Psychology and Psychotherapy-Theory Research and Practice最新文献

Objectives

To evaluate the effectiveness of inpatient cognitive analytic therapy (CAT) for functional neurological disorder and associated suicidality.

Design

A single case experimental A-B-C plus follow-up design. Intervention phases (A-B-C) were conducted on a psychiatric ward, with the 1-month follow-up (FU) phase in the community.

Methods

The intervention was eight-session CAT. The ABC phases of the SCED were synchronized with the reformulation, recognition and revision phases of the CAT. Idiographic anxiety, depression, burden, emotion regulation, distrust and frequency counts of epileptic and functional seizures were measured daily for N = 61 days across all the phases of the study. Recognition and revision of target problems (TPs) and target problem procedures (TPPs) were rated at each session. The PHQ-9 and GAD-7 were completed at assessment, end of therapy and follow-up. A change interview was conducted at the point of discharge from the ward and at follow-up.

Results

The number of seizure-free days did not change markedly. Recognition and revision of TP and TPPs increased positively over time and according to the phase of CAT. Daily depression significantly improved, but there was less change in other idiographic measures. There was a reliable improvement in PHQ-9 and GAD-7 scores. Personal changes at end of therapy and at follow-up were described in the change interview as important, impactful and unlikely without therapy.

Conclusions

The outcome picture was complex, with evidence of significant change on some indices and little change on others. This suggests a partially effective intervention. Inpatient CAT and also CAT as an FND intervention both seem to hold promise, but clearly more controlled research is needed.

Objective

Although there is notable evidence supporting the importance of the therapeutic alliance and therapist presence in psychotherapy practice, the question of how these factors interact dynamically over time remains to be answered. This study investigated how therapists adjust their presence in response to client distress and how this responsive pattern is moderated by therapeutic alliance during the beginning phase of psychotherapy.

Method

Pre-session symptom measurements and post-session ratings of therapist presence and alliance were collected across the first five consecutive sessions from 46 clients and 22 novice therapists, allowing examination of temporal sequences in therapeutic processes.

Results

Therapists' presence increased in response to higher pre-session symptom levels, with this responsive pattern evolving over time. This relationship was moderated by therapeutic alliance, with stronger alliance providing a context that attenuated the presence-symptom association. Notably, therapist ratings showed stronger predictive relationships with outcomes than client ratings, possibly reflecting the unique observational capacity of therapists in their earliest professional encounters.

Conclusion

These findings demonstrated how therapist presence operates as a dynamic, responsive intervention rather than a static therapeutic factor, suggesting that alliance functions as a contextual moderator rather than merely a direct predictor of outcome.

Objectives

Eye movement desensitization and reprocessing (EMDR) is an effective evidence-based treatment for post-traumatic stress disorder. However, the therapeutic mechanisms underlying eye movements (EM) remain unclear. This study aimed to investigate the effect of horizontal EM on fear extinction learning in healthy individuals, using an Eye Blink Conditioning (EBC) task. This experimental paradigm has been widely used to explore associative fear learning and memory as a form of classical conditioning.

Methods

Healthy participants were included to the study protocol and divided randomly into two groups. The EM group (n = 20) were asked to follow horizontally the experimenter's moving finger at the beginning of the extinction phase and the control group (n = 19) did not engage in any specific task. Sociodemographic and clinical information was collected. Percentage of conditioned response (CR) occurrence, time of onset and intensity between and within groups over longitudinal time were analysed using generalized multilevel mixed effects for repeated measures.

Results

Results showed accelerated extinction learning in the EM group, with an 18.2% probability of CR occurrence in the first block of extinction, compared to the control group (40.9%) (p-value = .007).

Conclusions

The findings indicate that horizontal EM accelerates the extinction process in the EBC task. Therefore, this paradigm, used for studying associative learning and memory, could serve as an objective measure to investigate the mechanisms of action involved in desensitizing traumatic experiences during EMDR treatment.

Objective

Empathy is a critical skill for effective counselling, yet novice counsellors often struggle to develop it. Traditional training methods may not sufficiently address the complexities of empathic development. This study aims to develop and assess an empathy training programme using machine learning (ML) and natural language processing (NLP) to enhance empathy in novice counsellors.

Methods

We developed the ‘Empathy Feedback’ WeChat mini-programme to provide real-time feedback through counselling exercises. In a randomized controlled trial (RCT), 143 participants were randomly assigned to one of four groups: control, feedback, practice or feedback-practice. Over 5 days, participants completed daily empathy exercises through the mini-programme. Empathy levels, as measured by the Helpful Responses Questionnaire (HRQ), and self-efficacy were assessed immediately post-intervention and at a 2-week follow-up.

Results

Significant improvements in empathy and HRQ scores were observed in the experimental groups compared to the control group (p < .05), but no changes were found in self-efficacy scores.

Conclusions

The AI-driven empathy training programme effectively enhanced empathic skills among novice counsellors, demonstrating the potential of integrating machine learning and NLP into counsellor education. The lack of change in self-efficacy suggests that additional strategies may be needed to boost counsellors' confidence in applying these skills in practice.

Over recent decades, there has been more evidence of the connection between trauma and depression. More research is needed on the relationship between different types of trauma and their combination (cumulative trauma) with respect to the severity of depressive symptoms. The extent to which trauma and cognitive processes that manifest as polarised or ‘black and white’ thinking affect the severity of depression has yet to be explored.

Objective

The objective of this research was to examine the impact of cumulative trauma and polarised thinking on the severity of depressive symptoms.

Method

In total, 172 patients, mostly women, with a diagnosis of Major Depressive Disorder or Dysthymia (or both) were evaluated using the Cumulative Trauma Scale. The Repertory Grid Technique was used to measure polarised thinking, and the Beck Depression Inventory-II was used to assess the severity of depressive symptoms.

Results

The severity of depressive symptoms was strongly associated with a high level of polarised thinking and a high frequency of perceived negative trauma.

Conclusions

Our findings underscore the need to address polarised thinking and trauma (when present) as a target of interventions aimed at reducing depression symptoms.

Background

Greater Intolerance of Uncertainty (IU: the tendency to find uncertainty negative) is associated with greater paranoia (mistrust of others) in clinical samples with schizophrenia spectrum disorders (SSDs). Questions remain on whether the relationship between IU and paranoia/prodromal symptoms is: (1) specific over other related negative affective traits and cognitive biases, and (2) specific to SSDs or is transdiagnostic.

Methods

To examine these research questions, we conducted a survey in those with SSDs (n = 103), anxiety disorders (n = 102) a non-clinical sample (n = 102). Questionnaires included: IU, paranoia, prodromal symptoms of schizophrenia, neuroticism and jumping to conclusions bias.

Results

IU, neuroticism and jumping to conclusions bias were elevated in those with SSDs and anxiety disorders, compared to the non-clinical group. Both paranoia and prodromal symptoms were highest in those with SSDs, then anxiety disorders and lowest in the non-clinical group. Greater IU was associated with greater paranoia and prodromal symptoms across SSDs, anxiety disorders and a non-clinical sample. The majority of the relationships between IU and paranoia/prodromal symptoms remained significant when controlling for neuroticism and the jumping to conclusions bias. However, the relationship between IU and paranoia in the SSD group was not specific over the jumping to conclusions bias.

Discussion

These findings highlight the potentially transdiagnostic role of IU in paranoia/prodromal symptoms across SSDs and anxiety disorders, which has implications for the development of transdiagnostic treatment interventions for SSDs and anxiety disorders.

Introduction

Cisnormativity is a sociocultural narrative that contributes to the marginalisation of transgender and gender diverse (TGD) people. The schema therapy model theorises that humans have five core emotional needs that must be met to support psychological well-being. Experiences of marginalisation may result in TGD people feeling as if their core emotional needs are not being met. Integrating the schema therapy model with an ecological systems perspective, this study aimed to examine how manifestations of cisnormativity across different levels of the social ecology impact the extent to which TGD people feel their core emotional needs are met.

Methods

An online qualitative survey was completed by 101 TGD adults, and the data were analysed using reflexive thematic analysis.

Results

Cisnormativity greatly impacted TGD people in ways that reflected the denial of numerous core emotional needs under the schema therapy model. The frustration of these needs was represented in four themes: disconnection and rejection; representation and reputation; suppressing and performing gender; and autonomy. The sources for these unmet needs were present across multiple levels of people's ecological systems.

Conclusion

Integrating an ecological systems perspective with the schema model demonstrated how the sociocultural context can directly and indirectly interfere with the meeting of core emotional needs. Some of the needs constructs demonstrated conceptual overlap, necessitating further investigation of the schema therapy model. This study documented the wide-ranging impacts of cisnormativity on TGD people, highlighting novel considerations that should be incorporated into the schema therapy model and models of TGD mental health and well-being.

Background

Negative emotions and stress are theorised to play a role in the onset and maintenance of voice-hearing experiences. However, previous research has not explored these temporal relationships in daily life using differentiated psychological constructs.

Aim

Using ecological momentary assessment, this study examined the moment-to-moment relationships between negative and positive emotion valence and intensity, stressful and pleasurable events, and voice-hearing onset.

Materials & Methods

Forty voice-hearers completed seven days of smartphone-based surveys, rating their emotions and their intensity, perceived stress and pleasure of life events, and presence of voice-hearing.

Results

Multilevel modelling showed that stressful events, but not pleasurable events, were significantly predictive of voice-hearing, both concurrently and in the next time point. Neither negative nor positive emotion intensity predicted voice-hearing, nor did they moderate the relationship between voice-hearing onset and stressful or pleasurable events, respectively.

Discussion

These findings suggest that factors which differentiate perception of stressful events from self-reported negative emotions may be useful intervention targets, such as mitigating prolonged external stressors, reducing sensitivity to external stressors and targeting negative perceptions or resistance to these stressors.

Conclusion

Clinically, our findings underscore the relevance of stress and a negative perception of externally oriented events, with further research needed to explore useful interventions for targeting these mechanisms.