Annual Review of Clinical Psychology最新文献

英文中文

Personality Disorders: Current Conceptualizations and Challenges 人格障碍：当前的概念和挑战

IF 18.4 1区心理学 Q1 PSYCHOLOGY

Annual Review of Clinical Psychology

Pub Date : 2025-01-21 DOI: 10.1146/annurev-clinpsy-081423-030513

Thomas A. Widiger, Michelle Smith

The personality disorders are said to be at the vanguard in the shift to a dimensional model of classification, as exemplified in the Alternative Model of Personality (AMPD) presented in Section III of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for emerging models and in the 11th edition of the International Classification of Diseases (ICD-11). Considered herein are some limitations and challenges. For the DSM-5 AMPD trait model, these include problematic placements, inadequate coverage, perceived complexity, and lack of cutoff points. For the DSM-5 AMPD Level of Personality Functioning (LPF), they include the complexity, the questionable presumption that the LPF defines the core of personality disorder, the presumption that the LPF identifies what is unique to the personality disorders, and the premise that the LPF is distinct from the maladaptive traits. Limitations and challenges of the ICD-11 model are the absence of lower-order facet scales and the fact that only the level of severity is required. This review suggests that the trait of depressivity belongs with negative affectivity and suspicion belongs within antagonism, that maladaptive traits from all 10 poles of the five domains should be provided, and that cutoff points based on social-occupational impairment and/or distress should be provided. The review summarizes research that questions whether the LPF represents the core of personality disorder, identifies what is unique to the personality disorders, and is distinct from maladaptive traits. Finally, the review suggests that the ICD-11 should require the assessment of the traits and include facet scales.

人格障碍被认为是向维度分类模型转变的先锋，如《精神疾病诊断与统计手册》（DSM-5）第五版第三节中提出的替代性人格模型（AMPD）和《国际疾病分类》（ICD-11）第11版中提出的新兴模型。这里考虑了一些限制和挑战。对于DSM-5的AMPD特征模型，这些包括有问题的位置、不充分的覆盖、可感知的复杂性和缺乏截断点。对于DSM-5 AMPD人格功能水平（LPF），它们包括复杂性，LPF定义人格障碍核心的可疑假设，LPF识别人格障碍特有的假设，以及LPF与适应不良特征不同的前提。ICD-11模型的局限性和挑战在于缺乏低阶关节面尺度，并且只需要严重程度。本综述认为，抑郁特征属于负性情感，怀疑属于对抗性，应提供五个领域的所有十个极点的适应不良特征，并提供基于社会职业障碍和/或痛苦的分界点。这篇综述总结了质疑LPF是否代表人格障碍核心的研究，确定了人格障碍的独特之处，以及与适应不良特征的区别。最后，本综述建议ICD-11应要求对这些特征进行评估，并包括关节面量表。

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引用次数: 0

Autism Spectrum Disorder Across the Lifespan 自闭症谱系障碍贯穿整个生命周期

IF 18.4 1区心理学 Q1 PSYCHOLOGY

Annual Review of Clinical Psychology

Pub Date : 2025-01-21 DOI: 10.1146/annurev-clinpsy-081423-031110

Maira Tafolla, Hannah Singer, Catherine Lord

Autism is a neurodevelopmental condition that affects individuals worldwide throughout their lives. Copious advances in research have enhanced our understanding of autism significantly since Dr. Leo Kanner's first description of the condition in 1943. This review aims to provide an overview of our current knowledge of autism, examining its manifestations across age, race, gender, and co-occurring conditions (e.g., intellectual disability) from childhood through adulthood. We also focus on the identification and diagnosis of autism, long-term outcomes with a spotlight on adulthood, and appropriate supports and interventions across different developmental stages for autistic individuals and their families. We stress the importance of a lifespan perspective that considers the evolving needs of individuals with autism as they age, and we highlight the role of longitudinal research.

自闭症是一种影响全世界个体一生的神经发育疾病。自1943年利奥·坎纳博士首次描述自闭症以来，研究的大量进展大大提高了我们对自闭症的理解。这篇综述的目的是概述我们目前对自闭症的认识，检查其在年龄、种族、性别和从童年到成年的共同发生条件（如智力残疾）中的表现。我们还关注自闭症的识别和诊断，以成年期为重点的长期结果，以及自闭症患者及其家庭在不同发育阶段的适当支持和干预。我们强调终身视角的重要性，考虑到自闭症患者随着年龄增长而不断变化的需求，我们强调纵向研究的作用。

引用次数: 0

Stress and Cardiovascular Disease: The Role of Affective Traits and Mental Disorders 压力与心血管疾病：情感特征和精神障碍的作用

IF 18.4 1区心理学 Q1 PSYCHOLOGY

Annual Review of Clinical Psychology

Pub Date : 2025-01-13 DOI: 10.1146/annurev-clinpsy-081423-023833

Richard J. Contrada

Personality traits involving negative affect, as well as mental disorders including depression, anxiety, and posttraumatic stress disorder, are cardiovascular risk factors. However, which of these confer risk independently is uncertain, and the implications of their overlap, combinations, and interactions are poorly understood. Potential explanatory mechanisms are being characterized with increasing detail and sophistication. Of particular interest are psychobiological processes initiated by stress. Other mechanisms involve stress-related health behaviors and illness behaviors that delay or reduce the effectiveness of medical treatment. With some promising exceptions, findings of intervention trials are uncertain regarding the effectiveness of psychological treatments for modifying affective traits and mental disorders to reduce their impact on cardiovascular disease. Recent developments include novel conceptualizations of mental disorders; examination of the interplay between cognitive factors and emotion; and theoretical frameworks that integrate psychological stress processes with neuroscience, health behavior, and social cognition. Also promising is increased attention to gender identity and minority group membership.

涉及负面影响的人格特征，以及包括抑郁、焦虑和创伤后应激障碍在内的精神障碍，都是心血管疾病的危险因素。然而，这些因素中哪一个单独赋予风险是不确定的，它们的重叠、组合和相互作用的含义也知之甚少。潜在的解释机制正在被越来越详细和复杂地描述。特别有趣的是由压力引发的心理生物学过程。其他机制包括与压力相关的健康行为和疾病行为，这些行为会延迟或降低医疗的有效性。除了一些有希望的例外，干预试验的结果不确定心理治疗在改变情感特征和精神障碍以减少其对心血管疾病的影响方面的有效性。最近的发展包括精神障碍的新概念；认知因素与情绪之间相互作用的检验；以及将心理压力过程与神经科学、健康行为和社会认知相结合的理论框架。同样有希望的是，对性别认同和少数群体成员资格的关注也在增加。

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引用次数: 0

Mental Illness and Substance Use Disorder Stigma: Mapping Pathways Between Structures and Individuals to Accelerate Research and Intervention 精神疾病和物质使用障碍的污名化：结构和个体之间的路径映射以加速研究和干预

IF 18.4 1区心理学 Q1 PSYCHOLOGY

Annual Review of Clinical Psychology

Pub Date : 2025-01-13 DOI: 10.1146/annurev-clinpsy-081423-023228

Valerie A. Earnshaw, Mohammad Mousavi, Xueli Qiu, Annie B. Fox

Researchers, interventionists, and clinicians are increasingly recognizing the importance of structural stigma in elevating the risk of mental illnesses (MIs) and substance use disorders (SUDs) and in undermining MI/SUD treatment and recovery. Yet, the pathways through which structural stigma influences MI/SUD-related outcomes remain unclear. In this review, we aim to address this gap by summarizing scholarship on structural MI/SUD stigma and identifying pathways whereby structural stigma affects MI/SUD-related outcomes. We introduce a conceptual framework that describes how structural-level stigma mechanisms influence the MI/SUD treatment cascade via (a) interpersonal- and individual-level stigma mechanisms and (b) mediating processes among people with MI/SUD (i.e., access to resources, psychological responses, behavioral responses, social isolation). We consider intersections between MI/SUD stigma and stigma based on race/ethnicity, gender identity, and sexual orientation. Finally, we discuss the implications of this review for future research, interventions, and clinical practice.

研究人员、干预学家和临床医生越来越多地认识到结构性耻辱感在增加精神疾病（MIs）和物质使用障碍（SUD）风险以及破坏MI/SUD治疗和康复方面的重要性。然而，结构耻辱感影响心肌梗死/ sud相关结果的途径仍不清楚。在这篇综述中，我们旨在通过总结结构性心梗/SUD病耻感的学术研究，并确定结构性病耻感影响心梗/SUD相关结果的途径，来解决这一差距。我们引入了一个概念框架，描述了结构层面的耻辱机制如何通过(a)人际和个人层面的耻辱机制以及(b) MI/SUD患者之间的中介过程（即获取资源、心理反应、行为反应、社会孤立）影响MI/SUD治疗级联。我们考虑MI/SUD耻辱感和基于种族/民族、性别认同和性取向的耻辱感之间的交集。最后，我们讨论了这篇综述对未来研究、干预措施和临床实践的意义。

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引用次数: 0

Pathways to Racial/Ethnic Inequalities in Dementia 痴呆症中种族/民族不平等的途径

IF 18.4 1区心理学 Q1 PSYCHOLOGY

Annual Review of Clinical Psychology

Pub Date : 2025-01-13 DOI: 10.1146/annurev-clinpsy-081423-032631

Jordan D. Palms, Ketlyne Sol, Laura B. Zahodne

Individuals from minoritized racial/ethnic groups face a disproportionate burden of Alzheimer's disease and related dementias. This health inequality reflects structural racism, which creates and sustains racial differences in social determinants of health, including education access and quality, economic stability, social and community context, neighborhood and built environment, and health care access and quality. Thus, understanding pathways that lead to dementia inequalities requires addressing individual- and system-level factors. This article summarizes evidence linking each social determinant of health to racial/ethnic inequalities in dementia, emphasizing upstream factors and mechanisms as potential levels of intervention. The importance of resilience in marginalized groups as well as critical research considerations for dementia inequalities are also discussed. Future directions highlight the need to understand the common and unique mechanisms driving inequalities across minoritized groups, where research is lacking.

来自少数种族/族裔群体的个体面临着不成比例的阿尔茨海默病和相关痴呆症负担。这种健康不平等反映了结构性种族主义，它在健康的社会决定因素方面造成并维持了种族差异，包括教育机会和质量、经济稳定、社会和社区背景、邻里和建筑环境以及保健机会和质量。因此，了解导致痴呆症不平等的途径需要解决个人和系统层面的因素。本文总结了将健康的每个社会决定因素与痴呆症中的种族/民族不平等联系起来的证据，强调了上游因素和机制作为潜在的干预水平。还讨论了边缘群体复原力的重要性以及对痴呆症不平等的关键研究考虑因素。未来的方向强调需要了解导致少数群体之间不平等的共同和独特机制，这方面缺乏研究。

引用次数: 0

Climate Change and Mental Health 气候变化与心理健康

IF 18.4 1区心理学 Q1 PSYCHOLOGY

Annual Review of Clinical Psychology

Pub Date : 2024-12-11 DOI: 10.1146/annurev-clinpsy-081423-025932

Susan Clayton, Tara Crandon

Climate change negatively threatens mental health through acute, chronic, indirect, and vicarious pathways. Though these psychological consequences will be felt globally, specific populations are at increased risk. This article describes the complex and diverse ways in which climate change can affect mental health and the resulting challenges that health care services will inevitably face. In responding to these threats, both prevention and intervention are urgently needed. Although mitigating the extent of climate change is crucial, we can also foster resilience to climate change—the ability to manage, respond to, and prepare for climate-related adversity—at the systemic, community, and individual levels. The mental health field must prepare for the significant burden that climate change will place on population health and well-being in the long term. In this review, we aim to inform and provide examples of how decision makers, the mental health discipline, and mental health professionals can respond.

气候变化通过急性、慢性、间接和替代途径对心理健康造成负面威胁。虽然这些心理后果将在全球范围内感受到，但特定人群面临的风险更高。本文描述了气候变化影响心理健康的复杂而多样的方式，以及由此带来的卫生保健服务将不可避免地面临的挑战。在应对这些威胁时，迫切需要预防和干预。虽然减缓气候变化的程度至关重要，但我们也可以在系统、社区和个人层面培养对气候变化的适应能力，即管理、应对和准备应对气候相关逆境的能力。心理健康领域必须做好准备，应对气候变化将给人口健康和福祉带来的长期沉重负担。在这篇综述中，我们的目的是告知并提供决策者、心理健康学科和心理健康专业人员如何应对的例子。

引用次数: 0

Wisdom, Resilience, and Well-Being in Later Life 智慧、韧性和晚年的幸福

IF 18.4 1区心理学 Q1 PSYCHOLOGY

Annual Review of Clinical Psychology

Pub Date : 2024-12-02 DOI: 10.1146/annurev-clinpsy-081423-031855

Dilip V. Jeste, George S. Alexopoulos, Dan G. Blazer, Helen Lavretsky, Perminder S. Sachdev, Charles F. Reynolds

As the numbers of older adults continue to increase globally, the need for facilitating healthy aging has become critical. While a physically healthy lifestyle, including exercise and diet, is important, recent research has highlighted a major impact of psychosocial determinants of health, such as resilience, wisdom, positive social connections, and mental well-being, on whole health. This article focuses on keeping the mind and brain healthy with psychosocially active aging. It has six sections: Philosophy Concepts of Wisdom, Resilience, and Well-Being; Wisdom: Clinical, Neurobiological, and Evolutionary Perspectives; Resilience, Adaptation, and Augmentation; Psychological Resilience, Brain Health, and Whole Person Health; Preventing Depression and Promoting Resilience and Well-Being in Old Age; and The Centenarian as a Model of Resilience and Well-Being. We discuss the biopsychosocial mechanisms and effectiveness of healthy lifestyle strategies and propose a framework for future research and its practical implications for promoting wisdom, resilience, and well-being at the individual, societal, and policy levels.

随着全球老年人数量的不断增加，促进健康老龄化的需求已变得至关重要。虽然身体健康的生活方式（包括锻炼和饮食）很重要，但最近的研究强调了健康的心理社会决定因素（如恢复力、智慧、积极的社会关系和心理健康）对整体健康的重大影响。这篇文章的重点是保持精神和大脑健康与心理社会积极老龄化。它有六个部分：智慧，弹性和幸福的哲学概念；智慧：临床、神经生物学和进化观点；弹性、适应和增强；心理弹性、大脑健康与整体健康预防抑郁症，促进老年人的适应能力和幸福感以及《百岁老人》作为韧性和幸福的典范。我们讨论了健康生活方式策略的生物心理社会机制和有效性，并提出了未来研究的框架及其在个人，社会和政策层面上促进智慧，弹性和福祉的实际意义。

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引用次数: 0

The Mental Health of Sexual Minority Individuals: Five Explanatory Theories and Their Implications for Intervention and Future Research 性少数个体的心理健康：五种解释理论及其干预和未来研究的意义

IF 18.4 1区心理学 Q1 PSYCHOLOGY

Annual Review of Clinical Psychology

Pub Date : 2024-12-02 DOI: 10.1146/annurev-clinpsy-081423-022014

John E. Pachankis, Kirsty A. Clark

Research on the disparity in common mental health problems borne by sexual minority individuals has entered a stage of increasing theoretical complexity. Indeed, such a substantial disparity is likely not determined by a singular cause and therefore warrants diverse etiological perspectives tested with increasingly rigorous methodologies. The research landscape is made even more complex by the constant and rapid shift in the ways in which sexual minority people understand and characterize their own identities and experiences. This review introduces readers to this complexity by summarizing the historical legacy of research on the sexual orientation disparity in mental health, describing five contemporary theoretical explanations for this disparity and their supporting evidence, and suggesting theoretically informed interventions for reducing this disparity. Last, we offer an agenda for future research to accurately model the complexity of the pathways and solutions to the disproportionately poorer mental health of sexual minority populations.

对性少数群体常见心理健康问题差异的研究已进入一个理论复杂性不断增加的阶段。事实上，如此巨大的差异很可能不是由单一原因决定的，因此需要用越来越严格的方法对各种病因学观点进行检验。性少数群体理解和描述自己身份和经历的方式不断快速变化，使研究前景变得更加复杂。这篇综述通过总结心理健康中的性取向差异研究的历史遗产，描述了对这种差异的五种当代理论解释及其支持证据，并提出了理论上明智的干预措施来减少这种差异，向读者介绍了这种复杂性。最后，我们为未来的研究提供了一个议程，以准确地模拟性少数群体不成比例的心理健康状况较差的途径和解决方案的复杂性。

引用次数: 0

Immune Dysfunction in Schizophrenia Spectrum Disorders. 精神分裂症谱系障碍中的免疫功能失调。

IF 17.8 1区心理学 Q1 PSYCHOLOGY

Annual Review of Clinical Psychology

Pub Date : 2024-07-01 DOI: 10.1146/annurev-clinpsy-081122-013201

S S Gangadin, A D Enthoven, N J M van Beveren, J D Laman, I E C Sommer

Evidence from epidemiological, clinical, and biological research resulted in the immune hypothesis: the hypothesis that immune system dysfunction is involved in the pathophysiology of schizophrenia spectrum disorders (SSD). The promising implication of this hypothesis is the potential to use existing immunomodulatory treatment for innovative interventions for SSD. Here, we provide a selective historical review of important discoveries that have shaped our understanding of immune dysfunction in SSD. We first explain the basic principles of immune dysfunction, after which we travel more than a century back in time. Starting our journey with neurosyphilis-associated psychosis in the nineteenth century, we continue by evaluating the role of infections and autoimmunity in SSD and findings from assessment of immune function using new techniques, such as cytokine levels, microglia density, neuroimaging, and gene expression. Drawing from these findings, we discuss anti-inflammatory interventions for SSD, and we conclude with a look into the future.

流行病学、临床和生物学研究的证据提出了免疫假说：即免疫系统功能障碍与精神分裂症谱系障碍（SSD）的病理生理学有关。这一假说的潜在意义在于利用现有的免疫调节治疗方法对精神分裂症谱系障碍进行创新性干预。在此，我们有选择性地回顾了影响我们对 SSD 免疫功能障碍认识的重要发现。我们首先解释了免疫功能障碍的基本原理，然后将时间回溯到一个多世纪以前。从十九世纪的神经梅毒相关性精神病开始，我们继续评估了感染和自身免疫在 SSD 中的作用，以及使用细胞因子水平、小胶质细胞密度、神经影像学和基因表达等新技术评估免疫功能的发现。根据这些发现，我们讨论了针对 SSD 的抗炎干预措施，最后展望了未来。

引用次数: 0

Prevalence Increases as Treatments Improve: An Evolutionary Perspective on the Treatment-Prevalence Paradox in Depression. 患病率随着治疗方法的改进而增加：从进化角度看抑郁症的治疗-患病率悖论》。

IF 17.8 1区心理学 Q1 PSYCHOLOGY

Annual Review of Clinical Psychology

Pub Date : 2024-07-01 DOI: 10.1146/annurev-clinpsy-080822-040442

Iony D Ezawa, Noah Robinson, Steven D Hollon

Depression is an eminently treatable disorder that responds to psychotherapy or medications; the efficacy of each has been established in hundreds of controlled trials. Nonetheless, the prevalence of depression has increased in recent years despite the existence of efficacious treatments-a phenomenon known as the treatment-prevalence paradox. We consider several possible explanations for this paradox, which range from a misunderstanding of the very nature of depression, inflated efficacy of the established treatments, and a lack of access to efficacious delivery of treatments. We find support for each of these possible explanations but especially the notion that large segments of the population lack access to efficacious treatments that are implemented as intended. We conclude by describing the potential of using lay therapists and digital technologies to overcome this lack of access and to reach historically underserved populations and simultaneously guarantee the quality of the interventions delivered.

抑郁症是一种非常容易治疗的疾病，对心理治疗或药物治疗均有反应；数百项对照试验已经证实了每种疗法的疗效。然而，尽管存在有效的治疗方法，近年来抑郁症的患病率却在上升--这种现象被称为治疗-患病率悖论。对于这种悖论，我们考虑了几种可能的解释，包括对抑郁症本质的误解、夸大已有治疗方法的疗效，以及缺乏有效的治疗方法。我们发现这些可能的解释都得到了支持，尤其是大部分人无法获得按预期实施的有效治疗这一观点。最后，我们介绍了利用非专业治疗师和数字技术来克服这种缺乏机会的问题，并帮助历史上得不到充分服务的人群，同时保证所提供干预措施的质量的潜力。

引用次数: 0

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