Psychotherapy最新文献

{"title":"Is employment status associated with baseline symptoms, engagement, and outcomes in naturalistic psychotherapy? Evaluation in a large community mental health agency.","authors":"Zishan Jiwani, Qiang Xie, John J Curtin, Kevin M Riordan, Robbie Babins-Wagner, Derek Caperton, Mindi N Thompson, Simon B Goldberg","doi":"10.1037/pst0000597","DOIUrl":"10.1037/pst0000597","url":null,"abstract":"<p><p>Employment status, an essential socioeconomic factor, may be an important driver of disparities in mental health and access to treatment. However, prior research has been inconclusive and utilized broad employment categories. The present study investigated the associations between various types of employment status and baseline symptomology, psychotherapy engagement, and psychotherapy outcomes. We examined 27,258 patients (<i>M</i>age = 32.54; 62.9% female; 75.8% White) who attended 115,936 psychotherapy sessions at a Canadian mental health agency between January 2014 and July 2022. Employment status was categorized into nine distinct groups (e.g., full-time, part-time, unemployed and looking for work, unemployed not looking for work, and retirement). Multilevel models examined the association between employment status and baseline symptoms, psychotherapy engagement (e.g., total sessions, early termination), and outcomes (e.g., symptom change). Patients who were unemployed (both looking for and not looking for work) reported higher baseline symptoms and increased odds of suicide concern compared to patients with full-time employment. Contrary to our preregistered hypotheses, patients who were unemployed attended more sessions and showed no significant differences in symptom change or trajectory of change compared to those employed full-time. Retirement was linked to lower baseline symptomology, and both retirement and full-time student status were associated with slower trajectories of change relative to full-time employment. Findings suggest that unemployment is associated with worse baseline mental health but does not hinder psychotherapy engagement and effectiveness. Ensuring accessibility of psychotherapy for unemployed individuals is crucial, given their heightened risk of psychological distress. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"495-508"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Black clients' perceptions of therapists' cultural comfort, alliance, and outcome and the discussion of anti-Black racism in psychotherapy.","authors":"Theodore T Bartholomew, Emma Smith, Andrés E Pérez-Rojas, Krista A Robbins, Eileen E Joy, Mukasa Mubirumusoke","doi":"10.1037/pst0000598","DOIUrl":"10.1037/pst0000598","url":null,"abstract":"<p><p>Prior scholarship has helped demonstrate therapists' perceptions of the value of discussing anti-Black racism with Black clients in a manner that espouses cultural comfort or the ability to be at ease when discussing lived experiences related to clients' culture during treatment. Better understanding cultural comfort, an aspect of multicultural orientation, when discussing anti-Black racism with Black clients could help clarify paths by which psychotherapy does not perpetuate harm reflected in the dehumanization of such racism. However, Black clients' perspectives are missing in the literature. As such, we collected data from 153 Black participants with recent therapy experiences. They were asked about discussing anti-Black racism during therapy, satisfaction/helpfulness of these conversations, and items related to initiation and frequency of such discussions. Participants also completed measures of cultural comfort, working alliance, and perceived outcome. Perceived therapist cultural comfort did not significantly vary if anti-Black racism was discussed, and discussing anti-Black racism did not moderate the relationship between cultural comfort and working alliance or cultural comfort and outcome. Satisfaction and helpfulness positively correlated with cultural comfort. Cultural comfort scores also varied by who initiated these conversations and their frequency. We contextualize these findings in a need for greater nuance with respect to examining discussions of racism in psychotherapy and consider our findings with respect to broaching literature. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"529-536"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapist personality factors as predictors of between-therapist effectiveness differences.","authors":"Michael J Constantino, Averi N Gaines, Alice E Coyne, Henricus L Van, Anuj H P Mehta, Jaap Peen, Frank J Don, Jack J M Dekker, Ellen Driessen","doi":"10.1037/pst0000591","DOIUrl":"10.1037/pst0000591","url":null,"abstract":"<p><p>Abundant research across various treatments indicates that therapists can differ in their general, caseload-level effectiveness. However, relatively little is known about therapist factors that predict such \"performance\" variability. Moreover, most of the limited existing work on this topic has relied on demographic and professional convenience variables, which have demonstrated low predictive power. Thus, it is possible that therapist effectiveness differences would be better explained by personality characteristics that are inescapably present in a clinician's work. Addressing this question, the present preregistered study preliminarily explored whether more versus less effective therapists possess more adaptive personality traits among the \"big five,\" defense style maturity, and psychological mindedness. Data were derived from a randomized clinical trial comparing the efficacy of 16 sessions of cognitive behavioral therapy and psychodynamic therapy for depression (Driessen et al., 2013). Effective sample participants were 142 adult outpatients treated by 32 therapists nested within the treatment condition. Therapists completed multiple personality measures, and patients' depression and global distress symptoms were assessed (via self-report or observer ratings) at baseline and posttreatment. Despite there being significant between-therapist effectiveness differences (on their average patient's posttreatment outcome), multilevel models revealed no significant associations between personality characteristics and such differences on any outcome. It may be that therapists' overall effectiveness has more to do with their transferable actions <i>in the room</i> versus traits they bring into their work. Alternatively, certain traits may predict between-therapist effects but only in specific treatment, patient, and/or cultural contexts that differ from the ones herein. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"509-517"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying a theory of change approach to evaluating evidence for circle of security interventions: A systematic review.","authors":"Erinn Hawkins, Brittnee Byron, Anna Huber, Nicole Perry, Catherine McMahon, Neil W Boris","doi":"10.1037/pst0000592","DOIUrl":"10.1037/pst0000592","url":null,"abstract":"<p><p>Circle of Security (COS) interventions aim to improve parent-child relationships. Preliminary evidence of the effectiveness of COS interventions has been positive, but recent studies suggest mixed results that may be due to a lack of differentiation between different versions of COS interventions. This systematic review used a theory of change/program logic approach to summarize the evidence for COS interventions and to explore the conditions under which each protocol was most effective. A comprehensive systematic literature search was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for studies administering a verified COS intervention protocol with parents/caregivers of children aged 0-8 years. Studies were coded for study design, protocol type, sample characteristics, treatment fidelity, dose, risk of bias, and type of outcome. Nineteen eligible studies were included; seven were randomized controlled trials. Studies of the higher dose protocols (i.e., COS-Intensive, COS-Intensive-Revised Hybrid, COS-Perinatal Protocol) showed promising results across primary and secondary parent outcomes, longer term relationship and child outcomes, and clinical samples. Results showed mixed evidence for the efficacy of the more scalable COS-Parenting. Reviewing studies according to the theory of change/program logic suggested three sources of variability in COS-Parenting studies compared to the higher dose COS interventions that could impact outcome: treatment dose/strategies, sample type, and treatment fidelity. Differential effectiveness of COS interventions tested in seven randomized controlled trials, two nonrandomized controlled trials, and 10 single-arm trials suggests that different COS variants may be better suited to different target populations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"445-456"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rumination in response to repugnant obsessions: Catching the sneakiest of compulsions.","authors":"Jean-Philippe Gagné, Shiu F Wong","doi":"10.1037/pst0000585","DOIUrl":"10.1037/pst0000585","url":null,"abstract":"<p><p>Rumination is a mental process characterized by the repetitive analysis of concerns without taking concrete or helpful action. It has been shown to be transdiagnostic, contributing to the maintenance and exacerbation of symptoms across various mental disorders, including obsessive-compulsive disorder (OCD). Historically conceptualized as part of the obsessional domain due to its repetitive and intrusive qualities, rumination is now better understood as a covert compulsion-one that reinforces the overimportance of otherwise normal, unwanted intrusions, particularly in the case of repugnant obsessions. Consequently, it is crucial for clinicians to frame rumination as a mental habit or behavior in which individuals with OCD attempt to understand the causes, meaning, and consequences of their thoughts. This unproductive and time-consuming process not only amplifies intrusive doubts but also worsens mood, placing individuals at high risk for comorbid depression. This article outlines how rumination fits within the cognitive-behavioral model of OCD and, more importantly, offers practical refinements to standard cognitive-behavioral therapy interventions, drawing from evidence-based strategies for OCD and related disorders as well as from behavioral activation. The aim is to better equip clinicians with tools to effectively target rumination in OCD, particularly in presentations involving repugnant obsessions. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"518-528"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Core principles of treating the suicidal adult: What we have learned from patients about restoring safety, emotion regulation, mentalizing, and epistemic trust.","authors":"J Christopher Fowler, Stuart Weir, William H Orme","doi":"10.1037/pst0000601","DOIUrl":"10.1037/pst0000601","url":null,"abstract":"<p><p>Treating the suicidal patient is a risky, often emotionally exhausting process that strains the best therapist's capacity to maintain the primary focus of psychotherapy. When fear, desperation, and urgency to resolve the suicidal state become overwhelming, therapists and patients can get lost in protracted power struggles and crisis management (Plakun, 2001). Starting from the proposition that suicidal states are primarily driven by overwhelming affective experiences (Maltsberger, 2004), the authors expand upon an earlier clinical article (Fowler, 2013) to include new facets of interventions accompanied by clinical vignettes. Targeted research findings supporting these core interventions follow each vignette. Therapists are encouraged to flexibly shift among clinical interventions while carefully monitoring the emotional state and responsivity of the patient: (a) creating a sense of interpersonal safety in the therapy dyad; (b) coregulation of emotion utilizing mentalization-based therapy interventions (Bateman & Fonagy, 2016) and elements of therapeutic presence (Geller & Porges, 2014); (c) enhancing mentalizing by modeling curiosity about suicidal states of mind (Allen, 2011; Bateman & Fonagy, 2016); (d) identifying meaning(s) and pattern(s) that precipitate suicidal states; and (e) aiding the patient in fostering an enduring sense of trust. While informed by attachment theory, mentalization-based therapy, and polyvagal theory, these interventions are best conceptualized as common factors and can be utilized in conjunction with third-wave cognitive behavioral therapy, interpersonal, and integrative approaches. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"433-444"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of patients' preferences for psychotherapy with psychotherapists' preferences for delivering psychotherapy in China.","authors":"Zhuang She, Mick Cooper, Gina Di Malta","doi":"10.1037/pst0000600","DOIUrl":"10.1037/pst0000600","url":null,"abstract":"<p><p>Despite the evidence indicating that accommodating preferences leads to better outcomes, we currently know very little about what psychotherapists prefer to deliver and whether this matches patient preferences. This research aimed to understand the degree of mismatching between patients' preferences in psychotherapy and psychotherapists' preferred psychotherapy delivery in Chinese clinical contexts. We utilized three samples from two different Chinese clinical contexts. Study 1 consisted of two independent samples of patients (<i>N</i> = 301) and psychotherapists (<i>N</i> = 1,054). The Cooper-Norcross Inventory of Preferences patient and therapist versions were administered to assess preferences. In Study 2, a paired patient-psychotherapist sample (<i>N</i>_{psychotherapists} = 155, <i>N</i>_patients = 3,060) was used to replicate Study 1 findings. Results from both studies indicated two significant areas of mismatch. First, psychotherapists had a stronger preference for their patients to take the lead in psychotherapy when compared with lay patients (<i>d</i> = 0.74∼0.82). Second, psychotherapists showed a stronger preference for emotional intensity than patients (<i>d</i> = 0.57∼0.62). These differences were relatively consistent across psychotherapists' theoretical orientations and personal psychotherapy experiences, with some variation linked to psychotherapists' clinical experience. Psychotherapists' preferred delivery styles, as compared with patients' actual preferences, are consistent with psychotherapists' own preferences (as patients) and may reflect a false consensus bias. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"486-494"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multilevel meta-analysis of client and therapist predictors for alliance quality: Absolute and relative associations with working alliance.","authors":"Hui Xu, Yun Lu, Weidi Huang, Wenxi Deng, Jiaying Lu, Yun Qiu, Zhanren Shen","doi":"10.1037/pst0000603","DOIUrl":"10.1037/pst0000603","url":null,"abstract":"<p><p>Extensive research, including meta-analytic studies, has underscored the role of working alliance in influencing psychotherapy outcomes. However, far fewer studies and meta-analyses have delved into the predictors of working alliance quality. To synthesize the literature and highlight key predictors for alliance, the present study conducted a meta-analysis of predictors of subsequent working alliance. Drawing on 898 Pearson's r effects from 130 studies involving 12,449 clients and 2,840 therapists, a multilevel meta-analysis identified five major groups of factors that preceded alliance. Among client-related factors, client resource and readiness positively correlated with alliance, showing small and medium effect sizes, respectively (<i>r</i> = 0.18, 95% CI [0.12, 0.24], <i>p</i> < .001 and <i>r</i> = 0.34, 95% CI [0.25, 0.42], <i>p</i> < .001), while client distress negatively predicted alliance (small effect size, <i>r</i> = -0.14, 95% CI [-0.18, -0.11], <i>p</i> < .001). Regarding therapist-related factors, treatment execution showed a small effect size (<i>r</i> = 0.15, 95% CI [0.03, 0.28], <i>p</i> = .019), and rapport building contributed to alliance quality with a medium effect size (r = 0.39, 95% CI [0.31, 0.47], <i>p</i> < .001). The study revealed notable between-study heterogeneity and found several moderation effects. The meta-analytic effects remained robust across various sensitivity analyses. This study illuminates the significant roles of both clients and therapists in developing working alliance and discusses its implications, limitations, and future research directions. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"457-473"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an artificial intelligence-based measure of therapists' skills: A multimodal proof of concept.","authors":"Katie Aafjes-van Doorn, Marcelo Cicconet, Jordan Bate, Jeffrey F Cohn, Marc Aafjes","doi":"10.1037/pst0000561","DOIUrl":"10.1037/pst0000561","url":null,"abstract":"<p><p>The facilitative interpersonal skills (FIS) task is a performance-based task designed to assess clinicians' capacity for facilitating a collaborative relationship. Performance on FIS is a robust clinician-level predictor of treatment outcomes. However, the FIS task has limited scalability because human rating of FIS requires specialized training and is time-intensive. We aimed to catalyze a \"big needle jump\" by developing an artificial intelligence- (AI-) based automated FIS measurement that captures all behavioral audiovisual markers available to human FIS raters. A total of 956 response clips were collected from 78 mental health clinicians. Three human raters rated the eight FIS subscales and reached sufficient interrater reliability (intraclass correlation based on three raters [ICC3k] for overall FIS = 0.85). We extracted text-, audio-, and video-based features and applied multimodal modeling (multilayer perceptron with a single hidden layer) to predict overall FIS and eight FIS subscales rated along a 1-5 scale continuum. We conducted 10-fold cross-validation analyses. For overall FIS, we reached moderate size relationships with the human-based ratings (Spearman's ρ = .50). Performance for subscales was variable (Spearman's ρ from .30 to .61). Inclusion of audio and video modalities improved the accuracy of the model, especially for the Emotional Expression and Verbal Fluency subscales. All three modalities contributed to the prediction performance, with text-based features contributing relatively most. Our multimodal model performed better than previously published unimodal models on the overall FIS and some FIS subscales. If confirmed in external validation studies, this AI-based FIS measurement may be used for the development of feedback tools for more targeted training, supervision, and deliberate practice. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"301-314"},"PeriodicalIF":3.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antisocial personality traits and outcome in psychotherapy: Does the therapeutic alliance mediate negative effects?","authors":"Bianca H Cersosimo, Mark J Hilsenroth, Caleb J Siefert, Mark A Blais","doi":"10.1037/pst0000583","DOIUrl":"10.1037/pst0000583","url":null,"abstract":"<p><p>Process and outcome studies focusing on antisocial traits (ANT) are limited (Van den Bosch et al., 2018), especially in nonforensic/nonoffender outpatient settings (Thylstrup & Hesse, 2016). ANT can impact outcomes through several mechanisms, such as treatment rejection, premature dropout, or poor alliance formation (Van den Bosch et al., 2018; Messina et al., 2002). In a prior study (Cersosimo, Hilsenroth, Bornstein, & Gold, 2022), we found that patient-rated alliance early in outpatient psychotherapy was negatively related to pretreatment ratings on Personality Assessment Inventory scales assessing ANT. The present study extends this work by examining ANT, alliance, and treatment readiness with outcome. We found that ANT, treatment rejection, and patient-rated alliance were significantly related to patient-rated outcome (<i>n</i> = 65). Regression analysis indicated that both ANT (β = -.29, <i>p</i> = .014; <i>f</i>² = 0.09) and treatment rejection (β = -.28, <i>p</i> = .019; <i>f</i>² = 0.09) were unique, negative, predictors of outcome, explaining 18% of the variance. Adding the significant, positive, patient-rated alliance to the model (β = .34, <i>p</i> = .003; <i>f</i>² = 0.13) increased explained variance to 25%. Subsequent analyses revealed that the negative impacts of treatment rejection on outcome occur separate from both ANT and alliance, while the negative impact of ANT on outcome is partially mediated by the positive effects of alliance (indirect effect = -.10, lower level confidence interval = -.208; upper level confidence interval = -.003). We discuss how early assessment of ANT and treatment readiness informs treatment planning. Limitations of the study and next steps for research are noted. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"397-406"},"PeriodicalIF":3.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}