Pub Date : 2024-10-17DOI: 10.1016/j.brat.2024.104646
James Carson , Kalliopi Demetriou , Gemma Barlow , Kim Wright , Maria Loades , Barnaby D. Dunn
Augmented Depression Therapy (ADepT) is an individual psychotherapy for depression, which has been shown to be effective in the general adult population. A randomised multiple baseline case series evaluated the feasibility, acceptability, and effectiveness of ADepT in young adults (aged 20–24). Eleven depressed young adults were recruited from a UK university wellbeing service to receive ADepT during the COVID-19 pandemic, with outcomes evaluated relative to pre-specified continuation targets. All participants received a minimum adequate treatment dose (>60% target); 89% judged ADepT as acceptable and satisfactory and would recommend it to others (>60% target); only 9% showed reliable deterioration for depression or wellbeing (meeting <30% target); and there were no trial- or treatment-related serious adverse events. Qualitative interviews revealed most participants were satisfied with and experienced benefits from ADepT. At post-treatment, reliable improvement was shown by 33% of participants for depression and 67% of participants for wellbeing (not meeting target of both >60%), with medium effect size improvements for depression (g = 0.78) and large effect size improvement for wellbeing (g = 0.93; not meeting target of both >0.80). ADepT is feasible, acceptable, and safe in young adults but may require modification to maximise effectiveness. Further research outside of the COVID-19 pandemic is warranted.
{"title":"Augmented Depression Therapy for young adults: A mixed methods randomised multiple baseline case series evaluation","authors":"James Carson , Kalliopi Demetriou , Gemma Barlow , Kim Wright , Maria Loades , Barnaby D. Dunn","doi":"10.1016/j.brat.2024.104646","DOIUrl":"10.1016/j.brat.2024.104646","url":null,"abstract":"<div><div>Augmented Depression Therapy (ADepT) is an individual psychotherapy for depression, which has been shown to be effective in the general adult population. A randomised multiple baseline case series evaluated the feasibility, acceptability, and effectiveness of ADepT in young adults (aged 20–24). Eleven depressed young adults were recruited from a UK university wellbeing service to receive ADepT during the COVID-19 pandemic, with outcomes evaluated relative to pre-specified continuation targets. All participants received a minimum adequate treatment dose (>60% target); 89% judged ADepT as acceptable and satisfactory and would recommend it to others (>60% target); only 9% showed reliable deterioration for depression or wellbeing (meeting <30% target); and there were no trial- or treatment-related serious adverse events. Qualitative interviews revealed most participants were satisfied with and experienced benefits from ADepT. At post-treatment, reliable improvement was shown by 33% of participants for depression and 67% of participants for wellbeing (not meeting target of both >60%), with medium effect size improvements for depression (g = 0.78) and large effect size improvement for wellbeing (g = 0.93; not meeting target of both >0.80). ADepT is feasible, acceptable, and safe in young adults but may require modification to maximise effectiveness. Further research outside of the COVID-19 pandemic is warranted.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"183 ","pages":"Article 104646"},"PeriodicalIF":4.2,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-17DOI: 10.1016/j.brat.2024.104644
Zhenjie Xu, Kairui Yu, Yingying Wang
Traumatic memory intrusions, the involuntary retrieval of unwanted memories, significantly impact mental health. The dual representation theory proposes that the origin of intrusion lies in the overactivated sensory memory not being integrated with the corresponding contextual memory, highlighting the crucial associations between memory contextualization and intrusion. To test this, our study investigated whether enhancing memory contextualization could effectively reduce intrusion. After experiencing analogue trauma with the trauma film paradigm, 96 healthy participants were randomly allocated to three intervention groups: active contextualization (AC) in which participants actively retrieve and restructure film content, passive contextualization (PC) in which participants passively restudy content-matched pre-contextualized information, and working memory taxation (WM) in which participants performed a working memory dual-task. Diary recordings over the subsequent week revealed a significant reduction in intrusion frequency in the AC group compared to both the PC group and a no-intervention control group. Furthermore, comparing AC with WM, a well-established laboratory intervention on intrusion, established a superior efficacy of the AC intervention in reducing intrusions. Finally, analyses of the explicitly recollected film memories identified the critical element of active contextualization to be memory integration induced by active memory retrieval. Together, our findings suggest that active contextualization causally diminishes intrusions, providing novel insights into the regulation of the contextual memory system in intrusion intervention.
创伤性记忆入侵，即非自愿地检索不想要的记忆，对心理健康有重大影响。双重表征理论认为，入侵的根源在于过度激活的感官记忆没有与相应的情境记忆整合在一起，这凸显了记忆情境化与入侵之间的重要关联。为了验证这一点，我们的研究调查了增强记忆情境化是否能有效减少入侵。96名健康参与者在经历了创伤电影范式的模拟创伤后，被随机分配到三个干预组：主动情境化（AC）组，参与者主动检索和重组电影内容；被动情境化（PC）组，参与者被动地重新学习内容匹配的预情境化信息；工作记忆征税（WM）组，参与者执行工作记忆双重任务。随后一周的日记记录显示，与 PC 组和未干预对照组相比，AC 组的入侵频率明显降低。此外，将 AC 与 WM（一种成熟的实验室入侵干预方法）进行比较后发现，AC 干预方法在减少入侵方面具有更优越的效果。最后，对明确回忆起的电影记忆进行分析后发现，主动情境化的关键因素是主动记忆检索所引起的记忆整合。总之，我们的研究结果表明，主动情境化会因果性地减少闯入，为情境记忆系统在闯入干预中的调节提供了新的见解。
{"title":"Active contextualization reduces traumatic memory intrusions via memory integration","authors":"Zhenjie Xu, Kairui Yu, Yingying Wang","doi":"10.1016/j.brat.2024.104644","DOIUrl":"10.1016/j.brat.2024.104644","url":null,"abstract":"<div><div>Traumatic memory intrusions, the involuntary retrieval of unwanted memories, significantly impact mental health. The dual representation theory proposes that the origin of intrusion lies in the overactivated sensory memory not being integrated with the corresponding contextual memory, highlighting the crucial associations between memory contextualization and intrusion. To test this, our study investigated whether enhancing memory contextualization could effectively reduce intrusion. After experiencing analogue trauma with the trauma film paradigm, 96 healthy participants were randomly allocated to three intervention groups: active contextualization (AC) in which participants actively retrieve and restructure film content, passive contextualization (PC) in which participants passively restudy content-matched pre-contextualized information, and working memory taxation (WM) in which participants performed a working memory dual-task. Diary recordings over the subsequent week revealed a significant reduction in intrusion frequency in the AC group compared to both the PC group and a no-intervention control group. Furthermore, comparing AC with WM, a well-established laboratory intervention on intrusion, established a superior efficacy of the AC intervention in reducing intrusions. Finally, analyses of the explicitly recollected film memories identified the critical element of active contextualization to be memory integration induced by active memory retrieval. Together, our findings suggest that active contextualization causally diminishes intrusions, providing novel insights into the regulation of the contextual memory system in intrusion intervention.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"183 ","pages":"Article 104644"},"PeriodicalIF":4.2,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510598","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 : 2024-10-16DOI: 10.1016/j.brat.2024.104645
Jun Hu , Yiqun Gan , Zhenyu Li , Xianrui Li , Tianwei Xu , Jiang Qiu , Xiaoqin Wang , Dongtao Wei
The dynamic view of emotion regulation (ER) posits that ER is a temporally dynamic process unfolding over time. Cognitive reappraisal and rumination, two extensively investigated ER strategies, are implicated in depression. However, it remains unclear whether these two strategies exhibit reciprocal relations in real-world contexts, and whether such relations vary across baseline depressive symptoms. To address this, we conducted two experience sampling studies and applied residual dynamic structural equation modeling (RDSEM). Results of the RDSEM revealed significant bidirectional associations between cognitive reappraisal and rumination in the Chinese sample, whereas in the Belgian sample, only a unidirectional relationship was found where rumination predicts subsequent cognitive reappraisal. Additionally, both strategies demonstrated stable autoregressive effects. Interestingly, higher depressive symptoms predicted a lower autoregressive effect of cognitive reappraisal within the Chinese sample, while this was not the case in the Belgian sample. These findings highlight the importance of targeting factors such as dynamics in ER and its relationship with depression symptoms.
情绪调节（ER）的动态观点认为，情绪调节是一个随着时间推移而展开的时间动态过程。认知再评价和反刍这两种被广泛研究的情绪调节策略与抑郁症有关。然而，这两种策略在现实世界中是否表现出互为因果的关系，以及这种关系是否随基线抑郁症状的不同而变化，目前仍不清楚。为了解决这个问题，我们进行了两项经验取样研究，并应用了残差动态结构方程模型（RDSEM）。残差动态结构方程模型的结果显示，在中国样本中，认知重评与反刍之间存在显著的双向关系，而在比利时样本中，只发现了反刍预测后续认知重评的单向关系。此外，两种策略都表现出稳定的自回归效应。有趣的是，在中国样本中，抑郁症状越严重，认知重评的自回归效应就越低，而在比利时样本中却并非如此。这些发现凸显了针对 ER 动态性等因素及其与抑郁症状关系的重要性。
{"title":"Examining the moderating role of depressive symptoms on the dynamic interplay between cognitive reappraisal and rumination: Evidence from experience sampling","authors":"Jun Hu , Yiqun Gan , Zhenyu Li , Xianrui Li , Tianwei Xu , Jiang Qiu , Xiaoqin Wang , Dongtao Wei","doi":"10.1016/j.brat.2024.104645","DOIUrl":"10.1016/j.brat.2024.104645","url":null,"abstract":"<div><div>The dynamic view of emotion regulation (ER) posits that ER is a temporally dynamic process unfolding over time. Cognitive reappraisal and rumination, two extensively investigated ER strategies, are implicated in depression. However, it remains unclear whether these two strategies exhibit reciprocal relations in real-world contexts, and whether such relations vary across baseline depressive symptoms. To address this, we conducted two experience sampling studies and applied residual dynamic structural equation modeling (RDSEM). Results of the RDSEM revealed significant bidirectional associations between cognitive reappraisal and rumination in the Chinese sample, whereas in the Belgian sample, only a unidirectional relationship was found where rumination predicts subsequent cognitive reappraisal. Additionally, both strategies demonstrated stable autoregressive effects. Interestingly, higher depressive symptoms predicted a lower autoregressive effect of cognitive reappraisal within the Chinese sample, while this was not the case in the Belgian sample. These findings highlight the importance of targeting factors such as dynamics in ER and its relationship with depression symptoms.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"183 ","pages":"Article 104645"},"PeriodicalIF":4.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478038","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 : 2024-10-16DOI: 10.1016/j.brat.2024.104647
Dorothee Scheuermann , Christiane A. Melzig , Christoph Benke
Occasionally presenting the unconditioned stimulus (US) during extinction training (occasional reinforced extinction, ORE) either unpaired or paired with the conditioned stimulus (CS) provides initial evidence for a less pronounced return of fear. However, translating this approach into clinical practice is challenging due to ethical and practical concerns of exposing patients to the original USs. The present study investigated extinction of fear responses in a novel approach employing ORE using vivid fear imagery of the US instead of actually exposing to it. Three experimental groups underwent differential fear conditioning. Subsequently, participants either received a non-reinforced (standard extinction, N = 25), occasional paired (N = 26), or occasional unpaired (N = 25) reinforced extinction training, followed by assessments for spontaneous recovery, reinstatement, and reacquisition of fear responses. Response patterns during spontaneous recovery, reinstatement and reacquisition showed no benefit from either paired or unpaired imaginative ORE. The current findings suggest that incorporating fear imagery of the US in ORE so far does not result in reducing the return of fear. Further investigation is needed to determine whether imaginal ORE with adjustments could still be a readily applicable strategy for translating the ORE approach into clinical practice.
{"title":"Leveraging occasional reinforced extinction via mental imagery of the unconditioned stimulus to optimize extinction learning","authors":"Dorothee Scheuermann , Christiane A. Melzig , Christoph Benke","doi":"10.1016/j.brat.2024.104647","DOIUrl":"10.1016/j.brat.2024.104647","url":null,"abstract":"<div><div>Occasionally presenting the unconditioned stimulus (US) during extinction training (occasional reinforced extinction, ORE) either unpaired or paired with the conditioned stimulus (CS) provides initial evidence for a less pronounced return of fear. However, translating this approach into clinical practice is challenging due to ethical and practical concerns of exposing patients to the original USs. The present study investigated extinction of fear responses in a novel approach employing ORE using vivid fear imagery of the US instead of actually exposing to it. Three experimental groups underwent differential fear conditioning. Subsequently, participants either received a non-reinforced (standard extinction, <em>N</em> = 25), occasional paired (<em>N</em> = 26), or occasional unpaired (<em>N</em> = 25) reinforced extinction training, followed by assessments for spontaneous recovery, reinstatement, and reacquisition of fear responses. Response patterns during spontaneous recovery, reinstatement and reacquisition showed no benefit from either paired or unpaired imaginative ORE. The current findings suggest that incorporating fear imagery of the US in ORE so far does not result in reducing the return of fear. Further investigation is needed to determine whether imaginal ORE with adjustments could still be a readily applicable strategy for translating the ORE approach into clinical practice.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"183 ","pages":"Article 104647"},"PeriodicalIF":4.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-15DOI: 10.1016/j.brat.2024.104643
Bethany M. Wootton , Eyal Karin , Maral Melkonian , Sarah McDonald , Nickolai Titov , Blake F. Dear
Internet-delivered cognitive behavioural therapy (ICBT) is an effective treatment for obsessive-compulsive disorder (OCD). Currently there is limited research examining the predictors and moderators of outcome in ICBT for OCD. This study examined moderators of treatment outcome in a sample of 216 individuals who commenced a self-guided ICBT intervention for OCD (Mage = 34.00; SD = 12.57; 72.7% female). The results indicated that those with higher baseline OCD severity, depression severity, and neuroticism had less improvement at post-treatment and follow up (resulting in 40%, 24% and 12% higher symptom severity for every standard deviation increase on the measure at post-treatment and 33%, 17% and 20% higher symptoms at follow up respectively). However, participants with higher baseline treatment expectancy and readiness to reduce rituals and compulsions had better outcomes at post-treatment and three-month follow up (resulting in a 5% and 7% lower symptom severity for every standard deviation increase on the measure at post-treatment and 12% and 12% lower symptoms at follow up respectively). The results have important implications for who may respond best to self-guided ICBT.
{"title":"Moderators of outcome in self-guided internet-delivered cognitive-behavior therapy for obsessive-compulsive disorder","authors":"Bethany M. Wootton , Eyal Karin , Maral Melkonian , Sarah McDonald , Nickolai Titov , Blake F. Dear","doi":"10.1016/j.brat.2024.104643","DOIUrl":"10.1016/j.brat.2024.104643","url":null,"abstract":"<div><div>Internet-delivered cognitive behavioural therapy (ICBT) is an effective treatment for obsessive-compulsive disorder (OCD). Currently there is limited research examining the predictors and moderators of outcome in ICBT for OCD. This study examined moderators of treatment outcome in a sample of 216 individuals who commenced a self-guided ICBT intervention for OCD (<em>M</em>age = 34.00; <em>SD</em> = 12.57; 72.7% female). The results indicated that those with higher baseline OCD severity, depression severity, and neuroticism had less improvement at post-treatment and follow up (resulting in 40%, 24% and 12% higher symptom severity for every standard deviation increase on the measure at post-treatment and 33%, 17% and 20% higher symptoms at follow up respectively). However, participants with higher baseline treatment expectancy and readiness to reduce rituals and compulsions had better outcomes at post-treatment and three-month follow up (resulting in a 5% and 7% lower symptom severity for every standard deviation increase on the measure at post-treatment and 12% and 12% lower symptoms at follow up respectively). The results have important implications for who may respond best to self-guided ICBT.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"183 ","pages":"Article 104643"},"PeriodicalIF":4.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.brat.2024.104640
Kenny Yu , Tom Beckers , Francis Tuerlinckx , Wolf Vanpaemel , Jonas Zaman
In this study we aimed to investigate gender differences in fear generalization tendencies in humans and, inspired by recent findings in animal research, examine whether any such differences could stem from differences in memory precision. Forty men and forty women underwent a differential fear conditioning procedure using geometric shapes as cues. Subsequently, generalized fear responses were assessed across a spectrum of perceptually similar shapes. Throughout generalization testing, perceptual memory accuracy was repeatedly probed using a stimulus recreation task. Using statistical and computational modeling, we found strong evidence for the absence of gender differences in fear learning and generalization behavior. The evidence for gender differences in related processes such as perception and memory was inconclusive. Although some of our findings hinted at the possibility that women may be more perceptive of physical differences between stimuli and have more accurate memory than men, those observations were not consistently replicated across experimental conditions and analytical approaches. Our results contribute to the emerging literature on gender differences in perceptual fear generalization in humans and underscore the need for further systematic research to explore the interplay between gender and mechanisms associated with fear generalization across different experimental contexts.
{"title":"The assessment of gender differences in perceptual fear generalization and related processes","authors":"Kenny Yu , Tom Beckers , Francis Tuerlinckx , Wolf Vanpaemel , Jonas Zaman","doi":"10.1016/j.brat.2024.104640","DOIUrl":"10.1016/j.brat.2024.104640","url":null,"abstract":"<div><div>In this study we aimed to investigate gender differences in fear generalization tendencies in humans and, inspired by recent findings in animal research, examine whether any such differences could stem from differences in memory precision. Forty men and forty women underwent a differential fear conditioning procedure using geometric shapes as cues. Subsequently, generalized fear responses were assessed across a spectrum of perceptually similar shapes. Throughout generalization testing, perceptual memory accuracy was repeatedly probed using a stimulus recreation task. Using statistical and computational modeling, we found strong evidence for the absence of gender differences in fear learning and generalization behavior. The evidence for gender differences in related processes such as perception and memory was inconclusive. Although some of our findings hinted at the possibility that women may be more perceptive of physical differences between stimuli and have more accurate memory than men, those observations were not consistently replicated across experimental conditions and analytical approaches. Our results contribute to the emerging literature on gender differences in perceptual fear generalization in humans and underscore the need for further systematic research to explore the interplay between gender and mechanisms associated with fear generalization across different experimental contexts.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"183 ","pages":"Article 104640"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401641","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 : 2024-10-01DOI: 10.1016/j.brat.2024.104641
Yafeng Pan , Matteo Sequestro , Armita Golkar , Andreas Olsson
Human touch is a powerful means of social and affective regulation, promoting safety behaviors. Yet, despite its importance across human contexts, it remains unknown how touch can promote the learning of new safety memories and what neural processes underlie such effects. The current study used measures of peripheral physiology and brain activity to examine the effects of interpersonal touch during safety learning (extinction) on the recovery of previously learned threat. We observed that handholding during extinction significantly reduced threat recovery, which was reflected in enhanced prefrontal hemodynamic responses. This effect was absent when learners were instructed to hold a rubber ball, independent of the presence of their partners. Our findings indicate that social touch contributes to safety learning, potentially influencing threat memories via prefrontal circuitry.
{"title":"Handholding reduces the recovery of threat memories and magnifies prefrontal hemodynamic responses","authors":"Yafeng Pan , Matteo Sequestro , Armita Golkar , Andreas Olsson","doi":"10.1016/j.brat.2024.104641","DOIUrl":"10.1016/j.brat.2024.104641","url":null,"abstract":"<div><div>Human touch is a powerful means of social and affective regulation, promoting safety behaviors. Yet, despite its importance across human contexts, it remains unknown how touch can promote the learning of new safety memories and what neural processes underlie such effects. The current study used measures of peripheral physiology and brain activity to examine the effects of interpersonal touch during safety learning (extinction) on the recovery of previously learned threat. We observed that handholding during extinction significantly reduced threat recovery, which was reflected in enhanced prefrontal hemodynamic responses. This effect was absent when learners were instructed to hold a rubber ball, independent of the presence of their partners. Our findings indicate that social touch contributes to safety learning, potentially influencing threat memories via prefrontal circuitry.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"183 ","pages":"Article 104641"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-29DOI: 10.1016/j.brat.2024.104639
Andrew G. Guzick , Sophie C. Schneider , Minjee Kook , Rebecca Greenberg , Amanda Perozo-Garcia , Morgan P. Lee , Jessica Garcia , Ogechi Cynthia Onyeka , David B. Riddle , Eric A. Storch
This study tested two versions of parent-led, Internet-delivered cognitive behavioral therapy for anxiety among autistic youth; one that provided weekly email support (iCBT-Email), and one that provided alternating bi-weekly emails and video calls (iCBT-Video) across 12 weeks. It was expected that those in the iCBT-Video condition would complete more treatment content, which in turn would lead to more anxiety improvement. Fifty-seven autistic youth (7-15 years-old) with anxiety disorders were randomized to iCBT-Email or iCBT-Video. There were no significant differences in improvement in clinician-rated, child-reported, or parent-reported anxiety severity or functional impairment. Posttreatment response rates were 55% in iCBT-Email and 67% in iCBT-Video. Module completion predicted improved treatment outcome, though there was no difference in module completion across groups. Therapists spent an average of 16.29 min/family/week (SD = 7.11) in the iCBT-Email condition and 24.13 min/family/week (SD = 6.84) in the iCBT-Video condition. Email and telehealth-supported, parent-led iCBT both appear to be effective treatments for autistic youth with anxiety disorders that require reduced therapist effort. Future research should seek novel methods to enhance engagement with iCBT content.
{"title":"Internet-based, parent-led cognitive behavioral therapy for autistic youth with anxiety-related disorders: A randomized trial comparing email vs. telehealth support","authors":"Andrew G. Guzick , Sophie C. Schneider , Minjee Kook , Rebecca Greenberg , Amanda Perozo-Garcia , Morgan P. Lee , Jessica Garcia , Ogechi Cynthia Onyeka , David B. Riddle , Eric A. Storch","doi":"10.1016/j.brat.2024.104639","DOIUrl":"10.1016/j.brat.2024.104639","url":null,"abstract":"<div><div>This study tested two versions of parent-led, Internet-delivered cognitive behavioral therapy for anxiety among autistic youth; one that provided weekly email support (iCBT-Email), and one that provided alternating bi-weekly emails and video calls (iCBT-Video) across 12 weeks. It was expected that those in the iCBT-Video condition would complete more treatment content, which in turn would lead to more anxiety improvement. Fifty-seven autistic youth (7-15 years-old) with anxiety disorders were randomized to iCBT-Email or iCBT-Video. There were no significant differences in improvement in clinician-rated, child-reported, or parent-reported anxiety severity or functional impairment. Posttreatment response rates were 55% in iCBT-Email and 67% in iCBT-Video. Module completion predicted improved treatment outcome, though there was no difference in module completion across groups. Therapists spent an average of 16.29 min/family/week (<em>SD</em> = 7.11) in the iCBT-Email condition and 24.13 min/family/week (<em>SD</em> = 6.84) in the iCBT-Video condition. Email and telehealth-supported, parent-led iCBT both appear to be effective treatments for autistic youth with anxiety disorders that require reduced therapist effort. Future research should seek novel methods to enhance engagement with iCBT content.</div></div><div><h3>ClinicalTrials.gov identifier</h3><div>NCT05284435.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"183 ","pages":"Article 104639"},"PeriodicalIF":4.2,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378380","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 : 2024-09-22DOI: 10.1016/j.brat.2024.104638
Ronald M. Rapee , Lauren F. McLellan , Talia Carl , Jennifer L. Hudson , Ellen Parker , Nora Trompeter , Viviana M. Wuthrich
Background
Paediatric social anxiety disorder (SoAD) responds poorly to treatment. Improved understanding of potential psychological maintaining processes may indicate fruitful directions to improve treatment outcomes. The current study compared self-reported psychological processes and state anxiety in response to two social tasks experienced by children and adolescents with SoAD against comparison samples.
Methods
641 children and adolescents aged 6–17 years (Mage = 9.45 yr; 47.6% girls) engaged in a brief, impromptu speech and a social discussion with a confederate. Participants included 307 with SoAD, 285 with other mental disorders, and 49 non-clinical controls. Participants who completed each task self-reported their anticipated probability and cost of negative evaluation, self-focused attention, personal evaluation of social performance, and engagement in post-event rumination (assessed 1 h later). Independent raters also scored their social performance. Relationships between the variables were tested through path analysis.
Results
Participants with SoAD were more likely to avoid and reported significantly greater state anxiety than both comparison groups. They also reported higher levels of each of the putative maintaining processes than either comparison group. In contrast, independent observers did not discriminate between groups on their overt social performance. Path analyses demonstrated good fit of a priori models to the data for both social tasks.
Conclusions
Paediatric SoAD is associated with strong expectation of the probability and cost of negative evaluation, excess self-focused attention, and more negative evaluation of one's own social performance. In turn, these putative processes are strong predictors of state anxiety and post-event processing in response to both a speech and social interaction.
背景儿童社交焦虑症（SoAD）的治疗效果不佳。提高对潜在心理维持过程的认识可能会为改善治疗效果指明富有成效的方向。本研究比较了患有 SoAD 的儿童和青少年与对比样本在应对两项社交任务时的自我报告心理过程和状态焦虑。方法641 名 6-17 岁的儿童和青少年（年龄=9.45 岁；47.6% 为女孩）参与了简短的即兴演讲和与同伴的社交讨论。参与者中包括 307 名 SoAD 患者、285 名其他精神障碍患者和 49 名非临床对照组患者。完成每项任务的参与者都会自我报告他们预期的负面评价概率和代价、自我关注、对社交表现的个人评价以及参与事件后反刍（1 小时后评估）的情况。独立评分员也对他们的社会表现进行了评分。通过路径分析对各变量之间的关系进行了测试。结果患有 SoAD 的参与者更有可能回避，而且他们所报告的状态焦虑明显高于两个对比组。他们报告的每一种假定的维持过程的水平也高于任何一个对比组。与此相反，独立观察者并没有在公开社交表现上对不同组别进行区分。路径分析显示，先验模型与两项社交任务的数据拟合良好。结论小儿 SoAD 与对负面评价的概率和代价的强烈预期、过度自我关注以及对自身社交表现的负面评价有关。反过来，这些假定的过程也能有力地预测讲话和社交互动时的状态焦虑和事件后处理。
{"title":"Testing theoretical processes that maintain paediatric social anxiety: A comparison between children and adolescents with social anxiety disorder, other mental disorders, and non-clinical controls","authors":"Ronald M. Rapee , Lauren F. McLellan , Talia Carl , Jennifer L. Hudson , Ellen Parker , Nora Trompeter , Viviana M. Wuthrich","doi":"10.1016/j.brat.2024.104638","DOIUrl":"10.1016/j.brat.2024.104638","url":null,"abstract":"<div><h3>Background</h3><div>Paediatric social anxiety disorder (SoAD) responds poorly to treatment. Improved understanding of potential psychological maintaining processes may indicate fruitful directions to improve treatment outcomes. The current study compared self-reported psychological processes and state anxiety in response to two social tasks experienced by children and adolescents with SoAD against comparison samples.</div></div><div><h3>Methods</h3><div>641 children and adolescents aged 6–17 years (<em>M</em>age = 9.45 yr; 47.6% girls) engaged in a brief, impromptu speech and a social discussion with a confederate. Participants included 307 with SoAD, 285 with other mental disorders, and 49 non-clinical controls. Participants who completed each task self-reported their anticipated probability and cost of negative evaluation, self-focused attention, personal evaluation of social performance, and engagement in post-event rumination (assessed 1 h later). Independent raters also scored their social performance. Relationships between the variables were tested through path analysis.</div></div><div><h3>Results</h3><div>Participants with SoAD were more likely to avoid and reported significantly greater state anxiety than both comparison groups. They also reported higher levels of each of the putative maintaining processes than either comparison group. In contrast, independent observers did not discriminate between groups on their overt social performance. Path analyses demonstrated good fit of a priori models to the data for both social tasks.</div></div><div><h3>Conclusions</h3><div>Paediatric SoAD is associated with strong expectation of the probability and cost of negative evaluation, excess self-focused attention, and more negative evaluation of one's own social performance. In turn, these putative processes are strong predictors of state anxiety and post-event processing in response to both a speech and social interaction.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"183 ","pages":"Article 104638"},"PeriodicalIF":4.2,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0005796724001657/pdfft?md5=d6e64d85a3e19165cd91b7453411ba09&pid=1-s2.0-S0005796724001657-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-18DOI: 10.1016/j.brat.2024.104637
Catherine E. Myers , Chintan V. Dave , Megan S. Chesin , Brian P. Marx , Lauren M. St. Hill , Vibha Reddy , Rachael B. Miller , Arlene King , Alejandro Interian
Objective
Develop and evaluate a treatment matching algorithm to predict differential treatment response to Mindfulness-Based Cognitive Therapy for suicide prevention (MBCT-S) versus enhanced treatment-as-usual (eTAU).
Methods
Analyses used data from Veterans at high-risk for suicide assigned to either MBCT-S (n = 71) or eTAU (n = 69) in a randomized clinical trial. Potential predictors (n = 55) included available demographic, clinical, and neurocognitive variables. Random forest models were used to predict risk of suicidal event (suicidal behaviors, or ideation resulting in hospitalization or emergency department visit) within 12 months following randomization, characterize the prediction, and develop a Personalized Advantage Index (PAI).
Results
A slightly better prediction model emerged for MBCT-S (AUC = 0.70) than eTAU (AUC = 0.63). Important outcome predictors for participants in the MBCT-S arm included PTSD diagnosis, decisional efficiency on a neurocognitive task (Go/No-Go), prior-year mental health residential treatment, and non-suicidal self-injury. Significant predictors for participants in the eTAU arm included past-year acute psychiatric hospitalizations, past-year outpatient psychotherapy visits, past-year suicidal ideation severity, and attentional control (indexed by Stroop task). A moderation analysis showed that fewer suicidal events occurred among those randomized to their PAI-indicated optimal treatment.
Conclusions
PAI-guided treatment assignment may enhance suicide prevention outcomes. However, prior to real-world application, additional research is required to improve model accuracy and evaluate model generalization.
{"title":"Initial evaluation of a personalized advantage index to determine which individuals may benefit from mindfulness-based cognitive therapy for suicide prevention","authors":"Catherine E. Myers , Chintan V. Dave , Megan S. Chesin , Brian P. Marx , Lauren M. St. Hill , Vibha Reddy , Rachael B. Miller , Arlene King , Alejandro Interian","doi":"10.1016/j.brat.2024.104637","DOIUrl":"10.1016/j.brat.2024.104637","url":null,"abstract":"<div><h3>Objective</h3><div>Develop and evaluate a treatment matching algorithm to predict differential treatment response to Mindfulness-Based Cognitive Therapy for suicide prevention (MBCT-S) versus enhanced treatment-as-usual (eTAU).</div></div><div><h3>Methods</h3><div>Analyses used data from Veterans at high-risk for suicide assigned to either MBCT-S (n = 71) or eTAU (n = 69) in a randomized clinical trial. Potential predictors (n = 55) included available demographic, clinical, and neurocognitive variables. Random forest models were used to predict risk of suicidal event (suicidal behaviors, or ideation resulting in hospitalization or emergency department visit) within 12 months following randomization, characterize the prediction, and develop a Personalized Advantage Index (PAI).</div></div><div><h3>Results</h3><div>A slightly better prediction model emerged for MBCT-S (AUC = 0.70) than eTAU (AUC = 0.63). Important outcome predictors for participants in the MBCT-S arm included PTSD diagnosis, decisional efficiency on a neurocognitive task (Go/No-Go), prior-year mental health residential treatment, and non-suicidal self-injury. Significant predictors for participants in the eTAU arm included past-year acute psychiatric hospitalizations, past-year outpatient psychotherapy visits, past-year suicidal ideation severity, and attentional control (indexed by Stroop task). A moderation analysis showed that fewer suicidal events occurred among those randomized to their PAI-indicated optimal treatment.</div></div><div><h3>Conclusions</h3><div>PAI-guided treatment assignment may enhance suicide prevention outcomes. However, prior to real-world application, additional research is required to improve model accuracy and evaluate model generalization.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"183 ","pages":"Article 104637"},"PeriodicalIF":4.2,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298901","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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