British Journal of Clinical Psychology最新文献_第7页

Validation of a transdiagnostic measure of fears of recurrence and progression about mental health conditions 对精神健康状况复发和进展恐惧的一种跨诊断测量方法的验证

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-02-27 DOI: 10.1111/bjc.12536

Daelin Coutts-Bain, Louise Sharpe, Caroline Hunt

Objectives

Fears of recurrence and progression (FORP) in people with mental health conditions are understudied despite predicting poorer psychological outcomes and increased rates of relapse. However, there are no well-validated questionnaires that assess FORP in people with non-psychotic conditions. Moreover, it is not known whether FORP is empirically distinct from mental health anxiety.

Design

Online survey collected data at two time points.

Method

A 40-item FORP About Mental Health Questionnaire (FORP-MHQ) was derived from lived experience interviews. Analyses were conducted with a sample of 865 people with different mental health conditions. Exploratory factor analysis in a randomly split sub-sample (N = 432) yielded a 10-item, single-factor structure that measures FORP severity. Confirmatory factor analysis on these items was conducted in the remaining sample (N = 433). Discriminant and convergent validity, and reliability, analyses were conducted in the complete sample. Measurement invariance was assessed between men and women, those with and without a history of psychosis or mania, and those with and without diagnoses across different diagnostic categories.

Results

The 10-item FORP-MHQ demonstrated good structural, convergent and concurrent validity, internal consistency, and test–retest reliability. It was also empirically distinct from mental health anxiety with good discriminant validity. The FORP-MHQ was invariant between men and women, those with and without a history of psychosis or mania, and those with and without diagnoses across diagnostic categories.

Conclusion

The FORP-MHQ is a valid and reliable tool to assess FORP in people with a range of different mental health conditions, both psychotic and non-psychotic.

目的：对有精神健康状况的人的复发和进展的恐惧（FORP）的研究尚不充分，尽管预测较差的心理结果和复发率增加。然而，目前还没有经过良好验证的问卷来评估非精神病患者的FORP。此外，尚不清楚FORP是否在经验上与心理健康焦虑不同。设计：在线调查在两个时间点收集数据。方法：采用生活经验访谈法编制40项心理健康问卷（FORP- mhq）。研究人员对865名不同心理健康状况的人进行了分析。在随机分割的子样本（N = 432）中进行探索性因素分析，产生了一个10项单因素结构，用于测量FORP的严重程度。对剩余样本（N = 433）进行验证性因子分析。在完整样本中进行了判别效度和收敛效度以及信度分析。测量不变性评估了男性和女性、有和没有精神病或躁狂病史的人、有和没有不同诊断类别诊断的人。结果：10项FORP-MHQ量表具有良好的结构效度、收敛效度和并发效度、内部一致性和重测信度。与心理健康焦虑有明显的经验差异，具有良好的判别效度。FORP-MHQ在男性和女性、有和没有精神病或躁狂病史的人、有和没有诊断类别的人之间是不变的。结论：FORP- mhq是一种有效和可靠的工具，可用于评估具有一系列不同精神健康状况（包括精神病性和非精神病性）的人的FORP。

{"title":"Validation of a transdiagnostic measure of fears of recurrence and progression about mental health conditions","authors":"Daelin Coutts-Bain, Louise Sharpe, Caroline Hunt","doi":"10.1111/bjc.12536","DOIUrl":"10.1111/bjc.12536","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Fears of recurrence and progression (FORP) in people with mental health conditions are understudied despite predicting poorer psychological outcomes and increased rates of relapse. However, there are no well-validated questionnaires that assess FORP in people with non-psychotic conditions. Moreover, it is not known whether FORP is empirically distinct from mental health anxiety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Online survey collected data at two time points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A 40-item FORP About Mental Health Questionnaire (FORP-MHQ) was derived from lived experience interviews. Analyses were conducted with a sample of 865 people with different mental health conditions. Exploratory factor analysis in a randomly split sub-sample (<i>N</i> = 432) yielded a 10-item, single-factor structure that measures FORP severity. Confirmatory factor analysis on these items was conducted in the remaining sample (<i>N</i> = 433). Discriminant and convergent validity, and reliability, analyses were conducted in the complete sample. Measurement invariance was assessed between men and women, those with and without a history of psychosis or mania, and those with and without diagnoses across different diagnostic categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 10-item FORP-MHQ demonstrated good structural, convergent and concurrent validity, internal consistency, and test–retest reliability. It was also empirically distinct from mental health anxiety with good discriminant validity. The FORP-MHQ was invariant between men and women, those with and without a history of psychosis or mania, and those with and without diagnoses across diagnostic categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The FORP-MHQ is a valid and reliable tool to assess FORP in people with a range of different mental health conditions, both psychotic and non-psychotic.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"757-772"},"PeriodicalIF":3.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characteristics of young people referred for treatment of depression and anxiety in a school-based mental health service 在校本心理健康服务机构接受抑郁和焦虑治疗的年轻人的特征。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-02-26 DOI: 10.1111/bjc.12526

Emilia Robinson, Chloe Chapman, Faith Orchard, Clare Dixon, Mary John

Objectives

The aim of the paper was to describe referrals to a UK school-based mental health service for children and adolescents.

Methods

Children and young people (CYP) (N = 485, aged 4–18) were referred to two Mental Health Support Team sites in the South of England in 2021, for CBT-informed interventions for mild-to-moderate anxiety and depression. Child and parent reported outcome measures were completed pre-intervention, including measures of symptom severity and impact.

Results

Referrals consisted of 61% female, 57% secondary school age (12–18 years old) and 81% White British. Children of secondary school age self-reported significantly higher levels of anxiety (p = .003) and depression (p < .001) than children of primary age. Females self-reported significantly higher levels of anxiety (p < .001) and depression (p < .001) than males. The majority of CYP self-reported below or borderline threshold anxiety, depression and overall internalizing symptoms. The majority of caregiver-reported CYP difficulties met the clinical threshold for anxiety and overall internalizing symptoms, but not depression.

Conclusions

The findings have direct relevance to the transformation and delivery of school-based public mental health services for children and adolescents. There is a need to collect routine data from other services to assess the broader needs of CYP referred for low intensity early interventions across regions.

目的：本文的目的是描述转介到英国学校为基础的儿童和青少年心理健康服务。方法：儿童和青少年（CYP）（N = 485，年龄4-18岁）于2021年被转介到英格兰南部的两个心理健康支持团队站点，接受cbt知情干预，治疗轻度至中度焦虑和抑郁。在干预前完成儿童和家长报告的结果测量，包括症状严重程度和影响的测量。结果：转介包括61%的女性，57%的中学年龄（12-18岁）和81%的白人英国人。中学适龄儿童自我报告的焦虑（p = 0.003）和抑郁(p)水平显著较高。结论：研究结果与以学校为基础的儿童和青少年公共心理卫生服务的转变和提供直接相关。有必要从其他服务收集常规数据，以评估各区域转介进行低强度早期干预的CYP的更广泛需求。

{"title":"Characteristics of young people referred for treatment of depression and anxiety in a school-based mental health service","authors":"Emilia Robinson, Chloe Chapman, Faith Orchard, Clare Dixon, Mary John","doi":"10.1111/bjc.12526","DOIUrl":"10.1111/bjc.12526","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of the paper was to describe referrals to a UK school-based mental health service for children and adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Children and young people (CYP) (<i>N</i> = 485, aged 4–18) were referred to two Mental Health Support Team sites in the South of England in 2021, for CBT-informed interventions for mild-to-moderate anxiety and depression. Child and parent reported outcome measures were completed pre-intervention, including measures of symptom severity and impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Referrals consisted of 61% female, 57% secondary school age (12–18 years old) and 81% White British. Children of secondary school age self-reported significantly higher levels of anxiety (<i>p</i> = .003) and depression (<i>p</i> < .001) than children of primary age. Females self-reported significantly higher levels of anxiety (<i>p</i> < .001) and depression (<i>p</i> < .001) than males. The majority of CYP self-reported below or borderline threshold anxiety, depression and overall internalizing symptoms. The majority of caregiver-reported CYP difficulties met the clinical threshold for anxiety and overall internalizing symptoms, but not depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings have direct relevance to the transformation and delivery of school-based public mental health services for children and adolescents. There is a need to collect routine data from other services to assess the broader needs of CYP referred for low intensity early interventions across regions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"744-756"},"PeriodicalIF":3.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A preliminary investigation of the relationships between attachment insecurity, fear of compassion, and OCD severity 依恋不安全感、同情恐惧和强迫症严重程度之间关系的初步调查。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-02-24 DOI: 10.1111/bjc.12533

Aliya McNeil, Christine Purdon

Objectives

The most successful psychological treatment for obsessive-compulsive disorder (OCD) is cognitive behavioural therapy (CBT). However, treatment success remains around 50% when refusal and dropout are considered. Purdon (Journal of Behavior Therapy and Experimental, Psychiatry, 2023, 78, 101773) argued that the CBT model is under-specified, suggesting that there may be important treatment targets that are not directly addressed. Based on emerging research, she identified insecure attachment and fear of compassion (FOC) as potentially important targets. Insecure attachment and FOC are associated with OCD symptoms, and past research suggests that FOC may explain the relationship between attachment insecurity and emotional distress. We reasoned that FOC may also be an important predictor of OCD symptom severity.

Methods

We conducted two preliminary, pre-registered online survey studies with undergraduate samples to explore potential theoretical relationships between attachment, FOC, and OCD.

Results

Study one (N = 329) revealed that the indirect effect of attachment anxiety on OCD symptom severity through fear of self-compassion was significant, even when controlling for trait self-compassion. A significant indirect effect of attachment avoidance predicting OCD severity, through fear of receiving compassion, also emerged. Study two (N = 340) replicated these findings and extended this research by controlling for depression.

Conclusions

Taken together, these findings suggest that FOC could be an important variable to consider when conceptualizing OCD. Further exploration is warranted to understand the directionality of these relationships and whether attachment and FOC could be valuable targets in OCD treatment.

目的：对强迫症（OCD）最成功的心理治疗是认知行为疗法（CBT）。然而，如果考虑到拒绝和退出，治疗成功率仍在50%左右。Purdon （Journal of Behavior Therapy and Experimental, Psychiatry, 2023, 78, 101773）认为，CBT模型没有明确规定，这表明可能存在没有直接解决的重要治疗目标。根据最新的研究，她确定了不安全依恋和同情恐惧（FOC）是潜在的重要目标。不安全依恋和FOC与强迫症症状有关，过去的研究表明FOC可以解释依恋不安全和情绪困扰之间的关系。我们推断FOC也可能是强迫症症状严重程度的重要预测因子。方法：我们对大学生样本进行了两项初步的、预先注册的在线调查研究，以探索依恋、FOC和强迫症之间潜在的理论关系。结果：研究一（N = 329）发现，即使在控制特质性自我同情的情况下，依恋焦虑通过对自我同情的恐惧对强迫症症状严重程度的间接影响也是显著的。通过害怕得到同情，依恋回避对强迫症严重程度的预测也产生了重要的间接影响。研究二（N = 340）重复了这些发现，并通过控制抑郁来扩展这项研究。结论：综上所述，这些发现表明FOC可能是概念化强迫症时需要考虑的一个重要变量。进一步的探索是必要的，以了解这些关系的方向性，以及依恋和FOC是否可以成为强迫症治疗的有价值的目标。

{"title":"A preliminary investigation of the relationships between attachment insecurity, fear of compassion, and OCD severity","authors":"Aliya McNeil, Christine Purdon","doi":"10.1111/bjc.12533","DOIUrl":"10.1111/bjc.12533","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The most successful psychological treatment for obsessive-compulsive disorder (OCD) is cognitive behavioural therapy (CBT). However, treatment success remains around 50% when refusal and dropout are considered. Purdon (<i>Journal of Behavior Therapy and Experimental, Psychiatry</i>, 2023, 78, 101773) argued that the CBT model is under-specified, suggesting that there may be important treatment targets that are not directly addressed. Based on emerging research, she identified insecure attachment and fear of compassion (FOC) as potentially important targets. Insecure attachment and FOC are associated with OCD symptoms, and past research suggests that FOC may explain the relationship between attachment insecurity and emotional distress. We reasoned that FOC may also be an important predictor of OCD symptom severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted two preliminary, pre-registered online survey studies with undergraduate samples to explore potential theoretical relationships between attachment, FOC, and OCD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Study one (<i>N</i> = 329) revealed that the indirect effect of attachment anxiety on OCD symptom severity through fear of self-compassion was significant, even when controlling for trait self-compassion. A significant indirect effect of attachment avoidance predicting OCD severity, through fear of receiving compassion, also emerged. Study two (<i>N</i> = 340) replicated these findings and extended this research by controlling for depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Taken together, these findings suggest that FOC could be an important variable to consider when conceptualizing OCD. Further exploration is warranted to understand the directionality of these relationships and whether attachment and FOC could be valuable targets in OCD treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"725-743"},"PeriodicalIF":3.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Imagining Futures: Evaluation of a blended programme of dialectical behaviour therapy and the creative arts for young women with a history of self-harm 想象未来：对有自残史的年轻女性的辩证行为疗法和创造性艺术混合方案的评估。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-02-19 DOI: 10.1111/bjc.12528

L. M. Smith, B. Barrett, S. Barnes, B. Oltean, L. Ige, C. Day, T. Tranah

Objectives

To evaluate an arts-enhanced dialectical behavioural therapy skills group for managing emotions and self-harm, implemented via an innovative public sector/third sector partnership to increase access to care.

Design

This is a pilot mixed-methods study.

Methods

To assess participant experience in the ‘Imagining Futures’ programme, we examined self-report questionnaires and qualitative focus group interviews using framework analysis. We collected recruitment, session attendance and programme completion rates. To explore impact, we also report on quantitative psychological outcome measures, including self-harm frequency and overall well-being.

Results

We recruited 45 young women (mean age: 15.9, s.d. = 1.24, range 13.9–18.0 years) with a history of emotional dysregulation, self-harm and other contextual risks who were not receiving support from statutory child and adolescent mental health services in the United Kingdom. Participants were 22% not in education, employment or training and 77% were from United Kingdom racially minoritized backgrounds. The overall completion rate was 62% (n = 28/45). Qualitative data analysed from respondents (n = 25/28 young people and n = 12 parents) suggested high levels of satisfaction with the project. Thirteen themes were identified which described service elements perceived to support engagement and observed impact. There was an important role for relationships and the creative components. Quantitative clinical data indicated reductions in the frequency of self-harming, significant reductions in the perceived impact of difficulties and increased perceived social support.

Conclusions

This novel delivery of a DBT skills group, incorporating blended psychology arts activities, has the potential to support engagement with psychological supports that improve mental well-being.

目的：评估通过创新的公共部门/第三部门合作伙伴关系实施的艺术增强的辩证行为治疗技能小组，以管理情绪和自我伤害，以增加获得护理的机会。设计：这是一项试验性混合方法研究。方法：为了评估参与者在“想象未来”项目中的体验，我们使用框架分析检查了自我报告问卷和定性焦点小组访谈。我们收集了招聘、课程出勤率和课程完成率。为了探索影响，我们还报告了定量的心理结果测量，包括自残频率和整体幸福感。结果：我们招募了45名年轻女性（平均年龄：15.9岁，s.d. = 1.24，范围13.9-18.0岁），她们有情绪失调、自残和其他背景风险史，没有得到英国法定儿童和青少年心理健康服务机构的支持。22%的参与者没有接受教育、就业或培训，77%的参与者来自英国的少数民族背景。总体完成率为62% （n = 28/45）。从受访者（n = 25/28名年轻人和n = 12名家长）中分析的定性数据表明，对该项目的满意度很高。确定了13个主题，其中描述了支持参与和观察到的影响的服务要素。人际关系和创造性元素扮演着重要的角色。定量临床数据表明，自我伤害的频率减少了，感知到的困难影响显著减少，感知到的社会支持增加了。结论：结合混合心理艺术活动的DBT技能组的这种新颖交付，有可能支持参与心理支持，从而改善心理健康。

{"title":"Imagining Futures: Evaluation of a blended programme of dialectical behaviour therapy and the creative arts for young women with a history of self-harm","authors":"L. M. Smith, B. Barrett, S. Barnes, B. Oltean, L. Ige, C. Day, T. Tranah","doi":"10.1111/bjc.12528","DOIUrl":"10.1111/bjc.12528","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate an arts-enhanced dialectical behavioural therapy skills group for managing emotions and self-harm, implemented via an innovative public sector/third sector partnership to increase access to care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This is a pilot mixed-methods study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To assess participant experience in the ‘Imagining Futures’ programme, we examined self-report questionnaires and qualitative focus group interviews using framework analysis. We collected recruitment, session attendance and programme completion rates. To explore impact, we also report on quantitative psychological outcome measures, including self-harm frequency and overall well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We recruited 45 young women (mean age: 15.9, s.d. = 1.24, range 13.9–18.0 years) with a history of emotional dysregulation, self-harm and other contextual risks who were not receiving support from statutory child and adolescent mental health services in the United Kingdom. Participants were 22% not in education, employment or training and 77% were from United Kingdom racially minoritized backgrounds. The overall completion rate was 62% (<i>n</i> = 28/45). Qualitative data analysed from respondents (<i>n</i> = 25/28 young people and <i>n</i> = 12 parents) suggested high levels of satisfaction with the project. Thirteen themes were identified which described service elements perceived to support engagement and observed impact. There was an important role for relationships and the creative components. Quantitative clinical data indicated reductions in the frequency of self-harming, significant reductions in the perceived impact of difficulties and increased perceived social support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This novel delivery of a DBT skills group, incorporating blended psychology arts activities, has the potential to support engagement with psychological supports that improve mental well-being.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"702-724"},"PeriodicalIF":3.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Relevance of ecological momentary assessment for medication adherence in clinical settings: A precision psychiatry approach 临床环境中对药物依从性的生态瞬时评估的相关性：一种精确的精神病学方法。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-02-17 DOI: 10.1111/bjc.12532

Valentine Chirokoff, Arnaud Tessier, Fuschia Serre, Maud Dupuy, Marc Auriacombe, Sandra Chanraud, Sylvie Berthoz, Melina Fatseas, David Misdrahi

Background

Medication non-adherence is a leading cause of treatment failure in psychiatric populations. However, current studies highlight the lack of methodological guidance on medication assessments. Ecological Momentary Assessment (EMA), using smartphone-based evaluations, shows promise for real-time monitoring in everyday settings.

Aims

This study evaluated EMA's effectiveness in assessing medication adherence in patients with schizophrenia, depression, and substance use disorders (SUD), covering various treatment regimens.

Materials & Methods

A total of 133 participants (27 with schizophrenia, 20 with depression, 44 with SUDs, and 42 healthy controls) completed EMA via study-provided smartphones five times daily over 1 week. Treatment regimens, categorized by mono vs. polytherapy and single vs. multiple daily doses, were documented. EMA adherence was calculated from the completion rate of the assessments, while medication adherence was assessed daily for patients. Both mean medication adherence and adherence variation over time were analysed by diagnosis and treatment regimen.

Results

All groups demonstrated high mean EMA and medication adherence, with minor variations across treatment types. Importantly, patients showed improved adherence over time, independently of diagnosis or regimen.

Discussion

These findings indicate EMA's potential as an effective method for capturing medication adherence in psychiatric populations.

Conclusion

The approach's capacity for real-time, context-sensitive data collection could reveal adherence patterns and changes not detectable by conventional methods, offering valuable insights for clinical practice.

背景：药物不依从性是精神科人群治疗失败的主要原因。然而，目前的研究强调缺乏药物评估的方法学指导。生态瞬间评估（EMA）使用智能手机进行评估，有望在日常环境中进行实时监测。目的：本研究评估了EMA在评估精神分裂症、抑郁症和物质使用障碍（SUD）患者药物依从性方面的有效性，涵盖了各种治疗方案。材料与方法：共有133名参与者（27名精神分裂症患者，20名抑郁症患者，44名sud患者和42名健康对照者）通过研究提供的智能手机完成EMA，每天5次，持续1周。治疗方案分为单药与多药、单药与多药。EMA依从性是根据评估的完成率计算的，而药物依从性是每天对患者进行评估的。通过诊断和治疗方案分析平均药物依从性和依从性随时间的变化。结果：所有组均表现出较高的平均EMA和药物依从性，不同治疗类型差异较小。重要的是，随着时间的推移，患者表现出更好的依从性，独立于诊断或治疗方案。讨论：这些发现表明EMA作为捕获精神科人群药物依从性的有效方法的潜力。结论：该方法具有实时、上下文敏感的数据收集能力，可以揭示常规方法无法检测到的依从性模式和变化，为临床实践提供有价值的见解。

{"title":"Relevance of ecological momentary assessment for medication adherence in clinical settings: A precision psychiatry approach","authors":"Valentine Chirokoff, Arnaud Tessier, Fuschia Serre, Maud Dupuy, Marc Auriacombe, Sandra Chanraud, Sylvie Berthoz, Melina Fatseas, David Misdrahi","doi":"10.1111/bjc.12532","DOIUrl":"10.1111/bjc.12532","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Medication non-adherence is a leading cause of treatment failure in psychiatric populations. However, current studies highlight the lack of methodological guidance on medication assessments. Ecological Momentary Assessment (EMA), using smartphone-based evaluations, shows promise for real-time monitoring in everyday settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study evaluated EMA's effectiveness in assessing medication adherence in patients with schizophrenia, depression, and substance use disorders (SUD), covering various treatment regimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials & Methods</h3>\u0000 \u0000 <p>A total of 133 participants (27 with schizophrenia, 20 with depression, 44 with SUDs, and 42 healthy controls) completed EMA via study-provided smartphones five times daily over 1 week. Treatment regimens, categorized by mono vs. polytherapy and single vs. multiple daily doses, were documented. EMA adherence was calculated from the completion rate of the assessments, while medication adherence was assessed daily for patients. Both mean medication adherence and adherence variation over time were analysed by diagnosis and treatment regimen.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All groups demonstrated high mean EMA and medication adherence, with minor variations across treatment types. Importantly, patients showed improved adherence over time, independently of diagnosis or regimen.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>These findings indicate EMA's potential as an effective method for capturing medication adherence in psychiatric populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The approach's capacity for real-time, context-sensitive data collection could reveal adherence patterns and changes not detectable by conventional methods, offering valuable insights for clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"692-701"},"PeriodicalIF":3.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial acknowledgement 社论承认

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-02-05 DOI: 10.1111/bjc.12521

引用次数: 0

The role of impulsivity in the association between rumination and cannabis-related problems among trauma-exposed cannabis users 在创伤暴露的大麻使用者中，冲动在反刍和大麻相关问题之间的关联中的作用。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-02-05 DOI: 10.1111/bjc.12530

Jennifer U. Le, Regine M. Deguzman, Norman B. Schmidt, Nicole A. Short

Objectives

The Emotional Cascade Model posits that rumination is associated with impulsivity and risky behaviours such as substance use. Although trauma-exposed individuals often engage in rumination and problematic cannabis use, this model has not been tested on trauma-exposed cannabis users. Therefore, our study examines the direct and indirect effects between rumination and its subtypes with problematic cannabis use among trauma-exposed cannabis users. We also examine how these associations occur through impulsivity.

Methods

A cross-sectional sample of 56 trauma-exposed young adult cannabis users (M_age = 21 years, 59% female, 73% white) self-reported rumination, impulsivity, and cannabis-related problems. All participants provided written informed consent, and procedures were approved by the university's Institutional Review Board and pre-registered.

Results

Regression analyses indicated total and brooding rumination were related to greater cannabis-related problems, after covarying for number of traumas and cannabis use frequency. Rumination, specifically brooding, was incrementally associated with greater cannabis-related problems and had an indirect effect on cannabis-related problems through impulsivity. Consistent with hypothesis, rumination and impulsivity were incrementally associated with greater problematic cannabis use among trauma-exposed cannabis users.

Conclusion

The current study expands work on the Emotional Cascade Model by supporting the indirect effect of impulsivity in the association between rumination and problematic cannabis use.

研究目的情绪级联模型认为，反刍与冲动和药物使用等危险行为有关。虽然遭受创伤的人经常会产生反刍和使用问题大麻，但这一模型尚未在遭受创伤的大麻使用者身上进行过测试。因此，我们的研究探讨了反刍及其亚型对受创伤影响的大麻使用者使用问题大麻的直接和间接影响。我们还研究了这些关联是如何通过冲动性发生的：56名受创伤的年轻成人大麻使用者（年龄=21岁，59%为女性，73%为白人）自我报告了反刍、冲动和大麻相关问题。所有参与者都提供了书面知情同意书，研究程序获得了大学机构审查委员会的批准，并进行了预先登记：回归分析表明，在与创伤次数和大麻使用频率相关联后，总遐想和忧郁遐想与大麻相关问题的增加有关。反刍，特别是沉思，与大麻相关问题的增加呈递增关系，并通过冲动性对大麻相关问题产生间接影响。与假设一致的是，反刍和冲动与受到创伤的大麻使用者使用大麻的问题更多呈递增关系：本研究通过支持冲动在反刍与问题性吸食大麻之间的关联中的间接作用，扩展了情绪级联模型的研究工作。

{"title":"The role of impulsivity in the association between rumination and cannabis-related problems among trauma-exposed cannabis users","authors":"Jennifer U. Le, Regine M. Deguzman, Norman B. Schmidt, Nicole A. Short","doi":"10.1111/bjc.12530","DOIUrl":"10.1111/bjc.12530","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The Emotional Cascade Model posits that rumination is associated with impulsivity and risky behaviours such as substance use. Although trauma-exposed individuals often engage in rumination and problematic cannabis use, this model has not been tested on trauma-exposed cannabis users. Therefore, our study examines the direct and indirect effects between rumination and its subtypes with problematic cannabis use among trauma-exposed cannabis users. We also examine how these associations occur through impulsivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional sample of 56 trauma-exposed young adult cannabis users (<i>M</i><sub>age</sub> = 21 years, 59% female, 73% white) self-reported rumination, impulsivity, and cannabis-related problems. All participants provided written informed consent, and procedures were approved by the university's Institutional Review Board and pre-registered.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Regression analyses indicated total and brooding rumination were related to greater cannabis-related problems, after covarying for number of traumas and cannabis use frequency. Rumination, specifically brooding, was incrementally associated with greater cannabis-related problems and had an indirect effect on cannabis-related problems through impulsivity. Consistent with hypothesis, rumination and impulsivity were incrementally associated with greater problematic cannabis use among trauma-exposed cannabis users.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The current study expands work on the Emotional Cascade Model by supporting the indirect effect of impulsivity in the association between rumination and problematic cannabis use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"677-691"},"PeriodicalIF":3.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Negative interpretation bias and repetitive negative thinking as mechanisms in the association between insomnia and depression in young adults. 消极解释偏见和重复消极思维是年轻人失眠和抑郁之间的关联机制。

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-01-15 DOI: 10.1111/bjc.12529

Isabel Clegg, Lies Notebaert, Amy Whittle-Herbert, Cele Richardson

Objectives: Despite evidence supporting sleep's role in the development and maintenance of depression, mechanisms underlying this association in young people are less established. Negative interpretation bias (the tendency to interpret ambiguous situations negatively) and repetitive negative thinking (RNT) are important candidate mechanisms. Whilst negative interpretation bias is implicated in depression development, it is a transdiagnostic process and may result from insomnia. Yet, research relating to these constructs is lacking. RNT is another transdiagnostic process implicated in association between negative interpretation bias, depression and insomnia. However, an elaborated model that includes both mechanisms is yet to be tested. It was hypothesised that negative interpretation bias and RNT would sequentially mediate the relationship between sleep/insomnia and depressive symptoms in young people.

Design: The associations predicted by this hypothesis were tested via cross-sectional mediation in a sample of 214 participants (M_age = 19.19 years, SD = 1.67, Range_age = 17-24 years, 20% male).

Methods: Participants completed questionnaire measures of insomnia symptoms, depression symptoms and RNT, an ambiguous scenarios task and a 1-week sleep diary.

Results: Results were consistent with negative interpretation bias and RNT as sequential mechanisms which partially account for the relationship between sleep (i.e., insomnia severity and sleep parameters) and depression.

Conclusions: This study supports negative interpretation bias and RNT as mechanisms linking insomnia and depression in young people, as the predicted associations between these variables were observed. Future research should investigate the causal/directional associations. However, results support theoretical models, and suggest sleep, interpretation bias and RNT may be important processes to target in preventing and treating depression.

目的：尽管有证据支持睡眠在抑郁症的发展和维持中所起的作用，但在年轻人中这种关联的机制尚不明确。负性解释偏差（消极解读模棱两可情境的倾向）和重复性消极思维（RNT）是重要的候选机制。虽然负面解释偏差与抑郁症的发展有关，但它是一个跨诊断过程，可能由失眠引起。然而，与这些结构相关的研究是缺乏的。RNT是另一个与负性解释偏差、抑郁和失眠相关的跨诊断过程。然而，一个包含这两种机制的详细模型还有待检验。假设负性解释偏差和RNT会依次介导年轻人睡眠/失眠与抑郁症状之间的关系。设计：通过横断面中介在214名参与者（Mage = 19.19岁，SD = 1.67, age = 17-24岁，20%为男性）的样本中检验该假设预测的关联。方法：参与者完成失眠症状、抑郁症状和RNT的问卷测量、模糊情景任务和为期一周的睡眠日记。结果：研究结果与负解释偏倚和RNT作为顺序机制一致，部分解释了睡眠（即失眠严重程度和睡眠参数）与抑郁之间的关系。结论：本研究支持负解释偏倚和RNT作为联系年轻人失眠和抑郁的机制，因为这些变量之间的预测关联被观察到。未来的研究应探讨因果/定向关联。然而，研究结果支持理论模型，并提示睡眠、解释偏差和RNT可能是预防和治疗抑郁症的重要目标过程。

{"title":"Negative interpretation bias and repetitive negative thinking as mechanisms in the association between insomnia and depression in young adults.","authors":"Isabel Clegg, Lies Notebaert, Amy Whittle-Herbert, Cele Richardson","doi":"10.1111/bjc.12529","DOIUrl":"https://doi.org/10.1111/bjc.12529","url":null,"abstract":"<p><strong>Objectives: </strong>Despite evidence supporting sleep's role in the development and maintenance of depression, mechanisms underlying this association in young people are less established. Negative interpretation bias (the tendency to interpret ambiguous situations negatively) and repetitive negative thinking (RNT) are important candidate mechanisms. Whilst negative interpretation bias is implicated in depression development, it is a transdiagnostic process and may result from insomnia. Yet, research relating to these constructs is lacking. RNT is another transdiagnostic process implicated in association between negative interpretation bias, depression and insomnia. However, an elaborated model that includes both mechanisms is yet to be tested. It was hypothesised that negative interpretation bias and RNT would sequentially mediate the relationship between sleep/insomnia and depressive symptoms in young people.</p><p><strong>Design: </strong>The associations predicted by this hypothesis were tested via cross-sectional mediation in a sample of 214 participants (M<sub>age</sub> = 19.19 years, SD = 1.67, Range<sub>age</sub> = 17-24 years, 20% male).</p><p><strong>Methods: </strong>Participants completed questionnaire measures of insomnia symptoms, depression symptoms and RNT, an ambiguous scenarios task and a 1-week sleep diary.</p><p><strong>Results: </strong>Results were consistent with negative interpretation bias and RNT as sequential mechanisms which partially account for the relationship between sleep (i.e., insomnia severity and sleep parameters) and depression.</p><p><strong>Conclusions: </strong>This study supports negative interpretation bias and RNT as mechanisms linking insomnia and depression in young people, as the predicted associations between these variables were observed. Future research should investigate the causal/directional associations. However, results support theoretical models, and suggest sleep, interpretation bias and RNT may be important processes to target in preventing and treating depression.</p>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correlates of suicidal ideation and suicide attempts among bisexual+, gay/lesbian, and heterosexual young adults 双性恋+、男同性恋/女同性恋和异性恋年轻人自杀意念和自杀企图的相关性

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2025-01-13 DOI: 10.1111/bjc.12525

Erik M. Benau, Matthew R. Hanna, Felix Yirdong, Lillian Polanco-Roman

Introduction

Compared to their exclusively gay/lesbian or heterosexual identifying peers, young people identifying as bisexual+ (e.g. bisexual, pansexual, asexual, queer or questioning) are at elevated risk for suicidal ideation (SI) and attempts (SA). The present study aimed to establish whether the prevalence of, and psychosocial risk factors for, SI and SA vary as a function of sexual identity.

Methods

Young adults (N = 274; 18–29 years old) were recruited via online crowdsourcing. They completed questionnaires assessing adverse childhood experiences (ACEs), emotion dysregulation, impulsivity, depression symptoms and lifetime history of SI and SA. Spearman correlations, Kruskal-Wallis H-tests and binomial logistic regression models were used.

Results

No variable was associated with SI. Bisexual+ individuals reported greater SA than the heterosexual group, though statistically similar to the gay/lesbian group. A similar pattern emerged for ACEs. The bisexual+ group reported greater depression symptoms than the gay/lesbian group. Impulsivity and emotion dysregulation did not vary by sexual identity. Controlling for these psychosocial and sociodemographic variables did not alter results: bisexual+ individuals were almost three times more likely to report SA than heterosexual individuals, OR = 2.93 95% CI [1.16, 7.44]; gay/lesbian and heterosexual individuals had a statistically similar likelihood of reporting SA, OR = 1.09, 95% CI [0.27, 4.37].

Conclusion

This is the first study to establish that young adults identifying as bisexual+ are at greater risk for SA after controlling for well-established psychosocial correlates; this was not the case for SI. Further work is needed to establish the aetiology of this risk.

引言：与他们的纯同性恋或异性恋同龄人相比，被认定为双性恋+的年轻人（如双性恋、泛性恋、无性恋、酷儿或有疑问的人）有更高的自杀意念（SI）和企图（SA）的风险。本研究旨在确定SI和SA的患病率及其社会心理风险因素是否随性别认同而变化。方法：青壮年(N = 274；18-29岁)通过网络众包招募。他们完成了评估童年不良经历（ace）、情绪失调、冲动、抑郁症状以及SI和SA的终生史的问卷调查。采用Spearman相关、Kruskal-Wallis h检验和二项logistic回归模型。结果：没有与SI相关的变量。双性恋+个体报告的SA高于异性恋组，尽管统计上与男同性恋/女同性恋组相似。ace也出现了类似的模式。双性恋+组报告的抑郁症状比男同性恋/女同性恋组更严重。冲动和情绪失调并没有因性别而异。控制这些社会心理和社会人口学变量并没有改变结果：双性恋+个体报告SA的可能性几乎是异性恋个体的三倍，OR = 2.93 95% CI [1.16, 7.44]；男女同性恋者和异性恋者报告SA的可能性在统计学上相似，OR = 1.09, 95% CI[0.27, 4.37]。结论：这是第一个在控制了已确立的社会心理相关因素后，确定为双性恋+的年轻人患SA的风险更高的研究；SI不是这样的。需要进一步的工作来确定这种风险的病因。

{"title":"Correlates of suicidal ideation and suicide attempts among bisexual+, gay/lesbian, and heterosexual young adults","authors":"Erik M. Benau, Matthew R. Hanna, Felix Yirdong, Lillian Polanco-Roman","doi":"10.1111/bjc.12525","DOIUrl":"10.1111/bjc.12525","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Compared to their exclusively gay/lesbian or heterosexual identifying peers, young people identifying as bisexual+ (e.g. bisexual, pansexual, asexual, queer or questioning) are at elevated risk for suicidal ideation (SI) and attempts (SA). The present study aimed to establish whether the prevalence of, and psychosocial risk factors for, SI and SA vary as a function of sexual identity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Young adults (<i>N</i> = 274; 18–29 years old) were recruited via online crowdsourcing. They completed questionnaires assessing adverse childhood experiences (ACEs), emotion dysregulation, impulsivity, depression symptoms and lifetime history of SI and SA. Spearman correlations, Kruskal-Wallis <i>H</i>-tests and binomial logistic regression models were used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No variable was associated with SI. Bisexual+ individuals reported greater SA than the heterosexual group, though statistically similar to the gay/lesbian group. A similar pattern emerged for ACEs. The bisexual+ group reported greater depression symptoms than the gay/lesbian group. Impulsivity and emotion dysregulation did not vary by sexual identity. Controlling for these psychosocial and sociodemographic variables did not alter results: bisexual+ individuals were almost three times more likely to report SA than heterosexual individuals, OR = 2.93 95% CI [1.16, 7.44]; gay/lesbian and heterosexual individuals had a statistically similar likelihood of reporting SA, OR = 1.09, 95% CI [0.27, 4.37].</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the first study to establish that young adults identifying as bisexual+ are at greater risk for SA after controlling for well-established psychosocial correlates; this was not the case for SI. Further work is needed to establish the aetiology of this risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"657-676"},"PeriodicalIF":3.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A systematic review of predictors and moderators of treatment response in psychological interventions for persisting forms of depression 对持续性抑郁症心理干预治疗反应的预测因子和调节因子的系统回顾。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-12-31 DOI: 10.1111/bjc.12513

Margaret Lyons, Jaime Delgadillo

Background

Although psychological interventions can be effective for the treatment of major depressive disorder, some patients' symptoms persist or rapidly recur after therapy. This study aimed to synthesize research findings on predictors and moderators of treatment response for persisting forms of depression, such as chronic, recurrent, and treatment-resistant depression.

Methods

A systematic review of studies investigating predictors and moderators of response to outpatient psychological treatment for adults with persisting forms of depression was conducted by searching Web of Science, Scopus, and PsycInfo. A total of 23 eligible studies were included, assessed for risk of bias, and summarized using a narrative synthesis.

Results

Sixty-five predictor and moderator variables were examined across studies, categorized into sociodemographic, clinical, interpersonal/personality, psychological, and treatment variables. Most variables were only examined in single studies, which were rarely adequately powered for predictor and moderator analyses. Among variables studied more frequently (age, gender, baseline depression severity, childhood trauma), only baseline depression severity was found to be a replicated and consistent predictor of poorer treatment response. Risk of bias was low to medium for the majority of studies.

Limitations

Meta-analysis could not be done due to methodological heterogeneity among studies.

Conclusion

Our current understanding of significant predictors and moderators for persisting forms of depression is limited. A high level of baseline severity of depressive symptoms is so far the only variable consistently associated with poorer treatment response in this clinical population.

背景：虽然心理干预对重度抑郁症的治疗是有效的，但一些患者的症状在治疗后持续存在或迅速复发。本研究旨在综合有关慢性、复发性和难治性抑郁症治疗反应的预测因子和调节因子的研究结果。方法：通过检索Web of Science、Scopus和PsycInfo，系统回顾了调查持续形式抑郁症成人门诊心理治疗反应的预测因素和调节因素的研究。共纳入23项符合条件的研究，评估偏倚风险，并采用叙事综合法进行总结。结果：65个预测变量和调节变量在研究中被检查，分类为社会人口学、临床、人际/人格、心理和治疗变量。大多数变量仅在单个研究中进行了检查，很少有足够的预测和调节分析能力。在更频繁研究的变量（年龄、性别、基线抑郁严重程度、童年创伤）中，只有基线抑郁严重程度被发现是较差治疗反应的重复和一致的预测因子。大多数研究的偏倚风险为低至中等。局限性：由于研究方法的异质性，不能进行meta分析。结论：我们目前对持续形式抑郁的重要预测因子和调节因子的理解是有限的。到目前为止，高水平的基线抑郁症状严重程度是与该临床人群较差的治疗反应一致相关的唯一变量。

{"title":"A systematic review of predictors and moderators of treatment response in psychological interventions for persisting forms of depression","authors":"Margaret Lyons, Jaime Delgadillo","doi":"10.1111/bjc.12513","DOIUrl":"10.1111/bjc.12513","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although psychological interventions can be effective for the treatment of major depressive disorder, some patients' symptoms persist or rapidly recur after therapy. This study aimed to synthesize research findings on predictors and moderators of treatment response for persisting forms of depression, such as chronic, recurrent, and treatment-resistant depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review of studies investigating predictors and moderators of response to outpatient psychological treatment for adults with persisting forms of depression was conducted by searching Web of Science, Scopus, and PsycInfo. A total of 23 eligible studies were included, assessed for risk of bias, and summarized using a narrative synthesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-five predictor and moderator variables were examined across studies, categorized into sociodemographic, clinical, interpersonal/personality, psychological, and treatment variables. Most variables were only examined in single studies, which were rarely adequately powered for predictor and moderator analyses. Among variables studied more frequently (age, gender, baseline depression severity, childhood trauma), only baseline depression severity was found to be a replicated and consistent predictor of poorer treatment response. Risk of bias was low to medium for the majority of studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Limitations</h3>\u0000 \u0000 <p>Meta-analysis could not be done due to methodological heterogeneity among studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our current understanding of significant predictors and moderators for persisting forms of depression is limited. A high level of baseline severity of depressive symptoms is so far the only variable consistently associated with poorer treatment response in this clinical population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 3","pages":"623-656"},"PeriodicalIF":3.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0