Pub Date : 2025-03-19DOI: 10.1146/annurev-clinpsy-081423-025310
Dominic Dwyer, Rochelle Ruby Ye, Barnaby Nelson, Pat McGorry
A global mental health crisis is threatening a generation of young people with a lifetime of symptoms that do not fit neatly into diagnostic systems. Optimal decisions regarding treatments, services, research, and policies are critically needed, yet such decisions are based on idiosyncratic categorization of clinical courses. This review suggests clinical staging approaches may unite mental health stakeholders around shared targets to reduce mental illness. It first presents key approaches to clinical staging and then outlines how clinical knowledge has been translated into a unified transdiagnostic staging heuristic and clinical service structure over the past 30 years. Directions for short-, medium-, and long-term action are recommended with global community engagement. With investment from the mental health community, staging could reduce suffering through the use of an ethical, organized, and targeted system of communication.
{"title":"Clinical Staging for Psychiatry and Psychology.","authors":"Dominic Dwyer, Rochelle Ruby Ye, Barnaby Nelson, Pat McGorry","doi":"10.1146/annurev-clinpsy-081423-025310","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-081423-025310","url":null,"abstract":"<p><p>A global mental health crisis is threatening a generation of young people with a lifetime of symptoms that do not fit neatly into diagnostic systems. Optimal decisions regarding treatments, services, research, and policies are critically needed, yet such decisions are based on idiosyncratic categorization of clinical courses. This review suggests clinical staging approaches may unite mental health stakeholders around shared targets to reduce mental illness. It first presents key approaches to clinical staging and then outlines how clinical knowledge has been translated into a unified transdiagnostic staging heuristic and clinical service structure over the past 30 years. Directions for short-, medium-, and long-term action are recommended with global community engagement. With investment from the mental health community, staging could reduce suffering through the use of an ethical, organized, and targeted system of communication.</p>","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":17.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659620","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}
Pub Date : 2025-03-11DOI: 10.1146/annurev-clinpsy-080822-041621
Robin Nusslock, Vijay A. Mittal, Lauren B. Alloy
Major depressive disorder (MDD), bipolar disorder, and schizophrenia involve disruptions in processing rewarding stimuli. In this review, we propose that distinct mechanistic pathways underlie these disruptions in mood disorders versus schizophrenia, and we highlight the importance of understanding these differences for developing personalized treatments. We summarize evidence suggesting that reward processing abnormalities in mood disorders are driven by dysregulated motivational systems; MDD is characterized by blunted responses to reward cues, and bipolar disorder is characterized by heightened responses. In contrast, we argue that reward processing disruptions in schizophrenia do not reflect abnormalities in motivation or hedonic experience; rather, they reflect impairments in the cognitive representation of past and future rewards as well as misdirected attention to irrelevant stimuli. To integrate these findings, we present a neurodevelopmental framework for the onset of mood and psychotic disorders and explore how disruptions in normative brain development contribute to their pathophysiology, timing, and onset. Additionally, we move beyond viewing these conditions as homogeneous disorders and discuss how reward processing profiles may align with specific symptom dimensions.
{"title":"Reward Processing in Mood Disorders and Schizophrenia: A Neurodevelopmental Framework","authors":"Robin Nusslock, Vijay A. Mittal, Lauren B. Alloy","doi":"10.1146/annurev-clinpsy-080822-041621","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-080822-041621","url":null,"abstract":"Major depressive disorder (MDD), bipolar disorder, and schizophrenia involve disruptions in processing rewarding stimuli. In this review, we propose that distinct mechanistic pathways underlie these disruptions in mood disorders versus schizophrenia, and we highlight the importance of understanding these differences for developing personalized treatments. We summarize evidence suggesting that reward processing abnormalities in mood disorders are driven by dysregulated motivational systems; MDD is characterized by blunted responses to reward cues, and bipolar disorder is characterized by heightened responses. In contrast, we argue that reward processing disruptions in schizophrenia do not reflect abnormalities in motivation or hedonic experience; rather, they reflect impairments in the cognitive representation of past and future rewards as well as misdirected attention to irrelevant stimuli. To integrate these findings, we present a neurodevelopmental framework for the onset of mood and psychotic disorders and explore how disruptions in normative brain development contribute to their pathophysiology, timing, and onset. Additionally, we move beyond viewing these conditions as homogeneous disorders and discuss how reward processing profiles may align with specific symptom dimensions.","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"22 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143599877","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}
Pub Date : 2025-02-20DOI: 10.1146/annurev-clinpsy-081423-021727
Rinad S. Beidas, Meredith Boyd, Elizabeth Casline, Kelli Scott, Zabin Patel-Syed, Chynna Mills, Brian Mustanski, Simone Schriger, Faith Summersett Williams, Claire Waller, Sarah A. Helseth, Sara J. Becker
Implementation science aspires to equitably accelerate the uptake of clinical research into practice to improve population health. The focus of implementation science includes individual behavior change mechanisms that are similar to those that drive the field of clinical psychology. For this reason, clinical psychologists are well-suited to take up implementation science methods in pursuit of improving the quality of behavioral health care. To do so, clinical psychologists must expand beyond individual behavior change to include a focus on organizations and systems. In this review, we reflect on ways that clinical psychologists can lead in the integration of implementation science principles and approaches into clinical psychology research and practice. We discuss the role clinical psychologists play in closing know–do gaps in behavioral health and describe how clinical psychologists can build implementation science competencies. We end with current controversies and opportunities for innovation to further improve the quality of behavioral health care.
{"title":"Harnessing Implementation Science in Clinical Psychology: Past, Present, and Future","authors":"Rinad S. Beidas, Meredith Boyd, Elizabeth Casline, Kelli Scott, Zabin Patel-Syed, Chynna Mills, Brian Mustanski, Simone Schriger, Faith Summersett Williams, Claire Waller, Sarah A. Helseth, Sara J. Becker","doi":"10.1146/annurev-clinpsy-081423-021727","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-081423-021727","url":null,"abstract":"Implementation science aspires to equitably accelerate the uptake of clinical research into practice to improve population health. The focus of implementation science includes individual behavior change mechanisms that are similar to those that drive the field of clinical psychology. For this reason, clinical psychologists are well-suited to take up implementation science methods in pursuit of improving the quality of behavioral health care. To do so, clinical psychologists must expand beyond individual behavior change to include a focus on organizations and systems. In this review, we reflect on ways that clinical psychologists can lead in the integration of implementation science principles and approaches into clinical psychology research and practice. We discuss the role clinical psychologists play in closing know–do gaps in behavioral health and describe how clinical psychologists can build implementation science competencies. We end with current controversies and opportunities for innovation to further improve the quality of behavioral health care.","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"22 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451460","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}
Pub Date : 2025-02-15DOI: 10.1146/annurev-clinpsy-081423-020126
Nichole Fairbrother, Fiona L. Challacombe, Sheryl M. Green, Heather A. O'Mahen
Anxiety and anxiety-related disorders are, as a group, the most common mental health conditions and are more common among women compared with among men. It is now evident that these disorders affect one in five pregnant and postpartum people and are more common than depression. For some disorders (e.g., obsessive–compulsive disorder), there is also evidence of an elevated risk for their development and exacerbation during perinatal periods. In this article, we review the literature pertaining to anxiety and anxiety-related disorders during the perinatal period. We also provide information related to pregnancy-specific anxiety and fear of childbirth constructs that exist outside of diagnostic classification but are particularly important in the perinatal context. We review the scope, prevalence, and etiology of these disorders as well as comorbidity, screening, assessment, and treatment. We conclude with an overview of some of the key gaps in knowledge and recommendations for future research.
{"title":"Anxiety and Related Disorders During the Perinatal Period","authors":"Nichole Fairbrother, Fiona L. Challacombe, Sheryl M. Green, Heather A. O'Mahen","doi":"10.1146/annurev-clinpsy-081423-020126","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-081423-020126","url":null,"abstract":"Anxiety and anxiety-related disorders are, as a group, the most common mental health conditions and are more common among women compared with among men. It is now evident that these disorders affect one in five pregnant and postpartum people and are more common than depression. For some disorders (e.g., obsessive–compulsive disorder), there is also evidence of an elevated risk for their development and exacerbation during perinatal periods. In this article, we review the literature pertaining to anxiety and anxiety-related disorders during the perinatal period. We also provide information related to pregnancy-specific anxiety and fear of childbirth constructs that exist outside of diagnostic classification but are particularly important in the perinatal context. We review the scope, prevalence, and etiology of these disorders as well as comorbidity, screening, assessment, and treatment. We conclude with an overview of some of the key gaps in knowledge and recommendations for future research.","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"62 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417685","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}
Pub Date : 2025-02-11DOI: 10.1146/annurev-clinpsy-081423-020831
Cheri A. Levinson, Avantika Kapadia, Luis E. Sandoval-Araujo, Irina A. Vanzhula, Karyne Machry
Obsessive–compulsive disorder (OCD) and eating disorders (EDs) are highly comorbid. Despite the high comorbidity, there is little understanding of why these disorders coexist and even less research on how to best treat this co-occurrence. In this article, we review the literature on comorbid OCD-ED and discuss potential underlying shared mechanisms, including anxiety/avoidance, perfectionism, intolerance of uncertainty, habit formation, disgust, shame and guilt, rumination, metacognitive beliefs, and shared biological characteristics. We then discuss prior models of OCD-ED comorbidity and shift the perspective from latent or categorical models to dimensional symptom models (e.g., network models). We describe how dimensional symptom models could advance the conceptualization, treatment, and prevention of comorbid OCD-ED. Next, we discuss how idiographic (one-person) symptom models could advance personalized treatment and provide a treatment example. Finally, we discuss future research needed to advance the field and improve treatment outcomes.
{"title":"Movement Toward Dimensional Symptom Models of Comorbid Obsessive–Compulsive Disorder and Eating Disorders","authors":"Cheri A. Levinson, Avantika Kapadia, Luis E. Sandoval-Araujo, Irina A. Vanzhula, Karyne Machry","doi":"10.1146/annurev-clinpsy-081423-020831","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-081423-020831","url":null,"abstract":"Obsessive–compulsive disorder (OCD) and eating disorders (EDs) are highly comorbid. Despite the high comorbidity, there is little understanding of why these disorders coexist and even less research on how to best treat this co-occurrence. In this article, we review the literature on comorbid OCD-ED and discuss potential underlying shared mechanisms, including anxiety/avoidance, perfectionism, intolerance of uncertainty, habit formation, disgust, shame and guilt, rumination, metacognitive beliefs, and shared biological characteristics. We then discuss prior models of OCD-ED comorbidity and shift the perspective from latent or categorical models to dimensional symptom models (e.g., network models). We describe how dimensional symptom models could advance the conceptualization, treatment, and prevention of comorbid OCD-ED. Next, we discuss how idiographic (one-person) symptom models could advance personalized treatment and provide a treatment example. Finally, we discuss future research needed to advance the field and improve treatment outcomes.","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"18 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143385608","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}
This article provides an overview of the current state of assessment and clinical intervention approaches for youth with juvenile legal system (JLS) involvement. The review includes (a) a brief overview of characteristics of youth with JLS involvement; (b) current screening and assessment frameworks within the JLS that identify treatment needs; (c) an overview of effective clinical interventions for common behavioral health concerns among youth with JLS involvement, including information about tailoring interventions to address the multiple intersecting identities (e.g., race, ethnicity, gender identity, sexual orientation) of youth within the JLS; and (d) an overview of implementation models and scalability of interventions.
{"title":"Youth with Behavioral Health Symptoms in the Juvenile Legal System: From Assessment of Needs to Interventions to Scalability","authors":"Kathleen Kemp, Kaitlin Sheerin, Casey Pederson, Miyah Grant, Crosby Modrowski, Anthony Spirito","doi":"10.1146/annurev-clinpsy-081423-021503","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-081423-021503","url":null,"abstract":"This article provides an overview of the current state of assessment and clinical intervention approaches for youth with juvenile legal system (JLS) involvement. The review includes (<jats:italic>a</jats:italic>) a brief overview of characteristics of youth with JLS involvement; (<jats:italic>b</jats:italic>) current screening and assessment frameworks within the JLS that identify treatment needs; (<jats:italic>c</jats:italic>) an overview of effective clinical interventions for common behavioral health concerns among youth with JLS involvement, including information about tailoring interventions to address the multiple intersecting identities (e.g., race, ethnicity, gender identity, sexual orientation) of youth within the JLS; and (<jats:italic>d</jats:italic>) an overview of implementation models and scalability of interventions.","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"14 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143385732","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}
Pub Date : 2025-02-11DOI: 10.1146/annurev-clinpsy-081423-024754
Edelyn Verona, Bryanna Fox
The United States has one of the highest rates of correctional supervision among all nations in the world, reflecting the disproportionate incarceration of racial minorities and economically disadvantaged groups. Scholars have emphasized the role of structural factors and governmental policies in long-term shifts in crime and incarceration. However, much of the psychological research on crime and antisocial behaviors has not deeply considered this broader context, focusing mostly on individual and proximal environmental risk factors. This article presents a novel synthesis of large cross-disciplinary literatures that have not been previously integrated. After a brief summary of dominant themes in psychological research on the topic, we review the strong evidence, primarily from fields outside of psychology, for structural forces that explain pathways into criminal justice involvement, independent of individual-level explanations. A broader ecological framework is outlined to help unconfound individual and structural influences, with the hope of motivating policy change that is evidence-based and equitable.
{"title":"Pathways to Crime and Antisocial Behavior: A Critical Analysis of Psychological Research and a Call for Broader Ecological Perspectives","authors":"Edelyn Verona, Bryanna Fox","doi":"10.1146/annurev-clinpsy-081423-024754","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-081423-024754","url":null,"abstract":"The United States has one of the highest rates of correctional supervision among all nations in the world, reflecting the disproportionate incarceration of racial minorities and economically disadvantaged groups. Scholars have emphasized the role of structural factors and governmental policies in long-term shifts in crime and incarceration. However, much of the psychological research on crime and antisocial behaviors has not deeply considered this broader context, focusing mostly on individual and proximal environmental risk factors. This article presents a novel synthesis of large cross-disciplinary literatures that have not been previously integrated. After a brief summary of dominant themes in psychological research on the topic, we review the strong evidence, primarily from fields outside of psychology, for structural forces that explain pathways into criminal justice involvement, independent of individual-level explanations. A broader ecological framework is outlined to help unconfound individual and structural influences, with the hope of motivating policy change that is evidence-based and equitable.","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"13 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143385731","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}
Pub Date : 2025-02-07DOI: 10.1146/annurev-clinpsy-081423-022947
E.L. Hamaker
Research based on intensive longitudinal data (ILD)—consisting of many repeated measures from one or multiple individuals—is rapidly gaining popularity in psychological science. To appreciate the unique potential of ILD research for clinical psychology, this review begins by examining how our three traditional research approaches fall short when the goal is to investigate processes. It then explores how the analysis of ILD can be used to study a process as it unfolds within a specific person over time but also to study average process features or individual differences therein. By emphasizing the alignment between research questions, data collection, and analytical strategies, the potential of ILD research is further highlighted. It is argued that for future progress it is essential to integrate machine learning and causal inference methods with statistical techniques for ILD and to become more explicit about timescales, time frames, and dynamics in psychological theories.
{"title":"Analysis of Intensive Longitudinal Data: Putting Psychological Processes in Perspective","authors":"E.L. Hamaker","doi":"10.1146/annurev-clinpsy-081423-022947","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-081423-022947","url":null,"abstract":"Research based on intensive longitudinal data (ILD)—consisting of many repeated measures from one or multiple individuals—is rapidly gaining popularity in psychological science. To appreciate the unique potential of ILD research for clinical psychology, this review begins by examining how our three traditional research approaches fall short when the goal is to investigate processes. It then explores how the analysis of ILD can be used to study a process as it unfolds within a specific person over time but also to study average process features or individual differences therein. By emphasizing the alignment between research questions, data collection, and analytical strategies, the potential of ILD research is further highlighted. It is argued that for future progress it is essential to integrate machine learning and causal inference methods with statistical techniques for ILD and to become more explicit about timescales, time frames, and dynamics in psychological theories.","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"64 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143258408","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}
Pub Date : 2025-02-03DOI: 10.1146/annurev-clinpsy-081423-021101
Lisa M. Horowitz, Nathan J. Lowry, Tesia Shi, Ritika Merai, Maryland Pao, Jeffrey A. Bridge
Youth suicide remains a leading cause of death in the United States and is especially pronounced in populations that have been historically underserved. Multipronged public health strategies aimed at addressing suicide may be particularly effective in pediatric medical settings, as most youth who die by suicide have visited a health care provider prior to their death. The finding that most youth suicide decedents have no mental illness diagnosis further underscores the importance of screening. This review highlights universal screening as a strategy to improve detection and management of at-risk youth. We present current research on evidence-based screening tools, clinical pathways to support the feasibility and fidelity of screening, brief interventions for managing positive screens, issues regarding screening and health equity, considerations for diverse populations, current innovations, and future directions for research and clinical practice. Evidence supports universal suicide risk screening through feasible clinical pathways that leverage pediatric health care providers as partners in suicide prevention.
{"title":"Detecting Suicide Risk Among Pediatric Patients: Screening, Clinical Pathways, and Care","authors":"Lisa M. Horowitz, Nathan J. Lowry, Tesia Shi, Ritika Merai, Maryland Pao, Jeffrey A. Bridge","doi":"10.1146/annurev-clinpsy-081423-021101","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-081423-021101","url":null,"abstract":"Youth suicide remains a leading cause of death in the United States and is especially pronounced in populations that have been historically underserved. Multipronged public health strategies aimed at addressing suicide may be particularly effective in pediatric medical settings, as most youth who die by suicide have visited a health care provider prior to their death. The finding that most youth suicide decedents have no mental illness diagnosis further underscores the importance of screening. This review highlights universal screening as a strategy to improve detection and management of at-risk youth. We present current research on evidence-based screening tools, clinical pathways to support the feasibility and fidelity of screening, brief interventions for managing positive screens, issues regarding screening and health equity, considerations for diverse populations, current innovations, and future directions for research and clinical practice. Evidence supports universal suicide risk screening through feasible clinical pathways that leverage pediatric health care providers as partners in suicide prevention.","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"38 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143083771","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}
Pub Date : 2025-01-29DOI: 10.1146/annurev-clinpsy-081423-023518
Suky Martinez, Jennifer D. Ellis, Cecilia L. Bergeria, Andrew S. Huhn, Kelly E. Dunn
The opioid crisis, driven by illicitly manufactured fentanyl, presents significant challenges in treating opioid use disorder (OUD) and opioid withdrawal syndrome. Fentanyl is uniquely lethal due to its rapid onset and respiratory depressant effects, driving the surge in overdose deaths. This review examines the limitations of traditional diagnostic criteria like those of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) and explores the potential of dimensional models such as the Hierarchical Taxonomy of Psychopathology (HiTOP) for a more nuanced understanding of OUD. Current treatments, including medications for OUD, are evaluated for efficacy in managing fentanyl-related OUD. Innovations in drug formulations and alternative induction methods are discussed to address the unique challenges posed by fentanyl. Psychotherapeutic and behavioral interventions, such as cognitive behavioral therapy and contingency management, are highlighted as crucial complements to pharmacotherapy. The review underscores the need for increased precision, comprehensive phenotyping, and advanced diagnostics to develop personalized treatment plans, all with the aim of improving patient outcomes and mitigating the societal impact of the opioid crisis.
{"title":"Treating Opioid Use Disorder and Opioid Withdrawal in the Context of Fentanyl","authors":"Suky Martinez, Jennifer D. Ellis, Cecilia L. Bergeria, Andrew S. Huhn, Kelly E. Dunn","doi":"10.1146/annurev-clinpsy-081423-023518","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-081423-023518","url":null,"abstract":"The opioid crisis, driven by illicitly manufactured fentanyl, presents significant challenges in treating opioid use disorder (OUD) and opioid withdrawal syndrome. Fentanyl is uniquely lethal due to its rapid onset and respiratory depressant effects, driving the surge in overdose deaths. This review examines the limitations of traditional diagnostic criteria like those of the <jats:italic>Diagnostic and Statistical Manual of Mental Disorders</jats:italic>, Fifth Edition, Text Revision (DSM-5-TR) and explores the potential of dimensional models such as the Hierarchical Taxonomy of Psychopathology (HiTOP) for a more nuanced understanding of OUD. Current treatments, including medications for OUD, are evaluated for efficacy in managing fentanyl-related OUD. Innovations in drug formulations and alternative induction methods are discussed to address the unique challenges posed by fentanyl. Psychotherapeutic and behavioral interventions, such as cognitive behavioral therapy and contingency management, are highlighted as crucial complements to pharmacotherapy. The review underscores the need for increased precision, comprehensive phenotyping, and advanced diagnostics to develop personalized treatment plans, all with the aim of improving patient outcomes and mitigating the societal impact of the opioid crisis.","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"20 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056211","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}
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