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Heterogeneous experiences of people with bipolar disorder during euthymia: Profiles of global remission and personal recovery 心境中双相情感障碍患者的异质经历:整体缓解和个人恢复的概况。
IF 3.1 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-12-05 DOI: 10.1111/bjc.12519
Caroline Munuera, Philippe Compagnone, Sébastien Gard, François Chevrier, Basilie Chevrier, Katia M'Bailara

Objectives

Clinical heterogeneity is a major problem in mental health, referring to wide clinical variability among people with the same diagnosis. In bipolar disorders (BD), an heterogeneity was found both in global remission (symptomatic and functional) and in personal recovery during euthymia. This heterogeneity is a challenge for clinicians, who have to adapt their care to the individuals' characteristics. This preliminary study aimed at identifying profiles of experiences during euthymia by considering global remission (manic and depressive symptomatology, and functional impairment) and personal recovery, and exploring personal and contextual correlates associated with the heterogeneity of experiences.

Methods

A convenience sample of 58 participants in euthymia of BD was recruited. Data were collected using self-report questionnaires. Consistent with a person-oriented approach, clustering was performed to identify profiles by simultaneously considering symptomatology, functional impairment, and personal recovery. Associations between the identified profiles and socio-demographic, clinical, and family characteristics were explored using analysis of variance, Fisher's exact tests, and post hoc tests.

Results

Five profiles were identified when considering both global remission and personal recovery: adverse experience (20.69%), slightly adverse experience (22.41%), unbalanced experience (10.34%), positive experience (22.14%), and hyperthymic positive experience (24.14%). Among the correlates, only current family functioning was significantly associated with the identified profiles through cohesion, communication, and satisfaction dimensions.

Conclusions

These results highlight that personal recovery and family dynamics of people with BD should be more considered in the clinical practice to better understand their experience during euthymia and adapt therapeutic care accordingly.

目的:临床异质性是心理健康的一个主要问题,指的是具有相同诊断的人之间广泛的临床差异。在双相情感障碍(BD)中,在整体缓解(症状和功能)和精神状态期间的个人恢复中都发现了异质性。这种异质性对临床医生来说是一个挑战,他们必须根据个人的特点调整他们的护理。本初步研究旨在通过考虑整体缓解(躁狂和抑郁症状学以及功能障碍)和个人恢复来确定心境愉悦期间的经历概况,并探索与经历异质性相关的个人和环境相关性。方法:招募了58名双相障碍心境障碍患者作为方便样本。采用自我报告问卷收集数据。与以人为本的方法一致,通过同时考虑症状、功能损害和个人恢复,进行聚类来确定概况。使用方差分析、Fisher精确检验和事后检验来探讨已确定的概况与社会人口统计学、临床和家庭特征之间的关联。结果:在考虑整体缓解和个人康复时,确定了五种特征:不良体验(20.69%)、轻微不良体验(22.41%)、不平衡体验(10.34%)、积极体验(22.14%)和亢奋积极体验(24.14%)。在相关因素中,只有当前家庭功能与通过凝聚力、沟通和满意度维度确定的特征显著相关。结论:这些结果强调在临床实践中应更多地考虑双相障碍患者的个人康复和家庭动态,以更好地了解他们在心境愉悦期间的经历,并相应地调整治疗护理。
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引用次数: 0
Experiences of imagery in obsessive-compulsive disorder: An interpretative phenomenological analysis 强迫症的意象体验:解释性现象学分析。
IF 3.1 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-12-05 DOI: 10.1111/bjc.12518
Hannah E. F. Wedge, Louise Waddington, Andrew R. Thompson

Introduction

Mental imagery is a defining criterion within current OCD diagnoses, and yet little has been written about how this is experienced. This study aimed to investigate how people with a diagnosis of OCD experience imagery, to better understand how this might contribute to the condition.

Methods

This research employed Interpretative Phenomenological Analysis (IPA) and used semi-structured interviews. An expert-by-experience was involved in the study design. Eight adults with an OCD diagnosis were purposively sampled from NHS mental health services and interviewed about their experience of imagery. Interviews were transcribed and analysed in accordance with IPA guidelines. A reflexive log and audit trail were maintained during the research process to enhance quality control and to support the analytical process.

Results

Six superordinate themes were found: Submersion in intense and multifaceted imagery; Overwhelming, uncontrollable imagery; Imagery is explosive and expansive; Imagery involves past memories and future fears; People respond to imagery as if it is real; Therapy shifts imagery.

Conclusions

This study highlights the intensity of OCD-related imagery experienced by people with OCD and the significance of this imagery in their everyday lives. All participants experienced imagery related to their OCD, demonstrating its importance in the phenomenology of the condition. Images relating to past experiences and images of future fears were identified. Clinicians should routinely seek to include imagery in assessment, formulation, and individual treatment plans for those with OCD.

心理意象是当前强迫症诊断的一个定义标准,但很少有关于如何体验的文章。这项研究旨在调查被诊断为强迫症的人是如何体验图像的,以更好地了解这可能是如何导致这种情况的。方法:本研究采用解释现象学分析(IPA)和半结构化访谈法。在研究设计中加入了一位经验专家。有目的地从NHS心理健康服务中抽取了8名患有强迫症的成年人,并对他们的意象体验进行了采访。访谈记录和分析都是按照国际音标协会的准则进行的。在研究过程中保持了反射性日志和审计跟踪,以加强质量控制并支持分析过程。结果:发现了6个上级主题:沉浸在强烈和多面意象中;压倒性的、无法控制的意象;意象是爆炸性和扩张性的;意象包括过去的记忆和未来的恐惧;人们对意象的反应就好像它是真实的;治疗改变了意象。结论:本研究突出了强迫症患者所经历的与强迫症相关的意象的强度,以及这种意象在他们日常生活中的重要性。所有参与者都经历了与强迫症相关的意象,证明了它在强迫症现象学中的重要性。与过去经历有关的图像和未来恐惧的图像被识别出来。临床医生应该在强迫症患者的评估、制定和个人治疗计划中定期寻求包括图像。
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引用次数: 0
‘Not my mess’?: How do supporters of individuals with hoarding difficulties rate the quality of the support they offer? 不是我的烂摊子"?囤积癖患者的支持者如何评价他们所提供支持的质量?
IF 3.1 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-11-22 DOI: 10.1111/bjc.12520
James Dennis, Kate Rosen, Paul M Salkovskis

Objectives

Hoarding difficulties (HD) affect many people and cause upset and danger for the person, as well as friends and family. Previous research found that people with HD feel less adequately socially supported compared with individuals with obsessive compulsive disorder (OCD). This study used the perspective of those offering support to infer whether people with HD view their support differently, or if there is a gap in support quality compared with those with OCD.

Design

The design was cross-sectional, comparing those supporting OCD with those supporting HD.

Methods

An online questionnaire was completed by 116 people offering support (POS) to people with these conditions. Support quality was measured using an adapted, proxy version of the Revised Norbeck Social Support Questionnaire. The research hypothesized that POS(HD) would not differ on support ratings compared with POS(OCD); or that POS(HD) would report comparatively lower ratings across support components. Secondary analysis investigated group differences in stigmatized attitudes and associative stigma; internalized stigma by virtue of having a connection to a stigmatized individual.

Results

POS(HD) rated their wish to support and the perceived success as significantly lower. Public stigma was rated more highly by POS(HD) relative to POS(OCD) and associative stigma felt more acutely by POS(HD).

Conclusions

Motivation to support was significantly lower in the HD group with associative stigma a significant predictive factor. Further research involving dyads is needed to investigate what is causing this shortfall in support. Clinical research for HD interventions should also examine how involving POS could enhance treatment outcomes.

目的:囤积症(HD)会影响许多人,并给患者、朋友和家人带来困扰和危险。以往的研究发现,与强迫症(OCD)患者相比,囤积症患者觉得自己没有得到足够的社会支持。本研究利用提供支持者的视角来推断 HD 患者是否以不同的方式看待他们所获得的支持,或者与强迫症患者相比,在支持质量方面是否存在差距:设计:本研究采用横断面设计,比较了为强迫症患者提供支持的人员与为 HD 患者提供支持的人员:116 名为上述患者提供支持(POS)的人员填写了一份在线问卷。支持质量采用诺贝克社会支持问卷(Revised Norbeck Social Support Questionnaire)的改编替代版进行测量。研究假设:与 POS(强迫症)相比,POS(HD)在支持评分上没有差异;或者 POS(HD)在各支持要素上的评分相对较低。辅助分析调查了鄙视态度和联想鄙视方面的群体差异;由于与被鄙视者有联系而内化的鄙视:结果:POS(HD)对其支持意愿和成功感知的评价明显较低。相对于 POS(强迫症),POS(HD)对公众鄙视的评价更高,POS(HD)对联想鄙视的感受更强烈:结论:HD 组的支持动机明显较低,联想成见是一个重要的预测因素。需要进一步开展涉及二人组的研究,以探究造成这种支持不足的原因。有关 HD 干预措施的临床研究也应探讨 POS 的参与如何能够提高治疗效果。
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引用次数: 0
Brief remote cognitive behaviour therapy for generalized anxiety disorder: An open trial 治疗广泛性焦虑症的简短远程认知行为疗法:一项公开试验。
IF 3.1 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-11-20 DOI: 10.1111/bjc.12516
Vesna Trenoska Basile, Toby Newton-John, Sarah McDonald, Bethany M. Wootton

Objective

Generalized anxiety disorder (GAD) is a persistent mental health condition that results in significant individual and economic burden. The uptake of evidence-based treatment is low, with many individuals with GAD citing cost as one of the key barriers. Brief treatments, which are typically more cost effective than standard length treatments, have the potential to make treatment more accessible to patients with GAD. Despite evidence demonstrating the efficacy of brief treatments for a range of anxiety disorders, there are currently no such studies examining brief Internet videoconferencing-delivered cognitive behavioural therapy (VCBT) interventions for patients with diagnosed GAD. The current study aims to examine the preliminary efficacy and acceptability of brief VCBT for GAD.

Method

The authors adopted an open trial design with 36 participants (77.8% female; Mage = 36.81 years; SD = 12.25) to examine the preliminary efficacy of a brief five-session VCBT intervention delivered remotely.

Results

Large pre-treatment to post-treatment effects were seen on the primary outcome measure, the Generalized Anxiety Disorder Questionnaire-7 item (GAD-7; d = 1.13; 95% CI: .62–1.61) and treatment effects increased at 3-month follow-up (d = 1.58; 95% CI: 1.04–2.10). Participants rated the intervention as highly acceptable with 92% reporting that they were satisfied with the treatment.

Conclusion

These results provide preliminary support for the viability of brief remotely delivered CBT treatment in managing GAD symptoms.

目的:广泛性焦虑症(GAD广泛性焦虑症(GAD)是一种长期存在的心理健康问题,给个人和经济造成沉重负担。循证治疗的采用率很低,许多 GAD 患者认为费用是主要障碍之一。简短治疗通常比标准的长期治疗更具成本效益,有可能使 GAD 患者更容易接受治疗。尽管有证据表明简短治疗对一系列焦虑症具有疗效,但目前还没有此类研究对确诊为 GAD 的患者进行简短的互联网视频会议认知行为疗法(VCBT)干预。本研究旨在考察简短的 VCBT 治疗 GAD 的初步疗效和可接受性:作者采用开放式试验设计,对 36 名参与者(77.8% 为女性;平均年龄 = 36.81 岁;标准差 = 12.25)进行了研究,以考察远程提供的为期五节的简短 VCBT 干预的初步疗效:在主要结果测量--广泛性焦虑症问卷-7项目(GAD-7;d = 1.13;95% CI:.62-1.61)上,治疗前与治疗后的效果差异很大,而且在3个月的随访中,治疗效果也有所提高(d = 1.58;95% CI:1.04-2.10)。参与者对干预措施的接受度很高,92%的人对治疗表示满意:这些结果为远程提供的简短 CBT 治疗在控制 GAD 症状方面的可行性提供了初步支持。
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引用次数: 0
Predictors of dropout in self-guided internet-delivered cognitive behaviour therapy for obsessive-compulsive disorder: An exploratory study 强迫症患者在自我指导的互联网认知行为疗法中辍学的预测因素:一项探索性研究。
IF 3.1 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-11-20 DOI: 10.1111/bjc.12517
Bethany M. Wootton, Maral Melkonian, Sarah McDonald, Eyal Karin, Nickolai Titov, Blake F. Dear

Objectives

Self-guided internet-delivered cognitive behaviour therapy (ICBT) is an effective treatment for obsessive-compulsive disorder (OCD); however, there is little research investigating who dropouts of treatment. Therefore, the aim of this study was to conduct an exploratory study of predictors of dropout in self-guided ICBT for OCD. Given that definitions of dropout vary across ICBT studies, we conceptualized dropout in multiple ways: (1) early dropout (proportion of participants who did not complete the pre-treatment questionnaires); (2) proportion of participants who did not commence the intervention; (3) proportion of participants who did not complete the treatment; and (4) proportion of participants who did not complete the post-treatment questionnaires.

Method

This was a secondary data analysis of 323 participants with OCD symptoms who provided a successful screening assessment to commence an ICBT intervention. Binary logistic regression was used to predict dropout based on a number of exploratory variables.

Results

Early dropout was predicted by the country of the participant (participants in the United Kingdom and India being more likely to dropout), as well as shorter symptom duration (explaining 7% of the variance). Medication use predicted non-completion of the intervention with those taking medication for OCD being less likely to complete the treatment (explaining 3% of the variance). Completion of the post-treatment questionnaires was predicted by higher contamination symptoms, lower depressive symptoms and higher pre-treatment conscientiousness (explaining 13% of the variance). There were no significant predictors of treatment commencement.

Conclusions

The study provides important preliminary information concerning which patients with OCD may be more likely to drop out of a self-guided ICBT intervention.

目的:自我指导的互联网认知行为疗法(ICBT)是一种治疗强迫症(OCD)的有效方法;然而,对治疗中途退出者的调查研究却很少。因此,本研究旨在对强迫症自我指导认知行为疗法的辍学预测因素进行探索性研究。鉴于不同的 ICBT 研究对辍学的定义各不相同,我们从多个方面对辍学进行了概念化:(1)早期辍学(未完成治疗前调查问卷的参与者比例);(2)未开始干预的参与者比例;(3)未完成治疗的参与者比例;以及(4)未完成治疗后调查问卷的参与者比例:这是一项二手数据分析,研究对象是323名有强迫症症状的参与者,他们成功通过了筛查评估,并开始接受综合心理治疗干预。根据一些探索性变量,采用二元逻辑回归法预测辍学情况:受试者所在国家(英国和印度的受试者更有可能辍学)以及症状持续时间较短(解释了7%的方差)可预测早期辍学。使用药物可预测未完成干预的情况,那些服用强迫症药物的人完成治疗的可能性较低(解释了3%的差异)。较高的污染症状、较低的抑郁症状和较高的治疗前自觉性可以预测治疗后问卷的完成情况(解释了 13% 的方差)。治疗开始与否没有重要的预测因素:这项研究提供了重要的初步信息,说明哪些强迫症患者更有可能放弃自我指导的 ICBT 干预。
{"title":"Predictors of dropout in self-guided internet-delivered cognitive behaviour therapy for obsessive-compulsive disorder: An exploratory study","authors":"Bethany M. Wootton,&nbsp;Maral Melkonian,&nbsp;Sarah McDonald,&nbsp;Eyal Karin,&nbsp;Nickolai Titov,&nbsp;Blake F. Dear","doi":"10.1111/bjc.12517","DOIUrl":"10.1111/bjc.12517","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Self-guided internet-delivered cognitive behaviour therapy (ICBT) is an effective treatment for obsessive-compulsive disorder (OCD); however, there is little research investigating who dropouts of treatment. Therefore, the aim of this study was to conduct an exploratory study of predictors of dropout in self-guided ICBT for OCD. Given that definitions of dropout vary across ICBT studies, we conceptualized dropout in multiple ways: (1) early dropout (proportion of participants who did not complete the pre-treatment questionnaires); (2) proportion of participants who did not commence the intervention; (3) proportion of participants who did not complete the treatment; and (4) proportion of participants who did not complete the post-treatment questionnaires.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This was a secondary data analysis of 323 participants with OCD symptoms who provided a successful screening assessment to commence an ICBT intervention. Binary logistic regression was used to predict dropout based on a number of exploratory variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Early dropout was predicted by the country of the participant (participants in the United Kingdom and India being more likely to dropout), as well as shorter symptom duration (explaining 7% of the variance). Medication use predicted non-completion of the intervention with those taking medication for OCD being less likely to complete the treatment (explaining 3% of the variance). Completion of the post-treatment questionnaires was predicted by higher contamination symptoms, lower depressive symptoms and higher pre-treatment conscientiousness (explaining 13% of the variance). There were no significant predictors of treatment commencement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study provides important preliminary information concerning which patients with OCD may be more likely to drop out of a self-guided ICBT intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 2","pages":"458-474"},"PeriodicalIF":3.1,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjc.12517","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677307","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
More than Body Appearance! Improving body image in young women through a functionality-focused intervention combined with psychoeducation: A randomized controlled trial 不仅仅是身体外观!通过功能性干预与心理教育相结合改善年轻女性的身体形象:随机对照试验
IF 3.1 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-11-13 DOI: 10.1111/bjc.12514
Silvia Cerea, Anna Panzeri, Beatrice Burdisso, Gioia Bottesi, Paolo Mancin, Martina Rapisarda, Marta Ghisi

Objectives

Body dissatisfaction is a public health concern, prevalent among women. This study aims to investigate the efficacy of a 2-week online functionality-focused intervention combined with psychoeducation on improving body image among young women at both high and low risk of Body Image Disorders (BIDs).

Design

A randomized controlled trial was conducted among young women at high risk and low risk of developing BIDs.

Methods

In total, 231 young women (n = 64 at high risk of BIDs) were randomized into: experimental (n = 113) and waitlist (n = 118) groups. The experimental group underwent the intervention at baseline (T0) for 15 days (T1), while the waitlist group started the intervention at T1 for 15 days (T2). Participants completed questionnaires about body and functionality appreciation, eating disorders (EDs) risk and extreme body dissatisfaction at baseline, 15 days from baseline and 30 days from baseline.

Results

Mixed linear models revealed enhancements in body and functionality appreciation post-intervention for women at both high risk and low risk of BIDs. Reductions in EDs risk and body dissatisfaction were observed in participants at high risk.

Conclusions

The intervention proves to be useful in promoting a positive body image (i.e. body and functionality appreciation) in women at both high and low risk of BIDs, while the results concerning the risk of developing EDs and extreme body dissatisfaction are more nuanced.

目的:身体不满意是一个公共健康问题,在女性中普遍存在。本研究旨在调查为期两周的在线功能性干预与心理教育相结合对改善身体形象障碍(BIDs)高风险和低风险年轻女性身体形象的效果:设计:在身体形象障碍高风险和低风险年轻女性中开展随机对照试验:总共有 231 名年轻女性(64 名身体形象障碍高危女性)被随机分为实验组(113 人)和候选组(118 人)。实验组在基线(T0)接受为期 15 天(T1)的干预,而候补组在 T1 开始接受为期 15 天(T2)的干预。参与者分别在基线期、基线期后 15 天和基线期后 30 天填写了有关身体和功能评价、饮食失调(ED)风险和身体极度不满意度的问卷:混合线性模型显示,高风险和低风险女性在干预后对身体和功能的评价都有所提高。在高风险参与者中观察到,EDs 风险和身体不满意度有所降低:事实证明,干预措施有助于促进高危和低危女性树立积极的身体形象(即对身体和身体功能的欣赏),而对罹患 ED 的风险和对身体的极端不满意度的影响则更为微妙。
{"title":"More than Body Appearance! Improving body image in young women through a functionality-focused intervention combined with psychoeducation: A randomized controlled trial","authors":"Silvia Cerea,&nbsp;Anna Panzeri,&nbsp;Beatrice Burdisso,&nbsp;Gioia Bottesi,&nbsp;Paolo Mancin,&nbsp;Martina Rapisarda,&nbsp;Marta Ghisi","doi":"10.1111/bjc.12514","DOIUrl":"10.1111/bjc.12514","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Body dissatisfaction is a public health concern, prevalent among women. This study aims to investigate the efficacy of a 2-week online functionality-focused intervention combined with psychoeducation on improving body image among young women at both high and low risk of Body Image Disorders (BIDs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A randomized controlled trial was conducted among young women at high risk and low risk of developing BIDs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In total, 231 young women (<i>n</i> = 64 at high risk of BIDs) were randomized into: experimental (<i>n</i> = 113) and waitlist (<i>n</i> = 118) groups. The experimental group underwent the intervention at baseline (T0) for 15 days (T1), while the waitlist group started the intervention at T1 for 15 days (T2). Participants completed questionnaires about body and functionality appreciation, eating disorders (EDs) risk and extreme body dissatisfaction at baseline, 15 days from baseline and 30 days from baseline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mixed linear models revealed enhancements in body and functionality appreciation post-intervention for women at both high risk and low risk of BIDs. Reductions in EDs risk and body dissatisfaction were observed in participants at high risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The intervention proves to be useful in promoting a positive body image (i.e. body and functionality appreciation) in women at both high and low risk of BIDs, while the results concerning the risk of developing EDs and extreme body dissatisfaction are more nuanced.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 2","pages":"415-441"},"PeriodicalIF":3.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjc.12514","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629888","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 single-session feedback training modifies interpretation bias in individuals with high social anxiety: A randomized controlled trial 单次反馈训练可改变高度社交焦虑者的解释偏差:随机对照试验
IF 3.1 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-11-04 DOI: 10.1111/bjc.12512
Jisu Choi, Geunyoung Kim, Jae-Won Yang

Objectives

The ability to interpret facial expressions accurately is important to adaptive social functioning. Social anxiety disorder is associated with a biased interpretation of facial emotions. This study aimed to demonstrate the effects of feedback training on modifying interpretation bias in individuals with high social anxiety.

Methods

A total of 451 university students were screened, and 69 participants with high social anxiety were randomly assigned to either a training (n = 37) or a control (n = 32) group. Participants completed pre-questionnaires on social anxiety and depression symptoms, then performed a single session of experiment, followed by post-questionnaires on social anxiety symptoms. In the experiment, participants viewed an ambiguous facial expression and rated the intensity on a continuous scale. The training group received feedback that presented their ratings alongside the actual intensity, allowing them to accurately assess their emotional perception bias through trial-by-trial feedback. The control group received no feedback.

Results

The training group showed a significant reduction in interpretation bias for happy and angry faces after the experiment, while the control group did not. However, although the training group's social anxiety symptoms decreased post-experiment, the difference was not statistically significant compared to the control group.

Conclusions

These findings provide preliminary evidence that the feedback training targeting dimensional ratings of emotions may be a promising option for correcting interpretation bias in individuals with high social anxiety. Future research could implement multiple sessions of training to potentially reduce both interpretation bias and social anxiety symptoms and verify the long-term effects.

目的:准确解读面部表情的能力对于适应社会功能非常重要。社交焦虑症与面部情绪解读偏差有关。本研究旨在证明反馈训练对改变高度社交焦虑症患者解读偏差的效果:共筛选了 451 名大学生,并将 69 名高度社交焦虑的参与者随机分配到训练组(37 人)或对照组(32 人)。参与者填写社交焦虑和抑郁症状的前置问卷,然后进行一次实验,再填写社交焦虑症状的后置问卷。在实验中,参与者观看模棱两可的面部表情,并按连续量表对其强度进行评分。训练组收到的反馈会将他们的评分与实际强度一并显示,这样他们就能通过逐次试验的反馈准确评估自己的情绪感知偏差。对照组不接受任何反馈:结果:实验后,训练组对快乐和愤怒面孔的解释偏差明显减少,而对照组则没有。然而,尽管训练组的社交焦虑症状在实验后有所减轻,但与对照组相比,差异在统计学上并不显著:这些研究结果提供了初步证据,表明针对情绪维度评级的反馈训练可能是纠正高度社交焦虑者解释偏差的一种有前途的选择。未来的研究可以通过多次训练来减少解释偏差和社交焦虑症状,并验证其长期效果。
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引用次数: 0
Trauma and social pathways to psychosis: Examining the role of attachment, social rank and dissociation in a clinical sample 创伤和精神病的社会途径:在临床样本中研究依恋、社会等级和分离的作用。
IF 3.1 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-10-29 DOI: 10.1111/bjc.12511
Shelley Grady, Niall Crowley, Seamus Scott, Charles Ifegwu Ndukwe, Rebecca Donohoe, Keith Gaynor

Objectives

The trauma and social pathways model of psychosis proposes interactions between trauma, attachment, social rank and dissociation in pathways to psychosis, though this model has yet to be empirically investigated. The primary aim of this study was to examine the overall predictive value of the trauma and social pathways model using regression analysis. A secondary aim was to delineate hypothesized pathways between trauma and positive symptoms of psychosis using serial mediation analysis.

Method

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

Results

A model of recurrent trauma, insecure attachment, social rank and dissociation predicted 23.2% of the variance in positive symptoms of psychosis. Recurrent trauma, attachment and dissociation contributed significantly to the model, while social rank did not. Further, serial mediation analysis indicated that the sequence of disorganized attachment and dissociation fully mediated the relationship between recurrent trauma and positive symptoms.

Conclusions

Results provide preliminary support for the trauma and social pathways model of psychosis, specifically as it relates to recurrent trauma, insecure attachment and dissociation. Results did not support the social rank component of this model, however. These findings provide clear targets for the development of next-wave psychological interventions that focus on trauma-related variables in psychosis. Future studies should replicate these findings with a larger clinical sample, and consider a measure of shame to further elucidate social processes in pathways to psychosis.

目的:精神病的创伤和社会途径模型提出了创伤、依恋、社会等级和解离在精神病发病途径中的相互作用,但这一模型尚未得到实证研究。本研究的主要目的是通过回归分析来检验创伤和社会路径模型的总体预测价值。次要目的是利用序列中介分析法来界定创伤与精神病阳性症状之间的假设路径:这是一项横断面研究,研究对象是因精神病相关诊断而接受精神健康服务的人(N = 71)。研究人员完成了对创伤、精神病阳性症状、依恋、社会比较和分离的测量:一个由反复出现的创伤、不安全依恋、社会等级和分离组成的模型预测了 23.2% 的精神病阳性症状变异。反复出现的创伤、依恋和解离对该模型有显著贡献,而社会等级则没有。此外,序列中介分析表明,无序依恋和解离的序列完全中介了复发性创伤和阳性症状之间的关系:结论:研究结果初步支持了精神病的创伤和社会路径模型,特别是与反复创伤、不安全依恋和解离有关的部分。然而,研究结果并不支持该模式中的社会等级部分。这些发现为下一轮心理干预措施的开发提供了明确的目标,即关注精神病中与创伤相关的变量。未来的研究应该在更大的临床样本中重复这些发现,并考虑采用羞耻感的测量方法,以进一步阐明精神病发病途径中的社会过程。
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引用次数: 0
Ensuring that psychological interventions are delivered as intended on mental health inpatient wards 确保在心理健康住院病人病房中按照预期进行心理干预。
IF 3.1 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-10-28 DOI: 10.1111/bjc.12510
Katherine Berry, Fritz Handerer, Sandra Bucci, Georgia Penn, Helen Morley, Jessica Raphael, Karina Lovell, Owen Price, Dawn Edge, Richard J. Drake, Gillian Haddock

Objectives

Talk, Understand and Listen for InPatient Settings (TULIPS) was a multi-centred randomized control trial of an intervention that aimed to increase patient access to psychological therapies on acute mental health wards. This paper aims to: (i) describe a strategy for designing a psychological intervention that is implementable in inpatient mental health settings; (ii) describe methods for assessing the fidelity of interventions within these settings; (iii) report on the extent to which fidelity was achieved in the TULIPS trial.

Methods

The TULIPS intervention was designed using information from a systematic review, stakeholder interviews, pilot work and a consensus workshop. We assessed fidelity to the model in terms of the delivery and dose of essential elements of the intervention, quality of intervention delivery, engagement of participants with the intervention and differentiation between the intervention and usual care.

Results

Although the TULIPS intervention targeted known barriers to the delivery of psychological interventions on mental health wards, we found issues in implementing aspects of the intervention that were dependent upon the participation of members of the multidisciplinary team. Psychologists were able to overcome barriers to delivering individual therapy to patients as this provision was not reliant on the availability of other staff.

Conclusions

The intervention period in the study was 6 months. A greater period of time with a critical mass of psychological practitioners is needed to embed psychological interventions on inpatient wards. Our fidelity framework and assessment methods can be used by other researchers implementing and testing psychological therapies within inpatient environments.

目标:针对住院环境的谈话、理解和倾听(TULIPS)是一项多中心随机对照试验,旨在增加急诊精神科病房患者获得心理治疗的机会。本文旨在:(i) 描述一种设计可在住院精神健康环境中实施的心理干预的策略;(ii) 描述在这些环境中评估干预忠实性的方法;(iii) 报告 TULIPS 试验在多大程度上实现了忠实性:TULIPS 干预方案的设计参考了系统综述、利益相关者访谈、试点工作和共识研讨会的信息。我们从干预措施基本要素的实施和剂量、干预措施实施的质量、参与者对干预措施的参与度以及干预措施与常规护理之间的区别等方面评估了该模式的忠实性:结果:尽管TULIPS干预针对的是心理健康病房在实施心理干预时遇到的已知障碍,但我们发现在实施干预的某些方面存在问题,这些问题取决于多学科团队成员的参与。心理学家能够克服为患者提供个别治疗的障碍,因为这种治疗不依赖于其他工作人员的参与:本研究的干预期为 6 个月。要在住院病房开展心理干预,需要更长的时间和更多的心理从业人员。我们的忠实度框架和评估方法可供其他在住院环境中实施和测试心理疗法的研究人员使用。
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引用次数: 0
Predicting optimal treatment allocation for cognitive analytic-guided self-help versus cognitive behavioural-guided self-help 预测认知分析指导自助与认知行为指导自助的最佳治疗分配。
IF 3.1 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-10-23 DOI: 10.1111/bjc.12508
Caroline Wojnarowski, Melanie Simmonds-Buckley, Stephen Kellett

Objectives

Given the ubiquity in routine services of low-intensity guided self-help (GSH) psychological interventions, better patient selection for these brief interventions would be organizationally efficient. This study therefore sought to define who would respond best to two different types of GSH for anxiety to enable better future treatment matching.

Methods

The study used outcome data from a patient preference trial (N = 209) comparing cognitive analytic therapy-guided self-help (CAT-GSH) with cognitive behavioural therapy-guided self-help (CBT-GSH). Elastic Net regularization and Boruta random forest variable selection methods were applied. Regression models calculated the patient advantage index (PAI) to designate which GSH was likely the most effective for each patient. Outcomes were compared for those receiving their PAI-indicated optimal and non-optimal GSH.

Results

Lower baseline depression and anxiety severity predicted better outcomes for both types of GSH. Patient preference status was not associated with outcome during either GSH. Sixty-three % received their model indicating optimal GSH and these had significantly higher rates of reliable and clinically significant reductions in anxiety at both post-treatment (35.9% vs. 16.6%) and follow-up (36.6% vs. 19.2%). No single patient with a large PAI had a reliable and clinically significant reduction in anxiety at post-treatment or follow-up when they did not receive their optimal GSH.

Conclusions

Treatment matching algorithms have the potential to support evidenced-based treatment selection for GSH. Treatment selection and supporting patient choice needs to be integrated. Future research needs to investigate the use of the PAI for GSH treatment matching, but with larger and more balanced samples.

目的:鉴于低强度的指导性自助(GSH)心理干预在常规服务中无处不在,更好地选择患者接受这些简短的干预将提高组织效率。因此,本研究试图确定哪些患者对两种不同类型的焦虑症指导自助疗法反应最佳,以便今后更好地进行治疗匹配:研究使用了一项患者偏好试验(N = 209)的结果数据,该试验比较了认知分析疗法指导下的自助(CAT-GSH)和认知行为疗法指导下的自助(CBT-GSH)。应用了弹性网正则化和 Boruta 随机森林变量选择方法。回归模型计算了患者优势指数(PAI),以确定哪种GSH对每位患者最有效。结果比较了接受 PAI 指示的最佳和非最佳 GSH 治疗的患者的疗效:结果:基线抑郁和焦虑严重程度越低,两种 GSH 的疗效越好。患者的偏好状况与两种 GSH 的疗效无关。63%的患者接受了其模型显示的最佳GSH治疗,这些患者在治疗后(35.9%对16.6%)和随访中(36.6%对19.2%)的焦虑程度均有明显的临床显著降低。没有一名PAI较大的患者在治疗后或随访时,如果没有接受最佳的GSH治疗,其焦虑程度都没有得到可靠且有临床意义的缓解:治疗匹配算法有可能支持基于证据的GSH治疗选择。治疗选择和支持患者选择需要结合起来。未来的研究需要调查PAI在GSH治疗匹配中的应用,但需要更大、更均衡的样本。
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引用次数: 0
期刊
British Journal of Clinical Psychology
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