Understanding Compliant Behavior During a Pandemic: Contribution From the Perspective of Schema-Based Psychotherapy.

OBJECTIVE: The current study examined whether compliance with anti-pandemic measures during the COVID-19 pandemic relates to (a) importance of the fulfillment of core psychological needs, namely, relationship, self-esteem, efficacy, and pleasure; (b) coping behavior styles, namely, surrender, self-soothing, divert attention, and confrontation; and (c) worries or concerns beyond COVID-19 which may impair wellbeing. METHODS: This study used a cross-sectional design and online survey data from responses to a structured questionnaire developed within the theoretical framework of schema-based psychotherapy on psychological needs and coping behavior styles from 740 participants in Central Europe and West Africa. RESULTS: Analysis indicated that people with the psychological needs of "pleasure" and "efficacy" and the coping style of "surrender" were more likely to comply with anti-pandemic measures. We also found that people with the coping style of "confrontation" were less likely to comply. There were no statistically significant relationships between compliance and "relationship," "self-esteem," "self-soothing," "divert attention," and "existential concerns." DISCUSSION: Our findings indicate that how likely a given individual is to comply with prescribed pandemic countermeasures varies based on their specific psychological needs and behavior styles. Therefore, to control contagion during a pandemic, authorities must recognize the relevance of human need fulfillment and their behavior styles and accordingly highlight and encourage admissible and feasible actions. The findings demonstrate that some individual differences in core psychological needs and coping behavior patterns predict compliance behavior.

Treatments for internet addiction, sex addiction and compulsive buying: A meta-analysis.

BACKGROUND AND AIMS: Internet addiction, sex addiction and compulsive buying are common behavioral problems, which share similarities with gambling disorder and substance use disorders. However, little is known about the efficacy of their treatments. The objective of this meta-analysis was to examine the efficacy of the treatments of such problem behaviors, and to draw parallels to gambling disorder and substance use disorders in terms of treatment response. METHODS: Literature search yielded 91 studies totaling 3,531 participants to provide a comprehensive evaluation of the short-term and long-term efficacy of psychological, pharmacological and combined treatments for internet addiction, sex addiction, and compulsive buying. RESULTS: Psychological, pharmacological, and combined treatments were associated with robust pre-post improvements in the global severity of internet addiction (Hedges's g: 1.51, 1.13, and 2.51, respectively) and sex addiction (Hedges's g: 1.09, 1.21, and 1.91, respectively). For compulsive buying, psychological and pharmacological treatments were also associated with a large-sized pre-post reduction in global severity (Hedges's g: 1.00 and 1.52, respectively). The controlled pre-post and within-group pre-follow-up effect sizes were in the similar range, with few exceptions. Moderator analyses suggest that psychological interventions are effective for reducing compulsive behaviors, especially when delivered face-to-face and conducted over extended periods of time. Combinations of cognitive-behavioral approaches with medications showed an advantage over monotherapies. DISCUSSION AND CONCLUSIONS: The results suggest that treatments for common behavioral addictions are effective in the short term, similar to those implemented for gambling disorder and substance use disorders, but more rigorous clinical trials are needed.

Neurofeedback Treatment of Negative Symptoms in Schizophrenia: Two Case Reports.

Negative symptoms of schizophrenia, like diminished emotional expression and a dearth of self-initiated behavior do not respond reliably to anti-psychotic medication or to conventional psychotherapeutic approaches. Starting from evidence on the probable neural basis of such symptoms and on the effectiveness of neurofeedback with other psychological disorders, the present case study applied 20 sessions of EEG neurofeedback to a 45-year-old female and a 30-year-old male, both diagnosed with severe negative symptoms of schizophrenia. In both cases GAF scores were improved significantly and at the end of treatment, both patients did not meet the diagnostic criteria of negative symptomatology any longer. Symptom reduction went along with an obvious improvement of social, interpersonal, and cognitive abilities according to the clinical impression. Detailed data analysis revealed that these improvements went along with corresponding changes of EEG parameters and with distinct patterns and strategies of change in each of the two individuals. The results suggest that EEG neurofeedback should be examined on a larger scale as it offers a promising alternative to existing treatment approaches for negative symptoms in schizophrenia.

Pharmacological Treatments for Disordered Gambling: A Meta-analysis.

Disordered gambling is a public health concern associated with detrimental consequences for affected individuals and social costs. Currently, opioid antagonists are considered the first-line treatments to reduce symptoms of uncontrolled gambling. Only recently, glutamatergic agents and combined pharmacological and psychological treatments have been examined appearing promising options for the management of gambling disorder. A multilevel literature search yielded 34 studies including open-label and placebo-controlled trials totaling 1340 participants to provide a comprehensive evaluation of the short- and long-term efficacies of pharmacological and combined treatments. Pharmacological treatments were associated with large and medium pre-post reductions in global severity, frequency, and financial loss (Hedges's g: 1.35, 1.22, 0.80, respectively). The controlled effect sizes for the outcome variables were significantly smaller (Hedges's g: 0.41, 0.11, 0.22), but robust for the reduction of global severity at short-term. In general, medication classes yielded comparable effect sizes independent of predictors of treatment outcome. Of the placebo controlled studies, results showed that opioid antagonists and mood stabilizers, particularly the glutamatergic agent topiramate combined with a cognitive intervention and lithium for gamblers with bipolar disorders demonstrated promising results. However, more rigorously designed, large-scale randomized controlled trials with extended placebo lead-in periods are necessary. Moreover, future studies need to monitor concurrent psychosocial treatments, the type of comorbidity, use equivalent measurement tools, include outcome variables according to the Banff, Alberta Consensus, and provide follow-up data in order to broaden the knowledge about the efficacy of pharmacological treatments for this disabling condition.

Efficacy of face-to-face versus self-guided treatments for disordered gambling: A meta-analysis.

Background and aims In the light of growing traditional and novel forms of gambling, the treatment of disordered gambling is gaining increasing importance and practical relevance. Most studies have examined face-to-face treatments. Although trials implementing self-guided treatments have recently been conducted, these options have not yet been systematically examined. The primary objective of this meta-analysis, therefore, was to analyze the efficacy of all types of psychological face-to-face and self-guided treatments. Methods A multilevel literature search yielded 27 randomized controlled studies totaling 3,879 participants to provide a comprehensive comparative evaluation of the short- and long-term efficacies of face-to-face and self-guided treatments for disordered gambling. Results As expected, the results revealed significantly higher effect sizes for face-to-face treatments (16 studies with Hedges's g ranging from 0.67 to 1.15) as compared with self-guided treatments (11 studies with Hedges's g ranging from 0.12 to 0.30) regarding the reduction of problematic gambling behavior. The intensity of treatment moderated the therapy effect, particularly for self-guided treatments. Discussion and Conclusions The results of this meta-analysis favor face-to-face treatments over self-guided treatments for the reduction of disordered gambling. Although the findings broaden the scope of knowledge about psychological treatment modalities for disordered gambling, further research is needed to identify the reasons for these differences with the goal to optimize the treatment for this disabling condition.

Confidence analyses of self-interpretation and self-description in depressive behaviour.

The present paper represents an investigation in the procedure to validate a new questionnaire (Salzburg Subjective Behavioural Analysis, SSBA). This questionnaire is based on a new approach to the diagnosis of depressive behaviour. It is hypothesized that a patient suffering from a depressive disorder loses the ability to produce one or more modes of behaviour at a given time and simultaneously has the urge to produce one or more modes of behaviour constantly. Although the patient is capable of describing this behavioural disorder, he/she is unable to interpret it confidently. This inability of interpretation of depressive behaviour assessed with the SSBA may represent a special kind of cognitive impairment in depression that is tested in conducting an analysis of confidence. The analysis of confidence shows that the capability of interpretation in the patient group is significantly impaired. Finally, a discriminant analysis allows to differentiate between depressive behaviour and normal behaviour based on the questionnaire.

Factorial structure and convergent and discriminant validity of the E (Empathy) scale.

The Empathy (E) scale has been proposed as a theoretically and psychometrically more satisfying alternative to existing self-report measures of empathy. Its four scales (facets) cover both components (cognitive vs. emotional) and both reality statuses (fictitious vs. real-life) of empathy in pairwise combinations. Confirmatory factor analyses of the E-scale in an Austrian community sample (N = 794) suggested that one prior assumption, namely the mutual orthogonality of these facets, may partly need revision; particularly, the E-scale facets seemed to reflect more strongly differences in the reality statuses than in the components of empathy. Utilizing numerous informative psychological traits, the scale's convergent and discriminant validity were examined. E-scale scores were consistently predicted by sex-related and relationship-related constructs and measures of antisocial attitudes and behavior. Among the Big Five personality dimensions, openness emerged as a major positive correlate of empathy. Sex and age were demographic correlates of E-scale scores (higher in women and the younger). Findings were discussed with regards to the definition and measurement of empathy.

Suicide attempts: Patients with and without an affective disorder show impaired autobiographical memory specificity.

A number of studies have shown reduced recall of specific autobiographical memories (AMs) in patients after attempted suicide, but in all of them the study samples were confounded with diagnoses of affective disorders. The present study aims to demonstrate impaired specific autobiographical memory in patients after a suicide attempt without a diagnosis of an affective disorder. Four groups were compared: (1) patients with an actual major depression and a suicide attempt; (2) patients after a suicide attempt without a lifetime history of an affective diagnosis; (3) patients currently suffering from major depression without a suicide attempt; and (4) control persons not suffering from either of the two conditions during their entire life. Individuals with major depression and a suicide attempt showed reduced specificity of AM and, most importantly, patients with a suicide attempt-despite the absence of an affective disorder-were equally impaired with recall of specific AMs as were patients with major depression. The authors propose that reduced specific AM is a common vulnerability factor that can lead either to the development of an affective disorder and/or to a suicide attempt.

Prognosis of multifactorial outcome in lumbar discectomy: a prospective longitudinal study investigating patients with disc prolapse.

OBJECTIVES: Although previous research has shown that certain medical data and psychosocial factors predict postoperative pain, it remains unclear whether they also contribute to a more distinct outcome measure that is based on classification of self-reported outcome criteria. To assess the prognostic power of somatic, psychologic, and social predictors when evident outcome criteria of surgical treatment are investigated, this study used a prospective longitudinal design examining preoperative factors associated with outcome six months after lumbar discectomy. METHODS: Forty-eight out of 58 consecutive patients were included (60% male, 40% female, mean age 47 years). Preoperative data comprised of Lasegue sign (straight leg raising test), pain duration, paresis and radicular distribution, depression, pain disability, pain coping strategies, and qualitative descriptions of pain. Additionally, sociodemographic and occupational characteristics were observed. Six months' postoperative classification of outcome included pain intensity, pain locations, functional capacity, return to work, and health-related quality of life. RESULTS: From a surgical point of view, lumbar discectomy was successfully carried out on all patients. But, when subjective criteria of outcome were investigated, 56% of patients benefited from lumbar discectomy, whereas 44% of patients had poor results. Lasegue sign, depression, and sensory pain descriptions proved to be significant predictors, whereas pain cognition and pain coping strategies had no significant influence on evident outcome classification. DISCUSSION: Classification of patients regarding their individual outcome profiles showed that patients responded differently to lumbar disc-surgery. High risk factors for poor outcome of surgery are Laseque-sign and depression.

Are depressive persons capable of describing changes in their reactions without being able to explain them? A proof of a cybernetic hypothesis of depression.

BACKGROUND: Many studies on the autobiographical memory and the explanation of reasons for success and failure proved that persons suffering from major depression tend to overgeneralize. This study examines the hypothesis that changes of reactions caused by a depressive disorder can be described by the affected persons but not explained. SAMPLE AND METHODS: Persons suffering from major depression and persons with posttraumatic stress disorder or disturbance of accommodation with depressive mood (= reactive form of a depressive disorder) were presented with a list of modalities (behaviour, emotional and physical reactions) characteristic for depression. They were asked to identify modalities applicable to them and to describe and explain them. Their responses were analysed using a content analysis and assigned to the categories description and explanation. RESULTS: Persons with a major depression tended to use explanations or evaluations rather than descriptions for their depression-related modalities. Those persons suffering from a reactive form of depressive disorder tended to prefer evaluations. CONCLUSION: These results support the assumption that states of depression cause general descriptions of depression-relevant behaviour. The specific characteristics that have been perceived confirm the general concepts, which however make the patient prone to the respective selective perceptions. Persons suffering from a reactive form of depressive mood cannot be assumed to have this tendency of self-affirmation. Their depressive state may be maintained by perseverating general pessimistic schemes. LIMITATIONS: It must however be conceded that it was not possible to control the physical comorbidity methodically and to take its effects into consideration, even though only persons without serious illnesses were included in the samples. This study did not verify whether other clinical groups, like patients suffering from anxiety, show the same patterns of explaining and describing their problems. It should furthermore be reviewed how other actions, e.g. positive ones, are represented by depressive persons.

Autobiographical memory predicts the course of depression during detoxification therapy in alcohol dependent men.

BACKGROUND: Recall of autobiographical memories (AM) has shown to predict the course of depression during psychiatric treatment [British Journal of Psychiatry 162 (1993)]; therefore, we assume that AM also predicts the remissive course of depression during detoxification therapy in alcohol dependent men. METHODS: In a longitudinal study, 65 patients were assessed twice: at admission to a detoxification unit and about 3 weeks later for follow-up. AM scores at the beginning of the detoxification program were used as predictors in hierarchical regression analyses. RESULTS: After controlling for initial depression, mental status and degree of alcohol dependence, AM in response to positive and aggressive cue words significantly predicted affective change. These results validate the assumption that AM is a psychological depression marker. LIMITATIONS: No data are reported on depression prior to drinking onset. CONCLUSIONS: As a practical consequence, AM can assist the physician with the decision for concomittant antidepressive therapy during detoxification and rehabilitation of alcohol dependent men.

Experiencing tinnitus: which factors are important for perceived severity of the symptom?

This study attempted to determine those factors important for predicting the experienced severity of tinnitus. For this purpose, we examined affected patients' perception of tinnitus as an illness, comorbidity, scores on locus of control, length of time since onset of tinnitus, pitch and loudness of tinnitus sounds, and depression. One hundred and forty-nine patients (72 women, 77 men) experiencing chronic tinnitus participated in our study. An ordinal logit regression analysis showed that depression and loudness of tinnitus sounds were the best predictors of perceived severity of tinnitus and were followed in importance by the internal locus of control. In contrast, the patients' perception of tinnitus as an illness and comorbidity had no predictive value on the severity of tinnitus. These findings underscore the predominant role of depression, loudness of tinnitus, and internal locus of control in patients with tinnitus and provide an overview of relevant factors concerning tinnitus described in studies to date.