Clinical Psychology Review最新文献_第3页

Inter-identity amnesia and memory transfer in dissociative identity disorder: A systematic review with a meta-analysis 分离性身份识别障碍中的身份间遗忘和记忆转移：系统回顾与荟萃分析。

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review

Pub Date : 2024-10-30 DOI: 10.1016/j.cpr.2024.102514

Julia C. Beker , Martin J. Dorahy , Jaimee Moir , Jacinta Cording

Individuals with dissociative identity disorder (DID) often report an inability to retrieve memories associated with other identities, termed inter-identity amnesia (IIA). Research investigating IIA has amassed, and interest surrounds whether objective deficits in retrieval mechanisms necessarily underlie the experience of IIA. This study conducted a systematic literature review with meta-analyses to examine current findings on IIA in DID. In particular, we explored whether DID patients' clinical reports of retrieval failure across identities were substantiated by controlled measures of memory. Nineteen empirical and four case studies informed the systematic review. The meta-analyses comprised twelve of the included studies. The systematic review findings suggested a degree of inter-identity memory transfer, a conclusion which was supported by two of the four meta-analyses. The remaining two meta-analyses evidenced patterns closer to IIA. Closer examination drew attention to methodological considerations that may limit definitive conclusions drawn from present studies. These include substantial heterogeneity between participants' scores which is masked by group statistics, a small and homogenous cumulative sample, limited research teams, and minimal domains of memory assessed. The paper urges a nuanced understanding of the phenomenon of IIA in light of current findings.

分离性身份识别障碍（DID）患者经常报告无法检索与其他身份相关的记忆，这被称为身份间遗忘症（IIA）。有关 IIA 的研究已经很多，人们对检索机制的客观缺陷是否一定是 IIA 体验的基础产生了兴趣。本研究通过系统性文献综述和荟萃分析，对目前有关 DID IIA 的研究结果进行了研究。特别是，我们探讨了 DID 患者关于跨身份检索失败的临床报告是否得到了对照记忆测量的证实。19项实证研究和4项病例研究为系统综述提供了信息。荟萃分析包括所纳入研究中的 12 项。系统综述的结果表明，身份间记忆有一定程度的转移，这一结论得到了四项荟萃分析中两项的支持。其余两项荟萃分析的模式更接近于 IIA。仔细研究会发现，方法上的考虑可能会限制从目前的研究中得出明确的结论。这些因素包括被分组统计所掩盖的参与者得分之间的巨大异质性、累积样本量小而单一、研究团队有限以及评估的记忆领域极少。本文呼吁根据目前的研究结果对 IIA 现象进行细致入微的理解。

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引用次数: 0

A systematic review and meta-analysis of the relationship between sensory processing differences and internalising/externalising problems in autism 自闭症患者感觉处理差异与内化/外化问题之间关系的系统回顾和荟萃分析。

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review

Pub Date : 2024-10-29 DOI: 10.1016/j.cpr.2024.102516

Yixin Chen , Zhenyang Xi , Rob Saunders , David Simmons , Vasiliki Totsika , Will Mandy

There is evidence to suggest that sensory processing differences (SPDs) to external stimuli are a plausible underlying mechanism for mental health problems among autistic people. In the current systematic review, we examined the associations between, on the one hand, eleven types of SPDs and, on the other hand, internalising and externalising problems. The literature search was conducted on five databases (MEDLINE, PsycINFO, Web of Science, EMBASE, and CINAHL) between 1990 and August 2024. Studies with autistic people aged under 65 years-old that reported correlations between SPDs and internalising/externalising problems were included. Three-level and random-effects meta-analyses and narrative synthesis were conducted. In total, we included 63 articles (11,659 participants) in the current review. Overall, higher levels of all SPD subtypes were found to be associated with greater internalising/externalising problems. Hypersensitivity, visual, auditory, and tactile sensitivities were strongly associated with internalising/externalising problems, while smaller effects were observed for unusual processing of smell and taste. Sensation seeking was highly linked with externalising problems, whereas it was the least associated sensory subtype with internalising problems. Future studies could address the limitations in the extant literature (e.g., heterogeneity in the estimates of associations, a lack of externalising problem investigations and longitudinal studies) to further advance our understanding of the role of SPDs in the aetiology, development, and treatment of internalising/externalising problems in autism.

有证据表明，对外界刺激的感觉处理差异（SPDs）是自闭症患者出现心理健康问题的一个可信的潜在机制。在本系统综述中，我们研究了 11 种 SPD 与内化和外化问题之间的关联。文献检索在 1990 年至 2024 年 8 月期间的五个数据库（MEDLINE、PsycINFO、Web of Science、EMBASE 和 CINAHL）中进行。研究对象为 65 岁以下的自闭症患者，研究内容包括 SPD 与内化/外化问题之间的相关性。我们进行了三级随机效应荟萃分析和叙述性综合分析。本次综述共纳入 63 篇文章（11659 名参与者）。总体而言，所有 SPD 亚型的较高水平都与较严重的内化/外化问题有关。过度敏感、视觉、听觉和触觉敏感与内化/外化问题密切相关，而嗅觉和味觉异常处理的影响较小。寻求感觉与外部化问题的关联度很高，而它是与内部化问题关联度最低的感官亚型。未来的研究可以解决现有文献的局限性（例如，关联估计的异质性、缺乏外部化问题调查和纵向研究），从而进一步加深我们对自闭症患者内化/外部化问题的病因、发展和治疗中SPDs作用的理解。

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引用次数: 0

Altered representation of peripersonal and interpersonal space in psychopathology 精神病理学中的个人和人际空间表征改变

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review

Pub Date : 2024-10-29 DOI: 10.1016/j.cpr.2024.102509

Hyeon-Seung Lee , Daphne J. Holt , Sohee Park

The space surrounding the body, and the regulation of this buffer zone play a central role in adaptive behavior, with direct implications for psychopathology. The physical distance that we choose to maintain between ourselves and others for social comfort is known as Interpersonal Distance (IPD), whereas the action space that marks the perceptual border between the self and the external world is known as Peripersonal Space (PPS

). While both IPD and PPS represent personal space, they are distinct constructs, each associated with different methodologies. Here we review the existing literature on IPD and PPS to elucidate their distinct and common contributions to psychiatric conditions including schizophrenia, autism, anxiety, and others. Altered representation and regulation of IPD and PPS were associated with clinical symptoms and social impairments across a wide range of psychiatric disorders, underscoring the important role of the self-other boundary and personal space regulation in adaptive social behavior. Future research should clarify the relationship between IPD and PPS and specify risk factors for self-other boundary dysregulation and associated psychopathologies.

身体周围的空间以及对这一缓冲区的调节在适应行为中发挥着核心作用，并对精神病理学产生直接影响。为了社交舒适，我们选择在自己与他人之间保持的物理距离被称为人际距离（IPD），而标志着自我与外部世界之间感知边界的行动空间则被称为周身空间（PPS）。虽然 IPD 和 PPS 都代表个人空间，但它们是不同的概念，各自与不同的方法论相关联。在此，我们回顾了有关 IPD 和 PPS 的现有文献，以阐明它们对精神分裂症、自闭症、焦虑症等精神疾病的不同和共同作用。IPD和PPS的表征和调节的改变与多种精神疾病的临床症状和社交障碍有关，强调了自他边界和个人空间调节在适应性社交行为中的重要作用。未来的研究应阐明 IPD 和 PPS 之间的关系，并明确自我-他者边界失调和相关精神病理学的风险因素。

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引用次数: 0

The psychometric assessment of the older adult in pain: A systematic review of assessment instruments 老年人疼痛心理评估：对评估工具的系统回顾。

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review

Pub Date : 2024-10-29 DOI: 10.1016/j.cpr.2024.102513

Andrew I.G. McLennan , Emily M. Winters , Michelle M. Gagnon , Thomas Hadjistavropoulos

We conducted a systematic review of pain assessment tools suitable for community-dwelling older adults. For this work, we conceptualized existing psychometric tools as falling under the following domains: a) pain intensity/characteristics; b) pain-related interference/disability; c) coping strategies; d) pain beliefs/attitudes/cognitions; e) pain-related fear and anxiety; and f) pain-specific emotional distress. Multi-dimensional and condition-specific tools were also considered. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology for systematic reviews of patient-reported outcome measures guided the evaluation of measurement properties, quality of evidence ratings, and recommendations for each measure. A search of Medline, PsycINFO, Web of Science, and the Cumulative Index of Nursing and Allied Health Literature, yielded a total of 21,755 records. Of these, 120 studies, focusing on 57 psychometric tools, were included in this review and categorized into the aforementioned pain assessment domains. The availability of psychometric studies with older adult populations was insufficient for most tools and the quality of evidence ranged from very low to high. Only a small number of tools met the criteria for a strong or tentative recommendation favoring their use. We identified gaps that should be addressed in future research.

我们对适用于社区老年人的疼痛评估工具进行了系统回顾。在这项工作中，我们将现有的心理测量工具归纳为以下几个领域：a) 疼痛强度/特征；b) 与疼痛相关的干扰/残疾；c) 应对策略；d) 疼痛信念/态度/认知；e) 与疼痛相关的恐惧和焦虑；f) 与疼痛相关的情绪困扰。此外，还考虑了多维工具和针对特定病症的工具。基于共识的健康测量工具选择标准（COSMIN）方法用于对患者报告的结果测量方法进行系统性回顾，指导对每种测量方法的测量特性、证据质量评级和建议进行评估。通过对 Medline、PsycINFO、Web of Science 和 Cumulative Index of Nursing and Allied Health Literature 的检索，共获得 21,755 条记录。其中有 120 项研究被纳入本综述，这些研究主要涉及 57 种心理测量工具，并按上述疼痛评估领域进行了分类。对于大多数工具而言，针对老年人群的心理测量研究并不充分，证据质量从很低到很高不等。只有少数工具符合强烈推荐或暂定推荐使用的标准。我们发现了未来研究中需要解决的不足之处。

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引用次数: 0

Comparison of effects of interventions to promote the mental health of parents of children with autism: A systematic review and network meta-analysis 促进自闭症儿童家长心理健康的干预措施效果比较：系统综述和网络荟萃分析。

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review

Pub Date : 2024-10-29 DOI: 10.1016/j.cpr.2024.102508

Shuliang Mo , Fan Bu , Shujuan Bao , Zhou Yu

Individuals diagnosed with autism spectrum disorders often face persistent challenges in social interaction and engage in repetitive and stereotyped behaviors. Parenting a child with autism can profoundly affect parents both physically and psychologically, potentially leading to negative impacts on their mental health. This study employs a network meta-analysis methodology to evaluate the comparative effectiveness of mental health interventions specifically designed for parents of autistic children. A total of 69 empirical intervention studies involving 4213 parents of autistic children were included in the analysis. Employing the frequency framework model and utilizing Stata 16.0 software, we quantitatively analyzed the impact of various interventions on anxiety, depression, parenting stress, and parenting self-efficacy. Our findings indicate that mindfulness-based interventions demonstrate the highest efficacy in reducing parenting stress, while cognitive behavioral therapy is effective in alleviating anxiety and depression in parents of children with autism. Psychoeducational interventions have shown significant benefits in mitigating parental anxiety, depression, and parenting stress, and acceptance and commitment (ACT) displays promising outcomes in reducing depression. We also elaborate on the underlying mechanisms that contribute to the effectiveness of these interventions. This network meta-analysis presents valuable insights for the development of targeted interventions to provide support to parents of children with autism.

被诊断出患有自闭症谱系障碍的患者通常在社交互动方面面临持续的挑战，并有重复和刻板的行为。养育自闭症儿童会对父母的生理和心理产生深远影响，并可能对他们的心理健康造成负面影响。本研究采用网络荟萃分析方法，评估专门针对自闭症儿童家长的心理健康干预措施的比较效果。共有 69 项涉及 4213 名自闭症儿童家长的实证干预研究被纳入分析范围。我们采用频率框架模型和 Stata 16.0 软件，定量分析了各种干预措施对焦虑、抑郁、养育压力和养育自我效能的影响。我们的研究结果表明，以正念为基础的干预措施在减轻养育压力方面效果最佳，而认知行为疗法则能有效缓解自闭症儿童家长的焦虑和抑郁。心理教育干预在减轻父母焦虑、抑郁和养育压力方面有显著效果，而接纳与承诺（ACT）在减轻抑郁方面也显示出良好的效果。我们还阐述了这些干预措施产生效果的潜在机制。这项网络荟萃分析为开发有针对性的干预措施，为自闭症儿童的父母提供支持提供了宝贵的见解。

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引用次数: 0

Network meta-analysis examining efficacy of components of cognitive behavioural therapy for insomnia 对认知行为疗法治疗失眠的疗效进行网络荟萃分析

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review

Pub Date : 2024-10-28 DOI: 10.1016/j.cpr.2024.102507

Lisa Steinmetz , Laura Simon , Bernd Feige , Dieter Riemann , Anna F. Johann , Johanna Ell , David D. Ebert , Harald Baumeister , Fee Benz , Kai Spiegelhalder

Cognitive behavioural therapy for insomnia (CBTI) is recommended as first-line treatment for insomnia. CBT-I is a multi-component intervention comprising psychoeducation, sleep restriction, stimulus control, cognitive, and relaxation therapy. The relative efficacy of its components has yet to be investigated with state-of-the-art meta-analytic methods. PubMed, MEDLINE, PsycINFO, PsycARTICLES, and CINAHL were searched according to a pre-registered protocol using search terms indicative of insomnia and CBTI. Baseline-to-post-treatment effect sizes (Cohen's d) were calculated in a component network meta-analysis. Eighty studies representing 15,351 participants (mean age 44.9 years, 70.1 % female) were included. For the primary outcome insomnia severity, a significant positive effect for sleep restriction therapy (d = −0.45; 95 % CI: [−0.63; −0.36]) was found. Overall, the results suggest that sleep restriction therapy improves self-reported sleep continuity and sleep quality, and stimulus control therapy improves self-reported and objective total sleep time. No significant effects of psychoeducation, relaxation therapy, and cognitive therapy, and no further significant effects of any CBT-I component on objective sleep parameters were found. The most common sources of bias were a lack of blinding, missing outcome data, and the absence of study protocols. The current results suggest that sleep restriction therapy and stimulus control therapy are the most effective components of CBT-I.

失眠认知行为疗法（CBTI）被推荐为失眠症的一线治疗方法。CBT-I 是一种多成分干预方法，包括心理教育、睡眠限制、刺激控制、认知和放松疗法。其各组成部分的相对疗效还有待采用最先进的荟萃分析方法进行研究。根据预先登记的方案，使用表明失眠和 CBTI 的检索词对 PubMed、MEDLINE、PsycINFO、PsycARTICLES 和 CINAHL 进行了检索。在成分网络荟萃分析中计算了基线到治疗后的效应大小（Cohen's d）。共纳入了代表 15,351 名参与者（平均年龄 44.9 岁，70.1% 为女性）的 80 项研究。就主要结果失眠严重程度而言，睡眠限制疗法具有显著的正效应（d = -0.45；95 % CI：[-0.63; -0.36]）。总体而言，研究结果表明，睡眠限制疗法可改善自我报告的睡眠连续性和睡眠质量，而刺激控制疗法则可改善自我报告的和客观的总睡眠时间。心理教育、放松疗法和认知疗法对客观睡眠参数均无明显影响，而 CBT-I 的任何组成部分对客观睡眠参数均无进一步的明显影响。最常见的偏差来源是缺乏盲法、结果数据缺失和缺乏研究方案。目前的结果表明，睡眠限制疗法和刺激控制疗法是 CBT-I 最有效的组成部分。

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引用次数: 0

Motor actions across psychiatric disorders: A research domain criteria (RDoC) perspective 精神病患者的运动行为：研究领域标准（RDoC）视角。

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review

Pub Date : 2024-10-28 DOI: 10.1016/j.cpr.2024.102511

K. Juston Osborne , Sebastian Walther , Vijay A. Mittal

The motor system is critical for understanding the pathophysiology and treatment of mental illness. Abnormalities in the processes that allow us to plan and execute movement in a goal-directed, context-appropriate manner (i.e., motor actions) are especially central to clinical motor research. Within this context, the NIMH Research Domain Criteria (RDoC) framework now includes a Motor Actions construct within the recently incorporated Sensorimotor Systems Domain, providing a useful framework for conducting research on motor action processes. However, there is limited available resources for understanding or implementing this framework. We address this gap by providing a comprehensive critical review and conceptual integration of the current clinical literature on the subconstructs comprising the Motor Actions construct. This includes a detailed discussion of each Motor Action subconstruct (e.g., action planning/execution) and its measurement across different units of analysis (e.g., molecules to behavior), the temporal and conceptual relationships among the Motor Action subconstructs (and other relevant RDoC domain constructs), and how abnormalities in these Motor Action subconstructs manifest in mental illness. Together, the review illustrates how motor system dysfunction is implicated in the pathophysiology of many psychiatric conditions and demonstrates shared and distinct mechanisms that may account for similar manifestations of motor abnormalities across disorders.

运动系统对于了解精神疾病的病理生理学和治疗至关重要。我们能够以目标为导向、与环境相适应的方式计划和执行运动的过程（即运动动作）出现异常，这对临床运动研究尤为重要。在此背景下，NIMH 研究领域标准（RDoC）框架现在包括了最近纳入的感觉运动系统领域中的运动动作结构，为开展运动动作过程研究提供了一个有用的框架。然而，用于理解或实施该框架的可用资源非常有限。为了弥补这一不足，我们对当前有关运动动作建构子结构的临床文献进行了全面的批判性回顾和概念整合。这包括详细讨论每个运动动作子结构（如动作计划/执行）及其在不同分析单位（如分子到行为）中的测量、运动动作子结构（以及其他相关的 RDoC 领域结构）之间的时间和概念关系，以及这些运动动作子结构的异常在精神疾病中的表现。综上所述，该综述说明了运动系统功能障碍是如何与许多精神疾病的病理生理学相联系的，并展示了可能导致不同疾病的运动异常表现相似的共同和独特机制。

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引用次数: 0

The current evidence of solution-focused brief therapy: A meta-analysis of psychosocial outcomes and moderating factors 以解决方案为重点的简短疗法的现有证据：社会心理成果和调节因素的荟萃分析。

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review

Pub Date : 2024-10-28 DOI: 10.1016/j.cpr.2024.102512

E. Vermeulen-Oskam , C. Franklin , L.P.M. van’t Hof , G.J.J.M. Stams , E.S. van Vugt , M. Assink , E.J. Veltman , A.S. Froerer , J.P.C. Staaks , A. Zhang

Purpose

Solution Focused Brief Therapy (SFBT) focuses on the strengths and resources of clients, and is assumed to achieve positive results on various psychosocial outcomes. This meta-analysis is an extension of previous meta-analyses on SFBT, and examines if the effectiveness of SFBT is influenced by participant, intervention, study and publication characteristics.

Methods

Experimental and quasi-experimental studies were included. A three-level meta-analysis was performed on 72 studies and 489 effect sizes, accounting for within and between study differences.

Results

The overall effect of SFBT on psychosocial problems was large (g = 1.17). Moderator analyses revealed larger effects of SFBT in non-clinical samples (g = 1.50) than in clinical samples (g = 0.78). Studies with treatment-as-usual (TAU) as control condition reported smaller effects (g = 0.58) than studies with a no-treatment control condition (g = 1.59). Relatively large effects were found for couples (g = 3.02) compared to other client groups (0.41 < g < 1.70), and marital functioning (g = 3.02) compared to other outcomes (0.23 < g < 1.31). Group therapy (g = 1.64) yielded a larger effect than individual therapy (g = 0.48).

Conclusion

The findings indicate that SFBT is applicable for a variety of clients and psychosocial problems.

目的：以解决问题为重点的简易疗法（SFBT）关注客户的优势和资源，被认为能在各种社会心理结果上取得积极效果。本荟萃分析是对之前有关 SFBT 的荟萃分析的延伸，旨在研究 SFBT 的有效性是否受参与者、干预、研究和出版特征的影响：方法：纳入实验和准实验研究。方法：纳入实验和准实验研究，对 72 项研究和 489 个效应大小进行了三级荟萃分析，并考虑了研究内部和研究之间的差异：结果：SFBT 对社会心理问题的总体影响较大（g = 1.17）。主持人分析显示，SFBT 在非临床样本中的效应（g = 1.50）大于在临床样本中的效应（g = 0.78）。将 "常规治疗"（TAU）作为对照条件的研究报告的效果（g = 0.58）小于无治疗对照条件的研究报告的效果（g = 1.59）。与其他客户群体（0.41）相比，夫妻群体（g = 3.02）的效果相对较大：研究结果表明，SFBT 适用于各种客户和社会心理问题。

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引用次数: 0

Bridging perspectives - A review and synthesis of 53 theoretical models of delusions 视角的桥梁--53 种妄想症理论模型的回顾与综述。

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review

Pub Date : 2024-10-28 DOI: 10.1016/j.cpr.2024.102510

S. Denecke, S.N. Schönig , A. Bott , J.L. Faße , T.M. Lincoln

The degree to which numerous existing models of delusion formation disagree or propose common mechanisms remains unclear. To achieve a comprehensive understanding of delusion aetiology, we summarised 53 theoretical models of delusions extracted from a systematic literature search. We identified central aspects and unique or overarching features of five core perspectives: cognitive (n = 22), associative learning (n = 4), social (n = 6), neurobiological (n = 6), and Bayesian inference (n = 15). These perspectives differ in foci and mechanistic explanations. Whereas some postulate delusions to result from associative and operant learning, others assume a disbalance in the integration of prior beliefs and sensory input or emphasise the relevance of information processing biases. Postulated moderators range from maladaptive generalised beliefs over neurocognitive impairment to dopamine, stress, and affective dysregulation. The models also differ in whether they attempt to explain delusion formation in general or the delusional content (i.e., persecutory). Finally, some models postulate functional aspects of delusions, such as insight relief. Despite their differences, the perspectives converge on the idea that delusions form as an explanation for an experienced ambiguity. Building on this common ground, we propose an integrative framework incorporating essential mechanistic explanations from each perspective and discuss its implications for research and clinical practice.

现有的众多妄想形成模型在多大程度上存在分歧或提出了共同的机制，目前仍不清楚。为了全面了解妄想的病因，我们总结了从系统文献检索中提取的 53 种妄想理论模型。我们确定了五种核心观点的中心内容和独特或总体特征：认知（22 个）、联想学习（4 个）、社会（6 个）、神经生物学（6 个）和贝叶斯推理（15 个）。这些观点的重点和机理解释各不相同。一些人认为妄想是联想和操作性学习的结果，而另一些人则认为是先前的信念和感觉输入的整合失衡，或强调信息处理偏差的相关性。推测的调节因素包括适应不良的泛化信念、神经认知障碍、多巴胺、压力和情感失调。这些模型在试图解释妄想形成的一般情况还是妄想内容（即迫害性妄想）方面也有所不同。最后，一些模型假设了妄想的功能方面，如洞察力缓解。尽管存在差异，但这些观点的共同点是，妄想的形成是对经验模糊性的一种解释。在这一共同点的基础上，我们提出了一个综合框架，其中包含了每种观点的基本机理解释，并讨论了其对研究和临床实践的影响。

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引用次数: 0

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review

Pub Date : 2024-09-24 DOI: 10.1016/j.cpr.2024.102504

Nathan R. Huff, Laura Dunderdale, Alexander J. Kellogg, Linda M. Isbell

The aim of this umbrella review is to summarize evidence on factors that influence help-seeking and service utilization for professional mental healthcare among young people ages 0–30. The CINAHL, Cochrane, Epistemonikos, MEDLINE, PsycINFO, PubMed, and Web of Science databases were searched in December 2023 for systematic reviews in English. The search yielded 26 eligible reviews, all of which are medium or high quality. Primary study overlap was rare. Using an established framework, we organize intrapersonal (n = 37), interpersonal (n = 14), institutional (n = 9), community (n = 7), and public policy (n = 6) factors. The most frequently reviewed factor at each level is trust of professionals (intrapersonal), close others' support for treatment (interpersonal), cost (institutional), availability (community), and insurance (public policy). Stigma is widely referenced (18 reviews) and classified as multi-dimensional. Narrative synthesis reveals population-specific variability (e.g., rural, racial/ethnic minority, refugees, immigrants) in the importance of many factors. To develop interventions and healthcare systems sensitive to young people's needs, we recommend promoting stigma-reduction campaigns, and targeting trustworthiness, affordability, anonymity, accessibility, and mental health literacy. Identifying commonalities and differences across populations and contexts assists in the design of nuanced and efficient treatment delivery systems for young people, who are at a critical time for their mental health.

本综述旨在总结影响 0-30 岁青少年寻求帮助和利用专业心理保健服务的因素的相关证据。2023 年 12 月，我们在 CINAHL、Cochrane、Epistemonikos、MEDLINE、PsycINFO、PubMed 和 Web of Science 数据库中检索了英文系统综述。检索结果显示有 26 篇符合条件的综述，全部为中等或高质量。主要研究重叠的情况很少见。利用既定框架，我们整理了个人内部因素（n = 37）、人际因素（n = 14）、机构因素（n = 9）、社区因素（n = 7）和公共政策因素（n = 6）。在各个层面上，最常被提及的因素是对专业人员的信任（个人内部）、亲密他人对治疗的支持（人际关系）、费用（机构）、可用性（社区）和保险（公共政策）。成见被广泛引用（18 篇综述），并被归类为多维成见。叙述性综述揭示了特定人群（如农村、少数种族/族裔、难民、移民）在许多因素的重要性方面存在差异。为了开发对年轻人的需求敏感的干预措施和医疗保健系统，我们建议推广减少污名化运动，并以可信度、可负担性、匿名性、可及性和心理健康知识为目标。找出不同人群和背景下的共性和差异，有助于为正处于心理健康关键时期的年轻人设计细致高效的治疗体系。

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引用次数: 0