Greater self-oriented and socially prescribed perfectionism in severe alcohol use disorder.

BACKGROUND: Perfectionistic individuals present exaggerated performance standards, generating a constant search for flawlessness and a high tendency to self-criticize. Dominant models distinguish three dimensions of perfectionism: namely, self-oriented, socially prescribed and other-oriented. Perfectionism constitutes a vulnerability factor for psychopathological disorders, but its role in severe alcohol use disorder (SAUD) remains unexplored. METHODS: Sixty-five recently detoxified patients with SAUD and 65 matched controls completed a perfectionism questionnaire (the Hewitt Multidimensional Perfectionism Scale), together with measures of psychopathology. RESULTS: SAUD was associated with greater self-oriented and socially prescribed perfectionism, with no group differences on other-oriented perfectionism. This differential pattern persisted when controlling for depression and anxiety levels, and there was no correlation with alcohol consumption. CONCLUSION: This specific perfectionistic profile is consistent with those of previous studies showing lower self-evaluation (e.g., higher self-blame and reduced self-esteem) and impaired social cognition (e.g., unrealistic social standards and greater social isolation) in SAUD. In view of its potential role in the development and maintenance of SAUD, perfectionism may constitute a valuable treatment target in patients with this disorder.

Repetitive Thinking in Alcohol-Dependent Patients.

BACKGROUND: Recent studies proposed that a tendency to have repetitive negative thinking (RNT) could be a predictor of alcohol use. Nevertheless, results differ depending on the studied population (nonclinical samples or patients with alcohol abuse or alcohol dependence) and on the type of repetitive thinking (rumination or worry). These heterogeneous results might be explained by the impact of anxiety and depression level on RNT and alcohol consumption. OBJECTIVES: The aim of the present study was to explore different type of repetitive thinking (i.e., worry, brooding and reflection rumination, analytic-abstract repetitive thinking, and concrete-experiential thinking) in a clinical sample of alcohol-dependent patients and a non-clinical sample and the role played by depression and anxiety. METHOD: Eighty-four inpatients with a diagnosis of alcohol dependence and 68 individuals from a nonclinical sample completed questionnaires evaluating repetitive thinking, anxiety, depression and alcohol consumption. RESULTS: Mann-Whitney U tests showed that patients with alcohol dependence reported more analytic-abstract repetitive thinking, brooding and reflection rumination and worry, as well as anxious and depressive symptoms, compared with social drinkers, who reported more concrete-experiential repetitive thinking. Moreover, a multiple mediation model indicated that the link between RNT and alcohol consumption was significantly mediated by both anxiety and depression. Conclusion/Importance: The results support the implication of RNT in alcohol dependence and the distinction between different types of repetitive thinking with adaptive or maladaptive consequences. This link seems to be explained by the levels of depression and anxiety that mediate the impact of RNT on alcohol consumption.

Clinical Psychology and the COVID-19 Pandemic: A Mixed Methods Survey Among Members of the European Association of Clinical Psychology and Psychological Treatment (EACLIPT).

Background: The COVID-19 pandemic has affected people globally both physically and psychologically. The increased demands for mental health interventions provided by clinical psychologists, psychotherapists and mental health care professionals, as well as the rapid change in work setting (e.g., from face-to-face to video therapy) has proven challenging. The current study investigates European clinical psychologists and psychotherapists' views on the changes and impact on mental health care that occurred due to the COVID-19 pandemic. It further aims to explore individual and organizational processes that assist clinical psychologists' and psychotherapists' in their new working conditions, and understand their needs and priorities. Method: Members of the European Association of Clinical Psychology and Psychological Treatment (EACLIPT) were invited (N = 698) to participate in a survey with closed and open questions covering their experiences during the first wave of the pandemic from June to September 2020. Participants (n = 92) from 19 European countries, mostly employed in universities or hospitals, completed the online survey. Results: Results of qualitative and quantitative analyses showed that clinical psychologists and psychotherapists throughout the first wave of the COVID-19 pandemic managed to continue to provide treatments for patients who were experiencing emotional distress. The challenges (e.g., maintaining a working relationship through video treatment) and opportunities (e.g., more flexible working hours) of working through this time were identified. Conclusions: Recommendations for mental health policies and professional organizations are identified, such as clear guidelines regarding data security and workshops on conducting video therapy.

Social anxiety biases the evaluation of facial displays: evidence from single face and multi-facial stimuli.

This study examined the contribution of social anxiety to the evaluation of emotional facial stimuli, while controlling for the gender of participants and stimuli. Participants (n=63) completed two tasks: a single face evaluation task in which they had to evaluate angry versus neutral faces and, a facial crowd evaluation task in which they had to evaluate displays with a varying number of neutral and angry faces. In each task, participants had to evaluate the stimuli with respect to (a) the degree of disapproval expressed by the single face/crowd, and (b) the perceived difficulty of interacting with the face/crowd (emotional cost). Consistent with earlier studies, results showed that social anxiety modulated the evaluation of single faces for emotional cost, but not for disapproval ratings. In contrast, the evaluation of facial crowds was modulated by social anxiety on both ratings.

Concrete vs. Abstract Processing in Repetitive Negative Thinking: Distinct Functional Effects on Emotional Reactivity and Attentional Control.

Repetitive negative thinking (RNT) is a transdiagnostic process linked to emotional regulation impairment and involved in mood, anxiety, eating disorders and addictions. Attentional disengagement impairment is one of the factors hypothesized to be responsible for the recurrent and uncontrollable character of RNT. The aim of the present study was to empirically test this hypothesis with evaluation of disengagement from negative and RNT-related stimuli separately. Sixty participants were randomly allocated to one of three experimental conditions: abstract RNT, concrete RNT, and control condition (distraction). The change in their negative affect (PANAS) and their attentional disengagement impairment (exogenous cueing task) were measured. The analysis revealed that participants in abstract RNT condition presented higher emotional reactivity comparing to concrete or distraction conditions. The results indicated no differences between induction conditions in attentional disengagement. However, participants after concrete RNT induction had longer mean response times in exogenous cueing task comparing to control induction suggesting that they detected presented stimuli slower than participants in control condition. The results raised an important, from clinical point of view, question of distinctive impact of two types of RNT on emotional reactivity and attentional processes.

Effects of induced rumination on body dissatisfaction: Is there any difference between men and women?

BACKGROUND AND OBJECTIVES: Rumination is a factor in the development and maintenance of body dissatisfaction. However, no study has yet investigated the impact of the type of rumination on body image. The first aim of this study was to examine whether the induction of analytic-abstract vs. concrete-experiential rumination affects body dissatisfaction following an induction of negative body image. The second objective was to examine gender differences in these effects. METHODS: Following induction of negative body image, 102 university undergraduates were randomly assigned to one of three experimental conditions-distraction, concrete rumination or abstract rumination. RESULTS: As expected, there were significant main effects of gender and condition, and a significant interaction between gender and condition on change in body dissatisfaction. In women abstract rumination predicted the highest increase in body dissatisfaction, whereas concrete rumination predicted the highest increase in body dissatisfaction in men. LIMITATIONS: Given that our sample consisted of undergraduate students, our findings cannot be generalized to clinical sample suffering from eating disorder. CONCLUSIONS: The different types of rumination seem to impact differentially body dissatisfaction in men and women.

Specifying emotional information: Regulation of emotional intensity via executive processes.

The degree of specificity at which emotional information is activated might determine evoked emotional intensity. However, the nature of this effect remains unclear. Four studies tested (a) whether people hold the naïve theory that activating specific details of emotional information arouses acute feelings; (b) whether an emotionally distressed population (social phobics) also holds that theory; and (c) whether voluntarily focusing on specific aspects of a distressing situation reduces its emotional impact. Results indicate that control as well as emotionally distressed people hold a naïve theory that specifying emotion increases its intensity. However, Studies 3 and 4 showed that voluntarily elaborating specific aspects of a distressing situation reduces distress. Results are discussed in terms of voluntary versus automatic processing of emotional information.

Abstract and concrete repetitive thinking modes in alcohol-dependence.

Emotional and interpersonal deficits play a crucial role in alcohol-related disorders as they predict alcohol consumption and relapse. Recent models of emotion regulation in psychopathology postulate that these deficits are centrally related to increased abstract/analytic repetitive thinking, combined with reduced concrete/experiential repetitive thinking. As this assumption has not been tested in addictions, this study aimed at investigating repetitive thinking modes in a large sample of alcohol-dependent individuals. One hundred recently detoxified alcohol-dependent individuals (29 females; mean age = 49.51-years-old) recruited during the 3rd week of their treatment in a detoxification center were compared to 100 healthy controls (29 females; mean age = 48.51-years-old) recruited in the experimenters' social network, matched at the group level for age, gender, and educational level. All participants completed the Mini Cambridge Exeter Repetitive Thought Scale measuring abstract/analytic and concrete/experiential repetitive thinking modes as well as complementary psychopathological measures (Beck Depression Inventory and State/Trait Anxiety Inventory). Alcohol-dependent individuals have similar levels of concrete repetitive thinking as controls but report significantly higher levels of abstract repetitive thinking (p < 0.001; d = 1.28). This effect remains significant after controlling for depression and anxiety. Relative to healthy controls, alcohol-dependent patients report more frequent use of abstract/analytic repetitive thinking, with preserved concrete/experiential thinking. Despite the cross-sectional nature of the study, the frequent use of abstract repetitive thinking thus appears to constitute a main feature of alcohol-dependence.

Social phobics do not misinterpret facial expression of emotion.

Attentional biases in the processing of threatening facial expressions in social anxiety are well documented. It is generally assumed that these attentional biases originate in an evaluative bias: socially threatening information would be evaluated more negatively by socially anxious individuals. However, three studies have failed to evidence a negative evaluative bias in the processing of emotional facial expression (EFE) in socially anxious individuals. These studies however suffer from several methodological limitations that the present study has attempted to overcome. Twenty-one out-patients diagnosed with generalized social phobia have been compared to 20 out-patients diagnosed with another anxiety disorder and with 39 normal controls matched for gender, age and level of education. They had to decode on seven emotion intensity scales a set of 40 EFE whose intensity and emotional nature were manipulated. Although sufficient statistical power was ensured, no differences among groups could be found in terms of decoding accuracy, attributed emotion intensity, or reported difficulty of the task. Based on these findings as well as on other evidences, we propose that, if they exist, evaluative biases in social anxiety should be implicit and automatic and that they might be determined by the relevance of the stimulus to the person's concern rather than by the stimulus valence. The implications of these findings for the interpersonal processes involved in social phobia are discussed.

Difficulty in disengaging attention from threatening facial expressions in anxiety: a new approach in terms of benefits.

BACKGROUND AND OBJECTIVES: Recent work suggests that the ability to disengage attention from threatening information is impaired in anxiety. The present study compared the difficulty to disengage from angry, fearful and neutral faces in Low Trait Anxious individuals (LTA) versus High Trait Anxious individuals (HTA) at two stages of facial expression processing (i.e., initial and later face processing). METHODS: HTA and LTA individuals performed an attentional shifting task to assess attentional disengagement. Participants had to classify a peripheral target letter, appearing 200 or 500 ms after a face was displayed. RESULTS: LTA individuals were quicker when the letter appears after 500 ms compared to 200 ms regardless of the emotion of the face. An impaired disengagement in HTA individuals was observed for fearful and angry faces (i.e., no reaction differences between 200 and 500 ms) but not for neutral faces. These results suggest that it is particularly difficult for anxious individuals to switch attention from one stimulus to another if the engaged stimulus is a threatening face. LIMITATIONS: Generalisation of our results is restricted to trait anxiety and emotional facial expression processing. CONCLUSIONS: LTA individuals can benefit from the emotional processing (i.e., from 200 to 500 ms) to make a rapid attentional shift and engagement to the target stimuli whereas HTA individuals did not and continue to process the threatening facial expression. These results also point out the role of top down processes on the regulation of disengagement from threatening information in anxiety.