The relationship between attachment, primary emotions and positive/negative spirituality: a path analysis.

Objective: The present study investigates what may influence individuals to experience their religiosity/spirituality as either subjectively positive [religious or spiritual (r/s) wellbeing] or as negative (r/s struggles). Drawing on existing literature attachment insecurity and the seven primary emotions as outlined by Jaak Panksepp in Affective Neuroscience are identified as likely influences. Methods: The final sample consisted of 340 participants (age: M = 36, SD = 14.2; 68.5% = female), among which 65% self-identified as religious/spiritual. A path analysis was conducted to test a proposed mediation model in which the expected effects of primary emotions (B-ANPS) on r/s wellbeing (MI-RSWB) and r/s struggles (RSSS) were mediated through attachment insecurity (ECR-RD8). Results: The data indicated that attachment insecurity fully mediated the relationships between the primary emotions SADNESS and LUST with r/s struggles. Furthermore, the primary emotions FEAR and ANGER displayed small direct effects on both r/s struggles and r/s wellbeing. Overall, the model, which demonstrated excellent model fit, was able to explain 30% of the variance of r/s struggles, 24% of attachment insecurity and 5% of r/s wellbeing. Conclusions: The findings suggest that primary emotions such as SADNESS and LUST substantially explain r/s struggles and that these relationships seem to be mediated through attachment. Moreover, r/s struggles seem to be qualitatively distinct from r/s wellbeing. Finally, a moderate link between LUST and attachment suggests that sexuality plays a significant role in (adult) attachment processes.

Influence of anxious attachment on the relationship between primary emotions and substance-related addictive behaviors.

Objectives: To date there is no universally accepted model that describes the development of substance related addictive behavior. In order to address this gap, the study sought to examine whether the association between primary emotions and the inclination toward addictive behavior is mediated by an anxious attachment style. Methods: The total sample consisted of 900 German speaking non-clinical adults (age: M = 27; SD = 9.60; 71.6% female). Structural Equation Modeling (SEM) was applied to examine the connection between the primary emotions (SADNESS and ANGER), and the latent variables attachment anxiety and symptoms of addictive behavior. Results: Substance use symptomatology was correlated with higher attachment anxiety (r = 0.15), SADNESS (r = 0.15), and ANGER (r = 0.11). The effect of SADNESS on addictive behavior is mediated by attachment anxiety (p < 0.01) whereas ANGER had a direct effect on addictive behavior (p < 0.01). The final SEM explains 4% of the variance of addictive behaviors and 22% of attachment anxiety. Conclusion: Our findings suggest that both SADNESS and ANGER, along with attachment anxiety, are dispositions that contribute to the risk of engaging in addictive behavior. However, while ANGER directly influences addictive behavior, SADNESS acts through its impact on attachment anxiety.

Does adult attachment mediate the relationship between primary emotion traits and eating disorder symptoms?

Objectives: Primary emotion traits and attachment patterns, have been linked to various mental disorders. This study aims to shed more light on the less studied relationship with eating disorder (ED) symptoms. Methods: A total of 921 non-clinical subjects (69.9% females) were assessed for primary emotions traits (B-ANPS-GL), attachment insecurity (ECR-RD8), and eating disorder pathology (EDE-Q8). A theoretically derived model was evaluated by means of a path analysis with attachment anxiety as assumed mediator variable. Results: Global problematic eating behavior showed negative correlations with the positive emotions PLAY, CARE, and LUST (r = -0.10 to -0.24), positive correlations with the negative primary emotions ANGER, FEAR, and SADNESS (r = 0.12-0.27), as well as with attachment anxiety (r = 0.22, all p < 0.01). Path analyses revealed direct effects between eating behavior pathology with LUST (ß = -0.07 to -0.15) and FEAR (ß = 0.12-0.19; all p < 0.05). The association of SADNESS and Weight (ß = 0.05) and Shape Concern (ß = 0.06, p < 0.001) was fully mediated by attachment anxiety. Overall, the path model explained 17% of the variance for attachment anxiety and 6% of the Restraint, 13% for Eating, 10% for Weight and 14% for Shape Concern Subscales. Discussion: The findings shed light on the multifactorial relationship between affective traits, attachment security, and eating disorder pathology. In line with previous research, the results emphasize the role of attachment and affective functioning in ED symptoms.

Is there an affective neuroscience of spirituality? The development and validation of the OCEANic feelings scale.

Background: Oceanic feelings represent a phenomenological structure of affective sensations that characteristically involve feelings of self-dissolution and feelings of unity and transcendence. This study presents the preliminary version of a self-report instrument to measure individual dispositions toward oceanic feelings in order to enable further research within the concept of primary emotions postulated by Jaak Panksepp. Methods: A first version of the questionnaire was applied to a total sample of 926 German-speaking adults of the general population. After performing item analysis and principal component analysis (PCA) in a first study (N = 300), the questionnaire was shortened. In a second study (N = 626), confirmatory factor analysis (CFA) was conducted and emerged scales were related to the already established instruments for the assessment of primary emotions (BANPS-GL) and Big Five personality traits (BFI-44). Results: The OCEANic scale exhibited reliabilities ranging from Cronbach's α = 0.82 (positive) to α = 0.88 (negative) and plausible correlations with behavioral traits related to the seven affective neurobiological systems (ANGER, FEAR, CARE, SEEK, PLAY, SADNESS, and LUST) as well as with personality factors measured by the Big Five Inventory. For CFA, a bifactorial model with an overall factor demonstrated good fit: RMSEA = 0.00 (90% CI:0.00, 0.03); TLI = 1.00; CFI = 1.00; NFI = 0.99. Discussion: The OCEANic scale enables the operationalization of oceanic feelings comprising two subscales and one total scale. The results indicate good reliability and acceptable factorial validity. Establishment and further validation of the OCEANic scale within future research will be needed to fully understand the role of oceanic feelings within the human affective life, especially the personality trait of spirituality.

Anxious and depressive symptoms mediate the influence of sleep quality on suicidality in young adults.

This study investigated how sleep quality affects the global severity of psychiatric symptoms, including suicidality, in young adults. Poor sleep quality has a significant impact on mental health and should therefore be given special attention in suicidal treatment. 1,214 participants (914 females; age: M = 25.81, SD = 6.35) completed the Brief Symptom Inventory (BSI-18), the Scale for Suicidal Experience and Behavior (SSEV), and the Pittsburgh Sleep Quality Index (PSQI) via an online survey. Correlation statistics and path analysis were conducted for data evaluation. Thereby, anxiety and depression but not somatization mediated the relationship between sleep quality and suicidality. Our findings confirm the putative link between diminished sleep quality and increased suicidality and may lead to an early detection of suicidal behavior.

Originalbeiträge (Originals). Primäremotionen und Bindung bei psychischer Störung.

Primaryemotions and attachment in mental disorder Objectives: There is increasing evidence for associations between primary emotions and attachment with mental illness. This study illuminates the mediation relationship of these psychodynamic constructs in relation to psychiatric disorders. METHODS: 921 subjects (69.9 % female) were examined, who completed the questionnaires Brief Affective Neuroscience Personality Scales including a LUST Scale, Experiences in Close Relationships - Revised 8, and ICD-10 Symptom Rating online. A path analysis was conducted to evaluate the mediation effects of attachment anxiety. RESULTS: A disease-specific pattern of direct associations between primary emotions, attachment anxiety, and psychological impairment emerged (all p < .01). Attachment exerted mediating effects primarily for SADNESS (p < .01), and to a lesser extent for LUST and CARE (p > .01).The model provided variance resolution ranging from7%(eating disorders) to 47%(depression). CONCLUSION: The results demonstrate the relevance of affective explanations regarding the development of psychological symptoms, as well as therapeutic implications.

The Influence of Vitamin D Status on Cognitive Ability in Patients with Bipolar Disorder and Healthy Controls.

Recent evidence on the association between vitamin D and cognition in mentally healthy individuals is inconsistent. Furthermore, the link between vitamin D and cognitive ability in individuals with bipolar disorder has not been studied yet. Thus, we aimed to investigate the association between 25-hydroxyvitamin D (25(OH)D), 24,25 dihydroxyvitamin D (24,25(OH)2D, the vitamin D metabolite ratio (VMR) and cognition in a cohort of euthymic patients with bipolar disorder. Vitamin D metabolites were measured simultaneously by liquid-chromatography tandem mass-spectrometry in serum samples from 86 outpatients with bipolar disorder and 93 healthy controls. Neither the inactive precursor 25(OH)D, nor the primary vitamin D catabolite 24,25(OH)2D, or the vitamin D metabolite ratio were significantly associated with the domains "attention", "memory", or "executive function" in individuals with bipolar disorder and healthy controls. Further, no vitamin D deficiency effect or interaction group × vitamin D deficiency was found in the cognitive domain scores. In summary, the present study does not support vitamin D metabolism as a modulating factor of cognitive function in euthymic BD patients. Considering the current study's cross-sectional design, future research should expand these results in a longitudinal setting and include additional aspects of mental health, such as manic or depressive symptoms, long-term illness course and psychopharmacological treatment.

On the trail of Sisyphus - addiction as an existential neurosis?

In Greek mythology, Sisyphus, king of the Corinthians, dared to deceive the gods and was condemned to roll a boulder to the top of a mountain for all eternity. Shortly before reaching the summit, however, the boulder rolled back down into the valley, and the arduous task had to begin anew. Many of the contents of this classic myth are reminiscent of the therapeutic approach to addictive disorders. In addiction therapy, too, it is often a long and rocky road that ends with a relapse. The therapeutic effort was not entirely in vain, but one often begins to doubt its usefulness. In terms of Sisyphus and a Bio-Psycho-Social Model (BPSM) of health and disease, addiction can be located at the end of a downward spiral. By extension of the BPSM, can addictive disease be considered an expression of existential neurosis? The results of our own research speak in favor of this and show a clearly reduced experience of sense and meaning, but also diminished feelings of hope and forgiveness in addiction patients. However, positive correlations between various parameters of existential well-being and mental health or more appropriate stress coping are also found for the addiction group. These results are supported by neuronal correlates and are mirrored in the general population. Based on this, the consideration of existential issues in addiction therapy can be discussed. Finally, the use of art therapy and work training are proposed as examples of a meaning based therapeutic intervention in dealing with people with addictive diseases.

Psychophysiological stress response after a 6-week Mindful Self-Compassion training in psychiatric rehabilitation inpatients: a randomized post-test only study.

Objectives: Mindfulness-based interventions (including self-compassion interventions) are effective in improving stress management at psychological and physical levels. Mindful Self-Compassion (MSC) is a newly developed program particularly aimed at increasing self-compassion. The main objective of this study was to determine whether the psychophysiological stress response during a social-evaluative speaking task differs in inpatients participating in the MSC or the Progressive Muscle Relaxation (PMR) program at the end of their 6-week psychiatric rehabilitation stay (i.e., post-test only design). Method: Data from 50 inpatients (25 MSC, 25 PMR, 35 female) aged 19 to 76 years (M = 47.22, SD = 12.44) were analyzed in terms of psychophysiological stress response. For this purpose, heart rate variability, heart rate, and blood pressure were assessed together with several psychometric variables: positive and negative affect (PANAS), subjective stress perception (Visual Analog Scale), self-compassion (Self-Compassion Scale), cognitive reappraisal and suppression (Emotion Regulation Questionnaire), psychological distress (Brief Symptom Inventory-18), and appraisal and rumination (selected items). Results: After correction for alpha inflation no differences in the psychophysiological stress response and psychometric parameters between the MSC and PMR group were found. Discussion: In general, our results indicate that MSC is not superior to PMR training. However, more research with clinical randomized controlled trials investigating larger samples are needed to further affirm these initial findings.

The German version of the brief affective neuroscience personality scales including a LUST scale (BANPS-GL).

Objectives: This study presents the German version of the Brief Affective Neuroscience Personality Scales (BANPS), which includes an additional subscale for the dimension LUST. The BANPS represents a shortened version of the Affective Neuroscience Personality Scales (ANPS), a self-report instrument to assess individual dispositions toward primary emotional systems as proposed by Jaak Panksepp. Methods: In a large sample (N = 926), the reliability and various facets of validity of the German translation of the BANPS were examined together with the newly included LUST scale. The BANPS-GL was related to the Big Five Inventory (BFI) and Sexual Sensation Seeking Scale (SSSS) and analyzed via confirmatory factor analysis (CFA). Results: Overall, the BANPS-GL exhibited reliabilities ranging from McDonald's ω = 0.70 (CARE) to α = 0.86 (SADNESS) and plausible correlations with external criteria. For CFA a correlated 7-factor model demonstrated good fit [TLI = 0.95; RMSEA = 0.04 (90% CI: 0.04, 0.05); SRMR = 0.06]. A similar fit was demonstrated for a 2-higher-factor model [TLI = 0.93; RMSEA = 0.05 (90% CI: 0.05, 0.06); SRMR = 0.07]. Conclusion: In broad agreement with the results of the original English version, the BANPS-GL showed good reliability and acceptable factorial validity, and overall improved the psychometric properties of the original long form. Finally, the inclusion of the dimension LUST allows for a complete coverage of the primary emotion dispositions as originally conceptualized by Panksepp.

Effects of Metabolic Syndrome and Sex on Stress Coping Strategies in Individuals with Depressive Disorder.

Metabolic syndrome (MetS) is related to depression and contributes to reduced life expectancy in individuals with mental disorders. Stress coping strategies are important factors in the development and maintenance of depressive disorders and have been related to metabolic disturbances. The aim of this study was to determine whether there is a difference in the use of positive (re- and devaluation, distraction, and control) and negative stress coping strategies in relation to patients' MetS. A sample of 363 individuals (n female = 204, n male = 159) with a diagnosis of depression was measured with the Stress Coping Style Questionnaire and the Beck Depression Inventory. In addition, we collected data on MetS (waist circumference, triglycerides, high-density lipoprotein, fasting glucose/diabetes, blood pressure/hypertonia) according to the International Diabetes Federation. A 2 × 2 design including Mets (with vs. without) and sex (female vs. male) was performed to test for differences in stress coping strategies. Individuals with depression and MetS scored higher on distraction strategies than depressed individuals without MetS (p < 0.01, corrected with false discovery rate). In addition, we found sex differences in stress coping strategies indicating that women with depression scored higher on distraction strategies (p < 0.001, FDR corrected), as well as negative strategies (p < 0.001, FDR corrected), than men. No significant interaction between MetS and sex was found regarding the higher value of stress coping strategies. Findings suggest that individuals with depression and MetS used distraction strategies to a higher amount to cope with stress, which could be stress eating in some cases, than those without MetS. Women with depressive disorders had higher values than men on other coping strategies in our sample of individuals with depression. A better understanding of MetS and sex-specific differences in stress coping strategies might help to plan more effective preventive strategies and personalized treatment options for depression.

Effect of Yoga involvement on mental health in times of crisis: A cross-sectional study.

Background: Yoga involvement can be understood as a degree of immersion in the philosophical/spiritual teachings of Yoga. Previous research has shown a positive association between Yoga involvement and mental health. This study further investigates the effect of Yoga involvement on several parameters of psychological well-being and distress amidst a global crisis precipitated by the COVID-19 pandemic. Methods: A total sample of 246 participants (216 females; 118 Yoga versus 128 age-matched Pilates practitioners) were included in the study. Via an online-survey the following questionnaires were completed: the WHO-Five Well-Being Index, the Multidimensional Inventory for Religious/Spiritual Well-Being short version, the Leipzig Short Scale of Sense of Coherence, the Brief Symptom Inventory and the Yoga Immersion Scale which was adapted for the control group to Pilates Immersion Scale. Results: When controlling for occupation and psychiatric disorder, involvement in general was higher for Yoga practitioners than for Pilates controls. Furthermore, Yoga practice was associated with increased religious/spiritual well-being and decreased sense of coherence, but neither with psychological well-being nor with psychological distress. Involvement, in general, positively predicted psychological well-being, religious/spiritual well-being and sense of coherence, but there was no connection with psychological distress. Lastly, involvement mediated the positive relationship between Yoga practice and religious/spiritual well-being and suppressed the negative effect of Yoga practice on sense of coherence. Conclusion: Our findings suggest that involvement in a certain relaxation practice has a positive impact and might be a key component in understanding Yoga's influence on mental health. Further randomized controlled research, including clinical groups, is necessary to explain how involvement changes and how it effects well-being more specifically.

The Swedish version of the multidimensional inventory for religious/spiritual well-being - Part II: Development of a four-field typology.

Background: In the field of mental health, religiosity and spirituality have gained particular attention in recent decades. However, only a few studies to date have investigated the effects of different types of religiosity and spirituality. In association with the recent introduction of a Swedish version of the multidimensional inventory of religious/spiritual well-being (MI-RSWB-S), the present study aimed to identify possible types of Religious/Spiritual Well-Being by using cluster analyses and to examine the extracted groups for differences in the sense of coherence (SOC), the Big Five personality factors, and central aspects of religiosity. Additionally, the study design was intended to further contribute to the validation of the MI-RSWB-S. Methods: Based on a convenience sample of Swedish students (N = 1,011), initially obtained for the development of the MI-RSWB-S, the study included the MI-RSWB-S, the 13-items sense of coherence scale, the 10-item personality inventory, and the centrality of religiosity scale. For the statistical analysis, cluster analyses and one-way analyses of variance (ANOVAs) were conducted. Results: The cluster analyses yielded the following four groups: Religiosity and spirituality high (n = 124), religiously oriented (n = 200), spiritually oriented (n = 149), and religiosity and spirituality low (n = 538). The groups differed in most aspects of well-being, in the personality dimensions agreeableness and openness to experience, as well as in central aspects of religiosity. In contrast, no differences were found for SOC, extraversion, conscientiousness, and emotional instability. Conclusion: Our results suggest that different types of religious/spiritual well-being are associated with mental health and personality dimensions in substantially different ways, thus offering an interesting potential for future research.

Eating Habits and Eating Disorder Associated Behavior in Bipolar Disorder.

ABSTRACT: A relevant comorbidity of bipolar disorder (BD) is eating disorders (EDs). Crossed vulnerability factors as eating disorder-specific symptoms (EDSSs) may trigger the onset of both disorders in either direction. The Structured Inventory for Anorexic and Bulimic Eating Disorders for Self-Report was used to examine the occurrence of EDs in euthymic/subsyndromal individuals with BD ( n = 86) and healthy controls ( n = 86) matched for age and sex. Furthermore, we explored EDSSs with the subscales "general psychopathology and social integration," "bulimic symptoms," "body image and slimness ideal," "sexuality and body weight," "counteract," and "atypical binge." Higher rates of all EDSSs were reported in BD. Younger individuals with BD showed higher expression in "bulimic symptoms," "body image and slimness ideal," and "atypical binge" subscales. No participants fulfilled ED diagnosis. The findings show a link between EDSS and BD. Clinicians should pay attention to a multimodal intervention, considering risk factors, investigating eating habits and ED associated behaviors.

The relationship between religious/spiritual well-being, psychiatric symptoms and addictive behaviors among young adults during the COVID-19-pandemic.

Background: It is becoming increasingly apparent that the COVID-19 pandemic not only poses risks to physical health, but that it also might lead to a global mental health crisis, making the exploration of protective factors for mental well-being highly relevant. The present study seeks to investigate religious/spiritual well-being (RSWB) as a potential protective factor with regard to psychiatric symptom burden and addictive behavior. Materials and Methods: The data was collected by conducting an online survey in the interim period between two national lockdowns with young adults (N = 306; age: 18-35) in Austria. The primary study variables were assessed through the Brief Symptom Inventory 18 (BSI-18; psychiatric symptom load), the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST; addictive behavior/addiction risk) and the Multidimensional Inventory for Religious/Spiritual Well-Being short version (MI-RSWB 12), with its sub-dimensions Hope (HO), Forgiveness (FO), General Religiosity (GR), and Connectedness (CO). Results: We observed HO and FO as substantial negative predictors of psychiatric symptom burden. With regard to addictive behavior, HO in particular but also GR seem to have a protective function. Furthermore, we found positive connections between CO, psychiatric symptom burden, and addictive behavior. Conclusion: In line with our assumptions, HO, FO and to a minor extent GR were confirmed as negative predictors regarding psychiatric symptom burden or addictive behavior in young adults, coping with the psychological threat of COVID-19 pandemic. These dimensions might be further considered as potential resources in clinical treatment. However, the positive prediction of mental illness parameters by increased feelings of CO could also be interpreted as an expression of exhaustion and alienation from the real world.

Effects of metabolic syndrome and obesity on suicidality in individuals with bipolar disorder.

BACKGROUND: The prevalence of metabolic syndrome and overweight/obesity is increased in bipolar disorder (BD) compared to the general population and is related to suicidality. The aim of this study was to examine the association between both the rate of suicidal ideation and suicide attempts and metabolic variables in individuals with BD. METHODS: Anthropometric measures, socio-demographic data, suicide history and serum lipid levels were measured in 215 individuals with BD. Individuals were divided into normal weight, overweight and obese according to their body mass index (BMI), and metabolic syndrome was assessed using "The International Diabetes Federation"-criteria. RESULTS: Of the 215 individuals studied, 80.9% reported suicidal ideation, 35.3% reported at least one suicide attempt and 30.7% were diagnosed with metabolic syndrome. Both metabolic syndrome and BMI were not related to suicide attempts. However, individuals with normal weight had more suicidal ideation than overweight individuals, while obese individuals did not differ from either group. Furthermore, there was no association between suicide attempts or suicidal ideation and serum lipid levels. LIMITATIONS: The cross-sectional design of the study, a non-standardized questionnaire for suicidality, and not controlling the medication intake are limiting factors. CONCLUSION: Contrary to expectations, a difference was found in the BMI categories and suicidal ideation, but not suicide attempts. Serum lipid levels were found to be unsuitable as possible biomarkers for suicidality in individuals with BD. Special attention should be paid to suicidal ideation and BMI rather than metabolic syndrome or lipid values when treating suicidal individuals with BD.

The Affective Neuroscience of Sexuality: Development of a LUST Scale.

Background: In recent years, there have been many studies using the Affective Neuroscience Personality Scales (ANPS) to investigate individual differences in primary emotion traits. However, in contrast to other primary emotion traits proposed by Jaak Panksepp and colleagues, there is a considerable lack of research on the LUST (L) dimension - defined as an individual's capacity to attain sexual desire and satisfaction - a circumstance mainly caused by its exclusion from the ANPS. Therefore, this study aims to take a first step toward the development of a standardized self-rate measurement for the L-disposition. For this purpose, two versions of the L-scales (L-12 and L-5) were developed and evaluated regarding reliability and aspects of validity. Materials and Methods: After a pilot study (N = 204; female: 81%) with an initial 20-item pool item reductions were conducted. This led to the construction of a 12-item (L-12) version and a 5-item version (L-5), which were assessed in a second sample consisting of 371 German-speaking healthy adults (58.50% female) aged 18-69 years (M = 28; SD = 9.75). Aspects of external validity were assessed by investigation of correlations with the ANPS, psychiatric symptoms (Brief Symptom Inventory-18), attachment security (Adult Attachment Scales) and personality functioning (Operationalized Psychodynamic Diagnostics Structure Questionnaire). To evaluate structural validity, both L-scales were investigated via confirmatory factor analysis (CFA). Results: Cronbach's α indicated excellent internal consistency regarding L-12 (α = 0.90), while L-5 showed acceptable reliability (α = 0.82). CFA of a bifactor model of the L-12 indicated excellent model fit. Moreover, an excellent model fit was observed regarding a single factor model of L-5. For both scales small to moderate positive correlations were observed with SEEKING, PLAY, and secure attachment, while they exhibited small to moderate negative correlations with SADNESS, insecure attachment, lower personality functioning, and increased psychiatric symptom load. Conclusion: Both newly developed scales exhibit satisfying psychometric properties, indicating high reliability, good structural validity and plausible correlations with external criteria. Hence, this study poses an important step toward the operationalization of the LUST concept. However, more research is needed in particular with respect to the scale's external validity and its applicability in clinical populations.

[Questionnaire for Assessment of Mental Pain after Traumatic Events (FESSTE-30): Preliminary Standard Values and Factorial Structure]. / Erste Vergleichswerte und faktorielle Struktur des Fragebogens zur Erfassung von seelischem Schmerz nach traumatischen Ereignissen (FESSTE-30).

BACKGROUND: The questionnaire for the assessment of mental pain after traumatic experiences (FESSTE-30) is the first instrument in the German language which can be used for the standardized operationalization of mental pain in research and expert review process. The primary aim of the present study was to present quality criteria of the questionnaire and its preliminary gender-specific comparative values for the German-speaking general population. METHODS: The FESSTE-30 consists of five subscales ("Depression", "Somatization", "Dissociation", "Intrusive Memories" and "Fear"), and the total scale "Mental Pain". In addition, the attached trauma checklist enables a structured assessment of the extent of traumatic experiences. The questionnaire was investigated regarding reliability and validity based on a convenience sample of the German-speaking general population (n=1448; 86.2% female). RESULTS: The reliabilities of the subscales and the total scale ranged between Cronbach's alpha=0.81-0.94. The internal consistency of the scale "extent of traumatic experiences" showed a Cronbach's alpha=0.65. Regarding confirmatory factor analysis, a latent bifactor structure with a general factor and five residual factors showed the following model fit: RMSEA=0.05 (90% CI: 0.05, 0.06); TLI=0.93; CFI=0.94; NFI=0.92; χ²/df=4.94. DISCUSSION: The results indicate that FESSTE-30 is a reliable and valid self-assessment method for assessment of mental pain, suitable for application in research, treatment and expert review processes. The preliminary standard values can be used as a guideline for the evaluation of individual cases. Further investigations with clinical samples are planned.

Attachment and Therapeutic Alliance in Substance Use Disorders: Initial Findings for Treatment in the Therapeutic Community.

Background: There is convincing evidence that individuals suffering from Substance Use Disorder (SUD) often present insecure attachment patterns. In contrast, a strong therapeutic alliance in treatment of SUD has been found to lead to a more positive treatment outcome. However, insecure attachment has been observed to be linked with weaker therapeutic alliance strength. The primary aim of this explorative study was to gain initial insights regarding the influence of attachment and personality characteristics on therapeutic alliance and therapy motivation in SUD patients undergoing treatment at a therapeutic community. Furthermore, SUD patients were compared to healthy controls regarding attachment, personality and mood pathology. Methods: A total sample of 68 participants, 34 inpatients in SUD treatment and 34 age-gender and education adjusted controls, were investigated. Both groups filled in the Adult Attachment Scale (AAS), the Inventory of Personality Organization (IPO-16), and the Brief Symptom Inventory (BSI-18) questionnaires. Additionally, SUD patients filled in the Working Alliance Inventory (WAI-SR) and the adapted German version of the University of Rhode Island Change Assessment scale (FEVER). Results: In line with our assumptions, SUD patients exhibited a decreased amount of attachment security (AAS) which was related to higher personality (IPO-16) and mood pathology (BSI-18). Furthermore, correlational analysis revealed the WAI-SR dimension Bond being positively associated with more secure attachment. A strong task alliance was linked to the Action stage of change (FEVER) and decreased mood but not personality pathology. Conclusion: Our findings confirm the putative negative effect of attachment and personality pathology on therapy motivation and therapeutic alliance in addiction therapy as well as more specifically in therapeutic community treatment. Future research in enhanced samples might focus more on the long-term effects of the interaction of attachment, personality and therapeutic alliance variables.