BackgroundAlthough positive psychology interventions (PPIs) show beneficial effects on mental health in non-clinical populations, the current literature is inconclusive regarding its effectiveness in clinical settings. We aimed to examine the effects of PPIs on well-being (primary outcome), depression, anxiety, and stress (secondary outcomes) in clinical samples with psychiatric or somatic disorders.MethodsA systematic review and meta-analysis was conducted following PRISMA guidelines. PsycINFO, PubMed, and Scopus were searched for controlled studies of PPIs in clinical samples between Jan 1, 1998 and May 31, 2017. Methodological quality of each study was rated. We used Hedges’ adjusted g to calculate effect sizes and pooled results using random-effect models.ResultsThirty studies were included, representing 1864 patients with clinical disorders. At post-intervention, PPIs showed significant, small effect sizes for well-being (Hedges’ g = 0.24) and depression (g = 0.23) compared to control conditions when omitting outliers. Significant moderate improvements were observed for anxiety (g = 0.36). Effect sizes for stress were not significant. Follow-up effects (8–12 weeks), when available, yielded similar effect sizes. Quality of the studies was low to moderate.ConclusionThese findings indicate that PPIs, wherein the focus is on eliciting positive feelings, cognitions or behaviors, not only have the potential to improve well-being, but can also reduce distress in populations with clinical disorders. Given the growing interest for PPIs in clinical settings, more high quality research is warranted as to determine the effectiveness of PPIs in clinical samples.Trial registrationPROSPERO CRD42016037451Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1739-2) contains supplementary material, which is available to authorized users.

ASPD patients did not display a deviant self-reported anger but physiological hyporesponsivity and cognitive hyper-responsivity. This ASPD anger response might reflect a controlled predatory-like fight preparation.

Introduction Although there is a growing body of research on the role of offense supporting cognitive distortions in child sexual offending, little is known about the origins of these distortions. According to cognitive theory, maladaptive cognitive schemas originating in adverse childhood experiences with caregivers have been hypothesized to underlie these cognitive distortions. Aim This exploratory study investigates early maladaptive schemas (EMSs) in child sexual offenders compared with sexual offenders against adults and nonsexual offenders. Main Outcome Measures EMSs were measured with the Young Schema Questionnaire, and psychopathy was measured with the Psychopathy Checklist-Revised. Methods Three groups of forensic inpatients—23 child sexual offenders, 19 sexual offenders against adults, and 24 nonsexual violent offenders—were assessed. Multivariate analyses of covariance were used to examine the hypothesized group differences in EMSs. Results Results showed that, after controlling for level of psychopathy, EMSs related to Abandonment (M =2.61 vs. M =1.73, P <0.01), Social Isolation (M =2.50 vs. M =1.62, P <0.01), Defectiveness/Shame (M =2.05 vs. M =1.42, P <0.05), Subjugation (M =2.28 vs. M =1.57, P <0.05), and Self-Sacrifice (M =3.29 vs. M =2.41, P <0.05) were more prevalent in child sexual offenders compared with nonsexual violent offenders. Compared with sexual offenders against adults, child sexual offenders showed a trend to have higher scores on EMSs related to Social Isolation (M =2.50 vs. M =1.88, P =0.066). Conclusions Our findings suggest that EMSs may play a role in offending behavior in child sexual offenders and offer the possibility of informing treatment strategies.

Purpose. Current knowledge suggests that the psychopathy construct is multifaceted in nature, and reflects different underlying pathological mechanisms, including neurobiological dysfunction and maladaptive cognitions. Although many contemporary studies focus on neurobiological aspects of psychopathy, few have addressed the maladaptive cognitions.Method. In this study, we examined facets of Hare's psychopathy construct in terms of their associations with maladaptive cognitions, as defined by Young's cognitive theory of Early Maladaptive Schemas (EMS). Personality disordered offenders (N = 124) were assessed with the PCL-R and the Young Schema Questionnaire.Results. The PCL-R Lifestyle and Antisocial Facets were significantly related to EMS Mistrust/Abuse and Insufficient Self-Control, consistent with our hypotheses, and were significantly, but negatively, related to EMS Subjugation. Also as hypothesized, EMS showed no associations with the PCL-R Affective and Interpersonal facets. Contrary to our expectation, EMS did not predict institutional violence.Conclusion. Our findings suggest that schemas relating to mistrust, inadequate self-control/low frustration tolerance, and autonomy/dominance, play a role in the impulsive lifestyle and antisocial behaviour features of psychopathy. Treatments that focus on ameliorating these schemas may lead to better outcomes in psychopathic offenders.Psychopathy affects about 0.6%-1.2% of the general population (Coid, Yang, Ullrich, Roberts, & Hare, 2009a;Neumann & Hare, 2008) and prevalence rates have been reported consisting of 7.7% for correctional settings in England and Wales (Coid et al., 2009b; 15%-25% of the North-American forensic and correctional samples (Hare, 2003), and 24% of the Dutch forensic psychiatric samples (Hildebrand,

From its first conceptualization in modern psychiatry, psychopathy has been considered difficult if not impossible to treat. Schema Therapy (ST) is a psychotherapeutic approach that has shown efficacy in patients with borderline personality disorder. ST has recently been adapted for personality disordered forensic patients, including patients with high levels of psychopathy. The present case study examined the process of individual ST, combined with movement therapy and milieu therapy by the nursing staff, with a forensic inpatient with psychopathic features (Psychopathy Checklist-Revised total score = 28.4). The patient had been sentenced to a mandatory treatment order in relation to a sexual assault. We assessed change using independent assessments of psychopathic traits, cognitive schemas, and risk-related behaviors over the 4-year treatment period and a 3-year follow-up. We also assessed the quality of the working alliance. Reliable change analyses showed significant improvements in psychopathic traits, cognitive schemas, and risk-related outcomes. At 3 years posttreatment, the patient was living independently outside of the forensic institution without judicial supervision and he had not reoffended. While many questions remain about the effectiveness of psychotherapeutic treatment for psychopathic patients, our study challenges the view that they are untreatable.