Clinical psychology & psychotherapy最新文献

Although metacognitive training (MCT) and cognitive-behavioural therapy (CBT) have been proven to be effective interventions for the treatment of symptoms of schizophrenia, still little is known about the effects on quality of life (QoL). This systematic review compares the effectiveness of MCT and CBT-based interventions for QoL in individuals with schizophrenia spectrum disorders (SSD). Three electronic databases were screened up to October 2025 for MCT and CBT studies reporting QoL outcomes for patients diagnosed with SSD. Data from 38 randomized controlled trials (RCTs) met the inclusion criteria, of which eight MCT and 30 studies included CBT-based interventions. When comparing MCT against control interventions, none of the eight MCT studies found significant differences in the overall score of QoL scales at posttest and at 1- or 6-month follow-up. Only one study has assessed the effects of MCT after 3 years, yet it demonstrated significant improvements in QoL. For CBT-based interventions, nine of 26 available between-group comparisons in overall QoL showed a significant improvement in QoL after CBT at the posttest, and five of 19 effects were observed at follow-up. This review provides modest evidence for improvements in QoL from CBT-based interventions and a small number of studies concerning QoL in MCT, emphasizing the need for further research that prioritizes QoL as a primary outcome as well as the need for research with longer follow-ups to capture the delayed effects of MCT and CBT on QoL. It awaits to be tested whether the recent extension of MCT (app, 2 modules on self-esteem and stigma) augments QoL.

Artificial Intelligence (AI) technologies are rapidly evolving and their integration into psychological practices has progressively expanded, offering new tools for diagnosis, treatment and therapeutic monitoring. This review examines the transformative role of AI, particularly Natural Language Processing (NLP) systems, in reshaping clinical psychology and digital mental health interventions (DMHIs). In particular, it explores how AI and NLP can facilitate human-machine interaction in therapy by analysing how language is used within clinical conversations and providing personalized, real-time interventions. Following PRISMA guidelines, a systematic review of literature from 2019 to 2025 identified 17 studies that met inclusion criteria, emphasizing AI's use in psychological assessment and intervention. The review focuses on two key aspects: the functions and applications of NLP-based systems in clinical practice and the advantages and benefits they offer for both psychologists and patients. Findings suggest that NLP-driven AI systems enhance both patient engagement and clinician efficiency, offering scalable, cost-effective solutions that improve access and personalization. However, challenges remain, including ethical concerns around data privacy, lack of standardization, limited generalizability across disorders and reduced human empathy. Moreover, current systems are primarily designed for well-defined conditions like anxiety and depression, with limited applicability to complex or comorbid psychological presentations. This review underscores the importance of supervised, ethically governed AI implementation. While AI holds substantial promise in augmenting clinical psychology, its success depends on maintaining human oversight, ensuring transparency and establishing shared scientific and ethical standards across the psychological community.

Although diagnostically distinct from suicidal behaviour and, by definition, not intended to cause death, nonsuicidal self-injury (NSSI) remains one of the strongest predictors of suicide. NSSI and suicidal behaviour appear to share a suicidal state of mind, marked by detachment from life and ambivalence toward death. This study investigates suicidal risk in adolescents with NSSI by examining suicidal motivations and regulatory needs linked to psychache and by exploring their contribution to suicidal behaviour. A sample of 134 adolescents with active suicidal ideation, self-harm or recent suicide attempts was assessed using self-report measures and structured interviews. Associations between suicidal ideation, motivations and NSSI features were explored using linear regressions. Logistic regressions tested links between suicidal motivations and suicidal attempts in a filtered NSSI subsample. A hierarchical logistic regression compared the associative value of suicidal motivations and personality disorder criteria on suicidal behaviour. Suicidal ideation and motivations were significantly associated with NSSI variables. In the NSSI subsample, interpersonal influence and low fear were linked to suicide attempts. Suicidal motivations showed greater predictive power for suicidal behaviour than personality disorder traits, improving model accuracy. These findings suggest that assessing suicidal motivations in adolescents with NSSI may enhance clinical risk evaluation and support more targeted interventions.

Auditory verbal hallucinations, or hearing voices, occur across various mental health conditions and can vary widely in distress and content. Understanding the factors that influence these experiences is essential for effective therapy. Schema therapy, particularly its concept of schema modes, offers a framework to explore how emotional states and coping strategies shape the nature and distress of voice hearing. Despite this, there is limited research on the relationship between schema modes and voice-hearing experiences. This study aimed to address this gap by developing a schema mode profile for transdiagnostic voice hearers, and investigating whether schema modes predict voice-related distress and positive or negative voice-related content. The study included 76 voice hearers who completed assessments of their voices and schema modes. The schema mode scores in voice hearers were generally elevated compared to nonclinical and Axis I populations (e.g., those with anxiety or depressive disorders) and closely mirrored those of Axis II populations (e.g., personality disorders). The greatest elevations compared to Axis I patients were observed in the Vulnerable Child, Impulsive Child, Detached Protector, Bully and Attack and Punitive Parent modes. Regression analyses showed that Vulnerable Child mode significantly predicted greater voice-related distress. For negative voice content, both the Vulnerable Child and Detached Self-Soother modes were associated with an increased negativity. For positive voice content, the Happy Child and Enraged Child modes were positive predictors, while the Detached Self-Soother was negatively associated with positive voice experiences. These findings suggest schema modes may play a role in voice-hearing experiences, offering promising avenues for schema therapy interventions and future research.

Post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG) are recognized psychological outcomes of trauma, yet their relationship and role of resilience remain incompletely understood. Resilience, shaped by social and cultural factors, may reduce distress and facilitate growth, making it critical for public mental health strategies. The objective is to systematically map and synthesize evidence on the mediating and moderating role of resilience in the relationship between PTSD and PTG, with attention to social, cultural and contextual determinants relevant to population mental health. A scoping review followed PRISMA-ScR guidelines. PubMed, Scopus, PsycINFO and Google Scholar were searched for English-language studies from 2015 to May 2025. Eligible studies examined PTSD and PTG outcomes related to resilience in trauma-exposed populations. Data were charted on study design, population, measures used, main findings and social and cultural factors. The review identified 14 relevant studies that demonstrated varying relationships between PTSD and PTG. Some studies found a positive linear relationship, where higher PTSD symptoms were linked to increased PTG, provided cognitive processing and resources were available. Other studies revealed a non-linear relationship, with moderate PTSD levels corresponding to the highest PTG, while very low or high symptoms were associated with lower PTG. Resilience consistently showed a positive association with PTG, acting either as a mediator that transforms distress into growth or as a moderator that mitigates the impact of PTSD. Additionally, social support, self-compassion, cognitive reappraisal and hope were found to enhance PTG. Resilience is a key factor shaping trauma outcomes, but its interaction with social determinants warrants further exploration. Strengthening individual and community resilience through social support, equitable access to care and culturally sensitive interventions may enhance recovery and foster growth at the population level. These findings have direct implications for clinical assessment and trauma-focused psychotherapy, highlighting resilience as a modifiable therapeutic target.

While selective mutism (SM) is often conceptualized as a childhood anxiety disorder, longitudinal evidence suggests persistent difficulties into adolescence, yet the underlying cognitive and emotional mechanisms remain poorly understood. We aimed to address this gap by examining whether specific neurocognitive impairments and emotion regulation difficulties characterize adolescents with SM. Eighty-nine adolescents (42 SM, 47 HC), aged 11-17 years, were assessed using the Strengths and Difficulties Questionnaire (SDQ), the Difficulties in Emotion Regulation Scale (DERS) and a neuropsychological battery evaluating attention, inhibition, processing speed, memory and social cognition. Adolescents with SM demonstrated greater emotional awareness difficulties (p = 0.010), with no differences in total DERS scores. SDQ scores indicated higher inattention/hyperactivity (p < 0.001), alongside significantly higher prosocial behaviour (p < 0.001). Neurocognitive findings revealed intact verbal learning but impaired immediate and delayed recall (p < 0.001), better delayed visual memory (p = 0.001). Children with SM made fewer total errors on Wisconsin Card Sorting Test (p = 0.021) and showed higher foil accuracy on CPT (p = 0.007), but demonstrated significantly poorer Stroop colour-word (p = 0.001) and interference scores (p = 0.001). Adolescents with SM showed a distinctive cognitive-emotional profile, suggesting that internal emotional processing and external social sensitivity are dissociated during adolescence. Longitudinal and neurobiological research is warranted to elucidate mechanisms and refine treatment strategies.

Background: Solution-focused brief therapy is a growing practice within adult community mental health that focuses on enhancing the person's sense of hope in achieving their desired outcome. The aim of this scoping review was to better understand the breadth of empirical literature related to the use of solution-focused brief therapy in community adult mental health practices.

Materials and methods: We conducted a scoping review according to PRISMA-ScR guidelines. PsychINFO, MEDLINE and CINAHL were searched on 3rd February 2025. Original research papers focusing on adults receiving solution-focused brief therapy in a community mental health context that were published in English were included. Studies in emergency departments, general practice, or inpatient mental health units were excluded. The following characteristics of each study were extracted: author(s), year, design, country, aims, population, intervention tested, outcomes measured and major findings.

Results: After removal of duplicates, the search returned 1468 citations. Of these, 20 studies were identified. Study designs included randomised trials, quasi-experimental studies, observational studies and qualitative narrative analysis. All studies demonstrated the effectiveness of the use of solution-focused brief therapy within adult community mental health settings, achieving positive health outcomes. In some randomised trials, a more rapid or more effective response was found when compared with other interventions.

Conclusion: This scoping review mapped the empirical evidence available for the use of solution-focused brief therapy in adult community mental health settings. A small number of empirical investigations were identified overall. Solution-focused brief therapy was associated with positive outcomes across various domains including psychiatric symptoms and improving psychosocial functioning. More empirical research focusing on process, comparative studies and broader populations within adult community mental health would strengthen the evidence base and generalisability of solution-focused brief therapy.

Intolerance of uncertainty (IU) and resilience are two psychological constructs that can influence the onset, maintenance and prognosis of individuals with anorexia nervosa (AN). Existing literature in various contexts suggests that resilience is inversely associated with IU and may mediate the relationship between IU and affective symptoms. This study aimed to explore the interplay between these variables in AN by comparing a group of affected individuals with healthy controls (HCs). The cross-sectional study included 108 patients with AN accessing a specialized eating disorders centre and 121 HCs. Participants completed questionnaires measuring IU, resilience, eating and body-related psychopathology and anxious and depressive symptoms. The groups were compared with non-parametric tests, although correlation and bootstrapped mediation analyses were used to analyse the relationships among variables. Individuals with AN showed higher IU and lower resilience compared to HCs. IU scores positively correlated with all psychopathology measures across both groups and were negatively associated with resilience; resilience negatively correlated with anxiety and depression in both groups and with eating psychopathology only in the control group. Resilience partially mediated the relationship between IU and anxiety/depression in both groups. This study paves the way for a line of research focused on these psychological constructs in AN: Enhancing resilience resources in therapeutic settings may help address the emotional burden associated with high levels of IU, particularly regarding non-ED symptoms.

Introduction: Psychosocial interventions are a core component of substance use disorder (SUD) treatment, yet recent evidence remains fragmented across substances, delivery formats and clinical contexts. The objective was to identify the most effective psychosocial intervention strategies for the treatment of SUD, considering different substances and delivery formats (face-to-face/digital/hybrid).

Method: A PRISMA-guided systematic review was conducted and registered in PROSPERO (CRD42024600203). Searches were performed in Web of Science, PubMed/MEDLINE and Scopus (19 November-18 December 2025), including peer-reviewed RCTs published in English or Spanish (2021-2025) and excluding samples < 18 years. Methodological quality was assessed using the PEDro scale.

Results: From 843,112 articles, 64 randomized controlled trials were included. Cognitive behavioural therapy (CBT) and multicomponent approaches showed the most consistent support, particularly for alcohol and tobacco, while contingency management emerged as especially effective for engagement/retention and short-term abstinence, notably in cannabis and stimulants. Third-wave approaches (e.g., mindfulness) showed benefits for specific outcomes (e.g., craving, emotion regulation, stress tolerance), but with heterogeneous effects that depend on clinical and implementation factors. Accordingly, their use requires screening, monitoring and tailoring, and may not be advisable or potentially contraindicated for certain clinical profiles or in high-complexity contexts. Technology-assisted interventions appeared promising for expanding access and continuity, though impact depended on adherence and clinical integration.

Conclusions: Evidence supports psychosocial interventions as essential for SUD care, with effectiveness varying by substance, format and context. When indicated, combined psychosocial and pharmacological care improves stabilization and maintenance.

This review provided a meta-analysis, narrative synthesis and quality appraisal of quantitative studies examining associations between adolescent attachment concepts and suicidal ideation and suicide attempts among adolescents. A systematic search of PsycINFO, PubMed, EMBASE, Web of Science and CINAHL was undertaken. Studies on attachment and suicidal ideation or attempts in adolescents aged 10-24 years were included. Fifty-four studies met inclusion criteria. Subgroup meta-analyses showed small associations with suicidal ideation for attachment security (r = -0.161) and attachment anxiety (r = 0.198). Avoidance was not significantly associated with ideation (r = 0.061). Narrative synthesis suggested a weak link between attachment anxiety and suicide attempts, while the association with avoidance remained uncertain. Lower attachment quality, lower parental care and higher parental overprotection were associated with both ideation and attempts. Heterogeneity was high across most subgroups, and potential publication bias was detected for the parental overprotection group, warranting caution in interpretation. Findings also suggested mediating roles for interpersonal and emotional difficulties and moderating roles for social support and environmental sensitivity. These findings align with adult models of suicidal thoughts and behaviour, suggesting they can be extended to adolescents. Based on these findings, clinical implications could include enhancing attachment security, improving emotional management, addressing difficulties in developing relationships with others, providing support for adolescents experiencing low social support and fostering positive family and school environments. Future research should evaluate these interventions using randomised controlled trials with sufficient samples to examine mediators and moderators of change.