Pub Date : 2026-03-01Epub Date: 2026-01-29DOI: 10.1016/j.brat.2026.104965
D.J. Hallford
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.
{"title":"Future thinking and psychopathology: A review of dysfunction, intervention, and a roadmap for future research","authors":"D.J. Hallford","doi":"10.1016/j.brat.2026.104965","DOIUrl":"10.1016/j.brat.2026.104965","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"198 ","pages":"Article 104965"},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-29DOI: 10.1016/j.brat.2026.104981
Mahdi Mazidi , Elaina Davies , Ben Grafton , Michelle L. Moulds , Jill M. Newby , Colin MacLeod
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.
{"title":"Repetitive negative thinking during pregnancy: The role of biased information seeking and negative prenatal expectations","authors":"Mahdi Mazidi , Elaina Davies , Ben Grafton , Michelle L. Moulds , Jill M. Newby , Colin MacLeod","doi":"10.1016/j.brat.2026.104981","DOIUrl":"10.1016/j.brat.2026.104981","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"198 ","pages":"Article 104981"},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-27DOI: 10.1016/j.brat.2026.104983
Jan Schittenhelm , Ronja von Rechenberg , Laura Schäfer , Linda Weber , Johanna Schüller , Ulrich Stangier , Juergen Hoyer
Objectives
Internet-based cognitive behavioral therapy has demonstrated encouraging outcomes for patients diagnosed with social anxiety disorder (SAD). However, the impact of additional therapist-guidance remains debatable. The present study evaluates the effectiveness of the cognitive therapy app “Mindable: Social Phobia” comparing a therapist-guided (vCT) and unguided self-help app (iCT) against a waitlist control group (WLC).
Method
We assigned 164 patients diagnosed with SAD randomly to one of the three groups, treatment lasting 12 weeks with 8 manualized video-conference delivered sessions in vCT. Assessments took place pre-treatment, midtreatment, posttreatment and follow-up 6 months after treatment (follow-up). The primary outcome was clinician-rated symptom severity (Liebowitz Social Anxiety Scale; LSAS), secondary outcomes included symptoms of depression and interpersonal pleasure.
Results
Drop-out rates were 9.3 % in WLC, 42.6 % in iCT and 15 % in vCT (χ2 = 19.5, p < .01). Both treatments reached significant stronger reduction of LSAS scores compared to WLC in all analyses (d [iCT vs. WLC] = −1.01, d [vCT vs. WLC] = −1.1). Using multiple imputation analyses, no significant difference was found in the LSAS between the two treatment groups (t = −0.22, p = .830, d = 0.04). Patterns of results were similar for secondary outcomes. At follow-up, both treatment groups maintained treatment gains.
Conclusion
Overall, the app demonstrates promising results, with patients clearly benefiting from the intervention. The add-on effects of the therapist-guidance favor provision of blended care as it prevents drop-out.
目的基于互联网的认知行为疗法对社交焦虑障碍（SAD）患者的治疗效果令人鼓舞。然而，额外的治疗师指导的影响仍然存在争议。本研究评估了认知治疗应用程序“Mindable：社交恐惧症”的有效性，将治疗师指导（vCT）和非指导自助应用程序（iCT）与等候名单对照组（WLC）进行了比较。方法将164例诊断为SAD的患者随机分为三组，通过vCT进行8次人工视频会议，持续12周。评估分别在治疗前、治疗中、治疗后和治疗后6个月（随访）进行。主要结果是临床评定的症状严重程度（Liebowitz社交焦虑量表；LSAS），次要结果包括抑郁症状和人际愉悦。结果WLC组、iCT组和vCT组的退选率分别为9.3%、42.6%和15% （χ2 = 19.5, p < 0.01）。在所有分析中，与WLC相比，两种治疗的LSAS评分均显著降低（d [iCT vs. WLC] = - 1.01, d [vCT vs. WLC] = - 1.1）。采用多重归算分析，两治疗组的LSAS无显著差异（t = - 0.22, p = .830, d = 0.04）。次要结果的结果模式相似。在随访中，两个治疗组都保持了治疗效果。总的来说，该应用程序展示了令人鼓舞的结果，患者显然从干预中受益。治疗师指导的附加效果有利于提供混合护理，因为它可以防止辍学。
{"title":"App-based cognitive therapy for social anxiety disorder: A randomized-controlled comparison of guided and unguided app-based treatment versus waitlist","authors":"Jan Schittenhelm , Ronja von Rechenberg , Laura Schäfer , Linda Weber , Johanna Schüller , Ulrich Stangier , Juergen Hoyer","doi":"10.1016/j.brat.2026.104983","DOIUrl":"10.1016/j.brat.2026.104983","url":null,"abstract":"<div><h3>Objectives</h3><div>Internet-based cognitive behavioral therapy has demonstrated encouraging outcomes for patients diagnosed with social anxiety disorder (SAD). However, the impact of additional therapist-guidance remains debatable. The present study evaluates the effectiveness of the cognitive therapy app “Mindable: Social Phobia” comparing a therapist-guided (vCT) and unguided self-help app (iCT) against a waitlist control group (WLC).</div></div><div><h3>Method</h3><div>We assigned 164 patients diagnosed with SAD randomly to one of the three groups, treatment lasting 12 weeks with 8 manualized video-conference delivered sessions in vCT. Assessments took place pre-treatment, midtreatment, posttreatment and follow-up 6 months after treatment (follow-up). The primary outcome was clinician-rated symptom severity (Liebowitz Social Anxiety Scale; LSAS), secondary outcomes included symptoms of depression and interpersonal pleasure.</div></div><div><h3>Results</h3><div>Drop-out rates were 9.3 % in WLC, 42.6 % in iCT and 15 % in vCT (<em>χ</em><sup>2</sup> = 19.5, <em>p</em> < .01). Both treatments reached significant stronger reduction of LSAS scores compared to WLC in all analyses <em>(d</em> [iCT vs. WLC] = −1.01, <em>d</em> [vCT vs. WLC] = −1.1). Using multiple imputation analyses, no significant difference was found in the LSAS between the two treatment groups (<em>t</em> = −0.22, <em>p</em> = .830, <em>d</em> = 0.04). Patterns of results were similar for secondary outcomes. At follow-up, both treatment groups maintained treatment gains.</div></div><div><h3>Conclusion</h3><div>Overall, the app demonstrates promising results, with patients clearly benefiting from the intervention. The add-on effects of the therapist-guidance favor provision of blended care as it prevents drop-out.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"198 ","pages":"Article 104983"},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-28DOI: 10.1016/j.brat.2026.104976
Alex H.K. Wong , Matthias J. Wieser , Marta Andreatta
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.
{"title":"The role of relief in persistent avoidance of learnt fear","authors":"Alex H.K. Wong , Matthias J. Wieser , Marta Andreatta","doi":"10.1016/j.brat.2026.104976","DOIUrl":"10.1016/j.brat.2026.104976","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"198 ","pages":"Article 104976"},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Self-guided functional imagery training to reduce anxiety","authors":"Jackie Andrade, Stephanie Hartgen-Walker, Caroline Morgan, Ayan, Idil Aytekin, Khadijah Sekoni, Kardelen Sengul, Jonathan Rhodes","doi":"10.1016/j.brat.2026.104962","DOIUrl":"10.1016/j.brat.2026.104962","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Design</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"198 ","pages":"Article 104962"},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-27DOI: 10.1016/j.brat.2026.104982
Paula Balea , Diego Alaminos , Francisco J. López , Pedro L. Cobos
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.
{"title":"The influence of cost on avoidance recovery after fear extinction with response prevention","authors":"Paula Balea , Diego Alaminos , Francisco J. López , Pedro L. Cobos","doi":"10.1016/j.brat.2026.104982","DOIUrl":"10.1016/j.brat.2026.104982","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"198 ","pages":"Article 104982"},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-12DOI: 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.
{"title":"Components of cognitive-behavioral interventions to prevent the onset of depression among the high-risk population: a systematic review and component network meta-analysis","authors":"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","doi":"10.1016/j.brat.2026.104960","DOIUrl":"10.1016/j.brat.2026.104960","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Eligibility criteria</h3><div>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.</div></div><div><h3>Methods of synthesis</h3><div>The primary outcome was incidence of diagnosed depression. Both intervention-level NMA and cNMA estimated the preventive effect of intervention arms and components.</div></div><div><h3>Results</h3><div>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 (<span><span>https://yan-luo.shinyapps.io/cNMA_depression/</span><svg><path></path></svg></span>).</div></div><div><h3>Conclusion</h3><div>Our results support the preventive effect of CBT on depression onset. In particular, efficacious depression prevention interventions can include problem-solving and behavioral activation.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"197 ","pages":"Article 104960"},"PeriodicalIF":4.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-08DOI: 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。
{"title":"Reappraising negative situations after a night of sleep deprivation","authors":"Rebecca L. Campbell , Linda Thompson , Parker Williams , Arash Assar , L. Riley Gournay-Berman , Anna Marie Nguyen , Nishka Gupta , Ivan Vargas , Ellen W. Leen-Feldner","doi":"10.1016/j.brat.2026.104958","DOIUrl":"10.1016/j.brat.2026.104958","url":null,"abstract":"<div><div>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.</div><div>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.</div><div>Sleep-deprived participants struggled to reappraise as indicated by significantly more negative valence (<em>F</em>(1, 74) = 11.23, <em>p</em> = 0.001, <em>η</em><sup><em>2</em></sup><em>G</em> = 0.05) and lower arousal (<em>F</em>(1, 74) = 18.93, <em>p</em> < 0.001, <em>η</em><sup><em>2</em></sup><em>G</em> = 0.05) compared to baseline and controls. Pairwise contrasts indicated more negative valence post-manipulation for sleep-deprived participants compared to both baseline (<em>t</em>(148) = 4.19, <em>p</em> < 0.001) and controls (<em>t</em>(148) = 4.27, <em>p</em> < 0.001) and lower arousal post-manipulation compared to baseline (<em>t</em>(148) = 3.80, <em>p</em> = 0.001) and controls (<em>t</em>(148) = 3.43, <em>p</em> = 0.004). Sleep deprivation did not significantly impact self-reported use of reappraisal or fluency.</div><div>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.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"197 ","pages":"Article 104958"},"PeriodicalIF":4.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-10DOI: 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.
{"title":"Learning from experience: Depressive bias and updating beliefs about common life events","authors":"Joseph Maffly-Kipp , Daniel R. Strunk , Robert J. Zhou , Jay C. Fournier","doi":"10.1016/j.brat.2026.104959","DOIUrl":"10.1016/j.brat.2026.104959","url":null,"abstract":"<div><div>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 (<em>N</em> = 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.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"197 ","pages":"Article 104959"},"PeriodicalIF":4.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-12-31DOI: 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.
{"title":"From innovation to implementation: Artificial intelligence in cognitive behaviour therapy training and supervision","authors":"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","doi":"10.1016/j.brat.2025.104945","DOIUrl":"10.1016/j.brat.2025.104945","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"197 ","pages":"Article 104945"},"PeriodicalIF":4.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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