Behavior Therapy最新文献

{"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":"2025-09-01","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":"Exploring Structural Adaptations to Cognitive Processing Therapy: A Systematic Review and Meta-Analysis","authors":"Priyadharshany Sandanapitchai,&nbsp;Reginald D.V. Nixon","doi":"10.1016/j.beth.2025.03.003","DOIUrl":"10.1016/j.beth.2025.03.003","url":null,"abstract":"<div><div>In the evolving field of psychological interventions for posttraumatic stress disorder (PTSD), Cognitive Processing Therapy (CPT) has emerged as a first-line treatment, backed by robust empirical evidence. Despite the proven efficacy of CPT in improving PTSD symptoms, individuals face significant barriers when seeking treatment. To overcome these challenges, CPT has undergone testing in diverse settings, accompanied by structural modifications deviating from its commonly delivered format of weekly (or bi-weekly) face-to-face contact, including changes in delivery method, length or intensity of sessions, or format (e.g., group). We conducted a systematic review and meta-analysis to assess the effectiveness of these structural adaptations within CPT for treating PTSD. Fifteen randomized controlled trials (RCTs) and 12 non-RCTs were included for the review. The meta-analysis of the 15 RCTs revealed significant improvements in PTSD and depression outcomes with structural adaptations of CPT. Generally, no significant differences were found when comparing these adaptations with standard CPT or non-CPT treatments, although this is accompanied by the caveat of likely modest power for subanalyses involving different comparator types. The findings suggest that adapting the delivery of CPT typically yields similar outcomes in PTSD symptom improvement as standard CPT and confirms its flexibility in addressing barriers to PTSD treatment access. Limitations and future directions are discussed.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 5","pages":"Pages 948-963"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886470","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":"Testing Reciprocal Within-Person Changes in Aversive Reactions to Emotions and Skill Use in the Unified Protocol","authors":"Hannah E. Croom,&nbsp;Matthew W. Southward,&nbsp;Shannon Sauer-Zavala","doi":"10.1016/j.beth.2025.04.002","DOIUrl":"10.1016/j.beth.2025.04.002","url":null,"abstract":"<div><div>Emotional disorders are thought to be maintained in large part by the experience of frequent and intense negative emotions and aversive reactions to these emotions. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) was designed to teach patients skills to manage aversive reactions and reduce the frequency and intensity of negative emotions. However, it is unclear how skill use and aversive reactions are related to each other in this treatment. Participants (<em>N</em> = 70; <em>M</em>_age = 33.75, 67% female, 74% White, 74% heterosexual) completed measures of aversive reactivity, skillfulness, anxiety, and depression before each session. We used hierarchical linear modeling to explore if within-person changes in aversive reactivity predicted residualized session-to-session changes in skill use and if within-person changes in skill use predicted residualized session-to-session changes in aversive reactivity. We then used multilevel mediation analyses to test whether aversive reactivity or skill use mediated the effect of the other construct on changes in anxiety and depression. Within-person increases in skillfulness significantly predicted session-to-session improvements in cognitive skills and mindfulness but did not predict improvements in any aspect of aversive reactivity. Within-person changes in aversive reactivity did not significantly predict changes in skillfulness. Between-person changes in skillfulness were significantly related to changes in between-person aversive reactivity. Only the indirect effect of skillfulness through mindfulness on anxiety/depression was significant. These results suggest that aversive reactivity and skillfulness may be relatively independent constructs.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 5","pages":"Pages 1014-1024"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886374","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":"2025-09-01","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":"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":"2025-09-01","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":"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":"2025-09-01","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":"Differences in Emotion Regulation Indices in Participants With a History of Nonsuicidal Self-Injury Based on Sexual and Gender Minority Identity","authors":"Michaela S. Ahrenholtz,&nbsp;Konrad Bresin","doi":"10.1016/j.beth.2025.03.007","DOIUrl":"10.1016/j.beth.2025.03.007","url":null,"abstract":"<div><div>Theories posit nonsuicidal self-injury (NSSI) regulates emotions through the reduction of negative affect and increasing of positive affect, and prior research using daily diary methods show differences across emotion dynamics (i.e., mean level, variation, inertia, and differentiation) based on NSSI history. The current study aimed to replicate and expand work done by Bresin (2014) by examining emotion dynamics using ecological momentary assessment and exploring group differences based on sexual and gender minority identity. To our knowledge, no research has explored emotion dynamic differences based on identity. We hypothesized a replication of Bresin’s (2014) results and conducted exploratory analyses for sexual and gender minority status. Analyses of ecological momentary assessment data (5 times a day for 28 days) showed that individuals with a history of NSSI reported higher mean level and within-person variance of negative affect, and lower positive affect inertia. Sexual and gender minority individuals also reported lower positive affect inertia. Interaction effects found that sexual and gender minority individuals with a history of NSSI had lower negative affect inertia compared to cisgender straight individuals with a history of NSSI. Results from Bresin (2014) were replicated for mean-level and within-person variation of negative affect, as well as positive affect inertia using ecological momentary assessment data, strengthening the conclusion that individuals with a history of NSSI differ from controls across emotion dynamics. Future research should assess the role of minority stress on this association to continue to explore the differing results based on sexual and gender minority identity. The results of this study should inform theory and treatment surrounding affect and NSSI.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 5","pages":"Pages 989-1001"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886417","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 Emotional Pendulum in ADHD: Insights From Ecological Momentary Assessment of Emotional States in Young Adults","authors":"Neta Yitzhak,&nbsp;Maayan Cohen,&nbsp;Ruth Traub Bar-Ilan,&nbsp;Adina Maeir,&nbsp;Eran Eldar,&nbsp;Mor Nahum","doi":"10.1016/j.beth.2025.03.004","DOIUrl":"10.1016/j.beth.2025.03.004","url":null,"abstract":"<div><div>Emotion dysregulation, and specifically emotional instability, characterizes adults with ADHD. This study utilized ecological momentary assessment (EMA) to track emotional states and examine patterns of emotional instability within individuals over different time scales. Specifically, it focused on two aspects: overall emotional variability over time, and emotional lability, reflected in emotional states fluctuations within and across days. We further examined the interaction of these emotional instability factors with the subjective experience of emotion regulation difficulties. Young adults with (<em>n</em> = 57) and without (HC; <em>n</em> = 54) ADHD diagnosis completed a self-report questionnaire for emotion regulation difficulties, followed by a 5-day EMA protocol of 5 emotion reports/day. Individuals with ADHD displayed significantly higher intra-individual emotional variability, but no group differences were found for emotional lability, both between and across days. This higher emotional variability was linked to self-reported emotion regulation difficulties in the ADHD group. Finally, using cluster analysis, we found a higher probability of individuals with ADHD being included in a cluster characterized by elevated emotional variability and emotion regulation difficulties. This study demonstrates that young adults with ADHD may experience a broader range of emotions in their daily lives, which may be related to the way they evaluate their challenges in emotion regulation. The findings highlight the need to address emotion dysregulation difficulties in clinical practice, as understanding these emotional dynamics could enhance personalized therapeutic strategies for ADHD, and help design interventions tailored to the breadth and intensity of emotional experiences in ADHD.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 5","pages":"Pages 964-978"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886471","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":"Cognitive-Behavioral Factors Associated With Posttraumatic Stress Symptoms Following Two “Armed and Dangerous Person” Campus Lockdowns","authors":"Joseph B. Friedman,&nbsp;Emily K. Juel,&nbsp;Nicholas S. Myers,&nbsp;Heidi J. Ojalehto,&nbsp;Jonathan S. Abramowitz","doi":"10.1016/j.beth.2025.04.001","DOIUrl":"10.1016/j.beth.2025.04.001","url":null,"abstract":"<div><div>Consistent with the cognitive-behavioral model of posttraumatic stress disorder (PTSD), research has found associations among posttraumatic cognitions, avoidance coping, and posttraumatic stress symptoms (PTSS). Less is known, however, about the occurrence of these relationships in the context of “armed and dangerous person” university lockdowns that affect campus communities at large<strong>.</strong> This cross-sectional study evaluated predictors of PTSS following two sequential lockdowns. In the aftermath of these lockdowns, campus community members (<em>N</em> = 287) completed self-report measures assessing posttraumatic cognitions, avoidance coping, and PTSS. Results indicated that posttraumatic cognitions involving negative views of oneself or the world (but not self-blame), avoidance coping, and physical proximity were positively associated with PTSS. These relationships remained robust after controlling for general distress and retrospectively reported peritraumatic fear. Findings are interpreted and discussed in light of conceptual models of PTSD and provide paths for early screening of those experiencing community-wide stressors, such as university lockdowns.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 5","pages":"Pages 1002-1013"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886418","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 of the Science: Hoarding Disorder and Its Treatment","authors":"David F. Tolin,&nbsp;Blaise L. Worden,&nbsp;Hannah C. Levy","doi":"10.1016/j.beth.2025.03.002","DOIUrl":"10.1016/j.beth.2025.03.002","url":null,"abstract":"<div><div>This state-of-the-science review describes the relatively new diagnosis of hoarding disorder (HD), characterized by difficulty discarding possessions and resulting clutter in living spaces. We review current theoretical models of HD, including a cognitive-behavioral model, a biopsychosocial model, an attachment model, and an addictions model. We then describe interventions for HD, focusing largely on cognitive-behavioral therapy for hoarding disorder (CBT-HD), the only treatment with conclusive evidence of efficacy. We review the components of CBT-HD and their rationale, noting that clinical results have been modest. The cross-cultural efficacy of CBT-HD is unclear, as are the effects of cultural modifications to the treatment. Future clinical and research directions are discussed.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 4","pages":"Pages 667-679"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313023","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}