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In psychotherapeutic treatment of trauma-affected refugees, it is common that psychologists and language interpreters work together. In this qualitative study, the experiences of interpreters and psychologists are examined to gain insight into factors that enhance and challenge the interaction between the two groups of professionals. Three interpreters and three psychologists working with trauma-affected refugees in Denmark were interviewed about their perceptions of conducting interpreter-mediated psychotherapy (IMP) and their experiences of the interaction between interpreters and psychologists. The interviews followed a semi-structured format and were analyzed according to Interpretative Phenomenological Analysis (IPA). In the analysis, we found that the role of the interpreter is ambiguous. A neutral and objective interpreter was described as ideal, yet interpreters found it difficult to adhere to strict neutrality and psychologists sometimes also requested a more active engagement of the interpreters. Further, we found that conflicts in the interaction between psychologists and interpreters emerged when the two professionals intervened with each other's areas of expertise. These findings are discussed by including theory concerning therapeutic alliance and interprofessional collaboration., Author(s): Jasmin Rejaye Gryesten [sup.1] [sup.2] [sup.3] [sup.4] , Kathrine Jastrup Brodersen [sup.1] [sup.2] , Laura Glahder Lindberg [sup.2] [sup.5] , Jessica Carlsson [sup.2] [sup.6] , Stig Poulsen [sup.1] Author [...]

Psychometric analyses of different rating scales have shown that the construct validity of depression in relation to patients from other cultural backgrounds than Western is unclear. This calls for more knowledge on the qualitative properties of depression in a transcultural context. The aim of the study was to examine how Arabic speaking patients understand and speak about mental distress, while also exploring to what degree they find depressive symptoms as defined in the ICD-10 and selected rating scales meaningful. Six semi-structured interviews with Arabic speaking patients from Syria, Lebanon and Iraq receiving treatment at a Danish treatment centre were conducted. Data was analysed by the use of thematic analysis. Various Arabic terms in relation to a state comparable to depression were obtained, especially in relation to the core depressive symptoms of 'low mood', 'low energy' and 'loss of interest'. Symptoms regarding guilt and loss of self-confidence were not recognized as a part of a depressive state to the same degree as the other depressive symptoms. Some symptoms, such as somatic complaints, were more accepted to speak openly about than others. It was concluded that the participants in the study generally recognized the depressive symptoms as defined in the ICD-10 and would use comparable Arabic terms to describe mental distress. However, cultural background may influence to what extend depression is accepted to speak about, which should thus be taken into consideration and addressed by mental health professionals. In a clinical setting, this knowledge can be used to include culture specific terms and phrases in the conversations with Arabic speaking patients., Author(s): Hanke Vink [sup.1] , Jessica Carlsson [sup.1] , Stig Poulsen [sup.1] , Erik Vindbjerg [sup.1] Author Affiliations: (1) grid.425848.7, 0000 0004 0639 1831, Competence Centre for Transcultural Psychiatry, , [...]

Objective: Theoretical conceptualizations of emotion and affect regulation have a considerable common ground. However, mentalization theory considers the ability to regulate affects as being contingent on the ability to mentalize. The aim of the present study is to examine the association between emotion regulation and mentalization, operationalized as reflective functioning, in a sample of patients with depression and/or anxiety. Methods: The study used data from the TRAns‐diagnostic Cognitive behavioural Therapy versus standard cognitive behavioural therapy (TRACT‐RCT) trial. Patients with depression and/or anxiety (N = 291; 64.4% female; Mage = 32.2; SD = 11.0) completed the Emotion Regulation Strategies Questionnaire (ERSQ) and the Reflective Functioning Questionnaire (RFQ‐6). Correlation and regression analyses were performed to determine associations of the measures of ERSQ and RFQ‐6 in relation to the outcome variables, global well‐being (World Health Organization Well‐being Index; WHO‐5) and social functioning (Work and Social Adjustment Scale; WSAS). Results: Overall, the patients had a reduced level of emotion regulation (MERSQ_Total = 1.77; SD = 0.59). However, only mildly impaired reflective functioning was found (MRFQ‐6 = 3.57; SD = 1.26). ERSQ correlated significantly with RFQ‐6 (r = −0.31), that is, more frequent use of emotion regulation strategies was associated with less hypomentalization. ERSQ was a stronger predictor of well‐being and social function than RFQ‐6. Conclusion: In patients with anxiety and/or depression, hypomentalization as measured by the RFQ‐6 is not a major problem, but emotion regulation is. It seems that these two, theoretically related constructs, do not necessarily co‐occur. Alternatively, the RFQ‐6 scale might not capture the mentalization construct in a valid way. Emotion regulation strategies are highly related to symptomatology; therefore, they are likely to be an important target for psychotherapy. [ABSTRACT FROM AUTHOR]

Stigmatization within mental health care has previously been identified, and some diagnoses have been shown to be particularly exposed to negative attitudes and stigma. However, no previous studies have explored practitioners' discursive construction of patients with different diagnoses within a transdiagnostic group context. We performed discourse analysis on 12 interviews with Danish mental health practitioners, who had been conducting either transdiagnostic psychotherapy (The Unified Protocol) or standard group cognitive behavioral therapy (CBT) with patients treated for anxiety disorders or major depressive disorder. The purpose of this study was to identify how patients with anxiety and depression were represented by therapists. We identified a "training discourse," within which patients were evaluated through perceived motivation, responsibility, active participation, and progression. We argue that this training discourse can be related to a broader neoliberal order of discourse valuing efficiency and agency. The analysis indicated that patients with anxiety were sometimes "favorized" over patients with depression, and it is argued that the neoliberal order of discourse and pre-assumptions related to the diagnoses are contributing to this. The interviews indicate that multiple discourses were applied when describing patients, and ambivalence was often detectable. We discuss the findings of the analysis in relation to therapists' general critical attitudes toward the psychiatric system and in relation to broader societal tendencies. [ABSTRACT FROM AUTHOR]

The Work and Social Adjustment Scale (WSAS) is a self-administered measure designed to assess the level of inability to function socially as a consequence of a defined problem or disorder. A total of 230 patients with emotional disorders completed the Danish translation of the WSAS, measures of anxiety and depression, the Level of Personality Functioning Brief Form, the Personality Inventory for DSM-5 Short Form, and the World Health Organization Five-Item Well-Being Index (WHO-5). We conducted a confirmatory factor analysis of the previously suggested factor structure of the instrument. We furthermore evaluated the construct validity of the WSAS by means of its relationship with depression, anxiety, personality functioning, and overall well-being. Finally, we evaluated the utility of the WSAS to identify those on long-term sick-leave by conducting receiver operating characteristic (ROC) curves. The instrument had a poor to average fit with the previously reported single-factor structure, but a better fit to a modified single-factor structure. Cronbach's alpha and McDonald's omega showed good internal scale reliability (α =.79, ωtotal =.85). WSAS was positively correlated with measures of anxiety (r =.33), depression (r =.44), and personality functioning (r =.23 and r =.20), and negatively correlated with WHO-5 wellbeing (r = –.57). The optimal cut-off point in the ROC-analyses was 23, which yielded a sensitivity of 74% and a specificity of 55% in the prediction of sick-leave status. The Danish WSAS shows promising psychometric properties, but has limited external validity insofar as predicting long-term sick leave in psychiatric patients with emotional disorders. [ABSTRACT FROM AUTHOR]

Introduction: Borderline personality disorder (BPD) is a severe and prevalent psychiatric disorder. Mentalization-based therapy (MBT) is an evidence-based intervention for BPD, and several countries offer treatment programs for BPD lasting for years, which is resource demanding. No previous trial has compared short-term with long-term MBT. Objective: The aim of the study was to assess the efficacy and safety of short-term versus long-term MBT for outpatients with BPD. Methods: Adult outpatients (≥18 years) with subthreshold or diagnosed BPD were randomly assigned (1:1) to short-term MBT (5 months) or long-term MBT (14 months). The primary outcome was BPD symptoms assessed with the Zanarini Rating Scale for Borderline Personality Disorder. Secondary outcomes were functional impairment, quality of life, global functioning, and severe self-harm. All outcomes were primarily assessed at 16 months after randomization. This trial was prospectively registered at ClinicalTrials.gov, NCT03677037. Results: Between October 4, 2018, and December 3, 2020, we randomly assigned 166 participants to short-term MBT (n = 84) or long-term MBT (n = 82). Regression analyses showed no evidence of a difference when assessing BPD symptoms (MD 0.99; 95% CI: −1.06 to 3.03; p = 0.341), level of functioning (MD 1.44; 95% CI: −1.43 to 4.32; p = 0.321), quality of life (MD −0.91; 95% CI: −4.62 to 2.79; p = 0.626), global functioning (MD −2.25; 95% CI: −6.70 to 2.20; p = 0.318), or severe self-harm (RR 1.37; 95% CI: 0.70–2.84; p = 0.335). More participants in the long-term MBT group had a serious adverse event compared with short-term MBT (RR 1.63; 95% CI: 0.94–3.07; p = 0.088), primarily driven by a difference in psychiatric hospitalizations (RR 2.03; 95% CI: 0.99–5.09; p = 0.056). Conclusion: Long-term MBT did not lead to lower levels of BPD symptoms, nor did it influence any of the secondary outcomes compared with short-term MBT. [ABSTRACT FROM AUTHOR]