Internet-based intervention for mental health and substance use problems in disaster-affected populations: a pilot feasibility study

Early interventions that reduce the societal burden of mental health problems in the aftermath of disasters and mass violence have the potential to be enormously valuable. Internet-based interventions can be delivered widely, efficiently, and at low cost and as such are of particular interest. We describe the development and feasibility analysis of an Internet-delivered intervention designed to address mental health and substance-related reactions in disaster-affected populations. Participants (n = 285) were recruited from a cohort of New York City-area residents that had been followed longitudinally in epidemiological research initiated 6 months after the terrorist attacks of September 11, 2001. The intervention consisted of 7 modules: posttraumatic stress/panic, depression, generalized anxiety, alcohol use, marijuana use, drug use, and cigarette use. Feasibility data were promising and suggest the need for further evaluation.     

Internet-delivered physical activity intervention for college students with mental health disorders: a randomized pilot trial

The prevalence of mental health disorders among college students is rising and the increasing rates of anxiety and depression have important societal implications. Physical activity has been proposed as an adjuvant to traditional treatment approaches (i.e. psychotherapy or pharmacotherapy), and the internet is a potentially useful means of delivering physical activity information to the college-aged population. This randomized pilot trial examined the effects of an internet-based physical activity intervention on physical activity, self-efficacy, depression, and anxiety in college students (n?=?47) receiving mental health counseling. Physical activity, depression, anxiety, exercise self-efficacy, and barriers self-efficacy were assessed at baseline and post-intervention. There was a significant time effect for physical activity, with both groups increasing their physical activity levels across the 10-week intervention but with a larger increase in the intervention condition (d?=?0.68) than the control condition (d?=?0.05). Exercise and barriers self-efficacy declined across the intervention, but more so in the control than intervention condition. Effects on depression and anxiety were nonsignificant. Finally, correlation analyses showed increases in physical activity were associated with increases in exercise self-efficacy (r?=?0.62) and barriers self-efficacy (r?=?0.63) and decreases in depression (r?=?-0.44) in the intervention condition, but not in the control condition. These results suggest that an internet-delivered physical activity intervention may be a promising approach to promoting physical activity among college students undergoing mental health counseling.     

Well-being on campus: testing the effectiveness of an online strengths-based intervention for first year college students

The present research examined the effectiveness of an 8-week online strengths-based intervention in promoting subjective and psychological well-being of first year university students. The intervention was composed of five modules pertaining to (a) finding and cultivating on character strengths, (b) regulation of emotions and increasing positive emotions, (c) constructive communication, establishing social connectedness and positive relationships (d) effective decision-making and problem solving and (e) achieving flow and practicing gratitude. A total 92 students volunteered to participate in the study. They were randomly assigned to either the intervention or a control group. Students’ quality of life (psychological health and social relations domains), life satisfaction, subjective happiness and ontological well-being were measured before and after the intervention. Significant improvements in well-being of intervention group participants were observed over an 8-week period whereas control group participants did not show a significant increase in any of these well-being variables.     

Chinese Internet addiction inventory: developing a measure of problematic Internet use for Chinese college students.

The current study developed a psychometrically sound multidimensional measure of Internet addiction: the Chinese Internet Addiction Inventory (CIAI). Data were collected from 1,029 Chinese undergraduate students from 14 universities and colleges. The initial sample was split randomly into two samples (N1=516; N2=513). An exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) were conducted on the two samples respectively. Findings from the EFA suggest that this measure assesses three dimensions of Internet addiction: conflicts, mood modification, and dependence. Items in each dimension showed high internal consistency and acceptable test-retest reliability. Findings from the CFA further confirmed the three-factor measurement structure of CIAI. Test of criterion-related validity also showed good abilities for all three CIAI subscales to discriminate between an Internet addictive group and non-Internet addictive group. The theoretical and clinical implications of CIAI and its limitations are discussed.     

An acceptance-based behavioral intervention for weight loss: a pilot study

On average, participants in behavioral weight-loss interventions lose 8 kilograms (kg) at 6 months, but there is marked variability in outcomes with some participants losing little or no weight. Individuals with difficulties with internal disinhibition (i.e., eating in response to emotions or thoughts) typically lose less weight in such programs and may require an innovative, specialized approach. This pilot study examined the preliminary acceptability and efficacy of a 24-week acceptance-based behavioral intervention for weight loss among overweight and obese adults reporting difficulty with eating in response to emotions and thoughts. Participants were 21 overweight or obese men and women (mean age=52.2±7.6 years; baseline mean body mass index=32.8±3.4). Eighty-six percent completed the 6-month program and a 3-month follow-up assessment. Ratings of program satisfaction averaged 4.9 on a five-point scale. Multilevel modeling analyses indicated participants lost an average of 12.0 kg (SE=1.4) after 6 months of treatment and 12.1 kg (SE=1.9) at 3-month follow-up, thus exceeding the weight losses typically seen in behavioral treatment programs. Decreases in internal disinhibition and weight-related experiential avoidance were found at 6- and 3-months follow-up. Greater decreases in weight-related experiential avoidance were associated with greater weight loss at the end of the program (r=.64, p=.002), suggesting a potential mechanism of action. Although there have been a few preliminary studies using acceptance-based approaches for obesity, this is the first study to specifically target emotional overeaters, a subgroup that might be particularly responsive to this new approach. Our findings provide initial support for the feasibility, efficacy, and acceptability of this approach for this subgroup of participants. Further study with longer follow-up, a more diverse sample, and comparison to a standard behavioral program is clearly warranted.     

Asian American college women's body image: a pilot study

The purpose of this study was to examine the effects of values acculturation and the influence of media on Asian American college women's overall body image. A sample of 59 Asian American women from two large universities completed self-report surveys, which included questions regarding values acculturation, media internalization, and overall body satisfaction. Results showed that Asian American women who identified more strongly with traditional Asian values reported higher levels of body image dissatisfaction. Further, Asian American women who reported higher internalization of media portrayals of beauty ideals reported higher body image dissatisfaction. Research and clinical recommendations are made to enhance psychologists' understanding of Asian American women's body image and acculturation.     

Questions and reflections: the use of motivational interviewing microskills in a peer-led brief alcohol intervention for college students

The purpose of this study was to examine the association between peer facilitator adherence to motivational interviewing (MI) microskills and college student drinking behavior. First year students (N=67) took part in a Brief Alcohol Screening and Intervention for College Students (BASICS) led by peer facilitators trained in MI and BASICS. Participants were assessed pre- and 2 weeks post-intervention on contemplation to change, as well as, pre- and 3 months post- intervention on drinking quantity. Independent coders used the Motivational Interviewing Treatment Integrity scale (MITI, Moyers, Martin, Manuel, & Miller, 2003) to evaluate therapist MI adherence. Peer facilitators met beginning proficiency in MI on scores of empathy, the ratio of MI adherent behaviors to non-adherent behaviors and the ratio of open questions to total questions as defined by the MITI. Results indicated that a higher number of closed questions was related to less contemplation and a higher number of open questions was related to more contemplation post intervention. A higher number of simple reflections was associated with increased drinking at the 3 month assessment, however, complex reflections were found to attenuate the effect of simple reflections on changes in drinking. These findings highlight the importance of competent reflective listening skills and the need for continual training and supervision for peer facilitators.     

Brief residential treatment for nicotine addiction: a five-year follow-up study.

Relapse is a major problem with nicotine addiction. This study investigated the long-term abstinence rate and effectiveness of a five-day residential nicotine treatment program. Questionnaires were mailed to all clients who completed the program between 1991 and 1996. 47% of the questionnaires were returned. Of these, 65% of respondents reported being abstinent from nicotine for an average period of 120 weeks. Of this group, 15% reported at least one relapse before a sustained abstinence. The primary relapse triggers for both the abstinent and nonabstinent groups were coping with "strong emotional feelings". Over 50% of the sample was comorbid for other addictions, depression or anxiety disorders.     

Mindfulness training for loneliness among Chinese college students: A pilot randomized controlled trial

Loneliness has been found to predict a wide range of physical and mental health problems. It is suggested that China's One‐Child Policy places young Chinese people at a particularly high risk for loneliness. Although loneliness is most prevalent in late adolescence and early adulthood, interventions have primarily targeted children or older adults with limited success. The current study examines a pilot randomized controlled trial of a mindfulness training program among Chinese college students. Participants with elevated loneliness (N = 50, ages 17–25) were randomized into either an 8‐week mindfulness training or a control group. Self‐reported measures of loneliness and mindfulness were administered at baseline and posttest. The training group also completed a program evaluation form and a 3‐month follow‐up assessment. Results provided preliminary evidence indicating that the intervention was feasible and effective at reducing loneliness among Chinese college students. Limitations and future directions were discussed.     

Behavioral group treatment for obsessive-compulsive disorder in adolescence: a pilot study

This pilot study is a preliminary evaluation of the effectiveness of a cognitive-behavioral outpatient group treatment (CBT) protocol for adolescents with Obsessive-Compulsive Disorder (OCD). Seven adolescents were treated in a 10-session group CBT program with weekly 2-hour sessions. The treatment protocol was an adaptation of approaches with established effectiveness and emphasized three main components: externalizing the OCD by cultivating mindful detachment; exposure and response prevention (ERP); and refocusing on alternative, constructive behaviors following exposure. An occupational therapy component played a significant role in designing creative exposure and refocusing challenges. Self-report measures at pre, post, and 12-month follow-up suggested clinical improvements for 5 of the 7 patients, thus partially supporting a group treatment format for adolescents with mild to moderate OCD.     

Home-based family intervention for low-income children with asthma: a randomized controlled pilot study

Low-income African American children have disproportionately higher asthma morbidity and mortality. Education alone may not address barriers to asthma management due to psychosocial stress. This study evaluated the efficacy of a home-based family intervention integrating asthma education and strategies to address stress using a community-based participatory research model. Children age 8 to 13 with poorly controlled asthma and their caregivers were recruited from an urban hospital and an asthma camp. Caregivers with elevated scores on a stress measure were enrolled. Forty-three families were randomized to the 4- to 6-session Home Based Family Intervention (HBFI) or the single session of Enhanced Treatment as Usual (ETAU). All families received an asthma action plan and dust mite covers; children performed spirometry and demonstrated MDI/spacer technique at each home visit. The HBFI addressed family-selected goals targeting asthma management and stressors. Asthma management, morbidity, family functioning, and caregiver stress were assessed at baseline, postintervention, and 6 months after the intervention. ED visits and hospitalizations were ascertained by medical record review for a year after intervention completion. Only one child (5%) in HBFI had an asthma-related hospitalization compared to 7 patients (35%) in ETAU in the year following intervention. Participants in both groups demonstrated improved asthma management and family functioning, and reduced ED visits, symptom days, missed school days, and caregiver stress, but there were no differential treatment effects. The results suggest that a home-based intervention addressing medical and psychosocial needs may prevent hospitalizations for children with poorly controlled asthma and caregivers under stress.     

Effects of an Internet-based intervention for subthreshold eating disorders: a randomized controlled trial

BackgroundWomen reporting initial eating disorder (ED) symptoms are at highest risk for the development of an eating disorder. Preventive interventions should, therefore, be specifically tailored for this subgroup.AimsTo adapt and evaluate the effects of the Internet-based prevention program “Student Bodies?” for women with symptoms of disordered eating and/or subthreshold eating disorder (ED) syndromes.Method126 women, reporting subthreshold ED symptoms (high weight and shape concerns and below threshold bingeing, purging, chronic dieting or several of these symptoms) were randomly assigned to a Student Bodies?+ (SB+) intervention or a wait-list control group and assessed at pre-intervention, post-intervention, and 6-month follow-up. “Student Bodies?” was adapted to be suitable for subthreshold EDs. Main outcome measures were attitudes and symptoms of disordered eating. Pre-follow-up data were analyzed by ANCOVAS with mixed effects.ResultsAt 6-month follow-up, compared to participants in the control group, participants in the intervention group showed significantly greater improvements on ED-related attitudes. Intervention participants also showed 67% (95% CI = 20–87%) greater reductions in combined rates of subjective and objective binges, and 86% (95% CI = 63–95%) greater reduction in purging episodes. Also, the rates of participants abstinent from all symptoms of disordered eating (restrictive eating, binge eating and any compensatory behavior) were significantly higher in the intervention group (45.1% vs. 26.9%). Post-hoc subgroup analyses revealed that for participants with binge eating the effect on EDE-Q scores was larger than in the pure restricting subgroup.ConclusionThe adapted “SB+” program represents an effective intervention for women with subthreshold EDs of the binge eating subtype.     

Examining the initial usability,acceptability and feasibility of a digital mental health intervention for college students in India

Generalised anxiety disorder (GAD) is prevalent among college students in India; however, barriers like stigma, treatment accessibility and cost prevent engagement in treatment. Web- and mobile-based, or digital, mental health interventions have been proposed as a potential solution to increasing treatment access. With the ultimate goal of developing an engaging digital mental health intervention for university students in India, the current study sought to understand students' reactions to a culturally and digitally adapted evidence-based cognitive behavioural therapy (CBT) for GAD intervention. Specifically, through theatre testing and focus groups with a non-clinical sample of 15 college students in India, the present study examined initial usability, acceptability and feasibility of the “Mana Maali Digital Anxiety Program.” Secondary objectives comprised identifying students' perceived barriers to using the program and eliciting recommendations. Results indicated high usability, with the average usability rating ranking in the top 10% of general usability scores. Participants offered actionable changes to improve usability and perceived acceptability among peers struggling with mental health issues. Findings highlight the benefits of offering digital resources that circumvent barriers associated with accessing traditional services. Results build on existing evidence that digital interventions can be a viable means of delivering mental healthcare to large, defined populations.     

Cognitive-behavioral intervention among women with slight menopausal symptoms: a pilot study

Menopause is associated with a considerable variety of physical, psychological and social symptoms that can be treated using cognitive-behavioral techniques. In the present study, 21 women took part in an eight-week group intervention consisting of weekly two-hour sessions to address their slight symptoms related to the climacteric stage of life. The intervention included: psycho education on menopause, relaxation techniques, nutrition and fitness exercises, Kegel exercises, and problem-solving techniques. A control group was included that did not receive treatment and consisted of 28 women. The results revealed a significant reduction in most symptoms (including depression and anxiety) after intervention as compared to the baseline period. No changes appeared in the control group. The relevance of this work lies in the potential element of prevention this therapeutic package could offer to relieve various symptoms, slight and incipient, during the perimenopausal stage.     

Psychological well-being and exercise addiction: The treatment effects of an REBT intervention for females

Whilst there is growing research on the benefits of Rational Emotive Behaviour Therapy (REBT) for athletic performance and wellbeing, there has been little attention on the effectiveness of REBT for the exercising population. Recent evidence suggests that REBT may be helpful for males who show signs of exercise addiction, but the effects for females are currently unknown. The current study aims to build on the extant research by adopting a single-case research design to examine the effects of REBT on irrational beliefs, exercise addiction symptomology, psychological distress, and unconditional self-acceptance (USA) of three female exercisers. Self-report data were collected at pre-, during, and post-REBT timepoints. Visual analyses revealed reductions in irrational beliefs and psychological distress, and increases in USA, maintained two-weeks post-REBT. Exercise addiction symptomology also reduced during the intervention, and this was maintained for two out of the three exercisers post-REBT. Social validation data supported these findings. The study adds weight to the efficacy of REBT in improving exercise addiction and its comorbidities.     

Assessment of depression in college students: Geriatric Depression Scale versus Center for Epidemiological Studies Depression Scale.

103 college students took the Geriatric Depression Scale and Center for Epidemiological Studies Depression Scale along with five measures of life satisfaction. The correlation between scores on the first scales was .66. Both depression scales had moderate negative correlations (-.34 to -.71) with each measure of life satisfaction. However, on every measure of life satisfaction, the correlation with scores on the Geriatric Depression Scale was higher than with those on the CES-Depression Scale.     

Prevalence and psychosocial risk factors associated with internet addiction in a nationally representative sample of college students in Taiwan

The aim of this study was to examine the prevalence of Internet addiction in a nationally representative sample of college students and to identify any associated psychosocial risk factors. The present study was constructed using a cross-sectional design with 3,616 participants. Participants were surveyed during the middle of the spring and fall semesters and recruited from colleges around Taiwan using stratified and cluster random sampling methods. Associations between Internet addiction and psychosocial risk factors were examined using stepwise logistic regression analysis. The prevalence of Internet addiction was found to be 15.3 percent (95 percent confidence interval, 14.1 percent to 16.5 percent). More depressive symptoms, higher positive outcome expectancy of Internet use, higher Internet usage time, lower refusal self-efficacy of Internet use, higher impulsivity, lower satisfaction with academic performance, being male, and insecure attachment style were positively correlated with Internet addiction. The prevalence of Internet addiction among college students in Taiwan was high, and the variables mentioned were independently predictive in the logistic regression analysis. This study can be used as a reference for policy making regarding the design of Internet addiction prevention programs and can also aid in the development of strategies designed to help Internet-addicted college students.