Johannes Larsson, Olivia Ojala, Johan Bjureberg, Philip Sederström, Oskar Hvass, Patrik Björk, Samuel Lidskog, Hugo Hesser
{"title":"Online emotion regulation treatment for maladaptive anger inhibition – an open-label pilot with a pooled interrupted time series design","authors":"Johannes Larsson, Olivia Ojala, Johan Bjureberg, Philip Sederström, Oskar Hvass, Patrik Björk, Samuel Lidskog, Hugo Hesser","doi":"10.1080/16506073.2025.2542355","DOIUrl":"https://doi.org/10.1080/16506073.2025.2542355","url":null,"abstract":"Despite documented risks associated with excessive anger inhibition, few treatments specifically target maladaptive anger inhibition. Building on a previously evaluated treatment for general anger, this study evaluated the feasibility, acceptability, and preliminary efficacy of a brief (4-week), therapist-supported online emotion-regulation treatment for maladaptive anger inhibition. In total 38 participants (89.5% female; M-age = 43.8, SD = 14.1) with elevated levels of maladaptive anger inhibition were offered treatment, which was evaluated using a pooled interrupted time series design (ITS). Treatment outcomes included measures of anger inhibition, anger rumination, and anger assertion that were assessed during a baseline phase (4 weeks) and a treatment phase (4 weeks). Feasibility was supported by high retention and adherence, and minor adverse events. Moreover, participants reported high treatment credibility and satisfaction, indicating good acceptability of the treatment. Piecewise growth curve analysis for ITS, comparing baseline and treatment phases, revealed significant and large immediate effects on all outcomes: anger inhibition (d = 1.26), anger rumination (d = 0.80), and anger assertion (d = 0.79), with small additional gains observed at 3-month follow-up. Taken together, the findings suggest that this brief online emotion-regulation treatment for maladaptive anger inhibition is feasible, acceptable, potentially effective, warranting further investigation in an RCT. ClinicalTrials.gov identifier: NCT06697587.","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":"30 1","pages":"1-16"},"PeriodicalIF":4.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144770102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecka Astenvald, Martina Isaksson, Jenny Meyer, Måns Lööf, Matilda A. Frick, Johan Isaksson
{"title":"Emotion regulation training for adolescents with ADHD: a multiple-baseline single-case experimental study","authors":"Rebecka Astenvald, Martina Isaksson, Jenny Meyer, Måns Lööf, Matilda A. Frick, Johan Isaksson","doi":"10.1080/16506073.2025.2537812","DOIUrl":"https://doi.org/10.1080/16506073.2025.2537812","url":null,"abstract":"Adolescents with attention-deficit/hyperactivity disorder (ADHD) often experience difficulties with emotion regulation, but treatment alternatives remain limited. This study investigates the feasibility and effectiveness of a newly developed psychological intervention aiming to increase emotion regulation skills in adolescent ADHD. A single-case experimental design with multiple baselines across participants was employed. Seven girls aged 13-17 years with ADHD completed the intervention. Outcomes of feasibility included attrition and retention rates, therapist-rated adherence, homework completion and engagement with the intervention material, as well as self- and caregiver ratings of client satisfaction and adverse outcomes. Primary outcomes of emotion dysregulation included weekly self- and caregiver ratings of the Difficulties in Emotion Regulation Scale Short Form during baseline, the intervention and a follow-up period of 2 weeks. Data was analyzed through descriptive statistics, visual inspection and effect size (Tau). The intervention was deemed feasible, although homework completion and engagement between sessions proved challenging. Six adolescents and caregivers reported lower emotion dysregulation after the intervention. However, six adolescent and four caregiver ratings demonstrated improvement before the intervention during baseline, complicating determination of intervention effects. Nevertheless, four participants showed a visual and/or statistical improvement from the intervention. Sensitivity analyses suggest that the intervention may have positive effects on emotional clarity.","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":"22 1","pages":"1-17"},"PeriodicalIF":4.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jake Linardon, Mariel Messer, Remony Reid, Tayarna Bolger, Gerhard Andersson
{"title":"Absolute and relative rates of treatment non-initiation, dropout, and attrition in internet-based and face-to-face cognitive-behavioral therapy: a meta-analysis of randomized controlled trials","authors":"Jake Linardon, Mariel Messer, Remony Reid, Tayarna Bolger, Gerhard Andersson","doi":"10.1080/16506073.2025.2542364","DOIUrl":"https://doi.org/10.1080/16506073.2025.2542364","url":null,"abstract":"Internet-based cognitive-behavioral therapy (ICBT) appears to produce comparable clinical benefits to face-to-face CBT. However, whether these two CBT modalities are equally accepted by patients remains unclear. We conducted a meta-analysis examining absolute and relative rates of treatment non-initiation, dropout, and attrition in ICBT and face-to-face CBT. Thirty trials comparing ICBT to face-to-face CBT for psychiatric and somatic disorders were included. Pooled event rates were calculated to estimate absolute rates of treatment non-initiation, dropout, and attrition. Risk ratios (RR) were computed to compare relative rates between modalities. Absolute rates of treatment non-initiation for ICBT were 8.7% (95% CI = 5.0-14.5) compared to 11.9% for face-to-face CBT (95% CI = 8.3-16.8), which produced a significant RR of 0.58. This effect remained significant in various sensitivity analyses. Absolute rates of treatment dropout were 16.3% (95% CI = 11.8-22.2) for ICBT and 12.0% (95% CI = 7.6-18.5) for face-to-face CBT, while absolute rates of post-treatment and follow-up attrition were 15.2% (95% CI = 11.1-20.4) and 22.3% (95% CI = 16.9-28.8) for ICBT and 14.1% (95% CI = 10.3-19.0) and 23.1% (95% CI = 17.5-29.7) for face-to-face CBT, respectively. These RRs were non-significant. Findings suggest that while ICBT is more readily initiated than face-to-face CBT, both modalities demonstrate comparable rates of treatment completion and study retention across diverse clinical contexts.","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":"12 1","pages":"1-14"},"PeriodicalIF":4.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samuel J Leonard, Amanda Venta, Jaye Derrick, Elizabeth Anderson-Fletcher, Anka A Vujanovic
{"title":"Associations of insecure adult attachment style, trauma-related social cognition, and emotion regulation difficulties with PTSD symptom severity among first responders who served during Hurricane Harvey.","authors":"Samuel J Leonard, Amanda Venta, Jaye Derrick, Elizabeth Anderson-Fletcher, Anka A Vujanovic","doi":"10.1080/16506073.2025.2540922","DOIUrl":"https://doi.org/10.1080/16506073.2025.2540922","url":null,"abstract":"<p><p>First responders play a vital role in the response to natural disasters and are at a disproportionate risk for developing post-traumatic stress disorder (PTSD) symptoms following these events. The association between attachment style and PTSD is well-established and has been documented among first responders. Understanding the social cognitive and affective factors implicated in the association between insecure adult attachment style and PTSD symptoms among first responders has the potential to inform specialized treatments for this population. The present investigation examined the serial indirect effect of insecure adult attachment style (i.e. attachment avoidance; attachment anxiety) on PTSD symptom severity through trauma-related social cognition and emotion regulation difficulties (ERD). The sample was comprised of 115 first responders (<i>M</i>age = 42.25, <i>SD</i> = 10.38, 80.0% male) who served during Hurricane Harvey and were recruited to complete an online survey in 2022. Attachment avoidance was indirectly related to PTSD symptom severity via the sequential effects of trauma-related social cognition and ERD (β<i>=</i>.13, SE = .07, CI = .02-.29). The model including attachment anxiety as a statistical predictor was not significant (β = .10, SE = .07, CI = -.01-.27). These findings suggest that there is value in examining the role of social processes and emotion regulatory factors among first responders to inform evidence-based PTSD intervention efforts.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-14"},"PeriodicalIF":3.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
John H Riskind, Ayse Altan-Atalay, Jacqueline Sison, Evan Kleiman
{"title":"Perseverative effort and grit but not gratitude are protective against the onset of anxiety for cognitively at-risk individuals.","authors":"John H Riskind, Ayse Altan-Atalay, Jacqueline Sison, Evan Kleiman","doi":"10.1080/16506073.2025.2536787","DOIUrl":"https://doi.org/10.1080/16506073.2025.2536787","url":null,"abstract":"<p><p>Grit and gratitude protect against depression caused by cognitive vulnerability factors like hopelessness and rumination. This study examined whether these personality strengths could buffer against a cognitive vulnerability for anxiety, the looming cognitive style (LCS). A prospective design was used with university students (<i>N</i> = 247; 86.2% female; aged between 18 and 60) completing online questionnaires two times 6 weeks apart that assessed LCS, grit, gratitude, and anxiety and depression. Path analyses revealed that LCS had a significant main effect and a theoretically expected interaction effect on anxiety symptoms with \"grit perseverance but not with \"grit consistency\" or gratitude. Neither LCS, grit perseverance nor gratitude had any effects on depression symptoms, although an effect emerged for grit consistency. This study is the first to our knowledge to examine how personality strengths protect individuals against a cognitive vulnerability that is more specific to anxiety symptomatology than to depression. Along with other studies, the findings further suggest that a crucial way grit and personality strengths provide benefit is by protecting against cognitive vulnerabilities.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-11"},"PeriodicalIF":3.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anne Huntjens, Filip Smit, L M C Wies van den Bosch, Ad Kerkhof, Bram Sizoo, Mark van der Gaag
{"title":"Emotion regulation as a mediator of dialectical behaviour therapy for autistic adults with suicidal ideation.","authors":"Anne Huntjens, Filip Smit, L M C Wies van den Bosch, Ad Kerkhof, Bram Sizoo, Mark van der Gaag","doi":"10.1080/16506073.2025.2539301","DOIUrl":"https://doi.org/10.1080/16506073.2025.2539301","url":null,"abstract":"<p><p>Dialectical behaviour therapy (DBT) effectively reduces suicidality in autism by improving emotion regulation (ER), yet its underlying therapeutic mechanism is unclear. This study explores ER factors as mediators in DBT's impact on suicidal ideation in autistic individuals. Data from 123 adult outpatients with autism and suicidal behaviours were randomly assigned to DBT (<i>n</i> = 63) or treatment as usual (<i>n</i> = 60). Suicidal ideation was assessed using the Suicidal Ideation Attributes Scale, and six ER factors were measured with the Difficulties in Emotion Regulation Scale. Structural equation modelling compared a non-sequential model with a sequential model targeting ER factors in the following order: reducing suicide risk, enhancing emotional awareness, consolidating skills, and aligning coping strategies with long-term goals. ER mediated 67% of the total treatment effect. In the non-sequential mediation model, path coefficients were generally small (β ≤ 0.32) and largely not significant. Conversely, in the sequential model, path coefficients were stronger (range: 0.23 ≤ β ≤ 0.92) and all statistically significant (<i>p</i> < 0.01). DBT effectively reduces suicidal behaviour in autistic individuals, with ER playing a profound mediating role. Sequential targeting of ER factors cascades the therapeutic process, highlighting the importance of structured intervention.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-15"},"PeriodicalIF":3.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jakob Clason van de Leur, Karolina Lundbäck, Sanna Forslund, Nicole Virtanen, Monica Buhrman
{"title":"Feasibility, utility, and acceptability of an online ACT-based rehabilitation for clinical burnout.","authors":"Jakob Clason van de Leur, Karolina Lundbäck, Sanna Forslund, Nicole Virtanen, Monica Buhrman","doi":"10.1080/16506073.2025.2530420","DOIUrl":"10.1080/16506073.2025.2530420","url":null,"abstract":"<p><p>The prevalence of stress-related sick leave in Western society has increased clinical and scientific interest in conditions like clinical burnout. However, evidence-based treatments for clinical burnout remain scarce. This uncontrolled pilot study examined the feasibility, utility, and acceptability of an online rehabilitation program for clinical burnout based on Acceptance and Commitment Therapy (ACT). Twenty-six patients with clinical burnout were included in a 12-week online ACT rehabilitation. Self-rated questionnaires were administered pre-treatment, weekly during treatment, post-treatment, and at three- and six-month follow-ups. Independent raters assessed clinical severity, average working time, and functional disability. There were no dropouts and a high module completion rate (85%), demonstrating feasibility. The rehabilitation's utility was supported by clinical ratings indicating reduced clinical severity, functional disability, and increased working time from 18% at baseline to 75% at the six-month follow-up. Significant improvements were seen in exhaustion, anxiety, depression, psychological flexibility, and perfectionistic concerns with medium to large effect sizes (<i>g</i> = 0.67-1.31) at post-treatment, which were maintained at the six-month follow-up (<i>g</i> = 0.86-1.50). Treatment credibility and satisfaction were high, with few negative effects, indicating high acceptability. These findings suggest that this ACT-based online rehabilitation for clinical burnout holds sufficient promise to warrant further clinical trials.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-14"},"PeriodicalIF":4.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N M Sørensen, H Skaarnes, K Mathiasen, L F McLellan, M Thastum, J J Lomholt
{"title":"Internet-based cognitive behavioral therapy (ICBT) for adolescents with anxiety disorders delivered with different types of therapist support: a randomized feasibility trial.","authors":"N M Sørensen, H Skaarnes, K Mathiasen, L F McLellan, M Thastum, J J Lomholt","doi":"10.1080/16506073.2025.2522995","DOIUrl":"https://doi.org/10.1080/16506073.2025.2522995","url":null,"abstract":"<p><p>Internet-based cognitive behavioral therapy (ICBT) programs are offered with varying types of therapist support. But little is known about the impact of therapist support in these programs. The aim of this study was to test the feasibility of delivering ICBT for adolescents with anxiety disorders with different types of written therapist support in a routine care setting. This was done in preparation of a large-scale randomized controlled trial of clinical effectiveness. 15 adolescents aged 12-17 years, and their parents participated in the study. They were randomized 1:1 to either 1) ICBT with planned support, or 2) ICBT with support on demand. Feasibility measures included feasibility and acceptability of treatment and study procedures, and acceptability of the intervention and conditions. Clinical outcome measures included anxiety diagnosis and symptom severity. The results indicate that it may be feasible to deliver the ICBT intervention with different degrees of support. However, the results also indicate that some adaptations to procedures were needed, as the difference in support received between conditions was not as pronounced as expected. The main adaptation derived from this study was altering the planned support condition to provide support at fixed weekly intervals instead of upon session completion.ClinicalTrials.gov ID: NCT06076954.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-24"},"PeriodicalIF":4.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Phoebe R Joshua, Vivienne Lewis, Sally F Kelty, Douglas P Boer
{"title":"Applications of schema therapy in young people: a systematic review.","authors":"Phoebe R Joshua, Vivienne Lewis, Sally F Kelty, Douglas P Boer","doi":"10.1080/16506073.2025.2522375","DOIUrl":"https://doi.org/10.1080/16506073.2025.2522375","url":null,"abstract":"<p><p>Adolescents and young adults are increasingly susceptible to developing mental health conditions, but many young people do not respond well to the current evidence-based treatments. Schema therapy has been effective in adults with mental health conditions, and research suggests it holds promise in adolescents with chronic or treatment-resistant mental health conditions. Our systematic review searched for articles that applied schema therapy in people aged between 12 and 30. Databases searched using the EBSCOHost platform included PubMed MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Psychology and Behavioural Sciences Collection and American Psychological Association PsychInfo. Web of Science and the Cochrane Library was also searched. The quality of each article was assessed using the Mixed Method Appraisal Tool. Twelve studies including 180 participants were found meeting these criteria. These results provided preliminary support for the use of schema therapy in adolescents and young adults experiencing a wide range of mental health conditions including personality, conduct, anxiety, depressive or eating disorders. Our systematic review supports previous research on schema therapy, finding that it could be a promising treatment for young people. The present systematic review identifies directions for future research and provides guidance for clinicians providing schema therapy in this population.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-23"},"PeriodicalIF":4.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}