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Identifying components of modularized psychological interventions that contribute to symptom reduction is essential to improving depression treatment. In a secondary analysis of a randomized controlled trial (RCT), session-specific effects of Metacognitive Training-Silver, a group intervention for older adults with depression, were investigated. Thirty-eight older adults with major depressive disorder or dysthymia participated in up to eight sessions of MCT-Silver. A clinical assessment of depressive symptoms (Hamilton Depression Rating Scale) as well as additional interviews and questionnaires administered as part of the RCT were completed at pre- and post-intervention. Depressive symptoms, negative (meta)cognitive beliefs, emotion regulation strategies and attitudes toward aging were assessed pre- and post-session. The rate of change in each variable per module, elevation following the module in which the variable was addressed, and the rate of change post module were examined via linear mixed models. Clinician-rated depressive symptoms were significantly reduced from pre- to post-intervention (Cohens d = 1.31). Self-reported depression and negative mental filter measured within sessions improved significantly over treatment, whereas black-and-white thinking improved after module #3 (Should Statements, All or Nothing Thinking and Acceptance). Module-specific within-session effects were found for overgeneralization (module #1: Mental Filter) and rumination (module #6: Rumination and Social Withdrawal). Improvement in mental filter in module #1 was significantly associated with depression reduction. This study provides initial evidence that MCT-Silver partially meets its aims of reducing depression and specific cognitive variables within and across sessions. Improvement of the instrument used to measure change may improve detection of module-specific effects. Trial registration: NCT03691402. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion Cognitive theories emphasize the central role of anger and anger suppression in obsessive–compulsive disorder (OCD). According to these theories, anger suppression is seen as a consequence of OCD, whereas cognitive beliefs, such as an inflated sense of responsibility, are seen as antecedent factors. To extend the findings from cross‐sectional studies, the current study investigated the temporal associations between OCD symptoms, an inflated sense of responsibility, and anger suppression. Consistent with cognitive considerations, we hypothesized that OCD symptoms mediate the association between feelings of responsibility and anger suppression. These associations were also explored in patients presenting particularly high checking‐related symptoms. Further, the stability of effects beyond controlling for depressive symptoms and medication intake was explored.A total of N = 48 patients with OCD (50% female, M = 32.46 [SD = 10.63] years of age) completed measures on obsessive beliefs, OCD symptoms, and anger suppression at three assessment points: before and after a metacognitive intervention as well as at a follow‐up 6 months later. Mediation models investigating symptom associations at these three timepoints were conducted. Exploratory analyses investigating these associations in individuals presenting high checking‐related symptoms (n = 20) and testing the stability of effects beyond controlling for depressive symptoms and medication intake were conducted.The sense of responsibility did not significantly predict the level of anger suppression. A temporal association between OCD symptoms (as assessed with the self‐report measure) and anger suppression could be evidenced, which was stable beyond controlling for depressive symptoms and medication intake. Against the expectations based on cognitive theories, the sense of responsibility did not predict OCD symptoms. No mediating effect of OCD symptoms was found.In line with cognitive viewpoints, the present study shows that higher OCD symptoms predict higher levels of anger suppression in a longitudinal design, thereby contributing to the suppression of anger. This effect seems to be independent from depressive symptoms and medication intake. The effect of sense of responsibility on OCD symptoms was less clear and could only be found in the subgroup of patients with OCD and checking‐related symptoms, who generally presented higher levels of responsibility. Overall, this is the first study demonstrating temporal associations between OCD symptoms and anger suppression. Acknowledging that anger and anger suppression may be a consequence of OCD symptoms and may also affect aspects of psychotherapy, which can ultimately inform future adjustments to psychotherapeutic treatment. [ABSTRACT FROM AUTHOR]

Background: Prevalence estimates for body-focused repetitive behaviors (BFRBs) such as trichotillomania differ greatly across studies owing to several confounding factors (e.g. different criteria). For the present study, we recruited a diverse online sample to provide estimates for nine subtypes of BFRBs and body-focused repetitive disorders (BFRDs). Methods: The final sample comprised 1481 individuals from the general population. Several precautions were taken to recruit a diverse sample and to exclude participants with low reliability. We matched participants on gender, race, education and age range to allow unbiased interpretation. Results: While almost all participants acknowledged at least one BFRB in their lifetime (97.1%), the rate for BFRDs was 24%. Nail biting (11.4%), dermatophagia (8.7%), skin picking (8.2%), and lip-cheek biting (7.9%) were the most frequent BFRDs. Whereas men showed more lifetime BFRBs, the rate of BFRDs was higher in women than in men. Rates of BFRDs were low in older participants, especially after the age of 40. Overall, BFRBs and BFRDs were more prevalent in White than in non-White individuals. Education did not show a strong association with BFRB/BFRDs. Discussion: BFRBs are ubiquitous. More severe forms, BFRDs, manifest in approximately one out of four people. In view of the often-irreversible somatic sequelae (e.g. scars) BFRBs/BFRDs deserve greater diagnostic and therapeutic attention by clinicians working in both psychology/psychiatry and somatic medicine (especially dermatology and dentistry). [ABSTRACT FROM AUTHOR]

Increased hygiene behavior may be a factor in the development of contaminationrelated obsessive-compulsive symptoms (C-OCS). We aimed at investigating (1) the course of C-OCS over 1 year after the start of the COVID-19 pandemic and (2) the effects of changes in hand hygiene (i.e., duration and frequency of handwashing) and related distress regulation on the long-term course of C-OCS. In a longitudinal study, we assessed 1,220 individuals from the German general population at the start of the COVID-19 pandemic (t1), 3 months later (t2), and 12 months later (t3). Pre-pandemic data were available in a subsample from 2014 (n = 430). A decrease in C-OCS over the first year of the pandemic emerged with a small effect size. Thirty-six percent of the participants scored above the clinical cut-off score at t1, 31% at t2, and 27% at t3. In 2014, only 11% scored above the clinical cut-off score. Hierarchical regression showed that C-OCS at t1 was the strongest predictor of a long-term increase in C-OCS. With small effect sizes, change in the duration (not frequency) of handwashing from t1 to t2, as well as the distress-reducing effect of handwashing served as additional predictors. Implications for information on hand hygiene guidelines are discussed. [ABSTRACT FROM AUTHOR]

Objective Method Results Conclusion This study addresses the limitations of existing interventions for depression, such as a deficit‐oriented focus, overlooking the utilization of positive elements such as nature, and neglecting the incorporation of group effects. The present feasibility study examines FlowVR, a resource‐oriented, nature‐inspired virtual reality (VR)‐based group therapy. Previously tested individually in a pilot study for non‐clinical participants, FlowVR has demonstrated positive effects on depressive symptoms. This study assesses the impact and safety of FlowVR in a group setting within a clinical sample using a one‐armed study design.Forty‐two inpatients and day patients with depression were recruited. Before and after the FlowVR intervention period of 4 weeks (two sessions per week), depressive symptoms were assessed (Beck Depression Inventory‐II; BDI). Symptomatology (i.e., depressive symptoms), depression‐associated variables (i.e., self‐efficacy), intervention‐specific variables (feeling of flow), and VR‐specific variables (simulator sickness) were assessed before and after each session.Linear mixed effect models showed that symptomatology (depression, negative affect, current anxiety), depression‐associated constructs (self‐efficacy, motivation), and intervention‐specific variables (flow) improved over the course of the sessions. No variable deteriorated more in one session compared to any other session. The lasso regression identified five potential predictors for the change in depression (BDI‐II), yet these could not be validated in a subsequent linear regression analysis.To conclude, FlowVR had the hypothesized positive impact over the course of the sessions, showing, for example, improvements in symptomatology. The sessions have demonstrated safety with no notable deteriorations. Therefore, FlowVR is deemed safe for clinical patients and group settings. However, further research is needed to explore predictors for the change in depression. [ABSTRACT FROM AUTHOR]

Objectives: Despite high demand, culturally adapted therapies for Arabic speaking refugee patients with depression are rare. Aim of the study was to culturally adapt and evaluate the group treatment Metacognitive Training for Depression (D-MCT) for them., Methods: The cultural adaptation of the D-MCT included translation and surface adaptation as well as an expert discussion. The comprehensibility, acceptance and feasibility of the outpatient culturally adapted D-MCT (CA-D-MCT) were then tested in an uncontrolled pilot study with n=11 refugee patients., Results: The experts rated 83% of the translations and 78% of the illustrations as unproblematic in terms of equivalence. The acceptability and feasibility of the eight modules were predominantly positive., Conclusions: From the patients' perspective, the adapted training shows a high acceptance and comprehensibility for culturally sensitive, interpreter-supported implementation., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)