British Journal of Clinical Psychology最新文献_第8页

Working alliance in treating staff and patients with Schizophrenia Spectrum Disorder living in Residential Facilities 与居住在寄宿设施中的精神分裂症谱系障碍员工和患者结成工作联盟。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2023-12-19 DOI: 10.1111/bjc.12450

Laura Fusar-Poli, Fabio Panariello, Katherine Berry, Matteo Rocchetti, Letizia Casiraghi, Matteo Malvezzi, Fabrizio Starace, Manuel Zamparini, Cristina Zarbo, Giovanni de Girolamo, DiAPAson Consortium

Objectives

Working Alliance (WA) is important in the care of patients with Schizophrenia Spectrum Disorders (SSD). This study aims to determine which sociodemographic and clinical factors are associated with WA, as assessed by patients and staff members in Residential Facilities (RFs), and may predict WA dyads' discrepancies.

Methods

Three hundred and three SSD patients and 165 healthcare workers were recruited from 98 RFs and characterized for sociodemographic features. WA was rated by the Working Alliance Inventory (WAI) for patients (WAI-P) and staff members (WAI-T). SSD patients were assessed for the severity of psychopathology and psychosocial functioning.

Results

Pearson's correlation revealed a positive correlation (ρ = .314; p < .001) between WAI-P and WAI-T ratings. Linear regression showed that patients with higher education reported lower WAI-P ratings (β = −.50, p = .044), while not being engaged in work or study was associated with lower WAI-T scores (β = −4.17, p = .015). A shorter lifetime hospitalization was associated with higher WAI-P ratings (β = 5.90, p = .008), while higher psychopathology severity negatively predicted WAI-T (β = −.10, p = .002) and WAI-P ratings (β = −.19, p < .001). Better functioning level positively foresaw WAI-T (β = .14, p < .001) and WAI-P ratings (β = .12, p < .001). Regarding discrepancies, staff members' age was associated with higher dyads discrepancy in Total scale and Agreement subscale scores, which were also associated with more severe negative symptoms, while patients' age was negatively correlated to Relationship subscale discrepancy.

Conclusions

This study provides insight into the factors that influence WA in SSD patients and health workers in RFs. The findings address interventions to improve WA and ultimately patient outcomes.

目标：工作联盟（WA）对于精神分裂症谱系障碍（SSD）患者的护理非常重要。本研究旨在根据患者和住宿设施（RFs）工作人员的评估，确定哪些社会人口学和临床因素与工作联盟相关，并预测工作联盟二人组的差异：方法：我们从 98 个住宿设施中招募了 33 名 SSD 患者和 165 名医护人员，并对他们的社会人口学特征进行了分析。对患者（WAI-P）和医护人员（WAI-T）的工作联盟量表（WAI）进行WA评分。对 SSD 患者的精神病理学严重程度和社会心理功能进行了评估：结果：皮尔逊相关性显示出正相关性（ρ = .314；p 结论：该研究深入分析了影响 SSD 患者心理病理学和心理社会功能的因素：本研究深入探讨了影响地区医院 SSD 患者和医务工作者 WA 的因素。研究结果有助于采取干预措施，以改善 WA 并最终改善患者的治疗效果。

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引用次数: 0

Predicting treatment response using machine learning: A registered report 利用机器学习预测治疗反应：注册报告

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2023-12-18 DOI: 10.1111/bjc.12452

Kristin Jankowsky, Lina Krakau, Ulrich Schroeders, Rüdiger Zwerenz, Manfred E. Beutel

Objective

Previous research on psychotherapy treatment response has mainly focused on outpatients or clinical trial data which may have low ecological validity regarding naturalistic inpatient samples. To reduce treatment failures by proactively screening for patients at risk of low treatment response, gain more knowledge about risk factors and to evaluate treatments, accurate insights about predictors of treatment response in naturalistic inpatient samples are needed.

Methods

We compared the performance of different machine learning algorithms in predicting treatment response, operationalized as a substantial reduction in symptom severity as expressed in the Patient Health Questionnaire Anxiety and Depression Scale. To achieve this goal, we used different sets of variables—(a) demographics, (b) physical indicators, (c) psychological indicators and (d) treatment-related variables—in a naturalistic inpatient sample (N = 723) to specify their joint and unique contribution to treatment success.

Results

There was a strong link between symptom severity at baseline and post-treatment (R² = .32). When using all available variables, both machine learning algorithms outperformed the linear regressions and led to an increment in predictive performance of R² = .12. Treatment-related variables were the most predictive, followed psychological indicators. Physical indicators and demographics were negligible.

Conclusions

Treatment response in naturalistic inpatient settings can be predicted to a considerable degree by using baseline indicators. Regularization via machine learning algorithms leads to higher predictive performances as opposed to including nonlinear and interaction effects. Heterogenous aspects of mental health have incremental predictive value and should be considered as prognostic markers when modelling treatment processes.

以往有关心理疗法治疗反应的研究主要集中在门诊病人或临床试验数据上，而这些数据对自然住院病人样本的生态效度可能较低。为了通过主动筛查治疗反应低的高风险患者来减少治疗失败，获得更多关于风险因素的知识，并对治疗进行评估，我们需要对自然住院病人样本中的治疗反应预测因素有准确的了解。

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引用次数: 0

Predicting treatment response using machine learning: A registered report. 利用机器学习预测治疗反应：注册报告。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2023-12-18 DOI: 10.1111/bjc.12452

Kristin Jankowsky, Lina Krakau, Ulrich Schroeders, Rüdiger Zwerenz, Manfred E Beutel

Objective: Previous research on psychotherapy treatment response has mainly focused on outpatients or clinical trial data which may have low ecological validity regarding naturalistic inpatient samples. To reduce treatment failures by proactively screening for patients at risk of low treatment response, gain more knowledge about risk factors and to evaluate treatments, accurate insights about predictors of treatment response in naturalistic inpatient samples are needed.

Methods: We compared the performance of different machine learning algorithms in predicting treatment response, operationalized as a substantial reduction in symptom severity as expressed in the Patient Health Questionnaire Anxiety and Depression Scale. To achieve this goal, we used different sets of variables-(a) demographics, (b) physical indicators, (c) psychological indicators and (d) treatment-related variables-in a naturalistic inpatient sample (N = 723) to specify their joint and unique contribution to treatment success.

Results: There was a strong link between symptom severity at baseline and post-treatment (R² = .32). When using all available variables, both machine learning algorithms outperformed the linear regressions and led to an increment in predictive performance of R² = .12. Treatment-related variables were the most predictive, followed psychological indicators. Physical indicators and demographics were negligible.

Conclusions: Treatment response in naturalistic inpatient settings can be predicted to a considerable degree by using baseline indicators. Regularization via machine learning algorithms leads to higher predictive performances as opposed to including nonlinear and interaction effects. Heterogenous aspects of mental health have incremental predictive value and should be considered as prognostic markers when modelling treatment processes.

研究目的以往有关心理疗法治疗反应的研究主要集中在门诊病人或临床试验数据上，而这些数据对自然住院病人样本的生态效度可能较低。为了通过主动筛查有低治疗反应风险的患者来减少治疗失败，获得更多关于风险因素的知识并评估治疗方法，我们需要对自然住院病人样本中的治疗反应预测因素有准确的了解：我们比较了不同机器学习算法在预测治疗反应方面的性能，治疗反应是指患者健康问卷焦虑和抑郁量表中显示的症状严重程度大幅减轻。为实现这一目标，我们在自然住院病人样本（N = 723）中使用了不同的变量集--（a）人口统计学变量、（b）生理指标变量、（c）心理指标变量和（d）治疗相关变量变量，以明确它们对治疗成功的共同和独特贡献：结果：基线症状严重程度与治疗后症状严重程度之间存在密切联系（R2 = .32）。当使用所有可用变量时，两种机器学习算法的表现均优于线性回归，预测性能提高了 R2 = .12。与治疗相关的变量最具预测性，其次是心理指标。结论：在自然住院患者中，治疗反应是最重要的：结论：利用基线指标可以在很大程度上预测自然住院环境中的治疗反应。与包含非线性效应和交互效应相比，通过机器学习算法进行正则化可获得更高的预测性能。心理健康的异质性方面具有增量预测价值，在对治疗过程建模时应将其视为预后标记。

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引用次数: 0

A new network analysis model in anorexia nervosa patients based on self-reported eating disorder symptoms, psychological distress, and cognitive flexibility 基于自述饮食失调症状、心理困扰和认知灵活性的神经性厌食症患者新网络分析模型

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2023-12-10 DOI: 10.1111/bjc.12451

Sarah Giles, Elizabeth K. Hughes, David Castle, Zoe Jenkins, Andrea Phillipou, Susan Rossell, Gemma Urbini, Matthew Fuller-Tyszkiewicz, Isabel Krug

Objectives

Cognitive flexibility and psychological distress, such as depression and anxiety, have been implicated in the aetiology of Anorexia Nervosa (AN). Despite the known associations between eating disorder (ED) symptoms, depression, anxiety, and cognitive flexibility, the specific pathways that connect these constructs are unclear. We therefore used network analysis to examine the relationship between these symptoms in an AN sample.

Methods

One hundred and ninety-three treatment-seeking individuals diagnosed with AN (95.6% female, M = 26.89 [SD = 9.45] years old) completed self-report measures assessing depression, anxiety, cognitive flexibility, and ED symptoms. To determine each symptom's influence in the network, we calculated the expected influence.

Results

The two relationships with the greatest edges were those between (1) weight/shape concerns and eating/dietary restraint and (2) weight/shape concerns and psychological distress (a measure that combined depression and anxiety). Cognitive flexibility was not connected to weight/shape concerns but had negative partial associations with eating concerns/dietary restraint and psychological distress. There was also a slight, non-zero connection between eating concerns/dietary restraint and psychological distress.

Conclusions

The findings underscore the importance of weight/shape, eating/dietary concerns, and psychological distress in the AN network and suggest that addressing cognitive flexibility may be a useful target for eating concerns/dietary restraint and psychological distress. Future studies assessing the longitudinal course of psychopathology within the AN network structure may help in identifying whether specific symptoms function as risk factors or maintaining factors for this co-occurrence.

认知灵活性和心理困扰（如抑郁和焦虑）与厌食症（AN）的病因有关。尽管饮食失调（ED）症状、抑郁、焦虑和认知灵活性之间存在已知的关联，但连接这些结构的具体途径尚不清楚。因此，我们使用网络分析来研究厌食症样本中这些症状之间的关系。

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引用次数: 0

Editorial acknowledgement 编辑致谢

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2023-12-08 DOI: 10.1111/bjc.12448

引用次数: 0

Do you feel up when you go up? A pilot study of a virtual reality manic-like mood induction paradigm 你上去的时候感觉起来了吗?虚拟现实躁狂样情绪诱导范式的初步研究。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2023-11-17 DOI: 10.1111/bjc.12445

Roanne V. F. J. Glas, Roy E. de Kleijn, Eline J. Regeer, Ralph W. Kupka, Manja A. Koenders

Objectives

In order to understand the working mechanisms of mania, it is necessary to perform studies during the onset of manic (-like) mood states. However, clinical mania is difficult to examine experimentally. A viable method to study manic mood like states is mood induction, but mood induction tasks thus far show variable effectiveness.

Methods

In this pilot study, a new paradigm to induce mood through virtual reality (VR) is examined. Both state characteristics, namely changes in emotion, and trait characteristics, such as high and low scores on the hypomanic personality scale (HPS), were measured in 65 students. These students participated in either a neutral VR mood induction or an activating VR mood induction in which excitement, goal directedness, and tension (being aspects of mania) were induced. All participants performed a risk-taking behavioural task, Balloon Analogue Risk Task (BART).

Results

The experimental VR task induced excitement and tension. In participants with higher sensitivity to hypomanic personality (HPS), irritation increased in response to activation whereas it decreased in the low HPS group, and excitement increased more steeply in the low HPS group. There were no effects on the behavioural task.

Conclusions

The VR task is effective in inducing relevant state aspects of hypomania and is suitable as a paradigm for future experimental studies. Activation of dual affective states (excitement and tension) is an essential aspect in manic-like mood induction paradigms.

目的:为了了解躁狂的工作机制，有必要在躁狂(样)情绪状态发作时进行研究。然而，临床躁狂症很难通过实验来检验。一种可行的方法来研究躁狂情绪状态是情绪诱导，但情绪诱导任务到目前为止显示出不同的有效性。方法:在本初步研究中，研究了一种通过虚拟现实(VR)诱导情绪的新范式。对65名学生进行了状态特征(即情绪变化)和特质特征(如轻躁狂人格量表(HPS)的高分和低分)的测量。这些学生参加了中性VR情绪诱导或激活VR情绪诱导，其中兴奋，目标导向和紧张(躁狂的方面)被诱导。所有参与者都执行了一个冒险行为任务，气球模拟风险任务(BART)。结果:实验虚拟现实任务引起兴奋和紧张。在对轻躁狂人格(HPS)敏感程度较高的被试中，刺激在激活反应中增加，而低HPS组的刺激在激活反应中减少，兴奋在低HPS组中增加得更快。对行为任务没有影响。结论:虚拟现实任务在诱导轻躁狂相关状态方面是有效的，适合作为未来实验研究的范式。双情感状态(兴奋和紧张)的激活是躁狂样情绪诱导范式的一个重要方面。

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引用次数: 0

COVID-19 and mental health in the UK: Depression, anxiety and insomnia and their associations with persistent physical symptoms and risk and vulnerability factors 新冠肺炎与英国心理健康：抑郁、焦虑和失眠及其与持续身体症状、风险和脆弱因素的关系。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2023-11-06 DOI: 10.1111/bjc.12446

Lin Yu, Lance M. McCracken

Objectives

Mental health problems and persistent COVID-19 symptoms were prevalent in the context of COVID-19. However, despite the long-observed association between physical symptoms and mental health problems, such association has not been adequately examined in the context of COVID-19. Our understanding of wider patterns of risk and vulnerability factors for mental health also remains limited. This study investigated the associations between general mental health, and persistent physical symptoms, and additional risk and vulnerability factors in the context of COVID-19.

Methods

Two hundred fourteen adults, living in the UK, recruited via social media, completed the online survey and were included in the analyses. Correlation and regression analyses were conducted to examine the associations of persistent physical symptoms and risk and vulnerability factors with measures of general mental health including depressive symptoms, anxiety and insomnia.

Results

78.5% of the participants reported between 1 and 26 persistent symptoms, and about 28%–92% of them associated these symptoms with COVID-19 infection. Persistent physical symptoms were uniquely associated with all measures of mental health, β = .19–.32. Mental health history and worries were the most prominent risk factors, |β| = .12–.43.

Conclusions

People who experience more persistent physical symptoms post-COVID-19 have poorer mental health. It may be important to consider and discuss the recovery from COVID-19 beyond a negative COVID-19 test. Multidisciplinary interventions that address the complex impact of COVID-19 for people with long COVID are needed.

目的：心理健康问题和持续的新冠肺炎症状在新冠肺炎背景下普遍存在。然而，尽管长期观察到身体症状和心理健康问题之间的关联，但尚未在新冠肺炎的背景下充分研究这种关联。我们对心理健康风险和脆弱性因素的更广泛模式的理解仍然有限。这项研究调查了COVID-19背景下一般心理健康、持续身体症状以及其他风险和脆弱性因素之间的关联。方法：214名居住在英国的成年人通过社交媒体招募完成了在线调查并纳入分析。进行了相关和回归分析，以检验持续的身体症状、风险和脆弱性因素与一般心理健康指标（包括抑郁症状、焦虑和失眠）的相关性。结果：78.5%的参与者报告了1至26种持续症状，其中约28%-92%的参与者将这些症状与新冠肺炎感染联系起来。持续的身体症状与所有心理健康指标都有独特的相关性，β = .19-.32.心理健康史和担忧是最突出的危险因素，|β| = .12-.43结论：COVID-19后出现更持久身体症状的人心理健康状况较差。在新冠肺炎检测呈阴性后，考虑和讨论新冠肺炎的康复可能很重要。需要采取多学科干预措施，解决新冠肺炎对长期新冠肺炎患者的复杂影响。

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引用次数: 0

A randomized clinical trial of a gamified app for the treatment of perfectionism 一项游戏化应用程序治疗完美主义的随机临床试验。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2023-10-21 DOI: 10.1111/bjc.12444

Amitai Abramovitch, Akuekegbe Uwadiale, Anthony Robinson

Objectives

Perfectionism is a common transdiagnostic problem that may lead to substantial distress and functional impairments. Cognitive behavioural therapy (CBT) is an effective treatment for perfectionism. However, the existing significant barriers to access and utilization of mental health services, including among college students, demand the development of low-intensity accessible interventions. The aim of the present study was to evaluate the effectiveness of a low-intensity CBT-based self-help gamified app developed specifically for perfectionism in a sample of college students.

Methods

Participants completed assessments of perfectionism, related symptoms, emotional burden and functional impairments at pretreatment, posttreatment and at one-month follow-up.

Results

Compared with the waitlist condition (n = 35), the app condition (n = 35) demonstrated a significant and greater reduction in perfectionism, obsessive-compulsive symptoms, functional impairments and subjective ratings of emotional burden.

Conclusions

Results suggest that a brief, daily app-based game-like intervention targeting maladaptive perfectionistic beliefs may be a viable, low-cost alternative to traditional CBT treatments for vulnerable populations on college campuses.

目的：完美主义是一种常见的跨诊断问题，可能导致严重的痛苦和功能损伤。认知行为疗法（CBT）是治疗完美主义的有效方法。然而，在获得和利用心理健康服务方面，包括在大学生中，存在着重大障碍，需要制定低强度的可获得干预措施。本研究的目的是在大学生样本中评估专门为完美主义开发的基于低强度CBT的自助游戏化应用程序的有效性。方法：参与者在治疗前、治疗后和一个月的随访中完成了完美主义、相关症状、情绪负担和功能损伤的评估 = 35），应用程序条件（n = 35）表现出完美主义、强迫症症状、功能障碍和主观情绪负担评分的显著且更大程度的降低。结论：研究结果表明，针对适应不良的完美主义信念，针对大学校园中的弱势群体，一种简短的、基于每日应用程序的游戏式干预可能是一种可行的、低成本的传统CBT治疗方法。

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引用次数: 0

Emotion regulation flexibility and psychosis: A longitudinal study disentangling components of flexibility in psychosis-proneness 情绪调节灵活性与精神病：一项纵向研究，解开精神病倾向中灵活性的组成部分。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2023-10-17 DOI: 10.1111/bjc.12443

Carla Nardelli, George A. Bonanno, Shuquan Chen, Catherine Bortolon

Objectives

Flexibility in self-regulation has emerged as an important component of mental health. Previous findings found that deficits in two components of regulatory flexibility were linked cross-sectionally to psychosis-proneness. We aimed to replicate and extend these findings longitudinally.

Methods

We measured psychosis-proneness and components of emotion regulation flexibility (i.e. context sensitivity, repertoire and feedback) at two time points with three months in between.

Results

Two flexibility components predicted psychotic-like experiences. The ability to detect the absence of contextual cues was implicated in both positive and negative dimensions but through opposite pathways. Expressive suppression ability—a subcomponent of repertoire-predicted positive symptoms. None of the flexibility components predicted distress related to the symptoms.

Conclusions

The current study provides further evidence on the implication of emotion regulation flexibility in the longer-term maintenance of psychotic-like experiences. Future studies can advance this work further by evaluating possible bidirectional relationships between psychotic-like experiences and deficits in emotion regulation flexibility.

目标：自我调节的灵活性已成为心理健康的重要组成部分。先前的研究发现，调节灵活性的两个组成部分的缺陷在横断面上与精神病倾向性有关。我们旨在纵向复制和扩展这些发现。方法：我们在两个时间点测量了精神病倾向性和情绪调节灵活性的组成部分（即上下文敏感性、曲目和反馈），时间间隔为三个月。结果：两个灵活性成分预测了类似精神病的经历。检测上下文线索缺失的能力涉及积极和消极两个维度，但通过相反的途径。表达抑制能力——预测阳性症状的一个子组成部分。没有一个灵活性成分可以预测与症状相关的痛苦。结论：目前的研究为情绪调节灵活性在长期维持精神病样体验中的作用提供了进一步的证据。未来的研究可以通过评估精神病样经历和情绪调节灵活性缺陷之间可能的双向关系来进一步推进这项工作。

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引用次数: 0

Are dysfunctional attitudes elevated and linked to mood in bipolar disorder? A systematic review and meta-analysis 在双相情感障碍中，功能失调的态度是否被提升并与情绪有关？系统综述和荟萃分析。

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2023-10-08 DOI: 10.1111/bjc.12442

Chloe Woods, Thomas Richardson, Emma Palmer-Cooper

Objectives

Dysfunctional attitudes (DA) are higher in depression; however, less is understood about their role in bipolar disorder (BD). This paper aimed to explore the presence of DA in BD in comparison to clinical and non-clinical groups. Also explored were the associations between DA and mood states of depression, mania or euthymia in BD.

Methods

A systematic review and meta-analysis were conducted. A total of 47 articles were included in the systematic review of which 23 were included in the meta-analysis. The quality of each study was rated.

Results

The meta-analysis showed significantly higher DA in BD than healthy controls (d = .70). However, no difference was observed between BD and unipolar participants (d = −.16). When reviewing mood state within BD, a significant mean difference was found between DA scores for euthymic and depressed participants (d = −.71), with those who were depressed scoring higher. Three studies found that psychological therapies significantly reduce DA in BD (d = −.38).

Conclusions

These findings imply not only that DA are both a characteristic of BD that is not as prevalent in healthy populations but also that a depressed mood state is associated with increased severity. This implies that DA could possibly go ‘offline’ when mood symptoms are not present. Psychological therapies appear to reduce DA in BD. Implications for future research as well as practice-based implications are expanded on in the discussion.

目的：抑郁症患者的功能障碍态度（DA）较高；然而，人们对它们在双相情感障碍（BD）中的作用知之甚少。本文旨在与临床和非临床组相比，探讨BD中DA的存在。还探讨了DA与BD患者抑郁、躁狂或处女膜状态之间的关系。方法：进行系统综述和荟萃分析。共有47篇文章被纳入系统综述，其中23篇被纳入荟萃分析。对每项研究的质量进行评分。结果：荟萃分析显示BD患者的DA显著高于健康对照组（d = .70）。然而，BD和单极参与者之间没有观察到差异（d = -.16）。当回顾BD内的情绪状态时，发现正常和抑郁参与者的DA评分之间存在显著的平均差异（d = -.71），抑郁者得分更高。三项研究发现，心理治疗能显著降低BD患者的DA（d = -.38）。结论：这些发现不仅表明DA是BD的一个特征，在健康人群中并不普遍，而且抑郁情绪状态与严重程度的增加有关。这意味着，当情绪症状不存在时，DA可能会“离线”。心理疗法似乎可以减少BD中的DA。在讨论中，对未来研究的影响以及基于实践的影响都得到了扩展。

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引用次数: 0