Behaviour Research and Therapy最新文献_第2页

Circadian and gut–brain axis modulation is associated with neuroimmune and symptom recovery after rectal cancer surgery: An exploratory randomized controlled trial 昼夜节律和肠-脑轴调节与直肠癌手术后神经免疫和症状恢复相关：一项探索性随机对照试验

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-12-17 DOI: 10.1016/j.brat.2025.104943

Shengjie Pan , Gang Wang

Background

Disruption of circadian and neuroimmune regulation after rectal cancer surgery contributes to psychological distress, inflammation, and impaired recovery. This exploratory randomized controlled trial evaluated whether a perioperative multicomponent behavioral program targeting circadian and gut–brain processes was associated with improvements in neuroimmune profiles and symptom outcomes.

Methods

A total of 184 patients with stage I–III low rectal cancer undergoing ultra-low anterior resection were randomized to receive either standard ERAS care or an integrative perioperative intervention that combined emotion-regulation strategies (mindfulness-based stress reduction, heart-rate-variability biofeedback, neurofeedback) with structured sleep and circadian therapy (cognitive behavioral therapy for insomnia, controlled-release melatonin, circadian scheduling). Co-primary outcomes were depressive symptoms (Beck Depression Inventory-II) and sleep quality (Pittsburgh Sleep Quality Index) at 6 months. Secondary outcomes included inflammatory markers (C-reactive protein, interleukin-6, tumor necrosis factor-α), gastrointestinal recovery indices, and skeletal muscle index (SMI). Disease-free and overall survival were examined as pre-specified exploratory endpoints.

Results

Compared with standard care, the integrative intervention was associated with greater 6-month improvements in depressive symptoms and sleep quality (both p < 0.01), lower postoperative inflammation (e.g., POD7 interleukin-6: 39.7 vs 52.3 pg/mL; p < 0.001), and faster gastrointestinal recovery. Preservation of SMI at 12 months was associated with improved disease-free survival (hazard ratio 0.51, 95 % CI 0.29–0.92; p = 0.027). Two-year disease-free survival showed an exploratory signal favoring the intervention (89.7 % vs 74.0 %; hazard ratio 0.46, 95 % CI 0.23–0.93), although survival analyses were not powered for definitive inference.

Conclusions

Perioperative modulation of circadian and gut–brain processes was associated with improvements in depressive symptoms, sleep quality, postoperative inflammatory profiles, and functional recovery. Survival findings represent preliminary exploratory signals and require confirmation in larger, adequately powered randomized trials.

直肠癌手术后昼夜节律和神经免疫调节的中断会导致心理困扰、炎症和恢复受损。这项探索性随机对照试验评估了围手术期针对昼夜节律和肠-脑过程的多组分行为计划是否与神经免疫谱和症状结果的改善有关。方法184例接受超低前部切除术的I-III期低位直肠癌患者随机接受标准ERAS护理或综合围手术期干预，该干预将情绪调节策略（基于正念的减压、心率变异性生物反馈、神经反馈）与结构化睡眠和昼夜节律治疗（失眠认知行为治疗、控释褪黑素、昼夜节律计划）相结合。共同主要结局是6个月时的抑郁症状（贝克抑郁量表- ii）和睡眠质量（匹兹堡睡眠质量指数）。次要结局包括炎症标志物（c反应蛋白、白细胞介素-6、肿瘤坏死因子-α）、胃肠道恢复指数和骨骼肌指数（SMI）。无病生存期和总生存期作为预先指定的探索性终点进行检查。结果与标准治疗相比，综合干预与6个月后抑郁症状和睡眠质量的改善（p < 0.01）、术后炎症（例如，POD7白介素-6:39.7 vs 52.3 pg/mL; p < 0.001）和更快的胃肠道恢复相关。12个月时SMI的保存与无病生存率的提高相关（风险比0.51,95% CI 0.29-0.92; p = 0.027）。2年无病生存率显示了支持干预的探索性信号（89.7% vs 74.0%；风险比0.46,95% CI 0.23-0.93），尽管生存分析不能提供明确的推断。结论手术调节昼夜节律和肠-脑过程与抑郁症状、睡眠质量、术后炎症特征和功能恢复的改善有关。生存研究结果代表了初步的探索性信号，需要在更大的、足够有力的随机试验中得到证实。

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引用次数: 0

Dampened social motivation in dysphoria: the role of negative social expectancies and internal causal attribution style 社会动机在焦虑症中的抑制：负性社会期望和内在因果归因风格的作用。

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-12-11 DOI: 10.1016/j.brat.2025.104940

Julie L. Ji , Nilly Mor , Colin MacLeod

Dysphoria is associated with dampening of social interaction intention, but the cognitive mechanisms that underpin this relationship are under-investigated. This study tested the hypothesis that heightened negative social expectancies mediate the association between dysphoria and dampened social motivation. Additionally, it tested the hypothesis that the association between dysphoria and negative social expectancies is mediated by an attribution style bias that attributes negative, but not positive, outcomes to internal causes. University students (N = 271) with varied levels of dysphoria read vignettes describing hypothetical situations where they initiate a social interaction that results in positive or negative outcomes. Participants rated their expectancies concerning the likelihoods of these outcomes, and their expected emotional impact. Participants also forecast the emotions they would experience and reported the degree to which they attribute each outcome to internal factors (themselves) or to external factors (the other person/circumstance). Finally, participants reported their intention to seek social interaction in similar future situations. Results showed that negative biases in outcome likelihood and emotional impact expectancies both independently mediated the association between dysphoria and deficits in social interaction intention. Furthermore, negative internal causal attribution bias mediated the association between dysphoria and each type of expectancy bias. Dysphoria's association with negative internal causal attribution style converged with negative affective forecasts, reflecting greater self-focused negative emotions (humiliation, guilt, helplessness) and reduced self-focused positive emotions (pride). Findings indicate the utility of assessing dysphoria-linked biases in outcome and emotional impact expectancies and highlight the importance of attribution style bias in dampening social motivation in dysphoria. [250/250].

烦躁不安与社会互动意愿的抑制有关，但支撑这种关系的认知机制尚未得到充分研究。本研究验证了负性社会期望在焦虑与社会动机抑制之间起中介作用的假说。此外，它还检验了一个假设，即焦虑和消极社会期望之间的联系是由一种归因风格偏见介导的，这种偏见将消极而非积极的结果归因于内部原因。271名患有不同程度焦虑症的大学生阅读了一篇描述假设情境的短文，在这些情境中，他们发起了一场社会互动，结果可能是积极的，也可能是消极的。参与者对这些结果的可能性以及他们预期的情绪影响进行了评估。参与者还预测他们将经历的情绪，并报告他们将每种结果归因于内部因素（自己）或外部因素（他人/环境）的程度。最后，参与者报告了他们在未来类似情况下寻求社会互动的意图。结果表明，结果可能性的负向偏倚和情绪影响预期的负向偏倚都独立地介导了焦虑与社会交往意愿缺陷之间的关联。此外，负性内因果归因偏差在焦虑与各类期望偏差之间起中介作用。焦虑与负向内在因果归因风格的关联与负向情感预测相融合，反映出更大的自我关注的负面情绪（羞辱、内疚、无助）和更少的自我关注的积极情绪（骄傲）。研究结果表明，评估焦虑相关偏差在结果和情绪影响预期方面的效用，并强调归因风格偏差在抑制焦虑的社会动机方面的重要性。[250/250]。

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引用次数: 0

Trait anxiety and fear generalization: Overgeneralization of fear or undergeneralization of safety learning? 特质焦虑与恐惧概化：恐惧的过度概化还是安全学习的不足概化？

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-12-05 DOI: 10.1016/j.brat.2025.104939

Jessica C. Lee , Tracy Dang , Jack H. Collins

The tendency to overgeneralize fear learning has been identified as a potential risk factor for anxiety disorders. In this study, we examined whether highly anxious individuals differed from low anxious individuals in how they generalized fear (learning when an aversive stimulus is present) and safety (learning when an aversive stimulus is absent) following differential conditioning with an aversive scream outcome. We achieved this by using a morphed shape dimension to separately measure generalization from the fear cue (predicting the scream) and generalization from the safety cue (predicting the absence of the scream). In two experiments, we found that relative to low trait anxious participants, high trait anxious participants showed higher outcome predictions to stimuli resembling the safety cue (i.e., they undergeneralized safety learning), but not for stimuli resembling the fear cue (i.e., they did not overgeneralize fear learning). Undergeneralization was not found when a neutral outcome was used, suggesting that this effect is dependent on the use of an aversive outcome and specific to safety learning. Our findings suggest that safety generalization may vary more as a function of trait anxiety than fear generalization, and therefore future research should separately measure these processes to uncover the mechanisms driving excessive spread of fear.

过度概括恐惧学习的倾向已被确定为焦虑症的潜在风险因素。在本研究中，我们考察了高焦虑个体与低焦虑个体在不同条件作用下的泛化恐惧（当厌恶刺激存在时学习）和安全（当厌恶刺激不存在时学习）与厌恶尖叫结果的差异。我们通过使用一个变形的形状维度来分别测量来自恐惧线索（预测尖叫）和来自安全线索（预测没有尖叫）的泛化，从而实现了这一点。在两个实验中，我们发现相对于低特质焦虑的参与者，高特质焦虑的参与者对类似安全线索的刺激表现出更高的结果预测（即他们对安全学习的欠泛化），而对类似恐惧线索的刺激表现出更高的结果预测（即他们没有过度泛化恐惧学习）。当使用中性结果时，没有发现泛化不足，这表明这种效应依赖于厌恶结果的使用，并且特定于安全学习。我们的研究结果表明，与恐惧泛化相比，安全泛化在特质焦虑中的作用可能更大，因此未来的研究应该单独测量这些过程，以揭示驱动恐惧过度传播的机制。

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引用次数: 0

Effects of patient response pattern distributions on comparisons of psychosocial treatments for major depressive disorder 患者反应模式分布对重度抑郁症心理社会治疗比较的影响。

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-12-03 DOI: 10.1016/j.brat.2025.104937

Lois A. Gelfand , Lorenzo Lorenzo-Luaces , Anika Dalvie , Lana Mambula , Robert J. DeRubeis

The pharmaceutical industry has paid more attention to potential variability in depressed patients' ability to benefit from antidepressants vs. placebo than psychotherapy researchers have when comparing more to less intensive psychosocial treatments. DeRubeis et al. (2014) introduced the “patient response pattern” (PRP) as part of a quantitative framework to model variability in patients’ abilities to benefit from a psychosocial treatment. We extend this framework to examine the influence of PRP on the effect size of a comparison of two mechanistically similar psychosocial treatments. We simulated combinations of “stronger” and “weaker” treatments, crossed with different PRP distributions. Despite modeling a maximum standardized mean difference (SMD) of approximately 1.0, which is considered a large treatment effect, the simulation of a case mix intended to most closely model psychotherapy clinical trials resulted in an SMD of 0.22. Thus, different distributions of PRP can have a substantial effect on the ability to detect differences in the effectiveness of two treatments. Psychotherapy researchers should investigate the influence of heterogeneity in PRP distributions on the results of psychosocial treatment comparisons, and continue to investigate the possibility of using prediction of PRP (e.g., prognostic indicators) for risk stratification and tailored treatment development.

制药行业对抑郁症患者从抗抑郁药和安慰剂中获益的能力的潜在可变性的关注，比心理治疗研究人员在比较高强度和低强度的心理社会治疗时所关注的要多。DeRubeis等人（2014）引入了“患者反应模式”（PRP）作为定量框架的一部分，以模拟患者从心理社会治疗中获益的能力的可变性。我们扩展了这一框架，以检验PRP对两种机制相似的社会心理治疗比较的效应大小的影响。我们模拟了“强”和“弱”处理的组合，交叉使用不同的PRP分布。尽管建模的最大标准化平均差（SMD）约为1.0，这被认为是一个很大的治疗效果，但模拟的病例组合旨在最接近地模拟心理治疗临床试验，结果SMD为0.22。因此，不同的PRP分布可以对检测两种治疗效果差异的能力产生实质性影响。心理治疗研究人员应该调查PRP分布的异质性对心理社会治疗比较结果的影响，并继续研究使用PRP预测（如预后指标）进行风险分层和量身定制治疗开发的可能性。

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引用次数: 0

Corrigendum to “Multi-session online interpretation bias training for anxiety in a community sample” [Behaviour Research and Therapy, 142 (2021), 1–15 / 103864] “社区样本中焦虑的多会话在线解释偏差训练”的勘误表[行为研究与治疗，142 (2021),1-15 / 103864]

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-12-01 DOI: 10.1016/j.brat.2025.104898

Julie L. Ji , Sonia Baee , Diheng Zhang , Claudia Calicho-Mamani , M. Joseph Meyers , Daniel Funk , Samuel Portnow , Laura Barnes , Bethany A. Teachman

引用次数: 0

Editorial to “The role of belief updating in psychopathology: Relevance, mechanisms, and clinical implications” “信念更新在精神病理学中的作用：相关性、机制和临床意义”的社论。

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-12-01 DOI: 10.1016/j.brat.2025.104923

Tobias Κube, Jonas Everaert

引用次数: 0

Corrigendum to understanding factors related to treatment retention in an online mental health support service: Analysis of a service database behaviour research and therapy (194), November 2025, 104875 了解在线心理健康支持服务中与治疗保留有关的因素：对服务数据库行为研究和治疗的分析（194），2025年11月，104875。

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-12-01 DOI: 10.1016/j.brat.2025.104925

Breanne Hobden, Lauren Pollock, Vincent Lau, Sarah Leask, Kristy Fakes

引用次数: 0

Predicting Chinese adolescents’ non-suicidal self-injury urges at diathetic, environmental, and life-event levels——machine learning and network analysis 在素质、环境和生活事件层面预测中国青少年的非自杀自伤冲动——机器学习和网络分析

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-11-30 DOI: 10.1016/j.brat.2025.104936

Xun Deng , Yunlong Tian , Jingxing Xue , Kexin Zhu , Wei Tong , Wen He

This study employed machine learning (ML) and network analysis to identify key predictors of non-suicidal self-injury (NSSI) urges among a sample of Chinese adolescents (N = 1774) in a 10-month longitudinal survey. The Stacking ensemble ML model achieved optimal prediction (AUC = 0.72). SHAP analysis revealed significant multi-level predictors including diatheses (gender and ego-depletion), environmental factors (emotional abuse and neglect), and life events (emotional relative deprivation, peer stressors, and academic stressors). Network analysis was further used to explore the interaction patterns among key predictors and identified peer stressor and ego-depletion as the central nodes in both genders, with notable structural and global strength invariance across groups. These findings offer a theoretical foundation for early identification and targeted interventions for NSSI urges.

本研究采用机器学习（ML）和网络分析，在为期10个月的中国青少年样本（N = 1774）中确定非自杀性自伤（NSSI）冲动的关键预测因素。堆叠集成ML模型预测效果最佳（AUC = 0.72）。SHAP分析揭示了显著的多层次预测因子，包括素质（性别和自我耗竭）、环境因素（情感虐待和忽视）和生活事件（情感相对剥夺、同伴压力源和学业压力源）。网络分析进一步探讨了关键预测因子之间的相互作用模式，并确定同伴压力源和自我耗竭是男女的中心节点，在群体之间具有显著的结构和全局强度不变性。这些发现为自伤冲动的早期识别和有针对性的干预提供了理论基础。

引用次数: 0

Perturbations in observational threat learning predict anxiety symptoms in war-exposed adolescents: A longitudinal study 观察性威胁学习的扰动预测战争暴露青少年的焦虑症状：一项纵向研究

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-11-25 DOI: 10.1016/j.brat.2025.104934

Johnatan Fishman , Oded Cohen , Rany Abend , Jan Haaker , Tomer Shechner

Exposure to war and terrorism presents a significant, global mental health challenge. Such adverse events give rise to extreme stress, resulting in widely varying psychological outcomes, from minimal impact to severe anxiety and related symptoms. Adolescence, a developmental period marked by an increased prevalence of anxiety disorders, may render individuals particularly vulnerable to the psychological consequences of war. Identifying biomarkers predicting risk is critically important for early detection and intervention efforts. Considerable research examines the role of variation in firsthand (direct) threat learning processes in the emergence of enduring anxiety symptoms, highlighting potential learning-related biomarkers. However, observational (vicarious) threat learning, whereby individuals learn about potential dangers by observing others’ responses, has received limited attention. This longitudinal study examined whether observational threat acquisition and its generalization predicted subsequent anxiety symptom severity in 65 adolescents approximately one year later during exposure to acute war-related stress. At baseline, we assessed observational learning of safety and threat associations and their subsequent generalization, using psychophysiology and cognitive indices, alongside generalized anxiety disorder (GAD) symptoms. Approximately one year later, six weeks into the Israel-Hamas war (2023), GAD symptoms were reassessed. Results showed difficulty in adapting threat responses across contexts with varying threat levels, and cue overgeneralization, as measured in the laboratory, predicted elevated GAD symptoms during the war. These findings suggest difficulties in the adaptation and generalization of observational threat learning may increase vulnerability to anxiety during times of acute stress, highlighting its potential as an early risk marker.

暴露于战争和恐怖主义之中是一项重大的全球心理健康挑战。这些不良事件造成极大的压力，导致各种各样的心理后果，从最小的影响到严重的焦虑和相关症状。青春期是一个以焦虑症发病率增加为特征的发育时期，可能使个人特别容易受到战争心理后果的影响。识别预测风险的生物标志物对于早期发现和干预工作至关重要。相当多的研究考察了第一手（直接）威胁学习过程中的变异在持久焦虑症状出现中的作用，强调了潜在的与学习相关的生物标志物。然而，观察（替代）威胁学习，即个体通过观察他人的反应来了解潜在的危险，受到的关注有限。这项纵向研究考察了65名青少年在大约一年后暴露于急性战争相关压力时，观察性威胁习得及其泛化是否能预测随后的焦虑症状严重程度。在基线，我们使用心理生理学和认知指数，以及广泛性焦虑障碍（GAD）症状，评估了安全性和威胁关联的观察性学习及其随后的泛化。大约一年后，以色列-哈马斯战争（2023年）爆发六周后，对广泛性焦虑症的症状进行了重新评估。结果显示，在不同威胁水平的背景下，很难适应威胁反应，并且在实验室测量的线索过度概括预测了战争期间广泛性焦虑症症状的升高。这些发现表明，观察性威胁学习在适应和推广方面的困难可能会增加急性压力时期对焦虑的易感性，突出其作为早期风险标记的潜力。

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引用次数: 0

An integrated personalized feedback intervention for community adults with hazardous alcohol use, elevated anxiety sensitivity, and subclinical PTSD symptoms 对社区成人有害酒精使用、焦虑敏感性升高和亚临床PTSD症状的综合个性化反馈干预

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-11-25 DOI: 10.1016/j.brat.2025.104935

Antoine Lebeaut , Eric R. Pedersen , David J. Francis , Michael J. Zvolensky , Anka A. Vujanovic

Hazardous drinking and posttraumatic stress disorder (PTSD) frequently co-occur and lead to greater impairment and dysfunction than either condition alone. Anxiety sensitivity (AS; i.e., the fear of the anxiety-related sensations and consequences) is a transdiagnostic risk factor for hazardous drinking and PTSD that may serve to inform novel, integrated intervention development for these co-occurring conditions. However, an integrated intervention to specifically target AS in the context of hazardous drinking and PTSD symptoms has not yet been developed or tested. The present study aimed to develop and test the acceptability and efficacy of an integrated, novel computer-based personalized feedback intervention (PFI) in a sample of community adults with hazardous drinking, at least subclinical PTSD symptoms, and elevated AS. Participants (N = 101; M_age = 31.7) were randomized to either an integrated PFI condition (n = 50) focused on PTSD, AS, and alcohol, or an active comparison condition (n = 51) focused exclusively on alcohol use. Compared to the active comparison condition, acceptability ratings were greater for the integrated condition. Latent growth curve models found that participants in both conditions reported statistically significant reductions in alcohol-related cravings/urges and intention to reduce drinking. Participants randomized to the integrated condition reported statistically significantly lower PTSD symptom severity and average daily drinking quantity as well as greater motivation to reduce drinking over time relative to participants in the active comparison condition. Findings provide preliminary support for an integrated approach targeting PTSD, AS, and hazardous drinking, and underscore the need for their continued development.

危险饮酒和创伤后应激障碍（PTSD）经常同时发生，并导致比单独任何一种情况更大的损害和功能障碍。焦虑敏感性（AS，即对焦虑相关感觉和后果的恐惧）是危险饮酒和创伤后应激障碍的跨诊断风险因素，可能有助于为这些共同发生的疾病提供新的综合干预开发。然而，在危险饮酒和创伤后应激障碍症状的背景下，专门针对AS的综合干预措施尚未开发或测试。本研究旨在开发和测试一种集成的、新颖的基于计算机的个性化反馈干预（PFI）在社区成人样本中的可接受性和有效性，这些成年人有危险饮酒、至少有亚临床PTSD症状和AS升高。参与者（N = 101; Mage = 31.7）被随机分配到专注于PTSD、AS和酒精的综合PFI状态（N = 50）或专注于酒精使用的主动比较状态（N = 51）。与主动比较条件相比，综合条件的可接受性评分更高。潜在增长曲线模型发现，两种情况下的参与者都报告了与酒精相关的渴望/冲动和减少饮酒的意图的统计显着减少。随机分配到综合条件的参与者报告的PTSD症状严重程度和平均每日饮酒量在统计上显著降低，并且随着时间的推移，相对于主动比较条件的参与者减少饮酒的动机更大。研究结果为针对创伤后应激障碍、AS和危险饮酒的综合方法提供了初步支持，并强调了它们继续发展的必要性。

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引用次数: 0