Clinical psychology & psychotherapy最新文献

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.

Steven J. Lynn (1946–2024) was a prolific researcher who explored a wide array of topics in clinical psychology. He and his co-authors emphasized the importance of researching the side effects of psychological interventions. In the current studies (Study 1, N = 58; Study 2, N = 64), we examined clinicians' perspectives on side effects. A slight majority of clinicians in both studies reported familiarity with the topic (Study 1: n = 30, 51%; Study 2: n = 39, 61%). Those who claimed familiarity were more likely to discuss side effects with their patients compared with those who acknowledged a lack of knowledge. In Study 2, we found significant variation among clinicians regarding what constitutes avoidable, unavoidable or nonexistent side effects, and their views did not align with those of patients. This divergence may explain why a considerable number of clinicians refrain from discussing side effects with patients, despite patients' right to be fully informed about the potential benefits and risks of their treatment. Our findings underscore the need for clear guidelines that define the full spectrum of side effects and offer strategies for effective communication with patients. The first step in developing such guidelines is to raise awareness among professionals about the topic, which can be effectively achieved by engaging in the work of Steven J. Lynn and his co-authors, whose insights remain highly relevant.

This study explores the relationship between social camouflaging and pragmatic competence in adults diagnosed with autism spectrum disorder (ASD) and borderline personality disorder (BPD), with a particular focus on gender. It is based on the hypothesis that camouflaging contributes to under or misdiagnosis, especially in women and gender-diverse individuals. A total of 225 adults participated in a cross-sectional online survey, completing the Camouflaging Autistic Traits Questionnaire (CAT-Q) and the Pragmatic Awareness Questionnaire (PAQ). Participants were grouped based on clinical diagnosis (ASD or BPD) and self-identified gender (women, men and gender-diverse). Among women, no significant differences in camouflaging scores were found between the ASD and BPD groups, suggesting the use of similar adaptation strategies that may obscure clinical differentiation. In contrast, among men, camouflaging and pragmatic deficits were more distinctly associated with autistic traits. No substantial differences were observed among gender-diverse participants, highlighting the influence of contextual and identity-related factors. Findings emphasize the importance of integrating detailed pragmatic assessments and adopting gender-sensitive approaches in the differential diagnosis of ASD and BPD. Such strategies may help reduce misdiagnosis and improve recognition of autistic traits, particularly in populations that tend to camouflage more effectively.

This study aimed to evaluate the factor structure, internal consistency and concurrent validity of the Italian version of the Metacognitions about Smoking Questionnaire (MSQ), utilizing the framework of the Self-Regulation Executive Function model. A total of 532 smokers completed the Italian-translated version of the MSQ, the Fagerstrom Test for Nicotine Dependence, the Severity Dependence Scale, the Depression Anxiety and Stress Scale-21. To test the factorial structure of the MSQ, a series of confirmatory factor analyses (CFAs) were run; correlational analyses and structural equation modelling (SEMs) approaches were undertaken to evaluate the concurrent validity. The 12-item MSQ with four factors was confirmed: positive metacognitions about cognitive regulation (PM-CR), positive metacognitions about emotional regulation (PM-ER), negative metacognitions about uncontrollability (NM-U) and negative metacognitions about cognitive interference (NM-CI). The MSQ showed an overall satisfactory fit index (TLI = 0.949, CFI = 0.963, RMSEA = 0.082 [0.064–0.101]). Internal consistency was satisfactory. MSQ factors are associated with higher nicotine/cigarette dependence and emotional distress, supporting the concurrent validity of the tool. Specific metacognitions about smoking were associated with different clinical outcomes related to smoking. A higher engagement on PM-CR and on NM-U was positively associated with nicotine/cigarette dependence. A higher engagement on PM-ER and NM-CI was associated with greater emotional distress. The 12-item Italian version of the MSQ could be a promising tool to assess specific metacognitions about smoking in both research and clinical contexts. Metacognitions about smoking may be a suitable therapeutic target to reduce the levels of nicotine/cigarette dependence and emotional distress among smokers.