Behaviour Research and Therapy最新文献

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The future of the eating disorder field: Inclusive, aware of systems, and personalized 饮食失调领域的未来：包容性、系统意识和个性化

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2024-10-29 DOI: 10.1016/j.brat.2024.104648

Eating disorders are serious psychiatric illnesses associated with large amounts of suffering, high morbidity, and high mortality rates, signifying a clear need for rapid advancements in the underlying science. Relative to other fields of clinical psychological science, the eating disorder field is new. However, despite the fields’ late beginnings, there is growing science in several important areas. The current paper discusses the current literature in three primary areas of importance: (a) diversity and inclusion, (b) systemic and social factors, and (c) treatment personalization. We discuss how these areas have huge potential to push both eating disorder and clinical psychological science in general forward, to improve our underlying understanding of psychological illness, and to enhance treatment access and effectiveness. We call for more research in these areas and end with our vision for the field for the next decade, including areas in need of significant future research.

饮食失调症是一种严重的精神疾病，给患者带来巨大的痛苦，发病率高，死亡率也高，因此显然需要在基础科学方面取得快速进展。与临床心理科学的其他领域相比，进食障碍领域尚属新生事物。然而，尽管该领域起步较晚，但在几个重要领域的科学研究却在不断发展。本文讨论了当前三个重要领域的文献：(a) 多样性和包容性，(b) 系统性和社会因素，以及 (c) 个性化治疗。我们讨论了这些领域如何在推动饮食失调症和临床心理科学向前发展、改善我们对心理疾病的基本理解、提高治疗的可及性和有效性方面具有巨大潜力。我们呼吁在这些领域开展更多研究，并在最后提出了我们对未来十年该领域的展望，包括未来需要开展重大研究的领域。

引用次数: 0

Augmented Depression Therapy for young adults: A mixed methods randomised multiple baseline case series evaluation 针对年轻人的抑郁强化疗法：混合方法随机多基线病例系列评估。

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2024-10-17 DOI: 10.1016/j.brat.2024.104646

Augmented Depression Therapy (ADepT) is an individual psychotherapy for depression, which has been shown to be effective in the general adult population. A randomised multiple baseline case series evaluated the feasibility, acceptability, and effectiveness of ADepT in young adults (aged 20–24). Eleven depressed young adults were recruited from a UK university wellbeing service to receive ADepT during the COVID-19 pandemic, with outcomes evaluated relative to pre-specified continuation targets. All participants received a minimum adequate treatment dose (>60% target); 89% judged ADepT as acceptable and satisfactory and would recommend it to others (>60% target); only 9% showed reliable deterioration for depression or wellbeing (meeting <30% target); and there were no trial- or treatment-related serious adverse events. Qualitative interviews revealed most participants were satisfied with and experienced benefits from ADepT. At post-treatment, reliable improvement was shown by 33% of participants for depression and 67% of participants for wellbeing (not meeting target of both >60%), with medium effect size improvements for depression (g = 0.78) and large effect size improvement for wellbeing (g = 0.93; not meeting target of both >0.80). ADepT is feasible, acceptable, and safe in young adults but may require modification to maximise effectiveness. Further research outside of the COVID-19 pandemic is warranted.

增强型抑郁疗法（ADepT）是一种针对抑郁症的个体心理疗法，已被证明对普通成年人群有效。一项随机多基线病例系列研究评估了 ADepT 在年轻人（20-24 岁）中的可行性、可接受性和有效性。我们从英国一所大学的健康服务机构招募了 11 名抑郁的年轻人，在 COVID-19 大流行期间接受 ADepT 治疗，并根据预先指定的持续目标对治疗效果进行评估。所有参与者都接受了最低足够的治疗剂量（>60%目标值）；89%的人认为ADepT是可接受和令人满意的，并会向他人推荐（>60%目标值）；只有9%的人显示抑郁或健康状况出现可靠的恶化（达到60%目标值），抑郁方面的中等效应改善（g = 0.78）和健康方面的大效应改善（g = 0.93；均未达到>0.80的目标值）。ADepT 在年轻人中是可行的、可接受的和安全的，但可能需要进行修改，以最大限度地提高疗效。有必要在 COVID-19 大流行之外开展进一步研究。

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引用次数: 0

Active contextualization reduces traumatic memory intrusions via memory integration 主动情境化通过记忆整合减少创伤记忆的侵入。

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2024-10-17 DOI: 10.1016/j.brat.2024.104644

Traumatic memory intrusions, the involuntary retrieval of unwanted memories, significantly impact mental health. The dual representation theory proposes that the origin of intrusion lies in the overactivated sensory memory not being integrated with the corresponding contextual memory, highlighting the crucial associations between memory contextualization and intrusion. To test this, our study investigated whether enhancing memory contextualization could effectively reduce intrusion. After experiencing analogue trauma with the trauma film paradigm, 96 healthy participants were randomly allocated to three intervention groups: active contextualization (AC) in which participants actively retrieve and restructure film content, passive contextualization (PC) in which participants passively restudy content-matched pre-contextualized information, and working memory taxation (WM) in which participants performed a working memory dual-task. Diary recordings over the subsequent week revealed a significant reduction in intrusion frequency in the AC group compared to both the PC group and a no-intervention control group. Furthermore, comparing AC with WM, a well-established laboratory intervention on intrusion, established a superior efficacy of the AC intervention in reducing intrusions. Finally, analyses of the explicitly recollected film memories identified the critical element of active contextualization to be memory integration induced by active memory retrieval. Together, our findings suggest that active contextualization causally diminishes intrusions, providing novel insights into the regulation of the contextual memory system in intrusion intervention.

创伤性记忆入侵，即非自愿地检索不想要的记忆，对心理健康有重大影响。双重表征理论认为，入侵的根源在于过度激活的感官记忆没有与相应的情境记忆整合在一起，这凸显了记忆情境化与入侵之间的重要关联。为了验证这一点，我们的研究调查了增强记忆情境化是否能有效减少入侵。96名健康参与者在经历了创伤电影范式的模拟创伤后，被随机分配到三个干预组：主动情境化（AC）组，参与者主动检索和重组电影内容；被动情境化（PC）组，参与者被动地重新学习内容匹配的预情境化信息；工作记忆征税（WM）组，参与者执行工作记忆双重任务。随后一周的日记记录显示，与 PC 组和未干预对照组相比，AC 组的入侵频率明显降低。此外，将 AC 与 WM（一种成熟的实验室入侵干预方法）进行比较后发现，AC 干预方法在减少入侵方面具有更优越的效果。最后，对明确回忆起的电影记忆进行分析后发现，主动情境化的关键因素是主动记忆检索所引起的记忆整合。总之，我们的研究结果表明，主动情境化会因果性地减少闯入，为情境记忆系统在闯入干预中的调节提供了新的见解。

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引用次数: 0

Examining the moderating role of depressive symptoms on the dynamic interplay between cognitive reappraisal and rumination: Evidence from experience sampling 研究抑郁症状对认知重评和反刍之间动态相互作用的调节作用：来自经验取样的证据

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2024-10-16 DOI: 10.1016/j.brat.2024.104645

The dynamic view of emotion regulation (ER) posits that ER is a temporally dynamic process unfolding over time. Cognitive reappraisal and rumination, two extensively investigated ER strategies, are implicated in depression. However, it remains unclear whether these two strategies exhibit reciprocal relations in real-world contexts, and whether such relations vary across baseline depressive symptoms. To address this, we conducted two experience sampling studies and applied residual dynamic structural equation modeling (RDSEM). Results of the RDSEM revealed significant bidirectional associations between cognitive reappraisal and rumination in the Chinese sample, whereas in the Belgian sample, only a unidirectional relationship was found where rumination predicts subsequent cognitive reappraisal. Additionally, both strategies demonstrated stable autoregressive effects. Interestingly, higher depressive symptoms predicted a lower autoregressive effect of cognitive reappraisal within the Chinese sample, while this was not the case in the Belgian sample. These findings highlight the importance of targeting factors such as dynamics in ER and its relationship with depression symptoms.

情绪调节（ER）的动态观点认为，情绪调节是一个随着时间推移而展开的时间动态过程。认知再评价和反刍这两种被广泛研究的情绪调节策略与抑郁症有关。然而，这两种策略在现实世界中是否表现出互为因果的关系，以及这种关系是否随基线抑郁症状的不同而变化，目前仍不清楚。为了解决这个问题，我们进行了两项经验取样研究，并应用了残差动态结构方程模型（RDSEM）。残差动态结构方程模型的结果显示，在中国样本中，认知重评与反刍之间存在显著的双向关系，而在比利时样本中，只发现了反刍预测后续认知重评的单向关系。此外，两种策略都表现出稳定的自回归效应。有趣的是，在中国样本中，抑郁症状越严重，认知重评的自回归效应就越低，而在比利时样本中却并非如此。这些发现凸显了针对 ER 动态性等因素及其与抑郁症状关系的重要性。

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引用次数: 0

Leveraging occasional reinforced extinction via mental imagery of the unconditioned stimulus to optimize extinction learning 通过对无条件刺激的心理想象，利用偶发强化消退来优化消退学习

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2024-10-16 DOI: 10.1016/j.brat.2024.104647

Occasionally presenting the unconditioned stimulus (US) during extinction training (occasional reinforced extinction, ORE) either unpaired or paired with the conditioned stimulus (CS) provides initial evidence for a less pronounced return of fear. However, translating this approach into clinical practice is challenging due to ethical and practical concerns of exposing patients to the original USs. The present study investigated extinction of fear responses in a novel approach employing ORE using vivid fear imagery of the US instead of actually exposing to it. Three experimental groups underwent differential fear conditioning. Subsequently, participants either received a non-reinforced (standard extinction, N = 25), occasional paired (N = 26), or occasional unpaired (N = 25) reinforced extinction training, followed by assessments for spontaneous recovery, reinstatement, and reacquisition of fear responses. Response patterns during spontaneous recovery, reinstatement and reacquisition showed no benefit from either paired or unpaired imaginative ORE. The current findings suggest that incorporating fear imagery of the US in ORE so far does not result in reducing the return of fear. Further investigation is needed to determine whether imaginal ORE with adjustments could still be a readily applicable strategy for translating the ORE approach into clinical practice.

在消退训练（偶发强化消退，ORE）过程中，偶尔出现非条件刺激（US），无论是不与条件刺激（CS）配对还是与条件刺激（CS）配对，都能提供初步证据，证明恐惧的恢复不那么明显。然而，将这种方法转化为临床实践具有挑战性，因为要让患者接触到原始的 USs，在伦理和实践方面都存在顾虑。本研究采用一种新颖的方法，即利用生动的 US 恐惧想象而不是实际暴露于 US，来研究 ORE 对恐惧反应的消减。三个实验组接受了不同的恐惧条件反射。随后，参与者分别接受非强化（标准消退，N = 25）、偶尔配对（N = 26）或偶尔不配对（N = 25）的强化消退训练，然后对恐惧反应的自发恢复、恢复和重新获得进行评估。在自发恢复、恢复和重新获得过程中的反应模式显示，配对或非配对的想象性诱发反应训练均无益处。目前的研究结果表明，将对美国的恐惧想象纳入定向障碍康复训练至今并不能减少恐惧的恢复。我们还需要进一步研究，以确定经过调整的想象性 ORE 是否仍然是将 ORE 方法转化为临床实践的一种适用策略。

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引用次数: 0

Moderators of outcome in self-guided internet-delivered cognitive-behavior therapy for obsessive-compulsive disorder 自我指导的互联网认知行为疗法治疗强迫症效果的调节因素。

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2024-10-15 DOI: 10.1016/j.brat.2024.104643

Internet-delivered cognitive behavioural therapy (ICBT) is an effective treatment for obsessive-compulsive disorder (OCD). Currently there is limited research examining the predictors and moderators of outcome in ICBT for OCD. This study examined moderators of treatment outcome in a sample of 216 individuals who commenced a self-guided ICBT intervention for OCD (Mage = 34.00; SD = 12.57; 72.7% female). The results indicated that those with higher baseline OCD severity, depression severity, and neuroticism had less improvement at post-treatment and follow up (resulting in 40%, 24% and 12% higher symptom severity for every standard deviation increase on the measure at post-treatment and 33%, 17% and 20% higher symptoms at follow up respectively). However, participants with higher baseline treatment expectancy and readiness to reduce rituals and compulsions had better outcomes at post-treatment and three-month follow up (resulting in a 5% and 7% lower symptom severity for every standard deviation increase on the measure at post-treatment and 12% and 12% lower symptoms at follow up respectively). The results have important implications for who may respond best to self-guided ICBT.

网络认知行为疗法（ICBT）是一种治疗强迫症（OCD）的有效方法。目前，对认知行为疗法治疗强迫症疗效的预测因素和调节因素的研究十分有限。本研究对216名强迫症患者（年龄=34.00；标准差=12.57；72.7%为女性）进行了自我指导的ICBT干预，并对治疗结果的调节因素进行了研究。结果表明，基线强迫症严重程度、抑郁严重程度和神经质程度较高的人在治疗后和随访中的改善程度较低（导致治疗后的测量值每增加一个标准差，症状严重程度分别增加 40%、24% 和 12%，随访中症状分别增加 33%、17% 和 20%）。然而，基线治疗期望值和减少仪式感和强迫症准备度较高的参与者在治疗后和三个月随访时的效果更好（治疗后测量值每增加一个标准差，症状严重程度分别降低 5% 和 7%，随访时症状分别降低 12% 和 12%）。这些结果对于哪些人最适合接受自我指导的综合心理治疗具有重要意义。

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引用次数: 0

Happy 100th anniversary, behavior therapy! 行为疗法 100 周年快乐！

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2024-10-15 DOI: 10.1016/j.brat.2024.104642

Georg W Alpers

引用次数: 0

The assessment of gender differences in perceptual fear generalization and related processes 评估感知恐惧泛化及相关过程中的性别差异。

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2024-10-01 DOI: 10.1016/j.brat.2024.104640

In this study we aimed to investigate gender differences in fear generalization tendencies in humans and, inspired by recent findings in animal research, examine whether any such differences could stem from differences in memory precision. Forty men and forty women underwent a differential fear conditioning procedure using geometric shapes as cues. Subsequently, generalized fear responses were assessed across a spectrum of perceptually similar shapes. Throughout generalization testing, perceptual memory accuracy was repeatedly probed using a stimulus recreation task. Using statistical and computational modeling, we found strong evidence for the absence of gender differences in fear learning and generalization behavior. The evidence for gender differences in related processes such as perception and memory was inconclusive. Although some of our findings hinted at the possibility that women may be more perceptive of physical differences between stimuli and have more accurate memory than men, those observations were not consistently replicated across experimental conditions and analytical approaches. Our results contribute to the emerging literature on gender differences in perceptual fear generalization in humans and underscore the need for further systematic research to explore the interplay between gender and mechanisms associated with fear generalization across different experimental contexts.

在这项研究中，我们旨在调查人类在恐惧泛化倾向方面的性别差异，并受动物研究最新发现的启发，研究这种差异是否可能源于记忆精度的不同。四十名男性和四十名女性接受了以几何图形为线索的不同恐惧条件反射程序。随后，在一系列知觉相似的形状中对泛化恐惧反应进行了评估。在整个泛化测试过程中，使用刺激再现任务反复检测知觉记忆的准确性。通过统计和计算建模，我们发现在恐惧学习和泛化行为方面不存在性别差异的有力证据。而在感知和记忆等相关过程中的性别差异则尚无定论。虽然我们的一些发现暗示了女性可能比男性更能感知刺激物之间的物理差异，记忆也更准确，但这些观察结果并没有在不同的实验条件和分析方法中得到一致的重复。我们的研究结果为有关人类感知恐惧泛化的性别差异的新兴文献做出了贡献，并强调了进一步系统研究的必要性，以探索不同实验情境下性别与恐惧泛化相关机制之间的相互作用。

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引用次数: 0

Handholding reduces the recovery of threat memories and magnifies prefrontal hemodynamic responses 手持减少了威胁记忆的恢复，并放大了前额叶血流动力学反应。

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2024-10-01 DOI: 10.1016/j.brat.2024.104641

Human touch is a powerful means of social and affective regulation, promoting safety behaviors. Yet, despite its importance across human contexts, it remains unknown how touch can promote the learning of new safety memories and what neural processes underlie such effects. The current study used measures of peripheral physiology and brain activity to examine the effects of interpersonal touch during safety learning (extinction) on the recovery of previously learned threat. We observed that handholding during extinction significantly reduced threat recovery, which was reflected in enhanced prefrontal hemodynamic responses. This effect was absent when learners were instructed to hold a rubber ball, independent of the presence of their partners. Our findings indicate that social touch contributes to safety learning, potentially influencing threat memories via prefrontal circuitry.

人体接触是一种强大的社会和情感调节手段，能促进安全行为。然而，尽管触摸在各种人类环境中都很重要，但触摸如何促进新的安全记忆的学习，以及这种影响的神经过程是怎样的，至今仍是个未知数。本研究使用外周生理学和大脑活动的测量方法来研究安全学习（消退）过程中的人际触摸对恢复先前学习到的威胁的影响。我们观察到，消退过程中的牵手能显著降低威胁恢复，这反映在前额叶血流动力学反应的增强上。当学习者被指示握住一个橡皮球时，这种效应就不存在了，与他们的伙伴是否在场无关。我们的研究结果表明，社会接触有助于安全学习，有可能通过前额叶回路影响威胁记忆。

引用次数: 0

Internet-based, parent-led cognitive behavioral therapy for autistic youth with anxiety-related disorders: A randomized trial comparing email vs. telehealth support 对患有焦虑症的自闭症青少年进行以互联网为基础、家长为主导的认知行为疗法：比较电子邮件与远程医疗支持的随机试验。

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2024-09-29 DOI: 10.1016/j.brat.2024.104639

This study tested two versions of parent-led, Internet-delivered cognitive behavioral therapy for anxiety among autistic youth; one that provided weekly email support (iCBT-Email), and one that provided alternating bi-weekly emails and video calls (iCBT-Video) across 12 weeks. It was expected that those in the iCBT-Video condition would complete more treatment content, which in turn would lead to more anxiety improvement. Fifty-seven autistic youth (7-15 years-old) with anxiety disorders were randomized to iCBT-Email or iCBT-Video. There were no significant differences in improvement in clinician-rated, child-reported, or parent-reported anxiety severity or functional impairment. Posttreatment response rates were 55% in iCBT-Email and 67% in iCBT-Video. Module completion predicted improved treatment outcome, though there was no difference in module completion across groups. Therapists spent an average of 16.29 min/family/week (SD = 7.11) in the iCBT-Email condition and 24.13 min/family/week (SD = 6.84) in the iCBT-Video condition. Email and telehealth-supported, parent-led iCBT both appear to be effective treatments for autistic youth with anxiety disorders that require reduced therapist effort. Future research should seek novel methods to enhance engagement with iCBT content.

ClinicalTrials.gov identifier

NCT05284435.

本研究测试了两种由家长主导、通过互联网向自闭症青少年提供的焦虑认知行为疗法；一种是每周提供一次电子邮件支持（iCBT-Email），另一种是每两周交替提供一次电子邮件和视频通话（iCBT-Video），为期 12 周。我们预计，iCBT-视频条件下的受试者将完成更多的治疗内容，这反过来又会带来更多的焦虑改善。57 名患有焦虑症的自闭症青少年（7-15 岁）被随机分配到 iCBT-Email 或 iCBT-Video 治疗方案中。在临床医生评分、儿童报告或家长报告的焦虑严重程度或功能障碍方面，两者的改善程度没有明显差异。iCBT-Email和iCBT-Video的治疗后反应率分别为55%和67%。尽管各组的模块完成情况没有差异，但模块完成情况预示着治疗效果的改善。治疗师在 iCBT-Email 条件下平均花费 16.29 分钟/家庭/周（SD = 7.11），在 iCBT-Video 条件下平均花费 24.13 分钟/家庭/周（SD = 6.84）。对于患有焦虑症的自闭症青少年来说，电子邮件和远程医疗支持的、由家长主导的 iCBT 似乎都是有效的治疗方法，而且还能减少治疗师的工作量。未来的研究应寻求新的方法来提高 iCBT 内容的参与度。clinicaltrials.gov 标识符：NCT05284435。

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