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Background: Faecal incontinence is a common debilitating condition associated with poor quality of life that generates substantial economic strain on healthcare systems., Objectives: We aimed to evaluate, in a tertiary referral population presenting with faecal incontinence, the impact of suffering additional disorders of gut-brain interaction (DGBI) on symptom severity, anxiety, depression and quality of life., Methods: Design: Retrospective cohort study., Setting: Tertiary referral Neurogastroenterology centre., Patients: All patients presenting with faecal incontinence from 2007 to 2020 were included., Main Outcome Measures: The results from structured medical and surgical questionnaires including Rome III Integrative Questionnaire, Faecal Incontinence Severity Index, Hospital Anxiety and Depression Scale, SF-36, and anorectal physiology were analysed using Stata version 17. Patients were categorised into 3 groups: 0-1 additional DGBI, 2 DGBIs, and 3+ DGBI. Statistical significance was defined as p < 0.05 (two-tailed)., Key Results: Faecal incontinence patients (n = 249; mean age 63.4 ± 12.6 years; 93.6% female, 48.1% urge subtype) met diagnostic criteria for mean 2.2 additional DGBI each, mostly affecting bowel (n = 231, 42.4%) and anorectal (n = 150, 27.5%) regions. A greater number of DGBIs was associated with higher faecal incontinence symptom severity (p < 0.001), higher anxiety (p = 0.002) and depression (p = 0.003), and worse quality of life in areas of mental health (p = 0.037) and social effect (p < 0.001). Patients with a greater number of concurrent DGBI demonstrated a greater family history of gastrointestinal problems (p = 0.004). There were no associations found between a greater amount of DGBIs and anorectal physiology., Conclusions and Inferences: A greater number of additional DGBIs in faecal incontinence patients was associated with worse faecal incontinence symptoms, higher anxiety and depression scores, and worse quality of life but was unrelated to physiology. This highlights the need to proactively search for comorbid DGBI in patients presenting with faecal incontinence., (© 2024 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)

Background: Rome criteria differentiate distinct types of disorders of gut-brain interaction (DGBI); also known as functional gastrointestinal disorders. Overlap of symptom categories frequently occurs. This systematic review and meta-analysis aimed to define the prevalence of DGBI overlap and compare overlap in population-based, primary care or tertiary care health settings. Furthermore, we aimed to compare symptom severity of psychological comorbidities in DGBI with and without overlap., Methods: For this systematic review and meta-analysis we searched MEDLINE (PubMed) and Embase electronic databases from inception until March 1, 2022, for original articles and conference abstracts of observational cross-sectional, case-controlled, or cohort design studies that reported the prevalence of DGBI overlap in adult participants (aged ≥18 years). We included only those studies where the diagnosis of DGBI was based on clinical assessment, questionnaire data, or specific symptom-based criteria. Studies were excluded if reporting on mixed populations of DGBI and organic diseases. Aggregate patient data were extracted from eligible published studies. The prevalence of DGBI overlap in all studies was pooled using the DerSimonian and Laird random effects model, and further analysis stratified by subgroups (care setting, diagnostic criteria, geographic region, and gross domestic product per capita). We also assessed the relationship between DGBI overlap with anxiety, depression, and quality of life symptom scores. This study was registered with PROSPERO (CRD42022311101)., Findings: 46 of 1268 screened studies, reporting on 75 682 adult DGBI participants, were eligible for inclusion in this systematic review and meta-analysis. Overall, 24 424 (pooled prevalence 36·5% [95% CI 30·7 to 42·6]) participants had a DGBI overlap, with considerable between-study heterogeneity (I 2 =99·51, p=0·0001). In the tertiary health-care setting, overlap among participants with DGBI was more prevalent (8373 of 22 617, pooled prevalence 47·3% [95% CI 33·2 to 61·7]) compared with population-based cohorts (11 332 of 39 749, pooled prevalence 26·5% [95% CI 20·5 to 33·4]; odds ratio 2·50 [95% CI 1·28 to 4·87]; p=0·0084). Quality of life physical component scores were significantly lower in participants with DGBI overlap compared with participants without overlap (standardised mean difference -0·47 [95% CI -0·80 to -0·14]; p=0·025). Participants with DGBI overlap had both increased symptom scores for anxiety (0·39 [95% CI 0·24 to 0·54]; p=0·0001) and depression (0·41 [0·30 to 0·51]; p=0·0001)., Interpretation: Overlap of DGBI subtypes is frequent, and is more prevalent in tertiary care settings and associated with more severe symptom manifestations or psychological comorbidities. Despite the large sample size, the comparative analyses revealed substantial heterogeneity, and the results should be interpreted with caution., Funding: National Health and Medical Research Council and Centre for Research Excellence., Competing Interests: Declaration of interests GH has received payments or honoraria for lectures, presentations, or speakers bureaus from Bayer, and has also received travel/support for attending meetings from Bayer. He has participated on data safety monitoring boards or advisory boards from Australian Biotherapeutics, Glutagen, and Bayer. GH holds stock or stock options in Bayer. He serves on the boards of the West Moreton Hospital and Health Service (WMHHS), Queensland, UQ Healthcare, Brisbane, and is vice president of Gastro-Liga, Germany, and Chair of the WMHHS Board Quality and Safety Committee. He is on the Research Committee of the Royal Australasian College of Physicians. GH acknowledges funding from the National Health and Medical Research Council (NHMRC) for the Centre for Research Excellence in Digestive Health. GH holds a Medical Research Future Fund grant and an NHMRC ideas grant. NJT reports grants from NHMRC (Centre for Research Excellence in Digestive Health; investigator grant), HMRI, Defence department of the Australian government (Cognobiome grant), AusEE, Astra Zeneca, Allakos, and Intrinsic Medicine. He reports personal fees from Adelphi values, Allakos, Astra Zeneca, Bayer AG, Comvita Mānuka Honey, BluMaiden, twoXAR, Dr Falk Pharma/Jorveza, Glutagen, IsoThrive, Intrinsic Medicine, and Rose Pharma, and has acted as an educational speaker for GlaxoSmithKline Australia. He has non-financial support from Norgine for an IBS interest group. NJT has a patent for biomarkers of IBS licensed (#12735358·9 -1405/2710383 and #12735358·9 -1405/2710384), has licensed questionnaires (Talley Bowel Disease Questionnaire) to the Mayo Clinic, has a Nestec European Patent Application (No. 12735358·9), has a provision Australian patent application for a diagnostic marker for functional gastrointestinal disorders (2021901692), a Singapore provisional patent (NTU Ref: TD/129/17 “Microbiota Modulation Of BDNF Tissue Repair Pathway”), and copyright Nepean Dyspepsia Index (NDI) 1998. He has acted on an advisory board for Bristol Myers Squibb. NJT declares the following other financial or non-financial interests: Medical Journal of Australia (Editor in Chief), Up to Date (Section Editor), Precision and Future Medicine, Sungkyunkwan University School of Medicine, South Korea (Editorial Board Member), Med (Journal of Cell Press; Editorial Board Member), eGastroenterology (Editorial Board Member), and has received personal fees for a textbook from Elsevier. NJT has leadership or fiduciary roles (all unpaid) in the International Foundation for Functional Gastrointestinal Disorders (IFFGD; advisory board), AusEE (advisory board), OzSage, NHMRC Principal Committee (Research Committee), Asia Pacific Association of Medical Journal Editors (APAME), AAHMS, Rome V working team member (gastroduodenal committee), International Plausibility Project Co-Chair (Rome Foundation funded), COVID-19 vaccine forum member. WDC reports grants from Biomerica, Commonwealth Diagnostics International, QOL Medical, and Salix/Valeant, has received consulting fees from AbbVie, Alnylam, Biomerica, Gemelli, Ironwood, Isothrive, QOL Medical, Nestle, Redhill, Salix/Valenat, Urovant, Takeda, and Vibrant. He is on the board of trustees and an officer of the American College of Gastroenterology, board of directors of the Rome Foundation, and board of directors and is vice president of the IFFGD. TF, AS, NK, YYL, KAG, and MPG declare no competing interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Vasoactive intestinal polypeptide (VIP) is a neuroendocrine peptide distributed throughout the human body, including the CNS, where it is particularly abundant in brain regions associated with anxiety and depression. Based on earlier studies indicating that peripheral VIP may cross through the blood-brain barrier, we hypothesized plasma VIP levels to be associated with symptoms of anxiety and depression, as well as brain volume and resting-state functional connectivity in the amygdala, hippocampus, parahippocampus, and orbitofrontal cortex. Plasma VIP concentrations and anxiety/depression symptoms were measured in 37 healthy females. Functional and structural magnetic resonance imaging were used to evaluate functional connectivity and brain volume respectively, and their associations with VIP concentrations within brain regions associated with anxiety and depression. Negative correlations were found between VIP levels and symptoms of anxiety (r = - 0.44, p = 0.002) and depression (r = - 0.50, p = 0.001). Functional connectivity demonstrated significant VIP-dependent positive associations between the amygdala seed region with both the right parahippocampus (t (33)  = 3.1, p FDR  = 0.02) and right lateral orbitofrontal cortex (OFC; t (33)  = 2.9, p FDR  = 0.02). Moreover, VIP concentrations were significantly, positively correlated with brain volume in the left amygdala (r = 0.28, p = 0.007) and left lateral OFC (r = 0.29, p = 0.004). The present findings highlight a potential role for VIP in the neurobiology of affective symptoms.

Anxiety disorders are common mental health problems amongst youth with harmful impacts often extending into adulthood. Mindfulness-based interventions (MBIs) have become increasingly popular for addressing mental health issues, particularly in schools; however, it remains unclear how effective they are for reducing youth anxiety. This meta-analysis aimed to evaluate the efficacy and effect moderators of MBIs on anxiety outcomes in children and adolescents. Eligible studies were published randomised controlled trials (RCTs) of MBIs conducted with participants aged 18 years or younger, investigating anxiety outcomes using a well-validated anxiety scale. A systematic search of RCTs published through to February 2019 identified 20 studies for inclusion (n = 1582). A random effects model was used to synthesise MBI effects. Stratified meta-analyses as well as individual, random effects meta-regressions were performed to examine how effects varied by age group, intervention setting, control type, research location, and intervention dosage. Although, across all studies, there was a small beneficial effect of MBIs on anxiety post treatment (d = 0.26), this was significantly moderated by research location, with RCTs conducted in Iran producing large effects (d = 1.25), and RCTs conducted in Western countries demonstrating no significant beneficial effect compared to controls (very small, d = 0.05). Effects were non-significant at follow-up assessment points. Post-treatment effects were significant for MBIs conducted with children (d = 0.41) and for MBIs when compared to passive controls (d = 0.33), but non-significant for adolescents (d = 0.21), for MBIs conducted in schools (d = 0.30) and in clinics (d = 0.13), and when MBIs were compared to active controls (d = 0.12). Results suggest that MBIs are likely to have a small to medium, yet temporary effect in reducing anxiety symptoms in children (not adolescents), but amongst Western youth populations the most likely outcome, from RCTs to date, is that MBIs produce no beneficial effect in anxiety reduction. Results revealed a lack of evidence to support investment in school-based MBIs to address youth anxiety.

Background: There has been growing interest in the potential of emerging internet-delivered psychological treatments for supporting the mental health needs of university students. However, no large-scale prospective effectiveness trials examining their real-world potential have been reported., Objective: The aim of the current study was to evaluate the acceptability and effectiveness of a brief, 5-week, internet-delivered and therapist-guided intervention for anxiety and depression, when delivered as part of routine care by a university counselling service., Design: A large, prospective, single-group Phase-IV clinical trial. Students (n = 1326) engaging with the university counselling service were provided the opportunity to receive the intervention based on their preferences and identified needs. Students completed standardised measures of anxiety and depression at pre-treatment, each week of the intervention, post-treatment and 3-month follow-up., Results: Over a 4 year period, 1081 students (10% of those presenting to the counselling service) participated in the intervention. Large clinical reductions in symptoms of both anxiety (% reduction = 41%; Cohen's d = 0.94) and depression (% reduction = 36%; Cohen's d = 0.81) were observed alongside high levels of acceptability. The intervention required relatively little counsellor time (M = 36.28 mins; SD = 20.56) per student, and symptom deterioration was observed in less than 5% of students., Conclusion: The findings of the current study are supportive of internet-delivered interventions provided as routine care to university students. Further research is needed to carefully explore whether these interventions could be used with a larger proportion of students presenting to counselling services, paying close attention to acceptability, engagement and clinical outcomes., (Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.)

Cognitive-behavioural therapy (CBT) is an effective treatment for clinical and subclinical symptoms of depression and general anxiety, and increases life satisfaction. Patients' usage of CBT skills is a core aspect of treatment but there is insufficient empirical evidence suggesting that skills usage behaviours are a mechanism of clinical change. This study investigated if an internet-delivered CBT (iCBT) intervention increased the frequency of CBT skills usage behaviours and if this statistically mediated reductions in symptoms and increased life satisfaction. A two-group randomised controlled trial was conducted comparing internet-delivered CBT (n = 65) with a waitlist control group (n = 75). Participants were individuals experiencing clinically significant symptoms of depression or general anxiety. Mixed-linear models analyses revealed that the treatment group reported a significantly higher frequency of skills usage, lower symptoms, and higher life satisfaction by the end of treatment compared with the control group. Results from bootstrapping mediation analyses revealed that the increased skills usage behaviours statistically mediated symptom reductions and increased life satisfaction. Although skills usage and symptom outcomes were assessed concurrently, these findings support the notion that iCBT increases the frequency of skills usage behaviours and suggest that this may be an important mechanism of change.

Researchers have begun to consider whether there may be more than one psychological profile to describe adolescents who engage in self-harm. Limited past research suggests multiple different profiles. Australian high school students (n = 1,521, age 11-19, 56.4% female) completed an online questionnaire reporting risk and protective factors and self-harm frequency. Non-hierarchical cluster analysis allocated 256 students who reported 6-month self-harm to mutually exclusive profiles based on psychological similarity. Five distinct psychological profiles were identified: 1) Psychologically 'normal'; 2) Anxiety symptoms; 3) Impulsive; 4) Pathological; and 5) Pathological-Impulsive. The proportion of adolescents that reported 11 or more episodes of self-harm varied from 5.7% in the psychologically 'Normal' group to 27.7% in the 'Pathological- Impulsive' group. These results indicate that multiple psychological profiles exist. Adolescents with different risk factors may require disparate strategies for treatment and prevention. Given the variability in profiles, screening may assist in detecting adolescents who self-harm., (Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)

Functional gastrointestinal disorders (FGID) are common conditions, with well-established diagnostic criteria. They are associated with impaired health-related quality of life and increased societal and healthcare costs. Their symptoms are probably related to altered 5-HT transmission and central processing of noxious visceral stimuli. Evaluation and treatment are best formulated using a biopsychosocial model that integrates gut function with psychosocial assessment. Psychological therapies may improve overall well-being and appear to help patients without significant psychiatric comorbidity. Antidepressants help comorbid anxiety and depressive disorders and have primary efficacy in improving the symptoms of FGID. Finally, there is a need for greater involvement of psychiatrists in both the evaluation and treatment of patients with FGID as well as the education and training of practitioners caring for these patients.

Background: Esophagogastroduodenoscopy (EGD) and colonoscopy (CS) are commonly performed procedures that can cause anxiety related to potential findings, embarrassment and concern over discomfort. The objective of this study is to evaluate patient anxiety associated with diagnostic, sedated outpatient endoscopy and to correlate endoscopists' estimations of patient anxiety with those of the patient., Methods: Consecutive patients referred for diagnostic upper endoscopy or colonoscopy were evaluated. Anxiety was rated at baseline and immediately before the procedure using the State-Trait Anxiety Index (STAI-Y). Patients were categorized as whether they had been previously seen by a gastroenterologist in the clinic or were referred directly by another physician for endoscopy. Patients were also asked to rate their knowledge of the procedure using a visual analog scale. Physicians rated patient anxiety and procedure difficulty using 100 mm visual analog scales. Sedation administered during each procedure was recorded., Results: Ninety-four patients were enrolled; 47 had been referred from the gastroenterology clinic and 47 had been directly referred from primary care physicians. Thirty-nine percent completed baseline and pre-procedure STAI-Y. Endoscopy was associated with a significant increase in state anxiety (baseline, 31.2 +/- 1.8; procedure, 39.8 +/- 2.2; P = 0.001) but not trait anxiety (baseline, 35.4 +/- 1.7; procedure, 36.2 +/- 1.6; P = 0.59). Procedural state anxiety was not influenced by age, sex, referral source, type of procedure or perceived procedural knowledge but was correlated with trait anxiety (r = 0.38; P = 0.02). Physician estimates of patient anxiety did not correlate with either procedural state anxiety (r = -0.15; P = 0.37) or the change in state anxiety from baseline to the procedure (r = -0.04; P = 0.82)., Conclusions: Diagnostic outpatient endoscopy is associated with modest increases in state anxiety that are not significantly influenced by age, sex, procedure type, indication, or referral source. Endoscopists' ability to estimate patient anxiety is poor but this may reflect the generally mild increases in state anxiety that were encountered.

Objective: Mental health complaints are prevalent among people with epilepsy, yet there are major barriers that prevent access to psychological care, including high out‐of‐pocket costs and a lack of accessible specialized services. The purpose of the current study is to examine the comparative efficacy, acceptability, cost‐effectiveness, and long‐term outcomes of a digital psychological intervention when delivered under two models of care (i.e., guided vs. unguided) in supporting the mental health and functioning of adults with epilepsy. Method: Approximately 375 participants across Australia will be enrolled. Eligible participants will have a confirmed diagnosis of epilepsy, experience difficulties with their emotional health, be at least 18 years of age, and live in Australia. Participants will be randomized (2:2:1) to receive the Wellbeing Neuro Course, a 10‐week internet‐delivered program, with (i.e., guided) or without guidance by a mental health clinician (i.e., unguided), or be allocated to a treatment‐as‐usual waiting‐list control group. Participants will complete online questionnaires at pre‐, post‐treatment, and 3‐ and 12‐month follow‐up and consent to have their data linked to their medical records to capture healthcare system resource use and costs. Analysis: Primary outcome measures will be symptoms of depression and anxiety. A cost‐utility analysis will be undertaken using the Australian healthcare system perspective and according to current economic evaluation guidelines. Resource use and costs to the healthcare system during the study period will be captured via data linkage to relevant administrative datasets in Australia. Significance: The results of this trial will provide important data concerning the relative outcomes of these different models of care and will inform the integration of digital psychological interventions translation into healthcare services. Ethics and Dissemination: The Human Research Ethics Committee of Macquarie University approved the proposed study (Reference No: 520231325151475). The results will be disseminated through peer‐reviewed publication(s). ANZCTR Trial Registration Number: ACTRN12623001327673. Plain Language Summary: This study seeks to find out if a 10‐week online psychological treatment can improve the mental health and well‐being of Australian adults with epilepsy. Around 375 participants will be randomly assigned to different groups: one will receive treatment with guidance from mental health clinician (guided group), one without guidance (unguided group), and one starting later (waiting control group). All participants will fill out the same outcome measures online. The main goal of this research is to compare these groups and assess how well the treatment works in improving mental health outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Psychological adjustment to chronic health conditions is important, as poor adjustment predicts a range of adverse medical and psychosocial outcomes. Psychological treatments demonstrate efficacy for people with chronic health conditions, but existing research takes a disorder-specific approach and they are predominately delivered in face-to-face contexts. The internet and remotely delivered treatments have the potential to overcome barriers to accessing traditional face-to-face treatment. Objective: The current study examined the efficacy and acceptability of an internet-delivered transdiagnostic psychological intervention to promote adjustment to illness, based on cognitive behaviour therapy principles. Methods: In a two-arm randomised controlled trial, participants (n = 676) were randomly allocated to the 8-week intervention or a waitlist control. Treatment included five core lessons, homework tasks, additional resources, and weekly contact with a psychologist. Primary outcomes included depression, anxiety, and disability, assessed at pre-treatment, post-treatment, 3-month follow-up, and 12-month follow-up. Results: The treatment group reported significantly greater improvements in depression (between-groups d = 0.47), anxiety (d = 0.32), and disability (d = 0.17) at post-treatment (all ps <0.001). Improvements were sustained over the 3-month and 12-month follow-ups. High treatment completion rates (69%) and levels of satisfaction (86%) were reported by participants in treatment. The intervention required a mean clinician time of 56.70 min per participant. Conclusions: The findings provide preliminary and tentative support for the potential of internet-delivered transdiagnostic interventions to promote adjustment to chronic health conditions. Further research using robust control groups, and exploring the generalisability of findings, is needed before firm conclusions can be drawn. [ABSTRACT FROM AUTHOR]

Objectives: Co‐occurring mood and anxiety disorders are common in older adult populations and are associated with worse long‐term outcomes and poorer treatment response than either disorder alone. This systematic review and meta‐analysis aimed to examine the efficacy and effectiveness of psychological interventions for treating co‐occurring mood and anxiety disorders in older adults. Method: The study was registered (PROSPERO CRD4201603834), databases systematically searched (MEDLINE, PSYCINFO, PubMed and Cochrane Reviews) and articles screened according to PRISMA guidelines. Inclusion: Participants aged ≥60 years with clinically significant anxiety and depression, psychological intervention evaluated against control in randomised controlled trial, changes in both anxiety and depression reported at post‐treatment. ResultsFour studies were included (total n = 255, mean age range 67–71 years). Overall, psychological interventions (cognitive behavioural therapy, mindfulness) resulted in significant benefits over control conditions (active, waitlist) for treating depression in the presence of co‐occurring anxiety (Hedges' g = −0.44), and treating anxiety in the presence of depression (Hedges' g = −0.55). However, conclusions are limited; the meta‐analysis was non‐significant, few studies were included, several were low quality and there was high heterogeneity between studies. Benefits at follow‐up were not established. Conclusion: Co‐occurring anxiety and mood disorders can probably be treated simultaneously with psychological interventions in older adults with moderate effect sizes, however, more research is needed. Given comorbidity is common and associated with worse clinical outcomes, more high‐quality clinical trials are needed that target the treatment of co‐occurring anxiety and mood disorders, and report changes in diagnostic remission for both anxiety and mood disorders independently. Key Points: Comorbid anxiety and mood disorders are common in older adults and are associated with worse outcomes than anxiety or mood disorders aloneFew psychological interventions have examined the efficacy of treating co‐occurring mood and anxiety disorders in older adults, and the quality of these studies is mixedLimited evidence suggests that psychological therapy can simultaneously target anxiety and mood disorders with moderate effect sizesSignificantly more research is needed to understand the efficacy of psychological interventions to target comorbid mood and anxiety disorders in older adults [ABSTRACT FROM AUTHOR]

Use of the partial NMDA receptor agonist d-Cycloserine (DCS) to increase extinction to feared cues among anxious adults has shown mixed, although overall positive effects. Few studies have extended this effect to youth and none have addressed young people with broad-based anxiety such as separation anxiety, social anxiety, or generalised anxiety. In the current trial 51 children and adolescents with diagnosed anxiety disorders, aged 7–14 years received four sessions of graduated, experimenter-led, in vivo exposure to a hierarchy of feared cues relevant to their primary fear. They were randomly allocated to receive either 50 mg of DCS or a matched placebo capsule in a fully double-blind design. Both groups showed large reductions across sessions in their primary fear according to both parent and child report, but there were no significant differences between conditions at any session. The results are consistent with most studies to date of DCS-augmented exposure in young people. [ABSTRACT FROM AUTHOR]

This paper describes the development and preliminary psychometric evaluation of an instrument that measures the frequency of adaptive behaviours and cognitions related to therapeutic change during cognitive behavioural therapy (CBT), for symptoms of anxiety and depression. Two studies were conducted. In study one, 661 participants completed an online survey with 28 items targeting adaptive behaviours and cognitions. Exploratory factor analysis performed on part of the sample (n = 451) revealed that a four-factor solution ‘characterised’ the data. This led to the development of a 12-item instrument, the Frequency of Actions and Thoughts Scale (FATS). Confirmatory factor analysis was used to confirm the factor structure of the FATS using the remaining sample (n = 210), which revealed an acceptable model fit. In study two, 125 participants with clinically significant symptoms of anxiety, depression, or both were recruited to an Internet-delivered CBT (iCBT) treatment course. Participants completed the FATS and other measures throughout treatment, after treatment, and at three-month follow-up. Correlations and residual change scores of the FATS and its subscales with measures of anxiety, depression, behavioural activation, and CBT-related skills usage supported the construct validity of the FATS. A significant increase in FATS scores over treatment was also observed. The findings provide preliminary support for the psychometric properties of the FATS, which appears to have utility in research investigating mechanisms of change in CBT. [ABSTRACT FROM AUTHOR]

High trait emotional intelligence (TEI) is negatively associated with psychological distress, and researchers have been investigating the roles of emotion regulation strategies and coping styles in this association. However, a confusing variety of TEI scales are in use, and studies suggest that systematic differences may exist between them. Thus, the aim of this study was to examine the extent to which coping styles and emotion regulation strategies (reappraisal and suppression) explain the TEI–distress association using three TEI scales: the Trait Emotional Intelligence Questionnaire (TEIQue), the Assessing Emotions Scale (AES) and the Wong and Law Emotional Intelligence Scale (WLEIS). Participants ( N = 423) were recruited online (59% resided in India, 36% the USA, 5% elsewhere). Structural equation modelling showed that both the TEIQue and AES negatively predicted distress, mostly via avoidant coping, and with a stronger direct TEI–distress path in the TEIQue model. In contrast, the WLEIS showed a weaker overall relationship with distress, but a greater number of indirect paths (i.e., negatively predicting distress via less avoidant coping and more reappraisal; positively predicting distress via more suppression and religious coping). Implications of the use of different TEI scales in clinical research are discussed. [ABSTRACT FROM AUTHOR]