Behav Ther [JOURNAL]
Sun
200 papers
It Is Clean, But It Still Seems Dirty to Me: Implicit and Explicit Truth of Imagined Contamination as an Explanation of Ego-Dystonic Experience of Obsessions.
Strauss AY, Barzilay S, Huppert JD
Behav Ther · 2025 Mar · PMID 40010901 · Publisher ↗
Individuals suffering from obsessive-compulsive disorder often experience obsessions as ego-dystonic, knowing that a mental event does not reflect reality but acting as if it does. Imagination has been suggested as an im...
Individuals suffering from obsessive-compulsive disorder often experience obsessions as ego-dystonic, knowing that a mental event does not reflect reality but acting as if it does. Imagination has been suggested as an important process involved in this mismatch about the actual truth value of obsessions. Imagining false events has been found to impact spontaneous truth evaluations (implicit truth value; ITV), even when people explicitly acknowledged the imagined event as false (explicit truth value; ETV; Shidlovski et al., 2014). The current study examined discrepancies between ITV and ETV along with effects of imagination and their relationship to obsessive-compulsive contamination symptoms. Sixty-two students, recruited across the range of contamination symptoms, participated in this study. First, a table, at which participants were seated, was cleaned in their presence. Next, in a double-categorization autobiographical implicit association test (aIAT), participants classified true or false autobiographical statements together with "clean" or "contaminated" statements regarding the table. Then, they imagined that the table was contaminated prior to the second aIAT administration. ETV was measured by classifying the statements explicitly as true or false. Imagination was associated with reduced ITV, this association did not depend on symptoms, contrary to our predictions. However, symptoms were associated with elevated ETV evaluations of the contaminated statements. Finally, ETV correlated with ITV only for low symptom participants. This correlation was no longer significant following the imagination induction. In conclusion, individuals with contamination symptoms may be more likely to overweigh their explicit evaluations in the presence of contradictory implicit evaluations, creating a discrepancy. This process may account for ego-dystonic experiences reported by OCD patients.
Impact of an 8-Week, Intensive Summer Treatment Program on Improving Coercive Caregiver-Child Interactions Among Children With and Without Callous Unemotional Traits.
Piscitello J, Robertson EL, Renaud M … +3 more , Leon D, Hayes T, Pelham WE
Behav Ther · 2025 Mar · PMID 40010900 · Publisher ↗
The coercive process is the primary explanatory mechanism implicated in the maintenance of disruptive behavior disorders (DBDs), and understanding the coercive cycle may be especially important for caregivers with childr...
The coercive process is the primary explanatory mechanism implicated in the maintenance of disruptive behavior disorders (DBDs), and understanding the coercive cycle may be especially important for caregivers with children with elevated callous-unemotional (CU) traits. The purpose of the current pilot study is twofold. First, we assessed whether the Summer Treatment Program (STP), an established intensive behavioral intervention for children with DBDs, reduced coercive caregiver-child interactions using a novel parent-report measure of coercive interactions. We then sought to assess whether the STP improved coercive caregiver-child interactions among children with elevated CU traits (i.e., moderated the effect). Thirty-three caregivers and their children who had been diagnosed with DBDs participated in the STP, which involved the children receiving behavior modification for 9 hours per day and caregivers attending a weekly behavioral parent training group session over the course of 8 weeks. Children (M = 8.51 years old, SD = 1.70, range 6-12) were primarily male (78.5%) and Hispanic/Latine (84.8%). A linear multilevel model revealed a statistically significant improvement in caregiver-child coercive interactions from pre- to posttreatment. However, child pretreatment CU traits moderated this effect such that families with children with elevated CU traits did not show improvement in caregiver-child coercive cycles following treatment. Results suggest the benefits of intensive behavioral treatment on the caregiver-child coercive cycle for many families, but the need to modify the intensity or dose of treatments for those with children with DBDs and elevated CU traits.
The Efficacy of Technology-Enhanced Behavioral Parent Training for Families With Low Income: Do Parent-Centered Profiles Moderate Treatment Outcomes?
Yang Y, Parent J, Gil KM … +1 more , Jones DJ
Behav Ther · 2025 Mar · PMID 40010899 · Publisher ↗
Behavior disorders (BDs) in children are common and have long-term impacts. Financially disadvantaged families are at a greater risk of having a child with an early-onset BD but have more difficulty engaging in and there...
Behavior disorders (BDs) in children are common and have long-term impacts. Financially disadvantaged families are at a greater risk of having a child with an early-onset BD but have more difficulty engaging in and therefore benefiting from behavior parent training (BPT). Building upon the potential of technology-enhanced (TE) treatment approaches in addressing barriers to treatment engagement and effectiveness, TE to one BPT program, Helping the Noncompliant Child (HNC), were tested in a randomized controlled trial (RCT) with 101 families with low income. The current study aimed to examine for whom TE-HNC versus standard HNC is optimal at posttreatment by exploring how pretreatment, parent-centered profiles may moderate parenting and child outcomes at posttreatment. Latent profile analyses yielded four distinct parent-centered profiles. The profile membership differentially predicted treatment outcomes by group for positive and negative parenting, as well as child behavior intensity, but not child problem behavior. The heterogeneity of responses to standard relative to TE treatment models among underserved families may provide clues regarding the future personalization of BPT toward improved treatment efficacy.
Moderators and Mediators of Treatments for Suicidal Thoughts and Behaviors: A Review of More Than 50 Years of Randomized Controlled Trials.
Goger P, Guo R, Jo S … +4 more , Cha CB, Ribeiro J, Huang X, Fox KR
Behav Ther · 2025 Mar · PMID 40010898 · Publisher ↗
Psychosocial treatments for suicidal thoughts and behaviors (STBs) are in need of improvement, as suicide rates have substantially increased in the last 20 years and current interventions show limited efficacy. One way t...
Psychosocial treatments for suicidal thoughts and behaviors (STBs) are in need of improvement, as suicide rates have substantially increased in the last 20 years and current interventions show limited efficacy. One way to potentially boost response rates is to personalize treatments by identifying what works how and for whom to maximize impact across different individuals. A scoping review of all suicide treatment randomized controlled trials was performed on PubMed, PsycInfo, and GoogleScholar through May 2024 to identify moderators and mediators of suicide treatment. Forty-six studies including moderators and 15 studies including mediators were identified and evaluated by at least two independent researchers. The most frequently tested moderators across both adults and adolescents include age, gender/sex, history of STBs, therapeutic alliance, comorbid depression, and comorbid borderline personality disorder diagnoses or symptoms, with the strongest support found for therapeutic alliance in adults. No mediator was tested in more than one trial or research group, but hopelessness, avoidance, mentalization, and number of treatment contacts in adolescents and resilience, anxiety sensitivity, acceptance, and therapeutic relationship in adults showed positive signals. Overall, additional work is needed as heterogeneity, lack of replication attempts, and concerns about moderator and mediator quality currently limit confidence in findings.
Using Alma to Alleviate Tristeza Maternal: Preliminary Outcomes of a Peer-Led Behavioral Activation Program Among Latina Mothers.
Collado A, Hicks L, Hubley S … +7 more , Levy J, McKimmy C, Genovez M, Gallop R, Bauer D, Aranda E, Dimidjian S
Behav Ther · 2025 Mar · PMID 40010897 · Publisher ↗
Spanish-speaking Latinas in the United States encounter significant barriers when seeking culturally responsive treatment for perinatal mental health disorders, resulting in treatment disparities and elevated rates of me...
Spanish-speaking Latinas in the United States encounter significant barriers when seeking culturally responsive treatment for perinatal mental health disorders, resulting in treatment disparities and elevated rates of mental health symptoms. To address these challenges, peer-delivered support may be one promising strategy. This study examined the efficacy of Alma, a peer-delivered behavioral activation (BA) program comprising 6-8 sessions. Participants (N = 126) were Spanish-speaking Latina mothers experiencing elevated depression symptoms during the perinatal and early parenthood period. Participants were recruited through three community partner sites across rural and urban settings. Participants reported high satisfaction with the program and experienced decreases in depression symptoms, anxiety symptoms, and perceived stress. Importantly, significant clinical improvements occurred early in the program, indicating a rapid relief of symptoms. This symptom reduction was associated with improvements in putative mechanisms of BA, including activity level and environmental reward. Limitations of this study include participant attrition and the absence of a control group. Together, the findings indicate that Alma is a promising program to address depressed mood, anxiety, and stress among Spanish-speaking Latina mothers during the perinatal/early parenthood period, offering accessible and culturally responsive mental health support. Moreover, by meeting the mental health needs of Spanish-speaking Latina mothers, Alma holds promise for mitigating mental health disparities in underserved communities.
"Warning-This Content May Trigger Temporary Discomfort, Which Is Expected and Manageable": The Effect of Modified Trigger-Warning Language on Reactions to Emotionally Provocative Content.
Bell KM, Howardson R, Holmberg D … +1 more , Cornelius TL
Behav Ther · 2025 Mar · PMID 40010896 · Publisher ↗
A growing body of research suggests that trigger warnings do not actually reduce distress in those viewing emotionally provocative stimuli and may at times even worsen it. However, little is known regarding the potential...
A growing body of research suggests that trigger warnings do not actually reduce distress in those viewing emotionally provocative stimuli and may at times even worsen it. However, little is known regarding the potential benefits of modifying trigger-warning language so that it employs therapeutically consistent messaging to encourage adaptive coping. The current study explored whether a modified trigger warning might be more effective than a traditional trigger warning in reducing participants' negative affect (NA) when exposed to distressing content. University students (N = 606) participated in an online study and were randomly assigned to one of three conditions: traditional trigger warning, modified trigger warning, or a no-warning control group. NA was measured before and after display of two emotionally provocative stimuli (one article and one video). Anxiety sensitivity (AS) and posttraumatic stress symptoms (PTSS) were also measured to assess whether these preexisting individual vulnerabilities might moderate participants' responses to the different messages. Although the carefully pilot-tested stimuli were successful in increasing NA, there was no significant effect of trigger-warning condition, despite ample statistical power. AS and PTSS were associated with higher overall levels of NA but did not interact with study condition. These results add to the growing body of literature suggesting trigger warnings (whether traditional or modified) do not succeed in their goal of reducing the distress elicited by emotionally provocative content, including among vulnerable individuals. Alternative approaches to traditional trigger warnings are considered that may help individuals cope adaptively with potentially distressing material.
Metacognition in Children and Adolescents With Obsessive-Compulsive Disorder Treated With Cognitive Behavioral Therapy.
Isaksen CS, Hybel KA, Wolters L … +3 more , Højgaard DRMA, Farrell L, Thomsen PH
Behav Ther · 2025 Jan · PMID 39814519 · Publisher ↗
According to the metacognitive theory, maladaptive metacognition is associated with the development and maintenance of emotional disorders. This study is the first to explore maladaptive metacognition in a sample of chil...
According to the metacognitive theory, maladaptive metacognition is associated with the development and maintenance of emotional disorders. This study is the first to explore maladaptive metacognition in a sample of children and adolescents (7-17 years) with obsessive-compulsive disorder (OCD) in the context of cognitive behavioral therapy (CBT). A total of 114 children and adolescents were included in the study. Of these 56 were OCD patients who were assessed on metacognition (Metacognitions Questionnaire-Child Version) and OCD symptom severity (Children's Yale-Brown Obsessive Compulsive Scale) before and after 14 sessions of individual CBT. Fifty-eight children and adolescents without any psychiatric diagnoses constituted a control group and were assessed on metacognition temporally corresponding to the OCD group. Results showed that the OCD group had significantly elevated maladaptive metacognition relative to the control group, with the exception of positive beliefs about worry. The maladaptive metacognition in the OCD group was significantly reduced from pre- to posttreatment. Additionally, the reduction in the total level of maladaptive metacognition was significantly larger than that reported by the control group. However, it remained significantly elevated relative to controls at posttreatment. Furthermore, lower posttreatment OCD severity was associated with larger reductions in negative beliefs about worry, beliefs about the need to control thoughts, and cognitive self-consciousness, as well as with a higher pretreatment level of positive beliefs about worry. Overall, age group (children vs adolescents) did not moderate these results. Collectively, the results suggest that amending maladaptive metacognition in children and adolescents with OCD might be important considering the associations between reductions in maladaptive metacognition and favorable treatment outcome.
Preliminary Examination of Sympathetic Magic as a Psychological Endophenotype for Obsessive-Compulsive Disorder.
Jessup SC, Adamis AM, Olatunji BO
Behav Ther · 2025 Jan · PMID 39814518 · Publisher ↗
Although sympathetic magic (SM) beliefs (i.e., irrational understanding of contagion transmission) are observed in obsessive-compulsive disorder (OCD), it is unclear if such beliefs are psychological endophenotypes. Furt...
Although sympathetic magic (SM) beliefs (i.e., irrational understanding of contagion transmission) are observed in obsessive-compulsive disorder (OCD), it is unclear if such beliefs are psychological endophenotypes. Furthermore, predictors of SM beliefs in OCD remain unknown. Accordingly, the present study examined whether SM beliefs function as an endophenotype for OCD and whether perceived vulnerability to disease (PVD) contributes to SM beliefs. A sample of 30 individuals with OCD, 26 first-degree relatives, and 25 age-matched healthy controls completed self-report questionnaires and a SM task where we touched a clean pencil to a "contaminated" toilet, and rated the degree to which the pencil was contaminated. A second pencil was touched to the first pencil and was then rated. This process was continued for 12 pencils (12 degrees of removal from contagion). Results revealed no significant differences in the extent to which the three groups perceived a "chain of contagion" (i.e., contamination slopes) for the successive degrees of removal from the original contagion. However, the OCD group reported significantly less contamination reduction on the task, a group difference that was mediated by PVD. These findings suggest that although SM beliefs may not be an OCD endophenotype, such beliefs may derive from a PVD.
Therapist-Guided Internet-Delivered Acceptance-Enhanced Behavior Therapy for Skin-Picking Disorder: A Randomized Controlled Trial.
Asplund M, Lenhard F, Rück C … +6 more , Andersson E, Grimlund T, Nilsson M, Sarachu-Nilsson M, Sundh L, Ivanov VZ
Behav Ther · 2025 Jan · PMID 39814517 · Publisher ↗
Despite its high prevalence, individuals suffering from skin-picking disorder (SPD) face limited access to treatment due to several factors, including geographical and economic barriers, as well as a shortage of properly...
Despite its high prevalence, individuals suffering from skin-picking disorder (SPD) face limited access to treatment due to several factors, including geographical and economic barriers, as well as a shortage of properly trained therapists. Offering Internet-delivered therapy could be a solution to these barriers. This study aimed to evaluate the efficacy of therapist-guided Internet-delivered acceptance-enhanced behavior therapy (iBT) for SPD compared to a wait-list control condition. Participants randomized to the intervention group received 10 weeks of iBT (n = 35), while those in the control group were placed on a wait-list (n = 35). The primary outcome was the Skin Picking Scale-Revised (SPS-R). Mixed-model regression analyses demonstrated a significantly greater improvement in SPD symptoms in the iBT group compared to the control group at posttreatment (between-group difference -5.1 points, F = 9.69, p < .001). The between-group effect size was in the large range, with a bootstrapped d of 1.3 (95% CI [0.92, 1.69]). At posttreatment, 43% of the participants in the iBT group were classified as responders, and 31% were in remission, compared to 0% responders and 3% in remission in the control group. At the 6-month follow-up, the SPD symptoms had increased compared to posttreatment. However, the improvement from pretreatment remained significant. Participants reported a high level of satisfaction and credibility of the treatment, and a perceived good level of working alliance. Compared to wait-list control, iBT is an efficacious treatment for SPD at posttreatment and follow-up, with the potential to substantially increase the availability and access to evidence-based treatment for this disorder. Replication studies, particularly those comparing iBT to an active control, are warranted.
Measuring Psychological Response to Pandemics: Further Psychometric Investigation of the COVID Stress Scales.
Yap DL, Behar E
Behav Ther · 2025 Jan · PMID 39814516 · Publisher ↗
The COVID Stress Scales (CSS; Taylor et al., 2020b) were developed as a measure of stress related to any pandemic, making it a valuable self-report measure for potential future large-scale infectious disease outbreaks. A...
The COVID Stress Scales (CSS; Taylor et al., 2020b) were developed as a measure of stress related to any pandemic, making it a valuable self-report measure for potential future large-scale infectious disease outbreaks. Although the initial validation study of the CSS indicated evidence of its psychometric strength, further assessment is warranted of the measure's retest reliability, the long-term stability of its five-factor structure, discriminant validity, and its relationship with pandemic-related risk and precautionary behaviors. We examined these psychometric elements of the CSS using longitudinal data collected from a nationally representative sample of adults (N = 205) during the COVID-19 pandemic. Results indicate moderate retest reliability that is consistent with changing rates of morbidity. Results also support the five-factor structure and demonstrate convergent validity, discriminant validity, and the ability to predict relevant behavioral responses to an active pandemic. Use of the CSS for future pandemics is discussed.
Improvement in Distress Tolerance as a Mechanism of Symptom Reduction During Intensive Exposure and Response Prevention-Based Treatment for OCD.
Godfrey DA, Heinrich A, McIngvale E … +3 more , Sy J, Wheaton MG, Björgvinsson T
Behav Ther · 2025 Jan · PMID 39814515 · Publisher ↗
Exposure and Response Prevention (ERP) is an effective treatment for obsessive-compulsive disorder (OCD), yet the specific underlying mechanisms by which ERP improves symptoms remain unclear. Initial theories suggested t...
Exposure and Response Prevention (ERP) is an effective treatment for obsessive-compulsive disorder (OCD), yet the specific underlying mechanisms by which ERP improves symptoms remain unclear. Initial theories suggested that habituation to triggering events and stimuli was the key therapeutic factor in ERP, while other theories highlight the role of developing the ability to tolerate distress, rather than reduction of distress. The current study examined improvements in distress tolerance as a mechanism of OCD, anxiety, and depressive symptom reductions during an ERP-based intensive program. Participants (N = 180) completed weekly measures of distress intolerance, and symptom severity of OCD, anxiety, and depression. Using Multi-Level Structural Equation Modeling, we found that participants experienced significant weekly decreases in OCD, anxiety, and depressive symptom severity across the course of their ERP-based treatment. Weekly reductions in OCD symptom severity were partially accounted for by weekly improvements in participants' ability to tolerate distress, particularly for obsession symptoms. This effect was also significant for anxiety and depressive symptom severity, above and beyond the effects of weekly reductions in OCD symptom severity. The current study suggests improving the ability to tolerate distress represents a transdiagnostic mechanism of symptom severity reduction in OCD, anxiety, and depressive psychopathology via intensive ERP-based psychotherapy programming. Limitations and future directions for improving treatments for OCD, anxiety, and depressive symptoms are discussed.
State and Trait Disgust Uniquely Predict Avoidance in Contamination Fear: Specificity of Disease-Specific and Nonspecific Individual Differences.
Olatunji BO, Liu Q, Knowles KA … +1 more , Jessup SC
Behav Ther · 2025 Jan · PMID 39814514 · Publisher ↗
Although behavioral avoidance is observed among those with heightened contamination concerns, the extent to which such avoidance is best predicted by state and/or trait characteristics is unclear. Furthermore, while disg...
Although behavioral avoidance is observed among those with heightened contamination concerns, the extent to which such avoidance is best predicted by state and/or trait characteristics is unclear. Furthermore, while disgust proneness is a disease-specific trait that has been shown to predict avoidance among those with symptoms of contamination-based obsessive-compulsive disorder (OCD), it is unclear if other disease-specific traits may also serve a similar function. In the present study, contamination-fearful participants (N = 89) first completed self-report measures of disease-specific (disgust proneness, health anxiety, perceived vulnerability to disease) and disease-nonspecific (intolerance of uncertainty, trait anxiety) traits. They then completed a 16-step behavioral approach task (BAT) with increasing likelihood of contagion in a public restroom and provided ratings of state disgust and state anxiety at each step. Bayesian hierarchical logistic regression showed that state disgust, but not state anxiety, at a given step was associated with avoidance on the next step. Furthermore, disgust proneness was the only trait associated with avoidance on the BAT. A significant interaction between disgust proneness and BAT step completed in the public restroom was also found. Examination of this interaction suggests that intermediary, but not initial and latter, steps of the BAT differentiate those high and low in disgust proneness. These findings suggest that state and trait disgust uniquely drive behavioral avoidance among those with contamination concerns commonly observed in OCD.
A Network Control Theory of Dynamic Systems Approach to Personalize Therapy.
Hofmann SG
Behav Ther · 2025 Jan · PMID 39814513 · Publisher ↗
Contemporary latent disease models of psychopathology have shown limited clinical utility and the efficacy of conventional treatments have been disappointing. An alternative approach offers the network approach and a dyn...
Contemporary latent disease models of psychopathology have shown limited clinical utility and the efficacy of conventional treatments have been disappointing. An alternative approach offers the network approach and a dynamic systems perspective to psychopathology and treatment change. To understand and modify dynamic systems, engineering and mathematics have been relying on principles of network control theory. This article will discuss the application of network control theory of dynamic systems approach to personalize therapy. Network control theory can be used as a guide for personalizing treatment by choosing the most promising intervention strategy targeting the change processes based on the network structure. A composit case illustration will demonstrate the principles and application of network control theory to therapy in practice within the framework of process-based therapy. In conclusion, a network control theory of dynamic systems approach is highly relevant and applicable to clinical science.
Preventing Postpartum Anxiety and Obsessive-Compulsive Disorder Over the Internet: An Open-Trial Pilot Study.
Steinman SA, Edwards CB, Snider MDH … +5 more , Billingsley AL, Ponzini GT, Evey KJ, Doss B, Timpano KR
Behav Ther · 2025 Jan · PMID 39814512 · Publisher ↗
Anxiety disorders are the most common postpartum psychiatric conditions, yet limited research exists on the prevention of postpartum anxiety and obsessive-compulsive disorder (OCD). Postpartum anxiety leads to significan...
Anxiety disorders are the most common postpartum psychiatric conditions, yet limited research exists on the prevention of postpartum anxiety and obsessive-compulsive disorder (OCD). Postpartum anxiety leads to significant problems in both mother and child, such as maternal depression, difficulty breastfeeding, interference with parent-infant bonding, and childhood anxiety. In the current study, we tested the feasibility, acceptability, and initial efficacy of an Internet-delivered postpartum anxiety and OCD prevention program, "Preventing Postpartum Onset Distress" (P-POD), in a sample of 15 pregnant women in their third trimester. Geared toward at-risk pregnant people, P-POD includes seven 30-minute educational, interactive modules that teach skills derived from cognitive-behavioral treatment for anxiety and OCD. P-POD also includes three additional modules for partners, with strategies for supporting their partners. Findings suggest that P-POD is acceptable and feasible. Participants experienced reductions in postpartum anxiety risk factors. However, this was a small, open-trial pilot study with a relatively homogeneous sample. Future research should compare P-POD to an active control condition, use more diverse samples, include qualitative interviews, and assess symptoms postpartum.
Prospective Relationships Among Depression and Perceived Opportunity in Juvenile Offenders.
Sandella MF, Rackoff GN, Newman MG
Behav Ther · 2025 Jan · PMID 39814511 · Full text
Among juveniles in the justice system, depression and perceived opportunity have implications for long-term adjustment. The prospective associations between these two constructs have not yet been examined in this populat...
Among juveniles in the justice system, depression and perceived opportunity have implications for long-term adjustment. The prospective associations between these two constructs have not yet been examined in this population. We studied the longitudinal association between depression and perceived opportunity in a sample of recently adjudicated juvenile offenders. Juvenile offenders (n = 1,354) completed measures of depression and perceived opportunity shortly after adjudication and then every 6 months thereafter for 3 years (7 time points total). Relative to White juvenile offenders, lower average levels of perceived opportunity were observed among Black, Hispanic, and juveniles of other races/ethnicities. A random-intercept cross-lagged panel model revealed that greater depression was associated with lower subsequent perceived opportunity (d = -0.22, p < .001). Higher perceived opportunity did not predict subsequent depression (d = -0.07, p = .208). The nonexperimental design prevented inferences about causal links between depression and perceived opportunity. Results should also be replicated in a recently collected dataset. Findings suggested a scar-like effect, such that depression was unidirectionally and negatively associated with lower future perceived opportunity among juveniles. Future research should investigate if treatment for depression improves juvenile offenders' perceived opportunity.
A Pilot Randomized Controlled Trial of a Single-Session Intervention to Reduce Training Psychologists' Burnout.
Last BS, Jans LK, Schleider JL
Behav Ther · 2025 Jan · PMID 39814510 · Publisher ↗
Professional psychology trainees often experience burnout during their clinical training. In a pilot randomized controlled trial, we tested the feasibility, acceptability, utility, and preliminary efficacy of a 10-minute...
Professional psychology trainees often experience burnout during their clinical training. In a pilot randomized controlled trial, we tested the feasibility, acceptability, utility, and preliminary efficacy of a 10-minute, online single-session intervention (SSI), designed to address burnout, hopelessness, and perceived agency in psychology trainees. In March 2023, 151 doctoral students with symptoms of stress or burnout in accredited, U.S.-based professional psychology programs were randomized to either the SSI (n = 74) or an active control condition (n = 77). Immediately post-SSI, 98.5% of participants endorsed the SSI as likely helpful for their patients and 92.5% wanted more information on how to deliver it; at 2-week follow-up, 48.4% had used the SSI in their own life, and 16.1%, with a patient. On average, participants rated the SSI as somewhat helpful; feeling somewhat hopeful and somewhat motivated to use their SSI-driven action plan; and that they would mostly recommend the SSI to others. No significant cross-condition differences emerged in participants' reported burnout, hopelessness, or perceived agency at post-intervention or at follow-up, though effect sizes for these primary outcomes were generally in expected directions (ds = 0.01-0.36). In response to secondary outcome measures, SSI participants (versus control participants) reported perceiving significantly larger immediate improvements in hopelessness (d = 0.87), their problem-solving ability (d = 0.85), and their ability to help patients solve problems (d = 0.71). Overall, findings were inconclusive regarding the SSI's effects on overall burnout, hopelessness, and agency; however, the SSI appeared to support trainees' interest in SSI delivery and real-world use, both with themselves and with their patients. Participant feedback provided helpful guidance to inform SSI refinement, and potential best-uses, before larger-scale evaluation.
Symptom Profiles and Intensive Treatment Outcomes in Sexual Minority and Heterosexual Patients With OCD.
Pinciotti CM, Feinstein BA, Williams MT
Behav Ther · 2025 Jan · PMID 39814509 · Publisher ↗
Sexual minority (SM) individuals appear to be at greater risk for obsessive-compulsive disorder (OCD). Despite this, little is known about OCD presentation and treatment outcomes among SM individuals. Although some resea...
Sexual minority (SM) individuals appear to be at greater risk for obsessive-compulsive disorder (OCD). Despite this, little is known about OCD presentation and treatment outcomes among SM individuals. Although some research has suggested that SM individuals may be more likely to endorse intrusive thoughts related to violence/sex/religion compared to heterosexual individuals, extant literature has neglected to examine potential differences across different SM groups, a notable limitation given the apparent differences in the types of minority stress that each group experiences and the unique health disparities affecting each group. The current study sought to address these gaps by examining potential differences in OCD symptom severity, presentation, and treatment outcomes using analysis of variance and profile analysis in a clinical sample of 1,502 cisgender patients diagnosed with OCD enrolled in intensive OCD treatment (87.5% heterosexual, 6.6% bisexual, 4.7% lesbian or gay, and 1.1% questioning). Replicating previous research, neither OCD severity nor treatment outcomes differed by sexual orientation, and findings extended previous research that no differences across SM groups were observed, either. However, contrary to previous research, there was also no evidence for unique profiles of OCD symptoms across sexual orientation groups, and questioning individuals reported significantly less severe symmetry symptoms compared to heterosexual and bisexual individuals. Findings are encouraging in that they suggest that cisgender bisexual, lesbian or gay, and questioning individuals with OCD can still benefit significantly and to the same degree as their cisgender heterosexual peers in intensive OCD treatment. Potential explanations for conflicting findings regarding symptom profiles are discussed.
Feasibility, Acceptability, and Preliminary Efficacy of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents in China: A Pilot Study.
Pan MR, Liu XY, Gao X … +5 more , Fu ZF, Liu L, Li HM, Wang YF, Qian QJ
Behav Ther · 2025 Jan · PMID 39814508 · Publisher ↗
Currently, there is a lack of cost-effective and accessible intervention resources for Chinese adolescents with emotional disorders. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescent...
Currently, there is a lack of cost-effective and accessible intervention resources for Chinese adolescents with emotional disorders. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A), which aims to apply transdiagnostic treatment principles to target core dysfunctions across a range of emotional disorders with a single protocol, could fill this gap. We first modified the UP-A for use in the Chinese cultural context and then assessed its feasibility, acceptability, and preliminary efficacy using a single-arm design. Twenty-four Chinese adolescents (14.1 ± 1.2 years old) with emotional disorders completed a 12-week group UP-A intervention along with their parents. Multiple outcomes were evaluated at five time points: pretreatment (T1), week 4 (T2), week 8 (T3), posttreatment (T4), and 3-month follow-up (T5). The results showed a low dropout rate (16.7%), high attendance (at 10.2 ± 1.6 sessions in adolescents and 10.7 ± 2.0 sessions in parents), and sufficient participant satisfaction. Adolescents exhibited significant decreases in emotional disorder severity (g = -1.298 to -1.341) and emotional symptoms (g = -0.440 to -1.988) and significant improvements in emotion regulation (ER) strategies, resilience, functional outcomes, and executive function. The efficacy of the intervention was significant starting at T2 and was maintained at T4 and T5. Exploratory analyses revealed that predictors of treatment outcomes included the presence of multiple comorbidities, the severity of emotional disorders, adaptive ER strategies, and resilience at T1. This study demonstrated the feasibility, acceptability, and preliminary efficacy of the Chinese version of the UP-A, and future randomized controlled trials are warranted.
Targeted Sleep Enhancement Reduces Residual Anxiety Symptoms in Peri-Adolescents Previously Treated for Anxiety Disorders.
Akbar SA, Hayes T, Valente MJ … +10 more , Milbert MM, Cousins JC, Siegle GJ, Ladouceur CD, Silk JS, Forbes EE, Ryan ND, Harvey AG, Dahl RE, McMakin DL
Behav Ther · 2025 Jan · PMID 39814507 · Full text
Sleep-related problems (SRPs) are a common precursor to anxiety disorders, especially during peri-adolescence, and may be a predictor of treatment response. However, evidence-based anxiety treatments do not alleviate SRP...
Sleep-related problems (SRPs) are a common precursor to anxiety disorders, especially during peri-adolescence, and may be a predictor of treatment response. However, evidence-based anxiety treatments do not alleviate SRPs to a clinically significant degree. The current study examines whether improving sleep in a sample of young adolescents previously treated for anxiety disorders can further reduce anxiety severity. Participants include 46 adolescents (65% female, ages 9-14 years) previously treated for anxiety disorders who self-selected to participate in a 6-week open trial of targeted sleep enhancement (TIGERS). Measures of parent- and child report on SRPs, and clinician-rated anxiety severity, were collected at several time points of the study: pre-, and postanxiety treatment, pre- and post-TIGERS, and at four yearly follow-ups. Two hierarchical mediation models were run using either parent- or child report on sleep. On the between-subjects level, participants with higher overall average SRPs also had higher overall anxiety severity over all time points. On the within-subjects level, participation in TIGERS was not directly associated with change in anxiety severity-however, participation in TIGERS was associated with a drop in SRPs, which was associated with a drop in anxiety severity. Improving sleep in anxious peri-adolescents further improves anxiety above and beyond anxiety treatment. Further research is needed to confirm the effects of improving sleep on clinical anxiety in a randomized controlled trial.
Prolonged Grief Symptoms Predict Social and Emotional Loneliness and Depression Symptoms.
Eisma MC, Buyukcan-Tetik A
Behav Ther · 2025 Jan · PMID 39814506 · Publisher ↗
A minority of bereaved individuals develops severe, persistent, and disabling grief, termed "prolonged grief." The International Classification of Diseases, eleventh edition (ICD-11) and the Diagnostic and Statistical Ma...
A minority of bereaved individuals develops severe, persistent, and disabling grief, termed "prolonged grief." The International Classification of Diseases, eleventh edition (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision (DSM-5-TR) include such grief reactions as prolonged grief disorder (PGD). Loneliness is often experienced by bereaved persons and can have severe health consequences. Preliminary research suggests that loneliness may perpetuate grief, but prolonged grief may also aggravate loneliness. Since existing empirical research provides limited information on temporal relationships between both constructs, we aimed to fill this gap in knowledge. Bereaved adults (88% female, mean age 54 years) filled in questionnaires assessing general, social, and emotional loneliness and prolonged grief and depression symptoms across two time points, 6 months apart. Cross-lagged panel model analyses showed that prolonged grief symptoms predicted more severe general, social, and emotional loneliness, as well as more depression symptoms. Loneliness did not predict prolonged grief symptoms and depression symptoms. Depression symptoms did not predict prolonged grief symptoms and loneliness. Additionally, latent change score analyses demonstrated that within person changes in prolonged grief symptoms and loneliness were related. Findings are inconsistent with the notion that loneliness causes prolonged grief and depression. Possibly, severe grief could lead to stigmatization, reduced social support, and feeling socially disconnected, perpetuating loneliness and depression symptoms.
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