Clinical psychology & psychotherapy最新文献

Cultural factors play a central role in shaping responses to traumatic events. However, most trauma research has been conducted in Western populations, and culturally specific trauma sequelae remain underexplored in other contexts. This study applied the framework of cultural scripts of trauma (CSTs) to examine how cultural values, intrapersonal factors and symptoms of posttraumatic stress disorder (PTSD) and disturbances in self-organization (DSO) are interrelated in an East African context. This cross-sectional study used convenience sampling. Data from East African trauma survivors were analysed using structural equation modelling and path analysis to investigate links among social axioms, general self-efficacy, self-mastery, CSTs, and PTSD and DSO symptoms. Social axioms (social complexity, reward for application and religiosity) predicted growth-related CSTs more strongly than self-efficacy or self-mastery. CSTs such as frame of mind and body-related symptoms were positively associated with PTSD severity. Mediation analyses indicated that CSTs partially explained the association between social axioms and PTSD symptoms. Notably, CSTs such as family stress and cognitive disruption were not linked to PTSD or DSO, suggesting culturally specific trauma responses not captured by current diagnostic criteria. Findings provide empirical support for the CSTs framework in an East African setting. The study highlights the importance of integrating cultural values and culturally specific symptom expressions into trauma assessment and intervention, and advances the development of culturally sensitive models of adaptation to trauma by identifying both unique and cross-cultural dimensions of trauma responses.

The integration of AI-based digital technologies in mental healthcare represents a transformative shift, especially with regard to chatbots and avatar-based interventions. A central component of the success of AI-based digital mental health interventions has to do with the level of acceptance of this new technology: the degree to which stakeholders perceive a technology as useful, user-friendly and worth adopting. We aimed to establish the level of acceptance of AI-based digital mental health interventions (AI chatbot, AI avatar-based interventions) compared with the acceptance levels of teletherapy via videoconferencing among clinicians, patients and a representative community sample (i.e., potential future patients). We also explored the extent to which these differences towards these technologies might be explained by individuals' attitudes towards AI in general. Clinicians (N = 658), patients (N = 451) and US census–based community sample (N = 520) completed standardised measures of everyday artificial intelligence use, general attitudes towards AI and acceptability of digital technology use for mental health interventions. We found that community participants are most optimistic about AI-based mental health tools (chatbots and avatars), whereas clinicians consistently express more scepticism, especially regarding usability. In our sample, general attitudes towards AI (both positive and negative) were highly associated with acceptance of chatbot and avatar-based interventions, more than their professional role or demographic identity. These findings might carry clinical implications for the design, deployment and integration of these technologies into mental health services.

Psychotherapy process research increasingly uses intensive longitudinal monitoring to capture dynamic patterns of change in patients. In this study, 283 psychiatric inpatients diagnosed with depression (n = 70), PTSD (n = 148), dissociative disorders (n = 26) or personality disorders (n = 39) completed the Therapy Process Questionnaire each evening over an average of 81.5 days per patient, yielding a total of 23,074 assessment days. We computed eight dynamic process characteristics, including variability, autocorrelation, instability and complexity, for each TPQ scale, both on average per patient and in a moving-window approach. Then, the diagnostic groups were compared via one-way ANOVAs with Bonferroni–Holm correction. No significant differences emerged across diagnoses in any average process characteristics or their change over time, indicating that idiosyncratic within-person process dynamics overshadow diagnostic distinctions. Further, patients' clinical improvement was associated with rising mean levels and declining variability in positive emotions, mindfulness, insight and motivation. Again, these predictions of improvement were not moderated by patients' diagnoses. Our results support a transdiagnostic approach to measurement-based care that leverages individual process characteristics to guide interventions, rather than relying on diagnostic categories to predict therapy trajectories.

The aim of this systematic review was to identify how psychotherapies have been adapted to suit the needs of people with intellectual disabilities. A comprehensive literature search garnered 39,777 studies, which were screened for eligibility. Systematic searches, following PRISMA guidelines, identified 122 studies that met eligibility criteria, and findings were synthesised using framework synthesis. Six overarching adaptation categories were identified: (1) multisensory methods, (2) activities, (3) communication, (4) delivery medium, (5) additional support and (6) structure. Adaptations were primarily used to increase engagement, promote retention of information and improve communication between clients and clinicians. While a group of adaptations that aimed to improve the acceptability and accessibility of psychotherapy for people with intellectual disabilities were identified, larger studies are required to understand their efficacy.