Danielle Wing Lam Ng, Rachel Ng, Ceci Guo, Julia Chan, Richard Fielding, Julia Wei Chun Tang, Wylie Wai Yee Li, Chi Chung Foo, Ava Kwong, Simon Siu-Man Ng, Dacita Suen, Sara Fung, Oi Kwan Chun, Karen Kar Loen Chan, Amy Tien Yee Chang, Phyllis Butow, Wendy Wing Tak Lam
Introduction: Fear of cancer recurrence (FCR) is a prominent clinical issue among cancer survivors. This study evaluated the effectiveness of the culturally adapted ConquerFear-HK intervention in reducing FCR among Chinese cancer survivors, compared to standard survivorship care.
Methods: This assessor-masked, two-arm parallel randomized controlled trial, was conducted from June 2021 to February 2024. Cantonese- or Mandarin-speaking Chinese cancer survivors scoring ≥13 on the Fear of Cancer Recurrence Inventory Short Form (FCRI-SF) were randomized to either ConquerFear-HK, focusing on attention training, metacognition modification, acceptance, appropriate monitoring behaviour, and goal setting or active control providing standardized, multidisciplinary survivorship care. Primary outcome was changes in FCR assessed by FCRI at prior randomization, immediately post-intervention (T1), 3 months (T2), and 6 months (T3) post-intervention. Intention-to-treat analyses using linear mixed modelling compared outcome changes across time points. This trial was registered at ClinicalTrials.gov (NCT04568226).
Results: Of the 175/220 (79.5%) participants recruited, 89 were randomized to ConquerFear-HK and 86 to control. Significant greater FCRI reductions were observed in ConquerFear-HK at T1 (mean difference = -10.66; 95% CI:-20.15, -1.16) and T2 (mean difference = -12.00; 95% CI:-21.90, -2.11) vs. the control (g = 0.33-0.36). No significant between-group differences were found at T3.
Conclusion: ConquerFear-HK demonstrates promising short-term (3-month) improvements in FCR among Chinese cancer survivors; however, no sustained benefits were found at 6 months. Possible explanations include the high attrition at 6-month follow-up, a potential early ceiling effect, unconscious therapist bias, or an accelerated adaptation effect in the intervention arm that was achieved later by the control group.
癌症复发恐惧（Fear of cancer recurrence， FCR）是癌症幸存者中一个突出的临床问题。本研究评估了文化适应性的征服者恐惧- hk干预在降低中国癌症幸存者的FCR方面的有效性，与标准的幸存者护理相比。方法：在2021年6月至2024年2月期间进行了一项评估器屏蔽的双臂平行随机对照试验。在癌症复发恐惧量表短表（FCRI-SF）中得分为bb0 - 13分的粤语或普通话中国癌症幸存者被随机分配到征服者恐惧- hk，重点是注意训练，元认知修正，接受，适当的监测行为和目标设定；或者主动控制，提供标准化的，多学科的生存护理。主要结局是FCRI在随机化前、干预后立即（T1）、干预后3个月（T2）和干预后6个月（T3）评估的FCR变化。使用线性混合模型的意向治疗分析比较了不同时间点的结果变化。该试验已在ClinicalTrials.gov注册（NCT04568226）。结果：在招募的175/220（79.5%）参与者中，89人随机分配到征服者恐惧- hk组，86人随机分配到对照组。在T1时，征服者恐惧- hk组观察到显著更大的FCRI降低(平均差=-10.66；95% CI:-20.15, -1.16)和T2(平均差异=-12.00；95%置信区间:-21.90,-2.11),与控制(g = 0.33 - -0.36)。T3组间无明显差异。结论：征服者恐惧- hk在中国癌症幸存者中显示出有希望的短期（3个月）改善FCR；然而，在6个月时没有发现持续的益处。可能的解释包括6个月随访期间的高损耗率，潜在的早期天花板效应，无意识的治疗师偏见，或干预组后来由对照组实现的加速适应效应。
{"title":"ConquerFear-HK: A Randomized Controlled Trial of a Metacognition-Based, Manualized Intervention for Fear of Cancer Recurrence among Chinese Cancer Survivors.","authors":"Danielle Wing Lam Ng, Rachel Ng, Ceci Guo, Julia Chan, Richard Fielding, Julia Wei Chun Tang, Wylie Wai Yee Li, Chi Chung Foo, Ava Kwong, Simon Siu-Man Ng, Dacita Suen, Sara Fung, Oi Kwan Chun, Karen Kar Loen Chan, Amy Tien Yee Chang, Phyllis Butow, Wendy Wing Tak Lam","doi":"10.1159/000547888","DOIUrl":"10.1159/000547888","url":null,"abstract":"<p><strong>Introduction: </strong>Fear of cancer recurrence (FCR) is a prominent clinical issue among cancer survivors. This study evaluated the effectiveness of the culturally adapted ConquerFear-HK intervention in reducing FCR among Chinese cancer survivors, compared to standard survivorship care.</p><p><strong>Methods: </strong>This assessor-masked, two-arm parallel randomized controlled trial, was conducted from June 2021 to February 2024. Cantonese- or Mandarin-speaking Chinese cancer survivors scoring ≥13 on the Fear of Cancer Recurrence Inventory Short Form (FCRI-SF) were randomized to either ConquerFear-HK, focusing on attention training, metacognition modification, acceptance, appropriate monitoring behaviour, and goal setting or active control providing standardized, multidisciplinary survivorship care. Primary outcome was changes in FCR assessed by FCRI at prior randomization, immediately post-intervention (T1), 3 months (T2), and 6 months (T3) post-intervention. Intention-to-treat analyses using linear mixed modelling compared outcome changes across time points. This trial was registered at <ext-link ext-link-type=\"uri\" xlink:href=\"http://ClinicalTrials.gov\" xmlns:xlink=\"http://www.w3.org/1999/xlink\">ClinicalTrials.gov</ext-link> (NCT04568226).</p><p><strong>Results: </strong>Of the 175/220 (79.5%) participants recruited, 89 were randomized to ConquerFear-HK and 86 to control. Significant greater FCRI reductions were observed in ConquerFear-HK at T1 (mean difference = -10.66; 95% CI:-20.15, -1.16) and T2 (mean difference = -12.00; 95% CI:-21.90, -2.11) vs. the control (g = 0.33-0.36). No significant between-group differences were found at T3.</p><p><strong>Conclusion: </strong>ConquerFear-HK demonstrates promising short-term (3-month) improvements in FCR among Chinese cancer survivors; however, no sustained benefits were found at 6 months. Possible explanations include the high attrition at 6-month follow-up, a potential early ceiling effect, unconscious therapist bias, or an accelerated adaptation effect in the intervention arm that was achieved later by the control group.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-17"},"PeriodicalIF":17.4,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laurian Hafkemeijer,Simon Hofman,Ad de Jongh,Dorien de Roos,Maaike van Velzen,Annemieke Starrenburg,Karin Slotema
Background Individuals with a personality disorder (PD) often report high exposure to adverse events. Given the strong link between negative life events and PD pathology, it is essential to evaluate trauma-focused treatments in this population. Objective This study evaluated the effectiveness of EMDR versus waitlist in reducing PTSD symptoms and diagnostic status, distinguishing between patients with and without PTSD. Secondarily, it examined the impact of EMDR on adverse event memories, both meeting and not meeting Criterion A for PTSD. Method Participants (n=159) were randomly assigned to EMDR therapy or waitlist. PDs were assessed using the Structured Clinical Interview for DSM-5. PTSD symptoms and diagnoses were evaluated using the Clinician-Administered PTSD Scale for DSM-5. Secondary analyses examined the effectiveness of EMDR on various types of memories. Results Significant group-by-time interactions showed a greater reduction in PTSD symptoms in the EMDR group, regardless of baseline PTSD diagnosis. In patients with PTSD, large effects were found post-treatment (d = 1.26; control: d = .28) and at follow-up (d = 1.5; control: d = .69). In patients without PTSD, moderate to large effects emerged post-treatment (d = .77; control: d = .18) and at follow-up (d = 1.09; control: d = .46). EMDR reduced symptoms associated with Criterion A trauma and other adverse events. Post-treatment, 65.5% of EMDR patients lost their PTSD diagnosis, increasing to 73.1% at follow-up. Conclusions EMDR effectively reduced PTSD symptoms in individuals with a PD, regardless of PTSD diagnosis, and proved effective for memories not meeting Criterion A.
{"title":"The effectiveness of EMDR Therapy on PTSD symptoms and diagnostic status in patients with a personality disorder: a Randomized Controlled Trial.","authors":"Laurian Hafkemeijer,Simon Hofman,Ad de Jongh,Dorien de Roos,Maaike van Velzen,Annemieke Starrenburg,Karin Slotema","doi":"10.1159/000547622","DOIUrl":"https://doi.org/10.1159/000547622","url":null,"abstract":"Background Individuals with a personality disorder (PD) often report high exposure to adverse events. Given the strong link between negative life events and PD pathology, it is essential to evaluate trauma-focused treatments in this population. Objective This study evaluated the effectiveness of EMDR versus waitlist in reducing PTSD symptoms and diagnostic status, distinguishing between patients with and without PTSD. Secondarily, it examined the impact of EMDR on adverse event memories, both meeting and not meeting Criterion A for PTSD. Method Participants (n=159) were randomly assigned to EMDR therapy or waitlist. PDs were assessed using the Structured Clinical Interview for DSM-5. PTSD symptoms and diagnoses were evaluated using the Clinician-Administered PTSD Scale for DSM-5. Secondary analyses examined the effectiveness of EMDR on various types of memories. Results Significant group-by-time interactions showed a greater reduction in PTSD symptoms in the EMDR group, regardless of baseline PTSD diagnosis. In patients with PTSD, large effects were found post-treatment (d = 1.26; control: d = .28) and at follow-up (d = 1.5; control: d = .69). In patients without PTSD, moderate to large effects emerged post-treatment (d = .77; control: d = .18) and at follow-up (d = 1.09; control: d = .46). EMDR reduced symptoms associated with Criterion A trauma and other adverse events. Post-treatment, 65.5% of EMDR patients lost their PTSD diagnosis, increasing to 73.1% at follow-up. Conclusions EMDR effectively reduced PTSD symptoms in individuals with a PD, regardless of PTSD diagnosis, and proved effective for memories not meeting Criterion A.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"37 1","pages":"1-21"},"PeriodicalIF":22.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
INTRODUCTIONSomatic diseases comorbid with depression exacerbate the health burden. The interoceptive neural circuit (INC) might mediate brain-body connections. We aimed to assess the causal relationship between somatic diseases, the INC, and depression.METHODSWe conducted Mendelian randomization (MR) analysis to determine the following: 1) the causal effect of four categories of systemic somatic diseases (ulcerative colitis, essential hypertension, chronic pain, and type 2 diabetes) on the INC's morphology; 2) the causal effect of INC morphology on depression; and 3) the INC's mediating role between somatic diseases and depression. A replication analysis confirmed the results above in other GWAS datasets. An extended analysis further validated the predictive role of the INC for depression in another systemic disease (asthma).RESULTSWe found all four systemic somatic diseases resulted in morphological changes in the INC, with shared reduced left ventral diencephalon (L-VDC). The morphological alterations of the INC increased depression risk, with the bilateral ventral thalamus most impacted. The L-VDC volume mediated the relationship between somatic diseases and depression, a finding validated across different datasets. The mediating role of the L-VDC in the relationship between somatic diseases and depression remains present in asthma.CONCLUSIONThe INC, particularly the L-VDC, plays a crucial role in the pathogenesis of depression and the intersection of somatic diseases. The INC mediates the progression from somatic diseases to comorbid depression, suggesting that interventions targeting the INC may prevent and alleviate the burden of comorbid somatic diseases and depression.
{"title":"Interoceptive Neural Circuits Mediating the Progression from Somatic Diseases to Comorbid Depression.","authors":"Hongliang Zhou,Chenguang Jiang,Wenhao Jiang,Zhenhe Zhou,Yonggui Yuan","doi":"10.1159/000547584","DOIUrl":"https://doi.org/10.1159/000547584","url":null,"abstract":"INTRODUCTIONSomatic diseases comorbid with depression exacerbate the health burden. The interoceptive neural circuit (INC) might mediate brain-body connections. We aimed to assess the causal relationship between somatic diseases, the INC, and depression.METHODSWe conducted Mendelian randomization (MR) analysis to determine the following: 1) the causal effect of four categories of systemic somatic diseases (ulcerative colitis, essential hypertension, chronic pain, and type 2 diabetes) on the INC's morphology; 2) the causal effect of INC morphology on depression; and 3) the INC's mediating role between somatic diseases and depression. A replication analysis confirmed the results above in other GWAS datasets. An extended analysis further validated the predictive role of the INC for depression in another systemic disease (asthma).RESULTSWe found all four systemic somatic diseases resulted in morphological changes in the INC, with shared reduced left ventral diencephalon (L-VDC). The morphological alterations of the INC increased depression risk, with the bilateral ventral thalamus most impacted. The L-VDC volume mediated the relationship between somatic diseases and depression, a finding validated across different datasets. The mediating role of the L-VDC in the relationship between somatic diseases and depression remains present in asthma.CONCLUSIONThe INC, particularly the L-VDC, plays a crucial role in the pathogenesis of depression and the intersection of somatic diseases. The INC mediates the progression from somatic diseases to comorbid depression, suggesting that interventions targeting the INC may prevent and alleviate the burden of comorbid somatic diseases and depression.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"13 1","pages":"1-20"},"PeriodicalIF":22.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
INTRODUCTIONAvoidant/restrictive food intake disorder (ARFID) occurs in individuals across all weight ranges and age groups. While previous studies primarily focused on children and individuals with underweight, research on ARFID in adults with higher weight is virtually non-existent. Therefore, this study aimed to examine whether adults with (1) ARFID symptoms and (2) ARFID diagnosis differ clinically based on weight status (underweight, normal weight, overweight/obesity).METHODSAdults from the population participated in an online survey and optional clinical interview to verify ARFID diagnostic criteria. Data from 369 adults with ARFID symptoms (online survey) and 77 adults with ARFID diagnosis (interview) were analyzed.RESULTSOverweight/obesity was present in 34% of the online (30 ± 9 years, 77% female) and 39% of the interview sample (29 ± 8 years, 62% female). Adults with both ARFID symptoms and ARFID diagnosis and overweight/obesity showed less lack of interest in eating, higher eating disorder psychopathology, and more metabolic comorbidities compared to those with underweight or normal weight. Additionally, adults with ARFID and overweight/obesity exhibited more psychosocial impairment than those with underweight (100% vs. 65%), but no weight loss due to restricted food intake. There were no group differences in terms of food neophobia, smell and texture sensitivities, and depressive symptoms.CONCLUSIONThis study provides a first detailed analysis of ARFID in adults as a function of weight status, emphasizing its relevance for diagnosis and treatment of ARFID. Future longitudinal studies are needed to explore the role of ARFID in the development and management of higher weight.
{"title":"Psychopathology in Adults with Co-occurring Avoidant/Restrictive Food Intake Disorder (ARFID) and Higher Weight.","authors":"Anne-Kathrin Merz,Lena Kramer,Alexander Nettlau,Anja Hilbert,Ricarda Schmidt","doi":"10.1159/000547450","DOIUrl":"https://doi.org/10.1159/000547450","url":null,"abstract":"INTRODUCTIONAvoidant/restrictive food intake disorder (ARFID) occurs in individuals across all weight ranges and age groups. While previous studies primarily focused on children and individuals with underweight, research on ARFID in adults with higher weight is virtually non-existent. Therefore, this study aimed to examine whether adults with (1) ARFID symptoms and (2) ARFID diagnosis differ clinically based on weight status (underweight, normal weight, overweight/obesity).METHODSAdults from the population participated in an online survey and optional clinical interview to verify ARFID diagnostic criteria. Data from 369 adults with ARFID symptoms (online survey) and 77 adults with ARFID diagnosis (interview) were analyzed.RESULTSOverweight/obesity was present in 34% of the online (30 ± 9 years, 77% female) and 39% of the interview sample (29 ± 8 years, 62% female). Adults with both ARFID symptoms and ARFID diagnosis and overweight/obesity showed less lack of interest in eating, higher eating disorder psychopathology, and more metabolic comorbidities compared to those with underweight or normal weight. Additionally, adults with ARFID and overweight/obesity exhibited more psychosocial impairment than those with underweight (100% vs. 65%), but no weight loss due to restricted food intake. There were no group differences in terms of food neophobia, smell and texture sensitivities, and depressive symptoms.CONCLUSIONThis study provides a first detailed analysis of ARFID in adults as a function of weight status, emphasizing its relevance for diagnosis and treatment of ARFID. Future longitudinal studies are needed to explore the role of ARFID in the development and management of higher weight.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"52 1","pages":"1-23"},"PeriodicalIF":22.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Franziska Mosler,Aikaterini Christogianni,Sam Singleton,Tim G Hales,Janine Rennie,Lesley A Colvin,Line Caes
Children exposed to adverse experiences (ACEs) are more likely to experience mental health problems in adulthood. However, ACE assessment is highly heterogeneous, hampering widespread screening and trauma-informed care provision. We aimed to systematically identify and critically evaluate all validated, self-report ACE questionnaires, working with people with lived experience (PWLE). The review followed PRISMA guidelines to systematically search databases for validated self-report measures, completed by adults, assessing at least two ACEs. Articles were excluded if they were not written in English, were not original articles, assessed poor childhood health or adverse experiences happening in adulthood, and/or only assessed one ACE. Psychometric properties were evaluated using Cohen's criteria for evidence-based assessments, the COSMIN checklist, and a content validity form co-designed with PWLE. We identified 112 eligible studies covering 31 ACE questionnaires. Cohen's criteria classified 9 questionnaires as "well-established" and 2 as "approaching well-established". No questionnaire was rated as "sufficient" quality across all the COSMIN measurement properties. The ACE Study-questionnaire, Childhood Experiences Survey (CES) and the ACE-International Questionnaire had the highest number of properties rated as sufficient. The Childhood Trauma Questionnaire-Short Form (CTQ-SF) was most frequently evaluated but received "insufficient" ratings across all measurement properties. PWLE scored content validity highest for the CES. Consequently, no ACE questionnaires received good psychometric ratings, with the most widely used questionnaire (CTQ-SF) not performing well, which has implications for selecting an appropriate instrument. With increasing emphasis on trauma-informed health care, there is an urgent need to co-develop ACE questionnaires with PWLE to balance content validity with usability.
{"title":"Assessing exposure to childhood adversity in adults: A systematic review of validated self-report childhood adversity questionnaires.","authors":"Franziska Mosler,Aikaterini Christogianni,Sam Singleton,Tim G Hales,Janine Rennie,Lesley A Colvin,Line Caes","doi":"10.1159/000547529","DOIUrl":"https://doi.org/10.1159/000547529","url":null,"abstract":"Children exposed to adverse experiences (ACEs) are more likely to experience mental health problems in adulthood. However, ACE assessment is highly heterogeneous, hampering widespread screening and trauma-informed care provision. We aimed to systematically identify and critically evaluate all validated, self-report ACE questionnaires, working with people with lived experience (PWLE). The review followed PRISMA guidelines to systematically search databases for validated self-report measures, completed by adults, assessing at least two ACEs. Articles were excluded if they were not written in English, were not original articles, assessed poor childhood health or adverse experiences happening in adulthood, and/or only assessed one ACE. Psychometric properties were evaluated using Cohen's criteria for evidence-based assessments, the COSMIN checklist, and a content validity form co-designed with PWLE. We identified 112 eligible studies covering 31 ACE questionnaires. Cohen's criteria classified 9 questionnaires as \"well-established\" and 2 as \"approaching well-established\". No questionnaire was rated as \"sufficient\" quality across all the COSMIN measurement properties. The ACE Study-questionnaire, Childhood Experiences Survey (CES) and the ACE-International Questionnaire had the highest number of properties rated as sufficient. The Childhood Trauma Questionnaire-Short Form (CTQ-SF) was most frequently evaluated but received \"insufficient\" ratings across all measurement properties. PWLE scored content validity highest for the CES. Consequently, no ACE questionnaires received good psychometric ratings, with the most widely used questionnaire (CTQ-SF) not performing well, which has implications for selecting an appropriate instrument. With increasing emphasis on trauma-informed health care, there is an urgent need to co-develop ACE questionnaires with PWLE to balance content validity with usability.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"15 1","pages":""},"PeriodicalIF":22.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer Schuffelen,Leonie F Maurer,Annika Gieselmann
INTRODUCTIONManaging chronic pain is a significant healthcare challenge requiring a multimodal approach. The frequent presence of comorbid insomnia and its bidirectional relationship with pain complicates treatment. This study tested whether adding digital cognitive behavioral therapy for insomnia (dCBT-I) to standard chronic pain treatment improves symptoms compared to a waitlist control (WLC).METHODSParticipants with chronic pain and insomnia were randomized (1:1) to dCBT-I or WLC. Assessments occurred at baseline, eight, and 24 weeks post-randomization. The primary outcome was insomnia severity (Insomnia Severity Index; ISI). Secondary outcomes included sleep- and pain-related symptoms, well-being, and dreams. Linear mixed models assessed between-group differences.RESULTSA total of 207 participants (182 women, mean age=51.96±12.97 years) were randomized to dCBT-I (n=103) or WLC (n=104). The dCBT-I group showed large improvements in insomnia severity versus WLC at both eight (-4.36, p<.001; d=-1.18) and 24 weeks (-4.88, p<.001; d=-1.32). Pain-related impairments and life control also improved, favoring dCBT-I (ds=0.22-0.35). Moderate-to-large effects were observed for secondary outcomes, including daytime sleepiness, fatigue, and dysfunctional sleep beliefs (ds=0.47-1.12).CONCLUSIONdCBT-I effectively reduces insomnia severity in individuals with chronic pain and insomnia. Improvements in chronic pain symptoms highlight its potential as a scalable, evidence-based intervention for multimodal pain management.
{"title":"The Effects of Digital Cognitive Behavioral Therapy for Insomnia in Chronic Pain: A Randomized Controlled Trial.","authors":"Jennifer Schuffelen,Leonie F Maurer,Annika Gieselmann","doi":"10.1159/000547436","DOIUrl":"https://doi.org/10.1159/000547436","url":null,"abstract":"INTRODUCTIONManaging chronic pain is a significant healthcare challenge requiring a multimodal approach. The frequent presence of comorbid insomnia and its bidirectional relationship with pain complicates treatment. This study tested whether adding digital cognitive behavioral therapy for insomnia (dCBT-I) to standard chronic pain treatment improves symptoms compared to a waitlist control (WLC).METHODSParticipants with chronic pain and insomnia were randomized (1:1) to dCBT-I or WLC. Assessments occurred at baseline, eight, and 24 weeks post-randomization. The primary outcome was insomnia severity (Insomnia Severity Index; ISI). Secondary outcomes included sleep- and pain-related symptoms, well-being, and dreams. Linear mixed models assessed between-group differences.RESULTSA total of 207 participants (182 women, mean age=51.96±12.97 years) were randomized to dCBT-I (n=103) or WLC (n=104). The dCBT-I group showed large improvements in insomnia severity versus WLC at both eight (-4.36, p<.001; d=-1.18) and 24 weeks (-4.88, p<.001; d=-1.32). Pain-related impairments and life control also improved, favoring dCBT-I (ds=0.22-0.35). Moderate-to-large effects were observed for secondary outcomes, including daytime sleepiness, fatigue, and dysfunctional sleep beliefs (ds=0.47-1.12).CONCLUSIONdCBT-I effectively reduces insomnia severity in individuals with chronic pain and insomnia. Improvements in chronic pain symptoms highlight its potential as a scalable, evidence-based intervention for multimodal pain management.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"3 1","pages":"1-35"},"PeriodicalIF":22.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ludwig Franke Föyen,Victoria Sennerstam,Evelina Kontio,Mats Lekander,Erik Hedman-Lagerlöf,Elin Lindsäter
Introduction Stress-related disorders, including adjustment disorder and exhaustion disorder, are associated with cognitive complaints and prolonged sickness absence (SA). This study evaluated the effects of cognitive behavioral therapy (CBT) compared with an active control treatment (entitled General Health Promotion; GHP) on these outcomes and examined the association between cognitive impairment and SA. Methods In this randomized clinical trial, 300 participants were randomized to CBT or GHP. SA data from the Swedish Social Insurance register were collected from one year before to one year after treatment. Cognitive functioning, assessed via a validated test battery, was measured at baseline, posttreatment, and one-year follow-up (1YFU). Hurdle negative binomial models evaluated SA and linear mixed-effects models analyzed cognitive outcomes. Results CBT and GHP had comparable effects on SA and cognitive functioning with no significant between-group effects (all p > .05). Analyzing effects across the entire sample, the number of SA days among those with any SA did not significantly change (p = .946) but the likelihood of having any SA decreased significantly by the 1YFU (OR = .92, 95% CI [.87, .96], p < .001). Independent of treatment group, overall cognitive functioning improved both posttreatment (d = -.42, 95% CI [-.6, -.25], p < .001) and at 1YFU (d = -.72, 95% CI [-.91, -.54], p < .001). Improvements in cognitive functioning pre to posttreatment were associated with fewer SA days at the 1YFU (IRR = .54, 95% CI [.33, .87], p = .01). Conclusion This study found no specific effect of CBT on SA or cognitive functioning for individuals with stress-related disorders. Cognitive functioning improved regardless of treatment. Early support before SA initiation is likely important to prevent long-term SA.
压力相关障碍，包括适应障碍和疲劳障碍，与认知疾病和长期缺勤（SA）有关。本研究评估了认知行为疗法（CBT）与积极对照治疗(一般健康促进；GHP)对这些结果进行了研究，并研究了认知障碍与SA之间的关系。方法在这项随机临床试验中，300名参与者被随机分为CBT组和GHP组。来自瑞典社会保险登记的SA数据从治疗前一年到治疗后一年收集。在基线、治疗后和1年随访（1YFU）时，通过一组有效的测试来评估认知功能。障碍负二项模型评估SA，线性混合效应模型分析认知结果。结果CBT和GHP对SA和认知功能的影响相当，组间无显著差异（p < 0.05）。分析整个样本的影响，有任何SA的人的SA天数没有显着变化（p = 0.946），但有任何SA的可能性显着降低了1YFU （OR = 0.92, 95% CI）。87, .96], p < .001)。与治疗组独立，治疗后整体认知功能改善(d = -。42, 95% ci[-]。6日-。[25], p < .001)和1YFU (d = -。72, 95% ci[-]。91年-。[54], p < 0.001)。治疗前后认知功能的改善与1YFU时SA天数的减少相关（IRR = 0.54, 95% CI）。33, .87], p = .01)。结论：本研究未发现CBT对应激相关障碍患者的SA或认知功能有特异性影响。无论治疗方式如何，认知功能都有所改善。SA开始前的早期支持可能对预防长期SA很重要。
{"title":"Long-Term Effects of Cognitive Behavioral Therapy on Sickness Absence and Cognitive Functioning in Patients with Stress-Related Disorders: Secondary Results from a Randomized Clinical Trial.","authors":"Ludwig Franke Föyen,Victoria Sennerstam,Evelina Kontio,Mats Lekander,Erik Hedman-Lagerlöf,Elin Lindsäter","doi":"10.1159/000547266","DOIUrl":"https://doi.org/10.1159/000547266","url":null,"abstract":"Introduction Stress-related disorders, including adjustment disorder and exhaustion disorder, are associated with cognitive complaints and prolonged sickness absence (SA). This study evaluated the effects of cognitive behavioral therapy (CBT) compared with an active control treatment (entitled General Health Promotion; GHP) on these outcomes and examined the association between cognitive impairment and SA. Methods In this randomized clinical trial, 300 participants were randomized to CBT or GHP. SA data from the Swedish Social Insurance register were collected from one year before to one year after treatment. Cognitive functioning, assessed via a validated test battery, was measured at baseline, posttreatment, and one-year follow-up (1YFU). Hurdle negative binomial models evaluated SA and linear mixed-effects models analyzed cognitive outcomes. Results CBT and GHP had comparable effects on SA and cognitive functioning with no significant between-group effects (all p > .05). Analyzing effects across the entire sample, the number of SA days among those with any SA did not significantly change (p = .946) but the likelihood of having any SA decreased significantly by the 1YFU (OR = .92, 95% CI [.87, .96], p < .001). Independent of treatment group, overall cognitive functioning improved both posttreatment (d = -.42, 95% CI [-.6, -.25], p < .001) and at 1YFU (d = -.72, 95% CI [-.91, -.54], p < .001). Improvements in cognitive functioning pre to posttreatment were associated with fewer SA days at the 1YFU (IRR = .54, 95% CI [.33, .87], p = .01). Conclusion This study found no specific effect of CBT on SA or cognitive functioning for individuals with stress-related disorders. Cognitive functioning improved regardless of treatment. Early support before SA initiation is likely important to prevent long-term SA.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"65 1","pages":"1-24"},"PeriodicalIF":22.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Research, Relevance and Responsibility - for Psychotherapy and Psychosomatics.","authors":"Stephan Zipfel","doi":"10.1159/000547206","DOIUrl":"https://doi.org/10.1159/000547206","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"27 1","pages":"1-7"},"PeriodicalIF":22.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psychomotor disturbances (PmD) emerge as common symptoms in many psychiatric diseases. However, currently it lacks a systematic description of PmD among different mental disorders, largely due to the heterogeneity of PmD manifestations. Here we conducted a systematic review and meta-analysis to investigate this question. The initial literature search covered the period from the emergence of the concept of "Psychomotor" (1937) to June 27, 2024, which identified 5,701 relevant articles, then purified into 35 cross-sectional studies encompassing five types of mental disorders with 1,828 participants for further analyses. Our results suggest that patients with various mental disorders may commonly exhibit psychomotor retardation (PmR), with subgroup analyses showing effect sizes ranging from -0.32 to -2.31 across five mental disorder types. Moreover, there is preliminary evidence that patients exhibiting PmR may also experience cognitive impairments compared to healthy controls. In sum, our results indicated that PmD may involve in clinical manifestations of different mental disorders.
{"title":"Assessing psychomotor disturbances among mental disorders: A systematic review and meta-analysis.","authors":"Liang-Yuan Song,Zhen Lyu,Ji-Yu Xie,Yi Zhang,Di Zhao,Antao Chen,Taicheng Huang,Ti-Fei Yuan","doi":"10.1159/000546909","DOIUrl":"https://doi.org/10.1159/000546909","url":null,"abstract":"Psychomotor disturbances (PmD) emerge as common symptoms in many psychiatric diseases. However, currently it lacks a systematic description of PmD among different mental disorders, largely due to the heterogeneity of PmD manifestations. Here we conducted a systematic review and meta-analysis to investigate this question. The initial literature search covered the period from the emergence of the concept of \"Psychomotor\" (1937) to June 27, 2024, which identified 5,701 relevant articles, then purified into 35 cross-sectional studies encompassing five types of mental disorders with 1,828 participants for further analyses. Our results suggest that patients with various mental disorders may commonly exhibit psychomotor retardation (PmR), with subgroup analyses showing effect sizes ranging from -0.32 to -2.31 across five mental disorder types. Moreover, there is preliminary evidence that patients exhibiting PmR may also experience cognitive impairments compared to healthy controls. In sum, our results indicated that PmD may involve in clinical manifestations of different mental disorders.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"19 1","pages":"1-21"},"PeriodicalIF":22.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144521030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michal Tanzer, Marina Bobou, Athanasios Koukoutsakis, Alkistis Saramandi, Paul M Jenkinson, Sam Norton, Caroline Selai, Katerina Fotopoulou
Introduction: Interoception, the sensing, awareness, and regulation of physiological states, is crucial for wellbeing and mental health. Behavioural interventions targeting interoception exist, but randomised controlled trials (RCTs) testing efficacy remain limited. The present, preregistered (ISRCTN16762367) RCT tested the novel Interoceptive iNsight and Metacognitive Efficacy beliefs (InMe) intervention. InMe uses slow breathing and cardiac biofeedback during stress to train interoceptive self-efficacy beliefs and improve self-reported interoception.
Methods: Healthy participants aged 18-30 years with low self-reported interoception were randomly assigned (1:1) to the InMe intervention (n = 50) or an active control (guided imagery; n = 52). Participants blinded to allocation were stratified by gender and disordered eating. Assessments included baseline (T0), post-intervention (T1), and 7-8 weeks post-intervention (T2). The primary outcome was the "adaptive interoception" factor of the Multidimensional Assessment of Interoceptive Awareness questionnaire.
Results: Both arms improved in the primary outcome at T1 (InMe: adjusted M difference = 5.76; 95% CI [-0.03; 11.56], p = 0.05; control: adjusted M difference = 7.90; 95% CI [1.92; 13.87], p = 0.002; marginal R2 = 0.09). However, only InMe sustained this improvement at T2 (InMe: adjusted M difference = 9.25, 95% CI [3.37; 15.13], p < 0.001; control: adjusted M difference = 2.94, 95% CI [-3.07; 8.96], p = 0.72), as indicated by a significant time*arm interaction (b = 6.31; SE = 2.92, 95% CI [0.56; 12.05], p < 0.03; marginal R2 = 0.12). Secondary outcomes showed a reduction in disordered eating scores across both arms at both time points (T1: b = -1.44, SE = 0.37, 95% CI [-2.17; -0.71], p < 0.001; T2: b = -1.05, SE = 0.37, 95% CI [-1.79; -0.32], p = 0.005).
Conclusion: The InMe intervention selectively improved self-reported interoception at follow-up but did not outperform the control for secondary outcomes. Future research should explore its efficacy in clinical populations alongside complementary therapies.
内感受是对生理状态的感知、意识和调节，对身心健康至关重要。针对内感受的行为干预措施是存在的，但随机对照试验（RCTs）测试效果仍然有限。目前，预注册的（ISRCTN16762367）随机对照试验测试了新的内感受性洞察力和元认知效能信念（InMe）干预。InMe在压力下使用慢呼吸和心脏生物反馈来训练内感受性自我效能感信念并改善自我报告的内感受。方法将年龄在18-30岁、自我报告内感受较低的健康参与者随机（1:1）分配到InMe干预组（n=50）或主动对照组(引导图像；n = 52)。对分配不知情的参与者按性别和饮食紊乱进行分层。评估包括基线（T0）、干预后（T1）和干预后7-8周（T2）。主要结果为内感受意识多维度评估问卷中的“适应性内感受”因子。结果：T1时，两组患者的主要转归均有改善(InMe：调整后M差=5.76；95%可信区间[-0.03,11.56],p = 0.05;对照：调整M差=7.90；95%可信区间[1.92,13.87],p = 0.002;边际R2 = 0.09)。然而，只有InMe在T2时维持了这种改善(InMe：调整后的M差=9.25,95%CI[3.37;15.13], p
{"title":"Biofeedback and Training of Interoceptive Insight and Metacognitive Efficacy Beliefs to Improve Adaptive Interoception: A Subclinical Randomised Controlled Trial.","authors":"Michal Tanzer, Marina Bobou, Athanasios Koukoutsakis, Alkistis Saramandi, Paul M Jenkinson, Sam Norton, Caroline Selai, Katerina Fotopoulou","doi":"10.1159/000546298","DOIUrl":"10.1159/000546298","url":null,"abstract":"<p><strong>Introduction: </strong>Interoception, the sensing, awareness, and regulation of physiological states, is crucial for wellbeing and mental health. Behavioural interventions targeting interoception exist, but randomised controlled trials (RCTs) testing efficacy remain limited. The present, preregistered (ISRCTN16762367) RCT tested the novel Interoceptive iNsight and Metacognitive Efficacy beliefs (InMe) intervention. InMe uses slow breathing and cardiac biofeedback during stress to train interoceptive self-efficacy beliefs and improve self-reported interoception.</p><p><strong>Methods: </strong>Healthy participants aged 18-30 years with low self-reported interoception were randomly assigned (1:1) to the InMe intervention (n = 50) or an active control (guided imagery; n = 52). Participants blinded to allocation were stratified by gender and disordered eating. Assessments included baseline (T0), post-intervention (T1), and 7-8 weeks post-intervention (T2). The primary outcome was the \"adaptive interoception\" factor of the Multidimensional Assessment of Interoceptive Awareness questionnaire.</p><p><strong>Results: </strong>Both arms improved in the primary outcome at T1 (InMe: adjusted M difference = 5.76; 95% CI [-0.03; 11.56], p = 0.05; control: adjusted M difference = 7.90; 95% CI [1.92; 13.87], p = 0.002; marginal R2 = 0.09). However, only InMe sustained this improvement at T2 (InMe: adjusted M difference = 9.25, 95% CI [3.37; 15.13], p < 0.001; control: adjusted M difference = 2.94, 95% CI [-3.07; 8.96], p = 0.72), as indicated by a significant time*arm interaction (b = 6.31; SE = 2.92, 95% CI [0.56; 12.05], p < 0.03; marginal R2 = 0.12). Secondary outcomes showed a reduction in disordered eating scores across both arms at both time points (T1: b = -1.44, SE = 0.37, 95% CI [-2.17; -0.71], p < 0.001; T2: b = -1.05, SE = 0.37, 95% CI [-1.79; -0.32], p = 0.005).</p><p><strong>Conclusion: </strong>The InMe intervention selectively improved self-reported interoception at follow-up but did not outperform the control for secondary outcomes. Future research should explore its efficacy in clinical populations alongside complementary therapies.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-23"},"PeriodicalIF":17.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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