Early interventions following psychological trauma

What is the best way to provide early interventions for psychiatric disorders after trauma? The terrorist attacks of September 11, 2001, have raised urgent concerns about the evidence for early treatments after trauma that can prevent psychiatric disorders. This review outlines the expected course of posttraumatic stress reactions and discusses the current means of identifying people who are at risk of developing disorders. A critique of psychological debriefing and an analysis of evidence for cognitive-behavioral therapy as an early intervention is provided. The major challenges for early intervention are discussed, including increasing treatment effectiveness, delivering therapy when it is required by thousands of people, and developing early interventions for a wide array of psychiatric disorders in addition to posttraumatic stress disorder that can develop following trauma.     

Disruptive innovations for designing and diffusing evidence-based interventions

Evidence-based therapeutic and preventive intervention programs (EBIs) have been growing exponentially. Yet EBIs have not been broadly adopted in the United States. In order for our EBI science to significantly reduce disease burden, we need to critically reexamine our scientific conventions and norms. Innovation may be spurred by reexamining the traditional biomedical model for validating, implementing, and diffusing EBI products and science. The model of disruptive innovations suggests that we reengineer EBIs on the basis of their most robust features in order to serve more people in less time and at lower cost. A disruptive innovation provides a simpler and less expensive alternative that meets the essential needs for the majority of consumers and is more accessible, scalable, replicable, and sustainable. Examples of disruptive innovations from other fields include minute clinics embedded in retail chain drug stores, $2 generic eyeglasses, automated teller machines, and telemedicine. Four new research approaches will be required to support disruptive innovations in EBI science: synthesize common elements across EBIs; experiment with new delivery formats (e.g., consumer controlled, self-directed, brief, paraprofessional, coaching, and technology and media strategies); adopt market strategies to promote and diffuse EBI science, knowledge, and products; and adopt continuous quality improvement as a research paradigm for systematically improving EBIs, based on ongoing monitoring data and feedback. EBI science can have more impact if it can better leverage what we know from existing EBIs in order to inspire, engage, inform, and support families and children to adopt and sustain healthy daily routines and lifestyles. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Commentary on evidence-based psychological treatments for older adults

This article comments on the articles in the Special Section on Evidence-Based Psychological Treatments for Older Adults. The articles apply criteria developed by the Society of Clinical Psychology to evaluate treatments for late-life anxiety, insomnia, behavior disturbances in dementia, and caregiver distress. The articles document that there are evidence-based psychological treatments that can help older adults. However, there are 2 substantial hurdles: evidence and access. Gaps in the evidence, as mentioned by the authors of the articles in the special section, result from disproportionate research attention to some psychotherapies and some mental disorders, with corresponding lack of research about other treatments and disorders. The challenge for access is to ensure that older adults with treatable mental disorders will get connected to psychologists trained in these evidence-based therapies.     

Developing evidence-based guidance – implications for systemic interventions

This article provides a brief review of the history and current approaches to the development of clinical guidelines, particularly as applied to systemic and more generally psychological therapies. Some commonly identified problems associated with guideline development in mental health are reviewed and their implications for guideline development considered. The challenges this work presents for systemic therapies are considered, along with likely future development in clinical guidelines.     

Reducing AIDS-related stigma in developing countries: the importance of theory- and evidence-based interventions

In many developing countries persons living with HIV and AIDS experience strong stigma and discrimination, and AIDS-related stigma has an enormous negative impact on their social relationships, access to resources, and psychological well being. Moreover, AIDS-related stigma hampers HIV-related health promotion, including voluntary HIV counselling and testing. In this article, we will argue that programs to reduce AIDS-related stigma are most likely to be effective if these programs are based upon thorough needs assessments, theory- and evidence-based intervention strategies and collaborative planning. A protocol for health promotion programs design is outlined. Furthermore, psychosocial correlates of AIDS-related stigma in developing countries, social-psychological theories that might be useful in designing intervention strategies to reduce stigmatisation and successful elements of previous interventions aimed at stigma reduction are discussed. It is concluded that psychological theory does provide guidelines for the development of stigma-reducing intervention programs, but that such programs can only be effective when based upon context-specific needs assessment and collaborative planning.     

Causal discovery and the problem of psychological interventions

Finding causes is a central goal in psychological research. In this paper, I argue based on the interventionist approach to causal discovery that the search for psychological causes faces great obstacles. Psychological interventions are likely to be fat-handed: they change several variables simultaneously, and it is not known to what extent such interventions give leverage for causal inference. Moreover, due to problems of measurement, the degree to which an intervention was fat-handed, or more generally, what the intervention in fact did, is difficult to reliably estimate. A further complication is that the causal findings in psychology are typically made at the population level, and such findings do not allow inferences to individual-level causal relationships. I also discuss the implications of these problems for research, as well as various ways of addressing them, such as focusing more on the discovery of robust but non-causal patterns.     

Sensory marketing,embodiment, and grounded cognition: A review and introduction

There has been a recent swell of interest in marketing as well as psychology pertaining to the role of sensory experiences in judgment and decision making. Within marketing, the field of sensory marketing has developed which explores the role of the senses in consumer behavior. In psychology, the dominant computer metaphor of information processing has been challenged by researchers demonstrating various manners in which mental activity is grounded in sensory experience. These findings are arduous to explain using the amodal model of the human mind. In this introduction, we first delineate key assumptions of the information processing paradigm and then discuss some of the key conceptual challenges posed by the research generally appearing under the titles of embodiment, grounded cognition, or sensory marketing. We then address the use of bodily feelings as a source of information; next, we turn to the role of context sensitive perception, imagery, and simulation in consumer behavior, and finally discuss the role of metaphors. Through this discourse, we note the contributions to the present special issue as applicable.     

Effects of psychological interventions on competitive anxiety in sport: A meta-analysis

ObjectivesThis study reviewed the effects of psychological interventions on competitive anxiety in sport.DesignMeta-analysis and systematic review.MethodPsycINFO, PsycARTICLES, SPORTDiscus, Web of Science, ProQuest, and Sage databases were searched for experimental studies that fulfilled the inclusion criteria. Risk of bias was assessed using the 12 criteria Cochrane Review Book Group tool. Hedge's g and 95% confidence intervals (CIs) were calculated and pooled using a random effects model employing the Hartung-Knapp-Sidik-Jonkman (HKSJ) method.ResultsThe search strategy identified 37 studies which fulfilled the inclusion criteria. The meta-analysis was conducted on 34 studies after removal of outliers. The results showed an overall small to medium-sized effect for psychological interventions on competitive anxiety in athletes (g = −0.42; 95% CI, −0.58 to −0.25). Subsequent subgroup analyses showed that this finding was robust regardless of experimental design, anxiety measure, anxiety type, gender, country, sport, intervention component, intervention delivery method, and intervention duration. The results indicated that the effects might be greater for athletes of higher levels of competition as compared to those from lower levels of competition. Separate meta-analyses also suggested that there were medium to large-sized effects for cognitive anxiety (g = −0.54) and self-confidence (g = 0.55) intensity, and a small to medium-sized effect for somatic anxiety (g = −0.36) intensity.ConclusionThe findings from this review study provide a robust evidence base for the use of psychological interventions to help reduce competitive anxiety in athletes. Future studies need to investigate how psychological interventions might affect the directional interpretation of anxiety symptoms.     

Procedures for identifying evidence-based psychological treatments for older adults

The authors describe the methods used to identify evidence-based psychological treatments for older adults in this contribution to the special section. Coding teams were assembled to review the literature on several problems relevant to mental health and aging. These teams used the manual developed by the Committee on Science and Practice of the Society for Clinical Psychology (Division 12) of the American Psychological Association that provided definitions of key constructs used in coding. The authors provide an overview of the process followed by the review teams and of some of the issues that emerged to illustrate the steps involved in the coding procedure. Identifying evidence-based treatments is a fundamental aspect of promoting evidence-based practice with older adults; such practice is advocated by most health care disciplines, including psychology.     

群体内疚:界定、心理机制、行动倾向及干预策略

当个体认为内群体为外群体受到的不道德伤害负有责任时会体验到群体内疚。该情绪常见的触发情境包括过往历史的伤害事件、当下的群际冲突、不公正的社会关系及未来的伤害事件。群体认同、内群体责任和不当性评估是影响群体内疚产生的三大心理机制。群体内疚会导致施害群体对受害群体表现出积极行动,如友善态度,冲突和解、群体补偿及群际支持。通过群体肯定、自我肯定、促进共同认同、强调内群体责任及展现已有补偿行为等干预策略可以引发施害群体的群体内疚。未来的研究应澄清群体内疚的成因机制,进一步探索群体内疚与补偿行为间的作用关系。     

Promoting child and family wellness: priorities for psychological and social interventions

In order to foster the well‐being of children and families we propose a shift in the priorities of psychological and social interventions. Following a brief discussion of the concept of wellness, we present a framework for interventions to promote child and family wellness. Psychological and social intervention strategies to promote child and family wellness are then reviewed and interpreted in terms of the framework. Recommendations for changing priorities for programmes and policies are based on the framework and a review of the effectiveness of existing interventions. Copyright © 2000 John Wiley & Sons, Ltd.     

心理干预的优先获益者——来自发展可塑性的研究证据

近些年, 发展可塑性领域出现两个新模型--差别易感性模型和优势敏感性模型, 两个模型均表明个体从积极环境中的获益具有差异性。而心理干预作为一种特殊的积极环境被引入到该领域的研究中。已有的研究已经发现一些证据表明, 具备某些特征的当事人从心理干预中获益更多。这些特征包括人格和气质类、遗传类和生理类。本质上, 这些研究在处理“什么对谁最有效”的问题, 但现有研究仅能部分回答这个问题。因此, 心理干预的效果差异有多少可归于这些易感特征, 是有待继续回答的问题。     

Methodology for identifying specific psychological deficits: introduction to the special section

A long-standing problem in psychopathology research is establishing that patterns of differences between groups reflects differences of underlying constructs and not artifacts of research design, measurement, or analysis. This introduction provides a context for 4 articles that consider several controversial issues regarding this problem and presents a précis. Although these articles focus on schizophrenia, it is noted how the issues are of more general relevance to psychopathology researchers.     

Meta-analysis of psychological interventions for chronic low back pain.

The purpose of this meta-analysis of randomized controlled trials was to evaluate the efficacy of psychological interventions for adults with noncancerous chronic low back pain (CLBP). The authors updated and expanded upon prior meta-analyses by using broad definitions of CLBP and psychological intervention, a broad data search strategy, and state-of-the-art data analysis techniques. All relevant controlled clinical trials meeting the inclusion criteria were identified primarily through a computer-aided literature search. Two independent reviewers screened abstracts and articles for inclusion criteria and extracted relevant data. Cohen's d effect sizes were calculated by using a random effects model. Outcomes included pain intensity, emotional functioning, physical functioning (pain interference or pain-specific disability, health-related quality of life), participant ratings of global improvement, health care utilization, health care provider visits, pain medications, and employment/disability compensation status. A total of 205 effect sizes from 22 studies were pooled in 34 analyses. Positive effects of psychological interventions, contrasted with various control groups, were noted for pain intensity, pain-related interference, health-related quality of life, and depression. Cognitive-behavioral and self-regulatory treatments were specifically found to be efficacious. Multidisciplinary approaches that included a psychological component, when compared with active control conditions, were also noted to have positive short-term effects on pain interference and positive long-term effects on return to work. The results demonstrated positive effects of psychological interventions for CLBP. The rigor of the methods used, as well as the results that reflect mild to moderate heterogeneity and minimal publication bias, suggest confidence in the conclusions of this review.     

Effects of psychological interventions for patients with osteoarthritis: a systematic review and meta-analysis

The aim of this study was to determine the effects of psychological interventions (e.g. cognitive restructuring, relaxation) on physiological and psychological health in osteoarthritis patients. A systematic literature search was done using PubMed, Embase, PsycINFO, Web of Science, China National Knowledge Infrastructure, and Wanfang Database through November 2016. Studies were included if they used a randomized controlled trial designed to explore the effects of psychological interventions in osteoarthritis patients. Two independent authors assessed the methodological quality of the trials using criteria outlined by Jadad et al. Meta-analysis was done with the Revman5.0. Twelve randomized controlled trials, including 1307 osteoarthritis patients, met the study inclusion criteria. Meta-analysis showed that psychological interventions could reduce the levels of pain [standard mean difference (SMD) ?0.28, 95% CI ?0.48, ?0.08, P-value 0.005)] and fatigue (SMD ?0.18, 95% CI ?0.34, ?0.01, P-value 0.04). In addition, psychological interventions significantly improved osteoarthritis patients’ self-efficacy (SMD 0.58, 95% CI 0.40, 0.75, P-value 0.00) and pain coping (MD 1.64, 95% CI 0.03, 3.25, P-value 0.05). Although the effects on physical function, anxiety, depression, psychological disability were in the expected direction, they were not statistically significant. In conclusion, the role of psychological interventions in the management of osteoarthritis remains equivocal. Some encouraging results were seen with regard to pain, pain coping, self-efficacy, and fatigue. We believe that more methodologically rigorous large-scale randomized controlled trials are necessary to answer this study question.     

Childhood trauma and psychosis: Review of the evidence and directions for psychological interventions

There is controversy over whether childhood trauma (CT) is a causal risk factor for psychosis. The aim of this study was to provide psychologists with a brief overview of the research into relationship between childhood trauma and psychosis and directions for psychological interventions. It details six of the highest quality studies in the area and tentatively concludes from these that there is evidence for a relationship between CT and psychosis. Hallucinations and delusions have been implicated as important factors in the relationship between CT and psychotic disorder and these are discussed, along with post‐traumatic intrusions and schemas, which have been conceptualised as part of the psychological mechanisms whereby CT confers a risk for psychosis. The development of psychological interventions for people with psychosis who have experienced CT is in its infancy but has been based on evidence‐based cognitive behavioural interventions in psychosis and post‐traumatic stress disorder. A formulation‐based approach is described in this paper, along with a case study.