Emily Newman

An Overview of the Research on Mindfulness-Based Interventions for Treating Symptoms of Posttraumatic Stress Disorder: A Systematic Review

OBJECTIVE This systematic review aimed to collate and evaluate the existing research for the use of mindfulness-based approaches to treat posttraumatic stress disorder (PTSD). Our primary objectives were to explore the effects of mindfulness-based approaches on PTSD symptoms and associated psychological distress, with secondary objectives to explore the attrition rate, adverse effects, resource implications, and long-term effects of such interventions. METHOD We systematically searched research databases, EMBASE, OVID MedLine, Psycinfo, CINAHL, and PILOTS, contacted relevant authors in the field, and conducted a hand search of relevant papers. RESULTS The search resulted in 12 studies that met eligibility criteria, many of which studies lacked methodological rigor. The majority of the studies indicated positive outcomes with improvements in PTSD symptoms, particularly in reducing avoidance. CONCLUSIONS The preliminary evidence for the use of mindfulness-based approaches to treat PTSD symptoms is encouraging, although further studies with a more robust research design are required.

Childhood trauma and eating psychopathology : a mediating role for dissociation and emotion dysregulation?

The present study examined the relationship between different forms of childhood trauma and eating psychopathology using a multiple mediation model that included emotion dysregulation and dissociation as hypothesised mediators. 142 female undergraduate psychology students studying at two British Universities participated in this cross-sectional study. Participants completed measures of childhood trauma (emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect), eating psychopathology, dissociation and emotion dysregulation. Multiple mediation analysis was conducted to investigate the studys proposed model. Results revealed that the multiple mediation model significantly predicted eating psychopathology. Additionally, both emotion dysregulation and dissociation were found to be significant mediators between childhood trauma and eating psychopathology. A specific indirect effect was observed between childhood emotional abuse and eating psychopathology through emotion dysregulation. Findings support previous research linking childhood trauma to eating psychopathology. They indicate that multiple forms of childhood trauma should be assessed for individuals with eating disorders. The possible maintaining role of emotion regulation processes should also be considered in the treatment of eating disorders.

Attention bias modification (ABM) as a treatment for child and adolescent anxiety: A systematic review

BACKGROUND Attention Bias Modification (ABM) is a novel computer based treatment for anxiety disorders. It has been proposed as an efficient, accessible psychological therapy and is based on cognitive theories of attention. The present review sought to investigate the efficacy of ABM as a potential treatment for child and adolescent anxiety. METHOD A systematic literature review was conducted, using three main databases, PsycINFO, Embase and Medline, to identify original research articles which measured the effect of ABM on anxiety levels in children and/or adolescents. RESULTS Ten articles met the inclusion criteria and of these 10, three were randomised control trials. A lack of standardisation in relation to the treatment protocol was observed; nonetheless the identified studies generally provided evidence for the efficacy of ABM as an anxiety treatment. LIMITATIONS Due to the nature of the studies found, a statistical meta-analysis was not possible. CONCLUSIONS ABM seems to be a promising, novel treatment for child and/or adolescent anxiety disorders with merits over lengthier, talking based therapies. However, more rigorous research trials are needed to clarify the mechanisms behind ABM and establish effective, standardised treatment protocols.

Emotional maltreatment and disordered eating in adolescents: Testing the mediating role of emotion regulation

The present study aimed to determine if emotion regulation mediates the relationship between emotional maltreatment and disordered eating behavior in adolescents. Participants were 222 secondary school pupils (aged 14-18 years) from a state high school in the UK. Standardized questionnaire measures were used to gather self-report data on emotional abuse and emotional neglect, functional and dysfunctional emotion regulation strategies and disordered eating behavior. Results showed that disordered eating was associated with emotional abuse, dysfunctional emotion regulation and being female. Multiple mediation analysis found an indirect relationship between emotional abuse and disordered eating through dysfunctional emotion regulation. Interestingly, emotional neglect predicted lower levels of functional emotion regulation. The findings support previous research showing emotion regulation to mediate the relationship between childhood abuse and disordered eating in adults and a differential effect of abuse and neglect on emotion regulation. Longitudinal studies are required to confirm the direction of relationships; however these data suggest that dysfunctional emotion regulation is a significant variable in the development of disordered eating and may be a useful target for intervention.

Exercise identity as a risk factor for exercise dependence

OBJECTIVES The aim of the study was to explore the relationship between exercise identity and exercise dependence. We hypothesized that stronger exercise identities would be associated with greater odds of experiencing exercise dependence symptoms. DESIGN Logistic regression was used to assess the extent of association between exercise identity and the risk of experiencing exercise dependence symptoms. METHOD Participants (101) were recruited online via sports clubs and social networking sites and were asked to complete online measures of exercise identity and exercise dependence. RESULTS The overall model fit was a significant improvement on the baseline model, but only the exercise beliefs factor was significantly associated with the odds of dependence symptoms, with higher scores on the belief scale predicting greater odds of experiencing dependence symptoms. Exercise role identity, in contrast, was not significantly associated with odds of experiencing dependence symptoms. Per cent correct classification was 55.9% for asymptomatic and 88.2% for symptomatic individuals and the overall per cent correct classification was 77.5%. CONCLUSIONS The relation between identity and dependence could represent both a fruitful research avenue and a potential therapeutic target for those experiencing dependence symptoms; although our findings only showed a relationship between one of the two factors of the exercise identity measure and dependence. Longitudinal research is required to examine the relationship between identity and dependence in the context of other variables to better understand why some individuals become exercise dependent whereas others do not. STATEMENT OF CONTRIBUTION What is already known on this subject? Exercise identity has been identified as an important determinant of exercise behaviour and studies within the exercise identity framework have proven elucidative with respect to the psychological processes that may underpin commitment to exercise. It has separately been established that some individuals may become dependent on exercise and exhibit symptoms indicative of a behavioural addiction to exercise according in line with clinical definitions. What does this study add? Psychological explanation for exercise dependence based on escalation of normal exercise identity processes. Empirical investigation of identity-dependence link using a sample of physically active individuals. Comparison of two alternative structures for the exercise identity construct.

Neuropsychological impairments in panic disorder: a systematic review.

BACKGROUND There is a growing body of literature investigating the neuropsychological profile of panic disorder (PD), some of which suggests potential cognitive dysfunction. This paper systematically reviews the existing literature on neuropsychological performance in PD. METHOD PsycINFO, EMBASE, MEDLINE and PsycARTICLES databases were searched to identify articles reporting on neuropsychological function in PD published in English during the time period 1980 to March 2012. 14 studies were identified. RESULTS There was limited support for impairment in short term memory among individuals with PD, although this was not found across all studies. Overall, the reviewed studies did not support the presence of impairment in other areas of cognitive functioning, including executive function, long term memory, visuospatial or perceptual abilities and working memory. LIMITATIONS Studies with samples of fewer than 15 participants per group were excluded from this review. A limited amount of research has been published on this topic and small sample sizes (under 25 per group) have been used by many studies. Therefore, the current review is based on a small number of studies with limited power. CONCLUSIONS There is limited evidence of specific neuropsychological impairments in participants with PD. Impairments in short term memory warrant further investigation to establish their relevance to clinical practice. Larger sample sizes and appropriate statistical adjustment for multiple comparisons in future studies is highly recommended.

Is there a difference between child self-ratings and parent proxy-ratings of the quality of life of children with a diagnosis of attention-deficit hyperactivity disorder (ADHD)? A systematic review of the literature

There are contemporary indicators that parent proxy-ratings and child self-ratings of a child’s quality of life (QoL) are not interchangeable. This review examines dual informant studies to assess parent–child agreement on the QoL of children with attention-deficit/hyperactivity disorder. A systematic search of four major databases (PsycINFO, MEDLINE, EMBASE and Cochrane databases) was completed, and related peer-reviewed journals were hand-searched. Studies which reported quantitative QoL ratings for matched parent and child dyads were screened in accordance with relevant inclusion and exclusion criteria. Key findings were extracted from thirteen relevant studies, which were rated for conformity to the recommendations of an adapted version of the STROBE statement guidelines for observational studies. In the majority of studies reviewed, children rated their QoL more highly than their parents. There was some evidence for greater agreement on the physical health domain than psychosocial domains.

Staff Responses to behaviour that challenges: The role of knowledge, attributions and emotion regulation style

Background In this study, we explored the extent to which the knowledge and attributions of support staff predicted their reported helping behaviour in relation to people with an intellectual disability who displayed challenging behaviour (CB), and whether emotion regulation style moderated the relationship between attributions and this helping behaviour. Method Participants (N = 107) completed self-report measures of knowledge of the meaning and management of CB, causal attributions and behavioural response to CB, and emotion regulation style. Results Knowledge and helpful attributions were significantly correlated with reported helping behaviour; however, in a regression analysis with both predictors, only knowledge significantly contributed to the variance. No moderating effect was found for emotion regulation styles on the relationship between attributions and reported helping behaviour. Conclusion Knowledge was the only significant predictor of reported positive staff approaches in managing CB, giving some support for the provision of staff training aimed at increasing knowledge, rather than changing attributions.

The Role of Sexual Images in Online and Offline Sexual Behaviour With Minors

Sexual images have long been associated with sexual interest and behaviour with minors. The Internet has impacted access to existing content and the ability to create content which can be uploaded and distributed. These images can be used forensically to determine the legality of the behaviour, but importantly for psychiatry, they offer insight into motivation, sexual interest and deviance, the relationship between image content and offline sexual behaviour, and how they might be used in online solicitation and grooming with children and adolescents. Practitioners will need to consider the function that these images may serve, the motivation for their use and the challenges of assessment. This article provides an overview of the literature on the use of illegal images and the parallels with existing paraphilias, such as exhibitionism and voyeurism. The focus is on recent research on the Internet and sexual images of children, including the role that self-taken images by youth may play in the offending process.

Research Activity in British Clinical Psychology Training Staff: do we lead by example?

Sixty-two members of staff from clinical psychology doctoral training programmes across Britain completed a survey about their level of research output, the extent to which they felt this met their own expectations and job requirements, and how it influenced promotion prospects. In addition, they listed perceived barriers to and facilitators of research activity. There was wide variation in research activity, such that many participants had limited or no publications while a smaller proportion had many. Respondents were as, or more, dissatisfied than satisfied with their publications, submissions and grant applications and over half felt that the number of grant applications failed to meet their expectations. Support from and collaboration with colleagues was the main facilitator for research, while a lack of time was viewed as the main barrier.