Behaviour Research and Therapy最新文献

{"title":"Ten generic competences to improve outcomes of cognitive behaviour therapy: Evidence, postulated processes, and clinical implications","authors":"Tracey D. Wade ,&nbsp;Glenn Waller","doi":"10.1016/j.brat.2025.104826","DOIUrl":"10.1016/j.brat.2025.104826","url":null,"abstract":"<div><div>In the 18 years since higher-order, generic competences (metacompetences) were first identified to guide the implementation of cognitive behaviour therapy (CBT) across anxiety and depression, much evidence has accrued supporting these generic competences and identifying others. We describe 10 generic competences that can support therapists to deliver the strongest possible outcomes in CBT across different forms of psychopathology. In each case, the robustness of the evidence-base is reviewed, the theoretical processes that link the generic competence with improved outcome for the patient are considered, and practical suggestions are offered to the therapist. The ten generic competences include: balance firmness and empathy to ensure an effective working alliance; manage therapist discomfort to use effective techniques; push for early behavioural change; focus on (and respond to) session-by-session progress in therapy; require your patient (and service) to invest in an intensive start to therapy; complex presentations should initially be met with routine therapy, changing only where guided by evidence; deliver therapy competently rather than with rigid adherence; encourage the patient to argue for behavioural change; homework completion is critical for therapy to be effective; and positive outcomes require therapists who are well-trained and well-supervised. We provide recommendations for clinical practice and future research, recognising that this list will change and grow as new evidence accumulates.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"193 ","pages":"Article 104826"},"PeriodicalIF":4.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749798","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":"Fear extinction using a conditioned stimulus that was temporally proximal to the unconditioned stimulus reduces physiological and subjective return of fear","authors":"Kobi Eales,&nbsp;Ottmar V. Lipp,&nbsp;Joe Anderson,&nbsp;Madeline Jarvis,&nbsp;Luke J. Ney","doi":"10.1016/j.brat.2025.104828","DOIUrl":"10.1016/j.brat.2025.104828","url":null,"abstract":"<div><div>Fear conditioning is often used as a model paradigm to understand memory processes in posttraumatic stress disorder (PTSD). The Ehlers and Clark (2000)cognitive model of PTSD states that a neutral stimulus should be temporally proximal to trauma to become a conditioned stimulus (CS). In two groups of participants, we tested whether presentation of a CS (CSX) simultaneously to a mild electric shock resulted in a stronger fear extinction cue compared to a standard CS+, which precedes the shock. Both groups underwent identical conditioning protocols, except the CSX group viewed the CSX during extinction, whereas the CS + group viewed the CS+ during extinction. We also tested whether salivary cortisol and endogenous cannabinoids were associated with fear conditioning. We found that the CSX group had significantly reduced physiological and subjective return of fear compared to the CS + group. The CSX was rated by all participants as less pleasant and more arousing than the CS+ and also more rapidly re-acquired conditioned responding during re-acquisition. Salivary cortisol and endogenous cannabinoids were both associated with the return of fear. These findings suggest that re-evaluation of the utility of the standard fear conditioning paradigm to understand PTSD symptomology is required and that an increased focus on identifying the most salient cues to extinguish is needed. Our findings also suggest that salivary endogenous cannabinoid measurements may be useful for studying fear conditioning, though this work needs replication in larger and more diverse participant samples.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"193 ","pages":"Article 104828"},"PeriodicalIF":4.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738826","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":"Behavioral experiments vs. verbal interventions in cognitive therapy for social anxiety disorder: A randomized controlled trial","authors":"Cem Yilmaz ,&nbsp;Arwin Nemani ,&nbsp;Jan Schittenhelm ,&nbsp;David M. Clark ,&nbsp;Graham Thew ,&nbsp;Ulrich Stangier","doi":"10.1016/j.brat.2025.104825","DOIUrl":"10.1016/j.brat.2025.104825","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The efficacy of cognitive therapy (CT) for social anxiety disorder (SAD) is well documented, although effect sizes (ES) vary significantly across studies. These variations may be attributable to differences in the active components of the treatments. A key component potentially influencing outcomes is the use of behavioral experiments (BEs), as opposed to purely verbal interventions (VIs) for changing social anxiety related negative beliefs. The present trial compared the effectiveness of CT incorporating behavioral experiments (CT-BE) with that of CT focusing more exclusively on verbal interventions (CT-VI). We hypothesized that CT-BE would lead to greater reductions in social anxiety symptoms.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Sixty patients were randomly assigned to one of two treatment conditions: CT-BE or CT-VI (&lt;em&gt;n&lt;/em&gt; = 30 per group). The primary outcome was the severity of social anxiety symptoms, which was assessed via the clinician-administered Liebowitz Social Anxiety Scale (LSAS). This measure was also used to compute response. The secondary outcomes included the self-administered Social Phobia Inventory (SPIN), clinician-rated and self-rated depression, and clinician-rated skills in emotion regulation regarding social anxiety. Assessments were conducted at baseline, posttreatment and (for clinician-administered measures) 6-months follow-up.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;No significant differences between treatment groups were found for social anxiety outcomes or any other measure at post-treatment, however, a statistical trend in favor of CT-BE was observed for the primary outcome LSAS (&lt;em&gt;p&lt;/em&gt; = .072). Between-group ES for anxiety outcomes at post-treatment were sizeable (&lt;em&gt;d&lt;/em&gt; = 0.55 for LSAS, &lt;em&gt;d&lt;/em&gt; = 0.41 for SPIN), suggesting a potential advantage of CT-BE over CT-VI. Although both treatments showed high overall effectiveness, as reflected in large within-participant ES for anxiety outcomes and high response probabilities (97.7 % for CT-BE, 74.9 % for CT-VI), within-participant ES for anxiety-related outcomes were particularly high in the CT-BE group (up to &lt;em&gt;d&lt;/em&gt; = 2.59) and substantially exceeded those in the CT-VI group (up to &lt;em&gt;d&lt;/em&gt; = 1.02). At follow-up, significant group differences emerged for emotion regulation, favoring CT-BE (&lt;em&gt;p&lt;/em&gt; &lt; .001, &lt;em&gt;d&lt;/em&gt; = 1.19), indicating a large advantage of BEs in fostering long-term improvements in emotion regulation skills.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The results indicate that behavioral experiments may be an effective component in cognitive therapy for patients with social anxiety disorder, especially facilitating long term emotional regulation skills, in addition to verbal interventions and other experiential exercises. Future research should expand the use of behavioral experiments to larger trials and clarify which mechanisms are involved in the mediating effects of behavioral experiments on outcomes","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"193 ","pages":"Article 104825"},"PeriodicalIF":4.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756943","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 randomized-controlled trial comparing relative effects of mindfulness-based interoceptive exposure focus versus distraction on cold-pressor induced pain","authors":"Corinna Baum,&nbsp;Vanessa Ditter,&nbsp;Janina Wurtz,&nbsp;Maureen Schitter,&nbsp;Anne Martinelli","doi":"10.1016/j.brat.2025.104824","DOIUrl":"10.1016/j.brat.2025.104824","url":null,"abstract":"<div><div>Pain can positively be influenced by the control or direction of attention, e.g. attention diversion from or focusing on pain. The Mindfulness-based Interoceptive Exposure Task (MIET) is an easy to learn and simple to apply interoceptive desensitization method using a sensory focus strategy. This study investigates the distinct effects of sensory-focus and distraction on experimental pain reduction. One hundred and sixty participants (mean age = 24 years, 71 % female) were randomized to a MIET, distraction or passive control condition. Cold pain tolerance, intensity and aversiveness were assessed during task performance and compared to baseline. The MIET and distraction task both improved pain tolerance while reducing pain intensity and aversiveness. Even considering individual pain baselines, both tasks were effective for pain intensity and the MIET for pain tolerance, in particular. Dispositional mindfulness, measured by the Five Factor Mindfulness Questionnaire (FFMQ), and pain-related fear, measured by the Fear of Pain Questionnaire, served as distinct predictors of the pain-reducing MIET effect. Individuals with lower mindful awareness and nonreactivity on the FFMQ appeared to benefit more from the MIET method, particularly for pain tolerance. Higher fear of pain reduced the effect of the MIET on pain intensity but not on pain tolerance. This study demonstrates the efficacy of attention directing tasks on pain processing and shows distinct advantages of an exposure-based mindfulness task on pain tolerance and intensity.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"193 ","pages":"Article 104824"},"PeriodicalIF":4.5,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721516","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":"Imagery rescripting for patients with obsessive-compulsive disorder not responding to outpatient cognitive behavioral therapy","authors":"Fatma Arslan ,&nbsp;Julie Krans ,&nbsp;Gert-Jan Hendriks ,&nbsp;Lynn Mobach ,&nbsp;Mirjam Kampman","doi":"10.1016/j.brat.2025.104823","DOIUrl":"10.1016/j.brat.2025.104823","url":null,"abstract":"<div><div>This study tested the effects of Imagery Rescripting (ImRs) on obsessive-compulsive disorder (OCD) symptoms in seven individuals who remained symptomatic after at least one earlier exposure and response prevention treatment. ImRs was provided twice per week for three weeks. A single-case experimental design with repeated measures was utilized to test the intervention effectiveness with measurements at baseline, pre-treatment, post-treatment, and 2.5–5.5 weeks and 3-month follow-up. Results revealed a statistically significant overall decrease in OCD symptoms from baseline to 3-month follow-up (p = .001, d = 1.06). At 3-month follow-up three participants exhibited reliable improvements in depression symptoms and three participants showed reliable improvements in quality of life. The findings highlight that ImRs has potential as an effective treatment for patients with persistent OCD symptoms after exposure and response prevention treatment. Further research is needed to determine the optimal application of IMRS in OCD treatment, including the appropriate number of sessions and the selection of the target memory.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"193 ","pages":"Article 104823"},"PeriodicalIF":4.2,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633023","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":"The role of the body in altered facial emotion perception in autism and social anxiety","authors":"Julia Folz ,&nbsp;Kristina Nikić ,&nbsp;Milica Nikolić ,&nbsp;Vivien Janowicz ,&nbsp;Katja Koelkebeck ,&nbsp;Mariska E. Kret","doi":"10.1016/j.brat.2025.104819","DOIUrl":"10.1016/j.brat.2025.104819","url":null,"abstract":"<div><div>Alterations in the perception of facial emotional expression and their physiological resonance, as well as in accurately sensing bodily states (i.e., interoception) have been reported in both autism and social anxiety. In the current study, we aimed to examine the association between physiological responses, their sensation, and facial emotion perception in individuals on the autism spectrum (N = 40), individuals with social anxiety (N = 27) and neurotypical controls (N = 40). Participants first viewed videos of spontaneous facial expressions (anger, happiness, sadness, fear and neutral) while facial muscle responses (corrugator supercilii and zygomaticus major), indicating facial mimicry, and skin conductance, indicating emotional arousal, were recorded. In a separate task, the same expressions were judged regarding their emotion category, the confidence in the accuracy of this judgment, and the intensity of the observed emotional experience. Compared to controls, individuals with social anxiety showed a stronger link between physiological arousal and the perceived intensity of sadness. Individuals on the autism spectrum showed a relatively weaker link between the mimicry of anger and the intensity at which this expression was perceived. Differences in self-reported interoceptive accuracy also played a role in the latter link, suggesting alterations in integrating embodied emotions in autism.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"193 ","pages":"Article 104819"},"PeriodicalIF":4.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694432","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 rigidity in adolescents prospectively predicts future depressive symptoms assessed via self-report and clinical interview","authors":"Hadar Fisher ,&nbsp;Kristina Pidvirny ,&nbsp;Nigel M. Jaffe ,&nbsp;Anna O. Tierney ,&nbsp;Diego A. Pizzagalli ,&nbsp;Christian A. Webb","doi":"10.1016/j.brat.2025.104818","DOIUrl":"10.1016/j.brat.2025.104818","url":null,"abstract":"<div><div>Adolescence is a critical developmental period marked by an elevated risk for Major Depressive Disorder (MDD). Identifying predictive risk factors is crucial for the development and timely delivery of preventative interventions. One potential risk factor is maladaptive and rigid emotion dynamics, which findings suggest is linked with depressive symptoms. Accordingly, to identify individuals at risk, the current study investigated whether emotional rigidity is a prospective predictor of depressive symptoms in adolescence using both self-reported and clinician-rated depression assessments. Adolescents (n = 117, aged 12–18) completed self-reported and clinician-rated measures of depressive symptoms at baseline and every 6 months for two years. Additionally, they received one month of ecological momentary assessment (EMA) surveys at baseline, reporting their emotions four times a day (n = 10,196). Multilevel vector autoregressive (mlVAR) models estimated temporal and contemporaneous density (operationalization of emotion rigidity) of subject-specific networks. Higher temporal and contemporaneous network density, as well as an aggregate density score, predicted greater future depressive symptoms controlling for baseline symptoms, as measured by either participants' self-report or clinician reports. Density emerged as a stronger predictor of future depression than any specific emotion inertia (i.e., predictability of one emotion state). Additionally, and supporting incremental predictive validity, temporal and aggregated density scores predicted future clinician-rated depression, and the aggregated score predicted self-reported depression, over and above mean levels of negative and positive affect. Collectively, these findings may have significant clinical implications for early identification and targeted preventative interventions among youth at risk of future depression by virtue of relatively rigid emotion dynamics.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"193 ","pages":"Article 104818"},"PeriodicalIF":4.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656647","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":"Introduction to special issue honoring Dianne L. Chambless (1948-2023).","authors":"Alyson K Zalta, Thomas Rodebaugh, Jedidiah Siev","doi":"10.1016/j.brat.2025.104822","DOIUrl":"https://doi.org/10.1016/j.brat.2025.104822","url":null,"abstract":"","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":" ","pages":"104822"},"PeriodicalIF":4.2,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620912","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":"Obsessional cognitive styles in scrupulosity and contamination OCD","authors":"Jedidiah Siev ,&nbsp;Alyssa H. Berman ,&nbsp;Jessica Rasmussen ,&nbsp;Sabine Wilhelm","doi":"10.1016/j.brat.2025.104821","DOIUrl":"10.1016/j.brat.2025.104821","url":null,"abstract":"<div><div>Scrupulosity is an understudied and challenging form of obsessive-compulsive disorder (OCD) characterized by core obsessional fears that focus on religious or moral themes. Previous research demonstrates that obsessional cognitive styles differ across OCD symptom dimensions; however, scrupulosity does not fit neatly within such dimensions. The goal of the present investigation was to compare obsessional cognitive styles among individuals with primary scrupulosity (<em>n</em> = 29), those with primary contamination OCD (<em>n</em> = 20), and healthy controls (<em>n</em> = 19). 68 participants were administered a diagnostic interview and measure of symptom severity, and completed self-report measures of symptoms and cognitions. Individuals with scrupulosity endorsed stronger beliefs about the importance and control of thoughts and moral thought-action fusion than did individuals with contamination OCD and healthy controls. Similarly, scrupulous individuals endorsed stronger responsibility beliefs. This, despite that the OCD groups did not differ in OCD severity. Both OCD groups reported greater intolerance of uncertainty than did healthy controls, but did not differ from each other. The results of dimensional analyses indicated that symptoms of scrupulosity were strongly associated with beliefs about the importance and control of thoughts, moral thought-action fusion, responsibility, and intolerance of uncertainty. In contrast, washing symptoms were not associated with beliefs about thoughts, and moderately associated with beliefs about responsibility and intolerance of uncertainty. More extreme obsessional thinking may be part of the reason why scrupulosity can be particularly challenging to treat. Increasing focus on cognitive targets may enhance treatment efficacy for scrupulous individuals, although this remains to be examined.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"193 ","pages":"Article 104821"},"PeriodicalIF":4.2,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144595749","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":"Temporal associations between adolescents’ psychological inflexibility and posttraumatic stress symptoms after a super typhoon: Examining the mediation of cognitive emotion regulation","authors":"Yifan Li ,&nbsp;Yingying Ye ,&nbsp;Zhengyi Liu ,&nbsp;Zijian He ,&nbsp;Jiali Huang ,&nbsp;Xiao Zhou","doi":"10.1016/j.brat.2025.104820","DOIUrl":"10.1016/j.brat.2025.104820","url":null,"abstract":"<div><div>This study investigated the temporal associations between psychological inflexibility, adaptive and maladaptive cognitive emotion regulation (CER), and posttraumatic stress symptoms (PTSS) in adolescents after a super typhoon. We surveyed adolescents 3 (November 2019, T1), 15 (November 2020, T2), and 27 (November 2021, T3) months after the super typhoon Lekima. Cross-lagged panel analysis was conducted among 1342 adolescents (Age: <em>M</em> = 14.14, <em>SD</em> = 1.60; 54.9 % girls) who participated in at least two out of three measurements. We further tested the mediation effects of CER in the relationship between psychological inflexibility and PTSS. Our main results indicated that psychological inflexibility at T1 directly influenced PTSS at T2, maladaptive CER at T2 mediated the association between PTSS at T1 and psychological inflexibility at T3. In addition, CER and PTSS shared bidirectional association from T1 to T2, whereas PTSS at T2 unidirectionally influenced maladaptive CER at T3. Psychological inflexibility at T2 was related with adaptive CER at T3. The results indicated that psychological inflexibility directly exacerbated PTSS in the short time after trauma, whereas PTSS indirectly exacerbated future psychological inflexibility in the longer time after trauma. For intervention designs, the broad focus on psychological inflexibility, adaptive and maladaptive CER, and PTSS shortly after trauma should be gradually narrowed to reducing maladaptive CER and PTSS in the longer time after trauma.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"193 ","pages":"Article 104820"},"PeriodicalIF":4.2,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631148","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}