Clinical psychology & psychotherapy最新文献_第7页

Temporal Directionality Between Symptoms During Treatment of Depressed Inpatients: A Dynamic Time Warp Network Analysis 抑郁症住院患者治疗期间症状之间的时间方向性：动态时间扭曲网络分析

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2024-10-08 DOI: 10.1002/cpp.3062

Daphne A. Cocx-Swiebel, Gabrielle van Son, Anita Scheper, Mirella Stuivenga, Bernard Sabbe, Kaat Hebbrecht, Erik J. Giltay

Background

Depression is generally perceived from the perspective of the common-cause disease model. However, the network perspective assumes mutual influence of individual symptoms and stresses the importance of investigating symptom dynamics. Gaining a better understanding of symptom dynamics within individuals might contribute to more effective treatments.

Methods

Current exploratory longitudinal research studied the associations and directionality between 43 symptoms from the generic questionnaire Symptom Questionnaire-48 (SQ-48) using dynamic time warp (DTW) analyses, in which trajectories with similar time-dependent patterns can be identified. Data from individuals were analysed first, yielding distance matrices for all symptom trajectories, after which the data were aggregated.

Results

The 148 included patients were all admitted for the treatment of their clinical depression. Undirected DTW analyses of three patients with longer time series but otherwise randomly chosen showed large variability among individuals. Group-level undirected DTW analyses showed numerous significant edges between symptoms, largely clustering symptoms according to the eight pre-existing subscales of the SQ-48. Group-level directed DTW analyses showed five symptoms with significant outstrength: ‘hopeless’, ‘restless’, ‘down/depressed’, ‘feeling tense’ and ‘no enjoyment’, meaning that change in these key symptoms preceded change in other symptoms.

Limitations

The 43 included symptoms of the SQ-48 primarily focus on internalizing problems in severely depressed inpatients, potentially limiting generalizability.

Conclusions

DTW networks provided us with five key symptoms based on the dynamics of symptom scores. Future studies could explore whether process-based therapy targeted at symptoms with high outstrength might result in more effectivity as part of personalized treatment.

背景：人们通常从常见病因模式的角度来看待抑郁症。然而，网络观点认为个体症状之间存在相互影响，并强调了调查症状动态的重要性。更好地了解个体的症状动态可能有助于更有效的治疗：目前的探索性纵向研究使用动态时间扭曲（DTW）分析法研究了通用问卷《症状问卷-48》（SQ-48）中 43 种症状之间的关联性和方向性。首先对个人数据进行分析，得出所有症状轨迹的距离矩阵，然后对数据进行汇总：结果：所纳入的 148 名患者均因治疗临床抑郁症而入院。对三名时间序列较长但随机选择的患者进行的非定向 DTW 分析表明，个体之间存在很大差异。组级非定向 DTW 分析表明，症状之间存在许多显著的边缘，主要是根据 SQ-48 中预先存在的八个分量表对症状进行了分组。组级定向 DTW 分析表明，有五个症状具有明显的外倾性："绝望"、"不安"、"沮丧/抑郁"、"紧张 "和 "无乐趣"，这意味着这些关键症状的变化先于其他症状的变化：局限性：SQ-48 包含的 43 个症状主要集中在严重抑郁住院患者的内化问题上，这可能会限制其普遍性：DTW网络根据症状评分的动态变化为我们提供了五种关键症状。未来的研究可以探索针对高强度症状的过程性治疗是否会作为个性化治疗的一部分产生更大的效果。

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引用次数: 0

Predictors and Patterns of Dropout From Psychiatric Treatment Among Trauma-Affected Refugees: A Large Data Pool Analysis 受创伤影响的难民中精神病治疗辍学的预测因素和模式：大型数据池分析。

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2024-10-08 DOI: 10.1002/cpp.3060

Erik Vindbjerg, Hinuga Sandahl, Laura Glahder Lindberg, Henriette Laugesen Attardo, Erik Lykke Mortensen, Jessica Carlsson

Dropout from mental health treatment is a substantial hindrance to relevant and effective treatment. Despite the high prevalence of PTSD among refugees, research into their treatment dropout has received limited attention. This study aimed to identify patterns and predictors of treatment dropout versus completion through different treatment stages. The sample included 940 patients with a refugee background undergoing outpatient treatment for PTSD in Denmark. All patients were offered 10 medical doctor sessions and 16–20 psychotherapy sessions. Dropout was analysed in three stages: (1) during the first six MD sessions, (2) during the first eight psychotherapy sessions upon completion of Stage 1, and (3) during psychotherapy sessions 9 to 16. A stepwise multiple regression analysis was conducted for each stage to identify predictors of stage-specific dropout. Counter to expectations, both early dropout and full completion were associated with better symptom outcomes, relative to late-treatment dropout. Key predictors varied by stage, with younger age predicting early dropout, whereas chronic pain and poor Danish proficiency predicted late dropout. Female gender and a clearly articulated motivation for active participation were predictors for full treatment completion. Practical advice is suggested to accommodate at-risk patients and to re-evaluate patient engagement after familiarisation with treatment.

心理健康治疗中的辍学现象严重阻碍了相关的有效治疗。尽管创伤后应激障碍在难民中的发病率很高，但对他们放弃治疗的研究却很少受到关注。本研究旨在通过不同的治疗阶段，识别治疗辍学与治疗完成的模式和预测因素。样本包括940名在丹麦接受创伤后应激障碍门诊治疗的难民患者。所有患者均接受了10次医生治疗和16-20次心理治疗。辍学情况分三个阶段进行分析：(1) 前六次医生治疗期间；(2) 完成第一阶段治疗后的前八次心理治疗期间；(3) 心理治疗第9至16次期间。我们对每个阶段进行了逐步多元回归分析，以确定特定阶段辍学的预测因素。与预期相反的是，相对于治疗后期的辍学，早期辍学和完全完成治疗与更好的症状疗效相关。不同阶段的主要预测因素各不相同，年龄越小越容易早期辍学，而慢性疼痛和丹麦语水平低则容易晚期辍学。女性性别和明确表达的积极参与动机是完全完成治疗的预测因素。本文提出了一些实用建议，以帮助有风险的患者，并在熟悉治疗方法后重新评估患者的参与度。

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引用次数: 0

Assessing Patient Satisfaction With Metacognitive Training (MCT) for Psychosis: A Systematic Review of Randomized Clinical Trials 评估患者对治疗精神病的元认知训练（MCT）的满意度：随机临床试验系统回顾》。

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2024-10-08 DOI: 10.1002/cpp.3065

Vanessa Acuña, Álvaro Cavieres, Marcelo Arancibia, Camila Escobar, Steffen Moritz, Lukasz Gaweda, María Lamarca, Fabrice Berna, Caroline König, Susana Ochoa

Objectives

Metacognitive training (MCT) for psychosis is a group intervention that combines cognitive-behavioural therapy and psychoeducation. It has proven efficacy in reducing psychotic symptoms and correcting cognitive biases implicated in the development and maintenance of psychotic symptoms. However, other outcomes, such as patient satisfaction with the intervention, have not been well studied despite their importance for adherence and overall success. A systematic review of randomized clinical trials was conducted to assess satisfaction with MCT among adults with psychotic spectrum disorders.

Methods

The search was conducted in Ovid Embase, Ovid MEDLINE, PsycINFO and Cochrane Central Register of Controlled Trials (CENTRAL). PRISMA guidelines and the Cochrane Risk of Bias Tool were followed, and certainty of evidence was ascertained using the Grading of Recommendations Assessment, Development and Evaluation framework. The study is registered with PROSPERO (CRD42023418097).

Results

Patient satisfaction was considered the primary outcome in 3 of the 10 studies reviewed. Four studies compared MCT with other psychosocial interventions (a newspaper discussion group, cognitive remediation and supportive therapy), two of which found significantly higher satisfaction with MCT. A high percentage of all patients found MCT comprehensible and considered it an important part of their treatment; they would recommend the training to others and found the group setting advantageous. Most participants expressed high subjective satisfaction or acceptance of MCT.

Conclusions

The authors found evidence that MCT may be associated with high levels of satisfaction in clinical trials whose main objective is to assess patient satisfaction, but more research is needed to consolidate the findings, especially for the extended version of MCT.

目的：治疗精神病的元认知训练（MCT）是一种结合了认知行为疗法和心理教育的集体干预措施。事实证明，它能有效减轻精神病症状，纠正与精神病症状的发展和维持有关的认知偏差。然而，尽管患者对干预的满意度等其他结果对坚持治疗和总体成功非常重要，但对这些结果的研究却不多。我们对随机临床试验进行了系统回顾，以评估患有精神谱系障碍的成人对 MCT 的满意度：在 Ovid Embase、Ovid MEDLINE、PsycINFO 和 Cochrane 对照试验中央注册中心 (CENTRAL) 中进行了检索。研究遵循了PRISMA指南和Cochrane偏倚风险工具，并使用建议分级评估、发展和评价框架确定了证据的确定性。该研究已在 PROSPERO 注册（CRD42023418097）：结果：在所审查的 10 项研究中，有 3 项研究将患者满意度视为主要结果。四项研究将 MCT 与其他社会心理干预（报纸讨论小组、认知矫正和支持疗法）进行了比较，其中两项研究发现 MCT 的满意度明显更高。在所有患者中，有很高比例的人认为 MCT 是可以理解的，并认为它是治疗的重要组成部分；他们会向其他人推荐这种培训，并认为小组环境很有利。大多数参与者对MCT表示了高度的主观满意度或接受度：作者发现有证据表明，在以评估患者满意度为主要目标的临床试验中，MCT 可能与高满意度相关，但还需要更多的研究来巩固研究结果，尤其是针对扩展版的 MCT。

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引用次数: 0

Negative Flashforward Imagery in Adolescent Social Anxiety Disorder: A Pilot Study of Imagery Reports and a Short EMDR Intervention 青少年社交焦虑症中的消极闪回意象：意象报告和短期 EMDR 干预的试点研究。

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2024-10-03 DOI: 10.1002/cpp.3063

Marjolein R. Thunnissen, Peter J. de Jong, Jiska Weijermans, Leonieke J. J. Vet, Marleen M. Rijkeboer, Maaike H. Nauta

Psychological treatments for social anxiety disorder (SAD) in adolescents have shown poorer outcomes than for other anxiety disorders. A relevant factor to consider for improving outcomes may be negative imagery. In this pilot study, we examined negative ‘flashforward’ imagery of feared catastrophic outcomes in adolescents with SAD and evaluated the feasibility and preliminary outcomes of a short eye movement desensitization and reprocessing (EMDR) intervention targeting this imagery. We used a case series design with a 1-week baseline period. Outcomes included symptoms of social anxiety and avoidance related to selected social situations and features of associated flashforward imagery as the proposed mechanism of change during the intervention. We found that six out of seven assessed adolescents reported to experience flashforwards and rated image distress, vividness and threat appraisal as high. In these six participants (aged 14–17 years old), the short EMDR flashforward intervention appeared feasible and was followed by a decrease in social anxiety and avoidance in five participants, while no notable changes were observed during the baseline period. Furthermore, we observed a decrease in flashforward imagery features in at least five participants. Nonparametric tests of the overall (group-based) changes during the intervention period partially supported these findings. Limitations include the small sample size and the lack of a control group. Results suggest that vivid and distressing flashforward imagery is a common experience and that targeting flashforwards with EMDR may be beneficial in treating social anxiety in youth. Further experimental research on effects and added value to current treatments is necessary.

Trial Registration: Dutch Clinical Trial Register (National Trial Register [NTR]): NL8974

与其他焦虑症相比，青少年社交焦虑症（SAD）的心理治疗效果较差。消极意象可能是改善疗效的一个相关因素。在这项试验性研究中，我们研究了患有社交焦虑症的青少年所担心的灾难性结果的负面 "闪回 "意象，并评估了针对这种意象的短期眼动脱敏和再处理（EMDR）干预的可行性和初步结果。我们采用了为期一周的基线期的病例系列设计。干预结果包括与选定社交情境相关的社交焦虑和回避症状，以及作为干预期间拟议改变机制的相关闪回意象的特征。我们发现，在七名接受评估的青少年中，有六名报告说经历过闪回，并对图像的痛苦程度、生动程度和威胁评估进行了高度评价。在这六名参与者（14-17 岁）中，短暂的 EMDR 闪回干预似乎是可行的，五名参与者的社交焦虑和回避情绪随之下降，而在基线期没有观察到明显的变化。此外，我们还观察到至少有五名参与者的闪回意象特征有所减少。对干预期间整体（基于群体）变化的非参数检验部分支持了这些发现。不足之处包括样本量较小和缺乏对照组。研究结果表明，生动而痛苦的闪回意象是一种常见的体验，针对闪回意象进行 EMDR 可能对治疗青少年的社交焦虑有益。有必要对当前治疗方法的效果和附加值进行进一步的实验研究。试验注册：荷兰临床试验登记处（国家试验登记处 [NTR]）：NL8974。

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引用次数: 0

Dropout From Psychological Interventions for Pathological Health Anxiety: A Three-Level Meta-Analysis of Randomized Controlled Trials 病理性健康焦虑心理干预的辍学率：随机对照试验的三级元分析》。

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2024-10-03 DOI: 10.1002/cpp.3064

Congrong Shi, Ying Wu, Hongrui Wei, Yang Xiao, Xiaohui Lv, Zhihong Ren

This study aimed to provide the first comprehensive evidence on the prevalence and predictors of dropout in psychological interventions for pathological health anxiety. A database search in Web of Science, EMBASE, PubMed, Scopus, PsycINFO and the Cochrane Central Register of Controlled Trials identified 28 eligible randomized controlled trials (40 intervention conditions; 1783 participants in the intervention condition), published up to 18 June 2024. Three-level meta-analytic results showed a weighted average dropout rate of 9.67% (95% confidence interval [CI] [6.49%, 14.17%]), with dropout equally likely from treatment and control conditions (odds ratio = 1.07, 95% CI [0.80, 1.44]). Moderator analyses indicated no statistically significant effects of study, participant, treatment or therapist characteristics, except for the country of study. These findings suggest that the average dropout rate is relatively low compared with those reported for other mental health conditions and highlight the importance of considering cultural and societal factors when evaluating treatment adherence. Future research should continue to explore the complex and multifaceted factors influencing dropout to improve the design and implementation of psychological interventions for pathological health anxiety.

本研究旨在提供第一份有关病态健康焦虑心理干预中的辍学率和辍学预测因素的全面证据。通过在 Web of Science、EMBASE、PubMed、Scopus、PsycINFO 和 Cochrane Central Register of Controlled Trials 中进行数据库检索，发现了 28 项符合条件的随机对照试验（40 种干预条件；1783 名参与者参与了干预条件），这些试验的发表日期均截止到 2024 年 6 月 18 日。三级荟萃分析结果显示，加权平均辍学率为9.67%（95%置信区间[CI][6.49%, 14.17%]），治疗条件和对照条件的辍学几率相同（几率比=1.07，95% CI [0.80, 1.44]）。调节分析表明，除研究国家外，研究、参与者、治疗或治疗师的特征在统计学上没有显著影响。这些研究结果表明，与其他精神疾病相比，平均辍学率相对较低，并强调了在评估治疗依从性时考虑文化和社会因素的重要性。未来的研究应继续探索影响辍学的复杂而多方面的因素，以改进病态健康焦虑心理干预的设计和实施。

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引用次数: 0

A Latent Class Analysis on Indicators of Early Prolonged Grief Disorder and Well-Being Among Dutch Adults Bereaved During the First Year of the COVID-19 Pandemic 对 COVID-19 大流行第一年期间失去亲人的荷兰成年人的早期长期悲伤障碍指标和幸福感进行潜类分析》（A Latent Class Analysis on Indicators of Early Prolonged Grief Disorder and Well-Being Among Dutch Adults Bereaved during the First Year of the COVID-19 Pandemic）。

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2024-10-01 DOI: 10.1002/cpp.3054

Lyanne Reitsma, Trudy M. Mooren, Joanne Mouthaan, Marie-José Van Hoof, Simon P. N. Groen, Iris Van Dijk, Annett Lotzin, Paul A. Boelen, Lonneke I. M. Lenferink

Most studies examining prolonged grief disorder (PGD) in people bereaved during the COVID-19 pandemic are focused on psychopathology. However, mental health encompasses both absence of psychopathology and presence of well-being. This is the first study examining symptom profiles of early PGD and subjective mental well-being in 266 Dutch adults recently bereaved during the pandemic. Early PGD and well-being indicators were assessed with the Traumatic Grief Inventory–Self Report Plus and the World Health Organization–Five Well-Being Index, respectively. Latent class analysis identified four classes: low PGD/high well-being (32%), low PGD/moderate well-being (24%), moderate PGD/high well-being (23%) and high PGD/low well-being class (21%). People in the poorer mental health classes were more likely to be female, lower educated, suffering from a mental disorder, have a poor health status, closer kinship to the deceased, and higher risk of severe COVID-19. Classifying adults according to symptom profiles of negative and positive outcomes provides a more complete picture of mental health in bereaved people and offers potential intervention targets.

大多数针对 COVID-19 大流行期间丧亲人群长期悲伤障碍（PGD）的研究都侧重于心理病理学。然而，心理健康既包括不存在精神病理学，也包括存在幸福感。这是首次对 266 名在大流行中丧亲的荷兰成年人进行早期 PGD 症状和主观心理健康的研究。研究分别采用创伤性悲伤量表--自我报告增强版和世界卫生组织--五项幸福指数对早期创伤性悲伤和幸福指标进行了评估。潜类分析确定了四个等级：低 PGD/高幸福感（32%）、低 PGD/中等幸福感（24%）、中等 PGD/高幸福感（23%）和高 PGD/低幸福感等级（21%）。精神健康状况较差等级的人更有可能是女性、教育程度较低、患有精神障碍、健康状况较差、与死者的亲属关系较近，以及患严重 COVID-19 的风险较高。根据消极和积极结果的症状特征对成年人进行分类，可以更全面地了解丧亲者的心理健康情况，并提供潜在的干预目标。

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引用次数: 0

Intelligence and Treatment Outcome of Mentalization-Based Treatment in Borderline Personality Disorder 边缘型人格障碍患者的智力和基于心智化治疗的治疗效果。

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2024-10-01 DOI: 10.1002/cpp.3061

Lieke Muskens, Samantha Bouwmeester, Miranda Nooijen, Nathan Bachrach

<div> <section> <h3> Background</h3> <p>Mentalization-based treatment (MBT) is an evidence based treatment for patients diagnosed with borderline personality disorder (BPD). Although MBT is effective, on average, for individuals with BPD, there are large individual differences in treatment outcomes. Research on predictors of the treatment effect of MBT, such as intelligence, is needed to determine which treatment is most effective for which ‘category’ of BPD patients, providing more knowledge about optimal indications.</p> </section> <section> <h3> Objective</h3> <p>The study aimed to investigate whether intelligence is associated with MBT outcomes in patients with BPD and exploratively studying the difference between two variants of MBT.</p> </section> <section> <h3> Methods and Procedures</h3> <p>A pre-post intervention design was used to examine the effects of MBT on BPD severity. Personal and social recovery were measured as secondary outcome measures. The association between intelligence and the degree of recovery was examined.</p> </section> <section> <h3> Results</h3> <p>No significant correlation was found between intelligence level and treatment efficacy. In addition, a negative correlation between IQ and personal and social recovery was found, indicating that, as IQ increased, the level of recovery decreased. Secondary subanalyses showed the treatment effect of MBT was large and significant in reducing BPD symptoms (Cohen's <i>d</i> = 1.5) and that there was no significant difference between the 2-day MBT and 3-day MBT programmes in terms of a decrease in BPD severity. However, a significant medium positive correlational relationship was found between intelligence and a decrease in BPD severity level for the 3-day MBT, which was not found for the 2-day MBT programme. This indicates that in the 3-day MBT programme, the higher the IQ, the higher the decrease in BPD severity level.</p> </section> <section> <h3> Conclusions and Implications</h3> <p>This study is the first to examine the association between intelligence and the outcome of MBT in BPD patients. It shows that patients with a wide range of intelligence (72–124) can equally benefit from MBT and that effectiveness of MBT was not influenced negatively by lower intelligence. Secondary subanalyses showed that this was particularly evident when the intervention was delivered within the context of a 2-day MBT programme. Nevertheless, further randomized studies are required to ascertain t

背景：心智化治疗（MBT）是针对被诊断为边缘型人格障碍（BPD）患者的一种循证治疗方法。虽然基于心智的治疗对边缘型人格障碍患者平均有效，但治疗结果存在很大的个体差异。需要对预测MBT治疗效果的因素（如智力）进行研究，以确定哪种治疗方法对哪 "类 "BPD患者最有效，从而为最佳适应症提供更多知识：本研究旨在调查智力是否与 BPD 患者的 MBT 治疗效果相关，并探索性地研究 MBT 两种变体之间的差异：方法和程序：采用前后干预设计来研究 MBT 对 BPD 严重程度的影响。个人和社会康复作为次要结果测量。对智力与康复程度之间的关系进行了研究：结果：智力水平与治疗效果之间没有发现明显的相关性。此外，智商与个人和社会康复之间呈负相关，表明随着智商的提高，康复程度也会降低。二级子分析表明，MBT 在减少 BPD 症状方面的治疗效果显著（Cohen's d = 1.5），在降低 BPD 严重程度方面，2 天 MBT 和 3 天 MBT 方案没有显著差异。然而，在为期 3 天的 MBT 方案中，智力与 BPD 严重程度的下降之间存在着明显的中正向相关关系，而在为期 2 天的 MBT 方案中却没有发现这种关系。这表明，在为期 3 天的 MBT 方案中，智商越高，BPD 严重程度的下降幅度就越大：本研究首次探讨了BPD患者的智力与MBT结果之间的关系。研究表明，智力范围广泛（72-124）的患者同样可以从MBT中获益，而且智力较低不会对MBT的效果产生负面影响。二次子分析表明，在为期 2 天的 MBT 计划中进行干预时，这一点尤为明显。不过，还需要进一步开展随机研究，以确定智商与治疗效果之间的关系，以及其他预测甲基溴治疗效果的因素。

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引用次数: 0

Posttraumatic Stress Disorder Symptom Clusters, Exposure to Potentially Morally Injurious Events, and Aggression Among Army Veterans 退伍军人中的创伤后应激障碍症状群、暴露于潜在道德伤害事件和攻击行为。

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2024-09-23 DOI: 10.1002/cpp.3056

David Potik, Tomer Einat, Yael Idisis

Objective

Very few studies have examined the association between posttraumatic stress disorder (PTSD) symptom clusters and aggression since the change in PTSD diagnosis criteria a decade ago. Furthermore, these studies have used measures based on PTSD criteria of the DSM-IV. The current study therefore examines the association between PTSD symptom clusters, exposure to potentially morally injurious events (PMIEs), and various types of aggression following the change in PTSD criteria and in accordance with the criteria of the DSM-5-TR.

Method

A sample of 167 Israeli combat veterans completed validated self-report questionnaires tapping PTSD symptoms, exposure to PMIEs, and aggression levels.

Results

Our analysis revealed a significant positive relationship between the number of court-martials, betrayal-based PMIEs, all PTSD symptom clusters, and aggression. We also found that the arousal cluster, as well as the number of court-martials and age, predicted aggression, whereas the re-experiencing cluster predicted lower aggression levels.

Conclusion

Besides an updated understanding of the association between all PTSD symptom clusters and various forms of aggression, these findings emphasize the importance of targeting arousal symptoms and especially anger in treatment of veterans with PTSD symptoms and those who report experiences of betrayal. The findings also suggest clinicians to consider arousal symptoms, age, and history of court-martials when conducting either clinical or actuarial risk assessments of veterans.

目的：自十年前创伤后应激障碍（PTSD）诊断标准发生变化以来，很少有研究探讨创伤后应激障碍（PTSD）症状群与攻击行为之间的关系。此外，这些研究都是根据 DSM-IV 中的创伤后应激障碍标准进行测量的。因此，本研究根据 DSM-5-TR 的标准，研究了 PTSD 诊断标准改变后 PTSD 症状群、潜在道德伤害事件（PMIE）暴露与各种类型的攻击行为之间的关联：方法：167 名以色列退伍军人完成了有效的自我报告问卷，调查创伤后应激障碍症状、PMIEs 暴露和攻击水平：我们的分析表明，军法审判次数、基于背叛的PMIEs、所有创伤后应激障碍症状群和攻击性之间存在明显的正相关关系。我们还发现，唤醒症状群、军法审判次数和年龄都能预测攻击行为，而重新体验症状群则能预测较低的攻击行为水平：除了对所有创伤后应激障碍症状群与各种形式的攻击行为之间的关联有了新的认识外，这些研究结果还强调了在治疗有创伤后应激障碍症状的退伍军人和报告有背叛经历的退伍军人时，针对唤醒症状，尤其是愤怒症状进行治疗的重要性。研究结果还建议临床医生在对退伍军人进行临床或精算风险评估时，考虑唤醒症状、年龄和军法审判史。

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引用次数: 0

Suicide in China: The Trends and Differentials From 2002 to 2021 中国的自杀现象：2002 至 2021 年中国自杀率的趋势与差异》。

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2024-09-22 DOI: 10.1002/cpp.3053

Fei-Hong Hu, Peng Liu, Yi-Jie Jia, Meng-Wei Ge, Lu-Ting Shen, Xiao-Peng Xia, Hong-Lin Chen

Objective

The objective of this study was to provide an updated analysis of suicide characteristics in China from 2002 to 2021, with the aim of informing the development of evidence-based suicide prevention strategies.

Methods

The Ministry of Health-Vital Registration System (MOH-VR) provided the data on suicide mortality, which enabled us to examine the average annual percentage change (AAPC) in suicide rates using a Poisson regression model.

Results

Notably, there has been a significant decline in suicide rates observed in both urban and rural areas. In the early years of the study period, higher suicide rates were observed among females compared to males; however, a shift occurred after 2005, with male suicide rates surpassing those of females. Except for 2005, rural areas consistently exhibited higher suicide rates than urban areas. Furthermore, suicide rates exhibited an increasing trend with age, irrespective of gender or region.

Conclusion

These findings highlight a decreasing trend in suicide rates in China over the past two decades, although gender and regional disparities persist. Going forward, sustained efforts in suicide prevention, with a specific focus on mental health, are warranted.

研究目的本研究旨在对2002年至2021年中国的自杀特征进行最新分析，为制定循证自杀预防策略提供参考：方法：由卫生部生命登记系统（MOH-VR）提供自杀死亡率数据，利用泊松回归模型研究自杀率的年均百分比变化（AAPC）：值得注意的是，城市和农村地区的自杀率都有明显下降。在研究初期，女性自杀率高于男性；但 2005 年后，情况发生了变化，男性自杀率超过了女性。除 2005 年外，农村地区的自杀率一直高于城市地区。此外，随着年龄的增长，自杀率也呈上升趋势，与性别或地区无关：这些研究结果表明，在过去二十年中，中国的自杀率呈下降趋势，但性别和地区差异依然存在。展望未来，有必要继续努力预防自杀，特别是关注心理健康。

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引用次数: 0

The Factors of the Psychotherapists' Attitude Towards Technology: Combining Attitudes Towards Technology and Technology Readiness Models 心理治疗师对技术的态度因素：结合对技术的态度和技术就绪模型。

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2024-09-22 DOI: 10.1002/cpp.3055

Agnieszka Koch, Agata Graczykowska, Szymon Szumiał, Patrycja Rudnicka, Magdalena Marszał-Wiśniewska

Objectives

The study aimed to explore psychotherapists' attitudes towards new technologies. Understanding the factors influencing their acceptance of technologies is essential to improving the accessibility, quality, and effectiveness of psychotherapeutic care in the digital age. Based on previous research from different fields (e.g., e-government and mobile applications), we integrated the Unified Theory of Acceptance and Use of Technology (UTAUT-T) with the Technology Readiness Index (TRI). UTAUT-T focuses on one's perception of technology, while TRI emphasizes individual characteristics. Therefore, we regard psychotherapists' attitudes towards digital solutions by analysing factors related to technology and users (psychotherapists).

Methods

We conducted an online questionnaire study involving 391 psychotherapists aged 25–66 (M = 40.90; SD = 7.79). Participants completed self-report questionnaires: UTAUT-T, TRI 2.0, and a survey measuring technology usage at work.

Results

The model explained 30.2% of the variance in actual technology usage and 57.6% in behavioural intention. Both technology-related and therapist-related factors affect technology use. Some factors directly influence use behaviour (optimism, ease of use, convenience), while others are mediated by behavioural intention (pressure from others, professional support, therapy quality expectations).

Conclusions

Technology-related and therapist-related factors influence psychotherapists' use of technology. The study revealed that optimism plays a crucial role in addition to behavioural intention. This insight is vital for implementing new technologies in mental health services.

研究目的本研究旨在探讨心理治疗师对新技术的态度。了解影响他们接受技术的因素对于提高数字时代心理治疗的可及性、质量和有效性至关重要。基于以往不同领域（如电子政务和移动应用）的研究，我们将技术接受和使用统一理论（UTAUT-T）与技术准备指数（TRI）进行了整合。UTAUT-T侧重于个人对技术的感知，而TRI则强调个人特征。因此，我们通过分析与技术和用户（心理治疗师）相关的因素来了解心理治疗师对数字化解决方案的态度：我们对 391 名年龄在 25-66 岁之间的心理治疗师（M=40.90；SD=7.79）进行了在线问卷调查。参与者填写了自我报告问卷：研究结果显示，该模型解释了30.2%的心理健康问题：结果：模型解释了 30.2% 的实际技术使用差异和 57.6% 的行为意向差异。与技术相关的因素和与治疗师相关的因素都会影响技术的使用。一些因素直接影响使用行为（乐观、易用性、便利性），而另一些因素则通过行为意向（来自他人的压力、专业支持、治疗质量预期）进行中介：结论：与技术和治疗师相关的因素会影响心理治疗师对技术的使用。研究表明，除行为意向外，乐观情绪也起着至关重要的作用。这种洞察力对于在心理健康服务中实施新技术至关重要。

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引用次数: 0