Kate Clauss, Travis A Rogers, Thomas A Daniel, Joseph R Bardeen
{"title":"Attentional control dampens the effects of intolerance of uncertainty and uncertainty-related attentional bias on posttraumatic stress symptoms.","authors":"Kate Clauss, Travis A Rogers, Thomas A Daniel, Joseph R Bardeen","doi":"10.1080/16506073.2025.2487798","DOIUrl":"https://doi.org/10.1080/16506073.2025.2487798","url":null,"abstract":"<p><p>Intolerance of uncertainty (IU) is a risk factor for posttraumatic stress symptoms (PTSS) following trauma, and attentional biases for uncertainty stimuli (ABU) may be as well. Evidence suggests that better attentional control protects individuals who are vulnerable to several forms of psychopathology from developing such pathology. However, to our knowledge, the potential buffering effect of attentional control in relations between IU, ABU, and PTSS has yet to be examined. In the present study, 125 trauma-exposed undergraduate participants completed a battery of self-report measures and an eye-tracking visual-search task to assess ABU. The sample was primarily White (88.80%) and female (83.2%) with an average age of 19.70 years (<i>SD</i> = 2.60). A series of hierarchical regressions demonstrated that elevated IU and difficulties disengaging from uncertainty stimuli were associated with higher PTSS, but only among participants with lower scores on a measure of attentional control. For participants with relatively better attentional control, the associations between IU, ABU, and PTSS were non-significant. The non-clinical nature and relative homogeny of the current sample may limit generalizability of results, which warrant replication. Attentional control may protect trauma-exposed individuals from the negative effects of IU and ABU on PTSS.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-19"},"PeriodicalIF":4.3,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810669","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}
Golnaz L Atefi, Rosalie J M van Knippenberg, Sara Laureen Bartels, Andrés Losada-Baltar, María Márquez-González, Frans R J Verhey, Marjolein E de Vugt
{"title":"Preliminary efficacy of an online intervention based on Acceptance and Commitment Therapy for family caregivers of people with dementia: a feasibility study.","authors":"Golnaz L Atefi, Rosalie J M van Knippenberg, Sara Laureen Bartels, Andrés Losada-Baltar, María Márquez-González, Frans R J Verhey, Marjolein E de Vugt","doi":"10.1080/16506073.2025.2477600","DOIUrl":"https://doi.org/10.1080/16506073.2025.2477600","url":null,"abstract":"<p><p>With the rising number of dementia cases, supporting family caregivers to maintain their well-being is crucial. Acceptance and Commitment Therapy (ACT) shows promise in promoting psychological flexibility and positive behaviour change. However, it is still developing in caregiving contexts. This study evaluated the preliminary efficacy of a fully online ACT intervention for caregivers of people with dementia. This study employed a pre-post design with two follow-up assessments at 3 and 6 months. A 9-week web-based self-help ACT program, including individual goal setting prior to the intervention, and minimal contact motivational coaching, was provided to 30 family caregivers in the Netherlands. Linear mixed-effect models based on a complete-case analysis showed significant changes in depressive symptoms (mean difference: -3.34, <i>d</i> = -0.78). Significant and sustained improvements were observed in stress (mean difference: -6, <i>d</i> = -1.13) and anxiety (mean difference: -5.55, <i>d</i> = -1.38), both of which were clinically significant. Sense of competence increased (mean difference: 1.1, <i>d</i> = 0.45). ACT-specific measures, including psychological flexibility, engaged living, and inflexibility, also showed significant improvements with medium-to-large effect sizes. This online intervention demonstrated promising preliminary evidence of ACT's potential efficacy on caregivers' well-being, warranting further research in larger-scale controlled trials.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-22"},"PeriodicalIF":4.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717972","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}
Kristen H Walter, Nicholas P Otis, Alexander C Kline, Erin L Miggantz, W Michael Hunt, Lisa H Glassman
{"title":"Was it helpful? Treatment outcomes and practice assignment adherence and helpfulness among U.S. service members with PTSD and MDD.","authors":"Kristen H Walter, Nicholas P Otis, Alexander C Kline, Erin L Miggantz, W Michael Hunt, Lisa H Glassman","doi":"10.1080/16506073.2025.2482155","DOIUrl":"https://doi.org/10.1080/16506073.2025.2482155","url":null,"abstract":"<p><p>Practice assignments (i.e. homework) are a key component in cognitive behavioral therapies that predict treatment outcomes for posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) separately. However, research has not explored these variables among individuals with comorbid PTSD and MDD. This study evaluated whether practice assignment adherence and helpfulness predicted PTSD (Clinician-Administered PTSD Scale for DSM-5; CAPS-5) and MDD (Montgomery-Åsberg Depression Rating Scale; MADRS) outcomes at posttreatment and 3-month follow-up. Data were derived from a randomized clinical trial comparing cognitive processing therapy (CPT) and behavioral activation-enhanced CPT (BA+CPT) among 83 U.S. active duty service members with comorbid PTSD and MDD. Participants reported greater assignment adherence in BA+CPT than CPT (<i>p</i> = .008), primarily due to higher adherence to BA assignments within BA+CPT. Multilevel models indicated helpfulness ratings were significantly related to decreased CAPS-5 scores (<i>p</i> = .044) but not MADRS scores (<i>p</i> = .074); service members with the highest helpfulness ratings achieved the best outcomes. Adherence was not significantly related to CAPS-5 (<i>p</i> = .494) or MADRS (<i>p</i> = .114) outcomes. Findings provide clinical insights regarding compliance in integrated treatments and highlight the value in assessing helpfulness of practice assignments during treatment.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-19"},"PeriodicalIF":4.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708897","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}
Nicholas Holder, Rachel M Ranney, Alejandra K Delgado, Natalie Purcell, Gayle Y Iwamasa, Adam Batten, Thomas C Neylan, Brian Shiner, Shira Maguen
{"title":"Transitions to trauma-focused evidence-based psychotherapy for posttraumatic stress disorder from other treatments: a qualitative investigation of clinicians' perspectives.","authors":"Nicholas Holder, Rachel M Ranney, Alejandra K Delgado, Natalie Purcell, Gayle Y Iwamasa, Adam Batten, Thomas C Neylan, Brian Shiner, Shira Maguen","doi":"10.1080/16506073.2025.2481475","DOIUrl":"10.1080/16506073.2025.2481475","url":null,"abstract":"<p><p>Many veterans do not initiate trauma-focused evidence-based psychotherapy (TF-EBP) to treat posttraumatic stress disorder (PTSD). Instead, veterans receive other treatments prior to TF-EBP and the process of transitioning to TF-EBP is poorly understood. The goal of the current study was to understand clinicians' beliefs about and approaches to transitioning veterans into TF-EBP. Clinicians (<i>n</i> = 20) with any experience providing TF-EBP from across the national VA healthcare system participated in semi-structured qualitative interviews. Rapid qualitative analysis procedures were used to identify themes: (1) TF-EBP is rarely contraindicated; (2) there is no consensus on treatment alternatives after veterans decline TF-EBP; (3) unstructured therapy can be a barrier to TF-EBP; (4) data from non-TF-EBP can be used to encourage TF-EBP engagement; (5) veterans are poorly informed about PTSD referrals; (6) culturally responsive PTSD care involves asking questions throughout the treatment process; (7) TF-EBP was delivered with attention to how identity may impact treatment; (8) TF-EBP was among the first treatment option offered by all clinicians; (9) veterans initiate TF-EBP when willing; and (10) clinicians developed resources socialize veterans to structured treatment. Since non-TF-EBP approaches may be indicated (or requested) for some veterans, strategies to facilitate transitions to TF-EBP are needed.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-19"},"PeriodicalIF":3.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699871","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}
Jonathan W Murphy, Marley Warren, Dale L Smith, Sarah Pridgen, Philip Held
{"title":"Negative posttraumatic cognitions and cognitive emotion regulation strategies as predictors of PTSD symptom change during an intensive outpatient program for PTSD.","authors":"Jonathan W Murphy, Marley Warren, Dale L Smith, Sarah Pridgen, Philip Held","doi":"10.1080/16506073.2025.2481312","DOIUrl":"https://doi.org/10.1080/16506073.2025.2481312","url":null,"abstract":"<p><p>Negative posttraumatic cognitions (NPCs) and cognitive emotion regulation (CER) strategies have both been proposed as predictors of change in evidence-based cognitive behavioral therapies for posttraumatic stress disorder (PTSD). However, they are rarely studied simultaneously, with only one study examining these predictors in a randomized clinical trial of prolonged exposure therapy. It remains to be tested how these variables predict improvements in PTSD severity in real world clinical settings or different delivery formats. Data from 487 military service members and veterans that participated in a 2-week nonrandomized, uncontrolled cognitive processing therapy-based intensive treatment program (ITP) for PTSD were used to evaluate NPCs and CER strategies as predictors of improvements in PTSD severity. Results showed that, in a model with both predictors, decreases in self-focused NPCs, world-focused NPCs, and catastrophizing (CER strategy) were associated with reductions in PTSD severity during treatment and at follow-up. However, these effects were small (<i>R</i><sup><i>2</i></sup> ranging from .005 to.04) relative to reductions in depression severity (<i>R2 =</i> .40). Although NPCs and CER strategies significantly predicted reductions in PTSD severity, their overall impact was relatively small in this nonrandomized, uncontrolled ITP. Future research should continue to investigate these and other predictors in a variety of treatment settings.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-11"},"PeriodicalIF":4.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656270","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}
Emily J Wilson, Maree J Abbott, Alice R Norton, David Berle, Ronald M Rapee
{"title":"Exploring pathways from intolerance of uncertainty to worry in adults with generalised anxiety disorder.","authors":"Emily J Wilson, Maree J Abbott, Alice R Norton, David Berle, Ronald M Rapee","doi":"10.1080/16506073.2025.2478246","DOIUrl":"https://doi.org/10.1080/16506073.2025.2478246","url":null,"abstract":"<p><p>Three decades of research indicate that intolerance of uncertainty (IU) plays a role in the maintenance of mental health conditions. In particular, the relationship between IU and worry is especially strong. The current study aimed to conduct a partial examination of the Intolerance of Uncertainty Model (IUM) of GAD as well as the Transdiagnostic Model of Intolerance of Uncertainty (TMIU), in a clinical sample of adults with GAD using path analysis. Participants with a primary diagnosis of GAD (<i>N</i> = 112) completed a range of measures that assessed IU, cognitive avoidance (CA), positive beliefs about worry (PBW), threat estimates, worry, and anxiety, with two path analysis models constructed for the IUM and TMIU. In a preliminary analysis of the IUM, path analysis found that CA and PBW did not have an indirect effect the relationship between IU and worry, however, CA (and not PBW) had an indirect effect on the relationship between IU and anxiety. For the TMIU, the first model demonstrated a poor fit. In an alternative model, threat estimates were found to indirect effect the relationship between IU and worry as well as anxiety. This suggests that threat appraisals do play a role in the relationship between IU, worry and anxiety in individuals with GAD.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-21"},"PeriodicalIF":4.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656256","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":"A randomized controlled feasibility trial of a single-session metacognitive training intervention for reducing eating disorder risk factors.","authors":"Matthew Thompson, Tracey D Wade, Ryan P Balzan","doi":"10.1080/16506073.2025.2474237","DOIUrl":"https://doi.org/10.1080/16506073.2025.2474237","url":null,"abstract":"<p><p>This study investigates the feasibility and preliminary evidence for the efficacy of a single-session online metacognitive training (MCT-ED) among a population considered to be at-risk of developing an eating disorder. A total of <i>N</i> = 95 participants with high weight concerns were randomised to an MCT-ED condition (<i>n</i> = 43) or a waitlist control condition (<i>n</i> = 52). Participants completed measures of body image flexibility, perfectionism, weight and shape concerns and mood at baseline, post-treatment (one-week post-baseline), and 3-months post-treatment. The MCT-ED intervention consisted of content targeting cognitive flexibility and perfectionism. Treatment completion for MCT-ED was 93.62%, indicating that the intervention was feasible and acceptable. Participants also provided positive ratings on a feedback questionnaire indicating preliminary feasibility. At 1-week post-treatment, relative to the waitlist condition, the MCT-ED group had significantly lower personal standards (<i>d</i> = 0.64) and experienced a significantly greater decrease in concern over mistakes (<i>d</i> = 0.57). These improvements were not sustained at 3-month follow-up. Findings suggested that MCT-ED is a feasible brief intervention format for those with elevated weight concerns, but more research is required to produce longer, more meaningful effects that may impact weight and shape concerns.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-18"},"PeriodicalIF":4.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604029","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}
Mia Bennion, Karina Lovell, Amy Blakemore, Penny Bee
{"title":"Barriers and facilitators to engagement with between-session work for low-intensity Cognitive Behavioural Therapy (CBT)-based interventions: a qualitative exploration of patient perceptions.","authors":"Mia Bennion, Karina Lovell, Amy Blakemore, Penny Bee","doi":"10.1080/16506073.2025.2475168","DOIUrl":"https://doi.org/10.1080/16506073.2025.2475168","url":null,"abstract":"<p><p>Low-intensity interventions, designed as accessible, scalable, and cost-effective, are increasingly adopted globally to address common mental health problems. Typically, based on Cognitive Behavioural Therapy (CBT), low-intensity interventions emphasise patient self-management techniques, practiced outside of sessions as between-session work (BSW). Although crucial for symptom improvement, task completion remains a challenge, and research on predictors of BSW engagement in low-intensity contexts is limited. This qualitative study employed interpretive description methodology and framework analysis to interview 24 patients from UK NHS Talking Therapies services, exploring barriers and facilitators to between-session engagement in low-intensity CBT-based interventions. Themes constructed emphasised the importance of prioritising BSW, where between-session activities are endorsed during sessions to cultivate favourable patient attitudes. Specific, tailored task planning, continuous practitioner review and proactive responses to non-completion were key to secure engagement. External support from patients' social networks also reinforced engagement and mitigated barriers such as time constraints. Findings highlight the need for targeted provider training to ensure consistent application of engagement-enhancing techniques, as well as adjustments to intervention delivery to better incorporate patient preferences and leverage social support. This study provides critical insights and actionable guidance that can enhance the global delivery and effectiveness of low-intensity interventions.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-21"},"PeriodicalIF":4.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604078","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":"Cognitive-behavioural therapy (CBT) for outpatients with anorexia nervosa: a systematic review and meta-analysis of clinical effectiveness.","authors":"Heather C Duggan, Gillian Hardy, Glenn Waller","doi":"10.1080/16506073.2025.2465745","DOIUrl":"https://doi.org/10.1080/16506073.2025.2465745","url":null,"abstract":"<p><p>Anorexia nervosa is commonly treated using outpatient cognitive-behavioural therapy (CBT), but its effectiveness needs to be established. This systematic review and meta-analysis (PROSPERO CRD42023484924) assessed outpatient CBT's effectiveness for anorexia nervosa and explored potential moderators (pre-treatment Body Mass Index (BMI), age, illness duration, protocol duration of therapy, dropout). Searches (SCOPUS, PsycINFO, MEDLINE, grey literature) identified 26 studies reporting pre- to post-treatment outcomes for at least one primary measure (weight, eating disorder symptoms). Studies were medium to high quality. Secondary outcome data (depression, anxiety, quality of life) were also extracted. Meta-analyses (26 studies) found medium to large post-treatment effect sizes for weight (g = 0.87; 95% CI 0.67-1.08) and eating disorder symptoms (g = -0.74; 95% CI -0.93 - -0.54), with change starting early and increasing to follow-up. Effect sizes for secondary outcome measures were medium to large. Pre-treatment BMI moderated weight gain. This review was constrained by excluding non-English language papers and the limited number of papers reporting minimum data for inclusion. Overall, results suggest an optimistic picture for patients with anorexia nervosa treated with outpatient CBT. Clinicians can expect good outcomes using CBT, regardless of patients' starting weight, age, or illness duration.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-46"},"PeriodicalIF":4.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585029","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}
Isaac B J M D Dunn, Emma Power, Liam J Casey, Bethany M Wootton
{"title":"Cognitive behavioural therapy for internalizing symptoms in LGBTQ+ people: a preliminary meta-analysis.","authors":"Isaac B J M D Dunn, Emma Power, Liam J Casey, Bethany M Wootton","doi":"10.1080/16506073.2024.2434021","DOIUrl":"10.1080/16506073.2024.2434021","url":null,"abstract":"<p><p>Internalizing disorders are common in lesbian, gay, bisexual, transgender, queer, questioning, and otherwise non-heterosexual or non-cisgender (LGBTQ+) people. Few studies have evaluated the efficacy of cognitive behavior therapy (CBT), a well-established treatment for internalizing disorders, in LGBTQ+ people. The current study quantitatively synthesized outcomes from existing trials of CBT for internalizing disorders in LGBTQ+ people. Seven databases were searched, identifying 14 relevant studies with a total of 414 participants. A medium within-group effect size was found for depressive symptoms from pre-treatment to post-treatment (k = 14; g = 0.60; 95% CI: 0.44-0.76; I<sup>2</sup> = 71.59) and pre-treatment to 2-6-month follow-up (k = 7; g = 0.63; 95% CI: 0.40-0.86; I<sup>2</sup> = 71.59). For anxiety and related disorder symptoms, a medium within-group effect size was found from both pre-treatment to post-treatment (k = 10; g = 0.73; 95% CI: 0.47-0.99; I<sup>2</sup> = 71.59) and to 3-9-month follow-up (k = 5; g = 0.70; 95% CI: 0.54-0.87; I<sup>2</sup> = 36.04). Exploratory analyses indicated small between-group effects at post-treatment between intervention and control groups. Effect sizes were comparable to those in the general population, indicating preliminary support for treating internalizing disorders in LGBTQ+ people with CBT.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"246-275"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766954","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}