Behavior Therapy最新文献

{"title":"State of the Science: Disgust and the Anxiety Disorders","authors":"","doi":"10.1016/j.beth.2024.02.005","DOIUrl":"10.1016/j.beth.2024.02.005","url":null,"abstract":"<div><div>Anxiety disorders have long been conceptualized as disorders of fear, while other emotions have largely been overlooked. However, an emerging literature has increasingly implicated disgust in certain anxiety-related disorders, including obsessive–compulsive disorder, specific phobias (e.g., spider phobia), health anxiety, and posttraumatic stress disorder. Roughly two decades of research has accumulated evidence identifying various mechanisms linking disgust-related phenomena to these disorders. In the present “State of the Science” review, we sought to summarize the current state of the literature with respect to disgust-related mechanisms in anxiety disorders, including trait-level vulnerabilities (e.g., disgust proneness), cognitive processes (e.g., biases of attention and memory), and associated learning mechanisms (e.g., evaluative conditioning). Research in these areas has revealed important ways in which disgust differs from fear-related phenomena, which have important treatment implications. From there, we sought to summarize research on laboratory interventions that attempt to target and attenuate disgust, as well as the early research on formal cognitive-behavioral treatments that integrate disgust-related interventions for anxiety disorders. Although the past two decades of research have revealed important insights related to the role of disgust in psychopathology, much remains to be learned in this area. We propose some future directions, emphasizing the importance of a guiding framework that highlights studying disgust-related mechanisms across different levels of analysis.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 6","pages":"Pages 1144-1157"},"PeriodicalIF":3.4,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140322119","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":"Psychometric Evaluation of the Insomnia Severity Index in U.S. College Students","authors":"","doi":"10.1016/j.beth.2024.02.003","DOIUrl":"10.1016/j.beth.2024.02.003","url":null,"abstract":"<div><p><span>Psychometric properties of the Insomnia Severity Index (ISI) were analyzed in U.S. college samples. ISI items and total score with sleep and psychosocial questionnaires were examined in Experiment I. ISI diagnostic accuracy in a clinical sample with and without insomnia was assessed in Experiment II. ISI test–retest validity, confirmatory factor analysis (CFA), and item response theory via graded response model (GRM) were assessed in Experiment III. Results indicated analogous ISI and sleep diary items showed moderate correlations (</span><em>r</em>₁ <em>=</em> .40; <em>r</em>₂ = .45). The ISI total had weak to strong correlations with other indicators of sleep-related disturbance (<em>r</em>s = .25–.62). The ISI had weak to moderate correlations with psychosocial measures commonly associated with insomnia (<em>r</em>s = .10–.57). The diagnostic accuracy of the ISI was very high (area under the curve [AUC] = .999). Sensitivity and specificity were maximized at a cutoff score ≥ 8. The ISI demonstrated good test–retest reliability (ICC = .87). CFA revealed a three-factor model for two study samples and GRM indicated better ability of the ISI to assess moderate (Sample III) and moderate to high (Sample I) levels of insomnia severity. The ISI demonstrated good psychometric properties and appears generally valid for screening insomnia disorder and assessing insomnia severity in college students. Overlap with psychological symptoms suggests caution while interpreting these constructs independently.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 5","pages":"Pages 990-1003"},"PeriodicalIF":3.4,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140322114","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 In-Depth Exploration of the Relationship Between Suicidal Ideation and Emotion Processes in Adolescents","authors":"","doi":"10.1016/j.beth.2024.02.002","DOIUrl":"10.1016/j.beth.2024.02.002","url":null,"abstract":"<div><p>Previous research has shown a relationship between proximal (i.e., close-in-time) emotion experiences and suicidal ideation (SI). Yet, it remains unclear which emotion processes (i.e., the level of the emotion [intensity], how much emotions vary [variability], emotional consistency [inertia], how specific emotions are [differentiation]) and which emotions (i.e., sadness, hopelessness, anger, nervousness, happiness) are most potent predictors of SI. Seventy-seven adolescents (67.5% assigned female at birth) completed daily diaries for 4 weeks after psychiatric hospitalization. Levels of the above-mentioned emotions and frequency of SI were recorded. For each week and each emotion, mean (intensity), standard deviation (variability), autocorrelation (inertia), and intraclass correlation coefficients (ICCs; negative emotion differentiation) were calculated (i.e., four observations/person). Multilevel models examined whether (a) mean intensity, variability, and their interaction; and (b) mean intensity, inertia, and their interaction, were related to mean weekly SI frequency. A separate model examined whether negative emotion differentiation was related to mean weekly SI frequency after adjusting for mean intensity. A significant interaction between mean intensity of anger and variability of anger emerged (<em>B</em> = 0.54, <em>SE</em> = 0.24, <em>p</em> = .023); a positive relationship between mean anger and mean SI frequency was present at moderate or high levels of anger variability but not at its low levels. Mean intensity of most emotions was related to SI frequency in the expected directions. No other statistically significant findings emerged. Results revealed the importance of considering multiple emotion features, their dynamic nature, and their combined effect. Future research should explore mechanisms accounting for anger being related to heightened proximal SI, along with an examination of effective intervention strategies to reduce anger intensity and variability.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 5","pages":"Pages 961-973"},"PeriodicalIF":3.4,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140196583","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":"Latent Change Trajectories in Mood During Focused CBT Enhanced for Eating Disorders Are Associated With Global Eating Pathology at Posttreatment and Follow-Up Among Individuals With Bulimia Nervosa Spectrum Disorders: A Preliminary Examination","authors":"","doi":"10.1016/j.beth.2024.01.005","DOIUrl":"10.1016/j.beth.2024.01.005","url":null,"abstract":"<div><p>Bulimia nervosa (BN) is characterized by recurrent loss of control over eating (LOC) and inappropriate compensatory behaviors. Although cognitive-behavioral therapy (CBT) is efficacious for BN, many patients continue to experience symptoms at posttreatment. One potential driver of this low treatment response may be low mood, which maintains BN symptoms through negative reinforcement. Thus, it is important to understand how mood changes over enhanced cognitive-behavioral therapy (CBT-E) and whether these changes are associated with improved treatment outcomes. Participants (<em>N</em> = 56) with BN-spectrum eating disorders (EDs) received 16 sessions of the focused version of CBT-E. The Eating Disorder Examination (EDE) was used to measure ED symptoms (global ED pathology, frequency of binge episodes, and compensatory behaviors) at pre- and posttreatment. Latent growth mixture modeling (LGMM) of affective ratings via digital self-monitoring identified latent growth classes. Kruskal–Wallis <em>H</em> tests examined the effect of trajectory of change in mood on pre- to posttreatment symptom change. LGMM yielded a four-class model that best fit the data representing distinct mood trajectories over the course of treatment: (a) highest baseline mood, linear improving; (b) moderate baseline mood, stable; (c) moderate baseline mood, quadratic worsening; and (d) lowest baseline mood, quadratic improving. Participants who demonstrated worsening mood over treatment (i.e., individuals in the “moderate baseline mood, quadratic worsening” class) had significantly higher EDE global scores at posttreatment and follow-up compared to participants with stable mood across treatment. Change in LOC eating frequency and compensatory behaviors across treatment did not significantly differ by mood class. The main effect of mood class or interaction effect between time and mood class on objective binge episodes, subjective binge episodes, and compensatory behaviors was not significant. There were no significant differences in global ED pathology at either posttreatment or follow-up for any other class comparisons. These results suggest that certain trajectories of change in mood during treatment are particularly associated with change in pre- to posttreatment EDE global score. If replicated, our findings could suggest that future iterations of CBT-E should target mood early in treatment in order to maximize reductions in global eating pathology.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 5","pages":"Pages 950-960"},"PeriodicalIF":3.4,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139828524","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":"Emotion Regulation in Obsessive-Compulsive Disorder: An Ecological Momentary Assessment Study","authors":"","doi":"10.1016/j.beth.2024.01.011","DOIUrl":"10.1016/j.beth.2024.01.011","url":null,"abstract":"<div><p>Emotion dysregulation is a central process implicated in the genesis and maintenance of obsessive-compulsive disorder (OCD). However, past research on OCD has examined emotion regulation with a trait-level approach, thereby neglecting important situational and temporal dynamics. The present study is the first one to examine moment-to-moment emotion regulation in individuals with OCD. A 6-day ecological momentary assessment was used to assess affect, emotion regulation strategies, perceived effectiveness of emotion regulation strategies, and acceptance of emotional experiences in <em>n</em> = 72 individuals with OCD and <em>n</em> = 54 psychologically healthy controls. As expected, individuals with OCD reported more negative and less positive affect. Group differences in positive (but not negative) affect did remain significant when controlling for baseline depression. Furthermore, the OCD group reported to use a higher momentary number of avoidance-oriented regulation strategies and less perceived effectiveness of emotion regulation, even when controlling for current symptoms and negative affect or baseline depression scores. Further, irrespective of group, more momentary negative affect amplified use of avoidance-oriented strategies and diminished perceived effectiveness and emotional acceptance. Contrary to expectations, these effects were not more pronounced in the OCD group. Possible explanations for unexpected findings and implications for future research, particularly regarding more holistic emotion regulation treatments, are discussed.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 5","pages":"Pages 935-949"},"PeriodicalIF":3.4,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0005789424000224/pdfft?md5=05d3111385962313d80bf7c8f127d516&pid=1-s2.0-S0005789424000224-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139874795","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":"Clinician Knowledge of and Attitudes Toward Guided Self-Help","authors":"","doi":"10.1016/j.beth.2024.01.006","DOIUrl":"10.1016/j.beth.2024.01.006","url":null,"abstract":"<div><p>The current study evaluated knowledge of and attitudes toward guided self-help (GSH) among clinicians who use evidence-based practices to treat one or more of the following: panic disorder, major depressive disorder, bulimia nervosa, binge-eating disorder, and generalized anxiety disorder. A total of 153 of 256 individuals recruited online and at professional conferences were eligible. This study assessed prior experience with and knowledge of GSH, as well as hypothetical use with a mock patient. Less than 20% of clinicians had ever used GSH, and fewer had used it as a stand-alone treatment. Given a mock patient reporting moderate symptoms, clinicians indicated a 53.62% likelihood that they would use GSH. Exploratory analyses indicated that hypothetical use was predicted by prior use of GSH as well as the Openness subscale of the Evidence-Based Practice Attitude Scale. Study findings suggest that clinicians using evidence-based practices do not uniformly know of or endorse the use of GSH. Lack of training in GSH was one of the most frequently endorsed barriers to implementing GSH in clinical practice (<em>n</em> = 99, 64%). These findings have implications for the use of therapy formats that scale evidence-based treatments in the United States.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 5","pages":"Pages 922-934"},"PeriodicalIF":3.4,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139883603","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":"Corrigendum to “Feasibility of Automated Training for Facial Emotion Expression and Recognition in Autism” [Behav. Therapy 49(6) (2018) 881–888]","authors":"Susan W. White,&nbsp;Lynn Abbott,&nbsp;Andrea Trubanova Wieckowski,&nbsp;Nicole N. Capriola-Hall,&nbsp;Sherin Aly,&nbsp;Amira Youssef","doi":"10.1016/j.beth.2024.01.002","DOIUrl":"10.1016/j.beth.2024.01.002","url":null,"abstract":"","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 2","pages":"Page 429"},"PeriodicalIF":3.7,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0005789424000078/pdfft?md5=6161ab76472911bd756c50ac87ef2e7d&pid=1-s2.0-S0005789424000078-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139649043","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":"Corrigendum to “Group Differences in Facial Emotion Expression in Autism: Evidence for the Utility of Machine Classification” [Behav. Therapy 50(4) (2019) 828–838]","authors":"Nicole N. Capriola-Hall,&nbsp;Andrea Trubanova Wieckowski,&nbsp;Deanna Swain,&nbsp;Sherin Aly,&nbsp;Amira Youssef,&nbsp;A. Lynn Abbott,&nbsp;Susan W. White","doi":"10.1016/j.beth.2024.01.003","DOIUrl":"10.1016/j.beth.2024.01.003","url":null,"abstract":"","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 2","pages":"Page 430"},"PeriodicalIF":3.7,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S000578942400008X/pdfft?md5=1caa2d7ded95322d8f2a5cfb77ccc8fe&pid=1-s2.0-S000578942400008X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139648927","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":"Naturalistic evaluation of HeadGear: A smartphone app to reduce depressive symptoms in workers","authors":"Mark Deady, Daniel A. J. Collins, Nicholas Glozier, Evangeline Gardiner, Andrew Arena, Aimee Gayed, Richard Bryant, Rafael A. Calvo, Samuel B. Harvey","doi":"10.1016/j.beth.2024.01.001","DOIUrl":"https://doi.org/10.1016/j.beth.2024.01.001","url":null,"abstract":"<p>Mobile health (mHealth) apps have the potential to expand access to evidence-based interventions for mental health conditions, including depression. <em>HeadGear</em> was developed to prevent depression and improve wellbeing among the working population and was associated with significant positive effects in an efficacy trial. This study presents the results from a naturalistic trial intended to evaluate real-world usage of the app. We examined the naturalistic use of <em>HeadGear</em> between March 2019 and March 2022, using app analytic data, in-app event data, and surveys assessing depressive symptoms, wellbeing, and work performance repeated at 30-day intervals over 5-month app usage. During the observation period, <em>HeadGear</em> was widely disseminated to the public, and downloaded 26,455 times. Of those who downloaded the app, 12,995 completed baseline. The mean age of users was 38.23 (<em>SD</em> = 12.39) and 60% were women. Approximately one in four met criteria for probable depression at baseline. Depressive symptoms showed consistent improvement at all timepoints (Cohen’s <em>d</em> ranging from 0.24 at 1 month to 0.13 at 5 months). A similar pattern emerged for wellbeing. Work performance showed improvement to 2-month follow-up only. The strongest change was found for those with greater symptom severity at baseline, and those with high app engagement. Attrition at follow-up points was high. Findings regarding the real-world use of <em>HeadGear</em> are promising and highlight the use of such apps among those with higher symptom severity (despite the intended use of the app as a prevention tool). Further work is required to tailor mHealth apps to reach their full potential through an enhanced understanding of the utility of individual features for effectiveness and engagement.</p>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"82 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139463548","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, Allison Heinrich, Elizabeth McIngvale, Jennifer Sy, Michael G. Wheaton, Thröstur Björgvinsson","doi":"10.1016/j.beth.2023.12.006","DOIUrl":"https://doi.org/10.1016/j.beth.2023.12.006","url":null,"abstract":"<p>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.</p>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"1 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-01-03","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}