Journal of Clinical Psychology最新文献

Objective: Digital interventions designed to prevent development of chronic pain and comorbid mental health symptoms, specifically targeting the acute injury recovery period, are in the early stages of development. The evidence-based PTSD Coach mobile application is a free resource offering cognitive-behavioral interventions to self-manage posttraumatic symptoms; it is used widely in varied populations, and it is feasible and acceptable to injured Emergency Department patients. However, patients' subjective experience and feedback regarding optimizing the app are lacking.

Methods: We conducted a qualitative study in which we recruited and interviewed 18 acutely injured adult patients (5 men; 13 women) at-risk for persistent pain and psychological problems. Participants were instructed to use PTSD Coach for at least 1 week; during the interview, participants discussed post-injury needs and challenges, their experience with the app, and general perceptions of its suitability to address post-injury distress.

Results: Favorable feedback centered on the variety of user-friendly tools to help manage symptoms, ability to increase awareness of symptoms and identify and cope with distressing reminders of the trauma, and on facilitating openness and linking to resources for mental health treatment. Suggestions for improvement included: increased personalization through app onboarding, text messages and other notifications to prompt use, having voice-overs to read content to participants, and linkages to in-person mental healthcare if needed.

Conclusion: These findings support PTSD Coach as a potential self-management tool to prevent the chronicity of maladaptive psychological reactions to injury and highlight features that may improve its utility for this unique underserved population.

This case study presents the treatment of a young adult with severe mental contamination (MC), a subtype of obsessive-compulsive disorder (OCD) characterized by internal feelings of dirtiness triggered by trauma-related emotions rather than physical contaminants. The patient, Federico, exhibited intense shame and disgust linked to a bullying episode, leading to compulsive rituals and functional impairments. Treatment integrated emotion regulation training, Imagery Rescripting (ImRs), and behavioral experiments, targeting dysfunctional beliefs about emotions. ImRs allowed reprocessing of the traumatic memory and reshaping of self-related meanings of impurity and unworthiness. Behavioral experiments tested and modified catastrophic appraisals of emotional experiences, fostering tolerance of distress without compulsive neutralization. By the end of treatment, Federico's Y-BOCS-II score fell from 42 to 15 (-64%) and his VOCI-MC score from 50 to 9 (-82%), with stability at 3-month follow-up. Follow-up confirmed the stability of gains and increased emotional autonomy. This case supports the utility of combining trauma-focused cognitive techniques and behavioral experiments in MC, particularly when compulsions are maintained by unprocessed emotional memories rather than concrete contamination threats. It highlights the need for individualized interventions in which ImRs may serve as a central component in treating MC symptoms.

Dialectical behavior therapy (DBT) is an extensively studied treatment for borderline personality disorder (BPD), with skills use being one of the hypothesized mechanisms of change. Research has previously been hindered by the absence of an appropriate tool to measure skills use, leading to the development of the DBT Ways of Coping Checklist (DBT-WCCL). The DBT-WCCL aims to assess DBT skills use (DSS) as well as dysfunctional coping (DCS), which can be divided into dysfunctional coping in general (DCS1) and blaming others (DCS2). This study evaluated the Dutch version of the DBT-WCCL by examining (1) the dimensional structure and measurement invariance across BPD and non-clinical samples, (2) psychometric properties (reliability and validity), and (3) sensitivity to change. A total of 204 participants diagnosed with BPD and 103 non-clinical controls completed the Dutch DBT-WCCL along with instruments assessing emotion regulation and BPD manifestations. First, when including all DBT-WCCL items, the hypothesized two-factor and three-factor models were not tenable due to substantial content overlap. When factor analyses included only items representing DBT skills or dysfunctional coping, support was found for three subscales (DSS, DCS1, and DCS2). Partial measurement invariance was established only for the DSS subscale. Reliability and known-group validity were satisfactory for all scales, while inconclusive results were found for the concurrent validity of the DSS subscale. Finally, the DBT-WCCL proved to be sensitive to change. In conclusion, our findings largely support the use of the Dutch DBT-WCCL, but warrant caution when comparing samples on dysfunctional coping.

Trial Registration: The BOOTS study was registered in the Overview of Medical Research in the Netherlands (NL-OMON21337).

Objective: This systematic review and meta-analysis aim to evaluate the efficacy of acupuncture in reducing anxiety by synthesizing evidence from randomized controlled trials (RCTs).

Methods: A comprehensive search was conducted across six databases-AMED, CINAHL, CENTRAL, Embase, Ovid MEDLINE, and PubMed-for RCTs published in English up to January 22, 2025. Eligible studies included patients with anxiety complications and compared RCTs comparing manual acupuncture (MA) with sham acupuncture (SA) or usual care or wait list control (UC/WLC) were included if anxiety was assessed as the primary outcome using validated measures. SMDs with 95% CIs were calculated using a random-effects model, and heterogeneity was assessed using I² and REML. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 (RoB 2) tool.

Results: A total of 20 RCTs with 1462 participants were included. MA significantly reduced anxiety at post-treatment compared to SA (SMD = -1.06, 95% CI: -1.74 to -0.39, p = 0.0005, I² = 94%) and UC/WLC (SMD = -1.35, 95% CI: -2.26 to -0.44, p = 0.00006, I² = 59%). The effect was maintained at follow-up when compared to SA (SMD = -0.78, 95% CI: -1.21 to -0.35, p < 0.00001) but not significant compared to UC/WLC (SMD = -0.60, 95% CI: -1.68 to 0.49, p = 0.12). RoB assessment showed low risk in 14 studies, while others had unclear allocation concealment and blinding issues. Seventy-nine adverse events were reported, mainly transient discomfort, minor bleeding, or localized pain, with no severe events.

Conclusion: MA effectively reduces anxiety symptoms in the short term, with effects sustained at follow-up when compared to SA but not UC/WLC. Further research is needed to confirm long-term efficacy and standardize methodologies. Acupuncture remains a promising, safe, and minimally invasive therapy for chronic anxiety.

Clinical trial registration: The review protocol was preregistered on the International Prospective Register of Systematic Reviews (PROSPERO; CRD420250621404) and can be accessed at https://www.crd.york.ac.uk/PROSPERO/view/CRD420250621404.

Objectives: Intolerance of uncertainty (IU) is a cognitive vulnerability factor that plays a role in obsessive compulsive disorder (OCD). Most research has looked at IU at an omnibus level. This paper aimed to investigate the two dimensions of IU, prospective and inhibitory IU, and their relation to overall OCD symptom severity, as well as the severity of obsessions and compulsions.

Method: Fifty-nine individuals with OCD completed measures of OCD symptom severity and IU at pre- and post- group cognitive behavioral therapy (CBT).

Results: IU and OCD symptoms, and their dimensions, all reduced over the CBT treatment. At the start of treatment, only prospective IU was associated with compulsion symptom severity. In contrast, at the end of treatment, prospective and inhibitory IU were associated with compulsion symptom severity, and inhibitory IU was associated with obsession symptom severity. Baseline IU, prospective and inhibitory IU were not associated with post OCD symptom severity scores, when controlling for pre-treatment OCD severity levels. Change in prospective IU was associated with changes in OCD symptom severity, and change in compulsions, but not change in obsessions. The results cannot speak to causal or temporal predictions, or directionality of the relationship between IU and OCD.

Conclusion: These findings underscore the dynamic relationship between the IU dimensions and OCD symptoms, and highlights prospective IU as a potential important target in CBT for OCD to achieve reductions in compulsions and overall OCD symptom severity.

Objective: The present study aimed to translate and validate the French version of the Pain Resilience Scale (PRS) that was initially created and validated within English-speaking populations.

Methods: A total of 137 participants experiencing chronic pain completed the French version of the PRS and other questionnaires commonly used to evaluate resilience or vulnerability towards pain. Of these, 71 participants successfully retook the PRS measure within 15 days of their initial participation. A principal component analysis was employed to evaluate the internal structure of the questionnaire. Following classical test theory, internal consistency, convergent validity, and test-retest reliability were checked for the chosen model. Lastly, an item response theory analysis (IRT) was conducted for the 2 PRS dimensions. Factor analyses identified a two-factor solution consistent to the original English version of the PRS.

Results: The findings demonstrated that the scale's internal consistency and test-retest reliability meet the requirements for classical psychometric qualities. The overall PRS score and its subscales showed good convergent validity with measures assessing resilience or vulnerability processes to pain. IRT results highlighted difficulties with some items on each of the 2 dimensions that complement the results of the previous classical analyses.

Conclusions: The French version of the PRS scale is a reliable tool for measuring pain-specific resilience toward persistent pain.

The relationship between misophonia and sleep-related problems (SRPs) in youth is underexplored. This paucity of research is concerning because SRPs might be elevated among youth with misophonia. If left untreated, SRPs can contribute to long-term health consequences. Thus, in this study we examined the link between misophonia and SRPs in youth aged 8 to 17. In this study, we compared SRPs in 102 children and adolescents with clinically significant misophonia to SRPs in a normative youth sample and a sample of 94 youth with anxiety disorders. We also examined the extent to which SRPs were associated with misophonia severity. Approximately 30% of youth with misophonia endorsed clinical levels of SRPs. SRPs were more prevalent in youth with misophonia compared to normative data from the general youth population (d = 1.22) and similar to SRPs in youth with anxiety disorders (d = 0.13). Youth with more severe misophonia symptoms had greater difficulties with SRPs and this association was attenuated but still significant when adjusting for gender, age, and internalizing and externalizing symptoms. In this study, we provided the first evidence of substantial issues with SRPs in youth with misophonia. Importantly, there was a moderate association between misophonia severity and SRPs, indicating that SRPs should be carefully assessed and potentially addressed in treatment for youth with misophonia. We discussed suggestions for clinical practice and future research.