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}
Pub Date : 2025-01-29DOI: 10.1146/annurev-clinpsy-081423-022604
Brett T. Litz, Hannah E. Walker
Moral injury (MI) is a potential clinical problem characterized by functionally impairing moral emotions, beliefs, and behaviors as well as adverse beliefs about personal or collective humanity and life's meaning and purpose. MI can arise from personal transgressive acts or from being a victim of or bearing witness to others’ inhumanity. Despite widespread interest in MI, until recently, there was no reliable measure of MI as an outcome, and prior research has revealed little about its causes, consequences, and intervention approaches. This review provides background information on the history of MI, defines key terms, and critically reviews assessment tools. Additionally, we describe a social-functional theory of the etiology of MI and a social-functional rehabilitation approach to treatment. This treatment approach, which can be used by any clinician regardless of clinical context, employs cross-cutting change agents to promote lasting corrective and humanizing prosocial experiences, enhancing belonging through valued actions and relationships.
{"title":"Moral Injury: An Overview of Conceptual, Definitional, Assessment, and Treatment Issues","authors":"Brett T. Litz, Hannah E. Walker","doi":"10.1146/annurev-clinpsy-081423-022604","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-081423-022604","url":null,"abstract":"Moral injury (MI) is a potential clinical problem characterized by functionally impairing moral emotions, beliefs, and behaviors as well as adverse beliefs about personal or collective humanity and life's meaning and purpose. MI can arise from personal transgressive acts or from being a victim of or bearing witness to others’ inhumanity. Despite widespread interest in MI, until recently, there was no reliable measure of MI as an outcome, and prior research has revealed little about its causes, consequences, and intervention approaches. This review provides background information on the history of MI, defines key terms, and critically reviews assessment tools. Additionally, we describe a social-functional theory of the etiology of MI and a social-functional rehabilitation approach to treatment. This treatment approach, which can be used by any clinician regardless of clinical context, employs cross-cutting change agents to promote lasting corrective and humanizing prosocial experiences, enhancing belonging through valued actions and relationships.","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"60 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056629","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 : 2025-01-28DOI: 10.1146/annurev-clinpsy-081423-025033
Jessica L. Schleider, Juan Pablo Zapata, Andy Rapoport, Annie Wescott, Arka Ghosh, Benji Kaveladze, Erica Szkody, Isaac L. Ahuvia
Most people with mental health needs cannot access treatment; among those who do, many access services only once. Accordingly, single-session interventions (SSIs) may help bridge the treatment gap. We conducted the first umbrella review synthesizing research on SSIs for mental health problems and service engagement in youth and adults. Our search yielded 24 systematic reviews of SSIs, which included 415 unique trials. Twenty reviews (83.33%) reported significant, positive effects of SSIs for one or more outcomes (anxiety, depression, externalizing problems, eating problems, substance use, treatment engagement or uptake). Across 12 reviews that meta-analytically examined SSIs’ effectiveness relative to controls, SSIs showed a positive effect across outcomes and age groups (standardized mean difference = −0.25, I2 = 43.17%). Per AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews), some methodological concerns emerged across reviews, such as low rates of preregistration. Overall, findings support the clinical utility of SSIs for certain psychological problems and populations. Implementation research is needed to integrate effective SSIs into systems of care.
{"title":"Single-Session Interventions for Mental Health Problems and Service Engagement: Umbrella Review of Systematic Reviews and Meta-Analyses","authors":"Jessica L. Schleider, Juan Pablo Zapata, Andy Rapoport, Annie Wescott, Arka Ghosh, Benji Kaveladze, Erica Szkody, Isaac L. Ahuvia","doi":"10.1146/annurev-clinpsy-081423-025033","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-081423-025033","url":null,"abstract":"Most people with mental health needs cannot access treatment; among those who do, many access services only once. Accordingly, single-session interventions (SSIs) may help bridge the treatment gap. We conducted the first umbrella review synthesizing research on SSIs for mental health problems and service engagement in youth and adults. Our search yielded 24 systematic reviews of SSIs, which included 415 unique trials. Twenty reviews (83.33%) reported significant, positive effects of SSIs for one or more outcomes (anxiety, depression, externalizing problems, eating problems, substance use, treatment engagement or uptake). Across 12 reviews that meta-analytically examined SSIs’ effectiveness relative to controls, SSIs showed a positive effect across outcomes and age groups (standardized mean difference = −0.25, <jats:italic>I</jats:italic> <jats:sup>2</jats:sup> = 43.17%). Per AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews), some methodological concerns emerged across reviews, such as low rates of preregistration. Overall, findings support the clinical utility of SSIs for certain psychological problems and populations. Implementation research is needed to integrate effective SSIs into systems of care.","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"118 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054859","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 : 2025-01-21DOI: 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.
{"title":"Personality Disorders: Current Conceptualizations and Challenges","authors":"Thomas A. Widiger, Michelle Smith","doi":"10.1146/annurev-clinpsy-081423-030513","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-081423-030513","url":null,"abstract":"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 <jats:italic>Diagnostic and Statistical Manual of Mental Disorders</jats:italic> (DSM-5) for emerging models and in the 11th edition of the <jats:italic>International Classification of Diseases</jats:italic> (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.","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"11 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142992771","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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