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Objective The objective of this paper was to examine the relationships between perceived parental bonding, Early Maladaptive Schemas (Young et al., 2003), and outcome of schema therapy of Cluster C personality problems and whether the perceptions of parental bonding could be influenced by schema therapy. Method The sample consisted of 45 patients with panic disorder and/or agoraphobia and Diagnostic and Statistical Manual of Mental Disorders, fourth edition, Cluster C personality traits who participated in an 11-week inpatient programme consisting of two phases; the first was a 5-week panic/agoraphobia-focused cognitive therapy, whereas the second phase was a personality-focused schema therapy. The patients were assessed at pre-treatment, mid-treatment and post-treatment and at 1-year follow-up. Results Opposite to our hypothesis, lower paternal care at pre-treatment was related to more reduction in Cluster C personality traits from pre-treatment to 1-year follow-up. Maternal protection was related to the schema domains of impaired autonomy and exaggerated standards. Overall schema severity and the schema emotional inhibition at pre-treatment were associated with less change in Cluster C traits. Perceived maternal care was reduced from pre-treatment to 1-year follow-up, and more reduction in maternal care was related to less reduction in Cluster C traits. Discussion Parental bonding failed to predict treatment outcome in the expected direction, but maternal protection was related to two of the schema domains. Overall schema severity and the particular schema emotional inhibition predicted outcome. Furthermore, perceived maternal care was reduced from before to after treatment. Future studies should examine these questions in larger samples of Cluster C patients receiving schema therapy of a longer duration. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Message Most schemas within the impaired autonomy domain and the schema self-sacrifice seem to be related to low perceived maternal protection., Overall schema severity and the schema emotional inhibition predict a poorer outcome of schema therapy of Cluster C personality problems, and therapy should give priority to emotional inhibition when this schema is endorsed., Therapists should be aware that schema therapy carries the risk to lead to a more negative view of mother's care during upbringing and this risk is accentuated with less benefit of therapy. [ABSTRACT FROM AUTHOR]

A randomized controlled trial is reported in which three treatments were compared for the management of depression in Primary Care. The treatments were Treatment As Usual (TAU) carried out by the General Practitioners, Cognitive-Behaviour Therapy (CBT) or Interpersonal Psychotherapy (IPT). Measurements of depressive symptomatology were taken at Baseline (Time1), at end of treatment (Time2), and at 5-month follow-up (Time3). An initial analysis of the longitudinal data revealed that there were a significant number of missing values, especially in the Time3 follow-up for the TAU group. That is, the missing data were not missing at random within the dataset, which is one of the considerations for usual procedures for replacement of missing values (RMV). The paper presents, therefore, the outcome of different approaches to RMV and their consequences for conclusions about the relative efficacy of the treatment conditions. The results showed that clients in all conditions improved significantly, with at least some analyses showing superiority of IPT and CBT at end of treatment Time 2. However, by the follow-up clients in all conditions performed equally well. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The study aim was to test whether a 12-week publically rebated group programme, based upon Steketee and Frost's Cognitive Behavioural Therapy-based hoarding treatment, would be efficacious in a community-based setting. Over a 3-year period, 77 participants with clinically significant hoarding were recruited into 12 group programmes. All completed treatment; however, as this was a community-based naturalistic study, only 41 completed the post-treatment assessment. Treatment included psychoeducation about hoarding, skills training for organization and decision making, direct in-session exposure to sorting and discarding, and cognitive and behavioural techniques to support out-of-session sorting and discarding, and nonacquiring. Self-report measures used to assess treatment effect were the Savings Inventory-Revised (SI-R), Savings Cognition Inventory, and the Depression, Anxiety and Stress Scales. Pre-post analyses indicated that after 12 weeks of treatment, hoarding symptoms as measured on the SI-R had reduced significantly, with large effect sizes reported in total and across all subscales. Moderate effect sizes were also reported for hoarding-related beliefs (emotional attachment and responsibility) and depressive symptoms. Of the 41 participants who completed post-treatment questionnaires, 14 (34%) were conservatively calculated to have clinically significant change, which is considerable given the brevity of the programme judged against the typical length of the disorder. The main limitation of the study was the moderate assessment completion rate, given its naturalistic setting. This study demonstrated that a 12-week group treatment for hoarding disorders was effective in reducing hoarding and depressive symptoms in an Australian clinical cohort and provides evidence for use of this treatment approach in a community setting. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message A 12-week group programme delivered in a community setting was effective for helping with hoarding symptoms with a large effect size., Hoarding beliefs (emotional attachment and responsibility) and depression were reduced, with moderate effect sizes., A third of all participants who completed post-treatment questionnaires experienced clinically significant change., Suggests that hoarding CBT treatment can be effectively translated into real-world settings and into a brief 12-session format, albeit the study had a moderate assessment completion rate. [ABSTRACT FROM AUTHOR]

The present study examines a more fine-grained analysis of anxiety-related and depression-related outcomes amongst a sample of treatment completers who were assigned to complicated grief treatment (CGT) ( n = 35) or interpersonal psychotherapy (IPT) ( n = 34) in a previously reported randomized controlled trial. We examined effects of antidepressant use and measures of anxiety and depression, focusing especially on guilt related to the death or deceased and grief-related avoidance in order to further understand the differential effectiveness of CGT and IPT amongst participants who received the full course of treatment. Analyses showed that CGT produced greater reductions in anxiety and depressive symptoms including negative thoughts about the future and grief-related avoidance. CGT's advantage over IPT in lowering depression was most pronounced amongst those not taking antidepressants. Our results further elucidate CGT effects and support the idea that CG and major depressive disorder are distinct conditions. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Message Targeted treatment for complicated grief (CG) produces benefits in associated mood and anxiety symptoms and CG symptoms., Amongst patients with CG, interpersonal psychotherapy seems relatively ineffective in ameliorating depressive symptoms., Grief-related depressive symptoms may not respond to standard treatments unless CG symptoms are also addressed., Reducing grief-related symptoms, such as anxieties about the future, guilt related to the death or deceased and avoidance of reminders of the loss may be important aspects in reducing CG. [ABSTRACT FROM AUTHOR]

Well-being is now defined in a number of multicomponent ways. One approach to defining well-being-psychological well-being (PWB; Ryff, )-encompasses six dimensions of positive functioning. This study's first aim was to compare PWB self-report scores from a group of depressed participants ( N = 26) with a non-depressed group ( N = 26). The second aim was to examine anticipated well-being, specifically, how the positive events people anticipate in the future are seen as being related to various aspects of their well-being. Participants completed the self-report scales of PWB and a task which elicited events participants were looking forward to in the future and their thoughts about what was good about those events. Responses about the value of the events were independently coded for the presence of the six PWB dimensions. The depressed group scored significantly lower on all dimensions of self-reported PWB than the control group, with particularly marked deficits on environmental mastery and self-acceptance. For anticipated events, positive relations with others was the most commonly present aspect of PWB in participants' responses about what was good about the events. The frequency of PWB dimensions present in participants' responses was similar between the two groups with the exception of the depressed group having more self-acceptance related responses and fewer positive relationship responses. The well-established lack of positive anticipation found in depressed individuals is likely to mean a diminished resource for a wide range of aspects of well-being but especially positive relationships with others. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Message The treatment of depression is thought to be more effective when it enhances psychological well-being as well as reducing dysfunction., In the present study, all dimensions of psychological well-being were lower in depressed participants with particularly marked deficits in environmental mastery and self-acceptance, suggesting that these may be particularly important treatment targets., People with depression show specific deficits in being able to anticipate future positive events., The present study suggests that anticipated well-being linked to positive relationships with other people may be particularly impacted by the lack of anticipated future events found in depression. [ABSTRACT FROM AUTHOR]

Paranoid personality disorder (PPD) presents as chronic and widespread interpersonal distrust, whereby the actions of others are interpreted as malevolent and malicious. This research details the assessment, formulation and treatment of a case of PPD within a 24-session contract of cognitive analytic therapy (CAT). The outcome methodology was an A/B with extended follow-up single case experimental design (SCED). The SCED was supplemented with qualitative patient interviewing via the Change Interview regarding their experience of CAT, whether change had taken place and detailing of any identified change mechanisms. Quantitative results show that five out of the six daily rated paranoia target complaint measures were extinguished during the treatment phase. Qualitatively, the patient attributed change to the therapy conducted. The results suggest that CAT was an effective intervention in this case of PPD and are discussed in terms of identified methodological shortcomings, treatment implications and the potential for generating a convincing evidence base for the psychotherapy of PPD. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Message Narrative reformulation using a CAT model offers a key opportunity for the patient to achieve a new understanding of their paranoia., Psychotherapy for PPD requires a cognitive component, within a boundaried and relational therapy, that is able to reflect on paranoid enactments and ruptures within the therapeutic relationship., There is a large role for clinician-researchers in developing a PPD outcome evidence base. [ABSTRACT FROM AUTHOR]

Background It has been increasingly recognized that subthreshold depression is associated with considerable personal, social and economic costs. However, there is no accepted definition or clear-cut treatment for subthreshold depression. Cognitive bibliotherapy is a promising approach, but further research is necessary in order to assess its clinical efficacy and key mechanisms of change. Aim This study aimed to investigate the efficacy of bibliotherapy for subthreshold depression and test whether maladaptive cognitions mediate the effects of bibliotherapy on depressive symptoms. Method A total of 96 young adults with subthreshold depression were randomized in one of the following treatment conditions: immediate treatment, delayed treatment, placebo and no treatment. The main outcome was represented by depressive symptoms assessed before, during and immediately after the treatment, as well as at 3-month follow-up. Automatic thoughts, dysfunctional attitudes and irrational beliefs were also assessed throughout the study, and we investigated their involvement as mediators of bibliotherapy effects on depressive symptoms. Results The results indicated that cognitive bibliotherapy resulted in statistically and clinically significant changes both in depressive symptoms and cognitions, which were maintained at follow-up. In contrast, placebo was only associated with a temporary decrease in depressive symptoms, without significant cognitive changes. No changes in symptoms or cognitions were found in the delayed treatment and no treatment groups. We also found that automatic thoughts significantly mediated the effect of bibliotherapy on depressive symptoms. Conclusion This study provided compelling evidence for the efficacy of cognitive bibliotherapy in subthreshold depression and showed that changes in automatic thoughts mediated the effect of bibliotherapy on depressive symptoms. Copyright © 2012 John Wiley & Sons, Ltd. Key Practitioner Message Cognitive bibliotherapy is an effective treatment of subthreshold depression., Changing automatic thoughts is important, as they mediate the bibliotherapy effect on depressive symptoms., Cognitive bibliotherapy is a potential alternative or adjunct to psychotherapy for mildly depressed adults. [ABSTRACT FROM AUTHOR]