The Communication and Bioethical Training (CoBiT) Program for assisting dialysis decision-making in Spanish ACKD units

Healthcare professionals currently working in Advanced Chronic Kidney Disease (ACKD) units must cope with difficult situations regarding assisting patients with the dialysis decision-making process, and they are often untrained for these conversations. Although we have evidence from the literature that these skills can be learned, few professionals feel confident in this area. A Communication and Bioethical Training (CoBiT) Program for ACKD staff (physicians, nurses and allied health professionals) was developed to improve their ability and self-confidence in conducting these conversations. A four-stage study was conducted: (1) development of the CoBiT program, beginning with the creation of an interdisciplinary focus group (N = 10); (2) design of a questionnaire to assess self-confidence based on the areas identified by the focus group. The face validity of the instrument was tested using an inter-judge methodology (N = 6); (3) design of the format and contents of the program; (4) piloting the program. Thirty-six health professionals took an 8-h workshop based on role-playing methodology. Participants assessed their self-confidence in their communication skills before and after the program using self-report measures. The results show that after the program, participants reported significantly higher levels of self-confidence measured with a five-point Likert scale (p < 0.001). Participants felt that communication with colleagues of other professions significantly increased after the workshop (p = 0.004). The CoBiT program improves ACKD Unit healthcare professionals’ self-confidence in their ability to perform a specific communication task.     

The efficacy of a pilot pediatric cognitive remediation summer program to prepare for transition of care

This study assessed the efficacy of a time-sensitive cognitive remediation summer program (CRSP) that provided patients and their families with tools to help mitigate neurocognitive deficits and promote independence to foster precursor transition of medical care skills. A total of 38 participants (aged 9–15) were included in one of the CRSPs offered yearly from 2013 to 2016. A longitudinal design was employed and at each evaluation time point, one week before start of the CRSP (pre-testing) and within three weeks after the end of the program (post-testing)), participants were administered measures of executive functioning in addition to parent ratings of behavior, executive functioning, and adaptive skills (Year 1–Year 4). In Year 4, additional measures were collected, including parenting style and parent engagement and involvement in the program. Results from Year 1 to Year 4 (n = 35) demonstrated that participants in the CRSP showed significant improvement on neuropsychological testing in sustained and selective attention, planning, and cognitive flexibility. Robust changes in parent ratings of adaptive functioning from pre- to post-treatment were also found. Specific to Year 4 (n = 13), results revealed that participants showed improvement in levels of independence with at least one of the individualized goals focused on during the program. This study provided a systematic method to gauge the levels of instruction necessary to reach goals, a crucial tool in skill-teaching. Overall, our study provides evidence for the efficacy of the CRSP and validates a feasible intervention that can be integrated into standard of care for pediatric medical populations.     

Reducing Academic Procrastination Through a Group Treatment Program: A Pilot Study

The present study assessed a short-term group treatment program using cognitive interventions focused on students’ procrastination. A structured 90-min session program was used with 10 students (5 female, 5 male; M _age = 21.8, SD = 3.2) across 5 weeks. In the first and last session of the program participants completed a two reliable and valid procrastination scales, and then 8 weeks later in the follow up sessions filled out the same questionnaires. During the group sessions, participants identified their irrational thoughts as well as cognitive distortions associated with their procrastination tendencies. Results of a non-parametric Friedman Test revealed a significant decrease in participants’ academic procrastination score and general procrastination scores from the pre-test to follow-up test suggesting that the program was deemed to be successful.     

An examination of the roles of trauma exposure and posttraumatic stress disorder on emotion regulation strategies of Operation Iraqi Freedom,Operation Enduring Freedom,and Operation New Dawn veterans

Theories of posttraumatic stress disorder (PTSD) implicate emotional processes, including difficulties utilizing adaptive emotion regulation strategies, as critical to the etiology and maintenance of PTSD. Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn (OIF/OEF/OND) veterans report high levels of combat exposure and PTSD. We aimed to extend findings suggesting that emotion regulation difficulties are a function of PTSD, rather than combat trauma exposure or common comorbidities, to OIF/OEF/OND veterans, in order to inform models of PTSD risk and recovery that can be applied to returning veterans. We tested differences in emotion regulation, measured with the Difficulties in Emotion Regulation Scale and Emotion Regulation Questionnaire, among trauma-exposed veterans with (n = 24) or without PTSD (n = 22) and healthy civilian comparison participants (n = 27) using multivariate analyses of covariance, adjusting for major depressive disorder, anxiety disorders, and demographic variables (age, sex, and ethnicity). Veterans with PTSD reported more use of expressive suppression and more difficulties with emotion regulation than veterans without PTSD and healthy comparison participants. Groups did not differ on cognitive reappraisal. Findings suggest the key role of PTSD above and beyond trauma exposure, depression, and anxiety in specific aspects of emotion dysregulation among OIF/OEF/OND veterans. Interventions that help veterans expand and diversify their emotion regulation skills may serve as helpful adjunctive treatments for PTSD among OIF/OEF/OND veterans.     

Examining explanatory mechanisms of positive and expressive writing: Towards a resource-oriented perspective

This study tested the hypothesis that benefits of positive and expressive writing accrue when the intervention matches or activates the participant’s personal resources. Students were randomly assigned to keep a newly developed resource diary (RD, n = 114), which asked the participants to write about positive experiences and personal resources, or an expressive writing diary (ED, n = 114), which asked the participants to engage with negative emotional experiences, at home on three consecutive days per week for four weeks. Participants keeping the RD perceived significantly more social support and reported a significantly better mood at post-test than participants keeping the ED. Compared to a control group (n = 81) treatment effects of both writing interventions were higher for participants with lower pre-test values of well-being and brooding as well as for participants who wrote in an ‘atmosphere of activated resources.’ It is suggested that research should move away from testing deficit-compensating hypotheses towards a stronger resource orientation.     

Increased skills usage statistically mediates symptom reduction in self-guided internet-delivered cognitive–behavioural therapy for depression and anxiety: a randomised controlled trial

Cognitive–behavioural therapy (CBT) is an effective treatment for clinical and subclinical symptoms of depression and general anxiety, and increases life satisfaction. Patients’ usage of CBT skills is a core aspect of treatment but there is insufficient empirical evidence suggesting that skills usage behaviours are a mechanism of clinical change. This study investigated if an internet-delivered CBT (iCBT) intervention increased the frequency of CBT skills usage behaviours and if this statistically mediated reductions in symptoms and increased life satisfaction. A two-group randomised controlled trial was conducted comparing internet-delivered CBT (n = 65) with a waitlist control group (n = 75). Participants were individuals experiencing clinically significant symptoms of depression or general anxiety. Mixed-linear models analyses revealed that the treatment group reported a significantly higher frequency of skills usage, lower symptoms, and higher life satisfaction by the end of treatment compared with the control group. Results from bootstrapping mediation analyses revealed that the increased skills usage behaviours statistically mediated symptom reductions and increased life satisfaction. Although skills usage and symptom outcomes were assessed concurrently, these findings support the notion that iCBT increases the frequency of skills usage behaviours and suggest that this may be an important mechanism of change.     

Rehabilitating civilian victims of war through psychosocial intervention in Sierra Leone

This research assessed an intervention (involving drug therapy and psychoeducational counseling) for war trauma in Sierra Leone. We examine the impact of the intervention on symptoms of post‐traumatic stress disorder (PTSD) and indicators of intergroup emotions and attitudes. Civilian war victims were drawn from a rehabilitation program (Intervention, N=50) or a waiting list Control group (N=50). The rehabilitation program combined general psychiatric treatment with additional life skills support. Those in the Intervention group had significantly lower PTSD symptoms and also scored lower on Intergroup Anxiety and Outgroup Blame, than those in Control. The intervention had an indirect effect on PTSD symptoms through Intergroup Anxiety. The reduction in PTSD in the intervention was greater for participants with a stronger identification with Sierra Leone.     

Self-regulation in early childhood: the interplay between family risk,temperament and teacher–child interactions

Abstract

This study investigates the interplay between family risk and the quality of classroom interactions and their impact on self-regulation skills in two groups of children—children from socioeconomically disadvantaged backgrounds (at-risk) and non-risk children. Participants included 485 children (N = 93 classrooms)—233 (N = 47 classrooms) of which were from socioeconomically disadvantaged areas. Temperament was measured using teacher report. Trained observers rated classroom quality via live observations of a typical preschool day. Behavioral regulation was assessed using direct measures and emotional regulation was assessed using a teacher report. Analyses using multiple group structural equation modeling showed that at-risk children had lower levels of cool behavior regulation than non-risk children. In addition, classroom quality was positively linked to cool behavioral self-regulation. Moderating effects were additionally found between family risk and classroom quality on both hot behavioral regulation and emotional regulation. Classroom quality served as a protective factor for children exposed to more risk factors. Results showed complex associations between individual characteristics, classroom quality, and family risk, indicating a need to further explore the interplay among these variables.     

Association of Stress Management Skills and Perceived Stress with Physical and Emotional Well-Being Among Advanced Prostrate Cancer Survivors Following Androgen Deprivation Treatment

Advanced prostate cancer (APC) is associated with disruptions that compromise health related quality of life (HRQOL). Treatment often includes androgendeprivation therapy (ADT), which results in a range of side effects (e.g., fatigue, urinary dysfunction) that further impact HRQOL. Despite these challenges, there are limited evaluations of the impact of stress and stress management skills on HRQOL among APC survivors on ADT. This study evaluated relationships among stress, stress management skills, and HRQOL, and it was hypothesized that better stress management skills would relate to greater physical and emotional well-being by mitigating perceived stress levels. Participants (N = 77) were 69.7 years old (SD = 9.8), 18.6 months post-treatment (SD = 17.5), and ethnically diverse (65 % Non-Hispanic White, 13 % Hispanic, 21 % African-American). Measures included the Measure of Current Status for stress management skills, the Perceived Stress Scale for perceived stress, and the Medical Outcomes Study—Short Form (MOS SF-36; physical functioning and emotional well-being subscales) for HRQOL. Direct effects and mediation models were evaluated to determine the relationships between perceived stress, stress management skills, and HRQOL domains, controlling for relevant covariates. Stress management skills and perceived stress were significantly associated with physical functioning (β = .24, p < .05 and β = ?.43, p < .01, respectively) and emotional well-being (β = .35, p < .01 and β = ?.64, p < .01, respectively). Regression analyses supported the hypothesis that reduced perceived stress mediated the relationship between stress management skills and both physical functioning and emotional well-being. These results demonstrate that one way stress management skills may impact HRQOL is by lessening ongoing perceptions of stress.     

Moving Beyond the Gym: Exploring Life Skill Transfer Within a Female Physical Activity-Based Life Skills Program

Physical activity programs are viable contexts to foster life skills. Researchers contend that programs must be structured to deliberately teach life skills and teach how such skills can be transferred. The purpose of this study is to understand female youths’ perceptions of life skills transfer from participation in a physical activity-based life skills program. Interviews were conducted with eight youth. Results indicated that youth learned intrapersonal (i.e., emotional regulation, focus, goal setting), interpersonal (i.e., respect, responsibility, social skills), and physical activity skills and applied these skills in other life domains. Leaders’ practical strategies used to explicitly teach transferable skills are discussed.     

Let’s be healthy together: Relational motivation for physical health is more effective for women

Four studies examined the role of relationally-autonomous reasons in health behavior (RARHs) and how gender moderates their association with health outcomes. Study 1 (n = 160) involved the development of a measure of RARHs. The results of a factor analysis distinguished RARHs from other types of health reasons. In Study 2, participants (n = 284) completed a survey assessing their relational reasons prior to taking assessments of their body composition and fitness level. In Study 3, participants (n = 577) completed an online survey assessing RARHs, self-construal and health behaviors. The results of Studies 2 and 3 showed that RARHs positively predicted healthy outcomes for females only. In Study 4, participants (n = 72) were asked to complete an online survey, attend an orientation session, keep track of their exercise and nutrition over the course of a week, and attend a follow-up session. The results revealed that having an exercise partner was positively associated with RARHs, and that this in turn predicted reported effort and progress outcomes at the follow-up session for females only. Implications for theories of motivation and gender differences are discussed.     

Evaluation of a Sexual Abuse Prevention Program for Children with Intellectual Disabilities

The present study evaluated the effectiveness of a sexual abuse prevention program for children with intellectual disabilities. Three children with mild to moderate intellectual disabilities participated in the study. They were taught skills relative to identifying body parts and discrimination between appropriate and inappropriate situations, refusal skills (verbal refusing and leaving situations), and reporting skills through this program. A multiple probe across participants design was used to determine the effects of the program. Results demonstrated that the program was effective for teaching the skills to all three children with intellectual disabilities. In addition, these skills generalized in probes conducted in real‐life settings and maintained at 10‐week follow‐up probes. Copyright © 2015 John Wiley & Sons, Ltd.     

Effective regulation of affect: An action control perspective on emotion regulation

The present review adopts an action control perspective on emotion regulation, contextualising the gap between emotion control goals (e.g., I want to remain calm) and emotional outcomes (e.g., anger, anxiety, and aggression) in terms of the broader literature on goal pursuit. We propose that failure to effectively regulate emotions can result from difficulties with the self-regulatory tasks of (i) identifying the need to regulate, (ii) deciding whether and how to regulate, and (iii) enacting a regulation strategy. Next we review evidence that a technique traditionally associated with regulating behavioural goals (forming implementation intentions or “if-then” planning) can help to overcome these difficulties. Meta-analysis indicated that forming implementation intentions is effective in modifying emotional outcomes, with a large effect relative to no regulation instructions (k = 21, N = 1306 d ₊ = 0.91, 95% CI = 0.61 to 1.20) and a medium-sized effect relative to goal intention instructions (k = 29, N = 1208, d ₊ = 0.53, 95% CI = 0.42 to 0.65). Our conclusion is that research on emotion regulation might benefit from an action control perspective and the interventions that this perspective offers.     

Meta-analysis of psychosocial interventions on survival time in patients with cancer

Objective: This study was to evaluate the effects of psychosocial interventions on survival in adult patients with cancer.

Method: MEDLINE via PubMed, Cochrane Library CENTRAL, CINAHL, and Korean electronic databases (September 2014) were searched. Methodological quality was assessed using Cochrane’s Risk of Bias for randomized studies. The RevMan 5.3 program of the Cochrane library was used for data analysis.

Results: Fifteen randomized controlled trials met the inclusion criteria, with a total of 2940 participants. Overall, psychosocial interventions was not associated with better survival (HR = .83, 95% CI [.68, 1.10], p = .06, I² = 64%). In subgroup analysis, based on six trials with 1448 subjects, psychoeducational interventions for cancer patients with non-metastatic at intervention implementation resulted in a 41% reduction in the risk of dying of cancer (HR = .59, 95% CI [.49, .71], p < .001, I² = 0%). For psychoeducational intervention, significant survival benefit were found when health staff delivered the intervention and at a follow-up time of more than 10 years.

Conclusions: Use of psychoeducational interventions for cancer patients at early stage appeared to have beneficial effects on survival, preferably for delivering of health staff. However, conduct of further psychosocial studies with adequate power will lead to better understanding of the effects of treatments on survival outcome.     

Mathematics ability and related skills in preschoolers born very preterm

Children born very preterm (VPT) are at risk for academic, behavioral, and/or emotional problems. Mathematics is a particular weakness and better understanding of the relationship between preterm birth and early mathematics ability is needed, particularly as early as possible to aid in early intervention. Preschoolers born VPT (n = 58) and those born full term (FT; n = 29) were administered a large battery of measures within 6 months of beginning kindergarten. A multiple-mediation model was utilized to characterize the difference in skills underlying mathematics ability between groups. Children born VPT performed significantly worse than FT-born children on a measure of mathematics ability as well as full-scale IQ, verbal skills, visual–motor integration, phonological awareness, phonological working memory, motor skills, and executive functioning. Mathematics was significantly correlated with verbal skills, visual–motor integration, phonological processing, and motor skills across both groups. When entered into the mediation model, verbal skills, visual–motor integration, and phonological awareness were significant mediators of the group differences. This analysis provides insights into the pre-academic skills that are weak in preschoolers born VPT and their relationship to mathematics. It is important to identify children who will have difficulties as early as possible, particularly for VPT children who are at higher risk for academic difficulties. Therefore, this model may be used in evaluating VPT children for emerging difficulties as well as an indicator that if other weaknesses are found, an assessment of mathematics should be conducted.     

Work-anxiety-coping intervention improves work-coping perception while a recreational intervention leads to deterioration: Results from a randomized controlled trial

Work-anxieties are costly and need early intervention. The perception of being able to cope with work is a basic requirement for work ability. This randomized controlled trial investigates whether a cognitive behavioural, work-anxiety-coping group (WAG) intervention leads to better work-coping perception than an unspecific recreational group (RG). Heterogeneous people in medical rehabilitation, who were due to return to work, were interviewed concerning their work-anxieties, and either randomly assigned to a WAG (n = 85) or a RG (n = 95). The participants (with an average of 50 years old [range 23–64]; 51% women; 70% workers or employees, 25% academics, 5% unskilled) followed the group intervention for four or six sessions. The perceived work-coping was assessed by self-rating (Inventory for Job-Coping and Return Intention JoCoRi) after each group session. Although participants had a slight temporary decrease in work-coping after group session two (from M₁ = 2.47 to M₂ = 2.28, d_Cohen = ?.22), the WAG led to the improvement of perceived work-coping over the intervention course (from M₁ = 2.47 to M₆ = 2.65, d_Cohen = .18). In contrast, participants from the RG reported lower work-coping after six group sessions (from M₁ = 2.26 to M₆ = 2.02, d_Cohen = ?.18). It is considered that people with work-anxieties need training in work-coping. By focusing on recreation only, this may lead to deterioration of work-coping. Indeed, intervention designers should be aware of temporary deterioration (side effects) when confronting participants with work-coping.     

Randomized Effectiveness Trial of an Internet,Pure Self-Help,Cognitive Behavioral Intervention for Depressive Symptoms in Young Adults

This study evaluated an Internet-delivered, cognitive behavioral skills training program versus a treatment-as-usual (TAU) control condition targeting depression symptoms in young adults aged 18 to 24 years. Potential participants were mailed a recruitment brochure; if interested, they accessed the study website to complete an online consent and baseline assessment. Intervention participants could access the website at their own pace and at any time. Reminder postcards were mailed periodically to encourage return use of the intervention. The pure self-help intervention was delivered without contact with a live therapist. The primary depression outcome measure was the Patient Health Questionnaire, administered at 0, 5, 10, 16, and 32 weeks after enrollment. A small but significant between-group effect was found from Week 0 to Week 32 for the entire sample (N = 160, d = .20, 95% confidence interval [CI] 0.00–0.50), with a moderate effect among women (n = 128, d .42, 95%C1 = 0.09–0.77). Greater depression reduction was associated with two measures of lower website usage, total minutes, and total number of page hits. Although intervention effects were modest, they were observed against a background of substantial TAU depression pharmacotherapy and psychosocial services. Highly disseminable, low-cost, and self-help interventions such as this have the potential to deliver a significant public health benefit.     

Character strengths predict resilience over and above positive affect,self-efficacy,optimism, social support,self-esteem,and life satisfaction

The incremental value of character strengths in the prediction of resilience, after the effects of other well-known resilience-related factors (i.e. positive affect, self-efficacy, optimism, social support, self-esteem, life satisfaction) and sociodemographic variables are accounted for, is examined. Using a cross-sectional design, participants (N = 363 adults) completed online measures of character strengths, resilience, and resilience-related factors. A principal component analysis of character strengths was conducted and five factors were extracted, which could be interpreted as emotional, interpersonal, intellectual, restraint, and theological strengths. All strengths factors, except theological strengths, yielded significant positive correlations with resilience. A hierarchical regression showed that strengths predicted an additional 3% of the variance in resilience over and above sociodemographic variables, positive affect, self-efficacy, optimism, social support, self-esteem, and life satisfaction. Emotional strengths and strengths of restraint were significant positive predictors. Implications, limitations, and future research are discussed.     

Tailoring Social Competence Interventions for Children with Learning Disabilities

Challenges in social competence are common in children with Learning Disabilities (LDs), particularly those who present with co-occurring mental health challenges (LD + MH). Social competence calls upon a complex set of skills, including social skills, perspective-taking abilities, and an understanding of the social environment. Successful enactment of these skills necessitates behavioral and emotion regulation, an area of weakness for many youth with LD + MH. Using a mixed-method design, the present study assessed the efficacy of a social competence group program for children with LD + MH (mean age = 11.4 years) in which group size, content, and structure are tailored to the child’s level of emotion regulation, information processing abilities, and social competence goals. Quantitative measures completed by parents and coded behavioral observations completed pre- and post-treatment indicated significant gains in initiation and engagement in positive social interactions, foundational skills that support improvement in social competence. Qualitative interviews with parents, children and teachers suggested improvements in social self-concept, initiation, and emotion regulation. Tailoring treatment to the child’s information processing and emotion regulation abilities, as well as ‘in the moment’ feedback, supported gains made and contributed to participants having a positive social experience. Directions for future research are discussed.     

Internet-based acceptance and commitment therapy for psychological distress experienced by people with hearing problems: a pilot randomized controlled trial

Psychological distress is common among people with hearing problems, but treatments that specifically target this aspect have been almost non-existent. In this pilot randomized controlled trial, an eight-week long Internet-based treatment, informed by Acceptance and Commitment Therapy, was administered to explore the feasibility and efficacy of such a treatment. Included participants were randomized to either treatment (n = 31) or wait-list control (n = 30) condition. All participants were measured prior to randomization and immediately after treatment ended using standardized self-report instruments measuring hearing-related emotional and social adjustment (Hearing Handicap Inventory for the Elderly – S, HHIE-S), quality of life (Quality of Life Inventory, QOLI), and symptoms of depression and anxiety (Patient health Questionnaire, PHQ-9 and Generalized Anxiety Disorder scale, GAD-7). Linear mixed effects regression analysis using the full intention-to-treat sample demonstrated that the treatment had superior outcomes on the main outcome measure as compared with the control group, Cohen’s d = 0.93, 95% CI [0.24, 1.63]. The benefits of treatment over control were also evident in scores of depression, Cohen’s d = 0.61, 95% CI [0.04, 1.19], and quality of life, Cohen’s d = 0.88, 95% CI [0.14, 1.61]. The results provide preliminary support for Internet-delivered acceptance and commitment therapy as a potentially effective treatment of psychological symptoms associated with hearing problems.