Behavior Therapy最新文献

{"title":"For Whom and for How Long Does the “Be a Mom” Intervention Work? A Secondary Analysis of Data From a Randomized Controlled Trial Exploring the Mid-Term Efficacy and Moderators of Treatment Response","authors":"Carlos Carona,&nbsp;Marco Pereira,&nbsp;Anabela Araújo-Pedrosa,&nbsp;Fabiana Monteiro,&nbsp;Maria Cristina Canavarro,&nbsp;Ana Fonseca","doi":"10.1016/j.beth.2023.11.001","DOIUrl":"10.1016/j.beth.2023.11.001","url":null,"abstract":"<div><p>This study explored clinical and sociodemographic moderators of treatment response to “Be a Mom”, an internet-based cognitive behavioral therapy (iCBT) intervention, from baseline to postintervention, in women at high risk for postpartum depression (PPD). The study also assessed the stability of women’s treatment gains from baseline to 4-months postintervention (follow-up). This open-label randomized controlled trial (RCT) involved a sample of 1,053 postpartum Portuguese women identified as being at high risk for PPD (i.e., having a score of 5.5 or higher on the Postpartum Depression Predictors Inventory-Revised); participants were allocated to “Be a Mom” intervention group or a waiting-list control group, and completed self-report measures at baseline, postintervention, and a 4-month follow-up (554 women completed follow-up assessments). Depressive and anxiety symptoms were measured using the Edinburgh Postnatal Depression Scale and the anxiety subscale of the Hospital Anxiety and Depression Scale, and flourishing/positive mental health was assessed with the Mental Health Continuum. Regression models and linear mixed models were used to examine moderators of treatment and the mid-term efficacy of the “Be a Mom” intervention, respectively. The results revealed that treatment completion, higher depression scores at baseline, and higher income levels were linked to greater symptom reduction and positive mental health enhancement. Moreover, the efficacy of the “Be a Mom” intervention was supported at the 4-month follow-up. The “Be a Mom” intervention appears to be an effective iCBT tool for reducing psychological distress and enhancing positive mental health in women at risk for PPD, with therapeutic improvements maintained over a 4-month period.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 4","pages":"Pages 768-785"},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138514463","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":"Reckoning With Our Past and Righting Our Future: Report From the Behavior Therapy Task Force on Sexual Orientation and Gender Identity/Expression Change Efforts (SOGIECEs)","authors":"Jonathan S. Comer,&nbsp;Christopher Georgiadis,&nbsp;Katie Schmarder,&nbsp;Diane Chen,&nbsp;Claire A. Coyne,&nbsp;Omar G. Gudiño,&nbsp;Nikolaos Kazantzis,&nbsp;David A. Langer,&nbsp;Richard T. LeBeau,&nbsp;Richard T. Liu,&nbsp;Carmen McLean,&nbsp;Denise M. Sloan,&nbsp;Monnica T. Williams,&nbsp;John E. Pachankis","doi":"10.1016/j.beth.2024.05.006","DOIUrl":"10.1016/j.beth.2024.05.006","url":null,"abstract":"<div><p>Sexual orientation and gender identity/expression change efforts (SOGIECEs) are discredited practices that are associated with serious negative effects and incompatible with modern standards for clinical practice. Despite evidence linking SOGIECEs with serious iatrogenic effects, and despite support for LGBTQ+-affirmative care alternatives, SOGIECE practices persist. In the 1970s and 1980s, <em>Behavior Therapy</em> published articles testing and/or endorsing SOGIECEs, thereby contributing to their overall development, acceptance, and use. The <em>Behavior Therapy</em> Task Force on SOGIECEs was assembled to conduct a rigorous review of the SOGIECE articles published in <em>Behavior Therapy</em> and to decide whether, and what, formal action(s) should be taken on these articles. This report provides a detailed review of the historic SOGIECE literature published in <em>Behavior Therapy</em> and outlines the Task Force’s deliberative and democratic processes resulting in actions to: (1) add prominent advisory information to <em>k</em> = 24 SOGIECE papers in the form of digital “black box” disclaimers that caution readers that the SOGIECE practices tested or described in these papers are inconsistent with modern standards, (2) offset organizational financial benefits from the publication of these papers, and (3) promote LGBTQ+-affirmative practices. SOGIECEs are not the only concerning practices across the field’s history, and the pages of today’s scientific journals include practices that will be at odds with tomorrow’s moral standards and ethical guidelines. This report calls for precautionary measures and editorial safeguards to minimize the future likelihood and impact of problematic published scholarship, including the need to fully include those with relevant lived experiences in all aspects of clinical science and peer review.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 4","pages":"Pages 649-679"},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141193276","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":"School-Based Intervention for Adolescents With ADHD: Predictors of Effects on Academic, Behavioral, and Social Functioning","authors":"George J. DuPaul,&nbsp;Steven W. Evans,&nbsp;Courtney L. Cleminshaw-Mahan,&nbsp;Qiong Fu","doi":"10.1016/j.beth.2024.01.010","DOIUrl":"10.1016/j.beth.2024.01.010","url":null,"abstract":"<div><p>Adolescents with attention-deficit/hyperactivity disorder (ADHD) experience significant academic, behavioral, and social skill difficulties including underachievement, risk for school dropout, poor peer relations, and emotion dysregulation. Although stimulant medication reduces ADHD symptoms, psychosocial and educational interventions are necessary to address functional impairments. We examined the nature and predictors of academic, behavioral, and social skills trajectories in response to multicomponent organizational and interpersonal skills training in 92 high school students with ADHD. Latent trajectory class analyses revealed positive treatment response ranging from 61.5% (report card grades) to 100% (inattention symptoms, organizational skills, social skills). Organizational skill and academic grade treatment response trajectories were predicted by assigned sex, pretreatment anxiety, and treatment dosage, while improvement in behavioral and social functioning was associated with better emotion regulation and family relations prior to treatment along with stronger working alliance with treatment coach at midtreatment. Multicomponent organizational and interpersonal skills training appears effective for most high school students with ADHD and the degree treatment-induced change is associated with multiple malleable factors can be leveraged to enhance intervention response.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 4","pages":"Pages 680-697"},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139878916","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":"Pilot Effectiveness and Acceptability of Partial Hospitalization Treatment Incorporating Transdiagnostic, Cognitive-Behavioral Intervention","authors":"Sarah M. Kennedy,&nbsp;Veronica Henderson-Davis,&nbsp;Lauren Henry,&nbsp;Jessica L. Hawks,&nbsp;Kathleen I. Diaz,&nbsp;Taylor Crabbs,&nbsp;Neena Khindria,&nbsp;Jami Moe-Hartman,&nbsp;Laurel Nook,&nbsp;Kayin F. President,&nbsp;Samaria Stovall,&nbsp;Laura G. Anthony","doi":"10.1016/j.beth.2023.11.002","DOIUrl":"10.1016/j.beth.2023.11.002","url":null,"abstract":"<div><p>Acute mental health treatment (e.g., partial hospitalization or PHP) is a critical component of the mental health services landscape for youth whose symptoms are too acute for a typical outpatient setting, but for whom inpatient psychiatric hospitalization is not recommended or desired. Very few interventions have been developed, adapted for, or evaluated in these fundamentally different delivery contexts. Transdiagnostic treatments may be ideal for addressing the comorbidity, complexity, and heterogeneity typical of acute mental health settings. Our aim was to examine initial acceptability and effectiveness of an adaptation of the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A; Ehrenreich-May, Kennedy, et al., 2017), delivered as part of comprehensive therapeutic programming in a general psychiatric PHP. We recruited 152 youths (<em>M</em> age = 13.1 years, 62.5% female) and caregivers, who participated in an average of 11 days of intensive UP-C/A intervention. Participants rated symptoms and functioning at baseline, weekly, posttreatment, and 1-month follow-up. Latent growth curve modeling was used to examine patterns of change and evaluate the impact of potential demographic and treatment-related covariates. For all outcomes, a quadratic model best fit the data, with symptoms and emotional reactivity decreasing significantly during treatment and then leveling off during follow-up. There was a medium-sized change in functional impairment from baseline to the 1-month follow-up, and ≥90% of participants reported treatment as acceptable and helpful. Results provide initial support for use of a transdiagnostic, cognitive-behavioral intervention in acute mental health settings and suggest important future directions, including controlled trials and investigation of implementation supports.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 4","pages":"Pages 751-767"},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138514445","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":"A Pilot Randomized-Controlled Trial of Sleep Scholar: A Brief, Internet-Based Insomnia Intervention for College Students","authors":"Eric S. Crosby,&nbsp;Wendy Troop-Gordon,&nbsp;Tracy K. Witte","doi":"10.1016/j.beth.2024.06.007","DOIUrl":"10.1016/j.beth.2024.06.007","url":null,"abstract":"<div><div>This randomized-controlled trial examined the efficacy of Sleep Scholar, a brief, internet-based insomnia intervention tailored to the needs of college students. College students commonly experience insomnia and various other mental health symptoms, including suicide ideation. Cognitive-Behavioral Therapy for Insomnia (CBT-I) is a promising suicide prevention effort for college students because insomnia is robust risk factor for suicide ideation and CBT-I reduces suicide ideation. Moreover, CBT-I can be brief, self-guided, and internet-based. CBT-I also may elicit less stigma than treatment specifically targeting suicide ideation. However, existing forms of brief CBT-I are neither self-guided nor internet-based, and existing forms of self-guided, internet-based CBT-I are not brief. In addition, previous iterations of CBT-I are not typically designed to address the unique sleep needs of college students. For this registered clinical trial, we recruited 61 college students with at least subclinical insomnia symptoms. Participants were randomized to either Sleep Scholar or a control condition, Building Healthy Habits. Participants completed pretreatment daily sleep diaries and surveys, a posttreatment assessment of acceptability and satisfaction, a 1-week and 1-month survey follow-up, and daily sleep diaries throughout the 1-month follow-up period. Results showed that Sleep Scholar was more acceptable and satisfactory compared to the control condition at posttreatment. However, Sleep Scholar was not more effective for improving sleep or mental health symptoms compared to the control condition. These findings suggest that modifications to Sleep Scholar are needed to improve its efficacy.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 2","pages":"Pages 366-380"},"PeriodicalIF":3.4,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142203254","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 “The Effects of a Meaning-Centered Intervention on Meaning in Life and Eating Disorder Symptoms in Undergraduate Women With High Weight and Shape Concerns: A Randomized Controlled Trial” [Behav. Therapy 55(1) (2024) 177–190]","authors":"","doi":"10.1016/j.beth.2024.06.001","DOIUrl":"10.1016/j.beth.2024.06.001","url":null,"abstract":"","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 5","pages":"Pages 1098-1099"},"PeriodicalIF":3.4,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0005789424000935/pdfft?md5=3202325123e1f009410f048661332ecd&pid=1-s2.0-S0005789424000935-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141414905","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":"Why Research From Lower- and Middle-Income Countries Matters to Evidence-Based Intervention: A State of the Science Review of ACT Research as an Example","authors":"","doi":"10.1016/j.beth.2024.06.003","DOIUrl":"10.1016/j.beth.2024.06.003","url":null,"abstract":"<div><div>Despite the global nature of psychological issues, an overwhelming majority of research originates from a small segment of the world’s population living in high-income countries (HICs). This disparity risks distorting our understanding of psychological phenomena by underrepresenting the cultural and contextual diversity of human experience. Research from lower- and middle-income countries (LMIC) is also less frequently cited, both because it is seemingly viewed as a “special case” and because it is less well known due to language differences and biases in indexing algorithms. Acknowledging and actively addressing this imbalance is crucial for a more inclusive, diverse, and effective science of evidence-based intervention. In this state-of-the-science review, we used a machine learning method to identify key topics in LMIC research on Acceptance and Commitment Therapy (ACT), choosing ACT due to the significant body of work from LMICs. We also examined one indication of study quality (study size), and overall citations. Research in LMICs was often nonindexed, leading to lower citations, but study size could not explain a lack of indexing. Many objectively identified topics in ACT research became invisible when LMIC research was ignored. Specific countries exhibited potentially important differences in the topics. We conclude that strong and affirmative actions are needed by scientific associations and others to ensure that research from LMICs is conducted, known, indexed, and used by CBT researchers and others interested in evidence-based intervention science.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 6","pages":"Pages 1348-1363"},"PeriodicalIF":3.4,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141413864","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":"The Role of Pain and Blood Simulation of Nonsuicidal Self-Injury in Emotion Regulation Among Adolescents With Depression Based on the Principle of Harm Reduction: An Experimental Study","authors":"Lu Wang,&nbsp;Hai-Ou Zou,&nbsp;Yan-Hua Qu,&nbsp;Jing-Fang Hong,&nbsp;Juan Chen","doi":"10.1016/j.beth.2024.06.002","DOIUrl":"10.1016/j.beth.2024.06.002","url":null,"abstract":"<div><div>This study aims to explore the role of pain and blood in emotion regulation during nonsuicidal self-injury (NSSI) among adolescents with depression, which included 108 depressed adolescents with NSSI and 110 depressed adolescents without NSSI, to assess the impact of pain and blood on subjective emotional states, and pulse frequency (Pf), respiratory frequency (Rf), galvanic skin response (GSR), and electromyography (EMG). Significant condition×group×time interactions for positive emotions (<em>β =</em> −0.082, <em>SE =</em> 0.026, <em>P =</em> 0.002), Pf (<em>β =</em> −0.045, <em>SE =</em> 0.013, <em>P =</em> 0.001) and GSR (<em>β =</em> −0.041, <em>SE =</em> 0.018, <em>P =</em> 0.027) were found, indicating a significant increase in positive emotions and a significant decrease in Pf and GSR in the NSSI group post-pain/blood stimulus, especially within the first 10 seconds (for Pf, GSR)/3.5 minutes (for positive emotions) following stimulus. And Pf and GSR showed a more pronounced decrease over time in the NSSI group during the pain condition than in the blood condition. These findings highlight the significance of pain and blood in emotion regulation for adolescents with depression who engage in NSSI. Moreover, clinical healthcare professionals may be inspired by the pain and blood stimulus of NSSI based on the harm reduction principle, which provides new ideas for exploring potential interventions that can assist adolescents with depression regulate their emotions and reduce the occurrence of NSSI. And more relevant studies need to be carried out in this area.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 3","pages":"Pages 543-554"},"PeriodicalIF":3.4,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141401695","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 Trajectories of Depressive Symptoms During a Transdiagnostic Partial Hospitalization Program","authors":"Emma H. Moscardini,&nbsp;Chloe C. Hudson,&nbsp;Divya Kumar,&nbsp;Rivian Lewin,&nbsp;Timothy J. McDermott,&nbsp;Evan J. Giangrande,&nbsp;Lynne-Marie Shea,&nbsp;Valeria Tretyak,&nbsp;Courtney Beard,&nbsp;Thröstur Björgvinsson","doi":"10.1016/j.beth.2024.05.008","DOIUrl":"10.1016/j.beth.2024.05.008","url":null,"abstract":"<div><div>Partial hospitalization programs (PHPs) offer a critical level of care that bridges the gap between outpatient and inpatient treatment. Many PHPs implement transdiagnostic approaches, treating patients with a wide range of presenting problems. Despite research suggesting that transdiagnostic PHPs are associated with favorable treatment outcomes, research has yet to examine possible heterogeneity in symptom trajectories as well as factors which may be related to said heterogeneity. We analyzed daily depression symptoms (both cognitive/affective and somatic) of 2,640 patients receiving treatment in a transdiagnostic PHP and identified latent subgroups characterized by heterogeneous trajectories. We then sought to determine if certain patient demographic factors or diagnostic factors were related to trajectories of depression symptoms throughout treatment. Results indicated three classes of trajectories for both cognitive/affective and somatic symptoms of depression: (1) low initial symptoms with steady improvement, (2) consistently high symptoms, and (3) initial worsening then rapid improvement. Female sex and greater psychiatric comorbidity were significantly associated with the consistently high symptom trajectory. Implications and future directions are discussed.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 2","pages":"Pages 334-351"},"PeriodicalIF":3.4,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141408978","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":"A Pilot Open Trial of a Text Message Safety Behavior Fading Intervention for Appearance Concerns Among Women","authors":"Tapan A. Patel,&nbsp;Jesse R. Cougle","doi":"10.1016/j.beth.2024.05.010","DOIUrl":"10.1016/j.beth.2024.05.010","url":null,"abstract":"<div><div>Appearance concerns are a key feature in body dysmorphic disorder and eating disorders, and they have been found to be a common feature of social anxiety disorder. Given the lack of transdiagnostic treatments for appearance concerns, we developed a preliminary text-based intervention targeting appearance-related safety behaviors (ARSBs; i.e., maladaptive behavioral strategies that seek to mitigate the feared consequences of the evaluation of appearance). The intervention utilized a daily text-message protocol where individuals are asked to fade their behaviors, provided encouragement, and log ARSB use in the past day. We evaluated the efficacy of ARSB fading in two successive cohorts of women with elevated appearance concerns (Study 1 <em>N</em> = 38, Study 2 <em>N</em> = 39). We found that across both studies participants experienced large reductions in appearance concerns (<em>d =</em> .93–1.36) and eating disorder symptoms (<em>d</em> = 1.06–1.20) that were maintained 1 month after treatment. Further, participants experienced small-to-medium reductions in social anxiety (<em>d</em> = 0.38–0.58) and depression (<em>d</em> = 0.52–0.96) from pre- to posttreatment. Notably, there were missing data in both studies (31%–50%), but multiple imputation was used to observe stability of effects. We also collected and incorporated feedback on the treatment to optimize the treatment before conducting the second trial. While these changes did not lead to significant differences in study outcomes, the second cohort demonstrated greater adherence to treatment and found the treatment to be more credible than the first cohort. Further, we found that greater baseline ARSBs predicted greater pre- to follow-up changes in appearance concerns. Taken together, text-based ARSB fading appears to be a promising treatment, and further research on the treatment appears warranted.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 2","pages":"Pages 352-365"},"PeriodicalIF":3.4,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141409211","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}