Clinical psychology & psychotherapy最新文献

{"title":"An Intra-Interpersonal Vulnerability Model for Understanding Trauma Conditions: Factors in the Development and Maintenance of PTSD and Complex PTSD.","authors":"Reuben Kindred, Maja Nedeljkovic, Glen Bates","doi":"10.1002/cpp.70333","DOIUrl":"10.1002/cpp.70333","url":null,"abstract":"<p><p>Adverse childhood events and insecure attachment lead to difficulties in emotion regulation and social support, predisposing individuals to post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD) when exposed to potentially traumatic events. However, the field lacks an integrated account of how these risk and protective factors combine, including the pathways through which attachment-related vulnerability contributes to trauma symptoms. This study tested a proposed intra-interpersonal vulnerability model using structural equation modelling with a sample of 706 participants (M = 30.64 years, SD = 11.00). Model fit was strong for symptoms of ICD-11 PTSD (CFI = 0.969; SRMR = 0.055) and ICD-11 CPTSD (CFI = 0.976; SRMR = 0.056). The model explained 35% of variance in PTSD symptoms and 75.7% of variance in CPTSD symptoms. Cross-validation supported the generalisability of the model, with the overall pattern of effects also replicated among participants with elevated PTSD/CPTSD symptoms. As expected, adverse childhood events were linked to attachment insecurity (e.g., β = 0.29), which influenced emotional identification, emotion dysregulation and social connectedness (β = 0.24 to β = -0.69). Contrary to expectations attachment insecurity did not impact either PTSD or CPTSD trauma symptoms directly. Emotion dysregulation was significantly associated with both PTSD and CPTSD symptoms, whereas social connectedness was associated with CPTSD but not PTSD symptoms. Overall, the results indicate that risk and protective factors build upon each other, reinforcing the importance of developmental aspects in the emergence of post-traumatic stress. Limitations include a community sample and cross-sectional data, suggesting a need for longitudinal research.</p>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 5","pages":"e70333"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Voice Gender and Hearer Gender on Voice-Related Distress: Examining Gendered Interpersonal Dyads in Voice Hearing.","authors":"Lucas Cabezas Klikovac, Mark Hayward","doi":"10.1002/cpp.70323","DOIUrl":"10.1002/cpp.70323","url":null,"abstract":"<p><strong>Background: </strong>Voice-related distress has traditionally been explained by voice content and severity; however, emerging research highlights the importance of relational, social rank and gendered dynamics. This study examined whether the gender of the hearer and perceived voice gender interacted to influence distress and whether specific hearer gender-voice gender configurations were associated with heightened distress.</p><p><strong>Method: </strong>Assessments within routine clinical practice were completed by 347 adults referred to a UK specialist clinic for distressing voices between 2016 and 2024. Participants provided data for gender (self and main voice) and voice-related distress. Hypotheses were tested in relation to perceived voice gender, the pairing of hearer gender and voice gender and associated distress.</p><p><strong>Results: </strong>Male voices were significantly more common, and men were more likely to hear male voices than women. Women who heard male voices reported the highest levels of distress.</p><p><strong>Conclusions: </strong>Voice-related distress appears to be influenced by gendered interpersonal dynamics. Women who hear male voices may be especially vulnerable and could benefit from more targeted, relationally informed support in clinical settings.</p>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 5","pages":"e70323"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imagery Interventions and Cognitive-Behavioural Therapy for Psychological Complaints Related to Bullying: A Systematic Review and Meta-Analysis","authors":"Meng Liang,&nbsp;Gerly Tamm,&nbsp;Olivia De Laere,&nbsp;Yannick Vander Zwalmen,&nbsp;Ernst H. W. Koster","doi":"10.1002/cpp.70330","DOIUrl":"10.1002/cpp.70330","url":null,"abstract":"<div>\u0000 \u0000 <p>Bullying is associated with internalizing symptoms and impaired everyday functioning. Cognitive-behavioural therapy (CBT) and imagery interventions have been studied as treatments to improve mental health after such experiences.</p>\u0000 <p>This meta-analysis aimed to evaluate the effects of individual CBT and imagery interventions in targeting internalizing symptoms (negative affect, depression, anxiety and post-traumatic stress symptoms) and improving self-perception and coping in bullying victims.</p>\u0000 <p>Systematic searches of PubMed, PsycInfo, Embase and Web of Science identified 23 studies applying CBT (<i>n</i> = 15) and imagery interventions (<i>n</i> = 8) in bullying victims. Risk of bias and random-effects meta-analyses were conducted for pre - post and pre - follow-up comparisons. Sensitivity analyses and meta-regressions explored potential moderators.</p>\u0000 <p>Unadjusted analyses showed reductions in internalizing symptoms pre- to post - intervention (<i>k</i> = 21, <i>g</i> = 0.72). These symptoms were maintained at follow-up assessments (<i>k</i> = 9, <i>g</i> = 0.54). Similar initial improvements emerged for self-perception and coping outcomes (<i>k</i> = 15, <i>g</i> = 0.75). However, substantial heterogeneity existed (<i>I</i>² = 68%–98%). Crucially, after adjusting for publication bias, the pre–post internalizing effect dropped to <i>g</i> = 0.26 and was no longer statistically significant. Conversely, the adjusted effect for self-perception and coping increased to <i>g</i> = 0.98, whereas the follow-up internalizing effect decreased (<i>g</i> = 0.37) but remained significant.</p>\u0000 <p>Both CBT and imagery interventions may offer potential benefits for bullying victims in reducing internalizing symptoms and in improving self-perception and coping abilities. However, large heterogeneity, methodological limitations and publication bias warrant cautious interpretation. Further high-quality controlled trials are needed to establish the robustness and clinical efficacy of these interventions.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Metacognitive Beliefs and Cognitive Flexibility Associated With Cannabis Use Disorder In Adolescents? A Case–Control Study","authors":"Neval Kızıl,&nbsp;Masum Öztürk,&nbsp;Fatma Subaşı Turgut,&nbsp;Yağmur Soysal,&nbsp;Ayfer Gözü Pirinççioğlu","doi":"10.1002/cpp.70326","DOIUrl":"10.1002/cpp.70326","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Cannabis is among the most commonly used substances by adolescents and is frequently associated with the development of addiction. Various individual, environmental and psychological factors are associated with the onset and maintenance of cannabis use disorder (CUD). Our study aimed to compare levels of depression, anxiety, stress, perceived cognitive flexibility and metacognitive beliefs in adolescents diagnosed with CUD with those in a healthy control (HC) group. Another objective was to investigate the relationship between CUD severity and these parameters within the CUD group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our study included a total of 69 patients aged 12–18 years with a diagnosis of CUD and 83 age- and gender-matched HC subjects. Participants completed the Sociodemographic Data Form, Addiction Profile Index (API), Metacognition Scale–Children and Adolescents Form (MCQ-C), Cognitive Flexibility Scale (CFS) and Depression-Anxiety-Stress Scale (DASS-21).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with CUD had significantly higher MCQ-C total scores (<i>p</i> = 0.033), higher levels of superstition-punishment-responsibility beliefs (<i>p</i> = 0.001) and higher DASS-21 scores (<i>p</i> &lt; 0.001) compared to the HC group. Perceived cognitive flexibility was significantly lower in the CUD group (<i>p</i> &lt; 0.001). Higher levels of negative metacognitive beliefs (<i>p</i> = 0.006) and total emotional symptoms in the CUD group were positively associated with CUD severity (<i>p</i> &lt; 0.001, <i>F</i> = 7.512, <i>R</i>² = 0.365).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These results demonstrate the significant association between metacognitive beliefs, accompanying emotional symptoms and perceived cognitive flexibility in adolescents with CUD. Our findings highlight the importance of addressing these psychological correlates during treatment planning. Interventions targeting not only substance use reduction but also these associated cognitive and metacognitive factors may be beneficial for improving treatment outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Incremental Validity of Transdiagnostic Dimensions of Personality and Psychopathology in Predicting Important Psychological Outcomes","authors":"Emily A. Dowgwillo,&nbsp;Jessica L. Kopitz,&nbsp;Xiyu Cao,&nbsp;Michelle B. Stein,&nbsp;Mark Blais","doi":"10.1002/cpp.70329","DOIUrl":"https://doi.org/10.1002/cpp.70329","url":null,"abstract":"<div>\u0000 \u0000 <p>Dimensional models of psychopathology offer an alternative to traditional categorical systems, yet research examining the incremental validity of transdiagnostic dimensions over diagnostic categories remains limited. The current study uses data from 685 outpatients, who presented at an academic medical centre for psychological assessment, to determine whether transdiagnostic dimensions derived from commonly used clinical assessment measures (Fear/Distress, Narcissistic Antagonism, Attachment, Flexible Thinking, Somatization, External Coping and Anger/Aggression) increment the variance in suicidal ideation, cognitive functioning, psychosocial functioning, pain and quality of life explained by diagnostic categories. When considered in isolation, diagnostic categories significantly predicted pain (<i>R</i>² = 0.08) but did not predict the other four outcome measures. When transdiagnostic dimensions were added to the model, all five outcome models were significant, and dimensions explained substantial additional variance: suicidal ideation (Δ<i>R</i>² = 0.41), cognitive concerns (Δ<i>R</i>² = 0.28), psychosocial functioning (Δ<i>R</i>² = 0.55), pain (Δ<i>R</i>² = 0.21) and quality of life (Δ<i>R</i>² = 0.38). Across models, somatization emerged as the most robust predictor and was significantly associated with cognitive concerns, psychosocial functioning, pain and quality of life. When the order of entry was reversed, a trauma diagnosis significantly incremented transdiagnostic dimensions when predicting suicidal ideation. Overall, these results suggest that transdiagnostic dimensions demonstrate substantial incremental validity over categorical diagnoses in predicting clinically meaningful outcomes. These findings support dimensional approaches to psychopathology and suggest that existing clinical data can be leveraged to implement dimensional conceptualizations in practice.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loneliness and Suicidal Ideation/Behaviour: A Longitudinal Study in a Large German Population Sample","authors":"Chiara Spielmann,&nbsp;Tobias Teismann,&nbsp;Julia Brailovskaia,&nbsp;Lena Marie Hensel,&nbsp;Hermann Spießl,&nbsp;Lena Marie Precht,&nbsp;Heide Glaesmer,&nbsp;Jürgen Margraf,&nbsp;Silvia Schneider","doi":"10.1002/cpp.70322","DOIUrl":"https://doi.org/10.1002/cpp.70322","url":null,"abstract":"<div>\u0000 \u0000 <p>Recent representative studies from Germany report that between 16% and 36% of the population regularly experience loneliness. Available research findings indicate a significant positive association between loneliness and suicidal ideation and/or behaviour. The aim of the present longitudinal study was to investigate whether loneliness at baseline (T0) is prospectively associated with suicidal ideation and/or behaviour at follow-up (T1), independent of gender, social circle, depression, anxiety, stress and prior lifetime suicidal ideation and/or behaviour. Data were obtained via an online survey in a repeated-measures design in a large German population sample (<i>N</i> = 4277; 18–89 years of age), divided into four age groups (18–29, 30–45, 46–65 and 66–89 years). In order to examine the association between loneliness and suicidal ideation and/or behaviour, three-step hierarchical regression analyses were conducted in each age group, respectively. The regression models explained between 25.2% and 39.3% of the variance in T1-suicidal ideation and/or behaviour. Loneliness proved to be significantly associated with T1-suicidal ideation and/or behaviour, beyond affective symptoms, social circle and previous suicidal ideation and/or behaviour. The results underscore the importance of loneliness as a relevant component of suicidal ideation and/or behaviour in the German population. The findings emphasise the need to address loneliness in suicide risk assessment.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Psychosocial Interventions for Substance Use Disorder: A Systematic Review of Therapeutic Approaches and Their Clinical Effectiveness”","authors":"","doi":"10.1002/cpp.70324","DOIUrl":"https://doi.org/10.1002/cpp.70324","url":null,"abstract":"<p>\u0000 <span>Mateu-Mollá, J</span>, <span>Mesas-Fernández, J</span>, <span>Villanueva-Blasco, VJ</span>. <span>Psychosocial Interventions for Substance Use Disorder: A Systematic Review of Therapeutic Approaches and Their Clinical Effectiveness</span>. <i>Clin Psychol Psychother.</i> <span>2026</span> Mar-Apr; <span>33</span>(<span>2</span>):e70253. https://doi.org/10.1002/cpp.70253.\u0000 </p><p>The authors wish to provide additional clarification regarding the identification, screening, and data-extraction procedures used in the review, as well as to correct two factual errors identified post-publication.</p><p>Search fields and database limits</p><p>Duplicate records were removed during the final stage of screening. This decision was made for operational reasons, as the identification stage yielded <b>843,112 records</b>.</p><p>Identification of randomized controlled trials</p><p>For PubMed/MEDLINE, the filter <b>“Randomized Controlled Trial”</b> was applied. In Web of Science and Scopus, the search strategy was supplemented with the following Boolean clause terms: <b>AND (randomized OR randomised)</b>.</p><p>Protocol deviations introduced during peer review</p><p>The authors wish to clarify that several methodological modifications were made during the peer-review process in response to reviewer feedback. These changes were incorporated into the final version of the review but were <b>not updated in the PROSPERO record at that time due to an administrative oversight</b>. The authors acknowledge that these amendments should have been documented when implemented.</p><p>The initially submitted manuscript was based on an earlier search conducted between November 2024 and April 2025, which yielded 30 included randomized controlled trials. Following reviewer feedback, the search strategy was redesigned and rerun in full; the November-December 2025 search replaced the earlier corpus and resulted in the final set of 64 included randomized controlled trials.</p><p>The final search was conducted between <b>19 November and 18 December 2025</b>, resulting in <b>64 included randomized controlled trials</b>. The PROSPERO record (CRD42024600203) was updated on 13 July 2026 to document these amendments and their rationale.</p><p>Corrections to Table 3</p><p>Final statement</p><p>The authors apologize for these errors and for any lack of clarity in the original description of the methods. These corrections are intended to improve the transparency, traceability, and reproducibility of the review. The methodological clarifications and the two transcription corrections to Table 3 do not alter the results of the included studies, the qualitative synthesis, or the main conclusions of the review.</p>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.70324","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148753787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of Anticipatory Trauma Scale: Relationship With Social Support, Resilience, Mental Well-Being","authors":"Yusuf Akyıl,&nbsp;Süleyman Akçıl,&nbsp;Azmi Çağlar,&nbsp;Beste Erdinç","doi":"10.1002/cpp.70317","DOIUrl":"https://doi.org/10.1002/cpp.70317","url":null,"abstract":"<div>\u0000 \u0000 <p>Anticipatory trauma involves extreme anxiety, mental preoccupation, bodily tension and emotional distress experienced before a potential traumatic event. Individuals may suffer from stress, worry, preparedness behaviours and impairments in social and personal functioning due to the expectation that they or their loved ones may face a significant risk, accident, attack, disaster or similar traumatic experience in the future. This study aims to develop a reliable and valid Anticipatory Trauma Scale (ATS) and examine its role within a serial mediation model among adults. The study was conducted in three stages. In Study 1 (<i>N</i> = 463), confirmatory factor analysis was used to validate the 10-item ATS. Reliability analyses showed that the scale had high internal consistency, while item response analysis indicated the discriminatory power of the items. In Study 2 (<i>N</i> = 491), correlation analysis indicated that the ATS was significantly associated with life satisfaction, the Big Five personality traits, stress, anxiety, depression and trauma coping self-efficacy. In Study 3 (<i>N</i> = 569), structural equation modelling demonstrated that social support and resilience serially mediated the relationship between ATS and mental well-being. Findings suggest that interventions should focus on building resilient social networks and effective coping mechanisms to support the mental health of individuals experiencing trauma and anxiety.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148753349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Dropout in Psychotherapy for Major Depressive Disorder: A Machine Learning Approach to Identifying At-Risk Patients","authors":"Susanne Bremer-Hoeve,&nbsp;Suzanne C. van Bronswijk,&nbsp;Aartjan T. F. Beekman,&nbsp;Maartje Miggiels,&nbsp;Sanne J. E. Bruijniks,&nbsp;Maarten K. van Dijk","doi":"10.1002/cpp.70320","DOIUrl":"10.1002/cpp.70320","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Dropout from psychotherapy for major depressive disorder (MDD) undermines treatment effectiveness for both patients and clinicians. Early identification of individuals at risk of discontinuation is therefore essential. Machine learning methods, particularly those incorporating resampling techniques to address imbalanced clinical data, may offer improved predictive capacity. This study evaluates several machine-learning approaches to determine their potential in identifying patients at elevated risk of dropout.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were drawn from a randomised controlled trial of outpatients with MDD (<i>n</i> = 290) receiving short-term psychodynamic supportive psychotherapy (SPSP) or cognitive behavioural therapy (CBT). Candidate predictors were restricted to variables available in both the development and external validation datasets, resulting in a limited number of overlapping predictors. Multiple machine learning models and resampling strategies were applied to predict dropout, and the best-performing models were subsequently externally validated using an independent clinical dataset (<i>n</i> = 96).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Models demonstrated low predictive performance overall. Resampling strategies influenced outcomes, with SMOTE consistently improving F1-scores compared with no resampling. The combination of random forest with SMOTE achieved the highest F1-score (0.303). Five key predictors of dropout emerged: younger age, unemployment, a higher number of comorbid Axis I disorders, absence of a partner, and moderate depression severity. All models showed reduced performance during external validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The models showed very limited predictive performance, which may in part reflect the restricted predictor set resulting from the requirement that variables be assessed in both trials. While clinical application is premature at this stage, the findings provide a valuable proof of concept and highlight key methodological challenges inherent in cross-trial dropout prediction. Despite this, the identified predictors are routinely available in clinical practice, suggesting that future models, if developed with richer predictor sets and validated in larger samples, could ultimately support therapists in the early identification of patients at risk of dropout and in proactively addressing disengagement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can All Oxygen Molecules Accumulate in One Corner of the Room? Treating Pathological Narcissism Requires High Standard Randomized Clinical Trials. A Commentary on the Trial by Mohajerin et al.","authors":"Giancarlo Dimaggio,&nbsp;Felix Inchausti,&nbsp;Anthony Bateman,&nbsp;Sune Bo,&nbsp;Lois Choi-Kain,&nbsp;Majse Lind,&nbsp;Patrick Luyten,&nbsp;Angus MacBeth,&nbsp;Sophie Juul,&nbsp;David Kealy,&nbsp;Carla Sharp,&nbsp;Igor Weinberg","doi":"10.1002/cpp.70319","DOIUrl":"10.1002/cpp.70319","url":null,"abstract":"<div>\u0000 \u0000 <p>Narcissistic personality disorder (NPD) and pathological narcissism (PN) urgently need empirically supported treatment options. Mohajerin et al. randomized controlled trial yielded promise in addressing this gap. However, in this commentary, an international group of personality disorder experts identify a number of issues with the trial methodology, reporting and interpretation: (i) the unlikeliness that consecutive sample recruitment would result in almost equal number of participants in grandiose vs. vulnerable subgroups; (ii) the unlikeliness that consecutive sample recruitment would result in almost equal number of participating men and women; (iii) the unlikely possibility that grandiose and vulnerable narcissism would appear as uncorrelated subtypes; (iv) dissimilar treatment responses to schema-focused therapy vs. Unified Protocol; (v) absence of dropouts; (vi) unclear randomization procedure; (vii) poor screening and recruitment procedures and limited transparency in trial registration; (viii) exclusive reliance on self-report measures; (ix) limited transparency in supervision and treatment fidelity procedures; (x) nonequivalence of treatment dose and duration; and (xi) lack of clarity on how the disclosure of NPD diagnosis to participants was handled in the trial. In light of these concerns, it is difficult to reconcile the results of this trial with the inherent challenges of treating NPD and PN. We therefore warrant against considering it a benchmark in NPD treatment innovation.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"33 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}