Aerobic exercise training ameliorates craving and inhibitory control in methamphetamine dependencies: A randomized controlled trial and event-related potential study

ObjectiveMethamphetamine (MA) usage has been recognized as a prominent substance-abuse issue. While exercise training reportedly improves fitness and mental status in the MA-dependent, how exercise training affects addiction and cognitive deficiency has yet to be established. The current study aimed to determine the effects of aerobic exercise training on both MA-associated cravings and inhibitory control among those with MA dependencies.DesignA 12-week randomized controlled trial.MethodSixty-two people with MA dependencies recruited through the Drug Rehabilitation Bureau were assigned to either an aerobic exercise or attentional control group, with 50 participants completing the trial. The aerobic exercise program involved three 30-min sessions of moderate-intensity exercise per week. Along with a pre-test assessment, craving levels were evaluated every three weeks, and data on neutral and MA-related inhibitory control as well as its elicited neuroelectric activation were collected at the end of the intervention.ResultsCompared with the control group, the exercise group experienced attenuated MA craving levels after 6 weeks of the exercise program, and the decreased trend was maintained until the termination of treatment. In the post-test, the exercise group also demonstrated more accuracy in behavioral inhibitory control as well as greater N2 amplitude in the Nogo condition of both the standard and MA-related tasks than those in the control group or pre-test.ConclusionsThe current study provides the first evidence that aerobic exercise training may be efficacious for MA-associated cravings and inhibitory control from behavioral and neuroelectric perspectives among MA-dependent individuals.     

Mental imagery increases self-determined motivation to exercise with university enrolled women: A randomized controlled trial using a peer-based intervention

ObjectivesThe purpose of this study was to examine the effects of a peer-based mental imagery intervention on the self-determined motivation and cardio-respiratory fitness of university enrolled women.DesignRandomized controlled trial.Method43 University enrolled women were randomized to peer-mentored or peer-mentored plus mental imagery conditions while 32 completed three meetings with peer-mentors and post-testing (M^age = 19.91; SD = 1.70).ResultsSignificant improvements in cardio-respiratory endurance, ratings of perceived endurance, and self-determined motivation to exercise were observed across both study conditions. Participants assigned to the peer mentored plus mental imagery condition reported significantly greater increases in self-determined motivation to exercise at post-test compared to those in the peer-mentored condition.ConclusionsPeer-based interventions are a viable way to improve fitness and health outcomes while mental imagery appears to be associated with increases in autonomous forms of exercise motivation.     

Promoting exercise behavior among Chinese youth with hearing loss: a randomized controlled trial based on the transtheoretical model

The transtheoretical model proposes that behavior change is experienced as a series of stages. Interventions tailored to these stages are most likely to be effective in progressing people through the model's hypothesized behavior change continuum. In this study, a stage-tailored, 12-week, exercise behavior intervention based on the transtheoretical model was conducted among a sample of 150 Chinese youth with hearing loss. Participants were randomized into an intervention or control group with all the core transtheoretical model constructs assessed pre- and post-intervention. Participants in the intervention group showed greater advances in their stage of exercise behavior change, decisional balance, and processes of change use compared to those in the control group. The intervention, however, was insufficient for increasing participants' self-efficacy for exercise behavior. The findings partially support the utility of the theory-based intervention for improving the exercise behavior of Chinese youth with hearing loss, while simultaneously helping to identify areas in need of improvement for future applications.     

Prevention of depression with primary care patients: A randomized controlled trial

The prevention of major depression is an important research goal which deserves increased attention. Depressive symptoms and disorders are particularly common in primary care patients and have a negative impact on functioning and well-being comparable with other major chronic medical conditions. The San Francisco Depression Prevention Research project conducted a randomized, controlled, prevention trial to demonstrate the feasibility of implementing such research in a public sector setting serving low-income, predominantly minority individuals: 150 primary care patients free from depression or other major mental disorders were randomized to an experimental cognitive-behavioral intervention or to a control condition. The experimental intervention group reported a significantly greater reduction in depressive levels. Decline in depressive levels was significantly mediated by decline in the frequency of negative conditions. Group differences in the number of new episodes (incidence) of major depression did not reach significance during the 1-year trial. We conclude that depression prevention trials in public sector primary care settings are feasbile, and that depressive symptoms can be reduced even in low-income, minority populations. To conduct randomized prevention trials that can test effects on incidence with sufficient statistical power, subgroups at greater imminent risk have to be identified.     

Treatment of obsessions: A randomized controlled trial

This study tested Rachman's cognitive behavioral method for treating obsessions not accompanied by prominent overt compulsions. The cognitive behavioral treatment was compared to waitlist control and an active and credible comparison of stress management training (SMT). Of the 73 adults who were randomized, 67 completed treatment, and 58 were available for one-year follow-up. The active treatments, compared to waitlist, resulted in substantially lower YBOCS scores, OCD-related cognitions and depression as well as improved social functioning. Overall, CBT and SMT showed large and similar reductions in symptoms. Pre-post effect sizes on YBOCS Obsessions for CBT and SMT completers was d = 2.34 and 1.90, respectively. Although CBT showed small advantages over SMT on some symptom measures immediately after treatment, these differences were no longer apparent in the follow-up period. CBT resulted in larger changes on most OCD-related cognitions compared to SMT. The cognitive changes were stable at 12 months follow-up, but the differences in the cognitive measures faded. The robust and enduring effects of both treatments contradict the long-standing belief that obsessions are resistant to treatment.     

Mindfulness training for loneliness among Chinese college students: A pilot randomized controlled trial

Loneliness has been found to predict a wide range of physical and mental health problems. It is suggested that China's One‐Child Policy places young Chinese people at a particularly high risk for loneliness. Although loneliness is most prevalent in late adolescence and early adulthood, interventions have primarily targeted children or older adults with limited success. The current study examines a pilot randomized controlled trial of a mindfulness training program among Chinese college students. Participants with elevated loneliness (N = 50, ages 17–25) were randomized into either an 8‐week mindfulness training or a control group. Self‐reported measures of loneliness and mindfulness were administered at baseline and posttest. The training group also completed a program evaluation form and a 3‐month follow‐up assessment. Results provided preliminary evidence indicating that the intervention was feasible and effective at reducing loneliness among Chinese college students. Limitations and future directions were discussed.     

Real-time kinematic biofeedback improves scapulothoracic control and performance during scapular-focused exercises: A single-blind randomized controlled laboratory study

Emerging evidence suggests that scapular-focused therapeutic exercises hold promise for shoulder dynamic stability retraining. While recent findings show that therapeutic exercises can alter scapular neuromuscular function measured with muscle electromyography, no study has yet addressed the effects of kinematic biofeedback for improving scapulothoracic control and performance. The aim of this study was to assess the effectiveness of kinematic biofeedback on motor relearning transfer during shoulder flexion and a daily activity, on the quality of scapular-focused exercise performance, and on execution time. Thirty healthy young adults were randomly distributed into two groups. Skin mounted electromagnetic sensors were used to collect kinematic data of the thorax, scapula and humerus while subjects performed a shoulder flexion and a daily activity, prior to and after scapular-focused exercises. For both groups, the exercise execution error and the execution time determined the scapulothoracic control and performance. Significant statistical differences were found in the exercise execution error results within the experimental group (z = 5.313; p = 0.037) and between groups (u = 37.00; p = 0.001; u = 64.00; p = 0.024). This study’s results demonstrate that real-time kinematic biofeedback improves scapulothoracic control and performance during scapular-focused exercise execution.     

Cognitive-behavioral therapy for insomnia in alcohol dependent patients: a randomized controlled pilot trial

In a randomized controlled trial, we evaluated the efficacy of cognitive-behavioral treatment for insomnia to improve sleep and daytime symptoms, and to reduce relapse in recovering alcohol dependent (AD) participants. Seventeen abstinent AD patients with insomnia (6 women, mean age 46.2 ± 10.1 years) were randomized to 8 sessions of cognitive-behavioral treatment for insomnia for AD (CBTI-AD, n = 9) or to a behavioral placebo treatment (BPT, n = 8). Subjective measures of sleep, daytime consequences of insomnia and AD, alcohol use, and treatment fidelity were collected at baseline and post-treatment. Diary-rated sleep efficiency and wake after sleep onset, and daytime ratings of General Fatigue on the Multidimensional Fatigue Inventory improved more in the CBTI-AD compared to the BPT group. In addition, more subjects were classified as treatment responders following CBTI-AD. No group differences were found in the number of participants who relapsed to any drinking or who relapsed to heavy drinking. The findings suggest that cognitive-behavioral insomnia therapy benefits subjective sleep and daytime symptoms in recovering AD participants with insomnia more than placebo. The benefits of treating insomnia on drinking outcomes are less apparent.     

Influence of regular aerobic exercise on psychological health: a randomized, controlled trial of healthy middle-aged adults

Although a variety of psychological benefits have been attributed to regular exercise, few experimentally controlled studies of healthy individuals currently exist. One hundred twenty healthy, sedentary, middle-aged men and women were randomly assigned to either a 6-month home-based aerobic exercise training program or to an assessment-only control condition. Adherence across the 6-month period was found by both self-report and heart rate microprocessor methods to exceed 75% in both sexes. To assess changes in a variety of psychological variables over time, a 14-item Likert rating scale was completed and returned on a biweekly basis throughout the 6-month period. Slope analyses conducted on the 11 items attaining acceptable test-retest reliability coefficients showed significant between-groups differences on the 3 items most closely associated with the actual physical changes that occurred with exercise (all ps less than .004). Implications in relation to repeated measurement of psychological changes in nonclinical populations and the determination of the relevant population-, activity-, and program-specific parameters involved are discussed.     

Acceptance and commitment therapy for the treatment of stress among social workers: a randomized controlled trial

Chronic stress increases the risk of health problems and absenteeism, with negative consequences for individuals, organizations and society. The aim of the present study was to examine the effect of a brief stress management intervention based on the principles of Acceptance and Commitment Therapy (ACT) on stress and general mental health for Swedish social workers (n = 106) in a randomized, controlled trial. Participants were stratified according to stress level at baseline in order to examine whether initial stress level moderated the effect of the intervention. Two thirds of the participants had high stress levels at baseline (Perceived Stress Scale; score of ≥ 25). The results showed that the intervention significantly decreased levels of stress and burnout, and increased general mental health compared to a waiting list control. No statistically significant effects were, however, found for those with low levels of stress at baseline. Among participants with high stress, a substantial proportion (42%) reached criteria for clinically significant change. We concluded that the intervention successfully decreased stress and symptoms of burnout, and increased general mental health. Evidence is, thus, provided supporting ACT as brief, stress management intervention for social workers.     

Mindfulness-based stress reduction for patients with anxiety disorders: evaluation in a randomized controlled trial

The aim of this study was to investigate the effect of mindfulness-based stress reduction (MBSR) for patients with heterogeneous anxiety disorders. Seventy-six self-referred patients were randomized to MBSR or a waiting-list control condition. Eight participants did not complete the eight-week MBSR intervention. Treatment completers improved significantly on all outcome measures compared to controls. The completer sample showed medium to large effect sizes on measures of anxiety (Cohen’s d = 0.55–0.97), and a large effect size for symptoms of depression (Cohen’s d = 0.97). Intention-to-treat analyses yielded effect sizes in the small to moderate range (Cohen’s d = 0.32–0.76). Gains were maintained at six months follow-up. The percentage of participants reaching recovered status was highest for symptom measures of depression and anxiety, and lower for worry and trait anxiety. Mediation analyses indicated that mindfulness fully mediated changes in acute anxiety symptoms, and partially mediated changes in worry and trait anxiety. However, the present study did not find evidence of temporal precedence for the proposed mediator. In the absence of true mediation and an active control condition, it cannot be ruled out that results are due to non-specific aspects of treatment. Despite these and other limitations, we conclude that MBSR is an effective treatment for anxiety disorders and related symptomatology.     

Effects of an acute bout of localized resistance exercise on cognitive performance in middle-aged adults: A randomized controlled trial study

ObjectivesTo examine the effect of an acute bout of resistance exercise on cognitive performance in healthy middle-aged adults.DesignA randomized controlled trial design.MethodsForty-one adults (M_age = 49.10 years, SD = 8.73) were randomly assigned to either resistance exercise or a control condition. The resistance exercise condition consisted of 2 sets of 10 repetitions for 6 exercises, and the control condition involved reading about resistance exercise for a time period approximating the duration of the exercise condition. The Stroop Test and the Trail Making Test (TMT) were completed at baseline and immediately following performance of the treatment.ResultsResults indicated that resistance exercise significantly benefits speed of processing (Stroop Word and Stroop Color), and that there is a trend towards resistance exercise benefiting performance on an executive function task (Stroop Color–Word) that requires shifting of the habitual response. However, the results for the TMT were not significant which demonstrates that acute resistance exercise has a limited effect on inhibition.ConclusionThe present findings extend the literature by indicating that an acute bout of resistance exercise has a positive impact on automatic cognitive processes and on particular types of executive function in middle-aged adults.     

Evaluation of the effect of Spiritual care on patients with generalized anxiety and depression: a randomized controlled study

The present study was conducted to assess the effect of spiritual care in patients with depression, anxiety or both in a randomized controlled design. The participants were randomized either to receive spiritual care or not and Hamilton anxiety rating scale-A (HAM-A), Hamilton depression rating scale-D (HAM-D), WHO-quality of life-Brief (WHOQOL-BREF) and Functional assessment of chronic illness therapy – Spiritual well-being (FACIT-Sp) were assessed before therapy and two follow-ups at 3 and 6 week. However, with regard to the spiritual care therapy group, statistically significant differences were observed in both HAM-A and HAM-D scales between the baseline and visit 2 (p < 0.001), thus significantly reducing symptoms of anxiety and depression, respectively. No statistically significant differences were observed for any of the scales during the follow-up periods for the control group of participants. When the scores were compared between the study groups, HAM-A, HAM-D and FACIT-Sp 12 scores were significantly lower in the interventional group as compared to the control group at both third and sixth weeks. This suggests a significant improvement in symptoms of anxiety and depression in the spiritual care therapy group than the control group; however, large randomized controlled trials with robust design are needed to confirm the same.     

Efficacy of self-administered treatments for pathological academic worry: A randomized controlled trial

Research on treatments for reducing pathological worry is limited. In particular, academic worry is a common theme in generalized anxiety disorder (GAD) samples as well as non-clinical student samples. Given the high cost of anxiety disorders to society, research is needed to examine the efficacy of self-administered treatments designed to reduce pathological worry. The primary goal of this study was to investigate the benefits of three self-administered interventions for reducing academic worry. College students (N = 113) experiencing clinically significant academic worry were randomized to either: (a) worry exposure (WE); (b) expressive writing (EW); (c) relaxation consisting of pulsed audio-photic stimulation (APS); or (d) waitlist control (WLC). Participants were instructed to practice their interventions three times per week for one month and completed home practice logs online to track treatment adherence. Academic worry, general anxiety, and perceived stress were assessed at baseline and post-treatment. Academic worry and general anxiety were also assessed at a three-month follow-up. Those assigned to the WE and APS conditions showed significant improvement relative to EW and WLC at post-treatment. All treatment conditions showed continued improvement by follow-up, with no between-group differences. Treatment and public health implications are discussed.     

Enhanced retention of drop vertical jump landing technique: A randomized controlled trial

External focus instructions have been shown to result in superior motor performance compared to internal focus instructions. Using an EF may help to optimize current anterior cruciate ligament (ACL) injury prevention programs. The purpose of the current study was to investigate the effects of instructions on landing technique and performance by comparing an external focus (EF), internal focus (IF), video (VI) and control (CTRL) group. Subjects (age 22.50 ± 1.62 years, height 179.70 ± 10.43 cm, mass 73.98 ± 12.68 kg) were randomly assigned to IF (n = 10), EF (n = 10), VI (n = 10) or CTRL group (n = 10). Landing was assessed from a drop vertical jump (DVJ) in five sessions: pretest, two training blocks (TR1 and TR2) and directly after the training sessions (post test) and retention test 1 week later. Group specific instructions were offered in TR1 and TR2. Landing technique was assessed with the Landing Error Scoring System (LESS) and jump height was taken as performance measure. The results show that males in the VI group and females both in the VI and EF groups significantly improved jump-landing technique. Retention was achieved and jump height was maintained for males in the VI group and females both in the VI and EF groups. It is therefore concluded that EF and VI instructions have great potential in ACL injury prevention.