Chair: Keith Dobson
10:30 Impairment and participation restriction in patients with mental disorders: treatment
goal in cognitive behaviour therapy
Michael Linden, Charité Univesity Medicine
10:45 Mapping negative influences of Facebook using network methodology
Lien Faelens; Kristof Hoorelbeke; Eiko Fried; Rudi De Raedt; Ernst H.W. Koster, Ghent
University and University of Amsterdam
11:00 Be a Mom, a web-based intervention to prevent postpartum depression: Results from a
pilot randomized controlled trial
Ana Fonseca, Stephanie Alves, Fabiana Monteiro, University of Coimbra
Ricardo Gorayeb, University of São Paulo
Maria Cristina Canavarro, University of Coimbra
11:15 The barriers for exposure-based interventions and how practitioners see it
Juergen Hoyer, Andre Pittig, Technische Universitaet Dresden
11:30 Effects of stressor controllability and emotion regulation on refugee mental health
Lillian Le, Michelle Moulds, Angela Nickerson, University of New South Wales
1)Impairment and participation restriction in patients with mental disorders: treatment goal in cognitive behaviour therapy
Michael Linden, Charité Univesity Medicine
Mental illness does not only result in symptoms but also impairment and restrictions in participation. While there are many treatment modalities for symptoms of illness, capacities to cope with life and support of participation accross different areas of life can only be addressed by psychotherapy. These are therefore most important treatment targets for psychotherapy in general and behavior therpy in particular. Goal of the present study has been to investigate the rate of participation restrictions in outpatients with mental disorders in the perspective of the patient and the therapist. Method 307 mentally ill outpatients in general practice filled in the IMET, a self-rating instrument for the asessment of disability. During a comprehensive clincial assessment, a psychotherapist filled in the IMEP, a parallel observer rating scale, and also the Mini-ICF-APP, which describes the profile of capacity limitations in respect to soft skills. Result The IMET impairment score is M = 4.09 and the IMEP score M = 3.57, reflecting "mild to moderate" impairment, with lowest scores for activities of daily living and most impairment in relation to work and stress. Patients and physician see the same spectrum of disabilities, but patients see themselves as more impaired. Participation restrictions were correlated with capacity limitations. Discussion Patients with mental disorders show relevant rates of participation impairment across different areas in life, and especially in relation to work. Patients and physicians have similar but also divergent views and should be seen as complementary. The type and spectrum of capacity limitations and participation restrictions can define treatment targets in cognitive behavior therapy.
2) Mapping negative influences of Facebook using network methodology
Lien Faelens; Kristof Hoorelbeke; Eiko Fried; Rudi De Raedt; Ernst H.W. Koster, Ghent University and University of Amsterdam
Social networking sites (SNS) are an important part of everyday life. With 2.13 billion visitors per month, Facebook is currently the most widespread SNS, followed by Twitter and LinkedIn. Given the importance of this SNS, researchers have become increasingly interested in possible negative consequences of Facebook use on mental health. For instance, Facebook use has been related to decreased mental well-being, as often shown by elevated depressive or anxiety symptoms. Yet, empirical evidence for this association is mixed, raising the question under which conditions Facebook use is related to negative outcome measures. Our study addresses this by investigating the relationship between Facebook use, rumination, depressive, anxiety-, and stress-related symptoms, taking into account potential key variables such as social comparison, contingent self-esteem and global self-esteem. Method. In a first cross-sectional study, we used network analysis to explore the unique relations between our variables of interest. As a second step - and to our knowledge for the first time in empirical studies on network models in psychology - we conducted a power analysis to determine the optimal sample size for a preregistered replication study. More information about the preregistration of study 2 can be accessed at https://osf.io/ahgxk/. Results. Both studies showed a highly similar network structure in which social comparison and (contingent and global) self-esteem held a central position in the network, connecting social media use with indicators of psychopathology. Discussion. Our findings are consistent with the rapidly growing literature suggesting that social comparison might mediate the relationship between Facebook use and depressive symptomatology. Because Facebook profiles tend to strategically emphasize people’s most desirable traits, Facebook users are constantly exposed to the positive life events and successes of others. Consequently, they might be comparing their (truthful) offline selves to strategically presented online profiles of others which could lead induce feelings of inferiority. Surprisingly, less research focused on the relationship between Facebook, (contingent) self-esteem and well-being. Therefore, the current studies serve as an initial step in relating these constructs and highlights the prominent role of both self-esteem and social comparison in the context of social media and mental health. Conclusion. Our study provides key insights on which psychological factors are involved in the association between Facebook use and risk for affective disorders. Further in-depth studies, using longitudinal and experimental designs, will be needed to further support these novel findings. Subsequently, evidence-based guidelines should be developed to inform adolescents and young adults on how to prevent negative effects of Facebook use.
3) Be a Mom, a web-based intervention to prevent postpartum depression: Results from a pilot randomized controlled trial
Ana Fonseca; Stephanie Alves; Fabiana Monteiro; Center for Research in Neuropshychology and Cognitive-Behavior Intervention, University of Coimbra, Portugal;
Ricardo Gorayeb, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brasil; Maria Cristina Canavarro, Center for Research in Neuropshychology and Cognitive-Behavior Intervention, University of Coimbra, Portugal.
Be a Mom is a self-guided web-based intervention, grounded on Cognitive Behavioral Therapy principles, delivered at postpartum women to prevent PPD. This pilot study aimed to evaluate the Be a Mom considering: a) preliminary evidence of efficacy; b) feasibility of the intervention; and c) acceptability of the intervention. Method: A pilot randomized, two-arm controlled trial was conducted. Women were eligible to participate if they were in the early postpartum period (up to 3 months postpartum) and presented PPD risk factors or early-onset symptoms. Participants in both groups completed baseline (T1) and post-intervention (8 weeks after) assessments (T2).
194 women were randomly allocated to the intervention group (n=98) or to the control group (n=96). In the intervention group (p=.013), a significantly higher number of women ceased to have clinically relevant depressive symptoms, from T1 to T2. Of the 98 women who registered at Be a Mom, 41.8% (n=41) completed the program. More than half of dropouts (50.9%) occurred before completing any module. Most women (71.4%) would use Be a Mom again and would recommend it to a friend in a similar situation (83.9%). Moreover, they consider that Be a Mom has helped them to feel better about themselves (72.2%). 27.0% consider that Be a Mom is very demanding.
Results provide preliminary evidence of the efficacy of Be a Mom in reducing early-onset depressive symptoms among at-risk women. Dropout rates are similar to other self-guided interventions. Despite acceptability indicators are also promising, there is room for improvements before conducting further evaluations
4) The barriers for exposure-based interventions and how practitioners see it
Juergen Hoyer; Andre Pittig, Technische Universitaet Dresden
The present study aimed to provide more insight into the dissemination barriers of exposure-based interventions. The self-reported frequency of using exposure and four categories of potential barriers were examined: i) barriers regarding the practicability of exposure-based intervention, ii) therapist distress related to the use of exposure, iii) negative beliefs about exposure, and iv) problematic health care regulations. In addition, the self-reported competence to conduct exposure was assessed for different anxiety disorders. A survey covering the above-mentioned variables was developed and sent to licensed behavioral psychotherapists working in outpatient routine care in two regions of Germany. N = 684 licensed therapists responded. All categories of barriers proofed relevant, with practicability issues (e.g., time management, cancellation of sessions) being approved most frequently. All categories were negatively correlated with self-reported utilization rates. In addition, all barriers were positively inter-correlated to a moderate degree and negatively correlated with the subjective competence to conduct exposure. Personal and health-care system variables interact in promoting versus blocking the dissemination of exposure. Ideas to enhance the appropriate routine usage of exposure via improving training and supervision will be put forward and discussed
5) Effects of stressor controllability and emotion regulation on refugee mental health
Lillian Le, Michelle Moulds , Angela Nickerson, University of New South Wales, Sydney, NSW, Australia
Refugees are exposed to multiple traumatic events and ongoing stressors. Unsurprisingly, they demonstrate high rates of psychological disorders, including posttraumatic stress disorder and depression. However, the psychological mechanisms underlying refugee psychopathology remain unclear. One possible mechanism underlying refugee mental health is the degree of control, or lack thereof, the individual experiences over a stressful situation. Preliminary evidence from non-refugee studies suggest that in the context of uncontrollable stress, emotion-focused coping strategies such as cognitive reappraisal may be potentially useful in reducing distress. This study investigated the effects of stressor controllability and emotion regulation on psychosocial outcomes among individuals from refugee backgrounds. Participants were 37 refugees and asylum seekers assigned to an experimental condition where they had control or no control over the viewing duration of trauma-related images. Next, participants were randomly assigned to reappraise or ruminate about their emotional responses to the images. While data collection is ongoing, preliminary findings revealed that cognitive reappraisal led to lower levels of negative affect compared to rumination, regardless of controllability condition, and this effect is influenced by current posttraumatic stress symptoms. The findings suggest that not all coping strategies are equally effective, and may be influenced by current psychological symptoms and other psychosocial factors.