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A home-based telehealth randomized controlled trial of skills training in affective and interpersonal regulation versus present-centered therapy for women veterans who have experienced military sexual trauma. 一项以家庭为基础的远程医疗随机对照试验,针对经历过军队性创伤的女性退伍军人进行情感和人际关系调节方面的技能培训与以现在为中心的治疗。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-05-01 Epub Date: 2024-01-15 DOI: 10.1037/ccp0000872
Marylene Cloitre, Danielle Morabito, Kathryn Macia, Sarah Speicher, Jessilyn Froelich, Katelyn Webster, Annabel Prins, Diana Villasenor, Asha Bauer, Christie Jackson, Laura Fabricant, Shannon Wiltsey-Stirman, Leslie Morland

Objective: This randomized trial tested the effectiveness of Skills Training in Affective and Interpersonal Regulation (STAIR) compared to present-centered therapy (PCT) delivered virtually to women veterans who had experienced military sexual trauma (MST) and screened positive for posttraumatic stress disorder (PTSD).

Method: One hundred sixty-one eligible women veterans were randomized into the study. The primary outcome was clinician-assessed PTSD severity (Clinician-Administered PTSD Scale-5), while secondary outcomes included social support and several other symptom measures at posttreatment through 2- and 4-month follow-up.

Results: PTSD severity decreased in both conditions by posttreatment but significantly more (p = .028, d = 0.39) in STAIR (d = 1.12 [0.87, 1.37]) than PCT (d = .78 [0.54, 1.02]). STAIR was also superior in improving social support and emotion regulation and reducing depression and negative cognitions. Improvement in psychosocial functioning was moderate and did not differ between conditions. All changes were maintained through 2- and 4-month follow-ups. Dropout rates were low and did not differ (19.0% and 12.2%, respectively).

Conclusion: STAIR provided superior outcomes compared to PCT regarding PTSD, social support, and multiple types of mental health problems among women veterans with MST. The application of STAIR to other populations with social support and related concerns warrants investigation. The substantial effect sizes for PTSD symptoms in both treatments suggest that they are practical alternatives for individuals who do not wish to participate in trauma-focused therapy and may increase engagement in mental health services. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

试验目的这项随机试验测试了情感和人际关系调节技能培训(STAIR)与当前中心疗法(PCT)的有效性比较,后者是以虚拟方式提供给经历过军队性创伤(MST)并筛查出创伤后应激障碍(PTSD)的女性退伍军人:方法:161 名符合条件的女性退伍军人被随机纳入研究。主要结果是临床医生评估的创伤后应激障碍严重程度(临床医生管理的创伤后应激障碍量表-5),次要结果包括治疗后 2 个月和 4 个月随访期间的社会支持和其他一些症状测量:治疗后,两种情况下的创伤后应激障碍严重程度都有所下降,但 STAIR(d = 1.12 [0.87, 1.37])的下降幅度(p = .028,d = 0.39)明显高于 PCT(d = .78 [0.54, 1.02])。STAIR 在改善社会支持和情绪调节、减少抑郁和消极认知方面也更胜一筹。社会心理功能的改善程度适中,在不同条件下没有差异。所有的变化都在 2 个月和 4 个月的随访中得以保持。辍学率较低且无差异(分别为 19.0% 和 12.2%):结论:与 PCT 相比,STAIR 在创伤后应激障碍、社会支持以及患有创伤后应激障碍的女性退伍军人的多种心理健康问题方面提供了更好的结果。将 STAIR 应用于其他有社会支持和相关问题的人群值得研究。这两种治疗方法对创伤后应激障碍症状的显著效果表明,对于那些不愿意参加以创伤为中心的治疗的人来说,这两种治疗方法是切实可行的替代疗法,而且可以提高心理健康服务的参与度。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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引用次数: 0
Psychotherapies for the treatment of borderline personality disorder: A systematic review. 边缘型人格障碍的心理治疗:一项系统综述。
IF 4.5 1区 心理学 Q1 Psychology Pub Date : 2024-05-01 Epub Date: 2023-10-30 DOI: 10.1037/ccp0000833
Karen Crotty, Meera Viswanathan, Sara Kennedy, Mark J Edlund, Rania Ali, Mariam Siddiqui, Roberta Wines, Piotr Ratajczak, Gerald Gartlehner

Objective: Borderline personality disorder (BPD) is the most common personality disorder, affecting 1.8% of the general population, 10% of psychiatric outpatients, and 15%-25% of psychiatric inpatients. Practice guidelines recommend psychotherapies as first-line treatments. However, psychotherapies commonly used for the treatment of BPD are numerous, and little is known about the comparative effectiveness of each individual psychotherapy versus treatment as usual (TAU) or other psychotherapies. To systematically assess the comparative effectiveness of commonly used psychotherapies versus TAU or versus other psychotherapies for BPD treatment.

Method: We conducted systematic literature searches in MEDLINE, EMBASE, the Cochrane Library, and APA PsycINFO up to July 14, 2022, and searched reference lists of pertinent articles and reviews. Inclusion criteria were (a) patients 13 years or older with a diagnosis of BPD, (b) treatment with commonly used psychotherapies, (c) comparison with TAU or another psychotherapy, (d) assessment of relevant BPD-related health outcomes, and (e) randomized or nonrandomized trials or controlled observational studies. Two investigators independently screened abstracts and full-text articles and graded the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Results: We found 25 psychotherapy studies meeting inclusion criteria with data on 2,545 participants. Seventeen studies compared nine psychotherapies with TAU and nine studies compared eight psychotherapies with another psychotherapy for the treatment of BPD. Overall, both TAU and included psychotherapies were effective in treating the severity and symptoms of BPD. Moderate certainty of evidence suggests that systems training for emotional predictability and problem solving is more effective than TAU for the treatment of BPD; low certainty of evidence suggests that dialectical behavior therapy, schema therapy, transference-focused psychotherapy, acceptance and commitment therapy, manual-assisted cognitive therapy, and cognitive behavioral therapy are more effective than TAU for treating BPD. We were unable to draw conclusions from head-to-head comparisons of psychotherapies, which were limited to single studies with very low to low certainty of evidence.

Conclusions: All commonly used psychotherapies improve BPD severity, symptoms, and functioning. Our assessment found no strong evidence suggesting that any one psychotherapy is more beneficial than another. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:边缘型人格障碍(BPD)是最常见的人格障碍,影响1.8%的普通人群、10%的精神科门诊患者和15%-25%的精神科住院患者。实践指南建议将心理治疗师作为一线治疗方法。然而,通常用于治疗BPD的心理治疗师有很多,而且对每种个体心理治疗与常规治疗(TAU)或其他心理治疗师的比较有效性知之甚少。系统评估常用心理治疗师与TAU或其他心理治疗师治疗BPD的比较有效性。方法:截至2022年7月14日,我们在MEDLINE、EMBASE、Cochrane图书馆和APA PsycINFO进行了系统的文献检索,并检索了相关文章和综述的参考文献列表。纳入标准为(a)13岁或以上诊断为BPD的患者,(b)常用心理治疗师的治疗,(c)与TAU或其他心理治疗的比较,(d)评估相关BPD相关的健康结果,以及(e)随机或非随机试验或对照观察性研究。两名研究人员独立筛选了摘要和全文文章,并使用建议分级评估、发展和评估方法对证据的确定性进行了分级。结果:我们发现25项心理治疗研究符合纳入标准,数据涉及2545名参与者。17项研究将9种心理治疗师与TAU进行了比较,9项研究将8种心理疗法与另一种治疗BPD的心理疗法进行了比较。总体而言,TAU和纳入的心理治疗师在治疗BPD的严重程度和症状方面都是有效的。适度的证据确定性表明,在治疗BPD方面,情绪可预测性和问题解决的系统训练比TAU更有效;证据的低确定性表明,辩证行为疗法、图式疗法、移情心理治疗、接受和承诺疗法、手动辅助认知疗法和认知行为疗法在治疗BPD方面比TAU更有效。我们无法从心理治疗师的正面比较中得出结论,这些比较仅限于证据确定性非常低的单一研究。结论:所有常用的心理治疗师都能改善BPD的严重程度、症状和功能。我们的评估没有发现强有力的证据表明任何一种心理治疗都比另一种更有益。(PsycInfo数据库记录(c)2023 APA,保留所有权利)。
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引用次数: 0
What works better? 1-year outcomes of an effectiveness trial comparing online, telehealth, and group-based formats of a military parenting program. 哪种方法更有效?比较在线、远程医疗和基于小组形式的军事育儿计划的有效性试验的 1 年结果。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-05-01 Epub Date: 2024-03-28 DOI: 10.1037/ccp0000882
Abigail H Gewirtz, David S DeGarmo, Susanne Lee

Objective: The present study, conducted with a population of military families, examined the comparative effectiveness of three program formats of Adaptive Parenting Tools (ADAPT), a parenting program for families of school-aged children in which a National Guard or Reserve (NG/R) parent had returned from deployment to the post-9/11 conflicts. Despite well-documented need, parenting programs for NG/R families are scarce and often inaccessible. We predicted that both facilitator-delivered conditions (i.e., in-person group; individual telehealth) would result in stronger improvements in observed parenting than assignment to the online self-directed condition. We further proposed a noninferiority hypothesis wherein no significant difference would be detected between telehealth and group conditions.

Method: Families (N = 244; 87% Caucasian) were recruited from NG/R units in two midwestern states. Families (with a 5-12-year-old child) were randomized to one of three conditions: in-person multifamily group, individual telehealth, or an online, self-directed condition. The intervention was delivered using the same content across conditions, over 14 weeks (group, telehealth conditions) or 12 modules (online condition); either or both parents could participate.

Results: Intent-to-treat analyses supported both hypotheses: families in both in-person group and telehealth conditions showed significant improvements to observed parenting at 1-year postbaseline compared with those assigned to the self-directed online condition.

Conclusions: This is the first study to demonstrate that in-person group and telehealth parenting programs are equally effective and that both are superior to a self-directed online program. Limitations include differences between the session lengths in each format, as well as greater attrition in the in-person format. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

研究目的本研究以军人家庭为对象,考察了 "适应性育儿工具"(ADAPT)三种计划形式的比较效果。"适应性育儿工具 "是一项针对国民警卫队或后备役(NG/R)军人家庭的育儿计划,其对象是在 9/11 后冲突中服役归来的学龄儿童。尽管需求已得到充分证实,但针对 NG/R 家庭的育儿计划却很少,而且往往难以获得。我们预测,两种由辅导员提供的条件(即面对面小组辅导;个人远程保健)都会比分配到在线自我指导条件下更能改善所观察到的养育情况。我们还提出了一个非劣效性假设,即在远程保健和小组条件之间不会发现显著差异:从美国中西部两个州的 NG/R 单位招募家庭(N = 244;87% 为白种人)。家庭(有一个 5-12 岁的孩子)被随机分配到三种条件之一:面对面多家庭小组、个人远程保健或在线自我指导条件。不同条件下的干预采用相同的内容,为期 14 周(小组、远程保健条件)或 12 个模块(在线条件);父母双方或其中一方均可参与:结果:意向治疗分析支持了两个假设:与那些被分配到自我导向在线条件下的家庭相比,在基线后 1 年,参加面对面小组和远程保健条件的家庭在观察到的养育方面都有显著改善:这是第一项证明面对面小组和远程保健育儿计划同样有效,并且都优于自主在线计划的研究。研究的局限性包括两种形式的疗程长短不同,以及面对面形式的损耗更大。(PsycInfo Database Record (c) 2024 APA, 版权所有)。
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引用次数: 0
Testing psychosocial interventions in context: Commentary on Beidas et al. (2023). 测试背景下的社会心理干预:对 Beidas 等人(2023 年)的评论。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-05-01 DOI: 10.1037/ccp0000877
Kenneth E Freedland, Lynda H Powell, Susan M Czajkowski, Leonard H Epstein

In their recent Viewpoint article, Beidas et al. (2023) argue that researchers should test psychosocial interventions in the contexts in which they are meant to be delivered and that they can accelerate the deployment of these interventions by advancing directly from pilot trials to effectiveness and implementation studies without conducting efficacy trials. In this commentary, we argue that this is a well-intended but problematic approach and that there is a more productive strategy for translational behavioral intervention research. The commentary discusses issues concerning intervention development, refinement, and optimization; pilot and efficacy testing of interventions; the contexts in which interventions are delivered; clinical practice guidelines; and quick versus programmatic answers to significant clinical research questions. Testing psychosocial interventions in the contexts in which they are meant to be delivered is a complex task for interventions that are designed to be used in a wide variety of contexts. Nevertheless, interventions can be tested in the contexts in which they are meant to be delivered without sacrificing programmatic intervention development or safety and efficacy testing. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Beidas等人(2023年)在最近发表的《观点》文章中认为,研究人员应该在社会心理干预措施的实施环境中对其进行测试,他们可以不进行疗效试验,直接从试点试验推进到有效性和实施研究,从而加快这些干预措施的部署。在这篇评论中,我们认为这种方法的初衷是好的,但却存在问题,还有一种更有成效的转化行为干预研究策略。本评论讨论了有关干预措施的开发、改进和优化;干预措施的试验和疗效测试;实施干预措施的环境;临床实践指南;以及对重大临床研究问题的快速回答与方案回答等问题。对于设计用于各种环境的干预措施来说,在干预措施的实施环境中测试社会心理干预措施是一项复杂的任务。尽管如此,在不影响干预项目开发或安全性和有效性测试的前提下,可以在干预措施的实施环境中对其进行测试。(PsycInfo Database Record (c) 2024 APA, 版权所有)。
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引用次数: 0
Advancing a mission of translational intervention science: Comment on premature implementation. 推进转化干预科学的使命:关于过早实施的评论。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-05-01 DOI: 10.1037/ccp0000885
Rinad S Beidas, Lisa Saldana, Rachel C Shelton

Replies to comments made by Kenneth E. Freedland et al. (see record 2024-89430-002) on Rinad S. Beida, Lisa Saldana, and Rachel C. Shelton's original article (see record 2023-46817-001). In reading Freedland et al.'s (2024) commentary, it appears that their lens prioritizes internal validity and more explanatory and mechanistic work. While we also value these scientific goals and concur that the approaches they identify are clearly methodologically rigorous, we do not think the approaches will substantially reduce the unacceptable translation gap or address the fundamental issues of context. Our approach recognizes that there is tremendous value in cocreating solutions and interventions with patients, clinicians, and community members in the settings where we are seeking to promote health and address health inequities, and questions traditional assumptions and paradigms that scientists "know best" have effective solutions or should hold all of the power and knowledge (Brownson et al., 2022; Sanchez et al., 2023; Shelton, Adsul, & Oh, 2021; Shelton, Adsul, Oh, et al., 2021). We believe it is critical that we expand the pathways through which we advance intervention science in a meaningful and impactful way, and with more explicit attention to issues of context, equity, engagement, and external validity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

答复肯尼斯-E-弗里德兰等人(见记录 2024-89430-002)对 Rinad S. Beida、Lisa Saldana 和 Rachel C. Shelton 的原始文章(见记录 2023-46817-001)的评论。在阅读弗里德兰等人(2024)的评论时,他们的视角似乎优先考虑内部有效性以及更具解释性和机制性的工作。虽然我们也重视这些科学目标,并同意他们所确定的方法显然在方法论上是严谨的,但我们并不认为这些方法能大幅缩小不可接受的转化差距或解决背景的根本问题。我们的方法认识到,在我们寻求促进健康和解决健康不平等问题的环境中,与患者、临床医生和社区成员共同创造解决方案和干预措施具有巨大价值,并质疑科学家 "最了解 "有效解决方案或应掌握所有权力和知识的传统假设和范式(Brownson 等人,2022 年;Sanchez 等人,2023 年;Shelton、Adsul 和 Oh,2021 年;Shelton、Adsul、Oh 等人,2021 年)。我们认为,至关重要的是,我们要拓展途径,以有意义、有影响的方式推进干预科学的发展,并更明确地关注背景、公平、参与和外部有效性等问题。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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引用次数: 0
Dose-response relationship in cognitive behavioral therapy for depression: A nonlinear metaregression analysis. 抑郁症认知行为疗法的剂量-反应关系:非线性元回归分析
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-05-01 DOI: 10.1037/ccp0000879
Thomas Klein, Johanna Breilmann, Carolin Schneider, Francesca Girlanda, Ines Fiedler, Sarah Dawson, Alessio Crippa, Stefan Priebe, Corrado Barbui, Thomas Becker, Markus Kösters

Objective: Evidence on the optimal "dose" of cognitive behavioral therapy (CBT) for treating major depressive disorder is sparse. This analysis aimed to evaluate the dose-response curve in CBT using a nonlinear approach, whereby "dose" was defined as number of treatment sessions. The dose-response curve of CBT was compared to other psychotherapies and pharmacological treatments for depression.

Method: A systematic review and metaregression analysis of randomized controlled trials (RCTs) examining the efficacy of CBT in adults with acute depression was conducted. Treatment arms examining other psychosocial or pharmacological interventions were also analyzed. Cubic spline metaregression techniques were used to model nonlinear dose-response curves.

Results: Seventy-two studies and 7,377 participants were included. Modeling the dose-response curve between change of depression symptom severity and the number of CBT sessions resulted in a nonlinear curve characterized by a strong improvement in symptom severity from baseline within the first eight sessions. Symptom reduction continues in the further course of the treatment, but at a slower pace. A similar pattern of symptom development was found for other therapies as well, although the prominence of early improvement and overall effect sizes vary across treatment arms.

Conclusion: Results imply a general tendency for the strongest alleviation of depressive symptom severity in early stages of CBT treatment, thus, if aiming at symptom alleviation, speak for short CBT interventions. However, these findings have to be discussed in the light of the limited data regarding the sustainability of treatment effects in short-term therapies and effects beyond symptomatic changes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:关于认知行为疗法(CBT)治疗重度抑郁障碍的最佳 "剂量 "的证据并不多。本分析旨在使用非线性方法评估 CBT 的剂量-反应曲线,其中 "剂量 "被定义为治疗次数。将 CBT 的剂量-反应曲线与其他抑郁症心理疗法和药物疗法进行比较:方法:我们对随机对照试验(RCT)进行了系统回顾和元回归分析,研究了 CBT 对成人急性抑郁症患者的疗效。此外,还分析了研究其他社会心理或药物干预措施的治疗臂。立方样条元回归技术用于模拟非线性剂量-反应曲线:结果:共纳入 72 项研究和 7377 名参与者。建立抑郁症状严重程度变化与 CBT 治疗次数之间的剂量-反应曲线模型后,得出了一条非线性曲线,其特点是在最初的 8 次治疗中,症状严重程度与基线相比有很大改善。在接下来的治疗过程中,症状会继续减轻,但速度会放慢。其他疗法也发现了类似的症状发展模式,但不同疗法的早期改善程度和总体效果大小各不相同:结论:研究结果表明,CBT 治疗早期对抑郁症状严重程度的缓解作用最强,因此,如果以缓解症状为目标,应采用短期 CBT 干预疗法。不过,在讨论这些研究结果时,必须考虑到有关短期疗法疗效的可持续性以及症状变化以外的效果的数据有限。(PsycInfo Database Record (c) 2024 APA, 版权所有)。
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引用次数: 0
Cognitive and interpersonal moderators of two evidence-based depression prevention programs. 两个以证据为基础的抑郁症预防计划的认知和人际调节因素。
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-04-18 DOI: 10.1037/ccp0000886
Jason D Jones, Karen T G Schwartz, Molly Davis, Robert Gallop, B. Hankin, Jami F. Young
OBJECTIVETo test potential cognitive and interpersonal moderators of two evidence-based youth depression prevention programs.METHODTwo hundred four adolescents (Mage = 14.62 years, SD = 1.65; 56% female; 71% White, 11% Black, 11% multiracial, 5% Asian, 2% other races, 18% Hispanic/Latinx) were randomized to either a cognitive-behavioral (Coping With Stress [CWS]) or interpersonal (Interpersonal Psychotherapy-Adolescent Skills Training [IPT-AST]) prevention program. Potential moderators, selected based on theory and research, included rumination, negative cognitive style, dysfunctional attitudes, hopelessness, parent-adolescent conflict, negative interactions with parents and friends, and social support from parents and friends. Depression symptoms were assessed repeatedly through 18 months postintervention.RESULTSAfter adjusting for multiple comparisons, rumination (B = -2.02, SE = .61, p = .001, d = .47), hopelessness (B = -2.03, SE = .72, p = .005, d = .41), and conflict with father (B = 1.68, SE = .74, p = .02, d = .32) moderated intervention effects on change in depression symptoms from postintervention through 18-month follow-up. For example, at high levels of conflict with father, youth in IPT-AST reported a significant decrease in symptoms during follow-up, whereas youth in CWS reported a nonsignificant change in symptoms. At low levels of conflict with father, youth in IPT-AST reported a significant increase in symptoms during follow-up, whereas youth in CWS reported a nonsignificant change in symptoms.CONCLUSIONSThese exploratory secondary analyses of Personalized Depression Prevention study data highlight specific cognitive and interpersonal risk factors that could be considered when determining which prevention program may be most effective for a given adolescent. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
目的测试两种基于证据的青少年抑郁症预防计划的潜在认知和人际调节因素。方法将 244 名青少年(平均年龄 = 14.62 岁,标准差 = 1.65;56% 为女性;71% 为白人,11% 为黑人,11% 为多种族,5% 为亚洲人,2% 为其他种族,18% 为西班牙裔/拉丁裔)随机分配到认知行为(应对压力 [CWS])或人际(人际心理疗法-青少年技能培训 [IPT-AST])预防计划中。根据理论和研究选取的潜在调节因素包括反刍、消极认知风格、功能失调态度、绝望、父母与青少年冲突、与父母和朋友的消极互动以及父母和朋友的社会支持。结果经多重比较调整后,反刍(B = -2.02,SE = .61,p = .001,d = .47)、绝望(B = -2.03,SE = .72,p = .005,d = .41)和与父亲的冲突(B = 1.68,SE = .74,p = .02,d = .32)调节了干预对干预后至 18 个月随访期间抑郁症状变化的影响。例如,在与父亲冲突程度较高的情况下,接受 IPT-AST 的青少年在随访期间的症状明显减少,而接受 CWS 的青少年的症状变化则不明显。结论这些对个性化抑郁预防研究数据的探索性二次分析强调了在确定哪种预防计划对特定青少年最有效时可以考虑的特定认知和人际风险因素。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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引用次数: 0
Family engagement in a behavioral parenting intervention: A randomized comparison of telehealth versus office-based treatment formats. 家庭参与行为养育干预:远程医疗与办公室治疗形式的随机比较。
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-04-15 DOI: 10.1037/ccp0000887
Amanda L. Sanchez, Natalie Javadi, Jonathan S Comer
OBJECTIVEDespite effective treatment options, many families-especially those from marginalized backgrounds-lack access to quality care for their children's behavioral difficulties. Since the COVID-19 pandemic, telehealth has become a prominent format for the delivery of outpatient services, with potential to increase access to quality care. Although telehealth-delivered parenting interventions are associated with positive clinical outcomes, limited research has examined whether telehealth formats improve treatment engagement relative to office-based care. The present study is the first controlled comparison of engagement across office-based parent-child interaction therapy (PCIT) and internet-delivered PCIT (iPCIT).METHODChildren ages 3-5 years, and their caregiver(s) (N = 40) participated in a randomized trial comparing iPCIT to office-based PCIT in the treatment of behavioral problems. Analyses examined the effects of treatment format on engagement (i.e., missed sessions, premature treatment discontinuation, homework completion, therapeutic alliance, and treatment satisfaction). Logistic and linear regressions further explored whether treatment format moderated the effects of common predictors of treatment engagement (i.e., family economic means, racial/ethnic background, caregiver stress).RESULTSiPCIT improved attendance rates relative to office-based PCIT, especially for families from minoritized racial/ethnic backgrounds. At the same time, among families with relatively higher levels of caregiver stress, office-based PCIT was associated with lower dropout rates and improved treatment alliance and satisfaction, relative to iPCIT.CONCLUSIONSThis study provides the first experimental support that telehealth formats can improve treatment attendance in behavioral parenting interventions. Findings highlight nuances in treatment engagement across treatment formats that reveal limits to the extent telehealth transcends engagement concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
目的:尽管有有效的治疗方案,但许多家庭(尤其是那些来自边缘化背景的家庭)仍然无法获得高质量的医疗服务来治疗其子女的行为障碍。自 COVID-19 大流行以来,远程保健已成为提供门诊服务的一种重要形式,并有可能增加获得优质护理的机会。虽然远程医疗提供的育儿干预与积极的临床结果有关,但对远程医疗形式是否能提高治疗参与度的研究还很有限。本研究首次对基于诊室的亲子互动疗法(PCIT)和基于互联网的亲子互动疗法(iPCIT)的参与度进行了对照比较。方法 3-5 岁的儿童及其照顾者(N = 40)参加了一项随机试验,该试验比较了 iPCIT 和基于诊室的 PCIT 对行为问题的治疗效果。研究分析了治疗形式对参与度的影响(即错过疗程、过早中断治疗、作业完成情况、治疗联盟和治疗满意度)。逻辑回归和线性回归进一步探讨了治疗形式是否调节了参与治疗的常见预测因素(即家庭经济状况、种族/民族背景、照顾者压力)的影响。结果相对于办公室 PCIT,iPCIT 提高了出勤率,尤其是对于来自少数种族/民族背景的家庭。同时,在照顾者压力相对较高的家庭中,相对于 iPCIT,办公室 PCIT 与较低的辍学率以及较好的治疗联盟和满意度相关。研究结果凸显了不同治疗形式在治疗参与度上的细微差别,揭示了远程医疗在超越参与度问题上的局限性。(PsycInfo Database Record (c) 2024 APA, 版权所有)。
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引用次数: 0
Supplemental Material for Cognitive and Interpersonal Moderators of Two Evidence-Based Depression Prevention Programs 两项循证抑郁症预防计划的认知和人际关系调节因素》补充材料
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-04-04 DOI: 10.1037/ccp0000886.supp
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引用次数: 0
Examining strength at home couples to prevent intimate partner violence on a military installation: A randomized controlled trial. 研究家庭中夫妻的力量,预防军事设施中的亲密伴侣暴力:随机对照试验。
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-04-01 Epub Date: 2024-01-11 DOI: 10.1037/ccp0000863
Casey T Taft, Emily F Rothman, Matthew W Gallagher, Evelyn G Hamilton, Anissa Garza, Suzannah K Creech

Objectives: In this study, the effectiveness of a couples-based group intervention to prevent intimate partner violence (IPV), Strength at Home Couples (SAH-C), was examined on a military installation relative to a comparison intervention, Supportive Prevention (SP). It was expected that greater reductions in use of physical, psychological, and sexual IPV behaviors, as well as reduced suicidality, would be found among service members and their partners in SAH-C relative to SP.

Method: Participants included 138 couples randomized to SAH-C and SP through a clinical controlled trial embedded in a hybrid effectiveness implementation study which took place on a military installation. The Revised Conflict Tactics Scales and Multidimensional Measure of Emotional Abuse were used to measure IPV, and 13 Military Suicide Research Consortium common data elements were used to assess suicidality.

Results: Service members randomized to SAH-C evidenced greater reductions based on effect sizes across the assessment time points for all IPV variables, including use of overall physical IPV, severe physical IPV, sexual IPV, psychological IPV, and coercive control IPV relative to those randomized to SP. Partners of service members demonstrated a similar general pattern for reductions in use of IPV, but findings were not as robust as for service members. Both service members and partners demonstrated greater reductions in suicidality based on effect sizes when randomized to SAH-C relative to SP.

Conclusions: Findings extend prior work demonstrating the promising effects of SAH-C delivered in the military context and highlight the possible benefits of SAH-C in preventing self-harm thoughts and behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

研究目的在这项研究中,我们在一个军事设施中考察了以夫妻为基础的预防亲密伴侣暴力(IPV)的团体干预措施--"家庭中的夫妻力量"(SAH-C)与对比干预措施--"支持性预防"(SP)的效果。预计与 SP 相比,参加 SAH-C 的军人及其伴侣在使用身体、心理和性 IPV 行为方面会有更大的减少,自杀率也会降低:参与者包括138对夫妇,他们通过一项临床对照试验被随机分配到SAH-C和SP中,该试验嵌入了一项在军事设施中进行的混合有效性实施研究中。修订版冲突策略量表和情感虐待多维测量法用于测量IPV,13个军事自杀研究联盟的通用数据元素用于评估自杀倾向:结果:与随机接受SP治疗的军人相比,随机接受SAH-C治疗的军人在所有IPV变量(包括总体身体IPV、严重身体IPV、性IPV、心理IPV和胁迫性控制IPV的使用)的评估时间点上都有更大的减少(基于效应大小)。服役人员的伴侣在减少使用 IPV 方面表现出了类似的总体模式,但研究结果不如服役人员那样有力。根据效应大小,相对于 SP,随机接受 SAH-C 治疗的服役人员及其伴侣的自杀率都有更大的降低:研究结果扩展了之前的工作,证明了在军队环境中实施SAH-C的良好效果,并强调了SAH-C在预防自残想法和行为方面可能带来的益处。(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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