Randomized Controlled Trial Testing the Effectiveness of a Depression Prevention Program (‘Op Volle Kracht’) Among Adolescent Girls with Elevated Depressive Symptoms

Depression rates rise dramatically from the early to late adolescence. Especially young adolescent girls with elevated depressive symptoms are at high risk for developing a depression during adolescence or adulthood. Therefore, the prevention of depression is important especially in this high-risk group. The aim of the present study was to examine the effectiveness of the Cognitive Behavioral Therapy (CBT) component of the depression prevention program ‘Op Volle Kracht’ (OVK) among Dutch adolescent girls with elevated depressive symptoms. In total, 102 adolescent girls (11–15 years) in the first and second year of secondary school participated in this study. The girls in the experimental group (n?=?50) followed the eight CBT-lessons of OVK and reported depressive symptoms 1 week prior to the start of the lessons, after every lesson, at one-month and 6-months follow-up. The girls in the control group (n?=?52) exclusively reported depressive symptoms at the same time points. Latent Growth Curve Modeling showed that the decrease in depressive symptoms was significantly larger for girls in the experimental group compared to the girls in the control group. Furthermore, it was found that at 6-months follow-up, the girls in the experimental group had significantly lower levels of depressive symptoms compared to the girls in the control group. These findings indicate that the CBT-component of OVK effectively reduces depressive symptoms in short term and possibly prevents the development of a clinical depression.     

Parent Programs for Reducing Adolescent’s Antisocial Behavior and Substance Use: A Randomized Controlled Trial

Two theoretically based parent training programs, delivered in real-world settings by the social services, were examined in this randomized controlled trial for effectiveness in reducing adolescents’ antisocial behavior and substance use. Two hundred and thirty-seven (237) adolescents in ages between 12 and 18 and their parents were assigned to one of two programs or to a wait-list control condition. The programs were the nine weekly group sessions program Comet 12–18 (Swedish Parent Management Training Program) and the six weekly ParentSteps (Swedish shortened version by Strengthening Families Program 10–14). Outcome measures were antisocial behavior, substance use, and delinquency, and psychosocial dysfunction. Data based on adolescents’ and parents’ ratings of the adolescents’ problem behavior at baseline and 6 months later were analyzed with repeated measures ANVOA, Logistic regression, and Kruskal–Wallis H test. The results showed that parents’ ratings of adolescents’ antisocial behaviors decreased significantly over time, but no time by group effect emerged. No program effects were found in the adolescents’ self-reported antisocial behavior, delinquency, or psychosocial functioning. A threefold risk of illicit drug use was found in both intervention groups. The results suggest that neither Comet nor ParentSteps had beneficial effects on adolescent’s antisocial or delinquent behavior, or on alcohol use. The only significant group difference found was a threefold risk of drug use in the intervention adolescents at follow-up, but for several reasons this finding should be interpreted with caution. Trial registration number: ISRCTN76141538.     

Promoting Alternative Thinking Strategies (PATHS) and Elementary School Aged Children’s Aggression: Results from a Cluster Randomized Trial

This study reports on aggressive outcomes from a cluster randomized trial of the Promoting Alternative Thinking Strategies (PATHS) curriculum. Fourteen elementary schools were randomly assigned to intervention or control condition and third grade students were followed through the fifth grade. Teacher and self-reports of student aggression, conduct problems, delinquency, acting out problems, and social information processing (SIP) variables were collected. Linear change for each of the SIP variables was noted with control students demonstrating increased normative beliefs about aggression, increased aggressive social problem solving, increased hostile attribution bias, and increased aggressive interpersonal negotiation strategies over time while PATHS students remained relatively stable. Teachers reported significant curvilinear change in student aggression, conduct problems, and acting out behavior problems; all favoring PATHS students.     

Assessing Fidelity to and Satisfaction with the “Adolescent Coping with Depression Course” (ACDC) Intervention in a Randomized Controlled Trial

Journal of Rational-Emotive & Cognitive-Behavior Therapy - This paper aims at describing the process for assessing the intervention fidelity of a randomized controlled trial (RCT) of an...     

Putting the ‘app’ in Happiness: A Randomised Controlled Trial of a Smartphone-Based Mindfulness Intervention to Enhance Wellbeing

Smartphones are revolutionizing approaches to wellbeing investment. Those seeking greater happiness can engage with thousands of downloadable self-help applications instantly, yet their effectiveness remains largely unknown. This investigation explored the viability of delivering a positive psychological intervention in application format to authentic happiness seekers. A smartphone-based randomized-controlled trial was conducted with a diverse self-selecting pool, randomly assigned to engage with an empirically supported mindfulness intervention (n = 57) or a control intervention (n = 64) for 10 days. The study explored smartphone methodology, the importance of empirically based content for wellbeing enhancement and the extent to which user experience related to wellbeing gains. Results of repeated measures ANOVAs showed statistically significant increases in positive affect with a medium effect size and reduced depressive symptoms with a small effect size, although no statistically significant differences in satisfaction with life, flourishing or negative affect were found. No statistically significant gains were observed in the control condition. Ratings of task enjoyment were positively correlated (Pearson’s r) with positive affect increase. Findings support the viability of smartphone-based interventions to significantly enhance elements of wellbeing, underscoring the importance of application content and the role of person-activity fit. This investigation presents implications for happiness seeking strategies in the real world whilst showcasing a dynamic method of intervention delivery that can benefit future research and practice. If the greatest mission of positive psychology is to enhance global flourishing, the potential of smartphone-based interventions may play a vital role.     

Improving Couples’ Relationship Functioning Leads to Improved Coparenting: A Randomized Controlled Trial With Rural African American Couples

Family-centered prevention programs for couples with children are being increasingly disseminated, with the hope that improving couples’ romantic relationships will lead to other benefits for families. To date, however, it is unclear whether these interventions do in fact yield these benefits. The current study addressed this gap by examining whether postintervention improvements in couples’ relationship functioning following family-centered prevention predicted longer-term change in coparenting, and whether postintervention improvements in coparenting predicted longer-term change in relationship functioning. We used four waves of data collected over 2 years from 346 rural African American couples with an early adolescent child who participated in a randomized controlled trial of the Protecting Strong African American Families (ProSAAF) program, an intervention designed to promote strong couple, coparenting, and parent–child relationships in two-parent African American families. Results indicated that ProSAAF had significant short-term positive effects on both romantic relationship functioning and coparenting and that these effects did not differ in magnitude. Over time, however, only romantic relationship functioning postintervention was positively associated with long-term changes in coparenting; coparenting postintervention was not associated with long-term changes in relationship functioning and this association was significantly weaker than the other pathway. These findings support a key premise underlying relationship enhancement programs for parents, indicating that improving couples’ romantic relationship functioning can have longer-term benefits for the coparenting relationship as well. Further research examining long-term parent, child, and family outcomes following family-centered prevention for couples and the mechanisms of change underlying these outcomes is needed.     

Distance-Delivered Parent Training for Childhood Disruptive Behavior (Strongest Families™): a Randomized Controlled Trial and Economic Analysis

Disruptive behavior disorders are prevalent in youth, yet most children with disruptive behavior do not have access to timely, effective treatment. Distance-delivered service (e.g., via telephone, Internet) can overcome several barriers to care. This study tested the effectiveness of a 12-week parent training program, Strongest Families? Parenting the Active Child, delivered via written material, skill-based videos, and telephone coaching sessions, as compared to usual care in reducing child externalizing behavior. Participants were 172 primary caregivers of a 6- to 12-year-old (29% girls; M age?=?8.5 years) recruited from community children’s mental health clinics. Participants were randomized to either Strongest Families? or usual care and completed measures of child externalizing behavior, parenting practices, parent distress, and intervention services consumed at baseline and 5-, 10-, 16-, and 22-months post-baseline. Growth curve analysis showed significant reductions in externalizing behavior in both conditions over time. Improvements were significantly greater at 10 months in the Strongest Families? condition (d =?0.43). At 22 months, however, the differences were not significant and small in magnitude (d =??0.05). The intervention decreased inconsistent discipline significantly more than usual care. Parents in both conditions showed significant reductions in distress. We also conducted a cost-effectiveness analysis to assess the value for money of the Strongest Families? program versus usual care. Distance parent training is a promising way to increase access to, and reduce costs associated with, mental health care for families with a child with disruptive behavior.     

Randomized Controlled Trial of Cognitive–Behavioral Group Therapy for Irritable Bowel Syndrome in a Medical Setting

Standard medical treatments have not been effective for irritable bowel syndrome (IBS) patients. Though individualized cognitive–behavior therapy is an empirically supported treatment option, cognitive–behavioral group therapy (CBGT) has yet to be established as an effective alternative in a randomized controlled trial. This study compared the efficacy of a 10-session CBGT with a home-based symptom monitoring with weekly telephone contact (SMTC) treatment for IBS, extending previous quasi-experimental research in this area. Twenty-eight refractory IBS patients, evaluated and referred by gastroenterologists using the Rome criteria, participated in the study. IBS symptoms, psychological functioning, and health-related quality of life were assessed pre- and posttreatment, and at 3-month follow-up. CBGT patients reported significantly more gastrointestinal (GI) symptom improvement than SMTC patients on posttreatment global measures and had significantly reduced daily diary pain scores at 3-month follow-up. Based on MANOVA, there was significant improvement in psychological distress and health-related quality of life for the CBGT patients in comparison to the SMTC patients. These improvements were also maintained at the 3-month follow-up. Reductions in GI symptoms, psychological distress, and improved health related quality of life may contribute to less behavioral avoidance, disability, and health care utilization in refractory IBS patients.     

Promoting “Healthy Futures” to Reduce Risk Behaviors in Urban Youth: A Randomized Controlled Trial

There is increasing evidence of the interconnection between educational and health outcomes. Unfortunately wide disparities exist by both socioeconomic status and race/ethnicity in educational and vocational success. This study sought to promote urban youths’ career readiness as a way to reduce involvement in risk behaviors. Two hundred primarily African‐American youth (ages 14–21) were recruited from a pediatric primary care clinic. Youth randomized to the intervention received three motivational interviewing sessions focused around expectations and planning for the future. Baseline and 6‐month follow‐up assessments included measures of career readiness and risk behavior involvement (i.e., physical fighting, alcohol and marijuana use). At 6‐months, youth randomized to the intervention condition showed increased confidence in their ability to perform the behaviors needed to reach their college/career goals. Additionally, youth randomized to the intervention arm showed decreased fighting behavior (adjusted rate ratio: .27) and marijuana use (adjusted rate ratio: .61). Assisting urban youth in thinking and planning about their future holds promise as a way to reduce their involvement in risk behaviors. This study also demonstrated that motivational interviewing could be used to promote positive behaviors (i.e., career readiness).     

E‐Mailed Standardized Cognitive Behavioural Treatment of Work‐Related Stress: A Randomized Controlled Trial

The aim of this study was to assess the effects of a 7‐week standardized cognitive behavioural treatment of work‐related stress conducted via e‐mail. A total of 342 people applied for treatment in reaction to a newspaper article. Initial screening reduced the sample to a heterogeneous (sub)clinical group of 239 participants. Participants were assigned randomly to a waiting list condition (n = 62), or to immediate treatment (n = 177). A follow‐up was conducted 3 years after inception of the treatment. The outcome measures used were the Depression Anxiety Stress Scales (DASS‐42) and the Emotional Exhaustion scale of the Maslach Burnout Inventory – General Survey (MBI‐GS). Fifty participants (21%) dropped out. Both groups showed statistically significant improvements. Intention‐to‐treat analysis of covariance (ANCOVAs) revealed that participants in the treatment condition improved significantly more than those in the waiting control condition (0.001<p?0.025). In the treatment group, the effects were large to moderate (0.9 (stress)?d?0.5 (anxiety)). The between‐group effects ranged from d = 0.6 (stress) to d = 0.1 (anxiety). At follow‐up, the effects were more pronounced, but this result requires replication in view of high attrition at follow‐up. The results warrant further research on Internet‐driven standardized cognitive behavioural therapy for work‐related stress. Such research should include the direct comparison of this treatment with face‐to‐face treatment, and should address the optimal level of therapist contact in Internet‐driven treatment.     

Parent Training Adapted to the Needs of Children With Callous–Unemotional Traits: A Randomized Controlled Trial

Callous–unemotional (CU) traits designate a distinct subgroup of children with early-starting, stable, and aggressive conduct problems. Critically, traditional parenting interventions often fail to normalize conduct problems among this subgroup. The aim of this study was to test whether parent–child interaction therapy (PCIT) adapted to target distinct deficits associated with CU traits (PCIT-CU) produced superior outcomes relative to standard PCIT. In this proof-of-concept trial, 43 families with a 3- to 7-year-old child (M age = 4.84 years, SD = 1.12, 84% male) with clinically significant conduct problems and elevated CU traits were randomized to receive standard PCIT (n = 21) or PCIT-CU (n = 22) at an urban university-based research clinic. Families completed five assessments measuring child conduct problems, CU traits, and empathy. Parents in both conditions reported good treatment acceptability and significantly improved conduct problems and CU traits during active treatment, with no between-group differences. However, linear mixed-effects models showed treatment gains in conduct problems deteriorated for children in standard PCIT relative to those in PCIT-CU during the 3-month follow-up period (ds = 0.4–0.7). PCIT-CU shows promise for sustaining improvements in conduct problems for young children with conduct problems and CU traits, but requires continued follow-up and refinement.     

All at Once or One at a Time? A Randomized Controlled Trial Comparing Two Ways to Deliver Bibliotherapy for Panic Disorder

Bibliotherapy is potentially effective in the treatment of panic disorder (PD). A still unanswered question is whether pacing is important. This study was designed to test whether there is a difference between being assigned a full book as therapy and receiving one individual chapter every week (i.e. pacing). A total of 28 participants were randomized to either 10 paced chapters or one book with 10 chapters. To maximize compliance, short weekly telephone calls were added in both conditions (M = 17.8 min, SD = 4.2). Both treatments showed promising results, with effects maintained up to 2 years and with within-group effect sizes (Cohen's d) between 0.95 and 1.11. Pretreatment ratings of credibility were positively correlated with the change scores at both posttest and 2-year follow-up for three panic measures. Pacing of text material in bibliotherapy for PD is not needed, and all material can be provided at once when the treatment is guided by a therapist.     

‘Bricolage’: reclaiming a conceptual tool

This article provides the genealogy of bricolage and underscores the modifications it has undergone within the sociologies of culture and religion. It draws on the study of three new religious movements that teach unconventional versions of Hinduism and kabbalah, to show that the current understanding of bricolage in the studies of popular culture and religion over-estimates its eclectic and personal nature and neglects its sociocultural logics. It tends to take for granted the availability of cultural resources used in bricolage, and finally it fails to understand the social significance of individualism, overlooking the ways in which norms and power could be expressed through culture in the contemporary world. This article suggests that it would be best reclaiming bricolage's original meaning, prompting questions about the contexts that make certain elements available, social patterns that may organise bricolage, who ‘bricole’, what for, who is empowered, from what and by using whose tradition.     

Treatment of Panic Disorder with Agoraphobia: Randomized Placebo‐Controlled Trial of Four Psychosocial Treatments Combined with Imipramine or Placebo

Few randomized controlled trials have included panic disorder patients with moderate to severe agoraphobia. Therefore, this population was studied using pharmacotherapy as well as psychotherapy. At the time of the study, imipramine was widely used as a pharmacological treatment. Also, current practice guidelines for patients with panic disorder find selective serotonin reuptake inhibitors and tricyclic antidepressants roughly comparable in terms of efficacy. Therefore, the main objective of this study is to compare four psychosocial treatments—cognitive and graded in vivo exposure treatments, graded in vivo exposure, cognitive treatment, and supportive therapy—to evaluate the benefits of combining cognitive therapy with exposure in vivo. These treatments were combined with imipramine or placebo for a total of eight experimental conditions. Participants presented moderate to severe agoraphobia. The method involved a randomized, double‐blind, placebo‐controlled trial with 137 participants who completed a 14‐session protocol involving the treatments just mentioned. Measures were taken at baseline and posttreatment and at 3‐, 6‐, and 12‐month follow‐up. All treatment conditions were statistically and clinically effective in reducing self‐reported panic–agoraphobia symptoms over the 1‐year follow‐up. No statistical differences were observed between imipramine and placebo conditions. This study found that all treatment modalities helped reduce panic and agoraphobic symptomatology over a 1‐year follow‐up period. These surprising results support the need to document the relations among the various components of an intervention. This would make it possible to assess the relative efficacy of the treatment components rather than of the intervention as a whole.     

From ‘Intersex’ to ‘DSD’: a case of epistemic injustice

Synthese - The 2005 International Consensus Conference on Intersex resulted in a substantive revision of the lexicon and guidelines for treating intersex conditions. The speed with which the new...     

Jan Amos Comenius’s Trinitarian and Conciliar Vision of a United Europe: Christ as the Universal ‘Centre of Security’

This article explores Jan Amos Comenius’s vision of a Christian united Europe and its connection to his theological programme of reform. This is manifest first of all in his linguistic projects, in which he sought to break down the language barriers separating Christians both from each other and from the mission field of the New World, but it came to fruition especially in his comprehensive reform project of pansophia, especially as this was represented in his massive Consultatio catholica. For it is here that Comenius expands on his dream of a union of nations under one Christian religion. In this, Christ who transcends time and space, uniting in himself all the diverse aspirations of the nations, is revealed as the global ‘centre of security.’ Importantly, Comenius’s expression of this is profoundly indebted to Nicholas of Cusa and the article concludes by highlighting Comenius’s own Trinitarian and conciliar vision of Christian Europe.     

Facing Down the Representation of An Impossibility: Indigenous Responses to a ‘Universal’ Problem in the Repatriation Context

This paper explores the ways Native Americans and Native Hawiians have responded to what Ernesto Laclau has called ‘the representation of an impossibility’—the discursive crisis faced by non-dominant groups who seek to advance rights claims in ways that are culturally rooted but universally audible to ideologically dominant audiences. Taking the NAGPRA law of 1990 as its case study, this paper asserts the need for a re-theorisation of indigenous religious discourse in order to illuminate the ways native peoples build rather than concede agency through self-representations in the current political moment. Pursuing this argument, the paper charts an analytical course specifying the relationship of rights claims to discourse, hegemony, articulation, tradition, and religion. The paper then focuses upon specific examples of religious claims in the context of the Native American Graves Protection and Repatriation Act to demonstrate the ways Native Americans have faced down an ‘impossibility’.     

Internet‐Based Self‐Help Versus One‐Session Exposure in the Treatment of Spider Phobia: A Randomized Controlled Trial

The authors compared guided Internet‐delivered self‐help with one session of live‐exposure treatment in a sample of spider‐phobic patients. A total of 30 patients were included following screening on the Internet and a structured clinical interview. The Internet treatment consisted of five weekly text modules, which were presented on a web page, a video in which exposure was modelled, and support provided via Internet. The live‐exposure treatment was delivered in a 3‐hr session following a brief orientation session. The main outcome measure was the behavioural approach test (BAT), and as secondary measures the authors used questionnaires measuring anxiety symptoms and depression. Results showed that the groups did not differ at posttreatment or follow‐up, with the exception of the proportion showing clinically significant change on the BAT. At posttreatment 46.2% of the Internet group and 85.7% in the live‐exposure group achieved this change. At follow‐up the corresponding figures were 66.7% for the Internet group and 72.7% for the live treatment. Within‐group effect sizes for the spider phobia questionnaire were large (d = 1.84 and 2.58 for the Internet and live‐exposure groups, respectively, at posttreatment). The authors conclude that guided Internet‐delivered exposure treatment is a promising new approach in the treatment of spider phobia.     

Changing Parent’s Mindfulness,Child Management Skills and Relationship Quality With Their Youth: Results From a Randomized Pilot Intervention Trial

We evaluated the efficacy of a mindful parenting program for changing parents’ mindfulness, child management practices, and relationships with their early adolescent youth and tested whether changes in parents’ mindfulness mediated changes in other domains. We conducted a pilot randomized trial with 65 families and tested an adapted version of the Strengthening Families Program: For Parent and Youth 10–14 that infused mindfulness principles and practices against the original program and a delayed intervention control group. Results of pre-post analyses of mother and youth-report data showed that the mindful parenting program generally demonstrated comparable effects to the original program on measures of child management practices and stronger effects on measures of mindful parenting and parent–youth relationship qualities. Moreover, mediation analyses indicated that the mindful parenting program operated indirectly on the quality of parent–youth relationships through changes in mindful parenting. Overall, the findings suggest that infusing mindful parenting activities into existing empirically validated parenting programs can enhance their effects on family risk and protection during the transition to adolescence.