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Multiculturalism: A paradigmatic force in psychology. 多元文化主义:心理学的典范力量。
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-04-01 DOI: 10.1037/ccp0000876
Lillian Comas-Diaz
Prior to the advent of multiculturalism, mainstream psychology mirrored the Euro-American culture. In contrast, multiculturalism acts as a prism that reveals the diversity in the human condition. Since most empirical research is still conducted on Western, educated, industrialized, rich, and democratic populations, we need to construct a representative map of the human psychological and behavioral phenome. To work toward this goal, multicultural psychologists go beyond personal transformation and openness to the other. They question power relations, oppose oppressive systems, address psychology's fallacy of neutrality, and engage in social justice action. Specifically, multicultural psychologists work to restore the humanity of both the oppressed and the oppressor. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
在多元文化主义出现之前,主流心理学反映的是欧美文化。相比之下,多元文化主义就像一面多棱镜,揭示了人类状况的多样性。由于大多数实证研究仍然是针对西方的、受过教育的、工业化的、富裕的和民主的人群进行的,因此我们需要构建一个具有代表性的人类心理和行为表型图。为了努力实现这一目标,多元文化心理学家们超越了个人的转变和对他人的开放。他们质疑权力关系,反对压迫性制度,解决心理学的中立谬误,并参与社会正义行动。具体而言,多元文化心理学家致力于恢复被压迫者和压迫者的人性。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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引用次数: 0
Grief-focused cognitive behavioral therapies for prolonged grief symptoms: A systematic review and meta-analysis. 针对长期悲伤症状的以悲伤为中心的认知行为疗法:系统回顾和荟萃分析。
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-04-01 DOI: 10.1037/ccp0000884
K. Komischke-Konnerup, R. Zachariae, P. Boelen, M. M. Marello, Maja O'Connor
BACKGROUNDStudies suggest that cognitive behavioral therapies (CBTs) may be efficacious in reducing symptoms of prolonged grief disorder (PGD), but no comprehensive overview and pooled estimate of CBTs' effect on PGD in adulthood exist. We conducted a systematic review and meta-analysis of randomized controlled trials.METHODStudies were selected independently by two researchers based on a systematic literature search in Pubmed, APA PsycInfo, Web of Science, and Embase. Meta-analyses provided pooled effect sizes for the effects of CBTs on PGD symptoms and secondary outcomes. We explored potential moderators of effect, risk of bias of included studies, and evaluated the quality of the meta-analytical evidence through the Grading of Recommendations, Assessment, Development, and Evaluation system.RESULTSThe meta-analysis included 22 studies of 2,602 bereaved adults (averaged study Mage = 49 years). CBTs had a statistically significant medium effect on PGD symptoms at postintervention (K = 22, g = 0.65, 95% CI [0.49, 0.81]), and a large effect at follow-up (K = 7, g = 0.90, 95% CI [0.37, 1.43]). Statistically significant small-to-medium effects were found at postintervention on posttraumatic stress symptoms (K = 10, g = 0.74, 95% CI [0.49, 0.98]), depression (K = 19, g = 0.53, 95% CI [0.36, 0.71]), and anxiety (K = 9, g = 0.35, 95% CI [0.22, 0.49]). The effects on PGD remained unchanged when adjusted for possible outliers. None of the moderator analyses reached statistical significance.CONCLUSIONThis review suggests that CBTs are efficacious in reducing PGD symptoms in adulthood. Generalization of findings should be done with caution due to considerable inconsistency and indirectness of meta-analytic evidence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
背景研究表明,认知行为疗法(CBT)可以有效减轻长期悲伤障碍(PGD)的症状,但目前还没有关于 CBT 对成年期 PGD 的影响的全面综述和汇总评估。我们对随机对照试验进行了系统综述和荟萃分析。方法由两名研究人员根据在 Pubmed、APA PsycInfo、Web of Science 和 Embase 中进行的系统文献检索,独立筛选出相关研究。元分析提供了 CBT 对 PGD 症状和次要结果影响的集合效应大小。我们探讨了潜在的效应调节因素、纳入研究的偏倚风险,并通过 "建议、评估、发展和评价分级系统 "评估了荟萃分析证据的质量。结果荟萃分析纳入了 22 项研究,涉及 2,602 名失去亲人的成年人(平均研究年龄 = 49 岁)。在干预后,CBT 对 PGD 症状有统计学意义的中等效果(K = 22,g = 0.65,95% CI [0.49,0.81]),在随访时有较大效果(K = 7,g = 0.90,95% CI [0.37,1.43])。干预后对创伤后应激症状(K = 10,g = 0.74,95% CI [0.49,0.98])、抑郁(K = 19,g = 0.53,95% CI [0.36,0.71])和焦虑(K = 9,g = 0.35,95% CI [0.22,0.49])的中小型影响具有统计学意义。在对可能的异常值进行调整后,对 PGD 的影响保持不变。本综述表明,CBT 可有效减轻成年后的 PGD 症状。由于荟萃分析证据存在相当大的不一致性和间接性,因此应谨慎推广研究结果。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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引用次数: 0
Changes in positive and negative affect in psychotherapy for depression and anxiety. 抑郁症和焦虑症心理治疗中积极和消极情绪的变化。
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-04-01 Epub Date: 2023-12-21 DOI: 10.1037/ccp0000865
Nora M Barnes-Horowitz, Allison Metts, David Rosenfield, Julia S Yarrington, Michael Treanor, Aileen Echiverri-Cohen, Thomas Ritz, Alicia E Meuret, Michelle G Craske

Objective: Positive and negative affect play critical roles in depression and anxiety treatment, but the dynamic processes of how affect changes over treatment in relation to changes in symptoms is unclear. The study goal was to examine relationships among changes in positive and negative affect with changes in depression and anxiety symptoms.

Method: This secondary analysis used a combined sample (N = 196) of two trials (Craske et al., 2019, 2023) comparing positive affect treatment (PAT) to negative affect treatment. Longitudinal cross-lag panel models explored whether changes in positive and negative affect (Positive and Negative Affect Schedule; Watson et al., 1988) predicted subsequent changes in depression and anxiety symptoms (Depression Anxiety Stress Scales; Lovibond & Lovibond, 1995), whether symptoms predicted subsequent changes in affect, and whether treatment condition moderated these relationships.

Results: Increases in positive affect predicted subsequent decreases in depression and anxiety symptoms, regardless of treatment condition. Symptoms did not reciprocally predict changes in positive affect. For individuals in PAT, decreases in negative affect predicted subsequent decreases in symptoms. Moreover, decreases in symptoms predicted subsequent decreases in negative affect, regardless of treatment condition.

Conclusions: Results did not support a reciprocal relationship between positive affect and symptoms of depression and anxiety since positive affect predicted depression and anxiety symptoms but not vice versa. Results supported a reciprocal relationship between negative affect and symptoms of depression and anxiety since negative affect predicted depression and anxiety symptoms in PAT, and depression and anxiety symptoms predicted negative affect in both treatment conditions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:积极情绪和消极情绪在抑郁症和焦虑症治疗中起着至关重要的作用,但情绪在治疗过程中的变化与症状变化之间的动态变化过程尚不清楚。本研究旨在探讨积极情绪和消极情绪的变化与抑郁和焦虑症状变化之间的关系:这项二次分析使用了两项试验(Craske 等人,2019 年,2023 年)的合并样本(N = 196),将积极情绪治疗(PAT)与消极情绪治疗进行了比较。纵向跨滞后面板模型探讨了积极情绪和消极情绪的变化(积极情绪和消极情绪量表;Watson等人,1988年)是否能预测抑郁和焦虑症状(抑郁焦虑压力量表;Lovibond和Lovibond,1995年)的后续变化,症状是否能预测情感的后续变化,以及治疗条件是否能调节这些关系:结果:无论治疗条件如何,积极情绪的增加都预示着随后抑郁和焦虑症状的减少。症状并不能相互预测积极情绪的变化。对于 PAT 患者来说,负性情绪的降低预示着随后症状的减轻。此外,无论治疗条件如何,症状的减轻都会预示着消极情绪的减轻:结果不支持积极情绪与抑郁和焦虑症状之间的相互关系,因为积极情绪能预测抑郁和焦虑症状,反之亦然。结果支持负性情绪与抑郁和焦虑症状之间的相互关系,因为负性情绪可以预测 PAT 中的抑郁和焦虑症状,而抑郁和焦虑症状可以预测两种治疗条件下的负性情绪。(PsycInfo Database Record (c) 2023 APA,保留所有权利)。
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引用次数: 0
Peak experiences during insight mindfulness meditation retreats and their salutary and adverse impact: A prospective matched-controlled intervention study. 洞察正念冥想闭关期间的巅峰体验及其有益和不利影响:前瞻性配对对照干预研究
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-04-01 DOI: 10.1037/ccp0000875
Yuval Hadash, Tatyana Veksler, Omer Dar, Romi Oren-Schwartz, Amit Bernstein
OBJECTIVEWe sought to address a growing debate regarding the adverse and salutary impact of unusual, extraordinary or intense subjective experiences during meditation-based interventions. To do so, we empirically characterized such peak experiences during an intensive meditation intervention and their impact postintervention.METHODWe conducted a preregistered prospective intervention study among 96 adults who registered for 6-day insight (Vipassana) mindfulness meditation retreats and 47 matched controls. Controls were selected from a pool of 543 people recruited from the same community of meditators as retreat participants and systematically matched to retreat participants on age and lifetime meditation experience. Measures included the novel Peak Meditative Experience Scale and the Impact of PMES.RESULTSSeventeen peak experiences that were primarily pleasant (e.g., deep and unusual peace, aha! Moment) occurred more frequently among retreat participants than among matched controls in daily living (ps < .05; mean ϕ = .33). In contrast, 14 peak experiences that were mostly unpleasant (e.g., flashbacks, overwhelming sadness) occurred at similar rates in both groups (ps > .05). At 2-week follow-up, the perceived impact of all pleasant and most unpleasant peak experiences was more salutary than adverse (ps ≤ .015; M Cohen's d = 1.61).CONCLUSIONSPeak experiences that resulted from meditation retreats were primarily pleasant and had a large salutary impact postretreat. Inconsistent with conclusions from uncontrolled retrospective studies, findings document that intensive insight mindfulness meditation training in retreats may not contribute to unpleasant peak experiences and even when they occurred their impact was typically more salutary than adverse. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
目标我们试图解决一个日益激烈的争论,即在冥想干预过程中,不寻常、非同寻常或强烈的主观体验会产生不良影响还是有益影响。为此,我们对密集冥想干预期间的这种高峰体验及其干预后的影响进行了实证描述。方法 我们对 96 名注册参加为期 6 天的洞察力(唯识)正念冥想静修的成年人和 47 名匹配的对照者进行了预先注册的前瞻性干预研究。对照组是从与静心禅修参加者来自同一社区的 543 名静心禅修者中挑选出来的,他们与静心禅修参加者在年龄和一生的静心禅修经历上进行了系统匹配。结果与匹配的对照组相比,静修参与者在日常生活中更经常出现 17 种主要是令人愉悦的高峰体验(例如,深沉而不寻常的平静、啊哈!时刻)(PS < .05;平均值 j = .33)。与此相反,14 种主要是不愉快的高峰体验(例如,闪回、压抑的悲伤)在两组中的发生率相似(PS > .05)。在两周的随访中,所有令人愉快和最令人不愉快的高峰体验所产生的影响都是有益的多于有害的(ps ≤ .015;M Cohen's d = 1.61)。研究结果表明,静心闭关中的强化正念洞察力冥想训练可能不会导致不愉快的高峰体验,即使出现这种体验,其影响通常也是有益而非有害的。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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引用次数: 0
Predicting effects of a digital stress intervention for patients with depressive symptoms: Development and validation of meta-analytic prognostic models using individual participant data. 预测数字压力干预对抑郁症状患者的影响:利用个体参与者数据开发和验证元分析预后模型。
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-04-01 Epub Date: 2023-12-21 DOI: 10.1037/ccp0000852
Mathias Harrer, Harald Baumeister, Pim Cuijpers, Elena Heber, Dirk Lehr, Ronald C Kessler, David Daniel Ebert

Objective: Digital stress interventions could be helpful as an "indirect" treatment for depression, but it remains unclear for whom this is a viable option. In this study, we developed models predicting individualized benefits of a digital stress intervention on depressive symptoms at 6-month follow-up.

Method: Data of N = 1,525 patients with depressive symptoms (Center for Epidemiological Studies' Depression Scale, CES-D ≥ 16) from k = 6 randomized trials (digital stress intervention vs. waitlist) were collected. Prognostic models were developed using multilevel least absolute shrinkage and selection operator and boosting algorithms, and were validated using bootstrap bias correction and internal-external cross-validation. Subsequently, expected effects among those with and without a treatment recommendation were estimated based on clinically derived treatment assignment cut points.

Results: Performances ranged from R² = 21.0%-23.4%, decreasing only slightly after model optimism correction (R² = 17.0%-19.6%). Predictions were greatly improved by including an interim assessment of depressive symptoms (optimism-corrected R2 = 32.6%-35.6%). Using a minimally important difference of d = -0.24 as assignment cut point, approximately 84.6%-93.3% of patients are helped by this type of intervention, while the remaining 6.7%-15.4% would experience clinically negligible benefits (δ^ = -0.02 to -0.19). Using reliable change as cut point, a smaller subset (39.3%-46.2%) with substantial expected benefits (δ^ = -0.68) receives a treatment recommendation.

Conclusions: Meta-analytic prognostic models applied to individual participant data can be used to predict differential benefits of a digital stress intervention as an indirect treatment for depression. While most patients seem to benefit, the developed models could be helpful as a screening tool to identify those for whom a more intensive depression treatment is needed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:数字压力干预作为一种 "间接 "治疗抑郁症的方法可能会有所帮助,但对于哪些人来说这是一种可行的选择仍不清楚。在这项研究中,我们建立了一些模型,预测数字压力干预在 6 个月随访时对抑郁症状的个体化益处:方法:从 k = 6 项随机试验(数字压力干预与等待名单)中收集了 N = 1,525 名抑郁症状患者(流行病学研究中心抑郁量表,CES-D ≥ 16)的数据。使用多层次最小绝对收缩和选择算子以及提升算法建立了预后模型,并使用引导偏差校正和内部外部交叉验证进行了验证。随后,根据临床得出的治疗分配切点,估算了有治疗建议和无治疗建议人群的预期效果:结果:结果表明,R²=21.0%-23.4%,在模型乐观度校正后(R²=17.0%-19.6%),结果表明模型乐观度略有下降。通过对抑郁症状进行中期评估,预测结果大大提高(乐观校正后的 R2 = 32.6%-35.6%)。以最小重要差异 d = -0.24 作为分配切点,约有 84.6%-93.3% 的患者可通过此类干预获得帮助,而其余 6.7%-15.4% 的患者的临床获益可忽略不计(δ^ = -0.02 至 -0.19)。以可靠的变化作为切点,较小的子集(39.3%-46.2%)具有可观的预期收益(δ^ = -0.68),可获得治疗建议:结论:应用于个体参与者数据的元分析预后模型可用于预测数字压力干预作为抑郁症间接治疗方法的不同益处。虽然大多数患者似乎都能从中获益,但所开发的模型可以作为一种筛选工具,帮助确定哪些患者需要接受更深入的抑郁症治疗。(PsycInfo Database Record (c) 2023 APA, 版权所有)。
{"title":"Predicting effects of a digital stress intervention for patients with depressive symptoms: Development and validation of meta-analytic prognostic models using individual participant data.","authors":"Mathias Harrer, Harald Baumeister, Pim Cuijpers, Elena Heber, Dirk Lehr, Ronald C Kessler, David Daniel Ebert","doi":"10.1037/ccp0000852","DOIUrl":"10.1037/ccp0000852","url":null,"abstract":"<p><strong>Objective: </strong>Digital stress interventions could be helpful as an \"indirect\" treatment for depression, but it remains unclear for whom this is a viable option. In this study, we developed models predicting individualized benefits of a digital stress intervention on depressive symptoms at 6-month follow-up.</p><p><strong>Method: </strong>Data of <i>N</i> = 1,525 patients with depressive symptoms (Center for Epidemiological Studies' Depression Scale, CES-D ≥ 16) from <i>k</i> = 6 randomized trials (digital stress intervention vs. waitlist) were collected. Prognostic models were developed using multilevel least absolute shrinkage and selection operator and boosting algorithms, and were validated using bootstrap bias correction and internal-external cross-validation. Subsequently, expected effects among those with and without a treatment recommendation were estimated based on clinically derived treatment assignment cut points.</p><p><strong>Results: </strong>Performances ranged from <i>R</i>² = 21.0%-23.4%, decreasing only slightly after model optimism correction (<i>R</i>² = 17.0%-19.6%). Predictions were greatly improved by including an interim assessment of depressive symptoms (optimism-corrected R2 = 32.6%-35.6%). Using a minimally important difference of <i>d</i> = -0.24 as assignment cut point, approximately 84.6%-93.3% of patients are helped by this type of intervention, while the remaining 6.7%-15.4% would experience clinically negligible benefits (δ^ = -0.02 to -0.19). Using reliable change as cut point, a smaller subset (39.3%-46.2%) with substantial expected benefits (δ^ = -0.68) receives a treatment recommendation.</p><p><strong>Conclusions: </strong>Meta-analytic prognostic models applied to individual participant data can be used to predict differential benefits of a digital stress intervention as an indirect treatment for depression. While most patients seem to benefit, the developed models could be helpful as a screening tool to identify those for whom a more intensive depression treatment is needed. (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":5.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138829921","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
Supplemental Material for Session-Level Effects of Cognitive Processing Therapy and Prolonged Exposure on Individual Symptoms of Posttraumatic Stress Disorder Among U.S. Veterans 认知加工疗法和长期暴露疗法对美国退伍军人创伤后应激障碍个体症状的疗程级影响》补充材料
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-03-25 DOI: 10.1037/ccp0000880.supp
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引用次数: 0
Supplemental Material for Monitoring Emotional Intensity and Variability to Forecast Depression Recurrence in Real Time in Remitted Adults 补充材料: 监测情绪强度和变异性以实时预测缓解期成人抑郁复发情况
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-03-14 DOI: 10.1037/ccp0000871.supp
{"title":"Supplemental Material for Monitoring Emotional Intensity and Variability to Forecast Depression Recurrence in Real Time in Remitted Adults","authors":"","doi":"10.1037/ccp0000871.supp","DOIUrl":"https://doi.org/10.1037/ccp0000871.supp","url":null,"abstract":"","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140243096","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
Supplemental Material for Parent–Child Emotion Dynamics in Families Presenting for Behavioral Parent Training: Is There a Link With Child Behavior, Parenting, and Treatment Outcome? 行为父母培训家庭的亲子情绪动态》补充材料:儿童行为、养育方式和治疗结果之间有联系吗?
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-03-14 DOI: 10.1037/ccp0000878.supp
{"title":"Supplemental Material for Parent–Child Emotion Dynamics in Families Presenting for Behavioral Parent Training: Is There a Link With Child Behavior, Parenting, and Treatment Outcome?","authors":"","doi":"10.1037/ccp0000878.supp","DOIUrl":"https://doi.org/10.1037/ccp0000878.supp","url":null,"abstract":"","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140243622","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
A controlled trial of adaptive disclosure-enhanced to improve functioning and treat posttraumatic stress disorder. 为改善功能和治疗创伤后应激障碍而进行的适应性披露强化对照试验。
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-03-01 DOI: 10.1037/ccp0000873
Brett T Litz, Julie Yeterian, Danielle Berke, Ariel J Lang, Matt J Gray, Tasha Nienow, Sheila Frankfurt, Jeanette Irene Harris, Shira Maguen, Luke Rusowicz-Orazem

Objective: This is a randomized controlled trial (NCT03056157) of an enhanced adaptive disclosure (AD) psychotherapy compared to present-centered therapy (PCT; each 12 sessions) in 174 veterans with posttraumatic stress disorder (PTSD) related to traumatic loss (TL) and moral injury (MI). AD employs different strategies for different trauma types. AD-Enhanced (AD-E) uses letter writing (e.g., to the deceased), loving-kindness meditation, and bolstered homework to facilitate improved functioning to repair TL and MI-related trauma.

Method: The primary outcomes were the Sheehan Disability Scale (SDS), evaluated at baseline, throughout treatment, and at 3- and 6-month follow-ups (Brief Inventory of Psychosocial Functioning was also administered), the Clinician-Administered PTSD Scale (CAPS-5), the Dimensions of Anger Reactions, the Revised Conflict Tactics Scale, and the Quick Drinking Screen.

Results: There were statistically significant between-group differences on two outcomes: The intent-to-treat (ITT) mixed-model analysis of SDS scores indicated greater improvement from baseline to posttreatment in the AD-E group (d = 2.97) compared to the PCT group, d = 1.86; -2.36, 95% CI [-3.92, -0.77], t(1,510) = -2.92, p < .001, d = 0.15. Twenty-one percent more AD-E cases made clinically significant changes on the SDS than PCT cases. From baseline to posttreatment, AD-E was also more efficacious on the CAPS-5 (d = 0.39). These differential effects did not persist at follow-up intervals.

Conclusion: This was the first psychotherapy of veterans with TL/MI-related PTSD to show superiority relative to PCT with respect to functioning and PTSD, although the differential effect sizes were small to medium and not maintained at follow-up. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:这是一项随机对照试验(NCT03056157):这是一项随机对照试验(NCT03056157),研究对象是174名患有创伤后应激障碍(PTSD)的退伍军人,他们都患有与创伤性失落(TL)和精神伤害(MI)相关的PTSD。针对不同的创伤类型,AD 采用了不同的策略。AD增强型(AD-E)采用写信(如给逝者)、慈爱冥想和强化家庭作业等方法,促进功能改善,以修复TL和MI相关创伤:主要结果包括基线、整个治疗过程、3 个月和 6 个月随访时评估的希恩残疾量表(SDS)(同时还进行了社会心理功能简表的评估)、临床医师管理创伤后应激障碍量表(CAPS-5)、愤怒反应维度、修订版冲突策略量表和快速饮酒筛查:在两项结果上,组间差异具有统计学意义:SDS评分的意向治疗(ITT)混合模型分析表明,与PCT组(d = 1.86; -2.36, 95% CI [-3.92, -0.77],t(1,510) = -2.92, p < .001,d = 0.15)相比,AD-E组从基线到治疗后的改善幅度更大(d = 2.97)。在SDS上有显著临床变化的AD-E病例比PCT病例多21%。从基线到治疗后,AD-E 对 CAPS-5 的疗效也更好(d = 0.39)。结论:这是首次对退伍军人进行心理治疗:这是对患有 TL/MI 相关创伤后应激障碍的退伍军人进行的首次心理治疗,在功能和创伤后应激障碍方面显示出相对于 PCT 的优越性,尽管差异效应大小为小到中等,且在随访中并未保持。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
{"title":"A controlled trial of adaptive disclosure-enhanced to improve functioning and treat posttraumatic stress disorder.","authors":"Brett T Litz, Julie Yeterian, Danielle Berke, Ariel J Lang, Matt J Gray, Tasha Nienow, Sheila Frankfurt, Jeanette Irene Harris, Shira Maguen, Luke Rusowicz-Orazem","doi":"10.1037/ccp0000873","DOIUrl":"10.1037/ccp0000873","url":null,"abstract":"<p><strong>Objective: </strong>This is a randomized controlled trial (NCT03056157) of an enhanced adaptive disclosure (AD) psychotherapy compared to present-centered therapy (PCT; each 12 sessions) in 174 veterans with posttraumatic stress disorder (PTSD) related to traumatic loss (TL) and moral injury (MI). AD employs different strategies for different trauma types. AD-Enhanced (AD-E) uses letter writing (e.g., to the deceased), loving-kindness meditation, and bolstered homework to facilitate improved functioning to repair TL and MI-related trauma.</p><p><strong>Method: </strong>The primary outcomes were the Sheehan Disability Scale (SDS), evaluated at baseline, throughout treatment, and at 3- and 6-month follow-ups (Brief Inventory of Psychosocial Functioning was also administered), the Clinician-Administered PTSD Scale (CAPS-5), the Dimensions of Anger Reactions, the Revised Conflict Tactics Scale, and the Quick Drinking Screen.</p><p><strong>Results: </strong>There were statistically significant between-group differences on two outcomes: The intent-to-treat (ITT) mixed-model analysis of SDS scores indicated greater improvement from baseline to posttreatment in the AD-E group (d = 2.97) compared to the PCT group, d = 1.86; -2.36, 95% CI [-3.92, -0.77], t(1,510) = -2.92, p < .001, d = 0.15. Twenty-one percent more AD-E cases made clinically significant changes on the SDS than PCT cases. From baseline to posttreatment, AD-E was also more efficacious on the CAPS-5 (d = 0.39). These differential effects did not persist at follow-up intervals.</p><p><strong>Conclusion: </strong>This was the first psychotherapy of veterans with TL/MI-related PTSD to show superiority relative to PCT with respect to functioning and PTSD, although the differential effect sizes were small to medium and not maintained at follow-up. (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":5.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139735367","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
The availability of dialectical behavior therapy in partial hospitalization and residential services for borderline personality disorder: An exploratory longitudinal study of the National Mental Health Services Survey from 2014 to 2021. 边缘型人格障碍部分住院和住院服务中辩证行为治疗的可得性:2014 - 2021年全国精神卫生服务调查的探索性纵向研究
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-03-01 Epub Date: 2023-12-07 DOI: 10.1037/ccp0000870
Daniel S Spina, Kenneth N Levy

Objective: Treatment guidelines on borderline personality disorder (BPD) recommend day-hospital or residential treatments for patients with BPD who cannot tolerate outpatient treatment (American Psychiatric Association, 2010; National Health & Medical Research Council, 2013). However, the current literature suggests that evidence-based treatment for BPD may be difficult to access (Lohman et al., 2017). The present study aims to characterize the accessibility of dialectical behavioral therapy (DBT) in day-treatment and residential programs in the United States in the last 7 years and examines whether day-treatment and residential programs that accept state benefits (i.e., Medicaid) are significantly less likely to offer DBT.

Method: Using mixed logistic regression, we examined trends in the National Mental Health Services Survey data from 2014 to 2021, a survey of U.S. mental health facilities which tracks whether facilities provide DBT.

Results: We found that the likelihood that a residential or day-hospital facility offers DBT has been growing over time at the national level (ORday-treatment = 1.07, SE = .03, z = 1.90, p = .05; ORresidential = 1.08, SE = .05, z = 1.77, p = .08). We also found significant variability in these trends at the state level. In addition, we found that facilities accepting state benefits were less likely to offer DBT (ORday-treatment = .66, SE = .021, z = -1.93, p = .05; ORresidential = .67, SE = .21, z = -1.91, p = .06).

Conclusion: Consistent with previous literature, our study suggests that these programs are very scarce across the United States and difficult to access for those with Medicaid.guidelines on borderline personality disorder (BPD) recommend day-hospital or residential treatments for patients with BPD who cannot tolerate outpatient treatment (American Psychiatric Association, 2010; National Health & Medical Research Council, 2013). However, the current literature suggests that evidence-based treatment for BPD may be difficult to access (Lohman et al., 2017). The present study aims to characterize the accessibility of dialectical behavioral therapy (DBT) in day-treatment and residential programs in the United States in the last 7 years and examines whether day-treatment and residential programs that accept state benefits (i.e., Medicaid) are significantly less likely to offer DBT.

Method: Using mixed logistic regression, we examined trends in the National Mental Health Services Survey data from 2014 to 2021, a survey of U.S. mental health facilities which tracks whether facilities provide DBT.

Results: We found that the likelihood that a residential or day-hospital facility offers DBT has been growing over time at the na

目的:边缘型人格障碍(BPD)治疗指南推荐对不能忍受门诊治疗的BPD患者进行日间住院或住院治疗(美国精神病学协会,2010;国家卫生和医学研究委员会,2013年)。然而,目前的文献表明,BPD的循证治疗可能难以获得(Lohman等人,2017)。本研究旨在描述辩证行为疗法(DBT)在过去7年中在美国日间治疗和住院治疗项目中的可及性,并检查接受国家福利(即医疗补助)的日间治疗和住院治疗项目是否明显不太可能提供DBT。方法:使用混合逻辑回归,我们检查了2014年至2021年国家精神卫生服务调查数据的趋势,这是一项对美国精神卫生机构的调查,追踪设施是否提供DBT。结果:我们发现,在全国范围内,住宅或日间医院设施提供DBT的可能性随着时间的推移而增加(日间治疗= 1.07,SE = 0.03, z = 1.90, p = 0.05;ORresidential = 1.08, SE = 0.05, z = 1.77, p = 0.08)。我们还发现,这些趋势在各州层面上存在显著差异。此外,我们发现接受国家福利的机构不太可能提供DBT(日常治疗= 0.66,SE = 0.021, z = -1.93, p = 0.05;ORresidential = .67, SE = .21, z = -1.91, p = .06)。结论:与之前的文献一致,我们的研究表明,这些项目在美国非常稀缺,而且对于那些有医疗补助的人来说很难获得。边缘型人格障碍(BPD)指南建议对不能忍受门诊治疗的BPD患者进行日间医院或住院治疗(美国精神病学协会,2010;国家卫生和医学研究委员会,2013年)。然而,目前的文献表明,BPD的循证治疗可能难以获得(Lohman等人,2017)。本研究旨在描述辩证行为疗法(DBT)在过去7年中在美国日间治疗和住院治疗项目中的可及性,并检查接受国家福利(即医疗补助)的日间治疗和住院治疗项目是否明显不太可能提供DBT。方法:使用混合逻辑回归,我们检查了2014年至2021年国家精神卫生服务调查数据的趋势,这是一项对美国精神卫生机构的调查,追踪设施是否提供DBT。结果:我们发现,在国家层面上,住宅或日间医院设施提供DBT的可能性随着时间的推移而增加(PsycInfo数据库记录(c) 2023 APA,所有权利保留)。
{"title":"The availability of dialectical behavior therapy in partial hospitalization and residential services for borderline personality disorder: An exploratory longitudinal study of the National Mental Health Services Survey from 2014 to 2021.","authors":"Daniel S Spina, Kenneth N Levy","doi":"10.1037/ccp0000870","DOIUrl":"10.1037/ccp0000870","url":null,"abstract":"<p><strong>Objective: </strong>Treatment guidelines on borderline personality disorder (BPD) recommend day-hospital or residential treatments for patients with BPD who cannot tolerate outpatient treatment (American Psychiatric Association, 2010; National Health & Medical Research Council, 2013). However, the current literature suggests that evidence-based treatment for BPD may be difficult to access (Lohman et al., 2017). The present study aims to characterize the accessibility of dialectical behavioral therapy (DBT) in day-treatment and residential programs in the United States in the last 7 years and examines whether day-treatment and residential programs that accept state benefits (i.e., Medicaid) are significantly less likely to offer DBT.</p><p><strong>Method: </strong>Using mixed logistic regression, we examined trends in the National Mental Health Services Survey data from 2014 to 2021, a survey of U.S. mental health facilities which tracks whether facilities provide DBT.</p><p><strong>Results: </strong>We found that the likelihood that a residential or day-hospital facility offers DBT has been growing over time at the national level (<i>OR</i><sub>day-treatment</sub> = 1.07, <i>SE</i> = .03, <i>z</i> = 1.90, <i>p</i> = .05; <i>OR</i><sub>residential</sub> = 1.08, <i>SE</i> = .05, <i>z</i> = 1.77, <i>p</i> = .08). We also found significant variability in these trends at the state level. In addition, we found that facilities accepting state benefits were less likely to offer DBT (<i>OR</i><sub>day-treatment</sub> = .66, <i>SE</i> = .021, <i>z</i> = -1.93, <i>p</i> = .05; <i>OR</i><sub>residential</sub> = .67, <i>SE</i> = .21, <i>z</i> = -1.91, <i>p</i> = .06).</p><p><strong>Conclusion: </strong>Consistent with previous literature, our study suggests that these programs are very scarce across the United States and difficult to access for those with Medicaid.guidelines on borderline personality disorder (BPD) recommend day-hospital or residential treatments for patients with BPD who cannot tolerate outpatient treatment (American Psychiatric Association, 2010; National Health & Medical Research Council, 2013). However, the current literature suggests that evidence-based treatment for BPD may be difficult to access (Lohman et al., 2017). The present study aims to characterize the accessibility of dialectical behavioral therapy (DBT) in day-treatment and residential programs in the United States in the last 7 years and examines whether day-treatment and residential programs that accept state benefits (i.e., Medicaid) are significantly less likely to offer DBT.</p><p><strong>Method: </strong>Using mixed logistic regression, we examined trends in the National Mental Health Services Survey data from 2014 to 2021, a survey of U.S. mental health facilities which tracks whether facilities provide DBT.</p><p><strong>Results: </strong>We found that the likelihood that a residential or day-hospital facility offers DBT has been growing over time at the na","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138498543","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
期刊
Journal of consulting and clinical psychology
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