Journal of Behavioral and Cognitive Therapy最新文献_第8页

Guest editorial: Progress in CBT for anxiety disorders 客座评论:CBT治疗焦虑症的进展

Journal of Behavioral and Cognitive Therapy Pub Date : 2022-03-01 DOI: 10.1016/j.jbct.2022.02.001

Jasper Smits Ph.D. (Professor of psychology)

引用次数: 0

Expectancy violation during exposure therapy: A pilot randomized controlled trial 暴露治疗期间的预期违反:一项随机对照试验

Journal of Behavioral and Cognitive Therapy Pub Date : 2022-03-01 DOI: 10.1016/j.jbct.2021.12.004

Jennifer L. Buchholz , Shannon M. Blakey , Samantha N. Hellberg , Maya Massing-Schaffer , Lillian Reuman , Heidi Ojalehto , Joe Friedman , Jonathan S. Abramowitz

{"title":"Expectancy violation during exposure therapy: A pilot randomized controlled trial","authors":"Jennifer L. Buchholz , Shannon M. Blakey , Samantha N. Hellberg , Maya Massing-Schaffer , Lillian Reuman , Heidi Ojalehto , Joe Friedman , Jonathan S. Abramowitz","doi":"10.1016/j.jbct.2021.12.004","DOIUrl":"10.1016/j.jbct.2021.12.004","url":null,"abstract":"<div><p><span><span>Despite empirical support for the efficacy of exposure-based therapy for anxiety-related disorders, many individuals do not respond to this intervention or else experience a return of fear after treatment. Inhibitory learning theory has informed novel approaches to exposure therapy delivery that aim to improve both short- and long-term outcomes. One exposure optimization strategy is to maximize expectancy violation (i.e., the difference between expected and actual outcomes), which is thought to strengthen inhibitory (i.e., non-threat) associations and enhance long-term fear extinction. In practice, exposure therapy is traditionally preceded by cognitive restructuring to lessen the magnitude of harm expectancies. Yet this technique may restrict the discrepancy between expected and actual outcomes, thus reducing the potency of exposure and limiting the durability of treatment gains. The present study examined the effects of manipulating the timing of cognitive techniques during exposure-based therapy by randomly assigning 45 participants with </span>spider phobia to one of three conditions: (a) cognitive restructuring before exposure (CR-EXP; </span><em>n</em>  ==15). Although both CR-EXP and EXP-CR were more effective than SM, there were no significant differences between CR-EXP and EXP-CR on measures of fear, avoidance, spider-related cognitions, or change in harm expectancy. Clinical implications, study limitations, and future directions are discussed.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"32 1","pages":"Pages 13-24"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117309091","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}

引用次数: 1

Barriers to remission from child and adolescent anxiety disorders following extensive treatment: An exploratory study 广泛治疗后儿童和青少年焦虑症缓解的障碍:一项探索性研究

Journal of Behavioral and Cognitive Therapy Pub Date : 2022-03-01 DOI: 10.1016/j.jbct.2021.12.002

Sarah Farraway , Viviana M. Wuthrich , Heidi Lyneham , Jennifer Hudson , Maria Kangas , Mary-Lou Chatterton , Catherine Mihalopoulos , Ronald M. Rapee

{"title":"Barriers to remission from child and adolescent anxiety disorders following extensive treatment: An exploratory study","authors":"Sarah Farraway , Viviana M. Wuthrich , Heidi Lyneham , Jennifer Hudson , Maria Kangas , Mary-Lou Chatterton , Catherine Mihalopoulos , 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}

引用次数: 0

Changes in affect, physical activity, physical health, and sleep in cognitive behavioral therapy for anxiety: A pilot study 认知行为治疗焦虑的情绪、身体活动、身体健康和睡眠的变化:一项初步研究

Journal of Behavioral and Cognitive Therapy Pub Date : 2022-03-01 DOI: 10.1016/j.jbct.2021.12.006

Lily A. Brown , Kevin Narine , Anu Asnaani , Keith Bredemeier , Wenting Mu

{"title":"Changes in affect, physical activity, physical health, and sleep in cognitive behavioral therapy for anxiety: A pilot study","authors":"Lily A. Brown , Kevin Narine , Anu Asnaani , Keith Bredemeier , 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}

引用次数: 1

Internet delivered guided cognitive behavioral self-help for panic disorder: An open trial and benchmarking study 互联网为恐慌障碍提供引导认知行为自助:一项公开试验和基准研究

Journal of Behavioral and Cognitive Therapy Pub Date : 2022-03-01 DOI: 10.1016/j.jbct.2021.12.005

Asher Y. Strauss , Asala Halaj , Dina Zalaznik , Isaac Fradkin , Benjamin A. Katz , Elad Zlotnick , Snir Barzilay , Gerhard Andersson , David Daniel Ebert , Jonathan D. Huppert

{"title":"Internet delivered guided cognitive behavioral self-help for panic disorder: An open trial and benchmarking study","authors":"Asher Y. Strauss , Asala Halaj , Dina Zalaznik , Isaac Fradkin , Benjamin A. Katz , Elad Zlotnick , Snir Barzilay , Gerhard Andersson , David Daniel Ebert , 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}

引用次数: 1

Avoidance of negative emotional contrast from worry and rumination: An application of the Contrast Avoidance Model 从忧虑和反刍中避免负面情绪对比:对比回避模型的应用

Journal of Behavioral and Cognitive Therapy Pub Date : 2022-03-01 DOI: 10.1016/j.jbct.2021.12.007

Hanjoo Kim , Michelle G. Newman

{"title":"Avoidance of negative emotional contrast from worry and rumination: An application of the Contrast Avoidance Model","authors":"Hanjoo Kim , 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>  =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}

引用次数: 13

Associations between improvements in aversive reactions to negative emotions and increased quality of life in the unified protocol 在统一方案中，改善对负面情绪的厌恶反应与提高生活质量之间的关系

Journal of Behavioral and Cognitive Therapy Pub Date : 2022-03-01 DOI: 10.1016/j.jbct.2021.12.001

Sohayla A. Elhusseini , Lauren E. Cravens, Matthew W. Southward, Shannon Sauer-Zavala

{"title":"Associations between improvements in aversive reactions to negative emotions and increased quality of life in the unified protocol","authors":"Sohayla A. Elhusseini , Lauren E. Cravens, Matthew W. Southward, 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}

引用次数: 2

Acceptability of telehealth CBT during the time of COVID-19: Evidence from patient treatment initiation and attendance records COVID-19期间远程医疗CBT的可接受性:来自患者治疗开始和出勤记录的证据

Journal of Behavioral and Cognitive Therapy Pub Date : 2022-03-01 DOI: 10.1016/j.jbct.2022.01.001

Kristy Cuthbert, E. Marie Parsons, Lisa Smith, Michael W. Otto

引用次数: 7

Concurrent and prospective links between sleep disturbance and repetitive negative thinking: Specificity and effects of cognitive behavior therapy for insomnia 睡眠障碍与重复性消极思维之间的并发和前瞻性联系:失眠认知行为治疗的特异性和效果

Journal of Behavioral and Cognitive Therapy Pub Date : 2022-03-01 DOI: 10.1016/j.jbct.2021.12.003

Rebecca C. Cox, Bunmi O. Olatunji

{"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, 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}

引用次数: 1

Non-pharmacological interventions for depression among survivors of adverse childhood experiences: A meta-analysis 儿童期不良经历幸存者抑郁症的非药物干预:荟萃分析

Journal of Behavioral and Cognitive Therapy Pub Date : 2021-12-01 DOI: 10.1016/j.jbct.2021.05.001

Shaimaa Mosad Elrefaay , Susan Wang , Mijung Park

{"title":"Non-pharmacological interventions for depression among survivors of adverse childhood experiences: A meta-analysis","authors":"Shaimaa Mosad Elrefaay , Susan Wang , 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>      <!-->0.53, 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}

引用次数: 3