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Cognitive-Behavioral Therapy for Complicated Grief Reactions: Treatment Protocol and Preliminary Findings From a Naturalistic Setting 针对复杂悲伤反应的认知行为疗法:自然环境下的治疗方案和初步结果
IF 2.9 3区 心理学 Q1 Psychology Pub Date : 2023-12-13 DOI: 10.1016/j.cbpra.2023.11.001
Katrine B. Komischke-Konnerup, Maja O'Connor, Herbert Hoijtink, Paul A. Boelen

In bereavement, some individuals develop complicated grief reactions (CGR), including symptoms of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depression. Symptoms of PGD often co-occur with other complicated grief reactions, e.g., PTSD and depression, pointing to the need for a transdiagnostic understanding of CGR to inform treatment. In this paper, a transdiagnostic cognitive-behavioral therapy for CGR called “CBTgrief” is explained, including its theoretical framework and treatment content. CBTgrief is based on previous cognitive-behavioral conceptualizations of PGD, PTSD, and depression and includes 12 sessions consisting of exposure, cognitive restructuring, and behavioral activation. Preliminary findings of CBTgrief are evaluated in terms of feasibility, acceptability, and treatment satisfaction in a sample of eight older bereaved individuals treated for different types of CGR in a naturalistic clinical setting. Additionally, theory-driven hypotheses about changes in CGR and theoretical proposed core maintaining processes are evaluated using Bayesian informative hypotheses testing. Preliminary findings, limitations, implications, and future directions are discussed.

在丧亲之痛中,有些人会出现复杂悲伤反应(CGR),包括长期悲伤障碍(PGD)、创伤后应激障碍(PTSD)和抑郁症状。PGD 的症状经常与其他复杂悲伤反应(如创伤后应激障碍和抑郁症)同时出现,这表明需要对 CGR 进行跨诊断理解,以便为治疗提供依据。本文解释了一种针对 CGR 的跨诊断认知行为疗法 "CBTgrief",包括其理论框架和治疗内容。CBTgrief 基于之前对创伤后应激障碍、创伤后应激障碍和抑郁症的认知行为概念,包括 12 个疗程,包括暴露、认知重组和行为激活。在一个自然的临床环境中,对 8 名因不同类型的 CGR 而接受治疗的老年丧亲者进行了抽样调查,从可行性、可接受性和治疗满意度等方面对 CBTgrief 的初步研究结果进行了评估。此外,还使用贝叶斯信息假设检验法评估了有关 CGR 变化和理论上提出的核心维持过程的理论驱动假设。本文讨论了初步研究结果、局限性、影响和未来发展方向。
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引用次数: 0
Preliminary Investigation of the Influence of Treatment Regimen on Outcomes in Behavioral Parent Training 行为父母培训中治疗方案对结果影响的初步调查
IF 2.9 3区 心理学 Q1 Psychology Pub Date : 2023-12-01 DOI: 10.1016/j.cbpra.2023.09.003
Matthew L. Edelstein, Joshua A. Mellott

Caregiver engagement and implementation of behavioral strategies are essential to effective interventions targeting childhood behavior problems. The aim of this preliminary investigation was to better understand caregiver decision-making when selecting different treatment regimens in an open trial format. Treatment packages included: (1) an intensive treatment program (ITP), involving a compressed 20-hour intervention occurring 2 hours per day for 10 days; and (2) a standard dosage treatment as usual (TAU) behavioral treatment program, involving weekly 50-minute appointments. Sixty-seven families with a child between 4–11 years old (M age = 5.82) with clinically significant problem behaviors self-referred to a hospital-based outpatient behavior therapy program. Results suggest that while caregivers chose a standard treatment regimen at a ratio of 2:1, compressed treatment (ITP) was associated with increased caregiver engagement and more significant reductions in child target behavior using both direct and indirect measures. Findings provide preliminary support for the use of high dosage treatment regimens as a means of increasing caregiver engagement and in the reduction of problem behavior in young children.

照顾者的参与和行为策略的实施对于有效干预儿童行为问题至关重要。这项初步调查旨在更好地了解护理人员在以开放试验的形式选择不同治疗方案时的决策。治疗方案包括(1)强化治疗方案(ITP),包括为期10天、每天2小时的20小时压缩干预;(2)标准剂量照常治疗(TAU)行为治疗方案,包括每周50分钟的预约。67个家庭的孩子年龄在4-11岁之间(平均年龄为5.82岁),有明显的临床问题行为,这些家庭自我推荐参加医院的门诊行为治疗项目。结果表明,虽然照顾者选择标准治疗方案的比例为 2:1,但压缩治疗(ITP)与照顾者参与度的提高以及使用直接和间接测量方法对儿童目标行为的显著减少有关。研究结果为使用高剂量治疗方案作为提高护理人员参与度和减少幼儿问题行为的手段提供了初步支持。
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引用次数: 0
Acceptability of Men’s Externalizing Depression Constructs Among Black American Men and Middle-Aged and Older White Men 美国黑人男性和中老年白人男性外化抑郁结构的可接受性
3区 心理学 Q1 Psychology Pub Date : 2023-11-01 DOI: 10.1016/j.cbpra.2023.08.004
Douglas Gazarian
Research on the dissemination and implementation of gender-based care for men has rarely considered diversity within the male-identifying population. The present study evaluated the acceptability of men’s externalizing depression (MED) constructs across purposive samples of men understudied in the MED literature and at higher risk for MED-related outcomes (Black American men and middle-aged and older White men). Following brief psychoeducation, participants rated MED constructs for comprehensibility and perceived clinical value. Using a convergent mixed-methods design, we examined how attitudes varied by sample and experimentally-manipulated psychoeducational variables pertaining to different MED conceptual models. Across samples and psychoeducation conditions, we observed similarly strong levels of acceptability for MED as a gender-based conceptualization of internalizing-externalizing symptoms. Small differences emerged as a function of sample-psychoeducation interactions. Quantitative and qualitative data converged to suggest race-gender intersections influence men’s construal of psychological symptoms. Overall, results supported MED as an acceptable formulation of symptoms across multiple subpopulations of men in the context of an international, online community sample.
对男性基于性别的护理的传播和实施的研究很少考虑到男性认同人口中的多样性。本研究评估了男性外化抑郁(MED)结构的可接受性,目的样本为MED文献中未被充分研究的男性和MED相关结果风险较高的男性(美国黑人男性和中老年白人男性)。经过简短的心理教育后,参与者对MED构念的可理解性和感知的临床价值进行评分。采用融合混合方法设计,我们研究了态度如何随样本和实验操纵的心理教育变量而变化,这些变量与不同的MED概念模型有关。在样本和心理教育条件下,我们观察到MED作为一种基于性别的内化-外化症状的概念化,同样具有很强的可接受性。作为样本-心理教育互动的功能,微小的差异出现了。定量和定性的数据显示,种族和性别的交集会影响男性对心理症状的解释。总体而言,在国际在线社区样本的背景下,结果支持MED在多个男性亚群中作为一种可接受的症状表述。
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引用次数: 0
Reduction in Feeding Problems and Impact on Family Following a 12-Week Interdisciplinary Group Feeding Intervention for Children With Feeding Problems and Their Caregivers 对有喂养问题的儿童及其照顾者进行为期12周的跨学科小组喂养干预后,喂养问题的减少及其对家庭的影响
3区 心理学 Q1 Psychology Pub Date : 2023-11-01 DOI: 10.1016/j.cbpra.2023.07.002
Olivia Hsin, Haven Qualman, Ayala Ben-Tall, James A. Proudfoot, Adam Khan
Caregivers and their children with clinical levels of feeding problems participated in Picnic Group, an outpatient interdisciplinary family group treatment program for children with feeding disorders and their caregivers at a large regional pediatric hospital. The manualized treatment is based on an interdisciplinary systematic approach that draws from sensory integration, communication, and cognitive behavioral strategies (e.g., classical conditioning, systematic desensitization, communication of automatic thoughts) to increase pleasurable interactions with food over a 12-week period and includes caregiver and child intervention components. Escape extinction techniques such as nonremoval of the spoon were not used in treatment. Caregivers completed measures focused on their children’s feeding behaviors and family strain at baseline and at the end of the 12-week intervention. Wilcoxon signed-rank tests compared measures between baseline and the end of treatment. Results indicated that at the 12th week, caregivers generally reported one less feeding problem, fewer specific types of eating and mealtime problematic behaviors, and decreased impact of feeding problems on the family. Children were able to work up a hierarchy of food interactions with more foods per group session than at the first session. Caregivers of children with a developmental diagnosis showed the most decrease in caregiver strain. Outpatient interdisciplinary group treatment can decrease feeding problems and caregiver strain in families with children with feeding disorders.
护理人员及其有临床喂养问题的孩子参加了野餐小组,这是一家大型地区儿科医院针对喂养障碍儿童及其护理人员的门诊跨学科家庭小组治疗项目。手动治疗基于跨学科的系统方法,该方法从感觉整合,沟通和认知行为策略(例如,经典条件反射,系统脱敏,自动思维的沟通)中提取,以在12周的时间内增加与食物的愉快互动,包括护理人员和儿童干预成分。在治疗中没有使用诸如不移除勺子之类的逃逸消除技术。护理人员在基线和12周干预结束时完成了针对儿童喂养行为和家庭压力的测量。Wilcoxon符号秩检验比较基线和治疗结束时的测量值。结果表明,在第12周,照顾者普遍报告的喂养问题减少了一次,具体类型的饮食和用餐时间问题行为减少了,喂养问题对家庭的影响也减少了。孩子们能够建立起食物互动的层次结构,每次小组会议比第一次会议有更多的食物。发展性诊断儿童的照顾者压力减少最多。门诊跨学科团体治疗可以减少喂养问题和照顾者压力的家庭与儿童喂养障碍。
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引用次数: 0
Cover 2: Editorial Board 封面2:编辑部
IF 2.9 3区 心理学 Q1 Psychology Pub Date : 2023-10-12 DOI: 10.1016/S1077-7229(23)00067-6
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引用次数: 0
Reconnecting Hope: The Treatment of Eating Disorders in Rural America 重新连接希望:美国农村饮食失调的治疗
3区 心理学 Q1 Psychology Pub Date : 2023-09-01 DOI: 10.1016/j.cbpra.2023.08.001
Jenny E. Copeland, Jacob Hefner, Sarah E. Estep, Carolyn Black Becker
Eating disorders (EDs), a significant public health concern, impact millions of Americans every year. Many people with EDs are often overlooked for multiple reasons, including the stereotype that EDs predominantly affect thin, White, affluent young women and girls. One historically overlooked group is impoverished individuals in rural areas of the United States (U.S.), who may, in fact, be at an increased risk for EDs. The Reconnect Eating Disorders treatment program (REDTP) at Ozark Center is the first comprehensive, evidence-based, multidisciplinary ED treatment program to be developed in a Certified Community Behavioral Health Organization (CCBHO) in the U.S. CCBHOs are a unique model of financially sustainable integrated care well-suited to the treatment of biopsychosocial illnesses such as EDs because CCBHOs offer a full range of services to treat both physical and mental health. This paper details the development of REDTP, including its team, barriers, and successes. The role of Community Support Specialists/Reconnect Coaches and Healthcare Home/Medical Support is reviewed, which includes providing outpatient care and intensifying treatment for the most acute clients. Key domains of growth for REDTP included selecting core evidence-based treatments, building a team and defining team roles, and intensive training to develop evidence-based ED expertise. Persistent barriers included staffing limitations for providing intensive treatment to a small number of clients. Adult case studies of REDTP clients are presented. Recommendations for future ED and other specialized treatment programs in low resource agencies are provided.
饮食失调(EDs)是一个重大的公共卫生问题,每年影响数百万美国人。由于多种原因,许多患有急症的人经常被忽视,其中包括一种刻板印象,即急症患者主要是瘦弱、富裕的白人年轻女性和女孩。一个历来被忽视的群体是美国农村地区的贫困人群,事实上,他们患ed的风险可能会增加。Ozark中心的重新连接饮食失调治疗计划(REDTP)是美国认证社区行为健康组织(CCBHO)开发的第一个全面的,基于证据的,多学科的ED治疗计划。CCBHO是一个独特的经济可持续的综合护理模式,非常适合治疗生物心理社会疾病,如ED,因为CCBHO提供全方位的服务来治疗身体和心理健康。本文详细介绍了REDTP的开发,包括它的团队、障碍和成功。回顾了社区支持专家/重新连接教练和保健之家/医疗支持的作用,其中包括提供门诊护理和加强对最急性客户的治疗。REDTP增长的关键领域包括选择核心循证治疗,建立团队并定义团队角色,以及强化培训以发展循证ED专业知识。持续存在的障碍包括为少数病人提供强化治疗的人员配备限制。介绍了REDTP客户的成人案例研究。对未来的ED和其他专业治疗方案在低资源机构提供了建议。
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引用次数: 0
Development and Pilot Test of a Therapist-Assisted Self-Management Program for Completers of Trauma-Focused Therapy for Posttraumatic Stress Disorder 创伤后应激障碍创伤集中治疗完成者治疗师辅助自我管理计划的开发和试点测试
IF 2.9 3区 心理学 Q1 Psychology Pub Date : 2023-09-01 DOI: 10.1016/j.cbpra.2023.08.002
S. Kehle-Forbes, Tara Galovski, Melissa A. Polusny, Kyle Possemato, Sean Nugent, Eliza McManus, Allison L. Baier
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引用次数: 0
The Impact of Exposure Therapy on Cancer-Related Future Cognitions in Severe Health Anxiety 暴露疗法对严重健康焦虑患者癌症相关未来认知的影响
3区 心理学 Q1 Psychology Pub Date : 2023-09-01 DOI: 10.1016/j.cbpra.2023.07.001
Nora Brier, Lily A. Brown
Individuals with illness anxiety disorder (IAD) experience a preoccupation with having or acquiring a serious illness despite having mild or absent physical symptoms. Formerly hypochondriasis, individuals with IAD experience high rates of disability, contribute to elevated annual health care costs, and experience multiple comorbidities. IAD has been historically difficult to treat for both medical and mental health providers. Research suggests cognitive behavior therapy has mixed results for individuals with IAD. In this fictitious case presentation, we describe a course of successful exposure therapy for IAD drawing on the principals of inhibitory learning theory. Thus, through this example we demonstrate how to overcome common obstacles to successful treatment for IAD, such as willingness to participation, comorbid depression, and therapeutic alliance.
患有疾病焦虑障碍(IAD)的个体尽管有轻微或没有身体症状,但仍然对患有或获得严重疾病感到担忧。以前患有疑病症的IAD患者致残率高,导致年度卫生保健费用增加,并伴有多种合并症。从历史上看,对医疗和精神卫生提供者来说,IAD都是难以治疗的。研究表明,认知行为疗法对IAD患者的效果好坏参半。在这个虚构的案例介绍中,我们描述了一个成功的暴露治疗过程,利用抑制学习理论的原则。因此,通过这个例子,我们展示了如何克服成功治疗IAD的常见障碍,如参与意愿、共病抑郁症和治疗联盟。
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引用次数: 0
Using Visual Displays in a Manualized Cognitive-Behavioral Treatment for Adults With ADHD and Comorbid Mood or Anxiety Disorders: A Pilot Study 视觉显示在成人多动症和共病情绪或焦虑障碍的人工认知行为治疗中的应用:一项初步研究
IF 2.9 3区 心理学 Q1 Psychology Pub Date : 2023-09-01 DOI: 10.1016/j.cbpra.2023.08.003
Antonio F. Pagán, G. H. Mumma, Andrew K. Littlefield
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引用次数: 0
Clinical Effectiveness of an Intensive Outpatient Program for Integrated Treatment of Comorbid Substance Abuse and Mental Health Disorders 强化门诊综合治疗合并药物滥用和精神健康障碍的临床疗效
IF 2.9 3区 心理学 Q1 Psychology Pub Date : 2023-08-01 DOI: 10.1016/j.cbpra.2022.05.005
Laura E. Watkins, Samantha C. Patton, Karen Drexler, Sheila A.M. Rauch, Barbara O. Rothbaum

Comorbid substance use disorders (SUDs) and mental health disorders are a pervasive problem among post-9/11 veterans and service members. Treatment of SUD and comorbid disorders has historically occurred separately and sequentially, and when treated concurrently has been primarily done in a weekly outpatient setting, which has high rates of dropout. The current study describes an integrated 2-week intensive outpatient treatment (IOP) using cognitive-behavioral therapy, including prolonged exposure for posttraumatic stress disorder (PTSD), unified protocol for anxiety and mood disorders, and relapse prevention for SUD. Forty-two patients completed the comorbid treatment program. Results indicated that self-reported substance use, PTSD, and depression symptoms significantly decreased following treatment, while satisfaction with participation in social roles increased. These preliminary effectiveness data indicate that comorbid SUD and mental health disorders can be effectively treated in a 2-week intensive outpatient program.

共病性物质使用障碍(sud)和精神健康障碍是9/11后退伍军人和服役人员中普遍存在的问题。从历史上看,SUD和合并症的治疗是分开和顺序进行的,当同时治疗时,主要是在每周一次的门诊环境中进行,这有很高的辍学率。目前的研究描述了一种综合的2周强化门诊治疗(IOP),使用认知行为疗法,包括创伤后应激障碍(PTSD)的长时间暴露,焦虑和情绪障碍的统一方案,以及SUD的复发预防。42名患者完成了共病治疗方案。结果表明,自我报告的物质使用、创伤后应激障碍和抑郁症状在治疗后显著减少,而参与社会角色的满意度增加。这些初步的有效性数据表明,合并症的SUD和精神健康障碍可以在为期2周的强化门诊项目中得到有效治疗。
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引用次数: 2
期刊
Cognitive and Behavioral Practice
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