiety, and the interaction between IS and SNS. Moreover, the relationship between income and stress was influenced by SNS and the interaction between IS and SNS. These results indicated that SNS or the interaction between IS and SNS were the only variables regulating the relationship among annual income, mental health, and well-being. These findings suggested that accepting feelings of inferiority or striving to avoid inferiority influences the mental health and well-being of people.
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Affiliation(s)
- Asa Nagae
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kenichi Asano
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Psychology, Mejiro University, Tokyo, Japan
| | - Yasuhiro Kotera
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
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20
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Kreibig SD, Samson AC, Gross JJ. Experiential, expressive, and physiological effects of positive and negative emotion regulation goals while reappraising amusing stimuli. Int J Psychophysiol 2022; 178:71-89. [PMID: 35597400 DOI: 10.1016/j.ijpsycho.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 04/27/2022] [Accepted: 05/05/2022] [Indexed: 11/17/2022]
Abstract
We examined whether positive and negative emotion regulation (ER) goals while cognitively reappraising amusing stimuli differentially engage positive (PA) and negative affect (NA) systems. Forty-eight women watched 20-30s amusing film clips. They were instructed to either respond naturally (no ER goal) or emphasize the film clips' positive (positive ER goal) or negative (negative ER goal) aspects in their interpretation. We measured PA and NA system activity on experiential, expressive, and physiological response channels through self-reported amusement and disgust, electromyography of zygomaticus major and corrugator supercilii, and autonomic nervous system reactivity from respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP). Natural viewing (no ER goal) of amusing clips increased self-reported amusement (and to a lesser degree disgust), zygomaticus reactivity, and RSA. Compared to no and negative ER goals, reappraising the amusing clips with a positive ER goal decreased corrugator reactivity, decreasing negative emotional expression. Compared to no and positive ER goals, reappraising the amusing clips with a negative ER goal decreased self-reported amusement and zygomaticus reactivity and increased self-reported disgust and corrugator reactivity, decreasing positive and increasing negative emotional experience and expression. We conclude that positive and negative ER goals while reappraising amusing stimuli differentially engaged PA and NA systems: The positive ER goal engaged withdrawal of the expressive NA system, whereas the negative ER goal engaged reciprocal NA-PA system activation on experiential and expressive response channels.
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Affiliation(s)
- Sylvia D Kreibig
- Department of Psychology, Stanford University, 450 Jane Stanford Way, Bldg 420, Stanford, 94305, CA, USA.
| | - Andrea C Samson
- Faculty of Psychology, UniDistance Suisse, University Campus Brig, Schinerstr. 18-20, 3900 Brig, Switzerland; Institute of Special Education, University of Fribourg, Rue Saint-Pierre Canisius 21, 1700 Fribourg, Switzerland
| | - James J Gross
- Department of Psychology, Stanford University, 450 Jane Stanford Way, Bldg 420, Stanford, 94305, CA, USA
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21
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Setiowati D, Maudina S, Jamaludin J, Rasdiyanah R. Psycho-Religious Therapy improving the Quality of Life of the Elderly in Nursing Homes. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
BACKGROUND As people get older, body functions in the elderly will decrease so that it will affect their quality of life. One way to improve the quality of life of the elderly is to meet the basic needs of the elderly through a spiritual approach (Islamic psychotherapy).
AIM: This study aims to determine the effect of Zikr on the quality of life of the elderly in nursing homes.
METHODS: This study used a quasi-experimental nonequivalent control group design. The sampling technique used purposive sampling , a total of 10 respondents from the intervention group and 10 respondents from the control group. Quality of life score using the World Health Organization Quality of Life-BREF questionnaire (WHOQOL-BREF). The research analysis used paired t-test and Wilcoxon test for differences in quality-of-life scores of each group and for differences in quality of life between the intervention group and control group using unpaired t-test and Mann-Whitney test.
RESULTS: The effect of psycho-religious therapy (Zikr) on the quality of life of the elderly in the intervention group before and after doing Zikr (p = 0.000), there were differences in 3 domains of quality of life, namely the psychological domain ( p = 0.000), the domain of social relations (p = 0.027), and the environmental domain. p = 0.010).
CONCLUSION: Psycho-religious therapy (Zikr) affects the quality of life of the elderly in the nursing home and suggests Nursing homes to provide guidance with a religious approach, especially Zikr to improve the quality of life of the elderly.
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22
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Steindl S, Bell T, Dixon A, Kirby JN. Therapist perspectives on working with fears, blocks and resistances to compassion in compassion focused therapy. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Stan Steindl
- Compassionate Mind Research Group School of Psychology University of Queensland Brisbane Queensland Australia
| | - Tobyn Bell
- Division of Psychology and Mental Health School of Health Sciences University of Manchester Manchester UK
| | - Alison Dixon
- Greater Manchester Mental Health NHS Foundation Trust Manchester UK
| | - James N. Kirby
- Compassionate Mind Research Group School of Psychology University of Queensland Brisbane Queensland Australia
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23
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Bennetts A. How does yoga practice and therapy yield psychological benefits? A review and model of transdiagnostic processes. Complement Ther Clin Pract 2021; 46:101514. [PMID: 34837807 DOI: 10.1016/j.ctcp.2021.101514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/12/2021] [Accepted: 11/14/2021] [Indexed: 11/03/2022]
Abstract
Interest in yoga as an intervention for psychological wellbeing has increased in recent years, with literature investigating beneficial effects in a variety of presentations and settings. The theoretical understanding of this benefit has previously focused on physiological changes involved in yoga practice, however interest has turned to the potential psychological mechanisms eliciting psychological wellbeing. The current paper builds on previous theory and argues that yoga practice targets transdiagnostic psychological processes; mechanisms that feature commonly across a wide range of presentations, thus reducing distress and increasing wellbeing across clinical and non-clinical populations. Features of yoga practice are discussed in relation to these transdiagnostic processes and the features of modern talking therapies. A new model is proposed positing specific aspects of yoga practice correlate with specific transdiagnostic processes to elicit psychological change and argues that the mechanisms by which change occurs are directly compared with the changes observed in talking therapies. The implications for future research and the potential for this to support the commissioning of holistic approaches in clinical practice are discussed.
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Affiliation(s)
- Alison Bennetts
- School of Psychology, The University of Southampton, Southampton, England, SO17 1BJ, UK.
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24
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Abstract
Como motivação pró-social, a compaixão tende a promover maior envolvimento em mentalidades de cuidado e ações de senso coletivo, capacidades prejudicadas pelos medos da compaixão. O estudo objetivou investigar o papel dos medos da compaixão em fatores envolvidos no engajamento às medidas de distanciamento social. 284 adultos (idade média = 36,47) responderam as Escalas de Medos da Compaixão, Escala de Dificuldades de Regulação Emocional e um questionário sobre engajamento aos protocolos contra a COVID-19. Um modelo de path analysis explicou 32% da variância na adesão aos protocolos por duas vias: o medo de ser compassivo por outros diminui o engajamento por motivações pró-sociais; enquanto os medos de expressar compaixão por si e outros predizem maiores dificuldades de regulação emocional, diminuindo a aderência por exaustão emocional. Oportunizar o desenvolvimento da compaixão pode contribuir para um enfrentamento mais saudável às dificuldades emocionais suscitadas pela pandemia e no envolvimento em ações coletivas.
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25
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Sousa R, Petrocchi N, Gilbert P, Rijo D. HRV patterns associated with different affect regulation systems: Sex differences in adolescents. Int J Psychophysiol 2021; 170:156-167. [PMID: 34673123 DOI: 10.1016/j.ijpsycho.2021.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/19/2021] [Accepted: 10/14/2021] [Indexed: 01/28/2023]
Abstract
Evolutionary perspectives of human behavior propose the existence of three emotion regulation systems (i.e., threat, drive and soothing systems). An unbalanced functioning of the systems represents greater risk for emotion dysregulation and psychopathology. In recent years, heart rate variability (HRV) has been reported as an accurate index of emotion regulation, and although adolescence is characterized by multiple neurophysiological, psychological and social changes, there is no study exploring the HRV patterns of each emotion regulation system in this developmental stage. In Study 1, a standardized procedure (SP) aiming to elicit the three different systems was developed and validated by experts (n = 14) and community adolescents (n = 31). In study 2, differences in HRV patterns across the three emotion regulation systems and across sex, were investigated in a sample of community adolescents (n = 155; 70 males), aged between 14 and 18 years old. Results showed that the threat and drive systems were associated with decreases in HRV, while the soothing system was associated with decreased heart rate. Sex differences were found for the activation of the threat system: while males maintained a decreasing trend in HRV indexes, from resting to recovery, females did not show a decrease in HRV during the activation of this system. Overall, physiological correlates of each specific emotion regulation system corroborate the theoretical assumptions. Moreover, a SP able to trigger each system independently while measuring physiological data is now available and can be used in future research.
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Affiliation(s)
- Rúben Sousa
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences of the University of Coimbra, Portugal.
| | - Nicola Petrocchi
- Department of Economics and Social Sciences, John Cabot University, Rome, Italy
| | - Paul Gilbert
- University of Derby, School of Allied Health and Social Care, United Kingdom
| | - Daniel Rijo
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences of the University of Coimbra, Portugal
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26
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Psychological distress in late adolescence: The role of inequalities in family affluence and municipal socioeconomic characteristics in Norway. PLoS One 2021; 16:e0254033. [PMID: 34214137 PMCID: PMC8253448 DOI: 10.1371/journal.pone.0254033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 06/17/2021] [Indexed: 11/19/2022] Open
Abstract
The present study aims to explore, in the national context of Norway, how municipal socioeconomic indicators affect anxiety and depressive symptom scores among senior high school students and whether this potential municipal effect is dependent on the adolescents' family affluence levels. This cross-sectional study is based on questionnaire data collected in five waves (2014-2018) of the Ungdata survey. The study sample consisted of 97,460 adolescents aged 16-18 years attending high school in 156 municipalities in Norway. Measures of psychological distress, depression, and anxiety symptoms were based on the screening instrument, Hopkins Symptom Checklist-10. Two-level random intercept models were fitted to distinguish the individual and municipality sources of variation in adolescents' mental health. In general, the results indicate substantial psychological symptom load among the study sample. Inequalities in adolescents' psychological distress between family affluence groups were evident, with the lowest symptom loads in the most affluent families. The predicted depressive and anxiety symptoms among the students increased slightly along with the percentage of municipal residents with tertiary educations and with increasing income inequalities in their residential municipality. However, the interaction models suggest that the adverse effects of higher municipal education level and greater income inequality are, to a certain extent, steepest for adolescents with medium family affluence. This study highlights two key findings. Both municipality effects and family affluence account for a relatively small proportion of the total variance in the students' psychological symptoms loads; however, the mental health inequalities we explored between socioeconomic strata on both the individual and municipal levels are not insignificant in a public health perspective. Results are discussed in the context of psychosocial mechanisms related to social comparison and perceptions of social status that may be applicable in egalitarian welfare states such as Norway.
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Day J, Finkelstein JC, Field BA, Matthews B, Kirby JN, Doty JR. Compassion-Focused Technologies: Reflections and Future Directions. Front Psychol 2021; 12:603618. [PMID: 34054636 PMCID: PMC8155300 DOI: 10.3389/fpsyg.2021.603618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 04/19/2021] [Indexed: 12/30/2022] Open
Abstract
Compassion is a prosocial motivation that is critical to the development and survival of the human species. Cultivating compassion involves developing deep wisdom, insight, and understanding into the nature and causes of human suffering; and wisdom and commitment to take positive action to alleviate suffering. This perspective piece discusses how compassion relates to the context of modern technology, which has developed at a rapid pace in recent decades. While advances in digital technology build on humankind's vast capacity to develop practical tools that promise to enrich our lives and improve our social connections, in reality the effects are often far from benign. The motives underlying the development of many contemporary digital platforms seem rooted in competitiveness and capitalism; while modern social media and online platforms are having a profound and pervasive impact on the mental health and wellbeing of humans around the globe. Nonetheless, digital technology holds considerable potential to promote compassionate insight, wisdom, and prosocial behavior. We reflect on the current state of technology within human society and examine the notion of compassionate technologies; discuss how contemporary paradigm shifts such as the inclusive design movement may be harnessed to build tools and platforms that promote collective good and increase prosocial behavior; and highlight examples of initiatives that are harnessing modern technology to advance democracy, collective knowledge, and personal freedoms and agency.
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Affiliation(s)
- Jamin Day
- College of Health, Medicine and Wellbeing, Family Action Center, The University of Newcastle, Newcastle, NSW, Australia
| | - Joel C Finkelstein
- School of Medicine, The Center for Compassion and Altruism Research and Education (CCARE), Stanford University, Stanford, CA, United States
| | - Brent A Field
- Princeton Neuroscience Institute, Princeton University, Princeton, NJ, United States
| | - Benjamin Matthews
- School of Creative Industries, College of Human and Social Futures, The University of Newcastle, Newcastle, NSW, Australia
| | - James N Kirby
- School of Psychology, Faculty of Health and Behavioral Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - James R Doty
- School of Medicine, The Center for Compassion and Altruism Research and Education (CCARE), Stanford University, Stanford, CA, United States
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Baiardini I, Contoli M, Corsico AG, Scognamillo C, Ferri F, Scichilone N, Rogliani P, Di Marco F, Santus P, Braido F. Exploring the Relationship between Disease Awareness and Outcomes in Patients with Chronic Obstructive Pulmonary Disease. Respiration 2021; 100:291-297. [PMID: 33706318 DOI: 10.1159/000513953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/21/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Disease awareness is a challenge in the management of chronic obstructive pulmonary disease (COPD). OBJECTIVES The aim of this analysis was to explore the association between COPD optimal and suboptimal awareness, clinical parameters, and the following patient-reported outcomes: modified Medical Research Council (mMRC), Treatment Satisfaction Questionnaire (TSQM-9), COPD Assessment Test (CAT), Morisky Medication-Taking Adherence Scale (MMAS-4), and Brief Illness Perception Questionnaire (B-IPQ). METHODS This post hoc analysis of the SAT study included all enrolled patients for whom awareness (Disease Awareness in COPD Questionnaire - DACQ) was assessed at baseline and 12 months. DACQ scores ≥80 were considered an indicator of an optimal awareness. RESULTS 367 patients (25.8% women, median age 72 years) were included in the analysis. At enrollment, 74 patients (20.2%) had a DACQ score ≥80. Patients with suboptimal awareness, compared to those in which awareness was optimal, had higher median scores for CAT (p = 0.0001) and mMRC (p = 0.0031), a lower median TSQM-9 global score (p < 0.0001), and higher median B-IPQ score (p < 0.0001). The proportion of patients who had exacerbations during the previous year was higher in patients with suboptimal COPD awareness than in those with DACQ score ≥80 (42.8 vs. 21.4%, p = 0.0009). During the 12-month observation period, illness perception, adherence, and treatment satisfaction were found to be independent factors significantly associated with level of disease awareness. CONCLUSION The results of our post hoc analysis suggest that patients' awareness of their COPD disease is related to both clinical outcomes and how they perceive and manage their condition.
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Affiliation(s)
- Ilaria Baiardini
- Respiratory Unit for Continuity of Care, Department of Internal Medicine, University of Genova, Genoa, Italy,
| | - Marco Contoli
- Respiratory Diseases Department of Morphology, Surgery and Experimental Medicine-Università di Ferrara- Ferrara, Ferrara, Italy
| | - Angelo Guido Corsico
- Respiratory Diseases Division, Medical Sciences and Infectious Diseases Department, IRCCS Policlinico San Matteo Foundation, and Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | | | - Fabio Ferri
- MediNeos Observational Research, Modena, Italy
| | - Nicola Scichilone
- Dipartimento Universitario PROMISE, Università di Palermo, UOC di Pneumologia, Policlinico Universitario P. Giaccone, Palermo, Italy
| | - Paola Rogliani
- Respiratory Medicine, Department of Experimental Medicine Università di Roma Tor Vergata,", Rome, Italy
| | - Fabiano Di Marco
- Department of Health Sciences, Università degli Studi di Milano, Respiratory Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Pierachille Santus
- Department of Biomedical and Clinical Sciences (DIBIC), Università degli Studi di Milano. Division of Respiratory Diseases, University Hospital "L. Sacco," ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Fulvio Braido
- Respiratory Unit for Continuity of Care, Department of Internal Medicine, University of Genova, Genoa, Italy
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Gilbert P. Creating a Compassionate World: Addressing the Conflicts Between Sharing and Caring Versus Controlling and Holding Evolved Strategies. Front Psychol 2021; 11:582090. [PMID: 33643109 PMCID: PMC7902494 DOI: 10.3389/fpsyg.2020.582090] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/23/2020] [Indexed: 11/13/2022] Open
Abstract
For thousands of years, various spiritual traditions and social activists have appealed to humans to adopt compassionate ways of living to address the suffering of life. Yet, along with our potential for compassion and self-sacrifice, the last few thousand years of wars, slavery, tortures, and holocausts have shown humans can be extraordinarily selfish, callous, vicious, and cruel. While there has been considerable engagement with these issues, particularly in the area of moral psychology and ethics, this paper explores an evolutionary analysis relating to evolved resource-regulation strategies that can be called "care and share" versus "control and hold." Control and hold are typical of primates that operate through intimidatory social hierarchies. Care and share are less common in non-human primates, but evolved radically in humans during our hunter-gatherer stage when our ancestors lived in relatively interdependent, small, mobile groups. In these groups, individualistic, self-focus, and self-promoting control and hold strategies (trying to secure and accumulate more than others) were shunned and shamed. These caring and sharing hunter-gatherer lifestyles also created the social contexts for the evolution of new forms of childcare and complex human competencies for language, reasoning, planning, empathy, and self-awareness. As a result of our new 'intelligence', our ancestors developed agriculture that reduced mobility, increased group size, resource availability and storage, and resource competition. These re-introduced competing for, rather than sharing of, resources and advantaged those who now pursue (often aggressively) control and hold strategies. Many of our most typical forms of oppressive and anti-compassionate behavior are the result of these strategies. Rather than (just) thinking about individuals competing with one another, we can also consider these different resource regulation strategies as competing within populations shaping psychophysiological patterns; both wealth and poverty change the brain. One of the challenges to creating a more compassionate society is to find ways to create the social and economic conditions that regulate control and hold strategies and promote care and share. No easy task.
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Affiliation(s)
- Paul Gilbert
- Centre for Compassion Research and Training, College of Health and Social Care Research Centre, University of Derby, Derby, United Kingdom
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Gilbert P. Compassion: From Its Evolution to a Psychotherapy. Front Psychol 2020; 11:586161. [PMID: 33362650 PMCID: PMC7762265 DOI: 10.3389/fpsyg.2020.586161] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/20/2020] [Indexed: 12/16/2022] Open
Abstract
The concept, benefits and recommendations for the cultivation of compassion have been recognized in the contemplative traditions for thousands of years. In the last 30 years or so, the study of compassion has revealed it to have major physiological and psychological effects influencing well-being, addressing mental health difficulties, and promoting prosocial behavior. This paper outlines an evolution informed biopsychosocial, multicomponent model to caring behavior and its derivative "compassion" that underpins newer approaches to psychotherapy. The paper explores the origins of caring motives and the nature and biopsychosocial functions of caring-attachment behavior. These include providing a secure base (sources of protection, validation, encouragement and guidance) and safe haven (source of soothing and comfort) for offspring along with physiological regulating functions, which are also central for compassion focused therapy. Second, it suggests that it is the way recent human cognitive competencies give rise to different types of "mind awareness" and "knowing intentionality" that transform basic caring motives into potentials for compassion. While we can care for our gardens and treasured objects, the concept of compassion is only used for sentient beings who can "suffer." As psychotherapy addresses mental suffering, cultivating the motives and competencies of compassion to self and others can be a central focus for psychotherapy.
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Affiliation(s)
- Paul Gilbert
- Centre for Compassion Research and Training, College of Health and Social Care Research Centre, University of Derby, Derby, United Kingdom
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Alonso-Stuyck P. Parenting and Healthy Teenage Lifestyles. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155428. [PMID: 32731468 PMCID: PMC7432849 DOI: 10.3390/ijerph17155428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/15/2020] [Accepted: 07/24/2020] [Indexed: 11/16/2022]
Abstract
How can one promote adolescent adjustment toward a healthy lifestyle? The first step is to locate the healthy habit configuration within the family environment. The hypothesis is that, if adolescent lifestyles are assumed autonomously during adolescence, then it is very likely that they will last throughout life. How does this relate to parenting styles? After reviewing the literature of the last four decades on adolescent behavioral autonomy and scientific articles that link healthy lifestyles with parenting, several conclusions have been reached, such as the relevance of recovering the biopsychosocial richness of healthy lifestyles, the need to use a dialogue strategy to resolve discrepancies between adolescents and their parents, and the adequacy of the personalistic parenting style to promote adjusted adolescent behavioral autonomy, and with it maintain healthy lifestyles in the long term.
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Affiliation(s)
- Paloma Alonso-Stuyck
- Institute for Higher Family Studies, International University of Catalonia, 08017 Barcelona, Spain
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32
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Myhr A, Anthun KS, Lillefjell M, Sund ER. Trends in Socioeconomic Inequalities in Norwegian Adolescents' Mental Health From 2014 to 2018: A Repeated Cross-Sectional Study. Front Psychol 2020; 11:1472. [PMID: 32733331 PMCID: PMC7358281 DOI: 10.3389/fpsyg.2020.01472] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 06/02/2020] [Indexed: 01/20/2023] Open
Abstract
Background Adolescents’ mental health, and its consistent relationship with their socioeconomic background, is a concern that should drive education, health, and employment policies. However, information about this relationship on a national scale is limited. We explore national overall trends and investigate possible socioeconomic disparities in adolescents’ mental health, including psychological distress and symptoms of depression, anxiety, and loneliness in Norway during the period 2014–2018. Methods The present study builds on data retrieved from five waves of the national cross-sectional Ungdata survey (2014–2018). In total 136,525 upper secondary school students (52% girls) completed the questionnaire during the study period. Trends in socioeconomic inequalities were assessed using the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII). Results The prevalence of students with moderate to high symptoms score and mean symptoms scores of psychological distress (in terms of symptoms of depression, anxiety, and loneliness) increased among girls and boys during 2014–2018, with girls showing higher rates. Our results suggest distinct, but stable, inequalities between socioeconomic groups, both in absolute and relative terms, among girls and boys during the study period. Conclusion Rising rates of adolescents’ psychological distress, particularly among girls, may have long-term consequences for individuals involved and the society as a whole. Future studies should investigate the causes of these results. We did not find evidence of any change in inequalities in adolescents’ mental health between socioeconomic groups, suggesting current strategies are not sufficiently addressing mental health inequalities in the adolescent population and therefore a significant need for research and public health efforts.
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Affiliation(s)
- Arnhild Myhr
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Trøndelag R&D Institute, Steinkjer, Norway
| | - Kirsti S Anthun
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Monica Lillefjell
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Erik R Sund
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology, Levanger, Norway.,Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway.,Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
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Turk F, Waller G. Is self-compassion relevant to the pathology and treatment of eating and body image concerns? A systematic review and meta-analysis. Clin Psychol Rev 2020; 79:101856. [PMID: 32438284 DOI: 10.1016/j.cpr.2020.101856] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/06/2020] [Accepted: 04/23/2020] [Indexed: 01/09/2023]
Abstract
Eating disorders are severe mental health conditions, with substantial consequences for health and quality of life. Such disorders are strongly associated with body image concerns. It is important to consider treatments that might enhance our ability to treat such cases. Recently, there has been a growing body of research on self-compassion in relation to such problems. However, we are not yet clear about the extent of such effects, given the range of studies and methodologies used. Therefore, a systematic literature review was carried out using four key databases. Meta-analysis was used to reach conclusions about the size of the effects and moderators. Random-effects meta-analyses were conducted with 59 studies. Higher self-compassion was associated with lower eating pathology, reduced body image concerns, and greater positive body image, with medium to strong effect sizes (respectively, r = -0.34, r = -0.45, r = 0.52). Furthermore, self-compassion interventions for eating pathology and body image were effective, and superior to control groups (respectively, g = 0.58, g = 0.39). These findings support the role of self-compassion in understanding and addressing eating and body image concerns. Self-compassion appears to be an adaptive emotion regulation strategy in eating disorders and body image.
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Affiliation(s)
- Fidan Turk
- Department of Psychology, University of Sheffield, Sheffield, UK.
| | - Glenn Waller
- Department of Psychology, University of Sheffield, Sheffield, UK
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Wiltshire TJ, Philipsen JS, Trasmundi SB, Jensen TW, Steffensen SV. Interpersonal Coordination Dynamics in Psychotherapy: A Systematic Review. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10106-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Abstract
Background
The aim of this study was to gain a better understanding of interpersonal coordination (i.e., covariation over time) in different modalities (e.g., physiology, language) during psychotherapy and their importance for understanding the dynamics of psychotherapeutic interaction and efficacy.
Methods
We conducted a systematic review of all studies examining some form of interpersonal coordination in a psychotherapeutic context.
Results
We first summarize details of the included studies such as gender composition, therapy types, and methods used. The collation of these studies provided evidence that, during psychotherapeutic contexts, interpersonal coordination occurs in physiology, movements, interpersonal displays, and language/vocalizations. Further, it also showed that movement coordination was most frequently associated with psychotherapy outcomes, physiological coordination was most frequently associated with empathy, and coordination in a variety of modalities including language/vocalizations were most frequently associated with therapeutic alliance.
Conclusions
We discuss these results, shortcomings with the current literature, and highlight three crucial questions for future research. Research on interpersonal coordination in psychotherapy has potential to advance the both the research and practice of psychotherapy.
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35
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Farnsworth JK, Borges LM, Walser RD. Moving Moral Injury Into the Future With Functional Contextualism: A Response to Nash's "Unpacking Two Models for Understanding Moral Injury" (2019). J Trauma Stress 2019; 32:633-638. [PMID: 31356700 DOI: 10.1002/jts.22429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 07/08/2019] [Indexed: 12/21/2022]
Abstract
In his commentary on the Journal of Traumatic Stress special issue on moral injury (Vol. 32, Issue 3), Nash (2019) critiques both Farnsworth's (2019) descriptive-prescriptive framework for differentiating posttraumatic stress disorder (PTSD) from moral injury and Farnsworth, Drescher, Evans, and Walser's (2017) functional contextual definition of moral injury and related concepts. To make his arguments, Nash contrasts these two frameworks with the Navy and Marine Corps Combat Operational Stress Control (COSC) model wherein moral stressors are presumed to cause literal damage to intrapsychic structures. Unfortunately, in drawing his comparisons, Nash makes several misstatements that we feel are important to clarify. We respond to Nash's commentary by first identifying the proper sources for the critiqued frameworks and correctly locate Farnsworth et al.'s functional contextual definition of moral injury within the domain of third-wave cognitive behavioral therapies. We go on to compare and contrast the respective origins of the COSC and functional contextual models, noting important differences in their intended purposes. Next, we defend our model against Nash's critiques by highlighting how a functional contextual approach to moral injury (a) links with evolutionary science, (b) captures multiple levels of analysis, (c) is parsimonious, (d) serves diverse populations, (e) directly informs interventions, (f) promotes moral humility, and (g) decreases stigma while preserving client autonomy. In our conclusion, we recognize the value of the COSC model for its intended purposes while also encouraging deep and respectful dialogue among researchers and clinicians regarding the proposed benefits of the functional contextual model of moral injury.
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Affiliation(s)
| | - Lauren M Borges
- Rocky Mountain Mental Illness Research, Education, and Clinical Center, Aurora, Colorado, USA.,Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Robyn D Walser
- Dissemination and Training Division, National Center for PTSD, Menlo Park, California, USA.,Department of Psychology, University of California, Berkeley, California, USA
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36
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Richardson GB, Hanson-Cook BS, Figueredo AJ. Bioecological Counseling. EVOLUTIONARY PSYCHOLOGICAL SCIENCE 2019. [DOI: 10.1007/s40806-019-00201-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gilbert P, Kirby JN. Building an integrative science for psychotherapy for the 21st century: Preface and introduction. Psychol Psychother 2019; 92:151-163. [PMID: 30932325 DOI: 10.1111/papt.12225] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Indexed: 01/14/2023]
Abstract
Psychotherapy is plagued with fragmentation of models, theories, and interventions. The future of psychotherapy requires an integrative framework rooted in the expanding science of psychology, neuroscience, and social contextualism. The papers in this special issue address these challenges for psychotherapy, ranging from explorations of the implications of epigenetics, evolutionary functional analysis, interpersonal neurobiology, the importance of social relationships as physiological regulators, through to the challenges of ethnic diversities and the growing digital technologies. PRACTITIONER POINTS: As therapists, we should be aware of the challenges posed by the proliferating 'schools of therapy' and consider commonalities rooted in a scientific understanding of the mind. The science of understanding the causes, alleviation, and prevention of mental health problems is increasingly multidimensional taking into consideration the interactions between biological, psychological and social processes and in the process dissolving the boundaries between different schools of psychotherapy.
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Affiliation(s)
- Paul Gilbert
- Centre for Compassion Research and Training, College of Health and Social Care Research Centre, University of Derby, UK
| | - James N Kirby
- Compassionate Mind Research Group, School of Psychology, The University of Queensland, St Lucia, Qld, Australia
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Edge D, Lemetyinen H. Psychology across cultures: Challenges and opportunities. Psychol Psychother 2019; 92:261-276. [PMID: 31001925 DOI: 10.1111/papt.12229] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Indexed: 12/27/2022]
Abstract
Large variations of inequalities in rates of mental health disorders and access to mental health care exist within and between countries. Globally, disparities range from countries where there is little provision to those where, despite the availability of evidence-based mental health care, service access and outcomes are mediated by social factors such as socio-economic status, race/ethnicity, and culture. This is salient because increasingly diverse populations are inevitably created with globalization. We posit that in multicultural contexts, effective therapeutic engagement requires therapists who are competent and confident to work with diversity and difference, utilizing insights into their own as well as their clients' internal and external worlds. Although there are many reasons why psychotherapies can be insensitive and harmful, for example, the inherent power imbalance in therapeutic relationships, a lack of awareness of cultural and ethnic variation and needs are among them. Acquisition of 'cultural competence' and increasing availability of culturally-adapted interventions should, in theory, enable practitioners to work with a range of individuals with whom they might have little in common. However, whilst cultural adaptation appears promising, there are concerns regarding its viability as a strategy for tackling disparities in access to psychological care. Evidence for cultural competency is patchy at best. We show how and why delivering effective psychotherapy in the twenty-first century requires a paradigm shift from current approaches to truly integrated models, developed in collaboration with recipients of care. Coproducing interventions, training, and means of evaluating them with clients necessitates taking into consideration social contexts, alternative conceptualizations of mental health and disorders and difficulties, and what constitutes appropriate helpful interventions for psychological distress. PRACTITIONER POINTS: Upskilling therapists to work with diversity and difference is essential for effective delivery of psychological treatments. Increasing the availability of culturally-adapted interventions together with therapists who are sufficiently competent and confident to deliver them should enable practitioners to work with a range of individuals with whom they might have little in common. Coproducing culturally appropriate means of responding to mental health difficulties, staff training and development, and service evaluation methods with clients necessitates taking into consideration social contexts, alternative explanatory models of mental health and 'illness', and what constitutes helpful interventions for psychological distress.
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Affiliation(s)
- Dawn Edge
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, UK.,Research & Innovation, Greater Manchester Mental Health NHS Trust, UK
| | - Henna Lemetyinen
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, UK
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Siegel DJ. The mind in psychotherapy: An interpersonal neurobiology framework for understanding and cultivating mental health. Psychol Psychother 2019; 92:224-237. [PMID: 31001926 DOI: 10.1111/papt.12228] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/27/2019] [Indexed: 12/29/2022]
Abstract
In this brief overview, I offer a conceptual approach to the mind that can support whatever clinical, research, public policy, or other approach you may be involved with. It seeks to help both the understanding and cultivating of mental health and well-being in our world, and may be especially important in encouraging future psychotherapists to be systems-oriented and multidisciplinary in their work. As the ideas of this framework have been published in a number of texts, I will simply have a brief listing of those and other selected publications at the end of this article and outline the main ideas and factual points as we move along. PRACTITIONER POINTS: Consilience across wide range of disciplines leads to an integrated framework defining the mind, mental health, and the strategies of intervention to cultivate well-being.
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Gilbert P. Psychotherapy for the 21st century: An integrative, evolutionary, contextual, biopsychosocial approach. Psychol Psychother 2019; 92:164-189. [PMID: 30932302 PMCID: PMC6593829 DOI: 10.1111/papt.12226] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/01/2019] [Indexed: 12/12/2022]
Abstract
Fragmentation of processes and interventions plague the psychotherapies (Gilbert & Kirby, ). Part of the problem is that we have not agreed on a framework that could be the basis for integrating knowledge and the scientific enquiry of processes and interventions. This paper outlines an approach that brings together a variety of different disciplines in the service of consilience (Wilson, , Consilience: The unity of knowledge, Vintage, New York, NY; Siegel, ). It presents the importance of an evolutionary framework for understanding the proclivities and dispositions for mental suffering and antisocial behaviour, and how they are choreographed in different sociodevelopmental contexts. Building on earlier models (Gilbert, , Human nature and suffering, Routledge, London, UK; Gilbert, , Clin. Psychol. Psychother., 2, 135; Gilbert, , Br. J. Med. Psychol., 71, 353; Gilbert, , Case formulation in cognitive behaviour therapy: The treatment of challenging cases, Wiley, Chichester, UK, pp. 50-89) the call is for an integrative, evolutionary, contextual, biopsychosocial approach to psychology and psychotherapy. PRACTITIONER POINTS: Evolutionary functional analysis is part of an evolutionary, contextual, biopsychosocial approach to mental health that can serve as a scientific platform for the future developments of psychotherapy. Therapist skills and training will increasing need to focus on the multidimensional textures of mental states especially the context-social-body linkages. Therapies of the future will also focus more on the moral aspects of therapy and address the need to promote prosocial and ethical behaviour to self and others.
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Affiliation(s)
- Paul Gilbert
- Centre Compassion Research and TrainingUniversity of DerbyUK
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