Development of a Brief Motivational Enhancement Intervention for Intimate Partner Violence in Alcohol Treatment Settings

The current studies were a manual development study and a small pilot study of a 90-minute motivational enhancement style intervention to address intimate partner violence in alcohol-treatment-seeking men. Analyses of feedback provided during manual development suggest participants (a) liked the intervention, (b) reported behavior change intentions, and (c) found the feedback compelling. Findings from the pilot study suggest the intervention might be superior to referral only in increasing short-term help-seeking and lead to marginally significant enhancements in motivation and self-reported intimacy. Help-seeking and motivation findings were associated with medium-large to large effect sizes. At 3- and 6-month follow-up, both groups showed improvements in self-reported alcohol outcomes, anger, and verbal and physical aggression. These findings support further research on this intervention.     

Development of a telephone-based intervention for support persons to help smokers quit

This study represents the first step toward systematic behavioral treatment development and pilot testing of a novel approach to smoking cessation that utilizes adults interested in helping someone to stop smoking (i.e., support persons) as the agent of change. The counselor manual for a telephone-based intervention for support persons was developed based on a previous clinic-based intervention. Social cognitive theory served as the conceptual basis for the intervention. Ten adult non-smoking females completed the treatment protocol, consisting of six 20 - 30-min sessions and written materials. The support person was the sole recipient of the professional intervention. Feedback was obtained from 8 of the 10 participants and all 4 telephone counselors 1 week post-treatment (week 10). Results indicate that the telephone-based intervention was feasible and acceptable to participants. The intervention was refined based on participant and counselor feedback and will be subsequently tested in a randomized pilot trial.     

Telling perfectionists about their perfectionism: Effects of providing feedback on emotional reactivity and psychological symptoms

A randomized, controlled clinical trial was conducted to determine the efficacy of receiving feedback in a sample of maladaptive perfectionists. A total of 60 young adults were randomly assigned to a feedback intervention or control group. Hierarchical Linear Modeling was utilized to analyze the effects of perfectionism over time, as well as the effects of treatment condition on the relationship between perfectionism and outcomes. Measures of interest included emotional reactivity, self-esteem, and psychological distress. Findings revealed that providing feedback to maladaptive perfectionists reduced self-reported global symptomatic distress as well as emotional reactivity. The results are discussed in light of treatment implications, especially with regard to the manner in which perfectionists respond to therapeutic interventions. Overall, study findings suggest that a brief, low-cost feedback intervention is effective at decreasing psychological distress in maladaptive perfectionists and may serve as a beneficial precursor to individual therapy or counseling.     

Patient-Informed Treatment Development of Behavioral Smoking Cessation for People With Schizophrenia

The objective of this study was to use qualitative methodology to tailor and refine an existing smoking cessation intervention for the population of people who use cigarettes and are diagnosed with schizophrenia, schizoaffective, or psychotic disorder. Successive cohort design methodology was used to iteratively modify the treatment in response to qualitative participant, therapist, and consultant feedback on the intervention. Qualitative methodology for participant feedback included analysis of semistructured interviews with participants, visualization of app utilization data, and stakeholder feedback from study therapists and consultants. Using the successive cohort design, a tailored multicomponent mobile health smoking cessation intervention was developed. The intervention included mobile contingency management (i.e., financial compensation for confirmed abstinence from smoking), pharmacotherapy for smoking cessation, cognitive-behavioral counseling sessions, and the Stay Quit app for relapse prevention. Two cohorts (N = 13) were completed in the study; after each cohort, the treatment protocol was revised. The intervention is described, as well as the qualitative findings from each cohort and subsequent changes made to the intervention based upon patient and provider feedback. Metrics of patient engagement included treatment adherence (40% in Cohort 1 and 63% in Cohort 2). Both participants and therapists reported that the intervention was helpful. Over one third of participants self-reported abstinence at posttreatment. Since qualitative methodology is often underutilized in mental health treatment development, this study demonstrates the utility of the successive cohort design for treatment development of behavior change interventions for at-risk, vulnerable populations.     

Social anxiety and vulnerability for problematic drinking in college students: the moderating role of post-event processing

Socially anxious college students are at increased risk for engaging in problematic drinking (i.e. heavy or risky drinking) behaviors that are associated with the development of an alcohol use disorder. The present study examined whether post-event processing (PEP), repeatedly thinking about and evaluating one’s performance in a past social situation, strengthens the association between social anxiety and vulnerability to problematic drinking among college students. Eighty-three college drinkers with high or low social anxiety participated in a social interaction task and were exposed to a manipulation that either promoted or inhibited PEP about the social interaction. Among participants randomized to the PEP promotion condition, those with high social anxiety exhibited a greater urge to use alcohol after the social interaction and greater motivation to drink to cope with depressive symptoms over the week following the manipulation than did those with low social anxiety. These findings suggest that targeting PEP in college drinking intervention programs may improve the efficacy of such programs for socially anxious students.     

Effectiveness of a brief intervention using mental simulations in reducing alcohol consumption in corporate employees

A theory-based intervention aimed at reducing corporate employees' alcohol consumption in excess of guideline limits is presented. The intervention adopted an outcome mental simulation technique and was administered to a sample of corporate employees from three companies. A single-arm randomized-controlled design was adopted. All participants completed baseline psychological measures and self-reported number of alcohol units consumed and binge-drinking occasions. Participants allocated to the intervention condition were presented with a mental simulation exercise. One month later, participants completed follow-up measures of the psychological variables and alcohol consumption. Results revealed a significant effect of the mental simulation intervention on number of units of alcohol consumed at follow-up. There was no effect of the intervention on frequency of binge-drinking occasions. There was no evidence for the mediation of the effect of mental simulations on alcohol consumption by the perceived behavioural control and motivation variables. Results support the efficacy of the mental simulation intervention in reducing alcohol consumption but not in reducing binge drinking or alcohol consumption in excess of guideline limits, among corporate employees. Results are discussed with respect to the importance of the mental simulation intervention to inform practice and the proposed processes by which mental simulations affect alcohol consumption.     

Pilot test of Project CHOICE: a voluntary afterschool intervention for middle school youth.

The current study reports findings from a pilot evaluation of a voluntary alcohol and marijuana intervention for young teens. Students at 2 middle schools completed 4 surveys over 2 years. During Year 2, an intervention, Project CHOICE (PC), was implemented at 1 school and was voluntarily attended by 13% of adolescents. Participants ranged from 10 to 15 years of age and were approximately 45% male, 45% White, 30% Latino, and 15% of mixed ethnic origin. Outcomes included assessments of self use and perceptions of friends' and schoolmates' past-month use of alcohol and marijuana. Analyses that compared PC participants (n=64) with a matched control sample of students (n=264) revealed that PC participants reported lower rates of alcohol use and lower perceptions of friends' marijuana use and of schoolmates' use of these substances. Random-effects growth models indicated that self use and perceptions of friends' use of alcohol and marijuana increased more sharply among control school students (n=178) relative to students from the PC school (n=270), regardless of participation. Results suggest that a brief voluntary intervention attended by a small proportion of students can impact both individual and schoolwide substance-related outcomes.     

Exercise motivation in university community members: a behavioural intervention

The purpose of this study was to examine how exercise level, exercise motives, and barriers changed from the baseline phase to the follow-up phase after a behavioural and cognitive intervention aimed at increasing exercise. Seventy-five members of our university community (43 subjects in the control group and 32 in the experimental group), all of whom received cognitive feedback, agreed to complete the baseline phase. Only the experimental group received behavioural feedback and a free-access gym ticket with personal training in order to facilitate their adherence to exercise. The results suggest that a combination of behavioural and psychological techniques is an efficient strategy for increasing exercise level. In addition, the results showed that extrinsic motivation predominates the early stages of change-of-exercise behaviour, and that intrinsic motivation is important for progression towards maintenance. Subjects who decreased their exercise level increased their extrinsic exercise motivation and subjects who increased their exercise level decreased the barriers related to intrinsic motivation. These findings indicate that, in order to facilitate exercise adherence, feedback about motives for undertaking exercise is needed, combined with advice about how to improve physical condition. This combination could help eliminate certain barriers that hinder engaging in an active and healthy life-style.     

Investigating the effects of a virtual reality-based stress management programme on inpatients with mental disorders: A pilot randomised controlled trial

This study aimed to examine the effects and feasibility of a virtual screen-based stress management programme (V-DESSERTS) on inpatients with mental disorders. A single-blinded, pilot randomised controlled trial was conducted in a tertiary hospital in Singapore. Convenience sampling was used and participants were randomised into either the intervention group or the waitlisted control group (WL). The intervention group received individual-based, twice-daily sessions of the programme. Each session comprised education and virtual screen-based relaxation practice. Data were collected through self-reported questionnaires and physiological measures. The intervention group showed a significant increase in perceived relaxation and knowledge in comparison with the WL group. However, inconclusive results were observed on subjective and objective stress. The findings in this study indicated that the V-DESSERTS programme is feasible to be implemented for patients with schizophrenia, depression and bipolar disorders.     

Feedback format: Does it influence manager's reactions to feedback?

This study investigated the influence of feedback format (text versus numeric/normative) on leaders' reactions to 360 degree feedback received from bosses, direct reports, and peers. Leaders who received numeric/normative feedback reacted more favourably than those who received text feedback regardless of the source. The reactions recipients experienced following feedback were relevant to changes in their number of development needs compared pre‐ and post feedback. Those who reacted negatively had a larger number of development needs reported post feedback while those who had positive reactions showed fewer development needs post feedback. These findings suggest that, contrary to predictions of feedback intervention theory (FIT), feedback that provided scores and comparative information was reacted to more positively than text feedback that provided only self‐relevant data. In addition, negative reactions to feedback were detrimental to future changes.     

Mechanisms in Self-Determined Exercise Motivation: Effects of a Theory Informed Pilot Intervention

The purpose was to examine the effects of an exercise pilot intervention informed by Self-determination theory. The 64 participants were randomized into experimental and control group. The main questions were whether the intervention would influence (a) exercise level, (b) motivation quality, and (c) autonomy and competence need satisfaction. We also examined the indirect effects of self-determined motivation on exercise. Significant intervention effects were found regarding exercise level and motivation quality. Also, intervention effect on exercise was found to be mediated by motivation quality and identified regulation. The results provide interesting information about the underlying mechanisms involved in exercise behaviour change.     

Self‐Construals,Motivation, and Feedback‐Seeking Behaviors

The current study explores the relations between individualism, motivation, and feedback‐seeking behaviors. Specifically, we examined how three motivational factors (i.e., status‐striving, achievement‐striving, and affiliation‐striving) mediated or moderated the relations between individualism and feedback‐seeking behaviors. Data were collected from 154 Singaporean undergraduate students across two time periods. Results indicated that only status motivation mediates the individualism–feedback‐seeking relation. Affiliation was found to moderate that same relation but only for a specific subset of feedback‐seeking behaviors. The implications of these findings for performance management and development are discussed.     

Preventing Substance Abuse Among American-Indian Adolescents: A Bicultural Competence Skills Approach

Tobacco, alcohol, and drug use are problems for American-Indian people. We reviewed these problems and the explanations for them and described a bicultural competence skills approach for preventing substance abuse with American-Indian adolescents. Data from a study of that approach suggest its efficacy with American-Indian youth. At posttest and a 6-month follow-up, American-Indian subjects who received preventive intervention based on bicultural competence skills concepts improved more than did American-Indian subjects in a no-intervention control condition on measures of substance-use knowledge, attitudes, and interactive skills, and on self-reported rates of tobacco, alcohol, and drug use. Our findings have implications for future substance-abuse prevention research with American-Indian people.     

21st birthday celebratory drinking: evaluation of a personalized normative feedback card intervention.

This research was designed to evaluate a personalized normative feedback birthday card intervention aimed at reducing normative perceptions, alcohol consumption, and negative consequences associated with 21st birthday celebrations among college students (N=281; 59.15% women). Students were randomly assigned to receive or not receive a birthday card about 1 week prior to their 21st birthday. Approximately 1 week following their birthday, students were asked to complete a brief survey concerning their birthday celebration activities. Findings indicated that the birthday card intervention was not successful at reducing drinking or consequences; however, the card did reduce normative misperceptions. Additional findings indicated that many students experienced negative consequences, such as passing out or driving after consuming alcohol. Combined, these findings suggest that prevention is needed for drinking associated with turning 21. However, prevention efforts should consist of more than a birthday card.     

Family connectedness and women's sexual risk behaviors: implications for the prevention/intervention of STD/HIV infection

The present study explores the relationship between connectedness with the intergenerational family and women's sexual risk-taking as a guide to the development of family-focused prevention and intervention. Cross-sectional interview data from a pilot study were analyzed for correlations between a number of self-reported, risky sexual practices, the range of extended family members with whom the respondent was in contact, and awareness of stories pertaining to intergenerational family history. Structured interviews were administered by female interviewers to 56 women from two contexts: a STD (sexually transmitted disease) Clinic (N = 26), and an inner-city, Hispanic Community Organization (N = 30). Knowledge of stories about grandparents or great-grandparents was a robust predictor of lower sexual risk-taking in the STD Clinic sample. This relationship persisted, but only at the trend level in the Community Organization sample. In both the total sample and the STD subsample, the number of categories of extended family members with whom a respondent was in at least monthly contact was correlated with less sexual risk-taking. Given the fundamental importance of the family system as the primary social unit, these findings argue for further family theory-based research and for its potential application in the development of health prevention and intervention. Implications for practice and future research are discussed.     

Pilot Study of a Personalized Feedback Intervention for Problem Gamblers

A pilot study was conducted of a personalized feedback intervention for problem gamblers. Respondents (N = 61) were recruited from an ongoing gambling research study to take part in another study to help us “develop and evaluate self-help materials for gamblers.” Respondents were randomly assigned to receive a personalized feedback summary or to a waiting list control. At 3-month follow-up (80.3% follow-up rate, N = 49), after controlling for baseline demographic characteristics and gambling severity, respondents in the feedback condition displayed some evidence that they were spending less money on gambling than those in the control condition. Further, ratings of the usefulness of the feedback summary were positive and most recipients (96%) recommended that they be made available to other gamblers interested in evaluating or modifying their gambling. Given these promising pilot results, a full-scale evaluation of these personalized feedback materials would appear justified. An online version of the intervention is now also available at www.CheckYourGambling.net.     

Alcohol-Induced Amnesia and Personalized Drinking Feedback: Blackouts Predict Intervention Response

Alcohol-induced amnesia (“blackout”) is a reliable predictor of alcohol-related harm. Given its association with other negative consequences, experience of alcohol-induced amnesia may serve as a teachable moment, after which individuals are more likely to respond to intervention. To test this hypothesis, alcohol-induced amnesia was evaluated as a moderator of brief intervention effect on (a) alcohol-related consequences and (b) the proposed intervention mediators, protective behavioral strategies and peak blood alcohol concentration (BAC). Baseline alcohol risk measured using the Alcohol Use Disorders Identification Test (AUDIT) was also evaluated as a moderator to rule out the possibility that amnesia is simply an indicator of more general alcohol risk. College students (N = 198) reporting alcohol use in a typical week completed assessments at baseline and 1-month follow-up as part of a larger intervention trial. Participants were randomized to assessment only (AO; n = 58) or personalized feedback intervention (PFI; n = 140). Hierarchical regression was used to examine direct and indirect intervention effects. A significant group-by-amnesia interaction revealed that only PFI participants who had experienced alcohol-induced amnesia in the past month reported decreases in alcohol consequences at 1-month follow-up. The PFI reduced alcohol-related consequences indirectly through changes in peak BAC, but only among those who had experienced amnesia at baseline. In contrast, baseline alcohol risk (AUDIT) did not moderate intervention effects, and use of protective behavioral strategies did not statistically mediate intervention effects. Findings suggest that loss of memory for drinking events is a unique determinant of young adult response to brief alcohol intervention. Normative feedback interventions may be particularly effective for individuals who have experienced alcohol-induced amnesia in the past 30 days.     

Cultural Differences in the Motivation to Seek Performance Feedback: A Comparative Policy-Capturing Study

We examined differences in the motivation to directly seek performance feedback between Canadian (n?=?72) and Chinese (n?=?64) participants using a policy-capturing methodology. Results generally support the premise that the motivation to seek performance feedback varies as a function of national culture. Compared to Canadians, image-defense motivation was more predictive of (a) the importance placed on feedback source, and (b) whether feedback is sought in public, for feedback-seeking decisions among Chinese participants. Ego-defense motivation was more predictive of the importance placed on feedback valence for feedback-seeking decisions among Canadian participants than among those from China. We discuss the implications of the study findings and consider future research directions.     

The assumed effects of positive feedback paired with success on motivation to do a task: The cases of characters with high and low initial levels of interest

This study investigated the effects of positive feedback paired with success on motivation to do a task, and examined whether this differed according to whether the person performing the task had a high or low initial level of interest in that task. Subjects (448 junior college students) were asked to rate (from 0–10) the level of motivation of characters in four different stories. Subjects believed that positive feedback would encourage the character to do a task regardless of initial level of interest. However, when positive feedback could not be expected, ratings for motivation fell. Ratings for motivation were further analyzed when no positive feedback could be expected, either after an earlier experience of positive feedback paired with success or after success only (no feedback). In the case of a low initial level of interest, it was assumed that motivation would be increased after positive feedback, but in the case of a high initial level of interest motivation was assumed to be decreased by an earlier experience of positive feedback paired with success. These results suggest that the effect of positive feedback paired with success will differ according to the level of a person's initial interest.     

Feasibility of Pairing Behavioral Activation With Exercise for Women With Type 2 Diabetes and Depression: The Get It Study Pilot Randomized Controlled Trial

Major depressive disorder is often comorbid with diabetes and associated with worse glycemic control. Exercise improves glycemic control and depression, and thus could be a parsimonious intervention for patients with comorbid diabetes and major depression. Because patients with diabetes and comorbid depression are often sedentary and lack motivation to exercise, we developed a group exercise intervention that integrates strategies from behavioral activation therapy for depression to increase motivation for and enjoyment of exercise. We conducted a 6-month pilot randomized controlled trial to test the feasibility of the behavioral activation exercise intervention (EX) for women with diabetes and depression. Of the 715 individuals who contacted us about the study, 29 participants were randomized to the EX condition or an enhanced usual care condition (EUC), which represents 4.1% of participants who initially contacted us. Inclusion criteria made recruitment challenging and limits the feasibility of recruiting women with diabetes and depression for a larger trial of the intervention. Retention was 96.5% and 86.2% at 3 and 6 months. Participants reported high treatment acceptability; use of behavioral activation strategies and exercise class attendance was acceptable. No condition differences were observed for glycemic control, depressive symptoms, and physical activity, though depressive symptoms and self-reported physical activity improved over time. Compared to participants in the EUC condition, participants in the EX condition reported greater exercise enjoyment and no increase in avoidance behavior over time. Using behavioral activation strategies to increase exercise is feasible in a group exercise setting. However, whether these strategies can be delivered in a less intensive manner to a broader population of sedentary adults, for greater initiation and maintenance of physical activity, deserves further study.