Behaviour Research and Therapy最新文献_第9页

Better to keep a negative self-perception than ask for feedback? - How depressive symptoms are associated with the desire for social feedback 保持消极的自我认知比寻求反馈更好吗？-抑郁症状与渴望社会反馈之间的关系

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-09-21 DOI: 10.1016/j.brat.2025.104872

Edith Rapo , Christopher Milde , Julia Anna Glombiewski , Tobias Kube

Background

We investigated whether depressive symptom severity is associated with incongruence between how people perceive themselves (self-perception) and how they expect others to perceive them (meta-perception). We also examined whether these discrepancies explain feedback-seeking. We hypothesized that elevated depressive symptoms are related to low preference for positive and self-incongruent feedback and high preference for negative and self-congruent feedback.

Method

In study 1 (N = 149), we presented 20 positive and 20 negative traits. For each trait, participants rated their self- and meta-perception. In study 2 (N = 212), we presented the same traits. In addition to their self- and meta-perception, participants indicated their desire to receive other people's feedback for each trait.

Results

In study 1, depressive symptom severity was related to a higher incongruence between self- and meta-perception, as participants’ self-perception was more negative than their meta-perception. Study 2 indicated that depressive symptom severity was related to less feedback-seeking. Incongruence between self-and meta-perception and valence did not moderate the relationship between depressive symptoms and feedback-seeking.

Conclusion

Depressive symptoms are associated with incongruence between self- and meta-perception and reduced feedback-seeking. However, incongruence between self- and meta-perception and valence did not explain reduced feedback-seeking in depression, emphasizing the importance to further investigate the causes for feedback avoidance in depression.

背景：我们调查了抑郁症状的严重程度是否与人们如何感知自己（自我感知）和他们如何期望他人感知自己（元感知）之间的不一致性有关。我们还研究了这些差异是否解释了反馈寻求。我们假设抑郁症状的升高与对积极和自我不一致反馈的低偏好和对消极和自我一致反馈的高偏好有关。方法：在研究1 （N = 149）中，采用20个阳性性状和20个阴性性状。对于每个特征，参与者对他们的自我和元知觉进行评分。在研究2 （N = 212）中，我们表现出相同的性状。除了他们的自我认知和元认知之外，参与者还表示他们希望收到其他人对每个特质的反馈。结果：在研究1中，抑郁症状的严重程度与自我知觉与元知觉之间的不一致性相关，被试的自我知觉比元知觉更负性。研究2显示抑郁症状严重程度与反馈寻求较少相关。自我、元知觉和效价之间的不一致并不能调节抑郁症状与反馈寻求之间的关系。结论：抑郁症状与自我知觉与元知觉不一致、反馈寻求减少有关。然而，自我知觉与元知觉和效价之间的不一致并不能解释抑郁症中反馈寻求减少的原因，这强调了进一步研究抑郁症中反馈回避的原因的重要性。

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引用次数: 0

The effect of state anxiety on jumping-to-conclusions bias in social anxiety: An experimental and computational modelling study 状态焦虑对社交焦虑中跳脱结论偏见的影响：一项实验和计算模型研究

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-09-19 DOI: 10.1016/j.brat.2025.104859

Nicole Tan , Yiyun Shou , Junwen Chen , Bruce K. Christensen

Research indicates that the tendency to make hasty decisions based on minimal information, also known as the Jumping-to-Conclusions bias, may be linked to social anxiety and could be exacerbated under high state anxiety, but this relationship is inconclusive due to a lack of consistent findings. The present study applied a Bayesian computational modelling approach alongside frequentist hypothesis testing to investigate the relationships between trait and state social anxiety and the Jumping-to-Conclusions bias across various beads tasks. An online experimental study involving 131 participants experiencing subclinical social anxiety revealed that higher trait social anxiety significantly attenuated one's belief updating in neutral situations when exposed to a state social anxiety induction. Conversely, higher trait social anxiety significantly increased belief updating about one's social performance, but this depended on the state social anxiety induction. No significant associations were found between trait and state social anxiety and observed dependent variables measured in the beads tasks. The implications are explored.

研究表明，基于极少信息仓促做出决定的倾向，也被称为“草率下结论偏见”，可能与社交焦虑有关，并且在高度焦虑状态下可能会加剧，但由于缺乏一致的研究结果，这种关系尚无定论。本研究采用贝叶斯计算建模方法和频率假设检验来研究特质和状态社交焦虑以及在各种珠子任务中直接得出结论的偏见之间的关系。一项涉及131名经历亚临床社交焦虑的参与者的在线实验研究表明，当暴露于状态社交焦虑诱导时，高特质社交焦虑显著减弱了一个人在中性情境下的信念更新。相反，高特质社交焦虑显著提高了个体对社会绩效的信念更新，但这取决于状态社交焦虑的诱导。在珠子任务中，特质和状态社会焦虑和观察到的因变量之间没有发现显著的关联。本文对其影响进行了探讨。

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引用次数: 0

The Leuven Exeter Dampening Scale (LEDS) to measure dampening appraisals towards positive affect: Psychometric evaluation and initial validation in a Dutch and English community sample 鲁汶埃克塞特抑制量表（LEDS）测量对积极影响的抑制评价：荷兰和英语社区样本的心理测量评估和初步验证。

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-09-17 DOI: 10.1016/j.brat.2025.104861

Liesbeth Bogaert , Helen Lau , Barnaby D. Dunn , Filip Raes

Dampening – the tendency to downplay positive feelings – is linked to various psychopathologies, demonstrating transdiagnostic relevance. Most research to date has relied on the dampening subscale of the Responses to Positive Affect Scale (RPA-d; Feldman et al., 2008). However, concerns about its limited content validity, not reflecting clinical complexity, and potential cross-cultural universality issues prompted the development of the Leuven Exeter Dampening Scale (LEDS). Study 1 details scale development in Dutch-speaking undergraduates (N = 308); Studies 2 and 3 further validate it in a Dutch-speaking (N _T1 = 214, N _T2 = 148) and English-speaking UK (N _T1 = 177, N _T2 = 152, N _T3 = 102) adult community sample. Across samples, the LEDS showed excellent internal consistency (αs > .90) and good test-retest reliability (ICCs = .77-.89). Confirmatory factor analyses supported a one-factor structure, demonstrating structural validity. LEDS scores positively correlated with RPA-d scores, indicating convergent validity. Multiple regressions showed the LEDS to significantly predict concurrent anhedonic/depressive symptoms, beyond age, gender, and negative rumination, supporting its concurrent predictive validity. Even with the RPA-d included as predictor, the LEDS accounted for unique variance in concurrent outcomes, showing incremental validity. Longitudinal analyses, covarying baseline symptoms, provided mixed evidence with predictive and incremental validity only verified in the UK sample. Crucially, the RPA-d never outperformed the LEDS, and mixed prospective findings align with prior inconsistent prospective relations between dampening and symptomatology. Findings support the LEDS as a valid alternative to the RPA-d, with a more comprehensive assessment of general dampening as key strength.

压抑——淡化积极情绪的倾向——与各种精神病理有关，显示出跨诊断的相关性。迄今为止，大多数研究都依赖于积极情绪反应量表的抑制子量表（RPA-d; Feldman et al., 2008）。然而，考虑到其有限的内容有效性，不能反映临床复杂性，以及潜在的跨文化普遍性问题，促使了鲁汶埃克塞特阻尼量表（LEDS）的发展。研究1详细介绍了荷兰语本科生的量表发展情况（N = 308）；研究2和研究3在荷兰语（NT1 = 214, NT2 = 148）和说英语的英国（NT1 = 177, NT2 = 152, NT3 = 102）成人社区样本中进一步验证了这一点。在不同的样品中，led显示出良好的内部一致性（αs > .90）和良好的测试-重测信度（ICCs = .77-.89）。验证性因子分析支持单因子结构，证明结构效度。LEDS得分与RPA-d得分正相关，表明趋同效度。多元回归结果显示，LEDS能显著预测并发性快感缺乏症/抑郁症状，超越年龄、性别和消极反刍，支持其并发性预测效度。即使包括RPA-d作为预测因子，led在并发结果中占唯一的方差，显示出增量的有效性。纵向分析，共变基线症状，提供了混合证据，预测和增量有效性仅在英国样本中得到验证。至关重要的是，RPA-d的表现从未超过LEDS，混合的前瞻性研究结果与先前不一致的抑制和症状之间的前瞻性关系一致。研究结果支持led作为RPA-d的有效替代品，更全面地评估了一般阻尼作为关键强度。

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引用次数: 0

Neural mechanisms underlying exposure and response prevention for obsessive compulsive disorder: A randomized controlled trial 强迫症暴露和反应预防的神经机制：一项随机对照试验

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-09-17 DOI: 10.1016/j.brat.2025.104858

Ryan J. Jacoby , Jennifer L. Greenberg , Aura Hurtado , Walker Pedersen , Kristen K. Ellard , Edward F. Pace-Schott , Katelyn I. Oliver , Mohammed R. Milad , Sabine Wilhelm , Joan A. Camprodon

Background

Fear extinction is an important treatment target of obsessive-compulsive disorder (OCD). In the current randomized controlled trial, we examined the therapeutic modulation of exposure and response prevention (ERP) on neural activation during fear extinction in OCD to identify mechanisms of action and response biomarkers.

Methods

Thirty-four patients with OCD were randomized to either 12-weeks of ERP or a waitlist. Before, during, and 12-weeks after treatment, patients were assessed using functional magnetic resonance imaging (fMRI) during a 2-day fear extinction paradigm. Neural activation was examined in disease- and construct-relevant circuits and nodes (n = 18).

Results

The ERP group had a significant reduction in OCD severity compared to waitlist. A voxel-wise GLM analysis of fMRI data revealed clusters of ERP > waitlist activation during fear conditioning (bilateral dorsal amygdala and right hippocampus) and extinction (right ventrolateral prefrontal cortex, located within the salience network). These changes in activation did not correlate with OCD severity changes, however. In contrast, we observed that a reduction in the activation of the left supramarginal gyrus (in the executive control network) during extinction recall correlated with OCD symptom improvement, suggesting a possible role as a response biomarker.

Conclusions

This study highlights the relevance of a dimensional approach (e.g., focused on fear extinction) for biomarker discovery in neuropsychiatry, provides insights into the mechanisms of action of ERP in OCD, and identifies a potential treatment target in the parietal cortex that could support the biomarker-driven development of novel therapies (e.g., brain stimulation protocols), including combination treatments with ERP.

Clinicaltrials.gov identifier

NCT02467374.

背景恐惧消除是强迫症（OCD）的重要治疗目标。在当前的随机对照试验中，我们研究了暴露和反应预防（ERP）对强迫症患者恐惧消退过程中神经激活的治疗调节，以确定其作用机制和反应生物标志物。方法34例强迫症患者随机分为12周ERP组和等待组。在治疗前、治疗期间和治疗后12周，在为期2天的恐惧消退范式中，使用功能磁共振成像（fMRI）对患者进行评估。在与疾病和构造相关的回路和节点中检测神经激活（n = 18）。结果与等待组相比，ERP组强迫症严重程度显著降低。对fMRI数据的体素级GLM分析显示，在恐惧调节（双侧杏仁核背侧和右侧海马）和消退（位于突出网络内的右侧腹外侧前额皮质）期间，ERP >；等待列表激活簇。然而，这些激活的变化与强迫症严重程度的变化无关。相反，我们观察到，在消失记忆过程中，左边缘上回（执行控制网络）激活的减少与强迫症症状的改善相关，这表明它可能是一种反应生物标志物。结论：本研究强调了神经精神病学生物标志物发现的维度方法（例如，专注于恐惧消退）的相关性，提供了ERP在强迫症中的作用机制的见解，并确定了顶叶皮层的潜在治疗靶点，可以支持生物标志物驱动的新疗法的开发（例如，脑刺激方案），包括与ERP的联合治疗。

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引用次数: 0

The update of interpersonal beliefs in everyday life situations in relation to depressive symptoms and state affect – An ecological momentary assessment proof-of-principle study 日常生活情境中人际信念与抑郁症状和状态影响的更新——一项生态瞬时评估原理证明研究。

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-09-13 DOI: 10.1016/j.brat.2025.104860

Saskia Scholten , Lea Gegner , Maja Stoverock , Tobias Kube

Previous research has provided valuable insights into associations of belief updating with aspects of psychopathology. However, prior work was mostly based on laboratory studies or scenario-based tasks. Thus, applications to everyday life situations are unclear. To address this limitation, the present study employed an Ecological Momentary Assessment (EMA) design to examine change in interpersonal expectations following interpersonal experiences and its relationship with depressive symptoms, assessed once at baseline. After a baseline assessment, a non-clinical sample (N = 43, age 18–66, 67 % female) indicated their interpersonal expectations in the morning and actual interpersonal experiences as well as updated expectations in the evening over 18 days. Multi-level modelling shows that, consistent with associative learning models, participants updated their beliefs the more, the greater the expectation-outcome discrepancy was – irrespective of the valence of the discrepancy. When considering the valence of the expectation-outcome discrepancy, participants updated their beliefs more towards better-than-expected than towards worse-than-expected experiences, in line with the optimistic update bias. Depressive symptoms were associated with increased updating in a negative direction after worse-than-expected experiences, but not with reduced updating in a positive direction after better-than-expected experiences. These findings provide proof-of-principle evidence for investigating biased belief updating using EMA.

先前的研究为信念更新与精神病理学方面的联系提供了有价值的见解。然而，之前的工作主要是基于实验室研究或基于场景的任务。因此，在日常生活中的应用尚不清楚。为了解决这一局限性，本研究采用生态瞬时评估（EMA）设计来检查人际交往经历后人际期望的变化及其与抑郁症状的关系，在基线评估一次。基线评估后，非临床样本（N = 43，年龄18-66岁，67%为女性）在18天内表明了他们在早上的人际期望和实际的人际体验，以及在晚上更新的期望。多层次模型表明，与联想学习模型一致，参与者更新他们的信念越多，期望-结果差异越大-无论差异的效价如何。当考虑期望-结果差异的效价时，参与者更新他们的信念更多地倾向于好于预期而不是坏于预期的经历，这与乐观更新偏见一致。在经历了比预期差的事情后，抑郁症状与向消极方向更新的增加有关，但在经历了比预期好的事情后，抑郁症状与向积极方向更新的减少无关。这些发现为研究使用EMA的偏见信念更新提供了原则性证据。

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引用次数: 0

Explaining anxiety prediction in psychotherapy transcripts: The role of patient linguistic features and theoretical constructs 解释心理治疗记录中的焦虑预测：患者语言特征和理论结构的作用。

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-09-09 DOI: 10.1016/j.brat.2025.104857

Tobias Steinbrenner , Christopher Lalk , Kim Targan , Jana Schaffrath , Steffen Eberhardt , Anke Haberkamp , Wolfgang Lutz , Julian Rubel

Objective

Linguistics can be a helpful tool when researching psychological processes and symptoms. This study aimed to predict anxiety severity from patient language in psychotherapy transcripts. In contrast to prior work focusing on isolated feature types, we combine theory-driven psychological constructs with state-of-the-art NLP and machine learning techniques to enhance both performance and interpretability. Specifically, we asked (1) how well anxiety can be predicted, (2) which models perform best, (3) which features are most important.

Method

We extracted LIWC features, unigrams and bigrams, Transformer emotions, and topics from 529 psychotherapy transcripts from 118 patients. In addition, we constructed theory-driven features to measure negative self-focused attention, self-insight, future focus of perceived threat, and uncertainty avoidance. Each feature set was modeled using multiple machine learning algorithms. To gain insights into the most informative predictors of anxiety, eXplainable Artificial Intelligence was applied.

Results

The Unigram-Bigram Model achieved the best predictive performance (r = .77; 95 %-CI = .75–0.80). However, the Anxiety Process Model achieved notable predictive accuracy despite having only four interpretable, theory-based features. Features related to leisure, social relationships, and insecurity were associated with lower anxiety severity, health-related features and “certainty words” (e.g., totally) with higher severity.

Conclusions

Our findings highlight a trade-off between performance and interpretability. Unigram-bigram models maximized predictive accuracy, whereas theory-driven constructs provided clinically meaningful insights into core psychological processes. Identifying predictive linguistic features, especially those linked to psychological theory, may guide future research on feedback systems and clinical applications by providing interpretable and theory-aligned insights.

目的：语言学是研究心理过程和症状的有效工具。本研究旨在通过心理治疗记录中的患者语言来预测焦虑的严重程度。与之前专注于孤立特征类型的工作相反，我们将理论驱动的心理结构与最先进的NLP和机器学习技术相结合，以提高性能和可解释性。具体来说，我们问了(1)焦虑的预测效果如何，(2)哪些模型表现最好，(3)哪些特征最重要。方法：从118例患者的529份心理治疗记录中提取LIWC特征、单字和双字、变形情绪和主题。此外，我们构建了理论驱动特征来衡量消极的自我关注、自我洞察、感知威胁的未来焦点和不确定性回避。每个特征集使用多种机器学习算法建模。为了深入了解最具信息量的焦虑预测因素，应用了可解释人工智能（eXplainable Artificial Intelligence）。结果：Unigram-Bigram模型预测效果最佳（r = 0.77; 95% -CI = 0.75 -0.80）。然而，焦虑过程模型取得了显著的预测准确性，尽管只有四个可解释的，基于理论的特征。与休闲、社会关系和不安全感相关的特征与较低的焦虑严重程度相关，与健康相关的特征和“确定性词”（例如，完全）与较高的严重程度相关。结论：我们的研究结果强调了性能和可解释性之间的权衡。单图模型最大限度地提高了预测准确性，而理论驱动的结构提供了对核心心理过程有临床意义的见解。识别预测性语言特征，特别是那些与心理学理论相关的特征，可以通过提供可解释和理论一致的见解来指导反馈系统和临床应用的未来研究。

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引用次数: 0

Reduced anxiety and depression predict improved health-related quality of life in school-based CBT 减少焦虑和抑郁预示着学校CBT中健康相关生活质量的改善

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-09-05 DOI: 10.1016/j.brat.2025.104855

Pal (Pål) Teigland Lystrup , Bente Storm Mowatt Haugland , Gro Janne Wergeland , Asle Hoffart , Ronald M. Rapee , Rolf Gjestad

Health-related quality of life (HRQOL) adds important information about the quality and usefulness of interventions. It has not previously been examined in school-based indicated prevention for anxiety in adolescents. Using secondary analyses of data from a randomized controlled trial of cognitive behavioral therapy (CBT) interventions for anxious adolescents (N = 302; mean age 14), we examined whether HRQOL increased during and after treatment. Additionally, we examined whether changes and pre-treatment levels in anxiety and depression symptoms predicted changes in and final levels of HRQOL. This was done using latent growth curve modeling. Results showed that the interventions increased levels of HRQOL and that the levels of HRQOL were sustained at 1-year follow-up, independent of the timing of change. Pre-treatment levels and changes in symptoms of anxiety and depression predicted the changes and final levels in HRQOL. The results indicate that the school-based indicated-preventive interventions may have benefits on HRQOL in addition to reduction in symptoms of anxiety and depression and that these benefits are associated with changes in symptoms.

健康相关生活质量（HRQOL）增加了有关干预措施质量和有用性的重要信息。以前还没有在以学校为基础的青少年焦虑预防中进行过研究。通过对一项针对焦虑青少年的认知行为疗法（CBT）干预的随机对照试验（N = 302，平均年龄14岁）的数据进行二次分析，我们检查了治疗期间和治疗后HRQOL是否增加。此外，我们检查了焦虑和抑郁症状的变化和治疗前水平是否预测了HRQOL的变化和最终水平。这是使用潜在生长曲线模型完成的。结果显示，干预提高了HRQOL水平，并且HRQOL水平在1年随访中持续，与改变时间无关。治疗前焦虑和抑郁症状的水平和变化预测了HRQOL的变化和最终水平。结果表明，以学校为基础的指示性预防干预措施除了减轻焦虑和抑郁症状外，还可能对HRQOL有好处，而且这些好处与症状的改变有关。

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引用次数: 0

ACTing with Mindfulness for Pain (AMP): A pilot randomized controlled trial of an integrated acceptance and commitment therapy and mindfulness meditation program 以正念治疗疼痛（AMP）：一项综合接受和承诺疗法和正念冥想计划的随机对照试验

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-09-05 DOI: 10.1016/j.brat.2025.104854

M.S. Herbert , J.N. Fishbein , M. Tynan , E. Martinez , A.J. Lang , P. Casmar , A. Higdon , A. Backhaus , S. Golshan , N. Afari

Acceptance and commitment therapy (ACT) is an empirically-supported psychotherapy for chronic pain. Although mindfulness is a key component of ACT, most ACT protocols do not include formal mindfulness meditation practice as a principal treatment method, leaving open the question of whether formal practice may bolster ACT's effects. Addressing this gap, the present study assessed the feasibility and preliminary treatment effects of ACTing with Mindfulness for Pain (AMP), an ACT-based protocol that emphasizes and measures daily formal mindfulness meditation practice. A total of 87 Veterans (M_age = 49.44, SD = 12.42) were randomized to AMP or cognitive behavioral therapy (CBT). Feasibility was supported by attainment of enrollment targets, achievement of retention rates at post-treatment greater than 80 %, and high levels of treatment credibility and satisfaction. Treatment expectancy was lower than hypothesized in both groups. Within the AMP group, there were significant improvements in pain interference (primary outcome; d = −0.58), pain acceptance (d = 0.72), cognitive defusion (d = 0.23) and pain catastrophizing (d = −0.50) at posttreatment. Within the CBT group, there were significant improvements in pain interference (d = −0.59), pain acceptance (d = 0.50), and pain catastrophizing (d = −0.39) at posttreatment. In both groups, effect sizes were reduced at 3-month follow-up. Home meditation practice was dose-dependently associated with a greater reduction of depressive symptoms and pain-related helplessness in the AMP group. Taken together, despite meeting important feasibility metrics, the effect size estimates from this pilot randomized controlled trial highlight the need for further treatment development before moving to formal efficacy evaluation.

接受与承诺疗法（ACT）是一种经验支持的治疗慢性疼痛的心理疗法。虽然正念是ACT的关键组成部分，但大多数ACT协议并不包括正式的正念冥想练习作为主要治疗方法，这就留下了正式练习是否会增强ACT效果的问题。为了解决这一问题，本研究评估了正念治疗疼痛（AMP）的可行性和初步治疗效果，AMP是一种基于act的方案，强调并测量日常正式的正念冥想练习。87名退伍军人（Mage = 49.44, SD = 12.42）随机接受AMP或认知行为治疗（CBT）。可行性得到了入学目标的实现、治疗后保留率大于80%、治疗可信度和满意度的高水平的支持。两组的治疗预期均低于假设。在AMP组中，治疗后疼痛干扰（主要结局d = - 0.58）、疼痛接受（d = 0.72）、认知融合（d = 0.23）和疼痛灾难化（d = - 0.50）均有显著改善。在CBT组中，治疗后疼痛干扰（d = - 0.59）、疼痛接受（d = 0.50）和疼痛灾难化（d = - 0.39）均有显著改善。在三个月的随访中，两组的效应量都有所减少。在AMP组中，家庭冥想练习与抑郁症状和疼痛相关无助的更大减少呈剂量依赖关系。综上所述，尽管满足了重要的可行性指标，但该试点随机对照试验的效应量估计强调了在进行正式疗效评估之前进一步开发治疗方法的必要性。

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引用次数: 0

Testing associations between negative interpretation inflexibility, anxiety symptoms and intolerance of uncertainty 测试消极解释缺乏灵活性、焦虑症状和对不确定性的不耐受之间的关系

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-09-04 DOI: 10.1016/j.brat.2025.104851

Gabriella Tyson , Victoria Ferreira , Persia Shoja-Assadi , Colette R. Hirsch

Anxiety is a highly prevalent psychological problem. Transdiagnostic mechanisms such as intolerance of uncertainty and repetitive negative thinking (RNT) are associated with current and future anxiety. Both intolerance of uncertainty and RNT are themselves maintained by a more negative interpretation bias of ambiguous situations. Once negative interpretations have been generated, they might be amended when incongruent information comes to light. If an individual has interpretation inflexibility, they do not revise negative interpretations once generated. The relationship between interpretation inflexibility and general (non-social specific) anxiety has not been investigated.

The current research examines how interpretation bias and interpretation inflexibility are related to intolerance of uncertainty and repetitive negative thinking in single-session online studies, using cognitive tasks to measure interpretation bias and inflexibility and self-report measurements of symptoms. Two experiments aimed to recruit people with a range of anxiety levels, Study 1 ended up recruiting a relatively low anxious sample (N = 120), but Study 2 (N = 120) recruited participants with full range of general anxiety scores.

Significant relationships were found between interpretation bias and anxiety symptoms, repetitive negative thinking, and intolerance of uncertainty in Study 2 but not Study 1. Neither study found significant relationships with interpretation inflexibility. The findings suggest that interpretation inflexibility does not play the same role in maintaining general anxiety symptoms as it has been shown to in social anxiety, and that interpretation bias and inflexibility have unique relationships with cognitive factors related to general anxiety.

焦虑是一种非常普遍的心理问题。跨诊断机制，如对不确定性的不耐受和重复性消极思维（RNT）与当前和未来的焦虑有关。对不确定性的不容忍和RNT本身都是通过对模棱两可情况的更消极的解释偏见来维持的。一旦产生了负面的解释，当不一致的信息出现时，它们可能会被修正。如果一个人有解释的不灵活性，他们不会修改负面的解释一旦产生。口译缺乏灵活性与一般（非社会特异性）焦虑之间的关系尚未被调查。目前的研究考察了在单次在线研究中，解释偏差和解释缺乏灵活性如何与不确定性的不容忍和重复的消极思维相关，使用认知任务来测量解释偏差和缺乏灵活性以及症状的自我报告测量。两个实验旨在招募具有不同焦虑水平的人，研究1最终招募了一个相对较低的焦虑样本（N = 120），但研究2 （N = 120）招募了一个全面的一般焦虑评分的参与者。在研究2中发现解释偏差与焦虑症状、重复消极思维和不确定性耐受之间存在显著关系，但在研究1中没有发现。两项研究都没有发现与口译缺乏灵活性有显著关系。研究结果表明，解释不灵活在维持一般焦虑症状中所起的作用与在社交焦虑中所显示的不同，解释偏见和不灵活与一般焦虑相关的认知因素具有独特的关系。

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引用次数: 0

Mechanisms of change in cognitive functional therapy: A longitudinal mediation analysis of the RESTORE clinical trial for disabling chronic low back pain 认知功能治疗改变的机制：对慢性腰痛致残RESTORE临床试验的纵向中介分析

IF 4.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy

Pub Date : 2025-09-03 DOI: 10.1016/j.brat.2025.104853

Robert Schütze , Bernard Liew , J.P. Caneiro , Peter O'Sullivan , Peter Kent , Mark Hancock , Jan Hartvigsen , Kieran O'Sullivan , Alison McGregor , Amity Campbell , Stephanie Attwell , Anne Smith

Chronic low back pain (CLBP) is an urgent global health priority given its high prevalence and impact as the leading cause of disability. While several efficacious treatments exist, most have modest effects. Improving outcomes requires a better understanding of treatment mechanisms to enable optimisation. This study explored the mechanisms of cognitive functional therapy (CFT), a biopsychosocial intervention with large, durable effects for adults with disabling CLBP. A longitudinal mediation analysis was performed on data from the RESTORE multisite clinical trial comparing CFT (n = 327) to usual care (n = 165). Mediators (self-efficacy, fear, catastrophising, and pain intensity) were specified based on behavioural theories underlying CFT and previous research. The joint mediation of treatment effects on disability (Roland Morris Disability Questionnaire) and pain intensity (numerical rating scale), were examined using a counterfactual framework for mediation analysis. As hypothesised, earlier changes in self-efficacy, fear, catastrophising, and pain intensity mediated improvements in disability at the end of treatment and at 12-month follow-up, explaining up to 61 % of the effect. Similarly, self-efficacy, fear, and catastrophising mediated the effect of CFT on pain intensity, explaining up to 62 % of the effect. Results are consistent with previous CLBP mediation research highlighting self-efficacy, fear, and catastrophising as likely common mechanisms among effective biopsychosocial treatments. CFT demonstrates large, durable, and clinically important effects on these mechanisms. Findings shed light for clinicians and researchers on how CFT works, although the role of other mechanisms such as movement changes requires further exploration, along with research analysing how different treatment components activate these mechanisms.

慢性腰痛（CLBP）是一个紧迫的全球卫生优先事项，因为它的高患病率和影响作为残疾的主要原因。虽然有几种有效的治疗方法，但大多数效果一般。改善结果需要更好地了解治疗机制以实现优化。本研究探讨了认知功能治疗（CFT）的机制，这是一种对成人致残性CLBP具有大而持久效果的生物心理社会干预。对RESTORE多地点临床试验的数据进行纵向中介分析，比较CFT （n = 327）和常规治疗（n = 165）。调节因子（自我效能、恐惧、灾难化和疼痛强度）是根据CFT的行为理论和先前的研究来指定的。采用反事实框架进行中介分析，考察了治疗效果对残疾（Roland Morris残疾问卷）和疼痛强度（数值评定量表）的联合中介作用。正如假设的那样，在治疗结束和12个月的随访中，自我效能、恐惧、灾难和疼痛强度的早期变化介导了残疾的改善，解释了高达61%的效果。同样，自我效能、恐惧和灾难化介导了CFT对疼痛强度的影响，解释了高达62%的影响。结果与先前的CLBP调解研究一致，强调自我效能、恐惧和灾难化可能是有效的生物心理社会治疗中的共同机制。CFT对这些机制具有巨大、持久和重要的临床作用。研究结果为临床医生和研究人员揭示了CFT的工作原理，尽管其他机制（如运动变化）的作用需要进一步探索，以及分析不同治疗成分如何激活这些机制的研究。

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引用次数: 0