Linking obsessions to morality: A cross-cultural study among Turkish and Belgian university students.

The present study examines the links between different types of morality and obsessions in university students from Leuven, Belgium (N = 252) and Istanbul, Turkey (N = 301) using validated scales for morality and obsessions. Belgium and Turkey were chosen as two exemplar cultural contexts expected, and in the current study found, to differ in the relative levels of individualizing and binding morality. We hypothesized that obsessions involving potential harm (e.g., aggressive obsessions) are cross-culturally associated with individualizing morals, and obsessions indicating impurity (e.g., contamination) are cross-culturally associated with binding morals. Moreover, we expected that cultural differences in the frequency of obsessions could be linked to differences in culturally prevalent moralities. As predicted, contamination obsessions were cross-culturally linked to binding morals. Also, the frequency of contamination obsessions was higher in the Turkish sample compared to the Belgian, which was predicted by higher levels of binding morals in Turkey. Doubts were cross-culturally endorsed at similar rates and were associated with individualizing morals. Aggressive obsessions were relatively more frequent in the Belgian compared to the Turkish sample, however-unexpectedly-these intrusions were not positively linked to either type of morality, neither in Belgium nor in Turkey. Taken together, these findings provide initial support for the role of morality in obsessive-compulsive disorder (OCD), at least for certain types of obsessions (contamination and doubts), as well as suggest that some differences in the moral foundations may play a role in explaining the prevalence of certain obsessions (i.e., contamination).

Development of a stepped care intervention model of evidence-based interventions for the management of posttraumatic stress in the Belgian Police.

Background: Police officers are frequently exposed to a wide variety of potentially traumatic events (PTE) and are therefore at a considerable risk of developing posttraumatic stress disorder (PTSD). Previous research estimated the point prevalence of PTSD in Belgian police officers at 7.4%, significantly higher than in the general population. An effective organisational strategy to manage posttraumatic stress is essential.Objective: We aimed to develop a novel organisational approach regarding traumatic stress for Belgian police, combining evidence-based strategies for the prevention and treatment of posttraumatic stress in a stepped care intervention model.Method: In a broad development process, we combined scientific literature, case studies of best practices from other police organisations with insights gathered from a number of expert panels, thematic working groups and feedback groups.Results: A comprehensive stepped care intervention model was developed, consisting of evidence-based interventions for the prevention and treatment of posttraumatic stress.Conclusions: The intervention model is a promising organisational strategy for the management of posttraumatic stress in police organisations based on evidence-based interventions. Its effectiveness will be studied in the coming years.

Police officers are at considerable risk of developing PTSD as they are consistently exposed to a wide array of PTE.An adequate organisational response to manage the consequences of this exposure as much as possible is essential.We developed a comprehensive stepped care intervention model consisting of evidence-based interventions, based on scientific literature, best practices in other police organisations, and thorough expert review.

A validation of the Dutch version of the Awareness of Narrative Identity Questionnaire (ANIQ-NL).

Individuals build a narrative identity through the construction of an internalised, unfolding life story based on significant autobiographical memories. The current study validated a Dutch version of the Awareness of Narrative Identity Questionnaire (ANIQ-NL), which assesses how aware individuals are of having a narrative identity as well as their perception of the global coherence within their autobiographical memories, specifically, in terms of temporal ordering, causal connections and thematic integration. The questionnaire was administered to 541 adults (65.1% female, Mage = 34.09, SDage = 15.04, age range = 18-75). The results of a confirmatory factor analysis provided evidence for a four-factor structure, consisting of awareness and the three coherence subscales. The factor loadings of the items varied between .67 and .96. Moreover, the ANIQ-NL subscales showed good to excellent internal consistency, with Cronbach's alphas ranging from .86 to .96. Furthermore, higher levels of perceived autobiographical memory coherence were found to be significantly correlated to lower levels of depression, anxiety, and stress symptoms. The ANIQ-NL was determined to be a valid and reliable tool to measure narrative identity awareness and perceived narrative coherence. Future research could utilise the ANIQ-NL to further investigate the role of narrative identity in psychological well-being.

Posttraumatic stress disorder in Belgian police officers: prevalence and the effects of exposure to traumatic events.

Background: Police officers are at considerable risk of developing posttraumatic symptoms because they frequently encounter violent or emotionally disturbing incidents. We investigate experiences with potentially traumatic events (PTE), traumatic exposure, and the prevalence of probable posttraumatic stress disorder (PTSD), complex PTSD and subclinical PTSD in a sample of Belgian police officers.Methods: In total, 1,465 police officers from 15 Belgian Local Police zones participated in a web-based survey, consisting of three segments: evaluating experiences with a list of 29 PTE, assessing if any of these PTE accounted for traumatic exposure, and evaluating 1-month probable PTSD, complex PTSD and subclinical PTSD prevalence using the International Trauma Questionnaire (ITQ).Results: Police officers frequently experience a wide range of PTE. A large majority of 93.0% reports traumatic exposure. Assessment with ITQ shows a 1-month prevalence of 5.87% for probable PTSD and 1.50% for probable complex PTSD, while an additional 7.58% report subclinical PTSD. No demographic variables influenced PTSD prevalence. Cumulative PTE experiences in itself did not predict PTSD, while the characteristics of certain PTE did entail a higher prevalence of probable PTSD and subclinical PTSD.Discussion: This study is the first to evaluate experiences with PTE, traumatic exposure and 1-month prevalence of probable PTSD, complex PTSD, and subclinical PTSD in Belgian police officers. Police officers are frequently confronted with a broad variety of PTE, and a large majority reports traumatic exposure. The 1-month prevalence of probable PTSD is significantly higher compared to previous international research in the general population, but lower than in similar international research involving police officers. In this study, cumulative PTE experiences in itself did not reliably predict PTSD, while the characteristics of certain PTE did. Posttraumatic symptoms are an important mental health challenge in Belgian police.

This study is the first to evaluate experiences with PTE, traumatic exposure and 1-month prevalence of probable PTSD, complex PTSD, and subclinical PTSD in Belgian police officers.Results show that police officers are frequently confronted with a broad variety of PTE, and a large majority reports traumatic exposure.The 1-month prevalence of probable PTSD is significantly higher compared to previous international research in the general population, but lower than in similar international research involving police officers.In this study, cumulative PTE experiences in itself did not reliably predict PTSD, while the characteristics of certain PTE did.Posttraumatic symptoms are an important mental health challenge in Belgian police.

Understanding clinical fear and anxiety through the lens of human fear conditioning.

Fear is an adaptive emotion that mobilizes defensive resources upon confrontation with danger. However, fear becomes maladaptive and can give rise to the development of clinical anxiety when it exceeds the degree of threat, generalizes broadly across stimuli and contexts, persists after the danger is gone or promotes excessive avoidance behaviour. Pavlovian fear conditioning has been the prime research instrument that has led to substantial progress in understanding the multi-faceted psychological and neurobiological mechanisms of fear in past decades. In this Perspective, we suggest that fruitful use of Pavlovian fear conditioning as a laboratory model of clinical anxiety requires moving beyond the study of fear acquisition to associated fear conditioning phenomena: fear extinction, generalization of conditioned fear and fearful avoidance. Understanding individual differences in each of these phenomena, not only in isolation but also in how they interact, will further strengthen the external validity of the fear conditioning model as a tool with which to study maladaptive fear as it manifests in clinical anxiety.

A Learning Theory Approach to Attachment Theory: Exploring Clinical Applications.

Although clinicians typically acknowledge the importance of insecure attachment as one factor that can contribute to children's psychopathology, translating attachment theory into clinical practice has proved a challenge. By specifying some of the mechanisms through which the child's attachment develops and changes, learning theory can enhance attachment based approaches to therapy. Specifically, interventions building on operant (parent management training) and classical (exposure therapy) learning can be used to stimulate new learning that increases the child's security and confidence in the parent's availability and responsiveness. To explore the clinical application and utility of a Learning Theory of Attachment (LTA), we focus on two attachment-focused interventions: Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) and Middle Childhood Attachment-based Family Therapy (MCAT). VIPP-SD is an evidence-based parent management training designed to promote sensitive parenting and secure attachment in early childhood. MCAT is a recently developed intervention that uses exposure to stimulate secure attachment in middle childhood. LTA sheds light on the mechanisms set in train by VIPP-SD and MCAT facilitating the induction of professionals in clinical applications.

Narrative coherence predicts emotional well-being during the COVID-19 pandemic: a two-year longitudinal study.

Prior research has shown that narrative coherence is associated with more positive emotional responses in the face of traumatic or stressful experiences. However, most of these studies only examined narrative coherence after the stressor had already occurred. Given the outbreak of the novel coronavirus disease COVID-19 in March 2020 in Belgium and the presence of data obtained two years before (February 2018), we could use our baseline narrative coherence data to predict emotional well-being and perceived social support in the midst of the pandemic. In a sample of emerging adults (NT1 = 278, NT2 = 198), higher baseline coherence of narratives about positive autobiographical experiences predicted relative increases in emotional well-being during the COVID-19 pandemic. Furthermore, the relation between the coherence of positive narratives and emotional well-being was partially mediated by perceived social support. These findings suggest that narrative coherence could be an enhancement factor for adaptive emotional coping with stressful situations, in part by evoking more supportive social reactions. This study demonstrates the importance of researching cognition (narrative coherence) and emotion (well-being) to shed light on pressing societal matters such as the global COVID-19 pandemic.

Reconciling a phenomenological with a functional approach to memory: narrative coherence and its social function.

To date, the phenomenological and functional aspects of autobiographical memory have by and large been studied separately. This is quite remarkable, given that both can inform each other, and that investigating their interaction can add to the understanding of the (in)adaptivity of certain memory characteristics for our well-being. In other words, examining how particular features of autobiographical memory are adept or inept at serving specific functions, could help us to better comprehend and explain relations between memory and psychological well-being. We discuss previous attempts to integrate phenomenology with functionality and formulate three main directions for future research based on the current state of the art. The directions concern (1) focusing on functionality (adaptivity) and not merely on the use of memories in phenomenological work, (2) attention for the bidirectionality of the relation between phenomenology and functionality, and (3) the addition of narrative constructs like coherence to the traditional range of phenomenological features. We will illustrate our directions for the reintegration of phenomenology with functionality through the social function of coherent autobiographical memories. This framework could help to stimulate future empirical studies and pave the road for new clinical interventions to improve psychological well-being.

Predicting clinical outcomes via human fear conditioning: A narrative review.

A common assumption in human fear conditioning research is that findings are informative for the etiology and treatment of clinical anxiety. One way to empirically evaluate the external validity of fear conditioning is by prospective studies. We review available prospective research investigating whether individual performance in fear conditioning predicts individual differences in anxiety levels and exposure-based treatment outcome. We focus on fear extinction, generalization, acquisition, and avoidance. Results suggest that reduced extinction and broader generalization predict higher anxiety levels. Results with respect to the predictive value of acquisition for anxiety levels are mixed. With regard to predicting exposure-based treatment outcome, some studies do find an association with extinction whereas others do not. The majority of studies does not find an association with acquisition. Evidence on extinction recall is limited and not consistent. The interpretation of these results requires caution. The number of available studies is limited. It is possible that not all work, in particular studies with only null effects, has found its way to publication. Future research on this topic will benefit from large sample sizes, preregistered hypotheses, full transparency about the conducted analyses and the publication of high-quality studies with null effects.

Reasons to remember: A functionalist view on the relation between memory and psychopathology.

Memory is under investigation as one of the core mechanisms of psychopathology. The traditional cognitive view of memory as a stable structure with a range of set characteristics can be complemented with a perspective that considers remembering as a behaviour that varies fluidly across contexts. Remembering may serve adaptation to the environment by fulfilling a directive function, a self-function and a social function. A failure to fulfil these functions may be a risk factor for psychopathology. Implications of the discussed functionalist perspective include the importance of reinforcing adaptive ways of remembering during early development, the possibility of treating maladaptive ways of remembering through contextual interventions and the added ecological validity of using ambulatory assessment methods.

Perceived Autobiographical Coherence Predicts Depressive Symptoms Over Time Through Positive Self-Concept.

The coherence of autobiographical memories plays an important role in psychological well-being, as borne out by recent studies. This study aimed to advance this understanding by assessing whether coherence predicted depressive symptoms over time in adults. Further, it aimed to specify mediators through which this association might occur, namely psychological resources of self-esteem self-efficacy, meaning in life, and optimism. A sample of 160 participants (M age = 26.4, SD = 3.2, 58.1% women) completed surveys at three time-points spaced 1 week apart. The surveys contained measures of the perceived coherence of life stories and autobiographical memories, psychological resources, and depressive symptoms. The results of a path analysis model, controlling for depressive symptoms at baseline, indicated that perceived causal coherence was the only unique predictor of later depressive symptoms, and that this occurred through positive self-concept, represented by self-esteem and self-efficacy. Limitations of the study include no examination of cultural background as a moderating factor and the short time-intervals. Overall, the findings provide further evidence that the perception of how events have unfolded and impacted on one's life and sense of self is particularly important in mitigating depressive symptoms. It extends on our understanding by showing this occurs through changes in self-concept.

Narrative Coherence of Turning Point Memories: Associations With Psychological Well-Being, Identity Functioning, and Personality Disorder Symptoms.

Individuals develop a narrative identity through constructing and internalizing an evolving life story composed of significant autobiographical memories. The ability to narrate these memories in a coherent manner has been related to well-being, identity functioning, and personality pathology. Previous studies have particularly focused on coherence of life story narratives, overlooking coherence of single event memories that make up the life story. The present study addressed this gap by examining associations between narrative coherence of single turning point memories and psychological well-being, identity functioning, and personality disorder (PD) symptoms among 333 Belgian emerging adults (72.1% female; M age = 22.56, SD = 3.13, age range = 18-30). In addition, the present study tested whether narrative coherence could predict unique variance in PD symptoms above and beyond identity and interpersonal functioning, both considered key components of personality pathology. The findings showed that narrative coherence was not significantly related to psychological well-being, but yielded significant negative associations with disturbed identity functioning and antisocial PD symptoms. Furthermore, narrative coherence predicted unique variance in antisocial PD symptoms above and beyond identity functioning, but did not predict unique variance in borderline and antisocial PD symptoms above and beyond both identity and interpersonal functioning. Collectively, these findings suggest that narrative incoherence within single event memories might be characteristic for disturbed identity functioning and antisocial personality pathology.

Keep Calm and Carry On: The Relations Between Narrative Coherence, Trauma, Social Support, Psychological Well-Being, and Cortisol Responses.

In order to explain trauma resilience, previous research has been investigating possible risk and protective factors, both on an individual and a contextual level. In this experimental study, we examined narrative coherence and social support in relation to trauma resilience. Participants were asked to write about a turning point memory, after which they did the Maastricht Acute Stress Test, our lab analog of a traumatic event. Following, half of the participants received social support, whereas the other half did not. Afterwards, all participants wrote a narrative on the traumatic event. Moment-to-moment fluctuations in psychological and physiological well-being throughout the experiment were investigated with state anxiety questionnaires and cortisol measures. Results showed that narratives of traumatic experiences were less coherent than narratives of turning point memories. However, contrary to our predictions, coherence, and, in particular, thematic coherence, related positively to anxiety levels. Possibly, particular types of thematic coherence are a non-adaptive form of coping, which reflect unfinished attempts at meaning-making and are more similar to continuous rumination than to arriving at a resolution. Furthermore, coherence at baseline could not buffer against the impact of trauma on anxiety levels in this study. Contrary to our hypotheses, social support did not have the intended beneficial effects on coherence, neither on well-being. Multiple explanations as to why our support manipulation remained ineffective are suggested. Remarkably, lower cortisol levels at baseline and after writing about the turning point memory predicted higher coherence in the trauma narratives. This may suggest that the ability to remain calm in difficult situations does relate to the ability to cope adaptively with future difficult experiences. Clinical and social implications of the present findings are discussed, and future research recommendations on the relations between narrative coherence, social support, and trauma resilience are addressed.

Be coherent and become heard: The multidimensional impact of narrative coherence on listeners' social responses.

Previous research has suggested that sharing autobiographical memories in a coherent manner has a beneficial impact on consequent social reactions of listeners. In this experimental study, we were able to replicate earlier findings by demonstrating that listeners (N = 107) showed significantly more willingness to interact with, more social support towards, and a more positive attitude towards coherent than incoherent narrators. Remarkably, these beneficial effects of coherence were observed only for narratives about positive memories. Results are explained in the light of the relevance of positive memories for the social bonding function of autobiographical memory. Furthermore, earlier work was extended and refined by investigating effects of the individual constituting dimensions of coherence (context, chronology, theme) on social responses. In line with our predictions, the dimensions of chronology and theme were most important in impacting social responses of listeners. Possibly a reduction of the attraction effect due to increased effortful processing and reduced credibility due to insufficient emotional elaboration might explain these results respectively. Furthermore, social responses were worse when narratives were incoherent with regard to more than one dimension, in line with the expected additive effect. Overall, fully incoherent narratives, which had had low scores on context, chronology, and theme, had the most adverse effect on listeners' social responses. This study adds significantly to the domain of memory and cognition by showing how cognitive psychological research would benefit from extending a merely intrapersonal perspective to include an interpersonal perspective that considers social implications of memory and cognition as well.

Validation and Measurement Invariance of the Leuven Obsessional Intrusions Inventory in Two Different Cultures.

Obsessions - recurrent unwanted intrusive thoughts - are one of the two pillars of the Obsessive Compulsive Disorder (OCD). Although OCD has been reported across many different cultures, research on these cultural variations is hampered by the lack of cross-culturally sound instruments to assess intrusive thoughts. The aim of the current study is to investigate the psychometric properties of the recently developed Leuven Obsessional Intrusions Instrument (LOII) in two different cultural contexts. Turkish (N = 663) and Belgian (N = 496) participants were sampled from non-clinical student populations. Results from confirmatory factor analyses yielded a shortened version of the LOII (i.e., LOII-R) with a four-factor solution - aggressive, sexual, and contamination intrusions, and 'just-right' doubts - as the best fitting model across both cultures. The model met most criteria for strong measurement invariance, and proved to be both valid and reliable. The results of this study suggest that the LOII-R is a good candidate for cross-cultural studies on obsessional intrusions.

How am I going to tell you this? The relations between social anxiety and narrative coherence.

Recently, evidence has been increasing that individuals who are able to narrate coherently about their autobiographical memories, receive more positive social feedback, have higher-quality social relationships and are overall less likely to suffer from internalising psychopathology, like depression and anxiety. However, the relation between narrative coherence and social anxiety, in particular, has not been topic of research until now. This is remarkable, since the concern about negative evaluations by others in social situations is at the core of social anxiety. In the present experimental study (N = 68), we investigated in a two-by-two design how trait and state social anxiety are related to narrative coherence, as well as possible underlying mechanisms. In our study, neither trait nor state social anxiety, nor their interaction had the expected detrimental effect on narrative coherence. However, trait differences in the proposed mechanisms of social anxiety were in line with the literature. Results showed that trait social anxiety and thematic narrative coherence were indirectly negatively related, via the intervening effects of an increased internal focus on anxiety cues, an excessive external focus on negative social evaluation, larger working memory load, more rumination and more depressive symptoms. Limitations and recommendations for future research are addressed.

Validation of the Impact of Event Scale With Modifications for COVID-19 (IES-COVID19).

Viral outbreaks can be experienced as disruptive and can be associated with trauma-related stress symptoms. In the current study, we adjusted the Dutch version of the Impact of Event Scale (IES) to assess traumatic stress symptoms related to the impact of the COVID-19 outbreak. The psychometric properties of this Impact of Event Scale with modifications for COVID-19 (IES-COVID19) were investigated by administering the IES-COVID19 to 380 university students who participated during the early stage of the COVID-19 outbreak, upon invitation via e-mail. Using confirmatory factor analysis, the factor structure of the IES-COVID19 was found to be similar to the original IES, indicating two latent factors: intrusion and avoidance, χ2 (85) = 147.51, CFI = .92, TLI = .90, RMSEA = .044, SRMR = .049. Cronbach's alpha showed acceptable internal consistency of the total IES-COVID19, α = .75. Pearson's correlations of the IES-COVID19 over time were also sufficient, demonstrating adequate test-retest reliability, r = .62. Significant correlations (ranging between .15 and .50) between the IES-COVID19 and symptoms of depression, anxiety, stress, stress-related rumination, as well as negative social interactions, demonstrate adequate convergent validity. Overall, the IES-COVID19 shows to be a valid and reliable measure that can be utilized to investigate trauma-related stress symptoms of intrusion and avoidance related to the short- and long-term impact of the COVID-19 outbreak.

Psychometric Properties of the Dutch Cognitive Avoidance Questionnaire.

Various psychological disorders, such as major depressive disorder and anxiety disorders, share cognitive avoidance as one of the main mechanisms underlying symptom severity and maintenance. A valid and reliable measure that covers a broad array of cognitive avoidance strategies is therefore instrumental, though currently greedily missing. The Questionnaire d'Évitement Cognitif (QEC) was developed as a comprehensive instrument measuring five cognitive avoidance strategies. The current study aimed to evaluate the psychometric properties of the Dutch Cognitive Avoidance Questionnaire (CAQ-NL) in three samples (N sample 1 = 607; N sample 2 = 357; N sample 3 = 448). Confirmatory factor analysis supported the hypothesized five-factor structure of the CAQ-NL. Reliability analysis showed good to excellent internal consistency for the CAQ-NL and its five subscales. Furthermore, Multi-Group CFA revealed that the CAQ-NL demonstrated configural and metric invariance across the three samples. Convergent validity of the CAQ-NL was supported by substantial correlations with brooding, with more cognitive avoidance being related to more brooding. In addition, cognitive avoidance was negatively associated with psychological well-being and positively with symptoms of depression and anxiety, which corroborates the instrument's concurrent validity. Moreover, the CAQ-NL was predictive of depressive symptoms six months later, supporting its predictive validity. In sum, results of the present study provide support for the validity and reliability of the CAQ-NL.

Transitions from avoidance: Reinforcing competing behaviours reduces generalised avoidance in new contexts.

Generalised avoidance behaviours are a common diagnostic feature of anxiety-related disorders and a barrier to affecting changes in anxiety during therapy. However, strategies to mitigate generalised avoidance are under-investigated. Even less attention is given to reducing the category-based generalisation of avoidance. We therefore investigated the potential of an operant-based approach. Specifically, it was examined whether reinforcing competing (non-avoidance) behaviours to threat-predictive cues would interfere with the expression of generalised avoidance. Using a matching-to-sample task, artificial stimulus categories were established using physically dissimilar nonsense shapes. A member of one category (conditioned stimulus; CS1) was then associated with an aversive outcome in an Acquisition context, unless an avoidance response was made. Next, competing behaviours were reinforced in response to the CS1 in new contexts. Finally, we tested for the generalisation of avoidance to another member of the stimulus category (generalisation stimulus; GS1) in both a Novel context and the Acquisition context. The selective generalisation of avoidance to GS1 was observed, but only in the Acquisition context. In the Novel context, the generalisation of avoidance to GSs was significantly reduced. A comparison group (Experiment 2), which did not learn any competing behaviours, avoided GS1 in both contexts. These findings suggest that reinforcing competing behavioural responses to threat-predictive cues can lead to reductions in generalised avoidance. This study is among the first study to demonstrate sustained reductions in generalised avoidance resulting from operant-based protocols, and the clinical and research implications are discussed.

The influence of an induced negative emotional state on autobiographical memory coherence.

Individuals who experience difficulty constructing coherent narratives about significant personal experiences generally report less psychological well-being and more depressive symptoms. It remains, however, unclear whether a negative emotional state, one of the core symptoms of depression, causes this impairment in autobiographical memory coherence. The current study aimed to examine the causal relation between mood and memory coherence by means of a mood induction paradigm. A group of 165 students were randomly allocated to one of three mood groups: negative, positive, and neutral. We hypothesized that memory coherence would decrease following a negative mood induction. In addition, working memory capacity was expected to mediate the association between mood and memory coherence. Contrary to predictions, memory coherence increased following a negative mood induction. This increase was likewise observed in the positive mood group, though memory coherence remained consistent in the neutral mood group. This effect of mood on memory coherence was solely observed in female participants and not in the small male subsample. Results provided no support for the hypothesis that working memory capacity functioned as an underlying mechanism. Different theoretical explanations are discussed.