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Personal values are considered as guiding principles for humans’ attitudes and behavior, what makes them an essential component of mental health. Although these notions are widely recognized, investigations in clinical samples examining the link between values and mental health are lacking. We assessed n = 209 patients with affective disorders, neurotic disorders, reaction to severe stress, and adjustment disorders and personality disorders and compared them to a stratified random sample (n = 209) drawn from the European Social Survey. Personal values were assessed using the Portraits Value Questionnaire. Severity of psychopathology was assessed using the Beck Depression Inventory and the Brief Symptom Inventory. Clinical participants showed a higher preference for the values power, achievement and tradition/conformity and a lower preference for hedonism compared to controls. Patients exhibited more incompatible value patterns than controls. Across diagnostic groups, patients with neurotic disorders reported incompatible values most frequently. Value priorities and value conflicts may have the potential to contribute to a better understanding of current and future actions and experiences in patients with mental disorders.
Reduced social functioning in depression has been explained by different factors. Reduced social connectedness and prosocial motivation may contribute to interpersonal difficulties, particularly in chronic depression. In the present study, we tested whether social connectedness and prosocial motivation are reduced in chronic depression. Forty-seven patients with persistent depression and 49 healthy controls matched for age and gender completed the Inclusion of the Other in the Self Scale (IOS), the Compassionate Love Scale (CLS), the Beck Depression Inventory-II, and the Childhood Trauma Questionnaire. A Multivariate analysis of variance (MANOVA) with IOS and CLS as dependent variables revealed a highly significant difference between both groups. The IOS and the CLS-subscale Close Others were lower in persistent depression, whereas there was no difference in the CLS-subscale Strangers/Humanity. IOS and CLS-Close Others showed significant negative correlations with depressive symptoms. Connectedness to family members as measured by the IOS was negatively correlated with childhood trauma in patients with chronic depression. The results indicate that compassion and perceived social connection are reduced in depressed patients toward close others, but not to others in general. Implications for the treatment of depression are discussed.
In the face of the worldwide COVIV-19 pandemic, refugees represent a particularly vulnerable group with respect to access to health care and information regarding preventive behavior. In an online survey the Perceived Vulnerability to Disease Scale, self-reported changes in preventive and risk behaviors, knowledge about COVID-19, and psychopathological symptoms (PHQ-4) were assessed. The convenience sample consisted of n = 76 refugees (n = 45 Arabic speaking, n = 31 Farsi speaking refugees) and n = 76 German controls matched with respect to age and sex. Refugees reported a significantly larger fear of infection, significantly less knowledge about COVID-19, and a higher frequency of maladaptive behavior, as compared to the control group. This study shows that refugees are more vulnerable to fear of infection and maladaptive behaviors than controls. Culturally adapted, easily accessible education about COVID-19 may be beneficial in improving knowledge and preventive behaviors related to COVID-19.
The COVID-19 pandemic has called worldwide for strong governmental measures to contain its spread, associated with considerable psychological distress. This study aimed at screening a convenience sample in Germany during lockdown for perceived vulnerability to disease, knowledge about COVID-19, symptoms of depression and anxiety, and behavioral responses. In an online survey, 1358 participants completed the perceived vulnerability to disease scale (PVD), the Patient Health Questionnaire (PHQ-4), and questionnaires on knowledge about COVID-19 and self-perceived change in behaviors in response to COVID-19. Lower and upper quartiles of the PVD were used to classify individuals into low and high PVD. A confirmatory factor analysis supported three factors representing risk, preventive and adaptive behavior as behavioral responses to COVID-19 lockdown. A structural equation model showed that the score of the knowledge scale significantly predicted the self-reported increase in adaptive and preventive behavior. The score in the PVD-subscale Perceived Infectability predicted a self-reported increase in preventive behavior, whereas the Germ Aversion score predicted a self-reported increase in preventive and a decrease in risk behavior. The score in PHQ-4 predicted a higher score in the perceived infectability and germ aversion subscales, and a self-reported decrease in adaptive behavior. Low-, medium- and high-PVD groups reported distinct patterns of behavior, knowledge, and mental health symptoms. This study shows that perceived vulnerability to disease is closely linked to preventive behaviors and may enhance adaptation to COVID-19 pandemic.
Objectives: Current treatments for chronic depression have focused on reducing interpersonal problems and negative affect, but paid little attention to promoting prosocial motivation and positive affect. Following this treatment focus, the objective of the present study was to examine whether the combination of metta (Loving Kindness) group meditation and subsequent tailored individual therapy focusing on kindness towards oneself and others (metta-based therapy, MBT) shows greater improvements in depressive symptoms than a wait list control group in patients with chronic depression. Methods: Forty-eight patients with DSM-5 persistent depressive disorder were randomly assigned to MBT or a wait list control condition. Outcome was assessed after group meditation, after subsequent individual therapy, and at 6-month follow-up. The primary outcome measure was an independent blind rating of depressive symptoms at post-test. Secondary outcome included changes in self-reported depression, behavioral activation, rumination, social functioning, mindfulness, compassion, and clinician-rated emotion regulation. Results: Mixed-design analyses showed significant differences between MBT and WLC in changes from pre- to post-test in clinician-rated and self-rated depression, behavioral activation, rumination, social functioning, mindfulness, and emotion regulation. Most of the changes occurred during group meditation and were associated with large effect sizes. Improvements were maintained at 6-month follow-up. Conclusions: The results provide preliminary support for the effectiveness of MBT in treating chronic depression. Trial Registration: ISRCTN, ISRCTN97264476.
This review provides an overview of the current state of research concerning the role of mental imagery (MI) in mental disorders and evaluates treatment methods for changing MI in childhood. A systematic literature search using PubMed/Medline, Web of Science, and PsycINFO from 1872 to September 2020 was conducted. Fourteen studies were identified investigating MI, and fourteen studies were included referring to interventions for changing MI. Data from the included studies was entered into a data extraction sheet. The methodological quality was then evaluated. MI in childhood is vivid, frequent, and has a significant influence on cognitions and behavior in posttraumatic stress disorder (PTSD), social anxiety disorder (SAD), and depression. The imagery’s perspective might mediate the effect of MI on the intensity of anxiety. Imagery rescripting, emotive imagery, imagery rehearsal therapy, and rational-emotive therapy with imagery were found to have significant effects on symptoms of anxiety disorders and nightmares. In childhood, MI seems to contribute to the maintenance of SAD, PTSD, and depression. If adapted to the developmental stages of children, interventions targeting MI are effective in the treatment of mental disorders.
Social pain is an emotional reaction to social exclusion which has been widely investigated in experimental settings. We developed the Social Pain Questionnaire (SPQ) and examined its factor structure, reliability, and construct validity. We constructed a 46-item pool that covered a broad range of situations related to social pain. Using three different subsamples (Online convenience sample: n = 623, Representative sample: n = 2531, Clinical sample of outpatients seeking psychotherapy: n = 270) we reduced the item pool to 10 items for the final SPQ scale, paying particular attention to content validity and factorial structure. Convergent, divergent and discriminant validity were assessed using standardized measures of related constructs and group differences. For the final 10-item version, a good factorial structure and reliability were found. Convergent validity was supported by correlations with related instruments of interpersonal sensitivity, attachment styles, depression and social anxiety. The representative and clinical sample differed significantly in social pain. The SPQ is an economic self-report measure with solid psychometric properties. Our data support the factorial, construct and convergent validity. The SPQ can be used to clarify the role of social pain in mental disorders and to incorporate interventions targeted towards social pain in psychotherapeutic settings.
Culturally adapted cognitive behavioral therapy (CA-CBT) is a well-evaluated, transdiagnostic group intervention for refugees that uses psychoeducation, meditation, and stretching exercises. In the current study, we added problem-solving training to CA-CBT and evaluated this treatment (i.e., CA-CBT+) in a randomized controlled pilot trial with a sample of Farsi-speaking refugees. Participants (N = 24) were male refugees diagnosed with DSM-5 PTSD, major depressive disorder, and anxiety disorders who were randomly assigned to either a treatment or waitlist control (WLC) condition. Treatment components were adapted both to the specific cultural background and the current social problems of asylum seekers. Assessments were performed pretreatment, 12-weeks posttreatment, and 1-year follow-up. The primary treatment outcome was the General Health Questionnaire (GHQ-28); secondary outcome measures included the Posttraumatic Stress Disorder Checklist, Patient Health Questionnaire, Somatic Symptom Scale, World Health Organization Quality of Life, and Emotion Regulation Scale. Eleven of 12 participants were randomized to CA-CBT+ completed treatment. Based on intent-to-treat data, large between-group effect sizes were seen at posttreatment in the GHQ-28, d = 3.0, and for most secondary outcome measures. Improvements for individuals in the treatment group decreased at 1-year follow-up, but effect sizes demonstrated continued large improvements on all measures as compared to pretreatment levels. In summary, CA-CBT+ led to large improvements in general psychopathological distress and quality of life, which were maintained in the long term. In addition, the dropout rate was very low, with delivery in group format. Thus, problem-solving training appears to be a promising addition to CA-CBT.