Behaviour Research and Therapy最新文献

Objective: Despite increasing prevention efforts, military populations are consistently at increased risk of suicide compared to their civilian counterparts. The Interpersonal Theory of Suicide provides a framework that may help explain increased suicide risk in the military through two key risk factors: perceived burdensomeness (PB) and thwarted belongingness (TB). Thus, the current study aimed to examine the acceptability and effectiveness of Building Stronger Allies (BSA), a 50-min web-based intervention with eight weeks of text-message based prompts for continued engagement, specifically tailored to target PB and TB among active-duty military personnel.

Method: At-risk active-duty soldiers (N = 58) were recruited from an Army base in the southeast. Participant demographics were representative of the active-duty population (male = 72 %; M_age = 26.00, SD = 6.24). Participants were randomized to the BSA or an active health education control intervention and completed assessments at pre-, post-intervention, 1-month, and 3-month.

Results: Participants rated both interventions as highly acceptable. Significant improvement was demonstrated across time in both conditions for TB, Depression, and Suicidal Ideation. However, for PB only individuals in the BSA condition endorsed significant improvement across time (B = -1.750, p = .001). These findings must be considered in light of limitations including small sample size and attrition of 50 % at 3-month.

Conclusions: The current study suggests that BSA is a promising intervention that should be further tested among larger samples of active-duty military personnel, including those not already receiving treatment.

Imagining experiences that might occur in our personal future, i.e., future thinking, is a fundamental ability in healthy psychological functioning. Research over the last few decades indicates that a range of different psychopathologies are related to impairments and biases in future thinking. This includes changes in the content, valence, phenomenological characteristics, and the affective responses that arise from this process. This paper provides a narrative review and description of current evidence of dysfunction in future thinking in psychopathology, and interventions that focus on future thinking among people experiencing psychopathology. Lastly, it provides a range of suggestions for future research to further our understanding of when and how future thinking dysfunction occurs, how it perpetuates psychopathology, and how we can leverage future thinking to improve people's mental health.

Repetitive Negative Thinking (RNT) during pregnancy is a key risk factor for psychopathology in the perinatal period. However, the cognitive mechanisms underlying prenatal RNT remain poorly understood. Recent research has suggested that a tendency to volitionally seek negative rather than positive information (i.e., biased information seeking) may contribute to the formation of more negative prenatal expectations, which in turn predict elevated prenatal RNT. The current study aimed (i) to replicate the findings of a previous study that demonstrated associations between expectations about parenthood, biased information seeking about parenthood-related information, and RNT, and (ii) examine the generality of the observed effects beyond parenthood by investigating whether biased information seeking and negative expectations show similar associations with prenatal RNT across the other two main domains of prenatal RNT, i.e., pregnancy and childbirth. A total of 126 first-time expecting mothers were recruited online and completed a task that assessed biased information seeking, along with questionnaires measuring prenatal RNT and expectations. Replicating previous findings, biased information seeking predicted stronger negative expectations, which in turn predicted higher prenatal RNT. These effects were consistent across the domains of pregnancy, childbirth, and parenthood, supporting the generality of the findings across these domains. These findings have important implications for expectation-focused interventions and cognitive bias modification procedures aimed at reducing prenatal RNT.

Avoiding an imminent threat evokes a feeling of relief, a pleasant feeling that is believed to positively reinforce behavioral avoidance. Preliminary evidence suggests that a strong level of relief is associated with persistent behavioral avoidance, even when there is no realistic threat. The present study examined whether this association extends to avoidance of learnt fear, a behavioral response that avoids a threat-predicting signal. Using a sensory preconditioning procedure, two neutral preconditioning stimuli (PSs) were first paired with two neutral to-be conditioned stimuli (CSs). One CS (CS+) was then paired with an aversive outcome, whereas another CS (CS-) was paired with the absence of the aversive outcome (i.e., safety). In test, participants showed stronger avoidance of learnt fear to the threat-related PS that was associated with the CS+ compared to the safety-related PS that was associated with the CS-. Participants showed higher subjective relief ratings to the threat-related PS than the safety-related PS, presumably due to the omission of the CS+ and the aversive outcome. Of note, participants who reported higher relief ratings also showed more persistent avoidance of learnt fear. Exploratory analyses showed that anxiety severity and intolerance of uncertainty were associated with persistent avoidance of learnt fear, however, these risk factors were not associated with relief. In sum, stronger relief ratings are associated with persistent avoidance of learnt fear.

Eliminating avoidance responses is crucial for the treatment of anxiety disorders. However, previous experimental research indicates that conventional therapies, such as exposure with response prevention, may fail to fully eradicate avoidance when it does not entail a cost. This is evident in studies where individuals, after completing an extinction with response prevention (ERP) phase, are given the opportunity to avoid again. This study investigated the impact of introducing a cost for avoidance on the persistence of avoidance responses after an ERP phase. After fear conditioning, participants underwent an avoidance training phase. Introducing a cost midway through the phase reduced avoidance, suggesting the efficacy of incorporating costs into therapies. Following an ERP phase, the presence or absence of a cost for avoiding was manipulated at test. Extinction with response prevention successfully eliminated costly avoidance responses but was less effective for costless responses. Additionally, intolerance of uncertainty influenced the effect of introducing a cost. These findings suggest that addressing avoidance costs in therapy may help promote more adaptive coping strategies and improve treatment outcomes for anxiety disorders.

Introduction: Young gay and bisexual men (YGBM) face elevated risk for co-occurring mental (e.g., depression, anxiety), behavioral (e.g., substance use), and sexual (e.g., HIV-transmission-risk behavior) health challenges compared to their heterosexual peers. LGBTQ-affirmative cognitive-behavioral therapy (CBT) targets psychosocial pathways through which minority stress is hypothesized to contribute to these disparities. We evaluated whether LGBTQ-affirmative CBT operates through these candidate mechanisms.

Methods: We analyzed trial data from 254 HIV-negative YGBM (ages 18-35; 67.2 % racial/ethnic minority) with mental, behavioral, and/or sexual health concerns randomly assigned to receive LGBTQ-affirmative CBT or one of two control conditions: LGBTQ-affirmative community counseling or HIV testing and counseling. Using baseline and 4-, 8-, and 12-month follow-up assessments, trajectories of identity-specific (i.e., sexual orientation-related acceptance concerns, concealment motivation, and internalized stigma) and general (i.e., assertiveness, emotion regulation difficulties, rumination, self-esteem, and social support) mechanisms were examined. Additionally, latent change score structural equation models tested whether these mechanisms mediated the relative impact of LGBTQ-affirmative CBT (vs. control) on depression, anxiety, substance use, HIV-transmission-risk behavior, or their co-occurrence.

Results: Across the LGBTQ-affirmative CBT and control conditions, participants showed improvements in all mediators and clinical outcomes. While no formal mediation effects were detected, improvements in sexual orientation-related acceptance concerns were associated with improvements in problematic substance use across conditions, suggesting that this process may represent one promising target irrespective of treatment condition.

Conclusion: Identifying treatment mechanisms may help to maximize the efficacy of LGBTQ-affirmative CBT. While no definitive mediators emerged in this study, the consistent improvement across all candidate processes underscores their potential importance. Our findings highlight several challenges in establishing mechanisms of LGBTQ-affirmative CBT, including statistical power, active comparators, and measurement. We provide recommendations for advancing mechanistic tests in future work.