Clinical Psychology Review最新文献_第8页

Corrigendum to “Inter-identity amnesia and memory transfer in dissociative identity disorder: A systematic review with a meta-analysis” [Clinical Psychology Review 114 (2024) 102514] “分离性身份障碍中的身份间健忘症和记忆转移：一项荟萃分析的系统回顾”[临床心理学评论114(2024)102514]的勘误表。

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review

Pub Date : 2025-05-27 DOI: 10.1016/j.cpr.2025.102594

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

引用次数: 0

Machine learning in the prediction of treatment response for emotional disorders: A systematic review and meta-analysis 机器学习在情绪障碍治疗反应预测中的应用：一项系统综述和荟萃分析

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review

Pub Date : 2025-05-22 DOI: 10.1016/j.cpr.2025.102593

Joshua Curtiss , Christopher DiPietro

Background

Emotional disorders such as depression and anxiety affect millions globally and pose a significant burden on public health. Personalized treatment approaches using machine learning (ML) to predict treatment response could revolutionize treatment strategies. However, there is limited evidence as to whether ML is successful in predicting treatment outcomes. This meta-analysis aims to evaluate the accuracy of ML algorithms in predicting binary treatment response (responder vs. non-responder) to evidence-based psychotherapies, pharmacotherapies, and other treatments for emotional disorders, and to examine moderators of prediction accuracy.

Methods

Following PRISMA guidelines, a comprehensive literature search was conducted across PubMed and PsycINFO from January 1st, 2010 to March 27th, 2025. Studies were included if they used ML methods to predict treatment response in patients with emotional disorders. Data were extracted on sample size, type of treatment, predictors used, ML methods, and prediction accuracy. Meta-analytic techniques were used to synthesize findings and identify moderators of prediction accuracy.

Results

Out of 3816 non-duplicate records, 155 studies met inclusion criteria. The overall mean prediction accuracy was 0.76 (95 % CI: 0.74–0.78), and the mean area under the curve was 0.80 indicating good discrimination. The average sensitivity and specificity were 0.73 and 0.75, respectively. Moderator analyses indicated that studies using more robust cross-validation procedures exhibited higher prediction accuracy. Neuroimaging data as predictors were associated with higher accuracy compared to clinical and demographic data. Moreover, results indicated that studies with larger responder rates, as well as those that did not correct for imbalances in outcome rates, were associated with higher prediction accuracy.

Conclusions

ML methods show promise in predicting treatment response for emotional disorders, with varying degrees of accuracy depending on the type of predictors used and the rigor of methodological procedures implemented. Future research should focus on improving methodological integrity and exploring the integration of multimodal data to enhance prediction accuracy.

抑郁和焦虑等情绪障碍影响着全球数百万人，并对公共卫生构成重大负担。使用机器学习（ML）预测治疗反应的个性化治疗方法可能会彻底改变治疗策略。然而，关于ML是否能成功预测治疗结果的证据有限。本荟萃分析旨在评估ML算法在预测基于证据的心理治疗、药物治疗和其他情绪障碍治疗的二元治疗反应（反应者与无反应者）方面的准确性，并检查预测准确性的调节因子。方法按照PRISMA指南，对2010年1月1日至2025年3月27日的PubMed和PsycINFO进行全面的文献检索。如果研究使用ML方法预测情绪障碍患者的治疗反应，则纳入研究。从样本量、治疗类型、使用的预测因子、ML方法和预测准确性等方面提取数据。荟萃分析技术用于综合研究结果并确定预测准确性的调节因子。结果3816份非重复记录中，155项研究符合纳入标准。总体平均预测准确率为0.76 (95% CI: 0.74-0.78)，平均曲线下面积为0.80，判别良好。平均敏感性和特异性分别为0.73和0.75。调节分析表明，使用更稳健的交叉验证程序的研究显示出更高的预测准确性。与临床和人口统计数据相比，神经影像学数据作为预测指标具有更高的准确性。此外，结果表明，应答率较高的研究，以及那些没有纠正结果率不平衡的研究，与较高的预测准确性相关。结论sml方法有望预测情绪障碍的治疗反应，根据所使用的预测因子的类型和方法程序的严谨性，具有不同程度的准确性。未来的研究应注重提高方法的完整性，探索多模态数据的整合，以提高预测精度。

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引用次数: 0

Trauma and eating disorders: an integrated umbrella and scoping review 创伤和饮食失调：综合保护伞和范围审查

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review

Pub Date : 2025-05-18 DOI: 10.1016/j.cpr.2025.102592

Irina Moroshko Master of Clinical Psychology, PhD candidate , Anita Raspovic PhD , Jintana Liu Master of Professional Psychology , Leah Brennan PhD

Objective

This comprehensive mixed-method review synthesised the trauma-eating disorder (trauma-ED) research across six objectives addressing; prevalence and risk, covariates, clinical characteristics, theories, lived experience, and intervention.

Methods

An umbrella review of systematic reviews, a scoping review of narrative summaries, and quality assessments were conducted.

Results

One hundred and ninety-nine publications were identified. Higher prevalence rates of childhood, later life, and marginalisation traumas were evident in ED samples compared to healthy controls. Dependant on trauma type, trauma rates in those with ED were higher or comparable to psychiatric controls. More consistent findings, larger effect sizes, and higher prevalence rates of trauma were evident in binge-purge, rather than restrictive, ED presentations. Overall, individuals experiencing trauma-ED present with greater emotional and behavioural dysregulation and more complex illness and treatment course. Several theories explaining the trauma-ED intersection received some empirical support. Few investigations examined mechanisms and treatment; no evidence on lived experience perspectives on treatment and no trauma-ED clinical practice guidelines were identified.

Discussion

The positive association between trauma and ED and the negative impact of co-existing trauma on ED illness and treatment, have been established. The clinical relevance, need, and urgency of addressing co-existing trauma in ED treatment are evident. Qualitative and intervention research is urgently needed to understand trauma-ED, elucidate lived experience perspectives on treatment, test novel treatments, and provide clinical guidance.

目的对创伤性进食障碍（traumatic -eating disorder，简称创伤性进食障碍）的六个研究目标进行综合综述；患病率和风险，协变量，临床特征，理论，生活经验和干预。方法对系统综述进行总体综述，对叙述性摘要进行范围综述，并进行质量评价。结果共鉴定出199篇文献。与健康对照组相比，ED样本中儿童期、晚年和边缘化创伤的患病率明显更高。根据创伤类型的不同，ED患者的创伤率高于或与精神病对照组相当。更一致的研究结果、更大的效应量和更高的创伤患病率在暴饮清除中明显，而不是限制性ED。总体而言，经历创伤性ed的个体表现出更大的情绪和行为失调，更复杂的疾病和治疗过程。有几个理论解释了创伤与ed的交集，得到了一些经验的支持。很少有调查审查机制和治疗；没有证据表明生活经验的治疗观点，也没有创伤性ed临床实践指南。创伤与ED之间的正相关以及同时存在的创伤对ED疾病和治疗的负面影响已经确立。在急诊科治疗中处理共存创伤的临床相关性、必要性和紧迫性是显而易见的。迫切需要定性和干预研究来了解创伤性ed，阐明治疗的生活经验观点，测试新的治疗方法，并提供临床指导。

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引用次数: 0

Perceived need for treatment for mental disorders: A review and critical evaluation 精神障碍治疗的感知需求：回顾和批判性评价

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review

Pub Date : 2025-05-07 DOI: 10.1016/j.cpr.2025.102591

Alan E. Kazdin

Mental disorders are highly prevalent worldwide. Unfortunately, most people with these disorders do not receive any treatment. This is due in part to a large set of barriers that impede treatment delivery. An initial barrier is the perception that one does not need treatment. Perceived need for treatment (PNFT) refers to whether an individual sees a need to obtain an intervention for their mental health problem. Among individuals with a mental disorder, lack of perceived need is the most common reason people give for not initiating treatment. This article describes PNFT, its characteristics, correlates, and predictors. A critical evaluation of the concept challenges key notions such as whether meeting criteria for a disorder means that someone needs treatment, whether PNFT actually is the initial obstacle limiting treatment seeking, how people may seek an intervention but do not elect mental health treatment, and that PNFT is neither a necessary nor a sufficient condition for entering treatment. Several research priorities are discussed including the importance of perceived need among parents and other caregivers, evaluating whether increasing the rates of PNFT would actually increase service use, the need to study the treatment needs of many neglected groups, and considering whether PNFT influences other facets of the treatment process (e.g., adherence to treatment, dropping out early) where perceiving there no longer is a mental health problem may occur.

精神障碍在世界范围内非常普遍。不幸的是，大多数患有这些疾病的人没有得到任何治疗。这在一定程度上是由于阻碍提供治疗的一系列障碍。最初的障碍是人们认为自己不需要治疗。感知治疗需求（PNFT）是指个体是否认为需要对其心理健康问题进行干预。在精神障碍患者中，缺乏感知需求是人们不开始治疗的最常见原因。本文描述了PNFT、它的特征、相关因素和预测因素。对这一概念的批判性评估挑战了一些关键概念，如符合疾病标准是否意味着某人需要治疗，PNFT是否实际上是限制寻求治疗的最初障碍，人们如何寻求干预但不选择心理健康治疗，以及PNFT既不是进入治疗的必要条件，也不是充分条件。讨论了几个研究重点，包括父母和其他照顾者感知需求的重要性，评估增加PNFT的比率是否实际上会增加服务的使用，研究许多被忽视群体的治疗需求的必要性，以及考虑PNFT是否影响治疗过程的其他方面（例如，坚持治疗，早期退出），在这些方面可能会出现不再存在心理健康问题的感觉。

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引用次数: 0

Using the experience sampling methodology to measure anhedonia and its correlates in mental health research: A systematic review 在心理健康研究中使用经验抽样方法测量快感缺乏症及其相关因素：系统综述

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review

Pub Date : 2025-05-04 DOI: 10.1016/j.cpr.2025.102590

Joanne R. Beames , Lotte Uyttebroek , Clementine J. Edwards , Gudrun V. Eisele , Nian D.F. Kemme , Olivia Collier , Eeske van Roekel , Thomas R. Kwapil , Olivia J. Kirtley , Inez Myin-Germeys

Anhedonia is a lack or loss of pleasure in daily life. This is the first systematic review to investigate anhedonia in mental health research with a focus on experience sampling methodology (ESM). The review aimed to identify how anhedonia is conceptualized and measured in ESM research, how it is experienced during daily life, and the quality of reporting in the published literature. To generate a comprehensive picture of anhedonia, we also examined associations between time-invariant measures of anhedonia and other affective, cognitive, and behavioral processes assessed via ESM. We searched PsychARTICLES, MEDLINE, Psychology Databases, EMBASE, Web of Science Core Collection, and Europe PMC (last search 6th January 2025). We identified 113 relevant articles. Anhedonia was typically conceptualized as diminished pleasure, enjoyment, or liking, with emphasis on consummatory rather than anticipatory experiences. Anticipatory and consummatory anhedonia were present in samples that experienced different mental health conditions or symptoms (between-person) and varied across daily contexts and time (within-person). Daily life correlates of anhedonia included increased negative affect, decreased positive affect, affect prediction biases, and social processes. Most studies explored anhedonia in depression or psychotic disorders, although measurement was heterogeneous, and compliance with a reporting quality assessment tool for ESM studies was generally low. This review demonstrates that using ESM to measure anhedonia in mental health research is critical to identify how and when it is experienced in daily life. Future anhedonia research would benefit from using a transdiagnostic perspective, standardized and validated ESM items, exploration of moment-to-moment changes over shorter time-scales, and increased transparency in methodological reporting.

快感缺乏症是指在日常生活中缺乏或失去快乐。这是第一个系统回顾调查快感缺乏症在心理健康研究的重点是经验抽样方法（ESM）。本综述旨在确定在ESM研究中如何概念化和测量快感缺乏症，在日常生活中是如何经历的，以及在已发表文献中报告的质量。为了对快感缺乏症有一个全面的了解，我们还研究了通过ESM评估的快感缺乏症的时不变测量与其他情感、认知和行为过程之间的联系。我们检索了PsychARTICLES、MEDLINE、Psychology Databases、EMBASE、Web of Science Core Collection和Europe PMC（最后检索日期为2025年1月6日）。我们确定了113篇相关文章。快感缺乏症通常被定义为快乐、享受或喜好的减少，强调完成性体验而不是预期性体验。预期性和完满性快感缺乏症存在于经历不同心理健康状况或症状的样本中（人与人之间），并且在日常环境和时间（人与人之间）有所不同。与快感缺乏症相关的日常生活因素包括消极情绪增加、积极情绪减少、情绪预测偏差和社会过程。大多数研究探讨了抑郁症或精神障碍中的快感缺乏症，尽管测量方法不同，而且对ESM研究报告质量评估工具的依从性普遍较低。这篇综述表明，在心理健康研究中使用ESM来测量快感缺乏症对于确定日常生活中如何以及何时经历快感缺乏症至关重要。未来的快感缺乏症研究将受益于使用跨诊断视角、标准化和验证的ESM项目、在更短的时间尺度上探索瞬间到瞬间的变化，以及增加方法报告的透明度。

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引用次数: 0

Dyadic coping and relationship satisfaction among couples with a chronic illness: A meta-analytical actor–partner interdependence model 慢性疾病夫妻的二元应对与关系满意度：一个元分析行为者-伴侣相互依赖模型

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review

Pub Date : 2025-05-04 DOI: 10.1016/j.cpr.2025.102587

Jianhua Hou , Mariana Karin Falconier , Wilson Tam , Mike W.-L. Cheung , Rong Fu , He Bu , Nancy Xiaonan Yu

Chronic illness (CI) burdens both the patient and their romantic partner. CI management has been viewed as a dyadic process by theorists and clinical practitioners. Dyadic coping (DC) refers to the processes where one partner aids the other or both partners work together to cope with stress. We used the meta-analytical actor–partner interdependence model and its extension of actor–partner interdependence moderation model to evaluate the aggregated actor and partner effects of DC on relationship satisfaction (RS) in CI partners (CIP) and healthy partners (HP). This meta-analysis included 61 samples from 57 reports. The combined zero-order correlation (r) between total DC and RS was 0.37 (95 % CI: 0.33–0.40, p < .001). The total DC for both partners with and without CI showed significant actor effects on their own RS (CIP → CIP: b = 0.33, SE = 0.03, p < .001; HP → HP: b = 0.32, SE = 0.03, p < .001) and significant partner effects on the other's RS (HP → CIP: b = 0.18, SE = 0.03, p < .001; CIP → HP: b = 0.20, SE = 0.03, p < .001). Similar patterns were observed for positive DC and negative DC. These effects were observed regardless of study quality, years since diagnosis, age, sex, and relationship length. Moreover, type of publication, publication year, country, DC measures, CI types, and both partners' education attainment moderated observed associations. Couple-based interventions for CI should incorporate psychoeducation on the importance of DC (e.g., viewing illness as a “we-disease,” communicating about stress, and providing mutual support) and skill-building components to enhance RS, recognizing the interdependent nature of both partners' coping processes.

慢性疾病（CI）给病人和他们的伴侣都带来了负担。CI管理被理论家和临床实践者视为一个二元过程。二元应对（DC）是指一方帮助另一方或双方共同应对压力的过程。我们运用元分析的行动者-伴侣相互依赖模型及其对行动者-伴侣相互依赖调节模型的扩展来评估DC对CI伴侣（CIP）和健康伴侣（HP）关系满意度（RS）的综合行动者和伴侣效应。本荟萃分析包括来自57份报告的61份样本。总DC和RS之间的联合零级相关(r)为0.37 (95% CI: 0.33-0.40, p <；措施)。有CI和没有CI的伴侣的总DC对自身RS有显著的行动者效应(CIP→CIP: b = 0.33, SE = 0.03, p <；措施;HP→HP: b = 0.32, SE = 0.03, p <；.001)和显著的伴侣效应对对方的RS (HP→CIP: b = 0.18, SE = 0.03, p <；措施;CIP→HP: b = 0.20, SE = 0.03, p <；措施)。在正直流电和负直流电中观察到类似的模式。这些影响与研究质量、诊断时间、年龄、性别和关系长度无关。此外，出版物类型、出版年份、国家、DC测量、CI类型和双方的受教育程度调节了观察到的关联。以夫妻为基础的CI干预措施应包括关于DC重要性的心理教育（例如，将疾病视为“我们的疾病”，就压力进行沟通，并提供相互支持）和技能建设组成部分，以增强RS，认识到伴侣双方应对过程的相互依赖性质。

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引用次数: 0

Characterizing predictors of response to behavioral interventions for children with autism spectrum disorder: A meta-analytic approach 自闭症谱系障碍儿童对行为干预反应的预测因素特征：一种元分析方法

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review

Pub Date : 2025-05-03 DOI: 10.1016/j.cpr.2025.102588

Lacey Chetcuti , Mirko Uljarević , Rachel K. Schuck , Antonio Y. Hardan , Grace W. Gengoux , David Trembath , Yagnesh Vadgama , Kandice J. Varcin , Giacomo Vivanti , Andrew J.O. Whitehouse , Maria Helton , Thomas W. Frazier

A comprehensive understanding of specific factors contributing to variability in responsiveness of children with autism to interventions is paramount for making evidence-based clinical and policy decisions. This meta-analysis examined child and family characteristics, as well as intervention design factors, associated with outcomes of behavioral interventions for children with autism. A systematic review identified 95 studies published between 1987 and 2024, encompassing 6780 children on the autism spectrum and 2150 independent effect sizes. Results indicated that stronger post-intervention effects were observed across intervention approaches for children with higher cognitive, language, and other developmental abilities, greater adaptive functioning, and fewer autism-related features. Additionally, interventions of longer duration and greater total hours were associated with stronger post-intervention outcomes. In contrast, intervention approach (Early Intensive Behavioral Intervention, Naturalistic Developmental Behavioral Interventions, or Developmental Interventions), delivery agent, and child age at intervention onset did not significantly predict the strength of post-intervention outcomes. While study methodology and reporting quality were marginally associated with predictive strength, adjusting for these factors had minimal impact on the reported findings. The insights from this meta-analysis have significant implications for the development of personalized intervention models for children with autism. These models have the potential to optimize outcomes and offer critical guidance for decision-making in both the service and policy levels, ensuring efficient and equitable allocation of resources.

全面了解导致自闭症儿童对干预措施反应差异的具体因素，对于制定循证临床和政策决策至关重要。本荟萃分析考察了与自闭症儿童行为干预结果相关的儿童和家庭特征，以及干预设计因素。一项系统综述确定了1987年至2024年间发表的95项研究，涉及6780名自闭症儿童和2150个独立的效应值。结果表明，对于认知、语言和其他发展能力较高、适应功能较强、自闭症相关特征较少的儿童，干预后效果更强。此外，干预时间越长、总时间越长，干预后的结果越好。相比之下，干预方式（早期强化行为干预、自然发展行为干预或发展干预）、递送剂和干预开始时的儿童年龄并不能显著预测干预后结果的强度。虽然研究方法和报告质量与预测强度有轻微关联，但调整这些因素对报告结果的影响最小。本荟萃分析的见解对自闭症儿童个性化干预模式的发展具有重要意义。这些模型有可能优化结果，并为服务和政策层面的决策提供关键指导，确保有效和公平地分配资源。

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引用次数: 0

Risk factors for depression, anxiety, and PTSS after loss: A systematic review and meta-analysis 丧失亲人后抑郁、焦虑和创伤后应激障碍的危险因素：一项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 : 2025-05-03 DOI: 10.1016/j.cpr.2025.102589

C. Buur , R. Zachariae , M.M. Marello , M. O'Connor

Background

Bereavement can lead to complicated grief reactions including clinically significant symptoms of depression, anxiety, and post-traumatic stress (PTSS) post-loss. Gaining insight into specific and shared risk factors for these complicated grief reactions can help identify individuals needing support.

Methods

A comprehensive systematic review and meta-analysis of risk factors for post-loss depression, anxiety, and PTSS. PsycInfo, PubMed, Web of Science, and CINAHL were searched to identify risk factors for inclusion in the meta-analysis.

Results

The systematic review included 144 studies. Most risk factors were of small magnitude. For depression, 21 risk factors were analyzed, with six analyses of adjusted risk factors reaching statistical significance. Pre-loss depression was the strongest risk factor (ESr = 0.25, 95 %CI [0.03,0.45]). Of nine analyzed risk factors for PTSS, four reached statistical significance, with the death of a close relative yielding the largest effect (ESr = 0.24, 95 %CI [0.01,0.44]). Only female gender significantly predicted anxiety (ESr = 0.21, 95 %CI [0.09,0.32]). Female gender, the death of a partner, and violent/unnatural losses were transdiagnostic risk factors.

Conclusions

An overview of risk factors for three complicated grief reactions, including their predictive strength, is presented. The results provide insights into transdiagnostic risk factors and can aid early identification of people at risk of complicated grief reactions.

丧亲之痛会导致复杂的悲伤反应，包括临床显著的抑郁、焦虑和创伤后应激（ptsd）。深入了解这些复杂的悲伤反应的具体和共同的风险因素可以帮助识别需要支持的个人。方法对失联后抑郁、焦虑和创伤后应激障碍的危险因素进行综合系统回顾和荟萃分析。检索PsycInfo、PubMed、Web of Science和CINAHL以确定纳入meta分析的风险因素。结果系统评价纳入144项研究。大多数危险因素都是小范围的。对于抑郁症，共分析了21个危险因素，其中6个调整后的危险因素分析具有统计学意义。失前期抑郁是最强的危险因素（ESr = 0.25, 95% CI[0.03,0.45]）。在分析的9个PTSS危险因素中，有4个具有统计学意义，其中近亲死亡的影响最大（ESr = 0.24, 95% CI[0.01,0.44]）。只有女性性别与焦虑有显著关系（ESr = 0.21, 95% CI[0.09,0.32]）。女性、伴侣死亡和暴力/非自然损失是跨诊断的风险因素。结论综述了三种复杂悲伤反应的危险因素及其预测强度。研究结果提供了对跨诊断风险因素的见解，并有助于早期识别有复杂悲伤反应风险的人。

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引用次数: 0

Evaluation of assessment instruments for working alliance in psychological interventions with adolescents: A systematic review 对青少年心理干预工作联盟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 : 2025-04-27 DOI: 10.1016/j.cpr.2025.102586

Mariana Veloso Martins , Zorana Jolić Marjanović , Nuno Ferreira , Camellia Hancheva , Emma Motrico , Jose M. Mestre , Nele A.J. De Witte , Sibel Halfon , Sidse Arnfred , Margarida Rangel Henriques , Nina Petričević , Marcin Rzeszutek , Jana Volkert , Randi Ulberg , Fredrik Falkenström

The working alliance is one of the most robust predictors of outcomes in adult psychotherapy. Since the alliance is often challenging to establish and maintain in psychotherapy with adolescents, conducting high-quality assessments of the alliance using sound measures in this population is critical. Still, measurement instruments developed for adults cannot be directly transferred to adolescent samples. This systematic review aimed to identify and critically evaluate available assessment tools for working alliance in adolescent psychotherapy using the COnsensus-based Standards for the Selection of Health Measurement INstruments (COSMIN) framework. A comprehensive literature search across PsycINFO, PubMed, Web of Science, and PsycARTICLES, up to October 2024, yielded 47 research studies reporting on working alliance measurement properties. Findings indicate that self-report measures are most commonly studied, with the Working Alliance Inventory-Short Form (WAI-S) and Therapeutic Alliance Quality Scale (TAQS) showing the best psychometric properties. Nevertheless, even with these measures, there are notable shortcomings in cross-cultural validity, measurement error, and responsiveness, which are essential for applications in longitudinal studies and with diverse populations. Less commonly studied, often with very small samples, observer-rated tools displayed high reliability but limited predictive validity. Our review highlights the need for more stringent research on developmentally appropriate, reliable working alliance instruments for adolescents to support clinicians and researchers in studying and monitoring this aspect of patient-therapist relations. These findings, together with the COSMIN guidelines, inform recommendations for future research mainly in terms of improved content validity, measurement error, cross-cultural validity, and responsiveness.

工作联盟是成人心理治疗结果最可靠的预测因素之一。由于在青少年心理治疗中建立和维持联盟往往具有挑战性，因此在这一人群中使用合理的措施对联盟进行高质量的评估至关重要。然而，为成年人开发的测量仪器不能直接用于青少年样本。本系统综述旨在使用基于共识的健康测量工具选择标准（COSMIN）框架，确定并批判性地评估青少年心理治疗工作联盟的现有评估工具。通过对PsycINFO、PubMed、Web of Science和PsycARTICLES的综合文献检索，截至2024年10月，得出了47项关于工作联盟测量特性的研究报告。研究结果表明，自我报告测量最常被研究，其中工作联盟清单-短表（WAI-S）和治疗联盟质量量表（TAQS）显示出最好的心理测量特性。然而，即使使用这些测量方法，在跨文化有效性、测量误差和响应性方面仍存在明显的缺陷，这些缺陷对于纵向研究和不同人群的应用至关重要。很少有人研究，通常只有很小的样本，观察者评价的工具显示出高可靠性，但预测效度有限。我们的综述强调需要更严格地研究适合青少年发展的、可靠的工作联盟工具，以支持临床医生和研究人员研究和监测这方面的医患关系。这些发现与COSMIN指南一起，为未来的研究提供了建议，主要是在改进内容效度、测量误差、跨文化效度和反应性方面。

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引用次数: 0

Clusters of healthy lifestyle behaviours are associated with symptoms of depression, anxiety, and psychological distress: A systematic review and meta-analysis of observational studies 健康生活方式行为群与抑郁、焦虑和心理困扰症状相关：观察性研究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 : 2025-04-11 DOI: 10.1016/j.cpr.2025.102585

Matthew Bourke , Hiu Fei Wendy Wang , Sarah A. McNaughton , George Thomas , Joseph Firth , Mike Trott , John Cairney

Engagement in healthy and unhealthy lifestyle behaviours are related to a range of mental health outcomes. Most existing research has focussed on individual lifestyle behaviours, so it is not clear the extent to which clusters of healthy lifestyle behaviours relate to mental health outcomes. Therefore, this study aimed to systematically review and quantitatively synthesise research which have examined the association between clusters of lifestyle behaviours with symptoms of depression, anxiety, and psychological distress. A systematic search of five electronic databases were conducted to identify studies which used person-centred approaches (e.g., cluster analysis, latent class analysis) to identify subgroups of participants based on at least two unique lifestyle behaviours (i.e., physical activity/sedentary behaviours, diet, sleep, alcohol/tobacco/drug use) and examined differences in symptoms of depression, anxiety, or psychological distress between clusters. A correlated and hierarchical random effects meta-analysis was used to synthesise the results. A total of 81 studies reporting on nearly one-million individual participants were included in the review. Results demonstrated that participants who engaged in the healthiest clusters of lifestyle behaviours reported significantly fewer symptoms of depression (SMD = −0.41), anxiety (SMD = −0.43) and psychological distress (SMD = −0.34) compared to participants engaging in less healthy combinations of lifestyle behaviours, and a dose response relationship was observed across outcomes. These results demonstrate that there is a moderate-to-strong relationship between engaging in clusters of healthy lifestyle behaviours and mental health outcomes and demonstrate the importance of considering healthy lifestyle as a whole instead of as individual parts.

参与健康和不健康的生活方式行为与一系列心理健康结果有关。大多数现有的研究都集中在个人的生活方式行为上，因此尚不清楚健康生活方式行为在多大程度上与心理健康结果有关。因此，本研究旨在系统回顾和定量综合研究，这些研究已经检查了生活方式行为集群与抑郁、焦虑和心理困扰症状之间的关系。对五个电子数据库进行了系统搜索，以确定采用以人为中心的方法（例如，聚类分析、潜在类分析）的研究，根据至少两种独特的生活方式行为（即，身体活动/久坐行为、饮食、睡眠、酒精/烟草/药物使用）确定参与者的亚组，并检查聚类之间抑郁、焦虑或心理困扰症状的差异。采用相关和分层随机效应荟萃分析来综合结果。共有81项研究报告了近100万个体参与者被纳入该综述。结果表明，与从事不太健康的生活方式行为组合的参与者相比，从事最健康的生活方式行为群的参与者报告的抑郁（SMD = - 0.41）、焦虑（SMD = - 0.43）和心理困扰（SMD = - 0.34）症状显著减少，并且在各个结果中观察到剂量反应关系。这些结果表明，参与一系列健康生活方式行为与心理健康结果之间存在中等到强烈的关系，并表明将健康生活方式视为一个整体而不是单个部分的重要性。

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