Clinical Psychology in Europe

Does Body Checking Regulate Emotions? An Experimental Study on Appearance- and Health-Related Body Checking

2026-02-27T00:35:19+00:00

Background: Body checking (BC) is widespread among healthy populations and in individuals with eating disorders (EDs), body dysmorphic disorder (BDD), and illness anxiety disorder (IAD). Etiological models of these three disorders originate from research on obsessive-compulsive disorder and propose a short-term reduction of negative affect after BC. However, as empirical evidence shows a heterogenous pattern regarding the reduction of negative affect, the primary objective of this study was to test the etiological models in a cross-over laboratory experiment. Method: After induction of negative affect, N = 102 healthy females underwent a 10-min BC task, in which they were randomly assigned to perform ED-, BDD-, or IAD-related BC, and a 10-min control checking condition of checking the characteristics of two vases. Before and after each task, participants completed state questionnaires on affect and disorder-specific pathology. Results: The results revealed increased negative affect and disorder-specific pathology from before to after BC, but a reduction of these variables after the control checking condition. Conclusion: Thus, contrary to expectation, the theory explaining reduced negative affect in compulsive checking may not directly be applicable to ED-, BDD-, and IAD-related BC in healthy populations, thus providing evidence of the dysfunctionality of BC in the short term.

Mental Health Professionals’ Attitudes Towards the Network Theory of Mental Disorders

2026-02-27T00:35:16+00:00

Background: The network theory describes mental disorders as a network of interacting symptoms. While most research on the network theory is based on network analyses of symptom data, little is known about mental health professionals´ attitudes towards this theory. Clinical expertise could offer a valuable additional perspective on the validity of the theory and its applications to clinical practice. Method: Mental health professionals rated their agreement with propositions of the network theory regarding the phenomenology, aetiology, and treatment of mental disorders in an online survey. Further, the acceptability and appropriateness of possible applications were evaluated. We calculated descriptive statistics and examined associated factors with regression analyses. Results: The participating psychotherapists (n = 183), specialized physicians (n = 45), and clinical psychologists (n = 29, total n = 257) largely agreed with the network theory’s propositions regarding the phenomenology of mental disorders and treatment effects. Appraisal of the network theory regarding the aetiology of mental disorders, regarding important treatment targets, and regarding acceptability and appropriateness of possible applications was mixed. A theoretical background in cognitive behavioural therapy and previous knowledge of the network theory were associated with a stronger agreement in most domains. Conclusions: The fundamental assumptions of the network approach seem to resonate with mental health professionals, while the consequences for the diagnosis and treatment of mental disorders were questioned. Our findings indicate that the general conceptualization of mental disorders as symptom networks seems to align with mental health professionals’ perceptions but, at the same time, emphasizes the novelty and limited specificity of the theory’s implications for clinical practice.

Theoretical Orientations and the Stereotype Content Model – Are Prejudices Barriers to Psychotherapy Integration?

2026-02-27T00:35:15+00:00

Background: Despite efforts to integrate psychotherapy, the field remains fragmented into distinct theoretical orientations and practical approaches. Prejudices held by psychotherapists towards those from other theoretical orientations may hinder cooperation in research and clinical practice. This study examines stereotypes among psychotherapists from different theoretical orientations and practical approaches (‘psychotherapy schools’) towards their in-group and out-group colleagues. Method: The cross-sectional online study assessed socially shared evaluations of ‘warmth’ and ‘competence’ from the stereotype content model in a sample of 586 German psychotherapists (60.9% licensed; 39.1% in training) from different psychotherapy schools (34.5% psychoanalytic and psychodynamic psychotherapists, 19.8% psychodynamic psychotherapists, 28.7% cognitive behavioural therapists, and 17.1% systemic therapists). Linear mixed-effects models were used to examine differences in evaluations based on the rater’s and the rated psychotherapy school. Results: The psychotherapists' assumed socially shared evaluations of ‘warmth’ and ‘competence’ varied depending on their psychotherapy school affiliation, with significantly higher evaluations assigned to their in-groups than to their out-groups. Conclusion: The results indicate in-group biases in the social perception of psychotherapists with different theoretical orientations, representing potential barriers to inter-group contact and collaboration. Addressing prejudices is key to strengthening integrative competence in both research and clinical practice.

Conducting Behavioural Experiments Using an App-Based Self-Help Program for Social Anxiety Disorder (SMASH): Outcomes of a Quasi-Experimental Pre-Post Pilot Trial

2026-02-27T00:35:19+00:00

Background: Social Anxiety Disorder (SAD) is a prevalent mental disorder characterised by fear of negative evaluation. Although effective treatment approaches are available, access remains limited due to psychological and organisational barriers. Internet-based cognitive behavioural therapy (iCBT) has shown promising results and may facilitate an easy and more resource-efficient access to treatment. Method: We developed an app-based self-help intervention for SAD based on the Clark and Wells treatment program, implemented as an unguided smartphone application, which was evaluated in this quasi-experimental pre-post pilot study consisting of N = 33 patients with a primary diagnosis of SAD. Feasibility was assessed through usage parameters and qualitative feedback. Effectiveness was evaluated in regard to SAD and depression, using clinician-rated measures (LSAS, QIDS-C) at post-treatment (12 weeks) and self-report measures (SPIN, SCQ, BDI-FS) at midpoint and post-treatment. Additionally, moderating effects of usage parameters on symptom reduction were examined. Results: Clinician- and self-reported SAD symptoms were significantly reduced at post-measurement (within-group effect sizes LSAS: η2 = .54; SPIN: η2 = .47), with 52% of patients achieving a clinically significant improvement. Despite moderate overall adherence, the amount of conducted behavioural experiments moderated reduction in self-reported SAD symptom severity and SAD-related cognitions. Open feedback supported feasibility and acceptability of the app. Conclusion: In conclusion, findings provide preliminary support for feasibility, acceptability, and potential effectiveness of Mindable: Soziale Phobie. A randomised controlled trial will further evaluate the effectiveness and explore the impact of therapist guidance.

Insufficient Quality of Mental Health Information on German-Speaking TikTok: A Content Analysis

2026-02-27T00:35:17+00:00

Background: The increasing popularity of mental-health information on social media platforms such as TikTok is raising concerns regarding misinformation. Previous research is limited to single disorders and videos in the English language only. Our objective was to investigate the quality of mental health information on German-language TikTok for a broader spectrum of disorders. Method: Thirty German-language TikTok-videos of each of the six most viewed hashtags on mental disorders (attention-deficit and hyperactivity disorder (ADHD), depression, autism, anxiety disorder, narcissism and post-traumatic stress disorder (PTSD)) were classified regarding authorship and rated either as “correct”, “overgeneralized”, “incorrect” or “subjective experience”. The modified DISCERN (mDISCERN) and the Global Quality Scale (GQS) were used to rate reliability and quality of information for patients. Results: The 177 videos finally included in this study gathered a total of 94,348,220 views and 19.2% (n = 34) of the videos were rated as correct, 33.3% (n = 59) as incorrect, 18.1% (n = 32) as overgeneralized and 29.4% (n = 52) as personal experience. Chi-Square tests and Kruskal-Wallis tests showed significant relationships between either authorship or diagnosis and quality and reliability. Videos on PTSD and videos by expert authors showed the best and videos on narcissism and videos by laypeople the worst overall results. Conclusion: With around half of the analyzed videos supplying incorrect information, the quality of German-language TikTok mental health content is insufficient. Differences in the quality of content seem to be influenced by the topic and the authorship. Healthcare institutions and clinicians should be aware of this, educate patients accordingly, and could improve the quality of information by participating in online discourses.

The Need for a Translational Model of Childhood Maltreatment: From Research to Principles to Action

2026-02-27T00:35:15+00:00

No abstract available.

The Relationship Between Body Dysmorphic Symptoms, Depressive Symptoms and Suicidality – A Mediation Analysis

2026-02-27T00:35:18+00:00

Background: Body dysmorphic disorder (BDD) is characterized by an excessive preoccupation with perceived appearance flaws, often accompanied by repetitive behaviors such as frequent mirror checking. It is further associated with severe occupational and social impairments, depression, and high levels of suicidality, including suicidal thoughts, suicide attempts and completed suicide. Given the high rates of depression and suicidality found in BDD, this study aimed to examine whether BDD symptoms may also be directly linked to suicidality, independent of depressive symptoms. Method: A mediation analysis was conducted to investigate the relationships between BDD symptoms, depression, and suicidality. Cross-sectional data were collected through an online self-test for BDD, assessing BDD symptoms, depression and suicidality. A total of 1,256 participants (aged 18–71; 72% female) met DSM-5 criteria for BDD (based on self-report). Results: Depressive symptoms partially mediated the relationship between BDD symptoms and suicidality. However, a direct association between BDD symptoms and suicidality was also observed, indicating that suicidality in individuals with BDD is not solely attributable to comorbid depressive symptoms. Conclusion: The findings underscore the need for thorough suicidality assessments in individuals with BDD, regardless of the presence of depressive symptoms. This further highlights the importance of targeted interventions to address suicidality in this population.

Transdiagnostic Network Mapping of Psychopathology in Daily Life: Rationale and Research Protocol

2025-11-28T01:00:45+00:00

Background: The burden of mental health problems and the need for more effective interventions is well established. One path towards treatment improvement involves more effective (evidence-based) tailoring, which requires a deeper understanding of differences in individual profiles of psychopathology. The network approach to mental disorders has emerged as a promising framework in this regard, as it sees and assesses psychopathology as individual networks of interacting symptoms and other variables and uses analysis methods that allow fine-grained analyses of (differences in) individual processes. Method: We describe the protocol of a 6-week ecological momentary assessment (EMA) study in a broad clinical population, designed to capture various transdiagnostic psychopathology relevant states. Participants are Dutch adults (desired = 600) who are currently awaiting intake- or start of treatment for psychopathology. In addition to EMA self-reports, we collect digital phenotyping data, a broad range of baseline data on symptomatology and transdiagnostic traits, and diagnostic classifications after intake. The study’s primary aims are to estimate individual- and group networks of psychopathology (identifying), explore what factors can explain individual differences in networks (linking), and identify potential subgroups based on the networks (clustering). Finally, we plan to evaluate the measures and procedures to facilitate future transdiagnostic EMA (network) research. Discussion: The prospective study findings have the potential to advance the description, prediction, and assessment of psychopathology and to evaluate the utility of the network framework in achieving these aims. The insights gained may facilitate the evaluation and refinement of current classifications of mental health conditions and alternative transdiagnostic approaches.

Structured Diagnostic Interviews in Psychotherapy Training: Trainees’ Beliefs About Interviews and Their Relationship to Overall Interview Satisfaction

2025-11-28T01:00:40+00:00

Background: Structured diagnostic interviews (SDIs) are frequently used in science and are highly recommended for diagnosing mental disorders in clinical practice. However, the actual SDI familiarity and use among psychotherapy practitioners is limited. To identify opportunities for training improvement and ensure a frequent SDI application by future practitioners, data on SDI experiences and beliefs among current psychotherapy trainees is essential. Method: N = 233 psychotherapy trainees completed an online survey that included questions about their SDI experiences, use, beliefs, and their estimation of patient SDI satisfaction and acceptance. In addition, adherence to psychotherapeutic orientation and personality factors were assessed. Correlation between SDI satisfaction and familiarity was computed. Multiple linear regression analysis was performed to predict trainees’ SDI satisfaction by beliefs about SDIs. Exploratory correlations between SDI satisfaction, adherence to psychotherapeutic orientations, and personality factors were analyzed. Results: SDI familiarity was significantly related to trainees’ overall SDI satisfaction. Both positive (e.g., “SDIs are efficient”) and negative (e.g., “SDIs disturb the relationship to patients”) beliefs about SDIs predicted trainees’ overall satisfaction. Small relationships were found between SDI satisfaction and adherence to psychotherapeutic orientation, but none to personality factors. Conclusion: Psychotherapy training programs should provide sufficient opportunity for SDI practice to promote trainee satisfaction. Training providers should address trainees’ beliefs and concerns, underline advantages of SDIs, and inform about actual SDI acceptance among patients to resolve prejudice. Trainees’ personality appears to be less relevant to SDI satisfaction, but further investigations are needed. The findings have important implications for overcoming barriers to the use of structured diagnostic interviews.

Dissociative Experiences and Substance Use Disorder in Adulthood After Childhood Trauma: A Systematic Review of the Literature

2025-11-28T01:00:40+00:00

Context: Childhood trauma is more prevalent among individuals with substance use disorders compared to the general population, representing a significant public health concern. The presence of comorbid dissociative symptoms poses a significant challenge for psychological care. Objectives: We conducted a systematic review of the literature, using the PRISMA method, to establish the relationship between dissociative experiences and substance misuse in adults who have experienced traumatic childhood events. Method: We used electronic databases (PubMed, PsycInfo, PsycArticles, Web of Science and ProQuest) up to August 2023. Studies were selected which included adults over 18 years old who had been exposed to one or more traumatic events in childhood, and which jointly assessed Substance Use Disorder (SUD) and dissociation, using quantitative methodology. The review included both cross-sectional and longitudinal studies, with the risk of bias assessed using the AXIS tool and the Qualitative Assessment Tool for Observational Cohort and Cross-Sectional Studies. The results are entered in a table and analyzed using a narrative summary. Results: Among the 18 included studies, encompassing a total of 6,451 participants, the majority (n = 10) showed a significant positive correlation between dissociative experiences and SUD. The studies collectively indicate a general trend: childhood traumatic antecedents can influence the severity of dissociative symptomatology and SUD. Discussion: These results are discussed in greater depth in relation to the two main theories explaining the link between SUD and dissociation, namely self-medication and chemical dissociation theory. This paper clarifies the relationship between dissociation and substance use in a population traumatized in childhood, although the heterogeneity of the studies necessitates a cautious interpretation of this primary finding.