{"title":"Characterizing gender differences in appearance-related safety behaviors and their relationship with clinical symptoms.","authors":"Tapan A Patel, Jesse R Cougle","doi":"10.1080/16506073.2025.2516200","DOIUrl":"10.1080/16506073.2025.2516200","url":null,"abstract":"<p><p>Concerns with one's physical appearance is a core feature of multiple psychiatric disorders including body dysmorphic disorder and eating disorders. Recent research has evaluated smartphone-based interventions for appearance targeting appearance-related safety behaviors (ARSB), maladaptive strategies that individuals use to avoid being negatively evaluated due to their appearance. These studies have largely focused on women and excluded men representing a major gap in the literature. The present study sought to examine the relevance ARSBs in two studies. In Study 1, we examined the invariance of ARSBs in a large sample (<i>N</i> = 840) of young adults. We found evidence of partial scalar gender invariance of ARSBs, which also showed similar relationship with clinical symptoms between genders. In Study 2, we evaluated the efficacy of targeting ARSBs in an open trial of men with elevated appearance concerns (<i>N</i> = 40), most of whom identified as a sexual minority (97.3%). Participants showed reductions in appearance concerns, eating disorder symptoms, social anxiety, and overvaluation of appearance that were maintained one-month after treatment. Taken together, the present investigation suggests that ARSBs are also clinically relevant in men, and ARSB fading shows similar efficacy in men as it does in women.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"477-495"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257511","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}
Laura Duddeck, Ava Schulz, Babette Renneberg, Thomas Berger, Johanna Boettcher
{"title":"Working alliance and empowerment in internet-based groups versus individual treatment: a secondary analysis.","authors":"Laura Duddeck, Ava Schulz, Babette Renneberg, Thomas Berger, Johanna Boettcher","doi":"10.1080/16506073.2025.2521126","DOIUrl":"10.1080/16506073.2025.2521126","url":null,"abstract":"<p><p>Internet-based interventions show promise for meeting the increasing demand for psychological support, yet the mechanisms driving their effectiveness remain unclear. This study examines the roles of empowerment and working alliance in reducing social anxiety disorder (SAD) and improving adherence in a clinician-guided group (GT) compared to a clinician-guided individual treatment (IT). A total of 120 individuals meeting the SAD diagnostic criteria were randomized into one of the two active conditions. Both empowerment and working alliance were repeatedly assessed, and their effects on social anxiety and adherence (measured by completed exercises) were analyzed through t-tests, correlations, repeated measures ANOVA, and mediation models. Results revealed no significant differences between GT and IT in empowerment or alliance, although both improved throughout the intervention. GT demonstrated early advantages in alliance, while IT showed slightly better adherence and a stronger connection between empowerment and adherence. No mediation effects were observed. This study is among the first to indicate that online interventions can enhance empowerment. However, neither group nor individual treatment proved superior in enhancing empowerment or alliance. This could be due to power limitations; therefore, results should be interpreted as tendencies. Further research is needed to clarify how these factors help reduce symptoms of social anxiety.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"496-516"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495036","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":"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":"517-527"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","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}
Ashleigh B Correa, Madelyne A Bisby, Amelia J Scott, Blake F Dear
{"title":"Perceived credibility and outcome expectations: important factors for understanding willingness to engage in psychological therapy for anxiety and depression in the general community.","authors":"Ashleigh B Correa, Madelyne A Bisby, Amelia J Scott, Blake F Dear","doi":"10.1080/16506073.2026.2689747","DOIUrl":"10.1080/16506073.2026.2689747","url":null,"abstract":"<p><p>A meaningful proportion of adults with anxiety and depression symptoms do not seek out psychological therapy. Studies show that higher treatment credibility (how logical therapy seems) and outcome expectations (perceptions of therapy effectiveness) are associated with greater treatment uptake. Most research has included individuals in therapy, who may perceive therapy as more logical and effective than those not seeking treatment. No studies have investigated these constructs in detail in the general community. This study examined perceptions of psychological therapy for anxiety and depression symptoms, and its relationship to treatment willingness in a community sample of Australian adults. Participant factors associated with credibility and expectations were explored. Participants (<i>n</i> = 911) completed an online survey covering demographic information, anxiety and depression symptoms, credibility and expectations, coping self-efficacy, and therapy willingness. Results indicated that participants held positive beliefs about therapy. Credibility and expectations uniquely predicted willingness to engage in therapy. Participant characteristics explained little variance in credibility and expectations. The findings have important implications for improving treatment uptake: credibility and expectations should be considered and could be targeted via public health interventions and in primary care settings. Research exploring optimal approaches for increasing credibility and expectations would be a valuable future direction.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-14"},"PeriodicalIF":3.4,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351045","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}
{"title":"Daily appearance-related safety behaviors are associated with same-day appearance concerns and social anxiety: a preliminary examination.","authors":"Tapan A Patel, Victoria K Swaine, Jesse R Cougle","doi":"10.1080/16506073.2026.2690436","DOIUrl":"10.1080/16506073.2026.2690436","url":null,"abstract":"<p><p>Appearance-related safety behaviors (ARSBs) are maladaptive behavioral strategies employed to manage a perceived flaw in physical appearance or avoid judgment from others due to appearance. While a growing body of research have examined ARSBs using between-person designs, there is a lack of evidence examining how ARSBs may be associated with appearance concerns and social anxiety within-person. The present study preliminarily examined the validity of a daily measure of ARSBs and how daily ARSBs may be associated with same-day appearance concerns and social anxiety. Using a daily-diary approach, young undergraduate adults (<i>N</i> = 107) completed daily-diary surveys twice a week for one month (513 total surveys). Our measure of daily ARSBs converged with a baseline measure of ARSBs. Also, baseline ARSBs predicted daily ARSBs above and beyond daily anxiety and baseline appearance concerns. Within-person analyses also revealed that increases in ARSBs were associated with same day increases in appearance concerns and social anxiety. Baseline clinical symptoms moderated the observed daily relationships, indicating that they were either more pronounced or only present among individuals with elevated appearance concerns or social anxiety. Overall, the present study provides preliminary evidence that ARSBs are a salient factor for appearance concerns and social anxiety within-persons.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-13"},"PeriodicalIF":3.4,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Madelyne A Bisby, Alana Fisher, Noni Jervis, Milena Gandy, Shianika S Chandra, Andreea I Heriseanu, Taylor Hathway, Ashleigh B Correa, Nickolai Titov, Blake F Dear
{"title":"Ultra-brief psychological treatment for adults with depression or anxiety symptoms: a systematic review and meta-analysis.","authors":"Madelyne A Bisby, Alana Fisher, Noni Jervis, Milena Gandy, Shianika S Chandra, Andreea I Heriseanu, Taylor Hathway, Ashleigh B Correa, Nickolai Titov, Blake F Dear","doi":"10.1080/16506073.2026.2689743","DOIUrl":"https://doi.org/10.1080/16506073.2026.2689743","url":null,"abstract":"<p><p>Depression and anxiety are common but most adults experiencing these symptoms do not receive psychological treatment. Ultra-brief psychological treatments are a time-limited and potentially lower cost option for those who would otherwise not receive treatment. This prospectively registered review examined the acceptability and efficacy of ultra-brief psychological treatments for adults with depression or anxiety symptoms. A systematic search was undertaken up to April 2025. All clinical trials examining an ultra-brief psychological treatment for adults with depression or anxiety symptoms were included. This review returned 16,670 results and included 34 studies (<i>N</i> = 3,679). High rates of uptake (91% [95% CI 86, 94]) and completion (96% [95% CI 90, 98]) were reported. Compared to control, treatment resulted in small to moderate reductions in depression <i>g</i> = 0.35 (<i>k</i> = 20, 95% CI 0.13, 0.56) and moderate reductions in anxiety <i>g</i> = 0.51 (<i>k</i> = 14, 95% CI 0.40, 0.61) at post-treatment. Within-group effects appear to be maintained at follow-up. Overall heterogeneity was high; several moderators of between-group and within-group effects were identified. Control groups and follow-up periods varied greatly. Ultra-brief treatments appear to be acceptable and associated with significant symptom improvements. Larger clinical trials with longer follow-up periods are needed.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-16"},"PeriodicalIF":3.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249564","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}
David Morales Tejera, Silvia Di Bonaventura, Jo Nijs, Raúl Ferrer-Peña, Josué Fernández-Carnero, Anneleen Malfliet, Kelly Ickmans, Ward Willaert, Iris Coppieters
{"title":"The role of symptoms of post-traumatic stress disorders and anxiety on pain catastrophizing, disability, and illness perceptions in patients with chronic whiplash-associated disorders: a cross-sectional study.","authors":"David Morales Tejera, Silvia Di Bonaventura, Jo Nijs, Raúl Ferrer-Peña, Josué Fernández-Carnero, Anneleen Malfliet, Kelly Ickmans, Ward Willaert, Iris Coppieters","doi":"10.1080/16506073.2026.2671226","DOIUrl":"10.1080/16506073.2026.2671226","url":null,"abstract":"<p><p>Whiplash is an injury caused by a sudden acceleration-deceleration of the head, transferring energy to the spine. The clinical symptoms after the injury are known as whiplash-associated disorders (WAD), and the mechanisms of its chronicity and recovery remain unclear. We aimed to explore the relationship between post-traumatic stress disorder (PTSD) symptoms and anxiety with disability, pain catastrophizing, and illness perceptions in patients with chronic whiplash-associated disorders (cWAD). We carried out a multi-center cross-sectional study in which 120 participants with cWAD were recruited. Main outcomes included sociodemographic, PTSD symptoms, anxiety, pain catastrophizing, illness perceptions, and disability. A correlation and a multiple linear regression analysis were performed. In cWAD, PTSD symptoms correlated positively with anxiety (<i>r</i> = 0.667; <i>p</i> = 0.01). Anxiety also shows positive associations with the illness perceptions questionnaire (IPQ-R) identity subscale (<i>r</i> = 0.378; <i>p</i> = 0.01). In regression analyses, pain-related anxiety (PASS) was significantly associated with PTSD symptoms (IES-R), neck disability (NDI), and illness identity (IPQ-R Identity), explaining 58.5% of the variance (R<sup>2</sup> = 0.585, <i>p</i> < 0.001). These findings highlight the relevance of PTSD symptoms and anxiety in relation to pain-related disability and illness perceptions in patients with cWAD.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-16"},"PeriodicalIF":3.4,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155453","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}
{"title":"Latent profiles of psychological flexibility and inflexibility among Korean young adults: associations with depression and anxiety.","authors":"Duckhyun Jo, Sojeong Im, Eunbi Lee, Eunjoo Yang","doi":"10.1080/16506073.2026.2680603","DOIUrl":"https://doi.org/10.1080/16506073.2026.2680603","url":null,"abstract":"<p><p>This study explored the latent profiles of psychological flexibility and inflexibility, core processes in acceptance and commitment therapy (ACT). Psychological flexibility refers to the capacity to stay open to internal experiences and to pursue valued actions even in the presence of distress, whereas inflexibility involves rigid attempts to avoid or control them. Using a subgroup-based approach within a nomothetic framework, we investigated how the identified subgroups were associated with depression and anxiety. Participants comprised 1,000 Korean young adults (<i>M</i><sub>age</sub> = 28.68, <i>SD</i><sub>age</sub> = 4.10). Latent profile analysis was conducted alongside the Bolck-Croon-Hagenaars (BCH) method to identify distinct profiles. Three latent profiles of ACT processes emerged (i.e. high flexibility, moderate flexibility, high inflexibility). Women were more likely to be classified in the high inflexibility profile. Participants in the high flexibility profile reported lower levels of depression and anxiety, whereas those in the high inflexibility profile had more severe symptoms. Interestingly, unexpected findings were obtained regarding experiential avoidance. The identification of distinct profiles suggests that psychological flexibility and inflexibility may be more polarized in the study sample, with individuals clustering into either adaptive or maladaptive coping styles. Cultural factors may also play a role in shaping the function and impact of experiential avoidance.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-13"},"PeriodicalIF":3.2,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013839","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}
Michael A Kreminski, Shantha W Rajaratnam, Sean Cowlishaw
{"title":"A hierarchical model of affective and cognitive factors in trauma: examination utilizing the AURORA database of participants following trauma exposure.","authors":"Michael A Kreminski, Shantha W Rajaratnam, Sean Cowlishaw","doi":"10.1080/16506073.2026.2667839","DOIUrl":"https://doi.org/10.1080/16506073.2026.2667839","url":null,"abstract":"<p><p>There is debate regarding how affective and cognitive styles may underpin traumatic symptomology, and the aim of this study was to examine a hierarchical model comprising negative affect and anxiety sensitivity explaining trauma symptoms in the acute period following trauma exposure, and over 12 months. Participants were <i>n</i> = 2987 patients recruited from emergency departments in the U.S. within 72 h of exposure to acute trauma, who completed self-report assessments of anxiety sensitivity, negative affect and traumatic symptomology at 2-week post-trauma; with <i>n</i> = 1374 of these participants also reporting traumatic symptomology again at 12-month post-trauma. Structural equation modelling was utilized to assess the hierarchical model at 2 weeks and then longitudinally at 12-month post-trauma. negative affect and anxiety sensitivity both showed direct effects on traumatic symptomology in the acute period (2 weeks) post-trauma and then upon traumatic symptomology at 12 months. Anxiety sensitivity was found to be the dominant factor in both models. These findings support assertions that these deeper affective and cognitive styles are important factors that can account for later traumatic symptoms and may also be useful intervention targets to reduce acute symptoms and later post-traumatic mental health problems.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-15"},"PeriodicalIF":3.2,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147940605","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}
Vasile Sîrbu, Oana Alexandra David, Alvaro Sanchez-Lopez, Ivan Blanco
{"title":"Mapping the interplay between psychological vulnerability and protective factors in mental health: a network analysis study.","authors":"Vasile Sîrbu, Oana Alexandra David, Alvaro Sanchez-Lopez, Ivan Blanco","doi":"10.1080/16506073.2026.2668692","DOIUrl":"10.1080/16506073.2026.2668692","url":null,"abstract":"<p><p>Stress-related disorders like depression and anxiety highlight the need for prevention, prompting increased research into various risk and protective factors associated with psychological distress. This study aimed to identify key factors and their strongest associations with distress symptoms within a comprehensive network model of self-reported and behaviorally measured variables. We analyzed interactions between cognitive biases, emotion regulation strategies, emotions, beliefs, and symptoms of depression, anxiety, and stress in a cross-sectional sample of 489 participants (78% female) from the general Romanian population using network analysis. Findings indicate that negative emotions, stress, and positive reappraisal were the most highly connected variables to the rest of the network (based on expected influence centrality index). Bridge analyses suggest that stress statistically connects between functional and dysfunctional negative emotions and their associations with mental health factors. Additionally, positive emotions, interpretation bias, and rational beliefs are key in this interplay. These results highlight stress and negative emotions as highly connected nodes in the estimated psychological network, which may guide hypothesis generation for future longitudinal and intervention research.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-17"},"PeriodicalIF":3.2,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147926834","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}