Clinical psychology & psychotherapy最新文献

{"title":"Associations Between Transdiagnostic Psychological Processes and Global Symptom Severity Among Outpatients With Various Mental Disorders: A Cross-Sectional Study","authors":"Anna Katharina Frei, Thomas Studnitz, Britta Seiffer, Jana Welkerling, Johanna-Marie Zeibig, Eva Herzog, Mia Maria Günak, Thomas Ehring, Keisuke Takano, Tristan Nakagawa, Leonie Sundmacher, Sebastian Himmler, Stefan Peters, Anna Lena Flagmeier, Lena Zwanzleitner, Ander Ramos-Murguialday, Sebastian Wolf","doi":"10.1002/cpp.70046","DOIUrl":"https://doi.org/10.1002/cpp.70046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Knowledge about transdiagnostic factors associated with global symptom severity among patients diagnosed with various mental disorders remains limited. This study examined the cross-sectional associations between transdiagnostic processes including global emotion regulation and specific emotion regulation strategies (i.e., amount of physical activity and sedentary behaviour, repetitive negative thinking and sleep routines) with global symptom severity, while controlling for sociodemographic data (age, gender, employment status, relationship status, and educational level) and fear of the coronavirus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 401 outpatients, aged 42.08 years on average (<i>SD</i> = 13.26; 71.3% female), diagnosed with depressive disorders, non-organic primary insomnia, agoraphobia, panic disorder and/or post-traumatic stress disorder were examined. This study is a secondary analysis of a randomized controlled trial. Data were collected from 10 different study sites between March 2021 and May 2022 for cross-sectional analysis. The influence of predictors of global symptom severity was determined using three-step hierarchical multiple regression: (1) control variables, (2) global emotion regulation and (3) specific emotion regulation strategies. Global symptom severity was measured using the Global Severity Index, derived from the Brief Symptom Inventory-18. Predictors were measured using validated scales, and physical activity was additionally assessed via accelerometer-based sensors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the first step, control variables accounted for 4% of variance in global symptom severity. The inclusion of global emotion regulation in the second step explained 26% of the outcome variance, and the incorporation of specific emotion regulation strategies in the third step increased the explained variance to 37%. Significant predictors included global emotion regulation (<i>β</i> = 0.28), repetitive negative thinking (<i>β</i> = 0.26) and sleep routines (<i>β</i> = 0.25).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Global emotion regulation along with repetitive negative thinking and sleep routines as specific emotion regulation strategies are identified as transdiagnostic psychological processes that may serve as treatment targets for evidence-based interventions designed to enhance emotion regulation, particularly in transdiagnostic samples of stress-related disorders. Additional prospective longitudinal studies with transdiagnostic samples are n","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362446","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":"Psychosocial Factors Associated With Posttraumatic Stress Disorder Symptom Clusters in a Sample of Women Survivors of Intimate Partner Violence","authors":"Ana Bellot Valenzuela,&nbsp;Cerrato Ignacio Montorio,&nbsp;Marina Muñoz Rivas","doi":"10.1002/cpp.70044","DOIUrl":"https://doi.org/10.1002/cpp.70044","url":null,"abstract":"<div>\u0000 \u0000 <p>The DSM-5 classifies posttraumatic stress disorder (PTSD) symptomatology into four distinct clusters and numerous studies have examined the psychosocial risk factors predicting these clusters across various types of trauma. However, no research has specifically explored the unique predictors of PTSD clusters in women survivors of intimate partner violence (IPV) This retrospective study analysed the DSM-5-proposed psychosocial predictors of PTSD symptom clusters (severity of violence, previous trauma, social support, emotional regulation, coping strategies and blame) in 333 women who had filed a police report for IPV. Through linear step regression analysis, five models were estimated for the four clusters and the PTSD diagnosis dissociation specifier. The findings showed both common and specific factors associated with the different PTSD clusters. Unsatisfactory emotional processing and negative self-focussing emerged as the predominant factors common to PTSD clusters and, to a lesser extent, emotional impoverishment and emotions of guilt. Childhood trauma was identified as a risk factor in all clusters, although its influence was attenuated when emotional regulation was considered. The severity of violence was a specific predictor for the intrusion cluster, and emotional avoidance predicted the PTSD cluster of avoidance symptoms. Social support acted as a protective factor for the cluster of mood disorders. The adjusted <i>R</i>² for the models ranged from 0.23 to 0.45. Taken together, the results highlight the need to distinguish specific symptom categories within the overall diagnosis of PTSD and offer an empirical perspective for better understanding and more accurate treatment for women survivors of IPV with PTSD.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362445","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":"Walk-and-Talk Therapy Versus Conventional Indoor Therapy for Men With Low Mood: A Randomised Pilot Study","authors":"Andrea Dickmeyer,&nbsp;Jordan J. Smith,&nbsp;Sean Halpin,&nbsp;Stacey McMullen,&nbsp;Ryan Drew,&nbsp;Philip Morgan,&nbsp;Sarah Valkenborghs,&nbsp;Frances Kay-Lambkin,&nbsp;Myles D. Young","doi":"10.1002/cpp.70035","DOIUrl":"10.1002/cpp.70035","url":null,"abstract":"<p>While psychotherapy is effective for treating depression, men are less likely than women to attend and more likely to drop out. The value of alternative therapeutic approaches for men needs to be investigated. In this randomised pilot trial, we investigated the feasibility and preliminary efficacy of outdoor ‘walk-and-talk’ therapy compared to conventional indoor therapy for 37 men with low mood (mean [SD] PHQ-9 score = 11.4 [5.0]; mean [SD] age = 44.1 [15.8] years). Over 6 weeks at the University of Newcastle participants received weekly 60-min sessions delivered (i) while walking along a 4-km route on campus or (ii) indoors in a psychology clinic, delivered by provisional psychologists using non-directive supportive counselling. Outcomes included validated measures of depression, anxiety, stress and overall psychological distress, male-type depression, mental well-being, behavioural activation and therapeutic alliance. At post-intervention, all pre-registered feasibility benchmarks were exceeded including recruitment capability, retention (89%), average attendance (walk-and-talk: 91%, indoor: 89%), proportion of sessions delivered in intended setting (walk-and-talk: 100%, indoor: 98%) and overall perceived acceptability of the therapy (walk-and-talk: 4.4/5, indoor: 4.2/5, where 1 = <i>poor</i> and 5 = <i>excellent</i>). Linear mixed model analysis demonstrated both groups achieved similar improvements in depressive symptoms (<i>d</i> = −0.02), but the walk-and-talk group reported greater improvements in overall psychological distress (<i>d</i> = −0.5), anxiety (<i>d</i> = −0.4) and stress (<i>d</i> = −0.7). In contrast, male-type depression improved more in the conventional indoor group (<i>d</i> = 0.6). Other outcomes were comparable between groups. Results indicate that walk-and-talk therapy may be acceptable and effective for men with depression. A powered trial to interrogate these effects and identify moderators of effectiveness is warranted.</p><p><b>Trial Registration:</b> Australian New Zealand Clinical Trials Registry number: ACTRN12622001318774.</p>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.70035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188457","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":"Unified Protocol vs Mentalization-Based Therapy for Adolescents With Borderline Personality Disorder: A Randomized Controlled Trial","authors":"Banafsheh Mohajerin,&nbsp;Matthew W. Gallagher,&nbsp;Richard Howard","doi":"10.1002/cpp.70033","DOIUrl":"10.1002/cpp.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite several treatments, e.g., mentalization-based therapy (MBT) and Unified Protocol (UP), being adapted to treat adolescents with borderline personality disorder (BPD), there exists a dearth of literature regarding their relative efficacy. In this study modified forms of MBT and UP – MBT-A and UP-A respectively—were compared in their ability to reduce borderline symptoms in a sample of 91 Iranian adolescents (two-thirds female) with a BPD diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Individuals randomly allocated to one of two treatment groups, MBT-A (<i>N</i> = 45) or UP-A (<i>N</i> = 46) were followed up across 36 months following treatment. A MIXED ANCOVA was applied to compare the effectiveness of these interventions in reducing severity of borderline symptoms (the primary outcome), impulsivity, self-harm, emotion dysregulation and anger (secondary outcomes). The trial was retrospectively registered at IRCT20231106059970N1.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both primary outcomes and secondary outcomes decreased significantly following both MBT-A and UP-A. In comparison with MBT-A, UP-A was more effective in reducing emotional dysregulation, but levels of remission declined progressively up to 36 months of follow-up following both treatments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>UP-A appears to be more effective than MBT-A in reducing emotional dysregulation in adolescents with BPD, despite being a shorter and less intensive treatment. An important <i>caveat</i> is that the treatment induced changes were largely limited to the emotion dysregulation aspect of BPD; other aspects (interpersonal and identity disturbances) were largely unchanged by either treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078777","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":"A Novel Transdiagnostic Approach to the Prevention of Eating Disorders Using Virtual Reality: Preliminary Evaluation of the H.O.M.E. Intervention","authors":"Valentina Gardini,&nbsp;Silvana Grandi,&nbsp;Elena Tomba","doi":"10.1002/cpp.70040","DOIUrl":"10.1002/cpp.70040","url":null,"abstract":"<p>“Virtual reality” (VR) has been used effectively in clinical psychology to improve existing treatments and prevention protocols for many psychopathologies, including eating disorders (EDs). However, no VR software was developed to concurrently tackle dysfunctional eating behaviours and three third wave cognitive–behavioural transdiagnostic factors linked to EDs: psychological inflexibility, emotion dysregulation and experiential avoidance. This preliminary study is aimed at evaluating potential effects of a new VR-based preventive intervention (H.O.M.E.—How to Observe and Modify Emotions) in improving selected outcomes of transdiagnostic factors and dysfunctional eating behaviours in the general population (GP) with ED risk compared to a waiting list (WL). <i>N</i> = 40 GP participants with ED risk were screened (using the SCOFF and Eating Disorder Examination Questionnaire (EDE-Q)) and randomised into VR (<i>n</i> = 20) or WL (n = 20) groups. Before and after intervention and at 3- and 6-month follow-up, participants completed EDE-Q, Difficulties in Emotion Regulation Scale—brief version (DERS-16) for emotion dysregulation, Acceptance and Action Questionnaire II (AAQ-II) for psychological inflexibility and Multidimensional Psychological Flexibility Inventory (MPFI) experiential avoidance scale. H.O.M.E. improved scores in all EDE-Q subscales (EDE-Q-total: <i>p</i> = 0.003; EDE-Q-restraint: <i>p</i> = 0.028; EDE-Q-eating concerns: <i>p</i> = 0.035; EDE-Q-shape concerns: <i>p</i> = 0.003; EDE-Q-weight concerns: <i>p</i> = 0.023), AAQ-II (<i>p</i> = 0.005), DERS-16-total (<i>p</i> = 0.006), DERS-16-difficulty in engaging in goal-directed behaviours (<i>p</i> = 0.008), and DERS-16-limited access to emotion regulation strategies (<i>p</i> = 0.001), with results greater than WL and maintained at follow-ups. Results showed potential for H.O.M.E. to represent a feasible tool to prevent EDs. Given the similarity between VR and technologies used in everyday life, H.O.M.E. may help in engaging young individuals with ED risk towards psychological support before ED onset.</p>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078774","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 Symptom Structure of Depression, Anxiety and Suicidal Ideation Among Chinese Shidu Parents — A Network Analysis","authors":"Hongfei Ma,&nbsp;Shuang Zhao,&nbsp;Yang Wang","doi":"10.1002/cpp.70042","DOIUrl":"10.1002/cpp.70042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In China, Shidu parents, who have experienced the pain of losing their only child, are more likely to suffer from mental health issues such as depression, anxiety, and suicidal ideation compared to other bereaved groups. Currently, the relationships between symptoms of depression, anxiety, and suicidal ideation among Shidu parents remain unclear, necessitating further research to elucidate these connections. Our study aims to estimate the network of depression and anxiety symptoms and identify the bridge symptoms between depression, anxiety and suicidal ideation based on network analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was conducted in five urban districts and one rural district in Shenyang City, Liaoning Province, China. Data collection was conducted from March 2017 to February 2020. Network analysis was implemented by using the R packages qgraph and bootnet.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>‘Felt depressed’ and ‘felt sad’ were central symptoms of depression, while ‘feeling fainting and passing out’ and ‘afraid for no reason’ were central symptoms of anxiety. Two pairs of bridge symptoms and one overlapping symptom were found in the transdiagnostic network. In addition, one depressive symptom and one anxiety symptom were identified to be significantly associated with suicidal ideation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The current study is the first to conduct a network analysis of depression, anxiety, and suicidal ideation among Chinese Shidu parents. The association among disease symptoms were found, and the most central symptoms were identified. Results of the present study can provide some new intervention and treatment ideas for corresponding diseases, which lays a theoretical foundation for the future longitudinal research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064197","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":"EMDR Interventions in Refugees and Asylum Seekers: A Systematic Review and Meta-Analysis","authors":"Celia Antuña-Camblor,&nbsp;Víctor Tejedor Hernández","doi":"10.1002/cpp.70039","DOIUrl":"10.1002/cpp.70039","url":null,"abstract":"<div>\u0000 \u0000 <p>Both refugees and asylum seekers exhibit poorer mental health and higher rates of mental disorders, particularly posttraumatic stress disorder (PTSD), for which EMDR therapy has been shown to be effective. This review analyses the efficacy of EMDR in reducing PTDS in refugees or asylum seekers using randomized controlled studies (RCTs). A systematic review and meta-analysis published in PROSPERO (CRD42024595506) using the databases PubMed, PsycINFO and Web of Science were conducted. The authors independently reviewed the articles to maintain double blind. A total of 10 articles met the criteria for inclusion. The analysis of these studies revealed that a nonsignificant effect of EMDR on PTSD symptoms was observed at the end of the intervention period and the effect sizes reflect interaction effects between treatment/control over time on outcome, and these represent changes over time. It should be interpreted with awareness of the potential limitations introduced by excluding other study designs due to heterogeneity.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058308","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 High Place Phenomenon: Associations With Markers of Positive and Negative Mental Health in Individuals Suffering From Specific Phobia or Agoraphobia","authors":"Lara Wiesmann,&nbsp;André Wannemüller,&nbsp;Tobias Teismann","doi":"10.1002/cpp.70038","DOIUrl":"10.1002/cpp.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Call of the Void phenomenon describes an inexplicable urge to consider dangerous or self-destructive actions in certain situations. Previous studies have focused on the high place phenomenon (HPP), which is the sudden urge to jump from high places. One aim of this study is to replicate the previously found associations of HPP with suicidality and anxiety in a larger sample of patients suffering from flight phobia or agoraphobia. Furthermore, the influence of personality traits and protective factors, such as self-efficacy and self-esteem, will be examined to identify associations between the HPP and potential markers of both positive and negative mental health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study sample comprised 612 patients (76% female; <i>M</i>_age = 43.77, <i>SD</i>_age = 12.82) suffering from clinically relevant fear of flying. Participants filled out questionnaires on experiences with the high place phenomenon, depression, personality traits, anxiety sensitivity, suicidal ideation, insecurity in social contact, flight phobia symptoms, positive mental health, self-efficacy expectations, self-esteem and satisfaction with life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Consistent with previous findings, the high place phenomenon was known to nearly 43% of the patient sample. Multiple regression analysis showed that openness to experiences, neuroticism, suicidal ideation and insecurity in social contacts were positively related to the high place phenomenon, whereas agreeableness, self-efficacy and self-esteem were negatively related.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The high place phenomenon is a common experience in individuals, whether or not they suffer from suicidal ideation. It is therefore cautioned not to interpret such experiences as an expression of a hidden death wish. Nevertheless, the occurrence of the HPP is influenced by the presence of negative and positive mental health markers. Future studies should examine the association between HPP and intrusions in the context of obsessive-compulsive disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045825","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":"Social Support and Depression Mediate the Relationship Between Childhood Trauma and Nonsuicidal Self-Injury","authors":"Jiazheng Yao,&nbsp;Yurong Zou,&nbsp;Qianyi Luo,&nbsp;Yuhan Luo,&nbsp;Tse Chunghon,&nbsp;Herui Shang","doi":"10.1002/cpp.70030","DOIUrl":"10.1002/cpp.70030","url":null,"abstract":"<div>\u0000 \u0000 <p>Nonsuicidal self-injury (NSSI), which involves the deliberate destruction of body tissue without suicidal intent, is strongly associated with an increased risk of later suicidal behaviour. Disclosing the risk factors for NSSI is therefore vital to prevent the progression to suicide. While documented evidence links NSSI to childhood trauma, depression, social support, a comprehensive perspective that integrates these factors together is lacking. To bridge this gap, we leveraged a chain-mediating model in this study, to examine the mediating effect of social support and depression on the relationship between childhood trauma and NSSI. As expected, NSSI behaviours were positively correlated with depression scores (<i>r</i> = 0.492, <i>p</i>_adj &lt; 0.001), childhood trauma scores (<i>r</i> = 0.306, <i>p</i>_adj &lt; 0.001), and negatively correlated with the social support scores (<i>r</i> = −0.168, <i>p</i>_adj = 0.020). Importantly, in the chain-mediating model, increased childhood trauma was associated with decreased social support (<i>β</i> = −0.532, <i>t</i> = −9.086, <i>p</i> &lt; 0.001), which in turn was linked with increased depressive symptoms (<i>β</i> = −0.193, <i>t</i> = −2.957, <i>p</i> &lt; 0.01), ultimately contributing to greater odds of NSSI behaviours. Our findings elucidated the complex psychological mechanisms underlying the interplay between childhood trauma, social support and depression severity, suggesting that improving social support and intervening early in depression may be potential ways to reduce the risk of NSSI.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045810","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":"Evaluating Evidence-Based Psychotherapy Utilization Patterns Among Suicide-Risk-Stratified Veterans Diagnosed With Posttraumatic Stress Disorder","authors":"Maxwell Levis,&nbsp;Monica Dimambro,&nbsp;Joshua Levy,&nbsp;Henry Platt,&nbsp;Abby Fraade,&nbsp;Brian Shiner","doi":"10.1002/cpp.70041","DOIUrl":"10.1002/cpp.70041","url":null,"abstract":"<div>\u0000 \u0000 <p>Posttraumatic stress disorder (PTSD) is a prevalent psychiatric condition, particularly among US Veterans. PTSD-diagnosed patients are more likely to experience suicidal ideation, suicide attempts and death by suicide when compared to non-PTSD-diagnosed patients. The US Department of Veterans Affairs (VA) emphasizes evidence-based psychotherapy (EBP) for PTSD, including prolonged exposure and cognitive processing therapy. This study focuses on how suicide risk impacts PTSD by evaluating utilization of nondifferentiated psychotherapy and EBP in a national sample of VA patients diagnosed with PTSD who died by suicide in 2017–2018.</p>\u0000 <p>The study used a dataset of VA patients diagnosed with PTSD who died by suicide and received psychotherapy in the year before death (cases) and patients who had comparable diagnoses, demographics and received psychotherapy during the same interval and remained alive (controls). Cases and controls were matched on suicide risk (high, moderate and low). The study tracked nondifferentiated psychotherapy and EBP and analyzed cases and control utilization rates across risk-tiers.</p>\u0000 <p>The final sample included high-risk (cases = 171; controls = 2052), moderate-risk (cases = 428; controls = 4280) and low-risk (cases = 53; controls = 529) patients. EBP utilization was markedly low, especially among cases. Higher proportions of moderate- and low-risk controls received EBP and received more sessions than matched cases.</p>\u0000 <p>Even with VA efforts to promote EBPs, usage remains limited, particularly among patients who die by suicide. Further research is needed to understand utilization barriers and improve EBP delivery to better support PTSD-diagnosed patients and reduce their suicide risk.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051917","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}