Behavior TherapyPub Date : 2025-11-01Epub Date: 2025-05-14DOI: 10.1016/j.beth.2025.05.002
Tapan A. Patel, James M. Zech, Jesse R. Cougle
{"title":"Two Studies on the Role of Appearance Concerns in Social Anxiety and Depression","authors":"Tapan A. Patel, James M. Zech, Jesse R. Cougle","doi":"10.1016/j.beth.2025.05.002","DOIUrl":"10.1016/j.beth.2025.05.002","url":null,"abstract":"<div><div>Appearance concerns are a core feature of multiple psychiatric disorders, including body dysmorphic disorder and eating disorders; however, some have argued that they may also play a key role in social anxiety and depression. The present study sought to determine whether reductions in appearance concerns explain reductions in social anxiety and depression in two separate studies. Two studies examined the effects of fading appearance-related safety behaviors (ARSB; i.e., behaviors meant to avoid or reduce a perceived feared outcome related to appearance) experimentally (Study 1) or in a treatment context (Study 2). In Study 1 (<em>N</em> = 94), we found that changes in appearance concerns fully accounted for the effect of fading ARSBs on social anxiety and depression in a clinical sample of women; further, pre- to mid-manipulation changes in appearance concerns (across conditions) predicted residual change in social anxiety at post. In Study 2, among a large community sample of women (<em>N</em> = 203) who participated in a 1-month smartphone-based treatment for appearance concerns, we found that pre- to posttreatment changes in appearance concerns mediated the effect of ARSB fading on social anxiety at 1-month follow-up. Additionally, we found that regardless of condition, changes in appearance concerns predicted residual change in depression one-month later. Taken together, the present findings suggest that appearance concerns may maintain symptoms of social anxiety and depression, and changes in appearance concern may indirectly lead to changes in these outcomes.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 6","pages":"Pages 1082-1095"},"PeriodicalIF":3.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340981","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}
Behavior TherapyPub Date : 2025-11-01Epub Date: 2025-06-14DOI: 10.1016/j.beth.2025.06.001
Christina Dyar, Ethan Morgan
{"title":"Shared and Unique Effects of Enacted Stigma Based on Sexual Identity, Age, and Race/Ethnicity Among a Sample of Sexual and Gender Minority Older Adults","authors":"Christina Dyar, Ethan Morgan","doi":"10.1016/j.beth.2025.06.001","DOIUrl":"10.1016/j.beth.2025.06.001","url":null,"abstract":"<div><div>Numerous daily diary studies have demonstrated that sexual minority enacted stigma is associated with elevated same-day anxious/depressed affect. Despite the multiple marginalized identities held by many sexual and gender minorities (SGM), studies have rarely examined other types of enacted stigma (e.g., racism, ageism) experienced by SGM at the daily level. Further, it is unclear whether enacted stigma based on different identities have similar or distinct effects on anxious/depressed affect. The current study aimed to examine the effect of experiencing enacted stigma based on any marginalized identity on anxious/depressed affect (i.e., a common enacted stigma effect) and to determine if specific types of enacted stigma have unique effects above and beyond this common enacted stigma effect. We utilized ecological momentary assessment data from a sample of SGM older adults (50+ in age; 38% people of color). Experiencing any type of enacted stigma was associated with elevated anxious/depressed affect during the same observation. No specific types of enacted stigma predicted anxious/depressed affect above and beyond the common enacted stigma effect. Among SGM of color, experiencing multiple types of enacted stigma during the same observation was associated with additional anxious/depressed affect, but this did not generalize to the full sample. Results suggest that enacted stigma has a concurrent effect on anxious/depressed affect regardless of the targeted identity and specific types of enacted stigma do not have additional effects. This has potential implications for future research on effects of enacted stigma at the daily level, particularly among samples with multiple marginalized identities.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 6","pages":"Pages 1185-1196"},"PeriodicalIF":3.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340935","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}
Behavior TherapyPub Date : 2025-11-01Epub Date: 2025-05-22DOI: 10.1016/j.beth.2025.05.003
Margaret E. Crane , Julia S. Ney , Katherine E. Holland, Jonathan Rabner, Marisa L. Meyer, Anthony J. Leon, Abigail M. Farina, Madison R. Brown, Philip C. Kendall
{"title":"Children’s Literature on Anxiety: A Systematic Review and Content Analysis","authors":"Margaret E. Crane , Julia S. Ney , Katherine E. Holland, Jonathan Rabner, Marisa L. Meyer, Anthony J. Leon, Abigail M. Farina, Madison R. Brown, Philip C. Kendall","doi":"10.1016/j.beth.2025.05.003","DOIUrl":"10.1016/j.beth.2025.05.003","url":null,"abstract":"<div><div>Children’s literature can teach life lessons and effective coping strategies, and can be a way to disseminate practice elements (i.e., building blocks of evidence-based practices) for mental health as a universal prevention strategy. We conducted a content analysis on the presence of practice elements for youth anxiety in children’s literature picture books about anxiety.</div><div>Analytic plan was preregistered on OSF. Books 1,640 children’s literature books were screened, and 191 books were coded for eight practice elements for youth anxiety: psychoeducation, labeling body sensations, relaxation, cognitive, problem solving, contingency management (e.g., rewards and praise), exposure, and post-exposure processing.</div><div>Characters in the books modeled an average of 2.39 practice elements (<em>SD</em> = 1.76). The most frequently modeled practice elements were cognitive (60% of books), exposure (46%), and labeling body sensations (42%). The least commonly modeled practice element was contingency management (7%). Books written by mental health professionals were more likely to demonstrate post-exposure processing. Books with additional self-help information were more likely to model post-exposure processing and relaxation skills. Books written for youth age 9–12 years modeled more practice elements than books written for youth age 8 years and younger.</div><div>Children’s books on youth anxiety model relatively few practice elements. Although exposure was one of the most used practice elements, 54% of books with an anxious character do not model having that character face their fears—a key strategy for youth anxiety. Additionally, few books demonstrate use of rewards and praise by caregivers, who often read stories with their children. Clinicians, caregivers, and librarians are encouraged to purchase books written by therapists or with self-help information, given that these books are more likely to model practice elements.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 6","pages":"Pages 1096-1104"},"PeriodicalIF":3.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145341019","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}
Behavior TherapyPub Date : 2025-11-01Epub Date: 2025-04-22DOI: 10.1016/j.beth.2025.04.004
Sophie Mazza, Matthew Kieran, Kate E. Tonta, David M. Erceg-Hurn, Amanda Swan, Bruce N.C. Campbell, Peter M. McEvoy
{"title":"Online Group Metacognitive Therapy for Repetitive Negative Thinking: A Pilot Study","authors":"Sophie Mazza, Matthew Kieran, Kate E. Tonta, David M. Erceg-Hurn, Amanda Swan, Bruce N.C. Campbell, Peter M. McEvoy","doi":"10.1016/j.beth.2025.04.004","DOIUrl":"10.1016/j.beth.2025.04.004","url":null,"abstract":"<div><div>Group metacognitive therapy (MCT) for anxiety and depression has been shown to be effective, but access could be increased if delivered via telehealth. This pilot study compared outcomes for individuals with anxiety disorders and depression who received group MCT via telehealth (<em>N</em> = 23) to historical controls that received face-to-face (F2F) MCT (<em>N</em> = 52). Patients received six weekly, 2-hour group sessions plus a 1-month follow-up of MCT in a community mental health clinic and completed measures of repetitive negative thinking (RNT), metacognitive beliefs (positive and negative), and symptoms (anxiety, depression) at pretreatment, posttreatment, and follow-up. Group MCT via telehealth achieved medium to very large effects on all outcomes to posttreatment and follow-up. The telehealth and F2F MCT groups did not significantly differ on any demographic or clinical variable at pretreatment. Between-group effect sizes, rates of reliable and clinically significant change, and participant evaluations of treatment acceptability and satisfaction were similar for the two modes of delivery at posttreatment and/or follow-up. Overall, these preliminary findings indicate that telehealth-delivered group MCT is a promising transdiagnostic intervention for anxiety disorders and depression.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 6","pages":"Pages 1041-1054"},"PeriodicalIF":3.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340978","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}
Behavior TherapyPub Date : 2025-11-01Epub Date: 2025-04-25DOI: 10.1016/j.beth.2025.04.005
Mingcong Tang, Laura J. Long, Marie Torre, Daniella Spencer-Laitt, Julián D. Moreno-Villamizar, David H. Barlow, Todd J. Farchione
{"title":"Cognitive Reappraisal as a Potential Mechanism of Unified Protocol for Emotional Disorders","authors":"Mingcong Tang, Laura J. Long, Marie Torre, Daniella Spencer-Laitt, Julián D. Moreno-Villamizar, David H. Barlow, Todd J. Farchione","doi":"10.1016/j.beth.2025.04.005","DOIUrl":"10.1016/j.beth.2025.04.005","url":null,"abstract":"<div><div>This study aimed to investigate changes in cognitive reappraisal as a mechanism of the unified protocol (UP) for emotional disorders. Data were collected as part of a larger randomized clinical equivalence trial that assessed the efficacy of the UP, a transdiagnostic cognitive-behavioral therapy (CBT), relative to well-established single-disorder protocols and a wait-list control. The present sample included 132 individuals with primary diagnoses of panic disorder, generalized anxiety disorder, social anxiety disorder, or obsessive-compulsive disorder who were randomized to either the UP or the control group. They were assessed at five major time points during treatment, as well as a 6- and 12-month follow-up. Measures included the Overall Anxiety Severity and Impairment Scale for anxiety symptoms, the Overall Depression Severity and Impairment Scale for depression symptoms, and the Emotion Regulation Questionnaire to assess cognitive reappraisal. Multilevel mixed-effects models showed that cognitive reappraisal skills improved significantly over time in the UP group compared to a wait-list control group. Within the UP group, increases in cognitive reappraisal predicted subsequent reductions in anxiety and depression scores at the following time point. The greatest degree of improvement in cognitive reappraisal was observed at the last two time points during treatment, and these gains were sustained across the follow-up period. These findings underscore the importance of cognitive reappraisal, suggesting that it functions as a key transdiagnostic mechanism contributing to the UP’s efficacy in treating emotional disorders. This research highlights the necessity for targeted interventions to enhance reappraisal skills, informing the optimization of the UP for individuals with emotional disorders.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 6","pages":"Pages 1055-1067"},"PeriodicalIF":3.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340979","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}
Behavior TherapyPub Date : 2025-11-01Epub Date: 2025-06-28DOI: 10.1016/j.beth.2025.06.004
Azure Reid-Russell, Matthew K. Nock
{"title":"Interoceptive Accuracy, Sensitivity, and Attention are Associated with Suicidal Thoughts and Behaviors","authors":"Azure Reid-Russell, Matthew K. Nock","doi":"10.1016/j.beth.2025.06.004","DOIUrl":"10.1016/j.beth.2025.06.004","url":null,"abstract":"<div><div>Suicide is a leading cause of death. Although significant research has focused on suicide, surprisingly little examines the role of interoception, or the perception of internal bodily states. We examined associations between dimensions of interoception and suicidal thoughts and behaviors (STBs). This online study (<em>N</em> = 450) assessed self-reported interoceptive accuracy, sensitivity, and attention as well as STBs. People with recent STBs reported perceiving body sensations less accurately (i.e., lower interoceptive accuracy), difficulty perceiving lower intensity sensations (i.e., lower interoceptive sensitivity), and paying more attention to sensations (i.e., greater interoceptive attention). Interoceptive sensitivity moderated the association between negative affect and recent suicidal behaviors, such that people with lower interoceptive sensitivity (i.e., difficulty perceiving lower intensity sensations) were more likely to report suicidal behaviors at all levels of negative affect, whereas people with higher interoceptive sensitivity were more likely to report suicidal behaviors only at high levels of negative affect. This study examines cross-sectional, self-reported associations between interoceptive processes and STBs. Future work should focus on examining objective measures of interoception and longitudinal associations. We provide evidence that the process of perceiving and understanding internal body states may differ for people with suicidal thoughts and behaviors – people with suicidal thoughts and behaviors described perceiving their body sensations inaccurately, especially when sensations were low intensity, and attending to their body sensations often. Interoception may represent an important, underexamined process for understanding STBs.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 6","pages":"Pages 1170-1184"},"PeriodicalIF":3.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340934","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}
Behavior TherapyPub Date : 2025-11-01Epub Date: 2025-05-19DOI: 10.1016/j.beth.2025.05.004
Dana Basel, Rotem Asher, Amit Lazarov
{"title":"Attention Allocation in OCD: Contrasting Obsession-Provoking Stimuli With Stimuli Signaling the Completion of Compulsive Acts","authors":"Dana Basel, Rotem Asher, Amit Lazarov","doi":"10.1016/j.beth.2025.05.004","DOIUrl":"10.1016/j.beth.2025.05.004","url":null,"abstract":"<div><div><span>Research on attention allocation in obsessive-compulsive disorder (OCD) shows that obsessive-compulsive individuals are biased toward stimuli reflecting the completion of compulsive acts (end-states stimuli) over traditional obsession-provoking threatening stimuli. Yet, past research compared individuals with high and low levels of obsessive-compulsive symptoms, restricting generalizability to clinical OCD, while also inherently confounding OCD and anxiety symptoms. The present addressed both limitations. Participants with OCD (</span><em>n</em> = 32), participants with anxiety disorders (AN; <em>n</em> = 30), and healthy control participants (HC; <em>n</em> = 33) freely viewed 2-by-2 picture matrices, each presented for 8 seconds, contrasting two types of pictures: obsession-provoking threat pictures and end-state pictures. Gaze data was recorded throughout. Participants’ subjective discomfort experienced while viewing the different pictures was also assessed. Participants with OCD dwelled longer on end-state stimuli, compared to obsession-provoking threat stimuli, while AN and HC participants demonstrated no difference in dwell time between the two picture types. While all participants experienced less discomfort when viewing end-sate pictures, compared with obsession-provoking threat pictures, this difference was largest among OCD participants. Moreover, an indirect-only mediation effect emerged when using this difference in subjective discomfort as a mediator of group differences in attention allocation to the two picture types. Finally, task reliability was found to be high. Biased attention allocation toward stimuli associated with the completion of compulsive acts over obsession-provoking threat stimuli generalizes to clinical OCD. This biased attention allocation pattern may, in turn, serve as a novel target for attention bias modification procedures in OCD.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 6","pages":"Pages 1105-1117"},"PeriodicalIF":3.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145341020","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}
Behavior TherapyPub Date : 2025-11-01Epub Date: 2025-05-08DOI: 10.1016/j.beth.2025.05.001
Bryce D. McLeod, Erica Ross, Grace Li, Robert Cross, Heather A. Jones, Michael A. Southam-Gerow, Bruce F. Chorpita, John R. Weisz
{"title":"Initial Score Reliability and Validity of an Observer-Rated Caregiver-Clinician Alliance Scale in Treatment for Youth Anxiety","authors":"Bryce D. McLeod, Erica Ross, Grace Li, Robert Cross, Heather A. Jones, Michael A. Southam-Gerow, Bruce F. Chorpita, John R. Weisz","doi":"10.1016/j.beth.2025.05.001","DOIUrl":"10.1016/j.beth.2025.05.001","url":null,"abstract":"<div><div>The caregiver-clinician alliance plays a vital role in youth psychosocial treatment. However, the psychometric properties of observer-rated instruments designed to assess the caregiver-clinician alliance have not been adequately assessed. To address this gap, this study examined the interrater reliability, item performance, and validity of scores on the Therapy Process Observational Coding System for Child Psychotherapy–Alliance Caregiver scale (TPOCS-A) used to assess the caregiver-clinician alliance in two independent samples of youth with primary anxiety problems who participated in randomized effectiveness trials. The first sample was comprised of 38 racially and ethnically diverse youth (<em>M</em> age = 10.83 years, <em>SD</em> = 2.11; 57.9% female), whereas the second sample was comprised of 55 racially and ethnically diverse youth (<em>M</em> age = 9.89 years, <em>SD</em> = 1.71; 54.5% female). Treatment sessions from both samples were coded by independent coders using the TPOCS-A along with observer-rated instruments of alliance, treatment adherence, and clinician competence. Across the samples, the interrater reliability, ICC(2,2), of the TPOCS-A Caregiver item scores ranged from −.04 to .78. TPOCS-A items were used to form two subscales (Bond & Task, Goal), and internal consistency ranged from .56 to .77 across the samples. Scores on the TPOCS-A Caregiver subscales (Bond & Task, Goal) evidenced convergent validity with scores on observer-report caregiver-clinician alliance instruments and discriminant validity with scores on adherence and competence instruments. Overall, the findings provide preliminary support for the reliability and validity of the TPOCS-A Caregiver scale and subscale scores.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 6","pages":"Pages 1068-1081"},"PeriodicalIF":3.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340980","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}
Behavior TherapyPub Date : 2025-09-01Epub Date: 2025-03-08DOI: 10.1016/j.beth.2025.03.001
Rosy L. Chavez-Najera, Lorraine T. Benuto
{"title":"Necesito Un Psicólogo: A Feasibility Study Examining a Behavioral Activation Telenovela Intervention for Depressed Latinas","authors":"Rosy L. Chavez-Najera, 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":"2025-09-01","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}
Behavior TherapyPub Date : 2025-09-01Epub Date: 2025-03-26DOI: 10.1016/j.beth.2025.03.005
Leah Bullinger , Afsoon Gazor , Stephen Buerkert, Savannah M. Dieste, W. David Brown, Sunita M. Stewart
{"title":"Dysfunctional Beliefs About Sleep in Suicidal Adolescents: Associations and Treatment Implications","authors":"Leah Bullinger , Afsoon Gazor , Stephen Buerkert, Savannah M. Dieste, W. David Brown, Sunita M. Stewart","doi":"10.1016/j.beth.2025.03.005","DOIUrl":"10.1016/j.beth.2025.03.005","url":null,"abstract":"<div><div>Cognitive behavior therapy for insomnia has shown increasing promise in reducing suicidality in adults and may be effective in reducing suicidality in adolescents. Dysfunctional beliefs about sleep (DBs) are a primary target of such interventions. However, there are few studies of DBs in adolescents, let alone suicidal adolescents. Our study (1) assessed the sleep and suicide-related correlates of DBs, and (2) examined if change in DBs was associated with change in sleep, in a sample of acutely suicidal adolescents aged 12–18 years in an intensive cognitive behavior therapy–informed treatment program that did not target sleep. Measures of DBs (using the 16-item Dysfunctional Beliefs About Sleep Scale’s (DBAS) total score and four subscale scores: Consequences, Helplessness, Expectations, and Medications), sleep disturbance, depressive symptoms, emotion regulation, and suicide ideation were administered at program admission and discharge. Total DBs were concurrently associated (all <em>p</em>s < .05) with sleep disturbance, depressive symptoms, emotion regulation, and suicide ideation, and reduction of DBs was associated with improvement in sleep over treatment. There was some variability in the association between types of DBAS and variables of interest, with the Helplessness subscale showing the strongest and most consistent associations. Limitations include subjective measurements only, a lack of specific insomnia symptom measures, and a nondiverse sample. DBs show promise as a target in the management of suicidal adolescents. Our findings also suggest that the development of an adolescent-specific scale could enhance construct measurement validity.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 5","pages":"Pages 979-988"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886472","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}