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Transdiagnostic Cognitive Behavioural Therapy for Individuals with Anxiety Disorders: An Open Trial 焦虑症患者的跨诊断认知行为疗法:一项公开试验
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2020-12-09 DOI: 10.1017/bec.2020.17
Shaun Pearl, P. Norton
To evaluate the effect of a transdiagnostic cognitive behavioural therapy (tCBT) protocol in an individual delivery format, adapted from a protocol that has been extensively evaluated in a group delivery format.tCBT was provided to a cohort (N = 18) of adults with a range of anxiety disorders (55.6% male; M age = 40.6, SD = 17.6), at a speciality anxiety disorder research clinic. A within-subjects repeated measures design was employed. Pre-to-post-treatment diagnostic assessments were analysed through repeated measures analysis of variance, and session-by-session self-reported measures of anxiety, depression, and quality of life were modelled through mixed-effect regression modelling (MRM) to maximise the sample of treatment initiators.Significant and large reductions for clinician-rated primary diagnosis severity (Hedges g = 1.63), and overall clinical global impressions (g = 1.43) were observed, and self-reported anxiety and depression symptoms showed significant reductions over the course of treatment with medium-to-large effect sizes (g = 0.66 and 0.74, respectively). Significant improvement to quality of life was also observed with medium effect size (g = 0.53).There is now preliminary support for the use of an adaptation of an established group-based tCBT protocol for use with individuals. Implications and recommendations for future investigations are provided.
评估跨诊断认知行为治疗(tCBT)方案在个体交付格式中的效果,该方案改编自已在群体交付格式中广泛评估的方案。tCBT提供给一组(N = 18)患有一系列焦虑症的成年人(55.6%为男性;M年龄= 40.6,SD = 17.6),在一家专科焦虑障碍研究诊所就诊。采用受试者内重复测量设计。通过重复测量方差分析分析治疗前后的诊断评估,并通过混合效应回归模型(MRM)对每次自我报告的焦虑、抑郁和生活质量测量进行建模,以最大限度地提高治疗发起者的样本。观察到临床评定的初级诊断严重程度(Hedges g = 1.63)和总体临床总体印象(g = 1.43)显著降低,自我报告的焦虑和抑郁症状在治疗过程中显着降低,具有中大型效应量(g = 0.66和0.74)。生活质量也有显著改善,效应大小中等(g = 0.53)。目前初步支持对已建立的基于群体的tCBT协议进行调整,以供个人使用。为今后的研究提供了启示和建议。
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引用次数: 2
‘Treatable and Changeable’: The Effect of Treatment and Malleability Information on Stigma Towards Children with Behavioural Problems and Their Parents “可治疗和可改变”:治疗和可延展性信息对行为问题儿童及其父母的污名化的影响
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2020-12-01 DOI: 10.1017/bec.2020.15
Sarah Li, L. Tully, M. Dadds
Abstract Improving knowledge about childhood mental health issues, reducing stigma, and encouraging appropriate treatment-seeking are important goals for public health. This study examined the effect of treatment and malleability information on stigmatisation towards children with Oppositional Defiant Disorder (ODD) and their parents, and on endorsements of causal beliefs. In an experimental study, university students (N = 234) were randomly allocated to receive/not receive treatment information (information on the existence and effectiveness of treatment for ODD) and to receive/not receive malleability information (information emphasising brain malleability and the potential to change). Participants then rated four measures of stigma towards a fictitious child with ODD and mother (blame, incompetence, dangerousness, and social distance), and rated their endorsements of causal explanations for ODD. Neither treatment nor malleability information had significant effects on stigmatisation towards either the child or mother. However, this information did impact upon causal beliefs about ODD as stemming from biological or mixed biological/environmental causes. Implications for the future development of public health initiatives and stigma research on childhood mental health are discussed.
摘要提高对儿童心理健康问题的认识,减少耻辱感,鼓励适当的治疗是公共卫生的重要目标。这项研究考察了治疗和延展性信息对对立违抗症(ODD)儿童及其父母的污名化以及对因果信念的支持的影响。在一项实验研究中,大学生(N=234)被随机分配接受/不接受治疗信息(关于ODD治疗的存在和有效性的信息)和接受/不接收延展性信息(强调大脑延展性和变化潜力的信息)。然后,参与者对一个虚构的患有ODD的孩子和母亲的污名程度进行了四项评分(责备、无能、危险性和社交距离),并对他们对ODD因果解释的支持程度进行了评分。治疗和延展性信息对儿童或母亲的污名化都没有显著影响。然而,这些信息确实影响了关于ODD的因果信念,认为其源于生物学或生物/环境混合原因。讨论了公共卫生倡议和儿童心理健康污名化研究对未来发展的影响。
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引用次数: 0
Mindfulness and Behaviour Therapy for Insomnia: An Assessment of Treatment Effect in a Sleep Disorders Clinic Population with Insomnia 正念与行为疗法治疗失眠:睡眠障碍临床失眠患者的治疗效果评估
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2020-11-27 DOI: 10.1017/bec.2020.18
A. Peters, J. Reece, H. Meaklim, M. Junge, D. Cunnington, J. Ong, Mervyn Jackson, K. Greenwood
Insomnia is a common major health concern, which causes significant distress and disruption in a person's life. The objective of this paper was to evaluate a 6-week version of Mindfulness-Based Therapy for Insomnia (MBTI) in a sample of people attending a sleep disorders clinic with insomnia, including those with comorbidities. Thirty participants who met the DSM-IV-TR diagnosis of insomnia participated in a 6-week group intervention. Outcome measures were a daily sleep diary and actigraphy during pre-treatment and follow-up, along with subjective sleep outcomes collected at baseline, end-of-treatment, and 3-month follow-up. Trend analyses showed that MBTI was associated with a large decrease in insomnia severity (p < .001), with indications of maintenance of treatment effect. There were significant improvements in objective sleep parameters, including sleep onset latency (p = .005), sleep efficiency (p = .033), and wake after sleep onset (p = .018). Significant improvements in subjective sleep parameters were also observed for sleep efficiency (p = .005) and wake after sleep onset (p < .001). Overall, this study indicated that MBTI can be successfully delivered in a sleep disorders clinic environment, with evidence of treatment effect for both objective and subjective measures of sleep.
失眠是一种常见的主要健康问题,它会给一个人的生活带来巨大的痛苦和破坏。本文的目的是评估一种为期六周的基于正念的失眠治疗(MBTI),该治疗对象是参加睡眠障碍诊所的失眠患者,包括那些有合并症的患者。30名符合DSM-IV-TR失眠症诊断的参与者参加了为期6周的小组干预。结果测量包括治疗前和随访期间的每日睡眠日记和活动记录仪,以及基线、治疗结束和3个月随访时收集的主观睡眠结果。趋势分析显示MBTI与失眠严重程度的大幅降低相关(p < 0.001),有维持治疗效果的迹象。客观睡眠参数有显著改善,包括睡眠开始潜伏期(p = 0.005)、睡眠效率(p = 0.033)和睡眠开始后清醒(p = 0.018)。主观睡眠参数在睡眠效率(p = 0.005)和睡眠后清醒(p < 0.001)方面也有显著改善。总的来说,本研究表明MBTI可以在睡眠障碍的临床环境中成功实施,并有证据表明对客观和主观睡眠测量的治疗效果。
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引用次数: 2
Treatment for Younger Siblings of Participants in a Home-Based Intensive Paediatric Feeding Programme in Australia 澳大利亚以家庭为基础的强化儿科喂养计划参与者的弟弟妹妹的治疗
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2020-11-26 DOI: 10.1017/bec.2020.14
Tessa Taylor, Alayna T. Haberlin
Abstract Early childhood feeding problems can be challenging. Children who limit their food consumption may significantly impact multiple critical areas of development. Effective treatment should be accessed as early as possible but has been limited to a handful of US hospital programmes. Feeding problems affect both children with and without disability, and families may struggle with multiple children having feeding difficulties. We provided short-term (less than 2 weeks), in-home, intensive, behaviour-analytic feeding intervention to two children with typical development who were younger siblings of children already in the programme. We used a withdrawal/reversal design to assess the effects of nonremoval of the spoon, re-presentation, contingent and noncontingent access to tangibles, differential attention, and response cost. This multi-component intervention was effective in increasing the consumption of a wide variety of foods at regular texture and self-feeding for both participants. Variety was increased to over 60 foods from all food groups. Admission goals were met (100%). We trained caregivers to high procedural integrity and generalised the protocol. We provided actual plate picture examples of family meals consumed where the brothers and parents ate the same meal. Caregiver satisfaction and social acceptability were high. Gains were maintained at 3-year follow-up where parents reported problems were fully resolved.
摘要幼儿喂养问题可能具有挑战性。限制食物消费的儿童可能会对发育的多个关键领域产生重大影响。应尽早获得有效治疗,但仅限于少数美国医院项目。喂养问题影响残疾儿童和非残疾儿童,家庭可能会与多个有喂养困难的儿童作斗争。我们为两名具有典型发育的儿童提供了短期(不到2周)的家庭强化行为分析喂养干预,这两名儿童是已经参加该计划的儿童的弟弟妹妹。我们使用撤回/逆转设计来评估勺子的不可移动性、重新呈现、有形资产的偶然和非接触访问、差异注意力和响应成本的影响。这种多组分干预措施有效地增加了两名参与者对各种有规律质地和自我喂养的食物的消费。所有食物组的食物种类增加到60多种。达到入学目标(100%)。我们对护理人员进行了高程序完整性的培训,并推广了该方案。我们提供了兄弟和父母吃同一顿饭的家庭用餐的实际盘子图片示例。护理人员的满意度和社会接受度都很高。在父母报告的问题得到完全解决的3年随访中,收益保持不变。
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引用次数: 1
The Role of Self-Criticism and Shame in Body-Focused Repetitive Behaviour Symptoms 自我批评和羞耻在身体聚焦重复行为症状中的作用
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2020-11-24 DOI: 10.1017/bec.2020.16
S. Houazene, F. Aardema, J. Leclerc, K. O'Connor
Body-focused repetitive behaviours (BFRBs), such as hair-pulling, skin-picking, and nail-biting, are non-functional habits associated with difficulties in emotion regulation. Although several models have been developed to explain the difficulties experienced by people suffering from BFRBs, a number of cognitive and emotional processes have yet to be explored. This study sought to investigate the psychological characteristics involved in the development and maintenance of BFRB symptoms. In particular, we aimed to evaluate the relationship of self-criticism, shame, and maladaptive cognitive emotion strategies with symptoms and examine if the relationship between perfectionism and symptoms was mediated by self-criticism and shame. Seventy-six participants from a community sample completed a number of self-report measures. Findings from our multivariate linear regression model supported that shame and maladaptive cognitive emotion regulation strategies significantly predicted BFRB symptoms. Results of our mediational analyses revealed that shame significantly mediated the relationship between perfectionism and BFRB symptoms. Interventions that target shame may be beneficial for treating these conditions. Future studies should replicate these findings with clinical populations and other BFRB subtypes.
以身体为中心的重复行为(BFRB),如拔头发、抠皮肤和咬指甲,是与情绪调节困难相关的非功能性习惯。尽管已经开发了几种模型来解释患有BFRB的人所经历的困难,但许多认知和情绪过程仍有待探索。本研究旨在调查BFRB症状发展和维持过程中涉及的心理特征。特别是,我们旨在评估自我批评、羞耻感和不适应的认知情绪策略与症状的关系,并检验完美主义与症状之间的关系是否由自我批评和羞耻感介导。来自社区样本的76名参与者完成了一些自我报告措施。我们的多元线性回归模型的研究结果支持羞耻感和不适应的认知情绪调节策略显著预测BFRB症状。我们的中介分析结果显示,羞耻感在完美主义和BFRB症状之间具有显著的中介作用。针对羞耻感的干预措施可能对治疗这些疾病有益。未来的研究应该在临床人群和其他BFRB亚型中复制这些发现。
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引用次数: 1
Effectiveness of Group Cognitive Therapy for Social Anxiety Disorder in Routine Care 团体认知疗法在日常护理中治疗社交焦虑障碍的效果
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2020-11-24 DOI: 10.1017/bec.2020.19
H. Colhoun, L. Kannis-Dymand, Marion Rudge, Dianne Le Compte, Sarah J. O'Flaherty, C. Gilbert, Monique Jones, S. Harrow, Ron Chambers, Colette Woolcock, Julie MacLeod, G. Lovell, C. Bell
Social anxiety disorder (SAD) is a prevalent chronic condition with a large demand for treatment. This community outpatient study examined the effectiveness of a group intervention version of the established one-to-one cognitive therapy derived from the Clark and Wells model for SAD. Questionnaires were completed pre-treatment and post-treatment for SAD symptoms (Social Phobia Scale, Social Interaction Anxiety Scale), depressive symptoms (BDI-II), self-focused attention, safety behaviours (Social Phobia Weekly Summary Scale and Subtle Avoidance Frequency Examination), and impaired functioning (Work and Social Adjustment Scale). From an initial sample of 159 participants, 101 completed at least seven of the nine weekly group sessions (Mage = 34.1 years, SDage = 10.8 years, 53% female). Significant improvements were demonstrated on all measures. Large effect sizes were found for social anxiety symptoms and safety behaviour use. Self-focused attention, depressive symptoms, and impaired functioning had moderate effect sizes. Effect sizes for anxiety (d = 1.00 and 1.32) and mood measures (d = 0.71) were as high, or in some cases, higher than previous group treatment studies. Results suggest group cognitive therapy for SAD based on the Clark and Wells model is effective in a clinical setting for individuals with moderate/severe and treatment-resistant social anxiety.
社交焦虑症(SAD)是一种普遍存在的慢性疾病,需要大量的治疗。这项社区门诊研究检验了根据Clark和Wells SAD模型建立的一对一认知疗法的团体干预版本的有效性。完成SAD症状(社交恐惧量表、社交焦虑量表)、抑郁症状(BDI-II)、自我专注注意力、安全行为(社交恐惧周总结量表和微妙回避频率检查)和功能障碍(工作和社会适应量表)的治疗前和治疗后问卷。从159名参与者的初始样本中,101人至少完成了九次每周小组会议中的七次(Mage=34.1岁,SDage=10.8岁,53%为女性)。所有措施都得到了显著改进。社交焦虑症状和安全行为使用的影响大小较大。自我关注、抑郁症状和功能受损具有中等程度的影响。焦虑(d=1.00和1.32)和情绪测量(d=0.71)的影响大小与之前的小组治疗研究一样高,或者在某些情况下更高。结果表明,基于Clark和Wells模型的SAD群体认知治疗在临床环境中对中度/重度和耐治疗社交焦虑的个体是有效的。
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引用次数: 0
A Narrative Review of the Needs of Children in Foster and Kinship Care: Informing a Research Agenda 寄养和亲属照料中儿童需求的叙述性回顾:告知研究议程
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2020-10-07 DOI: 10.1017/bec.2020.11
Jacqueline Kemmis-Riggs, J. McAloon
Abstract As a result of maltreatment, children in care can present with a range of complex needs and challenges. In addition to direct clinical care commonly provided by paediatricians, psychiatrists, and clinical psychologists, the provision of knowledge and skills to foster and kinship carers have become modes of support common in responding to these needs and challenges. A narrative review of key systematic reviews and empirical research was conducted to assess the effectiveness of existing foster carer interventions. Results indicated a range of methodological characteristics that limit our ability to develop a sound, research-driven, evidence base. As a result, we remain limited in our knowledge about which treatments are effective, for which symptoms they are effective, and for which population subgroups they are most likely to be effective. This review provides a summary of identified needs and challenges in the delivery of foster carer interventions. It provides an account of current treatment components and offers a platform for the development and progression of a programme of research in an effort to advance knowledge in the area.
摘要由于虐待,被照顾的儿童可能会面临一系列复杂的需求和挑战。除了儿科医生、精神病学家和临床心理学家通常提供的直接临床护理外,向寄养和亲属护理人员提供知识和技能已成为应对这些需求和挑战的常见支持模式。对关键的系统审查和实证研究进行了叙述性审查,以评估现有寄养照顾者干预措施的有效性。结果表明,一系列方法学特征限制了我们建立健全、研究驱动的证据基础的能力。因此,我们对哪些治疗有效、对哪些症状有效以及对哪些人群亚组最有可能有效的了解仍然有限。本综述概述了在提供寄养照顾者干预措施方面确定的需求和挑战。它介绍了目前的治疗组成部分,并为制定和推进研究方案提供了一个平台,以努力提高该领域的知识。
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引用次数: 1
Linking Grazing to Inhibition and Goal-Directed Behaviour in Obesity With and Without Eating Disorder Features 在有或没有饮食失调特征的肥胖中,将放牧与抑制和目标导向行为联系起来
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2020-09-28 DOI: 10.1017/BEC.2020.12
Andreea I. Heriseanu, P. Hay, S. Touyz
Recent models of obesity and eating behaviour have implicated both automatic responding to food-related cues and executive functioning in driving dietary choice. This study aimed to relate grazing severity to high weight with and without significant eating disorder features via the effects of inhibition and degree of goal-directed behaviour, in persons with obesity with and without significant eating disorder features compared to healthy controls. Forty-four participants with obesity (43.1% endorsing marked eating disorder features), and 43 healthy-weight age- and sex-matched participants (N = 87; 67.8% female, age = 28.57 (8.70; 18.18–58.34) years, BMI = 29.18 (7.80; 18.65–51.95) kg/m2) completed demographic and eating disorder-related questionnaires, a neuropsychological task of inhibition and an instrumental decision-making task. Bootstrapped serial mediation analyses were performed to examine the effect of group on grazing via goal-directed behaviour and inhibition. While significant differences existed between the groups in terms of inhibition, goal-directed behaviour and grazing severity, the effect of group on grazing severity was not found to be mediated by the degree of behavioural goal-directedness and inhibition. Therefore, :in persons with obesity with or without eating disorder symptoms, putative relationships between a reduced inhibitory profile and/or behaviour that is less flexible and goal-directed and eating behaviours such as grazing, remain unclear.
最近的肥胖和饮食行为模型表明,对食物相关线索的自动反应和驱动饮食选择的执行功能。与健康对照组相比,本研究旨在通过抑制和目标导向行为的程度,将具有和不具有显著饮食障碍特征的肥胖者的放牧严重程度与具有和不存在显著饮食障碍特点的高体重联系起来。44名肥胖参与者(43.1%的人支持明显的饮食障碍特征)和43名健康体重、年龄和性别匹配的参与者(N=87;67.8%的女性,年龄=28.57(8.70;18.18-58.34)岁,BMI=29.18(7.80;18.65-51.95)kg/m2)完成了人口统计学和饮食障碍相关问卷、抑制的神经心理学任务和工具性决策任务。进行自举系列中介分析,通过目标导向行为和抑制来检验群体对放牧的影响。虽然两组在抑制、目标导向行为和放牧严重程度方面存在显著差异,但未发现行为目标导向和抑制程度介导了组对放牧严重程度的影响。因此,在有或没有饮食障碍症状的肥胖者中,抑制性特征和/或不那么灵活和目标导向的行为与放牧等饮食行为之间的假定关系仍不清楚。
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引用次数: 0
What Influences Parenting Behaviour? The Role of Parent Self-Concept 什么影响父母的行为?父母自我概念的作用
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2020-09-25 DOI: 10.1017/bec.2020.13
C. Gittins, Maree J. Abbott, C. Hunt
Abstract Parenting has a strong influence on child development. However, there is minimal empirical evidence on why some parents use beneficial techniques, while others use harmful behaviours. Thus, there is a significant gap in the knowledge needed to address problematic parenting. Theories suggest that parental self-concept has a large influence on parenting behaviours. The aim of this study was to examine the relation between parent self-cognitions and parenting behaviours. One-hundred and four mothers of Grade 7 students completed questionnaires measuring their self-esteem, self-criticism, domain-specific self-concept, and parenting behaviours (support, behavioural control, and psychological control). Regression analyses demonstrated that self-cognitions largely predicted psychological control but support or behavioural control did not. These findings suggest that psychologically controlling behaviour in parents may be due to poor self-worth. With psychological control known to deeply damage children, these findings have major implications for interventions targeting harmful parenting.
摘要为人父母对孩子的发展有很大的影响。然而,关于为什么一些父母使用有益的技术,而另一些父母使用有害的行为,几乎没有经验证据。因此,在解决育儿问题所需的知识方面存在很大差距。理论表明,父母的自我概念对养育行为有很大影响。本研究的目的是检验父母的自我认知与养育行为之间的关系。104名七年级学生的母亲完成了问卷调查,测量了她们的自尊、自我批评、特定领域的自我概念和育儿行为(支持、行为控制和心理控制)。回归分析表明,自我认知在很大程度上可以预测心理控制,而支持或行为控制则不能。这些发现表明,父母的心理控制行为可能是由于缺乏自我价值。众所周知,心理控制会对儿童造成严重伤害,这些发现对针对有害育儿的干预措施具有重要意义。
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引用次数: 2
Death Anxiety, Loss, and Grief in the Time of COVID-19 新冠肺炎时期的死亡焦虑、损失和悲伤
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2020-09-01 DOI: 10.1017/bec.2020.10
R. Menzies, R. Neimeyer, R. Menzies
According to TMT, when thoughts of death are conscious we engage in ‘proximal defences’, which include suppressing these thoughts (e.g. turning off a news report about COVID-19 death tolls), denying one's vulnerability (e.g. thinking "I'm not in a high risk group, so I'll probably be fine"), or trying to prevent death (e.g. cleaning down all home surfaces with antibacterial wipes). [...]as fear of the virus increased, mental health declined. [...]death-related losses arising from COVID-19 are compounded by non-death losses, such as global financial strain, massive unemployment, and financial hardship, all of which are also associated with impoverished mental health (Paul & Moser, 2006). In this form of life-vitiating, protracted, and anguishing response to loss, mourners struggle with turbulent emotions of longing, guilt, loneliness, and desolation which tangibly impair their ability to function in the contexts of family, work, and the social world for many months beyond the death, and not uncommonly, years. [...]ongoing ruminative preoccupation with the lost relationship or the circumstances of the death carries real health risks for a variety of stress-related disorders, cardiac problems, addictions, immune system dysfunction, impaired quality of life, and even suicide (Maercker, Neimeyer, & Simiola, 2016).
据TMT报道,当意识到死亡的想法时,我们会进行“近端防御”,包括抑制这些想法(例如关闭关于新冠肺炎死亡人数的新闻报道)、否认自己的脆弱性(例如认为“我不是高危人群,所以我可能会好起来”),或试图防止死亡(例如用抗菌湿巾清洁所有家庭表面)。[…]随着对病毒的恐惧加剧,心理健康状况下降。[…]新冠肺炎造成的死亡相关损失与非死亡损失相结合,如全球金融紧张、大规模失业和经济困难,所有这些都与贫困的心理健康有关(Paul和Moser,2006)。在这种破坏生命、旷日持久、对失去的痛苦反应中,哀悼者与渴望、内疚、孤独和凄凉的动荡情绪作斗争,这些情绪明显削弱了他们在死亡后的几个月,甚至几年里,在家庭、工作和社会世界中发挥作用的能力。[…]对失去的关系或死亡情况的持续沉思会带来各种压力相关疾病、心脏问题、成瘾、免疫系统功能障碍、生活质量受损甚至自杀的真正健康风险(Maercker,Neimeyer,&Simiola,2016)。
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引用次数: 62
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Behaviour Change
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