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Psychological treatments for social anxiety disorder (SAD) in adolescents have shown poorer outcomes than for other anxiety disorders. A relevant factor to consider for improving outcomes may be negative imagery. In this pilot study, we examined negative 'flashforward' imagery of feared catastrophic outcomes in adolescents with SAD and evaluated the feasibility and preliminary outcomes of a short eye movement desensitization and reprocessing (EMDR) intervention targeting this imagery. We used a case series design with a 1‐week baseline period. Outcomes included symptoms of social anxiety and avoidance related to selected social situations and features of associated flashforward imagery as the proposed mechanism of change during the intervention. We found that six out of seven assessed adolescents reported to experience flashforwards and rated image distress, vividness and threat appraisal as high. In these six participants (aged 14–17 years old), the short EMDR flashforward intervention appeared feasible and was followed by a decrease in social anxiety and avoidance in five participants, while no notable changes were observed during the baseline period. Furthermore, we observed a decrease in flashforward imagery features in at least five participants. Nonparametric tests of the overall (group‐based) changes during the intervention period partially supported these findings. Limitations include the small sample size and the lack of a control group. Results suggest that vivid and distressing flashforward imagery is a common experience and that targeting flashforwards with EMDR may be beneficial in treating social anxiety in youth. Further experimental research on effects and added value to current treatments is necessary. Trial Registration: Dutch Clinical Trial Register (National Trial Register [NTR]): NL8974 [ABSTRACT FROM AUTHOR]

Current models point to weight/shape concerns as core symptoms of eating disorders. A striking feature of these concerns is their persistence even in the absence of objective signs of overweight. To help delineate the mechanisms involved in persistent weight and shape concerns, we focused on feelings of disgust following food intake. In two studies, we tested if individuals with weight/shape concerns interpret feelings of disgust as a signal of threatening eating-disorder-related outcomes. Participants read scenarios involving high or low amounts of food intake that varied in the presence/absence of feelings of disgust. Following each scenario, participants rated perceived threat related to gaining weight. In Study 1, we compared women with high (n = 26) versus low (n = 32) weight/shape concerns. Specifically, the high group inferred heightened threat related to gaining weight when scenarios implied disgust. This disgust-based reasoning was especially pronounced following small amounts of food intake (i.e., low objective threat). These findings were replicated in Study 2 (N = 346) using a correlational approach. This study showed a positive relationship between weight/shape concerns and disgust-based reasoning for scenarios implying low objective threat of food-induced weight gain. Together, the results provide converging evidence consistent with the view that disgust-based emotional reasoning might be involved in weight/shape concerns. [ABSTRACT FROM AUTHOR]

Psychological treatment for social anxiety disorder (SAD) has been found to be less effective than for other anxiety disorders. Targeting the vivid and distressing negative mental images typically experienced by individuals with social anxiety could possibly enhance treatment effectiveness. To provide both clinicians and researchers with an overview of current applications, this systematic review and meta‐analysis aimed to evaluate the possibilities and effects of imagery‐based interventions that explicitly target negative images in (sub)clinical social anxiety. Based on a prespecified literature search, we included 21 studies, of which 12 studies included individuals with a clinical diagnosis of SAD. Imagery interventions (k = 28 intervention groups; only in adults) generally lasted one or two sessions and mostly used imagery rescripting with negative memories. Others used eye movement desensitization and reprocessing and imagery exposure with diverse intrusive images. Noncontrolled effects on social anxiety, imagery distress and imagery vividness were mostly large or medium. Meta‐analyses with studies with control groups resulted in significant medium controlled effects on social anxiety (d = −0.50, k = 10) and imagery distress (d = −0.64, k = 8) and a nonsignificant effect on imagery vividness. Significant controlled effects were most evident in individuals with clinically diagnosed versus subclinical social anxiety. Overall, findings suggest promising effects of sessions targeting negative mental images. Limitations of the included studies and the analyses need to be considered. Future research should examine the addition to current SAD treatments and determine the relevance of specific imagery interventions. Studies involving children and adolescents are warranted. [ABSTRACT FROM AUTHOR]

Current models propose that inhibited sexual arousal is a key component in maintaining sexual pain in women with Genito-Pelvic Pain/Penetration Disorder. It thus follows that enhancing sexual arousal may be an effective strategy to modulate pain, but this effect has not been successfully demonstrated with women, although it has been successful with men. This study built on previous works and examined if the pain-killing effect of sexual arousal might have been undermined by concurrently-elicited disgust. We tested whether women experience disgust as well as sexual arousal when viewing sex stimuli, and whether disgust has an exacerbating effect on pain. Female participants (N = 164) were randomly distributed to watch a porn, disgust, or neutral train-ride film. A cold pressor test (CPT) was utilized to induce pain at the same time that participants viewed their respective film. Pain was indexed by the duration that participants kept their hand in the cold water, and by self-reported pain intensity at the time they quit the CPT. The results showed no differences in pain across conditions. The sex stimulus elicited substantial disgust as well as sexual arousal, and there was a negative correlation between the two emotions. Disgust was not found to increase pain compared to both the neutral and sex conditions. Thus, the findings provide no support for a pain-modulatory effect of subjective sexual arousal on pain in women. This might, however, be due to the sex stimulus having elicited an ambivalent state between an appetitive and aversive emotion concurrently. [ABSTRACT FROM AUTHOR]

Increasing evidence indicates that disgust might compromise sexual functioning and can contribute to sexual problems. Although the stimuli and conditions that elicit disgust vary greatly across individuals, they cluster in three categories of disgust elicitors: Stimuli that are associated with an increased risk of the transmission of infectious diseases (pathogen disgust), stimuli that signal poor mating quality and may jeopardize reproductive success (sexual disgust), and behaviors that violate social norms (moral disgust). It has been argued that each of these categories of disgust may interfere with sexual responses. Thus far, research on the role of disgust in sexual contexts focused on external stimuli (e.g., sperm). Yet, recently it has been proposed that disgust can also become directed to features of the self. Such self-directed disgust may also apply to sexual contexts and contribute to sexual problems. As a first step to explore the relevance of self-disgust in sexual functioning, we tested if indeed particular sexual experiences have the ability to elicit self-disgust. Using a within subject design, participants (N = 124; all women) imagined themselves as well as others experiencing a series of sex-related scenarios, each relevant for one of the three categories of disgust, and subsequently rated their self-disgust. For all types of disgust, the scenarios evoked self-disgust, and the "self-perspective" elicited significantly more self-disgust than the "other-perspective." These findings support theoretical models pointing to the relevance of taking self-disgust into consideration as a factor that may compromise sexual functioning. Future research should test whether this also holds for men. [ABSTRACT FROM AUTHOR]

Summary: Sleep problems are very common in individuals with a mental disorder. Given the abundant evidence indicating the negative impact of disturbed sleep on mental health outcome, insight into the prevalence of all types of sleep disorders in specific mental disorders and neurodevelopmental conditions is of practical importance. Therefore, we estimated the prevalence of six types of sleep disorders with the Holland Sleep Disorders Questionnaire in an overall mental health sample (n = 1082) and separately for different mental and neurodevelopmental conditions. Furthermore, associations between specific sleep disorders, psychopathology and well‐being were studied. The impact of the total number of sleep disorders on these associations was examined. Overall, 46.2% of all participants scored above the cut‐off for having a sleep disorder. Specifically, 26.8% scored on insomnia, 12.1% on sleep breathing disorders, 9.7% on hypersomnia, 13.7% on circadian rhythm sleep–wake disorders, 11.2% on parasomnia, and 17.9% on sleep‐related movement disorders. Most sleep disorders were associated with greater severity of psychopathology and lower well‐being. These associations got stronger with an increasing number of sleep disorders. Our study revealed higher suspected prevalence of most sleep disorders in a mental disorder sample compared to the general population. Moreover, the presence of sleep disorder(s) was strongly associated with symptom severity and reduced well‐being. These findings extend the notion that early detection and treatment of sleep disorders in mental health populations is essential for psychiatric outcome. [ABSTRACT FROM AUTHOR]

Exposure therapy is the treatment of choice for specific phobias but prolonged exposure to feared stimuli is strenuous and may lead to treatment dropout. Previous research showed that repeated exposure to masked spiders was effective in reducing psychophysiological and behavioural fear responses, but appeared ineffective in changing subjective feelings towards spiders. This study investigated in an unselected female sample if masked counterconditioning would be more effective in reducing spider dislike compared to masked exposure, and if masked counterconditioning would also be more effective than non-masked counterconditioning. Women with varying levels of spider aversion (N = 272) were randomly assigned to one of four conditions. Three spider pictures were always (counterconditioning) or never (exposure) followed by smiling faces. For half of the participants in each condition the spiders were masked. Results indicated that participants rated the spider more positively after both masked counterconditioning and masked exposure. However, the increase in valence after masked counterconditioning was not significantly larger than after mere masked exposure, or after non-masked counterconditioning. Thus, our findings show that repeated exposure to masked spider pictures is effective in reducing spider aversion, but they provided no support for the anticipated added benefit of pairing the spider with positive stimuli. [ABSTRACT FROM AUTHOR]

Theory suggests that low meaning in life might be an important factor in the refractoriness of eating disorders (EDs). However, empirical findings on the relationship between life meaning and ED symptoms are relatively scarce, and previous studies are limited by their methodological approach. To expand on previous findings, the present study included a homogenous sample of first-year female students (N = 112), used a validated measure of ED symptoms, and included two measures of life meaning. As life meaning was not related to ED symptoms, the results of the current study cast doubt on the importance of low life meaning as a factor in nonclinical ED symptomatology. However, lower life meaning was related to higher body mass index (BMI). Future longitudinal studies are necessary to examine whether low life meaning can be best seen as a risk factor or as a consequence of increased BMI. [ABSTRACT FROM AUTHOR]