Cognitive Behaviour Therapy最新文献

Understanding the mechanisms underlying pathological safety behavior is crucial for the development of effective treatments for mental disorders. This study investigates the interplay between intolerance of uncertainty (IU), not just right experiences (NJREs), and safety behaviors using a behavior-based checking paradigm in individuals (N = 164) diagnosed with obsessive-compulsive disorder and/or anxiety disorders. Findings revealed that IU was related to more disturbance caused by experimentally induced NJREs. In addition, IU was linked to more NJREs on a trait level. Regarding safety behavior in the form of checking, IU was also indirectly associated with longer checking via NJRE-related disturbance. This indirect effect is in line with a conceptual pathway where IU promotes NJRE-related disturbance, thus contributing to excessive uncertainty-reducing safety behaviors. These results add evidence regarding IU as a factor driving safety behaviors, which can contribute to maintaining pathology. Furthermore, the findings demonstrate a mediating role of NJREs in this relationship. Implications include considering IU and NJREs in therapies across anxiety-related diagnoses for addressing pathological safety behaviors.

The aim of the study was to validate the 30-item version of the Multidimensional Experiential Avoidance Questionnaire (MEAQ-30) in a sample of individuals who smoke combustible cigarettes and to examine the relationship between nicotine dependence, cigarette smoking, and experiential avoidance. Confirmatory factor analysis (CFA) was used to verify the structure of the MEAQ-30 and to test measurement invariance in a general population sample (n = 1040) and a sample of individuals who smoke combustible cigarettes (n = 550). Correlation and regression analyses were performed in a sample of individuals who smoke combustible cigarettes (n = 242) to evaluate the stability, dependability, convergent validity, discriminant validity, predictive validity and incremental predictive validity of the measure. The MEAQ-30 demonstrated adequate model fit and met criteria for measurement invariance. It exhibited good internal consistency, good stability, good discriminant validity, weak incremental predictive validity, and lower than expected levels of dependability. Based on our findings, the MEAQ-30 appears to be a valid measure of experiential avoidance in individuals who smoke combustible cigarettes.

Mood Lifters for College Students (ML-CS) is a virtual, group-based, peer-led mental health program designed to address common stressors faced by undergraduate college students. This study was conducted to gain a preliminary understanding of the efficacy, feasibility, acceptability, and appropriateness of Mood Lifters before conducting a large, randomized control trial. After screening and randomization, 31 participants were placed into a treatment group and 16 were placed on the waitlist. Participant in both groups completed pre- and post-surveys measuring symptoms of depression, anxiety, and flourishing. Participants in the treatment group completed feedback surveys. Treatment group participants showed significant reductions in feelings of anxiety and depression as compared to their waitlist peers. Feedback measures suggested that ML-CS is feasible, acceptable, and appropriate for this population. The preliminary results of this pilot study show great potential and suggest the need for a large-scale randomized control trial.

Cognitive models of social anxiety (SA) have posited that individuals elevated in SA exhibit a bias to interpret neutral social situations as threatening. While social-evaluative interpretation bias (IB) has been extensively studied, little research has examined the relationship between SA and hostile IB, a specific form of IB characterized by the interpretation of ambiguous stimuli as indicating hostile intent, meanness, or aggression. In Study 1 (N = 120), we found in a sample of college students that while SA was associated with hostile IB cross-sectionally, it did not predict hostile IB one month later, while controlling for baseline hostile IB. In Study 2 (N = 69), we examined the effect of a one-month safety behavior fading intervention for SA, wherein participants were asked to systematically reduce their use of SA safety behaviors. Relative to a waitlist control, this one-month safety behavior fading intervention led to lower hostile IB at posttreatment among individuals elevated in baseline SA. We also found that changes in SA mediated the effect of treatment on hostile IB. Overall, the present study provides preliminary evidence suggesting that SA maintains hostile IB, and that hostile IB may be an outcome worth investigating in future intervention studies pertaining to clinical SA.

Access to high-quality evidence-based mental healthcare is limited, particularly among those living in extremely rural, frontier communities. Frontier communities often face unique stressors and have inflated mental health concerns including depressive symptoms and suicidality. Telehealth is a helpful option used to overcome barriers to care access; however, those living in frontier communities may be overlooked for fear that internet connection may not allow for adequate mental healthcare provision. Accordingly, we sought to demonstrate feasibility, acceptability, and efficacy of delivering the Unified Protocol (UP) for Transdiagnostic Treatment of Emotional Disorders via telehealth among a frontier community of National Park Service (NPS) workers. Participants were asked to complete well-researched symptom measures of anxiety, depression, suicidality, and posttraumatic stress before treatment, following six weeks, 12-weeks, final treatment session and one-month post-treatment. Treatment outcome data are shared from four cases. All four patients completed treatment and endorsed improvements in all four domains of quality of life. No adverse events were reported. Overall, pilot data from this descriptive brief report demonstrate that treatment delivery is possible and well-accepted even in extremely rural and remote, at-risk communities.

This pilot trial aimed to evaluate feasibility and acceptability of co-designed unguided internet CBT for grief. Efficacy was assessed for anxiety (primary outcome), well-being, depression, posttraumatic stress disorder (PTSD), and prolonged grief (secondary outcomes), relative to four-week wait-list control. There were 88 participants, M age = 16.95 years, SD = 1.45, who had experienced the death of a person (n = 72; 81.82%) or other loss (e.g. parental divorce; n = 16; 18.81%). Participants were randomised to intervention (n = 49; 55.68%), or waitlist control (n = 39; 44.31%). Outcome measures included the Revised Children's Anxiety and Depression Scale, Prolonged Grief Disorder Scale Revised, Children's Revised Impact of Events Scale, and the WHO-5 Well-Being Index. Findings suggest good feasibility, with acceptable recruitment and attrition (n = 9; 18.37% of 49 intervention participants at post-intervention). While no differences in anxiety, depression, PTSD, or prolonged grief were observed between intervention and waitlist control post-intervention, there was a significant small between groups effect on well-being in favour of intervention. There was a significant within group reduction for intervention participants in anxiety, depression and PTSD at follow-up. Acceptability was high, 97% (n = 33 of 34 completers) liked the program, however uptake was moderate.Trial Registration: The trial was registered on 26 March 2024 with the Australian and New Zealand Clinical Trials Registry (ACTRN12624000337572).

Dysfunctional beliefs are one key factor in the development and maintenance of social phobia. Modifying the appraisal of such beliefs might be achieved with the help of approach-avoidance modification trainings (AAMTs). In these trainings individuals are instructed to push dysfunctional stimuli away and pull functional ones toward themselves via joystick- or swipe-based push/pull-movements. However, the efficacy of the AAMTs could be enhanced by using high-valence words as well as facial expressions of emotions as approach/avoidance responses. The present study aimed to examine the safety and feasibility of an emotion-focused AAMT (eAAMT) targeting dysfunctional beliefs. We conducted a feasibility study with a sample of 10 participants with social anxiety. With regard to acceptability, not all predefined cutoffs where met, indicating need for further optimization of the intervention. Regarding the therapeutic potential, the social anxiety symptom severity decreased with a large effect size (g = 0.89 [0.66, 1.79]) from T1 to T2 and with a moderate effect size (g = 0.72 [0.38, 1.31]) from T1 to T3. Thus, the results of the study confirmed the clinical safety and technical feasibility of delivering the eAAMT in a laboratory setting, albeit within a Wizard-of-Oz paradigm. Furthermore, results provide preliminary evidence for its potential efficacy.Preregistration: https://osf.io/d4ye2/overview.

Perfectionism is a transdiagnostic process associated with multiple mental health disorders. Perfectionism can moderate the effectiveness of Cognitive Behavioural Therapy (CBT) for depression, but it remains unclear whether perfectionism is associated with CBT outcomes for anxiety disorders. This study investigated the relationship between perfectionism, treatment outcomes and adherence for individuals seeking internet-based CBT (iCBT) for Generalised Anxiety Disorder (GAD). A total of 1,904 adults from the general Australian community commenced an iCBT GAD program and completed measures of perfectionism, generalised anxiety, depression and psychological distress at baseline, mid-treatment, and post-treatment. Regression analyses were used to examine relationships between baseline perfectionism, post-treatment symptom reductions and treatment completion. Baseline perfectionism was significantly associated with pre-treatment GAD symptom severity, but not treatment completion or reductions in GAD severity post-iCBT. Significant reductions in generalised anxiety symptom severity (Hedges' g = 1.32), depression symptoms (g = 0.97), distress (g = 1.34) and perfectionism (both striving and evaluative concerns, g = 0.49 and g = 0.37, respectively) were observed with treatment. These findings suggest that iCBT for GAD is effective in reducing perfectionism, despite not directly targeting this process. Given there was no significant relationship between baseline perfectionism and treatment outcomes, it may not be necessary to specifically target perfectionism when delivering iCBT for GAD.

This study investigates the feasibility and preliminary evidence for the efficacy of a single-session online metacognitive training (MCT-ED) among a population considered to be at-risk of developing an eating disorder. A total of N = 95 participants with high weight concerns were randomised to an MCT-ED condition (n = 43) or a waitlist control condition (n = 52). Participants completed measures of body image flexibility, perfectionism, weight and shape concerns and mood at baseline, post-treatment (one-week post-baseline), and 3-months post-treatment. The MCT-ED intervention consisted of content targeting cognitive flexibility and perfectionism. Treatment completion for MCT-ED was 93.62%, indicating that the intervention was feasible and acceptable. Participants also provided positive ratings on a feedback questionnaire indicating preliminary feasibility. At 1-week post-treatment, relative to the waitlist condition, the MCT-ED group had significantly lower personal standards (d = 0.64) and experienced a significantly greater decrease in concern over mistakes (d = 0.57). These improvements were not sustained at 3-month follow-up. Findings suggested that MCT-ED is a feasible brief intervention format for those with elevated weight concerns, but more research is required to produce longer, more meaningful effects that may impact weight and shape concerns.

Negative posttraumatic cognitions (NPCs) and cognitive emotion regulation (CER) strategies have both been proposed as predictors of change in evidence-based cognitive behavioral therapies for posttraumatic stress disorder (PTSD). However, they are rarely studied simultaneously, with only one study examining these predictors in a randomized clinical trial of prolonged exposure therapy. It remains to be tested how these variables predict improvements in PTSD severity in real world clinical settings or different delivery formats. Data from 487 military service members and veterans that participated in a 2-week nonrandomized, uncontrolled cognitive processing therapy-based intensive treatment program (ITP) for PTSD were used to evaluate NPCs and CER strategies as predictors of improvements in PTSD severity. Results showed that, in a model with both predictors, decreases in self-focused NPCs, world-focused NPCs, and catastrophizing (CER strategy) were associated with reductions in PTSD severity during treatment and at follow-up. However, these effects were small (R² ranging from .005 to.04) relative to reductions in depression severity (R2 = .40). Although NPCs and CER strategies significantly predicted reductions in PTSD severity, their overall impact was relatively small in this nonrandomized, uncontrolled ITP. Future research should continue to investigate these and other predictors in a variety of treatment settings.