Journal of Anxiety Disorders最新文献

{"title":"Memory and identity processes in ICD-11 complex posttraumatic stress disorder: Tests of a new theory","authors":"Philip Hyland ,&nbsp;Marcus Broughill ,&nbsp;Mark Shevlin ,&nbsp;Chris R. Brewin","doi":"10.1016/j.janxdis.2025.103055","DOIUrl":"10.1016/j.janxdis.2025.103055","url":null,"abstract":"<div><h3>Background</h3><div>This study empirically tested several predictions arising from the Memory and Identity (M&amp;I) Theory of <em>ICD-11</em> Complex PTSD (CPTSD). Specifically, it examined the psychometric properties of two measures—the Experiences of Traumatic Memories Questionnaire (ETMQ) and the Trauma Identity Questionnaire (TIQ)—and tested relationships between different types of trauma exposure, disturbances in memory and identity, and CPTSD symptoms.</div></div><div><h3>Methods</h3><div>Data were collected from a non-probability based representative sample of the general adult population of the United Kingdom (<em>N</em> = 975), and latent variable modelling was used to test all hypotheses.</div></div><div><h3>Results</h3><div>Confirmatory factor analytic results provided support for the psychometric properties of the ETMQ and TIQ as measures of traumatic memories and negative identities. Multiple traumatization and interpersonal forms of trauma were associated with more disturbances in trauma memories and negative identities. Seven of the nine model-predicted associations between trauma memories, negative identities, and CPTSD symptoms were observed, including a link between a fragmented sense of self and emotional numbing.</div></div><div><h3>Conclusions</h3><div>Results support core elements of the M&amp;I Theory, highlighting trauma memory and identity disturbances as key mechanisms in CPTSD.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"114 ","pages":"Article 103055"},"PeriodicalIF":4.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Savoring meditation for emotional disorders: Targeting positive emotion regulation deficits","authors":"Tomoko Kishimoto ,&nbsp;Ximing Hao ,&nbsp;Jianwei Qian","doi":"10.1016/j.janxdis.2025.103054","DOIUrl":"10.1016/j.janxdis.2025.103054","url":null,"abstract":"<div><div>Deficits in positive emotion regulation (PER) contribute to emotional disorders but are less studied than negative emotion regulation (NER). One maladaptive PER strategy, positive emotion contrast-seeking (PEC-seeking), involves sustaining negative affect to enhance later positive emotions, reinforcing anxiety and depression. This study developed and tested a savoring-based, transdiagnostic intervention to reduce PEC-seeking and alleviate emotional disorder symptoms. A single-blind RCT with 59 Chinese college students with elevated depression and anxiety (majority meeting depression criteria) compared a two-week group savoring meditation intervention to waitlist control. Changes in depression, anxiety, savoring beliefs, and PEC-seeking were assessed at Baseline (T0), MidTest (T1), PostTest (T2), and one-month Follow-up (T3). The experimental group also reported positive and negative affect before and after each group session and individual practice. Savoring meditation significantly reduced depression (T1, <em>d</em> = −1.11, <em>p</em> = .005; T2, <em>d</em> = −1.60, <em>p</em> &lt; .001) with effects maintained at follow-up (T3, <em>p</em> &lt; .001). Negative affect also declined significantly (Session 5, <em>p</em> &lt; .001), though changes in positive affect were not statistically significant. The intervention increased savoring beliefs (T1, <em>d</em> = 1.42, T2, <em>d</em> = 1.41, <em>ps</em> =.003) and reduced PEC-seeking (T1, <em>d</em> = −0.92, <em>p</em> = .027), which in turn mediated reductions in depression. Although anxiety symptoms declined within the experimental group over time, between-group differences did not reach statistical significance. Nonetheless, the effect size was larger for the experimental group (T2, <em>d</em> = 0.34) than for the waitlist group (<em>d</em> = 0.01), suggesting a potential anxiolytic effect of the intervention. These findings suggest that targeting maladaptive PER strategies, especially PEC-seeking, via savoring meditation may effectively reduce emotional disorder symptoms. This study highlights PER’s role in transdiagnostic interventions and provides novel insights into PER-focused therapies.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"114 ","pages":"Article 103054"},"PeriodicalIF":4.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emetophobia (fear of vomiting): A meta-analysis","authors":"Adrian Meule,&nbsp;Leonie Seufert,&nbsp;David R. Kolar","doi":"10.1016/j.janxdis.2025.103053","DOIUrl":"10.1016/j.janxdis.2025.103053","url":null,"abstract":"<div><div>Emetophobia refers to a specific fear of vomiting. There are only few original research studies on this condition and no study that has meta-analytically synthesized findings to describe the characteristics of persons with emetophobia. To this end, we extracted data from 31 reports and—as we examined different dependent variables—each meta-analysis was based on five to 21 samples. The pooled mean age of persons with emetophobia was 29 years but was reduced to 21–27 years when adjusting for publication bias. The pooled mean age of disorder onset was 10 years. The pooled proportion of females was 91 %. The pooled proportions of reporting fear of vomiting oneself, fear of seeing others vomit, or both, were 47 %, 11 %, and 39 %. The most common comorbid mental disorders were social anxiety disorder, depression, and generalized anxiety disorder. The pooled point prevalence of emetophobia was 5 %. Higher emetophobic symptomatology moderately related to higher disgust propensity and higher anxiety, and weakly related to higher depressive symptomatology. This meta-analysis is the first to quantify that most adults with emetophobia are in early adulthood but the disorder started in childhood, almost all are women, the primary locus of fear is vomiting oneself, the most common comorbid mental disorders are other anxiety and affective disorders, and higher emetophobic symptomatology relates to a more general tendency to be easily disgusted and to be anxious. Studies based on representative samples to obtain reliable estimates on the prevalence of emetophobia are needed.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"114 ","pages":"Article 103053"},"PeriodicalIF":4.8,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep disturbances predict nine-year panic disorder chronicity: The sleep-panic nexus theory with machine learning insights","authors":"Nur Hani Zainal ,&nbsp;Natalia Van Doren","doi":"10.1016/j.janxdis.2025.103052","DOIUrl":"10.1016/j.janxdis.2025.103052","url":null,"abstract":"<div><h3>Background</h3><div>Panic disorder (PD) is a chronic and impairing anxiety disorder. Individuals with more sleep disturbances might be predisposed to nine-year PD chronicity. However, linearity assumptions, small predictor sets, and analytic and design limitations have hindered optimal identification of which sleep disturbance variables are distal risk factors for PD chronicity. We thus used machine learning (ML) to predict nine-year PD chronicity using high-dimensional data.</div></div><div><h3>Method</h3><div>Community-dwelling adults (<em>N</em> = 1054) completed clinical interviews, self-reports, and seven-day sleep actigraphy at Wave 1 (W1) and the same clinical interview at Wave 2 (W2) nine years later. The baseline data comprised 43 actigraphy, self-reported sleep disturbances, clinical, and demographic variables. Seven ML models were examined. Gradient boosting machine (GBM) was the best-performing algorithm. PD chronicity was defined as the presence of a PD diagnosis at both W1 and W2.</div></div><div><h3>Results</h3><div>The GBM accurately predicted PD chronicity (area under the receiver operating characteristic curve [AUC] =.764). Shapley additive explanation analysis showed that the top W1 predictors of PD chronicity were comorbid major depressive disorder, low healthcare utilization, sleep medication use, lengthier wake after sleep onset, and sleep-wake circadian disruptions based on actigraphy and self-reports. Lower household income and younger age were also top predictors. Additionally, the final multivariate model was well-calibrated.</div></div><div><h3>Conclusions</h3><div>As proposed in our <em>sleep-panic nexus theory</em>, actigraphy and subjective sleep disturbances have essential prognostic value in predicting long-term PD chronicity. Harnessing ML facilitates accurate prediction by identifying complex, nonlinear relations across high-dimensional datasets, possibly improving prevention and treatment tailoring.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"114 ","pages":"Article 103052"},"PeriodicalIF":4.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bidirectional associations between PTSD symptoms and pain in daily life among women survivors of sexual assault","authors":"Alexandra N. Brockdorf ,&nbsp;Lauren E. Simpson ,&nbsp;David DiLillo","doi":"10.1016/j.janxdis.2025.103051","DOIUrl":"10.1016/j.janxdis.2025.103051","url":null,"abstract":"<div><div>The co-occurrence between pain and posttraumatic stress disorder (PTSD) is commonly explained by the mutual maintenance model, which proposes that each condition exacerbates the other. We tested this model by examining within-day associations between pain and PTSD using a three-week ecological momentary assessment (EMA) design. Young adult cisgender women (<em>N</em> = 82) who experienced sexual assault and reported PTSD symptoms and probable alcohol misuse completed three self-report surveys per day assessing momentary pain intensity and PTSD symptoms. Results from a dynamic structural equation model supported hypotheses, such that pain predicted greater PTSD symptoms four hours later and PTSD symptoms predicted greater pain. However, exploratory follow up analyses revealed differential findings by cluster, such that intrusions, negative alterations in cognition and mood, and hyperarousal each predicted subsequent pain, whereas pain predicted only later hyperarousal. Findings add nuance to our understanding of the mutual maintenance model and point to hyperarousal symptoms as a key symptom cluster linking daily pain and PTSD among women who have experienced sexual assault. Findings underscore the potential value of targeting hyperarousal symptoms in integrative interventions.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"114 ","pages":"Article 103051"},"PeriodicalIF":4.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding climate anxiety and potential impacts on pro-environment behaviours","authors":"Zac Coates,&nbsp;Scott Brown,&nbsp;Michelle Kelly","doi":"10.1016/j.janxdis.2025.103049","DOIUrl":"10.1016/j.janxdis.2025.103049","url":null,"abstract":"<div><div>Previous studies have identified harmful social, physical, and mental impacts due to climate change. Anxiety due to climate change or “climate anxiety” may be an adaptive or reasonable response to a real threat; however, it may also be associated with considerable functional impairment of associated behaviours. In this study, we examined the relationship between climate anxiety and pro-environment behaviours, via an online discrete choice experiment, with 374 participants recruited from prolific academic and undergraduate university recruitment program. This experiment included our discrete choice measure of pro-environment behaviours and self-report survey items examining climate anxiety, general anxiety, death anxiety, and locus of control. We found that a moderate level of climate anxiety may be optimal for making pro-environmental choices, with this group having significantly more eco-friendly choices than participants in the low or high climate anxiety groups. We also examined the relationships between climate anxiety and three other psychological concepts, locus of control, general anxiety, and death anxiety, and found that these 3 factors were positively related to climate anxiety. These findings may indicate that some additional negative mental health outcomes are associated with high levels of climate anxiety. This study provides evidence for the use of discrete choice experiments when examining pro-environment behaviours, which may allow future studies to further examine various other trade-offs or factors such as the cost that participants are willing to “pay” for an eco-friendly option.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"114 ","pages":"Article 103049"},"PeriodicalIF":4.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered resting-state amygdala-cerebellar functional connectivity is associated with intolerance of uncertainty in patients with obsessive-compulsive disorder: A longitudinal study","authors":"Qihui Guo ,&nbsp;Rongrong Zhu ,&nbsp;Huixia Zhou ,&nbsp;Dongmei Wang ,&nbsp;Xiangyang Zhang","doi":"10.1016/j.janxdis.2025.103048","DOIUrl":"10.1016/j.janxdis.2025.103048","url":null,"abstract":"<div><h3>Objectives</h3><div>Intolerance of uncertainty (IU) plays an important role in the pathology of obsessive-compulsive disorder (OCD). The amygdala and anterior insula (AI) appear to be important neural correlates of IU. However, the relationship between altered resting-state functional connectivity (rsFC) and IU in OCD patients has not been reported.</div></div><div><h3>Methods</h3><div>This study recruited 39 patients with OCD and 45 healthy controls (HC). IU was measured using the Intolerance of Uncertainty Scale (IUS). The seed-to-voxel method was used to construct rsFC maps. Between-group differences in rsFC and their correlations with IU were analyzed. Following an eight-week psychological intervention, OCD patients underwent a second assessment. The association between rsFC changes and IU changes was investigated.</div></div><div><h3>Results</h3><div>OCD patients exhibited significantly higher IUS scores. Significant alterations in rsFC were observed between the left amygdala and the left cerebellum posterior lobe (CPL), as well as between the left AI and the left cuneus in OCD patients. In the OCD group, only the left amygdala - left CPL rsFC significantly correlated with IUS scores. No significant correlations were found between rsFC and IUS scores in the HC group. Longitudinal analysis revealed that changes in the left amygdala - left CPL rsFC were significantly associated with changes in IUS scores.</div></div><div><h3>Conclusions</h3><div>This study establishes amygdala-cerebellar rsFC as a specific neural signature of IU in patients with OCD, patterns absent in healthy controls. Moreover, the amygdala-cerebellar rsFC displayed longitudinal coupling with IU changes. These findings provide novel insights into the neural mechanisms of OCD pathology.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"114 ","pages":"Article 103048"},"PeriodicalIF":4.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PTSD and cognition in older adults: A systematic literature review","authors":"Jasmijn E. van Rossum ,&nbsp;Semmy Op den Camp ,&nbsp;Renske Uiterwijk ,&nbsp;Kay Deckers ,&nbsp;Vasiliki Orgeta ,&nbsp;Bernice J.A. Gulpers ,&nbsp;Sjacko Sobczak","doi":"10.1016/j.janxdis.2025.103047","DOIUrl":"10.1016/j.janxdis.2025.103047","url":null,"abstract":"<div><div>Post-traumatic stress disorder (PTSD) is a disabling mental health disorder affecting psychosocial functioning and quality of life. This systematic review is the first to summarize existing global literature on the relationship between PTSD and specific domains of cognitive function in the general population of older adults. We searched PsycINFO, Medline and CINAHL up until November 1st 2024. Studies were included if they were longitudinal cohort or cross-sectional studies of adults aged 60 years and over with a clinical diagnosis of PTSD or subthreshold PTSD symptoms, reporting on any domain of cognitive functioning using a standardised measure. Eighteen good or satisfactory quality articles met criteria for this review, of which three were longitudinal cohort studies and fifteen were cross-sectional studies. PTSD was associated with significant accelerated general cognitive decline and possible accelerated decline in attention and memory over time. Older adults with PTSD additionally performed significantly worse on measures of global cognitive function and memory compared to those without PTSD. For executive function results were mixed; two studies showed significant negative associations, whereas four other studies showed no significant differences between individuals with and without PTSD. Proactive screening of individuals with PTSD for cognitive decline and an additional focus of PTSD treatment on cognitive functioning are needed.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"114 ","pages":"Article 103047"},"PeriodicalIF":4.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Affective forecasting during a horror attraction: Insights into Intolerance of Uncertainty","authors":"L. FitzGibbon ,&nbsp;J. Morriss ,&nbsp;M. Clasen ,&nbsp;S. Wake ,&nbsp;R. Nesbit ,&nbsp;M. Malmdorf Andersen ,&nbsp;H.F. Dodd","doi":"10.1016/j.janxdis.2025.103046","DOIUrl":"10.1016/j.janxdis.2025.103046","url":null,"abstract":"<div><div>In this field study, we examined for the first time how Intolerance of Uncertainty influences expectations about negative, positive, and anxiety-related affect alongside the accuracy of those expectations. The study was conducted at a horror attraction, which offers an immersive, uncertain and threat-related experience. Participants (n = 1029) completed a measure of forecasted negative, positive and anxiety-related affect prior to the experience. Immediately after the experience, they rated their actual subjective experience of each of these affective states. Additionally, confidence ratings were reported for each forecasted emotion so that metacognitive awareness of forecasting accuracy could be assessed. Results showed that participants high in IU anticipated and actually experienced less positive affect, more anxiety-related affect and more negative-affect compared to those low in IU. IU predicted bias (overestimations) in emotional forecasts for negative affect, but not for positive or anxiety-related affect. The findings demonstrate that IU may be related to affective forecasting, which has implications for transdiagnostic models and treatment of psychopathology.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"114 ","pages":"Article 103046"},"PeriodicalIF":4.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of the implementation of transdiagnostic PsicAP-CV protocol for anxiety and depression in primary care: A Stepped Wedge Cluster Randomised Trial","authors":"Gabriel Esteller-Collado ,&nbsp;Virtudes Pérez-Jover ,&nbsp;Carlos Van-der Hofstadt Román ,&nbsp;Elisabeth Malonda-Vidal ,&nbsp;Anna Llorca-Mestre ,&nbsp;Maider Prieto-Vila ,&nbsp;María Carpallo-González ,&nbsp;César González-Blanch ,&nbsp;Paloma Ruíz-Rodríguez ,&nbsp;Juan Antonio Moriana ,&nbsp;Antonio Cano-Vindel ,&nbsp;Roger Muñoz-Navarro","doi":"10.1016/j.janxdis.2025.103045","DOIUrl":"10.1016/j.janxdis.2025.103045","url":null,"abstract":"<div><h3>Introduction</h3><div>Anxiety and depressive disorders represent a public health challenge, with high prevalence rates and considerable impact on quality of life (QoL) and functioning. Despite evidence supporting the efficacy of transdiagnostic cognitive behavioural therapy (TD-CBT), its implementation in settings such as primary care (PC) remains limited. The aim of this paper is to analyse the results of the PsicAP-CV, a clinical trial evaluating the effectiveness and implementation of TD-CBT in the PC setting.</div></div><div><h3>Methods</h3><div>The study included 320 patients from the PsicAP-CV trial, a Stepped Wedge Cluster-Randomised Trial (SW-CRT). Symptoms of anxiety and depression were assessed, as well as QoL and functioning. Linear models were used to study treatment effects on outcomes and rates of recovery, reliable recovery and deterioration were calculated.</div></div><div><h3>Results</h3><div>findings indicate that TD-CBT is more effective than treatment-as-usual (TAU) in reducing symptoms of anxiety and depression, as well as improving QoL and functioning. In addition, although the overall reduction in symptomatology was similar between patients who received immediate treatment (EG₁) and those who received delayed treatment (EG₂), there was a trend in favour of the EG₁ group in the recovery indicators.</div></div><div><h3>Discussion</h3><div>these findings confirm the efficacy of TD-CBT for treating common mental disorders in PC and point to SW-CRT designs as a feasible and ethically sound avenue for implementing and scaling these evidence-based interventions within public health systems. They also support the broader integration of psychologists into PC, thus offering a scalable model that can significantly improve access to and outcomes of mental health care.</div></div><div><h3>Trial registration</h3><div>EURADICT 2013-001955-11/ISRCTN58437086.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"114 ","pages":"Article 103045"},"PeriodicalIF":4.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}