Journal of Behavioral and Cognitive Therapy最新文献

{"title":"Analyzing data in single-case experimental designs: Objectives and available software options","authors":"Rumen Manolov ,&nbsp;Lucien Rochat","doi":"10.1016/j.jbct.2024.100511","DOIUrl":"10.1016/j.jbct.2024.100511","url":null,"abstract":"<div><div>The current paper aims to explain the analysis of the data once it has been gathered. Given the multiple data analytical options available and the lack of consensus on which is optimal, we provide a series of organizing principles to better understand these options. We consider this a necessary first step before choosing an option and justifying that choice. Furthermore, in addition to discussing the applicability of each analytical option mentioned, we highlight freely available, user-friendly software that implements these options. We also include an example of application with real data to illustrate how different kinds of information can be obtained and used to draw conclusions about intervention effectiveness. Finally, we provide recommendations to applied researchers regarding planning (before data is gathered and analyzed) to increase the likelihood of conducting research that provides a solid basis for practice. We also offer recommendations related to reporting (after data is gathered and analyzed) to improve transparency.</div></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"34 4","pages":"Article 100511"},"PeriodicalIF":1.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142661135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of online mental health education on occupational burnout among medical staff","authors":"Yuze Shen ,&nbsp;Jiafeng Wang ,&nbsp;Peiqiang Yang ,&nbsp;Qiaozhen Chen","doi":"10.1016/j.jbct.2024.100512","DOIUrl":"10.1016/j.jbct.2024.100512","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To understand the levels of occupational burnout, anxiety, and depression among medical staff, to construct a mental health model for medical staff based on personality traits and demographic variables. Design and validate the effectiveness of health education via an online platform.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Using an online questionnaire platform, demographic and occupational information was collected from healthcare workers in the medical community of the First People’s Hospital of Linping District. The Eysenck Personality Questionnaire (EPQ), Job Burnout Inventory, Generalized Anxiety Disorder Self-Assessment Scale-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and psychological introspection were used to build a mental health model. For those identified with occupational burnout, an online mental health education program was conducted once a week for four weeks, focusing on self-emotional identification and management. The effectiveness of the program was re-evaluated one month later.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Out of 1127 questionnaires, the rate of positive occupational burnout was 22.1%. The analysis revealed that age (OR = 0.965, 95%CI 0.944–0.987), experiencing medical violence (OR = 2.585, 95%CI 1.829–3.654), treatment identification (OR = 0.831, 95%CI 0.753–0.917), medical versus nursing positions (OR = 0.654, 95%CI 0.468–0.914), administrative versus nursing positions (OR = 0.436, 95%CI 0.229–0.828) were significantly associated with the occurrence of occupational burnout. In addition, the EPQ test indicated that introverted personality (OR = 2.078, 95% CI 1.282–3.367, P = 0.003) and unstable personality (OR = 3.365, 95% CI 2.172–5.214, P &lt; 0.001) increased the risk of occupational burnout, whereas extroverted personality (OR = 0.394, 95% CI 0.231–0.672, P = 0.001) and stable personality (OR = 0.347, 95% CI 0.231–0.522, P &lt; 0.001) reduced it. Before and after the online mental health education intervention, self-comparison found that the participants showed significant improvement in emotional exhaustion (&lt;em&gt;t&lt;/em&gt; = 3.520), depersonalization (&lt;em&gt;t&lt;/em&gt; = 2.035), reduced personal accomplishment (&lt;em&gt;t&lt;/em&gt; = 4.749), total burnout score (&lt;em&gt;t&lt;/em&gt; = 5.952), PHQ-9 (&lt;em&gt;t&lt;/em&gt; = 4.017), and GAD-7 (&lt;em&gt;t&lt;/em&gt; = 4.234). However, compared to healthcare workers who have experienced medical violence, the average improvement rate in overall burnout scores for those who have not experienced medical violence is 9.28% higher (&lt;em&gt;t&lt;/em&gt; = 2.172).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;With increasing age, the risk of occupational burnout may decrease, while experiencing medical violence, being in a nursing position, and having an introverted or unstable personality are significant risk factors for occupational burnout. Online mental health education is effective in improving occupational burnout among healthcare workers, but its effectiveness is impacted by experiencing medical violen","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"34 4","pages":"Article 100512"},"PeriodicalIF":1.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142661031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of cognitive behavioral therapy in mental health problems of children and adolescents in child protection system: A meta-analysis","authors":"Hilal Daş ,&nbsp;M. Furkan Kurnaz ,&nbsp;Nilüfer Koçtürk","doi":"10.1016/j.jbct.2024.100509","DOIUrl":"10.1016/j.jbct.2024.100509","url":null,"abstract":"<div><div>Evidence on the effectiveness of cognitive behavioral therapy (CBT)-based interventions for mental health problems of children and adolescents in institutional/foster care has been presented in various studies. However, the literature does not contain a meta-analysis study that examines and synthesizes the results together. This study aimed to examine the effectiveness of CBT in the mental health problems of children and adolescents in foster and institutional care. In the literature review, we included eight studies that met the inclusion criteria in the analysis. The results showed CBT had a strong effect (<em>g</em> = −1.08) on improving the mental health problems of children and adolescents in institutional/foster care. The results also showed that CBT interventions were more effective in depression (<em>g</em> = −1.70) than anxiety (<em>g</em> = −0.87) in children and adolescents in institutional/foster care. Additionally, the results indicated that CBT-based interventions were more effective in groups consisting solely of children (<em>g</em> = −4.06) than in groups comprising children and adolescents (<em>g</em> = −1.70). Thus, this study’s results suggest promising findings for CBT-based interventions, indicating a need for more research in this sample.</div></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"34 4","pages":"Article 100509"},"PeriodicalIF":1.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing user acceptance of a mental health app & its impact on depression and attention deficit hyperactivity disorder related knowledge: A mixed method experimental study","authors":"Yeganeh Shahsavar ,&nbsp;Avishek Choudhury","doi":"10.1016/j.jbct.2024.100508","DOIUrl":"10.1016/j.jbct.2024.100508","url":null,"abstract":"<div><div>Mental health problems have become a public health challenge particularly among younger generation. The research gap in mental health care and prevalence of issues in access to care services has led to a growing demand for treatment options. Digital health technologies exhibit the potential to supplement mental health clinics by facilitating accessible and affordable services. Here we develop and evaluate the effectiveness of My Friendly Mind, a web-based app, designed to increase awareness of depression and attention deficit hyperactivity disorder (ADHD) while providing preliminary mental health screening. The objectives of this study were threefold. First to identify and analyze the factors influencing the intention to use the My Friendly Mind app. Second, to evaluate the app’s impact on users’ knowledge about depression and ADHD. Third, to capture users’ overall perception of the My Friendly Mind app. Seventy-Seven individuals with mental health problems participated in the study with the mean age of 24 years. Of all the participants 43 were males. Our findings indicate that perceived usefulness significantly influences both the intention to utilize the app and attitudes toward mental health improvement. A pre- and post-intervention analysis demonstrated a significant improvement in participants’ mental health knowledge. The semi-structured interviews revealed the app’s strengths and identified areas for improvement, with participants expressing a strong inclination to continue using the app, indicating its potential as a valuable resource for student mental health support. In conclusion, our app effectively increases users’ knowledge about- and familiarity with- depression and ADHD while providing a user-friendly platform for preliminary mental health screening. Future research should prioritize user-centered design, content depth, educational material integration, longitudinal engagement analysis, user feedback incorporation, and exploration of digital inequalities. Addressing these areas will contribute to the development of more effective and user-friendly mHealth applications, ultimately improving mental health outcomes.</div></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"34 4","pages":"Article 100508"},"PeriodicalIF":1.7,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphological changes and body representation: A study of the link between weight cycling and body schema disturbances","authors":"Klervi Propice ,&nbsp;Sonia Pellissier ,&nbsp;Jessica Bourgin ,&nbsp;Marie Chancel ,&nbsp;Rachel Carron ,&nbsp;Thierry Atzeni ,&nbsp;Morgane Metral","doi":"10.1016/j.jbct.2024.100507","DOIUrl":"10.1016/j.jbct.2024.100507","url":null,"abstract":"<div><div>A drastic change in one body part can result in body misestimations and consequences for motor behaviors. One hypothesis for this occurrence is a lack of body schema updating due to the rapid morphological change. However, in anorexia nervosa, a condition with weight loss and a global body change, the oversized body schema can instead be explained by the individual’s negative attitudes toward the body (body image). The objective of this study was to determine the impact of global body changes on the body schema due to weight variations outside the context of anorexia nervosa. To this end, we compared the body schema performances of 37 participants with frequent weight variations over the past 5 years (weight cycling) with those of 37 participants with stable weight over the same period (control) on a task specifically design to precisely assess the tactile dimension of the body schema (SKIN) and over different body parts. We found that people with weight cycling had more body schema distortions, with a mean oversized body surface on all body parts tested, compared with those of the control group. The body schema was affected for the body parts that were more sensitive to dissatisfaction (lower back [love handles], hip, thigh, belly), but there was no impact of pathological eating behaviors or actual weight. These results illustrate for the first time the direct negative impact of global body changes on the body schema due to weight variations. This study suggests that vigilance is needed in treating patients who have undergone significant morphological modifications, such as occurs in eating disorders, the postpartum period, and after bariatric or any reconstructive surgery.</div></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"34 4","pages":"Article 100507"},"PeriodicalIF":1.7,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of interventions aimed at improving emotional regulation in children, adolescents, and adults","authors":"Deborah Lancastle ,&nbsp;Nyle H. Davies ,&nbsp;Shelley Gait ,&nbsp;Andrea Gray ,&nbsp;Bev John ,&nbsp;Alexis Jones ,&nbsp;Taf Kunorubwe ,&nbsp;Josh Molina ,&nbsp;Gareth Roderique-Davies ,&nbsp;Philip Tyson","doi":"10.1016/j.jbct.2024.100505","DOIUrl":"10.1016/j.jbct.2024.100505","url":null,"abstract":"<div><p>There are a wide range of interventions designed to target emotional regulation, but there has yet to be a holistic examination of their comparable effectiveness. The aim of this review was to map the landscape of interventions targeting emotional regulation difficulties and identify their effectiveness and the methodologies employed. Controlled studies examining the impact of interventions targeting emotion regulation in children and adults were included in the review. This review demonstrated that there was considerable heterogeneity in the conceptualisation of emotional regulation, the characteristics and mental health problems of the participants, the measures used, and the duration of follow-up assessment (where one was reported). In addition, the emotional regulation interventions used in the studies were adapted in many cases. Together, this heterogeneity makes it difficult to draw firm conclusions about the specific circumstances where emotional regulation interventions will be more effective than alternatives and precluded a meta-analysis of the included papers. Clinicians and researchers should examine the relevant literature closely when selecting interventions and measures for research and practice to ensure that these are appropriate for the aims and intended outcomes of their work.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"34 3","pages":"Article 100505"},"PeriodicalIF":1.7,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589979124000234/pdfft?md5=5f2c8d02e6d5ecf743540b27e32eb048&pid=1-s2.0-S2589979124000234-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142167509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Doing better on dialysis: Open pilot outcomes of a technology-assisted, entertaining, CBT-based depression treatment for people with end stage kidney disease at a dialysis clinic","authors":"Peter Felsman ,&nbsp;Addie Weaver ,&nbsp;Jonathan Segal ,&nbsp;Marni Jacobson ,&nbsp;Caroline Landry ,&nbsp;Karen Crampton ,&nbsp;Jamila Abdur-Rahman ,&nbsp;Andrea DeKam ,&nbsp;Tracey Doss-Simmons ,&nbsp;Joseph Himle","doi":"10.1016/j.jbct.2024.100498","DOIUrl":"10.1016/j.jbct.2024.100498","url":null,"abstract":"<div><p>This pilot study examines change in dialysis patients’ depressive and anxiety symptoms after participation in a technology-assisted, entertaining, 8-session CBT program called Doing Better on Dialysis (DBD). A one-group pre-/post- test design assessed symptom change over time (baseline, post-treatment, three-month follow-up). Nonparametric tests, including Wilcoxon signed rank tests and Friedman’s related samples tests, were used to assess outcomes. Participants experienced a statistically and clinically significant decrease in depressive symptoms between baseline (<em>Median</em> = 12.00, <em>n</em> = 8) and post-treatment (<em>Median</em> = 5.00, <em>n</em> = 7) assessments, as measured by the PHQ-9 (<em>z</em> = −2.12, <em>p</em> = .034). Similar, though non-significant, patterns were observed for anxiety, via the GAD-7. Friedman’s tests revealed a significant overall pattern of difference on the PHQ-9 across all three timepoints in the expected direction. This pilot study provides preliminary support for DBD as a depression treatment for end stage kidney disease patients.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"34 3","pages":"Article 100498"},"PeriodicalIF":1.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-case methodology in cognitive behavior therapy: Promoting good practice within personalized psychotherapy research","authors":"Lucien Rochat ,&nbsp;Rumen Manolov","doi":"10.1016/j.jbct.2024.100502","DOIUrl":"10.1016/j.jbct.2024.100502","url":null,"abstract":"<div><p>Psychotherapy continually evolves through innovative approaches, with single-case methodology gaining prominence for its detailed insights into individual psychological interventions. This article briefly explores the historical roots and empirical foundation of the single-case methodology and underlines the significance of single-case methodology in psychotherapy by stressing the limitations of group studies and advantages of single-case studies. It then exposes some of the most frequent designs with their pros and cons, presents a scale to assess methodological biases relevant for appraising the scientific literature on single-case studies and for planning research in the field, exposes guidelines to publish single-case research articles as well as briefly introduces relevant elements related to data analyses and statistics. The resurgence of single-case methodology in the 21st century, driven by advancements in statistical methods and influences from evidence-based medicine and education, underscores their growing importance. The flexibility of this methodology allows for adaptation to various research and clinical settings, accommodating complex and individualized treatment plans.</p><p>This article aims to guide clinicians and researchers in the field of cognitive and behavior therapy in conducting and publishing single-case studies with a rigorous methodological approach, highlighting the value of single-case methodology in advancing personalized, evidence-based psychotherapy.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"34 3","pages":"Article 100502"},"PeriodicalIF":1.7,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589979124000209/pdfft?md5=bae72dd0605c1765a0e7bd9db265d450&pid=1-s2.0-S2589979124000209-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142012233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot implementation of group-based psychotherapy led by non-specialists for lung cancer patients with depression at Vietnam National Cancer Hospital","authors":"Mai Tuyet Do ,&nbsp;Anh Tuan Pham ,&nbsp;Linh Thi Thuy Nguyen ,&nbsp;Tam Thanh Nguyen ,&nbsp;Ngoc Minh Le ,&nbsp;Huong Thi Thanh Tran","doi":"10.1016/j.jbct.2024.100501","DOIUrl":"10.1016/j.jbct.2024.100501","url":null,"abstract":"<div><h3>Aim</h3><p>The prevalence of non-small cell lung cancer (NSCLC) is increasing globally. This is the first study to evaluate the effectiveness of group-based psychotherapy in NSCLC patients with depression in Vietnam during the COVID-19 pandemic.</p></div><div><h3>Methods</h3><p>A non-randomized controlled intervention study was conducted on 40 depressed adult patients with NSCLC at the Vietnam National Cancer Hospital (VNCH) from August 2021 to August 2022. Depression was assessed using the Patient Health Questionnaire, nine items (PHQ-9) with a cutoff 8. The virtual group intervention consisted of eight weekly sessions with the facilitation of two trained non-specialists under specialist’s supervision. Quantitative data from 16 participants in each arm were analyzed using proper statistics, with a statistical significance 0.05.</p></div><div><h3>Results</h3><p>Depression remission was observed in both groups. The decrease in the median PHQ-9 score of the intervention group (from 10.5 to 7) was higher than that of the control group (from 10.5 to 9 score). The intervention yielded a 29% reduction in the risk of depression relative to the control group (RR = 0.71). However, these findings were not statistically significant (<em>p</em> &gt; 0.05). Notably, participants in the intervention group who remained depressed attended significantly fewer sessions on average compared to their counterparts in the control group (1.4 vs. 5.1 sessions), the difference was statistically significant (<em>p</em> &lt; 0.05)</p></div><div><h3>Conclusion</h3><p>Group psychological intervention led by non-specialists is a promising approach to managing mental health problems in cancer patients, especially in online formats with low cost. It is of necessity to have more larger studies with long term follow-up in the study.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"34 3","pages":"Article 100501"},"PeriodicalIF":1.7,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589979124000192/pdfft?md5=bc3141b81e011a148d6983bda5f4acb3&pid=1-s2.0-S2589979124000192-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141985869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential fearful situations in virtual reality – A pilot study assessing the effects of exposure in virtual reality and in vivo on anxious healthy participants in narrow rooms","authors":"Vanessa Renner ,&nbsp;Michael Witthöft ,&nbsp;Jochen Hardt ,&nbsp;Rupert Conrad ,&nbsp;Katja Petrowski","doi":"10.1016/j.jbct.2024.100500","DOIUrl":"10.1016/j.jbct.2024.100500","url":null,"abstract":"<div><p>In vivo exposure is a highly effective but rarely implemented treatment for agoraphobia. Most of the patients receive medication or cognitive therapy without exposure because of a high expenditure of money and time for in vivo exposure. Exposure in virtual reality (VR) is easier to implement but the effectiveness of stimulating fear compared to in vivo exposure is still questionable. Therefore, in this study, the effects of in vivo and VR exposure on subjective symptom burden and heart rate variability (HRV) were assessed. 30 healthy individuals with fears in narrow rooms went through in vivo and VR exposure in a randomized order while HRV parameters (RMSSD, HF) and subjective symptom burden was assessed. Linear mixed models were calculated. The effect of condition (VR vs. in vivo), scenario (varying conditions in narrow rooms) and slot (first 30 s, peak, last 30 s) on RMSSD and HF was assessed. A random effect for participants (random-intercept term) to allow the intercept to vary across participants was included. Regarding RMSSD and HF, participants showed significantly higher levels during in vivo exposure compared to exposure in VR (RMSSD: <em>p</em> = 0.005; HF: <em>p</em> &lt; 0.001), reflecting a stronger activation of the parasympathetic nervous system during in vivo exposure or presumably higher stress levels during VR exposure. This study highlights the necessity of assessing subjective and objective parameters allowing the evaluation of the effectiveness of fear stimulation by exposure approaches.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"34 3","pages":"Article 100500"},"PeriodicalIF":1.7,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589979124000180/pdfft?md5=8aa7cd5e5248b3d39eae66f66481ac4e&pid=1-s2.0-S2589979124000180-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}