Behavior Therapy最新文献

{"title":"Feasibility of Using ChatGPT to Generate Exposure Hierarchies for Treating Obsessive-Compulsive Disorder","authors":"Emily E. Bernstein,&nbsp;Adam C. Jaroszewski,&nbsp;Ryan J. Jacoby,&nbsp;Natasha H. Bailen,&nbsp;Jennifer Ragan,&nbsp;Aisha Usmani,&nbsp;Sabine Wilhelm","doi":"10.1016/j.beth.2025.02.005","DOIUrl":"10.1016/j.beth.2025.02.005","url":null,"abstract":"<div><div>Obsessive-compulsive disorder (OCD) is a chronic, severe condition. Although exposure and response prevention (ERP), the first-line treatment for OCD, is highly effective, too few clinicians are equipped to deliver it. One barrier is the time and expertise required to develop personalized exposure hierarchies. In this study, we examined the feasibility and promise of using large language models (LLMs) to generate appropriate exposure suggestions for OCD treatment. We used ChatGPT-4 (Generative Pretrained Transformer, Version 4) to generate 10-item exposure hierarchies for simulated patient cases that were systematically varied along the following dimensions: OCD subtype, symptom complexity or number, level of detail, patient age, and patient gender. Expert clinicians also generated hierarchies for a subset of prompts. ChatGPT-generated hierarchies were first rated for completeness and degree to which input information was incorporated. Three OCD experts blinded to the aims of the study then rated each ChatGPT- and expert-generated hierarchy’s appropriateness, specificity, variability, safety/ethics, and overall usefulness or quality. ChatGPT generated partial (<em>n</em> = 15) or complete (<em>n</em> = 55) responses to 70 of 72 prompts and incorporated most input information (<em>M</em> = 4.29 out of 5, <em>SD</em> = 0.85). The only significant predictor of degree of input information incorporated was number of OCD symptoms; prompts with the most symptoms were rated as incorporating less input information than prompts with both low and moderate number of symptoms, <em>p</em>s &lt; .05. Overall, ChatGPT-generated hierarchies were viewed as appropriate (<em>M</em> = 4.47, SD = 0.58), specific (<em>M</em> = 4.17, SD = 0.65), variable (<em>M</em> = 3.96, <em>SD</em> = 0.79), safe/ethical (<em>M</em> = 4.89, <em>SD</em> = 0.24), and useful (<em>M</em> = 3.99, <em>SD</em> = 0.82). However, expert human-generated hierarchies were still rated as significantly more appropriate, specific, variable, and useful, <em>p</em>s &lt; .05, but not more or less safe and ethical than ChatGPT-generated hierarchies, <em>p</em> = .24. Only the level of symptom detail included in prompts was associated with ratings of ChatGPT-generated hierarchies, <em>p</em>s &lt; .05, such that hierarchies were rated significantly better when prompts had been more detailed. Results suggest that LLMs such as ChatGPT hold great promise in helping generate effective OCD exposure hierarchies, while also highlighting key limitations that require resolution prior to clinical implementation. Given that few clinicians specialize in OCD treatment, it would be advantageous to establish how face-to-face or digital treatment can be augmented with this technology.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 4","pages":"Pages 680-688"},"PeriodicalIF":3.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313024","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":"Necesito Un Psicólogo: A Feasibility Study Examining a Behavioral Activation Telenovela Intervention for Depressed Latinas","authors":"Rosy L. Chavez-Najera,&nbsp;Lorraine T. Benuto","doi":"10.1016/j.beth.2025.03.001","DOIUrl":"10.1016/j.beth.2025.03.001","url":null,"abstract":"<div><div>Latines in the United States experience considerable rates of depression and while behavioral activation is an effective treatment for depression, internal and external barriers contribute to the underutilization of behavioral health services among Spanish-speaking Latines (SSLs). Fortunately, internet-based interventions have the potential to mitigate these barriers given their increased privacy, cost-effectiveness, and logistical flexibility. The present (pilot) study examined clinical outcomes and feasibility (engagement, satisfaction) with a culturally attuned behavioral activation telenovela intervention (BAD-TI) for SSLs using a quasi-experimental design. The BAD-TI is modeled after the telenovela entertainment genre (a limited-run serial drama popular in Latin America). The six-episode animated telenovela series chronicles the behavioral health journey of Maria, a Latina who is in her 40s and is experiencing depression. The six units from behavioral activation treatment for depression (BATD), including the core skills from each unit, are depicted in the telenovela series. Results indicated that 21 of the 32 participants (65.63%) who enrolled in the study completed treatment and 11 of the 32 participants (34.38%) dropped out of treatment. Intent-to-treat analysis revealed that participants experienced a statistically significant reduction in depressive symptom from pre- to posttreatment. Satisfaction ratings for the intervention and engagement with the intervention was high. Results from this study suggest that behavioral activation delivered via an online telenovela intervention format is a feasible and acceptable treatment approach for depressed SSLs.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 5","pages":"Pages 935-947"},"PeriodicalIF":3.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886469","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 Impact of Parental Cognitions on Outcomes of Behavioral Parent Training for Children With Conduct Problems","authors":"Georgette E. Fleming,&nbsp;Vilas Sawrikar,&nbsp;Silvana Kaouar,&nbsp;Bryan Neo,&nbsp;Campbell McDonogh,&nbsp;Eva R. Kimonis","doi":"10.1016/j.beth.2025.02.004","DOIUrl":"10.1016/j.beth.2025.02.004","url":null,"abstract":"<div><div>Despite decades of support for behavioral parent training, studies consistently comprise a proportion of families who do not experience sustained improvement in child conduct problems. Recent innovations to enhance treatment effects use predictors of treatment response to guide efforts to personalize treatment. We investigated whether baseline parental cognitions predicted response to Parent-Child Interaction Therapy (PCIT) in a sample of <em>N</em> = 61 children (<em>M</em> = 4.78 years, <em>SD</em> = 1.23, 74% boys) with conduct problems. Families received PCIT at an Australian urban university-based clinic. Parental positive and negative relational schemas were coded from baseline 5-minute speech samples. Linear mixed-effects models showed that mothers’ unhelpful cognitions predicted significantly less improvement in child conduct problems and internalizing problems, parenting stress, and observed parenting behaviors from baseline to follow-up. In contrast, children of fathers with unhelpful cognitions began treatment with more severe problems than other children, but experienced similar or greater magnitude of improvement in child conduct problems, paternal parenting stress, and observed paternal negative parenting behaviors during treatment relative to other children. Findings suggest that PCIT may be a useful alternative to parent-only behavioral parent training for fathers with unhelpful cognitions. We also discuss methods for tailoring PCIT for mothers with unhelpful cognitions to enhance treatment effects.</div><div>These trials were registered with the Australian and New Zealand Clinical Trial Registry (ACTRN12616000280404; ACTRN12616000221459).</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 5","pages":"Pages 917-934"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886212","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":"Insomnia Symptom Improvement as a Mediator for Mental Health Symptom Reduction Following Behavioral Insomnia Treatment Among Women Veterans","authors":"Alexander J. Erickson,&nbsp;Gwendolyn C. Carlson,&nbsp;Monica R. Kelly,&nbsp;Michael N. Mitchell,&nbsp;Constance H. Fung,&nbsp;Yeonsu Song,&nbsp;Sarah Kate McGowan,&nbsp;Karen Josephson,&nbsp;Michelle Zeidler,&nbsp;Donna L. Washington,&nbsp;Elizabeth M. Yano,&nbsp;Cathy A. Alessi,&nbsp;Jennifer L. Martin","doi":"10.1016/j.beth.2025.02.003","DOIUrl":"10.1016/j.beth.2025.02.003","url":null,"abstract":"<div><div>Cognitive-behavioral therapy for insomnia (CBT-I) improves comorbid mental health symptoms (depression, anxiety, and posttraumatic stress disorder [PTSD]), with sleep improvements hypothesized as the mechanism for the observed improvements. This study examined change in insomnia severity as a mediator of mental health symptom improvements in women veterans following behavioral insomnia treatment. Secondary analysis was conducted using data from a comparative effectiveness trial that evaluated insomnia outcomes in women veterans following CBT-I and an acceptance and commitment therapy-informed insomnia (ABC-I) treatment. The treatments were statistically equivalent in improving sleep, so were combined for the current analyses. The sample included 149 middle-age women veterans of diverse race and ethnicity (mean age 48 years, 34.2% White, 26.9% Black or African American, 18.8% Hispanic/Latinx). Variables of interest included insomnia severity (Insomnia Severity Index), and measures of depression (Patient Health Questionnaire–9) and generalized anxiety (Generalized Anxiety Disorder–7). A generalized structural equations model was conducted to test study hypotheses. Study treatment phase (baseline, posttreatment, 3-month follow-up) significantly predicted depression (–3.95 ≤ <em>b</em> ≤ –4.35, <em>p</em> &lt; .001) and anxiety (–4.29 ≤ <em>b</em> ≤ –4.75, <em>p</em> &lt; .001) symptom improvement in nonmediation models. Insomnia severity mediated improvement in depression and anxiety symptoms (0.515 ≤ <em>b</em> ≤ 0.584, <em>p</em> &lt; .001), with change in insomnia severity accounting for 88%–97% of depression and anxiety symptom reduction following insomnia-focused behavioral psychotherapies. This study identified reduction in insomnia severity as a major mechanism of improvement in depression and anxiety symptoms following behavioral insomnia treatment. Findings also reinforce the value of insomnia-focused behavioral psychotherapies in patients with comorbid mental health conditions.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 5","pages":"Pages 907-916"},"PeriodicalIF":3.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886211","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":"Effects of a Multifamily App-Enhanced Cognitive-Behavioral Therapy Delivered via Telehealth for Parents of Adolescents With Mood or Psychotic Spectrum Disorders","authors":"Marc J. Weintraub,&nbsp;Megan C. Ichinose,&nbsp;Jamie L. Zinberg,&nbsp;Anabel Salimian,&nbsp;Robin D. Brown,&nbsp;Georga Morgan-Fleming,&nbsp;Jennifer M. Gamarra,&nbsp;Tiffany Tran,&nbsp;David J. Miklowitz","doi":"10.1016/j.beth.2025.02.002","DOIUrl":"10.1016/j.beth.2025.02.002","url":null,"abstract":"<div><div>Parents of youth with mood or psychotic disorders are affected by and also impact the course of their offspring’s psychiatric illness(es). Few studies have examined the effects of family psychotherapy on parents’ mental health in this population. This study involved a multifamily group cognitive-behavioral therapy (CBT) for adolescents with mood or psychotic spectrum disorders and their parents, and tested whether a mobile application (app) could increase therapeutic engagement and skill practice. In a secondary analysis of a randomized controlled trial, we examined whether provision of an adjunctive app was associated with increases in parents' engagement in treatment skill practices and improvements in their emotional and parenting stress. Sixty adolescents and their primary parents were randomized into group cohorts to receive either an app-enhanced group delivery of the CBT unified protocol (AppUP) or the standard delivery of the group UP without an app, both delivered via telehealth. Families were followed over the 9-week treatment and 3 months posttreatment (21 weeks total). Unexpectedly, parents in AppUP reported fewer skill practices than parents in the standard UP. There were no differences between treatment conditions in parents’ psychological distress. In a within-group examination of the full sample (i.e., both treatment conditions), parents with higher psychological distress upon entry to the study showed greater decreases in their distress over the 21-week trial than those with lower distress at entry. These improvements in distress levels were positively associated with parents’ treatment skill practice and improvements in family functioning. Greater parental engagement in skill practice across both treatment conditions was also associated with improvements in adolescents’ psychiatric functioning. Among adolescents with mood or psychotic spectrum disorders, parental engagement in group CBT may contribute to reductions in parents' distress and improvements in the mental health of offspring.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 5","pages":"Pages 892-906"},"PeriodicalIF":3.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886312","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":"Racial Trauma and Mental Health: The Adaptive Role of Psychological Flexibility for Young Black Adults","authors":"Jasmin R. Brooks Stephens,&nbsp;Elijah R. Murphy,&nbsp;Matthew W. Gallagher,&nbsp;Rheeda L. Walker","doi":"10.1016/j.beth.2025.02.001","DOIUrl":"10.1016/j.beth.2025.02.001","url":null,"abstract":"<div><div>Although recent work has highlighted the relation of racial trauma and adverse mental health sequelae specifically among Black Americans, the potential mechanisms underlying these associations remain relatively unknown. The present study examined psychological flexibility as a mediator of the association between racial trauma and symptoms of depression, suicide ideation, and anxiety. A sample of 417 Black young adults between the ages of 18 and 29 (53.5% male; <em>M</em>_age = 24.7, <em>SD</em> = 2.5) were recruited from a southwestern public university and social media to complete an online self-report survey. Structural equation modeling (SEM) analyses revealed significant indirect effects of racial trauma on increased symptoms of depression, anxiety, and suicide ideation via lower levels of psychological flexibility. This study demonstrated a link between racial trauma and depressive symptoms, anxiety, and suicide ideation, providing further evidence for the significant psychological burden of racial trauma. Additionally, study findings suggest that psychological flexibility is a key intervention target that may reduce the adverse impact of race-based traumatic stress for Black young adults.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 5","pages":"Pages 879-891"},"PeriodicalIF":3.8,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886264","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 Impact of Depressive Symptoms on Overidentification of Anger in Couples: A Daily Diary Study","authors":"Ramya Ramadurai,&nbsp;Ella S. Sudit,&nbsp;Kathleen C. Gunthert,&nbsp;Nathaniel R. Herr","doi":"10.1016/j.beth.2025.01.007","DOIUrl":"10.1016/j.beth.2025.01.007","url":null,"abstract":"<div><div>Anger is intricately linked to symptoms of depression and has implications for functioning outcomes in romantic couples. There is a lack of research on whether symptoms of depression influence empathic accuracy of anger in couples, as well as whether perceptions of anger impact relationship quality for both partners. Using daily diary data, we examined these outcomes among 79 cohabitating couples (<em>n</em> = 158). Participants completed a baseline survey assessing relationship satisfaction and depression, as well as daily surveys rating their mood, their perception of their partner’s mood, and relationship satisfaction and closeness. Results indicated that partners of individuals with higher depressive symptoms display empathic inaccuracy of anger. They evidenced a bias towards perceiving higher participant anger even when participants themselves report low levels of anger or low overall negative affect. Partner bias towards perceiving their partners as angry predicted poorer ratings of relationship satisfaction and closeness from both partner and participant perspectives. Findings suggest that for couples in which one individual struggles with symptoms of depression, empathic inaccuracy of anger or biased perception of anger may be a mechanism by which interpersonal dysfunction is maintained.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 4","pages":"Pages 866-877"},"PeriodicalIF":3.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312827","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":"An Idionomic Network Analysis of Trichotillomania Treatment Processes: Gathering Group-Level and Individual-Level Insights to Inform a Personalized Therapeutic Framework","authors":"Mercedes G. Woolley,&nbsp;Baljinder K. Sahdra,&nbsp;Emily M. Bowers,&nbsp;Leila K. Capel,&nbsp;Michael P. Twohig,&nbsp;Michael E. Levin","doi":"10.1016/j.beth.2025.01.006","DOIUrl":"10.1016/j.beth.2025.01.006","url":null,"abstract":"<div><div>Trichotillomania, characterized by repetitive hair-pulling, leads to significant distress and impairment. Heterogeneity in symptom profiles challenges the effectiveness of treatment protocols for trichotillomania. Recent research endorses personalized treatment, emphasizing the assessment of biopsychosocial processes to tailor interventions more closely to the individual. This shift to a process-based, person-centered framework necessitates analytic methods capable of probing beyond nomothetic patterns to unveil nuanced individual-level processes. This study utilized Group Iterative Multiple Model Estimation (GIMME) to examine group-level and individual-level network dynamics as an initial step towards a process-based treatment framework for trichotillomania. Ecological momentary assessment data from 54 affected individuals were analyzed to identify shared patterns applicable at the group level and individual level for individualized treatment. Analysis revealed a nomothetic process dynamically related to cognitive fixation on the urge to pull. At the individual level, notable variability in network structures emerged. While centrality measures consistently identified the urge to pull as a pivotal process within GIMME individual-level networks, the influence of other processes differed considerably between individuals. Results indicate that despite some shared components, the heterogeneity within individual networks calls for customized treatment approaches, and the assessment of psychological process dynamics at the individual level. These insights support incorporating idionomic methods into the developmental stages of personalized interventions.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 4","pages":"Pages 851-865"},"PeriodicalIF":3.4,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312826","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":"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":"2025-01-21","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}

{"title":"Anxiety, Worry, and Difficulty Concentrating: A Longitudinal Examination of Concurrent and Prospective Symptom Relationships","authors":"Mary Blendermann,&nbsp;Rosanna Breaux,&nbsp;Eiko I. Fried,&nbsp;Kristin Naragon-Gainey,&nbsp;Lisa R. Starr,&nbsp;Jeremy Stewart,&nbsp;Bethany A. Teachman ,&nbsp;COVID-19 Mental Health Workgroup ,&nbsp;Lauren S. Hallion","doi":"10.1016/j.beth.2025.01.004","DOIUrl":"10.1016/j.beth.2025.01.004","url":null,"abstract":"<div><div>Difficulty concentrating is an understudied cognitive phenomenon, despite its status as a diagnostic criterion for generalized anxiety disorder and contributor to clinically significant distress and impairment. Worry may constitute a cognitive mechanism by which anxiety leads to difficulty concentrating. The present study examined concurrent and prospective associations between self-reported anxiety, worry, and subjective difficulty concentrating across three timepoints (T1 April/May, T2 July/August, T3 October/November 2020) in 198 adults (<em>M</em> age = 37.94, <em>SD</em> = 13.42; 81% women, 2% gender minority) drawn from a larger study of trajectories of psychopathology during the COVID-19 pandemic. In multilevel models, anxiety was associated with worry both between (<em>β</em> = 0.65, <em>SE</em> = 0.13) and within participants (<em>β</em> = 0.12, <em>SE</em> = 0.11). Difficulty concentrating was also associated with worry between (<em>β</em> = 0.38, <em>SE</em> = 0.03) and within participants (<em>β</em> = 0.09, <em>SE</em> = 0.02). In a structural equation model, worry partially mediated the longitudinal association between anxiety and difficulty concentrating, though this effect was nonsignificant after controlling for difficulty concentrating at T2 and worry, depression, sleep disturbance, and difficulty concentrating at T1. The unadjusted mediation and these other findings are in line with theoretical accounts of worry as a cognitive mechanism linking anxiety to subjective attentional problems.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 4","pages":"Pages 838-850"},"PeriodicalIF":3.4,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312878","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}