Indirect self-destructive behavior in patients with Buerger's disease.

Patients with Buerger's disease (a circulatory illness) were studied to evaluate indirect self-destructive behavior (ISDB), evidence by neglect in following medical regimen, disregard of suggestions for environmental imporvements (avoidance of undue exposure to cold) and refusal to abstain from smoking. Personality characteristics and behavioral phenomena associated with ISDB were obtained by comparison of the files of 26 uncooperative patients with 26 matched cooperative controls with Buerger's disease and with 25 Buerger's disease patients representing a unselected annual population in a Veterans Administration (VA) hospital. The experimental group was characterized as more often complaining, manipulative, and aggressive. They manifested denial, negligence, and a tendency to minimize their illness. They were more likely to complain of pain and to demand relief. In a second clinical investigation of patients still in the hospital, 12 experimentals were compared with 12 controls using interview data and psychological tests measuring attitudes toward time and toward death. The experimentals did not seem to value time nor to be interested in achievement. They felt that a dull life was worse than death.     

Independence training vs modeling procedures for teaching phone conversation skills to the mentally retarded

Forty-five mildly mentally retarded adults were assessed for deficits in telephone conversational skills. They were ranked on the basis of their pretest scores and matched into triplets on skill level. One member from each of these groups was then randomly assigned to either a no-treatment control group, a modeling condition or independence training—a treatment that incorporated social reinforcement, instructions, performance feedback, modeling, shaping by successive approximations and self-monitoring and evaluation. For the two latter conditions, treatment was provided three times weekly for 2 months in group sessions (N = 5) of 1 hr duration. The dependent variable, conversational skills of subjects was assessed at pretest, posttest and at a 3-month follow-up based on verbal responses that subjects made to nine questions asked by an experimenter and related social responses during a phone call. Independence training proved to be significantly more effective than the other two experimental conditions at posttest and follow-up. In addition, modeling proved to be significantly more effective than the no-treatment controls at both of these assessment points.     

An Evaluation of Two Types of Cognitive Intervention in the Management of Chronic Tinnitus

Abstract

Fifty-four subjects with chronic distressing tinnitus were randomly allocated to one of four experimental treatment conditions: (1) attention control and imagery training (AC1); (2) cognitive restructuring (CR); (3) combined attention control and imagery training plus cognitive restructuring (ACI + CR); and (4) a waiting list control (WLC). Significant overall improvements were found on measures of distress associated with tinnitus, and on a number of other measures of cognition and coping strategies. These improvements were maintained at the six-month follow-up. Relative to the WLC, the three treatment conditions (combined) were associated with improvements in tinnitus-related distress, reductions in tinnitus-related dysfunctional cognitions and an increase in the frequency of use of coping strategies. There was a significant effect in favour of the ACI group compared to the CR group on the measure of irrational beliefs. The analyses also revealed that the combined treatment condition (ACI + CR) showed significantly greater improvement on a measure of psychological distress and achieved a higher clinical response rate compared to the two single treatments. There were significant improvements from pretreatment to follow-up on some measures, although the mean scores revealed that some of the gains had been lost at this stage on the main measure of tinnitus-related distress. There were no significant group X time effects for any of the dependent variables at the six-month follow-up. The results were interpreted as supporting the practice of combining the two cognitive approaches.     

Assertive training for agoraphobics

Twenty-one unassertive agoraphobic patients were assigned to one of three treatments: (1) prolonged exposure in vivo, (2) assertive training and (3) a combination of assertive training and prolonged exposure in vivo. Each treatment was conducted in groups which were led by two therapists. Assessments involved both phobic targets and assertiveness, and were made before and after treatment, and at 1-month follow-up. Exposure in vivo was found to be superior to assertive training on phobic targets. Assertive training produced greater gains in assertiveness than exposure in vivo. The combination of treatments produced results comparable to exposure in viro. Results indicated that the type of change produced by the treatments is a rather specific one and is related to the specific target of treatment.     

Changing unbalanced coping profiles-A prospective controlled intervention trial in worksite health promotion

Abstract

Effective coping is based upon a broad variety of available strategies and a good balance between instrumental and palliative coping efforts. Thus, stress management training (SMT) should focus on broadening and balancing individual coping-profiles. This study investigated changes in coping profiles after participation in SMT at the worksite. The sample consisted of 82 healthy working persons who participated in a 12-week-SMT and 55 matched controls without intervention. The SMT consisted of six training elements: three of them (assertiveness, cognitive restructuring and time management) addressed instrumental coping and the other three (relaxation, physical activity and scheduling of pleasant activities) focussed on palliative coping. All subjects filled in standardized questionaires on coping, well-being and strain before and after the training. Cluster analyses performed on initial coping scores resulted in a 3-cluster solution: (1) “active flexible coping” (n = 53), (2) “problem-focused coping” (n = 40) and (3) “resignative avoidant coping” (n = 44). Analyses of covariance revealed that SMT-participants of Cluster 2 showed significant improvements regarding emotion-focused coping and those of Cluster 3 regarding problem-focused coping compared to controls of the same cluster. There were also significant associations between these clusterspecific changes of coping and improvements of well-being. In consequence, the SMT improved coping by supplementing one-sided initial coping-profiles.     

Training career adaptability to facilitate a successful school-to-work transition

The transition from school to work is one of the most critical steps in graduates' careers, as it can determine vocational outcomes and future career success. Yet, these newcomers to the labor market often take longer than regular job seekers to find a suitable job, are more likely to experience a job mismatch and to suffer from underemployment. In this study, we proposed that career adaptability might help remedy this problem. We therefore developed a training aimed at providing graduates with career adaptability resources, with the assumption that this may foster training-participants' later career adaptability and employment quality. A longitudinal field quasi-experiment compared the development of each career adaptability dimension between a training group (n = 32) and a control group (n = 24) over three points in time (pre-training measurement, post-training measurement and follow-up measurement six months later). Repeated measures analyses showed an overall increase in concern, control and curiosity within the training group, whereas there was no increase (concern) or even an overall decrease (control and curiosity) within the control group. Consequently, the training succeeded in enhancing participants' control and curiosity in the long run. Furthermore, among participants who had found employment half a year later, training participants reported higher employment quality than did members of the control group. In sum, results show that providing graduates with career adaptability resources can raise their chances on finding a qualitatively good job.     

Computer-assisted dieting: Effects of a randomised controlled intervention

In this pilot study, the effects of two computer-assisted dieting (CAD) interventions on weight loss and blood chemistry were examined among overweight and obese adults. Participants (91 community members, average age 42.6 years) were randomly assigned to CAD-only (a single-session introduction and provision of a dieting software, n = 30), CAD plus an additional four-session self-management group training (CAD+G, n = 31) and a waitlist control group whose members were randomised into the two interventions at the 3-month follow-up (n = 30). A three (group)-by-two (time) repeated measures ANOVA revealed no significant group by time interaction during the initial 3-month period. However, the two intervention groups combined showed a significant, though moderate weight loss relative to the control group. Further, although a general improvement was found with regard to the lipid panel results during the first 3 months of the trial, the treatment by time interaction was not significant. A comparison of the developments in the two intervention groups during the 3- to 6-month follow-up time period revealed a tendency towards greater weight regain in the CAD-only condition. The evidence suggests that CAD supports initial weight loss; however, additional self-management training might be necessary to support maintenance.     

A Randomized Test of Interpretation Bias Modification for Perfectionism Versus Guided Visualization Relaxation Among High Perfectionistic Undergraduate Students

Clinical perfectionism contributes to the onset and maintenance of multiple psychological concerns. We conducted a randomized, longitudinal test of the efficacy of a web-based intervention for perfectionism (specifically, cognitive bias modification, interpretation retraining; CBM-I), compared to an active treatment comparison condition (specifically, guided visualization relaxation training) for reducing perfectionism and related psychopathology. College students (N = 167) with elevated perfectionism were randomized to one of the two study conditions and were asked to complete their assigned intervention twice weekly for 4 weeks. Participants completed measures of perfectionism and psychological symptoms at baseline, 2 weeks (midway through the intervention period), 4 weeks (at the conclusion of the intervention period), and 8 weeks (1 month follow-up). CBM-I was rated as acceptable overall, though relaxation training was rated slightly more favorably. CBM-I outperformed relaxation training on improving perfectionism-relevant interpretation biases (i.e., increasing nonperfectionistic interpretations and decreasing perfectionistic interpretations), though with small effect sizes and inconsistency across study timepoints. Self-reported perfectionism showed small decreases across time in both intervention conditions. Support was found for a key hypothesized mechanism of CBM-I, such that randomization to CBM-I had a longitudinal, indirect effect on decreasing psychopathology symptom scores through improving perfectionism-relevant interpretation biases. However, in light of small effect sizes, the present study failed to provide compelling evidence that CBM-I for perfectionism contributes meaningfully to the treatment of perfectionism.     

Enhanced response inhibition during intensive meditation training predicts improvements in self-reported adaptive socioemotional functioning

We examined the impact of training-induced improvements in self-regulation, operationalized in terms of response inhibition, on longitudinal changes in self-reported adaptive socioemotional functioning. Data were collected from participants undergoing 3 months of intensive meditation training in an isolated retreat setting (Retreat 1) and a wait-list control group that later underwent identical training (Retreat 2). A 32-min response inhibition task (RIT) was designed to assess sustained self-regulatory control. Adaptive functioning (AF) was operationalized as a single latent factor underlying self-report measures of anxious and avoidant attachment, mindfulness, ego resilience, empathy, the five major personality traits (extroversion, agreeableness, conscientiousness, neuroticism, and openness to experience), difficulties in emotion regulation, depression, anxiety, and psychological well-being. Participants in Retreat 1 improved in RIT performance and AF over time whereas the controls did not. The control participants later also improved on both dimensions during their own retreat (Retreat 2). These improved levels of RIT performance and AF were sustained in follow-up assessments conducted approximately 5 months after the training. Longitudinal dynamic models with combined data from both retreats showed that improvement in RIT performance during training influenced the change in AF over time, which is consistent with a key claim in the Buddhist literature that enhanced capacity for self-regulation is an important precursor of changes in emotional well-being.     

Group interpersonal skills training in a natural setting: an experimental study.

This study assessed effectiveness of group interpersonal skills training conducted in a natural setting with nonanalogue clients. Subjects (Ss) in a behavioral-training condition received 4 hr of instruction consisting of modeling, behavioral rehearsal, coaching, feedback and reinforcement. Training focused on positive and negative social responses and on initiating interactions, as well as reacting to interactions initiated by others. Subjects in a discussion-control condition engaged in focused discussion of interpersonal concerns but received no experiential practice. Within a pre-test-post-test control group design, subjective and objective measures were used to assess training effects. When compared to Ss involved in group discussion. Ss participating in group behavioral training revealed greater pre- to post-test changes on selfreported probability of engaging in selected interpersonal responses and on objective measures of eye contact, speech duration, positive affective responses, use of no-statements, compliance, refusals and requests for new behavior. Support for generalization of training is presented and methodological issues are discussed.     

Covert and overt rehearsal and elaboration during treatment in the development of assertive behavior

The present investigation examined the effects of covert and overt rehearsal and client elaboration of situations designed to train assertive behavior. Nonassertive clients (n = 61) received one of four treatments resulting from the 2 × 2 factorial combination of Modality of Rehearsal (covert vs overt) and Elaboration (elaboration vs no elaboration of training situations). A delayed-treatment group was included in the design to serve as a no-treatment control condition before subjects were assigned randomly to one of the above treatments. Treatment led to significant improvements on self-report and behavioral measures of assertiveness and self-efficacy. Covert and overt rehearsal were equally effective. However, elaboration of training situations significantly enhanced the effects of covert and overt rehearsal. Treatment effects were maintained up to a 6-month follow-up, transferred to novel role-playing situations, and brought clients within the range of other subjects (n = 45) who regarded themselves as adept in social situations requiring assertive behavior and who had not sought treatment.     

Cognitive changes associated with social skills training

Changes in locus of control and self-esteem during social skills training and at 6 month follow-up were investigated. Forty-four adolescent, male offenders were randomly assigned to a social skills training, attention-placebo, or no-treatment control procedure. The results showed that pre- to post-training increases in self-esteem were produced for both the social skills training and attention-placebo control groups, but not for the no-treatment control group. These increases did not continue during the follow-up phase; the social skills training group, which showed the greatest improvement during training, displayed a decrease in self- esteem during follow-up.The locus of control measures showed a statistically significant shift towards internality for the social skills training group during training, which was not found for the attention-placebo and no-treatment controls. During the follow-up phase, all three groups showed a statistically significant shift towards externality, suggesting a tendency for boys to view their behaviour and consequences as being under the control of chance factors or powerful others, during institutionalization. This effect was partly reversed during training for the social skills training group, but the effect was not long lasting. It seems therefore that social skills training is effective in producing an increase in self-esteem and a shift towards internal locus of control. These changes are, however, of short duration and the self-esteem shift may be the result of increased staff contact or other non-specific therapy factors.     

Training career adaptability to facilitate a successful school-to-work transition

The transition from school to work is one of the most critical steps in graduates' careers, as it can determine vocational outcomes and future career success. Yet, these newcomers to the labor market often take longer than regular job seekers to find a suitable job, are more likely to experience a job mismatch and to suffer from underemployment. In this study, we proposed that career adaptability might help remedy this problem. We therefore developed a training aimed at providing graduates with career adaptability resources, with the assumption that this may foster training-participants' later career adaptability and employment quality. A longitudinal field quasi-experiment compared the development of each career adaptability dimension between a training group (n = 32) and a control group (n = 24) over three points in time (pre-training measurement, post-training measurement and follow-up measurement six months later). Repeated measures analyses showed an overall increase in concern, control and curiosity within the training group, whereas there was no increase (concern) or even an overall decrease (control and curiosity) within the control group. Consequently, the training succeeded in enhancing participants' control and curiosity in the long run. Furthermore, among participants who had found employment half a year later, training participants reported higher employment quality than did members of the control group. In sum, results show that providing graduates with career adaptability resources can raise their chances on finding a qualitatively good job.     

Reducing Test Anxiety in School Settings: A Controlled Pilot Study Examining a Group Format Delivery of the Attention Training Technique Among Adolescent Students

Researchers have called for the examination of test anxiety interventions that extend beyond the delivery of individual services by a trained professional. Following from conceptual models and research findings underscoring the importance of metacognitive beliefs to test anxiety, a controlled pilot study examined whether a group format delivery of the attention training technique (ATT) component of metacognitive therapy reduces test anxiety among eighth-grade students. Students completed baseline study measures and were allocated based upon class period to five sessions of ATT (n = 39) or a music listening control (n = 34) delivered within a group format during a school week. Students completed postintervention study measures on the final day of the intervention and completed follow-up study measures approximately 3 weeks following the intervention. As predicted, students receiving ATT reported less postintervention test anxiety than the control when they held stronger baseline metacognitive beliefs about worry. The patterns of findings held at the follow-up and when specifically examining the cognitive (i.e., worry) dimension of test anxiety. Study results suggest that ATT may be a viable test anxiety intervention for students holding heightened metacognitive beliefs about worry. Future directions are discussed.     

A transfer of self-discrimination response functions through equivalence relations

The present study tested the idea that human self-discrimination response functions may transfer through equivalence relations. Four subjects were trained in six symbolic matching-to-sample tasks (if see A1, choose B1; A1-C1, A2-B2, A2-C2, A3-B3, A3-C3) and were then tested for the formation of three equivalence relations (B1-C1, B2-C2, B3-C3). Two of the B stimuli (B1 and B2) were then used to train two different self-discrimination responses using either detailed instructions (Subjects 1 to 3) or minimal instructions (Subject 4) on two complex schedules of reinforcement (i.e., subjects were trained to pick the B1 stimulus if they had not emitted a response, and to pick the B2 stimulus if they had emitted one or more responses on the previous schedule). All 4 subjects showed the predicted transfer of self-discrimination response functions through equivalence relations (i.e., no response on the schedule, pick C1; one or more responses on the schedule, pick C2). Subjects also demonstrated this transfer when they were required to discriminate their schedule performance before exposure to the schedule (i.e., “what I intend to do”). Four control subjects were also used in the study. Two of these (Subjects 5 and 6) were not exposed to any form of matching-to-sample training and testing (nonequivalence controls). The 2 remaining subjects (7 and 8) were exposed to matching-to-sample training and testing that incorporated stimuli not used during the transfer test; C1 and C2 were replaced by N1 and N2 during the matching-to-sample training and testing, but C1 and C2 were used for the transfer tests (equivalence controls). All 4 subjects failed to produce the self-discrimination transfer performances observed with the experimental subjects.     

Parent Programs for Reducing Adolescent’s Antisocial Behavior and Substance Use: A Randomized Controlled Trial

Two theoretically based parent training programs, delivered in real-world settings by the social services, were examined in this randomized controlled trial for effectiveness in reducing adolescents’ antisocial behavior and substance use. Two hundred and thirty-seven (237) adolescents in ages between 12 and 18 and their parents were assigned to one of two programs or to a wait-list control condition. The programs were the nine weekly group sessions program Comet 12–18 (Swedish Parent Management Training Program) and the six weekly ParentSteps (Swedish shortened version by Strengthening Families Program 10–14). Outcome measures were antisocial behavior, substance use, and delinquency, and psychosocial dysfunction. Data based on adolescents’ and parents’ ratings of the adolescents’ problem behavior at baseline and 6 months later were analyzed with repeated measures ANVOA, Logistic regression, and Kruskal–Wallis H test. The results showed that parents’ ratings of adolescents’ antisocial behaviors decreased significantly over time, but no time by group effect emerged. No program effects were found in the adolescents’ self-reported antisocial behavior, delinquency, or psychosocial functioning. A threefold risk of illicit drug use was found in both intervention groups. The results suggest that neither Comet nor ParentSteps had beneficial effects on adolescent’s antisocial or delinquent behavior, or on alcohol use. The only significant group difference found was a threefold risk of drug use in the intervention adolescents at follow-up, but for several reasons this finding should be interpreted with caution. Trial registration number: ISRCTN76141538.     

Refreshing Older Adults’ Driving Skills (ROADSkills): A randomized controlled trial examining the effect of video feedback

ObjectivesThis study evaluated the effectiveness of a personalized video-based driver training program on the behind-the-wheel skills of community-dwelling older adults.MethodIn this randomized controlled trial (RCT), 80 older drivers [mean age (SD) = 71.0 (3.9)] were randomly assigned to view one of two educational videos: 1) personalized video feedback on their driving (n = 40) or 2) a generic video on aging-in-place (n = 40). The primary outcome, the total number of errors accrued in a 30-minute standardized on-road evaluation, was analyzed at baseline and 4 weeks after watching the assigned video. On-road evaluations were video-recorded and scored by a blinded rater. Self-report measures of driving abilities, behaviors, and comfort were also compared.ResultsAt the 4-week follow-up, the mean difference in the number of on-road performance errors [mean (95% CI) = -12.0 (-16.6, −7.4), p < 0.001] favored the intervention group compared to controls, with significant improvements across multiple domains: vehicle control [mean (95% CI) = -4.8 (-8.1, −1.5), p < 0.01], observing the roadway [mean (95% CI) = -5.5 (-8.4, −2.6), p < 0.001], and compliance with traffic rules [mean (95% CI) = -1.3 (-2.3, −0.2), p < 0.05]. Within-group change on behind-the-wheel errors was significant for the intervention group [mean (95% CI) = -10.3 (-13.5, −7.1), p < 0.001], but not for the control group [mean (95% CI) = 1.7 (-1.6, 4.9), p > 0.05]. No significant differences were found on the self-report measures.DiscussionA novel, video-based approach that provided personalized feedback to older drivers significantly reduced behind-the-wheel errors 4-weeks post-intervention. Changes in self-reported driving behaviors and abilities were not significant. Future research will examine the long-term effects of this approach on older adults’ actual and perceived driving abilities.     

Increasing Middle School Students’ Life Satisfaction: Efficacy of a Positive Psychology Group Intervention

This study identified middle school students who were less than delighted with their lives (reported life satisfaction scores between 1 and 6 on a 7-point scale), and attempted to improve these students’ mental health via a 10-week group wellness-promotion intervention developed from prior applications of positive psychology research. Complete data at baseline, post-intervention, and 6-month follow-up was gathered from 55 sixth grade students who were randomly assigned to the intervention condition (n = 28) or wait-list control (n = 27). Repeated measures analyses of a propensity score matched sample of 40 participants indicated a significant group by time interaction for global life satisfaction from baseline to post-intervention. Specifically, life satisfaction of students in the intervention group increased significantly, while the control group declined during the same period (although this change was not statistically significant). The intervention group’s gains were maintained at follow-up, but were matched by similar gains for students in the control group. No effects of intervention group were identified in the indicators of affect or psychopathology. The improvements in life satisfaction evidenced by students in the intervention group during the first semester of middle school are important given the adjustment difficulties that often appear during this sensitive developmental period marked by biological and educational changes.     

The effects of mindfulness training on beginners' skill acquisition in dart throwing: A randomized controlled trial

ObjectivesThe present study was into whether or not mindfulness training, based on the mindfulness-acceptance-commitment approach (MAC), can improve beginners' skill acquisition of dart throwing.DesignRandomised controlled trial.MethodsA total of 43 first-year college students who had not played darts professionally prior to the study were randomly assigned to either an attention control group (n = 21) or a mindfulness training group (n = 22) during an eight-week dart training program. Dart throwing and psychological variables were assessed at pre-intervention, post-intervention, and two-week follow-up.ResultsTwo-way repeated measures ANOVA revealed that the mindfulness group, but not the attention control group had significant improvements in mindfulness, experiential acceptance, and flow at post-intervention and follow-up. Although both groups improved dart throwing performance after the intervention, the improvement of the mindfulness group was statistically higher in comparison to that of the attention control group.ConclusionsIt was concluded that the MAC approach could improve the performance and adaptive sport experience of beginners in dart throwing.