Pub Date : 2025-12-01DOI: 10.1016/j.brat.2025.104925
Breanne Hobden, Lauren Pollock, Vincent Lau, Sarah Leask, Kristy Fakes
{"title":"Corrigendum to understanding factors related to treatment retention in an online mental health support service: Analysis of a service database behaviour research and therapy (194), November 2025, 104875","authors":"Breanne Hobden, Lauren Pollock, Vincent Lau, Sarah Leask, Kristy Fakes","doi":"10.1016/j.brat.2025.104925","DOIUrl":"10.1016/j.brat.2025.104925","url":null,"abstract":"","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"195 ","pages":"Article 104925"},"PeriodicalIF":4.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574816","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 : 2025-11-30DOI: 10.1016/j.brat.2025.104936
Xun Deng , Yunlong Tian , Jingxing Xue , Kexin Zhu , Wei Tong , Wen He
This study employed machine learning (ML) and network analysis to identify key predictors of non-suicidal self-injury (NSSI) urges among a sample of Chinese adolescents (N = 1774) in a 10-month longitudinal survey. The Stacking ensemble ML model achieved optimal prediction (AUC = 0.72). SHAP analysis revealed significant multi-level predictors including diatheses (gender and ego-depletion), environmental factors (emotional abuse and neglect), and life events (emotional relative deprivation, peer stressors, and academic stressors). Network analysis was further used to explore the interaction patterns among key predictors and identified peer stressor and ego-depletion as the central nodes in both genders, with notable structural and global strength invariance across groups. These findings offer a theoretical foundation for early identification and targeted interventions for NSSI urges.
{"title":"Predicting Chinese adolescents’ non-suicidal self-injury urges at diathetic, environmental, and life-event levels——machine learning and network analysis","authors":"Xun Deng , Yunlong Tian , Jingxing Xue , Kexin Zhu , Wei Tong , Wen He","doi":"10.1016/j.brat.2025.104936","DOIUrl":"10.1016/j.brat.2025.104936","url":null,"abstract":"<div><div>This study employed machine learning (ML) and network analysis to identify key predictors of non-suicidal self-injury (NSSI) urges among a sample of Chinese adolescents (N = 1774) in a 10-month longitudinal survey. The Stacking ensemble ML model achieved optimal prediction (AUC = 0.72). SHAP analysis revealed significant multi-level predictors including diatheses (gender and ego-depletion), environmental factors (emotional abuse and neglect), and life events (emotional relative deprivation, peer stressors, and academic stressors). Network analysis was further used to explore the interaction patterns among key predictors and identified peer stressor and ego-depletion as the central nodes in both genders, with notable structural and global strength invariance across groups. These findings offer a theoretical foundation for early identification and targeted interventions for NSSI urges.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"196 ","pages":"Article 104936"},"PeriodicalIF":4.5,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685417","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}
Exposure to war and terrorism presents a significant, global mental health challenge. Such adverse events give rise to extreme stress, resulting in widely varying psychological outcomes, from minimal impact to severe anxiety and related symptoms. Adolescence, a developmental period marked by an increased prevalence of anxiety disorders, may render individuals particularly vulnerable to the psychological consequences of war. Identifying biomarkers predicting risk is critically important for early detection and intervention efforts. Considerable research examines the role of variation in firsthand (direct) threat learning processes in the emergence of enduring anxiety symptoms, highlighting potential learning-related biomarkers. However, observational (vicarious) threat learning, whereby individuals learn about potential dangers by observing others’ responses, has received limited attention. This longitudinal study examined whether observational threat acquisition and its generalization predicted subsequent anxiety symptom severity in 65 adolescents approximately one year later during exposure to acute war-related stress. At baseline, we assessed observational learning of safety and threat associations and their subsequent generalization, using psychophysiology and cognitive indices, alongside generalized anxiety disorder (GAD) symptoms. Approximately one year later, six weeks into the Israel-Hamas war (2023), GAD symptoms were reassessed. Results showed difficulty in adapting threat responses across contexts with varying threat levels, and cue overgeneralization, as measured in the laboratory, predicted elevated GAD symptoms during the war. These findings suggest difficulties in the adaptation and generalization of observational threat learning may increase vulnerability to anxiety during times of acute stress, highlighting its potential as an early risk marker.
{"title":"Perturbations in observational threat learning predict anxiety symptoms in war-exposed adolescents: A longitudinal study","authors":"Johnatan Fishman , Oded Cohen , Rany Abend , Jan Haaker , Tomer Shechner","doi":"10.1016/j.brat.2025.104934","DOIUrl":"10.1016/j.brat.2025.104934","url":null,"abstract":"<div><div>Exposure to war and terrorism presents a significant, global mental health challenge. Such adverse events give rise to extreme stress, resulting in widely varying psychological outcomes, from minimal impact to severe anxiety and related symptoms. Adolescence, a developmental period marked by an increased prevalence of anxiety disorders, may render individuals particularly vulnerable to the psychological consequences of war. Identifying biomarkers predicting risk is critically important for early detection and intervention efforts. Considerable research examines the role of variation in firsthand (direct) threat learning processes in the emergence of enduring anxiety symptoms, highlighting potential learning-related biomarkers. However, observational (vicarious) threat learning, whereby individuals learn about potential dangers by observing others’ responses, has received limited attention. This longitudinal study examined whether observational threat acquisition and its generalization predicted subsequent anxiety symptom severity in 65 adolescents approximately one year later during exposure to acute war-related stress. At baseline, we assessed observational learning of safety and threat associations and their subsequent generalization, using psychophysiology and cognitive indices, alongside generalized anxiety disorder (GAD) symptoms. Approximately one year later, six weeks into the Israel-Hamas war (2023), GAD symptoms were reassessed. Results showed difficulty in adapting threat responses across contexts with varying threat levels, and cue overgeneralization, as measured in the laboratory, predicted elevated GAD symptoms during the war. These findings suggest difficulties in the adaptation and generalization of observational threat learning may increase vulnerability to anxiety during times of acute stress, highlighting its potential as an early risk marker.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"196 ","pages":"Article 104934"},"PeriodicalIF":4.5,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616777","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 : 2025-11-25DOI: 10.1016/j.brat.2025.104935
Antoine Lebeaut , Eric R. Pedersen , David J. Francis , Michael J. Zvolensky , Anka A. Vujanovic
Hazardous drinking and posttraumatic stress disorder (PTSD) frequently co-occur and lead to greater impairment and dysfunction than either condition alone. Anxiety sensitivity (AS; i.e., the fear of the anxiety-related sensations and consequences) is a transdiagnostic risk factor for hazardous drinking and PTSD that may serve to inform novel, integrated intervention development for these co-occurring conditions. However, an integrated intervention to specifically target AS in the context of hazardous drinking and PTSD symptoms has not yet been developed or tested. The present study aimed to develop and test the acceptability and efficacy of an integrated, novel computer-based personalized feedback intervention (PFI) in a sample of community adults with hazardous drinking, at least subclinical PTSD symptoms, and elevated AS. Participants (N = 101; Mage = 31.7) were randomized to either an integrated PFI condition (n = 50) focused on PTSD, AS, and alcohol, or an active comparison condition (n = 51) focused exclusively on alcohol use. Compared to the active comparison condition, acceptability ratings were greater for the integrated condition. Latent growth curve models found that participants in both conditions reported statistically significant reductions in alcohol-related cravings/urges and intention to reduce drinking. Participants randomized to the integrated condition reported statistically significantly lower PTSD symptom severity and average daily drinking quantity as well as greater motivation to reduce drinking over time relative to participants in the active comparison condition. Findings provide preliminary support for an integrated approach targeting PTSD, AS, and hazardous drinking, and underscore the need for their continued development.
{"title":"An integrated personalized feedback intervention for community adults with hazardous alcohol use, elevated anxiety sensitivity, and subclinical PTSD symptoms","authors":"Antoine Lebeaut , Eric R. Pedersen , David J. Francis , Michael J. Zvolensky , Anka A. Vujanovic","doi":"10.1016/j.brat.2025.104935","DOIUrl":"10.1016/j.brat.2025.104935","url":null,"abstract":"<div><div>Hazardous drinking and posttraumatic stress disorder (PTSD) frequently co-occur and lead to greater impairment and dysfunction than either condition alone. Anxiety sensitivity (AS; i.e., the fear of the anxiety-related sensations and consequences) is a transdiagnostic risk factor for hazardous drinking and PTSD that may serve to inform novel, integrated intervention development for these co-occurring conditions. However, an integrated intervention to specifically target AS in the context of hazardous drinking and PTSD symptoms has not yet been developed or tested. The present study aimed to develop and test the acceptability and efficacy of an integrated, novel computer-based personalized feedback intervention (PFI) in a sample of community adults with hazardous drinking, at least subclinical PTSD symptoms, and elevated AS. Participants (<em>N</em> = 101; <em>M</em><sub>age</sub> = 31.7) were randomized to either an integrated PFI condition (<em>n</em> = 50) focused on PTSD, AS, and alcohol, or an active comparison condition (<em>n</em> = 51) focused exclusively on alcohol use. Compared to the active comparison condition, acceptability ratings were greater for the integrated condition. Latent growth curve models found that participants in both conditions reported statistically significant reductions in alcohol-related cravings/urges and intention to reduce drinking. Participants randomized to the integrated condition reported statistically significantly lower PTSD symptom severity and average daily drinking quantity as well as greater motivation to reduce drinking over time relative to participants in the active comparison condition. Findings provide preliminary support for an integrated approach targeting PTSD, AS, and hazardous drinking, and underscore the need for their continued development.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"196 ","pages":"Article 104935"},"PeriodicalIF":4.5,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616780","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 : 2025-11-21DOI: 10.1016/j.brat.2025.104924
Kibby McMahon , Scott N. Compton , Andrada D. Neacsiu , Nathaniel R. Herr , Kevin S. LaBar , Lisalynn Kelley , Marissa Howard , M. Zachary Rosenthal
Transdiagnostic behavioral interventions often fail to generalize learning beyond the therapy setting, limiting their effectiveness in daily life. This two-experiment study investigated whether pairing novel auditory stimuli with reductions in emotional arousal can help generalize habituation learning and facilitate emotion regulation across contexts and over time. In Experiment 1, participants who had habituation reminders (HRs; novel auditory stimuli) paired repeatedly with a laboratory exposure task showed reduced self-reported distress during a different stressor task one week later. No differences were found when examining markers of physiological arousal. Experiment 2 tested the generalization of HR training to naturalistic settings using mobile phones. Participants receiving HRs during distressing moments in daily life reported more significant reductions in subjective distress compared to controls. Taken together, these results suggest that HRs -- novel auditory stimuli associated with repeated reductions in emotional arousal -- can facilitate the regulation of subjective distress across time and contexts. Clinical implications involve using HRs to enhance emotion regulation interventions by integrating therapy with real-world applications. Future research should explore HR effectiveness across diverse emotional triggers. Overall, HRs represent a promising method for enhancing the durability and generalization of emotion regulation interventions.
{"title":"Generalization of emotion regulation using conditioned reminders on mobile phones","authors":"Kibby McMahon , Scott N. Compton , Andrada D. Neacsiu , Nathaniel R. Herr , Kevin S. LaBar , Lisalynn Kelley , Marissa Howard , M. Zachary Rosenthal","doi":"10.1016/j.brat.2025.104924","DOIUrl":"10.1016/j.brat.2025.104924","url":null,"abstract":"<div><div>Transdiagnostic behavioral interventions often fail to generalize learning beyond the therapy setting, limiting their effectiveness in daily life. This two-experiment study investigated whether pairing novel auditory stimuli with reductions in emotional arousal can help generalize habituation learning and facilitate emotion regulation across contexts and over time. In Experiment 1, participants who had habituation reminders (HRs; novel auditory stimuli) paired repeatedly with a laboratory exposure task showed reduced self-reported distress during a different stressor task one week later. No differences were found when examining markers of physiological arousal. Experiment 2 tested the generalization of HR training to naturalistic settings using mobile phones. Participants receiving HRs during distressing moments in daily life reported more significant reductions in subjective distress compared to controls. Taken together, these results suggest that HRs -- novel auditory stimuli associated with repeated reductions in emotional arousal -- can facilitate the regulation of subjective distress across time and contexts. Clinical implications involve using HRs to enhance emotion regulation interventions by integrating therapy with real-world applications. Future research should explore HR effectiveness across diverse emotional triggers. Overall, HRs represent a promising method for enhancing the durability and generalization of emotion regulation interventions.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"196 ","pages":"Article 104924"},"PeriodicalIF":4.5,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716374","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 : 2025-11-21DOI: 10.1016/j.brat.2025.104921
Noboru Matsumoto , David John Hallford , Lynn Ann Watson
Overgeneral autobiographical memory (OGM), the inability to recall specific events and instead recall general memories, is a well-known feature of psychopathology. Although OGM has been regarded as a deficit in generative retrieval, recent studies highlight the role of direct and involuntary (associative) retrieval in OGM. We propose the accessibility model, which discards the hierarchical structure of autobiographical memory and truncated search hypothesis. The accessibility model assumes that memory representations of different specificities are structured in parallel, and compete to be retrieved. The model contends that direct and generative retrieval are serial processes (i.e., direct retrieval initially, followed by generative retrieval), and specific and general memory accessibility each affect OGM. We argue that increased accessibility of negative general memories and decreased accessibility of positive specific memories underlie OGM in depression. These changes in accessibility are differentially associated with hippocampal abnormalities, memory suppression, self-referential processing, and positivity biases, suggesting different mechanisms depending on emotional valence. Furthermore, we propose that metacognitive monitoring and control are required to initiate generative retrieval when retrieved memories are goal inconsistent. The accessibility model integrates existing basic memory and OGM research, which may lead to improved memory therapeutics, and new avenues for research development.
{"title":"Accessibility model of overgeneral autobiographical memory","authors":"Noboru Matsumoto , David John Hallford , Lynn Ann Watson","doi":"10.1016/j.brat.2025.104921","DOIUrl":"10.1016/j.brat.2025.104921","url":null,"abstract":"<div><div>Overgeneral autobiographical memory (OGM), the inability to recall specific events and instead recall general memories, is a well-known feature of psychopathology. Although OGM has been regarded as a deficit in generative retrieval, recent studies highlight the role of direct and involuntary (associative) retrieval in OGM. We propose the accessibility model, which discards the hierarchical structure of autobiographical memory and truncated search hypothesis. The accessibility model assumes that memory representations of different specificities are structured in parallel, and compete to be retrieved. The model contends that direct and generative retrieval are serial processes (i.e., direct retrieval initially, followed by generative retrieval), and specific and general memory accessibility each affect OGM. We argue that increased accessibility of negative general memories and decreased accessibility of positive specific memories underlie OGM in depression. These changes in accessibility are differentially associated with hippocampal abnormalities, memory suppression, self-referential processing, and positivity biases, suggesting different mechanisms depending on emotional valence. Furthermore, we propose that metacognitive monitoring and control are required to initiate generative retrieval when retrieved memories are goal inconsistent. The accessibility model integrates existing basic memory and OGM research, which may lead to improved memory therapeutics, and new avenues for research development.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"196 ","pages":"Article 104921"},"PeriodicalIF":4.5,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616778","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}
This study examined the acceptability of a new fatigue-focused Cognitive Bias Modification training for interpretations (CBM-I) for those with long term health conditions (LTC) and the feasibility of delivering a randomised controlled trial of fatigue-focused CBM-I compared to control training. Effects on fatigue-related interpretation bias, self-reported fatigue, depression and anxiety were also explored.
Methods
A two-armed (CBM-I or control) randomised controlled feasibility and acceptability trial. Participants with a LTC (cancer, multiple sclerosis, chronic fatigue syndrome or post-COVID condition) were randomly allocated to 12 online training sessions of CBM-I (N = 66) or a matched control condition (N = 65). Participants were assessed at baseline pre-randomisation (T0), and post-intervention (T1), two (T2) and four months post-randomisation (T3). Assessments included measures of acceptability, interpretation bias, self-reported fatigue and mood.
Results
The results indicate that fatigue-focused CBM-I training appears acceptable to people with LTCs, shown by good rates of adherence (77% completing full dose) and acceptability scores. It appears feasible to recruit and retain participants through follow-up (70% retained at four months). There was a large effect size (g = 0.834, 95% CI [0.472,1.196]) in favour of the intervention on the purported mechanism of change (interpretation biases) and small effects on self-reported fatigue and depression but not anxiety.
Conclusions
The study suggests that CBM-I training is an easy to administer, relatively brief digital intervention which shows promise in reducing fatigue and associated symptoms in those with long term health conditions. A full-scale trial of CBM-I for fatigue LTCs is justified on the basis of the findings.
{"title":"Interpretation bias modification (CBM-I) for fatigue in long term health conditions – A feasibility study","authors":"Alicia Hughes , Gabriella Tyson , Rona Moss-Morris , Serena McGuinness , Sophie Fawson , Trudie Chalder , Colette R. Hirsch","doi":"10.1016/j.brat.2025.104917","DOIUrl":"10.1016/j.brat.2025.104917","url":null,"abstract":"<div><h3>Background</h3><div>This study examined the acceptability of a new fatigue-focused Cognitive Bias Modification training for interpretations (CBM-I) for those with long term health conditions (LTC) and the feasibility of delivering a randomised controlled trial of fatigue-focused CBM-I compared to control training. Effects on fatigue-related interpretation bias, self-reported fatigue, depression and anxiety were also explored.</div></div><div><h3>Methods</h3><div>A two-armed (CBM-I or control) randomised controlled feasibility and acceptability trial. Participants with a LTC (cancer, multiple sclerosis, chronic fatigue syndrome or post-COVID condition) were randomly allocated to 12 online training sessions of CBM-I (N = 66) or a matched control condition (N = 65). Participants were assessed at baseline pre-randomisation (T0), and post-intervention (T1), two (T2) and four months post-randomisation (T3). Assessments included measures of acceptability, interpretation bias, self-reported fatigue and mood.</div></div><div><h3>Results</h3><div>The results indicate that fatigue-focused CBM-I training appears acceptable to people with LTCs, shown by good rates of adherence (77% completing full dose) and acceptability scores. It appears feasible to recruit and retain participants through follow-up (70% retained at four months). There was a large effect size (<em>g</em> = 0.834, 95% CI [0.472,1.196]) in favour of the intervention on the purported mechanism of change (interpretation biases) and small effects on self-reported fatigue and depression but not anxiety.</div></div><div><h3>Conclusions</h3><div>The study suggests that CBM-I training is an easy to administer, relatively brief digital intervention which shows promise in reducing fatigue and associated symptoms in those with long term health conditions. A full-scale trial of CBM-I for fatigue LTCs is justified on the basis of the findings.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"196 ","pages":"Article 104917"},"PeriodicalIF":4.5,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145570807","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 : 2025-11-14DOI: 10.1016/j.brat.2025.104922
Helena Widdrington , Mary Gemma Cherry , Katie Herron , Charlotte Krahé
Introduction
To develop effective and acceptable interventions for reducing distress in adults living with chronic pain, understanding the psychological processes presumed to underlie therapeutic approaches is needed. This longitudinal study examined the relative contribution of illness perceptions (grounded in the common-sense model informing cognitive behavioural therapy) and compassion (key to compassion-focused therapy) in predicting anxiety and depression in chronic pain, and explored whether effects were mediated by worry and rumination.
Method
Adults with chronic primary pain, recruited through a tertiary pain management service in the United Kingdom, completed pain interference and severity, illness perceptions, compassion, worry, rumination, anxiety, and depression measures at baseline (N = 159), and three months later (N = 96).
Results
At baseline, lower compassion from others and greater worry were associated with greater anxiety, while more negative illness perceptions, lower compassion (for self and others), greater rumination, and greater pain interference were linked to higher depression scores. Longitudinally, there were no significant direct effects of baseline illness perceptions or compassion on anxiety three months later, and no mediating effects of worry when controlling for pain interference and severity. For depression, more negative illness perceptions at baseline directly predicted greater rumination and depression levels three months later, but no mediating effect of rumination on depression was found.
Discussion
Therapeutic approaches grounded in the common-sense model may be useful in understanding depression in individuals living with chronic pain. Further research is needed to explore processes and mechanisms underpinning anxiety.
{"title":"Illness perceptions and compassion are important psychological processes involved in distress in chronic pain: A longitudinal study","authors":"Helena Widdrington , Mary Gemma Cherry , Katie Herron , Charlotte Krahé","doi":"10.1016/j.brat.2025.104922","DOIUrl":"10.1016/j.brat.2025.104922","url":null,"abstract":"<div><h3>Introduction</h3><div>To develop effective and acceptable interventions for reducing distress in adults living with chronic pain, understanding the psychological processes presumed to underlie therapeutic approaches is needed. This longitudinal study examined the relative contribution of illness perceptions (grounded in the common-sense model informing cognitive behavioural therapy) and compassion (key to compassion-focused therapy) in predicting anxiety and depression in chronic pain, and explored whether effects were mediated by worry and rumination.</div></div><div><h3>Method</h3><div>Adults with chronic primary pain, recruited through a tertiary pain management service in the United Kingdom, completed pain interference and severity, illness perceptions, compassion, worry, rumination, anxiety, and depression measures at baseline (<em>N</em> = 159), and three months later (<em>N</em> = 96).</div></div><div><h3>Results</h3><div>At baseline, lower compassion from others and greater worry were associated with greater anxiety, while more negative illness perceptions, lower compassion (for self and others), greater rumination, and greater pain interference were linked to higher depression scores. Longitudinally, there were no significant direct effects of baseline illness perceptions or compassion on anxiety three months later, and no mediating effects of worry when controlling for pain interference and severity. For depression, more negative illness perceptions at baseline directly predicted greater rumination and depression levels three months later, but no mediating effect of rumination on depression was found.</div></div><div><h3>Discussion</h3><div>Therapeutic approaches grounded in the common-sense model may be useful in understanding depression in individuals living with chronic pain. Further research is needed to explore processes and mechanisms underpinning anxiety.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"196 ","pages":"Article 104922"},"PeriodicalIF":4.5,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616776","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 : 2025-11-14DOI: 10.1016/j.brat.2025.104916
Mathias Twardawski, Gizem Syuleyman
Imagery Rescripting (ImRs) is a well-established psychotherapeutic intervention for treating aversive memories, such as those related to interpersonal transgressions. However, questions remain regarding the optimal implementation of ImRs, particularly concerning which components are most effective. In this experimental study (N = 271), we examined whether guiding participants to imagine forgiving versus taking revenge on a transgressor would differentially affect key emotional and cognitive outcomes. Additionally, we investigated the moderating role of the initial victim-transgressor commitment. Participants were instructed to imagine being the victims in a fictional interpersonal transgression. The imagined transgressor was a person with whom they had either a weak or strong commitment. Participants then engaged in an audio-guided ImRs session oriented toward either forgiveness or revenge, before indicating their aggressive inclinations, positive and negative affect, justice-related satisfaction, and feelings of empowerment. Results indicated that forgiveness-oriented ImRs led to lower aggressive inclinations and negative affect, as well as higher justice-related satisfaction, compared to revenge-oriented ImRs. No differences emerged between conditions in positive affect and feelings of empowerment. Moreover, the effectiveness of both ImRs approaches was independent of the victim-transgressor commitment. These findings suggest that forgiveness-oriented ImRs may offer a promising approach to reduce the emotional consequences of transgressions, with a reduced risk of increasing aggressive inclinations among victims. This highlights the potential value of incorporating forgiveness into ImRs protocols. However, given the fictional nature of the transgression and the standardized, non-clinical setting, further research is needed to evaluate the clinical applicability of these findings.
{"title":"Imagery rescripting of interpersonal transgressions: Forgiveness, revenge, and commitment in the victim-transgressor relationship","authors":"Mathias Twardawski, Gizem Syuleyman","doi":"10.1016/j.brat.2025.104916","DOIUrl":"10.1016/j.brat.2025.104916","url":null,"abstract":"<div><div>Imagery Rescripting (ImRs) is a well-established psychotherapeutic intervention for treating aversive memories, such as those related to interpersonal transgressions. However, questions remain regarding the optimal implementation of ImRs, particularly concerning which components are most effective. In this experimental study (<em>N</em> = 271), we examined whether guiding participants to imagine forgiving versus taking revenge on a transgressor would differentially affect key emotional and cognitive outcomes. Additionally, we investigated the moderating role of the initial victim-transgressor commitment. Participants were instructed to imagine being the victims in a fictional interpersonal transgression. The imagined transgressor was a person with whom they had either a weak or strong commitment. Participants then engaged in an audio-guided ImRs session oriented toward either forgiveness or revenge, before indicating their aggressive inclinations, positive and negative affect, justice-related satisfaction, and feelings of empowerment. Results indicated that forgiveness-oriented ImRs led to lower aggressive inclinations and negative affect, as well as higher justice-related satisfaction, compared to revenge-oriented ImRs. No differences emerged between conditions in positive affect and feelings of empowerment. Moreover, the effectiveness of both ImRs approaches was independent of the victim-transgressor commitment. These findings suggest that forgiveness-oriented ImRs may offer a promising approach to reduce the emotional consequences of transgressions, with a reduced risk of increasing aggressive inclinations among victims. This highlights the potential value of incorporating forgiveness into ImRs protocols. However, given the fictional nature of the transgression and the standardized, non-clinical setting, further research is needed to evaluate the clinical applicability of these findings.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"195 ","pages":"Article 104916"},"PeriodicalIF":4.5,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558309","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 : 2025-11-12DOI: 10.1016/j.brat.2025.104914
Halaina R. Winter , Alice R. Norton , Bethany M. Wootton
Imagery rescripting (ImR) has demonstrated efficacy in reducing symptoms of social anxiety disorder (SAD). However, there are many logistical and psychological barriers that prevent individuals with SAD from accessing treatment. The efficacy of remote treatment methodologies, such as internet videoconferencing, has recently been demonstrated across a range of mental disorders. However, the efficacy of videoconferencing-delivered ImR (vImR) has not yet been examined. The present study aims to examine the efficacy and acceptability of vImR for SAD in a multiple baseline trial utilising the waitlist control group from a larger randomised controlled trial (RCT). 35 participants (Mage = 37.86; SD = 12.90) received no intervention for 8-weeks, then received an 8-session manualised vImR treatment protocol. Within-group analyses indicated negligible effect sizes from baseline to pre-treatment (SIAS-6: d = 0.22; 95 % CI: 0.25 – 0.69; SPS-6: d = −0.03; 95 % CI: 0.49 – 0.44). Large effect sizes were found from pre-treatment to post-treatment (SIAS-6: d = 0.81; 95 % CI: 0.32–1.29; SPS-6: d = 0.80; 95 % CI: 0.30–1.27) and pre-treatment to 3-month follow-up (SIAS-6: d = 0.85; 95 % CI: 0.36–1.33; SPS-6: d = 0.90; 95 % CI: 0.40–1.38). At post-treatment, 66 % of participants no longer met criteria for SAD (74 % at 3-month follow-up). Benchmarking analyses indicated similar treatment effect sizes to in-person ImR for SAD. Participants rated the program as highly acceptable. The results indicate that the mechanisms of ImR appear to be transferable to vImR and therefore this may be a viable remote treatment option for individuals with SAD who do not respond to first-line treatments.
意象处方（ImR）在减轻社交焦虑障碍（SAD）症状方面已被证明有效。然而，有许多后勤和心理障碍阻碍了SAD患者获得治疗。网络视频会议等远程治疗方法的有效性最近已在一系列精神疾病中得到证实。然而，视频会议提供的ImR （vImR）的有效性尚未得到检验。本研究旨在检验vImR治疗SAD的有效性和可接受性，该试验采用多基线试验，利用来自更大的随机对照试验（RCT）的等待名单对照组。35名参与者（Mage = 37.86; SD = 12.90）在8周内不接受干预，然后接受8个疗程的手动vImR治疗方案。组内分析表明，从基线到预处理的效应大小可以忽略不计（SIAS-6: d = 0.22; 95% CI: 0.25 - 0.69; SPS-6: d = -0.03; 95% CI: 0.49 - 0.44）。从治疗前到治疗后（SIAS-6: d = 0.81; 95% CI: 0.32-1.29; SPS-6: d = 0.80; 95% CI: 0.30-1.27）和治疗前到3个月的随访（SIAS-6: d = 0.85; 95% CI: 0.36-1.33; SPS-6: d = 0.90; 95% CI: 0.40-1.38）均发现了较大的效应量。在治疗后，66%的参与者不再符合SAD的标准（3个月随访时为74%）。基准分析表明，SAD的治疗效果与现场ImR相似。参与者对这个项目的评价是高度可接受的。结果表明，ImR的机制似乎可以转移到vImR，因此对于对一线治疗无效的SAD患者来说，这可能是一个可行的远程治疗选择。
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