Journal of Behavioral and Cognitive Therapy最新文献

{"title":"Barriers to remission from child and adolescent anxiety disorders following extensive treatment: An exploratory study","authors":"Sarah Farraway ,&nbsp;Viviana M. Wuthrich ,&nbsp;Heidi Lyneham ,&nbsp;Jennifer Hudson ,&nbsp;Maria Kangas ,&nbsp;Mary-Lou Chatterton ,&nbsp;Catherine Mihalopoulos ,&nbsp;Ronald M. Rapee","doi":"10.1016/j.jbct.2021.12.002","DOIUrl":"10.1016/j.jbct.2021.12.002","url":null,"abstract":"<div><p><span>Although treatments for child and adolescent (hereafter, children) anxiety show good efficacy, a significant proportion of children do not remit, even 12</span> <span><span>months after receiving treatment. Barriers to treatment responsiveness among chronically anxious children is not well studied. The current study evaluated barriers and predictors of poor treatment response among a small sample of children who reached the third step in a three-stage stepped-care intervention. Stepped-care involved low-intensity CBT, followed by standard CBT if required, and subsequently high intensity CBT if still warranted. Children moved to the next step of stepped-care if requested by their caregiver following feedback of clinical status and symptom change by their </span>therapist. From the initial sample of 139 children entering step 1, 26 (18.7%) children provided data in the third step and were assessed approximately 12</span> <!-->months following their baseline assessment. Several baseline constructs and treatment engagement measures were completed both quantitatively and qualitatively. At the end of Step 3, 14 of 26 (54%) participants had not remitted from their primary disorder and 19 (77%) were not remitted from all anxiety disorders. Non-remission was associated with baseline measures of higher primary disorder severity, fewer anxiety disorders, higher child self-reported social anxiety and total difficulties, and poorer mood. Therapy factors associated with non-remission included greater avoidance, less engagement with exposure tasks, and poorer homework completion. Identifying factors that predict poor response to treatment can help to tailor intervention and improve outcomes for this very complex group of young people.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"32 1","pages":"Pages 3-11"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121537082","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":"Changes in affect, physical activity, physical health, and sleep in cognitive behavioral therapy for anxiety: A pilot study","authors":"Lily A. Brown ,&nbsp;Kevin Narine ,&nbsp;Anu Asnaani ,&nbsp;Keith Bredemeier ,&nbsp;Wenting Mu","doi":"10.1016/j.jbct.2021.12.006","DOIUrl":"10.1016/j.jbct.2021.12.006","url":null,"abstract":"<div><p><span>Anxiety disorders are associated with poorer physical activity and sleep. While associated with significant reductions in anxiety, it is not clear whether CBT for anxiety also improves physical health, sleep and physical activity. We evaluated changes in psychological and physical health outcomes using technology-based assessments in a naturalistic sample of adult patients receiving CBT for anxiety disorders (</span><em>N<!--> <!-->=<!--> </em><span><span>40). Participants were provided with a wearable device (Fitbit) and </span>ecological momentary assessments (EMA) throughout the duration of their CBT, or up to 20 weeks. We observed significant improvements in anxiety, depression, social isolation, and self-efficacy in emotion management. Self-reported sleep disorder symptoms, global physical health, or physical functioning and objectively measured sleep efficiency or physical activity (steps) did not significantly change. Steeper reductions in EMA-assessed anxiety were associated with steeper improvements in depression, social isolation, self-efficacy in emotion management, and physical function. These findings highlight the utility of EMA assessments during CBT in a naturalistic clinic. Whereas CBT for anxiety-related disorders is associated with significant improvements in affect, it may not be associated with improvements in sleep or physical activity. CBT for anxiety may require augmentation for patients who have goals of improving sleep, physical health, or physical activity.</span></p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"32 1","pages":"Pages 45-56"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123183937","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":"Internet delivered guided cognitive behavioral self-help for panic disorder: An open trial and benchmarking study","authors":"Asher Y. Strauss ,&nbsp;Asala Halaj ,&nbsp;Dina Zalaznik ,&nbsp;Isaac Fradkin ,&nbsp;Benjamin A. Katz ,&nbsp;Elad Zlotnick ,&nbsp;Snir Barzilay ,&nbsp;Gerhard Andersson ,&nbsp;David Daniel Ebert ,&nbsp;Jonathan D. Huppert","doi":"10.1016/j.jbct.2021.12.005","DOIUrl":"10.1016/j.jbct.2021.12.005","url":null,"abstract":"<div><p><span>An open trial of a therapist-guided internet cognitive-behavioral therapy (ICBT) for panic disorder with and without agoraphobia<span> (PD/A) was conducted. Ninety adults diagnosed with PD/A were treated using ICBT adapted from a face to face (FTF) protocol. Results were benchmarked against two FTF samples, one at the same research site using the same protocol and another from a large cognitive-behavioral therapy (CBT) study. In addition, effects were compared to mean aggregated estimates from four meta-analyses. Attrition rates and therapist<span> time were also examined to facilitate cost-effectiveness analyses and inform policy makers. Both full intent-to-treat and completer samples were used when analyzing data. Overall, results suggest that within-group effects for ICBT (0.88 to 1.7) are similar to the effects found in the benchmarking samples and to effects across meta-analytic studies. Effects were larger for symptoms assessed by an independent evaluator compared to self-report measures. Treatment gains continued to increase 3 months after post treatment and were maintained at 6 month and 1 year follow-up. However, attrition rates in ICBT were twice as large (46%) compared to the FTF sample, possibly due to a more conservative definition of attrition used here compared to previous reports. Therapist time in ICBT was reduced by a factor of three (14</span></span></span> <!-->min/week) compared to FTF, suggesting that treatment effects can be maintained even when reducing therapist time. Taken together, these findings suggest good short and long-term efficacy and time efficiency along with greater attrition for ICBT, allowing for dissemination and enhancing accessibility to quality, evidence-based treatment in the community.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"32 1","pages":"Pages 73-83"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123881666","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":"Avoidance of negative emotional contrast from worry and rumination: An application of the Contrast Avoidance Model","authors":"Hanjoo Kim ,&nbsp;Michelle G. Newman","doi":"10.1016/j.jbct.2021.12.007","DOIUrl":"10.1016/j.jbct.2021.12.007","url":null,"abstract":"<div><p><span>According to the Contrast Avoidance model (CAM), worry causes increased and sustained negative affect and such negative affect enables avoidance of a future sharp increase in negative emotion. However, only pathological worriers (vs. controls) view worry as a positive coping strategy<span> to avoid a negative emotional contrast (NEC). We examined if rumination, which is another type of repetitive negative thought, would function similarly. Individuals with self-reported symptoms of pure generalized anxiety disorder (GAD; </span></span><em>n</em> <!-->=<!--> <!-->90), pure depression (MDD; <em>n</em> <!-->=<!--> <!-->85), and non-anxious/non-depressed controls (HC; <em>n</em> <!-->=<!--> <span>93) were randomly assigned to conditions where they were asked to worry, ruminate, or relax. Emotional and physiological changes were measured during worry and subsequent exposure to fearful and sad videos. We also assessed participant group differences in preference for worry or rumination as a strategy to cope with negative affect during the negative emotional video exposures. Consistent with CAM, regardless of the group, both worry and rumination enabled avoidance of NEC. Whereas worry led to greater avoidance of a fear contrast, rumination led to greater avoidance of a sadness contrast. On the other hand, relaxation enhanced NEC. Skin conductance also indicated patterns in line with CAM. In the subjectively perceived preference, the GAD group reported a greater preference for worry in coping with a fear contrast than HC. However, such a salient pattern was not found for the MDD group. Treatment implications of these findings are discussed.</span></p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"32 1","pages":"Pages 33-43"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130980862","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":"Associations between improvements in aversive reactions to negative emotions and increased quality of life in the unified protocol","authors":"Sohayla A. Elhusseini ,&nbsp;Lauren E. Cravens,&nbsp;Matthew W. Southward,&nbsp;Shannon Sauer-Zavala","doi":"10.1016/j.jbct.2021.12.001","DOIUrl":"10.1016/j.jbct.2021.12.001","url":null,"abstract":"<div><p><span>Emotional disorders are thought to be maintained by the transaction between frequent experiences of strong, negative emotions (i.e., neuroticism) and aversive reactions to those emotions. The Unified Protocol (UP) is an efficacious treatment for transdiagnostic emotional disorders designed to target specific forms of aversive reactivity to negative emotions. In addition to symptom change, the UP has also been shown to lead to increases in </span>quality of life<span>. However, it remains unclear which specific mechanisms targeted in the UP are related to improvements in quality of life. We explored the relations between changes in five aspects of aversive reactivity included in the UP (i.e., non-acceptance of emotions, [lack of] mindfulness<span>, cognitive rigidity, behavioral avoidance, and anxiety sensitivity) and overall quality of life during treatment. Person-specific regression slopes revealed that improvements in emotional non-acceptance, behavioral avoidance, and mindfulness were each significantly associated with increases in quality of life over the six sessions of treatment. Although in the expected direction, improvements in anxiety sensitivity and cognitive flexibility were not significantly associated with increases in quality of life. These findings generally suggest a model of equifinality in which improvements in most aspects of aversive reactivity are similarly related to changes in quality of life.</span></span></p></div><div><h3>Clinical trials registration number</h3><p><span>NCT04584879</span><svg><path></path></svg>.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"32 1","pages":"Pages 25-32"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115774102","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":"Acceptability of telehealth CBT during the time of COVID-19: Evidence from patient treatment initiation and attendance records","authors":"Kristy Cuthbert,&nbsp;E. Marie Parsons,&nbsp;Lisa Smith,&nbsp;Michael W. Otto","doi":"10.1016/j.jbct.2022.01.001","DOIUrl":"10.1016/j.jbct.2022.01.001","url":null,"abstract":"<div><p>The COVID-19 pandemic provided unique conditions for examining outpatient psychotherapy clinics’ rapid transition to telehealth. The current study utilized data from a large, specialty CBT clinic to investigate attendance and treatment engagement changes when services were provided via telehealth versus in-person. Results indicate that, following a complete transition to telehealth services, clinic referrals were maintained. Further, telehealth treatment appeared to be entirely acceptable as assessed by a decreased missed visit rate of telehealth appointments compared to in-person appointments. Given the elimination of commuting times, telehealth has the potential to address disparities in care linked to physical distance from the clinic and/or differential ability to take time off work for appointments.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"32 1","pages":"Pages 67-72"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39902231","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":"Concurrent and prospective links between sleep disturbance and repetitive negative thinking: Specificity and effects of cognitive behavior therapy for insomnia","authors":"Rebecca C. Cox,&nbsp;Bunmi O. Olatunji","doi":"10.1016/j.jbct.2021.12.003","DOIUrl":"10.1016/j.jbct.2021.12.003","url":null,"abstract":"<div><p><span>Sleep and circadian rhythm disturbance are increasingly recognized in anxiety-related disorders; however, the links between sleep and circadian rhythms and specific transdiagnostic processes evident in these disorders and their treatment<span><span> have not been delineated. The present study examined the associations between chronotype, insomnia symptoms, and repetitive negative thinking (RNT) using a two-study approach. Study 1 examined concurrent and prospective associations between chronotype, insomnia symptoms, and RNT in a community sample. Study 2 then examined change in RNT following </span>cognitive behavior therapy for insomnia (CBTI). The findings of Study 1 showed that evening chronotype and higher insomnia symptoms were concurrently associated with higher RNT in the community sample; however, only </span></span>eveningness prospectively predicted increased RNT over 5 months, controlling for depression symptoms. Study 2 found that RNT decreased following CBTI, and decreased eveningness and insomnia symptoms were associated with decreased RNT, controlling for change in depression symptoms. Together these findings highlight the role of sleep and circadian rhythms in RNT. The implications for conceptualizing the etiology and treatment of anxiety-related disorders characterized by RNT are discussed.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"32 1","pages":"Pages 57-66"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116999285","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":"Non-pharmacological interventions for depression among survivors of adverse childhood experiences: A meta-analysis","authors":"Shaimaa Mosad Elrefaay ,&nbsp;Susan Wang ,&nbsp;Mijung Park","doi":"10.1016/j.jbct.2021.05.001","DOIUrl":"https://doi.org/10.1016/j.jbct.2021.05.001","url":null,"abstract":"<div><p><span><span><span>Adverse childhood experiences (ACEs) are associated with various </span>mental health problems such as depression, anxiety, drug abuse, and suicide-related behaviors. Yet, it is largely unknown if non-pharmacological interventions are beneficial in improving mental health among ACEs survivors. The purposes of the current meta-analysis were to: (1) evaluate the efficacy of non-pharmacological interventions in reducing depressive symptom severity among those exposed to ACEs, and, (2) estimate the pooled effect size of these interventions. We searched PubMed, CINAHL, and PsycINFO for </span>randomized controlled trials of psychological interventions for depression among ACEs survivors. Two reviewers independently extracted article data and evaluated the quality of studies using the Cochrane risk-of-bias criteria. We estimated the pooled effect sizes using a random-effects model. We also performed sensitivity tests using a meta-regression and sub-group analyses. Using the pooled data of 1624 individuals from 20 unique RCTs, we found that non-pharmacological intervention had a medium to large effect size in reducing depressive symptom severity compared to control conditions (Hedges’ g</span> <!-->=<!--> <!-->0.714, 95% CI [0.46, 0.97]). Such efficacy was sustained over the shorter-term follow-up (0 to 6 months; Hedges’ g<!--> <!-->=<!--> <!-->0.23, 95% CI [0.04, 0.49]). Although there was an indication that the efficacy may be sustained in the longer term (12 months or more; Hedges’ g<!--> <!-->=<!--> <!-->0.53, 95% CI: [−0.17, 1.22]), this finding was not statistically significant. Cognitive approaches had a larger effect size than noncognitive interventions. In conclusion, non-pharmacological interventions are efficacious options for treating depression among individuals with a history of adverse childhood experiences.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"31 4","pages":"Pages 349-362"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92140439","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":"Dissociating compulsive washing and hoarding tendencies through differences in comorbidities and the content of concerns","authors":"Tingting Liu,&nbsp;Joshua M. Ackerman,&nbsp;Stephanie D. Preston","doi":"10.1016/j.jbct.2021.05.003","DOIUrl":"10.1016/j.jbct.2021.05.003","url":null,"abstract":"<div><p>Clinical compulsive washing and hoarding are intercorrelated and share comorbidities even though they are distinct and appear to manifest through opposing extremes of cleanliness and disorder (respectively). We attempted to resolve this paradox by testing five hypotheses in online, non-clinical samples (<em>N</em>_{<em>study</em>} _<em>1</em> <!-->=<!--> <!-->123, <em>N</em>_{<em>study</em>} _<em>2</em> <!-->=<!--> <!-->177, <em>N</em>_{<em>study</em>} _<em>3</em> <!-->=<!--> <!-->217). We replicated the intercorrelation of washing and hoarding tendencies in all studies, despite observing non-clinical individual differences. Both washing and hoarding were associated with anxiety, depression, and fears of social rejection and failure, but they were also distinguishable. Compulsive washing was associated with greater anxiety, disgust, perceptions of infection vulnerability, and the desire to organize a cluttered space, whereas hoarding was associated with reduced concerns about germs and full or cluttered spaces and higher concerns about assault, threats to safety, and insects. A third study tested and confirmed the hypothesis that washing and hoarding may be related because they are adaptive in combination during stressful conditions, like a global pandemic. During COVID-19, washing and hoarding tendencies were even more strongly interrelated, and disease-avoidant behaviors like wearing a mask and avoiding people increased with washing tendencies but decreased with hoarding tendencies. Overlapping psychopathological states can be distinguished even in non-clinical samples through psychopathological profiles and the content of concerns—that shift with one's context. Treatment may benefit from not only working to cease undesirable behaviors but also from ameliorating root fears and anxieties that are dissociable by condition and individual but not always linked to the behavioral expression.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"31 4","pages":"Pages 291-308"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125333110","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":"Lost in translation? Cultural adaptation of treatment content for Japanese internet-based cognitive therapy for social anxiety disorder","authors":"Naoki Yoshinaga ,&nbsp;Graham R. Thew ,&nbsp;Osamu Kobori ,&nbsp;Yuta Hayashi ,&nbsp;David M. Clark","doi":"10.1016/j.jbct.2021.05.004","DOIUrl":"10.1016/j.jbct.2021.05.004","url":null,"abstract":"<div><p>Studies that look to disseminate psychological therapies in different countries often discuss whether and how much cultural adaptation may be required. However, most do not provide sufficient descriptions of how language translation and cultural adaptations were performed, and rarely give examples of specific changes. This makes it hard to understand how much the adapted treatment differs from the original, causing difficulty when comparing studies. This study aimed to describe the translation and cultural adaptation process used to generate a Japanese version of a UK-developed online psychological therapy for social anxiety. It aimed to evaluate the translated and adapted content with a case series of Japanese patients. Following translation and back-translation, incorporating cultural adaptations where appropriate, the new Japanese content was reviewed and a list of adaptations collated and categorised. The Japanese treatment material was then evaluated using a guided self-study approach with six Japanese patients with social anxiety. Four categories of adaptation were identified: Linguistics and Metaphors, Social Systems, Social Behaviours, and Familiarity. Assigning instances of adaptation into these categories showed good interrater reliability (0.78). The Japanese materials showed excellent treatment efficacy (pre-post Hedges’ g<!--> <!-->=<!--> <!-->2.31). Patient feedback highlighted areas of strength, and further suggestions to improve suitability for Japanese settings. The clinical outcomes observed suggest that the translation and adaptation procedures were effective. Ways of further improving the adaptation based on patient feedback were identified. It is hoped that the translation procedure and adaptation categories described in this study may help other clinicians/researchers working to disseminate both online or in-person psychological therapies cross-culturally.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"31 4","pages":"Pages 363-368"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jbct.2021.05.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125568037","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}