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The Role of Pain and Blood Simulation of Nonsuicidal Self-Injury in Emotion Regulation Among Adolescents With Depression Based on the Principle of Harm Reduction: An Experimental Study 基于减轻伤害原则的疼痛和血液模拟非自杀性自伤在抑郁症青少年情绪调节中的作用:一项实验研究
IF 3.4 2区 心理学
Behavior Therapy Pub Date : 2025-05-01 Epub Date: 2024-06-13 DOI: 10.1016/j.beth.2024.06.002
Lu Wang, Hai-Ou Zou, Yan-Hua Qu, Jing-Fang Hong, Juan Chen
{"title":"The Role of Pain and Blood Simulation of Nonsuicidal Self-Injury in Emotion Regulation Among Adolescents With Depression Based on the Principle of Harm Reduction: An Experimental Study","authors":"Lu Wang,&nbsp;Hai-Ou Zou,&nbsp;Yan-Hua Qu,&nbsp;Jing-Fang Hong,&nbsp;Juan Chen","doi":"10.1016/j.beth.2024.06.002","DOIUrl":"10.1016/j.beth.2024.06.002","url":null,"abstract":"<div><div>This study aims to explore the role of pain and blood in emotion regulation during nonsuicidal self-injury (NSSI) among adolescents with depression, which included 108 depressed adolescents with NSSI and 110 depressed adolescents without NSSI, to assess the impact of pain and blood on subjective emotional states, and pulse frequency (Pf), respiratory frequency (Rf), galvanic skin response (GSR), and electromyography (EMG). Significant condition×group×time interactions for positive emotions (<em>β =</em> −0.082, <em>SE =</em> 0.026, <em>P =</em> 0.002), Pf (<em>β =</em> −0.045, <em>SE =</em> 0.013, <em>P =</em> 0.001) and GSR (<em>β =</em> −0.041, <em>SE =</em> 0.018, <em>P =</em> 0.027) were found, indicating a significant increase in positive emotions and a significant decrease in Pf and GSR in the NSSI group post-pain/blood stimulus, especially within the first 10 seconds (for Pf, GSR)/3.5 minutes (for positive emotions) following stimulus. And Pf and GSR showed a more pronounced decrease over time in the NSSI group during the pain condition than in the blood condition. These findings highlight the significance of pain and blood in emotion regulation for adolescents with depression who engage in NSSI. Moreover, clinical healthcare professionals may be inspired by the pain and blood stimulus of NSSI based on the harm reduction principle, which provides new ideas for exploring potential interventions that can assist adolescents with depression regulate their emotions and reduce the occurrence of NSSI. And more relevant studies need to be carried out in this area.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 3","pages":"Pages 543-554"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141401695","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}
引用次数: 0
Enhancing Understanding of Eating Psychopathology: A Network Analysis Study 增进对饮食精神病理学的了解:一项网络分析研究
IF 3.4 2区 心理学
Behavior Therapy Pub Date : 2025-05-01 Epub Date: 2024-10-02 DOI: 10.1016/j.beth.2024.09.004
Cristiana C. Marques, Paula Castilho, Miguel Castelo-Branco, Ana T. Pereira, Kenneth Goss
{"title":"Enhancing Understanding of Eating Psychopathology: A Network Analysis Study","authors":"Cristiana C. Marques,&nbsp;Paula Castilho,&nbsp;Miguel Castelo-Branco,&nbsp;Ana T. Pereira,&nbsp;Kenneth Goss","doi":"10.1016/j.beth.2024.09.004","DOIUrl":"10.1016/j.beth.2024.09.004","url":null,"abstract":"<div><div>Compassion Focused Therapy for eating disorders (CFT-E) has been shown to be effective in treating eating psychopathology. Exploring which processes identified by the CFT-E model are most linked with eating disorder symptoms could help develop targeted treatments. However, the relationship between these variables requires further investigation. This study explores the interconnections between eating disorder symptoms and processes identified by the CFT-E using a network analysis approach. Participants were 497 individuals (77.3% female) from a community sample who completed measures to assess body dissatisfaction, shape and weight overvaluation, cognitive restraint, bingeing, emotional eating, purging, self-compassion, social comparison through appearance, self-criticism, appearance-related shame, guilt and pride, and positive and negative affect. A regularized partial correlation network was estimated. Appearance-related shame, inadequate self and body dissatisfaction emerged as the central nodes in the network. These findings support the use of interventions targeting shame and self-criticism for the treatment of eating disorder symptoms. Studies with diverse samples are needed to further examine the interconnections between eating psychopathology and the key processes identified by the CFT-E theoretical model.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 3","pages":"Pages 605-617"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869029","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}
引用次数: 0
Dissemination Trial of Provider Training of ACT-Enhanced Behavior Therapy for Trichotillomania: A Waitlist Controlled Study act强化拔毛癖行为治疗提供者培训的推广试验:一项候补对照研究
IF 3.4 2区 心理学
Behavior Therapy Pub Date : 2025-05-01 Epub Date: 2025-01-21 DOI: 10.1016/j.beth.2025.01.005
Mercedes G. Woolley, Sarah E. Schwartz, Kate L. Morrison, Michael P. Twohig
{"title":"Dissemination Trial of Provider Training of ACT-Enhanced Behavior Therapy for Trichotillomania: A Waitlist Controlled Study","authors":"Mercedes G. Woolley,&nbsp;Sarah E. Schwartz,&nbsp;Kate L. Morrison,&nbsp;Michael P. Twohig","doi":"10.1016/j.beth.2025.01.005","DOIUrl":"10.1016/j.beth.2025.01.005","url":null,"abstract":"<div><div>Trichotillomania is a psychiatric disorder characterized by recurrent hair-pulling, leading to distress and impairment. Despite the efficacy of habit reversal training (HRT) and ACT-enhanced behavior therapy (A-EBT), there is a significant knowledge gap among providers about evidence-based treatments. This study aimed to bridge this gap by evaluating the feasibility, acceptability, and effects of internet-delivered therapist training in A-EBT for trichotillomania. A randomized waitlist-controlled implementation trial was conducted with 119 licensed mental health providers assigned to either immediate training or waitlist cohorts. The immediate training group participated in a 1-day online workshop followed by 6 months of consultation. Compared to the waitlist cohort, the immediate training cohort showed significant improvements in knowledge of trichotillomania, its treatments, and self-efficacy in providing the therapy, which were maintained throughout the end of the consultation period. Behavioral outcomes indicated that the immediate training cohort was more likely to self-promote their ability to treat trichotillomania, leading to an increased caseload of clients with trichotillomania and other body-focused repetitive behaviors (BFRBs). Approximately one-third of providers in both groups began treating at least one client with trichotillomania or another BFRB during the training period. In conclusion, training providers in A-EBT for trichotillomania is feasible and effective in improving provider knowledge and self-efficacy, leading to more individuals receiving evidence-based care. Future research should explore long-term impacts on client outcomes and ways to further enhance training dissemination and implementation for trichotillomania and other BFRBs.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 3","pages":"Pages 648-665"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869032","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}
引用次数: 0
Impact of a Brief Parenting Intervention on Parent and Infant Imitation 简短育儿干预对父母和婴儿模仿的影响
IF 3.4 2区 心理学
Behavior Therapy Pub Date : 2025-05-01 Epub Date: 2024-08-20 DOI: 10.1016/j.beth.2024.08.007
Caroline J. Gillenson, Matthew J. Valente, Mary B. Hagan, Anastassia Cafatti Mac-Niven, Daniel M. Bagner
{"title":"Impact of a Brief Parenting Intervention on Parent and Infant Imitation","authors":"Caroline J. Gillenson,&nbsp;Matthew J. Valente,&nbsp;Mary B. Hagan,&nbsp;Anastassia Cafatti Mac-Niven,&nbsp;Daniel M. Bagner","doi":"10.1016/j.beth.2024.08.007","DOIUrl":"10.1016/j.beth.2024.08.007","url":null,"abstract":"<div><div>Research examining the effect of behavioral parenting interventions, such as parent–child interaction therapy (PCIT), on parent and child imitation is limited despite known benefits to early child development. We examined the effect of a brief, home-based adaptation of PCIT, the Infant Behavior Program (IBP), on changes in observed frequency of parent and infant imitation, moderating effects of parent language (English, Spanish), and mediational effects of parent and infant imitation on the effect of intervention on infant behavior problems. Participants were 60 12- to 15-month-olds with elevated behavior problems and their primary caregiver, all of which were mothers. Parent–infant dyads were randomly assigned to receive either the IBP or standard pediatric primary care. Parents receiving the IBP demonstrated significantly higher rates of observed imitation at postintervention and at the 3-month follow-up compared to those receiving standard care, and the effect at postintervention was stronger for English-speaking than for Spanish-speaking families. Although the IBP did not directly affect changes in infant imitation at postintervention or the 3-month follow-up, rates of infant imitation increased significantly for those who received the IBP at the 6-month follow-up. Additionally, moderation results suggested that the IBP led to improvements in infant imitation at post for Spanish-speaking families but not for English-speaking families. There were no significant mediational effects of parent or infant imitation. Future research is needed to examine the impact of increases in imitation on other aspects of child development, such as social–cognitive and language abilities, and to examine how cultural factors may play a role in individual differences in imitation.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 3","pages":"Pages 487-500"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249472","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}
引用次数: 0
Examining the Reciprocal Association Between Worry and Sleep: Disaggregating Between- and Within-Person Effects 检查焦虑和睡眠之间的相互关系:分解人与人之间和人与人之间的影响
IF 3.4 2区 心理学
Behavior Therapy Pub Date : 2025-05-01 Epub Date: 2024-10-18 DOI: 10.1016/j.beth.2024.09.005
Clara Law, Alexander W. Sokolovsky, David L. Yap, Joel Erblich, Kathleen Gunthert, Evelyn Behar
{"title":"Examining the Reciprocal Association Between Worry and Sleep: Disaggregating Between- and Within-Person Effects","authors":"Clara Law,&nbsp;Alexander W. Sokolovsky,&nbsp;David L. Yap,&nbsp;Joel Erblich,&nbsp;Kathleen Gunthert,&nbsp;Evelyn Behar","doi":"10.1016/j.beth.2024.09.005","DOIUrl":"10.1016/j.beth.2024.09.005","url":null,"abstract":"<div><div>Studies investigating the reciprocal association between worry and sleep have yielded mixed findings and suffered from methodological limitations. The purpose of this study was to assess the reciprocal association between worry and various indices of sleep (i.e., sleep onset latency [SOL], total sleep duration [TSD], sleep quality [SQ], and morning lingering [ML]). In a longitudinal daily assessment study, participants (<em>N</em> = 182) completed a sleep diary and a measure of worrisome thinking three times per day for 7 days. We used linear mixed effects models to examine worry predicting sleep, and Tobit regression models to examine sleep predicting worry, and controlled for previous day report of the outcome variable and person- and day-level effects. Results indicate that greater person-level worry, but not day-level worry, was significantly associated with longer SOL, worse SQ, and longer ML. Furthermore, greater person-level SOL, TSD, and ML was associated with greater worry, and greater person-level SQ was associated with less worry. Finally, we found that shorter day-level TSD and lower day-level SQ was associated with greater next-day worry. These findings support a reciprocal person-level association between worry and sleep (except for TSD), and a unidirectional day-level association between TSD and SQ as predictors of worry.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 3","pages":"Pages 634-647"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869031","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}
引用次数: 0
Beyond Jacobson and Truax: Estimation of Clinical Significance Trajectories in the Coping Power Intervention Using Measurement Error-Corrected Multilevel Modeling 超越Jacobson和Truax:使用测量误差校正的多层次模型估计应对能力干预的临床意义轨迹
IF 3.4 2区 心理学
Behavior Therapy Pub Date : 2025-05-01 Epub Date: 2024-08-20 DOI: 10.1016/j.beth.2024.08.003
Antonio A. Morgan-López, Lissette M. Saavedra, Heather L. McDaniel, Stephen G. West, Nicholas S. Ialongo, Catherine P. Bradshaw, Alexandra T. Tonigan, Barrett W. Montgomery, Nicole P. Powell, Lixin Qu, Anna C. Yaros, John E. Lochman
{"title":"Beyond Jacobson and Truax: Estimation of Clinical Significance Trajectories in the Coping Power Intervention Using Measurement Error-Corrected Multilevel Modeling","authors":"Antonio A. Morgan-López,&nbsp;Lissette M. Saavedra,&nbsp;Heather L. McDaniel,&nbsp;Stephen G. West,&nbsp;Nicholas S. Ialongo,&nbsp;Catherine P. Bradshaw,&nbsp;Alexandra T. Tonigan,&nbsp;Barrett W. Montgomery,&nbsp;Nicole P. Powell,&nbsp;Lixin Qu,&nbsp;Anna C. Yaros,&nbsp;John E. Lochman","doi":"10.1016/j.beth.2024.08.003","DOIUrl":"10.1016/j.beth.2024.08.003","url":null,"abstract":"<div><div>Coping Power (CP) is a preventive intervention that focuses on reducing child externalizing problems. Although it is typically delivered in a group format (GCP), individually delivered CP (ICP) has produced greater mean reductions in externalizing problems. However, standard analysis of randomized trials loses individual-level information regarding which youth improve, fail to improve, or get worse, whereas clinically significant change (CSC) metrics capture information on individual change. The present study is a secondary analysis of an ICP/GCP trial (<em>N</em> = 360) that examines differences in CSC-based individual-level inferences on externalizing. A novel method for assessing CSC under measurement error-corrected multilevel modeling was used, overcoming three limitations of traditional CSC methods: (a) restriction to two time points, (b) use of total scores, and (c) assumption of constant reliability across time and participants. Because of concerns about Type II errors with all CSC methods, an individual-level effect size metric for CSC was also developed. Based on individualized Cohen’s <em>d</em> estimates, individual-level improvements in externalizing from 4th through 11th grades of <em>d</em> ≥ 0.5 were significantly greater in ICP (73%) versus GCP (45%). Further, GCP saw significantly higher percentages of youth with worsening of externalizing, underscoring concerns about diminished effects for GCP. Half of the sample had improvement that was not statistically significant but exceeded <em>d</em> ≥ 0.5, highlighting the susceptibility to Type II errors of CSC’s results based on statistical significance. An examination of ICP/GCP differences under advanced CSC analysis gives more nuanced information than conventional randomized controlled trial analysis and greater precision in estimating individual-level outcomes than standard CSC methodologies.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 3","pages":"Pages 513-528"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869074","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}
引用次数: 0
Underlying Working Mechanisms of Virtual Reality Exposure: Exploring the Role of Fearful Expectancies and Habituation 虚拟现实暴露的基本工作机制:探索恐惧预期和习惯的作用
IF 3.4 2区 心理学
Behavior Therapy Pub Date : 2025-05-01 Epub Date: 2024-08-20 DOI: 10.1016/j.beth.2024.08.004
Sara Scheveneels, Naomi Carpentier
{"title":"Underlying Working Mechanisms of Virtual Reality Exposure: Exploring the Role of Fearful Expectancies and Habituation","authors":"Sara Scheveneels,&nbsp;Naomi Carpentier","doi":"10.1016/j.beth.2024.08.004","DOIUrl":"10.1016/j.beth.2024.08.004","url":null,"abstract":"<div><div>While research has primarily focused on establishing the efficacy of virtual reality (VR) exposure, relatively scant attention has been paid to the underlying working mechanisms that drive the effects. The present study examined the role of fearful expectancies and fear reduction (habituation) in VR exposure. Fearful expectancies were measured before, during (retrospectively), and after a VR exposure session in 121 participants with elevated fear of spiders. In addition, skin-conductance and heart rate were measured throughout the exposure session to examine fear reduction within the exercises and across the session. Fearful expectancies decreased after VR exposure. Larger decreases were associated with better outcomes 1 week (in the verbal and behavioral measures) and 3 months (in one of the verbal measures) after exposure. Levels of expectancies <em>during</em> exposure were not associated with the outcome. We did not find evidence that expectancies about own reactions were better testable in VR exposure than expectancies about the spider. Fear reduction within the exercises or across the session did generally not predict VR exposure outcome. It is recommended to focus on various operationalizations and experimental manipulations of the mechanisms, as well as to compare these mechanisms between VR and in vivo exposure in future research.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 3","pages":"Pages 555-565"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142203253","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}
引用次数: 0
The Exposure Guide: A Practical Measure of Exposure Quality 曝光指南:曝光质量的实用测量方法
IF 3.4 2区 心理学
Behavior Therapy Pub Date : 2025-05-01 Epub Date: 2024-11-27 DOI: 10.1016/j.beth.2024.11.002
Kristen M. Benito, Jennifer A. Herren, Lesley A. Norris, Kristen M. Gardiner, Molly Choate, Jennifer B. Freeman
{"title":"The Exposure Guide: A Practical Measure of Exposure Quality","authors":"Kristen M. Benito,&nbsp;Jennifer A. Herren,&nbsp;Lesley A. Norris,&nbsp;Kristen M. Gardiner,&nbsp;Molly Choate,&nbsp;Jennifer B. Freeman","doi":"10.1016/j.beth.2024.11.002","DOIUrl":"10.1016/j.beth.2024.11.002","url":null,"abstract":"<div><div>Quality monitoring is essential for the use of evidence-based interventions (EBIs) in both practice and research settings, yet few quality measures have been developed or validated for any treatment. This study examined the initial psychometric properties of a brief, practical measure of quality for exposure therapy (Exposure Guide; EG) in a sample of youth from three randomized clinical trials for pediatric OCD (<em>N</em> = 103 patients and 368 sessions). The EG was initially developed based on the behavioral principles underlying exposure, delivery factors linked to clinical outcomes in prior literature, and with input from both exposure therapy researchers and partners in community mental health settings. Results indicated good to excellent inter-rater reliability (item ICCs = .64 to 1.00). When compared against a validated, time-intensive coding system, each EG item exhibited large correlations with parallel coding system variables; these were significantly larger than correlations with other variables. Variance components analysis demonstrated EG subscale variability at the level of therapists, patients, and time. The EG demonstrates strong initial reliability and construct validity in a clinical trial context; future studies will be needed to establish psychometric properties in practice settings and to elucidate therapist, patient, and treatment course factors that may influence quality.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 3","pages":"Pages 594-604"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869028","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}
引用次数: 0
A Comparison of Pragmatic and Scalable Strategies to Assess Fidelity to Cognitive Processing Therapy in Routine Care Settings 在常规护理环境中评估认知加工治疗忠实度的实用和可扩展策略的比较
IF 3.4 2区 心理学
Behavior Therapy Pub Date : 2025-05-01 Epub Date: 2024-12-12 DOI: 10.1016/j.beth.2024.12.003
Shannon Wiltsey Stirman, Nicole B. Gumport, Amber Calloway, Cassidy Gunter, Luana Marques, Samantha Hernandez, Jiyoung Song, Clara Johnson, Soo Jeong Youn, Sohayla Elhusseini, Regine M. Deguzman-Lucero, Taylor Loskot, Heidi La Bash, Yesenia Aguilar Silvan, Caroline Canale, Alayna L. Park, Jansey Lagdamen, Anna D. Bartuska, Booil Jo, Paul Barnett, Torrey A. Creed
{"title":"A Comparison of Pragmatic and Scalable Strategies to Assess Fidelity to Cognitive Processing Therapy in Routine Care Settings","authors":"Shannon Wiltsey Stirman,&nbsp;Nicole B. Gumport,&nbsp;Amber Calloway,&nbsp;Cassidy Gunter,&nbsp;Luana Marques,&nbsp;Samantha Hernandez,&nbsp;Jiyoung Song,&nbsp;Clara Johnson,&nbsp;Soo Jeong Youn,&nbsp;Sohayla Elhusseini,&nbsp;Regine M. Deguzman-Lucero,&nbsp;Taylor Loskot,&nbsp;Heidi La Bash,&nbsp;Yesenia Aguilar Silvan,&nbsp;Caroline Canale,&nbsp;Alayna L. Park,&nbsp;Jansey Lagdamen,&nbsp;Anna D. Bartuska,&nbsp;Booil Jo,&nbsp;Paul Barnett,&nbsp;Torrey A. Creed","doi":"10.1016/j.beth.2024.12.003","DOIUrl":"10.1016/j.beth.2024.12.003","url":null,"abstract":"<div><div>Fidelity monitoring is crucial for successful implementation of evidence-based practices, but traditional methods such as observation and video recording are impractical for routine mental health care due to their high resource demands. A reliable, low-burden fidelity (adherence and competence) assessment can support the implementation of cognitive behavioral therapies (CBTs). This study evaluated two pragmatic alternatives to the time and cost-intensive “gold standard” observer ratings based on session recordings to assess fidelity in Cognitive Processing Therapy (CPT). We assessed the feasibility of clinician-completed adherence checklists and ratings of worksheets that were completed during sessions in public and private mental healthcare settings by a diverse sample of patients with significant trauma histories and their therapists. We also examined whether fidelity ratings using these approaches were associated with observer ratings of fidelity and with subsequent PTSD symptom change. Results indicated high overall rater agreement for adherence and competence on CPT worksheets and session recordings. We found significant associations among traditional observer ratings of adherence and our two low-burden alternatives for assessing adherence. Clinician-completed adherence checklists were also associated with subsequent symptom change. Checklists and worksheets required substantially less time to rate than session recordings. Overall, checklists and worksheets emerged as reliable and feasible methods for fidelity assessment, potentially diminishing the necessity for time- and labor-intensive fidelity ratings based on session recordings. Our findings suggest a scalable approach for integrating fidelity monitoring and support into policies aimed at enhancing the accessibility and effectiveness of evidence-based care.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 3","pages":"Pages 453-469"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869071","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}
引用次数: 0
Body Dissatisfaction Is Central to Military Eating Disorder Pathology: A Multi-Time-Point Network Analysis 身体不满意是军人进食障碍病理学的核心:多时点网络分析
IF 3.4 2区 心理学
Behavior Therapy Pub Date : 2025-03-01 Epub Date: 2024-07-20 DOI: 10.1016/j.beth.2024.07.003
Shruti S. Kinkel-Ram, William Grunewald, Lt. Col. S. David Tubman, Maj. Aaron Esche, Cheri A. Levinson, April R. Smith
{"title":"Body Dissatisfaction Is Central to Military Eating Disorder Pathology: A Multi-Time-Point Network Analysis","authors":"Shruti S. Kinkel-Ram,&nbsp;William Grunewald,&nbsp;Lt. Col. S. David Tubman,&nbsp;Maj. Aaron Esche,&nbsp;Cheri A. Levinson,&nbsp;April R. Smith","doi":"10.1016/j.beth.2024.07.003","DOIUrl":"10.1016/j.beth.2024.07.003","url":null,"abstract":"<div><div>Military membership may put individuals at risk for eating disorders (EDs) due to military specific risk factors such as strict physical fitness requirements, increased salience of weight, and exposure to trauma. Current ED assessments and treatments do not account for these military-specific risk factors. Empirically identifying maintaining factors for EDs can clarify which specific ED symptoms may be efficacious treatment targets for service members and veterans. Thus, we employed network analysis within a military sample to identify central ED symptoms and compare if these symptoms changed across three time-points. We hypothesized that body dissatisfaction and overexercise would be identified as central symptoms across all three time-points. Individuals in the military (73.7% male, 84.8% active duty, M<sub>age</sub> = 30.74) completed the Eating Pathology Symptom Inventory (EPSI; Forbush et al., 2013) at baseline (<em>n</em> = 216), and at 1-month (<em>n</em> = 191) and 3-month follow-up (<em>n</em> = 176). We computed cross-sectional graphical LASSO networks and found that the most central symptoms were related to body dissatisfaction, overexercise, binge eating and diet pill/diuretics; these symptoms were largely stable across multiple time-points. Body dissatisfaction was identified as central across all three time-points and overexercise, binge eating, and diet pill/diuretics were identified as central across two timepoints. These findings are in line with network studies among men and clinical patients that find weight/shape concerns consistently emerge as central ED symptoms. Given that overexercise and diuretics are both central symptoms and frequently employed by military populations, providers should assess these symptoms and work to treat them in a culturally responsive way when they arise.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 2","pages":"Pages 395-408"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141846345","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}
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