Clinical Psychology-science and Practice最新文献

Objective: Growing evidence indicates anger-related affect (i.e., anger, hostility, and irritability) is a transdiagnostic risk factor for suicide. The goal of this meta-analysis was to systematically review the literature and calculate the effect size of these relationships.

Method: We examined the relationships between suicidal thoughts and behaviors and anger, irritability, and hostility with data from 107 published studies (total N = 141,434).

Results: Our analyses uncovered a moderate-sized average correlation (r = .31) between anger-related affect and suicidal thoughts and behaviors. There were no significant differences between the effect size estimates of the three separate anger constructs. Studies assessing suicide attempts were associated with significantly lower effect sizes than studies assessing death by suicide or suicidal ideation. Studies that assessed suicidal thoughts and behaviors using a clinical interview were associated with lower effect size estimates than those assessing via self-report or chart review. Additionally, studies that assessed current suicidal thoughts and behaviors were associated with higher effect size estimates versus those that assessed lifetime occurrence. Studies that assessed suicide in an outpatient setting were associated with lower effect sizes than those in community, inpatient, or forensic settings. There were no other significant moderators (i.e., sociodemographic or study design variables) of the relationship between overall anger and suicide.

Conclusions: Findings highlight the importance of anger as a potential risk factor for suicide. Future research is needed to examine these relationships longitudinally and to look at different facets of anger (e.g. experience vs. expression).

Objectives: Over a decade ago, a model was proposed to explain the role of emotion regulation in the development and maintenance of anorexia nervosa (AN). Research on emotion regulation in AN has since rapidly increased, prompting a need to revisit the evidence base regarding whether AN may be considered a disorder of emotion regulation.

Methods: We conducted a systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across PubMed, PsychInfo, and Web of Science on the emotion regulation literature in the years following the proposal of this emotion regulation model. Inclusion criteria were: (a) empirical and quantitative articles in English; (b) human samples; (c) analysis pertaining to AN; and (d) focused on a domain of emotion regulation. The review yielded 134 eligible articles (from a pool of 562 non-duplicate studies) examining emotion regulation constructs in AN, encompassing individual-level emotional and environmental vulnerabilities, use of adaptive and maladaptive emotion regulation strategies, and eating disorder behaviors as emotion regulation.

Results: Overall, evidence supported the relevance of emotion regulation to the conceptualization of AN. Individuals with AN demonstrated greater individual and environmental vulnerabilities to dysregulation, less adaptive and more maladaptive emotion regulation strategies, and greater tendency to engage in eating disorder behaviors to regulate emotions. Findings on emotional reactivity were more mixed.

Discussion: Results highlight that continued research on emotion regulation across restrictive eating presentations is needed. Further, treatments directly targeting emotion regulation warrant further investigation. Emotion regulation models continue to hold promise in characterizing core mechanisms of AN.

Several professional organizations and federal agencies recommend contingency management (CM) as an empirically supported treatment for drug use disorder. However, the release of the "Tolin criteria" warrants an updated recommendation. Using this methodology, five meta-analyses (84 studies, 11,000 participants) were reviewed. Two meta-analyses were rated moderate quality, and three were rated low or critically low quality. Comparator conditions included active treatment, placebo, treatment as usual, and no treatment. The primary outcome was abstinence. Considering only the moderate quality meta-analyses, the effect of CM versus control on posttreatment abstinence was d = 0.54 [0.43, 0.64] and follow-up abstinence was d=0.08 [0.00, 0.16]. A "strong" recommendation was provided for CM as an empirically supported treatment for drug use disorder.