Cognitive Behaviour Therapy最新文献

Despite efforts to implement evidence-based guidelines, little is known about the quality of cognitive-behavioural therapy (CBT) for depression, anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder in routine clinical practice. The present study aimed to investigate therapist adherence to CBT, and related aspects of quality of care, from a patient perspective. In a cross-sectional study, 90 participants from 21 routine psychiatric outpatient units in Stockholm completed a web-based survey post-CBT. Participants reported a high degree of therapist adherence to CBT techniques and procedures (M = 3.02 on a scale of 0 to 4), with higher adherence for social anxiety disorder and posttraumatic stress disorder than for depression (p = .002, ω² = 0.21). Therapist adherence was moderately correlated with patient improvement (τs = .37-.38, ps < .001). Participants reported a high degree of symptom improvement (M  = 3.10) and treatment satisfaction (M = 3.38) and received a median of 15 sessions. Also, we found examples of excessive healthcare provision and non-adherence, as 17% far exceeded the recommended number of sessions, 80% had concurrent psychotropic treatments despite lower guideline priority, and 11% took benzodiazepines though not recommended. In conclusion, we found that CBT was delivered with high quality.

Videoconferencing-delivered cognitive behaviour therapy (vCBT) has the potential to overcome barriers to accessing treatment for social anxiety disorder (SAD). The present study examines the efficacy and acceptability of vCBT for SAD in a randomised controlled trial. Seventy-eight participants were randomised to a vCBT condition or waitlist control group (61.8% female, 34.2% male, 3.9% non-binary; Mage = 39.19, SD = 12.28). On the Social Interaction Anxiety Scale and Social Phobia Scale-short form (SIAS-6; SPS-6), vCBT within-group analyses indicated large effect sizes from pre-treatment to post-treatment on the SIAS-6 (Cohen's d = 0.95; 95% CI: 0.45-1.41) and SPS-6 (d = 0.90; 95% CI: 0.41-1.37). The between-group effect size at post-treatment was large on the SPS-6 (d = 1.01; 95% CI: 0.51-1.47) and medium on the SIAS-6 (d = 0.55; 95% CI: 0.09-1.00). At post-treatment, 57% of participants in the vCBT condition no longer met criteria for SAD and 68% at 3-month follow-up. Benchmarking analyses indicated similar treatment effect sizes to in-person CBT for SAD. Participants rated the program as acceptable and treatment completion rates were high. The results suggest that vCBT may be a viable remote treatment option for individuals with SAD.

First responders play a vital role in the response to natural disasters and are at a disproportionate risk for developing post-traumatic stress disorder (PTSD) symptoms following these events. The association between attachment style and PTSD is well-established and has been documented among first responders. Understanding the social cognitive and affective factors implicated in the association between insecure adult attachment style and PTSD symptoms among first responders has the potential to inform specialized treatments for this population. The present investigation examined the serial indirect effect of insecure adult attachment style (i.e. attachment avoidance; attachment anxiety) on PTSD symptom severity through trauma-related social cognition and emotion regulation difficulties (ERD). The sample was comprised of 115 first responders (Mage = 42.25, SD = 10.38, 80.0% male) who served during Hurricane Harvey and were recruited to complete an online survey in 2022. Attachment avoidance was indirectly related to PTSD symptom severity via the sequential effects of trauma-related social cognition and ERD (β=.13, SE = .07, CI = .02-.29). The model including attachment anxiety as a statistical predictor was not significant (β = .10, SE = .07, CI = -.01-.27). These findings suggest that there is value in examining the role of social processes and emotion regulatory factors among first responders to inform evidence-based PTSD intervention efforts.

Grit and gratitude protect against depression caused by cognitive vulnerability factors like hopelessness and rumination. This study examined whether these personality strengths could buffer against a cognitive vulnerability for anxiety, the looming cognitive style (LCS). A prospective design was used with university students (N = 247; 86.2% female; aged between 18 and 60) completing online questionnaires two times 6 weeks apart that assessed LCS, grit, gratitude, and anxiety and depression. Path analyses revealed that LCS had a significant main effect and a theoretically expected interaction effect on anxiety symptoms with "grit perseverance but not with "grit consistency" or gratitude. Neither LCS, grit perseverance nor gratitude had any effects on depression symptoms, although an effect emerged for grit consistency. This study is the first to our knowledge to examine how personality strengths protect individuals against a cognitive vulnerability that is more specific to anxiety symptomatology than to depression. Along with other studies, the findings further suggest that a crucial way grit and personality strengths provide benefit is by protecting against cognitive vulnerabilities.