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Background: Common clinical sense would suggest that individuals with milder obsessive-compulsive disorder (OCD) symptoms should be the most suitable for guided internet-delivered cognitive behaviour therapy (CBT), with more intensive forms of treatment reserved for more severe or complex cases. Results: In this secondary data analysis of a non-inferiority clinical trial comparing internet-delivered CBT with in-person CBT for young people with OCD (N = 152), we found that higher baseline symptom severity predicted worse treatment outcomes in the in-person group but not the internet-delivered CBT group. Additional analyses showed that among individuals with milder symptoms, internet-delivered CBT was associated with worse outcomes than in-person CBT. Conclusions: If replicated, these results would question the axiom that internet-delivered CBT is most suitable for milder cases. Trial registration: The original trial was registered at ClinicalTrials.gov ID NCT03263546. Date of registration 2017–08–28. [ABSTRACT FROM AUTHOR]

Background: Anxiety is one of the causes and consequences of a heart attack, and its therapy is critical in lowering the risk of recurrence and improving patients' quality of life. The current study aims to examine the effectiveness of behavioral therapy (BT) and cognitive behavioral therapy (CBT) on the anxiety levels of patients with heart attack. Methods: In the current experimental study, the statistical population included 387 patients with heart attack who visited Al Budoor Hospital in Baghdad, Iraq, in 2022. A random sample of 150 individuals was selected via simple random sampling. Using a multiple-group pre-test-post-test design, two intervention groups and one control group were examined by the Beck Anxiety Inventory (BAI) (50 people in each group). To analyze the data obtained from the pre-test and post-test for each group, the analysis of covariance (ANCOVA) was used to examine the significance of the results between groups. The SPSS software was used for analyses, and the statistical significance level of the results was deemed to be 0.05. Results: The one-way analysis of variance (ANOVA) test showed a significant difference between at least two groups (F = 14.90, P < 0.001). Furthermore, Tukey's post hoc test findings revealed that the post-test anxiety scores of both intervention groups were significantly different from the control group (P < 0.001). Moreover, the cognitive behavioral intervention group had lower mean anxiety scores than the behavioral intervention group, but this difference was not significant (P > 0.05). Conclusion: The findings indicated that BT and CBT methods significantly reduced anxiety in patients with heart attack, with cognitive-behavioral methods being more effective. [ABSTRACT FROM AUTHOR]

Objectives: Children and adolescents with intellectual disabilities (ID) have high rates of mental health disorders, particularly anxiety disorders. Cognitive behavior therapy (CBT) has largely remained unexamined as a treatment option for this population. Fearless Me! © is an adapted CBT treatment program specifically designed for children and adolescents with ID. Method: Eleven children, aged between eight and 17, completed 10 therapy sessions. Measures of anxiety were completed pre and posttreatment and at 3 and 12‐month follow‐ups by both the children and parents. Results: Six children reported significant reductions in anxiety, with all showing significant reductions in parent‐reported child anxiety at either posttreatment assessment, 3‐month follow‐up, or 12‐month follow‐up. Results varied across the six children as all parents reported heightened anxiety, but not all children reported high levels of anxiety for themselves. Conclusion: Overall, this evaluation provides a sound basis for continued investigation and research into the use of the Fearless Me! © modified CBT program to treat children with ID and anxiety. [ABSTRACT FROM AUTHOR]

AbstractObjective: Although therapists are encouraged to balance emotionally involving work on the patient’s problems with need satisfaction in therapy sessions, effects of this balance have rarely been studied empirically. Hence, we examined congruence effects between problem-related affective and need-satisfying experiences in cognitive–behavioral therapy (CBT). Method: 165 distressed family caregivers rated problem-related affective experiences, need-satisfying experiences comprising self-esteem, positive interpersonal, and control experiences, as well as coping experiences after 12 CBT sessions. We examined within-person congruence effects of problem-related affective and need-satisfying experiences on subsequent coping in multilevel response surface analysis. Further, we included between-person problem-related affective and need-satisfying experiences and pretreatment depression and anxiety as moderators of within-person effects. Results: A slight predominance of self-esteem over problem-related affective experiences as well as exact correspondence between problem-related affective and both interpersonal and control experiences was most predictive of coping. Between-person moderators supported a cross-level balance heuristic of problem-related affective and self-esteem experiences. Finally, a stronger emphasis on self-esteem and interpersonal over problem-related affective experiences proved more beneficial for patients with high anxiety and low depression. Conclusions: The findings highlight the importance of balancing problem-related affective and need-satisfying experiences in CBT and provide insights into how balancing may be tailored to specific patients. [ABSTRACT FROM AUTHOR]

Background: Post-stroke depression (PSD) is a prevalent psychiatric disorder affecting about one-third of stroke survivors, significantly hindering recovery and quality of life. PSD also imposes a substantial burden on caregivers and healthcare systems. Aromatherapy has shown promise in alleviating depression, anxiety, and sleep disorders. This pilot randomized controlled trial aims to assess the feasibility and preliminary efficacy of mixed herb aromatherapy in treating PSD. Feasibility outcomes encompass recruitment, intervention adherence, assessment completion and safety assessment. Secondary outcomes include evaluations of depression, anxiety, cognitive function, sleep quality, quality of life, and brain function using EEG and fNIRS. Methods: This single-blind pilot randomized controlled trial will be conducted at the Second Rehabilitation Hospital of Shanghai, enrolling ninety-nine poststroke patients with PSD. Participants will be randomized into three groups: a Non-Active Control Group receiving standardized rehabilitation therapy, a CBT Group receiving conventional rehabilitation with bi-weekly CBT sessions, and an Aromatherapy Group receiving conventional rehabilitation with daily aromatic inhalation sessions. Interventions will last for four weeks, with efficacy assessed at baseline, post-intervention, and one month post-intervention. Rating scales will be used to measure changes in depression, sleep quality, cognitive function, and quality of life. EEG and fNIRS will specifically be used to measure changes in cerebral cortex activity and their correlations with depression. Feasibility will be evaluated through recruitment, intervention adherence, assessment completion and safety assessment. Discussion: This pilot study highlights the potential of mixed herb aromatherapy inhalation for treating PSD, addressing limitations of CBT by promoting selfmanagement. While demonstrating feasibility through recruitment, adherence, assessment completion and safety assessment, the study also acknowledges limitations such as unequal intervention times, the lack of physical function data. And the use of culturally relevant plant powders may enhance compliance but limits generalizability. Despite these constraints, the study provides valuable preliminary data and insights into the mechanisms of aromatherapy, encouraging further research and development of effective PSD treatments. [ABSTRACT FROM AUTHOR]

In this article, we describe a qualitative study in which we examined perceived effects of the COVID-19 pandemic on help-seeking individuals who access child sexual abuse material (CSAM, legally referred to as child pornography). The study recruited 18 participants who were part of the internet based Prevent It Cognitive Behavior Therapy (CBT) clinical trial, which aims to reduce CSAM use and child exploitation, and were willing to answer questions during a semi-structured interview about the perceived impact of the pandemic restrictions on their lives, including their sexual thoughts and behaviors. Key themes that were identified from the participants' answers included changes in day-to-day life, mental health, sexual thoughts, behaviors or urges, responses and coping strategies used to deal with sexual urges, changes on the forums, positive changes, and how they could best be assisted with coping in this situation. Our qualitative analysis also suggested that the pandemic affected urges to use CSAM, therefore potentially increasing the risk of online sexual offending. These results support that there is a need to investigate this potential negative side effect of quarantines or lockdowns before future pandemics. Users of child sexual abuse material were interviewed about changes in their daily lives as well as sexual thoughts and behaviors during the COVID-19 restrictions. The changes found, such as in general mental health and sexual urges, can increase the risk for sexual offending and are therefore important to consider regarding possible future lockdowns. [ABSTRACT FROM AUTHOR]

Objective: Eating disorders (EDs) often co‐occur with social anxiety disorder (SAD). However, little research has examined the influence of SAD symptoms on ED treatment outcomes in the context of individual outpatient cognitive‐behavior therapy for eating disorders (CBT‐ED). It is plausible that SAD symptom severity could improve as a result of ED treatment, given the high overlap between EDs and SAD. We sought to test whether baseline SAD symptoms moderate early response to CBT‐ED or post‐treatment outcomes in CBT‐ED, and the degree to which SAD symptoms improve during therapy despite SAD not being an explicit treatment target. Method: ED clients (N = 226) aged ≥16 years were treated with CBT‐ED. Outcomes were ED symptoms, clinical impairment, and SAD symptoms measured at baseline, session 5 and post‐treatment. Results: Baseline SAD was a weak moderator of early and post‐treatment ED symptoms and impairment. SAD symptoms improved moderately over treatment among clients who started with elevated levels of SAD symptomology. Discussion: Clients with EDs can experience good therapeutic outcomes regardless of their social anxiety severity at pre‐treatment. SAD symptoms reduced over CBT‐ED, but protocol enhancements such as exposure‐based strategies that directly target co‐occurring social‐evaluative concerns may help achieve larger reductions in SAD symptoms. Public significance: Eating disorders often co‐occur with anxiety disorders such as social anxiety. We found people who had both social anxiety and an eating disorder benefited as much from eating disorder treatment as people who did not have social anxiety. People who were socially anxious became less anxious as a by‐product of receiving eating disorder treatment. It may be possible to reduce social anxiety further by enhancing eating disorder treatment protocols. [ABSTRACT FROM AUTHOR]

Abstract Background Common clinical sense would suggest that individuals with milder obsessive-compulsive disorder (OCD) symptoms should be the most suitable for guided internet-delivered cognitive behaviour therapy (CBT), with more intensive forms of treatment reserved for more severe or complex cases. Results In this secondary data analysis of a non-inferiority clinical trial comparing internet-delivered CBT with in-person CBT for young people with OCD (N = 152), we found that higher baseline symptom severity predicted worse treatment outcomes in the in-person group but not the internet-delivered CBT group. Additional analyses showed that among individuals with milder symptoms, internet-delivered CBT was associated with worse outcomes than in-person CBT. Conclusions If replicated, these results would question the axiom that internet-delivered CBT is most suitable for milder cases. Trial registration The original trial was registered at ClinicalTrials.gov ID NCT03263546. Date of registration 2017–08–28.

The article offers information on evidence-based approaches for treating obsessive-compulsive disorder (OCD) as outlined in the latest clinical guideline. Topics discussed include the evolution of OCD's classification in the DSM-5; the effectiveness of cognitive-behavioral therapy (CBT) as a frontline treatment; and the incorporation of recent advances in therapeutic practices and access to treatment.

• Grief-focused CBTs have the strongest evidence to support their use in treating PGD. • Effects of PGD psychotherapies for racially/ethnically diverse populations are unclear. • Uniform diagnoses/measures of grief will support efforts to improve PGD treatments. Prolonged grief disorder (PGD) is a distinct diagnostic entity that has recently garnered considerable attention as it describes an intense, enduring, distressing and disabling bereavement reaction experienced by a small minority of community-based mourners. In recent decades, research has exploded to address how best to treat PGD with different psychotherapeutic interventions. In this state-of-the-science review, the strength of the evidence will be discussed regarding common psychotherapeutic interventions used to treat grief. Specifically, we focus on the most commonly used interventions, cognitive behavioral (CB)-based therapies, bereavement and support groups, and brief contact interventions (BCIs), in an effort to summarize the relevant clinical takeaways of the current available research. A discussion of the use of these therapies in specific clinical populations is also included, with a focus on those traumatically bereaved, pediatric populations, communities of color, and underserved communities. Important foci and directions for future research are also discussed. [ABSTRACT FROM AUTHOR]

Individuals with social anxiety disorder (SAD) experience overall emotion regulation difficulties, but less is known about the long-term role of such difficulties in cognitive behavior therapy (CBT) for SAD. Forty-six patients with SAD receiving internet-delivered CBT, and matched healthy controls (HCs; n = 39), self-reported the Difficulties in Emotion Regulation Scale (DERS), Liebowitz Social Anxiety Scale (LSAS-SR), and participated in anticipatory speech anxiety behavioral experiments. Patients were measured at seven time points before, during and after CBT over a total period of 28 months, and HCs at two timepoints. Disaggregated growth curve models with a total of 263 observations were used, as well as intra-class correlation coefficients and regression models. Patients’ LSAS-SR and DERS ratings were reliable (ICC = .83 and .75 respectively), and patients, relative to controls, showed larger difficulties in emotion regulation at pre-treatment (p < .001). During CBT, within-individual improvements in emotion regulation significantly predicted later LSAS-SR reductions (p = .041, pseudo-R2 = 43%). Changes in emotion regulation may thus be important to monitor on an individual level and may be used to improve outcomes in future developments of internet-delivered CBT. [ABSTRACT FROM AUTHOR]

Treatment assignment for patients with personality disorders (PDs) involves a complex process consisting of diagnostic assessment and deciding on the most appropriate psychotherapeutic treatment. This article describes the development of a checklist for systematic analysis of life stories to support reflective and transparent assignment of patients to either dialectical behavioral therapy (DBT) or schema-focused therapy (SFT). In a first study, an email survey, focus group, and member check were conducted among eight clinical experts to identify relevant dimensions in life stories in patients with PDs. In a second study, a checklist based on these dimensions was developed in three rounds of testing with nine clinical experts and nine psychology students. Checklist results were compared to actual assigned treatment for 20 patients. Systematic evaluation of life stories, is promising in supporting the allocation of patients with PDs to a suitable treatment approach by focusing on specific and consensual dimensions in patients' life stories. [ABSTRACT FROM AUTHOR]

The objective of this systematic review is to examine the effectiveness of psychotherapy in treating Post-Traumatic Stress Disorder (PTSD) in military personnel. PubMed, Web of Science, The Cochrane Library, EBSCO and CNKI databases were searched from 1 January, 2000 to November 2022 for Randomized Controlled Trials (RCTs) on psychotherapeutic interventions for military PTSD. The physical Therapy Evidence Database (PEDro) scale was used to evaluate the quality of the literature. Two researchers conducted literature screening, data extraction, and risk bias assessment in accordance with inclusion and exclusion criteria. Ultimately, 49 RCTs were included, involving a total of 5073 veterans, retired and active military from four countries. The average score on the PEDro scale was 7.60. The primary psychotherapeutic modalities for military PTSD intervention include Cognitive-Behavioral Therapy, Exposure Therapy, Mindfulness interventions, psychotherapy based on new technological tools, and other emerging psychotherapeutic tools. The review highlights that Cognitive Processing Therapy (CPT) and Prolonged Exposure Therapy (PET) stand out as the primary psychotherapeutic modalities for treating PTSD in military personnel. In cases where CPT and PET yield limited benefits, Mindfulness interventions emerge as effective alternatives. Moreover, considering the diverse needs and high dropout rates in the military, population, the review suggests using web-based, computer, and virtual reality technology tools as supplements to first-line treatments (CPT/PET) to enhance overall intervention effectiveness. For the advancement of future psychotherapeutic initiatives, there is a pronounced emphasis on prioritizing proven first-line interventions, CPT and PET while also recognizing the potential of mindfulness-based interventions as credible alternatives. In tandem with this, the active integration of technological tools is advocated to amplify the therapeutic impact of conventional psychological treatment modalities. Supplementary Material Supplementary Material File [ABSTRACT FROM AUTHOR]

Background: Individuals with anxiety disorders (ADs) often display hypervigilance to threat information, although this response may be less pronounced following psychotherapy. This study aims to investigate the unconscious recognition performance of facial expressions in patients with panic disorder (PD) posttreatment, shedding light on alterations in their emotional processing biases. Methods: Patients with PD (n=34) after (exposure-based) cognitive behavior therapy and healthy controls (n=43) performed a subliminal affective recognition task. Emotional facial expressions (fearful, happy, or mirrored) were displayed for 33 ms and backwardly masked by a neutral face. Participants completed a forced choice task to discriminate the briefly presented facial stimulus and an uncovered condition where only the neutral mask was shown. We conducted a secondary analysis to compare groups based on their four possible response types under the four stimulus conditions and examined the correlation of the false alarm rate for fear responses to non-fearful (happy, mirrored, and uncovered) stimuli with clinical anxiety symptoms. Results: The patient group showed a unique selection pattern in response to happy expressions, with significantly more correct "happy" responses compared to controls. Additionally, lower severity of anxiety symptoms after psychotherapy was associated with a decreased false fear response rate with nonthreat presentations. Conclusion: These data suggest that patients with PD exhibited a "happy-face recognition advantage" after psychotherapy. Less symptoms after treatment were related to a reduced fear bias. Thus, a differential facial emotion detection task could be a suitable tool to monitor response patterns and biases in individuals with ADs in the context of psychotherapy. [ABSTRACT FROM AUTHOR]

Fibromyalgia is a debilitating pain condition for which treatment effects are typically modest. The most evaluated psychological treatment is traditional cognitive behavior therapy (T-CBT), but promising effects have recently been seen in exposure-based cognitive behavior therapy (Exp-CBT). We investigated whether Exp-CBT was superior to T-CBT in a randomized controlled trial. Self-referred participants with fibromyalgia (N = 274) were randomized (1:1) to 10 weeks of Exp-CBT or T-CBT. Treatments were delivered online and presented as "CBT for fibromyalgia." Participants were assessed at baseline, weekly during treatment, posttreatment, and at 6- and 12-month follow-up. Primary outcome was the difference in reduction in fibromyalgia severity as measured using the Fibromyalgia Impact Questionnaire (FIQ) over 11 assessment points from baseline to posttreatment, modelled within an intention-to-treat framework using linear mixed effects models fitted on multiple imputed data. Approximately 91% of weekly FIQ scores were collected over the main phase. There was no significant difference between Exp-CBT and T-CBT in the mean reduction of fibromyalgia severity from pretreatment to posttreatment (b = 1.3, 95% CI -3.0 to 5.7, P = 0.544, d = -0.10). Minimal clinically important improvement was seen 60% in Exp-CBT vs 59% in T-CBT. Effects were sustained up to 12 months posttreatment. This well-powered randomized trial indicated that Exp-CBT was not superior to T-CBT for fibromyalgia. Both treatments were associated with a marked reduction in fibromyalgia severity, and the online treatment format might be of high clinical utility. T-CBT can still be regarded a reference standard treatment that remains clinically relevant when compared to novel treatment approaches. [ABSTRACT FROM AUTHOR]

Background: We compared dissociative seizure specific cognitive behavior therapy (DS-CBT) plus standardized medical care (SMC) to SMC alone in a randomized controlled trial. DS-CBT resulted in better outcomes on several secondary trial outcome measures at the 12-month follow-up point. The purpose of this paper is to evaluate putative treatment mechanisms. Methods: We carried out a secondary mediation analysis of the CODES trial. 368 participants were recruited from the National Health Service in secondary / tertiary care in England, Scotland, and Wales. Sixteen mediation hypotheses corresponding to combinations of important trial outcomes and putative mediators were assessed. Twelve-month trial outcomes considered were final-month seizure frequency, Work and Social Adjustment Scale (WSAS), and the SF-12v2, a quality-of-life measure providing physical (PCS) and mental component summary (MCS) scores. Mediators chosen for analysis at six months (broadly corresponding to completion of DS-CBT) included: (a) beliefs about emotions, (b) a measure of avoidance behavior, (c) anxiety and (d) depression. Results: All putative mediator variables except beliefs about emotions were found to be improved by DS-CBT. We found evidence for DS-CBT effect mediation for the outcome variables dissociative seizures (DS), WSAS and SF-12v2 MCS scores by improvements in target variables avoidance behavior, anxiety, and depression. The only variable to mediate the DS-CBT effect on the SF-12v2 PCS score was avoidance behavior. Conclusions: Our findings largely confirmed the logic model underlying the development of CBT for patients with DS. Interventions could be additionally developed to specifically address beliefs about emotions to assess whether it improves outcomes. [ABSTRACT FROM AUTHOR]

Inhibitory learning (IL) theory offers promising therapeutic strategies. However, more evidence is needed, especially regarding OCD treatment in routine care. The present pilot study investigated the positive and negative effects of IL-focused cognitive-behavioral therapy (CBT) in a university outpatient setting. A total of N = 21 patients (57.14% male, mean age 31.14, SD = 12.39 years) passed through manualized therapy delivered by licensed psychotherapists. Between the first and 20th IL-focused CBT session, obsessive-compulsive symptoms (Obsessive Compulsive Inventory-Revised, d = 3.71), obsessive beliefs (Obsessive-Beliefs Questionnaire, d = 1.17), depressive symptoms (Beck Depression Inventory, d = 3.49), and overall psychological distress (Global Severity Index, d = 3.40) decreased significantly (all ps < 0.01). However, individual patients reported some negative effects of therapy. The results underline the value of thorough investigations of novel therapeutic interventions in naturalistic settings. [ABSTRACT FROM AUTHOR]

Perfectionism can be problematic when your self-worth is dependent on achievements and leads to inflexible standards, cognitive biases, and rigid behaviors. Cognitive behavior therapy for perfectionism is shown to be effective, including for targeting psychiatric symptoms and when delivered via the Internet (iCBT-P). However, few studies have compared it to an active comparator. The current study randomly assigned 138 participants seeking help for perfectionism to iCBT-P or Internet-based Unified Protocol (iUP). Both treatments provided guidance on demand from a therapist and were eight weeks in duration. The results indicated large within-group effects of Cohen's d 2.03 (iCBT) and 2.51 (iUP) on the Clinical Perfectionism Questionnaire at post-treatment, and maintained effects at 6- and 12-month follow-up, but no between-group difference (β = 0.02, SE = 1.04, p =.98). Secondary outcomes of depression, anxiety, quality of life, self-compassion, procrastination, and stress ranged from small to large, with no differences between the conditions. Both treatments were deemed credible, relevant, of high quality, and well-adhered by the participants. Further research needs to be conducted, but the findings could indicate a lack of specificity, perhaps suggesting there is no need to differentiate between different treatments that are transdiagnostic in nature. [ABSTRACT FROM AUTHOR]

According to the cognitive behavioral approach, the basis of psychological disorders are dysfunctional thoughts that affect emotions and behavior. It is aimed to replace dysfunctional thoughts with functional thoughts by using various techniques. In social work practices, it is aimed to increase the social functionality of the individual by intervening in different problem areas such as poverty, unemployment, inability to effectively benefit from education and health services, alcohol and substance addiction, migration, abuse and violence. The main purpose of this study is to synthesize theory and practice by revealing how the cognitive behavioral approach, which is on the theoretical basis of social work, can be used in clinical social work practices. For this purpose, the study includes the history, scope, basic concepts of the cognitive behavioral approach, intervention techniques that can be used in clinical social work practice, and the skills that clinical social workers who adopt the cognitive behavioral approach should have. Finally, it is discussed how this approach can be used in which problem areas and for which client groups. Clinical social workers intervene with clients who have different psychosocial problems. In this study, it is aimed for clinical social workers to have an idea about which cognitive behavioral therapy techniques can be used and how. [ABSTRACT FROM AUTHOR]

Menopause, a crucial transitioning stage for women, can significantly impact mood and wellbeing. We aimed to evaluate the effectiveness of psychosocial interventions on non-physiological symptoms of menopause (depression, anxiety, cognition, and quality of life) through systematic review and meta-analysis. Five databases were searched from inception to August 2023 for randomized controlled trials. Pre- and post-test means and standard deviations for groups were extracted and used to calculate effect sizes. The effectiveness of Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Interventions (MBI) on depression and anxiety were examined by subgroup analysis. Thirty studies comprising 3501 women were included. From meta-analysis, mood symptoms significantly benefited from CBT (anxiety: d = −0.22, 95 % CI = -0.35, −0.10; depression: d = −0.33, 95 % CI = -0.45, −0.21) and MBI (anxiety: d = −0.56, 95 % CI = -0.74, −0.39; depression: d = −0.27, 95 % CI = -0.45, −0.09). Psychosocial interventions were also found to significantly improve cognition (d = −0.23, 95 % CI = -0.40, −0.06) and quality of life (d = −0.78, 95 % CI = -0.93, −0.63). Mean total therapy hours ('dose') was lower for CBT (11.3) than MBI (18.6), indicating reduced costs and burden for women. Data regarding menopausal status were not collected, limiting our ability to identify the optimal timing of interventions. Potential longer-term, effects of interventions were not investigated. Our review highlighted the value of psychosocial interventions in improving non-physiological symptoms (particularly depression and anxiety) during menopause, noting the heterogeneity of findings and importance of implementing effective interventions. • Menopausal transition can significantly impact depression, anxiety and cognition. • Psychosocial interventions include Cognitive Behavioral Therapy and Mindfulness. • Psychosocial interventions can improve anxiety and depression in menopause. • Psychosocial interventions may help cognition in menopause. More research is needed. [ABSTRACT FROM AUTHOR]

Clinical guidelines and some studies recommend cognitive-behavioral therapy (CBT) as the most effective treatment for body dysmorphic disorder (BDD). However, owing to the lack of randomized controlled trials (RCTs), the research evidence is insufficient. This study aimed to explore the effectiveness of CBT in the treatment of BDD using RCTs. This meta-analysis was registered in PROSPERO (CRD42023410577). After a literature search and screening, 11 RCTs with 667 patients were included. The ROB 2.0 tool, funnel plots, sensitivity analysis, and meta-regression analysis were used to assess the quality, publication bias, and sources of heterogeneity. After CBT intervention, the severity of BDD (SMD = −1.73, 95 % CI (confidence interval) = [−2.90; −0.57]), depression symptoms (SMD = −1.72, 95 % CI = [−3.16; −0.28]), and anxiety levels were all reduced in the patients of the experimental group; the remission of BDD (OR = 7.37, 95 % CI = [2.17; 24.98]) and the response of BDD (OR = 8.86, 95 % CI = [4.85; 16.18]) were all increased; incorrect beliefs such as disability and BABS were also reduced; the quality of life was improved. The difference between the groups was statistically significant (p < 0.01). Meta-regression analysis showed that age and sample size were the predictive factors of the effectiveness of CBT. The heterogeneity of most meta-analyses was high (I2 > 75 %). Although CBT is effective in treating BDD, there is insufficient evidence to suggest that it is the best psychological intervention for BDD. More high-quality evidence is still needed in the future. • This study systematically evaluated the efficacy of cognitive behavioral therapy (CBT) in the treatment of body dysmorphic disorder (BDD). • This study explored the impact of CBT on obsessive-compulsive behavior, adverse cognition, psychological state and prognosis of BDD patients. • Compared with previous meta-analysis, the quality of the included studies is high, the sample size is large, and the research indicators are rich. [ABSTRACT FROM AUTHOR]

Background: Cognitive behavior therapy (CBT) is a proven treatment for many psychological disorders. It has been extensively studied and is effective for anxiety, depression, and schizophrenia. However, a bibliometric analysis of the CBT literature for these disorders is needed. This study reviewed this field's research and identifies key trends, influential studies, and gaps. Methods: Using MeSH-generated keywords and PRISMA guidelines, the Scopus database retrieved bibliographic data without temporal or geographical constraints. Data-driven studies were analyzed for performance, collaborative pattern, impact, co-word frequency, knowledge structure, and trending topics using R-package-based Bibliometrix and VOSviewer applications. The current study applied bibliometric and statistical analyses. Results: Scopus yielded 2757 studies since inception in 1979. The polynomial regression coefficient of 0.945 (R2) indicates a strong positive trend, and the research has increased at an annual rate of 12.67 %. Scholars from five countries had a noteworthy production of CBT research in treating PsD, namely the United States, the United Kingdom, Germany, Australia, and the Netherlands. Depression, oppositional defiant disorder, schizophrenia, and implementation are the clusters in the CBT research map. The thematic map needed to meet the desired criteria for representing all anticipated themes. Thematic evolution is evidence of noticeable changes that contributed to the creation of new research clusters and the disappearance of some of them. COVID-19 has significantly impacted the adoption and efficacy of internet-based interventions for mental health. The cross-sectional study provides valuable insights into the development and dissemination of CBT in Saudi Arabia, emphasizing the importance of training, awareness, and research. Conclusions: This study proposes that further investigation be conducted in contemporary literature to create a comprehensive framework for enhancing policy decisions regarding CBT.

Abstract Insomnia and poor sleep are associated with an increased risk of developing cardiovascular disease (CVD) and its precursors, including hypertension. In 2022, the American Heart Association (AHA) added inadequate sleep to its list of health behaviors that increase the risk for CVD. It remains unknown, however, whether the successful treatment of insomnia and inadequate sleep can reduce heightened CVD risk. SLEEPRIGHT is a single‐site, prospective clinical trial designed to evaluate whether the successful treatment of insomnia results in improved markers of CVD risk in patients with untreated hypertension and comorbid insomnia disorder. Participants (N = 150) will undergo baseline assessments, followed by a 6‐week run‐in period after which they will receive cognitive behavior therapy for insomnia (CBT‐I), comprised of 6 hourly sessions with an experienced CBT‐I therapist over a 6‐week period. In addition to measures of insomnia severity, as well as both subjective and objective measures of sleep, the primary outcome measures are nighttime blood pressure (BP) and BP dipping assessed by 24‐h ambulatory BP monitoring (ABPM). Secondary outcomes include several CVD risk biomarkers, including clinic BP, lipid profile, vascular endothelial function, arterial stiffness, and sympathetic nervous system (SNS) activity. Data analysis will evaluate the association between improvements in insomnia and sleep with primary and secondary CVD risk biomarker outcomes. The SLEEPRIGHT trial (ClinicalTrials.Gov NCT04009447) will utilize CBT‐I, the current gold standard treatment for insomnia disorder, to evaluate whether reducing insomnia severity and improving sleep are accompanied by improved biomarkers of CVD risk in patients with untreated hypertension.

Abstract Objective Mental health complaints are prevalent among people with epilepsy, yet there are major barriers that prevent access to psychological care, including high out‐of‐pocket costs and a lack of accessible specialized services. The purpose of the current study is to examine the comparative efficacy, acceptability, cost‐effectiveness, and long‐term outcomes of a digital psychological intervention when delivered under two models of care (i.e., guided vs. unguided) in supporting the mental health and functioning of adults with epilepsy. Method Approximately 375 participants across Australia will be enrolled. Eligible participants will have a confirmed diagnosis of epilepsy, experience difficulties with their emotional health, be at least 18 years of age, and live in Australia. Participants will be randomized (2:2:1) to receive the Wellbeing Neuro Course, a 10‐week internet‐delivered program, with (i.e., guided) or without guidance by a mental health clinician (i.e., unguided), or be allocated to a treatment‐as‐usual waiting‐list control group. Participants will complete online questionnaires at pre‐, post‐treatment, and 3‐ and 12‐month follow‐up and consent to have their data linked to their medical records to capture healthcare system resource use and costs. Analysis Primary outcome measures will be symptoms of depression and anxiety. A cost‐utility analysis will be undertaken using the Australian healthcare system perspective and according to current economic evaluation guidelines. Resource use and costs to the healthcare system during the study period will be captured via data linkage to relevant administrative datasets in Australia. Significance The results of this trial will provide important data concerning the relative outcomes of these different models of care and will inform the integration of digital psychological interventions translation into healthcare services. Ethics and Dissemination The Human Research Ethics Committee of Macquarie University approved the proposed study (Reference No: 520231325151475). The results will be disseminated through peer‐reviewed publication(s). ANZCTR Trial Registration Number ACTRN12623001327673. Plain Language Summary This study seeks to find out if a 10‐week online psychological treatment can improve the mental health and well‐being of Australian adults with epilepsy. Around 375 participants will be randomly assigned to different groups: one will receive treatment with guidance from mental health clinician (guided group), one without guidance (unguided group), and one starting later (waiting control group). All participants will fill out the same outcome measures online. The main goal of this research is to compare these groups and assess how well the treatment works in improving mental health outcomes.

The purpose of this study was to compare the effectiveness of acceptance and commitment therapy and cognitive behavior therapy on female sexual interest/arousal disorder, sexual intimacy and sexual self- concept of married women referring to counseling centers in Isfahan city. This was a quasi-experimental design with pretest, posttest, three months follow up and control group. The population included married women with sexual interest arousal problems who responded to calls from counseling centers. 45 Samples were selected with Diagnostic and Statistical Manual of Mental Disorders-fifth edition criteria and female sexual function questionnaire scores. Subjects were randomly assigned in two experimental groups and control group. The experimental groups received 8 sessions 90 minutes weekly intervention. The instruments used in this study included Rosen Female Sexual Function Questionnaire, Botlani Sexual Intimacy Questionnaire and Snell Sexual Self- Concept Questionnaire. Data analysis was performed by analysis of covariance with repeated measures. The results showed that both treatment approaches had a significant effect on all three variables. (P>0.05). And there was no significant difference between the two treatment approaches. Thus, both therapeutic interventions can be used to improve sexual desire / arousal disorders and increase sexual intimacy and sexual self-concept.

Insomnia and poor sleep are associated with an increased risk of developing cardiovascular disease (CVD) and its precursors, including hypertension. In 2022, the American Heart Association (AHA) added inadequate sleep to its list of health behaviors that increase the risk for CVD. It remains unknown, however, whether the successful treatment of insomnia and inadequate sleep can reduce heightened CVD risk. SLEEPRIGHT is a single‐site, prospective clinical trial designed to evaluate whether the successful treatment of insomnia results in improved markers of CVD risk in patients with untreated hypertension and comorbid insomnia disorder. Participants (N = 150) will undergo baseline assessments, followed by a 6‐week run‐in period after which they will receive cognitive behavior therapy for insomnia (CBT‐I), comprised of 6 hourly sessions with an experienced CBT‐I therapist over a 6‐week period. In addition to measures of insomnia severity, as well as both subjective and objective measures of sleep, the primary outcome measures are nighttime blood pressure (BP) and BP dipping assessed by 24‐h ambulatory BP monitoring (ABPM). Secondary outcomes include several CVD risk biomarkers, including clinic BP, lipid profile, vascular endothelial function, arterial stiffness, and sympathetic nervous system (SNS) activity. Data analysis will evaluate the association between improvements in insomnia and sleep with primary and secondary CVD risk biomarker outcomes. The SLEEPRIGHT trial (ClinicalTrials.Gov NCT04009447) will utilize CBT‐I, the current gold standard treatment for insomnia disorder, to evaluate whether reducing insomnia severity and improving sleep are accompanied by improved biomarkers of CVD risk in patients with untreated hypertension. [ABSTRACT FROM AUTHOR]

Objective: Mental health complaints are prevalent among people with epilepsy, yet there are major barriers that prevent access to psychological care, including high out‐of‐pocket costs and a lack of accessible specialized services. The purpose of the current study is to examine the comparative efficacy, acceptability, cost‐effectiveness, and long‐term outcomes of a digital psychological intervention when delivered under two models of care (i.e., guided vs. unguided) in supporting the mental health and functioning of adults with epilepsy. Method: Approximately 375 participants across Australia will be enrolled. Eligible participants will have a confirmed diagnosis of epilepsy, experience difficulties with their emotional health, be at least 18 years of age, and live in Australia. Participants will be randomized (2:2:1) to receive the Wellbeing Neuro Course, a 10‐week internet‐delivered program, with (i.e., guided) or without guidance by a mental health clinician (i.e., unguided), or be allocated to a treatment‐as‐usual waiting‐list control group. Participants will complete online questionnaires at pre‐, post‐treatment, and 3‐ and 12‐month follow‐up and consent to have their data linked to their medical records to capture healthcare system resource use and costs. Analysis: Primary outcome measures will be symptoms of depression and anxiety. A cost‐utility analysis will be undertaken using the Australian healthcare system perspective and according to current economic evaluation guidelines. Resource use and costs to the healthcare system during the study period will be captured via data linkage to relevant administrative datasets in Australia. Significance: The results of this trial will provide important data concerning the relative outcomes of these different models of care and will inform the integration of digital psychological interventions translation into healthcare services. Ethics and Dissemination: The Human Research Ethics Committee of Macquarie University approved the proposed study (Reference No: 520231325151475). The results will be disseminated through peer‐reviewed publication(s). ANZCTR Trial Registration Number: ACTRN12623001327673. Plain Language Summary: This study seeks to find out if a 10‐week online psychological treatment can improve the mental health and well‐being of Australian adults with epilepsy. Around 375 participants will be randomly assigned to different groups: one will receive treatment with guidance from mental health clinician (guided group), one without guidance (unguided group), and one starting later (waiting control group). All participants will fill out the same outcome measures online. The main goal of this research is to compare these groups and assess how well the treatment works in improving mental health outcomes. [ABSTRACT FROM AUTHOR]

Studies shown that young adults are more prone to develop mental health problems. One of the feature in emerging adulthood – instability, makes them more vulnerable to depression compared to other age groups. Many studies have demonstrated similar effectiveness between cognitive behavior therapy (CBT) and acceptance and commitment therapy (ACT) on depression. However, previous studies have been focusing more on education settings rather than emerging adults in general, and more on western countries compared to eastern cultures where they prioritize collectivism. Presently, generation Z is the one that still going through the emerging adulthood phase. They have different exposures and preferences towards technology and social media compared to the older generations. Thus, it is beneficial to keep researching on what is the therapy that works best for them. Hence, this study examines the effectiveness of CBT and ACT on depression and anxiety symptoms among emerging adults in Malaysia. This is an experimental study with pre-post-test design that involved 102 emerging adults. They were assigned into two treatment groups (CBT and ACT) and one control group through random assignment. The questionnaires involved are Beck Depression Inventory II and Beck Anxiety Inventory. There is a statistically significant difference in depression at post-test between ACT and control, but not between CBT and control, and between CBT and ACT. At follow-up, depression scores differ significantly between CBT and control, as well as between ACT and control. No significant difference among the groups in anxiety symptoms at post-test and follow-up. ACT seems to be more superior compared to CBT and control group in terms of depression post-test and follow-up. For anxiety, CBT and ACT exhibit similar reductions at post-test, with ACT showing more improvement at follow-up. Since eastern cultures seems to be more responsive of acceptance-based therapy compared to the western counterparts, therefore ACT is one of the best option to manage Malaysian emerging adults with depression symptoms. Future study could emphasize more on emerging adults who have limited access to higher education such as those in rural areas. [ABSTRACT FROM AUTHOR]

This article explores the concept of grounded cognition and its potential impact on cognitive-oriented cognitive behavioral therapy (CBT). It challenges the traditional view of cognition as purely information-based and suggests that cognition is closely tied to our experiences through brain simulations. The author argues for the adoption of a grounded cognition model in CBT, which takes into account biological influences on cognition. This shift in perspective could have practical implications for therapy, such as using affective methods to change beliefs and diversifying interventions aimed at changing irrational beliefs. The article also emphasizes the importance of understanding the connection between cognition and emotion in therapy. [Extracted from the article]

Objective: Emerging research indicates that skills acquisition may be important to behavior change in cognitive behavior therapy (CBT) for eating disorders. This study investigated whether skills use assessed in real time during the initial 4 weeks of CBT‐based day treatment was associated with momentary eating disorder behavior change and rapid response to treatment. Methods: Participants with DSM‐5 bulimia nervosa or purging disorder (N = 58) completed ecological momentary assessments (EMA) several times daily for the first 28 days of treatment. EMA assessed skills use, the occurrence of binge eating and/or purging, and state negative affect. Rapid response was defined as abstinence from binge eating and/or purging in the first 4 weeks of treatment. Results: Greater real‐time skills use overall, and use of "planning ahead," "distraction," "social support," and "mechanical eating" skills in particular, were associated with a lower likelihood of engaging in binge eating or purging during the same period. After controlling for baseline group differences in overall difficulties with emotion regulation, rapid and non‐rapid responders did not differ in overall skills use, or skills use at times of higher negative affect, during the EMA period. Discussion: Momentary use of skills appears to play an important role in preventing binge eating and purging, and certain skills appear to be particularly helpful. These findings contribute to the literature elucidating the processes by which CBT treatments for eating disorders work by providing empirical evidence that skills use helps to prevent binge eating and purging behaviors. Public Significance: Individuals with eating disorders learn new skills during treatment to help them improve their symptoms. This study shows that for people with eating disorders, using skills helps prevent eating disorder behaviors in the moment. Certain skills may be particularly helpful, including planning ahead, distracting activities, support from others, and focusing on eating meals and snacks regardless of how one is feeling. These findings help us better understand how treatments work. [ABSTRACT FROM AUTHOR]

Individuals with traumatic brain injury (TBI) are at increased risk of depression and anxiety, leading to impaired recovery. While cognitive-behavioral therapy (CBT) addresses anxiety and depression maintenance factors, its efficacy among those with TBI has not been clearly demonstrated. This review aims to bridge this gap in the literature. Several databases, including Medline, PsycInfo and EMBASE, were used to identify studies published between 1990 and 2021. Studies were included if: (1) trials were randomized controlled trials (RCT) involving CBT-based intervention targeting anxiety and/or depression; (2) participants experienced brain injury at least 3-months previous; (3) participants were ≥18 years old. An SMD ± SE, 95% CI and heterogeneity were calculated for each outcome. Thirteen RCTs were included in this meta-analysis. The pooled-sample analyses suggest that CBT interventions had small immediate post-treatment effects on reducing depression (SMD ± SE: 0.391 ± 0.126, p < 0.005) and anxiety (SMD ± SE: 0.247 ± 0.081, p < 0.005). Effects were sustained at a 3-months follow-up for depression. A larger effect for CBT was seen when compared with supportive therapy than control. Another sub-analysis found that individualized CBT resulted in a slightly higher effect compared to group-based CBT. This meta-analysis provides substantial evidence for CBT in managing anxiety and depression post-TBI. [ABSTRACT FROM AUTHOR]

Debate is ongoing on the efficacy of cognitive behavior therapy (CBT) for myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). With an individual patient data (IPD) meta-analysis we investigated whether the effect of CBT varied by patient characteristics. These included post-exertional malaise (PEM), a central feature of ME/CFS according to many. We searched for randomized controlled trials similar with respect to comparison condition, outcomes and treatment-protocol. Moderation on fatigue severity (Checklist Individual Strength, subscale fatigue severity), functional impairment (Sickness Impact Profile-8) and physical functioning (Short Form-36, subscale physical functioning) was investigated using linear mixed model analyses and interaction tests. PROSPERO (CRD42022358245). Data from eight trials (n = 1298 patients) were pooled. CBT showed beneficial effects on fatigue severity (β = −11.46, 95% CI −15.13 to −7.79); p < 0.001, functional impairment (β = −448.40, 95% CI −625.58 to −271.23); p < 0.001; and physical functioning (β = 9.64, 95% CI 3.30 to 15.98); p < 0.001. The effect of CBT on fatigue severity varied by age (p interaction = 0.003), functional impairment (p interaction = 0.045) and physical activity pattern (p interaction = 0.027). Patients who were younger, reported less functional impairments and had a fluctuating activity pattern benefitted more. The effect on physical functioning varied by self-efficacy (p interaction = 0.025), with patients with higher self-efficacy benefitting most. No other moderators were found. It can be concluded from this study that CBT for ME/CFS can lead to significant reductions of fatigue, functional impairment, and physical limitations. There is no indication patients meeting different case definitions or reporting additional symptoms benefit less from CBT. Our findings do not support recent guidelines in which evidence from studies not mandating PEM was downgraded. [ABSTRACT FROM AUTHOR]

• Transgender and gender diverse (TGD) people experience health disparities. • CBT interventions must be tailored to TGD people to address these disparities. • Case vignettes are used to demonstrate CBT principles tailored to TGD clients. Mental and physical health disparities for transgender and gender diverse (TGD) communities have been well-documented. While advancements have been made in the development of guidelines when providing mental health care to TGD clients, gaps remain, particularly related to concrete applications of cognitive behavior therapy (CBT) approaches to address the unique mental health needs of TGD people. Such gaps leave many mental health professionals inadequately prepared to assess and treat clinical distress in TGD people, which in turn maintains health disparities. Utilizing case vignettes reflecting diverse TGD identities, this paper discusses minority stress and intersectional stigma frameworks and demonstrates their integration with CBT principles in the delivery of culturally tailored assessment, case conceptualization, and treatment of TGD clients. [ABSTRACT FROM AUTHOR]

Internet-based psychological treatments for depression have been around for more than 20 years. There has been a continuous line of research with new research questions being asked and studies conducted. In this paper, the author reviews studies with a focus on papers published from 2020 and onwards based on a Medline and Scopus search. Internet-based cognitive behavior therapy (ICBT) programs have been developed and tested for adolescents, older adults, immigrant groups and to handle a societal crisis (e.g. COVID-19). ICBT works in regular clinical settings and long-term effects can be obtained. Studies on different treatment orientations and approaches such as acceptance commitment therapy, unified protocol, and tailored treatments have been conducted. Effects on quality-of-life measures, knowledge acquisition and ecological momentary assessment as a research tool have been reported. Factorial design trials and individual patient data meta-analysis are increasingly used in association with internet intervention research. Finally, prediction studies and recent advances in artificial intelligence are mentioned. Internet-delivered treatments are effective, in particular if therapist guidance is provided. More target groups have been covered but there are many remaining challenges including how new tools like artificial intelligence will be used when treating depression. [ABSTRACT FROM AUTHOR]

In post war regions, especially in low-income countries, the health care systems often require immediate support. For example, after the terror of the so-called Islamic State of Iraq and Syria (ISIS) in 2014, many internally displaced persons took refuge in the Kurdistan Region of Iraq (KRI). Those displaced by war have had to face the reality that psychotherapy did not exist as a service in the Kurdish health system. Many projects and Non-Government-Organizations (NGOs) that work in post-conflict regions focus on short term and quick response and/or basic psychological services. The implementation of the “Institute for Psychotherapy and Psychotraumatology” (IPP) at the University of Dohuk, follows a long-term approach. The 3-year-program teaches students to become professional psychotherapists, with respect to evidence-based and culturally adapted methods of psychotherapy. To achieve sustainability, the project is working towards handing over the teaching and organizational responsibilities into local hands. This article highlights the chances and challenges during this transition, as well as the importance of cultural understanding and realistic, practical solutions. An honest reflection on existing cultural challenges, e.g. inflexible hierarchical structures or an “old-fashioned” religious view of homosexuality, can then lead to practical solutions. These include winning over local authorities by including them in the process, culturally adapting to customs with the help of educated locals, demonstrating non-authoritarian forms of leadership, and explicitly promoting newly graduated young lecturers into positions of authority.

Inhibitory learning (IL) theory offers promising therapeutic strategies. However, more evidence is needed, especially regarding OCD treatment in routine care. The present pilot study investigated the positive and negative effects of IL-focused cognitive-behavioral therapy (CBT) in a university outpatient setting. A total of N = 21 patients (57.14% male, mean age 31.14, SD = 12.39 years) passed through manualized therapy delivered by licensed psychotherapists. Between the first and 20th IL-focused CBT session, obsessive-compulsive symptoms (Obsessive Compulsive Inventory-Revised, d = 3.71), obsessive beliefs (Obsessive-Beliefs Questionnaire, d = 1.17), depressive symptoms (Beck Depression Inventory, d = 3.49), and overall psychological distress (Global Severity Index, d = 3.40) decreased significantly (all ps

Individuals with disabilities are more vulnerable to depression development than the general population. This study sought to map the evidence on current knowledge of depression, intervention strategies, and assessment tools among people with disabilities. This review was conducted following Arksey and O′Malley’s scoping review methodology framework. An electronic search was performed on four English databases: PubMed, Cochrane Library, PsycINFO, and Web of Science. The original search returned 1802 results, with 1,116 from Web of Science, 626 from PubMed, 25 from Cochrane, and 35 from PsycINFO. After removing duplicates, 786 articles were chosen for the title and abstract screening processes. Finally, 112 full-text publications were deemed eligible, with 41 papers being included in this scoping review for analysis. A large proportion (32; 78.04%) of the studies chosen were cross-sectional, 14 (34.14%) of them reported general disability, 12 (29.26%) used a patient health questionnaire (PHQ-9) to measure depression, and 14 (34.14%) had interventions, including cognitive behavioral therapy, psychological counseling, social support, and physical activity. All interventions successfully reduced the severity of the depression. Cognitive behavioral therapies and psychological counseling were widely used interventions that had a significant impact on reducing depression. More randomized controlled trials are required, and they should focus on individuals with specific disabilities to provide disability-specific care that can improve the quality of life for disabled individuals.

Background and purpose: Major depressive disorder (MDD) is among the most common psychiatric diseases. Brain-derived neurotrophic factor (BDNF) is a suitable biomarker for treatment response. In the present research، serum changes of this biomarker were assessed between the two groups of MDD patients undergoing Fluoxetine therapy and cognitive-behavioral therapy (CBT). Materials and methods: In this randomized controlled trial study, 40 female MDD patients (DSM-V criteria) were assigned to two Fluoxetine therapy (20 mg/d for 3 months) (N=20) and CBT (90-minute sessions، once a week، for 12 weeks) (N=20) groups. The Beck Depression Inventory-II (BDI-II) score and serum BDNF concentration were measured before and after the treatment. The data were analyzed at a significance level of P≤0.05 using Graphpad prism 9 statistical software. Results: The BDI-II score significantly decreased in both Fluoxetine therapy (from 23.2±1.5 to 11.1±1.01) and CBT (from 26.8±0.6 to 9.5±0.8) groups. No significant change was observed in the serum BDNF level in the Fluoxetine therapy group، while it was increased in the CBT group (from 1.13±0.71 to 3 ± 0.72 ). The intergroup comparison after treatment indicated that the BDI-II score decrease and the serum BDNF increase were higher in the CBT group than in the Fluoxetine therapy group. Conclusion: The BDI-II score decrease and the serum BDNF increase were higher in the CBT group than in the Fluoxetine therapy group. Thus، it seems appropriate for MDD treatment. Serum BDNF is not an appropriate biomarker for treatment response. It is suggested that a study be conducted with a larger sample size and a longer investigation period. (Clinical Trials Registry Number: IRCT20190710044171N1)

Abstract Background Some of the women experience low self-esteem and negative body image in pregnancy and postpartum. These two factors along with other factors can reduce the rate of exclusive breastfeeding among women. Cognitive-behavior therapy (CBT) is one of the psychological approaches that is effective on the betterment of many of the psychological and personality disorders such as body image disorders as well as improvement of self-esteem. The aim of this randomized control trial is to recognize the effects of CBT during pregnancy period on self-esteem, body image (primary outcome) and exclusive breastfeeding (secondary outcome). Method In this randomized controlled trial, 70 eligible pregnant women referring to health centers of Tabriz- Iran were assigned to two groups of 35 as intervention and control groups using randomized blocking method. For intervention group, 8 sessions of CBT based on Cash and Strachan’s body image protocol and Michael Freeʼs for self-esteem were performed. Control group was received routine pregnancy care by their health provider. Rosenberg self-esteem scale and multidimensional body self-relation questionnaire (MBSRQ) were completed before intervention, immediately after intervention and 4 weeks after delivery. Likewise, exclusive breastfeeding questionnaire was completed 4 weeks after childbirth. Independent t-test, chi square and repeated measures ANOVA tests were used to analyze the data. Results According to repeated measures ANOVA test and with controlling baseline score, the mean scores on self-esteem (AMD): 7.18; 95%confidence interval (CI): 4.43 to 9.94; p

Objective:Method:Results:Conclusions:The objective was to test the hypothesis that externalizing and internalizing helpfulness beliefs and learning styles at baseline moderate panic severity and overall mental illness as short-term and long-term outcomes of two panic-focused psychotherapies, Panic Control Treatment (PCT) and Panic-Focused Psychodynamic Psychotherapy (PFPP).Participants were 108 adults with DSM-IV Panic Disorder with or without Agoraphobia (PD/A) who were randomized to treatment in a trial of PCT and PFPP. Piece-wise/segmented multilevel modeling was used to test three-way interactions (Treatments × Moderator × Time), with participants and therapists as random factors. Outcome variables were clinician-rated panic severity and self-rated mental illness post-treatment and during follow-up.Patients’ externalizing (but not internalizing) helpfulness beliefs moderated mental illness outcomes during follow-up (but not during treatment); low levels of Externalization were facilitative for PFPP but not PCT. Internalizing and externalizing helpfulness beliefs and learning style did not moderate clinician-rated panic severity, whether short- or long-term.These results suggest that helpfulness beliefs and learning style have limited use in assignment to either PCT or PFPP for PD/A. Although further research is needed, low levels of helpfulness beliefs about externalizing coping may play a role in mental illness outcomes for PFPP. [ABSTRACT FROM AUTHOR]

Introduction. Burnout syndrome is a complex phenomenon of great magnitude, which occurs in extremely demanding professions emotionally and nervously, with deep echoes in the psychoaffective structure of individuals, which makes its mark on professional life, but also that social. Acknowledging the problem and requesting specialized help remain the first step toward healing. Material and methods. This article reviews the literature on the discovery of burnout management strategies and its adverse effects. Articles found through this indexed search (PubMed and Google Scholar: 2017-2021) were reviewed and analyzed manually by the authors to identify relevant studies. Discussions. This study specifically focuses on the strategies that health care workers use to address resource depletion associated with fatigue, reduce work burden, and alter work characteristics to increase motivation. Conclusions. In order to prevent, manage or treat burnout, it is necessary to recognize the problems that contribute to burnout. Focusing on individual approaches, along with organizational ones, seems to be a promising way to deal with burnout and stimulate a healthier workforce. [ABSTRACT FROM AUTHOR]

Sixty-nine psychology students (M = 24.93 years, 82.6% female, 81% B.Sc. level) were randomly assigned to live supervision or a control group in an experiment with two simulated therapy sessions. In Session 1, their task was to conduct the beginning of a cognitive-behavioral therapy session with a standardized patient. In Session 2, all students repeated the task, but only one group received live supervision from a licensed psychotherapist. Live supervision improved students' (observer-based) skills (ds ≥0.91), and students were satisfied with the feedback. In terms of self-efficacy and self-assessed skills, live supervision had no significant advantage over merely practicing. [ABSTRACT FROM AUTHOR]

This study examined the attainment of individual treatment goals as an approach to measure treatment outcomes retrospectively in comparison to standardized self-report measures. In total, 189 outpatients defined 1–3 treatment goals (N = 455) using the Goal Attainment Scaling (GAS) at the beginning of cognitive behavioral therapy (CBT) and indicated the degree of their individual goal attainment post-treatment. The goals were assigned to content-related goal types of the Bern Inventory of Treatment Goals (BIT-T). The extent of goal attainment was, on average, between 1 (goal halfway attained) and 2 (goal attained) (M = 1.43), regardless of goal content and diagnostic group. Goals of the goal type "problems and symptoms" were chosen most frequently and showed significantly higher goal attainment than "interpersonal" goals, thereby indicating that outpatients in CBT mainly want to work on treatment goals like coping with problems and symptoms. Additionally, standardized self-report measures (Brief Symptom Inventory, Beck Depression Inventory-II) were assessed, and associations with the GAS were calculated. They correlated significantly but moderately, thus indicating that the two concepts complement each other and should ideally be implemented together. [ABSTRACT FROM AUTHOR]

Objective: The therapeutic alliance is related to treatment outcome but less is known about the agreement on alliance between patients and therapists and its relationship to outcomes. We examined the association of patient-therapist congruence of alliance perceptions, early and late in cognitive behavioral therapy for panic disorder in relation to symptom reduction and dropout. Method: Patients (n = 181) and their therapists provided alliance ratings early and late during 11-session treatment. Independent evaluators rated patients' symptomatic levels post-treatment. Polynomial regression and response surface analysis were used to examine congruence as a predictor of outcome. Results: Early in therapy, stronger combined patient-therapist alliances, regardless of agreement, predicted lower symptom severity at the end of therapy and a lower likelihood of dropout. Late in treatment, the outcome was worse when therapist ratings of the alliance were higher than those of the patient. Conclusions: Therapist-patient agreement on the strength of the alliance is important for symptom improvement and dropout. The study highlights the importance of understanding the dyadic nature of the alliance and its impact on therapeutic change. [ABSTRACT FROM AUTHOR]

Background: Internet-based cognitive behavioral therapy (CBT) and stand-alone mindfulness meditation interventions are gaining empirical support for a wide variety of mental health conditions. In this study, we test the efficacy of web-based therapist-guided mindfulness-based cognitive behavioral therapy (CBT-M) for body dysmorphic disorder (BDD), a psychiatric disorder characterized by preoccupations with perceived defects in appearance. Objective: This study aims to determine whether CBT-M for BDD delivered on the web is feasible and acceptable and whether mindfulness meditation adds to CBT treatment effects for BDD. Methods: In this 8-week, 2-arm, parallel pilot randomized controlled trial, n=28 adults (aged between 18 and 55 years) were randomly allocated to an experimental group (web-based therapist-guided CBT-M) or a control group (web-based therapist-guided CBT). Study retention, accrual, and intervention adherence were assessed, along with self-report measures for BDD, depression, anxiety, and pain intensity taken at baseline and postintervention. Results: This study was feasible to implement and deemed acceptable by participants. After 8 weeks, significant improvements were found on all outcome measures for both treatment groups, and large between-group effect sizes favoring CBT-M were found for BDD symptom severity (d=--0.96), depression (d=--1.06), pain severity (d=--1.12), and pain interference (d=--1.28). However, linear mixed models demonstrated no significant differences between the groups over 8 weeks. Conclusions: The results suggest that mindfulness meditation may add to beneficial web-based CBT treatment effects for BDD. An adequately powered randomized control trial of web-based CBT-M is warranted. [ABSTRACT FROM AUTHOR]