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Why Research From Lower- and Middle-Income Countries Matters to Evidence-Based Intervention: A State of the Science Review of ACT Research as an Example 为什么中低收入国家的研究对循证干预很重要?以 ACT 研究的科学现状回顾为例
IF 3.4 2区 心理学 Q2 PSYCHIATRY Pub Date : 2024-06-13 DOI: 10.1016/j.beth.2024.06.003
Despite the global nature of psychological issues, an overwhelming majority of research originates from a small segment of the world’s population living in high-income countries (HICs). This disparity risks distorting our understanding of psychological phenomena by underrepresenting the cultural and contextual diversity of human experience. Research from lower- and middle-income countries (LMIC) is also less frequently cited, both because it is seemingly viewed as a “special case” and because it is less well known due to language differences and biases in indexing algorithms. Acknowledging and actively addressing this imbalance is crucial for a more inclusive, diverse, and effective science of evidence-based intervention. In this state-of-the-science review, we used a machine learning method to identify key topics in LMIC research on Acceptance and Commitment Therapy (ACT), choosing ACT due to the significant body of work from LMICs. We also examined one indication of study quality (study size), and overall citations. Research in LMICs was often nonindexed, leading to lower citations, but study size could not explain a lack of indexing. Many objectively identified topics in ACT research became invisible when LMIC research was ignored. Specific countries exhibited potentially important differences in the topics. We conclude that strong and affirmative actions are needed by scientific associations and others to ensure that research from LMICs is conducted, known, indexed, and used by CBT researchers and others interested in evidence-based intervention science.
尽管心理问题具有全球性质,但绝大多数研究都源自生活在高收入国家(HICs)的一小部分世界人口。这种差距可能会扭曲我们对心理现象的理解,因为它没有充分反映人类经验的文化和背景多样性。来自中低收入国家(LMIC)的研究成果也较少被引用,这一方面是因为这些研究成果似乎被视为 "特例",另一方面是因为语言差异和索引算法的偏差导致这些研究成果鲜为人知。承认并积极解决这一不平衡问题,对于建立更具包容性、多样性和有效性的循证干预科学至关重要。在这篇科学现状综述中,我们使用机器学习方法确定了低收入国家接受与承诺疗法(ACT)研究中的关键主题,之所以选择ACT,是因为来自低收入国家的大量研究成果。我们还考察了研究质量的一个指标(研究规模)和总体引用情况。低收入国家和地区的研究往往未被收录,因此引用率较低,但研究规模并不能解释未被收录的原因。由于忽视了低收入国家的研究,ACT 研究中许多客观确定的主题变得不为人知。特定国家的研究课题可能存在重大差异。我们的结论是,科学协会和其他机构需要采取有力和积极的行动,以确保来自低收入国家的研究被CBT研究人员和其他对循证干预科学感兴趣的人所开展、了解、索引和使用。
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引用次数: 0
The Cultural Formulation Interview in Case Formulations: A State-of-the-Science Review 案例研究中的文化表述访谈:科学现状综述
IF 3.4 2区 心理学 Q2 PSYCHIATRY Pub Date : 2024-06-05 DOI: 10.1016/j.beth.2024.05.009
The publication of the 16-item Cultural Formulation Interview (CFI) in DSM-5 has initiated a robust line of international scholarship on whether patients and clinicians find it feasible, acceptable, and useful in different practice settings. Studies have routinely concluded that the CFI improves rapport when clinicians use it with patients, though less attention has been focused on how clinicians use information from the CFI in clinical tasks or case formulations. This state-of-the-science review describes the development of the CFI and uses a specific methodology, the state-of-the-art review, to analyze peer-reviewed studies reporting how clinicians have used information from the CFI in clinical tasks, namely diagnostic and treatment planning. Twelve studies met inclusion criteria, with 10 indicating that the CFI was helpful for these tasks. All studies emphasized that the CFI can help clinicians understand the social contexts of patients’ lives. The article concludes with an agenda for future research, such as exploring how preexisting conceptions of culture influence clinical decision making and determining how the CFI affects case formulations.
DSM-5 中公布的 16 项文化表述访谈(CFI)引发了国际学术界对患者和临床医生是否认为该访谈在不同的实践环境中可行、可接受和有用的热烈讨论。研究得出的常规结论是,当临床医生与患者一起使用文化构成访谈时,可以改善双方的关系,但对于临床医生如何在临床任务或病例制定中使用文化构成访谈的信息则关注较少。这篇最新科学综述介绍了 CFI 的发展,并使用一种特定的方法(最新综述)分析了同行评议的研究,这些研究报告了临床医生如何在临床任务(即诊断和治疗计划)中使用 CFI 中的信息。有 12 项研究符合纳入标准,其中 10 项研究表明 CFI 对这些任务有帮助。所有研究都强调,CFI 可以帮助临床医生了解患者生活的社会背景。文章最后提出了未来研究的议程,例如探索已有的文化观念如何影响临床决策,以及确定 CFI 如何影响病例的制定。
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引用次数: 0
State of the Science on Racial Microaggressions 关于种族微词的科学现状
IF 3.4 2区 心理学 Q2 PSYCHIATRY Pub Date : 2024-05-21 DOI: 10.1016/j.beth.2024.05.005
Despite racism being widespread and research evidence of racial disparities growing, those who lack the lived experience of racial oppression often find it difficult to acknowledge this specific phenomena due to in-group bias and social learning, among other reasons. The devaluing of this research topic within psychology and greater scientific skepticism around the construct continues to undermine research on racism and microaggressions. The science of microaggressions has advanced significantly in conceptual and theoretical clarity over the last 15 years. Many initial assumptions about the nature of microaggressions have since been found to be incorrect. This state of the science review addresses these concerns by reviewing the concept, validated measures, physical and mental health impacts, critiques and misinformation, recommended strategies and interventions, and clinical implications. We propose future research directions to help advance the scientific study of racial microaggressions.
尽管种族主义普遍存在,种族差异的研究证据也越来越多,但由于群体内偏见和社会学习等原因,那些缺乏种族压迫生活经验的人往往很难承认这一特定现象。心理学界对这一研究课题的贬低,以及对这一概念的科学怀疑态度,继续破坏着对种族主义和微表达的研究。在过去的 15 年里,微侵害科学在概念和理论清晰度方面取得了长足的进步。许多最初关于微侵害性质的假设后来都被发现是不正确的。这篇科学现状综述通过回顾微侵害的概念、验证措施、对身心健康的影响、批评和错误信息、推荐策略和干预措施以及临床影响,来解决这些问题。我们提出了未来的研究方向,以帮助推进种族微表达的科学研究。
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引用次数: 0
State of the Science: The Hierarchical Taxonomy of Psychopathology (HiTOP) 科学现状:精神病理学层次分类法(HiTOP)
IF 3.4 2区 心理学 Q2 PSYCHIATRY Pub Date : 2024-05-08 DOI: 10.1016/j.beth.2024.05.001
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a dimensional framework for psychopathology advanced by a consortium of nosologists. In the HiTOP system, psychopathology is grouped hierarchically from super-spectra, spectra, and subfactors at the upper levels to homogeneous symptom components and maladaptive traits and their constituent symptoms, and maladaptive behaviors at the lower levels. HiTOP has the potential to improve clinical outcomes by planning treatment based on symptom severity rather than heterogeneous diagnoses, targeting treatment across different levels of the hierarchy, and assessing distress and impairment separately from the observed symptom profile. Assessments can be performed according to this framework with the recently developed HiTOP-Self-Report (HiTOP-SR). Examples of how to use HiTOP in clinical practice are provided for the internalizing spectrum, including the use of the Unified Protocol and other modularized treatments, measurement-based care, psychopharmacology, and in traditionally underserved populations. Future directions are discussed in this State of the Science review including HiTOP’s use in further developing transdiagnostic treatments, extending the model to include other information such as environmental factors, establishing the treatment utility of clinical assessment for the HiTOP-SR, developing new treatments, and disseminating the model.
精神病理学分层分类法(HiTOP)是一个由分类学家组成的联盟提出的精神病理学维度框架。在 HiTOP 系统中,精神病理学是按层次分组的,从高层次的超谱、光谱和子因子到低层次的同质症状成分、适应不良特质及其组成症状和适应不良行为。HiTOP 可以根据症状的严重程度而不是异质性诊断来规划治疗,在层次结构的不同层次上有针对性地进行治疗,并将痛苦和损伤与观察到的症状轮廓分开进行评估,从而有可能改善临床结果。最近开发的 HiTOP-Self-Report(HiTOP-SR)可根据这一框架进行评估。文中举例说明了如何将 HiTOP 应用于内化谱的临床实践,包括使用统一方案和其他模块化治疗方法、基于测量的护理、精神药理学以及传统上服务不足的人群。本科学现状综述讨论了未来的发展方向,包括 HiTOP 在进一步开发跨诊断治疗中的应用、扩展该模型以纳入其他信息(如环境因素)、确定 HiTOP-SR 临床评估的治疗效用、开发新的治疗方法以及推广该模型。
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引用次数: 0
It Is Clean, But It Still Seems Dirty to Me: Implicit and Explicit Truth of Imagined Contamination as an Explanation of Ego-Dystonic Experience of Obsessions 它是干净的,但在我看来仍是肮脏的:想象污染的隐性和显性真相是对自我强迫症体验的解释
IF 3.7 2区 心理学 Q2 PSYCHIATRY Pub Date : 2024-04-29 DOI: 10.1016/j.beth.2024.04.010
Asher Strauss, Snir Barzilay, Jonathan D. Huppert
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引用次数: 0
State of the Science: The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders 科学现状:情绪障碍跨诊断治疗统一方案
IF 3.4 2区 心理学 Q2 PSYCHIATRY Pub Date : 2024-04-29 DOI: 10.1016/j.beth.2024.04.007
Before the development of the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP), evidence-based treatment options for commonly co-occurring anxiety, mood, and related disorders consisted of numerous single-disorder protocols that shared many similarities, reflecting the overlap among these disorders themselves. The UP distilled common elements of cognitive behavioral protocols into a unified intervention directly targeting core temperamental features underlying these disorders of emotion, namely neuroticism and associated emotion dysregulation. The UP has since become a leading “transdiagnostic” treatment for emotional disorders, which is now available in several formats (e.g., individual, group, digital) and has accumulated a strong evidence base, leading to international implementation. There is now also research evidence that the UP can be flexibly applied to a range of clinical presentations, including borderline personality disorder, trauma- and stressor-related disorders, eating disorders, alcohol use disorder, and comorbid chronic physical health conditions. Yet additional research is needed to evaluate the UP in routine clinical settings, with more heterogeneous patient populations, and under circumstances that mirror actual clinical practice. Thus, we must also continue to explore the benefits of large-scale UP training initiatives and implementation in major healthcare systems.
在《情绪障碍跨诊断治疗统一方案》(UP)问世之前,针对常见的焦虑、情绪和相关障碍的循证治疗方案由许多单一障碍方案组成,这些方案有许多相似之处,反映了这些障碍本身的重叠性。UP 将认知行为方案的共同要素提炼为统一的干预措施,直接针对这些情绪障碍的核心气质特征,即神经质和相关的情绪失调。自此以后,UP 成为治疗情绪障碍的一种领先的 "跨诊断 "疗法,目前有多种形式(如个人、小组、数字)可供选择,并积累了强大的证据基础,在国际上得到广泛应用。现在也有研究证据表明,UP 可以灵活应用于一系列临床表现,包括边缘型人格障碍、创伤和压力相关障碍、进食障碍、酒精使用障碍以及合并慢性身体健康问题。然而,我们还需要进行更多的研究,以便在常规临床环境中、在更多异质性患者群体中以及在反映实际临床实践的情况下对 UP 进行评估。因此,我们还必须继续探索大规模 UP 培训计划的益处,并在主要医疗保健系统中实施。
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引用次数: 0
The Interpersonal Theory of Suicide: State of the Science 自杀的人际关系理论:科学现状
IF 3.4 2区 心理学 Q2 PSYCHIATRY Pub Date : 2024-04-24 DOI: 10.1016/j.beth.2024.04.008
In this state-of-the-science review, we summarize the key constructs and concepts within the interpersonal theory of suicide. The state of the scientific evidence regarding the theory is equivocal, and we explore the reasons for and some consequences of that equivocal state. Our particular philosophy of science includes criteria such as explanatory reach and pragmatic utility, among others, in addition to the important criterion of predictive validity. Across criteria, the interpersonal theory fares reasonably well, but it is also true that it struggles somewhat—as does every other theory of suicidality—with stringent versions of predictive validity. We explore in some depth the implications of the theory and its status regarding people who are minoritized. Some implications and future directions for research are also presented.
在这篇科学现状综述中,我们总结了自杀的人际关系理论中的关键结构和概念。有关该理论的科学证据目前尚不明确,我们将探讨这种不明确状态的原因和后果。我们的科学哲学除了预测有效性这一重要标准外,还包括解释力和实用性等标准。在所有标准中,人际关系理论的表现还算不错,但它也确实与其他所有自杀理论一样,在严格的预测有效性标准面前有些力不从心。我们深入探讨了这一理论的影响及其在少数群体中的地位。此外,我们还提出了一些影响和未来的研究方向。
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引用次数: 0
Experiential Avoidance During Mealtimes Among Individuals With Eating Disorders 进食障碍患者进餐时的回避体验
IF 3.4 2区 心理学 Q2 PSYCHIATRY Pub Date : 2024-04-10 DOI: 10.1016/j.beth.2024.04.001

The relationship between negative emotions and avoidance is widely theorized as a bidirectional cycle implicated in a range of psychopathology. Historically, research on this cycle has examined one type of negative emotion: anxiety. Yet, a broader range of internal experiences may be implicated in the maintenance of unhealthy avoidance cycles in psychopathology. This study examines prospective relationships among anxiety, guilt, physical discomfort, and experiential avoidance during mealtimes for individuals with eating disorders (EDs). Participants (N = 108) completed ecological momentary assessments four times a day for 25 days. We computed multilevel models to examine between- and within-person effects of negative emotions and physical discomfort on experiential avoidance. When including guilt and anxiety in one model, guilt, but not anxiety, explained the significant variance in experiential avoidance at the next meal. Mealtime physical discomfort and experiential avoidance evidenced reciprocal prospective relationships. Future research should test whether interventions targeting experiential avoidance and physical discomfort at mealtimes disrupt guilt.

消极情绪与回避之间的关系被广泛认为是一种双向循环,与一系列精神病理学有关。从历史上看,对这种循环的研究只涉及一种负面情绪:焦虑。然而,在心理病理学中,更广泛的内部体验可能与不健康的回避循环的维持有关。本研究探讨了进食障碍(ED)患者在进餐时焦虑、内疚、身体不适和体验性回避之间的前瞻性关系。参与者(108 人)在 25 天内每天完成四次生态瞬间评估。我们计算了多层次模型来研究消极情绪和身体不适对体验性回避的人际和人内影响。当把内疚和焦虑纳入一个模型时,内疚(而不是焦虑)可以解释下一顿饭时体验性回避的显著差异。进餐时的身体不适与体验性回避之间存在互为因果的前景关系。未来的研究应测试针对进餐时体验性回避和身体不适的干预措施是否会破坏内疚感。
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引用次数: 0
Advancing Psychosocial Treatment for Body Dysmorphic Disorder: A State-of-the-Science Review 推进身体畸形障碍(BDD)的社会心理治疗:科学现状综述
IF 3.4 2区 心理学 Q2 PSYCHIATRY Pub Date : 2024-04-10 DOI: 10.1016/j.beth.2024.04.002
Body dysmorphic disorder (BDD) is an underrecognized, challenging illness with severe comorbidities, demanding urgent advancements in treatment strategies. This state-of-the-science review describes current research on existing BDD treatments, beginning with a detailed discussion of cognitive-behavioral therapy (CBT), the primary psychosocial intervention for BDD, and its foundational theories. We emphasize the significant progress in the field, including the efficacy of face-to-face CBT, the promising outcomes of digital interventions for broadening access to care, and emerging treatments that warrant further exploration. The review also addresses the critical gap of targeted interventions for youth, considering the diseases’ typical onset during adolescence. Our review also sheds light on the significant gap in research dedicated to testing these treatments in underserved communities, stressing the importance of including these populations in research and culturally informed and adapted, if necessary, care. The review concludes with recommendations for future directions, outlining areas for ongoing treatment development and research to expand the scope and efficacy of interventions for BDD.
身体畸形障碍(BDD)是一种未被充分认识的、具有挑战性的疾病,并发症严重,急需改进治疗策略。这篇科学现状综述介绍了目前对现有 BDD 治疗方法的研究,首先详细讨论了认知行为疗法 (CBT)(BDD 的主要社会心理干预方法)及其基础理论。我们强调了该领域取得的重大进展,包括面对面 CBT 的疗效、为扩大治疗范围而采取的数字干预措施所取得的可喜成果,以及值得进一步探索的新兴疗法。考虑到这些疾病通常在青少年时期发病,本综述还探讨了针对青少年的干预措施这一关键缺口。我们的综述还揭示了在服务不足的社区测试这些治疗方法的研究中存在的巨大差距,强调了将这些人群纳入研究和文化知情护理的重要性,并在必要时进行调整。综述最后提出了未来发展方向的建议,概述了当前治疗开发和研究的领域,以扩大 BDD 干预措施的范围和疗效。
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引用次数: 0
Meaning-Centered Psychotherapy Versus Cognitive Behavioral Therapy for Cancer Survivors: A Randomized Controlled Trial☆ 针对癌症幸存者的意义中心心理疗法与认知行为疗法:随机对照试验
IF 3.4 2区 心理学 Q2 PSYCHIATRY Pub Date : 2024-04-10 DOI: 10.1016/j.beth.2024.03.005

Meaning-centered psychotherapy (MCP) has been found to be effective in improving meaning in life and increasing fulfillment in participants with cancer. However, to date, no previous studies have compared MCP with evidence-based treatments such as cognitive behavioral therapy (CBT). The aim of this study was to analyze the differential efficacy of MCP, compared to CBT, in participants with cancer. The study is a randomized controlled trial with 76 participants, n = 41 (MCP) and n = 35 (CBT). At posttreatment, the MCP intervention for cancer survivors was more effective than CBT in increasing the presence of meaning in life, purpose and meaning in life, and life goals. Moreover, our results showed that, at posttreatment and the 6-month follow-up, MCP and CBT were similarly effective in improving depression and developing posttraumatic growth. This study suggests that MCP could be more effective than CBT in improving meaning in life, purpose, and life goals, and equally effective as CBT in improving depression and posttraumatic growth, in cancer survivors.

研究发现,以意义为中心的心理疗法(MCP)能有效改善癌症患者的生活意义并提高其成就感。然而,迄今为止,还没有研究将 MCP 与认知行为疗法(CBT)等循证疗法进行过比较。本研究旨在分析 MCP 与 CBT 相比对癌症患者的不同疗效。该研究是一项随机对照试验,共有 76 名参与者,其中 n = 41(MCP)和 n = 35(CBT)。在治疗后,针对癌症幸存者的 MCP 干预在增加生命意义的存在、生命目的和意义以及生命目标方面比 CBT 更有效。此外,我们的研究结果表明,在治疗后和 6 个月的随访中,MCP 和 CBT 在改善抑郁和发展创伤后成长方面的效果相似。这项研究表明,在改善癌症幸存者的人生意义、人生目的和人生目标方面,MCP 比 CBT 更有效,而在改善抑郁和创伤后成长方面,MCP 和 CBT 同样有效。
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引用次数: 0
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Behavior Therapy
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