British Journal of Clinical Psychology最新文献_第6页

The role of trauma, attachment, dissociation, and alexithymia in pathways to negative symptoms in psychosis 创伤、依恋、分离和述情障碍在精神病阴性症状通路中的作用

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-05-24 DOI: 10.1111/bjc.12554

Shelley Grady, Niall Crowley, Seamus Scott, Charles Ifegwu Ndukwe, Rebecca Donohoe, Keith Gaynor

Objectives

Emerging models of trauma and psychosis highlight the role of attachment, dissociation, and emotion regulation processes in pathways to positive symptoms, yet little is known about the relevance of these processes to negative symptoms. The primary aim of this study was to examine trauma, attachment, dissociation, and alexithymia as predictors of negative symptoms in psychosis. A secondary, exploratory aim was to delineate pathways by which trauma may lead to negative symptoms (via attachment, dissociative or alexithymic processes).

Method

This was a cross-sectional study of people attending mental health services for a psychosis-related diagnosis (N = 71). Measures of trauma, negative symptoms, attachment, alexithymia, dissociation, and depression were completed.

Results

Regression analyses indicated that recurrent trauma, disorganized attachment, difficulty identifying feelings (DIF), and depression accounted for a significant portion of the variance in negative symptoms, though only DIF and depression were significant independent predictors. Subsequent serial mediation analyses indicated that recurrent trauma exerted its influence on negative symptoms through a sequence of disorganized attachment and DIF, while controlling for depression. As avoidant attachment was not associated with trauma and dissociation was not associated with total negative symptoms, hypothesized models related to these variables were not examined.

Conclusions

These exploratory findings highlight the relevance of trauma-related variables in our formulation and treatment of negative symptoms. Future research should focus on replication studies with larger clinical samples and longitudinal designs to establish causality.

目的：创伤和精神病的新兴模型强调了依恋、分离和情绪调节过程在产生阳性症状的途径中的作用，但对这些过程与阴性症状的相关性知之甚少。本研究的主要目的是检查创伤、依恋、分离和述情障碍作为精神病阴性症状的预测因子。第二个探索性目的是描述创伤可能导致负面症状的途径（通过依恋、解离或述情过程）。方法：这是一项横断面研究，研究对象是因精神病相关诊断而前往精神卫生服务的人（N = 71）。完成创伤、阴性症状、依恋、述情障碍、分离和抑郁的测量。结果：回归分析表明，复发性创伤、无组织依恋、情感识别困难（DIF）和抑郁占阴性症状方差的很大一部分，尽管只有DIF和抑郁是显著的独立预测因子。随后的一系列中介分析表明，复发性创伤通过一系列无组织依恋和DIF对阴性症状产生影响，同时控制抑郁。由于回避型依恋与创伤无关，分离与全部阴性症状无关，因此未对与这些变量相关的假设模型进行检验。结论：这些探索性发现强调了创伤相关变量在我们对阴性症状的表述和治疗中的相关性。未来的研究应侧重于更大临床样本的重复性研究和纵向设计，以确定因果关系。

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引用次数: 0

An intervention to build social identities improves mental health and wellbeing in people with elevated social anxiety: Evidence from a single-arm clinical trial 建立社会身份的干预措施可以改善社交焦虑加剧者的心理健康和福祉：来自单臂临床试验的证据。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-05-21 DOI: 10.1111/bjc.12539

Jessica L. Donaldson, Alysia M. Robertson, Tegan Cruwys, Joanne A. Rathbone, Catherine Haslam, Junwen Chen, Amy Dawel

Objectives

Current best-practice treatments for social anxiety disorder do not directly address loneliness, despite its role in the maintenance of the condition. The current study targets this issue directly, using mixed methods to provide an initial test of the efficacy of an established loneliness intervention, Groups 4 Health (G4H), among 33 people with clinically elevated social anxiety symptoms.

Design

A single-arm design was used and outcomes were assessed at baseline, programme completion and 5-month follow-up (3 months after programme completion).

Methods

Loneliness, social anxiety symptoms, depression symptoms and well-being were assessed at each time point. Semi-structured follow-up interviews were also conducted to explore the feasibility and acceptability of G4H in this population.

Results

Results from intention-to-treat analyses provide initial evidence of the programme's efficacy: participants' loneliness (d = −1.08), social anxiety symptoms (d = −.45), and depression symptoms (d = −.60) reduced significantly from baseline to 5-month follow-up while their well-being (d = 1.00) increased. Four themes emerged from reflexive thematic analysis: (1) the importance of challenging initial anxiety about attending group therapy, (2) the value of being vulnerable with fellow group members, (3) the role of G4H in increasing participants' social confidence, and (4) processes which both helped and hindered participants' ability to engage with their group.

Conclusions

Together, results suggest that G4H is a promising and innovative treatment option for people with social anxiety, and further controlled evaluation is warranted.

目的：目前社交焦虑障碍的最佳治疗方法并没有直接解决孤独感，尽管它在维持状态中起着作用。目前的研究直接针对这一问题，采用混合方法，对33名临床社交焦虑症状升高的人进行了一项既定的孤独感干预措施——4健康组（G4H）的疗效进行了初步测试。设计：采用单臂设计，在基线、方案完成和5个月随访（方案完成后3个月）时评估结果。方法：对各时间点的孤独感、社交焦虑症状、抑郁症状和幸福感进行评估。还进行了半结构化的随访访谈，以探讨G4H在该人群中的可行性和可接受性。结果：意向治疗分析的结果为该方案的有效性提供了初步证据：从基线到5个月的随访，参与者的孤独感（d = -1.08）、社交焦虑症状（d = - 0.45）和抑郁症状（d = - 0.60）显著减少，而他们的幸福感（d = 1.00）增加。反身性主题分析产生了四个主题：(1)挑战参加团体治疗的初始焦虑的重要性，(2)与同伴群体成员一起脆弱的价值，(3)G4H在增加参与者社会信心方面的作用，以及(4)帮助和阻碍参与者与群体互动能力的过程。结论：综上所述，研究结果表明，G4H对于社交焦虑患者来说是一种有前景的创新治疗选择，需要进一步的对照评估。

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引用次数: 0

Hoarding and aggression: Using the voodoo doll task to tease apart associations with direct and displaced aggression 囤积和攻击：使用巫毒娃娃任务来区分直接攻击和替代攻击之间的联系。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-05-14 DOI: 10.1111/bjc.12552

Wenting Chen, Phaedra Fuller, Jessica R. Grisham, Thomas F. Denson, Kiara R. Timpano

Objectives

Hoarding disorder is a debilitating and severe psychiatric condition. Research has implicated interpersonal factors as contributing to the development and maintenance of the disorder. Emerging evidence has suggested that aggression and anger-related concepts may contribute to these interpersonal difficulties, but aggression has only been measured thus far through self-report, which is limited by responding biases.

Methods

In the present study, we examined the associations between self-reported hoarding symptoms and two forms of aggression using both questionnaire measures and a novel behavioural task of aggression. Participants included 466 participants from the community recruited through an online crowdsourcing platform, who completed an anger-induction task followed by a voodoo doll task as a measure of direct and displaced aggression.

Results

Results revealed that hoarding symptoms were associated with greater aggression in both self-report and in the behavioural task. Self-report results also indicated that the relationship with displaced aggression may be modestly stronger than that of direct aggression, accounting for covariation.

Conclusions

These findings suggest that aggression may be relevant in understanding interpersonal difficulties in hoarding and may have clinical and theoretical relevance for the disorder.

目的：囤积症是一种使人衰弱的严重精神疾病。研究表明人际关系因素对这种障碍的发展和维持起着促进作用。新出现的证据表明，攻击性和与愤怒相关的概念可能会导致这些人际关系困难，但迄今为止，攻击性只能通过自我报告来衡量，而自我报告受到反应偏见的限制。方法：在本研究中，我们使用问卷测量和一种新的攻击行为任务来研究自我报告的囤积症状与两种形式的攻击之间的关系。参与者包括通过在线众包平台从社区招募的466名参与者，他们完成了一个愤怒诱导任务，然后是一个巫毒娃娃任务，作为直接攻击和转移攻击的衡量标准。结果：结果显示，囤积症状在自我报告和行为任务中都与更大的攻击性有关。自我报告的结果还表明，与转移攻击的关系可能比直接攻击的关系略强，说明了协变。结论：这些发现提示攻击性可能与理解囤积症的人际困难有关，并可能与囤积症的临床和理论相关。

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引用次数: 0

Understanding the relationships between parenting, attachment, schemas and psychosis: A serial mediation analysis 了解父母教养、依恋、图式与精神病之间的关系：一项系列中介分析。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-05-10 DOI: 10.1111/bjc.12545

Nadia Akers, Christopher D. J. Taylor, Katherine Berry

Background

Parenting experiences during childhood have been suggested to inform the development of an individual's attachment style and core schemas. Additionally, parenting, attachment and schemas have all individually been linked to symptoms of psychosis in adulthood. However, there is limited research drawing together these concepts to understand the process by which parenting influences psychosis in adulthood. The current study, therefore, aimed to test a serial mediation model in which attachment and schemas mediate the relationship between parenting experiences and adult experiences of psychosis.

Method

A cross-sectional study collected data from 132 adult participants regarding their childhood caregivers' parenting style, their attachment style, core schemas, and adult symptoms of psychosis.

Results

A serial mediation analysis revealed that the relationship between abusive or overcontrolling parenting and psychosis in adulthood was fully mediated by anxious or disorganized attachment styles and negative schema. The relationship between indifferent parenting and psychosis was fully mediated by avoidant attachment and negative schemas.

Conclusions

The findings support the tested hypotheses suggesting that attachment and schemas act as serial mediators in the relationship between parenting style and psychosis. The results highlight the importance of considering attachment and schemas when working therapeutically with people with psychosis. Further research is needed to elaborate on this understanding, develop early parenting interventions to support parents to foster secure attachment in their children and place a focus on schema change within CBT for psychosis.

背景：童年时期的养育经历被认为会影响个体依恋风格和核心图式的发展。此外，育儿、依恋和图式都与成年后的精神病症状有关。然而，有有限的研究将这些概念结合起来，以了解育儿影响成年精神病的过程。因此，本研究旨在检验依恋和图式在养育经历与成年精神病经历之间的中介关系中的串行中介模型。方法：一项横断面研究收集了132名成年参与者关于其童年照顾者的养育方式、依恋方式、核心图式和成年精神病症状的数据。结果：通过系列中介分析发现，焦虑型或无序型依恋类型和负性图式完全中介了虐待型或过度控制型父母教养与成年期精神病的关系。回避型依恋和负性图式完全介导了冷漠教养与精神病的关系。结论：本研究结果支持了已验证的假设，即依恋和图式在父母教养方式与精神病的关系中起连续中介作用。研究结果强调了在对精神病患者进行治疗时考虑依恋和图式的重要性。需要进一步的研究来阐述这一理解，开发早期育儿干预措施，以支持父母培养孩子的安全依恋，并将重点放在精神病CBT中的图式改变上。

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引用次数: 0

Using sleep to enhance exposure treatment for anxious children: A pilot study. 利用睡眠加强对焦虑儿童的暴露治疗：一项初步研究。

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-05-02 DOI: 10.1111/bjc.12550

Ella L Oar, Ronald M Rapee, Cassie H Lavell, Allison G Harvey, Thomas H Ollendick

Objectives: Exposure therapy is a well-established treatment for anxiety disorders in children; however, many young people do not fully respond to treatment. Advances in strategies to enhance extinction learning from exposure therapy are urgently needed. Emerging adult research suggests that sleep could be used to augment exposure therapy outcomes. To the best of our knowledge, the current study is the first published pilot evaluation of the potential benefits of sleep to enhance extinction learning in anxious children.

Methods: Eighteen children aged 7-12 years (M = 9.11; 38.9% Male) with a primary diagnosis of an anxiety disorder were randomized to either a period of sleep immediately following a single session of exposure (SLEEP group), or a day of wakefulness following exposure (WAKE group).

Results: Both groups improved on clinician-rated anxiety severity and children's danger severity expectancies from pre-treatment to post-treatment and 1-week follow-up. Child- and parent-rated target symptom fear ratings also improved from pre-treatment to 1-week follow-up. However, there was no evidence that children in the SLEEP group improved significantly more than the WAKE group.

Conclusions: The current pilot study failed to demonstrate an augmentation effect of post-exposure sleep in children. Practical and methodological challenges are reported for consideration in future investigations.

目的：暴露疗法是一种行之有效的治疗儿童焦虑症的方法；然而，许多年轻人对治疗没有完全反应。迫切需要在策略方面取得进展，以增强从暴露疗法中学习的灭绝。新兴的成人研究表明，睡眠可以用来增加暴露疗法的效果。据我们所知，目前的研究是首次发表的关于睡眠对增强焦虑儿童的灭绝学习的潜在益处的初步评估。方法：7 ~ 12岁儿童18例(M = 9.11；（38.9%男性），初步诊断为焦虑症的患者被随机分为两组，一组在单次暴露后立即睡眠（sleep组），另一组在暴露后清醒一天（WAKE组）。结果：从治疗前到治疗后及随访1周，两组临床评定的焦虑严重程度和儿童危险严重程度预期均有改善。儿童和家长评定的目标症状恐惧评分也从治疗前到随访1周有所改善。然而，没有证据表明SLEEP组的孩子比WAKE组的孩子进步明显。结论：目前的初步研究未能证明暴露后睡眠对儿童的增强作用。报告了实际和方法上的挑战，供今后调查时考虑。

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引用次数: 0

Time-varying associations between daily skills practice and affect in a mindfulness and positive psychology-based intervention for early psychosis 早期精神病的正念和积极心理学干预中日常技能练习与影响之间的时变关联。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-05-01 DOI: 10.1111/bjc.12548

Bryan J. Stiles, Aslıhan İmamoğlu, Tate F. Halverson, Julia Browne, Piper S. Meyer-Kalos, Diana Perkins, David L. Penn

Objective

Using daily life methods, the present study investigated the impact of Integrated Coping Awareness Therapy (I-CAT), which includes mindfulness and positive psychological interventions, versus treatment-as-usual (TAU) on improving daily affective well-being. Among I-CAT participants only, we also examined the time-varying effect of daily I-CAT skill practice on daily affective well-being.

Methods

Data are drawn from a randomized controlled treatment trial involving 38 young adults with a schizophrenia spectrum disorder. Participants completed daily reports of positive (happiness, relaxation) and negative (stress, sadness) affect across 9 months of treatment. I-CAT recipients completed daily practice of mindfulness and positive coping skills.

Results

I-CAT and TAU did not differentially impact daily affect across treatment. However, daily skill practice was associated with better daily affective outcomes in certain phases of I-CAT. We also found that increased daily practice of positive coping skills was associated with better daily affective outcomes, whereas mindfulness practice was associated with poorer affective outcomes during certain periods of the I-CAT intervention.

Conclusions

In general, I-CAT did not improve daily affective outcomes compared with TAU. However, components of I-CAT, specifically the daily practice of positive coping skills, were associated with improved daily emotional well-being in young adults with psychosis. Implications of these findings are discussed.

目的：采用日常生活方法，研究综合应对意识疗法（I-CAT）与常规治疗（TAU）在改善日常情感幸福感方面的影响。仅在I-CAT参与者中，我们还研究了日常I-CAT技能练习对日常情感幸福感的时变影响。方法：数据来自一项随机对照治疗试验，涉及38名患有精神分裂症谱系障碍的年轻成年人。在9个月的治疗中，参与者每天完成积极（快乐、放松）和消极（压力、悲伤）影响的报告。I-CAT接受者完成了正念和积极应对技能的日常练习。结果：I-CAT和TAU在整个治疗过程中对日常影响没有差异。然而，在I-CAT的某些阶段，日常技能练习与更好的日常情感结果相关。我们还发现，在I-CAT干预的特定时期，增加积极应对技能的日常练习与更好的日常情感结果相关，而正念练习与较差的情感结果相关。结论：总的来说，与TAU相比，I-CAT并没有改善日常情感结果。然而，I-CAT的组成部分，特别是积极应对技能的日常实践，与年轻精神病患者日常情绪健康的改善有关。讨论了这些发现的意义。

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引用次数: 0

Generality or specificity? Examining the mechanism of the transdiagnostic associations between different aspects of emotion dysregulation and various anxiety-related disorders 普遍性还是特殊性？探讨情绪失调不同方面与各种焦虑相关障碍的跨诊断关联机制。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-04-28 DOI: 10.1111/bjc.12546

Yanling Yue, Jeremy Tyler, Yiqin Zhu, Keith Bredemeier, Nisha Yao, Wenting Mu

Objectives

Different aspects of emotion dysregulation (ED) have been found to be broadly associated with various anxiety-related disorders (ADs), but the mechanism underlying these transdiagnostic associations is largely unknown. There are at least two possible hypotheses. The generality hypothesis suggests that the associations are better explained by the link between a general ED factor and the general vulnerability factor derived from various ADs. The specificity hypothesis posits that specific ED facets make a unique contribution beyond the general ED factor.

Methods

In a treatment-seeking sample of 351 patients with a primary diagnosis of an AD, we simultaneously examined both the general and facet-specific effects of ED, as assessed by the Difficulties in Emotion Regulation Scale (DERS), on the general vulnerability factor underlying ADs over the course of treatment using a bifactor latent change modelling approach.

Results

Supporting the generality hypothesis, we found decreases in the general DERS factor were associated with symptoms reduction and improvement in life functioning. Except for emotional clarity, specific DERS factors had limited effects beyond the general factor.

Conclusions

Our findings suggested that the well-documented broad associations between ED and various ADs are best explained by the relationship between the general ED factor, rather than specific facets, and the general vulnerability factor to ADs. Thus, assessing overall ED, rather than focusing on specific facets, may be more effective for screening individuals at risk for ADs and monitoring therapeutic progress in the treatment of ADs.

目的：情绪失调（ED）的不同方面已被发现与各种焦虑相关障碍（ADs）广泛相关，但这些跨诊断关联的机制在很大程度上是未知的。至少有两种可能的假设。一般假设认为，一般ED因素与各种ad衍生的一般易损因素之间的联系可以更好地解释这种关联。特异性假设认为，特定ED方面在一般ED因素之外做出了独特的贡献。方法：在351例初步诊断为AD的寻求治疗的患者样本中，我们使用双因素潜在变化建模方法，通过情绪调节困难量表（DERS）评估ED对治疗过程中AD的一般脆弱性因素的影响，同时检查ED的一般影响和特定方面的影响。结果：支持一般假设，我们发现一般DERS因子的降低与症状减轻和生活功能的改善有关。除情绪清晰度外，特定的DERS因素对一般因素的影响有限。结论：我们的研究结果表明，ED与各种ad之间的广泛关联最好的解释是一般ED因素（而不是特定方面）与ad的一般易感因素之间的关系。因此，评估整体ED，而不是专注于特定方面，可能更有效地筛选ad风险个体，并监测ad治疗的治疗进展。

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引用次数: 0

Understanding adolescent suicide risk through alexithymia and hikikomori behaviours: A three-wave study 通过述情障碍和隐蔽青年行为了解青少年自杀风险：一项三波研究。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-04-24 DOI: 10.1111/bjc.12549

Danilo Calaresi, Valeria Saladino, Fiorenza Giordano, Valeria Verrastro

Objective

Suicide risk (SR) has emerged as a critical issue among adolescents, with various factors potentially contributing to this complex problem. Among these, alexithymia and hikikomori behaviours (HB) are two key elements that warrant further investigation. This study examines their longitudinal relationships through the lens of a unified model of SR.

Method

A total of 1814 adolescents from Italy (M = 15.43, SD = 1.09) participated in a three-wave longitudinal study, with surveys administered at baseline (T1), 6 months later (T2), and 12 months later (T3). Structural equation modelling (SEM) was utilized to analyse the bidirectional relationships and mediation effects between the variables.

Results

The results revealed that alexithymia consistently predicted HB and SR, while HB also predicted SR. However, HB did not predict alexithymia, nor did SR predict either alexithymia or HB. Significant mediation effects were observed from alexithymia at T1 to SR at T3 through alexithymia at T2, HB at T2, and SR at T2, as well as from HB at T1 to SR at T3 through HB at T2 and SR at T2. No significant indirect effect was found from HB at T2 to SR at T3 through alexithymia at T2.

Conclusions

These findings suggest that adolescents with higher levels of alexithymia are at greater risk for suicidal behaviours, with HB intensifying this risk. Effective interventions may include programmes aimed at enhancing emotional awareness and promoting social reintegration, which could ultimately improve mental health outcomes and reduce SR among adolescents.

目的：自杀风险（SR）已成为青少年中的一个关键问题，各种因素可能导致这一复杂问题。其中，述情障碍和隐蔽青年行为（HB）是值得进一步调查的两个关键因素。方法：共有1814名意大利青少年（M = 15.43, SD = 1.09）参与了一项三波纵向研究，分别在基线（T1）、6个月后（T2）和12个月后（T3）进行调查。利用结构方程模型（SEM）分析了变量之间的双向关系和中介效应。结果：结果显示，述情障碍一致预测HB和SR，而HB也预测SR。然而，HB不能预测述情障碍，SR也不能预测述情障碍或HB。从T1述情到T3述情，再到T2述情，再到T2 HB，再到T2 SR，以及从T1 HB到T3 SR，再到T2 HB和T2 SR，观察到显著的中介作用。T2时HB与T3时SR通过T2时述情障碍没有明显的间接影响。结论：这些发现表明，述情障碍水平较高的青少年有更大的自杀行为风险，HB加剧了这种风险。有效的干预措施可包括旨在提高情感意识和促进重返社会的方案，这些方案最终可改善青少年的心理健康结果并减少社会暴力现象。

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引用次数: 0

Cross-sectional and longitudinal associations of screen time with adolescent depression and anxiety 屏幕时间与青少年抑郁和焦虑的横断面和纵向关联。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-04-22 DOI: 10.1111/bjc.12547

Sophie H. Li, Philip J. Batterham, Alexis E. Whitton, Kate Maston, Asaduzzaman Khan, Helen Christensen, Aliza Werner-Seidler

Objective

The relationship between screen time and mental health in adolescents is debated in the scientific literature, with longitudinal studies lacking. This study examined the cross-sectional and longitudinal associations between screen time and depression and anxiety and the influence of maladaptive social media use and gender on these associations.

Methods

We analysed a sample of 4058 adolescents (mean age = 13.9) recruited from 134 Australian schools as part of the Future Proofing Study, a 5-year prospective cohort study of adolescent mental health. Linear mixed models used Time 1 and Time 2 (12-month follow-up) data to examine cross-sectional and longitudinal associations of screen time with depression and anxiety and the influence of maladaptive social media use and gender.

Results

Screen time was associated with mental health symptoms cross-sectionally, with each additional hour of screen time corresponding with a 1.25 and .79 increase in measures of depression and anxiety, respectively. Longitudinally, these associations were markedly weaker. Each additional hour of screen time corresponded with only a .15 increase in depression at 12 months and showed no association with anxiety at 12 months. Neither gender nor maladaptive social media use substantially influenced screen time–symptom associations.

Conclusions

Compared to cross-sectional associations, longitudinal associations were weak, indicating that high screen time is unlikely to cause depression and anxiety; instead, observed relationships may be bidirectional. Experimental studies to understand the nuances underlying the relationship between screen time and mental health are needed to support the development of targeted strategies that promote healthy screen time habits among adolescents.

目的：屏幕时间与青少年心理健康之间的关系在科学文献中存在争议，缺乏纵向研究。这项研究调查了屏幕时间与抑郁和焦虑之间的横断面和纵向联系，以及不适应社交媒体使用和性别对这些联系的影响。方法：我们分析了来自134所澳大利亚学校的4058名青少年（平均年龄= 13.9岁）的样本，作为未来证明研究的一部分，这是一项为期5年的青少年心理健康前瞻性队列研究。线性混合模型使用时间1和时间2（12个月随访）数据来检查屏幕时间与抑郁和焦虑的横断面和纵向关联，以及不适应社交媒体使用和性别的影响。结果：屏幕时间与心理健康症状横断面相关，屏幕时间每增加一小时，抑郁和焦虑的测量分别增加1.25和0.79。纵向上，这些关联明显较弱。在12个月的时间里，每增加一个小时的屏幕时间，抑郁只会增加0.15%，而在12个月的时间里，与焦虑没有任何联系。性别和不适应社交媒体的使用对屏幕时间-症状的关联都没有实质性影响。结论：与横断面关联相比，纵向关联较弱，表明高屏幕时间不太可能引起抑郁和焦虑；相反，观察到的关系可能是双向的。需要进行实验研究，了解屏幕时间与心理健康之间关系的细微差别，以支持制定有针对性的策略，促进青少年健康的屏幕时间习惯。

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引用次数: 0

The therapeutic alliance during remotely delivered therapy: A Delphi study with health professionals 远程交付治疗期间的治疗联盟：一项与卫生专业人员的德尔菲研究。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-04-04 DOI: 10.1111/bjc.12544

Sam Tyrrell, Sandra Bucci, Katherine Berry

Objectives

Delivering psychological therapy via videoconferencing and telephone is now commonplace across mental health services, but many therapists remain concerned about the impact on the therapeutic alliance. This study aimed to establish consensus amongst psychological therapists regarding the factors involved in establishing and maintaining the therapeutic alliance during remote therapy interventions.

Methods

Psychological therapists from a range of professional backgrounds were invited to complete a three-Round Delphi survey online. Round 1 generated qualitative data which was used to develop a list of statements relating to key factors in establishing and maintaining alliance in therapy delivered over the telephone or videoconferencing. Participants were invited to rate their level of agreement with these statements in Rounds 2 and 3.

Results

Of the 149 participants who completed Round 1, 93 completed Round 2, and 71 participants completed all three Rounds. Following Round 3, a high level of agreement (above 80%) was obtained in relation to 31/63 statements reflecting communication style, contracting, quality and value, environment, emotional differences, effort, and technological aspects of engaging clients in this way. Participants reported similar views for therapies delivered via telephone and videoconferencing.

Discussion

Clinicians who have had to navigate the rapid rise in online delivery of therapy have valuable insights which warrant sharing amongst communities of practicing therapists and those in training. Identifying factors which therapists agree are important in developing alliances with patients remotely also guides researchers in identifying factors that warrant further investigation through empirical studies.

目的：目前，通过视频会议和电话提供心理治疗在心理健康服务中已司空见惯，但许多治疗师仍然担心这会对治疗联盟产生影响。本研究旨在就远程治疗干预过程中建立和维持治疗联盟的相关因素在心理治疗师之间达成共识：方法：邀请不同专业背景的心理治疗师在线完成三轮德尔菲调查。第一轮调查产生的定性数据被用于制定一份陈述清单，该清单涉及在电话或视频会议治疗中建立和维持治疗联盟的关键因素。第二轮和第三轮调查邀请参与者对这些陈述的同意程度进行评分：在完成第一轮的 149 名参与者中，93 人完成了第二轮，71 人完成了全部三轮。在第三轮中，31/63 项陈述获得了很高的同意度（80% 以上），这些陈述反映了以这种方式与客户接触的沟通方式、合同、质量和价值、环境、情感差异、努力和技术方面。对于通过电话和视频会议提供的治疗，参与者也有类似的看法：讨论：临床医生在网上治疗迅速兴起的过程中积累了宝贵的经验，值得在执业治疗师和接受培训的治疗师群体中分享。找出治疗师认为在与患者建立远程联盟方面非常重要的因素，也有助于研究人员找出值得通过实证研究进一步调查的因素。

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引用次数: 0