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Telehealth-delivered depression prevention: Short-term outcomes from a school-based randomized controlled trial. 远程医疗预防抑郁症:基于学校的随机对照试验的短期结果。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-10-31 DOI: 10.1037/ccp0000913
Jami F Young, Jason D Jones, Karen T G Schwartz, Amy So, Gillian C Dysart, Rebecca M Kanine, Jane E Gillham, Robert Gallop, Molly Davis

Objective: To examine short-term (i.e., postintervention) outcomes from a randomized controlled trial comparing a school-based telehealth-delivered depression prevention program, Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), to services as usual (SAU). We expected IPT-AST would be acceptable and feasible and that IPT-AST adolescents would experience greater reductions in depression symptoms, anxiety symptoms, and impairment compared with SAU.

Method: Adolescents (N = 242; Mage = 14.80 years, SD = 0.70; 65% female; 21% Black; 13% Hispanic/Latinx) with elevated scores on the Center for Epidemiologic Studies Depression Scale (Radloff, 1977) at screening provided data at baseline, 2-month (midpoint of IPT-AST), and 3-month (postintervention) assessments. They reported depression symptoms on the Center for Epidemiologic Studies Depression Scale, anxiety symptoms on the Screen for Child Anxiety Related Emotional Disorders (Birmaher et al., 1997), and impairment on the Columbia Impairment Scale (Bird et al., 1993). Baseline depression diagnosis was examined as a moderator.

Results: Hierarchical linear models showed that adolescents reported significant reductions in depression symptoms and impairment across conditions. IPT-AST adolescents reported significantly greater reductions in anxiety symptoms than SAU adolescents, d = .39, 95% CI [.05, .72], p = .003. Depression diagnosis moderated outcomes (ds = .33-.34, ps ≤ .05), such that IPT-AST adolescents without a diagnosis at baseline showed greater improvements in depression and anxiety symptoms than SAU adolescents. Adolescents in SAU with a depression diagnosis at baseline showed greater improvements in impairment compared with IPT-AST. Attendance and satisfaction data demonstrated the feasibility and acceptability of telehealth-delivered IPT-AST.

Conclusions: Results support telehealth-delivered IPT-AST as a promising intervention for improving short-term outcomes among adolescents with depression symptoms but without a depression diagnosis. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的研究一项随机对照试验的短期(即干预后)结果,该试验比较了基于学校的远程医疗抑郁症预防项目--人际心理治疗-青少年技能培训(IPT-AST)和常规服务(SAU)。我们希望IPT-AST是可接受的、可行的,而且与SAU相比,IPT-AST能更有效地减少青少年的抑郁症状、焦虑症状和障碍:筛查时在流行病学研究中心抑郁量表(Radloff,1977 年)上得分较高的青少年(N = 242;年龄 = 14.80 岁,SD = 0.70;65% 为女性;21% 为黑人;13% 为西班牙裔/拉丁裔)提供了基线、2 个月(IPT-AST 中点)和 3 个月(干预后)的评估数据。他们根据流行病学研究中心抑郁量表报告了抑郁症状,根据儿童焦虑相关情绪障碍筛查(Birmaher 等人,1997 年)报告了焦虑症状,并根据哥伦比亚障碍量表(Bird 等人,1993 年)报告了障碍情况。基线抑郁症诊断作为调节因素进行了研究:分层线性模型显示,青少年在不同条件下的抑郁症状和障碍均有显著减少。与 SAU 青少年相比,IPT-AST 青少年的焦虑症状明显减轻,d = .39,95% CI [.05, .72],p = .003。抑郁诊断对结果有调节作用(ds = .33-.34,Ps ≤ .05),因此,与 SAU 青少年相比,基线时未确诊抑郁的 IPT-AST 青少年在抑郁和焦虑症状方面有更大的改善。与 IPT-AST 相比,基线诊断为抑郁症的 SAU 青少年在障碍方面的改善更大。出勤率和满意度数据证明了远程医疗提供的 IPT-AST 的可行性和可接受性:研究结果表明,远程医疗提供的 IPT-AST 是一种很有前景的干预措施,可改善有抑郁症状但未确诊为抑郁症的青少年的短期疗效。(PsycInfo Database Record (c) 2024 APA, 版权所有)。
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引用次数: 0
Results of a randomized waitlist-controlled trial of online cognitive behavioral sex therapy and online mindfulness-based sex therapy for hypoactive sexual desire dysfunction in women. 在线认知行为性疗法和在线正念性疗法治疗女性性欲减退功能障碍的随机候选对照试验结果。
IF 5.9 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-10-24 DOI: 10.1037/ccp0000922
Julia Velten,Gerrit Hirschfeld,Milena Meyers,Jürgen Margraf
OBJECTIVEThis study aimed to investigate the efficacy of two internet-delivered psychological treatments for hypoactive sexual desire dysfunction (HSDD) in women: internet-based cognitive behavioral sex therapy (iCBST) and internet-based mindfulness-based sex therapy (iMBST).METHODWomen with HSDD were randomly assigned to one of three groups: iCBST, iMBST, or a waitlist control group. The interventions consisted of eight modules delivered via an e-health platform with e-coach support to enhance adherence. Sexual desire and sexual distress were assessed at baseline and at 3-, 6-, and 12-month follow-ups (active conditions only). Per protocol, of the 266 consenting women, 106 were randomized to iCBST (Mage = 36.1, SD = 10.3), 106 to iMBST (Mage = 36.4, SD = 0.2), and 54 to the control condition (Mage = 36.7, SD = 11.0). Primary analyses utilized an intention-to-treat approach with linear mixed models. Clinical significance, assessed with clinical cutoffs and the reliable change index, was examined for active conditions.RESULTSCompared to the control condition, both iCBST and iMBST demonstrated significant improvements in sexual desire and sexual distress at 3-month (d = 0.89-1.14) and 6-month follow-up (d = 0.74-1.18). Results were sustained at 12-month follow-up, with 35 and 41% demonstrating reliable improvements and additional 20 and 24% achieving clinically significant improvements in sexual desire after iCBST and iMBST. Regarding sexual distress, 49 and 42% exhibited reliable change, with an additional 37%-42% achieving clinically significant improvements.CONCLUSIONSResults provide support for the overall long-term efficacy of psychological therapies in treating HSDD in women. However, fewer than one in four women showed improvements in sexual desire that met the threshold for clinically significant change. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
目的本研究旨在调查两种通过互联网提供的女性性欲减退(HSDD)心理治疗方法的疗效:基于互联网的认知行为性治疗(iCBST)和基于互联网的正念性治疗(iMBST)。方法患有 HSDD 的女性被随机分配到三组中的一组:iCBST、iMBST 或候补对照组。干预措施包括通过电子健康平台提供的八个模块,并配有电子教练支持,以提高依从性。在基线以及 3 个月、6 个月和 12 个月的随访中对性欲和性困扰进行了评估(仅限于活动状态)。根据方案,在 266 名同意接受治疗的女性中,106 人随机接受了 iCBST 治疗(Mage = 36.1,SD = 10.3),106 人接受了 iMBST 治疗(Mage = 36.4,SD = 0.2),54 人接受了对照治疗(Mage = 36.7,SD = 11.0)。主要分析采用线性混合模型的意向治疗方法。结果与对照组相比,iCBST 和 iMBST 均在 3 个月(d = 0.89-1.14)和 6 个月随访(d = 0.74-1.18)时显著改善了性欲和性困扰。iCBST 和 iMBST 治疗后,分别有 35% 和 41% 的患者在性欲方面得到了可靠的改善,另有 20% 和 24% 的患者在性欲方面得到了临床意义上的改善。在性困扰方面,分别有 49% 和 42% 的人表现出可靠的变化,另有 37%-42% 的人获得了临床显著改善。然而,只有不到四分之一的女性在性欲方面有所改善,达到了临床显著变化的临界值。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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引用次数: 0
Safety behavior reduction for appearance concerns: A randomized controlled trial of a smartphone-based intervention. 减少外观问题的安全行为:基于智能手机的干预随机对照试验。
IF 5.9 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-10-24 DOI: 10.1037/ccp0000920
Tapan A Patel,Jesse R Cougle
OBJECTIVEAppearance concerns are a core feature of multiple psychiatric disorders (i.e., body dysmorphic disorder, eating disorders, and social anxiety disorders). Individuals with these concerns commonly engage in appearance-related safety behaviors (ARSB), behaviors intended to avoid, prevent, or manage the negative evaluation of one's physical appearance. The present study evaluated a brief ARSB reduction intervention for appearance concerns.METHODWomen with elevated appearance concerns (N = 203) were recruited from across the United States and randomized to receive one of two 1-month smartphone-based interventions targeting ARSBs or unhealthy behaviors (UHBs). Both consisted of daily text messages with links to behavior checklists and reminders to avoid the respective behaviors.RESULTSParticipants in both treatments saw substantial reductions in symptoms. Though the UHB fading condition showed significantly better treatment adherence than ARSB fading, ARSB fading led to significantly lower appearance concerns (sr² = .028, p = .014) and eating disorder symptoms (sr² = .024, p = .020) at posttreatment, and lower appearance concerns (sr² = .041, p = .004), eating disorder symptoms (sr² = .029, p = .006), social anxiety (sr² = .048, p = .005), and appearance importance at 1-month follow-up (sr² = .042, p = .011), relative to UHB fading. Changes in ARSBs were found to partially mediate the effect of treatment on appearance concerns.CONCLUSIONSThese preliminary findings provide novel evidence for the efficacy of targeting ARSBs and suggest that this text-based intervention may be an efficacious and accessible intervention for women with elevated appearance concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
目的:外貌问题是多种精神障碍(如身体畸形障碍、饮食障碍和社交焦虑障碍)的核心特征。有这些顾虑的人通常会做出与外貌相关的安全行为(ARSB),这些行为旨在避免、预防或管理对自己外貌的负面评价。本研究评估了一种针对外貌问题的简短ARSB减少干预措施。方法从美国各地招募了外貌问题严重的女性(N = 203),并随机分配她们接受两种为期1个月的智能手机干预措施,其中一种针对ARSB或不健康行为(UHB)。这两种干预都包括每日短信,短信中包含行为清单链接和避免相应行为的提醒。虽然 UHB 消退的治疗依从性明显优于 ARSB 消退,但 ARSB 消退使患者在治疗后对外表的担忧(sr² = .028,p = .014)和饮食失调症状(sr² = .024,p = .与 UHB 消退相比,ARSB 消退会在治疗后明显降低外貌问题(sr² = .028,p = .014)和饮食失调症状(sr² = .024,p = .020),并在 1 个月的随访中降低外貌问题(sr² = .041,p = .004)、饮食失调症状(sr² = .029,p = .006)、社交焦虑(sr² = .048,p = .005)和外貌重要性(sr² = .042,p = .011)。这些初步研究结果为针对 ARSBs 的疗效提供了新的证据,并表明这种基于文本的干预措施可能是一种有效且易于接受的干预措施,适用于对外貌高度关注的女性。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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引用次数: 0
Individualized Assessment and Treatment Program (IATP) for alcohol use disorder: Comparison with conventional cognitive-behavioral treatment and examination of coping skills as a mediator of treatment. 针对酒精使用障碍的个性化评估和治疗计划(IATP):与传统认知行为治疗的比较,以及将应对技能作为治疗中介的研究。
IF 5.9 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-10-07 DOI: 10.1037/ccp0000907
Mark D Litt,Howard Tennen,Ronald M Kadden
OBJECTIVEThis study tested a highly individualized cognitive-behavioral coping skills treatment for alcohol use disorder (AUD). Recent studies have indicated that coping skills training programs are not always effective. A possible explanation is that the training provided in these programs may not address the specific needs of the patient. The Individualized Assessment and Treatment Program (IATP) was intended to provide a highly individualized approach to the training of skills most relevant for each individual.METHODMen and women with AUD (N = 173) were randomly assigned to one of three, manualized, 12-session treatments: IATP, a conventional (Packaged) cognitive-behavioral program (PCBT), or a Case Management control condition (CaseM). An experience sampling (ES) procedure was employed prior to, and during, treatment to record alcohol use and coping behaviors in all patients. In IATP, this information was used by therapists to plan treatment that would address the specific strengths and weaknesses of each patient in alcohol-use situations. ES data were collected at multiple time points and patients were followed every 3 months out to 21 months posttreatment.RESULTSMultilevel model analyses indicated that IATP yielded better drinking outcomes than the CaseM or PCBT conditions. Mediation analyses indicated that the effects of IATP versus the other treatments on outcomes were accounted for at least partly by changes in active coping with high-risk situations.CONCLUSIONDue to the limited diversity of the sample, generalizability of the results may be limited. Results are discussed in terms of the importance of tailoring treatment for the individual patient. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
目的:本研究测试了一种针对酒精使用障碍(AUD)的高度个性化认知行为应对技能治疗方法。最近的研究表明,应对技能训练计划并不总是有效的。一种可能的解释是,这些项目提供的训练可能无法满足患者的具体需求。个性化评估和治疗计划(IATP)旨在提供一种高度个性化的方法,以训练与每个人最相关的技能:IATP、传统(包装)认知行为项目(PCBT)或个案管理对照条件(CaseM)。在治疗前和治疗过程中,采用经验取样(ES)程序记录所有患者的饮酒情况和应对行为。在 IATP 中,治疗师利用这些信息制定治疗计划,以解决每位患者在酒精使用情况下的具体优势和劣势。结果多层次模型分析表明,与 CaseM 或 PCBT 条件相比,IATP 产生了更好的饮酒结果。中介分析表明,IATP 相对于其他治疗方法对结果的影响至少部分是通过积极应对高风险情况的变化来解释的。本文从针对个体患者进行量身定制治疗的重要性角度对研究结果进行了讨论。(PsycInfo Database Record (c) 2024 APA, 版权所有)。
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引用次数: 0
Change processes associated with functional improvement in a web-based version of Skills Training in Affective and Interpersonal Regulation (webSTAIR) for trauma-exposed veterans. 针对受过创伤的退伍军人的情感和人际关系调节技能培训(webSTAIR)网络版中与功能改善相关的变化过程。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-10-01 DOI: 10.1037/ccp0000906
Kathryn S Macia, Eve B Carlson, Daniel M Blonigen, Jan Lindsay, Marylène Cloitre

Objective: In spite of the evidence that both symptom reduction and functional improvement are important for supporting recovery from trauma, psychotherapy process research has largely focused on mechanisms of symptom reduction. A better understanding of how change occurs in treatments that emphasize functional improvement rather than trauma processing is critical for optimizing effective, patient-centered care.

Method: This study involved secondary analysis of data collected in three multisite trials of a 10-module web-based version of Skills Training in Affective and Interpersonal Regulation, a skills-focused transdiagnostic intervention. The sample included 314 trauma-exposed veterans (38% male; 64% non-Hispanic White) who screened positive for elevated symptoms of posttraumatic stress disorder and/or depression. Latent change score modeling examined prospective relationships between changes from pre-to-mid and mid-to-post treatment in four potential mechanisms (emotion regulation, interpersonal problems, posttraumatic stress disorder symptoms, and depression symptoms) and the association of these changes with overall functional improvement (at posttreatment and follow-up).

Results: Emotion regulation change during the first half of treatment predicted interpersonal and symptom improvements during the second half of treatment, but not vice versa. Changes in each potential mechanism were uniquely associated with functional improvement and together statistically accounted for 78% additional variance in functional improvement beyond what was associated with baseline functioning and covariates.

Conclusions: Results support emotion regulation as an early mechanism of transdiagnostic therapeutic change in web-based version of Skills Training in Affective and Interpersonal Regulation and highlight the relevance of all four potential mechanisms to functional improvement. The study contributes to an understanding of how change occurs in skills-focused interventions for trauma-exposed individuals. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:尽管有证据表明,减轻症状和改善功能对于支持创伤康复都很重要,但心理治疗过程的研究却主要集中在减轻症状的机制上。更好地了解强调功能改善而非创伤处理的治疗中如何发生变化,对于优化有效的、以患者为中心的护理至关重要:本研究对情感和人际关系调节技能培训(一种以技能为重点的跨诊断干预方法)的 10 个模块网络版的三项多站点试验所收集的数据进行了二次分析。样本包括 314 名受到创伤的退伍军人(38% 为男性;64% 为非西班牙裔白人),他们的创伤后应激障碍和/或抑郁症状均呈阳性。隐性变化评分模型研究了四种潜在机制(情绪调节、人际关系问题、创伤后应激障碍症状和抑郁症状)从治疗前中期到治疗中期后的变化之间的前瞻性关系,以及这些变化与整体功能改善(治疗后和随访时)之间的关联:结果:治疗前半期的情绪调节变化预示着治疗后半期人际关系和症状的改善,但反之亦然。每种潜在机制的变化都与功能改善有着独特的联系,并且在统计学上,除了与基线功能和协变量相关的变化外,它们还共同解释了功能改善中78%的额外差异:研究结果表明,情绪调节是情感和人际关系调节技能训练网络版跨诊断治疗改变的早期机制,并强调了所有四种潜在机制与功能改善的相关性。这项研究有助于人们理解,针对受到创伤的个体进行的以技能为重点的干预是如何产生变化的。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
{"title":"Change processes associated with functional improvement in a web-based version of Skills Training in Affective and Interpersonal Regulation (webSTAIR) for trauma-exposed veterans.","authors":"Kathryn S Macia, Eve B Carlson, Daniel M Blonigen, Jan Lindsay, Marylène Cloitre","doi":"10.1037/ccp0000906","DOIUrl":"https://doi.org/10.1037/ccp0000906","url":null,"abstract":"<p><strong>Objective: </strong>In spite of the evidence that both symptom reduction and functional improvement are important for supporting recovery from trauma, psychotherapy process research has largely focused on mechanisms of symptom reduction. A better understanding of how change occurs in treatments that emphasize functional improvement rather than trauma processing is critical for optimizing effective, patient-centered care.</p><p><strong>Method: </strong>This study involved secondary analysis of data collected in three multisite trials of a 10-module web-based version of Skills Training in Affective and Interpersonal Regulation, a skills-focused transdiagnostic intervention. The sample included 314 trauma-exposed veterans (38% male; 64% non-Hispanic White) who screened positive for elevated symptoms of posttraumatic stress disorder and/or depression. Latent change score modeling examined prospective relationships between changes from pre-to-mid and mid-to-post treatment in four potential mechanisms (emotion regulation, interpersonal problems, posttraumatic stress disorder symptoms, and depression symptoms) and the association of these changes with overall functional improvement (at posttreatment and follow-up).</p><p><strong>Results: </strong>Emotion regulation change during the first half of treatment predicted interpersonal and symptom improvements during the second half of treatment, but not vice versa. Changes in each potential mechanism were uniquely associated with functional improvement and together statistically accounted for 78% additional variance in functional improvement beyond what was associated with baseline functioning and covariates.</p><p><strong>Conclusions: </strong>Results support emotion regulation as an early mechanism of transdiagnostic therapeutic change in web-based version of Skills Training in Affective and Interpersonal Regulation and highlight the relevance of all four potential mechanisms to functional improvement. The study contributes to an understanding of how change occurs in skills-focused interventions for trauma-exposed individuals. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Disruptive child behavior severity and parenting program session attendance: Individual participant data meta-analysis. 儿童破坏性行为的严重程度与亲子计划课程的出席率:个体参与者数据荟萃分析。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-10-01 Epub Date: 2024-05-23 DOI: 10.1037/ccp0000893
G J Melendez-Torres, Patty Leijten, Stephen Scott, Frances Gardner, Nick Axford, Maria João Seabra Santos, Ankie Menting, Judy Hutchings, Vashti Berry

Objective: We tested if baseline disruptive child behavior problem severity predicts parental attendance at sessions of a parenting group program.

Method: We used a database of randomized trials of the Incredible Years parenting program in Europe and restricted the sample to participants randomized to the intervention arm. Using baseline Eyberg Child Behavior Inventory scores, we distinguished between trial-level problem severity and child-level problem severity, compared linear and quadratic functional forms at both levels, and considered cross-level interactions, all in a multilevel Poisson regression framework.

Results: Drawing on 918 participants in 12 trials, we found that within trials, parents of children with the least and most severe problems attended fewer sessions. Between trials, each additional 10-point increase in the Eyberg Child Behavior Inventory trial mean predicted an 11% increase in attendance. Models including child sex, age, or family low-income did not change coefficients or their interpretation.

Conclusions: Our findings suggest that although generally attendance is higher in parents of children with more challenging behavior, it seems difficult for group programs to keep families with the least or most severe problems engaged. Our findings call for the need to better understand the conditions under which lower attendance translates into equivalent or lesser program benefits. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的我们测试了基线儿童破坏性行为问题的严重程度是否能预测父母参加亲子小组项目的情况:我们使用了欧洲 "不可思议的岁月"(Incredible Years)亲子项目随机试验数据库,并将样本限制在随机干预组的参与者中。利用艾伯格儿童行为量表的基线分数,我们区分了试验水平的问题严重性和儿童水平的问题严重性,比较了这两个水平的线性和二次函数形式,并考虑了跨水平的交互作用,所有这些都是在多水平泊松回归框架下进行的:从 12 项试验的 918 名参与者中,我们发现在试验中,问题最不严重和最严重儿童的家长参加的课程较少。在不同试验之间,艾伯格儿童行为量表试验平均值每增加 10 分,出席率就会增加 11%。包括儿童性别、年龄或家庭低收入在内的模型并没有改变系数或其解释:我们的研究结果表明,虽然行为更具挑战性的儿童的父母一般出席率较高,但小组项目似乎很难让问题最少或最严重的家庭参与进来。我们的调查结果表明,有必要更好地了解在哪些条件下,较低的出席率会转化为同等或较低的项目收益。(PsycInfo Database Record (c) 2024 APA, 版权所有)。
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引用次数: 0
Data-informed psychological therapy, measurement-based care, and precision mental health. 以数据为依据的心理治疗、基于测量的护理和精准心理健康。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-10-01 DOI: 10.1037/ccp0000904
Wolfgang Lutz, Antonia Vehlen, Brian Schwartz

Measurement-based care, that is, incorporating data-informed decision support for therapists into psychological therapy, has undergone significant advancements over the past 2 decades. Technological innovations such as computerized data assessment and feedback tools have facilitated its widespread adoption across various settings. For instance, clinicians can utilize psychometric data to personalize therapeutic approaches, strategies, or modules and track a patient's response to therapy in real time (e.g., Lutz, Schwartz, & Delgadillo, 2022). Furthermore, new algorithm-based clinical support tools used within measurement-based care can optimize treatment for such patients at risk for treatment failure. Consequently, measurement-based care is evolving into a data-informed and precision psychological therapy concept that can be viewed as a low-intensity transtheoretical adjunct to evidence-based treatments. It can be integrated at multiple care points into clinical practice regardless of the clinical modality, manual, or program used in a given health care system. Therefore, it emerges as an important component of clinical competence, practice, and training, akin to continuous monitoring of physical health indicators (e.g., insulin, fever, or blood pressure). In this viewpoint article, we summarize the core concepts of data-informed psychological therapy that customizes individual psychological interventions to meet specific patient needs. We also explore implications and future steps to integrate this approach into clinical practice and further advance precision mental health care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

以测量为基础的护理,即在心理治疗中为治疗师提供以数据为依据的决策支持,在过去二十年间取得了长足的进步。计算机化数据评估和反馈工具等技术创新促进了其在各种环境中的广泛应用。例如,临床医生可以利用心理测量数据来个性化治疗方法、策略或模块,并实时跟踪患者对治疗的反应(例如,Lutz, Schwartz, & Delgadillo, 2022)。此外,在基于测量的护理中使用的基于算法的新临床支持工具可以优化对这类有治疗失败风险的患者的治疗。因此,基于测量的护理正在发展成为一种以数据为依据的精准心理治疗概念,可被视为循证治疗的低强度跨理论辅助手段。无论在特定的医疗保健系统中使用哪种临床模式、手册或方案,它都可以在多个护理点与临床实践相结合。因此,它已成为临床能力、实践和培训的重要组成部分,类似于对身体健康指标(如胰岛素、发烧或血压)的持续监测。在这篇观点文章中,我们总结了以数据为依据的心理疗法的核心理念,即根据患者的具体需求定制个性化的心理干预措施。我们还探讨了将这种方法融入临床实践的意义和未来步骤,并进一步推进精准心理保健。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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引用次数: 0
School-based organizational skills training for students in grades 3-5: A cluster randomized trial. 针对 3-5 年级学生的校本组织能力培训:分组随机试验。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-10-01 DOI: 10.1037/ccp0000909
Jenelle Nissley-Tsiopinis, Thomas J Power, Phylicia F Fleming, Katie L Tremont, Bridget Poznanski, Shannon Ryan, Jaclyn Cacia, Theresa Egan, Cristin Montalbano, Alex Holdaway, Ami Patel, Richard Gallagher, Howard Abikoff, A Russell Localio, Jennifer A Mautone

Objective: Research has demonstrated the effectiveness of interventions to reduce organizational skills deficits and homework problems, including the clinic-based Organizational Skills Training (OST-C) program (Abikoff et al., 2013). In this study, OST-C was adapted for schools as a small-group (Tier 2) intervention delivered by school partners (OST-T2).

Method: The study was conducted in 22 schools serving students from diverse backgrounds. Students (n = 186; 122 male) in Grades 3-5, ages 8-12 (M = 9.7 years; SD = 0.88) with organizational skills deficits referred by teachers were enrolled. Schools were randomly assigned to OST-T2 or treatment as usual with waitlist. OST-T2 consisted of sixteen 35-min child sessions, two caregivers, and two teacher consultations. Outcomes were evaluated with longitudinal mixed effects modeling at posttreatment, 5-month and 12-month follow-up using caregiver and teacher reports of organizational skills, homework, and academic performance.

Results: OST-T2 resulted in reductions in organizational skills deficits on caregiver and teacher report (p < .001) at posttreatment and 5-month follow-up (effect sizes [ES], Cohen's d = 0.96, 1.20). Findings also revealed a reduction in caregiver-reported homework problems at posttreatment and 5-month follow-up (p < .001, ES = 0.60, 0.72), and an improvement in teacher-rated homework at posttreatment (p = .007, ES = 0.64). Effects were attenuated at 12-month follow-up. The effects of OST-T2 on academic measures were not significant.

Conclusions: Findings provide evidence for the immediate and short-term effectiveness of OST-T2 delivered by school professionals. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:研究表明,减少组织能力缺陷和家庭作业问题的干预措施非常有效,其中包括基于诊所的组织能力训练(OST-C)项目(Abikoff 等人,2013 年)。在本研究中,OST-C 被改编为由学校合作伙伴提供的小组(第二级)干预(OST-T2):研究在 22 所学校进行,这些学校为来自不同背景的学生提供服务。参加研究的学生(n = 186;122 名男生)来自 3-5 年级,年龄在 8-12 岁之间(M = 9.7 岁;SD = 0.88),他们都是由教师推荐的组织能力有缺陷的学生。学校被随机分配到 OST-T2 或照常治疗和候补名单中。OST-T2包括16节35分钟的儿童课程、2名保育员和2名教师咨询。在治疗后、5 个月和 12 个月的随访中,利用照顾者和教师对组织技能、家庭作业和学习成绩的报告,采用纵向混合效应模型对结果进行评估:在治疗后和 5 个月的随访中,OST-T2 导致护理人员和教师报告的组织能力缺陷减少(p < .001)(效应大小 [ES],Cohen's d = 0.96,1.20)。研究结果还显示,在治疗后和 5 个月的随访中,护理人员报告的家庭作业问题有所减少(p < .001, ES = 0.60, 0.72),在治疗后,教师评定的家庭作业有所改善(p = .007, ES = 0.64)。随访 12 个月后,效果有所减弱。OST-T2对学习成绩的影响不显著:研究结果为学校专业人员提供的 OST-T2 的直接和短期有效性提供了证据。(PsycInfo Database Record (c) 2024 APA, 版权所有)。
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引用次数: 0
A randomized controlled trial comparing brief online self-guided interventions for loneliness. 一项随机对照试验,比较了针对孤独的简短在线自我指导干预措施。
IF 5.9 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-26 DOI: 10.1037/ccp0000908
Benjamin T Kaveladze,Sara F Gastelum,Dong-Anh C Ngo,Paul Delacruz,Katherine A Cohen,Anton Käll,Gerhard Andersson,Jessica L Schleider,Stephen M Schueller
OBJECTIVELoneliness is a global health issue, but current loneliness interventions are not scalable enough to reach many who might benefit from them. Brief online interventions could greatly expand access to evidence-based loneliness interventions.METHODWe conducted a preregistered three-armed trial (N = 908, ages 16-78) to compare three self-guided online interventions: a single-session intervention (SSI) for loneliness, a 3-week, three-session intervention for loneliness, and an active control supportive therapy SSI (https://ClinicalTrials.gov, ID: NCT05687162).RESULTSLoneliness decreased between baseline and Week 8 across all conditions (b = -5.80; d = -0.55; 95% CI [-0.62, -0.47]; p < .01), but did not decrease significantly more in those assigned to either the loneliness SSI (b = -1.27; d = -0.12; 95% CI [-0.30, 0.06]; p = .20) or the 3-week intervention (b = -0.93; d = -0.09; 95% CI [-0.27, 0.09]; p = .34) than those assigned to the control SSI. Participants found all three interventions acceptable but rated both loneliness interventions as more acceptable than the control (p < .01). Far more participants completed the 10-min control SSI (86.6%) and 20-min loneliness SSI (69.4%) than the 60-min 3-week intervention (14.9%).CONCLUSIONSAn SSI for loneliness was not significantly less effective than a longer loneliness intervention and had a much higher completion rate. Yet, against our hypotheses, neither loneliness intervention reduced loneliness more than an active control SSI did. Future work should aim to design more effective SSIs for loneliness and identify populations for which SSIs might be most helpful. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
目的孤独是一个全球性的健康问题,但目前的孤独干预措施规模不够大,无法惠及许多可能从中受益的人。简短的在线干预可以大大增加获得循证孤独干预的机会。方法我们进行了一项预先登记的三臂试验(N = 908,年龄在 16-78 岁之间),比较了三种自我指导的在线干预:针对孤独的单次干预(SSI)、针对孤独的 3 周 3 次干预以及主动对照支持疗法 SSI(https://ClinicalTrials.结果在所有条件下,孤独感在基线和第 8 周之间都有所下降(b = -5.80; d = -0.55; 95% CI [-0.62, -0.47];p < .01),但在被分配到孤独感 SSI 的患者中,孤独感的下降幅度并不明显(b = -1.27; d = -0.12; 95% CI [-0.30, 0.06]; p = .20)或为期 3 周的干预(b = -0.93; d = -0.09; 95% CI [-0.27, 0.09]; p = .34)与对照 SSI 相比并没有明显下降。参与者认为所有三种干预措施都是可以接受的,但对两种孤独干预措施的评分都高于对照组(p < .01)。完成 10 分钟对照 SSI(86.6%)和 20 分钟孤独感 SSI(69.4%)的参与者远远多于完成 60 分钟 3 周干预的参与者(14.9%)。然而,与我们的假设相反的是,这两种孤独干预措施在减少孤独感方面的效果都不如积极的对照SSI。未来的工作应着眼于设计更有效的孤独感干预措施,并确定孤独感干预措施可能对哪些人群最有帮助。(PsycInfo Database Record (c) 2024 APA, 版权所有)。
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引用次数: 0
Multimodal analysis of temporal affective variability within treatment for depression. 对抑郁症治疗过程中的时间情感变化进行多模式分析。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-01 Epub Date: 2024-07-25 DOI: 10.1037/ccp0000901
Adar Paz, Eshkol Rafaeli, Eran Bar-Kalifa, Eva Gilboa-Schechtman, Sharon Gannot, Shrikanth S Narayanan, Dana Atzil-Slonim

Objective: Affective flexibility, the capacity to respond to life's varying environmental changes in a dynamic and adaptive manner, is considered a central aspect of psychological health in many psychotherapeutic approaches. The present study examined whether affective two-dimensional (i.e., arousal and valence) temporal variability extracted from voice and facial expressions would be associated with positive changes over the course of psychotherapy, at the session, client, and treatment levels.

Method: A total of 22,741 mean vocal arousal and facial expression valence observations were extracted from 137 therapy sessions in a sample of 30 clients treated for major depressive disorder by nine therapists. Before and after each session, the clients self-reported their level of well-being on the outcome rating scale. Session-level affective temporal variability was assessed as the mean square of successive differences between consecutive two-dimensional affective measures.

Results: Session outcome was positively associated with temporal variability at the session level (i.e., within clients, between sessions) and at the client level (i.e., between clients). Importantly, these associations held when controlling for average session- and client-level valence scores. In addition, the expansion of temporal variability throughout treatment was associated with steeper positive session outcome trajectories over the course of treatment.

Conclusions: The continuous assessment of both vocal and facial affective expressions and the ability to extract measures of affective temporal variability from within-session data may enable therapists to better respond and modulate clients' affective flexibility; however, further research is necessary to determine whether there is a causal link between affective temporal variability and psychotherapy outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:情感灵活性是一种以动态和适应的方式应对生活中不同环境变化的能力,在许多心理治疗方法中被认为是心理健康的一个核心方面。本研究探讨了从声音和面部表情中提取的情感二维(即唤醒和情绪)时间变异性是否与心理治疗过程中,在疗程、客户和治疗层面的积极变化有关:从九位治疗师治疗的 30 位重度抑郁障碍患者的 137 个治疗疗程中,共提取了 22,741 个平均声音唤醒度和面部表情愉悦度观测值。在每次治疗前后,患者都会根据结果评分量表自我报告其幸福程度。疗程水平的情感时间变异性被评估为连续二维情感测量之间连续差异的均方差:疗程结果与疗程水平(即客户内部、疗程之间)和客户水平(即客户之间)的时间变异性呈正相关。重要的是,在控制了会话和客户水平的平均情绪分数后,这些关联仍然存在。此外,在整个治疗过程中,时间变异性的扩大与治疗过程中更陡峭的积极疗程结果轨迹有关:对声音和面部情感表达的连续评估,以及从疗程内数据中提取情感时间变异性测量值的能力,可以使治疗师更好地应对和调节求助者的情感灵活性;然而,要确定情感时间变异性与心理治疗结果之间是否存在因果关系,还需要进一步的研究。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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Journal of consulting and clinical psychology
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