首页 > 最新文献

Clinical psychology & psychotherapy最新文献

英文 中文
The Cognitive Architecture of Obsessional Doubt: Inferential Confusion and Feared Selves in OCD-Relevant Intrusions 强迫性怀疑的认知架构:强迫症相关入侵中的推理混乱和恐惧自我。
IF 2.7 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2025-10-21 DOI: 10.1002/cpp.70164
Mohammad Aminaee, Seyed Mohammadreza Taghavi, Frederick Aardema, Seyed Alireza Sadjadi, Mehdi Reza Sarafraz, Mohammad Ali Goodarzi

Although previous research has examined the individual roles of unwanted intrusive thoughts (UITs), inferential confusion and feared selves in obsessive-compulsive disorder (OCD), no study to date has evaluated their combined effects on OCD severity. This is particularly relevant given that the inference-based approach (IBA) posits a close link between inferential confusion and feared selves in the context of obsessional doubt. The present study with a cross-sectional design investigated the role of inferential confusion and feared selves in mediating the relationship between OCD-relevant UITs and OCD severity. A clinical sample of 306 individuals with a primary diagnosis of OCD (mean age = 32.95, SD = 9.99, female = 58.8%) who also had some comorbid psychiatric disorders, with the exception of a current or previous history of personality disorders, psychotic disorders and substance use disorders, completed a battery of self-reported measures—including the Questionnaire of Unpleasant Intrusive Thoughts, Fear of Self Questionnaire-Multidimensional Version, Patient Health Questionnaire and Expanded Version of the Inference Confusion Questionnaire)—as well as the clinician-administered version of the Yale-Brown Obsessive-Compulsive Scale. Bootstrapped mediation analyses (5000 resamples, 95% confidence interval) revealed that UITs were indirectly associated with OCD severity via inferential confusion and one specific dimension of feared selves: the feared corrupted self. Mediation was not supported for the feared culpable or malformed selves in this model. However, a serial mediation pathway emerged wherein inferential confusion and both feared corrupted and culpable selves sequentially mediated the link between UITs and clinician-rated OCD severity. The findings suggest that inferential confusion, along with specific feared self domains, plays a critical role in differentiating intrusive thoughts that are common in the general population from obsessional doubt, as conceptualised in the IBA. Within the inference-based framework, these processes do not merely escalate UITs; rather, they actively produce obsessional doubts that disconnect the individual from reality and render the imagined threat personally meaningful, persistent and in need of resolution.

虽然之前的研究已经考察了不想要的侵入性思想(UITs)、推理混乱和恐惧自我在强迫症(OCD)中的个体作用,但迄今为止还没有研究评估过它们对强迫症严重程度的综合影响。这是特别相关的,因为基于推理的方法(IBA)假设在强迫性怀疑的背景下,推理混乱和恐惧自我之间存在密切联系。本研究采用横断面设计,探讨了推理混淆和恐惧自我在强迫症相关单元与强迫症严重程度之间的中介作用。临床样本为306例初诊为强迫症的个体(平均年龄32.95,SD = 9.99,女性= 58.8%),除目前或既往有人格障碍、精神障碍和物质使用障碍病史外,还伴有一些共病性精神障碍,完成了一系列自我报告测量,包括“不愉快侵入性想法问卷”、“自我恐惧问卷-多层面版”、病人健康问卷和扩展版推理困惑问卷),以及临床医生管理的耶鲁-布朗强迫症量表。自举中介分析(5000个样本,95%置信区间)显示,单元与强迫症严重程度通过推理混乱和恐惧自我的一个特定维度间接相关:恐惧的腐败自我。在这个模型中,调解不支持可怕的有罪或畸形的自我。然而,出现了一系列的中介途径,其中推理混乱和恐惧腐败和有罪的自我依次介导了unit和临床评定的强迫症严重程度之间的联系。研究结果表明,推理混乱,以及特定的恐惧自我领域,在区分一般人群中常见的侵入性思想和IBA概念化的强迫性怀疑方面起着关键作用。在基于推理的框架内,这些过程不仅仅升级单元;相反,他们积极地产生强迫性的怀疑,使个人与现实脱节,并使想象中的威胁对个人有意义、持久和需要解决。
{"title":"The Cognitive Architecture of Obsessional Doubt: Inferential Confusion and Feared Selves in OCD-Relevant Intrusions","authors":"Mohammad Aminaee,&nbsp;Seyed Mohammadreza Taghavi,&nbsp;Frederick Aardema,&nbsp;Seyed Alireza Sadjadi,&nbsp;Mehdi Reza Sarafraz,&nbsp;Mohammad Ali Goodarzi","doi":"10.1002/cpp.70164","DOIUrl":"10.1002/cpp.70164","url":null,"abstract":"<div>\u0000 \u0000 <p>Although previous research has examined the individual roles of unwanted intrusive thoughts (UITs), inferential confusion and feared selves in obsessive-compulsive disorder (OCD), no study to date has evaluated their combined effects on OCD severity. This is particularly relevant given that the inference-based approach (IBA) posits a close link between inferential confusion and feared selves in the context of obsessional doubt. The present study with a cross-sectional design investigated the role of inferential confusion and feared selves in mediating the relationship between OCD-relevant UITs and OCD severity. A clinical sample of 306 individuals with a primary diagnosis of OCD (mean age = 32.95, <i>SD</i> = 9.99, female = 58.8%) who also had some comorbid psychiatric disorders, with the exception of a current or previous history of personality disorders, psychotic disorders and substance use disorders, completed a battery of self-reported measures—including the Questionnaire of Unpleasant Intrusive Thoughts, Fear of Self Questionnaire-Multidimensional Version, Patient Health Questionnaire and Expanded Version of the Inference Confusion Questionnaire)—as well as the clinician-administered version of the Yale-Brown Obsessive-Compulsive Scale. Bootstrapped mediation analyses (5000 resamples, 95% confidence interval) revealed that UITs were indirectly associated with OCD severity via inferential confusion and one specific dimension of feared selves: the feared corrupted self. Mediation was not supported for the feared culpable or malformed selves in this model. However, a serial mediation pathway emerged wherein inferential confusion and both feared corrupted and culpable selves sequentially mediated the link between UITs and clinician-rated OCD severity. The findings suggest that inferential confusion, along with specific feared self domains, plays a critical role in differentiating intrusive thoughts that are common in the general population from obsessional doubt, as conceptualised in the IBA. Within the inference-based framework, these processes do not merely escalate UITs; rather, they actively produce obsessional doubts that disconnect the individual from reality and render the imagined threat personally meaningful, persistent and in need of resolution.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Occurrence of and Distress From Pathogenic Beliefs: Examining Pathways From Childhood Adversity to Psychopathology 致病信念的发生和痛苦:从童年逆境到精神病理的途径研究
IF 2.7 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2025-10-20 DOI: 10.1002/cpp.70163
George Silberschatz, Xiaochen Luo, James McCollum, David Kealy

Introduction

Pathogenic beliefs are dysfunctional beliefs that impede the pursuit of adaptive goals, which have been shown as key pathways between early childhood trauma and psychopathology. This study examined whether the occurrence of pathogenic beliefs and the distress from having pathogenic beliefs, which were assessed through the latest version of the pathogenic belief scale (PBS-21) separately, would both mediate the childhood adversity-outcome relationship, and whether reactivity of pathogenic beliefs (standardized difference between distress and occurrence) moderates them.

Methods

A total of 390 adult participants with prior psychotherapy experience were recruited from the United Kingdom online. Participants completed self-report measures assessing perceived adverse parenting, psychopathology (depression, anxiety, general distress and interpersonal problems) and pathogenic beliefs (occurrence, distress and reactivity).

Results

Both occurrence and distress of pathogenic beliefs fully mediated the relationship between adverse parenting and depressive/anxiety symptoms and general distress, and partially mediated interpersonal problems. Reactivity significantly moderated the pathway from adverse parenting to pathogenetic beliefs. Individuals who reported more adverse parenting and were categorized as having higher reactivity were more likely to develop pathogenic beliefs and experience greater psychological distress.

Discussion

These findings align with prior research showing that pathogenic beliefs are key in the association between childhood adversity and psychopathology. The study supports the validity of the PBS-21 and demonstrates the value of assessing the occurrence of pathogenic beliefs and the distress from having these beliefs separately. Reactivity to pathogenic beliefs may serve as a clinically meaningful marker for identifying individuals with resilience and tailoring interventions accordingly.

致病性信念是阻碍适应性目标追求的功能失调信念,是幼儿创伤与精神病理之间的关键途径。本研究通过最新版的致病信念量表(PBS-21)分别评估致病信念的发生和因拥有致病信念而产生的痛苦,考察了致病信念的反应性(痛苦与发生的标准化差异)是否会调节童年逆境与结果的关系。方法从英国在线招募390名有心理治疗经验的成人受试者。参与者完成了自我报告测量,评估感知到的不良教养、精神病理(抑郁、焦虑、一般痛苦和人际关系问题)和致病信念(发生、痛苦和反应)。结果致病信念的发生和困扰完全介导了不良教养与抑郁/焦虑症状和一般困扰的关系,部分介导了人际关系问题。反应性显著调节了从不良教养到致病信念的途径。那些被归类为具有较高反应性的不良父母的个体更有可能产生致病信念,并经历更大的心理困扰。这些发现与先前的研究一致,表明致病信念是童年逆境和精神病理之间联系的关键。本研究支持PBS-21的有效性,并证明了单独评估致病信念发生和拥有这些信念的痛苦的价值。对致病信念的反应性可以作为临床有意义的标志,用于识别具有适应力的个体并相应地调整干预措施。
{"title":"The Occurrence of and Distress From Pathogenic Beliefs: Examining Pathways From Childhood Adversity to Psychopathology","authors":"George Silberschatz,&nbsp;Xiaochen Luo,&nbsp;James McCollum,&nbsp;David Kealy","doi":"10.1002/cpp.70163","DOIUrl":"https://doi.org/10.1002/cpp.70163","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Pathogenic beliefs are dysfunctional beliefs that impede the pursuit of adaptive goals, which have been shown as key pathways between early childhood trauma and psychopathology. This study examined whether the occurrence of pathogenic beliefs and the distress from having pathogenic beliefs, which were assessed through the latest version of the pathogenic belief scale (PBS-21) separately, would both mediate the childhood adversity-outcome relationship, and whether reactivity of pathogenic beliefs (standardized difference between distress and occurrence) moderates them.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 390 adult participants with prior psychotherapy experience were recruited from the United Kingdom online. Participants completed self-report measures assessing perceived adverse parenting, psychopathology (depression, anxiety, general distress and interpersonal problems) and pathogenic beliefs (occurrence, distress and reactivity).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both occurrence and distress of pathogenic beliefs fully mediated the relationship between adverse parenting and depressive/anxiety symptoms and general distress, and partially mediated interpersonal problems. Reactivity significantly moderated the pathway from adverse parenting to pathogenetic beliefs. Individuals who reported more adverse parenting and were categorized as having higher reactivity were more likely to develop pathogenic beliefs and experience greater psychological distress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>These findings align with prior research showing that pathogenic beliefs are key in the association between childhood adversity and psychopathology. The study supports the validity of the PBS-21 and demonstrates the value of assessing the occurrence of pathogenic beliefs and the distress from having these beliefs separately. Reactivity to pathogenic beliefs may serve as a clinically meaningful marker for identifying individuals with resilience and tailoring interventions accordingly.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.70163","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of a Cognitive Behavioural Therapy Program on Resilience and Complex Post-Traumatic Stress Disorder Symptoms Among Palestinian Children Affected by Political Detention: A Quasi-Experimental Study 认知行为治疗方案对受政治拘留影响的巴勒斯坦儿童恢复力和复杂创伤后应激障碍症状的影响:一项准实验研究
IF 2.7 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2025-10-20 DOI: 10.1002/cpp.70166
Lubna Harazni, Malakeh Z. Malak, Ahmad Ayed

Few studies have examined the effectiveness of CBT among war-traumatised Arab children, including Palestinian children. This study aimed to assess the effect of a cognitive behavioural therapy (CBT) program on enhancing resilience and alleviating complex post-traumatic stress disorder (CPTSD) symptoms among Palestinian children affected by political detention. A quasi-experimental design utilising a one-group pretest–posttest approach was employed. The study included 50 affected children recruited from non-governmental organizations and community organizations in conflict-affected regions of the West Bank. The CBT program comprised seven sessions totaling 9 h. Each session lasted between 60 and 90 min. Data were collected before and after the program, which was implemented from March to May 2025. The findings from the pretest and posttest revealed a statistically significant reduction in CPTSD symptoms and improvement in resilience following the program. Resilience scores increased from a mean of 19.6 ± 4.6 to 30.0 ± 2.6, indicating enhanced resilience capacity (t = 16.457, p < 0.001). Post-traumatic stress disorder symptoms showed a substantial decline from severe 14.1 ± 2.5 to minimal 1.4 ± 1.8 (p ≤ 0.001). Similarly, disturbances in self-organization significantly decreased. The results proved the effectiveness of a CBT program in improving resilience and minimising CPTSD symptoms among participants. Thus, policymakers and healthcare professionals must ensure that psychological support programs, such as CBT, are implemented among war-traumatised children. Additionally, healthcare professionals, including nurses, should be equipped to respond effectively and provide high-quality care for traumatised children.

很少有研究考察CBT对受战争创伤的阿拉伯儿童(包括巴勒斯坦儿童)的有效性。本研究旨在评估认知行为疗法(CBT)在巴勒斯坦受政治拘留影响儿童中增强复原力和减轻复杂创伤后应激障碍(CPTSD)症状方面的效果。采用准实验设计,采用一组前测后测方法。这项研究包括从西岸受冲突影响地区的非政府组织和社区组织招募的50名受影响儿童。CBT项目包括七个疗程,共9小时。每次会议持续60到90分钟。该计划于2025年3月至5月实施,数据收集于计划前后。前测和后测的结果显示,CPTSD症状在统计上显著减少,康复能力在项目后得到改善。弹性得分从平均19.6±4.6分增加到30.0±2.6分,表明弹性能力增强(t = 16.457, p < 0.001)。创伤后应激障碍症状从严重的14.1±2.5显著下降到轻微的1.4±1.8 (p≤0.001)。同样,自组织中的干扰也显著减少。结果证明了CBT计划在提高参与者的恢复力和最小化CPTSD症状方面的有效性。因此,决策者和医疗保健专业人员必须确保在受战争创伤的儿童中实施心理支持方案,如CBT。此外,包括护士在内的保健专业人员应具备有效应对和为受创伤儿童提供高质量护理的能力。
{"title":"Effect of a Cognitive Behavioural Therapy Program on Resilience and Complex Post-Traumatic Stress Disorder Symptoms Among Palestinian Children Affected by Political Detention: A Quasi-Experimental Study","authors":"Lubna Harazni,&nbsp;Malakeh Z. Malak,&nbsp;Ahmad Ayed","doi":"10.1002/cpp.70166","DOIUrl":"https://doi.org/10.1002/cpp.70166","url":null,"abstract":"<div>\u0000 \u0000 <p>Few studies have examined the effectiveness of CBT among war-traumatised Arab children, including Palestinian children. This study aimed to assess the effect of a cognitive behavioural therapy (CBT) program on enhancing resilience and alleviating complex post-traumatic stress disorder (CPTSD) symptoms among Palestinian children affected by political detention. A quasi-experimental design utilising a one-group pretest–posttest approach was employed. The study included 50 affected children recruited from non-governmental organizations and community organizations in conflict-affected regions of the West Bank. The CBT program comprised seven sessions totaling 9 h. Each session lasted between 60 and 90 min. Data were collected before and after the program, which was implemented from March to May 2025. The findings from the pretest and posttest revealed a statistically significant reduction in CPTSD symptoms and improvement in resilience following the program. Resilience scores increased from a mean of 19.6 ± 4.6 to 30.0 ± 2.6, indicating enhanced resilience capacity (<i>t</i> = 16.457, <i>p</i> &lt; 0.001). Post-traumatic stress disorder symptoms showed a substantial decline from severe 14.1 ± 2.5 to minimal 1.4 ± 1.8 (<i>p</i> ≤ 0.001). Similarly, disturbances in self-organization significantly decreased. The results proved the effectiveness of a CBT program in improving resilience and minimising CPTSD symptoms among participants. Thus, policymakers and healthcare professionals must ensure that psychological support programs, such as CBT, are implemented among war-traumatised children. Additionally, healthcare professionals, including nurses, should be equipped to respond effectively and provide high-quality care for traumatised children.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Authenticity as a Mediator of Change in the Unified Protocol for Transdiagnostic Treatment of Depressive and Anxiety Disorders 真实性在抑郁和焦虑障碍跨诊断治疗统一方案中的中介作用。
IF 2.7 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2025-10-15 DOI: 10.1002/cpp.70161
So Sugita, Masaya Ito, Hiroko Fujisato, Ayako Kanie, Shun Nakajima, Todd J. Farchione, Hironori Kuga

Objectives

Authenticity is defined as awareness of one's internal states and actions that align with personal values, preferences and goals. Research has linked authenticity to wellbeing and lower depression and anxiety symptoms. Although authenticity has been proposed as an important process of change, there is limited empirical research examining the effect of psychotherapy on authenticity and whether changes in authenticity mediate improved mental health outcomes. This study investigated the mediating role of authenticity in psychotherapy.

Methods

This study is a secondary analysis of a randomized controlled trial including patients with depressive (n = 52) and anxiety disorders (n = 52). Multilevel models were used to assess (1) whether the Unified Protocol (UP), a transdiagnostic cognitive-behavioural treatment, improved subjective sense of authenticity as measured by the Sense of Authenticity Scale, and (2) whether changes in authenticity mediated the treatment effect on depression.

Results

At post-treatment, patients who received the UP showed significantly higher levels of self-reported sense of authenticity compared to waitlist controls (d = 0.97, 95% CI [0.28, 1.65]). This effect was maintained at the six-month follow-up. Additionally, authenticity mediated the treatment effect on depression (indirect effect: b = −6.51, SE = 2.89, 95% CI [−14.04, −1.88]), accounting for 22.90% of the total effect. This mediation remained significant when controlling for therapeutic alliance.

Conclusions

This study provides the first empirical evidence that changes in authenticity mediate outcomes in the UP. These findings suggest that authenticity represents a viable candidate for future research examining the mechanisms of psychotherapy.

目标:真实性被定义为意识到一个人的内在状态和行为与个人价值观、偏好和目标相一致。研究表明,真实性与幸福感、抑郁和焦虑症状的减少有关。虽然真实性被认为是一个重要的变化过程,但关于心理治疗对真实性的影响以及真实性的变化是否会改善心理健康结果的实证研究有限。本研究探讨了真实性在心理治疗中的中介作用。方法:本研究是对一项随机对照试验的二次分析,该试验包括抑郁症(n = 52)和焦虑症(n = 52)。采用多水平模型来评估(1)统一方案(UP),一种跨诊断的认知行为治疗方法,是否提高了主观真实性感(通过真实性量表测量),以及(2)真实性的改变是否介导了抑郁症的治疗效果。结果:在治疗后,接受UP治疗的患者自我报告的真实性水平明显高于等候名单对照组(d = 0.97, 95% CI[0.28, 1.65])。这种效果在六个月的随访中保持不变。此外,真实性介导了抑郁症的治疗效果(间接效应:b = -6.51, SE = 2.89, 95% CI[-14.04, -1.88]),占总效应的22.90%。当控制治疗联盟时,这种调解仍然是显著的。结论:本研究首次提供了真实性变化介导UP结果的实证证据。这些发现表明,真实性代表了未来研究心理治疗机制的可行候选。
{"title":"Authenticity as a Mediator of Change in the Unified Protocol for Transdiagnostic Treatment of Depressive and Anxiety Disorders","authors":"So Sugita,&nbsp;Masaya Ito,&nbsp;Hiroko Fujisato,&nbsp;Ayako Kanie,&nbsp;Shun Nakajima,&nbsp;Todd J. Farchione,&nbsp;Hironori Kuga","doi":"10.1002/cpp.70161","DOIUrl":"10.1002/cpp.70161","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Authenticity is defined as awareness of one's internal states and actions that align with personal values, preferences and goals. Research has linked authenticity to wellbeing and lower depression and anxiety symptoms. Although authenticity has been proposed as an important process of change, there is limited empirical research examining the effect of psychotherapy on authenticity and whether changes in authenticity mediate improved mental health outcomes. This study investigated the mediating role of authenticity in psychotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study is a secondary analysis of a randomized controlled trial including patients with depressive (<i>n</i> = 52) and anxiety disorders (<i>n</i> = 52). Multilevel models were used to assess (1) whether the Unified Protocol (UP), a transdiagnostic cognitive-behavioural treatment, improved subjective sense of authenticity as measured by the Sense of Authenticity Scale, and (2) whether changes in authenticity mediated the treatment effect on depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At post-treatment, patients who received the UP showed significantly higher levels of self-reported sense of authenticity compared to waitlist controls (d = 0.97, 95% CI [0.28, 1.65]). This effect was maintained at the six-month follow-up. Additionally, authenticity mediated the treatment effect on depression (indirect effect: b = −6.51, SE = 2.89, 95% CI [−14.04, −1.88]), accounting for 22.90% of the total effect. This mediation remained significant when controlling for therapeutic alliance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study provides the first empirical evidence that changes in authenticity mediate outcomes in the UP. These findings suggest that authenticity represents a viable candidate for future research examining the mechanisms of psychotherapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring Moderators and Mediators of the Outcome of Group Cognitive Behavioural Therapy Compared With Group Schema Therapy for Social Anxiety Disorder and Comorbid Avoidant Personality Disorder 探讨团体认知行为治疗与团体图式治疗治疗社交焦虑障碍和共病回避型人格障碍效果的调节因子和中介因子。
IF 2.7 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2025-10-13 DOI: 10.1002/cpp.70148
Astrid E. Baljé, Anja Greeven, Mathijs Deen, Anne E. van Giezen, Arnoud Arntz, Philip Spinhoven

Background

Identifying moderators and mediators in a randomised controlled trial is important to improve treatment effectiveness and elucidate mechanisms of change. Putative moderating and mediating variables of treatment outcome of 30 weekly sessions of group cognitive behavioural therapy (GCBT) and group schema therapy (GST) were investigated in a sample of 154 patients with both social anxiety disorder (SAD) and avoidant personality disorder (AVPD). Significant improvements were realised in both modalities at 3 and 12 months after treatment. No significant differences between conditions were found.

Objectives

The current study explored several demographic and clinical patient characteristics as putative moderators of reducing SAD symptoms, AVPD manifestations, and treatment attrition. Emotion regulation, self-esteem, experiential avoidance and schema modes were considered as putative mediators of SAD symptoms.

Methods

Baseline variables moderating treatment effects on SAD symptoms and AVPD manifestations were investigated by comparing multilevel models. Differential effects of moderators on attrition hazard were examined by Cox regression. To assess possible mediators (measured pre-, mid- and post-treatment) of the effect of GCBT versus GST on SAD symptoms, separate three-wave random-intercept cross-lagged panel models were performed.

Results

No moderators and mediators were identified. Self-esteem, the average mode score and avoidant protector mode at mid-treatment predicted social anxiety at the end of treatment irrespective of treatment condition, while an inverse relationship was ruled out.

Conclusions

The moderator analyses indicated that the examined patient characteristics cannot inform treatment decisions for either GCBT or GST. Furthermore, the mediation analysis did not point to different underlying treatment processes between both modalities.

背景:在随机对照试验中确定调节因子和调节因子对于提高治疗效果和阐明改变机制非常重要。以154例社交焦虑障碍(SAD)和回避型人格障碍(AVPD)患者为研究对象,研究了群体认知行为治疗(GCBT)和群体图式治疗(GST) 30周治疗效果的调节变量和中介变量。治疗后3个月和12个月,两种治疗方式均有显著改善。两种情况之间没有发现显著差异。目的:目前的研究探讨了几种人口统计学和临床患者特征作为减轻SAD症状、AVPD表现和治疗损耗的推定调节因素。情绪调节、自尊、经验回避和图式模式被认为是SAD症状的可能中介。方法:通过比较多水平模型,研究调节SAD症状和AVPD表现的基线变量。采用Cox回归检验调节因子对磨耗危害的差异效应。为了评估GCBT与GST对SAD症状影响的可能介质(治疗前、治疗中和治疗后测量),进行了单独的三波随机截距交叉滞后面板模型。结果:未发现调节因子和中介因子。不论治疗状况如何,治疗中期的自尊、平均模式得分和回避保护模式均可预测治疗结束时的社交焦虑,但不存在负相关关系。结论:调节分析表明,所检查的患者特征不能为GCBT或GST的治疗决策提供信息。此外,中介分析并没有指出两种模式之间不同的潜在治疗过程。
{"title":"Exploring Moderators and Mediators of the Outcome of Group Cognitive Behavioural Therapy Compared With Group Schema Therapy for Social Anxiety Disorder and Comorbid Avoidant Personality Disorder","authors":"Astrid E. Baljé,&nbsp;Anja Greeven,&nbsp;Mathijs Deen,&nbsp;Anne E. van Giezen,&nbsp;Arnoud Arntz,&nbsp;Philip Spinhoven","doi":"10.1002/cpp.70148","DOIUrl":"10.1002/cpp.70148","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Identifying moderators and mediators in a randomised controlled trial is important to improve treatment effectiveness and elucidate mechanisms of change. Putative moderating and mediating variables of treatment outcome of 30 weekly sessions of group cognitive behavioural therapy (GCBT) and group schema therapy (GST) were investigated in a sample of 154 patients with both social anxiety disorder (SAD) and avoidant personality disorder (AVPD). Significant improvements were realised in both modalities at 3 and 12 months after treatment. No significant differences between conditions were found.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The current study explored several demographic and clinical patient characteristics as putative moderators of reducing SAD symptoms, AVPD manifestations, and treatment attrition. Emotion regulation, self-esteem, experiential avoidance and schema modes were considered as putative mediators of SAD symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Baseline variables moderating treatment effects on SAD symptoms and AVPD manifestations were investigated by comparing multilevel models. Differential effects of moderators on attrition hazard were examined by Cox regression. To assess possible mediators (measured pre-, mid- and post-treatment) of the effect of GCBT versus GST on SAD symptoms, separate three-wave random-intercept cross-lagged panel models were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No moderators and mediators were identified. Self-esteem, the average mode score and avoidant protector mode at mid-treatment predicted social anxiety at the end of treatment irrespective of treatment condition, while an inverse relationship was ruled out.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The moderator analyses indicated that the examined patient characteristics cannot inform treatment decisions for either GCBT or GST. Furthermore, the mediation analysis did not point to different underlying treatment processes between both modalities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychosocial Effects of Romantic Breakups During Emerging Adulthood: A Systematic Review 成年初期失恋的社会心理影响:一项系统综述
IF 2.7 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2025-10-10 DOI: 10.1002/cpp.70139
Joana G. Fernandes, Carina Santos, Mariana V. Martins

The current study reviewed the psychosocial effects of romantic breakups in emerging adulthood, particularly focused on evidence related to psychological health and psychosocial development, including aspects of identity and intimacy. A systematic literature search was conducted in accordance with the PRISMA guidelines across EBSCOhost, PubMed and Web of Science (ISI) databases. Studies with available evidence on psychosocial dimensions and emerging adult populations who had experienced a romantic breakup were included and subjected to review evaluation. Forty-seven studies were eligible for inclusion. Results showed several negative and positive psychosocial outcomes and supported the effect of breakups on changes in self-concept and interpersonal intimacy. Diverse factors influenced positive and negative adjustment. Specifically, individuals experiencing more challenges were especially those with insecure attachment, a history of childhood abuse and maladaptive coping strategies. Conversely, individuals employing adaptive coping mechanisms and personal resources such as emotional regulation and mentalization tended to exhibit better postbreakup outcomes. The long-term effects remain inconclusive, highlighting the need for further research. These findings underscore the complexity of breakup experiences and highlight the crucial role of supportive factors in shaping psychosocial adjustment. This first systematic review of the psychosocial effects of breakups suggested that interventions targeted at emerging adults should enhance psychosocial transformations and individuals' specific needs to prevent maladjustment to breakups and psychological problems.

目前的研究回顾了恋爱分手对成年初期的社会心理影响,特别关注与心理健康和社会心理发展有关的证据,包括身份和亲密关系方面。根据PRISMA指南,在EBSCOhost、PubMed和Web of Science (ISI)数据库中进行系统的文献检索。有社会心理方面现有证据的研究和经历过失恋的新成年人群被纳入研究,并接受审查评估。47项研究符合纳入条件。结果显示了一些消极和积极的社会心理结果,并支持分手对自我概念和人际亲密关系变化的影响。影响正向和负向调整的因素多种多样。具体来说,经历更多挑战的人,尤其是那些有不安全依恋、童年虐待史和适应不良应对策略的人。相反,采用适应性应对机制和个人资源(如情绪调节和心理化)的个体往往表现出更好的分手后结果。长期影响仍不确定,因此需要进一步研究。这些发现强调了分手经历的复杂性,并强调了支持性因素在塑造心理社会适应中的关键作用。这是对分手的社会心理影响的第一次系统回顾,表明针对新生成人的干预措施应该加强社会心理转变和个人的特定需求,以防止对分手和心理问题的不适应。
{"title":"Psychosocial Effects of Romantic Breakups During Emerging Adulthood: A Systematic Review","authors":"Joana G. Fernandes,&nbsp;Carina Santos,&nbsp;Mariana V. Martins","doi":"10.1002/cpp.70139","DOIUrl":"https://doi.org/10.1002/cpp.70139","url":null,"abstract":"<div>\u0000 \u0000 <p>The current study reviewed the psychosocial effects of romantic breakups in emerging adulthood, particularly focused on evidence related to psychological health and psychosocial development, including aspects of identity and intimacy. A systematic literature search was conducted in accordance with the PRISMA guidelines across EBSCOhost, PubMed and Web of Science (ISI) databases. Studies with available evidence on psychosocial dimensions and emerging adult populations who had experienced a romantic breakup were included and subjected to review evaluation. Forty-seven studies were eligible for inclusion. Results showed several negative and positive psychosocial outcomes and supported the effect of breakups on changes in self-concept and interpersonal intimacy. Diverse factors influenced positive and negative adjustment. Specifically, individuals experiencing more challenges were especially those with insecure attachment, a history of childhood abuse and maladaptive coping strategies. Conversely, individuals employing adaptive coping mechanisms and personal resources such as emotional regulation and mentalization tended to exhibit better postbreakup outcomes. The long-term effects remain inconclusive, highlighting the need for further research. These findings underscore the complexity of breakup experiences and highlight the crucial role of supportive factors in shaping psychosocial adjustment. This first systematic review of the psychosocial effects of breakups suggested that interventions targeted at emerging adults should enhance psychosocial transformations and individuals' specific needs to prevent maladjustment to breakups and psychological problems.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Content and Topography of Auditory Verbal Hallucinations in Adult Psychosis Patients: What Does a Voice Say, and How Does It Say It? An Umbrella Review and Collation 成人精神病患者言语幻听的内容和地形:声音在说什么,它是如何说的?总结性审查和整理。
IF 2.7 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2025-10-01 DOI: 10.1002/cpp.70145
Anna Callahan, Cassie Hazell, Elena Serena Piccardi, Jonathan Souray, David Raune

Background

Auditory verbal hallucinations (‘voices’) in clinical psychosis are associated with significant distress and disability, but the efficacy of CBT for voices is modest. Greater phenomenological understanding is crucial for the development of theoretical models and more tailored CBT interventions.

Aim

This work aimed to produce an evidence-based empirical framework of features of voice content and topography in adult psychosis.

Method

Electronic databases, journal pages and book publishers were systematically searched. Identified reviews were screened against inclusion criteria and included reviews critically appraised. Study characteristics and data relating to voice content/topography were extracted and collated.

Results

Forty-two reviews were identified. A framework of 172 features of voice content and topography was produced.

Conclusions

This paper offers the most comprehensive evidence-based dissection of voice content and topography to date. Many features have been overlooked and should be tested for theoretical and clinical significance in order to further develop CBT and related interventions for voices.

背景:临床精神病患者的听觉言语幻觉(“声音”)与显著的痛苦和残疾有关,但CBT对声音的疗效一般。更深入的现象学理解对于理论模型的发展和更有针对性的CBT干预措施至关重要。目的:本研究旨在建立一个基于证据的成人精神病语音内容和地形特征的经验框架。方法:系统检索电子数据库、期刊页面和图书出版商。根据纳入标准筛选已确定的评论,并对纳入的评论进行严格评价。提取并整理了与语音内容/地形相关的研究特征和数据。结果:共发现42篇综述。生成了一个包含172个语音内容和地形特征的框架。结论:本文提供了迄今为止最全面的基于证据的语音内容和地形解剖。为了进一步发展CBT和相关的声音干预措施,许多特征被忽视了,应该进行理论和临床意义的测试。
{"title":"The Content and Topography of Auditory Verbal Hallucinations in Adult Psychosis Patients: What Does a Voice Say, and How Does It Say It? An Umbrella Review and Collation","authors":"Anna Callahan,&nbsp;Cassie Hazell,&nbsp;Elena Serena Piccardi,&nbsp;Jonathan Souray,&nbsp;David Raune","doi":"10.1002/cpp.70145","DOIUrl":"10.1002/cpp.70145","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Auditory verbal hallucinations (‘voices’) in clinical psychosis are associated with significant distress and disability, but the efficacy of CBT for voices is modest. Greater phenomenological understanding is crucial for the development of theoretical models and more tailored CBT interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This work aimed to produce an evidence-based empirical framework of features of voice content and topography in adult psychosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Electronic databases, journal pages and book publishers were systematically searched. Identified reviews were screened against inclusion criteria and included reviews critically appraised. Study characteristics and data relating to voice content/topography were extracted and collated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-two reviews were identified. A framework of 172 features of voice content and topography was produced.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This paper offers the most comprehensive evidence-based dissection of voice content and topography to date. Many features have been overlooked and should be tested for theoretical and clinical significance in order to further develop CBT and related interventions for voices.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychotherapists' Perspectives and Support Needs in Treating Patients With Disabilities: Results From an Online Survey 心理治疗师在治疗残疾患者中的观点和支持需求:一项在线调查的结果。
IF 2.7 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2025-09-30 DOI: 10.1002/cpp.70159
Bastian Hardt, Merit Donauer, Kristina Dürr, Johannes Michalak

Objectives

Persons with disabilities are at elevated risk for mental disorders, yet little is known about the experiences, attitudes and needs of psychotherapists regarding this population. This study is among the first to examine outpatient psychotherapists' experiences in treating patients with disabilities and to explore their perspectives on accessibility and therapists' support needs.

Design

An exploratory cross-sectional online survey was conducted in collaboration with a regional statutory health association.

Methods

A total of N = 371 licensed outpatient psychotherapists in Germany participated in the study. All were qualified to treat adult patients under statutory health insurance. The survey included self-constructed items assessing treatment experiences, perceived accessibility and support needs, as well as a questionnaire for measuring explicit attitudes towards disability.

Results

Most participants (n = 340; 91.6%) reported prior experience treating patients with disabilities. Attitudes were generally positive and significantly associated with the quality—but not the quantity—of treatment experience. Psychotherapists perceived greater efforts in treating patients with intellectual and hearing impairments, and 357 (96.2%) identified barriers in their own outpatient settings. Only 93 (25.1%) considered themselves experts in disability-related topics. A strong demand for further training was expressed, particularly for working with specific types of impairments, with a preference for professional development programmes offered both online and in person.

Conclusions

The findings highlight the need for enhanced training, improved structural accessibility and informed policy development. Despite positive attitudes, notable gaps remain in preparedness and environmental access, emphasizing the importance of integrating disability-related content into psychotherapist training and professional development.

目的:残疾人患精神障碍的风险较高,但人们对这一人群的心理治疗师的经验、态度和需求知之甚少。本研究首次考察门诊心理治疗师治疗残疾患者的经验,并探讨他们对无障碍和治疗师支持需求的看法。设计:与地区法定卫生协会合作进行了一项探索性横断面在线调查。方法:共有371名德国有执照的门诊心理治疗师参与了这项研究。所有人都有资格在法定健康保险下治疗成年患者。该调查包括自编项目,评估治疗经历、感知可及性和支持需求,以及测量对残疾的明确态度的问卷。结果:大多数参与者(n = 340; 91.6%)报告了先前治疗残疾患者的经验。态度通常是积极的,并且与治疗体验的质量(而不是数量)显著相关。心理治疗师认为在治疗智力和听力障碍患者方面付出了更大的努力,357人(96.2%)在自己的门诊环境中发现了障碍。只有93人(25.1%)认为自己是残疾相关领域的专家。与会者强烈要求进一步培训,特别是针对特定类型的残疾人士的培训,他们更喜欢在线和面对面提供的专业发展方案。结论:研究结果强调了加强培训、改善结构可及性和制定知情政策的必要性。尽管态度积极,但在准备和环境准入方面仍存在显著差距,这强调了将残疾相关内容纳入心理治疗师培训和专业发展的重要性。
{"title":"Psychotherapists' Perspectives and Support Needs in Treating Patients With Disabilities: Results From an Online Survey","authors":"Bastian Hardt,&nbsp;Merit Donauer,&nbsp;Kristina Dürr,&nbsp;Johannes Michalak","doi":"10.1002/cpp.70159","DOIUrl":"10.1002/cpp.70159","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Persons with disabilities are at elevated risk for mental disorders, yet little is known about the experiences, attitudes and needs of psychotherapists regarding this population. This study is among the first to examine outpatient psychotherapists' experiences in treating patients with disabilities and to explore their perspectives on accessibility and therapists' support needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>An exploratory cross-sectional online survey was conducted in collaboration with a regional statutory health association.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of <i>N</i> = 371 licensed outpatient psychotherapists in Germany participated in the study. All were qualified to treat adult patients under statutory health insurance. The survey included self-constructed items assessing treatment experiences, perceived accessibility and support needs, as well as a questionnaire for measuring explicit attitudes towards disability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most participants (<i>n</i> = 340; 91.6%) reported prior experience treating patients with disabilities. Attitudes were generally positive and significantly associated with the quality—but not the quantity—of treatment experience. Psychotherapists perceived greater efforts in treating patients with intellectual and hearing impairments, and 357 (96.2%) identified barriers in their own outpatient settings. Only 93 (25.1%) considered themselves experts in disability-related topics. A strong demand for further training was expressed, particularly for working with specific types of impairments, with a preference for professional development programmes offered both online and in person.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings highlight the need for enhanced training, improved structural accessibility and informed policy development. Despite positive attitudes, notable gaps remain in preparedness and environmental access, emphasizing the importance of integrating disability-related content into psychotherapist training and professional development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prevalence of Eating Disorders in People With Borderline Personality Disorder: A Systematic Review and Meta-Analysis 边缘型人格障碍患者饮食失调的患病率:系统回顾和荟萃分析
IF 2.7 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2025-09-27 DOI: 10.1002/cpp.70150
Théo Paudex, Francky Teddy Endomba, Nathalie Forestier, Achille Pierandrei, Jean-Christophe Chauvet-Gélinier, Jean-Michel Pinoit

Objective

The aim of the study was to estimate the prevalence of eating disorders (EDs) across the borderline personality disorder (BPD) population.

Method

After protocol registration (number = CRD42023415721), we systematically searched PubMed/MEDLINE, PsycINFO and Web of Science for articles that allowed the assessment of the proportion of at least one ED in a sample of patients with BPD. Risk of bias was estimated using the Joanna Briggs Institute (JBI) checklist for studies reporting prevalence data, and we used a random-effects meta-analytic model. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) statement.

Results

A total of 34 articles were included, with 20 reports (N = 4107) related to EDs without distinction, and 20 (n = 3901), 20 (n = 4369), seven (n = 766), and six (n = 1773) reports related to anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and eating disorder not otherwise specified (EDNOS), respectively. The overall frequency of EDs in BPD was estimated to be 29.7% (95% CI = [21.6%, 38.4%]), while the frequencies of AN, BN, BED, and EDNOS were estimated to be 9.98% (95% CI = [5.6%, 15.3%]), 16.3% (95% CI = [12.1%, 21.1%]), 16.3% (95% CI = [6%, 30%]) and 18.8% (95% CI = [10.6%, 28.6%]), respectively. The overall risk of bias was moderate, there was no publication bias, and the certainty levels of our evidence were low.

Discussion

This meta-analytic review highlights the high frequency of EDs in BPD. It could serve as a basis for exploring the determinants of these comorbidities.

Conclusions

Through this systematic review and meta-analysis, we found a high prevalence of EDs and their subtypes in patients with BPD.

目的研究边缘型人格障碍(BPD)人群中饮食失调(EDs)的患病率。方法在方案注册(编号= CRD42023415721)后,我们系统地检索PubMed/MEDLINE、PsycINFO和Web of Science,查找允许评估BPD患者样本中至少一种ED比例的文章。使用乔安娜布里格斯研究所(JBI)报告患病率数据的研究清单估计偏倚风险,我们使用随机效应荟萃分析模型。我们使用了系统评价和荟萃分析首选报告项目(PRISMA 2020)声明。结果共纳入34篇文献,其中与EDs相关的文献20篇(N = 4107),与神经性厌食症(AN)、神经性贪食症(BN)、暴食症(BED)和非特异性饮食失调(EDNOS)相关的文献分别为20篇(N = 3901)、20篇(N = 4369)、7篇(N = 766)和6篇(N = 1773)。BPD中ed的总发生率估计为29.7% (95% CI =[21.6%, 38.4%]),而AN、BN、BED和EDNOS的发生率估计分别为9.98% (95% CI =[5.6%, 15.3%])、16.3% (95% CI =[12.1%, 21.1%])、16.3% (95% CI =[6%, 30%])和18.8% (95% CI =[10.6%, 28.6%])。偏倚的总体风险为中等,无发表偏倚,证据的确定性水平较低。本荟萃分析综述强调了BPD中ed的高频率。它可以作为探索这些合并症的决定因素的基础。通过系统回顾和荟萃分析,我们发现BPD患者中ed及其亚型的患病率很高。
{"title":"Prevalence of Eating Disorders in People With Borderline Personality Disorder: A Systematic Review and Meta-Analysis","authors":"Théo Paudex,&nbsp;Francky Teddy Endomba,&nbsp;Nathalie Forestier,&nbsp;Achille Pierandrei,&nbsp;Jean-Christophe Chauvet-Gélinier,&nbsp;Jean-Michel Pinoit","doi":"10.1002/cpp.70150","DOIUrl":"https://doi.org/10.1002/cpp.70150","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of the study was to estimate the prevalence of eating disorders (EDs) across the borderline personality disorder (BPD) population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>After protocol registration (number = CRD42023415721), we systematically searched PubMed/MEDLINE, PsycINFO and Web of Science for articles that allowed the assessment of the proportion of at least one ED in a sample of patients with BPD. Risk of bias was estimated using the Joanna Briggs Institute (JBI) checklist for studies reporting prevalence data, and we used a random-effects meta-analytic model. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) statement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 34 articles were included, with 20 reports (<i>N</i> = 4107) related to EDs without distinction, and 20 (<i>n</i> = 3901), 20 (<i>n</i> = 4369), seven (<i>n</i> = 766), and six (<i>n</i> = 1773) reports related to anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and eating disorder not otherwise specified (EDNOS), respectively. The overall frequency of EDs in BPD was estimated to be 29.7% (95% CI = [21.6%, 38.4%]), while the frequencies of AN, BN, BED, and EDNOS were estimated to be 9.98% (95% CI = [5.6%, 15.3%]), 16.3% (95% CI = [12.1%, 21.1%]), 16.3% (95% CI = [6%, 30%]) and 18.8% (95% CI = [10.6%, 28.6%]), respectively. The overall risk of bias was moderate, there was no publication bias, and the certainty levels of our evidence were low.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This meta-analytic review highlights the high frequency of EDs in BPD. It could serve as a basis for exploring the determinants of these comorbidities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Through this systematic review and meta-analysis, we found a high prevalence of EDs and their subtypes in patients with BPD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.70150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Beneficial Effect of Psychological Flexibility on First Responders' Traumatic Symptomatology in the Outbreak of War 战争爆发时心理弹性对急救人员创伤症状的有益影响
IF 2.7 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2025-09-24 DOI: 10.1002/cpp.70158
Rotem Saar-Ashkenazy

Background

The Israeli–Gaza conflict has re-erupted on October 7th, and the unique events of that day presented unprecedented challenges to first responders (FRs). Notwithstanding, while there is empirical evidence regarding the long-term psychological consequences of FRs, little is known regarding the immediate mental health consequences, as well as personal resources, as events continued to unfold on a daily basis.

Objective

The current study examined the relationship between traumatic stress symptoms (TSS) and psychological flexibility (PF) levels among FRs and controls during the first weeks of the Iron Swords war.

Method

Data were collected during the first month of the Iron Swords war from 295 participants living in Southern Israel, of whom 55 (19%) were FRs. All participants filled out scales assessing TSS and PF and provided relevant background information.

Results

Overall, high TSS levels were associated with low PF. In addition, FRs showed higher levels of TSS, whereas no group differences were found in PF. Most importantly, a significant interaction of study group × PF was observed, revealing that while the PF–TSS link connection was significant for both FRs and non-FRs, it was significantly stronger among FRs.

Conclusions

The findings highlight the importance of targeting specific tailored interventions in the mentioned population. Clinical interventions aimed towards FRs should focus on the extent to which they are able to use PF as a resource, as this appears to be an important parameter in their ability to cope with traumatic stress symptomatology.

背景:10月7日,以色列-加沙冲突再次爆发,当天发生的独特事件给急救人员带来了前所未有的挑战。然而,虽然有经验证据表明FRs的长期心理后果,但由于事件每天都在不断发生,人们对FRs的直接心理健康后果以及个人资源知之甚少。目的:本研究旨在探讨铁剑战争初期创伤应激症状(TSS)与心理弹性(PF)水平之间的关系。方法:在铁剑战争的第一个月,收集了生活在以色列南部的295名参与者的数据,其中55名(19%)是FRs,所有参与者都填写了TSS和PF的量表,并提供了相关的背景资料。结果:总体而言,高TSS水平与低PF相关。此外,FRs显示较高的TSS水平,而PF没有组间差异。最重要的是,观察到研究组× PF之间的显著相互作用,表明尽管PF-TSS联系在FRs和非FRs中都是显著的,但FRs之间的联系明显更强。结论:研究结果突出了针对上述人群的针对性针对性干预的重要性。针对FRs的临床干预应侧重于他们能够将PF作为一种资源的程度,因为这似乎是他们应对创伤应激症状的能力的一个重要参数。
{"title":"The Beneficial Effect of Psychological Flexibility on First Responders' Traumatic Symptomatology in the Outbreak of War","authors":"Rotem Saar-Ashkenazy","doi":"10.1002/cpp.70158","DOIUrl":"10.1002/cpp.70158","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Israeli–Gaza conflict has re-erupted on October 7th, and the unique events of that day presented unprecedented challenges to first responders (FRs). Notwithstanding, while there is empirical evidence regarding the long-term psychological consequences of FRs, little is known regarding the immediate mental health consequences, as well as personal resources, as events continued to unfold on a daily basis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The current study examined the relationship between traumatic stress symptoms (TSS) and psychological flexibility (PF) levels among FRs and controls during the first weeks of the Iron Swords war.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Data were collected during the first month of the Iron Swords war from 295 participants living in Southern Israel, of whom 55 (19%) were FRs. All participants filled out scales assessing TSS and PF and provided relevant background information.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, high TSS levels were associated with low PF. In addition, FRs showed higher levels of TSS, whereas no group differences were found in PF. Most importantly, a significant interaction of study group × PF was observed, revealing that while the PF–TSS link connection was significant for both FRs and non-FRs, it was significantly stronger among FRs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings highlight the importance of targeting specific tailored interventions in the mentioned population. Clinical interventions aimed towards FRs should focus on the extent to which they are able to use PF as a resource, as this appears to be an important parameter in their ability to cope with traumatic stress symptomatology.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Clinical psychology & psychotherapy
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1