Behaviour Research and Therapy最新文献_第7页

Mobile intervention to address cannabis use disorder among black adults: A proof-of-concept randomized controlled trial 移动干预解决黑人成人大麻使用障碍：一项概念验证随机对照试验。

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-10-14 DOI: 10.1016/j.brat.2025.104889

Lorra Garey , Ava A. Jones , Pamella Nizio , Tzuan A. Chen , Julia D. Buckner , Brooke Y. Redmond , Michael S. Businelle , Marshall K. Cheney , Ezemenari M. Obasi , Michael J. Zvolensky

Background

African American or Black adults who use cannabis face significant cannabis-related health disparities, including more frequent cannabis use and higher rates of Cannabis Use Disorder (CUD) relative to non-Hispanic/Latinx White adults who use cannabis. This highlights the need for accessible, culturally tailored interventions that address the unique needs of Black adults with CUD. This study evaluated the feasibility, utilization, acceptability, and initial efficacy of a culturally tailored mobile intervention (Culturally Tailored-Mobile Integrated Cannabis and Anxiety Reduction Treatment [CT-MICART]), integrating false safety behavior (FSB) reduction or elimination skills with use reduction or cessation skills.

Methods

Participants (N = 50, 50.0% female, M_age = 42.9 years, SD = 10.7) were randomized to: 1) CT-MICART + ecological momentary assessments (EMAs) or 2) EMAs-only for a period of 6-weeks. Feasibility outcomes included enrollment, retention, and EMA completion rates, and utilization was assessed via app feature engagement. Acceptability was evaluated via self-reported app satisfaction, and preliminary efficacy was examined by testing changes in cannabis use outcomes.

Results

Results indicated strong feasibility, high utilization, and positive acceptability. Participants in the CT-MICART + EMA group demonstrated statistically significantly lower cannabis use frequency rates and less time spent intoxicated from cannabis compared to the EMA-only group. No significant effects were observed for cannabis-related problems, CUD severity, or FSB use at the 6-week follow-up.

Conclusion

This study provides initial evidence for the feasibility, acceptability, and efficacy of CT-MICART + EMA for certain cannabis use processes among Black adults with probable CUD. Larger trials are necessary to test whether CT-MICART holds potential as a scalable solution to support use reduction or cessation goals for this population.

背景：使用大麻的非裔美国人或黑人成年人面临着与大麻相关的重大健康差异，包括与使用大麻的非西班牙裔/拉丁裔白人成年人相比，更频繁地使用大麻和更高的大麻使用障碍（CUD）率。这突出了需要采取可获得的、适合文化的干预措施，以解决患有CUD的黑人成年人的独特需求。本研究评估了一种文化定制的移动干预（文化定制-移动大麻和焦虑减少综合治疗[CT-MICART]）的可行性、利用、可接受性和初步疗效，该干预将减少或消除虚假安全行为（FSB）的技能与减少或停止使用的技能相结合。方法：参与者（N = 50，女性50.0%，年龄42.9岁，SD = 10.7）随机分为：1)CT-MICART +生态瞬时评估（EMAs）或2)仅EMAs，为期6周。可行性结果包括注册、保留和EMA完成率，并通过应用功能参与评估使用率。通过自我报告的应用程序满意度来评估可接受性，通过测试大麻使用结果的变化来检查初步疗效。结果：结果可行性强，利用率高，可接受性好。与仅使用EMA的组相比，CT-MICART + EMA组的参与者表现出统计学上显著降低的大麻使用频率和更少的大麻中毒时间。在6周的随访中，没有观察到大麻相关问题、CUD严重程度或FSB使用的显著影响。结论：本研究为CT-MICART + EMA在可能患有CUD的黑人成人中某些大麻使用过程的可行性、可接受性和有效性提供了初步证据。需要更大规模的试验来检验CT-MICART是否有潜力作为一种可扩展的解决方案来支持这一人群的减少使用或戒烟目标。

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引用次数: 0

Enhancing parenting skills for pregnant women with depressive symptoms: a randomised controlled trial of triple P for baby in Kenya 提高有抑郁症状孕妇的育儿技能：肯尼亚婴儿3p随机对照试验

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-10-09 DOI: 10.1016/j.brat.2025.104886

Japheth Adina , Alina Morawska , Amy E. Mitchell , Divna Haslam , David Ayuku

Despite the evidence in favour of Triple P for Baby (TPB), a parenting intervention to support parents at the transition to parenthood in high-income countries, little is known about whether the program would be efficacious in enhancing parenting skills and alleviating psychological distress among women in low-and middle-income countries. This randomised controlled trial evaluated the efficacy of TPB in Kenya with an urban-based sample of 82 pregnant women with depressive symptoms randomly assigned to the intervention (TPB) or standard care as usual (CAU) conditions. The intervention was delivered prenatally in four group sessions, and postnatally through four individually tailored telephone sessions. Participants were assessed at three-time points, and 90 % of participants were retained at follow-up. We applied intention-to-treat analysis and found improvements in maternal responsiveness and parental confidence and reductions in depressive and anxiety symptoms for mothers in the TPB group relative to the CAU group. There were no between-group differences in maternal self-efficacy. Infants of mothers in the TPB group had better outcomes for attaining fine motor and receptive language milestones compared to infants of mothers allocated to CAU. The findings of this trial indicate that Triple P for Baby is an efficacious early parenting intervention for women with depressive symptoms in low-resource settings.

尽管有证据支持“婴儿三重P”（Triple P for Baby， TPB），这是一种在高收入国家支持父母向为人父母过渡的育儿干预措施，但人们对该计划是否能有效提高低收入和中等收入国家妇女的育儿技能和减轻心理困扰知之甚少。这项随机对照试验评估了TPB在肯尼亚的疗效，以城市为基础的82名有抑郁症状的孕妇为样本，随机分配到干预组（TPB）或常规标准治疗组（CAU）。干预在产前通过四组会议进行，在产后通过四次单独定制的电话会议进行。参与者在三个时间点进行评估，90%的参与者在随访中被保留。我们应用意向治疗分析发现，与CAU组相比，TPB组母亲的反应性和父母信心有所改善，抑郁和焦虑症状有所减轻。母亲自我效能感组间无差异。与母亲被分配到CAU组的婴儿相比，母亲被分配到TPB组的婴儿在达到精细运动和接受性语言里程碑方面有更好的结果。本试验的结果表明，婴儿三重P是一个有效的早期育儿干预妇女抑郁症状在低资源环境。

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引用次数: 0

When emotions persist: Emotional inertia predicts adolescent depression amid COVID-19 stress 当情绪持续时：情绪惯性预测青少年在COVID-19压力下的抑郁

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-10-08 DOI: 10.1016/j.brat.2025.104885

Sihan Liu , Jianjie Xu , Wisteria Deng , Anan Feng , Jutta Joormann , Reuma Gadassi-Polack

Emotional inertia—the extent to which emotional states persist over time—has been identified as a risk factor for depression. However, longitudinal evidence from real-world chronic stress remains limited. Leveraging the COVID-19 pandemic as a naturalistic stressor, this study examined: (a) how emotional inertia changed across distinct phases of the pandemic, and (b) how changes in positive versus negative emotional inertia related to depression risk. A total of 140 adolescents (M_age = 11.91, 47.9 % girls) completed ecological momentary assessments across three stress phases: pre-pandemic (one year before pandemic onset), acute pandemic, and chronic pandemic (one year after pandemic onset), yielding 7465 observations. Hypotheses and data analyses were preregistered. Latent change score modeling showed that both positive and negative emotional inertia increased from pre-pandemic to acute pandemic, then decreased from acute to chronic pandemic. However, positive and negative emotional inertia showed distinct associations with depressive symptoms. Increases in positive emotional inertia associated with fewer depressive symptoms at Wave 3, whereas increases in negative emotional inertia associated with more depressive symptoms at Wave 3. These associations remained significant even after controlling for baseline (Wave 1) depressive symptoms. These findings suggest that persistent negative emotions may amplify vulnerability, while stable positive emotions confer resilience in the face of stress. Emotional inertia may thus serve as a key marker of stress reactivity and an early intervention target for youth mental health.

情绪惯性——情绪状态持续一段时间的程度——已被确定为抑郁症的一个风险因素。然而，来自现实世界慢性压力的纵向证据仍然有限。本研究利用COVID-19大流行作为自然压力源，研究了：(a)情绪惯性在大流行的不同阶段如何变化，以及(b)积极和消极情绪惯性的变化如何与抑郁风险相关。共有140名青少年（年龄为11.91，其中47.9%为女孩）完成了三个应激阶段的生态瞬时评估：大流行前（大流行发病前一年）、急性大流行和慢性大流行（大流行发病后一年），得出7465项观察结果。假设和数据分析是预先登记的。潜在变化评分模型显示，从大流行前到急性大流行，积极和消极情绪惯性均呈上升趋势，从急性大流行到慢性大流行均呈下降趋势。然而，积极和消极的情绪惯性与抑郁症状有明显的联系。在第三波中，积极情绪惯性的增加与抑郁症状的减少有关，而在第三波中，消极情绪惯性的增加与抑郁症状的增加有关。即使在控制了基线（第一波）抑郁症状后，这些关联仍然显著。这些发现表明，持续的负面情绪可能会放大脆弱性，而稳定的积极情绪会在面对压力时赋予弹性。因此，情绪惯性可能是应激反应的关键标志，也是青少年心理健康的早期干预目标。

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引用次数: 0

Results from a randomized controlled trial testing theory-driven enhancements – Growth mindsets and message framing -- to a brief CBT text-message invention for co-occurring PTSD symptoms and alcohol misuse 一项随机对照试验的结果测试了理论驱动的增强——成长心态和信息框架——到一项简短的CBT短信发明，用于同时发生的PTSD症状和酒精滥用

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-10-06 DOI: 10.1016/j.brat.2025.104883

Kristen P. Lindgren , Emily R. Dworkin , Ty T. Tristao , Brian H. Calhoun , Mai L. Pham , Debra L. Kaysen , Isaac C. Rhew , Michele A. Bedard-Gilligan

This paper describes the primary outcomes from a registered randomized clinical trial (RCT; NCT05372042) evaluating a brief, self-directed cognitive behavioral therapy-based (CBT) text message intervention for individuals with PTSD symptoms and co-occurring alcohol misuse (PTSD + AM). The trial aimed to refine the intervention by testing whether evidence-based techniques from cognitive psychology (message framing) and social psychology (growth mindsets) increased intervention efficacy. A combination of messages that highlighted using skills to avoid future losses (vs. for future gains vs. no framing) and that sought to facilitate a mindset that challenges setbacks and encourages growth opportunities (vs. a simple reminder to use skills) was predicted to increase efficacy. The trial had a three (framing: loss vs. gain vs. no framing) x two (mindset: growth vs. simple reminder) factorial design. A series of a priori decision rules was created to identify the most efficacious and simplest condition. A sample of 505 adults from Washington State was recruited (71 % female, 20 % male, 9 % identified as another gender). Trauma exposure, PTSD symptoms, AM, and other mental health concerns were assessed. The 4-week intervention had follow-ups at post-intervention, 1-month, and 3-months, with excellent retention (89+%). Participants’ PTSD symptoms and AM improved across all conditions with large effect sizes. Decision rule implementation indicated the selection of the loss framing and growth mindset condition. This condition will be tested in a subsequent RCT with longer-term follow-up. It is expected to yield an additional, effective brief treatment option for individuals with PTSD + AM—a high risk population facing multiple treatment barriers.

本文描述了一项注册的随机临床试验（RCT; NCT05372042）的主要结果，该试验评估了一种简短的、基于自我导向的认知行为疗法（CBT）的短信干预，用于治疗PTSD症状并伴有酒精滥用（PTSD + AM）的个体。该试验旨在通过测试认知心理学（信息框架）和社会心理学（成长心态）的循证技术是否能提高干预效果，从而改进干预措施。强调使用技能来避免未来损失（vs.为了未来的收益vs.没有框架）和寻求促进挑战挫折和鼓励增长机会的心态（vs.简单提醒使用技能）的信息组合预计会提高效率。该试验采用三因子设计（框架：损失vs.收益vs.无框架）x二因子设计（心态：成长vs.简单提醒）。建立了一系列先验决策规则，以确定最有效和最简单的条件。从华盛顿州招募了505名成年人（71%为女性，20%为男性，9%为其他性别）。评估了创伤暴露、PTSD症状、AM和其他心理健康问题。干预4周后分别随访干预后、1个月和3个月，保留率89%以上。在所有条件下，参与者的创伤后应激障碍症状和AM都得到了改善，效果显著。决策规则的实施表现为损失框架和成长心态条件的选择。这种情况将在随后的长期随访的随机对照试验中进行测试。它有望为PTSD + am患者提供一种额外的、有效的短期治疗选择——这是一种面临多重治疗障碍的高风险人群。

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引用次数: 0

Taxonomic and thematic generalization of safety behaviors 安全行为的分类和专题概括

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-10-04 DOI: 10.1016/j.brat.2025.104881

Alex H.K. Wong , Jonas Zaman , Steven Verheyen

Fear generalization refers to the spread of fear to novel stimuli. Recent evidence suggests that fear generalization is linked with inductive reasoning. In the inductive reasoning literature, inferences are stronger to taxonomically related stimuli that share conceptual features with the target stimulus (e.g., duck and swan), compared to thematically related stimuli that often co-occur with the target stimulus (e.g., duck and pond). Preliminary evidence also shows greater fear generalization to taxonomically related stimuli compared to thematically related stimuli in a fear conditioning framework. The current study aimed to extend this pattern to safety behavior, a behavioral response that minimizes the onset of an expected threat. In a fear and avoidance conditioning framework, participants (N = 74) first acquired stronger safety behaviors to a threat predicting conditioned stimulus (CS+) than to a safety predicting conditioned stimulus (CS-). In a following generalization test, participants showed stronger generalized safety behaviors to novel generalization stimuli (GSs) that were taxonomically related to the CS + compared to those thematically related to the CS+. Low distress tolerance, a risk factor for clinical anxiety, was associated with less differentiated generalized safety behaviors to the GSs. The findings suggest that taxonomic generalization of safety behaviors is stronger than thematic generalization of safety behaviors.

恐惧泛化是指恐惧对新刺激的扩散。最近的证据表明，恐惧泛化与归纳推理有关。在归纳推理文献中，与目标刺激具有相同概念特征的分类相关刺激（如鸭子和天鹅）相比，通常与目标刺激共同出现的主题相关刺激（如鸭子和池塘）的推理更强。初步证据还表明，在恐惧条件反射框架中，与主题相关的刺激相比，分类相关刺激的恐惧泛化程度更高。目前的研究旨在将这种模式扩展到安全行为，一种将预期威胁最小化的行为反应。在恐惧和回避条件反射框架下，74名被试首先对威胁预测条件刺激（CS+）获得了比对安全预测条件刺激（CS-）更强的安全行为。在随后的概化测试中，受试者对分类上与CS+相关的新概化刺激表现出更强的概化安全行为，而与主题上与CS+相关的新概化刺激表现出更强的概化安全行为。低痛苦耐受性是临床焦虑的一个危险因素，与GSs的一般安全行为差异较小有关。研究结果表明，安全行为的分类概括强于安全行为的主题概括。

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引用次数: 0

The physiological signature of imagery rescripting: Associations between heart rate and session-level outcomes 图像描述的生理特征：心率与会话水平结果之间的关系。

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-10-04 DOI: 10.1016/j.brat.2025.104879

Jessica Uhl , Wolfgang Lutz , Eshkol Rafaeli

Objective

Imagery rescripting (IR) as an emotion-focused technique involves an evoking as well as a rescripting phase, which incorporates cognitive restructuring. The different components of IR might be characterized by different physiological patterns. The main aim of this study is to test whether clients' physiological arousal during the evoking phase and clients’ physiological arousal during the rescripting phase follows specific patterns and predicts improvement on next-session outcomes.

Methods

The results are based on 108 therapy sessions from an imagery-based treatment with 64 clients with test anxiety. The treatment protocol involves two consecutive IR sessions of past events related to test anxiety. Clients’ heart rate (HR) was continuously monitored, next-session outcome was assessed with the State Test Anxiety Measure and Outcome Rating Scale.

Results

Clients showed on average an increase in HR during the evoking phase and a decrease during the rescripting phase in the first IR session. These effects reduced in the second IR session. In addition, no latent subgroups were identified. Furthermore, an increase in HR during the evoking phase was significantly associated with lower next-session test anxiety and marginally associated with higher next-session well-being.

Conclusion

The results provide initial evidence that clients’ physiological arousal during the evoking phase of IR might play a role in the effectiveness of IR.

目的：意象重写（IR）作为一种以情绪为中心的技术，包括一个唤起和一个重写阶段，其中包括认知重构。IR的不同成分可能具有不同的生理模式。本研究的主要目的是检验来访者在唤起阶段的生理唤醒和在重写阶段的生理唤醒是否遵循特定的模式，并预测下一次治疗结果的改善。方法：结果是基于108个治疗疗程的图像为基础的治疗64个客户的测试焦虑。治疗方案包括两个连续的与考试焦虑相关的过去事件的IR会话。持续监测患者的心率（HR），用状态测试焦虑量表和结果评定量表评估下一阶段的结果。结果：在第一次IR会话中，客户平均表现出在唤起阶段的HR增加和在重新描述阶段的HR减少。这些影响在第二次IR治疗中减少。此外，未发现潜在亚群。此外，在唤起阶段，人力资源的增加与较低的下一次考试焦虑显著相关，与较高的下一次考试幸福感轻微相关。结论：本研究结果初步证明，来访者在心理刺激诱发阶段的生理觉醒可能对心理刺激的有效性起作用。

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引用次数: 0

The imagery rescripting protocol for obsessive-compulsive disorder (ImRs-OCD): A decade of iterative refinement in treatment sequencing following ERP 强迫症（ImRs-OCD）的图像重写协议：ERP后治疗顺序的十年迭代改进。

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-10-02 DOI: 10.1016/j.brat.2025.104878

Gayle Maloney , Arnoud Arntz , Christopher Pittenger

Obsessive-Compulsive Disorder (OCD) is a debilitating psychological condition that remains resistant to treatment in a significant proportion of clients, even following completion of first-line psychological and pharmacological treatments. This paper describes a sequenced treatment protocol combining Exposure and Response Prevention (ERP) with Imagery Rescripting for OCD (ImRs-OCD) as an adjunctive intervention for individuals with treatment-resistant OCD. The ImRs-OCD protocol has undergone multiple rounds of refinement over the past 10 years through iterative protocol development, based on clinician and client feedback. We describe the evolution of the protocol, key adaptations for OCD, illustrative case examples, and preliminary evidence supporting its efficacy. A standardised 10-step ImRs-OCD protocol is presented, along with guidelines for implementation and a set of standard rescripting questions and handouts. This work aims to provide guidance to clinicians and to encourage further research into imagery rescripting as a comprehensive treatment approach for treatment-resistant OCD.

强迫症（OCD）是一种使人衰弱的心理状态，在很大一部分患者中，即使在完成了一线心理和药物治疗后，仍然对治疗有抵抗力。本文介绍了一种结合暴露与反应预防（ERP）和影像处方治疗强迫症（ImRs-OCD）的序列治疗方案，作为治疗难治性强迫症患者的辅助干预措施。在过去的10年里，基于临床医生和客户的反馈，ImRs-OCD协议经历了多轮的改进。我们描述了该方案的演变，强迫症的关键适应，说明性案例，以及支持其有效性的初步证据。提出了标准化的10步ImRs-OCD协议，以及实施指南和一套标准的处方问题和讲义。这项工作旨在为临床医生提供指导，并鼓励进一步研究图像处方作为治疗难治性强迫症的综合治疗方法。

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引用次数: 0

Effectiveness of body exposure for the treatment of body image disturbance: A meta-analysis 身体暴露治疗身体形象障碍的有效性：一项meta分析

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-09-30 DOI: 10.1016/j.brat.2025.104876

Hannah Weins , Noemi Berliner , Alina Riefler , Jana Kessel , Fridtjof W. Nussbeck , Andrea S. Hartmann

Body image disturbance (BID) is a defining feature of several psychiatric disorders, notably eating disorders and body dysmorphic disorder. Although body exposure (BE) has been proposed as an effective intervention, the strength of its effects and the factors influencing its efficacy remain uncertain. We conducted random-effects meta-analyses of randomized controlled trials in which BE was delivered as a stand-alone intervention. Outcomes included negative affect, BID-related measures, arousal, and disorder-specific symptoms. Potential moderators (e.g., attention focus, facilitator presence) were examined. BE produced moderate effects on BID-related measures (0.60, 95 % CI [0.40, 0.80]) and disorder-specific symptoms (0.76, 95 % CI [0.15, 1.36]), but did not significantly reduce negative affect (0.30, 95 % CI [−0.07, 0.67]). Arousal could not be assessed due to insufficient data, and no significant moderators emerged, likely reflecting the small, heterogeneous evidence base. These results support BE as an effective approach for reducing BID and disorder-specific symptoms and highlight the need for experimental research comparing BE variations and targeting broader outcome domains to guide individualized, evidence-based clinical practice.

身体形象障碍（BID）是几种精神疾病的典型特征，尤其是饮食障碍和身体畸形障碍。虽然身体暴露（BE）已被认为是一种有效的干预措施，但其作用强度和影响其疗效的因素仍不确定。我们对随机对照试验进行了随机效应荟萃分析，其中BE作为独立干预措施。结果包括负面影响、bid相关测量、觉醒和障碍特异性症状。研究了潜在的调节因素（例如，注意力集中、引导者在场）。BE对bid相关措施（0.60,95% CI[0.40, 0.80]）和疾病特异性症状（0.76,95% CI[0.15, 1.36]）产生中等影响，但没有显著减少负面影响（0.30,95% CI[- 0.07, 0.67]）。由于数据不足，无法对觉醒进行评估，也没有出现显著的调节因子，这可能反映了证据基础的小而异构。这些结果支持BE作为减少BID和疾病特异性症状的有效方法，并强调需要进行实验研究，比较BE的变化和针对更广泛的结果领域，以指导个体化、循证临床实践。

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引用次数: 0

‘Episodic Threat Conditioning’: a novel approach to simultaneously measure Pavlovian threat conditioning and episodic memory “情景威胁条件反射”：一种同时测量巴甫洛夫威胁条件反射和情景记忆的新方法

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-09-30 DOI: 10.1016/j.brat.2025.104882

Olivier T. de Vries , Sascha B. Duken , Nadža Džinalija , Merel Kindt , Vanessa A. van Ast

The powerful ways future behavior and cognition can be affected by emotional events are typically studied either by means of Pavlovian conditioning or episodic memory paradigms, which both rest on the idea that associations are formed between distinct stimuli experienced closely together in space or time. However, due to their incompatible methods, little is known about how physiological read-outs of Pavlovian conditioning and episodic memory work in concert to affect behavior and other cognitive processes, how they relate to each other, or whether they reflect the activity of distinct associative processes in the first place. To shed light on such questions, a paradigm is needed that can assess both conditioned psychophysiology and episodic memory. We reasoned that multimodal stimuli, consisting of congruent image-sound combinations, have the potential to serve as potent unconditioned stimuli in a paradigm where participants encode a large number ‘mini-conditioning events’. Measuring both pupil dilation and facial electromyography, we found that psychophysiological responses to 20 unique aversive USs – but not positive USs - transferred to arbitrary predictors already after a single paired presentation in this novel paradigm. Real-life emotional aversive and stressful events are likely to involve both Pavlovian conditioning and episodic memory processes. The ‘Episodic Threat Conditioning’ paradigm enables their simultaneous assessment, thereby providing an opportunity to gain more holistic insight into how different expressions of memory interact in mental health and disease.

情绪事件对未来行为和认知的强大影响通常是通过巴甫洛夫条件反射或情景记忆范式来研究的，这两种范式都基于这样一种观点，即在空间或时间上紧密相连的不同刺激之间形成了联系。然而，由于它们的方法不相容，巴甫洛夫条件反射和情景记忆的生理读出是如何协同影响行为和其他认知过程的，它们是如何相互关联的，或者它们是否首先反映了不同的联想过程的活动，人们对这些问题知之甚少。为了阐明这些问题，需要一种既能评估条件心理生理学又能评估情景记忆的范式。我们推断，在参与者编码大量“迷你条件反射事件”的范式中，由一致的图像-声音组合组成的多模态刺激有可能成为有效的非条件刺激。通过测量瞳孔扩张和面部肌电图，我们发现，在这种新模式下，对20种独特的厌恶USs（而不是积极USs）的心理生理反应在单对呈现后就已经转移到任意预测因子上。现实生活中的情绪厌恶和压力事件可能涉及巴甫洛夫条件反射和情景记忆过程。“情景威胁条件反射”范式使他们能够同时进行评估，从而为更全面地了解记忆的不同表达如何在心理健康和疾病中相互作用提供了机会。

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引用次数: 0

Joy beyond fear: Positive emotions after exposure in patients with anxiety disorders and their link to threat expectancy and treatment outcome 超越恐惧的快乐：焦虑障碍患者暴露后的积极情绪及其与威胁预期和治疗结果的联系

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-09-30 DOI: 10.1016/j.brat.2025.104880

Thomas Borchert , Ingmar Heinig , Volker Arolt , Christina Bartnick , Udo Dannlowski , Jürgen Deckert , Katharina Domschke , Thomas Fydrich , Stephan Goerigk , Alfons O. Hamm , Maike Hollandt , Jürgen Hoyer , Tilo Kircher , Katja Koelkebeck , Ulrike Lueken , Jürgen Margraf , Peter Neudeck , Paul Pauli , Jan Richter , Winfried Rief , Andre Pittig

Exposure-based CBT is effective in treating anxiety disorders, but individual responses vary substantially, underlining the need to identify and boost mechanisms underlying exposure. In this study, the role of positive emotions occurring after exposure was examined. In an analysis of 8416 exposure records of 648 anxiety patients undergoing exposure therapy, the degree of positive emotions hope and joy occurring after exposure exercises, their predictors, and their role regarding treatment success were investigated. Positive emotions after exposure were medium to high and increased slightly across repeated exposure exercises. They were associated with exposure-related learning indicators (i.e., expectancy violation and change as well as the prediction-error learning rate) and were mainly predicted by adjusted threat expectancy assessed after completing exposure, controlling for baseline depressive symptoms and affect. Higher positive emotions independently predicted better treatment outcome beyond learning indicators, and partially mediated the association between learning indicators and treatment outcome. These findings indicate that positive emotions are partly associated with successful learning during exposure but seem to have a unique contribution to overall treatment success, underlining the need to strengthen positive emotions via different possible means.

基于暴露的CBT在治疗焦虑症方面是有效的，但个体的反应差异很大，这强调了识别和促进暴露机制的必要性。本研究考察了暴露后积极情绪的作用。通过对648例接受暴露治疗的焦虑患者的8416份暴露记录的分析，探讨了暴露练习后出现的积极情绪、希望和喜悦的程度、影响因素及其对治疗成功的作用。暴露后的积极情绪是中等到高的，在重复的暴露练习中略有增加。它们与暴露相关的学习指标（即期望违反和改变以及预测错误学习率）有关，主要通过完成暴露后评估的调整威胁期望来预测，控制基线抑郁症状和影响。高的积极情绪独立地预测了学习指标之外更好的治疗结果，并部分介导了学习指标与治疗结果之间的关联。这些发现表明，积极情绪在一定程度上与暴露期间的成功学习有关，但似乎对整体治疗成功有独特的贡献，强调了通过不同可能的手段加强积极情绪的必要性。

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