Journal of Behavior Therapy and Experimental Psychiatry最新文献_第4页

Imagery rescripting: The value of an added positive emotion component 意象重写：添加积极情绪成分的价值

IF 1.8 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2024-03-12 DOI: 10.1016/j.jbtep.2024.101958

Nicole Geschwind , Evelyn Keasberry , Marisol Voncken , Jill Lobbestael , Maarten Peters , Marleen Rijkeboer , Dalena van Heugten-van der Kloet

Background and objectives

Imagery Rescripting (ImRs) aims to reduce trauma-related negative emotions and intrusions. Positive emotions during ImRs may aid coping with the consequences of trauma, but protocols vary in the extent to which they explicitly target such positive emotions. We used a multiple-day design with a trauma film paradigm to investigate whether adding an explicit positive emotion component to ImRs improved intervention effects in a non-clinical sample. In addition, we explored potentially differential effects on high, medium, and low arousal positive affect.

Methods

Participants (n = 105) were randomly assigned to either a standard ImRs condition, to an ImRs condition with an added explicit positive emotion component targeting joy (ImRs+), or to a non-intervention control (NIC) condition. Participants watched a trauma film on day 1, received the condition-specific intervention on day 2, and completed additional post-assessments of positive and negative affect on day 3. In addition, participants recorded intrusions from the trauma film from day 1 until day 3.

Results

Compared to standard ImRs and NIC, ImRs + significantly increased positive affect. Exploratory analyses showed that this increase concerned medium and high, but not low arousal positive affect. No significant between-group differences were found for negative affect and intrusion-related outcomes.

Limitations

Floor effects for intrusions and negative affect limited our ability to fully investigate the potential benefits of targeting positive affect.

Conclusions

Adding a positive emotion component to ImRs reliably improved positive affect. More research is needed to determine whether explicitly targeting positive affect improves efficacy of ImRs for intrusion-related outcomes.

意象重编（ImRs）旨在减少与创伤相关的负面情绪和侵扰。意象重塑过程中的积极情绪可能有助于应对创伤后果，但在明确针对这种积极情绪的程度上，方案各不相同。我们采用多天设计和创伤电影范例，研究在 ImRs 中添加明确的积极情绪成分是否会改善非临床样本的干预效果。此外，我们还探讨了高、中、低唤醒积极情绪的潜在差异效应。参与者（= 105 人）被随机分配到标准的 ImRs 条件下、添加了明确的积极情绪成分以获得快乐的 ImRs 条件下（ImRs+）或非干预对照（NIC）条件下。参与者在第 1 天观看创伤影片，在第 2 天接受特定条件干预，并在第 3 天完成额外的积极和消极情绪后评估。此外，受试者还记录了从第 1 天到第 3 天创伤影片中的闯入行为。与标准 ImRs 和 NIC 相比，ImRs + 显著增加了积极情感。探索性分析表明，这种增加与中度和高度唤醒的积极情绪有关，但与低度唤醒的积极情绪无关。在消极情绪和入侵相关结果方面，没有发现明显的组间差异。入侵和消极情绪的底限效应限制了我们全面研究以积极情绪为目标的潜在益处的能力。在 ImRs 中添加积极情绪成分能有效改善积极情绪。我们需要进行更多的研究，以确定明确针对积极情绪是否能提高 ImRs 对入侵相关结果的疗效。

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引用次数: 0

Compulsive rituals in Obsessive-Compulsive Disorder – A qualitative exploration of thoughts, feelings and behavioral patterns 强迫症患者的强迫仪式--对思想、情感和行为模式的定性研究

IF 1.8 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2024-03-11 DOI: 10.1016/j.jbtep.2024.101960

Yair Wairauch , Jedidiah Siev , Udi Hasdai , Reuven Dar

Background and objectives

Rituals are common among healthy individuals and across cultures and often serve adaptive purposes. In individuals with obsessive-compulsive disorder (OCD), rituals become compulsive, time-consuming and distressing, and may lead to functional impairment. Previous research has examined the functions and characteristics of compulsive rituals, but there is paucity of in-depth, first-person reports about this topic.

Method

We used a qualitative approach to explore thoughts, feelings, and behavioral patterns that characterize OCD rituals. Ten individuals with OCD participated in a semi-structured interview that focused on their most prominent compulsive ritual. The interviews were subjected to a thematic analysis.

Results

Eight themes emerged from the analysis and were organized in two main categories: Micro Level perspective, comprising triggers, attention, emotional changes, and stopping criteria; and Macro Level perspective, comprising feelings and perceptions, change over time, motives, and inhibitors. The findings shed light on the role of fixed rules and feelings of “completeness” in OCD rituals, the nature of emotional and attentional characteristics during rituals performance, and the evolution of compulsive rituals over time.

Limitations

This study used a qualitative approach based on a small number of participants, which limits the generalizability of the findings.

Conclusion

Our results, if replicated, may have clinical implications. The reported patterns of anxiety reduction during ritual performance may contribute to the fine-tuning of CBT for OCD. The findings concerning the nature of attention during ritual performance and the development of rituals over time may be important for understanding the mechanisms that maintain compulsive rituals.

仪式在健康人和不同文化中都很常见，通常具有适应目的。对于患有强迫症（OCD）的人来说，仪式会变得强迫、耗时和痛苦，并可能导致功能障碍。以往的研究已对强迫性仪式的功能和特点进行了研究，但有关这一主题的第一手深入报道却很少。我们采用定性的方法来探讨强迫症仪式的思想、情感和行为模式。十名强迫症患者参加了半结构化访谈，访谈的重点是他们最突出的强迫仪式。对访谈内容进行了主题分析。分析得出了八个主题，并将其分为两大类：微观层面的视角，包括触发因素、注意力、情绪变化和停止标准；宏观层面的视角，包括感受和认知、随时间的变化、动机和抑制因素。研究结果揭示了强迫症仪式中固定规则和 "完整 "感的作用、仪式过程中情绪和注意力特征的性质以及强迫症仪式随时间的演变。本研究采用定性方法，参与者人数较少，这限制了研究结果的推广性。我们的研究结果如能复制，可能会对临床产生影响。所报告的仪式过程中焦虑减少的模式可能有助于对强迫症的 CBT 进行微调。有关仪式表演过程中注意力的性质以及仪式随着时间的推移而发展的研究结果，对于理解强迫性仪式的维持机制可能非常重要。

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引用次数: 0

Transitioning to college: Testing cognitive bias modification for interpretations as an inoculation tool for social anxiety in college first-years 向大学过渡：测试将认知偏差修正解释作为预防大学一年级学生社交焦虑的工具

IF 1.8 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2024-03-11 DOI: 10.1016/j.jbtep.2024.101961

Sarah E. Dreyer-Oren , Akanksha Das , Rachel B. Geyer , Robert E. Fite , Elizabeth J. Kiel , Elise M. Clerkin

Background and objectives

Reducing social anxiety development among incoming college students may improve college adjustment and mental health outcomes. This study tested whether cognitive bias modification for interpretations (CBM-I) reduces social anxiety and increases adjustment during the transition to college, and whether changes in outcomes would be mediated by changes in interpretation biases.

Methods

Participants (N = 73) were randomly assigned to a 3-session weekly CBM-I condition or symptom tracking (ST) control condition. Multilevel models were used to estimate within-person trajectories from baseline to one week post-intervention and to test whether trajectories differed by condition.

Results

Those in the CBM-I condition (vs. ST) reported higher increases in social adjustment across time. There were not significant differences between conditions for changes in social anxiety, academic adjustment, and personal adjustment. CBM-I was indirectly linked to improvements in outcome variables via more adaptive interpretation biases.

Limitations

CBM-I was administered in a laboratory setting, requiring more resources than some computerized interventions.

Conclusions

Data tentatively support CBM-I for first-year students to increase social adjustment. Further, mediation findings provide support for targeting interpretation biases to improve social anxiety and adjustment outcomes. Yet, CBM-I did not outperform ST in improving social anxiety symptoms or other areas of college adjustment, and effect sizes were small, suggesting that more work is needed to amplify the potential of CBM-I as a therapeutic tool.

背景和目的减轻大学新生的社交焦虑可能会改善大学适应和心理健康结果。本研究测试了解释性认知偏差修正（CBM-I）是否能减少大学过渡期间的社交焦虑并提高适应性，以及结果的变化是否会受到解释性偏差变化的影响。方法将参与者（N = 73）随机分配到每周 3 节课的 CBM-I 条件下或症状跟踪（ST）对照条件下。使用多层次模型估算从基线到干预后一周的人内轨迹，并检验不同条件下的轨迹是否存在差异。结果CBM-I 条件（与 ST 条件相比）下的参与者在不同时间段的社会适应能力提高幅度更大。在社交焦虑、学业适应性和个人适应性的变化方面，不同条件下的差异并不明显。局限性CBM-I是在实验室环境中进行的，与某些计算机化干预相比需要更多的资源。此外，调解结果为针对解释偏差改善社交焦虑和适应结果提供了支持。然而，CBM-I 在改善社交焦虑症状或大学适应的其他方面的效果并没有优于 ST，而且效果大小很小，这表明还需要做更多的工作来扩大 CBM-I 作为治疗工具的潜力。

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引用次数: 0

The effect of self-focused attention during mirror gazing on body image evaluations, appearance-related imagery, and urges to mirror gaze 镜像凝视时的自我关注对身体形象评价、外貌相关意象和镜像凝视冲动的影响

IF 1.8 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2024-03-03 DOI: 10.1016/j.jbtep.2024.101952

Jasmine Chuah, Oliver Suendermann

Background and objectives

Mirror gazing has been linked to poor body image. Cognitive-behavioral models propose that mirror gazing induces self-focused attention. This activates appearance-related imagery, increases body dissatisfaction, and promotes further mirror gazing. However, evidence for these relationships remains scarce. Our study experimentally investigated how self-focused attention impacts overall and facial appearance satisfaction, perceived attractiveness, distress about appearance and disliked features, vividness and emotional quality of appearance-related imagery, and urges to mirror gaze. Baseline body dysmorphic concerns were studied as a moderator.

Methods

Singaporean undergraduates (M_age = 21.22, SD_age = 1.62; 35 females, 28 males) were randomly assigned to high or low self-focused attention during a mirror gazing task. Dependent variables were measured with visual analogue scales, and body dysmorphic concerns with the Body Image Disturbance Questionnaire (BIDQ). Analysis of variance and moderation analyses were conducted.

Results

Self-focused attention lowered overall and facial appearance satisfaction. Perceived attractiveness decreased only in individuals with high baseline body dysmorphic concerns. Contrary to predictions, distress, appearance-related imagery, and urges to mirror gaze were unaffected.

Limitations

This study used a non-clinical sample. The BIDQ has not been psychometrically validated in Singaporean samples.

Conclusions

Self-focused attention during mirror gazing lowers positive body image evaluations. Individuals with higher body dysmorphic concerns are particularly vulnerable to low perceived attractiveness.

注视镜子与不良身体形象有关。认知行为模型认为，注视镜子会诱发自我关注。这激活了与外貌相关的想象，增加了对身体的不满，并促进了对镜子的注视。然而，这些关系的证据仍然很少。我们的研究通过实验调查了自我关注如何影响整体和面部外貌满意度、感知吸引力、对外貌和不喜欢的特征的困扰、外貌相关意象的生动性和情感质量以及镜像凝视的冲动。研究将身体畸形的基线关注作为调节因素。新加坡大学生（=21.22，=1.62；35 名女性，28 名男性）在镜像凝视任务中被随机分配到高或低自我关注度。自变量用视觉模拟量表测量，身体畸形问题用身体形象干扰问卷（BIDQ）测量。研究进行了方差分析和调节分析。自我关注降低了整体和面部外貌满意度。有趣的是，只有那些身体畸形基线关注度高的人，其感知吸引力才会降低。与预测相反，困扰、与外貌相关的想象和镜像凝视冲动均未受到影响。这项研究使用的是非临床样本，而且 BIDQ 还没有在新加坡样本中进行心理计量学验证。注视镜子时的自我关注会降低对身体形象的积极评价。对外貌有更多关注的人特别容易认为自己的吸引力低。

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引用次数: 0

Non-fear emotions in changes in posttraumatic stress disorder symptoms during treatment 治疗期间创伤后应激障碍症状变化中的非恐惧情绪

IF 1.8 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2024-02-29 DOI: 10.1016/j.jbtep.2024.101954

Sophie A. Rameckers , Arnold A.P. van Emmerik , Raoul P.P.P. Grasman , Arnoud Arntz

Background and objectives

Posttraumatic stress disorder (PTSD) is not only associated with fear but also with other emotions. The present study aimed to examine if changes in shame, guilt, anger, and disgust predicted changes in PTSD symptoms during treatment, while also testing if PTSD symptoms, in turn, predicted changes in these emotions.

Methods

Participants (N = 155) with childhood-related PTSD received a maximum of 12 sessions of eye movement desensitization and reprocessing or imagery rescripting. The data was analyzed using Granger causality models across 12 treatment sessions and 6 assessment sessions (up until one year after the start of treatment). Differences between the two treatments were explored.

Results

Across treatment sessions, shame, and disgust showed a reciprocal relationship with PTSD symptoms, while changes in guilt preceded PTSD symptoms. Across assessments, anger was reciprocally related to PTSD, suggesting that anger might play a more important role in the longer term.

Limitations

The individual emotion items were not yet validated, and the CAPS was not administered at all assessments.

Conclusions

These findings partly differ from earlier studies that suggested a unidirectional relationship in which changes in emotions preceded changes in PTSD symptoms during treatment. This is in line with the idea that non-fear emotions do play an important role in the treatment of PTSD and constitute an important focus of treatment and further research.

创伤后应激障碍（PTSD）不仅与恐惧有关，还与其他情绪有关。本研究旨在探讨羞愧、内疚、愤怒和厌恶情绪的变化是否能预测治疗过程中创伤后应激障碍症状的变化，同时检验创伤后应激障碍症状是否反过来也能预测这些情绪的变化。患有童年相关创伤后应激障碍的参与者（= 155 人）接受了最多 12 次的眼动脱敏和再处理或意象重写治疗。我们使用格兰杰因果关系模型对 12 个疗程和 6 个评估疗程（直至治疗开始后一年）的数据进行了分析。探讨了两种治疗方法之间的差异。在整个治疗过程中，羞耻感和厌恶感与创伤后应激障碍症状呈互为因果的关系，而内疚感的变化则先于创伤后应激障碍症状。在不同的评估中，愤怒与创伤后应激障碍呈互为因果的关系，这表明从长远来看，愤怒可能会发挥更重要的作用。单个情绪项目尚未得到验证，而且 CAPS 并未在所有评估中使用。这些研究结果在一定程度上不同于之前的研究，之前的研究表明，在治疗过程中，情绪的变化先于创伤后应激障碍症状的变化，这是一种单向关系。这符合非恐惧情绪在创伤后应激障碍的治疗中发挥重要作用的观点，也是治疗和进一步研究的重点。

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引用次数: 0

Testing a brief attention training protocol to prevent emotional distress from a fear induction procedure 测试简短注意力训练方案，防止恐惧诱导程序造成情绪困扰

IF 1.8 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2024-02-28 DOI: 10.1016/j.jbtep.2024.101956

Mikael Rubin

Background and objectives

Attentional hypervigilance to threat in posttraumatic stress disorder (PTSD) is an important topic to investigate. Efforts to leverage attention training to prevent PTSD have been promising but underlying mechanisms have not been fully elucidated. The current study tested whether Attention Bias Modification (ABM) prior to an emotion induction of fear could reduce self-reported fear and arousal compared to two control conditions.

Methods

Participants (N = 86) were recruited from Amazon Mechanical Turk and randomized to receive either (1) ABM where they were directed towards fear related words on every trial; (2) Attention Control Training (ACT) where they were directed towards fear related words on 50% of trials; or (3) Neutral training where all words were neutral. Participants then completed a fear emotion induction (a 2-min video), reporting fear, arousal, and mood before and after the emotion induction.

Results

Participants in the ABM condition had lower fear compared to the Neutral condition b = 11.43, 95% CI (1.20, 21.65), d = 0.48. Participants in the ABM condition did not have lower fear compared to the ACT condition b = 9.75, 95% CI (−0.64, 19.96), d = 0.41. Importantly, attentional avoidance at baseline moderated the effect of condition for both fear and arousal; higher avoidance at baseline for the ABM condition was associated with lower fear and arousal after the emotion induction compared to the Neutral condition.

Limitations

The sample size was relatively small and limited in diversity.

Conclusions

These findings are the first experimental evidence showing that the benefit of ABM prior to a fearful experience may be in its reduction of the target emotion. Additionally, ABM may work best for those that demonstrate the most avoidance at baseline in their attention towards fearful stimuli.

背景和目的创伤后应激障碍（PTSD）患者对威胁的过度警觉是一个重要的研究课题。利用注意力训练预防创伤后应激障碍的努力很有希望，但其潜在机制尚未完全阐明。本研究测试了与两种对照条件相比，在进行恐惧情绪诱导之前进行注意力偏差修正（ABM）是否能减少自我报告的恐惧和唤醒。方法从亚马逊 Mechanical Turk 中招募参与者（N = 86），并随机分配他们接受（1）注意力偏差修正（ABM），即在每次试验中都引导他们使用与恐惧相关的单词；（2）注意力控制训练（ACT），即在 50% 的试验中引导他们使用与恐惧相关的单词；或（3）中性训练，即所有单词都是中性的。然后，参与者完成恐惧情绪诱导（一段 2 分钟的视频），并在情绪诱导前后报告恐惧、唤醒和情绪。结果与中性条件相比，ABM 条件下参与者的恐惧感较低，b = 11.43，95% CI (1.20, 21.65)，d = 0.48。与 ACT 条件相比，ABM 条件下的参与者的恐惧感并不低，b = 9.75，95% CI (-0.64, 19.96)，d = 0.41。重要的是，基线时的注意回避调节了条件对恐惧和唤醒的影响；与中性条件相比，ABM 条件下基线时较高的回避与情绪诱导后较低的恐惧和唤醒相关。此外，ABM 对那些在基线时对恐惧刺激表现出最大回避的人可能最有效。

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引用次数: 0

Embodied cognitive restructuring: The impact of posture and movement on changing dysfunctional attitudes 体现式认知重组：姿势和动作对改变功能失调态度的影响

IF 1.8 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2024-02-24 DOI: 10.1016/j.jbtep.2024.101955

M.S. O’Toole , J. Michalak

Background and objectives

Previous theoretical and empirical work has pointed to the important role of the body in emotion generation and emotion regulation. In the present study, we wanted to investigate if the performance of certain body postures and movement could facilitate cognitive restructuring of dysfunctional cognitive attitudes more effectively than traditional, verbal-only methods.

Methods

In total, 130 participants were randomized to one of two groups. One group was subjected to cognitive restructuring (i.e., restructure only group; CR-only), verbally exploring a dysfunctional attitude from a curious, strong, and courageous perspective. The other group received the same verbal instructions but in addition to this, was asked to perform different bodily exercises (i.e., motor-enhanced restructuring group; M-CR) supposed to enhance experience of the different perspectives from which cognitive restructuring was employed.

Results

Results confirmed the primary hypothesis, showing that the M-CR-group showed a larger decline in belief in dysfunctional attitudes compared with the CR-only group (F = 4.2, p = 0.041, d = 0.25). No differences on secondary outcomes were observed between the two groups.

Limitations

Future research should explore the effects of motor-enhanced CR both more long-term (e.g., durability over weeks) and in clinical samples (e.g., anxiety and depression).

Conclusion

Should the findings be replicated in clinical samples, it is encouraging that simple bodily exercises can enhance the effect of one of the most central skills of cognitive therapy.

背景和目的以前的理论和实证研究都指出了身体在情绪产生和情绪调节中的重要作用。在本研究中，我们希望调查某些身体姿势和动作的表现是否能比传统的、只用语言表达的方法更有效地促进对功能失调认知态度的认知重组。其中一组接受认知重组（即仅重组组；CR-only），从好奇、坚强和勇敢的角度对功能失调的态度进行口头探索。另一组接受同样的口头指导，但除此之外，还被要求进行不同的身体练习（即运动增强重组组；M-CR），以增强对认知重组所采用的不同视角的体验。结果结果证实了主要假设，显示与纯 CR 组相比，M-CR 组在功能失调态度信念方面的下降幅度更大（F = 4.2，p = 0.041，d = 0.25）。局限性未来的研究应探索运动增强 CR 的长期效果（如持续数周）和临床样本（如焦虑和抑郁）。

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引用次数: 0

Fear-related associations in children of parents with an anxiety disorder 父母患有焦虑症的儿童与恐惧有关的联想

IF 1.8 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2024-02-21 DOI: 10.1016/j.jbtep.2024.101953

Anke M. Klein , Rianne E. Van Niekerk , Esther Allart Van Dam , Mike Rinck , Marc J.P.M. Verbraak , Giel J.M. Hutschemaekers , Eni S. Becker

Background and objectives

Children of parents with an anxiety disorder are at elevated risk for developing an anxiety disorder themselves. According to cognitive theories, a possible risk factor is the development of schema-related associations. This study is the first to investigate whether children of anxious parents display fear-related associations and whether these associations relate to parental anxiety.

Methods

44 children of parents with panic disorder, 27 children of parents with social anxiety disorder, and 84 children of parents without an anxiety disorder filled out the SCARED-71, and the children performed an Affective Priming Task.

Results

We found partial evidence for disorder-specificity: When the primes were related to their parent's disorder and the targets were negative, the children of parents with panic disorder and children of parents with social anxiety disorder showed the lowest error rates related to their parents' disorder, but they did not have faster responses. We did not find any evidence for the expected specificity in the relationship between the parents' or the children's self-reported anxiety and the children's fear-related associations, as measured with the APT.

Limitations

Reliability of the Affective Priming Task was moderate, and power was low for finding small interaction effects.

Conclusions

Whereas clearly more research is needed, our results suggest that negative associations may qualify as a possible vulnerability factor for children of parents with an anxiety disorder.

背景和目的父母患有焦虑症的儿童自身患焦虑症的风险较高。根据认知理论，一个可能的风险因素是模式相关联想的发展。本研究首次调查了父母患有焦虑症的儿童是否会表现出与恐惧相关的联想，以及这些联想是否与父母的焦虑症有关：当引物与父母的焦虑症有关且目标是负面的时候，父母患有恐慌症的儿童和父母患有社交焦虑症的儿童与父母的焦虑症有关的错误率最低，但他们的反应速度并不快。我们没有发现任何证据表明父母或子女自我报告的焦虑与子女与恐惧有关的联想之间存在预期的特异性关系，这种特异性关系是通过 APT 测定的。局限性情感引物任务的可靠性一般，发现微小交互效应的能力较低。

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引用次数: 0

Sleep-related attentional bias in insomnia: The mediating role of arousal 失眠症中与睡眠有关的注意偏差：唤醒的中介作用

IF 1.8 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2024-02-01 DOI: 10.1016/j.jbtep.2024.101943

Cindy Lebrun , Pom Charras , Sophie Bayard

Background and objectives

Characterize the nature of attentional biases toward nocturnal and diurnal sleep-related stimuli in individuals with insomnia disorder. We investigated the contributing role of sleep-related attentional biases in insomnia severity and whether their effects on insomnia severity were mediated by arousal and valence levels of the presented stimuli.

Methods

Sixty-four individuals with insomnia disorder and 70 controls completed two Posner spatial cueing tasks including both nocturnal (alarm clocks) and diurnal (fatigue) pictorial stimuli associated with neutral cues. Arousal and valence of the sleep-related stimuli were assessed using a 5-point Likert type scale.

Results

Attention biases characterized by difficulty disengaging from and increased avoidance for daytime fatigue, and by difficulty disengaging from alarm clocks were observed in individuals with insomnia disorder compared to controls. On the whole sample, difficulty to disengage from diurnal and nocturnal sleep-related stimuli were related mostly to higher arousal rating of sleep-related stimuli and insomnia severity. Higher arousal rating for sleep-related stimuli mediates the relationship between difficulty disengaging and insomnia severity.

Limitations

The cross-sectional nature of the study.

Conclusions

We provide first initial evidence for an attentional bias characterized by on one side, avoidance for diurnal sleep-related stimuli and on other side, disengagement for both diurnal and nocturnal sleep-related stimuli in patients with insomnia. Disengagement difficulties for both diurnal and nocturnal sleep-related stimuli indirectly affected insomnia severity through arousal elicited by these stimuli. It appears important to develop and apply attentional bias modification training therapeutic interventions that can effectively reduce sleep-related arousal and attentional biases.

背景和目的描述失眠症患者对夜间和昼间睡眠相关刺激的注意偏差的性质。方法64名失眠症患者和70名对照组患者完成了两项Posner空间线索任务，包括与中性线索相关的夜间（闹钟）和昼夜（疲劳）图形刺激。结果与对照组相比，失眠症患者出现了注意偏差，其特点是难以脱离白天的疲劳并增加了对疲劳的回避，以及难以脱离闹钟。在所有样本中，难以脱离昼间和夜间睡眠相关刺激主要与睡眠相关刺激的唤醒等级较高和失眠严重程度有关。研究的横断面性质。结论我们首次提供了失眠症患者注意力偏差的初步证据，这种偏差的特点是一方面回避昼间睡眠相关刺激，另一方面脱离昼间和夜间睡眠相关刺激。对昼间和夜间睡眠相关刺激的脱离困难会通过这些刺激引起的唤醒间接影响失眠的严重程度。看来，开发和应用能有效减少睡眠相关唤醒和注意偏差的注意偏差修正训练治疗干预非常重要。

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引用次数: 0

Effectiveness of exposure-based treatment for childhood anxiety disorders: An open clinical trial to test its relation with indices of emotional processing and inhibitory learning 暴露疗法对儿童焦虑症的疗效：测试其与情绪处理和抑制性学习指数关系的开放式临床试验

IF 1.8 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2024-01-18 DOI: 10.1016/j.jbtep.2024.101942

Rachel de Jong , Miriam J.J. Lommen , Peter J. de Jong , Wiljo J.P.J. van Hout , Adina C.E. Duin-van der Marel , Maaike H. Nauta

Background and objectives

The current study examined how effectiveness of exposure-based CBT was related to indices of emotional processing and inhibitory learning during exposure exercises.

Methods

Adolescents with anxiety disorder(s) (N = 72; age 11–19; 85% girls) received a group-based, intensive two-week treatment of which effectiveness was indexed by the SCARED and by ratings of anxiety and approach towards individualized goal situations. To index emotional processing, subjective units of distress (SUDs) were used to indicate both initial and final fear level, and absolute, relative, and total dose of fear reduction. To index inhibitory learning, subjective threat expectancies (STEs) were used to indicate initial and final threat expectancy, and absolute, relative, and total dose of expectancy change.

Results

From pre-treatment to follow-up, there was a large-sized reduction of anxiety symptoms, small-sized decrease of subjective anxiety and a large-sized increase in subjective approach towards individual treatment goals. Higher fear levels prior to exposure were related to a larger decrease of symptoms. Higher threat expectancies after exposure exercises were independently associated with less decrease of anxiety and increase of approach towards treatment goals. Total dose of experienced fear reduction and total dose of experienced expectancy change were (partly) independently related to more increase in approach towards individualized goal situations.

Limitations

As patients also received other treatment elements, the results cannot be interpreted unequivocally.

Conclusions

The pattern of findings seems to indicate that emotional processing (as indexed by fear reduction) and inhibitory learning (as indexed by expectancy change) are both relevant in exposure-based CBT.

方法患有焦虑症的青少年（72 人；年龄 11-19 岁；85% 为女孩）接受了为期两周的小组强化治疗，治疗效果由 SCARED 以及焦虑评分和对个性化目标情境的接近程度来衡量。在情绪处理方面，采用主观痛苦单位（SUDs）来表示最初和最终的恐惧水平，以及减少恐惧的绝对、相对和总剂量。结果从治疗前到随访期间，焦虑症状大幅减少，主观焦虑大幅减少，对个人治疗目标的主观态度大幅提高。暴露前较高的恐惧水平与症状的大幅减少有关。暴露练习后，较高的威胁预期与焦虑的减少和治疗目标的增加有独立的联系。局限性由于患者还接受了其他治疗要素，因此无法对结果做出明确的解释。结论研究结果的模式似乎表明，情绪处理（以恐惧减少为指标）和抑制性学习（以期望值变化为指标）在基于暴露的 CBT 中都是相关的。

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