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Existing descriptions of the treatment of avoidant/restrictive food intake disorder (ARFID) at higher levels of care (HLOC) for eating disorders are limited, despite HLOC settings frequently serving patients with ARFID. The purpose of this commentary is to expand on the preliminary literature that describes pediatric ARFID treatment at HLOC by describing two specific components of our approach to treating pediatric ARFID that may not yet have traction in the current literature. Specifically, we highlight the utility of (1) treatment accommodations that appropriately account for patients neurodevelopmental needs (e.g., executive functioning, sensory processing) and (2) the adjunctive use of Dialectical Behavior Therapy (DBT) elements within family-based pediatric ARFID treatment. We also describe necessary future directions for research in these domains to clarify if incorporating these considerations and approaches into pediatric ARFID treatment at HLOC does indeed improve treatment outcomes.

AbstractObjectiveMethodResultsConclusionThe purpose of this study was to assess the implementation of suicide-focused treatments delivered via a hybrid telemental health (TMH) and in-person format.This study was conducted at four university counseling centers (UCCs) across the United States. Treatment-seeking clients were recruited from their local UCCs and participated in adaptive treatment strategies (ATSs) involving Treatment as Usual (TAU), Collaborative Assessment and Management of Suicidality (CAMS), and Dialectical Behavior Therapy (DBT). Implementation outcomes, including appropriateness, acceptability, feasibility, fidelity, safety, and client satisfaction, were assessed. UCC clinicians participated in qualitative interviews focused on implementation of TMH for clients presenting with suicidal ideation (SI).Overall, treatments delivered via hybrid format were reported to be appropriate, acceptable, feasible, and satisfactory by clinicians and clients. Implementation of TMH was reported to be equivalent to in-person treatment across multiple measurement methods.Results from this study demonstrate that TMH is an implementable treatment modality for addressing suicidality, particularly for college students presenting to UCCs with SI. This study has implications for real-world clinical settings planning to offer hybrid treatment modalities to address SI.Trial registration: ClinicalTrials.gov identifier: NCT04728815. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion The study aims to investigate the efficacy of sertraline medication plus dialectical behavior therapy (DBT) in reducing nonsuicidal self‐injury (NSSI) behavior and depression among adolescents.Participants were 100 adolescents with depression and NSSI behaviors, 50 of whom received sertraline medication plus DBT and 50 of whom received sertraline medication plus cognitive behavioral therapy (CBT) for 12 weeks.During 6 months post intervention, 26 (57.8%) participants did not report having engaged in any form of NSSI in the sertraline + DBT group and 15 (32.6%) in the sertraline + CBT group, showing significant difference. The sertraline + DBT group and the sertraline + CBT group exhibited significant difference regarding the proportions of cutting skin and biting self. The scores of anxiety, depression, aggression against self in four modified overt aggression scale categories, and Personal and Social Performance were notably lower in the sertraline + DBT group than those in the sertraline + CBT group at 6 months post intervention.Sertraline medication plus DBT could decrease NSSI episodes and improve symptoms of anxiety and depression for adolescents, and these changes were comparable to those of CBT. More importantly, DBT was demonstrated better clinical improvements at 6‐month follow‐up. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to comprehensively review existing treatments for impulsivity and compulsivity in non-substance addictions, driven by the importance of these factors in addictive disorder development and treatment efficacy. Methods: A systematic review carried out following PRISMA guidelines identified 14 articles from a total of 764 studies, highlighting the limited literature that is available on psychological treatments for non-substance addictions, in particular studies focusing on impulsivity and compulsivity. The studies were categorized by behavioral addiction type. Results: For compulsive sexual behavior and problematic pornography use, cognitive-behavioral therapy (CBT) has shown significant improvements in compulsivity. In gambling disorder, interventions like cognitive bias modification and motivational interviewing combined with CBT have been effective in reducing impulsivity. Cognitive-behavioral therapy was advocated for compulsive shopping, although results varied. For problematic internet use, dialectical behavior therapy and acceptance and commitment therapy have been effective in addressing impulsivity. Despite literature supporting CBT for most behavioral addictions, the review noted that some articles indicate that dialectical behavior therapy and acceptance and commitment therapy were also effective for problematic internet use, suggesting different underlying mechanisms for this type of addiction. Discussion: It also highlighted limitations, including the small number of studies and the lack of standardized assessment measures. Further research is needed to understand underlying mechanisms and develop tailored treatments for impulsivity and compulsivity in non-substance addictions. These findings offer new directions for research and intervention guidelines in behavioral addictions. [ABSTRACT FROM AUTHOR]

This study investigates the efficacy of a short-term integrative psychotherapeutic intervention designed to reduce suicidal behavior and ideation in depressed patients admitted to a psychiatric ward. Suicidal risk, influenced by mental health disorders, personal crises, social isolation, substance abuse, and trauma, is typically treated with pharmacotherapy and psychotherapy. The study focuses on combining various psychotherapeutic techniques including Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and Mindfulness-Based Cognitive Therapy (MBCT) into a cohesive intervention program. The intervention, delivered over four weeks, included six modules encompassing psychoeducation, behavioral activation, cognitive restructuring, mindfulness practices, and personal development strategies. Participants were divided into an experimental group receiving both the psychotherapeutic intervention and medication and a control group receiving only medication. The study measured changes in hopelessness and depression using the Beck Hopelessness Scale (BHS), Montgomery-Åsberg Depression Rating Scale (MADRS), and the DASS-21R depression scale. The study concludes that integrative psychotherapeutic intervention significantly improves psychological outcomes for depressed patients at risk of suicide, offering a viable complement to pharmacological treatments. These findings support the potential of combining cognitive-behavioral and mindfulness techniques for the holistic management of depression and suicidal ideation in clinical settings. Results indicated significant reductions in hopelessness and depression among the experimental group. Specifically, the BHS and MADRS scores showed substantial decreases post-intervention, highlighting the immediate efficacy of the integrated psychotherapeutic approach. However, the DASS-21R results did not demonstrate statistically significant differences. [ABSTRACT FROM AUTHOR]

Youth mental health is a major public health concern. Adolescents experiencing mental health crises are increasingly presenting to high-intensity settings such as inpatient and partial hospitalization programs. These services offer a multimodal approach involving medication management, cognitive-behavioral therapy (CBT), and dialectical behavior therapy (DBT).1 Treating these distressed youth in intense settings is challenging due to their high acuity, limited lengths of stay, and frequent lack of resources. However, CBT/DBT are typically evaluated in outpatient settings, leaving clinicians in high-intensity programs to adapt models with limited guidance.2 While traditional CBT/DBT interventions are not new or unfamiliar, and various literature reviews report their effectiveness, few reports offer specific guidance and practical tips for implementing these procedures.1-6 This Clinical Perspectives article highlights the necessary adaptations of traditional CBT/DBT for these intense settings in which high acuity, shorter stays, limited resource allocation, and a lack of staff involvement/training are limiting factors. [ABSTRACT FROM AUTHOR]

Background: Binge-eating disorder (BED) is a serious mental health condition characterized by recurrent episodes of consuming large quantities of food in a short period, accompanied by feelings of loss of control. Individuals with BED often experience negative emotional states such as selfblame and mental rumination, which can exacerbate their binge-eating behaviors. Dialectical Behavior Therapy (DBT) is an evidence-based treatment approach that focuses on developing skills to manage emotions, improve interpersonal relationships, and regulate behaviors and in this population has not been studied. Aims: The aim of the present study was investigate of the effectiveness of dialectical behavior therapy on self-blame and mental rumination of patients with binge-eating disorder. Methods: The current research was a semi-experimental with a pretest, posttest, and 3-month followup design and a control group. The statistical population include all obese and overweight women aged 18 to 45 suffering from overeating in Karaj, who had regular visits to Overeaters Anonymous Association in Karaj between July 2022 and May 2023. A convenience method was used to select the sample (n=40) from among the statistical population, who volunteered to participate in the intervention and met the inclustion criteria. The subjects were assigned equally in two experimental (20 patients) and one wait-list control (20 patients). After the pretest, the subjects of the experimental group received the dialectical behavior therapy intevention in 2-hour weekly sessions for 9 sessions. Then the posttest stage and three months later follow-up was carried out. The tools used in this research were the levels of self-criticism scale (Thompson & Zuroff, 2004), the mental rumination (Nolen-Hoeksema and Maro, 1991) and the overeating questionnaire (Gormali et al., 1982). The data obtained from this research were analyzed using SPSS-27 software using mixed ANOVA. Results: The results showed that dialectical behavior therapy has a significant effect in reducing selfblame and mental rumination in binge eating patients and this effect has been stable after three months. Conclusion: In conclusion, this study adds to the evidence supporting Dialectical Behavior Therapy (DBT) for treating binge-eating disorder. It shows that DBT reduces self-blame and mental rumination, and these improvements last at least three months. DBT's focus on addressing cognitive distortions and improving emotion regulation skills offers hope for long-term recovery. [ABSTRACT FROM AUTHOR]

Dialectical behavior therapy (DBT) and its adaptation for adolescents (DBT‐A) provide evidence‐based tools for individuals with chronic emotion dysregulation and their families (Linehan, 2015; Miller et al., 2007). Teens with emotion dysregulation struggle to understand, label, and accept their emotions; they are frequently unable to modulate the intensity of their emotions to match the goals of the present context. No matter how much emotionally‐dysregulated teens and their families may wish it were so, emotion regulation does not include getting rid of emotions. Why not? We need emotions for survival, as emotions serve essential functions: to motivate us for action and to communicate to ourselves and others. Rather than eliminating emotions, emotion regulation aims to help individuals understand their own emotions, decrease emotional vulnerability and suffering, and change unwanted emotions. This article presents "Check the Facts," a DBT skill for helping individuals with emotion dysregulation effectively change unwanted emotions. We share a handout that we adapted from DBT with step‐by‐step tips based on our experience treating adolescents with chronic emotion dysregulation co‐occurring with obsessive‐compulsive disorder (OCD)/anxiety disorders. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine the effectiveness of dialectical behavior therapy-based skills training on distress tolerance, cognitive emotion regulation, and marital quality of life in women with recurrent miscarriages. Methods: The statistical population consisted of all women who visited infertility clinics in Tehran in 2019-2020. A sample of 30 women was selected using convenience and purposive sampling methods, based on inclusion and exclusion criteria, and was randomly assigned to experimental and control groups (15 women in each group). The questionnaires used in this study were the Distress Tolerance Questionnaire by Simons and Gaher (2005), the Cognitive Emotion Regulation Questionnaire by Garnefski, Kraaij, and Spinhoven (2006), and the Marital Quality of Life Questionnaire by Fletcher, Simpson, and Thomas (2000). The statistical method used was repeated measures, with a significance level of 0.05. Findings: According to the results, the differences in means between the two groups in the pre-test, post-test, and follow-up stages were significant. There were significant differences in distress tolerance, cognitive emotion regulation, and marital quality of life between the two groups. The dialectical behavior therapy-based skills training had an impact on the variables of distress tolerance, cognitive emotion regulation, and marital quality of life, with effect sizes of 0.885, 0.910, and 0.983, respectively. Conclusion: Given the confirmed effectiveness of this therapy, it is recommended that these women receive appropriate psychological treatments alongside medical treatments. [ABSTRACT FROM AUTHOR]

Objective: Borderline Personality Disorder (BPD) begins in adolescence or early adulthood and can lead to difficulties in conflict resolution and emotion regulation. The aim of this study was to compare the effectiveness of Mentalization-Based Therapy (MBT) and Dialectical Behavior Therapy (DBT) on emotion regulation, impulsivity, and self-esteem in individuals with Borderline Personality Disorder. Methods and Materials: This study employed an applied research design and a quasi-experimental pretest-posttest and follow-up design with a control group. The statistical population included all individuals with Borderline Personality Disorder in Tehran. The sample comprised 45 individuals with Borderline Personality Disorder selected through convenience sampling. Data were collected using the Jackson and Claridge Borderline Personality Inventory (1991), the Garnefski et al. Emotion Regulation Questionnaire (2001), the Dickman Impulsivity Inventory (1990), and the Rosenberg Self-Esteem Scale (1965). Data were analyzed using repeated measures ANOVA and SPSS-26 software. Findings: The results indicated a significant difference between the two therapy groups (MBT and DBT) on emotion regulation, impulsivity, and self-esteem in individuals with Borderline Personality Disorder. Dialectical Behavior Therapy had a greater impact on improving emotion regulation, impulsivity, and self-esteem in individuals with Borderline Personality Disorder (P<0.001). Conclusion: It can be concluded that both Dialectical Behavior Therapy and Mentalization-Based Therapy can be effective intervention methods for improving emotion regulation, impulsivity, and self-esteem in individuals with Borderline Personality Disorder. [ABSTRACT FROM AUTHOR]

The prevalence of youth mental illness in the United States is on the rise, and this increases the need for effective counseling interventions for children. This article introduces the integration of Adlerian play therapy (AdPT) and dialectical behavior therapy (DBT) skills with children who struggle with emotion dysregulation. We include an overview of both theoretical approaches, justification for integration, and a case study illustrating this dual approach in session. Finally, counseling implications and suggestions for future research are discussed. [ABSTRACT FROM AUTHOR]

Objective: We examined whether the emotions that clients experience within session are associated with treatment outcome in dialectical behavior therapy (DBT) for borderline personality disorder (BPD). Method: Participants were 52 adults who met criteria for BPD and were enrolled in a 12-month DBT treatment. The Classification of Affective-Meaning States, an observer-rated measure of discrete emotions, was used to code videos of individual DBT sessions. Raters coded three psychotherapy sessions for each participant: one session from each of the early, working, and late phases of psychotherapy. Self-report measures of BPD symptoms were used to assess treatment outcome. Results: More emotional experience overall during the early phase predicted fewer BPD symptoms at 12-month treatment outcome, explaining 19% of the variance in symptoms. However, increases across treatment in global distress predicted higher levels of BPD (24% of the variance explained) and depression symptoms (15% explained) at termination. Increases in emotional flexibility (i.e., variation between states) from the early to working phase predicted fewer depressive symptoms at termination (14% explained). Self-compassion coded during the working phase also predicted a better treatment outcome (explaining 19%–34%). Conclusions: Clients' in-session emotional experiences predict treatment outcome 8–10 months later. Clients with BPD may benefit from more overall exploration of their emotional experiences early in DBT, as well as expression of self-compassion. Increases in nonspecific, intense negative affect anticipates poor prognosis, whereas increases in emotional flexibility during early treatment anticipates better prognosis. What is the public health significance of this article?: This study highlights the importance of discrete emotional experiences in dialectical behavior therapy for borderline personality disorder. Specific kinds of emotional experience in individual dialectical behavior therapy sessions anticipate treatment outcome. [ABSTRACT FROM AUTHOR]

SUMMARY: Personality disorders are a group of psychological disorders characterised by a developmental nature, long-lasting impairment and emotional suffering. Personality disorders have an estimated prevalence rate of approximately 8% in community settings, but in in-patient settings the rate might be as high as 76%. Cognitive–behavioural therapies (CBTs) include psychotherapies that emphasise the identification and modification of maladaptive thought patterns and behaviours that contribute to the maintenance of psychological disorders. CBTs have demonstrated their effectiveness in treating various types of personality disorder. This article focuses on the nature of personality disorders and their categorial and dimensional assessment and neurobiology. We present three influential CBT models used in personality disorders: schema therapy, cognitive interpersonal therapy and dialectical behaviour therapy. For each one, we outline the rationale, intervention strategies and therapeutic techniques, with practical examples and summary tables to illustrate their application. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your awareness of the categories, risks and effects of various new psychoactive substances • To recognise the challenges involved in identifying new psychoactive substances • To consider psychosocial and pharmacological interventions that you could use with people who misuse new psychoactive substances. The use of new psychoactive substances is a growing concern across healthcare services in the UK. To date, more than 1,000 types of new psychoactive substances have been identified and they have a wide range of effects, potency and mechanisms of action, which can result in overdose and death. This article reviews the challenges experienced by nurses including in identifying new psychoactive substances, their associated risks and various psychosocial and pharmacological interventions. Currently, evidence surrounding the appropriate nursing interventions required for the misuse of new psychoactive substances is limited. Further research and training opportunities are required for nurses to manage service users who present having taken new psychoactive substances, particularly in hospital, substance misuse and mental health settings. [ABSTRACT FROM AUTHOR]

School teachers are susceptible to mental health issues due to the challenging responsibilities the teaching profession entails. While several interventions have demonstrated effectiveness in improving teachers' social emotional competencies and mental health outcomes, little work has examined the potential of dialectical behavior therapy–skills training (DBT‐ST) in improving teacher outcomes. This study aimed to assess the effects of a five‐session, Malay‐translated DBT‐ST on psychological symptoms (anxiety, depression, stress, burnout), social‐emotional competencies, DBT skills use, and dysfunctional coping in a sample of school teachers in East Malaysia. Fifty‐three participants were recruited and assigned into DBT‐ST or a control group, consisting of attending a mental health talk. Analyses showed that DBT‐ST participants reported greater decreases in student‐related burnout and dysfunctional coping, and greater increases in DBT skills use compared to the control group from pre‐ to post‐intervention. There were no between‐condition differences on changes in other mental health outcomes, though session attendance was linked positively to improvements in several outcomes in the DBT‐ST condition. Analyses of post‐intervention feedback indicated that brief DBT‐ST was deemed acceptable and feasible among the research participants. In conclusion, DBT‐ST holds promise as an intervention to lower student‐related burnout and facilitate adaptive coping among school teachers. Practitioner Points: Teachers undergoing dialectical behavior therapy (DBT) skills training showed greater decreases in student‐related burnout and dysfunctional coping, and greater increases in DBT skills use compared to teachers in the control condition.There were no between‐condition differences on changes in other mental health outcomes.Number of DBT skills training sessions attended was associated with decreases in depressive symptoms and personal burnout, and with increases in DBT skills use. [ABSTRACT FROM AUTHOR]

To evaluate rates of remission, recovery, relapse, and recurrence in suicidal youth who participated in a clinical trial comparing Dialectical Behavior Therapy (DBT) and Individual and Group Supportive Therapy (IGST). Participants were 173 youth, aged 12 to 18 years, with repetitive self-harm (including at least 1 prior suicide attempt [SA]) and elevated suicidal ideation (SI). Participants received 6 months of DBT or IGST and were followed for 6 months post-treatment. The sample was 95% female, 56.4% White, and 27.49% Latina. Remission was defined as absence of SA or nonsuicidal self-injury (NSSI) across one 3-month interval; recovery was defined across 2 or more consecutive intervals. Relapse and recurrence were defined as SA or NSSI following remission or recovery. Cross-tabulation with χ2 was used for between-group contrasts. Over 70% of the sample reported remission of SA at each treatment and follow-up interval. There were significantly higher rates of remission and recovery and lower rates of relapse and recurrence for SA in DBT than for IGST. Across treatments and time points, SA had higher remission and recovery rates and lower relapse and recurrence rates than NSSI. There were no significant differences in NSSI remission between conditions; however, participants receiving DBT had significantly higher NSSI recovery rates than those receiving IGST for the 3- to 9-month, 3- to 12-month, and 6- to 12-month intervals. Results showed higher percentages of SA remission and recovery for DBT as compared to IGST. NSSI was less likely to remit than SA. This study examined rates of remission, recovery, relapse, and recurrence of suicide attempts (SA) and nonsuicidal self-injury (NSSI) among the participants in the CARES Study, a randomized clinical trial of 6 months of Dialectical Behavior Therapy or Individual and Group Supportive Therapy. 173 youth aged 12 to 18 years participated in the study and were followed for 6 months post treatment. Over 70% of the sample reported remission of SA at each treatment and follow-up interval. There were significantly higher rates of remission and recovery and lower rates of relapse and recurrence for SA among participants who received Dialectical Behavioral Therapy. Across both treatments, remission and recovery rates were lower and relapse and recurrence rates were higher for NSSI than for SA. These results underscore the value of Dialectical Behavioral Therapy as a first line treatment for youth at high risk for suicide. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. Collaborative Adolescent Research on Emotions and Suicide (CARES); https://www.clinicaltrials.gov/ ; NCT01528020. [ABSTRACT FROM AUTHOR]

Background: Dialectical behaviour therapy (DBT) has been successfully adapted for use with adolescents experiencing difficulties associated with the maladaptive undercontrol of emotion. However, clinical observation and research findings suggest that adolescents may exhibit traits of both undercontrol and overcontrol—where over‐regulation of emotion predominates. In the adult population, distinct groups of individuals with under‐ and overcontrolled regulation styles can be identified, and treatments such as Group Radical Openness (GRO) have shown promise in treating difficulties associated with the latter. However, there are difficulties identifying distinct groups of under‐ and overcontrolled adolescents. Aims: The present study therefore sought to qualitatively explore the experiences of participants (adolescents and parents) and facilitators of an intervention integrating DBT for adolescents' skills training with GRO. Method: Six adolescents, seven parents and six clinicians completed semi‐structured interviews. Data were analysed using thematic analysis. Nine themes and six subthemes were generated. Findings: Findings suggested that an intervention of this type may have particular utility for adolescents with emotion regulation difficulties in the context of both overcontrol and undercontrol. Participants described improvements in symptoms and relational functioning, which they attributed to the development of a shared language for communicating about emotion and the multifamily group context within which the intervention was delivered. Findings also emphasised the utility of rolling groups. Discussion: Further research investigating the efficacy of this intervention is warranted. Strengths, limitations, future directions and implications for practice are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Suicide attempt is one of the important problems of general world health. The present study aimed to investigate the effectiveness of dialectical behavior therapy on social problem-solving, difficulty in emotion regulation, impulsiveness, and resilience in suicide attempts in Ilam Province, Iran. Materials & Methods: This research was a quasi-experimental design with experimental and control groups. The study population consisted of 457 people from Ilam province who committed suicide attempts. A sample of 40 subjects was selected and randomly assigned to two groups (20 experimental and 20 control). The pretest was performed on both groups. Then, the intervention was performed on the experimental group in 12 sessions (1 h), and the control group did not receive any intervention. After the intervention, a post-test was performed in two groups. The research tools included the D’Zurilla social problem-solving scale, Gratz & Roemer difficulties in emotion regulation scale, Barratt impulsiveness scale, and the Connor-Davidson resilience scale questionnaires. Moreover, multivariate covariance analysis was used to analyze the data. Results: The results of the covariance analysis indicated that there was a significant difference between the post-test mean scores of the experimental and control groups in the variables, including social problem-solving (F=430), emotional regulation difficulty (F=94.714), impulsiveness (F=72.404), and resilience (F=11.168), with all variables showing significance at P<0.001. Conclusion: The results indicate that dialectical behavior therapy can be used to increase social problem-solving skills and resilience, as well as to decrease difficulty in emotion regulation and impulsiveness in people who commit suicide attempts. [ABSTRACT FROM AUTHOR]

Borderline personality disorder (BPD) is thought to be shaped around emotional dysregulation. Physical exercise is an effective way to improve emotional regulation in individuals both with and without mental disorder. However, to this day no study examined the effect of regular physical exercise on emotion regulation in adults with BPD. This study used a series of single case experimental design (A-B-A) combined with ecological momentary assessment and individual interviews to explore and analyze the effect of physical exercise on emotion regulation in adults with BPD. Emotions of participants were monitored thrice daily with an app that prompted them to report their emotions on a 0–100 analogue scale. Both A (control) phases lasted 2 weeks and the B phase (intervention) lasted 4 weeks (3 1-hour supervised sessions of physical exercise weekly). Emotionrelated data were analyzed by piecewise linear regression and qualitative data with thematic analysis. Seven women with BPD completed this study and five of them participated in the interviews. Three participants showed an increase in positive emotions and four participants showed a decrease in negative emotions throughout the study and those results are confirmed with interindividual analyses. Participants reported enjoying the exercise program and the trainer they were assigned. Finally, participants also reported being less reactive and more patient when encountering irritating or stressing events. In conclusion, adult women with BPD found that physical exercise decreases their negative emotions and reactivity to psychological stressors. [ABSTRACT FROM AUTHOR]

Objective: Intense emotions following physical, psychological, and cognitive changes in adolescents may lead to aggression. Aggressive adolescents, due to negative experiences in relationships, are at risk for multiple psychological problems. Therefore, the present study aimed to investigate the effectiveness of dialectical behavior therapy on cognitive flexibility and alexithymia in aggressive adolescents. Methods and Materials: This quasi-experimental study employed a pre-test, post-test design with a control group. The statistical population included all high school students (grades 1 and 2) in Shahdad County during the 2021-2022 academic year. Thirty students were selected using convenience sampling from these schools, having scored higher than 78 on the Buss-Perry Aggression Questionnaire. Out of these, 30 students were randomly assigned to experimental (n=15) and control (n=15) groups. The research instruments included the Cognitive Flexibility Inventory (Dennis & Vander Wal, 2010), the Toronto Alexithymia Scale (1994), and the Buss-Perry Aggression Questionnaire. Multivariate analysis of covariance (MANCOVA) was used to analyze the data using SPSS-26 software. Findings: The findings indicated that dialectical behavior therapy had a significant effect on cognitive flexibility and alexithymia in aggressive adolescents (p<0.005). Conclusion: Considering the effectiveness of dialectical behavior therapy on cognitive flexibility and alexithymia in aggressive adolescents, the implementation of intervention methods based on dialectical behavior therapy, particularly for emotional regulation and increasing cognitive flexibility, is recommended in schools and for high school students. [ABSTRACT FROM AUTHOR]

Functional seizures (FS) are classified as conversion disorders in the DSM-5 and dissociative disorders in the ICD-11, showing a multifactorial psychopathology with various psychiatric comorbidities, such as depression and anxiety. Several studies have found a correlation between FS and personality disorders, mainly those in cluster B. Within this cluster, borderline personality disorder (BPD) or borderline personality traits are the most prevalent in FS. Emotion dysregulation is a hallmark of BPD and is commonly reported in individuals with FS. Cluster C personality disorders, such as avoidant or obsessive-compulsive disorders, have also been reported in FS. In this review, we aim to evaluate the relationship between FS and personality disorders. Assessing personality disorders in the context of FS is relevant for determining the most appropriate intervention. Cognitive-behavioral therapy (CBT) is considered the first-line approach to treating FS. Among various CBT strategies, dialectical behavior therapy, which specifically targets emotion dysregulation, may be helpful for individuals with BPD. Future research should assess the advantages of systematically evaluating personality disorders in FS to address specific treatment planning and evaluate its effectiveness on seizure recurrence, psychological comorbidities, and quality of life. [ABSTRACT FROM AUTHOR]

Dysregulated eating behaviors, comprising subthreshold and clinical binge-eating disorder (BED) and bulimia nervosa (BN), are increasing among the general population, with a consequent negative impact on one's health and well-being. Despite the severity of these outcomes, people with BED and BN often face a delay in receiving a diagnosis or treatment, often due to difficulties in accessing care. Hence, evidence-based and sustainable interventions for eating symptomatology are needed. The present study aims to assess the effectiveness of a web-based 10-session multidisciplinary group intervention based on Dialectical Behavior Therapy (DBT) for BED and BN, aimed at reducing psychological distress and binge-eating-related symptomatology in a sample of patients with dysregulated eating behaviors and including one session of nutritional therapeutic education. A total of 65 participants (84.6% F; age M = 38.5 ± 13.2; experimental group, N = 43; treatment-as-usual group, TAU, N = 22) took part in the study. The results show, after the 9 weekly sessions, a significant reduction in binge-eating-related symptomatology and general psychopathology and an increased self-esteem and eating self-efficacy in social contexts in the experimental group compared to the treatment-as-usual group (T0 vs. T1). Improvements in the experimental group were significantly maintained after one month from the end of the intervention (T2) in terms of binge-eating symptoms, general psychopathology, and eating self-efficacy in social contexts. This study supports the effectiveness of a brief web-based multidisciplinary group intervention in reducing eating symptomatology and psychological distress and enhancing self-esteem and eating self-efficacy in a group of people with dysregulated eating behaviors. Brief web-based interventions could represent an accessible and sustainable resource to address binge-eating-related symptomatology in public clinical settings. [ABSTRACT FROM AUTHOR]

Objective: The effects of Dialectical Behavioral Therapy for Adolescents (DBT-A) on emotional and interpersonal instability were explored in adolescents exhibiting Borderline Personality Disorder (BPD) features, using ecological momentary assessment (EMA) to reduce recall bias.Method: N = 28 help-seeking female adolescents were enrolled, meeting ≥ 3 DSM-IV BPD criteria. BPD criteria, non-suicidal self-injury (NSSI), and depressive symptoms were examined pre- and post-DBT-A treatment (mean duration: 42.74 weeks, SD = 7.46). Participants maintained e-diaries pre- and post-treatment, hourly rating momentary affect, attachment to mother and best friend, and self-injury urges.Results: Interview-rated BPD symptoms decreased (χ²(1) = 5.66, p = .017), alongside reduced self-rated depression severity (χ²(1) = 9.61, p = .002). EMA data showed decreased NSSI urges (χ²(1) = 9.05, p = .003) and increased mother attachment (χ²(1) = 6.03, p = .014). However, mean affect, affective instability, mean attachment to the best friend, and attachment instability showed no significant change over time.Conclusion: DBT-A yielded limited evidence for altering momentary affective states and instability in adolescents based on EMA. Nevertheless, significant effects were observed in reducing NSSI urges and enhancing interpersonal dynamics during treatment, as assessed via EMA. [ABSTRACT FROM AUTHOR]

Purpose: Although there is research establishing that physical pain is a risk factor for suicidal ideation, there is limited understanding of how physical pain confers risk. Methods: The current study uses ecological momentary assessment to explore hopelessness as a potential mechanism of physical pain's effect on suicidal ideation in two distinct samples: an undergraduate population reporting elevated levels of suicidal ideation and an outpatient population with borderline personality disorder receiving comprehensive dialectical behavior therapy. Results: Our results demonstrated that hopelessness significantly mediated the relationship between physical pain and suicidal ideation in both samples. This implies that physical pain might increase hopelessness, which may in turn increase suicidal ideation. Conclusions: Our study adds to a growing body of research of risk factors for suicide, and future research should explore this relationship between physical pain and hopelessness with suicidal behavior. [ABSTRACT FROM AUTHOR]

This study examined the effectiveness of dialectical behavior therapy (DBT) in a partial hospitalization program (PHP) for adolescents and young adults. In the present study, 146 patients (mean age = 17.5) in a DBT PHP completed surveys assessing suicidality, difficulties in emotion regulation, depression, and anxiety, as well as effective coping skills on their admission and discharge from the program. After a 20-day course of intensive DBT programming, patients showed statistically significant decreases, associated with mostly medium and large effect sizes, in suicidal behaviors, depression, anxiety, stress, and emotion dysregulation. Patients also showed significant increases in the use of mindfulness and functional coping skills. These results demonstrate the significant effects of intensive-level (PHP) DBT delivered over a relatively brief period to adolescents and young adults with severe difficulties. Future studies should explore DBT impact on additional treatment targets and identify the strongest predictors of improved outcomes. [ABSTRACT FROM AUTHOR]

This document explores the use of arts and psychomotor therapies in the treatment of personality disorders (PDs). PDs are patterns of thinking, feeling, and relating to others that cause distress and impairment. While traditional talk therapy can be helpful, it may not fully address symptoms and functioning. Arts and psychomotor therapies, such as art, dance, drama, and music therapy, can be used alongside traditional therapy to improve mental health. These therapies have been shown to reduce distress, improve emotional regulation, and enhance social functioning. While more research is needed, arts and psychomotor therapies show promise in the treatment of PDs. [Extracted from the article]

Whereas the therapeutic action centres on emotional participation and containment of the patient's intolerable experiences, the supervisory action centres on interpreting the reconstructed therapeutic reality. Since the emergent interpretation is subjective and contextual, it requires processing in a dialogue between the supervisor and the supervisee. However, their existential need to define and assert themselves as professionals often urges them to highlight the differences between their perceptions and beliefs and keenly convince each other. Uncontained, this dialectical tension might disrupt the supervisory process and the participants' well‐being. Despite the existential urges, when the supervisor and the supervisee recognize and validate each other as independent and autonomous professionals, they can restrain their competitiveness, maintain a productive dialectical dialogue, achieve creative and integrated understandings of the therapeutic process and consolidate their professional identities. Moreover, despite the hierarchical supervisory relationship, acknowledging their vulnerability helps supervisors recognize and validate their supervisees and facilitate the dialectical supervisory dialogue. [ABSTRACT FROM AUTHOR]

Objective: During the COVID-19 pandemic, the prevalence of depression and anxiety among children and adolescents significantly increased, along with the number of visits to emergency departments due to suicidality and/or suicide attempts. Relatedly, health care workers experienced significant burnout and symptoms of anxiety, depression, and posttraumatic stress disorder during this time. However, the corresponding impact on psychiatric inpatient treatment has not yet been researched. We hypothesized that during the pandemic, adolescents hospitalized in an acute care psychiatric inpatient unit had increased incidents of suicide attempts and nonsuicidal self-injurious behaviors and of aggressive behaviors toward others, resulting in greater use of constant observation and restraints. Method: This study was a retrospective chart review based on electronic medical record data examining use of restraints and constant observation one year before the pandemic (March 2019 to February 2020) and 1 year following the onset of the pandemic (March 2020 to February 2021) in an acute-care adolescent (12 to 17 years old) psychiatric inpatient unit. Results: There were 571 admissions during the year before the pandemic and 500 admissions during the pandemic. The number of patients who were restrained (χ2 = 7.86, p = 0.005), number of patients who were placed on constant observation (χ2 = 13.41, p < 0.001), and number of constant observation orders per patient (χ2 = 91.90, p < 0.001) were all significantly greater during the pandemic. Conclusion: Psychiatrically hospitalized adolescents during the pandemic received more intensive interventions such as restraints and constant observation. Severe patient psychopathology and staff shortages, as well as limitations of and decreases to the dialectical behavior therapy program, may have been the contributing factor. [ABSTRACT FROM AUTHOR]

Summary: Researchers at the intersection of sleep and suicide research have advocated for investigation of sleep disturbances as a therapeutic target for the purposes of treating and preventing suicide. This study aims to provide the first systematic review and meta‐analysis on the efficacy of sleep interventions to treat suicidal ideation. This systematic review and meta‐analysis, registered with the International Prospective Register of Systematic Reviews, was conducted in PsycINFO, through Ovid. A sample of eight articles were deemed eligible and a total of 21 effect sizes were included. Egger's test suggested that no publication bias was present (b = 0.3695; p = 0.0852). The pooled effect size for sleep treatments on suicidal ideation was small (g = −0.0931, p = 0.3047). Significant heterogeneity was present (I2 = 44.13%), indicating the need for moderator analyses. Treatment type (medication versus psychotherapy; g = −0.2487, p = 0.3368), sex (g = −0.0007; p = 0.9263), and race (g = −0.0081; p = 0.1624) were all considered as moderators and were all found to be insignificant. This meta‐analysis revealed that initial studies exploring the efficacy of sleep interventions on suicidal ideation demonstrate small effect sizes. Despite this, the handful of studies included in this review nonetheless highlight this as an important area for continued exploration. The use of larger and more diverse samples, as well as intentionally designing sleep‐related interventions to improve ideation and behaviour, have the potential to enhance the efficacy of sleep interventions for this novel purpose. [ABSTRACT FROM AUTHOR]

• Youth living with chronic medical conditions and their families face several challenges. • Traditional CBT approaches may feel inaccessible or unhelpful for pediatric patients and their families who face illness-related challenges. • Dialectical behavior therapy balances both change and acceptance-based strategies and may be helpful for pediatric patients, families, and medical providers. Youth living with chronic medical conditions and their families face several challenges (e.g., adjustment to a new diagnosis, ongoing daily condition management, coping with potential long-term consequences of illness). Traditional CBT approaches emphasize collaborative problem-solving with a core focus on change. At times, these approaches may feel inaccessible or unhelpful for pediatric patients and their families who are facing illness-related challenges that they cannot change or control. Dialectical behavior therapy integrates CBT-based change interventions with acceptance-based strategies to normalize challenging thoughts and emotions and help individuals feel validated. Medical providers working with pediatric patients and families can also benefit from a DBT-based conceptualization and approach to improve patient/family-provider relationships. This article summarizes the current evidence base for and justifies the use of adaptations of DBT for patients with medical illness. Further, through clinical case examples, it illustrates the use of DBT skills and concepts in improving outcomes for pediatric patients and their families. [ABSTRACT FROM AUTHOR]

Around the world, suicide ideation, attempts, and deaths pose a major public and mental health challenge for patients (and their loved ones). Accordingly, there is a clear need for effective clinical treatments that reliably reduce suicidal thoughts and behaviors. In this article, we review the Collaborative Assessment and Management of Suicidality (CAMS) and Dialectical Behavior Therapy (DBT), two clinical treatments that rise to the highest levels of empirical rigor. Both CAMS and DBT are now supported by randomized controlled trials (RCTs), with independent replications, and meta-analyses. There are also supportive data related to training clinical providers to use CAMS and DBT with adherence. RCTs that investigate the use of both interventions within clinical trial research designs and the increasing use of these complementary approaches within routine clinical practice are discussed. Future directions for research and clinical use of CAMS and DBT are explored as means to effectively treat suicidal risk. [ABSTRACT FROM AUTHOR]

Although the clinical symptoms of borderline personality disorder (BPD) tend to remit over time, a substantial proportion continues to present "long‐lasting symptoms" (LLS). This term refers to individuals who present some degree of clinical improvement, but low mood, feelings of emptiness, and poor psychosocial adjustment typically persist. The aim of this study was to compare the sociodemographic, clinical, and therapeutic variables in individuals with BPD with and without LLS. A total of 620 participants with BPD were included and subdivided into two groups: non‐LLS group (n = 549, mean age = 28.02 [6.1] and range, 18–40 years) and LLS group (n = 71, mean age = 44.69 [3.6] and range, 41–56 years). The groups were compared in sociodemographic, clinical, and drug treatment characteristics. We also evaluated the impact of dialectical behavioral therapy‐skills training (DBT‐ST) on polypharmacy. The prevalence of individuals with long‐lasting BPD symptoms increased significantly over a 20‐year period (from <1% to 16%). The LLS group was characterized by less clinical severity, higher comorbidity with affective disorders but lower comorbidity with eating disorders, more disability, and more medication taking. Patients with LLS who received DBT‐ST experienced a significant decrease in the use of benzodiazepines and the number of medications prescribed compared with those who did not receive DBT‐ST. Clinicians should be aware of the specific features of older patients with BPD in order to better identify and address their specific therapeutic needs. [ABSTRACT FROM AUTHOR]

Anxiety and depression among adolescents in the United States has steadily increased. In addition, significant disparities in access to mental health care exist for African Americans. The purpose of the current project was to support the mental health of African American adolescents involved in faith-based youth groups through implementation of dialectical behavioral therapy (DBT). The community partner was an African American church in Southwest Georgia. Mindfulness training modules are offered in monthly sessions. Pre- and post-intervention surveys and the Generalized Anxiety Disorder-7 (GAD-7) were analyzed, comparing mean GAD-7 scores before and after participation. Nurse-led quality improvement initiatives support adolescent mental health and provide sustainable resources for mental health in rural areas. Results of the quality improvement project reveal improvement in self-reported anxiety symptoms among participants after the 4-month DBT intervention. [Journal of Psychosocial Nursing and Mental Health Services, 62(8), 7–10.] [ABSTRACT FROM AUTHOR]

Abstract Background Mindfulness skills training is a core component of Dialectical Behavior Therapy and aims to improve emotion dysregulation (ED) in people with Borderline Personality Disorder (BPD). However, the underlying mechanisms of change are not fully understood. Methods A total of 75 BPD outpatients participated in a 10-week mindfulness skills training. Multilevel models with a time-lagged approach were conducted to examine the temporal dynamics between the proposed mechanisms and ED. Decentering, nonjudgment, body awareness and attention awareness as putative mechanisms and ED as outcome were assessed on a session-by-session basis. Results Greater nonjudgment and body awareness showed within-person effects; participants who reported higher nonjudgement of inner experience and body awareness than their own personal average at a given week showed improvement in ED at the following week. Notably, decentering moderated these associations, such that increased nonjudgment and body awareness predicted improvements in ED more strongly in those participants with high decentering ability. Lastly, a bidirectional relationship between the mechanisms and ED was found; when participants were more emotionally dysregulated than their usual state, they showed less gain in the mechanisms at the following week. Conclusions Knowing how mindfulness training works is relevant to optimize treatments. Clinicians may use strategies to increase these mechanisms when the goal is to improve emotion regulation difficulties in BPD.

Abstract Background Families and significant others of people with borderline personality disorder (BPD) show increased levels of psychological distress. Family Connections®, a 12-week group intervention based on the principles of Dialectical Behavior Therapy, was designed to provide families with both information about the disorder and emotion regulation skills. It has been progressively implemented in French-speaking European countries. Methods We conducted an observational, multicenter study in France and Switzerland. In total, 149 participants of the Family Connections program were included among five centers. Burden, depression, coping, and emotion regulation were assessed before and after the intervention. Results One-way repeated measures MANOVA showed that the burden, depressive symptoms, emotion regulation and coping all changed significantly after the intervention (p

Abstract Dialectical behavior therapy (DBT) is widely acknowledged as an effective treatment for individuals with borderline personality disorder (BPD). However, the optimal treatment duration within DBT remains a topic of investigation. This retrospective, naturalistic non-randomized study aimed to compare the efficacy of 8 week and 12 week DBT interventions with equivalent content, focusing on the change of BPD-specific symptomatology as the primary outcome and depressive symptoms as the secondary outcome. Overall, 175 patients who participated in DBT and received either 8 week or 12 week intervention were included in the analysis. Routine inpatient treatment was adapted from standard DBT with the modules: skill training, interpersonal skills, dealing with feelings, and mindfulness. Measurements were taken at baseline, mid-point, and endpoint. The borderline symptom list-23 (BSL-23) was used for the assessment of borderline-specific symptoms, while the Beck depression inventory-II (BDI-II) was used for the assessment of depressive symptoms. Statistical analysis was conducted using linear mixed models. Effect sizes were calculated for both measures. The results of the analysis indicated an improvement in both groups over time. Effect sizes were d = 1.29 for BSL-23 and d = 1.79 for BDI-II in the 8 week group, and d = 1.16 for BSL-23 and d = 1.58 for BDI-II in the 12 week group. However, there were no differences in the change of BPD-specific symptoms or the severity of depressive symptoms between the 8 week and 12 week treatment duration groups. Based on these findings, shorter treatment durations, like 8 weeks, could be a viable alternative, offering comparable therapeutic benefits, potential cost reduction, and improved accessibility. However, further research is needed to explore factors influencing treatment outcomes and evaluate the long-term effects of different treatment durations in DBT for BPD. Trial registration: drks.de (DRKS00030939) registered 19/12/2022.

Background Adolescent non-suicidal self-injury has become an increasingly serious mental health problem, and its course is protracted, causing serious burdens to patients, families and society. Intervention of non-suicidal self-injury in adolescents requires a comprehensive intervention model, and the practice of online intervention management in China is still in its infancy. Objective To investigate the intervention effect of "Internet+" dialectical behavior therapy (DBT) on suicidal ideation, cognitive emotion regulation, and alleviation of depression in adolescent patients with non-suicidal self-injury. Methods A total of 120 adolescent patients with non-suicidal self-injury who were discharged from the Second Affiliated Hospital of Xinxiang Medical University from May 2021 to May 2022 were selected and randomly divided into the control group (n=60) and intervention group by randomized controlled single-blind method (n=60). The control group received drug intervention, telephone follow-up and psychological counseling, the intervention group implemented a one-year "Internet+" DBT training based on the control group, which was divided into 4 modules of mindfulness training, interpersonal effectiveness training, emotion regulation training and pain tolerance training. Before the intervention, 6 months and 12 months after the intervention, the Self-rating Idea of Suicide Scale (SIOSS), Chinese version of Cognitive Emotion Regulation Questionnaire, (CERQ-C) and Montgomery and Asberg Depression Rating Scale (MADRS) were used to evaluate the suicidal ideation, cognitive emotion regulation, and depression status of the two groups of patients. Repeated measures analysis of variance was used to compare the health status of the two groups at different time points. Results Finally, 57 cases in the control group and 55 cases in the intervention group completed the study. There was an interaction between group and time on SIOSS, CERQ-C, and MADRS scores (P0.001). The difference was statistically significant when comparing the self-blame, acceptance, and contemplation dimensions of the CERQ-C scores before and after intervention within the control group (P

There is a growing interest in the role of leisure, arts and creative activities in cultivating health and wellbeing across different contexts. Leisure sports have historically been considered beneficial for achieving health, and similar focus has recently been placed on arts and creativity. Recent research into the role of arts and creative engagement for wellbeing highlights the benefits of these modes of engagement on emotional wellbeing and social connectedness. In this article, we examine the ways arts, creative and leisure practices and mental health converge, co-exist and collide. We draw on feminist leisure studies scholarship and Sarah Ahmed’s work on emotion to discuss insights from our research into the everyday experiences of people living with a diagnosis of borderline personality disorder (BPD). We utilise qualitative methods to investigate people’s experiences of meaningful leisure practices and the dynamics between leisure practices and living well with the distress. We explore how leisure activities initiate complex processes of discovery and production of meanings, identity and wellbeing. Our discussion emphasises that leisure practices contribute to producing everyday forms of self-care and provide transformative space for self-discovery yet are simultaneously inseparable from the politics of living with mental distress while navigating accumulated effects of distress. [ABSTRACT FROM AUTHOR]

The ability to form a mental representation of the surroundings is a critical skill for spatial navigation and orientation in humans. Such a mental representation is known as a "cognitive map" and is formed as individuals familiarize themselves with the surrounding, providing detailed information about salient environmental landmarks and their spatial relationships. Despite evidence of the malleability and potential for training spatial orientation skills in humans, it remains unknown if the specific ability to form cognitive maps can be improved by an appositely developed training program. Here, we present a newly developed computerized 12-days training program in a virtual environment designed specifically to stimulate the acquisition of this important skill. We asked 15 healthy volunteers to complete the training program and perform a comprehensive spatial behavioral assessment before and after the training. We asked participants to become familiar with the environment by navigating a small area before slowly building them up to navigate within the larger and more complex environment; we asked them to travel back and forth between environmental landmarks until they had built an understanding of where those landmarks resided with respect to one another. This process repeated until participants had visited every landmark in the virtual town and had learned where each landmark resided with respect to the others. The results of this study confirmed the feasibility of the training program and suggested an improvement in the ability of participants to form mental representations of the spatial surrounding. This study provides preliminary findings on the feasibility of a 12-days program in training spatial orientation skills. We discuss the utility and potential impact of this training program in the lives of the many individuals affected by topographical disorientation as a result of an acquired or developmental condition. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Methods Results Discussion Dialectical behavior therapy (DBT) is an evidence‐based treatment for disorders characterized by recurrent binge eating. Yet, access to specialized treatment like DBT remains limited. To increase the accessibility of DBT, we developed a DBT skills training app (Resilience: eDBT) for the management of eating disorder (ED) symptoms. This paper delineates the developmental process of Resilience and tests its usability.Descriptive information on the development and features of Resilience is provided, including its framework, content structure and delivery formats, functionality, data storage procedure, and privacy protocols. Usability was assessed via a mixed methods approach in 10 symptomatic individuals. Qualitative data were organized based on an existing framework, which included six themes: usability, visual design, user engagement, content, therapeutic persuasiveness, and therapeutic alliance.Resilience demonstrated good usability via a Systems Usability Scale score of 85.5, which exceeded the recommended cutoff of 68. Positive aspects of the app, according to interview data, were the ease of use and the visual design, while the addition of peer support was suggested as an opportunity for improvement.A novel DBT‐based app may serve as an acceptable, low‐intensity option or adjunct to traditional treatment for targeting ED symptoms that emerge in daily life. However, notable limitations include the small sample size and the single time point at which the usability assessment was conducted. [ABSTRACT FROM AUTHOR]

Patients with chronic and serious illnesses experience significant quality of life concerns. More research is needed to understand the impact of financial burden on patients with COPD, heart failure, and kidney failure. Patients with COPD, heart failure, or kidney failure completed a cross-sectional online survey using validated measures of financial burden (general financial strain as well as financial toxicity attributable to treatment), physical quality of life (symptom burden and perceived health), and emotional quality of life (anxiety, depression, and suicidal ideation). ANCOVA was used to examine whether financial strain and financial toxicity were associated with physical and emotional quality of life, while accounting for key covariates. Among 225 participants with COPD (n = 137), heart failure (n = 48), or kidney failure (n = 40), 62.2% reported general financial strain, with 34.7% experiencing financial toxicity attributable to treatments. Additionally, 68.9% rated their health as fair or poor, experiencing significant symptom burden including fatigue, dyspnea, and chest pain. Participants also reported clinically relevant levels of anxiety (55.1%), depression (52.0%), and suicidal ideation (21.8%). In the total sample, financial strain was associated with worse physical and emotional quality of life on all measures (all Ps <.001). Financial toxicity attributable to treatment was not associated with quality of life in the total sample or subsamples. Patients with COPD, heart failure, and kidney failure face significant financial, physical, and emotional burdens. Financial strain appears to undermine physical and emotional quality of life. Our study highlights the demand for interventions aimed at mitigating financial strain and toxicity experienced by individuals with chronic illnesses. [ABSTRACT FROM AUTHOR]

Background: Over 30,000 people experience out-of-hospital cardiac arrest in the United Kingdom annually, with only 7–8% of patients surviving. One of the most effective methods of improving survival outcomes is bystander intervention in the form of calling the emergency services and initiating chest compressions. Additionally, the public must feel empowered to act and use this knowledge in an emergency. This study aimed to evaluate an ultra-brief CPR familiarisation video that uses empowering social priming language to frame CPR as a norm in Scotland. Methods: In a randomised control trial, participants (n = 86) were assigned to view an ultra-brief CPR video intervention or a traditional long-form CPR video intervention. Following completion of a pre-intervention questionnaire examining demographic variables and prior CPR knowledge, participants completed an emergency services-led resuscitation simulation in a portable simulation suite using a CPR manikin that measures resuscitation quality. Participants then completed questionnaires examining social identity and attitudes towards performing CPR. Results: During the simulated resuscitation, the ultra-brief intervention group's cumulative time spent performing chest compressions was significantly higher than that observed in the long-form intervention group. The long-form intervention group's average compressions per minute rate was significantly higher than the ultra-brief intervention group, however both scores fell within a clinically acceptable range. No other differences were observed in CPR quality. Regarding the social identity measures, participants in the ultra-brief condition had greater feelings of expected emergency support from other Scottish people when compared to long-form intervention participants. There were no significant group differences in attitudes towards performing CPR. Conclusions: Socially primed, ultra-brief CPR interventions hold promise as a method of equipping the public with basic resuscitation skills and empowering the viewer to intervene in an emergency. These interventions may be an effective avenue for equipping at-risk groups with resuscitation skills and for supplementing traditional resuscitation training. [ABSTRACT FROM AUTHOR]

In 2011, Leslie Baxter published Voicing Relationships: A Dialogic Perspective, updating the 1996 articulation of relational dialectics theory (RDT). Baxter provided clarity on concepts introduced 15 years prior. Organized around RDT's central premise – that the meaning of phenomena transpires in the moment through struggles of competing discourses – Baxter positioned RDT within the critical postmodern project. Since then, RDT research has proliferated, but no systematic assessment of its theoretical characteristics has transpired. We conducted a prescriptive review of the first decade of research following the 2011 volume. We first identified sources citing Baxter's (2011) volume (n = 505), ultimately narrowing to studies using RDT with its companion method, contrapuntal analysis (n = 55). We then coded for six constructs (genre, utterance, utterance chain location, speaker, addressee, and semantic object). This article presents our selection criteria and processes of review, findings, and research agenda based on our review. [ABSTRACT FROM AUTHOR]

In Turkey, married couples are traditionally not considered families until they include children. Moreover, voluntarily childfree married couples in this culture are marginalized and struggle to legitimate their choices. Using relational dialectics theory, we sought to better understand these couples' experiences by identifying the discourses they use in their meaning-making around family. Husbands and wives from eight childfree couples in heterosexual marriages participated in in-depth interviews. Contrapuntal analysis identified two primary discourses: the discourse of families include children (DFIC) and the discourse of couples are families (DCAF). The DCAF challenged the DFIC, which frames having children as achieving an accepted family, creating meaningful life and marriage, and as an inevitable result for married couples. The DCAF recognizes that families do not need children, create their own happiness, and can (re)make their choices about adding children. Findings have implications for professionals supporting couples about deciding to be childfree in this culture. [ABSTRACT FROM AUTHOR]

BACKGROUND: Challenging behaviours and emotional dysregulation are common sequelae of acquired brain injury (ABI), but treatment remain underdeveloped. Dialectical behaviour therapy is an evidence-based therapy for emotional dysregulation. OBJECTIVE: To explore the feasibility and preliminary efficacy of dialectical behaviour therapy for ABI. METHODS: An exploratory longitudinal study that compared thirty adults with brain injury presenting persistent emotion dysregulation or challenging behaviours. Control group received a personalized multidisciplinary program only (n = 13). The dialectical behaviour therapy group received five months of emotion regulation skills learning as an add-on (n = 17). Preliminary efficacy was measured on Difficulties in Emotion Regulation Scale-16 and Quality of Life after Brain Injury total score and emotion subscore. RESULTS: Fourteen participants completed the dialectical behaviour therapy. This study provided preliminary evidence for the feasibility and acceptability of dialectical behaviour therapy. Repeated measures revealed improvement on the Difficulties in Emotion Regulation Scale-16 (–7.6 [–17.3; 1.7]; Pr = 0.95) and on the Quality Of Life emotion subscore (13.5 [–3.8; 30.9]; Pr = 0.94). CONCLUSION: This study raises important questions regarding the type of patients who can benefit from this intervention, necessary adaptations of dialectical behaviour therapy and the way it can help post-traumatic growth and identity reconstruction after ABI. [ABSTRACT FROM AUTHOR]

This paper contrasts two versions of a pragmatist critique of deflationism about truth. According to the critique, understanding the practice of factual discourse requires understanding a role played in that practice by speakers' use of the concept of truth. Huw Price takes this role to lie in the expression of attitudes of approval and disapproval toward other speakers' assertions. Proceeding from Robert Brandom's analysis of assertion, I defend an alternative account of truth's role in terms of the acknowledgement and disacknowledgement of communicative authority. I explain why this account fails to yield Price's key anti-deflationary conclusion, namely that engaging in factual discourse requires holding that false assertions are ipso facto normatively incorrect. [ABSTRACT FROM AUTHOR]