Development of a Multi-Disciplinary Intervention for the Treatment of Childhood Obesity Based on Cognitive Behavioral Therapy

Along the lines of the evidence-based recommendations, we developed a multi-disciplinary intervention for overweight children 7- to 12-years-old, primarily aiming at helping children to adopt healthier eating habits and a physically active lifestyle. The program combined nutrition intervention, based on a non-dieting approach, with physical activity intervention, implemented through the basic principles of Cognitive Behavioral Therapy (CBT), along with parental support. The program was conducted by dieticians with the collaboration of child psychiatrists and pediatricians. Training and regular supervision upon CBT priniciples application was intended to enhance dieticians' efficiency. The intervention is currently being evaluated to determine its effectiveness in treating childhood obesity.     

Cognitive, Affective and Behavioral Correlates of Internalization of Regulations for Religious Activities

The main goal of this study was to examine the relationship between different types of extrinsic motivation for religious behaviors as conceptualised within self-determination theory (Ryan & Deci, 2000) and Wulff's (1991) framework of literal versus symbolic approaches of religious contents. Results from a Belgian sample of active believers (N=186) show that the internalization of one's reasons for performing religious behaviors was positively associated with an open, symbolic interpretation of religious belief contents and a stronger adherence to Christian beliefs. Moreover, internalization was also positively related to general well-being and frequency of prayer but unrelated to church attendance. It is concluded that individuals who engage in religious behaviors because of its perceived personal significance will show more cognitive flexibility and open-mindedness towards Christian belief contents, a stronger adherence to this message, higher well-being and more frequent engagement in specific religious behaviors.

Effectiveness of a Cognitive Behavioral Intervention for Young Adults with Cystic Fibrosis

This study examined the effectiveness of a cognitive behavioral intervention for young adults with cystic fibrosis (CF). Four young adults were referred for the therapy by medical staff because of perceived problems with anxiety, anger, or coping. Treatment impact was assessed on measures of anxiety, anger, perceptions of functional disability, and coping. A multiple baseline design across subjects was used. Overall, the impact of the cognitive behavioral intervention for young adults with CF was mixed. If participants had elevated baseline scores on anxiety, anger, or perceived functional disability, then some improvement was shown. However, only one participant had elevated baseline anxiety and anger scores, while two had higher functional disability scores. For coping, only one participant clearly displayed a greater use of approach relative to avoidance coping by the end of treatment. Results are discussed in terms of treatment implications, assessment, and coping issues.     

Behavioral,Affective, and Cognitive Parenting Mechanisms of Child Internalizing and Externalizing Problems during the COVID-19 Pandemic

Research on Child and Adolescent Psychopathology - The COVID-19 pandemic has led to increased mental health concerns, including depression and anxiety among parents and internalizing and...     

Deconstructing Organizational Commitment: Associations Among Its Affective and Cognitive Components,Personality Antecedents,and Behavioral Outcomes1

This study tests whether measurement of the cognitive aspect of organizational commitment can explain variance in behavioral expressions of commitment beyond Allen & Meyer's (1990 ) measure of the affective component of commitment. This cognitive component was measured by an index of belief accentuation. Undergraduates (N = 110) completed a questionnaire that measured all variables. Results show that students who polarize their judgments about the appropriateness of behavior at the university support the university more by defending it from criticism and praising it. This effect holds even after controlling for personality and demographic variables. Results also show that extraversion and agreeableness explain variance in the affective element of commitment and that conscientiousness explains variance in the cognitive element of commitment.     

卫生行为干预的认知-情感网络模型

行为的影响因素错综复杂,有效的干预方案的设计离不开合理的理论模型指导.提出的模型认为,个体的行为是由其大脑中的认知-情感神经网络决定的,它包括自己、他人、环境和行为动机四个层次化的子系统.该理论模型不仅为系统理解卫生行为提供了有用的思维框架,还对行为干预提出了许多有益的启示.     

Preliminary Psychometric Evidence for Distinct Affective and Cognitive Mechanisms Mediating Contamination Aversion

Contamination aversion is implicated in a range of psychological disorders, such as obsessive-compulsive disorder and health anxiety. Despite broad implications, the core mechanisms mediating contamination aversion are mixed and have not clearly been elucidated. The present studies are psychometric investigations of the components of contamination aversion and tests of the different mechanisms that mediate the severity of these components. In Study 1, items from existing measures of contamination aversion were compiled into one measure and administered to a large sample of nonclinical participants (N?=?1,286). Exploratory factor analyses demonstrated a two-factor structure, with one factor comprised of items related to intrinsically (direct) contaminated objects and the other factor comprised of items related to extrinsically (indirect) contaminated objects. In Study 2, items were added and confirmatory factor analyses supported a two-factor model in another large nonclinical sample (N?=?612). In Study 3 (N?=?471), structural modeling demonstrated distinct relations between the two factors and affective and cognitive constructs. Affective constructs related more to aversions toward more directly contaminated objects and situations while cognitive constructs related more to aversions toward more indirectly contaminated objects and situations. The present studies help clarify and articulate the unique roles of cognition and affect in specific contamination aversions, and, as such, have important implications for conceptual modeling of contamination-related psychopathology.     

Processes in Group Cognitive and Behavioral Treatment for Hoarding

Processes that emerge in the course of group treatment, such as universality and mutual aid, have been posited to promote therapeutic change (e.g., Yalom, 1995); however, they have received relatively little attention in the group cognitive behavioral treatment (CBT) literature (Rose, 2004). Group CBT interventions have been successful in alleviating symptoms of mood and anxiety disorders, such as major depression and obsessive-compulsive spectrum disorder (e.g., Anderson & Rees, 2007; Himle et al., 2001). A specialized group CBT protocol has been developed to treat hoarding (Muroff et al., 2009; Steketee & Frost, 2007), characterized by excessive clutter in the home, difficulty discarding objects that appear of little value, and often excessive acquisition, resulting in significant distress and/or impairment (Frost & Hartl, 1996). Individual (Tolin, Frost, & Steketee, 2007) and group (Muroff et al.) CBT for hoarding have shown promising effects. An examination of group process factors relevant to hoarding, however, is critical in order to further understand and tailor group interventions for this complex problem. The current paper characterizes four group processes specific to group CBT for hoarding: (a) universality or inclusion may reduce stigma and shame about having hoarding; (b) cohesion seems to support attendance and to provide positive peer pressure to motivate change; (c) the opportunity to give mutual aid seems to instill hope and motivate change; (d) social contact and socializing may reduce social isolation, a characteristic of this population. Discussion includes specific case examples illustrating these group processes and their potential complexity, within the context of group CBT for hoarding. Recommendations are advanced for future directions in evaluating group CBT for hoarding, particularly the formal study of group process variables with this population.     

Overcoming Barriers to HIV Treatment Adherence: A Brief Cognitive Behavioral Intervention for HIV-Positive Adults on Antiretroviral Treatment

Maximizing HIV treatment adherence is critical in efforts to optimize health outcomes and to prevent further HIV transmission. The Balance Project intervention uses cognitive behavioral approaches to improve antiretroviral medication adherence through promoting adaptive coping with medication side effect and distress related to HIV. This 5-session intervention has been documented to prevent nonadherence among persons living with HIV who experience high levels of distress associated with their antiretroviral medication side effects. We describe the theoretical underpinnings of the intervention, provide details of the training and session protocols with a case example, and discuss implications for future applications of the intervention in both research and clinical settings.     

Treatment Effectiveness of a Brief Behavioral Intervention for Preschool Disruptive Behavior

Parent management training is an evidence-based treatment for disruptive behavior. However, the number of treatment sessions can be high, contributing to high attrition rates. The purpose of this study was to examine post-treatment, 6-month, and 1-year treatment outcomes of the Brief Behavioral Intervention. One hundred twenty children aged 2–6.5 years demonstrating clinically significant disruptive behavior were referred to an outpatient clinic for treatment and participated in the study. Attrition was below reported rates in the literature. Significant decreases in child disruptive behavior and parent stress were found from pre-to-post intervention, and improvements were maintained at follow-ups. Significant pre-to-post intervention teacher reported decreases in behavior were reported.     

A Cognitive Behavioral Adherence Intervention for Adolescents with Type 1 Diabetes

This study examined the impact of a cognitive behavioral intervention for nonadherent adolescents with type 1 diabetes. Six youths having problems following the diabetes regimen received training in cognitive restructuring and problem solving during individual sessions. A multiple baseline design across participants was used. Treatment effectiveness was assessed through 24-hr recall adherence interviews with adolescents and frequency of testing data was downloaded from glucose meters. Data was also collected for diabetes-specific stress. Five youths displayed improvement on at least one self-care behavior. Furthermore, the results suggest that the cognitive behavioral intervention was effective in diminishing diabetes-related stress in two participants. Cognitive behavioral interventions show promise for increasing self-care behaviors among nonadherent youths with type 1 diabetes. However, individual youths varied in their response to treatment. Further research is needed in developing procedures to better meet the needs of youths, improve youth participation, and enhance treatment effectiveness.     

Tailoring Cognitive Behavioral Treatment for Binge Eating in Adolescent Girls

Whereas effective treatments exist for adults with recurrent binge eating, developmental factors specific to adolescents point to the need for a modified treatment approach for youth. We adapted an existing cognitive behavioral therapy treatment manual for adults with bulimia nervosa and binge eating disorder (Fairburn, 2008) for use with adolescents. This paper presents a number of clinical case vignettes, drawn directly from interactions with teen participants, that illustrate some of the developmental factors common to adolescents—as well as the importance of our adaptations to address for these factors.     

Predictors and Outcomes of Sudden Gains and Sudden Regressions in Cognitive Behavioral Therapy for Youth Anxiety

Sudden gains (SGs), referring to large, stable symptom improvement occurring between consecutive treatment sessions, have been associated with improved outcomes among adults with various psychological disorders. Little research exists on SGs or sudden symptom worsening (i.e., sudden regressions [SRs]) during treatment for youth disorders. The current study examined predictors and outcomes of SGs/SRs via multiple informants in youth anxiety treatment. Participants were 118 youth (age M = 11.6, SD = 2.5; 53.8% female) and their caregivers receiving a cognitive-behavioral therapy protocol for a principal anxiety disorder. Anxiety symptom severity was assessed weekly via the State-Trait Anxiety Inventory for Children–Trait–Child/Parent versions. SGs and SRs occurred in 45.8 and 31.3% of youth, respectively. SRs were more common among youth with comorbid mood or externalizing disorders, while SGs occurred more often among youth with greater pretreatment anxiety symptom severity. SGs were not associated with posttreatment outcomes, but SRs predicted significantly higher posttreatment internalizing symptoms based on child report (β = .23, p = .03) and externalizing symptoms based on child (β = .15, p = .04) and parent report (β = .16, p = .03), controlling for overall magnitude of symptom change. SRs among youth receiving cognitive-behavioral therapy for anxiety are associated with pretreatment clinical complexity and poorer posttreatment outcomes and may serve as a warning sign to clinicians of possible treatment failure.     

Learning at Workstations in the Zoo: A Controlled Evaluation of Cognitive and Affective Outcomes

ABSTRACT

This study aimed to test the cognitive and affective benefits gained through the provision of educational materials at workstations in the Wilhelma Zoo in Stuttgart, Germany. Structured learning materials were developed for use with visiting school groups. The materials focused on the adaptations of 6 selected groups of bird species and were organized as a self-guided learning environment (workstations). The value of the materials was assessed in terms of cognitive (learning and retention) and emotional (interest, well-being, boredom, anxiety, contentedness) variables. The authors measured prior knowledge (1 week before the zoo visit), learning effect (1 week after the visit), and retention (8 to 9 weeks later). A total of 103 students (6th graders aged between 11–12 years) participated in the study, 77 receiving a treatment about adaptations in bird species and 26 receiving a treatment about reptiles which served as a control. Students had similar prior knowledge, but 1 week later students receiving the bird unit scored significantly better and this persisted into retention. Girls achieved higher scores than boys, both 1 week and 8 to 9 weeks after the visit. Surprisingly, students in the control group reported higher interest, well-being and contentedness, and lower boredom than those in the treatment group.     

Happy Family Kitchen: Behavioral Outcomes of a Brief Community-Based Family Intervention in Hong Kong

Positive psychology interventions commonly involve behavioral exercises to improve psychosocial well-being. Intervention effect on behavior is unclear. The Happy Family Kitchen project, one of the community-based brief intervention projects under The FAMILY: A Jockey Club Initiative for a Harmonious Society, was conducted in Hong Kong to develop and evaluate the effectiveness of a positive psychology family intervention. We have previously reported positive intervention effects on family communication, family well-being, and subjective happiness. This paper aims to explore the effectiveness of the intervention on behavioral outcomes and their associations with psychosocial well-being. A total of 23 social service units organized and conducted intervention programs for 1419 individuals from 612 families in Hong Kong. Each intervention was developed with emphasis on one of five positive psychology themes: gratitude, flow, happiness, health, and savoring. Intervention outcomes were assessed at pre-intervention, immediate post-intervention, and 6 weeks and 12 weeks post-intervention. Results showed that family communication time and frequency of meal preparation with family members increased with sustainable small effects up to 12 weeks. Theme-specific behavior change was observed in the gratitude, flow, and happiness interventions, respectively. Family communication time, frequency of eating with family members, and theme-specific behaviors, including gratitude, flow, happiness behavior, health attitude, and health behavior, were positively associated with psychosocial well-being. Qualitative data provided additional evidence of effectiveness with in-depth insights into behavior change. The positive associations between target behaviors and well-being suggest that improvements in well-being as a function of the intervention may be associated with behavior change.     

Hoarding Disorder and a Systematic Review of Treatment with Cognitive Behavioral Therapy

Until recently, compulsive hoarding has been treated as a type of obsessive-compulsive disorder with mixed results. Little research exists on the efficacy of behavioral interventions specifically designed to treat hoarding disorder, and most existing research is limited with regard to the numbers of participants, their ethnic and cultural diversity, and study replication; therefore, the generalizability of findings is limited. This article reviews the prevalence of hoarding disorder, cognitive behavioral therapy treatment approaches, and measurement of symptoms. A systematic review compares the efficacy of various CBT methods, with particular attention to comparing therapy that is traditionally used to treat OCD with those designed specifically to treat hoarding disorder. Only clinical studies using CBT interventions designed to treat hoarding associated with OCD or hoarding disorder were included. Studies included participants of all ages, and articles were published in peer-reviewed journals. Case studies were excluded. After a comprehensive search and removing duplicates from databases and references, 65 articles were reviewed, of which 12 met criteria for review. Preliminary results demonstrate improvement in hoarding symptoms with CBT interventions that are both for OCD and those designed to specifically treat hoarding disorder; however, when compared to each other, the efficacy of these treatments is inconclusive, thus more research is needed.     

Exploring the Effectiveness of a Mixed-Diagnosis Group Cognitive Behavioral Therapy Intervention Across Diverse Populations

Depression and anxiety are the most common mental health disorders seen in clinical practice and they are highly comorbid. Cognitive behavioral therapy (CBT) has been demonstrated as an effective treatment for both depression and anxiety but is often not available to all individuals who could benefit from it. This paper investigates the effectiveness of a mixed-diagnosis group CBT intervention that incorporates mindfulness meditation for individuals presenting with depression and/or anxiety: CBT Basics II. This intervention was evaluated across two distinct mental health programs to determine both if it can demonstrate positive results and if it is feasible to implement in these types of programs. Sample 1 (n = 42 completers) consisted of higher-functioning individuals in a general mental health program. Sample 2 (n = 53 completers) consisted of individuals with more chronic and severe mental health diagnoses. Overall, intent-to-treat analyses revealed improvements in psychiatric symptoms, and increases in CBT knowledge and mindfulness skill across both programs. This indicates that CBT Basics II is effective across diverse mental health populations and shows promise for improving access to CBT.     

Cognitive Behavioral Therapy for HIV-Negative Heterosexual Meth Users: The FASTLANE II Intervention

The purpose of this paper is to provide clinicians with a theoretical roadmap and practical toolkit for the FASTLANE II intervention, a 9-session behavior change intervention for HIV-negative meth-using heterosexual men and women that simultaneously targets depressive symptoms, meth use, and sexual risk behavior. The intervention was grounded in cognitive behavioral therapy (CBT), social cognitive theory (SCT), and the theory of reasoned action (TRA), and utilized a variety of cognitive and behavioral techniques. Examples of those techniques are provided, as well how those techniques map onto core theoretical elements of CBT, SCT, and TRA. We present three case studies with sample counseling session dialogue. Techniques and skills from FASTLANE II may be of use to clinicians interested in targeting depression, meth use, and high-risk sexual behavior.