The association between OCD and Shame: A systematic review and meta-analysis.

BACKGROUND: Due to rumination and self-criticism over unwanted obsessions and repetitive rituals, shame is a common emotion experienced by individuals with obsessive-compulsive disorder (OCD). Shame is also theorized to have relevance to unacceptable thoughts in OCD. However, empirical research looking at the relationship between OCD and shame is still emerging and findings have been mixed. OBJECTIVES: Our review systematically examines the association of shame with OCD and unacceptable thoughts. METHODS: The last updated search was conducted across five databases between 27 and 29 February 2022. The final selection included 20 papers, 18 of which were used in the primary meta-analysis to calculate pooled effect sizes between OCD and shame measures using a random effects model. In a separate analysis, three papers were used to calculate pooled effect sizes between shame and OCD symptom dimensions also using a random effects model. RESULTS: The meta-analyses identified a significant, moderate and positive correlation between total OCD and shame scores r = .352, 95% CI [0.260, 0.438]. In addition, significant, weak and positive relationships were found between shame and three OCD symptom dimensions: unacceptable thoughts r = .252, 95% CI [-0.467, 0.9708], harm obsessions r = .224, CI [-0.190, 0.638] and symmetry concerns r = .200, CI [-0.108, 0.509]. LIMITATIONS: Shame measures in the reviewed studies were not specific to OCD, and between-study variance in the analyses examining unacceptable thoughts was significant. CONCLUSIONS: Our findings support a medium positive relationship between shame and OCD. As shame in OCD can be a barrier to seeking treatment and impair quality of life, it is imperative to address this emotion through psychoeducation, assessment and treatment.

Digital Interventions for Psychological Well-being in University Students: Systematic Review and Meta-analysis.

BACKGROUND: Life at university provides important opportunities for personal growth; however, this developmental phase also coincides with the peak period of risk for the onset of mental health disorders. In addition, specific university lifestyle factors, including impaired sleep and academic and financial stress, are known to exacerbate psychological distress in students. As a result, university students have been identified as a vulnerable population who often experience significant barriers to accessing psychological treatment. Digital psychological interventions are emerging as a promising solution for this population, but their effectiveness remains unclear. OBJECTIVE: This systematic review and meta-analysis aimed to assess digital interventions targeting psychological well-being among university students. METHODS: Database searches were conducted on December 2, 2021, via Embase, MEDLINE, PsycINFO, and Web of Science. RESULTS: A total of 13 eligible studies were identified, 10 (77%) of which were included in the meta-analysis. Mean pre-post effect sizes indicated that such interventions led to small and significant improvement in psychological well-being (Hedges g=0.32, 95% CI 0.23-0.4; P<.001). These effects remained, albeit smaller, when studies that included a wait-list control group were excluded (Hedges g=0.22, 95% CI 0.08-0.35; P=.002). An analysis of acceptance and commitment therapy approaches revealed small and significant effects (k=6; Hedges g=0.35, 95% CI 0.25-0.45; P<.001). CONCLUSIONS: Digital psychological interventions hold considerable promise for university students, although features that optimize service delivery and outcomes require further assessment. TRIAL REGISTRATION: PROSPERO CRD42020196654; https:/www.crd.york.ac.uk/prospero/display_record.php?RecordID=196654.

The information-motivation-behavioral skills model explains physical activity levels for adults with type 2 diabetes across all weight classes.

Physical activity is an evidence-based, effective treatment for type 2 diabetes mellitus (T2D), yet insufficient numbers of adults achieve recommended daily levels, particularly amongst higher weight classes. This cross-sectional study assessed whether the Information-Motivation-Behavioural Skills (IMB) Model explained physical activity levels in adults with T2D across different body mass index (BMI) levels (N = 381). Measures included the American Adults Knowledge of Exercise Recommendations (AAKER), Behavioural Regulation in Exercise Questionnaire (BREQ-2), Barriers Specific Self-Efficacy Scale (BARSE) and the outcome measure, International Physical Activity Questionnaire (IPAQ-short form). Analyses included structural equation modelling (SEM) and ordinal logistic regression models. SEM demonstrated a good fit of the IMB Model to the data, accounting for 44% of variance in physical activity levels. Both motivation and self-efficacy had a direct effect, and motivation indirectly predicted physical activity through self-efficacy. Further analyses found the effect of the IMB predictors did not vary according to BMI status. This study supports the application of the IMB Model in explaining physical activity behavior in adults with T2D. In particular, the contribution of motivation and self-efficacy as substantive and modifiable predictors of physical activity will facilitate the development of targeted and evidence-based interventions for individuals of all BMI classes.

Preliminary evaluation of a brief mindfulness-based stress reduction intervention for mental health professionals.

OBJECTIVES: Mental health professionals are particularly susceptible to occupational stress; however, there are limited formal programmes to address the problem. This paper discusses the preliminary results of a brief mindfulness-based stress reduction (MBSR) programme for practising professionals in a public hospital mental health unit. METHOD: A mixed-group of nine mental health professionals participated in eight weeks of daily 15-minute MBSR training interspersed with three 30-minute education sessions developed by the authors (AD and AT). Levels of psychological distress and mindfulness skill were measured before and immediately after participation. RESULTS: Following the brief MBSR programme, quantitative and qualitative participant feedback revealed a perceived reduction in psychological distress. CONCLUSIONS: A brief MBSR programme can be incorporated into the full-time workloads of practicing mental health professionals, potentially addressing a significant unmet workplace need.

Mechanisms of Change in the Relationship between Self-Compassion, Emotion Regulation, and Mental Health: A Systematic Review.

BACKGROUND: Research suggests that self-compassion may improve mental health by promoting emotion regulation (Berking & Whitley, ). This review aimed to identify studies which investigated the relationship between self-compassion, emotion regulation, and mental health in order to examine the role of emotional regulation as a mechanism of change. METHODS: Searches were conducted in PsycINFO, CINAHL, Medline complete, Web of Science and Scopus databases. Inclusion criteria required publications to be: peer reviewed, published in English, contain validated measures of self-compassion and emotion regulation, and report a direct analysis on the relationship between these constructs. RESULTS: The search yielded five studies which met inclusion criteria. Emotion regulation significantly mediated the relationship between self-compassion and mental health. This pattern was consistent across community and clinical samples, for a range of mental health symptoms including stress, depression, and post-traumatic stress disorder. A critical limitation of the review was that all included studies used cross-sectional data, limiting interpretations regarding causation. CONCLUSIONS: Results provide preliminary evidence that emotion regulation may be a mechanism of change in the relationship between self-compassion and mental health. Self-compassion may be a pertinent preliminary treatment target for individuals who avoid experiences of emotions.

A qualitative comparison of needles and insulin pump use in children with type 1 diabetes.

Managing type 1 diabetes mellitus is an ongoing and challenging process; we investigated children's experience of different treatment regimens. Interviews with 17 children (7-15 years) at two time points were analysed using the grounded theory approach. Illness phase and treatment regimen shaped how bodily cues were interpreted. Insulin pump therapy allowed children to listen to and trust their bodily cues rather than override. Shame was a barrier to support engagement. Different internalised and externalised views of type 1 diabetes mellitus emerged. Overall, children were insightful experts of their own experiences. Recommendations for psychological interventions would benefit from empirical testing.

Self-compassion moderates the perfectionism and depression link in both adolescence and adulthood.

BACKGROUND: Psychological practitioners often seek to directly change the form or frequency of clients' maladaptive perfectionist thoughts, because such thoughts predict future depression. Indirect strategies, such as self-compassion interventions, that seek to change clients' relationships to difficult thoughts, rather than trying to change the thoughts directly could be just as effective. This study aimed to investigate whether self-compassion moderated, or weakened, the relationship between high perfectionism and high depression symptoms in both adolescence and adulthood. METHODS: The present study utilised anonymous self-report questionnaires to assess maladaptive perfectionism, depression, and self-compassion across two samples covering much of the lifespan. Questionnaires were administered in a high school setting for the adolescent sample (Study 1, Mage = 14.1 years, n = 541), and advertised through university and widely online to attract a convenience sample of adults (Study 2, Mage = 25.22 years, n = 515). RESULTS: Moderation analyses revealed that self-compassion reduced the strength of relationship between maladaptive perfectionism and depression in our adolescent Study 1 (ß = -.15, p < .001, R2 = .021.) and our adult study 2 (ß = -.14, p < .001, R2 = .020). LIMITATIONS: Cross-sectional self-reported data restricts the application of causal conclusions and also relies on accurate self-awareness and willingness to respond to questionnaire openly. CONCLUSIONS: The replication of this finding in two samples and across different age-appropriate measures suggests that self-compassion does moderate the link between perfectionism and depression. Self-compassion interventions may be a useful way to undermine the effects of maladaptive perfectionism, but future experimental or intervention research is needed to fully assess this important possibility.

Mindfulness-based interventions for adults who are overweight or obese: a meta-analysis of physical and psychological health outcomes.

OBJECTIVE: The aim of this study was to evaluate the impact of mindfulness-based interventions on psychological and physical health outcomes in adults who are overweight or obese. METHODS: We searched 14 electronic databases for randomized controlled trials and prospective cohort studies that met eligibility criteria. Comprehensive Meta-analysis software was used to compute the effect size estimate Hedge's g. RESULTS: Fifteen studies measuring post-treatment outcomes of mindfulness-based interventions in 560 individuals were identified. The average weight loss was 4.2 kg. Overall effects were large for improving eating behaviours (g = 1.08), medium for depression (g = 0.64), anxiety (g = 0.62) and eating attitudes (g = 0.57) and small for body mass index (BMI; g = 0.47) and metacognition (g = 0.38) outcomes. Therapeutic effects for BMI (g = 0.43), anxiety (g = 0.53), eating attitudes (g = 0.48) and eating behaviours (g = 0.53) remained significant when examining results from higher quality randomized control trials alone. There was no efficacy advantage for studies exceeding the median dose of 12 h of face-to-face intervention. Studies utilizing an Acceptance and Commitment Therapy approach provided the only significant effect for improving BMI (g = 0.66), while mindfulness approaches produced great variation from small to large (g = 0.30-1.68) effects across a range of psychological health and eating-related constructs. Finally, the limited longitudinal data suggested maintenance of BMI (g = 0.85) and eating attitudes (g = 0.75) gains at follow-up were only detectable in lower quality prospective cohort studies. CONCLUSIONS: Mindfulness-based interventions may be both physically and psychologically beneficial for adults who are overweight or obese, but further high-quality research examining the mechanisms of action are encouraged.