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

Investigating the dissociative subtype of post-traumatic stress disorder in single- and multi-event trauma-exposed youth: Prevalence, course, prognosis, severity and functional impairment 调查遭受单一和多重事件创伤的青少年创伤后应激障碍的分离亚型：患病率、病程、预后、严重程度和功能障碍。

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-03-15 DOI: 10.1111/bjc.12461

William F. White, Aaron Burgess, Tim Dalgleish, Clare Dixon, Sarah L. Halligan, Rachel M. Hiller, Anna McKinnon, Patrick Smith, Richard Meiser-Stedman

Objectives

This study aimed, following both single- and multi-event trauma, to ascertain prevalence and course of the dissociative subtype of post-traumatic stress disorder (PTSD-DS) in youth; how well early PTSD-DS predicts later PTSD; and whether dissociation accounts for unique variance in post-traumatic stress symptoms (PTSS) and functional impairment over and above the effect of other post-trauma cognitive processing factors and PTSS respectively.

Design and Methods

This study is a secondary analysis of data from the Acute Stress Programme for Children and Teenagers study (n = 234) and the Coping in Care After Trauma study (n = 110) in which children had experienced single- and multi-event trauma respectively.

Results

PTSD-DS diagnosis was common in children with PTSD regardless of trauma experienced (>39.0%). PTSD-DS showed a similar trajectory of natural recovery to PTSD, and it was similarly predictive of later PTSD following single-event trauma. Finally, dissociation was a significant factor in PTSS and functional impairment.

Conclusions

These results should be viewed in the context of several limitations including narrow sample of participants which reduces the generalizability of results, concerns around children's ability to conceptualize challenging concepts such as dissociation and the use of self-report measures to form diagnostic groups. The PTSD-DS diagnosis may offer clinical utility to the extant PTSD diagnosis in children and adolescents, as dissociation has been shown to be a contributory factor in the maintenance of both PTSS and functional impairment. Further research is required to inform further editions of the DSM and other diagnostic systems.

研究目的本研究旨在确定单次和多次创伤后青少年创伤后应激障碍分离亚型（PTSD-DS）的患病率和病程；早期PTSD-DS对日后PTSD的预测能力；以及分离是否分别在其他创伤后认知处理因素和PTSS的影响之外，在创伤后应激症状（PTSS）和功能障碍方面造成独特的差异：本研究是对儿童和青少年急性应激方案研究（n = 234）和创伤后护理应对研究（n = 110）的数据进行的二次分析：结果：无论经历过何种创伤，PTSD-DS 诊断在患有创伤后应激障碍的儿童中都很常见（大于 39.0%）。创伤后应激障碍-DS与创伤后应激障碍的自然恢复轨迹相似，同样可以预测单次事件创伤后的创伤后应激障碍。最后，解离是导致创伤后应激障碍和功能障碍的重要因素：在看待这些结果时，应考虑到一些局限性，包括参与者样本较少，这降低了结果的普遍性；儿童对解离等高难度概念的概念化能力令人担忧；以及使用自我报告测量来形成诊断组别。创伤后应激障碍-DS 诊断可为儿童和青少年的现有创伤后应激障碍诊断提供临床实用性，因为解离已被证明是维持创伤后应激障碍和功能障碍的一个促成因素。还需要进一步的研究，以便为 DSM 和其他诊断系统的进一步版本提供信息。

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引用次数: 0

Acceptability of internet-delivered cognitive behavioural therapy for adults with symptoms of obsessive-compulsive disorder: A meta-analysis 对有强迫症症状的成年人进行网络认知行为疗法的可接受性：荟萃分析

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-03-14 DOI: 10.1111/bjc.12462

Shifra Waks, Karen Moses, Bethany M. Wootton

Objectives

Obsessive-compulsive disorder (OCD) is a chronic mental health disorder. Internet-delivered cognitive behaviour therapy (ICBT) is demonstrated to be effective for OCD; however little is known about the acceptability of the treatment. Therefore the aim of this study was to examine the acceptability of ICBT for adults with OCD symptoms using a meta-analytic approach.

Method

Seventeen studies (N = 1661; M_age range = 28–41 years; 58%–93% female) were included in this analysis.

Results

The random effects pooled estimates indicated that 16.3% (95% CI: 9.8%–25.7%) of participants did not commence the treatment once they were enrolled in the study, 27.6% (95% CI: 19.0%–38.2%) did not complete the treatment, and 27.0% (95% CI: 18.2%–38.0%) did not complete the post-treatment questionnaires of the study. The mean score on the Client Satisfaction Questionnaire ranged from 22.4 to 26.5. Overall, pooled estimates indicated that 81.6% (95% CI: 76.1%–86.0%) of participants were satisfied with the ICBT intervention and 84.7% (95% CI: 72.8%–92.0%) indicated that they would recommend the treatment to a friend. Some of the acceptability moderator analyses indicated that self-guided ICBT interventions had lower levels of acceptability compared with clinician-guided interventions. However, given low power, these results should be considered preliminary.

Conclusions

This study has important implications in the dissemination of ICBT for OCD.

目的：强迫症（OCD）是一种慢性精神疾病。网络认知行为疗法（ICBT）已被证明对强迫症有效，但人们对该疗法的接受程度却知之甚少。因此，本研究的目的是采用元分析方法，考察有强迫症症状的成年人对 ICBT 的接受程度：方法：17 项研究（N = 1661；年龄范围 = 28-41 岁；58%-93% 为女性）被纳入本次分析：随机效应汇总估计结果显示，16.3%（95% CI：9.8%-25.7%）的参与者在加入研究后没有开始治疗，27.6%（95% CI：19.0%-38.2%）的参与者没有完成治疗，27.0%（95% CI：18.2%-38.0%）的参与者没有完成研究的治疗后问卷。客户满意度问卷的平均得分在 22.4 到 26.5 之间。总体而言，汇总估算结果显示，81.6%（95% CI：76.1%-86.0%）的参与者对 ICBT 干预表示满意，84.7%（95% CI：72.8%-92.0%）的参与者表示会向朋友推荐该疗法。一些可接受性调节分析表明，与临床医生指导的干预相比，自我指导的 ICBT 干预的可接受性水平较低。然而，由于研究力量不足，这些结果应被视为初步结果：本研究对传播 ICBT 治疗强迫症具有重要意义。

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引用次数: 0

The influence of attachment style on support and feedback seeking and depression severity among mothers during the COVID-19 pandemic 在 COVID-19 大流行期间，依恋风格对母亲寻求支持和反馈以及抑郁严重程度的影响。

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-02-29 DOI: 10.1111/bjc.12458

Caroline Capute, Leanne Quigley, Jordan Bate

Objectives

The ways that people seek support during times of stress influence their mental health outcomes, including depression. Insecure attachment is a risk factor for depression and may also interfere with adaptive support and feedback-seeking behaviour during stress. The purpose of the present study was to test theorized associations between insecure attachment, support and feedback seeking, and changes in depression symptoms over 1 year, in a sample of mothers of school-age children in the context of stress elicited by the COVID-19 pandemic.

Methods

Participants (N = 70 mothers) completed self-report measures of anxious and avoidant attachment and depression severity at baseline in spring 2020 and then completed measures of past-year engagement in direct and indirect support seeking and excessive reassurance seeking (ERS), preference for negative feedback, and depression severity at a follow-up assessment in summer 2021.

Results

Greater attachment anxiety at baseline predicted more frequent direct support seeking, indirect support seeking, and ERS during the 1-year follow-up period. In turn, greater indirect support seeking predicted greater increases in depression from baseline to follow-up. Greater attachment avoidance at baseline predicted less direct support seeking during the 1-year follow-up period. Greater attachment avoidance at baseline also predicted depression severity at follow-up, particularly among mothers with moderate to high levels of attachment anxiety, although none of the examined support and feedback-seeking behaviours mediated this association.

Conclusions

These results provide support for the role of activated attachment systems in determining support and feedback-seeking behaviour during stress, as well as the role of support and feedback-seeking behaviour in the maintenance and exacerbation of depression.

目标：人们在压力时期寻求支持的方式会影响其心理健康结果，包括抑郁症。不安全依恋是抑郁症的一个风险因素，也可能会干扰压力期间的适应性支持和反馈寻求行为。本研究的目的是以学龄儿童的母亲为样本，在 COVID-19 大流行病引发的压力背景下，检验不安全依恋、支持和反馈寻求与抑郁症状一年内的变化之间的理论关联：参与者（N = 70 位母亲）在 2020 年春季的基线调查中完成了关于焦虑型和回避型依恋以及抑郁严重程度的自我报告测量，然后在 2021 年夏季的后续评估中完成了关于过去一年中直接和间接寻求支持、过度寻求安慰（ERS）、偏好负面反馈以及抑郁严重程度的测量：结果：基线时更大的依恋焦虑预示着在一年的随访期间更频繁地寻求直接支持、间接支持和过度安抚。反过来，更多的间接寻求支持也预示着从基线到随访期间抑郁程度的增加。基线时依恋回避程度越高，预示着在一年随访期间寻求直接支持的次数越少。基线时更大的依恋回避也预示着随访时抑郁的严重程度，尤其是在具有中度到高度依恋焦虑的母亲中，尽管所研究的支持和反馈寻求行为中没有一项能调节这种关联：这些结果支持了激活的依恋系统在压力期间决定支持和寻求反馈行为的作用，以及支持和寻求反馈行为在抑郁症的维持和恶化中的作用。

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引用次数: 0

Personal reformulation during the clinical associate psychologist apprenticeship: Exploratory mixed methods evaluation 临床副心理学家见习期间的个人重塑：探索性混合方法评估。

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-02-23 DOI: 10.1111/bjc.12459

Stephen Kellett, Katie Brown, Sheena K. Au-Yeung, Victoria Tew, Glenys Parry

Objectives

Clinical associate psychologists (CAPs) train under the auspices of the apprenticeship programme and are a new addition to the psychological workforce. This project sought to evaluate whether a “personal reformulation” (PR) was helpful in terms of personal and professional development during the apprenticeship.

Methods

A mixed methods evaluation containing a longitudinal quantitative element and a “Big Q” qualitative element with a single cohort of N = 18 CAPs. A PR consists of a 2-hr one-to-one session and a follow-up session with a cognitive analytic psychotherapist. During a PR, a sequential diagrammatic reformulation is produced to aid recognition and revision of potentially problematic relationship patterns at work. Two outcome measures concerning reflective capacity and professional quality of life were completed at the start of the apprenticeship, pre-PR and at 3-month PR follow-up. The semi-structured interviews (n = 11) conducted at the follow-up were analysed using reflexive thematic analysis.

Results

Quantitative changes were limited to significant increases to general confidence and 8/12 apprentices had a reliable increase in confidence in communication. Qualitatively, five overarching themes were found: (1) gaining insight, (2) wellbeing, (3) nature of the space, (4) being an apprentice, and (5) moving forward.

Conclusions

PRs were generally found to be emotionally challenging, but relatively large amounts of insight are possible from a very brief intervention that can contribute to personal and professional development during clinical training. More controlled research needs to be conducted and wider applications and evaluations of PRs in different professions would be welcome.

目的：临床助理心理学家（CAPs）在学徒计划的支持下接受培训，是心理工作队伍中的新成员。本项目旨在评估 "个人重新规划"（PR）是否有助于学徒期的个人和专业发展：方法：混合方法评估，包括纵向定量评估和 "大 Q "定性评估，评估对象为 N = 18 名 CAPs。PR 包括一次 2 小时的一对一课程和一次认知分析心理治疗师的后续课程。在 "PR "过程中，会产生一个顺序图式重构，以帮助识别和修正工作中可能存在问题的关系模式。在学徒期开始时、PR 前和 3 个月的 PR 跟踪时，完成了有关反思能力和职业生活质量的两项结果测量。采用反思性主题分析法对随访时进行的半结构式访谈（n = 11）进行了分析：结果：数量上的变化仅限于总体信心的显著增强，8/12 的学徒在沟通方面的信心有了可靠的增强。在定性方面，发现了五大主题：(1) 获得洞察力，(2) 幸福感，(3) 空间的性质，(4) 作为学徒，(5) 向前迈进：结论：人们普遍认为公共关系具有情感挑战性，但通过非常简短的干预可以获得相对较多的洞察力，有助于临床培训期间的个人和专业发展。需要进行更多的对照研究，并欢迎在不同专业中更广泛地应用和评估公关。

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引用次数: 0

Urged to feel certain again: The role of emotion-related impulsivity on the relationships between intolerance of uncertainty and OCD symptom severity 再次感到确定：情绪相关冲动对不确定性不容忍与强迫症症状严重程度之间关系的作用。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-02-13 DOI: 10.1111/bjc.12456

Junjia Xu, Manon L. Ironside, Hannah C. Broos, Sheri L. Johnson, Kiara R. Timpano

Objectives

Obsessive–compulsive disorder (OCD) is a debilitating mental disorder characterized by persistent and intrusive thoughts accompanied by repetitive mental or physical acts. While both intolerance of uncertainty and emotion-related impulsivity have been consistently evidenced as cognitive risk factors of OCD, no studies have considered their joint effects. The current study examined the interaction between intolerance of uncertainty and two forms of emotion-related impulsivity—including both a behavioural and cognitive form—in predicting OCD symptoms.

Design

Cross-sectional data were collected online from community-based adult participants.

Methods

Participants (N = 673) completed a battery of self-report measures of OCD symptom severity, intolerance of uncertainty, and emotion-related impulsivity.

Results

The behavioural form of emotion-related impulsivity positively moderated the relationship between intolerance of uncertainty and OCD symptoms. Elevated levels of both factors predicted the most severe symptoms, particularly checking, washing, and obsessing. This interaction effect was not found for the cognitive form of emotion-related impulsivity, which still emerged as a unique predictor of OCD symptom severity, specifically obsessing symptoms.

Conclusions

Current findings furthered the understanding of the link between intolerance of uncertainty and OCD symptoms by highlighting the role of emotion-related impulsivity. When uncertainty triggers distress in individuals with high intolerance of uncertainty, the urge to behaviourally alleviate this distress could promote the use of maladaptive obsessions and compulsions, leading to greater OCD symptoms. Results also indicated the potentially differential effects from the behavioural versus cognitive forms of emotion-related impulsivity on different symptom domains, and the mechanistic link here is worthy of further investigation.

目的：强迫症（OCD）是一种使人衰弱的精神障碍，其特征是持续的、侵入性的想法，并伴有重复的心理或身体行为。虽然不确定性不容忍和情绪相关冲动一直被证明是强迫症的认知风险因素，但还没有研究考虑过它们的共同影响。本研究探讨了不确定性不容忍与两种形式的情绪相关冲动（包括行为和认知形式）在预测强迫症症状方面的相互作用：设计：从社区成年参与者处在线收集横截面数据：参与者（N = 673）完成了一系列自我报告强迫症症状严重程度、不确定性不容忍度和情绪相关冲动性的测量：结果：情绪相关冲动的行为形式正向调节了不确定性不容忍度与强迫症症状之间的关系。这两个因素水平的升高预示着最严重的症状，尤其是检查、清洗和强迫。情绪相关冲动的认知形式没有发现这种交互作用，但它仍然是强迫症症状严重程度的独特预测因素，尤其是强迫症状：目前的研究结果通过强调情绪相关冲动的作用，进一步加深了对不确定性不容忍与强迫症症状之间联系的理解。当不确定性引发具有高度不确定性不耐受性的个体的痛苦时，通过行为缓解这种痛苦的冲动可能会促进使用适应不良的强迫症和强迫症，从而导致强迫症症状加重。研究结果还表明，情绪相关冲动的行为和认知形式对不同症状领域可能产生不同的影响，其中的机制联系值得进一步研究。

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引用次数: 0

Identifying predictors of a favourable outcome for outpatients with a persistent depressive disorder treated with Cognitive Behavioural Analysis System of Psychotherapy: A prospective cohort study 识别采用认知行为分析系统心理疗法治疗的持续性抑郁障碍门诊患者获得良好疗效的预测因素：前瞻性队列研究。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-02-05 DOI: 10.1111/bjc.12454

Juliana A. Dean, Marieke J. Eldering, Robert A. Schoevers, Catheleine M. G. van Driel

Objectives

Cognitive Behavioural Analysis System of Psychotherapy (CBASP) is the first therapy specifically developed for persistent depressive disorder (PDD). This study aimed to identify predictors of favourable treatment outcome after group CBASP and assess change in depression severity over 24 weeks.

Design

A prospective cohort study was conducted in patients with PDD treated with group-CBASP.

Methods

Outcomes were depression severity measured by the Inventory of Depression Severity—self-report (IDS-SR) after 6 and 12 months. Potential predictors investigated were baseline depression severity, prior antidepressant use, age, family status, income source, age of onset and childhood trauma. Multivariate logistic regression was performed to assess their effects with a ≥25% IDS-SR score decrease as the dependent variable.

Results

The IDS-SR score (range 0–84) significantly decreased from 37.78 at start to 33.45 at 6 months, an improvement which was maintained at 12 months. Having paid work and no axis I comorbidity significantly predicted favourable response. In the groups without a favourable outcome predictor a substantial percentage still showed at least partial response (16.7% and 19.2%).

Conclusions

Source of income and axis I comorbidity were predictors of response to group-CBASP. Within the group without favourable outcome predictors, a subgroup showed at least partial response. These results suggest that group-CBASP has promise for patients who do not respond to standard treatments. Future studies should include outcome measures that take into account comorbidity and other clinically relevant changes, such as social functioning.

目标认知行为分析心理治疗系统（CBASP）是首个专门针对持续性抑郁障碍（PDD）开发的疗法。本研究旨在确定CBASP小组治疗后取得良好疗效的预测因素，并评估24周内抑郁严重程度的变化：设计：对接受CBASP团体治疗的PDD患者进行前瞻性队列研究：研究结果为6个月和12个月后通过抑郁严重程度自我报告量表（IDS-SR）测量的抑郁严重程度。调查的潜在预测因素包括基线抑郁严重程度、之前使用抗抑郁药的情况、年龄、家庭状况、收入来源、发病年龄和童年创伤。以 IDS-SR 评分下降≥25%为因变量，进行多变量逻辑回归以评估其影响：IDS-SR评分（范围0-84）从开始时的37.78分大幅下降到6个月时的33.45分，这一改善在12个月时仍保持不变。有偿工作和无 I 轴合并症可明显预示良好反应。在没有有利结果预测指标的组别中，仍有相当比例的患者至少出现了部分反应（16.7% 和 19.2%）：结论：收入来源和 I 轴合并症是预测对分组-CBASP 反应的因素。结论：收入来源和 I 轴并发症是预测团体-CBASP 反应的因素，在没有有利结果预测因素的群体中，有一个亚群至少出现了部分反应。这些结果表明，对标准治疗无效的患者来说，团体-CBASP 是有希望的。未来的研究应包括考虑合并症和其他临床相关变化（如社会功能）的结果测量。

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引用次数: 0

Experiences of a communication-skills course for care partners of people living with dementia, empowered conversations: A qualitative framework analysis 为痴呆症患者的护理伙伴开设的沟通技能课程的经验，增强对话能力：定性框架分析。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-01-30 DOI: 10.1111/bjc.12447

Lydia Morris, Anthea Innes, Tracey Williamson, Megan Wyatt, Emma Smith, Phil McEvoy

Objectives

Our aims were to examine whether an experiential course for care partners of people living with dementia, Empowered Conversations (EC), was acceptable to participants and to explore participants' perceptions of the impact of the course upon their communicative interactions. EC is based on an integrative model derived from psychological and linguistic theory and empirical evidence. EC is based on mentalisation theory, perceptual control theory and linguistic theory (The Communicative Impact Model).

Methods

Qualitative data were collected via 28 semistructured interviews. Framework analysis was used to analyse data.

Results

Three superordinate themes, ‘improved communication’, ‘improved well-being’ and ‘support through others’ were identified. Twenty-seven out of the 28 participants described feeling that they were able to better connect with the person living with dementia that they were supporting through attending EC.

Conclusions

The findings indicated that EC was acceptable and beneficial to care partners. Care partners developed a range of strategies and understandings that enabled them to communicate better with the person they were supporting, enhanced well-being and relationships, as well as developing social networks. This is the first qualitative study to examine a psychosocial intervention for care partners of people living with dementia using a non-CBT framework and indicates that perceived control could influence how care partners respond to stress and difficulties.

目的：我们的目的是研究痴呆症患者护理伙伴的体验课程 "增强对话能力（EC）"是否为参与者所接受，并探讨参与者对该课程对其交流互动的影响的看法。EC是基于心理学和语言学理论以及经验证据的综合模型。EC以心智化理论、知觉控制理论和语言理论（交际影响模型）为基础：方法：通过 28 个半结构式访谈收集定性数据。采用框架分析法对数据进行分析：结果：确定了 "改善交流"、"改善福祉 "和 "通过他人提供支持 "这三个首要主题。28 名参与者中有 27 人表示，他们感觉通过参加老年教育活动，能够更好地与他们所支持的痴呆症患者建立联系：研究结果表明，EC 是可以接受的，并且对护理伙伴有益。护理伙伴发展了一系列策略和理解，使他们能够与所支持的患者更好地沟通，增进了福祉和人际关系，并发展了社交网络。这是第一项采用非 CBT 框架对痴呆症患者的护理伙伴进行心理干预的定性研究，研究结果表明，感知控制会影响护理伙伴如何应对压力和困难。

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引用次数: 0

The key components of a clinical psychology formulation: A consensus study 临床心理学配方的关键组成部分：共识研究。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-01-18 DOI: 10.1111/bjc.12455

Naomi E. Thrower, Sandra Bucci, Lydia Morris, Katherine Berry

Objective

Psychological formulation is a key competency for clinical psychologists. However, there is a lack of consensus regarding the key components and processes of formulation that are hypothesized to contribute to poor reliability of formulations. The aim of this study was to develop consensus on the essential components of a formulation to inform training for clinical psychologists and best practice guidelines.

Methods

A Delphi methodology was used. Items were generated from the literature and discussed and refined with a panel of experts (n = 10). In round one, 110 clinical psychologists in the United Kingdom rated the importance of components of formulation via an online questionnaire. Criteria for consensus were applied and statements were rerated in round two if consensus was not achieved.

Results

Consensus was achieved on 30 items, with 18 statements regarding components of a formulation and 12 statements regarding formulation process. Items that clinicians agreed upon emphasized the importance of integrating sociocultural, biological, strengths and personal meaning alongside well-established theoretical frameworks. Consensus was not reached on 20 items, including whether a formulation should be parsimonious or adhere to a model.

Conclusion

Our findings provide mixed evidence regarding consensus on the key components of formulation. There was an agreement that formulation should be client-led and incorporate strengths and sociocultural factors. Further research should explore client perspectives on the key components of formulation and how these compare to the clinicians' perspectives.

目的：心理配方是临床心理学家的一项关键能力。然而，对于心理治疗方案的关键组成部分和过程却缺乏共识，而据推测，这正是导致心理治疗方案可靠性较差的原因。本研究旨在就心理治疗方案的基本要素达成共识，为临床心理学家的培训和最佳实践指南提供参考：方法：采用德尔菲法。研究项目来自文献，并由专家小组（n = 10）讨论和完善。在第一轮中，英国的 110 名临床心理学家通过在线问卷对配方的各个组成部分的重要性进行了评分。如果未能达成共识，则在第二轮中对陈述进行评分：结果：在 30 个项目上达成了共识，其中 18 个陈述涉及配方的组成部分，12 个陈述涉及配方过程。临床医生达成共识的项目强调了将社会文化、生物、优势和个人意义与成熟的理论框架相结合的重要性。有 20 个项目未达成共识，其中包括治疗方案是否应具有可比性或遵循某种模式：我们的研究结果提供了有关配方关键要素共识的不同证据。大家一致认为，配制应由服务对象主导，并结合服务对象的优势和社会文化因素。进一步的研究应探讨客户对配方关键要素的看法，以及这些看法与临床医生看法的比较。

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引用次数: 0

Home-based video assessment of children's autism-related behaviours: Psychometric analysis and linkages with parental responsiveness and context 对儿童自闭症相关行为的家庭视频评估：心理计量分析以及与父母反应能力和环境的联系。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-01-12 DOI: 10.1111/bjc.12449

Jeffrey J. Wood, John Danial, Samara Wolpe

Objectives

Assessment of autism-related behaviours (ARBs) in children has generally been limited to direct observations in clinical settings or informant-based reports. The widespread availability of video-streaming devices has made home observations of children's ARBs feasible. This approach could enable assessment of the generalization and durability of interventions and may be able to overcome methodological limitations of predominant current assessment approaches (response biases, limited sensitivity to treatment).

Design and Methods

Forty-four autistic children and their families participated in a repeated-measures study with a correlational design. Approximately 10 hr of unprompted behaviour at home were videorecorded over the course of a week (2 hr per day) for each participant. Gold standard measures of ARBs were also administered (ADOS-2 and ADI-R). Two home-based observational measures of ARBs utilizing streaming video were developed and evaluated: the ARCHER and the CHEERS. Trained independent evaluators made ratings on the ARCHER, CHEERS and an observational measure of parental responsiveness.

Results

Correlations with the ADOS-2 and ADI-R were .47 and .34 for ARCHER scores and .51 and .48 for CHEERS scores, respectively. In linear mixed models, more responsive parenting was associated with fewer ARBs on a daily basis. Children spent their afternoons engaged in many typical activities including electronics, homework and games with family members, and ARBs were more prominent in some of these contexts (e.g., electronics) than others (e.g., family games).

Conclusions

Home-based observational assessment of ARBs may be useful for clinical and descriptive research.

目的：对儿童自闭症相关行为（ARB）的评估通常仅限于在临床环境中进行直接观察或根据线人报告。随着视频流设备的普及，在家中观察儿童的自闭症相关行为已变得可行。这种方法可以评估干预措施的普遍性和持久性，并能克服目前主要评估方法在方法学上的局限性（反应偏差、对治疗的敏感性有限）：44 名自闭症儿童及其家庭参加了一项相关设计的重复测量研究。在一周的时间内（每天 2 小时），对每位参与者在家中约 10 小时的无提示行为进行了录像。同时还进行了 ARB 金标准测量（ADOS-2 和 ADI-R）。利用流媒体视频开发并评估了两种基于家庭的 ARBs 观察测量方法：ARCHER 和 CHEERS。训练有素的独立评估员对 ARCHER、CHEERS 和父母反应能力的观察指标进行评分：结果：ARCHER 分数与 ADOS-2 和 ADI-R 的相关性分别为 0.47 和 0.34，CHEERS 分数与 ADOS-2 和 ADI-R 的相关性分别为 0.51 和 0.48。在线性混合模型中，父母对孩子的回应越多，孩子每天的 ARB 就越少。孩子们在下午进行了许多典型的活动，包括电子产品、家庭作业和与家庭成员的游戏，而在其中一些活动（如电子产品）中，ARB 比在其他活动（如家庭游戏）中更为突出：结论：对 ARB 的家庭观察评估可能有助于临床和描述性研究。

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引用次数: 0

The ‘revolving door’ of mental illness: A meta-analysis and systematic review of current versus lifetime rates of psychological disorders 精神病的 "旋转门"：对当前与终生心理失调率的荟萃分析和系统回顾。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-01-10 DOI: 10.1111/bjc.12453

Rachel E. Menzies, Bethany Richmond, Louise Sharpe, Amira Skeggs, Janessa Liu, Daelin Coutts-Bain

Objectives

Therapists have long observed a phenomenon referred to as the ‘revolving door’ of mental health services, in which individuals often develop, seek treatment for, and recover from multiple mental illnesses across their life. However, this has not been systematically examined. If this phenomenon is widespread, one would expect that the number of lifetime disorders would exceed that of current disorders. The aim of this meta-analysis was to test this hypothesis.

Methods

A search was conducted of the following databases: MEDLINE, PsycINFO and Web of Science. In total, 38 studies were included in the current review; 27 of these contained sufficient quantitative data to be included in the meta-analysis, addressing the primary research aim. The remaining 11 studies were included in the systematic review only.

Results

Meta-analyses of the 27 studies indicated that the average number of lifetime disorders was 1.84 times that of current disorders. Previous treatment significantly moderated this relationship, while the clinical nature of the sample did not. Examination of the remaining studies revealed common temporal sequences, indicating disorders which typically develop first or consequently to other disorders.

Conclusions

These findings provide support for the revolving door of mental illness, suggesting a need for transdiagnostic treatments and broader conceptualisation of relapse prevention.

目的：长期以来，治疗师们一直在观察一种被称为心理健康服务 "旋转门 "的现象，即一个人在一生中往往会患上、寻求治疗并从多种精神疾病中康复。然而，这种现象并没有得到系统的研究。如果这种现象普遍存在，人们就会认为终生患有精神疾病的人数会超过目前患有精神疾病的人数。本荟萃分析旨在验证这一假设：方法：对以下数据库进行了检索：方法：对以下数据库进行了检索：MEDLINE、PsycINFO 和 Web of Science。共有 38 项研究被纳入本次综述；其中 27 项研究包含足够的定量数据，可纳入荟萃分析，以实现主要研究目标。其余 11 项研究仅纳入系统综述：对 27 项研究进行的元分析表明，终生失调的平均次数是当前失调的 1.84 倍。曾经接受过的治疗在很大程度上调节了这种关系，而样本的临床性质则没有调节作用。对其余研究的审查显示了共同的时间顺序，表明失调症通常先出现或随后出现其他失调症：这些研究结果为精神疾病的 "旋转门 "提供了支持，表明需要跨诊断治疗和更广泛的预防复发概念。

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引用次数: 0