Journal Of Clinical Psychology[JOURNAL]
Sun
200 papers
Pre-Treatment Resilience as a Predictor of Veterans' Post-Traumatic Stress Disorder Symptom Outcomes Immediately and Up To 12-Months Following Intensive Cognitive Processing Therapy.
Ptak MK, Smith D, Pridgen S … +1 more , Held P
J Clin Psychol · 2025 Dec · PMID 41074762 · Full text
OBJECTIVE: Resilience is associated with lower post-traumatic stress disorder (PTSD) severity and may play a beneficial role in PTSD treatment. The present study explored if pre-treatment resilience and changes in resili...
OBJECTIVE: Resilience is associated with lower post-traumatic stress disorder (PTSD) severity and may play a beneficial role in PTSD treatment. The present study explored if pre-treatment resilience and changes in resilience during intensive treatment for PTSD were associated with PTSD and depression symptom change among veterans during and up to a year after treatment. METHODS: A total of 727 veterans (age: M = 45.1 years, SD = 10.3) participated in a 2-week Cognitive Processing Therapy (CPT)-based Intensive PTSD Treatment Program (ITP). Resilience was assessed at the start and end of the program, while PTSD and depression were assessed every other day of the program and 3-, 6-, and 12-months post-treatment. RESULTS: Veterans with higher pre-treatment resilience tended to have lower PTSD (b = -0.24, p < 0.001, R = 0.04) and depression severity (b = -0.10, p < 0.001, R = 0.07) throughout the ITP. Pre-treatment resilience was not associated with differing treatment trajectories for PTSD (b = -0.01, p = 0.492) or depression (b = -0.01, p = 0.184). Improvements in resilience from the beginning to end of treatment were associated with improvements in PTSD (b = -0.24, p < 0.001, R = 0.02) and depression symptoms (b = -0.10, p < 0.001, R = 0.01). Pre-treatment resilience was associated with PTSD severity 3- and 12-months following treatment, and with depression severity 3- and 6-months post-treatment. Changes in resilience during treatment were associated with PTSD severity up to 1 year post-treatment, and up to 3 months for depression severity. CONCLUSION: The findings highlight that patients may experience similarly beneficial treatment trajectories regardless of their pre-treatment resilience. This may offer hope to patients with lower resilience that they can still achieve meaningful PTSD and depression symptom reductions.
Comparing American and Chinese Primary School Students' Psychosocial Symptoms: Psychometric Network Analysis With Pediatric Symptom Checklist-17.
Xia A, Liu J, Liu T … +2 more , Pan J, Ding R
J Clin Psychol · 2026 Feb · PMID 41063467 · Publisher ↗
This study aimed to compare the American and Chinese primary school students' psychosocial problems, utilizing the psychometric network analysis. American (n = 71, M = 36.93 years, SD = 10.52 years, all females) and Chin...
This study aimed to compare the American and Chinese primary school students' psychosocial problems, utilizing the psychometric network analysis. American (n = 71, M = 36.93 years, SD = 10.52 years, all females) and Chinese (n = 74, M = 35.70 years, SD = 7.89 years, 85.92% females) primary school teachers were recruited to evaluate children's internalizing, externalizing, and attention problems using the Pediatric Symptom Checklist-17 (PSC-17). Each teacher evaluated 9 children in their classes. A total of 639 American students (M = 8.88 years, SD = 2.02 years, 55.56% females) and 666 Chinese students (M = 12.88 years, SD = 9.34 years, 57.96% females) were evaluated. Psychometric network analysis revealed distinct structures for American and Chinese children's psychosocial problems. In America, three distinct communities emerged, aligning with the theoretical constructs of the PSC-17. Conversely, while three communities were identified in China, three items assessing attention problems showed strong associations with those assessing internalizing problems, merging into the same community. The remaining two items assessing attention problems and the items assessing externalizing problems formed two other distinct communities. Moreover, in both cultures, the top three nodes with the highest centralities ('Distracted easily,' 'Blame others for his or her troubles,' and 'has trouble concentrating') are similar and all relate to externalizing and attention problems. However, the highest centralized node in the two cultures differed, with "Distracted easily" in America and "Blames others for his or her troubles" in China. In conclusion, the observed patterns in American and Chinese networks highlight the significant impact of culture on children's psychosocial issues. Although PSC-17 is a widely used screening tool in many languages, its application should be carefully considered in different cultural contexts, particularly when making cultural comparisons.
Metacognitive Interpersonal Group Therapy for Adolescents With Emerging Personality Disorders: The Case of Nora.
Inchausti F, García-Poveda NV, González de Betolaza SMH … +3 more , Morrás II, Popolo R, Dimaggio G
J Clin Psychol · 2026 Feb · PMID 41056507 · Publisher ↗
An increasing number of adolescents attending child and adolescent mental health services present symptoms consistent with an emerging personality disorder (PD). Early identification and intervention are critical to prev...
An increasing number of adolescents attending child and adolescent mental health services present symptoms consistent with an emerging personality disorder (PD). Early identification and intervention are critical to preventing the devastating progression of symptoms, reducing the duration of untreated disorders, and supporting the recovery, development, and future quality of life of these individuals. The primary aim of this paper is to introduce a group therapy proposal designed for the entire spectrum of adolescent PDs: Metacognitive Interpersonal Group Therapy for Adolescents (MIT-GA). MIT-GA is a profoundly experiential interpersonal psychotherapy aimed at promoting the progressive growth of awareness and regulation of mental states, that is metacognition, and so alleviating symptoms and interpersonal problems. The paper first outlines the core principles of the treatment, its general structure, and session content. Next, it illustrates the therapeutic methodology through the case of Nora, a 16-year-old adolescent suffering from emerging, moderate PD with mixed features, primarily dependent and borderline. To evaluate the therapy's impact, quantitative and qualitative results are presented before and after the treatment, as well as 6 months post-therapy, focusing on symptomatology, interpersonal functioning, and overall functioning. Finally, the paper offers reflections on working with PDs, and discusses the advantages and challenges of MIT-GA.
Examining Demographic Characteristics of Firearm Owners Currently Engaged in Mental Health Treatment.
Bond AE, Rodriguez TR, Burke K … +2 more , Altikriti S, Anestis MD
J Clin Psychol · 2026 Feb · PMID 41047231 · Full text
OBJECTIVE: Research on the demographic characteristics and mental health profiles of those with firearm access is scarce. To address this gap, the current study examined the demographic characteristics and use of mental...
OBJECTIVE: Research on the demographic characteristics and mental health profiles of those with firearm access is scarce. To address this gap, the current study examined the demographic characteristics and use of mental health services among firearm owners in the United States. METHODS: Using a sample of 3018 US adults with firearm access drawn from a nationally representative sample of adults (n = 8009), this study assessed the relationships between individual characteristics, engagement in therapy, and receiving prescribed psychiatric medication among respondents who have access to firearms. RESULTS: Among those with firearm access, being younger, female, having higher education, and a history of suicidal ideation were associated with engagement in therapy and receiving psychiatric medication. Additionally, being nonwhite and employed were associated with lower odds of receiving medication. The findings highlight the need to better identify high-risk subgroups (e.g., nonwhite, older, and less educated) with firearm access who do not engage with mental health services. CONCLUSION: It is hypothesized that extending mental health services and suicide prevention strategies to those who traditionally underutilize these services despite an elevated risk of self-harm can help reduce self-injury and potentially reduce firearm-related suicides among these populations.
Negative Emotion Regulation Self-Efficacy Moderates the Association Between PTSD Symptom Severity and Suicidal Thoughts and Behaviors in a Trauma-Exposed Community Sample of Adults.
Hall KE, Tull MT, Gratz KL
J Clin Psychol · 2026 Jan · PMID 41021433 · Full text
Individuals who experience symptoms of post-traumatic stress disorder (PTSD) are more likely to experience suicidal thoughts and behaviors (STB). However, additional research is needed to clarify for whom the relationshi...
Individuals who experience symptoms of post-traumatic stress disorder (PTSD) are more likely to experience suicidal thoughts and behaviors (STB). However, additional research is needed to clarify for whom the relationship between PTSD symptoms and STB is the strongest. Considering that both PTSD and STB are characterized by difficulties with emotion regulation, one construct worth exploring in this regard is emotion regulation self-efficacy (ERSE), or one's beliefs in their ability to regulate negative emotions. Thus, the current study sought to explore the role of ERSE in the association between PTSD symptoms and STB. Using Amazon's Mechanical Turk, participants (N = 227; M = 39.91, 65.2% assigned female sex at birth) completed self-report measures of PTSD symptoms, ERSE, and STB. Controlling for depression, results revealed a significant interaction between PTSD and ERSE in relation to STB. Simple slopes analyses revealed a significant positive association between PTSD symptom severity and STB among individuals with low or moderate, but not high, self-efficacy for managing negative emotions. Results highlight the relevance of ERSE in understanding STB among individuals experiencing PTSD symptoms.
Loving in Secret, Grieving in Silence: Emotion-Focused Therapy With the Other Woman After an Affair in a Japanese Cultural Context.
Iwakabe S
J Clin Psychol · 2026 Jan · PMID 40996429 · Full text
Although extensive literature exists on supporting couples after an affair, there is a notable lack of clinical focus on working with the other woman-a figure often viewed as a moral transgressor and subjected to social...
Although extensive literature exists on supporting couples after an affair, there is a notable lack of clinical focus on working with the other woman-a figure often viewed as a moral transgressor and subjected to social stigma. Despite this marginalization, her experience is frequently marked by secrecy, emotional ambivalence, and a mix of profound pleasure, guilt, and shame. This paper presents a case study of individual therapy with a Japanese woman in her late 30 s, struggling with the unresolved emotional aftermath of a 5-year affair that had ended more than 7 years earlier. Early sessions revealed significant unfinished emotional business with her ex-boyfriend, who left her shortly after his wife gave birth, a relationship she had entered unaware of his marital status. The therapy focused on helping the client process the complex emotional residue of this relationship, which had affected nearly every aspect of her life. Drawing on an affect-focused integrative approach that combined Emotion-Focused Therapy (EFT) and Accelerated Experiential Dynamic Psychotherapy (AEDP), the therapist supported the client in processing both the pleasurable and painful aspects of the affair. These had remained unspoken due to the absence of a safe space for expression. Within the safety of the therapeutic relationship, she was able to articulate long-suppressed needs, reclaim her sense of self-worth, and regain agency. The case also explores the cultural and gendered dimensions of infidelity within the Japanese context and reflects on implications for affect-focused clinical practice with clients experiencing stigma or struggling with morally complex personal issues.
Neurobehavioral Therapy Is Associated With Improvements in Social Functioning in Patients With Functional Seizures and Traumatic Brain Injury.
Van Patten R, Cotton E, Chan L … +11 more , Altalib H, Tocco K, Gaston TE, Grayson LP, Martin A, Fry S, Goodman A, Allendorfer JB, Blum A, Szaflarski JP, LaFrance WC
J Clin Psychol · 2026 Jan · PMID 40996372 · Publisher ↗
OBJECTIVE: Functional (nonepileptic) seizures (FS) frequently co-occurs with traumatic brain injury (TBI) and reduces social functioning. In the current study, we aimed to identify whether psychotherapy is associated wit...
OBJECTIVE: Functional (nonepileptic) seizures (FS) frequently co-occurs with traumatic brain injury (TBI) and reduces social functioning. In the current study, we aimed to identify whether psychotherapy is associated with changes in social functioning in TBI + FS. METHODS: Participants were 96 adults with TBI, 48 of whom had FS and 48 of whom did not. Both TBI cohorts received standard medical care (SMC), and the TBI + FS group received adjunctive 12-session neurobehavioral therapy (NBT) for seizures. Neuropsychiatric evaluations measured sociodemographics, mental health, cognition, medications, social functioning, and quality of life, with a subset of items completed at 8- and 12-month post-enrollment follow ups. Social functioning was assessed with a quality of life scale. RESULTS: Baseline seizure worry was the most reliable correlate of baseline social functioning (r = 0.52; p < 0.001; multivariable linear regression: β = 0.42, t = 2.80, p = 0.04) in the TBI + FS cohort. A 2-time (treatment baseline to endpoint) × 2-group (TBI + FS vs. TBI comparison) mixed ANOVA showed improved QOLIE-31 Social Functioning in the SMC + NBT-treated TBI + FS cohort but not for SMC TBI-only participants, F(1, 94) = 17.62, p < 0.001, partial η = 0.16. NBT was associated with improved social activities and leisure time, reduced social limitations, and increased work status. None of the baseline clinical variables predicted pre-post change in social functioning in TBI + FS participants. CONCLUSION AND IMPLICATIONS FOR PRACTICE: Seizure worry appears to be an important component of social functioning in patients with FS and TBI and could be a worthwhile target of intervention. Our results suggest that multimodal NBT may be associated with improvements in aspects of social functioning for these patients. Those with TBI who were treated with SMC (no NBT) displayed no symptomatic or social benefit. This study highlights the importance of assessing and considering treatments for social functioning in FS. TRIAL REGISTRATION: Data in this secondary analysis came from ClinicalTrials. gov: NCT03441867.
Adverse Childhood Experiences, Insomnia, and Depressive Symptoms in Later Life: Moderation Effect of Loneliness but Not Hair Cortisol.
Ballesio A, Zagaria A, Fiori V … +2 more , Vacca M, Lombardo C
J Clin Psychol · 2026 Jan · PMID 40924017 · Publisher ↗
OBJECTIVES: Adverse childhood experiences (ACEs) are established risk factors for developing depression in adulthood, although the mechanisms of this association are yet to be fully elucidated. In this study, we tested w...
OBJECTIVES: Adverse childhood experiences (ACEs) are established risk factors for developing depression in adulthood, although the mechanisms of this association are yet to be fully elucidated. In this study, we tested whether insomnia (i.e., difficulties in sleep onset and maintenance) can mediate the association between ACEs and adult depressive symptoms, and whether loneliness and hair cortisol, reflecting hypothalamic-pituitary-adrenal axis activity, can act as moderators. METHODS: We analyzed data of 1593 participants (64.7% female) aged 65.25 ± 8.15 from the English Longitudinal Study of Ageing (ELSA) across three waves of data collection. ACEs were retrospectively assessed in 2008-2009 (wave 4), insomnia symptoms, loneliness, and hair cortisol in 2012-2013 (wave 6), while depressive symptoms were assessed in 2014-2015 (wave 7). RESULTS: After accounting for health-related confounders and baseline values, conditional process analysis showed that insomnia symptoms exerted a mediating role between ACEs (ACEs total, parental bonding, and household dysfunction) and depressive symptoms, with a stronger effect in lonely older adults. Hair cortisol did not moderate the association between ACEs and insomnia symptoms. CONCLUSION: Results are consistent with the view of insomnia as a mechanism linking ACEs to depressive symptoms later in life. Elderly experience of loneliness may further increase the mediatory role of insomnia between ACEs and depression.
Psychological Vulnerability to Perinatal Depression: A Longitudinal Mediation Model.
Provencio M, Rodríguez-Muñoz MF, Kovacheva K … +4 more , López-Salmerón MD, Fonseca A, Soto-Balbuena C, Macayo-Sánchez E
J Clin Psychol · 2026 Jan · PMID 40906042 · Publisher ↗
Perinatal depression (PD) is a significant mental health concern affecting women during pregnancy (antenatal depression, AD) and postpartum (postpartum depression, PPD). The association between AD and PPD is well establi...
Perinatal depression (PD) is a significant mental health concern affecting women during pregnancy (antenatal depression, AD) and postpartum (postpartum depression, PPD). The association between AD and PPD is well established, with AD serving as a risk factor for PPD. Additionally, a history of depression and neuroticism have been identified as key vulnerability factors. However, the role of neuroticism remains controversial in the scientific literature, with some studies suggesting it is a stable predictor of depression, while others propose it may exhibit fluctuations in response to life events, altering its mediating role in PD. We aim to explore the role of psychological vulnerability (history of depression and neuroticism) and AD, as transdiagnostic risks factors contributing on PPD in a longitudinal sample of 229 women. Self-report questionnaires were administered during pregnancy and postpartum. Results indicate that a history of depression had an indirect effect on PPD, mediated by both neuroticism and AD. Given the uncertainties regarding the stability of neuroticism, further longitudinal research is needed to clarify its mediating role in perinatal depression. These findings underscore the importance of early identification of vulnerability factors, particularly a history of depression, to prevent AD and subsequent PPD. Screening for psychological vulnerability is essential in clinical practice. Early identification of psychological vulnerability may help reduce the risk of postpartum depression. Screening for these factors during pregnancy could help identify women with high levels of neuroticism, who may benefit from brief, evidence-based psychological interventions, such as mindfulness-based cognitive therapy. Implementing targeted preventive strategies may enhance maternal mental health.
Deliberate Practice in Psychotherapy Supervision: A Promising Paradigm for Enhancing Clinical Effectiveness Even if We Still Have Puzzles to Solve.
Nissen-Lie HA
J Clin Psychol · 2026 Jan · PMID 40884483 · Publisher ↗
The current paper is a commentary of the four papers (Brand et al.; Husby, Sacks, and Rosén) on deliberate practice (DP) as applied to psychotherapy supervision across therapeutic methods and contexts, published in this...
The current paper is a commentary of the four papers (Brand et al.; Husby, Sacks, and Rosén) on deliberate practice (DP) as applied to psychotherapy supervision across therapeutic methods and contexts, published in this virtual issue of the Journal of Clinical Psychology: In Session. The commentary starts by situating the efforts of DP into the broader context of psychotherapy research and therapist effects (TEs), before providing a brief summary of each paper. All the papers point to the fact that traditional supervision often misses opportunities to practice specific clinical skills and the promotion of translation of reflection into action. They each give hands on and engaging cases of supervisory practices. Still, there are some critical questions that warrant attention which concern some of the assumptions that DP supervision is based on, which are discussed here. These are: (1) Are client outcomes enhanced as a result of DP supervision?; (2) Is it true that declarative knowledge does not translate into procedural knowledge?; (3) Does DP supervision put too much emphasis on the supervisor's ability to know what needs to be changed? and (4) Is it possible to apply the principles of DP to a dyadic enterprise such as psychotherapy? While clinical supervision based on DP principles is promising, there are issues to be solved, and we should proceed with sobriety with regard to how much DP may enhance the training of psychotherapists and clinical practice.
Relationships Among Patients' Interpersonal Behaviors in Sessions, Therapist Competence, and the Therapeutic Alliance in Cognitive Behavior Therapy: A Cross-Lagged Panel Analysis.
Maaß U, Witthöft M, Junga YM … +2 more , Hahn D, Weck F
J Clin Psychol · 2026 Jan · PMID 40884452 · Full text
OBJECTIVE: To investigate the reciprocal relationships between patient interpersonal behavior (IB), therapist competence, and the alliance within- and between-persons. METHODS: A secondary analysis was conducted of a ran...
OBJECTIVE: To investigate the reciprocal relationships between patient interpersonal behavior (IB), therapist competence, and the alliance within- and between-persons. METHODS: A secondary analysis was conducted of a randomized controlled trial with 67 cognitive behavior therapists and 114 patients with depression. The therapists evaluated their patients' IB, and they both judged the alliance. Pre- and post-treatment, the patients indicated their general levels of interpersonal problems. Every fourth session, independent raters judged the patients' IB and therapists' competence. Random-intercept cross-lagged panel analyses were calculated. RESULTS: First, intraindividual deviations in patient IB were associated with deviations in therapist competence or the alliance (within-person); and patients with generally more positive IB experienced not only better alliances but also more competent therapists (between-person). Second, the perspective of the evaluating person and the time interval were decisive, as significant cross-lagged effects between patients' IB in one session and the alliance in subsequent sessions (and vice versa) only occurred from the therapist perspective, but not when the patient perspective was considered. Third, patients with more interpersonal problems before treatment did not show more negative IB, nor did they experience poorer alliances or less competent therapists. CONCLUSION: The study supports the idea that patient IB is as an important part of both therapeutic competence and the alliance. However, therapists and raters may be prone to evaluation bias, interpreting negative patient IB as a sign of poor alliance or competence (and vice versa). Finally, the extent of interpersonal problems before treatment does not substantially influence the three process variables. TRIAL REGISTRATION: https://clinicaltrials.gov/study/NCT02479594.
Faculty Reports About Training in Evidence-Based Practice and Empirically-Supported Treatments Across Mental Health Graduate Programs in the United States.
Eubanks Fleming CJ, Ernestus SM, Wenze SJ … +1 more , Blomquist KK
J Clin Psychol · 2025 Nov · PMID 40880120 · Publisher ↗
Evidence-based practice (EBP) and empirically-supported treatments (EST) are considered by many to be gold standards of care in the mental health field, and yet understanding of and use of the concepts lag behind their p...
Evidence-based practice (EBP) and empirically-supported treatments (EST) are considered by many to be gold standards of care in the mental health field, and yet understanding of and use of the concepts lag behind their popularity. The current study sought to clarify the current state of training in EBP and EST across graduate mental health programs in the United States. Participants in the study were graduate instructors who taught first-year graduate students in mental health programs, (N = 540 teaching faculty; 320 masters, 220 doctoral). Three specific questions were analyzed, asking participants if they teach EBP, if they teach students how to read and evaluate randomized controlled trials, and asking what ESTs they teach. The majority of both masters- and doctoral-level faculty (masters= 90.2%; doctoral = 90.4%) reported teaching evidence-based practice. Doctoral-level faculty (74.6%) were significantly more likely to report teaching students how to read and evaluate randomized controlled trials than masters-level faculty (52.7%, n = 126; X = 20.6, p < 0.001). Cognitive Behavioral Therapy and its counterparts were the most commonly reported, but even those were only reported by 60% of faculty. Many faculty reported techniques and concepts that were not ESTs. Graduate and undergraduate faculty should intentionally consider how to best prepare students to engage in EBP and EST.
Teletherapy Post-COVID-19: Comparisons With In-Person Client Characteristics and Service Utilization in Routine Practice.
Trusty WT, Scofield BE, Cooper SE … +3 more , Castonguay LG, Hayes JA, Janis RA
J Clin Psychol · 2026 Jan · PMID 40857716 · Full text
OBJECTIVE: Telehealth psychotherapy (TH) has become widespread since the COVID-19 pandemic and has generally proven to be equally effective and acceptable as in-person (IP) treatment. However, it is unclear how TH and IP...
OBJECTIVE: Telehealth psychotherapy (TH) has become widespread since the COVID-19 pandemic and has generally proven to be equally effective and acceptable as in-person (IP) treatment. However, it is unclear how TH and IP client characteristics and service utilization compare in routine practice post-pandemic. METHODS: Individual psychotherapy clients (N = 22,710) receiving routine treatment at 72 university counseling centers from 2021 to 2023 reported on their demographic and clinical characteristics, while service utilization was determined through chart review. RESULTS: Compared to IP clients, TH clients were more likely to identify as cisgender women, Hispanic/Latinx, and bisexual and were less likely to live with roommates. TH and IP clients reported roughly equivalent symptom severity at the beginning of treatment, but TH clients were less likely to report recent suicidal ideation and more likely to have a history of past psychotherapy and psychiatric medication use. Regarding service utilization, TH clients scheduled slightly more psychotherapy appointments yet attended a lower percentage of appointments, but these differences were small. Exploratory analyses on matched samples of TH and IP clients did not detect differences in pre- to posttreatment symptom reduction. CONCLUSION: In routine practice, TH and IP psychotherapy appear to facilitate access to care for slightly different client populations, are associated with similar utilization patterns, and produce similar outcomes in university counseling post-COVID-19. Clinical systems may best serve a diverse public by offering both TH and IP services. Policy-level (e.g., equitable reimbursement for TH) and administrative support are needed to facilitate continued access to both modalities.
"A Lot of Gray": Ambiguity, Beliefs, and Discretion in Veterans Benefits Administration Military Sexual Trauma-Related Posttraumatic Stress Disorder Disability Claims.
Webermann AR, Bonnes SM, Rupcic S … +5 more , Holliday R, Monteith LL, Rosen MI, Portnoy GA, Murdoch M
J Clin Psychol · 2026 Jan · PMID 40851385 · Publisher ↗
OBJECTIVES: Thousands of Veterans file claims for military sexual trauma (MST)-related posttraumatic stress disorder (PTSD) disability through the Department of Veterans Affairs' (VA) Veterans Benefits Administration (VB...
OBJECTIVES: Thousands of Veterans file claims for military sexual trauma (MST)-related posttraumatic stress disorder (PTSD) disability through the Department of Veterans Affairs' (VA) Veterans Benefits Administration (VBA) annually to receive covered healthcare benefits and monthly nontaxable compensation for MST-related conditions. Although 72% of MST claims in 2021 were granted, prior reporting found other claims had been erroneously denied due to issues around VA staff not ordering disability exams for claims and not gathering necessary evidence on behalf of claimants. The present study explores decision-making processes around evidence-gathering for MST-related disability claims through interviews with VA staff who develop, rate, and evaluate MST disability claims (n = 21). METHODS: Interviews occurred from October 2021 to January 2024 and were analyzed using rapid qualitative methods and inductive coding, revealing themes of ambiguity, beliefs, and discretion. Participants described MST "markers" (e.g., behavioral events or patterns indicating effects of MST) as difficult to reliably identify and demonstrated disagreements about what constituted a marker. Within this ambiguity, factors that shaped participants' decision-making included beliefs about the MST and its impacts, the veracity of Veteran PTSD and/or MST claims, and the role of VA staff. Participants' judgments appeared to depend in part on their beliefs about sexual assault myths and the trustworthiness of Veterans: those who endorsed sexual assault myths or believed Veterans often lie were more likely to approach MST claims with skepticism. CONCLUSION: Future policy and programming around MST claims processing should focus on reducing ambiguity and impacts of beliefs on discretion and objectivity.
Usability and Acceptance by Therapists and Users of an Internet-Based Intervention Based on the Unified Protocol in Argentina.
Celleri M, Klajner F, Cremades FC … +3 more , Garay CJ, Etchevers M, Osma J
J Clin Psychol · 2025 Dec · PMID 40831296 · Full text
UNLABELLED: Latin American countries face a significant mental health gap, characterized by an increasing prevalence of mental disorders and limited access to evidence-based treatments. Internet-based interventions hold...
UNLABELLED: Latin American countries face a significant mental health gap, characterized by an increasing prevalence of mental disorders and limited access to evidence-based treatments. Internet-based interventions hold promise for bridging this gap. In Argentina, there are currently no locally developed internet-based interventions. To address this gap, our research team recently developed an Internet-Based Unified Protocol Intervention (IUPI), a transdiagnostic intervention adapted from the Unified Protocol. This study aimed to evaluate its usability and acceptability in the local population, a necessary step for its subsequent implementation. METHODOLOGY: A mixed-methods study was conducted with 20 professionals and 10 users who tested IUPI for 2 weeks. The System Usability Scale, an ad-hoc questionnaire, and focus groups were conducted. RESULTS: Usability scores indicated good usability for both professionals (M = 71.37 SD = 19.61) and users (M = 73.75 SD = 2.60). Both groups expressed willingness to use and recommend the platform. Thematic analysis revealed the perception that these interventions can enhance access to treatment. On the other hand, barriers such as connectivity issues, limited resources, and perceived lack of warmth and support were described. DISCUSSION: This is the first usability study of an internet-based intervention in Argentina. Findings are promising for cultural adaptation and broader implementation, potentially increasing access to psychotherapeutic treatments.
Measuring Misophonia: Assessing the Psychometric Properties of the MisoQuest and Its Ability to Predict Cognitive Impacts of Triggering Sounds.
Raymond KE, Butler BE
J Clin Psychol · 2025 Dec · PMID 40823932 · Full text
OBJECTIVES: Misophonia is characterized by an aversion to specific sounds, such as chewing and breathing. These "trigger" sounds can elicit negative emotional reactions, physiological stress, and cognitive impairments in...
OBJECTIVES: Misophonia is characterized by an aversion to specific sounds, such as chewing and breathing. These "trigger" sounds can elicit negative emotional reactions, physiological stress, and cognitive impairments in people with misophonia. Despite its impact, misophonia lacks formal diagnostic classification, largely due to challenges in conceptualization and assessment. One of the few psychometrically robust self-report measures for misophonia (the MisoQuest) was originally developed and evaluated in Polish. The current study evaluated the utility of the English language version of the MisoQuest, including assessment of its criterion validity using cognitive performance as an outcome. METHODS: A total of 139 participants (44 people with misophonia and 95 controls) completed the MisoQuest, the Selective Sound Sensitivity Syndrome Scale (S-Five), the Generalized Anxiety Disorders Scale, and the Sensory Hypersensitivity Scale. Participants then completed either a Stroop task or reading comprehension task in the presence/absence of triggering sounds. A subset of participants retook the MisoQuest after 5 weeks. RESULTS: The MisoQuest showed excellent internal consistency and strong test-retest reliability. Additionally, MisoQuest scores strongly correlated with S-Five scores, supporting convergent validity, and moderately correlated with measures of generalized anxiety and sensory hypersensitivity, indicating some overlap while supporting discriminant validity. Higher MisoQuest scores predicted poorer reading comprehension performance when trigger sounds were present, supporting criterion validity. However, MisoQuest scores showed no significant relationship with Stroop task performance. CONCLUSION: These findings support the MisoQuest as a reliable and useful measure of misophonia in English-speaking individuals and suggest its scores may relate to clinically relevant outcomes.
Post-9/11 Veterans Military-to-Civilian Transitions: Predictors of Mental Health Symptoms Over the First 3 Years.
Mitchell MM, Aronson KR, Perkins DF
J Clin Psychol · 2026 Jan · PMID 40823782 · Full text
OBJECTIVE: Many post-9/11 veterans struggle with psychological symptoms as they transition to civilian life. Adverse childhood experiences, combat exposure, and deployment characteristics are factors associated with symp...
OBJECTIVE: Many post-9/11 veterans struggle with psychological symptoms as they transition to civilian life. Adverse childhood experiences, combat exposure, and deployment characteristics are factors associated with symptoms. This study examined changes in the predictive power of these factors over the first 3 years of the military-to-civilian transition among post-9/11 veterans. METHODS: This was a longitudinal survey study in which six waves of data were collected over 3 years. RESULTS: The associations between combat, ACEs, deployment characteristics, and psychological symptoms were complex, not static, not always linear, and differed between male and female veterans. The number of deployments was associated with fewer psychological symptoms at baseline for both genders. For males, longer deployments at baseline predicted worse mental health, while more deployments were associated with improving mental health over time. CONCLUSION: Temporal explorations of veteran mental health are needed to gain insights into how and when psychological problems develop and change over time. Veterans need a robust support network to prevent mental health problems as they transition to civilian life.
Adapt-Life on Remand: A Pilot Randomized Trial With Individuals in Pretrial Detention.
Andrade J, Gonçalves RA, Rodrigues AC
J Clin Psychol · 2025 Dec · PMID 40811726 · Publisher ↗
Remand prisoners (RP) are in a precarious situation marked by uncertainty and vulnerability, facing significant challenges from the moment they are admitted. Despite numerous efforts to provide treatment in correctional...
Remand prisoners (RP) are in a precarious situation marked by uncertainty and vulnerability, facing significant challenges from the moment they are admitted. Despite numerous efforts to provide treatment in correctional settings, most interventions have been designed primarily for sentenced prisoners. The ADAPT program, however, is a structured intervention specifically tailored for RP. It aims to enhance emotion and behavior regulation, address cognitive distortions, improve problem-solving skills, and offer strategies for suicide prevention. The primary objective of this pilot study was to assess the effectiveness of the ADAPT in improving emotional literacy and emotional regulation, while reducing cognitive distortions and suicide risk. Our findings indicated that, at the Posttreatment phase, there were statistically significant improvements across all measured outcomes in the treatment group compared to the control group. Specifically, participants in the ADAPT exhibited lower levels of anxiety, somatization, and depression. Additionally, there was a notable decrease in suicide concerns, negative affect, and difficulties in emotional regulation. Conversely, there was an increase in positive affect among those who underwent the program. These results provide preliminary evidence supporting the effectiveness of the ADAPT as a valuable intervention for RP, a population often overlooked in treatment efforts.
Impact of Switching to an Inhibitory Learning Approach to Exposure Therapy on Outcomes of an Intensive Outpatient Program.
Nadel MH, Rogers K, Hadlock S … +2 more , Schuler ER, Haaga DAF
J Clin Psychol · 2025 Dec · PMID 40811725 · Publisher ↗
OBJECTIVE: Exposure therapy is a commonly used, efficacious treatment for reducing symptoms of obsessive-compulsive disorder and anxiety disorders. Though exposure therapy has primarily been conducted using principles de...
OBJECTIVE: Exposure therapy is a commonly used, efficacious treatment for reducing symptoms of obsessive-compulsive disorder and anxiety disorders. Though exposure therapy has primarily been conducted using principles derived from emotional processing theory, many researchers are now suggesting that it would be more successful if it was conducted in accordance with learning research (i.e., the inhibitory learning approach). There is a strong conceptual rationale for conducting exposure therapy in accordance with the inhibitory learning approach but a paucity of direct empirical comparisons of the two methods, particularly in a naturalistic setting. METHODS: The current study includes 1968 participants seeking treatment for OCD and anxiety disorders. An interrupted time series analysis was used to compare treatment outcomes after participation in an intensive outpatient program for individuals who received exposure therapy based on emotional processing versus inhibitory learning. RESULTS: Symptom reduction following exposure therapy using the inhibitory learning approach was not significantly different than exposure therapy using emotional processing. CONCLUSION: One possible interpretation for these findings is that in practice, the exposure approaches share significant overlap and therefore lead to comparable outcomes. Future research should assess the comparative efficacy of these treatment approaches using randomized controlled trials with standardized outcome measures to increase internal validity.
The Outside of Psychotherapy-The Socioecological Approach to Treating Severe Personality Pathology in a Young Patient.
Bo S, Lind M, Fonagy P
J Clin Psychol · 2025 Dec · PMID 40811721 · Publisher ↗
The socioecological treatment approach is rooted in fundamental principles of mentalization-based therapy (MBT) and evolutionary theory. Rather than focusing solely on the individual, this approach broadens the perspecti...
The socioecological treatment approach is rooted in fundamental principles of mentalization-based therapy (MBT) and evolutionary theory. Rather than focusing solely on the individual, this approach broadens the perspective to include the patient's wider social network in understanding and treating mental health disorders such as personality pathology. A core premise of this approach is that problems and their solutions should not be viewed in isolation but identified in close collaboration with the patient's environment. The socioecological approach integrates treatment network meetings, involving individuals who are directly engaged in and significant to the patient's life. These meetings facilitate the development of a system case-formulation and a system attachment map. A self-report instrument, NETWORK-AIM (NET-AIM), is used throughout the process to assess interventions and evaluate meetings, with input from all key members of the patient's network. This approach is illustrated through the case of Olivia, a young girl suffering from personality pathology. Her treatment exemplifies how multiple individuals within her environment collaborated to support her reintegration into the social world (communication system 3) alongside individual therapy. Olivia's 13-month treatment process led to substantial improvements, including enhanced social engagement, increased trust in others, fewer mood swings, reduced self-harm, and greater involvement with friends and work. The findings underscore the need to move beyond individual treatment models towards systemic, proactive interventions that integrate broader social relationships into therapeutic processes when treating adolescents with personality pathology.
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