Journal of Clinical Psychology最新文献

{"title":"One Simple Question Predicts Well-Being in Radiation Therapy: The Role of Desire for Psychological Intervention and Perceived Social Support","authors":"Roni Laslo-Roth,&nbsp;Sivan George-Levi,&nbsp;Yael Galin Loncich,&nbsp;Myriam Sultan,&nbsp;Nirit Wiskop-Farkash,&nbsp;Eli Sapir","doi":"10.1002/jclp.23814","DOIUrl":"10.1002/jclp.23814","url":null,"abstract":"<p>Radiation therapy (RT) is a critical part of cancer treatment often accompanied by heightened anxiety, depression, and reduced life satisfaction. Although psycho-oncological (PO) interventions and social support can alleviate distress, it is unclear whether patients' desire for PO intervention reflects temporary or ongoing distress and whether all patients benefit from social support or only those seeking help. In this study we examined whether the desire for PO intervention during the start of RT predicted anxiety, depression, and life satisfaction at the start and end of RT and whether perceived social support moderated these effects. One-hundred-and-forty-six patients completed questionnaires at three time-points (pre-treatment, first treatment, and last treatment). Results showed that patients desiring PO intervention reported higher anxiety and depression at the start and end of RT. Higher perceived social support predicted lower depression and improved life satisfaction but only for patients expressing a desire for PO intervention. Screening for psychological distress is standard in oncology but often limited by time and resources during RT. The current study findings suggest that a single, straightforward question at the start of RT could identify at-risk patients, enabling proactive intervention. Moreover, fostering perceptions of social support may help mitigate negative outcomes in the absence of professional intervention.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 9","pages":"819-831"},"PeriodicalIF":2.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.23814","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225619","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":"Virtual Reality in Psychotherapy: A Commentary on Strategies, Interventions, and Perspectives From Five Clinical Reports","authors":"Sofia Seinfeld,&nbsp;Adrián Montesano","doi":"10.1002/jclp.23813","DOIUrl":"10.1002/jclp.23813","url":null,"abstract":"<p>Virtual reality (VR) applications have shown significant potential in enhancing psychological interventions by evoking vivid emotional reactions and creating immersive environments. This commentary provides an overview of five clinical case reports illustrating the advantages and pitfalls of VR-enhanced psychotherapy in social anxiety disorder, PTSD due to military trauma, auditory hallucinations, depression, and chronic pain. The case reports are analyzed with a dimensional framework designed to evaluate VR applications to be used in psychotherapy. The framework is based on three key dimensions: <i>Strategy</i> (e.g., Exposure, Training, Exploration), <i>Focus</i> (Symptom, Attitudes, Identity and Flourishing), and <i>Perspective</i> (Self, Other, Witness, Multiperspective). For example, the use of VR-based body scan exercises in chronic pain management can enable the training of body-related attentional skills helping individuals to not only focus on pain sensations, while VR exposure therapy helps clients with social anxiety or PTSD to confront feared situations, reprocess traumatic experiences, and develop coping skills. VR Avatar Therapy, on the other hand, enables individuals with auditory hallucinations to actually have a dialogue with the voices they hear since these are embodied in avatars controlled by therapists, promoting symptom externalization and self-identity exploration. Finally, the Explore Your Meanings tool enables immersive multi-perspective exploration of self-identity in 3D immersive spaces where it is easy to visualize the differences between the perceived and ideal self. The cases demonstrate VR's unique ability to provide real-time, dynamic treatment personalization, aligning with the trend toward individualized care in psychotherapy.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 9","pages":"888-894"},"PeriodicalIF":2.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.23813","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215971","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":"Exploring Typologies of Immediacy Events in Psychodynamic Therapy: A Latent Class Analysis","authors":"Anna Mylona,&nbsp;Evrinomy Avdi,&nbsp;Julie Vaiopoulou","doi":"10.1002/jclp.23812","DOIUrl":"10.1002/jclp.23812","url":null,"abstract":"<p>Immediacy is a therapeutic intervention that entails the explicit discussion between therapist and client about their relationship in the here-and-now. It is considered a potentially powerful intervention that can facilitate relational processing, especially in psychodynamic psychotherapies. Τhis study aims to explore the use of immediacy in psychodynamic psychotherapy through a case-series analysis. Videos of 139 sessions, drawn from 7 psychotherapies with 2 therapists, were coded in terms of the type of immediacy used and its immediate effects, as reflected in the client's response. A total of 121 immediacy events were identified in 57 sessions, occupying 8% of the total therapy time; the majority were initiated by the therapist. A Latent Class Analysis was conducted to explore where there exist clusters of immediacy events that share patterns of immediacy type and effect. Two distinct clusters of immediacy events were identified. The most common group, which we termed ‘limited engagement in immediacy’, was characterised by a primarily insight-oriented agenda on the therapist's part, smooth collaboration during the immediacy event, and limited engagement on the client's part. The second cluster, termed ‘mutual engagement in immediacy,’ reflected more complex processes characterised by conflict, with the therapist using a range of interventions (from alliance-building to insight-oriented interventions), evidence of disruption in the therapist-client collaboration, and the client showing increased engagement and reporting improvement. The findings are discussed drawing upon the literature on the processes of repairing ruptures in the therapeutic alliance and clinical implications regarding the use of immediacy.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 9","pages":"806-818"},"PeriodicalIF":2.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.23812","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187139","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":"A Longitudinal Examination of the Predictive Effects of Alexithymia on Nonsuicidal Self-Injury Among Emerging Adults","authors":"Lola Leving,&nbsp;Tracy K. Wong,&nbsp;Chloe A. Hamza","doi":"10.1002/jclp.23811","DOIUrl":"10.1002/jclp.23811","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In the present study, the association between alexithymia and NSSI was examined among 1125 emerging adults (<i>M</i>age = 17.96, 72% female), who completed a survey at two time points 4 months apart.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 (<i>p</i> &lt; 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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings underscore that alexithymia may be relevant to understanding NSSI severity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 9","pages":"790-805"},"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,&nbsp;Jason B. Luoma","doi":"10.1002/jclp.23810","DOIUrl":"10.1002/jclp.23810","url":null,"abstract":"<div>\u0000 \u0000 <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>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 9","pages":"878-887"},"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":"10.1002/jclp.23807","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Study 1 (<i>N</i> = 395 undergraduates) examined associations among dysfunctional attitudes, attributional style, imposter phenomenon, and depressive symptoms, whereas Study 2 (<i>N</i> = 443 undergraduates) examined associations among dysfunctional attitudes regarding performance evaluation and approval by others, imposter phenomenon, and depressive symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 8","pages":"715-725"},"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,&nbsp;Jürgen Thaler,&nbsp;Christina Kirchhoff,&nbsp;Hanna Kampling,&nbsp;Johannes Kruse,&nbsp;Tobias Nolte,&nbsp;Chloe Campbell,&nbsp;Vincent Grote,&nbsp;Michael J. Fischer,&nbsp;Astrid Lampe","doi":"10.1002/jclp.23809","DOIUrl":"10.1002/jclp.23809","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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 &gt; 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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of <i>n</i> = 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 (<i>p</i> &lt; 0.001, <i>d</i> = 1.70) as well as reduced symptoms of depression (<i>p</i> = 0.009, <i>d</i> = 0.84) and anxiety (<i>p</i> = 0.009, <i>d</i> = 0.1.24) and improved social participation (<i>p</i> = 0.012, <i>d</i> = 1.06). At follow-up, 59% of participants no longer fulfilled CPTSD criteria. Improved epistemic trust (<i>r</i> = −0.43, <i>p</i> = 0.007), and reduced epistemic credulity (<i>r</i> = 0.44, <i>p</i> = 0.006) were associated with reduced CPTSD symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 8","pages":"739-754"},"PeriodicalIF":2.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.23809","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":"OA","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,&nbsp;Rick Kye Gan,&nbsp;Carlos Alsua,&nbsp;Mark Peterson,&nbsp;Ricardo Úbeda Sales,&nbsp;Ann Zee Gan,&nbsp;José Antonio Cernuda Martínez,&nbsp;Pedro Arcos González","doi":"10.1002/jclp.23808","DOIUrl":"10.1002/jclp.23808","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 (<i>p</i> = 0.01). In the Look domain, ChatGPT-4 scored higher (<i>p</i> = 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%), (<i>p</i> &lt; 0.01). Five themes emerged from the qualitative analysis: Look, Listen, Link, Professionalism, Mental Health, and Psychosocial Support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 8","pages":"726-738"},"PeriodicalIF":2.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.23808","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":"OA","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,&nbsp;Kyle Buchan,&nbsp;Ellen Maloney,&nbsp;Sarah Kettley,&nbsp;Michelle Sader,&nbsp;Fiona Duffy,&nbsp;Karri Gillespie-Smith","doi":"10.1002/jclp.23802","DOIUrl":"10.1002/jclp.23802","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective(s)</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five themes were identified that highlighted research priorities for Autistic people with an ED: (1) Impact of early experiences (with subthemes I<i>nternalizing of socio-cultural food and body narratives</i> and <i>generational cycles</i>); (2) Function of the ED (with sub-themes <i>ED as a regulatory strategy</i> and <i>ED as a social acceptance strategy</i>); (3) Barriers and facilitators to ED recovery (with sub-themes <i>Autistic traits as barriers, Autistic traits as facilitators</i> and <i>Help and harm of unravelling</i>); (4) Understanding and accommodating for complexity (with sub-themes <i>Co-occurring conditions</i> and <i>Intersectionality</i>); and (5) Changing research culture (with sub-themes <i>Inclusive and participatory research</i> and <i>Nonclinical support</i>).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 8","pages":"677-693"},"PeriodicalIF":2.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.23802","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":"OA","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,&nbsp;Roz Shafran","doi":"10.1002/jclp.23806","DOIUrl":"10.1002/jclp.23806","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 8","pages":"768-776"},"PeriodicalIF":2.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.23806","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}