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What guides guided self-help? Recognising the role of formulation in Low Intensity CBT 什么指南指导自助?认识配方在低强度CBT中的作用
Pub Date : 2023-03-01 DOI: 10.1002/mhs2.15
Paul Cromarty, Dominic Gallagher

The emphasis on formulation, as a lynchpin and driver of cognitive behavior therapy (CBT) has received increasing attention, consensus of value among practitioners and emerging studies of efficacy. The terms, “formulation” and “conceptualisation” are frequently used interchangeably in literature which is exclusively focussed on high intensity CBT. In contrast, little has been included on the value or recognising the existence of formulation, for Low Intensity CBT practitioners providing guided self-help. This may contribute to misconceptions that Low Intensity CBT is a mechanistic set of techniques. Links to CBT competencies, curricula, role of supervision and roots in UK Behavioral Nurse Therapist training, are made to highlight the implicit presence of Low Intensity formulation. We suggest a definition of formulation, as a key Low Intensity competency. This uses an individualised treatment rationale and problem statement, derived from a structured functional assessment. We propose, explicitly emphasising these, constitutes Low Intensity case formulation, which guides intervention. This is a refocus of existing practice, not introduction of completely new elements. A brief illustration of “how to” deliver formulation-driven Low Intensity CBT is made. This promotes a concise “within-session” and “between-session” thread. This adjustment, on what guides Low Intensity interventions, is relevant to practitioners, supervisors and trainers in promoting Low Intensity best practice. This argues that recognising the value of formulation assists in optimising skills development, client outcomes and satisfaction with Low Intensity CBT. Cautions with the approach and the need for further research are noted.

对配方的重视,作为认知行为疗法(CBT)的关键和驱动因素,受到了越来越多的关注,在从业者中达成了价值共识,并出现了新的疗效研究。术语“公式化”和“概念化”在专门关注高强度CBT的文献中经常互换使用。相比之下,对于提供自助指导的低强度CBT从业者来说,几乎没有关于配方的价值或认识到配方的存在。这可能导致人们误解低强度CBT是一套机械的技术。将CBT能力、课程、监督作用和英国行为护士治疗师培训的根源联系起来,以强调低强度配方的隐含存在。我们建议将配方定义为关键的低强度能力。这使用了从结构化功能评估中得出的个性化治疗原理和问题陈述。我们建议,明确强调这些,构成低强度病例公式,指导干预。这是对现有做法的重新关注,而不是引入全新的要素。简要说明了“如何”提供配方驱动的低强度CBT。这促进了简洁的“会话内”和“会话间”线程。这种关于指导低强度干预措施的调整与从业者、主管和培训师推广低强度最佳实践有关。这表明,认识到配方的价值有助于优化技能发展、客户结果和对低强度CBT的满意度。注意该方法的注意事项以及进一步研究的必要性。
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引用次数: 0
Depression symptoms and core affect: Results from network and regression analyses 抑郁症状和核心情感:网络和回归分析结果
Pub Date : 2023-01-21 DOI: 10.1002/mhs2.13
Edmunds Vanags, Malgožata Raščevska

Depression is measured in most studies by surveys that sum individual symptom scores into one common variable. Given the high heterogeneity of depressive disorders and the diversity of symptom profiles at the same levels of depression, a significant amount of information is, therefore, not evaluated. In this study, we aimed to investigate how distinct depression symptoms from the tripartite model of anxiety and depression relate to the dimensions of core affect. The study included N = 1102 individuals who completed depression, anxiety and stress, and core affect scales. Participants were recruited from the convenience sample and were aged between 18 and 59 years (M = 39.70; SD = 12.03) with 38.2% men and 61.8% women, whose average number of years spent in education was M = 14.17; SD = 3.63. Correlation and regression analysis with JASP and R software showed that all depressive symptoms were significantly related to the core affect dimensions (valence and activation), and network analysis indicated which symptoms formed undirected interrelationships and what their possible roles were in the model. We concluded that not all depression symptoms in the network model formed similar relationships with the dimensions of core affect, which may be explained through both validity and nonclinical sampling aspects.

在大多数研究中,抑郁是通过将个人症状得分汇总为一个共同变量的调查来衡量的。鉴于抑郁障碍的高度异质性和相同抑郁水平下症状特征的多样性,因此没有对大量信息进行评估。在这项研究中,我们旨在调查焦虑和抑郁三方模型中不同的抑郁症状与核心情感维度之间的关系。该研究包括N = 1102名完成抑郁、焦虑和压力以及核心情感量表的个体。参与者是从便利样本中招募的,年龄在18-59岁之间(M = 39.70;SD = 12.03),其中38.2%为男性,61.8%为女性,平均受教育年限为M = 14.17;SD = 3.63.JASP和R软件的相关和回归分析表明,所有抑郁症状都与核心情感维度(效价和激活)显著相关,网络分析表明哪些症状形成了无方向的相互关系,以及它们在模型中可能扮演的角色。我们得出的结论是,并非网络模型中的所有抑郁症状都与核心情感维度形成了相似的关系,这可以通过有效性和非临床抽样两个方面来解释。
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引用次数: 0
Prevalence of underweight in people with severe mental illness: Systematic review and meta-analysis 严重精神疾病患者体重不足的患病率:系统综述和荟萃分析
Pub Date : 2022-12-11 DOI: 10.1002/mhs2.7
Bilal Ahmad Khan, Humaira Khalid, Najma Siddiqi, Faiza Aslam, Rubab Ayesha, Medhia Afzal, Sukanya Rajan, Kavindu Appuhamy, Kamrun Nahar Koly, Maria Bryant, Richard I. G. Holt, Gerardo A. Zavala

People with severe mental illness (SMI) have a higher prevalence of obesity as compared with the general population, however, there is mixed evidence about the prevalence of underweight. Thus, the aim of this study is to determine the pooled prevalence of underweight in people with SMI and its association with socio-demographic factors; and to compare the prevalence of underweight between SMI and the general population. MEDLINE, PsycINFO, and EMBASE databases were searched to identify observational studies assessing the prevalence of underweight in adults with SMI (schizophrenia, major depressive disorder with psychotic features, and bipolar disorders). Screening, data extraction, and risk of bias assessments were performed independently by two co-authors, with disagreements resolved by consensus. Random effect estimates for the pooled prevalence of underweight and the pooled odds of underweight in people with SMI compared with the general population were calculated. Subgroup analyses were conducted for the type of SMI, setting, antipsychotic medication, region of the world, World Bank country income classification, data collection, and sex. Forty estimates from 22 countries were included. The pooled prevalence of underweight in people with SMI was 3.8% (95% confidence interval [CI] = 2.9–5.0). People with SMI were less likely to be underweight than the general population (odds ratio [OR] 0.65; 95% CI = 0.4–1.0). The pooled prevalence of underweight in SMI in South Asia was 7.5% (95% CI = 5.8–14.1) followed by Europe and Central Asia at 5.2% (95% CI = 3.2–8.1) and North America at 1.8% (95% CI = 1.2–2.6). People with SMI have lower odds of being underweight compared to the general population. People with schizophrenia had the highest prevalence of underweight compared to other types of SMI. Japan and South Asia have the highest prevalence of underweight in people with SMI.

与普通人群相比,患有严重精神疾病(SMI)的人肥胖的患病率更高,然而,关于体重不足的患病率,有各种各样的证据。因此,本研究的目的是确定SMI患者体重不足的综合患病率及其与社会人口因素的关系;并比较SMI和普通人群体重不足的患病率。检索MEDLINE、PsycINFO和EMBASE数据库,以确定评估成人SMI(精神分裂症、具有精神病特征的重度抑郁障碍和双相情感障碍)体重不足患病率的观察性研究。筛查、数据提取和偏倚风险评估由两位合著者独立进行,分歧通过协商一致解决。计算了SMI患者与普通人群相比体重不足合并患病率和体重不足合并几率的随机效应估计值。对SMI的类型、环境、抗精神病药物、世界地区、世界银行国家收入分类、数据收集和性别进行了亚组分析。其中包括来自22个国家的40个估计数。SMI患者体重不足的合并患病率为3.8%(95%置信区间[CI] = 2.9–5.0)。SMI患者体重不足的可能性低于普通人群(比值比[OR]0.65;95%可信区间 = 0.4–1.0)。南亚SMI中体重不足的合并患病率为7.5%(95%置信区间 = 5.8–14.1),其次是欧洲和中亚,为5.2%(95% CI = 3.2–8.1),北美为1.8%(95%置信区间 = 1.2–2.6)。与普通人群相比,患有SMI的人体重不足的几率较低。与其他类型的SMI相比,精神分裂症患者的体重不足患病率最高。日本和南亚的SMI患者体重不足的患病率最高。
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引用次数: 0
Posttraumatic stress symptoms and chronic pain: Cross-sectional associations with perception of sensory and social stimuli 创伤后应激症状和慢性疼痛:与感觉和社会刺激感知的横断面关联
Pub Date : 2022-12-09 DOI: 10.1002/mhs2.8
Jennifer Pierce PhD, Nitesh Mohan BS, Megha G. Fatabhoy MS, Jenna McAfee PhD, Guohao Zhu PhD, Afton L. Hassett PsyD

Chronic pain and posttraumatic stress symptoms frequently co-occur. Both may be associated with how individuals perceive stimuli; yet, to our knowledge, studies have not considered their joint effects on the perception of stimuli. In the present study, we examined main and interactive effects of chronic pain phenotype (no chronic pain; <4 regions of chronic pain; ≥4 regions of chronic pain) and high posttraumatic stress symptoms (>3 symptoms) on sensory sensitivity (i.e., external sensory sensitivity and somatic awareness) and sensitivity to social stimuli (i.e., hostility, perceived rejection, and rejection sensitivity). Adult patients with a self-reported history of trauma or abuse (n = 305) completed across-sectional, online survey. A chronic pain phenotype indicating ≥4 regions of chronic pain exhibited significant main effects on somatic awareness and hostility. High posttraumatic stress symptoms exhibited significant main effects on all sensory and social variables. An interaction between chronic pain phenotype and high posttraumatic stress symptoms was also found for perceived rejection, such that the association between high posttraumatic stress symptoms and higher perceived rejection was buffered for individuals with <4 regions of chronic pain. The findings suggest that both chronic pain phenotype, particularly ≥4 regions of chronic pain, and high posttraumatic stress symptoms are related to the perception of sensory and social stimuli. These findings may be important for understanding the impact of each condition on functioning and well-being, as well as how to appropriately treat and manage symptoms.

慢性疼痛和创伤后应激症状经常同时出现。两者都可能与个体如何感知刺激有关;然而,据我们所知,研究还没有考虑它们对刺激感知的共同影响。在本研究中,我们研究了慢性疼痛表型(无慢性疼痛;<;4个慢性疼痛区域;≥4个慢性痛苦区域)和高创伤后应激症状(>;3个症状)对感觉敏感性(即外部感觉敏感性和躯体意识)和对社会刺激的敏感性(即敌意、感知排斥和排斥敏感性)的主要和交互影响。有创伤或虐待自我报告史的成年患者(n=305)通过分段在线调查完成。显示≥4个慢性疼痛区域的慢性疼痛表型对躯体意识和敌意表现出显著的主要影响。高创伤后应激症状对所有感觉和社会变量都表现出显著的主要影响。慢性疼痛表型和高创伤后应激症状之间的相互作用也被发现用于感知排斥,使得对于<;慢性疼痛的4个区域。研究结果表明,慢性疼痛表型,特别是≥4个慢性疼痛区域,以及创伤后高应激症状都与感觉和社会刺激的感知有关。这些发现对于了解每种情况对功能和幸福感的影响,以及如何适当治疗和管理症状可能很重要。
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引用次数: 1
Type 1 and Type 2 psychosis-related disorders for optimal treatment and management 1型和2型精神病相关疾病的最佳治疗和管理
Pub Date : 2022-11-03 DOI: 10.1002/mhs2.6
Mohiuddin Ahmed

Psychosis and psychosis-related disorders (including schizophrenia) have been one of the most challenging psychiatric disorders to treat. Despite successful recovery and relapse rates, a substantial number continue to struggle with ongoing “psychotic symptoms” and residual functional impairments needing ongoing treatment and support services (Ahmed et al., 2007; Jaaskelainen et al., 2013; Javitt & Coyle, 2004; Owen et al., 2016). Psychosis may reflect an underlying deficit in “information processing” that may contribute to “atypical” thoughts, feelings, and behaviors with impaired level of functioning and at-risk behaviors raising need for clinical services (Ahmed & Boisvert, 2013; Ahmed et al., 2014; Bodatsch et al., 2013; Turetsky et al., 2009).

The “atypical” life adaptations in psychosis may be considered to be akin to Freud's theory of Ego's defense with projection against “conscious Id” (Fenichel, 2014; Freud, 1961). and the cognitive behavioral theoretical formulation of individuals adaptations to atypical information processing with perceptual misattribution (Allen et al., 2004; Costafreda et al., 2008; Kingdon & Mander, 2015). These atypical experiences may originate from multiple factors including genetic predispositions that interact with unique adverse personal and social experiences contributing to a heightened sense of existential uncertainty and anxiety (Braehler et al., 2013; Legge et al., 2021; Longden & Read, 2016; Mayo et al., 2017; Merikangas et al., 2022). This developmental process is further compounded by increased confusion relating to self-identity and age-expected role functions during the challenging transitional period of experiencing changes from adolescence to adulthood (Braehler et al., 2013; Legge et al., 2021; Longden & Read, 2016; Mayo et al., 2017; Merikangas et al., 2022).

Human beings routinely engage in “autistic imageries” with an inward focusing of the mind as expressed in daydreaming and fantasies. For many it may supply inspiration for all forms of creativity and self-reflection and can contribute to innovative scientific developments and varied creative expressions in arts and writings appreciated by others. While engaging in such “autistic” preoccupations, people can navigate between both worlds and redirect themselves, for example, from the inner world of self-refection and fantasy to the outer world of social reality in response to various social cues or role expectations. However, due to various bio-psycho-social experiences not yet fully understood, this self-redirection may be more challenging for some people who may find themselves incessantly preoccupied with the inner

精神病和精神病相关障碍(包括精神分裂症)一直是治疗最具挑战性的精神障碍之一。尽管成功的恢复率和复发率,相当多的人继续与持续的“精神病症状”和残余的功能损伤作斗争,需要持续的治疗和支持服务(Ahmed等人,2007;Jaaskelainen等人,2013;Javitt和Coyle,2004;Owen等人,2016)。精神病可能反映了“信息处理”的潜在缺陷,以及功能受损的行为和增加临床服务需求的风险行为(Ahmed&amp;Boisvert,2013;Ahmed等人,2014;Bodatsch等人,2013;Turetsky等人,2009)。精神病中的“非典型”生活适应可能被认为类似于弗洛伊德的自我防御理论,即对“意识Id”的投射(Fenichel,2014;弗洛伊德,1961)。以及个体适应具有感知错误归因的非典型信息处理的认知行为理论表述(Allen等人,2004;Costafreda等人,2008;Kingdon和Mander,2015)。这些非典型经历可能源于多种因素,包括与独特的不良个人和社会经历相互作用的遗传倾向,这些因素会导致存在的不确定性和焦虑感加剧(Braehler等人,2013;Legge等人,2021;Longden&amp;Read,2016;Mayo等人,2017;Merikangas等人,2022)在经历从青春期到成年的变化这一具有挑战性的过渡时期,与自我认同和年龄预期的角色功能相关的困惑加剧(Braehler等人,2013;Legge等人,2021;Longden&amp;Read,2016;Mayo等人,2017;Merikangas等人,2022)在白日梦和幻想中表达的思想。对许多人来说,它可以为各种形式的创造力和自我反思提供灵感,并有助于创新的科学发展和他人欣赏的艺术和作品中的各种创造性表达。在从事这种“自闭症”关注的同时,人们可以在两个世界之间导航,并根据各种社会线索或角色期望,将自己从自我反思和幻想的内心世界重定向到社会现实的外部世界。然而,由于各种生物-心理-社会体验尚未被完全理解,这种自我重定向对一些人来说可能更具挑战性,他们可能会发现自己不断地被幻想和沉思的内心世界所困扰,从而模糊了客观和主观现实之间的界限。这种界限的模糊有时可能会导致社交障碍和伴随的精神病症状的表达。Crow(1980)提出了一种“具有潜在生物成因因果关系的精神分裂症双过程治疗方法:1型综合征、“急性精神分裂症”和2型综合征,他将其描述为具有不可逆性的“缺陷状态”,即Kraepelin痴呆症。后来的临床理论家,如Bleuler,Meyer和其他人低估了Kraepelin提出的有机假说,并强调了精神分裂症的心理动力学起源和心理治疗方法(Heckers,2011;Hoff,2008;Katzelbogen,1942)生物和社会心理环境因素在不同程度上促进了人类的功能。正在兴起的关于性状和行为中基因表达的基因型-表型维度的表观遗传学研究越来越多地证实了一代人的心理社会和环境经历的影响可能会影响下一代人(Dempster等人,2013;Lind和Spagopoulou,2018)。虽然生物和心理社会科学可能强调不同的关注点和影响的重点——反映出个人对临床实践和进行学科导向的调查研究的专业兴趣的偏好——但需要跨学科综合和合作,以开发最有效的临床实践方法。1型精神病可以是短期的,可以在有或没有任何精神干预的情况下解决。康复后,许多1型精神病患者可能表现出有限或没有残余影响。然而,其他人可能需要定期或持续的精神支持服务,以支持他们持续的康复功能。有些人甚至可能报告说,这种短暂的精神病经历具有更高的创造力。
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引用次数: 0
Mental Health Science: A multidisciplinary journal 心理健康科学:多学科期刊
Pub Date : 2022-07-18 DOI: 10.1002/mhs2.5
Adrian Meule, Nathaniel G. Harnett, Taeho Greg Rhee

Health is not merely the absence of disease or infirmity. Instead, it is a state of complete physical, mental, and social well-being (World Health Organization, 2020). As such, studying mental health requires broad, interdisciplinary approaches that will help better understand how the brain, body, and environment interact in maintaining mental health, how people with (or at risk of) impaired mental health can be identified or grouped, or how to develop new and improved interventions for persons with mental disorders. Mental Health Science adopts this broad scope of mental health and aims to support the establishment of mental health science as a “super discipline.”

The primary scope of the journal covers global mental research in its core disciplines such as psychology, psychiatry, neuroscience, and public health and policy. However, the field of mental health research worldwide is broad and fragmented. It covers a diversity of health conditions and is driven by a large and varied population of researchers and funding organizations. Thus, the journal aims to not only include the more “traditional” disciplines associated with mental health, but also integrate with research from related fields such as nursing, genomics research, pharmacology, education, criminology, medical sociology, and others. This focus on both transdiagnostic and transdisciplinary approaches will facilitate a greater and more pronounced understanding of mental health disorders from individual pathophysiology to community-wide consequences. Given the scope of our journal, we have three co-editors-in-chief—Dr. Adrian Meule (psychology), Dr. Nathaniel G. Harnett (neuroscience), and Dr. T. Greg Rhee (clinical psychiatry and public mental health)—who will assist with scientifically rigorous and fair publication processes.

Mental Health Science will further embrace a global perspective on mental health research. For example, several inequities have been found in mental health research with most funding—in fact, more than 98%—being awarded by and spent in high-income countries (Woelbert et al., 2020). At the same time, mental health research has become more collaborative in recent decades; while only 3% of articles published in 1980 were the result of international collaboration, this proportion rose to 22% in 2011 (Larivière et al., 2013). As an international journal, Mental Health Science' editorial board is composed of experts from different countries with an effort to cover diverse regions and cultures. Following this mindset, the journal is committed to publishing scholarship that respects diversity, which includes work from scholars from a range of institutional affiliations, nationalities, and career stages.

There is a prescient need for easily accessible and available research to serve the global scientific community. As such, Mental Health Science is a gold open access journal and all pub

作为一本跨学科、开放获取的期刊,我们强烈支持开放的研究实践,我们希望提高心理健康研究的质量,并促进其研究结果的传播,以提高公众意识,消除污名化,更好地理解,并最终为有效治疗和预防心理疾病做出贡献。
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引用次数: 0
Scene 1 场景1
Pub Date : 2021-12-31 DOI: 10.1017/9781316564042.006
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引用次数: 0
Scene 2 场景2
Pub Date : 2021-12-31 DOI: 10.18772/32016119742.9
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引用次数: 1
Scene 1 场景1
Pub Date : 2021-12-31 DOI: 10.1017/9781316564028.005
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引用次数: 0
Scene 2 场景2
Pub Date : 2021-12-31 DOI: 10.1017/9781316563915.006
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引用次数: 0
期刊
Mental health science
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