Randomized Controlled Trial of Cognitive–Behavioral Group Therapy for Irritable Bowel Syndrome in a Medical Setting

Standard medical treatments have not been effective for irritable bowel syndrome (IBS) patients. Though individualized cognitive–behavior therapy is an empirically supported treatment option, cognitive–behavioral group therapy (CBGT) has yet to be established as an effective alternative in a randomized controlled trial. This study compared the efficacy of a 10-session CBGT with a home-based symptom monitoring with weekly telephone contact (SMTC) treatment for IBS, extending previous quasi-experimental research in this area. Twenty-eight refractory IBS patients, evaluated and referred by gastroenterologists using the Rome criteria, participated in the study. IBS symptoms, psychological functioning, and health-related quality of life were assessed pre- and posttreatment, and at 3-month follow-up. CBGT patients reported significantly more gastrointestinal (GI) symptom improvement than SMTC patients on posttreatment global measures and had significantly reduced daily diary pain scores at 3-month follow-up. Based on MANOVA, there was significant improvement in psychological distress and health-related quality of life for the CBGT patients in comparison to the SMTC patients. These improvements were also maintained at the 3-month follow-up. Reductions in GI symptoms, psychological distress, and improved health related quality of life may contribute to less behavioral avoidance, disability, and health care utilization in refractory IBS patients.     

Parent Training Adapted to the Needs of Children With Callous–Unemotional Traits: A Randomized Controlled Trial

Callous–unemotional (CU) traits designate a distinct subgroup of children with early-starting, stable, and aggressive conduct problems. Critically, traditional parenting interventions often fail to normalize conduct problems among this subgroup. The aim of this study was to test whether parent–child interaction therapy (PCIT) adapted to target distinct deficits associated with CU traits (PCIT-CU) produced superior outcomes relative to standard PCIT. In this proof-of-concept trial, 43 families with a 3- to 7-year-old child (M age = 4.84 years, SD = 1.12, 84% male) with clinically significant conduct problems and elevated CU traits were randomized to receive standard PCIT (n = 21) or PCIT-CU (n = 22) at an urban university-based research clinic. Families completed five assessments measuring child conduct problems, CU traits, and empathy. Parents in both conditions reported good treatment acceptability and significantly improved conduct problems and CU traits during active treatment, with no between-group differences. However, linear mixed-effects models showed treatment gains in conduct problems deteriorated for children in standard PCIT relative to those in PCIT-CU during the 3-month follow-up period (ds = 0.4–0.7). PCIT-CU shows promise for sustaining improvements in conduct problems for young children with conduct problems and CU traits, but requires continued follow-up and refinement.     

Telephone-Administered Cognitive Behavioral Therapy: A Case Study of Anxiety and Depression in Parkinson’s Disease

Parkinson’s disease (PD) is a chronic medical illness with a high incidence of psychiatric comorbidity, specifically depression and anxiety. Research on treatment of such psychiatric complications is scarce. Non-pharmaceutical treatment options are especially attractive. Cognitive behavioral therapy (CBT) is a psychotherapeutic treatment option that has been successful in other chronically medically ill populations with comorbid depression and anxiety. The current research had two aims. The first was to pilot the feasibility of screening and identifying PD patients with symptoms of anxiety and depression in a specialized outpatient clinic. The second aim was to pilot the feasibility of telephone-administered CBT for the treatment of depression and anxiety in persons with PD, which was done through a case series comparing telephone-administered CBT to a Support strategy. A fairly large portion (67.5%) of patients screened in the outpatient clinic were identified as having symptoms of anxiety and/or depression. Results also indicated that CBT delivered via the telephone is a useful approach for targeting psychiatric symptoms in this population. A case example is given to illustrate the clinical considerations associated with delivering therapy via telephone to persons with PD. This study was conducted at the Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX. The first author was previously affiliated with the Houston Center for Quality of Care and Utilization Studies.     

Can Subjects Be Proper Parts of Subjects? The De‐Combination Problem

Growing concern with the panpsychist's ostensive inability to solve the ‘combination problem’ has led some authors to adopt a view titled ‘Cosmopsychism’. This position turns panpsychism on its head: rather than many tiny atomic minds, there is instead one cosmos‐sized mind. It is supposed that this view voids the combination problem, however I argue that it does not. I argue that there is a ‘de‐combination problem’ facing the cosmopsychist, which is equivalent to the combination problem as they are both concerned with subjects being proper parts of other subjects. I then propose two methods for both theorists to avoid the problem of subject‐subject proper parthood relations: a distinction between absolute and relative phenomenal unity, and a modification of the essential nature of subjects. Of these two options, I find the latter option wanting and propose that the first should be adopted.     

How Has the Economic Downturn Affected Communities and Implementation of Science‐Based Prevention in the Randomized Trial of Communities That Care?

This study examined implications of the economic downturn that began in December 2007 for the Community Youth Development Study (CYDS), a longitudinal randomized controlled trial of the Communities That Care (CTC) prevention system. The downturn had the potential to affect the internal validity of the CYDS research design and implementation of science-based prevention in study communities. We used archival economic indicators and community key leader reports of economic conditions to assess the extent of the economic downturn in CYDS communities and potential internal validity threats. We also examined whether stronger economic downturn effects were associated with a decline in science-based prevention implementation. Economic indicators suggested the downturn affected CYDS communities to different degrees. We found no evidence of systematic differences in downturn effects in CTC compared to control communities that would threaten internal validity of the randomized trial. The Community Economic Problems scale was a reliable measure of community economic conditions, and it showed criterion validity in relation to several objective economic indicators. CTC coalitions continued to implement science-based prevention to a significantly greater degree than control coalitions 2 years after the downturn began. However, CTC implementation levels declined to some extent as unemployment, the percentage of students qualifying for free lunch, and community economic problems worsened. Control coalition implementation levels were not related to economic conditions before or after the downturn, but mean implementation levels of science-based prevention were also relatively low in both periods.     

How is Systemic and Constructionist Therapy Change Process Narrated in Retrospective Accounts of Therapy? A Systematic Meta‐synthesis Review

Despite the considerable potential of qualitative approaches for studying the systemic and constructionist therapy process due to shared theoretical and epistemological premises, to date there is lack of a comprehensive qualitative synthesis of how change process is experienced and conceptualized by clients and therapists. To address this evidence gap, we performed a systematic meta‐synthesis review of 30 studies reporting clients’ and therapists’ retrospective narratives of change process across systemic and constructionist models and across a range of client configurations, including individuals, couples, families, and groups. The studies were identified following a systematic search in PsycINFO and MEDLINE resulting in 2,977 articles, which were screened against eligibility criteria. Thematic analysis led to the identification of four main themes: (1) navigating through differences, (2) toward nonpathologizing construction of problems, (3) navigating through power imbalances, and (4) toward new and trusting ways of relating. Findings illustrate the multifaceted aspects of systemic and constructionist change process, the importance for their reflexive appraisal, and the need for further research contributing to the understanding of the challenges inherent in the systemic and constructionist therapeutic context.     

Entertainment–Education? A Fotonovela? A New Strategy to Improve Depression Literacy and Help‐Seeking Behaviors in At‐Risk Immigrant Latinas

Research shows high risk for depression among immigrant Latinas known to increase during the acculturation process. Several barriers such as stigma and low health literacy result in an under-utilization of needed treatment among these women. In response, this study replicated the effectiveness of a Spanish language fotonovela, a form of Entertainment–Education (E–E), designed to increase depression literacy, decrease stigma, and increase help-seeking knowledge and behavior in Latinos. Specifically, this study evaluated a fotonovela delivered in a multifaceted approach to health education used by promotoras. A pretest–posttest randomized control group experimental design with 142 immigrant Latinas at risk for depression was employed. Results indicate significant posttest improvements in depression knowledge, self-efficacy to identify the need for treatment, and decreased stigma in experimental as compared to control group participants. Findings support the application of E–E health literacy tools such as fotonovelas, delivered in multifaceted approaches to health education used by promotoras, to Latinas at risk for mental health concerns.     

Sticking to the Evidence? A Behavioral and Computational Case Study of Micro‐Theory Change in the Domain of Magnetism

Constructing an intuitive theory from data confronts learners with a “chicken‐and‐egg” problem: The laws can only be expressed in terms of the theory's core concepts, but these concepts are only meaningful in terms of the role they play in the theory's laws; how can a learner discover appropriate concepts and laws simultaneously, knowing neither to begin with? We explore how children can solve this chicken‐and‐egg problem in the domain of magnetism, drawing on perspectives from computational modeling and behavioral experiments. We present 4‐ and 5‐year‐olds with two different simplified magnet‐learning tasks. Children appropriately constrain their beliefs to two hypotheses following ambiguous but informative evidence. Following a critical intervention, they learn the correct theory. In the second study, children infer the correct number of categories given no information about the possible causal laws. Children's hypotheses in these tasks are explained as rational inferences within a Bayesian computational framework.     

Family‐Based Preventive Interventions: Can the Onset of Suicidal Ideation and Behavior Be Prevented?

Suicide is the second leading cause of death for youth aged 10–24. Research informed prevention efforts have the opportunity to decrease risk for suicidal ideation and behavior before it is manifested. Indeed, there is a small body of research findings demonstrating both proximal and distal effects of preventive interventions delivered in childhood and adolescence on suicidal ideation and/or behavior. These efforts build off of other secondary analyses of prevention research that has demonstrated benefits for multiple types of youth outcomes. This supplement provides “proof of concept” that family‐based preventive interventions aimed at reducing a number of risk factors for suicide (e.g., substance use, externalizing, and internalizing behavior) can prevent suicidal ideation and behaviors.     

Can low Behavioral Activation System predict depressive mood?: An application of non‐normal structural equation modeling

Previous studies have reported a negative correlation between the Behavioral Activation System (BAS) and the depressive mood. However, which is the cause and which is the effect cannot be determined simply by evaluating the correlation coefficients. In a series of this study, we used non‐normal structural equation modeling, which could provide a statistically plausible answer to the question on the path direction. We tested for the path direction between the variables of interest by statistically comparing all possible models. The models assuming a unidirectional path from the BAS to the depressive mood were consistently supported. This suggested that low BAS could be a predisposition to developing the depressive mood. These findings could enhance our understanding of the mechanism underlying the development of the depressive mood.     

Does Adding the Dialectical Behavior Therapy Prolonged Exposure (DBT PE) Protocol for PTSD to DBT Improve Outcomes in Public Mental Health Settings? A Pilot Nonrandomized Effectiveness Trial With Benchmarking

The Dialectical Behavior Therapy Prolonged Exposure (DBT PE) protocol improves DBT’s effects on PTSD in research settings, but its effectiveness in community settings is largely unknown. This pilot nonrandomized controlled trial examined DBT with and without DBT PE in four public mental health agencies. Patients (N = 35, 12-56 years old, 80.0% female, 64.7% racial/ethnic minorities, 44.1% sexual minorities) had PTSD, were receiving DBT, and completed assessments every four months over one year. Sixteen patients (45.7%) initiated DBT PE, 19 (54.3%) did not, and dropout did not differ between groups (31.3% vs. 26.3%). The primary barrier to initiating DBT PE was clinician turnover (57.9% of non-initiators). After adjusting for confounds, DBT PE initiators (g = 1.1) and completers (g = 1.4) showed a greater reduction in PTSD than patients who received DBT only (g = 0.5; p’s < .05). Rates of reliable improvement in PTSD were 71.4% (DBT PE completers), 53.8% (DBT PE initiators), and 31.3% (DBT). Similar patterns were observed for posttraumatic cognitions, emotion dysregulation, general psychological distress, and limited activity days. There was no worsening of self-injurious behavior or crisis service use among patients who received DBT PE. Benchmarking analyses indicated comparable feasibility, acceptability, and safety, but a smaller magnitude of clinical change, than in efficacy studies. Results require replication in a randomized trial but suggest that DBT PE can be transported effectively to community settings.     

Can Acceptance,Mindfulness, and Self-Compassion Be Learned by Smartphone Apps? A Systematic and Meta-Analytic Review of Randomized Controlled Trials

The potential health benefits of acceptance, mindfulness, and self-compassion are well-documented. However, interventions that teach these principles typically rely on face-to-face delivery, which can limit their dissemination. Delivering these interventions through smartphone apps could help overcome this. This meta-analysis examined whether principles of acceptance, mindfulness, and self-compassion can be learned through smartphone apps. Twenty-seven randomized controlled trials were included. Smartphone apps that included acceptance and/or mindfulness components resulted in significantly higher levels of acceptance/mindfulness than comparison conditions (k = 33; g = 0.29; 95% CI = 0.17, 0.41). These effects were moderated by the type of comparison and whether reminders to engage were offered. Smartphone apps also resulted in significantly lower levels of psychological distress than comparisons (k = 22; g = −0.32; 95% CI = −0.48, −0.16). Meta-regression revealed a negative relationship between the effect sizes for mindfulness/acceptance and the effect sizes for distress. Smartphone apps produced significantly greater increases in self-compassion than comparisons (k = 9; g = 0.31; 95% CI = 0.07, 0.56), although the quality of RCTs in this analysis was poor. Findings suggest that principles of acceptance, mindfulness, and self-compassion may be learned through cheap, easily accessible, and low-intensity interventions delivered via smartphone apps. However, the quality of available evidence is poor, as low risk of bias was noted in few trials (18%) and the observed effects were likely explained by a digital placebo.     

Psychometric Properties of Parent–Child (0–5 years) Interaction Outcome Measures as Used in Randomized Controlled Trials of Parent Programs: A Systematic Review

This systematic review sought to identify observational measures of parent–child interactions commonly implemented in parenting program research, and to assess the level of psychometric evidence available for their use with this age group. Two separate searches of the same databases were conducted; firstly, to identify eligible instruments, and secondly to identify studies reporting on the psychometric properties of the identified measures. Five commercial platforms hosting 19 electronic databases were searched from their inception to conducted search dates. Fourteen measures were identified from Search 1; a systematic search of randomized controlled trial evaluations of parenting programs. For Search 2, inclusion/exclusion criteria were applied to 1327 retrieved papers that described the development and/or validation of the 14 measures identified in Search 1. Seventeen articles met the inclusion criteria, resulting in five observational measures for the final review. Data were extracted and synthesized using the COSMIN rating system to describe the methodological quality of each article alongside the overall quality rating of the psychometric property reported for each measure using the Terwee checklist. Measure reliability was categorized into four domains (internal consistency, test-re-test, inter-rater, and intra-rater). Measure validity was categorized into four domains (content, structural, convergent/divergent, and discriminant). Results indicated that the majority of psychometric evidence related to children aged from birth the three with internal consistency, inter-rater reliability, and structural validity the most commonly reported properties, although this evidence was often weak. The findings suggest further validation of the included measures is required to establish acceptability for the whole target age group.

     

Role of the Leader in Therapy Groups Conducted With Illicit Drug Abusers: How Directive Does the Leader Have to Be?

A 17-hour marathon group was conducted in a residential treatment center established for inmates in a correctional setting in the southeastern United States. The Hill Interaction Matrix (HIM-G; Hill, 1965) was used to measure the types of leader activity and the types of member activity during portions of each hour of the group activity. It was found that when the group was most therapeutic, there was a relationship between the therapists' actions and behaviors and the types of issues that were discussed in the group. The results that were found do not agree with some of the established drug and alcohol abuse literature.     

To Have or To Be? A Comparison of Materialism‐Based Theories and Self‐Determination Theory as Explanatory Frameworks of Prejudice

ABSTRACT The present study aimed to delineate the psychological structure of materialism and intrinsic and extrinsic value pursuit. Moreover, we compared models based on self‐determination theory (SDT), Fromm's marketing character, and Inglehart's theory of social change to account for racial prejudice. In a sample of undergraduate students (n=131) and adults (n=176) it was revealed that the extrinsic value pursuit Financial Success/Materialism could be distinguished from the extrinsic value scales Physical Appeal and Social Recognition, and Community Concern could be distinguished from the intrinsic value pursuit scales Self‐acceptance and Affiliation. Moreover, Financial Success/Materialism and Community Concern were consistently and significantly related to prejudice, whereas the other SDT facet scales yielded weaker relationships with prejudice. Structural models based on SDT and Inglehart were not corroborated, but instead the present data supported a mediation model based on Fromm's work in which the effect of Community Concern was mediated by Financial Success/Materialism. Broader implications for SDT are critically assessed.     

Can parent‐to‐parent consultation improve the effectiveness of the Maudsley model of family‐based treatment for anorexia nervosa? A randomized control trial

Objective: This paper describes a preliminary randomized control trial that explores the use of parent‐to‐parent consultations as a potential augmentation to the Maudsley model of family‐based treatment for anorexia. Method: Twenty families were randomized into two groups, ten receiving standard treatment and ten receiving an additional parent‐to‐parent consultation early on in treatment. Measures of parental efficacy (Parents versus Anorexia Scale), patient distress (Depression Anxiety and Stress Scale) and percentage ideal body weight were taken each week. The effects of parent‐to‐parent consultations on parental efficacy and weight were analysed by comparing data with random effects models. Results: A significant treatment effect was found, with parent‐to‐parent consultations leading to a small increase in the rate of weight restoration. Conclusion: This practice has the potential to enhance weight restoration when included in the Maudsley model of family‐based treatment for anorexia nervosa. Research that tests more potent forms of intervention may also have merit.     

Can Thrift Bring Well‐being? A Review of the Research and a Tentative Theory

Contemporary forms of consumer capitalism encourage people to prioritize materialistic values, an orientation associated with lower personal well‐being. Such materialistic values stand in contrast to the economic attitude of thrift, which encourages saving, self‐sufficiency, reuse of goods, and avoiding debt. This article reviews the existing empirical literature on thrift and well‐being, finding it to be very contradictory, with studies showing positive, negative, and null associations between various operationalizations of well‐being and of thrift. A need‐based theory is presented to explain these inconsistent findings. The theory suggests that thrifty attitudes, behaviors, and lifestyles sometimes can work to satisfy psychological needs for safety/security, competence, relatedness, and autonomy (and thus promote well‐being) but sometimes interfere with satisfaction of these needs (and thus diminish well‐being). Empirical and anecdotal evidence is reviewed in support of this theory, and future directions for testing and refining it are proposed.     

Can Self‐Determination Theory Explain the Self‐Perpetuation of Social Innovations? A Case Study of Slow Food at the University of Wisconsin—Madison

This case study of Slow Food at the University of Wisconsin—Madison (SFUW) examines the success of a volunteer social innovation that promotes sustainable food access. Using inductive thematic analysis of 19 in‐depth, semi‐structured interviews of past and current members, advisors, and collaborators, we find that the success of SFUW is consistent with Self‐Determination Theory. We find that among the participants, the organization satisfies the basic psychological needs for autonomy, competence, and relatedness, which in turn support intrinsic motivation. In this way, volunteering tasks become interesting, fun, and are more likely to be performed over time. The findings suggest that needs fulfillment and intrinsic motivation are linked to creating a self‐propagating social innovation where volunteers generate new ideas and successfully transfer skills to others. Copyright © 2015 John Wiley & Sons, Ltd.