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Pathological narcissism is associated with problematic interpersonal behaviours. Because of the high need for external validation in pathological narcissism, the experience of loneliness may exacerbate the relationship between pathological narcissism and interpersonal problems. Moreover, these interpersonal problems may contribute to psychological distress, potentially accounting for the association between pathological narcissism and psychological distress symptoms. The present study was aimed at examining whether loneliness moderated the association between pathological narcissism and interpersonal sensitivity, ambivalence, and aggression problems--and whether these interpersonal problems mediated the narcissism-distress association. Using self-report, cross-sectional data from a sample of 248 Canadian community members (73.5% female; average age 25.8 ± 10.5 years), significant interactions were found between pathological narcissism and loneliness--indicating moderation--in relation to interpersonal sensitivity problems, B = .07, SE = .02, t = 3.21, p = .002, and interpersonal aggression, B = .07, SE = .03, t = 2.66, p = .009. Conditional process modelling indicated significant moderated mediation--moderated by loneliness--of the relationship between pathological narcissism and distress symptoms through interpersonal sensitivity, index = .20, SE = .12, 95% CI[.02, .47], and aggression, index = .21, SE = .11, 95% CI[.02, .46]. The findings suggest that as individuals high in pathological narcissism experience more loneliness, they are more likely to evince greater sensitivity and aggressive interpersonal problems, which may in turn influence severity of distress symptoms., Author(s): David Kealy [sup.1] , Sarah Woolgar [sup.1] [sup.2] , Jackson M. A. Hewitt [sup.1] , Daniel W. Cox [sup.2] Author Affiliations: (1) grid.17091.3e, 0000 0001 2288 9830, Department of [...]

Narcissistic vulnerability has been proposed as a dispositional feature that confers susceptibility to depression from earlier maladaptive parent-child relations. Limited research has examined narcissistic vulnerability as a mediator between perceived parental responsiveness and depressive symptoms, particularly with consideration of interpersonal motives such as needs for acceptance and belonging. A sample of 334 college undergraduates completed self-report measures of perceived parental responsiveness, narcissistic vulnerability, the need to belong, and depressive symptoms. Regression analyses using bootstrapped 99% confidence intervals tested a hypothesized moderated mediation model predicting depressive symptoms from parental responsiveness through narcissistic vulnerability as a mediator, moderated by the need to belong. Narcissistic vulnerability was found to significantly mediate the association between perceived parental responsiveness and depressive symptoms, with significant moderation by the need to belong. The mediating effect of narcissistic vulnerability was stronger as the need to belong increased. The findings indicate that narcissistic vulnerability may be an important mechanism in the link between childhood adversity and depressive symptoms, particularly when needs for acceptance from and inclusion with others are prominent., Author(s): David Kealy [sup.1] , Paul L. Hewitt [sup.2] , Daniel W. Cox [sup.3] , Olivier Laverdière [sup.4] Author Affiliations: (1) grid.17091.3e, 0000 0001 2288 9830, Department of Psychiatry, University [...]

Meaning in life is an important aspect of wellbeing for young adults transitioning into new roles. While research suggests young adults' quality of family environments is associated with meaning, few studies have examined mechanisms that explain how early parental support may facilitate young adults' sense of meaning. Understanding factors that contribute to the development of meaning can shape helping practices for young adults, particularly those lacking in earlier parental support. The present study explored the relationship between young adults' appraisals of childhood parental support and present meaning in life, through mediation effects of dispositional optimism and identity commitment. A sample of 120 young adults aged 18-25 completed assessments of early parental support, optimism, identity commitment, and meaning in life. Parallel mediation was used to examine the hypothesized model, controlling for neuroticism. Analyses supported the association between early parental support and meaning in life being mediated by optimism and identity commitment. The findings may inform prevention and intervention practices in support of healthy development and wellbeing among youth., Author(s): David Kealy [sup.1] , Shelly Ben-David [sup.2] , Daniel W. Cox [sup.3] Author Affiliations: (1) grid.17091.3e, 0000 0001 2288 9830, Department of Psychiatry, University of British Columbia, , Vancouver, [...]

Cognitive fusion occurs when people experience their thoughts as literally true and allow them to dictate behavior. Fusion has been shown to be associated with increased symptoms of post-traumatic stress disorder (PTSD) and depression; however, the association between change in cognitive fusion, PTSD, and depression symptoms has been relatively uninvestigated. Our study aims to examine the associations between PTSD, depression symptoms, and cognitive fusion in Canadian veterans from pre- to post-treatment. Clients (N = 287) completed measures of PTSD symptom severity, depression symptom severity, and cognitive fusion at pre- and post-treatment. Our results supported that pretreatment PTSD and depression symptom severity were found to be negatively associated with changes in pre- to post-treatment cognitive fusion, while pretreatment cognitive fusion was not associated with changes in depression or PTSD symptoms. Furthermore, pretreatment depression symptoms predicted pre- to post-treatment changes in PTSD symptoms. However, pretreatment PTSD symptoms did not predict changes in depression symptoms. These findings highlight the importance of understanding the bidirectional associations between PTSD, depression, and cognitive fusion. Furthermore, our results are indicative of PTSD and depression symptoms playing a role in the change in cognitive fusion (e.g., defusion) and of depression playing a larger role in the maintenance of PTSD symptoms. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

The desire to die by suicide has been linked with interpersonal difficulties and impeded clinical outcomes. Despite the emphasis on the therapeutic relationship in clinical guidelines for working with suicidal clients, little is known about how suicidal clients' interpersonal difficulties manifest in clinical contexts. Additionally, there is limited understanding of the therapeutic relationship in single-session suicidal crisis contexts. Our aim was to examine the trajectory of the therapeutic bond in mediating clients' suicidal desire and outcome in single-session suicidal crisis intervention. Single-session online text-based crisis intervention sessions (N = 354; Mage = 29.43, SD = 9.15; 64.5% women) were coded for suicidal desire, therapeutic bond (each quarter), and outcome. We examined the proposed sequential mediating model (suicidal desire to early bond to bond change to outcome) using structural equation modeling. The proposed sequential mediation model fits the data well, χ2(11) = 22.030, p =.0241, root-mean-square error of approximation =.053, 90% CI [.019,.085], comparative fit index =.983, Tucker–Lewis index =.977, and was a better fit than several alternative models. Further, the indirect effect from suicidal desire to outcome through early bond and bond change was significant (b = −0.474, 99% CI [−0.782, −0.203]). Our findings indicate that therapeutic bonds were beneficial for clients with elevated suicidal desire—and—elevated suicidal desire was negatively associated with therapeutic bonds. These findings highlight the importance of training clinicians to navigate the unique challenges of developing therapeutic bonds with acutely suicidal clients. Public Significance Statement: Contemporary suicide theory has emphasized the interpersonal challenges that those with suicidal desire often experience. Our findings indicate that these challenges extend into the clinical context—greater suicidal desire was associated with poorer therapeutic bonds. Despite the difficulty in developing strong therapeutic relationships with suicidal clients, it is important that clinicians prioritize these relationships as we found a strong link between the therapeutic bond and suicidal clients' outcomes. [ABSTRACT FROM AUTHOR]

Talking with others about traumatic experiences (i.e., trauma disclosure) has been associated with increased posttraumatic growth (PTG). Although this association indicates the value of disclosing, there is evidence that external pressure to disclose can hinder the benefits of trauma disclosure. The aim of the current study was to examine the influence of pressure to disclose on the association between trauma disclosure and PTG. People who had experienced a traumatic event and disclosed their trauma to a close other were recruited using Amazon's Mechanical Turk (N = 208). Participants completed measures of trauma exposure, trauma disclosure, pressure to disclose, PTG, posttraumatic stress symptoms, and response to disclosure. The results indicated that the linear association between trauma disclosure and PTG was quadratically moderated by pressure to disclose, ηp2 =.025. Pressure to disclose strengthened the positive association between trauma disclosure and PTG from low, B = 0.818 (SE = 0.267), to moderate levels of pressure, B = 2.109 (SE = 0.471). However, when pressure was high, the association between disclosure and PTG was not significant, B = −1.19 (SE = 1.327). These findings indicate that a moderate amount of pressure to disclose may facilitate the positive impact of disclosure on PTG, yet a high amount of pressure may impede the positive association between disclosure and PTG. This research furthers understanding of the nuances of trauma disclosure and how close others' involvement in disclosure can impact the process of PTG for trauma survivors. [ABSTRACT FROM AUTHOR]

To date, no empirically based inpatient intervention for individuals who have attempted suicide exists. We present an overview of a novel psychotherapeutic approach, Post-Admission Cognitive Therapy (PACT), currently under development and empirical testing for inpatients who have been admitted for a recent suicide attempt. PACT is adapted from an efficacious and brief outpatient cognitive therapy protocol (Brown, Henriques, Ratto, & Beck, 2002; Brown et al., 2005) for inpatient delivery to individuals with recent suicide attempts. Within a cognitive framework, attempting suicide is conceptualized as a maladaptive coping strategy that deserves immediate targeted clinical attention regardless of the patient's diagnosis. The primary aims of PACT are to reduce the likelihood of suicide attempt recurrence as well as decrease the severity of established psychological risk factors for suicide. The three phases of PACT involve (1) building a therapeutic alliance and developing a cognitive conceptualization based on the recent suicide attempt; (2) instilling hope, practicing effective coping strategies, and addressing problem-solving deficits; and (3) preventing relapse, constructing a safety plan, and promoting timely linkage with outpatient aftercare services. The efficacy of PACT as a targeted inpatient treatment package remains to be established. The cognitive behavioral components of PACT, as described here, are based on evidence-informed practices aimed at improving the quality of care provided to inpatients following a suicide attempt. (Contains 1 table.)

Theorized to stem from experiences of childhood emotional neglect, narcissistic vulnerability has been identified as contributing to expressions of psychiatric distress such as depressive and anxiety symptoms, particularly due to shame-proneness. To investigate narcissistic vulnerability and shame as mediators between perceived childhood emotional neglect and depressive and generalized anxiety symptoms among psychiatric outpatients. Adults (N = 137) attending community mental health services completed self-report measures at intake. Mediation analyses tested the indirect effect of perceived emotional neglect on depressive and generalized anxiety symptom severity through narcissistic vulnerability; shame was added to subsequent models to examine narcissistic vulnerability and shame as sequential mediators. Perceived emotional neglect was significantly associated with narcissistic vulnerability, which in turn was linked with depressive and generalized anxiety symptoms as separate dependent variables. Indirect effects were significant in each model, indicating narcissistic vulnerability as a significant mediator. With the inclusion of shame, narcissistic vulnerability and shame were significant as sequential mediators. Narcissistic vulnerability and shame may operate as mechanisms in conferring affective symptom severity from perceived childhood emotional neglect. Narcissistic vulnerability and susceptibility to shame may thus be important treatment targets when addressing psychological distress in the context of childhood adversity. [ABSTRACT FROM AUTHOR]

Endorsement of traditional masculinity ideology has been indicated as a complicating factor in psychotherapeutic treatment engagement and process; however, little is known about how these findings extend to treatment outcome. This study sought to examine the impact of traditional masculinity ideology endorsement on treatment outcome in a sample (N = 178) of Canadian military veterans. Treatment outcome was measured according to changes in psychosocial functioning from pre- to posttreatment and at 3, 12, and 18 months posttreatment. Results indicated that higher endorsement of self-reliance was negatively associated with treatment outcome and that endorsement of toughness was associated with improved outcomes over time. This study suggests that treatment outcomes are differentially impacted by varying facets of traditional masculinity ideology. While certain facets (i.e., self-reliance) may impede treatment outcome, others (i.e., toughness) may support long-term treatment gains. Outcomes from this study may help clinicians develop more gender-sensitive interventions for military service veteran men and others who endorse traditional masculinity. [ABSTRACT FROM AUTHOR]

Endorsement of traditional masculinity ideology is frequently associated with interference in the treatment of posttraumatic stress disorder (PTSD); however, there is little empirical basis for this association. Moreover, there is increasing attention on masculinity ideology being contextual in nature, which may have important implications for our understanding of its impact on treatment. Here, we examine how the outcome of a group-based treatment for veterans with PTSD was impacted by traditional masculinity facets held at the individual level, and among other group members. Our sample consisted of (N = 255) Canadian veteran men. Results indicated that the degree of individual self-reliance and dominance attenuated positive treatment outcomes, with respect to total PTSD symptom change and PTSD-related avoidance symptoms. Self-reliance also attenuated symptom change in negative alterations in cognitions and mood and hyperarousal clusters. Other group members' degree of masculinity did not appear to impact individual participants' pre- to post-treatment PTSD symptom change. The R2 for significant results ranged from.01-.05. This study provides evidence that, within the context of group-based treatment, an individual's endorsement of traditional masculinity ideology may impede reduction of PTSD symptomatology, but the effect of other group members' masculinity endorsement does not. [ABSTRACT FROM AUTHOR]

The present study used thematic analysis to explore participants' subjective experiences of two group approaches targeting emerging adults' possible selves. Eighty-six emerging adults were randomly assigned to one of the interventions and responded to four open-ended questions following the completion of the group program. The themes that materialized from the researchers' interpretation of the data were organized into three overarching categories. These categories included psychosocial changes (four themes), experiences that facilitated group processes (nine themes), and experiences that hindered group processes (five themes). Themes were associated with one or both interventions. The researcher's analyses of participant experiences highlighted both shared and distinct aspects of the interventions. Findings from the present inquiry provided further support for group intervention as a promising means of strengthening possible selves in emerging adulthood. Moreover, they suggest different possibilities for group counsellors to consider when offering such programming to emerging adult clients. [ABSTRACT FROM AUTHOR]

Maladaptive schemas have been linked with increased posttraumatic stress disorder (PTSD) symptoms. Posttraumatic negative self-appraisals (i.e., posttraumatic shame and self-blame) have also been empirically supported as contributors to PTSD symptom severity following traumatic events. These associations are well known; however, the pathways between maladaptive schemas and PTSD symptoms remain largely unclear. The present study aimed to examine the mediating effects of posttraumatic negative self-appraisals (shame and self-blame) on the association between maladaptive schemas and PTSD symptom severity in patients completing a partial hospitalization program. Patients (N = 98) completed measures of early maladaptive schemas, posttraumatic shame, posttraumatic self-blame, and PTSD symptom severity at intake. Posttraumatic negative self-appraisals mediated the association between maladaptive schemas and PTSD symptom severity. When we examined the specific mediating effects of shame and blame – rather than negative self-appraisals overall – shame was a significant mediator (b =.153, 95% CI [.031,.296]), but not blame (b =.038, 95% CI [−.083,.204]). Further, posttraumatic shame mediated the association between two of the four schema domains – disconnection & rejection (b =.092, 95% CI [.030,.201]) and impaired autonomy & performance (b =.047, 95% CI [.002,.124]) – and PTSD symptom severity. These findings highlight the importance of posttraumatic shame in the association between maladaptive schemas and PTSD symptom severity. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]