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Rationale: Clinical pathways (CPWs) are structured care plans that set out essential steps in the care of patients with a specific clinical problem. Amidst calls for the prioritisation of integrated mental and physical health care for young people, multidisciplinary CPWs have been proposed as a step towards closer integration. There is very limited evidence around CPWs for young people with mental and physical health needs, necessitating a review of the literature. Aims and Objectives: The aim of this review is to understand how clinical pathways have been used to deliver mental health support to children and young people with long‐term physical health conditions and their effectiveness across a range of outcomes. Methods: The databases MEDLINE, CENTRAL, PsycINFO and CINAHL were searched from inception to 6 September 2023. Keywords linked to children and young people, mental health, long‐term physical health conditions and CPWs were used. Studies using either quantitative or qualitative research designs were included. All studies must have evaluated a CPW to provide mental health support to children and young people (up to 25 years old) with long‐term health physical conditions. Both mental and physical health outcomes were considered. Pathways were grouped by integration 'model' as described in the wider literature. Results: The initial search returned 4082 studies after deduplication. A total of eight studies detailing six distinct care pathways (232 participants [170 children and young people; 50 caregivers; 12 healthcare professionals]) met eligibility criteria and were included in the analysis. Four pathways were conducted within an 'integrated model'; two were a combination of 'integrated' and 'colocated'; and none within a 'co‐ordinated model'. Only pathways within an integrated model reported quantitative health outcomes, with improvements across a range of mental health measures. One negative physical health outcome was reported from an integrated diabetes pathway, but this should be interpreted with caution. Conclusion: This review identified a range of CPW designs but most fell under an integrated model. The results suggest that calls for integrated mental health pathways in this population may be appropriate; however, conclusions are limited by a paucity of evidence. [ABSTRACT FROM AUTHOR]

Background: CBT is an effective treatment for depression, but access varies across the United Kingdom. Online CBT increases access. The INTERACT platform was designed to support patient engagement in CBT, enabling therapists to deliver high‐intensity CBT via typed instant messaging and allowing patients and therapists access to an integrated online library of resources during and between sessions. Methods: The INTERACT trial aimed to evaluate this integrated approach to delivering CBT for primary care patients with depression. A nested qualitative study was conducted within the trial. Interviews were conducted with 20 patients who received the intervention, 9 therapists who delivered it and 3 therapist supervisors. Data were analysed using thematic analysis. Results: The combination of receiving support from a therapist and having access to integrated online CBT resources enabled patients to better manage their depression. Platform benefits included the opportunity to review transcripts to clarify how to complete homework tasks and track progress in managing their depression. The typing process allowed reflection and a focused discussion. However, less could be covered than during an in‐person session, which reduced therapists' expectations around goal setting. Patients who did not complete therapy struggled with the typing and found the CBT approach too demanding. Conclusion: Findings highlight the importance of establishing patient and therapist goals and expectations about what can be achieved in CBT mediated by typing. Some patients are comfortable communicating via typing and are motivated to utilise online resources in between sessions. Exploring the benefits and challenges of typed CBT with patients will enable them to make an informed choice about referral for this novel approach to therapy. Patient or Public Contribution: Patients, service users and members of the public were involved in the study design and management. Substantial pilot work gathered stakeholder feedback and informed the design of the intervention, before undertaking the RCT. Coauthor P.L. is a service user representative co‐applicant and member of the management group responsible for developing the intervention and the trial. Two PPI members sit on the Independent Steering Committee. PPI members provided valuable feedback on the study resources and documents. [ABSTRACT FROM AUTHOR]

Objective: While co‐occurring mental health conditions are the norm in eating disorders, no testable protocol addresses management of these in psychotherapy. Method: The literature on managing mental health conditions that co‐occur with eating disorders is outlined and reviewed. Results: In the absence of clear evidence to inform managing co‐occurring mental health conditions, we advocate for use of an iterative, session‐by‐session measurement to guide practice and research. We identify three data‐driven treatment approaches (focus solely on the eating disorder; multiple sequential interventions either before or after the eating disorder is addressed; integrated interventions), and the indications for their use. Where a co‐occurring mental health condition/s impede effective treatment of the eating disorder, and an integrated intervention is required, we outline a four‐step protocol for three broad intervention approaches (alternate, modular, transdiagnostic). A research program is suggested to test the usefulness of the protocol. Discussion: Guidelines that provide a starting point to improving outcomes for people with eating disorders that can be evaluated/researched are offered in the current paper. These guidelines require further elaboration with reference to: (1) whether any difference in approach is required where the co‐occurring mental health condition is a comorbid symptom or condition; (2) the place of biological treatments within these guidelines; (3) precise guidelines for selecting among the three broad intervention approaches when adapting care for co‐occurring conditions; (4) optimal approaches to involving consumer input into identifying the most relevant co‐occurring conditions; (5) detailed specification on how to determine which adjuncts to add. Public significance: Most people with an eating disorder also have another diagnosis or an underlying trait (e.g., perfectionism). Currently no clear guidelines exist to guide treatment in this situation, which often results in a drift away from evidence‐based techniques. This paper outlines data‐driven strategies for treating eating disorders and the accompanying comorbid conditions and a research program that can test the usefulness of the different approaches suggested. [ABSTRACT FROM AUTHOR]

Background: Although Cognitive Behavioural Therapy (CBT) is effective for 60% of adolescents with anxiety disorders, only 36% are in remission post‐intervention. This indicates that more effective treatments are needed which should be reflected in the NICE guidelines. We hypothesised that Single‐case experimental designs (SCEDs) may provide a framework for accelerating the development of novel interventions. The primary purpose of this review was to investigate whether SCEDs are currently followed by randomised controlled trials (RCTs) of CBT intervention for adolescent anxiety disorders named in the NICE guidelines. The secondary objective was to investigate whether using SCEDs prior to RCTs could be a helpful approach. Method: For the primary search of SCEDs five databases were used (PsycINFO, PubMed, PsycArticles, Web of Science and ProQuest). Nineteen articles met eligibility criteria including a total of 107 participants. For the secondary search of RCTs named in the NICE guidelines for adolescent anxiety disorders 53 articles met inclusion criteria and were included in the systematic review. Results: The 19 SCED studies included in the review were conducted with participants with a diverse range of anxiety disorders and across a range of CBT formats. Two of the SCEDs were followed by RCTs, but neither of these were named in the NICE guidelines for anxiety disorders. All of the SCEDs identified were rated as low quality with none meeting the criteria for the highest or second highest quality rating. From the secondary searches, none of the RCTs named in the NICE guide were preceded by SCEDs. Conclusions: It was concluded that currently SCEDs were not followed by RCTs of CBT interventions named in the NICE guidelines for adolescent anxiety disorders. However, it was suggested that SCEDs may provide an important framework for the development of more effective interventions for adolescents with anxiety. [ABSTRACT FROM AUTHOR]

Because the diagnostic criteria of generalized anxiety disorder (GAD) are not tied to specific worry domains (worry is 'generalized'), research on the content of worry in GAD is lacking. To our knowledge, no study has addressed vulnerability for specific worry topics in GAD. The goal of the current study, a secondary analysis of data from a clinical trial, is to explore the relationship between pain catastrophizing and worry about health in a sample of 60 adults with primary GAD. All data for this study were collected at pretest, prior to randomization to experimental condition in the larger trial. The hypotheses were that (1) pain catastrophizing would be positively related to the severity of GAD, (2) the relationship between pain catastrophizing and the severity of GAD would not be explained by intolerance of uncertainty and psychological rigidity, and (3) pain catastrophizing would be greater in participants reporting worry about health compared to those not reporting worry about health. All hypotheses were confirmed, suggesting that pain catastrophizing may be a threat‐specific vulnerability for health‐related worry in GAD. The implications of the current findings include a better understanding of the ideographic content of worry, which could help focus treatment interventions for individuals with GAD. [ABSTRACT FROM AUTHOR]

Background: Children and young people with long‐term physical health conditions (LTC) are known to have higher levels of co‐morbid mental health problems than medically healthy children. Evidence‐based treatments for mental health problems are effective in children who also have an LTC. This study aimed to explore the factors associated with participants' perceived acceptability and impact of a transdiagnostic mental health centre offering brief psychological assessment and treatment for children and young people and/or their families with mental health needs in the context of long term physical conditions. Methods: One‐hundred twenty‐eight patients attending the drop‐in centre were invited to participate. Overall, 35 participated (31 parents/carers; 4 children and young people) in semi‐structured interviews (either in person or by phone) exploring their experience of the centre. Interviews were audio‐recorded, transcribed and checked. Framework analysis was then conducted on all transcripts. Results: Overall, participants found the drop‐in centre highly acceptable and reported a positive experience. Reasons for this varied but broadly focused around four themes: (1) efficient sufficiency; (2) autonomy; (3) fusion of process and content factors and (4) (dis)parities of esteems and 'seeing both sides of the coin'. Conclusions: Participants found the intervention acceptable. A mental health drop‐in centre in a paediatric hospital appears to be a positive and valued adjunct to supplement existing mental health services. [ABSTRACT FROM AUTHOR]

There are strong arguments for standardizing therapies for mental health difficulties in young people and for the development of digital therapies. At the same time, the importance of personalized treatments is also increasingly apparent. In this editorial, we discuss challenges and the continued need to find the sweet spot between standardization and personalization when it comes to therapies for mental health difficulties. We illustrate our discussion with reference to insomnia in adolescents/young adults as well as the chronic health condition type 1 diabetes. [ABSTRACT FROM AUTHOR]

Objectives: To explore the impact of various measurements of long‐term health conditions (LTCs) on the resulting prevalence estimates using data from a nationally representative dataset. Methods: Children and young people in the Millennium Cohort Study were followed at ages 3, 5, 7, 11, and 14 years (N = 15,631). We estimated the weighted prevalence of LTCs at each time point and examined the degree to which estimates agreed with alternate health indicators (special educational needs and disability [SEND], specific chronic conditions, and common chronicity criteria) using descriptive analyses, Cohen's kappa statistic, and percentage agreement. Results: The estimated weighted prevalence of LTCs peaked at 5 years old (20%). Despite high percentage agreement, we observed at best moderate chance‐corrected agreement between the type of LTC and reasons for SEND (kappas from 0.02 to 0.56, percentage agreement from 97% to 99%) or specified chronic conditions (kappas from 0.002 to 0.02, percentage agreement from 73% to 97%). Applying chronicity criteria decreased the estimated weighted prevalence of LTCs (3%). Conclusion: How long‐term conditions are defined drastically alters the estimated weighted prevalence of LTCs. Improved clarity and consistency in the definition and measurement of LTCs is urgently needed to underpin policy and commissioning of services. [ABSTRACT FROM AUTHOR]

In their paper on "Realizing the Untapped Promise of Single‐Session Interventions for Eating Disorders" Schleider and colleagues suggest an innovative approach to addressing a much‐ discussed critical issue in the treatment of eating disorders—how we help more people quickly and with greater efficiency. While building on the feasibility and success of program‐led approaches, they make a potentially transformative proposal for the use of single‐session, "one‐at‐a‐time" interventions freely accessible to those in need. We suggest that not only does this proposal have the potential to narrow the treatment gap, but its ability to generate informative data at scale may also contribute to improving treatment outcomes overall. We also note the need for further independent support for the claim that single sessions produce meaningful benefit especially in the field of the prevention and treatment of eating disorders. While Schleider and colleagues' proposal is potentially transformative and has heuristic value, some caution needs to be exercised. In our view, single‐session interventions should not be regarded as displacing existing treatment provision. Rather they should be seen as complementary and a potential way of improving provision overall. [ABSTRACT FROM AUTHOR]

Objectives: Periods of social isolation are associated with loneliness in children and young people, and loneliness is associated with poor mental and physical health. Children and young people with pre‐existing mental health difficulties may be prone to loneliness. Containment of COVID‐19 has necessitated widespread social isolation, with unprecedented school closures and restrictions imposed on social interactions. This rapid review aimed to establish what is known about the relationship between loneliness and mental health problems in children and young people with pre‐existing mental health problems. Methods: We sought to identify all primary research that examined the cross‐sectional and longitudinal associations between loneliness/perceived social isolation and mental health in children and young people with pre‐existing mental health problems. We also aimed to identify effective interventions that reduce the adverse impact of loneliness. A rapid systematic search was conducted using MEDLINE, PsycINFO, and Web of Science. Results: Of 4,531 papers screened, 15 included children and young people with pre‐existing mental health conditions. These 15 studies included 1,536 children and young people aged between 6 and 23 years with social phobia, anxiety and/or depression, and neurodevelopmental disorders. Loneliness was associated with anxiety and depression both cross‐sectionally and prospectively in children and young people with mental health problems and neurodevelopmental conditions. We found preliminary evidence that psychological treatments can help to reduce feelings of loneliness in this population. Conclusions: Loneliness is associated with depression and anxiety in children and young people with pre‐existing mental health conditions, and this relationship may be bidirectional. Existing interventions to address loneliness and/or mental health difficulties in other contexts may be applied to this population, although they may need adaptation and testing in younger children and adolescents. Practitioner points: Loneliness is common in children and young people, and during periods of enforced social isolation such as during COVID‐19, children and young people report high levels of loneliness (or increased rates of loneliness).The review showed that loneliness is associated, both cross‐sectionally and prospectively, in children and young people with mental health problems and also in children and young people with neurodevelopmental conditions, such as autism spectrum disorder. Thus, loneliness is a possible risk factor of which mental health providers should be aware.Maintaining social contact both by direct and by indirect means, especially through the Internet, could be important in mitigating loneliness.Interventions to address loneliness should be further developed and tested to help children and young people with pre‐existing mental health problems who are lonely by preventing exacerbation of their mental health difficulties, in particular anxiety and depression. [ABSTRACT FROM AUTHOR]

Aims: There has been a surge in child mental health literacy training programmes for non‐mental health professionals. No previous review has examined the effectiveness of child mental literacy training on all professionals in contact with children. Methods: Studies were identified through a systematic literature search of the Cochrane, EMBASE, Medline, and PsycINFO databases in February 2019. The review included studies that delivered training to professionals who have regular contact with young people aged 0 to 19 in the context of their role and at least one component of mental health literacy; (a) knowledge, (b) attitudes, (c) confidence in helping, (d) intention to help and (e) actual helping behaviour. The quality of papers was reviewed using the Cochrane revised Risk of Bias Tool for randomized controlled trials (RCTs) and the Integrated Quality Criteria for the Review of Multiple Study Designs for non RCTs. Results: Twenty‐one studies met eligibility criteria (n = 3243). There was some evidence that global and specific child mental health literacy training improved professionals' knowledge and stigma‐related attitudes towards mental health. Few studies investigated the impact of training on actual helping behaviour. Conclusion: There may be value in providing child mental health literacy training to professionals in contact with children, however there is a need for studies to evaluate the long‐term impact of such training, particularly on subsequent access to appropriate support. Findings raise concerns about the quality of the studies reported in the systematic review and recommendations are made for future studies. [ABSTRACT FROM AUTHOR]

Background: This study evaluated whether clinical and economic outcomes from CBT for child anxiety disorders in the context of maternal anxiety disorders are improved by adding treatment focused on (a) maternal anxiety disorders or (b) mother–child interactions. Methods: Two hundred and eleven children (7–12 years, 85% White British, 52% female) with a primary anxiety disorder, whose mothers also had a current anxiety disorder, were randomised to receive (a) child‐focused CBT with nonspecific control interventions (CCBT+Con), (b) CCBT with CBT for the maternal anxiety disorder (CCBT+MCBT), or (c) CCBT with an intervention targeting the mother–child interaction (CCBT+MCI). A cost‐utility analysis from a societal perspective was conducted using mother/child combined quality‐adjusted life years (QALYs). [Trial registration: https://doi.org/10.1186/isrctn19762288]. Results: MCBT was associated with immediate reductions in maternal anxiety compared to the nonspecific control; however, after children had also received CCBT, maternal outcomes in the CCBT+MCI and CCBT+Con arms improved and CCBT+MCBT was no longer superior. Neither CCBT+MCBT nor CCBT+MCI conferred a benefit over CCBT+Con in terms of child anxiety disorder diagnoses post‐treatment [primary outcome] (adj RR: 1.22 (95% CI: 0.88, 1.67), p =.23; adj RR: 1.21 (95% CI: 0.88, 1.65), p =.24, respectively) or global improvement ratings (adj RR: 1.25 (95% CI: 0.99, 1.57), p =.06; adj RR: 1.18 (95% CI: 0.93, 1.50), p =.17) or six and 12 months later. No significant differences between the groups were found on the main economic outcome measures (child/mother combined QALY mean difference: CCBT+MCBT vs. CCBT+Con: −0.04 (95% CI: −0.12, 0.04), p =.29; CCBT+MCI vs. CCBT+Con: 0.02 (95% CI: −0.05, −0.09), p =.54). CCBT+MCI was associated with nonsignificantly higher costs than CCBT (mean difference: £154 (95% CI: −£1,239, £1,547), p =.83) but, when taking into account sampling uncertainty, it may be cost‐effective compared with CCBT alone. Conclusions: Good outcomes were achieved for children and their mothers across treatment arms. There was no evidence of significant clinical benefit from supplementing CCBT with either CBT for the maternal anxiety disorder or treatment focussed on mother–child interactions, but the addition of MCI (and not MCBT) may be cost‐effective. [ABSTRACT FROM AUTHOR]

Background: Children and young people with long‐term physical health conditions are at increased risk of experiencing mental health and well‐being difficulties. However, there is a lack of research that explores the experiences of and attitudes towards interventions aiming to improve their mental health and well‐being. This systematic review seeks to address this gap in the literature by exploring what children and young people with long‐term conditions, their caregivers, and health practitioners perceive to be important aspects of interventions aiming to improve their mental health and well‐being. Methods: An information specialist searched five academic databases using predefined criteria for qualitative evaluations of interventions aiming to improve the mental health or well‐being of children with long‐term physical conditions. Reviewers also performed supplementary citation and grey literature searches. Two reviewers independently screened titles, abstracts, and full texts that met the inclusion criteria and conducted data extraction and quality assessment. Meta‐ethnography was used to synthesize the findings. Results: Screening identified 60 relevant articles. We identified five overarching constructs through the synthesis: (a) Getting In and Staying In, (b) Therapeutic Foundation, (c) Social Support, (d) A Hopeful Alternative, and (e) Empowerment. The line of argument that links these constructs together indicates that when interventions can provide an environment that allows young people to share their experiences and build empathetic relationships, it can enable participants to access social support and increase feelings of hope and empowerment. Conclusion: These findings may provide a framework to inform the development of mental health interventions for this population and evaluate existing interventions that already include some of the components or processes identified by this research. Further research is needed to establish which of the constructs identified by the line of argument are most effective in improving the mental well‐being of young people living with long‐term conditions. [ABSTRACT FROM AUTHOR]

Mental health problems are common in children and adolescents, yet evidence‐based treatments are hard to access. Self‐help interventions can increase such access. The aim of this paper was to conduct a systematic review and meta‐analysis of the use of guided and unguided self‐help for children and young people with symptoms of common mental health disorders. In contrast to previous reviews of self‐help in children, all types of self‐help and multiple mental health disorders were investigated in order to increase power to investigate potential moderators of efficacy. Importantly, studies with control arms as well as those comparing against traditional face‐to‐face treatments were included. Fifty studies (n = 3396 participants in self‐help/guided self‐help conditions) met the inclusion criteria. Results demonstrated a moderate positive effect size for guided and unguided self‐help interventions when compared against a control group (n = 44; g = 0.49; 95% CI: 0.37 to 0.61, p <.01) and a small but significant negative effect size when compared to other therapies (n = 15; g = −0.17; 95% CI: –0.27 to –0.07, p <.01). Few potential moderators had a significant effect on outcome. Most comparisons resulted in significant heterogeneity and therefore results are interpreted with caution. [ABSTRACT FROM AUTHOR]

The coronavirus pandemic has highlighted the need for remote technologies to be used in child and adolescent mental health services. With the UK being placed in lockdown one week before a scheduled 'face‐to‐face' low‐intensity CBT training day due to COVID‐19, there was a need for rapid adaptations to be made to the content, structure and format of a training day for practitioners in mental health services, to suit the online environment. The content covered the core areas of low‐intensity CBT in children and adolescents. Findings showed that the one‐day low‐intensity training day increased knowledge and understanding in all key areas measured, and was positively received, providing further evidence for the effectiveness and acceptability of remote delivery. Given discussed benefits of remote delivery, as well as rapid developments in technologies helping to address some of the challenges raised, going forward, remote delivery could continue to be beneficial for increasing access to much needed evidence‐based interventions. [ABSTRACT FROM AUTHOR]

Treatment guidelines for eating disorders (ED) are unclear about the optimal length of psychological care. We aimed to investigate associations between treatment duration and changes in ED pathology. Data for 164 outpatients accessing psychological interventions for ED were analyzed using MANOVA. We tested associations between number of therapy sessions and pre-post treatment changes in clinical outcomes (EDE-Q global scores, binge eating, purging); adjusting for baseline measures, diagnoses, and treatment type. Secondary analyses included rapid response variables in the above outcomes by treatment session eight. Partial correlations between treatment duration and BMI changes (adjusting for intake BMI) were examined for anorexia nervosa cases. Treatment duration was not significantly associated with changes in ED outcomes after adjusting for rapid response. BMI change (weight regain) was not correlated with treatment duration in anorexia nervosa cases. Rapid response was associated with better EDE-Q outcomes, but not with changes in binge eating or purging behaviors. ED outcomes are unrelated to treatment duration; rapid response is a useful prognostic indicator for treatment planning. [ABSTRACT FROM AUTHOR]

Background If left untreated, obsessive compulsive disorder (OCD) can cause significant distress and impact on functioning throughout the lifespan. Despite the severity of the disorder, there is often a significant delay between the onset of symptoms and successful treatment. This is in part due to delays in recognising OCD symptoms in young people, particularly if the symptom forms are less common. Once OCD is accurately diagnosed, cognitive behavioural therapy (CBT) is known to be an efficacious treatment, sometimes in combination with medication, producing good long-term prognosis. It is therefore important to accurately detect OCD in children and young people so that they can be offered timely intervention. Use of the best tools in clinical and research settings improves detection and diagnosis, as well as enabling the tracking of progress through treatment. The aim of this current paper was to review measurement tools for OCD in young people with a focus on the practicalities of using tools in busy child mental health clinical settings. Method To discover what measurement tools are available for OCD in young people, we conducted a pragmatic literature of measurement tools for OCD in young people. We searched PsycINFO, Med-Line and the Cochrane databases for reports relating to the measurement of OCD. Additionally, we sought information from the National Institute for Health and Care Excellence (NICE) guidance, the Child Outcomes Research Consortium (CORC) website and the Children and Young People's Improving Access to Psychological Therapies (CYP IAPT) Programme. We also reviewed large trials and meta-analyses of the treatment of OCD in young people and communicated with relevant researchers/clinicians. Results Seventeen questionnaire measurement tools, with variable psychometric properties, and four commonly used semistructured clinician administered interview measures were identified. Conclusions There are several measurement tools with good psychometric properties that are useful for initial screening/identification of OCD, as well as formal diagnosis, symptom tracking and treatment evaluation. With the availability of brief screens, as well as online diagnostic measures, such tools should not be a burden on clinical practice, but rather a helpful aid to support clinicians' assessment and treatment of OCD. [ABSTRACT FROM AUTHOR]

Morphing fears (also called transformation obsessions) involve concerns that a person may become contaminated by and acquire undesirable characteristics of others. These symptoms are found in patients with obsessive-compulsive disorder (OCD) and are thought to be related to mental contamination. Given the high levels of distress and interference morphing fears can cause, a reliable and valid assessment measure is needed. This article describes the development and evaluation of the Morphing Fear Questionnaire (MFQ), a 13-item measure designed to assess for the presence and severity of morphing fears. A sample of 900 participants took part in the research. Of these, 140 reported having a current diagnosis of OCD (SR-OCD) and 760 reported never having had OCD (N-OCD; of whom 24 reported a diagnosis of an anxiety disorder and 23 reported a diagnosis of depression). Factor structure, reliability and construct and criterion-related validity were investigated. Exploratory and confirmatory factor analyses supported a one-factor structure replicable across the N-OCD and SR-OCD group. The MFQ was found to have high internal consistency and good temporal stability and showed significantly greater associations with convergent measures (assessing obsessive-compulsive symptoms, mental contamination, thought-action fusion and magical thinking) than with divergent measures (assessing depression and anxiety). Moreover, the MFQ successfully discriminated between the SR-OCD sample and the N-OCD group, anxiety disorder sample and depression sample. These findings suggest that the MFQ has sound psychometric properties and that it can be used to assess morphing fear. Clinical implications are discussed. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message Little remains known about morphing fears, but it is an important area of investigation due to symptoms being highly distressing and often debilitating, Because morphing fears commonly present as obscure symptoms, they may not be recognized as a type of OCD, The MFQ is a robust measure with clinical utility; it can facilitate recognition and assessment of morphing fears, The MFQ will allow for further investigations of the prevalence, correlates and treatment outcomes of morphing fears. [ABSTRACT FROM AUTHOR]

Digital Health Innovations have great potential to improve access to evidence-based psychological therapies. This comprehensive review and meta-analysis sets out the current state of the field including the efficacy of the interventions for different types of mental health problems and the desirability of the interventions from the patients' perspective. It also highlights the poor methodology of much of the research and suggests important ways forward to improve the quality of the data. The importance of assessing and understanding the potential negative impact of such interventions is emphasised both in the review and the commentary, and suggestions are made to maximise the likelihood that such interventions are accessible within routine services. [ABSTRACT FROM AUTHOR]

Objective: Thought-shape fusion (TSF) is a cognitive distortion that has been linked to eating pathology. Two studies were conducted to further explore this phenomenon and to establish the psychometric properties of a French short version of the TSF scale. Method: In Study 1, students ( n = 284) completed questionnaires assessing TSF and related psychopathology. In Study 2, the responses of women with eating disorders ( n = 22) and women with no history of an eating disorder ( n = 23) were compared. Results: The French short version of the TSF scale has a unifactorial structure, with convergent validity with measures of eating pathology, and good internal consistency. Depression, eating pathology, body dissatisfaction, and thought-action fusion emerged as predictors of TSF. Individuals with eating disorders have higher TSF, and more clinically relevant food-related thoughts than do women with no history of an eating disorder. Discussion: This research suggests that the shortened TSF scale can suitably measure this construct, and provides support for the notion that TSF is associated with eating pathology. © 2012 by Wiley Periodicals, Inc. (Int J Eat Disord 2013) [ABSTRACT FROM AUTHOR]

Purpose. The purpose of this paper is to review the rationale for 'transdiagnostic' approaches to the understanding and treatment of anxiety disorders. Methods. Databases, searches and examination of the reference lists of relevant studies were used to identify papers of relevance. Results. There is increasing recognition that diagnosis-specific interventions for single anxiety-disorders are of less value than might appear since a large proportion of patients have more than one coexisting anxiety disorder and the treatment of one anxiety disorder does not necessarily lead to the resolution of others. As transdiagnostic approaches have the potential to address multiple coexisting anxiety disorders they are potentially more clinically relevant than single anxiety disorder interventions. They may also have advantages in ease of dissemination and in treating anxiety disorder not otherwise specified. Conclusions. The merits of the various transdiagnostic cognitive-behavioural approaches that have been proposed are reviewed. Such approaches have potential benefits, particularly in striking the balance between completely idiosyncratic formulations and diagnosis-driven treatments of anxiety disorders. However, caution is needed to ensure that transdiagnostic theories and treatments benefit from progress made by research on diagnosis-specific treatments, and further empirical work is needed to identify the shared maintaining processes that need to be targeted in the treatment of anxiety disorders. [ABSTRACT FROM AUTHOR]

Objectives. This study was designed to evaluate a new brief cognitive-behavioural intervention to reduce concerns about body shape. Design. Women with high levels of shape concern (N = 50) were randomly assigned to cognitive behaviour therapy or applied relaxation (AR). Baseline assessments were made and then women received their treatment immediately after this assessment, ('immediate' treatment) or 5 weeks after this assessment, during which time no treatment was given ('delayed' treatment, DT). Methods. Shape concern and related cognitions and emotions were assessed at baseline, post-treatment and at 4 and 12 week follow-up (FU). Results. Immediate treatment was superior to DT in reducing shape concerns, and this difference was maintained at 4 week FU. The cognitive behavioural intervention was more effective than AR in changing shape concern and this difference was largely maintained for 3 months. Conclusions. These initial findings support the further investigation of this brief intervention. [ABSTRACT FROM AUTHOR]

Objective: The aims of these studies were (a) to investigate the relationship between attentional bias and eating disorders and (b) examine the impact of psychological treatment on attentional bias. Method: The first study compared performance on a pictorial dot probe of 82 female patients with clinical eating disorders and 44 healthy female controls. The second study compared the performance of 31 patients with eating disorder on the same task before and after receiving 20 weeks of standardized cognitive behavior therapy. Twenty-four patients with eating disorder served as wait-list controls Results: With the exception of neutral shape stimuli, attentional biases for eating, shape, and weight stimuli were greater in the patient sample than the healthy controls. The second study found that attentional biases significantly reduced after active treatment only. Conclusion: Attentional biases may be an expression of the eating disorder. The question of whether such biases warrant specific intervention requires further investigation. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2008 [ABSTRACT FROM AUTHOR]

Objective: Previous research has indicated that temporal factors [specifically, the duration of interstimulus intervals (ISI) during a threat processing task] may influence the nature of processing biases exhibited in nonclinical populations with some degree of eating disorder psychopathology (Meyer et al., Int J Eat Disord, 27, 405–410, 2000). The current study aimed to test this hypothesis by investigating attentional biases for eating-disorder-relevant images and irrelevant visual images (animals) in patients with eating disorders (n = 23) and psychiatric (n = 19) and nonpsychiatric (n = 65) controls. Method: A dot probe task was modified from previous research (Shafran et al., Int J Eat Disord, 40, 369–380, 2007), whereby an original ISI of 500 ms was increased to 2,000 ms. Results: Patients with an eating disorder continued to display a bias in the processing of weight stimuli. However, biases noted in previous research for shape and weight stimuli disappeared when the ISI duration was increased in this way. Conclusion: These findings highlight the importance of temporal factors in whether processing biases are displayed and may point to ways in which biases actually work in this population. However, further research is warranted. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2008 [ABSTRACT FROM AUTHOR]

Objective: To examine the relationship between eating disorders and attentional biases. Method: The first study comprised 23 female patients with clinical eating disorders, women with high levels ofanxiety (n = 19), and three female normal control groups comprising low (n = 31), moderate (n = 21), or high levels of shape concern (n = 23). The second study comprised 82 women with clinical eating disorders and 44 healthy controls. All participants completed measures of eating disorder psychopathology and completed a modified pictorial dot-probe task. Results: In the first study, biases were found for negative eating and neutral weight pictures, and for positive eating pictures in women with eating disorders; these biases were greater than those found in anxious and normal controls. The second study replicated these findings and biases were also found for negative and neutral shape stimuli. Conclusion: It is concluded that future research should establish whether such biases warrant specific therapeutic interventions. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2007 [ABSTRACT FROM AUTHOR]

Objective. The construct of 'clinical perfectionism' has been developed in response to criticisms that other approaches have failed to yield advances in the treatment of the type of self-oriented perfectionism that poses a clinical problem. The primary aim of this study was to conduct a preliminary investigation into the efficacy of a theory-driven, cognitive-behavioural intervention for 'clinical perfectionism'. Design. A multiple baseline single case series design was used. Method. A specific, 10-session cognitive-behavioural intervention to address clinical perfectionism in eating disorders was adapted to allow its use in nine patients referred with a range of axis I disorders and clinical perfectionism. Results. The intervention led to clinically significant improvements in self-referential perfectionism from pretreatment to follow-up for six of the nine participants on two perfectionism measures and for three of the nine participants on the measure of clinical perfectionism. Statistically significant improvements from pre- to post-intervention for the group as a whole were found on all three measures. The improvements were maintained at follow-up. Conclusions. The finding that clinical perfectionism is improved in the majority of participants is particularly encouraging given that perfectionism has traditionally been viewed as a personality characteristic resistant to change. These preliminary findings warrant replication in a larger study. [ABSTRACT FROM AUTHOR]

Body image disturbance is both a risk factor for the development of disturbed eating and a central feature of clinical eating disorders. This review examines empirically tested interventions for people with high levels of body image disturbance. The most commonly used therapies with the most empirical support are cognitive-behavioural. The specificity of the body image interventions and the importance of individual components have not yet been established. Prevention programmes to address body image disturbance appear promising, although further research evidence is required. It is concluded that treatments for addressing body image disturbance are hindered by the lack of a clearly specified theoretical model of the maintenance of body image disturbance and that such an analysis is needed to increase the effectiveness of current interventions. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

The overestimation of body size has been suggested to play an important role in the maintenance of anorexia nervosa. It has been assessed in a variety of ways and the aim of this review is to present a comprehensive and critical appraisal of body size estimation in eating disorders. The review starts by classifying the different methods used to assess the estimation of body size, and considers factors that have been shown to influence it. The signal detection approach to body size estimation is examined and the impact of body size estimation on treatment outcome is reviewed. It is concluded that the significance of body size estimation research in the understanding and treatment of eating disorders can only be determined by combining ecologically valid assessment methods with state-of-the-art interventions. Copyright © 2005 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Objectives. The aims of the present study were (1) to examine the association between a cognitive distortion ('thought-shape fusion') and eating disorder psychopathology and (2) to examine the degree of thought-shape fusion in people with eating disorders and a non-eating-disorder control group. Design. Associations between thought-shape fusion and eating disorder psychopathology were examined and the degree of thought-shape fusion was compared between people with and without clinical eating disorders. Method. Forty-two women with clinical eating disorders and a group of 42 age-matched women with no self-reported history of an eating disorder completed self-report questionnaires to assess thought-shape fusion, eating disorder symptoms, body checking and body avoidance, and depression. Results. Thought-shape fusion was significantly associated with eating disorder psychopathology. The majority of the associations remained significant when controlling for levels of depression. Patients with eating disorders showed significantly more thought-shape fusion than the non-clinical controls. Conclusions. Thought-shape fusion is a cognitive distortion associated with eating disorders. It may be a direct expression of the overevaluation of eating, shape and weight. It is recommended that thought-shape fusion be tackled directly in cases where it is a barrier to changing the core psychopathology of eating disorders. [ABSTRACT FROM AUTHOR]

Presents information on a study which compared ecologically valid method of body size estimation with an existing, commonly used method. Insight on body image disturbance as a central concept in eating disorder psychopathology; Methodology of the study; Results and discussion.

The aim of this study was to develop a reliable self-report instrument to assess obsessive–compulsive disorder (OCD) in young people. The children''s Obsessional Compulsive Inventory (CHOCI) had good internal consistency, criterion validity and was significantly correlated with the Children''s Yale-Brown Obsessive Compulsive Scale (CY-BOCS). This preliminary new measure could serve to provide a more efficient and accessible way of assessing OCD in young people. [Copyright &y& Elsevier]

Presents information on a study which developed an ecologically valid method for assessing the perception of body size. Components of body image disturbance; Results of body size estimation and body size dissatisfaction; Data analysis; Descriptive statistics.

Obsessive-compulsive disorder (OCD) is estimated to affect between 0.5% and 2% of children and adolescents. The majority of clinical cases has both obsessions and compulsions. Depression, anxiety and tic disorders are common comorbid diagnoses, and assessment can therefore be complex. Several theories have been proposed for the aetiology and maintenance of the disorder, including cognitive-behavioural and neuropsychiatric theories. Cognitive-behavioural and pharmacological treatments are both probably efficacious therapies for children and adolescents but further research is needed to compare these treatments with each other, and to examine the use of combination therapies in controlled trials. [ABSTRACT FROM AUTHOR]

Higher Education Institutes (HEIs) have been met with an unprecedented demand on their student counselling and wellbeing services in recent years with the impacts of COVID‐19 and high rates of mental health concerns amongst student populations. Online mental health programs offer one solution by providing students with quick and easy access to effective therapeutic content. The Focused Minds Program is an evidence‐based eight‐module online self‐guided cognitive behavioural intervention that targets the transdiagnostic risk factor of perfectionism and has been shown to decrease depression, anxiety, and disordered eating. The program was implemented at a UK university between 2021 and 2023. Recruitment occurred via departmental emails, academic staff, and the university's counselling staff and website. Participants were provided with access to the intervention for 6‐weeks and completed weekly surveys of psychosocial measures. The trial's implementation was assessed using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework: reach (uptake via the recruitment channels), effectiveness (outcomes on psychometric measures of mental wellbeing), adoption (staff and organisational support), implementation (intervention engagement and attrition), and maintenance (continued implementation across the trial period). Key barriers to successful implementation, as well as proposed solutions, are discussed to guide future online mental health interventions provided in HEIs. [ABSTRACT FROM AUTHOR]

Thought–action fusion (TAF) is a cognitive distortion with two forms: ‘probability TAF’ in which the intrusive thought is believed to increase the probability that a specific negative event will occur and ‘morality TAF’ in which experiencing the intrusive thoughts is morally equivalent to carrying out a prohibited action. This distortion is especially prominent in obsessions, is closely related to guilt and is associated with subsequent attempts at neutralization. A comparable cognitive distortion termed ‘thought–shape fusion’ has been found in a minority of people with eating problems and occurs when the thought of eating is sufficient to induce feelings of fatness, moral unacceptability and weight gain. These cognitive distortions can be manipulated experimentally and have clinical implications that include improvement in understanding the nature of the disorder and its treatment. Copyright © 1999 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

There has been considerable debate with respect to the relationship between Obsessive Compulsive Disorder (OCD) and psychotic phenomena. In the present study, a large sample of subjects suffering from OCD completed a self report instrument of features associated with Schizotypal Personality Disorder. A systematic and positive relationship was found between the presence of schizotypal features and OCD, independent of the effects of depression and anxiety. Moreover, consistent with previous experimental work, the presence of schizotypal features predicted the presence of obsessional phenomena attributable to reduced cognitive inhibition. © 1997 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Discusses the condition of patient John Alexander whether he has sleep phobia or an obsessive behavior. Behavioral description; Speculation of psychological trauma after seeing the grandfather in a coma; Primary diagnosis of sleep phobia; Escalation of avoidance strategies; Indications of compulsive behavior due to strict nightly rituals; Fear of losing control over physical environment.