Behavior Therapy最新文献

{"title":"A Network Control Theory of Dynamic Systems Approach to Personalize Therapy","authors":"Stefan G. Hofmann","doi":"10.1016/j.beth.2024.10.006","DOIUrl":"10.1016/j.beth.2024.10.006","url":null,"abstract":"<div><div>Contemporary latent disease models of psychopathology have shown limited clinical utility and the efficacy of conventional treatments have been disappointing. An alternative approach offers the network approach and a dynamic systems perspective to psychopathology and treatment change. To understand and modify dynamic systems, engineering and mathematics have been relying on principles of network control theory. This article will discuss the application of network control theory of dynamic systems approach to personalize therapy. Network control theory can be used as a guide for personalizing treatment by choosing the most promising intervention strategy targeting the change processes based on the network structure. A composit case illustration will demonstrate the principles and application of network control theory to therapy in practice within the framework of process-based therapy. In conclusion, a network control theory of dynamic systems approach is highly relevant and applicable to clinical science.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 1","pages":"Pages 199-212"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014028","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 Randomized Controlled Trial of a Single-Session Intervention to Reduce Training Psychologists’ Burnout","authors":"Briana S. Last ,&nbsp;Laura K. Jans ,&nbsp;Jessica L. Schleider","doi":"10.1016/j.beth.2024.06.004","DOIUrl":"10.1016/j.beth.2024.06.004","url":null,"abstract":"<div><div>Professional psychology trainees often experience burnout during their clinical training. In a pilot randomized controlled trial, we tested the feasibility, acceptability, utility, and preliminary efficacy of a 10-minute, online single-session intervention (SSI), designed to address burnout, hopelessness, and perceived agency in psychology trainees. In March 2023, 151 doctoral students with symptoms of stress or burnout in accredited, U.S.-based professional psychology programs were randomized to either the SSI (<em>n</em> = 74) or an active control condition (<em>n</em> = 77). Immediately post-SSI, 98.5% of participants endorsed the SSI as likely helpful for their patients and 92.5% wanted more information on how to deliver it; at 2-week follow-up, 48.4% had used the SSI in their own life, and 16.1%, with a patient. On average, participants rated the SSI as <em>somewhat</em> helpful; feeling <em>somewhat</em> hopeful and <em>somewhat</em> motivated to use their SSI-driven action plan; and that they would <em>mostly</em> recommend the SSI to others. No significant cross-condition differences emerged in participants’ reported burnout, hopelessness, or perceived agency at post-intervention or at follow-up, though effect sizes for these primary outcomes were generally in expected directions (<em>d</em>s = 0.01–0.36). In response to secondary outcome measures, SSI participants (versus control participants) reported <em>perceiving</em> significantly larger immediate improvements in hopelessness (<em>d</em> = 0.87), their problem-solving ability (<em>d</em> = 0.85), and their ability to help patients solve problems (<em>d</em> = 0.71). Overall, findings were inconclusive regarding the SSI’s effects on overall burnout, hopelessness, and agency; however, the SSI appeared to support trainees’ interest in SSI delivery and real-world use, both with themselves and with their patients. Participant feedback provided helpful guidance to inform SSI refinement, and potential best-uses, before larger-scale evaluation.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 1","pages":"Pages 162-176"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141411572","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":"Symptom Profiles and Intensive Treatment Outcomes in Sexual Minority and Heterosexual Patients With OCD","authors":"Caitlin M. Pinciotti,&nbsp;Brian A. Feinstein,&nbsp;Monnica T. Williams","doi":"10.1016/j.beth.2024.06.006","DOIUrl":"10.1016/j.beth.2024.06.006","url":null,"abstract":"<div><div>Sexual minority (SM) individuals appear to be at greater risk for obsessive-compulsive disorder (OCD). Despite this, little is known about OCD presentation and treatment outcomes among SM individuals. Although some research has suggested that SM individuals may be more likely to endorse intrusive thoughts related to violence/sex/religion compared to heterosexual individuals, extant literature has neglected to examine potential differences across different SM groups, a notable limitation given the apparent differences in the types of minority stress that each group experiences and the unique health disparities affecting each group. The current study sought to address these gaps by examining potential differences in OCD symptom severity, presentation, and treatment outcomes using analysis of variance and profile analysis in a clinical sample of 1,502 cisgender patients diagnosed with OCD enrolled in intensive OCD treatment (87.5% heterosexual, 6.6% bisexual, 4.7% lesbian or gay, and 1.1% questioning). Replicating previous research, neither OCD severity nor treatment outcomes differed by sexual orientation, and findings extended previous research that no differences across SM groups were observed, either. However, contrary to previous research, there was also no evidence for unique profiles of OCD symptoms across sexual orientation groups, and questioning individuals reported significantly less severe symmetry symptoms compared to heterosexual and bisexual individuals. Findings are encouraging in that they suggest that cisgender bisexual, lesbian or gay, and questioning individuals with OCD can still benefit significantly and to the same degree as their cisgender heterosexual peers in intensive OCD treatment. Potential explanations for conflicting findings regarding symptom profiles are discussed.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 1","pages":"Pages 16-31"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142203260","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":"Improvement in Distress Tolerance as a Mechanism of Symptom Reduction During Intensive Exposure and Response Prevention–Based Treatment for OCD","authors":"Donald A. Godfrey,&nbsp;Allison Heinrich,&nbsp;Elizabeth McIngvale,&nbsp;Jennifer Sy,&nbsp;Michael G. Wheaton,&nbsp;Thröstur Björgvinsson","doi":"10.1016/j.beth.2023.12.006","DOIUrl":"10.1016/j.beth.2023.12.006","url":null,"abstract":"<div><div>Exposure and Response Prevention (ERP) is an effective treatment for obsessive-compulsive disorder (OCD), yet the specific underlying mechanisms by which ERP improves symptoms remain unclear. Initial theories suggested that habituation to triggering events and stimuli was the key therapeutic factor in ERP, while other theories highlight the role of developing the ability to tolerate distress, rather than reduction of distress. The current study examined improvements in distress tolerance as a mechanism of OCD, anxiety, and depressive symptom reductions during an ERP-based intensive program. Participants (<em>N</em> = 180) completed weekly measures of distress intolerance, and symptom severity of OCD, anxiety, and depression. Using Multi-Level Structural Equation Modeling, we found that participants experienced significant weekly decreases in OCD, anxiety, and depressive symptom severity across the course of their ERP-based treatment. Weekly reductions in OCD symptom severity were partially accounted for by weekly improvements in participants’ ability to tolerate distress, particularly for obsession symptoms. This effect was also significant for anxiety and depressive symptom severity, above and beyond the effects of weekly reductions in OCD symptom severity. The current study suggests improving the ability to tolerate distress represents a transdiagnostic mechanism of symptom severity reduction in OCD, anxiety, and depressive psychopathology via intensive ERP-based psychotherapy programming. Limitations and future directions for improving treatments for OCD, anxiety, and depressive symptoms are discussed.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 1","pages":"Pages 43-56"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139084391","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":"Prospective Relationships Among Depression and Perceived Opportunity in Juvenile Offenders","authors":"Michael F. Sandella,&nbsp;Gavin N. Rackoff,&nbsp;Michelle G. Newman","doi":"10.1016/j.beth.2024.07.006","DOIUrl":"10.1016/j.beth.2024.07.006","url":null,"abstract":"<div><div>Among juveniles in the justice system, depression and perceived opportunity have implications for long-term adjustment. The prospective associations between these two constructs have not yet been examined in this population. We studied the longitudinal association between depression and perceived opportunity in a sample of recently adjudicated juvenile offenders. Juvenile offenders (<em>n</em> = 1,354) completed measures of depression and perceived opportunity shortly after adjudication and then every 6 months thereafter for 3 years (7 time points total). Relative to White juvenile offenders, lower average levels of perceived opportunity were observed among Black, Hispanic, and juveniles of other races/ethnicities. A random-intercept cross-lagged panel model revealed that greater depression was associated with lower subsequent perceived opportunity (<em>d</em> = -0.22, <em>p</em> &lt; .001). Higher perceived opportunity did not predict subsequent depression (<em>d</em> = -0.07, <em>p</em> = .208). The nonexperimental design prevented inferences about causal links between depression and perceived opportunity. Results should also be replicated in a recently collected dataset. Findings suggested a scar-like effect, such that depression was unidirectionally and negatively associated with lower future perceived opportunity among juveniles. Future research should investigate if treatment for depression improves juvenile offenders’ perceived opportunity.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 1","pages":"Pages 177-191"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851959","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":"State and Trait Disgust Uniquely Predict Avoidance in Contamination Fear: Specificity of Disease-Specific and Nonspecific Individual Differences","authors":"Bunmi O. Olatunji,&nbsp;Qimin Liu,&nbsp;Kelly A. Knowles,&nbsp;Sarah C. Jessup","doi":"10.1016/j.beth.2024.06.005","DOIUrl":"10.1016/j.beth.2024.06.005","url":null,"abstract":"<div><div>Although behavioral avoidance is observed among those with heightened contamination concerns, the extent to which such avoidance is best predicted by state and/or trait characteristics is unclear. Furthermore, while disgust proneness is a disease-specific trait that has been shown to predict avoidance among those with symptoms of contamination-based obsessive-compulsive disorder (OCD), it is unclear if other disease-specific traits may also serve a similar function. In the present study, contamination-fearful participants (<em>N</em> = 89) first completed self-report measures of disease-specific (disgust proneness, health anxiety, perceived vulnerability to disease) and disease-nonspecific (intolerance of uncertainty, trait anxiety) traits. They then completed a 16-step behavioral approach task (BAT) with increasing likelihood of contagion in a public restroom and provided ratings of state disgust and state anxiety at each step. Bayesian hierarchical logistic regression showed that state disgust, but not state anxiety, at a given step was associated with avoidance on the next step. Furthermore, disgust proneness was the only trait associated with avoidance on the BAT. A significant interaction between disgust proneness and BAT step completed in the public restroom was also found. Examination of this interaction suggests that intermediary, but not initial and latter, steps of the BAT differentiate those high and low in disgust proneness. These findings suggest that state and trait disgust uniquely drive behavioral avoidance among those with contamination concerns commonly observed in OCD.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 1","pages":"Pages 32-42"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141944389","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":"Using Alma to Alleviate Tristeza Maternal: Preliminary Outcomes of a Peer-Led Behavioral Activation Program Among Latina Mothers","authors":"Anahí Collado,&nbsp;Laurel Hicks,&nbsp;Samuel Hubley,&nbsp;Joseph Levy,&nbsp;Caitlin McKimmy,&nbsp;Marta Genovez,&nbsp;Robert Gallop,&nbsp;Desiree Bauer,&nbsp;Elena Aranda,&nbsp;Sona Dimidjian","doi":"10.1016/j.beth.2024.11.003","DOIUrl":"10.1016/j.beth.2024.11.003","url":null,"abstract":"<div><div>Spanish-speaking Latinas in the United States encounter significant barriers when seeking culturally responsive treatment for perinatal mental health disorders, resulting in treatment disparities and elevated rates of mental health symptoms. To address these challenges, peer-delivered support may be one promising strategy. This study examined the efficacy of Alma, a peer-delivered behavioral activation (BA) program comprising 6–8 sessions. Participants (<em>N</em> = 126) were Spanish-speaking Latina mothers experiencing elevated depression symptoms during the perinatal and early parenthood period. Participants were recruited through three community partner sites across rural and urban settings. Participants reported high satisfaction with the program and experienced decreases in depression symptoms, anxiety symptoms, and perceived stress. Importantly, significant clinical improvements occurred early in the program, indicating a rapid relief of symptoms. This symptom reduction was associated with improvements in putative mechanisms of BA, including activity level and environmental reward. Limitations of this study include participant attrition and the absence of a control group. Together, the findings indicate that Alma is a promising program to address depressed mood, anxiety, and stress among Spanish-speaking Latina mothers during the perinatal/early parenthood period, offering accessible and culturally responsive mental health support. Moreover, by meeting the mental health needs of Spanish-speaking Latina mothers, Alma holds promise for mitigating mental health disparities in underserved communities.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 2","pages":"Pages 225-240"},"PeriodicalIF":3.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143480607","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":"“Warning—This Content May Trigger Temporary Discomfort, Which Is Expected and Manageable”: The Effect of Modified Trigger-Warning Language on Reactions to Emotionally Provocative Content","authors":"Kathryn M. Bell,&nbsp;Rebeka Howardson,&nbsp;Diane Holmberg,&nbsp;Tara L. Cornelius","doi":"10.1016/j.beth.2024.11.001","DOIUrl":"10.1016/j.beth.2024.11.001","url":null,"abstract":"<div><div>A growing body of research suggests that trigger warnings do not actually reduce distress in those viewing emotionally provocative stimuli and may at times even worsen it. However, little is known regarding the potential benefits of modifying trigger-warning language so that it employs therapeutically consistent messaging to encourage adaptive coping. The current study explored whether a modified trigger warning might be more effective than a traditional trigger warning in reducing participants’ negative affect (NA) when exposed to distressing content. University students (<em>N</em> = 606) participated in an online study and were randomly assigned to one of three conditions: traditional trigger warning, modified trigger warning, or a no-warning control group. NA was measured before and after display of two emotionally provocative stimuli (one article and one video). Anxiety sensitivity (AS) and posttraumatic stress symptoms (PTSS) were also measured to assess whether these preexisting individual vulnerabilities might moderate participants’ responses to the different messages. Although the carefully pilot-tested stimuli were successful in increasing NA, there was no significant effect of trigger-warning condition, despite ample statistical power. AS and PTSS were associated with higher overall levels of NA but did not interact with study condition. These results add to the growing body of literature suggesting trigger warnings (whether traditional or modified) do not succeed in their goal of reducing the distress elicited by emotionally provocative content, including among vulnerable individuals. Alternative approaches to traditional trigger warnings are considered that may help individuals cope adaptively with potentially distressing material.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 2","pages":"Pages 213-224"},"PeriodicalIF":3.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143480606","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":"Moderators and Mediators of Treatments for Suicidal Thoughts and Behaviors: A Review of More Than 50 Years of Randomized Controlled Trials","authors":"Pauline Goger,&nbsp;Ruiyuan Guo,&nbsp;Soobin Jo,&nbsp;Christine B. Cha,&nbsp;Jessica Ribeiro,&nbsp;Xieyining Huang,&nbsp;Kathryn R. Fox","doi":"10.1016/j.beth.2024.10.003","DOIUrl":"10.1016/j.beth.2024.10.003","url":null,"abstract":"<div><div>Psychosocial treatments for suicidal thoughts and behaviors (STBs) are in need of improvement, as suicide rates have substantially increased in the last 20 years and current interventions show limited efficacy. One way to potentially boost response rates is to personalize treatments by identifying what works how and for whom to maximize impact across different individuals. A scoping review of all suicide treatment randomized controlled trials was performed on PubMed, PsycInfo, and GoogleScholar through May 2024 to identify moderators and mediators of suicide treatment. Forty-six studies including moderators and 15 studies including mediators were identified and evaluated by at least two independent researchers. The most frequently tested moderators across both adults and adolescents include age, gender/sex, history of STBs, therapeutic alliance, comorbid depression, and comorbid borderline personality disorder diagnoses or symptoms, with the strongest support found for therapeutic alliance in adults. No mediator was tested in more than one trial or research group, but hopelessness, avoidance, mentalization, and number of treatment contacts in adolescents and resilience, anxiety sensitivity, acceptance, and therapeutic relationship in adults showed positive signals. Overall, additional work is needed as heterogeneity, lack of replication attempts, and concerns about moderator and mediator quality currently limit confidence in findings.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 2","pages":"Pages 241-260"},"PeriodicalIF":3.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143480608","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 Efficacy of Technology-Enhanced Behavioral Parent Training for Families With Low Income: Do Parent-Centered Profiles Moderate Treatment Outcomes?","authors":"Yexinyu Yang,&nbsp;Justin Parent,&nbsp;Karen M. Gil,&nbsp;Deborah J. Jones","doi":"10.1016/j.beth.2024.10.002","DOIUrl":"10.1016/j.beth.2024.10.002","url":null,"abstract":"<div><div>Behavior disorders (BDs) in children are common and have long-term impacts. Financially disadvantaged families are at a greater risk of having a child with an early-onset BD but have more difficulty engaging in and therefore benefiting from behavior parent training (BPT). Building upon the potential of technology-enhanced (TE) treatment approaches in addressing barriers to treatment engagement and effectiveness, TE to one BPT program, Helping the Noncompliant Child (HNC), were tested in a randomized controlled trial (RCT) with 101 families with low income. The current study aimed to examine for whom TE-HNC versus standard HNC is optimal at posttreatment by exploring how pretreatment, parent-centered profiles may moderate parenting and child outcomes at posttreatment. Latent profile analyses yielded four distinct parent-centered profiles. The profile membership differentially predicted treatment outcomes by group for positive and negative parenting, as well as child behavior intensity, but not child problem behavior. The heterogeneity of responses to standard relative to TE treatment models among underserved families may provide clues regarding the future personalization of BPT toward improved treatment efficacy.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 2","pages":"Pages 261-275"},"PeriodicalIF":3.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479881","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}