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Purpose: The aim of this systematic review was to synthesise the research identifying possible influences on CBT outcomes in chronic pain. Variations in the effectiveness of psychological therapies, such as CBT, in chronic pain have led to research investigating predictors of improved treatment outcomes. Materials and methods: We identified randomised controlled and cohort studies of CBT for chronic pain, published between 1974 to 2nd August 2023, which identified predictors of CBT outcomes. Results: Nineteen studies were included in the review. Baseline sociodemographic, physical and emotional factors that influence the outcomes of CBT for chronic pain were identified. The most commonly reported predictors of CBT outcome, with medium to large effect sizes, were anxiety, depression and negative cognitions about pain and coping. Sociodemographic predictors of outcomes demonstrated small effects and lacked replicability. Conclusions: There was variability across study designs, CBT delivery and outcomes measures. Further research is needed in chronic pain to identify the predictive factors which influence treatment outcomes, and consistency across study designs and outcome variables is needed to reduce heterogeneity. IMPLICATIONS FOR REHABILITATION: This review synthesised research identifying factors predicting outcomes of Cognitive Behavioural Therapy for chronic pain. The most commonly reported predictors of Cognitive Behavioural Therapy outcome, with medium to large effect sizes, were anxiety, depression, and negative cognitions about pain and coping. sociodemographic predictors of outcomes demonstrated small effects and lacked replicability. There is a move towards more individualised treatments in chronic pain. Our results suggest that decisions regarding Cognitive Behavioural Therapy for chronic pain should carefully consider baseline levels of anxiety, depression, and negative cognitions about pain. [ABSTRACT FROM AUTHOR]

Background: Anxiety disorders are among the most prevalent mental health concerns affecting children and adolescents. Despite their high prevalence, statistics indicate that fewer than 25% of individuals in this demographic seek professional assistance for their condition. Consequently, there is a pressing need to develop innovative interventions aimed at improving treatment accessibility. Objectives: This study aims to assess the effectiveness of Internet-delivered Cognitive Behavioral Therapy (iCBT) for adolescents with anxiety, with a specific emphasis on involving parents in the treatment process. Methods: The study is structured as a parallel three-armed randomized controlled trial, comparing Internet-delivered Cognitive Behavioral Therapy (iCBT) with planned feedback, iCBT with on-demand feedback, and a waitlist control group, each group including 56 participants. Participants in the two iCBT conditions will undergo a 14-week treatment regimen, while those in the waitlist control group will wait for 14 weeks before starting iCBT with planned feedback. Additionally, participants in the iCBT groups will be randomly assigned to receive a booster session or not. The study design is factorial including two factors: type of therapist feedback (factor 1) and booster or no booster (factor 2). The study population comprises adolescents aged between 12 and 17 years, residing in Denmark, diagnosed with an anxiety disorder according to DSM-5 criteria. The primary outcome measures are the Youth Online Diagnostic Assessment and the Spence Children's Anxiety Scale. Assessments will occur at baseline, post-treatment, and at 3-, 6-, and 12-month follow-ups post-treatment. Discussion: The findings of this study are anticipated to contribute to improving the accessibility of evidence-based treatments for adolescents with anxiety. Trial registration: The study is registered at clinicalTrials.gov, under protocol ID 22/59602. The Initial release was the 16.10.2023, first posted due to technical problems 16.04.2024. https://clinicaltrials.gov/study/NCT06368557?locStr=Odense,%20Denmark&country=Denmark&city=Odense&page=2&rank=13. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion The study aims to investigate the efficacy of sertraline medication plus dialectical behavior therapy (DBT) in reducing nonsuicidal self‐injury (NSSI) behavior and depression among adolescents.Participants were 100 adolescents with depression and NSSI behaviors, 50 of whom received sertraline medication plus DBT and 50 of whom received sertraline medication plus cognitive behavioral therapy (CBT) for 12 weeks.During 6 months post intervention, 26 (57.8%) participants did not report having engaged in any form of NSSI in the sertraline + DBT group and 15 (32.6%) in the sertraline + CBT group, showing significant difference. The sertraline + DBT group and the sertraline + CBT group exhibited significant difference regarding the proportions of cutting skin and biting self. The scores of anxiety, depression, aggression against self in four modified overt aggression scale categories, and Personal and Social Performance were notably lower in the sertraline + DBT group than those in the sertraline + CBT group at 6 months post intervention.Sertraline medication plus DBT could decrease NSSI episodes and improve symptoms of anxiety and depression for adolescents, and these changes were comparable to those of CBT. More importantly, DBT was demonstrated better clinical improvements at 6‐month follow‐up. [ABSTRACT FROM AUTHOR]

Objective Background Methods Results Conclusion This study was an open‐label single‐arm clinical trial evaluating the fidelity, feasibility, acceptability, and clinical signal of abbreviated mindfulness‐based cognitive therapy (MBCT‐brief) delivered either via telephone (MBCT‐T) or by video conferencing (MBCT‐V) for people with migraine and comorbid depressive symptoms.Migraine is commonly comorbid with elevated depressive symptoms. MBCT reduces depressive symptoms and shows promise to reduce migraine‐related disability. An abbreviated and remotely delivered version of MBCT could increase access to care.People with migraine and elevated depressive symptoms were recruited from a large urban health system. Participants were assigned in blocks of eight to receive an evidence‐based MBCT‐brief treatment, including eight weekly group classes and home practice delivered via telephone (MBCT‐T) or video (MBCT‐V); MBCT‐T was randomly selected for the first block. Sessions were recorded and coded for treatment fidelity. Feasibility was assessed via session attendance (primary), homework completion, recruitment rate, and survey completion rate. Acceptability was assessed via the eight‐item Client Satisfaction Questionnaire (CSQ‐8; primary), the Credibility/Expectancy Questionnaire (CEQ), the System Usability Scale (SUS), and items assessing survey acceptability. Participants completed the Headache Disability Inventory (HDI) and Quick Inventory of Depressive Symptomatology‐Self Report 16‐item (QIDS‐SR16) at baseline, mid‐treatment, and post‐treatment. Feasibility and acceptability rates were compared to a priori benchmarks.Participants (n = 16) were all female with a mean (standard deviation [SD]) age of 45 (13) years, the majority of whom identified as White (13/16, 81%) and non‐Hispanic (14/16, 88%). The intervention met the a priori criteria set for therapist fidelity to treatment protocol (mean [SD] MBCT‐Treatment Acceptability and Competence Scale Adherence score 2.9 [0.2]), feasibility (mean [SD] session attendance was 7.9/8 [0.3]), and acceptability (mean [SD] CSQ‐8 score 28.8 [3.3]) for the entire sample and for each treatment arm. The usability of the remote‐delivery system was high across study participants (mean [SD] SUS score 84.8 [11.0]). Survey procedures were broadly deemed acceptable, with at least 80% participants either endorsing “Agree” or “Strongly Agree” across all items. Using Wilcoxon tests, we observed significant reductions in both the HDI (pre‐treatment median [interquartile range] score 63 [40, 70] vs. post‐treatment 36 [26, 54], p = 0.004) and the QIDS‐SR16 (pre‐treatment median [interquartile range] score 8 [5, 13] vs. post‐treatment 4 [3, 6], p = 0.003).We found that remotely delivered MBCT‐brief for migraine and depressive symptoms was feasible and acceptable to patients in both the telephone and video modalities. Intervention was associated with significant post‐treatment reductions in headache‐related disability and depressive symptomatology, findings that must be interpreted cautiously in the absence of a control group. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study assessed the effectiveness of a school-based suicide prevention program in Hong Kong. Methods: 105 secondary school students aged 14–16, identified as having high levels of depression and suicidal ideation. Participants were divided into three intervention groups: one for adolescents only, another for adolescents with peers, and a third for adolescents with parental involvement. All groups engaged in weekly online exercises. Repeated measures ANOVA was used to analyze the within-group and between-group differences in the levels of adolescents' suicidal ideation, depression and anxiety. Results: The results indicated a statistically significant reduction in suicidal ideation, depression and anxiety levels after participation in all three groups. No statistically significant between-group differences were identified, meaning the effects of the three interventions on the measured outcomes were similar. Conclusions: This study demonstrates the promise of implementing school-based suicide prevention programs in the Hong Kong context. [ABSTRACT FROM AUTHOR]

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: Sexual and gender minority (SGM) individuals such as those who identify as lesbian, bisexual, pansexual, transgender or nonbinary, uniquely experience heightened stress as compared to their heterosexual and cisgender cohorts. Cognitive behavioural therapy (CBT) can address the cognitive, affective and interpersonal pathways via which minority stress adversely impacts mental health among SGM individuals. Objective: This systematic review aims to explore the qualitative evidence about the experiences of CBT therapists working with SGM individuals, focusing on the challenges they encounter and the strategies they employ to deliver effective care. Method: Electronic searches were conducted across APA Psychnet, Web of Science, Medline, Embase, PubMed and Google Scholar using specific keywords related to SGM populations and CBT. Included studies were qualitative, published between 2000 and 2023, and focused on therapists' experiences with SGM clients. Seven studies met the inclusion criteria and were analysed. Results: The review identified several challenges faced by CBT therapists, including issues related to cultural competency, stigma, discrimination, and the need for culturally adapted interventions. Therapists reported difficulties in acknowledging and integrating the unique aspects of their clients' sexual and gender identities into therapy, which sometimes resulted in microaggressions and therapeutic neglect. Therapists who sought additional training and incorporated frameworks such as minority stress and intersectional stigma reported more effective therapeutic outcomes. Conclusions: This review underscores the importance of enhancing training programs and delineating comprehensive guidelines to equip therapists with the requisite skills for providing culturally competent and individualised care to SGM clients. Despite the challenges, CBT holds promise for effectively addressing minority stress and promoting resilience among SGM populations when therapists are adequately prepared. Future studies must bridge the gap between theoretical recommendations and practical applications to improve outcomes for SGM clients. [ABSTRACT FROM AUTHOR]

The aim of this clinical article is to propose the relevance of the acceptance and commitment therapy (ACT) model Hayes, S. C., Villatte, M., Levin, M., & Hildebrandt, M. [2011. Open, aware, and active: Contextual approaches as an emerging trend in the behavioral and cognitive therapies. Annual Review of Clinical Psychology, 7(1), 141–168. https://doi.org/10.1146/annurev-clinpsy-032210-104449] to alleviate climate-induced psychological suffering. After a brief introduction establishing the need for climate-informed mental health intervention, the article is divided into three sections. The first section briefly presents ACT, highlighting the six core components of psychological flexibility. The second section provides a discussion to broaden and deepen psychotherapists’ understanding of eco-emotions, particularly eco-anxiety and eco-anger. The third section presents how this framework is relevant to assessing psychological flexibility in the context of climate change, using a hypothetical clinical example partly based on empirical findings. [ABSTRACT FROM AUTHOR]

Background: Up to 1.9 million youth in the USA sustain a concussion each year, and up to 30% experience persistent post-concussive symptoms (PPCS) lasting 1 month or more. PPCS can substantially interfere with social, emotional, and academic functioning. Despite these concerns, few evidence-based treatments are available for youth with PPCS. We previously found effectiveness in treating youth with concussion using a collaborative care intervention that integrates mental health care into a medical model, with improvements in concussive symptoms and quality of life at 1 year. Using the multiphase optimization strategy (MOST) framework, we now aim to assess the contribution of each of the three components that were part of collaborative care: concussion-focused cognitive behavioral therapy (cf-CBT), parenting skills training (PST), and care management (CM). Methods: The MOST factorial design examines all three intervention components with two levels of each (present or absent), resulting in 8 possible treatment combinations. We will recruit 368 youth with PPCS from 2 geographic locations (Seattle and Dallas), randomizing them to 1 of 8 treatment groups. Youth and/or parents will attend treatment sessions via video conferencing software over 3 months, and complete surveys regarding primary outcomes (concussive symptoms and health-related quality of life) and secondary outcomes (sleep, pain, mood, and parental distress) at 6 weeks and 3, 6, and 12 months. We will also assess potential mediators and moderators to allow for future tailoring and refinement. Discussion: The overarching goal of this investigation is to determine which collaborative care components (delivered individually or in combination) are most effective in treating PPCS in concussion-exposed youth. The investigation will inform mental health screening, intervention, and referral procedures for youth and families following concussion. At the completion of this study, we will have an optimized and refined intervention for youth with PPCS ready for large-scale implementation and dissemination. Trial registration: ClinicalTrials.gov NCT06036147. Registered on September 13, 2023. [ABSTRACT FROM AUTHOR]

Background Methods Results Discussion Nocturia (waking from sleep at night to void) and chronic insomnia frequently co‐exist in older adults, contributing synergistically to sleep disturbance. Treatments typically target either nocturia or insomnia rather than simultaneously addressing shared mechanisms for these disorders.We conducted a multisite feasibility study to: (1) test and refine a protocol for recruitment, randomization, and assessment of older adults with co‐existing nocturia and insomnia; and (2) examine preliminary changes in outcome measures to inform a future larger, multisite clinical trial. Participants were men and women aged 60 years and older recruited from outpatient clinics, reporting an average of two or more nocturia episodes per night over the past 4 weeks and meeting diagnostic criteria for chronic insomnia disorder. Participants were randomized to receive either integrated cognitive‐behavioral therapy for insomnia and nocturia or a health education control program involving five weekly visits with a trained nurse practitioner interventionist. Outcomes (e.g., nocturia episodes) were measured 1‐week post‐treatment and 4‐month post‐randomization. Descriptive statistics examined the feasibility of outcomes to guide preparations for a future efficacy trial.Of 245 adults screened, 55% were ineligible and 25% declined to participate. Sixty‐one percent of 49 participants who provided informed consent were randomized. Of the 30 participants randomized (mean age = 70.6 years, 60% White), 14 were assigned to integrated cognitive‐behavioral treatment and 16 to the control group. All randomized participants provided 4‐month follow‐up data. At 4 months, mean nightly nocturia episodes decreased by 0.9 (SD 1.0) in the integrated treatment group and by 0.2 (SD 1.2) in the control group compared with baseline.Findings demonstrate the feasibility of recruiting, randomizing, and collecting outcome data from older adults (predominantly male) assigned to an integrated cognitive‐behavioral therapy for coexisting insomnia and nocturia or a health education control program. [ABSTRACT FROM AUTHOR]

Introduction: The present study investigates the feasibility and usability of a sensorbased eHealth treatment in psychotherapy for pediatric obsessive-compulsive disorder (OCD), and explores the promises and pitfalls of this novel approach. With eHealth interventions, therapy can be delivered in a patient's home environment, leading to a more ecologically valid symptom assessment and access to experts even in rural areas. Furthermore, sensors can help indicate a patient's emotional and physical state during treatment. Finally, using sensors during exposure with response prevention (E/RP) can help individualize therapy and prevent avoidance behavior. Methods: In this study, we developed and subsequently evaluated a multimodal sensor-based eHealth intervention during 14 video sessions of cognitivebehavioral therapy (CBT) in 20 patients with OCD aged 12-18. During E/RP, we recorded eye movements and gaze direction via eye trackers, and an ECG chest strap captured heart rate (HR) to identify stress responses. Additionally, motion sensors detected approach and avoidance behavior. Results: The results indicate a promising application of sensor-supported therapy for pediatric OCD, such that the technology was well-accepted by the participants, and the therapeutic relationship was successfully established in the context of internet-based treatment. Patients, their parents, and the therapists all showed high levels of satisfaction with this form of therapy and rated the wearable approach in the home environment as helpful, with fewer OCD symptoms perceived at the end of the treatment. Discussion: The goal of this study was to gain a better understanding of the psychological and physiological processes that occur in pediatric patients during exposure-based online treatment. In addition, 10 key considerations in preparing and conducting sensor-supported CBT for children and adolescents with OCD are explored at the end of the article. This approach has the potential to overcome limitations in eHealth interventions by allowing the real-time transmission of objective data to therapists, once challenges regarding technical support and hardware and software usability are addressed. [ABSTRACT FROM AUTHOR]

Cognitive symptoms are prevalent across neuropsychiatric disorders, increase distress and impair quality of life. Self-guided digital interventions offer accessibility, scalability, and may overcome the research-to-practice treatment gap. Seventy-six trials with 5214 participants were identified. A random-effects meta-analysis investigated the effects of all digital self-guided interventions, compared to controls, at post-treatment. We found a small-to-moderate positive pooled effect on cognition (k = 71; g = −0.51, 95%CI −0.64 to −0.37; p < 0.00001) and mental health (k = 30; g = −0.41, 95%CI −0.60 to −0.22; p < 0.0001). Positive treatment effects on fatigue (k = 8; g = −0.27, 95%CI −0.53 to −0.02; p = 0.03) and quality of life (k = 22; g = −0.17, 95%CI −0.34 to −0.00; p = 0.04) were only marginally significant. No significant benefit was found for performance on activities of daily living. Results were independent of control groups, treatment duration, risk of bias and delivery format. Self-guided digital transdiagnostic interventions may benefit at least a subset of patients in the short run, yet their impact on non-cognitive outcomes remains uncertain. [ABSTRACT FROM AUTHOR]

Cognitive Behavioral Therapy in group settings (CBTG) has proven to be an effective treatment for obsessive-compulsive disorder (OCD). This study aims to evaluate the effectiveness of CBGT for obsessive-compulsive disorder OCD compared to the control condition in the Turkish-speaking population with a treatment protocol that considers cultural aspects. Seventy-five participants were assigned to the intervention, and 46 were assigned to the control condition randomly. All participants were evaluated before and after the therapy with a demographic information form, Structured Clinical Interview for Diagnosis, Yale-Brown Obsessive Compulsion Scale, Beck Anxiety Inventory, and Beck Depression Inventory. CBGT for OCD decreases levels of obsession, compulsion, depression, and anxiety more than control conditions with large effect sizes (d > 0.8, p <.05). This study shows the effectiveness of CBGT for OCD compared to the control condition in the Turkish-speaking population. Improvement in depression and anxiety alongside OCD symptoms is a strength of the CBGT applied. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Data Sources Methods Results Conclusions Impact To evaluate the association between oral hygiene behaviour and cognitive decline in adults. The outcomes include changes in global cognitive function, visual attention, task switching and the risk of dementia.We conducted a systematic review following the preferred reporting items for systematic reviews and meta‐analyses guidelines.A systematic search of 11 databases and grey literature sources was conducted from inception to January 2024. We included interventional trials or cohort studies that investigated the effect of oral hygiene behaviours (e.g., toothbrushing, mouth washing, flossing, using toothpicks and cleaning dentures) on cognitive decline in adults.Data extraction and risk of bias assessment were performed by two independent reviewers with expertise in conducting systematic reviews. Meta‐analyses were conducted using random‐effects models, and heterogeneity was assessed with the I2 statistic and χ2 test.A total of eight studies (six intervention studies and two cohort studies) met inclusion criteria, including 261,772 participants. Follow‐up periods ranged from 30 days to 48 months for interventions and 9 to 18 years for cohorts. Toothbrushing was associated with a significantly slower decline in global cognitive overtime. Toothbrushing in older adults with moderate/severe dementia could achieve significant changes in cognitive decline. There was no significant difference between the effectiveness of toothbrushing performed by professionals and caregivers. Other oral hygiene behaviours, including dental flossing, using mouthwash, using toothpicks and cleaning dentures, were not associated with the risk of dementia.Toothbrushing is linked to a decreased risk of dementia and improved global cognitive function. Promoting toothbrushing at least twice daily may significantly reduce the risk of cognitive decline and dementia.These findings highlight the urgent need for programmes that encourage daily toothbrushing, particularly in nursing home settings and among older adults with moderate‐to‐severe dementia. [ABSTRACT FROM AUTHOR]

Aims: The treatment of diabetes distress plays an important role in diabetes care; however, no meta-analysis has been performed to synthesize the short- and long-term effects of psychological interventions tailored for diabetes distress in people with type 2 diabetes. We aim to evaluate the evidence on tailored psychological interventions for diabetes distress as the primary outcome, focusing on individuals with type 2 diabetes. Methods: Two reviewers independently searched eight databases from their inception to September 2024. EndNote X9 was used to screen records. The Revised Cochrane risk-of-bias tool for randomized trials was used to assess the risk of bias. The GRADE system was used to assess the overall certainty of the evidence. A random effect model was used to determine the mean difference or standardized mean difference with 95% CIs. Subgroup analyses based on several intervention characteristics and sensitivity analyses were also conducted. Results: Totally, 22,279 records were yielded, and we finally included 18 studies in our systematic review. The meta-analysis included data from 16 studies representing 1639 participants. Interventions types included mindfulness-based and cognitive behavioral therapy, among others. Duration of interventions ranged from 4 weeks to 6 months. We found that psychological interventions that measured diabetes distress significantly reduced diabetes distress in the short-term in people with type 2 diabetes (SMD= -0.56; 95% CI= -0.90, -0.22; p = 0.001). Subgroup analysis indicated that this effect could be enhanced when delivered in a group format, by psychologist, using a technology component, or including participants having elevated baseline diabetes distress. However, the short- and long-term effects on HbA1c were non-significant, with results showing (MD = 0.02; 95% CI = -0.23 to 0.26; p = 0.89) and (MD = -0.27; 95% CI = -0.64 to 0.10; p = 0.15), respectively. The long-term effect on diabetes distress was also non-significant (SMD = -0.45; 95% CI = -0.93 to 0.03; p = 0.07). Conclusions: Psychological interventions tailored for diabetes distress in people with type 2 diabetes are effective in reducing the level of diabetes distress immediately after the intervention. More trials are still needed to further enrich the evidence in this area. [ABSTRACT FROM AUTHOR]

Background: Social anxiety disorder (SAD) is one of the most prevalent anxiety disorders in Canada. Viable therapy options for the treatment of SAD include CBT being delivered virtually. In Australia, an innovative internet-delivered cognitive-behavioral therapy (iCBT) program for social anxiety has been developed, implemented, and demonstrated as effective. To make available high-quality and real-time evidence in response to the crucial need to access psychological services to meet population mental health needs, we propose to conduct a Canadian adaptation of the iCBT Shyness Program and to examine the program's effectiveness, and implementation in two Canadian provinces (Quebec and Ontario). Methods: The overall study design is a hybrid effectiveness-implementation study of a quasi-experimental parallel group trial. Prior to implementing the iCBT Shyness Program, it will undergo an initial adaptation to the Canadian context and focus groups will be conducted with key actor groups to discuss the adaptations to the graphics, narration of the lessons, and this to better reflect varying socio-cultural context among Canadian French- and English-speaking populations. We will evaluate the effectiveness of the program in three parallel pathways reflecting real-world pathways: (1) self-refer to the intervention; (2) recommended by a health professional without guidance; and (3) recommended by a health professional, with low-intensity guidance. Data collection will be carried out at baseline, at the beginning of each lesson, 12-week and 6-month follow-up. Outcomes measured will include anxiety and depressive symptoms, psychological distress, disability, as well as health service utilization and satisfaction. Semi-structured interviews will then be conducted with study participants and health care providers to explore facilitating factors and barriers to the implementation of the iCBT adapted program. Discussion: This study will provide evidence on the effectiveness, barriers and facilitating factors to implementing a low-intensity iCBT in the Canadian context for SAD, which will bridge an important care gap for undeserved populations in Canada with SAD. Findings will inform the eventual scaling up of the program in community-based primary care across Canada. This would improve equity of the health care system by helping a large number of Canadians to timely access to mental health services. Trial registration: clinicaltrials.gov NCT06403995. Prospectively registered on 05/03/2024. [ABSTRACT FROM AUTHOR]

Background: There is broad scientific evidence for the effectiveness of individual trauma-focused evidence-based treatments (EBTs) such as "trauma-focused cognitive behavioural therapy" (TF-CBT) for children and adolescents with posttraumatic stress symptoms. However, there is a significant research-to-practice gap resulting in traumatized children in high-income countries in Europe having only very limited access to these treatments. The aim of this study was, therefore, to identify common barriers and successful dissemination and implementation (D&I) strategies of evidence-based trauma-focused treatments (in particular TF-CBT) in seven European countries. Methods: For this study, we chose a mixed-method approach: an online survey among certified European TF-CBT trainers (N = 22) and the collection of country-based narratives from TF-CBT experts in different European countries (Finland, Germany, Italy, Netherlands, Norway, Sweden). Results: Common modifiable barriers to the implementation of TF-CBT were identified on different levels (e.g. government or treatment level), and successful D&I strategies were highlighted across all countries, such as translations of materials. Additionally, the experts from the country narratives put together a broad overview of TF-CBT research in Europe. Conclusions: The results of this study revealed that especially learning collaborations and the development of joint European efforts in funding and researching D&I strategies are crucial for future implementation of trauma-focused EBTs in Europe. [ABSTRACT FROM AUTHOR]

For many students, foreign language anxiety can be a paralyzing condition that prevents learners from fully learning and slows the use of their second language in communication. Past studies have confirmed the effectiveness of psychological therapies in alleviating anxiety-based disorders. At the same time, there is a lack of studies, particularly in cognitive-behavioral group therapy (CBT) on foreign language learning anxiety. The study aimed to explore the efficiency of cognitive-behavioral group therapy in reducing foreign language learning anxiety among young adults. This pretest–posttest with a control group study was conducted with sixty eligible English-preparatory university students with noticeable foreign language learning anxiety selected as a sample by purposive sampling and randomized to an intervention and a control group into equal numbers. The Bangla version of the Foreign Language Classroom Anxiety Questionnaire (FLCAS) was used to measure foreign language learning anxiety at baseline and post-intervention. The obtained data were subsequently analyzed by t-test, ANOVA, and repeated measures with between-groups multivariate variance analysis (MANOVA) with effect size. The results revealed that over time, in the intervention group, communication nervousness, fear of negative appraisal, test anxiety, and overall foreign language learning anxiety considerably dropped. In contrast, these issues remained steady in the control group. The findings reflected the benefits of CBT in groups by considering its limitations which might be regarded as a practical treatment option for alleviating foreign language learning anxiety in clinical settings among youth in developing countries. Therapeutic ramifications for reducing anxiety-based issues in both research and practice are explained. [ABSTRACT FROM AUTHOR]

Background: Depression is a leading cause of disability worldwide, and treatments could be more effective. Identifying methods to improve treatment success has the potential to reduce disease burden dramatically. Preparing or "priming" someone to respond more effectively to psychotherapy (e.g., cognitive behavioral therapy [CBT]) by preceding sessions with aerobic exercise, a powerful neurobiological activator, could enhance the success of the subsequently performed therapy. However, the success of this priming approach for increasing engagement of working mechanisms of psychotherapy (e.g., increased working alliance and behavioral activation) has yet to be formally tested. Methods: The CBT + trial will be a parallel-arm randomized controlled trial that will recruit 40 adult participants with DSM-5 diagnosed depression (verified with clinical interview) via referrals, mass emails, local flyers, and social media posts. Participants will be randomized to an ActiveCBT or CalmCBT condition. The ActiveCBT group will receive an 8-week CBT intervention primed with 30 min of moderate-intensity aerobic exercise (cycling on a stationary bike at a 13 rating of perceived exertion). The CalmCBT group will receive the same 8-week CBT intervention while resting for 30 min before CBT (i.e., cycling vs no cycling is the only difference). The primary outcome measures will be mean working alliance (assessed with the client version of the Working Alliance Inventory—Short Revised) and mean behavioral activation (self-reported Behavioral Activation for Depression Scale) recorded at each of the 8 therapy sessions. Secondary outcomes include evaluation of state anhedonia and serum brain-derived neurotrophic factor before the active/calm conditions, between the condition and therapy, and after the therapy. Additional exploratory analyses will evaluate group differences in algorithm-generated ratings of therapist-participant interactions via the Lyssn platform. Discussion: The novel approach of priming CBT with moderate-intensity aerobic exercise evaluated in a randomized controlled trial (CBT + trial) has the potential to demonstrate the usefulness of exercise as an augmentation strategy that improves working mechanisms of therapy and overall treatment outcomes for adults with depression. Trial registration: ClinicalTrials.gov NCT06001346. Registered on August 21, 2023. [ABSTRACT FROM AUTHOR]

Summary Although there have been promising findings for smartphone application (app)‐delivered cognitive behavioural therapy for insomnia (CBT‐I), previous trials have not screened participants rigorously for insomnia disorder and used therapist support. Based on the above, we aimed to examine the effects of smartphone app‐delivered CBT‐I with telephone support against a waitlist (WL) in a sample with insomnia disorder. A total of 64 participants with insomnia disorder were randomised to smartphone app‐delivered CBT‐I (n = 32) or a WL (n = 32). Smartphone app‐delivered CBT‐I consisted of six weekly smartphone app modules with 15 min of telephone support per week. At pre‐ and post‐treatment, and the 3‐month follow‐up, we assessed insomnia symptoms and associated correlates and consequences. At post‐treatment, we also assessed measures related to adherence (therapist support, exercise/module completion), self‐rated perception of treatment content, activity, and adverse events. CBT‐I significantly outperformed the WL with large effects on the primary outcome (d = 2.26) and was significantly different on most of the secondary outcomes with medium to large effects. CBT‐I also resulted in a significantly larger proportion of treatment remitters (CBT‐I: 64.5–77.4%, WL: 6.5–6.9%) and responders (CBT‐I: 77.4–90.3%, WL: 19.4–24.1%) at post‐treatment and follow‐up, compared to the WL. Treatment was associated with high satisfaction, high adherence, low attrition, and few treatment‐impeding adverse events. Based on the medium to large effects of smartphone app‐delivered CBT‐I with telephone support, this trial highlights the potential of delivering CBT‐I exclusively through an app with therapist telephone support for high efficacy, satisfaction, and adherence. [ABSTRACT FROM AUTHOR]

Introduction: Misophonia is an increasingly recognized disorder characterized by negative emotional and sensory reactions to specific noises. Although misophonia most often begins in childhood, there has been minimal research on its clinical presentation in youth. This qualitative study explored cognitive behavioral processes that are involved in misophonia and its associated functional impairment in young people and their families. Methods: Focused interviews were conducted with 20 youth with misophonia (ages 10–17) and their parents. Thematic analyses of these interviews using a cognitive behavioral theoretical framework were conducted. Results: A number of themes were identified, which included internalizing and externalizing cognitive behavioral processes at the individual level (e.g., hypervigilance, anticipatory anxiety, escape, automatic negative attributions), secondary emotional and functional consequences (e.g., negative perception of self, guilt, anxiety, depression, emotional exhaustion, concentration difficulties at school), as well as significant impacts to school, social life, and particularly to family life (e.g., conflict/tension, anger and resentment, family accommodation). These themes are integrated in a proposed theoretical model. Discussion: Misophonia is characterized by several transdiagnostic cognitive behavioral processes, including avoidance, maladaptive cognitions, emotional reactivity, and family communication difficulties, as well as significant functional impairment. Developing treatments that target these processes has the potential to help youth overcome misophonia and improve the quality of life of youth and their families. [ABSTRACT FROM AUTHOR]

Background/objective: Emotional dysregulation is bidirectionally associated with sleep disturbances, with potentially critical implications for emotional reactivity, in patients with borderline personality disorder (BPD). This study evaluated subjective and objective sleep quality, emotional regulation, and emotional reactivity in 20 patients with BPD compared to 20 non-clinical individuals. Methods: Subjective and objective sleep quality was assessed using the Pittsburgh Sleep Quality Index and a 3-day actigraphic measurement. Emotional regulation was evaluated using the Difficulties in Emotion Regulation Scale and the Berkeley Expressivity Questionnaire. Furthermore, each participant underwent an emotional reactivity task selected from the International Affective Picture System. Results: Compared to control subjects, individuals with BPD reported poor subjective sleep quality and objective sleep continuity disturbances, with more sleep fragmentation and decreased sleep efficiency. Moreover, BPD patients showed emotional dysregulation and altered subjective reactivity to emotional stimuli, particularly positively valenced stimuli. Conclusion: These results suggest the importance of further clarifying the specific direction of sleep-dependent emotional modulation in individuals with BPD, with significant clinical implications for patients with co-occurring sleep disturbances. [ABSTRACT FROM AUTHOR]

Background: Depression is common in older adults and is related to reduced quality of life and functional ability as well as increased mortality and morbidity. Current guidelines recommend psychological treatments for the treatment of depression in adults. Studies show that about 30% of older adults with depression in Sweden receive pharmacological treatment and about 3% receive psychological treatment. However, a majority receive no treatment at all. There is a need for effective and scalable psychological treatment options for older adults with depression in primary care. Behavioural activation is an extensively evaluated, effective, and relatively simple treatment for depression that can be delivered by health care professionals without comprehensive training in psychological treatment. Methods: We will conduct a randomised controlled 2-armed parallel group multicentre trial comparing treatment as usual in primary care to a five-session telephone-delivered behavioural activation treatment as add on to treatment as usual. The current trial is open labelled. In all, 250 older adults (≥ 65 years) with depression will be recruited from primary healthcare centres in three Swedish regions. The primary outcome is depressive symptoms measured with the Montgomery Åsberg Depression Rating Scale – Self rating version (MADRS-S) after treatment and at 3- and 6-month follow-up. Secondary outcomes include depression diagnoses, activity level (self-rated and measured with accelerometer), and self-rated anxiety, daily functioning, quality of life, self-efficacy, and loneliness. Discussion: There is a need for fully powered studies of brief behavioural activation for older adults with depression delivered by telephone in a primary care context. This study has the potential to improve first-line treatment of depression in older adults in primary care, consequently reducing morbidity and mortality within this population. Increasing the availability and accessibility to effective psychological treatment for depression in older adults is needed to meet future demographic changes. Trial registration: ClinicalTrials.gov: NCT06284889. Registered February 28, 2024. [ABSTRACT FROM AUTHOR]

Background: Emotional disorders such as depression and anxiety disorders share substantial similarities in their etiology and treatment. In recent decades, these commonalities have been increasingly recognized in classification systems and treatment programs crossing diagnostic boundaries. Methods: To examine the prospective effects of different transdiagnostic markers on relevant treatment outcomes, we plan to track a minimum of N = 200 patients with emotional disorders during their routine course of cognitive behavioral therapy at two German outpatient clinics. We will collect a wide range of transdiagnostic markers, ranging from basic perceptual processes and self-report measures to complex behavioral and neurobiological indicators, before entering therapy. Symptoms and psychopathological processes will be recorded before entering therapy, between the 20th and 24th therapy session, and at the end of therapy. Discussion: Our results could help to identify transdiagnostic markers with high predictive power, but also provide deeper insights into which patient groups with which symptom clusters are less likely to benefit from therapy, and for what reasons. Trial Registration: The trial was preregistered at the German Clinical Trial Register (DRKS-ID: DRKS00031206; 2023–05-09). [ABSTRACT FROM AUTHOR]

Migraine is a common neurological disorder globally. Migraines, with or without aura, are episodic and recurring with symptom-free periods. Frequent and prolonged attacks can lead to chronic migraine. This pilot randomized controlled trial (RCT) aimed to evaluate feasibility of therapist-guided, acceptance-based internet cognitive behavioral therapy (iCBT) as an adjunct to standard medical care for migraine patients in Swedish primary healthcare settings using a mixed methods approach. Participants (treatment n = 15, control n = 14) underwent qualitative and quantitative assessments to evaluate feasibility, acceptance, and initial treatment effects. Interviews with participants (n = 7) indicate that most participants had struggled with migraines for decades and expressed dissatisfaction with the limited medical care. They found the flexible, digital format particularly helpful, praising its accessibility and structured learning. While they appreciated the comprehensive content, some faced challenges with the psychological language and the program pace. Post-treatment, participants reported emotional and behavioral changes, and better migraine management. Seventy-two percent of the 29 participants completed both baseline and 3-month follow-up measures. On average, participants completed 7.7 modules, with 60% completing all 10 modules. Promising effect size indicated a reduction in migraine days during the three-month follow-up. Both qualitative and quantitative data support the feasibility and acceptability of the intervention in primary care settings. [ABSTRACT FROM AUTHOR]

Background: Following acute coronary syndrome (ACS), up to 40% of patients report elevated depressive symptoms which is associated with a two-fold increase in mortality risk due to behavioral and biological mechanisms. Mindfulness-Based Cognitive Therapy (MBCT) delivered via synchronous group videoconferencing could help reduce depressive symptoms. Objective: To guide MBCT adaptation for ACS patients for a future clinical trial, this qualitative study aimed to explore ACS patients' (1) symptoms after ACS, (2) needs for behavioral health treatment, (3) perspectives on mindfulness intervention and group videoconference delivery, and (4) willingness to self-collect dried blood spots in a research study. Methods: We compared ACS patients with and without depressive symptoms to highlight particularly relevant treatment topics for patients developing depression following ACS experience. From 2/2019-11/2019, we conducted semi-structured individual telephone interviews with N = 23 patients after ACS (N = 13 with and N = 10 without elevated depressive symptoms; 63.4 (SD = 8.5) years, 87% male, 96% non-Hispanic white, 7.1 (SD = 7.5) years since ACS). In qualitative content analyses, four independent coders coded each interview. Results: Participants with depressive symptoms experienced emotional, physical, social, and health behavior problems, while those without depressive symptoms made positive health behavior changes and struggled with anxiety symptoms. Both groups were interested in a behavioral health treatment for emotional and social support. Most were willing to participate in a mindfulness group via videoconferencing; some preferred in-person, but accessibility and convenience outweighed these cons. Almost all were willing to self-collect dried blood spots and some were already familiar with this technique. Conclusion: ACS patients, especially those with depressive symptoms, need help managing a multitude of quality of life concerns that can be targeted with an adapted MBCT approach. A videoconference-delivered MBCT approach is of interest. Suggestions for adapting MBCT to target the needs of ACS patients are discussed. [ABSTRACT FROM AUTHOR]

Objective: Despite the widespread application of non-pharmacological therapies in treating cancer-related insomnia, a comprehensive assessment of these methods is lacking. This study aims to compare the efficacy of 11 non-pharmacological interventions for cancer-related insomnia, providing a theoretical basis for clinicians in choosing treatment methods. Methods: We searched five databases, including the Cochrane Central Register of Controlled Trials, PubMed, Embase, Wiley Library, and Web of Science, for relevant randomized controlled trials. Included studies involved patients diagnosed with cancer-related insomnia, employed non-pharmacological treatments, and reported outcomes using the PSQI and ISI. Bayesian statistical methods were used for the network meta-analysis, and statistical processing was performed using Review Manager 5.4 and Stata 14.0 software. The results were thoroughly analyzed and evaluated, and publication bias was assessed using funnel plot tests. Results: Our study included 41 randomized controlled trials, comprising 11 different non-pharmacological interventions (3,541 participants), the network analysis identifying Electroacupuncture as the most effective, with a SUCRA value of 92.2% in ISI, this was followed by Professionally administered Cognitive behavioral therapy for insomnia(PCBT-I) and Mindfulness-based cognitive therapy(MBCT), with SUCRA values of 78.4 and 64.1%, respectively. Traditional Cognitive behavioral therapy for insomnia(CBT-I) and VCBT-I showed lower efficacy with SUCRA values of 55.9 and 55.2%, respectively. Exercise interventions and control groups had the lowest efficacy, with SUCRA values of 24.0 and 16.1%. Using PSQI as the outcome measure, Massage therapy ranked highest in improving sleep quality with a SUCRA value of 92.2%, followed by Professionally administered Cognitive behavioral therapy for insomnia (PCBT-I) and Electroacupuncture. League tables indicated significant improvements in sleep outcomes for Electroacupuncture and MT compared to control groups, with Electroacupuncture (EA) showing an MD of -7.80 (95% CI: -14.45, -1.15) and MT an MD of -4.23 (CI: -8.00, -0.46). Conclusion: Considering both outcome indicators, Electroacupuncture was significantly effective in alleviating the severity of insomnia, while MT was most effective in improving sleep quality. Therefore, in the non-pharmacological interventions for cancer-related insomnia, Electroacupuncture and MT May be particularly effective choices. Future research should further explore the specific mechanisms of action of these interventions and their efficacy in different patient groups. [ABSTRACT FROM AUTHOR]

Given that creative ideation has been widely characterized as involving disinhibition, we tested whether a brief creative ideation effort increased subsequent indulgence through the choice of real or imagined rewards. Across 10 experiments (and an additional four in the Supplemental Material) and 3,412 participants (including the ones in the Supplemental Material), we show that a short creative ideation (vs. control) task led to more indulgent eating, drinking, and exercise choices and behaviors. Participants who generated creative ideas subsequently assembled burgers with higher calorie content (Studies 1a, 3a, 3b, 4), proposed cocktails with higher alcohol content (Study 1b), planned workouts that burned fewer calories (Study 1c), chose candy more often (Study 1d), and ate more candy (Study 2) than participants who engaged in control tasks. In line with the perspective that creativity involves disinhibition, these effects were mediated by the behavioral activation system, which is thought to underlie the uninhibited pursuit of desires and rewards (Studies 2, 3a, 4). Furthermore, an experiment in which we manipulated the behavioral activation system showed a causal effect on indulgent eating choices (Study 5). We discuss the implications for future research on the consequences of creativity as well as the possibility that creative work might lead to indulgent, potentially unhealthy choices and behaviors. [ABSTRACT FROM AUTHOR]

Regular pelvic exams after completing cancer treatment are critical for detecting endometrial and cervical cancer recurrence. Patients report high levels of distress and pain during exams. We conducted in-depth individual interviews with patients (N = 13) and providers (N = 10) to explore patients' pelvic exam experiences and intervention preferences. Findings suggested that most patients experience exam-related distress and pain, and a telemedicine cognitive behavioral intervention targeting anxiety and pain would be acceptable and feasible for most patients. Findings informed PEACE (Pelvic Examination and Anxiety Coping skills for Empowerment) intervention development. Formative work is described, including a conceptual model, qualitative data collection and analysis, and session content. [ABSTRACT FROM AUTHOR]

Patients with long‐term disease experience low resilience, emphasising the importance of psychological interventions to improve resilience. However, there is no comprehensive evidence on the efficacy of resilience‐related psychological interventions (RRPIs) in this population. Therefore, we performed a meta‐analysis to evaluate and extend knowledge from previous meta‐analyses on the efficacy of RRPIs on resilience, stress, anxiety, depression and quality of life among patients with long‐term disease. Cochrane Library, Embase, Ovid‐MEDLINE, PubMed, Scopus, Web of Science and CINAHL electronic databases were searched until 3 February 2023. The pooled effect size of the efficacy of RRPIs was calculated using the Hedges' g (g) with random‐effects model, while Cochrane Q‐statistics and I2 tests assessed heterogeneity in Comprehensive Meta‐Analysis 3.0 software. The Cochrane Risk of Bias 2.0 tool evaluated the quality of studies. Moderator analysis was used to explore sources of heterogeneity. Twenty randomised controlled trial studies were identified, representing a total of 1388 individuals with long‐term disease. RRPIs significantly enhance resilience (g = 0.79), alleviate stress (g = −0.78), decrease anxiety (g = −1.14), mitigate depression (g = −0.96) and improve quality of life (g = 0.48). Positive psychology, mindfulness, cognitive behavioural therapy, acceptance and commitment‐based intervention exhibited medium effects in strengthening resilience. Short‐term effects of RRPIs on enhancing resilience were observed at 3‐month follow‐up period (g = 0.50). The incorporation of RRPIs into the management of patients with long‐term disease shows a positive impact on their resilience, stress, anxiety, depression and quality of life. The results offer an evidence‐based foundation for nurses in promoting resilience among patients with long‐term disease. [ABSTRACT FROM AUTHOR]

Older adults often experience loss of partnership, illness, and declining health which can contribute to anxiety and depression. This can be a significant public health concern. Senior centers play an important role in providing support and community which may reduce these symptoms. Yoga-Cognitive Behavioral Therapy (Y-CBT) is an innovative approach that specifically targets symptoms of anxiety and depression. Within a group model, Y-CBT integrates cognitive behavioral therapy (CBT) with chair yoga. Y-CBT has demonstrated significant reductions in anxiety and co-occurring depression for adults receiving services at an outpatient behavioral health center. The goal of this study was to evaluate the effectiveness of Y-CBT for older adults attending a senior center setting. Thirty-seven older adults (age 62+) from three senior centers enrolled in the study. After the Y-CBT intervention, anxiety improved (p <.0056) with a large effect size (g = 0.88). Though not significant, depression also improved (g = 0.418), with many participants reporting reduced levels of depression into the minimal or clinically non-significant ranges after, as compared with before the Y-CBT experience. These results indicate that Y-CBT may be a promising approach for the symptoms of anxiety and co-occurring depression which older adults experience. [ABSTRACT FROM AUTHOR]

Abdominal pain is part of the definition of irritable bowel syndrome (IBS) according to the ROME IV criteria, having to be present at least once a week. This sometimes intense pain can lead to a significant impairment of quality of life. Drug treatments are occasionally insufficient to provide relief to patients and can be poorly tolerated. More than a third of patients use treatments that are part of complementary and alternative medicine, most often without talking to their doctor about it. In this context, it seems important to discuss with them the possibilities of alternative care and to know how to direct them as a priority towards those who have demonstrated their effectiveness, especially since most alternative treatments are not reimbursed. Studies investigating the effectiveness of this type of treatment are more complex to realize. There is a particularly high placebo effect in cases of IBS, with more than one in three patients being improved by taking a placebo, making it essential to constitute a control group for the evaluation of IBS treatments. Concerning alternative treatments, the control group is more difficult to choose, and double-blind studies are most often impossible to carry out. With these caveats, studies on hypnosis, cognitive and behavioral therapies and meditation support their effectiveness on IBS symptoms, particularly abdominal pain. For other techniques such as osteopathy, auricular vagal stimulation or yoga, the results of the studies are encouraging but insufficient to be able to formally advise them. Studies on acupuncture, foot reflexology or homeopathy do not support an effect greater than a placebo effect. [ABSTRACT FROM AUTHOR]

This paper presents as its central theme the importance of psychological care in cases of domestic violence: a cognitive-behavioral approach, highlighting and seeking understanding mainly regarding the mental health of victims of domestic violence, emphasizing the importance of the psychologist with a cognitive-behavioral approach, considering that this approach presents strong evidence of effectiveness as an intervention. Domestic violence has increased and caused alarming consequences, as it significantly affects the functional lives of women every day. Therefore, the objective of this paper is to emphasize the importance of psychological support as a form of intervention and reduction of psychological damage, in addition to contributing to a greater knowledge of the subject. The work has a bibliographic methodological basis, with a qualitative approach. Thus, scientific materials were selected from databases on the proposed theme, and based on the findings, the importance of specialized psychological treatment in cases of domestic violence is concluded. [ABSTRACT FROM AUTHOR]

This study examined the utilization of trauma‐focused cognitive behavioral therapy (TF‐CBT) treatment components, as well as factors that predicted therapist TF‐CBT component use. Participants were 264 TF‐CBT‐trained mental health therapists. The most frequently used components, as reported by therapists, were affect regulation, relaxation, and psychoeducation about trauma, while the least frequently used were in vivo exposure, conjoint sessions, and caregiver involvement. Results of a hierarchical linear regression indicated that therapist self‐efficacy and child trauma clinical beliefs (i.e., clinical structure and verbal capacity) positively predicted therapist TF‐CBT component use. Perceived barriers to TF‐CBT use negatively predicted therapist TF‐CBT component use. Implications for counseling practice and future research directions are included. [ABSTRACT FROM AUTHOR]

We review Bandura's contributions to cognitive‐behavioural theory, research and practice. His basic research on the causal role of cognitive processes in social learning was a major factor in the emergence of cognitive‐behavioural therapies in the 1970s. His investigations on observational learning and self‐efficacy beliefs led to the development of guided mastery therapy, a specific cognitive‐behavioural intervention for anxiety disorders. His research on self‐regulatory processes provided an empirical basis for the emergence of numerous therapies targeting self‐regulation. We conclude by discussing how Bandura's social cognitive theory, as well as more recent advances in social cognitive theorising, might be further applied to innovative approaches to therapeutic interventions, assessment and clinical case conceptualization. [ABSTRACT FROM AUTHOR]

This clinical case assessed the efficacy of cognitive behavioral therapy (CBT) in treating major depressive disorder in a 26-year-old female, Sara, attributing her depression to pregnancy, financial constraints, parental duties, and emotional stress. Sara had eight sessions of CBT, during which her symptoms were measured using the Hamilton Depression Rating Scale (HAM-D) and the Beck Depression Inventory-Second Edition (BDI-II). Sara's depressive symptoms dramatically decreased after the intervention, moving her HAM-D and BDI-II scores from moderate to mild depression and from clinically depressed to mild, respectively. The assessment showed improved interest, concentration, energy levels, and a more positive self-perception. Integrating Malaysian cultural elements into CBT, emphasizing family support, community engagement, and spirituality positively impacted Sara. This study emphasizes the value of culturally appropriate CBT for depression as it can help with symptom management, challenging negative thoughts, and bolstering self-esteem. This method identifies and addresses cultural impacts on mental health, recommending the incorporation of cultural aspects in therapy, enhancing relapse prevention and quality of life for Malaysians experiencing depression. [ABSTRACT FROM AUTHOR]

Trichotillomania is a debilitating and chronic condition involving repeated hair pulling from various areas of the body. Trichotillomania often begins in childhood, suggesting that the development and understanding of treatments for trichotillomania in youth are of utmost importance, especially for successful early intervention. While habit reversal training (HRT) is considered the gold standard treatment for trichotillomania in young people, this article reviews a nascent treatment approach for trichotillomania in youth, acceptance-enhanced behavior therapy (AEBT). AEBT combines HRT and acceptance and commitment therapy skills. Each component of AEBT is described and reviewed. A detailed case exemplar of the 10-session protocol is presented. Future research directions and important clinical considerations are discussed. [ABSTRACT FROM AUTHOR]

Pediatric obsessive–compulsive disorder (OCD) affects approximately.25%–3% of children, and if left untreated, can cause significant impairment for the child and family. Cognitive behavioral therapy with exposure and response prevention (ERP) is the gold-standard treatment for pediatric OCD. When using ERP with children and adolescents, it is essential to assess and target family factors in treatment in order to help the youth make therapeutic progress. The following case study illustrates the successful implementation of family-based ERP in a young female with contamination OCD. It further highlights strategies for targeting family accommodation and family conflict within the course of treatment. [ABSTRACT FROM AUTHOR]

Introduction. Insomnia is a common sleep disorder in cancer patients, characterized by a reduction in the quality or quantity of sleep. It can lead to fatigue, mood disturbances, and may contribute to immunosuppression, affecting both disease progression and quality of life. Materials and methods. In an attempt to answer the question: "Does non-pharmacological treatment of insomnia improve the quality of life in cancer patients?", we conducted a systematic search in the international databases PubMed and ScienceDirect, following the PRISMA guidelines. The search keywords were "insomnia," "sleep disorders," "cancer," and "quality of life." Results. The systematic review included eight randomized trials that evaluated the effect of non-pharmacological therapies on insomnia and quality of life in oncology patients. Cognitive-behavioral therapy (CBT) is the first-line treatment with proven efficacy. Variants of CBT delivered through online platforms were found to be non-inferior in studies involving small patient groups. Another alternative treatment is acupuncture, which, while not as effective as CBT, improves sleep quality and enhances quality of life. Physical exercise, dance, nutrition programs, and psychological counseling also improve sleep and enhance quality of life compared to the usual hospital approaches. Conclusions. Non-pharmacological treatment of insomnia improves the quality of life in cancer patients. [ABSTRACT FROM AUTHOR]

This study aims to determine the effect of Mindfulness Based Cognitive Therapy (MBCT) in reducing anxiety in unemployed pilot school graduates. The research method used in this study is to use an experimental research design. The research design that will be used in this study is a one-group pretest-posttest design. The population in this study were 9 graduates of the 2019 class of BIFA pilot school, while the sample was 3 graduates of the 2019 class of BIFA pilot school who were not yet working. And the results of this study state that there was a decrease in anxiety of 55% for the first subject, 32% for the second subject, and 51% for the third subject. This means that there is a change in reducing the level of anxiety in unemployed pilot school graduates after being given MBCT. Also MBCT is also able to reduce negative or dysfunctional thoughts. Aspects that decreased included aspects of labelling, catastrophizing, regret orientation, what if, mind reading, and should-must. [ABSTRACT FROM AUTHOR]

The research aimed to explore the effectiveness of a counseling program based on schema therapy in cognitive distortions and academic buoyancy among Faculty of Education students, Al-Azhar University. The study sample consisted of (20) students enrolled in the first year at Faculty of Education. Their ages ranged from 17 to 20 years, with a mean age of 18.06 and a standard deviation of 0.80. They were divided into two groups: an experimental group and a control group, each consisting of 10 students. The researchers designed and utilized two scales for cognitive distortions, academic buoyancy scale and the schema therapy based program. Data analysis revealed that there were statistically significant differences between the mean ranks of the experimental group's pre- and post-measurements in the cognitive distortions scale in favor of the post-measurement. There were also statistically significant differences between the mean ranks of the experimental and control groups in the postmeasurement of the cognitive distortions scale, with the control group showing higher scores. However, the experimental group demonstrated higher scores on the academic buoyancy scale. Finally, there were no statistically significant differences between the mean ranks of experimental group's post- and follow up-measurements on the scales of cognitive distortions and academic buoyancy. [ABSTRACT FROM AUTHOR]

This study's purpose is to examine the differences between how men and women use cognitive coping mechanisms in stressful situations, specifically the COVID-19 pandemic. Research suggests that men and women cope with stress differently. Women tend to have a more emotional response to stressors and are expected to spend more time discussing issues with family and friends. Men are socialized for problem-focused coping. Only using problem-focused coping can be problematic when the cause of the stress cannot be changed by the individual. A secondary goal of this study was to evaluate other factors that affected cognitive coping, such as knowing someone who died of COVID-19. Participants ages 18–24 were invited to take part in an online survey evaluating cognitive coping mechanisms. After analysis, we found that in many ways men and women cognitively coped similarly. More often, women use a wider range of coping strategies except for self-blame and other blame. The participants used the coping mechanisms at significantly higher levels than adults during pre-pandemic times. Knowing someone who died of COVID-19 correlated with statistically significantly higher usage of several coping mechanisms. Understanding young adults' cognitive coping during high-stress scenarios can uncover solutions to improved mental health care. [ABSTRACT FROM AUTHOR]

This study investigated the psychological factors related to the attitudes of Chinese arts college students toward integrated arts education. It also examined predictive models incorporating psychological variables, demographic profiles, and art education-related characteristics to offer valuable insights for future research and art education practices. The sample comprised 303 Chinese college students majoring in arts and aged 18–22 years. The predictive models were examined using stepwise regression and decision tree analyses. The results indicated positive correlations between attitudes toward integrated arts education and several psychological variables, including extraversion, openness, conscientiousness, agreeableness, the Behavioral Inhibition System (BIS), hardiness, creativity, self-efficacy, and purpose orientation for personal growth. Neuroticism and the Behavioral Activation System (BAS) were negatively correlated with attitudes toward integrated arts education. Further, extraversion accounted for the greatest variance in attitudes toward integrated arts education. Extraversion, self-efficacy, purpose orientation for personal growth, BIS, and commitment accounted for approximately 38.3% of the variance. The decision tree model, predicting the attitudes of college students majoring in the arts toward integrated arts education, included extraversion, self-efficacy, teaching experience in their major, and academic year. This study contributes to a better understanding of the psychological and educational factors that shape the attitudes of Chinese arts students toward integrated arts education and provides a predictive framework that can inform future research and educational practices. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate whether Internet-based cognitive behavioural therapy intervention (ICBT) for individuals with tinnitus had an indirect effect on the third-party disability noticed by significant others (SOs). Methods: Significant Others Questionnaire (CTSOQ). Individuals with tinnitus completed standardized self-reported outcome measures for tinnitus severity, anxiety, depression, insomnia, hearing-related quality of life, tinnitus cognitions, hearing disability, and hyperacusis. Results: In total, 194 pairs of individuals with tinnitus and their SOs participated. The impact of third-party disability experienced by SOs was significantly reduced after individuals with tinnitus undertook the ICBT intervention (d = 0.41). This reduced SOs with severe difficulties from 52% to 35%. The remaining impact was mild for 30% and moderate for 35%. SOs with higher baseline difficulties and SOs who were partners (e.g., spouses) were less likely to notice indirect benefits from intervention undertaken by their family members. There was a moderate positive correlation between the post-intervention CTSOQs and the clinical variables of tinnitus severity and depression. Conclusions: Third-party disability may be reduced as an indirect effect of individuals with tinnitus undertaking ICBT. Including SOs of individuals with tinnitus within the rehabilitation process may add additional benefits, and such involvement should be encouraged. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer (BC) is the most common type of cancer and the second cause of cancer‐related death among women. Psychological treatments such as cognitive behavioral therapy (CBT) have been used as an effective method in the treatment of depression and anxiety in BC patients, and their effectiveness has been approved in various studies. Objective: The present study aimed to systematically investigate the effectiveness of CBT on depression and anxiety symptoms in BC patients and survivors. Methods: Electronic databases such as PubMed, Scopus, Web of Science [WOS], ScienceDirect, Cochrane Library, and Google Scholar were systematically searched from "October 2023" to "February 2024." The quality of the included studies was evaluated using the Critical Appraisal Skills Programme (CASP). In this study, the randomized controlled trials and quasi‐experimental studies that assessed the effectiveness of CBT, cognitive behavioral group therapy (CBGT), and the combination of CBT with other psychological studies on depression and anxiety of BC patients and survivors were reviewed. Results: Out of the 16 included studies, six used CBT, and six used CBGT. In the other four studies, a combination of CBT with other psychological interventions was implemented as an interventional program. Among 16 included studies, 14 studies showed that CBT, CBGT, and a combination of CBT with other psychological interventions significantly decreased the anxiety and depression scores among BC patients and survivors (p < 0.05), and only in two studies, no significant effect was observed. Conclusion: As most included studies showed the effectiveness of CBT in decreasing the depression and anxiety scores among BC patients and survivors, this study strongly suggests CBT as an effective non‐pharmacological method for the treatment of psychiatric disorders of BC patients during cancer treatments and also for BC survivors. [ABSTRACT FROM AUTHOR]

Background: Anxiety disorder is one of the most common mental disorders and often accompanied with sleep disturbance which can in turn exacerbate anxiety symptoms, creating a vicious cycle. In addition to psychopharmacological therapy, the effectiveness of psychotherapy as cognitive behavioral therapy (CBT) for treating anxiety disorders and insomnia has been well documented and widely accepted, but it is labor‐intensive and costly. However, virtual reality (VR)–integrated CBT may improve this condition but needs more evidences to support its extensive application in routine clinical practice. Objectives: This explorative study was aimed to conduct a retrospective analysis to evaluate the acute (2 weeks) augmented effect of VR‐integrated relaxation and mindfulness exercising in improving anxiety and insomnia symptoms for patients who were diagnosed with anxiety disorders and concurrently with prominent insomnia symptoms and admitted to the Department of Psychiatry, The Affiliated Guangdong Second Provincial General Hospital of Jinan University during January 2021 to June 2021. Methods: All patients who were admitted to the department of psychiatry during January 1, 2021 to June 30, 2021 were screened with inclusion criteria and exclusion criteria, and the sociodemographic and clinical data of those included patients were collected from the electronic medical record system of the hospital using a self‐designed case report form (CRF). Subjects who were administrated with medication alone were designated as conventional group, and those receiving treatment of medication combined with VR‐integrated CBT (VR relaxation and mindfulness exercising) as VR group. The baseline and 2‐week posttreatment data were compared between the two groups. Results: In total, there were 103 patients (70 female, 68%) included in the study. Among all, 68 (66.02%) were designated as the "VR group," and 35 (33.98%) as the "conventional group." The majority of patients (67%) were diagnosed with generalized anxiety disorder (GAD). Twenty‐three (22.3%) patients had a comorbid diagnosis with primary insomnia, and insomnia was just one of the accompanying symptoms with anxiety for the rest 80 subjects. No statistically significant differences were found between VR and conventional groups in all baseline sociodemographic and clinical characteristics except for occupation. There were statistically significant differences for the remission rates of anxiety symptoms or insomnia symptoms and reduction of Hamilton Anxiety Rating Scale or Insomnia Severity Index total scores between conventional and VR groups. Greater remission rates or score reductions were found in VR group than in conventional group either for anxiety or for insomnia. Robust differences still existed when controlled for the variable "occupation." Conclusions: Two‐week augmented VR‐integrated relaxation and mindfulness exercising is acutely beneficial for relieving both anxiety and insomnia symptoms and worth being recommended for routine clinical practice. Further prospective and randomized study compared to traditional CBT to explore its acute and long‐term effect on anxiety and insomnia is needed. [ABSTRACT FROM AUTHOR]

Objective: Adjuvant endocrine therapy (AET) is increasingly being prescribed for up to 10 years to people diagnosed with hormone receptor‐positive breast cancer. AET intake is often accompanied by side effects that significantly impact the well‐being of people. The way individuals cope with medication‐related side effects might play a pivotal role in their emotional adaption. Methods: This intensive‐longitudinal study investigated the association between self‐reported coping strategies (Brief COPE) and psychological well‐being (Patient Health Questionnaire‐4) among women undergoing AET. A multilevel factor analysis resulted in the identification of four coping factors, namely, problem‐focused, support‐focused, meaning‐focused, and avoidance‐focused coping. Daily coping efforts and experienced side effects were analyzed as predictors of psychological well‐being using multilevel modeling. Results: A total of 215 women (Mage = 56.5 ± 10.9 years) participated, resulting in a total of n = 2080 daily surveys (M = 9.67 ± 1.08). On average, women reported 3.7 ± 2.2 different side effects per day. Days characterized by an elevated frequency of side effects and increased burden were associated with diminished well‐being. Using more problem‐ and meaning‐focused strategies than usual to cope with side effects correlated positively with well‐being. Conversely, employing more support‐ and avoidance‐focused coping strategies than usual was linked to reduced psychological well‐being. Exploratory analyses focusing on individual coping strategies provided nuanced insights into coping behaviors. Conclusion: The present findings underscore the relationship between women's coping efforts concerning medication‐related side effects during AET and their daily well‐being. Psychosocial education (e.g., cognitive behavioral therapy) may offer valuable benefits for patients by helping them develop adaptive coping strategies to manage side effects. [ABSTRACT FROM AUTHOR]

Objective: Breast cancer has a strong impact on the mental state of those affected. Cognitive behavioral therapy (CBT) is one effective approach to reduce disease burden. This randomized controlled pilot trial aimed to assess the effect of the digital CBT‐based application Living Well on psychological outcomes in a German female breast cancer population. Methods: Female breast cancer patients (n = 70) with ongoing or finished oncological treatment that is who were receiving or had received any type of oncological treatment were included in the study and randomized to an intervention group (IG, n = 32) receiving Living Well in addition to care as usual, and a control group (CG, n = 38) receiving care as usual only. Participants completed standardized questionnaires at baseline and after 2, 4, 8, and 12 weeks to assess anxiety and depression (HADS) as primary outcomes, distress (DT), health‐related quality of life (HRQoL, AQoL‐8D), and illness perception (B‐IPQ) as secondary outcomes. Results: After 12 weeks, significant (p < 0.05) higher improvements in the IG could be observed in anxiety levels, HRQoL, and illness perception, when compared to the CG. Age and time since diagnosis were found to be relevant covariates for anxiety levels. In distress levels, the IG showed a clinically relevant and nearly significant reduction compared to the CG (p = 0.057). No effects could be observed in depression levels. Conclusions: The results demonstrate the potential of Living Well to improve psychological outcomes of female breast cancer patients and encourage further studies evaluating the effectiveness of the digital application. Trial Registration: The trial has been registered in the German Clinical Trials Register (DRKS00029918) [ABSTRACT FROM AUTHOR]

Introduction Tinnitus can be distressing, and it affects the quality of life (QoL) through psychological and cognitive impairments. Cognitive behavioral therapy (CBT) and notched sound therapy (NST) are tinnitus management approaches aiming to reduce symptoms and improve QoL via two different mechanisms. The CBT attains the cognitive principle, whereas the NST initiates tinnitus habituation. Objective To evaluate the effect of CBT and NST and compare their results in the management of chronic subjective tinnitus. Methods The present prospective study involved 64 adults with normal hearing and chronic subjective tinnitus. They were subjected to history taking, basic audiological evaluation, and extended high-frequency audiometry at 10 and 12.5 kHz. The participants were divided into two equal groups, the first treated with CBT and the second treated with NST. The psychoacoustic measures of tinnitus and the Arabic Questionnaire for Tinnitus Reaction (Arabic-QTR) were used to monitor the outcomes of both therapies. Results Both groups showed significant reduction in tinnitus severity according to the Arabic-QTR and tinnitus loudness matching. Improvement in the Arabic-QTR was better in the CBT group, while tinnitus loudness improvement was better in the NST group. Conclusion Both CBT and NST are effective in the management of chronic subjective tinnitus. In a comparison of the effect of the two therapies, CBT was found to be more effective in decreasing tinnitus-related distress, whereas SNT was found to be more helpful in reducing tinnitus loudness. [ABSTRACT FROM AUTHOR]