Behaviour Research and Therapy最新文献

{"title":"Predictors of smartphone addiction in adolescents with depression: combing the machine learning and moderated mediation model approach","authors":"Yongjie Zhou ,&nbsp;Chenran Pei ,&nbsp;Hailong Yin ,&nbsp;Rongting Zhu ,&nbsp;Nan Yan ,&nbsp;Lan Wang ,&nbsp;Xuankun Zhang ,&nbsp;Tian Lan ,&nbsp;Junchang Li ,&nbsp;Lingyun Zeng ,&nbsp;Lijuan Huo","doi":"10.1016/j.brat.2025.104749","DOIUrl":"10.1016/j.brat.2025.104749","url":null,"abstract":"<div><div>Smartphone addiction (SA) significantly impacts the physical and mental health of adolescents, and can further exacerbate existing mental health issues in those with depression. However, fewer studies have focused on the predictors of SA in adolescents with depression. This study employs machine learning methods to identify key risk factors for SA, using the interpretable SHapley Additive exPlanations (SHAP) method to enhance interpretability. Additionally, by constructing a mediation moderation model, the interactions between significant risk factors are analyzed. The study included 2203 adolescents with depression. Machine learning results from four models (Random Forest, Support Vector Machine, Logistic Regression, XGBoost) consistently identified emotion-focused coping, rumination, and school bullying as the strongest predictors of SA. Further mediation moderation analyses based on the Interaction of Person-Affect-Cognition-Execution (I-PACE) model revealed that rumination significantly mediated the relationship between school bullying and SA, and emotion-focused coping significantly moderated the relationships between school bullying and both rumination and SA. This is the first study to use machine learning to explore the predictors of SA in depressive adolescents and further analyze the interactions among these predictors. Future interventions for SA in adolescents with depression may benefit from psychotherapy that addresses emotion-focused coping and rumination.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"189 ","pages":"Article 104749"},"PeriodicalIF":4.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851477","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":"Processes of change in digital interventions for depression: A meta-analytic review of cognitive and behavioral mediators","authors":"Matthias Domhardt ,&nbsp;Vera Mennel ,&nbsp;Florian Angerer ,&nbsp;Simon Grund ,&nbsp;Axel Mayer ,&nbsp;Rebekka Büscher ,&nbsp;Lasse B. Sander ,&nbsp;Pim Cuijpers ,&nbsp;Yannik Terhorst ,&nbsp;Harald Baumeister","doi":"10.1016/j.brat.2025.104735","DOIUrl":"10.1016/j.brat.2025.104735","url":null,"abstract":"<div><div>The efficacy of digital interventions for depression has been established. In contrast, only limited knowledge on their change processes is currently available, and precise effect size estimates for mediators are pending. This study aimed to systematically review mediation studies and meta-analytically evaluate indirect effects of cognitive and behavioral mediators in digital interventions for adults with depression. The databases CENTRAL, Embase, MEDLINE, and PsycINFO were systematically searched for eligible randomized controlled trials. Two independent reviewers extracted the data, assigned mediators to eight categories and evaluated the methodological quality of included studies. Two-stage structural equation modeling was applied to synthesize indirect effects for cognitive and behavioral mediators. Overall, 25 studies (8110 participants) were eligible, which investigated 31 cognitive, 29 behavioral and 24 other mediators. Meta-analyses yielded significant indirect effects for combined cognitive mediators (ab = −0.068; 95 %-CI: [-0.093, −0.047]; <em>k</em> = 14 studies) and combined behavioral mediators (ab = −0.037; 95 %-CI: [-0.048, −0.028]; <em>k</em> = 13), but not for the specific cognitive mediators interpretation bias and dysfunctional attitudes. The systematic review revealed that all studies fulfilled at least five out of nine methodological quality criteria for psychotherapy process research, but the risk of bias assessment raised some concerns, particularly in regard to potential deviations from intended interventions. Overall, the findings of this meta-analytic review contribute to the understanding of the mechanisms of change in digital interventions for depression, and can inform the evidence-based advancement of future interventions.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"189 ","pages":"Article 104735"},"PeriodicalIF":4.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820910","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":"How people with major depression adjust their expectations of future life events in response to other patients’ reports of the positive effects of psychotherapy","authors":"Tobias Kube ,&nbsp;Edith Rapo ,&nbsp;Julia A. Glombiewski ,&nbsp;Winfried Rief","doi":"10.1016/j.brat.2025.104736","DOIUrl":"10.1016/j.brat.2025.104736","url":null,"abstract":"<div><div>Research proposed the devaluation of positive information, referred to as cognitive immunisation, as a mechanism underlying the persistence of negative expectations in depression. In a pre-registered experimental study, we tested this hypothesis by enhancing vs. inhibiting the engagement in cognitive immunisation and comparing it with a distraction control condition and a no-instruction control condition. In a between-subjects design, we presented participants with major depression (<em>N</em> = 156) with video recordings of other patients in which they reported on the positive effects of psychotherapy. Cognitive immunisation was manipulated by instructing participants to focus on similarities vs. differences between themselves and the persons from the videos. The results show that the other patients' reports led to a significant increase in participants’ expectations of future life events and treatment expectations. However, there were no significant differences between the experimental conditions in expectation change, most likely because the manipulation was not powerful enough according to the manipulation check. Only in men the cognitive immunisation-promoting condition effectively blocked expectation change, according to exploratory analyses. This study shows that watching positive reports from other patients helps people with major depression improve their pre-treatment expectations. However, cognitive immunisation does not modulate this process, unless gender is considered.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"189 ","pages":"Article 104736"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783748","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":"Reducing childhood externalizing behavior: A feasibility RCT of the being a Parent program","authors":"Laura Maciel ,&nbsp;Miguel Basto-Pereira ,&nbsp;Crispin Day","doi":"10.1016/j.brat.2025.104737","DOIUrl":"10.1016/j.brat.2025.104737","url":null,"abstract":"<div><h3>Objective</h3><div>Rising rates of childhood behavioral problems are a global concern and in Portugal cases of behavioral problems in youth have been following international trends. Parenting interventions are widely regarded as one of the most effective ways to address externalizing behaviors early on, and thus their dissemination is crucial. This paper presents a feasibility randomized controlled trial (RCT) conducted in Portugal to evaluate the effectiveness of a parenting intervention for childhood behavioral problems. Our goals were threefold: a) assess feasibility parameters; b) evaluate program fidelity and acceptability; and c) examine the program's potential impact on child behavior, parenting skills, parental concern, and parental competence.</div></div><div><h3>Method</h3><div>A double-blinded, two-arm design was employed. Fifty-five families of children aged 2–11 years old who reported difficulties managing their child's behavior were included. Parents were randomly assigned to either the intervention group or a waitlist control group, and the intervention group participated in the eight-week \"Being a Parent\" program (Portuguese version: <em>Ser Pai &amp; Ser Mãe</em>). Data were collected at two time points (pre- and post-intervention) using quantitative measures.</div></div><div><h3>Results</h3><div>Findings confirmed the program's successful implementation in Portugal and demonstrated significant positive effects, particularly in reducing externalizing behavior, as well as aggressive behavior, and increasing parental competence, more specifically parental satisfaction.</div></div><div><h3>Conclusions</h3><div>This study represents the first trial of the Being a Parent program conducted outside the UK, and highlights its potential for broader international application. Key challenges and clinical implications are also addressed.</div></div><div><h3>Trial registration</h3><div>ClinicalTrials.gov (nº NCT05626244).</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"189 ","pages":"Article 104737"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835295","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":"To focus on a confederate or oneself? Attentional bias and state anxiety in socially anxious individuals during real-time online video calls","authors":"Wen Gao,&nbsp;Qinglin Hu,&nbsp;Yongqi Xu","doi":"10.1016/j.brat.2025.104734","DOIUrl":"10.1016/j.brat.2025.104734","url":null,"abstract":"<div><div>Attentional bias toward threatening stimuli and heightened self-focused attention are pivotal factors in the activation and perpetuation of high social anxiety. Literature on attentional biases between external social cues and self-relevant information has yielded inconsistent findings due to diverse experimental tasks and materials. With a videoconferencing platform and eye-tracking technology, this study assessed state anxiety and attentional bias between self- and other-related cues among individuals with different sex and social anxiety levels (n = 82) in various social contexts (speech and conversation) and social feedback (positive, neutral, and negative). Eye-movement data revealed that individuals focus more on the other person than themselves during online video interactions. However, individuals with high social anxiety tend to focus more on themselves and less on others compared to those with low social anxiety, particularly in males. Males with high social anxiety distributed their attention equally between their social partners and themselves, while females with high social anxiety did not. Self-reported data indicated higher anxiety during speeches than conversations. Those with high social anxiety showed significant differences from baseline levels during tasks, in contrast to those with low social anxiety. Subjective anxiety was more pronounced for negative feedback than for neutral or positive feedback, especially in females. These findings enhance understanding of attentional biases in individuals with high social anxiety and suggest that videoconferencing could benefit therapy for individuals with social anxiety disorder.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"188 ","pages":"Article 104734"},"PeriodicalIF":4.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715540","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":"Anxiety sensitivity and cannabis use: A systematic review and conceptualization of research findings","authors":"Nicole A. Short ,&nbsp;Rachel Weese ,&nbsp;Mattea Pezza ,&nbsp;Michele A. Bedard-Gilligan","doi":"10.1016/j.brat.2025.104733","DOIUrl":"10.1016/j.brat.2025.104733","url":null,"abstract":"<div><h3>Objectives</h3><div>Anxiety sensitivity (AS), or fear of anxious arousal, is a transdiagnostic risk factor that may be associated with greater risk for problematic cannabis use. Individuals with high AS may use cannabis to cope with distressing physiological sensations. However, there is also conflicting research suggesting that individuals with high AS may avoid cannabis use because it is perceived to cause unpleasant physiological sensations. Rates of cannabis use disorder (CUD) are high and escalating in the US, so identification and understanding of risk factors such as AS is crucial for prevention and treatment of CUD. The purpose of the current review is to summarize and critically review the, at times, conflicting existing research on AS and CUD, present a unifying conceptualization of AS as a risk factor for CUD, and establish a future research agenda.</div></div><div><h3>Methods</h3><div>Empirical studies indexed in PubMed or PsycInfo as of Spring 2024 testing associations between AS and cannabis use were included. Fifty studies were reviewed and coded by two independent coders who evaluated study characteristics and risk of bias.</div></div><div><h3>Results</h3><div>Results were qualitatively synthesized and suggested a direct association between elevated AS and greater levels of coping-oriented and possibly problematic cannabis use, but not lifetime cannabis use or cannabis use frequency.</div></div><div><h3>Discussion</h3><div>A conceptual model is presented in which high AS may lead to greater coping-oriented cannabis use, and, in turn, problematic cannabis use in the presence of symptoms of psychopathology and positive cannabis expectancies. Future research should test this model utilizing prospective and/or experimental studies with valid assessments of AS and cannabis use among diverse cannabis using samples.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"188 ","pages":"Article 104733"},"PeriodicalIF":4.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143706374","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 not: Combining digital and virtual reality interventions for the treatment of social anxiety disorder – a randomized controlled trial","authors":"Anne Sophie Hildebrand ,&nbsp;Jari Planert ,&nbsp;Kati Roesmann ,&nbsp;Alla Machulska ,&nbsp;Marie Neubert ,&nbsp;Tim Klucken","doi":"10.1016/j.brat.2025.104731","DOIUrl":"10.1016/j.brat.2025.104731","url":null,"abstract":"<div><h3>Introduction</h3><div>Social anxiety disorder (SAD) poses a significant mental health challenge. Despite cognitive behavior therapy being the first-line treatment for SAD, its accessibility remains limited. Internet- and mobile-based interventions (IMIs) offer approaches to enhance accessibility and reduce waiting times. As part of this, some recent approaches have incorporated virtual reality (VR) to enable behavioral experiments and exposure. This pilot study aimed to explore the efficacy of an IMI, including CBT interventions via smartphone apps and VR to alleviate the severity of SAD symptoms.</div></div><div><h3>Methods</h3><div>Thirty-two patients diagnosed with SAD were randomly assigned to either an experimental group (<em>n</em> = 16) receiving the IMI or an active control group (<em>n</em> = 16). The number of therapeutic appointments was held constant across conditions to account for unspecific treatment effects. The primary outcome was SAD severity, obtained at baseline, interim, post-treatment, and follow-up assessments. The secondary outcome remission was evaluated through a diagnostic interview at follow-up. The trial was registered with ISRCTN (ID: ISRCTN18013983).</div></div><div><h3>Results</h3><div>Regarding the differential effectiveness between the active control condition and the IMI, two different results were found: There was a higher remission rate in the experimental group compared to the control group, while no significant differences in SAD severity were found.</div></div><div><h3>Conclusion</h3><div>While SAD severity showed a comparable reduction in both groups, significantly fewer patients in the experimental group were still diagnosed with SAD at follow-up. This suggested a difference between self-report and clinical evaluation. Despite the mixed results, IMIs provide a low-barrier intervention and could be used to increase access to therapy and reduce waiting times.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"188 ","pages":"Article 104731"},"PeriodicalIF":4.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697221","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":"A randomized controlled trial of online mindfulness and cognitive-behavioral interventions for sexual interest/arousal disorder in women: eSense","authors":"Elizabeth A. Mahar ,&nbsp;Kyle R. Stephenson ,&nbsp;Lori A. Brotto","doi":"10.1016/j.brat.2025.104732","DOIUrl":"10.1016/j.brat.2025.104732","url":null,"abstract":"<div><h3>Objective</h3><div>Sexual interest/arousal disorder (SIAD) is a common and distressing sexual dysfunction in women. Although efficacious psychological treatments for SIAD exist, they are generally underutilized and inaccessible. <em>eSense</em> is a feasible and useable online intervention containing Cognitive-Behavioral Therapy (CBT) and Mindfulness-Based Therapy (MBT) programs. Our goal was to test the efficacy of the CBT and MBT arms of <em>eSense</em> relative to a waitlist control condition.</div></div><div><h3>Method</h3><div>Women with SIAD were randomized to <em>eSense</em>-CBT (<em>n</em> = 43), <em>eSense</em>-MBT (<em>n</em> = 43), or a waitlist (<em>n</em> = 43). Both interventions consisted of 8 modules with a recommended completion time of 8–12 weeks. Participants also met remotely with non-expert “navigators” for up to 12 weeks. Participants completed validated self-report measures of primary outcomes (sexual desire/arousal and distress) and secondary outcomes (sexual satisfaction, dissatisfaction, and overall sexual function) at baseline, mid-treatment, posttreatment, and 6-month posttreatment.</div></div><div><h3>Results and conclusions</h3><div>Compared to waitlist, both active treatment groups reported significant improvements in primary outcomes at post-treatment (desire/arousal <em>d &gt;</em> .90; sexual distress <em>d</em> &lt; −0.62) and these improvements were generally maintained at follow-up. The two active treatments did not differ in terms of primary outcomes. Effects on sexual satisfaction were also significant (<em>d</em> = 0.70–0.81) and MBT resulted in slightly greater improvements. There was no effect on sexual dissatisfaction. For overall sexual function, the effect was large (<em>d</em> = 1.20 to 1.23) with no between-arm differences. Future steps to improve engagement and increase access are discussed. <em>Keywords:</em> digital health; sexual interest/arousal disorder; mindfulness-based therapy; cognitive behavioral therapy; sexual dysfunction. <em>Public health significance</em>: This study strongly suggests that <em>eSense</em> is an efficacious digital health tool that holds much potential to improve accessibility for the treatment of SIAD.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"188 ","pages":"Article 104732"},"PeriodicalIF":4.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697222","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":"Costly avoidance in pediatric anxiety and OCD - The impact of emotional reactivity and reward sensitivity","authors":"Stefan Möller ,&nbsp;Gustav Nordin ,&nbsp;Adam Larsson ,&nbsp;Matti Cervin ,&nbsp;Johannes Björkstrand","doi":"10.1016/j.brat.2025.104730","DOIUrl":"10.1016/j.brat.2025.104730","url":null,"abstract":"<div><div>A central feature of internalizing mental disorders, such as obsessive-compulsive disorder (OCD) and anxiety disorders, is the avoidance of rewarding situations to prevent the risk of experiencing distressing emotions. Previous research has shown that obsessive and anxious individuals avoid situations where rewards come at the cost of aversive experiences, a phenomenon termed costly avoidance. Costly avoidance has not previously been examined in clinical samples of youths with OCD or anxiety disorders, which is an important gap as these disorders typically onset during the first two decades of life. In this study, treatment-seeking youths with OCD (n = 62) and anxiety disorders (n = 43), and a comparison group of youths without mental disorders (n = 47) performed an approach-avoidance conflict task. Participants selected to face either neutral outcomes or to obtain rewards that co-occurred with aversive images and sounds. Results showed more costly avoidance in the OCD and anxiety disorder groups compared to the non-clinical comparison group, but no differences between the two clinical groups emerged. Trait reward sensitivity and subjective negative emotional reactions to aversive sounds and images were the best individual predictors of costly avoidance. The results of our study show that youths with OCD and anxiety disorders display elevated levels of costly avoidance, which is in line with clinical theories and previous findings in adults with anxiety disorders. We also show that these elevated levels of costly avoidance are best explained by individual differences in reward sensitivity and emotional reactivity, suggesting that sensitivity to appetitive and aversive outcomes might underlie differences in maladaptive costly avoidance.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"188 ","pages":"Article 104730"},"PeriodicalIF":4.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682077","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":"Digital acceptance and commitment therapy for adults with chronic health conditions: Results from a waitlist-controlled trial","authors":"Michael E. Levin ,&nbsp;Ty B. Aller ,&nbsp;Korena S. Klimczak ,&nbsp;Marissa L. Donahue ,&nbsp;Francesca M. Knudsen","doi":"10.1016/j.brat.2025.104729","DOIUrl":"10.1016/j.brat.2025.104729","url":null,"abstract":"<div><div>Digital mental health interventions (DMHIs) provide a promising avenue for addressing the mental health needs of adults with chronic health conditions (CHCs). Transdiagnostic DMHIs, which apply to a range of conditions by focusing on common core processes of change (e.g., acceptance and commitment therapy; ACT), are particularly needed to address the various ways a wide range of CHCs impact quality of life. The present study evaluated an ACT DMHI designed to improve quality of life and mental health transdiagnostically for adults with CHCs. A sample of 100 adults with CHCs were randomized to ACT or waitlist, with baseline, 6-week, and 10-week assessment points. Recruitment (100 participants in 3 months with a wide range of CHCs), retention (84% at follow-up), and adherence rates (<em>M</em> = 4 of 6 sessions) indicated feasibility, with high program satisfaction ratings for acceptability. Only psychological flexibility improved more in ACT versus waitlist at post-intervention (6-week follow-up), with no differences on other outcomes until 10-week follow-up. Participants in ACT improved significantly more than waitlist at 10-week follow-up on the primary outcome of quality of life as well as functional impairment from CHCs and psychological flexibility. An exploratory moderation test suggested participants with elevated mental health symptoms at baseline improved more on these symptoms in ACT relative to waitlist at 10-week follow-up. Overall, results support the feasibility, acceptability, and efficacy of a transdiagnostic ACT DMHI to improve quality of life and mental health for adults with a wide range of CHCs.</div></div><div><h3>Clinicaltrialsgov identifier</h3><div>NCT06179264.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"188 ","pages":"Article 104729"},"PeriodicalIF":4.2,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682075","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}