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Novel treatment based on acceptance and commitment therapy versus cognitive behavioral therapy for insomnia: A randomized comparative effectiveness trial in women veterans. 基于接受和承诺疗法与认知行为疗法治疗失眠的新疗法:一项针对女性退伍军人的随机比较有效性试验。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2023-11-01 Epub Date: 2023-08-03 DOI: 10.1037/ccp0000836
Jennifer L Martin, Gwendolyn C Carlson, Monica R Kelly, Yeonsu Song, Michael N Mitchell, Karen R Josephson, Sarah Kate McGowan, Najwa C Culver, Morgan A Kay, Alexander J Erickson, Katie S Saldana, Kimiko J May, Lavinia Fiorentino, Cathy A Alessi, Donna L Washington, Elizabeth M Yano

Objective: This randomized comparative effectiveness trial evaluated a novel insomnia treatment using acceptance and commitment therapy (ACT) among women veterans. Participants received either the acceptance and the behavioral changes to treat insomnia (ABC-I) or cognitive behavioral therapy for insomnia (CBT-I). The primary objectives were to determine whether ABC-I was noninferior to CBT-I in improving sleep and to test whether ABC-I resulted in higher treatment completion and adherence versus CBT-I.

Method: One hundred forty-nine women veterans with insomnia disorder (Mage = 48.0 years) received ABC-I or CBT-I. The main sleep outcomes were Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and sleep efficiency (SE) by actigraphy (objective) and sleep diary (subjective). Measures were collected at baseline, immediate posttreatment, and 3-month posttreatment follow-up. Treatment completion and adherence were assessed during the interventions.

Results: Both interventions improved all sleep outcomes from baseline to immediate posttreatment and 3-month posttreatment follow-up. At immediate posttreatment, ABC-I was statically noninferior for sleep diary SE and objective SE, but noninferiority was not statistically confirmed for ISI or PSQI total scores. At 3-month posttreatment follow-up, ABC-I was noninferior for all four of the key outcome variables. There was not a statistically significant difference between the number of participants who discontinued CBT-I (11%) versus ABC-I (18%; p = .248) before completing treatment. ABC-I was superior to CBT-I for some adherence metrics.

Conclusions: Overall, ABC-I was similar in effectiveness compared to CBT-I for the treatment of insomnia and may improve adherence to some behavioral elements of treatment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

目的:这项随机比较有效性试验评估了一种在女性退伍军人中使用接受和承诺疗法(ACT)的新型失眠治疗方法。参与者接受了治疗失眠的接受和行为改变(ABC-I)或失眠的认知行为疗法(CBT-I)。主要目的是确定ABC-I在改善睡眠方面是否不劣于CBT-I,并测试ABC-I是否比CBT-I更高的治疗完成率和依从性。方法:149名患有失眠障碍的女性退伍军人(Mage=48.0岁)接受ABC-I或CBT-I治疗。主要的睡眠结果是失眠严重程度指数(ISI)、匹兹堡睡眠质量指数(PSQI)和活动描记术(客观)和睡眠日记(主观)的睡眠效率(SE)。在基线、治疗后立即和治疗后3个月随访时收集测量结果。在干预期间评估治疗完成情况和依从性。结果:两种干预措施都改善了从基线到治疗后立即和治疗后3个月随访的所有睡眠结果。在治疗后即刻,ABC-I在睡眠日记SE和客观SE方面静态无劣效,但ISI或PSQI总分的无劣效性未得到统计学证实。在治疗后3个月的随访中,ABC-I在所有四个关键结果变量中均为非劣效。在完成治疗前停止CBT-I(11%)和ABC-I(18%;p=.248)的参与者人数之间没有统计学上的显著差异。ABC-I在某些依从性指标上优于CBT-I。结论:总的来说,ABC-I在治疗失眠方面与CBT-I的疗效相似,并可能提高对某些行为治疗要素的依从性。(PsycInfo数据库记录(c)2023 APA,保留所有权利)。
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引用次数: 0
Examining engagement effects in an adaptive preventive intervention for college student drinking. 研究大学生饮酒适应性预防干预的参与效果。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2023-11-01 Epub Date: 2023-08-31 DOI: 10.1037/ccp0000845
Megan E Patrick, Aparajita Sur, Brooke Arterberry, Sarah Peterson, Nicole Morrell, David M Vock

Objective: This study determined the characteristics of engagement and whether engagement in an adaptive preventive intervention (API) was associated with reduced binge drinking and alcohol-related consequences.

Method: Incoming students were recruited for a sequential multiple assignment randomized trial (SMART; N = 891, 62.4% female, 76.8% non-Hispanic White) with an assessment-only control group. The API occurred during the first semester of college, with outcomes assessed at the end of the semester. The API involved two stages. Stage 1 included universal intervention components (personalized normative feedback [PNF] and self-monitoring). Stage 2 bridged heavy drinkers to access additional resources. We estimated the effect of engagement in Stage 1 only and in the whole API (Stages 1 and 2) among the intervention group, and the effect of the API versus control had all students assigned an API engaged, on alcohol-related outcomes.

Results: Precollege binge drinking, intention to pledge a fraternity/sorority, and higher conformity motives were most associated with lower odds of Stage 1 engagement. Action (readiness to change) and PNF engagement were associated with Stage 2 engagement. API engagement was associated with significant reductions in alcohol-related consequences among heavy drinkers. Compared to the control, we estimated the API would reduce the relative increase in alcohol-related consequences from baseline to follow-up by 25%, had all API students engaged.

Conclusions: Even partial engagement in each component of the "light-touch" API rendered benefits. Analyses suggested that had all students in the intervention group engaged, the API would significantly reduce the change in alcohol-related consequences over the first semester in college. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

目的:本研究确定了参与的特征,以及参与自适应预防干预(API)是否与酗酒和酒精相关后果的减少有关。方法:招募来校学生参加一项连续的多任务随机试验(SMART;N=891,62.4%为女性,76.8%为非西班牙裔白人),对照组仅进行评估。API发生在大学第一学期,在学期末评估结果。API涉及两个阶段。第1阶段包括普遍干预部分(个性化规范性反馈[PNF]和自我监测)。第二阶段为重度饮酒者提供额外资源。我们估计了干预组中仅参与第1阶段和整个API(第1和第2阶段)对酒精相关结果的影响,以及API与对照组的影响,即所有被分配API参与的学生对酒精相关结果的影响。结果:大学前酗酒、承诺加入兄弟会/女生联谊会的意图以及较高的从众动机与第一阶段参与的几率较低最相关。行动(准备改变)和PNF参与与第2阶段参与相关。在重度饮酒者中,API的参与与酒精相关后果的显著降低相关。与对照组相比,我们估计,如果所有API学生都参与,API将使从基线到随访的酒精相关后果的相对增加减少25%。结论:即使部分参与“轻接触”API的每个组成部分也会带来好处。分析表明,如果干预组的所有学生都参与,API将显著减少大学第一学期与酒精相关的后果的变化。(PsycInfo数据库记录(c)2023 APA,保留所有权利)。
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引用次数: 0
Evaluating the effectiveness of concurrent sessions and counselors' attention allocation in online counseling. 评估在线咨询中并发会议和咨询师注意力分配的有效性。
IF 5.9 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2023-11-01 Epub Date: 2023-08-24 DOI: 10.1037/ccp0000831
Yucan Xu, Christian S Chan, Christy Tsang, Florence Cheung, Evangeline Chan, Paul S F Yip

Objective: With its anonymity and accessibility, text-based online counseling has shown great potential in reaching people with mental health needs. One strategy adopted to meet the service gap is concurrent counseling, that is, each counselor attending to more than one client at a time. To date, there is no reported evidence supporting its rationality and effectiveness. This study investigated the potential opportunities, effectiveness, and caveats in concurrent service delivery and identified the optimal cutoff number of concurrent sessions while maintaining the quality of service at or above a set threshold.

Method: We analyzed the transcript of 54,716 online counseling sessions from Open Up, a free, 24/7 text-based counseling service, to develop an attention score that measures the attention allocation of counselors and examined the impact of the counselor's attention allocation on client satisfaction and service outcomes.

Results: On average, compared to nonconcurrent sessions, concurrent sessions were longer, more likely to end prematurely, and had lower client satisfaction. We also identified an optimal attention score of approximately 0.4 (out of 1.0, which denotes full attention), which translates to two to three concurrent sessions.

Conclusions: This study provides empirical evidence for the feasibility of conducting multiple text-based sessions concurrently without compromising service quality and client experience. Our method of measuring the counselor attention allocation offers a way to systematically assess and evaluate concurrent sessions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

目的:基于文本的在线咨询具有匿名性和可访问性,在帮助有心理健康需求的人方面显示出巨大的潜力。为弥补服务差距而采取的一种策略是同时咨询,即每个咨询师一次照顾多个客户。到目前为止,没有任何证据支持其合理性和有效性。这项研究调查了并发服务提供的潜在机会、有效性和注意事项,并确定了在将服务质量保持在或高于设定阈值的情况下并发会话的最佳截止数量。方法:我们分析了Open Up的54716次在线咨询会议的记录,Open Up是一项免费的、全天候的基于文本的咨询服务,以制定一个注意力得分来衡量辅导员的注意力分配,并考察辅导员的注意力分配对客户满意度和服务结果的影响。结果:平均而言,与非同期会话相比,同期会话更长,更有可能提前结束,客户满意度更低。我们还确定了大约0.4的最佳注意力得分(满分1.0,表示完全注意力),这意味着两到三次同时进行。结论:本研究为在不影响服务质量和客户体验的情况下同时进行多个基于文本的会话的可行性提供了经验证据。我们测量辅导员注意力分配的方法提供了一种系统评估和评估同期会议的方法。(PsycInfo数据库记录(c)2023 APA,保留所有权利)。
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引用次数: 0
Supplemental Material for The Efficacy of Cognitive Behavioral Therapies for Depression in China in Comparison With the Rest of the World: A Systematic Review and Meta-Analysis 认知行为疗法治疗抑郁症在中国与世界其他地区的疗效比较:系统回顾和荟萃分析
1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2023-10-30 DOI: 10.1037/ccp0000854.supp
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引用次数: 0
Supplemental Material for Psychotherapies for the Treatment of Borderline Personality Disorder: A Systematic Review 边缘型人格障碍心理治疗补充材料:系统回顾
1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2023-10-30 DOI: 10.1037/ccp0000833.supp
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引用次数: 0
Treatment length and symptom improvement in prolonged exposure and present-centered therapy for posttraumatic stress disorder: Comparing dose-response and good-enough level models in two manualized interventions. 创伤后应激障碍长期暴露和以现状为中心的治疗的治疗时间和症状改善:比较两种手动干预的剂量反应和足够好的水平模型。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2023-10-01 Epub Date: 2023-07-20 DOI: 10.1037/ccp0000834
Johanna Thompson-Hollands, Carole A Lunney, Denise M Sloan, Shannon Wiltsey Stirman, Paula P Schnurr

Objective: The dose-response model of change in psychotherapy posits that each session of therapy is incrementally beneficial across patients. The contrasting good-enough level model suggests that patients improve at different rates in therapy and discontinue treatment when they are satisfied with their improvement. Support for each theory has been mixed, and many prior studies have relied on samples of patients receiving unstructured treatment approaches. We conducted this study to compare these two theories across two manualized treatments for posttraumatic stress disorder (PTSD).

Method: Two hundred eighty-four female veterans and military service members with PTSD (Mage = 44.79; 54.6% White non-Hispanic, 6.7% Black non-Hispanic, 37% other) were randomized to receive 10 sessions of prolonged exposure (PE), a trauma-focused therapy, or present-centered therapy (PCT), a non-trauma-focused therapy. Participants completed the PTSD Checklist (PCL) at even-numbered treatment sessions, and the timing of dropout/treatment completion was monitored.

Results: The point of highest risk for dropout differed between the treatments, with risk in PE corresponding to the beginning of imaginal exposures. In the PE condition, but not in PCT, a higher number of sessions completed increased the likelihood of achieving reliable clinically significant improvement. Across treatments, the rate of change in PTSD symptoms did not differ according to the number of sessions completed (b = 0.06, p = .687).

Conclusions: Findings support the dose-response model of change in psychotherapy. There were notable differences in dropout across the treatment conditions, including rates, timing, and implications for outcomes. These differences likely reflect differences in content between the protocols. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

目的:心理治疗变化的剂量反应模型认为,每一次治疗对患者都是递增的有益。对比良好水平模型表明,患者在治疗中的改善率不同,当他们对自己的改善感到满意时,停止治疗。对每种理论的支持都参差不齐,许多先前的研究都依赖于接受非结构化治疗方法的患者样本。我们进行了这项研究,以比较创伤后应激障碍(PTSD)的两种手动治疗方法中的这两种理论,或以当前为中心的治疗(PCT),一种非创伤为主的治疗。参与者在偶数次治疗中完成了创伤后应激障碍检查表(PCL),并监测了辍学/治疗完成的时间。结果:不同治疗的辍学最高风险点不同,PE的风险与想象暴露的开始相对应。在PE条件下,但在PCT条件下,完成的疗程数量越高,实现可靠的临床显著改善的可能性就越大。在不同的治疗中,创伤后应激障碍症状的变化率根据完成的疗程数没有差异(b=0.06,p=.687)。结论:研究结果支持心理治疗变化的剂量反应模型。不同治疗条件下的辍学率存在显著差异,包括发病率、时间和对结果的影响。这些差异可能反映了协议之间内容的差异。(PsycInfo数据库记录(c)2023 APA,保留所有权利)。
{"title":"Treatment length and symptom improvement in prolonged exposure and present-centered therapy for posttraumatic stress disorder: Comparing dose-response and good-enough level models in two manualized interventions.","authors":"Johanna Thompson-Hollands, Carole A Lunney, Denise M Sloan, Shannon Wiltsey Stirman, Paula P Schnurr","doi":"10.1037/ccp0000834","DOIUrl":"10.1037/ccp0000834","url":null,"abstract":"<p><strong>Objective: </strong>The dose-response model of change in psychotherapy posits that each session of therapy is incrementally beneficial across patients. The contrasting good-enough level model suggests that patients improve at different rates in therapy and discontinue treatment when they are satisfied with their improvement. Support for each theory has been mixed, and many prior studies have relied on samples of patients receiving unstructured treatment approaches. We conducted this study to compare these two theories across two manualized treatments for posttraumatic stress disorder (PTSD).</p><p><strong>Method: </strong>Two hundred eighty-four female veterans and military service members with PTSD (<i>M</i><sub>age</sub> = 44.79; 54.6% White non-Hispanic, 6.7% Black non-Hispanic, 37% other) were randomized to receive 10 sessions of prolonged exposure (PE), a trauma-focused therapy, or present-centered therapy (PCT), a non-trauma-focused therapy. Participants completed the PTSD Checklist (PCL) at even-numbered treatment sessions, and the timing of dropout/treatment completion was monitored.</p><p><strong>Results: </strong>The point of highest risk for dropout differed between the treatments, with risk in PE corresponding to the beginning of imaginal exposures. In the PE condition, but not in PCT, a higher number of sessions completed increased the likelihood of achieving reliable clinically significant improvement. Across treatments, the rate of change in PTSD symptoms did not differ according to the number of sessions completed (<i>b</i> = 0.06, <i>p</i> = .687).</p><p><strong>Conclusions: </strong>Findings support the dose-response model of change in psychotherapy. There were notable differences in dropout across the treatment conditions, including rates, timing, and implications for outcomes. These differences likely reflect differences in content between the protocols. (PsycInfo Database Record (c) 2023 APA, all rights reserved).</p>","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":" ","pages":"596-605"},"PeriodicalIF":4.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10527917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9840881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Interpersonal problems as a predictor of outcome in psychotherapy for depressive and anxiety disorders: A multilevel meta-analysis. 人际问题作为抑郁症和焦虑症心理治疗结果的预测因素:一项多层次荟萃分析。
IF 5.9 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2023-10-01 Epub Date: 2023-06-01 DOI: 10.1037/ccp0000828
Juan Martín Gómez Penedo, Christoph Flückiger

Objective: Although interpersonal problems are assumed to play an important role in the treatment of depression and anxiety, meta-analytic attempts to explore the association between interpersonal problems and outcome in psychotherapy for these patients are missing. This study aims to conduct a systematic review and meta-analytic synthesis of the association between patients' baseline interpersonal problems and outcome in psychotherapy for depressive and anxiety disorders.

Method: We conducted a three-level meta-analysis (i.e., disaggregating sampling variance, within-study variance, and between-study variance) of the interpersonal problems-outcome prediction (IPOP; as measured by the total distress factor of Inventory of Interpersonal Problems).

Results: We found 40 effect sizes (ESs) nested within 21 primary studies. The three-level model showed a significant aggregated effect size of IPOP, r = -.13, SE = 0.02, 95% CI [-.18, -.09]; t(39) = -5.71, p < .001; d = -0.27, with greater interpersonal distress being associated with worse psychotherapy outcome. Results showed significant heterogeneity across effect sizes with considerable variability across studies (I² = .39) and to a lower extent across reported outcomes (I² = .19). Graphical measures did not show evidence of a substantial publication bias.

Conclusions: This meta-analysis showed that baseline overall interpersonal problems are a small but robust negative predictor of psychotherapy outcome. Therapists might benefit from exploring patients' interpersonal problems at the beginning of therapy to enhance their prognostic inferences. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

目的:尽管人际关系问题被认为在抑郁症和焦虑症的治疗中发挥着重要作用,但在这些患者的心理治疗中,探索人际关系问题与结果之间关系的元分析尝试却很少。本研究旨在对抑郁症和焦虑症患者的基线人际问题与心理治疗结果之间的关系进行系统综述和元分析综合。方法:我们对人际问题结果预测(IPOP)进行了三级荟萃分析(即分解抽样方差、研究内方差和研究间方差)。结果:我们在21项主要研究中发现了40个效应大小。三级模型显示IPOP的聚集效应大小显著,r=-1.13,SE=0.02,95%CI[-.18,-.09];t(39)=-5.71,p<0.001;d=-0.27,人际关系痛苦越大,心理治疗结果越差。结果显示,效应大小之间存在显著的异质性,研究之间存在相当大的可变性(I²=0.39),报告结果之间的可变性较低(I²=1.19)。图形测量没有显示出实质性发表偏倚的证据。结论:这项荟萃分析表明,基线总体人际问题是心理治疗结果的一个小而有力的负面预测因素。治疗师可能受益于在治疗开始时探究患者的人际关系问题,以增强他们的预后推断。(PsycInfo数据库记录(c)2023 APA,保留所有权利)。
{"title":"Interpersonal problems as a predictor of outcome in psychotherapy for depressive and anxiety disorders: A multilevel meta-analysis.","authors":"Juan Martín Gómez Penedo,&nbsp;Christoph Flückiger","doi":"10.1037/ccp0000828","DOIUrl":"10.1037/ccp0000828","url":null,"abstract":"<p><strong>Objective: </strong>Although interpersonal problems are assumed to play an important role in the treatment of depression and anxiety, meta-analytic attempts to explore the association between interpersonal problems and outcome in psychotherapy for these patients are missing. This study aims to conduct a systematic review and meta-analytic synthesis of the association between patients' baseline interpersonal problems and outcome in psychotherapy for depressive and anxiety disorders.</p><p><strong>Method: </strong>We conducted a three-level meta-analysis (i.e., disaggregating sampling variance, within-study variance, and between-study variance) of the interpersonal problems-outcome prediction (IPOP; as measured by the total distress factor of Inventory of Interpersonal Problems).</p><p><strong>Results: </strong>We found 40 effect sizes (ESs) nested within 21 primary studies. The three-level model showed a significant aggregated effect size of IPOP, <i>r</i> = -.13, <i>SE</i> = 0.02, 95% CI [-.18, -.09]; <i>t</i>(39) = -5.71, <i>p</i> < .001; <i>d</i> = -0.27, with greater interpersonal distress being associated with worse psychotherapy outcome. Results showed significant heterogeneity across effect sizes with considerable variability across studies (<i>I</i>² = .39) and to a lower extent across reported outcomes (<i>I</i>² = .19). Graphical measures did not show evidence of a substantial publication bias.</p><p><strong>Conclusions: </strong>This meta-analysis showed that baseline overall interpersonal problems are a small but robust negative predictor of psychotherapy outcome. Therapists might benefit from exploring patients' interpersonal problems at the beginning of therapy to enhance their prognostic inferences. (PsycInfo Database Record (c) 2023 APA, all rights reserved).</p>","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":" ","pages":"562-573"},"PeriodicalIF":5.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9557743","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: 1
The impact of multiple-behavior HIV interventions as a function of regional disadvantages: An analysis of syndemics. 多种行为HIV干预措施对地区劣势的影响:综合征分析。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2023-10-01 Epub Date: 2023-07-06 DOI: 10.1037/ccp0000827
Man-Pui Sally Chan, Sicong Liu, Benjamin White, Angela Zhang, Yubo Zhou, Melody Leung, Wenhao Dai, Xi Liu, Marta Durantini, Qijia Ye, Lidia Palmese, Devlin O'Keefe, Dolores Albarracín

Objective: Disadvantaged populations, including inhabitants of developing countries as well as racial/ethnic and sexual minorities in the United States, are disproportionally burdened by human immunodeficiency virus (HIV) infection, delayed HIV diagnosis, and unfavorable HIV-treatment outcomes. HIV interventions targeting single behaviors (e.g., testing) in these populations have shown to be efficacious at producing behavioral and clinical change but have been unable to eliminate the social health disparities associated with syndemics (i.e., a set of connected risks, interacting synergistically, and contributing to excess burden of disease in a population).

Method: This meta-analysis of 331 reports (clusters; number of effect sizes [k] = 1,364) assessed whether multiple-behavior interventions that target clusters of syndemic risks are more efficacious for those in disadvantaged regions and social groups.

Results: Across the board, multiple-behavior interventions were more efficacious than single-behavior ones as well as passive control groups among samples from countries with lower log gross domestic product (GDP), lower Human Development Index (HDI), and lower Healthcare Access and Quality (HAQ) Index.

Conclusions: Within the United States, the efficacy of multiple-behavior interventions was similar across different levels of representation of racial/ethnic and sexual minorities. The analyses used robust variance estimation with small-sample corrections to assess the differential effects of multiple-behavior interventions and Egger Sandwich test with the multilevel meta-analysis approach to detect selection biases. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

目标:弱势群体,包括发展中国家的居民以及美国的种族/族裔和性少数群体,因人类免疫缺陷病毒(HIV)感染、HIV诊断延迟和不利的HIV治疗结果而承受着不成比例的负担。针对这些人群的单一行为(如检测)的HIV干预措施已被证明在产生行为和临床变化方面是有效的,但无法消除与综合征相关的社会健康差异(即一组相互关联的风险,协同作用,并导致人群疾病负担过重)331份报告(集群;效应大小数[k]=1364)评估了针对综合征风险集群的多种行为干预措施是否对弱势地区和社会群体更有效。结果:在来自国内生产总值对数(GDP)较低、人类发展指数(HDI)较低和医疗保健可及性和质量指数(HAQ)较低的国家的样本中,综合而言,多重行为干预比单一行为干预以及被动对照组更有效。结论:在美国,在不同种族/民族和性少数群体的代表性水平上,多种行为干预的效果相似。分析使用了小样本校正的稳健方差估计来评估多种行为干预的差异效应,并使用多水平荟萃分析方法的Egger Sandwich检验来检测选择偏差。(PsycInfo数据库记录(c)2023 APA,保留所有权利)。
{"title":"The impact of multiple-behavior HIV interventions as a function of regional disadvantages: An analysis of syndemics.","authors":"Man-Pui Sally Chan, Sicong Liu, Benjamin White, Angela Zhang, Yubo Zhou, Melody Leung, Wenhao Dai, Xi Liu, Marta Durantini, Qijia Ye, Lidia Palmese, Devlin O'Keefe, Dolores Albarracín","doi":"10.1037/ccp0000827","DOIUrl":"10.1037/ccp0000827","url":null,"abstract":"<p><strong>Objective: </strong>Disadvantaged populations, including inhabitants of developing countries as well as racial/ethnic and sexual minorities in the United States, are disproportionally burdened by human immunodeficiency virus (HIV) infection, delayed HIV diagnosis, and unfavorable HIV-treatment outcomes. HIV interventions targeting single behaviors (e.g., testing) in these populations have shown to be efficacious at producing behavioral and clinical change but have been unable to eliminate the social health disparities associated with syndemics (i.e., a set of connected risks, interacting synergistically, and contributing to excess burden of disease in a population).</p><p><strong>Method: </strong>This meta-analysis of 331 reports (clusters; number of effect sizes [<i>k</i>] = 1,364) assessed whether multiple-behavior interventions that target clusters of syndemic risks are more efficacious for those in disadvantaged regions and social groups.</p><p><strong>Results: </strong>Across the board, multiple-behavior interventions were more efficacious than single-behavior ones as well as passive control groups among samples from countries with lower log gross domestic product (GDP), lower Human Development Index (HDI), and lower Healthcare Access and Quality (HAQ) Index.</p><p><strong>Conclusions: </strong>Within the United States, the efficacy of multiple-behavior interventions was similar across different levels of representation of racial/ethnic and sexual minorities. The analyses used robust variance estimation with small-sample corrections to assess the differential effects of multiple-behavior interventions and Egger Sandwich test with the multilevel meta-analysis approach to detect selection biases. (PsycInfo Database Record (c) 2023 APA, all rights reserved).</p>","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":" ","pages":"574-595"},"PeriodicalIF":4.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10527151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9753057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Twelve-month follow-up: Comparative efficacy of cognitive therapy, behavior therapy, and cognitive behavior therapy for patients with insomnia. 12个月随访:认知疗法、行为疗法和认知行为疗法对失眠患者的疗效比较。
IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2023-10-01 Epub Date: 2023-02-23 DOI: 10.1037/ccp0000802
Laurel D Sarfan, Charles M Morin, Allison G Harvey

Objective: Treatments that alleviate insomnia over the long term are critical. We evaluated the relative long-term efficacy of cognitive therapy (CT), behavior therapy (BT), and cognitive behavior therapy (CBT) for insomnia.

Method: Patients (N = 188, 62.2% female, 81.1% White, 6.5% Hispanic or Latinx, Mage = 47.4 years) with insomnia were randomized to eight sessions of CT, BT, or CBT for insomnia. Assessments at pretreatment and 12-month follow-up measured insomnia severity, insomnia response/remission, sleep diary parameters, and daytime functioning.

Results: Patients in all three treatment groups improved on insomnia severity, sleep onset latency, wake after sleep onset, total sleep time, sleep efficiency, work and social adjustment, and mental health (ps < .05). Moreover, in each treatment group, a substantial proportion of patients achieved remission and response. CBT was associated with larger improvements in insomnia severity relative to CT as well as greater remission and improvements in physical health, relative to CT and BT (ps < .05). For patients with a psychiatric comorbidity, CBT was associated with greater improvements in work and social adjustment and mental health, relative to CT (ps < 0.05). CT was not associated with change in time in bed, and none of the treatment conditions were associated with change in daytime fatigue (ps > .05).

Conclusions: These encouraging results suggest that therapists may be able to offer CBT, BT, or CT to improve nighttime and daytime symptoms of insomnia over the long-term, with CBT offering a relative advantage for select outcomes and subgroups. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

目的:长期治疗失眠至关重要。我们评估了认知疗法(CT)、行为疗法(BT)和认知行为疗法(CBT)治疗失眠的相对长期疗效。方法:将患有失眠的患者(N=188,女性62.2%,白人81.1%,西班牙裔或拉丁裔6.5%,Mage=47.4岁)随机分为八组,分别接受CT、BT或CBT治疗。预处理和12个月随访的评估测量了失眠的严重程度、失眠反应/缓解、睡眠日记参数和日间功能。结果:三个治疗组的患者在失眠严重程度、睡眠开始潜伏期、睡眠开始后醒来、总睡眠时间、睡眠效率、工作和社会适应以及心理健康方面都有所改善(ps<.05)。此外,在每个治疗组中,相当大比例的患者都获得了缓解和缓解。与CT相比,CBT与失眠严重程度的更大改善以及与CT和BT相比,身体健康的更大缓解和改善相关(ps<.05)。对于患有精神病合并症的患者,与CT相比(ps<0.05),CBT在工作、社会适应和心理健康方面有更大改善。CT与卧床时间的变化无关,结论:这些令人鼓舞的结果表明,治疗师可能能够长期提供CBT、BT或CT来改善夜间和日间失眠症状,CBT在选择结果和亚组方面具有相对优势。(PsycInfo数据库记录(c)2023 APA,保留所有权利)。
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引用次数: 0
Clinical science and practice in the age of large language models and generative artificial intelligence. 大型语言模型和生成人工智能时代的临床科学与实践。
IF 5.9 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2023-10-01 DOI: 10.1037/ccp0000848
Stephen M Schueller, Robert R Morris

In this article, Schueller and Morris discuss the recent advances made from large language models (LLMs) and generative artificial intelligence (AI). These advances include supporting humans to provide better interventions, understanding processes in clinical interventions, and providing ethical considerations for the use of generative AI in clinical research and practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

在这篇文章中,Schueller和Morris讨论了大型语言模型(LLM)和生成人工智能(AI)的最新进展。这些进展包括支持人类提供更好的干预,理解临床干预的过程,以及为在临床研究和实践中使用生成性人工智能提供伦理考虑。(PsycInfo数据库记录(c)2023 APA,保留所有权利)。
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引用次数: 0
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Journal of consulting and clinical psychology
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