Behavior Therapy最新文献

{"title":"Latent Change Trajectories in Mood During Focused CBT Enhanced for Eating Disorders Are Associated With Global Eating Pathology at Posttreatment and Follow-Up Among Individuals With Bulimia Nervosa Spectrum Disorders: A Preliminary Examination","authors":"","doi":"10.1016/j.beth.2024.01.005","DOIUrl":"10.1016/j.beth.2024.01.005","url":null,"abstract":"<div><p>Bulimia nervosa (BN) is characterized by recurrent loss of control over eating (LOC) and inappropriate compensatory behaviors. Although cognitive-behavioral therapy (CBT) is efficacious for BN, many patients continue to experience symptoms at posttreatment. One potential driver of this low treatment response may be low mood, which maintains BN symptoms through negative reinforcement. Thus, it is important to understand how mood changes over enhanced cognitive-behavioral therapy (CBT-E) and whether these changes are associated with improved treatment outcomes. Participants (<em>N</em> = 56) with BN-spectrum eating disorders (EDs) received 16 sessions of the focused version of CBT-E. The Eating Disorder Examination (EDE) was used to measure ED symptoms (global ED pathology, frequency of binge episodes, and compensatory behaviors) at pre- and posttreatment. Latent growth mixture modeling (LGMM) of affective ratings via digital self-monitoring identified latent growth classes. Kruskal–Wallis <em>H</em> tests examined the effect of trajectory of change in mood on pre- to posttreatment symptom change. LGMM yielded a four-class model that best fit the data representing distinct mood trajectories over the course of treatment: (a) highest baseline mood, linear improving; (b) moderate baseline mood, stable; (c) moderate baseline mood, quadratic worsening; and (d) lowest baseline mood, quadratic improving. Participants who demonstrated worsening mood over treatment (i.e., individuals in the “moderate baseline mood, quadratic worsening” class) had significantly higher EDE global scores at posttreatment and follow-up compared to participants with stable mood across treatment. Change in LOC eating frequency and compensatory behaviors across treatment did not significantly differ by mood class. The main effect of mood class or interaction effect between time and mood class on objective binge episodes, subjective binge episodes, and compensatory behaviors was not significant. There were no significant differences in global ED pathology at either posttreatment or follow-up for any other class comparisons. These results suggest that certain trajectories of change in mood during treatment are particularly associated with change in pre- to posttreatment EDE global score. If replicated, our findings could suggest that future iterations of CBT-E should target mood early in treatment in order to maximize reductions in global eating pathology.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 5","pages":"Pages 950-960"},"PeriodicalIF":3.4,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139828524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotion Regulation in Obsessive-Compulsive Disorder: An Ecological Momentary Assessment Study","authors":"","doi":"10.1016/j.beth.2024.01.011","DOIUrl":"10.1016/j.beth.2024.01.011","url":null,"abstract":"<div><p>Emotion dysregulation is a central process implicated in the genesis and maintenance of obsessive-compulsive disorder (OCD). However, past research on OCD has examined emotion regulation with a trait-level approach, thereby neglecting important situational and temporal dynamics. The present study is the first one to examine moment-to-moment emotion regulation in individuals with OCD. A 6-day ecological momentary assessment was used to assess affect, emotion regulation strategies, perceived effectiveness of emotion regulation strategies, and acceptance of emotional experiences in <em>n</em> = 72 individuals with OCD and <em>n</em> = 54 psychologically healthy controls. As expected, individuals with OCD reported more negative and less positive affect. Group differences in positive (but not negative) affect did remain significant when controlling for baseline depression. Furthermore, the OCD group reported to use a higher momentary number of avoidance-oriented regulation strategies and less perceived effectiveness of emotion regulation, even when controlling for current symptoms and negative affect or baseline depression scores. Further, irrespective of group, more momentary negative affect amplified use of avoidance-oriented strategies and diminished perceived effectiveness and emotional acceptance. Contrary to expectations, these effects were not more pronounced in the OCD group. Possible explanations for unexpected findings and implications for future research, particularly regarding more holistic emotion regulation treatments, are discussed.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 5","pages":"Pages 935-949"},"PeriodicalIF":3.4,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0005789424000224/pdfft?md5=05d3111385962313d80bf7c8f127d516&pid=1-s2.0-S0005789424000224-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139874795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician Knowledge of and Attitudes Toward Guided Self-Help","authors":"","doi":"10.1016/j.beth.2024.01.006","DOIUrl":"10.1016/j.beth.2024.01.006","url":null,"abstract":"<div><p>The current study evaluated knowledge of and attitudes toward guided self-help (GSH) among clinicians who use evidence-based practices to treat one or more of the following: panic disorder, major depressive disorder, bulimia nervosa, binge-eating disorder, and generalized anxiety disorder. A total of 153 of 256 individuals recruited online and at professional conferences were eligible. This study assessed prior experience with and knowledge of GSH, as well as hypothetical use with a mock patient. Less than 20% of clinicians had ever used GSH, and fewer had used it as a stand-alone treatment. Given a mock patient reporting moderate symptoms, clinicians indicated a 53.62% likelihood that they would use GSH. Exploratory analyses indicated that hypothetical use was predicted by prior use of GSH as well as the Openness subscale of the Evidence-Based Practice Attitude Scale. Study findings suggest that clinicians using evidence-based practices do not uniformly know of or endorse the use of GSH. Lack of training in GSH was one of the most frequently endorsed barriers to implementing GSH in clinical practice (<em>n</em> = 99, 64%). These findings have implications for the use of therapy formats that scale evidence-based treatments in the United States.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 5","pages":"Pages 922-934"},"PeriodicalIF":3.4,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139883603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Feasibility of Automated Training for Facial Emotion Expression and Recognition in Autism” [Behav. Therapy 49(6) (2018) 881–888]","authors":"Susan W. White,&nbsp;Lynn Abbott,&nbsp;Andrea Trubanova Wieckowski,&nbsp;Nicole N. Capriola-Hall,&nbsp;Sherin Aly,&nbsp;Amira Youssef","doi":"10.1016/j.beth.2024.01.002","DOIUrl":"10.1016/j.beth.2024.01.002","url":null,"abstract":"","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 2","pages":"Page 429"},"PeriodicalIF":3.7,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0005789424000078/pdfft?md5=6161ab76472911bd756c50ac87ef2e7d&pid=1-s2.0-S0005789424000078-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139649043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Group Differences in Facial Emotion Expression in Autism: Evidence for the Utility of Machine Classification” [Behav. Therapy 50(4) (2019) 828–838]","authors":"Nicole N. Capriola-Hall,&nbsp;Andrea Trubanova Wieckowski,&nbsp;Deanna Swain,&nbsp;Sherin Aly,&nbsp;Amira Youssef,&nbsp;A. Lynn Abbott,&nbsp;Susan W. White","doi":"10.1016/j.beth.2024.01.003","DOIUrl":"10.1016/j.beth.2024.01.003","url":null,"abstract":"","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 2","pages":"Page 430"},"PeriodicalIF":3.7,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S000578942400008X/pdfft?md5=1caa2d7ded95322d8f2a5cfb77ccc8fe&pid=1-s2.0-S000578942400008X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139648927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Naturalistic evaluation of HeadGear: A smartphone app to reduce depressive symptoms in workers","authors":"Mark Deady, Daniel A. J. Collins, Nicholas Glozier, Evangeline Gardiner, Andrew Arena, Aimee Gayed, Richard Bryant, Rafael A. Calvo, Samuel B. Harvey","doi":"10.1016/j.beth.2024.01.001","DOIUrl":"https://doi.org/10.1016/j.beth.2024.01.001","url":null,"abstract":"<p>Mobile health (mHealth) apps have the potential to expand access to evidence-based interventions for mental health conditions, including depression. <em>HeadGear</em> was developed to prevent depression and improve wellbeing among the working population and was associated with significant positive effects in an efficacy trial. This study presents the results from a naturalistic trial intended to evaluate real-world usage of the app. We examined the naturalistic use of <em>HeadGear</em> between March 2019 and March 2022, using app analytic data, in-app event data, and surveys assessing depressive symptoms, wellbeing, and work performance repeated at 30-day intervals over 5-month app usage. During the observation period, <em>HeadGear</em> was widely disseminated to the public, and downloaded 26,455 times. Of those who downloaded the app, 12,995 completed baseline. The mean age of users was 38.23 (<em>SD</em> = 12.39) and 60% were women. Approximately one in four met criteria for probable depression at baseline. Depressive symptoms showed consistent improvement at all timepoints (Cohen’s <em>d</em> ranging from 0.24 at 1 month to 0.13 at 5 months). A similar pattern emerged for wellbeing. Work performance showed improvement to 2-month follow-up only. The strongest change was found for those with greater symptom severity at baseline, and those with high app engagement. Attrition at follow-up points was high. Findings regarding the real-world use of <em>HeadGear</em> are promising and highlight the use of such apps among those with higher symptom severity (despite the intended use of the app as a prevention tool). Further work is required to tailor mHealth apps to reach their full potential through an enhanced understanding of the utility of individual features for effectiveness and engagement.</p>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"82 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139463548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reciprocal and Indirect Effects Among Intervention, Perceived Social Support, and Anxiety Sensitivity Within a Randomized Controlled Trial for Anxiety Disorders","authors":"Allison V. Metts,&nbsp;Peter Roy-Byrne,&nbsp;Murray B. Stein,&nbsp;Cathy D. Sherbourne,&nbsp;Alexander Bystritsky,&nbsp;Michelle G. Craske","doi":"10.1016/j.beth.2023.05.008","DOIUrl":"10.1016/j.beth.2023.05.008","url":null,"abstract":"<div><p>Social support may facilitate adaptive reappraisal of stressors, including somatic symptoms. Anxiety sensitivity refers to negative beliefs about somatic symptoms of anxiety, which may influence one’s perception of social support. Evidence-based treatment may impact these associations. The current longitudinal study evaluated reciprocal relationships between perceived social support and anxiety sensitivity, and explored indirect intervention effects, in a randomized controlled trial for anxiety disorders that compared cognitive behavioral therapy with or without medications (CALM) to usual care. Data collected over 18 months from 940 primary care patients were examined in random intercept cross-lagged panel models. There were significant reciprocal associations between perceived social support increases and anxiety sensitivity decreases over time. There were significant indirect effects from intervention to perceived social support increases through anxiety sensitivity decreases and from intervention to anxiety sensitivity decreases through perceived social support increases. These data suggest that, relative to usual care, CALM predicted changes in one construct, which predicted subsequent changes in the other. Secondary analyses revealed an influence of anxiety and depressive symptoms on reciprocal associations and indirect effects. Findings suggest that future treatments could specifically address perceived social support to enhance reappraisal of somatic symptoms, and vice versa.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 1","pages":"Pages 80-92"},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0005789423000588/pdfft?md5=ffe432e2a6cb8012db4d3c14ab724993&pid=1-s2.0-S0005789423000588-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134903461","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":"Time to Response in Therapy for Body Dysmorphic Disorder: A Comparison of Cognitive Behavioral Therapy and Supportive Psychotherapy","authors":"Susanne S. Hoeppner,&nbsp;Margaret D. Hall,&nbsp;Marc Hiranandani,&nbsp;Jennifer L. Greenberg,&nbsp;Sabine Wilhelm,&nbsp;Katharine A. Phillips","doi":"10.1016/j.beth.2023.05.006","DOIUrl":"10.1016/j.beth.2023.05.006","url":null,"abstract":"<div><p>Psychotherapy has been shown to be effective for individuals with body dysmorphic disorder (BDD); however, time to treatment response for different treatments have not yet been examined. We randomized 120 patients to either weekly cognitive behavioral therapy (CBT) or supportive psychotherapy (SPT) at two academic medical research centers. In this secondary data analysis, we aimed to determine the time to first response (30% or greater reduction in BDD symptom severity) in both treatment conditions among those who attended at least one post-baseline assessment (<em>n</em> = 109). As previously reported, CBT for BDD was associated with more consistent improvement in symptom severity and quality of life than SPT. In a pooled analysis combining both sites, the median time to first response was shorter for CBT (76 days [10.9 weeks], 95% CI: 76-107 days) than for SPT (88 days [12.6 weeks], 95% CI: 88–nonestimable days; Χ²_df=1 = 3.85, <em>p</em> = .0498). For CBT, the estimated 75^th percentile response times were 148 days [21.1 weeks] at site 1 and 134 days [19.1 weeks] at site 2. Response times were not estimable for SPT at either site because the response rate was too low. Thus, therapy clients seeking treatment for BDD and clinicians should be aware that an initial treatment response requires more than 11 therapy sessions for the majority of clients, and that 21 or even more sessions may be required. Treatment response is likely to occur earlier with CBT for BDD (the first-line therapy for BDD) than with supportive psychotherapy.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 1","pages":"Pages 68-79"},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81701747","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 Initial Efficacy of Stand-Alone DBT Skills Training for Treating Impulsivity Among Individuals With Alcohol and Other Substance Use Disorders” [Behav. Therapy 54(5) (2023) 809–822]","authors":"Marco Cavicchioli,&nbsp;Mariagrazia Movalli,&nbsp;Aurora Bruni,&nbsp;Rachele Terragni,&nbsp;Maria Elena Goldoni,&nbsp;Elisabetta Borgia,&nbsp;Marco Begarani,&nbsp;Anna Ogliari","doi":"10.1016/j.beth.2023.10.001","DOIUrl":"10.1016/j.beth.2023.10.001","url":null,"abstract":"","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 1","pages":"Page 212"},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0005789423001223/pdfft?md5=51ff37ab370508337adcbe621ae3a5d0&pid=1-s2.0-S0005789423001223-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138555713","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":"New Therapy for a New Normal: Comparing Telehealth and in-Person Time-Limited Parent-Child Interaction Therapy","authors":"Abigail Peskin,&nbsp;Alexandra Barth,&nbsp;W. Andrew Rothenberg,&nbsp;Amanda Turzi,&nbsp;Diana Formoso,&nbsp;Dainelys Garcia ,&nbsp;Jason Jent","doi":"10.1016/j.beth.2023.05.002","DOIUrl":"10.1016/j.beth.2023.05.002","url":null,"abstract":"<div><p>Telehealth treatment for child disruptive behavior has the potential to overcome multiple barriers to access (e.g., transportation, therapist availability). Traditional Parent-Child Interaction Therapy (PCIT) has demonstrated efficacy via telehealth in randomized controlled trials. The current study extends this research by examining community-based effectiveness of time-limited (i.e., 18 week) telehealth PCIT, comparing intake and posttreatment child behavior and caregiver skills for both telehealth and in-person PCIT. Participants included predominantly racially, ethnically, linguistically, and socioeconomically diverse children aged 2 to 8 years, and their caregivers. Dyads (<em>N</em> = 380) received either telehealth (IPCIT) or in-person PCIT.<!--> <!-->Propensity score analyses were conducted to address potential selection bias due to the nonrandomized sample. Regression analyses revealed no difference between IPCIT and in-person treatment for child disruptive behaviors or compliance outcomes. However, caregivers who received IPCIT demonstrated fewer positive statements and greater corrective/directive statements at posttreatment than caregivers who received in-person treatment.<!--> <!-->This research demonstrated that time-limited IPCIT can effectively improve child disruptive behavior among a socioeconomically, linguistically, and culturally diverse population, and represents the largest sample to date demonstrating the effectiveness of PCIT via telehealth. Future research is warranted to document intervention sustainability on a more system-wide level, and balance prioritizing caregiver skill acquisition over family-derived treatment goals.</p></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"55 1","pages":"Pages 106-121"},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79192857","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}