A Special Feature in Commemoration of Aaron T. Beck’s Contributions to the Science and Practice of CBT

This special feature in Cognitive and Behavioral Practice is a commemoration to Aaron T. Beck’s contributions to the science and practice of CBT. The fact that so many leading scholars participated, including several Past Presidents of the Association for Behavioral and Cognitive Therapies, speaks volumes about the high regard held for Beck. Included are papers that cover the Beckian model of depression, its refinement and application to obsessions, compulsions, hoarding, as well as how the model addresses interpretational biases in emotional psychopathology and has been adapted for youth. Additionally there are papers conveying how Beck’s phenomenological approach to understanding the client’s perspective is useful in attending to cultural differences, and in mitigating the mental health impact of marginalization and discrimination. Expert commentaries are extended to relational processes (case formulation, therapeutic relationship, collaboration and guided discovery, alliance, rupture repair, homework), change processes (cognitive reappraisal, dialectical thinking, acceptance and defusion, emotional schemas), and to important scientific advances (conceptualizing processes within techniques, data analytic advances that bridge the scientist-practitioner gap, and technology augmentation). Many of the contributions herein also include brief personal stories to help illustrate the enormity of Beck’s contributions.     

囤积症的行为心理特征及相关因素

囤积症是指过度获取和不能丢弃那些没有用处或失去价值的物品。这种行为通常会给患者本人及其家庭成员带来感情、躯体、财务、社会甚至法律方面的负面影响。对于囤积症的行为特征、心理特征及相关因素,学界已有大量的研究。近期,囤积症已被纳入DSM-5,这将有助于确定有持续性丢弃困难的个体,并对其予以帮助与干预。     

强迫症诊断研究的新变化

临床实践与相关研究表明,强迫症的诊断标准已不能满足复杂的临床工作需要。首先,有关患者的自知力以及主观痛苦程度等诊断指标需要进一步修订。其次,就强迫症的核心症状而产生的争议,研究者提出应重新考虑强迫症、焦虑障碍、强迫谱系障碍和囤积障碍这四个概念之间的从属关系和诊断标准。未来研究应考虑从认知神经科学的视角探索强迫症的核心症状和病理机制,为强迫症的诊断标准提供新的依据。     

Panic Disorder: Cognitive Behavioral and Pharmacological Treatment Strategies

The past decade has seen significant advances in both psychosocial, notably cognitive behavioral (CBT), and pharmacological treatments for panic disorder. Given the widely acknowledged efficacy of both forms of treatment, it is reasonable to consider that the combination of approaches should yield an extremely potent strategy to treating panic disorder. The present report summarizes scientific evidence for the singular and combined treatment approaches to panic disorder. Data across studies indicate that combined treatments yield immediate and short-term benefits above those provided by either pharmacologic treatment or CBT alone. In the long-term, however, these benefits disappear. In fact, the combination of benzodiazepines and CBT appears to produce poorer end-state functioning than CBT alone. Other data indicate that the sequencing of pharmacotherapy and CBT may be useful for benzodiazepine fading. Although these data are preliminary, combined treatments do not appear to be the treatment of choice for patients with panic disorder. Treatment algorithms are suggested based on existing data.     

Homework Compliance and Quality in Cognitive Behavioral Therapies for Anxiety Disorders and Obsessive-Compulsive Disorder

Homework assignments are an integral part of cognitive behavioral therapy, providing patients with opportunities to practice skills between sessions. Generally, greater homework compliance is associated with better treatment outcomes. However, fewer studies have examined the effect of homework quality on treatment outcomes. This study examined homework compliance and quality as predictors of outcome and attrition across five CBT protocols. A sample of 179 individuals with principal diagnoses of generalized anxiety disorder, panic disorder, social anxiety disorder, or obsessive-compulsive disorder were randomized to receive a transdiagnostic CBT protocol (the Unified Protocol) or a single-diagnosis CBT protocol corresponding to their principal diagnosis. The Unified Protocol had a lower homework burden than the majority of the single-diagnosis protocols, which varied in degree of assigned homework. Despite this, there were no differences in average homework compliance or quality across principal diagnosis, treatment condition, or their interaction. Homework quality was significantly related to all symptom outcomes (self-reported and clinician-rated anxiety and depressive symptoms, clinician-rated clinical severity). Homework compliance was significantly related to clinician-rated anxiety symptom outcomes. Additionally, greater homework quality and compliance were both significantly associated with increased odds of completing treatment, suggesting homework variables can be useful and easily obtainable predictors of treatment retention.