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Negative affect variability as a potential mechanism of behavior change in alcohol use disorder treatment. 消极情绪变异是酒精使用障碍治疗中行为改变的潜在机制。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-08-01 DOI: 10.1037/ccp0000914
Braden K Linn, Junru Zhao, Paul R Stasiewicz, Gregory E Wilding, Charles LaBarre, Kyler S Knapp, Clara M Bradizza

Objective: Negative affect and affect variability figure prominently in models of addictive behaviors but are not without controversy. Negative affect variability may better capture a mechanism of behavior change in alcohol use disorder (AUD) treatment because it contains information about affect regulation, a common clinical target. The aims of this study are to examine the change in: (a) trajectory of negative affect variability, (b) association of negative affect variability and abstinence, and (c) association of negative affect variability and heavy drinking during AUD treatment.

Method: This article is a secondary analysis of data drawn from a randomized clinical trial. N = 181 participants diagnosed with Diagnostic and Statistical Manual of Mental Disorders, fifth edition AUD (Mage = 50.8, SDage = 10.6; 51.4% female) received 12 sessions of Cognitive Behavioral Coping Skills Therapy for AUD. Participants completed one daily diary prompt per day for 84 consecutive days. Each day, participants reported on negative affect and number of alcoholic drinks consumed the previous day. Time-varying effect models examined changes in negative affect variability and its associations with abstinence and heavy drinking.

Results: Negative affect variability decreased throughout treatment. The positive association between negative affect variability and heavy drinking became nonsignificant (decoupled) midway through treatment. The inverse association between negative affect variability and daily abstinence became nonsignificant (decoupled) at approximately day 75 of 84. When mean levels of NA were added as a covariate, the effects were in the same direction but no longer statistically significant.

Conclusion: Reductions in negative affect variability may capture an important change mechanism of behavioral treatments for AUD because it contains information about affect regulation as compared with mean levels of negative affect. Negative affect variability warrants further consideration as a mechanism of behavior change. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:消极情绪和情绪变异性在成瘾行为模型中占有重要地位,但并非没有争议。消极情绪变异性可以更好地捕捉到酒精使用障碍(AUD)治疗中行为改变的机制,因为它包含了情绪调节的信息,而情绪调节是临床上的一个常见目标。本研究旨在探讨:(a) 在酒精使用障碍治疗期间,负性情感变异性的变化轨迹;(b) 负性情感变异性与戒酒的关联;(c) 负性情感变异性与大量饮酒的关联:本文是对一项随机临床试验数据的二次分析。N = 181 名被诊断为《精神障碍诊断与统计手册》第五版 AUD 的参与者(Mage = 50.8,SDage = 10.6;51.4% 为女性)接受了 12 次认知行为应对技能疗法治疗 AUD。在连续 84 天的时间里,受试者每天填写一份日记提示。每天,参与者报告前一天的负面情绪和饮酒次数。时变效应模型研究了负性情绪变异性的变化及其与戒酒和大量饮酒的关系:结果:在整个治疗过程中,负性情绪变异性都在下降。负性情绪变异性与大量饮酒之间的正相关在治疗中途变得不显著(脱钩)。负性情绪变异性与每日戒酒之间的反向关系在治疗的第 75 天左右变得不显著(脱钩)。如果将 NA 的平均水平作为协变量加入,两者的影响方向相同,但不再具有统计学意义:消极情绪变异性的降低可能捕捉到了 AUD 行为疗法的一个重要变化机制,因为与消极情绪的平均水平相比,它包含了有关情绪调节的信息。消极情绪变异性作为一种行为改变机制值得进一步考虑。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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引用次数: 0
Monitoring emotional intensity and variability to forecast depression recurrence in real time in remitted adults. 监测情绪强度和变异性,实时预测病情缓解的成年人抑郁症复发情况。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-08-01 Epub Date: 2024-03-21 DOI: 10.1037/ccp0000871
Marieke J Schreuder, Evelien Schat, Arnout C Smit, Evelien Snippe, Eva Ceulemans

Objective: Recurrent depressive episodes are preceded by changing mean levels of repeatedly assessed emotions (e.g., feeling restless), which can be detected in real time using statistical process control (SPC). This study investigated whether monitoring changes in the standard deviation (SD) of emotions and negative thinking improves the early detection of recurrent depression.

Method: Formerly depressed adults (N = 41) monitored their emotions five times a day for 4 consecutive months. During the study, 22 individuals experienced recurrent depression. We used SPC to detect warning signs (i.e., changing means and SDs) of four emotions (positive and negative affect with high or low arousal) and negative thinking.

Results: SD-based warning signs only preceded 23%-36% of recurrences, but almost never reflected a false alarm (0%-16%). Correspondingly, SD-based warnings had a high specificity (at the cost of sensitivity), while mean-based warnings had a higher sensitivity (but lower specificity). There was little overlap in mean- and SD-based warning signs. For the majority of emotions, monitoring for high SDs alongside monitoring changes in mean levels improved the detection of depression (p < .015) compared to when only monitoring for changing mean levels.

Conclusions: Warning signs for depression manifest not only in changing mean levels of emotions and cognitions but also in increasing SDs. These warnings could eventually be used to detect not just who is at increased risk for depression but also when risk is rising. Further research is needed to evaluate the clinical utility of depression SPC. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:复发性抑郁症发作前,反复评估的情绪(如坐立不安)的平均水平会发生变化,这可以通过统计过程控制(SPC)实时检测到。本研究探讨了监测情绪和负面思维的标准偏差(SD)变化是否能提高复发性抑郁症的早期发现率:方法:曾经患有抑郁症的成年人(41 人)连续 4 个月每天 5 次监测自己的情绪。在研究期间,有 22 人经历了复发性抑郁。我们使用 SPC 检测了四种情绪(高唤醒或低唤醒的积极和消极情绪)和消极思维的预警信号(即变化的平均值和标差):结果:在 23%-36% 的复发案例中,基于 SD 值的预警信号仅出现在复发之前,但几乎从未出现过误报(0%-16%)。相应地,基于标化的警告具有较高的特异性(以牺牲灵敏度为代价),而基于平均值的警告具有较高的灵敏度(但特异性较低)。以平均值和标度为基础的预警信号几乎没有重叠。对于大多数情绪而言,在监测平均水平变化的同时监测高标度值可提高抑郁症的检测率(p < .015),而只监测平均水平变化则无法提高检测率:结论:抑郁症的预警信号不仅表现为情绪和认知的平均水平变化,还表现为自变量的增加。这些警告最终不仅可用于检测哪些人患抑郁症的风险增加,还可用于检测风险上升的时间。要评估抑郁症 SPC 的临床实用性,还需要进一步的研究。(PsycInfo Database Record (c) 2024 APA, 版权所有)。
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引用次数: 0
Does it matter how meditation feels? An experience sampling study. 冥想的感觉重要吗?经验取样研究
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-08-01 DOI: 10.1037/ccp0000857
Simon B Goldberg, Daniel M Bolt, Cortland J Dahl, Richard J Davidson, Matthew J Hirshberg

Objective: Meditation apps are the most widely used mental health apps. The precise mechanisms underlying their effects remain unclear. In particular, the degree to which affect experienced during meditation is associated with outcomes has not been established.

Method: We used the meditation app arm of a recently completed randomized controlled trial comparing a self-guided meditation app (Healthy Minds Program) to a waitlist control. Predominantly distressed public school employees (n = 243, 80.9% with clinically elevated depression and/or anxiety) reported positive and negative affect during meditation practice. Data were analyzed using two-level multivariate latent growth curve models (observations nested within participants) that simultaneously attended to both positive and negative affect. We examined whether positive and negative affect during meditation changed over time and whether these changes were associated with changes in psychological distress (parent trial's preregistered primary outcome) at posttest or 3-month follow-up.

Results: On average, participants reported decreased negative affect but no change in positive affect during meditation over time. Increased positive affect and decreased negative affect during meditation were associated with improvements in distress at posttest and follow-up. Change in positive affect was a stronger predictor of distress at follow-up than change in negative affect.

Conclusions: Despite notions embedded within mainstream mindfulness meditation training that deemphasize the importance of the affective experience of practice (i.e., nonjudgmental awareness of present moment experience, regardless of valence), results indicate that these experiences contain signals associated with outcomes. Monitoring affect during meditation may be worthwhile to guide intervention delivery (i.e., measurement-based care, precision medicine). (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的冥想应用程序是使用最广泛的心理健康应用程序。但它们产生效果的确切机制仍不清楚。特别是,冥想过程中体验到的情感与结果的关联程度尚未确定:我们使用了最近完成的一项随机对照试验中的冥想应用程序部分,该试验将自我指导冥想应用程序(Healthy Minds Program)与候补对照进行了比较。在冥想练习过程中,主要患有抑郁症和/或焦虑症的公立学校员工(n = 243,80.9% 患有抑郁症和/或焦虑症)报告了积极和消极情绪。我们使用同时关注积极和消极情绪的两级多变量潜增长曲线模型(观察结果嵌套在参与者中)对数据进行了分析。我们研究了冥想过程中的积极和消极情绪是否会随着时间的推移而发生变化,以及这些变化是否与测试后或 3 个月随访时的心理困扰(家长试验预先登记的主要结果)变化有关:平均而言,参与者在冥想过程中的消极情绪有所减少,但积极情绪没有变化。冥想过程中积极情绪的增加和消极情绪的减少与测试后和随访时痛苦程度的改善有关。积极情绪的变化比消极情绪的变化更能预测随访时的困扰:结论:尽管主流正念冥想训练的理念不强调练习中情感体验的重要性(即对当下体验的非评判意识,无论其价值如何),但结果表明这些体验包含与结果相关的信号。对冥想过程中的情感进行监测可能值得用来指导干预措施的实施(即基于测量的护理、精准医疗)。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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引用次数: 0
Dynamic processes in behavioral activation therapy for anhedonic adolescents: Modeling common and patient-specific relations. 青少年享乐缺乏症行为激活疗法的动态过程:共同关系和患者特定关系的建模。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-08-01 Epub Date: 2023-06-05 DOI: 10.1037/ccp0000830
Christian A Webb, Laura Murray, Anna O Tierney, Kathleen M Gates

Objective: Behavioral activation (BA) is a brief intervention for depression encouraging gradual and systematic re-engagement with rewarding activities and behaviors. Given this treatment focus, BA may be particularly beneficial for adolescents with prominent anhedonia, a predictor of poor treatment response and common residual symptom. We applied group iterative multiple model estimation (GIMME) to ecological momentary assessment (EMA) treatment data to investigate common and person-specific processes during BA for anhedonic adolescents.

Method: Thirty-nine adolescents (Mage = 15.7 years old, 67% female, 81% White) with elevated anhedonia (Snaith-Hamilton Pleasure Scale) were enrolled in a 12-week BA trial, with weekly anhedonia assessments. EMA surveys were triggered every other week (2-3 surveys per day) throughout treatment assessing current positive affect (PA) and negative affect (NA), engagement in pleasurable activities and social interactions, anticipatory pleasure, rumination, and recent pleasurable and stressful experiences.

Results: A multilevel model revealed significant decreases in anhedonia, t(25.5) = -4.76, p < .001, over the 12-week trial. GIMME results indicated substantial heterogeneity in variable networks across patients. PA was the variable with the greatest number (22% of all paths vs. 11% for NA) of predictive paths to other symptoms (i.e., highest out-degree). Higher PA (but not NA) out-degree was associated with greater anhedonia improvement, t(25.8) = -2.22, p = .035.

Conclusions: Results revealed substantial heterogeneity in variable relations across patients, which may obscure the search for common processes of change in BA. PA may be a particularly important treatment target for anhedonic adolescents in BA. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:行为激活(Behavioral activation, BA)是一种针对抑郁症的短期干预方法,鼓励患者逐渐、系统地重新参与有益的活动和行为。鉴于这种治疗重点,BA可能对有明显快感缺乏症的青少年特别有益,这是治疗反应差和常见残留症状的预测因子。我们将群体迭代多模型估计(GIMME)应用于生态瞬间评估(EMA)治疗数据,以研究青少年快感缺乏症BA期间的共同和个人特异性过程。方法:39名青少年(年龄15.7岁,67%女性,81%白人)快感缺缺性升高(Snaith-Hamilton快乐量表),参加为期12周的BA试验,每周进行快感缺缺性评估。在整个治疗过程中,每隔一周触发一次EMA调查(每天2-3次调查),评估当前的积极影响(PA)和消极影响(NA),参与愉快活动和社会互动,预期愉悦,反刍以及最近的愉快和压力体验。结果:在12周的试验中,多水平模型显示快感缺乏症显著降低,t(25.5) = -4.76, p < 0.001。GIMME结果表明,患者之间的可变网络存在很大的异质性。PA是其他症状预测路径(即最高输出度)最多的变量(占所有路径的22%,NA为11%)。较高的PA(而非NA)输出度与快感缺乏症改善程度相关,t(25.8) = -2.22, p = 0.035。结论:结果显示患者之间的变量关系存在很大的异质性,这可能会模糊对BA共同变化过程的研究。PA可能是BA中快感缺乏症青少年的一个特别重要的治疗靶点。(PsycInfo数据库记录(c) 2023 APA,版权所有)。
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引用次数: 0
The role of affect dynamics as mechanisms of change in mental health interventions: Integrating applied and basic science. 情感动力学在心理健康干预中作为改变机制的作用:应用科学与基础科学的结合。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-08-01 DOI: 10.1037/ccp0000905
Eran Bar-Kalifa, Laura F Bringmann, Sigal Zilcha-Mano

In recent years, there has been growing empirical interest in examining the role of affect dynamics in mental health. However, research on affect has largely progressed independently in the basic and applied sciences, yielding significant advances in each domain but little cross-disciplinary integration. This special issue addresses this gap by showcasing some of the most promising recent developments in the field. The articles featured in this special issue offer insights into key innovations in affect dynamics and their potential implications for mental health interventions. Comprising a total of 17 articles, the issue is divided into two sections: Daily Life Assessment of Affect, encompassing seven articles, and In-Treatment Assessment of Affect, comprising 10 articles. In this editorial, we synthesize the contributions of these articles and propose a set of fundamental principles for conducting and interpreting research on the role of affect dynamics as mechanisms of change in mental health interventions. These principles encompass (a) the content of affect research related to mental health and its treatment (the What), (b) the timing of the assessment (the When), (c) the target populations under investigation (the Who), and (d) the methodologies employed (the How). The synthesis presented here, along with the articles featured in this special issue, holds significant potential to inform clinical research and practice on the role of affect dynamics in mental health interventions and stimulate future scientific inquiry in this important area. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

近年来,人们对研究情感动态在心理健康中的作用越来越感兴趣。然而,有关情感的研究在基础科学和应用科学领域基本上是各自为政,每个领域都取得了重大进展,但跨学科整合却很少。本特刊通过展示该领域一些最有前途的最新进展,弥补了这一空白。本特刊收录的文章深入探讨了情感动力学的关键创新及其对心理健康干预的潜在影响。本期特刊共收录 17 篇文章,分为两个部分:情感的日常生活评估》包括 7 篇文章,《情感的治疗评估》包括 10 篇文章。在这篇社论中,我们对这些文章的贡献进行了综合,并提出了一套基本原则,用于开展和解释有关情感动态作为心理健康干预中的变化机制所起作用的研究。这些原则包括:(a) 与心理健康及其治疗相关的情感研究的内容("什么");(b) 评估的时间("何时");(c) 调查的目标人群("谁");(d) 采用的方法("如何")。这里介绍的综述以及本特刊中介绍的文章都具有很大的潜力,可为临床研究和实践提供有关情感动态在心理健康干预中的作用的信息,并激发这一重要领域未来的科学探索。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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引用次数: 0
Evidence for a vicious socioemotional cycle of negative emotions and interpersonal conflict. 负面情绪和人际冲突的社会情感恶性循环的证据。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-08-01 DOI: 10.1037/ccp0000891
Colin E Vize, Whitney R Ringwald, Lori N Scott, Thomas W Kamarck, Paul A Pilkonis, Aidan G C Wright

Objective: Interpersonal and emotional functioning are closely linked and reciprocally influence one another. Contemporary integrative interpersonal theory (CIIT) offers a useful framework to conceptualize these patterns and guide interventions in cases where these patterns result in dysfunction. Stress processes offer several dynamic frameworks to guide empirical investigations using methods that allow for fine-grained analyses in the context of daily life.

Method: Four samples of adults (Sample 1, N = 145; Sample 2, N = 160; Sample 3, N = 297; Sample 4 = 89 dyads, 178 individuals) completed ecological momentary assessment protocols focused on a variety of interpersonal and emotional experiences. Samples were enriched for aggressive and self-harming behavior (Sample 1), trait hostility (Sample 2), interpersonal problems (Sample 3), and personality disorder features (Sample 4).

Results: Using multilevel dynamic structural equation modeling, we investigated how emotions and interpersonal functioning operate over brief timescales in daily life. We found evidence for a vicious socioemotional cycle across all four samples, whereby negative emotions related to interpersonal conflict (i.e., perceptions of and enacting cold, antagonistic, or quarrelsome behavior; components that contribute to the interpersonal situation from the perspective of CIIT) which in turn related to increased negative emotions. Although individuals differed in the strength of this process, it was unrelated to trait negative affectivity.

Conclusions: Viewing these results through the lens of CIIT, we discuss multiple intervention points highlighted by these dynamic results whereby the vicious cycle might be changed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的人际关系和情绪功能密切相关,并相互影响。当代综合人际关系理论(CIIT)为这些模式的概念化提供了一个有用的框架,并在这些模式导致功能障碍的情况下为干预措施提供指导。压力过程提供了几个动态框架,可用于指导实证调查,使用的方法允许在日常生活背景下进行精细分析:四个成人样本(样本 1,N = 145;样本 2,N = 160;样本 3,N = 297;样本 4 = 89 个二人组,178 个个体)完成了生态瞬间评估协议,重点关注各种人际关系和情绪体验。对样本进行了攻击性和自残行为(样本 1)、特质敌意(样本 2)、人际关系问题(样本 3)和人格障碍特征(样本 4)的富集:通过多层次动态结构方程模型,我们研究了日常生活中情绪和人际功能如何在短暂的时间尺度内发挥作用。我们在所有四个样本中都发现了社会情绪恶性循环的证据,即消极情绪与人际冲突(即冷漠、对立或争吵行为的感知和实施;从 CIIT 的角度来看,这些都是造成人际状况的因素)有关,而人际冲突反过来又与消极情绪的增加有关。虽然个体在这一过程的强度上存在差异,但它与特质消极情绪无关:通过 CIIT 的视角来看待这些结果,我们讨论了这些动态结果所强调的多个干预点,通过这些干预点可以改变恶性循环。(PsycInfo Database Record (c) 2024 APA, 版权所有)。
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引用次数: 0
Outcome prediction in psychological therapy with continuous time dynamic modeling of affective states and emotion regulation. 利用情感状态和情绪调节的连续时间动态模型预测心理治疗的结果。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-08-01 DOI: 10.1037/ccp0000862
Miriam I Hehlmann, Danilo Moggia, Brian Schwartz, Charles Driver, Steffen Eberhardt, Wolfgang Lutz

Objective: To date, many prediction studies in psychotherapy research have used cross-sectional data to predict treatment outcome. The present study used intensive longitudinal assessments and continuous time dynamic modeling (CTDM) to investigate the temporal dynamics of affective states and emotion regulation in the early phase of therapy and their ability to predict treatment outcome.

Method: Ninety-one patients undergoing psychological treatment at a university outpatient clinic took part in a 2-week ecological momentary assessment (EMA) period. Participants answered self-report measures on positive affect (PA), negative affect, and emotion regulation (ER) four times a day. Hierarchical Bayesian CTDM was conducted to identify temporal effects within (autoregressive) and between (cross-regressive) PA, negative affect, and ER. The resulting CTDM parameters, simple EMA parameters (e.g., mean), and cross-sectional predictors were entered into a LASSO model to be examined as predictors of treatment outcome at Session 15.

Results: Two significant predictors were identified: initial impairment and the continuous time cross-effect of PA on ER. The final model explained 40% of variance in treatment outcome, with the cross-effect (PA-ER) accounting for 4% of variance beyond initial impairment.

Conclusions: The results demonstrate that temporal patterns of affective EMA data are valuable for the mapping of individual differences and the prediction of treatment outcome. This information can be used to provide therapists with feedback to personalize treatments. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

研究目的迄今为止,心理治疗研究中的许多预测研究都使用横断面数据来预测治疗结果。本研究采用强化纵向评估和连续时间动态模型(CTDM)来研究治疗早期的情感状态和情绪调节的时间动态及其预测治疗结果的能力:在一所大学门诊部接受心理治疗的 91 名患者参加了为期两周的生态瞬间评估(EMA)。参与者每天四次回答有关积极情绪(PA)、消极情绪和情绪调节(ER)的自我报告测量。我们采用层次贝叶斯 CTDM 方法来识别 PA、负面情绪和 ER 内部(自回归)和之间(交叉回归)的时间效应。由此得出的 CTDM 参数、简单 EMA 参数(如平均值)和横截面预测因子被输入 LASSO 模型,作为疗程 15 治疗结果的预测因子进行检验:结果:发现了两个重要的预测因素:初始损伤和 PA 对 ER 的连续时间交叉效应。最终模型解释了治疗结果中 40% 的变异,交叉效应(PA-ER)占初始损伤之外 4% 的变异:研究结果表明,情感 EMA 数据的时间模式对于绘制个体差异图和预测治疗结果很有价值。这些信息可用于为治疗师提供反馈,以实现个性化治疗。(PsycInfo Database Record (c) 2024 APA, 版权所有)。
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引用次数: 0
Reducing intrusive suicidal mental images in patients with depressive symptoms through a dual-task add-on module: Results of a multicenter randomized clinical trial. 通过双任务附加模块减少抑郁症状患者的侵入性自杀心理图像:多中心随机临床试验结果。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-07-18 DOI: 10.1037/ccp0000874
Jaël S van Bentum, Marit Sijbrandij, Ad J F M Kerkhof, Emily A Holmes, Arnoud Arntz, Nathan Bachrach, Chloë S C Bollen, Daan Creemers, Maarten K van Dijk, Pieter Dingemanse, Monique van Haaren, Marieke Hesseling, Annemiek Huisman, Fleur L Kraanen, Yvonne Stikkelbroek, Jos Twisk, Henricus L Van, Janna Vrijsen, Remco F P de Winter, Marcus J H Huibers

Objective: To examine the safety and efficacy of a brief cognitive dual-task (using eye movements) add-on module to treatment as usual (TAU) in reducing the severity and frequency of intrusive suicidal mental images and suicidal ideation.

Method: We conducted a single-blind, parallel multicenter randomized trial (No. NTR7563) among adult psychiatric outpatients (N = 91; Mage = 34.4, SD = 13.54; 68% female) with elevated depressive symptoms and experiencing distressing suicidal intrusions in the Netherlands. Primary outcome was the severity (Suicidal Intrusions Attributes Scale) and frequency (Clinical Interview for Suicidal Intrusions) of suicidal mental imagery intrusions at 1-week posttreatment and 3-month follow-up. Primary analysis was intention-to-treat.

Results: Between November 27, 2018 and September 13, 2021, 91 patients were included and randomly assigned to intervention group (Cognitive Dual Task Add-on + TAU) (n = 46) or TAU-only (n = 45). Cognitive Dual Task Add-on + TAU had greater reductions in severity (mean difference, -15.50, 95% CI [23.81, -7.19]; p < .001, d = 0.60), and frequency (geometric mean difference, 0.47, 95% CI [0.29, 0.79]; p = .004) of suicidal intrusions over time than TAU-alone. Cognitive Dual Task Add-on + TAU patients also showed lower suicidal ideation over time (p = .008, d = 0.42). There were no significant group differences in reductions in depressive symptoms, rumination, or hopelessness. Four serious adverse events occurred (three Cognitive Dual Task Add-on + TAU; one TAU-only); all unlikely attributable to intervention/trial.

Conclusions: Findings provide support for the effectiveness of adding a cognitive dual-task module to the treatment of psychiatric outpatients with elevated depressive symptoms in reducing suicidal intrusions and ideation and can be executed safely. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的研究在常规治疗(TAU)的基础上添加简短的认知双任务(使用眼动)模块,以降低侵入性自杀心理图像和自杀意念的严重程度和频率的安全性和有效性:方法:我们在荷兰对抑郁症状加重并有自杀倾向的成年精神病门诊患者(N = 91;年龄 = 34.4,SD = 13.54;68% 为女性)进行了一项单盲平行多中心随机试验(编号:NTR7563)。主要结果是治疗后一周和随访三个月时自杀意象的严重程度(自杀意象属性量表)和频率(自杀意象临床访谈)。主要分析为意向治疗。结果:2018年11月27日至2021年9月13日期间,91名患者被纳入并随机分配到干预组(认知双重任务插件+TAU)(n = 46)或纯TAU(n = 45)。随着时间的推移,认知双重任务附加装置+TAU比单纯TAU更能降低自杀倾向的严重程度(平均差异为-15.50,95% CI [23.81,-7.19];p < .001,d = 0.60)和频率(几何平均差异为0.47,95% CI [0.29,0.79];p = .004)。随着时间的推移,认知双重任务附加疗法+TAU患者的自杀意念也有所降低(p = .008,d = 0.42)。在抑郁症状、反刍或绝望情绪的减少方面,没有明显的组间差异。发生了四例严重不良事件(三例认知双重任务附加+TAU;一例仅TAU);所有不良事件都不太可能与干预/试验有关:研究结果支持在治疗抑郁症状加重的精神科门诊患者时增加认知双任务模块,以减少自杀念头和意念的有效性,并且可以安全实施。(PsycInfo Database Record (c) 2024 APA, 版权所有)。
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引用次数: 0
Supplemental Material for Reducing Intrusive Suicidal Mental Images in Patients With Depressive Symptoms Through a Dual-Task Add-on Module: Results of a Multicenter Randomized Clinical Trial 通过双任务附加模块减少抑郁症患者侵入性自杀意象的补充材料:多中心随机临床试验结果
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-07-15 DOI: 10.1037/ccp0000874.supp
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引用次数: 0
Do improvements in motivational language predict alcohol use in motivational interviewing? Ambivalence matters. 动机性访谈中动机性语言的改进是否能预测饮酒情况?矛盾心理很重要。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-07-01 DOI: 10.1037/ccp0000889
David P Forman, Jon M Houck, Theresa B Moyers

Objective: Motivational Interviewing (MI) is described as a method for improving clinical outcomes by reducing client ambivalence. If this is true, MI's focus on improving clients' motivational language should be most useful for clients with ambivalence about change and less valuable for those who are ready to implement new behaviors or are opposed to change. To address this hypothesis and potentially add precision to MI delivery in clinical settings, we tested whether the relationship between clients' in-session motivational language and posttreatment alcohol use depended on their baseline motivation to change.

Method: Client speech from 149 sessions from Project MATCH were analyzed. A cluster analysis of the percent change talk during the first decile of the session identified three motivational groups: opposed, ambivalent, and ready. The change in percent change talk (C-PCT) across the session was calculated for each group. Zero-inflated negative binomial analysis was used to test whether the effect of C-PCT on end-of-treatment drinking varied between motivational groups.

Results: The count part of the model revealed a significant interaction between C-PCT and membership in the ambivalent group (b = -17.710, 95% CI [-25.775, -9.645], p < .001), only for those who received MI. Favorable C-PCT was associated with less drinking (b = -15.735, p = .004). Only baseline drinking was a significant predictor of abstinence at follow-up (b = .032, 95% CI [0.012, 0.051], p = .001).

Conclusion: A putative MI mechanism-improved client motivational language-appears most important for clients who express ambivalence in the opening minutes of the session, with minimal value for those who do not. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:动机访谈法(MI)被描述为一种通过减少客户的矛盾心理来改善临床效果的方法。如果这是真的话,那么动机访谈法对改善客户动机语言的关注应该对那些对改变有矛盾心理的客户最有用,而对那些已经准备好实施新行为或反对改变的客户则价值不大。为了解决这一假设,并在临床环境中提高多元智能实施的精确性,我们测试了客户在治疗过程中的动机语言与治疗后酒精使用之间的关系是否取决于他们的基线改变动机:方法:分析了 "MATCH 项目 "149 个疗程中患者的谈话。对疗程前十分之一的改变谈话百分比进行聚类分析,确定了三个动机组:反对、矛盾和准备。计算了每个组在整个会话期间的变化谈话百分比(C-PCT)。使用零膨胀负二项分析来检验 C-PCT 对治疗末期饮酒量的影响在不同动机组之间是否存在差异:该模型的计数部分显示,C-PCT与矛盾组的成员资格之间存在显著的交互作用(b = -17.710,95% CI [-25.775, -9.645],p < .001),但仅适用于接受MI治疗的患者。良好的 C-PCT 与较少饮酒有关(b = -15.735,p = .004)。只有基线饮酒才是随访时戒酒的重要预测因素(b = .032,95% CI [0.012,0.051],p = .001):结论:一种假定的多元智能机制--改善客户的动机语言--对于那些在疗程开始几分钟就表达矛盾心理的客户来说似乎最为重要,而对于那些没有表达矛盾心理的客户来说,其价值则微乎其微。(PsycInfo Database Record (c) 2024 APA, 版权所有)。
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Journal of consulting and clinical psychology
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