No Health without Mental Health: European Clinical Psychology Takes Responsibility
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Single Talks

Session chair: Hoyer, Jürgen, Professor (Technische Universität Dresden, Dresden, Germany)
 
Shortcut: S7
Date: Thursday, 31 October, 2019, 4:30 p.m.
Room: E05
Session type: Symposia

Contents

Click on an contribution to preview the abstract content.

4:30 p.m. S7-01

Reclaiming the role of the social context in new clinical disorders: the interplay between social distrust and negative affectivity in Problematic Internet Use among adolescents. (#96)

L. Ferrante1, C. Venuleo1, S. Rollo1

1 Università del Salento, Department of History, Society and Human Studies, Lecce, Italy

Structured Abstract

Scholars have highlighted the role of both individual and relational dimensions as factors that influence vulnerability for problematic internet use (PIU). According to the Caplan’s model (2010), the preference for online interactions and the internet use as a way to regulate mood compromise the ability to self-regulate both thoughts and behaviors about internet use (e.g. compulsive use), resulting in negative outcomes that characterize PIU. Studies suggest that the preference for online interactions might derive from higher levels of social anxiety; internet use might be serve as a strategy for mood-regulation from negative affectivity that also impacts self-regulation capabilities. Few attention was paid to the wider social context and to the meanings associated to one’s own off-line experience. In order to fill this gap, the present study explores the role of the cultural models through people interpret their own social environment in affecting negative affect and social anxiety.

Measures of PIU (GPIUS-2), social anxiety (IAS), negative affectivity (PANAS) and cultural models (VOC) were detected in a sample of 424 students from the 9th and 11th grade (age 13-19 years old) of public high schools in the territory of Lecce (Apulia – South Italy). Structural Equation Model was developed to verify the role of view of social context.

Findings show that cultural models characterized by low sense of belonging and absolute distrust towards the social context impact measures of social anxiety and negative affect, which in turn affect PIU.

At the theoretical level, the study suggests that our understanding of PIU should include the role of the ways people interpret their social context. On the plane of intervention, it might be effective to extend the attention to the context of belonging which triggers individuals’ social malaise.

Keywords: clinical psychology, problematic internet use, cultural models, adolescence
4:42 p.m. S7-02

What do experts say? Do's and Don'ts in school-based suicide awareness and prevention programs for adolescents (#132)

L. Grosselli1, K. Herzog1, J. Hoyer1, S. Knappe1

1 Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany

Structured Abstract

Background: Effective randomized-controlled-trials provided evidence for the effectiveness of school-based awareness curricula for the prevention of suicide among adolescents in the last decade. However, historical doubts regarding negative side-effects of this prevention approach still exist. This study aims to systematically collect expert consensus to promote the development of effective and safe suicide prevention programs.
Methods: Following a three-stage Delphi survey, a panel of 63 experts in suicide prevention was recruited. Experts with an H-factor ≥10 in Web of Science and suicidality or prevention of suicide/mental diseases in adolescents as a main research field were eligible. 19 experts participated in the first round, 12 in each of three survey rounds. Round 1 consisted of open questions on conditions and contents of effective suicide awareness programs and putative side effects. In round 2 and 3, experts rated statements delineated from round 1. Rating was stopped when items reached consensus (interquartile-range ≤ 1) or stability between 2 rounds.
Findings: Consensus was reached on 174 of 214 items in round 3; only 2 items did not reach stability at this point. Overall, experts endorsed the effectiveness and efficacy of school-based awareness suicide prevention programs. Concerns about unwanted side effects were reported as well, albeit sound evidence for these was limited.
Discussion: Findings represent the perspective of clinical practice on suicide awareness prevention programs in youth and supplement the data-driven results from RCTs. Findings have the potential to inform the development and implementation of both effective and safe prevention programs.

Keywords: Delphi Survey, suicide prevention
4:54 p.m. S7-03

The study of external signal processing in depression and panic disorder, before and after psychotherapy (#109)

C. Valt1, D. Huber1, 2, B. Stürmer1

1 International Psychoanalytic University , Berlin, Germany
2 Klinikum München, Department of Psychosomatic Medicine and Psychotherapy, Munich, Germany

Structured Abstract

Investigations of performance monitoring in psychological disorders characterized by internalization have consistently observed abnormal processing of internal signals related to errors. Compared to controls, patients present enlarged error-related negativity (Ne/ERN), whose abnormal amplitude does not change during psychotherapy. In a series of experiments, we investigated whether electrophysiological responses other than the Ne/ERN can distinguish between psychological disorders characterized by distress/misery (depression) or fear symptoms (panic disorder), and give insight into the functional changes induced by psychotherapy. To this end, we focused on the processing of external signals.

We conducted three experiments where participants (patients and controls) performed a response-choice task with feedback and a passive-viewing task of faces or houses. In two experiments, we tested patients with depression (exp. 1) or panic disorder (exp. 2) before the beginning of therapy. In a third study, patients with panic disorder took part in the same experiment after one year of psychotherapy (exp. 3).

In line with previous studies, the Ne/ERN was more negative in patients than in controls, both when patients had depression (Exp. 1) or panic disorder (Exp. 2). However, only in panic disorder, we observed that, compared to controls, patients presented an enlarged vertex positive potential (VPP) evoked by external stimuli (Exp. 2). Interestingly, after one year, controls and panic patients did not show any significant difference in the processing of external signals, resulting from a significant normalization of the VPP in patients after psychotherapy (Exp. 3).

These experiments show that the electrophysiological responses evoked by external signals offer promising insights into the functional differences among psychological disorders characterized by internalization and into the functional changes induced by psychotherapy.

Keywords: Panic disorder, Psychotherapy, Abnormal brain functioning, Performance monitoing
5:06 p.m. S7-04

The mediating role of distress tolerance in the relationship between coping and psychological distress among Turkish adults (#145)

A. Altan-Atalay1, Y. Sohtorik İlkmen2

1 Koc University, Psychology, Istanbul, Turkey
2 Bogazici University, Psychology, istanbul, Turkey

Structured Abstract

Introduction: Different types of coping strategies that individuals adapt have been suggested as both protective and vulnerability factors for psychological health. In a similar vein, lack of distress tolerance is considered a transdiagnostic risk factor which is potentially related to one’s coping strategies. Exploring the mechanisms through which coping strategies relate to mental health is particularly important for understanding psychological disorders as well as informing treatments. The current study aimed to investigate the mediator role of distress tolerance in the relationship between two different coping strategies (preventive and proactive coping) and severity of anxiety and depression in a community sample.

Methods: The participants were composed of 413 (252 women) adults between the ages of 18 and 59 (M= 31.1, SD=11.9). The participants completed a set of questionnaires through an online survey platform.

Results:The results suggested that distress tolerance significantly mediated the association of proactive coping with both anxiety and depression. However, a similar pattern was not observed for preventive coping.

Conclusions: The findings suggested that distress tolerance may be one of the mechanisms throough which  certain coping strategies exert their effects on mental health. In addition to providing support for the available studies on distress tolerance and psychological distress, the current results have important implications for coping literature. The results are discussed in the light of current studies.

 

Keywords: proactive coping, preventive coping, distress tolerance, psychological distress
5:18 p.m. S7-05

Symptom Remission Promotes Long-term Stability of Benefits in Cognitive Behavioral Therapy for Obsessive Compulsive Disorder (#148)

B. Reuter1, B. Elsner1, T. Jacobi1, N. Kathmann1

1 Humboldt-Universität zu Berlin, Institut für Psychologie, Berlin, Berlin, Germany

Structured Abstract

Introduction: For the treatment of obsessive-compulsive disorder, cognitive behavioral therapy (CBT) is effective and recommended as first choice method. Although average improvements appear to be largely preserved at follow-up assessments after one year or later, the status of individual patients may deteriorate after treatment. This study tested whether the achievement of certain symptom levels after treatment can predict stability vs. deterioration at follow-up. Methods: 120 patients with OCD participated in a follow-up assessment one year after termination of individual CBT at a university outpatient unit. Using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), we first tested whether response only (Y-BOCS score reduction by at least 35%) and remission status (response with a post-treatment Y-BOCS score < 13) at the end of treatment predicted deterioration of symptoms at follow-up. Secondly, we identified optimal cut-off scores to classify for deterioration and for sustained gains using receiver-operating characteristic (ROC) curves. Results: Compared to remission, response only at post-treatment increased the chance for deterioration at follow-up at an Odds Ratio of 8.8. In addition, ROC curves revealed that a post-treatment cut-off of ≥ 13 distinguished optimally between patients with later symptom deterioration and those with symptom stability at follow-up assessment. The optimal cut-off score for classifying patients with and without any sustained gains (response, remission, or both) at follow-up was ≤ 12. Conclusions: The results suggest clinical utility of the expert consensus criteria for remission. Reducing symptoms below this limit appears to promote long-term stability.

Keywords: obsessive-compulsive disorder, cognitive behavioral therapy, long-term outcome, remission
5:30 p.m. S7-06

Timing of developmental tasks by young and adult children of parents with mental disorders (#95)

I. Grzegorzewska1, E. Soroko2, L. Cierpiałkowska3

1 University of Zielona Gora, Institute of Psychology, Zielona Góra, Poland
2 Adam Mickiewicz University in Poznan, Institute of Psychology, Poznan, Poland
3 Adam Mickiewicz University in Poznan, Institute of Psychology, Poznan, Poland

Structured Abstract

A positive approach to mental health defines it as the level of fulfilment of developmental tasks that express the individual's adaptation to life-long changes. Being raised by a parent suffering from mental disorder may affect the fulfilment of developmental tasks and worsen their adaptation.

We intend to present results of two self-report studies. The first study (N = 540) was conducted in a group of children (age 9-19) of alcoholic fathers in comparison to the control groups. Study 2 (N = 47) was focused on a group of highly functioning adult children of mothers who suffered from schizophrenia accounting for the age of the child at the time of the schizophrenia diagnosis in the mother (before 10 years of age compare to over 10 years of age; B10y vs O10y). In both studies we identified psychological and social factors that determine the fulfillment of developmental tasks.

Results of the first study show that factors supporting the timeliness of development tasks in COAs are varied. There are also different protective factors dependent on the age of children. In second study the lack of awareness of experienced emotions, the need for support, inconsistency in the mother's parental attitude and diagnosis O10y were predictors of a sense of punctuality, while the available instrumental support, the need for support and the inconsistency of the parental style appeared to be predictors of a sense of acceleration of developmental tasks.

To conclude, both studies have shown that being brought up in a family with a parent suffering from mental disorders is linked to difficulties in fulfilling developmental tasks. Those difficulties however were varied especially across age and parental disorder. Thus we presented a discussion of possible developmental paths and we expoided them in a clinical practice, expressing a need to diversify the type of support for children of parents with mental disorders.

 

Keywords: parental disorders, psychological and social factors, adaptation, developmental tasks
5:42 p.m. S7-07

The Development of Resilience in Later Life in Response to Low, Moderate, or High Levels of Adversity: A Longitudinal, Person-Centered Investigation (#67)

M. V. Thoma1, S. L. Mc Gee1, A. Maercker1, J. Höltge1

1 University of Zurich, Psychological Institute, Zurich, Zürich, Switzerland

Structured Abstract

Introduction: It is well known that high levels of adversity are linked to an increased risk for the development of impaired physical and mental health. The dominating pathological perspective of previous research on the impact of adversity has however overshadowed research efforts on the potential beneficial impact of adversity. One theory behind the latter is the steeling effect, which states that (successfully) dealing and coping with moderate amounts of adversity, foster the development of beneficial adaptational resources and as such the promotion of future stress resilience. While the number of studies on the steeling effect is steadily growing, the majority of previous studies has used cross-sectional designs with younger participants. To gain insight into the development of stress resilience, and this also in older individuals, this study applied a longitudinal, person-centered approach to examine the steeling effect in older adults.

Methods: A longitudinal survey study with two assessments one year apart has been conducted in individuals of 50 years and older. A broad set of resilience resources has been assessed twice via standardized questionnaires. In order to identify resilience profiles, latent profile analysis was applied.

Results: The total sample was comprised of N=187 (Mage=67 years; 71% female) participants. Three profiles emerged from the data: one with maintaining resilience resources (n=168), one with a general decrease (n=12), and one with an increase (n=17) in resilience. The ‘decrease’-group had the lowest number of adversity, followed by the ‘maintenance’ and ‘increase’-groups.

Conclusions: The study could partly support the steeling effect by showing the worst outcomes in those with the lowest levels of adversity. Given that an increase in resilience was found in those with the highest (rather than in those with moderate) levels of adversity, suggests a potential age-specific steeling effect in later life.

Keywords: steeling effect, older adults, resilience