Behaviour Research and Therapy最新文献

{"title":"Social anxiety and romantic conflict: Examining prospective interpersonal dynamics","authors":"Julia M. Levitan,&nbsp;Thomas L. Rodebaugh","doi":"10.1016/j.brat.2025.104704","DOIUrl":"10.1016/j.brat.2025.104704","url":null,"abstract":"<div><div>Social anxiety disorder (SAD) is associated with impairment in close relationship functioning, including romantic relationships. Although interpersonal theories point to dimensions of dominance and warmth as relevant factors, the momentary interpersonal dynamics that may be contributing to relationship problems remain poorly understood. In the present study, we examined contemporaneous and prospective associations between dominance and warmth in individuals with (<em>n</em> = 30) and without (<em>n</em> = 29) SAD and their romantic partners during a 10-min conflict task. Using the Continuous Assessment of Interpersonal Dynamics system and multilevel residual dynamic structural equation modeling, we found that on average, both partners tended to become colder and more dominant over time and showed strong warmth complementarity. Prospective effects indicated that momentary ratings of dominance and warmth positively predicted subsequent ratings, and cross-lagged effects suggested that each partner's behavior predicted change in the other over time. Critically, moderation analyses identified multiple cross-lagged effects that differed significantly as a function of primary participants' SAD diagnosis, all involving warmth. Our methods suggested that future work at longer time scales (i.e., across lags between 20 and 60 s) may be fruitful.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"187 ","pages":"Article 104704"},"PeriodicalIF":4.2,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520062","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":"Predicting clinical improvement in youth using a national-scale multicomponent digital mental health intervention","authors":"Shane Cross ,&nbsp;Ping Liu ,&nbsp;Isabelle Scott ,&nbsp;Shaunagh O'Sullivan ,&nbsp;Jennifer Nicholas ,&nbsp;Lee Valentine ,&nbsp;Shaminka Mangelsdorf ,&nbsp;Simon Baker ,&nbsp;John Gleeson ,&nbsp;Mario Alvarez-Jimenez","doi":"10.1016/j.brat.2025.104703","DOIUrl":"10.1016/j.brat.2025.104703","url":null,"abstract":"<div><h3>Introduction</h3><div>Youth mental health services are characterised by high demand and modest clinical outcomes. While digital mental health interventions (DMHIs) have been shown to be clinically effective, the relationship between DMHI use and outcome is unclear. The current study sought to identify the factors affecting the relationship between DMHI use and depression and anxiety symptom improvement in sub-groups of young people.</div></div><div><h3>Method</h3><div>An observational cohort design included young people aged 12–25 years engaging with a DMHI (MOST) from October 2020 to October 2023. The primary outcome was improvement at 12 weeks on the Patient Health Questionnaire-4 (PHQ4). DMHIs were combinations of self-paced digital cognitive-behavioural therapy content, social network interactions, and professional support. A machine learning clustering algorithm was used to identify distinct user clusters based on baseline characteristics and multiple logistic regression models examined the relationship between DMHI usage and improvement.</div></div><div><h3>Results</h3><div>Two distinct user clusters emerged, differing by symptom severity, age, service setting, and concurrent external treatment. 46.7% of “Severe” users and 39.8% of “Mild-Moderate” users significantly improved. Greater use of therapy content and professional support interactions were associated with improvement for the Mild-Moderate group only (OR = 1.16, 95% CI: 1.04–1.30, p = 0.008).</div></div><div><h3>Conclusion</h3><div>While a greater proportion of users in the Severe group significantly improved, increased MOST use was associated with symptom improvement only for the Mild-Moderate group. These findings highlight the complexity of the relationship between DMHI use and outcome. Other unmeasured mediating or moderating factors such concurrent ‘offline’ treatment may help explain the results. Further research is required to better understand the relationship between DMHI use and clinical outcomes.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"186 ","pages":"Article 104703"},"PeriodicalIF":4.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429878","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":"Broadening the conceptualization of panic disorder to include the fear presentation of avoidant/restrictive food intake disorder: The legacy of panic control therapy","authors":"Hana F. Zickgraf,&nbsp;Rachel A. Schwartz","doi":"10.1016/j.brat.2024.104677","DOIUrl":"10.1016/j.brat.2024.104677","url":null,"abstract":"<div><div>The presentation of avoidant/restrictive food intake disorder (ARFID) characterized by fear of aversive consequences of eating (<em>fear-ARFID</em>) has both phenomenological and mechanistic similarities to panic disorder. In this narrative review, we propose a shared model of the pathogenesis of the two disorders, centered on interoceptive sensitivity as the key maintenance mechanism. We review the evidence that fear-ARFID, which involves restrictive eating motivated by a desire to avoid aversive events (e.g., choking, vomiting, abdominal pain) related to the gastrointestinal tract, onsets with an unexpected event and develops through catastrophic misinterpretation of the probability or significance of the event reoccurring, heightened awareness of minor interoceptive sensations associated with the feared event (i.e., interoceptive sensitivity), escalating anxiety and increasingly frequent experience of minor interoceptive sensations, and increasingly extensive avoidant behavior. Given the support for shared maintenance mechanisms with panic disorder, we suggest a program of clinical research evaluating the adaptation of elements of Panic Control Therapy (PCT), a well-established empirically supported treatment for panic disorder, to treat fear-ARFID. Developing and testing new intervention strategies based on PCT could expand ARFID patients’ access to appropriate care by enabling anxiety-experienced clinicians to use their existing competencies to treat fear-ARFID using a disorder-specific evidence-based treatment.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"185 ","pages":"Article 104677"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899230","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":"Accelerometer-based sedentary time and physical activity with incident and progressive tobacco smoking in 2503 children: A 13-year mediation and temporal longitudinal study","authors":"Andrew O. Agbaje","doi":"10.1016/j.brat.2024.104674","DOIUrl":"10.1016/j.brat.2024.104674","url":null,"abstract":"<div><h3>Background</h3><div>Long-term accelerometer-based studies examining whether engaging in physical activity (PA) reduces the risk of smoking in children are lacking, and whether directly measured adiposity increases smoking risk is uncertain.</div></div><div><h3>Methods</h3><div>From the Avon Longitudinal Study of Parents and Children (ALSPAC), UK birth cohort, 2503 children aged 11 years with complete smoking and at least one valid time-point movement behaviour data were followed up until age 24 years. ActiGraph assessed sedentary time (ST), light PA (LPA), and moderate-to-vigorous PA (MVPA) at ages 11, 15, and 24-year clinic visits and smoking-based questionnaires were administered, whilst fat mass was measured with dual-energy x-ray absorptiometry scanner. Data were analysed with generalized linear-mixed effect models with logit-links and structural equation models.</div></div><div><h3>Results</h3><div>Mean [SD] age at baseline was 11.71 [0.20] years and the prevalence of smoking at ages 13, 15, and 24 years were 1.5%, 13.5%, and 26.6%, respectively. Higher MVPA at age 11 years was significantly associated with lower odds of smoking at age 13 years (odds ratio, 0.991; [95% CI, 0.983–0.999], <em>P</em> = 0.035). Cumulative MVPA during ages 11–24 years was significantly associated with lower odds of progressive smoking during growth from ages 13–24 years (0.992; [95% CI, 0.989–0.996], <em>P</em> &lt; 0.001). Cumulative ST and LPA had no significant associations with smoking. Higher fat mass suppressed (10% suppression) the inverse relationship between MVPA and smoking. In path analysis, higher MVPA at age 15 years temporally preceded reduced smoking at age 24 years.</div></div><div><h3>Conclusion</h3><div>In the present study, engaging in MVPA from age 11 years may prevent 9 in 1000 children from starting smoking at the age of 13 years when smoking prevalence was 15 in 1000 children, i.e potentially preventing 60% of children from initiating smoking. However, the MVPA preventive approach diminished as children grew into young adults.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"185 ","pages":"Article 104674"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903964","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":"The renewal reducing effect of unpaired unconditional stimuli presented during extinction is not specific to the unconditional stimulus used during acquisition","authors":"Ottmar V. Lipp ,&nbsp;Camilla C. Luck ,&nbsp;Luke J. Ney ,&nbsp;Michelle G. Craske ,&nbsp;Allison M. Waters","doi":"10.1016/j.brat.2024.104675","DOIUrl":"10.1016/j.brat.2024.104675","url":null,"abstract":"<div><div>Presenting unpaired unconditional stimuli (US) during extinction training reduces the renewal of conditional fear due to context change. The present study investigated whether this reduced return of fear is specific to the aversive US presented during acquisition or can also be observed after extinction with unpaired presentations of another aversive or of a non-aversive US. Using an ABA renewal paradigm that trained extinction in a context different from that of the acquisition, renewal and re-acquisition test phases, participants received five unpaired presentations of either the aversive US used during acquisition (Group Aversive-Same), an aversive US not presented during acquisition (Group Aversive-Different) or a non-aversive US (Group Non-aversive) during extinction training. Renewal of electrodermal conditional responses was observed in group Non-aversive, but not in groups Aversive-Same or Aversive-Different. Re-acquisition did not differ across the groups. These results are consistent with a valenced arousal account to explain the effects of unpaired presentations of the US during extinction training which would suggest that extinction learning is enhanced under conditions of increased aversive arousal.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"185 ","pages":"Article 104675"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899237","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":"Supporting parents to reduce children's anxiety: A meta-analysis of interventions and their theoretical components","authors":"Karen Rienks ,&nbsp;Elske Salemink ,&nbsp;Liina Björg Laas Sigurðardóttir ,&nbsp;G.J. Melendez-Torres ,&nbsp;Janneke P.C. Staaks ,&nbsp;Patty Leijten","doi":"10.1016/j.brat.2025.104692","DOIUrl":"10.1016/j.brat.2025.104692","url":null,"abstract":"<div><div>Parent-focused interventions hold promise for reducing child anxiety, but their content varies greatly, and little is known on the intervention content. We estimated the effects of parent-focused interventions on child anxiety and the most effective combinations of theoretical components.</div><div>We searched PsycINFO, Medline, and Web of Science in October 2022 for randomized trials on parent-focused interventions to reduce children's anxiety. We used robust variance estimation to estimate main effects and differential effects by individual theoretical components, and network meta-analysis to estimate the effects of clusters of components (preregistration: PROSPERO CRD42022362983).</div><div>We identified 26 studies (<em>k</em> = 157, <em>N</em> = 4098). Parent-focused interventions had a significant medium effect on children's anxiety (<em>d</em> = −0.59; 95% CI [−0.92, −0.26]). Interventions used seven theoretically distinct components. No significant differential effects were found, but all clusters of components that produced significant effects contained a behavioral component. Adding cognitive and emotional components to behavioral components seemed beneficial.</div><div>This meta-analysis highlights the potential of parent-focused interventions for children's anxiety, and of behavioral components in particular, but is limited by the very low certainty of evidence. More high-quality research is needed to understand the exact potential of parent-focused interventions on children's anxiety, and their most effective components.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"185 ","pages":"Article 104692"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029500","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":"Mediators and Moderators of two online interventions for managing pain, fear of progression and functional ability in rheumatoid arthritis","authors":"Louise Sharpe ,&nbsp;Rachel E. Menzies ,&nbsp;Jack Boyse ,&nbsp;Madelyne A. Bisby ,&nbsp;Bethany Richmond ,&nbsp;Jemma Todd ,&nbsp;Amy-Lee Sesel ,&nbsp;Blake F. Dear","doi":"10.1016/j.brat.2024.104676","DOIUrl":"10.1016/j.brat.2024.104676","url":null,"abstract":"<div><div>This is a secondary analysis of a trial comparing online mindfulness-based stress reduction with cognitive-behaviour therapy for people with rheumatoid arthritis. Both interventions were administered over eight weeks with five lessons and accompanied by weekly therapist contact. For the purposes of this study, we investigated the pain severity, fear of progression and functional ability as the outcome variables because the treatments had differential effects on these three outcomes but had equivalent effects on other variables. We examined mediators and moderators of relative treatment efficacy of mindfulness based stress reduction (n = 91) versus cognitive-behaviour therapy (n = 103) for these outcomes. For pain severity, no significant mediators or moderators were identified. However, amongst those with low pain severity, mindfulness-based stress reduction was more efficacious than cognitive-behaviour therapy for fears of progression. Furthermore, mindfulness-based stress reduction was more efficacious than cognitive-behaviour therapy for functional ability for those with high trait mindfulness at baseline. Changes in fear of progression during treatment fully mediated the effect of treatment group on functional ability over follow-up. While both online mindfulness-based stress reduction and cognitive-behaviour therapy were efficacious for people with rheumatoid arthritis, mindfulness-based stress reduction was more effective in reducing fears of progression and improving functional ability for those with low levels of pain severity and high levels of mindfulness at baseline, respectively. These results highlight the importance of treating fear of progression for people with rheumatoid arthritis as reductions in fears of progression over treatment led to improvements in functional ability six months later.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"185 ","pages":"Article 104676"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916018","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":"Efficacy and working mechanisms of a Go/No-Go task-based inhibition training in smoking: A randomized-controlled trial","authors":"Franziska Motka ,&nbsp;Charlotte E. Wittekind ,&nbsp;Leonie Ascone ,&nbsp;Simone Kühn","doi":"10.1016/j.brat.2024.104672","DOIUrl":"10.1016/j.brat.2024.104672","url":null,"abstract":"<div><h3>Objective</h3><div>Deficits in inhibitory control contribute to smoking behavior. Inhibitory control training (ICT), which involves repeatedly inhibiting responses to general or substance-related stimuli, shows promise in reducing problematic substance use. This preregistered randomized-controlled trial is the first to investigate the efficacy of general and smoking-specific Go/No-Go task-based ICT on smoking behavior compared to control groups receiving no ICT. Three potential working mechanisms were examined: inhibitory enhancement, automatic stimulus-stop associations, and stimulus devaluation.</div></div><div><h3>Method</h3><div>Individuals who smoke (<em>N</em> = 122) were randomly assigned to complete 28 sessions of smoking-specific Go/No-Go, general Go/No-Go, Sham training, or to a Waitlist control condition. Clinical outcomes included daily cigarettes (primary outcome), carbon monoxide levels, tobacco dependence severity, and craving, assessed at post-intervention and 3-month follow-up.</div></div><div><h3>Results</h3><div>Go/No-Go training resulted in a significantly greater reduction in tobacco dependence (<em>β</em> = −0.88, <em>p</em> = .004) and craving (<em>β</em> = −4.31, <em>p</em> = .012) post-intervention compared to both control groups. The greater reduction in craving remained significant when compared to the Sham training group only (<em>β</em> = −4.64, <em>p</em> = .026). No significant effects of group were observed on daily cigarette consumption (<em>β</em> = −1.97, <em>p</em> = .093) or carbon monoxide levels (<em>β</em> = 2.16, <em>p</em> = .818) post-intervention. At the 3-month follow-up, no significant effects of group emerged (all <em>p</em>s &gt; .794). Smoking-specific Go/No-Go training did not outperform general Go/No-Go training (all <em>p</em>s &gt; .075). No working mechanism for clinical outcome improvements was identified.</div></div><div><h3>Conclusions</h3><div>Preliminary evidence suggests that (smoking-specific) GNG training reduces tobacco dependence severity and craving post-intervention in individuals who smoke compared to non-ICT-based control conditions. Its efficacy as an add-on in smoking cessation needs to be investigated.</div></div><div><h3>Clinical trial registration number</h3><div>DRKS00014652.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"185 ","pages":"Article 104672"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903965","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":"Diverging paths: Modeling the relation between adverse effects, attitudes, perceived adherence, and treatment effect in an internet-based cognitive-behavioral intervention for obsessive-compulsive disorder","authors":"Anna Baumeister ,&nbsp;Lea Schuurmans ,&nbsp;Josephine Schultz ,&nbsp;Johanna Schröder ,&nbsp;Steffen Moritz ,&nbsp;Lena Jelinek","doi":"10.1016/j.brat.2024.104673","DOIUrl":"10.1016/j.brat.2024.104673","url":null,"abstract":"<div><h3>Background and aim</h3><div>The efficacy of internet-based interventions (IBI) for various psychiatric disorders is widely established, but little is known about the mechanisms or possible influencing factors. One of the most prominent problems in IBI is low adherence, but the relationship between adherence and level of improvement is still unclear. Patients’ attitudes and beliefs about IBI as well as the experience of adverse effects—another widely neglected topic—may also influence the effectiveness of these interventions. This secondary analysis is aimed at investigating the relationship between adverse effects, attitudes, perceived adherence (i.e., patient's impression of their compliance), and treatment effect in an IBI for obsessive-compulsive disorder (OCD).</div></div><div><h3>Methods</h3><div>Participants were 151 individuals with symptoms of OCD, of which 59.96% (<em>n</em> = 90) took part in the post-assessment. Attitudes toward IBI were assessed before they used an IBI for OCD; subjective adherence perception and experience of negative effects were assessed afterward. OCD symptom severity was evaluated at two time points, the difference score defining the treatment effect. A path analysis was conducted to test the hypothesized model. Objective and subjective adherence measures were correlated exploratively.</div></div><div><h3>Results</h3><div>The path analysis revealed that attitude toward IBI and adverse effects were negatively associated with adherence perception but adherence perception was not associated with the treatment effect. Objective and subjective adherence measures did not correlate.</div></div><div><h3>Conclusion</h3><div>The results did not support the hypothesized model. Since both attitudes toward IBI and adverse effects were negatively associated with adherence perception, managing users’ expectations clearly before using IBI might improve adherence. The role of adherence perception on the treatment effect is yet to be clarified.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"185 ","pages":"Article 104673"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878254","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":"Using network analysis to characterize clinical improvement during cognitive processing therapy","authors":"Ante J. Schlesselmann ,&nbsp;Richard J. McNally ,&nbsp;Philip Held","doi":"10.1016/j.brat.2024.104678","DOIUrl":"10.1016/j.brat.2024.104678","url":null,"abstract":"<div><h3>Objective</h3><div>Cross-sectional network studies find mixed results regarding changes in network structure as a response to treatment across disorders. This study characterized improvement in mental health following Cognitive Processing Therapy (CPT) for PTSD in veterans from the perspective of network psychometrics and explored how cross-sectional networks inform our understanding of PTSD recovery.</div></div><div><h3>Methods</h3><div>Veterans with PTSD participated in CPT-based intensive treatment programs (ITPs), offered in two-week (N = 635) or three-week (N = 457) formats. PTSD symptoms were self-reported on the PTSD Checklist for DSM-5 (PCL-5) at pre-, mid-, and post-treatment. Cross-sectional networks for each time point were compared using network comparison tests. Linear regression tested if the relationship of initial treatment gains from admission to mid-treatment with overall outcomes was associated with the expected influence centrality of a node.</div></div><div><h3>Results</h3><div>Substantial improvement in PTSD symptoms were found, but network structure remained largely unaffected, with global edge strength increasing from pre-to post-treatment. Initial treatment gains in nodes with high expected influence were associated with overall treatment outcomes. A post-hoc simulation based on a common-cause model produced similar regression results, indicating that while our findings align with spreading activation, they are not exclusive to this mechanism.</div></div><div><h3>Conclusion</h3><div>The indiscernibility of cross-sectional networks between pre- and post-treatment raises questions about whether cross-sectional networks can illuminate PTSD recovery beyond traditional measures of treatment response.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"185 ","pages":"Article 104678"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972812","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}