Journal of Clinical Psychology最新文献

{"title":"A Longitudinal Examination of the Predictive Effects of Alexithymia on Nonsuicidal Self-Injury Among Emerging Adults.","authors":"Lola Leving, Tracy K Wong, Chloe A Hamza","doi":"10.1002/jclp.23811","DOIUrl":"https://doi.org/10.1002/jclp.23811","url":null,"abstract":"<p><strong>Objectives: </strong>Emerging evidence suggests that alexithymia, a psychological construct defined by the inability to describe emotion, differentiate feelings, and think in an internally oriented way, may be relevant in understanding engagement in nonsuicidal self-injury (NSSI). However, there is a paucity of longitudinal work on alexithymia and NSSI, which is necessary to discern whether alexithymia may heighten risk for NSSI over time.</p><p><strong>Methods: </strong>In the present study, the association between alexithymia and NSSI was examined among 1125 emerging adults (Mage = 17.96, 72% female), who completed a survey at two time points 4 months apart.</p><p><strong>Results: </strong>Participants with a history of NSSI reported higher levels of alexithymia than those with no NSSI engagement. A zero-inflated negative binomial regression model revealed that higher alexithymia at Time 1 predicted greater diversity in NSSI methods (i.e., NSSI versatility), but not NSSI frequency, at Time 2, for those already engaging in NSSI (p < 0.01, controlling for NSSI history at Time 1, emotion regulation difficulties, age, and gender). Significant differences were found in NSSI functions based on alexithymia among individuals with a lifetime history of NSSI at both time points. Among participants with a history of NSSI, alexithymia was most strongly correlated with anti-dissociation, sensation seeking, self-punishment, toughness, and interpersonal boundaries NSSI functions.</p><p><strong>Conclusion: </strong>Findings underscore that alexithymia may be relevant to understanding NSSI severity.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111053","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 Case Study on Transforming Shame: The Role of Acceptance and Commitment Therapy in Fostering Psychological Flexibility and Self-Compassion.","authors":"M Kati Lear, Jason B Luoma","doi":"10.1002/jclp.23810","DOIUrl":"https://doi.org/10.1002/jclp.23810","url":null,"abstract":"<p><p>Shame is related to a host of social and psychological problems including depression, PTSD, social anxiety, substance misuse, borderline personality disorder, eating disorders, and self-directed violence. Shame is an acutely painful emotion that motivates humans to protect the \"flawed\" or \"fragile\" self, often through withdrawal or avoidance. Consequently, many clients who frequently and intensely experience shame persistently avoid life situations where shame could be triggered and engage in frequent self-criticism geared toward self-improvement. Though well-intentioned, these repeated attempts to reduce or avoid shame can exacerbate the sense of being defective, other, or unworthy already associated with shame and prevent people from living out their values in relationship with themselves and important others. Acceptance and Commitment Therapy (ACT) is a transdiagnostic treatment approach that aims to promote psychological and behavioral flexibility in response to painful internal experiences, like shame. This case illustration depicts how ACT can be applied to target shame by incorporating a collaborative case conceptualization process and principles from affective science to help the client respond more flexibly to shame when it is cued, and take steps to cultivate a more compassionate, values-driven relationship with self and others. The client, Courtney, was an adult heterosexual cisgender white woman working in secondary education. She presented to therapy with symptoms of anxiety, depression, and self-esteem issues and underwent 20 sessions of ACT for shame. By the final session, Courtney reported significantly reduced shame and self-criticism and increased self-compassion.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078356","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":"Indirect Pathways From Dysfunctional Attitudes and Attributional Style to Depressive Symptoms Through Imposter Phenomenon.","authors":"Mark A Whisman","doi":"10.1002/jclp.23807","DOIUrl":"https://doi.org/10.1002/jclp.23807","url":null,"abstract":"<p><strong>Objectives: </strong>Cognitive theories of depression focus on how cognitive vulnerabilities increase risk for depression in the context of negative life events. To complement this perspective, two studies were conducted to examine associations among cognitive vulnerabilities, imposter phenomenon, and depressive symptoms to better understand how cognitively vulnerable individuals may respond to positive life events in ways that minimize their potential benefits.</p><p><strong>Methods: </strong>Study 1 (N = 395 undergraduates) examined associations among dysfunctional attitudes, attributional style, imposter phenomenon, and depressive symptoms, whereas Study 2 (N = 443 undergraduates) examined associations among dysfunctional attitudes regarding performance evaluation and approval by others, imposter phenomenon, and depressive symptoms.</p><p><strong>Results: </strong>Dysfunctional attitudes and, to a lesser degree, negative causal attributions for positive life events, were significantly and positively associated with imposter phenomenon, which served as an indirect pathway linking cognitive vulnerabilities with depressive symptoms (Study 1). Dysfunctional attitudes regarding performance evaluation were more strongly associated with imposter phenomenon than those regarding approval by others, and imposter phenomenon served as an indirect pathway linking dysfunctional attitudes with depressive symptoms (Study 2).</p><p><strong>Conclusion: </strong>Minimizing achievements and successes in ways characterized by imposter phenomenon may be one pathway by which people with cognitive vulnerabilities, particularly dysfunctional attitudes regarding performance evaluation, are vulnerable to depression.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026690","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":"Long-Term Improvements of Complex Post-Traumatic Stress Disorder (CPTSD) Symptoms After Multimodal Psychodynamic Inpatient Rehabilitation Treatment-An Observational Single Center Pilot Study.","authors":"David Riedl, Jürgen Thaler, Christina Kirchhoff, Hanna Kampling, Johannes Kruse, Tobias Nolte, Chloe Campbell, Vincent Grote, Michael J Fischer, Astrid Lampe","doi":"10.1002/jclp.23809","DOIUrl":"https://doi.org/10.1002/jclp.23809","url":null,"abstract":"<p><strong>Background: </strong>Complex post-traumatic stress disorder (CPTSD) is a severely disabling mental health condition, frequently observed in survivors of prolonged, repeated or multiple traumatic stressors. While studies indicate that engaging in psychotherapy can reduce CPTSD symptom severity, data on long-term effectiveness of interventions is scarce. The aim of this study was to evaluate long-term CPTSD trajectories of affected individuals after a 6-week multimodal psychodynamic inpatient rehabilitation treatment.</p><p><strong>Methods: </strong>In this observational single center study participants completed questionnaires on CPTSD symptoms (ITQ), anxiety, depression, and somatization (BSI-18), functional impairment (WHODAS-12), mentalizing (MZQ-6) and epistemic trust, mistrust and credulity (ETMCQ) before (T1) and at the end of treatment (T2) as well as > 12 months after treatment. Repeated measures analyses of variance (ANOVAs) and reliable change index (RCIs) for the ITQ as primary outcome variable were calculated to evaluate mean symptom change. The influence of a range of potential factors affecting change was evaluated using correlation coefficients and ANOVAs.</p><p><strong>Results: </strong>A total of n = 38 individuals diagnosed with CPTSD completed the questionnaires 14-28 (median: 21.2) months after treatment. Participants reported a significant reduction of CPTSD symptoms with large effect sizes at follow-up (p < 0.001, d = 1.70) as well as reduced symptoms of depression (p = 0.009, d = 0.84) and anxiety (p = 0.009, d = 0.1.24) and improved social participation (p = 0.012, d = 1.06). At follow-up, 59% of participants no longer fulfilled CPTSD criteria. Improved epistemic trust (r = -0.43, p = 0.007), and reduced epistemic credulity (r = 0.44, p = 0.006) were associated with reduced CPTSD symptoms.</p><p><strong>Discussion: </strong>To the authors knowledge, this is the first study to report long-term CPTSD symptom trajectories after psychodynamic inpatient treatment. The results indicate lasting symptom change and identify improvements in epistemic trust as associated with symptom change. Due to the observational nature of the study, no causal attributions as to the effectiveness of the treatment can be drawn.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982349","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":"Psychological First Aid by AI: Proof-of-Concept and Comparative Performance of ChatGPT-4 and Gemini in Different Disaster Scenarios.","authors":"Jun Tat Tan, Rick Kye Gan, Carlos Alsua, Mark Peterson, Ricardo Úbeda Sales, Ann Zee Gan, José Antonio Cernuda Martínez, Pedro Arcos González","doi":"10.1002/jclp.23808","DOIUrl":"https://doi.org/10.1002/jclp.23808","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the performance and proof-of-concept of psychological first aid (PFA) provided by two AI chatbots, ChatGPT-4 and Gemini.</p><p><strong>Methods: </strong>A mixed-method cross-sectional analysis was conducted using validated PFA scenarios from the Institute for Disaster Mental Health. Five scenarios representing different disaster contexts were selected. Data were collected by prompting both chatbots to perform PFA based on these scenarios. Quantitative performance was assessed using the PFA principles of Look, Listen, and Link, with scores assigned using IFRC's PFA scoring template. Qualitative analysis involved content analysis for AI hallucination, coding responses, and thematic analysis to identify key subthemes and themes.</p><p><strong>Results: </strong>ChatGPT-4 outperformed Gemini, achieving an overall score of 90% (CI: 86%-93%) compared to Gemini's 73% (CI: 67%-79%), a statistically significant difference (p = 0.01). In the Look domain, ChatGPT-4 scored higher (p = 0.02), while both performed equally in the Listen and Link domain. The content analysis of AI hallucinations reveals that ChatGPT-4 has a relative frequency of 18.4% (CI: 12%-25%), while Gemini exhibits a relative frequency of 50.0% (CI: 26.6%-71.3%), (p < 0.01). Five themes emerged from the qualitative analysis: Look, Listen, Link, Professionalism, Mental Health, and Psychosocial Support.</p><p><strong>Conclusion: </strong>ChatGPT-4 demonstrated superior performance in providing PFA compared to Gemini. While AI chatbots show potential as supportive tools for PFA providers, concerns regarding AI hallucinations highlight the need for cautious implementation. Further research is necessary to enhance the reliability and safety of AI-assisted PFA, particularly by eliminating hallucinations, and to integrate the current advances in voice-based chatbot functionality.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020952","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":"Using Photovoice Methods to Set Research Priorities With Autistic People With Experience of an Eating Disorder.","authors":"Emy Nimbley, Kyle Buchan, Ellen Maloney, Sarah Kettley, Michelle Sader, Fiona Duffy, Karri Gillespie-Smith","doi":"10.1002/jclp.23802","DOIUrl":"https://doi.org/10.1002/jclp.23802","url":null,"abstract":"<p><strong>Objective(s): </strong>Autism and Autistic traits are heightened in individuals with eating disorders (EDs), with Autistic people reporting poorer treatment outcomes and experiences. Despite this, mechanisms of this overlap remain poorly understood, perhaps due to an exclusion of lived experience perspectives in setting research agendas. The study therefore sought to identify research priorities for Autistic people with an eating disorder (ED) by using accessible and inclusive arts-based research methodologies.</p><p><strong>Methods: </strong>Research questions were explored using Photovoice, a creative research methodology involving the creation and discussion of images. 14 participants attended group workshops, in two of which they explored research priorities for Autistic people with an ED. Images and transcripts were analysed using an adapted Photovoice Question Matrix (production, content and meaning of the image) and thematic analysis. Participants had the opportunity to provide feedback on emerging themes before themes were finalised.</p><p><strong>Results: </strong>Five themes were identified that highlighted research priorities for Autistic people with an ED: (1) Impact of early experiences (with subthemes Internalizing of socio-cultural food and body narratives and generational cycles); (2) Function of the ED (with sub-themes ED as a regulatory strategy and ED as a social acceptance strategy); (3) Barriers and facilitators to ED recovery (with sub-themes Autistic traits as barriers, Autistic traits as facilitators and Help and harm of unravelling); (4) Understanding and accommodating for complexity (with sub-themes Co-occurring conditions and Intersectionality); and (5) Changing research culture (with sub-themes Inclusive and participatory research and Nonclinical support).</p><p><strong>Discussion: </strong>Study findings are contextualised within existing autism and ED research, highlighting avenues for future research and making recommendations for future research questions. By identifying community-driven research priorities, it is hoped that study findings will inspire novel, interdisciplinary and co-produced research that will serve as a meaningful evidence base towards improving the lives of Autistic people with an ED.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020750","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":"Using CBT-E in the Treatment of Anorexia Nervosa With Comorbid Obsessive-Compulsive Personality Disorder and Clinical Perfectionism.","authors":"Liv Sand, Roz Shafran","doi":"10.1002/jclp.23806","DOIUrl":"https://doi.org/10.1002/jclp.23806","url":null,"abstract":"<p><strong>Objective: </strong>Several studies and clinical vignettes emphasize the association between eating disorders and maladaptive personality traits that should be targeted in treatment to strengthen the therapeutic prognosis and outcome. The aim of this paper is to present a single case study with a patient showing comorbid Anorexia Nervosa (AN) and Obsessive-Compulsive Personality Disorder (OCPD) with perfectionistic traits, using Cognitive Behavioral Therapy for Eating disorders (CBT-E) and Perfectionism (CBT-P).</p><p><strong>Methods: </strong>The patient, a young girl aged 17 years, was underweight when entering therapy and received an enhanced version of CBT-E with 40 sessions as recommended in the manual. The treatment was adjusted for adolescents with a heightened focus on motivation, therapeutic alliance, and parental involvement. The clinical interventions were structured in accordance with CBT-E for adolescents with six added sessions targeting clinical perfectionism based on CBT-P focusing on over-evaluation of achievements in addition to weight and shape.</p><p><strong>Results: </strong>The patient showed a gradual decrease in eating disorder symptoms and perfectionism through the 1-year treatment. She was normal weight by the end of therapy, enjoyed varied food, was more socially engaged and balanced clinical perfectionism with more healthy strivings and standards. She was also able to express her need for boundaries and rest to family, friends and her sports team. At the final assessment, she did not fulfill diagnostic criteria for AN or OCPD with perfectionistic traits, but she showed some symptoms in achievement situations that was targeted by information and preventive interventions.</p><p><strong>Conclusion: </strong>In accordance with the manual for CBT-E, perfectionism should be targeted as part of the treatment for eating disorders when in the clinical range. This was done in the present case with AN and perfectionistic traits within a comorbid OCPD, using elements of CBT-P that showed positive results and meaningful changes for the patient.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009294","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":"«Scaringly Safe»: Therapeutic Processes in Longstanding Eating Disorders With Comorbid Avoidant Personality Disorders in the Recovered Case of Jade.","authors":"Hanna P Eielsen, KariAnne Vrabel, Malin E Olofsson","doi":"10.1002/jclp.23805","DOIUrl":"https://doi.org/10.1002/jclp.23805","url":null,"abstract":"<p><p>Personality disorders (PD) are highly prevalent among patients with eating disorders (ED) and are often associated with unfavorable treatment outcomes. This may be due to poor engagement in therapy, interpersonal difficulties hampering the treatment alliance, and emotional instability overshadowing the ED symptoms. However, the patients' perspectives on these processes are understudied. To illustrate the potential of addressing personality vulnerabilities and relational issues in ED treatment, we present the case of Jade, a 29-year-old female with longstanding bulimia nervosa, major depressive disorder, and posttraumatic stress disorder following childhood maltreatment. Jade had been diagnosed with multiple PD such as paranoid, borderline, and avoidant PD, and at the time of treatment, she fulfilled the diagnostic criteria for the latter. Jade participated in a 12-week Cognitive Behavioral Therapy (CBT) inpatient program in a specialized ED unit. The treatment focused on the complex symptom interplay, specifically connecting early memories to current reactions, coping strategies, and relationship patterns. Jade normalized her eating patterns and trauma symptoms decreased. She highlighted being able to trust the staff and the treatment program as a prerequisite for ED improvement. Her narrative was triangulated with real-time self-report data examining ED symptoms (EDE-Q), interpersonal patterns (IIP-64), and trauma symptoms (PSS-SR) at assessment, admission, discharge, and 1-year follow-up. Jade was fully recovered from the ED at 1-year follow-up, however, the avoidant PD persisted. Considering the frequent ED-PD co-occurrence, the patient perspective may provide valuable insight to reduce long-term suffering by guiding tailored treatment approaches to improve outcomes for these difficult-to-treat patients. Trial Registration: NCT02649114.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970878","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":"\"When Standard Treatments Are Not Enough\" - Showcasing Schema Therapy for the Treatment of Anorexia Nervosa and Borderline Personality Disorder.","authors":"Natasha S Hepworth, Susan G Simpson","doi":"10.1002/jclp.23801","DOIUrl":"https://doi.org/10.1002/jclp.23801","url":null,"abstract":"<p><p>Whilst standard cognitive and behavioural treatments lead to clinical improvement for approximately half of the people with eating disorders, preliminary evidence indicates that complex comorbidity, including personality difficulties, insecure attachment patterns and Posttraumatic stress disorder, may hinder treatment engagement and outcomes. Such comorbidities tend to be associated with increased emotional dysregulation, rigidity of beliefs, and dissociation. Schema Therapy is a transdiagnostic approach that interweaves the treatment of current eating disorder symptomatology and comorbid presentations through addressing early maladaptive schemas linked to unmet attachment needs and traumas. The goals are to promote integration, coherence, and resilience of self, whilst reducing reliance on the eating disorder as a means of self-regulation and substitute identity. In this case example, we follow a 27-year-old woman with an eating disorder (Anorexia Nervosa) and comorbid personality disorder (Borderline Personality Disorder), illustrating how Schema Therapy can effectively treat both conditions by healing the underlying schemas. This case study highlights the ways in which the therapeutic 'limited reparenting' approach is used to interweave cognitive, experiential, and behavioural techniques that address clients' chronically unmet emotional needs, and the importance of enhancing the individual's Healthy Adult mode to facilitate self-regulation and the client's capacity to effectively manage their own psychological needs in the future.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002595","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":"Age Disparities in the Association Between Leisure-Time Physical Activity and Depression Among American Adults.","authors":"Juxiang Yang, Xi Zheng, Yi Wang, Hongchu Wang, Gang Song","doi":"10.1002/jclp.23804","DOIUrl":"https://doi.org/10.1002/jclp.23804","url":null,"abstract":"<p><strong>Background: </strong>This study aims to investigate the association between leisure-time physical activity (LTPA), age, and depressive symptoms.</p><p><strong>Methods: </strong>We included and analyzed data from 18,052 participants (age ≥ 20 years) from the cross-sectional National Health and Nutrition Examination Survey (NHANES) (2007-2014). Multivariable logistic regression was employed to assess the independent associations between physical activity and household income with depressive symptoms. Restricted cubic spline plots were utilized to analyze the non-linear relationship between LTPA and depression.</p><p><strong>Results: </strong>Among the 18,052 participants, 1,676 (9.28%) were defined as having depressive symptoms. We found: 1. Age exhibits a non-linear relationship with depression, with a turning point around 40 years. 2. Compared to those with no LTPA, individuals with higher levels of LTPA (Q3) in both younger and older age groups experienced the lowest risk of depression, with risk reductions of 53% (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.33-0.67) and 74% (OR 0.26, 95% CI 0.14-0.50), respectively. Conversely, in the middle-aged group, those with the highest level of LTPA (Q4) experienced the greatest reduction in depression risk, by 67% (OR 0.33, 95% CI 0.21-0.53). 3. A U-shaped relationship between LTPA and depression risk was observed in younger and older age groups.</p><p><strong>Conclusion: </strong>The risk of depression peaks around the age of 40 in adults. For middle-aged individuals, greater engagement in LTPA is associated with reduced depression risk. Conversely, higher levels of LTPA in younger and older adults may not confer additional protective effects.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003793","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}