Annual Review of Clinical Psychology最新文献

Bipolar disorder is a recurrent, heterogeneous condition that often begins in adolescence and typically requires lifelong, multimodal management. Advances in evidence-based assessment (EBA) offer structured frameworks for prediction, prescription, and progress monitoring, and pharmacological and psychosocial interventions supported by recent reviews and the Canadian Network for Mood and Anxiety Treatments (CANMAT)/International Society for Bipolar Disorders (ISBD) guidelines provide effective options across phases of illness. Despite these advances, the impact of evidence-based approaches remains blunted in practice: Diagnosis is often delayed, pharmacotherapy is inconsistently prescribed or monitored, psychosocial interventions are underused, and relapse prevention strategies are rarely sustained. Therefore, the field must embed prediction, treatment, and monitoring within community treatment settings-primary care, schools, digital platforms, and family systems-where risk can be identified early, preventive strategies can be delivered, and long-term maintenance can be supported. Framing EBA as a dynamic, community-anchored cycle offers the best chance of translating evidence into improved outcomes, bridging the gap between research efficacy and real-world effectiveness in the care of bipolar disorder.

Clinical psychology is a discipline reliant on self-reports but uniquely susceptible to specific biases associated therewith. Here we provide a prototype for objective behavioral assessment drawn from the field of alcohol science, reviewing the research on an emerging class of wearable transdermal biosensor. We note the challenges of transdermal alcohol assessment and describe recent performance gains from updated devices and machine learning analytic tools. We indicate unanswered questions for transdermal technology, including device longevity and the accuracy of devices for producing fine-grained estimates of drinking quantity. We identify factors that can impede development of transdermal sensors and other new objective measures, including the tendency to judge new tools against an implicit ideal, and consider scientific findings divorced from methodology. Finally, in evaluating novel objective measurement tools, we argue for careful consideration of not only error magnitude but also error type (i.e., random versus systematic), and we identify measurement diversification as a priority for clinical psychology moving forward.

Mounting evidence supports the efficacy of nonpharmacologic or psychosocial interventions for reducing behavioral and psychological symptoms of dementia (BPSD), identifies the comparative risks and benefits of psychotropic medication, and underscores the importance of deprescribing psychotropic medications. However, evidence from clinical settings indicates that uptake of nonpharmacologic interventions and potential overuse of medications remain problematic. We begin by discussing the importance of exploring potential contributors to BPSD, using person-centered language to describe BPSD, implementing holistic and person-centered care plans, measuring clinically important changes in BPSD, and considering social determinants of health when assessing and managing BPSD; we also discuss the historical context informing how clinicians manage BPSD. Next, we compare and contrast nonpharmacologic and pharmacologic approaches to managing BPSD, evaluate their individual and comparative efficacy, and describe recommendations for intervention deprescribing or deimplementation. Lastly, we discuss strengths and limitations of the current evidence supporting BPSD management as well as recommendations for future research.

Hormone sensitivity is a heterogeneous phenomenon involving multiple dimensions of sensitivity to estrogen and progesterone fluctuations across the menstrual cycle. While the majority of menstruating individuals do not experience any significant impact from these hormone changes on mood or behavior, rates of hormone sensitivity in clinical populations, particularly affective disorders, are substantially elevated, suggesting potential shared psychosocial or physiological mechanisms or moderators of risk. In this review, we provide an overview of menstrually related mood disorders and dimensions of hormone sensitivity across the cycle contributing to these presentations. We discuss how hormone sensitivity during the menstrual cycle corresponds with affective problems during other reproductive life events (puberty, perimenopause, pregnancy/postpartum) and review the evidence for environmental, neurobiological, and cognitive/affective factors associated with hormone sensitivity. Methodological considerations and directions for further research are highlighted throughout.

This review provides an overview of biological processes that contribute to obsessive-compulsive disorder (OCD). It encourages nonreductionist integration of biological findings with psychological and social constructs. OCD runs in families; studies are beginning to identify genetic variants that contribute to risk, though these findings are not yet clinically actionable. A robust body of neuroimaging research implicates hyperactivity in certain brain circuits in the pathophysiology of OCD, which often normalizes following successful treatment. The efficacy of serotonin reuptake inhibitors is well-established; however, evidence does not support a simple serotonin deficit model. The role of the neurotransmitter glutamate in pathophysiology and treatment is under investigation. Emerging research is exploring the contributions of immune system dysregulation and of hormones to pathophysiology. Pharmacological treatment strategies are reviewed, as are anatomically targeted interventions for refractory cases. Future treatments will likely synergistically deploy somatic and psychotherapeutic interventions, leveraging biological tools to enhance mechanisms of psychological change.

Adults who provide care to family members living with dementia experience substantial impacts to their well-being. Dementia family caregivers are the backbone of health and long-term care services in the United States, yet they typically do not access evidence-based caregiver interventions. This is especially the case for racial and ethnic minoritized populations, who experience higher rates of dementia yet lower access to diagnostic and specialty care services and evidence-based interventions. This review appraises the peer-reviewed literature on randomized clinical trials to test the effectiveness of caregiver interventions, the extent of cultural adaptations, and their impact on psychological outcomes, including mastery. We find that few evidence-based interventions incorporate cultural and linguistic adaptations, and when they do, most fall short of following formal adaptation frameworks and documenting treatment effects on psychological outcomes by racial and ethnic group. Research must address these shortcomings to increase the equitable distribution of caregiver interventions for all Americans.