Clinical Psychology Review最新文献

Background

Personal recovery represents a paradigm shift in mental healthcare. Validated self-report outcome measures (PROMs) are needed to facilitate the transformation towards recovery-oriented practices and services. Objectives were to identify published measures and analyze their measurement properties using a standardized methodology.

Methods

Following the COSMIN guidelines, we conducted a systematic review of personal recovery PROMs in serious mental illness. The MEDLINE, PMC, PsycINFO, PsycARTICLES, PBSC and Scopus electronic databases were searched for articles published between May 2012 and February 2024. Full-text articles from a previous systematic review were also examined.

Results

91 studies were included in the review, describing 25 PROMs. Ten of them had not been identified in previous reviews. Quality of evidence was globally poor for most PROM measurement properties. Very little evidence was found for cross-cultural validity, measurement invariance, measurement error and criterion validity. The Recovery Assessment Scale and Questionnaire about the Process of Recovery showed the strongest evidence for sufficient psychometric data on a wide range of measurement properties.

Conclusions

Several personal recovery measures are now available. While research is still needed to enhance their validity on some psychometric properties, the current tools appear sufficient to cover most research and clinical needs.

Perception has been conceptualised as an active and adaptive process, based upon incoming sensory inputs, which are modified by top-down factors such as cognitions. Visuospatial perception is thought to be scaled based on threat, with highly threatening objects or contexts visually inflated to promote escape or avoidance behaviours. This meta-analytical systematic review quantified the effect and evidence quality of threat-evoked visuospatial scaling, as well as how visuospatial scaling relates to affordances (perceived action capabilities) and behavioural avoidance/escape outcomes. Databases and grey literature were systematically searched inclusive to 10/04/24. Studies were assessed with a customised Risk of Bias form and meta-analysis was performed using a random-effects model. 12,354 records were identified. Of these, 49 experiments (n = 3027) were included in the review. There was consistent evidence that threat the of height influenced contextual perception (g = 0.66, 95% CI: 0.45, 0.88) and affordances (g = -0.43, 95% CI: -0.84, -0.03). Threatening objects were viewed as larger (g = 0.76, 95% CI: 0.26, 1.26) and as closer (g = 0.30, 95% CI: 0.17, 0.42). Bodily threat (pain) yielded conflicting effects on visuospatial perception/affordances. We conclude that threat may influence visuospatial perception and affordances. However, since behavioural measures were poorly reported, their relationship with visuospatial perception/affordances remains elusive.

Theories of psychopathy development traditionally emphasize that individuals high in psychopathy experience diminished internalizing symptoms (e.g., anxiety and depression). However, many studies find null or even positive relationships between psychopathy and internalizing. The current meta-analysis therefore aimed to provide a comprehensive understanding of heterogeneity in psychopathy-anxiety/depression relationships by examining measurement and sample-related variables that may moderate these associations (e.g., psychopathy subdimensions assessed, different measures/operationalizations of psychopathy and anxiety/depression, and demographic characteristics). Results suggest that psychopathy demonstrates a small, positive overall association with anxiety/depression (r = 0.09), which may indicate that psychopathy is unrelated to subjective experiences of anxiety and sadness, but results could also reflect that varying psychopathy and anxiety/depression assessment practices contribute to heterogeneity in psychopathy-anxiety/depression associations. Most notably, results indicate that associations vary substantially across different measures/operationalizations of psychopathy, even when controlling for sample type and informant. Some psychopathy scales could therefore inadvertently capture anxiety/depression symptoms or broader psychopathology in addition to psychopathic traits. Findings from the current meta-analysis can inform future efforts to understand how measurement-related considerations influence relationships between psychopathy and anxiety/depression.

Cognitive behavioral therapies have been identified as evidence-based treatments for anxiety-related disorders. However, data supporting the effectiveness of these treatments have been largely collected from participants with majoritized identities, potentially limiting the extent to which they can be considered “evidence-based” for clients from minoritized groups. The current review examined sociodemographic representation and quality of sociodemographic reporting in randomized controlled trials for anxiety-related disorders in the U.S. between 1993 and 2023. We conducted a systematic literature review of U.S.-based randomized controlled trials of cognitive behavioral therapies for anxiety-related disorders, extracted data on sociodemographic variables, and rated quality of reporting. Data from 55 eligible studies (N = 4492) indicated that white and female identities were overrepresented relative to the U.S. population, with variables like disability status, sexual orientation, and religious identification consistently ignored. In addition, quality of reporting was generally poor (mean = 3.6 out of 10), with many studies failing to account for demographic variables in their analyses or description of study limitations. Publication year, sample size, and NIH funding status did not significantly predict gender representation (% women), ethnoracial representation (% white), or quality of reporting. These findings underscore the importance of critically evaluating to whom “evidence-based” treatments apply and increasing diversity of clinical samples, to ensure that evidence-based treatments are inclusive. Recommendations for future research, clinical implications, and limitations are discussed.

Harmful outcomes of psychological interventions are under-researched, including in mindfulness-based interventions (MBI) for psychosis. This systematic review summarizes reporting and prevalence of 8 harm indices (death, adverse events, hospitalisation, study drop out, noncompletion of therapy, side effects of therapy, symptom deterioration and crisis service use) in Randomised Controlled Trials (RCTs) of MBIs for psychosis. Meta-analyses of risk differences were also calculated for each harm index. The review included 39 studies, with a total n of 2684 participants across studies. The percentage of studies reporting on each index of harm, and the prevalence of harm, varied greatly across each index. 0% of studies reported on side effects of interventions compared to 92% of studies reporting on study dropout. Meta-analyses of risk differences (RD) found a higher risk of hospitalisation (RD (95% CI) = −0.136 (−0.23 to −0.05), p = 0.003) and crisis service use (RD (95% CI) = −0.160 (−0.299, −0.024), p = 0.02) in control arms compared to intervention arms, and no significant difference in adverse events, death, symptom deterioration, noncompletion of therapy, drop out and side effects of therapy. Overall, reporting of harm was inconsistent across studies and the quality of data collection and reporting varied. MBIs for psychosis appear to be safe and may reduce the risk of hospitalisation and use of crisis services. However, the absence of thorough reporting on harm precludes a balanced analysis of benefits versus harms. Future research into the effectiveness of MBIs should consistently operationalise, monitor and report data on harm.

Committed romantic relationships between two individuals with Substance Use Disorder (or dual-SUD couples) are prevalent. Dual-SUD couples have poor treatment engagement and outcomes. Research has established a reciprocal link between relationship dynamics (e.g., conflict, intimacy) and substance use. Thus, the couple's relationship presents a distinct social context for both partner's substance use. Dual-SUD couples face unique challenges due to substance use being a shared behavior that may serve as a rewarding source of compatibility, closeness, and short-term relationship satisfaction despite it being at the cost of other alternative sources of substance-free reinforcement. Yet, treatment options for these couples are scarce. Dual-maladaptive health behaviors (e.g., dual-substance use) are challenging to treat; however, theory and preliminary research suggests that transformation of couple's joint motivation toward adaptive health behavior change may result in a more satisfying relationship and improved treatment outcomes for both individuals. The current paper reviews the extant literature on dual-SUD couples from theoretical, empirical, and treatment research and proposes an expanded paradigm regarding how we understand dual-SUD couples with the aim of informing basic research and treatment development.

This meta-analytic review is an update to the first meta-analysis of battering interventions (Babcock et al., 2004) and includes 59 studies that evaluated treatment efficacy for domestically violent men and women. The outcome literature of controlled quasi-experimental and experimental studies was reviewed to test the relative impact of Duluth, cognitive-behavioral therapy (CBT), and novel types of treatment on subsequent recidivism of violence. The first model examines studies comparing interventions to no treatment control conditions. The second model compares novel interventions to treatment as usual (i.e., the Duluth curriculum). Study design and type of treatment were tested as moderators in both models. Consistent with previous meta-analyses, effect sizes were in the small range, smaller in true experiments as compared to quasi-experimental designs when recidivism was based on partner or police reports. However, new experiments comparing novel treatments to the Duluth curriculum reveal effect sizes comparable to when comparing novel interventions to an untreated comparison group. Novel interventions, including Acceptance and Commitment Therapy and Circles of Peace had the largest effect sizes when put head-to-head with Duluth control groups. Future research directions include testing moderators and mechanisms of change of the battering interventions that work. Implications for evidence-based practice in criminal justice include broader implementation and continued testing of these novel interventions with demonstrated efficacy in stopping intimate partner violence.

Attention biases towards disease-relevant cues have been implicated in numerous disorders and health conditions, such as anxiety, cancer, drug-use disorders, and chronic pain. Attention bias modification (ABM) has shown that changing attention biases can change related emotional processes. ABM most commonly uses a modified dot-probe task, which has received increasing criticism regarding its reliability and inconsistent findings. The purpose of the present review was thus to systematically review and meta-analyse alternative tasks used in ABM research. We sought to examine whether alternative tasks significantly changed attention biases and emotional outcomes, and critically examined whether relevant sample, task and intervention characteristics moderated each of these effect sizes. Seventy-four (completer n = 15,294) study level comparisons were included in the meta-analysis. Overall, alternative ABM designs had a medium effect on changing biases (g = 0.488), and a small, but significant effect on improving clinical outcomes (g = 0.117). We found this effect to be significantly larger for studies which successfully changed biases compared to those that did not. Across all tasks, it appeared that targeting engagement biases results in the largest change to attention biases. Importantly, we found tasks incorporating gaze-contingency – encouraging engagement with non-biased stimuli – show the most promise for improving emotional outcomes.

In recent years, there has been increasing interest in utilizing time-lagged panel models to study mechanisms of change in psychotherapy. These models offer valuable insights into the dynamic relationships between variables over time and offer stronger causal inference capabilities than cross-sectional analyses. Therefore, they are well-suited for modeling the intricate relationships between mechanisms of change and outcomes in psychotherapy studies, which are typically beyond experimental control. However, their complexity, coupled with the fact that detailed explanations are often embedded in dense statistical or econometric texts, poses challenges. This paper provides a background on cross-lagged panel models and delves deeper into explaining the issues of 1) dynamic panel bias, 2) long-run effects, and 3) testing whether different treatments work by different mechanisms. Using data from a psychotherapy study on treatment of adolescent depression, I demonstrate how these issues manifest in real data. In conclusion, I recommend using structural equation modeling to circumvent dynamic panel bias, reporting long-run effects to reveal the long-term impact of sustained therapeutic work on mechanisms of change, and carefully considering whether mediation, moderation, or a combination of both, best describes differential effects of mechanisms between treatments.

Loving-kindness meditations involve sending feelings of kindness and care to a series of people including oneself, loved ones, strangers, and all beings. Loving-kindness interventions (LKIs), which include knowledge and/or practice related to loving-kindness, have been gaining attention as a potential intervention for improving mental health in adults. This meta-analysis synthesized the effects of LKIs on both positive (i.e., mindfulness, compassion, positive affect) and negative (i.e., negative affect, psychological symptoms) indices of mental health across comparison types (i.e., passive control, active control, alternative treatment) and general sample types (i.e., community, university), and explored characteristics of LKIs that may impact their effectiveness (i.e., intervention format, intervention length, presence/absence of a live facilitator). Following a systematic review of six databases in November 2023, 23 randomized controlled studies met eligibility criteria and were included in the review. Relative to passive control groups, LKIs had positive effects on mindfulness, compassion, positive affect, negative affect, and psychological symptoms; these effects were non-significant relative to active control groups and alternative therapeutic treatments. Notably, the effects of LKIs did not differ as a function of sample type, intervention format, intervention length, or the presence/absence of a live facilitator. Findings provide support for the effectiveness of LKIs relative to passive control conditions, as well as their potential comparability to alternative evidence-based therapeutic treatments, and provide insight into resource-effective approaches to the delivery of effective LKIs. However, additional studies are needed to confirm the impacts of LKIs relative to other interventions in the field.