Pub Date : 2025-08-31DOI: 10.1016/j.jbtep.2025.102069
Robin.P.A. van der Linde , Nathan. Bachrach , Paul. Lodder , Marleen. Rijkeboer , Rafaële.J.C. Huntjens
This study explored the relationships between dissociative experiences, childhood trauma, maladaptive schemas, schema modes, and schema coping in a nonclinical sample. Three theoretical models were tested: (1) dissociative experiences resulting from schema mode activation, (2) dissociative experiences as an innate trait shaping schema coping, and (3) dissociative experiences arising from childhood trauma that influence coping strategies. Data from 401 Dutch psychology students were analyzed using path analyses to compare model fit. While all models showed good fit, Model 2 emerged as the best based on AIC and BIC values. This model linked dissociative experiences to avoidance and surrender coping styles and specific schema modes, such as the punitive parent and detached self-soother. Findings suggest dissociative experiences shape responses to schema-related stress through disengagement or immersion. Future research in clinical populations is recommended to further explore these dynamics and their therapeutic relevance.
{"title":"Exploring the links between dissociative experiences, schemas, modes, and coping","authors":"Robin.P.A. van der Linde , Nathan. Bachrach , Paul. Lodder , Marleen. Rijkeboer , Rafaële.J.C. Huntjens","doi":"10.1016/j.jbtep.2025.102069","DOIUrl":"10.1016/j.jbtep.2025.102069","url":null,"abstract":"<div><div>This study explored the relationships between dissociative experiences, childhood trauma, maladaptive schemas, schema modes, and schema coping in a nonclinical sample. Three theoretical models were tested: (1) dissociative experiences resulting from schema mode activation, (2) dissociative experiences as an innate trait shaping schema coping, and (3) dissociative experiences arising from childhood trauma that influence coping strategies. Data from 401 Dutch psychology students were analyzed using path analyses to compare model fit. While all models showed good fit, Model 2 emerged as the best based on AIC and BIC values. This model linked dissociative experiences to avoidance and surrender coping styles and specific schema modes, such as the punitive parent and detached self-soother. Findings suggest dissociative experiences shape responses to schema-related stress through disengagement or immersion. Future research in clinical populations is recommended to further explore these dynamics and their therapeutic relevance.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"90 ","pages":"Article 102069"},"PeriodicalIF":2.2,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926494","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}
Pub Date : 2025-08-23DOI: 10.1016/j.jbtep.2025.102057
Steffen Moritz , Lara Wille , Anja S. Göritz , Tana Gabbert , Rose Doherty , Ryan Balzan , Jakob Scheunemann
Background and objectives
Jumping to conclusions (JTC) is the most widely researched cognitive bias in schizophrenia. Notwithstanding meta-analyses demonstrating a higher level of JTC across the psychosis spectrum, important research questions remain unanswered. First, whether JTC is a primary process or in part an epiphenomenon reflecting contributions of other variables is still unresolved, which may explain why interventions targeting cognitive biases are effective on positive symptoms but less so on reducing JTC. Secondly, the beads task, the traditional procedure to capture JTC, is a complex procedure prone to misunderstanding and vulnerable to inattentive and careless responding. In this study, we tested a video assessment of the beads task aiming to reduce errors due to misunderstanding and to gain more insight into the processes contributing to JTC.
Methods
A sample of 801 participants from the general population was divided into various levels of paranoid ideation, based on cut-off criteria. The newly developed video JTC task, which is available at no cost at https://clinical-neuropsychology.de/jtc/, was presented online, as were the Revised Green et al. Paranoid Thoughts Scale (R-GPTS) and other psychological scales that served to separate individuals scoring high versus low on paranoia.
Results
As hypothesized, participants scoring high on both the ideas of social reference and persecution subscales of the R-GPTS showed more JTC than those with lower scores. Yet, a large number of participants (24 %) made illogical responses or showed signs of careless performance. Important contributors to JTC were lack of motivation, skipping some of the instructions, and speeding through the trials. Yet, significant differences remained when these influences were accounted for with matched samples.
Conclusions
While the newly developed video task was able to confirm elevated JTC in individuals scoring higher on paranoid ideation, core problems seen in prior versions of the beads task remain. Researchers are advised to develop alternative tests, preferably ones that allow repeated measurement. Our results indicate that JTC is a multi-causal bias that is unlikely to be explained by a single cognitive or psychopathological process.
{"title":"On the multi-causal nature of jumping to conclusions in psychosis","authors":"Steffen Moritz , Lara Wille , Anja S. Göritz , Tana Gabbert , Rose Doherty , Ryan Balzan , Jakob Scheunemann","doi":"10.1016/j.jbtep.2025.102057","DOIUrl":"10.1016/j.jbtep.2025.102057","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Jumping to conclusions (JTC) is the most widely researched cognitive bias in schizophrenia. Notwithstanding meta-analyses demonstrating a higher level of JTC across the psychosis spectrum, important research questions remain unanswered. First, whether JTC is a primary process or in part an epiphenomenon reflecting contributions of other variables is still unresolved, which may explain why interventions targeting cognitive biases are effective on positive symptoms but less so on reducing JTC. Secondly, the beads task, the traditional procedure to capture JTC, is a complex procedure prone to misunderstanding and vulnerable to inattentive and careless responding. In this study, we tested a video assessment of the beads task aiming to reduce errors due to misunderstanding and to gain more insight into the processes contributing to JTC.</div></div><div><h3>Methods</h3><div>A sample of 801 participants from the general population was divided into various levels of paranoid ideation, based on cut-off criteria. The newly developed video JTC task, which is available at no cost at <span><span>https://clinical-neuropsychology.de/jtc/</span><svg><path></path></svg></span>, was presented online, as were the Revised Green et al. Paranoid Thoughts Scale (R-GPTS) and other psychological scales that served to separate individuals scoring high versus low on paranoia.</div></div><div><h3>Results</h3><div>As hypothesized, participants scoring high on both the ideas of social reference and persecution subscales of the R-GPTS showed more JTC than those with lower scores. Yet, a large number of participants (24 %) made illogical responses or showed signs of careless performance. Important contributors to JTC were lack of motivation, skipping some of the instructions, and speeding through the trials. Yet, significant differences remained when these influences were accounted for with matched samples.</div></div><div><h3>Conclusions</h3><div>While the newly developed video task was able to confirm elevated JTC in individuals scoring higher on paranoid ideation, core problems seen in prior versions of the beads task remain. Researchers are advised to develop alternative tests, preferably ones that allow repeated measurement. Our results indicate that JTC is a multi-causal bias that is unlikely to be explained by a single cognitive or psychopathological process.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"89 ","pages":"Article 102057"},"PeriodicalIF":2.2,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889034","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}
Pub Date : 2025-08-23DOI: 10.1016/j.jbtep.2025.102056
Rory Wallace , Cameron Lacey , Rebecca J. Sargisson
Emetophobia (fear of vomiting) is an understudied disorder that affects .2 % of people, with extreme (non-phobic) fear affecting up to 8 % of people. The most effective treatment for specific phobias is exposure therapy, and virtual reality exposure therapy (VRET), has become a viable treatment alternative to traditional in-vivo or imaginal exposure therapy. However, using VRET to treat emetophobia has not yet been explored. We used a within-subjects, multiple-baseline-across-participants design with six participants to evaluate the emetophobia programme of oVRcome; a low-cost, Aotearoa New Zealand-based VRET app. After using the oVRcome VRET app, we saw visible improvements in self-reported phobia symptoms for four of the six participants (P2, P4, P5, and P6). For half the participants (P4, P5, and P6), the reported decreases were large, with two participants scoring below the threshold for a likely phobia diagnosis. The emetophobia programme of the oVRcome VRET app may be effective at reducing emetophobia severity, and our results support research showing eHealth apps can be a low-cost and effective treatment for a range of psychological issues.
{"title":"Can a virtual reality exposure therapy app improve symptoms of Emetophobia? A single-subject Experimental design study","authors":"Rory Wallace , Cameron Lacey , Rebecca J. Sargisson","doi":"10.1016/j.jbtep.2025.102056","DOIUrl":"10.1016/j.jbtep.2025.102056","url":null,"abstract":"<div><div>Emetophobia (fear of vomiting) is an understudied disorder that affects .2 % of people, with extreme (non-phobic) fear affecting up to 8 % of people. The most effective treatment for specific phobias is exposure therapy, and virtual reality exposure therapy (VRET), has become a viable treatment alternative to traditional in-vivo or imaginal exposure therapy. However, using VRET to treat emetophobia has not yet been explored. We used a within-subjects, multiple-baseline-across-participants design with six participants to evaluate the emetophobia programme of oVRcome; a low-cost, Aotearoa New Zealand-based VRET app. After using the oVRcome VRET app, we saw visible improvements in self-reported phobia symptoms for four of the six participants (P2, P4, P5, and P6). For half the participants (P4, P5, and P6), the reported decreases were large, with two participants scoring below the threshold for a likely phobia diagnosis. The emetophobia programme of the oVRcome VRET app may be effective at reducing emetophobia severity, and our results support research showing eHealth apps can be a low-cost and effective treatment for a range of psychological issues.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"89 ","pages":"Article 102056"},"PeriodicalIF":2.2,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889033","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}
Pub Date : 2025-08-23DOI: 10.1016/j.jbtep.2025.102059
Rosita Borlimi , Irene Brianzoni , Greta Riboli , Mattia Nese , Gianni Brighetti , Giancarlo Dimaggio
Background
One key ingredient for guided imagery interventions’ effectiveness is their capacity to increase emotional arousal. However, individual responses vary, as some people can have negative experiences that undermine treatment adherence or effectiveness. Research is needed to understand predictors of negative reactions to experiencing negative events during imagery. One idea suggests that some individuals struggle to return to baseline, making the experience unpleasant or distressing. Which predictors contribute to slower recovery after imagery of negative events?
Aims and hypothesis
We tested the following hypotheses in a non-clinical sample: (H1) participants experienced an increase in physiological arousal upon recalling an unpleasant autobiographical event, (H2) participants returned spontaneously to baseline physiological levels during the recovery period, but (H3) emotion dysregulation, depression and trait anxiety predicted recovery arousal, and (H4) repetitive thinking (rumination and worry) was also associated with recovery arousal.
Methods
Participants completed questionnaires assessing repetitive thinking (rumination and worry), trait anxiety, depression, and emotion dysregulation. Arousal was measured through continuous recording of Skin Conductance Response (SCR) and Heart Rate Variability (HRV).
Results
After the predicted arousal increase following imagery, participants returned to baseline. There were individual differences in average physiological return to baseline as measured by SCR, but not HRV. Emotion regulation, trait anxiety, rumination and worry significantly predicted physiological recovery.
Conclusions
Individuals with severe tendencies towards repetitive thinking and, to a lesser extent, with higher trait anxiety and emotion dysregulation may require preliminary work before undergoing imagery aimed at working through distressing memories.
{"title":"Arousal grows up, arousal goes down. Emotion regulation, trait anxiety, rumination and worry as predictors of recovery time after mental imagery","authors":"Rosita Borlimi , Irene Brianzoni , Greta Riboli , Mattia Nese , Gianni Brighetti , Giancarlo Dimaggio","doi":"10.1016/j.jbtep.2025.102059","DOIUrl":"10.1016/j.jbtep.2025.102059","url":null,"abstract":"<div><h3>Background</h3><div>One key ingredient for guided imagery interventions’ effectiveness is their capacity to increase emotional arousal. However, individual responses vary, as some people can have negative experiences that undermine treatment adherence or effectiveness. Research is needed to understand predictors of negative reactions to experiencing negative events during imagery. One idea suggests that some individuals struggle to return to baseline, making the experience unpleasant or distressing. Which predictors contribute to slower recovery after imagery of negative events?</div></div><div><h3>Aims and hypothesis</h3><div>We tested the following hypotheses in a non-clinical sample: (H1) participants experienced an increase in physiological arousal upon recalling an unpleasant autobiographical event, (H2) participants returned spontaneously to baseline physiological levels during the recovery period, but (H3) emotion dysregulation, depression and trait anxiety predicted recovery arousal, and (H4) repetitive thinking (rumination and worry) was also associated with recovery arousal.</div></div><div><h3>Methods</h3><div>Participants completed questionnaires assessing repetitive thinking (rumination and worry), trait anxiety, depression, and emotion dysregulation. Arousal was measured through continuous recording of Skin Conductance Response (SCR) and Heart Rate Variability (HRV).</div></div><div><h3>Results</h3><div>After the predicted arousal increase following imagery, participants returned to baseline. There were individual differences in average physiological return to baseline as measured by SCR, but not HRV. Emotion regulation, trait anxiety, rumination and worry significantly predicted physiological recovery.</div></div><div><h3>Conclusions</h3><div>Individuals with severe tendencies towards repetitive thinking and, to a lesser extent, with higher trait anxiety and emotion dysregulation may require preliminary work before undergoing imagery aimed at working through distressing memories.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"89 ","pages":"Article 102059"},"PeriodicalIF":2.2,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888848","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}
Pub Date : 2025-08-23DOI: 10.1016/j.jbtep.2025.102040
Victoria M.E. Bridgland , Ella K. Moeck , Melanie K.T. Takarangi
Trigger warnings are alerts that intend to help people emotionally prepare for, or avoid, potentially distressing material likely to trigger memories or emotions related to past experiences. Lab studies suggest that warnings overwhelmingly result in approach behaviour rather than avoidance. However, no research to date has tracked exposure and responses to trigger warnings in daily life. Here 261 young adults (aged 17–25) completed a 7-day daily diary study in which they tracked exposure to trigger warnings on social media and reported if they approached or avoided the content marked by the warnings. Because trigger warnings are intended for use by certain groups of vulnerable people (e.g., trauma survivors/people with mental health concerns), we also measured various psychopathological characteristics (posttraumatic stress disorder [PTSD] symptoms, trauma exposure, etc.). Consistent with lab-based studies, we found that most people (∼90 %) reported approaching content marked by a trigger warning, and most commonly did so out of “curiosity”. Moreover, only ∼10 % of participants reported always avoiding content marked by a trigger warning when they saw it—signalling a tendency to approach warned material in the real world. We also found no relationship between self-reported avoidance of content marked with trigger warnings that was encountered in daily life and any mental health risk marker (e.g., PTSD symptoms, trauma exposure). Our findings therefore further question claims that trigger warnings are an effective online mental health intervention.
{"title":"“I'm always curious”: Tracking young adults exposure and responses to social media trigger warnings in daily life","authors":"Victoria M.E. Bridgland , Ella K. Moeck , Melanie K.T. Takarangi","doi":"10.1016/j.jbtep.2025.102040","DOIUrl":"10.1016/j.jbtep.2025.102040","url":null,"abstract":"<div><div>Trigger warnings are alerts that intend to help people emotionally prepare for, or avoid, potentially distressing material likely to trigger memories or emotions related to past experiences. Lab studies suggest that warnings overwhelmingly result in approach behaviour rather than avoidance. However, no research to date has tracked exposure and responses to trigger warnings in <em>daily life.</em> Here 261 young adults (aged 17–25) completed a 7-day daily diary study in which they tracked exposure to trigger warnings on social media and reported if they approached or avoided the content marked by the warnings. Because trigger warnings are intended for use by certain groups of vulnerable people (e.g., trauma survivors/people with mental health concerns), we also measured various psychopathological characteristics (posttraumatic stress disorder [PTSD] symptoms, trauma exposure, etc.). Consistent with lab-based studies, we found that most people (∼90 %) reported approaching content marked by a trigger warning, and most commonly did so out of “curiosity”. Moreover, only ∼10 % of participants reported always avoiding content marked by a trigger warning when they saw it—signalling a tendency to approach warned material in the real world. We also found no relationship between self-reported avoidance of content marked with trigger warnings that was encountered in daily life and any mental health risk marker (e.g., PTSD symptoms, trauma exposure). Our findings therefore further question claims that trigger warnings are an effective online mental health intervention.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"89 ","pages":"Article 102040"},"PeriodicalIF":2.2,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889023","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}
Pub Date : 2025-08-23DOI: 10.1016/j.jbtep.2025.102051
Charlie W. McDonald, Richard E. Mattson, Fiona G. Sleight, Steven J. Lynn, Christina Balderrama-Durbin, Meredith E. Coles
Few studies have directly compared variables implicated in the etiology of dissociation within an experimental paradigm. Virtual reality (VR) has recently received empirical support as a vehicle for experimentally manipulating state dissociation to test these etiological models. We conducted a study to induce state dissociation to examine key variables in the etiology of dissociation (e.g., trauma experiences). First, participants completed demographic information and baseline measures of state and trait dissociation, positive and negative affect, and a set of theoretically important variables within the transdiagnostic and transtheoretical model (TTM; e.g., emotional dysregulation). Next, they were randomized to a VR or personal computer (PC) condition, in which they navigated a virtual cityscape for 15 minutes, followed by another set of questionnaires to capture change in state dissociation and positive and negative affect. We evaluated (a) residualized change scores for state dissociation and positive and negative affect; and (b) explored associations between variables in the TTM and these outcomes. Findings revealed that (a) VR did significantly increase state dissociation when controlling for trait dissociation; (b) positive but not negative affect increased in the VR condition from pre-to post-induction; and (c) variables in the TTM were correlated with pre- and post-induction scores of state dissociation, but these associations were not stronger in the VR condition compared to the PC condition. Combined, these findings suggest that VR is an effective laboratory paradigm for increasing state dissociation and positive affect. Furthermore, several proposed etiological variables in the TTM do relate to and explain state dissociation as hypothesized.
{"title":"Using an ecologically generalizable virtual reality (VR) paradigm for studying state dissociation and etiological models of clinically-significant dissociation","authors":"Charlie W. McDonald, Richard E. Mattson, Fiona G. Sleight, Steven J. Lynn, Christina Balderrama-Durbin, Meredith E. Coles","doi":"10.1016/j.jbtep.2025.102051","DOIUrl":"10.1016/j.jbtep.2025.102051","url":null,"abstract":"<div><div>Few studies have directly compared variables implicated in the etiology of dissociation within an experimental paradigm. Virtual reality (VR) has recently received empirical support as a vehicle for experimentally manipulating state dissociation to test these etiological models. We conducted a study to induce state dissociation to examine key variables in the etiology of dissociation (e.g., trauma experiences). First, participants completed demographic information and baseline measures of state and trait dissociation, positive and negative affect, and a set of theoretically important variables within the transdiagnostic and transtheoretical model (TTM; e.g., emotional dysregulation). Next, they were randomized to a VR or personal computer (PC) condition, in which they navigated a virtual cityscape for 15 minutes, followed by another set of questionnaires to capture change in state dissociation and positive and negative affect. We evaluated (a) residualized change scores for state dissociation and positive and negative affect; and (b) explored associations between variables in the TTM and these outcomes. Findings revealed that (a) VR did significantly increase state dissociation when controlling for trait dissociation; (b) positive but not negative affect increased in the VR condition from pre-to post-induction; and (c) variables in the TTM were correlated with pre- and post-induction scores of state dissociation, but these associations were not stronger in the VR condition compared to the PC condition. Combined, these findings suggest that VR is an effective laboratory paradigm for increasing state dissociation and positive affect. Furthermore, several proposed etiological variables in the TTM do relate to and explain state dissociation as hypothesized.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"89 ","pages":"Article 102051"},"PeriodicalIF":2.2,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889025","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}
Pub Date : 2025-08-23DOI: 10.1016/j.jbtep.2025.102058
Lisa Zöbl , Anika Frühauf , Alexander Heimbeck , Ulrich Voderholzer , Martin Kopp
Background
Therapeutic climbing (TC) is increasingly used as a therapy form in psychosomatic settings. Recent studies have shown its effectiveness in terms of symptom severity and other psychological factors compared to other sports and even to group cognitive behavioural therapy. To gain a deeper understanding of TC, the present study aimed to qualitatively explore the patients' perspectives.
Methodology
The qualitative study used semi-structured interviews to explore the experiences of inpatients at a psychosomatic clinic who participated in a standardised climbing therapy group. The main diagnoses of the participants were depression, anxiety, or obsessive-compulsive disorder (n = 17; 12 female, 5 male). Data were analysed using thematic content analysis.
Results
Most patients described positive effects of TC. The following four factors emerged: Cognitive (e.g. concentration, focus), emotional (e.g. trust in oneself and others), social (e.g. mutual support), and physical (e.g. strength). Patients also reported positive perceived aspects in connection with their mental disorder and listed various transfer options, which indicates an effectiveness beyond TC.
Discussion
From the patients' perspective, TC influences various factors, which also interact. Many of the identified effects could be assigned to the common factors of psychotherapy, which indicates that TC addresses similar factors as established psychotherapies. In addition to the researched aspects of self-efficacy and affective responses, new aspects were identified: Focus and concentration, social interaction, facing challenges, improved self-confidence, trust in others, and resource activation. Practical implications could be derived from this. Future studies should investigate the efficacy of TC in randomised, controlled clinical trials, considering the aspects identified.
{"title":"Therapeutic climbing as an adjunctive treatment for psychiatric inpatients: A qualitative study","authors":"Lisa Zöbl , Anika Frühauf , Alexander Heimbeck , Ulrich Voderholzer , Martin Kopp","doi":"10.1016/j.jbtep.2025.102058","DOIUrl":"10.1016/j.jbtep.2025.102058","url":null,"abstract":"<div><h3>Background</h3><div>Therapeutic climbing (TC) is increasingly used as a therapy form in psychosomatic settings. Recent studies have shown its effectiveness in terms of symptom severity and other psychological factors compared to other sports and even to group cognitive behavioural therapy. To gain a deeper understanding of TC, the present study aimed to qualitatively explore the patients' perspectives.</div></div><div><h3>Methodology</h3><div>The qualitative study used semi-structured interviews to explore the experiences of inpatients at a psychosomatic clinic who participated in a standardised climbing therapy group. The main diagnoses of the participants were depression, anxiety, or obsessive-compulsive disorder (n = 17; 12 female, 5 male). Data were analysed using thematic content analysis.</div></div><div><h3>Results</h3><div>Most patients described positive effects of TC. The following four factors emerged: Cognitive (e.g. concentration, focus), emotional (e.g. trust in oneself and others), social (e.g. mutual support), and physical (e.g. strength). Patients also reported positive perceived aspects in connection with their mental disorder and listed various transfer options, which indicates an effectiveness beyond TC.</div></div><div><h3>Discussion</h3><div>From the patients' perspective, TC influences various factors, which also interact. Many of the identified effects could be assigned to the common factors of psychotherapy, which indicates that TC addresses similar factors as established psychotherapies. In addition to the researched aspects of self-efficacy and affective responses, new aspects were identified: Focus and concentration, social interaction, facing challenges, improved self-confidence, trust in others, and resource activation. Practical implications could be derived from this. Future studies should investigate the efficacy of TC in randomised, controlled clinical trials, considering the aspects identified.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"89 ","pages":"Article 102058"},"PeriodicalIF":2.2,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889035","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}
Pub Date : 2025-08-23DOI: 10.1016/j.jbtep.2025.102055
Elham Monaghesh , Sara Farhang , Taha Samad-Soltani
Introduction
patients with schizophrenia have deficits in social cognition and functioning. Virtual reality is a 3D real-world simulation created by a computer. Virtual reality-based cognitive behavioral therapy might increase effectiveness and acceptability of treatment for these patients. This study investigated the efficacy of VR-CBT compared to traditional CBT in improving these outcomes in patients with recent-onset schizophrenia.
Methods
In this open-label, randomized controlled trial, 60 patients with schizophrenia (36 men, 24 women) were randomized to receive either four sessions of VR-CBT or traditional CBT, in addition to pharmacological treatment. The VR environment simulated a bus trip with 11 neutral-faced avatars. Outcomes were assessed using the Positive and Negative Syndrome Scale (PANSS; positive symptom subscale), the Green Paranoid Thoughts Scale (GPTS), and the Reading the Mind in the Eyes Test (Eyes Test) at baseline and post-treatment. Data were analyzed using repeated measures ANOVA.
Results
Both groups showed significant improvements in all measures (p < 0.05). However, the VR-CBT group demonstrated significantly greater reductions in PANSS (p < 0.001) and GPTS scores (p < 0.001), and a significantly greater increase in Eyes Test scores (p < 0.002) compared to the CBT group. No adverse effects were reported.
Conclusion
VR-CBT appears to be a promising adjunct to standard treatment for recent-onset schizophrenia, offering superior improvements in positive symptoms, paranoia, and ToM compared to traditional CBT. Further research is warranted to examine the long-term effects and underlying mechanisms of VR-CBT in this population.
{"title":"Virtual reality assisted cognitive behavioral therapy improves theory of mind and decreases paranoia in patients with schizophrenia: a randomized controlled trial","authors":"Elham Monaghesh , Sara Farhang , Taha Samad-Soltani","doi":"10.1016/j.jbtep.2025.102055","DOIUrl":"10.1016/j.jbtep.2025.102055","url":null,"abstract":"<div><h3>Introduction</h3><div>patients with schizophrenia have deficits in social cognition and functioning. Virtual reality is a 3D real-world simulation created by a computer. Virtual reality-based cognitive behavioral therapy might increase effectiveness and acceptability of treatment for these patients. This study investigated the efficacy of VR-CBT compared to traditional CBT in improving these outcomes in patients with recent-onset schizophrenia.</div></div><div><h3>Methods</h3><div>In this open-label, randomized controlled trial, 60 patients with schizophrenia (36 men, 24 women) were randomized to receive either four sessions of VR-CBT or traditional CBT, in addition to pharmacological treatment. The VR environment simulated a bus trip with 11 neutral-faced avatars. Outcomes were assessed using the Positive and Negative Syndrome Scale (PANSS; positive symptom subscale), the Green Paranoid Thoughts Scale (GPTS), and the Reading the Mind in the Eyes Test (Eyes Test) at baseline and post-treatment. Data were analyzed using repeated measures ANOVA.</div></div><div><h3>Results</h3><div>Both groups showed significant improvements in all measures (p < 0.05). However, the VR-CBT group demonstrated significantly greater reductions in PANSS (p < 0.001) and GPTS scores (p < 0.001), and a significantly greater increase in Eyes Test scores (p < 0.002) compared to the CBT group. No adverse effects were reported.</div></div><div><h3>Conclusion</h3><div>VR-CBT appears to be a promising adjunct to standard treatment for recent-onset schizophrenia, offering superior improvements in positive symptoms, paranoia, and ToM compared to traditional CBT. Further research is warranted to examine the long-term effects and underlying mechanisms of VR-CBT in this population.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"89 ","pages":"Article 102055"},"PeriodicalIF":2.2,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889032","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}
Pub Date : 2025-08-23DOI: 10.1016/j.jbtep.2025.102049
Laurel D. Sarfan, Anne E. Milner, Sondra Tiab, Diya Tuli, Allison G. Harvey
Habits are underexplored in research on evidence-based psychological treatments (EBPTs). We recruited participants (N = 286) with sleep problems via Mechanical Turk for an experiment to shift wake-up habits, a key target of EBPTs for sleep problems. Participants were randomly assigned to a control (i.e., psychoeducation about healthy wake-up habits) or one of five active habit-change strategies: substitution with RISE UP, awareness training, vigilant monitoring, implementation intentions, and values. New and old wake-up habit strength, sleep disruption, and sleep-related impairment were assessed at baseline, six-week follow-up, and three-month follow-up. Aim 1 tested within- and between-condition change in the outcomes. Aim 2 tested whether change in wake-up habit strength predicted improvements in sleep disruption and sleep-related impairment. Except the values condition, all habit-change strategies and the control were significantly associated with within-condition improvements at 6-week follow-up and 3-month follow-up in: new habit strength (d = 0.81 to 1.68), old habit strength (d = −0.63 to −1.04), sleep disruption (d = −0.97 to −1.98), and sleep-related impairment (d = −0.60 to −1.65). Few differences between conditions emerged. Across conditions, more than 50% of participants met thresholds for clinically meaningful improvement, except the values condition at 3-month follow-up. Change in new and old habit strength significantly predicted change in sleep problems. Key limitations included: an exclusively online study design, dropout rate, and sample collected via Mechanical Turk using self-report measures without formal assessment of sleep diagnoses. Future research should investigate the clinical presentations and EBPT skills for which these habit-change strategies are most effective.
{"title":"Let's kick that habit: An experiment of five habit-change strategies on habits and symptoms among adults with sleep problems","authors":"Laurel D. Sarfan, Anne E. Milner, Sondra Tiab, Diya Tuli, Allison G. Harvey","doi":"10.1016/j.jbtep.2025.102049","DOIUrl":"10.1016/j.jbtep.2025.102049","url":null,"abstract":"<div><div>Habits are underexplored in research on evidence-based psychological treatments (EBPTs). We recruited participants (<em>N</em> = 286) with sleep problems via Mechanical Turk for an experiment to shift wake-up habits, a key target of EBPTs for sleep problems. Participants were randomly assigned to a control (i.e., psychoeducation about healthy wake-up habits) or one of five active habit-change strategies: substitution with RISE UP, awareness training, vigilant monitoring, implementation intentions, and values. New and old wake-up habit strength, sleep disruption, and sleep-related impairment were assessed at baseline, six-week follow-up, and three-month follow-up. Aim 1 tested within- and between-condition change in the outcomes. Aim 2 tested whether change in wake-up habit strength predicted improvements in sleep disruption and sleep-related impairment. Except the values condition, all habit-change strategies and the control were significantly associated with within-condition improvements at 6-week follow-up and 3-month follow-up in: new habit strength (<em>d</em> = 0.81 to 1.68), old habit strength (<em>d</em> = −0.63 to −1.04), sleep disruption (<em>d</em> = −0.97 to −1.98), and sleep-related impairment (<em>d</em> = −0.60 to −1.65). Few differences between conditions emerged. Across conditions, more than 50% of participants met thresholds for clinically meaningful improvement, except the values condition at 3-month follow-up. Change in new and old habit strength significantly predicted change in sleep problems. Key limitations included: an exclusively online study design, dropout rate, and sample collected via Mechanical Turk using self-report measures without formal assessment of sleep diagnoses. Future research should investigate the clinical presentations and EBPT skills for which these habit-change strategies are most effective.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"89 ","pages":"Article 102049"},"PeriodicalIF":2.2,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889024","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}
Pub Date : 2025-08-22DOI: 10.1016/j.jbtep.2025.102068
M. Pelzer , C. Ouellet-Courtois , S. Krause , A. Coughtrey , J. Fink-Lamotte
Background
Perceiving a threat as constantly evolving, coming closer and escalating quickly can result in looming vulnerability (LV). LV may be a distal factor in contamination-based OCD (C-OCD) influencing disorder-specific mechanisms such as disgust. The aim of this study was to gain knowledge about three components of LV: speed, proximity and acceleration, and their influence on the relationship between disgust and C-OCD symptoms.
Methods
119 participants with subclinical C-OCD symptoms imagined four out of seven versions of a disgusting bathroom scene, varying in speed (slow/fast), proximity (farther away/closer), and acceleration (constant/exponential). These six dynamic conditions were compared to a static description. T-tests and a Bayesian multilevel model were used to assess differences in perceived dynamics of threat, disgust responses, and to examine the moderating role of C-OCD symptoms on responses to the experimental conditions.
Results
Threats in the dynamic conditions were perceived as significantly faster, closer, and more accelerated than in the static version. A difference within dynamic dimensions only emerged between the farther away and closer conditions. The Bayesian model showed a moderating effect of C-OCD symptoms leading to higher levels of disgust in the dynamic conditions, but not within the static condition.
Limitations
Without baseline disgust and LV measures, the specific contributions to disgust and LV for each condition remain unclear.
Conclusion
By showing that imagining dynamic contamination only elicits stronger disgust in individuals with higher C-OCD symptoms, the results support the idea of LV as a distal factor influencing symptom-maintaining factors in C-OCD such as disgust.
{"title":"Obsessive-compulsive symptoms moderate the effect of contamination motion on disgust intensity","authors":"M. Pelzer , C. Ouellet-Courtois , S. Krause , A. Coughtrey , J. Fink-Lamotte","doi":"10.1016/j.jbtep.2025.102068","DOIUrl":"10.1016/j.jbtep.2025.102068","url":null,"abstract":"<div><h3>Background</h3><div>Perceiving a threat as constantly evolving, coming closer and escalating quickly can result in looming vulnerability (LV). LV may be a distal factor in contamination-based OCD (C-OCD) influencing disorder-specific mechanisms such as disgust. The aim of this study was to gain knowledge about three components of LV: speed, proximity and acceleration, and their influence on the relationship between disgust and C-OCD symptoms.</div></div><div><h3>Methods</h3><div>119 participants with subclinical C-OCD symptoms imagined four out of seven versions of a disgusting bathroom scene, varying in speed (slow/fast), proximity (farther away/closer), and acceleration (constant/exponential). These six dynamic conditions were compared to a static description. T-tests and a Bayesian multilevel model were used to assess differences in perceived dynamics of threat, disgust responses, and to examine the moderating role of C-OCD symptoms on responses to the experimental conditions.</div></div><div><h3>Results</h3><div>Threats in the dynamic conditions were perceived as significantly faster, closer, and more accelerated than in the static version. A difference within dynamic dimensions only emerged between the farther away and closer conditions. The Bayesian model showed a moderating effect of C-OCD symptoms leading to higher levels of disgust in the dynamic conditions, but not within the static condition.</div></div><div><h3>Limitations</h3><div>Without baseline disgust and LV measures, the specific contributions to disgust and LV for each condition remain unclear.</div></div><div><h3>Conclusion</h3><div>By showing that imagining dynamic contamination only elicits stronger disgust in individuals with higher C-OCD symptoms, the results support the idea of LV as a distal factor influencing symptom-maintaining factors in C-OCD such as disgust.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"90 ","pages":"Article 102068"},"PeriodicalIF":2.2,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144894950","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}
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