High numbers of people present with common mental health disorders and co-morbid personality disorder traits in primary care ‘Improving Access to Psychological Therapies’ (IAPT) services in England and they receive sub-optimal treatments. No previous studies have explored the treatment experiences or needs of this patient population in England.

This qualitative study explored the treatment experiences of patients (n = 22) with common mental health difficulties and co-morbid personality disorder as indicated by a score of 3 or more on the ‘Standardised Assessment of Personality – Abbreviated Scale’ (SAPAS) in receipt of primary care-based IAPT treatment.

A qualitative health research approach was used. Qualitative individual face-to-face semi-structured interviews were conducted. All interviews were audio recorded, data were transcribed verbatim and analysed using a framework analysis approach.

Findings revealed a need to adapt away from prescriptive cognitive behavioural therapy (CBT) treatment models towards more flexible, personalised and individualised treatment with this patient group. Time to emotionally offload, build a therapeutic relationship and link past experiences to presenting problems were highlighted as important.

For the first time, the needs and treatment experiences of this patient group have been explored. This paper provides a unique patient experience insight that should be considered when exploring new approaches to working with and developing effective interventions via a stepped care approach.

Social anxiety disorder (SAD) is common in youths. However, our understanding of SAD in children is inferior to that of SAD in adolescents or adults, and it is unclear if known adult SAD maintenance mechanisms may also operate in children with SAD.

The paper sets out to investigate the specificity of positive automatic thoughts, social threat negative automatic thoughts, repetitive negative thinking, positive and negative metacognitions in predicting SAD symptoms and diagnoses in clinically anxious children.

We enrolled 122 clinically anxious children aged 7–13 years; of these, 33 had an SAD diagnosis.

SAD symptoms correlated positively with social threat negative automatic thoughts, repetitive negative thinking, and negative metacognitions, and negatively with positive automatic thoughts. Linear regression indicated that, of these variables, only social threat negative automatic thoughts predicted social anxiety symptoms. Logistic regression indicated that social threat negative automatic thoughts, a higher number of diagnoses and negative metacognitive beliefs specifically predicted the presence of SAD diagnosis.

Our findings suggest that content-specific social threat negative automatic thoughts was the only variable that specifically distinguished both higher levels of social anxiety symptoms and diagnoses.

Perinatal mental illnesses are a major public health issue, which untreated can have devastating impacts on women and their families. Problems with emotion regulation are a common feature across perinatal mental illnesses.

This study sought to evaluate the impacts of dialectical behaviour therapy (DBT) skills groups for mothers and babies in a community perinatal service. We hypothesised that community perinatal DBT skills groups that included babies would reduce distress and improve emotional regulation.

A mixed-methods within-subjects design was utilised with outcome measures collected pre- and post-intervention. Qualitative interviews exploring mothers’ experiences of bringing their baby to group were also conducted.

Results indicated that DBT skills groups significantly improved levels of psychological distress and emotional regulation.

Community perinatal DBT skills groups are effective when babies are present. Moreover, benefits of including babies were identified, under the themes of Self as Mother, Shared Experience, and Impact of Babies.

One of the main health-related worries for older adults is becoming dependent. Even healthy older adults may worry about becoming dependent, generating guilt feelings due to the anticipation of future needs that others must solve. The guilt associated with self-perception as a burden has not been studied in older adults, and there is no instrument available to measure these feelings.

To adapt the Self-Perceived Burden Scale (SPBS; Cousineau et al., 2003) for the assessment of feelings of guilt for perceiving oneself as a burden for the family in older adults without explicit functional or cognitive impairment.

Participants were 298 older adults living independently in the community. Participants completed the assessment protocol, which included measures of guilt associated with self-perception as a burden, depressive and anxious symptomatology, self-perceived burden, and sociodemographic information.

Results from exploratory, parallel and confirmatory factor analyses suggest that the scale, named Guilt associated with Self-Perception as a Burden Scale (G-SPBS), has a unidimensional structure, explaining 57.04% of the variance of guilt. Good reliability was found (Cronbach’s alpha = .94). The results revealed significant (p < .01) positive associations with depressive and anxious symptomatology.

These findings suggest that the G-SPBS shows good psychometric properties which endorse its use with healthy community older adults. Also, guilt associated with perceiving oneself as a burden seems to be a relevant variable that can contribute to improving our understanding of psychological distress in older adults.

Evidence-based treatment for panic disorder consists of disorder-specific cognitive behavioural therapy (CBT) protocols. However, most measures of CBT competence are generic and there is a clear need for disorder-specific assessment measures.

To fill this gap, we evaluated the psychometric properties of the Cognitive Therapy Competence Scale (CTCP) for panic disorder.

CBT trainees (n = 60) submitted audio recordings of CBT for panic disorder that were scored on a generic competence measure, the Cognitive Therapy Scale – Revised (CTS-R), and the CTCP by markers with experience in CBT practice and evaluation. Trainees also provided pre- to post-treatment clinical outcomes on disorder-specific patient report measures for cases corresponding to their therapy recordings.

The CTCP exhibited strong internal consistency (α = .79–.91) and inter-rater reliability (ICC = .70–.88). The measure demonstrated convergent validity with the CTS-R (r = .40–.54), although investigation into competence classification indicated that the CTCP may be more sensitive at detecting competence for panic disorder-specific CBT skills. Notably, the CTCP demonstrated the first indication of a relationship between therapist competence and clinical outcome for panic disorder (r = .29–.35); no relationship was found for the CTS-R.

These findings provide initial support for the reliability and validity of the CTCP for assessing therapist competence in CBT for panic disorder and support the use of anxiety disorder-specific competence measures. Further investigation into the psychometric properties of the measure in other therapist cohorts and its relationship with clinical outcomes is recommended.

Prior theory and research has implicated disgust as relevant to some, but not all phobias.

The current study examined whether anxiety sensitivity is more relevant to certain specific phobias and whether disgust sensitivity is more relevant to other specific phobias.

Participants (n = 201) completed measures of anxiety sensitivity, disgust sensitivity and measures of aversive reactions in the presence of two fear-relevant stimuli (i.e. heights and small, enclosed spaces) and two disgust-relevant stimuli (i.e. spiders and blood/injury).

Results of multiple linear regression analyses revealed that disgust sensitivity showed significant associations with aversive reactions in all four stimulus domains after controlling for anxiety sensitivity. After controlling for disgust sensitivity, anxiety sensitivity showed associations with the two fear-relevant phobias but not with the two disgust-relevant phobias included in this study. Anxiety sensitivity also showed an association with variance specific to one of the two fear-relevant specific phobias included in the study. Disgust sensitivity also showed associations with variance specific to both of the disgust-relevant phobias included in the study but not with variance specific to either of the fear-relevant specific phobias.

These results provide evidence that the distinction between fear-relevant and disgust-relevant specific phobias is meaningful and also implicate disgust sensitivity as relevant to aversive reactions to all stimuli included in this study.

Prior research has partially verified the significance of child temperament and styles of upbringing for schema intensity. However, there is still a lack of understanding of the inter-relations between them.

The present study examined how temperament (stable and labile) and style of parenting (positive and negative) are related to each other, and to early maladaptive schemas.

Participants (395 healthy adults) completed the Young Schema Questionnaire YSQ-S3 and the Retrospective Assessment of Parents’ Attitudes and Formal Characteristic of Behaviour – Temperament Inventory (FCB-TI). Structural equation modelling was used to verify hypotheses.

Temperament and parental styles together explain more than 59% of the variance of schema intensity. The obtained path coefficients show one-way directions of inter-relations. Stable temperament connects to schemas directly with a negative path coefficient. Labile temperament shows a significant positive association with negative parental attitudes, but not directly with schemas. Negative parenting is positively connected with schemas. A positive style of parenting is not significantly connected with temperament and schemas.

Results show evidence that negative style of parenting and labile temperament features are more important for schema developing and may be treated as risk factors. Because temperament seems to be a relatively persistent feature, it may play a similar role in adulthood, reinforcing emotions and feelings in the context of environment, and then maintain the schemas.

Psychological inflexibility and emotional dysregulation are a hallmark of psychopathology, being intrinsically embedded in emotional and personality disorders. However, the transdiagnostic mechanisms of psychological inflexibility and emotional dysregulation domains are still a matter of discussion.

The present study aims to explore the relationships between cognitive fusion (as a measure of psychological inflexibility), emotion regulation strategies, such as cognitive reappraisal and emotional suppression and emotional dysregulation domains in two different samples.

In a cross-sectional design, 297 individuals were assessed with self-report measures and divided into non-clinical (n = 231) and clinical samples (n = 66), according to diagnosis.

Results showed that the degree of cognitive fusion was higher in the clinical sample. However, significant correlations between cognitive fusion, emotional regulation strategies and emotional dysregulation domains were found in the two samples. Cognitive reappraisal and emotional dysregulation domains predicted cognitive fusion and mediated the relationship between cognitive fusion and symptomatology in the two samples.

Relationships between cognitive fusion and emotional dysregulation domains were found independent of diagnosis. The implementation of emotion regulation strategies may be related to individual differences. However, cognitive fusion, reappraisal and lack of strategies may be core transdiagnostic features in psychological inflexibility and emotion dysregulation.

Treatments for cancer-related anxiety show modest benefits, but most have been trialled in patients with early stage disease or patients who are currently disease free. However, many patients with cancer have incurable disease, or their disease is slowly progressing or likely to recur. Treating anxiety in the context of realistic threat and ongoing uncertainty is particularly challenging. Based on a theoretical model of cancer-related anxiety, we developed a transdiagnostic intervention for patients with advanced or recurred disease who are experiencing clinically significant anxieties. The intervention was a novel integration of traditional and contemporary CBT.

To evaluate the feasibility, acceptability and preliminary efficacy of the intervention in a pilot with patients with advanced or recurred cancer.

Twelve patients with advanced or recurred cancer, who were experiencing anxiety, participated. Feasibility and acceptability were assessed with participant’s ratings and adherence and retention rates. Psychological outcomes (anxiety, traumatic symptoms, fear of progression, depression, death anxiety and quality of life) were assessed pre-intervention, post-intervention and at 2-month follow-up.

Eleven of the 12 participants completed at least five therapy sessions of whom eight completed all nine sessions. Participants rated the intervention as having excellent face validity. Post-intervention, statistically significant improvements were demonstrated for anxiety, traumatic symptoms, fear of progression, depression and quality of life. These improvements were maintained at follow-up for anxiety, traumatic symptoms and depression.

This pilot provides preliminary evidence for the feasibility, acceptability and effectiveness of the novel intervention for cancer-related anxiety in the context of advanced disease.