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Zheng Q, Feng Y, Li J, Xu S, Ma Z, Wang Y. Distinct characteristics of social anxiety among youths with childhood sexual abuse: A latent profile analysis. CHILD ABUSE & NEGLECT 2024; 155:106967. [PMID: 39173507 DOI: 10.1016/j.chiabu.2024.106967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 07/20/2024] [Accepted: 07/29/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Childhood sexual abuse (CSA) is one type of childhood trauma that has long-term effects on physical and mental health, predisposing to social anxiety. OBJECTIVE This study attempted to investigate the characteristics of different subgroups of social anxiety among youths with CSA experiences. PARTICIPANTS AND SETTING 83,219 participants were recruited in a cross-sectional study from 63 colleges and universities in Jilin Province, China. METHODS The main variables were measured by a series of self-report questionnaires. Latent profile analysis was used to classify different subgroups of social anxiety, and multiple logistic regression was employed to investigate factors influencing transitions between different subgroups. RESULTS 3022 (3.63 %) youths who suffered from CSA (46.8 % were male, Mage = 19.57, SD = 1.76) could be divided into four subgroups of social anxiety: low-risk social anxiety (16.4 %), medium-risk social anxiety with high public speaking anxiety (30.3 %), medium-risk social anxiety with no prominent characteristics (22.9 %), and high-risk social anxiety (30.4 %). Shy bladder and bowel and virtual life orientation increased the level of social anxiety from low to medium and high risk. Smoking and drinking were more prevalent in the low- and medium-risk subgroups than in the high-risk subgroup. CONCLUSIONS There was heterogeneity in different subgroups of social anxiety among youths with CSA experiences. Potential targeted prevention and intervention suggestions could be beneficial in mitigating the risk of social anxiety and further preventing the aggravation of risk between subgroups.
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Affiliation(s)
- Qiaoqing Zheng
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yi Feng
- Mental Health Center, Central University of Finance and Economics, Beijing, China
| | - Jiaqi Li
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Shicun Xu
- Northeast Asian Research Center, Jilin University, Changchun, China
| | - Zhihao Ma
- Computational Communication Collaboratory, School of Journalism and Communication, Nanjing University, Nanjing, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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2
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de Ponti N, Matbouriahi M, Franco P, Harrer M, Miguel C, Papola D, Sicimoğlu A, Cuijpers P, Karyotaki E. The efficacy of psychotherapy for social anxiety disorder, a systematic review and meta-analysis. J Anxiety Disord 2024; 104:102881. [PMID: 38815481 DOI: 10.1016/j.janxdis.2024.102881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/19/2024] [Accepted: 05/22/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Given the growth in research examining the effects of psychotherapy on social anxiety disorder (SAD), an up-to-date comprehensive meta-analysis in this field is needed. METHODS We selected studies from a database of randomized trials (RCTs) on psychotherapies for anxiety disorders (last updated search of PubMed, PsycINFO, Embase, and Cochrane (CENTRAL): 1 January 2024) We included RCTs comparing psychotherapy to a control condition for adults with SAD and conducted random effects meta-analyses to examine the efficacy of psychotherapy compared to control conditions at post-treatment. RESULTS Sixty-six RCTs were included with 5560 participants and 98 comparisons between psychotherapy and control groups. Psychotherapy was effective in reducing SAD symptoms, with a large effect size (g = 0.88; 95 % CI: 0.76 to 1.0; I2 = 74 %; 95 % CI: 69 to 79, NNT = 3.8). Effects remained robust across sensitivity analyses. However, there was evidence for significant risk of bias in the included trials. The multivariable meta-regression indicated significant differences in treatment delivery formats, type of recruitment strategy, target group, and number of sessions. CONCLUSION Psychotherapy is an effective treatment for SAD, with moderate to large effect sizes across all treatment types and formats. Future research is needed to determine the long-term effects.
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Affiliation(s)
- Nino de Ponti
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - Minoo Matbouriahi
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Pamela Franco
- Department of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
| | - Mathias Harrer
- Psychology & Digital Mental Health Care, Technical University Munich, Munich, Germany
| | - Clara Miguel
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Davide Papola
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Ayşesu Sicimoğlu
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Babes,-Bolyai University, International Institute for Psychotherapy, Cluj-Napoca, Romania; WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Uysal B, Gormez V, Karatepe HT, Sönmez D, Taştekne F, Tepedelen MS, Jordan TR. Reducing Test Anxiety During the COVID-19 Pandemic: A Comparison of the Effectiveness of Cognitive Behavioral Therapy and Acceptance and Commitment Therapy. Psychol Rep 2024; 127:159-177. [PMID: 37140196 PMCID: PMC10160818 DOI: 10.1177/00332941231174394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Educational assessments can affect students' mental health, particularly during a pandemic. Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT) are widely efficacious for reducing test anxiety, as well as general anxiety and rumination. However, the effectiveness of these two therapies for students during COVID-19 is unclear. We measured the effectiveness of ACT and CBT for managing test anxiety, general anxiety, and rumination during COVID-19 for 77 students taking Türkiye's national university entrance exam, assigned to either the ACT or CBT psychoeducation programs. Both programs reduced test anxiety, general anxiety, and rumination, and showed similar levels of effectiveness. This suggests that ACT and CBT are both important for improving students' mental health during COVID-19 and either may be beneficial.
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Affiliation(s)
- Burcu Uysal
- Department of Psychology, School of Humanities and Social Sciences, Ibn Haldun University, Istanbul, Turkey
| | - Vahdet Gormez
- Department of Child and Adolescent, Medical Faculty, Istanbul Medeniyet University, Istanbul, Turkey
| | - Hasan Turan Karatepe
- Department of Psychiatry, Medical Faculty, Istanbul Medeniyet University, Istanbul, Turkey
| | - Dilruba Sönmez
- Department of Psychology, School of Humanities and Social Sciences, Ibn Haldun University, Istanbul, Turkey
| | - Feyzanur Taştekne
- Department of Psychology, School of Humanities and Social Sciences, Ibn Haldun University, Istanbul, Turkey
| | - Mehmed Seyda Tepedelen
- Department of Psychology, School of Humanities and Social Sciences, Ibn Haldun University, Istanbul, Turkey
| | - Timothy R Jordan
- Department of Psychology, School of Humanities and Social Sciences, Ibn Haldun University, Istanbul, Turkey
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4
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Seon Q, Mady N, Yang M, Karia M, Lashley M, Sescu C, Lalonde M, Puskas S, Outerbridge J, Parent-Racine E, Pagiatakis C, Gomez-Cardona L, Jiang D, Bouchard S, Linnaranta O. A Virtual Reality-Assisted Cognitive Behavioral Therapy for and With Inuit in Québec: Protocol for a Proof-of-Concept Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e40236. [PMID: 37223973 PMCID: PMC10248771 DOI: 10.2196/40236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 12/19/2022] [Accepted: 01/10/2023] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Emotion regulation is an ability related to psychological well-being; when dysregulated, individuals may have psychiatric symptoms and maladapted physiological responses. Virtual reality-assisted cognitive behavioral therapy (VR-CBT) is an effective psychotherapy to target and strengthen emotion regulation; however, it currently lacks cultural sensitivity and can be improved by adapting it to the cultural context of service users. During previous participatory research, we co-designed a culturally adapted cognitive behavioral therapy (CBT) manual and 2 virtual reality (VR) environments to function as a complement to therapy (VR-CBT) for Inuit who would like to access psychotherapy. Emotion regulation skill building will occur in virtual environments that have interactive components such as heart rate biofeedback. OBJECTIVE We describe a protocol for a proof-of-concept 2-arm randomized controlled trial (RCT) with Inuit (n=40) in Québec. The primary aims of this research are to investigate the feasibility, benefits, and challenges of the culturally adapted VR-CBT intervention versus an established VR self-management that is available commercially. We will also investigate self-rated mental well-being and objective psychophysiological measures. Finally, we will use proof-of-concept data to identify suitable primary outcome measures, conduct power calculations in a larger trial for efficacy, and collect information about preferences for on-site or at-home treatment. METHODS Trial participants will be randomly assigned to an active condition or active control condition in a 1:1 ratio. Inuit aged 14 to 60 years will receive a culturally adapted and therapist-guided VR-CBT with biofeedback or a VR relaxation program with nonpersonalized guided components over a 10-week period. We will collect pre- and posttreatment measures of emotion regulation and biweekly assessments over the treatment and at 3-month follow-up. The primary outcome will be measured by the Difficulties in Emotion Regulation Scale (DERS-16) and a novel psychophysiological reactivity paradigm. Secondary measures include psychological symptoms and well-being via rating scales (eg, anxiety or depressive symptoms). RESULTS As this is the prospective registration of an RCT protocol, we do not yet report any results from the trial. Funding was confirmed in January 2020, and recruitment is expected to start in March 2023 and is set to finish in August 2025. The expected results are to be published in spring 2026. CONCLUSIONS The proposed study responds to the community's desire for accessible and appropriate resources for psychological well-being, as it was developed in active collaboration with the Inuit community in Québec. We will test feasibility and acceptance by comparing a culturally adapted, on-site psychotherapy with a commercial self-management program while incorporating novel technology and measurement in the area of Indigenous health. We also aim to fulfill the needs for RCT evidence of culturally adapted psychotherapies that are lacking in Canada. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN) 21831510; https://www.isrctn.com/ISRCTN21831510. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/40236.
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Affiliation(s)
- Quinta Seon
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Noor Mady
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Michelle Yang
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Maharshee Karia
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Myrna Lashley
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | | | | | | | | | | | | | | | - Di Jiang
- National Research Council, Montreal, QC, Canada
| | - Stéphane Bouchard
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Outaouais, QC, Canada
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5
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Figueiredo DV, Alves F, Vagos P. Psychological inflexibility explains social anxiety over time: a mediation analyses with a clinical adolescent sample. CURRENT PSYCHOLOGY 2023:1-12. [PMID: 37359612 PMCID: PMC10117271 DOI: 10.1007/s12144-023-04650-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 06/28/2023]
Abstract
Social Anxiety Disorder (SAD) has its usual onset during adolescence when it is a highly prevalent and debilitating condition. Evidence regarding the processes that underline social anxiety and SAD is not compelling, especially in adolescents. Within an Acceptance and Commitment Therapy (ACT) framework, the causal role of ACT processes on adolescents' social anxiety and how these processes contribute to sustain social anxiety over time is still unknown. Hence, this study explored the role of psychological inflexibility (PI) and acceptance and committed action (as psychological flexibility processes) on social anxiety over time, in a clinical sample of adolescents. Twenty-one adolescents (Mage = 16.19, SD = 0.750) with a primary diagnosis of SAD completed a set of self-report measures assessing PI, acceptance (i.e., willingness to experience social anxiety symptoms), action (i.e., moving towards valued life directions despite social anxiety symptoms) and social anxiety. Path analysis was used to investigate a mediation model linking acceptance, committed action, and PI to social anxiety, directly and indirectly. Findings revealed that acceptance and action were negatively and directly associated with PI after 10-weeks. In turn, PI yielded a positive and direct effect on social anxiety after another 12-weeks. PI totally mediated the relation between acceptance and action and social anxiety, with significant indirect effects. Overall, findings offer evidence for the applicability of the ACT model to adolescent SAD and support the use of clinical interventions targeting PI to understand and alleviate adolescents' social anxiety.
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Affiliation(s)
- Diana Vieira Figueiredo
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention – CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, 3000-115 Portugal
| | - Francisca Alves
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention – CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, 3000-115 Portugal
| | - Paula Vagos
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention – CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, 3000-115 Portugal
- Institute of Human Development, Portucalense Infante D. Henrique University, Porto, 4200-072 Portugal
- William James Research Center, Departamento de Educação e Psicologia, Universidade de Aveiro, Aveiro, Portugal
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Abstract
BACKGROUND Emotion regulation (ER) refers to the process of modulating an affective experience or response. Objectives: This is a systematic review of the research on therapist methods to facilitate patient ER, including affect-focused, experiential methods that aim to enhance immediate patient emotion regulation, and structured psychoeducation, skills training in ER. METHOD A total of 10 studies of immediate and intermediate outcomes of emotion regulation methods were examined. A total of 38 studies were included in the meta-analysis of distal treatment effects on emotion regulation. RESULTS In eight studies with 84 clients and 33 therapists, we found evidence of positive intermediate outcomes for affect-focused therapist methods and interpretations. A meta-analysis of 26 studies showed that the average effect size of ER methods from pre- to post-treatment was large (g = 0.82). CONCLUSIONS Both affect-focused and structured skill training are associated with distal improvements in emotion regulation. When working with ER in psychotherapy, therapists must consider how patients' cultural backgrounds inform display rules, as well as what might be considered adaptive or maladaptive. The article concludes with training implications and therapeutic practices based on the research evidence.
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Affiliation(s)
- Shigeru Iwakabe
- Department of Psychology, Ritumeikan University, Ibaraki-Shi, Japan
| | - Kaori Nakamura
- Department of Psychology, Ritumeikan University, Ibaraki-Shi, Japan
| | - Nathan C Thoma
- Department of Psychology, Ritumeikan University, Ibaraki-Shi, Japan
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7
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Akbari M, Seydavi M, Davis CH, Levin ME, Twohig MP, Zamani E. The current status of acceptance and commitment therapy (ACT) in Iran: A systematic narrative review. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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8
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Caletti E, Massimo C, Magliocca S, Moltrasio C, Brambilla P, Delvecchio G. The role of the acceptance and commitment therapy in the treatment of social anxiety: An updated scoping review. J Affect Disord 2022; 310:174-182. [PMID: 35537544 DOI: 10.1016/j.jad.2022.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 04/27/2022] [Accepted: 05/04/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Social Anxiety Disorder (SAD) or Social Phobia is characterized by fear and anxiety of social circumstances that negatively impact an individual's occupational and relational life. There are several treatment options for this disorder ranging from pharmacological therapy to psychotherapies. In particular, the Acceptance and Commitment Therapy (ACT), a form of cognitive-behavioral therapy that practices acceptance and awareness strategies with behavior change strategies in order to increase an individual's mental flexibility, has been found to be effective. In this review, we aimed to provide an overview of recent studies that examined ACT's efficacy in SAD, also taking into consideration the comparison with traditional Cognitive-behavioral Therapy (CBT) interventions. METHODS A bibliographic search on PubMed, EMBASE and Scopus was conducted from inception to the 3rd of February 2022 of all studies investigating the effect of ACT in SAD individuals without any comorbidity. Among the articles retrieved, 11 met the inclusion criteria. RESULTS From the reviewed studies, ACT may be considered a promising treatment of social phobia by improving attentional bias, awareness, emotion regulation, and safety/avoidance behaviors; however, the results have not yet demonstrated a valid alternative to the CBT. LIMITATIONS Only four studies considered a follow-up evaluation, which is paramount to exploring the effectiveness of ACT and several studies have a very small sample size. Concerning the review itself we only considered original English articles and we did not measure the risk of publication bias and the risk of bias between studies. CONCLUSIONS The results of this study suggest that ACT can be a promising treatment for improving selective psychological problems often observed in SAD. However, larger longitudinal studies further exploring the effectiveness of the behavioral and cognitive "third-wave" psychotherapies, based mainly on acceptance of SAD, are necessary.
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Affiliation(s)
- Elisabetta Caletti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Massimo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Sara Magliocca
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Psychology, University of Milan-Bicocca, Milan, Italy
| | - Chiara Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
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9
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Lei H. Effect of Multivoice Chorus on Interpersonal Communication Disorder. Occup Ther Int 2022; 2022:6124778. [PMID: 35854942 PMCID: PMC9288328 DOI: 10.1155/2022/6124778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 06/09/2022] [Indexed: 11/17/2022] Open
Abstract
Objective As a type of music therapy, multipart chorus does not have high requirements for participants, and the basic level can be high or low. For college students, it is more likely to participate. Exploring the effect of multivoice chorus intervention on college students' mental health can provide reference for school psychological correction work. This study uses multivoice chorus as a means, combined with certain group psychological counseling techniques, to try to explore a new model for improving the mental health of college students. Method Fifty college students in prison were selected as subjects and randomly divided into the control group and experimental group. The multivoice chorus method was used to conduct an intervention test on the mental health of the college students in the experimental group, and the observation was carried out for 3 months. Before and after the intervention, the anxiety self-rating scale, the trust scale, the social avoidance and distress scale, the shyness scale, the UCLA loneliness scale, and the college student psychological test personality subtest were used for psychological testing and evaluation. Results/Discussion. College students can actively recognize and reflect on their own behavior, and objectively evaluate others. Through the cognition and management of emotions, college students can handle personal emotions well in interpersonal communication. In the later stage of multivoice chorus, they can help each other, establish a mutual assistance system, help each other, and discuss and learn interpersonal communication skills together, so that college students can learn good interpersonal communication experience and skills from others in various interactions, achieve self-help, and promote college students to work together. In the process of interfering with interpersonal communication disorder, simple psychological counseling has also improved the phenomenon of interpersonal communication disorder, but the experimental effect is far from the effect of the combination of music education and psychological counseling, and it is relatively unstable in the stability test. In the specific operation, in the purely psychological counseling process, college students with interpersonal barriers do not actively cooperate with the intervention, the operating atmosphere is relatively dull, and the teachers are time-consuming and labor-intensive during the psychological counseling process, but the results are minimal. The only effect is also worn out within a few weeks, and the stability is poor. It can be seen that music education has played a pivotal role as a medium in the intervention of interpersonal communication disorders, which can make the intervention process easier, more effective, and more stable.
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Affiliation(s)
- Huiling Lei
- Hunan First Normal University, Changsha City, Hunan Province, China 410205
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10
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Haller H, Breilmann P, Schröter M, Dobos G, Cramer H. A systematic review and meta-analysis of acceptance- and mindfulness-based interventions for DSM-5 anxiety disorders. Sci Rep 2021; 11:20385. [PMID: 34650179 PMCID: PMC8516851 DOI: 10.1038/s41598-021-99882-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/01/2021] [Indexed: 01/13/2023] Open
Abstract
This meta-analysis systematically reviewed the evidence on standardized acceptance-/mindfulness-based interventions in DSM-5 anxiety disorders. Randomized controlled trials examining Acceptance and Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Stress Reduction (MBSR) were searched via PubMed, Central, PsycInfo, and Scopus until June 2021. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for primary outcomes (anxiety) and secondary ones (depression and quality of life). Risk of bias was assessed using the Cochrane tool. We found 23 studies, mostly of unclear risk of bias, including 1815 adults with different DSM-5 anxiety disorders. ACT, MBCT and MBSR led to short-term effects on clinician- and patient-rated anxiety in addition to treatment as usual (TAU) versus TAU alone. In comparison to Cognitive Behavioral Therapy (CBT), ACT and MBCT showed comparable effects on both anxiety outcomes, while MBSR showed significantly lower effects. Analyses up to 6 and 12 months did not reveal significant differences compared to TAU or CBT. Effects on depression and quality of life showed similar trends. Statistical heterogeneity was moderate to considerable. Adverse events were reported insufficiently. The evidence suggests short-term anxiolytic effects of acceptance- and mindfulness-based interventions. Specific treatment effects exceeding those of placebo mechanisms remain unclear. Protocol registry: Registered at Prospero on November 3rd, 2017 (CRD42017076810).
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Affiliation(s)
- Heidemarie Haller
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
| | - Pascal Breilmann
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Marleen Schröter
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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11
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Swee MB, Hudson CC, Heimberg RG. Examining the relationship between shame and social anxiety disorder: A systematic review. Clin Psychol Rev 2021; 90:102088. [PMID: 34598054 DOI: 10.1016/j.cpr.2021.102088] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 07/21/2021] [Accepted: 09/17/2021] [Indexed: 11/28/2022]
Abstract
This paper is the first systematic review of the literature on the relationship between shame and social anxiety (SA). We reviewed a total of 60 peer-reviewed empirical articles that met criteria for inclusion. We begin by summarizing literature investigating the empirical association between shame and SA and review literature on whether this association is impacted by cultural or diagnostic differences. Next, we briefly describe the updated version of Rapee and Heimberg's (1997) cognitive-behavioral model of social anxiety disorder (SAD; Heimberg, Brozovich, & Rapee, 2014) and propose how shame may interact with five processes described therein: environmental experiences, observations/images of the self, perceived negative evaluation by others, post-event cognitive processes, and behavioral manifestations of SA. We review the current literature on shame and SA as it relates to each of these domains. Thereafter, we discuss existing research on the role of shame in the treatment of SAD and the implications of the research discussed in this review. Finally, we conclude with a discussion of some key limitations in the existing literature and areas for future research.
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Affiliation(s)
- Michaela B Swee
- Department of Psychology, Temple University, 1701 North 13(th) Street, Philadelphia, PA 19122, United States.
| | - Chloe C Hudson
- Department of Psychology, Queen's University, 62 Arch Street, Humphrey Hall, Kingston, ON K7L 3N6, Canada.
| | - Richard G Heimberg
- Department of Psychology, Temple University, 1701 North 13(th) Street, Philadelphia, PA 19122, United States.
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12
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Treatment of Major Depressive Disorder with Autism Spectrum Disorder by Acceptance and Commitment Therapy Matrix. Case Rep Psychiatry 2021; 2021:5511232. [PMID: 33880197 PMCID: PMC8046572 DOI: 10.1155/2021/5511232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 11/18/2022] Open
Abstract
Autism spectrum disorder (ASD) is known to increase a variety of psychiatric disorders, including major depressive disorder (MDD). Acceptance and commitment therapy (ACT) has been reported to be an effective psychotherapy for MDD. However, this is not the case with ASD. In this case study, based on the hypothesis that it is effective in treating MDD with ASD, we adapted the ACT Matrix, a tool for visualizing an individual's experiences in the context of ACT, and administered 15 sessions to a woman with MDD with ASD following the onset of photo dermatosis. By the end of the final session, there was an increase in value-based behaviors and significant changes in depressive symptoms as well as significant changes in process measures such as experience avoidance, mindfulness, and progress toward a valued life. Six months after the end of the session, the improvement in symptoms was even stronger and the process measure of obstruction to a valued life was significantly improved. The ACT Matrix may thus ameliorate MDD in patients with ASD.
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Bolghan-Abadi M, Keyvani E. The effectiveness of acceptance and commitment therapy on improving self-concept, depression, and anxiety in obese women. INTERNATIONAL ARCHIVES OF HEALTH SCIENCES 2021. [DOI: 10.4103/iahs.iahs_117_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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