Self-Criticism in the General Population: Development and Psychometric Properties of the Depressive Experiences Questionnaire Self-Criticism 4 (DEQ-SC4).

Self-criticism is a stable personality trait identified as a serious risk factor for psychopathology and weight-related health problems. Therefore, it is relevant to epidemiological research, which requires a relatively brief instrument for measuring trait self-criticism in the general population. The current study introduces a brief measure of self-criticism and presents empirical results that inform on its reliability and validity. Based on the six-item version of the Depressive Experiences Questionnaire Self-Criticism (DEQ-SC6), thorough psychometric analyses on a German representative sample (N = 2,516) were conducted and resulted in the final four-item scale: the Depressive Experiences Questionnaire Self-Criticism 4 (DEQ-SC4). Its internal consistency was good and a one-dimensional factor structure showed a good model fit. In terms of construct validity, the DEQ-SC4 was moderately linked to symptoms of depression and a non-linear association between the DEQ-SC4 and body mass index was observed, with the highest levels of self-criticism reported by underweight participants. In addition, the DEQ-SC4 showed high positive correlations with another short version of the DEQ-SC and the Big Five personality dimensions assessed in samples of university students (N = 206) and patients (N = 55), meeting theoretically-based expectations. The DEQ-SC4 therefore represents a brief screening measure of self-criticism in the general population with good psychometric properties.

Changes in General and Virus-Specific Anxiety During the Spread of COVID-19 in Israel: A 7-Wave Longitudinal Study.

We compared 3 hypothetical trajectories of change in both general and coronavirus disease 2019 (COVID-19)-specific anxiety during the first wave of the spread in the state of Israel: panic (very high anxiety, either from the outset or rapidly increasing), complacency (stable and low anxiety), and threat-sensitive (a moderate, linear increase compatible with the increase in threat). A representative sample of 1,018 Jewish-Israeli adults was recruited online. A baseline assessment commenced 2 days prior to the identification of the first case, followed by 6 weekly assessments. Latent mixture modeling analyses revealed the presence of 3 trajectories: 1) "threat-sensitivity" (29% and 66%, for general and virus-specific anxiety, respectively), 2) panic (12% and 25%), and 3) complacency (29% and 9%). For general anxiety only, a fourth class representing a stable mid-level anxiety was identified ("balanced": 30%). For general anxiety, women and the initially anxious-both generally and specifically from the spread of the virus-were more likely to belong to the panic class. Men and older participants were more likely to belong to the complacency class. Findings indicate a marked heterogeneity in anxiety responses to the first wave of the spread of COVID-19, including a large group evincing a "balanced" response.

Prenatal maternal sleep and trajectories of postpartum depression and anxiety symptoms.

Postpartum emotional distress is very common, with 10%-20% of postpartum women reporting depressive or anxiety disorders. Sleep is a modifiable risk factor for emotional distress that has a pivotal role in postpartum adjustment. The present study aimed to examine whether sleep duration and quality during pregnancy predict trajectories of emotional distress in the postpartum period. Participants were 215 women that were assessed from the third trimester of pregnancy to 18-months postpartum. At all five time points (third trimester, 3-, 6-, 12-, and 18-months postpartum), measures of sleep duration and quality (measured by wake time after sleep onset; WASO) were derived from both actiography and diary-based measures. Repeated measures of depression and anxiety symptoms were collected using self-report measures. Results indicated four bivariate postpartum depression and anxiety growth trajectories, including (a) high comorbidity (5.4%); (b) moderate comorbidity (19.4%); (c) low anxiety and decreasing depression symptomology (18.6%); and (d) low symptomology (56.6%). Multinomial logistic regression analyses showed that mothers with shorter sleep durations during pregnancy were more likely to belong to the high comorbidity or moderate symptoms classes compared to the low symptomology class. In addition, mothers with higher WASO (i.e. lower sleep quality) at 3-months postpartum were more likely to belong to the moderate class compared to the low symptomology class. Given the potential negative implications of disrupted sleep in the perinatal period, the present study may inform future intervention studies that target sleep problems during pregnancy.

Perceived social support, loneliness, and hope during the COVID-19 Pandemic: Testing a mediating model in the UK, USA, and Israel.

OBJECTIVES: The COVID-19 epidemic is affecting the entire world and hence provides an opportunity examine how people from different countries engage in hopeful thinking. The aim of this study was to examine the potentially facilitating role of perceived social support vis-à-vis hope as well as the mediating role of loneliness between perceived social support and hope. This mediating model was tested concurrently in the UK, the USA, and Israel. METHODS: In April 2020, as the first wave of the virus struck the three aforementioned countries, we assessed perceived social support, loneliness, and hope in 400 adults per country (N = 1,200). Assessments in the UK/USA were conducted via the Prolific platform, whereas in Israel they were conducted via Facebook/WhatsApp. RESULTS: In all three countries, perceived social support predicted elevated hope, although the effect was smallest in the UK. Loneliness mediated this effect in all three countries, although full mediation was attained only in the UK. CONCLUSIONS: Perceived social support may facilitate hope in dire times, possibly through the reduction of loneliness. PRACTITIONER POINTS: Findings are consistent with respect to the potentially protective role of perceived social support vis-à-vis hope. Perceived social support may increase hope through decreasing loneliness. In the UK, the above-noted mediating effect of loneliness appears to be stronger than in Israel and the USA. Elevated levels of perceived social support should serve as a desired outcome in individual and group psychotherapy, as well as in community based interventions.

Interdisciplinarity and Integration: An Introduction to the Special Issue on Psychopathology in Medical Settings.

As the world views, incredulously, the calamitous consequences of the COVID-19 pandemic, the inseparable connections between body and mind become more and more apparent, even for the heretics (i.e., biological determinists). Such realizations also bolster the understanding of the close link between medical conditions and psychopathology. Launched prior to the COVID-19 epidemic, this special issue sets out to illuminate the prevalence, course, etiology, and responses to a myriad of psychopathological conditions in medical conditions. The 13 articles in this special issue address a variety of medical conditions (chronic illness and chronic pain, Pica, cancer, acute delirium, factitious disorders, functional neurological symptoms, sleep disorders, fetal conditions), mental disorders (depression, anxiety, suicidality, eating disorders, personality disorders, PTSD), medical settings (primary care vs. specialty clinics), and developmental levels (children, adolescents, and adults). The overarching theme emanating from reading these articles is that clinical-health psychology, or clinical psychology in medical settings, is an ever-needed field of inquiry, epitomizing interdisciplinarity and science/practice integration.

Suicidality in Chronic Illness: An Overview of Cognitive-Affective and Interpersonal Factors.

Suicide rates are elevated in individuals with chronic illness, yet few studies have examined risk factors for suicide in this population. Drawing from theoretical models and risk factors identified in the suicide literature more broadly, this article provides a conceptual overview of cognitive (e.g., pain catastrophizing, self-criticism), affective (e.g., emotion dysregulation), interpersonal (e.g., perceived burdensomeness, thwarted belongingness, critical expressed emotion), and behavioral factors that may contribute, at least in part, to the link between chronic illness, and illness-specific factors, and suicidal thoughts and behaviors. We also outline several avenues for future research in this area and provide specific considerations and recommendations for the screening, assessment, and initial intervention of suicide risk within individuals with chronic health conditions.

The subjective-agentic personality sector (SAPS): Introduction to the special issue on self, identity, and psychopathology.

This special issue is predicated upon the premise that there exists a subjective-agentic personality sector (SAPS) that is crucially relevant to the understanding and treatment of psychopathology. SAPS is often overlooked by "trait" models in personality psychology. It is comprised of "hot" cognitions about one's self and identity as they unfold throughout the life span and are brought to bear on interpersonal relationships. There are four ways in which SAPS may be involved in psychopathology: (a) inherently, as a component of psychiatric disorders, (b) as a passive vulnerability dimension, namely by interacting with life stress, (c) as an active vulnerability dimension, that is, by propelling external situations that culminate in psychopathology, and (d) by constituting a central consequent of psychopathology (i.e., the scarring pattern, see below). In this Journal of Personality special issue, experts in personality and psychopathology demonstrate the centrality of SAPS in unipolar depression, anxiety disorders, bipolar spectrum disorder, eating disorders, posttraumatic stress disorder, complex trauma and borderline personality disorder, social anxiety disorder, suicidality in the context of mood disorders, and recovery from schizophrenia. A commentary by Dan McAdams, a leader in the study of self and identity, concludes this special issue.

Self-criticism, interpersonal conditions, and biosystemic inflammation in suicidal thoughts and behaviors within mood disorders: A bio-cognitive-interpersonal hypothesis.

We review the theoretical and empirical literature on the role of self-concept in suicidal behavior in the context of mood disorders (i.e., unipolar depression and bipolar spectrum disorders). The main themes emanating from this review are then juxtaposed against (a) the Interpersonal-Psychological Theory of Suicide and (b) biological research on the role of inflammatory processes in suicidality. Such a juxtaposition paves the way for a bio-cognitive-interpersonal hypothesis. Pathologies of the self-concept-primarily self-criticism-propel mood disorder sufferers to generate interpersonal stress that culminates in two proximal causes of suicidality: thwarted belongingness and perceived burdensomeness. In turn, these two interpersonal conditions set in motion systemic biosystemic inflammation, serving as a proximal cause for suicidality in mood disorders. We conclude by describing a research project aimed at testing this hypothesis, and by outlining pertinent implications for assessment, treatment, and prevention.

Supportive Relationships in Children and Adolescents Facing Political Violence and Mass Disasters.

PURPOSE OF REVIEW: We identify trends and gaps in the literature on the role of social support in the psychopathology and risky behavior of youths exposed to political violence and mass disasters. We also discuss the implications of recent research's findings and suggest directions for future research. RECENT FINDINGS: Political violence and natural disasters inflict serious blows to adolescents' mental and physical health and may have reverberating, negative impacts throughout the nested social systems in which youths develop. However, many adolescents are not adversely affected, suggesting the presence of resilience. While the beneficial effects of social support from close others are well documented, along with situations under which perceived support may even increase stress, the exact mechanisms behind social support's protective effects have not been thoroughly studied. Different personality attributes and/or different concepts of the self may possibly contribute to-or harm-youths' resilience. There is considerable variability in research on adolescents' social support in the context of political violence and mass disasters, stressors that may erode social support. Thus, further investigation of social support's protective effects via longitudinal studies is highly important.

Role of adolescent exposure to rockets in the links between personality vulnerability and psychopathology.

The aim of this study is to examine the role of repeated exposure to rocket attacks in the links between personality vulnerability (dependency and self-criticism) and internalizing/externalizing psychopathology. A main-effect vulnerability model (personality leads to psychopathology) was compared with a main-effect scarring model (psychopathology leads to personality vulnerability). Also, a stress-diathesis pattern (personality vulnerability is activated under stress) was compared to a dual-vulnerability pattern (either personality vulnerability or stress, but not both, lead to psychopathology). Israeli adolescents (N = 362) repeatedly exposed to rocket attacks were assessed annually over 3 years. In 2008 and 2010, personality and psychopathology were assessed. Cumulative exposure was measured as the sums of exposure across the three assessment waves. Theoretical models were tested via Autoregressive Cross-Lagged Structural Equation Modeling analyses. Baseline dependency and self-criticism were associated with an increase in anxiety, whereas baseline depression was associated with an increase in dependency. Under low, not high, levels of rocket exposure, self-criticism and depression were longitudinally associated. Violence commission was associated with an increase in dependency under high, not low, cumulative exposure. Results are consistent with both scarring and vulnerability models, and with both stress-diathesis and dual-vulnerability patterns of adolescent risk and resilience.

Depressive personality vulnerability in chronic physical pain: Centrality of sociotropy.

OBJECTIVE: Chronic physical pain is one of modern medicine's principal challenges. Recently, there has been a keen research interest in the role of depressive personality vulnerability (DPV) in the course of chronic pain. This is the first attempt to examine the role of three leading DPV dimensions-sociotropy, autonomy, and self-criticism-in chronic pain. METHOD: Chronic pain patients (N = 428) were assessed four times as to their pain, disability, anxious depression, and pain-based catastrophizing. At Time 1, sociotropy, autonomy, and self-criticism were also assessed. The effects of sociotropy, autonomy, and self-criticism on pain, disability, anxious depression, and pain-based catastrophizing were examined using structural equation modeling analyses. RESULTS: All DPV dimensions uniquely predicted Time 1, but not Time 2, anxious depression. Sociotropy predicted Time 1 pain and catastrophizing over and above anxious depression, as well as an increase in catastrophizing over time. Autonomy predicted a decrease in catastrophizing and disability, and Time 1 anxious depression predicted an increase in self-criticism. CONCLUSIONS: Sociotropy appears to be a unique dimension of DPV in chronic pain.

Immediate therapist self-disclosure bolsters the effect of brief integrative psychotherapy on psychiatric symptoms and the perceptions of therapists: A randomized clinical trial.

OBJECTIVE: We report a first randomized clinical trial examining the effect of immediate and non-immediate therapist self-disclosure in the context of a brief integrative psychotherapy for mild to moderate distress. METHOD: A total of 86 patients with mild to moderate forms of distress were randomly divided into three 12-session integrative psychotherapy conditions based primarily on [Hill, C. E. (2009). Helping skills: Facilitating, exploration, insight, and action (3rd ed.). Washington, DC: American Psychological Association.] three-stage model. Therapists trained in this treatment modality were instructed to use either immediate self-disclosure (expressing feelings towards the patient/treatment/therapeutic relationship) or non-immediate self-disclosure (expressing personal or factual information regarding the therapist's life outside the treatment). In the comparison condition, the therapists were instructed to refrain from self-disclosure altogether. RESULTS: Immediate therapist self-disclosure reduced psychiatric symptoms among patients with elevated pretreatment symptoms (as assessed by the Brief Symptoms Inventory) and bolstered a favorable perception of the therapist. Therapists in both the immediate and non-immediate self-disclosure group evaluated themselves more favorably than their counterparts in the non-disclosure group. CONCLUSIONS: Therapist self-disclosure, particularly of the immediate type, might enhance the effect of brief integrative treatment on psychiatric symptoms of high symptomatic patients and contribute to favorable perception of therapists.

Predictors and moderators of between-therapists and within-therapist differences in depressed outpatients' experiences of the Rogerian conditions.

The extent to which patients experience their therapists as providing empathy, positive regard and genuineness (the Rogerian Conditions) is an important predictor of outcome in the psychotherapy of depression (Zuroff & Blatt, 2006). Using data from 157 depressed outpatients treated by 27 therapists in the cognitive-behavior therapy, interpersonal therapy, or clinical management with placebo conditions of the Treatment of Depression Collaborative Research Program (Elkin et al., 1989), Zuroff, Kelly, Leybman, Blatt, and Wampold (2010) showed that between-therapists and within-therapist differences in Rogerian Conditions at the second treatment session predicted more rapid reductions in overall maladjustment. We conducted novel analyses intended to identify: 1) predictors of between-therapists and within-therapist differences in Rogerian Conditions and 2) moderators of the effects on maladjustment of between-therapists and within-therapist differences in Rogerian Conditions. Patients with lower levels of self-critical perfectionism, higher levels of an adaptive form of dependency or higher expectations of warmth from their therapists experienced higher levels of Rogerian Conditions than their therapist's average patient. High baseline self-critical perfectionism diminished the between-therapists effect of Rogerian Conditions on maladjustment, whereas baseline adaptive dependency enhanced the within-therapist effect of Rogerian Conditions. Results shed additional light on the centrality of patient characteristics, the Rogerian Conditions, and their transactions and interactions on outcome in brief outpatient therapy for depression.

Longitudinal associations between depression, anxiety, pain, and pain-related disability in chronic pain patients.

OBJECTIVE: The current study sets out to examine the longitudinal relationship between pain, pain-related disability, and symptoms of depression and anxiety. The latter symptoms are highly prevalent in chronic pain and seriously impede functioning and quality of life. Nevertheless, the direction of the relationship involving these variables among individuals with chronic pain is still unclear. METHODS: Four-hundred twenty-eight individuals with chronic pain (238 women, mean age 54.84 years, mean pain duration 85.21 months) treated at two pain clinics completed questionnaires regarding their pain (Short-Form McGill Pain Questionnaire), depression (Center for Epidemiological Studies-Depression Scale), state anxiety (State-Trait Anxiety Inventory), and pain-related disability (Pain Disability Index) at four time points, with an average of 5 months between measurements. Cross-lagged, structural equation modeling analyses were performed, enabling the examination of longitudinal associations between the variables. RESULTS: Significant symptoms of both depression and anxiety were reported by more than half of the sample on all waves. A latent depression/anxiety variable longitudinally predicted pain (ß = .27, p < .001) and pain-related disability (ß = .38, p < .001). However, neither pain (ß = .10, p = .126) nor pain-related disability (ß = -.01, p = .790) predicted depression/anxiety. CONCLUSIONS: Among adult patients with chronic pain treated at specialty pain clinics, high levels of depression and anxiety may worsen pain and pain-related disability.

Dissociative absorption: An empirically unique, clinically relevant, dissociative factor.

Research of dissociative absorption has raised two questions: (a) Is absorption a unique dissociative factor within a three-factor structure, or a part of one general dissociative factor? Even when three factors are found, the specificity of the absorption factor is questionable. (b) Is absorption implicated in psychopathology? Although commonly viewed as "non-clinical" dissociation, absorption was recently hypothesized to be specifically associated with obsessive-compulsive symptoms. To address these questions, we conducted exploratory and confirmatory factor analyses on 679 undergraduates. Analyses supported the three-factor model, and a "purified" absorption scale was extracted from the original inclusive absorption factor. The purified scale predicted several psychopathology scales. As hypothesized, absorption was a stronger predictor of obsessive-compulsive symptoms than of general psychopathology. In addition, absorption was the only dissociative scale that longitudinally predicted obsessive-compulsive symptoms. We conclude that absorption is a unique and clinically relevant dissociative tendency that is particularly meaningful to obsessive-compulsive symptoms.

Infant sleep development from 3 to 6 months postpartum: links with maternal sleep and paternal involvement.

The aims of this longitudinal study were to examine (a) development of infant sleep and maternal sleep from 3 to 6 months postpartum; (b) concomitant and prospective links between maternal sleep and infant sleep; and (c) triadic links between paternal involvement in infant caregiving and maternal and infant sleep. The study included 57 families that were recruited during pregnancy. Maternal and infant sleep was assessed using actigraphy and sleep diaries for 5 nights. Both fathers and mothers completed a questionnaire assessing the involvement of fathers relative to mothers in infant caregiving. The results demonstrated moderate improvement in infant and maternal sleep percent between 3 and 6 months. Maternal sleep percent at 3 months significantly predicted infant sleep percent at 6 months. Greater paternal involvement in infant daytime and nighttime caregiving at 3 months significantly predicted more consolidated maternal and infant sleep at 6 months. These findings suggest that maternal sleep is an important predictor of infant sleep and that increased involvement of fathers in infant caregiving responsibilities may contribute to improvements in both maternal and infant sleep during the first 6 months postpartum.

Clonality despite sex: the evolution of host-associated sexual neighborhoods in the pathogenic fungus Penicillium marneffei.

Molecular genetic approaches typically detect recombination in microbes regardless of assumed asexuality. However, genetic data have shown the AIDS-associated pathogen Penicillium marneffei to have extensive spatial genetic structure at local and regional scales, and although there has been some genetic evidence that a sexual cycle is possible, this haploid fungus is thought to be genetically, as well as morphologically, asexual in nature because of its highly clonal population structure. Here we use comparative genomics, experimental mixed-genotype infections, and population genetic data to elucidate the role of recombination in natural populations of P. marneffei. Genome wide comparisons reveal that all the genes required for meiosis are present in P. marneffei, mating type genes are arranged in a similar manner to that found in other heterothallic fungi, and there is evidence of a putatively meiosis-specific mutational process. Experiments suggest that recombination between isolates of compatible mating types may occur during mammal infection. Population genetic data from 34 isolates from bamboo rats in India, Thailand and Vietnam, and 273 isolates from humans in China, India, Thailand, and Vietnam show that recombination is most likely to occur across spatially and genetically limited distances in natural populations resulting in highly clonal population structure yet sexually reproducing populations. Predicted distributions of three different spatial genetic clusters within P. marneffei overlap with three different bamboo rat host distributions suggesting that recombination within hosts may act to maintain population barriers within P. marneffei.

Multiple emergences of genetically diverse amphibian-infecting chytrids include a globalized hypervirulent recombinant lineage.

Batrachochytrium dendrobatidis (Bd) is a globally ubiquitous fungal infection that has emerged to become a primary driver of amphibian biodiversity loss. Despite widespread effort to understand the emergence of this panzootic, the origins of the infection, its patterns of global spread, and principle mode of evolution remain largely unknown. Using comparative population genomics, we discovered three deeply diverged lineages of Bd associated with amphibians. Two of these lineages were found in multiple continents and are associated with known introductions by the amphibian trade. We found that isolates belonging to one clade, the global panzootic lineage (BdGPL) have emerged across at least five continents during the 20th century and are associated with the onset of epizootics in North America, Central America, the Caribbean, Australia, and Europe. The two newly identified divergent lineages, Cape lineage (BdCAPE) and Swiss lineage (BdCH), were found to differ in morphological traits when compared against one another and BdGPL, and we show that BdGPL is hypervirulent. BdGPL uniquely bears the hallmarks of genomic recombination, manifested as extensive intergenomic phylogenetic conflict and patchily distributed heterozygosity. We postulate that contact between previously genetically isolated allopatric populations of Bd may have allowed recombination to occur, resulting in the generation, spread, and invasion of the hypervirulent BdGPL leading to contemporary disease-driven losses in amphibian biodiversity.

Moderators of the effect of peer victimization during fifth grade on subsequent symptoms of (anxious) depression: the roles of engagement in bullying and baseline symptomatology.

Two hypothesized moderators of the effect of peer victimization during fifth grade on subsequent symptoms of (anxious) depression in sixth grade were examined: engagement in bullying and baseline fifth grade symptoms of (anxious) depression. Analyses were conducted on longitudinal data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Interview data from 1,081 fifth grade participants assessed peer victimization and engagement in bullying classmates during the school year. Self-reported symptoms of depression were measured in fifth and sixth grade with the Child Depression Inventory Short form. Additionally, maternal reports of child anxious depression were measured with the Child Behavior Checklist. Engagement in bullying and concurrent depression symptoms moderated the effect of peer victimization in fifth grade on child-reported symptoms of depression in sixth grade. The adverse effect of peer victimization was stronger for children with high levels of concurrent depression symptoms or engagement in bullying. Concurrent symptomatology also moderated the effects of peer victimization on mother-reported child anxious depression 1 year later.