Clinical Psychology Review最新文献

{"title":"Global PTSD prevalence among active first responders and trends over recent years: A systematic review and meta-analysis","authors":"Andrew F. Arena ,&nbsp;Mikayla Gregory ,&nbsp;Daniel A.J. Collins ,&nbsp;Bojana Vilus ,&nbsp;Richard Bryant ,&nbsp;Samuel B. Harvey ,&nbsp;Mark Deady","doi":"10.1016/j.cpr.2025.102622","DOIUrl":"10.1016/j.cpr.2025.102622","url":null,"abstract":"<div><div>First responders in emergency services are inherently exposed to potentially psychologically traumatic events, increasing their risk for PTSD, burnout, and work incapacity. The current meta-analysis aimed to comprehensively compare PTSD prevalence within varied first responders in the context of both routine exposures and large-scale disasters, assess trends over recent years and differences between economic contexts. In January 2025, five databases were searched for peer-reviewed observational studies on employed or volunteering samples. Publication date was limited to post-2008, given meta-analyses addressing similar questions captured literature until this point. Random effects meta-analyses and meta-regressions explored trends over time and the impacts of exposure category, occupation, economic context, volunteer status, sex, and PTSD measurement. Analyses included 138 studies (173 independent samples). General samples with routine exposures possessed greater prevalence (14.3 %) than samples exposed to large-scale disasters (8.3 %). For the first time, there was some evidence of increasing prevalence over time within routine exposure samples. Low/middle-income countries and non-volunteers exhibited greater PTSD prevalence than high-income countries and volunteers. Prevalence varied based on PTSD outcome measurement, although no differences emerged between occupational and sex subgroups. Increasing PTSD prevalence over time appears to have been largely driven by increases observed since the COVID-19 pandemic, yet important questions remain regarding why prevalence has not decreased in relation to increasing efforts to support this population's mental health. All first responder occupations appear equally prone to PTSD, and thus equally in need of intervention. Workers in low/middle-income countries are particularly vulnerable to PTSD, potentially due to more limited resourcing.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"120 ","pages":"Article 102622"},"PeriodicalIF":13.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review on predictors of treatment outcome among forcibly displaced adults receiving psychological and/or psychosocial interventions","authors":"Jennifer Kurath ,&nbsp;Dharani Keyan ,&nbsp;Aemal Akhtar ,&nbsp;William Vilella Martins ,&nbsp;Barbara Komenda ,&nbsp;Victoria Maurer ,&nbsp;Kadir Turgut ,&nbsp;Richard A. Bryant ,&nbsp;Naser Morina","doi":"10.1016/j.cpr.2025.102619","DOIUrl":"10.1016/j.cpr.2025.102619","url":null,"abstract":"<div><div>Forcibly displaced people (FDP) have an elevated risk of mental disorders. Though existing interventions reduce psychological symptoms overall, many FDP do not respond, indicating a need to explore contributing factors. This systematic review examined predictors of treatment outcome among adult FDP receiving psychological and/or psychosocial interventions. Studies were included if they reported predictor analyses with positive or negative mental health outcomes. Records from five databases (MEDLINE, PsycINFO, PTSDpubs, Cochrane, Embase) and citations and bibliographies of 78 reviews, as well as of all included articles were evaluated (last update: 13.09.24). Risk of bias was assessed using Cochrane tools (RoB 2.0, ROBINS-I). Findings were synthesised using a narrative review, including a summary of effect estimates and an evaluation of evidence strength with an adapted version of the Best Evidence Synthesis Research Strategy (BESRS) framework for specialised and low-intensity interventions separately. Sixty-four studies (<em>N</em> = 9982, mean age = 38.0 years, 44.9 % females) reported 321 effects, of which 223 were summarised in 21 predictor categories. Most categories yielded insufficient evidence. For specialised interventions, pain, disability, lower level of education, unemployment, and longer time since arrival to the host country were associated with worse outcomes. For low-intensity interventions, a higher level of education and female gender were associated with better outcomes. Despite identifying key predictors, the high heterogeneity across studies and the large proportion of missing data warrant caution when interpreting results. Future research should ensure larger datasets and more complex models to detect consistent effects and shed light on the interplay between predictor variables. Clinicians should consider systematically assessing disability and pain at intake to provide additional support to the severely impaired.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"120 ","pages":"Article 102619"},"PeriodicalIF":13.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating measures of LGBTQ+ intimate partner violence using consensus-based standards of validity","authors":"Sinéad Kelleher,&nbsp;Cal De Nicolas Audoin,&nbsp;Lisa Callaghan,&nbsp;Áine Travers","doi":"10.1016/j.cpr.2025.102620","DOIUrl":"10.1016/j.cpr.2025.102620","url":null,"abstract":"<div><h3>Background</h3><div>Evidence suggests that lesbian, gay, bisexual, transgender, queer, plus (LGBTQ+) people experience intimate partner violence (IPV) at similar or higher rates to their heterosexual and cisgender counterparts. However, there are also indications that LGBTQ+ people may experience IPV in particular ways, which are not usually included in existing standardised measures of IPV.</div></div><div><h3>Methods</h3><div>A review of existing measures for capturing IPV in LGBTQ+ samples was conducted using the COnsensus-based Standards for selecting health Measurement INstruments (COSMIN). Four databases (PubMed, PsychINFO via Ebsco, Cinahl Complete via Ebsco and Web of Science) were systematically searched, to identify all articles that used psychometric measures to capture IPV in the LGBTQ+ community.</div></div><div><h3>Results</h3><div>Forty-two articles describing twenty-two self-report measures were included. Few articles described a measure development process or assessed content validity. Although a significant proportion of measures were rated ‘very good’ for internal consistency, several received an ‘inadequate’ or ‘doubtful’ rating. All measures that had assessments of structural validity and measurement invariance were rated as ‘very good’. However, invariance testing was absent from most studies. The quality of hypothesis testing varied across studies and all but one carried out reliability analyses.</div></div><div><h3>Conclusions</h3><div>Due to a lack of high-quality psychometric assessment, more evidence for the validity, reliability, or responsiveness of IPV measures for LGBTQ+ samples is needed. Further psychometric testing is needed to improve the assessment of IPV across contexts and to strengthen the robustness of findings in this field of research.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"120 ","pages":"Article 102620"},"PeriodicalIF":13.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jumping to conclusions and delusional ideation: A systematic review and meta-analysis across the psychosis continuum","authors":"Rose Doherty ,&nbsp;Nathan Weber ,&nbsp;Charley Hillier ,&nbsp;Robert Ross ,&nbsp;Ryan Balzan","doi":"10.1016/j.cpr.2025.102618","DOIUrl":"10.1016/j.cpr.2025.102618","url":null,"abstract":"<div><div>We applied a two-stage Bayesian analysis to examine the relationship between the jumping to conclusions (JTC) bias (measured on the beads, box, fishing, and/or survey tasks) and delusional ideation (measured on the Peters et al. Delusions Inventory or the Community Assessment of Psychic Experiences). MEDLINE, PsycINFO, Scopus, Web of Science, and five previous JTC reviews were searched for eligible studies published between 1988 and December 2024. Risk of bias was assessed using an adapted version of the Agency for Healthcare Research and Quality assessment tool. Forty-two studies (<em>n</em> = 7604) were identified as meeting inclusion criteria, with four subgroups: general population (<em>n</em> = 7538), psychosis with current delusions (<em>n</em> = 449), psychosis without current delusions (<em>n</em> = 29), and clinical control (<em>n</em> = 77). Our first analysis presented a meta-analysis of correlations between delusional ideation and JTC. Our second analysis presented a zero-inflated Poisson regression, assessing change in JTC across variable delusional ideation scores. Impact of data quality was assessed in both analyses. No meaningful relationships between JTC and delusional ideation were found in the full dataset or any subgroup, but the subgroup with current delusions showed a relatively greater JTC bias than the general population subgroup. Data-quality procedures did not impact results. Overall, results suggest that the JTC bias is not related to delusional ideation, or indexes of delusional ideation and/or JTC used in this meta-analysis are poor measures of these constructs. Our results did not assess delusional severity, thus interpretations in clinical populations are limited. PROSPERO <span><span>https://www.crd.york.ac.uk/PROSPERO/view/CRD42021266402</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"120 ","pages":"Article 102618"},"PeriodicalIF":13.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the office: The role of clinical outreach services in counselling with Indigenous youth and families","authors":"Heba Elgharbawy ,&nbsp;Carrie Bove","doi":"10.1016/j.cpr.2025.102615","DOIUrl":"10.1016/j.cpr.2025.102615","url":null,"abstract":"<div><div>Stepping into a counselling office can be rife with barriers and inherent challenges, particularly for Indigenous communities who experience structural forms of marginalization or colonial violence or oppression. Outreach counselling, which is an alternative to traditional, often Eurocentric, office-based counselling services, can serve as a flexible, personal, cultural, and community-centered support. There is currently a scarcity of research that explores outreach counselling and its impacts on client engagement and wellness, specifically from Indigenous youth voices. This project involved a literature review of the available information on outreach counselling use with Indigenous communities across the globe. Through thematic analysis, four main themes were identified including 1) a lack of evidence on outreach service models and research evaluating its use with Indigenous communities and particularly with Indigenous youth, 2) evidence that suggests a strong call for more outreach counselling as it increases accessibility, 3) improved wellness through outreach models, and 4) considerations for practitioners when implementing outreach models in counselling. Actionable recommendations to enhance the accessibility and sustainability of outreach counselling services with Indigenous youth and families and ethical considerations are discussed. These findings offer communities and mental health professionals an overview of an alternative counselling model that can provide a more tailored approach to clinical care for Indigenous youth.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"120 ","pages":"Article 102615"},"PeriodicalIF":13.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growing through adversity: A meta-analytic and conceptual elucidation of the relationship between posttraumatic stress and posttraumatic growth among youth","authors":"Maria Jernslett ,&nbsp;Ryan P. Kilmer ,&nbsp;Demetris Avraam ,&nbsp;Xenia Anastassiou-Hadjicharalambous","doi":"10.1016/j.cpr.2025.102617","DOIUrl":"10.1016/j.cpr.2025.102617","url":null,"abstract":"<div><div>Trauma may engender both posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) among youth, but what is the nature of the relationship between these variables and what does it imply about youths' recovery trajectories? To explore this, PubMed, PsycINFO, Scopus, ERIC, and ProQuest Dissertations and Theses Global were searched, supplemented by reference trails, journal searches, and expert consultations, to identify quantitative studies on PTSS and PTG in youth (mean age ≤ 19 years). This resulted in 63 eligible articles. Both linear (<em>n</em> = 53) and curvilinear (<em>n</em> = 12) estimates were meta-analysed using random-effects models. Linear dependent estimates were pooled using weighted corrected averages and curvilinear dependent effects were clustered using robust variance estimation. The pooled linear estimate was <em>r</em> = 0.2028 [95 % CI 0.1348; 0.2689], <em>p</em> &lt; .0001, based on 53 independent estimates and a total sample size of 33,774.6. The pooled curvilinear estimate was <em>b</em> = −0.199 (<em>SE</em> = 0.0573, <em>p</em> = .012). Moderator analyses further revealed a significant cultural influence, with Western youth (<em>r</em> = 0.3100 [95 % CI 0.1977; 0.4142], <em>N</em> = 6141) demonstrating a stronger association between PTSS and PTG compared to their Eastern counterparts (<em>r</em> = 0.0727 [95 % CI −0.0130; 0.1574], <em>N</em> = 21,778.42). The findings paint a nuanced and complex picture of posttrauma responses among youth, ultimately underscoring that, while PTSS and PTG can coexist, PTSS that are too excessive may not be conducive to PTG.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"120 ","pages":"Article 102617"},"PeriodicalIF":13.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical inadequacy of the concept of treatment-resistant depression: Innovative strategies in assessment and psychotherapeutic management","authors":"Jenny Guidi ,&nbsp;Giovanni A. Fava","doi":"10.1016/j.cpr.2025.102616","DOIUrl":"10.1016/j.cpr.2025.102616","url":null,"abstract":"<div><div>Pharmacological strategies have been developed for patients with major depressive disorder who fail to respond to standard drug treatment. The current clinical approach primarily relies on counting episodes that fulfill specific criteria and regards non-pharmacological strategies as of marginal value, despite their recognized importance in treating depression. Most attention is devoted to treatment-resistant patients' characteristics rather than to the process related to therapeutic management. However, how the patient experiences the treatment process, his/her interaction with the physician/therapist and significant others, and the patient's role in treatment plan (self-management) are all essential therapeutic components. A broader evaluation of factors related to the patient (e.g., illness denial, psychological reactance, demoralization), the therapy (e.g., clinician's attitude, behavioral toxicity of antidepressants), the environment (e.g., allostatic load/overload and health-damaging behaviors), and morbidity (e.g., medical and psychiatric comorbidity) is warranted. Assessment based on clinimetric methods (i.e., staging, macro-analysis) and clinical judgment allow a differential diagnosis of phenomena such as non-response, pseudo-resistance, treatment resistance, loss of clinical effect during maintenance antidepressant treatment, failure to achieve remission after a psychotherapy trial, partially remitted depression (i.e., presence of residual symptoms). Choice of the psychotherapeutic approach for treatment-resistant depression (TRD), particularly cognitive-behavioral therapy, mindfulness-based cognitive therapy and interpersonal psychotherapy, should follow the indications derived from clinical assessment. Treatment of TRD can thus be conceptualized as an integrated therapeutic approach to different components encompassing symptoms, psychosocial factors, lifestyle and psychological well-being.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"120 ","pages":"Article 102616"},"PeriodicalIF":13.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of psychosocial suicide prevention interventions among adults: Clinical trial factors, predictors, mediators, and moderators in randomized controlled trials","authors":"Jaclyn C. Kearns ,&nbsp;Craig P. Polizzi ,&nbsp;Julia Naganuma-Carreras ,&nbsp;Kyle J. Bourassa ,&nbsp;Tate F. Halverson ,&nbsp;Rokas Perskaudas ,&nbsp;Nathan A. Kimbrel ,&nbsp;Alejandro Interian ,&nbsp;Robert M. Bossarte ,&nbsp;Bryann B. DeBeer ,&nbsp;Joseph I. Constans ,&nbsp;Melissa E. Dichter ,&nbsp;Steven K. Dobscha ,&nbsp;Marianne Goodman ,&nbsp;Mark Ilgen ,&nbsp;Richard R. Owen ,&nbsp;Brian P. Marx","doi":"10.1016/j.cpr.2025.102614","DOIUrl":"10.1016/j.cpr.2025.102614","url":null,"abstract":"<div><h3>Objective</h3><div>There has been a proliferation of psychosocial interventions to prevent suicide over the past several decades with varying levels of benefit. We conducted a comprehensive scoping review to synthesize our knowledge of the effectiveness, strengths, and limitations of these interventions among adults. We focused on important aspects of randomized controlled trials (RCTs), including internal and external validity, outcome measurement, and exclusion criteria. We examined predictors, mediators, and moderators associated with suicide outcomes.</div></div><div><h3>Methods</h3><div>A systematic search was conducted for RCTs of psychosocial suicide prevention interventions with adults, following PRISMA-ScR guidelines.</div></div><div><h3>Results</h3><div>We identified 141 publications and 131 were unique RCTs. Publications had some concerns with risk of bias (internal validity); publications had moderate or high external validity. A quarter of RCTs excluded older adults (60 years or older) and individuals with psychotic symptoms/features and bipolar disorder/symptoms despite the fact that these groups are at elevated risk for suicide death. Forty-one publications (29.1 % of total publications) examined predictors, mediators, and moderators of suicide outcomes. Sixteen (11.3 % of total publications) publications included predictors, two (1.4 %) included mediators, 11 (7.8 %) included posttreatment mediators, and 16 (11.3 %) included moderators. Participant gender/sex, marital status, and race did not moderate treatment effects. Mixed results may be due to insufficient statistical power to test predictor, mediator, and moderator hypotheses.</div></div><div><h3>Conclusion</h3><div>This review highlighted RCT aspects (e.g., exclusion of older adults and individuals with serious mental illness, improving suicide outcome measurement) that may be beneficial to consider in future RCTs. Additional research on predictors, mediators, and moderators is needed.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"120 ","pages":"Article 102614"},"PeriodicalIF":13.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Better together: The importance of brain health in the relationship between stress regulation, social connection and lifestyle in promoting mental health and well-being","authors":"Marie-Anne Vanderhasselt,&nbsp;Riet Vergauwe,&nbsp;Chris Baeken,&nbsp;Matias M. Pulopulos,&nbsp;Rudi De Raedt","doi":"10.1016/j.cpr.2025.102611","DOIUrl":"10.1016/j.cpr.2025.102611","url":null,"abstract":"<div><div>Regulating stress effectively has a profound impact on our well-being and is known to be significantly interrelated to our social connections, as well as healthy lifestyle behaviors. However, the complex mechanisms through which these components are associated with maintaining well-being remain enigmatic.</div><div>We propose a theoretical interrelated framework for which the maintenance of brain health assumes a central role. This involves the adaptive functionality of neural circuits associated with regulating emotions, self-control, and the ability to derive pleasure from rewards or enjoyable experiences. As a result, based on brain health as a central condition, we explore how different dimensions of social connections directly impact stress regulation, or indirectly through brain health. Furthermore, we delve into how lifestyle choices indirectly affect stress regulation, mediated by their impact on brain health. Reciprocally, our lifestyle choices are wired by our social connections, reinforcing the significant role of brain health.</div><div>In the context of this conceptual framework, it is emphasized that psychotherapeutic interventions need to expand beyond the sole concentration on psychological processes. It is imperative to focus on interconnected biopsychosocial components known to positively enhance brain health, and hence to enhance the capacity of psychotherapy to significantly amplify mental health and well-being.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"120 ","pages":"Article 102611"},"PeriodicalIF":13.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144272449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effects of different physical exercises on cognitive function and intervention adherence in older adults with cognitive impairment: A systematic review and network meta-analysis","authors":"Geng Li ,&nbsp;Gesi Teng ,&nbsp;Weikun Zhang ,&nbsp;Tao Song ,&nbsp;Yafen Li ,&nbsp;Ziqin Wang ,&nbsp;Antao Chen","doi":"10.1016/j.cpr.2025.102604","DOIUrl":"10.1016/j.cpr.2025.102604","url":null,"abstract":"<div><h3>Background</h3><div>Physical exercise is increasingly recognized as a beneficial nonpharmacological intervention for cognitive impairment in older adults; however, comparative evidence regarding the optimal exercise type and its sustainability remains unclear. This study aimed to compare and rank different exercise modalities based on their effects on cognition and intervention adherence among older adults (≥60 years) with cognitive impairment.</div></div><div><h3>Methods</h3><div>This systematic review, preregistered in PROSPERO (CRD42024497896), systematically searched MEDLINE, Web of Science, Scopus, PsycINFO, PubMed, and SPORTDiscus databases through February 1, 2024, with an updated search on March 16, 2025, to identify randomized controlled trials (RCTs). Two reviewers independently screened and evaluated eligible studies assessing the effects of physical exercise interventions on global cognition and adherence among older adults aged ≥60 years with cognitive impairment. Secondary outcomes included follow-up global cognition, cognitive subdomains, activities of daily living (ADL), physical function, and neuropsychiatric symptoms. A network meta-analysis using a frequentist framework was conducted. Interventions were ranked according to the Surface Under the Cumulative Ranking Curve (SUCRA), and a two-dimensional cluster ranking plot was used to identify the optimal intervention balancing cognitive improvement and adherence.</div></div><div><h3>Results</h3><div>Our network meta-analysis evaluated 128 qualified RCTs involving 12,403 older adults (≥60 years) with cognitive impairment. Mind-body exercise emerged as the most effective intervention, demonstrating the greatest improvements in global cognition (SUCRA = 95.9 %; SMD = 0.91; 95 % CI: 0.65–1.16) and significantly higher adherence (SUCRA = 93.6 %; OR = 1.31; 95 % CI: 1.02–1.68) compared to controls. Aerobic, resistance, and multicomponent exercises also improved cognition significantly, but adherence was comparatively lower. Mind-body exercise additionally showed consistent benefits across cognitive subdomains, functional outcomes and follow-up global cognition.</div></div><div><h3>Conclusions</h3><div>All physical exercise modalities significantly improved cognition, yet mind-body exercise was identified as the optimal intervention, exhibiting superior cognitive effects, adherence, and related functional benefits. These findings can guide clinicians in developing evidence-based exercise prescriptions tailored specifically to older adults with cognitive impairment.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"120 ","pages":"Article 102604"},"PeriodicalIF":13.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}