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Distress variability during exposure therapy and its relationship with PTSD symptom decline 暴露疗法中的压力变化及其与创伤后应激障碍症状下降的关系
IF 1.7 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-08-03 DOI: 10.1016/j.jbtep.2024.101983
Marike J. Kooistra , Chris M. Hoeboer , Danielle A.C. Oprel , Maartje Schoorl , Willem van der Does , Agnes van Minnen , Rianne A. de Kleine

Background and objectives

Inhibitory Learning Theory (ILT) framework implies that in-session distress variability may promote extinction learning and thereby enhance exposure therapy efficacy. Thus far, research has mainly focused on in-session distress reduction. The aim of the current study was to assess whether in-session distress variability predicts next session PTSD symptom decline in PTSD patients receiving prolonged exposure (PE).

Methods

Eighty-six patients with PTSD received 14 to 16 sessions of PE. Using dynamic panel models, we assessed the temporal relation (i.e., within-persons) between in-session distress variability and PTSD symptom decline. Moreover, we assessed the averaged relation (i.e., between-persons) between in-session distress variability and PTSD symptom decline.

Results

Temporal analyses showed that in-session distress variability did not precede PTSD symptom improvement. Averaged analyses showed that distress variability was related to PTSD symptom improvement.

Limitation

The operationalization of distress variability appeared to deviate from its theoretical conceptualization.

Conclusions

In absence of distress reduction, distress variability can vary. However, our findings suggest that in-session distress variability does not drive symptom reduction during PE. In contrast, averaged over participants, distress variability was related to symptom improvement, suggesting that those with a more variable distress pattern across sessions show better treatment response. More empirical work is needed to shed light on the effect of distress variability during exposure sessions on treatment outcome and to offer grounds for clinical recommendations.

背景和目的抑制性学习理论(ILT)框架意味着,治疗过程中的痛苦可变性可促进消退学习,从而提高暴露疗法的疗效。迄今为止,研究主要集中在会话中痛苦的减轻。本研究的目的是评估在接受长期暴露疗法(PE)的创伤后应激障碍患者中,疗程内的痛苦变异性是否能预测下一疗程创伤后应激障碍症状的下降。使用动态面板模型,我们评估了会话中痛苦变异性与创伤后应激障碍症状下降之间的时间关系(即人内关系)。此外,我们还评估了会话中痛苦变异性与创伤后应激障碍症状下降之间的平均关系(即人与人之间的关系)。结果时间分析表明,会话中痛苦变异性并不先于创伤后应激障碍症状的改善。平均分析表明,困扰变异性与创伤后应激障碍症状的改善有关。局限性困扰变异性的操作似乎偏离了其理论概念。然而,我们的研究结果表明,在 PE 过程中,会话中的痛苦可变性并不会导致症状减轻。相反,对所有参与者进行平均,痛苦的可变性与症状的改善有关,这表明那些在不同疗程中痛苦模式更具可变性的人对治疗的反应更好。我们还需要更多的实证研究来揭示暴露过程中的困扰变异性对治疗结果的影响,并为临床建议提供依据。
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引用次数: 0
Inhibition moderates the effect of attentional bias modification for reducing residual depressive symptoms: A randomized sham-controlled clinical trial 抑制调节了注意偏差修正对减轻残余抑郁症状的效果:随机假对照临床试验
IF 1.7 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-08-02 DOI: 10.1016/j.jbtep.2024.101982
Ragnhild Bø , Brage Kraft , August Skilbrei , Rune Jonassen , Catherine J. Harmer , Nils Inge Landrø

Objectives

Residual symptoms represent risk factor for relapse. Attention bias modification (ABM) may reduce clinical and sub-clinical depressive symptoms, indicating that is may be of relevance when preventing relapse. Current evidence suggests that executive functions may moderate the outcome of interventions targeting depressive symptoms.

Methods

We assessed inhibition and shifting as indicators of executive functioning by means of the Color-Word Interference Test (i.e., “Stroop task”). These baseline characteristics were investigated as moderator of the effect of ABM on depression symptoms in a double-blinded randomized sham-controlled trial of ABM including patients with a history of recurrent depression (N = 301). Inclusion and follow-ups took place from January 2015 to October 2016. The trial was retrospectively registered #NCT02658682 January 2016.

Results

The moderation analysis was based on the interaction term ABM x Stroop. Scaled inhibition scores ≤10.8, but not shifting ability, moderated the effect of ABM compared to sham on clinician-rated depression (HDRS). The difference from the 15th to the 85th percentile of the inhibition score was about 1 HDRS-point, indicating a small effect size. No moderation was found when self-reported depression and AB were the outcome. Post-hoc power calculation indicates risk of Type-II error.

Conclusion

When targeting depressive symptoms, ABM seems to be somewhat more effective in patients with weak inhibitory control. This suggests that evaluating the level of inhibition in individual patients could provide some information when making decisions about prescribing ABM to reduce residual symptoms, but the clinical implications of this is uncertain due to an overall small effect size attributable to ABM. Future studies should examine whether inhibitory control still is a relevant moderator when comparing ABM to treatment options other than the sham control condition.

目标:残留症状是导致复发的风险因素。注意力偏差修正(ABM)可减轻临床和亚临床抑郁症状,这表明它可能与预防复发有关。目前的证据表明,执行功能可能会影响针对抑郁症状的干预结果:方法:我们通过颜色-词语干扰测验(即 "Stroop任务")评估了作为执行功能指标的抑制和转移。在一项ABM双盲随机假对照试验中,我们将这些基线特征作为ABM对抑郁症状影响的调节因素进行了调查,试验对象包括有复发性抑郁症病史的患者(N = 301)。纳入和随访时间为2015年1月至2016年10月。该试验于2016年1月进行了回顾性注册#NCT02658682:调节分析基于交互项ABM x Stroop。抑制评分≤10.8分(而非移位能力)调节了ABM与假药相比对临床医师评分抑郁(HDRS)的影响。从抑制得分的第 15 百分位数到第 85 百分位数之间的差异约为 1 HDRS 分,显示出较小的效应规模。以自我报告的抑郁和 AB 为结果时,未发现调节作用。事后功率计算显示存在II型错误的风险:结论:针对抑郁症状,ABM 似乎对抑制控制能力较弱的患者更有效。这表明,评估个体患者的抑制水平可以为决定是否使用ABM来减轻残余症状提供一些信息,但由于ABM的总体效应大小较小,因此其临床意义尚不确定。未来的研究应该探讨在将 ABM 与假对照条件以外的治疗方案进行比较时,抑制控制是否仍然是一个相关的调节因素。
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引用次数: 0
Convergence of real-time and retrospective assessments: A systematic investigation of naturally occurring and experimentally induced intrusions 实时和回顾性评估的融合:对自然发生和实验诱发的入侵进行系统调查
IF 1.7 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-07-15 DOI: 10.1016/j.jbtep.2024.101981
Jacqueline Peters, Inga Marie Freund, Merel Kindt, Renée M. Visser , Arnold A.P. van Emmerik

Background and objectives

Ecological momentary assessment is a popular method for monitoring symptoms in real-time. Especially for fleeting experiences, such as intrusions, real-time assessments may be more accurate than retrospective estimates. However, there are concerns regarding reactivity effects associated with real-time assessments and, conversely, the reliance on bias-prone retrospective assessments in clinical science and practice. In this study we used a between-groups design to examine whether real-time intrusion assessments influence retrospective reports (aim 1). Then, we investigated whether real-time and retrospective assessments systematically differed within individuals (aim 2).

Methods

Over two weeks, 150 non-clinical individuals provided weekly retrospective intrusion assessments, while the majority (n = 102) additionally reported their intrusions in real-time, via smartphones. We examined both naturally occurring intrusions, which individuals experience in their everyday lives, and intrusions related to a standardized stressor (i.e., Trier Social Stress Test), taking place halfway.

Results

Using Bayesian statistics, we found that assessing intrusions in real-time did not convincingly affect retrospective reports, and there was no strong evidence that real-time and retrospective intrusion assessments differed. However, the evidence of absence was inconclusive for some measures. Real-time and retrospectively reported intrusion frequencies and distress were strongly associated with one another.

Limitations

Future research is advised to replicate these findings with larger samples, for other types of stressors, in clinical populations, and over extended assessment periods.

Conclusions

The general agreement between real-time and retrospective assessments of intrusions is encouraging, tentatively suggesting that researchers and clinicians can flexibly select the assessment method that best suits their objectives.

背景和目的 生态学瞬间评估是一种流行的实时监测症状的方法。特别是对于转瞬即逝的经历,如入侵,实时评估可能比回顾性估计更准确。然而,人们对与实时评估相关的反应性效应表示担忧,反之,在临床科学和实践中对容易产生偏差的回顾性评估的依赖也令人担忧。在本研究中,我们采用了组间设计来考察实时入侵评估是否会影响回顾性报告(目的 1)。方法在两周内,150 名非临床人员每周提供一次入侵回溯评估,而大多数人(n = 102)还通过智能手机实时报告了他们的入侵情况。我们既研究了个人在日常生活中自然发生的入侵,也研究了中途发生的与标准化压力源(即特里尔社会压力测试)相关的入侵。结果通过贝叶斯统计,我们发现实时评估入侵并不会对回顾性报告产生令人信服的影响,而且没有有力的证据表明实时和回顾性入侵评估存在差异。但是,在某些指标上,没有证据表明存在差异。结论对入侵的实时评估和回顾性评估之间的普遍一致令人鼓舞,这初步表明研究人员和临床医生可以灵活选择最适合其目标的评估方法。
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引用次数: 0
College students with depression symptom are more sensitive to task difficulty in reinforcement learning 有抑郁症状的大学生在强化学习中对任务难度更敏感
IF 1.7 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-07-14 DOI: 10.1016/j.jbtep.2024.101980
Yaru Zhang , Meng Wei , Rong Huang , Shiwei Jia , Li Li

Background

Depression is usually characterized by impairments in reward function, and shows altered motivation to reward in reinforcement learning. This study further explored whether task difficulty affects reinforcement learning in college students with and without depression symptom.

Methods

The depression symptom group (20) and the no depression symptom group (26) completed a probabilistic reward learning task with low, medium, and high difficulty levels, in which task the response bias to reward and the discriminability of reward were analyzed. Additionally, electrophysiological responses to reward and loss feedback were recorded and analyzed while they performed a simple gambling task.

Results

The depression symptom group showed more response bias to reward than the no depression symptom group when the task was easy and then exhibited more quickly decrease in response bias to reward as task difficulty increased. The no depression symptom group showed a decrease in response bias only in the high-difficulty condition. Further regression analyses showed that, the Feedback-related negativity (FRN) and theta oscillation could predict response bias change in the low-difficulty condition, the FRN and oscillations of theta and delta could predict response bias change in the medium and high-difficulty conditions.

Limitations

The electrophysiological responses to loss and reward were not recorded in the same task as the reinforcement learning behaviors.

Conclusions

College students with depression symptom are more sensitive to task difficulty during reinforcement learning. The FRN, and oscillations of theta and delta could predict reward leaning behavior.

背景抑郁症通常以奖赏功能受损为特征,并表现出强化学习中奖赏动机的改变。本研究进一步探讨了任务难度是否会影响有抑郁症状和无抑郁症状的大学生的强化学习。方法 有抑郁症状组(20 人)和无抑郁症状组(26 人)分别完成了难度为低、中、高的概率奖励学习任务,并对任务中奖励的反应偏差和奖励的可辨别性进行了分析。结果抑郁症状组在任务简单时比无抑郁症状组表现出更多的奖励反应偏差,然后随着任务难度的增加,奖励反应偏差下降得更快。无抑郁症状组仅在高难度条件下才出现反应偏差的下降。进一步的回归分析表明,反馈相关负性(FRN)和θ振荡可以预测低难度条件下的反应偏差变化,FRN和θ、δ振荡可以预测中、高难度条件下的反应偏差变化。FRN以及θ和δ的振荡可以预测奖励倾斜行为。
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引用次数: 0
The role of cognitive biases involving selective interrogation of taste-based information in sugar-sweetened beverage consumption 认知偏差在含糖饮料消费中的作用,包括对口味信息的选择性询问
IF 1.7 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-07-14 DOI: 10.1016/j.jbtep.2024.101979
Laura Dondzilo , Eva Kemps

Background and objectives

Consumption of sugar-sweetened beverages (SSBs) is a global public health issue. Consequently, there is strong interest in advancing understanding of the cognitive mechanisms that underpin excessive SSB consumption. This work proposes that selective interrogation of taste-based characteristics (e.g., flavour), rather than health-based characteristics (e.g., sugar content), of beverages is associated with greater SSB choice and consumption.

Methods

To evaluate this novel hypothesis, undergraduate students (n = 210) were recruited to complete self-report measures of SSB consumption, motivation and success in reducing SSB consumption and unhealthy eating more broadly, as well as a novel selective interrogation assessment task. This task provided participants with the opportunity to selectively interrogate taste-based and health-based characteristics of various mystery beverages.

Results

Results supported the hypothesis that greater selective interrogation of taste-based characteristics, rather than health-based characteristics, of beverages is associated with greater SSB choice and consumption. Additionally, results revealed that greater selective interrogation of taste-based characteristics was associated with decreased motivation to reduce SSB consumption and decreased motivation and success to reduce unhealthy consumption more broadly.

Limitations

The current study did not evaluate whether selective interrogation of taste-based characteristics of beverages predicted actual SSB consumption.

Conclusion

These findings provide novel evidence for the potential role of selective interrogation of taste-based characteristics of beverages in SSB choice and consumption. An important implication of these findings is that in order for interventions focusing on front-of-package nutrition labels to be effective in reducing unhealthy consumption, it is necessary that individuals are selectively interrogating this ‘health-based’ information.

背景和目标饮用含糖饮料(SSB)是一个全球性的公共卫生问题。因此,人们对促进了解支撑 SSB 过度消费的认知机制有着浓厚的兴趣。这项研究提出,选择性地询问饮料的口味特征(如风味)而非健康特征(如含糖量)与更多的固态饮料选择和消费有关。为了评估这一新颖的假设,研究人员招募了本科生(n = 210),让他们完成固态饮料消费、减少固态饮料消费和更广泛的不健康饮食的动机和成功率的自我报告测量,以及一项新颖的选择性询问评估任务。结果结果支持这样的假设:更多地选择性询问饮料的口味特征而不是健康特征与更多的固态饮料选择和消费有关。此外,结果还显示,对口味特征的选择性询问越多,减少 SSB 消费的动机就越低,减少更广泛的不健康消费的动机和成功率就越低。结论这些研究结果为饮料口味特征的选择性询问在 SSB 选择和消费中的潜在作用提供了新的证据。这些发现的一个重要意义在于,为了使以包装正面营养标签为重点的干预措施能够有效减少不健康消费,个人有必要有选择性地询问这些 "基于健康 "的信息。
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引用次数: 0
Does responsibility for potential harm attenuate the effects of repeated checking on metamemory and automatization? 对潜在伤害的责任感是否会减轻重复检查对元记忆和自动化的影响?
IF 1.7 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-06-27 DOI: 10.1016/j.jbtep.2024.101977
Karina Wahl, Martin Kollárik, Roselind Lieb

Background and objectives

Repeated checking results in large reductions in metamemory variables (confidence, details, and vividness). It has been suggested that the underlying mechanism is gradual automatization. At the same time, individuals with obsessive-compulsive disorder (OCD) are reluctant to automatize routine processes. The aim was to investigate whether high responsibility for potential harm, typical of OCD, would attenuate the effects of repeated checking on metamemory variables and automatization.

Methods

One hundred seventy-five participants were initially provided with a cover story that put the subsequent virtual checking task in a context of potential harm for not checking properly. Participants were randomly allocated to four experimental groups (varying high and low responsibility, relevant and irrelevant checking) and performed a virtual checking task repeatedly, using either identical stimuli (relevant checking) or different stimuli (irrelevant checking) between the first and final checking trial. Metamemory variables were rated on visual analogue scales, and response latencies were assessed to establish automatization.

Results

Larger reductions in metamemory variables following relevant checking compared to irrelevant checking replicated previous findings. High responsibility did not affect these results. Large reductions in response latencies across the checking trials (automatization) were also independent of the perceived responsibility.

Limitations

We did not include individuals with OCD.

Conclusions

Since responsibility did not influence the effects of repeated checking on metamemory variables, findings are consistent with the idea that automatization remains a plausible explanation of the effects of repeated checking on metamemory variables in individuals with OCD.

背景和目的:重复检查会导致元记忆变量(信心、细节和生动性)的大量减少。有人认为其根本机制是逐渐自动化。与此同时,患有强迫症(OCD)的人却不愿意将常规过程自动化。本研究旨在探讨强迫症患者对潜在伤害的高度责任感是否会减弱重复检查对元记忆变量和自动化的影响:175 名参与者最初会收到一个封面故事,将随后的虚拟检查任务置于不正确检查可能造成伤害的背景下。参与者被随机分配到四个实验组(责任感高低、相关检查和不相关检查各不相同),并在第一次和最后一次检查试验之间使用相同的刺激(相关检查)或不同的刺激(不相关检查)重复执行虚拟检查任务。元记忆变量采用视觉模拟量表进行评分,并对反应潜伏期进行评估,以确定自动化程度:结果:与无关检查相比,相关检查后元记忆变量的减少幅度更大,这与之前的研究结果一致。高度的责任感并没有影响这些结果。检查试验中反应潜伏期的大幅缩短(自动化)也与感知到的责任无关:局限性:我们没有将强迫症患者包括在内:由于责任感并不影响重复检查对元记忆变量的影响,因此研究结果与以下观点一致,即自动化仍然是强迫症患者重复检查对元记忆变量影响的一个合理解释。
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引用次数: 0
Effects of exposure to plus-size fashion models on weight-related attitudes in bulimia nervosa: Findings from an exploratory study 接触大尺码时装模特对神经性贪食症患者体重相关态度的影响:一项探索性研究的结果
IF 1.7 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-06-25 DOI: 10.1016/j.jbtep.2024.101976
Eva Naumann, Jennifer Svaldi

Background and Objectives

Eating disorders are often linked to the internalization of the thin-ideal and weight stigma. The present exploratory study investigates the effects of plus-sized fashion media on weight-related attitudes in bulimia nervosa (BN).

Methods

Women with BN (n=27) and without an eating disorder (n=28) were exposed to 17 pictures of plus-size fashion models. Participants rated the attractiveness of the models. Before and after the exposure task, participants completed questionnaires on their attitudes towards people with higher weight as well as thin-ideal media.

Results

The BN group rated the bodies of the plus-size fashion models as less attractive than controls, whereas no group differences were found in attractiveness ratings for the models' faces or full images. In both groups, negative attitudes about people with higher weight significantly decreased after viewing plus-size model pictures. Attitudes toward thin-ideal media remained unchanged, with scores higher for BN than controls.

Limitations

This exploratory study has several limitations, such as the lack of a control condition, small sample size, and reliance on only self-report data.

Conclusions

These exploratory results imply that the positive effects of plus-sized model images on reducing negative assumptions about people with high weight may not be limited to healthy individuals but also seem to extend to women with BN. Further controlled studies with larger samples and long-term assessments are needed to confirm these findings.

背景和目的进食障碍通常与瘦削理想的内化和体重耻辱化有关。本探索性研究调查了大尺码时尚媒体对神经性贪食症(BN)患者体重相关态度的影响。方法:让患有神经性贪食症(BN)和未患饮食失调症(BN)的女性(分别为 27 人和 28 人)观看 17 张大尺码时尚模特的图片。参与者对模特的吸引力进行评分。结果与对照组相比,BN 组对大码时装模特身体的吸引力评分较低,而对模特面部或完整图像的吸引力评分则没有发现组间差异。在观看大码模特图片后,两组人对体重较重的人的负面态度都明显降低。结论这些探索性研究结果表明,大尺码模特图片在减少对体重高的人的负面假设方面的积极作用可能不仅限于健康人,似乎也会延伸到患有 BN 的女性身上。要证实这些结果,还需要进行更多样本和长期评估的进一步对照研究。
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引用次数: 0
Associations between PTSD and temporal discounting: The role of future thinking 创伤后应激障碍与时间折扣之间的关联:未来思维的作用
IF 1.7 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-06-24 DOI: 10.1016/j.jbtep.2024.101978
Mieke Verfaellie , Virginie Patt , Ginette Lafleche , Jennifer J. Vasterling

Background and objectives

Despite documented alterations in future thinking in posttraumatic stress disorder (PTSD), our understanding of how individuals with PTSD make future-oriented decisions is limited. We tested the hypothesis that increased discounting in association with PTSD reflects failure to spontaneously envision future rewarding situations.

Methods

Thirty-seven trauma exposed war-zone veterans completed a standard temporal discounting task as well as a temporal discounting task accompanied by episodic future thinking cues.

Results

Severity of PTSD symptoms was associated with preference for sooner, smaller rewards in the standard task. Consistent with our hypothesis, when participants engaged in future thinking, greater PTSD symptom severity was no longer associated with steeper discounting. Moreover, difficulty anticipating future events, as measured contemporaneously in a separate task (Verfaellie et al., 2024), mediated the relationship between PTSD symptom severity and degree of discounting in the standard task. Among PTSD symptom clusters, the severity of avoidance and negative alterations in cognition and mood was related to steeper discounting. Measures of depression and alcohol use were not associated with discounting.

Limitations

The sample included mostly male, predominantly White veterans who experienced primarily combat-related trauma.

Conclusions

PTSD-associated alterations in temporal discounting reflect failure to spontaneously imagine future positive events. Two common correlates of PTSD, depression and alcohol use, could not account for the observed associations between PTSD and future-oriented decisions.

背景和目的:尽管有文献记载创伤后应激障碍(PTSD)患者的未来思维会发生改变,但我们对创伤后应激障碍患者如何做出面向未来的决策的了解还很有限。我们测试了这样一个假设:与创伤后应激障碍相关的贴现增加反映了患者无法自发地设想未来有回报的情况:结果:创伤后应激障碍症状的严重程度与创伤后应激障碍患者的未来决策有关:在标准任务中,创伤后应激障碍症状的严重程度与偏好更快、更小的奖励有关。与我们的假设一致的是,当参与者进行未来思考时,创伤后应激障碍症状的严重程度不再与陡峭的折现相关联。此外,在另一项任务中同时测量的未来事件预测困难(Verfaellie 等人,2024 年),在标准任务中对创伤后应激障碍症状严重程度与折扣程度之间的关系起到了中介作用。在创伤后应激障碍症状群中,回避的严重程度以及认知和情绪的负面改变与更陡峭的折扣有关。抑郁和酗酒与折现无关:局限性:样本中的退伍军人大多为男性,以白人为主,主要经历过与战斗有关的创伤:与创伤后应激障碍相关的时间折现改变反映了人们无法自发地想象未来的积极事件。创伤后应激障碍的两个常见相关因素--抑郁和酗酒,无法解释创伤后应激障碍与面向未来的决策之间的关联。
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引用次数: 0
Influences of sleep, cortisol reactivity, and risk/reward-based decision-making on suicide 睡眠、皮质醇反应性和基于风险/回报的决策对自杀的影响
IF 1.8 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-05-31 DOI: 10.1016/j.jbtep.2024.101975
Keyne C. Law Ph.D. , Katherine L. O'Connell M.S. , Samantha V. Jacobson M.S. , Margaret M. Baer M.A. , Phillip M. Baker Ph.D. , Matthew T. Tull Ph.D.

Background and objectives

Poor sleep quality is a known contributor to suicidal thoughts and behaviors. This study examines whether sleep quality modulates the effect of an individual's stress response and risk/reward-based decision making on suicide risk.

Methods

Participants were 160 adults at a residential substance use treatment facility with lifetime exposure to trauma who completed a clinician-administered measure of suicide risk, the Iowa Gambling Task (IGT), and a self-report measure of sleep. Cortisol reactivity (i.e., changes in cortisol before and after a personalized trauma script) was used to measure stress response. We used quantile regression to examine the effects of sleep, cortisol, and risk/reward decision-making on suicide risk.

Results

We found poor sleep quality to be increasingly salient in individuals at greater risk for suicide than those at lower risk for suicide. Furthermore, individuals with moderate to moderate-high levels of suicide risk seem to have greater cortisol reactivity. In the low-moderate quantile, we found suicide risk to be associated with both high stress reactivity and low-risk, high-reward decision-making, as well as low stress reactivity and high-risk/low-reward decision-making.

Limitations

These findings should be interpreted considering several methodological constraints, such as the use of a pre-determined sample and instruments not tailored for our hypotheses, the MINI ‘Suicide’ Module's limited differentiation between suicidal ideation and behavior, and variably timed cortisol sampling.

Conclusions

Despite these limitations, the findings from this study support the use of evidence-based interventions focused on improving sleep quality and managing emotional reactivity to decrease suicide risk.

背景和目的众所周知,睡眠质量差是导致自杀想法和行为的一个因素。本研究探讨了睡眠质量是否会调节个体的应激反应和基于风险/回报的决策对自杀风险的影响。方法参与者是一家药物使用住院治疗机构中的 160 名成年人,他们一生都暴露于创伤之中,并完成了由临床医生管理的自杀风险测量、爱荷华赌博任务(IGT)和睡眠自我报告测量。皮质醇反应性(即个性化创伤脚本前后皮质醇的变化)用于测量压力反应。结果我们发现,与自杀风险较低的人相比,睡眠质量差在自杀风险较高的人身上表现得越来越突出。此外,自杀风险处于中度到中度高水平的人似乎皮质醇反应性更强。我们发现,在低-中度量级中,自杀风险既与高压力反应性和低风险、高回报决策有关,也与低压力反应性和高风险/低回报决策有关。局限性在解释这些研究结果时应考虑到一些方法学上的限制因素,如使用了预先确定的样本和不适合我们假设的工具,MINI "自杀 "模块对自杀意念和行为的区分有限,以及皮质醇采样的时间不同等。结论尽管存在这些局限性,但本研究的结果支持使用以证据为基础的干预措施,重点改善睡眠质量和管理情绪反应性,以降低自杀风险。
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引用次数: 0
Effects of positivity training on character strengths, time perspective, and self-awareness in women with depression 积极性训练对女性抑郁症患者性格优势、时间观念和自我意识的影响
IF 1.8 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-05-22 DOI: 10.1016/j.jbtep.2024.101974
Simin Barzigar, Rezvan Homaei

Background and objectives

Depression exerts significant negative impacts across various life domains, including social interactions, occupational functioning, and economic well-being. These effects permeate both personal and interpersonal spheres. However, it seems that character strengths, time perspective, and self-awareness play a critical role in promoting mental well-being. The present study aimed to investigate the effectiveness of positivity training on character strengths, time perspective, and self-awareness in depressed women.

Method

Purposive sampling was employed to select 50 participants with depression based on the cut-off point (a score of 20 or greater) in Beck's Depression Inventory (BDI-II). They were then randomly assigned to a control group (n = 25) and an experimental group (n = 25). This quasi-experimental research adopted a pretest-posttest control group design. The experimental group received eight weekly 90-min sessions of positivity training. The control group participants did not receive any specific intervention related to depression management. The character strength scale, time perspective scale, self-awareness scale, and BDI-II were used to collect data. Data analysis methods included descriptive statistics (mean and standard deviation) and inferential statistics (ANCOVA). Data analysis was conducted using SPSS software.

Results

The study included a sample of 50 women diagnosed with Major Depressive Disorder (MDD). The participants' mean age was 38.03 years (SD = 7.96). Positivity training enhanced character strengths in women with depression. Moreover, the positivity intervention affected the time perspective factors of those women. It reduced “past negative” and “present fatalistic” and increased “past positive,” “present hedonistic,” and “future.” Finally, positivity training significantly increased self-awareness in women with depression (p < 0.01).

Limitations

The sample size was relatively small, which limits the statistical inferences.

Conclusions

In conclusion, this study provides promising initial evidence for the potential of positivity training as an intervention to improve character strengths, time perspective, and self-awareness in women with MDD. Further research is warranted to confirm and expand upon these findings, ultimately informing the development of more comprehensive treatment approaches for depression.

背景和目标抑郁症对生活的各个领域都产生了重大的负面影响,包括社会交往、职业功能和经济福祉。这些影响渗透到个人和人际领域。然而,性格优势、时间观念和自我意识似乎在促进心理健康方面发挥着至关重要的作用。本研究旨在探讨积极性训练对抑郁女性的性格优势、时间视角和自我意识的影响。方法采用目的性抽样,根据贝克抑郁量表(BDI-II)的临界点(20 分或以上)选择 50 名抑郁参与者。然后将他们随机分配到对照组(25 人)和实验组(25 人)。这项准实验研究采用了前测-后测对照组设计。实验组接受每周八次、每次 90 分钟的积极性训练。对照组参与者没有接受任何与抑郁管理相关的特定干预。实验组采用性格强度量表、时间观点量表、自我意识量表和 BDI-II 来收集数据。数据分析方法包括描述性统计(平均值和标准差)和推断性统计(方差分析)。数据分析使用 SPSS 软件进行。参与者的平均年龄为 38.03 岁(标准差 = 7.96)。积极性训练增强了女性抑郁症患者的性格力量。此外,积极干预还影响了这些女性的时间视角因素。它减少了 "过去消极 "和 "现在宿命",增加了 "过去积极"、"现在享乐 "和 "未来"。最后,积极性训练明显提高了抑郁症女性患者的自我意识(p < 0.01)。结论总之,本研究为积极性训练作为一种干预措施改善 MDD 女性患者的性格优势、时间观念和自我意识的潜力提供了令人鼓舞的初步证据。我们有必要开展进一步的研究来证实和扩展这些发现,最终为开发更全面的抑郁症治疗方法提供信息。
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引用次数: 0
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Journal of Behavior Therapy and Experimental Psychiatry
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