Prevention of internalizing difficulties in the middle years: Protocol for a noninferiority randomized trial of Mindfulness-Based Cognitive Therapy for Children and Cognitive Behavioural Therapy.

AIM: Mindfulness-based interventions have been tested as preventive programs for childhood internalizing difficulties, but most research has been at a 'universal' level with small to null effects. Mindfulness-Based Cognitive Therapy for Children (MBCT-C) has similar effects to Cognitive Behaviour Therapy (CBT) when used as a small-group, targeted preventive program. Knowledge gaps include the longer-term effectiveness of MBCT-C relative to CBT and the benefits of adding a parent module. This trial aims to compare MCBT-C to traditional CBT, including a parent module, to 15-months post-intervention and to test the feasibility and acceptability of adding a parent module. METHODS: Participants will be recruited from primary schools in areas of socio-economic disadvantage in South Australia (n = 194). Children (aged 9-12) years with signs of internalizing difficulties (e.g., shy, withdrawn, worried), and their parents, will be eligible for this two-armed randomized controlled non-inferiority trial (RCT). Children will participate in 10 group sessions of MBCT-C or CBT, facilitated by psychologists, and parents from both conditions will participate in two parent-only group sessions. Child self-report measures include depression and anxiety, as well as attention, mindfulness and self-compassion. Parent measures include symptoms of depression and anxiety, mindfulness, and parent-child relationship strength. The primary outcome will be child anxiety and depression (Revised Child Anxiety and Depression Scale-25). Measures will be collected pre and post intervention, and at 3, 6, 12 and 15-month follow up. RESULTS: Schools will be recruited from October 2022. Nomination of children will commence from February 2023. Program implementation will begin May 2023. CONCLUSIONS: This trial will have implications for the feasibility of involving parents in preventative programs, as well as whether mindfulness-based interventions prevent internalizing difficulties over time.

Addressing the challenges of remorse in the criminal justice system.

Remorse in offenders appears in a number of criminal justice domains. It is a mitigating factor in sentencing, influences parole decision making, may be influential in offender rehabilitation, and may be valued in forensic mental health. However, evaluation of remorse presents challenges in relation to evidence for remorse and expectations about its performance. Nevertheless, remorse is embedded deeply in criminal justice. The consideration of remorse in relation to emotions of shame, guilt and regret may offer an approach for evaluating remorse in sentencing and for addressing remorse in offender rehabilitation. This approach to understanding and working with remorse requires further elaboration, development and testing.

Suicide risk, psychological distress and treatment preferences in men presenting with prototypical, externalising and mixed depressive symptomology.

BACKGROUND: The prevalence of depression in men is significantly lower than women despite male suicide being higher. Therefore, improving the understanding and detection of depression in men is an important research and clinical aim. AIMS: To examine the prevalence of prototypic, externalising and mixed depressive symptoms and their relation to mental illness and suicide risk. METHODS: Quantitative data were obtained through a survey of N = 1000 Canadian males (median age = 49.63 years, SD = 14.60). A range of validated scales were incorporated including the PHQ-9, K6, SBQ-R and MDRS. RESULTS: Using established cut-off scores, the proportions classified into distinct symptom groups were: not depressed (69%), prototypical (8%), mixed (12%) and externalising (11%). Risk of mental illness and suicidal risk was significantly elevated in all depressed groups. Compared to the not-depressed group, those experiencing only externalising symptoms and those with mixed symptomology were at significantly increased risk of mental illness as well current suicide risk. CONCLUSION: These results highlight the clinical importance of considering a broad range of potential presentations of depression in men, all of which are associated with increased suicide risk.

The practicability and relevance of developing a yoga intervention for mental health consumers: A qualitative study.

The aim of the study was to understand the perspectives of mental health consumers, staff, and yoga teachers on the characteristics of a yoga-based intervention to be developed for consumers with a long-term mental health condition, in addition to anxiety and/or depression. Two focus groups were held with mental health consumers (n = 8), two focus groups with mental health staff (n = 13) from a metropolitan community mental health setting, and five one-on-one interviews with yoga teachers. Participants were asked about the feasibility and appropriateness of a range of yoga practice features to be tested as a newly developed yoga-based intervention. Thematic analysis was used to identify themes. Findings included the following consumer themes: Mental health understanding and experience of teachers and participants is important, Creating a safe space and Yoga practice elements. Staff themes included Mental health understanding and experience of teachers is important, Environmental design, and Yoga practice elements. Yoga teacher themes included Environmental design and Yoga practice elements. Mental health understanding and experience of the yoga teacher, and trauma-informed care were consistently emphasized by consumers and staff. Teachers focused less on specific mental health considerations, which may be reflective of a broader knowledge gap. Recommendations regarding yoga practice elements, including pre-information, regular and consistent practice, modifications, breathwork, mindfulness and guided practice, and environmental design features, were consistent with current trauma-informed yoga research. Findings will be used to guide the development of a yoga-based intervention for consumers with a long-term mental health condition, in addition to anxiety and/or depression.

Employing Multiple Mini Interviews in Selection Processes for Psychology Professional Training Programs: Ten Tips for Effective Implementation.

This article was migrated. The article was marked as recommended. In Australia and internationally, entry into many professional psychology training programs is highly competitive, and as a duty of care to the public, training institutions must seek to offer places to those best-suited to training to become a psychologist. Typically, part of this selection process involves an interview. While panel interviews have been widely utilised, recently, in a range of health disciplines, these have been substituted for multiple mini interviews (MMIs) with evidence for their acceptability, validity and reliability. There is limited research on the use of MMIs in psychology professional training selection processes. We have used this approach for three years to select approximately 100 trainees for Clinical, Health and Organisational and Human Factors postgraduate psychology training programs. Based on our experience and feedback from applicants, we provide information that suggests this selection method is well-received by applicants. We also provide ten tips on how to effectively implement this approach to determine those most suitable for further training.

The Role of Perspective Taking and Alexithymia in Associations Between Shame, Guilt, and Social Anxiety.

The present study expanded previous research concerning relationships between shame, guilt, and social anxiety by examining both internal and external shame and exploring the role of two cognitive constructs relating to emotion regulation, perspective taking, and alexithymia. Findings were consistent with the literature regarding positive associations between shame and social anxiety and no relationship between guilt and social anxiety. Perspective taking was positively related to guilt, while alexithymia was positively related to both shame types. Social anxiety was predicted by shame-proneness, external shame, and alexithymia. There were also small indirect effects for both types of shame on social anxiety through alexithymia. Further replication of relationships between shame, alexithymia, and social anxiety is needed. Alexithymia, with and without concurrent shame, has implications for therapeutic interventions for social anxiety as it may represent a barrier to implementing conventional therapies.

Professional reports for sentencing courts: recommendations for reporting on child exploitation material offenders' risk of recidivism and prospects for rehabilitation.

Denunciation and general deterrence are major objectives of sentencing those who are convicted of possessing or distributing child exploitation material in Australia (CEM offenders), but courts also strive to achieve specific deterrence. To this end, courts tend to rely on professional reports as evidence of risk of reoffending and prospects for rehabilitation. After outlining matters that courts consider when sentencing CEM offenders, we discuss key empirical findings concerning CEM offenders' risk of recidivism, and then evaluate two approaches for assessing this risk: actuarial assessments; and structured professional judgment. We recommend that professional reports prepared for sentencing reflect current research findings regarding risk of recidivism amongst CEM offenders and that the structured professional judgment approach is used. We also recommend that matters which inform offenders' risk of recidivism and their prospects for rehabilitation be reported separately.

Mindfulness, self-compassion, anxiety and depression measures in South Australian yoga participants: implications for designing a yoga intervention.

AIM: The aim of the study was to examine the demographic and practice characteristics of current yoga participants and assess their levels of mindfulness, self-compassion, stress, anxiety, depression and wellbeing and implications for designing a yoga intervention. METHODS: A web-based survey was administered to South Australian yoga teachers and students from September 2014 to February 2015. RESULTS: Results showed a positive correlation with mindfulness and self-compassion and negative correlation with Depression, Anxiety and Stress scores with months of practice. Mindfulness and self-compassion scores were significantly higher with two or more classes per week and mindfulness higher in those with a regular meditation practice. DISCUSSION: Key findings indicate that class frequency, practice experience and meditation practice are important factors in designing a yoga intervention examining mindfulness and mental health. CONCLUSION: Findings provide important information for guiding development of a yoga intervention for anxiety and depression.

Effects of mindfulness-based cognitive therapy on shame, self-compassion and psychological distress in anxious and depressed patients: A pilot study.

OBJECTIVES: The tendency to experience shame or guilt is associated differentially with anxiety and depression, with shame being associated with greater psychopathology. Correlational studies have shown self-compassion to be related to lower shame and rumination, and mindfulness-based interventions increase self-compassion. Therefore, mindfulness-based interventions may decrease shame. This pilot study aimed to assess the association of shame, rumination, self-compassion, and psychological distress and the effects of a mindfulness-based intervention on these measures in a clinical sample. DESIGN: Single-group design with pre-test and post-test measures. METHOD: Thirty-two service users who experienced clinically diagnosed depressive or anxiety disorders in a mindfulness-based cognitive therapy programme were assessed before and twenty-two after therapy with measures of shame-proneness, external shame, rumination, self-compassion, and psychological distress. RESULTS: Shame-proneness and external shame were positively correlated with self-coldness, and external shame was positively correlated with stress and depressive symptoms. Self-compassion increased and self-coldness decreased, while shame-proneness, rumination, anxiety, and stress symptoms decreased from pre- to post-treatment. There was no significant reduction in depressive symptoms, guilt-proneness, or external shame. CONCLUSION: Our preliminary findings suggest that mindfulness-based approaches may be helpful in increasing self-compassion and reducing shame-proneness in mixed groups of anxious and depressed patients. Controlled studies of the effects of mindfulness-based interventions on shame in clinical populations are warranted. PRACTITIONER POINTS: Shame-proneness and external shame showed different patterns of relationship with depressive and stress symptoms and with self-compassion. Shame-proneness decreased to a greater extent than external shame decreased following participation in an MBCT group. Mindfulness-based interventions may benefit shame-proneness to a greater extent than external shame.

Mindfulness and Loving-Kindness Meditation.

An experiment involving 115 undergraduate students (74.8% females; mean age = 20.5 years, SD = 4.3) was conducted to explore effects of meditation on social connectedness, nature connectedness, and affect. Participants listened to one of three brief guided meditation Mp3 recordings via the internet, which involved mindfulness meditation (MM), loving-kindness meditation (LKM), or progressive muscle relaxation (active control group). Participants in the MM and LKM groups reported greater social and nature connectedness at post-test than those in the control group. There were no significant differences in connectedness between the MM and LKM groups, suggesting they are both effective for enhancing connectedness. There were no significant changes in negative or positive affect at post-test due to the interventions. Recommendations for future research are provided.

Is dream recall underestimated by retrospective measures and enhanced by keeping a logbook? A review.

There are two methods commonly used to measure dream recall in the home setting. The retrospective method involves asking participants to estimate their dream recall in response to a single question and the logbook method involves keeping a daily record of one's dream recall. Until recently, the implicit assumption has been that these measures are largely equivalent. However, this is challenged by the tendency for retrospective measures to yield significantly lower dream recall rates than logbooks. A common explanation for this is that retrospective measures underestimate dream recall. Another is that keeping a logbook enhances it. If retrospective measures underestimate dream recall and if logbooks enhance it they are both unlikely to reflect typical dream recall rates and may be confounded with variables associated with the underestimation and enhancement effects. To date, this issue has received insufficient attention. The present review addresses this gap in the literature.

The impact of parental diagnosis of borderline personality disorder on offspring: learning from clinical practice.

The aim of this study was to explore mental health clinicians' opinions regarding the impact of a parental diagnosis of borderline personality disorder (BPD) on offspring and factors that may protect these children from developing emotional and/or behavioural difficulties. Expert opinions from 64 clinicians were collected through a voluntary and anonymous online qualitative survey. Thematic analysis of the data revealed five main themes relating to the impact of parental BPD symptoms on offspring. Children in these families were observed to develop behavioural, emotional and interpersonal difficulties, disturbances to cognitive processes and self dysfunction. A number of protective factors for offspring were also identified, such as supportive social networks, therapeutic intervention and child and parent characteristics. A model for the potential transgenerational transmission of emotional dysregulation from parent to child was proposed.

Brief mindfulness-based therapy for chronic tension-type headache: a randomized controlled pilot study.

BACKGROUND: Mindfulness-based therapy (MBT) has been demonstrated to be effective for reducing chronic pain symptoms; however, the use of MBT for Chronic Tension-Type Headache (CTH) exclusively has to date not been examined. Typically, MBT for chronic pain has involved an 8-week program based on Mindfulness Based Stress Reduction. Recent research suggests briefer mindfulness-based treatments may be effective for chronic pain. AIMS: To conduct a pilot study into the efficacy of brief MBT for CTH. METHOD: We conducted a randomized controlled trial of a brief (6-session, 3-week) MBT for CTH. RESULTS: Results indicated a significant decrease in headache frequency and an increase in the mindfulness facet of Observe in the treatment but not wait-list control group. CONCLUSION: Brief MBT may be an effective intervention for CTH.

Relationships of Mindfulness, Self-Compassion, and Meditation Experience With Shame-Proneness.

The tendency to experience shame or guilt is associated differentially with anxiety, depression, and substance abuse, with shame being associated with greater psychopathology. Recent interventions designed to decrease shame emphasize mindfulness or self-compassion. This study investigated correlational relationships of shame-proneness and guilt-proneness with mindfulness and with self-compassion in undergraduate participants. Shame-proneness was strongly negatively correlated with all facets of mindfulness and with self-compassion, whereas guilt-proneness was weakly positively correlated with self-compassion and some facets of mindfulness. Hierarchical regression analysis showed that shame-proneness was predicted by self-compassion but not by mindfulness. More frequent meditation was associated with greater mindfulness and self-compassion and lower shame-proneness but not guilt-proneness. Limitations of the study and implications of the findings for interventions to reduce shame are discussed.

The effects of verbalisation on cognitive performance in schizophrenia: a pilot study using tasks from the Delis Kaplan Executive Function System.

Cognitive impairment is common in schizophrenia, and has adverse effects on functional outcome. Cognitive remediation strategies in which people with schizophrenia speak aloud (verbalise) during task performance have demonstrated some success in improving performance on the Wisconsin Card Sorting Test. This study extends previous research by assessing whether verbalisation also improves performance on tasks selected from the Delis-Kaplan Executive Function System (D-KEFS). Twenty two subjects with schizophrenia participated in the study. We used a within subjects design to compare performance on the D-KEFS Tower Test and Trail Making Test when participants (a) produced concurrent verbalisation, or (b) remained silent. Results demonstrated selective benefits of verbalisation on a neuropsychological task requiring multiple executive functions (number-letter switching task), while performance on tasks requiring simpler single-component cognitive functions (visual scanning and motor speed tasks) was adversely affected. The effects of verbalisation on the cognitive task performance of patients with schizophrenia differ depending on the nature of the task. Benefits are seen in tests of executive skills but performance worsens in single component cognitive tasks. When developing cognitive remediation strategies for people with schizophrenia, consideration should be given to the nature and cognitive demands of each task before recommending verbalisation strategies.

Issues in the application of Bayes' Theorem to child abuse decision making.

Proposals for the application of Bayes' Theorem as an aid to child abuse decision making are discussed critically. Subsequently, two examples of the application of research findings concerning signs of child abuse to decision making are demonstrated, using data from research studies of signs of physical abuse and sexual abuse. The calculation of the probability of the presence of abuse using Bayes' Theorem is described, given prevalence information and specific indicators of abuse. In addition, a method for describing the degree of imprecision in estimates of the probability of abuse is discussed. Specific issues that affect the valid application of research findings within Bayes' Theorem are discussed, including estimates of the prevalence or base rate of child abuse, sensitivity and specificity of diagnostic signs, and the independence of information that is combined in Bayes' Theorem. Recommendations for addressing these issues when Bayes' Theorem is applied to child abuse decision making are discussed, including assessment of the independence of indicators that are combined in Bayes' Theorem, suitable bases for estimating the prevalence of abuse, and the calculation of imprecision in probability estimates of abuse.

A preliminary examination of specific risk assessment for sexual offenders against children.

Specific risk questions concerning sexual offending, such as risk of offending against male victims given identified female victims, have seldom been discussed in the child sexual abuse literature. Two approaches to specific risk questions are described: (a) conditional probability calculations, and (b) the development of risk assessment instruments. It is concluded that specific risk questions should be addressed by the use of established instruments for assessing risk of general sexual recidivism rather than by the development of additional specific risk assessment instruments. Research supporting risk assessment instruments and cautions about their use are discussed. Finally, the application of risk assessments for sexual offenders and assessments of risk to siblings of incest victims is discussed.

Shame and guilt in child sexual offenders.

In this article, the authors build on previous discussions of the possible role of shame and guilt in sexual offending. They review the general psychological literature on shame and guilt and conclude that the distinction between internal and external shame is an important one in considering sexual offenders. The effects of shame and guilt on victim empathy and relapse are discussed, and it is proposed that the phenomena of shame and guilt have implications for treatment beyond those identified in previous studies. Shame is a salient feature in the initial presentation of many sexual offenders against children. Furthermore, aspects of the treatment of sexual offenders can be characterized as a shift from shame toward guilt. Implications of shame and guilt for treatment of sexual offenders are described.