Cognitive Therapy and Research最新文献

Background

Despite impressive dissemination programs of best-practice therapies, clinical psychology faces obstacles in developing more efficacious treatments for mental disorders. In contrast to other medical disciplines, psychotherapy has made only slow progress in improving treatment outcomes. Improvements in the classification of mental disorders could enhance the tailoring of treatments to improve effectiveness. We introduce a multimodal dynamical network approach, to address some of the challenges faced by clinical research. These challenges include the absence of a comprehensive meta-theory, comorbidity, substantial diagnostic heterogeneity, violations of ergodicity assumptions, and a limited understanding of causal processes.

Methods

Through the application of multimodal dynamical network analysis, we describe how to advance clinical research by addressing central problems in the field. By utilizing dynamic network analysis techniques (e.g., Group Iterative Multiple Model Estimation, multivariate Granger causality), multimodal measurements (i.e., psychological, psychopathological, and neurobiological data), intensive longitudinal data collection (e.g., Ecological Momentary Assessment), and causal inference methods (e.g., GIMME), our approach could improve the comprehension and treatment of mental disorders. Under the umbrella of the systems approach and utilizing e.g., graph theory and control theory, we aim to integrate data from longitudinal, multimodal measurements.

Results

The multimodal dynamical network approach enables a comprehensive understanding of mental disorders as dynamic networks of interconnected symptoms. It dismantles artificial diagnostic boundaries, facilitating a transdiagnostic view of psychopathology. The integration of longitudinal data and causal inference techniques enhances our ability to identify influential nodes, prioritize interventions, and predict the impact of therapeutic strategies.

Conclusion

The proposed approach could improve psychological treatment by providing individualized models of psychopathology and by suggesting individual treatment angles.

Purpose

Research has identified risk factors for suicide, but resilience factors remain unexplored. Our study examined whether stronger emotion malleability beliefs may protect against suicidal ideation (SI) and/or behaviors. We also examined whether emotion malleability beliefs moderates the relation between SI and suicidal behaviors.

Method

Participants (n = 514 partial hospital patients) completed the Theories of Emotion Scale that assessed emotion malleability beliefs and Columbia Suicide Severity Rating Scale interview to measure SI severity and presence of suicidal behaviors.

Results

Consistent with hypotheses, stronger emotion malleability beliefs was associated with lower levels of past-month SI (β = – .12, p = .009) and lower odds of past-month suicidal behaviors (Exp[B] = 1.06, p = .009). However, these effects were no longer significant when controlling for depressive symptoms (β = – .05, p = .29; Exp[B] = 0.85, p = .11). Unexpectedly, past-month SI was a stronger predictor of past-month suicidal behavior at stronger emotion malleability beliefs (b = .87, p < .001) relative to more moderate (b = .65, p < .001) or weaker beliefs (b = .51, p < .001).

Conclusion

Emotion malleability beliefs does not predict suicidality beyond depressive symptoms, but paradoxically may increase risk of suicidal thoughts progressing into suicidal behaviors.

Introduction

Extinction is more vulnerable than the original acquisition memory, as relapse phenomena have systematically shown in the literature with different species and procedures. One strategy potentially useful to mitigate relapse is occasional reinforced extinction (ORE). In contrast to a standard extinction procedure, this strategy consists of the inclusion of a gradual and sparse number of conditioned stimulus–unconditioned stimulus pairings within the extinction phase. Here, we provide a comprehensive review of the available literature on ORE.

Method

We conducted a literature search using three databases (Web of Science, Scopus, and PsycInfo) in July 2022, with an additional citation search. We collected data on different variables of interest, like the relapse phenomena being studied, the outcome measures, or the specific effects obtained.

Results

A total of 350 studies were identified from the main database search, including 10 in the review. Five additional studies from the citation search were also included. The final sample consisted of 15 empirical reports. The observed procedural variability makes it difficult to evaluate the effectiveness of ORE to reduce different forms of relapse as the strategy has not consistently shown a general advantage over standard extinction.

Conclusion

The current evidence assessing the effectiveness of ORE does not appear to be consistent, although there are plenty theoretical studies recommending and discussing the potential effectiveness of such technique. Moreover, the lack of conclusive laboratory evidence calls into question how general the potential benefits of its use in clinical settings would be.

Background

Body Dysmorphic Disorder (BDD) is characterised by an appearance-related cognitive deficit based on distorted ideas and beliefs about one’s own body. These lead to high body dissatisfaction (BD), which affects attention, cognitive processing and behaviour.

Objective

The aim of this review was to systematically examine the evidence for the effectiveness of psychological interventions to improve cognitive impairments in BDD and high BD.

Method

The systematic review report followed the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) statement. The databases Pubmed, WOS, Scopus and EBSCO were searched, yielding a total of 2,153 records. After applying the inclusion and exclusion criteria, 10 articles, published until September 2023, were selected. Eligible studies were assessed for potential risk of bias using the Cochrane risk of bias assessment Review Manager (RevMan) tool for the Randomized Controlled Trials and ROBINS-I tool for non-randomized studies.

Results

The results suggest that psychological interventions can reduce cognitive deficits in BDD. However, the results are supported by a limited number of very diverse studies, conducted with non-clinical, small samples, few sessions and an overall moderate risk of bias.

Conclusions

Further research is needed to confirm the efficacy of psychological interventions on cognitive deficits in BDD.

Switching between different emotion regulation strategies may promote mental health by helping match strategy use to different situations. However, switching strategies very frequently might undermine any given regulation attempt. Individuals with high levels of self-reported neuroticism may have trouble finding the right balance of strategy switching versus persistence given increased negative emotionality and impulsivity; yet it is unclear whether this difficulty is characterized by too much switching, too little switching, or both. As such, we tested whether high or low rates of strategy switching within daily life was associated with trait neuroticism. We quantified how N = 89 college students switched between 20 strategies to regulate positive emotions and 20 strategies to regulate negative emotions when sampled three times daily for 10 days. We tested whether the linear or quadratic effects of strategy switching—when measured across all 20 positive emotion- or all 20 negative emotion-focused strategies, and within smaller classes of related strategies—were associated with neuroticism. We found that lower rates of switching amongst all strategies used to regulate negative emotions, and specifically amongst the adaptive engagement strategies, was associated with higher rates of neuroticism. Moderate switching amongst the aversive cognitive perseveration strategies, by contrast, was associated with higher neuroticism. Switching amongst strategies used to regulate positive emotions was not associated with neuroticism at the overall or class level. This pre-registered study suggests that neuroticism is associated with unique patterns of strategy switching in response to negative—but not necessarily positive—emotions in daily life.

Purpose

We evaluated whether recalling personal achievements would result in an increase in feelings of pride, and if so, whether social anxiety (SA) moderated this relationship.

Methods

Community samples were recruited in 2022 via the online platform Prolific. On average, participants in both studies were aged 32–33, had some post-secondary education, were married/cohabitating and self-identified as White (60%), Asian (10%) or Black (7%). Participants completed measures of state pride and affect before and after different types of writing tasks. Study 1 participants (N = 398) recalled and wrote about either one or three personal achievement experiences. To control for the general effects of self-reflection, Study 2 participants (N = 396) wrote about either achievement or non-achievement-oriented events.

Results

Mixed-model Time X Condition ANCOVAs were conducted with pride as the dependent variable and social anxiety as covariate. Both studies revealed significant increases in pride and positive affect following recall of achievement events, and (Study 2) no significant change following recall of non-achievement events. SA had no significant effect on change in pride, suggesting that SA did not suppress the benefits of achievement recall.

Conclusions

Facilitating recall of personal achievements may help to heighten pride and positive affect regardless of social anxiety level. The results support further research on the role of pride in social anxiety.

Purpose

Reduced motivation to expend cognitive effort is a clinically relevant but understudied feature of depression. Preliminary research indicates that depressed and dysphoric individuals may be less willing to expend cognitive effort for reward than non-depressed individuals. However, the extent to which this is due to reduced expectations of reward, and whether willingness to expend effort can be increased by altering affective expectations of reward, are unknown. The purpose of this study was to examine the effects of dysphoria, anhedonia, and affective expectations on cognitive effort expenditure for reward.

Methods

Dysphoric (n = 85) and non-dysphoric participants (n = 79) were randomly assigned to either a high expectancy condition designed to increase individuals’ expectations of a reward that could be earned during a cognitive effort progressive ratio task or a neutral expectancy condition that did not attempt to alter expectations. Expected pleasure ratings were collected, and then participants completed the cognitive effort progressive ratio task.

Results and Conclusions

The expectancy manipulation was unsuccessful, but we found that dysphoria group interacted with participants’ self-reported expectations of pleasure to predict their cognitive effort expenditure. Within the dysphoric group, higher expectations of pleasure were significantly associated with greater effort. In contrast, within the non-dysphoric group, effort was relatively high regardless of expectations. Anhedonia further moderated this relationship; in the dysphoric group, the relationship between expected pleasure and effort expenditure weakened as anhedonia increased. Implications for the treatment of depression are discussed.

Background

Current models of loneliness emphasise the role of maladaptive cognitions in causing and/or maintaining loneliness. However, standardised paradigms to experimentally examine the role of maladaptive cognition in loneliness are lacking, making it difficult to establish causality. This paper tested a mock online chat paradigm designed to induce changes in negative affect (loneliness, depression, and anxiety), and strength of belief in lonely thoughts, by manipulating comparative and normative fit.

Methods

Participants (N = 59) were randomised into either the loneliness arm (i.e., loneliness induction chat followed by a social connectedness induction chat), or the social connectedness arm (i.e., two separate social connectedness induction chats), and subsequently completed outcome measures.

Results

The experimental paradigm significantly and specifically increased lonely affect; however, this was associated with non-significant changes in strength of belief in lonely thoughts. The social connectedness induction chat led to significant reductions in broad negative affect for both groups, with these effects accruing across chats for participants in the social connectedness arm.

Conclusion

Experimentally manipulating comparative and normative fit to either emphasise differences or similarities between an individual and group members is an effective paradigm for increasing lonely affect or decreasing general negative affect, respectively.