Journal of Behavioral and Cognitive Therapy最新文献_第2页

Design and preliminary evaluation of AYRE: A virtual reality-based intervention for the treatment of emotional disorders AYRE的设计和初步评估：一种基于虚拟现实的情绪障碍治疗干预

IF 1.6 Q3 PSYCHIATRY

Journal of Behavioral and Cognitive Therapy

Pub Date : 2025-11-03 DOI: 10.1016/j.jbct.2025.100560

Zoilo Emilio García-Batista , Kiero Guerra-Peña , Ivan Alsina Jurnet , Antonio Cano-Vindel , Adriana Álvarez-Hernández , Solmary Herrera-Martinez , Marlia Bordas , Isis Cruz , Leonardo A. Medrano

Difficulties in emotional regulation are a key transdiagnostic challenge in mental health, contributing to the development and maintenance of anxiety and depression. Virtual reality (VR)-based interventions have emerged as promising tools to enhance emotional skills through immersive and interactive environments. This study presents a preliminary evaluation of Assistance for Emotional Regulation (AYRE), an innovative VR intervention that integrates mindfulness, diaphragmatic breathing, and progressive muscle relaxation; three evidence-based techniques combined for the first time in a fully immersive therapeutic setting.

A total of 123 adults from the Dominican Republic (mean age = 28.4 years; 62.6 % women) participated in the study. The intervention consisted of a single 1-hour AYRE session, delivered in a controlled laboratory setting at the university. The study followed a pre–post design without a control group, with anxiety and depressive symptoms assessed immediately before and after the intervention. After a single AYRE session, participants reported meaningful reductions in anxiety and depressive symptoms. Regression analyses showed that higher baseline levels of anxiety and depression were the only significant predictors of post-intervention improvement. Participants evaluated AYRE positively, describing the experience as “calming,” “intuitive,” and “more engaging than traditional techniques.” These impressions support AYRE’s feasibility and user acceptability in real-world settings.

In conclusion, AYRE appears to be a promising and scalable digital tool for supporting emotional regulation. Its integration of validated techniques into a personalized and immersive VR environment suggests potential for complementing traditional mental health interventions and improving access to care in underserved contexts.

情绪调节困难是心理健康中的一个关键的跨诊断挑战，有助于焦虑和抑郁的发展和维持。基于虚拟现实（VR）的干预措施已经成为通过沉浸式和交互式环境提高情感技能的有前途的工具。本研究对情绪调节辅助（AYRE）进行了初步评估，AYRE是一种创新的VR干预，整合了正念、膈呼吸和渐进式肌肉放松；三种基于证据的技术首次在完全沉浸式治疗环境中结合。来自多米尼加共和国的123名成年人（平均年龄28.4岁，62.6%为女性）参与了这项研究。干预包括一个1小时的AYRE会话，在大学的受控实验室环境中进行。该研究采用前后设计，没有对照组，在干预前后立即评估焦虑和抑郁症状。在一次AYRE治疗后，参与者报告焦虑和抑郁症状明显减轻。回归分析显示，较高的焦虑和抑郁基线水平是干预后改善的唯一显著预测因素。参与者对AYRE的评价是积极的，他们将这种体验描述为“平静”、“直观”和“比传统技术更吸引人”。这些印象支持AYRE在现实环境中的可行性和用户可接受性。总之，AYRE似乎是一个有前途的、可扩展的支持情绪调节的数字工具。它将经过验证的技术整合到个性化和沉浸式虚拟现实环境中，这表明有可能补充传统的精神卫生干预措施，并改善在服务不足的情况下获得护理的机会。

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引用次数: 0

Reconceptualizing cultural adaptation in cognitive behavioral therapy through a cross-paradigmatic synthesis of empirical strategies, therapeutic outcomes, and transformative frameworks 通过经验策略、治疗结果和变革框架的跨范式综合，重新定义认知行为治疗中的文化适应

IF 1.6 Q3 PSYCHIATRY

Journal of Behavioral and Cognitive Therapy

Pub Date : 2025-10-25 DOI: 10.1016/j.jbct.2025.100557

Sesilianus Fau , M. Ramli , Nur Hidayah , Tutut Chusniyah , Pakorn Akkakanjanasupar

Cognitive behavioral therapy (CBT) is effective across disorders, yet its cultural adaptability remains under-theorized and inconsistently evaluated. This review examines how cultural adaptations of CBT are designed, evaluated, and interpreted across epistemological paradigms. We conducted a PRISMA − guided systematic review of empirical studies on culturally adapted CBT (CA-CBT) published between 2014 and 2024. Searches were conducted in Scopus (final search: 15 February 2024). Eligible studies were coded using a structured extraction matrix and analyzed via reflexive thematic analysis within a cross-paradigmatic framework. Most studies adopted a positivist orientation (74 %, n = 26), with fewer interpretivist designs (26 %, n = 9) and none explicitly critical. Across settings, cultural adaptation was generally associated with improvements in symptoms, engagement, and retention – particularly when deep-structure modifications, such as integrating religious frameworks, culturally resonant metaphors, and community participation, were implemented. Effects varied by population and context, underscoring heterogeneity and the need for cautious interpretation and careful implementation. Interpretivist contributions illuminated cultural safety, therapeutic alliance, and identity restoration – dimensions rarely captured by symptom metrics. Overall, the findings support reframing cultural adaptation as a transformative process rather than a peripheral technical adjustment. We offer a pragmatic framework that aligns empirical rigor with cultural legitimacy and, with attention to structural responsiveness, to inform research design, therapist training, and policy aimed at context-responsive and equitable CBT globally.

认知行为疗法（CBT）是有效的跨障碍，但其文化适应性仍然缺乏理论和不一致的评估。本综述探讨了认知行为疗法的文化适应性是如何设计、评估和跨认识论范式解释的。我们对2014年至2024年间发表的文化适应性CBT （CA-CBT）的实证研究进行了PRISMA引导的系统综述。在Scopus中进行检索（最终检索：2024年2月15日）。使用结构化提取矩阵对符合条件的研究进行编码，并在交叉范式框架内通过反身性主题分析进行分析。大多数研究采用实证主义取向（74%,n = 26），较少的解释主义设计（26%,n = 9），没有明确的批评。在各种情况下，文化适应通常与症状、参与和保留的改善有关——特别是在实施深层结构修改时，例如整合宗教框架、文化共鸣隐喻和社区参与。影响因人口和环境而异，突出了异质性，需要谨慎解释和认真执行。解释主义者的贡献阐明了文化安全、治疗联盟和身份恢复——这些维度很少被症状度量所捕捉。总体而言，研究结果支持将文化适应重新定义为一个变革过程，而不是外围技术调整。我们提供了一个务实的框架，将经验的严谨性与文化的合法性结合起来，并关注结构的响应性，为研究设计、治疗师培训和政策提供信息，旨在全球范围内响应上下文和公平的CBT。

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引用次数: 0

Linguistic and cultural adaptation of internet-based cognitive behavioral therapy for tinnitus to Indian English: Methods and readability outcomes 基于互联网的耳鸣认知行为疗法对印度英语的语言和文化适应：方法和可读性结果

IF 1.6 Q3 PSYCHIATRY

Journal of Behavioral and Cognitive Therapy

Pub Date : 2025-10-18 DOI: 10.1016/j.jbct.2025.100558

Hari Prakash Palaniswamy , Harini Vasudevan , Aparna Oak , Keerthana Rajanbabu , Vinaya Manchaiah , Eldré Beukes , Gerhard Andersson

Background

Tinnitus often causes distress, irritability, difficulty sleeping, and lack of concentration due to its consistent persistence. Cognitive behavioral therapy (CBT) is a proven psychological treatment that can reduce tinnitus-related distress and can be provided via the Internet (ICBT). Such evidence-based, accessible treatments are not yet available in India. The increasing access to eHealth interventions in India will support and increase access to interventions like ICBT. This study aims to adapt ICBT for tinnitus to Indian English, ensuring it is culturally, linguistically, and contextually appropriate for the Indian population.

Method

The material was carefully reviewed by an audiologist, a linguist, a psychologist and a psychiatrist. The adaptation procedure primarily followed the ISPOR Principles of Good Practice for the translation and cultural adaptation, with a few adaptations from the Ecological validity model. Conflicts were resolved with consensus among all professionals. Then, the content was validated by the psychologist and psychiatrist. Additionally, readability adjustments ensured comprehensibility of the target population.

Results

A total of 76 (54 words and 22 phrases) were recommended for modification for reasons including cultural adaptation, lexicon, linguistic relevance, and concept coverage. Lexicons were the highest reason (52%) for modification. The material was critically validated by the expert committee and finalized based on comprehensibility, cultural appropriateness, and concept coverage, as the average scores were above 8 (benchmark pre-determined) for all modules. The readability scores also fell within the pre-determined criteria to finalize the material.

Conclusion

This material has been adapted and validated for the Indian population, and it can now be further developed as a treatment program. This represents a significant step towards establishing standard, evidence-based tinnitus treatment protocols in India. Further studies should examine the feasibility, efficacy, and effectiveness of ICBT for the Indian population through clinical trials.

背景：耳鸣由于持续存在，经常引起痛苦、易怒、睡眠困难和注意力不集中。认知行为疗法（CBT）是一种经过验证的心理治疗方法，可以通过互联网（ICBT）提供，可以减少耳鸣相关的痛苦。印度目前还没有这种循证的、可获得的治疗方法。印度越来越多地获得电子卫生干预措施将支持和增加获得ICBT等干预措施的机会。本研究旨在使耳鸣的ICBT适应印度英语，确保它在文化上、语言上和语境上适合印度人口。方法由一名听力学家、一名语言学家、一名心理学家和一名精神科医生仔细审阅材料。顺应过程主要遵循ISPOR翻译和文化顺应的良好实践原则，少数顺应来自生态效度模型。冲突在所有专业人员的共识下得到解决。然后，由心理学家和精神科医生对内容进行验证。此外，可读性调整确保了目标人群的可理解性。结果基于文化适应、词汇、语言相关性和概念覆盖等原因，共推荐修改76个词（54个词，22个短语）。词典是修改最多的原因（52%）。专家委员会对材料进行了严格的验证，并根据可理解性、文化适宜性和概念覆盖率最终确定，因为所有模块的平均分数都在8分以上（基准预先确定）。可读性分数也落在确定材料的预先确定的标准之内。结论：该材料已适应并验证了印度人群，现在可以进一步发展为一种治疗方案。这是朝着在印度建立标准的、以证据为基础的耳鸣治疗方案迈出的重要一步。进一步的研究应该通过临床试验来检验ICBT对印度人群的可行性、有效性和有效性。

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引用次数: 0

Exploring the correlation between engagement and sensory behaviors in children with autism using a portable dual-mode bubble tube in passive and active modes of operation 应用便携式双模气泡管在被动和主动操作模式下探讨自闭症儿童参与与感觉行为的关系

IF 1.6 Q3 PSYCHIATRY

Journal of Behavioral and Cognitive Therapy

Pub Date : 2025-10-18 DOI: 10.1016/j.jbct.2025.100556

Dundi Umamaheswara Reddy , Kanaparthi V. Phani Kumar , Bandaru Ramakrishna , Ganapathy Sankar Umaiorubagam

Integrating multiple intervention strategies with Cognitive Behavioral Therapy (CBT) tailored for children with autism could improve therapeutic outcomes. However, there has been no direct empirical investigation on how these intervention strategies affect the engagement of children with autism, which further relates to their sensory profiles. This gap leads to a new study exploring the integration of a visually stimulating sensory device, such as Bubble Tube (BT), into classical CBT. BTs are commercially viable and frequently used in sensory rooms and are recognised for enhancing visual perception, supporting color recognition, and improving attention. Despite the widespread use of BTs in clinical interventions, differentiating the effectiveness of passive and active modes of operation has not been explored. Hence, an enhanced version of BT, a Dual Mode Interactive Bubble Tube (DMIBT), is proposed and experimented for its use in CBT. Like BT, the DMIBT can be operated in both active mode (child-controlled) and passive mode (therapist-controlled) to provide versatile visual stimulations by changes in color intensity, bubble speed, and color transitions. To better understand how children with autism engage with the bubble tube in both passive and active modes, a pilot study was conducted with twenty children (n = 20) diagnosed with Autism Spectrum Disorder for five weeks. From the findings it is evident that children’s engagement was significantly (p < 0.001) higher in the active mode compared to the passive mode, and the engagement scores were positively correlated with their sensory-seeking sensory profile scores in both passive(r = 0.871, p < 0.001) and active (r = 0.844, p < 0.001) modes. The results suggest that DMIBT, when operated in active mode, provides greater opportunities for engagement in children with autism and those who have strong sensory-seeking profiles. Furthermore, the real-time customisation of sensory outputs through DMIBT allows children to better enhance their sensory experiences, making it a promising strategy for integration into modern CBT methods. This can ensure active engagement to support sensory regulation, relaxation, or behavioral activation in children with autism.

将多种干预策略与为自闭症儿童量身定制的认知行为疗法（CBT）相结合，可以改善治疗效果。然而，这些干预策略如何影响自闭症儿童的参与还没有直接的实证研究，这进一步关系到他们的感官特征。这一差距导致了一项新的研究，探索将视觉刺激的感官设备（如Bubble Tube (BT)）整合到经典的CBT中。bt在商业上是可行的，经常用于感官室，被认为可以增强视觉感知，支持颜色识别，提高注意力。尽管在临床干预中广泛使用bt，但尚未探索区分被动和主动操作模式的有效性。因此，BT的一个增强版本，双模式交互气泡管（DMIBT），被提出并实验用于CBT。与BT一样，DMIBT可以在主动模式（儿童控制）和被动模式（治疗师控制）下操作，通过改变颜色强度、气泡速度和颜色过渡来提供多种视觉刺激。为了更好地了解自闭症儿童是如何在被动和主动模式下使用泡泡管的，我们对20名被诊断为自闭症谱系障碍的儿童（n = 20）进行了为期5周的初步研究。从研究结果可以看出，儿童在主动模式下的投入明显高于被动模式（p < 0.001），并且在被动模式下（r = 0.871, p < 0.001）和主动模式下（r = 0.844, p < 0.001），投入得分与他们的感官寻求感官特征得分呈正相关。结果表明，当dmbt在主动模式下运行时，为自闭症儿童和那些有强烈感官寻求特征的儿童提供了更多的参与机会。此外，通过DMIBT实时定制的感官输出可以让儿童更好地增强他们的感官体验，使其成为整合现代CBT方法的一个有前途的策略。这可以确保自闭症儿童积极参与以支持感觉调节、放松或行为激活。

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引用次数: 0

Clinician perspectives on using exposure to treat “not just right” symptoms in obsessive-compulsive disorder 临床医生对使用暴露治疗强迫症“不太对”症状的看法

IF 1.6 Q3 PSYCHIATRY

Journal of Behavioral and Cognitive Therapy

Pub Date : 2025-10-18 DOI: 10.1016/j.jbct.2025.100559

Rachel A. Schwartz , Madeline Hartig , Martin E. Franklin

Not Just Right (NJR) is a prevalent and debilitating presentation of obsessive–compulsive disorder (OCD) in which compulsions are performed to relieve a sense of incompleteness. Exposure plus response prevention (ERP) is the first-line OCD treatment but shows diminished effectiveness for NJR unless specifically tailored. How clinicians modify ERP for NJR OCD in practice—and to what effect—remains unknown. In this study, 96 mental health clinicians completed an online survey assessing their experiences and perceptions applying ERP with NJR symptoms. Clinicians generally viewed ERP to be effective for NJR OCD. Of 22 tailoring strategies surveyed (derived from the empirical literature), the large majority were endorsed by at least 30 % of clinicians and rated as at least “fairly helpful” for both adult and youth clients. The most frequently used ERP modifications (endorsed by ≥70 %) were informal functional assessment, designing exposures that specifically elicit NJR sensations, emphasizing tolerating discomfort, additional acceptance and mindfulness techniques, more gradual ritual prevention, and adding cognitive therapy. Expertise in ERP and NJR OCD was not related to the total number of tailoring strategies endorsed, the endorsement of any given strategy, or ERP’s perceived effectiveness; expertise was moderately correlated with the perceived helpfulness of 9 tailoring strategies. In addition, 12 novel tailoring strategies were identified from open-ended response items. Results support the view that ERP can be tailored to treat NJR OCD, highlight the relevance of inhibitory learning and acceptance and commitment therapy, and inform the development and evaluation of the first treatment protocol for NJR OCD. 249/250 words.

不只是正确（NJR）是强迫症（OCD）的一种普遍且令人虚弱的表现，在这种情况下，强迫行为是为了缓解一种不完整感。暴露加反应预防（ERP）是强迫症的一线治疗方法，但除非特别定制，否则对NJR的效果会降低。临床医生如何在实践中修改NJR强迫症的ERP -以及效果如何-仍然未知。在这项研究中，96名心理健康临床医生完成了一项在线调查，评估了他们在NJR症状中应用ERP的经历和看法。临床医生普遍认为ERP对NJR强迫症有效。在被调查的22种定制策略中（来自经验文献），大多数都得到了至少30%的临床医生的认可，并且对成人和青少年客户都至少“相当有帮助”。最常用的ERP修改（认可率≥70%）是非正式的功能评估，设计专门引起NJR感觉的暴露，强调容忍不适，额外的接受和正念技术，更渐进的仪式预防，以及增加认知治疗。ERP和NJR强迫症的专业知识与认可的剪裁策略总数、任何给定策略的认可或ERP的感知有效性无关；专业知识与9种剪裁策略的感知有用性存在适度相关。此外，从开放式回答项目中确定了12种新颖的裁剪策略。研究结果支持了ERP可用于NJR强迫症治疗的观点，强调了抑制性学习与接受承诺治疗的相关性，并为NJR强迫症第一治疗方案的制定和评估提供了信息。249/250单词。

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引用次数: 0

Adaptation and psychometric network analysis of the Psy-Flex in Peruvian population 秘鲁人群心理- flex的适应与心理测量网络分析

IF 1.6 Q3 PSYCHIATRY

Journal of Behavioral and Cognitive Therapy

Pub Date : 2025-10-14 DOI: 10.1016/j.jbct.2025.100555

Samy L. Huerta , Rose Barbaran-Alvarado , Aaron Travezaño-Cabrera , Lindsey W. Vilca

Psychological flexibility is a primary factor for mental health and is the main process addressed within Acceptance and Commitment Therapy (ACT). In this sense, different instruments have been created to measure this variable. However, their limitations are resolved with the Psy-Flex, a brief instrument that measures psychological flexibility from its six components and demonstrates adequate psychometric properties. Therefore, the present study aims to validate the Psy-Flex in the Peruvian population from a network analysis. The sample comprised 1040 participants, and the translation of the Psy-Flex from a previous study in Latin America was used, along with the PHQ-2, GAD-2, and MLQ, which had been previously validated in Peru. Additionally, content validity was assessed. The Exploratory Graph Analysis (EGA) determined the unidimensionality of the Psy-Flex, as well as the stability of the items, structural consistency, validity of other variables, and measurement invariance across gender. In conclusion, the results of adapting the Psy-Flex in Peru enable us to accurately measure psychological flexibility due to its brevity, sensitivity, psychometric evidence, and relevance.

心理灵活性是心理健康的主要因素，也是接受和承诺治疗（ACT）的主要过程。从这个意义上说，已经创建了不同的工具来测量这个变量。然而，他们的局限性解决了psyf - flex，一个简短的仪器，测量心理灵活性，从它的六个组成部分，并展示了足够的心理测量特性。因此，本研究旨在通过网络分析验证秘鲁人口中的Psy-Flex。样本包括1040名参与者，使用了先前在拉丁美洲研究中翻译的Psy-Flex，以及先前在秘鲁验证的PHQ-2， GAD-2和MLQ。此外，评估了内容效度。探索性图分析（EGA）确定了Psy-Flex的单维性，以及项目的稳定性、结构一致性、其他变量的有效性和跨性别的测量不变性。总之，在秘鲁采用Psy-Flex的结果使我们能够准确地测量心理灵活性，因为它的简洁、敏感、心理测量证据和相关性。

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引用次数: 0

Perception and memory of sleep/wake states: implications for the treatment of insomnia 睡眠/清醒状态的感知和记忆：对失眠治疗的启示

IF 1.6 Q3 PSYCHIATRY

Journal of Behavioral and Cognitive Therapy

Pub Date : 2025-09-19 DOI: 10.1016/j.jbct.2025.100539

Michael L. Perlis , Wallace B. Mendelson

Among the historically loose strands in insomnia research have been the observations that: 1. sleep produces a form of mesograde amnesia; 2. patients with insomnia tend to differ from good sleepers in their perception of sleep/wake states; and 3. That sleep state misperception is reversed by some hypnotics. This brief note suggests that these observations, made in the 1980s and 1990s, along with studies of the arousal thresholds from sleep and investigations of the amnesia associated with sleep, might have renewed relevance for our current understanding of the pathophysiology and treatment of insomnia.

在历史上对失眠研究的松散线索中，有以下观察结果：睡眠会产生一种中度健忘症；2. 失眠症患者对睡眠/清醒状态的感知往往与睡眠良好者不同；和3。这种对睡眠状态的误解会被一些催眠药物逆转。这篇简短的笔记表明，这些在20世纪80年代和90年代进行的观察，以及对睡眠唤醒阈值的研究和对与睡眠相关的健忘症的调查，可能与我们目前对失眠的病理生理学和治疗的理解有新的联系。

引用次数: 0

Efficacy of acceptance and commitment therapy (ACT) as a stand-alone treatment for bipolar disorder: protocol for a randomized controlled trial 接受和承诺疗法（ACT）作为双相情感障碍独立治疗的疗效：一项随机对照试验方案

IF 1.6 Q3 PSYCHIATRY

Journal of Behavioral and Cognitive Therapy

Pub Date : 2025-09-08 DOI: 10.1016/j.jbct.2025.100545

Tatiana Cohab Khafif , William Ferreira Perez , Sofia Hamoui , Clara Nardini , Taís Biazus , Sofia Dayan , Karla de Almeida Matthias , Ana Kleinman , Renatha El Rafihi-Ferreira , Beny Lafer

Background

Bipolar Disorder (BD) involves recurrent episodes of mania/hypomania and depression, causing significant impairment in quality of life, functioning, and sleep. Although Psychoeducation, Cognitive Behavioral Therapy, and Family-Focused Therapy show efficacy, especially for recurrence of new episodes, novel interventions targeting bipolar depression and subthreshold symptoms remain necessary. Acceptance and Commitment Therapy (ACT), with effectiveness demonstrated across multiple psychiatric disorders, may improve depressive symptoms, quality of life, and functioning in BD.

Objectives

This study examines ACT’s impact as a stand-alone intervention, alongside usual pharmacotherapy, on depressive symptoms in BD. Additional targets include quality of life, functioning, sleep quality, and psychological flexibility.

Methods

This randomized controlled trial will compare ACT plus usual treatment to usual treatment alone in adults aged 18–65 years with BD, experiencing a current depressive episode or subthreshold depression. The ACT group will undergo 12 weekly sessions. Measurements (baseline, post, 6, 9 and 12 months) will encompass depression symptoms (primary outcome), and functioning, quality of life, sleep quality, and psychological flexibility as secondaries. Analyses using linear mixed models or generalized estimating equations (GEE) will assess group differences over time.

Discussion

If ACT reduces depressive symptoms and improves related outcomes, it could serve as a valuable adjunct treatment min BD management. This protocol describes the study framework, assessment tools, and intervention approach, expanding understanding of strategies for addressing depressive phases and subthreshold symptoms in BD.

背景双相情感障碍（BD）包括反复发作的躁狂/轻躁狂和抑郁，导致生活质量、功能和睡眠的显著损害。尽管心理教育、认知行为疗法和以家庭为中心的疗法显示出疗效，特别是对新发作的复发，但针对双相抑郁和阈下症状的新干预措施仍然是必要的。接受和承诺疗法（ACT）在多种精神疾病中都有疗效，可以改善双相障碍患者的抑郁症状、生活质量和功能。目的本研究考察ACT作为一种独立干预手段，与常规药物治疗一起，对双相障碍患者抑郁症状的影响。其他目标包括生活质量、功能、睡眠质量和心理灵活性。方法：本随机对照试验将比较ACT +常规治疗与常规治疗单独治疗18-65岁双相障碍患者，当前经历抑郁发作或阈下抑郁症。ACT小组每周将进行12次会议。测量（基线、后、6、9和12个月）将包括抑郁症状（主要结果），功能、生活质量、睡眠质量和心理灵活性作为次要结果。使用线性混合模型或广义估计方程（GEE）的分析将评估组间随时间的差异。如果ACT能减轻抑郁症状并改善相关结果，它可以作为双相障碍治疗中有价值的辅助治疗。本研究方案描述了研究框架、评估工具和干预方法，扩大了对双相障碍抑郁期和阈下症状处理策略的理解。

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引用次数: 0

The effects of exercise intervention for restricted and repetitive behavior in children with autism spectrum disorder: A network meta-analysis 运动干预对自闭症谱系障碍儿童限制性和重复性行为的影响：网络荟萃分析

IF 1.6 Q3 PSYCHIATRY

Journal of Behavioral and Cognitive Therapy

Pub Date : 2025-09-07 DOI: 10.1016/j.jbct.2025.100549

Kanglin Wang, Fen Qiu, Jingbo Liu, Xinyu Yang

Objective

To compare the relative effects of different interventions on repetitive stereotyped behaviors in children with autism spectrum disorders, and to compare the roles of different interventions, to provide an evidence-based basis for developing effective Exercise prescription.

Methods

Literature from domestic and international databases such as Cochrane Library, PubMed, Web of Science, MEDLINE, PsycINFO, Embase, China Knowledge, Baidu Academic, and Wanfang was searched. The search encompassed the period from the inception of the database to July 21, 2024, with analysis conducted using RevMan 5.3 and Stata 15.0.

Results

A total of 10 studies were included in the analysis. Meta-regression analyses revealed that exercise interventions can effectively ameliorate repetitive and stereotyped behaviors in children with Autism Spectrum Disorder (ASD). Further subgroup analyses demonstrated significant differences in the effects of these interventions based on varying intervention cycles and the ages of the participants. To delve deeper into the impact of different interventions, reticulated Meta-analyses were conducted. The results indicated that ball games (SMD = −5.35 [-6.92, −3.77]), karate training (SMD = −0.93 [-1.68, −0.17]), and bicycle riding (SMD = −0.97 [-1.90, −0.04]) interventions played a significant role in reducing repetitive and stereotyped behaviors in children with ASD. Additionally, the cumulative probability ranking (SUCRA) results suggested that ball games may be the most effective means of improving these behaviors in children with ASD (SUCRA = 79).

Conclusion

Ball games showed the highest SUCRA ranking (79 %), but their clinical application is limited by significant heterogeneity (I² = 78 %), small sample size (10 RCTs, n = 245), and tool-specific effects (SMD = -4.2 in RBS-R vs. −1.1 in GARS-2). Subgroup analyses highlighted age (5–8 years) and duration (>9 weeks) as critical factors. Additionally, potential biases (e.g., unclear allocation concealment in 30 % of studies) and the need for larger, multi-center trials should be noted. Sports interventions may be optimized by combining ball games with karate or cycling.

目的比较不同干预措施对自闭症谱系障碍儿童重复性刻板行为的相对影响，并比较不同干预措施的作用，为制定有效的运动处方提供循证依据。方法检索Cochrane Library、PubMed、Web of Science、MEDLINE、PsycINFO、Embase、China Knowledge、百度Academic、万方等国内外数据库的文献。搜索涵盖了从数据库建立到2024年7月21日的这段时间，使用RevMan 5.3和Stata 15.0进行分析。结果共纳入10项研究。荟萃回归分析显示，运动干预可以有效改善自闭症谱系障碍（ASD）儿童的重复和刻板行为。进一步的亚组分析表明，基于不同的干预周期和参与者的年龄，这些干预措施的效果存在显著差异。为了更深入地研究不同干预措施的影响，我们进行了网状元分析。结果表明，球类运动（SMD = - 5.35[-6.92, - 3.77]）、空手道训练（SMD = - 0.93[-1.68, - 0.17]）和骑自行车（SMD = - 0.97[-1.90, - 0.04]）干预对减少ASD儿童的重复和刻板行为有显著作用。此外，累积概率排序（SUCRA）结果表明球类运动可能是改善ASD儿童这些行为的最有效手段（SUCRA = 79）。结论球类运动具有最高的SUCRA排名（79%），但其临床应用受到显著异质性（I2 = 78%）、小样本量（10个rct， n = 245）和工具特异性效应（RBS-R的SMD = -4.2 vs. gar -2的SMD = - 1.1）的限制。亚组分析强调年龄（5-8岁）和病程（>；9周）是关键因素。此外，应该注意潜在的偏倚（例如，30%的研究中不明确的分配隐藏）和需要更大规模的多中心试验。通过将球类运动与空手道或自行车运动相结合，可以优化运动干预。

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引用次数: 0

Cross-cultural adaptation and psychometric properties of the Cognitive Behavioral Avoidance Scale- CBAS in Brazilian adults 巴西成人认知行为回避量表的跨文化适应和心理测量特征

IF 1.6 Q3 PSYCHIATRY

Journal of Behavioral and Cognitive Therapy

Pub Date : 2025-09-07 DOI: 10.1016/j.jbct.2025.100550

Adriana Munhoz Carneiro , Pedro Henrique Nunes Souto , Alia Garrudo Guirado , Ricardo Alberto Moreno , Keith S. Dobson

Background

Avoidance behavior, defined as a tendency to escape or disengage from negative stimuli, is an important psychosocial component in Major Depressive Disorder (MDD), related to its maintenance and severity.

Objective

The importance of measuring this variable to enhance results in clinical interventions, this study realized a cross-cultural adaptation of the CBAS into Brazilian-Portuguese (CBAS-BR) and investigated its psychometric properties in clinical and non-clinical samples.

Methods

After the translation-back translation process by an expert committee review, the CBAS-BR was applied to a total of 310 adults (67 with major depressive disorder; 243 healthy controls). The Beck Depression Inventory-II (BDI-II), Montgomery–Åsberg Depression Rating Scale (MADRS), and the Depression Thought Scale (DTS) were also applied. Internal consistency (Cronbach’s α, McDonald’s ω), confirmatory factor analysis (CFA), and convergent validity were examined.

Results

The original four-factor structure (Behavioral Social, Behavioral non-social, Cognitive Social, and Cognitive non-social) showed excellent fit (CFI = 0.981, TLI = 0.979, RMSEA = 0.046, 90 % CI = 0.039–0.053 [p = 0.85]). Internal consistency was high for the total scale (Cronbach’s α = 0.96; McDonald’s ω = 0.96) and for each subscale (α = 0.86–0.92). The CBAS-BR has moderate to strong correlations with the DTS, BDI II, and MADRS, supporting convergent validity.

Conclusions

The CBAS-BR is a reliable and valid measure for assessing cognitive-behavioral avoidance in Brazilian adults. It’s expected that its use may contribute to detecting maladaptive avoidance patterns and to proposing more targeted activation strategies to reduce symptoms or relapses in MDD.

逃避行为被定义为逃避或脱离负面刺激的倾向，是重度抑郁症（MDD）中重要的社会心理组成部分，与其维持和严重程度有关。目的通过对巴西-葡萄牙语（CBAS- br）的跨文化调整，研究CBAS- br在临床和非临床样本中的心理测量特性。方法经专家委员会审核后，将CBAS-BR应用于310例成人（重度抑郁症患者67例，健康对照243例）。采用Beck抑郁量表- ii （BDI-II）、Montgomery -Åsberg抑郁评定量表（MADRS）和抑郁思维量表（DTS）。检验内部一致性（Cronbach’s α, McDonald’s ω）、验证性因子分析（CFA）和收敛效度。结果原四因素结构（行为社会、行为非社会、认知社会、认知非社会）拟合良好（CFI = 0.981, TLI = 0.979, RMSEA = 0.046, 90% CI = 0.039 ~ 0.053 [p = 0.85]）。总体量表（Cronbach 's α = 0.96; McDonald 's ω = 0.96）和各子量表（α = 0.86-0.92）的内部一致性较高。CBAS-BR与DTS、BDI II和MADRS有中强相关，支持收敛效度。结论CBAS-BR是一种可靠、有效的评估巴西成人认知行为回避的方法。预计它的使用可能有助于发现适应不良的回避模式，并提出更有针对性的激活策略，以减少重度抑郁症的症状或复发。

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