Psychological interventions

心理干预
  • 文章类型: Journal Article
    关于心理干预的文化适应的研究表明,较高的适应水平与干预的较高效果大小有关。然而,不同适应水平的直接比较很少。
    这项研究使用了一种基于智能手机的自助计划,称为“一步一步”(阿尔巴尼亚语:Hap-pas-Hapi),用于治疗瑞士和德国说阿尔巴尼亚语的移民的心理困扰。文化适应的两个层面(即,表面与深层结构适应)进行了比较。我们假设深层结构适应将增强干预的接受度和有效性。
    我们进行了双臂,单盲随机对照试验。纳入标准是对阿尔巴尼亚语的良好掌握,年龄在18岁以上,心理困扰升高(凯斯勒心理困扰量表评分在15分以上)。主要结果指标是霍普金斯症状检查表的总分和至少完成三次(五次)的参与者人数。次要结果是全球功能,幸福,创伤后应激,和自我定义的问题。
    包括22名参与者,其中18人(8%)完成了后评估。在两种情况下,完成第三届会议的参与者人数相等,N=5(5%)和N=6(6%)。
    在这两种情况下,脱落率都很高,在接受干预措施方面没有发现组间差异.高退出率与其他逐步测试的试验相反。未来的研究应该检查影响招聘策略的文化因素,作为见解可能有助于降低临床试验参与者的辍学率。
    UNASSIGNED: Research on cultural adaptation of psychological interventions indicates that a higher level of adaptation is associated with a higher effect size of the intervention. However, direct comparisons of different levels of adaptations are scarce.
    UNASSIGNED: This study used a smartphone-based self-help programme called Step-by-Step (Albanian: Hap-pas-Hapi) for the treatment of psychological distress among Albanian-speaking immigrants in Switzerland and Germany. Two levels of cultural adaptation (i.e., surface vs. deep structure adaptation) were compared. We hypothesised that the deep structure adaptation would enhance the acceptance and efficacy of the intervention.
    UNASSIGNED: We conducted a two-arm, single-blind randomised controlled trial. Inclusion criteria were good command of the Albanian language, age above 18, and elevated psychological distress (Kessler Psychological Distress Scale score above 15). Primary outcome measures were the total score of the Hopkins Symptom Checklist and the number of participants who completed at least three (out of five) sessions. Secondary outcomes were global functioning, well-being, post-traumatic stress, and self-defined problems.
    UNASSIGNED: Two-hundred-twenty-two participants were included, of which 18 (8%) completed the post-assessments. The number of participants who completed the third session was equal in both conditions, with N = 5 (5%) and N = 6 (6%) respectively.
    UNASSIGNED: Drop-out rates were high in both conditions, and no group difference was found regarding the acceptance of the intervention. The high drop-out rate stands in contrast with other trials testing Step-by-Step. Future research should examine cultural factors impacting recruitment strategies, as insights could help to reduce participant drop-out rates in clinical trials.
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  • 文章类型: Journal Article
    目的:双相情感障碍(BD)和边缘性人格障碍(BPD)都是严重的精神疾病,会增加有害结果的风险。虽然这些条件代表不同的诊断实体,现有研究表明,约有20%的BD患者符合合并症BPD的标准。与单独患有BD的患者相比,患有BD/BPD合并症的患者的临床病程明显更严重且在现象学上不同。然而,治疗通常没有在这个特定人群中进行测试,目前,本亚组患者尚无正式的治疗指南.
    方法:在当前的论文中,我们回顾了BD/BPD合并症患者的流行病学和描述性研究,并讨论了这种合并症对社会心理治疗的影响。我们还回顾了目前关于BD和BPD循证治疗的发现,这些发现显示出有望治疗BD/BPD合并症的患者。
    结果:在我们对文献的回顾中,我们强调了认识到这一合并症的重要性,并讨论了为这一尚未得到充分研究的临床人群开发和整合循证治疗方法的途径.
    结论:尽管针对BD/BPD共病的干预措施的正式试验有限,有有希望的证据表明,有可能对该人群使用或整合现有的循证方法。也有几个领域的临床实践改进和未来的研究方向源于这些文献。
    OBJECTIVE: Bipolar disorder (BD) and borderline personality disorder (BPD) are both serious psychiatric conditions that elevate the risk for harmful outcomes. Although these conditions represent distinct diagnostic entities, existing research suggests that approximately 20% of individuals with BD meet the criteria for comorbid BPD. Individuals with comorbid BD/BPD appear to have a markedly more severe and phenomenologically distinct clinical course when compared with those with BD alone. However, treatments have generally not been tested in this specific population, and currently, no formal treatment guidelines exist for this subgroup of patients.
    METHODS: In the current paper, we review the epidemiological and descriptive research characterizing those with comorbid BD/BPD and discuss the impact of this comorbidity on psychosocial treatment. We also review current findings on evidence-based treatments for BD and BPD that show promise in treating those with comorbid BD/BPD.
    RESULTS: In our review of the literature, we highlight the importance of recognizing this comorbidity and discuss avenues for developing and integrating evidence-based treatment approaches for this understudied clinical population.
    CONCLUSIONS: Although formal trials of interventions targeted to comorbid BD/BPD are limited, there is promising evidence regarding the possibility of using or integrating existing evidence-based approaches for this population. There are also several areas of clinical practice improvement and future research directions that stem from this literature.
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  • 文章类型: Journal Article
    目的:成人研究表明,侵入性记忆和侵入性思维(通常称为侵入性认知)在普通人群中很常见,并且在临床疾病中也很常见。然而,关于青少年侵入性认知的经历知之甚少,特别是在患有重度抑郁症(MDD)和创伤后应激障碍(PTSD)的青少年中。本研究试图收集有关这些现象的基本数据(即,频率,患有MDD和PTSD的青少年的侵入性认知的特征和评估)。
    方法:11-18岁青少年MDD(n=11),PTSD(n=13)和非临床对照组(n=25)完成了有关其侵入性记忆和思想的结构化访谈。
    结果:侵入性思维在所有三组中都很常见,但在MDD组中尤其常见。侵入性记忆在PTSD组中非常普遍,但超过一半的MDD青少年也经历过。与非临床组相比,两个临床组都报告了更多的负面情绪来回应他们的侵入性思想或记忆,并且对这些认知的评价更加负面。
    结论:侵入性记忆和思想是患有MDD和PTSD的青少年的常见经历。与这些认知相关的情绪和评估可能是该年龄段心理干预的目标。然而,小样本量限制了可以得出的结论。大量临床参与者需要复制。
    OBJECTIVE: Research in adults suggests that intrusive memories and intrusive thoughts (often referred to as intrusive cognitions) are common in members of the general population and are often seen in clinical disorders. However, little is known about the experience of intrusive cognitions in adolescents, particularly in adolescents with major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). The present study sought to gather fundamental data on these phenomena (i.e., frequency, characteristics and appraisals of intrusive cognitions) in adolescents with MDD and PTSD.
    METHODS: Adolescents aged 11-18 with MDD (n = 11), PTSD (n = 13) and a non-clinical control group (n = 25) completed structured interviews concerning their intrusive memories and thoughts.
    RESULTS: Intrusive thoughts were common in all three groups but were particularly frequently experienced in the MDD group. Intrusive memories were expectedly very common in the PTSD group but also experienced by over half of the adolescents with MDD. Both clinical groups reported more negative emotions in response to their intrusive thoughts or memories and appraised these cognitions more negatively than the non-clinical group.
    CONCLUSIONS: Intrusive memories and thoughts are common experiences in adolescents with MDD and PTSD. Emotions and appraisals relating to these cognitions may be targets for psychological intervention in this age group. However, small sample sizes limit the conclusions that can be drawn. Replication is needed with larger numbers of clinical participants.
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  • 文章类型: Journal Article
    元认知训练(MCT)被广泛使用,可有效减少精神病中的阳性症状。体育锻炼,如水中健美操(WA),改善一般健康,生活质量和症状作为一种低影响活动,允许社交互动。初步结果表明多巴胺和精神病症状之间有关系,通过SP转录因子,SP1和SP4生物标志物。该项目的目的是评估精神病综合干预(WA和MCT)的疗效,以改善精神病症状,身体健康,和SP生物标志物的转录水平。
    这是一项由三个平行干预组组成的单中心随机对照试验:MCT,西澳和联合干预。估计的样本将是48名患有精神病谱系障碍诊断的患者。评估将在基线和2个月随访时进行。评估中使用的仪器将包括临床,认知,元认知,社会认知和心理社会变量。
    这将是第一项调查MCT和WA组合对精神病的影响的研究。此外,这将是第一项分析干预后转录生物标志物SP1和SP4变化的研究.这项研究的结果可能具有临床意义,有助于改善治疗选择。
    https://clinicaltrials.gov/,标识符:NCT05455593。
    UNASSIGNED: Metacognitive Training (MCT) is widely used and effective in reducing positive symptoms in psychosis. Physical exercise, such as Water Aerobics (WA), improves general health, quality of life and symptoms as a low impact activity that allows social interactions. Preliminary results suggest a relationship between dopamine and psychotic symptoms, through SP transcription factors, SP1 and SP4 biomarkers. The aims of the project are to evaluate the efficacy of a combined intervention (WA and MCT) for psychosis to improve psychotic symptoms, physical health, and transcription levels of SP biomarkers.
    UNASSIGNED: This is a unicentric randomized controlled trial of three parallel intervention groups: MCT, WA and combined intervention. The estimated sample will be 48 patients with a psychotic spectrum disorder diagnosis. The assessment will be performed at baseline and at 2-months\' follow-up. Instruments used in the assessment will include clinical, cognitive, metacognitive, social cognitive and psychosocial variables.
    UNASSIGNED: This will be the first study investigating the impact of the combination of MCT and WA in psychosis. Moreover, it will be the first study analyzing changes in the transcriptional biomarkers SP1 and SP4 after interventions. The results of this study may have clinical implications contributing to the improvement of treatment selection.
    UNASSIGNED: https://clinicaltrials.gov/, identifier: NCT05455593.
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  • 文章类型: Journal Article
    评估将临终关怀与心理干预相结合对患者健康的影响,并引入包含临床和社会心理变量的谵妄预测列线图模型,从而提高临终关怀环境的准确性。分析了2018年9月至2023年2月接受治疗的381例患者的数据。根据治疗方式将患者分为对照组(177例,接受标准护理)和实验组(204例,接受联合临终关怀和心理干预)。护理持续时间延长至患者出院或死亡。与对照组相比,实验组的情绪健康状况显着改善,谵妄发生率较低。具体来说,情绪健康评估显示实验组有显著改善,干预后焦虑自评量表(SAS)和抑郁自评量表(SDS)得分较低。列线图模型,使用基于临床特征的逻辑回归开发,有效预测晚期癌症患者谵妄的风险。模型中的重要预测因素包括ECOG评分≥3,姑息性预后指数评分≥6,阿片类药物的使用,多药,感染,睡眠障碍,器官衰竭,脑转移瘤,电解质失衡,活动限制,护理前SAS评分≥60分,护理前SDS评分≥63分,护理前KPS评分≥60分.对模型的预测准确性进行了验证,显示训练队列的AUC值为0.839,验证队列的AUC值为0.864,校准和决策曲线分析(DCA)证实了其临床实用性。将临终关怀与心理干预相结合,不仅可以显着提高晚期癌症患者的情绪幸福感,而且可以降低谵妄的实际发生率。这种方法,为精确的护理计划和风险管理提供有价值的列线图模型,强调一体化的重要性,高级癌症管理中的个性化护理策略。
    To assesses the impact of integrating hospice care with psychological interventions on patient well-being and to introduce a predictive nomogram model for delirium that incorporates clinical and psychosocial variables, thereby improving the accuracy in hospice care environments. Data from 381 patients treated from September 2018 to February 2023 were analyzed. The patients were divided into a control group (n=177, receiving standard care) and an experimental group (n=204, receiving combined hospice care and psychological interventions) according to the treatment modality. The duration of care extended until the patient\'s discharge from the hospital or death. The experimental group demonstrated significant improvements in emotional well-being and a lower incidence of delirium compared to the control group. Specifically, emotional well-being assessments revealed marked improvements in the experimental group, as evidenced by lower scores on the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) post-intervention. The nomogram model, developed using logistic regression based on clinical characteristics, effectively predicted the risk of delirium in patients with advanced cancer. Significant predictors in the model included ECOG score ≥3, Palliative Prognostic Index score ≥6, opioid usage, polypharmacy, infections, sleep disorders, organ failure, brain metastases, electrolyte imbalances, activity limitations, pre-care SAS score ≥60, pre-care SDS score ≥63, and pre-care KPS score ≥60. The model\'s predictive accuracy was validated, showing AUC values of 0.839 for the training cohort and 0.864 for the validation cohort, with calibration and Decision Curve Analysis (DCA) confirming its clinical utility. Integrating hospice care with psychological interventions not only significantly enhanced the emotional well-being of advanced cancer patients but also reduced the actual incidence of delirium. This approach, offering a valuable Nomogram model for precise care planning and risk management, underscores the importance of integrated, personalized care strategies in advanced cancer management.
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  • 文章类型: Journal Article
    背景:当前的临床指南建议同时患有精神病和酒精或物质使用障碍(A/SUD)的患者接受两种疾病的循证治疗,包括精神病的心理干预。然而,此类治疗对合并精神病和A/SUD患者的疗效尚不清楚.
    方法:对精神病心理干预的随机对照试验(RCTs)进行系统评价,调查酒精和物质使用如何在样本纳入和次要措施中得到解释。然后使用“无荟萃分析”指南对包括同时存在酒精或物质使用问题的个体在内的试验结果进行了叙述性总结。为了表明心理干预对精神病的总体疗效,对于这个合并症的人口。
    结果:在确定的131项试验中,60.3%的试验排除了有酒精或物质使用问题的个体。此外,基线时只有6.1%的酒精或物质使用量,而只有2.3%的人将酒精或物质的使用作为次要结果。在明确包括酒精或物质使用问题的个体的试验中,没有足够的证据来推断任何个体心理干预的疗效.然而,初步研究结果表明,心理教育(PE)和元认知治疗(MCT)可能被建议进一步研究。
    结论:总体而言,在最近的精神病心理干预RCT中,同时发生的酒精和药物使用问题在很大程度上被忽视;突出了使用当前证据基础为这些个体做出治疗决策的挑战.
    BACKGROUND: Current clinical guidelines recommend that patients with co-occurring psychosis and alcohol or substance use disorders (A/SUD) receive evidenced-based treatment for both disorders, including psychological intervention for psychosis. However, the efficacy of such treatments for individuals with co-occurring psychosis and A/SUD is unclear.
    METHODS: Randomized controlled trials (RCTs) of psychological interventions for psychosis were systematically reviewed, to investigate how alcohol and substance use has been accounted for across sample inclusion and secondary measures. Findings from trials including individuals with co-occurring alcohol or substance use issues were then narratively summarized using the Synthesis Without Meta-Analysis guidelines, to indicate the overall efficacy of psychological interventions for psychosis, for this comorbid population.
    RESULTS: Across the 131 trials identified, 60.3% of trials excluded individuals with alcohol or substance use issues. Additionally, only 6.1% measured alcohol or substance use at baseline, while only 2.3% measured alcohol or substance use as a secondary outcome. Across trials explicitly including individuals with alcohol or substance use issues, insufficient evidence was available to conclude the efficacy of any individual psychological intervention. However, preliminary findings suggest that psychoeducation (PE) and metacognitive therapy (MCT) may be proposed for further investigation.
    CONCLUSIONS: Overall, co-occurring alcohol and substance use issues have been largely neglected across the recent RCTs of psychological interventions for psychosis; highlighting the challenges of making treatment decisions for these individuals using the current evidence base.
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  • 文章类型: Journal Article
    毫无疑问,由于在COVID-19大流行期间照顾患者,医护人员(HCWs)的心理健康受到负面影响。然而,关于绘制COVID-19大流行期间HCW的挑战和需求的文献有限。公共卫生中广泛使用的制图证据框架包括社会生态模型,暗示行为可以受到个人的影响,人际关系,组织,和社区因素。这项快速范围审查的目的是利用社会生态模型来绘制和汇编从文献中吸取的经验教训,主要涉及挑战和需求,其次是针对照顾COVID-19患者的医护人员的可用心理干预措施。PubMed,搜索了CINAHL和Scopus数据库,最终有21项研究包括检查HCWs的挑战和需求,还有18项研究提出了心理干预措施。组织一级的挑战和需求,如工作人员准备不足和防护设备供应不足,报告最多的是灵活的工作政策和带薪休息时间。个人层面的挑战和需求包括与COVID-19相关的恐惧和精神健康下降,而人际关系相关的需求包括支持提供。社区层面的挑战包括社会耻辱。某些心理干预被发现对HCWs很有希望,但是这些仅用于解决个人层面的挑战和需求。鉴于幸福需要因素的相互作用,解决多个社会生态层面的多层次干预措施(人际关系,组织,社区),并且应管理HCWs在其社会背景下的位置,以长期增加和维持干预效果,并可能有助于更好地应对未来的流行病。
    Undoubtedly, the mental health of healthcare workers (HCWs) was negatively affected because of caring for patients during the COVID-19 pandemic. However, literature is limited on mapping the challenges and needs of HCWs during COVID-19 pandemic. A widely used framework in public health for mapping evidence includes the socio-ecological models, suggesting behavior can be influenced by individual, interpersonal, organizational, and community factors. The aim of this rapid scoping review was to use the socio-ecological model to map and compile lessons learnt from the literature regarding primarily the challenges and needs and secondly available psychological interventions for HCWs caring for COVID-19 patients. PubMed, CINAHL and Scopus databases were searched, with 21 studies finally included examining challenges and needs of HCWs and 18 studies presenting psychological interventions. Organizational-level challenges and needs such as inadequate staff preparation and supplies of protective equipment, flexible work policies and paid rest periods were the most reported. Individual-level challenges and needs included COVID-19-related fears and reduced mental health, whereas interpersonal-related needs included support provision. Community-level challenges included societal stigma. Certain psychological interventions were found to be promising for HCWs, but these were utilized to address only individual-level challenges and needs. Given that well-being entails an interaction of factors, multi-level interventions addressing multiple socio-ecological levels (interpersonal, organizational, community) and that place HCWs in their social context should be administrated to increase and maintain intervention\' effects long-term and possibly aid in better coping with future pandemics.
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  • 文章类型: Journal Article
    缩小高等教育中少数民族学生的成就差距需要解决这些学生经验中缺乏归属感的问题。本文介绍了一种心理干预方法,该方法战略性地针对学习环境中的关键要素,以促进少数民族学生的成功。该干预措施旨在通过增加巴勒斯坦少数民族学生的母语来增强他们的归属感。我们在以色列的两个现场实验中测试了干预的有效性(n>20,000),在COVID-19大流行的高峰期,所有课程都通过Zoom举行。处于实验状态的讲师在其默认显示(仅英语/希伯来语)中添加了阿拉伯语姓名的抄本。我们的研究结果揭示了对巴勒斯坦学生的归属感的重大和积极的影响,班级参与,和整体成绩。在实验1中,巴勒斯坦学生的平均成绩提高了10分。在实验2中,巴勒斯坦学生的学期成绩平均提高了4分。我们的干预表明,经过精心设计的微小制度变革可能会对少数民族人口产生重大影响。这些结果对解决教育差距和促进包容性学习环境具有重要意义。
    Closing the achievement gap for minority students in higher education requires addressing the lack of belonging these students experience. This paper introduces a psychological intervention that strategically targets key elements within the learning environment to foster the success of minority students. The intervention sought to enhance Palestinian minority student\'s sense of belonging by increasing the presence of their native language. We tested the effectiveness of the intervention in two field experiments in Israel (n > 20,000), at the height of the COVID-19 pandemic when all classes were held via Zoom. Lecturers in the experimental condition added a transcript of their names in Arabic to their default display (English/Hebrew only). Our findings revealed a substantial and positive impact on Palestinian student\'s sense of belonging, class participation, and overall grades. In experiment 1, Palestinian student\'s average grade increased by 10 points. In experiment 2, there was an average increase of 4 points among Palestinian students\' semester grade. Our intervention demonstrates that small institutional changes when carefully crafted can have a significant impact on minority populations. These results have significant implications for addressing educational disparities and fostering inclusive learning environment.
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  • 文章类型: English Abstract
    为了描述心理干预对焦虑的影响,抑郁症,结直肠癌患者的情绪困扰和/或生活质量(QoL)。
    MEDLINE中的叙事文献综述,PsycINFO,CINAHL和Cochrane图书馆,2011-2021年。
    共获得553篇文章,其中包括十二个。大多数是简短的,个人,面对面的干预。认知行为疗法是报道最多的干预措施,显示出对QoL的积极影响,特别是在造口患者中;接受和承诺疗法和聚焦解决方案疗法也确定了QoL的改善。回忆疗法和自我效能干预报告了焦虑和抑郁的显着改善。放松和写作训练没有被证明是有效的;心理教育显示出不一致的效果。
    过去几年进行的研究很少,这并不能证明在心理健康方面产生一致改善的治疗模式的共识。
    UNASSIGNED: To describe the effects of psychological interventions on anxiety, depression, emotional distress and/or quality of life (QoL) of patients with colorectal cancer.
    UNASSIGNED: Narrative literature review in MEDLINE, PsycINFO, CINAHL and Cochrane Library, 2011-2021.
    UNASSIGNED: A total of 553 articles were obtained, of which twelve were included. Most were brief, individual, face-to-face interventions. Cognitive Behavioral Therapy was the most reported intervention, showing positive effects on QoL, specifically in stoma patients; Acceptance and Commitment Therapy and solution-focused therapy also identified improvements in QoL. Reminiscence therapy and a self-efficacy intervention reported significant improvements in anxiety and depression. Relaxation and writing training were not proven effective; psychoeducation showed inconsistent effects.
    UNASSIGNED: There is a paucity of studies conducted during the last years, which do not evidence a consensus of the therapeutic model that produces consistent improvements in psychological well-being.
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  • 文章类型: Journal Article
    背景:针对一系列心理健康问题的低强度干预措施为中低收入国家的年轻创伤幸存者提供了一种可扩展的方法。
    目标:这里,我们给出了一个概念验证的结果,随机化,候补名单控制试验评估MemFlex,基于自传记忆的干预,居住在伊朗的遭受创伤的阿富汗青年。MemFlex旨在减少维持和预测不良心理健康的负面和过度笼统的记忆偏见。
    方法:从伊朗卡拉伊市的高中招募了12-18岁(N=40)的年轻人,他们的父母经历了从阿富汗的强迫移民。去年所有人都经历了一次创伤事件。参与者被随机分配接受为期四周的基于组的MemFlex或Waitlist交付。我们的主要认知结果是自传体记忆灵活性,也就是说,根据需要故意检索任何内存类型的能力。主要临床结果是情绪困扰,在波斯语版本的霍普金斯症状清单上测量。
    结果:结果表明,MemFlex参与者在记忆灵活性(d=2.04)和情绪困扰(d=1.23)的前后改善方面表现出较大的效应大小。这些改进明显大于Waitlist(ds<.49),并维持三个月的随访。
    结论:观察到完成MemFlex的积极益处,未来与积极干预的比较似乎是有道理的。
    结论:在这种情况下,对MemFlex的进一步评估可能会提供低成本,和低资源干预,以改善中低收入国家年轻移民获得心理干预的机会。
    BACKGROUND: Low-intensity interventions targeting a range of mental health issues offer a scalable approach for young trauma survivors in low-middle income countries.
    OBJECTIVE: Here, we present results from a proof-of-concept, randomized, waitlist-controlled trial evaluating MemFlex, an autobiographical memory-based intervention, for trauma-exposed Afghan youth residing in Iran. MemFlex seeks to reduce the negative and overgeneral memory biases which maintain and predict poor mental health.
    METHODS: Young people aged 12-18 years (N = 40) with parents who had experienced forced migration from Afghanistan were recruited from high schools in Karaj City in Iran. All had experienced a traumatic event in the last year. Participants were randomized to receive four weeks of a group-based delivery of MemFlex or Waitlist. Our primary cognitive outcome was autobiographical memory flexibility, that is, the ability to deliberately retrieve any memory type on demand. Primary clinical outcome was emotional distress, measured on the Farsi version of the Hopkins Symptom Checklist.
    RESULTS: Results indicated that MemFlex participants demonstrated large effect sizes for pre-to-post improvement in memory flexibility (d = 2.04) and emotional distress (d = 1.23). These improvements were significantly larger than Waitlist (ds < .49), and were maintained at three-month follow-up.
    CONCLUSIONS: Positive benefits were observed for completion of MemFlex, and future comparison against an active intervention appears warranted.
    CONCLUSIONS: Further evaluation of MemFlex in this context may offer a low-cost, and low-resource intervention to improve access to psychological intervention for young migrants in low-middle income countries.
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