Psychotherapy and Psychosomatics最新文献

{"title":"Menstrual Cycle Informed Psychotherapy: Preliminary findings in Women with Spider Phobia.","authors":"Gianna Zorzini, Patricia Patra Ritter, Gianandrea Pallich, Ursula Galli, Ulrike Ehlert, Susanne Fischer","doi":"10.1159/pps/aemag012","DOIUrl":"https://doi.org/10.1159/pps/aemag012","url":null,"abstract":"<p><strong>Background: </strong>Anxiety disorders are the most frequent mental disorders worldwide. Although exposure therapy is the gold-standard treatment for anxiety disorders, almost half of patients fail to achieve sufficient improvements. While much has been learned about for whom psychotherapy works and why, far less is understood about when it works. Emerging evidence indicates that estradiol and progesterone may affect fear extinction, yet studies examining the effects of menstrual cycle phase on exposure therapy outcomes remain lacking. This study is the first to investigate to what extent biologically informed menstrual cycle phase affects exposure therapy outcomes in women with spider phobia.</p><p><strong>Method: </strong>N=45 women with spider phobia in 1) the early to mid-follicular phase, 2) the mid-luteal phase, or 3) using hormonal contraceptives (HC), participated in a group-based exposure therapy. Symptoms were assessed at baseline, one-week post-therapy, and at 12-14 weeks follow-up, using the Spider Phobia Questionnaire (SPQ), the Fear of Spiders Questionnaire (FSQ), and a behavioral approach test (BAT).</p><p><strong>Results: </strong>Both phobic fear and avoidance behavior improved significantly over time. Although improvement did not differ between menstrual cycle groups, higher progesterone levels on the day of exposure therapy were associated with less improvement in behavioral avoidance.</p><p><strong>Conclusion: </strong>The present findings provide preliminary evidence that ovarian hormones on the day of exposure therapy may affect exposure-based outcomes, particularly reductions in behavioral avoidance. More research in larger samples is needed to further investigate menstrual cycle phase effects in exposure-based treatment. If replicated, the findings would attest to the potential of bio-rhythm informed psychotherapy.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1"},"PeriodicalIF":9.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Contribution of Childhood Maltreatment to the Sex Gap in Depression: Insights from the German National Cohort (NAKO).","authors":"Maja P Völker, Aina L Kresken, Jerome C Foo, Josef Frank, Iris Reinhard, Johanna Klinger-König, Lea Zillich, Diana S Ferreira de Sá, Rafael Mikolajczyk, Michael F Leitzmann, Patricia Fromherz, Lilian Krist, Thomas Keil, Claudia Meinke-Franze, Steffi G Riedel-Heller, Halina Greiser, Barbara Bohn, Hermann Brenner, Nadia Obi, Volker Harth, Tobias Pischon, Hans Joergen Grabe, Klaus Berger, Emanuel Schwarz, Jutta Mata, Stephanie Witt, Fabian Streit","doi":"10.1159/pps/aemag008","DOIUrl":"https://doi.org/10.1159/pps/aemag008","url":null,"abstract":"<p><p>Childhood maltreatment is a major risk factor for depression and may contribute to sex differences in depression prevalence. We examined sex-specific associations between childhood maltreatment and depression and estimated the proportion of depression cases attributable to maltreatment subtypes. We analyzed baseline data from 159,045 participants (49.4% female; aged 19-72) in the German National Cohort (NAKO). Childhood maltreatment was assessed via the Childhood Trauma Screener; depression via self-reported physician's diagnosis and MINI classification (lifetime) and the PHQ-9 (current). Associations, including sex interactions, were modeled using binary logistic regressions. Disparity decomposition and sex-stratified population attributable fractions quantified the contribution of childhood maltreatment to depression. Childhood maltreatment was associated with increased odds of lifetime (ORphysician's diagnosis=2.45 [2.38,2.53]; ORMINI=2.30 [2.18,2.43]) and current depression (OR=2.90 [2.79,3.02], all padj<0.001). Sex interactions were observed for physician's diagnosis: physical abuse (padj=0.024) and neglect (padj<0.001) had stronger associations in females (ORphysical abuse=2.74 [2.59,2.90]; ORphysical neglect=1.36 [1.28,1.44]) than males (ORphysical abuse=2.36 [2.21,2.52]; ORphysical neglect=1.08 [1.00,1.16]), whereas sexual abuse (padj=0.003) showed stronger associations in males (OR=3.23 [2.91,3.57]) than females (OR=2.61 [2.48,2.75]). Overall, childhood maltreatment accounted for 21.2-26.2% of lifetime and 33.4% of current depression. Population attributable fractions were higher in females than males for lifetime (24.5-28.5% vs. 16.0-20.9%) and current depression (36.1% vs. 28.4%). Emotional subtypes contributed the highest population attributable fractions (up to 10.2%). Childhood maltreatment contributed 19.2-22.4% to the association between sex and depression. Childhood maltreatment accounts for a substantial proportion of depression in both sexes, with stronger overall associations in females. Sex-specific prevention may help reduce depression prevalence.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1"},"PeriodicalIF":9.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Back to gut feelings. Latent class analysis of daily perceived health variations identifies later responses to antidepressant treatment.","authors":"Laura Di Lodovico, Charles Westphalen, Chloé Tezenas du Montcel, Loïck Le Tertre, Philippe Courtet, Philip Gorwood","doi":"10.1159/000553379","DOIUrl":"https://doi.org/10.1159/000553379","url":null,"abstract":"<p><p>Major depressive disorder (MDD) is a prevalent and disabling condition, yet predicting individual response to antidepressants remains difficult. Traditional symptom-based assessments, typically conducted weeks apart, may miss early and dynamic changes. Daily self-reported measures of wellbeing dimensions, particularly via simple tools such as visual analog scales (VAS), could provide ecologically valid and patient-centered markers of early treatment response. This study aimed to identify distinct early trajectories of self-rated health during antidepressant initiation and examine their associations with baseline clinical characteristics and outcomes at 6-8 weeks. In this multicentre naturalistic study, 1536 outpatients with MDD initiating agomelatine monotherapy were recruited across 388 community psychiatry centers. The primary outcome was daily self-rated health during the first 14 days, assessed using the EuroQol VAS. Latent class analysis identified distinct trajectories of self-rated health evolution, with model selection based on Akaike and Bayesian information criteria (AIC/BIC), entropy, and clinical interpretability. A five-class solution was retained, including persistently high or low trajectories, stable intermediate patterns, and one subgroup showing marked early improvement despite low baseline values. Trajectories were associated with baseline clinical severity and different symptomatic and functional outcomes at 6-8 weeks. Patients with rapid early improvement had the highest remission rates, whereas those with severe baseline symptoms and limited early improvement had the poorest outcomes. These findings support the clinical utility of early wellbeing trajectories for personalized monitoring during antidepressant treatment.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-19"},"PeriodicalIF":9.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of Trauma-Focused Cognitive Behaviour Therapy for psychosis on post-traumatic stress symptoms in daily life: ESM outcomes of the STAR Trial.","authors":"Morwenna Rickard, Peter Panayi, Amy Hardy, Richard Bentall, Richard Emsley, Craig Steel, Robert Dudley, Raphael Underwood, Ginette Lafit, Clementine J Edwards, Inez Myin-Germeys, Emmanuelle R Peters, Fillipo Varese","doi":"10.1159/pps/aemag010","DOIUrl":"https://doi.org/10.1159/pps/aemag010","url":null,"abstract":"<p><strong>Introduction: </strong>People with psychosis have high rates of post-traumatic stress-disorder (PTSD). The STAR (Study of Trauma And Recovery) randomised controlled trial found that a Trauma-Focused therapy integrated with Cognitive Behaviour Therapy for psychosis (TF-CBTp) added to Treatment-As-Usual (TAU) reduced PTSD symptoms in people with psychosis compared to TAU only. We hypothesized that TF-CBTp would also reduce PTSD symptoms in daily life, using Experience Sampling Methodology (ESM), which would be associated with improvements on a clinical measure of PTSD.</p><p><strong>Methods: </strong>Participants were adults with PTSD and schizophrenia-spectrum diagnoses, a subsample of the STAR trial (N=153; TF-CBTp+TAU=73, TAU=80). Participants completed ESM assessments of intrusive memories, hyperarousal, dissociation, avoidance and negative trauma-related cognitions through a smartphone app multiple times daily over six days, at baseline and 9-months post-randomisation (end-of-therapy).</p><p><strong>Results: </strong>No between-group differences were found in ESM measures of momentary PTSD symptoms at 9-months. Significant timepoint×therapy interactions indicated greater decrease over time in hyperarousal, negative cognitions, and avoidance, and in variability of intrusive memories, in TF-CBTp+TAU compared to TAU. ESM measures at 9-months were significantly associated with improvements on the Clinician-Administered PTSD Scale for DSM-5.</p><p><strong>Conclusion: </strong>While findings are tentatively in favour of TF-CBTp, the robust reductions in PTSD symptoms found in the STAR trial using retrospective outcome measures were not fully replicated with ESM, suggesting these methodologies may be capturing different features of symptom expression and processes of therapeutic change. Including both approaches in future research could provide a fuller picture of therapy effects on 'in-the-moment' versus reflective reports of experiences.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1"},"PeriodicalIF":9.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline prediction of two-year prevention and remission of anxiety, depression, and eating disorders in college students receiving a digital guided self-help intervention: derivation and external validation of a machine learning algorithm across 26 population-based cohorts.","authors":"Adam Calderon, Daoyi Zhu, Nur Hani Zainal, Chenyang Lu, Ellen E Fitzsimmons-Craft, Denise E Wilfely, Daniel Eisenberg, C Barr Taylor, Michelle G Newman","doi":"10.1159/pps/aemag007","DOIUrl":"https://doi.org/10.1159/pps/aemag007","url":null,"abstract":"<p><strong>Introduction: </strong>We examined whether machine learning identified baseline variables that predicted two-year prevention and remission from anxiety, depression, and eating disorders following digital cognitive-behavioral therapy guided self-help (D-CBTgsh).</p><p><strong>Methods: </strong>Undergraduates at risk for or meeting criteria for anxiety, depression, and eating disorders who were randomized to population-based screening and D-CBTgsh were examined. A five-step hybrid feature selection strategy reduced 863 baseline questionnaire items to 37 spanning demographics, mental health problems, treatment motivation, and treatment targets. Five supervised machine learning algorithms were trained and tested using nested cross-validation among students from 13 U.S. colleges (n = 1472) to discriminate who did versus did not achieve two-year prevention and remission of all anxiety, depression, and eating disorders. External validation was conducted in a separate set of 13 U.S. colleges (n = 823).</p><p><strong>Results: </strong>When externally validated, random forest outperformed all models in discriminative power, calibration, and clinical utility. Predictors of no disorders at two years included lower levels of behavioral avoidance, generalized anxiety interference, social fear, social anxiety interference, depressed mood, fear of observation, number of worry topics, perseverative thinking, and binge eating, along with higher feelings of calm/peacefulness, perceived need for treatment, and intention to seek help. Demographic predictors of no disorders were being male at birth, fewer financial difficulties, and a lower current body mass index.</p><p><strong>Conclusion: </strong>This predictive algorithm, using 37 single items, developed a scalable self-report measure that could be readily adopted by college campuses to help optimize and scale service delivery across campuses.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1"},"PeriodicalIF":9.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement in Fatigue and Depression During Post-COVID Rehabilitation.","authors":"Volker Köllner, Alexa Kupferschmitt, Lena Kohnle, Michael Jöbges, Thomas Horst Loew","doi":"10.1159/pps/aemag006","DOIUrl":"https://doi.org/10.1159/pps/aemag006","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1"},"PeriodicalIF":9.0,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward Personalized Psychotherapy in Anorexia Nervosa: Evidence from Long-Term Moderator Analyses of the ANTOP study.","authors":"Beate Wild, Hans-Christoph Friederich, Katrin Elisabeth Giel, Wolfgang Herzog, Gaby Resmark, Dieter Schellberg, Florian Junne, Martin Teufel, Martina de Zwaan, Andreas Dinkel, Stephan Herpertz, Markus Burgmer, Bernd Löwe, Almut Zeeck, Jörn von Wietersheim, Sefik Tagay, Carmen Schade-Brittinger, Henning Schauenburg, Ulrike Schmidt, Stephan Zipfel","doi":"10.1159/000553469","DOIUrl":"https://doi.org/10.1159/000553469","url":null,"abstract":"<p><strong>Background: </strong>The Anorexia Nervosa Treatment of OutPatients (ANTOP) randomized controlled trial (RCT) involved 242 adult patients with anorexia nervosa. Patients from 10 German university hospitals were randomly allocated to 10 months of treatment with focal psychodynamic therapy (FPT), enhanced cognitive behaviour therapy (CBT-E), or optimized treatment as usual (TAU-O). At the end of treatment and follow-up no significant BMI differences between groups were reported. The present study is an explorative, secondary analysis of moderators of weight gain for FPT and CBT-E.</p><p><strong>Methods: </strong>N=160 patients - randomized to FPT and CBT-E - were included in the analysis. Moderator analysis was conducted by using a mixed model approach for repeated measures (MMRM). The outcome variable was BMI at the last follow-up T5 (mean time of 5·96 years after the beginning of the study).</p><p><strong>Results: </strong>Low depression severity and high mental quality of life (QoL) at baseline moderated the outcome in favour of CBT-E, whereas high depression severity and low mental QoL was associated with a better outcome in FPT. Sensitivity analyses to predict BMI at earlier time points T1-T4 produced the same results. The direction of the moderator effects was the same for CBT-E and FPT across all time points. Graphical visualisation confirms that there is a wide range where both treatments perform similarly, while CBT or FPT perform differently in the extreme ranges of these two variables.</p><p><strong>Interpretation: </strong>These findings suggest that baseline psychological burden may inform the selection of psychotherapy modality in anorexia nervosa, supporting a move toward personalized, mechanism-informed treatment allocation.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-16"},"PeriodicalIF":9.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Long-term Safety Outcomes of Ketamine and Esketamine in Patients with Treatment-resistant Depression.","authors":"Tychique T Wasolua, Morgan S Hardy, Tanner J Bommersbach, Roger S McIntyre, Taeho Greg Rhee","doi":"10.1159/pps/aemag005","DOIUrl":"https://doi.org/10.1159/pps/aemag005","url":null,"abstract":"<p><strong>Introduction: </strong>Approximately 30-40% of patients with major depressive disorder fail to respond to conventional antidepressants. Ketamine and esketamine are increasingly used, yet synthesized data on cumulative safety remain limited. This systematic review evaluated long-term safety of both agents.</p><p><strong>Methods: </strong>MEDLINE, PsycINFO, Embase, and Cochrane Library were searched from inception through January 29, 2026. Eligible studies enrolled adults with depressive disorders receiving ketamine or esketamine with ≥12-week follow-up. Safety outcomes were synthesized narratively across nine domains: neurocognitive, dissociative/psychotomimetic, sedation, cardiovascular, hepatic, urinary, misuse/dependence, suicidality, and serious adverse events (SAEs). Risk of bias was assessed.</p><p><strong>Results: </strong>Thirty-two studies (11 RCTs, 21 non-randomized) met inclusion criteria, with follow-up ranging from 3 months to 9 years. Across cardiovascular, hepatic, and urinary domains, neither racemic ketamine nor intranasal esketamine demonstrated evidence of cumulative organ toxicity during maintenance treatment. Dissociative and sedative effects were common but consistently transient, resolving within 1-2 hours of administration. No treatment-emergent neurocognitive dysfunction was identified; urologic complications were rare and resolved with treatment discontinuation. No cases of iatrogenic addiction, drug-seeking, or withdrawal were documented for either formulation. Suicidal ideation scores showed reductions from baseline, though suicide attempts and completions occurred during follow-up periods. SAEs attributable to treatment were rare. The comparative analyses suggested essentially equivalent long-term safety profiles between racemic ketamine and intranasal esketamine.</p><p><strong>Conclusion: </strong>Current evidence supports the safety of ketamine and esketamine for TRD, with no cumulative organ toxicity or iatrogenic addiction during maintenance treatment. Acute effects remain transient and manageable. However, findings are limited by heterogeneity in safety monitoring across studies.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1"},"PeriodicalIF":9.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Determinants of Health in Medically Hospitalized Patients Seen in Consultation-Liaison Psychiatry: A Scoping Review.","authors":"Sofia E Matta, Helena Feldman, Michalla Braford, Rachel L Kanter, Melis Lydston, John W Cyrus, Melissa P Bui, Patrick Triplett, Michael Sharpe, Dilip V Jeste, Mark A Oldham","doi":"10.1159/000553244","DOIUrl":"https://doi.org/10.1159/000553244","url":null,"abstract":"<p><p>Psychiatric comorbidity affects at least one-third of patients hospitalized on medical-surgical services, with over half facing psychosocial stressors that impact care. These comorbidities are associated with poorer outcomes, including prolonged hospitalization, higher costs, increased restraint use, and readmission risk. However, the role of social determinants of health (SDoH) in shaping these outcomes remains insufficiently characterized. This scoping review examined how SDoH influence psychiatric comorbidity and clinical outcomes in medical-surgical inpatient settings. On February 6, 2024, a systematic search was conducted across Ovid MEDLINE, Embase, PsychINFO, Web of Science, and Cochrane databases. Of 5,372 articles screened, 77 met inclusion criteria. The 48 articles published since 2003 (the year Consultation-Liaison Psychiatry was first accredited as a subspecialty in the U.S.) were synthesized for contemporary relevance. Most were retrospective observational (37.5%) or cross-sectional studies (31.2%), with global representation across North America, Europe, Asia, and other regions. Commonly reported demographic factors and SDoH included age, sex, ethnicity, marital status, housing, and socioeconomic status. Psychiatric diagnoses were associated with social disadvantage and were frequently linked to longer length of stay. Factors like food insecurity, neighborhood disadvantage, and incarceration were underexplored. Few studies assessed proactive or interventional care. Findings highlight the need for longitudinal and interventional research to clarify the complex interrelationships among SDoH, psychiatric conditions, medical comorbidity, and hospital outcomes to inform equitable models of care.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-24"},"PeriodicalIF":9.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying Clinical Case Formulation: Person-Specific Dynamic Network Modelling of Posttraumatic Stress Disorder.","authors":"Nimrod Hertz-Palmor, Alicja Podgorski, Gary Brown, Amit Lazarov, Jana Porat, Shany Edelman Yaron, Anna Bevan, Tim Dalgleish","doi":"10.1159/pps/aemag004","DOIUrl":"10.1159/pps/aemag004","url":null,"abstract":"<p><strong>Introduction: </strong>Psychopathology research typically relies on nomothetic (group-level) data to infer idiographic (person-level) processes, limiting clinical relevance, and failing to capture complex individual presentations. Conversely, idiographic approaches capture within-person dynamics but often lack theoretical structure to support generalization, creating a nomothetic-idiographic gap. This study addresses this gap by operationalising Ehlers and Clark's (E&C) Cognitive Model of Posttraumatic Stress Disorder (PTSD) within a theory-guided idiographic network framework.</p><p><strong>Methods: </strong>Study 1 used simulations to establish data requirements for reliably testing model-derived hypotheses. Study 2 applied this framework to intensive longitudinal data from trauma-exposed individuals. Fifty-five participants (31 with PTSD, 24 with clinical-level symptoms) selected personalized items reflecting core model components: negative appraisals, trauma memory, triggers, sense of current threat, and maladaptive strategies. A subsample of 41 participants completed 3 weeks of Ecological Momentary Assessment, yielding 2,594 observations (M = 63.2 per participant). Individualized items were mapped onto shared theoretical constructs and analyzed using complementary network models.</p><p><strong>Results: </strong>Findings provided empirical support for key assumptions of the E&C model, particularly the central role of sense of current threat and its associations with trauma memory, negative appraisals, triggers, and maladaptive strategies. Clustering of individual networks identified four recurring formulation subtypes characterized by threat reactivity, appraisal centrality, memory centrality, or trigger-threat association.</p><p><strong>Conclusion: </strong>We demonstrate a method for bridging individualized assessment with theory-driven analysis. By combining personalized data collection with a shared mechanistic framework, idiographic networks can extend beyond single-case descriptions to identify common clinical patterns, with potential implications for formulation, intervention planning, and evaluation.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1"},"PeriodicalIF":9.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}