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Updated: Oct 18, 2025

Assessment of Stress Effects on Cognitive Flexibility using an Operant Strategy Shifting Paradigm
Published on: May 4, 2020
Cognitive-behavioral therapy for management of mental health and stress-related disorders: Recent advances in
Mutsuhiro Nakao1, Kentaro Shirotsuki2, Nagisa Sugaya3
1Department of Psychosomatic Medicine, School of Medicine, International University of Health and Welfare, 4-3, Kozunomori, Narita-shi, Chiba, 286-8686, Japan. m-nakao@iuhw.ac.jp.
Abstract:
Cognitive-behavioral therapy (CBT) helps individuals to eliminate avoidant and safety-seeking behaviors that prevent self-correction of faulty beliefs, thereby facilitating stress management to reduce stress-related disorders and enhance mental health. The present review evaluated the effectiveness of CBT in stressful conditions among clinical and general populations, and identified recent advances in CBT-related techniques. A search of the literature for studies conducted during 1987-2021 identified 345 articles relating to biopsychosocial medicine; 154 (45%) were review articles, including 14 systemic reviews, and 53 (15%) were clinical trials including 45 randomized controlled trials. The results of several randomized controlled trials indicated that CBT was effective for a variety of mental problems (e.g., anxiety disorder, attention deficit hypersensitivity disorder, bulimia nervosa, depression, hypochondriasis), physical conditions (e.g., chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome, breast cancer), and behavioral problems (e.g., antisocial behaviors, drug abuse, gambling, overweight, smoking), at least in the short term; more follow-up observations are needed to assess the long-term effects of CBT. Mental and physical problems can likely be managed effectively with online CBT or self-help CBT using a mobile app, but these should be applied with care, considering their cost-effectiveness and applicability to a given population.
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