AATP Journals

Cognitive behavioral digital therapeutic effects on distress and quality of life in patients with cancer: National randomized controlled trial. Objective: Cancer-specific psychological interventions like cognitive behavioral stress management (CBSM) demonstrate distress (e.g., anxiety/depression) and quality of life (QoL) benefits. Digital formats can expand access. Method: Patients (80.6% female; 76.5% White; 25–80 years) with Stage I–III cancer and elevated anxiety within 6 months of treatment (surgery/chemotherapy/radiation/immunotherapy) receipt were randomized 1:1 to a 10-module CBSM or health education control digital app and completed questionnaires at Weeks 0, 4, 8, 12. Primary outcomes of greater group-level anxiety (PROMIS-A) and depression symptom (PROMIS-D) reductions for CBSM were met and published; this secondary report evaluates individual-level response results for these outcomes and outcomes beyond anxiety and depression. Chi-square tests compared responder proportions using PROMIS-A/PROMIS-D symptom categories and two levels (≥5/≥7.5) of T-score point reductions. Changes across conditions over time for stress (Perceived Stress Scale), cancer-specific distress (Impact of Event Scale–Intrusions), and QoL (Functional Assessment of Cancer Therapy–General) were analyzed using repeated measures linear mixed-effects modeling (N = 449). Patient Global Impression of Change–Well-being was also examined. Results: At Week 12, a greater proportion of CBSM (vs. control) participants reported normal-to-mild (vs. moderate-to-severe) PROMIS-A and PROMIS-D, and a greater proportion of CBSM participants at Week 8 or 12 had a ≥7.5 T-score reduction in PROMIS-A and a ≥5 T-score reduction in PROMIS-D (ps < .05). CBSM participants (vs. control) showed significantly greater reductions in Perceived Stress Scale and Impact of Event Scale-Intrusions and increases in Patient Global Impression of Change–Well-being and Functional Assessment of Cancer Therapy emotional and physical well-being (ps < .05), but not functional or social/family well-being. Conclusion: Digitized CBSM benefits distress and QoL. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
View Mon, 02 Dec 2024 00:00:00 GMT

Results of a randomized waitlist-controlled trial of online cognitive behavioral sex therapy and online mindfulness-based sex therapy for hypoactive sexual desire dysfunction in women. Objective: This study aimed to investigate the efficacy of two internet-delivered psychological treatments for hypoactive sexual desire dysfunction (HSDD) in women: internet-based cognitive behavioral sex therapy (iCBST) and internet-based mindfulness-based sex therapy (iMBST). Method: Women with HSDD were randomly assigned to one of three groups: iCBST, iMBST, or a waitlist control group. The interventions consisted of eight modules delivered via an e-health platform with e-coach support to enhance adherence. Sexual desire and sexual distress were assessed at baseline and at 3-, 6-, and 12-month follow-ups (active conditions only). Per protocol, of the 266 consenting women, 106 were randomized to iCBST (M_age = 36.1, SD = 10.3), 106 to iMBST (M_age = 36.4, SD = 0.2), and 54 to the control condition (M_age = 36.7, SD = 11.0). Primary analyses utilized an intention-to-treat approach with linear mixed models. Clinical significance, assessed with clinical cutoffs and the reliable change index, was examined for active conditions. Results: Compared to the control condition, both iCBST and iMBST demonstrated significant improvements in sexual desire and sexual distress at 3-month (d = 0.89–1.14) and 6-month follow-up (d = 0.74–1.18). Results were sustained at 12-month follow-up, with 35 and 41% demonstrating reliable improvements and additional 20 and 24% achieving clinically significant improvements in sexual desire after iCBST and iMBST. Regarding sexual distress, 49 and 42% exhibited reliable change, with an additional 37%–42% achieving clinically significant improvements. Conclusions: Results provide support for the overall long-term efficacy of psychological therapies in treating HSDD in women. However, fewer than one in four women showed improvements in sexual desire that met the threshold for clinically significant change. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
View Thu, 24 Oct 2024 00:00:00 GMT

Reducing intrusive suicidal mental images in patients with depressive symptoms through a dual-task add-on module: Results of a multicenter randomized clinical trial. Objective: To examine the safety and efficacy of a brief cognitive dual-task (using eye movements) add-on module to treatment as usual (TAU) in reducing the severity and frequency of intrusive suicidal mental images and suicidal ideation. Method: We conducted a single-blind, parallel multicenter randomized trial (No. NTR7563) among adult psychiatric outpatients (N = 91; M_age = 34.4, SD = 13.54; 68% female) with elevated depressive symptoms and experiencing distressing suicidal intrusions in the Netherlands. Primary outcome was the severity (Suicidal Intrusions Attributes Scale) and frequency (Clinical Interview for Suicidal Intrusions) of suicidal mental imagery intrusions at 1-week posttreatment and 3-month follow-up. Primary analysis was intention-to-treat. Results: Between November 27, 2018 and September 13, 2021, 91 patients were included and randomly assigned to intervention group (Cognitive Dual Task Add-on + TAU) (n = 46) or TAU-only (n = 45). Cognitive Dual Task Add-on + TAU had greater reductions in severity (mean difference, −15.50, 95% CI [23.81, −7.19]; p < .001, d = 0.60), and frequency (geometric mean difference, 0.47, 95% CI [0.29, 0.79]; p = .004) of suicidal intrusions over time than TAU-alone. Cognitive Dual Task Add-on + TAU patients also showed lower suicidal ideation over time (p = .008, d = 0.42). There were no significant group differences in reductions in depressive symptoms, rumination, or hopelessness. Four serious adverse events occurred (three Cognitive Dual Task Add-on + TAU; one TAU-only); all unlikely attributable to intervention/trial. Conclusions: Findings provide support for the effectiveness of adding a cognitive dual-task module to the treatment of psychiatric outpatients with elevated depressive symptoms in reducing suicidal intrusions and ideation and can be executed safely. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
View Thu, 18 Jul 2024 00:00:00 GMT

Examining racial and ethnic differences in youth psychotherapy treatment engagement and outcomes. Objective: Research has identified racial/ethnic disparities in mental health treatment engagement, and there have been recent calls to examine effects of mental health treatment engagement on clinical outcomes among youth of color. This study aimed to examine racial/ethnic differences in (a) behavioral and attitudinal engagement, (b) treatment effectiveness, and (c) the associations between engagement and treatment effectiveness. Method: N = 200 youth (ages 7–15; 33% White, 28% Black, 25% Hispanic/Latinx, and 14% multiracial; 52% male) and their N = 200 parents participated in a randomized controlled trial testing the effectiveness of a transdiagnostic psychotherapy for common youth emotional and behavioral problems. Youth and parents reported internalizing and externalizing symptoms and treatment engagement (e.g., behavioral and attitudinal). Multilevel regression models examined variations in youth symptom trajectories by racial/ethnic group. Results: While all racial/ethnic groups showed comparable attitudinal engagement scores, Black and Latinx youth attended significantly fewer sessions than White and multiracial youth (8–9 vs. 13). However, youth in all racial/ethnic groups showed significant and similar improvements in treatment outcomes. Conclusions: Black and Latinx youth attended fewer sessions than White youth, but their clinical outcomes were similar to those of White youth. Future research should examine the meaning and implications of session attendance in relation to outcomes in youth of color. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
View Mon, 02 Dec 2024 00:00:00 GMT

Letter to the editor: Methodological flaws on the conduct and reporting in “Psychotherapies for the treatment of borderline personality disorder: A systematic review”. This brief commentary critically examines the study “Psychotherapies for the Treatment of Borderline Personality Disorder: A Systematic Review” by Crotty et al. (2023) It highlights several methodological and reporting concerns that impact the study’s credibility and conclusions. Key issues include the retrospective registration of the study protocol, discrepancies in authorship and protocol content, lack of clarity in inclusion and exclusion criteria, and limitations in geographical scope without clear justification. Furthermore, the letter discusses inconsistencies in the risk of bias and quality of evidence assessments, particularly in the application of the Grading of Recommendations Assessment, Development, and Evaluation system. These methodological shortcomings question the study’s findings, contrasting with other comprehensive reviews in the field. The critique emphasizes the importance of methodological rigor and transparency in systematic reviews, especially those influencing clinical practice and policy decisions in mental health care. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
View Mon, 02 Dec 2024 00:00:00 GMT

Response to commentary by Mattos et al. (2024). Replies to comments made by Mattos et al. (see record 2025-49982-003) on the original article (see record 2024-19816-001). Mattos et al. critiqued our assessments of the certainty of evidence as being overly permissive and not adhering to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group’s guidelines. GRADE has become an international standard to describe the level of confidence that investigators have in estimates of effects. Like the risk of bias evaluations, determining the certainty of evidence involves subjective judgment. The true value of GRADE is not in yielding a definitive evidence certainty rating but in its emphasis on transparency. While we acknowledge and respect the differing viewpoints of Mattos et al. regarding our ratings, we caution against the rigid and formulaic use of the GRADE methodology. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
View Mon, 02 Dec 2024 00:00:00 GMT