Behavior TherapyPub Date : 2024-04-10DOI: 10.1016/j.beth.2024.04.001
{"title":"Experiential Avoidance During Mealtimes Among Individuals With Eating Disorders","authors":"","doi":"10.1016/j.beth.2024.04.001","DOIUrl":"10.1016/j.beth.2024.04.001","url":null,"abstract":"<div><p>The relationship between negative emotions and avoidance is widely theorized as a bidirectional cycle implicated in a range of psychopathology. Historically, research on this cycle has examined one type of negative emotion: anxiety. Yet, a broader range of internal experiences may be implicated in the maintenance of unhealthy avoidance cycles in psychopathology. This study examines prospective relationships among anxiety, guilt, physical discomfort, and experiential avoidance during mealtimes for individuals with eating disorders (EDs). Participants (<em>N</em> = 108) completed ecological momentary assessments four times a day for 25 days. We computed multilevel models to examine between- and within-person effects of negative emotions and physical discomfort on experiential avoidance. When including guilt and anxiety in one model, guilt, but not anxiety, explained the significant variance in experiential avoidance at the next meal. Mealtime physical discomfort and experiential avoidance evidenced reciprocal prospective relationships. Future research should test whether interventions targeting experiential avoidance and physical discomfort at mealtimes disrupt guilt.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 5","pages":"Pages 1084-1097"},"PeriodicalIF":3.4,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140762675","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 : 2024-04-10DOI: 10.1016/j.beth.2024.04.002
{"title":"Advancing Psychosocial Treatment for Body Dysmorphic Disorder: A State-of-the-Science Review","authors":"","doi":"10.1016/j.beth.2024.04.002","DOIUrl":"10.1016/j.beth.2024.04.002","url":null,"abstract":"<div><div>Body dysmorphic disorder (BDD) is an underrecognized, challenging illness with severe comorbidities, demanding urgent advancements in treatment strategies. This state-of-the-science review describes current research on existing BDD treatments, beginning with a detailed discussion of cognitive-behavioral therapy (CBT), the primary psychosocial intervention for BDD, and its foundational theories. We emphasize the significant progress in the field, including the efficacy of face-to-face CBT, the promising outcomes of digital interventions for broadening access to care, and emerging treatments that warrant further exploration. The review also addresses the critical gap of targeted interventions for youth, considering the diseases’ typical onset during adolescence. Our review also sheds light on the significant gap in research dedicated to testing these treatments in underserved communities, stressing the importance of including these populations in research and culturally informed and adapted, if necessary, care. The review concludes with recommendations for future directions, outlining areas for ongoing treatment development and research to expand the scope and efficacy of interventions for BDD.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 6","pages":"Pages 1249-1288"},"PeriodicalIF":3.4,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140772469","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 : 2024-04-10DOI: 10.1016/j.beth.2024.03.005
{"title":"Meaning-Centered Psychotherapy Versus Cognitive Behavioral Therapy for Cancer Survivors: A Randomized Controlled Trial☆","authors":"","doi":"10.1016/j.beth.2024.03.005","DOIUrl":"10.1016/j.beth.2024.03.005","url":null,"abstract":"<div><p>Meaning-centered psychotherapy (MCP) has been found to be effective in improving meaning in life and increasing fulfillment in participants with cancer. However, to date, no previous studies have compared MCP with evidence-based treatments such as cognitive behavioral therapy (CBT). The aim of this study was to analyze the differential efficacy of MCP, compared to CBT, in participants with cancer. The study is a randomized controlled trial with 76 participants, <em>n</em> = 41 (MCP) and <em>n</em> = 35 (CBT). At posttreatment, the MCP intervention for cancer survivors was more effective than CBT in increasing the presence of meaning in life, purpose and meaning in life, and life goals. Moreover, our results showed that, at posttreatment and the 6-month follow-up, MCP and CBT were similarly effective in improving depression and developing posttraumatic growth. This study suggests that MCP could be more effective than CBT in improving meaning in life, purpose, and life goals, and equally effective as CBT in improving depression and posttraumatic growth, in cancer survivors.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 5","pages":"Pages 1071-1083"},"PeriodicalIF":3.4,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0005789424000418/pdfft?md5=6f51939341746faa4c15497108683a5a&pid=1-s2.0-S0005789424000418-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140774216","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}
Behavior TherapyPub Date : 2024-04-10DOI: 10.1016/j.beth.2024.04.004
{"title":"State of the Science: Using Digital Mental Health Interventions to Extend the Impact of Psychological Services","authors":"","doi":"10.1016/j.beth.2024.04.004","DOIUrl":"10.1016/j.beth.2024.04.004","url":null,"abstract":"<div><div>In recent years, digital mental health interventions (DMHIs) have emerged as a paradigm shift in care delivery that could expand the scale, efficiency, and effectiveness of psychological services. However, DMHI impact is constrained by issues related to limited reach, poor adoption, implementation barriers, and insufficient long-term maintenance. Organized by the <em>Reach, Effectiveness, Adoption, Implementation, and Maintenance</em> <!-->(RE-AIM) framework, this paper surveys the current state of DMHIs, highlighting research and practice gaps as well as potential strategies to move the field forward. Similarly, we discuss the role that emerging technologies and changes in the profession will play in shaping DMHIs in years to come. Finally, concrete and actionable steps to advance equity in the DMHI field are provided, with an emphasis on strategies to increase the representativeness of marginalized populations in DMHI research, the inclusion of these groups in the design and testing of DMHIs, and how to improve the contextual and cultural fit of DMHIs.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 6","pages":"Pages 1364-1379"},"PeriodicalIF":3.4,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140790217","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 : 2024-04-09DOI: 10.1016/j.beth.2024.04.003
{"title":"State of the Science of Cognitive Processing Therapy","authors":"","doi":"10.1016/j.beth.2024.04.003","DOIUrl":"10.1016/j.beth.2024.04.003","url":null,"abstract":"<div><div>This state of the science review provides an overview of the history and findings of cognitive processing therapy (CPT), one of the most recommended treatments for posttraumatic stress disorder, acute stress disorder, and comorbid conditions. After an introduction to CPT and the randomized controlled trials that have been conducted, the effects of CPT on comorbid conditions are reviewed, as well as new combination treatments. Cognitive mediators of change are described. Different formats for CPT that have been developed are described, as well as patient, therapy, and therapist factors in outcome; applicability across diverse populations; efforts to disseminate CPT; and ongoing studies into the future.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 6","pages":"Pages 1205-1221"},"PeriodicalIF":3.4,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140778826","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 : 2024-04-08DOI: 10.1016/j.beth.2024.03.004
{"title":"Mindfulness Effects on Anxiety: Disentangling the Role of Decentering and Treatment Expectations","authors":"","doi":"10.1016/j.beth.2024.03.004","DOIUrl":"10.1016/j.beth.2024.03.004","url":null,"abstract":"<div><p>Mindfulness interventions have been found to lower anxiety. However, the current literature has not adequately considered the role of its individual components and of placebo effects. In an online experiment using a balanced placebo design, we aimed to disentangle effects of decentering, a key component of mindfulness, and expectations, a key component of placebo effects, on anxiety related to the COVID-19 pandemic. One hundred twenty-eight adults were randomly assigned to one of four groups: placebo/mindful decentering, placebo/sham decentering, sham/mindful decentering, and sham/sham decentering. Instructions were provided using standardized audio instructions. Current anxiety was assessed pre- and postintervention with the Short State version of the State-Trait Anxiety Inventory. Mindful decentering was found to reduce anxiety postintervention, as compared to sham decentering, regardless of induced expectations regarding its effectiveness. Participants in the mindful decentering group also mentioned more decentering-related words than those in the sham decentering group. These findings indicate that a short, standardized, and online mindful decentering intervention can effectively decrease pandemic-related anxiety independently of one’s expectations. These findings provide insights into the efficacy of the individual elements of mindfulness, highlighting decentering as an effective active component for anxiety relief. Moreover, these findings suggest that, in a nonclinical sample, individuals can apply mindful decentering with minimal training.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 5","pages":"Pages 1059-1070"},"PeriodicalIF":3.4,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S000578942400039X/pdfft?md5=853565185b0928f3ec063247c735622f&pid=1-s2.0-S000578942400039X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140782021","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}
Behavior TherapyPub Date : 2024-03-20DOI: 10.1016/j.beth.2024.03.001
{"title":"A Randomized Controlled Trial of Two Parent–Child Parallel Interventions to Enhance Positive Adaptation of Immigrant Families in Hong Kong: The Moderating Role of Depressive Symptoms","authors":"","doi":"10.1016/j.beth.2024.03.001","DOIUrl":"10.1016/j.beth.2024.03.001","url":null,"abstract":"<div><p>Parents and children who have recently immigrated from the Chinese mainland to Hong Kong face various challenges, including psychological and sociocultural adaptation difficulties. In collaboration with community partners, our research team has developed and implemented culturally sensitive and preventive parent–child parallel interventions to enhance positive adaptation among immigrant parents and children. Two interventions were conducted in this randomized controlled trial: an emotion regulation (ER) arm, which addressed psychological adaptation by reducing parent–child conflicts and improving emotions, and an information provision (IP) arm targeting sociocultural adaptation by increasing participants’ knowledge about Hong Kong. The study randomly assigned 113 and 73 parent–child pairs (allocation ratio 3:2) into the ER and IP arms, respectively. Parents and children attended four two-hour weekly sessions of their assigned intervention and completed assessments before, immediately after, and one month following the intervention. The results showed that in the ER arm, parents showed improved positive affect, and children reported decreases in parent–child conflicts more than their counterparts in the IP arm. In the IP arm, parents and children increased their knowledge, and parents decreased sociocultural adaptation difficulties more than their counterparts in the ER arm. In addition, the moderation analyses showed that in both interventions, parents and children with elevated baseline depressive symptoms obtained greater benefits relative to their counterparts with fewer symptoms. Such marked improvements were seen among parents in negative affect and adaptation difficulties and among children in parent–child conflict, positive and negative affect in the ER arm. More improvements were noted among parents in negative affect and sociocultural adaptation difficulties and among children in negative affect in the IP arm. Future studies are suggested to develop and provide parent–child parallel interventions targeting both psychological and sociocultural adaptations to parents and children with heightened baseline depressive symptoms to facilitate their positive adaptation in Hong Kong.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 5","pages":"Pages 1026-1042"},"PeriodicalIF":3.4,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140275953","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 : 2024-03-18DOI: 10.1016/j.beth.2024.03.003
{"title":"Family Accommodation in Anxious Irritable and Anxious Nonirritable Youth","authors":"","doi":"10.1016/j.beth.2024.03.003","DOIUrl":"10.1016/j.beth.2024.03.003","url":null,"abstract":"<div><p>Family accommodation is a significant contributor to the maintenance and course of youth anxiety. There is also high co-occurrence of anxiety and irritability in youth. Research is lacking, however, on the influence of irritability in the association between anxiety and family accommodation, including among youth with clinically diagnosed anxiety disorders. We therefore examined this issue in a sample of clinic-referred anxious irritable and anxious nonirritable youth. Youth (<em>N</em> = 645, <em>M</em><sub>age</sub> = 9.86 years, <em>SD</em> = 2.92) and their parents completed diagnostic interviews and questionnaires assessing youth anxiety, irritability, and family accommodation. Based on both youth and parent ratings, family accommodation was significantly and positively associated with youth anxiety and irritability. Anxious irritable youth rated family accommodation significantly higher than anxious nonirritable youth. In addition, youth self-rated irritability levels significantly moderated the association between their anxiety and family accommodation. No moderation effect was found for the parent ratings. Based on the youth ratings, our overall findings show that parents of anxious irritable youth are more accommodating of their children’s anxiety, compared with parents of anxious nonirritable youth. Anxiety levels also predict family accommodation more strongly in youth with lower levels of irritability. Our findings provide novel insights about accommodation behaviors in families of anxious irritable youth and suggest its potential utility as a treatment target when working with anxious irritable youth.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 5","pages":"Pages 913-921"},"PeriodicalIF":3.4,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140205729","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 : 2024-03-18DOI: 10.1016/j.beth.2024.03.002
{"title":"Once in Contact, Forever Contaminated! Introducing a Clinically Validated Imagery- and Video-Based Chain of Contagion Task for the Measurement of Disgust and Contamination Change in Experimental Research and Clinical Practice","authors":"","doi":"10.1016/j.beth.2024.03.002","DOIUrl":"10.1016/j.beth.2024.03.002","url":null,"abstract":"<div><p>Tolin et al. (2004) developed the Chain of Contagion Task (CCT) to experimentally test the law of contagion and looming vulnerability (LV). In the CCT, contaminated pencils are brought into contact with clean pencils. The degree of contamination transferred to further new pencils refers to the level of biased contagious beliefs. Although this could be an important transdiagnostic tool, the usability of the original paradigm has been very laborious. Therefore, an imagery- and video-based CCT is introduced and validated in Study 1 in a nonclinical sample with 85 participants. In Study 2, the imagery-based CCT was validated in a clinical study with 15 participants diagnosed with contamination-related obsessive-compulsive disorder (C-OCD), 15 participants suffering from an anxiety disorder, and 15 nonclinical controls. The number of participants is consistent with those in Tolin’s original sample and the statistical evaluation of Study 2 was preregistered. Both CCT could be validated and the results could be replicated. In the imagery-based CCT, the C-OCD group displayed significantly higher contamination ratings, avoidance tendencies and LV than the two control groups. We argue that this open access diagnostic instrument can be applied in research as well as in therapeutic practice (Download CCT videos and imagery: <span><span>https://doi.org/10.5281/zenodo.7730459</span><svg><path></path></svg></span>).</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 5","pages":"Pages 1043-1058"},"PeriodicalIF":3.4,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140196581","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 : 2024-03-07DOI: 10.1016/j.beth.2024.02.008
{"title":"Avoidance and Rumination as Predictors of Substance Use, Mental Health, and Pain Outcomes Among People Living With HIV","authors":"","doi":"10.1016/j.beth.2024.02.008","DOIUrl":"10.1016/j.beth.2024.02.008","url":null,"abstract":"<div><p>Pain, substance use, and mental health conditions are common among people living with HIV (PLWH), and avoidance and rumination may influence the co-occurrence of these conditions. The present study examined longitudinal associations between avoidance/rumination and pain outcomes, anxiety, anger, and substance use among PLWH. Participants (<em>N</em> = 187) with chronic pain and depressive symptoms completed self-report assessments over a 1-year period. Greater avoidance/rumination was positively associated with mental health outcomes (anxiety, anger), pain interference, and alcohol use across participants after controlling for depression severity. At time points with greater avoidance/rumination than average, participants also reported increased pain severity and interference, anxiety and anger symptoms, and alcohol use. No associations were found between avoidance/rumination and cannabis use. Results suggest a mechanistic effect of avoidance/rumination, such that increases in avoidance/rumination correspond with poorer health outcomes among PLWH over time. Targeting avoidance/rumination through intervention approaches may be beneficial for addressing comorbid health conditions among PLWH. Additional research is necessary to investigate this possibility and further characterize the effects of avoidance/rumination on health outcomes for PLWH.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 5","pages":"Pages 1015-1025"},"PeriodicalIF":3.4,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140269083","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}