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.
{"title":"Brief remote cognitive behaviour therapy for generalized anxiety disorder: An open trial","authors":"Vesna Trenoska Basile, Toby Newton-John, Sarah McDonald, Bethany M. Wootton","doi":"10.1111/bjc.12516","DOIUrl":"10.1111/bjc.12516","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The authors adopted an open trial design with 36 participants (77.8% female; <i>M</i><sub>age</sub> = 36.81 years; <i>SD</i> = 12.25) to examine the preliminary efficacy of a brief five-session VCBT intervention delivered remotely.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Large pre-treatment to post-treatment effects were seen on the primary outcome measure, the Generalized Anxiety Disorder Questionnaire-7 item (GAD-7; <i>d</i> = 1.13; 95% CI: .62–1.61) and treatment effects increased at 3-month follow-up (<i>d</i> = 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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These results provide preliminary support for the viability of brief remotely delivered CBT treatment in managing GAD symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 2","pages":"442-457"},"PeriodicalIF":3.1,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677304","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}
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.
{"title":"Predictors of dropout in self-guided internet-delivered cognitive behaviour therapy for obsessive-compulsive disorder: An exploratory study","authors":"Bethany M. Wootton, Maral Melkonian, Sarah McDonald, Eyal Karin, Nickolai Titov, 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}
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.
{"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, Anna Panzeri, Beatrice Burdisso, Gioia Bottesi, Paolo Mancin, Martina Rapisarda, 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}
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.
{"title":"A single-session feedback training modifies interpretation bias in individuals with high social anxiety: A randomized controlled trial","authors":"Jisu Choi, Geunyoung Kim, Jae-Won Yang","doi":"10.1111/bjc.12512","DOIUrl":"10.1111/bjc.12512","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 451 university students were screened, and 69 participants with high social anxiety were randomly assigned to either a training (<i>n</i> = 37) or a control (<i>n</i> = 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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 2","pages":"403-414"},"PeriodicalIF":3.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577162","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}
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.
{"title":"Trauma and social pathways to psychosis: Examining the role of attachment, social rank and dissociation in a clinical sample","authors":"Shelley Grady, Niall Crowley, Seamus Scott, Charles Ifegwu Ndukwe, Rebecca Donohoe, Keith Gaynor","doi":"10.1111/bjc.12511","DOIUrl":"10.1111/bjc.12511","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This was a cross-sectional study of people attending mental health services for a psychosis-related diagnosis (<i>N</i> = 71). Measures of trauma, positive symptoms of psychosis, attachment, social comparison and dissociation were completed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 2","pages":"385-402"},"PeriodicalIF":3.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjc.12511","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523362","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}
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.
{"title":"Ensuring that psychological interventions are delivered as intended on mental health inpatient wards","authors":"Katherine Berry, Fritz Handerer, Sandra Bucci, Georgia Penn, Helen Morley, Jessica Raphael, Karina Lovell, Owen Price, Dawn Edge, Richard J. Drake, Gillian Haddock","doi":"10.1111/bjc.12510","DOIUrl":"10.1111/bjc.12510","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 2","pages":"371-384"},"PeriodicalIF":3.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjc.12510","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523361","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}
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.
{"title":"Predicting optimal treatment allocation for cognitive analytic-guided self-help versus cognitive behavioural-guided self-help","authors":"Caroline Wojnarowski, Melanie Simmonds-Buckley, Stephen Kellett","doi":"10.1111/bjc.12508","DOIUrl":"10.1111/bjc.12508","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study used outcome data from a patient preference trial (<i>N</i> = 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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 2","pages":"355-370"},"PeriodicalIF":3.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjc.12508","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510475","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}
Intolerance of uncertainty, the tendency to interpret and react negatively to uncertainty, is a transdiagnostic risk factor for anxiety, depression and eating-related disorders. Given the high comorbidity between anxiety, depression and schizophrenia-spectrum diagnoses (SSDs), there is potential for intolerance of uncertainty to play a role in modulating psychosis symptoms. To address this gap in our understanding, we conducted the first prospectively registered systematic review on intolerance of uncertainty and psychotic symptoms in both people with SSDs and in the general population.
Methods
Four databases were searched (PsycINFO, Medline, Web of Science and PubMed), which identified ten studies with a total of 1503 participants that measured intolerance of uncertainty and psychosis symptoms.
Results
Key findings suggest the following: (1) Intolerance of uncertainty was associated with total negative psychotic symptoms with small–medium effect sizes; (2) intolerance of uncertainty was higher in individuals with an ‘at-risk’ mental state for psychosis compared to controls; (3) higher intolerance of uncertainty was associated with more individual psychotic symptoms related to delusions and paranoia within clinical and nonclinical samples; and (4) there was mixed evidence for a relationship between intolerance of uncertainty and auditory hallucinations and intolerance of uncertainty and total positive symptoms in clinical samples.
Conclusions
Overall, these findings highlight that intolerance of uncertainty may be an important transdiagnostic dimension and potential treatment target for psychotic symptoms such as delusions and paranoia in people with SSDs.
研究目的对不确定性的不容忍，即对不确定性做出负面解释和反应的倾向，是焦虑症、抑郁症和饮食相关障碍的一个跨诊断风险因素。鉴于焦虑症、抑郁症和精神分裂症谱诊断（SSDs）之间的高度共病性，不确定性不容忍有可能在调节精神病症状方面发挥作用。为了弥补我们认识上的这一不足，我们首次对不确定性不耐受与精神分裂症患者和普通人群的精神病症状进行了前瞻性系统回顾：我们检索了四个数据库（PsycINFO、Medline、Web of Science和PubMed），发现了10项研究，共有1503人参与，这些研究测量了不确定性不容忍度和精神病症状：主要发现如下(结果：主要研究结果表明：（1）不确定性不容忍度与总体负面精神病症状相关，且具有中小效应量；（2）与对照组相比，精神病 "高危 "精神状态个体的不确定性不容忍度更高；（3）在临床和非临床样本中，不确定性不容忍度越高，与妄想和偏执相关的个体精神病症状越多；以及（4）在临床样本中，不确定性不容忍度与幻听之间的关系以及不确定性不容忍度与总体积极症状之间的关系存在混合证据：总之，这些研究结果突出表明，不确定性不耐受可能是一个重要的跨诊断维度，也是治疗 SSD 患者妄想和偏执等精神病性症状的潜在目标。
{"title":"Intolerance of uncertainty and psychosis: A systematic review","authors":"Jayne Morriss, Daisy Butler, Lyn Ellett","doi":"10.1111/bjc.12509","DOIUrl":"10.1111/bjc.12509","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Intolerance of uncertainty, the tendency to interpret and react negatively to uncertainty, is a transdiagnostic risk factor for anxiety, depression and eating-related disorders. Given the high comorbidity between anxiety, depression and schizophrenia-spectrum diagnoses (SSDs), there is potential for intolerance of uncertainty to play a role in modulating psychosis symptoms. To address this gap in our understanding, we conducted the first prospectively registered systematic review on intolerance of uncertainty and psychotic symptoms in both people with SSDs and in the general population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four databases were searched (PsycINFO, Medline, Web of Science and PubMed), which identified ten studies with a total of 1503 participants that measured intolerance of uncertainty and psychosis symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Key findings suggest the following: (1) Intolerance of uncertainty was associated with total negative psychotic symptoms with small–medium effect sizes; (2) intolerance of uncertainty was higher in individuals with an ‘at-risk’ mental state for psychosis compared to controls; (3) higher intolerance of uncertainty was associated with more individual psychotic symptoms related to delusions and paranoia within clinical and nonclinical samples; and (4) there was mixed evidence for a relationship between intolerance of uncertainty and auditory hallucinations and intolerance of uncertainty and total positive symptoms in clinical samples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overall, these findings highlight that intolerance of uncertainty may be an important transdiagnostic dimension and potential treatment target for psychotic symptoms such as delusions and paranoia in people with SSDs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 2","pages":"344-354"},"PeriodicalIF":3.1,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjc.12509","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510474","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}
Stephanie Jarvi Steele, Nigel M. Jaffe, Claire A. Kelly, Thröstur Björgvinsson, Lance P. Swenson
Objectives
We examine correlates and predictors for implicit associations with non-suicidal self-injury (NSSI) with the Self-Injury Implicit Association Test (SI-IAT) in a treatment-seeking sample. We also examine group differences in the SI-IAT among those with low/none, moderate and high/clinically significant borderline personality disorder (BPD) symptomatology in a treatment-seeking sample.
Methods
Participants (N = 111; 58% female; 89% White; Mage = 30.25) completed the SI-IAT and self-report measures at two time points.
Results
Higher BPD symptom scores were significantly, positively correlated with implicit identification with NSSI, and predicted NSSI identity when controlling for depression indices, history of NSSI and other covariates. With Time 1 SI-IAT scores entered as a covariate, BPD scores no longer significantly predicted Time 2 SI-IAT scores. Individuals with moderate and high/clinically significant symptom counts of BPD had higher/stronger implicit associations with NSSI identity than those with no/low BPD symptoms.
Conclusions
Individuals with symptoms of BPD may implicitly identify with NSSI more than other clinical groups; examination of implicit assessments in BPD in future research is needed to further explore implicit identification with NSSI in this patient group to further understand both cross-sectional and prospective relations.
{"title":"Implicit associations with non-suicidal self-injury: Examination in a clinical sample by borderline personality symptomatology","authors":"Stephanie Jarvi Steele, Nigel M. Jaffe, Claire A. Kelly, Thröstur Björgvinsson, Lance P. Swenson","doi":"10.1111/bjc.12506","DOIUrl":"10.1111/bjc.12506","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We examine correlates and predictors for implicit associations with non-suicidal self-injury (NSSI) with the Self-Injury Implicit Association Test (SI-IAT) in a treatment-seeking sample. We also examine group differences in the SI-IAT among those with low/none, moderate and high/clinically significant borderline personality disorder (BPD) symptomatology in a treatment-seeking sample.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants (<i>N</i> = 111; 58% female; 89% White; <i>M</i><sub><i>age</i></sub> = 30.25) completed the SI-IAT and self-report measures at two time points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher BPD symptom scores were significantly, positively correlated with implicit identification with NSSI, and predicted NSSI identity when controlling for depression indices, history of NSSI and other covariates. With Time 1 SI-IAT scores entered as a covariate, BPD scores no longer significantly predicted Time 2 SI-IAT scores. Individuals with moderate and high/clinically significant symptom counts of BPD had higher/stronger implicit associations with NSSI identity than those with no/low BPD symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Individuals with symptoms of BPD may implicitly identify with NSSI more than other clinical groups; examination of implicit assessments in BPD in future research is needed to further explore implicit identification with NSSI in this patient group to further understand both cross-sectional and prospective relations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 2","pages":"330-343"},"PeriodicalIF":3.1,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382018","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}
Inflexibility of thought and behaviour is a transdiagnostic feature of many neuropsychiatric disorders and presents several empirical measurement challenges. Here, we developed and validated the Flexibility in Daily Life scale (FIDL); a novel, self-report questionnaire, which captures expressions of cognitive and behavioural flexibility in daily life and is sensitive to natural shifts in these processes across the adult lifespan.
Methods
The FIDL was developed using a deductive scale development approach, which aimed to capture common themes within the flexibility literature and across diagnoses (e.g. insistence on sameness, preference for routines). Following multidisciplinary consensus, an initial 37-item questionnaire was submitted for validation in an online sample of 295 healthy adult participants (19–78 years).
Results
Exploratory factor analysis produced a revised 21-item version comprising five factors, labelled: Repetition, Switching, Predictability/Control, Routine, and Thoughts/Beliefs. Internal consistency reliability was good-to-strong for the total FIDL score and moderate-to-strong for individual subscales. Convergent validity was established between the FIDL and an existing measure of cognitive flexibility. Critically, the FIDL total score evinced a U-shaped relationship with age, whereby flexibility was lower at the younger and older tails of the lifespan and greater in middle age. The same U-shaped trajectory emerged for the Repetition, Routine, and Thoughts/Beliefs factors.
Conclusions
Overall, the FIDL is a valid and reliable multidimensional measure of flexibility, which upholds a clearly defined factor structure and good psychometric properties. It promises to be a valuable clinical and research tool to assess the natural fluctuations in flexibility across the lifespan and departures thereof.
{"title":"Development of the Flexibility in Daily Life scale to measure multidimensional cognitive and behavioural flexibility in health and disease","authors":"Kristina Horne, Tao Chen, Muireann Irish","doi":"10.1111/bjc.12505","DOIUrl":"10.1111/bjc.12505","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Inflexibility of thought and behaviour is a transdiagnostic feature of many neuropsychiatric disorders and presents several empirical measurement challenges. Here, we developed and validated the Flexibility in Daily Life scale (FIDL); a novel, self-report questionnaire, which captures expressions of cognitive and behavioural flexibility in daily life and is sensitive to natural shifts in these processes across the adult lifespan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The FIDL was developed using a deductive scale development approach, which aimed to capture common themes within the flexibility literature and across diagnoses (e.g. insistence on sameness, preference for routines). Following multidisciplinary consensus, an initial 37-item questionnaire was submitted for validation in an online sample of 295 healthy adult participants (19–78 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Exploratory factor analysis produced a revised 21-item version comprising five factors, labelled: <i>Repetition</i>, <i>Switching</i>, <i>Predictability/Control</i>, <i>Routine</i>, and <i>Thoughts/Beliefs</i>. Internal consistency reliability was good-to-strong for the total FIDL score and moderate-to-strong for individual subscales. Convergent validity was established between the FIDL and an existing measure of cognitive flexibility. Critically, the FIDL total score evinced a U-shaped relationship with age, whereby flexibility was lower at the younger and older tails of the lifespan and greater in middle age. The same U-shaped trajectory emerged for the <i>Repetition</i>, <i>Routine</i>, and <i>Thoughts/Beliefs</i> factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overall, the FIDL is a valid and reliable multidimensional measure of flexibility, which upholds a clearly defined factor structure and good psychometric properties. It promises to be a valuable clinical and research tool to assess the natural fluctuations in flexibility across the lifespan and departures thereof.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"64 2","pages":"315-329"},"PeriodicalIF":3.1,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjc.12505","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298876","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}
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