The effects of a video vignette on increasing treatment acceptability

The effects of a video vignette on the treatment acceptability ratings of four behavioral interventions were evaluated. Two interventions involved positive reinforcement (DRO and DRI) and two negative consequences (contingent physical restraint and contingent electric shock). Eighty-five individuals involved in programs for individuals with developmental disabilities were randomly assigned into two groups. The experimental group (n=41) viewed a video vignette of an extremely aggressive individual whereas the control group (n=44) did not. Acceptability ratings prior to the video showed no differences between the experimental and control groups except for the physical restraint intervention. The experimental group’s post video ratings indicated significant acceptability increases for electric shock and significant decreases for DRO. There also was a significant group by testing effect with the means for the experimental group rising whereas the control group means were stable. These results showed that acceptability is alterable through video. © 1997 John Wiley & Sons, Ltd.     

Factor structure of the Treatment Evaluation Inventory: Implications for measurement of treatment acceptability

The Treatment Evaluation Inventory (TEI), a frequently used measure of treatment acceptability, was used by 164 undergraduates to rate the acceptability of each of the following treatments: differential reinforcement of other behavior, exclusionary time-out, overcorrection, medical restraint, contingent electric shock, and physical restraint. TEI ratings of each treatment type were grouped separately, variance-covariance matrices were formed and compared, and data were subjected to factor analysis. The results indicated that the factor structure of the TEI varied with the treatment it was used to evaluate. Item analysis of the TEI indicated a high degree of internal consistency, although item-total correlations varied between rated treatments. The findings suggest that although the TEI is a reliable instrument, sensitive assessment of the treatment acceptability construct probably requires multidimensional measurement.     

Efficacy of guided self-help behavioural activation and physical activity for depression: a randomized controlled trial

Behavioural activation and physical activity have received empirical support that highlight their efficacy in reducing depression. Even though both behavioural activation and physical activity share the common goal of reactivating the individual, limited research has directly compared these interventions, and more research is required to evaluate their efficacy when offered in low-intensity formats. The present study involves a randomized controlled clinical trial comparing the efficacy of two guided self-help interventions for the treatment of depression: behavioural activation and physical activity. Fifty-nine participants presenting mild-to-moderate symptoms of depression were randomized either to a behavioural activation intervention (n = 20), a physical activity intervention (n = 19) or a wait-list control group (n = 20). All participants completed symptom measure pre-, mid- and post-intervention, as well as at a two-month follow-up. Mixed-model analyses of variance revealed that both interventions were significantly more efficacious in reducing depressive symptoms in comparison with the control group. Physical activity involved significantly less time-investment compared to the behavioural activation condition (less than half the amount of time). These results indicate that physical activity and behavioural activation both effectively reduce depressive symptoms and are favourably applicable in low-intensity formats. Implications of these results and avenues for future research are discussed.     

The impact of rater agreeableness and rating context on the evaluation of poor performance

We tested the effects of rater agreeableness on the rating of others’ poor performance in performance appraisal (PA). We also examined the interactions between rater agreeableness and two aspects of the rating context: ratee self‐ratings and the prospect of future collaboration with the ratee. Participants (n= 230) were allocated to one of six experimental groups (a 3 × 2 between‐groups design) or a control group (n= 20). Participants received accurate, low‐deviated, or high‐deviated self‐ratings from the ratee. Half were notified they would collaborate with the ratee in a future task. High rater agreeableness, positive deviations in self‐rating, and the prospect of future collaboration were all independent predictors of higher PA ratings. The interactions between rater agreeableness and rating context were very small. We argue that conflict avoidance is an important motivation in the PA process.     

Effects of In-Group Bias on Planned Encounters of Jewish and Arab Youths

Abstract

In a sample of 9th-grade Jewish (n = 118) and Arab (n = 100) students in Israel who participated in planned binational encounters, the author examined in-group biases as a function of (a) their perceptions of the encounter between the groups as interpersonal or as intergroup contact and (b) their views of the status of their respective national groups in Israel as legitimate and stable. In comparisons of the 2 encounter groups (of equals status), both groups showed in-group biases. In comparisons of the national groups at large (of unequals status), the Arab students considered their group similar to the Jewish group, whereas the Jewish students rated their group more favorably than they rated the Arab group. For the Jewish, but not the Arab, students, in-group bias was contingent on simultaneous ratings (legitimate–illegitimate; stable–unstable) of the binational situation in Israel. The data support a 2-dimensional model rather than a 1-dimensional model of intergroup-interpersonal definition of the encounter.     

Reduced ADHD symptoms in adults with ADHD after structured skills training group: results from a randomized controlled trial

Objective

Feasibility, acceptability, and efficacy of a Dialectical Behavioral Therapy (DBT) -based method developed in Germany were evaluated in a Swedish outpatient psychiatric context.

Method

Fifty-one adults with ADHD on stable medical treatment or on no medication were randomized to the DBT-based skills training (n = 26) or a parallel loosely structured discussion group (n = 25). Self-rating scales were administered before randomization and after the treatment.

Results

Feasibility and participant satisfaction were good in both groups while skills training was perceived as more logical and effective for ADHD-related problems. The analyses of the individuals who completed the treatment and remained stable with regard to medication (n = 19 in skills training; n = 18 in control group) showed a significant reduction in ADHD symptoms in the skills training group, but not in the control group. No reduction of comorbidity was observed in any of the groups.

Conclusions

The treatment was feasible in an outpatient psychiatric context, well tolerated, and significantly reduced ADHD symptoms in on-treatment individuals who remained stable regarding medication status.     

Can imagery facilitate improvements in anticipation behavior?

ObjectivesWe examined the effectiveness of interventions involving imagery, video, and outcome feedback in improving anticipation in skilled junior cricket batters.Design/methodParticipants (N = 34, Mean age = 14.9 years, SD = 0.75) were allocated to one of three groups matched on imagery ability or a no practice control. The experimental groups received a four-week, film-based training intervention.ResultsAll experimental groups improved anticipation performance during training. Pre to posttest improvements were greater for the group that received outcome Knowledge of Results (KR) compared to groups that also received a video replay of the bowler's action or imaged the previously seen action. All experimental groups improved visual imagery ability, measured by the VMIQ-2, but only the imagery intervention group improved in the kinesthetic dimension.ConclusionOur findings show that all three interventions are effective in improving anticipation and benefit imagery ability.     

The Effect of Holy Qur’an Recitation on Depressive Symptoms in Hemodialysis Patients: A Randomized Clinical Trial

Patients with advanced renal failure often face considerable sociopsychological stress as a result of lifestyle changes due to the disease and its treatment. The aim of the present study is to examine the effect of the Holy Qur’an recitation on depressive symptoms in hemodialysis patients. In this clinical trial, 54 hemodialysis patients were randomized to either an experimental (n = 27) or a control (n = 27) group. Patients completed the Beck Depression Inventory-II (BDI-II) at baseline and at 1 month after the intervention. Participants in the experimental group listened to recitation of the Holy Qur’an, while those in the control group received no intervention. The mean BDI-II score at baseline was 33.6 (±6.7) for the experimental group and 29.3 (±9.0) for the control group; at the end of treatment, BDI-II scores in the experimental and control groups were 14.5 (±4.8) and 31.6 (±9.2), respectively. Results from the repeated-measures general linear model controlling for baseline differences indicated a significant treatment effect (F = 9.30, p = 0.004, Cohen’s d = 0.85). Holy Qur’an recitation has a significant effect on lowering depressive symptoms in hemodialysis patients. Holy Qur’an recitation is an easy-to-implement and cost-effective strategy that may be used to supplement the treatment of depression in this setting in Iran.

     

Meta-analysis of the effects of cognitive-behavioral therapy on the core eating disorder maintaining mechanisms: implications for mechanisms of therapeutic change

The original and enhanced cognitive model of eating disorders proposes that cognitive-behavioral therapy (CBT) "works" through modifying dietary restraint and dysfunctional attitudes towards shape and weight. However, evidence supporting the validity of this model is limited. This meta-analysis examined whether CBT can effectively modify these proposed maintaining mechanisms. Randomized controlled trials that compared CBT to control conditions or non-CBT interventions, and reported dietary restraint and shape and weight concern outcomes were searched. Twenty-nine trials were included. CBT was superior to control conditions in reducing shape (g=0.53) and weight (g=0.63) concerns, and dietary restraint (g=0.36). These effects occurred across all diagnoses and treatment formats. Improvements in shape and weight concerns and restraint were also greater in CBT than non-CBT interventions (g's=0.25, 0.24, 0.31, respectively) at post-treatment and follow-up. The magnitude of improvement in binge/purge symptoms was related to the magnitude of improvement in these maintaining mechanisms. Findings demonstrate that CBT has a specific effect in targeting the eating disorder maintaining mechanisms, and offers support to the underlying cognitive model. If changes in these variables during treatment are shown to be causal mechanisms, then these findings show that CBT, relative to non-CBT interventions, is better able to modify these mechanisms.     

Symptoms,blood-pressure information and mood effects on symptom recall

Abstract

After completion of an illness symptom checklist (PILL) covering the previous three months, 97 nor-motensives were allocated to either experimental (false pressor feedback, n=42), or information control (accurate pressor feedback, n = 55), groups. The median reported symptom score divided high from low symptom subjects. All were given standard cuff blood pressure (BP) assessment and were normotensive. However, experimental subjects were misinformed that their BP was raised while information control subjects were told their BP was normal. Subsequently, subjects completed the state anxiety form of the State-Trait Personality Inventory, the PILL, and were asked about their belief of the ascribed BP label (normo/hypertensive) and then any perceived causal relationship between their BP and symptoms. Experimental subjects had significantly higher anxiety scores but no change in symptom recall after pressor feedback, whereas control subjects showed lower anxiety scores and decreases in symptom recall.

A post hoc treatment control (no pressor information) group (n = 20) excluded effects of BP labeling on post-BP scores, and a post hoc symptom control group (n = 55) ensured that symptom levels were representative of the normal population. The majority of subjects in both groups rejected any association between BP labels and symptoms. Data are discussed in the light of Leventhal's models of illness representation.     

“Weak,Sad, and Lazy Fatties”: Adolescents’ Explicit and Implicit Weight Bias Following Exposure to Weight Loss Reality TV Shows

Weight loss reality TV shows, which portray obese individuals and their struggle to lose weight, are highly popular. However, the shows often contain negative and stereotypical portrayals of obese individuals that can contribute to the formation of weight bias among viewers. In particular, adolescents might be highly susceptible to such portrayals, since physical appearance and body image play an important role during adolescence. In our experimental study, we investigated the priming effects of exposure to weight loss reality TV shows on implicit and explicit attitudes toward obese individuals among 353 adolescents. We exposed a treatment group (n = 173) to video clips of a weight loss reality TV show and a control group (n = 180) to video clips of an information-based TV magazine. Results indicated that for individuals who expressed a fear of being obese, exposure to the weight loss reality TV show reinforced negative explicit attitudes toward obese individuals by activating a perception of weight controllability. Exposure to the weight loss reality TV show also enhanced negative implicit attitudes toward obese individuals among all adolescents, irrespective of their fear of being obese. Altogether, our findings underscore the role of media in perpetuating weight bias.     

Conversation on mental states at nursery: Promoting social cognition in early childhood

Despite growing evidence that conversation on inner states fosters gains in children’s social cognition, this mechanism has yet to be tested with toddlers. To address this gap, we examined whether an intervention based on conversing about mental states with small groups of 2-year-old children at nursery had a significant effect on toddlers’ theory of mind (ToM) and emotion understanding (EU). Participants were 68 children (M_age at pre-test: 29.9 months) who were assigned to either an experimental or a control condition. Measures of verbal ability, ToM and EU were administered at pre-test, post-test and follow-up stages. Over a one-month intervention, all children were read a series of brief illustrated stories. After listening to the stories, the experimental group (n = 34) was involved in conversations on mental states, whereas the control group (n = 34) was engaged in conversation regarding the material entities and actions featured in the storybook. The experimental group significantly outperformed the control group on measures of both ToM and EU, independently of gains in verbal ability. Furthermore, these positive effects remained stable over time. We discuss the theoretical and practical implications of these findings.     

Being transformed: Delivering a psychotherapeutic group intervention targeting repeat suicide attempts

Clients who make repeat suicide attempts have complex needs, are at high risk of completed suicide and pose a range of challenges for clinicians. Targeted interventions are required. Acceptability, the perceived appropriateness of an intervention, is associated with successful implementation, engagement and effectiveness of interventions. Despite the advantages of group interventions, there is limited research into the acceptability of groups with this population. Using Interpretative Phenomenological Analysis, this paper reports on facilitators’ experiences (n = 9) of the acceptability of a therapeutic group intervention (PISA – a Psychoeducational/psychosocial Intervention for persons who make recurrent Suicide Attempts). Analysis of focus group data revealed how involvement with the intervention profoundly influenced facilitators’ perceptions of and approach to their work with this client group. They embraced the model, developed a deeper appreciation of clients’ resources and became unburdened from sole responsibility for the clients, the therapeutic process and outcomes. PISA provided a model that helped facilitators to work in a focused, compassionate and creative manner as they addressed the central concern of these clients, their suicidal desire, with newly found confidence and eagerness. PISA was experienced as acceptable to facilitators as it was useful to them and deemed appropriate and beneficial to the target population.     

Effects of differential reinforcement on the behavior and self-esteem of children with emotional and behavioral disorders

Students in a residential special school for children with emotional and behavioral disorders participated in a study designed to reduce their levels of inappropriate behavior. The residential care staff rated the students' behavioral problems and their class teachers rated their overt self-esteem pre and post intervention. In addition, the students completed self-ratings of their self-esteem. The students were divided into two groups, experimental and control. A multiple baseline across behaviors design was used to assess behavioral changes in the experimental group. Both groups received tangible rewards to the same level but only the experimental group received them contingent upon behaving appropriately. Results showed that the experimental group students made substantial reductions in their levels of inappropriate behavior, which were maintained at a three-month followup. Also, ratings of their behavioral problems by residential child care staff suggested that this improvement in behavior had generalized beyond the classroom to the residential setting. However, no significant differences were found between the pre- and post-intervention ratings of their self-esteem or teacher ratings of their overt self-esteem.     

The linear regression line as a judgmental aid in visual analysis of serially dependent A-B time-series data

The purpose of this study was to investigate the effects of different types and magnitudes of serial dependence (first-order moving average and autoregression) and of linear regression lines within experimental phases on the agreement between results of visual and results of statistical data analyses. The stimulus material consisted of computer-simulated A-B-design data graphs. The time series were generated with a constant variance, varying degrees of treatment effects (changes in level), five conditions of serial dependency, and with or without linear regression lines. The material was presented to three groups of student raters (n₁=52, n₂=14, n₃=17) who rated the treatment effect in the graphs on a five-point scale. These ratings were compared with statistical results (time-series analyses). Each group had to interpret 70 graphs, 35 of which had regression lines. Data were analyzed by means of two three-factor and one four-factor ANOVA and by graphic display. The linear regression lines generally enhanced the agreement between the raters' estimations and the statistical results. Serial dependency also increased the agreement between the two analysis methods. However, with strong autoregression processes in the data, the raters tended to overestimate treatment effects relative to time-series analysis.Parts of this study were presented at the World Congress on Behavior Therapy, Washington, DC, December 11, 1983. The authors wish to express their appreciation to Christoph Bonk and Willi Ecker for their extensive collaboration in data analysis and for their assistance in carrying out the study.     

A Videotape Module to Teach Assertion Skills1

A LifeSkills© video module to teach assertion has been developed that uses dramatizations of the effective and ineffective ways to respond to a provocation. Normal volunteers were randomly assigned to watch the assertion video (n= 50) or a control instructional video (n= 53). Participants completed pre‐/post‐assessment batteries that tested their knowledge of the steps of assertion and their ability to apply this knowledge in response to 3 written scenarios. The answers were scored for both the presence of aggression and the use of assertion. Participants randomized to the assertion video showed larger increases in assertion and decreases in aggression compared to controls, indicating that a video dramatizing the use of assertion can be a practical and effective means of improving assertion skills, with decreased aggression a potential added benefit.     

Student Ratings of a Male and Female Professors’ Lecture on Sex Discrimination in the Workforce

Using an experimental design, male (n = 41) and female (n = 46) undergraduate students in the southeastern USA evaluated an identical written lecture by a male and female professor on pay disparities between men and women in the workforce suggesting sex discrimination. Regardless of the students’ sex, the male professor and his lecture was rated more positively and less sexist than the female professor. Moderated multiple regression analysis indicated that more traditional and gender stereotypical attitudes toward women in male students were related to greater sexism ratings of the female professor compared to the male professor whereas; no differences on ratings of sexism between the male and female professor were found for male students with more liberal attitudes.     

How am I doing? Performance feedback mitigates the effects of mental fatigue on endurance exercise performance

Mental fatigue induced by an earlier cognitive task can impair performance on a subsequent physical task. The current study investigated whether such performance impairment could be mitigated by performance feedback. In an experimental sequential-task design, 63 sport science students completed a series of three tasks: 5-min physical (pre-test), 20-min cognitive, 5-min physical (post-test). Participants were randomly allocated to one of three groups: feedback (n = 23), no feedback (n = 20), control (n = 20). The physical tasks, which assessed force production during a self-paced rhythmic handgrip task as a measure of physical endurance performance, were performed with (feedback group) or without (no feedback group, control group) visual performance feedback. The cognitive tasks involved either completing a 2-back memory task to induce mental fatigue (feedback and no feedback groups) or watching a didactic film (control group). Self-report measures (fatigue, exertion, vigor, motivation) were collected throughout. The 2-back cognitive task increased mental fatigue, mental exertion and general fatigue in the feedback and no feedback groups compared to the control group. Relative to the pre-test physical task, post-test endurance performance declined in the no feedback group (−14.4%) but did not change in the control (−2.6%) and feedback (−2.4%) groups. This mitigation of performance effect was not accompanied by parallel changes in fatigue, exertion, vigor, or motivation. In conclusion, visual performance feedback mitigates the negative effects of mental fatigue on physical endurance performance.     

An Open Trial of an Acceptance-Based Behavioral Intervention for Weight Loss

Innovative approaches are urgently needed to improve behavioral treatment for weight loss. The weight regain that is so common after treatment may be a result of an environment that makes it challenging to adhere, long-term, to a dietary and physical activity regimen. This study was designed to test, via a 12-week open trial, the preliminary feasibility, acceptability, effectiveness, and possible mechanisms of action of a behavioral treatment that was modified to incorporate acceptance-based therapy components designed to (a) bolster participants’ commitment to behavior change, (b) build distress-tolerance skills, and (c) promote mindful awareness of eating behaviors and goals. Participants (n = 29) were overweight or obese women. Among completers (n = 19; 34% attrition), weight loss averaged 6.6% of body weight at posttreatment and 9.6% at 6-month follow-up (n = 14; 52% attrition). Intention-to-treat weight losses were 4.5% at posttreatment and 6.6% at 6-month follow-up. Psychological variables targeted by the intervention (e.g., cognitive restraint, disinhibition, urge-related eating behavior, emotional eating, eating-related experiential acceptance, mindfulness and motivation) changed in the expected directions, and many of these changes were consistent with decreases in weight loss. Moreover, despite the limitations of the single-group design, this pilot study demonstrated the preliminary feasibility, acceptability, and effectiveness of a novel, acceptance-based behavioral treatment for obesity. One potential implication is that behaviorally based weight loss interventions might be improved by overlaying an acceptance-based framework.     

Same clinic,different conceptions: Drug users’ and healthcare professionals’ perceptions of how stigma may affect clinical care

Stigma experienced by drug users by their healthcare professionals can be a barrier to treatment engagement, which in turn affects mortality and morbidity rates. Attribution theory suggests that stigma will be greatest whenever drug use is attributed to factors within personal control. Here, clients (n = 76) and healthcare professionals (n = 62) identified features that characterize good and bad clinical interactions, and responded to a vignette about a drug user who attributed his use to personal control or situational factors. Healthcare professionals completed the vignette and drug users gave their best guess of how healthcare professionals would react to this vignette. Clients and professionals held overlapping prototypes of clinical interactions. Clients overestimated both how negative healthcare professionals’ reactions would be, and the extent to which healthcare professionals’ reactions would accord with attribution theory. Despite healthcare professionals’ believing they are acting in nonstigmatizing ways, they may engender stigma in clinical situations more than they realize. Discrepancies between professionals’ hypothetical responses and clients’ anticipation of these responses are discussed in terms of the influence of self‐stigma and societal understandings of drug use and control. Attribution theory only offers a limited explanation for these discrepancies, because professionals’ beliefs about drug users are complex. Implications for theories of stigma and engagement with services are discussed, and the importance of clients’ anticipation of stigma is highlighted as a primary target for addressing treatment disengagement. Anti‐stigma campaigns may also benefit from changing their focus from individuals’ attributions to holistically addressing discrepant conceptions of treatment.