Toward a paradigm shift in treatment and research of mental disorders

Leichsenring, Falk; Steinert, Christiane; Ioannidis, John P. A.

doi:10.1017/s0033291719002265

Cited by 36 publications

(31 citation statements)

References 99 publications

(180 reference statements)

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“…The small effect sizes in the present study were anticipated because of the short treatment period for adolescents experiencing complex MH problems. The results are in line with a previous finding, which showed that efficacy of psychotherapy when compared to TAU is limited with an effect size of 0.30 or below (46). However, according to a systematic review of adolescent depression (47), most studies used clinicians' measures of symptom change, while patients' and parents' perspectives, as well as their personal growth, interpersonal relationships, and school performance were not assessed.…”

Section: Discussionsupporting

confidence: 89%

An exploration of group-based compassion-focused therapy for adolescents and their parents

Bratt

Rusner

Svensson

2020

Scandinavian Journal of Child and Adolescent Psychiatry and Psychology

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Background: The long-term negative consequences of mental health problems during adolescence highlight the need for effective treatments. Compassion-focused therapy (CFT) aims to help individuals to enhance their ability to support and care for themselves and to alleviate shame and self-stigmatization. Objective: This non-randomized controlled trial examined the effectiveness of group-based CFT on perceived stress and the extent of self-compassion in a clinical sample of adolescents receiving psychiatric care for complex mental health difficulties and their parents. Method: The participants were 43 adolescents (ages 14-17; 83.7 % female) under treatment at a child and adolescent psychiatric outpatient clinic in Sweden and their parents (n = 77; 61 % female). The adolescents volunteered for group-based CFT (n = 19); if they did not want to participate, they were asked to join the control group receiving treatment as usual (TAU, n = 24). The CFT parents were given the same treatment as their children in parallel parent groups. The participants completed questionnaires measuring self-compassion and perceived stress before and after treatment. Paired samples t-tests and independent samples t-tests assessed the within-group and between-group differences via change scores. Results: The fathers scored highest on self-compassion and had less perceived stress at both times than the adolescents or mothers. There were no significant differences between the CFT and TAU groups in self-compassion or perceived stress at either time, and the effect sizes were small (g ≤ 0.25). The TAU mother group was the only group with a significantly changed mean self-compassion score post-treatment. Conclusions: Some patients seem to benefit from group-based CFT in ways similar to the benefits of specialized therapeutic approaches. Further research into the utility of CFT for adolescents with MH problems and their parents, as well as the longterm clinical effects of CFT for this group is needed.

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Section: Discussionsupporting

confidence: 89%

An exploration of group-based compassion-focused therapy for adolescents and their parents

Bratt

Rusner

Svensson

2020

Scandinavian Journal of Child and Adolescent Psychiatry and Psychology

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“…Interoception is now recognized to be a fundamental mechanism underlying motivation, emotion, social cognition and selfawareness (Tsakiris and Critchley, 2016), and interoceptive awareness is associated with individual differences in one's ability to inhibit behavior (Rae et al, 2019). There is also increasing multidisciplinary evidence that interoception is predictably impaired in mental health conditions and should be considered as a transdiagnostic therapeutic target (Khalsa et al, 2018), especially given that psychiatric patients do not completely remit and at least 50% do not respond to standard treatments (Leichsenring et al, 2019). Accordingly, therapy approaches that emphasize interoceptive mechanisms are important to consider and are likely to be central to future developments in clinical interventions.…”

Section: Introductionmentioning

confidence: 99%

Co-emergence Reinforcement and Its Relevance to Interoceptive Desensitization in Mindfulness and Therapies Aiming at Transdiagnostic Efficacy

Cayoun¹,

Shires

2020

Front. Psychol.

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Interoception, the ability to feel the body’s internal sensations, is an essential aspect of emotional experience. There is mounting evidence that interoception is impaired in common mental health disorders and that poor interoceptive awareness is a major contributor to emotional reactivity, calling for clinical interventions to address this deficit. The manuscript presents a comprehensive theoretical review, drawing on multidisciplinary findings to propose a metatheory of reinforcement mechanisms applicable across a wide range of disorders. We present a reconsideration of operant conditioning through the co-emergence model of reinforcement, which is a neurophenomenological account of the interaction between cognition and interoception, and its consequences on behavior. The model suggests that during memory processing, the retrieval of autobiographical memory (including maladaptive cognition) is dependent upon its co-emerging interoceptive cues occurring at the encoding, consolidation and reconsolidation stages. Accordingly, “interoceptive reinforcement” during emotional distress is a common factor to all emotional disorders and a major cause for relapse. We propose that interoceptive desensitization has transdiagnostic benefits, readily achievable through the cultivation of equanimity during mindfulness training and can be integrated in cognitive and behavioral interventions to permit a transdiagnostic applicability. We summarize the contributions of this approach into 10 specific and testable propositions.

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“…On the other hand, the core of DBT is to help people build four essential skills: mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation. Recently these new approaches have been used to treat patients with BD [187]; [188]; [189]. Thus, through this research, our group aims to select patients for a future study about DBT, allowing them to develop new behaviors and skills.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the Impairment in Domain functionalities and Executive Functions in Euthymic Patients, with Bipolar Disorder I/II - Utilizing the FAST and FAB tests

Cyrino¹,

Calegari²,

Tomasi³

et al. 2021

IJAERS

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Objective: In this article, we focus on assessing two key predictors of outcomes in Bipolar Disorder (BD): cognition and functionality performance, and researching for a correlation between them. Methods: Subjects were patients with BD in the euthymic phase (n=50), and healthy controls (n=25). Psychosocial functioning was evaluated using the Functioning Assessment Short Test (FAST), and the same group underwent the Frontal Assessment Battery (FAB) to assess the Executive Functions (EF). Clinical and sociodemographic characteristics were analyzed using one-way analysis of variance or the chisquare test. To verify a correlation between FAB and FAST tests, we used the Spearman Correlation Coefficient. Results: Patients with BD showed higher FAST total scores (24.60±11.09) than healthy controls (9.80±5.94) (p< 0.001), and patients with BD showed lower FAB total scores (13.56±2.81) than healthy control (15.72±1.64) (p<0.001). Associated with these results, bipolar patients showed higher FAST scores in all domains predominantly with moderate impairment (score 21-40), and also lower scores in the following three domains: conceptualization, sensitivity to interference, and inhibitory control in the FAST test (p<0.05). The correlation between the variables FAB and FAST presented a moderate intensity (r 2 = -0.539). Conclusion: This study reinforced the impact of BD in functionality and the EF, demonstrating alterations in several domains: social, occupational, and cognitive functions impairment. Understanding them is crucial for these patients, which increases the possibility of rehabilitation and the response to treatment. I. INTRODUCTIONBipolar Disorder (BD) is a chronic and severe disease that affects approximately 1.1% of the world population and is associated with a high rate of morbidity, mortality, suicide, and clinical comorbidities [1]. Its pathophysiology is complex, multifactorial, and is not yet fully understood, being influenced by genetic and environmental factors [2]. Multiple changes occur in the brain, such as neuroplasticity, neurotransmission failures, apoptosis, activation in the immune-inflammatory process, and more recently, oxidative stress [3]. These events involve a pathological reorganization in the brain and therefore are associated with morphological modifications, such as the reduced volume of the Luiz Arthur Rangel Cyrino et. al.

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Toward a paradigm shift in treatment and research of mental disorders

Cited by 36 publications

References 99 publications

An exploration of group-based compassion-focused therapy for adolescents and their parents

An exploration of group-based compassion-focused therapy for adolescents and their parents

Co-emergence Reinforcement and Its Relevance to Interoceptive Desensitization in Mindfulness and Therapies Aiming at Transdiagnostic Efficacy

Assessment of the Impairment in Domain functionalities and Executive Functions in Euthymic Patients, with Bipolar Disorder I/II - Utilizing the FAST and FAB tests

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