Online behaviours during the COVID-19 pandemic and their associations with psychological factors: an international exploratory study

This cross-sectional study aimed to explore specific online behaviours and their association with a range of underlying psychological and other behavioural factors during the COVID-19 pandemic. Eight countries (Italy, Spain, the United Kingdom, Lithuania, Portugal, Japan, Hungary, and Brazil) participated in an international investigation involving 2223 participants (M = 33 years old; SD = 11), 70% of whom were females. Participants were surveyed for specific type of Internet use severity, appearance anxiety, self-compassion, and image and use of performance-enhancing drugs (IPEDs). Results were compared cross-culturally. The mean time spent online was 5 h (SD = ±3) of daily browsing during the pandemic. The most commonly performed activities included social networking, streaming, and general surfing. A strong association between these online behaviours and appearance anxiety, self-compassion, and IPEDs use was found after adjustment for possible confounders, with higher scores being associated with specific online activities. Significant cross cultural differences also emerged in terms of the amount of time spent online during the initial stages of the COVID-19 pandemic.info:eu-repo/semantics/publishedVersio

Mental Fatigue, But Not other Fatigue Characteristics, as a Candidate Feature of Obsessive Compulsive Personality Disorder in Patients with Anxiety and Mood Disorders—An Exploratory Study

Background: Obsessive compulsive personality disorder (OCPD) is commonly associated with anxiety and mood disorders (AMDs), in which fatigue and executive dysfunction represent key symptoms. Executive dysfunction has also been demonstrated in subjects with OCPD, and is additionally found to be a cardinal feature of fatigue. This study aimed to investigate the associations between fatigue, executive dysfunction, and OCPD in patients with AMDs. Methods: In this cross-sectional study, 85 AMD patients (78% females, mean age 39 ± 11 years) were evaluated for OCPD traits by using the observer-rated Compulsive Personality Assessment Scale. The Multidimensional Fatigue Inventory-20 was used to measure different aspects of fatigue, and the Trail Making Test was employed to assess executive functioning. The Hamilton rating scales were used to evaluate anxiety and depression symptoms. Results: Controlling for potential confounders, there was a significant link between OCPD and mental fatigue (OR, 1.27; 95% CI, 1.02 to 1.58; p = 0.033). No associations were found between the presence of OCPD and other relevant fatigue characteristics, including general fatigue, physical fatigue, reduced activity, and reduced motivation, as well as executive functions. Conclusions: To the best of our knowledge, this study is the first to report associations between OCPD and mental fatigue in patients with AMDs, suggesting mental fatigue as a clinically important symptom when considering particular personality pathologiesPeer reviewedFinal Published versio

Individual obsessive-compulsive traits are associated with poorer adjustment to the easing of COVID-19 restrictions.

BACKGROUND: As COVID-19 restrictions ease, the public are expected to relinquish previously enforced safety behaviors and resume a more normal lifestyle. Despite these aims, our recent survey of 438 adults from the general population, during a temporary release of lockdown in the United Kingdom (July-November 2020), showed that 25% of the public find re-adjustment problematic. This was especially the case in those with a history of mental disorder and obsessive-compulsive (OC) traits and symptoms, including rigidity as measured by a neurocognitive test of attentional flexibility. To aid in identifying those most at risk, we performed a secondary analysis on the data to determine which specific OC traits were related to specific aspects of behavioral adjustment. METHODS: Correlational and multiple regression analyses were performed to determine associations between the eight individual personality traits constituting DSM-5 Obsessive-Compulsive Personality Disorder (OCPD), as measured by the self-rated Compulsive Personality Assessment Scale (CPAS) and a range of self-rated Post-Pandemic Adjustment Questionnaire items. RESULTS: Three items on the Post-Pandemic Adjustment Questionnaire correlated with individual CPAS items: 'General difficulties adjusting' correlated with perfectionism, preoccupation with details, over-conscientiousness and need for control; 'social avoidance' correlated with perfectionism and preoccupation with details; and 'disinfecting behaviors' correlated with preoccupation with details and miserliness (Pearson's r - all p < .001). Intriguingly, none of the adjustment items correlated significantly with self-rated rigidity. CONCLUSIONS: Several OCPD traits predict post-pandemic adjustment difficulties, but perfectionism and preoccupation-with-details showed the most robust correlations. These traits constitute a platform for the development of new screening and interventional strategies aimed at restoring public mental health and wellbeing. Cognitive rigidity may be more reliably evaluated using an objective form of assessment

Mental Fatigue in Individuals with Psychiatric Disorders: A Scoping Review

© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/)Objective: The aim of this study was to complete a scoping review of the published literature describing the relationship between mental fatigue and various psychiatric disorders, in order to better understand its frequency and clinical impact, and to provide recommendations for future clinical research. Methods: A scoping review using PubMed/MEDLINE, Cochrane and PsychArticles databases was conducted using the keywords “mental fatigue”, “mental tiredness” or “mental exhaustion”, and completed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols Extension for Scoping Reviews 2018 checklist. Results: We extracted 10 studies fulfilling our inclusion criteria from a total of publications. Mental fatigue was studied within mood disorders, anxiety disorders, obsessive compulsive disorder, and obsessive-compulsive personality disorder. A commonly used tool to measure mental fatigue in these samples was the Multidimensional Fatigue Inventory-20. Specific cognitive factors (unhelpful beliefs about sleep, symptom-focused rumination) and personality risk factors (harm avoidance, self directedness, cooperativeness, persistence) were relevant to predicting mental fatigue symptoms and rates of mental fatigue may vary with gender and diagnosis. Conclusion: Research into mental fatigue in adult psychiatric sample was limited to a few psychiatric disorders and requires further investigation.Peer reviewe

Neurocognitive markers of suicidal ideation in patients with anxiety and mood disorders

© 2020 Informa UK Limited, trading as Taylor & Francis Group. This is an accepted manuscript of an article published by Taylor & Francis in International Journal of Psychiatry in Clinical Practice on 12/03/2020, available online: https://doi.org/10.1080/13651501.2019.1666148.Objective: This study aims at identifying associations between cognitive function and suicidal ideation in the sample of patients with anxiety and mood disorders (AMD). Methods: In sum, 186 (age = 39 ± 12.3 years; 142 [76.3%] females) patients with AMD were enrolled in the study. Assessment included evaluation of socio-demographic information, medication use, anxiety and depression symptoms. Cognitive tests included measures of psychomotor performance and incidental learning using the Digit Symbol Test. Trail Making Tests respectively measured perceptual speed, task-switching and executive control. Additionally, 21 patients completed tests from the Cambridge Automated Neuropsychological Test Battery measuring set shifting (Interdimensional/extradimensional set-shift), executive planning (Stockings of Cambridge), and decision making (Cambridge Gamble Task [CGT]). Results: Almost half (45.0%, n = 86) of the study sample patients had experienced suicidal ideations. In multivariable regression analysis, suicidal ideation was associated with a greater overall proportion of bet and risk taking on the CGT task (β = 0.726, p = .010 and β = 0.634, p = .019), when controlling for socio-demographic characteristics, medication use, anxiety and depression symptoms. Conclusions: Outpatients with AMD and suicidal ideation could be distinguished by the presence of cognitive deficits in the executive function domain, particularly in impulse-control and risk taking.Peer reviewe

Psychometrics and validation of the EQ-5D-5L instrument in individuals with ischemic stroke in Lithuania

BackgroundExperiencing stroke is associated with deterioration in health-related quality of life (HRQL). One of the generic tools used for HRQL assessment is the EuroQol instrument of five dimensions and five levels (EQ-5D-5L), which has not yet been validated in Lithuania. This study aimed to evaluate validity, reliability, and factor structure of the EQ-5D-5L instrument in a sample of Lithuanian individuals at the end of the first week after experiencing ischemic stroke (IS).MethodsThe study had a cross-sectional design, including 134 individuals [61.9% men and 38.1% women; median (IQR) age was 66 years (59–73) years, in the final analysis]. Alongside the EQ-5D-5L, psychological distress was evaluated using the Hospital Anxiety and Depression Scale (HADS), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder Assessment-7 (GAD-7); neurological impairment with the National Institutes of Health Stroke Scale (NIHSS); and functional independence with the Barthel index (BI). Confirmatory factor analysis (CFA) was performed for validation of the factor structure.ResultsThe internal consistency of the EQ-5D-5L instrument was 0.81. A significant ceiling effect (17.2%) of the descriptive part of the EQ-5D-5L was detected. The convergent validity of the EQ-5D-5L descriptive system was confirmed, with significant correlations with the other scales used, except for the visual analog scale. The two-factor (“physical” and “emotional”) model was confirmed by CFA, with acceptable fit [root mean square error of approximation (RMSEA) = 0.045, RMSEA 90% CI = 0.000–0.145; comparative fit indices (CFI) = 0.996; non-normal fit index (NFI) = 0.983; Tucker–Lewis Index (TLI) = 0.936; χ2/df = 1.27)].ConclusionThis study provides information on the psychometric properties of the EQ-5D-5L instrument in Lithuanian individuals, showing that the EQ-5D-5L descriptive system is a reliable and valid tool for HRQL assessment. The Lithuanian version of the descriptive part of the EQ-5D-5L instrument is best expressed as a two-factor model, estimating the physical and emotional dimensions of HRQL in individuals who have experienced IS

Validation of the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7 in Lithuanian individuals with anxiety and mood disorders

© 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) are short self-report questionnaires used to screen and assess depression and anxiety severity in medical and community samples. However, little is known about their psychometric properties in individuals with anxiety and mood disorders (AMD) This study evaluated the psychometric properties of the PHQ-9 and GAD-7 in individuals with AMD. Individuals (n = 244, mean age 39.9 ± 12.3 years) with AMD completed the PHQ-9, GAD-7, as well as other measures of depression, anxiety, and a structured diagnostic interview. The PHQ-9 and GAD-7 demonstrated good internal consistency (Cronbach's alpha 0.87 and 0.84, respectively). The PHQ-9 and GAD-7 showed a weak correlation with clinician-rated scales HAM-D and HAM-A (r = 0.316, p < 0.01, r = 0.307, p < 0.01, respectively). For the PHQ-9, a cut score of ≥11 resulted in 72% sensitivity and 72% specificity at recognizing depression symptoms. For the GAD-7, a cut score ≥7 resulted in 73% sensitivity and 54% specificity at recognizing any anxiety disorders. The confirmatory factor analysis suggested a two-factor structure (“cognitive/affectional”, “somatic”) for both the PHQ-9 and GAD-7. In conclusion, the PHQ-9 and GAD-7 have adequate formal psychometric properties as severity measures for symptoms of anxiety and depression in individuals with AMD. The PHQ-9 performs well as a screener using a cut score of ≥11. However, the clinical utility of the GAD-7 as a diagnostic tool for recognition of anxiety disorders is limited.Peer reviewe

Psychometric Properties of the Nine-Item Problematic Internet Use Questionnaire (PIUQ-9) in a Lithuanian Sample of Students

Objectives: To date, there is no reliable instrument which could be used to assess problematic Internet use (PIU) in Lithuania. The nine-item Problematic Internet Use Questionnaire (PIUQ-9) previously validated in multiple countries, could be a potential tool for measuring PIU severity. The main objective of the present study was to explore the psychometric properties of the Lithuanian version of the questionnaire. Methods: A total of 272 students (17% men, mean age 27 ± 9 years) completed the PIUQ-9, the Patient Health Questionnaire (PHQ) and answered questions about the impairment of daily functioning caused by PIU in an online survey. Results: A confirmatory factor analysis indicated that a bi-factor model with one general factor "general problem" and two-specific factors "obsession" and "neglect + control disorder" fitted the data well. The presence of a strong global factor was supported by the common variance index in the bi-factor model indicating that the "general problem" factor explained 67.7% of common variance. The multiple indicators multiple causes (MIMIC) model showed that psychiatric symptoms (β = 0.25) had a moderate, while impairment due to PIU (β = 0.41) had a moderate-to-strong direct effect on the factor "general problem" supporting the construct validity of the scale. Conclusion: The Lithuanian version of the PIUQ-9 has appropriate psychometric properties to be used in measuring PIU severity in student samples

Problems in Cognitive-Behavioral Supervision : Theoretical Background and Clinical Application

Cognitive-behavioural therapists and trainees are encouraged to undergo supervision when offering therapy to troubled clients and to process personal attitudes and events likely to affect their therapeutic work. We discuss common problems in cognitive behavioural therapy (CBT) supervision, which may arise at the client, supervisee, or supervisor level. These issues include difficulties with case formulation, therapeutic strategies, and the therapeutic relationship. A supervisor can help their supervisee deal with clients with multifaceted or particularly challenging problems, such as difficulties with compliance, complex psychosocial problems, or chronic mental disorders. We also discuss matters related to the supervision process, the supervisor's role, different supervisory styles, and issues affecting a supervisee's feelings of vulnerability and shame. Furthermore, we analyze distinct supervision styles and potential problems arising from the supervision of experienced CBT therapists.Peer reviewe

Chairwork in cognitive behavioral therapy and schema therapy : Options in practice

Chairwork is a creative and emotionally charged technique that enhances therapeutic progress. It is based on the assumption that if individuals become aware and express their inner beliefs or conflicts, it would help them understand and choose solutions more freely than if they act unaware and automatically. When used within the conceptualization of the client's problems, it can liberate clients' intense emotional pain and change their maladaptive cognitions. This article shares the clinical experience using the chair techniques by describing and illustrating typical examples of chairwork in cognitive behavioural and schema therapy. Additional recommendations on how to do chairwork and consider the pace, tone of voice, or location of the chairs are also provided.publishersversionPeer reviewe