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Insomnia treatment among individuals with comorbid insomnia and obstructive sleep apnea is suboptimal. In a pilot randomized controlled trial, 19 individuals with comorbid insomnia and obstructive sleep apnea were allocated to one of two arms: EX + EX, consisting of two 8-week phases of exercise training (EX), or RE + CBTiEX, encompassing 8 weeks of relaxation training (RE) followed by 8 weeks of combined cognitive-behavioral therapy and exercise (CBTiEX). Outcomes included Insomnia Severity Index (ISI), polysomnography, and cardiorespiratory fitness measures. A mixed-model analysis of variance revealed a Group × Time interaction on peak oxygen consumption change, F(1, 14) = 10.1, p =.007, and EX increased peak oxygen consumption (p =.03, g′ = −0.41) and reduced ISI (p =.001, g′ = 0.82) compared with RE (p =.49, g = 0.16) post-8 weeks. Post-16 weeks, there was a significant Group × Time interaction (p =.014) driven by RE + CBTiEX yielding a larger improvement in ISI (p =.023, g′ = 1.48) than EX + EX (p =.88, g′ < 0.1). Objective sleep was unchanged. This study showed promising effects of regular EX alone and combined with cognitive-behavioral therapy for insomnia on ISI in comorbid insomnia and obstructive sleep apnea. [ABSTRACT FROM AUTHOR]

Cognitive-behavioral therapies and related approaches are highly prevalent within sport psychology practice. Traditionally, these approaches are delivered across interventions comprising multiple sessions. However, in the fast-paced environments in which many applied sport psychologists operate, practitioners are sometimes required to provide fast, effective, and impactful interventions to athletes at their point of need within a single session. Single-session integrated cognitive-behavioral therapy presents a potentially effective approach for practice wherein time is often at a premium, and there is frequently pressure to make an impact quickly to improve performance. In this article, we put forward a stimulus piece that contextualizes single-session integrated cognitive-behavioral therapy and overviews how sport psychology practitioners may use such techniques with athletes. We also put forth a call for more practitioners to report more idiographic case studies that feature the use of brief or single-session interventions to further build the evidence base for such approaches. [ABSTRACT FROM AUTHOR]

"Why Has Nobody Told Me This Before?" by Julie Smith is a book that addresses the increasing incidents of mental health issues among students, faculty, and staff at universities, particularly exacerbated by the COVID-19 pandemic. The book aims to provide practical advice and concepts to individuals who may not have access to psychotherapy or mental health services. It covers various topics such as sleep, diet, exercise, motivation, emotional pain, grief, self-doubt, fear, and stress, offering a balanced approach between resilience and self-compassion. The book's accessible tone and structure make it a useful resource for both faculty and students in managing mental health and well-being. [Extracted from the article]

Internet-Based Cognitive Behavioral Therapy (iCBT) is an innovative modality of cognitive-behavioral intervention that presents a promising therapeutic strategy for individuals diagnosed with binge spectrum eating disorders. This study employed a meta-analysis methodology to assess the clinical effectiveness and acceptability of iCBT. We conducted searches in databases such as PubMed, Embase, Web of Science, Cochrane Library, and PsycINFO, collecting literature that met the inclusion criteria until August 5, 2023. A comprehensive analysis was conducted, encompassing a total of 11 randomized controlled studies that satisfied the predetermined criteria for inclusion. The summary results demonstrated that iCBT could significantly improve the pathological features related to eating in patients with binge spectrum eating disorders and also significantly reduce the frequency of binge episodes. Additionally, iCBT could ameliorate the depressive and anxious emotions of patients with binge spectrum eating disorders and boost their self-esteem. Furthermore, a notable disparity in dropout rates was seen in comparison to the control group. Heterogeneity across studies，limitations of self-assessment scales and potential publication bias. iCBT can effectively assist patients with binge spectrum eating disorders in improving clinical symptoms. However, it is important to use caution when interpreting the findings of this study, as there are limitations pertaining to the quantity and quality of the included studies. • Patients with binge spectrum eating disorders face challenges in accessing standardized treatment. • iCBT markedly ameliorated clinical symptoms associated with binge spectrum eating disorders. • Our meta-analysis illustrates the clinical efficacy and acceptability of iCBT for binge spectrum eating disorders. [ABSTRACT FROM AUTHOR]

Greater difficulties in emotion regulation (ER) and decreased use of adaptive ER strategies have been associated with higher levels of posttraumatic stress disorder (PTSD) symptoms. To date, limited research has explored whether ER improves with PTSD treatment or whether such improvements are linked with improvements in PTSD symptoms. Veterans and service members with PTSD (N = 223) participated in a 2-week intensive treatment program (ITP) based in Cognitive Processing Therapy (CPT). ER was measured using the Difficulties in Emotion Regulation Short Form (DERS-SF) at baseline and on days 4 and 9 of treatment. PTSD symptoms were reported on the PTSD Symptom Checklist for DSM-5 (PCL-5) at baseline, on days 3, 5, 6, and 8 of treatment, and at post-treatment. DERS-SF scores decreased during treatment (M change = 5.12, d = 0.38). Baseline DERS-SF did not predict overall PCL-5 scores across timepoints (p =.377). However, scores on the DERS-SF over time were significantly associated with PCL-5 improvement over the course of treatment (p <.001, R 2 b = 0.07). Finally, improvements in all subscales of the DERS-SF across time except clarity were significantly associated with improvement in PCL-5 over time. Additional treatment components in the ITP beyond CPT may have contributed to ER improvements. Conclusions are also limited by the use of self-report data. An intensive CPT-based treatment program for veterans and service members can lead to improved ER in two weeks. ER improvements are associated with PTSD symptom severity during the ITP. • Emotion regulation improved across an intensive treatment program for PTSD. • Baseline emotion regulation was not associated with PTSD symptom severity. • Emotion regulation was associated with PTSD symptom severity across treatment. • The clarity subscale was not uniquely associated with PTSD symptom severity. • All other subscales were uniquely associated with PTSD symptom severity. [ABSTRACT FROM AUTHOR]

Anhedonia is a transdiagnostic symptom often resistant to treatment. The identification of biomarkers sensitive to anhedonia treatment will aid in the evaluation of novel anhedonia interventions. This is an exploratory analysis of changes in subcortical brain volumes accompanying psychotherapy in a transdiagnostic anhedonic sample using ultra-high field (7-Tesla) MRI. Outpatients with clinically impairing anhedonia (n = 116) received Behavioral Activation Treatment for Anhedonia, a novel psychotherapy, or Mindfulness-Based Cognitive Therapy (ClinicalTrials.gov Identifiers NCT02874534 and NCT04036136). Subcortical brain volumes were estimated via the MultisegPipeline, and regions of interest were the amygdala, caudate nucleus, hippocampus, pallidum, putamen, and thalamus. Bivariate mixed effects models estimated pre-treatment relations between anhedonia severity and subcortical brain volumes, change over time in subcortical brain volumes, and associations between changes in subcortical brain volumes and changes in anhedonia symptoms. As reported previously (Cernasov et al., 2023), both forms of psychotherapy resulted in equivalent and significant reductions in anhedonia symptoms. Pre-treatment anhedonia severity and subcortical brain volumes were not related. No changes in subcortical brain volumes were observed over the course of treatment. Additionally, no relations were observed between changes in subcortical brain volumes and changes in anhedonia severity over the course of treatment. This trial included a modest sample size and did not have a waitlist-control condition or a non-anhedonic comparison group. In this exploratory analysis, psychotherapy for anhedonia was not accompanied by changes in subcortical brain volumes, suggesting that subcortical brain volumes may not be a candidate biomarker sensitive to response to psychotherapy. • Pre-treatment anhedonia severity and pre-treatment subcortical brain volumes were not related. • Psychotherapy for anhedonia was not accompanied by changes in subcortical brain volumes. • There was a modest relation between pre-treatment anhedonia and change in caudate nucleus volumes during treatment. • Subcortical brain volumes may not be a candidate biomarker sensitive to response to psychotherapy. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) is a relatively common neurodevelopmental mental disorder affecting an estimated 7.2% of children and adolescents, and 2.5% of adults. It manifests primarily through inattention, impulsivity, and hyperactivity. Multimodal treatment approaches are recommended, addressing the psychological, behavioral, vocational, and educational needs of patients and their families. Conventional therapies include pharmacologic interventions (e.g., psychostimulants) and non-pharmacologic strategies (e.g., psychotherapy, cognitive-behavioral therapy). The ongoing search for novel treatment options focuses on improving cognitive function, psychological well-being, and ADHD symptomatology. Nutritional interventions with vitamins and minerals are emerging as potential complementary or adjunctive therapies. This review summarizes recent literature (past 5 years) on the relationship between magnesium and ADHD, encompassing observational studies, interventional trials, and meta- analyses. Evidence from recent publications suggests that children with ADHD have reduced magnesium levels and that magnesium supplementation improves symptoms. However, these studies do not definitively establish the exact cause-and-effect relationship between magnesium and ADHD. Current data are insufficient to recommend magnesium for routine ADHD treatment. High-quality, large-scale, and long-term studies are necessary to definitively understand the magnesium-ADHD link and to evaluate the effectiveness and safety of magnesium supplementation as an adjunct therapy. These studies should define optimal doses, forms, and duration of supplementation for safe and effective clinical use. [ABSTRACT FROM AUTHOR]

Objectives Design Methods Results Conclusions Appearance anxiety (AA) is a probable risk factor for body dysmorphic disorder and a prevalent and debilitating concern. Extant literature suggests that romantic partners’ commentary and accommodation behaviour may contribute to women's appearance concerns. The aim of this study is to explore how women experience and make sense of romantic partner feedback about their appearance.Qualitative semi‐structured interview study.Semi‐structured interviews with 13 cis‐gender women explored how they make sense of appearance anxiety in the context of romantic relationships. Reflexive thematic analysis with a hybrid inductive‐deductive coding approach was utilised, drawing on cognitive behavioural theory (CBT) as a theoretical lens to interpret the data.Four themes were created from the data: (1) ‘Then he said to me … you could probably tone up a bit’: Maintaining cycles; (2) ‘I think those comments down the line do eventually help’: breaking out of maintenance cycles, (3) ‘It's like they're talking in a foreign language’; beliefs as a filter and (4) ‘Cheering me on from the side‐lines’; romantic partner a supportive coach. These themes highlight the perceived unhelpful (e.g. accommodation of behaviours) and helpful (e.g. affection) impact of romantic partners' behaviours and commentary on participants’ AA.Romantic partners are perceived by women to have a potent impact on their AA. Clinical practice implications include involving romantic partners in treatment, and clinicians using their formulation and CBT skills (e.g. Socratic questioning), to understand and target these possible maintenance processes within couples. [ABSTRACT FROM AUTHOR]

BackgroundMethodsResultsConclusionAlthough cognitive-behavioral therapy for insomnia (CBT-I) is an effective treatment for sleep disorders, little is known about the role of hyperarousal (especially trait arousal) in CBT-I interventions. Therefore, this study investigated the role of trait arousal in the maintenance of sleep problems using cross-sectional and longitudinal methods.Study 1, 1209 Chinese university students (63.9% female) completed the Dysfunctional Beliefs and Attitudes about Sleep (DBAS-16), Pre-sleep Arousal Scale (PSAS), Arousal Predisposition Scale (APS), and Pittsburgh Sleep Quality Index (PSQI). The study calculated the moderating role of trait arousal in the relationship between dysfunctional beliefs about sleep and sleep quality. In study two, 89 participants completed the questionnaire used in Study 1 during pre-and post-treatment. A within-subjects mediation analysis examined the indirect effects of dysfunctional beliefs about sleep pre-sleep arousal (cognitive and somatic) on sleep quality. A within-subjects moderation analysis was used to investigate whether baseline trait arousal moderated sleep quality.Cross-sectional findings indicated that pre-sleep cognitive arousal mediated the effects of dysfunctional beliefs about sleep on sleep quality and that trait arousal moderated the first half of the mediating pathway described above; longitudinal analyses indicated that changes in dysfunctional beliefs about sleep and pre-sleep cognitive arousal mediated changes in sleep quality, and that, in addition, trait arousal moderated changes in sleep quality.Trait arousal correlates with the maintenance of sleep problems, and participants with higher trait arousal benefited less from CBT-I. Enhancement programs that incorporate mindfulness may be a direction for future research. [ABSTRACT FROM AUTHOR]

Background: Poly-victimization (PV) not only threatens physical and mental health but also causes a range of social problems. Left-behind children in rural areas are more likely to experience PV problems. However, there have been fewer studies on PV among rural children, and even fewer intervention studies. Objective: The difference-in-differences method was employed to analyze the impact of intervention measures, based on the theory of planned behavior, on PV among left-behind children in rural areas. Methods: The study subjects were left-behind children from six middle schools in two cities in southern China, who completed the baseline survey from 2020 to 2021. They were divided into a control group and an intervention group, each consisting of 228 cases, based on their schools. Before and after the intervention, the Self-made victimization-related knowledge, attitude, and practice questionnaire, Poly-victimization scale, and Middle school students' coping style scale were used to evaluate the victimization-related KAP(knowledge, attitude, and practice), victimization occurrence, and coping styles of left-behind children, respectively. Stata 15.0 was used to establish a difference-in-differences regression model to analyze the impact of the intervention measures on poly-victimization and coping styles. Results: Mixed Anova revealed that after the intervention, the KAP scores of the intervention group were significantly higher than those of the control group (p < 0.05). After the intervention, the incidence of child victimization in the intervention group dropped to 9.60% (n = 22), lower than in the baseline survey, with a statistically significant difference (p < 0.01). The incidence of PV among children in the intervention group was lower than that in the control group, with the difference being statistically significant (p < 0.01). The net reduction in the incidence of PV among children was 21.20%. After the intervention, the protection rate for preventing PV among children was 73.33%, and the effect index was 3.75. The intervention improved children's coping styles, problem-solving, and help-seeking, while reducing negative coping styles such as avoidance and venting, with the differences being statistically significant (p < 0.05). Conclusion: Intervention measures based on the theory of planned behavior reduce the occurrence of PV among left-behind children, and the intervention effects on different types of victimization are also different. [ABSTRACT FROM AUTHOR]

Background Aims Methods Results Conclusions Insomnia is a prevalent condition in Australia that increases the risk of depression and anxiety symptoms. Cognitive behaviour therapy for insomnia (CBT‐i) is the recommended ‘first line’ treatment but is accessed by a minority of people with insomnia.To improve CBT‐i access in Australia, we aimed to develop and test a self‐guided interactive digital CBT‐i program.An online randomised controlled trial was conducted from August 2022 to August 2023 to investigate the effect of digital CBT‐i, versus digital sleep education control, on symptoms of insomnia (ISI), depression (PHQ‐9), anxiety (GAD‐7), fatigue, sleepiness and maladaptive beliefs about sleep at 8‐week follow‐up. The control group accessed the intervention after the 8‐week follow‐up. Questionnaires were additionally administered at 16 and 24 weeks. Intent‐to‐treat mixed models and complete‐case chi‐squared analyses were used.Participants included 62 adults with insomnia symptoms (age M (SD) = 52.5 (16.3), 82% female, ISI = 18.6 (2.9)). There were no between‐group differences in baseline characteristics or missing 8‐week data (14.5%). After adjusting for baseline scores, CBT‐i was associated with lower insomnia (Diffadj (95% CI) = 7.32 (5.0–9.6), P < 0.001, d = 1.64), depression (3.36 (1.3–5.4), p = 0.002, d = 0.84), fatigue (5.2 (2.5–7.9), P < 0.001, d = 1.00) and maladaptive beliefs about sleep (11.0 (4.1–18.0), P = 0.002, d = 0.82), but not anxiety symptoms at 8 weeks (1.84 (−0.1 to 3.8), p = 0.060, d = 0.50). Compared to control, CBT‐i was associated with greater rates of insomnia remission (ISI <8; 0.0%, vs 40.0%, P < 0.001) and response at 8 weeks (ISI reduction ≥6; 7.1% vs 72.0%, P < 0.001). Improvements in insomnia and depression were maintained at 24 weeks in the CBT‐i group.This interactive digital CBT‐i program resulted in large and sustained improvements in symptoms of insomnia, depression, fatigue and maladaptive beliefs about sleep in Australian adults with insomnia symptoms. Implementation programs are required to increase digital CBT‐i access and uptake. [ABSTRACT FROM AUTHOR]

BackgroundMethodResultsDiscussionPeople experiencing psychosis in acute crisis should be offered Cognitive Behavioural Therapy for psychosis (CBTp) however there are no protocols developed to inform delivery specifically for people in acute crisis receiving inpatient mental health care. This paper narratively describes a CBTp-informed crisis-focused therapy protocol to inform the delivery of therapy in inpatient settings.This study draws on relevant systematic reviews, qualitative interview studies with stakeholders, Delphi studies, and coproduction to develop the protocol. It draws upon crisis theories and CBTp theories to underpin it.This paper outlines a modularised approach to working with people with psychosis and in crisis. It outlines the key values underpinning the protocol, and the key modules of: engagement, assessment and identifying priorities; formulation of the crisis, stabilisation, safety, and problem solving, crisis plans and crisis cards, change strategy work focusing on crisis appraisals, and discharge and relapse planning.A crisis-focused cognitive behavioural therapy protocol is presented which can be used to inform therapy for people experiencing psychosis and in crisis. More research is required to explore the efficacy of such therapies. [ABSTRACT FROM AUTHOR]

Objective: To examine the effectiveness of one-week inpatient cognitive behavioral therapy for insomnia (CBT-I) in patients without severe mental disorders in the real-world setting to answer the research question "Can inpatient CBT-I be abbreviated?". Methods: In this retrospective, single-group, pretest-posttest study, the clinical outcome data of 94 patients who underwent one-week inpatient CBT-I were collected. Self-report scale scores and hypnotic medication use were obtained at baseline and at the 3-month follow-up after therapy. Results: CBT-I significantly improved insomnia severity (Z = -7.65, P < 0.001, Cohen's d = 1.34), anxiety (Z = -6.23, P < 0.001, Cohen's d = 1.02), depression (Z = -6.42, P < 0.001, Cohen's d = 1.06), daytime sleepiness (Z = -2.40, P = 0.016, Cohen's d = 0.35), and fatigue severity (Z = -5.54, P < 0.001, Cohen's d = 0.88) and reduced hypnotic medication use (χ² = 33.62, P < 0.001). At the follow-up assessment, 58 patients (67.4%) had clinically meaningful changes in insomnia, and 51 patients (59.3%) met the criteria for insomnia remission. Conclusion: The results of this preliminary study imply that one-week inpatient CBT-I may be an effective intervention for the treatment of insomnia in patients without severe mental disorders. [ABSTRACT FROM AUTHOR]

Background: Patients with chronic pain on opioids frequently experience loneliness, which is associated with poorer health outcomes and higher risk for opioid misuse and opioid use disorder. Given that almost half of opioids are prescribed in primary care, a critical need exists for the development and testing of interventions to reduce loneliness in primary care patients at risk for opioid misuse. Cognitive behavioral therapy and social prescribing have been shown to be efficacious in reducing loneliness and improving outcomes in other populations but have not been tested in patients at risk for substance use disorder. The overall objective of our study is to reduce opioid misuse and opioid use disorder by addressing loneliness in patients on long-term opioid therapy in real-world primary care settings. Methods: We will conduct a 3-arm pragmatic, randomized controlled trial to compare the effectiveness of two group-based, telehealth-delivered interventions with treatment as usual: (1) cognitive behavioral therapy to address maladaptive thought patterns and behaviors around social connection and (2) a social prescribing intervention to connect participants with social opportunities and develop supportive social networks. Our primary outcome is loneliness as measured by the UCLA Loneliness Scale and our dependent secondary outcome is opioid misuse as measured by the Common Opioid Misuse Measure. We will recruit 102 patients on long-term opioid therapy who screen positive for loneliness from 2 health care systems in Washington State. Implementation outcomes will be assessed using the RE-AIM framework. Discussion: Our study is innovative because we are targeting loneliness, an under-addressed but critical social risk factor that may prevent opioid misuse and use disorder in the setting where most patients are receiving their opioid prescriptions for chronic pain. If successful, the project will have a positive impact in reducing loneliness, reducing opioid misuse, improving function and preventing substance use disorder. Trial Registration: NCT06285032, issue date: February 28, 2024, original. [ABSTRACT FROM AUTHOR]

Social exclusion stands as a source of social discord and holds substantial research value. Prior investigations on social exclusion have overlooked the interactive relationship between the excluded individuals and the observers. Hence, this study comparatively explores the neural mechanisms underlying the psychological responses of two distinct roles within the same social exclusion context. A total of 35 pairs (19 pairs of females) participated in the experiment. Within each pair, one individual assumed the role of a socially excluded participant (target), while the other acted as a social exclusion observer. Targets engaged in an online ball-passing game where controlled ball allocations to the participants created an exclusion scenario. Meanwhile, observers spectated the targets playing the game. Throughout the ball-passing activity, functional near-infrared spectroscopy (fNIRS) recorded the blood oxygen data in the prefrontal cortex (PFC) and temporoparietal junction (TPJ) of both participants. Our findings revealed varied levels of rejection sensitivity elicited by direct or observed social exclusion experiences. Additionally, distinct patterns of neural activation were observed: targets displayed conditional differences in the medial prefrontal cortex (mPFC), while male observers exhibited conditional activation differences in the mPFC, and female observers showed conditional activation differences in the right dorsolateral prefrontal cortex (dlPFC). This study juxtaposes the behavioral and neural activation variances between targets and observers within the same social context, offering a novel perspective on investigating the neural mechanisms of social exclusion. [ABSTRACT FROM AUTHOR]

Various digital therapeutic products have been validated and approved since 2017. They have demonstrated efficacy and safety as a new therapeutic modality in various disorders or conditions. Hypertension is a common but serious condition that can be prevented or controlled with lifestyle changes and medicines. Although a digital therapeutic in hypertension is validated and approved in Japan, whether digital therapeutics (DTx) can significantly improve sustainable lifestyle changes is still a controversial topic. Most studies did not discuss the long‐term gain challenges. In this review, the authors discuss the definition of DTx, and analyze the motivation, engagement and adherence challenges of DTx in hypertension. Some ongoing artificial intelligence (AI)‐enabled or cognitive behavioral therapy (CBT)‐based digital interventions and behavioral strategies for implementing sustainable lifestyle changes are identified and analyzed. With AI‐enabled interventions and behavioral strategies, DTx might be one of the effective approaches to make sustainable lifestyle changes. [ABSTRACT FROM AUTHOR]

ObjectivesMethodsResultsConclusionsInsomnia and chronic pain are common symptoms in people with HIV. Poor sleep has been associated with chronic pain. While cognitive behavioral therapy for insomnia improves insomnia in clinical populations, there are barriers to people with HIV accessing treatment including the lack of trained providers and lengthy sessions. Only one study has examined the efficacy of brief behavioral treatment for insomnia (BBTI) in people with HIV. This study examined BBTI effects on sleep and pain in people with HIV.Ten adults with HIV and chronic pain completed a 4-week, telephone-delivered BBTI treatment. A control group (n = 10) completed a brief mindfulness training (BMT). The Insomnia Severity Index and Brief Pain Inventory were used to assess insomnia severity and pain outcomes, respectively.There was a significant interaction between intervention and time on insomnia severity, F (2,14) = 5.7, p = .02, partial η2 = 0.45). The BBTI group demonstrated significant improvements in insomnia severity from pre- to post-intervention (p < .001) and from pre-intervention to one-month post-intervention (p = .001) compared to the BMT group. There was a significant interaction between intervention and time on pain interference, F (1,18) = 4.9, p = .02, partial η2 = 0.27). The BBTI group demonstrated a significant decrease in pain interference from pre- to post-intervention (p < .001) compared to the BMT group.This pilot study demonstrated that BBTI improved insomnia in people with HIV for up to one-month post-treatment. Novel preliminary evidence suggests that BBTI may also improve pain outcomes in people with HIV. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the feasibility and acceptability of a newly developed online psychoeducation intervention on childhood anxiety for school staff using a within groups pre‐post design. The intervention is informed by cognitive behavioural therapy principles. Seventy six participants volunteered to attend a brief online training, and complete two brief questionnaires pre and post the training. Following the intervention, school staff reported that they were significantly less likely to respond to children's anxious behaviours with anxiety‐promoting responses (i.e., sanctions, avoidance reinforcement and overprotection), and were more likely to respond with autonomy‐promoting responses in line with cognitive behavioural theory (i.e., problem‐solving, reward and encouragement). On average, participants found the intervention engaging, useful, suitable, appropriate and easy‐to‐access. Participants also reported that they felt more confident in understanding childhood anxiety and implementing anxiety strategies in their work following the intervention. Areas of development were noted regarding the drop‐out rates of the online intervention. Overall, the novel, online intervention appears to be a feasible and acceptable method for those who participated. In addition, the preliminary outcomes show promise and warrant further investigation. Limitations of the study are discussed with suggestions for future research and areas for improvement. [ABSTRACT FROM AUTHOR]

Background: Recent literature suggests that ADHD is a risk factor for the development of antisocial behavior that is more severe and persistent than in community and other psychiatric populations. The combination of stimulant medication and psychotherapy (particularly cognitive behavioral therapy, CBT) is considered an evidence-based intervention for adults with ADHD. In contrast, few studies have evaluated the efficacy of medication in adult prisoners with ADHD, and the literature on the efficacy of psychotherapy is virtually nonexistent. Therefore, this article presents the protocol of a trial that will assess the efficacy of a formulation-based CBT program for inmates with ADHD. Methods: The study has a multicenter randomized controlled trial design. After screening and recruitment, participants will be randomly assigned to the CBT intervention, a general offender treatment program, or a waitlist. Pre- and post-treatment self-report and clinician-report assessments, as well as 6- and 12-month follow-up assessments will be conducted. These will include both clinical (e.g., ADHD symptoms, depression and anxiety symptoms, self-esteem, alcohol/drug abuse, treatment adherence, quality of life) and criminological (e.g., recidivism and risk of recidivism) measures. Linear mixed models will be used to assess differences between groups. Discussion: This study may be the first to evaluate the efficacy of a psychotherapy intervention in adult inmates with ADHD. It is expected that addressing the specific needs of ADHD would not only result in the previously reported clinical improvements (e.g., reduction in ADHD and comorbidity symptoms), but also reduce the risk and rate of recidivism compared to the general intervention or no intervention. However, the design may be limited by the difficulties inherent in the prison setting and in following up the sample after release. Trial registration: ClinicalTrials.gov NCT06080373. Registered on October 12, 2023. [ABSTRACT FROM AUTHOR]

Background: Non-specific low back pain is a common and costly global issue. Many people with low back pain live for years with ongoing symptom recurrence and disability, making it crucial to find effective prevention strategies. Motivational interviewing (MI) is an evidence-based patient-centred counselling style that helps motivate individuals to change their behaviours. In combination, MI and cognitive-behavioural therapy (MI-CBT) has the potential to yield long term improvements in pain and disability and reduce incidence of recurrence. Method: This is a two-arm superiority randomised controlled trial comparing MI-CBT and Education (n = 83) with Education only (n = 83). Participants that have recovered from a recent episode of non-specific low back pain (7th consecutive day with pain ≤ 2 on a 0–10 numeric pain rating scale) will be eligible for inclusion into the study. Both groups will receive five 30-min sessions over a 10-week period as well as the Navigating Pain booklet, homework book and a standardised exercise programme. In the intervention group, MI-CBT techniques will be used to provide individualised support, identify beliefs, and increase engagement with the resources provided. Outcomes measures include pain (current and in the last 7 days) as rated on the numeric pain rating scale. This will be used to determine recurrence (number of participants who report back pain ≥ 3 out of 10 on the numeric pain rating scale). Furthermore, self-reported (1) pain intensity; (2) pain catastrophizing; (3) fear-avoidance beliefs; (4) pain self-efficacy; (5) depression and anxiety; (6) disability will be measured. All outcomes will be measured at baseline, and again at 3-, 6-, and 12-months post allocation. Discussion: The effective delivery of self-management strategies to prevent recurrence of low back pain is an important aspect that requires urgent attention. This study will provide new information on the effectiveness of using an MI-CBT approach to facilitate self-management through education and exercise to improve low back pain outcomes. Evidence emerging from this trial has the potential to inform clinical practice and healthcare management of non-specific low back pain. Trial registration: Prospectively registered with Australian New Zealand Clinical Trials Registry: ACTRN12623000746639 (10/07/2023). [ABSTRACT FROM AUTHOR]

Scrupulosity is treated as a particular presentation of the symptomatology characteristic for obsessive-compulsive disorder (OCD). However, typical treatment of OCD (e.g. cognitive-behavioral therapy) is less effective in the case of religious scruples. Recently, schema therapy has appeared as an alternative effective treatment in obsessive-compulsive symptomatology. The present study investigated the associations between early maladaptive schemas (EMSs) and scrupulosity in a non-clinical sample of 376 poles. The participants assessed their EMSs with the Young Schema Questionnaire 3 – Short Form and their scrupulosity with the Pennsylvania Inventory of Scrupulosity. We used network analysis to control for the EMS interconnectivity. We showed that accounting for the interactions within the EMSs, three schemas, namely, Punitiveness, Subjugation, and Enmeshment/Undeveloped Self, were positively correlated with scrupulosity. Given the central position of the Negativity/Pessimism schema in the examined network, we suggested that activation of this schema could be indirectly correlated to scruples via an escalation of activation to the Punitiveness, Subjugation, and Enmeshment schemas. The findings suggest that dependency and fear of rejection problems (present in Subjugation and Enmeshment EMSs) and over-compensation by perfectionism (present in Punitiveness EMS) could be addressed in the treatment of scruples. [ABSTRACT FROM AUTHOR]

Introduction: Chronic pain is common after traumatic brain injury (TBI), frequently limits daily activities, and is associated with negative outcomes such as decreased community participation. Despite the negative impact of chronic pain, few people with TBI receive effective treatment. This paper describes a collaborative care (CC) intervention, TBI Care, adapted specifically to treat chronic pain in people living with TBI, emphasizing expert clinician input, cognitive behavioral therapy (CBT) techniques, and other nonpharmacological approaches for decreasing pain interference. Methods: 79participantsengagedintheCCintervention fromtwoacademicmedical rehabilitation clinics with weekly assessments of pain intensity, interference, and medication use. Participant feedback on the intervention was gathered by interview with the care manager (CM) at the last treatment session and/or booster session. Provider feedback was gathered by a confidential survey post intervention. Results: Ninety percent of participants received at least 11 of the target 12 sessions with a care manager (CM), the majority occurring over the phone. Participants endorsed an average of 7 pain locations. All participants received pain education, skills in self-monitoring, goal setting/behavioral activation and relaxation training. Pain interference scores (impact on activity and enjoyment), tracked weekly by the CM, significantly decreased across sessions. 89% of participants received recommendations for CBT skills, 65% received referrals for additional treatments targeting pain interference, and 43% received care coordination. 75% of participants reported 6 or more medications/supplements at both the first and last session, with changes recommended primarily for headache treatment. Feedback from participants and providers was positive. Discussion: TBI Care, a novel patient-centered CC approach, was flexibly delivered, tailored to the needs of those living with TBI and chronic pain, with a high level of participant engagement, and satisfaction among participants and providers. This approach, prioritizing pain self-management strategies and other non-pharmacological approaches, along with optimizing pharmacological treatment, led to significant reductions in self-reported pain interference and intensity during the intervention. Using a CC model in TBI is feasible and successfully improved access to evidence-based treatments for chronic pain as well as outcomes for pain interference and intensity. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion Manual‐based treatments, such as cognitive behavioural therapy and metacognitive therapy, are effective for patients with generalised anxiety disorder (GAD), but no studies have examined non‐manualised clinically representative treatment for GAD.The sample consisted of 103 patients with GAD who completed non‐manualised eclectic outpatient treatment at a local psychiatric outpatient clinic from 2020 to 2023. Questionnaires before and after treatment measured GAD symptoms, depressive symptoms, functioning, health and treatment satisfaction.There were significant improvements with large effect sizes (Cohen's d using pooled standard deviations) for GAD symptoms (d = 1.30, p < .001), depressive symptoms (d = 1.22, p < .001) and functioning (d = 0.87, p < .001). There was a medium improvement in health (d = −0.66, p < .001). Regarding GAD symptoms, half of the sample achieved clinically significant change (scoring below cut‐off at post‐treatment and achieving reliable improvement), and 69% showed reliable improvement (statistically significant change). Most patients (72%–84%) were satisfied with their treatment.Clinically representative treatment is associated with improvement in GAD, but the effect sizes were smaller than in manual‐based treatments. Research using randomised controlled trial designs comparing manual‐based treatment to clinically representative treatment is needed to establish relative efficacy and for refining treatment guidelines in Norway. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Depression and anxiety are prevalent psychological symptoms among COVID‐19 survivors. This study compared the efficacy of mindfulness‐based cognitive therapy (MBCT) and Beck cognitive therapy (BCT) in addressing these issues.Forty‐five COVID‐19 survivors were randomly assigned to one of three groups: MBCT, BCT or a control. Pre‐ and postintervention assessments, using the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI), were conducted. Both interventions consisted of eight 90‐minute sessions.An ANCOVA analysis revealed that BCT was more effective than MBCT in reducing depression and anxiety symptoms. Both interventions led to significant improvements, but no significant differences were observed between post‐test and follow‐up.BCT is a promising intervention for depression and anxiety in COVID‐19 survivors. Facilities providing cognitive therapy should be integrated into healthcare settings to support mental health recovery. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusions We report the effect of quality of therapy delivery on outcomes in a randomized, controlled trial of behavioural activation (BA) and guided self‐help (GSH) for depression in adults with intellectual disabilities.A study specific measure of quality was used in a linear mixed effect model to determine the effects therapy and therapy quality on therapy outcome.There was a significant interaction between quality and treatment type, with lower quality therapy associated with better outcome for GSH but poorer outcome for BA, with little difference in outcomes at higher levels of therapy quality.Factors suggesting high quality in individualized BA may indicate problematic engagement for GSH. More research into processes in therapy for people with intellectual disabilities is required. [ABSTRACT FROM AUTHOR]

It has been reported that a scenario-based cognitive behavioral therapy mobile app including Todac Todac was effective in improving depression in the general public. However, no study has been conducted on whether Todac Todac is effective in dialysis patients. Therefore, this study was intended to determine whether the use of this app was effective in improving depression in dialysis patients. Sixty-five end-stage kidney disease patients receiving dialysis at Soonchunhyang University Cheonan Hospital were randomly assigned to the Todac Todac app program (experimental group) or an E-moods daily mood chart app program (control group) for 3 weeks. The degree of depression was measured before and after using the app.After the end of the 3-week program, a small but significant improvement was observed in the Trait anxiety (p < 0.05) and Beck depression index (p < 0.05) in E-moods group and DAS-K scores (p < 0.05) in Todac Todac group. However, no differences were seen in any parameters between the two groups. In addition, Todac Todac was not statistically more effective than the control intervention in the subgroup analysis. The Todac Todac, a scenario-based cognitive behavioral therapy mobile app, seemed to have a limited effect on improving depression in dialysis patients. Therefore, it is necessary to develop new tools to improve depression in dialysis patients. [ABSTRACT FROM AUTHOR]

Background and Purpose Methods Results Conclusion Fatigue is a common and disabling symptom in multiple sclerosis (MS). Educational interventions have shown potential to reduce fatigue. The aim was to systematically review the current best evidence on patient education programmes for MS‐related fatigue.This was a systematic review and meta‐analysis following Cochrane methodology. A systematic search was conducted in eight databases (September 2023). Moreover, reference lists and trial registers were searched and experts in the field were contacted. Randomized controlled trials were included evaluating patient education programmes for people with MS with the primary aim of reducing fatigue.In total, 1176 studies were identified and assessed by two independent reviewers; 15 studies (1473 participants) were included. All interventions provided information and education about different aspects of MS‐related fatigue with different forms of application, some with components of psychological interventions. Amongst those, the most frequently applied were cognitive behavioural therapy (n = 5) and energy‐conservation‐based approaches (n = 4). Studies differed considerably concerning mode of intervention delivery, number of participants and length of follow‐up. Interventions reduced fatigue severity (eight studies, n = 878, standardized mean difference −0.28; 95% confidence interval −0.53 to −0.03; low certainty) and fatigue impact (nine studies, n = 824, standardized mean difference −0.21; 95% confidence interval −0.42 to 0.00; moderate certainty) directly after the intervention. Mixed results were found for long‐term effects on fatigue, for secondary endpoints (depressive symptoms, quality of life, coping) and for subgroup analyses.Educational interventions for people with MS‐related fatigue may be effective in reducing fatigue in the short term. More research is needed on long‐term effects and the importance of specific intervention components, delivery and context. [ABSTRACT FROM AUTHOR]

Background: The medical profession faces a critical challenge with the mental health of its practitioners, leading to an alarming increase in suicide rates among healthcare workers (HCW). Factors such as the culture of perfectionism, excessive workloads, and stigma against seeking help exacerbate this issue. This umbrella review synthesizes the existing literature on HCW suicide, exploring the prevalence, causes, and potential preventive strategies. Methods: This study conducted a search of the literature from PubMed/Medline, Scopus, Web of Science, Cochrane Library, PsycINFO, and Google Scholar until April 2, 2024. The non-exhaustive search terms used were "doctor suicide," "physician suicide," "medical professional suicide," "suicide in healthcare," "healthcare worker suicide prevention," and "causes of healthcare worker suicide." Hand-searches were also conducted. Of the 487 studies initially identified, a total of 10 systematic reviews/meta-analyses were included. Results: This umbrella review collates findings from 400 primary clinical studies conducted between the years 2004 and 2023. With a focus on mental health factors contributing to suicide in HCW, there are regional and specialty-specific variations in stress prevalence in the populace. Further, anesthesiologists and psychiatrics depicted higher rates of burnout compared to other HCW; causative factors such as seeking perfection and challenging work-life balance were key when assessing suicidal behaviors in these groups. Job demand level was found to correlate directly with suicidal thoughts, specifically among psychiatric ward HCW, where access to drugs and sharp instruments is readily available. In specific contexts, female HCWs showed a standardized mortality ratio (SMR), indicating that the rate of suicide was higher among them as compared to the general female population. Interventions such as cognitive behavioral therapy (CBT) and mindfulness were effective in decreasing depression, psychological distress, and anxiety in several included studies. This umbrella review also identified major obstacles to seeking help, including stigma and the fear of professional consequences. Conclusion: To reduce suicide rates among HCWs, it is the need of the hour to implement evidence-based interventions and create supportive work environments that encourage mutual care for each other's emotional health. Further research is necessary to determine the effectiveness of various measures in preventing suicide among HCW. [ABSTRACT FROM AUTHOR]

Background: Pain catastrophization (PC) is related to motor control changes in individuals with nonspecific chronic low back pain (NSCLBP). However, differences in dynamic balance control based on the level of PC still remain unclear in these individuals. Objective: The aim of this study was to compare the dynamic balance control between healthy controls and individuals with NSCLBP with high and low PC. Methods: Forty individuals with NSCLBP and 20 healthy participants were enrolled in this cross-sectional study. Individuals with NSCLBP were classified into two groups of high and low PC. Dynamic balance control was assessed using the Modified Star Excursion Balance Test (MSEBT), Five-Time Sit-to-Stand Test (FTSST), and Timed Up and Go Test (TUGT). Results: Statistical analyses showed that mean values of reach distances in the anterior, posteromedial, and posterolateral directions of the MSEBT were significantly lower in individuals with NSCLBP with high PC compared to low PC (p =.04, p =.01, and p =.04, respectively) and healthy controls (p <.001, p =.001, and p =.006, respectively). In addition, for both the FTSS and TUG tests, the mean time was significantly greater in individuals with NSCLBP with high PC compared to low PC (p <.001 and p =.004, respectively) and healthy controls (p <.001). Conclusions: Our results showed poor dynamic balance control in individuals with NSCLBP with high PC. This suggests that PC could contribute to the impaired dynamic balance control in individuals with NSCLBP. Combining balance exercises and cognitive-behavioral treatments targeting PC may be useful for the improvement of dynamic balance control in individuals with NSCLBP with high PC. [ABSTRACT FROM AUTHOR]

Background: An extended group program called Mind and Body (MB), based on body awareness exercises and cognitive behavioral therapy (CBT), was offered to a subgroup of patients who had completed their traditional outpatient multidisciplinary rehabilitation and were motivated for further treatment. Purpose: To explore how patients with multisite musculoskeletal pain experienced participation in the MB program with respect to usefulness, meaningfulness, behavioral changes, and transferability to daily life and work. Method: The study is rooted in the phenomenological tradition. Individual, semi-structured interviews were performed with eight patients aged 29–56 years. The data were analyzed using systematic text condensation. Results: Two main themes emerged: 1) New knowledge provided increased body awareness, new ways of thinking, and acceptance of one's own situation. This theme reflected how new knowledge and MB coping strategies were useful in the process of changing problematic thoughts, increasing body awareness, and facilitating acceptance; and 2) Implementing new habits and strategies in daily life revealed how demanding it was to alter behavior, a process that unfolded over time. Conclusion: A combination of body awareness exercises and cognitive coping strategies was described as helpful in further improving function and coping with pain and stress in daily life and work. [ABSTRACT FROM AUTHOR]

Les Thérapies cognitives et comportementales (TCC) explorent les schémas de pensée en lien avec les troubles psychiques, agissant sur le plan cognitif, comportemental et émotionnel, selon des protocoles structurés et validés. Les représentations culturelles du patient peuvent être questionnées dès l'étape initiale de l'Analyse fonctionnelle (AF), permettant ainsi l'adaptation des modèles TCC en situation transculturelle. L'AF interroge le trouble et son contexte. La Synchronie, selon le modèle SECCA (Cottraux), aborde les cognitions, les émotions et les croyances en lien avec la situation problématique. La Diachronie recueille les données structurales et d'anamnèse en lien avec le trouble. Une modélisation de l'AF peut être proposée en contexte transculturel, prenant en compte la construction sociale et culturelle du symptôme, de la maladie, du trouble, ou de la crise. L'AF, à travers l'adaptation du modèle SECCA et de la grille de lecture diachronique, s'adapte à la situation transculturelle et prend en compte les aspects relatifs à la culture, à l'exil, à la migration, au modèle étiologique, à l'itinéraire thérapeutique, au traitement traditionnel de la maladie, aux représentations du patient et à ses croyances. Elle questionne également la notion de famille et d'affiliations, de transmission, et ce qui relève chez certains patients du « monde invisible ». L'ajustement de l'AF en contexte transculturel interroge les représentations, le système de croyance et l'histoire individuelle et collective dans laquelle s'inscrit le patient. La sensibilisation des cliniciens à la question culturelle en TCC permet de mieux appréhender l'influence de celle-ci dans l'expression clinique des troubles psychiatriques, et leur conceptualisation par les patients, au-delà des stéréotypes et des représentations du thérapeute lui-même. Le modèle théorique de l'AF ainsi conceptualisé prend en compte la subjectivité du patient, mêlant l'approche transculturelle à la méthodologie cognitivo-comportementale et permet ainsi de s'adapter à nos patients du monde et à leurs singularités. Cognitive and Behavioral Therapies (CBT) explore thought patterns related to psychological disorders, acting on the cognitive, behavioral, and emotional levels, according to structured and validated protocols. The patient's cultural representations can be questioned as early as the initial stage of Functional Analysis (FA), enabling CBT models to be adapted to transcultural situations. FA examines the disorder and its context. Synchrony, based on Cottraux's SECCA model, addresses the cognitions, emotions and beliefs associated with the problematic situation. Diachrony collects structural and anamnestic data related to the disorder. A model of FA can be proposed in a transcultural context, taking into account the social and cultural construction of the symptom, illness, disorder or crisis. By adapting the SECCA model and the diachronic reading grid, FA is adjusted to the transcultural situation, considering aspects relating to culture, exile, migration, the etiological model, the therapeutic itinerary, the traditional treatment of the illness, and the patient's representations and beliefs. It also questions the notion of family and affiliations, transmission, and what, for some patients, is the "invisible world". The adjustment of FA in a transcultural context raises questions about representations, belief systems and the individual, and the collective history of the patient. Raising the clinicians' awareness of the cultural issue in CBT helps them to better understand its influence on the clinical expression of psychiatric disorders and their conceptualization by patients, over and above stereotypes and the therapist's own representations. The theoretical model of FA conceptualized in this way takes into account the subjectivity of the patient, combining the transcultural approach with cognitive-behavioral methodology; and thus making it possible to adapt to our global patients and their singularities. [ABSTRACT FROM AUTHOR]

The main purpose of this study was to evaluate the feasibility of an online psychological intervention for individuals with gambling-related problems, supported by ecological momentary assessments and interventions (EMAs and EMIs), along with weekly phone-calls, before conducting a randomized controlled trial. Participants were required to complete 3 of the 8 modules of the program based on cognitive-behavioral therapy (CBT) and extensions and innovations of CBT. The study measured the outcomes of feasibility (i.e., reach, appropriateness, technology literacy and technology usability, fidelity, and adherence). In terms of reach, 19.8% (n = 11) of the initial population met the inclusion criteria and completed the three modules (mean age = 41; 90.9% men). The perceived appropriateness and the technology usability after the first use were both excellent, fidelity and adherence to the online treatment (73.3%) were adequate. Adherence to the EMAs and the weekly phone calls were more modest (54.51% and 66.67%, respectively). The results of the present study show that an online treatment for gambling problems enhanced by EMA and EMI might be feasible but challenges were noted in terms of reach and adherence to these assessments and calls. These challenges are important to consider for future trials and the scalability of treatments for individuals with gambling disorders. [ABSTRACT FROM AUTHOR]

Cross-sectional research suggests an association between loneliness and psychotic symptoms, but the causal direction of this association is still unclear. Even though loneliness has been proposed as a potential treatment target to improve psychotherapy for psychosis, not much is known about its role in the treatment process. In this study, we re-analyzed data from a therapy process study to investigate the temporal dynamics between loneliness and psychotic symptoms throughout therapy and to explore whether state-of-the-art CBT for psychosis (CBTp) decreases loneliness. Over the course of up to 45 weekly sessions of CBTp, 57 patients reported their feelings of loneliness and current positive, negative and depressive symptom levels at each session. Multilevel regression revealed a reduction in all symptoms over time, but no reduction in loneliness. Time-lagged multilevel regression showed that loneliness predicted subsequent negative and depressive symptoms, whereas positive symptom levels predicted subsequent loneliness. Thus, changes in loneliness seem to be both cause and consequence of psychotic symptom changes. These findings highlight the importance of loneliness as a treatment target, particularly in patients with negative symptoms and depression. Future research should address loneliness-specific interventions as an augmentation of state-of-the-art CBTp. • Re-analysis of a therapy study on Cognitive Behavior Therapy for psychosis (CBTp) • CBTp is effective in reducing psychotic symptoms, but not loneliness. • Loneliness follows positive symptoms, but precedes negative and depressive symptoms. • Loneliness should be specifically addressed in psychotherapy for psychosis. [ABSTRACT FROM AUTHOR]

Personalizing psychotherapy can be challenging within standardized group Cognitive Behavioral Therapy (CBT), in which sessions are structured according to a protocol and must accommodate the needs and preferences of multiple patients. In the current study, we aimed to examine patients' and therapists' experiences of standardized group CBT and identify their perceptions of different patient needs. Furthermore, we explored how these needs can inform possible content of add-on interventions for patients who are not improving as expected during group CBT. We conducted 21 individual in-depth interviews with patients with depression and their therapists about their experiences during group CBT with Routine Outcome Monitoring (ROM) and feedback. Interviews were analyzed by using a hermeneutic-phenomenological thematic analysis. Five themes, representing different patient needs, were identified: (1) Individual attention, (2) Psychological exploration, (3) A focus on the patient's life outside of therapy, (4) Extended assessment, and (5) Agreement on therapeutic tasks. The study supports that "one size does not fit all" when it comes to psychotherapy. Patients have varying needs when they are not making progress in therapy, and these needs, when unmet, can negatively impact the overall experience of group CBT. By acknowledging the unique needs of each patient and providing additional individual sessions as necessary, we can move towards a more personalized approach that maximizes the benefits of group psychotherapy. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate the short- and long-term effects of a new cognitive sound exposure therapy (CSET) in patients with hyperacusis. Method: A new therapy was developed to reduce hyperacusis using sound exposure combined with breathing and relaxation strategies from both accep- tance and commitment therapy and cognitive behavioral therapy. Patients who were referred to the Speech and Hearing Centers located in Hengelo and Zwolle in the Netherlands and aged ≥ 18 years with hyperacusis as main complaint and no or mild hearing loss were included in this study. Patients were seen for CSET between June 2020 and August 2022. The sessions took place biweekly. Sessions ended when exposure reached a level with a maximum of 70--80 dB SPL. Short-term effects between the start and the end of therapy were based on tolerable level of sound exposure (dB SPL), subjective-level hinderance of hypera- cusis, and sensitivity to sound using the Hyperacusis Questionnaire (HQ). The long-term effect was based on HQ 6 months after the end of therapy. Linear mixed-effects and regression models were applied to study outcomes over time. Results: In total, 30 patients, 15 men and 15 women, aged between 24 and 76 years were included in this study. The mean number of sessions during ther- apy was 6 and ranged between 4 and 8. Results showed an increase of exposure level (mean change was +23.7 dB with an SD of 7.9, p< .001), a decrease in sensitivity to daily sounds (mean [SD] change was -1.6 [2.1], p<.001),anda decrease in HQ (mean [SD] change was -9.8 [4.9], p< .001), between the start and the end of therapy. There was no significant change in HQ after the end of therapy and 6 months later; mean (SD) change was 0.2 (4.3), p=.81. Conclusions: The evaluation of CSET indicated a decrease in short- and long- term sensitivity to sound in patients with hyperacusis. Additionally, CSET has shown a positive impact, not only for the sounds used in the therapy sessions but also in transferring benefits to everyday sounds. The results of combining psychoeducation, sound exposure, and counseling are promising and warrant further evaluation. [ABSTRACT FROM AUTHOR]

The future welfare of older adults is a worldwide concern. By 2034, it is estimated that individuals 65 and older in the U.S. will be 77 million. Consequently, this reality will impact healthcare facilities and increase Medicare and Medicaid costs, resulting in higher incidents of homeless older adults, children caring for parents, the need for more caregivers, and an increased number of older individuals experiencing various forms of dementia. To address these concerns, the current trend for treating the onset of dementia and Alzheimer's disease has been moving toward nonpharmaceutical interventions. Even though researchers have tapped into the benefits of several nonpharmaceutical treatments, there appears to be a constant debate on establishing which method is most effective. Deciding on best practices and methods to slow down and/or halt the progression of dementia is the gap this research needs to fill. To provide clarity on the topic, an analysis of alternative interventions to treat the onset of dementia is what this paper strived to achieve. The analysis involved comparing and contrasting the benefits of each intervention as well as illustrating the implications of the findings. In this regard, a systematic review was conducted examining the benefits of five nonpharmaceutical strategies; mental training, music therapy, technology usage, physical activity, and social interaction. Although findings revealed some form of improvement in each of the nonpharmacological interventions examined, the overarching theme appeared to lean toward providing mental stimulation. It was also not conclusive that physical activity prevented cognitive decline. More research is recommended. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your awareness of the categories, risks and effects of various new psychoactive substances • To recognise the challenges involved in identifying new psychoactive substances • To consider psychosocial and pharmacological interventions that you could use with people who misuse new psychoactive substances. The use of new psychoactive substances is a growing concern across healthcare services in the UK. To date, more than 1,000 types of new psychoactive substances have been identified and they have a wide range of effects, potency and mechanisms of action, which can result in overdose and death. This article reviews the challenges experienced by nurses including in identifying new psychoactive substances, their associated risks and various psychosocial and pharmacological interventions. Currently, evidence surrounding the appropriate nursing interventions required for the misuse of new psychoactive substances is limited. Further research and training opportunities are required for nurses to manage service users who present having taken new psychoactive substances, particularly in hospital, substance misuse and mental health settings. [ABSTRACT FROM AUTHOR]

Purpose: Stress during pregnancy has many negative repercussions on maternal and foetal health. It is therefore important to understand which therapies are effective in reducing stress levels and which variables influence the outcomes of these therapies. In this line, psychological resilience could play a key role. Thus, the aim of the study was to check whether pregnant women with different levels of resilience have different benefits in reducing cortisol levels, perceived stress, pregnancy worries, stress vulnerability, anxiety or depression through Cognitive Behavioural Stress Management Therapy. Method: The total sample consisted of 56 pregnant women: one group of pregnant women with high levels of resilience (n = 35); and another group with low levels of resilience (n = 21). Participants' cortisol concentration levels, perceived stress, pregnancy concerns, stress vulnerability, anxiety and depressive symptoms were assessed before and after therapy. Linear mixed models were performed to compare the two groups, which showed a group x time interaction for perceived stress. Results: The low resilience group showed a reduction in their perceived stress levels with a medium effect after the intervention compared to the high resilience group, but no reduction was found in this group. No differences were found between the two groups on the other variables. Conclusion: Knowing which variables have a differential effect on the results of psychological therapy would allow delimiting the groups that obtain greater benefits from the therapy. This may lead to more efficient implementation of effective intervention programmes. [ABSTRACT FROM AUTHOR]

There has been little attention to personality in research on school refusal (SR). This study examined personality traits among 41 adolescents receiving cognitive–behavioral therapy (CBT) during participation in a School Refusal Program in the Netherlands. Traits were examined via clinical scales and 2-point code types derived from the Minnesota Multiphasic Personality Inventory–Adolescent. The influence of personality traits on treatment outcome was examined at post-treatment and 1-year follow-up. At pretreatment, eight of the 10 clinical scales were disproportionately skewed toward the "high to very high" range relative to a norm group. Social introversion and depressive symptomatology were significantly increased relative to the norm group, and nearly one-half of the adolescents were characterized by code type 2-3/3-2 (depression/hysteria) or 2-0/0-2 (depression/social introversion). Adolescents characterized by a 2-0/0-2 code type were almost twice as likely (odds ratio = 1.78) to be treatment responders at post-treatment. There was no relation between personality traits and treatment outcome at follow-up. The small sample size limits generalization of the study's findings. If the results are replicated, personality traits may provide useful indications for personalizing treatment when employing interventions recommended in CBT manuals for SR. [ABSTRACT FROM AUTHOR]

Background: Despite the increased risk for people with an intellectual disability developing dementia, post‐diagnostic psychosocial supports such as cognitive stimulation therapy (CST) are not routinely offered and there is limited research examining this intervention with people with intellectual disabilities. The aim of this study was to explore the feasibility of CST for older adults with intellectual disability to support active ageing. Methods: Five client participants attended a 14‐session CST group and four staff attended a focus group. Reflexive thematic analysis was used to investigate the client and staff narratives. Results: Three key themes were generated: (1) Brain Health, (2) Connecting with others, and (3) Barriers and Enablers. Conclusion: Findings indicated the suitability of CST as a way of supporting active ageing for older adults with intellectual disability. This study adds to the growing knowledge about service provision for older adults and their changing needs as they age and identifies clinical implications such as staff training to support intervention adherence. [ABSTRACT FROM AUTHOR]

This pilot study tested a single-session digital values affirmation for behavioral activation (VABA) intervention. Hypotheses predicted the VABA intervention would be more effective than an active control condition in improving mood, decreasing COVID-19 fear/worry and depressive symptoms, and promoting positively reinforcing behaviors during early weeks of the COVID-19 pandemic. Participants were a diverse sample of undergraduate students (N = 296) under a state-wide lockdown. Students were randomized to either VABA, a 10-min values clarification and affirmation task, or Control, a time- and attention-matched task. Positive and negative affects were assessed pre- and post-intervention. At next-day follow-up, positive and negative affects were reassessed, as well as past 24-h behavioral activation and depressive symptoms. Within-group increases in positive affect were observed in both conditions (VABA d = 0.39; Control d = 0.19). However, VABA produced a significantly larger increase than Control (F[2] = 3.856, p =.022, d = 0.22). At 24-h follow-up, behavioral activation, which was significantly higher in VABA versus Control (t[294] = −5.584, p <.001, d = 0.65), predicted fewer depressive symptoms (R2 change =.019, β = -.134, p =.003). VABA is an ultra-brief intervention that appears to have acute effects on mood-enhancement and behavioral activation. [ABSTRACT FROM AUTHOR]

• We compare Meaning Centered Psychotherapy (MCP) to Cognitive Behavioral Therapy (CBT) • This is a randomized controlled trial in a natural setting with cancer survivors. • MCP was more effective than CBT in increasing meaning in life. • MCP and CBT were similarly effective in improving depression. • MCP and CBT were similarly effective in developing posttraumatic growth. Meaning-centered psychotherapy (MCP) has been found to be effective in improving meaning in life and increasing fulfillment in participants with cancer. However, to date, no previous studies have compared MCP with evidence-based treatments such as cognitive behavioral therapy (CBT). The aim of this study was to analyze the differential efficacy of MCP, compared to CBT, in participants with cancer. The study is a randomized controlled trial with 76 participants, n = 41 (MCP) and n = 35 (CBT). At posttreatment, the MCP intervention for cancer survivors was more effective than CBT in increasing the presence of meaning in life, purpose and meaning in life, and life goals. Moreover, our results showed that, at posttreatment and the 6-month follow-up, MCP and CBT were similarly effective in improving depression and developing posttraumatic growth. This study suggests that MCP could be more effective than CBT in improving meaning in life, purpose, and life goals, and equally effective as CBT in improving depression and posttraumatic growth, in cancer survivors. [ABSTRACT FROM AUTHOR]

• Four distinct affect trajectories based on rate of change. • Quadratic worsening in moderate affect associated with increased eating pathology. • Stable affect linked to improved cognitions, not eating or compensatory behaviors. • Affect-directed treatments may enhance cognitive remission in eating disorder pathology. Bulimia nervosa (BN) is characterized by recurrent loss of control over eating (LOC) and inappropriate compensatory behaviors. Although cognitive-behavioral therapy (CBT) is efficacious for BN, many patients continue to experience symptoms at posttreatment. One potential driver of this low treatment response may be low mood, which maintains BN symptoms through negative reinforcement. Thus, it is important to understand how mood changes over enhanced cognitive-behavioral therapy (CBT-E) and whether these changes are associated with improved treatment outcomes. Participants (N = 56) with BN-spectrum eating disorders (EDs) received 16 sessions of the focused version of CBT-E. The Eating Disorder Examination (EDE) was used to measure ED symptoms (global ED pathology, frequency of binge episodes, and compensatory behaviors) at pre- and posttreatment. Latent growth mixture modeling (LGMM) of affective ratings via digital self-monitoring identified latent growth classes. Kruskal–Wallis H tests examined the effect of trajectory of change in mood on pre- to posttreatment symptom change. LGMM yielded a four-class model that best fit the data representing distinct mood trajectories over the course of treatment: (a) highest baseline mood, linear improving; (b) moderate baseline mood, stable; (c) moderate baseline mood, quadratic worsening; and (d) lowest baseline mood, quadratic improving. Participants who demonstrated worsening mood over treatment (i.e., individuals in the "moderate baseline mood, quadratic worsening" class) had significantly higher EDE global scores at posttreatment and follow-up compared to participants with stable mood across treatment. Change in LOC eating frequency and compensatory behaviors across treatment did not significantly differ by mood class. The main effect of mood class or interaction effect between time and mood class on objective binge episodes, subjective binge episodes, and compensatory behaviors was not significant. There were no significant differences in global ED pathology at either posttreatment or follow-up for any other class comparisons. These results suggest that certain trajectories of change in mood during treatment are particularly associated with change in pre- to posttreatment EDE global score. If replicated, our findings could suggest that future iterations of CBT-E should target mood early in treatment in order to maximize reductions in global eating pathology. [ABSTRACT FROM AUTHOR]