Clinical psychology & psychotherapy最新文献_第2页

Reciprocal Dynamics of Therapeutic Alliance and Depressive Symptoms in Inpatient Cognitive Behavioural Analysis System of Psychotherapy: The Role of Attachment Insecurity 住院患者心理治疗认知行为分析系统中治疗联盟与抑郁症状的相互动力学：依恋不安全感的作用。

IF 2.7 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2025-12-08 DOI: 10.1002/cpp.70200

Mona L. Diehm, Julia I. Kunz, Stephan Goerigk, Johannes Wolf, Jennifer Lange, Andrea Jobst, Frank Padberg, Matthias A. Reinhard

Background

Persistent depressive disorder (PDD) is marked by interpersonal dysfunction, presenting significant challenges for effective treatment. The Cognitive Behavioural Analysis System of Psychotherapy (CBASP) is specifically designed for PDD, offering a structured framework to foster a meaningful therapeutic relationship. However, its effectiveness in patients with attachment insecurities—commonly observed in PDD—remains unclear. This study examined the bidirectional relationship between the therapeutic working alliance and depressive symptoms, alongside the moderating role of attachment anxiety and attachment avoidance, in patients undergoing inpatient CBASP.

Methods

A total of 164 patients completed a 10-week inpatient CBASP programme. Depressive symptoms and the therapeutic working alliance were assessed weekly via self-report measures, while attachment anxiety and attachment avoidance were evaluated before and after treatment. Linear mixed-effects models were employed to analyse symptom and alliance trajectories, their reciprocal influences and the moderating effects of attachment insecurity.

Results

Over the course of treatment, depressive symptoms significantly decreased, while therapeutic alliance scores significantly increased. In addition, attachment anxiety decreased significantly. Attachment anxiety and attachment avoidance did not significantly moderate changes in depressive symptoms or therapeutic working alliance over time. Increases in the working alliance predicted subsequent reductions in depressive symptoms, and improvements in symptoms predicted subsequent strengthening of the working alliance. Attachment anxiety and attachment avoidance did not moderate these reciprocal associations.

Conclusion

Findings demonstrate a robust bidirectional relationship between working alliance and depressive symptomatology, independent of attachment insecurity. A brief CBASP intervention effectively reduces symptoms and strengthens the therapeutic alliance, highlighting its clinical utility in treating PDD.

背景：持续性抑郁障碍（PDD）以人际功能障碍为特征，对有效治疗提出了重大挑战。心理治疗的认知行为分析系统（CBASP）是专门为PDD设计的，提供了一个结构化的框架来培养有意义的治疗关系。然而，它对患有依恋不安全感的患者（通常在pdd中观察到）的有效性尚不清楚。本研究探讨了住院CBASP患者治疗工作联盟与抑郁症状之间的双向关系，以及依恋焦虑和依恋回避的调节作用。方法：164例患者完成了为期10周的住院CBASP计划。每周通过自我报告量表评估抑郁症状和治疗工作联盟，同时在治疗前后评估依恋焦虑和依恋回避。采用线性混合效应模型分析依恋不安全感的症状和联盟轨迹、相互影响和调节效应。结果：治疗过程中抑郁症状明显减轻，治疗联盟评分明显升高。此外，依恋焦虑显著降低。随着时间的推移，依恋焦虑和依恋回避对抑郁症状或治疗工作联盟没有显著的调节作用。工作联盟的增加预示着随后抑郁症状的减少，而症状的改善预示着随后工作联盟的加强。依恋焦虑和依恋回避并没有调节这些相互关联。结论：研究结果表明工作联盟与抑郁症状之间存在强大的双向关系，独立于依恋不安全感。短暂的CBASP干预有效地减轻了症状并加强了治疗联盟，突出了其在治疗PDD中的临床应用。

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引用次数: 0

Measuring Anxiety and Depression in Adolescents: Psychometric Properties of the Overall Anxiety and Depression Severity and Impairment Scales 青少年焦虑和抑郁的测量：总体焦虑和抑郁严重程度和损害量表的心理测量特征。

IF 2.7 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2025-12-08 DOI: 10.1002/cpp.70196

Inês Maçãs-Carvalho, Nélio Brazão, Marco Pereira, Maria Cristina Canavarro, Daniel Rijo

Background

Anxiety and depression are among the most prevalent mental health disorders in adolescence. However, there is a lack of efficient instruments that simultaneously assess both the severity and impairment associated with these symptoms. This study aims to adapt and further validate the Overall Anxiety Severity and Impairment Scale (OASIS) and the Overall Depression Severity and Impairment Scale (ODSIS) for adolescents.

Methods

The psychometric properties of the OASIS-A and ODSIS-A were examined in a community sample of 598 adolescents (51% male) from Portuguese public schools. Analyses included factor structure, internal consistency, measurement invariance, construct validity, gender-based comparisons and cutoff scores.

Results

Factor analysis supported a unidimensional structure for both the OASIS-A and ODSIS-A. The internal consistency was excellent for both scales (Cronbach's α and McDonald's ω for the OASIS-A were 0.90 and for ODSIS-A were 0.94) and measurement invariance across gender was established. The OASIS-A and ODSIS-A showed significant correlations with measures of anxiety, depression, quality of life and mental well-being, in theoretically expected directions. Additionally, girls reported significantly higher levels of anxiety and depression. Optimal cutoff scores were identified as 7 for OASIS-A and 5 for ODSIS-A.

Conclusions

This study presents the first psychometric evaluation of the OASIS-A and ODSIS-A, underscoring the utility of brief self-report measures for the severity and impairment associated with anxiety and depression in adolescents. Findings also support the use of these tools for screening purposes, particularly in school settings.

背景：焦虑和抑郁是青少年最普遍的心理健康障碍。然而，缺乏同时评估这些症状的严重程度和损害的有效工具。本研究旨在对青少年整体焦虑严重程度与损害量表（OASIS）和整体抑郁严重程度与损害量表（ODSIS）进行调整和进一步验证。方法：对来自葡萄牙公立学校的598名青少年（51%为男性）的社区样本进行OASIS-A和ODSIS-A的心理测量特性检测。分析包括因素结构、内部一致性、测量不变性、结构效度、基于性别的比较和截止分数。结果：因子分析支持osis - a和ODSIS-A的单维结构。两个量表的内部一致性都很好（osis - a的Cronbach's α和McDonald's ω为0.90，osis - a的Cronbach's α和McDonald's ω为0.94），并且建立了跨性别的测量不变性。OASIS-A和ODSIS-A与焦虑、抑郁、生活质量和心理健康的测量结果在理论上预期的方向上显示出显著的相关性。此外，女孩报告的焦虑和抑郁程度明显更高。osis - a的最佳分值为7分，osis - a的最佳分值为5分。结论：本研究首次对osis - a和ODSIS-A进行了心理测量评估，强调了简短自我报告测量与青少年焦虑和抑郁相关的严重程度和损害的效用。研究结果还支持将这些工具用于筛查目的，特别是在学校环境中。

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引用次数: 0

The Impact of Prolonged Exposure Therapy on Posttraumatic Stress Disorder Symptom Clusters in Adults Maintained on Medications for Opioid Use Disorder 长期暴露治疗对阿片类药物使用障碍维持的成人创伤后应激障碍症状群的影响

IF 2.7 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2025-12-08 DOI: 10.1002/cpp.70199

Jillian A. Giannini, Gary J. Badger, Rebecca Cole, Kelly R. Peck

Although prolonged exposure (PE) therapy has shown promise for improving overall posttraumatic stress disorder (PTSD) severity in individuals receiving treatment for opioid use disorder (OUD), its effect on individual PTSD symptom clusters has not been examined in this population. Thus, we examined PTSD symptom clusters (intrusion, avoidance, negative alterations in cognitions and mood [NACM], arousal and reactivity) in 82 adults who participated in one of two randomized trials wherein participants with PTSD who were receiving medications for OUD (MOUD) were randomized to: MOUD treatment as usual (TAU; n = 27), prolonged exposure therapy (PE; n = 27) or PE plus financial incentives contingent upon session attendance (PE+; n = 28). PTSD symptoms were assessed using the Clinician Administered PTSD Scale for DSM-5 at baseline and 4-, 8- and 12-week post-randomization. We compared the effect of experimental condition on PTSD symptom clusters. PTSD symptom clusters improved significantly (p's < 0.05) between baseline and week 12 (end of treatment) in all experimental conditions except for intrusion symptoms in TAU participants (p = 0.050). PE and PE+ participants reported greater improvements than TAU participants on intrusion symptoms (p's < 0.05). PE+ participants also experienced greater improvements on avoidance symptoms than TAU participants (p < 0.001). PE and PE+ participants achieved comparable reductions on all symptom clusters. Furthermore, participants in all experimental conditions improved similarly on NACM and arousal and reactivity symptom clusters. These results support the putative mechanisms of PE and suggest that PE+ may be well suited for improving more trauma-specific symptom clusters such as intrusion and avoidance in individuals receiving MOUD.

尽管长期暴露（PE）疗法已显示出改善接受阿片类药物使用障碍（OUD）治疗的个体创伤后应激障碍（PTSD）整体严重程度的希望，但其对个体PTSD症状群的影响尚未在该人群中得到检验。因此，我们检查了82名参加两项随机试验之一的成年人的PTSD症状群（入侵，回避，认知和情绪的负面改变[NACM]，唤醒和反应性），其中接受OUD药物治疗的PTSD患者（mod）被随机分为：常规OUD治疗（TAU, n = 27），延长暴露治疗（PE, n = 27）或PE加经济奖励（PE+, n = 28）。在基线和随机化后4周、8周和12周，使用DSM-5临床医生管理的PTSD量表评估PTSD症状。比较实验条件对PTSD症状群的影响。PTSD症状群显著改善（p’s）

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引用次数: 0

From Trauma to Recovery: A Systematic Review and Meta-Analysis on the Effectiveness of Psychosocial Interventions Applied to War Victims 从创伤到康复：应用于战争受害者的心理社会干预有效性的系统回顾和荟萃分析。

IF 2.7 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2025-12-08 DOI: 10.1002/cpp.70192

Çiçek Ediz, Sevda Uzun

Purpose

Trauma survivors in warring countries may show intense traumatic symptoms as they are forced to repeatedly experience severe traumatic experiences. Psychosocial intervention and support activities are of great importance in order to repair the deep psychological traumas caused by war. This study was conducted with the aim of demonstrating the effectiveness of psychosocial interventions applied to war victims.

Method

For this systematic review and meta-analysis study, studies were obtained by searching PubMed, Web of Science, EBSCOhost, Google Scholar and YÖK Thesis Center databases without any year limitation. After the reviews, 13 studies were included in the study.

Results

This systematic review and meta-analysis analysed the effects of psychosocial interventions on depression (SMD: −0.502; 95% CI: −0.966 to −0.037; Z = −2.117, p = 0.037 [I² = 87.32%]) and psychological well-being (SMD: −0.030; 95% CI: −0.721 to 0.660; Z = −0.886, p = 0.931 [I² = 97.99%]).

Conclusion

This study demonstrated that psychosocial interventions for war victims can play a beneficial role on individuals' mental health. These findings highlight the importance of early and targeted psychosocial intervention programs for war victims.

目的：战争国家的创伤幸存者可能表现出强烈的创伤症状，因为他们被迫反复经历严重的创伤经历。心理社会干预和支持活动对于修复战争造成的深层心理创伤具有重要意义。进行这项研究的目的是证明对战争受害者进行心理社会干预的有效性。方法：本系统综述和荟萃分析研究通过检索PubMed、Web of Science、EBSCOhost、谷歌Scholar和YÖK论文中心数据库获得，不受年份限制。经过审查，13项研究被纳入研究。结果：本系统综述和荟萃分析分析了心理社会干预对抑郁症（SMD: -0.502; 95% CI: -0.966 ~ -0.037; Z = -2.117, p = 0.037 [I2 = 87.32%]）和心理健康（SMD: -0.030; 95% CI: -0.721 ~ 0.660; Z = -0.886, p = 0.931 [I2 = 97.99%]）的影响。结论：本研究表明，对战争受害者的心理社会干预可以对个人的心理健康起到有益的作用。这些发现强调了为战争受害者提供早期和有针对性的社会心理干预方案的重要性。

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引用次数: 0

Mind Meets Machine: A Narrative Review of Artificial Intelligence Role in Clinical Psychology Practice 思维与机器的相遇：人工智能在临床心理学实践中的作用述评。

IF 2.7 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2025-12-04 DOI: 10.1002/cpp.70191

Andrea Calderone, Desirèe Latella, Elvira La Fauci, Roberta Puleo, Arturo Sergi, Mariachiara De Francesco, Maria Mauro, Angela Foti, Leda Salemi, Rocco Salvatore Calabrò

Background/Objectives

Clinical psychology is undergoing a profound transformation with the integration of artificial intelligence (AI) technologies. While the field has traditionally advanced from psychodynamic theories to cognitive-behavioural and evidence-based approaches, the emergence of AI presents both unprecedented opportunities and new challenges. This narrative review accordingly critically evaluates the integration of AI into clinical psychology practice, encompassing the continuum from assessment and diagnosis to intervention and follow-up care. It applies an analytic lens that differentiates clinically validated tools from experimental prototypes, and it appraises study quality against contemporary standards.

Methods

We conducted a comprehensive narrative review of the recent literature, focusing on studies and expert opinions regarding the application of machine learning (ML), deep learning (DL) and natural language processing (NLP) in psychological assessment and therapy, the use of digital phenotyping through smartphones and wearables and the implementation of AI-assisted care models in clinical practice.

Results

AI technologies are increasingly used to automate assessment scoring and analyse multimodal data, enhancing objectivity and scalability while requiring ongoing clinician oversight to address bias and interpretability issues. In therapeutic contexts, AI-driven conversational agents and hybrid ‘AI-in-the-loop’ systems show promise in supporting engagement and personalization, though ethical and relational concerns remain.

Conclusions

AI offers opportunities for selected assessment, monitoring and triage tasks, but evidence remains heterogeneous. Clinical integration should be incremental and evaluative, prioritizing external validation, calibration and patient-centred outcomes.

背景/目的：随着人工智能技术的融合，临床心理学正在经历一场深刻的变革。虽然该领域传统上从心理动力学理论发展到认知行为和循证方法，但人工智能的出现既带来了前所未有的机遇，也带来了新的挑战。这篇叙述性综述相应地批判性地评估了人工智能与临床心理学实践的整合，包括从评估和诊断到干预和后续护理的连续统一体。它应用了一种分析的视角，将临床验证的工具与实验原型区分开来，并根据当代标准评估研究质量。方法：我们对最近的文献进行了全面的叙述回顾，重点关注机器学习（ML），深度学习（DL）和自然语言处理（NLP）在心理评估和治疗中的应用，通过智能手机和可穿戴设备使用数字表型以及在临床实践中实施人工智能辅助护理模型的研究和专家意见。结果：人工智能技术越来越多地用于自动化评估评分和分析多模态数据，增强客观性和可扩展性，同时需要持续的临床医生监督来解决偏见和可解释性问题。在治疗环境中，人工智能驱动的对话代理和混合“人工智能在环”系统在支持参与和个性化方面表现出了希望，尽管伦理和关系问题仍然存在。结论：人工智能为选定的评估、监测和分类任务提供了机会，但证据仍然不一致。临床整合应该是渐进的和可评估的，优先考虑外部验证、校准和以患者为中心的结果。

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引用次数: 0

Hopelessness and Suicidal Ideation Across Age in Individuals Residing in Ukraine During the Ongoing Russian Occupation 在俄罗斯持续占领期间居住在乌克兰的个人的绝望和自杀意念。

IF 2.7 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2025-12-04 DOI: 10.1002/cpp.70190

José Vicente Esteve-Rodrigo, Iryna Semkiv, Samuel Mayoral, Iryna Zharova, María José Jorques Infante, Carmen Moret-Tatay

Living in a war zone is a profoundly traumatic experience that can lead to mental health disorders, such as post-traumatic stress disorder, as well as hopelessness and suicidal ideation (SI). The ongoing Russian occupation in Ukraine has resulted in casualties, population displacement and ongoing political strain, making individuals particularly vulnerable. This study aims to examine the interconnections between feelings of hopelessness and SI across age in individuals residing in Ukraine during the occupation. Additionally, this research aims to revisit the psychometric properties of the Beck Hopelessness Scale (BHS) for the Ukrainian population and explore the moderating role of SI in the relationship between age and hopelessness. Results suggest that the BHS has satisfactory psychometric properties and factor structure. Furthermore, the BHS displayed an inverse association with resilience. Age was found to be linked to specific subfactors associated with future but not with failure. Additionally, a moderation effect of SI was identified in the relationship between age and expectations of failure. The findings might contribute to understanding the mental health needs of the affected population and inform strategies to enhance overall well-being and reduce SI.

生活在战区是一种深刻的创伤经历，可能导致精神健康障碍，如创伤后应激障碍，以及绝望和自杀念头（SI）。俄罗斯对乌克兰的持续占领造成了伤亡、人口流离失所和持续的政治紧张，使个人特别脆弱。本研究旨在探讨在乌克兰占领期间居住的个体的绝望感和SI之间的相互联系。此外，本研究旨在重新审视乌克兰人口的贝克绝望量表（BHS）的心理测量特性，并探讨SI在年龄和绝望之间的关系中的调节作用。结果表明，BHS具有满意的心理测量特性和因子结构。此外，BHS与弹性呈负相关。研究发现，年龄与与未来相关的特定子因素有关，但与失败无关。此外，在年龄和失败预期之间的关系中发现了SI的调节作用。研究结果可能有助于了解受影响人群的心理健康需求，并为提高整体幸福感和减少SI提供策略。

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引用次数: 0

Clinical and Cost-Effectiveness of Eye Movement Desensitisation and Reprocessing for Post-Traumatic Stress Disorder in Children and Adolescents: A Systematic Review and Meta-Analysis 眼动脱敏和再加工治疗儿童和青少年创伤后应激障碍的临床和成本效益：系统回顾和荟萃分析。

IF 2.7 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2025-12-04 DOI: 10.1002/cpp.70186

Anthea Sutton, Christopher Carroll, Emma Simpson, Jessica Forsyth, Annabel Rayner, Shijie Ren, Matthew Franklin, Emily Wood

Eye movement desensitisation and reprocessing (EMDR) is a psychological therapy used to treat trauma. While trauma-focused cognitive behavioural therapy (TF-CBT) is often used, EMDR has potential for treating post-traumatic stress disorder (PTSD). Previous research has focused on adult populations, with limited evidence for children and adolescents available. A systematic review was conducted to evaluate the clinical and cost-effectiveness of EMDR for treating or preventing PTSD in children and adolescents. Randomised controlled trials (RCTs) were identified through a comprehensive search of six databases in September 2023. Eligibility criteria were based on the NICE 2018 PTSD guidelines. Data were extracted, and risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Meta-analyses were conducted where appropriate. Of 1220 unique records identified, nine studies met the inclusion criteria. Eight RCTs (n = 794 participants) explored clinical effectiveness, and one study examined cost-effectiveness. Most studies compared EMDR with waitlist/usual care. A meta-analysis demonstrated a significant and large effect size (SMD 1.57 95% CrI = 0.07–3.21) of EMDR treatment (delivered 3 months or more following trauma) compared with waitlist/usual care for children and adolescents with PTSD, in various populations including refugees, and victims of physical and/or sexual violence. Two trials compared EMDR with TF-CBT and found no significant difference between therapies. From the very limited cost-effectiveness evidence available, EMDR was ranked sixth out of 10 interventions. EMDR was demonstrated to be effective in reducing PTSD symptoms in children and adolescents, particularly when compared with waitlist/usual care. However, more high-quality RCTs are needed to establish definitive conclusions. In addition, future research should prioritise within-trial cost-effectiveness analyses to provide a more comprehensive understanding of the cost–benefit profile of EMDR.

Trial Registration: PROSPERO prospective register of systematic reviews: CRD42023463360.

眼动脱敏和再处理（EMDR）是一种用于治疗创伤的心理疗法。虽然经常使用以创伤为重点的认知行为疗法（TF-CBT），但EMDR具有治疗创伤后应激障碍（PTSD）的潜力。以前的研究主要集中在成年人身上，关于儿童和青少年的证据有限。本研究对EMDR治疗或预防儿童和青少年创伤后应激障碍的临床和成本效益进行了系统评价。随机对照试验（rct）于2023年9月通过对6个数据库的全面检索确定。入选标准基于NICE 2018 PTSD指南。提取数据，使用Cochrane risk of bias 2.0工具评估偏倚风险。适当时进行meta分析。在确定的1220个独特记录中，有9个研究符合纳入标准。8项随机对照试验（n = 794名参与者）探讨了临床效果，1项研究考察了成本效益。大多数研究将EMDR与等候名单/常规护理进行比较。一项荟萃分析显示，EMDR治疗（创伤后3个月或更长时间）与等候名单/常规护理相比，在包括难民和身体暴力和/或性暴力受害者在内的各种人群中，具有显著且较大的效应量（SMD 1.57 95% CrI = 0.07-3.21）。两项试验比较了EMDR和TF-CBT，发现两种疗法之间没有显著差异。从现有的非常有限的成本效益证据来看，EMDR在10项干预措施中排名第六。EMDR已被证明在减少儿童和青少年的创伤后应激障碍症状方面是有效的，特别是与等候名单/常规护理相比。然而，需要更多高质量的随机对照试验来建立明确的结论。此外，未来的研究应优先考虑试验内成本效益分析，以便更全面地了解EMDR的成本效益概况。试验注册：PROSPERO前瞻性系统评价注册：CRD42023463360。

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引用次数: 0

Why Mindfulness Doesn't Work for Everyone: Networked Lived Tensions in a Reflexive Thematic Study Across Psychiatric Contexts 为什么正念不是对每个人都有效：在精神病学背景下的反身性主题研究中，网络化的生活紧张。

IF 2.7 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2025-12-04 DOI: 10.1002/cpp.70194

Mehdi Akbari, Mohammad Seydavi

A significant proportion of individuals receiving mindfulness-based interventions (MBIs) do not experience meaningful clinical improvement, and understanding these nonresponses is critical for enhancing the adaptability, precision and inclusivity of MBI approaches. This study aimed to systematically investigate the subjective and process-related obstacles reported by individuals who failed to respond adequately to standard MBIs. A reflexive thematic analysis (RTA) design was employed in a large clinical sample of 194 participants (mean age = 36.4; 58.9% female), diagnosed with a range of psychiatric conditions. Participants were classified into four nonresponse subtypes: symptom nonresponses, early relapses, functional nonresponses and treatment dropouts. Analysis identified five interrelated themes: cognitive rigidity and effortful control, emotional avoidance and fear of exposure, meta-awareness fatigue, contextual alienation and relational distrust and identity threat with self-critical resistance. Reflexive analysis revealed these themes as dynamically intertwined, forming patterns that participants described as interconnected, in which cognitive overcontrol appeared linked to emotional avoidance, greater fatigue, heightened social alienation and increased identity vulnerability. Intersections highlighted the relational, sociocultural and motivational dimensions of nonresponse, with variability across diagnostic, gender, educational and prior treatment histories. Nonresponse was associated with adaptive, contextually mediated strategies to maintain psychological safety and self-coherence. Implications for enhancing MBI design and delivery include attention to identity, relational safety, metacognitive load and culturally informed facilitation strategies to support adaptive engagement and minimize inadvertent harm.

很大一部分接受正念干预（MBI）的个体没有经历有意义的临床改善，了解这些无反应对于提高MBI方法的适应性、准确性和包容性至关重要。本研究旨在系统地调查那些对标准mbi反应不充分的个体所报告的主观障碍和过程相关障碍。采用反身性主题分析（RTA）设计，对194名被诊断患有一系列精神疾病的参与者（平均年龄36.4岁，58.9%为女性）进行了大型临床样本分析。参与者被分为四种无反应亚型：症状无反应、早期复发、功能性无反应和治疗退出。分析确定了五个相互关联的主题：认知僵化和努力控制、情绪回避和暴露恐惧、元意识疲劳、语境异化和关系不信任以及自我批评抵抗的身份威胁。反身性分析显示，这些主题是动态交织在一起的，形成了参与者描述为相互关联的模式，其中认知过度控制似乎与情绪回避、更大的疲劳、更高的社会异化和更大的身份脆弱性有关。交叉点突出了无反应的关系、社会文化和动机维度，具有诊断、性别、教育和先前治疗史的可变性。无反应与维持心理安全和自我一致性的适应性、情境介导策略有关。加强MBI设计和交付的意义包括关注身份、关系安全、元认知负荷和文化知情的促进策略，以支持适应性参与并最大限度地减少无意伤害。

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引用次数: 0

Latent Profiles of Mental Health in Spanish Youth: Analysing Internalizing and Externalizing Problems 西班牙青年心理健康的潜在特征：内化与外化问题分析

IF 2.7 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2025-12-03 DOI: 10.1002/cpp.70188

Jose P. Espada, Àngela Belzunegui-Pastor, Samuel Tomczyk, José A. Piqueras, Alexandra Morales, Mireia Orgilés

Psychological problems are a common concern among children and adolescents. Identifying distinct profiles of internalizing and externalizing problems offers a comprehensive understanding of the psychological challenges faced by this population. This study aimed to explore mental health profiles in a sample of 5652 Spanish children and adolescents aged 8–16 years, examining differences between these profiles and reference groups. Using the Child and Adolescent Assessment System (SENA) and latent profile analysis (LPA), six profiles were identified among children and seven among adolescents, based on internalizing, externalizing and contextual problems. Among children, the most frequent profiles were ‘moderate problems, low conflict’ and ‘low problems’, while adolescents most commonly exhibited ‘moderate internalizing, low externalizing’ and ‘low problems’ profiles. Significant differences across profiles were linked to emotional regulation, self-esteem and social competence. These findings provide a nuanced perspective on the mental health landscape of Spanish youth, emphasizing the critical role of early detection of emotional difficulties in educational settings. Furthermore, the study offers valuable insights for developing tailored interventions to meet the specific emotional needs of children and adolescents.

心理问题是儿童和青少年普遍关心的问题。识别内化和外化问题的不同特征，可以全面了解这一人群面临的心理挑战。本研究旨在探讨5652名8-16岁的西班牙儿童和青少年的心理健康状况，检查这些状况与参考组之间的差异。利用儿童与青少年评估系统（SENA）和潜在特征分析（LPA），根据内化、外化和情境问题，确定了儿童和青少年的6个特征和7个特征。在儿童中，最常见的特征是“中度问题、低冲突”和“低问题”，而青少年最常见的特征是“中度内化、低外化”和“低问题”。不同侧面的显著差异与情绪调节、自尊和社交能力有关。这些发现为西班牙青年的心理健康状况提供了一个细致入微的视角，强调了在教育环境中早期发现情感困难的关键作用。此外，该研究为开发量身定制的干预措施以满足儿童和青少年的特定情感需求提供了有价值的见解。

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引用次数: 0

Impulsivity Does Not Lead to Physical Aggression in All Patients With Schizophrenia: The Moderating Role of Metacognition 冲动并不会导致所有精神分裂症患者的身体攻击：元认知的调节作用。

IF 2.7 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2025-12-03 DOI: 10.1002/cpp.70193

Özge Selin Özen Sekmek, Behice Han Almiş, Mustafa Uğurlu

Introduction

Aggressive behaviours are more frequent in schizophrenia patients compared to the general population. Impulsivity is a significant risk factor for aggressive behaviour. No previous studies have examined the role of metacognition in impulsivity that leads to physical aggression (PA) in schizophrenia patients. We hypothesised that impulsive schizophrenia patients with more maladaptive metacognitive beliefs may exhibit increased physical aggression. The aim of this study was to explore the moderating role of metacognition in the effects of impulsivity on PA in schizophrenia patients, as well as interventions for effectively managing PA.

Method

This study included 83 schizophrenia patients and 83 healthy controls. Positive and Negative Syndrome Scale was used to assess symptomatology, and Buss–Perry Aggression Scale (BP) was used to measure physical aggression. Barratt Impulsivity Scale (BIS) was utilised to evaluate impulsivity, and Metacognitions Scale-30 (MCQ-30) assessed metacognition.

Results

The BP total scores and BIS total scores were significantly higher in schizophrenia patients than healthy controls. Attentional Impulsivity (BIS-Att), negative beliefs about the uncontrollability and danger of worry (MCQ-UD), BIS-Att × MCQ-UD, and Motor Impulsivity (BIS-Motor) × Positive beliefs about worry (MCQ-PB) were especially strong predictors of BP-PA scores.

Discussion

Our findings indicate that not all types of impulsivity lead to an increase in PA among schizophrenia patients. Metacognitions play a significant role in moderating impulsivity when predicting PA, which may either support or prevent its escalation into acts of PA.

Conclusions

It may be beneficial to explore the effectiveness of metacognitive therapies in preventing impulsive aggression among schizophrenia patients.

与一般人群相比，精神分裂症患者的攻击行为更为频繁。冲动是攻击性行为的一个重要风险因素。此前没有研究考察元认知在导致精神分裂症患者身体攻击（PA）的冲动性中的作用。我们假设冲动性精神分裂症患者具有更不适应的元认知信念可能会表现出更多的身体攻击行为。本研究旨在探讨元认知在冲动性对精神分裂症患者PA的影响中的调节作用，以及有效管理PA的干预措施。方法：83例精神分裂症患者和83例健康对照。采用阳性和阴性综合征量表评估症状，采用Buss-Perry攻击量表（BP）测量肢体攻击。采用Barratt冲动性量表（BIS）评估冲动性，元认知量表-30 （MCQ-30）评估元认知。结果：精神分裂症患者BP总分和BIS总分明显高于健康对照组。注意冲动性（BIS-Att）、关于忧虑的不可控性和危险性的消极信念（MCQ-UD）、BIS-Att × MCQ-UD和运动冲动性（BIS-Motor） ×关于忧虑的积极信念（MCQ-PB）是BP-PA得分的较强预测因子。讨论：我们的研究结果表明，并不是所有类型的冲动都会导致精神分裂症患者PA的增加。元认知在预测PA时对冲动性起到调节作用，支持或阻止其升级为PA行为。结论：探讨元认知疗法对精神分裂症患者冲动性攻击行为的预防效果是有益的。

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引用次数: 0