Journal of Cognitive Psychotherapy最新文献

The present study aimed to examine the relationship between perfectionism, OCD symptom dimensions, harm avoidance, and incompleteness at varying levels (i.e., higher-order/subscale) in college students. College students (n = 548) completed measures of perfectionism, obsessive-compulsive symptoms, harm avoidance and incompleteness. The results revealed that all five higher-order dimensions of perfectionism were related to incompleteness but only three were related to harm avoidance. Parallel mediation revealed an indirect relationship between concern for mistakes and doubts about actions and checking and cleaning behaviors, respectively, through incompleteness. An indirect relationship between concern for mistakes and doubts about actions with ordering, respectively, through both incompleteness and harm avoidance was found. However, incompleteness played a stronger role than harm avoidance in this relationship. These results suggest that incompleteness might be a stronger motivator than harm avoidance for perfectionistic individuals. Therefore, interventions targeting incompleteness should be implemented to potentially circumvent the development or worsening of obsessive-compulsive symptoms.

We describe the perceptions of mental health clinicians practicing in the United States about the effects of the COVID-19 pandemic on the presentation and treatment course of active clients with anxiety. Clinician participants reported on client symptomology at the beginning of treatment, just before (prior to March 2020), and at a mid-pandemic timepoint (December 2020/January 2021). An initial sample of 70 clinicians responded to a survey assessing their clients' overall anxiety severity, anxiety sensitivity, pathological uncertainty, family accommodation, and avoidance levels. Of these, 54 clinician responses were included in study analyses, providing detailed clinical information on 81 clients. Findings suggest that the COVID-19 pandemic was associated with increases in anxiety severity in the majority of clients; overall, clinicians reported that 53% of clients had symptoms worsen due to COVID-19 and that only 16% experienced improvement of symptoms during treatment. Those who had lower levels of avoidance pre-pandemic and those who increased their frequency of treatment were more likely to experience increases in anxiety severity by the mid-pandemic timepoint. Further research is needed to understand the extended effects of the COVID-19 pandemic on anxiety symptomology and treatment.

Objective: This study investigated the roles of adherence and usage activity in adolescents' (n = 161) gains during a 5-week web intervention program based on acceptance and commitment therapy (ACT).

Method: Program adherence was calculated as adherence percentage in relation to intended usage, whereas completion percentage, usage time, and usage weeks were used as indicators for usage activity. Subjective well-being was measured by self-reported life satisfaction and stress before and after the intervention.

Results: First, regression analysis results showed that higher adherence predicted an increase in life satisfaction during intervention. Second, three subgroups of adolescents were identified using K-means cluster analysis in regard to adherence, usage activity and intervention gains: (1) "Adhered, committed users with relatively large intervention gains" (35%), (2) "Less committed users with no intervention gains" (42%), and (3) "Non-committed users with no intervention gains" (23%). The results showed that the highest gains from the Youth Compass intervention program are most likely obtained when the program is used as intended in its design. In addition, time investment and engagement in doing exercises seem as important as filling the minimum adherence criterion.

Conclusions: The results support the feasibility of ACT-based web intervention programs in promoting adolescent well-being, although more attention should be paid to motivating adolescents to commit to them and invest enough time in them.

Interventions for functional impairments in adolescents and young adults at clinical high risk (CHR) for psychosis are needed. Cognitive-Behavioral Social Skills Training (CBSST) has been found to improve functioning in patients with schizophrenia. The CBSST manual was adapted for CHR and implemented across 3 sites. The key changes that were made were to present a focus of normalization and destigmatization of attenuated psychotic symptoms and since CBSST has a major focus on role plays, problem solving and challenging thoughts, examples of these were changed to be more appropriate for this young CHR population. We describe the manual modifications and present fidelity data to examine the success of training and supervision methods in a multi-site randomized controlled trial of CBSST in CHR youth. Fidelity was high and comparable across sites. Case vignettes are presented to demonstrate how CBSST techniques were adapted for UHR individuals to target functional impairments.