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Temple J, Gemma Cherry M, Gray V, Jones A, Fisher P. Experience sampling methodology study of anxiety and depression in adolescents with epilepsy: The role of metacognitive beliefs and perseverative thinking. Epilepsy Behav 2024; 151:109599. [PMID: 38160577 DOI: 10.1016/j.yebeh.2023.109599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/10/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024]
Abstract
Emotional distress is common in young people with epilepsy (YPwE). According to the Self-Regulatory Executive Function (S-REF) model, maladaptive metacognitive beliefs and perseverative thinking are fundamental in the development and maintenance of emotional distress. As emotional distress and perseverative thinking can highly fluctuate over short intervals in YPwE, it is important to account for this variability when testing the utility of psychological models. Experience sampling methodology (ESM) was therefore used to explore the momentary relationship between metacognitive beliefs, perseverative thinking, and emotional distress in YPwE. Eighteen participants diagnosed with epilepsy (aged 12-17 years) completed the 10-day ESM period. Participants were prompted to complete the ESM assessment five times daily. The ESM assessment assessed participant's momentary levels of metacognitive beliefs, perseverative thinking (i.e., worry and rumination), and emotional distress (i.e., anxiety and depression). A series of multilevel regression analyses indicated that metacognitive beliefs were significantly positively associated with worry, rumination, anxiety and depression. After controlling for worry and rumination, respectively, metacognitive beliefs did not account for additional variance in anxiety or depression. Findings provide preliminary support for the utility of the S-REF model for emotional distress in YPwE. Metacognitive therapy, which is underpinned by the S-REF model, may be an appropriate intervention for emotional distress in YPwE. Future studies should assess the mediational relationship between metacognitive beliefs, perseverative thinking, and emotional distress using time-lagged models.
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Affiliation(s)
- James Temple
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK; Mersey Care NHS Foundation Trust, Liverpool, UK
| | - Mary Gemma Cherry
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK; Clinical Health Psychology Service, Liverpool University NHS Foundation Trust, Liverpool, UK.
| | - Victoria Gray
- Psychological Services (Paediatrics), Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Andrew Jones
- Department of Psychology, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Peter Fisher
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK; Clinical Health Psychology Service, Liverpool University NHS Foundation Trust, Liverpool, UK
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Brown RL, Innes PA, Carter JD, Wood A, Love S, Kannis-Dymand L. Beliefs About Traumatic Memories, Thought Control Strategies, and the Impact on PTSD Symptoms After a Natural Disaster. J Nerv Ment Dis 2023; 211:182-189. [PMID: 36095259 DOI: 10.1097/nmd.0000000000001586] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT This study aimed to investigate the relationships among self-reported meta-memory beliefs, thought control strategies ( i.e. , distraction, reappraisal, worry, social control, and punishment), and posttraumatic stress disorder (PTSD) symptomology, among a sample of earthquake survivors ( N = 412). Correlational analysis and structural equation modeling were used on the responses and showed that stronger positive and negative meta-memory beliefs, and greater worry and punishment, were associated with greater PTSD symptom severity. The results also indicated that meta-memory beliefs had a prominent indirect influence toward PTSD symptomology via their effects toward thought control strategies. Follow-up analysis of variance indicated that those with a history of mental health difficulties reported higher levels of PTSD symptom severity, were more likely to score in the range of clinically relevant PTSD, and had a stronger tendency to negatively appraise unwanted thinking styles. The results of this research provide overall support for the validity of the metacognitive model for PTSD.
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Affiliation(s)
| | | | - Janet D Carter
- Department of Psychology, Speech, and Hearing, University of Canterbury, Christchurch, New Zealand
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Wells A, Carter K, Hann M, Shields G, Wallis P, Cooper B, Capobianco L. Youth Metacognitive Therapy (YoMeta): protocol for a single-blind randomised feasibility trial of a transdiagnostic intervention versus treatment as usual in 11–16-year-olds with common mental health problems. Pilot Feasibility Stud 2022; 8:207. [PMID: 36096940 PMCID: PMC9465896 DOI: 10.1186/s40814-022-01162-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Mental health disorders in children and young people (CYP) are increasing but the provision of current evidence-based treatment for common mental health problems is limited. Treatment effects vary widely with no clear superiority of a single treatment approach. Further evaluation of contemporary and effective treatments in CYP is needed. Metacognitive therapy (MCT) has shown enhanced efficacy over ‘gold standard’ approaches in adult mental health, but so far has not been evaluated in a randomised trial of CYP. As such, we aim to assess the acceptability and feasibility of group-MCT for CYP with common mental health problems in comparison to usual treatment within Child and Adolescent Mental Health Services (CAMHS).
Method
YoMeta is a multicentre, two-arm, single-blind randomised feasibility trial comparing group-MCT to usual care in CYP with common mental health problems in CAMHS. CYP (target sample n = 100) with a common mental health problem will be recruited across at least three CAMHS services in the UK. Participants in the intervention arm will receive up to eight sessions of group-MCT delivered by a CAMHS mental health practitioner. The control arm will receive usual care in CAMHS which includes individual or group-based therapy. Feasibility will be assessed by the success of recruitment, retention, and data quality. Acceptability of the intervention will be assessed by the number of sessions attended and through qualitative interviews aimed at exploring CYP acceptability and understanding of the intervention. Symptoms of psychological distress will be assessed using the Revised Children Anxiety and Depression Scale (RCADS) at 20 weeks. We will also assess psychological well-being, symptoms of depression, metacognitive beliefs, quality of life, and measures to support economic evaluation (health status and health and social care use). Qualitative interviews will be conducted to understand practitioner’s views on training and delivery of group-MCT.
Discussion
The trial is designed to evaluate the acceptability and feasibility of group-MCT for CYP with common mental health problems. Group-MCT may aid in improving access to treatment, reduce waiting times, and improve outcomes for CYP with common mental health disorders. The study will provide important information and data to evaluate future research potential and confirm sample size estimation for a definitive large-scale RCT to test the effectiveness and cost-effectiveness of group-MCT in CYP.
Trial registration
NCT05260060; ISCTRN18335255
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Capobianco L, Nordahl H. A Brief History of Metacognitive Therapy: From Cognitive Science to Clinical Practice. COGNITIVE AND BEHAVIORAL PRACTICE 2021. [DOI: 10.1016/j.cbpra.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Santiago A, Carré A, Miranda R, Lemogne C, LeStrat Y, Benyamina A, Perney P, Luquiens A. Study protocol for an online randomised controlled trial among non-treatment seeking problem gamblers: training inhibition in online problem gambling (TRAIN-online) trial. BMJ Open 2021; 11:e051641. [PMID: 34848517 PMCID: PMC8634281 DOI: 10.1136/bmjopen-2021-051641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Development of fully internet-based programs could provide a new avenue to improve access to healthcare for problem gamblers. In this project, we aim to assess the efficacy of a web-based cognitive intervention targeting inhibitory control among problem gamblers, using a randomised controlled design. As impaired inhibitory control is involved in self-regulation difficulties in behavioural addictions, it represents a particularly relevant cognitive process to target for an online psychological intervention. METHODS AND ANALYSIS This will be a single-blinded, randomised, comparative therapeutic web-based, controlled trial. Up to 200 non-treatment seeking adult problem gamblers with a Problem Gambling Severity Index-recent (PGSI-recent) score ≥5 will be included. The intervention will be a computerised cognitive training program targeting inhibitory skills. The comparator, an active control, will be a computerised neutral sensorial program. Both programs will be carried out under similar conditions: biweekly online training for 6 weeks and optional telephone support will be offered to patients for debriefing. The main objective of the study is to assess the clinical efficacy of the online cognitive training program at 6 weeks, measured with the PGSI-recent. The secondary objectives are to assess the efficacy on the gambling behaviour assessed by the account-based gambling data, on the self-reported gambling practice, and on the inhibition performance at the neuropsychological level at 6, 14 and 52 weeks. We will also assess the acceptability of this program and the preferred level of guidance. Data analysis will be in intention-to-treat. ETHICS AND DISSEMINATION This randomized controlled trial will be executed in compliance with the Helsinki Declaration, and was approved by the local ethics boards (Comité de Protection des Personnes) in October 2017. The findings will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03673800.
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Affiliation(s)
- Antoine Santiago
- Addiction Team, CESP, Villejuif, Île-de-France, France
- Department of Addictology, Nîmes University Hospital, Nimes, Languedoc-Roussillon, France
| | - Arnaud Carré
- Addiction Team, CESP, Villejuif, Île-de-France, France
- LIP/PC2S, Université Savoie Mont-Blanc, Chambery, Rhône-Alpes, France
| | - Ruben Miranda
- Addiction Team, CESP, Villejuif, Île-de-France, France
- Adult Neurodeveloppment Center, Department of Psychiatry, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Cédric Lemogne
- Department of Psychiatry, Georges Pompidou European Hospital, AP-HP, Paris, Île-de-France, France
| | - Yann LeStrat
- U1266, Institute of Psychiatry and Neurosciences of Paris, Paris, Île-de-France, France
- Department of Psychiatry, Louis-Mourier Hospital, AP-HP, Colombes, Île-de-France, France
| | - Amine Benyamina
- Addiction Team, CESP, Villejuif, Île-de-France, France
- Department of Psychiatry and Addictology, Paul Brousse Hospital, AP-HP, Villejuif, Île-de-France, France
| | - Pascal Perney
- Department of Addictology, Nîmes University Hospital, Nimes, Languedoc-Roussillon, France
| | - Amandine Luquiens
- Addiction Team, CESP, Villejuif, Île-de-France, France
- Department of Addictology, Nîmes University Hospital, Nimes, Languedoc-Roussillon, France
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Brown RL, Wood A, Carter JD, Kannis-Dymand L. The metacognitive model of post-traumatic stress disorder and metacognitive therapy for post-traumatic stress disorder: A systematic review. Clin Psychol Psychother 2021; 29:131-146. [PMID: 34155731 DOI: 10.1002/cpp.2633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 11/11/2022]
Abstract
The metacognitive model of post-traumatic stress disorder (PTSD) implicates metacognitive beliefs, meta-memory beliefs and metacognitive control strategies in perpetuating and maintaining symptoms of PTSD. Despite this expanding area of research, the evidence for the metacognitive model of PTSD has not been reviewed. A systematic review according to the PRISMA statement was conducted. Searches across MEDLINE, PubMed and PsycNET, as well as reference lists of the included studies (2004 to March 2020), yielded 221 records. Two independent reviewers screened articles, which were included where the impact of the constructs of interest on PTSD symptoms was investigated within the framework of the metacognitive model for PTSD. Eighteen articles were included in the review. Eleven studies were determined to have good methodological robustness. Metacognitive therapy for PTSD demonstrated reductions in symptoms from pretreatment to post-treatment, which were maintained at follow-up. Predictors of greater PTSD symptom severity included metacognitive beliefs, meta-memory beliefs, and worry, punishment, thought suppression, experiential avoidance, and rumination. Overall, support was found for the validity of the metacognitive model of PTSD.
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Affiliation(s)
- Renee L Brown
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Andrew Wood
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Janet D Carter
- Department of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Lee Kannis-Dymand
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
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Kannis-Dymand L, Coleborn M, Innes P, Carter JD. Beliefs about Memory Questionnaire: psychometric properties in a natural disaster sample. Memory 2020; 29:78-89. [PMID: 33320030 DOI: 10.1080/09658211.2020.1856383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Several theories exist regarding the role of memory in the development of PTSD. The metacognitive model of PTSD contends beliefs about trauma memory are pivotal in the development and maintenance of PTSD. The Beliefs About Memory Questionnaire (BAMQ) was developed to measure metacognitive beliefs about trauma memory. This study aimed to test the psychometric properties of the BAMQ and its relationship to PTSD in a community sample of 674 adults exposed to the 2010-2011 Canterbury earthquakes and Queensland floods. Participants completed a series of online, self-report questionnaires between October and December 2012, exploring thinking and memory processes related to their experience of a natural disaster. Factor analysis validated the two-factor, positive and negative structure of the BAMQ. Convergent, concurrent, and discriminant validity was established through positive relationships with relevant metacognitive beliefs, thought control variables, and risk factors related to PTSD. Logistic regression revealed scores on the BAMQ predicted clinically significant symptoms of PTSD. The psychometric properties of the BAMQ suggest the instrument is a valuable addition to the assessment of metacognitive beliefs about trauma memory, and the utility of the BAMQ in the prediction of clinically significant symptoms of PTSD.
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Affiliation(s)
- Lee Kannis-Dymand
- School of Health and Behavioural Sciences, University of the Sunshine Coast (USC), Maroochydore DC, Australia.,Thompson Institute, USC, Birtinya, Australia
| | - Michael Coleborn
- School of Health and Behavioural Sciences, University of the Sunshine Coast (USC), Maroochydore DC, Australia
| | - Peter Innes
- School of Law and Society, USC, Maroochydore DC, Australia
| | - Janet D Carter
- Department of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
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Assessment of the cognitive attentional syndrome in children: an adaptation of the CAS-1. Behav Cogn Psychother 2020; 49:340-351. [PMID: 33172517 DOI: 10.1017/s135246582000082x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Research suggests that the metacognitive model is applicable to clinical child populations. However, few measures related to the model are available for younger age groups. A key concept of the model is the cognitive attentional syndrome (CAS), which encompasses the individual's worry and rumination, maladaptive coping strategies, and metacognitive beliefs. While the CAS has been successfully measured in adults, this has not yet been attempted in children. AIMS The aim of this study was to adapt a measure of the CAS for use with children and investigate the measure's associations with anxiety, worry, depression and metacognitions. METHODS Our study included 127 children with anxiety disorders aged 7-13 years. The adult measure of CAS was adapted for use with children and administered at pre- and post-treatment. We examined the correlations between variables and the ability of the CAS measure to explain variance in anxious symptomatology, as well as the measure's sensitivity to treatment change. RESULTS The adapted measure, CAS-1C, displayed strong associations with overall anxiety, depression, worry and metacognitions. The CAS-1C explained an additional small amount of variance in anxiety and worry symptoms after accounting for metacognitions, which may be due to the measure also assessing thinking styles and coping strategies. Furthermore, the measure displayed sensitivity to treatment change. CONCLUSIONS The child measure of the CAS is a brief tool for collecting information on metacognitive beliefs and strategies that maintain psychopathology according to the metacognitive model, and it can be used to monitor treatment changes in these components.
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Metakognitive und mentalisierungsbasierte Konzepte und Behandlungsmodelle: Implikationen für die Kinder- und Jugendpsychiatrie. Prax Kinderpsychol Kinderpsychiatr 2020; 69:252-271. [DOI: 10.13109/prkk.2020.69.3.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Reinholdt-Dunne ML, Blicher A, Nordahl H, Normann N, Esbjørn BH, Wells A. Modeling the Relationships Between Metacognitive Beliefs, Attention Control and Symptoms in Children With and Without Anxiety Disorders: A Test of the S-REF Model. Front Psychol 2019; 10:1205. [PMID: 31231273 PMCID: PMC6568246 DOI: 10.3389/fpsyg.2019.01205] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 05/07/2019] [Indexed: 01/04/2023] Open
Abstract
In the metacognitive model, attentional control and metacognitive beliefs are key transdiagnostic mechanisms contributing to psychological disorder. The aim of the current study was to investigate the relative contribution of these mechanisms to symptoms of anxiety and depression in children with anxiety disorders and in non-clinical controls. In a cross-sectional design, 351 children (169 children diagnosed with a primary anxiety disorder and 182 community children) between 7 and 14 years of age completed self-report measures of symptoms, attention control and metacognitive beliefs. Clinically anxious children reported significantly higher levels of anxiety, lower levels of attention control and higher levels of maladaptive metacognitive beliefs than controls. Across groups, lower attention control and higher levels of maladaptive metacognitive beliefs were associated with stronger symptoms, and metacognitions were negatively associated with attention control. Domains of attention control and metacognitions explained unique variance in symptoms when these were entered in the same model within groups, and an interaction effect between metacognitions and attention control was found in the community group that explained additional variance in symptoms. In conclusion, the findings are consistent with predictions of the metacognitive model; metacognitive beliefs and individual differences in self-report attention control both contributed to psychological dysfunction in children and metacognitive beliefs appeared to be the strongest factor.
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Affiliation(s)
| | - Andreas Blicher
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Nordahl
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Nicoline Normann
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | | | - Adrian Wells
- School of Psychological Sciences, University of Manchester and Greater Manchester Mental Health NHS Trust, Manchester, United Kingdom
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von Hammerstein C, Khazaal Y, Dupuis M, Aubin HJ, Benyamina A, Luquiens A, Romo L. Feasibility, acceptability and preliminary outcomes of a mindfulness-based relapse prevention program in a naturalistic setting among treatment-seeking patients with alcohol use disorder: a prospective observational study. BMJ Open 2019; 9:e026839. [PMID: 31154307 PMCID: PMC6550005 DOI: 10.1136/bmjopen-2018-026839] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Cultural differences between the USA and France led us to examine the feasibility, acceptability and preliminary efficacy data on craving, quality of life and psychological flexibility of the add-on Mindfulness-Based Relapse Prevention (MBRP) programme in alcohol use disorder (AUD) in France. DESIGN We conducted a prospective observational study with a 6-month follow-up. SETTING The study was performed in a naturalistic setting with adult outpatients from an addiction department. PARTICIPANTS We included all patients with a current AUD who participated in the MBRP programme (n=52). There was no non-inclusion criterion. INTERVENTIONS The intervention was an 8-week MBRP programme, combining elements of traditional relapse prevention cognitive behavioural therapy and mindfulness meditation training. This was an eight-session closed-group programme. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcomes were the number of attended treatment sessions, home practice frequency and dropout rate. Secondary outcomes were changes in craving, quality of life, psychological flexibility, drinking outcomes, depression, anxiety and mindfulness levels. RESULTS The average number of completed sessions was 6.6 (SD: 1.9). Most participants introduced mindfulness meditation into their everyday lives: 69% and 49% of included patients maintained formal practice at 3 and 6 months, respectively, and 80% and 64% maintained informal practice at 3 and 6 months, respectively. Most participants used mindfulness techniques to face high-risk situations (56% at 6 months). Participants reported a significant reduction in craving, days of alcohol use, depression and anxiety and an increase in mindfulness and psychological flexibility at 6 months. CONCLUSIONS The MBRP programme showed good acceptability and feasibility. MBRP seemed to improve craving, mindfulness and psychological flexibility. Comparative studies are needed to evaluate the programme's efficacy in AUD. TRIAL REGISTRATION NUMBER 2200863 v 0.
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Affiliation(s)
- Cora von Hammerstein
- Psychiatry and Addictology, University Paris-Saclay, University Paris-Sud, UVSQ, CESP, INSERM U 1178, APHP, Hopital Paul Brousse, Villejuif, France
- EA 4430 CLIPSYD, Universite Paris-Nanterre, Nanterre, France
| | - Yasser Khazaal
- Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Mathilde Dupuis
- EA 4430 CLIPSYD, Universite Paris-Nanterre, Nanterre, France
| | - Henri-Jean Aubin
- Psychiatry and Addictology, University Paris-Saclay, University Paris-Sud, UVSQ, CESP, INSERM U 1178, APHP, Hopital Paul Brousse, Villejuif, France
| | - Amine Benyamina
- Psychiatry and Addictology, University Paris-Saclay, University Paris-Sud, UVSQ, CESP, INSERM U 1178, APHP, Hopital Paul Brousse, Villejuif, France
| | - Amandine Luquiens
- Psychiatry and Addictology, University Paris-Saclay, University Paris-Sud, UVSQ, CESP, INSERM U 1178, APHP, Hopital Paul Brousse, Villejuif, France
- CMAP, Ecole Polytechnique, Palaiseau Cedex, France
| | - Lucia Romo
- EA 4430 CLIPSYD, Universite Paris-Nanterre, Nanterre, France
- Centre Hospitalier Sainte Anne, Inserm, U894, Center for Psychiatry and Neuroscience, Paris, France
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