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The Dutch protocol for Eye Movement Desensitization and Reprocessing (EMDR) uses two psychological myths as part of the therapeutic instruction: memory works as a video camera and individuals can have a photographic memory. This study explored how participants experience and evaluate such instructions and if these instructions affect their beliefs on memory. Participants received a video, photo, or a control instruction. Participants indicated on a visual analog scale how vivid and emotional they expected to recall the traumatic memory, how credible the therapeutic instruction was, and how reliable they would consider a therapist providing such an instruction. Next, participants completed a memory belief survey. Participants who received the video instruction were most likely to expect to vividly recall a memory. The credibility of the instructions and the reliability of the therapist providing the instruction were at chance level, which might pose problems for the therapeutic alliance and therapy outcome. ispartof: JOURNAL OF PSYCHOLOGY vol:155 issue:2 pages:129-139 ispartof: location:United States status: published

Group care workers of residential youth care settings face the challenge of creating a warm and involved treatment climate against the demands and restrictions of the treatment setting. We tested the effects of SafePath, a milieu-based intervention based on Schema Therapy principles, during the first year of implementation on two secure residential treatment units compared to two control units. Staff’s daily reports on 139 individual patients were coded on use of schema mode language (implementation check), occurrences of aggression (primary outcome) and repressive staff interventions. In addition, repeated questionnaires were filled out by patients (n = 87) on group climate and by staff (n = 50) on team functioning. Compared to the control units, SafePath units showed higher improvements in group climate and repressive interventions. Both SafePath and control units showed decreased aggression over time. Team functioning was consistently better in the SafePath units compared to the care-as-usual units from baseline through 12 months. In conclusion, a Schema Therapy based milieu as implemented with SafePath may contribute to a warm and supportive group climate with less repressive interventions in secure residential youth care.

This longitudinal study explored the relations between fear-enhancing parenting behaviors (modeling and threat information transmission) and children's cognitive biases and anxiety symptoms on three subsequent time points over a one-year period. Participants were 216 children aged 7-12 years (114 boys and 102 girls), and their mothers (n = 199) and/or fathers (n = 117). On each time point, children and parents completed the Parental Enhancement of Anxious Cognitions scale, which measures parental modeling and threat information transmission. Furthermore, children filled in a measure of anxiety disorder symptoms. In addition, confirmation bias and interpretation bias were measured by means of a number of computerized tasks. The results yielded support for a circular model in which cognitive biases enhanced anxiety symptoms, which in turn promoted cognitive biases on each of the three time points. However, no evidence was found for longitudinal effects of cognitive biases on anxiety or vice versa. In contrast to what we expected, cognitive biases and anxiety appeared to promote parental modeling and threat information rather than the other way around. These findings extend research on the relations between parenting behaviors, cognitive biases, and childhood anxiety symptoms, and suggest valuable leads for assessment and intervention.

Integrating a screening possibility for Autism Spectrum Disorder (ASD) within the widely applied Achenbach System of Empirically Based Assessment (ASEBA) scales could be of great value for daily clinical practice. The present study explored the ability of the school-aged Child Behavior Checklist (CBCL) and the Teacher’s Report Form (TRF) to screen for ASD in children and adolescents (aged 6 to 18 years) within a mixed clinically referred sample. Different screening variants were compared for the CBCL, TRF, and the combination of CBCL and TRF: the separate withdrawn/depressed, social problems, and thought problems syndrome scales; combinations of these syndrome scales; and special ASD scales composed of relevant individual items. Analyses were performed for: youth with a DSM-IV-based clinical diagnosis; youth for which the clinical DSM-IV diagnosis was confirmed by a standardized assessment (the Autism Diagnostic Interview-Revised); and youth with a DSM-IV- based clinical diagnosis of ASD that also met the DSM-5 criteria. The results clearly demonstrated that the special ASEBA-based scales – in particular when completed by the parents – were most predictive of ASD. The results also indicate that following the initial screen with these ASEBA scales, further thorough diagnostic assessment is necessary to definitively establish whether young people really suffer from ASD.

Eye movement desensitization and reprocessing (EMDR) is a widely used treatment for posttraumatic stress disorder. The idea behind EMDR is that lateral eye movements may mitigate the emotional impact of traumatic memories. Given the focus on changing patients' memories, it is important that EMDR practitioners have detailed knowledge about human memory. We explored beliefs and ideas about memory in samples of EMDR practitioners (Study 1: n = 12; Study 2: n = 41), students (Study 1: n = 35; Study 2: n = 24), and researchers (Study 2: n = 30). All groups seemed to be aware of the fallibility of memory. However, a majority of the surveyed EMDR practitioners (70-90%), students (around 90%), and researchers (66.7%) endorsed the controversial idea of repressed memories. Skepticism and endorsement of problematic ideas about memory-related topics may coexist within the same group. In clinical settings, this might be problematic, because a strong belief in repressed memories might lead therapists to suggestively seek for such memories in patients.

This study adds to the understanding of why some adolescent boys react to unfair situations with anger and aggression, whereas others do not. We used an experimental design to test whether early maladaptive schemas influence the causal links between perceived injustice, negative affect, and aggression. Thirty-seven adolescent boys (13–18 years old; participation rate 67%) with severe behavior problems were randomly assigned to either the experimental condition, where a feeling of unfairness was induced, or to the control condition. Results showed that the effects of perceived injustice on aggression were mediated by angry feelings, and that this mechanism was conditional on levels of Abandonment and Entitlement schemas. These results suggest that even vulnerable schemas may underlie aggression, and that aggression treatment may benefit from a focus on underlying maladaptive schemas.

Performing eye movements during memory retrieval is considered to be important for the therapeutic effect of eye movement desensitization and reprocessing (EMDR). We conducted a meta-analysis of laboratory studies that compared the effects of eye movements and/or alternative dual tasks (e.g., counting) on the vividness and emotionality of negative autobiographical memories with recall only (control) conditions. The databases PsycINFO and Web of Science were queried. Fifteen studies that involved 942 participants were included. Eye movements and alternative dual tasks produced similar vividness and emotionality decreases, with the impact on vividness being strong than that on emotionality. However, eye movements yielded a stronger overall vividness reduction than alternative dual tasks, although the associated effect size was small (Cohen’s d = .29). Because eye movements and alternative dual tasks produced comparable effects, one might conclude that both tasks are therapeutic equivalents. However, it should be acknowledged that only a limited number of laboratory studies were included in our meta-analysis, and the degree to which both procedures tax working memory was not independently established. Although our conclusion cannot be generalized to clinical practice, it does raise questions about the mode of action of EMDR.

Eye Movement Desensitization and Reprocessing (EMDR) is an effective treatment for post-traumatic stress disorder. However, literature on possible adverse memory effects of EMDR is scarce. Using the Deese/Roediger-McDermott (DRM) false memory paradigm, we examined the susceptibility to spontaneous false memories after performing eye movements, as used in EMDR. In Experiment 1, 72 undergraduates received word lists containing negative and neutral associated words and immediately after this they were given a free recall and recognition test. In Experiment 2, 68 undergraduates underwent the free recall and recognition test 48 h later. During the free recall phase in both experiments, participants either performed eye movements or not (control condition). In Experiment 1, the two conditions did not differ statistically with regard to correct and false recall/recognition. In Experiment 2, correct memory rates were higher in the eye movement than in the control condition and this was accompanied by an increase in spontaneous false memories on both free recall and recognition. Although our experimental approach is far removed from clinical practice, our findings suggest that eye movements as used in EMDR might amplify both correct and false memory rates.

Door de bewezen effectiviteit van schematherapie bij volwassenen met persoonlijkheidsstoornissen werd het toepassingsgebied steeds verder uitgebreid naar andere doelgroepen en problematieken, waaronder kinderen en jongeren. In dit hoofdstuk wordt de individuele schematherapie met adolescenten beschreven. We onderscheiden daarbij verschillende fases: de motivatiefase, diagnostische fase, fase van verandering en de fase van generalisatie, en illustreren deze met casuistiek. Kort wordt aangestipt hoe ouders betrokken kunnen worden bij de individuele therapie. Schematherapie bij adolescenten is niet heel verschillend van schematherapie bij volwassenen, maar er zijn wel een aantal aandachtspunten die we in dit hoofdstuk verder toelichten.

Contains fulltext : 219065.pdf (Publisher’s version ) (Open Access) Background and objectives: This study aimed to unravel the relationship between socially anxious individuals' expectation of being (dis)liked and actual likeability by looking at the mediating role of both strategic and automatic social behavior: Self-disclosure as well as mimicry were examined. Method: Female participants (N = 91) with various levels of social anxiety participated in a social task with a confederate. Before the task, participants indicated their expectation of being liked by the confederate. Afterwards, objective video-observers rated the likeability of the participants before and after the social task as well as their level of self-disclosure and mimicry. Results: Social anxiety correlated negatively with the expectation to be liked but was not related to observer ratings of likeability, self-disclosure or mimicry. However, degree of social anxiety moderated the relation between expectations and self-disclosure. As expected, participants with low levels of social anxiety disclosed more if they expected to be liked. A reversed pattern was found for the high socially anxious participants: Here, higher expectations of being liked were related to less self-disclosure. Limitations: The study used an analogue female sample. Our social interaction task was highly structured and does not reflect informal day-to-day conversations. Conclusion: Socially anxious individuals function rather well in highly structured social tasks. No support was found for declined likeability or disrupted mimicry. Nevertheless, high socially anxious individuals did have a cognitive bias and show a self-protective strategy: when expecting a neutral judgment they reduce their level of self-disclosure. This pattern probably adds to their feelings of social disconnectedness. 9 p.

In hoofdstuk 10 wordt de groep-schemacoaching voor ouders of verzorgers beschreven. De groep-schemacoaching is geprotocolleerd en bestaat uit acht sessies en twee modules. In de het theoretische model wordt schematherapie vanuit een intergenerationeel perspectief beschreven. Daar op volgend worden twee modules beschreven. De eerste module (eerste vier sessies) besteden aandacht aan psychoeducatie en de ‘schemataal’. De tweede module (tweede vier sessies) gaat over emotie coaching waarbij ouders geleerd wordt door middel van oefeningen en huiswerkopdrachten, zo goed mogelijk aan te sluiten bij de behoeften van hun kind. Er is nog weinig onderzoek gedaan naar de effectiviteit van groep-schemacoaching, de klinische indruk is echter positief.

In het tweede hoofdstuk wordt ingegaan op de indicatiestelling en de diagnostiekfase binnen een schematherapeutische behandeling. In deze fase wordt de relatie gelegd tussen de huidige klachten, de gemiste basisbehoeften, schema’s, modi en coping. Diverse instrumenten voor de indicatiestelling worden beschreven evenals diverse diagnostische technieken en instrumenten om binnen de diagnostiekfase tot een schemagerichte casusconceptualisatie te komen. De beschreven technieken worden geillustreerd met diverse voorbeelden.

Hoofdstuk 5 beschrijft de groepsschematherapie (GST)bij adolescenten. Na een beschrijving van het theoretische model wordt ingegaan op de indicatiestelling. Vervolgens worden de fasen van de GST besproken: in fase 1 staat verbinding, veiligheid, psychoeducatie en emotieregulatie centraal, fase 2 staat in het teken van het werken met modi, en fase 3 is gericht op het werken met de Gezonde modus en de Blije kind modus. Tenslotte wordt ingegaan op de effectiviteit van GST.

We investigated the relationships of adolescents’ internalizing and externalizing behaviors with their early maladaptive schemas (EMS), coping responses, and schema modes. We focused on EMS related to experiences of disconnection and rejection that comprise vulnerable emotions, such as shame, mistrust, deprivation, abandonment, and isolation/alienation. This cross-sectional study included a total of 699 adolescents (combined clinical and non-referred sample) who were 11 to 18 years old (M = 14.6; SD = 1.6), and of which 45% was male. All participants completed self-report questionnaires on EMS, coping responses, schema modes, and behavior problems. We aimed to clarify the relationships between these variables by testing mediation, moderation, and moderated mediation models. In general, coping responses functioned as mediators rather than moderators in the relationships between EMS and schema modes. Furthermore, EMS regarding experiences of disconnection and rejection were related to both internalizing and externalizing behavior problems, and coping responses and schema modes mediated these effects. In conclusion, although adolescent internalizing and externalizing behavior problems manifest quite differently, they seem related to the same EMS.

This study investigated whether the schema therapy constructs of schema coping and schema modes have val dity in adolescents. We examined the validity and reliability of the Schema Coping Inventory (SCI) and an 80-item version of the Schema Mode Inventory (SMI) in a mixed sample of adolescents. Confirmatory factor analyse showed that the first-order factor structures of the SCI and SMI were replicated, but that the hypothesized higher-order models of the SMI were not confirmed. Instead, we proposed an alternative higher-order model of Internalizing, Externalizing, Overachieving, and Healthy modes. In general, the SCI and SMI scales were able o distinguish the clinical sample from the community sample, and meaningful relationships were found between oping styles, schema modes, and behavior problems. In conclusion, our study supports the theorized relations ips between schema coping styles, schema modes, and behavior, problems in adolescents, and provides initial validation for the SCI and the, 80-item SMI in adolescent populations.

This multiple case study examined the feasibility and effectiveness of an innovative residential treatment, based on Schema Therapy (ST), for adolescents with disruptive behaviors and Personality Disorder (PD) traits. We reported case narratives as well as quantitative changes in behavior problems, early maladaptive schemas, and schema modes of four patients. In terms of feasibility, the therapist was able to use the full range of ST techniques (working in the here and now, experiential techniques, and cognitive-behavioral techniques) with all four patients. We trained and coached treatment teams in ST theory and practice, and were partially successful in involving patients' parents in the ST treatment. Qualitative and quantitative findings showed that patients improved in their behavior problems, early maladaptive schemas, and schema modes. These results support the feasibility of ST for adolescents with disruptive behaviors and PD traits in residential treatment, and provide preliminary evidence of its effectiveness.

Personality disorders are complex mental health problems, associated with chronic dysfunction in several life domains. Adolescents suffer from these disorders as well. The present study is a naturalistic case study, investigating whether group schematherapy (GST) can be applied to adolescents with personality disorders or personality disorder traits. Four clinically referred patients were included and completed questionnaires on quality of life, symptoms of psychopathology, schema modes, early maladaptive schemas, and schema coping styles. Patients participated in weekly GST sessions complemented by weekly or 2-weekly individual sessions. The parents of the adolescents participated in a separate parent group. From pre- to post-treatment, results demonstrated improvements for some patients in quality of life and symptoms of psychopathology. Changes in a number of modes and schemas were observed in all patients from pre- to post-therapy. In addition to assessing changes from pre- to post-treatment, the current study investigated the temporal changes in modes during therapy as well. Results demonstrated that maladaptive modes decreased, whereas healthy modes increased for all patients across the course of therapy. The present study provides preliminary support for the applicability of GST for adolescents as well as the effectiveness of GST. It is a starting point for further research on this intervention.

Eye movement desensitization and reprocessing (EMDR) is a popular treatment for posttraumatic stress disorder. However, little is known about the memory effects of EMDR. Using a misinformation paradigm, we examined whether lateral eye movements, as used in EMDR, enhance susceptibility to false memories. Undergraduates ( N = 82) saw a video depicting a car crash. Subsequently, participants either performed eye movements or held their eyes stationary. Afterward, all participants received misinformation in the form of an eyewitness narrative. The results indicate that eye movement participants were less accurate and were more susceptible to the misinformation effect than controls. Our finding suggests EMDR may have risky drawbacks in an eyewitness context and therefore urgently needs follow-up research.

ispartof: CLINICAL PSYCHOLOGICAL SCIENCE vol:7 issue:3 pages:405-406 status: published

The Structured Clinical Interview for DSM-IV Childhood Disorders (Kid-SCID) is a semi-structured interview for the classification of psychiatric disorders in children and adolescents. This study presents a first evaluation of the psychometric properties of the Kid-SCID in a Dutch sample of children and adolescents who had been referred to an outpatient treatment centre for mental health problems. Results indicated that the inter-rater reliability of the Kid-SCID classifications and the internal consistency of various (dimensional) criteria of the diagnoses were moderate to good. Further, for most Kid-SCID diagnoses, reasonable agreement between children and parents was found. Finally, the correspondence between the Kid-SCID and the final clinical diagnosis as established after the full intake procedure, which included the information as provided by the Kid-SCID, ranged from poor to good. Results are discussed in the light of methodological issues pertaining to the assessment of psychiatric disorders in youths. The Kid-SCID can generally be seen as a reliable and useful tool that can assist clinicians in carrying out clinical evaluations of children and adolescents.

A cross-sectional study was conducted to examine loneliness and its correlates in children (7 to 11 years) and adolescents (12 to 18 years) with autism spectrum disorders (ASD, n = 73) and control groups of clinically referred (ADHD, n = 76) and non-clinical (n = 106) youths. Youths completed questionnaires on loneliness and desire for social interaction, while parents and teachers filled out scales on other aspects of children's social functioning. Results indicated that only at an adolescent age, the ASD group reported higher levels of loneliness than the control groups. Further, the ASD group generally expressed relatively low levels of desire for social interaction, although these youths displayed a similar increase in the wish to belong during adolescence as participants in the control groups. Finally, the ASD group exhibited lower levels of social competence and social skills and higher levels of social problems and social anxiety than the control groups, and in all groups these social variables correlated in a theoretically meaningful with loneliness.

The present study investigated the relationship between parental rough-and-tumble (R&T) play and young children's anxiety symptoms. Parents of 105 non-clinical children (61 boys and 44 girls aged between 2 and 6 years) completed indices of childhood anxiety symptoms and parental trait anxiety and overprotection, as well as the Parental Play and Care Questionnaire, which was developed for the purpose of this study to assess parental R&T play and care activities. Results showed that fathers exhibited more R&T play towards their offspring, while mothers more often engaged in care activities. As predicted, trait anxiety and overprotection of mothers were positively related to child anxiety symptoms. No support was found for the idea that parental R&T play would be negatively related to childhood anxiety. However, an interaction effect of fathers' trait anxiety and R&T play on anxiety symptoms of the child was found: children tended to display higher levels of anxiety symptoms when their low trait anxious fathers were more involved in R&T play. The results provide support for the notion that mothers and fathers have unique parenting roles, which may have a differential impact on the development of anxiety symptoms in children.

Co-rumination involves excessively discussing personal problems with peers. This study examined correlates of co-rumination in a sample of 233 adolescents aged 12-15 years. Participants completed a battery of self-report questionnaires including the Co-rumination Scale. Results first of all showed that the Co-rumination Scale consists of three factors that can be labeled as 'comprehension', 'frequency', and 'detailed information'. Further, results showed that co-rumination, and in particular the factor of comprehension, was positively associated with symptoms of depression under the condition that communication with peers was low. Thus, in the absence of communication with peers, youngsters seem to co-ruminate with their best friend in order to get a better understanding of their problems. This suggests that co-rumination can best be seen as a behavioral coping strategy to deal with depressed mood.

BackgroundSubthreshold psychotic and bipolar experiences are common in major depressive disorder (MDD). However, it is unknown if effectiveness of psychotherapy is altered in depressed patients who display such features compared with those without. The current paper aimed to investigate the impact of the co-presence of subclinical psychotic experiences and subclinical bipolar symptoms on the effectiveness of psychological treatment, alone or in combination with pharmacotherapy.MethodIn a naturalistic study, patients with MDD (n = 116) received psychological treatment (cognitive behavioural therapy or interpersonal psychotherapy) alone or in combination with pharmacotherapy. Depression and functioning were assessed six times over 2 years. Lifetime psychotic experiences and bipolar symptoms were assessed at the second time point.ResultsSubclinical psychotic experiences predicted more depression over time (β = 0.20, p p p p ConclusionsIn general, subclinical psychotic experiences have a negative impact on the course and outcome of psychotherapy in MDD. Effects of subclinical bipolar experiences were less prominent.

Background: Controversy persists about how effectively empirically-supported treatments for major depression work in actual clinical practice as well as how patients choose among them. We examined the acute phase effectiveness of cognitive therapy (CT), interpersonal psychotherapy (IPT), and combined psychotherapy-pharmacotherapy (PHT) in a naturalistic setting, allowing patients their choice of treatment. Methods: The study compared CT (n=63), IPT (n=56), CT-PHT (n=34), and IPT-PHT (n=21) for 174 subjects with major depression in a secondary care mood disorders clinic. Patient preference, rather than randomization, determined treatment selection. The Beck Depression Inventory-II (BDI) was the primary outcome variable. Exclusion criteria were minimal. Results: All treatments were associated with a reduction in depressive symptoms, with a 35% remission rate by week 26. Overall improvement was well within ranges reported in efficacy trials. On average, treatment effects of the different interventions straddled the same range, but moderation analyses revealed that BDI scores dropped faster in the first 16 weeks in patients who received CT alone than patients who received CT and pharmacotherapy, a pattern not found in patients who received IPT (with or without pharmacotherapy). Limitations: Limitations consist of a modest sample size, choice of treatment was made by participants which may have been influenced by many sources, and the absence of a non-active control group. Conclusions: This study supports the effectiveness of empirically-supported antidepressant treatments selected by patients in routine settings, and provides an indication that speed of therapeutic response may vary amongst treatments. (c) 2012 Elsevier B.V. All rights reserved.

The Beck Depression Inventory (BDI-II) is a widely used instrument that provides information about the presence and severity of depressive symptoms. Although the BDI-II is a psychometrically sound instrument, relatively little is known about norm scores. This study aimed to develop reliable norms for the BDI-II in a Dutch community sample. Gender, age, and education were hypothesized to predict BDI-II scores. A total of 7,500 respondents from a community sample in The Netherlands completed the BDI-II. It was investigated by means of multiple regression analysis whether distinct norms for genders, education levels, and age group are appropriate. BDI-II scores depended on gender and education level, but not on age. BDI-II norms were computed based on the final regression model. These BDI-II norms can be used for diagnostic purposes, clinical decision making, or the evaluation of treatment effects. © 2012 Springer Science+Business Media, LLC.

A social skills training (SST) for high-functioning children with autism spectrum disorders (ASD) was evaluated in an outpatient setting using a combined between- and within-subject design in which SST and a waiting list condition were compared. According to parents and teachers, the SST produced greater improvement of social skills than the waiting list, and these effects were maintained at 3 months follow-up. No between-group effects were found for loneliness, although in general scores on this outcome measure decreased from pre- to follow-up. The effects of SST were unaffected by social anxiety, ADHD symptoms, Theory of Mind, or desire for social interaction. Altogether, SST seems an effective intervention for high-functioning children with ASD that can be applied in daily clinical practice.

Schema modes are strong, predominant, momentary (state-like) emotional and cognitive states, and maladaptive coping responses that occur when underlying personality schemas are activated by emotional events. The current study employed the Schema Mode Inventory for Adolescents (SMI-A) to assess such schema modes in a sample of non-clinical adolescents (n = 530). Confirmatory factor analysis revealed that the hypothesized model of the SMI-A with 14 separate schema modes provided a good fit for the data. Reliability coefficients for the various schema modes were all in the adequate to good range. Finally, the validity of the SMI-A was supported by significant and meaningful relations between schema modes on the one hand and early maladaptive schema domains, symptoms of psychopathology, and quality of life on the other. Taken together, the psychometric properties of the SMI-A are promising, and the SMI-A can be considered a viable instrument to assess schema modes in adolescents.

In chronic low back pain (CLBP) research, the self-discrepancy model has been applied to explain dysfunctional avoidance and persistence behaviour. The main aim of this study was to evaluate whether specific self-discrepancies in patients with CLBP are associated with the abovementioned types of activity-related behaviour and whether changes in self-discrepancies over time are associated with changes in activity-related behaviour. Furthermore, the aim was to evaluate whether avoidance and persistence behaviour are associated with a higher level of disability and a diminished quality of life and whether changes over time in avoidance and persistence behaviour result in changes in disability and quality of life. A longitudinal cohort study in a sample of patients with CLBP (N = 116), in which self-discrepancies, disability, quality of life, and objectively registered characteristics of activity-related behaviour were measured, was performed to evaluate the pathways in the aforementioned self-discrepancy model. Results indicate that patients with CLBP who feel closer to their ideal-other show more characteristics of persistence behaviour. Patients who move further away from their ideal-own also show more characteristics of persistence behaviour. Furthermore, in patients characterized as avoider, a decrease in a patient's daily uptime was associated with a decrease of mental health-related quality of life. (C) 2011 International Association for the Study of Pain. Published by Elsevier B. V. All rights reserved.

This study examined associations between indices of the quality of attachment relationships of adolescents with parents and peers, rumination, and symptoms of depression. More specifically, a mediation model was investigated in which rumination was hypothesized to mediate the relation between quality of attachment relations and symptoms of depression. A total of 455 high school students completed a battery of questionnaires, including quality of attachment relations, rumination, and depression. Results showed that most indices of quality of attachment relations were significantly associated with rumination and symptoms of depression. When examining the relative contribution of these variables in explaining variance in depression symptoms, trust in parents, communication with peers, and alienation from peers accounted for a significant portion of the variance in depression scores. Finally, the relation between communication with peers and depressive symptoms was fully mediated by rumination, whereas partial mediation was found for the relations between parental trust and depressive symptoms, and between alienation from peers and depressive symptoms. Implications of the findings may be that the treatment of depression in adolescence should consist of both cognitive interventions aimed at targeting ruminative thinking as well as a focus on interpersonal relationships of the adolescent with parents and peers.

Background:Quality of attachment relations between adolescents and their parents and peers may be related to early maladaptive schemas as well as to symptoms of depression.Aims:The aim of the current study was to assess whether schema domains and maladaptive schemas mediate the relation between indices of quality of attachment relationships with parents and peers and symptoms of depression in non-clinical adolescents (N= 222).Method:A battery of questionnaires was completed, including measures of quality of attachment relations, maladaptive schemas, and depression.Results:The schema domains of disconnection and rejection and other-directedness mediated the relation between quality of attachment relationships and symptoms of depression. More precisely, the schemas’ mistrust/abuse and social isolation mediated the relation between trust in parents and depressive symptoms, whereas the schemas’ social isolation and self-sacrifice mediated the relation between alienation from peers and symptoms of depression.Conclusions:The mediation analyses suggest that treatment of adolescent depression could be focused on both attachment bonds and on changing maladaptive schemas.

Chronic pain not only interferes with daily activities, it may also have a negative impact on the perceived integrity of one's self through self-discrepancies. Self-discrepancies are experienced distances between the actual self and self-guides that can exist from 2 perspectives (ie, own and other). Self-discrepancies are associated with negative mood states and incite self-regulatory behavior in order to reduce these discrepancies. The present study was aimed at replicating the emotional consequences of self-discrepancies in patients with chronic low back pain, and extending current knowledge of the behavioral consequences of self-discrepancies (ie, behavioral activity patterns such as avoidance and persistence). A cross-sectional design was employed with 83 patients who completed a number of self-report measures. We hypothesized that ideal and ought discrepancies, as well as feared congruencies were associated with depressed and anxious mood. On the behavioral level, a U-shaped relationship was hypothesized between ideal and ought self-discrepancies and persistence behavior, whereas feared self-discrepancies were hypothesized to be related to avoidance behavior. Results were partially in line with the hypotheses. With respect to the emotional consequences, feared (own and other) self-discrepancies were predictive of depressive and anxious mood. With regard to activity patterns, results showed a U-shaped relationship between ideal-other self-discrepancies and persistence behavior and a positive relationship between feared-own self-discrepancies and avoidance behavior. In contrast to expectations, none of the other self-discrepancies was related to activity patterns. Of interest was that avoidance, but not persistence behavior, was predictive of higher levels of disability and lower levels of quality of life. Support is provided for the role of self-discrepancies in the emotional well-being and behavioural patterns of patients with chronic low back pain.

Prior research has shown that depressive symptoms are associated with an enhanced attention toward negative stimuli and difficulty of disengaging attention from negative stimuli. The current study was an extension of a 2005 study by Koster and colleagues. A different stimulus presentation time and word set were used. The whole range of depressive symptoms was included in this sample instead of creating dichotomized groups. The Exogenous Cueing Task with negative, positive, and neutral cues was administered to 85 female undergraduate university students. Participants completed the Beck's Depression Inventory-II-NL questionnaire to measure self-reported depression. Contrary to previous findings, depressive symptoms were related to a facilitated rather than impaired attentional disengagement from negative stimuli. An explanation for the discrepancy with findings from Koster, et al. may be the different stimulus presentation time (1,000 msec, instead of 500 or 1,500 msec). (PsycINFO Database Record (c) 2011 APA, all rights reserved) (journal abstract)

This study aimed to (a) assess relationships between the Children's Depression Inventory (CDI) and DSM-oriented depression and anxiety scales of the Youth Self Report, (b) develop reliable norms for the CDI, and (c) determine CDI cutoff scores for selecting youngsters at risk for depression and anxiety. A total of 3,073 nonclinical and 511 clinically referred children and adolescents from The Netherlands and Belgium were included. Results showed that CDI scores were significantly related to DSM-oriented symptoms of both depression and anxiety. CDI scores correlated highly with depression symptoms and moderately with anxiety symptoms. Norms for the CDI were determined by means of multiple regression analysis and depended on sex, age, and country. CDI cutoff scores for selecting individuals at risk for depression and anxiety as measured by the DSM-oriented depression and anxiety scales of the Youth Self Report were determined by means of multiple regression analysis and receiver operating characteristic analysis. A CDI score of 16 was found to have the most optimal balance between sensitivity and specificity for depression, whereas a score of 21 provided the best sensitivity and specificity for anxiety in a subsample of children. We conclude that the CDI is an effective instrument for screening depression and to a lesser extent anxiety in primary and secondary care centers, before applying further assessment of high-risk individuals.

We investigated the relationships of adolescents' internalizing and externalizing behaviors with their early maladaptive schemas (EMS), coping responses, and schema modes. We focused on EMS related to experiences of disconnection and rejection that comprise vulnerable emotions, such as shame, mistrust, deprivation, abandonment, and isolation/alienation. This cross-sectional study included a total of 699 adolescents (combined clinical and non-referred sample) who were 11 to 18 years old (M = 14.6; SD = 1.6), and of which 45% was male. All participants completed self-report questionnaires on EMS, coping responses, schema modes, and behavior problems. We aimed to clarify the relationships between these variables by testing mediation, moderation, and moderated mediation models. In general, coping responses functioned as mediators rather than moderators in the relationships between EMS and schema modes. Furthermore, EMS regarding experiences of disconnection and rejection were related to both internalizing and externalizing behavior problems, and coping responses and schema modes mediated these effects. In conclusion, although adolescent internalizing and externalizing behavior problems manifest quite differently, they seem related to the same EMS.

Patients with chronic pain are not only faced with disabilities but are also challenged to maintain a valued sense of self. This sense of self is in part determined by the extent to which patients can accomplish their identity-related goals. The present study explores the content of three domains of the self, namely the ideal, ought and feared self and examines how the content relates to disability and depression. The ideal, ought and feared attributes of 80 chronic low back pain patients were analyzed and categorized in eight general goal-domains: interpersonal attributes, personal abilities, physical, emotional and psychological well-being, close interpersonal relationships, self-expression abilities, achievement-related attributes, physical appearance, and religion. Results showed that most of the attributes that patients generated involved interpersonal attributes. Comparisons between the self-guides revealed that ideal attributes were more intrapersonally focused while ought and feared attributes were interpersonally focused. The content appeared to be related to disability but not to depression. More specifically, the more disabled patients were, the more they listed well-being related attributes as part of their ought self. None of the other goal-domains was related to disability or depression. The present study provides additional insight into the goals of patients with chronic pain at the level of identity and has shown that these are, at least in part, related to the level of functional disability. These results might be useful for future studies incorporating the role of identity in chronic pain, such as psychological interventions. ispartof: European Journal of Pain vol:14 issue:6 pages:648-653 ispartof: location:England status: published

The present study sought to investigate psychometric properties of the Positive Beliefs about Rumination Scale (PBRS) and the Negative Beliefs about Rumination Scale (NBRS), two self-report measures of metacognitive beliefs of depressive rumination, in patients with major depressive disorder (N = 179). Confirmatory factor analysis of the PBRS showed good fit of the hypothesized one-factor model. The previously proposed two-factor model of the NBRS was supported after implementation of some modifications. The scales showed adequate to good internal consistency and validity was supported on some indices. Finally, the metacognitive model of rumination and depression was tested by means of structural equation modeling. After implementation of some theoretically consistent modifications, the model provided a good fit to the data. Clinical implications of the findings, including the implementation of a metacognitive-focused cognitive therapy of depression, and suggestions for future research are discussed.

The Dysfunctional Attitude Scale (DAS) was designed to measure the intensity of dysfunctional attitudes, a hallmark feature of depression. Various exploratory factor analytic studies of the DAS form A (DAS-A) yielded mixed results. The current study was set up to compare the fit of various factor models. We used a large community sample (N = 8,960) to test the previously proposed factor models of the DAS-A using confirmatory factor analysis. The retained model of the DAS-A was subjected to reliability and validity analyses. All models showed good fit to the data. Finally, a two-factor solution of the DAS-A was retained, consisting of 17 items. The factors demonstrated good reliability and convergent construct validity. Significant associations were found with depression. Norm-scores were presented. We advocate the use of a 17-item DAS-A, which proved to be useful in measuring dysfunctional beliefs. On the basis of previous psychometric studies, our study provides solid evidence for a two-factor model of the DAS-A, consisting of 'dependency' and 'perfectionism/performance evaluation'.

Deze meta-analyse had als doel om te onderzoeken in hoeverre de veronderstellingen van de response styles theory (rst), betreffende de relatie tussen rumineren en afleiding zoeken en depressieve klachten en geslachtsverschillen in het gebruik van deze responsestijlen, ondersteund worden in niet-klinische kinderen en adolescenten. In het samenvatten van de literatuur werden effectmaten (es) berekend voor cross-sectionele en longitudinale studies. De resultaten lieten zien dat stabiele en significante es werden gevonden voor de relatie tussen rumineren en depressie (zowel cross-sectioneel als longitudinaal), behoudens wanneer rekening werd gehouden met de voormetingen van depressie in de longitudinale studies. Ten slotte werd een significant en stabiel geslachtsverschil gevonden voor rumineren bij adolescenten. Samengevat, deze bevindingen leveren gedeeltelijke ondersteuning voor de rst en impliceren dat rumineren een cognitieve kwetsbaarheidfactor is voor depressieve klachten bij adolescenten, en middels diverse therapeutische technieken aangepakt kan worden.

This review examined evidence for some core predictions of the response styles theory (RST) concerning the relation between response styles and symptoms of depression and gender differences in the use of response styles in non-clinical children and adolescents. In summarizing the literature, effect sizes (pooled correlation coefficients) were calculated for cross-sectional and longitudinal studies. Stability of the obtained effect sizes was evaluated by means of a fail-safe N analysis. Results indicated that stable and significant effect sizes were found for rumination being associated with concurrent and future levels of depression. When controlling for baseline levels of depression, effect sizes for rumination and distraction were not stable, indicating that these findings should be interpreted with considerable caution. Finally, significant and stable effect sizes for gender differences in response styles were found only for rumination among adolescents. Taken together, the findings partly support the predictions of the response styles theory examined in this meta-analysis and may implicate that rumination is a cognitive vulnerability factor for depressive symptoms among adolescents.

Objectives Patients with social anxiety disorder (SAD) not only fear social rejection, but accumulating evidence also shows that they are indeed less liked than their non-anxious counterparts. Three factors are hypothesized to play a role in this social anxiety–social rejection relationship: (1) social performance; (2) elicited negative emotions, and (3) perceived similarity. Method Patients with SAD (N = 63) and control participants (N = 27) were observed during a 5 minutes ‘getting acquainted’ conversation with a male and female confederate who rated their social performance. Video-observers rated their own negative emotions and perceived similarity with the patients, while other video-observers rated their wish to engage in future contact with them (a measure of social rejection). Results Analysed by way of structural equation modelling (SEM), the results supported the social anxiety–social rejection relationship. More specifically, poor social performance was associated with perceived dissimilarity ratings and mediated by evoked negative emotions, both of which were in turn associated with social rejection. Conclusion These results suggest that a sequence of events links social anxiety to social rejection. Treatment should aim to improve social performance and perceived similarity to reverse SAD's vicious, negative interpersonal cycle.

Rumination and worrying are considered possible mediating variables that may explain the relation between neuroticism and symptoms of depression and anxiety. The Current study Sought to examine the mediational effects of rumination and worry in the relationships between neuroticism and symptoms of depression and anxiety in a sample of clinically depressed individuals (N = 198). All patients completed a battery Of questionnaires including measures of neuroticism, rumination, worrying, depression, and anxiety. Results showed that in subsequent analyses, rumination and worrying both mediated the relation between neuroticism and depression and anxiety. When rumination and worrying were simultaneously entered in the mediation analysis, only rumination Was found to mediate the relation between neuroticism and symptoms of anxiety and depression. Two Components of rumination (i.e., brooding and reflection) were also analyzed in the mediational analysis. Both reflection and brooding were significant mediators with respect to depressive symptoms, whereas brooding was the only significant mediator in relation to anxiety symptoms. The results are discussed in the light of current theories, previous research, and recent treatment developments. Clinical implications and Suggestions for future research are provided.

Neuroticism, is considered a vulnerability factor for depression and anxiety but the mechanism by which this vulnerability is increased is unknown. Rumination is considered a psychological vulnerability for depression and anxiety. The current study sought to examine the mediational effects of different components of rumination (i.e., rumination on sadness, symptom-based rumination, rumination on causes of sadness) in the relationships between neuroticism and symptoms of depression and anxiety in a sample of non-clinical undergraduates (N = 192). In line with the expectations, rumination on sadness was associated with more symptoms of depression and anxiety, while rumination on causes of sadness was related to fewer symptoms of depression but not anxiety. However, symptom-based rumination was not associated with depression or anxiety scores when controlling for the other two rumination factors. Furthermore, rumination on sadness partially mediated the relation between neuroticism and symptoms of depression and anxiety. Rumination on causes of sadness was found to partially mediate the relationship between neuroticism and symptoms of depression but not anxiety, indicating that this component of rumination might be characteristic for depressive symptomatology. The results are discussed in the light of current theories, previous research, and recent treatment developments. Clinical implications and suggestions for future research are provided.

This study examined psychometric properties of a Dutch version of the Fear of Pain Questionnaire (FPQ-DV), a measure of pain-related fear, in a sample of undergraduates. Confirmatory factor analysis showed inadequate fit of the hypothesized three-factor model of the FPQ-DV (e.g., severe pain, minor pain, medical pain). Within the subscales, some items were more strongly intercorrelated. A good fit of the model to the data was found when these items were allowed to correlate. The three-factor model of the FPQ-DV was retained as the changes to the model occurred within the subscales. With respect to the reliability, both the FPQ-DV and its subscales were internally consistent but test-retest stability was moderate. Convergent validity of the FPQ-DV (and the subscales) was (partly) supported by moderate correlations with related constructs. Further, discriminant validity of the FPQ-DV and the subscales was supported by low correlations with unrelated self-report measures. Moreover, modest correlations coefficients were found between the FPQ-DV (and the subscales) and other pain-related measures. Future research should be aimed at either reducing the number of items of the FPQ-DV or splitting the medical pain scale into a fear of injection and a dental fear scale. Further, the relative contribution of the FPQ-DV beyond other measures of pain-related pain should be established.

Contains fulltext : 49338.pdf (Publisher’s version ) (Closed access) STUDY DESIGN: Prospective inception cohort study. OBJECTIVE: To investigate prospectively whether pain-related fear predicts future perceived disability and participation in patients with acute low back pain (LBP). SUMMARY OF BACKGROUND DATA: There are indications that fear of movement/(re)injury, as measured by the Tampa Scale for Kinesiophobia, is present early in an episode of LBP, and that it might be a predictor of future perceived disability and participation. METHODS: A cohort of 555 patients with acute LBP included by general practitioners and physical therapists in primary care settings was followed for 6 months. RESULTS: Results indicate that baseline fear of movement/(re)injury was predictive of future perceived disability and, to a lesser extent (and together with duration and radiation), of participation. CONCLUSIONS: The results suggest that interventions aimed at reducing pain-related fear in the acute stage of LBP might prevent restrictions of activity and participation because of pain, and might be a way of preventing the transition from acute to chronic LBP.

Contains fulltext : 49973.pdf (Publisher’s version ) (Closed access) Pain-related fear and pain catastrophizing are associated with disability and actual performance in chronic pain patients. In acute low back pain (LBP), little is known about the prediction of actual performance or perceived disability by pain-related fear and pain catastrophizing. This experimental, cross-sectional study aimed at examining whether pain-related fear and pain catastrophizing were associated with actual performance and perceived disability. Ninety six individuals with an episode of acute LBP performed a dynamic lifting task to measure actual performance. Total lifting time was used as outcome measure. The results show that pain-related fear, as measured with the Tampa Scale for Kinesiophobia, was the strongest predictor of this physical task. Using the Roland Disability Questionnaire as a measure of perceived disability, both pain-related fear and pain catastrophizing, as measured with the Pain Catastrophizing Scale, were significantly predictive of perceived disability and more strongly than pain intensity was. The results of the current study suggest that pain-related fear is an important factor influencing daily activities in individuals suffering an episode of acute LBP. The study results have important clinical implications, especially in the development of preventive strategies for chronic LBP.