Journal of Behavioral and Cognitive Therapy最新文献

Self-compassion is the willingness to feel acceptance and kindness towards oneself. It is correlated with many health outcomes and is used in various research fields. This study focuses on the factorial structure of the short version of the self-compassion scale for a French population. Confirmatory factor analyses tested the structure of the French short version in comparison with the structure for the short version in other languages (1, 2, 3 and 6 factors). Results show that the 6-factor structure has the best-fit indices. The external validity of the 6-dimensional scale was then tested using different questionnaires targeting stress, self-esteem, affect and mindfulness. The results highlight the self-regulatory abilities, especially in stressful situations, of people with high self-compassion, and also distinguish self-compassion from related concepts such as mindfulness skills or self-esteem. Taken as a whole, the results reinforce the necessity to consider the 6 sub-dimensions as 6 specific and independent factors. This short version of the self-compassion scale, addressed to French speakers, reduces the time required to complete the questionnaire while still having access to a 6-dimensional structure.

Objectives

An up-and-coming concept that is gaining traction in the study of psychological states is psychological flexibility. This term refers to the individual’s ability to be fully present in real time, think with openness, and act in a way that promotes his or her life in ways important to the individual. To the best of our knowledge, no previous study in Israel has utilized Psy-Flex, a measurement tool for assessing psychological flexibility, and a Hebrew version of the tool has not been validated. This study aims to validate Psy-Flex-Heb by applying established validation protocols and leveraging insights from prior research on psychological flexibility measurements. The investigation delves into the associations between Psy-Flex-Heb and key psychological variables such as well-being, sense of meaning in life, and mindfulness. Additionally, the study rigorously examines and confirms the one-dimensional factor structure of Psy-Flex-Heb.

Methods

In this study, we conducted a psychometric evaluation by translating Psy-Flex into Hebrew (Psy-Flex-Heb) and examining its internal consistency and psychometric properties in 103 participants from the general population.

Results

The reliability of Psy-Flex-Heb scores based on Cronbach's alpha was 0.91. Confirmatory Factor Analysis showed that Psy-Flex-Heb fit a one-factor model. We found significant correlations between Psy-Flex-Heb, psychological flexibility (measured by.

Acceptance and Action Questionnaire – version 2 [AAQ-II]), well-being, meaning in life, and mindfulness.

Conclusions

The results strengthen the one-dimensional construct of psychological flexibility and show Psy-Flex-Heb is a reliable measure that can be useful in both research and practice.

Despite high prevalence of anxiety, current interventions for family carers of people with dementia are considered to be not as effective for anxiety as they are for depression. Understanding the mechanism by which a common stressor (i.e. carer subjective burden) and underlying psychological processes influence anxiety among this population is critical to inform these interventions. Roles of two psychological processes were explored: experiential avoidance in caregiving (attempt to control distressing thoughts/feelings related to caregiving) and cognitive fusion (tendency for one’s behaviour to be overly regulated by thoughts). With a sample of seventy-seven family carers, this study examined the indirect effect of carer subjective burden (ZBI-12) on anxiety (GAD-7) through experiential avoidance in caregiving (EACQ) and cognitive fusion (CFQ) using path analysis approach. The whole sample model showed a good fit to the data and accounted for 54 % of the variance in anxiety. The indirect effect of carer subjective burden on anxiety through its effect on cognitive fusion (β = 0.17), and its combined effect on experiential avoidance in caregiving and cognitive fusion (β = 0.01) were significant. Given the higher explanatory value of cognitive fusion alone, facilitating cognitive defusion through psychological interventions may be critical for preventing clinically significant levels of anxiety, particularly among those carers experiencing high levels of carer subjective burden. Results also demonstrated that carers with higher experiential avoidance in caregiving may be prone to cognitive fusion, which in turn could lead to greater anxiety. Therefore, early interventions targeting experiential avoidance may be beneficial for preventing increased cognitive fusion and anxiety.

Objective

The goal of the study was to conduct a pilot test of the effectiveness of Cognitive Processing Therapy (CPT) for the treatment of Posttraumatic Stress Disorder (PTSD) in Serious Mental Illness (SMI). Method: An open pilot trial was conducted at a certified community behavioral health center with 49 participants with major depressive, bipolar, or psychotic disorders to evaluate CPT which comprised of 12 individual weekly therapy sessions and included education about trauma and PTSD, emotional processing of the trauma, and cognitive restructuring of trauma-related stuck-point beliefs, with a specific focus on safety, trust, control, esteem, and intimacy. Results: The results demonstrated statistically significant changes in PTSD and depression symptoms and improvement in end-state functioning. Conclusion: Results demonstrate promising evidence of CPT in addressing PTSD and end-state functioning in the SMI population. Findings warrant rigorously designed trials with a focus on people with comorbid psychotic disorders and PTSD.

Objective

Increased physical activity may be associated with reduction in negative affect or increase in emotional self-efficacy, defined as one’s confidence to cope with negative affect, though these hypotheses have not been adequately empirically tested in individuals with anxiety-related disorders. We aimed to examine bi-directional associations among physical activity, negative affect, and emotional self-efficacy.

Methods

Data were collected from adult patients receiving cognitive behavior therapy (CBT) for anxiety (N = 35). Participants were provided with a Fitbit and completed ecological momentary assessment throughout their CBT, up to 20 weeks. We examined bi-directional relationships using linear mixed-effect models.

Results

Greater physical activity (steps) were significantly associated with same-day anxiety reduction and next-week depression reduction. Increased emotional self-efficacy was significantly associated with average physical activity in the next week.

Conclusions

Physical activity may bring direct emotional benefits for individuals receiving CBT for anxiety disorders. Clinicians should consider explicitly encouraging patients to increase physical activity after consulting with their physician as needed, through basic strategies like walking, and emotional self-efficacy could be a targeted precursor to encouraging physical activity.

Dimensional models provide a framework for characterizing psychopathology and personality disorders based on lower-order maladaptive traits, typically organized into five overarching domains: Negative Affect or Internalizing, Detachment, Antagonism, Disinhibition, and Psychoticism or Thought Disorder. Within the context of these dimensional models, the classification of Obsessive-Compulsive (OC) symptoms has raised questions, as they are often placed within the Negative Affect/Internalizing or Psychoticism/Thought Disorder domains. The discrepancy in their categorization may be attributed to the diversity in how these symptoms manifest. An alternative perspective involves the adoption of a measure associated with a vulnerability factor for OCD, which may transcend the specific symptoms of the disorder. In this study, our objective was to explore the association between 'Not Just Right Experiences' (NJREs) and the dimensions specified in the DSM-5 Alternative Model of Personality Disorders (AMPD). We utilized two distinct samples, one consisting of 978 participants and the other comprising 1004, all of whom were non-clinical individuals. Through a series of exploratory factor analyses conducted on the initial sample, we uncovered a hierarchical structure of general psychopathology. Within this structure, NJREs were situated within the AMPD's Psychoticism domain. Furthermore, the Psychoticism domain exhibited a strong and unique association with all OC symptoms, surpassing the influence of other AMPD components. A structural equation model applied to the second sample validated these findings, indicating that both the Psychoticism and Negative Affect played significant roles in explaining a substantial portion of the variance observed in NJRE measures. These outcomes have pertinent clinical implications, particularly in the context of Cognitive-Behavioral Therapy for individuals with OCD.

Aims

This paper aims at exploring the subjective experience, particularly in terms of acceptability and feasibility, of a mindfulness-based intervention for people with a psychotic disorder and social anxiety. Mindfulness interventions benefit from empirical support for decreasing anxiety in people with psychotic disorders, yet the effects on specific anxiety disorders, namely social anxiety, have scarcely been studied.

Methods

Three different studies were conducted in order to determine the feasibility and acceptability of the mindfulness intervention and of the use of homework and VR exposure for people with psychotic disorder and social anxiety: two single case studies (one with virtual reality) and a pilot study (n = 6).

Results

The intervention proposed was generally well-accepted and appreciated by the participants, but the meditation homework stood out as rather difficult for some participants. The virtual reality addition appeared to have a positive impact on the therapy, being also well-accepted and appreciated by the participant, but also considered stressfull.

Conclusions

This paper shows that the mindfulness-based intervention presented is feasible, appreciated by the participants and has potential to be useful and therapeutic in the context of social anxiety in people with a psychotic disorder, even though efficacy cannot be established in these exploratory studies. The added value of encouraging at-home practice and of using VR exposure to the treatment merits further investigation. Future studies are needed to determine the efficacy of the treatment, especially with the virtual reality exposure and homework encouragements.

Background

Patients’ expectations about psychotherapy are of great importance, since they can influence the outcome of psychotherapy. Thus, it is important to ensure that patients have positive expectations about the outcomes of psychotherapy. This is particularly relevant in patients with major depression, since they often hold (unrealistically) negative expectations and tend to maintain these expectations despite novel positive information. Here, we test the feasibility of a novel, ecologically valid experimental paradigm to investigate how depressed patients learn from other patients’ experiences with psychotherapy, and which cognitive mechanisms hinder the integration of novel positive information.

Method

N = 17 outpatients diagnosed with a major depressive disorder watched videotaped experience reports of five acting patients. Each acting patient was shown twice: first, before receiving psychotherapeutic treatment, where they reported on feeling depressed and pessimistic about their future; second, at the end of psychotherapy, where they reported on feeling better and having overcome the challenges they used to struggle with. Before and after watching the videos, participants rated their expectations for positive and negative future life events.

Results

Results indicate that the paradigm is well applicable and the videos were perceived as credible, interesting and helpful. Descriptive results show that the video reports led to a slight modification of expectations.

Conclusion

The results indicate that our new paradigm is a suitable tool to investigate expectation change in response to other patients’ experiences with psychotherapy. Furthermore, our paradigm is suitable to investigate potential cognitive mechanisms involved in expectation change in depression.

Cognitive reappraisal is an emotion regulation strategy based in cognitive behavioral therapy and can be associated with positive outcomes for individuals with and at risk for psychosis. However, the literature is mixed regarding whether this population uses cognitive reappraisal effectively. The current study examined cognitive reappraisal effectiveness in individuals at clinical high risk for psychosis and healthy control participants (N = 66; 34 clinical high risk, 32 healthy controls). The experimental task instructed participants to engage in reappraisal in real-time to regulate distress. We hypothesized that control participants would be more effective at using cognitive reappraisal compared to psychosis-risk participants, resulting in greater distress reduction post-reappraisal. Results demonstrated the opposite: the psychosis-risk group reported a greater change in distress level than the healthy control group after reappraisal was employed (Cohen’s d = 0.52). Exploratory analyses revealed that the clinical high risk group reported higher pre-task distress, but reported post-reappraisal distress levels equivalent to the healthy control group. These results contribute to emerging evidence that suggests individuals on the psychosis spectrum can implement reappraisal effectively. Therefore, complex training to improve cognitive reappraisal may not be needed. Instead, future research should examine the potential clinical utility of using simple reminders and/or guided prompts to promote cognitive reappraisal in individuals on the psychosis spectrum.