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A group-based transdiagnostic sleep and circadian treatment for major depressive disorder: A randomized controlled trial. 以小组为基础的跨诊断睡眠和昼夜节律治疗重度抑郁障碍:随机对照试验。
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-03-01 Epub Date: 2024-01-25 DOI: 10.1037/ccp0000869
Anneko Yuen-Yum Yau, Ka-Yan Ng, Wing-Yin Lau, Chun-Yin Poon, Wing-Fai Yeung, Ka-Fai Chung, Christian S Chan, Allison G Harvey, Fiona Yan-Yee Ho

Objective: Sleep and circadian disturbance is highly comorbid with a range of psychological disorders, especially major depressive disorder (MDD). In view of the complexity of sleep and circadian problems in MDD, this study aimed to evaluate the efficacy of a group-based transdiagnostic intervention for sleep and circadian dysfunction (TranS-C) for improving depressive symptoms and sleep and circadian functions.

Method: One hundred fifty-two adults diagnosed with comorbid MDD and sleep and circadian dysfunctions were randomized into TranS-C group treatment (TranS-C; n = 77) or care as usual (CAU; n = 75) control group. The TranS-C group received six weekly 2-hr group sessions of TranS-C, whereas the CAU group continued to receive usual care. Assessments were at baseline, immediate (Week 7), and 12-week (Week 19) posttreatment. Primary and secondary outcomes included depression, anxiety, sleep disturbances, fatigue, quality of life, and functional impairment.

Results: The TranS-C group showed significant improvement in depressive symptoms (p < .001, d = 0.84), insomnia severity (p < .001, d = 0.77), sleep disturbances (p < .001, d = 1.15), sleep-related impairment (p < .001, d = 1.22), fatigue (p < .001, d = 1.06), anxiety symptoms (p = .004, d = 0.67), quality of life (p < .001, d = 0.71), and sleep diary-derived parameters (ps < .05, d = 0.12-0.77) relative to the CAU group at immediate posttreatment. These treatment gains remained significant at 12-week follow-up. Significant improvement in functional impairment was also noted at 12-week follow-up.

Conclusions: TranS-C was efficacious and acceptable in alleviating depressive symptoms and sleep and circadian disruptions in adults with MDD. The group format appears to be a low-cost, widely disseminable option to deliver TranS-C. Further research on TranS-C to examine its benefits on other psychiatric disorders is warranted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:睡眠和昼夜节律紊乱是一系列心理疾病,尤其是重度抑郁症(MDD)的高合并症。鉴于睡眠和昼夜节律问题在重度抑郁症中的复杂性,本研究旨在评估以小组为基础的睡眠和昼夜节律功能障碍跨诊断干预(TranS-C)对改善抑郁症状、睡眠和昼夜节律功能的疗效:将152名被诊断为合并有MDD和睡眠与昼夜节律失调的成年人随机分为TranS-C小组治疗组(TranS-C;n = 77)或常规护理对照组(CAU;n = 75)。TranS-C小组每周接受六次2小时的TranS-C小组治疗,而CAU小组则继续接受常规护理。评估时间为基线、治疗后即刻(第 7 周)和 12 周(第 19 周)。主要和次要结果包括抑郁、焦虑、睡眠障碍、疲劳、生活质量和功能障碍:结果:TranS-C 治疗组在抑郁症状(p < .001,d = 0.84)、失眠严重程度(p < .001,d = 0.77)、睡眠障碍(p < .001,d = 1.15)、睡眠相关损伤(p < .001,d = 1.22)、疲劳(p < .001,d = 1.06)、焦虑症状(p = .004,d = 0.67)、生活质量(p < .001,d = 0.71)和睡眠日记衍生参数(ps < .05,d = 0.12-0.77)。在 12 周的随访中,这些治疗效果依然显著。随访12周时,功能障碍也有明显改善:结论:TranS-C在缓解抑郁症状、睡眠和昼夜节律紊乱方面对患有MDD的成年人有效且可接受。小组形式似乎是提供 TranS-C 的一种低成本、可广泛传播的选择。我们有必要对 TranS-C 进行进一步研究,探讨它对其他精神疾病的益处。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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引用次数: 0
Treatment credibility as a mechanism of change in cognitive behavioral therapy: Effects on depression and anxiety. 治疗可信度是认知行为疗法的一种变化机制:对抑郁和焦虑的影响
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-03-01 Epub Date: 2024-01-22 DOI: 10.1037/ccp0000866
Robin Anno Wester, Brian Schwartz, Wolfgang Lutz, Mila Hall, Thekla Hoos, Julian Rubel

Objective: This study aimed to provide evidence for treatment credibility (TC) as a potential mechanism of change in cognitive behavioral therapy (CBT). Therefore, it focused on within-person effects that are free of the influence of stable characteristics and thus allow to exclude certain alternative explanations for the association under study.

Method: The sample included 1,423 patients receiving outpatient CBT, who presented a wide variety of psychiatric diagnoses (mostly affective and anxiety disorders). TC, depression, and anxiety were measured every fifth session from Session 5 to 25 using the Credibility Expectancy Questionnaire (CEQ), the Patient Health Questionnaire-9 (PHQ-9), and the General Anxiety Disorder-7 (GAD-7), respectively. Symptom severity was assessed every session using the Hopkins Symptom Checklist-11. Within- and between-person effects of TC, depression, and anxiety were analyzed using the latent curve model with structured residuals (LCM-SRs). In exploratory analyses, within-person effects of TC on next-session symptom severity were assessed using a modification of the LCM-SR.

Results: LCM-SRs exhibited excellent fit in main analyses. There were significant negative correlations of both intercepts and slopes (between-person level) of CEQ and PHQ-9 as well GAD-7. No significant cross-lagged effects (within-person level) were found over the five-session interval. However, session-wise analyses revealed significant cross-lagged effects of CEQ on Hopkins Symptom Checklist-11.

Conclusions: This study is the first to find significant within-person effects of TC in session-wise analyses. This lends preliminary support to the notion of TC as a mechanism of change. The lack of significant findings at the five-session interval is discussed considering the specific design used in this study. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

研究目的本研究旨在提供证据,证明治疗可信度(TC)是认知行为疗法(CBT)改变的潜在机制。因此,研究重点放在不受稳定特征影响的人内效应上,从而排除研究中关联的某些替代解释:样本包括 1,423 名接受门诊 CBT 治疗的患者,他们被诊断患有多种精神病(主要是情感障碍和焦虑症)。从疗程 5 到 25,每隔 5 个疗程分别使用可信度期望问卷(CEQ)、患者健康问卷-9(PHQ-9)和一般焦虑症-7(GAD-7)测量 TC、抑郁和焦虑。每次治疗均使用霍普金斯症状检查表-11 评估症状严重程度。使用具有结构化残差的潜在曲线模型(LCM-SRs)对 TC、抑郁和焦虑的人内和人际效应进行了分析。在探索性分析中,使用 LCM-SR 的修正版评估了 TC 对下一次症状严重程度的人内效应:LCM-SRs 在主要分析中表现出极佳的拟合度。CEQ 和 PHQ-9 以及 GAD-7 的截距和斜率(人际水平)均呈显著负相关。在五个疗程的间隔中,没有发现明显的交叉滞后效应(人内水平)。然而,按疗程进行的分析显示,CEQ 对霍普金斯症状检查表-11 有明显的交叉滞后效应:本研究首次在会话分析中发现了TC的显著人内效应。结论:本研究首次在会话分析中发现了显著的人内效应,这为TC作为一种改变机制的概念提供了初步支持。考虑到本研究中使用的特殊设计,本研究讨论了在五个疗程间隔内缺乏重大发现的问题。(PsycInfo Database Record (c) 2024 APA, all rights reserved)。
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引用次数: 0
Identifying who benefits most from supportive versus expressive techniques in psychotherapy for depression: Moderators of within- versus between-individual effects. 确定谁从抑郁症心理治疗中的支持与表达技术中获益最多:个体内部与个体之间效应的调节因子。
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-03-01 Epub Date: 2023-12-07 DOI: 10.1037/ccp0000868
Sigal Zilcha-Mano, Christian A Webb

Objective: A recent randomized controlled trial (RCT) indicated that individuals with higher levels of attachment anxiety exhibited better treatment outcomes in supportive-expressive therapy (SET) relative to supportive therapy (ST). But to gain insight into within-patient therapeutic changes, a within-individual design is required. The present study contrasts previous findings based on theory-driven between-patient moderators with data-driven moderators of within-patient processes to investigate whether findings converge or diverge across these two approaches.

Method: We used data of 118 patients from the pilot and active phases of a recent RCT for patients with major depressive disorder, comparing ST with SET, a time-limited psychodynamic therapy. The predefined primary outcome measure was the Hamilton Rating Scale for Depression. Supportive versus expressive techniques were rated based on patients' end-of-session perspective. We compared previous findings based on moderators of between-patient effects with a data-driven approach for identifying moderators of within-patient effects of techniques on subsequent outcome.

Results: After false discovery rate corrections, of 10 preselected moderators, patients' attachment anxiety and domineering style remained significant. Of these, bootstrap resampling revealed significant differences between ST and SET techniques for the attachment anxiety moderator: Those with higher attachment anxiety benefited more from greater use of ST than SET techniques in a particular session, as evidenced by lower levels of symptoms at the subsequent session.

Conclusions: Our within-individual findings diverge from previously published between-individual analyses. This proof-of-concept study demonstrates the importance of complementing between-individuals with within-individual analyses to achieve better understanding of who benefits most from specific treatment techniques. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:最近的一项随机对照试验(RCT)表明,相对于支持治疗(ST),高水平依恋焦虑的个体在支持表达治疗(SET)中表现出更好的治疗效果。但要深入了解患者内部的治疗变化,需要进行个体内部设计。本研究对比了先前基于理论驱动的患者间调节因子和基于数据驱动的患者内部调节因子的研究结果,以调查这两种方法的研究结果是否一致或分歧。方法:我们使用了最近一项针对重度抑郁症患者的随机对照试验的先导期和活动期的118例患者的数据,比较了ST和SET(一种有时间限制的心理动力疗法)。预先确定的主要结果测量是汉密尔顿抑郁评定量表。支持性与表达性技术是基于患者的治疗结束观点进行评估的。我们比较了先前基于患者间效应调节因子的研究结果与数据驱动的方法,以确定技术对后续结果的患者内效应调节因子。结果:经错误发现率修正后,10个预选调节因子对患者依恋焦虑和霸道风格的影响仍然显著。其中,自举重新抽样揭示了ST和SET技术对依恋焦虑调节的显著差异:在特定的会话中,高依恋焦虑的人从更多地使用ST而不是SET技术中获益更多,正如在随后的会话中较低水平的症状所证明的那样。结论:我们的个体内研究结果与之前发表的个体间分析结果不同。这项概念验证研究证明了补充个体间和个体内分析的重要性,以更好地了解谁从特定治疗技术中获益最多。(PsycInfo数据库记录(c) 2023 APA,版权所有)。
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引用次数: 0
Can session-by-session changes in self-reported alliance scores serve as a measure of ruptures in the therapeutic alliance? 自我报告的联盟得分的每一次变化是否可以作为治疗联盟破裂的衡量标准?
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-02-01 Epub Date: 2023-11-27 DOI: 10.1037/ccp0000861
Anna Babl, Julian Rubel, Juan Martín Gómez Penedo, Thomas Berger, Martin Grosse Holtforth, Catherine F Eubanks

Objective: During treatment, the therapeutic alliance is characterized by rupture and repair episodes, which in turn are associated with psychotherapy outcome. It would be important to have a parsimonious tool to identify ruptures in psychotherapy sessions to provide therapists with meaningful feedback about when they occur. The present study thus aims to establish whether measuring self-reported alliance dynamics can function as a measure of alliance ruptures.

Method: The sample consisted of 58 depressed patients, who received 22 sessions of cognitive therapy for depression in an outpatient setting. The observer-rated Rupture Resolution Rating System (3RS) was applied to 58 sessions where the self-reported Working Alliance Inventory (WAI) completed by patients after each therapy session indicated that alliance ratings declined more than 2 SDs from that patient's individual mean. For comparison purposes, the 3RS was also applied to 58 randomly chosen sessions from the same treatment phase (early, middle, late).

Results: Results showed significant differences between sessions where the WAI indicated a drop in the alliance and randomly chosen sessions of the same treatment phase with regard to the frequency and impact of ruptures.

Conclusion: This speaks for the construct validity of the 3RS. Session-by-session alliance ruptures may reliably be measured using a case-sensitive approach to identify meaningful drops in alliance self-report (WAI). (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:在治疗过程中,治疗联盟以破裂和修复事件为特征,这反过来又与心理治疗结果相关。有一个简单的工具来识别心理治疗过程中的破裂,以便在破裂发生时向治疗师提供有意义的反馈,这一点很重要。因此,本研究旨在确定衡量自我报告的联盟动态是否可以作为衡量联盟破裂的指标。方法:样本包括58名抑郁症患者,他们在门诊接受了22次抑郁症认知治疗。观察者评定的破裂解决评分系统(3RS)应用于58个疗程,其中患者在每次治疗后完成的自我报告工作联盟量表(WAI)表明,联盟评分比患者的个体平均值下降了2个标准差以上。为了比较,3RS也被应用于58个随机选择的相同治疗阶段(早期、中期、晚期)。结果:结果显示,在WAI表明联盟下降的疗程和随机选择的同一治疗阶段的疗程之间,关于破裂的频率和影响有显著差异。结论:这说明了3RS的构念效度。可以使用区分大小写的方法可靠地测量每个会话的联盟破裂,以确定联盟自我报告(WAI)中有意义的下降。(PsycInfo数据库记录(c) 2023 APA,版权所有)。
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引用次数: 0
Randomized trial of parent-child interaction therapy improves child-welfare parents' behavior, self-regulation, and self-perceptions. 亲子互动疗法改善儿童福利父母行为、自我调节和自我认知的随机试验。
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-02-01 Epub Date: 2023-12-07 DOI: 10.1037/ccp0000859
Elizabeth A Skowron, Akhila K Nekkanti, Amanda M Skoranski, Carolyn M Scholtes, Emma R Lyons, Kathryn L Mills, David Bard, Alexus Rock, Elliot Berkman, Elizabeth Bard, Beverly W Funderburk

Objective: We conducted a large (N = 204) randomized, clinical trial to test the efficacy of parent-child interaction therapy (PCIT) on observed parenting, two key drivers of maladaptive parenting-self-regulation and social cognitions, and child behavior outcomes in a sample of child welfare-involved families.

Method: Participants were randomly assigned to standard PCIT (n = 120) or services-as-usual (SAU; n = 84). The sample was characterized by low household income, significant exposures to adverse childhood experiences, and substance abuse. Intention-to-treat analyses were conducted on multiply imputed data followed by secondary per-protocol analyses.

Results: Significant PCIT effects emerged on (a) increased positive parenting, reduced negative parenting and disruptive child behavior (small-to-medium intention-to-treat effects and medium-to-large per-protocol effects); (b) gains in parent inhibitory control on the stop-signal task (small-to-medium effects); (c) gains in parent-reported emotion regulation and (d) positive, affirming self-perceptions (small-to-medium effects), relative to the SAU control group. PCIT's effects on gains in parent emotion regulation were mediated by reductions in observed negative parenting. No differences in rates of parent commands or child compliance were observed across conditions. Harsh child attributions moderated treatment impact on parenting skills acquisition. PCIT parents who held harsher attributions displayed greater gains in use of labeled praises and declines in negative talk/criticism with their child, than control group parents.

Conclusions: This randomized trial presents the first evidence that PCIT improves inhibitory control and emotion regulation in a child welfare parents and replicates other published trials documenting intervention gains in positive parenting and child behavior in child welfare families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:我们进行了一项大型(N = 204)随机临床试验,以检验亲子互动疗法(PCIT)对观察性育儿、自我调节和社会认知这两个导致不适应育儿的关键因素以及涉及儿童福利的家庭的儿童行为结局的疗效。方法:参与者随机分配到标准PCIT组(n = 120)或常规服务组(SAU;N = 84)。该样本的特点是家庭收入低,严重暴露于不良童年经历和药物滥用。意向治疗分析是对多重输入的数据进行的,然后是二级协议分析。结果:显著的PCIT效应出现在(a)增加积极的父母教养,减少消极的父母教养和破坏性的儿童行为(小到中等的意向治疗效应和中到大的协议效应);(b)父母对停止信号任务的抑制控制(中小型影响);(c)与SAU对照组相比,父母报告的情绪调节能力有所提高,(d)积极、肯定的自我认知(中小型影响)。PCIT对父母情绪调节增益的影响是通过观察到的消极父母教养的减少来调节的。在不同条件下,没有观察到父母命令率或儿童依从性的差异。严厉的儿童归因调节了治疗对父母技能习得的影响。与控制组的父母相比,拥有严厉归因的PCIT父母在使用标签表扬方面表现出更大的进步,在与孩子进行消极谈话/批评方面表现出更大的下降。结论:这项随机试验首次提供了PCIT改善儿童福利家庭抑制控制和情绪调节的证据,并重复了其他已发表的试验,这些试验记录了儿童福利家庭中积极育儿和儿童行为的干预收益。(PsycInfo数据库记录(c) 2023 APA,版权所有)。
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引用次数: 0
Reducing suicidal ideation in African American adolescents: A randomized controlled clinical trial. 减少非裔美国青少年自杀意念:一项随机对照临床试验。
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-02-01 Epub Date: 2023-09-28 DOI: 10.1037/ccp0000849
W LaVome Robinson, Christopher R Whipple, Kate Keenan, Caleb E Flack, Sally Lemke, Leonard A Jason

Objective: Suicide rates among African American adolescents have increased exponentially in recent years. The socioecological stressors that can increase suicide risk for African American adolescents, in conjunction with unique suicide risk manifestations within this group, require culturally sensitive preventive interventions. This study examines the efficacy of the Adapted-Coping With Stress course (A-CWS), a culturally tailored preventive intervention, to reduce suicidal ideation in African American adolescents, utilizing a randomized controlled design.

Method: Participants included 410 ninth-grade students in a large Midwestern city; most students identified as Black/African American. Participants were randomly assigned to either the A-CWS intervention or standard care control condition. All participants were assessed at baseline, immediately postintervention, and 6 and 12 months postintervention.

Results: Treatment effects were examined using latent growth models comparing suicidal ideation trajectories in control and intervention conditions. Analyses were conducted using both intention-to-treat and treatment-as-received samples (i.e., intervention condition participants who attended at least 80% of sessions). In both intention-to-treat and treatment-as-received analyses, there was a significant treatment effect: Individuals in the A-CWS intervention condition with higher baseline ideation evidenced a superior reduction in suicidal ideation over the course of the study, relative to their counterparts in the standard care control condition.

Conclusion: Findings indicate that the A-CWS preventive intervention is efficacious in reducing suicidal ideation among African American adolescents with higher levels of baseline suicidal ideation and that effects sustain over time, with the strongest effect evidenced 12 months postintervention. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:近年来,非裔美国青少年的自杀率呈指数级增长。可能增加非裔美国青少年自杀风险的社会生态压力,加上这一群体中独特的自杀风险表现,需要对文化敏感的预防干预措施。本研究采用随机对照设计,检验了适应应对压力课程(A-CWS)的有效性,这是一种文化定制的预防干预措施,旨在减少非裔美国青少年的自杀意念。方法:参与者包括中西部大城市的410名九年级学生;大多数学生被认定为黑人/非裔美国人。参与者被随机分配到A-CWS干预或标准护理控制条件下。所有参与者在基线、干预后立即以及干预后6个月和12个月进行评估。结果:使用潜在生长模型检查治疗效果,比较控制和干预条件下的自杀意念轨迹。使用意向治疗和接受治疗样本(即至少参加80%疗程的干预条件参与者)进行分析。在意向治疗和接受治疗分析中,都存在显著的治疗效果:与标准护理对照条件下的个体相比,处于a-CWS干预条件下、基线意念较高的个体在研究过程中自杀意念显著降低。结论:研究结果表明,在基线自杀意念水平较高的非裔美国青少年中,A-CWS预防性干预在降低自杀意念方面是有效的,并且这种效果会随着时间的推移而持续,干预后12个月的效果最强。(PsycInfo数据库记录(c)2023 APA,保留所有权利)。
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引用次数: 0
The efficacy of cognitive behavioral therapies for depression in China in comparison with the rest of the world: A systematic review and meta-analysis. 认知行为疗法在中国治疗抑郁症的疗效与世界其他地区的比较:一项系统综述和荟萃分析。
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-02-01 Epub Date: 2023-10-30 DOI: 10.1037/ccp0000854
Xiao-Miao Li, Fang-Fang Huang, Pim Cuijpers, Huan Liu, Eirini Karyotaki, Zhan-Jiang Li, Clara Miguel, Marketa Ciharova, Keith Dobson

Objective: There is consistent evidence that cognitive behavioral therapies (CBTs) are effective interventions for adult depression. While some evidence has compared these effects in different countries, no prior systematic review and meta-analysis has compared the efficacy of CBTs between Chinese and people from the rest of the world. The current meta-analysis addressed this gap by a systematic review of eligible studies from Chinese and worldwide databases.

Method: Hedges' g was calculated using a random-effects model. Subgroup analyses and multilevel meta-analytic models were conducted to examine the relationship among effect sizes and the characteristics in Chinese studies. Metaregression analyses were conducted to explore the difference of the efficacy of CBTs between Chinese studies and non-Chinese studies after controlling for the moderators.

Results: A total of 34 (n = 3,710) studies in China and 307 (n = 30,333) studies from the rest of the world were included. The effect size of CBTs on depression for Chinese participants was 1.19 (95% CI [0.86, 1.52]), which was higher (Q = 4.63, p = .03) than the effect size of the rest of the world (0.82, 95% CI [0.74, 0.90]). After controlling for moderators, the effect size of Chinese studies was still higher than non-Chinese studies (β = 0.351, p = .011).

Conclusions: CBTs are effective interventions for adult depression and deserve more attention in China for depression management. Moderators related to study design, clinical features, and cultural factors need to be considered in the interpretation of the results. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:有一致的证据表明认知行为疗法是治疗成人抑郁症的有效干预措施。虽然一些证据比较了不同国家的这些效果,但此前没有系统综述和荟萃分析比较中国人和世界其他地区人的CBT疗效。目前的荟萃分析通过对中国和世界数据库中符合条件的研究进行系统综述来解决这一差距。方法:使用随机效应模型计算Hedges的g。采用亚组分析和多层次元分析模型考察了中国研究中效应大小与特征之间的关系。在控制了调节因子后,进行了元回归分析,以探讨中国研究和非中国研究之间CBT疗效的差异。结果:共纳入34项(n=3710)中国研究和307项(n=30333)来自世界其他地区的研究。中国参与者的CBT对抑郁的影响大小为1.19(95%CI[0.86,1.52]),高于世界其他地区的影响大小(0.82,95%CI[0.74,0.90])(Q=4.63,p=.03),中国研究的效果大小仍然高于非中国研究(β=0.351,p=.011)。结论:CBT是治疗成人抑郁症的有效干预措施,值得中国重视抑郁症的治疗。在解释结果时,需要考虑与研究设计、临床特征和文化因素相关的主持人。(PsycInfo数据库记录(c)2023 APA,保留所有权利)。
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引用次数: 0
Optimizing treatment expectations and decision making through informed consent for psychotherapy: A randomized controlled trial. 通过心理治疗的知情同意优化治疗期望和决策:一项随机对照试验。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-02-01 Epub Date: 2023-11-16 DOI: 10.1037/ccp0000851
Leonie Gerke, Franz Pauls, Sönke Ladwig, Sarah Liebherz, Klaus Michael Reininger, Levente Kriston, Manuel Trachsel, Martin Härter, Yvonne Nestoriuc

Objective: The objective of this research was to determine the efficacy and safety of an optimized informed consent (OIC) consultation for psychotherapy.

Method: We performed a randomized controlled superiority online trial involving 2 weeks of treatment and 3 months of follow-up. One hundred twenty-two adults with mental disorders confirmed by structured interview currently neither in out- nor inpatient psychotherapy (mean age: 32, gender identity: 51.6% female, 1.6% diverse), were randomized. Participants received an information brochure about psychotherapy for self-study (treatment as usual [TAU]; n = 61) or TAU plus a one-session OIC utilizing expectation management, contextualization, framing, and shared decision making (n = 61). The primary outcome was treatment expectations at 2-week follow-up.

Results: At 2-week follow-up, participants receiving OIC showed more positive treatment expectations compared to those receiving TAU only (mean difference: 0.70, 95% CI [0.36, 1.04]) with a medium effect size (d = 0.73). Likewise, OIC positively influenced motivation (d = 0.74) and adherence intention (d = 0.46). OIC entailed large effects on reduction of decisional conflict (d = 0.91) and increase of knowledge (d = 0.93). Participants receiving OIC showed higher capacity to consent to treatment (d = 0.63) and higher satisfaction with received information (d = 1.34) compared to TAU. No statistically significant group differences resulted for expected adverse effects of psychotherapy. Results were maintained at 3-month follow-up. Data sets for n = 10 cases (8.2%) were missing (postassessment n = 4, 2-week n = 6, 3-month follow-up n = 8).

Conclusions: Explaining to patients how psychotherapy works via a short consultation was effective in strengthening treatment expectations and decision making in a nonharmful way. Further trials clarifying whether this effectively translates to better treatment outcomes are required. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

目的:本研究的目的是确定一种优化的知情同意(OIC)心理治疗咨询的有效性和安全性。方法:我们进行了一项随机对照优势在线试验,包括2周的治疗和3个月的随访。通过结构化访谈确认的122名成人精神障碍患者目前既没有接受过门诊治疗也没有住院治疗(平均年龄:32岁,性别认同:51.6%为女性,1.6%为多元)被随机化。参与者收到一份关于心理治疗自学的信息手册(照常治疗[TAU];n = 61)或TAU加上利用期望管理、情境化、框架化和共享决策制定的一次会议OIC (n = 61)。主要结局是2周随访时的治疗预期。结果:在2周的随访中,与仅接受TAU治疗的参与者相比,接受OIC治疗的参与者表现出更积极的治疗预期(平均差异:0.70,95% CI[0.36, 1.04]),具有中等效应量(d = 0.73)。同样,OIC正向影响动机(d = 0.74)和依从性意愿(d = 0.46)。OIC对减少决策冲突(d = 0.91)和增加知识(d = 0.93)有很大的影响。与TAU相比,接受OIC的参与者表现出更高的同意治疗能力(d = 0.63)和更高的对接收信息的满意度(d = 1.34)。心理治疗预期不良反应的组间差异无统计学意义。结果在随访3个月时保持不变。n = 10例(8.2%)的数据集缺失(后评估n = 4, 2周n = 6, 3个月随访n = 8)。结论:通过简短的咨询向患者解释心理治疗如何起作用,可以有效地增强治疗预期和决策。需要进一步的试验来澄清这是否有效地转化为更好的治疗结果。(PsycInfo数据库记录(c) 2023 APA,版权所有)。
{"title":"Optimizing treatment expectations and decision making through informed consent for psychotherapy: A randomized controlled trial.","authors":"Leonie Gerke, Franz Pauls, Sönke Ladwig, Sarah Liebherz, Klaus Michael Reininger, Levente Kriston, Manuel Trachsel, Martin Härter, Yvonne Nestoriuc","doi":"10.1037/ccp0000851","DOIUrl":"10.1037/ccp0000851","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this research was to determine the efficacy and safety of an optimized informed consent (OIC) consultation for psychotherapy.</p><p><strong>Method: </strong>We performed a randomized controlled superiority online trial involving 2 weeks of treatment and 3 months of follow-up. One hundred twenty-two adults with mental disorders confirmed by structured interview currently neither in out- nor inpatient psychotherapy (mean age: 32, gender identity: 51.6% female, 1.6% diverse), were randomized. Participants received an information brochure about psychotherapy for self-study (treatment as usual [TAU]; <i>n</i> = 61) or TAU plus a one-session OIC utilizing expectation management, contextualization, framing, and shared decision making (<i>n</i> = 61). The primary outcome was treatment expectations at 2-week follow-up.</p><p><strong>Results: </strong>At 2-week follow-up, participants receiving OIC showed more positive treatment expectations compared to those receiving TAU only (mean difference: 0.70, 95% CI [0.36, 1.04]) with a medium effect size (<i>d</i> = 0.73). Likewise, OIC positively influenced motivation (<i>d</i> = 0.74) and adherence intention (<i>d</i> = 0.46). OIC entailed large effects on reduction of decisional conflict (<i>d</i> = 0.91) and increase of knowledge (<i>d</i> = 0.93). Participants receiving OIC showed higher capacity to consent to treatment (<i>d</i> = 0.63) and higher satisfaction with received information (<i>d</i> = 1.34) compared to TAU. No statistically significant group differences resulted for expected adverse effects of psychotherapy. Results were maintained at 3-month follow-up. Data sets for <i>n</i> = 10 cases (8.2%) were missing (postassessment <i>n</i> = 4, 2-week <i>n</i> = 6, 3-month follow-up <i>n</i> = 8).</p><p><strong>Conclusions: </strong>Explaining to patients how psychotherapy works via a short consultation was effective in strengthening treatment expectations and decision making in a nonharmful way. Further trials clarifying whether this effectively translates to better treatment outcomes are required. (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":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136397611","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 A Group-Based Transdiagnostic Sleep and Circadian Treatment for Major Depressive Disorder: A Randomized Controlled Trial 以小组为基础的跨诊断睡眠和昼夜节律治疗重度抑郁症的补充材料:随机对照试验
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-01-22 DOI: 10.1037/ccp0000869.supp
{"title":"Supplemental Material for A Group-Based Transdiagnostic Sleep and Circadian Treatment for Major Depressive Disorder: A Randomized Controlled Trial","authors":"","doi":"10.1037/ccp0000869.supp","DOIUrl":"https://doi.org/10.1037/ccp0000869.supp","url":null,"abstract":"","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139605929","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 Treatment Credibility as a Mechanism of Change in Cognitive Behavioral Therapy: Effects on Depression and Anxiety 作为认知行为疗法变化机制的治疗可信度的补充材料:对抑郁和焦虑的影响
IF 5.9 1区 心理学 Q1 Psychology Pub Date : 2024-01-08 DOI: 10.1037/ccp0000866.supp
{"title":"Supplemental Material for Treatment Credibility as a Mechanism of Change in Cognitive Behavioral Therapy: Effects on Depression and Anxiety","authors":"","doi":"10.1037/ccp0000866.supp","DOIUrl":"https://doi.org/10.1037/ccp0000866.supp","url":null,"abstract":"","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139446068","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
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Journal of consulting and clinical psychology
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