Clinical Psychology Review最新文献

Coherence in the science and practice of mental health assessment depends upon a tight connection between psychopathology concepts that are used and the way those concepts are operationalized and defined. In contrast, the use of the same word to mean more than one thing contributes to incoherence, inefficiency, and confusion. In this paper, we review three possible meanings of the word “dimension” as it relates to the assessment of psychopathology and describe how the indiscriminate use of this word has caused confusion in the general context of the transition to a more evidence-based approach to mental health diagnosis. We attempt to disambiguate the term “dimension” by demarcating three concepts that can be distinguished based on different empirical standards: continuous variables, unidimensional dimensions, and distinct dimensions.

This review provides an overview and update of empirical evidence for psychologically meaningful dynamic risk factors and protective factors for sexual offending. Using the review by Mann et al. (2010) as a starting point, we reviewed relevant literature that has appeared since this publication, focusing on meta-analyses, systematic and scoping reviews of dynamic risk factors, recent evaluations of commonly used dynamic assessment tools, and studies of dynamic risk and protective factors in community samples in addition to clinical or forensic samples. Two risk factors previously deemed promising by Mann et al. (2010), hostility towards women and dysfunctional coping (conceptualized as hostile masculinity and emotional regulation deficits, respectively, in this review), could now be considered supported using this review's criteria of three or more studies demonstrating an effect size of 0.15 or greater. No new risk factors were identified. We conducted a broader search of protective factors in recognition of the relative newness of this literature: Positive social support was the only protective factor identified as empirically supported. We also discuss situational risk and protective factors.

Eating disorders (EDs) are complex conditions with one of the highest mortality rates among psychiatric illnesses. While outpatient evidence-based treatments for EDs in adults exist, there is often utilisation of more intensive interventions as part of treatment. However, a comprehensive analysis of the impacts of intensive treatment (inpatient, residential and day program) on physical and psychosocial outcomes is lacking. Thus, the current systematic review and meta-analysis aimed to investigate the effectiveness of intensive treatments in adults with EDs for the outcomes of body mass index (BMI), disordered eating, depression, and quality of life, as well as a moderation analysis investigating a range of clinical characteristics. Overall, 62 studies were included in the meta-analysis. The results revealed that intensive treatment in adults yielded significant improvements in BMI (for underweight patients), disordered eating, depression, and quality of life. Treatment setting, length of stay and geographical region of the study all served as moderators for disordered eating and depression. Nevertheless, given the high heterogeneity in the meta- and moderation analyses, these results should be interpreted with caution. Future high-quality research is needed to determine the most beneficial elements of intensive treatment (compared to outpatient) in adults with EDs.

Objective

Anxiety and depression in chronic disease are common and burdensome co-morbidities. There has been growing interest in cognitive and behavioral therapies (CBTs) for anxiety and depression in chronic disease, however their efficacy has not been well-established. This study examined the efficacy of CBTs for depression and/or anxiety symptoms within chronic disease and explored the moderating role of clinical and methodological characteristics.

Methods

Following prospective registration, electronic databases were searched up to 2023 for randomized controlled trials (RCTs) examining CBTs for depression and/or anxiety in any adult chronic disease population.

Results

We included 56 RCTs. The overall effect of CBTs was g = 0.61 (95% CI, 0.49, 0.72) for depression and g = 0.56 (95% CI, 0.42, 0.70) for anxiety. A range of methodological features significantly moderated the effect sizes obtained, including type of control group and the outcome measure used. Risk of Bias ratings indicated some concerns regarding RCT conduct and reporting.

Conclusions

CBTs lead to moderate improvements in both depression and anxiety symptoms among people with chronic disease. However, the efficacy of CBT should be interpreted considering certain study and sample characteristics. It is recommended that future studies make improvements to study methodology and reporting.

The systematic review by Alpert and colleagues (Clinical Psychology Reviews, https://doi.org/10.1016/j.cpr.2023.102300) suggests methodological standards for mediation analysis and evaluates the evidence for mediation of PTSD treatment effects in published research. Although the article articulates important methodological guidelines related to timing of treatment, mediator, and outcome, it fails to incorporate the insights of causal mediation analysis into the methodological standards. In particular, the systematic review does not recognize the limitations of using time, rather than PTSD treatment type, in mediation analyses and does not include an assessment of the potential impact of uncontrolled confounding between the mediator and the outcome in the included studies. The conclusions about mediators of PTSD treatments from this systematic review should be considered carefully.

Globally, one out of three people suffer from a mental health issue during their lifetime. In romantic relationships, impaired mental health does not only affect the individual but also their partner and therefore needs to be coped with dyadically. In this systematic review, we summarize research examining dyadic coping (DC) in the context of mental health and individual and relational outcomes. We searched for peer-reviewed articles published between January 1990 and April 2023 on PsycInfo, Medline, and PSYNDEX on DC and mental health within romantic relationships. A total of 60 qualitative, quantitative, and intervention studies met the inclusion criteria, reporting on 16,394 individuals and 4,945 dyads. To synthesize the studies, we used a narrative synthesis approach. Overall, stress expression and positive DC yielded beneficial individual and relational outcomes, whereas, for negative DC, the opposite was true. Results differed between mental health clusters and context played an important role (e.g., symptom severity, life phase). Due to the great diversity of studies and variables, further research should focus on understudied mental health clusters (e.g., anxiety disorders). Clinicians are advised to view mental health issues as a dyadic rather than an individual phenomenon (“we-disease”) and develop tailored couple-centered interventions.

The co-existence of gaming disorder (GD) with other mental health problems has been widely reported. Despite the growing research interest in the comorbidity of GD with attention-deficit/hyperactivity disorder (ADHD), to date, no quantitative synthesis has been performed. The present study comprised a systematic literature search using Scopus, Science Direct, Web of Science, and PubMed databases. Three types of studies were included in the analyses: studies reporting (i) correlation coefficients between the symptoms of GD and ADHD, (ii) means, and standard deviations for comparison of GD severity between ADHD/non-ADHD individuals, and (iii) comparison of ADHD severity between GD/non-GD individuals. The results indicated a moderate relationship between GD and ADHD symptom severity when both subdomains of ADHD were combined (r = 0.296), and also when only inattention (r = 0.306) or hyperactivity (r = 0.266) symptoms were analyzed, which was also confirmed in a structural equation model meta-analysis. Studies showed a large average difference comparing the GD symptom severity of ADHD and non-ADHD individuals (g = 0.693), or ADHD symptom severity of GD and non-GD individuals (g = 0.854). In some cases, higher estimates of association were reported among studies that (i) had a higher proportion of males, (ii) assessed problematic internet use among predominantly videogame player samples rather than assessing only GD, and (iii) had been more recently published. The present review shows that this is an emerging field demonstrating significant results in cross-sectional correlational studies. However, future research should apply more rigorous methodologies to investigate the relationship further (e.g., longitudinal studies and studies using professional/clinical ratings and diagnosis). These results suggest that screening and treatment for ADHD among individuals with gaming disorder is necessary, and individuals with ADHD should be made aware of their higher susceptibility to gaming disorder.

There is a large evidence base supporting an important role of parenting behavior in influencing youth mental health; however, this literature often fails to capture the potentially unique and interactive role of mothers and fathers. This systematic review and meta-analysis aimed to investigate the role of maternal and paternal parenting behaviors in relation to child and adolescent internalizing problems. Following PRISMA (2020) guidelines, 88 studies were identified. Of these, 47 studies and upward of 65 parent-behavior and child-outcome combinations were examined. Findings indicated a unique role of maternal overprotection in the prediction of child anxiety symptoms. For other parenting behaviors, largely similar associations were found for maternal and paternal parenting behaviors with child and adolescent anxiety, depressive symptoms and broader internalizing problems. There was preliminary support for the interaction of maternal and paternal parenting being important in predicting youth symptoms. Although findings did not strongly substantiate differences in the effects of maternal and paternal parenting practices, with only one significant difference identified, further research would benefit from stronger representation of fathers, to enable a more rigorous and comprehensive understanding of each parent's role, and their interactive influence on internalizing outcomes of their children.

As observed in other mental health difficulties, behavioural addiction is a complex construct with several potential predisposing factors, which include biological factors (e.g., genetic predispositions), psychological factors (e.g., personality traits), and social factors (e.g., family, and social history). One factor that may play a significant role in both developing and perpetuating behavioural addiction is the activation of early maladaptive schemas (EMSs). The aim of the present review was to synthesize the evidence concerning the relationship between behavioural addiction and EMSs. A comprehensive literature search using keywords and subject headings was performed with three electronic databases, resulting in 20 studies that met the inclusion criteria. In relation to specific behavioural addiction, the 20 studies examined: binge-eating/food addiction (n = 6), sexual addiction/compulsive sexual behaviours (n = 3), multiple addictive behaviours (n = 2), internet addiction (n = 2), smartphone addiction (n = 2), social networking/Facebook addiction (n = 2), exercise dependence (n = 1), gambling (n = 1), and videogame addiction (n = 1). The patterns of association between EMS and behavioural addiction were examined in both clinical and non-clinical population. The ‘Disconnection and Rejection’ domain was the most strongly related schema domain across all addictive behaviours, followed by ‘Impaired Limits’. The present review suggests a positive relationship between schema activation and several addictive behaviours, including addictions to gambling, gaming, social media use sex, exercise, and food. The clinical implications of the findings are discussed, but further research is needed to inform treatment plans and interventions for those who struggle with behavioural addictions.