Psychology and Psychotherapy-Theory Research and Practice最新文献_第8页

Associations between treatment credibility, patient expectancies, working alliance and symptom trajectory in cognitive behaviour therapy for pathological health anxiety 病理性健康焦虑认知行为治疗中治疗可信度、患者期望、工作联盟与症状轨迹的关系

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-03-27 DOI: 10.1111/papt.12591

Erland Axelsson, Erik Hedman-Lagerlöf

Objectives

To evaluate how treatment credibility, the expectancy of improvement and the relationship with the therapist (the working alliance) change in relation to symptoms in cognitive behaviour therapy (CBT) for pathological health anxiety.

Design

Secondary study of a randomised controlled trial of Internet-delivered (n = 102) and face-to-face CBT (n = 102) for health anxiety.

Methods

The trial was conducted at a primary health care clinic in Stockholm, Sweden, between December 2014 and July 2018. Both treatments lasted 12 weeks. Health anxiety was measured using the 18-item Health Anxiety Inventory. Credibility/expectancy (Borkovec credibility/expectancy scale) and the strength of the working alliance (Working Alliance Inventory) were self-reported by the participant at weeks two and eight. Symptom slopes from a linear mixed model were related to these process scales.

Results

Correlations between the process variables (credibility/expectancy, working alliance) and the overall, 12-week pre- to post-treatment, reduction in health anxiety were small to moderate, and slightly higher based on data from week 8 (rs = 0.33–0.41) than week 2 (rs = 0.17–0.29). In the whole sample, week 2 credibility/expectancy and working alliance were significant predictors of subsequent symptom reduction. In secondary subgroup analyses, the process variables predicted improvement in Internet-delivered CBT, but not in face-to-face CBT. Direct between-format tests were not significant. Week 8 credibility/expectancy and working alliance were more closely related to previous than subsequent symptom reduction.

Conclusions

The patient's early ratings of credibility/expectancy and the strength of the working alliance appear to be predictive of subsequent symptom reduction. Later ratings appear to be of more limited predictive utility.

目的：评价认知行为疗法（CBT）治疗病理性健康焦虑的治疗可信度、改善期望和与治疗师（工作联盟）的关系变化与症状的关系。设计：对互联网提供（n = 102）和面对面CBT （n = 102）治疗健康焦虑的随机对照试验进行二次研究。方法：该试验于2014年12月至2018年7月在瑞典斯德哥尔摩的一家初级卫生保健诊所进行。两种治疗均持续12周。健康焦虑采用18项健康焦虑量表进行测量。可信性/期望（Borkovec可信性/期望量表）和工作联盟强度（工作联盟量表）由参与者在第2周和第8周自我报告。线性混合模型的症状斜率与这些过程尺度有关。结果：过程变量（可信度/期望，工作联盟）与总体，治疗前后12周健康焦虑减少之间的相关性为小至中度，根据第8周的数据（rs = 0.33-0.41）略高于第2周（rs = 0.17-0.29）。在整个样本中，第2周的可信度/期望和工作联盟是随后症状减轻的显著预测因子。在次级亚组分析中，过程变量预测了网络提供的CBT的改善，而不是面对面的CBT。直接格式间检验无显著性差异。第8周的可信度/期望和工作联盟与先前的症状减轻比随后的症状减轻更密切相关。结论：患者早期的可信度/期望评分和工作联盟的强度似乎可以预测随后的症状减轻。后来的评级的预测效用似乎更有限。

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引用次数: 0

Modelling the longitudinal associations between schizotypy and aberrant salience: The role of mentalization and attachment 精神分裂症与异常显著性之间的纵向关联建模：心理化和依恋的作用。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-03-21 DOI: 10.1111/papt.12589

Ercan Ozdemir, Angus MacBeth, Helen Griffiths

Objectives

This study investigates the role of mentalization and attachment in the development of schizotypy into aberrant salience. Specifically, we examine how disruptions in these socio-cognitive capacities interact with multidimensional schizotypy to influence self-fragmentation, emotional instability and social detachment.

Method

Study variables were measured using self-report scales. A two-wave cohort study design was implemented with a 9-month assessment interval. The cross-sectional and longitudinal associations between mentalizing, attachment, negative affect, aberrant salience and schizotypy were estimated using network modelling.

Results

The study involved 312 participants aged 18–37 years, with 77% identifying as female and 57% receiving mental health treatment during the follow-up period. Results indicated that mentalizing capacity was central in linking concurrent negative affect, attachment and psychosis risk and served as a temporal bridge connecting multiple dimensions of psychosis risk.

Conclusion

Mentalizing difficulties can heighten psychosis risk by maintaining affective dysregulation and consolidating schizotypy. The results may be influenced by potential sampling errors, as indicated by the analyses of network stability and accuracy. Interventions promoting mentalizing capacity may attenuate psychosis risk.

目的：探讨精神化和依恋在精神分裂型向异常显著性发展过程中的作用。具体而言，我们研究了这些社会认知能力的中断如何与多维分裂型相互作用，从而影响自我分裂、情绪不稳定和社会脱离。方法：采用自述量表测量研究变量。采用两波队列研究设计，评估间隔为9个月。利用网络模型估计了心理化、依恋、负面情绪、异常显著性和分裂型之间的横断面和纵向关联。结果：该研究涉及312名年龄在18-37岁之间的参与者，其中77%为女性，57%在随访期间接受了心理健康治疗。结果表明，心智化能力是连接并发负性情感、依恋和精神病风险的中心，是连接多个维度精神病风险的时间桥梁。结论：精神化困难可通过维持情感失调和巩固分裂型而增加精神病风险。从网络稳定性和准确性的分析中可以看出，潜在的抽样误差可能会影响结果。提高心智化能力的干预措施可能会降低精神病的风险。

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引用次数: 0

Between personal and professional involvement: A qualitative interview study on insights of novice and experienced therapists in Alliance ruptures 在个人介入与专业介入之间：新手与资深治疗师对联盟破裂的看法之质性访谈研究。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-03-10 DOI: 10.1111/papt.12587

Jelka Alice Berger, Lilli Katharina Kalmbach, Nadja Samia Bahr, Bernhard Strauß, Antje Gumz

Objectives

This study aimed to examine therapists' personal involvement in alliance ruptures, considering their level of experience by capturing their subjective perceptions through qualitative interviews.

Method

We conducted 23 interviews, which were subsequently analysed using Consensual Qualitative Research (CQR; American Psychological Association, 2012). Following that, group differences based on therapeutic experience were examined.

Results

The data analysis revealed a total of five overarching domains: characteristics of the initial therapeutic relationship, emotional reactions, attempts to repair the rupture, involvement in the rupture, and benefits and challenges of supervision, intervision, and personal therapy in managing ruptures. Although therapists generally considered the clients' disturbance as a contribution, 20 therapists also reported their own biographical issues that were triggered during the rupture. Experienced therapists reported biographical triggers more frequently and mentioned self-disclosure more often in dealing with the rupture than novice therapists.

Conclusion

The results of the qualitative study suggest that experienced therapists demonstrate a deeper personal involvement in reflecting on the causes of ruptures and in their efforts to repair them. It appears that experienced therapists have a stronger integration of personal and professional selves, whereas novice therapists tend to keep the two more separate. This should be considered in training and practice by dismantling the sharp divide between professional (supervision) and personal (personal therapy) development.

目的：本研究旨在考察治疗师在联盟破裂中的个人参与，考虑到他们的经验水平，通过定性访谈捕捉他们的主观感知。方法：我们进行了23次访谈，随后使用共识定性研究(Consensual Qualitative Research， CQR；美国心理学会，2012)。随后，基于治疗经验的组间差异被检查。结果：数据分析共揭示了五个主要领域：初始治疗关系的特征、情绪反应、修复破裂的尝试、破裂的参与、监督、面谈和个人治疗在处理破裂中的益处和挑战。虽然治疗师通常认为来访者的困扰是一个因素，但20名治疗师也报告了他们自己的传记问题，这些问题在破裂期间被触发。经验丰富的治疗师在处理破裂时比新手治疗师更频繁地报告传记触发因素，并更频繁地提到自我表露。结论：定性研究的结果表明，经验丰富的治疗师在反思破裂的原因并努力修复它们时表现出更深层次的个人参与。经验丰富的治疗师似乎更能将个人自我和职业自我结合起来，而新手治疗师则倾向于将两者分开。在培训和实践中应该考虑到这一点，消除专业（监督）和个人（个人治疗）发展之间的明显鸿沟。

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引用次数: 0

Compassion focused therapy for older people: Why it is needed and adaptations for clinical practice 针对老年人的同情疗法：为什么需要它以及临床实践中的调整。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-03-10 DOI: 10.1111/papt.12579

Rebecca Poz, Catriona Craig

Background

Compassion-focused therapy (CFT) has an emerging evidence base and is becoming an increasingly popular therapeutic modality. The journey through later life poses individuals with various challenges to navigate, including loss of roles and relationships, deteriorating physical health and cognition and death of friends and family members. In addition to any unprocessed challenges lived through in earlier life. Later life is also a unique period where reflection on one's life experiences and choices can occur, which can lead to feelings of regret, disappointment and shame for some, whilst simultaneously facing ageism and barriers to accessing therapy. CFT is well-placed to facilitate older people to face these challenges by exploring their relationship to themselves and others as they navigate ageing. This is increasingly important as we are living longer and more and more older people develop conditions where they will require care. Developing greater compassion for oneself and allowing ourselves to be cared for by others may facilitate a smoother journey and minimise distress.

Methodology

The paper summarises the published work trialling CFT across a range of older patient groups, which shows that older people are open to a CFT approach, they find it an acceptable intervention and it has had wide-reaching benefits. There remains a paucity of high-quality research delivering CFT to older people which limits our conclusions of its effectiveness.

Recommendations

Recommendations of ways in which CFT can be adapted for older people and those living with dementia, consistent with Gilbert's therapeutic themes (2022), are provided.

背景：以同情为中心的治疗（CFT）有一个新兴的证据基础，正在成为一种日益流行的治疗方式。晚年的人生之旅给个人带来了各种各样的挑战，包括角色和人际关系的丧失，身体健康和认知能力的恶化，以及朋友和家人的死亡。除了早年经历过的未处理的挑战。晚年也是一个独特的时期，人们会反思自己的生活经历和选择，这可能会导致一些人感到遗憾、失望和羞耻，同时面临年龄歧视和获得治疗的障碍。CFT很好地帮助老年人面对这些挑战，通过探索他们与自己和他人的关系来应对衰老。随着我们的寿命越来越长，越来越多的老年人出现需要照顾的情况，这一点变得越来越重要。培养对自己更大的同情心，允许自己被别人照顾，可能会使旅程更顺利，并将痛苦降到最低。方法：本文总结了在一系列老年患者群体中试验CFT的已发表工作，表明老年人对CFT方法持开放态度，他们发现这是一种可接受的干预措施，并且它具有广泛的益处。对老年人进行CFT的高质量研究仍然缺乏，这限制了我们对其有效性的结论。建议：提供了与Gilbert的治疗主题（2022）一致的CFT适用于老年人和痴呆症患者的方法建议。

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引用次数: 0

The benefits of sharing house-tree-fire-water-person drawings with parents when their anxious child is in sandplay therapy 当焦虑的孩子在进行沙盘游戏治疗时，与父母分享房子、树、火、水、人的图画的好处。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-03-07 DOI: 10.1111/papt.12586

Judith Bredekamp, Linda Theron

Introduction

The purpose of this study is to critically reflect on the value of the House-Tree-Fire-Water-Person (HTFWP) drawing as a tool to engage the parents of children aged 10–12 in sandplay therapy for Generalized Anxiety Disorder (GAD). To do so, we draw on empirical work that addressed gaps in the existing parent-psychologist alliance literature by exploring the usefulness of sharing the HTFWP drawing series with parents at feedback sessions.

Methods

We employed an instrumental, multiple case study design. The sample consisted of 7 cases, involving parents (n = 9) and child-clients referred for GAD (n = 7). Parent-generated data included the verbatim transcripts of initial semi-structured interviews, three HTFWP drawing elicitation conversations (i.e. HTFWP-facilitated feedback sessions) and a post-intervention semi-structured interview. Child-generated data included three HTFWP drawings and child-driven explanations of these drawings. Psychologist-generated data included journal-recorded reflections and process notes. Using reflexive thematic analysis, we identified patterns in these data.

Results

Findings suggest that an alliance created between parent and psychologist through sharing the HTFWP drawing series with parents was a win for everyone (parents, child and psychologist). This ‘win-win’ situation included enhanced care for the child, bolstered parental support and heightened efficacy for the psychologist.

Conclusion

The HTFWP drawing has high potential to support the therapeutic process, with emphasis on its facilitation of a parent –psychologist alliance and spillover benefits for parents, the treating psychologist and the child-client.

摘要：本研究的目的是批判性地反思屋-树-火-水-人（HTFWP）绘画作为一种工具的价值，以参与10-12岁儿童的沙游戏治疗广泛性焦虑障碍（GAD）。为了做到这一点，我们借鉴了实证工作，通过探索在反馈会议上与父母分享http绘图系列的有用性，解决了现有父母-心理学家联盟文献中的空白。方法：我们采用了一个工具，多案例研究设计。样本包括7例，涉及父母（n = 9）和转介广泛性焦虑症的儿童客户（n = 7）。家长生成的数据包括最初半结构化访谈的逐字记录，三次http绘图启发对话（即http促进的反馈会议）和干预后半结构化访谈。孩子生成的数据包括三个http图和孩子对这些图的解释。心理学家生成的数据包括日记记录的反思和过程笔记。使用反身性主题分析，我们确定了这些数据中的模式。结果：研究结果表明，父母和心理学家之间通过与父母分享http绘画系列而建立的联盟对每个人（父母，孩子和心理学家）都是双赢的。这种“双赢”的局面包括加强对孩子的照顾，加强父母的支持，提高心理学家的效力。结论：HTFWP绘图具有支持治疗过程的高潜力，其重点是促进家长-心理医生联盟和对家长、治疗心理医生和儿童来访者的溢出效益。

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引用次数: 0

“My entire life has moulded the person that I am”: Narrations of non-suicidal self-injury and complex trauma in individuals with complex posttraumatic stress experiences “我的整个生活塑造了我这个人”：具有复杂创伤后应激经历的个体的非自杀式自我伤害和复杂创伤的叙述。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-03-01 DOI: 10.1111/papt.12583

Reem Alharbi, Susanne Langer, Cheryl Hunter, Nusrat Husain, Filippo Varese, Peter James Taylor

Background

Previous research suggests that complex trauma and Complex Posttraumatic Stress Disorder (C-PTSD) experiences can contribute to the risk of developing and possibly maintaining Non-Suicidal Self-Injury (NSSI). Individuals' accounts of how complex trauma and subsequent development of C-PTSD experiences can contribute to the difficulties of NSSI remain underexplored. This qualitative study aimed to explore in-depth: (1) how individuals with C-PTSD experiences narrate life conditions and events that influenced their difficulties with NSSI over time and (2) what factors the individuals perceived to have helped the process of controlling their experience of NSSI.

Methodology

This novel qualitative narrative study used an adapted version of the Free Association Narrative Interviewing Method (FANIM) to facilitate the exploration of the lived experiences of eight individuals aged 20–56 years. The initial data analysis involved an interpretation of individuals' stories followed by a thematic narrative analysis of 14 interviews to explore the shared and unique experiences narrated by participants.

Results

Four primary themes were established: (1) Voiceless, invisible, and out of control within the dysfunctional system during childhood, (2) “shaky foundation” leading to future traumas, (3) the link between complex trauma, mental health difficulties, and NSSI, and (4) Regaining autonomy and a sense of control in managing NSSI. The findings highlight the importance of adopting a flexible and person-centred treatment that addresses the specific needs of these individuals. The treatment plan should empower individuals to improve their control and autonomy and support them to live a meaningful life.

背景：以往的研究表明，复杂创伤和复杂创伤后应激障碍（C-PTSD）经历可增加发生和可能维持非自杀性自伤（NSSI）的风险。个人对复杂创伤和随后发展的C-PTSD经历如何导致自伤困难的解释仍未得到充分探讨。本定性研究旨在深入探讨：(1)C-PTSD个体如何描述影响其自伤困难的生活条件和事件，以及(2)个体认为哪些因素有助于控制其自伤经历的过程。方法：本研究采用自由联想叙事访谈法（FANIM）的改编版本，对8名年龄在20-56岁之间的个体的生活经历进行了探索。最初的数据分析包括对个人故事的解释，然后是对14个访谈的主题叙事分析，以探索参与者叙述的共同和独特经历。结果：确立了四个主要主题：(1)儿童时期功能失调系统中的无声、隐形和失控；(2)“不稳固的基础”导致未来的创伤，(3)复杂创伤、心理健康困难和自伤之间的联系，以及(4)在处理自伤时重新获得自主性和控制感。研究结果强调了采取灵活和以人为本的治疗方法以解决这些人的具体需求的重要性。治疗计划应该使个人能够提高他们的控制力和自主性，并支持他们过有意义的生活。

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引用次数: 0

‘Lemons to lemonade’: Identity integration in researchers with lived experience of psychosis “柠檬到柠檬水”：具有精神病生活经验的研究人员的身份整合。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-02-24 DOI: 10.1111/papt.12582

Lorna I. Hogg, Alison Branitsky, Anthony P. Morrison, Tim Kurz, Laura G. E. Smith

Objectives

Lived experience input is becoming recognised as vital to developing and delivering high quality research. However, employment as a lived experience researcher can create identity conflict, which can undermine well-being. In this study, we explored the nuances of both social identification and identity integration processes in individuals with lived experience of psychosis employed in research.

Design

Qualitative study using a semi-structured interview format and thematic analyses.

Methods

Fifteen individuals were recruited, all employed in research in UK mental health care trusts or universities. All participants identified as having experience of psychosis and mental health care support and worked as a researcher, in a paid or voluntary capacity.

Results

Two overarching categories were identified in the data, the basis for social identification and the complexity of identity integration within an academic context; specific themes were identified within each of these categories. The data support the value of social identification within this group, although based on shared human experience or being a survivor rather than diagnosis. Challenges to identity integration included conflict between subjectivity and the scientific method and structural stigma. Strong values around using distressing experiences for the benefit of others both furnished self-growth and connected people in groups. A superordinate identity such as ‘useful person’ facilitated the integration of lived experience and researcher-based social identities within the self.

Conclusions

Researching this unique group advances understanding of how social identity forms and functions in a stigmatising context. Findings support the generalisability of the cognitive-developmental model of social identity integration.

目标：生活经验的输入被认为是开发和提供高质量研究的关键。然而，作为一名生活体验研究者的工作可能会产生身份冲突，这可能会损害幸福感。在这项研究中，我们探讨了社会认同和身份整合过程在研究中使用的精神病生活经历个体中的细微差别。设计：采用半结构化访谈形式和专题分析的定性研究。方法：招募了15个人，他们都在英国精神卫生保健信托机构或大学从事研究工作。所有参与者都被确定为有精神病和精神卫生保健支持的经历，并以有偿或自愿的身份担任研究人员。结果：在数据中确定了两个主要类别，即社会认同的基础和学术背景下身份整合的复杂性；在每个类别中都确定了具体的主题。数据支持社会认同在这一群体中的价值，尽管基于共同的人类经历或作为幸存者而不是诊断。身份整合面临的挑战包括主体性与科学方法的冲突和结构性耻辱感。强烈的价值观是利用痛苦的经历来造福他人，这既促进了自我成长，也将群体中的人联系在一起。像“有用的人”这样的上级身份促进了生活经验和自我内部基于研究的社会身份的整合。结论：对这一独特群体的研究促进了对社会身份在污名化背景下如何形成和发挥作用的理解。研究结果支持社会身份整合认知发展模型的普遍性。

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引用次数: 0

Young people's experiences of setting and monitoring goals in school-based counselling: A thematic analysis 青年人在校本咨询中设定和监测目标的经验：专题分析。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-02-24 DOI: 10.1111/papt.12581

Charlie Duncan, Jacqueline Hayes, Mick Cooper

Objective

To understand young people's experiences of setting and monitoring goals in the context of school-based counselling.

Design

Qualitative interview study of young people aged 13–16 years old who had undertaken school-based counselling and who had explicitly set and monitored goals.

Methods

Nineteen young people who were predominantly female (89.5%) and around half of whom were of white/European and/or British ethnicity (52.6%) were recruited from 4 secondary schools in London, UK. A reflexive thematic analysis was undertaken to identify themes.

Results

Fourteen themes were identified, which reflected both helpful and unhelpful aspects of working with goals. For some young people, goals were motivating, provided a tangible representation of progress, and focused the therapeutic work. For others, goals could mirror a sense of “stuckness” and elicit negative emotions when not progressed towards in a linear fashion. Assigning a number to goal progress meant that some young people felt it did not fully capture the context of their experience, although some did find this practice helpful. Similarly, not all young people found it helpful to monitor progress at every session.

Conclusions

Our findings align with the wider adult literature in that experiences of working with goals are mixed. Recommendations for practice include offering choice in the frequency and way goal progress is monitored, and using clinical judgement when working with goals. This might include noticing when goal setting or monitoring is contributing to young people's feelings of low self-worth and adjusting practice accordingly.

目的：了解青少年在校本辅导中设定和监控目标的经验。设计：对13-16岁接受校本辅导并明确设定和监测目标的青少年进行定性访谈研究。方法：从英国伦敦的4所中学招募了19名以女性为主（89.5%），其中约一半为白人/欧洲和/或英国种族（52.6%）的年轻人。进行了反身性专题分析以确定主题。结果：确定了14个主题，这些主题反映了实现目标的有益和无益方面。对一些年轻人来说，目标是激励，提供了进步的有形代表，并集中了治疗工作。对其他人来说，目标可能反映出一种“停滞感”，并在没有以线性方式前进时引发负面情绪。给目标进度分配一个数字意味着一些年轻人觉得它没有完全捕捉到他们经历的背景，尽管有些人确实发现这种做法很有帮助。同样，并非所有年轻人都认为在每次会议上监测进展情况是有帮助的。结论：我们的发现与更广泛的成人文献一致，即有目标的工作经验是混合的。对实践的建议包括提供监测目标进展的频率和方式的选择，以及在实现目标时使用临床判断。这可能包括注意到目标设定或监控何时会导致年轻人的低自我价值感，并相应地调整实践。

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引用次数: 0

“What I share is not the same as therapy”: Psychologist experiences of Instagram use as a mental health influencer “我分享的与治疗不一样”：心理学家将Instagram用作心理健康影响者的经历。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-02-21 DOI: 10.1111/papt.12585

Ella White, Terry Hanley

Introduction

Psychologists are increasingly using social media to share their therapeutic knowledge. Despite this, social media guidelines devised by professional bodies remain limited in content, with the focus typically on personal use rather than professional use as a mental health influencer. Therefore, this study aimed to explore practitioner psychologists' experiences of Instagram use with an influencer presence.

Methods

Twelve UK-based practitioner psychologists were interviewed who had an Instagram account that they used as a mental health influencer. The semi-structured interview transcripts were analysed using reflexive thematic analysis.

Results

Three themes were developed, each with four subthemes. The first theme ‘“I'm a psychologist, but I'm not your psychologist” explored psychologists’ experiences of trying to input boundaries on Instagram around self-disclosure, risk management, time management, and client work. The second theme ‘“anxiety about not wanting to do the wrong thing” highlighted the impact of an influencer presence on psychologists’ own mental health. The third theme ‘“I share what I think is going to be helpful for other people and myself” considered the psychologists’ motivations for Instagram use for social justice advocacy and business promotion, and the contradictions between these.

Conclusion

Psychologists can use their training to share evidence-based research as a free widely accessible form of psychoeducation potentially acting as a first step into therapy. However, there are still many ethical ambiguities thus updated guidance specifically for an influencer presence can reduce psychologists' anxieties and potential risks.

心理学家越来越多地使用社交媒体来分享他们的治疗知识。尽管如此，专业机构制定的社交媒体指南在内容上仍然有限，通常侧重于个人使用，而不是作为心理健康影响者的专业使用。因此，本研究旨在探讨从业心理学家在有网红存在的情况下使用Instagram的体验。方法：对12名英国执业心理学家进行了采访，他们都有一个Instagram账户，并将其用作心理健康影响者。采用反身性主题分析对半结构化访谈记录进行分析。结果：开发了三个主题，每个主题有四个子主题。第一个主题是“我是一名心理学家，但我不是你的心理学家”，探讨了心理学家试图在Instagram上围绕自我披露、风险管理、时间管理和客户工作设定界限的经历。第二个主题是“不想做错事的焦虑”，强调了网红对心理学家自身心理健康的影响。第三个主题“我分享我认为对别人和我有帮助的东西”，考虑了心理学家使用Instagram来倡导社会正义和商业推广的动机，以及两者之间的矛盾。结论：心理学家可以利用他们的培训来分享基于证据的研究，作为一种免费的、广泛可及的心理教育形式，有可能作为进入治疗的第一步。然而，仍然存在许多道德上的歧义，因此专门针对影响者的最新指导可以减少心理学家的焦虑和潜在风险。

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引用次数: 0

Associations between psychological inflexibility processes, pre-sleep arousal and sleep quality 心理不灵活性过程，睡前觉醒和睡眠质量之间的联系。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-02-20 DOI: 10.1111/papt.12584

Lisa Mastin-Purcell, Amanda L. Richdale, Lauren P. Lawson, Eric M. J. Morris

Objectives

Psychological inflexibility, the model of psychopathology underlying Acceptance and Commitment Therapy (ACT), has been linked to a broad range of psychological problems, but its link with sleep quality is not well understood. This study aimed to identify relationships between psychological inflexibility processes (cognitive fusion, experiential avoidance, limited perspective-taking, lack of present moment awareness and inaction) and sleep quality, investigating pre-sleep arousal and anxiety symptomatology as mechanisms mediating these relationships.

Design

A correlational, cross-sectional design was used to test two statistical models.

Methods

Participants (N = 704) from a general population sample completed an online survey, reporting on sleep quality, pre-sleep arousal, anxiety and measures of psychological inflexibility. Data were analysed using correlations and path analyses.

Results

All psychological inflexibility processes were moderate to strongly correlated with sleep quality. Path analysis showed cognitive fusion, lack of present moment awareness and experiential avoidance, mediated by pre-sleep cognitive and somatic arousal, explained 49% of the variance in sleep quality (Model 1). Cognitive fusion via pre-sleep cognitive arousal had the largest effect. Anxiety preceding pre-sleep arousal (Model 2) explained no additional variance, and model fit was poorer than Model 1.

Conclusions

These findings highlight the role of psychological inflexibility processes in disrupting the de-arousal process needed for healthy sleep, supporting evidence for ACT as a treatment for sleep disturbance.

目的：心理不灵活性是接受与承诺疗法（ACT）背后的精神病理学模型，它与一系列心理问题有关，但它与睡眠质量的关系尚不清楚。本研究旨在确定心理不灵活性过程（认知融合、经验回避、有限的换位思考、缺乏当下意识和不作为）与睡眠质量之间的关系，并研究睡眠前唤醒和焦虑症状作为调节这些关系的机制。设计：采用相关的横断面设计来检验两个统计模型。方法：来自普通人群样本的参与者（N = 704）完成了一项在线调查，报告了睡眠质量、睡前唤醒、焦虑和心理不灵活性的测量。数据分析采用相关性和路径分析。结果：所有心理不灵活性过程与睡眠质量均有中强相关。通径分析显示，由睡眠前认知唤醒和躯体唤醒介导的认知融合、当下意识缺失和经验回避解释了49%的睡眠质量差异（模型1）。通过睡眠前认知唤醒介导的认知融合的影响最大。睡眠前唤醒前的焦虑（模型2）不能解释额外的方差，模型拟合比模型1差。结论：这些发现强调了心理不灵活性过程在破坏健康睡眠所需的去唤醒过程中的作用，支持ACT作为治疗睡眠障碍的证据。

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引用次数: 0