Journal of Clinical Psychology最新文献

{"title":"Monitoring and Acceptance, or Monitoring Only? Effects of a Dismantled Mindfulness Intervention on Mindfulness and Emotional Outcomes: A Randomized Controlled Trial","authors":"Yanping Wei,&nbsp;Limin Sun,&nbsp;Jiang Xue,&nbsp;Chuansheng Chen,&nbsp;Shulin Chen","doi":"10.1002/jclp.70205","DOIUrl":"10.1002/jclp.70205","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Previous studies based on the Monitoring and Acceptance Theory (MAT) failed to find differential effects of monitoring plus acceptance (MA) and monitoring only (MO) training on negative affect. This study aimed to investigate the differences between MA and MO from the perspective of mindfulness and emotional outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 392 participants were randomly assigned to three groups (MA, MO, or Waiting-List [WL]). MA or MO participants received a 14-day online mindfulness training focused on monitoring and acceptance skills, or only monitoring skills, respectively. We used the Five Facet Mindfulness Questionnaire, the Positive and Negative Affect Scale, and the Emotional Reactivity Scale (ERS) assess the outcomes before the intervention (T1), after the intervention (T2), and at the 2-week follow up (T3). Linear mixed model (LMM) was conducted to explore the data based on intent-to-treat (ITT) and per-protocol (PP) analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both the MA and MO groups demonstrated significant improvements in the total mindfulness score and positive affect compared to the WL group (<i>p</i> &lt; 0.05). A significant Group × Time interaction was observed for ERS; however, post hoc tests revealed no significant between-group differences. Negative affect did not differ significantly across groups (<i>p</i> &gt; 0.05). No significant differences between MA and MO were observed for any outcome (<i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This study demonstrated that MA and MO had equivalent effects on mindfulness and emotional outcomes following a 2-week online training program.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"82 11","pages":"1922-1935"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Interactive Effects of Emotional Closeness, Positive Affect, and Perceived Positive Communication in Romantic Couples: A Daily Diary Study","authors":"Ramya Ramadurai,&nbsp;Yiqing Fan,&nbsp;Ella S. Sudit,&nbsp;Kelly V. Klein,&nbsp;Nathaniel R. Herr,&nbsp;Kathleen C. Gunthert","doi":"10.1002/jclp.70200","DOIUrl":"10.1002/jclp.70200","url":null,"abstract":"<div>\u0000 \u0000 <p>Research has suggested that independently and in combination, positive affect, emotional closeness, and perceived positive communication behaviors, are important to relationship satisfaction for adults in romantic relationships. The current study leveraged daily diary data from 158 individuals in cohabitating romantic couples to better understand the isolated and interactive effects of an individual's daily positive affect, emotional closeness, and perceived positive communication behaviors (verbal and nonverbal) on their daily relationship satisfaction. We expected that higher scores on each daily predictor would be associated with higher daily relationship satisfaction. Informed by positivity resonance theory, we also expected that the effect of these predictors would enhance each other in pairs, regardless of inclusion of the third component. We found that each of these predictors was individually associated with higher daily relationship satisfaction. We also found significant interactions between daily emotional closeness and both daily perceived positive communication behaviors and daily positive affect, in association with daily relationship satisfaction. There was not a significant interaction between positive affect and perceived positive communication behaviors. Across analyses, we found a buffering effect such that when one construct was low, the other tended to protect against the negative association with relationship satisfaction. Daily emotional closeness consistently emerged as beneficial to daily relationship satisfaction. Findings suggest that, from an individual perspective, endorsement of these positive experiences over the course of the day is relevant to relationship satisfaction on the same day.</p>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"82 11","pages":"1865-1873"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Dialectical Behavior Therapy in Reducing Self-Directed Violence and Suicidality in Usual Care Settings: A Meta-Analysis","authors":"Colleen A. Maxwell,&nbsp;Katherine E. Holland,&nbsp;Lauren Young,&nbsp;Eunice Y. Chen,&nbsp;Thomas Olino,&nbsp;Philip C. Kendall","doi":"10.1002/jclp.70195","DOIUrl":"10.1002/jclp.70195","url":null,"abstract":"<p>Dialectical behavior therapy (DBT) has shown efficacy in reducing suicidality, though less is known about its effectiveness when delivered in usual care (UC) settings, where the resource-intensive nature of the program often results in modifications during implementation. This systematic meta-analysis examined the effectiveness of DBT in reducing suicidality-related outcomes when delivered in usual care settings. A systematic search was conducted and studies were identified for inclusion if they evaluated a DBT-based intervention with original, quantitative data reflecting pre- and post-treatment measurement of at least one of the three suicidality-related outcomes: (i) self-directed violence (SDV), (ii) crisis service use (CSU), and (iii) suicidal ideation (SI). Random effects models were used to estimate pooled effects. Meta-regression analyses were used to compare pooled effects across usual care and non-usual care settings and to examine the differential effects of theoretical predictors often involved in treatment modification. The final sample included 83 studies. In uncontrolled studies, DBT was associated with a large reduction in SDV and medium reductions in CSU and SI. In controlled studies, DBT demonstrated a significant effect for SDV but not for CSU or SI. Adjustment for publication bias attenuated the CSU findings. No differences were observed between usual care and non-usual care settings. Substantial heterogeneity was observed across models. In uncontrolled studies, positive associations emerged between therapist training and SDV reduction, adherence reporting and CSU reduction, and outpatient setting and SI reduction. Results provide the strongest support for the effectiveness of DBT in reducing SDV, with more limited and variable evidence for CSU and SI. Results should be interpreted with caution given heterogeneity and evidence of publication bias.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"82 11","pages":"1699-1743"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.70195","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mindfulness Induction Reduces Cue-Induced Craving in Female Methamphetamine Users","authors":"Xuehui Zhou,&nbsp;Rui Wu,&nbsp;Ziyan Li,&nbsp;Fang Li","doi":"10.1002/jclp.70199","DOIUrl":"10.1002/jclp.70199","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Inspired by an affective processing model of negative reinforcement, this study aimed to examine the effects of mindfulness induction on self-reported methamphetamine craving and investigate the mechanism underlying this relationship.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were female methamphetamine users, with 120 in Experiment 1 (intervention: <i>n</i> = 59, control: <i>n</i> = 61) and 107 in Experiment 2 (intervention: <i>n</i> = 54, control: <i>n</i> = 53). Participants in the intervention condition listened to an 18.45-min mindful audiotape to attain a state of mindfulness. Participants in Experiment 1 listened to the audiotape after viewing images of methamphetamine to induce craving, whereas those in Experiment 2 listened to the mindful audiotape after viewing a film clip to induce craving. Experiment 1 used a rating task to measure craving and negative affect. Experiment 2 adopted a pretest–posttest design in which negative affect and craving were assessed using the PANAS scale and craving scale, respectively. Self-reported craving was the primary outcome of both experiments. ANOVAs and PROCESS macro Model 6 were used to test the direct and indirect effects of mindfulness induction on craving.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mindfulness induction had not only a direct effect on self-reported craving but also an indirect effect by decreasing negative affect and then improving emotion regulation in Experiments 1 and 2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings affirm and enrich theoretical and empirical evidence of the immediate positive effects of mindfulness induction on substance craving, suggesting its promise as a method to decrease substance craving.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"82 11","pages":"1830-1840"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669922","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":"Optimizing Expectations Leads to Enhanced Efficacy of a Mindfulness-Based Intervention in Individuals With Low-Baseline Expectations: A Randomized Controlled Trial","authors":"Stefan Salzmann,&nbsp;Frank Euteneuer,&nbsp;Christiane A. Melzig,&nbsp;Winfried Rief,&nbsp;Christoph Benke","doi":"10.1002/jclp.70194","DOIUrl":"10.1002/jclp.70194","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Treatment expectations for medical and psychological treatments and positive patient-provider interactions are critical mechanisms driving the placebo effect and may augment an intervention's effects. However, it remains unclear whether optimizing treatment expectations is beneficial for all individuals. This pilot randomized controlled trial (three-arm parallel design) examined whether i) optimizing treatment expectations would augment the efficacy of a mindfulness intervention and ii) whether participants' treatment expectations at baseline would moderate these effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sixty-six healthy participants were randomized (1:1:1) to one of 3 experimental groups: i) body scan and an instruction aiming to optimize treatment expectations (EXPECT), ii) body scan and a neutral instruction (NEUTRAL), or iii) listening to an audiobook and neutral instruction (CONTROL). Primary outcomes were changes in positive and negative affect; secondary outcomes included treatment expectations, perceived stress, and mindfulness. Baseline expectations were assessed as a moderator using ANCOVA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ANCOVA indicated a group effect on positive affect (<i>p</i> = 0.018, d = 0.65), with individuals in the EXPECT group showing a stronger reduction than both other groups. Post-hoc comparisons showed significant differences between EXPECT and NEUTRAL (<i>p</i> = 0.015, d = −0.77) and between EXPECT and CONTROL (<i>p</i> = 0.012, d = −0.80). Analyzes did not indicate main effects on other outcomes. Participants with low baseline expectations showed a stronger increase in reported treatment expectations and mindfulness, as well as a more pronounced decrease in perceived stress from baseline- to post-assessment in the EXPECT group compared to both other groups. In contrast, individuals with high baseline expectations indicated less stress reduction when undergoing the body scan and receiving the instruction with positive expectation induction (EXPECT) compared to the group with a body scan and neutral instruction (NEUTRAL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Inducing positive treatment expectations may be beneficial for individuals with low baseline expectations, likely due to an enhanced placebo response. However, it may be counterproductive for individuals with high baseline outcome expectations and could reflect expectation violation effects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"82 11","pages":"1809-1821"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.70194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Psychometric Properties and Clinical Usefulness of the Difficulties in Emotion Regulation Scale in Forensic Settings","authors":"Adam Meddeb,&nbsp;Märta Wallinius,&nbsp;Johan Berlin,&nbsp;Natalie Laporte,&nbsp;Malin Hildebrand Karlén,&nbsp;Claudia Mazzeschi,&nbsp;Elisa Delvecchio,&nbsp;Patrizia Velotti,&nbsp;Carlo Garofalo","doi":"10.1002/jclp.70193","DOIUrl":"10.1002/jclp.70193","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The Difficulties in Emotion Regulation Scale (DERS) is a widely used measure of emotion dysregulation across clinical contexts. However, its psychometric properties and clinical utility have not been thoroughly examined in forensic populations. This study evaluated the original 36-item DERS and two short forms, the DERS-16 and the DERS-8, in two independent forensic samples from two different countries: a forensic psychiatric inpatient sample (<i>N</i> = 88) and a prison sample (<i>N</i> = 389).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Confirmatory factor analysis was used to assess factor structure. Reliability was evaluated using Cronbach's <i>α</i> and McDonald's <i>ω</i>, and construct validity was examined through correlations with aggression, externalizing psychopathology, impulsivity, mindfulness, and alexithymia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The original six-factor model showed poor model fit, whereas data-model fit improved for the DERS-16 and DERS-8. The DERS total and subscale scores correlated meaningfully with measures of aggression, externalizing pathology, impulsivity, mindfulness, and alexithymia. However, DERS scores were not significantly associated with habitual use of specific emotion regulation strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings suggest that the DERS-16 and DERS-8 may be preferable to the full 36-item scale in forensic settings, offering promising psychometric properties while minimizing patient burden. Beyond psychometric adequacy, the results provide clinically relevant insights into the feasibility and practical utility of DERS in forensic mental health settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"82 11","pages":"1792-1808"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.70193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Daily Stress and Hot Flashes in Women of Menopausal Age","authors":"Yiqing Alice Fan,&nbsp;Evelyn Behar,&nbsp;Alice I. Cohen,&nbsp;Clara Law,&nbsp;Kathleen C. Gunthert","doi":"10.1002/jclp.70201","DOIUrl":"10.1002/jclp.70201","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The menopause transition is accompanied by various psychological and physical symptoms including hot flashes. There is emerging evidence on the link between stress and hot flashes, yet findings have been limited and mixed. Most studies have relied primarily on between-person relationships and have overlooked important nuances of whether stress on any given day is associated with more severe hot flashes on that same day. Our study bridges this gap by examining both the between- and within-person relationships between daily psychological stress (number of stressors, stressor severity sum, and stressor severity average) and hot flash severity among women who reported experiencing at least one hot flash. We also tested the potential moderating role of neuroticism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a secondary analysis of data from Midlife Development in the United States (MIDUS), and analyzed data from an 8-day self-report diary phase. Participants were 130 women aged 42 to 60 who reported experiencing at least 1 day of hot flashes in the 8-day period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results showed that on days when hot flash was reported, daily stress was significantly associated with hot flash severity on both the between- and within-person levels. However, the relationship between daily stress and hot flash <i>occurrence</i> was not significant. Neuroticism did not significantly moderate any of the relationships.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings indicate that among women who experienced hot flashes, on days when hot flash was reported, higher perceived stress is associated with higher hot flash severity; more importantly, hot flash severity is higher <i>on days when stress is higher</i>. If the within-person association is replicated in future studies, these findings may have implications for therapeutically targeting stress as a potential avenue for alleviating hot flashes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"82 11","pages":"1874-1885"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669909","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 Systematic Review of Ecological Momentary Assessment for Obsessive-Compulsive Disorder","authors":"Irene Jaén,&nbsp;María Mostazo-Arolo,&nbsp;Rosa Lorente-Català","doi":"10.1002/jclp.70202","DOIUrl":"10.1002/jclp.70202","url":null,"abstract":"<p>Obsessive-compulsive disorder (OCD) is characterized by its symptomatology heterogeneity, which poses challenges for its assessment and treatment. Ecological momentary assessment (EMA) has been proposed as a promising method for gathering information and may offer advantages over retrospective methods. The present study aims to conduct a systematic review of the use of EMA in OCD, examining the main variables assessed, methodological considerations, and the advantages of EMA compared with retrospective measures to assess OCD. The systematic search was conducted using databases including Scopus, Pubmed, Web of Science, PsycNET, and Cochrane Library. Of the identified studies, 28 met the inclusion criteria. These studies focused on the assessment of obsessions, compulsions, experiential avoidance, and sleep, with compulsions being the most studied variable. The studies reveal diverse EMA methods, with traditional paper recordings and smartphones differing in frequency and duration of the records. Some studies reported that EMA may serve as a valid and sensitive tool for detecting changes in OCD and overcome some limitations of retrospective assessments. Despite the potential of EMA, their validity is still questionable, and their application during intervention processes is limited, particularly given the heterogeneity of the available evidence and the limited application of EMA during intervention processes. Further research is essential to enhance their integration in clinical settings.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"82 11","pages":"1744-1768"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.70202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Directional Effects of Insomnia, Anxiety, and Depression Symptoms: Results From a Longitudinal Study Conducted During the COVID-19 Pandemic","authors":"Jamie Walker,&nbsp;Ana J. Bridges,&nbsp;Alexandria Muench,&nbsp;Michael L. Perlis,&nbsp;Ivan Vargas","doi":"10.1002/jclp.70207","DOIUrl":"10.1002/jclp.70207","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>While some research suggests that increases in anxiety symptoms drive changes in insomnia and depression symptoms, other studies support that these relations may be bidirectional. The present study therefore aimed to further examine how anxiety, insomnia and depression symptoms predict changes in these symptoms over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were recruited via an online participant database, social media advertisements, and other online sites, resulting in a large sample (<i>N</i> = 2,666) of adults from across the United States. Well validated instruments were used to measure symptoms of depression (CES-D), anxiety (STAI), and insomnia (ISI). Data were collected via a series of Qualtrics surveys administered online at two time points: March–June 2020 (baseline) and January–March 2021 (follow-up).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Insomnia symptoms (<i>β</i> = 0.142, <i>p</i> &lt; 0.001) but not anxiety symptoms (<i>β</i> = 0.019, <i>p</i> = 0.445) significantly predicted depression symptoms. Depression symptoms (<i>β</i> = 0.077, <i>p</i> = 0.001) but not anxiety symptoms (<i>β</i> = 0.039, <i>p</i> = 0.075) significantly predicted insomnia symptoms. Both insomnia (<i>β</i> = 0.060, <i>p</i> = 0.001) and depression symptoms (<i>β</i> = 0.281, <i>p</i> &lt; 0.001) significantly predicted anxiety symptoms. Although multiple cross-lagged paths were statistically significant, effect sizes were generally small, and no single pathway was meaningfully stronger than others. Additionally, secondary exploratory mediation models revealed significant indirect effects between anxiety and depression through insomnia (model 1 indirect <i>β</i> = 0.027, <i>p</i> = 0.007; model 2 indirect <i>β</i> = 0.008, <i>p</i> = 0.036).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings suggest that insomnia symptoms were prospectively associated with subsequent depressive and anxiety symptoms. Depression symptoms also predicted later anxiety symptoms, highlighting the complex longitudinal associations among these symptom domains. However, results did not support a temporal pathway in which anxiety precedes the development of comorbid insomnia. Future studies should assess temporal order more closely, using high density longitudinal sampling strategies (i.e., more than two data collection points) to further clarify the temporal ordering of these symptom domains.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"82 11","pages":"1897-1907"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.70207","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148712598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability and Validity of the Chinese Version of the Parental Acceptance Questionnaire (6-PAQ) Among Parents of Children With or Without Hearing Loss","authors":"Sini LI,&nbsp;Jianhe LI,&nbsp;Yamin Li,&nbsp;Jiao Xie","doi":"10.1002/jclp.70209","DOIUrl":"10.1002/jclp.70209","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The parental acceptance questionnaire (6-PAQ) is a user-friendly and contextually sensitive scale of psychological flexibility.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This research aimed to translate the original English version of the 6-PAQ into Chinese and to test its psychometric properties among Chinese parents of children with or without hearing loss (HL).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Two phases were conducted: (1) translation from English to Chinese (6-PAQ-C), followed by a semantic equivalence evaluation between two versions, a pre-test and face validity with 40 parents of children with or without HL, and content validity with 15 experts; (2) A cross-sectional study was conducted for providing empirical support among two samples: parents of children with (&lt;i&gt;n&lt;/i&gt; = 204) or without (&lt;i&gt;n&lt;/i&gt; = 336) HL. All participants were assessed for test–retest reliability over an 8-week interval.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The 6-PAQ-C showed satisfactory semantic equivalence with the original version, excellent internal consistency, and good 8-week test–retest stability. Exploratory factor analysis and parallel analysis confirmed a six-factor structure consisting of 18 items. Confirmatory factor analysis supported both the original six-factor structure and a bifactor model (one general factor plus six specific factors), both demonstrating excellent fit. Bifactor indices indicated a strong general factor (omega = 0.95; omega hierarchical = 0.80; proportion of uncontaminated correlations = 0.88) and more modest independent specific-factor reliability (omega hierarchical subscale = 0.41–0.49; specific explained common variance = 0.08–0.10), supporting use of the total score as the primary metric and subscale scores as supplementary indicators. The scale also exhibited significant mean score differences between parents with high and low parenting stress in both samples and correlated with measures of psychological flexibility, symptomatology, and mental well-being.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;These findings suggest that the 6-PAQ-C is a reliable and valid instrument for measuring psychological flexibility among parents of children with or without HL. In practice, the total score should be treated as the primary scoring metric, whereas the six subscale scores may be used cautiously to describe ACT process profiles rather than as fully independent dimensions. Future research should test the 6-PAQ-C with diverse samples across cultures/contexts to improve it","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"82 11","pages":"1908-1921"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857292","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}