Cognitive Behaviour Therapy最新文献

Individuals with Panic Disorder (PD) often have impaired insight, which can impede their willingness to seek treatment. Cognitive processes, including metacognitive beliefs, cognitive flexibility, and jumping to conclusions (JTC) may influence the degree of insight. By understanding the relationship between insight and these cognitive factors in PD, we can better identify individuals with such vulnerabilities to improve their insight. The aim of this study is to examine the relationships between metacognition, cognitive flexibility, and JTC with clinical and cognitive insight at pretreatment. We investigate the association among those factors' changes and changes in insight over treatment. Eighty-three patients diagnosed with PD received internet-based cognitive behavior therapy. Analyses revealed that metacognition was related to both clinical and cognitive insight, and cognitive flexibility was related to clinical insight at pre-treatment. Greater changes in metacognition were correlated with greater changes in clinical insight. Also, greater changes in cognitive flexibility were related to greater changes in cognitive insight. The current study extends previous studies suggesting potential relationships among insight, metacognition, and cognitive flexibility in PD. Determining the role of cognitive concepts in relation to insight may lead to new avenues for improving insight and can have implications for engagement and treatment-seeking behaviors.

Latinx persons are exposed to higher rates of traumatic events and conditional risks for developing posttraumatic stress disorder (PTSD) symptoms and comorbid mental health symptoms compared to other minority groups. The study evaluated PTSD symptom severity for global and specific cluster severity relating to co-occurring anxiety, social anxiety, depression, and suicidal ideation among 326 Latinx adults who endorsed trauma exposure. Results indicated that global PTSD symptom severity was significantly related to greater social anxiety, anxious arousal, depression, and suicidal ideation symptoms. PTSD arousal and reactivity symptom cluster had the strongest relation to anxious arousal, social anxiety, and depression, whereas negative alterations in cognitions and mood symptoms had the strongest association with social anxiety, depression, and suicidal ideation. The findings suggest that global PTSD symptom severity, alongside arousal and reactivity and negative alterations in cognitions and mood, are related to a range of concurrent negative mental health symptoms among trauma exposed Latinx young adults.

Little is known about psychological interventions for stress-induced Exhaustion disorder (ED), and there is a need for more research to improve the outcomes obtained in treatments. The present study examines predictors of improvement, including sub-group responses, in a large sample of ED patients receiving a Multimodal intervention (MMI) based on Cognitive Behavior Therapy (N = 915). In step one, available variables were explored separately as predictors of improvement in ED symptoms. In step two, sub-groups were explored through Latent Class Analysis to reduce the heterogeneity observed in the larger group and to investigate whether combining the variables from step one predicted symptom improvement. Younger age, no previous sick leave due to ED, and scoring high on anxiety, depression, insomnia, perfectionism, and treatment credibility emerged as separate predictors of improvement. In the sub-group analyses, a sub-group including participants who were single and had a lower income showed less improvement. Overall, people with ED participating in MMI report symptom improvement regardless of characteristics before treatment. However, the present findings do have the potential to inform future treatments for ED, as they highlight perfectionism as a predictor of improvement and the importance of assessing treatment credibility during treatment.

Digitally delivered behavioral interventions for chronic pain have been encouraging with effects similar to face-to-face treatment. Although many chronic pain patients benefit from behavioral treatment, a substantial proportion do not improve. To contribute to more knowledge about factors that predict treatment effects in digitally delivered behavioral interventions for chronic pain, the present study analyzed pooled data (N = 130) from three different studies on digitally delivered Acceptance and Commitment Therapy (ACT) for chronic pain. Longitudinal linear mixed-effects models for repeated measures were used to identify variables with significant influence on the rate of improvement in the main treatment outcome pain interference from pre- to post-treatment. The variables were sorted into six domains (demographics, pain variables, psychological flexibility, baseline severity, comorbid symptoms and early adherence) and analysed in a stepwise manner. The study found that shorter pain duration and higher degree of insomnia symptoms at baseline predicted larger treatment effects. The original trials from which data was pooled are registered at clinicaltrials.gov (registration number: NCT03105908 and NCT03344926).

Exposure therapy is effective but widely underused. Numerous studies indicate therapist factors that might explain this pattern of underuse. This systematic review and meta-analysis synthesised those previous research findings, to identify which therapist factors are clearly associated with their intent to use exposure therapy. A systematic review and six random-effects meta-analyses synthesised studies identified in three databases (Scopus, PsychINFO, Web of Science) and through reference lists and citation searches. Most studies relied on a survey design, resulting in weak quality of research. Twenty-six eligible studies were included in the narrative synthesis, (including 5557 participants), while 21 studies yielded sufficient data to enter the meta-analysis. Medium to large pooled effect sizes indicated that therapists with more positive beliefs, a CBT orientation, and training in exposure therapy were significantly more likely to use exposure. Small pooled effect sizes indicated that older and more anxious therapists were less likely to use exposure. Therapist years of experience was not significantly associated with exposure use. There was no evidence of publication bias. Therapist characteristics clearly play a role in the use of exposure therapy, and future clinical and research work is required to address this limitation in the delivery of this effective therapy.