How social rejection expectations and depressive symptoms bi-directionally predict each other - A cross-lagged panel analysis

A compassion-based treatment for couples with the female partner suffering from current depressive disorder: A randomized-controlled trial

BACKGROUND

Studies have shown that depression and interpersonal relationships are interdependently connected and that including the intimate partner in treatment for depression has beneficial effects. Given evidence that compassion is both an interpersonal quality and a promising treatment target, the goal of this study was to examine the effects of a compassion-based, contemplative treatment for couples employing a multi-method approach for evaluation.

METHODS

In a pre-post-follow-up design, n = 53 different-sex couples including women with current depression were randomly assigned to a 10-week-long CBCT®-fC (Cognitively-Based Compassion Training/intervention for couples) or treatment-as-usual (TAU) condition. Multi-level linear regression models and post-hoc contrasts were calculated to determine changes in depressive symptoms, mindfulness and self-compassion, interpersonal functioning and neuroendocrine markers collected during a partnership appreciation task (PAT) in the laboratory before and after CBCT-fC treatment.

RESULTS

While CBCT-fC led to a comparable decrease of depressive symptoms as TAU, the training specifically increased self-compassion and mindfulness versus TAU. Interestingly, interpersonal functioning did not improve, which was also reflected in participants' preferred self-focus in-between-session practices, instead of practices with interpersonal focus. There were no group-specific changes in psychobiological stress-marker reactivity.

CONCLUSIONS

CBCT-fC was effective in decreasing current depressive symptomatology and increasing mindfulness, and self-compassion. Especially the motivation to participate, such as improving interpersonal functioning, should be addressed and intrinsic motives of the partners to be involved. In highly burdened individuals, self-regulation may need to be improved before co-regulation can be addressed, which would requiring longer treatments. Facilitating factors for engaging in the practice between-sessions seem meaningful.

Measuring dysfunctional interpersonal beliefs: validation of the Interpersonal Cognitive Distortions Scale among a heterogeneous German-speaking sample

BACKROUND

Dysfunctional interpersonal beliefs (DIBs) are a key symptom domain in numerous mental disorders. Because DIBs exert a strong influence on social experience and behavior, they play an important role in a mental disorder's development and progression. To date, only the Interpersonal Cognitive Distortions Scale (ICDS) captures DIBs independently of specific disorders, populations, or contexts. The present study's aim was to psychometrically evaluate and validate a German translation of the ICDS.

METHODS

The ICDS was administered along with indicators of convergent (rejection sensitivity, depressive expectations, interpersonal trust, interpersonal problems, perceived social support), discriminant (self-efficacy, perseverative negative thinking, optimism), and clinical validity (psychopathology, perceived stress, well-being) to a pooled sample incorporating non-clinical (N = 114) and clinical (N = 94) participants.

RESULTS

An exploratory factor analysis (EFA) suggested a five-factor solution (factor loadings: .44 to .85). Correlational analyses demonstrated acceptable convergent (ρ = -.29 to -.35, ρ = .27 to .59), suboptimal discriminant (ρ = -.27 to -.38, ρ = .52), and acceptable clinical validity (ρ = -.21, ρ = .36 to .44) at the total-scale level. However, results at the subscale level were mixed and required nuanced interpretation. Likewise, internal consistency was acceptable at the total-scale level (α = .76), but ranged from good to poor at the subscale level (α = .61 to .80). DIBs mediated the negative relationship between mental disorder onset and psychopathology levels.

DISCUSSION

Our results imply DIBs' relevance to mental health and related outcomes. When working with the ICDS's German version, we recommend employing only the "insecurity" subscale, as this was the only scale revealing acceptable psychometric properties. Future studies should improve the construct validity of the ICDS (and its subscales), e.g., by adding more items to the respective subscales and further classes of DIBs.

If the discrepancy between expectations and actual information is too large, expectation change decreases - A replication study

BACKGROUND AND OBJECTIVES

Mental disorders have been related to aberrations in using novel positive information to revise established negative beliefs. Previous research used to make a binary distinction between belief-confirming vs. -disconfirming information, but recently it has been examined how varying levels of positive information is used to update beliefs. The present study aimed to replicate a recent finding suggesting that positive information that deviates to a large extent from people's prior expectations raises doubts about the credibility of new information and therefore hardly leads to change in expectations.

METHODS

In a heterogenous sample (N = 144), participants were provided with slightly positive, moderately positive, or extremely positive information in relation to their prior expectations about other people's behaviour.

RESULTS

Replicating previous research, the present study found that expectation change was greatest for moderately positive information. It also provided evidence for a possible mechanism underlying the inverse U-shaped relationship between the positivity of new information and change in expectations: Extremely positive information was devalued through defensive cognitive strategies, referred to as cognitive immunisation.

LIMITATIONS

Unlike previous research, the belief update task used in this study did not show any association with depressive symptoms, so it is questionable how suitable it is to study biased belief updating in depression.

CONCLUSIONS

Unlike traditional learning models, the present results suggest a tipping point above which the discrepancy between expectation and outcome is suspiciously large, so that the degree of expectation change decreases.

Reciprocal relationship between interpersonal communication and depressive symptoms and the mediating role of resilience across two years: Three-wave cross-lagged panel model

BACKGROUND

Depression among children has been a growing public health concern. It is generally recognized that individuals with depression are likely to have interpersonal malfunctioning. However, there remains a limited scientific understanding of the reciprocal relationship between interpersonal communication and depressive symptoms among rural Chinese children in a longitudinal approach.

METHODS

Therefore, guided by the interpersonal model of depression and the developmental cascade model, the present study conducted a cross-lagged panel analysis study to explore the bidirectional relationship between interpersonal communication and depressive symptoms across three waves among 2188 elementary school students in rural areas of one county of Gansu Province, China. We also examined the mediating effect of resilience and sex differences of the models.

RESULTS

Our results showed that depressive symptoms negatively predicted interpersonal communication from T1 to T2 and T2 to T3. Interpersonal communication negatively predicted depressive symptoms from T1 to T2, but not T2 to T3. Furthermore, resilience showed significant partial mediating effects in the reciprocal relationship between interpersonal communication and depressive symptoms. In terms of sex differences, the significant relationship between depressive symptoms at T1 and interpersonal communication at T2 was found to be significant among male students and marginally significant among female students. The full mediating effect of resilience at T1 was found only among male students, whereas resilience at T2 functioned as a full mediator between depressive symptoms at T2 and interpersonal communication at T3 only among female students.

LIMITATIONS

First, the present sample consisted of only third and fourth grade (i.e., in T1) students from one county in rural China. Second, the present study examined depressive symptoms instead of depression as a clinical diagnosis. Third, the third wave of the data was collected during COVID-19. The impact of the COVID-19 pandemic could unexpectedly pose on child mental health.

CONCLUSIONS

The finding underlined the importance of providing comprehensive depression prevention and intervention from fostering children's inner resilience and promoting their ability to navigate interpersonal resources.

Expectation focused and frequency enhanced cognitive behavioural therapy for patients with major depression (EFFECT): a study protocol of a randomised active-control trial

INTRODUCTION

The effectiveness of psychotherapy in depression is subject of an ongoing debate. The mechanisms of change are still underexplored. Research tries to find influencing factors fostering the effect of psychotherapy. In that context, the dose-response relationship should receive more attention. Increasing the frequency from one to two sessions per week seems to be a promising start. Moreover, the concept of expectations and its influence in depression can be another auspicious approach. Dysfunctional expectations and the lack of their modification are central in symptom maintenance. Expectation focused psychological interventions (EFPI) have been investigated, primarily in the field of depression. The aim of this study is to compare cognitive behavioural therapy (CBT) once a week with an intensified version of CBT (two times a week) in depression as well as to include a third proof-of-principle intervention group receiving a condensed expectation focused CBT.

METHODS AND ANALYSIS

Participants are recruited through an outpatient clinic in Germany. A current major depressive episode, diagnosed via structured clinical interviews should present as the main diagnosis. The planned randomised-controlled trial will allow comparisons between the following treatment conditions: CBT (one session/week), condensed CBT (two sessions/week) and EFPI (two sessions/week). All treatment arms include a total dose of 24 sessions. Depression severity applies as the outcome variable (Beck Depression Inventory II, Montgomery Asberg Depression Rating Scale). A sample size of n=150 is intended.

ETHICS AND DISSEMINATION

The local ethics committee of the Department of Psychology, Philipps-University Marburg approved the study (reference number 2020-68 v). The final research article including the study results is intended to be published in international peer-reviewed journals.

TRIAL REGISTRATION NUMBER

German Clinical Trials Registry (DRKS00023203).

Attention to faces in images is associated with personality and psychopathology

Humans show a robust tendency to look at faces in images, but also differ consistently in the strength of this attentional preference. Previous research remained inconclusive as to how a stronger face preference may be indicative of an individual's personality or clinical characteristics. Here we investigated face preferences in 120 participants (primarily drawn from a student population) who freely viewed photos in an internet browser showing a person in the context of a visually rich environment while attention was assessed using a cursor-based technique. Participants differed consistently in the strength of their face preference across images. A stronger preference for faces was correlated positively with openness to experience, extraversion, agreeableness and empathizing and was correlated negatively with social anxiety, depression levels and alexithymia. Trait measures were linked through a strong common factor which was additionally correlated with face preference. We conclude that face preferences may be linked to personality traits and to psychopathology but that an attribution to a specific facet of psychopathology may not be warranted. Future research should investigate links between face preferences and personality features in more diverse samples and across differing social situations.

Using expectation violation models to improve the outcome of psychological treatments

Expectations are a central maintaining mechanism in mental disorders and most psychological treatments aim to directly or indirectly modify clinically relevant expectations. Therefore, it is crucial to examine why patients with mental disorders maintain dysfunctional expectations, even in light of disconfirming evidence, and how expectation-violating situations should be created in treatment settings to optimize treatment outcome and reduce the risk of treatment failures. The different psychological subdisciplines offer various approaches for understanding the underlying mechanisms of expectation development, persistence, and change. Here, we convey recommendations on how to improve psychological treatments by considering these different perspectives. Based on our expectation violation model, we argue that the outcome of expectation violation depends on several characteristics: features of the expectation-violating situation; the dynamics between the magnitude of expectation violation and cognitive immunization processes; dealing with uncertainties during and after expectation change; controlled and automatic attention processes; and the costs of expectation changes. Personality factors further add to predict outcomes and may offer a basis for personalized treatment planning. We conclude with a list of recommendations derived from basic psychology that could contribute to improved treatment outcome and to reduced risks of treatment failures.