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Safety behavior fading for social anxiety: A randomized controlled trial of a self-monitoring intervention 社交焦虑的安全行为消退:自我监控干预的随机对照试验
IF 4.5 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-10-01 Epub Date: 2025-08-31 DOI: 10.1016/j.janxdis.2025.103068
James M. Zech , Tapan A. Patel , Jesse R. Cougle
Safety behaviors (SBs) are hypothesized to play a key role in social anxiety and present as a viable target of psychosocial treatments. While SB reduction is a component of some cognitive-behavioral therapies for social anxiety, prior research suggests safety behavior fading also represents a viable, standalone digital treatment for social anxiety. The aim of the present study was to test a one-month self-monitoring SB treatment in individuals reporting elevated social anxiety symptoms against a credible control condition. Participants (N = 201) were randomized to either a SB fading condition (n = 99) or an unhealthy behavior fading control (n = 102). Compared to control, SB fading led to lower SB use at post but not one-month follow-up. Contrary to predictions, both conditions saw significant and comparable reductions in social anxiety and related outcomes (depression, loneliness) at posttreatment and follow-up. Treatment credibility and expectancy moderated the effect of condition, such that among participants with more positive beliefs about treatment (after being provided with the rationale), those in the SB condition reported significantly lower follow-up social anxiety than those in control. Further, in the SB condition, both higher social interaction frequency and lower loneliness at baseline were predictive of lower social anxiety at follow-up. Overall, our findings show limitations to SB fading as a standalone intervention and suggest this strategy is more effective among those who interact with others more frequently and who are more confident in this treatment approach. We discuss clinical implications and future research directions, including potential refinements to SB treatment protocols.
安全行为(SBs)被假设在社交焦虑中发挥关键作用,并作为社会心理治疗的可行目标。虽然减少SB是社交焦虑的一些认知行为疗法的一个组成部分,但之前的研究表明,安全行为消退也代表了一种可行的、独立的社交焦虑数字治疗方法。本研究的目的是在可信的对照条件下,对报告社交焦虑症状升高的个体进行为期一个月的自我监测SB治疗。参与者(N = 201)被随机分为两组,一组是SB消退组(N = 99),另一组是不健康行为消退组(N = 102)。与对照组相比,脑缺血消退导致术后脑缺血使用减少,但1个月随访时无此影响。与预测相反,在治疗后和随访中,两种情况下的社交焦虑和相关结果(抑郁、孤独)都有显著和可比的减少。治疗可信度和期望调节了条件的影响,因此在对治疗有更积极信念的参与者中(在提供基本原理后),SB条件下的参与者报告的随访社交焦虑显著低于对照组。此外,在SB条件下,基线时较高的社交互动频率和较低的孤独感预示着随访时较低的社交焦虑。总的来说,我们的研究结果表明SB消退作为单独干预的局限性,并表明这种策略对那些与他人互动更频繁和对这种治疗方法更有信心的人更有效。我们讨论了临床意义和未来的研究方向,包括对SB治疗方案的潜在改进。
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引用次数: 0
Clinician guidance in digital therapeutics for panic disorder: Meta-analytic dissection and implications for regulatory framing and scalable deployment 惊恐障碍数字治疗的临床医生指导:元分析解剖和对监管框架和可扩展部署的影响。
IF 4.5 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-10-01 Epub Date: 2025-09-19 DOI: 10.1016/j.janxdis.2025.103074
Inhye Cho , Byung-Hoon Kim , Hankil Lee , Yun-Kyoung Song , Min Jung Chang , Junhyung Kim , Euna Han

Background

Digital therapeutics (DTx) have emerged as scalable and accessible treatment modalities for panic disorder.

Objective

This study aimed to identify the extent to which clinician guidance impacts the digital intervention effectiveness for panic disorder across multiple clinical outcomes.

Methods

This study included 40 randomized controlled trials of digital intervention for panic disorder published up to March 2025. Eligible studies enrolled adults with a primary diagnosis of panic disorder (with or without agoraphobia) and compared a digital therapeutic intervention against active (therapist-led or treatment-as-usual) or passive (waitlist or no-treatment) controls. Outcomes were the Panic Disorder Severity Scale (PDSS), Agoraphobic Cognitions Questionnaire (ACQ), and Body Sensations Questionnaire (BSQ). Random-effects meta-analyses, subgroup analyses, sensitivity analyses, and mixed-effects meta regressions were conducted. The moderator variables included the comparator type, guidance format (clinician-guidance or self-guided), intervention modality, and region.

Results

Self-guided DTx demonstrated a moderate effect size on PDSS (Hedges’ g =0.31, 95 % confidence interval [CI]: 0.05–0.68), whereas clinician-guided interventions exhibited stronger effects (g =0.95, 95 % CI: 0.44–1.46). These findings indicate that well-structured self-guided interventions can address symptom domains, involving panic frequency and physiological distress. Conversely, cognitive-focused outcome assessment using ACQ and BSQ revealed that only clinician-guided interventions yielded statistically significant and clinically meaningful improvements (ACQ: g =0.46, 95 % CI: 0.15–0.76; BSQ: g =0.67, 95 % CI: 0.30–1.05), whereas self-guided formats exhibited negligible effects (ACQ: g =0.11; BSQ: g =0.27).

Conclusions

This meta-analysis revealed that self-guided digital interventions effectively reduce the overall symptom severity in panic disorder, whereas clinician involvement exerts a notably stronger influence on cognition-related outcomes. These findings support a domain-specific and context-sensitive understanding of guidance. Accordingly, the DTx design and policy should match the mechanistic pathways through which psychological change will occur.
背景:数字疗法(DTx)已成为可扩展和可获得的恐慌障碍治疗方式。目的:本研究旨在确定临床医生指导在多大程度上影响了惊恐障碍的多种临床结果的数字化干预效果。方法:本研究纳入截至2025年3月发表的40项数字干预惊恐障碍的随机对照试验。符合条件的研究招募了初步诊断为惊恐障碍(有或没有广场恐怖症)的成年人,并将数字治疗干预与主动(治疗师主导或照常治疗)或被动(等候名单或无治疗)对照进行比较。结果为惊恐障碍严重程度量表(PDSS)、广场恐惧症认知问卷(ACQ)和身体感觉问卷(BSQ)。进行随机效应meta分析、亚组分析、敏感性分析和混合效应meta回归。调节变量包括比较者类型、指导形式(临床指导或自我指导)、干预方式和地区。结果:自我引导的DTx对PDSS表现出中等效应(Hedges' g =0.31, 95 %置信区间[CI]: 0.05-0.68),而临床指导的干预表现出更强的效应(g =0.95, 95 % CI: 0.44-1.46)。这些发现表明,结构良好的自我指导干预可以解决症状领域,包括恐慌频率和生理困扰。相反,使用ACQ和BSQ进行的以认知为中心的结果评估显示,只有临床指导的干预才能产生具有统计学意义和临床意义的改善(ACQ: g =0.46, 95 % CI: 0.15-0.76; BSQ: g =0.67, 95 % CI: 0.30-1.05),而自我指导的干预效果可以忽略(ACQ: g =0.11; BSQ: g =0.27)。结论:本荟萃分析显示,自我指导的数字干预有效地降低了恐慌障碍的整体症状严重程度,而临床医生的参与对认知相关结果的影响明显更强。这些发现支持对指导的特定领域和上下文敏感的理解。因此,DTx的设计和政策应该与心理变化发生的机制途径相匹配。
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引用次数: 0
The screen for child anxiety related emotional disorders scale: A longitudinal validation study based on Chinese children and adolescents 儿童焦虑相关情绪障碍量表的筛选:基于中国儿童和青少年的纵向验证研究
IF 4.5 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-10-01 Epub Date: 2025-09-18 DOI: 10.1016/j.janxdis.2025.103072
Xiang Li, Daniel T.L. Shek, Xintong Zhang
As anxiety disorders are common and clinically significant psychiatric disorders in children and adolescents linked to a broad spectrum of psychiatric problems, we need valid assessment instruments of anxiety. The Screen for Child Anxiety Related Emotional Disorders (SCARED) is widely used to assess anxiety symptoms. However, its factor structure remains debated, and its psychometric properties are underexplored in China. This study examined the factor structure of the SCARED and its measurement invariance across gender, age, and time among Chinese students. Specifically, this study used a two-wave longitudinal design, with a six-month interval (Time 1: December 2019–January 2020; Time 2: June 2020–July 2020). Data included 6176 children and adolescents aged 8–19 years (51.6 % boys; mean age = 11.52, SD = 1.62) from Sichuan, China. Confirmatory factor analyses supported a five-factor model as the best fit. Measurement invariances across gender, age, and time were established at the configural, metric, scalar, error variance, factor variance, and factor covariance levels, as supported by changes in the comparative fit index (CFI ≤ 0.004) and root mean square error of approximation (RMSEA ≤ 0.002). Furthermore, structured means modeling analyses showed that girls experienced more anxiety than did boys. Children experienced higher separation anxiety but lower general anxiety and school phobia than did adolescents. Moreover, participants experienced fewer anxiety symptoms at Time 2. Overall, the SCARED was valid and reliable for measuring anxiety symptoms in Chinese children and adolescents, confirming its utility as an objective outcome measure.
由于焦虑症在儿童和青少年中是一种常见且临床意义重大的精神疾病,与广泛的精神问题有关,我们需要有效的焦虑评估工具。儿童焦虑相关情绪障碍筛查(fear)被广泛用于评估焦虑症状。然而,其因素结构仍存在争议,其心理测量学特征在中国尚未得到充分探索。本研究考察了中国学生恐惧心理的因素结构及其在性别、年龄和时间上的测量不变性。具体来说,本研究采用了两波纵向设计,间隔6个月(时间1:2019年12月- 2020年1月;时间2:2020年6月- 2020年7月)。数据包括来自中国四川的6176名8-19岁的儿童和青少年(51.6 %男孩,平均年龄= 11.52,SD = 1.62)。验证性因子分析支持五因子模型为最佳拟合。通过比较拟合指数(CFI≤0.004)和近似均方根误差(RMSEA≤0.002)的变化,在构型、度量、标量、误差方差、因子方差和因子协方差水平上建立跨性别、年龄和时间的测量不变性。此外,结构化均值模型分析显示,女孩比男孩更焦虑。与青少年相比,儿童经历了更高的分离焦虑,但总体焦虑和学校恐惧症较低。此外,参与者在时间2时的焦虑症状较少。总的来说,在测量中国儿童和青少年的焦虑症状时,scare是有效和可靠的,证实了它作为一种客观结果测量的效用。
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引用次数: 0
The role of tonic immobility during re-experiencing trauma in PTSD treatment 强直静止在创伤再体验治疗中的作用
IF 4.5 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-10-01 Epub Date: 2025-08-10 DOI: 10.1016/j.janxdis.2025.103059
Nadine C. van der Burg , Muriel A. Hagenaars , Ad de Jongh , Agnes van Minnen
Tonic immobility (TI) is a profound paralysis that may occur during extreme stress. Previous studies have found that TI during trauma was associated with poorer recovery from posttraumatic stress disorder (PTSD). Importantly, TI can re-occur during re-experiencing the trauma (TIre-exp). It is unclear whether TIre-exp also hinders recovery from PTSD or declines along with other PTSD symptoms after treatment. We examined whether pre-treatment self-reported TIre-exp would predict PTSD symptoms after trauma-focused treatment, including related constructs as depression and dissociation. and investigated pre- to post-treatment changes in TIre-exp. We also explored individual differences in TIre-exp course. A total of 257 patients with PTSD, referred to a clinic for intensive trauma-focused therapy, completed measures for PTSD symptoms and TIre-exp at pre- and posttreatment, and potential confounding variables (dissociative tendencies, somatoform dissociation, dissociative subtype, and depression) at pre-treatment. Higher pre-treatment TIre-exp predicted elevated post-treatment PTSD symptoms, but not after controlling for potentially confounding constructs. Overall, TIre-exp decreased from pre- to post-treatment, and a greater decrease in TIre-exp was associated with a greater decrease in PTSD symptoms. However, four distinct clusters could be identified, which differed in TIre-exp course: High-stable, High-decrease, Moderate and Low TIre-exp. End-state was worse for patients in the High-stable and Moderate clusters. Thus, in the general sample, pre-treatment TIre-exp was not associated with reduced recovery, and TIre-exp generally decreased after treatment, suggesting that TIre-exp may be related to the PTSD symptomatology, responding well to trauma-focused CBT treatment. However, TIre-exp may not decline in specific patient groups. Future research may address how TIre-exp can be targeted for these patients.
强直性静止(TI)是一种在极端压力下可能发生的深度瘫痪。先前的研究发现,创伤期间的TI与创伤后应激障碍(PTSD)的较差恢复有关。重要的是,在重新经历创伤(轮胎-exp)时,TI可以再次发生。目前尚不清楚TIre-exp是否也会阻碍PTSD的恢复,或在治疗后随着其他PTSD症状一起下降。我们研究了治疗前自我报告的TIre-exp是否能预测创伤性治疗后的PTSD症状,包括抑郁和分离等相关构念。并研究了TIre-exp处理前后的变化。我们还在TIre-exp课程中探讨了个体差异。共有257名PTSD患者被转介到一家诊所接受强化创伤治疗,在治疗前和治疗后完成PTSD症状和TIre-exp的测量,并在治疗前完成潜在的混淆变量(分离倾向、躯体形式分离、分离亚型和抑郁)。较高的治疗前TIre-exp预测了治疗后PTSD症状的升高,但在控制了潜在的混杂因素后则不然。总体而言,TIre-exp从治疗前到治疗后下降,并且TIre-exp的更大下降与创伤后应激障碍症状的更大减少有关。然而,在不同的轮胎经验过程中,可以识别出四个明显的集群:高稳定、高减少、中等和低轮胎经验。高稳定组和中度组患者的终末状态更差。因此,在一般样本中,治疗前的TIre-exp与恢复降低无关,治疗后的TIre-exp普遍下降,提示TIre-exp可能与PTSD症状有关,对创伤性CBT治疗反应良好。然而,在特定的患者群体中,TIre-exp可能不会下降。未来的研究可能会解决TIre-exp如何针对这些患者。
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引用次数: 0
Predicting anxiety symptoms through gaze-directed attention: A mobile eye-tracking study of adolescents during a real-world speech task 通过注视引导注意力预测焦虑症状:在现实世界的言语任务中对青少年的移动眼动追踪研究
IF 4.5 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-10-01 Epub Date: 2025-08-14 DOI: 10.1016/j.janxdis.2025.103058
Emily Hutchinson , Erica Huynh , Mary Woody , Dev Chopra , Amelia Lint , Enoch Du , Kristy Benoit Allen , Cecile Ladouceur , Jennifer Silk
Adolescence is a key period in which anxiety symptoms dramatically increase, particularly among adolescent girls. Identifying potentially-modifiable risk factors that contribute to anxiety symptoms may be critical to mitigate anxiety symptoms and disorders among youth. Attention biases are one set of cognitive risk factors implicated in the development and maintenance of anxiety disorders. Yet previous research remains mixed as to what pattern of attention bias characterizes adolescents at-risk for developing anxiety. Further, prior literature has largely relied on indirect measures of attention (e.g., reaction time) and tasks with low ecological validity. The present study investigated how attention to social evaluative feedback contributed to concurrent and prospective anxiety symptoms in adolescent girls (n = 90, baseline Mage = 12.31, SD =.83). The present study used a novel speech task and mobile eye-tracking technology to assess gaze-directed attention in an ecologically valid context that adolescents encounter daily. We hypothesized that adolescents who engage in vigilance, avoidance, and the combination of vigilance-avoidance of potentially critical social evaluative feedback would report greater concurrent and prospective anxiety symptoms. We also explored the association between gaze-directed attention to positive social feedback. Contrary to our hypotheses, adolescents who exhibited both initial and sustained avoidance of potentially critical social feedback reported the greatest anxiety three-years later, controlling for baseline anxiety symptoms. Findings highlight the importance of avoidance in real-world socially threatening scenarios in contributing to and maintaining anxiety. Findings also highlight the value of studying attention biases that contribute to anxiety symptoms among adolescents using reliable methods and in real-world contexts.
青春期是焦虑症状急剧增加的关键时期,特别是在青春期女孩中。确定导致焦虑症状的潜在可改变的风险因素可能对减轻青少年的焦虑症状和障碍至关重要。注意偏差是一组涉及发展和维持焦虑症的认知风险因素。然而,之前的研究仍然是混合的,关于什么样的注意力偏差模式是青少年发展焦虑风险的特征。此外,先前的文献在很大程度上依赖于注意力的间接测量(如反应时间)和低生态效度的任务。本研究调查了对社会评价反馈的关注对青春期女孩并发和预期焦虑症状的影响(n = 90,基线Mage = 12.31, SD = 0.83)。本研究使用一种新颖的语音任务和移动眼动追踪技术来评估青少年在生态有效的环境中每天遇到的凝视注意力。我们假设,对潜在的批判性社会评价反馈保持警惕、回避以及警惕-回避结合的青少年会报告更大的并发和预期焦虑症状。我们还探讨了注视导向注意力与积极社会反馈之间的关系。与我们的假设相反,在控制基线焦虑症状的情况下,表现出最初和持续回避潜在批评性社会反馈的青少年在三年后报告了最大的焦虑。研究结果强调了在现实世界的社会威胁情境中,回避在促进和维持焦虑方面的重要性。研究结果还强调了使用可靠的方法和在现实环境中研究导致青少年焦虑症状的注意力偏差的价值。
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引用次数: 0
Assessing reliable change, MCID, treatment response, and remission using the Pediatric Anxiety Rating Scale (PARS) in youth with anxiety disorders 使用儿童焦虑评定量表(PARS)评估青少年焦虑症的可靠变化、MCID、治疗反应和缓解
IF 4.5 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-10-01 Epub Date: 2025-09-11 DOI: 10.1016/j.janxdis.2025.103070
Matti Cervin , Philip C. Kendall , John C. Piacentini , Elizabeth A. Gosch , Jeffrey J. Wood , Sophie C. Schneider , Alison Salloum , Boris Birmaher , Andrew G. Guzick , David Mataix-Cols , Eric A. Storch
Youth anxiety disorders are common and heterogeneous. The Pediatric Anxiety Rating Scale (PARS) is a clinician-administered tool designed to assess overall anxiety severity, independent of specific symptoms. The thresholds on PARS for the reliable change index (RCI), the minimal clinically important difference (MCID), treatment response, and full and partial remission remain unclear. Using the Clinical Global Impression (CGI) scales and diagnostic interviews as benchmark measures, several thresholds for the 6-item PARS were estimated using data from 904 youth with anxiety disorders, of which 36 % had an autism diagnosis. Data were drawn from 9 clinical trials conducted in the United States. Threshold accuracy was evaluated in a holdout sample and in an independent Swedish sample (n = 49). The reliable change index (RCI) was 3.39 points. A raw score reduction of ≥ 4 points or a ≥ 20 % reduction best defined the MCID. A raw score reduction of ≥ 8 points or a ≥ 43 % reduction best defined treatment response. Scores of 0–10 after treatment accurately defined full and partial remission, and scores of 0–5 defined full remission. Threshold accuracies ranged from 74–91 % in the holdout and 67–78 % in the Swedish sample. Treatment response accuracy was similar across samples, while MCID accuracy was lower in the Swedish sample. Similar cutoffs emerged in youth with and without autism and across age groups and genders. Threshold accuracies for the 5- and 7-item PARS versions were comparable to the 6-item version. This study establishes response and remission thresholds for PARS that are applicable across age groups, genders, and autism status. We advise against using the RCI as it does not exceed the MCID.
青少年焦虑症是常见的,也是异质性的。儿童焦虑评定量表(PARS)是一种临床医生管理的工具,旨在评估整体焦虑严重程度,独立于特定症状。PARS的可靠变化指数(RCI)、最小临床重要差异(MCID)、治疗反应以及完全和部分缓解的阈值仍不清楚。使用临床总体印象(CGI)量表和诊断访谈作为基准测量,使用904名患有焦虑症的青少年的数据估计了6项PARS的几个阈值,其中36% %被诊断为自闭症。数据来自于在美国进行的9项临床试验。阈值准确性在一个不含样本和一个独立的瑞典样本中进行评估(n = 49)。可靠变化指数(RCI)为3.39点。原始评分降低≥ 4分或≥ 20 %是MCID的最佳定义。原始评分降低≥ 8分或降低≥ 43 %为最佳治疗反应定义。治疗后0-10分准确定义完全缓解和部分缓解,0-5分定义完全缓解。阈值准确度范围从74-91 %在坚持和67-78 %在瑞典样本。不同样本的治疗反应准确性相似,而瑞典样本的MCID准确性较低。在有自闭症和没有自闭症的年轻人中,以及在不同年龄组和性别中,也出现了类似的截止点。5项和7项PARS版本的阈值准确性与6项版本相当。本研究建立了适用于不同年龄组、性别和自闭症状态的PARS的反应和缓解阈值。我们不建议使用RCI,因为它不超过MCID。
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引用次数: 0
Assessing executive functioning in individuals with social anxiety disorder (SAD) across the lifespan: A systematic literature review and meta-analysis 评估社交焦虑障碍(SAD)个体的执行功能:一项系统的文献回顾和荟萃分析
IF 4.5 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-10-01 Epub Date: 2025-07-25 DOI: 10.1016/j.janxdis.2025.103056
Alexandra A. Harrison, Lan Nguyen, Karen Murphy, David Neumann
Social anxiety disorder is a pervasive clinical disorder characterised by intense fear and/or avoidance of one or more social situations, and has been linked to deficits in executive functioning performance. However, methodological differences and mixed results have made it difficult to draw definitive conclusions from individual studies. The current systematic review and meta-analysis collated the results from 49 studies to examine the link between social anxiety disorder and executive functioning across the lifespan. Findings revealed that individuals with social anxiety performed significantly worse than healthy controls or low social anxiety groups on measures of executive functioning (r = -.15), specifically cognitive flexibility (r = -.20), inhibitory control (r = -.18), and global executive functioning (r = -.17). No significant association was evident between working memory and social anxiety (r = -.06). In addition, the type of measure (self-report vs cognitive task) moderated the relationship between social anxiety and executive functioning. Although age did not moderate the overall relationship, the association between the individual domains of executive functioning and social anxiety differed between youth and adults, which may reflect the different developmental timelines between the domains across the lifespan. The findings offer valuable insight into our understanding of the development of executive functions for individuals with social anxiety and could assist with forming new strategies or interventions to improve daily functioning in this clinical population.
社交焦虑障碍是一种普遍的临床障碍,其特征是对一种或多种社交场合的强烈恐惧和/或回避,并与执行功能表现的缺陷有关。然而,方法上的差异和结果的混杂使得很难从个别研究中得出明确的结论。目前的系统回顾和荟萃分析整理了49项研究的结果,以检验社交焦虑障碍与一生中执行功能之间的联系。研究结果显示,社交焦虑个体在执行功能(r = - 0.15),特别是认知灵活性(r = - 0.20)、抑制控制(r = - 0.18)和整体执行功能(r = - 0.17)方面的表现明显差于健康对照组或低社交焦虑组。工作记忆与社交焦虑无显著相关性(r = - 0.06)。此外,测量类型(自我报告vs认知任务)调节了社交焦虑和执行功能之间的关系。虽然年龄并没有调节整体关系,但执行功能的各个领域与社交焦虑之间的关联在青少年和成年人之间存在差异,这可能反映了在整个生命周期中,这些领域之间不同的发展时间表。这些发现为我们理解社交焦虑症患者执行功能的发展提供了有价值的见解,并有助于形成新的策略或干预措施,以改善临床人群的日常功能。
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引用次数: 0
Intensive 7-day internet-delivered cognitive behavioural therapy for social anxiety disorder: A randomized controlled trial 强化7天网络认知行为疗法治疗社交焦虑症:一项随机对照试验
IF 4.5 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-10-01 Epub Date: 2025-09-18 DOI: 10.1016/j.janxdis.2025.103073
Kayla R. Steele , Emily Upton , Monique Holden , Amy Regan , Matthew J. Coleshill , Sophie Li , Amy E. Joubert , Alison E.J. Mahoney , Michael Millard , Jill M. Newby
This is the first randomised controlled trial (RCT) to examine the efficacy of intensive internet-delivered CBT (iCBT) for social anxiety disorder (SAD). Adults (mean age: 44.77 years, 75.4 % female) diagnosed with SAD were randomly allocated to iCBT (n = 33) or a waitlist control group (WLC; n = 28). The iCBT group received a clinician-guided, six lesson program delivered online over seven days. Participants completed self-report measures of social anxiety and depression symptoms, and functional impairment at two- (post-treatment) and six-weeks post-baseline (one-month follow-up), and a diagnostic interview to assess SAD and major depressive disorder (MDD) at baseline and one-month follow-up. The iCBT group reported significantly lower social anxiety symptoms (Hedges’ g’s > .96), and functional impairment at post and one-month follow-up (g’s > .59), but there were no significant differences in depression symptoms (g’s = .42). Participants in the iCBT group were less likely to continue to meet criteria for SAD (47.6 %) at follow-up compared to WLC (96.4 %). Adherence (83.9 % completion) and program satisfaction (85.2 % reported being ‘mostly’ or ‘very satisfied’) were promising. Delivering iCBT over an intensive treatment period is feasible and acceptable to participants with SAD and showed promise for reducing social anxiety and functional impairment. Further research is needed to compare intensive iCBT with active control groups, using a larger and more diverse sample and longer-term outcomes.
这是首个随机对照试验(RCT),旨在检验强化网络CBT (iCBT)治疗社交焦虑症(SAD)的疗效。诊断为SAD的成年人(平均年龄:44.77岁,75.4 %为女性)被随机分配到iCBT组(n = 33)或等候名单对照组(n = 28)。iCBT小组接受了一个临床医生指导的、为期七天的六课在线课程。参与者在治疗后2周和基线后6周(随访1个月)完成了社交焦虑、抑郁症状和功能障碍的自我报告,并在基线和1个月随访时完成了评估SAD和重度抑郁症(MDD)的诊断性访谈。iCBT组报告的社交焦虑症状显著降低(赫奇斯的 >; )。96),工作后和随访1个月的功能障碍(g 's >; )。59),但抑郁症状无显著差异(g 's = .42)。与WLC(96.4 %)相比,iCBT组的参与者在随访时继续满足SAD标准的可能性较小(47.6 %)。依从性(83.9 %完成)和项目满意度(85.2% %报告“大部分”或“非常满意”)很有希望。在强化治疗期间提供iCBT对SAD患者是可行和可接受的,并显示出减少社交焦虑和功能障碍的希望。需要进一步的研究来比较强化iCBT与积极对照组,使用更大、更多样化的样本和更长期的结果。
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引用次数: 0
Prevalence and correlates of alcohol, cannabis, and tobacco use disorder in DSM-5 generalized anxiety disorder: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions-III DSM-5广泛性焦虑障碍中酒精、大麻和烟草使用障碍的患病率及其相关性:来自全国酒精及相关疾病流行病学调查的结果- iii
IF 4.5 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-10-01 Epub Date: 2025-08-14 DOI: 10.1016/j.janxdis.2025.103060
James M. Zech, Tapan A. Patel, Jesse R. Cougle
Substance use disorders have been linked to Generalized Anxiety Disorder (GAD), though much of this research predates DSM-5 diagnostic criteria. Further, little prior work has examined the demographic correlates of specific substance use disorders among individuals with GAD. These demographic correlates, as well as the presence of comorbid substance use disorder, may also impact treatment seeking in individuals with GAD. In the present study, we explored the relationship between GAD and common substance use disorders (Alcohol Use Disorder, Cannabis Use Disorder, and Tobacco Use Disorder), as well as the demographic factors associated with these disorders among individuals with GAD in a large, nationally representative sample. We also tested whether each of these substance use disorders were associated with GAD-related treatment seeking. Controlling for demographics and comorbidities, lifetime GAD was positively associated with lifetime Alcohol and Cannabis Use Disorder, but not Tobacco Use Disorder, whereas past-year GAD was positively associated with past year Cannabis and Tobacco Use Disorder but not past year Alcohol Use Disorder. Lastly, lifetime Alcohol Used Disorder but not Cannabis or Tobacco Use Disorder was associated with higher rates of GAD-related treatment seeking. Collectively, these findings reflect an updated examination of GAD and disordered substance use using DSM-5 diagnostic criteria and indicate the importance substance use comorbidities in the context of GAD.
物质使用障碍与广泛性焦虑症(GAD)有关,尽管这方面的许多研究早于DSM-5的诊断标准。此外,很少有先前的工作研究了广泛性焦虑症患者中特定物质使用障碍的人口学相关性。这些人口统计学相关性,以及共病物质使用障碍的存在,也可能影响广泛性焦虑症患者的治疗寻求。在本研究中,我们探讨了广泛性焦虑症与常见物质使用障碍(酒精使用障碍、大麻使用障碍和烟草使用障碍)之间的关系,以及与广泛性焦虑症患者中这些疾病相关的人口统计学因素。我们还测试了这些物质使用障碍是否与gad相关的治疗寻求有关。控制人口统计学和合并症,终生广泛性焦虑症与终生酒精和大麻使用障碍呈正相关,但与烟草使用障碍无关,而过去一年广泛性焦虑症与过去一年大麻和烟草使用障碍呈正相关,但与过去一年酒精使用障碍无关。最后,终生酒精使用障碍(而非大麻或烟草使用障碍)与较高的gad相关治疗寻求率相关。总的来说,这些发现反映了使用DSM-5诊断标准对广泛性焦虑症和药物使用紊乱的最新检查,并表明了药物使用合并症在广泛性焦虑症背景下的重要性。
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引用次数: 0
Corrigendum to “Efficacy of imagery rescripting in treating mental disorders associated with aversive memories – An updated meta-analysis” [Journal of Anxiety Disorders 99 (2023) 102772] “意象重写在治疗与厌恶记忆相关的精神障碍中的功效——一项更新的荟萃分析”的更正[焦虑障碍杂志99(2023)102772]。
IF 4.5 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-10-01 Epub Date: 2025-09-19 DOI: 10.1016/j.janxdis.2025.103071
Ahlke Kip , Luisa Schoppe , Arnoud Arntz , Nexhmedin Morina
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引用次数: 0
期刊
Journal of Anxiety Disorders
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