ABSTRACTBackgroundIn China, Shidu parents, who have experienced the pain of losing their only child, are more likely to suffer from mental health issues such as depression, anxiety, and suicidal ideation compared to other bereaved groups. Currently, the relationships between symptoms of depression, anxiety, and suicidal ideation among Shidu parents remain unclear, necessitating further research to elucidate these connections. Our study aims to estimate the network of depression and anxiety symptoms and identify the bridge symptoms between depression, anxiety and suicidal ideation based on network analysis.MethodsThis study was conducted in five urban districts and one rural district in Shenyang City, Liaoning Province, China. Data collection was conducted from March 2017 to February 2020. Network analysis was implemented by using the R packages qgraph and bootnet.Results‘Felt depressed’ and ‘felt sad’ were central symptoms of depression, while ‘feeling fainting and passing out’ and ‘afraid for no reason’ were central symptoms of anxiety. Two pairs of bridge symptoms and one overlapping symptom were found in the transdiagnostic network. In addition, one depressive symptom and one anxiety symptom were identified to be significantly associated with suicidal ideation.ConclusionsThe current study is the first to conduct a network analysis of depression, anxiety, and suicidal ideation among Chinese Shidu parents. The association among disease symptoms were found, and the most central symptoms were identified. Results of the present study can provide some new intervention and treatment ideas for corresponding diseases, which lays a theoretical foundation for the future longitudinal research.

ABSTRACTBoth refugees and asylum seekers exhibit poorer mental health and higher rates of mental disorders, particularly posttraumatic stress disorder (PTSD), for which EMDR therapy has been shown to be effective. This review analyses the efficacy of EMDR in reducing PTDS in refugees or asylum seekers using randomized controlled studies (RCTs). A systematic review and meta‐analysis published in PROSPERO (CRD42024595506) using the databases PubMed, PsycINFO and Web of Science were conducted. The authors independently reviewed the articles to maintain double blind. A total of 10 articles met the criteria for inclusion. The analysis of these studies revealed that a nonsignificant effect of EMDR on PTSD symptoms was observed at the end of the intervention period and the effect sizes reflect interaction effects between treatment/control over time on outcome, and these represent changes over time. It should be interpreted with awareness of the potential limitations introduced by excluding other study designs due to heterogeneity.

ABSTRACTPosttraumatic stress disorder (PTSD) is a prevalent psychiatric condition, particularly among US Veterans. PTSD‐diagnosed patients are more likely to experience suicidal ideation, suicide attempts and death by suicide when compared to non‐PTSD‐diagnosed patients. The US Department of Veterans Affairs (VA) emphasizes evidence‐based psychotherapy (EBP) for PTSD, including prolonged exposure and cognitive processing therapy. This study focuses on how suicide risk impacts PTSD by evaluating utilization of nondifferentiated psychotherapy and EBP in a national sample of VA patients diagnosed with PTSD who died by suicide in 2017–2018.The study used a dataset of VA patients diagnosed with PTSD who died by suicide and received psychotherapy in the year before death (cases) and patients who had comparable diagnoses, demographics and received psychotherapy during the same interval and remained alive (controls). Cases and controls were matched on suicide risk (high, moderate and low). The study tracked nondifferentiated psychotherapy and EBP and analyzed cases and control utilization rates across risk‐tiers.The final sample included high‐risk (cases = 171; controls = 2052), moderate‐risk (cases = 428; controls = 4280) and low‐risk (cases = 53; controls = 529) patients. EBP utilization was markedly low, especially among cases. Higher proportions of moderate‐ and low‐risk controls received EBP and received more sessions than matched cases.Even with VA efforts to promote EBPs, usage remains limited, particularly among patients who die by suicide. Further research is needed to understand utilization barriers and improve EBP delivery to better support PTSD‐diagnosed patients and reduce their suicide risk.

ABSTRACTNonsuicidal self‐injury (NSSI), which involves the deliberate destruction of body tissue without suicidal intent, is strongly associated with an increased risk of later suicidal behaviour. Disclosing the risk factors for NSSI is therefore vital to prevent the progression to suicide. While documented evidence links NSSI to childhood trauma, depression, social support, a comprehensive perspective that integrates these factors together is lacking. To bridge this gap, we leveraged a chain‐mediating model in this study, to examine the mediating effect of social support and depression on the relationship between childhood trauma and NSSI. As expected, NSSI behaviours were positively correlated with depression scores (r = 0.492, padj < 0.001), childhood trauma scores (r = 0.306, padj < 0.001), and negatively correlated with the social support scores (r = −0.168, padj = 0.020). Importantly, in the chain‐mediating model, increased childhood trauma was associated with decreased social support (β = −0.532, t = −9.086, p < 0.001), which in turn was linked with increased depressive symptoms (β = −0.193, t = −2.957, p < 0.01), ultimately contributing to greater odds of NSSI behaviours. Our findings elucidated the complex psychological mechanisms underlying the interplay between childhood trauma, social support and depression severity, suggesting that improving social support and intervening early in depression may be potential ways to reduce the risk of NSSI.

ABSTRACTBackgroundThe Call of the Void phenomenon describes an inexplicable urge to consider dangerous or self‐destructive actions in certain situations. Previous studies have focused on the high place phenomenon (HPP), which is the sudden urge to jump from high places. One aim of this study is to replicate the previously found associations of HPP with suicidality and anxiety in a larger sample of patients suffering from flight phobia or agoraphobia. Furthermore, the influence of personality traits and protective factors, such as self‐efficacy and self‐esteem, will be examined to identify associations between the HPP and potential markers of both positive and negative mental health.MethodsThe study sample comprised 612 patients (76% female; Mage = 43.77, SDage = 12.82) suffering from clinically relevant fear of flying. Participants filled out questionnaires on experiences with the high place phenomenon, depression, personality traits, anxiety sensitivity, suicidal ideation, insecurity in social contact, flight phobia symptoms, positive mental health, self‐efficacy expectations, self‐esteem and satisfaction with life.ResultsConsistent with previous findings, the high place phenomenon was known to nearly 43% of the patient sample. Multiple regression analysis showed that openness to experiences, neuroticism, suicidal ideation and insecurity in social contacts were positively related to the high place phenomenon, whereas agreeableness, self‐efficacy and self‐esteem were negatively related.ConclusionThe high place phenomenon is a common experience in individuals, whether or not they suffer from suicidal ideation. It is therefore cautioned not to interpret such experiences as an expression of a hidden death wish. Nevertheless, the occurrence of the HPP is influenced by the presence of negative and positive mental health markers. Future studies should examine the association between HPP and intrusions in the context of obsessive‐compulsive disorders.

ABSTRACTIntroductionThe current study aimed to evaluate the relationship between intimate partner violence (IPV) and suicidal ideation among women using a network analysis approach.MethodSecondary data including 440 women (mean age ± SD = 32.78 ± 8.09) who experienced IPV in the last 6 months were used. The Revised Composite Abuse Scale‐Short Form, Columbia‐Suicide Severity Rating Scale and Revised Scale of Economic Abuse were used to assess IPV and suicidal ideation. Network analysis, centrality measures and bridge centrality were applied to understand the interplay between IPV and suicide risk factors.ResultsThe strongest association in the network analysis was found between ‘Wish to be Dead’ (S.1) and ‘Non‐Specific Active Suicidal Thoughts’ (S.2) with a weight of 0.523, indicating a substantial correlation between general suicidal thoughts and particular desires to die. IPV symptoms, particularly economic exploitation and psychological abuse, showed strong links to suicidal ideation. ‘Active Suicidal Ideation with Specific Plan and Intent’ (S.5) was significantly related to ‘Make you take out a loan or buy something on credit when you didn't want to’ (EA.11) with a weight of 0.276. Additionally, centrality analysis showed that ‘Wish to be Dead’ (S.1) was the most central node in the network of suicidal ideation, with the highest centrality score (betweenness = 2.625).ConclusionThese findings suggest that IPV, mainly psychological abuse, plays a pivotal role in suicidal ideation among women. Mental health interventions should focus on addressing IPV‐related psychological abuse. Suicide prevention efforts must integrate IPV screening into clinical practice.

ABSTRACTIntroductionThe current paper aimed to translate psychometric properties and network structure of the Screen for Child Anxiety–Related Emotional Disorders (SCARED‐P) in children aged 4 to 7 years in Arabic‐speaking countries.MethodIn this study, 646 Arabic‐speaking parents of children aged 4 to 7 participated. Confirmatory factor analysis (CFA) was used to confirm the five‐factor structure of the SCARED‐P scale. Indices of reliability, test–retest reliability, convergent validity and measurement invariance were utilized. Additionally, a network perspective, which included exploratory graph analysis (EGA), was employed.ResultsThe results of the present study showed that the five‐factor model of the SCARED‐P scale was confirmed with good fit indices (χ2/df = 3.27, RMSEA = 0.059, CFI = 0.92). The scale demonstrated good internal consistency (total scale: α = 0.946, subscales: α = 0.68–0.96). Test–retest reliability over 2 weeks was satisfactory (ICC above 0.70). The convergent validity of the scale was also confirmed, as SCARED‐P scores had a significant correlation with the emotional problems subscale of the SDQ (r = 0.61, p < 0.001). The emotional subscale showed the highest correlation with the generalized anxiety component (r = 0.68, p < 0.001). Additionally, the network analysis supported the five‐factor model of the SCARED‐P scale.ConclusionThe SCARED‐P scale demonstrated excellent psychometric properties in Arabic‐speaking children aged 4 to 7, with a stable five‐factor structure and strong convergent validity. It suggested that this tool can be a valuable instrument for the early identification of anxiety disorders in Arab countries. This study emphasizes the importance of culturally adapted screening tools in detecting anxiety symptoms and providing opportunities for early interventions.

ABSTRACTThe network approach offers a novel perspective for conceptualizing the psychopathology of social anxiety disorder (SAD). This scoping review aimed to map the existing literature on the psychometric network structures of social anxiety symptoms and identify future research directions. A total of 61 studies were identified through searches in PubMed, PsycINFO, ScienceDirect, Cochrane Library, ClinicalTrials.gov and the Open Science Framework databases, employing the keywords (‘social anxiety disorder’ OR ‘social phobia’ OR ‘social anxiety’) AND (‘network analysis’). Of these, 10 studies examined the network structures of social anxiety symptoms in patients with SAD, 17 investigated such structures in individuals without an SAD diagnosis and 34 explored networks of other symptoms that included social anxiety symptoms. Most studies were conducted on Western and Chinese populations, underscoring the need for broader cross‐cultural comparisons. The central symptoms in SAD networks were fear and anxiety related to performing and interacting with groups, engaging with strangers or unfamiliar individuals, participating in events and being the center of attention. However, the network structures of SAD and related symptoms remain underexplored, with existing studies offering only partial insights. This review emphasizes the need for future research to comprehensively assess social anxiety symptoms and adopt cross‐cultural comparative designs to deepen the understanding of SAD psychopathology. These findings provide a foundation for future research on SAD utilizing network analysis.

ABSTRACTIntermittent explosive disorder (IED) is characterized by sudden, disproportionate outbursts of anger that can severely impact individuals' quality of life, causing difficulties in maintaining relationships, issues at work or school and potential legal troubles. This study aimed to systematically review and meta‐analyse the effectiveness of psychological and pharmacological treatments for IED, drawing insights from both case studies and randomized controlled trials (RCTs). A total of 12 RCTs and 14 case studies were included in this comprehensive analysis. The meta‐analysis revealed that psychological treatments, particularly cognitive behavioural therapy (CBT), showed significant effectiveness in reducing aggression and achieving full remission compared to pharmacological treatments. However, the latter, notably fluoxetine, demonstrated notable efficacy in managing irritability and achieving treatment response. Subgroup analysis identified follow‐up time and intervention type as significant moderators of treatment outcomes. The systematic review of case studies highlighted the successful application of deep brain stimulation (DBS) and various off‐label medications, including SSRIs and mood stabilizers, in managing IED symptoms. Despite these insights, the study emphasizes the need for more robust evidence‐based treatment protocols and further research into the underlying mechanisms of IED to develop targeted treatments.

ABSTRACTBackgroundFrustration intolerance (FI) is the belief that reality should meet our desires for ease, pleasure and comfort. Although extensively studied in adults, tools for measuring FI in children and adolescents are scarce. The Frustration Intolerance Scale for Students (FISS) was developed to fill this gap. This study aimed to evaluate the FISS's structure and, through a longitudinal design, assess its psychometric properties, including reliability and validity.MethodsConfirmatory factor analysis (CFA) was conducted with a sample of 780 participants (46.30% female, Agemean = 11.80 years). A retest was administered after 5 months to 611 participants (48.6% female, Agemean = 12.24 years). Both testing moments assessed FI, along with externalized and internalized anger, anger duration, empathy, academic interest and self‐efficacy.ResultsConfirmatory factor analyses revealed that the eight‐plus‐one model is the optimal structure for the FISS, allowing for scores on each FI component, frustration tolerance (FT) and a general irrationality FI factor. The eight subscales and the irrationality FI factor showed good internal consistency, whereas test–retest reliability was fair, indicating some variability between administrations. Regarding convergent evidence, significant longitudinal correlations were found between internalized and externalized anger, the degree of anger and all dimensions of FI. FT was positively associated with empathy, and this pattern remained consistent over time. The scale demonstrated discriminant validity by effectively differentiating between students with low and high levels of academic interest and self‐efficacy.ConclusionsThe FISS is a valid and reliable tool for assessing various dimensions of frustration intolerance in children and adolescents.

ABSTRACTThere is evidence that emotion regulation plays a role in the aetiology and maintenance of OCD, but knowledge about what impacts emotion dysregulation is limited. Attachment style is related to both emotion regulation and OCD symptoms, but the link between them has not been thoroughly studied. Examining emotion dysregulation within the context of OCD through an attachment theory framework may lead to a better understanding of the aetiology and maintenance of OCD. In the present study, we combined theoretically and empirically derived knowledge to examine the mediating role of emotion regulation between attachment dimensions (avoidance and anxiety) and OCD symptoms. One‐hundred seventy‐nine individuals with OCD were assessed with Experiences in Close Relationships‐Revised (ECR‐R), Difficulties in Emotion Regulation Scale (DERS) and Yale‐Brown Obsession Compulsion Scale (Y‐BOCS), and mediation analyses were conducted. Our results indicate that the association between OCD and attachment anxiety/avoidance was mediated by emotion dysregulation. The primary limitation of our study is that data are cross‐sectional and, therefore, we cannot infer anything about the causal direction of these relationships. A second limitation of the study is that two of the three measures were derived from self‐reported questionnaires, which may be prone to biassed reporting. Our results suggest that insecure attachment is important in OCD when taking emotion regulation into account. Thus, clinical interventions for OCD may improve by targeting attachment and difficulties related to emotion regulation. However, our findings are based on cross‐sectional data that preclude conclusions relating to causal influence.

ABSTRACTIntroductionThe Mental Pain Questionnaire (MPQ) was developed using a clinimetric approach to bring together the key features of mental pain into a single, brief, transdiagnostic scale. The present study aims at extending the validation of the MPQ to people from three different clinical settings.MethodsA multicentre, cross‐sectional study on adults diagnosed with migraine (n = 256), systemic sclerosis (n = 219), or mental disorders (n = 138) was conducted. The MPQ was administered; Rasch and Mokken analyses were performed to assess clinimetric validity.ResultsThe overall fit to the Rasch model indicated a misfit, improved by the exclusion of a single item. MPQ showed to be unidimensional. MPQ total score and individual items scalability were optimal except for the same item. The total MPQ score showed an optimal scalability for the systemic sclerosis sample and an acceptable scalability for the migraine and mental disorders samples. Local dependency was found between two pairs of items. Person separation reliability indices (PSI 0.45) showed that the MPQ could not distinguish between groups with different levels of mental pain.ConclusionMental pain has the potential to serve as a truly generic patient‐centred outcome measure. Recommendations are made for revisions of the original MPQ, but these will require testing in further validation studies.

ABSTRACTTurkey experienced two devastating earthquakes, which resulted in more than 50,000 deaths and millions of injured and homeless individuals. The negative influence of direct exposure to trauma has been proven, but the impact of indirect exposure remains unclear. In this study, we focused on indirect types of trauma exposure: the loss of someone in the earthquake and the exposure to disaster media. We aimed to explore the influence of these dimensions on psychological states, including earthquake trauma severity, post‐traumatic stress disorder (PTSD) symptoms, depression, anxiety, hopelessness and life satisfaction and temporal‐psychological measures, such as intertemporal decision‐making tendencies and time perspectives. The sample (N = 215) consisted of Turkish individuals who experienced the earthquakes through two types of indirect exposure: having lost someone and being exposed to disaster media. Findings showed that having a loss in the earthquake was related to high levels of trauma, anxiety, hopelessness and a past‐negative time perspective. Repetitive exposure to disaster media was linked to higher levels of trauma, PTSD symptoms, depression, anxiety, stress and a past‐negative time perspective. Importantly, the amount of traumatization in case of losing someone was modulated by the frequency of disaster‐media exposure. Even indirect exposure to the disaster substantially disturbs many processes, and the media magnifies such disturbances.

ABSTRACTDialectical Behaviour Therapy (DBT) has demonstrated effectiveness in reducing harmful behaviours associated with emotion dysregulation, including non‐suicidal self‐injury (NSSI) and binge eating. It has been hypothesized that the effects of DBT on NSSI and binge eating are the result of improvements in emotion regulation (ER); however, the extent to which changes in ER account for reductions in these behaviours is unclear. The present study leverages two unique clinical samples to examine the degree to which changes in ER influence changes in the frequency of NSSI and binge eating over the course of DBT. Participants included 189 Veterans receiving outpatient DBT and 117 civilians enrolled in a DBT Intensive Outpatient Program. Analyses examined changes in ER, binge eating and NSSI over the course of treatment, as well as the extent to which NSSI and binge eating frequency were influenced by changes in ER. In the Veteran sample, DBT led to improvements in ER abilities and significant reductions in NSSI and binge eating; however, changes in ER did not account for observed reductions in NSSI or binge eating. In the civilian sample, the effects of DBT on ER, NSSI and binge eating were nonsignificant. Our findings suggest that ER may not be the only mechanism through which DBT exerts its effects on NSSI and binge eating. The effects of DBT on ER and self‐damaging behaviours may vary based on factors such as treatment setting, time in treatment and clinical severity of the sample.

ABSTRACTBackgroundThe relationship between metacognitive beliefs and suicidal ideation is complex, yet there is limited research exploring ‘the fine‐grained and comorbid pathways between the two variables’, particularly in prisoners.MethodsData were collected from prisoners who completed demographic surveys and psychological scales between February and March 2024. Demographic information included age, educational background and duration of imprisonment. The Metacognitions Questionnaire‐30 (MCQ‐30) and Self‐Rating Idea of Suicide Scale (SIOSS) were administered. Using R 4.2.3 software, a network model of metacognitive beliefs and suicidal ideation was constructed, with expected influence (EI) and bridge expected influence (BEI) calculated to compare the roles of specific symptoms within the network.ResultsThe network model revealed 21 significant edges between metacognitive beliefs and the suicidal ideation community. The most vital edges across communities included ‘Negative beliefs about worry’ and ‘Despair’, ‘Cognitive confidence’ and ‘Despair’, ‘Cognitive self‐consciousness’ and ‘Optimism’, and ‘Cognitive confidence’ and ‘Sleep’ (with edge weights of 0.30, 0.16, −0.16 and 0.11, respectively). ‘Despair’ demonstrated the highest EI value, exerting the strongest impact on the network. The highest BEI values were found for ‘Negative beliefs about worry’ and ‘Despair’.ConclusionNetwork analyses underscore the intricate interplay between metacognitive beliefs and suicidal ideation among prisoners at the symptom level. These findings highlight specific areas for therapeutic focus, potentially leading to more effective mental health support for incarcerated individuals.

ABSTRACTThis cross‐sectional study investigated the relationship between the presence and impact of ACEs with both reactive and proactive aggression, and the possible moderating role of mentalization (operationalized as reflective functioning) in these expected relationships. Sixty‐five inpatient and outpatient adults with any kind of antisocial behaviour completed the Dutch version of the Traumatic Experiences Checklist, the Reactive‐Proactive Aggression Questionnaire, and the Adult Attachment Interview with the use of the Reflective Functioning Scale. Preliminary analysis showed a remarkably high level of ACEs, and a relatively high reported impact of these experiences. We found a positive relationship between the total presence of ACEs (including childhood maltreatment and adverse household factors), and both reactive and proactive aggression. We also found positive relationships between the experienced impact of these ACEs and both reactive and proactive aggression. Regarding childhood maltreatment in family of origin, we did not find a correlation between the presence of these experiences and respectively reactive and proactive aggression. However, we found a correlation between the impact of childhood maltreatment and reactive aggression. These results suggest that in addition to the cumulative experience of ACEs, the subjective burden of these experiences on individuals must not be underestimated in case of aggression. Additional moderation analysis showed no differences in these relationships in case of less developed versus medium‐high developed reflective functioning. The findings substantiate the importance of early prevention and treatment programs with focus on ACEs to possibly reduce aggression.

ABSTRACTIn routine outcome monitoring, psychotherapists receive feedback from their clients about their self‐reported progress during therapy. This practice is based on research indicating that therapists overestimate their effectiveness and cannot detect and predict negative client change. However, this assumption is based on only a few studies. This study aimed to investigate whether trainee therapists could estimate client deterioration after each session and after therapy and whether they, from session to session, could predict client post‐therapy outcomes. Fifty‐three postgraduate trainee therapists at a university clinic treated 105 clients, with an average of 13.1 sessions. A questionnaire was developed to measure the therapists' estimation of client change at each session and their session‐by‐session prediction of client post‐therapy outcomes. The 10‐item version of the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE‐OM) was used to measure clients' self‐reported change at each session. The data included 96 (91.5%) therapist estimations of client post‐therapy outcomes, 1015 (87.8%) estimations of client change from the second to the penultimate session, and 1140 predictions of post‐therapy outcomes. The study found that at post‐therapy, the therapists were only able to identify one out of eight clients who showed deterioration on the CORE‐10. Additionally, during therapy, they could accurately estimate only six out of 83 sessions in which clients had experienced deterioration on the CORE‐10, and they failed to predict any of the eight clients who ended therapy with deterioration. In conclusion, therapists cannot rely on their clinical judgement alone to assess client progress and outcomes and will depend on routine outcome monitoring to detect client deterioration.

ABSTRACTThe aim of the study was to investigate the mediating roles of resilience, posttraumatic growth (PTG) and religiosity between the impact of hurricane trauma and psychological distress. Using a cross‐sectional design, the study involved 101 Libyan participants with an average age of 30.43 years (SD = 9.59), of whom 72% were women. Participants completed validated tests, including the Impact of Event Scale (IES), Brief Resilience Scale, Muslim Religiosity Scale and Patient Health Questionnaire (PHQ). The results indicated that posttraumatic stress symptoms (PTSS) were not associated with PTG (r = 0.04, p > 0.05) or religiosity (r = 0.02, p > 0.05) but were negatively associated with resilience (r = −0.39, p < 0.001) and positively associated with psychological distress including anxiety (r = 0.72, p < 0.001) and depression (r = 0.69, p < 0.001). Structural equation modelling (SEM) revealed that only resilience positively mediated the association between PTSS and anxiety (indirect effect = 0.04, p = 0.031), while PTSS positively predicted psychological distress (β = 0.037, p < 0.001). Network analysis identified parent loss is strongly connected with intrusion (r = 0.121), as most central node, while partner loss was associated with hyperarousal (r = 0.063), irritability (r = 0.036) and both share the same connection with numbing, while interestingly partner and friends loss share connection with resilience (r = 0.177). The study concludes that urgent clinical interventions, such as trauma‐focused cognitive behavioural therapy, are required for the affected individuals, with a focus on enhancing resilience as a protective factor against PTSS.

ABSTRACTObjectiveNetwork models hold much promise for use in the form of personalized feedback, which the TheraNet Project aims to investigate. In the present study, we share therapists' first reactions to patient network models based on ecological momentary assessment (EMA) data.MethodTherapists (N = 24) were taught to interpret the network models based on their patient's data. They were provided with concrete use suggestions at the end of the workshop. The workshops were analysed using descriptive qualitative content analysis. The resulting codes were then grouped thematically.ResultsTherapists spoke about using the networks for “case conceptualization”, “therapy planning”, and “psychoeducation”, but also commented on the “study design”. Before the concrete suggestions, therapists most frequently voiced thoughts on its uses for “case conceptualization”. After the suggestions, “psychoeducation” was mentioned most frequently.ConclusionsTherapists intuitively connected network models to case conceptualizations. Once concrete suggestions were provided, therapists more frequently discussed networks as psychoeducative tools.

ABSTRACTObjectivesIntrusive thoughts and images in Health Anxiety are poorly understood. The current study aims to explore the rates and nature of health‐related intrusive thoughts and images in people with and without Health Anxiety.DesignWe used a cross‐sectional interview and survey design recruiting 82 participants (Health Anxiety: n = 37; control: n = 45).MethodsParticipants completed a diagnostic and clinical interview, and questionnaires to assess experiences and appraisals of intrusive thoughts and images about health.ResultsExperiencing an intrusive thought or image was common in both groups (Health Anxiety: 89.2%, control: 55.6%). However, the Health Anxiety group reported their intrusive thoughts as more frequent, more distressing, and associated them with more negative emotions than controls. Further, the Health Anxiety group had increased negative appraisals and specific maladaptive behaviours for both intrusive thoughts and intrusive images compared to controls.ConclusionsWe conclude that, relative to controls, individuals with Health Anxiety experience intrusive thoughts and images more intensely and negatively, have more dysfunctional appraisals of them, and are more likely to respond to them with specific maladaptive behaviours. As such, addressing intrusive thoughts and images as part of cognitive behavioural interventions for Health Anxiety is warranted.

ABSTRACTRoutine outcome monitoring (ROM) is one of the most important methodologies for evaluating client progress and improving the efficiency and quality of psychological assistance. Despite this, the culture of ROM use is struggling to establish itself in the Italian National Health System, shaping up as a sporadic and unevenly used practice. The main objective of the present study was to assess the frequency of use of different outcome monitoring measures and the attitudes toward ROM within psychological services of the Italian National Health System. The study involved 184 psychotherapist (75% female and 25% male) employed in the Italian Health System structures. Participants completed an anonymous questionnaire composed by Outcome monitoring use and Attitudes to ROM. The data reveal a general low‐frequency in ROM use, with the exception of the symptom monitoring measures. In our sample, the variables that significantly affect the level of ROM use are psychological capability and physical and social opportunity. The present study provides some empirical evidence to reflect on the importance of increasing the use of ROM within psychological services and to promote interventions to improve clinicians' positive attitudes toward ROM.

ABSTRACTIntroductionRecent research shows that there has been a decrease in meaning in life and an increase in hopelessness and nonsuicidal self‐injury in adolescents after the pandemic. The present study aims to address three objectives: (1) to compare the frequency, types and functions of nonsuicidal self‐injury before and after the pandemic, (2) to explore the relationship between meaning in life, hopelessness and nonsuicidal self‐injury and (3) to study differences in nonsuicidal self‐injury, meaning in life and hopelessness levels before and following the pandemic.MethodsThis research was conducted in a community sample of N = 3800 Spanish participants, including n = 1733 from the pre‐pandemic period and n = 2067 from the post‐pandemic period. Ages ranged between 11 and 19, and the average age was 14.87 (SD = 1.58). The sample had an equal distribution by gender, with 50.5% females (n = 1919) and 49.5% males (n = 1881). Standardized tests such as ISAS‐II, BHS and PIL‐10 were used, as well as descriptive statistics, Spearman correlations and non‐parametric ANCOVAs of Quade controlling for age and gender to compare pre‐ and post‐pandemic variables.ResultsThe results revealed a significant increase in the number of functions of nonsuicidal self‐injury, in the methods employed and in the levels of hopelessness, along with a notable decrease in meaning in life after the pandemic. However, the estimated prevalence of pre‐ and post‐pandemic nonsuicidal self‐injury remained similar. The estimated lifetime prevalence of NSSI was 24.9% (n = 432) before the pandemic and 19.4% (n = 401) after the pandemic. A positive correlation between nonsuicidal self‐injury and hopelessness and a negative correlation with meaning in life were observed.ConclusionsThese findings indicate that the pandemic influenced the mental health of young Spaniards and suggest it may be useful to incorporate meaning‐centred interventions in protocols to address nonsuicidal self‐injury and hopelessness in adolescent populations.

ABSTRACTThe growing demand for mental health services, exacerbated by long waiting lists and high psychotherapy dropout rates, highlights the urgent need for brief and effective approaches. The aim of this study was to analyse the presence and impact of change markers in online narrative single‐session therapy (NSST) and a change interview 1 month later. The change markers were coded in the NSST and the interview via the innovative moments (IMs) coding system. This coding system allows the identification of IMs (i.e., change markers), differentiating them into three levels of complexity (from lower complexity, Level 1, to the highest complexity, Level 3). Good and poor outcomes were categorized on the basis of the change in presession distress to the distress reported 1 month later at the change interview. Previous research has associated IMs with therapy outcomes, mostly with Level 2 and 3 IMs. In this study, more IMs emerged in the NSSTs of clients with good outcomes. The Level 3 IMs did not emerge in the NSST and only emerged in the change interview. There was a positive correlation between the decrease in distress and the emergence of Level 3 IMs in the change interview. The pattern of the relationship between the IMs in NSST and those in the change interview suggests that, in good outcome cases, there is a positive evolution in the emergence of change markers. These results demonstrate that IMs are produced in NSST, as occurs in regular psychotherapy, and suggest that the change initiated in a single session is expanded until the change interview for good outcome cases. The clinical implications of this study are discussed.

ABSTRACTBackgroundAs nonsuicidal self‐injury (NSSI) has become an increasing public health concern, the last few years have seen the emergence of efforts to address NSSI recovery. Although many recovery efforts adopt a medical view of self‐injury and focus on cessation of the behaviour, recovery can mean many different things to different people. In this study, we provide initial empirical validation of the self‐injury recovery framework, by assessing whether different recovery profiles exist.MethodsOur sample comprised 733 participants with lived experience of NSSI (M age = 24.54, sd = 6.39). Participants completed self‐report measures of constructs related to NSSI recovery and NSSI characteristics.ResultsUsing latent profile analysis, we identified six unique profiles reflecting differences in thoughts/urges to self‐injure, self‐efficacy, social support, optimism, coping, underlying adversities, perceptions of scarring, disclosure, resilience and self‐compassion. Multivariate analyses of variance confirmed these profiles differed according to NSSI characteristics such as frequency of NSSI, a self‐assessment of recovery, the desire to self‐injure or avoid self‐injury and the number of people disclosed to.LimitationsA homogenous sample and cross‐sectional design limit generalisability of our findings across populations and across time.ConclusionsOur findings reinforce that recovery can take many different forms, with different factors being relevant to different individuals. Adopting a person‐centred approach that centres an individual's lived experience and emphasises what is important to them in the recovery process offers opportunities for more empathic responses to self‐injury and better outcomes for individuals who self‐injure.