Larger comfortable interpersonal distances in adults exposed to child maltreatment: The role of depressive symptoms and social anxiety.

Previous studies report a preference for larger comfortable interpersonal distance (CIPD) in individuals with child maltreatment (CM) when being approached by others. Yet, research on approaching others, as opposed to being approached, as well as on potential effects of social anxiety and depression is lacking. We investigated if CM and depressive symptoms influence CIPD and if social anxiety mediates the possible association of CM and CIPD when approaching a female stranger. One hundred ten participants with CM (CM) and 58 participants without CM (non-CM) experiences performed the stop-distance paradigm and stopped first when feeling uncomfortable (D1) and again when feeling very uncomfortable (D2). CM experiences were associated with a preference for larger CIPD, independent of depressive symptoms. All CM subtypes were associated with a larger D2. The relationship between CM and CIPD was partially mediated by social anxiety. These novel findings can help to develop interventions strengthening socially relevant skills and processes in those affected by CM, targeting alterations in social anxiety and depression.

Construct validity of the German version of the Emotion Reactivity Scale.

BACKGROUND: Emotional reactivity is an important construct to consider when studying mental disorders. This study was conducted to translate and assess the factor structure, construct validity and internal consistency of a German version of the Emotion Reactivity Scale (ERS), which is an originally English questionnaire assessing three components of emotional reactivity: sensitivity, intensity and persistence of emotions. METHODS: The German ERS and a range of questionnaires used to assess convergent and discriminant validity were completed by 334 German speaking Swiss participants. RESULTS: Confirmatory factor analysis showed strong support for a bi-factor model, with evaluation indices pointing to a unidimensional construct rather than to domain specific factors. The questionnaire showed good reliability and the factor structure was similar across gender. The ERS showed convergent validity with general psychopathology, behavioral inhibition, negative affect, orienting sensitivity, depressive symptoms and symptoms of disordered eating, and discriminant validity with behavioral activation and alcohol consumption. CONCLUSIONS: Findings support the construct validity of the German ERS and suggest that it assesses a unidimensional construct with high internal consistency. Accounting for the unidimensional nature of the scale and aiming for efficient assessment tools, future research could, based on these findings, develop and evaluate the psychometric properties of a short version of the ERS.

Exploring Response Inhibition, the Behavioral Inhibition System and Possible Sex Differences in Athletes and Non-Athletes.

BACKGROUND: The objective of this study was to revisit the question concerning whether athletes are better than non-athletes at fundamental cognitive abilities, such as inhibitory control, in addition to also focusing on motivational dispositions and possible sex differences. Adding the latter could be crucial since both inhibitory control and motivational dispositions, such as approach and avoidance, are central to goal-directed behavior. METHODS: This study's sample was composed of 93 participants (40 males): 29 biathletes; 30 alpine skiers; and 34 non-athletes. A non-sport-specific stop-signal task was used for the assessment of inhibitory control in terms of response inhibition, and the motivational dispositions were assessed with the BIS/BAS scales. RESULTS: The results showed that there were no differences between the two different sports or non-athletes with regard to response inhibition. However, females showed significantly slower response inhibition than males (p = 0.018) and scored significantly higher on the trait variable BIS (p < 0.001). CONCLUSIONS: The results from this study suggest that it might be meaningful to explore the contribution of sex differences and motivational dispositions on response inhibition in conjunction with different types of sports.

Individuals with and without child maltreatment experiences are evaluated similarly and do not differ in facial affect display at zero- and first-acquaintance.

BACKGROUND: Individuals with a history of child maltreatment (CM) are more often disliked, rejected and victimized compared to individuals without such experiences. However, contributing factors for these negative evaluations are so far unknown. OBJECTIVE: Based on previous research on adults with borderline personality disorder (BPD), this preregistered study assessed whether negative evaluations of adults with CM experiences, in comparison to unexposed controls, are mediated by more negative and less positive facial affect display. Additionally, it was explored whether level of depression, severity of CM, social anxiety, social support, and rejection sensitivity have an influence on ratings. METHODS: Forty adults with CM experiences (CM +) and 40 non-maltreated (CM-) adults were filmed for measurement of affect display and rated in likeability, trustworthiness, and cooperativeness by 100 independent raters after zero-acquaintance (no interaction) and 17 raters after first-acquaintance (short conversation). RESULTS: The CM + and the CM- group were neither evaluated significantly different, nor showed significant differences in affect display. Contrasting previous research, higher levels of BPD symptoms predicted higher likeability ratings (p = .046), while complex post-traumatic stress disorder symptoms had no influence on ratings. CONCLUSIONS: The non-significant effects could be attributed to an insufficient number of participants, as our sample size allowed us to detect effects with medium effect sizes (f2 = .16 for evaluation; f2 = .17 for affect display) with a power of .95. Moreover, aspects such as the presence of mental disorders (e.g., BPD or post-traumatic stress disorder), might have a stronger impact than CM per se. Future research should thus further explore conditions (e.g., presence of specific mental disorders) under which individuals with CM are affected by negative evaluations as well as factors that contribute to negative evaluations and problems in social relationships.

Characteristics of Patients Who Complete Suicide and Suicide Attempts While Undergoing Treatment in Norway: Findings from Compensation Claims Records.

The aim of this study was to identify characteristics that differentiate patients who complete suicide (SC) from patients with suicide attempts (SA) while undergoing treatment in Norway. We examined data from the Norwegian System of Patient Injury Compensation (Norsk Pasientskade Erstatning-NPE). Data were extracted from NPE case records from a 10-year period (2009-2019) for 356 individuals who attempted (n = 78) or died by (n = 278) suicide. The two groups differed significantly in the types of medical errors identified by experts. Inadequate suicide risk assessment tended to be proportionally and significantly more prevalent among SC compared to SA. There was a weak but significant trend that SA had received medication only, whereas SC had received both medication and psychotherapy. There were no significant differences with respect to age group, gender, diagnostic category, number of previous suicide attempts, inpatient/outpatient status, or category of responsible clinic. We conclude that suicide attempters and suicide completers differed in terms of identified medical errors. Focusing on the prevention of these and other types of errors could help to reduce the number of suicides of patients in treatment.

Psychometric evaluation of the Swedish Multidimensional Psychological Flexibility Inventory (MPFI).

Psychiatric disorders are common, and reliable measures are crucial for research and clinical practice. A cross-diagnostic construct that can be used to index treatment outcomes as well as prevalence of psychological ill health is psychological flexibility. The aim of this study was to validate a Swedish version of the Multidimensional Psychological Flexibility Inventory (MPFI). The MPFI has 12 subscales, six of which measure flexibility, and six that measure inflexibility. Using confirmatory factor analysis in a community sample of 670 participants, we found that a model with two higher order factors had satisfactory fit (CFI = .933) and a 12-factor model had the best fit to the data (CFI = .955). All 12 subscales showed adequate reliability (CRs = .803-.933) and the factor structure was similar across age groups and gender. Findings suggest that the Swedish version of the MPFI is a reliable instrument that can be used to index psychological flexibility. Potential areas for improvement of the instrument are discussed.

Patients Who Die by Suicide: A Study of Treatment Patterns and Patient Safety Incidents in Norway.

Underlying patterns and factors behind suicides of patients in treatment are still unclear and there is a pressing need for more studies to address this knowledge gap. We analysed 278 cases of suicide reported to The Norwegian System of Patient Injury Compensation, drawing on anonymised data, i.e., age group, gender, diagnostic category, type of treatment provided, inpatient vs. outpatient status, type of treatment facility, and expert assessments of medical errors. The data originated from compensation claim forms, expert assessments, and medical records. Chi-square tests for independence, multinominal logistic regression, and Bayes factors for independence were used to analyse whether the age group, gender, diagnostic category, inpatient/outpatient status, type of institution, and type of treatment received by patients that had died by suicide were associated with different types of medical errors. Patients who received medication tended to be proportionally more exposed to an insufficient level of observation. Those who received medication and psychotherapy tended to be proportionally more exposed to inadequate treatment, including inadequate medication. Inpatients were more likely to be exposed to inappropriate diagnostics and inadequate treatment and follow up while outpatients to insufficient level of observation and inadequate suicide risk assessment. We conclude that the patients who had received medication as their main treatment tended to have been insufficiently observed, while patients who had received psychotherapy and medication tended to have been provided insufficient treatment, including inadequate medication. These observations may be used as learning points for the suicide prevention of patients in treatment in Norwegian psychiatric services.

Reduced vividness of emotional memories following reactivation in a second language.

We investigated the effect of second language use on the experienced vividness and emotionality of negative autobiographical memories. Fifty native Swedish speakers with English as their second language were asked to recall a negative episodic memory from their past in their native language. Half the participants were then asked to reactivate the same memory in their first language while the other half were asked to reactivate it in their second language, and then rate their experienced vividness and emotionality a second time. Following this reactivation, experienced emotionality was reduced for both groups of participants, with a similar magnitude of reduction for both groups. Experienced vividness, however, was only reduced for the group who reactivated the memory in their second language. No difference in intrusion frequency was found between the groups at a one-week follow-up. The results provide increased insight into how a second language can affect the experienced emotionality and vividness of a negative autobiographical memory.

The Reliability and Factorial Validity of the Swedish Version of the Revised Controlling Behaviors Scale.

This study focused on the factor structure of the victimization form of the revised Controlling Behaviors Scale (CBS-R). Data from 1,218 women and men were analyzed in the study. Results of confirmatory factor analysis (CFA) failed to find support for the proposed five-factor structure of the scale, as the items on the scale were better represented by one common factor. In addition, when examining if controlling behaviors are distinct from psychological aggression, the CFA indicated that the items on the CBS-R are clearly distinguishable from the items on the psychological aggression (as measured with the subscales of the revised Conflict Tactic Scales [CTS2]), and that this holds for both males and females. Implications for the general use of the CBS-R and for use in conjunction with psychological aggression and physical aggression in intimate partner violence were discussed.

Relational frame theory, mathematical and logical skills: a multiple exemplar training intervention to enhance intellectual performance

The current study investigated the effects of Relational Frame Theory (RFT) based training on mathematical and logical skills. A sample of 21 Swedish high school students attending first grade and second grade were assigned to either training (n= 10) or no-training conditions (n= 11). Measures of performance on mathematical tests, Raven’s Standard Progressive Matrices (SPM), and relational responding tasks were taken prior to and after training. For 8-10 weeks, the experimental group trained using SMART, an online multiple exemplar training program for enhancing relational skills. No significant differences between the groups were found on mathematical performance. A significant increase on SPM performance was observed for the experimental group. The findings are in line with previous research on RFT, suggesting that behaviorally based interventions can enhance intellectual performance. Population characteristics, SMART training procedures, strengths and methodological limitations are discussed (AU)

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Reducing involuntary memory by interfering consolidation of stressful auditory information: A pilot study.

BACKGROUND AND OBJECTIVES: Intrusive emotional memories were induced by aversive auditory stimuli and modulated with cognitive tasks performed post-encoding (i.e., during consolidation). METHOD: A between-subjects design was used with four conditions; three consolidation-interference tasks (a visuospatial and two verbal interference tasks) and a no-task control condition. Forty-one participants listened to a soundtrack depicting traumatic scenes (e.g., police brutality, torture and rape). Immediately after listening to the soundtrack, the subjects completed a randomly assigned task for 10 min. Intrusions from the soundtrack were reported in a diary during the following seven-day period. RESULTS: In line with a modality-specific approach to intrusion modulation, auditory intrusions were reduced by verbal tasks compared to both a no-task and a visuospatial interference task.. LIMITATIONS: The study did not control for individual differences in imagery ability which may be a feature in intrusion development. CONCLUSIONS: The results provide an increased understanding of how intrusive mental images can be modulated which may have implications for preventive treatment..

A structured approach to goal formulation in psychotherapy: differences between patients and controls

Therapeutic goals are considered a vital component in psychological treatments, but to date relatively little attention has been paid to the assessment and evaluation of these goals. In order to validate a self-rating version of the Bern Inventory of Therapeutic goals checklist (BIT-C), the present study investigated if goals, measured this way, can differentiate between patients (n= 147) and healthy controls (n= 106). Results suggested that BIT-C was successful in discriminating between client and non-clients. Most importantly, clients had a higher tendency to endorse goal categories related to depressive symptoms, substance abuse, coping with somatic problems and current relationships, but a lower tendency to endorse goal categories relating to eating behaviors compared to non-patients. Further, patients perceived attainment of prioritized goals as more distant than non-patients did. The results were discussed in terms of BIT-C being a measure that can be readily applied to identify key targets in psychological treatments (AU)

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Is preattentive bias predictive of autonomic reactivity in response to a stressor?

Biased processing of threatening information may play a casual role in the development of anxiety disorders. Even though empirical evidence points to the fact that preattentive bias can predict subjectively experienced distress in response to a stressor, it is still unknown whether it could be useful in predicting the physiological reactivity in response to a stressor. In the present study, the emotional Stroop task was used to measure preattentive bias. Whereas Stroop interference for masked threat words (i.e., preattentive bias) was found to be positively associated with emotional distress (self-reported) in response to a laboratory stressor, this association was reversed when the autonomic reactivity (electrodermal activity) was used as a measure of emotional response to the very same stressor. Also, neither of these effects were a function of pre-existing anxiety levels. The negative association between preattentive bias and autonomic reactivity corresponds to the autonomic inflexibility seen in clinical anxiety (or very high scores of trait anxiety) when exposed to stressful events. Results were discussed in terms of an inability to automatically inhibit the processing of threatening cues that seems to be a vulnerability marker for anxiety.

Skin conductance responses as predictor of emotional responses to stressful life events.

Preferential preattentive processing towards threat has been proposed to play a casual role in the development of anxiety, mainly because it reliably predicts emotional responding to stressful events. However, in the investigation of the predictive value of preferential preattentive processing towards threat, the emotional Stroop task has exclusively being used. This study was designed to prospectively investigate the predictive value of skin conductance reactivity in response to masked (i.e., preattentively perceived) threatening pictures on emotional responding following stressful life events. To collect skin conductance data, the picture perception task was administered to 136 police recruits due to enroll into active duty within 2-4 months. To assess psychological distress following emotionally stressful life events, the impact of event scale were administered approximately 24 months later. Controlling for trait anxiety, analyses indicated that enhanced skin conductance reactivity in response to masked threatening pictures (relative to neutrals) was a strong predictor of emotional responding to stressful life events. This finding support preferential preattentive processing towards threat as a relatively independent factor predictive of emotional responding.

Unconscious responses to threatening pictures: interactive effect of trait anxiety and social desirability on skin conductance responses.

The purpose of the present study was to examine the role of trait anxiety and social desirability on skin conductance responses (SCRs) following exposure to masked and unmasked pictures in a non-clinical sample. The most prominent results were found with regard to masked pictures (i.e. subliminal). Higher levels of social desirability were associated with a decrease in SCRs to masked threat pictures (relative to neutral), whereas elevated levels of trait anxiety were associated with an increase in SCRs. This latter effect, however, was mainly seen among participants who simultaneously scored low on social desirability. These results were discussed in terms of trait anxiety (combined with lower social desirability scores) being associated with (i) enhanced autonomic responses to threatening information most evident at a pre-attentive level, that (ii) may potentially be a vulnerability marker for anxiety disturbances.