Screening for depression: Psychometric properties of the German version of the Glasgow depression scale for people with a learning disability (individual and carer version).

BACKGROUND: Adults with intellectual disabilities should participate in the diagnostics of their mental health. The Glasgow Depression Scale for people with a Learning Disability (GDS-LD) and its Carer Supplement (GDS-CS) were translated into German and tested. METHODS: Internal consistency, criterion validity and inter-test reliability were tested in 64 adults with borderline, mild or moderate intellectual disabilities and their carers. Convergent validity was analysed in 57 adults without intellectual disabilities. RESULTS: Internal consistency was good (α = 0.81) for GDS-LD and acceptable (α = 0.72) for GDS-CS. The GDS-LD did not differentiate between groups with and without depression. The GDS-CS significantly differentiated between these groups. Convergent validity of the GDS-LD was high. The correlation of GDS-LD and GDS-CS was non-significant. CONCLUSIONS: In its present form the German version of the GDS-LD does not meet the psychometric properties to be used in clinical practice. This leads to the broader question, how to measure depression in people with learning disabilities with the knowledge of the fallibility of existing measures when utilised with this clinical cohort. Also, future studies need to investigate the role of self-rating.

Mindfulness-Based and Mindfulness-Informed Interventions at the Workplace: A Systematic Review and Meta-Regression Analysis of RCTs.

Objectives: Positive effects of mindfulness-based interventions (MBIs) on occupational health have been demonstrated by several systematic review studies during the last two decades. So far, existing reviews excluded mindfulness-informed interventions (MIIs) that build on informal approaches or mixed techniques aiming at improving mindfulness indirectly. To address this research gap, the present comprehensive meta-analysis synthesizes the results of RCTs of MBIs and MIIs conducted in various workplace settings. Method: A systematic literature search was conducted in five electronic databases complemented by manual search. Random-effects models were used to synthesize standardized mean differences (SMDs) for 25 outcomes and seven overarching categories of outcomes, and to detect various temporal effects. Meta-regressions were run to elucidate average SMDs between mindfulness intervention types and intervention and population characteristics, with the goal of detecting sources of heterogeneity and help guide the selection of the most appropriate mindfulness intervention type. Results: Based on 91 eligible studies (from 92 publications), including 4927 participants and 4448 controls, the synthesis shows that MBIs and MIIs significantly improve mindfulness (SMD = 0.43; 95%-CI [0.33;0.52]), well-being (SMD = 0.63; 95%-CI [0.34;0.93]), mental health (SMD = 0.67; 95%-CI [0.48;0.86]), stress (SMD = 0.72; 95%-CI [0.54;0.90]), resilience (SMD = 1.06; 95%-CI [-0.22;2.34]), physical health (SMD = 0.45; 95%-CI [0.32;0.59]), and work-related factors (SMD = 0.62; 95%-CI [0.14;1.10]). Sensitivity analyses demonstrate a tendency towards smaller effect sizes due to extreme outliers. Effect sizes are stable in short-term follow-up assessments (1-12 weeks) for most outcomes, but not for long-term follow-up assessments (13-52 weeks). Meta-regressions suggest that observable intervention characteristics (e.g., online delivery) and population characteristics (e.g., age of participants), as well as study quality, do not explain the prevalence of heterogeneity in effect sizes. Conclusions: Generally effective, mindfulness interventions are a useful tool to enhance aspects of employee health. However, because of heterogeneity and risk of bias, studies aiming at high-quality data collection and thorough reporting are necessary to draw firm conclusions. Preregistration: A protocol of this systematic review was registered with PROSPERO (Registration-No. CRD42020159927). Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-023-02130-7.

Bodily Experience in Depression: Using Focusing as a New Interview Technique.

INTRODUCTION: Research on body aspects in depression primarily focuses on somatic complaints, while phenomenologists emphasize the pre-reflective bodily experience of depression as relevant for the psychopathology of it. Despite this increasing acknowledgement of the subjective body's impact on depression, empirically, it remains rarely studied. METHODS: Relying on the psychotherapy method of Focusing (Gendlin, 1982), interviews were developed, which enable participants with depression to get in contact with pre-reflective bodily experiences through turning inward, attentively observing all bodily feelings that arise, and finding symbolizations for these feelings. RESULTS: In 501 codings of the conducted interviews, the theme of passivity emerged on a continuum ranging from inhibition of drive to lack of drive. It can be split into 5 components (heaviness, emptiness, paralysis, blockage, and alienation), which were felt in the head or the whole body. Moreover, participants reported active, pressuring feelings in the chest and stomach areas, which were associated with specific emotions in some participants. DISCUSSION: In conclusion, through focusing, participants were able to take note of their pre-reflective bodily feelings and described feelings of passivity, active, pressuring feelings, and an ambivalence between these two parts. Results support the notion that depression is associated with specific pre-reflective bodily experiences and lay a foundation for future research.

Reduced Jumping to Conclusion Bias after Experimentally Induced Enhancement of Subjective Body Boundaries in Psychosis.

INTRODUCTION: A disturbed sense of self is frequently discussed as an etiological factor for delusion symptoms in psychosis. Phenomenological approaches to psychopathology posit that lacking the sense that the self is localized within one's bodily boundaries (disembodiment) is one of the core features of the disturbed self in psychosis. The present study examines this idea by experimentally manipulating the sense of bodily boundaries. METHODS: Seventy-three patients with psychosis were randomly assigned to either a 10-min, guided self-massage in the experimental group (EG) to enhance the sense of bodily boundaries or a control group (CG), which massaged a fabric ring. Effects on an implicit measure (jumping to conclusion bias; JTC) and an explicit measure (Brief State Paranoia Checklist; BSPC) of delusion processes were assessed. The JTC measures the tendency to make a decision with little evidence available, and the BSPC explicitly measures the approval of paranoid beliefs. RESULTS: Patients in the EG showed a lower JTC (M = 4.11 draws before decision) than the CG (M = 2.43; Cohen's d = 0.64). No significant difference in the BSPC was observed. DISCUSSION/CONCLUSION: Our results indicate that enhancing the sense of body boundaries through a self-massage can reduce an implicit bias associated with delusional ideation and correspondingly support the idea that disembodiment might be a relevant factor in the formation of psychotic symptoms.

Psychometric properties of the German version of the fears of compassion scales.

The cultivation of compassion is associated with beneficial effects on physical and psychological health, satisfaction with life and social relationships. However, some individuals, especially those high in psychopathological symptoms or those with particular disorders such as borderline personality disorder (BPD) may demonstrate pronounced fears of engagement in compassionate experiences or behaviours. Furthermore, fears of compassion have been found to impede progress in psychotherapy. The 38-item fears of compassion scales (FCS) is a self-report questionnaire for measuring trait levels of fears of compassion (a) one receives from others (FCFO), (b) one feels towards others (FCTO) and (c) one feels for oneself (self-compassion; FSC). The FCS is an internationally used instrument of proven validity and reliability in both clinical and nonclinical samples. In the present study, a German translation of the FCS including its three subscales was provided, and the psychometric properties were examined in 430 participants from four different samples: (a) a sample from the general population; (b) a mixed sample of psychiatric residential and outpatients; (c) a clinical sample of residential and outpatients with a primary diagnosis of BPD and (d) a sample of healthy control participants. Internal consistencies were excellent for the German version of the FSC and acceptable to excellent for its subscales. Correlations with established measures of mental health demonstrate its validity. Additionally, the German FCS discriminates significantly between individuals from the general population and patients, thus supporting its specificity. The German FCS is suitable to detect potential obstacles in cultivating compassion in psychotherapeutic treatments and beyond.

Psychometric properties of the German version of the Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS).

Self-criticism is significantly associated with a variety of mental health difficulties affecting vulnerability, presentation, progress, and recovery. In contrast, self-reassurance is associated with good mental health, psychological well-being, and beneficial physiological processes. The 22-item Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS) is an internationally used self-report questionnaire for measuring manifestation and changes in different types of self-criticism and self-reassurance. It has been shown to be a valid and reliable measure in clinical and nonclinical samples. In the present study, a German translation of the FSCRS and its 3 subscales (hated self, inadequate self, reassured self) was provided, and the factor structure and psychometric properties were examined in 415 participants from 4 different population samples: (a) a sample from the general population, (b) a sample of psychiatric residential and outpatients, (c) a clinical sample of residential and outpatients with a primary diagnosis of borderline personality disorder (BPD), and (d) a sample of healthy control participants. Results from confirmatory factor analysis favored a 3-factor solution of the German FSCRS. Furthermore, findings indicate that the German version of the FSCRS and its subscales had good to excellent internal consistencies. Convergent validity was good for all 3 subscales as shown by medium to large correlations with established measures of self-criticism, self-compassion, self-esteem, satisfaction with life, symptoms of depression and anxiety, and secure attachment styles. Additionally, the 3 FSCRS subscales discriminated significantly between the clinical and nonclinical samples, with the BPD sample demonstrating significantly higher levels than the other samples on the hated self subscale. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Compassion and Loving-Kindness Meditation: An Overview and Prospects for the Application in Clinical Samples.

OBJECTIVES: This article presents a brief overview of the empirical evidence of well-established mindfulness interventions and an in-depth review of less-established compassion-based interventions (CBIs) and loving-kindness meditation (LKM). Definitions, cognitive and physiological mechanisms, and methods of assessment are discussed. METHOD: A literature review using the databases Google Scholar, PsycINFO, and PubMed was conducted. RESULTS: Whereas the efficacy of mindfulness-based stress reduction and mindfulness-based cognitive therapy has been documented in many trials, only seven randomized, controlled trials have been completed on CBIs and LKM. In these trials, CBIs were effective in treating psychotic disorders, affective disorders with psychotic features, major depressive disorder, eating disorders, and patients with suicide attempts in the past year; LKM was effective in treating chronic pain; and a combination of both was effective for borderline personality disorder. A larger number of nonrandomized studies indicate that CBIs and LKM may be effective in treating a wide range of clinical conditions, including depression, anxiety disorders, chronic pain, and posttraumatic stress disorder. CONCLUSIONS: Further studies are needed to confirm the promising effects of CBIs and LKM. Preliminary evidence suggests that both approaches might be beneficial across various clinical populations. Future studies need to clarify whether these approaches might be options as stand-alone treatments or as adjuncts or augmentation of evidence-based methods in psychotherapy.

Effects of a 12-Week Mindfulness, Compassion, and Loving Kindness Program on Chronic Depression: A Pilot Within-Subjects Wait-List Controlled Trial.

In this pilot study, N = 11 patients suffering from chronic depression were treated in a 12-week group program consisting of basic mindfulness exercises from Mindfulness-Based Cognitive Therapy and compassion exercises from Compassion Focused Therapy and Loving Kindness Meditation. In a 3-month waiting period prior to treatment, depression symptoms both in self-report and clinician rating did not change significantly. After treatment, depression severity was significantly reduced. After a 3-month follow-up, the symptoms further improved, with almost large effect sizes being observed in primary outcome measures.Changes in emotion regulation styles reflected by a significant increase in acceptance and significant decrease in suppression of emotions were observed at follow-up. Rumination about oneself was also significantly reduced at follow-up. Compassionate love and mindfulness were increased at follow-up, no effects were found on the Self-Compassion Scale and the Rosenberg Self-Esteem Scale. Given further confirming studies for this approach, it might improve treatment options for patients suffering from chronic depression.