Note From the Editor

Background and AimsTo review published studies on the effectiveness of combining cognitive-behavioural therapy (CBT) and motivational interviewing (MI) to treat comorbid clinical and subclinical alcohol use disorder (AUD) and major depression (MDD) and estimate the effect of this compared with usual care. MethodsWe conducted systematic literature searches in PubMed, PsycINFO and Embase up to June 2013 and identified additional studies through cross-references in included studies and systematic reviews. Twelve studies comprising 1721 patients met our inclusion criteria. The studies had sufficient statistical power to detect small effect sizes. ResultsCBT/MI proved effective for treating subclinical and clinical AUD and MDD compared with controls, with small overall effect sizes at post-treatment [g=0.17, confidence interval (CI)=0.07-0.28, Pless than0.001 for decrease of alcohol consumption and g=0.27, CI: 0.13-0.41, Pless than0.001 for decrease of symptoms of depression, respectively]. Subgroup analyses revealed no significant differences for both AUD and MDD. However, digital interventions showed a higher effect size for depression than face-to-face interventions (g=0.73 and g=0.23, respectively, P=0.030). ConclusionsCombined cognitive-behavioural therapy and motivational interviewing for clinical or subclinical depressive and alcohol use disorders has a small but clinically significant effect in treatment outcomes compared with treatment as usual

Can a One-Item Mood Scale Do the Trick? Predicting Relapse over 5.5-Years in Recurrent Depression

To examine whether a simple Visual Analogue Mood Scale (VAMS) is able to predict time to relapse over 5.5-years.187 remitted recurrently depressed out-patients were interviewed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and the 17-item Hamilton Depression rating scale (HAM-D) to verify remission status (HAM-D <10). All patients rated their current mood with the help of a Visual Analogue Mood Scale (VAMS) at baseline and at a follow-up assessment three months later. Relapse over 5.5-years was assessed by the SCID-I. Cox regression revealed that both the VAMS at baseline and three months later significantly predicted time to relapse over 5.5-years. Baseline VAMS even predicted time to relapse when the number of previous depressive episodes and HAM-D scores were controlled for. The baseline VAMS explained 6.3% of variance in time to relapse, comparable to the HAM-D interview.Sad mood after remission appears to play a pivotal role in the course of depression. Since a simple VAMS predicted time to relapse, the VAMS might be an easy and time-effective way to monitor mood and risk of early relapse, and offers possibilities for daily monitoring using e-mail and SMS.International Standard Randomized Controlled Trial Register Identifier: ISRCTN68246470

Entwicklung und Evaluation einer Emotionsregulations-App

Background Individuals with mental disorders have limited competence in dealing with difficult emotions. Berking (2017) provides a well-structured treatment manual to train emotional competencies across a broad range of mental disorders: Affect Regulation Training (ART). In studies, ART has been demonstrated to improve emotional competence and reduce symptom severity in patients with mental disorders. Due to the well-defined structure of ART, it is suitable for digital application. Objectives Among other goals, an ART app could bridge the gap between waiting lists and the initiation of treatment and also better exploit the potential of therapy-related exercises. Currently, there is a smartphone-based version of ART that can be complementarily used to provide support to ART group training. The long-term goal is to develop a complete standalone version of the ART app. Materials For this purpose, research findings will be implemented to address and minimize the hitherto problems of smartphone-based health promotion. Clinical trials will then be conducted to test the effectiveness of the ART app. Results Preliminary findings indicate that the ART training app is well-accepted by users when embedded in the group training. Results concerning effectiveness of the standalone version of the ART app are still pending. Conclusion The effectiveness of the ART app should be evaluated in individuals with mental disorders who are on treatment waiting lists and in the context of aftercare. In the long-term, the ART app is expected to benefit from the ongoing development of sensory technology and artificial intelligence and will enable the app to measure and provide feedback on biosignals of emotional processes.Hintergrund Ein adäquater bzw. kompetenter Umgang mit schwierigen Emotionen ist bei Personen mit psychischen Störungen oft eingeschränkt. Mit dem Training emotionaler Kompetenzen (TEK) nach Berking (2017) existiert ein gut strukturiertes Behandlungsmanual, mit dem man emotionale Kompetenzen störungsübergreifend trainieren kann. In Studien zeigte sich durch das TEK eine Verbesserung emotionaler Kompetenzen und eine Symptomreduktion bei Patienten mit psychischen Störungen. Aufgrund der hohen Strukturiertheit des TEK eignet es sich gut für eine digitalisierte Anwendung. Ziel Eine TEK-App könnte u. a. die Wartezeit auf einen Psychotherapieplatz überbrücken sowie das Potenzial therapierelevanter Übungen besser ausschöpfen. Aktuell existiert eine smartphonegestützte Version des TEK, welche in Ergänzung zum TEK-Gruppentraining eingesetzt werden kann. Das langfristige Ziel ist die Entwicklung einer TEK-App-Vollversion. Methode Hierfür werden Erkenntnisse aus der Forschung herangezogen, um die bisherigen Probleme smartphonegestützter Gesundheitsförderung gezielt zu adressieren und zu minimieren. In klinischen Studien soll dann die Effektivität der TEK-App überprüft werden. Ergebnisse Erste Ergebnisse deuten auf eine gute Akzeptanz der TEK-Trainings-App durch die Anwender hin, wenn diese in das Gruppentraining eingebettet ist. Ergebnisse der Effektivität der TEK-App-Vollversion stehen noch aus. Diskussion Die Effektivität der TEK-App soll bei Personen mit psychischen Störungen, die auf einen Psychotherapieplatz warten, sowie im Kontext der Nachsorge evaluiert werden. Langfristig soll die TEK-App von der fortschreitenden Entwicklung der Sensortechnologie und künstlichen Intelligenz profitieren und Biosignale emotionaler Vorgänge durch die App erfasst und rückgemeldet werden

DSM-IV und DSM-5: Was hat sich tatsächlich verändert?

From DSM-IV to DSM-5: What Has Changed in the New Edition? The fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in May 2013. To enable researchers and practitioners to appropriately evaluate and account for advantages and disadvantages, both groups should be informed about amendments to the previous version DSM-IV. In the present paper, we describe the main differences between DSM-IV and DSM-5. Major changes in the overall structure include the discontinuation of the multiaxial system and the revised order of categories. On the level of specific disorders, main differences include the introduction of Major and Mild Neurocognitive Disorders, the extinction of bereavement as an exclusion criterion for Major Depressive Disorder, and the inclusion of Agoraphobia as a distinct disorder. Further additional diagnoses in DSM-5 include Binge-Eating Disorder, Premenstrual Dysphoric Disorder, Disruptive Mood Dysregulation Disorder, Hoarding Disorder, Excoriation (Skin Picking) Disorder,and Caffeine Withdrawal. Categories no longer included in the DSM-5 include Sexual Aversion Disorder and Undifferentiated Somatoform Disorder. Finally, for almost all disorders diagnostic criteria were slightly modified and nosological information was updated. When evaluating the revision, the multiple purposes of the DSM-5 have to be taken into account. As many of these purposes are in conflict or even mutually exclusive, controversial discussions of the new edition by the various interest groups are to be expected.Im Mai 2013 ist die fünfte Auflage des Diagnostischen und Statistischen Manuals Psychischer Störungen (DSM-5) der American Psychiatric Association erschienen. Um die Vor- und Nachteile des DSM-5 beurteilen und gegebenenfalls in Forschung und Praxis angemessen berücksichtigen zu können, sollten Wissenschaftler und Praktiker gleichermaßen über die Änderungen gegenüber dem DSM-IV informiert sein. In diesem Beitrag werden die wesentlichen Unterschiede zwischen dem DSM-IV und DSM-5 beschrieben. Zentrale Unterschiede in dem Gesamtsystem ergeben sich durch die Aufgabe des multiaxialen Systems und die Neuanordnung der Störungen. Wesentliche Veränderungen auf Störungsebene enthalten die Einführung Schwerer und Leichter Neurokognitiver Störungen, die Aufhebung von Trauerreaktionen als Ausschlusskriterium für Major Depression und die Aufnahme von Agoraphobie als eigenständige Diagnose. Als neue Störungskategorien wurden beispielsweise die «Binge-Eating»-Störung, die Prämenstruelle Dysphorische Störung, die Disruptive immungsdysregulationsstörung, Zwanghaftes Horten, Dermatillomanie und Koffeinentzug eingeführt. Ausgeschlossen wurden unter anderem die Störung mit Sexueller Aversion und die Undifferenzierte Somatoforme Störung. Letztlich wurden bei fast allen Störungen die Informationen zur Störungsbeschreibung aktualisiert und/oder die diagnostischen Kriterien geringfügig modifiziert. Bei der Bewertung der vorgenommenen Veränderungen muss berücksichtigt werden, dass das DSM verschiedenen, teilweise konträren Zielstellungen dient. Eine kontroverse Bewertung der Neuauflage ist daher zu erwarten

Overcome procrastination: Enhancing emotion regulation skills reduce procrastination

AbstractProcrastination is a widespread phenomenon that affects performance in various life domains including academic performance. Recently, it has been argued that procrastination can be conceptualized as a dysfunctional response to undesired affective states. Thus, we aimed to test the hypothesis that the availability of adaptive emotion regulation (ER) skills prevents procrastination.In a first study, cross-sectional analyses indicated that ER skills and procrastination were associated and that these connections were mediated by the ability to tolerate aversive emotions. In a second study, cross lagged panel analyses showed that (1) the ability to modify aversive emotions reduced subsequent procrastination and that (2) procrastination affected the subsequent ability to tolerate aversive emotions. Finally, in a third study, a two-arm randomized control trial (RCT) was conducted. Results indicated that systematic training of the ER skills tolerate and modify aversive emotions reduced procrastination. Thus, in order to overcome procrastination, emotion-focused strategies should be considered

Are YouTube videos on cutaneous squamous cell carcinoma a useful and reliable source for patients?

A variety of new treatment options for skin cancer patients drives the need for information and education, which is increasingly met by videos and websites [1, 2]. However, distinguishing between high- and low-quality content becomes more difficult as the number of videos increases. Recently, videos addressing patients with melanoma or basal cell carcinoma (BCC) were found to be of predominantly mediocre quality and poor reliability [3, 4]. Until now, no evaluation of videos on cutaneous squamous cell carcinoma (cSCC) has been performed. Furthermore, no patient guideline currently exists for this entity [5–7]. Therefore, we aimed to systematically identify and evaluate videos on cSCC, the worldwide second most common type of skin cancer after BCC [8]. Our results will contribute to shared decision-making and help physicians and patients to select high-quality videos

Zero-shot personalization of speech foundation models for depressed mood monitoring

The monitoring of depressed mood plays an important role as a diagnostic tool in psychotherapy. An automated analysis of speech can provide a non-invasive measurement of a patient’s affective state. While speech has been shown to be a useful biomarker for depression, existing approaches mostly build population-level models that aim to predict each individual’s diagnosis as a (mostly) static property. Because of inter-individual differences in symptomatology and mood regulation behaviors, these approaches are ill-suited to detect smaller temporal variations in depressed mood. We address this issue by introducing a zero-shot personalization of large speech foundation models. Compared with other personalization strategies, our work does not require labeled speech samples for enrollment. Instead, the approach makes use of adapters conditioned on subject-specific metadata. On a longitudinal dataset, we show that the method improves performance compared with a set of suitable baselines. Finally, applying our personalization strategy improves individual-level fairness

The efficacy of a transdiagnostic emotion regulation skills training in the treatment of binge‐eating disorder—Results from a randomized controlled trial

Abstract Objectives Deficits in emotion regulation (ER) have been shown to be associated with binge‐eating disorder (BED). To further clarify the causal nature of this association, we tested whether systematically enhancing ER skills would reduce symptoms of BED. Methods We randomly allocated N = 101 individuals meeting the criteria for BED to a transdiagnostic ER skills training or to a waitlist control condition (WLC). Primary outcome was the reduction in binges during the treatment‐vs.‐waiting period as assessed with the Eating Disorder Examination (EDE) interview. Results Mixed‐model ANOVAs indicated that the average pre‐to‐post decrease in binges assessed with the EDE was significantly greater in the ER skills training condition than in the WLC (d = 0.66). These effects were stable over the 6‐month follow‐up period (d = 0.72). Remission rates at post/follow‐up were 34.4/45.0% in the skills training and 7.5/20.0% in the WLC. Additionally, we found a greater reduction in general eating disorder psychopathology, of food consumption in a bogus taste test and of depression in the ER skills training condition. Moreover, the greater reduction in binge‐eating episodes in the training condition was (partially) mediated by a greater increase in ER skills. Conclusions The findings provide further support for the assumed importance of deficits in ER as a maintaining factor and, hence, as a target in the treatment of BED. As ER skills trainings have been shown to also reduce other kinds of psychopathology, they might be considered a promising transdiagnostic add‐on component to disorder‐specific interventions

Treating internet use disorders via the internet? Results of a two-armed randomized controlled trial

Background and aims: Internet Use Disorders (IUDs) are emerging as a societal challenge. Evidence-based treatment options are scarce. Digital health interventions may be promising to deliver psychological treatment to individuals with IUDs directly in their online setting. The aim of this study was to evaluate the efficacy of a digital health intervention for IUDs compared to a waitlist control group (WCG). Methods: In a two-armed randomized controlled trial, N = 130 individuals showing IUDs (Internet Addiction Test; IAT ≥49) were randomly allocated to the intervention group (IG; n = 65) or WCG (n = 65). The intervention consisted of 7 sessions based on cognitive behavioral therapy. The primary outcome was IUD symptom severity measured via the IAT at post treatment 7 weeks after randomization. Secondary outcomes included IUD symptoms (Compulsive Internet Use Scale; CIUS), quality of life, depressive and anxiety symptoms, and other psychosocial variables associated with IUDs. Results: Participants were on average 28.45 years old (SD = 10.59) and 50% identified as women, 49% as men, and 1% as non-binary. The IG (n = 65) showed significantly less IUD symptom severity (IAT) (d = 0.54, 95% CI 0.19–0.89) and symptoms (d = 0.57, 95% CI 0.22–0.92) than the WCG (n = 65) at post-treatment. Study attrition was 20%. Effects on all other secondary outcomes were not significant. On average, participants completed 67.5% of the intervention. Discussion and Conclusions: A digital health intervention could be a promising first step to reduce IUD symptom severity