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The therapist is a neglected and poorly understood variable in pediatric rehabilitation. Much more attention has been paid to the role of intervention on client change than the role of therapist-related variables. This article synthesizes what is known in the adult and child mental health literature about the role of the therapist, and integrates this with work in pediatric rehabilitation. The article reviews the mental health literature on the therapist as a random variable associated with client outcomes (role of the therapist alone) and the role of three other therapist-related constructs: the therapist-client relationship (therapist and client), treatment implementation (therapist and intervention), and therapy process (therapist, client, and intervention considered holistically). Implications for clinical practice in pediatric rehabilitation include recognition of change as a multi-determined phenomenon involving common therapist-related factors, the therapist's role in creating facilitative conditions for change (through supportive relationships, positive expectancies, and mastery and learning experiences), and the importance of training in collaborative partnership skills. A contextual approach to therapeutic change is advocated, in which psychosocial factors and mechanisms are acknowledged, the therapist is seen as crucial, and the intervention process is seen as the context or vehicle through which changes occur. [ABSTRACT FROM PUBLISHER]

Experience sampling methodology (ESM) was used in a randomized controlled trial of short-term therapy to examine changes in daily affect and reactivity to daily event appraisals among depressed patients. Fifty-five depressed adults (mean age 37 years, 80 % female) were randomly assigned to one of two therapy conditions. Using an interactive voice response system, participants rated activities and emotional functioning eight times per day for 7 days. Twenty-nine participants completed treatment and repeated ESM at post-treatment. Broad improvements in mood, cognition, and physical functioning were similar across treatment conditions, with the largest improvements for markers of positive affect. Participants demonstrated increased resilience, i.e., diminished reactivity to stressors, at post-treatment. Changes in reactivity to positive daily situations were minimal. Findings underscore the utility of ESM in psychotherapy research and the importance of including measures of both positive and negative affect and experiences. [ABSTRACT FROM AUTHOR]

Introduction: Functional magnetic resonance imaging studies have shown changes in the activity of medial prefrontal, medial temporal, and occipital regions in major depressive disorder patients during recall of autobiographical memories. Electrophysiological underpinning of these changes is not known. It is also not clear whether they are a part of the clinical picture or appear at preclinical stages in individuals predisposed to depression. Method: In this study, the effect of depressive symptoms, as measured by the Beck Depression Inventory (BDI–II), on oscillatory dynamics accompanying retrieval of emotionally positive and negative autobiographical memories was investigated in a nonclinical sample using electroencephalographic event-related spectral power and connectivity measures. Results: Psychometric results showed that BDI scores correlated positively with the strength of negative emotion, vividness of negative memories, and their importance for participant’s life. In high BDI scorers, low-frequency synchronization, which is frequently used as a marker of emotional arousal, prevailed in negative episodes, whereas in low BDI scorers it prevailed in positive episodes. sLORETA localized sources of this synchronization in the medial prefrontal cortex. In negative episodes, depressive symptoms were associated with a diminished event-related connectivity in the alpha band in posterior regions and increased connectivity in beta and gamma bands in frontal regions. Conclusions: Overall, these results show that even at preclinical stages, depressive symptoms are associated with changes in electrophysiological processes accompanying retrieval of autobiographical memories. [ABSTRACT FROM PUBLISHER]

Depression is a developmental phenomenon with significantly increasing rates during adolescence. As Beck's cognitive model of depression has been commonly accepted to explain the development and maintenance of depression, it is crucial to understand how and when cognitive vulnerabilities predicted in this model begin to interact. Three sequential interpretations of this model were compared. The causal mediational interpretation identifies dysfunctional attitudes as most distal to depressive symptoms, followed by cognitive errors, cognitive triad, and negative automatic thoughts, with each construct successively more proximal to depressive symptoms. In the symptom model the causal chain is reversed, with depressive symptoms as the most distal construct, followed by negative automatic thoughts, the cognitive triad, cognitive errors, and then dysfunctional attitudes. The bidirectional model merges both interpretations in which the activation of cognitive constructs causes the development of depressive symptoms which in turn trigger and reinforce already existing dysfunctional attitudes. Further, while Beck's model of depression proposes full mediation, empirical studies identified repeatedly partial mediations. Thus, the causal meditational, the symptoms, and the bidirectional model were each tested as full and partial mediation models. Finally, sex differences in the associations between variables were studied. In the 3-wave longitudinal study, 518 high school students (62.7 % female, average age: 15.09 years) completed questionnaires measuring all mentioned elements of Beck's model. The bidirectional model with partial mediation fits the data best. Cognitive errors emerged as the main mediator in the bidirectional model with partial mediation and significant sex differences in the strengths of associations were identified. The findings demonstrate the relevance of adolescence as developmental period during which the examined associations develop into the network they form in adulthood. Further, psychological interventions focusing on cognitive errors promise to be most effective. [ABSTRACT FROM AUTHOR]

Background: Acute lymphoblastic leukemia (ALL) is one type of childhood cancer. In the past decades, cure rates of ALL have increased and the survivor's quality of life and physical fitness have become a growing concern. Furthermore cancer-related fatigue (CRF) is reported to be the most distressing symptom in cancer. Objective: We aimed to examine the effect of aerobic exercise on the physical fitness and fatigue in children suffering from ALL. Methods: Thirty patients of 8 to 16 years with ALL participated in this study. Participants were randomized to study group (Group A), who participated in supervised aerobic exercise program in addition to home program, and control group (Group B), who were instructed to maintain their usual level of activity in addition to home program. Measurement of physical fitness and fatigue were done at the baseline and after 16th weeks. Results: Post measurement results suggested that, there was significance difference between both groups (P< 0.05). The percentage of improvement of physical fitness and fatigue level for group A was 31.06% and 21.56% respectively, while the percentage of improvement for group B was 4.16 % and 2.78% respectively. Conclusion: Aerobic exercise is effective in improving physical fitness and management of CRF in children with ALL. [ABSTRACT FROM AUTHOR]

Copyright of Psychotherapy Research is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Neuroimaging research has identified systems that facilitate minimizing negative emotion, but how the brain is able to transform the valence of an emotional response from negative to positive is unclear. Behavioral and psychophysiological studies suggest a distinction between minimizing reappraisal, which entails diminishing the arousal elicited by negative stimuli, and positive reappraisal, which instead changes the emotional valence of arousal from negative to positive. Here we show that successful minimizing reappraisal tracked with decreased activity in the amygdala, but successful positive reappraisal tracked with increased activity in regions involved in computing reward value, including the ventral striatum and ventromedial pFC (vmPFC). Moreover, positive reappraisal enhanced positive connectivity between vmPFC and amygdala, and individual differences in positive connectivity between vmPFC and amygdala, ventral striatum, dorsomedial pFC, and dorsolateral pFC predicted greater positive reappraisal success. These data broaden models of emotion regulation as quantitative dampening of negative emotion and identify activity in a network of brain valuation, arousal, and control regions as a neural basis for the ability to create positive meaning from negative experiences. [ABSTRACT FROM AUTHOR]

Objectives: To determine the role of flexible goal adjustment in the impact of informal caregiving on depressive symptoms, using a longitudinal approach.Method: Data were gathered from the German Ageing Survey. This is a population-based longitudinal study among community-dwelling individuals aged 40 and above in Germany. Data were derived from the second (2002), third (2008) and fourth (2011) wave, drawing on 10,994 observations. Flexible goal adjustment was assessed using a scale by Brandstädter and Renner. Informal caregiving was measured by asking the individuals whether they provide informal care. Depressive symptoms were quantified by using the Center for Epidemiological Studies Depression scale.Results: Adjusting for several potential confounders, fixed effects regressions showed that the onset of informal caregiving markedly increased depressive symptoms. Furthermore, regressions revealed that this effect was significantly moderated by flexible goal adjustment.Discussion: Our results highlight the importance of informal caregiving for depressive symptoms. Furthermore, the importance of flexible goal adjustment in the relation between informal caregiving and depressive symptoms should be emphasized. Efforts to increase flexible goal adjustment might be beneficial in reducing depressive symptoms among informal caregivers. [ABSTRACT FROM AUTHOR]

Blunted positive affect is characteristic of depression. Altered positive affect regulation may contribute to this blunting, and two regulation strategies, dampening positive affect and positive rumination, have been implicated in depression. However, the conditions under which these strategies impart risk/protective effects prior to onset of depression are unknown. The current study examined 81 healthy children (age 7-10) at low and high risk for depression on the basis of maternal history of depression and tested how dampening and positive rumination interacted with the experience of recent positive life events to predict depressive symptoms. Children at high and low risk did not differ in their use of dampening or positive rumination. However, elevated use of dampening in the context of many positive life events predicted current depressive symptoms, and specifically anhedonic symptoms, in children at low-risk for depression. These findings held when controlling for negative rumination and negative life events. Positive rumination did not interact with positive life events but was associated with higher depressive symptoms in high-risk children. Results indicate that prior to the onset of depression, positive life events may impart risk when dampening positive affect is utilized in this context, while positive rumination may increase risk for depressive symptoms. [ABSTRACT FROM AUTHOR]

Self-regulation models of psychopathology provide a theory-based, empirically supported framework for developing psychotherapeutic interventions that complement and extend current cognitive-behavioral models. However, many clinicians are only minimally familiar with the psychology of self-regulation. The aim of the present manuscript is twofold. First, we provide an overview of self-regulation as a motivational process essential to well-being and introduce two related theories of self-regulation which have been applied to depression. Second, we describe how self-regulatory concepts and processes from those two theories have been translated into psychosocial interventions, focusing specifically on self-system therapy (SST), a brief structured treatment for depression that targets personal goal pursuit. Two randomized controlled trials have shown that SST is superior to cognitive therapy for depressed clients with specific self-regulatory deficits, and both studies found evidence that SST works in part by restoring adaptive self-regulation. Self-regulation-based psychotherapeutic approaches to depression hold significant promise for enhancing treatment efficacy and ultimately may provide an individualizable framework for treatment planning. [ABSTRACT FROM AUTHOR]

Recent studies suggest that reward anticipation decreases individuals' acute stress responses. However, individuals who have experienced early life stress (ELS) may have a blunted capacity for reward anticipation, which reduces its buffering effect on psychosocial stress responses. To investigate this phenomenon, 66 young adults completed the Trier Social Stress Test following a reward anticipation task, and their ELS levels were measured using the Childhood Trauma Questionnaire (CTQ). Meanwhile, the current study collected biological and psychological measures of stress by analysing cortisol levels, heart rates, heart rate variability (HRV) as well as subjective stress levels, in response to the Trier Social Stress test. Results showed that reward anticipation successfully decreased acute stress responses in general, and it also improved participants' HRV. However, this effect was more evident in individuals with low ELS than those with high ELS. These findings help us deepen understanding of the role of reward anticipation in fostering resilience under stress and the potentially important implications for individuals who have been exposed to ELS are also discussed., (© 2021 Society for Psychophysiological Research.)

The thesis of this article is that the lack of evidence related to the identification and development of therapist expertise is due to the inadequate definition and operationalization of the concept. We propose a definition of expertise that is restricted to performance in the conduct of psychotherapy: the manifestation of the highest levels of ability, skill, professional competence, and effectiveness. In addition, we offer several criteria that may be used to assess expertise: performance (including relational and technical expertise), cognitive processing, client outcomes, experience, personal and relational qualities, credentials, reputation, and self-assessment. We then review research related to the development of expertise, highlighting the role of experience with clients, personal therapy, supervision, deliberate practice, and feedback. Finally, we conclude with recommendations for conducting research on therapist expertise. [ABSTRACT FROM AUTHOR]

ᅟ: Breast cancer survivors (BCS) have been told in the past to avoid strenuous repetitive activities in order to decrease the risk of lymphedema development. Recent evidence suggests that exercise may be beneficial to decrease the signs/symptoms and development of lymphedema.Purpose/methods: This study assessed the arm circumferences of 27 BCS (64 ± 7 years) at baseline and every 2 weeks thereafter during a 6-month resistance exercise training (RT) intervention. RT consisted of 2 days/week of 10 exercises including two sets of 8-12 repetitions at 52-69 % of the participants' one-repetition maximum.Results: A repeated measure analysis of variance revealed no significant changes in percent difference of arm circumferences at any assessment point (pre, 1.31 ± 6.21 %; post, 0.62 ± 6.55 %), nor were there any adverse lymphedema-related events reported during the study.Conclusions: These findings imply that RT can be a safe activity for women with or at risk for breast cancer-related lymphedema. [ABSTRACT FROM AUTHOR]

The present study explores women clients’ experiences of the therapeutic relationship and their meaning making of the effective therapeutic dyad. The participants of the study were 27 female psychotherapy and counselling clients. Individual, semi-structured interviews were conducted and the data was analysed with the use of Interpretative Phenomenological Analysis. The findings indicated: (a) women clients’ attempt to define their relationship with their counsellor by comparing it to other interpersonal relationships, mostly to friendship or to family relationships; (b) their experience of the qualitative characteristics and the feelings associated with an effective therapeutic relationship; and (c) their experience of the counsellors’ role to the therapeutic outcome. The above results are fully discussed along with implications for practice. [ABSTRACT FROM AUTHOR]

There is extensive literature establishing the influence of rumination, hopelessness, and dysfunctional attitudes on depressive symptoms. However, it is unclear whether these vulnerability factors are distinctly related to depressive symptoms or show substantial overlap. In two large samples of undergraduates (Study #1, n = 304; Study #2, n = 491) and two samples of clinically depressed individuals (Study #3, n = 141; Study #4, n = 109, from published studies), questionnaire data were used to examine the relationship between cognitive vulnerability factors and depressive symptoms, along with additional measures of anxiety and stress symptoms. To decompose model fit into its specific and common partitions, we relied on commonality analysis (CA). CA showed that there is substantial overlap in cognitive risk factors for depression. Moreover, we found strong evidence that hopelessness provides a unique statistical contribution to depression. This pattern of findings was stable in healthy as well as clinical samples. Symptom-levels analysis revealed that a specific subset of depressive symptoms are associated with hopelessness. In closing, we showed that CA provides a powerful tool to map unique and overlapping variance between multiple risk factors. Moreover, hopelessness emerged to be an important focus of clinical attention. [ABSTRACT FROM AUTHOR]

Copyright of Person-Centered & Experiential Psychotherapies is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Accumulating behavioral and genetic research suggests that most forms of psychopathology share common genetic and neural vulnerabilities and are manifestations of a relatively few core underlying processes. These findings support the view that comorbidity mostly arises, not from true co-occurrence of distinct disorders, but from the behavioral expression of shared vulnerability processes across the life span. The purpose of this review is to examine the role of the prefrontal cortex (PFC) in the shared vulnerability mechanisms underlying the clinical phenomena of comorbidity from a transdiagnostic and ontogenic perspective. In adopting this perspective, we suggest complex transactions between neurobiologically rooted vulnerabilities inherent in PFC circuitry and environmental factors (e.g., parenting, peers, stress, and substance use) across development converge on three key PFC-mediated processes: executive functioning, emotion regulation, and reward processing. We propose that individual differences and impairments in these PFC-mediated functions provide intermediate mechanisms for transdiagnostic symptoms and underlie behavioral tendencies that evoke and interact with environmental risk factors to further potentiate vulnerability. [ABSTRACT FROM AUTHOR]

In response to rapidly growing rates of comorbidity among psychiatric disorders, clinical scientists have become interested in identifying transdiagnostic processes that can help explain dysfunction across diagnostic categories (e.g., Kring & Sloan, 2009). One factor that has received a great deal of attention is that of emotion regulation, namely, the ability to modulate the intensity and/or duration of emotional states (e.g., Cicchetti, Ackerman, & Izard, 1995; Gross, 1998). Recent theoretical and empirical work has begun to emphasize the role that emotion regulation plays in the temporal comorbidity between internalizing and externalizing conditions (e.g., Aldao & De Los Reyes, 2015; De Los Reyes & Aldao, 2015; Drabick & Kendall, 2010; Jarrett & Ollendick, 2008; Patrick & Hajcak, 2016). However, close inspection of this work reveals two very pertinent areas of growth: (a) this literature is characterized by mixed findings that are likely explained, in part, by methodological heterogeneity; and (b) emotion regulation tends to be studied in relatively narrow terms. To address these issues, we provide a series of recommendations for facilitating cross-study comparisons and leveraging multifaceted approaches to studying emotion regulation processes within a developmental psychopathology framework. We hope that our perspective can enhance the organization and growth of this very important area of inquiry, and ultimately result in more effective prevention and treatment programs. [ABSTRACT FROM AUTHOR]

The research related to the working alliance in career counseling is reviewed in this article. This review indicates that the working alliance does typically increase over the course of career counseling. Furthermore in career counseling, most of the correlations between the working alliance and various outcome measures were significant and hovered around .30, which is consistent with findings related to the correlation between the working alliance and the outcome in psychotherapy. In terms of factors that predict the working alliance’s contribution to career counseling outcome, there is a lack of studies and more research is needed in this area. This article also provides suggestions for practice in career counseling and recommendations for future research. [ABSTRACT FROM AUTHOR]

Background: In terms of the Nelson Mandela Fidel Castro Medical Collaboration programme, an agreement between the governments of South Africa and Cuba, cohorts of South African students receive their initial five years medical training at a Cuban university before returning to South Africa for a six to twelve months orientation before integration into the local final year class. It is common for these students to experience academic difficulty on their return. Frequently this is viewed merely as a matter of a knowledge deficit. Discussion: We argue that the problem arises from a fundamental divergence in the outcomes of the Cuban and South African medical curricula, each of which is designed with a particular healthcare system in mind. Using the discrepancy theory of identity proposed by Higgins in 1987, we discuss the challenges experienced by the returning Nelson Mandela Fidel Castro Medical Collaboration students in terms of a potential crisis of identity and suggest interventions which may prove valuable in promoting academic success and successful integration. Conclusions: Though providing additional training to address the gap in skills and knowledge in returning students is an important part of their successful reintegration, this could be insufficient on its own and must be complemented by a range of measures designed to ameliorate the discrepancies in identity which arise from the transition from one educational model to another. [ABSTRACT FROM AUTHOR]

During the past two decades there has been a pronounced increase in the number of published research studies that have employed near-infrared spectroscopy (NIRS) to measure neural activation. The technique is now an accepted neuroimaging tool adopted by cognitive neuroscientists to investigate a number of fields, one of which is the study of emotional processing. Crucially, one brain region that is important to the processing of emotional information is the prefrontal cortex (PFC) and NIRS is ideally suited to measuring activity in this region. Compared to other methods used to record neural activation, NIRS reduces the discomfort to participants, makes data collection from larger sample sizes more achievable, and allows measurement of activation during tasks involving physical movement. However, the use of NIRS to investigate the links between emotion and cognition has revealed mixed findings. For instance, whilst some studies report increased PFC activity associated with the processing of negative information, others show increased activity in relation to positive information. Research shows differences in PFC activity between different cognitive tasks, yet findings also vary within similar tasks. This work reviews a selection of recent studies that have adopted NIRS to study PFC activity during emotional processing in both healthy individuals and patient populations. It highlights the key differences between research findings and argues that variations in experimental design could be a contributing factor to the mixed results. Guidance is provided for future work in this area in order to improve consistency within this growing field. [ABSTRACT FROM AUTHOR]

The Person-of-the-Therapist Training (POTT) is a program designed to facilitate clinicians' ability to consciously and purposefully use their selves to effectively connect, assess, and intervene with clients. This study explored CFT students' perceptions of the effects of POTT on their ability to create positive therapeutic relationships. Course papers and final reflections were collected from 70 CFT students. Directed content analysis looking for evidence-supported elements of positive therapeutic relationships revealed 5 elements: empathy, management of countertransference, balancing multiple alliances, positive regard, and bond. Findings support the idea that a structured program focused on the training of the personal aspects of the therapists, like POTT, can promote the evidence-supported elements that make a therapeutic relationship effective. [ABSTRACT FROM AUTHOR]

Whereas in basic research, intuition has become a topic of great interest, clinical research and depression research in specific have not applied to the topic of intuition, yet. This is astonishing because a well-known phenomenon during depression is that patients have difficulties to judge and decide. In contrast to healthy individuals who take most daily life decisions intuitively (Kahneman, 2011), depressed individuals seem to have difficulties to come to fast and adaptive decisions. The current article pursues three goals. First, our aim is to establish the hypothesis that intuition is impaired in depression against the background of influential theoretical accounts as well as empirical evidence from basic and clinical research. The second aim of the current paper is to provide explanations for recent findings on the depression-intuition interplay and to present directions for future research that may help to broaden our understanding of decision difficulties in depression. Third, we seek to propose ideas on how therapeutic interventions can support depressed individuals in taking better decisions. Even though our knowledge regarding this topic is still limited, we will tentatively launch the idea that an important first step may be to enhance patients' access to intuitions. Overall, this paper seeks to introduce the topic of intuition to clinical research on depression and to hereby set the stage for upcoming theory and practice. [ABSTRACT FROM AUTHOR]

Copyright of Psychotherapy Research is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Authors assert the role of the core conditions from Rogers’ work in increasing effectiveness of career counseling with chronically undecided career decision-makers in college/university settings. After reviewing the needs and context of the population, the authors provide case examples emphasizing the roles of empathy, unconditional positive regard, and genuineness in career counseling helping previously stuck clients become unstuck. The core conditions are seen as building psychological contact, motivating the client opening to self-reflection, self-acceptance, and self-realization, including previously inhibited aspects of one’s self discovered as key to career decisions. The authors illustrate an integrated balance ofthe personal(attending with the core conditions) withthe informational(e.g. formal assessments, knowledge of the world of work) helping the counselor deepen her focus onthe person within her decision. The authors’ view of the role of the core conditions with chronically undecided college students provides a fresh look at the core conditions across career counseling and other settings in which (a) client connections are inhibited, and (b) there is a need for clients to also process information, such as from assessments, within counseling. [ABSTRACT FROM AUTHOR]

Copyright of Psychotherapy Research is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zeitschrift für Psychiatrie, Psychologie und Psychotherapie is the property of Hogrefe AG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Depression is a debilitating disorder causing significant societal and personal suffering. Improvements in identification of major depressive disorder (MDD) and its treatment are essential to reduce its toll. Recent developments in rodent models of MDD and neuroimaging of humans suffering from the disorder provide avenues through which gains can be made towards reducing its burden. In this review, new findings, integrating across rodent models and human imaging are highlighted that have yielded new insights towards a basic understanding of the disorder. In particular, this review focuses on cortical-subcortical interactions underlying the pathophysiology of MDD. In particular, evidence is accruing that dysfunction in prefrontal-subcortical circuits including the amygdala, ventral striatum (VS), hippocampus and dorsal raphe nucleus (DRN) are associated with MDD status. [ABSTRACT FROM AUTHOR]

Typically in the laboratory, cognitive and emotional processes are studied separately or as a stream of fleeting emotional stimuli embedded within a cognitive task. Yet in life, thoughts and actions often occur in more lasting emotional states of arousal. The current study examines the impact of emotions on actions using a novel behavioral paradigm and functional neuroimaging to assess cognitive control under sustained states of threat (anticipation of an aversive noise) and excitement (anticipation of winning money). Thirty-eight healthy adult participants were scanned while performing an emotional go/no-go task with positive (happy faces), negative (fearful faces), and neutral (calm faces) emotional cues, under threat or excitement. Cognitive control performance was enhanced during the excited state relative to a nonarousing control condition. This enhanced performance was paralleled by heightened activity of frontoparietal and frontostriatal circuitry. In contrast, under persistent threat, cognitive control was diminished when the valence of the emotional cue conflicted with the emotional state. Successful task performance in this conflicting emotional condition was associated with increased activity in the posterior cingulate cortex, a default mode network region implicated in complex processes such as processing emotions in the context of self and monitoring performance. This region showed positive coupling with frontoparietal circuitry implicated in cognitive control, providing support for a role of the posterior cingulate cortex in mobilizing cognitive resources to improve performance. These findings suggest that emotional states of arousal differentially modulate cognitive control and point to the potential utility of this paradigm for understanding effects of situational and pathological states of arousal on behavior. [ABSTRACT FROM AUTHOR]

The use of program evaluation to monitor client change and improve intervention effectiveness is gaining increasing importance in the mental health field. However, there is a lack of literature available in community-based clinics for those who desire to evaluate the effectiveness of services. Through this article the authors review the literature on the best methods to assess clinically significant treatment outcomes in community-based children's mental health services. The strengths and weaknesses of commonly recommended methods of evaluating change are discussed (i.e., reliable change index, percentage of improvement, normative comparisons, and effect size) using a dataset from a community-based parenting program (N = 308). [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Psychotherapy & Counselling is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

While agreeing with the mainstream view that psychotherapeutic practice must be grounded in science, including research on the effectiveness of psychotherapy, the author advocates giving more weight to the venerable philosophical literature on ethics that bears directly on what patients bring to therapists: problems in living. These problems have been the domain of ethics since Socrates, who-like psychotherapists-promoted reflective dialogue. This article reviews some contemporary thought regarding the importance of reflection and the limits that patients and therapists face in promoting it. Relying on attachment theory and the process of mentalizing, the author identifies a convergence of science and ethics in the therapeutic aspiration to cultivate epistemic trust and illustrates this convergence with a case example. [ABSTRACT FROM AUTHOR]

As the diagnosis and treatment of mental disorders has become increasingly medicalized (Conrad & Slodden, 2013), consideration for the relational nature of trauma has been minimized in the healing process. As psychiatrist R. D. Laing (1971) outlined in his essays, the medical model is an approach to pathology that seeks to find medical treatments for symptoms and syndromes based on categorized diagnoses. We argue that such a model implicitly locates the pathology of trauma within the individual instead of within the person(s) who perpetrated the harm or the social and societal contexts in which it took place. In this article, we argue that this framework is pathologizing insofar as it both prioritizes symptom reduction as the goal of treatment and minimizes the significance of relational harm. After providing a brief overview of betrayal trauma (Freyd, 1996) and the importance of relational processes in healing, we describe standard treatments for betrayal trauma that are grounded in the medical model. In discussing the limitations of this framework, we offer an alternative to the medicalization of trauma-related distress: relational cultural therapy (e.g., Miller & Stiver, 1997). Within this nonpathologizing framework, we highlight the importance of attending to contextual, societal, and cultural influences of trauma as well as how these influences might impact the therapeutic relationship. We then detail extratherapeutic options as additional nonpathologizing avenues for healing, as freedom to choose among a variety of options may be particularly liberating for people who have experienced trauma. Finally, we discuss the complex process of truly healing from betrayal trauma. [ABSTRACT FROM AUTHOR]

Low positive emotion distinguishes depression from most types of anxiety. Formative work in this area employed the Anhedonic Depression scale from the Mood and Anxiety Symptom Questionnaire (MASQ-AD), and the MASQ-AD has since become a popular measure of positive emotion, often used independently of the full MASQ. However, two key assumptions about the MASQ-AD—that it should be represented by a total scale score, and that it measures time-variant experiences—have not been adequately tested. The present study factor analyzed MASQ-AD data collected annually over 3 years (n = 618, mean age = 17 years at baseline), and then decomposed its stable and unstable components. The results suggested the data were best represented by a hierarchical structure, and that less than one quarter of the variance in the general factor fluctuated over time. The implications for interpreting past findings from the MASQ-AD, and for conducting future research with the scale, are discussed. [ABSTRACT FROM AUTHOR]

Copyright of Anales de Psicología is the property of Servicio de Publicaciones de la Universidad de Murcia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Virginia Satir continues to be a highly influential figure in family therapy. The summation of her decades of work with families, the Satir growth model (SGM), remains a relevant therapeutic approach that is still practiced by many. This narrative review sought to examine (a) the core therapeutic methods developed by Satir for working with families, and (b) the empirical evidence to support the use of such methods. The author reviewed both firsthand and secondhand accounts of Satir's model of therapy, as well as extant research. Results from four included studies lend equivocal support for the continued use of Satir's approaches in contemporary family therapy. Implications for clinicians include the need for further refinement and systematization of the SGM. Also, researchers must empirically test Satir's methods using stronger methodology with larger and more diverse samples. In an age where evidencebased practice has become standard, all stakeholders must actively work to bolster the support for Virginia Satir's work, lest her important contributions to family therapy be forgotten due to insufficient evidence. [ABSTRACT FROM AUTHOR]

The original cognitive-behavioural (CB) model of bulimia nervosa, which provided the basis for the widely used CB therapy, proposed that specific dysfunctional cognitions and behaviours maintain the disorder. However, amongst treatment completers, only 40-50 % have a full and lasting response. The enhanced CB model (CB-E), upon which the enhanced version of the CB treatment was based, extended the original approach by including four additional maintenance factors. This study evaluated and compared both CB models in a large clinical treatment seeking sample ( N = 679), applying both DSM-IV and DSM-5 criteria for bulimic-type eating disorders. Application of the DSM-5 criteria reduced the number of cases of DSM-IV bulimic-type eating disorders not otherwise specified to 29.6 %. Structural equation modelling analysis indicated that (a) although both models provided a good fit to the data, the CB-E model accounted for a greater proportion of variance in eating-disordered behaviours than the original one, (b) interpersonal problems, clinical perfectionism and low self-esteem were indirectly associated with dietary restraint through over-evaluation of shape and weight, (c) interpersonal problems and mood intolerance were directly linked to binge eating, whereas restraint only indirectly affected binge eating through mood intolerance, suggesting that factors other than restraint may play a more critical role in the maintenance of binge eating. In terms of strength of the associations, differences across DSM-5 bulimic-type eating disorder diagnostic groups were not observed. The results are discussed with reference to theory and research, including neurobiological findings and recent hypotheses. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) is characterized by high rates of comorbid internalizing and externalizing disorders. One mechanistic account of these comorbidities is that ASD is characterized by impaired emotion regulation (ER) that results in deficits modulating emotional responses. We assessed neural activation during cognitive reappraisal of faces in high functioning adults with ASD. Groups did not differ in looking time, pupilometry, or subjective ratings of faces during reappraisal. However, instructions to increase positive and negative emotional responses resulted in less increase in nucleus accumbens and amygdala activations (respectively) in the ASD group, and both regulation instructions resulted in less change in dorsolateral prefrontal cortex activation in the ASD group. Results suggest a potential mechanistic account of impaired ER in ASD. [ABSTRACT FROM AUTHOR]

Background: Self-Concept Clarity (SCC) describes the extent to which the schemas of the self are internally integrated, well defined, and temporally stable. This article presents a theoretical model that describes how different shapes of SCC change (especially stable increase and "V" shape) observed in the course of psychotherapy are related to the therapy outcome. Linking the concept of Jean Piaget and the dynamic systems theory, the study postulates that a stable SCC increase is needed for the participants with a rather healthy personality structure, while SCC change characterized by a "V" shape or fluctuations is optimal for more disturbed patients. Method: Correlational study in a naturalistic setting with repeated measurements (M = 5.8) was conducted on the sample of 85 patients diagnosed with neurosis and personality disorders receiving intensive eclectic group psychotherapy under routine inpatient conditions. Participants filled in the Self-Concept Clarity Scale (SCCS), Symptoms' Questionnaire KS-II, and Neurotic Personality Questionnaire KON-2006 at the beginning and at the end of the course of psychotherapy. The SCCS was also administered every 2 weeks during psychotherapy. Results: As hypothesized, among the relatively healthiest group of patients the stable SCC increase was related to positive treatment outcome, while more disturbed patients benefited from the fluctuations and "V" shape of SCC change. Conclusions: The findings support the idea that for different personality dispositions either a monotonic increase or transient destabilization of SCC is a sign of a good treatment prognosis. [ABSTRACT FROM AUTHOR]

This article discusses the role of moment-to-moment affect dynamics in mental disorder and aims to integrate recent literature on this topic in the context of complex dynamical system theory. First, we will review the relevance of temporal and contextual aspects of affect dynamics in relation to psychopathology. Related to this, we will discuss recent insights resulting from a network view on affect dynamics in psychopathology. Next, we explore how we can reconcile literature findings from a perspective of complex dynamical system theory. Finally, future directions with regard to personalized assessment of risk and diagnostic use are discussed. [ABSTRACT FROM AUTHOR]

Emotions are traditionally considered to be brief states that last for seconds or a few minutes at most. However, due to pioneering theoretical work of Frijda and recent empirical studies, it has become clear that the duration of emotions is actually highly variable with durations ranging from a few seconds to several hours, or even longer. We review research on determinants of emotion duration. Three classes of determinants are identified: features related to the (a) emotion-eliciting event (event duration and event appraisal), (b) emotion itself (nature of the emotion component, nature of the emotion, and emotion intensity), and (c) emotion-experiencing person (dispositions and emotion regulatory actions). Initial evidence on the psychological and neural mechanisms that underlie their effects is discussed. [ABSTRACT FROM AUTHOR]

Objective Trends indicate that clinical psychologists' theoretical orientations have changed over the last decades in North America, but research on this topic in Canada is scarce. We analyzed the orientation of psychologists over the last 20 years in the province of Quebec, where 46% of Canadian psychologists are located. Method Data were collected annually through the board registration form of Quebec psychologists' professional order from 1993 to 2013. Univariate statistical analyses were realized on aggregated data. Results In 20 years, the proportion of clinicians choosing cognitive-behavioral therapy (CBT) as their main orientation grew from 18.4% to 38%, while preference for other orientations slightly declined. Existential-humanistic and psychodynamic-psychoanalytic approaches remained the primary orientation for around 21.7% and 21.5%, respectively. In 2013 (N = 8608), when taking into account 2 choices of theoretical orientation, 55.8% of clinicians chose CBT, 34.3% existential-humanistic orientation, 27.9% psychodynamic-analytic theories, and 21.8% systemic-interactional orientation. Conclusions Findings underline trends in Quebec clinical practice characterized by an increase in the number of psychologists identifying cognitive-behavioral approach as their primary self-reported theoretical orientation. [ABSTRACT FROM AUTHOR]

For the last half-century, many in the social work academy have questioned whether private practitioners have forsaken the mission and values of social work. This article suggests that for the experienced social worker, private practice is part of a natural developmental process that can be deeply congruent with the values of the profession. However, there continues to be relatively little support within the academy for private practice. The more important question today may be: Has the social work profession forsaken the private practitioner? [ABSTRACT FROM AUTHOR]

Cognitive behavioral therapy (CBT) and psychodynamic therapy (PDT) are two major paradigms in the mental health care field. The present article reviews broad similarities and differences between each tradition while acknowledging that such generalizations may overlook heterogeneity within each. However, it is believed that a comparison between CBT and PDT is beneficial in dispelling myths about each tradition, fostering dialogue, encouraging further scholarship and research. While not an exhaustive account, this article will examine how CBT and PDT differ in how they view several topics such as the unconscious, the therapeutic alliance, the role of homework, symptom reduction, and therapeutic heuristics. Commentary is also offered on how research may be more effectively and collaboratively integrated with clinical work from both traditions. Future directions for partnership and improving mental health treatments are also discussed. [ABSTRACT FROM AUTHOR]

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Mood disorders are characterized by impaired emotion regulation abilities, reflected in alterations in frontolimbic brain functioning during regulation. However, little is known about differences in brain function when comparing regulatory strategies. Reappraisal and emotional acceptance are effective in downregulating negative affect, and are components of effective depression psychotherapies. Investigating neural mechanisms of reappraisal vs emotional acceptance in remitted major depressive disorder (rMDD) may yield novel mechanistic insights into depression risk and prevention. Thirty-seven individuals (18 rMDD, 19 controls) were assessed during a functional magnetic resonance imaging task requiring reappraisal, emotional acceptance or no explicit regulation while viewing sad images. Lower negative affect was reported following reappraisal than acceptance, and was lower following acceptance than no explicit regulation. In controls, the acceptance > reappraisal contrast revealed greater activation in left insular cortex and right prefrontal gyrus, and less activation in several other prefrontal regions. Compared with controls, the rMDD group had greater paracingulate and right midfrontal gyrus (BA 8) activation during reappraisal relative to acceptance. Compared with reappraisal, acceptance is associated with activation in regions linked to somatic and emotion awareness, although this activation is associated with less reduction in negative affect. Additionally, a history of MDD moderated these effects. [ABSTRACT FROM AUTHOR]