Tabea Kloos , Fernando Blanco , Winfried Rief , Ann Meulders , Jenny Riecke
{"title":"Visualizing one's Best Possible Self increases positive future expectancies, but does not boost selective learning in fibromyalgia","authors":"Tabea Kloos , Fernando Blanco , Winfried Rief , Ann Meulders , Jenny Riecke","doi":"10.1016/j.brat.2025.104748","DOIUrl":"10.1016/j.brat.2025.104748","url":null,"abstract":"<div><div>Compromised learning is considered to contribute importantly to the development and maintenance of chronic pain disability. More specifically, predictive learning is impaired in people with chronic pain. Therefore, learning mechanisms have been identified as treatment targets. A widely neglected, but relevant question is whether resilience factors can enhance selective learning. This online study combined a selective learning task with a positive psychology intervention in participants with fibromyalgia (FM). The Best Possible Self group (BPS) described and visualized a future in which everything had gone well, which is shown to increase optimism and positive affect, while the active control group described and visualized their Typical Day (TD). Subsequently, selective learning was tested within a contingency learning scenario task using a blocking procedure and pain expectancies as main outcome. We successfully manipulated positive future expectancies (a proxy for state optimism), but not positive affect within a single-session intervention. In contrast with our expectations, the positive psychology intervention did not increase selective learning in the BPS group compared to the TD group, but a small blocking effect was observed in the merged sample. However, because no healthy control group was included, no conclusions can be drawn as to whether the selective learning effect is reduced compared to a non-clinical population. To conclude, there was partial evidence for selective learning in people with fibromyalgia, but manipulated resilience factors did not modulate the selective learning effect.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"190 ","pages":"Article 104748"},"PeriodicalIF":4.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864787","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}
Janice R. Kuo , Katherine E. Christensen , Rachel Liebman , Skye Fitzpatrick , Alexander Chapman , Shelley McMain
{"title":"Which one impacts the other?: The relationship between change in borderline personality disorder severity and change in posttraumatic stress disorder severity among individuals in dialectical behavior therapy","authors":"Janice R. Kuo , Katherine E. Christensen , Rachel Liebman , Skye Fitzpatrick , Alexander Chapman , Shelley McMain","doi":"10.1016/j.brat.2025.104747","DOIUrl":"10.1016/j.brat.2025.104747","url":null,"abstract":"<div><div>Borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) commonly co-occur. Limited research, however, has examined the association between fluctuations in the severity of one disorder with fluctuations in the severity of the other disorder. In a sample of N = 240 self-harming individuals with BPD undergoing 6 or 12 months of Dialectical Behavior Therapy (DBT), we used a cross-lagged panel model with 3-month intervals to evaluate the temporal relationship between BPD severity and PTSD severity during DBT and throughout follow-up. We similarly examined the relationship in the sub-sample meeting criteria for both disorders (BPD + PTSD; N = 81). Results indicated that decreases in PTSD severity at one timepoint corresponded with decreases in BPD severity at the subsequent timepoint, and that there was minimal evidence for the reverse relationship. Findings were consistent across our analyses in both the full BPD sample and the BPD + PTSD subsample. In the context of DBT, addressing PTSD might help reduce subsequent BPD severity, but addressing BPD features might not have similar effects on PTSD severity.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"190 ","pages":"Article 104747"},"PeriodicalIF":4.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878506","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 influence of (social) anxiety and visual exploration on threat responding and generalization","authors":"Mario Reutter , Janna Teigeler , Matthias Gamer","doi":"10.1016/j.brat.2025.104746","DOIUrl":"10.1016/j.brat.2025.104746","url":null,"abstract":"<div><div>Fear generalization has been identified as an important mechanism that might contribute to the etiology and maintenance of anxiety disorders. It is, however, yet unclear to what degree attentional processes contribute to overgeneralization of fear in clinical samples. To address this issue, we utilized a set of facial photographs that was meticulously created such that pairs of faces could either be distinguished by looking into the eyes or the region around mouth and nose, respectively. These pairs were then employed as CS+ and CS− in a differential fear conditioning paradigm followed by a generalization test with morphs in steps of 20 %, creating a continuum between CS+ and CS−. In a sample with diverse levels of social and general anxiety (<em>N</em> = 87), we demonstrated that the amount of fear generalization depends on attentional orienting towards diagnostic facial features. While social anxiety did not affect the shape of generalization gradients, we observed altered visual exploration patterns and a distinct multi-phasic heart rate modulation in participants with higher social anxiety. General anxiety symptomatology was also related to these characteristics of visual exploration and additionally predicted a broad elevation of threat ratings. In summary, fear generalization depends on attentional deployment. Future work should build on these findings to further explore these processes in clinical populations.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"189 ","pages":"Article 104746"},"PeriodicalIF":4.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143837936","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}
Yongjie Zhou , Chenran Pei , Hailong Yin , Rongting Zhu , Nan Yan , Lan Wang , Xuankun Zhang , Tian Lan , Junchang Li , Lingyun Zeng , Lijuan Huo
{"title":"Predictors of smartphone addiction in adolescents with depression: combing the machine learning and moderated mediation model approach","authors":"Yongjie Zhou , Chenran Pei , Hailong Yin , Rongting Zhu , Nan Yan , Lan Wang , Xuankun Zhang , Tian Lan , Junchang Li , Lingyun Zeng , 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}
Matthias Domhardt , Vera Mennel , Florian Angerer , Simon Grund , Axel Mayer , Rebekka Büscher , Lasse B. Sander , Pim Cuijpers , Yannik Terhorst , Harald Baumeister
{"title":"Processes of change in digital interventions for depression: A meta-analytic review of cognitive and behavioral mediators","authors":"Matthias Domhardt , Vera Mennel , Florian Angerer , Simon Grund , Axel Mayer , Rebekka Büscher , Lasse B. Sander , Pim Cuijpers , Yannik Terhorst , 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}
Tobias Kube , Edith Rapo , Julia A. Glombiewski , Winfried Rief
{"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 , Edith Rapo , Julia A. Glombiewski , 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 , Miguel Basto-Pereira , 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 & 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, Qinglin Hu, 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}
Nicole A. Short , Rachel Weese , Mattea Pezza , Michele A. Bedard-Gilligan
{"title":"Anxiety sensitivity and cannabis use: A systematic review and conceptualization of research findings","authors":"Nicole A. Short , Rachel Weese , Mattea Pezza , 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}
Anne Sophie Hildebrand , Jari Planert , Kati Roesmann , Alla Machulska , Marie Neubert , Tim Klucken
{"title":"Fear not: Combining digital and virtual reality interventions for the treatment of social anxiety disorder – a randomized controlled trial","authors":"Anne Sophie Hildebrand , Jari Planert , Kati Roesmann , Alla Machulska , Marie Neubert , 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}