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Effectiveness of cognitive behavioral group therapy, psychodrama, and their integration for treatment of social anxiety disorder: A randomized controlled trial. 认知行为团体疗法、心理剧及其整合治疗社交焦虑症的有效性:一项随机对照试验。
IF 1.8 4区 医学 Q3 PSYCHIATRY Pub Date : 2023-08-01 DOI: 10.2139/ssrn.3985128
Hanieh Abeditehrani, Corine Dijk, Mohsen Dehghani Neyshabouri, A. Arntz
BACKGROUND AND OBJECTIVESAlthough cognitive behavioral group therapy (CBGT) is an effective treatment for social anxiety disorder, many socially anxious patients are still symptomatic after treatment. A possible improvement for CBGT could come from the more experiential group psychotherapy, psychodrama (PD). The integration of CBGT and PD (labeled CBPT) might offer an even more effective treatment than CBGT or PD alone. With the present study, we investigated first whether three kinds of group therapy (CBGT, PD, and CBPT) are superior to a waitlist (WL). Second, we investigated whether CBPT is more effective than CBGT or PD alone.METHODSOne hundred and forty-four social anxiety patients were randomly assigned to three active conditions or a WL. After wait, WL-participants were randomized over the active treatment conditions.RESULTSThe results of a multilevel analysis showed that all treatments were superior to WL in reducing social anxiety complaints. Only CBGT and CBPT differed significantly from WL in reducing fear of negative evaluations. There were no significant differences between active conditions in any of the variables after treatment and after six-month follow up, neither were there significant differences in treatment dropout.LIMITATIONSFirst there is the lack of a long-term follow-up. Second, because of loss of participants, we did not reach the planned numbers in the active treatment groups in comparison to WL. Moreover, this study was not designed as a non-inferiority or equivalence trial.CONCLUSIONSAlthough the integrative CBPT showed good results, it was not more effective than the other treatments.
背景与目的认知行为团体治疗(CBGT)是治疗社交焦虑障碍的有效方法,但许多社交焦虑患者治疗后仍有症状。对CBGT的一种可能的改善可能来自更有经验的群体心理治疗,心理剧(PD)。CBGT和PD的结合(标记为CBPT)可能比单独CBGT或PD提供更有效的治疗。在本研究中,我们首先调查了三种团体治疗(CBGT, PD和CBPT)是否优于等候名单(WL)。其次,我们调查了CBPT是否比CBGT或单独PD更有效。方法144例社交焦虑患者随机分为三种活动状态或一种活动状态。等待后,wl参与者在积极治疗条件下随机分组。结果多水平分析结果显示,所有治疗方法在减少社交焦虑主诉方面均优于WL。只有CBGT和CBPT在减少负面评价恐惧方面与WL有显著差异。治疗后和6个月随访后,活跃状态在任何变量上没有显著差异,治疗退出也没有显著差异。局限性:首先,缺乏长期的随访。其次,由于参与者的流失,与WL相比,我们没有达到积极治疗组的计划人数。此外,本研究并非设计为非劣效性或等效性试验。结论综合cbt治疗效果良好,但并不比其他治疗更有效。
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引用次数: 0
How do mindfulness and compassion programs improve mental health and well-being? The role of attentional processing of emotional information 正念和同情项目如何改善心理健康和幸福感?情绪信息的注意加工作用
IF 1.8 4区 医学 Q3 PSYCHIATRY Pub Date : 2023-07-23 DOI: 10.1016/j.jbtep.2023.101895
Pablo Roca , Carmelo Vazquez , Gustavo Diez , Richard J. McNally

Background and objectives

Although the benefits of Meditation-Based Programs are well documented, the mechanisms underlying these benefits have not been fully elucidated. Therefore, we examined whether: (1) formal training in mindfulness and compassion meditation modifies the distribution of attentional resources towards emotional information; and (2) whether changes in attentional processing of emotional information after the meditation programs mediate the improvements in psychological distress, emotion regulation, and well-being.

Methods

A sample of 103 participants enrolled in the study: 36 in the mindfulness program (MBSR), 30 in the compassion program (CCT), and 37 in the no-intervention comparison group (CG). The assessment before and after the programs included the completion of an emotional Attentional Blink task (AB) together with self-report measures of psychological distress, emotion regulation, and well-being.

Results

MBSR and CCT reduced similarly the AB deficit, whereas no changes occurred in the CG. This AB reduction was found for the different emotional and non-emotional stimuli (i.e., negative, positive, and neutral), showing a significant disengagement from first-target emotions and significant accessibility of second-target emotions to consciousness. The effects of both meditation programs on the psychological measures were mediated by changes in the AB and emotion regulation skills.

Limitations

Due to our naturalistic design in a real-world community setting, random assignment of participants was not feasible.

Conclusions

Meditation may promote more flexible and balanced attention to emotional information, which may be a key transdiagnostic mechanism underlying its benefits on emotional distress and well-being.

背景和目的尽管基于冥想的项目的好处有很好的记录,但这些好处背后的机制尚未完全阐明。因此,我们研究了:(1)正念和同情冥想的正式训练是否会改变注意力资源对情绪信息的分布;以及(2)冥想项目后情绪信息的注意处理的变化是否介导了心理困扰、情绪调节和幸福感的改善。方法103名参与者参加了研究:36名参加了正念项目(MBSR),30名参加了同情项目(CCT),37名参加了不干预比较组(CG)。项目前后的评估包括完成情绪注意眨眼任务(AB),以及心理困扰、情绪调节和幸福感的自我报告测量。结果MBSR和CCT同样减少了AB缺陷,而CG没有变化。这种AB降低是针对不同的情绪和非情绪刺激(即消极、积极和中性)发现的,显示出与第一目标情绪的显著脱离和第二目标情绪对意识的显著可及性。两个冥想项目对心理测量的影响是由AB和情绪调节技能的变化介导的。限制由于我们在现实世界社区环境中的自然主义设计,随机分配参与者是不可行的。结论编辑可以促进对情绪信息的更灵活和平衡的关注,这可能是其对情绪困扰和幸福感有益的一个关键的跨诊断机制。
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引用次数: 0
Examining the role of trait anxiety and attentional bias to negative information in intrusion vulnerability following an emotionally negative event 研究特质焦虑和对负面信息的注意偏见在情绪负面事件后的入侵脆弱性中的作用
IF 1.8 4区 医学 Q3 PSYCHIATRY Pub Date : 2023-07-20 DOI: 10.1016/j.jbtep.2023.101894
Ines Pandzic , Lies Notebaert , Julian Basanovic , Colin MacLeod

Background and objectives

Research shows that individuals with heightened trait anxiety are more likely to experience intrusions; however, the mechanism that accounts for this relationship is unclear. Two alternative hypotheses were tested to determine the nature of the associations between trait anxiety, attentional bias to negative information, and intrusion vulnerability.

Methods

Intrusions were elicited using the trauma film paradigm, and post-event attentional bias to negative information was assessed using the dot-probe task. Participants then completed a week-long intrusions diary.

Results

Results showed that attentional bias to negative information mediated the effect of heightened trait anxiety on elevated intrusion frequency. It was also revealed that heightened trait anxiety was associated with elevated intrusion-related distress, though attentional bias to negative information did not mediate this relationship.

Limitations

Our sample was comprised of undergraduate students who were not selected based on a previous pathology. Replication in clinical samples is warranted.

Conclusions

These findings provide new insight regarding individual differences in the experience of intrusions and suggest that both the frequency and distress associated with intrusions could represent clinical targets.

背景与目的研究表明,特质焦虑加剧的个体更有可能经历入侵;然而,造成这种关系的机制尚不清楚。测试了两个替代假设,以确定特质焦虑、对负面信息的注意力偏见和入侵脆弱性之间的关联性质。方法采用创伤电影范式引发创伤,采用点探针任务评估事件后对负面信息的注意偏向。参与者随后完成了为期一周的入侵日记。结果表明,对负面信息的注意偏向介导了特质焦虑对入侵频率升高的影响。研究还表明,特质焦虑的增加与入侵相关的痛苦的增加有关,尽管对负面信息的注意力偏见并不能调节这种关系。限制我们的样本由本科生组成,他们不是根据以前的病理学选择的。临床样本中的复制是有保证的。结论这些发现为个体入侵体验的差异提供了新的见解,并表明与入侵相关的频率和痛苦都可以代表临床目标。
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引用次数: 0
Metacognitive monitoring in schizotypy: Systematic literature review and new empirical data 精神分裂症的元认知监测:系统文献综述和新的实证数据
IF 1.8 4区 医学 Q3 PSYCHIATRY Pub Date : 2023-07-08 DOI: 10.1016/j.jbtep.2023.101891
Mirko Lehmann, Ulrich Ettinger

Background and objectives

Deficits in metacognition, the ability to monitor one's own mental states, are key elements of the functional pathology of schizophrenia spectrum disorders. Little is known, however, about the integrity of metacognitive processes in subclinical schizotypy. The purpose of the present investigation was two-fold: First, we conducted a preregistered, systematic literature review to synthesize previous research efforts on the role of metacognition in schizotypy. Second, we investigated the relationship between self-reported dimensions of schizotypy and psychometric as well as behavioral measures of metacognition in a preregistered online study.

Methods

A large sample (N = 330) completed a questionnaire battery and an episodic memory experiment; task-based metacognition was tapped via trial-by-trial confidence ratings.

Results

In keeping with findings from our literature review, higher schizotypy was associated with diminished introspective insight and an overly self-referential and maladaptive metacognitive style in metacognition questionnaires. Importantly, low task-based metacognitive efficiency was predictive of high levels of cognitive disorganization, whereas task-related overconfidence (i.e., increased metacognitive bias) was linked with positive schizotypy.

Limitations

Due to the comparatively small number of k = 20 studies meeting our inclusion criteria, the systematic literature review provides only preliminary indications for potential conclusions. Furthermore, control over potential disturbing influences in the experimental study was limited due to its online format.

Conclusions

Overall, we provide evidence for specific metacognitive deficits in schizotypy and discuss a potential continuity of preserved and impaired aspects of metacognitive monitoring along the psychosis continuum.

背景和目的元认知的缺陷,即监测自己心理状态的能力,是精神分裂症谱系障碍功能病理学的关键因素。然而,对于亚临床精神分裂症的元认知过程的完整性知之甚少。本研究的目的有两个:首先,我们进行了一项预先登记的、系统的文献综述,以综合以往关于元认知在分裂症中的作用的研究成果。其次,我们在一项预先注册的在线研究中调查了精神分裂症的自我报告维度与元认知的心理测量和行为测量之间的关系。方法采用大样本(N=330)进行问卷调查和情景记忆实验;基于任务的元认知是通过逐个试验的置信度评定来挖掘的。结果与文献综述一致,在元认知问卷中,较高的分裂型与内省洞察力的减弱以及过度自我参照和适应不良的元认知风格有关。重要的是,低的基于任务的元认知效率预示着高水平的认知混乱,而与任务相关的过度自信(即元认知偏见增加)与积极的分裂型有关。局限性由于符合我们纳入标准的k=20项研究数量相对较少,系统文献综述仅为潜在结论提供了初步指示。此外,由于其在线形式,实验研究中对潜在干扰影响的控制受到限制。结论总的来说,我们为分裂型患者的特定元认知缺陷提供了证据,并讨论了元认知监测的保留和受损方面在精神病连续体中的潜在连续性。
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引用次数: 0
Emotional interference and attentional control in schizophrenia-spectrum disorders: The special case of neutral faces 精神分裂症谱系障碍的情绪干扰与注意控制:中性面孔的特殊情况
IF 1.8 4区 医学 Q3 PSYCHIATRY Pub Date : 2023-07-05 DOI: 10.1016/j.jbtep.2023.101892
Joana Grave , Nuno Madeira , Sofia Morais , Paulo Rodrigues , Sandra C. Soares

Background and objectives

Schizophrenia-spectrum disorders (SSD) are characterized by impaired emotion processing and attention. SSD patients are more sensitive to the presence of emotional distractors. But despite growing interest on the emotion-attention interplay, emotional interference in SSD is far from fully understood. Moreover, research to date has not established the link between emotional interference and attentional control in SSD. This study thus aimed to investigate the effects of facial expression and attentional control in SSD, by manipulating perceptual load.

Methods

Twenty-two SSD patients and 22 healthy controls performed a target-letter discrimination task with task-irrelevant angry, happy, and neutral faces. Target-letter was presented among homogenous (low load) or heterogenous (high load) distractor-letters. Accuracy and RT were analysed using (generalized) linear mixed-effect models.

Results

Accuracy was significantly lower in SSD patients than controls, regardless of perceptual load and facial expression. Concerning RT, SSD patients were significantly slower than controls in the presence of neutral faces, but only at high load. No group differences were observed for angry and happy faces.

Limitations

Heterogeneity of SSD, small sample size, lack of clinical control group, medication.

Conclusions

One possible explanation is that neutral faces captured exogenous attention to a greater extent in SSD, thus challenging attentional control in perceptually demanding conditions. This may reflect abnormal processing of neutral faces in SSD. If replicated, these findings will help to understand the interplay between exogenous attention, attentional control, and emotion processing in SSD, which may unravel the mechanism underlying socioemotional dysfunction in SSD.

背景与目的精神分裂症谱系障碍(SSD)的特点是情绪处理和注意力受损。SSD患者对情绪干扰物的存在更敏感。但是,尽管人们对情绪-注意力的相互作用越来越感兴趣,但SSD中的情绪干扰还远未被完全理解。此外,迄今为止的研究还没有确定SSD中情绪干扰和注意力控制之间的联系。因此,本研究旨在通过操纵感知负荷来研究面部表情和注意力控制在SSD中的作用。方法22名SSD患者和22名健康对照者采用与任务无关的愤怒、快乐和中性面孔进行目标字母辨别任务。目标字母出现在同质(低负荷)或异质(高负荷)干扰物字母中。使用(广义)线性混合效应模型分析准确性和RT。结果无论感知负荷和面部表情如何,SSD患者的准确率均显著低于对照组。关于RT,SSD患者在中性面孔存在的情况下明显慢于对照组,但仅在高负荷下。愤怒和高兴的面孔没有观察到群体差异。限制SSD的异质性,样本量小,缺乏临床对照组,药物治疗。结论一种可能的解释是,在SSD中,中性面孔在更大程度上获得了外源性注意,从而在感知要求苛刻的条件下挑战了注意力控制。这可能反映了SSD中中性面的异常处理。如果重复,这些发现将有助于理解SSD中外源性注意、注意控制和情绪处理之间的相互作用,这可能揭示SSD中社会情绪功能障碍的潜在机制。
{"title":"Emotional interference and attentional control in schizophrenia-spectrum disorders: The special case of neutral faces","authors":"Joana Grave ,&nbsp;Nuno Madeira ,&nbsp;Sofia Morais ,&nbsp;Paulo Rodrigues ,&nbsp;Sandra C. Soares","doi":"10.1016/j.jbtep.2023.101892","DOIUrl":"10.1016/j.jbtep.2023.101892","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Schizophrenia-spectrum disorders (SSD) are characterized by impaired emotion processing and attention. SSD patients are more sensitive to the presence of emotional distractors. But despite growing interest on the emotion-attention interplay, emotional interference in SSD is far from fully understood. Moreover, research to date has not established the link between emotional interference and attentional control in SSD. This study thus aimed to investigate the effects of facial expression and attentional control in SSD, by manipulating perceptual load.</p></div><div><h3>Methods</h3><p>Twenty-two SSD patients and 22 healthy controls performed a target-letter discrimination task with task-irrelevant angry, happy, and neutral faces. Target-letter was presented among homogenous (low load) or heterogenous (high load) distractor-letters. Accuracy and RT were analysed using (generalized) linear mixed-effect models.</p></div><div><h3>Results</h3><p>Accuracy was significantly lower in SSD patients than controls, regardless of perceptual load and facial expression. Concerning RT, SSD patients were significantly slower than controls in the presence of neutral faces, but only at high load. No group differences were observed for angry and happy faces.</p></div><div><h3>Limitations</h3><p>Heterogeneity of SSD, small sample size, lack of clinical control group, medication.</p></div><div><h3>Conclusions</h3><p>One possible explanation is that neutral faces captured exogenous attention to a greater extent in SSD, thus challenging attentional control in perceptually demanding conditions. This may reflect abnormal processing of neutral faces in SSD. If replicated, these findings will help to understand the interplay between exogenous attention, attentional control, and emotion processing in SSD, which may unravel the mechanism underlying socioemotional dysfunction in SSD.</p></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"81 ","pages":"Article 101892"},"PeriodicalIF":1.8,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10474904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of acceptance-based strategies on psychological responses to disorder-relevant stimuli in inpatients with obsessive–compulsive disorder: An experimental study 基于接受的策略对强迫症住院患者对障碍相关刺激的心理反应的影响:一项实验研究
IF 1.8 4区 医学 Q3 PSYCHIATRY Pub Date : 2023-07-05 DOI: 10.1016/j.jbtep.2023.101890
David R. Kolar , Adrian Meule , Eva M. Zisler , Caroline Schwartz , Ulrich Voderholzer

Background and objectives

Preliminary findings suggest that acceptance and commitment therapy-informed exposure therapy may be an effective treatment for obsessive–compulsive disorder (OCD). However, there is a lack of experimental studies that have examined immediate effects of acceptance-based strategies during exposure to disorder-relevant stimuli in persons with OCD.

Methods

Fifty-three inpatients (64% female) with OCD participated in an experimental study during which they were exposed to obsessive–compulsive washing-relevant pictures and were instructed to either passively view these pictures for 5 s (neutral condition), to accept their feelings (acceptance condition) or to intensify their feelings (exposure condition) for 90 s each.

Results

The acceptance condition led to higher acceptance and lower unpleasantness of patients’ current feelings compared to the neutral condition and to lower strength of obsessions and urge to perform compulsions but only when compared to the exposure condition. Higher self-reported OCD symptom severity related to higher unpleasantness and strength of obsessions, particularly in the neutral condition.

Limitations

Future studies need to test whether the current findings translate to other stimuli and other forms of obsessions and compulsions. Due to the short duration, the exposure condition might have only mimicked the early phase of exposure and response prevention.

Conclusions

Acceptance-based strategies during cue exposure immediately increase acceptance of and reduce unpleasant feelings. In line with the rationale of acceptance-based treatment approaches, which do not aim at immediate disorder-specific symptom reductions, effects on obsessions and compulsions may be more delayed or require repeated training sessions.

背景和目的初步研究结果表明,接受和承诺疗法-知情暴露疗法可能是治疗强迫症的有效方法。然而缺乏实验研究来检验强迫症患者在接触与障碍相关的刺激时基于接受的策略的即时效果持续5秒的照片(中性条件)、接受他们的感受(接受条件)或强化他们的感觉(暴露条件)各持续90秒。结果与中性条件相比,接受条件使患者对当前感觉的接受度更高,不愉快感更低,强迫和冲动的强度更低,但仅与暴露条件相比。更高的强迫症症状严重程度与更高的不愉快感和强迫症强度有关,尤其是在中性条件下。限制未来的研究需要测试当前的发现是否转化为其他刺激和其他形式的痴迷和强迫。由于持续时间短,暴露条件可能只模拟了暴露和反应预防的早期阶段。结论线索暴露过程中基于接受的策略可以立即增加对不愉快情绪的接受并减少不愉快情绪。根据基于接受的治疗方法的基本原理,这种方法不旨在立即减少特定于疾病的症状,对强迫症和强迫性行为的影响可能会更加延迟,或者需要反复训练。
{"title":"Effects of acceptance-based strategies on psychological responses to disorder-relevant stimuli in inpatients with obsessive–compulsive disorder: An experimental study","authors":"David R. Kolar ,&nbsp;Adrian Meule ,&nbsp;Eva M. Zisler ,&nbsp;Caroline Schwartz ,&nbsp;Ulrich Voderholzer","doi":"10.1016/j.jbtep.2023.101890","DOIUrl":"10.1016/j.jbtep.2023.101890","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Preliminary findings suggest that acceptance and commitment therapy-informed exposure therapy may be an effective treatment for obsessive–compulsive disorder (OCD). However, there is a lack of experimental studies that have examined immediate effects of acceptance-based strategies during exposure to disorder-relevant stimuli in persons with OCD.</p></div><div><h3>Methods</h3><p>Fifty-three inpatients (64% female) with OCD participated in an experimental study during which they were exposed to obsessive–compulsive washing-relevant pictures and were instructed to either passively view these pictures for 5 s (neutral condition), to accept their feelings (acceptance condition) or to intensify their feelings (exposure condition) for 90 s each.</p></div><div><h3>Results</h3><p>The acceptance condition led to higher acceptance and lower unpleasantness of patients’ current feelings compared to the neutral condition and to lower strength of obsessions and urge to perform compulsions but only when compared to the exposure condition. Higher self-reported OCD symptom severity related to higher unpleasantness and strength of obsessions, particularly in the neutral condition.</p></div><div><h3>Limitations</h3><p>Future studies need to test whether the current findings translate to other stimuli and other forms of obsessions and compulsions. Due to the short duration, the exposure condition might have only mimicked the early phase of exposure and response prevention.</p></div><div><h3>Conclusions</h3><p>Acceptance-based strategies during cue exposure immediately increase acceptance of and reduce unpleasant feelings. In line with the rationale of acceptance-based treatment approaches, which do not aim at immediate disorder-specific symptom reductions, effects on obsessions and compulsions may be more delayed or require repeated training sessions.</p></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"81 ","pages":"Article 101890"},"PeriodicalIF":1.8,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10474901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of virtual reality applications in the treatment of anxiety disorders: A systematic review and meta-analysis of randomized-controlled trials 虚拟现实应用于焦虑症治疗的影响:随机对照试验的系统综述和荟萃分析
IF 1.8 4区 医学 Q3 PSYCHIATRY Pub Date : 2023-07-01 DOI: 10.1016/j.jbtep.2023.101893
Dominik Schröder , Kamil J. Wrona , Frank Müller , Stephanie Heinemann , Florian Fischer , Christoph Dockweiler

Background and objectives

Anxiety disorders are the most prevalent mental disorders worldwide. Virtual reality (VR) treatment approaches have increasingly been studied. Before clinical implementation, it is necessary to evaluate the treatment effect of VR applications. The objective is to evaluate the treatment effect of virtual reality applications in the treatment of anxiety disorders compared to conventional therapy.

Methods

A systematic literature review with meta-analysis was conducted. Four databases were used to identify randomized controlled trials published between April 2011 and April 2021 which compare VR applications with non-VR interventions or waiting lists. Study characteristics, pre- and post-treatment data were extracted. Hedges g was calculated as effect size. Primary outcome was anxiety symptoms.

Results

Data from 17 studies from 827 participants was extracted. The studies examined specific phobia (n = 9), social anxiety disorder (n = 4), agoraphobia (n = 2) and panic disorder (n = 2). 16 out of 17 studies used head-mounted displays as VR application. A non-significant effect size with significant heterogeneity was observed in favor of the use of VR applications in anxiety symptoms (g, 0.33; 95%-CI, −0.20–0.87). Compared to passive control groups, VR applications are associated significant with lower anxiety symptoms (g, 1.29; 95%-CI, 0.68–1.90).

Limitations

The study and patient characteristics varied between the individual studies which is reflected in a high statistical heterogeneity of the effect sizes.

Conclusions

The added value of VR applications over waiting-list or psychoeducation only control groups is obvious. VR applications can be used as part of the treatment of anxiety disorders, especially when conventional therapy is unavailable.

背景与目的焦虑障碍是世界范围内最常见的精神障碍。虚拟现实(VR)治疗方法已经得到越来越多的研究。在临床实施之前,有必要评估VR应用的治疗效果。目的是与传统疗法相比,评估虚拟现实应用在治疗焦虑症中的治疗效果。方法采用荟萃分析方法对文献进行系统回顾。使用四个数据库来确定2011年4月至2021年4月期间发表的随机对照试验,这些试验将VR应用与非VR干预或等待名单进行了比较。提取研究特征、治疗前后数据。套期保值g计算为效应大小。主要结果是焦虑症状。结果从827名参与者的17项研究中提取数据。这些研究检查了特定恐惧症(n=9)、社交焦虑症(n=4)、广场恐怖症(n=2)和恐慌症(n=2)。17项研究中有16项使用了头戴式显示器作为VR应用。观察到有利于在焦虑症状中使用VR应用的具有显著异质性的非显著效应大小(g,0.33;95%CI,-0.20-0.87)。与被动对照组相比,VR应用与较低的焦虑症状显著相关(g,1.29;95%CI,0.68-1.90)。局限性研究和患者特征在个体研究之间存在差异,这反映在效应大小的高度统计异质性中。结论VR应用的附加值明显高于等待名单或仅接受心理教育的对照组。VR应用程序可以作为焦虑症治疗的一部分,尤其是在无法获得常规治疗的情况下。
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引用次数: 2
The impact of mood-induction on maladaptive thinking in the vulnerability for depression 情绪诱导对易患抑郁症患者适应不良思维的影响
IF 1.8 4区 医学 Q3 PSYCHIATRY Pub Date : 2023-06-16 DOI: 10.1016/j.jbtep.2023.101888
Marlijn E. Besten , Marie-José van Tol , Jacolien van Rij , Marieke K. van Vugt

Background and objectives

Mind-wandering, and specifically the frequency and content of mind-wandering, plays an important role in the psychological well-being of individuals. Repetitive negative thinking has been associated with a high risk to develop and maintain Major Depressive Disorder. We here combined paradigms and techniques from cognitive sciences and experimental clinical psychology to study the transdiagnostic psychiatric phenomenon of repetitive negative thinking. This allowed us to investigate the adjustability of the content and characteristics of mind-wandering in individuals varying in their susceptibility to negative affect.

Methods

Participants high (n = 42) or low (n = 40) on their vulnerability for negative affect and depression performed a Sustained Attention to Response Task (SART) after a single session of positive fantasizing and a single session of stress induction in a cross-over design. Affective states were measured before and after the interventions.

Results

After stress, negative affect increased, while after fantasizing both positive affect increased and negative affect decreased. Thoughts were less off-task, past-related and negative after fantasizing compared to after stress. Individuals more susceptible to negative affect showed more off-task thinking after stress than after fantasizing compared to individuals low on this.

Limitations

In this cross-over design, no baseline measurement was included, limiting comparison to ‘uninduced’ mind-wandering. Inclusion of self-related concerns in the SART could have led to negative priming.

Conclusions

Stress-induced negative thinking underlying vulnerability for depression could be partially countered by fantasizing in a non-clinical sample, which may inform the development of treatments for depression and other disorders characterized by maladaptive thinking.

背景与目的精神游荡,特别是精神游荡的频率和内容,对个体的心理健康起着重要作用。重复的消极思维与发展和维持严重抑郁症的高风险有关。我们在这里结合了认知科学和实验临床心理学的范式和技术来研究重复消极思维的跨诊断精神现象。这使我们能够研究不同易受负面影响的个体的走神内容和特征的可调节性。方法在交叉设计中,高(n=42)或低(n=40)的参与者在单次积极幻想和单次压力诱导后进行持续注意反应任务(SART)。在干预前后测量情感状态。结果应激后消极情绪增加,幻想后积极情绪增加,消极情绪减少。与压力后相比,幻想后的想法较少偏离任务,与过去有关,消极。与消极情绪较低的人相比,更容易受到消极情绪影响的人在压力后比在幻想后表现出更多的非任务思维。限制在这种交叉设计中,不包括基线测量,将比较限制为“未引起的”思维漫游。将自我相关的担忧纳入严重急性呼吸系统综合征可能会导致负面启动。结论在非临床样本中进行幻想可以部分抵消压力诱导的消极思维,这可能为抑郁症和其他以思维不适应为特征的疾病的治疗提供信息。
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引用次数: 0
Impacts of repeated retrieval of positive and neutral memories on posttrauma health: An investigative pilot study 积极记忆和中性记忆的重复提取对创伤后健康的影响:一项初步调查研究
IF 1.8 4区 医学 Q3 PSYCHIATRY Pub Date : 2023-06-14 DOI: 10.1016/j.jbtep.2023.101887
Ateka A. Contractor , Brett Messman , Preston Gould , Danica C. Slavish , Nicole H. Weiss

Background and objectives

Evidence indicates that positive memory processes play a role in the etiology and maintenance of posttraumatic stress symptoms (PTSS) and related posttrauma health indicators. To extend this research, the current pilot study examined if repeated retrieval of positive vs. neutral memories was associated with (1) less PTSS and depression severity; and (2) improved affect and cognitions (fewer posttrauma cognitions, more positively-valenced affect, less negatively-valenced affect, less negative affect interference, less anhedonia, retrieval of more positive specific memories, retrieval of fewer negative specific memories).

Methods

Twenty-five trauma-exposed participants were randomly assigned to a positive or neutral memory task condition. They participated in four weekly experimental sessions facilitated by an experimenter virtually; each consecutive session was separated by 6–8 days. We conducted mixed between-within subjects ANOVAs to examine study hypotheses.

Results

No interaction effects were significant. There were significant main effects of time on PTSS and depression severity, posttrauma cognitions, positively-valenced and negatively-valenced affect, and negative affect interference.

Limitations

We used self-report measures, small and non-clinical sample with limited demographic diversity, and virtual format; did not record memory narratives; and did not have a trauma memory condition.

Conclusions

Based on pilot data, our findings suggest that individuals who retrieve positive or neutral memories repeatedly may report less PTSS and depression severity, fewer posttrauma cognitions, and improved affect. Results provide an impetus to examine impacts of and mechanisms underlying memory interventions (beyond a sole focus on negatively-valenced memories) in trauma work.

背景与目的有证据表明,积极记忆过程在创伤后应激症状(PTSS)和相关创伤后健康指标的病因和维持中发挥作用。为了扩展这项研究,目前的试点研究检查了重复提取阳性记忆与中性记忆是否与(1)减少创伤后应激障碍和抑郁严重程度有关;(2)情感和认知的改善(创伤后认知减少,正向情感增加,负向情感减少,负向情绪干扰减少,快感缺乏,恢复更多的正向特定记忆,恢复更少的负向特定记忆)。他们参加了由实验者虚拟协助的每周四次的实验会议;每个连续疗程间隔6-8天。我们进行了受试者之间的混合方差分析,以检验研究假设。结果无明显交互作用。时间对创伤后应激障碍和抑郁严重程度、创伤后认知、正向和负向情感以及负向情感干扰有显著的主要影响。局限性我们使用了自我报告测量、人口统计学多样性有限的小型非临床样本和虚拟形式;没有记录记忆叙述;并且没有创伤记忆状况。结论基于试点数据,我们的研究结果表明,反复获得积极或中性记忆的人可能会报告更少的创伤后应激障碍和抑郁严重程度,更少的创伤认知,并改善情绪。研究结果为研究记忆干预在创伤工作中的影响和机制提供了动力(不仅仅关注负价记忆)。
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引用次数: 0
Exploring intrusions without awareness: A preliminary study of the characteristics and influences of meta-awareness failures 探索无意识入侵:元意识失败的特征和影响的初步研究
IF 1.8 4区 医学 Q3 PSYCHIATRY Pub Date : 2023-06-12 DOI: 10.1016/j.jbtep.2023.101889
Yu-Tung J. Sun , Melanie K.T. Takarangi , Reginald D.V. Nixon

Background and Objectives

Research shows that people can lack meta-awareness (i.e., being explicitly aware) of their trauma-related thoughts, which impacts our understanding of re-experiencing symptoms, a key symptom type in posttraumatic stress disorder (PTSD), assessed through self-report. This preliminarily study explored differences between (meta-)aware and unaware intrusion characteristics to understand why some intrusions are not immediately apparent to individuals.

Methods

Trauma-exposed participants (N = 78) were recruited from online crowd-sourcing platforms to complete an online meta-awareness task. During a reading task, participants were intermittently probed to index the occurrence of unreported (i.e., unaware) trauma-related intrusions. Once participants indicated trauma-related intrusions were present, they then completed a questionnaire that indexed intrusion characteristics.

Results

Although unaware intrusions did occur in a subset of the sample, there were no fundamental differences between aware and unaware intrusions in terms of modality of experience (imagery vs. non-imagery), meaningfulness, accessibility, or other characteristics (e.g., vividness).

Limitations

There was potential for lower participant engagement and attention due to the online delivery of the meta-awareness task, which may have minimized meta-awareness failure. Future research could consider using a continuous measure to index levels of meta-awareness. In addition, recruiting clinical samples (e.g., individuals with PTSD) who typically experience multiple daily intrusions would allow generalizability of the current findings to be tested.

Conclusions

Our findings from this preliminary study suggest that unaware and aware intrusions show more commonality than not in their characteristics, with further research required to improve our understanding of the mechanisms leading to meta-awareness or lack of in PTSD.

背景和目的研究表明,人们可能对自己的创伤相关想法缺乏元意识(即明确意识),这影响了我们对重新体验症状的理解,这是创伤后应激障碍(PTSD)的一种关键症状类型,通过自我报告进行评估。这项初步研究探讨了(元)感知和非感知入侵特征之间的差异,以理解为什么一些入侵对个人来说并不明显。方法从在线众包平台招募创伤暴露参与者(N=78),完成在线元认知任务。在阅读任务中,参与者被间歇性地探测,以索引未报告(即未意识)的创伤相关入侵的发生情况。一旦参与者表示存在与创伤相关的入侵,他们就完成了一份索引入侵特征的问卷。结果尽管在样本的一个子集中确实发生了未意识的入侵,但在体验模式(图像与非图像)、意义、可及性、,限制由于元认知任务的在线交付,参与者的参与度和注意力可能会降低,这可能会将元认知失败降至最低。未来的研究可以考虑使用一种连续的衡量标准来衡量元意识的水平。此外,招募通常每天经历多次入侵的临床样本(如创伤后应激障碍患者),可以测试当前发现的普遍性。结论我们在这项初步研究中的发现表明,无意识和有意识的入侵在其特征上表现出更多的共性,需要进一步的研究来提高我们对导致创伤后应激障碍中元意识或缺乏元意识的机制的理解。
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引用次数: 0
期刊
Journal of Behavior Therapy and Experimental Psychiatry
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