Behaviour Research and Therapy最新文献_第3页

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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引用次数: 0

Interpretation bias in emotional disorders: a selective review 情绪障碍中的解释偏差：选择性回顾

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-12-30 DOI: 10.1016/j.brat.2025.104948

Colette R. Hirsch , Andrew Mathews

Ambiguity and uncertainty are evident in much of our day-to-day lives. We will discuss how, driven by clinical insights, researchers in the field of cognition and emotion developed methods to assess how individuals process ambiguous information that can be interpreted in positive or negative ways. People with emotional disorders, and those with high levels of anxiety or depression, tend to process ambiguity in more negative ways than others with low levels of anxiety or depression, who tend to generate positive interpretations of ambiguity. We will also discuss how methods to assess interpretation bias have been adapted to modify interpretation bias, and reveal its causal role in maintaining emotional problems. We then consider how interpretation can influence and be influenced by other biases such as in memory and imagery. Finally, we will discuss how interpretation bias can be targeted in psychological interventions to reduce anxiety and depression.

模棱两可和不确定性在我们的日常生活中随处可见。我们将讨论在临床见解的驱动下，认知和情感领域的研究人员如何开发方法来评估个体如何处理模棱两可的信息，这些信息可以以积极或消极的方式解释。患有情绪障碍的人，以及那些高度焦虑或抑郁的人，倾向于以更消极的方式处理歧义，而那些低水平焦虑或抑郁的人则倾向于对歧义产生积极的解释。我们还将讨论如何采用评估解释偏见的方法来修正解释偏见，并揭示其在维持情绪问题中的因果作用。然后，我们考虑解释如何影响和受其他偏见的影响，如记忆和意象。最后，我们将讨论如何在心理干预中有针对性地减少焦虑和抑郁。

引用次数: 0

Role of psychosocial factors of symptom flares in a cohort of patients with urologic chronic pelvic pain syndrome: A cognitive-affective approach 心理社会因素在慢性泌尿系统盆腔疼痛综合征患者症状发作中的作用：一种认知-情感方法。

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-12-18 DOI: 10.1016/j.brat.2025.104942

Jeffrey M. Lackner (.) , Yi Xiong , Andrew H. Rogers , Christopher D. Radziwon , Gregory D. Gudleski , Siobhan Sutcliffe , Jia Wang , Bruce D. Naliboff , J. Quentin Clemens , Teresa L. Danforth

Little is known about cognitive-affective factors associated with symptom exacerbations (“flares”) in individuals with Urologic Chronic Pelvic Pain Syndrome (UCPPS) even though pain is its cardinal feature and a defining attribute of flares which are regarded as a global marker of illness severity. Disease activity is unable to explain UCPPS flares because its pathophysiology involves altered pain modulation in the central nervous system independent of peripheral pain input. We sought to characterize how different psychosocial factors correspond with distinct flare attributes in UCPPS patients. Subjects included 92 formally diagnosed UCPPS (Interstitial Cystitis/Bladder Pain Syndrome or Chronic Prostatitis/Chronic Pelvic Pain Syndrome) patients (M_age = 43, SD = 14, 82 % female) with refractory pelvic pain. Data, completed as part of baseline evaluation of an NIH clinical trial, included the Pain Discomfort Scale (pain-related suffering), Coping Strategies Questionnaire, Catastrophizing subscale, revised McGill Pain Inventory-Short Form (pain quality), Positive and Negative Affect Scale, Childhood Trauma Questionnaire, as well as flare and UCPPS symptom measures. Regression analyses were applied to characterize the association between psychosocial factors and flare dimensions. Psychosocial factors were broadly associated with multiple flare attributes. Their combined effect was strongest for flare severity with mood, and pain-related suffering, as significant predictors. This investigation breaks new ground by linking psychosocial risk factors to multiple dimensions of UCPPS flares. Further studies are needed to leverage this line of research to develop behaviorally-based flare management programs that strengthen patients’ self-regulatory capacity for reducing flares, thereby decreasing the public health burden of UCPPS.

尽管疼痛是泌尿系统慢性盆腔疼痛综合征（UCPPS）患者症状恶化（“耀斑”）的主要特征，也是耀斑的定义属性，被认为是疾病严重程度的全球标志，但人们对与之相关的认知情感因素知之甚少。疾病活动性无法解释UCPPS耀斑，因为其病理生理学涉及中枢神经系统疼痛调节的改变，与外周疼痛输入无关。我们试图描述不同的社会心理因素如何与UCPPS患者的不同发作属性相对应。研究对象包括92例正式诊断为难治性盆腔疼痛的UCPPS（间质性膀胱炎/膀胱疼痛综合征或慢性前列腺炎/慢性盆腔疼痛综合征）患者（男性43例，女性14例，82%）。作为NIH临床试验基线评估的一部分，完成的数据包括疼痛不适量表（疼痛相关痛苦）、应对策略问卷、灾难化子量表、修订的McGill疼痛清单-短表（疼痛质量）、积极和消极影响量表、儿童创伤问卷以及耀斑和UCPPS症状测量。应用回归分析表征心理社会因素与耀斑尺寸之间的关系。心理社会因素与多重闪焰属性广泛相关。作为重要的预测因素，他们的综合效应在情绪和疼痛相关的痛苦程度上最强。这项研究通过将社会心理风险因素与UCPPS耀斑的多个维度联系起来，开辟了新的领域。需要进一步的研究来利用这一研究路线来制定基于行为的耀斑管理计划，以加强患者减少耀斑的自我调节能力，从而减少UCPPS的公共卫生负担。

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引用次数: 0

Efficacy of computer-assisted cognitive flexibility training and the moderating role of neuroticism in children with ADHD: A randomized controlled trial 计算机辅助认知灵活性训练的效果和ADHD儿童神经质的调节作用：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 : 2025-12-17 DOI: 10.1016/j.brat.2025.104944

Xiang Zhang , Shaoxia Wang , Yijie Wang , Qianyun Liu , Kun Wang , Chujun Wu , Yanrong Wang , Jianqun Fang

Objective

Cognitive flexibility (CF) deficits significantly impact academic and social functioning in individuals with Attention Deficit Hyperactivity Disorder (ADHD). This study aimed to evaluate the efficacy of an 8-week computer-assisted cognitive flexibility training (CFT) program and explore the moderating effect of neuroticism on intervention outcomes.

Methods

A total of 203 children with ADHD (152 boys, 51 girls; aged 6–12 years) were enrolled between December 2024 and April 2025 and randomly assigned to CFT arm (CFTA, n = 70), pharmacological treatment arm (PTA, Atomoxetine, n = 67), or wait-list control arm (WLCA, n = 66). Outcomes were measured at baseline, week 4, and week 8 using the Wisconsin Card Sorting Test for CF, the Weiss Functional Impairment Rating Scale-Parent Form for functional impairments, and the Swanson, Nolan, and Pelham, Version IV- Scale for ADHD symptom severity.

Results

Compared to PTA and WLCA, CFT was associated with significant near-transfer gains in CF and parent-reported improvements in life skills and social activities. In contrast, PTA yielded larger gains for inattention, learning and school, and risky activities, while both active arms surpassed the wait-list in reducing hyperactivity-impulsivity. Lower baseline neuroticism predicted greater CFT-related cognitive gains.

Conclusions

Targeted CFT demonstrated near-transfer cognitive gains and was associated with parent-reported improvements in some functional domains. Given its distinct profile from pharmacotherapy, CFT may be a promising adjunct, rather than a standalone treatment, for children with ADHD, particularly those with lower neuroticism.

目的：认知灵活性（CF）缺陷显著影响注意缺陷多动障碍（ADHD）患者的学业和社会功能。本研究旨在评估为期8周的计算机辅助认知灵活性训练（CFT）的效果，并探讨神经质对干预结果的调节作用。方法在2024年12月至2025年4月期间，共纳入203例ADHD儿童（男孩152例，女孩51例，年龄6-12岁），随机分为CFT组（CFTA, n = 70）、药物治疗组（PTA，托莫西汀，n = 67）和等候名单对照组（WLCA, n = 66）。结果在基线、第4周和第8周使用CF的威斯康星卡片分类测试、功能障碍的Weiss功能障碍评定量表-家长表格和ADHD症状严重程度的Swanson， Nolan, and Pelham，版本IV量表来测量。结果与PTA和WLCA相比，CFT与CF的显著接近转移收益以及父母报告的生活技能和社会活动的改善有关。相比之下，PTA在注意力不集中、学习和学校活动以及危险活动方面取得了更大的进步，而两支积极的手臂在减少多动冲动方面都超过了等候名单。较低的基线神经质预示着与cft相关的认知能力提高。结论靶向CFT表现出接近迁移的认知收益，并与父母报告的某些功能领域的改善有关。考虑到CFT与药物治疗的不同，它可能是一种有希望的辅助治疗，而不是一种独立的治疗方法，用于多动症儿童，特别是那些低神经质的儿童。

{"title":"Efficacy of computer-assisted cognitive flexibility training and the moderating role of neuroticism in children with ADHD: A randomized controlled trial","authors":"Xiang Zhang , Shaoxia Wang , Yijie Wang , Qianyun Liu , Kun Wang , Chujun Wu , Yanrong Wang , Jianqun Fang","doi":"10.1016/j.brat.2025.104944","DOIUrl":"10.1016/j.brat.2025.104944","url":null,"abstract":"<div><h3>Objective</h3><div>Cognitive flexibility (CF) deficits significantly impact academic and social functioning in individuals with Attention Deficit Hyperactivity Disorder (ADHD). This study aimed to evaluate the efficacy of an 8-week computer-assisted cognitive flexibility training (CFT) program and explore the moderating effect of neuroticism on intervention outcomes.</div></div><div><h3>Methods</h3><div>A total of 203 children with ADHD (152 boys, 51 girls; aged 6–12 years) were enrolled between December 2024 and April 2025 and randomly assigned to CFT arm (CFTA, n = 70), pharmacological treatment arm (PTA, Atomoxetine, n = 67), or wait-list control arm (WLCA, n = 66). Outcomes were measured at baseline, week 4, and week 8 using the Wisconsin Card Sorting Test for CF, the Weiss Functional Impairment Rating Scale-Parent Form for functional impairments, and the Swanson, Nolan, and Pelham, Version IV- Scale for ADHD symptom severity.</div></div><div><h3>Results</h3><div>Compared to PTA and WLCA, CFT was associated with significant near-transfer gains in CF and parent-reported improvements in life skills and social activities. In contrast, PTA yielded larger gains for inattention, learning and school, and risky activities, while both active arms surpassed the wait-list in reducing hyperactivity-impulsivity. Lower baseline neuroticism predicted greater CFT-related cognitive gains.</div></div><div><h3>Conclusions</h3><div>Targeted CFT demonstrated near-transfer cognitive gains and was associated with parent-reported improvements in some functional domains. Given its distinct profile from pharmacotherapy, CFT may be a promising adjunct, rather than a standalone treatment, for children with ADHD, particularly those with lower neuroticism.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"196 ","pages":"Article 104944"},"PeriodicalIF":4.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790479","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}

引用次数: 0

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