Behav Ther [JOURNAL]
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200 papers
Efficacy of the STEP-Home Transdiagnostic Group Workshop to Improve Functioning, Anger, and Impulse Control in Post-9/11 U.S. Veterans: A Randomized Clinical Trial.
Fortier CB, Kenna A, Katz D … +7 more , Currao A, Lebas A, Sablone CA, Hursh C, Beck B, Jorge RE, Fonda JR
Behav Ther · 2026 Jul · PMID 42276693 · Publisher ↗
Post-9/11 U.S. combat veterans are clinically complex with multiple co-occurring mental and physical health conditions that often lead to difficulty reintegrating and functioning in civilian life after military service....
Post-9/11 U.S. combat veterans are clinically complex with multiple co-occurring mental and physical health conditions that often lead to difficulty reintegrating and functioning in civilian life after military service. Difficulty controlling anger is the most frequently reported reintegration problem and is often present across a wide range of both mental and physical conditions. This randomized controlled trial tested the efficacy of the STEP-Home (SH) transdiagnostic intervention compared to Present Centered Group Therapy (PCGT) to improve functioning and impulse control/anger in veterans. One hundred and eighty-four (139M/45F) post-9/11 U.S. military veterans were randomized to either 12 sessions of SH or PCGT. Assessments were conducted at baseline, posttreatment, and 3-month follow-up. Linear mixed model analysis was based on intention to treat. Primary outcomes were reintegration functioning and impulse control/anger. At follow-up, SH and PCGT conditions demonstrated improvements in reintegration functioning with moderate to large within-group effect sizes (SH d = 0.86; PCGT d = 0.69). SH showed improvements in impulse control/anger with a moderate within-group effect size (d = 0.74). A significant Treatment x Time interaction indicated that SH uniquely improved impulse control/anger (B = -5.35, 95% CI: -8.39, -2.30). Both SH and PCGT improved daily functioning across multiple domains but only SH improved impulse control/anger. SH expands available treatment options for veterans that suffer from multiple co-occurring psychological and physical injuries and conditions common after combat. Transdiagnostic integrative approaches to mental health can address common symptoms across diagnostic categories and reduce treatment wait time offering efficient, acceptable alternatives to single modality treatment approaches.
Behavioral Practice and Homework Completion as Predictors of Outcome in a Transdiagnostic Brief Behavioral Therapy for Anxiety and Depression in Youth.
Gonzalez A, Goger P, Escobar M … +7 more , Rozenman M, Jeffreys M, Porta G, Brent DA, Lynch FL, Dickerson JF, Weersing VR
Behav Ther · 2026 Jul · PMID 42276692 · Publisher ↗
Exposure and behavioral activation have been identified as key therapeutic components in evidence-based treatment for youths with anxiety and depression, respectively. The current study expanded this work to transdiagnos...
Exposure and behavioral activation have been identified as key therapeutic components in evidence-based treatment for youths with anxiety and depression, respectively. The current study expanded this work to transdiagnostic treatment for youths with anxiety and depression and examined links between (a) amount of in-session exposure/behavioral activation, (b) out-of-session homework completion, and (c) anxiety, depression, and functioning outcomes of youths following a brief behavioral therapy. Therapy data were examined from 95 youths (ages 8-16; 56.8% female; 74.7% non-Hispanic White) with anxiety and/or depressive disorders who completed a transdiagnostic Brief Behavioral Therapy (BBT) as part of a randomized effectiveness trial. Observers recorded the occurrence of in-session youth participation in active behavioral practice (Minutes Practice) throughout session, and therapists rated Homework Completion after each session. Posttreatment outcomes (Week 16) included global functioning (Clinician Global Assessment Scale; CGAS) and disorder-specific clinician-rated measures of anxiety (Pediatric Anxiety Rating Scale; PARS) and depression (Children's Depression Rating Scale-Revised; CDRS-R). Controlling for baseline functioning, higher levels of in-session Minutes Practice were associated with higher youth functioning posttreatment (CGAS). Similarly, greater homework completion was associated with improved anxiety outcome (PARS), controlling for baseline PARS. Neither process was significantly associated with youth depression posttreatment. In sum, behavioral practice both in- and between-sessions appears beneficial for improving global functioning and anxiety outcomes in a transdiagnostic treatment for pediatric anxiety and depression. We discuss findings in the context of this intervention (primarily behavioral), sample (e.g., primarily anxious), and complex youth and family characteristics that may influence both in- and between session processes and outcomes.
The Role of Hope in Recovery During Transdiagnostic Exposure-Based Therapy for Anxiety-, Obsessive-Compulsive and Trauma- and Stressor-Related Disorders.
Long LJ, Fitzgerald HE, Parsons EM … +7 more , McSpadden B, Cobb A, Shumake J, Monfils MH, Telch M, Smits JAJ, Otto MW
Behav Ther · 2026 Jul · PMID 42276691 · Full text
Hope has been proposed as a nonspecific process that fosters positive change by enhancing motivation and treatment engagement. However, few studies have examined the temporal dynamics of hope across multiple timepoints,...
Hope has been proposed as a nonspecific process that fosters positive change by enhancing motivation and treatment engagement. However, few studies have examined the temporal dynamics of hope across multiple timepoints, limiting our understanding of its potentially iterative response to and influence on cognitive-behavior therapy (CBT) outcomes. For the present study, we examined data from a clinical trial investigating predictors of non-response to exposure-based therapy for anxiety-related disorders. The sample includes the first 100 participants who completed assessments during 12 weeks of treatment. Multilevel modeling was used to examine changes in hope during treatment and whether hope predicted subsequent anxiety severity. Between-person effects showed that individuals who were more hopeful than others on average during treatment experienced lower anxiety severity throughout (β = -0.31, 95% CI [-0.45, -0.17]), controlling for baseline anxiety severity, demographic characteristics, and psychiatric medication use. Within-person effects supported causal primacy for changes in hope in relation to treatment outcome: increased hope (relative to individual average) predicted less anxiety at the subsequent quarter of treatment (β = -0.09, 95% CI [-0.16, -0.03]), though these effects were comparatively weaker than between-person effects. Findings suggest that hope is a prospective predictor of anxiety reduction during exposure-based therapy, supporting its role as a common factor promoting positive treatment outcomes.
Who Benefits from Anxiety-Related Interpretation Bias Training? The Role of Individual Differences in Interpretation Inflexibility and Intolerance of Uncertainty.
Vrinzen S, Everaert J, Salemink E
Behav Ther · 2026 Jul · PMID 42276690 · Publisher ↗
While anxiety-related cognitive bias modification for interpretations (CBM-I) is generally effective in reducing negative interpretation bias and anxiety, individuals differ in the extent to which they benefit from CBM-I...
While anxiety-related cognitive bias modification for interpretations (CBM-I) is generally effective in reducing negative interpretation bias and anxiety, individuals differ in the extent to which they benefit from CBM-I. This proof-of-concept study investigated whether interpretation inflexibility and intolerance of uncertainty account for variability in CBM-I's effects on interpretations. Participants (N = 274), primarily female students, completed either a positive or a negative online single-session CBM-I training. Interpretation inflexibility and intolerance of uncertainty were measured before training. Interpretations and mood state were measured before and after training. For the positive CBM-I training, higher negative interpretation inflexibility (i.e., reluctance to revise negative interpretations based on positive information) and higher intolerance of uncertainty predicted smaller reductions in negative interpretations. Changes in negative interpretations mediated the relation between these predictors and changes in anxious emotions. These findings offer new insights into the role of intolerance of uncertainty and negative interpretation inflexibility as predictors of CBM-I outcomes and highlight the potential of personalized approaches that match CBM-I training to the specific needs of individuals with anxiety.
A Multidimensional Examination of Dissociation and Its Relationship With Suicide Ideation and Attempts.
Nedelmann SE, Pachkowski MC, Shahnaz A … +1 more , David Klonsky E
Behav Ther · 2026 Jul · PMID 42276689 · Publisher ↗
Dissociation is a multidimensional construct linked to suicide risk. However, it is unclear which dimensions of dissociation are most important to suicide risk, and whether they correlate with suicide ideation (SI), suic...
Dissociation is a multidimensional construct linked to suicide risk. However, it is unclear which dimensions of dissociation are most important to suicide risk, and whether they correlate with suicide ideation (SI), suicide attempts (SA), or both. Thus, the present study utilized multiple measures of dissociation to examine the differential relationships of distinct dissociation dimensions to SI and SA. Participants were 545 undergraduates, oversampled for suicide risk, including 141 with histories of SA and 255 with histories of SI but not attempts. Suicide history, dissociative symptoms, and potential covariates were measured via validated self-report questionnaires. In general, analyses indicated that dissociation was associated with both SI and SA among those with ideation. Regarding specific dimensions, depersonalization/derealization and zoning out best predicted SI, whereas reexperiencing best distinguished SA from those with SI only. The findings suggest that different types of dissociative experiences are associated with different aspects of suicide risk. Future research should continue to utilize updated, multidimensional models of dissociation to better understand the role of this construct in suicide risk.
Feasibility Trial of a Single Session of Crisis Response Planning for Youth at High Risk for Suicide.
Gorka SM, Fuller A, Toleson S … +7 more , Kreutzer KA, Allan NP, Khazem LR, Wastler HM, Hiser J, Burkhouse KL, Kendall AD
Behav Ther · 2026 Jul · PMID 42276688 · Publisher ↗
Suicide is the second leading cause of death among adolescents, yet access to mental health care remains limited. Youth have unique developmental and contextual considerations as they are avid users of digital technologi...
Suicide is the second leading cause of death among adolescents, yet access to mental health care remains limited. Youth have unique developmental and contextual considerations as they are avid users of digital technologies, which may influence how they engage with mental health interventions. Crisis Response Planning (CRP), a single-session intervention, has shown promise in adults but has not been systematically evaluated in youth. This study tested the feasibility, acceptability, and preliminary effectiveness of a chat-based version of CRP for adolescents with suicidal ideation (SI). Fifty-one adolescents (ages 14-18 years) endorsing recent SI were randomized to one of three single-session interventions: (1) chat-based CRP, (2) in-person CRP, or (3) virtual self-guided safety planning (control) (NCT06164106). Feasibility, usability, and other implementation outcomes were assessed posttreatment. Suicide risk was evaluated at baseline and 2 weeks posttreatment using the Ask Suicide Screening Questions (ASQ) and the Beck Scale for Suicidal Ideation (BSSI). All three treatments were rated as acceptable and feasible, though chat-based CRP was rated as more appropriate than the control. Approximately 40% of the sample no longer reported past-week SI at follow-up, with no group differences in binary SI outcomes. BSSI scores decreased in the chat-based CRP and control arms, but not in the in-person CRP arm. Results indicate that CRP and other safety planning interventions are feasible and acceptable for adolescents experiencing SI. Virtual formats, especially those that prioritize privacy and eliminate video, may be aligned with adolescent needs though continued development of scalable, youth-centered suicide prevention strategies is needed.
Transdiagnostic Prevalence and Characteristics of Suicidality Across the Spectrum of Restrictive Eating Pathology.
Harris LM, Lusich R, Wu KC … +5 more , Stancil J, Moussaoui JR, Cash ED, Levinson CA, Smith AR
Behav Ther · 2026 Jul · PMID 42276687 · Full text
Limited research has evaluated variability in the prevalence and characteristics of suicidality across the spectrum of restrictive eating disorders, including Anorexia Nervosa (AN) and atypical AN (AAN). It is also uncle...
Limited research has evaluated variability in the prevalence and characteristics of suicidality across the spectrum of restrictive eating disorders, including Anorexia Nervosa (AN) and atypical AN (AAN). It is also unclear the extent to which diagnostic subtypes (i.e., Restricting, Binge-Eating/Purging) and remission status (i.e., active diagnosis, partial remission) are associated with suicide risk in this population. Leveraging two unique samples, the present study substantially advances our transdiagnostic understanding of suicide risk in restrictive eating disorders. In Study 1 (n = 184), we compared the frequency and intensity of suicidal thoughts and behaviors across diagnostic subtypes of AN/AAN, as well as across remission status. In Study 2 (n = 83), using intensive longitudinal data, we examined average levels of suicidality and profiles of suicidal ideation over 21 days. The prevalence of suicidal ideation was comparable across AN/AAN diagnoses, though the BP subtype was associated with more lifetime suicide attempts. Individuals in partial remission were more likely to report past-month ideation than those with an active diagnosis. AN and AAN demonstrated similarities in the average intensity and variability of suicide-related cognitions and suicidality profiles. These findings suggest that a symptom-level or behavioral approach may provide the greatest insight into an individual's likelihood of suicidal thoughts and behaviors.
Impact of Parent Lifetime Depression and Anxiety on Youth Body Dissatisfaction and Disordered Eating Symptoms During Adolescence.
Faulkner LM, Levinson CA, Klein DN … +1 more , Bufferd SJ
Behav Ther · 2026 Jul · PMID 42276686 · Publisher ↗
Eating disorders (ED) are dangerous psychiatric conditions that can emerge in youth. In previous work, child psychopathology increased risk for elevated body dissatisfaction and ED. Although parent psychopathology contri...
Eating disorders (ED) are dangerous psychiatric conditions that can emerge in youth. In previous work, child psychopathology increased risk for elevated body dissatisfaction and ED. Although parent psychopathology contributes to a range of psychological disorders, it has not yet been tested as a risk factor for youth body dissatisfaction and ED symptoms. The current prospective study tested whether lifetime parent anxiety and depression (measured when the child was ages 3 and 9) predicted adolescent body dissatisfaction at age 12 and 15 and symptoms of anorexia nervosa (AN) or bulimia nervosa (BN) at age 15 in a community sample of youth. We also examined whether child psychopathology at age 3 or 6 (anxiety, depression, and oppositional defiant disorder [ODD]) moderated, and body dissatisfaction mediated, these relationships. Maternal anxiety and depression predicted youth body dissatisfaction at age 12, and maternal and paternal depression predicted youth body dissatisfaction at age 15. Preregistered moderation and mediation analyses (https://osf.io/s8a6y) identified that child ODD moderated relationships between maternal anxiety and youth AN symptoms at age 15 and between paternal anxiety and youth body dissatisfaction at age 12. In addition, youth body dissatisfaction at age 12 mediated relationships between both maternal anxiety and depression and youth AN symptoms at age 15. The present study demonstrates additional vulnerability factors in early childhood that may increase risk for the development of body dissatisfaction and ED symptoms in early and middle adolescence. These data suggest that parent psychopathology should be an area of focus when evaluating early childhood risk factors for EDs.
Effects of Appearance Preoccupation and Safety Behaviors in Body Dysmorphic Disorder: An Ecological Momentary Assessment Study.
Hohensee N, Dietel FA, Schulte J … +3 more , Doebler P, Klein N, Buhlmann U
Behav Ther · 2026 Jul · PMID 42276685 · Publisher ↗
Body dysmorphic disorder (BDD) is characterized by excessive appearance-related preoccupation and safety behaviors. Cognitive-behavioral models suggest that these processes reinforce dysfunctional beliefs about appearanc...
Body dysmorphic disorder (BDD) is characterized by excessive appearance-related preoccupation and safety behaviors. Cognitive-behavioral models suggest that these processes reinforce dysfunctional beliefs about appearance, thus maintaining BDD symptoms. To date, few experimental and cross-sectional studies suggest a potential etiological role of these mechanisms; however, they remain unstudied within an externally valid, daily life setting. In this study, we examined the functional relationships of appearance-related processes in daily life. Specifically, we investigated the effects of appearance-related preoccupation and safety behaviors on body dissatisfaction, conviction about perceived appearance flaws and affect using ecological momentary assessment. Thirty individuals with BDD and 30 psychiatrically healthy controls (HC) completed smartphone-based state measures including two event-based prompts (i.e., matutinal and nightly assessments) and up to eight random prompts daily over the course of 6 days. Out of 3,075 assessments, 875 assessments captured self-reports right after engaging in appearance-related preoccupation and safety behaviors. Multilevel regression analyses indicated immediate increases in body dissatisfaction and appearance-related conviction in individuals with BDD after engaging in any appearance-related process. Following preoccupation and gazing, individuals with BDD reported higher negative affect. HC showed increased body dissatisfaction and conviction after engaging in any appearance-related process, but no concurrent changes in negative affect. Associations for positive affect and delayed effects across prompts were nonsignificant. Overall, these findings demonstrate model-congruent negative effects of appearance-related preoccupation, gazing and other safety behaviors for BDD symptom maintenance, highlighting needs to carefully monitor and address these factors in treatment.
Mindfulness Intervention Reduced Executive Dysfunction, Delay Aversion, and ADHD Symptoms: A Randomized Controlled Trial Based on the Dual Pathway Model.
Kang MY, Cheung YCH, Wong DFK
Behav Ther · 2026 Jul · PMID 42276684 · Publisher ↗
In the dual pathway model, executive dysfunction (EDF) and delay aversion (DEL) are key mechanisms underlying ADHD. This study aimed to develop and evaluate a pathway model to elucidate the mediating roles of trait mindf...
In the dual pathway model, executive dysfunction (EDF) and delay aversion (DEL) are key mechanisms underlying ADHD. This study aimed to develop and evaluate a pathway model to elucidate the mediating roles of trait mindfulness (TM), EDF, and DEL in mindfulness-based interventions' (MBIs) impact on ADHD symptoms. 120 adults (M = 25.11, SD = 5.33) exhibiting elevated ADHD symptoms were randomized into either an 8-week MBI group (n = 60) or a waitlist control group (n = 60). ADHD symptoms, EDF, DEL, and TM were assessed. Structural equation modeling was used to examine a theoretical pathway model and construct a data-driven model. Compared with the control group, the intervention group exhibited significant reductions in EDF, DEL, and ADHD symptoms and increased TM. Changes in TM and EDF sequentially mediated the effect of MBI on ADHD symptom reduction. Additionally, changes in TM mediated the impact of MBI on DEL reduction. However, DEL reduction did not link to changes in ADHD symptoms when EDF and TM were considered. It empirically indicated that improvement in TM and, subsequently, improvement in EDF are possible therapeutic mechanisms of MBIs on adult ADHD symptoms. While increased TM was associated with DEL reductions, this pathway was insignificantly related to ADHD symptom reduction.
Changes in Phasic Heart Rate Variability Predict Clinical Outcomes Following Emotion Regulation Therapy for Generalized Anxiety Disorder and Comorbid Depression.
Szkutak A, Lee HH, Quintero JM … +3 more , Aldao A, Fresco DM, Mennin DS
Behav Ther · 2026 Jul · PMID 42276683 · Full text
Generalized anxiety disorder (GAD) and major depressive disorder (MDD) frequently co-occur and are marked by greater chronicity, severity, and poorer treatment response. Perseverative negative thinking (e.g., worry, rumi...
Generalized anxiety disorder (GAD) and major depressive disorder (MDD) frequently co-occur and are marked by greater chronicity, severity, and poorer treatment response. Perseverative negative thinking (e.g., worry, rumination) is a transdiagnostic mechanism implicated in both disorders and linked to disruptions in large-scale neural networks, threat and reward processing, and vagal modulation. Heart rate variability (HRV)-particularly phasic HRV (vagal reactivity/recovery)-is a peripheral marker of autonomic flexibility and dynamic emotion regulation that may be sensitive to therapeutic change. Yet few studies have tested whether evidence-based treatments modify phasic HRV and whether such changes predict clinical outcomes. Twenty-four adults with GAD ± MDD completed 20 sessions of Emotion Regulation Therapy. At pre- and midtreatment, participants completed laboratory emotion inductions (baseline, fear, sadness, recovery) while cardiac activity was recorded; community controls (n = 28) completed the same paradigm once. Patients self-reported anxiety, depression, worry, rumination, functional impairment, and quality of life at pre-, mid-, and posttreatment. Relative to controls, patients exhibited lower tonic HRV and marginally blunted phasic HRV during a sadness induction. During fear, patients showed decreased HRV from fear to recovery, whereas controls remained stable. From pre- to midtreatment, patients demonstrated improved vagal fear recovery, and greater improvements predicted lower posttreatment GAD severity, worry, and functional impairment, accounting for 12-29% of the variance. These findings preliminarily support vagal fear recovery as a modifiable, objective marker of treatment response in patients with GAD ± MDD. Limitations include small, demographically homogeneous samples and the absence of a midtreatment control group. Future work should incorporate ambulatory physiological monitoring to assess whether these effects generalize to daily life.
State of the Science: Culturally Adapted Cognitive-Behavioral Therapy for Asian Americans.
Hwang WC
Behav Ther · 2026 Jul · PMID 42276682 · Publisher ↗
Asian Americans are proportionately the fastest-growing racial group in the United States yet remain among the least likely to seek mental health services, often facing significant cultural and structural barriers. This...
Asian Americans are proportionately the fastest-growing racial group in the United States yet remain among the least likely to seek mental health services, often facing significant cultural and structural barriers. This state-of-the-science review synthesizes existing research on culturally adapted psychotherapy, with a focus on cognitive-behavioral therapy (CBT) for Asian American populations. Meta-analytic findings suggest that culturally adapted interventions, particularly those that utilize deep structural adaptations (e.g., those that incorporate cultural values, beliefs and worldviews), yield improved treatment outcomes compared to standard approaches or surface structure adaptations (e.g., more superficial modifications such as ethnic and linguistic match). However, few studies have examined culturally adapted CBT (CA-CBT) specifically for Asian Americans and much more work needs to be done. Future research needs to address several limitations and recommendations for future research are provided. Advancing CA-CBT is crucial for reducing health disparities and improving mental health outcomes by offering culturally relevant and effective services that may be more effective for diverse and underserved populations.
Corrigendum to "The Relationship Between the Therapeutic Alliance and Social Anxiety Symptoms Along the Course of Internet-Delivered Cognitive Behavioral Treatment" [Behav. Therapy 56(4) (2025) 812-822].
Shalom JG, Prihar A, Strauss AY … +3 more , Huppert JD, Andersson G, Aderka IM
Behav Ther · 2026 May · PMID 42097798 · Publisher ↗
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Fear of Food in Eating Disorders: Its Role in Eating Disorder Symptomatology, Psychopathology, and Early Outpatient Treatment.
Tomba E, Tecuta L, Gardini V … +4 more , Dato EL, Mazzoni C, Schumann R, Ballardini D
Behav Ther · 2026 May · PMID 42097797 · Publisher ↗
Anxiety is known to be correlated with eating disorder (ED) symptoms, but less is known about anxiety in terms of fear of food in EDs. The study aims to compare different ED groups, investigate early changes in fear of f...
Anxiety is known to be correlated with eating disorder (ED) symptoms, but less is known about anxiety in terms of fear of food in EDs. The study aims to compare different ED groups, investigate early changes in fear of food following cognitive-behavioral-based treatment (CBT) with integrated nutritional rehabilitation and counseling and test whether changes in fear of food are associated with changes in eating symptomatology and general psychopatology. ED outpatients (n = 282) and controls (n = 68) were assessed with the Fear of Food Measure (FOFM), Eating Attitude Test-40 (EAT-40), and Eating Disorder Inventory-3 (EDI-3 risk and General Psychological Maladjustment, GPM). MANOVA with post hoc comparisons was run to compare controls and ED subgroups in FOFM. Paired sample t-test evaluated FOFM changes between baseline and mid-treatment. Multiple regression analyses were conducted to test whether changes in FOFM were associated with changes in EAT-40, EDI-3 risk, and EDI-3 GPM. Results demonstrated all EDs exhibited significantly higher FOFM scores compared to controls. In EDs, AN and BN showed significantly greater scores in FOFM-anxiety about eating (AE) and FOFM-food avoidance behaviors (FAB) compared to BED and OSFED. Significant changes in all FOFM subscale scores were observed in patients who completed mid-treatment (n = 79). FOFM-AE emerged as the most significant predictor of early improvements not only in EAT-40 total and EDI-3 risk scores but also in EDI-3-GPM scores. Results indicate that fear of food is a transdiagnostic construct characterizing all EDs, in particular AN and BN. Outpatient interventions assessing and targeting early fear of food, in particular in anxiety about eating, may help improve prognosis and support recovery in EDs. The role of fear of food in general psychopathology, beyond EDspecific symptoms, represents a valuable addition to the field and highlights the interplay between fear-related and ED symptoms, providing new directions for future ED research and treatment.
The Transdiagnostic Role of Perfectionism: Insights From Longitudinal Network Analyses in a Sample of College-Age Women.
Claus N, Limburg K, Egan S … +4 more , Shafran R, Ehring T, Takano K, Cludius B
Behav Ther · 2026 May · PMID 42097796 · Publisher ↗
Perfectionism has been proposed as a transdiagnostic risk factor, preceding symptoms of psychopathology. However, further research is required to understand how perfectionism functions as a transdiagnostic process across...
Perfectionism has been proposed as a transdiagnostic risk factor, preceding symptoms of psychopathology. However, further research is required to understand how perfectionism functions as a transdiagnostic process across a range of psychological disorders. This study used a network approach in a longitudinal design which assessed both dimensions of perfectionism (perfectionistic strivings and perfectionistic concerns) and symptoms of various disorders (obsessive-compulsive disorder, eating disorders, anxiety, depression). Participants (N = 447; female community sample aged 18-30) completed online surveys at baseline and 6-month follow-up, including measures of perfectionism and psychopathology. To disentangle temporal dynamics between these variables, we estimated both separate cross-sectional networks for baseline and follow-up as well as a longitudinal (cross-lagged) network across time. In terms of cross-sectional results, perfectionistic strivings displayed low centrality in our networks. Conversely, perfectionistic concerns shared strong associations with all symptom clusters and emerged as a central bridge variable. Perfectionistic concerns shared its strongest connection with low self-worth. Longitudinal results could not be interpreted due to insufficient stability. Results were limited by very little variation of variables over time. Final centrality measures may be biased due to a disproportionate amount of eating disorder variables. Findings underscore the transdiagnostic role of perfectionistic concerns in psychological symptoms. However, no conclusions regarding temporal dynamics or causality can be drawn.
Attentional Control Moderates the Association Between Combat Trauma Exposure and Fear Conditioning Among Combat-Exposed Veterans.
Adamis AM, Olatunji BO
Behav Ther · 2026 May · PMID 42097795 · Publisher ↗
Traumatic events are common, yet only a small subset of trauma-exposed individuals go on to develop posttraumatic stress disorder (PTSD). This raises important questions about the psychological consequences of trauma and...
Traumatic events are common, yet only a small subset of trauma-exposed individuals go on to develop posttraumatic stress disorder (PTSD). This raises important questions about the psychological consequences of trauma and the individual differences that confer risk for maladaptive threat responding. Excessive acquisition and attenuated extinction of conditioned fear are implicated in the etiology of PTSD. However, the direct relation between trauma exposure and altered fear conditioning processes remains unclear. Further, attentional control (AC), or the executive capacity to regulate one's attention, might influence fear learning processes by modulating the extent to which one's attention is drawn to threats. The present study investigated if AC moderated the link between combat trauma exposure and maladaptive fear learning in a combat-exposed sample of veterans (n = 114). We found that AC significantly moderated the link between combat trauma exposure and fear acquisition, but not extinction. Specifically, for veterans low in AC, there was a stronger association between combat trauma exposure and expectancies of the unconditioned stimulus (i.e., a scream) in response to the reinforced conditioned stimulus (CS+). Further, strong AC was found to buffer against excessively fearful emotional responding, with high levels of AC corresponding to a negative relation between combat trauma exposure and anxiety experienced in response to the CS+. This pattern of results was observed even when controlling for responses to the CS- and symptoms of PTSD. The present findings point to AC as an important determinant of maladaptive threat responding in the wake of combat trauma.
Shifting the Load: A Pilot Study of a Behavioral Intervention to Reduce Gender Inequities in Household Labor and Improve Mental Health Outcomes.
Aviv EC, Vavala G, Lindquist EG … +2 more , Waizman YH, Saxbe DE
Behav Ther · 2026 May · PMID 42097794 · Publisher ↗
The division of household labor within couples has been linked to mental and physical health and relationship quality, and may be a modifiable target of behavioral change. However, interventions that focus on domestic wo...
The division of household labor within couples has been linked to mental and physical health and relationship quality, and may be a modifiable target of behavioral change. However, interventions that focus on domestic workload have received little empirical attention. Our pilot study evaluates the feasibility and acceptability of the commercially developed Fair Play Method online intervention among heterosexual, predominantly White mothers of preschool-aged children residing in the United States (n = 87). Just over half of participants (54%) completed the full intervention, indicating adequate but improvable feasibility, and participants rated the intervention as acceptable. Participants who completed a greater proportion of the intervention reported a significantly more egalitarian division of household labor at posttest. When women reported a more egalitarian balance of cognitive household labor after participating in the intervention, they reported lower posttest depression and stress and higher global mental and physical health, after adjusting for pretest levels. Women who reported a more egalitarian balance of physical household labor reported higher posttest relationship functioning and mental and physical health, after adjusting for pretest levels. In summary, this small, open-trial pilot study suggests that the division of labor can be modified in ways that benefit well-being, but our results warrant replication within a larger and more diverse sample.
A Comparative Analysis of Parent-Reported Treatment Acceptability in Collaborative and Proactive Solutions and Parent Management Training for Oppositional Youth.
Murrihy RC, Drysdale SAO, Dedousis-Wallace A … +2 more , McAloon J, Ollendick TH
Behav Ther · 2026 May · PMID 42097793 · Publisher ↗
Evaluating treatment acceptability is crucial, as higher acceptability is associated with better adherence and lower dropout rates, a particular concern in treating youth with disruptive behavior disorders. This study bu...
Evaluating treatment acceptability is crucial, as higher acceptability is associated with better adherence and lower dropout rates, a particular concern in treating youth with disruptive behavior disorders. This study built upon previous randomized controlled trials that demonstrated the efficacy of treatment for youth with oppositional defiant disorder (ODD) by comparing the acceptability of Collaborative and Proactive Solutions (CPS), an innovative approach, with Parent Management Training (PMT), a well-established intervention. This exploratory study aimed to determine whether families in the CPS group found the treatment acceptable and whether there were differences in parent-reported treatment acceptability between CPS and PMT. This comparison may assist clinicians in distinguishing the suitability of treatments. One hundred and sixty youth aged 7-14 years diagnosed with ODD were randomized to CPS (n = 81) or PMT (n = 79) for up to 16 weekly sessions at a community clinic in Australia. Treatment adherence, acceptability, satisfaction, and barriers to participation (relevance, therapeutic alliance, treatment demands) were assessed using parent and therapist-rated questionnaires. An intent-to-treat approach was employed, and analysis of variance tests were conducted. CPS demonstrated very high acceptability ratings, comparable to PMT. While both treatments were highly acceptable, PMT showed a small but statistically significant advantage in satisfaction, adherence, perceived relevance, and treatment demands. These results provide reassurance to clinicians that both CPS and PMT interventions, alongside their similar efficacy, are highly acceptable interventions for youth with ODD. Future research should replicate these findings and explore why PMT may hold slight advantages, potentially related to child engagement.
A Randomized Controlled Trial Comparing Transdiagnostic Behavior Therapy and Disorder-Specific Psychotherapies in Veterans With Emotional Disorders.
Gros DF, Allan NP
Behav Ther · 2026 May · PMID 42097792 · Full text
Transdiagnostic psychotherapies have been gaining in popularity due in part to their hypothesized ability to address multiple emotional disorders via a single protocol. However, to date, most randomized clinical trials o...
Transdiagnostic psychotherapies have been gaining in popularity due in part to their hypothesized ability to address multiple emotional disorders via a single protocol. However, to date, most randomized clinical trials of these treatments have focused on patients with anxiety disorders, or in mixed samples, limiting their use in other diagnoses. The present study compared Transdiagnostic Behavior Therapy (TBT) to disorder-specific therapies (DSTs) in 304 veterans with principal diagnoses of major depressive disorder (MDD), posttraumatic stress disorder (PTSD), or panic disorder. Disorder-specific symptom outcomes and overall impairment were assessed at baseline, mid-treatment, and posttreatment. Structural equation modeling was used to evaluate changes in outcomes over time via latent growth curve models. Support for noninferiority between TBT and the matching DSTs was found in participants with PTSD and panic disorder for the disorder-specific symptom scales and for overall impairment scores across diagnoses. Similar effect sizes were obtained for MDD, although noninferiority could not be concluded because confidence intervals were wide. Similar scores for patient satisfaction and treatment completion also were observed across TBT and the comparison DSTs. Together, these findings suggest that TBT demonstrates comparable efficacy to the established DSTs in addressing symptoms of depressive disorders (MDD), trauma and stressor-related disorders (PTSD), and the anxiety disorders (panic disorder). Thus, ongoing dissemination and implementation efforts for TBT should be considered for a wider range of diagnoses, easing provider training burden and expanding treatment coverage in clinical settings.
Give Me a Sine: Can Sinusoidal Patterns of Nonverbal Synchrony Differentiate Between Individuals With Social Anxiety Disorder and Panic Disorder?
Shatz H, Oren-Yagoda R, Aderka IM
Behav Ther · 2026 May · PMID 42097791 · Publisher ↗
Individuals with social anxiety disorder (SAD) have been found to have distinct patterns of nonverbal synchrony with others. In the present study, we examined whether patterns of nonverbal synchrony differ between indivi...
Individuals with social anxiety disorder (SAD) have been found to have distinct patterns of nonverbal synchrony with others. In the present study, we examined whether patterns of nonverbal synchrony differ between individuals with SAD and individuals with panic disorder (PD). We examined diagnostic interviews of 29 individuals with SAD and 22 individuals with PD, and assessed nonverbal synchrony using motion energy analysis (MEA). We divided interviews into 10 segments and derived nonverbal synchrony indices for each segment to capture changes in nonverbal synchrony over the course of the interview. According to our first hypothesis, we found that nonverbal synchrony was best modelled by a sinusoidal model (r = .59) which explained significantly more variance than linear, quadratic and logarithmic models. This suggests that nonverbal synchrony is best characterized by a repeating pattern of increases and decreases. According to our second hypothesis, we found that sine wave amplitudes were greater among individuals with SAD compared to those with PD. Thus, individuals with SAD experienced greater fluctuations in nonverbal synchrony during the interview, compared to individuals with PD. We discuss these findings in the context of models of SAD and models of synchrony, as well as suggest implications for research and clinical practice.
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