Rachel Lee, Dean McMillan, Jaime Delgadillo, Rachael Alexander, Mike Lucock
{"title":"Cognitive change before sudden gains in cognitive behavioural therapy for panic disorder.","authors":"Rachel Lee, Dean McMillan, Jaime Delgadillo, Rachael Alexander, Mike Lucock","doi":"10.1017/S1352465823000449","DOIUrl":"10.1017/S1352465823000449","url":null,"abstract":"<p><strong>Background: </strong>Sudden gains occur in a range of disorders and treatments and are of clinical and theoretical significance if they can shed light on therapeutic change processes. This study investigated the relationship between sudden gains in panic symptoms and preceding cognitive change during cognitive behavioural therapy (CBT) for panic disorder.</p><p><strong>Method: </strong>Participants with panic disorder completed in session measures of panic symptoms and catastrophic cognitions. Independent samples <i>t</i>-tests were used to compare the post-treatment score of those who met criteria for one or more sudden gain during treatment with those who did not, and to compare within-session cognitive change between pre-sudden gain sessions and the previous (control) session.</p><p><strong>Results: </strong>Twenty-two (42%) of 53 participants experienced a sudden gain during treatment. Participants demonstrating a sudden gain showed more improvement in panic symptoms from pre- to post-treatment than those without a sudden gain. The within-session cognitive change score in the pre-gain session was significantly greater than in the control session.</p><p><strong>Conclusions: </strong>Sudden gains occurred in individual CBT for panic disorder and within-session cognitive change was associated with sudden gains. This is consistent with the cognitive model of panic disorder and highlights how sudden gains can help to identify key change processes.</p>","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":" ","pages":"107-118"},"PeriodicalIF":1.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41216168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cognitive behavioural therapy for depression and anxiety in a carer for two family members with dementia: a single case experimental design study.","authors":"Lawson Falshaw, Leah Clatworthy","doi":"10.1017/S135246582300053X","DOIUrl":"10.1017/S135246582300053X","url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests that cognitive behavioural therapy (CBT) can be a helpful approach for older adults experiencing anxiety and depression. Some research has suggested this is also the case for those caring for a family member with dementia. Little research has been conducted into the impact of CBT for older adults juggling the demands of caring for multiple family members with dementia.</p><p><strong>Aims: </strong>This case study aimed to evaluate the application of CBT to 'Mrs P', a 68-year-old client experiencing anxiety and depression whilst caring for two family members with dementia.</p><p><strong>Method: </strong>A single case experimental design study was conducted to assess the effectiveness of CBT formulation and intervention, including cognitive restructuring of unhelpful thoughts about caregiving and increasing engagement in pleasurable activities.</p><p><strong>Results: </strong>Mrs P's depression and anxiety scores improved significantly throughout treatment, and she met her goal of being able to manage when caregiving activities go wrong during daily life.</p><p><strong>Conclusions: </strong>CBT may be a helpful approach to reducing anxiety and depression in dementia family caregivers.</p>","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":" ","pages":"194-199"},"PeriodicalIF":1.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emma Černis, Bao S Loe, Katie Lofthouse, Polly Waite, Andrew Molodynski, Anke Ehlers, Daniel Freeman
{"title":"Measuring dissociation across adolescence and adulthood: developing the short-form Černis Felt Sense of Anomaly scale (ČEFSA-14).","authors":"Emma Černis, Bao S Loe, Katie Lofthouse, Polly Waite, Andrew Molodynski, Anke Ehlers, Daniel Freeman","doi":"10.1017/S1352465823000498","DOIUrl":"10.1017/S1352465823000498","url":null,"abstract":"<p><strong>Background: </strong>Dissociation may be important across many mental health disorders, but has been variously conceptualised and measured. We introduced a conceptualisation of a common type of dissociative experience, 'felt sense of anomaly' (FSA), and developed a corresponding measure, the Černis Felt Sense of Anomaly (ČEFSA) scale.</p><p><strong>Aims: </strong>We aimed to develop a short-form version of the ČEFSA that is valid for adolescent and adult respondents.</p><p><strong>Method: </strong>Data were collected from 1031 adult NHS patients with psychosis and 932 adult and 1233 adolescent non-clinical online survey respondents. Local structural equation modelling (LSEM) was used to establish measurement invariance of items across the age range. Ant colony optimisation (ACO) was used to produce a 14-item short-form measure. Finally, the expected test score function derived from item response theory modelling guided the establishment of interpretive scoring ranges.</p><p><strong>Results: </strong>LSEM indicated 25 items of the original 35-item ČEFSA were age invariant. They were also invariant across gender and clinical status. ACO of these items produced a 14-item short-form (ČEFSA-14) with excellent psychometric properties (CFI=0.992; TLI=0.987; RMSEA=0.034; SRMR=0.017; Cronbach's alpha=0.92). Score ranges were established based on the expected test scores at approximately 0.7, 1.25 and 2.0 theta (equivalent to standard deviations above the mean). Scores of 29 and above may indicate elevated levels of FSA-dissociation.</p><p><strong>Conclusions: </strong>The ČEFSA-14 is a psychometrically valid measure of FSA-dissociation for adolescents and adults. It can be used with clinical and non-clinical respondents. It could be used by clinicians as an initial tool to explore dissociation with their clients.</p>","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":" ","pages":"163-177"},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7615643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Richard Hallam, Gary Brown, Liza Turner, Elizabeth Blomfield, Sharif El Leithy, Ines Mendes
{"title":"Development of a training programme in individual case formulation skills and a scale for assessing its effectiveness.","authors":"Richard Hallam, Gary Brown, Liza Turner, Elizabeth Blomfield, Sharif El Leithy, Ines Mendes","doi":"10.1017/S1352465823000577","DOIUrl":"10.1017/S1352465823000577","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the skills involved in clinical formulation. The individual case formulation (ICF) approach, based on functional analysis, employs clinical descriptions that are theory-free and depicts formulations constructed according to a set of basic conventions.</p><p><strong>Aims: </strong>We report a test of whether this method could be taught and if the quality of the resulting diagrams could be reliably rated.</p><p><strong>Method: </strong>Participants (<i>n</i>=40) participated in a training course in formulation. A draft rating scale was refined in the course of rating formulation diagrams and basic inter-rater reliability established.</p><p><strong>Results: </strong>Results of the study support further development of the ICF approach.</p>","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":" ","pages":"200-203"},"PeriodicalIF":1.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ben Lorimer, Stephen Kellett, Julia Giesemann, Wolfgang Lutz, Jaime Delgadillo
{"title":"An investigation of treatment return after psychological therapy for depression and anxiety.","authors":"Ben Lorimer, Stephen Kellett, Julia Giesemann, Wolfgang Lutz, Jaime Delgadillo","doi":"10.1017/S1352465823000322","DOIUrl":"10.1017/S1352465823000322","url":null,"abstract":"<p><strong>Background: </strong>Some patients return for further psychological treatment in routine services, although it is unclear how common this is, as scarce research is available on this topic.</p><p><strong>Aims: </strong>To estimate the treatment return rate and describe the clinical characteristics of patients who return for anxiety and depression treatment.</p><p><strong>Method: </strong>A large dataset (<i>N</i>=21,029) of routinely collected clinical data (2010-2015) from an English psychological therapy service was analysed using descriptive statistics.</p><p><strong>Results: </strong>The return rate for at least one additional treatment episode within 1-5 years was 13.7%. Furthermore, 14.5% of the total sessions provided by the service were delivered to treatment-returning patients. Of those who returned, 58.0% continued to show clinically significant depression and/or anxiety symptoms at the end of their first treatment, while 32.0% had experienced a demonstrable relapse before their second treatment.</p><p><strong>Conclusions: </strong>This study estimates that approximately one in seven patients return to the same service for additional psychological treatment within 1-5 years. Multiple factors may influence the need for additional treatment, and this may have a major impact on service activity. Future research needs to further explore and better determine the characteristics of treatment returners, prioritise enhancement of first treatment recovery, and evaluate relapse prevention interventions.</p>","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":" ","pages":"149-162"},"PeriodicalIF":1.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10028631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Feasibility, acceptability and clinical benefit of a trauma-focused stabilisation group for post-traumatic stress disorder patients with complex presentations on primary care waitlists.","authors":"Michelle Wells, Anke Karl, Rachel Handley","doi":"10.1017/S1352465823000486","DOIUrl":"10.1017/S1352465823000486","url":null,"abstract":"<p><strong>Background: </strong>Large numbers of people showing complex presentations of post-traumatic stress disorder (PTSD) in the NHS Talking Therapies services routinely require multi-faceted and extended one-to-one National Institute of Clinical Excellence (NICE) recommended treatment approaches. This can lead to longer waits for therapy and prolong patient suffering. We therefore evaluated whether a group stabilisation intervention delivered to patients on the waitlist for individual trauma-focused psychological treatment could help address this burden.</p><p><strong>Aims: </strong>The study aimed to ascertain a trauma-focused stabilisation group's acceptability, feasibility, and preliminary clinical benefit.</p><p><strong>Method and results: </strong>Fifty-eight patients with PTSD waiting for trauma-focused individual treatment were included in the study. Two therapists delivered six 5-session groups. The stabilisation group was found to be feasible and acceptable. Overall, PTSD symptom reduction was medium to large, with a Cohen's <i>d</i> of .77 for intent-to-treat and 1.05 for per protocol analyses. Additionally, for depression and anxiety, there was minimal symptom deterioration.</p><p><strong>Conclusions: </strong>The study provided preliminary evidence for the acceptability, feasibility and clinical benefit of attending a psychoeducational group therapy whilst waiting for one-to-one trauma therapy.</p>","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":" ","pages":"119-134"},"PeriodicalIF":1.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katharina Bosbach, Alexandra Martin, Johannes Stricker, Katrin Schoenenberg
{"title":"Enhancing self-esteem in adults with body dysmorphic symptoms: experimental testing and initial evaluation of a brief internet-based training","authors":"Katharina Bosbach, Alexandra Martin, Johannes Stricker, Katrin Schoenenberg","doi":"10.1017/s1352465824000110","DOIUrl":"https://doi.org/10.1017/s1352465824000110","url":null,"abstract":"<span>Background:</span><p>Low self-esteem is an important factor associated with body dysmorphic concerns. In treatment, self-esteem cannot always be adequately addressed. Internet-based interventions offer a low-threshold and cost-efficient possibility for treating body dysmorphic disorder (BDD).</p><span>Aims:</span><p>For this reason, we conducted two studies to explore the effectiveness of an internet-based intervention targeting improving self-esteem in adults with BDD symptoms.</p><span>Method:</span><p>The first study investigated the differential effects of a 1-week self-esteem training compared with a 1-week attention-focus training. Two hundred twenty adults with elevated body dysmorphic symptoms were randomly assigned to one of the two trainings. Our second study (<span>n</span> = 58 adults with body dysmorphic symptoms) evaluated an extended 2-week stand-alone self-esteem training.</p><span>Results:</span><p>In the first study, self-esteem in different domains (appearance, performance and social), self-focused attention, and BDD symptom severity improved in both groups. Other-focused attention only increased in the attention training group. Participants’ overall adherence was high. In the second study we observed significant improvements in self-esteem, BDD symptom severity, and other secondary outcomes, with additional improvements in most outcomes in the second week. Adherence was again high.</p><span>Conclusions:</span><p>Together, these findings show that a brief internet-based intervention may be a highly accepted and effective way of improving self-esteem in people suffering from BDD symptoms.</p>","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":"78 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139969720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Targeting beliefs and behaviours in misophonia: a case series from a UK specialist psychology service.","authors":"Jane Gregory, Tom Graham, Brett Hayes","doi":"10.1017/S1352465823000462","DOIUrl":"10.1017/S1352465823000462","url":null,"abstract":"<p><strong>Background: </strong>Misophonia, a disorder of decreased sound tolerance, can cause significant distress and impairment. Cognitive behavioural therapy (CBT) may be helpful for improving symptoms of misophonia, but the key mechanisms of the disorder are not yet known.</p><p><strong>Aims: </strong>This case series aimed to evaluate individual, formulation-driven CBT for patients with misophonia in a UK psychology service.</p><p><strong>Method: </strong>A service evaluation of one-to-one therapy for patients with misophonia (<i>n</i>=19) was conducted in a specialist psychology service. Patients completed an average of 13 hours of therapy with a focus on the meaning applied to their reactions to sounds and associated behaviours. Primary outcome measures were the Misophonia Questionnaire (MQ) and the Amsterdam Misophonia Scale (A-MISO-S). Repeated measures <i>t</i>-tests were used to compare scores from pre-treatment to follow-up, and reliable and clinically significant change on the MQ was calculated.</p><p><strong>Results: </strong>Scores significantly improved on both misophonia measures, with an average of 38% change on the MQ and 40% change on the A-MISO-S. From pre-treatment to follow-up, 78% of patients showed reliable improvement on the MQ and 61% made clinically significant change.</p><p><strong>Conclusions: </strong>Limitations included a lack of control group, small sample size, and the use of an outcome measure that had not been thoroughly validated for a treatment-seeking sample. These results suggest that one-to-one, formulation-driven CBT for misophonia is worth exploring further using experimental design. Potential mechanisms to explore further include feared consequences of escalating reactions, the role of safety-seeking behaviours and the impact of early memories associated with reactions to sounds.</p>","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":" ","pages":"33-48"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7615577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecca R Henderson, Alyssa M Nielsen, Aqueena M P Fernandez, Seth T Downing, Ryan J McCarty, Yulia A Strekalova, Journa Cobite-Njoh, Tannaz Mirhosseini, Andrew G Guzick, Joseph P H McNamara, Carol A Mathews
{"title":"Expectations and perspectives of cognitive behavioural therapy for childhood anxiety and related disorders.","authors":"Rebecca R Henderson, Alyssa M Nielsen, Aqueena M P Fernandez, Seth T Downing, Ryan J McCarty, Yulia A Strekalova, Journa Cobite-Njoh, Tannaz Mirhosseini, Andrew G Guzick, Joseph P H McNamara, Carol A Mathews","doi":"10.1017/S1352465823000346","DOIUrl":"10.1017/S1352465823000346","url":null,"abstract":"<p><strong>Background: </strong>Anxiety disorders are the most frequently diagnosed psychiatric conditions in children and adolescents. Cognitive behavioural therapy (CBT) is a well-established and effective treatment for anxiety and related disorders across the lifespan. Expectations of psychotherapy have been demonstrated to affect outcomes, yet there is sparse existing literature on adolescent patient and parent perspectives of CBT prior to engagement with treatment.</p><p><strong>Aims: </strong>This study aimed to qualitatively explore the expectations and perceptions of CBT for anxiety and related disorders among adolescent patients and parents.</p><p><strong>Method: </strong>Fourteen adolescent patients and 16 parents participated in semi-structured individual interviews or focus groups consisting of 2-3 participants. Interview transcripts were analysed using inductive analysis.</p><p><strong>Results: </strong>Three themes were identified: worries about CBT, expectations and knowledge of the CBT process, and the role of parents and families. Overall, we found that adolescents and parents had generally positive views of CBT. The outset of CBT saw adolescents and parents express concern about stigma as well as the ambiguity of CBT. Parents continued to express a lack of understanding of what CBT entailed during their child's treatment course.</p><p><strong>Conclusion: </strong>These results suggest that both adolescents and parents would benefit from early discussion and reinforcement of expectations for CBT treatment. Further research efforts are warranted and should be directed towards determining appropriate expectations for parental involvement in a child's CBT course and effective communication of treatment expectations to both adolescents and parents.</p>","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":" ","pages":"65-77"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10214747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jedidiah Siev, Rachel H Sinex, Samantha D Sorid, Evelyn Behar
{"title":"Anxiety sensitivity and disgust sensitivity predict blood-injection-injury fears in individuals with dental anxiety.","authors":"Jedidiah Siev, Rachel H Sinex, Samantha D Sorid, Evelyn Behar","doi":"10.1017/S1352465823000310","DOIUrl":"10.1017/S1352465823000310","url":null,"abstract":"<p><strong>Background: </strong>Anxiety sensitivity (AS) and disgust sensitivity (DS) are transdiagnostic vulnerability factors for anxiety. Both correlate with blood-injection-injury (BII) phobia symptoms in several studies; however, there is ambiguity about their relative contributions, and studies investigating this have relied on unselected samples. Furthermore, although DS reliably predicts BII in studies that do not account for AS, this may be limited to domain-specific DS rather than DS more broadly.</p><p><strong>Aims: </strong>The aims of this study were to examine AS and DS as separate and simultaneous predictors of BII fears in a sample with a wide range of BII symptoms, and with attention to the specificity of DS to BII-relevant domains.</p><p><strong>Method: </strong>Fifty-three participants who scored above a clinical threshold on a validated measure of dental anxiety, and who represented a wide range of BII severity, completed measures of AS, DS and BII symptoms.</p><p><strong>Results: </strong>AS and DS were moderately to strongly correlated with BII severity (<i>r</i> = .40 and .47, <i>p</i> = .004 and <.001), and both independently predicted BII severity when entered as simultaneous predictors (β = .32 and .35, <i>p</i> = .045 and .015). Furthermore, after omitting DS about injections and blood draws, domain-general DS was still moderately correlated with BII severity (<i>r</i> = .33, <i>p</i> = .017). However, domain-general DS did not significantly predict BII severity after accounting for AS (β = .20, <i>p</i> = .164).</p><p><strong>Conclusions: </strong>AS and DS both predict BII symptoms, and prospective research is warranted to examine them as potential vulnerability factors.</p>","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":" ","pages":"100-104"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9888763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}