Behavior Therapy最新文献

{"title":"Investigating the Theory of Clinical Perfectionism in a Transdiagnostic Eating Disorder Sample Using Network Analysis","authors":"Christina Ralph-Nearman,&nbsp;Brenna M. Williams,&nbsp;Anna Marie L. Ortiz,&nbsp;Cheri A. Levinson","doi":"10.1016/j.beth.2023.05.001","DOIUrl":"10.1016/j.beth.2023.05.001","url":null,"abstract":"<div><p>Eating disorders are deadly psychiatric illnesses, with treatments working for less than half of individuals who seek treatment. The transdiagnostic theory of eating disorders proposes that eating disorders share similar maintaining symptoms, such as what this theory calls <em>clinical perfectionism</em> (i.e., high levels of <em>concern over mistakes</em> and <em>personal standards</em>). However, it has been difficult to examine the interrelationship of specific aspects of perfectionism, beyond assessing moderation effects, which have generally not found support for the theory of clinical perfectionism in eating disorders. Thus, we used network analysis to test the theory of perfectionism by testing the interrelationships between maladaptive perfectionism facets (<em>concern over mistakes</em>, <em>personal standards, parental criticism</em>, <em>parental expectations</em>, and <em>personal standards</em>) and eating disorder symptoms in 397 individuals diagnosed with an eating disorder. <em>Concern over mistakes</em> was a central symptom and demonstrated the strongest interrelationships with eating disorder symptoms compared to the other aspects of perfectionism, connecting to eating concerns and cognitive restraint. Objective binge eating had a strong negative connection to <em>personal standards</em>. We identified specific central symptoms and illness pathways of perfectionism, which partially supports the theory of clinical perfectionism. Results, if replicated, may suggest that <em>concern over mistakes</em> might be best reconceptualized as part of eating disorder pathology and be targeted to improve treatment outcomes for eating disorders.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84734661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Unique and Moderating Role of Social and Self-Evaluative Factors on Perinatal Eating Disorder and Depression Symptoms","authors":"Caroline Christian,&nbsp;Stephanie C. Zerwas,&nbsp;Cheri A. Levinson","doi":"10.1016/j.beth.2023.05.009","DOIUrl":"10.1016/j.beth.2023.05.009","url":null,"abstract":"<div><p>Pregnancy and postpartum represent a critical transition period for changes in eating disorder (ED) symptoms and depression. Past research has established a relationship between ED and depressive symptoms during pregnancy. However, changes in depression and ED symptom across stages of pregnancy and postpartum, and factors that influence this relationship, remain understudied. Social factors and self-evaluative factors may be important given rapidly changing social pressures and expectations during this transitional time. The current study (<em>N</em> = 454 pregnant women) examined (1) differences in ED and depressive symptoms across pregnancy and postpartum and (2) whether social factors (social appearance anxiety; social support) and self-evaluative factors (maladaptive perfectionism; self-compassion) moderate the relationship between depression and ED symptoms cross-sectionally and prospectively. Study aims, hypotheses, and data analysis were preregistered on the Open Science Foundation (osf.io). This study did not identify differences in ED or depression symptoms across women at different stages of pregnancy; however, depression symptoms significantly improved within individuals from pregnancy to postpartum. ED symptoms and all social and self-evaluative factors were uniquely associated with depression during pregnancy. ED symptoms, maladaptive perfectionism, social appearance anxiety, and self-compassion during pregnancy significantly predicted postpartum depression, when accounting for prenatal depression. During pregnancy, but not postpartum, when social support and self-compassion were low, and when maladaptive perfectionism was high, there was a stronger relationship between ED and depression symptoms. ED symptoms and social and self-evaluative factors could be targeted in routine medical care and stepped-care interventions to improve maternal mental healthcare and prevent postpartum depression.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74561638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Therapy for a New Normal: Comparing Telehealth and in-Person Time-Limited Parent-Child Interaction Therapy","authors":"Abigail Peskin,&nbsp;Alexandra Barth,&nbsp;W. Andrew Rothenberg,&nbsp;Amanda Turzi,&nbsp;Diana Formoso,&nbsp;Dainelys Garcia ,&nbsp;Jason Jent","doi":"10.1016/j.beth.2023.05.002","DOIUrl":"10.1016/j.beth.2023.05.002","url":null,"abstract":"<div><p>Telehealth treatment for child disruptive behavior has the potential to overcome multiple barriers to access (e.g., transportation, therapist availability). Traditional Parent-Child Interaction Therapy (PCIT) has demonstrated efficacy via telehealth in randomized controlled trials. The current study extends this research by examining community-based effectiveness of time-limited (i.e., 18 week) telehealth PCIT, comparing intake and posttreatment child behavior and caregiver skills for both telehealth and in-person PCIT. Participants included predominantly racially, ethnically, linguistically, and socioeconomically diverse children aged 2 to 8 years, and their caregivers. Dyads (<em>N</em> = 380) received either telehealth (IPCIT) or in-person PCIT.<!--> <!-->Propensity score analyses were conducted to address potential selection bias due to the nonrandomized sample. Regression analyses revealed no difference between IPCIT and in-person treatment for child disruptive behaviors or compliance outcomes. However, caregivers who received IPCIT demonstrated fewer positive statements and greater corrective/directive statements at posttreatment than caregivers who received in-person treatment.<!--> <!-->This research demonstrated that time-limited IPCIT can effectively improve child disruptive behavior among a socioeconomically, linguistically, and culturally diverse population, and represents the largest sample to date demonstrating the effectiveness of PCIT via telehealth. Future research is warranted to document intervention sustainability on a more system-wide level, and balance prioritizing caregiver skill acquisition over family-derived treatment goals.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79192857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The High Impact of Low Intensity: Effectiveness of the BounceBack Program for Depression and Anxiety in Ontario","authors":"Lyndall Schumann,&nbsp;Katey Park,&nbsp;Jennifer Rouse,&nbsp;Helen Chagigiorgis","doi":"10.1016/j.beth.2023.05.010","DOIUrl":"10.1016/j.beth.2023.05.010","url":null,"abstract":"<div><p>High costs, long wait times, and lack of access to mental health supports in Ontario are leaving millions with unmet treatment needs. To address this need, Ontario launched BounceBack, a large-scale coach-supported intervention grounded in cognitive behavioral therapy (CBT) to target symptoms of anxiety, depression, and functional impairment. The objective of this program evaluation was to examine the effectiveness of the BounceBack program in Ontario by exploring (a) changes in participants’ depression and anxiety symptoms and functional impairment (as measured by the PHQ-9, GAD-7, and WSAS, respectively); and (b) rates for recovery and reliable improvement. Multilevel modelling (MLM) results indicated that participants reported significant improvements in their depression, anxiety, and functioning symptoms over time, which are not better accounted for by other demographic factors. Higher baseline severity of symptoms were associated with greater decreases in these symptoms. The strong recovery and reliable improvement rates identified further support the effectiveness of BounceBack as a potent intervention that leads to improvements in symptoms of anxiety and/or depression for the majority of its participants.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75013660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acknowledgment to 2023 Reviewers","authors":"","doi":"10.1016/j.beth.2023.12.001","DOIUrl":"10.1016/j.beth.2023.12.001","url":null,"abstract":"","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0005789423001296/pdfft?md5=369ce0c10fd37f0e7095efb92bac245e&pid=1-s2.0-S0005789423001296-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138572765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Trial of a Home-Based Parenting Intervention for High-Risk Infants: Effects on and Moderating Role of Effortful Control","authors":"Keara J. Neuman,&nbsp;Daniel M. Bagner","doi":"10.1016/j.beth.2023.05.003","DOIUrl":"10.1016/j.beth.2023.05.003","url":null,"abstract":"<div><p>Despite the important developmental outcomes associated with effortful control (EC), there is limited research demonstrating the efficacy of early interventions for improving EC and assessing the extent to which a child’s level of baseline EC impacts the outcome of intervention on externalizing problems. This study aims to fill these gaps in the literature by assessing the efficacy of the Infant Behavior Program (IBP), a parenting intervention for infants with elevated levels of behavior problems, in improving infant EC and the moderating effect of baseline infant EC on intervention outcomes. Participants included 60 high-risk 12- to 15-month-old infants and their mothers. Families were randomized to receive the IBP or standard pediatric<span> primary care. Parent-report measures of infant behavior and compliance were examined at baseline, post-intervention, and 3- and 6-month follow-up assessments. Results showed infants who received the IBP displayed significantly higher levels of EC at the post-intervention assessment compared to infants in the control group. Additionally, moderation analyses showed initial levels of EC moderated the effect of the IBP on externalizing problems and compliance, such that infants with higher levels of baseline EC displayed greater decreases in externalizing problems at post-intervention and greater increases in compliance at the 6-month follow-up. While these findings did not survive a false discovery rate correction, they offer preliminary support for the efficacy of the IBP in improving infants’ EC and highlight the importance of considering EC as a factor associated with early intervention outcomes for externalizing problems.</span></p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81852998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trait Mindfulness in Psychotic Disorders: Dimensions Predicting Symptoms, Cognition, and Functional Outcome","authors":"Ian M. Raugh,&nbsp;Gregory P. Strauss","doi":"10.1016/j.beth.2023.05.004","DOIUrl":"10.1016/j.beth.2023.05.004","url":null,"abstract":"<div><p>Mindfulness-based treatments are efficacious for psychotic disorders (PD). However, which components of mindfulness (i.e., attentive monitoring and nonjudgmental acceptance) are most relevant treatment targets is unclear. Further, there is a dearth of literature examining clinical correlates of mindfulness in people with PD. The present study aimed to examine group differences and clinical correlates of mindfulness in people with PD. We hypothesized that PD would report lower monitoring and acceptance than CN and that mindfulness components would be associated with symptoms including dysfunctional beliefs, alexithymia, neurocognitive ability, positive symptoms, and mood symptoms. Groups included individuals with PD (<em>n</em> = 54) and nonpsychiatric controls (<em>n</em> = 55). Participants completed self-report measures of mindfulness and related constructs and clinical interviews of symptoms. Results of ANOVA models indicated that global mindfulness was lower in PD relative to CN, with greatest differences evident for acceptance in the affective psychosis group. Regression models found that greater monitoring was associated with improved neurocognitive performance, while acceptance was associated with lower defeatist beliefs, alexithymia, and depression/anxiety symptoms. Results highlight the importance of targeting acceptance in the psychosocial treatment of PDs, especially for those with mood symptoms.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81717676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Self-Help Dangerous? Examination of Adverse Effects of a Psychological Internet-Based Self-Help Intervention for Body-Focused Repetitive Behavior (Free From BFRB)","authors":"Anna Baumeister,&nbsp;Stella Schmotz,&nbsp;Sarah Weidinger,&nbsp;Steffen Moritz","doi":"10.1016/j.beth.2023.05.013","DOIUrl":"10.1016/j.beth.2023.05.013","url":null,"abstract":"<div><p><span>Despite the proven effectiveness of psychotherapy for psychiatric disorders, adverse events or unwanted effects may occur. Unwanted effects, however, are rarely assessed. In self-help interventions, which usually are not supported by a therapist<span><span>, such effects have received even less attention even though special caution is needed regarding unwanted effects such as those related to misapplication. For the present study, we present the newly developed Positive and Negative Effects of Psychotherapy Scale for Internet-Based Intervention (PANEPS-I) and examine possible unwanted effects of an internet-based self-help intervention in individuals with body-focused repetitive behaviors (BFRBs), aggregating three different techniques: habit reversal training (HRT), decoupling (DC), and decoupling in sensu (DC-is). Some HRT users have expressed concern that the suppression of the </span>problematic behavior<span> could lead to rebound effects, but this has not been examined rigorously. Following baseline assessment, 141 participants with at least one BFRB were randomly assigned to two intervention groups that differed only with respect to the delivery mode (video, manual); the content was the same. After 6 weeks, a post-assessment was conducted. Unwanted effects were assessed using the PANEPS-I. A total of 70% of the participants (both treatment groups combined) reported at least one positive effect of the intervention. Negative effects were reported by 14–92% of participants, depending on the effect. The highest agreement rates were found for “no positive goal orientation” (52.5%), “did not address personal problems” (48.8%), “time/performance pressure” (20.9%), shame (16.3%), and concerns about data privacy (14.3%). Participants in the manual intervention group reported unethical procedures (e.g., data privacy concerns) more often (Cohen’s </span></span></span><em>d</em> = .44) than those in the video intervention group. Responders reported more positive effects and nonresponders more malpractice (|<em>d</em><span>| = .80, .54, respectively). HRT users (self-report) showed no significant differences compared to nonusers regarding negative effects. Stepwise hierarchical regression analyses indicated a dose-response relationship for reported positive effects and malpractice. Side effects may occur in any kind of intervention. Usage of HRT did not lead to more reported negative effects compared to nonusage. To improve the quality and effectiveness and ensure the safety of the user, especially those using digital self-help interventions, it is important to regularly assess unintended effects since there is no supervision of the patient in unguided self-help interventions.</span></p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85939141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Theories of State and Trait Change in Neuroticism and Symptom Improvement in the Unified Protocol","authors":"Nicole E. Stumpp,&nbsp;Matthew W. Southward,&nbsp;Shannon Sauer-Zavala","doi":"10.1016/j.beth.2023.05.005","DOIUrl":"10.1016/j.beth.2023.05.005","url":null,"abstract":"<div><p>Researchers have shown neuroticism decreases with treatment (Roberts et al., 2017), although it is unclear if this reflects fleeting state-level changes (state-artifact position) or trait-level change (cause-correction hypothesis). These theories further propose that changes in neuroticism predict symptom change (cause-correction hypothesis) or are predicted by symptom change (state-artifact position). We compared these theories in a clinical trial of the Unified Protocol (UP). Participants (N = 38; M_age = 34.55, 71.1% female, 78.9% Caucasian) meeting DSM-5 criteria for a primary emotional disorder completed up to 12 weekly sessions of the UP. Neuroticism exhibited state-level changes by Session 6 but trait-level changes by Session 12. Within-person reductions in neuroticism exhibited bidirectional relations with anxiety symptom change but predicted unidirectional session-to-session reductions in depression. These findings provide relatively more nuanced support for the cause-correction hypothesis that the UP leads to trait changes in neuroticism that tend to precede symptom change.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77484489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of a Meaning-Centered Intervention on Meaning in Life and Eating Disorder Symptoms in Undergraduate Women With High Weight and Shape Concerns: A Randomized Controlled Trial","authors":"Sanne F.W. van Doornik,&nbsp;Klaske A. Glashouwer,&nbsp;Brian D. Ostafin,&nbsp;Peter J. de Jong","doi":"10.1016/j.beth.2023.05.012","DOIUrl":"10.1016/j.beth.2023.05.012","url":null,"abstract":"<div><p>Low meaning in life has been proposed as an important factor in the maintenance of eating disorders and previous findings suggest that targeting meaning might optimize treatment effectiveness. The current randomized controlled trial aimed to investigate the efficacy of meaning-centered psychotherapy adjusted for eating disorders (MCP-ED) to improve meaning in women with high weight and shape concerns. Female students with high weight and shape concerns (<em>N</em> = 134) were randomly assigned to the waiting-list control condition or the experimental condition, in which they followed six weekly individual sessions of MCP-ED. Self-report measures of meaning, eating disorder symptoms, general distress, psychological well-being, and satisfaction with meaningful life domains were completed at baseline, after the final session of MCP-ED or a 7-week waiting period, and at 4-week follow-up. Participants in the experimental condition showed a stronger increase in meaning than participants in the waiting-list condition after the intervention and at follow-up. The intervention also resulted in lower eating disorder symptoms and general distress, and higher psychological well-being and satisfaction with meaningful life domains. Findings support the efficacy of MCP-ED as an intervention to increase meaning and point to the relevance of examining whether adding MCP-ED to regular treatment might increase treatment effectiveness in individuals with eating disorders.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0005789423000631/pdfft?md5=e36f8760f298f0562bb878841b8d7ccc&pid=1-s2.0-S0005789423000631-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77829504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}