Behaviour Research and Therapy最新文献_第2页

Self-guided functional imagery training to reduce anxiety 自我引导功能意象训练，减少焦虑

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2026-01-21 DOI: 10.1016/j.brat.2026.104962

Jackie Andrade, Stephanie Hartgen-Walker, Caroline Morgan, Ayan, Idil Aytekin, Khadijah Sekoni, Kardelen Sengul, Jonathan Rhodes

Objectives

Many university students experience high anxiety but have limited access to effective interventions. We evaluated a novel digital intervention for anxiety based on functional imagery training (FIT), designed to help individuals identify the impacts of anxiety, set engagement goals, and strengthen motivation for change. Functional Imagery for Keeping Anxiety low (FIKA) uses speak-aloud tasks, journalling, empathic questions, and personalised guided imagery for a person-centred approach. It builds motivation for engagement goals over safety goals through development and practice of vivid and emotionally laden multisensory imagery.

Design

Study 1 used semi-structured interviews and thematic analysis to explore user experiences of FIKA. Study 2 compared anxiety pre- and post-FIKA and waitlist using frequentist and Bayesian approaches, with content analysis of FIKA experiences.

Methods

Both studies recruited university students who self-identified as experiencing anxiety, assessed using GAD-7 at baseline and follow-up. In Study 1, participants (N = 12) completed FIKA over a two-week period before returning for interview in Week 3. Study 2 participants (N = 60) were assigned to either FIKA or waitlist, then completed Week 2 assessments and, for waitlist, were offered FIKA.

Results

Quantitative and qualitative analyses supported a reduction in anxiety following FIKA, with qualitative responses supporting the hypothesised role of mental imagery and the empathic, person-centred approach.

Conclusions

FIKA seems a promising digital intervention for anxiety that users found acceptable and helpful. The focus on gently building skills in self-motivation for engagement may encourage students experiencing anxiety to use it early to prevent anxiety becoming a chronic problem.

目的许多大学生经历高度焦虑，但获得有效干预的途径有限。我们评估了一种基于功能意象训练（FIT）的新型焦虑数字干预，旨在帮助个体识别焦虑的影响，设定参与目标，并加强改变的动机。保持低焦虑的功能意象（FIKA）使用大声说话任务、日志、移情问题和个性化引导意象来实现以人为本的方法。它通过发展和实践生动的、充满情感的多感官意象，为参与目标建立动力，而不是安全目标。设计研究1采用半结构化访谈和主题分析来探索FIKA的用户体验。研究2使用频率分析和贝叶斯方法比较了FIKA前后和候补名单的焦虑，并对FIKA经历进行了内容分析。方法两项研究均招募了自认为经历焦虑的大学生，在基线和随访时使用GAD-7进行评估。在研究1中，参与者（N = 12）在第3周返回面试前的两周内完成了FIKA。研究2的参与者（N = 60）被分配到FIKA或候补名单，然后完成第2周的评估，对于候补名单，给予FIKA。结果定量和定性分析支持FIKA后焦虑的减少，定性反应支持心理意象和共情，以人为本的方法的假设作用。结论fika似乎是一种有希望的焦虑数字干预，用户认为是可接受的和有用的。专注于培养参与的自我激励技能，可能会鼓励经历焦虑的学生尽早使用它，以防止焦虑成为一个长期问题。

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引用次数: 0

Components of cognitive-behavioral interventions to prevent the onset of depression among the high-risk population: a systematic review and component network meta-analysis 预防高危人群抑郁发作的认知行为干预成分：系统回顾和成分网络荟萃分析。

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2026-01-12 DOI: 10.1016/j.brat.2026.104960

Masatsugu Sakata , Ethan Sahker , Yan Luo , Tomohiro Takayama , Rie Toyomoto , Yuki Furukawa , So Sugita , Masami Ito , Masafumi Tada , Yukiko Honda , Sanae Kishimoto , Mathias Harrer , Claudia Buntrock , Antonia A. Sprenger , Clara Miguel , Pim Cuijpers , Toshi A. Furukawa

Objectives

Cognitive Behavioral Therapy (CBT) is a promising strategy for preventing onset of depression. This systematic review and component network meta-analysis (cNMA) investigated efficacious and harmful components including various skills and delivery formats of CBT for preventing depression onset among at-risk populations.

Eligibility criteria

We selected randomized trials of preventive CBT interventions from a previous systematic review (Cuijpers et al., 2021), and conducted an additional search on PubMed and PsycINFO up to January 2022.

Methods of synthesis

The primary outcome was incidence of diagnosed depression. Both intervention-level NMA and cNMA estimated the preventive effect of intervention arms and components.

Results

We identified 44 prevention trials (N = 9519). The intervention-level NMA demonstrated the preventive effects of CBT over no intervention (OR=0.52, 95 %CI: 0.39 to 0.69). There was some evidence from cNMA showing that problem-solving and behavioral activation may be beneficial in preventing depression. These two components combined in the unguided self-help or the group format showed an odds ratio of 0.25 (95 %CI: 0.08 to 0.81 ) and 0.31 (95 %CI: 0.15 to 0.64), respectively. We developed a web application estimating the relative and absolute effects of various combinations of components (https://yan-luo.shinyapps.io/cNMA_depression/).

Conclusion

Our results support the preventive effect of CBT on depression onset. In particular, efficacious depression prevention interventions can include problem-solving and behavioral activation.

目的：认知行为疗法（CBT）是一种很有前途的预防抑郁症发作的策略。本系统综述和成分网络荟萃分析（cNMA）调查了CBT预防高危人群抑郁发作的有效和有害成分，包括各种技能和交付形式。入选标准：我们从之前的系统综述中选择了预防性CBT干预的随机试验（Cuijpers等，2021），并在PubMed和PsycINFO上进行了额外的检索，截止到2022年1月。综合方法：主要观察指标为诊断抑郁症的发生率。干预水平的NMA和cNMA均评估了干预武器和成分的预防效果。结果：我们确定了44项预防试验（N = 9519）。干预水平的NMA显示CBT的预防效果优于不干预（OR=0.52, 95% CI: 0.39至0.69）。cNMA的一些证据表明，问题解决和行为激活可能有助于预防抑郁症。这两个组成部分在无指导自助或小组形式中分别显示0.25 （95% CI: 0.08至0.81）和0.31 （95% CI: 0.15至0.64）的优势比。我们开发了一个web应用程序来评估各种组件组合的相对和绝对效果（https://yan-luo.shinyapps.io/cNMA_depression/）。结论：本研究结果支持CBT对抑郁症发作的预防作用。特别是，有效的抑郁症预防干预可以包括解决问题和行为激活。

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引用次数: 0

Thought suppression worsens mood and obsessions but improves them subsequently: First evidence of a contrast avoidance effect for the maintenance of thought suppression 思想抑制会使情绪和强迫症恶化，但随后会改善它们：第一个证据表明，维持思想抑制存在对比回避效应。

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2026-01-12 DOI: 10.1016/j.brat.2026.104961

Valerie S. Swisher, Michelle G. Newman

Objective

The cognitive behavioral model for obsessive-compulsive disorder (OCD) suggests that suppression of unwanted thoughts (TS) is negatively reinforced by temporarily preventing obsessions and reducing distress. It further suggests that ceasing TS subsequently creates a rebound effect leading to increased obsessions/distress. However, the contrast avoidance model (CAM) suggests that TS concurrently increases and then sustains obsessions/negative affect, thus increasing the likelihood of negative and positive reinforcement (positive contrast) and avoiding a negative contrast later. We tested these theories using intensive ecological momentary assessment.

Method

Forty-nine individuals diagnosed with OCD received seven prompts/day for seven days examining current obsessions, TS, negative and positive mood.

Results

In line with CAM, higher TS was associated with higher concurrent negative mood and obsessions. Also, higher TS was associated with decreased obsessions and negative mood and increased positive mood 2 h later. Lower TS was associated with lower negative mood and obsessions concurrently and increased negative mood 2 h later. Thus, TS may have been negatively and positively reinforced—through subsequent (as opposed to concurrent) reduced negative mood and increased positive mood—and not engaging in prior TS was punished, such that it was associated with a subsequent uptick in negative mood.

Conclusion

Taken together, the present study showed the first evidence for a contrast avoidance effect (i.e., avoidance of sharp increases in negative emotion and decreases in positive emotion) for the maintenance of TS in OCD. Results suggest that targeting contrast avoidance may help reduce maladaptive cognitive strategies such as TS in OCD.

目的：强迫症（OCD）的认知行为模型表明，抑制不想要的想法（TS）通过暂时阻止强迫和减少痛苦而负向强化。它进一步表明，随后停止TS会产生反弹效应，导致强迫症/痛苦增加。然而，对比回避模型（CAM）表明，TS同时增加并维持了强迫/消极影响，从而增加了消极强化和积极强化（积极对比）的可能性，并避免了随后的消极对比。我们使用密集的生态瞬时评估来检验这些理论。方法：49名被诊断为强迫症的个体在7天内每天接受7次提示，检查当前的强迫行为、TS、消极和积极情绪。结果：与CAM一致，较高的TS与较高的并发负性情绪和强迫相关。此外，较高的TS与强迫症和消极情绪的减少以及2小时后积极情绪的增加有关。较低的TS与较低的负性情绪和强迫症同时相关，并在2小时后增加负性情绪。因此，TS可能通过随后的（而不是同时的）消极情绪的减少和积极情绪的增加而被消极和积极地强化，而不参与先前的TS则受到惩罚，因此它与随后的消极情绪上升有关。结论：综上所述，本研究首次证明了对比回避效应（即回避消极情绪的急剧增加和积极情绪的急剧减少）对强迫症患者TS维持的影响。结果表明，针对对比回避可能有助于减少强迫症患者的认知策略失调，如TS。

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引用次数: 0

Learning from experience: Depressive bias and updating beliefs about common life events 从经验中学习：抑郁偏见和对日常生活事件的更新信念

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2026-01-10 DOI: 10.1016/j.brat.2026.104959

Joseph Maffly-Kipp , Daniel R. Strunk , Robert J. Zhou , Jay C. Fournier

In this study we investigated the veracity of depressive cognitions and how they are updated over time in response to real-world environmental feedback. Participants (N = 372) with high and low depressive symptoms repeatedly predicted the likelihood of, and then reported on the occurrence of, common positive and negative life events occurring in the next month across three monthly intervals. Depressive symptoms were associated with predicting and experiencing fewer desirable outcomes. Depressive symptoms were also related to greater pessimistic bias, but only for positive events, and to decreased accuracy, but only for negative events. Unexpectedly, participants with elevated depressive symptoms were more likely to update their predictions in accord with feedback from the environment, particularly for positive events and when updating toward greater optimism. However, they also demonstrated a stronger oscillation pattern, being more likely to reverse their optimistic updates at the next timepoint. Participants high in depressive symptoms were less likely to reverse their predictions about negative events. This pattern of findings supports a depressive bias hypothesis (i.e., pessimistic bias increases as depressive symptoms increase) and provides new information about the stability of expectations about common positive and negative life events. Understanding the temporal dynamics of belief updating may help refine cognitive models of depression and inform interventions that target fragile expectations about positive experiences.

在这项研究中，我们调查了抑郁认知的真实性，以及它们是如何随着时间的推移而根据现实世界的环境反馈而更新的。有高抑郁症状和低抑郁症状的参与者（N = 372）反复预测下个月常见的积极和消极生活事件发生的可能性，然后在三个月的间隔中报告发生的可能性。抑郁症状与预期和经历较少的理想结果有关。抑郁症状也与更大的悲观偏见有关，但只与积极事件有关，与准确性降低有关，但只与消极事件有关。出乎意料的是，抑郁症状加重的参与者更有可能根据来自环境的反馈来更新他们的预测，尤其是对积极事件和向更乐观的方向更新时。然而，他们也表现出更强的振荡模式，更有可能在下一个时间点逆转他们的乐观更新。抑郁症状严重的参与者不太可能改变他们对负面事件的预测。这一发现模式支持了抑郁偏见假说（即，悲观偏见随着抑郁症状的增加而增加），并提供了关于对常见的积极和消极生活事件的期望稳定性的新信息。了解信念更新的时间动态可能有助于完善抑郁症的认知模型，并为针对积极体验的脆弱预期的干预提供信息。

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引用次数: 0

Reappraising negative situations after a night of sleep deprivation 在一夜睡眠不足后重新评估消极情况

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2026-01-08 DOI: 10.1016/j.brat.2026.104958

Rebecca L. Campbell , Linda Thompson , Parker Williams , Arash Assar , L. Riley Gournay-Berman , Anna Marie Nguyen , Nishka Gupta , Ivan Vargas , Ellen W. Leen-Feldner

The goal of the present study was to determine the effect of acute sleep deprivation on the ability to reappraise negative situations using a repeated-measures design.

Seventy-six undergraduate students completed self-report measures of reappraisal use and the Script-Based Reappraisal Test (SBRT; Zeier et al., 2020) before and after randomization to a night of at-home sleep deprivation or 8 h of sleep opportunity. The Self-Assessment Manikin (SAM) indexed changes in valence and arousal, with more negative valence and higher arousal indicating greater difficulty reappraising the anger-inducing scripts. Participant descriptions of reappraisals were coded to assess reappraisal fluency.

Sleep-deprived participants struggled to reappraise as indicated by significantly more negative valence (F(1, 74) = 11.23, p = 0.001, η²G = 0.05) and lower arousal (F(1, 74) = 18.93, p < 0.001, η²G = 0.05) compared to baseline and controls. Pairwise contrasts indicated more negative valence post-manipulation for sleep-deprived participants compared to both baseline (t(148) = 4.19, p < 0.001) and controls (t(148) = 4.27, p < 0.001) and lower arousal post-manipulation compared to baseline (t(148) = 3.80, p = 0.001) and controls (t(148) = 3.43, p = 0.004). Sleep deprivation did not significantly impact self-reported use of reappraisal or fluency.

Sleep deprivation negatively impacts reappraisal, reducing its effectiveness in regulating valence. However, contrary to predictions for arousal, sleep-deprived participants showed reduced rather than elevated arousal following reappraisal, suggesting a dissociation between valence and arousal regulation after sleep loss. Findings indicate that sleep deprivation disrupts cognitive emotion regulation, a key mechanism underlying mental health disorders, highlighting the importance of incorporating sleep into prevention and treatment efforts.

本研究的目的是使用重复测量设计来确定急性睡眠剥夺对重新评估消极情况能力的影响。76名本科生在随机分配到一个晚上在家剥夺睡眠或8小时睡眠机会之前和之后完成了重新评估使用的自我报告测量和基于脚本的重新评估测试（SBRT； Zeier等人，2020）。自我评估模型（SAM）显示了效价和唤醒的变化，负效价越高，唤醒越高，表明重新评估愤怒诱发脚本的难度越大。参与者对重评的描述被编码以评估重评的流畅性。与基线和对照组相比，睡眠剥夺的参与者难以重新评估，负效价显著增加（F(1,74) = 11.23, p = 0.001, η2G = 0.05），唤醒率显著降低（F(1,74) = 18.93, p < 0.001, η2G = 0.05）。两两对比显示，与基线（t(148) = 4.19, p < 0.001）和对照组（t(148) = 4.27, p < 0.001）相比，被剥夺睡眠的参与者在操作后的负效价更多，并且与基线（t(148) = 3.80, p = 0.001）和对照组（t(148) = 3.43, p = 0.004）相比，操作后的唤醒率更低。睡眠剥夺对自我报告的重新评估或流利程度没有显著影响。睡眠剥夺对重评价有负面影响，降低了重评价调节效价的有效性。然而，与对觉醒的预测相反，睡眠不足的参与者在重新评估后表现出降低而不是提高的觉醒，这表明睡眠不足后的价态和觉醒调节之间存在分离。研究结果表明，睡眠剥夺破坏了认知情绪调节，这是精神健康障碍的关键机制，强调了将睡眠纳入预防和治疗工作的重要性。

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引用次数: 0

Instructed increase in fear activation during exposure exercises does not enhance treatment effects of cognitive behavioral therapy for panic disorder and agoraphobia 暴露练习中有指示地增加恐惧激活并不能增强认知行为疗法对恐慌障碍和广场恐惧症的治疗效果

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2026-01-08 DOI: 10.1016/j.brat.2025.104946

Jan Richter , Alfons O. Hamm , Thomas Lang , Alexander L. Gerlach , Christiane A. Melzig , Anne Helms , Kezia-Lara Droste , Stephan Goerigk , Benjamin Straube , Tilo Kircher , Winfried Rief , Ulrike Lueken , Georg W. Alpers , Sylvia Helbig-Lang

The efficacy of exposure-based cognitive behavioral therapy (eCBT) for panic disorder and agoraphobia (PD/AG) is well established, but the mechanisms of action are still under debate. Here we investigated whether increased fear activation (by provoking additional bodily symptoms using interoceptive challenges) during exposure to agoraphobic situations would improve therapy outcome. Individuals diagnosed with PD/AG (N = 124) were randomized to one of the two variants of eCBT, with (exposure plus fear activation; E + FA) and without (exposure alone; E) guided evocation of unpleasant body symptoms (using additional interoceptive exposure exercises) and/or threat cognitions (expectations of potential threats that might occur during exposure). Primary outcome measures were assessed at baseline, post treatment, and at four-month follow-up. Reported fear and perceived likelihood of expected threat were assessed as moderators prior to, during, and after exposure sessions using ecological momentary assessment. Post treatment, E + FA was inferior to E in two of four primary outcome measures. At the follow-up assessment, both treatment variants were equally effective in all outcomes. In conclusion, increasing fear activation by explicitly activating the response units of the fear network did not result in better treatment outcome, questioning popular recommendations to maximize patient fear during eCBT - at least for patients with PD/AG.

基于暴露的认知行为疗法（eCBT）治疗惊恐障碍和广场恐怖症（PD/AG）的疗效已得到证实，但其作用机制仍在争论中。在这里，我们调查了暴露于广场恐惧症情境中增加的恐惧激活（通过使用内感受性挑战引发额外的身体症状）是否会改善治疗结果。诊断为PD/AG的个体（N = 124）被随机分配到两种eCBT变体中的一种，有（暴露加恐惧激活；E + FA）和没有（单独暴露；E）引导唤起不愉快的身体症状（使用额外的内感受性暴露练习）和/或威胁认知（在暴露期间可能发生的潜在威胁的预期）。在基线、治疗后和4个月随访时评估主要结局指标。报告的恐惧和预期威胁的感知可能性被评估为在暴露之前、期间和之后使用生态瞬时评估的调节因子。治疗后，E + FA在四项主要结局指标中的两项中低于E。在随访评估中，两种治疗方法在所有结果中都同样有效。总之，通过明确激活恐惧网络的反应单元来增加恐惧激活并没有带来更好的治疗结果，这质疑了在eCBT期间最大化患者恐惧的流行建议——至少对于PD/AG患者。

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引用次数: 0

Effectiveness of intensive exposure therapy for persistent post-concussion symptoms: an aggregated single-case design approach 强化暴露治疗对持续性脑震荡后症状的有效性：汇总单例设计方法

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2026-01-01 DOI: 10.1016/j.brat.2025.104941

Skye King , Marleen Rijkeboer , Ieke Winkens , Nora Tuts , Marthe Ford , Nikita Frankenmolen , René Tanious , Joukje van der Naalt , Caroline van Heugten

The fear-avoidance model suggests that catastrophising and avoidance behaviours can maintain persistent post-concussion symptoms (PPCS) after mild traumatic brain injury (mTBI). Although exposure therapy has shown preliminary success in this population, its effectiveness in mTBI remains unproven. This study investigated the therapeutic effects of this therapy across different settings. Twenty participants with PPCS took part in five concurrent multiple-baseline, multi-phase single-case experimental design studies. Phases included: baseline (A), exploration (B), active exposure (C), booster (D), and follow-up (E). Participants endorsed daily visual analogue scales assessing activity avoidance, satisfaction with daily functioning, and symptom experience. Data were aggregated and analysed using multi-level modelling. Results showed that the therapy effectively reduced avoidance behaviour, increased satisfaction, and reduced symptom burden. Phase B did not differ from baseline, whereas phase C, D, and E differed from baseline for avoidance (phase C: estimate = −4.33, p < .001; phase D: estimate = −4.02, p < .001; phase E: estimate = −3.92, p = .002), and satisfaction. Improvements in symptom burden were seen between baseline and phases D and E. Further analyses revealed that sex, treatment setting, and history of mental health treatment moderated the effects of avoidance. No other moderation effects were found. The rigorous study design, multiple replications, and robust statistical methods provide preliminary support for the effectiveness of this innovative therapy for PPCS. Additionally, findings reinforce the relevance of the fear-avoidance model and add to the growing evidence highlighting the benefits of exposure therapy – particularly intensive exposure approaches – for mTBI.

恐惧-回避模型提示，灾难化和回避行为可维持轻度创伤性脑损伤（mTBI）后持续的脑震荡后症状。尽管暴露疗法在这一人群中已显示出初步的成功，但其在mTBI中的有效性仍未得到证实。本研究调查了该疗法在不同环境下的治疗效果。20名PPCS患者同时参加了5项多基线、多阶段的单病例实验设计研究。阶段包括：基线(A)、探索(B)、主动暴露(C)、增强(D)和随访(E)。参与者认可每日视觉模拟量表，评估活动回避、日常功能满意度和症状体验。使用多层次建模对数据进行汇总和分析。结果表明，治疗有效地减少了回避行为，提高了满意度，减轻了症状负担。阶段B与基线无差异，而阶段C、D和E在回避方面与基线不同(阶段C：估计= -4.33,p

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引用次数: 0

Effectiveness of an online positive affect treatment targeting reward sensitivity in reducing depressive symptoms among college students: A randomized controlled trial 以奖励敏感性为目标的在线积极影响治疗减轻大学生抑郁症状的有效性：一项随机对照试验

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2026-01-01 DOI: 10.1016/j.brat.2025.104947

Heting Liang , Yuhong Xiang , Yiming Long , Liwen Jian , Lin Zhang

Low positive affect and deficits in reward sensitivity are core features of depressive symptoms, yet they are rarely addressed in traditional psychotherapies. This study examined the effectiveness of an internet-based Positive Affect Treatment (iPAT) in improving depressive symptoms, anxiety symptoms, and reward sensitivity, as well as the longitudinal mediation effect of dynamic changes in reward sensitivity. Eighty-eight individuals with depressive symptoms were enrolled in a randomized controlled trial and randomly assigned (1:1) to either an intervention group or a waitlist control group. The 6-week iPAT intervention was delivered via a WeChat mini program. The feasibility and acceptability of iPAT were evaluated, and participants completed seven assessments (baseline and weekly for six weeks) measuring depressive symptoms, anxiety symptoms, and reward sensitivity. Intervention effectiveness was analyzed using a generalised linear mixed model, and longitudinal mediation was examined using latent growth curve modeling. Results showed that iPAT significantly reduced depressive symptoms and enhanced reward sensitivity. Moreover, the mediation analysis revealed that the rate of change in reward sensitivity fully mediated the relationship between the intervention and reductions in depressive symptoms. iPAT demonstrated good feasibility and acceptability. To our knowledge, this is the first study to show that internet-based Positive Affect Treatment can alleviate depressive symptoms by enhancing reward sensitivity. These findings support reward sensitivity as a key mechanistic target for precision psychological interventions and suggest that iPAT offers a scalable digital solution for the indicated prevention of depression, targeting individuals with early or subthreshold symptoms to prevent further progression. Registration identifier: ChiCTR2400095048.

低积极情绪和奖励敏感性缺陷是抑郁症状的核心特征，但它们在传统的心理治疗中很少得到解决。本研究考察了基于网络的积极情绪治疗（iPAT）对抑郁症状、焦虑症状和奖励敏感性的改善效果，以及奖励敏感性动态变化的纵向中介效应。88名有抑郁症状的个体参加了一项随机对照试验，并按1:1的比例随机分配到干预组或候补对照组。6周的iPAT干预通过微信小程序进行。评估了iPAT的可行性和可接受性，参与者完成了7项评估（基线和每周，为期6周），测量抑郁症状、焦虑症状和奖励敏感性。采用广义线性混合模型分析干预效果，采用潜在增长曲线模型检验纵向中介作用。结果显示，iPAT显著减轻抑郁症状，增强奖励敏感性。此外，中介分析显示，奖励敏感性的变化率完全介导了干预与抑郁症状减轻之间的关系。iPAT具有良好的可行性和可接受性。据我们所知，这是第一个表明基于互联网的积极影响治疗可以通过增强奖励敏感性来缓解抑郁症状的研究。这些发现支持奖励敏感性作为精确心理干预的关键机制目标，并表明iPAT为指示性抑郁症预防提供了可扩展的数字解决方案，针对早期或阈下症状的个体，以防止进一步发展。注册标识：ChiCTR2400095048。

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引用次数: 0

Imagery rescripting: New developments special issue editorial 图像改写：新发展特刊社论。

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2026-01-01 DOI: 10.1016/j.brat.2025.104933

Sophie A. Rameckers , Charlotte E. Wittekind , Iris M. Engelhard , Muriel A. Hagenaars

引用次数: 0

From innovation to implementation: Artificial intelligence in cognitive behaviour therapy training and supervision 从创新到实施：人工智能在认知行为治疗中的培训与监督

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-12-31 DOI: 10.1016/j.brat.2025.104945

Roz Shafran , Laura Bond , Per Carlbring , Zachary D. Cohen , Torrey A. Creed , Emily Davey , Sarah J. Egan , Daniel Freeman , Steven D. Hollon , Nicholas C. Jacobson , Catherine Johnson , Debra Kaysen , Deborah L. McGuinness , Vikram Patel , Julia R. Pozuelo , Henrique Santos , Daisy R. Singla , Shannon Wiltsey Stirman , Daniel J. Taylor , Tracey D. Wade

Artificial intelligence (AI) can transform mental health care globally by improving the efficiency, consistency, effectiveness and accessibility of training and supervision in evidence-based psychotherapies, including cognitive and behavioral therapies. This paper describes the potential role of AI in the training and supervision of clinicians and the associated gains, challenges and risks. AI could revolutionize the process of training and supervision by simulating patients in assessment and therapy sessions, providing real-time personalized fidelity feedback, and helping trainees to develop cultural sensitivity. Key challenges remain, however, including the identification and curation of high-quality datasets and algorithms, ethical considerations, implementation in low-resource settings and lack of rigorous research. The paper concludes by outlining guidelines for the future development, evaluation, and implementation of AI in CBT training and supervision, with the goal of maximizing its potential benefits while mitigating associated risks.

人工智能（AI）可以通过提高循证心理疗法（包括认知和行为疗法）培训和监督的效率、一致性、有效性和可及性，改变全球精神卫生保健。本文描述了人工智能在临床医生培训和监督中的潜在作用，以及相关的收益、挑战和风险。人工智能可以在评估和治疗过程中模拟患者，提供实时个性化的保真度反馈，并帮助受训者培养文化敏感性，从而彻底改变培训和监督的过程。然而，关键的挑战仍然存在，包括识别和管理高质量的数据集和算法、伦理考虑、在低资源环境下的实施以及缺乏严格的研究。本文最后概述了人工智能在CBT培训和监督中的未来发展、评估和实施的指导方针，目标是在降低相关风险的同时最大化其潜在收益。

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