Behaviour Research and Therapy最新文献_第5页

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 Epub Date: 2025-12-31 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 Epub Date: 2025-11-21 DOI: 10.1016/j.brat.2025.104933

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

引用次数: 0

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

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2026-01-01 Epub Date: 2025-12-03 DOI: 10.1016/j.brat.2025.104937

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

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

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

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引用次数: 0

Accessibility model of overgeneral autobiographical memory 过度自传式记忆的可及性模型

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2026-01-01 Epub Date: 2025-11-21 DOI: 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.

过度概括自传式记忆（OGM），即不能回忆具体事件，而是回忆一般记忆，是精神病理学的一个众所周知的特征。虽然OGM一直被认为是生成检索的缺陷，但最近的研究强调了直接和非自愿（联想）检索在OGM中的作用。我们提出了可及性模型，该模型抛弃了自传体记忆的层次结构和截断搜索假设。可访问性模型假设不同特异性的内存表示是并行构建的，并竞争被检索。该模型认为，直接检索和生成检索是连续的过程（即首先是直接检索，然后是生成检索），特定和一般记忆可及性都影响OGM。我们认为，消极一般记忆的可及性增加和积极特定记忆的可及性减少是抑郁症OGM的基础。可及性的这些变化与海马异常、记忆抑制、自我参照加工和积极偏见有不同的关联，表明不同的机制取决于情绪效价。此外，我们提出，当检索到的记忆目标不一致时，需要元认知监测和控制来启动生成检索。可及性模型整合了现有的基础记忆和OGM研究，这可能会导致记忆治疗的改进，并为研究发展提供新的途径。

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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 : 2026-01-01 Epub 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。

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引用次数: 0

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

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2026-01-01 Epub Date: 2025-11-30 DOI: 10.1016/j.brat.2025.104936

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

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

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

引用次数: 0

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 : 2026-01-01 Epub 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

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

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2026-01-01 Epub Date: 2025-11-25 DOI: 10.1016/j.brat.2025.104935

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

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

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

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引用次数: 0

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 : 2026-01-01 Epub 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

On bias and balance: Updating agentic and communal self-beliefs in social anxiety and depression 偏见与平衡：在社交焦虑和抑郁中更新主观和集体的自我信念。

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-12-01 Epub Date: 2025-10-26 DOI: 10.1016/j.brat.2025.104905

Zohar Klein , Reut Zabag , Dan E. Hay , Einat Levy-Gigi , Eva Gilboa-Schechtman

Cognitive models propose that biased information processing in social anxiety (SA) and depression facilitates negative and inhibits the processing of positive self-information. These biases are postulated to reinforce persistent negative views of the self. Biased updating of self-beliefs in response to valanced new information in both SA and depression is theoretically postulated. The results, however, are not fully consistent with theoretical postulations. Importantly, self-information is structured around two main domains - agency (e.g., competence, assertiveness) and communion (e.g., warmth, connectedness). These domains distinctly influence the way information about the self is processed and integrated. However, this distinction is missing from the examination of self-belief updating. The current study examined how individuals update agentic and communal self-beliefs in response to negative and positive social feedback. We employed a novel ‘SocialMirror’ paradigm in a large subclinical sample (N = 560). In this two-phase reversal learning task, participants received negative feedback followed by positive feedback on their personality traits. SA was uniquely associated with increased negative updating of agentic, but not communal, self-beliefs. Depression was uniquely associated with reduced positive updating across both domains. Notably, these findings remained evident even after statistically controlling for initial beliefs. Across the sample, updating was domain dependent, with agentic traits being less malleable. These findings suggest domain- and valence-related patterns of self-belief updating in SA and depression. Results are interpreted in light of Bayesian models, emphasizing the need to integrate motivational aspects into cognitive theory. We highlight the implications of these findings for interventions aimed at updating self-belief in psychopathology.

认知模型表明，社交焦虑和抑郁的偏倚信息加工促进了消极自我信息的加工，抑制了积极自我信息的加工。这些偏见被认为是为了强化对自我的持续负面看法。在SA和抑郁症中，有偏见的自我信念更新是对有价值的新信息的反应，理论上是假设的。然而，结果并不完全符合理论假设。重要的是，自我信息是围绕两个主要领域构建的——代理（例如，能力、自信）和交流（例如，温暖、联系）。这些领域明显地影响着关于自我的信息被处理和整合的方式。然而，这种区别在自我信念更新的研究中是缺失的。目前的研究考察了个人如何在回应消极和积极的社会反馈时更新个人和群体的自我信念。我们在一个大型亚临床样本（N = 560）中采用了一种新颖的“SocialMirror”范式。在这个两阶段的逆向学习任务中，参与者先收到关于他们性格特征的负面反馈，然后收到正面反馈。SA与主观自我信念的负面更新增加有独特的关联，而与集体自我信念无关。抑郁症与这两个领域的积极更新减少有独特的联系。值得注意的是，即使在统计上控制了初始信念之后，这些发现仍然很明显。在整个样本中，更新是领域依赖的，代理特征的可塑性较小。这些发现提示了SA和抑郁症中自我信念更新的域和价相关模式。结果根据贝叶斯模型解释，强调需要将动机方面整合到认知理论中。我们强调这些发现对旨在更新精神病理学自我信念的干预措施的意义。

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引用次数: 0