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Individualized Bio- Psycho- Social Interventions for Youth with Mental Disorders
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Individualized Bio- Psycho- Social Interventions for Youth with Mental Disorders

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (30 September 2022) | Viewed by 48893

Special Issue Editors

Prof. Dr. Randi Ulberg

E-Mail Website
Chief Guest Editor
Division of Mental Health and Addiction, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
Department of Psychiatry, Diakonhjemmet Hospital, Forskningsveien 7, 0370 Oslo, Norway
Interests: psychotherapy outcome and in-session process; development of assessment tools; specific and non-specific treatment factors; dialogue and mutual learning among psychotherapists, psychotherapy researchers, psychotherapeutic orientations, and the development of new treatment methods
Dr. Henriette Löffler-Stastka

E-Mail Website
Assistant Guest Editor
Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria
Interests: psychotherapy research and training research; therapist variable; psychotherapy/psychoanalysis with severely disturbed patients; psychotic disorders; health care management
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Jan Ivar Røssberg

E-Mail Website
Assistant Guest Editor
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norway
Interests: personalized psychotherapy; moderators; mediators; severe mental disorders; cognitive behavior therapy; randomized controlled trials
Dr. Andrea Saliba

E-Mail Website
Assistant Guest Editor
Department of Psychiatry, University of Malta, MSD 2080 Msida, Malta
Interests: personalized psychotherapy; mediators; moderators; hard to reach young people; mental disorders; neurodevelopmental disorders; service development
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

There is a need for coordinated and multidisciplinary efforts in psychiatry to improve knowledge on individualized psychological treatment for young people. Psychotherapy works for the most frequent mental disorders in youth such as anxiety and depression. Different psychotherapy modalities work on average equally well. However, little is known about how different treatment modalities work (the mechanisms of change/mediators) and for whom (specific markers/moderators). Thus, empirically informed individualized treatment cannot be delivered yet.

50% of lifetime mental health disorders start by the age of 14, and the number increases to 75% by the age of 24. Mental disorders in youth are associated with direct and indirect costs including personal distress, costs to family and friends, high healthcare costs, barriers to employment and job performance, poverty and economic deprivation and social exclusion.

This special issue invites papers that identifies putative specific markers and mechanisms of change in different psychotherapy modalities, psychotherapy process and treatment measures, and study designs, as well as protocol papers, and papers rewiewing the state of the art in the field. Also papers focusing on cost-effectiveness of psychological and social interventions as well as papers integrating a neuroscientific approach and a bio-psychosomatic view are invited.

Prof. Dr. Randi Ulberg
Prof. Dr. Henriette Löffler-Stastka
Prof. Dr. Jan Ivar Røssberg
Dr. Andrea Saliba
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • personalized treatment
  • individualized treatment
  • psychotherapy
  • bio-psychosomatic
  • social interventions

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Published Papers (15 papers)

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Research

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14 pages, 746 KiB  
Article
Maintaining Factors of Anorexia Nervosa Addressed from a Psychotherapeutic Group for Parents: Supplementary Report of a Patient’s Therapeutic Success
by María García-Anaya, Alejandro Caballero-Romo and Laura González-Macías
Int. J. Environ. Res. Public Health 2022, 19(18), 11396; https://doi.org/10.3390/ijerph191811396 - 10 Sep 2022
Viewed by 1327
Abstract
(1) Background: Anorexia nervosa is an eating disorder (ED) where up to 30% of individuals remain unresponsive to treatments, whether they partially respond, or do respond and later relapse. It has been broadly reported how presenting maladaptive family functioning and communication style contributes [...] Read more.
(1) Background: Anorexia nervosa is an eating disorder (ED) where up to 30% of individuals remain unresponsive to treatments, whether they partially respond, or do respond and later relapse. It has been broadly reported how presenting maladaptive family functioning and communication style contributes to treatment drop-out, poor treatment compliance, and poor long-term outcomes. We studied the mother and father of a patient with AN, binge-purge subtype (according to DSM-IV TR) who achieved remission after her parents but not her attended an intervention through a psychotherapy group for parents (PGP). (2) Methods: We previously reported this patient’s case report, and now, through an Interpretative Phenomenological Analysis (IPA) approach, we aimed to explore the understanding and meanings ascribed by the mother and father to their experience at the PGP and to their daughter’s clinical and functional improvement. (3) Results: We identified two main stages along the process: one related to the presence of maintaining factors of their daughter’s disorder, and the other related to the emergence of a reflective function and to the implementation of behavioral, emotional and cognitive changes. (4) Conclusions: The interview revealed both parents’ experience at the PGP promoted a change process, where they were able to modify their previous style of communication and functioning, and to identify them as a contributors to maintain their daughter’s disorder. Reflective function (RF) emerged in the mother and father throughout the psychotherapeutic process. Both parents also revealed some elements that were intergenerationally transmitted, that affected three generations and contributed to maintaining the ED. We observed the multilevel open-group structure of the PGP, enhancing the mother’s and father’s change process. Full article
(This article belongs to the Special Issue Individualized Bio- Psycho- Social Interventions for Youth with Mental Disorders)
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12 pages, 379 KiB  
Article
Personality Disorders as a Possible Moderator of the Effects of Relational Interventions in Short-Term Psychoanalytic Psychotherapy with Depressed Adolescents
by Hans Ole Korsgaard, Randi Ulberg, Benjamin Hummelen, Nick Midgley, Agneta Thorén and Hanne-Sofie Johnsen Dahl
Int. J. Environ. Res. Public Health 2022, 19(17), 10952; https://doi.org/10.3390/ijerph191710952 - 02 Sep 2022
Cited by 1 | Viewed by 1833
Abstract
A significant proportion of adolescents suffering from major depressive disorder (MDD) are likely to have a co-morbid personality disorder (PD). Short-term psychoanalytic psychotherapy (STPP) was found to be one treatment of choice for adolescents suffering from MDD. Background: The first experimental study of [...] Read more.
A significant proportion of adolescents suffering from major depressive disorder (MDD) are likely to have a co-morbid personality disorder (PD). Short-term psychoanalytic psychotherapy (STPP) was found to be one treatment of choice for adolescents suffering from MDD. Background: The first experimental study of transference work-in teenagers (FEST-IT) demonstrated the efficaciousness of transference work in STPP with adolescents suffering from MDD. The usefulness of STPP may be enhanced by exploring possible moderators. Methods: Depressed adolescents (N = 69), aged 16–18 years, were diagnosed with the structured interview for DSM-IV PDs and randomized to 28 weeks of STPP with or without transference work. A mixed linear model was applied. The moderator effect was investigated by a three-way interaction including “time”, “treatment group” and “number of PD criteria”. Results: A small but significant moderator effect was found for cluster B personality pathology. Patients with a higher number of cluster B PD criteria at baseline did better up to one-year post-treatment where therapists encouraged patients to explore the patient–therapist relationship in the here and now. Conclusion: When treated with psychoanalytic psychotherapy for MDD, adolescents with cluster B PD symptoms seem to profit more from transference work than adolescents without such pathology. Full article
(This article belongs to the Special Issue Individualized Bio- Psycho- Social Interventions for Youth with Mental Disorders)
12 pages, 514 KiB  
Article
Why Is Maternal Control Harmful? The Relation between Maternal Control, Insecure Attachment and Antisocial Personality Disorder Features in Chinese College Students: A Sequential Mediation Model
by Hui Ling, Fanfei Meng, Yaqin Yan, Hong Feng, Jianren Zhang, Linrui Zhang and Siyang Yuan
Int. J. Environ. Res. Public Health 2022, 19(17), 10900; https://doi.org/10.3390/ijerph191710900 - 01 Sep 2022
Cited by 2 | Viewed by 2076
Abstract
Background: Previous work has indicated that a negative parenting style is associated with antisocial personality disorder features in Chinese college students, yet few studies have explored the unique role of negative mothering in children’s antisocial personality disorder. Methods: The current study mainly examined [...] Read more.
Background: Previous work has indicated that a negative parenting style is associated with antisocial personality disorder features in Chinese college students, yet few studies have explored the unique role of negative mothering in children’s antisocial personality disorder. Methods: The current study mainly examined the sequential mediation effect of parental antipathy and neglect (PAN) and mother negative loving (a form of insecure attachment) in the association between mother control and adulthood antisocial personality disorder features (ASPD features) in the framework of attachment theory and cognitive–behavioral theory. A community sample of 1547 Chinese college students filled in the Parental Bonding Instrument, the Childhood Experience of Care and Abuse Questionnaire, the Adult Attachment Questionnaire and the Personality Diagnostic Questionnaire-4+. Results: A sequential mediation model analysis showed that maternal control significantly predicted PAN, mother negative loving, as well as ASPD features. Conclusions: Mother control and mother negative loving appear to advance on the development and exacerbation of ASPD features in college students. Full article
(This article belongs to the Special Issue Individualized Bio- Psycho- Social Interventions for Youth with Mental Disorders)
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9 pages, 291 KiB  
Article
A Qualitative Exploration of Parental Views When Comparing Individual to Group Sports in Children with Autism Spectrum Disorder—A Pilot Study
by Daniel Vella Fondacaro, Francesca Vella Fondacaro and Nigel Camilleri
Int. J. Environ. Res. Public Health 2022, 19(11), 6906; https://doi.org/10.3390/ijerph19116906 - 05 Jun 2022
Cited by 1 | Viewed by 2498
Abstract
(1) Background: Physical activity is important for children with autism spectrum disorder. This study aimed to analyse autistic children’s and their parents’ preferences between group and individual physical activity, while exploring potential social barriers that they might encounter. (2) Methods: Retrospective analysis identified [...] Read more.
(1) Background: Physical activity is important for children with autism spectrum disorder. This study aimed to analyse autistic children’s and their parents’ preferences between group and individual physical activity, while exploring potential social barriers that they might encounter. (2) Methods: Retrospective analysis identified 701 new referrals received by the Maltese national child and adolescent mental health service, between 2016 and 2017. Of them, 24 received a sole diagnosis of autism and 10 were chosen via purposive sampling. A semi-structured interview guide was created, including readability testing, translation/back-translation, inter-rater agreements, and focus group testing. Parents were informed, consented, interviewed and thematic analysis carried out. Further quantitative data were tabled accordingly. (3) Results: Only one child met World Health Organisation recommendations for physical activity. More children preferred individual sports while parents described more benefits with group sports. Parents’ perceived benefits with group sports included better socialization, while improved levels of self-esteem and coping with anxiety were highlighted benefits for individual sports. Parents felt misunderstood, burnt out, and described a lack of autism-friendly sports facilities, including geographical disproportionation of adequate facilities on the island. Too much screen time was a major parental concern. (4) Conclusion: Recommendations aim to develop sport therapy systems and well-resourced services in Malta. Staff training is recommended to improve service quality. Full article
(This article belongs to the Special Issue Individualized Bio- Psycho- Social Interventions for Youth with Mental Disorders)
17 pages, 1741 KiB  
Article
Parental Bonding and Relationships with Friends and Siblings in Adolescents with Depression
by Sarah Christine Fahs, Randi Ulberg, Hanne-Sofie Johnsen Dahl and Per Andreas Høglend
Int. J. Environ. Res. Public Health 2022, 19(11), 6530; https://doi.org/10.3390/ijerph19116530 - 27 May 2022
Cited by 3 | Viewed by 2654
Abstract
According to attachment theory, the quality of the early child-parent bond determines the child’s interpersonal relationships later in life. Utilising data from The First Experimental Study of Transference Work-In Teenagers (FEST-IT), the current paper investigated the connection between the self-reported quality of bonding [...] Read more.
According to attachment theory, the quality of the early child-parent bond determines the child’s interpersonal relationships later in life. Utilising data from The First Experimental Study of Transference Work-In Teenagers (FEST-IT), the current paper investigated the connection between the self-reported quality of bonding with mother and father and the self-reported importance of relationships with friends and siblings in adolescents with depression. The scales employed were the Parental Bonding Instrument (PBI) and the Adolescent Relationship scale (ARS). A Pearson’s correlation tested the relationship between the reported levels of maternal and paternal care and control, and the reported importance of friendship and relationship with siblings. Results revealed a statistically significant negative correlation between high levels of maternal control and importance of friendship, and a statistically significant positive correlation between high levels of paternal care and importance of relationships with siblings. The results are in line with Bowlby’s theory of attachment. Full article
(This article belongs to the Special Issue Individualized Bio- Psycho- Social Interventions for Youth with Mental Disorders)
12 pages, 1978 KiB  
Article
Do Sleep Disturbances Improve Following Psychoanalytic Psychotherapy for Adolescent Depression?
by Thea Schønning, Hanne-Sofie Johnsen Dahl, Benjamin Hummelen and Randi Ulberg
Int. J. Environ. Res. Public Health 2022, 19(3), 1790; https://doi.org/10.3390/ijerph19031790 - 04 Feb 2022
Cited by 5 | Viewed by 3708
Abstract
Sleep disturbance is often a prominent symptom in adolescents diagnosed with major depressive disorder (MDD). Recent evidence indicates that short-term psychoanalytic psychotherapy (STPP) for depression may have an effect in reducing co-occurring sleep disturbance in youth. It is unknown if transference work (exploration [...] Read more.
Sleep disturbance is often a prominent symptom in adolescents diagnosed with major depressive disorder (MDD). Recent evidence indicates that short-term psychoanalytic psychotherapy (STPP) for depression may have an effect in reducing co-occurring sleep disturbance in youth. It is unknown if transference work (exploration of the patient–therapist relationship) has an additional effect in reducing sleep disturbance. Adolescents aged 16–18 years (n = 69, 84% female) who met diagnostic criteria for MDD based on the Mini International Neuropsychiatric Interview (M.I.N.I) were randomized to either STPP with transference work or without. Sleep problems were assessed at baseline, therapy session 20 (20 weeks), post-treatment (28 weeks), and one-year follow-up (80 weeks) with the Symptom Checklist-90-R. At baseline, 69% of the adolescents exhibited moderately to extreme sleep difficulties. Sleep disturbance was significantly correlated to depression depth at session 20 and at follow-up. Symptoms of insomnia significantly decreased from baseline to the end of treatment. Treatment gains were maintained until follow-up. No differences in recovery of sleep disturbance were found between the two treatment groups. The findings suggest that sleep disturbance improves following STPP for depression, with or without transference work. Future research should assess those with residual symptoms by different sleep measures. Full article
(This article belongs to the Special Issue Individualized Bio- Psycho- Social Interventions for Youth with Mental Disorders)
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5 pages, 271 KiB  
Article
Individual Perception of Telehealth: Validation of a German Translation of the Telemedicine Perception Questionnaire and a Derived Short Version
by Patrick Altmann, Dominik Ivkic, Markus Ponleitner, Fritz Leutmezer, Ulrike Willinger, Michaela Schmoeger, Thomas Berger, Gabriel Bsteh and Henriette Löffler-Stastka
Int. J. Environ. Res. Public Health 2022, 19(2), 902; https://doi.org/10.3390/ijerph19020902 - 14 Jan 2022
Cited by 4 | Viewed by 1835
Abstract
Telehealth is a growing domain with particular relevance for remote patient monitoring. With respect to the biopsychosocial model of health, it is important to evaluate perception and satisfaction with new methods in telehealth as part of an integrative approach. The Telemedicine Perception Questionnaire [...] Read more.
Telehealth is a growing domain with particular relevance for remote patient monitoring. With respect to the biopsychosocial model of health, it is important to evaluate perception and satisfaction with new methods in telehealth as part of an integrative approach. The Telemedicine Perception Questionnaire (TMPQ) is a 17-item questionnaire measuring patients’ perception of and satisfaction with telecare. We translated this survey into German and determined its validity and reliability in 32 adolescents and adults. Furthermore, we derived a short version of the TMPQ, named Patient and Physician Satisfaction with Monitoring (PPSM), which is a 5-item questionnaire that can be administered to both patients and physicians. Validity and reliability were tested in 32 patients and 32 physicians. Crohnbach’s α for the translated TMPQ was 0.76, and the German version yielded high validity (intraclass correlation coefficient (ICC) 0.995). We tested the PPSM in both patients and physicians and found acceptable values for Crohnbach’s α (0.72 and 0.78) with excellent validity (ICC 0.965). We therefore concluded from this small study that both German versions of the TMPQ and PPSM can be used to investigate the acceptance of telehealth applications. Full article
(This article belongs to the Special Issue Individualized Bio- Psycho- Social Interventions for Youth with Mental Disorders)
15 pages, 569 KiB  
Article
Interaction Structures in Psychodynamic Psychotherapy for Adolescents
by Barış Can and Sibel Halfon
Int. J. Environ. Res. Public Health 2021, 18(24), 13007; https://doi.org/10.3390/ijerph182413007 - 09 Dec 2021
Cited by 3 | Viewed by 2808
Abstract
Despite advances in psychotherapy research showing an evidence-base for psychodynamic psychotherapy (PDT) in adolescents, developmentally specific treatment characteristics are under-researched. We aimed to identify interaction structures (IS: reciprocal patterns of in-session interactions involving therapist interventions, patient behaviors, and the therapeutic relationship) and assess [...] Read more.
Despite advances in psychotherapy research showing an evidence-base for psychodynamic psychotherapy (PDT) in adolescents, developmentally specific treatment characteristics are under-researched. We aimed to identify interaction structures (IS: reciprocal patterns of in-session interactions involving therapist interventions, patient behaviors, and the therapeutic relationship) and assess associations between IS and outcome. The study cohort comprised 43 adolescents (Mage = 13.02 years) with nonclinical, internalizing, and comorbid internalizing–externalizing problems in PDT. A total of 123 sessions from different treatment phases were rated based on the Adolescent Psychotherapy Q-Set (APQ). Outcome was assessed with the Brief Problem Monitor-Youth (BPM-Y) administered repeatedly over the treatment course. Principal component analysis of APQ items resulted in five IS, named “Negative Therapeutic Alliance”, “Demanding Patient, Accommodating Therapist”, “Emotionally Distant Resistant Patient”, “Inexpressive Patient, Inviting Therapist”, and “Exploratory Psychodynamic Technique” (EPT). Multilevel modeling analyses with Bayesian Markov chain Monte Carlo (MCMC) estimations indicated a two-way interaction effect between EPT and problem levels at baseline such that patients with lower problems at baseline showed good outcome in the context of EPT, whereas an inverse relationship was found for patients with higher problems. Findings provide empirical evidence for characteristic components of PDT for adolescents and preliminary answers about who benefits from psychodynamic techniques. Full article
(This article belongs to the Special Issue Individualized Bio- Psycho- Social Interventions for Youth with Mental Disorders)
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11 pages, 340 KiB  
Article
Italian Children’s Well-Being after Lockdown: Predictors of Psychopathological Symptoms in Times of COVID-19
by Marcella Caputi, Barbara Forresi, Ludovica Giani, Giovanni Michelini and Simona Scaini
Int. J. Environ. Res. Public Health 2021, 18(21), 11429; https://doi.org/10.3390/ijerph182111429 - 30 Oct 2021
Cited by 9 | Viewed by 2343
Abstract
The first Italian lockdown imposed to fight the spread of COVID-19 caused important disruptions in families’ everyday lives. The main aim of this research was to investigate the predictors of psychopathology in children aged 5–10 years, immediately after the national 2-month lockdown. A [...] Read more.
The first Italian lockdown imposed to fight the spread of COVID-19 caused important disruptions in families’ everyday lives. The main aim of this research was to investigate the predictors of psychopathology in children aged 5–10 years, immediately after the national 2-month lockdown. A total of 158 Italian parents (148 mothers, 10 fathers, mean age = 41 years) were recruited and asked to complete an online research concerning their 158 children (76 boys, mean age = 7.4 years). Parents completed questionnaires on parent–child conflict, resilience, temperament, behavior, and previous adverse childhood experiences. Hierarchical regressions showed that children’s psychopathology was predicted by low child resilience, high novelty seeking and harm avoidance, adverse experiences, and high flooding levels. Moreover, girls exposed to adverse experiences appeared more vulnerable to psychopathology. The recruitment of a convenience sample, the small sample size, and the cross-sectional design of our study limit the generalizability and interpretation of the present findings. Nonetheless, this research extends our knowledge of children’s functioning in such an exceptional period. Shedding light on predictors of children’s psychopathology following prolonged quarantine can indeed guide effective psychological interventions now and in future similar situations. Full article
(This article belongs to the Special Issue Individualized Bio- Psycho- Social Interventions for Youth with Mental Disorders)
16 pages, 390 KiB  
Article
Therapeutic Alliance: A Comparison Study between Adolescent Patients and Their Therapists
by Vera Gergov, Mauri Marttunen, Nina Lindberg, Jari Lipsanen and Jari Lahti
Int. J. Environ. Res. Public Health 2021, 18(21), 11238; https://doi.org/10.3390/ijerph182111238 - 26 Oct 2021
Cited by 1 | Viewed by 3039
Abstract
The aim of this study was to examine the congruence of adolescent- and therapist-rated therapeutic alliance, and to explore which rating or combination of ratings would predict treatment outcome or premature termination. We also studied whether the alliance changes over the course of [...] Read more.
The aim of this study was to examine the congruence of adolescent- and therapist-rated therapeutic alliance, and to explore which rating or combination of ratings would predict treatment outcome or premature termination. We also studied whether the alliance changes over the course of treatment and if the change is related to the outcome or dropout. This study comprised 58 adolescents clinically referred for psychotherapeutic interventions. The alliance (Working Alliance Inventory, patient/therapist ratings) and treatment outcomes (Beck Depression Inventory, Clinical Outcomes in Routine Evaluation—Outcome Measure) were measured at baseline and at 3-, 6-, and 12-month follow-ups. The alliance did not change significantly over the course of therapy, but adolescent and therapist ratings did not correlate. Low values in the early assessment of adolescent-rated alliance and discrepancy between the ratings were significant predictors of undesirable treatment outcome. Weak adolescent- or therapist-rated alliance later in treatment and change for the worse in adolescent-rated alliance was associated with treatment dropout. As adolescent-rated alliance predicts treatment outcome better than therapist-rated alliance, therapists should frequently use assessments of therapeutic relationship within the therapy and pay attention if the adolescent feels the alliance is weakening or his/her evaluation is contrary to the therapist’s. Full article
(This article belongs to the Special Issue Individualized Bio- Psycho- Social Interventions for Youth with Mental Disorders)
20 pages, 415 KiB  
Article
Conflicted Anger as a Central Dynamic in Depression in Adolescents—A Double Case Study
by Arne Kristian Henriksen, Randi Ulberg, Bjørn Peter Urban Tallberg, André Løvgren and Hanne-Sofie Johnsen Dahl
Int. J. Environ. Res. Public Health 2021, 18(12), 6466; https://doi.org/10.3390/ijerph18126466 - 15 Jun 2021
Viewed by 2706
Abstract
The incidence of depression in teenagers has increased for many years and is one of the most common diagnosis in adolescent psychiatry. Effective and accessible psychotherapy methods need sustained attention since psychopharmaceutic treatment might be less effective in younger people than in adults. [...] Read more.
The incidence of depression in teenagers has increased for many years and is one of the most common diagnosis in adolescent psychiatry. Effective and accessible psychotherapy methods need sustained attention since psychopharmaceutic treatment might be less effective in younger people than in adults. The First Experimental Study of Transference–In Teenagers (FEST-IT) is a Randomized Controlled Study (RCT) with a dismantling design. The main intention in this study was to illustrate a way to address parts of a case formulation by focusing a psychodynamic feature in two different therapies with a good outcome suffering from depression. We present two representative patients from the FEST-IT with case formulations revealing conflicted anger. The patients were different in many aspects, as were the therapeutic methods. Therapies with and without transference interpretations may help to understand what is helpful in therapy in general. It may also show how a more individualized approach can guide the therapy beyond diagnosis and to make it more effective for the specific patient. Looking into individual cases with good outcomes can help us address dynamic features in therapy and give some ideas about what works for whom. The use of nested qualitative double case studies may together add more knowledge about working aspects in successful therapies. Full article
(This article belongs to the Special Issue Individualized Bio- Psycho- Social Interventions for Youth with Mental Disorders)
18 pages, 381 KiB  
Article
The Impact of Social Isolation during the COVID-19 Pandemic on Physical and Mental Health: The Lived Experience of Adolescents with Obesity and Their Caregivers
by Giada Pietrabissa, Clarissa Volpi, Michela Bottacchi, Vanessa Bertuzzi, Anna Guerrini Usubini, Henriette Löffler-Stastka, Tamara Prevendar, Giada Rapelli, Roberto Cattivelli, Gianluca Castelnuovo, Enrico Molinari and Alessandro Sartorio
Int. J. Environ. Res. Public Health 2021, 18(6), 3026; https://doi.org/10.3390/ijerph18063026 - 15 Mar 2021
Cited by 23 | Viewed by 7544
Abstract
Adolescence is a complex developmental phase, made more complex by obesity and the social isolation imposed by the COVID-19 pandemic. The literature related to the impact of social isolation on obesity self-management in adolescents is scant and inconsistent. This paper describes the phenomenon [...] Read more.
Adolescence is a complex developmental phase, made more complex by obesity and the social isolation imposed by the COVID-19 pandemic. The literature related to the impact of social isolation on obesity self-management in adolescents is scant and inconsistent. This paper describes the phenomenon from the perspectives of a sample of adolescents with obesity enrolled in an inpatients’ multidisciplinary rehabilitation program for weight-loss and their caregivers, and its impact on different life domains. Individual semi-structured ad hoc interviews were conducted with 10 adolescent-caregiver dyads, and narratives were qualitatively investigated using an interpretative phenomenology approach to data. Twenty participants took part in the study. The major themes that emerged from this study fall into five basic categories: (1) COVID-19 as an opportunity to reconsider what makes a good life; (2) Persistence in life; (3) Empowering relationship; (4) Daily routine in quarantine; (5) Lives on hold. Understandings drawn from this study may assist health care professionals in providing holistic support, and guidance to adolescents with weight-related issues and their caregivers who experience social isolation during the COVID-19 pandemic. Full article
(This article belongs to the Special Issue Individualized Bio- Psycho- Social Interventions for Youth with Mental Disorders)
10 pages, 1537 KiB  
Article
Reflective Functioning in Patients with Irritable Bowel Syndrome, Non-Affective Psychosis and Affective Disorders—Differences and Similarities
by Larisa Dzirlo, Felix Richter, Dagmar Steinmair and Henriette Löffler-Stastka
Int. J. Environ. Res. Public Health 2021, 18(5), 2780; https://doi.org/10.3390/ijerph18052780 - 09 Mar 2021
Cited by 4 | Viewed by 2429
Abstract
Irritable bowel syndrome (IBS), as part of the functional somatic syndromes, is frequent in the general population. Medical care and morbidity costs are high, and so is the psychological and somatic strain. The etiopathogenesis of IBS is still poorly understood; it is assumed [...] Read more.
Irritable bowel syndrome (IBS), as part of the functional somatic syndromes, is frequent in the general population. Medical care and morbidity costs are high, and so is the psychological and somatic strain. The etiopathogenesis of IBS is still poorly understood; it is assumed to be multifactorial and to include biopsychosocial factors. Links between the intestine, psyche, nervous system (e.g., via the hypothalamic–pituitary–adrenal axis (HPA-Axis/neurotransmitters) and with the microbiome, the immune system have lately been investigated. Factors such as personality traits, mentalization, and early attachment strategies (deactivating and hyperactivating) have been suggested to influence IBS with relevance for treatment regimens. At this time, data on reflective functioning (RF) is lacking. Within a cross-sectional, we examined the mentalizing capacity of a clinical sample (n = 90) consisting of patients with IBS (n = 30), affective disorders (AD; n = 28), and non-affective psychosis (NAP; n = 32). The reflective functioning scale was used based on the brief reflective function interview (BRFI). The results revealed severe impairment in patients with IBS concerning their mentalizing ability, which was comparable to patients with affective disorders. Patients with non-affective-psychosis showed the lowest mentalizing ability. Thus, psychotherapeutic treatment with a focus on mentalization could be a promising approach. Full article
(This article belongs to the Special Issue Individualized Bio- Psycho- Social Interventions for Youth with Mental Disorders)
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17 pages, 489 KiB  
Article
The Synergistic Process of Improvement in Cognitive Behavioral Therapy for Major Depression
by Anders Malkomsen, Jan Ivar Røssberg, Toril Dammen, Theresa Wilberg, André Løvgren and Julie Horgen Evensen
Int. J. Environ. Res. Public Health 2021, 18(5), 2292; https://doi.org/10.3390/ijerph18052292 - 26 Feb 2021
Cited by 4 | Viewed by 2819
Abstract
Background: There is a substantial lack of qualitative research concerning individual cognitive behavioral therapy (CBT) for patients with major depressive disorder (MDD). In the present study, we wanted to explore how patients suffering from MDD experience improvement in CBT. Method: Patients with MDD [...] Read more.
Background: There is a substantial lack of qualitative research concerning individual cognitive behavioral therapy (CBT) for patients with major depressive disorder (MDD). In the present study, we wanted to explore how patients suffering from MDD experience improvement in CBT. Method: Patients with MDD (N = 10) were interviewed at therapy termination with semi-structured qualitative interviews. The transcripts were analyzed using a thematic analysis approach. Results: We identified three elements that were relevant to the process of improvement for all patients: the therapeutic relationship, the therapeutic interventions and increased insight. There is a dynamic interrelationship and synergy between these elements that may explain why patients considered the same elements as helpful, but often in different ways and at different stages of therapy. Conclusions: Highlighting the synergies and interrelationship between the elements that patients experience as helpful, may help therapists to learn from and utilize these experiences. This is a reminder of the importance of always being attentive to the individual processes of patients. Full article
(This article belongs to the Special Issue Individualized Bio- Psycho- Social Interventions for Youth with Mental Disorders)
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Review

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14 pages, 358 KiB  
Review
Possible Interventions for Preventing the Development of Psychopathic Traits among Children and Adolescents?
by Gunnar Bjørnebekk and Dagfinn Mørkrid Thøgersen
Int. J. Environ. Res. Public Health 2022, 19(1), 409; https://doi.org/10.3390/ijerph19010409 - 31 Dec 2021
Cited by 4 | Viewed by 5502
Abstract
Individuals with the combination of psychopathy and severe conduct disorder often get in a lot of trouble from their early childhood, and can cause great suffering and problems for other people and their immediate environment. Their antisocial behaviour has a tendency to develop [...] Read more.
Individuals with the combination of psychopathy and severe conduct disorder often get in a lot of trouble from their early childhood, and can cause great suffering and problems for other people and their immediate environment. Their antisocial behaviour has a tendency to develop into a chronic pattern early in life, and the treatment prognosis in adulthood is poor. A large proportion of serious violent crimes in society can be attributed to this group of perpetrators. Until recently, it has been unclear whether traits of this type can be prevented or changed, so that these individuals and their surroundings can benefit from targeted treatments at an early stage. To reduce serious crime in a society, it is very important to develop effective measures for this particular group. A lack of empathy, indifference to others, and a lack of concern about their own performance appear to be key early signs in children and adolescents with persistent behavioural problems and more serious norm violations who continue into a criminal career upon reaching adulthood. These characteristics have been termed callous−unemotional (CU) traits, and they are considered to be a precursor to psychopathic traits in adulthood. In recent years, several studies have evaluated the degree to which treatments that have been proved effective for children and adolescents with severe behavioural problems also show effectiveness for children and adolescents with CU traits. Interventions specifically tailored to children with CU traits have also been developed with the aim of directly changing the ongoing development of this precursor to psychopathy. In this paper, we will address the extent to which current evidence-based treatment methods developed for children and adolescents with behavioural difficulties are equally effective when a child has CU traits. We will also take a closer look at the effects of interventions designed to change this trait. There will be a discussion regarding what seems relevant for a change in the trait itself, as well as a change in their antisocial behaviour. Full article
(This article belongs to the Special Issue Individualized Bio- Psycho- Social Interventions for Youth with Mental Disorders)
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