Process-based functional analysis can help behavioral science step up to novel challenges: COVID - 19 as an example

Psychological interventions for depression in children and adolescents: A bibliometric analysis

BACKGROUND

Depression has gradually become a common psychological disorder among children and adolescents. Depression in children and adolescents affects their physical and mental development. Psychotherapy is considered to be one of the main treatment options for depressed children and adolescents. However, our understanding of the global performance and progress of psychological interventions for depression in children and adolescents (PIDCA) research is limited.

AIM

To identify collaborative research networks in this field and explore the current research status and hotspots through bibliometrics.

METHODS

Articles and reviews related to PIDCA from January 2010 to April 2023 were identified from the Web of Science Core Collection database. The Charticulator website, CiteSpace and VOSviewer software were used to visualize the trends in publications and citations, the collaborative research networks (countries, institutions, and authors), and the current research status and hotspots.

RESULTS

Until April 16, 2023, 1482 publications were identified. The number of documents published each year and citations had increased rapidly in this field. The United States had the highest productivity in this field. The most prolific institution was the University of London. Pim Cuijpers was the most prolific author. In the context of research related to PIDCA, both reference co-citation analysis and keywords co-occurrence analysis identified 10 research hotspots, including third-wave cognitive behavior therapy, short-term psychoanalytic psychotherapy, cognitive behavioral analysis system of psychotherapy, family element in psychotherapy, modular treatment, mobile-health, emotion-regulation-based transdiagnostic intervention program, dementia risk in later life, predictors of the efficacy of psychological intervention, and risks of psychological intervention.

CONCLUSION

This bibliometric study provides a comprehensive overview of PIDCA from 2010 to present. Psychological intervention characterized as psychological-process-focused, short, family-involved, modular, internet-based, emotion-regulation-based, and personalized may benefit more young people.

The relationship between stressful life events and school engagement for junior high school students in China: A serial mediation model

The purpose of this study is to examine the relationship between stressful life events (SLE) and school engagement and to determine if there are some likely mediating variables between them. A sample of 1517 Chinese junior high school students (51.5% female) completed the adolescent self-rating life events checklist (ASLEC), Utrecht Work Engagement Scale-student (UWES-s), cognitive fusion questionnaire (CFQ), and positive psychological capital questionnaire (PPQ). The model was calculated using the PROCESS macro in SPSS. The serial mediator model revealed a significant negative effect of SLE on school engagement through psychological flexibility and psychological capital (effect = −.08, 95% CI [−.10, −.06]). There was also a direct mediating effect through psychological capital (effect = −.17, 95% CI [−.21, −.13]). The results of the present study may help to clarify mechanisms that might explain the association between SLE and school engagement. Future research on improving school engagement should consider the critical roles of psychological flexibility and psychological capital.

Probability Discounting in College Students’ Willingness to Isolate During COVID-19: Implications for Behavior Analysis and Public Health

The present study was a preliminary analysis of college students’ willingness to self-isolate and socially isolate during the COVID-19 pandemic analyzed through a probability discounting framework. Researchers developed a pandemic likelihood discounting task where willingness to isolate from others was measured in days as a function of the perceived probability of the escalation of a virus to pandemic levels. Experiment 1 was conducted immediately prior to the World Health Organization (WHO) declaring COVID-19 a pandemic and results showed that participants were more willing to self-isolate when the perceived probability of reaching pandemic levels was high and when there was a guarantee that others in the community would do the same. Experiment 2 was conducted with a subset of participants from Experiment 1 with the same discounting task, and results showed that participants were more willing to self-isolate 2 months following the onset of the pandemic, supporting the view that willingness to isolate from others is a dynamic process. Finally, Experiment 3 evaluated willingness to socially distance and introduced a hypothetical timescale to evaluate common trends with the real-world temporal dynamics observed in Experiments 1 and 2. Results showed similar trends in the data, supporting the use of hypothetical scenarios within probability discounting tasks in future behavior analytic research related to public health.

Case Conceptualizing in Acceptance and Commitment Therapy for Moral Injury: An Active and Ongoing Approach to Understanding and Intervening on Moral Injury

Acceptance and Commitment Therapy for Moral Injury (ACT-MI; 10-11), is an application of Acceptance and Commitment Therapy principles designed to help individuals live their values, even in the presence of moral pain. ACT-MI differs from other emerging treatments for moral injury in that ACT-MI is not based on a traditional syndromal approach to conceptualizing moral injury, which treats moral injury as a collection of signs and symptoms to be reduced. Rather than assuming moral injury causes suffering through a constellation of symptoms that a person has, in ACT-MI, moral injury is defined by what a person does in response to moral pain. Consistent with this framework, we present a unique approach to moral injury case conceptualization that emphasizes function over form, providing clients the opportunity to break free from the patterns of behavior that cause moral injury-related suffering to persist. Rooted in approaches to conceptualizing that have demonstrated utility in extant interventions (e.g., ACT), ACT-MI clinicians conduct ongoing functional analyses to inform case conceptualization and intervention. Functional analysis is used to disrupt the processes maintaining moral injury, as the client and therapist work to identify and intervene on the behaviors reinforcing avoidance and control of painful internal experiences causing moral injury. In the current article, we guide the reader through a framework for applying functional analysis to the conceptualization of moral injury where the reinforcers driving moral injury are explored. We also provide examples of questions that can be used to help uncover the functions of moral injury consistent behavior. Case examples based on our experiences treating moral injury are presented to demonstrate how various types of morally injurious events can evoke different features of moral pain which in turn motivate different repertoires of avoidance and control. These inflexible patterns of avoidance and control create suffering by engaging in behavior designed to escape moral pain, such as social isolation, spiritual disconnection, reduced self-care, suicidal ideation, and substance use. We discuss how to target this suffering using functional analysis to guide treatment decisions, matching interventional processes within ACT-MI to the specific functions that moral injury-related behavior is serving for an individual. We suggest that the use of functional analytic case formulation procedures described herein can assist clients in disrupting behavioral patterns maintaining moral injury and thereby free them to pursue lives of greater meaning and purpose.

Countercontrol: A Relational Frame Theory (RFT) Account and Revival of a 70-Year-Old Skinnerian Term

Countercontrol is a Skinnerian operant concept that posits that an individual’s attempts to exert control over another person’s behavior may evoke a countercontrolling response from the person being controlled that functions to avoid or escape the potentially aversive conditions generated by the controller. Despite Skinner’s historical concerns regarding the detrimental effects of countercontrol in terms of hindering optimal societal growth and cultural evolution, the concept has not been widely applied within behavior analysis. Drawing from recent developments in rule-governed behavior and relational frame theory, this article seeks to explicate countercontrol from a contemporary behavior analytic perspective and presents several modern-day societal applications. In particular, a relational frame theory account of rule-governed behavior is used as a framework to elucidate the behavioral processes by which rule-following occurs (or fails to occur) in the context of countercontrol. Implications of a renewed focus on countercontrol for understanding pressing societal issues are also discussed.

Beyond the "Third Wave of Positive Psychology": Challenges and Opportunities for Future Research

The positive psychology (PP) landscape is changing, and its initial identity is being challenged. Moving beyond the “third wave of PP,” two roads for future research and practice in well-being studies are discerned: The first is the state of the art PP trajectory that will (for the near future) continue as a scientific (sub)discipline in/next to psychology (because of its popular brand name). The second trajectory (main focus of this manuscript) links to pointers described as part of the so-called third wave of PP, which will be argued as actually being the beginning of a new domain of inter- or transdisciplinary well-being studies in its own right. It has a broader scope than the state of the art in PP, but is more delineated than in planetary well-being studies. It is in particular suitable to understand the complex nature of bio-psycho-social-ecological well-being, and to promote health and wellness in times of enormous challenges and changes. A unique cohering focus for this post-disciplinary well-being research domain is proposed. In both trajectories, future research will have to increase cognizance of metatheoretical assumptions, develop more encompassing theories to bridge the conceptual fragmentation in the field, and implement methodological reforms, while keeping context and the interwovenness of the various levels of the scientific text in mind. Opportunities are indicated to contribute to the discourse on the identity and development of scientific knowledge in mainstream positive psychology and the evolving post-disciplinary domain of well-being studies.

"Third-wave" cognitive and behavioral therapies and the emergence of a process-based approach to intervention in psychiatry

For decades, cognitive and behavioral therapies (CBTs) have been tested in randomized controlled trials for specific psychiatric syndromes that were assumed to represent expressions of latent diseases. Although these protocols were more effective as compared to psychological control conditions, placebo treatments, and even active pharmacotherapies, further advancement in efficacy and dissemination has been inhibited by a failure to focus on processes of change. This picture appears now to be evolving, due both to a collapse of the idea that mental disorders can be classified into distinct, discrete categories, and to the more central attention given to processes of change in newer, so-called "third-wave" CBTs. Here we review the context for this historic progress and evaluate the impact of these newer methods and models, not as protocols for treating syndromes, but as ways of targeting an expanded range of processes of change. Five key features of "third-wave" therapies are underlined: a focus on context and function; the view that new models and methods should build on other strands of CBT; a focus on broad and flexible repertoires vs. an approach to signs and symptoms; applying processes to the clinician, not just the client; and expanding into more complex issues historically more characteristic of humanistic, existential, analytic, or system-oriented approaches. We argue that these newer methods can be considered in the context of an idiographic approach to process-based functional analysis. Psychological processes of change can be organized into six dimensions: cognition, affect, attention, self, motivation and overt behavior. Several important processes of change combine two or more of these dimensions. Tailoring intervention strategies to target the appropriate processes in a given individual would be a major advance in psychiatry and an important step toward precision mental health care.

Integrating theory-based and data-driven methods to case conceptualization: A functional analysis approach with ecological momentary assessment

Objective Ecological momentary assessment (EMA) and network analysis are promising empirical developments for psychotherapy research and practice, but they lack a therapeutic rationale that could guide case conceptualization and treatment planning. We developed an assessment strategy that aims to assess functional analysis with EMA. Method: The assessment strategy was applied to a series of three N-of-1 assessments in a proof-of-concept study. After selecting a personalized set of items, EMA was implemented with three measurement time points per day for a period of 30 days. The participants evaluated feasibility and acceptance. Practicing psychotherapists discussed clinical implications in a focus group. Results: The implementation of the assessment strategy seemed feasible and accepted; participants did not report any side effects. Principal component and network analyses indicated interpretable components (e.g., participant 1: hopelessness, procrastination, coping, avoidance). The focus group pointed out potentials (e.g., efficient profit of the waiting time, empowering patients) and challenges (e.g., prioritize and interpret all the information). Conclusion: The presented assessment strategy may enhance the scientific quality of case conceptualization empowering therapists' decision-making regarding treatment planning. At the same time, it is a concrete demonstration of the challenges that need to be addressed in future research.

A process-based approach to psychological diagnosis and treatment:The conceptual and treatment utility of an extended evolutionary meta model

For half a century, the dominant paradigm in psychotherapy research has been to develop syndrome-specific treatment protocols for hypothesized but unproved latent disease entities, as defined by psychiatric nosological systems. While this approach provided a common language for mental health problems, it failed to achieve its ultimate goal of conceptual and treatment utility. Process-based therapy (PBT) offers an alternative approach to understanding and treating psychological problems, and promoting human prosperity. PBT targets empirically established biopsychosocial processes of change that researchers have shown are functionally important to long terms goals and outcomes. By building on concepts of known clinical utility, and organizing them into coherent theoretical models, an idiographic, functional-analytic approach to diagnosis is within our grasp. We argue that a multi-dimensional, multi-level extended evolutionary meta-model (EEMM) provides consilience and a common language for process-based diagnosis. The EEMM applies the evolutionary concepts of context-appropriate variation, selection, and retention to key biopsychosocial dimensions and levels related to human suffering, problems, and positive functioning. The EEMM is a meta-model of diagnostic and intervention approaches that can accommodate any set of evidence-based change processes, regardless of the specific therapy orientation. In a preliminary way, it offers an idiographic, functional analytic, and clinically useful alternative to contemporary psychiatric nosological systems.

Murray Sidman: fostering progress through foundational choices

The contributions of Murray Sidman to the field of behavior analysis have helped to put the field on a progressive path. In this paper we describe three areas as examples, drawn from the larger set of his notable contributions: the analysis of stimulus equivalence in a way that has fostered a behavior-analytic approach to derived stimulus relations and symbolic meaning; the observation and measurement of individual behavior through time; and his stance against punitive applied methods. In each of these areas Sidman was a dedicated behaviorist, avoiding appeals to mentalistic or transcendental forces, opposing hypothetical mediational accounts, and taking a functional and contextual approach. Clarity of assumptions was at the heart of Sidman's effective scientific practices and there is no reason to think that those same assumptions will not carry us further, as evidence mounts in support of these views on psychological research and practice.

Die COVID-19-Pandemie als Herausforderung für die psychische Gesundheit

Zusammenfassung. Die COVID-19-Pandemie als multidimensionaler und potenziell toxischer Stressfaktor führt auch in Deutschland zu psychischen Problemen in der Allgemeinbevölkerung und wird voraussichtlich einen Anstieg der Inzidenz- und Prävalenzraten psychischer Störungen bedingen. In diesem Positionspapier erfolgt daher eine wissenschaftlich differenzierte Betrachtung der psychologischen Auswirkungen der COVID-19-Pandemie auf verschiedene Altersstufen sowie psychische Vulnerabilitäten und Störungsbilder, wobei auch Chancen für die psychische Gesundheit und psychotherapeutische Versorgung diskutiert werden. Basierend auf den Befunden werden abschließend u. a. folgende gesundheitspolitische Ziele und Maßnahmen abgeleitet: Implementierung von universellen und indizierten modularen Präventionsangeboten sowie Anpassung der evidenzbasierten Richtlinienpsychotherapien hinsichtlich Bedarf, Inhalt und Modalität. Die Klinische Psychologie und Psychotherapie stellt aufgrund ihrer ausgewiesenen Expertise im Bereich der psychischen Gesundheit zentrales Wissen für die erfolgreiche Bewältigung der COVID-19-Pandemie zur Verfügung und kann in interdisziplinären und interprofessionellen Kooperationen dazu beitragen, die Herausforderungen für die psychische Gesundheit anzugehen.