New articles on psychology, therapy and healthcare, and summaries of research on MCT and ISTDP. Research entries state the study type, sample and limitations.https://www.psykologlundin.seen-GBhttps://www.psykologlundin.se/en/articles/procrastination-and-the-discomfort-that-comes-firsthttps://www.psykologlundin.se/en/articles/procrastination-and-the-discomfort-that-comes-firstAvoiding doing something by putting it off is what we call procrastination. Sometimes, just thinking about the task is enough for the body to react. A tension, a heaviness, an unease that comes before the task itself. Before we have even begun, we have already staged the effort inside ourselves and let the imagined performance settle it. It will have to wait.Mon, 07 Sep 2026 00:00:00 GMTArticleshttps://www.psykologlundin.se/en/articles/how-adhd-became-adhdhttps://www.psykologlundin.se/en/articles/how-adhd-became-adhdThe difficulties now grouped under ADHD are old. But the names, boundaries and assumed causes have changed. What does the history of the diagnosis show?Thu, 23 Jul 2026 00:00:00 GMTArticleshttps://www.psykologlundin.se/en/research#pmid-42064156https://www.psykologlundin.se/en/research#pmid-42064156MCT · Systematic review and meta-analysis (three clinical trials and experimental studies) · N=256 people in 12 independent samples; the clinical meta-analysis included 48 people in 3 studies · Frontiers in Psychiatry 2026. Detached mindfulness (DM) is a core technique in metacognitive therapy. The person practises noticing an intrusive thought, stepping back and allowing it to be there without continuing to process it or fight it. The technique is usually part of a full MCT protocol. This systematic review and meta-analysis examined DM as a stand-alone intervention. Fourteen studies, representing twelve independent samples, were included. In total, 256 people aged 17 and over had received DM. Limitations: The authors consider the evidence limited. The studies are few, small and methodologically uneven. Only one followed up participants, after four weeks. The clinical meta-analysis is based on three studies with 48 people in total; two had no control group, and results varied considerably between studies (I² = 77.7%). Only published studies were included, so reporting bias cannot be ruled out. The pooled effects compare change within groups before and after the intervention. They therefore do not show how much better DM is than no treatment or another treatment.Thu, 16 Jul 2026 00:00:00 GMTResearchhttps://www.psykologlundin.se/en/articles/c-ptsd-the-understanding-we-need-nowhttps://www.psykologlundin.se/en/articles/c-ptsd-the-understanding-we-need-nowTrauma is common. PTSD and C-PTSD are not. Yet someone living with a lasting trauma response may have their symptoms sorted under another label before anyone asks what has happened. This text does not offer a new answer key. It asks whether psychiatry’s old answer key has been given more certainty than the evidence allows.Wed, 15 Jul 2026 00:00:00 GMTArticleshttps://www.psykologlundin.se/en/articles/what-changes-in-therapyhttps://www.psykologlundin.se/en/articles/what-changes-in-therapyPTSD research knows something about which treatment interventions work, but less about what changes, when and for whom. MCT and ISTDP point towards two processes that deserve more space: our relationship with thinking and our relationship with feelings.Mon, 13 Jul 2026 00:00:00 GMTArticleshttps://www.psykologlundin.se/en/articles/a-nervous-system-for-another-worldhttps://www.psykologlundin.se/en/articles/a-nervous-system-for-another-worldA new conceptual review in Behavioral Sciences suggests that much of what we now call mental ill health can be understood as a mismatch between an ancient nervous system and a modern world it was never built for. It is a theory, not proof, but it resonates with much of what I see in the room.Tue, 07 Jul 2026 00:00:00 GMTArticleshttps://www.psykologlundin.se/en/research#doi-10-1016-j-jadr-2026-101116https://www.psykologlundin.se/en/research#doi-10-1016-j-jadr-2026-101116MCT · Open trial without a control group, with a six-month follow-up · N=34 people · Journal of Affective Disorders Reports 2026. The study starts from the observation that depression and anxiety diagnoses often overlap and co-occur. MCT targets processes that may be shared across diagnoses, such as worrying and ruminating, and similar treatment elements can be used with different diagnoses. The researchers therefore examined a generic MCT programme in groups with mixed conditions. Thirty-four participants with a primary depression or anxiety diagnosis and high comorbidity received ten sessions in specialist mental health care. Change was analysed for the whole group and three diagnostic subgroups. Limitations: The trial was open and had no control group, so it cannot establish that MCT caused the changes or compare the group format with another intervention. The sample was small and drawn from one specialist clinic. Outcomes were based on self-report, therapist effects could not be ruled out, and 28 of 34 participants provided data at the six-month follow-up. Follow-up was limited to six months. No formal health economic analysis was conducted, so resource efficiency is a possibility, not established cost-effectiveness. The authors call for larger randomised controlled studies with longer follow-up.Wed, 24 Jun 2026 00:00:00 GMTResearchhttps://www.psykologlundin.se/en/research#pmid-42100787https://www.psykologlundin.se/en/research#pmid-42100787ISTDP · Reanalysis of a randomised controlled trial with mediation and cross-lagged analyses · N=86 participants · Frontiers in Psychiatry 2026. Two researchers at Stockholm University analysed openly available data from a randomised study with 86 participants. The study compared 20 sessions of ISTDP with a waiting list for treatment-resistant depression. The reanalysis examined both change in depression and whether it could be explained by the three process variables included in the mediation analysis: emotional suppression, negative affect and psychological distress. The researchers also tested whether process measures before treatment could predict depression after treatment, and whether the relationship ran in the opposite direction. Limitations: The mechanism findings are exploratory and based on a secondary analysis of self-reports from three measurement points. This is not enough to capture rapid changes during or between sessions, and the measures may not correspond to the processes described by ISTDP theory. The study compared ISTDP with a waiting list, not an active treatment, which can produce larger effect sizes. Assessors were not blinded, the original study was registered retrospectively, and 11 of 86 participants had no post-treatment data. The reanalysis therefore supports large differences compared with a waiting list, but does not provide a definitive answer about how ISTDP works.Mon, 15 Jun 2026 00:00:00 GMTResearchhttps://www.psykologlundin.se/en/research#pmid-42178556https://www.psykologlundin.se/en/research#pmid-42178556MCT · Systematic review with meta-analysis and meta-regression · N=51 studies: 33 with a control or waiting-list group and 18 without a control group · Annals of General Psychiatry 2026. The review brought together 51 studies of full MCT programmes for adults in which depressive symptoms were measured. Studies of individual MCT techniques or MCT combined with other treatments were not included. The evidence covered both people with depression and groups in which depressive symptoms co-occurred with, for example, PTSD, GAD or long-term physical illness. Study designs varied and could be randomised, non-randomised or without a control group. The review followed Cochrane and PRISMA guidance and was preregistered in PROSPERO. Limitations: Results varied widely between studies (I² = 93.73% in the between-group analysis). The pooled effect should therefore not be read as a uniform or expected result for an individual. Most studies were judged to have a high risk of bias, meaning methodological problems that may distort results, and none were rated low risk. Samples were often small and active comparisons few. The analyses also showed signs of small-study effects and possible publication bias. After a statistical adjustment, the between-group effect fell from g = −1.28 to g = −1.07. The difference was still large, but the adjustment does not remove the uncertainty.Mon, 15 Jun 2026 00:00:00 GMTResearchhttps://www.psykologlundin.se/en/articles/a-swedish-patient-record-systemhttps://www.psykologlundin.se/en/articles/a-swedish-patient-record-systemReports of deaths in which Cosmic is identified as a factor, billion-krona projects that fail and large patient record systems with foreign owners. Yet the debate still centres on which existing system should be the hub of Swedish healthcare. I argue that the question is wrongly framed: Sweden should build its own patient record platform and use today’s developments in AI to reduce costs and dependencies. The actual costs and security need to be calculated and tested.Fri, 12 Jun 2026 00:00:00 GMTArticleshttps://www.psykologlundin.se/en/research#pmid-39692039https://www.psykologlundin.se/en/research#pmid-39692039MCT · Systematic review and meta-analysis of randomised controlled trials · N=49 RCTs with 3,239 participants: 21 MCT studies with 1,273 participants and 28 MCTraining studies with 1,966 participants · Cognitive Behaviour Therapy 2025. The review brought together 49 randomised controlled trials with 3,239 adults. Twenty-one studies with 1,273 participants examined metacognitive therapy, MCT, developed by Adrian Wells. The other 28 studies with 1,966 participants examined metacognitive training, MCTraining, developed by Steffen Moritz. This is a different intervention, mainly studied in schizophrenia and psychosis. Results were analysed separately and the interventions were not compared with each other. The MCT part is summarised here. The review followed PRISMA, was preregistered in PROSPERO and covered published English-language studies up to May 2024. Limitations: Results varied greatly between the MCT studies. The prediction intervals, which estimate what a new comparable study might show, included zero in both the waiting-list and CBT comparisons. The average advantage therefore cannot be expected in every new study or situation. Studies with moderate risk of bias, meaning methodological problems that may affect results, showed larger effects than studies with low risk. Smaller studies also showed larger effects.,The analysis of the MCT studies as a whole showed signs of possible publication bias. A statistical adjustment reduced the pooled effect from g = 0.90 to g = 0.38. However, tests for the separate comparisons with CBT and waiting lists did not show significant publication bias. Only 9 of 21 MCT studies had samples large enough from the outset to detect a moderate or large effect. Many also lacked information about study registration, treatment adherence, therapist competence, inter-rater agreement or whether blinding had worked. Overall, the results favour MCT, but do not say that MCT is always better than CBT or what an individual can expect.Thu, 11 Jun 2026 00:00:00 GMTResearchhttps://www.psykologlundin.se/en/research#pmid-38729024https://www.psykologlundin.se/en/research#pmid-38729024MCT · Randomised controlled non-inferiority trial with blinded assessors · N=74 adults with obsessive-compulsive disorder (OCD): 12 weekly sessions and a six-month follow-up · Journal of Anxiety Disorders 2024. The study compared metacognitive therapy (MCT) with exposure and response prevention (ERP), an established first-line treatment for obsessive-compulsive disorder. Seventy-four adults in outpatient care were randomly assigned to twelve weekly sessions of either treatment. OCD symptoms were assessed using the Y-BOCS before, during and after treatment and six months later. The assessors did not know which treatment participants had received. Limitations: The study was small, and the post-treatment result was very close to the chosen margin. The criterion was not met at six months. Without a waiting list or another inactive comparison, the study can compare MCT with ERP, but cannot on its own establish how much of the change was due to each treatment.,A published corrigendum corrected an error in the abstract: the ERP group, not the MCT group, had a greater reduction in state anxiety after treatment and at follow-up. A methodological commentary published in 2025 questioned, among other things, the comparison margin, sample-size calculation and choice of confidence interval. The authors later published a response on the methodology and its rationale. The result should therefore not be read as conclusive evidence that MCT and ERP are equivalent or suit the same people.Thu, 11 Jun 2026 00:00:00 GMTResearchhttps://www.psykologlundin.se/en/articles/poor-memory-and-attentionhttps://www.psykologlundin.se/en/articles/poor-memory-and-attentionMemory difficulties can have several causes. Illness, medication, brain injury and other medical conditions can affect memory. On the functional side, anxiety and negative or depressive thought patterns can affect attention and contribute to difficulties with memory and concentration. These are possible contributing processes, not a single explanation.Wed, 10 Jun 2026 00:00:00 GMTArticleshttps://www.psykologlundin.se/en/research#pmid-42079321https://www.psykologlundin.se/en/research#pmid-42079321MCT · Online cross-sectional study with self-reports and analysis of statistical interactions · N=564 university students in Canada; mean age 21.8 years and 72.3% women · Frontiers in Psychiatry 2026. The study used online self-reports from a sample of 564 university students. Four measures were analysed: bodily symptoms over the previous four weeks, health anxiety, anxiety sensitivity and metacognitive beliefs about health-related thinking. Anxiety sensitivity referred to fear of what bodily signals might mean or lead to, for example that palpitations signal serious illness. The metacognitive beliefs concerned the idea that negative thinking or worrying can be useful or protective, and that positive thinking can be risky. Limitations: The cross-sectional design shows concurrent associations, not what comes first or causes what. The sample came from one Canadian university, was young and non-clinical; 72.3% of participants were women. All data were collected through self-reports at the same time, and overlapping questions may have strengthened the associations. The three-way interaction was small. The study tested no treatment and cannot show that the metacognitive beliefs maintain health anxiety or that changing them would reduce it. Nor did it establish what caused the bodily symptoms or whether medical assessment was needed. The article reports 564 participants, but the reported degrees of freedom suggest that the regression models included 561 and 559 respectively; the difference is not explained. The pattern needs to be examined over time and in clinical and experimental studies.Wed, 10 Jun 2026 00:00:00 GMTResearchhttps://www.psykologlundin.se/en/research#pmid-34520637https://www.psykologlundin.se/en/research#pmid-34520637MCT · Long-term follow-up of participants from a randomised controlled trial · N=39 of the 60 participants in the study’s two treatment groups took part after an average of 9.1 years. · Brain and Behavior 2021. The study followed up adults with generalised anxiety disorder, GAD, who had previously been randomly assigned to metacognitive therapy, MCT, or a manual-based CBT programme. Follow-up took place between eight and eleven years after treatment. Among those who completed the questionnaires, 12 of 21 in the MCT group, 57%, and 6 of 16 in the CBT group, 38%, were classified as recovered according to the study’s measure of worrying. Limitations: The study was small and 39 of 60 possible participants took part in the follow-up. The results are based on those who provided complete data, making the estimates less certain. The findings are promising but need to be confirmed in larger studies.Wed, 10 Jun 2026 00:00:00 GMTResearchhttps://www.psykologlundin.se/en/research#pmid-32421603https://www.psykologlundin.se/en/research#pmid-32421603ISTDP · Randomised controlled trial with blinded assessors and an 18-month follow-up · N=60 adults in specialist psychiatric outpatient care. Depression measures were available for 37 participants at 18 months. · Journal of Affective Disorders 2020. The study followed adults whose depression had not improved sufficiently after at least one course of antidepressant medication. Participants were randomly assigned to up to 20 individual sessions of ISTDP or continued care from specialist psychiatric outpatient teams. The comparison group received, among other things, medication, clinical follow-up and, in many cases, talking therapy. Limitations: The study was small and conducted at a single centre. Depression measures were available for 37 of 60 participants at 18 months, although the longitudinal analysis used all available measurements. The health economic analysis was preliminary and affected by how missing data were handled. The findings are promising but need to be confirmed in larger studies.Wed, 10 Jun 2026 00:00:00 GMTResearchhttps://www.psykologlundin.se/en/research#pmid-28266318https://www.psykologlundin.se/en/research#pmid-28266318ISTDP · Randomised controlled trial with blinded assessors and a six-month follow-up · N=60 adults in specialist psychiatric outpatient care, 30 in each group · Journal of Affective Disorders 2017. The study included adults whose depression had not improved sufficiently after at least one course of antidepressant medication. Participants were randomly assigned to up to 20 individual sessions of ISTDP or treatment as usual in specialist psychiatric care, provided by outpatient teams. The comparison group received, among other things, medication, clinical follow-up and, in most cases, talking therapy. Limitations: The study was small and conducted at a single centre. At six months, the primary depression measure was available for 52 of 60 participants, although the analysis used all available measurements. The comparison group received varied interventions and the ISTDP group had more frequent sessions and more sessions on average, which may have contributed to the difference. The results need to be tested by more research groups and in other care settings.Wed, 10 Jun 2026 00:00:00 GMTResearchhttps://www.psykologlundin.se/en/articles/bodily-signals-and-worries-about-healthhttps://www.psykologlundin.se/en/articles/bodily-signals-and-worries-about-healthWhen the body feels different, worry may arise and attention may turn towards what the signals might mean. A study of 564 Canadian university students examined how bodily symptoms, fear of their possible meaning and beliefs about the usefulness of worrying were associated with health anxiety. The study found statistical associations but cannot show what causes what.Wed, 15 Apr 2026 00:00:00 GMTArticleshttps://www.psykologlundin.se/en/articles/research-evidence-for-mcthttps://www.psykologlundin.se/en/articles/research-evidence-for-mctWhat does research show about metacognitive therapy, and how do the results hold up over time? Here I read a meta-analysis and two follow-up studies of MCT, focusing on samples, measures and results.Fri, 10 Apr 2026 00:00:00 GMTArticleshttps://www.psykologlundin.se/en/articles/the-halifax-istdp-studyhttps://www.psykologlundin.se/en/articles/the-halifax-istdp-studyThe Halifax study tested time-limited ISTDP for depression that persisted despite previous antidepressant treatment. The results favoured ISTDP compared with treatment as usual in specialist psychiatric care.Sun, 05 Apr 2026 00:00:00 GMTArticleshttps://www.psykologlundin.se/en/articles/we-suffer-more-often-in-imaginationhttps://www.psykologlundin.se/en/articles/we-suffer-more-often-in-imaginationSeneca wrote it 2,000 years ago. It is still one of the most telling descriptions of what happens when someone sits in front of me and talks about their worries.Wed, 01 Apr 2026 00:00:00 GMTArticles