Cognitive Therapy and Research最新文献

{"title":"Understanding Veterans' Perceived Improvement in PTSD Treatment: Examining its Association with Clinical Predictors and Clinically Meaningful Improvement Thresholds.","authors":"Emily E Patton, Rhea Mundle, Sarah Pridgen, Philip Held","doi":"10.1007/s10608-025-10637-7","DOIUrl":"10.1007/s10608-025-10637-7","url":null,"abstract":"<p><strong>Background: </strong>Patients' perceived improvement has utility in contextualizing markers of treatment success, often measured through PTSD severity, other clinical factors, and clinically meaningful improvement (CMI). This study investigated the relationship between perceived improvement, self-reported PTSD symptom changes, and changes in other clinical factors in veterans undergoing PTSD treatment.</p><p><strong>Methods: </strong>Data were collected from 259 veterans who completed a two-week Cognitive Processing Therapy-based intensive PTSD treatment program. Self-report measures, including the Patient Global Impression of Improvement (PGI-I) and PTSD Checklist for DSM-5 (PCL-5), assessed symptom severity and perceived improvement. Ordinal logistic regression analyses examined associations between PTSD symptom changes, other clinical factors (e.g., depression, self-efficacy, emotion regulation), and perceived improvement.</p><p><strong>Results: </strong>The average PCL-5 improvement was 20.93 points, with 87.65% of veterans reporting feeling at least a little better post-treatment. All CMI thresholds were related to perceived improvement. Reductions in PTSD severity significantly predicted higher perceived improvement while self-efficacy and emotion regulation also emerged as significant predictors. In contrast, changes in depression symptoms, negative posttraumatic cognitions, and resilience were not significant.</p><p><strong>Conclusions: </strong>Perceived improvement in PTSD treatment aligns closely with reductions in PTSD severity and self-regulatory capacities, emphasizing their importance in subjective recovery. While the PGI-I may not fully replace other measures, its alignment with key outcomes and brevity make it a valuable patient-centered tool for assessing treatment effectiveness. Future research should assess the PGI-I's potential to complement or replace existing measures, and evaluate long-term outcomes across diverse treatment settings.</p>","PeriodicalId":48316,"journal":{"name":"Cognitive Therapy and Research","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety and Depression are Associated with More Distorted Thinking on Social Media: A Longitudinal Multi-Method Study.","authors":"Lauren A Rutter, Andy Edinger, Lorenzo Lorenzo-Luaces, Marijn Ten Thij, Danny Valdez, Johan Bollen","doi":"10.1007/s10608-025-10580-7","DOIUrl":"10.1007/s10608-025-10580-7","url":null,"abstract":"<p><strong>Background: </strong>Depression and anxiety are associated with patterns of negative thinking that can be targeted through cognitive restructuring as a part of cognitive therapy (CT) or cognitive behavioral therapy (CBT). Our team has created a set of cognitive distortion schemata (CDS) n-grams based on theories underlying CT to measure the linguistic markers that indicate cognitive vulnerability to depression. These CDS were specifically designed to examine online language. Our prior work supports a relationship between CDS and a diagnosis of depression, but less is known about the relationship between online language, CDS, and anxiety. The current study measures if CDS can be detected in people who report anxiety symptoms, and whether CDS increase with symptom severity.</p><p><strong>Methods: </strong>1,377 participants were recruited from a study assessing social media use and mental health symptoms, the Studies of Online Cohorts of Internalizing Symptoms and Language (SOCIAL). From this, 804 timelines were harvested, and after removing missing data and bots, our final sample was 537 respondents who posted 999,859 tweets. This is a longitudinal, multi-method design, using surveys and text-based analysis of social media timelines. We used bootstrap resampling to compare differences in CDS prevalence in anxious and depressed participants.</p><p><strong>Results: </strong>CDS can be observed in anxiety disorders, significantly increase as a function of anxiety symptom severity, and are related to depression and anxiety comorbidity.</p><p><strong>Conclusions: </strong>Using behavioral, affective, and cognitive indicators of distorted thinking from social media may yield new insight into the trajectories of depression and anxiety. This work has implications for the future of CT/CBT and other online interventions that target distorted thinking styles.</p>","PeriodicalId":48316,"journal":{"name":"Cognitive Therapy and Research","volume":"49 4","pages":"712-720"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harm Avoidance and Incompleteness as Motivational Dimensions of OCD: Associations with Clinical and Demographic Traits.","authors":"Heather S Martin, Martha J Falkenstein, Jacob A Nota, Jennie M Kuckertz","doi":"10.1007/s10608-024-10561-2","DOIUrl":"10.1007/s10608-024-10561-2","url":null,"abstract":"<p><strong>Purpose: </strong>Content-based models, which focus on observable symptom content, have dominated much of the literature on heterogeneity in OCD. However, alternate models emphasize the motivations underlying different symptom presentations, including harm avoidance (HA) and incompleteness (INC). To promote understanding of these motivations, we examined their associations with various content-based symptom dimensions, obsessive belief patterns, and other clinical characteristics.</p><p><strong>Methods: </strong>We examined a large set of demographic and clinical characteristics and their associations with HA and/or INC among individuals (<i>N</i> = 218) receiving treatment for OCD and related disorders in a partial hospital/residential program. We also examined the extent to which HA and INC mapped onto dimensions in prevailing symptom content and obsessive belief models.</p><p><strong>Results: </strong>Results showed that women reported more HA than men, and INC was associated with an earlier age of onset. HA and INC were not differentially associated with sexual orientation, self-view, quality of life, depression, or suicidality. HA and INC mapped onto symptom content and obsessive belief models in some, but not all the ways we expected. Notably, contamination/washing in our sample was associated with INC, but not HA.</p><p><strong>Conclusions: </strong>Understanding motivations underlying OCD symptoms may lead to personalized care and improvement in treatment outcomes. We suggest that future research should continue to examine the motivational model, as well as ways in which presentations of each motivation may differ.</p>","PeriodicalId":48316,"journal":{"name":"Cognitive Therapy and Research","volume":"49 4","pages":"795-806"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disentangling Attentional Dynamics in Early Childhood: Response-Based Indicators of Avoidance of and Vigilance to Angry Faces in Relation to Anxiety and Traumatic Stress.","authors":"Alysse M Loomis, Damion J Grasso, Kimberly McCarthy, Margaret Briggs-Gowan","doi":"10.1007/s10608-025-10640-y","DOIUrl":"10.1007/s10608-025-10640-y","url":null,"abstract":"<p><strong>Background: </strong>Threat-related attentional processes have been highlighted as an important mechanism in the developmental unfolding of childhood anxiety and stress-related disorders. The preschool affective dot probe task is a widely used measure of these attentional processes, however weak psychometric properties have led to inconsistent empirical findings and limited utility in guiding assessment and practice.</p><p><strong>Methods: </strong>The current study employs a novel approach to scoring the dot probe task to examine the relationship between dimensions of threat-related attentional processes (e.g., bias, orientation, disengagement), trauma exposure, and child mental health in a sample of 232 preschool children. Young children (ages 4-6) and mothers participated in surveys and an affective dot probe task using emotional faces to measure trauma exposure, mother reports of child anxiety and traumatic stress symptoms, and child-reported traumatic stress. Novel response-based scoring was used to identify vigilance and avoidance indices of threat-related attentional processes.</p><p><strong>Results: </strong>More pronounced avoidance (e.g., avoidant orientation) was related to reduced mental health symptoms and more pronounced vigilance (e.g., vigilance bias) was related to higher mental health symptoms, above and beyond the influence of trauma exposure. Trauma exposure moderated the influence of slow disengagement on child anxiety; for children not exposed to trauma, less pronounced slow disengagement was related to lower anxiety.</p><p><strong>Conclusions: </strong>Response-based scoring offers a nuanced understanding of the mechanisms of threat-related bias and child psychopathology, offering a potential alternative to traditional scoring approaches. Future research should examine the temporally dynamic and context-dependent nature of response-based dimensions of threat-related attentional processes and children's psychopathology.</p>","PeriodicalId":48316,"journal":{"name":"Cognitive Therapy and Research","volume":"2025 ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining State Affective and Cognitive Outcomes Following Brief Mobile Phone-Based Training Sessions to Reduce Anxious Interpretations.","authors":"Kaitlyn Petz, Emma Toner, Mark Rucker, Emily Leventhal, Sarah Livermon, Benjamin Davidson, Mehdi Boukhechba, Laura Barnes, Bethany Teachman","doi":"10.1007/s10608-025-10623-z","DOIUrl":"10.1007/s10608-025-10623-z","url":null,"abstract":"<p><strong>Background: </strong>Rates of stress and anxiety are alarmingly high in university communities, but most people do not receive treatment. Mobile health (mHealth) interventions show promise to improve psychological symptoms and increase access to interventions, but little is known about their effects in the moment. The present study evaluated the short-term impact of brief mHealth sessions to determine which intervention features are associated with the greatest momentary self-reported improvements.</p><p><strong>Methods: </strong>Participants (<i>N</i> = 100 undergraduate students, graduate students, and university staff members) completed brief training sessions 1-2 times daily of Hoos Think Calmly, a new mobile application for the university community that uses Cognitive Bias Modification for Interpretations (CBM-I) to shift anxious thinking patterns. Training sessions varied based on stressor domain/topic selected and writing requirements, among other features. Linear mixed effects models were used to test whether stressor domain or writing requirements predict post-training: (1) momentary affect, (2) reappraisal self-efficacy, and (3) emotion regulation self-efficacy.</p><p><strong>Results: </strong>Self-reported improvement in state affect, reappraisal self-efficacy, and emotion regulation self-efficacy occurred for six out of eight stressor domains. Additionally, training sessions requiring less (vs. more) writing were associated with greater positive changes in affect, but not reappraisal or emotion regulation self-efficacy.</p><p><strong>Conclusion: </strong>Stressor domain and writing requirements are associated with different in-the-moment cognitive and affective outcomes, pointing to the need to tailor mHealth programs to users' specific needs and current stressors.</p>","PeriodicalId":48316,"journal":{"name":"Cognitive Therapy and Research","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12890198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Pilot Testing of the Mobile Application to Prevent Suicide (MAPS).","authors":"Heather T Schatten, Christopher D Hughes, Sara K Kimble, Gemma Wallace, Madeline B Benz, Morganne A Kraines, Elizabeth Germain, Leslie Brick, Michael F Armey, A Rani Elwy, Lauren M Weinstock, Ivan W Miller, Jennifer Primack","doi":"10.1007/s10608-024-10568-9","DOIUrl":"10.1007/s10608-024-10568-9","url":null,"abstract":"<p><strong>Purpose: </strong>Although there are empirically supported interventions for suicidal ideation and behavior, suicide rates in the United States continue to increase. Suicide risk is particularly elevated during transitions from acute care. One potential reason for this is that existing suicide interventions do not match the dynamic and contextualized nature of suicide risk. The goal of this study was to examine feasibility, acceptability, and pilot testing of the Mobile Application to Prevent Suicide (MAPS), a novel ecological momentary intervention designed to reduce suicidal ideation and behavior.</p><p><strong>Methods: </strong>We conducted two open trials in which participants used MAPS for 28 days during transitions from acute care: 10 adult psychiatric inpatients (Study 1) and 10 young adults in a partial hospitalization program (Study 2).</p><p><strong>Results: </strong>Results demonstrated that MAPS was feasible to implement and acceptable to psychiatric patients with high risk for suicide. Descriptive analyses suggested that during their use of MAPS, most participants experienced either decreases or no change in suicidal ideation severity, and there was an upward observable trend in outpatient treatment utilization.</p><p><strong>Conclusions: </strong>Results of these open trials support further evaluation of MAPS as an adjunctive intervention for suicide prevention during transitions in care.</p><p><strong>Clinical trials registration: </strong>ClinicalTrials.Gov identifiers NCT05180383 and NCT05180331.</p>","PeriodicalId":48316,"journal":{"name":"Cognitive Therapy and Research","volume":"49 3","pages":"497-511"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Experimental Investigation of the Relationship Between Emotion Regulation Flexibility, Negative Affect and Posttraumatic Stress Disorder.","authors":"Madeleine Lim, Angela Nickerson, Philippa Specker","doi":"10.1007/s10608-024-10536-3","DOIUrl":"10.1007/s10608-024-10536-3","url":null,"abstract":"<p><strong>Purpose: </strong>Emerging research investigating mechanisms underpinning PTSD has identified emotion regulation (ER) flexibility - the ability to flexibly use ER strategies according to contextual demands - as one promising mechanism. To date, however, no study has investigated whether brief training in ER flexibility can minimise negative affect elicited from evocative stimuli. This study investigated the impact of instructed ER flexibility on emotional responding in probable PTSD.</p><p><strong>Methods: </strong>Participants (<i>N =</i> 148) viewed images that differed in negative emotional intensity (high or low). For each image, participants followed instructions to adopt either a flexible or inflexible ER approach through randomisation to either an <i>ER flexible</i> condition or one of three control conditions (<i>Inflexible Reappraisal</i>, <i>Inflexible Distraction</i>, <i>Context Insensitive</i>). In the <i>ER Flexible</i> condition, participants were instructed to switch between distraction and reappraisal according to the emotional intensity of the image. The control conditions required participants to either employ a single ER strategy (<i>Inflexible Distraction</i> and <i>Inflexible Reappraisal</i>) or switch between strategies in a way that did not align with image intensity (<i>Context Insensitive</i>). Negative affect was rated after each image.</p><p><strong>Results: </strong>Participants with probable PTSD in the <i>ER Flexible</i> condition demonstrated the lowest levels of negative affect. For participants without probable PTSD, negative affect did not differ between the ER conditions.</p><p><strong>Conclusions: </strong>Findings suggest that individuals with probable PTSD benefitted from being instructed in ER flexibility. This finding supports the adaptiveness of ER flexibility and provides a preliminary temporal link between instructed ER flexibility and improved emotional responding for those with PTSD.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s10608-024-10536-3.</p>","PeriodicalId":48316,"journal":{"name":"Cognitive Therapy and Research","volume":"49 2","pages":"249-261"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Predictors of Internalizing Symptoms in Clinically Anxious Youth.","authors":"Dania Y Amarneh, Michael J Zvolensky, Eric A Storch, Andres G Viana","doi":"10.1007/s10608-025-10612-2","DOIUrl":"10.1007/s10608-025-10612-2","url":null,"abstract":"<p><strong>Background: </strong>Internalizing disorders are the most common psychiatric disorders in youth and are associated with a host of deleterious outcomes (e.g., self-harm, substance use, interpersonal difficulties), highlighting the critical need for identifying risk factors that confer risk for these disorders. The present study investigated the unique and shared roles of two prominent cognitive biases-anxiety sensitivity and interpretation biases-as predictors of internalizing symptom severity in clinically anxious youth, above and beyond the effects of negative emotionality and after accounting for sociodemographic covariates.</p><p><strong>Method: </strong>A diverse sample of clinically anxious youth (<i>N</i> = 105; M_age = 10.09 years, SD = 1.22; 56.7% female; 49% ethnic minority) completed a diagnostic interview and self-report measures of interpretation biases, anxiety sensitivity, and internalizing symptom severity.</p><p><strong>Results: </strong>Hierarchical regression analyses revealed that both anxiety sensitivity (<i>b</i> = 0.77, 95% CI [0.53, 1.00], <i>sr</i> ^<i>2</i>  = 0.11) and interpretation biases (<i>b</i> = 0.21, 95% CI [0.11, 0.30], <i>sr</i> ^<i>2</i>  = 0.05) accounted for an additional 22% of unique variance in internalizing symptom severity (<i>p</i> <.001), above and beyond the effects of negative emotionality. Post hoc exploratory analyses identified the disease and social concerns facets of anxiety sensitivity, and the overgeneralization facet of interpretation biases, as predictors of internalizing symptoms.</p><p><strong>Conclusion: </strong>Future research should examine whether targeting cognitive biases would be beneficial among temperamentally labile youth.</p>","PeriodicalId":48316,"journal":{"name":"Cognitive Therapy and Research","volume":"49 6","pages":"1322-1336"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12638344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of an Abbreviated Form of the Cognitive Style Questionnaire.","authors":"Ivan Vargas, Olivia Wier, Abigail H Vance, Gerald J Haeffel","doi":"10.1007/s10608-025-10587-0","DOIUrl":"10.1007/s10608-025-10587-0","url":null,"abstract":"<p><strong>Background: </strong>According to the Hopelessness Theory of Depression, a negative cognitive style increases an individual's vulnerability to depression during stressful life events. The Cognitive Style Questionnaire (CSQ) is a widely used self-report measure to assess negative cognitive style or cognitive vulnerability. A limitation of the CSQ is its length, limiting its use in larger-scale research and applied settings. This research aims to validate a brief version of the CSQ.</p><p><strong>Method: </strong>We conducted two studies to develop and validate the CSQ-brief form (CSQ-BF) by (1) empirically determining which scenarios from the CSQ should be included and (2) validating the CSQ-BF. In study one, 207 university students completed the full-scale CSQ, and the six best-fitting items were selected for the CSQ-BF. In study two, 321 university students completed several self-report measures of depressive symptoms, stressor exposure, affect, and the CSQ-BF.</p><p><strong>Results: </strong>A factor analysis supported that the full-scale CSQ is comprised of a single factor structure. Six items were selected for the CSQ-BF based on factor loadings and item categories (to maximize content validity). Results from study two confirmed that the CSQ-BF had strong psychometric properties and could be completed in less time.</p><p><strong>Conclusion: </strong>The CSQ-BF offers a more convenient tool for measuring cognitive vulnerability to depression.</p>","PeriodicalId":48316,"journal":{"name":"Cognitive Therapy and Research","volume":"49 5","pages":"1070-1082"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Who</i> Cares What Other People Think? A Longitudinal Investigation of the Role of Autonomy-Connectedness in Self-Esteem Change Trajectories and Instability.","authors":"Laura E Kunst, Marcel A L M van Assen, Felix J Clouth, Caroline Hunt, Maree J Abbott, Joyce Maas, Marrie H J Bekker","doi":"10.1007/s10608-025-10604-2","DOIUrl":"10.1007/s10608-025-10604-2","url":null,"abstract":"<p><strong>Background: </strong>While low self-esteem is an established risk factor for depressive and anxiety disorders, psychological underpinnings of unstable self-esteem remain understudied. We investigated the role of autonomy-connectedness, the psychological capacity for self-governance, in self-esteem and its change trajectories and instability.</p><p><strong>Methods: </strong>Data spanning 12 years of the Longitudinal Internet studies for the Social Sciences [LISS] panel, a large, nationally representative population sample (<i>N</i> = 5367, ages 16-91), were used.</p><p><strong>Results: </strong>Mixed model analyses revealed that autonomy-connectedness was positively associated with self-esteem. Autonomy-connectedness component Sensitivity to others predicted less deterioration of self-esteem over time. Latent growth mixture modeling exploring individual differences revealed seven latent classes differing in slope and self-esteem instability over time. Individuals with healthy autonomy were more likely to belong to classes with above average self-esteem, but not necessarily more stable self-esteem trajectories. A subgroup (11%) displayed alarming autonomy deficits, which corresponded with low, stable self-esteem, as well as high levels of depressive and anxiety symptoms.</p><p><strong>Conclusions: </strong>Autonomous individuals have higher self-esteem and better mental health, but autonomy deficits were not necessarily associated with <i>unstable</i> self-esteem trajectories. Being sensitive to others buffers against declining self-esteem in older age. Results are discussed in light of depression and anxiety vulnerability.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s10608-025-10604-2.</p>","PeriodicalId":48316,"journal":{"name":"Cognitive Therapy and Research","volume":"49 6","pages":"1246-1263"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12638343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}