Background: Methamphetamine abuse is expanding in Europe, leading to a shortfall in medical care for related disorders in many regions. Research focusing on the effectiveness and feasibility of methamphetamine-specific treatment programs is scarce, especially in short-term settings. Methods: To this end, we treated 31 patients with methamphetamine dependence using a new group psychotherapy manual added to standard psychiatric care. Trained research assistants recorded demographic, illness and treatment variables using a standardized interview at baseline and a follow-up visit 3 months later. Outcome and process variables for this intervention encompassing 15 modules for qualified detoxification and motivation of patients with methamphetamine dependence are reported. Results: Retention and abstinence rates as well as acceptance and feasibility in daily routine were assessed positively. Patients with an unsuccessful outcome were characterized by longer regular methamphetamine use (t = −2.513, df = 29, p = 0.018) and a shorter abstinence period at baseline (U = 74.500, z = −1.808, p = 0.072). Among the demographic and clinical variables, the only predictor significantly increasing the odds of a successful outcome was a shorter period of regular methamphetamine use (OR = 1.318, CI 95% for OR = 1.021-1.700, b = 0.276, SE = 0.130, p = 0.034). Conclusions: This freely available therapy manual can help counter the shortfall in available psychotherapeutic interventions for patients with methamphetamine dependence in German-speaking countries. The routinely assessed parameters duration of regular methamphetamine use and abstinence before treatment were associated with outcome and may be used to personalize therapeutic strategies.

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Introduction: Embarrassment is a social affect. Once experienced in social interactions (SIs), it can be a precursor of clinical symptoms like depersonalization and ruminative thinking. This experience sampling study investigated predictors of embarrassment in social phobia (SP), major depressive disorder (MDD), and controls. Methods: For seven days, a total of n = 165 patients (n = 47 SP, n = 118 MDD) and n = 119 controls completed five surveys per day on their smartphones. The effect of social anxiety and depression facets on embarrassment was examined in contemporaneous and time-lagged models. Results: Individuals with SP or MDD experienced more embarrassing SIs than controls. Among facets of depression, feelings of guilt, and low self-worth significantly predicted embarrassment in contemporaneous, but not in time-lagged models. Among facets of social anxiety, worries about other people's opinion and worries of saying or doing something wrong during a social interaction significantly predicted embarrassment (contemporaneous and time-lagged; all p < .05). Discussion: The study reveals important cognitive factors that accompany embarrassment in SIs and that connect social experience and clinical symptoms. Targeting these putative dysfunctions could be an important strategy in therapy. The differential patterns in SP and MDD are discussed.

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Background Post-event processing (PEP) after social interactions (SIs) contributes to the persistence of social phobia (SP). This study investigated whether PEP as a transdiagnostic process also occurs in major depressive disorder (MDD) and controls. We also tested to what extent PEP was explained by trait levels of social anxiety (SA) or depression. Method For seven days, a total of n = 165 patients (n = 47 SP, n = 118 MDD) and n = 119 controls completed five surveys per day on their smartphones. Event-based experience sampling was used. PEP was assessed following subjective embarrassment in SIs with two reliable items from the Post-Event Processing Questionnaire. Data were analysed via multilevel regression analyses. Results Individuals with SP or MDD experienced more embarrassing SIs than controls and, accordingly, more PEP. The relative frequency of PEP after embarrassing SIs was equally high in all groups (86-96%). The groups did not differ regarding the amount of time PEP was experienced. After controlling trait depression, embarrassment occurred more frequently only in SP compared to controls. When controlling trait SA, between-group differences in indications of embarrassment, and consequently in PEP, dissipated. Conclusions PEP could be interpreted as a common coping strategy among all individuals, while more frequent embarrassment might be specific for clinical groups. Embarrassment was primarily driven by SA. The alleviation of SA could lead to the reduction of embarrassment and, further, of PEP. On this basis, a model describing PEP in MDD is proposed, while current models of PEP in SP are complemented.

Objectives: Impairments in social cognitive processes are discussed as a vulnerability factor for bipolar disorder (BD). Previous studies demonstrated aberrant neural activation in brain areas related to theory of mind (ToM) and impaired affective ToM (aToM) task performance in BD. However, it is yet unknown whether successful psychotherapy of BD influences neuroimaging markers of aToM.Methods: In the present study conducted within the multicentric randomized controlled trial of the BipoLife consortium, euthymic BD patients underwent two group interventions: a specific, cognitive-behavioral intervention (SEKT, n = 31) encompassing psychoeducation and the training of self-management, impulse regulation, and ToM and social skills versus a supportive, unstructured, emotion-focused intervention (FEST, n = 28). To compare the effect of SEKT and FEST on neural correlates of aToM, patients performed an aToM task during functional magnetic resonance imaging before and after interventions. Because ToM skills were trained in SEKT, we expected an increased ToM network activation in SEKT relative to FEST post intervention. Results: Both treatments were effective in stabilizing patients’ euthymic state in terms of affective symptoms, life satisfaction and global functioning. Confirming our expectations, patients who had completed SEKT showed an increased neural activation within four regions of the ToM brain network, the bilateral temporoparietal junction (TPJ), the posterior cingulate cortex (PCC), and the precuneus, whereas FEST patients did not. Conclusions: The stabilizing effect of SEKT on clinical outcomes went along with a boost in neural activation of the ToM network, while FEST possibly exerted its positive effect by other, yet unexplored routes.