Corrigendum: Epistemic trust and personality functioning mediate the association between adverse childhood experiences and posttraumatic stress disorder and complex posttraumatic stress disorder in adulthood.

[This corrects the article DOI: 10.3389/fpsyt.2022.919191.].

Attachment and borderline personality disorder as the dance unfolds: A quantitative analysis of a novel paradigm.

Current research on personality disorders strives to identify key behavioural and cognitive facets of patient functioning, to unravel the underlying root causes and maintenance mechanisms. This process often involves the application of social paradigms - however, these often only include momentary affective depictions rather than unfolding interactions. This constitutes a limitation in our capacity to probe core symptoms, and leaves potential findings uncovered which could help those who are in close relationships with affected individuals. Here, we deployed a novel task in which subjects interact with four unknown virtual partners in a turn-taking paradigm akin to a dance, and report on their experience with each. The virtual partners embody four combinations of low/high expressivity of positive/negative mood. Higher scores on our symptomatic measures of attachment anxiety, avoidance, and borderline personality disorder (BPD) were all linked to a general negative appraisal of all the interpersonal experiences. Moreover, the negative appraisal of the partner who displayed a high negative/low positive mood was tied with attachment anxiety and BPD symptoms. The extent to which subjects felt responsible for causing partners' distress was most strongly linked to attachment anxiety. Finally, we provide a fully-fledged exploration of move-by-move action latencies and click distances from partners. This analysis underscored slower movement initiation from anxiously attached individuals throughout all virtual interactions. In summary, we describe a novel paradigm for second-person neuroscience, which allowed both the replication of established results and the capture of new behavioural signatures associated with attachment anxiety, and discuss its limitations.

Mentalizing as a Predictor of Well-Being and Emotion Regulation: Longitudinal Evidence from a Community Sample of Young Adults.

Background: In recent years, mentalizing - the capacity to understand one's own and others' intentional mental states in social contexts - has been considered to be a protective capacity that enables adaptive processing of stress-related emotional arousal, benefits general well-being and underpins adaptive emotion regulation. Objective: Several studies using cross-sectional research designs have demonstrated the potential health-promoting effect of mentalizing in non-clinical samples. However, longitudinal evidence is scarce. The present study aimed to investigate whether mentalizing predicts well-being and emotion regulation strategies in a non-clinical sample of mainly young adults using a prospective longitudinal design. Methods: In a prospective research design, 135 participants completed questionnaires assessing well-being, psychological symptom severity and mentalizing capacity at baseline (T1). Twelve months later (T2), emotion regulation strategies (suppression and cognitive reappraisal), well-being and psychological symptom severity were assessed by self-report. The data were analyzed using multivariate linear regression analysis. Results: Impairments in mentalizing were a significant negative predictor of well-being 12 months later. Furthermore, impairments in mentalizing positively predicted suppression of emotional states at T2. No association was found between deficits in mentalizing and cognitive reappraisal of emotional states over the course of 1 year. Conclusion: The findings indicate that mentalizing is longitudinally associated with mental health indicators in a non-clinical adult sample. Specifically, ineffective mentalizing was associated with impaired psychological well-being and a tendency to suppress intense emotional states over a period of 1 year. Future research should replicate these findings using multiple measurement timepoints to etablish causality.

Transdiagnostic factors in the COVID-19 pandemic: Examining the role of childhood abuse and neglect in establishing latent profiles of risk and resilience.

BACKGROUND: Ample studies have focused on the negative consequences of COVID-19 on mental well-being, but fewer have explored the specific role of childhood abuse and neglect in the context of risk and resilience during this unprecedented crisis. OBJECTIVE: We aimed to identify distinct profiles of individuals based on their experiences of childhood abuse and neglect, coping strategies, and psycho-social transdiagnostic risk and protective factors, using a person-centered approach. PARTICIPANTS AND SETTING: A convenience sample of 914 Israelis completed self-report questionnaires during the second wave of COVID-19. METHODS: Latent Profile Analysis was employed based on levels of childhood abuse and neglect, coping strategies, and established factors underpinning risk and resilience in mental health: dissociation, self-criticism, self-efficacy, self-compassion, attachment insecurity, psychological resilience, mentalizing, distress disclosure, psychopathology, and relationship satisfaction. Profiles were compared in COVID-19-related distress and well-being using ANOVAs. RESULTS: A four-profile solution was found to be optimal for describing individuals with different profiles of risk and resilience: "risk" (5.1 %)-individuals with meaningfully high levels of childhood abuse and neglect and dissociation; "vulnerable" (14.2 %)-individuals high in risk factors and low in protective factors; "moderately resilient" (47.6 %)-those with moderate levels of protective and risk factors; "highly resilient" (33.1 %)-individuals high in protective factors and low in risk factors; groups differed in mental well-being and COVID-19-related distress. CONCLUSIONS: Results highlight the importance of childhood abuse and neglect in differentiating between the two distinct profiles of at-risk individuals. Implications for risk assessment and treatment in the context of potential traumatic stress are discussed.

Utilization of Mental Health Provision, Epistemic Stance and Comorbid Psychopathology of Individuals with Complex Post-Traumatic Stress Disorders (CPTSD)-Results from a Representative German Observational Study.

Background: Complex post-traumatic stress disorder (CPTSD) is a severely debilitating recently added symptom cluster in the International Classification of Diseases (ICD-11). So far, only limited information on mental health treatment-uptake and -satisfaction of individuals with CPTSD is available. The aim of this study is to investigate these aspects in a representative sample of the German general population. Methods: Participants completed the International Trauma Questionnaire (ITQ) to identify participants with CPTSD, as well as questionnaires on mental health treatment uptake and satisfaction, adverse childhood experiences, anxiety, depression, working ability, personality functioning, and epistemic trust. Results: Of the included n = 1918 participants, n = 29 (1.5%) fulfilled the criteria for CPTSD. Participants with CPTSD had received mental health treatment significantly more often than participants with PTSD or depression (65.5% vs. 58.8% vs. 31.6%; p = 0.031) but reported significantly less symptom improvement (52.9% vs. 78.0% vs. 80.0%; p = 0.008). Lower levels of epistemic trust were associated with higher CPTSD symptoms (p < 0.001). Conclusions: Our study shows that while the vast majority of individuals with CPTSD had received mental health treatment, subjective symptom improvement rates are not satisfactory. CPTSD was associated with a broad number of comorbidities and impairments in functioning. Lower levels of epistemic trust may partially explain worse treatment outcomes.

A machine-learning approach for differentiating borderline personality disorder from community participants with brain-wide functional connectivity.

BACKGROUND: Functional connectivity has garnered interest as a potential biomarker of psychiatric disorders including borderline personality disorder (BPD). However, small sample sizes and lack of within-study replications have led to divergent findings with no clear spatial foci. AIMS: Evaluate discriminative performance and generalizability of functional connectivity markers for BPD. METHOD: Whole-brain fMRI resting state functional connectivity in matched subsamples of 116 BPD and 72 control individuals defined by three grouping strategies. We predicted BPD status using classifiers with repeated cross-validation based on multiscale functional connectivity within and between regions of interest (ROIs) covering the whole brain-global ROI-based network, seed-based ROI-connectivity, functional consistency, and voxel-to-voxel connectivity-and evaluated the generalizability of the classification in the left-out portion of non-matched data. RESULTS: Full-brain connectivity allowed classification (∼70 %) of BPD patients vs. controls in matched inner cross-validation. The classification remained significant when applied to unmatched out-of-sample data (∼61-70 %). Highest seed-based accuracies were in a similar range to global accuracies (∼70-75 %), but spatially more specific. The most discriminative seed regions included midline, temporal and somatomotor regions. Univariate connectivity values were not predictive of BPD after multiple comparison corrections, but weak local effects coincided with the most discriminative seed-ROIs. Highest accuracies were achieved with a full clinical interview while self-report results remained at chance level. LIMITATIONS: The accuracies vary considerably between random sub-samples of the population, global signal and covariates limiting the practical applicability. CONCLUSIONS: Spatially distributed functional connectivity patterns are moderately predictive of BPD despite heterogeneity of the patient population.

Assessing concordance between Campylobacter prevalence in broilers and human cases before and during the COVID-19 pandemic in Lower Saxony, Germany, considering fresh chicken meat consumption patterns.

As the most common foodborne disease, number of campylobacteriosis decreased in Germany with the beginning of the COVID-19 pandemic in 2020. As the consumption of fresh chicken meat is a major risk factor for human infection, this study investigated the relationship between Campylobacter contamination levels on chicken carcasses and human cases in Lower Saxony, Germany and observed fresh chicken meat consumption patterns between 2018 and 2021 including the time of the COVID-19 pandemic. Campylobacter levels in broilers and human cases were classified based on the median and descriptively analysed per week using contingency tables. Before the COVID-19 pandemic (2018 and 2019), high Campylobacter contamination levels on neck samples and many human cases were more present, whereas with the beginning of the COVID-19 pandemic (2020 and 2021), low contamination levels on chicken carcasses and few human cases were more present. Lowest concordance between both parameters was shown in 2018 (Cohen's cappa coefficient: 0.37) and 2020 (0.38). The highest concordance was examined in 2021 (0.69). The private consumption of fresh chicken meat in Lower Saxony increased significantly with the beginning of the COVID-19 pandemic in 2020 by 63.9 tonnes compared to 2019 to an average of 453.5 tonnes per week. Public health measures and a reduced number of medical treatments have undoubtedly had an impact on less reported human cases during the COVID-19 pandemic. However, number of human cases remained at a low level in Germany in 2023 while chicken meat consumption increased. Thus, further risk assessments regarding the risk of campyloabcteriosis due to chicken meat consumption should include the country of origin, as the level of contamination of chicken carcasses varies between European countries.

Bayesian Decision-Making Under Uncertainty in Borderline Personality Disorder.

Bayesian decision theory suggests that optimal decision-making should use and weigh prior beliefs with current information, according to their relative uncertainties. However, some characteristics of borderline personality disorder (BPD) patients, such as fast, drastic changes in the overall perception of themselves and others, suggest they may be underrelying on priors. Here, we investigated if BPD patients have a general deficit in relying on or combining prior with current information. We analyzed this by having BPD patients (n = 23) and healthy controls (n = 18) perform a coin-catching sensorimotor task with varying levels of prior and current information uncertainty. Our results indicate that BPD patients learned and used prior information and combined it with current information in a qualitatively Bayesian-like way. Our results show that, at least in a lower-level, nonsocial sensorimotor task, BPD patients can appropriately use both prior and current information, illustrating that potential deficits using priors may not be widespread or domain-general.

Process Hygiene Criterion for Campylobacter and Number of Campylobacter Enteritis Cases in Northwest Germany.

Campylobacteriosis is the most commonly reported bacterial foodborne disease in the European Union. Its transmission is often associated with the consumption of poultry meat. In 2018, Regulation (EC) No. 2017/1495 introduced a process hygiene criterion and with this, the testing requirements for Campylobacter. The results of microbiological testing for Campylobacter of chicken carcass neck skin samples from several slaughter lines in Northwest Germany collected by the food business operators and contamination levels (cfu/g Campylobacter) of these samples were analysed from 2018 to 2021. Classification into three different categories was made based on contamination levels. The proportion of highly contaminated (category three) neck samples (>1000 cfu/g) decreased from 2018 to 2021. Our analysis showed a relationship between the number of neck samples with high Campylobacter contamination levels (>1000 cfu/g) and human cases in Northwest Germany. Spearman's rank test (p < 0.01) showed a higher correlation in 2018 (0.66) and 2019 (0.58) compared to 2020 and 2021. Campylobacter enteritis cases in Northwest Germany stayed at a low level in 2020 and 2021. It remains unclear whether the decrease in reported Campylobacter enteritis cases is related to a decrease in Campylobacter levels on chicken carcasses or due to other reasons like underreporting during the COVID-19 pandemic, and therefore must be investigated in further analyses.

To trust or not to trust in the thrall of the COVID-19 pandemic: Conspiracy endorsement and the role of adverse childhood experiences, epistemic trust, and personality functioning.

RATIONALE: Conspiracy endorsement is a public health challenge for the successful containment of the COVID-19 pandemic. While usually considered a societal phenomenon, little is known about the equally important developmental backdrops and personality characteristics like mistrust that render an individual prone to conspiracy endorsement. There is a growing body of evidence implying a detrimental role of adverse childhood experiences (ACEs) - a highly prevalent developmental burden - in the development of epistemic trust and personality functioning. This study aimed to investigate the association between ACEs and conspiracy endorsement in the general population, specifically questioning a mediating role of epistemic trust and personality functioning. METHODS: Based on cross-sectional data from a representative German survey collected during the COVID-19 pandemic (N = 2501), we conducted structural equation modelling (SEM) where personality functioning (OPD-SQS) and epistemic trust (ETMCQ) were included as mediators of the association between ACEs and conspiracy endorsement. Bootstrapped confidence intervals (5000 samples, 95%-CI) are presented for all paths. RESULTS: ACEs were significantly associated with conspiracy endorsement (ß = 0.25, p < 0.001) and explained 6% of its variance. Adding epistemic trust and personality functioning as mediators increased the explained variance of conspiracy endorsement to 19% while the direct association between ACEs and conspiracy endorsement was diminished (ß = 0.12, p < 0.001), indicating an indirect effect of personality functioning and epistemic trust in the association between ACEs and conspiracy endorsement. Fit indices confirmed good model fit. CONCLUSIONS: Establishing an association between ACEs and conspiracy endorsement further increases the evidence for early childhood adversities' far-reaching and detrimental effects. By including epistemic trust and personality functioning, these findings contribute to a deeper understanding of the underlying mechanisms in the way that ACEs may be associated with conspiracy endorsement.

A social inference model of idealization and devaluation.

People often form polarized beliefs, imbuing objects (e.g., themselves or others) with unambiguously positive or negative qualities. In clinical settings, this is referred to as dichotomous thinking or "splitting" and is a feature of several psychiatric disorders. Here, we introduce a Bayesian model of splitting that parameterizes a tendency to rigidly categorize objects as either entirely "Bad" or "Good," rather than to flexibly learn dispositions along a continuous scale. Distinct from the previous descriptive theories, the model makes quantitative predictions about how dichotomous beliefs emerge and are updated in light of new information. Specifically, the model addresses how splitting is context-dependent, yet exhibits stability across time. A key model feature is that phases of devaluation and/or idealization are consolidated by rationally attributing counter-evidence to external factors. For example, when another person is idealized, their less-than-perfect behavior is attributed to unfavorable external circumstances. However, sufficient counter-evidence can trigger switches of polarity, producing bistable dynamics. We show that the model can be fitted to empirical data, to measure individual susceptibility to relational instability. For example, we find that a latent categorical belief that others are "Good" accounts for less changeable, and more certain, character impressions of benevolent as opposed to malevolent others among healthy participants. By comparison, character impressions made by participants with borderline personality disorder reveal significantly higher and more symmetric splitting. The generative framework proposed invites applications for modeling oscillatory relational and affective dynamics in psychotherapeutic contexts. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Childhood maltreatment, dissociation and borderline personality disorder: Preliminary data on the mediational role of mentalizing in complex post-traumatic stress disorder.

OBJECTIVES: Treatments for borderline personality disorder (BPD) and post-traumatic stress disorder (PTSD) are less effective for patients with co-occurring symptoms of both disorders, who are considered to have complex PTSD (cPTSD), compared with patients with either condition alone. Evidence suggests that co-occurrence of symptoms indicates greater impairment in mentalizing. This study examines evidence for targeting mentalizing when treating individuals with co-occurring symptoms, irrespective of their exposure to developmental trauma and, for the first time, investigates the mediational role of mentalizing in the associations between BPD symptomatology and cPTSD. DESIGN: We identified in a routine clinical service a group of patients with BPD, with or without co-occurring symptoms of PTSD. We hypothesized that patients with co-occurring symptoms and a history of childhood maltreatment will show more severe clinical profiles and greater mentalizing problems, which in turn lead to symptoms consistent with cPTSD. METHOD: Clinical profiles of 72 patients with BPD (43 with and 29 without co-occurring symptoms of PTSD; mean age in both groups 28 years, 79% and 83% female, respectively) were identified using the Structured Clinical Interview for DSM-IV Axis II Disorders. Patients completed self-report measures of BPD and PTSD symptoms, well-being, dissociation and reflective functioning. Childhood trauma histories were evaluated. RESULTS: Compared with patients with BPD-only, those with co-occurring BPD and PTSD showed greater severity in terms of BPD and dissociative symptoms, met a broader range of BPD diagnostic criteria, had a greater sense of personal worthlessness and self-evaluated their well-being as considerably diminished. This group was also more inclined to recall increased instances of childhood sexual abuse. In a mediation analysis, mentalizing acted as a partial mediator for the relationship between BPD severity and cPTSD, as well as between dissociative symptoms and cPTSD. Interestingly, mentalizing did not mediate the relationship between childhood sexual abuse and cPTSD. CONCLUSIONS: Overall, the correlational findings are consistent with an intended focus on mentalizing to treat cPTSD symptoms in individuals who also meet criteria for a diagnosis of BPD.

"Trust me, do not trust anyone": how epistemic mistrust and credulity are associated with conspiracy mentality.

Previous research shows that the propensity to endorse conspiracy theories is associated with disrupted forms of epistemic trust, i.e., the appropriate openness towards interpersonally communicated information. There are associations, first, with an increased mistrust in several actors and institutions responsible for the communication of information in society, and second, with a pronounced credulity in unreliable sources and implausible phenomena (e.g., superstition, astrology). This study aims to investigate whether these phenomena are associated with specific personality-related disruptions of epistemic trust. Based on selfreported data of 417 individuals (mean = 33.28; standard deviation = 11.11) from a UK population sampled online, the potential relationships between disruptions in epistemic trust and the endorsement of a conspiracy mentality are explored. The epistemic stances characterized by mistrust and credulity (independent variables) are measured with the epistemic trust, mistrust, and credulity questionnaire (ETMCQ), and conspiracy mentality (dependent variable) is measured with the conspiracy mentality questionnaire. In a multiple linear regression model, mistrust is associated with the endorsement of a conspiracy mentality, even when accounting for other contributing factors (e.g., individual narcissism, attachment avoidance and anxiety, authoritarianism, loneliness). In a bootstrapped mediation model controlling for other relevant predictors, the association between credulity and conspiracy mentality is fully mediated by mistrust. In future research, the impact of disrupted epistemic trust on conspiracy beliefs should be investigated in terms of the specific epistemic stances of mistrust and credulity. In this respect, the ETMCQ represents a highly promising instrument to assess individual differences in factors underpinning aspects of conspiracy endorsement.

Mentalizing in first-time fathers: reflective functioning as a mediator between attachment representation and sensitivity.

Sensitivity in parent-child interaction is essential for child development. Since fathers are increasingly involved in childrearing, identifying factors leading to paternal sensitivity is crucial. We examined the relation between attachment representation and reflective functioning (RF) as factors influencing paternal sensitivity in a longitudinal study including N = 40 first-time fathers (Mage = 33) and their 6-month-old children. We used the Adult Attachment Interview during pregnancy to assess paternal attachment representation and general RF, the Parental Development Interview to assess fathers' parental RF, and the Emotional Availability Scale to measure sensitivity at child's age of 6 month. Data show that secure paternal attachment representation, high general and parental RF are associated with higher levels of paternal sensitivity. Further, parental RF mediates the association between attachment representation and paternal sensitivity. These findings contribute to the identification of a causal interplay in that they suggest an explanatory effect of RF on the association between fathers' attachment representation, and sensitivity.

Mentalizing partially mediates the association between attachment insecurity and global stress in preservice teachers.

Objective: Considering the fact that the teaching profession is a highly stressful occupation and that teachers' ineffective coping strategies contribute to higher levels of stress, the objective of the present study was to investigate whether insecure attachment is related to global stress experiences in preservice student teachers. Furthermore, it was examined whether this link is mediated by the preservice teachers' mentalizing-the capacity to perceive and consider one's own and others' behavior based on intentional mental states. Methods: Data of this cross-sectional study came from 202 preservice student teachers using self-report instruments (attachment: Expectation in Close Relationships; mentalizing: Reflective Functioning Questionnaire; stress: Trier Inventory of Chronic Stress). The hypotheses were tested using structural equation modelling. Results: Anxious attachment was positively related to stress and impairments in mentalizing. In addition, the link between attachment-related anxiety and stress was partially mediated by mentalizing. Avoidant attachment was not associated with stress or mentalizing. Discussion: Results indicate that anxious attachment is associated with higher perceived stress in preservice student teachers. Consequently, attachment-related anxiety may be a risk factor which, in turn, may foster perceptions of higher global stress experiences. Conclusion: Additional research needs to focus on exploring the link between attachment insecurity and global stress experiences among preservice student teachers. An examination of preservice student teachers' own attachment experiences proves to be useful, for example in the context of mentalization-based supervision or reflective practice.

Mentalizing and epistemic trust as critical success factors in psychosomatic rehabilitation: results of a single center longitudinal observational study.

Background: Inpatient psychosomatic rehabilitation is a key treatment for patients with mental health issues. However, knowledge about critical success factors for beneficial treatment outcomes is scarce. The aim of this study was to evaluate the association of mentalizing and epistemic trust with the improvement of psychological distress during rehabilitation. Methods: In this naturalistic longitudinal observational study, patients completed routine assessments of psychological distress (BSI), health-related quality of life (HRQOL; WHODAS), mentalizing (MZQ), and epistemic trust (ETMCQ) before (T1) and after (T2) psychosomatic rehabilitation. Repeated measures ANOVA (rANOVAs) and structural equation models (SEMs) were calculated to investigate the association of mentalizing and epistemic trust with the improvement in psychological distress. Results: A total sample of n = 249 patients were included in the study. Improvement in mentalizing was correlated with improvement in depression (r = 0.36), anxiety (r = 0.46), and somatization (r = 0.23), as well as improved cognition (r = 0.36), social functioning (r = 0.33), and social participation (r = 0.48; all p < 0.001). Mentalizing partially mediated changes in psychological distress between T1 and T2: the direct association decreased from ß = 0.69 to ß = 0.57 and the explained variance increased from 47 to 61%. Decreases in epistemic mistrust (ß = 0.42, 0.18-0.28; p < 0.001) and epistemic credulity (ß = 0.19, 0.29-0.38; p < 0.001) and increases in epistemic trust (ß = 0.42, 0.18-0.28; p < 0.001) significantly predicted improved mentalizing. A good model fit was found (χ2 = 3.248, p = 0.66; CFI = 0.99; TLI = 0.99; RMSEA = 0.000). Conclusion: Mentalizing was identified as a critical success factor in psychosomatic inpatient rehabilitation. A key component to increase mentalizing in this treatment context is the improvement of epistemic mistrust.

[Mentalizing as Psychosocial Vaccination in Child and Adolescent Psychotherapy]. / Mentalisieren als psychosoziale Impfung in der Kinder- und Jugendlichenpsychotherapie.

Based on the psychological stress caused by theCovid 19 pandemic in families, this article explores the fundamental question of how the psychological process of mentalizing - metaphorically speaking - can act as a psychosocial vaccination in stressful times. To this end, we look at the developments in the psychosocial context under the conditions of the pandemic and consider the effects on child and adolescent psychotherapy on the basis of a vignette of a group therapy session.

Editorial Perspective: The digital divide - inequalities in remote therapy for children and adolescents.

COVID-19 has triggered a shift towards remote delivery of therapy and, despite a number of benefits, it risks discriminating against young people already marginalised due to adverse early life experiences, poverty or ethnicity. This editorial perspective considers challenges for remote therapy, focusing on: the financial burden of telehealth; the necessity of safety to speak; and, how telehealth may exacerbate difficulties in therapeutic alliance formation by interfering with epistemic trust and mentalising. As well as compounding the inaccessibility for children who are subject to abuse, the implicit assumptions behind telehealth risk disproportionately excluding from therapy those from a low socioeconomic status, and who are from ethnic minorities. Suggestions are made for how these challenges may be addressed. It is argued that service design and delivery should seek to proceed with the practicalities and principles of engagement in mind and use this as an opportunity to improve parity of access, rather than risk further entrenching inequalities.

Mapping established psychopathology scales onto the Hierarchical Taxonomy of Psychopathology (HiTOP).

The Hierarchical Taxonomy of Psychopathology (HiTOP) organizes phenotypes of mental disorder based on empirical covariation, offering a comprehensive organizational framework from narrow symptoms to broader patterns of psychopathology. We argue that established self-report measures of psychopathology from the pre-HiTOP era should be systematically integrated into HiTOP to foster cumulative research and further the understanding of psychopathology structure. Hence, in this study, we mapped 92 established psychopathology (sub)scales onto the current HiTOP working model using data from an extensive battery of self-report assessments that was completed by community participants and outpatients (N = 909). Content validity ratings of the item pool were used to select indicators for a bifactor-(S-1) model of the p factor and five HiTOP spectra (i.e., internalizing, thought disorder, detachment, disinhibited externalizing, and antagonistic externalizing). The content-based HiTOP scales were validated against personality disorder diagnoses as assessed by standardized interviews. We then located established scales within the taxonomy by estimating the extent to which scales reflected higher-level HiTOP dimensions. The analyses shed light on the location of established psychopathology scales in HiTOP, identifying pure markers and blends of HiTOP spectra, as well as pure markers of the p factor (i.e., scales assessing mentalizing impairment and suspiciousness/epistemic mistrust).

What helps the helpers? Resilience and risk factors for general and profession-specific mental health problems in psychotherapists during the COVID-19 pandemic.

Introduction: Although the COVID-19 pandemic has severely affected wellbeing of at-risk groups, most research on resilience employed convenience samples. We investigated psychosocial resilience and risk factors (RFs) for the wellbeing of psychotherapists and other mental health practitioners, an under-researched population that provides essential support for other at-risk groups and was uniquely burdened by the pandemic. Method: We examined 18 psychosocial factors for their association with resilience, of which four were chosen due to their likely relevance specifically for therapists, in a cross-sectional multi-national sample (N = 569) surveyed between June and September 2020. Resilience was operationalized dimensionally and outcome-based as lower stressor reactivity (SR), meaning fewer mental health problems than predicted given a participant's levels of stressor exposure. General SR (SRG) scores expressed reactivity in terms of general internalizing problems, while profession-specific SR (SRS) scores expressed reactivity in terms of burnout and secondary trauma, typical problems of mental health practitioners. Results: Factors previously identified as RFs in other populations, including perceived social support, optimism and self-compassion, were almost all significant in the study population (SRG: 18/18 RFs, absolute ßs = 0.16-0.40; SRS: 15/18 RFs, absolute ßs = 0.19-0.39 all Ps < 0.001). Compassion satisfaction emerged as uniquely relevant for mental health practitioners in regularized regression. Discussion: Our work identifies psychosocial RFs for mental health practitioners' wellbeing during crisis. Most identified factors are general, in that they are associated with resilience to a wider range of mental health problems, and global, in that they have also been observed in other populations and stressor constellations.