{"title":"A possible shared dysregulation of sleep and eating in bipolar disorders?","authors":"Elaine Tian , Clément Bourguignon , Serge Beaulieu , Kai-Florian Storch , Outi Linnaranta","doi":"10.1016/j.jbct.2021.08.001","DOIUrl":"https://doi.org/10.1016/j.jbct.2021.08.001","url":null,"abstract":"<div><p><span>Problems with sleep and eating are common among patients with a bipolar disorder (BD). While learning to control rhythms is a common and evidence based aim of psychotherapy, no naturalistic study has explored correlations between sleep and eating rhythms. Consenting BD patients (</span><em>n</em> <!-->=<!--> <span>75) completed hourly charts of mood and eating occasions for two weeks. Sleep was calculated based on periods of inactivity derived from actigraphy recordings (≥</span> <!-->10 days). In addition to conventional sleep onset/offset, we calculated center of daily inactivity [CenDI] as a measure of sleep phasing, and consolidation of inactivity [ConDI] as a measure of sleep fragmentation. The regularity of eating patterns was assessed by quantifying the stability of eating events with regard to timing [I<sup>TIM</sup>] and intervals [I<sup>INT</sup><span>]. Sleep timing variability and fragmentation was robustly associated with eating irregularity, despite several other factors thought to mask this chronobiological association in humans with a psychiatric illness. Future work should confirm whether this relationship is causal, bidirectional and/or consequence of a shared dysregulation. The finding provides a theoretical framework for therapeutic interventions in improving outcome in BD. Our novel dimensional measures for sleep and eating patterns could serve as helpful tools for biofeedback and diagnostic and intervention assessment.</span></p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"31 4","pages":"Pages 337-347"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92036912","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":"Susceptibility to eating disorders is associated with cognitive inflexibility in female university students","authors":"Corrado Caudek , Claudio Sica , Silvia Cerea , Ilaria Colpizzi , Debora Stendardi","doi":"10.1016/j.jbct.2021.05.002","DOIUrl":"10.1016/j.jbct.2021.05.002","url":null,"abstract":"<div><p><span>The inability to learn from and adapt to changing feedback in our environment may be etiologically linked to eating disorders (EDs). However, previous investigations on this issue have shown conflicting results. In the current study with a non-clinical sample of female students, we investigated the relation between cognitive inflexibility (CI) and vulnerability to EDs by using a modified version of the probabilistic reversal learning (PRL) task, which requires participants to adapt their response strategy according to changes in stimulus-reward contingencies. We found that females vulnerable to EDs in the general population showed an impaired PRL performance, also after controlling for comorbidity. However, our results also show that the ED construct comprises separate dimensions, which affect contingency learning in opposite manners: some individuals vulnerable to EDs showed impaired contingency learning; others used unimpaired contingency learning skills to pursue self-harming goals. Such results point to the necessity of an appropriate assessment of CI in order to better apply individualized </span>treatment.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"31 4","pages":"Pages 317-328"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122015686","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}
Ani C. Keshishian , Nassim Tabri , Kendra R. Becker , Debra L. Franko , David B. Herzog , Jennifer J. Thomas , Kamryn T. Eddy
{"title":"Comorbid depression and substance use prospectively predict eating disorder persistence among women with anorexia nervosa and bulimia nervosa","authors":"Ani C. Keshishian , Nassim Tabri , Kendra R. Becker , Debra L. Franko , David B. Herzog , Jennifer J. Thomas , Kamryn T. Eddy","doi":"10.1016/j.jbct.2021.09.003","DOIUrl":"https://doi.org/10.1016/j.jbct.2021.09.003","url":null,"abstract":"<div><p><span><span><span><span>Longitudinal associations between eating disorders (EDs) and comorbid psychiatric disorders are poorly understood but important to examine as comorbidities are common and can impede ED recovery. We examined two common comorbidities, </span>major depressive disorder (MDD) and substance use disorder (SUD), in adult women with intake diagnoses of </span>anorexia nervosa (AN) and </span>bulimia nervosa (BN) who participated in a longitudinal study. To test the longitudinal reciprocal relations among ED, MDD, and SUD, we conducted a multi-group autoregressive cross-lagged path analysis. We tested whether ED, MDD, and SUD in a given three-month period (</span><em>t</em> – 1) each predicted ED, MDD, and SUD during the subsequent three-month period (<em>t</em>) over 5<!--> <!-->years. We examined the moderating effect of intake diagnosis (AN vs. BN). Among AN (but not BN) participants, having MDD at <em>t</em> – 1 predicted having an ED at time <em>t</em>, OR<!--> <!-->=<!--> <!-->1.98, <em>B</em> <!-->=<!--> <!-->.68, <em>z</em> <!-->=<!--> <!-->2.49, <em>p</em> <!-->=<!--> <!-->.01. Among BN (but not AN) participants, having a SUD at <em>t</em> – 1 predicted having an ED at time <em>t</em>, OR<!--> <!-->=<!--> <!-->5.16, <em>B</em> <!-->=<!--> <!-->1.64, <em>z</em> <!-->=<!--> <!-->2.34, <em>p</em> <!-->=<!--> <!-->.01. In contrast, having an ED at <em>t</em> – 1 did not predict MDD or SUD at time <em>t</em><span> for AN or BN participants. These results suggest for individuals with AN and MDD, treating MDD may facilitate ED recovery. For individuals with BN and SUD, treating SUD may facilitate ED recovery. These identified temporal associations between ED and comorbid disorders may guide cognitive behavioral researchers and therapists<span> in prioritizing treatment targets given the high rate of comorbidity in EDs.</span></span></p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"31 4","pages":"Pages 309-315"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92036914","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":"Learning to be emotionally competent: Preliminary results of a pilot intervention program focusing on affect processing and emotion regulation","authors":"Stéphanie Haymoz , Michaël Reicherts , Chantal Martin-Soelch","doi":"10.1016/j.jbct.2021.09.001","DOIUrl":"https://doi.org/10.1016/j.jbct.2021.09.001","url":null,"abstract":"<div><p>Emotional experience and emotion regulation<span> (ER) are associated with mental and physical health. Although different psychological interventions focusing directly or indirectly on ER have been developed in this domain, a manual-based intervention relying on an empirical emotional processing (EP) model that refers to an integration of cognitive, behavioral, and experiential approaches and techniques is still needed. This study aims to investigate the effects of an intervention working on several dimensions of EP based on the Openness to Emotions (OE) model, examined with 102 healthy participants assigned to treatment<span> or control conditions. The participants in the treatment condition, compared with those in the control group (CG), significantly increased their abilities to cognitively represent and regulate their affective states and achieved greater functional equilibrium of the EP components. Furthermore, in a subgroup of 35 participants, those in the treatment condition learned to use the strategies “acceptation of the situation” and “mental relaxation” to regulate negative affect more frequently. They also perceived “mental relaxation” to be more effective compared to the waiting list’ participants. They also reported significantly less difficulty in controlling their impulses and accessing strategies to regulate emotional states. Further research is necessary to evaluate the efficacy of this intervention program in larger samples with diverse mental and physical health characteristics.</span></span></p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"31 4","pages":"Pages 329-335"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92065289","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}
Myles S. Faith , William C. Cochran , Lisa Diewald , Karen Hoffer , Renee’ Moore , Robert I. Berkowitz , Chelsie A. Hauer , Nicolas Stettler-Davis , Gina Tripicchio , Margaret R. Rukstalis
{"title":"Group lifestyle modification vs. lifestyle newsletters for early childhood obesity: Pilot study in rural primary care","authors":"Myles S. Faith , William C. Cochran , Lisa Diewald , Karen Hoffer , Renee’ Moore , Robert I. Berkowitz , Chelsie A. Hauer , Nicolas Stettler-Davis , Gina Tripicchio , Margaret R. Rukstalis","doi":"10.1016/j.jbct.2021.01.002","DOIUrl":"https://doi.org/10.1016/j.jbct.2021.01.002","url":null,"abstract":"<div><p><span>Research on primary-care interventions for early childhood obesity in rural communities is lacking. We compared two interventions for 4- to 8-year-old children with overweight/obesity, launched from a rural primary-care clinic. Families were randomly assigned to Intensive Lifestyle Modification (ILM; </span><em>n</em> <!-->=<!--> <!-->23) or Lifestyle Newsletters (LN; <em>n</em> <!-->=<!--> <span>24). The primary outcome was 5-month change in child BMI z-score. ILM groups received behavior modification challenges, the Stop Light Diet, nutrition information, and parent training. LN families received by mail information on diet and physical activity. Results indicated no significant difference between groups in BMI z-score reduction (</span><em>p</em> <!-->=<!--> <!-->0.40; Cohen's d<!--> <!-->=<!--> <span>0.20), although treatment interacted with child food responsiveness (</span><em>p</em> <!-->=<!--> <!-->0.04) and parent perceived feeding responsibility (<em>p</em> <!-->=<!--> <span>0.006) in exploratory analyses. Specifically, ILM compared with LN was better for children higher in ‘food responsiveness’, with a reverse pattern for children lower in this trait. ILM also was superior to LN when parents were lower in feeding responsibility, with a reverse pattern when parents were higher in this trait. Thus, the success of ILM and LN in rural primary care may depend upon child and parent attributes. Lower-intensity family interventions for early childhood obesity may offer scalable options in rural communities for some families.</span></p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"31 3","pages":"Pages 215-228"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91618122","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}
Sho Okawa , Honami Arai , Satoko Sasagawa , Shin-ichi Ishikawa , Melissa M. Norberg , Norman B. Schmidt , Jung-Hye Kwon , Ronald M. Rapee , Eiji Shimizu
{"title":"A Cross-Cultural Comparison of the Bivalent Fear of Evaluation Model for Social Anxiety","authors":"Sho Okawa , Honami Arai , Satoko Sasagawa , Shin-ichi Ishikawa , Melissa M. Norberg , Norman B. Schmidt , Jung-Hye Kwon , Ronald M. Rapee , Eiji Shimizu","doi":"10.1016/j.jbct.2021.01.003","DOIUrl":"10.1016/j.jbct.2021.01.003","url":null,"abstract":"<div><p>Social anxiety is one of the most common mental health problems worldwide; however, the prevalence of social anxiety symptoms differs between collectivistic and individualistic cultures. These differences may have important implications for guiding cognitive-behavioral treatment. The purpose of this study was to determine whether differences in the experience of social anxiety exist across countries with varying cultures, and whether the bivalent fear of evaluation model is valid for both individualistic (Australia and the United States) and collectivistic countries (Korea and Japan). A total of 704 participants (279 from Australia, 137 from the United States, 101 from Korea, and 187 from Japan) completed questionnaires assessing these constructs. Analysis of covariance with age and gender as covariates revealed that symptoms of social anxiety and fear of negative evaluation are reported more in collectivistic countries, while fear of positive evaluation (FPE) is higher in individualistic countries. The results of path analysis and multiple group path analysis indicated that the structure of the bivalent fear of evaluation model differs across cultures. A direct path from FPE to social anxiety was only observed in individualistic countries; however, the relationship between disqualification of positive social outcomes (DPSO) and social anxiety was stronger in collectivistic countries. These findings imply that FPE and DPSO may have different functions of relevance to social anxiety in individualistic and collectivistic countries, and indicate that modifications may be necessary in the application of cognitive-behavioral treatment strategies across cultures.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"31 3","pages":"Pages 205-213"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jbct.2021.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"97378945","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}
Fanny Petit , Caroline Munuera , Mathilde M. Husky , Katia M’Bailara
{"title":"Mental imagery in bipolar disorder: A PRISMA-compliant systematic review of its characteristics, content and relation to emotion","authors":"Fanny Petit , Caroline Munuera , Mathilde M. Husky , Katia M’Bailara","doi":"10.1016/j.jbct.2021.03.003","DOIUrl":"10.1016/j.jbct.2021.03.003","url":null,"abstract":"<div><p><span>Mental imagery is often described as “seeing with the mind's eye” as it refers to perceptual experiences of sensory information in the absence of external </span>sensory input<span><span><span> (Kosslyn, Ganis, & Thompson, 2001). Mental imagery is known to be strongly related to emotion and is used in the context of therapy for the treatment of mood disorders, in particular in Imagery-focused </span>Cognitive Therapy. Due to the predominance of emotional dysfunction in </span>bipolar disorder<span> (BD), mental imagery may be helpful in providing a better characterization of the illness. This systematic review aimed at extracting data about mental images’ (a) clinical characteristics (frequency, vividness and likelihood), (b) contents and (c) relation to emotion in individuals with BD. Authors performed the systematic review following the PRISMA statement. Among the 81 articles screened, 55 were assessed for eligibility after the removal of duplicates. A total of 5 studies met inclusion criteria, and covered a total of 298 unique participants. Differences in the clinical characteristics of mental imagery were found in individuals with BD as compared to healthy controls. The contents of images in BD appeared to be related to individuals’ current preoccupations and seemed to push them to take action, with high associated emotional ratings. The level of evidence remains limited due to the designs of the included studies. Additional research is needed to characterize mental imagery during thymic phases of BD. Such studies may potentially identify markers of the transition from one thymic phase to the next.</span></span></p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"31 3","pages":"Pages 267-284"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jbct.2021.03.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133967459","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":"Electrodermal fear conditioning and sexual victimization in college students","authors":"Frances R. Chen, Leah E. Daigle","doi":"10.1016/j.jbct.2021.03.001","DOIUrl":"https://doi.org/10.1016/j.jbct.2021.03.001","url":null,"abstract":"<div><p>Little research on sexual victimization has explored factors, particularly biopsychological factors that impede a person's ability to respond to risk or fear. According to Read-React-Respond model, effectively responding to a sexual threat involves a person accurately recognizing risk cues, prioritizing self-preservation, and reacting to this threat, and we propose that fear conditioning is relevant for one to effectively respond to a sexual threat with its role in avoidance behavior<span>. This study tests whether electrodermal fear conditioning is associated with sexual victimization. The sample comprised 43 female college students, and 44% self-reported at least one sexual victimization experience. Skin conductance was recorded during a fear-conditioning task. The victims had a weaker fear conditioning skin conductance response (SCR) than the nonvictim group. Furthermore, the victims showed a larger SCR to the tone previously signifying no aversive events than the tone previously signifying aversive events during extinction. This is the first study documenting an association between sexual victimization and reduced electrodermal fear conditioning. Findings highlight the importance of the biopsychological factors in sexual victimization and lend support to the Read-React-Respond model. The findings of poor electrodermal fear conditioning among victims should be taken into consideration in preventive efforts. Our findings also have important implications for exposure-based therapy.</span></p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"31 3","pages":"Pages 229-238"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91618488","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}
Elizabeth M. Goetter , Kaloyan S. Tanev , Elyse Lynch , Rene’ Lento , Allyson M. Blackburn , Daria Mamon , Teodolinda Pique , Tom Spencer
{"title":"An accelerated, weekend-based, prolonged exposure therapy program for veterans and service members with posttraumatic stress disorder","authors":"Elizabeth M. Goetter , Kaloyan S. Tanev , Elyse Lynch , Rene’ Lento , Allyson M. Blackburn , Daria Mamon , Teodolinda Pique , Tom Spencer","doi":"10.1016/j.jbct.2021.02.001","DOIUrl":"10.1016/j.jbct.2021.02.001","url":null,"abstract":"<div><p><span>Accelerated models of care may be one solution to the problem of underutilization of mental health treatment<span> in veterans. We report on a novel implementation of prolonged exposure (PE) therapy in a four-day, weekend-based intensive outpatient treatment program. Seventeen military veterans and service members (</span></span><em>M</em><sub>age</sub> <!-->=<!--> <!-->45.23, <em>SD</em><sub>age</sub> <!-->=<!--> <span>10.18; 76.47% male) completed the program. Symptoms of posttraumatic stress disorder (PTSD) and depression were targeted in five separate cohorts. Given that this was an uncontrolled pilot study, we assessed patient satisfaction and treatment completion. In a completers analysis, PTSD and depression symptoms decreased significantly from pre- to posttreatment (</span><em>p'</em>s<!--> <!--><<!--> <!-->.05), with effect sizes of 1.22 and 0.85, respectively. Using recommended treatment response categories for the PCL-5, 76.47% were reliably changed at posttreatment. The dropout rate was 5.55%. Preliminary findings indicated that PTSD symptoms reductions were maintained from baseline to 1-month (<em>Cohen's d</em> <!-->=<!--> <!-->1.19) and 3-month (<em>Cohen's d</em> <!-->=<!--> <!-->1.46) follow-up. Delivering PE in a 4-day, intensive format was associated with clinically significant reductions in self-reported PTSD and depression symptoms. Additionally, completion rates and patient satisfaction were high, suggesting feasibility for patients.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"31 3","pages":"Pages 285-289"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92632948","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":"Utility of Psychophysiological Metrics in Guiding Treatment of Trauma Symptoms: A Systematic Review","authors":"Michelle Yang , Noor Mady , Outi Linnaranta","doi":"10.1016/j.jbct.2021.01.004","DOIUrl":"10.1016/j.jbct.2021.01.004","url":null,"abstract":"<div><p><span>The reliability of gold standard symptom assessments of post-traumatic stress disorder (PTSD) can be compromised by memory, emotional or cultural bias. The use of psychophysiological measures may complement psychometrics<span><span> in tracking changes during treatment in </span>physiological response<span> and emotion regulation. In this </span></span></span>systematic review<span><span>, we integrate knowledge about the correlation between psychometric and psychophysiological measures in 22 prospective studies with trauma-focused cognitive, exposure, pharmacological and other interventions. Our objective was to determine how physiological resting states and reactivity pre- vs. post-intervention correspond to the effect of intervention on PTSD symptoms. Trends towards normalizing physiological resting states and arousal, as measured before and after treatment, were seen to correlate with a psychometric recovery. In patients with significant changes in trauma symptoms, pre- vs. post-treatment </span>resting heart rate<span><span>, heart rate reactivity to trauma cues and skin conductance decreased, and heart rate variability increased. </span>Electromyography<span> could measure adaptive decreases in startle responses<span><span> to exposure content. Both blood pressure raw values and reactivity decreased post-treatment following </span>cognitive therapy. Additional longitudinal studies are needed to explore standard testing paradigms that can be used for psychophysiological measures, and the corresponding cut-off levels that can indicate healthy and abnormal treatment response levels. The current findings stress a need for the development of a psychophysiological methodology that is feasible and reliable during experimental and clinical procedures to elucidate the effects of trauma intervention on emotional processing. Systematic review PROSPERO registration ID:CRD42021227774.</span></span></span></span></p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"31 3","pages":"Pages 249-266"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"110862920","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}