Clinical psychology & psychotherapy最新文献_第8页

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

Clinical psychology & psychotherapy

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。

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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

Clinical psychology & psychotherapy

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。

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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

Clinical psychology & psychotherapy

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。

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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

Clinical psychology & psychotherapy

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。

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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

Clinical psychology & psychotherapy

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。

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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

Clinical psychology & psychotherapy

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。

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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

Clinical psychology & psychotherapy

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。

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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

Clinical psychology & psychotherapy

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。

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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

Clinical psychology & psychotherapy

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

Parent-Focused Group Schema Coaching; CAREFREE (Carers Programme for Fluency in Resonance and Empowerment in Eating Disorders) Intervention for Parents of Adolescents With Anorexia Nervosa: A Multiple Baseline Design 以家长为中心的小组图式辅导；对青少年神经性厌食症父母的干预：多重基线设计

IF 2.7 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy

Pub Date : 2025-09-22 DOI: 10.1002/cpp.70157

Fatemeh Seifi, Javad Molazadeh, Abdulaziz Aflakseir, Changiz Rahimi Taghanaki, Susan Simpson

Although family-based interventions are effective for adolescents with anorexia nervosa (AN), they often neglect the intense emotional burden faced by parents, which may limit their full therapeutic impact. This study aimed to pilot the CAREFREE parent-focused schema coaching programme and evaluate its feasibility, acceptability and preliminary effects on parental emotion regulation, parent–child interaction and adolescent AN outcomes. A three-tiered non-concurrent multiple baseline design was employed. Participants were Iranian mothers (M = 44.7 years, SD = 2.19) of female adolescents with AN (M = 15.16 years, SD = 5.54) enrolled in the 12-week online CAREFREE intervention. Outcomes were assessed at four time points using validated measures of parental difficulties in emotion regulation (DERS-16), parent–child interaction (PACHIQ-R) and adolescent percentage of median body mass index (%mBMI), alongside weekly visual analogue scales (VAS) assessing parental guilt, anger management, empathy and emotional presence. Feasibility, acceptability, and intervention fidelity were evaluated. Data were analysed in R software using visual inspection, non-overlap indices and linear mixed-effects modelling. Significant improvements were observed in all parental outcomes, including guilt, anger management, empathy, emotional presence, difficulties in emotion regulation and parent–child interaction, with effects maintained at follow-up. Adolescents' %mBMI significantly increased, whereas no significant changes were found in their body image-related outcomes. Feasibility and acceptability were supported by acceptable completion rates and high parent satisfaction. The CAREFREE intervention was feasible and acceptable and showed promising effects on parental functioning and adolescent weight outcomes. However, future research should incorporate direct adolescent-focused components, and larger controlled trials are required to more rigorously assess the intervention's impact.

Trial Registration: Iranian Registry of Clinical Trials: IRCT20220714055467N1

虽然以家庭为基础的干预措施对患有神经性厌食症的青少年是有效的，但他们往往忽视了父母所面临的强烈情感负担，这可能会限制其充分的治疗效果。本研究旨在对“无忧无虑”父母关注图式指导方案进行试点，评估其可行性、可接受性及其对父母情绪调节、亲子互动和青少年AN结果的初步影响。采用三层非并发多基线设计。参与者为伊朗女性青少年（M = 15.16岁，SD = 5.54）的母亲（M = 44.7岁，SD = 2.19），她们参加了为期12周的在线无忧无虑干预。在四个时间点评估结果，使用父母情绪调节困难（DERS-16）、亲子互动（PACHIQ-R）和青少年中位体重指数百分比（%mBMI），以及每周视觉模拟量表（VAS）评估父母内疚、愤怒管理、同理心和情绪存在。评估可行性、可接受性和干预保真度。数据在R软件中使用目视检查、非重叠指数和线性混合效应建模进行分析。在内疚、愤怒管理、共情、情绪存在、情绪调节困难和亲子互动等所有父母结局方面均观察到显著改善，并在随访中保持效果。青少年mBMI的百分比显著增加，而与身体形象相关的结果没有显著变化。可接受的完成率和较高的家长满意度支持了可行性和可接受性。无忧无虑的干预是可行和可接受的，并显示出对父母功能和青少年体重结果有希望的影响。然而，未来的研究应该纳入直接关注青少年的成分，并且需要更大规模的对照试验来更严格地评估干预的影响。试验注册：伊朗临床试验注册中心：IRCT20220714055467N1

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引用次数: 0