Cognitive Behaviour Therapy最新文献

Dialectical behaviour therapy (DBT) effectively reduces suicidality in autism by improving emotion regulation (ER), yet its underlying therapeutic mechanism is unclear. This study explores ER factors as mediators in DBT's impact on suicidal ideation in autistic individuals. Data from 123 adult outpatients with autism and suicidal behaviours were randomly assigned to DBT (n = 63) or treatment as usual (n = 60). Suicidal ideation was assessed using the Suicidal Ideation Attributes Scale, and six ER factors were measured with the Difficulties in Emotion Regulation Scale. Structural equation modelling compared a non-sequential model with a sequential model targeting ER factors in the following order: reducing suicide risk, enhancing emotional awareness, consolidating skills, and aligning coping strategies with long-term goals. ER mediated 67% of the total treatment effect. In the non-sequential mediation model, path coefficients were generally small (β ≤ 0.32) and largely not significant. Conversely, in the sequential model, path coefficients were stronger (range: 0.23 ≤ β ≤ 0.92) and all statistically significant (p < 0.01). DBT effectively reduces suicidal behaviour in autistic individuals, with ER playing a profound mediating role. Sequential targeting of ER factors cascades the therapeutic process, highlighting the importance of structured intervention.

The prevalence of stress-related sick leave in Western society has increased clinical and scientific interest in conditions like clinical burnout. However, evidence-based treatments for clinical burnout remain scarce. This uncontrolled pilot study examined the feasibility, utility, and acceptability of an online rehabilitation program for clinical burnout based on Acceptance and Commitment Therapy (ACT). Twenty-six patients with clinical burnout were included in a 12-week online ACT rehabilitation. Self-rated questionnaires were administered pre-treatment, weekly during treatment, post-treatment, and at three- and six-month follow-ups. Independent raters assessed clinical severity, average working time, and functional disability. There were no dropouts and a high module completion rate (85%), demonstrating feasibility. The rehabilitation's utility was supported by clinical ratings indicating reduced clinical severity, functional disability, and increased working time from 18% at baseline to 75% at the six-month follow-up. Significant improvements were seen in exhaustion, anxiety, depression, psychological flexibility, and perfectionistic concerns with medium to large effect sizes (g = 0.67-1.31) at post-treatment, which were maintained at the six-month follow-up (g = 0.86-1.50). Treatment credibility and satisfaction were high, with few negative effects, indicating high acceptability. These findings suggest that this ACT-based online rehabilitation for clinical burnout holds sufficient promise to warrant further clinical trials.

Internet-based cognitive behavioral therapy (ICBT) programs are offered with varying types of therapist support. But little is known about the impact of therapist support in these programs. The aim of this study was to test the feasibility of delivering ICBT for adolescents with anxiety disorders with different types of written therapist support in a routine care setting. This was done in preparation of a large-scale randomized controlled trial of clinical effectiveness. 15 adolescents aged 12-17 years, and their parents participated in the study. They were randomized 1:1 to either 1) ICBT with planned support, or 2) ICBT with support on demand. Feasibility measures included feasibility and acceptability of treatment and study procedures, and acceptability of the intervention and conditions. Clinical outcome measures included anxiety diagnosis and symptom severity. The results indicate that it may be feasible to deliver the ICBT intervention with different degrees of support. However, the results also indicate that some adaptations to procedures were needed, as the difference in support received between conditions was not as pronounced as expected. The main adaptation derived from this study was altering the planned support condition to provide support at fixed weekly intervals instead of upon session completion.ClinicalTrials.gov ID: NCT06076954.

Adolescents and young adults are increasingly susceptible to developing mental health conditions, but many young people do not respond well to the current evidence-based treatments. Schema therapy has been effective in adults with mental health conditions, and research suggests it holds promise in adolescents with chronic or treatment-resistant mental health conditions. Our systematic review searched for articles that applied schema therapy in people aged between 12 and 30. Databases searched using the EBSCOHost platform included PubMed MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Psychology and Behavioural Sciences Collection and American Psychological Association PsychInfo. Web of Science and the Cochrane Library was also searched. The quality of each article was assessed using the Mixed Method Appraisal Tool. Twelve studies including 180 participants were found meeting these criteria. These results provided preliminary support for the use of schema therapy in adolescents and young adults experiencing a wide range of mental health conditions including personality, conduct, anxiety, depressive or eating disorders. Our systematic review supports previous research on schema therapy, finding that it could be a promising treatment for young people. The present systematic review identifies directions for future research and provides guidance for clinicians providing schema therapy in this population.

A minority of bereaved adults experiences prolonged grief disorder, depression, and/or posttraumatic stress disorder, with heightened risks observed among bereaved parents. Cognitive-behavioural therapies, both face-to-face and online, have demonstrated efficacy in treating post-loss mental health problems. Mobile phone applications potentially offer an efficient and cost-effective way to deliver self-help to bereaved adults, yet controlled effectiveness studies are lacking. Therefore, we examined the short-term efficacy of the My Grief app, based on cognitive-behavioural therapy, in 248 bereaved parents, in a randomised controlled trial (Clinicaltrials.gov, identifier: NCT04552717). Participants were randomly allocated to access to the My Grief app (n = 126) or a waitlist (n = 122). At baseline and post-assessment, symptoms of prolonged grief, posttraumatic stress, and depression, negative grief cognitions, rumination, and avoidance were assessed. Reductions in prolonged grief and posttraumatic stress symptoms and negative cognitions in the intervention group were larger than in the control group, albeit with small effect sizes. Fifteen app users reported negative experiences with the app; for example, some mentioned that it elicited painful memories and emotions related to their loss. My Grief appears to achieve modest improvements in mental health in bereaved parents. Given that it is accessible and low-cost, it is an important addition to the suite of prolonged grief interventions.

An intimate partner relationship is one of the most significant life goals for humans. Romantic relationships can promote healthy behavior and buffer against the development of psychiatric disorders. However, reliable and valid measures of relationship satisfaction are lacking. The Valentine scale is a freely available brief measure of relationship satisfaction (https://osf.io/fb72s), intended to provide an easily interpretable index of relationship satisfaction. Across two studies, we evaluated the reliability, validity, and factor structure of the Valentine scale. Study One (n = 851) explored the factor structure of the Valentine scale, assessed its test-retest reliability, and criterion-related validity. Study Two (n = 527) confirmed the factor structure of the Valentine scale, explored its measurement invariance, and further evaluated criterion-related validity. The results supported a unidimensional structure of the Valentine scale. Furthermore, the Valentine scale exhibited good internal reliability (Cronbach's alpha = .75 and .81 in Study One and Two, respectively), high test-retest reliability (ICC₃ = .80 at a two-week follow-up in Study One), and appropriate criterion-related validity demonstrating positive correlations with other measures of relationship satisfaction and positive affect, as well as and negative correlations with measures of psychopathology. Together, these findings provide good support for the usage of the Valentine scale to quantify relationship satisfaction.

The Beliefs about Losing Control Inventory (BALCI) was developed to assess negative beliefs about losing control in obsessive-compulsive disorder (OCD). Since its creation, research and theoretical work support negative beliefs about losing control as a potential transdiagnostic construct. The present study revised and expanded the original BALCI to be more inclusive of control-related concerns beyond those that would be expected in OCD (e.g. concerns about losing control over how one comes across to others in social anxiety disorder; SAD). Undergraduate students (N = 440) completed a questionnaire battery including the BALCI-II item pool. An exploratory factor analysis of the 32-item BALCI-II supported a four-factor solution. Three of the identified factors capture the feared consequences of losing control: 1) overwhelming emotions, 2) dangerous behaviour, and 3) madness. The fourth factor captures inflated beliefs about probability/severity of those losses. The BALCI-II was found to have good convergent and divergent validity, good to excellent internal, and retest reliability and was shown to have predictive utility in both OCD and SAD, above and beyond existing disorder-specific maladaptive belief domains. Results suggest the BALCI-II is an improvement over the previous version and supports the relevance of these beliefs beyond OCD.

Black persons who smoke are recognized as a smoking health disparity group and face higher rates of tobacco-related disease and morbidity. These disparities result from, in part, exposure to minority-related stress, which results in lower rates of quit success. Anxiety sensitivity (AS), which refers to the fear of stress, is associated with lower rates of cessation and impedes quit success among Black adults who smoke. The current study evaluated the feasibility, utilization, acceptability, and initial efficacy of a smoking cessation and AS reduction smartphone application for Black adults with elevated AS who smoke (The Mobile Anxiety Sensitivity Program for Smoking [MASP]). Participants (N = 24; 62.50% female; M_age = 47.83 years, SD = 9.32) participated in a 6-week trial of MASP. Retention was 83.33% at the 6-week follow-up and MASP utilization was high, with all features used by most participants. Participants reported that MASP was acceptable and 25% of participants reported 7-day point-prevalence abstinence, demonstrating strong utility and impact potential. Results also indicated a statistically significant reduction in AS from baseline to follow-up (p = .003, Cohen's d=.76). Black persons who smoke with AS may benefit from an accessible, adaptive app with culturally tailored treatment that addressed AS in the context of smoking cessation.