How a transdiagnostic approach can improve the treatment of emotional disorders: Insights from clinical psychology and neuroimaging

Depressed mood as a transdiagnostic target relevant to anxiety and/or psychosis: a scoping review protocol

INTRODUCTION

Depressed mood is a psychological state characterised by sadness or loss of interest in activities. Depressed mood is a highly prevalent symptom across major mental disorders. However, there is limited understanding of the burden and management of comorbid depressed mood across major mental disorders. Therefore, this scoping review aims to summarise knowledge on depressed mood among persons with anxiety and/or psychosis. The specific aims are to describe the epidemiology and risk factors of depressed mood as a transdiagnostic target among persons with anxiety and/or psychosis, to identify commonly used outcome measures for depressed mood and to outline initial evidence of psychometric robustness and to identify and summarise the effectiveness of commonly applied depressed mood modification interventions. Our hope is that the proposed review will provide insights into the burden of depressed mood in persons with anxiety and psychosis and help to identify evidence gaps and recommendations for future research.

METHODS AND ANALYSIS

This scoping review will be conducted per Arksey and O'Malley's framework. We will first search for peer-reviewed articles and grey literature published from 2004 to 2023 in PubMed, Scopus, Web of Science, Africa-Wide Information, CINAHL, PsycINFO, Academic Search Premier, Humanities International Complete, Sabinet, SocINDEX, Open Grey and Google Scholar. We will include articles reporting depressed mood (subthreshold depression) among persons with anxiety and/or psychosis. Studies recruiting participants meeting depression diagnostic criteria and those published in non-English languages will be excluded. Two independent researchers will extract the data. We will analyse and chart data collaboratively with researchers with lived experiences of depressed mood.

ETHICS AND DISSEMINATION

This study does not require ethical approval as it is a literature review. The results will be submitted for publication in a peer-reviewed journal.

Validation of the Approach-Avoidance Temperament Questionnaire in Individuals with Anxiety and Depression

The Approach-Avoidance Temperament Questionnaire (ATQ) is a well-established measure assessing heightened sensitivity and reactivity to reward/positive stimuli (approach temperament) and to punishment/negative stimuli (avoidance temperament). These basic dimensions of personality are believed to be important for understanding the etiology and maintenance of anxiety and depressive disorders. Despite the ATQ's potential utility in clinical psychology research, its psychometric properties and factor structure have yet to be examined in a psychiatric sample. The aims of the present study were to 1) conduct confirmatory factor analysis to replicate the ATQ's factor structure in individuals diagnosed with an anxiety or depressive disorder (N = 244), 2) assess internal consistency and convergent and divergent validity, and 3) explore differences in approach and avoidance temperaments in individuals with versus without a diagnosis of anxiety or depression. Results confirmed the original two-factor structure of the ATQ in a clinical sample, with approach and avoidance temperaments representing orthogonal dimensions. The measure demonstrated strong internal consistency, convergent and divergent validity, and predictive validity. Individuals with anxiety and depression scored higher on avoidance items and lower on approach items compared to those without clinical diagnoses. This study supports the use of the ATQ in clinical populations.

Invariance of the Trait Emotional Intelligence Construct Across Clinical Populations and Sociodemographic Variables

Recent research has shown that cultural, linguistic, and sociodemographic peculiarities influence the measurement of trait emotional intelligence (trait EI). Assessing trait EI in different populations fosters cross-cultural research and expands the construct’s nomological network. In mental health, the trait EI of clinical populations has been scarcely researched. Accordingly, the present study examined the relationship between trait EI and key sociodemographic variables on Trait Emotional Intelligence Questionnaire (TEIQue-SF) datasets with mental healthcare patients from three different Spanish-speaking countries. Collectively, these datasets comprised 528 participants, 23% from Chile (120), 28% from Peru (150), and 49% from Spain (258). The sociodemographic variables we used for trait EI comparisons were gender, age, educational level, civil status, and occupational status. Analyses involved Multigroup Exploratory Structural Equation Modelling (to test measurement invariance) and analysis of covariance (ANCOVA). Our results revealed significant between-country differences in trait EI across the studied sociodemographic variables and interactions between these variables. Measurement invariance across the datasets was attained up to the scalar level regarding gender and education (i.e., strong invariance), although analyses on age, civil status, and occupation displayed non-invariance. The resultant psychometric evidence supports the suitability of the TEIQue-SF for the accurate cross-cultural assessment of trait EI in mental health settings. It also highlights the importance of incorporating trait EI into extant psychotherapeutic frameworks to enhance non-pharmacological treatment efficacy.