[Psychedelics and treatment of mental disorders: A survey of attitudes and knowledge among psychiatrists, general practitioners and psychologists in Iceland].

INTRODUCTION: Interest in the use of psychedelics has increased following reports of their possible therapeutic potential. However, little is known about the knowledge of and attitudes towards the substances among health care professional who provide treatment for mental disorders in Iceland. An online survey was therefore conducted among members of the Icelandic associations of psychiatrists, general practitioners and psychologists. METHODS: Respondents were 256 in total, including 177 psychologists, 38 psychiatrists and 41 general practitioners that provided information on their background, type of work, knowledge of and attitude towards different types of psychedelic substances and their views on optimal service delivery if psychedelics were approved by licencing authorities and used for treatment. RESULTS: Around half of psychiatrists reported having received questions about treatment with psychedelics in their clinical work, compared to only 14,6% of general practitioners and 17,5% of psychologists. The majority of respondents had little, or no knowledge of the substances targeted in the survey. A majority also expressed negative attitudes towards treatment with psilocybin mushrooms, but was positive towards ongoing scientific research and felt that such a treatment should be prescribed and provided by psychiatrists. Moreover, the majority view was that psilocybin treatment should be provided in specialised clinics or psychiatric units in a hospital setting. Scientific articles on the topic, discussions with colleagues and information in the media were identified as having had most influence on respondents´ attitudes towards psychedelics. Most respondents were interested in further education on psychedelics. CONCLUSIONS: Respondents among these three professions felt that the time has not yet come to use psychedelics in the treatment of mental disorders in Iceland but thought more education on psychedelics, their potential efficacy and adverse health effects is important given the increased interest in psychedelics.

Automaticity and depression: Daily mood-reactive rumination in people with and without depression history.

Depressive rumination has been conceptualized as a mental habit that is initiated automatically without conscious awareness, intent, or control in response to negative mood. However, it is unknown whether depression vulnerability is characterized by elevated levels of mood-reactive rumination at the level of short-term dynamics. Using mobile ecological momentary assessment, formerly depressed individuals with a recurrent history of depression (n = 94) and nonclinical controls (n = 55) recorded in-the-moment affect and rumination 10 times daily over 6 days, after completing baseline measures of trait ruminative brooding, early life stress, and habitual characteristics of negative thinking (e.g., automaticity, lack of conscious awareness, intent, and control). Momentary fluctuations in negative affect were prospectively associated with greater rumination at the next sampling occasion in formerly depressed participants whereas this pattern of mood-reactive rumination was not observed in nonclinical controls. In formerly depressed participants, habitual characteristics of negative thinking was associated with greater mood-reactivity of rumination, particularly among those with a history of early life stress. Mood-reactive rumination was not, however, associated with depression course nor with the frequency of trait ruminative brooding. Rumination may be triggered in response to negative affect with a high degree of automaticity, making it difficult to control. Greater mood-reactivity of rumination might be associated with increased depression risk, independent of the depressive course and may be exacerbated by early life stress. Future studies may need to go beyond frequency and focus on the role of mood-reactivity and automaticity of ruminative thinking in depression vulnerability. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Do daily mood fluctuations activate ruminative thoughts as a mental habit? Results from an ecological momentary assessment study.

It has been suggested that mental habits may underpin a heightened disposition to engage in rumination in response to negative mood. The aim of the current study was to assess the role of habit in the dynamic interplay between affect and ruminative thinking in the flow of daily life experiences. Using mobile ecological momentary assessment, 97 participants recorded affect and rumination ten times daily over six days, after completing measures of trait ruminative brooding and habitual characteristics of negative thinking (e.g. automaticity, lack of conscious awareness, intent and control). Momentary fluctuations in negative (increased) and positive (decreased) affect was prospectively associated with greater rumination-levels at the next sampling occasion. The degree to which affect triggered a subsequent ruminative response was moderated by habitual characteristics of negative thinking in a theoretically consistent way. Stronger temporal pairing of negative affect and rumination was also associated with greater emotional inertia but less carry-over of rumination from one moment to the next. Depression vulnerability may be in the form of rumination being habitually triggered in response to momentary fluctuations in affect, with deleterious effect on mood. The findings may have clinical implications, as targeting the habitual nature of rumination might help reduce depression vulnerability.

A Test of the Habit-Goal Framework of Depressive Rumination and Its Relevance to Cognitive Reactivity.

The aim of the present study was to test predictions derived from the habit-goal framework of depressive rumination and investigate its relevance to cognitive reactivity-another well-known vulnerability factor to depression. Formerly depressed (FD; n=20) and never depressed (ND; n=22) participants completed self-report measures of rumination, cognitive reactivity, and habitual characteristics of rumination (e.g., lack of awareness, control, intent). A standard mood-induction task was also used to measure cognitive reactivity and an outcome-devaluation task to measure general habit vs. goal-directed behavior control. Habitual characteristics of ruminative thoughts were greater in the FD group and were related to depressive brooding and cognitive reactivity, but not reflective pondering. Reliance on habit on the outcome-devaluation task was strongly correlated with number of depression episodes, although group differences were not observed in general habit vs. goal-directed control. Habitual characteristics of rumination (e.g., greater automaticity) may explain reactivity and persistence of negative thoughts in depression. Habitual behavior control may contribute to inflexible responding and vulnerability for depression episodes.

Disentangling Reward Processing in Trichotillomania: 'Wanting' and 'Liking' Hair Pulling Have Distinct Clinical Correlates.

Trichotillomania (TTM; hair-pulling disorder) is characterized by an irresistible urge or desire to pull out one's own hair, and a sense of pleasure when hair is pulled out. Evidence from translational neuroscience has shown that 'wanting' (motivation to seek a reward) and 'liking' (enjoyment when reward is received) are each mediated by overlapping but distinct neural circuitry, and that 'wanting' contributes to addictive/compulsive behaviors more so than 'liking'. In the present study, we developed the Hair Pulling Reward Scale (HPRS), a self-report measure that consists of two subscales designed to assess (a) cue-triggered urges and appetitive motivation to pull hair (i.e., putative correlates of 'wanting'), and (b) momentary pleasure and gratification during pulling episodes (i.e., putative correlates of 'liking'). We administered the HPRS to 259 individuals with TTM and examined its psychometric properties. Confirmatory factor analysis supported a two-factor model reflecting correlated Wanting and Liking scales. Consistent with predictions, Wanting, much more than Liking, had robust correlations with TTM severity, impulsiveness, difficulties in emotion regulation, psychiatric symptoms, and sleep dysfunction. The results suggest that the HPRS is a psychometrically sound instrument that can be used as a symptom-level measure of reward processing in TTM.

'Wanting' and 'liking' skin picking: A validation of the Skin Picking Reward Scale.

BACKGROUND AND AIMS: Excoriation (skin-picking) disorder (SPD) is often conceptualized as a behavioral addiction in which aberrant reward processing may play an important role. The current study sought to develop a self-report instrument--the Skin Picking Reward Scale (SPRS)--that measures how strongly skin picking is 'liked' (i.e., the degree of pleasurable feelings while receiving the reward) and 'wanted' (i.e., the degree of the motivation to seek the reward). METHODS: We administered the SPRS to individuals who endorsed excessive skin picking in online surveys and examined the scale's factor structure (Studies 1 and 2). We then asked individuals with documented pathological skin picking to complete the SPRS and other relevant questionnaires on two occasions one week apart (Study 3). RESULTS: Exploratory (Study 1; n = 330) and confirmatory (Study 2; n = 144) factor analyses consistently supported a two-factor structure reflecting the 'liking' and 'wanting' constructs. Results from Study 3 (N = 36) indicated that the Wanting and the Liking scales had adequate internal consistency and test-retest reliability. Additionally, consistent with predictions, the Wanting scale, but not the Liking scale, was associated with picking urges the following week, greater cue-reactivity, and more picking-related routines/habits. DISCUSSION: These initial findings suggest that SPRS is a psychometrically sound measure of 'wanting' and 'liking' in pathological skin picking. The SPRS may facilitate research on reward processing anomalies in SPD and serve as a useful clinical instrument (e.g., to identify those at risk for cue-induced relapse).

Replacing intrusive thoughts: investigating thought control in relation to OCD symptoms.

BACKGROUND AND OBJECTIVES: Control of obsessive thoughts in Obsessive Compulsive Disorder (OCD) involves both avoidance and removal of undesirable intrusive thoughts. Thought suppression tasks tap both of these processes but experimental results have been inconsistent. Experimental tasks allowing more focused study of the processes involved in controlling intrusive thoughts may be needed. In two experiments, control over neutral, standardized intrusive and personal intrusive thoughts was investigated as participants attempted to replace them with neutral thoughts. METHODS: Non-selected university students (Experiment 1: N = 61) and university students scoring high and low on self-report measure of OC symptoms (Experiment 2: N = 40) performed a computerized thought replacement task. RESULTS: In experiment 1 replacing personal intrusive thoughts took longer than replacing neutral thoughts. Self-reports showed that intrusive thoughts were rated more difficult to replace and were associated with greater thought reoccurrence during replacement, larger emotional reaction and more discomfort. These results were largely replicated in experiment 2. Furthermore, the high OC symptom group experienced greater overall difficulty controlling thoughts on the replacement task, experienced more reoccurrences of personal intrusive thoughts, larger emotional reactions and discomfort associated with them, and felt a greater urge to remove them. LIMITATIONS: All participants were non-clinical university students, and older adults with OCD should be tested. CONCLUSIONS: The findings are in line with cognitive behavioural theories of OCD. They support the usefulness of thought replacement as a research paradigm to study thought control in OCD and possibly other psychological conditions characterized by repetitive thoughts.

The relationship between physical appearance concerns, disgust, and anti-fat prejudice.

This study examined relationships between physical appearance concerns (fear of fat, body image disturbance; BIDQ), disgust, and anti-fat prejudice (dislike, blame), and tested whether disgust mediates relationships between physical appearance concerns and anti-fat prejudice. Participants (N=1649; age=28 years) provided demographic data and completed measures of anti-fat prejudice, tendency to feel disgust, and physical appearance concerns. Univariate, multivariate, and mediation analyses were conducted. Univariate and multivariate associations were found between fear of fat, BIDQ, disgust, and anti-fat prejudice for women. For women only, mediation analyses showed that disgust partially mediated relationships between physical appearance concerns and dislike of fat people. For men, univariate and multivariate relationships were found between fear of fat, and dislike and blame of fat people, but disgust was not related to anti-fat prejudice. Newer constructs centering on physical appearance concerns and disgust appear promising candidates for understanding anti-fat prejudice.

The Skin Picking Impact Scale: Factor structure, validity and development of a short version.

In the present study, we examined the psychometric properties of the Skin Picking Impact Scale (SPIS; Keuthen, Deckersbach, Wilhelm et al., 2001), a 10 item self-report questionnaire designed to assess the psychosocial impact of skin picking disorder (SPD). Participants were 650 individuals who met criteria for SPD in an online survey. Exploratory and confirmatory factor analyses demonstrated a unitary factor structure with high internal consistency (α = 0.94). Consequently, we constructed an abbreviated 4-item version that retained good internal consistency (α = 0.87) and a robust factor structure. Both the short and the full versions demonstrated discriminant and convergent/concurrent validity. In conclusion, the findings indicate that both versions are psychometrically sound measures of SPD related psychosocial impact; however, some potential limitations of the full scale are discussed.

Suppressing disgust related thoughts and performance on a subsequent behavioural avoidance task: implications for OCD.

We tested whether suppressing disgust related thoughts, compared with no suppression, differentially affected target thought frequency and emotional responses, and whether this was related to participants' cognitive inhibition abilities. We also tested whether different control instructions during a thought control task would affect performance on a subsequent behavioural avoidance task involving disgust related stimuli. Sixty university students, pre-selected on their level of disgust propensity/sensitivity, were instructed to either suppress or not to suppress all target-related thoughts following viewing of a disgust-related film fragment. Thought suppression immediately reduced target thought frequency, but only for participants with good inhibitory control. Thought suppression led to sustained thought frequency and levels of disgust after suppression was lifted, whereas a significant drop was observed for these measures in the no-suppression group. Thought control instructions did not affect performance on the behavioural avoidance task at the group level. However, regression analyses showed that changes in thought frequency during thought suppression interacted with beliefs concerning importance of thoughts and thought control when predicting fear and disgust reactions during the behavioural task.

Motor inhibition, reflection impulsivity, and trait impulsivity in pathological skin picking.

Pathological skin picking (PSP) is often recognized as an impulse control disorder. The current study sought to investigate the relationship between PSP and different forms of impulsivity. University students that met criteria for PSP (n = 55) and university students without history of PSP (n = 55) answered a multidimensional impulsivity questionnaire (the UPPS Impulsive Behavior Scale) and completed 2 neurocognitive tasks that assess impulsivity (the Stop Signal Task and the Information Sampling Task). The PSP group scored significantly higher than the control group on the negative and positive urgency subscales of the UPPS, but the groups did not differ on other subscales or the neurocognitive tasks. Logistic regression demonstrated that the urgency scales added to the prediction of PSP after negative affect and other forms of impulsivity were adjusted for. The results indicate that PSP sufferers are characterized by emotion-based impulsivity and do not appear to be impulsive in other ways.

Self reported attentional control with the Attentional Control Scale: factor structure and relationship with symptoms of anxiety and depression.

The Attentional Control Scale (ACS) is a self-report questionnaire that has been developed to measure individual differences in attentional control. Despite its fairly widespread use, little is known about the psychometric properties of the scale in adult samples. In the present study, factor structure of the ACS and its relationship with symptoms of anxiety and depression was investigated in a total sample of 728 Icelandic university students. Exploratory factor analysis in sample 1 (n=361), yielded two factors, labeled focusing and shifting. Confirmatory factor analysis in sample 2 (n=367) showed a reasonable fit of this two factor model. The two factors correlated strongly (0.73). The two subscales showed different predictive validity in a set of hierarchical regression analyses where the focusing subscale made a significant prediction of anxiety scores when depression scores were controlled for, and the shifting subscale significant prediction of depression scores when anxiety scores were controlled for. These findings are discussed in relation to previous studies on attentional and executive control in anxiety and depression.

Emotion regulation in pathological skin picking: findings from a non-treatment seeking sample.

Pathological skin picking (PSP) is characterized by excessive picking of the skin, resulting in significant distress or functional impairment. The aim of the present study was to investigate the emotion regulation hypothesis of PSP. University students with PSP (n = 55) and without history of PSP (n = 55) were asked to retrospectively rate the intensity of affective states before, during, and after skin picking episodes. The results showed that for a majority of the PSP sufferers, intensity of certain negative affective states (i.e. anxiety, tension or boredom) was pronounced just before picking, and diminished significantly in the period from before to after picking. Relief and gratification increased during picking whereas guilt increased afterwards. A similar pattern emerged in the control group, although a much lower level of intensity was reported. Participants were also asked to fill out questionnaires concerning emotion regulation difficulties, emotion reactivity, depression, anxiety and worry. Hierarchical logistic regressions demonstrated that emotion regulation difficulties as well as emotion reactivity predicted PSP diagnosis after depression, anxiety and worry were controlled for. Furthermore, emotion regulation difficulties statistically mediated the relationship between emotion reactivity and PSP. Overall, the findings support an emotion regulation model of PSP.

Fear of flying treatment methods: virtual reality exposure vs. cognitive behavioral therapy.

INTRODUCTION: Fear of flying (FOF) can be a serious problem for individuals who develop this condition and for military and civilian organizations that operate aircraft. The aim of this study was to compare the effectiveness of three treatments: bibliotherapy (BIB) without therapist contact; individualized virtual reality exposure therapy (VRE); and cognitive behavior therapy (CB). In addition, we evaluated the effect of following up VRE and CB with 2 d of group cognitive-behavioral training (GrCB). METHODS: There were 86 subjects suffering from FOF who entered the study; 19 BIB, 29 VRE, and 16 CB subjects completed the treatment protocols. The BIB subjects were then treated with VRE (n = 7) or CB (n = 12). There were 59 subjects who were then trained with GrCB. RESULTS: Treatment with VRE or CB was more effective than BIB. Both VRE and CB showed a decline in FOF on the two main outcome measures. There was no statistically significant difference between those two therapies. However, effect sizes were lower for VRE (small to moderate) than for CB (moderate) and the addition of GrCB had less effect for VRE than for CB. DISCUSSION: VRE holds promise as treatment for FOF, but in this trial CB followed by GrCB showed the largest decrease in subjective anxiety. The results suggest that future research should focus on comparing the effectiveness of VRE vs. VRE plus cognitive techniques or measure the effectiveness of each component of treatment. Moreover, the effectiveness of the GrCB as stand-alone treatment should be investigated, which might even be superior in cost-effectiveness.

Definitions of bullying: a comparison of terms used, and age and gender differences, in a fourteen-country international comparison.

The study of school bullying has recently assumed an international dimension, but is faced with difficulties in finding terms in different languages to correspond to the English word bullying. To investigate the meanings given to various terms, a set of 25 stick-figure cartoons was devised, covering a range of social situations between peers. These cartoons were shown to samples of 8- and 14-year-old pupils (N = 1,245; n = 604 at 8 years, n = 641 at 14 years) in schools in 14 different countries, who judged whether various native terms cognate to bullying, applied to them. Terms from 10 Indo-European languages and three Asian languages were sampled. Multidimensional scaling showed that 8-year-olds primarily discriminated nonaggressive and aggressive cartoon situations; however, 14-year-olds discriminated fighting from physical bullying, and also discriminated verbal bullying and social exclusion. Gender differences were less appreciable than age differences. Based on the 14-year-old data, profiles of 67 words were then constructed across the five major cartoon clusters. The main types of terms used fell into six groups: bullying (of all kinds), verbal plus physical bullying, solely verbal bullying, social exclusion, solely physical aggression, and mainly physical aggression. The findings are discussed in relation to developmental trends in how children understand bullying, the inferences that can be made from cross-national studies, and the design of such studies.