Journal of Anxiety Disorders最新文献

{"title":"Association of social and life threats with symptoms of posttraumatic stress disorder and social anxiety disorder","authors":"Johann P. Hardarson ,&nbsp;Berglind Gudmundsdottir ,&nbsp;Gunnar S. Jonsson ,&nbsp;Bergrun M. Johannesdottir ,&nbsp;Kristjana Thorarinsdottir ,&nbsp;Gunnar Tomasson ,&nbsp;Emily A. Holmes ,&nbsp;Arna Hauksdottir ,&nbsp;Unnur Valdimarsdóttir ,&nbsp;Gordon Asmundson ,&nbsp;Andri S. Bjornsson","doi":"10.1016/j.janxdis.2025.102981","DOIUrl":"10.1016/j.janxdis.2025.102981","url":null,"abstract":"<div><h3>Background</h3><div>This study examined psychological reactions to perceived threats, viewed within the context of human evolutionary history. We compared the relative weight of perceived threat to life or physical harm versus social threat, i.e., humiliation and/or rejection, in symptoms of posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD).</div></div><div><h3>Methods</h3><div>Participants were 50 women with clinically significant posttraumatic stress symptoms (PTSS) and 59 women with little or no PTSS (control group) selected from a large, population-based cohort of women in Iceland, the SAGA Cohort. Participants rated (1) life threat, (2) physical threat, (3) humiliation, and (4) rejection during their worst trauma or stressor.</div></div><div><h3>Results</h3><div>Rates of both life and social threats were higher in the PTSS than control group. Among the PTSS participants, 4 % (n = 2) reported primarily life threats (vs. 6.8 %, n = 4 in controls), 36 % (n = 18) reported primarily social threats (vs. 33.9 %, n = 20 in controls), and 60 % (n = 30) reported both types of threats (vs. 15.3 %, n = 9 in controls). Those who reported dual life and social threats exhibited elevated PTSS compared to those who experienced a single type of threat. The highest levels of life or physical threat, along with humiliation, predicted PTSS severity, but rejection did not. Nearly half of the PTSS group (approximately 50 %, n = 25) also met criteria for SAD compared to roughly 14 % (n = 8) in the control group, and humiliation predicted SAD symptom severity. Notably, 18 % of the PTSS group (n = 9) linked the onset of their SAD and PTSS to a singular trauma or stressor involving a social threat.</div></div><div><h3>Conclusions</h3><div>The findings underscore the role of social threat in PTSD and SAD, with implications for theoretical models of both disorders.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"110 ","pages":"Article 102981"},"PeriodicalIF":4.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348798","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":"Emotional growth mindsets and stress controllability buffer the link between stress intensity and anxiety symptoms: An ecological momentary assessment study","authors":"Jun Hu ,&nbsp;Jinmeng Liu ,&nbsp;Meng Meng ,&nbsp;Yiqun Gan","doi":"10.1016/j.janxdis.2025.102983","DOIUrl":"10.1016/j.janxdis.2025.102983","url":null,"abstract":"<div><div>Anxiety is highly prevalent among adults. Evidence suggests that perceived stress controllability and emotional growth mindsets are associated with decreased anxiety. However, whether these positive factors synergistically contribute to reducing the impact of stress on anxiety remains unclear, especially within everyday stress contexts. Multilevel models were used to investigate how perceived stress controllability and emotional growth mindsets interacted to mitigate the adverse impact of daily stress on anxiety, differentiating within- and between-person effects. Overall, 198 participants completed ecological momentary assessments of perceived stress intensity and controllability, emotional growth mindsets, and anxiety four times daily over 10–12 consecutive days. The within-person analyses showed that high emotional growth mindsets buffer the link between perceived stress intensity and anxiety. More importantly, the between-person and cross-level results suggested that the synergistic effect of emotional growth mindsets and perceived stress controllability maximally buffered the correlation between perceived stress intensity and anxiety. Additionally, these results highlighted that the positive association between perceived stress intensity and anxiety was most pronounced among participants with low emotional growth mindsets and perceived stress controllability. These findings further support a synergistic intervention approach that emphasizes anxiety alleviation through enhanced perceived stress controllability and the development of emotional growth mindsets.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"110 ","pages":"Article 102983"},"PeriodicalIF":4.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143232048","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":"Why do individuals with generalized anxiety disorder and depression engage in worry and rumination? A momentary assessment study of positive contrast enhancement","authors":"Seung Yeon Baik,&nbsp;Michelle G. Newman","doi":"10.1016/j.janxdis.2025.102982","DOIUrl":"10.1016/j.janxdis.2025.102982","url":null,"abstract":"<div><div>The contrast avoidance model suggests that individuals with generalized anxiety disorder (GAD) use worry to sustain negative emotionality and thus avoid a sharp increase in negative emotion. Maintenance of negative mood increases the probability of subsequent decreased negative and increased positive affect (positive emotional contrast; PEC) when worrisome outcomes are better than expected. However, occurrence of PECs via increased positive affect and its application to rumination are unclear. Using a momentary assessment design, we examined effects of worry/rumination on PECs associated with relief and positive events. Participants with GAD and/or major depressive disorder (MDD; <em>N</em> = 76), or without psychopathology (<em>N</em> = 85) rated the occurrence of relief and positive events, emotions, and repetitive thought 8x/day for 8 days. Higher vs. lower worry and rumination were associated with greater decreased anxiety and sadness, and greater increased happiness pre-to-post positive and relief events. Greater GAD and MDD symptoms predicted ongoing higher ratings on intentionally thinking pessimistically to be pleasantly surprised if something good happened. Results suggest that worry/rumination led to enhanced PECs via decreased negative and increased positive affect pre-to-post positive and relief events. Individuals with higher GAD and depression symptoms reported intentionally using worry/rumination to increase PECs in daily life.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"111 ","pages":"Article 102982"},"PeriodicalIF":4.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394269","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":"Is metacognitive therapy really non-inferior to exposure with response prevention in obsessive-compulsive disorder? – Methodological issues of non-inferiority testing","authors":"Falk Leichsenring ,&nbsp;Nikolas Heim ,&nbsp;Christiane Steinert","doi":"10.1016/j.janxdis.2025.102980","DOIUrl":"10.1016/j.janxdis.2025.102980","url":null,"abstract":"<div><div>There is evidence that exposure and response prevention (ERP) is efficacious in the treatment of obsessive-compulsive disorder <strong>(</strong>OCD). As an alternative to ERP metacognitive therapy (MCT) was developed. Two previous randomized controlled trials (RCTs) did not find significant differences between MCT and ERP. However, from non-significant results, non-inferiority of a treatment cannot be concluded. For this purpose, non-inferiority studies are required. Exner and colleagues carried out such a non-inferiority study whose results were recently published in this journal. The authors concluded from their results that MCT is a viable alternative treatment with efficacy similar to the standard ERP. However, this study raises several concerns, among them problems of transparency and of non-inferiority testing. These issues are critically discussed here in more detail. Taking all of these issues into account, the conclusions that can be drawn from the available studies are less clear. Further research is needed to decide whether MCT can really be considered as non-inferior to ERP or even as efficacious at all. Future studies need to fulfill the criteria of non-inferiority trials, that is (a) a priori define and (b) empirically justify a non-inferiority margin, (c) a preregistered sample size calculation ensuring a sufficient statistical power to confirm non-inferiority of the test treatment and (d) include a non-active control condition against which the standard and the test treatment are tested. Recommending a treatment prematurely as non-inferior to a standard treatment may prevent patients from receiving the most efficacious treatment.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"110 ","pages":"Article 102980"},"PeriodicalIF":4.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choosing certainty over risk: Associations of PTSD symptom severity with memory sampling during experiential decision making","authors":"Mieke Verfaellie ,&nbsp;Virginie Patt ,&nbsp;Ginette Lafleche ,&nbsp;Dominoe Jones ,&nbsp;Jennifer J. Vasterling","doi":"10.1016/j.janxdis.2025.102979","DOIUrl":"10.1016/j.janxdis.2025.102979","url":null,"abstract":"<div><div>The current study sought to examine whether lifetime PTSD symptom severity is associated with a bias toward sampling extreme negative events from memory when making decisions involving uncertainty. To this end, 40 trauma-exposed warzone veterans performed a decision task in which information about outcomes was learned through experience and making choices required sampling memories of past experiences. On each trial, participants made choices between certain and uncertain gains and between certain and uncertain losses. Uncertain outcomes were equally likely to yield a relatively positive or relatively negative outcome. After accounting for overall willingness to take risks, lifetime PTSD symptom severity was associated with less frequent choice of the uncertain option for gains and for losses, a pattern consistent with a memory sampling bias for all negative experiences rather than only extreme negative experiences. The overweighting of negative experiences as a function of lifetime PTSD symptom severity, however, was not observed in a subsequent explicit memory task in which participants estimated the frequency with which different outcomes had occurred during the decision task. These findings suggest that the memory mechanism responsible for the PTSD-associated memory bias in decision making is distinct from that mediating explicit memory performance.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"110 ","pages":"Article 102979"},"PeriodicalIF":4.8,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143071239","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":"Development of a machine learning-based multivariable prediction model for the naturalistic course of generalized anxiety disorder","authors":"Candice Basterfield,&nbsp;Michelle G. Newman","doi":"10.1016/j.janxdis.2025.102978","DOIUrl":"10.1016/j.janxdis.2025.102978","url":null,"abstract":"<div><h3>Background</h3><div>Generalized Anxiety Disorder (GAD) is a chronic condition. Enabling the prediction of individual trajectories would facilitate tailored management approaches for these individuals. This study used machine learning techniques to predict the recovery of GAD at a nine-year follow-up.</div></div><div><h3>Method</h3><div>The study involved 126 participants with GAD. Various baseline predictors from psychological, social, biological, sociodemographic and health variables were used. Two machine learning models, gradient boosted trees, and elastic nets were compared to predict the clinical course in participants with GAD.</div></div><div><h3>Results</h3><div>At nine-year follow-up, 95 participants (75.40 %) recovered. Elastic nets achieved a cross-validated area-under-the-receiving-operator-characteristic-curve (AUC) of .81 and a balanced accuracy of 72 % (sensitivity of .70 and specificity of .76). The elastic net algorithm revealed that the following factors were highly predictive of nonrecovery at follow-up: higher depressed affect, experiencing daily discrimination, more mental health professional visits, and more medical professional visits. The following variables predicted recovery: having some college education or higher, older age, more friend support, higher waist-to-hip ratio, and higher positive affect.</div></div><div><h3>Conclusions</h3><div>There was acceptable performance in predicting recovery or nonrecovery at a nine-year follow-up. This study advances research on GAD outcomes by understanding predictors associated with recovery or nonrecovery. Findings can potentially inform more targeted preventive interventions, ultimately improving care for individuals with GAD. This work is a critical first step toward developing reliable and feasible machine learning-based predictions for applications to GAD.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"110 ","pages":"Article 102978"},"PeriodicalIF":4.8,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143096802","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":"A comparison of virtual reality and verbal imaginal exposure for childhood anxiety disorders","authors":"Bridget K. Biggs ,&nbsp;Stephen P.H. Whiteside ,&nbsp;Matthew Knutson ,&nbsp;Sara Seifert ,&nbsp;Deanna R. Hofschulte ,&nbsp;Jennifer R. Geske ,&nbsp;Alisson N. Lass ,&nbsp;Kristin S. Vickers ,&nbsp;Lilianne M. Gloe ,&nbsp;Stephanie T. Reneson-Feeder","doi":"10.1016/j.janxdis.2025.102974","DOIUrl":"10.1016/j.janxdis.2025.102974","url":null,"abstract":"<div><div>Virtual reality is a promising tool for improving efficacy of exposure therapy for childhood anxiety disorders (CADs), particularly for exposures that are challenging to orchestrate <em>in vivo</em>. The present study compared virtual reality exposure (VRE) to verbal imaginal exposure (IE) on anxiety elicited, homework completion, and preparation for subsequent exposures. Forty-five youth with CADs completed both types of exposure in session (order randomly assigned), practiced one form of exposure as homework (randomly assigned), and returned a week later to repeat both exposures (in randomized order), provide user feedback, and complete a related <em>in vivo</em> exposure. Both VRE and IE elicited moderate anxiety that decreased to mild during the exposure and were associated with lower initial anxiety ratings in subsequent exposures. These patterns did not differ across exposure type. The two techniques did not differ on homework completion. VRE was associated with greater simulator (motion) sickness symptoms. Participants rated VRE as more realistic than IE and noted pros and cons for both approaches. The present study supported use of VRE and IE in treatment of CADs without demonstrating superiority of either technique in effectiveness or homework completion.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"110 ","pages":"Article 102974"},"PeriodicalIF":4.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067710","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":"Intolerance of uncertainty, aging, and anxiety and mental health concerns: A scoping review and meta-analysis","authors":"Mandy H.M. Yu ,&nbsp;Yuan Cao ,&nbsp;Sylvia S.Y. Fung ,&nbsp;Gerald S.Y. Kwan ,&nbsp;Zita C.K. Tse ,&nbsp;David H.K. Shum","doi":"10.1016/j.janxdis.2025.102975","DOIUrl":"10.1016/j.janxdis.2025.102975","url":null,"abstract":"<div><div>Although intolerance of uncertainty (IU) is associated with negative outcomes, studies focusing on older adults are still emerging. Specifically, the relationship between IU and psychological health in this population remains unclear. Moreover, no review has focused on understanding the unique contributions of IU and aging to anxiety and mental health in older adults. This scoping review and meta-analysis addressed this gap and provided a comprehensive understanding of the relationship between IU, aging, and mental health. Among 45 studies reviewed, 37 were included in the meta-analysis using mixed effect analysis to examine the relationship between IU and age across adulthood. The remaining eight studies, along with seven selected from the meta-analysis, were included in the scoping review to evaluate the relationship between IU, anxiety, and mental health. Among these, 12 studies focused on late adulthood, two on overall adulthood, and one included both late and overall adulthood. Results of the meta-analysis revealed an overall significant age difference in IU throughout adulthood. Moreover, results of the scoping review indicated a direct correlation between IU and anxiety, and other psychological issues in elderly. These findings provide insights for future research and interventions aimed at reducing IU and improving mental health among older adults.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"110 ","pages":"Article 102975"},"PeriodicalIF":4.8,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A meta-analytic review of cognitive processing therapy with and without the written account","authors":"Julia C. Sager ,&nbsp;Christopher R. DeJesus ,&nbsp;Jaclyn C. Kearns ,&nbsp;Johanna Thompson-Hollands ,&nbsp;Stephanie L. Trendel ,&nbsp;Brian P. Marx ,&nbsp;Denise M. Sloan","doi":"10.1016/j.janxdis.2025.102976","DOIUrl":"10.1016/j.janxdis.2025.102976","url":null,"abstract":"<div><div>There are two versions of the Cognitive Processing Therapy (CPT) protocol: one that includes a trauma narrative and one that does not. Despite both versions being used in clinical practice, to date, there has not been a comprehensive comparison of posttraumatic stress disorder (PTSD) treatment outcomes associated with these two protocols. The current study is a meta-analytic review of 29 randomized controlled trials of CPT+A (<em>k</em> = 13) and CPT-C (<em>k</em> = 16) in which we investigated whether there are differences in treatment outcome effect sizes and treatment dropout between the two protocol versions. Sample type (military/veteran versus non-military/non-veteran) as a moderator was examined, given that less robust PTSD treatment outcomes have been typically observed in military and veteran samples. Meta-regression analyses revealed that there were no significant differences between the two CPT protocol versions in pre-post PTSD treatment effect sizes, <em>t</em>(26) = -0.743, <em>p</em> = .463. As expected, studies that enrolled a military or veteran sample reported an average smaller symptom reduction (<em>g</em> = 0.95) than studies that enrolled a non-military or non-veteran sample (<em>g</em> = 1.41), <em>t</em>(26) = 2.48, <em>p</em> = .019. There were also no significant differences between the two CPT protocols for treatment dropout, <em>t</em>(26) = 1.69, <em>p</em> = .104, or between studies enrolling military/veteran and non-military/non-veteran samples <em>t</em>(26) <em>=</em> -1.10, <em>p</em> = .282. The findings support the use of either CPT protocol in practice, but also demonstrate that veterans and service members may be less responsive to either CPT protocol than other trauma samples.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"110 ","pages":"Article 102976"},"PeriodicalIF":4.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349075","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":"Mindfulness- and acceptance-based programmes for obsessive-compulsive disorder: A systematic review and meta-analysis","authors":"Johannes J. Bürkle ,&nbsp;Stefan Schmidt ,&nbsp;Johannes C. Fendel","doi":"10.1016/j.janxdis.2025.102977","DOIUrl":"10.1016/j.janxdis.2025.102977","url":null,"abstract":"<div><div>Mindfulness- and acceptance-based programmes (MABPs) in the treatment of obsessive-compulsive disorder (OCD) are increasingly gaining research interest, yet a comprehensive systematic review and meta-analysis is missing. To fill this gap, we analysed 46 trials involving 2221 patients. Two independent reviewers screened records, extracted data, assessed risk of bias, and rated overall quality of evidence. MABPs were associated with large reductions in OCD-severity in between-group analysis in randomised controlled trials (<em>k</em> = 33; <em>g</em> = -.87; CI = -1.13,-.60) and within-group pre-post analysis in all MABPs (<em>k</em> = 49; <em>g</em> = -1.72; CI = -2.00,-1.44). Depressive symptoms decreased between- and within-group with a small to moderate effect, with maintained reductions at follow-up for both OCD and depression. Moderate to large pre-post improvements were also observed in anxiety, obsessive beliefs, and quality of life. MABPs did not differ from cognitive behavioural therapy and exposure and response prevention (<em>k</em> = 9; <em>g</em>=.02; CI = -.23,.26) but were superior to medication (<em>k</em> = 5; <em>g</em> = -.77; CI = -1.44,-.11) and waitlist (<em>k</em> = 16; <em>g</em> = -1.66; CI = -2.1,-1.24). Symptom reductions were observed across world regions, but to varying degrees. When combined, increases in mindfulness and psychological flexibility predicted reductions in OCD symptoms. Outcomes were not moderated by treatment duration, samples’, and therapists’ characteristics. MABPs can reduce OCD-severity, but further high-quality trials with long-term follow-ups are needed to confirm results.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"110 ","pages":"Article 102977"},"PeriodicalIF":4.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}