Meta-analysis of CBT for Bulimia Nervosa: Investigating the Effects Using DSM-III-R and DSM-IV Criteria

This meta-analysis reports the effects of cognitive-behavioural treatment (CBT) on bulimia nervosa as defined by the DSM-III-R or DSM-IV criteria. In a previous meta-analysis, 26 studies were included using less strict diagnostic criteria for inclusion. The present meta-analysis only included randomized controlled studies fulfilling the DSM-III-R or DSM-IV criteria. Computer searches in MedLine, PsychLIT and references cited herein resulted in a large number articles, of which only seven fulfilled the criteria for inclusion. Effect sizes for binge eating and purging frequency were estimated using both between-group (treatment vs control) and within-group (pre- vs post-treatment) comparisons. The combined within-group effect size for binge eating was r = 0.55 ( d = 1.32) and for purging r = 0.61 ( d = 1.54). The corresponding combined effects for the between-group comparisons were r = 0.23 ( d = 0.47) and r = 0.28 ( d = 0.58), respectively. The combined probabilities for frequency of purging in between- and within-group comparisons were p = 0.00001 and p = 0.00000001, respectively. Although the number of studies included in the meta-analysis was limited, the obtained results are in line with the findings of the previous meta-analysis, and support the efficacy of CBT for the treatment of bulimia nervosa. This suggestion is also supported by the fact that in all the studies except one, comparison groups had received other active treatments.     

Last issue of SJBT

Abstract

A system providing prompts (verbal encouragement) at prearranged time intervals was used with a woman with total blindness and profound intellectual disability who had discontinuous performance. The woman was to transport objects from one end of a corridor to the other (a space in which orientation was not a problem) and then assemble them. Data indicated that there was a clear increase in the number of objects transported and assembled in the sessions with the prompting system. Implications of the findings are discussed.     

Dogs demonstrate perspective taking based on geometrical gaze following in a Guesser–Knower task

Currently, there is still no consensus about whether animals can ascribe mental states (Theory of Mind) to themselves and others. Showing animals can respond to cues that indicate whether another has visual access to a target or not, and that they are able to use this information as a basis for whom to rely on as an informant, is an important step forward in this direction. Domestic dogs (Canis familiaris) with human informants are an ideal model, because they show high sensitivity towards human eye contact, they have proven able to assess the attentional state of humans in food-stealing or food-begging contexts, and they follow human gaze behind a barrier when searching for food. With 16 dogs, we not only replicated the main results of Maginnity and Grace (Anim Cogn 17(6):1375–1392, 2014) who recently found that dogs preferred to follow the pointing of a human who witnessed a food hiding event over a human who did not (the Guesser–Knower task), but also extended this finding with a further, critical control for behaviour-reading: two informants showed identical looking behaviour, but due to their different position in the room, only one had the opportunity to see where the food was hidden by a third person. Preference for the Knower in this critical test provides solid evidence for geometrical gaze following and perspective taking in dogs.     

Internet-delivered transdiagnostic and tailored cognitive behavioral therapy for anxiety and depression: a systematic review and meta-analysis of randomized controlled trials

Anxiety and depressive disorders are often comorbid. Transdiagnostic and tailored treatments seem to be promising approaches in dealing with comorbidity. Although several primary studies have examined the effects of Internet-delivered cognitive behavior therapy (iCBT) for anxiety and depression, no meta-analysis including different types of iCBT that address comorbidity has been conducted so far. We conducted systematic searches in databases up to 1 July 2016. Only randomized trials comparing transdiagnostic/tailored iCBT for adult anxiety and/or depression with control groups were included. Nineteen randomized trials with a total of 2952 participants that met inclusion criteria were analyzed. The quality of the studies was high, however the blinding criteria were not fulfilled. The uncontrolled effect size (Hedges’ g) of transdiagnostic/tailored iCBT on anxiety and depression outcomes was large and medium for quality of life. The controlled effect size for iCBT on anxiety and depression outcomes was medium to large (anxiety: g = .82, 95% CI: .58–1.05, depression: g = .79, 95% CI: .59–1.00) and medium on quality of life (g = .56, 95% CI: .37–.73). Heterogeneity was small (quality of life) to moderate (anxiety, depression). There was a large effect on generic outcome measures and a moderate effect on comorbidities. When compared to disorder-specific treatments there were no differences on anxiety and quality of life outcomes, however there were differences in depression outcomes. Transdiagnostic and tailored iCBT are effective interventions for anxiety disorders and depression. Future studies should investigate mechanisms of change and develop outcome measures for these interventions.     

Reimagining gender in psychology: What can critical psychology offer?

In this article, I argue that gender is a complex sociocultural construct, yet how gender is accounted for in psychological research is limited. Specifically, psychologists conflate sex with gender, rely on quantifying gender differences and, by implication, conceptualise gender as merely a participant characteristic. To illustrate, I apply this viewpoint to the topic of gender differences in tobacco use/cessation using on a feminist quality appraisal tool. I show how these three issues promote the narrow study of sex/gender differences, despite problems surrounding this inquiry, and reduce insights into the intersection of gender and behaviour. To offer a way forward for psychology, I describe how a critical psychology perspective attends to the complexities of gender and its influence on behaviour. I showcase diverse ways of attending to gender as a sociocultural construct, inviting psychologists to engage with, and reflect on, their gender analyses.     

Differences in baseline and process variables between non-responders and responders in Internet-based cognitive behavior therapy for chronic tinnitus

Although Internet-based cognitive behavior therapy (iCBT) is an effective treatment for chronic tinnitus, several patients do not improve. In the current study, baseline and process variables were compared between non-responders and responders. Data from patients participating in two randomized controlled trials on iCBT for chronic tinnitus were re-analyzed. Based on the literature, a pre-post difference on the “Tinnitus Handicap Inventory” (THI) of less than seven points improvement was used to operationalize non-response. Associations between non-response and baseline variables (age, gender, and questionnaire scores), patient progress (THI), the process of the therapeutic alliance (“Working Alliance Inventory-Short Revised”; WAI-SR), as well as other process variables (number of logins, amount of messages sent from therapists to patients) were investigated. The results showed that non-responders had a less favorable change on the THI than responders already at mid-treatment (p < .05). The alliance (WAI-SR) during iCBT was not associated with non-response. Non-responders showed more severe sleep disturbances, logged in less in the iCBT platform, and received fewer messages from the therapists than responders, but these differences were mostly not significant anymore when correcting for multiple testing. To conclude, no symptom change in the first half of iCBT for chronic tinnitus patients is a risk factor of not benefiting from iCBT.     

Effects of social isolation and environmental enrichment on atherosclerosis in ApoE-/- mice

Social support and a stimulating environment have been suggested to reduce stress reactions and cardiovascular risk. The aim of this study was to assess the role of environmental enrichment and social interaction for development of atherosclerosis in atherosclerosis prone mice. Male ApoE-/- mice were divided into four groups and followed during 20 weeks: (i) enriched environment (E, n=12), (ii) deprived environment (ED, n=12), (iii) enriched environment with exercise (E-Ex, n=12) and (iv) socially deprived by individual housing (SD, n=10). Plasma lipid and cytokine concentrations were measured. Atherosclerosis was quantified in cross-sections of innominate artery and en face in thoracic aorta. Plaque area was significantly increased in SD mice in the innominate artery (P<0.05 vs. all other groups), but not in the thoracic aorta. Plasma lipids were increased in SD mice (P<0.001 vs. all for total cholesterol, P<0.05 vs. E and P<0.01 vs. ED for triglycerides). Plasma concentration of granulocyte-colony stimulating factor (G-CSF) was decreased in SD mice compared to E mice (P<0.05). Thus, social isolation increased atherosclerosis and plasma lipids in ApoE-/- mice. Reduction in plasma G-CSF levels may hamper endothelial regeneration in the atherosclerotic process. While environmental enrichment did not affect atherosclerosis, social isolation accelerated atherosclerosis.     

The relation between employee organizational and professional development activities

A model is presented showing hypothesized common and parallel antecedents of employee organizational development activity (ODA) versus professional development activity (PDA). A common antecedent is expected to affect both ODA and PDA, while a parallel antecedent is expected to affect its corresponding work referent. This model was tested using a sample of 197 medical technologists over a four year time period. Prior ODA and PDA were controlled for before testing hypotheses. Results showed that the common antecedent of learning motivation was a robust indicator of both ODA and PDA. Looking at parallel antecedents, job satisfaction and affective organizational commitment had a positive impact on ODA, while occupational satisfaction and affective occupational commitment had a positive impact on PDA. ODA had a negative impact on subsequent intent to leave organization, but PDA did not have a similar impact on intent to leave profession. Study limitations, issues around operationalizing ODA and PDA, and future research directions are discussed.     

Paruresis

The paruretic disorder, a special subtype of social phobia, is presented. It has been almost completely neglected by German research. The disorder manifests in an inability to urinate in public rest rooms. The corresponding fears concern the loss of visual and/or acoustic privacy. Based on considerations about its etiology and pathogenesis a cognitive behavior-therapeutic intervention is recommended. This is illustrated by a case vignette of a 29-year-old male patient.     

Long-term outcome of Internet-delivered cognitive-behavioural therapy for social phobia: A 30-month follow-up

Internet-delivered guided cognitive behaviour therapy for social anxiety disorder has been found to generate promising short-term results, up to one year posttreatment. No study has however documented longer follow-up periods. In this 30-month follow-up we contacted 57 participants from the original study of which 77.2% (44/57) responded to the Internet-administered outcome measures and 66.7% (38/57) completed a telephone interview. Results showed large pretreatment to follow-up within-group effect sizes for the primary outcome measures (Cohen's d 1.10-1.71), and a majority (68.4%; 26/38) reported improvements in the interview. The findings suggest that the long-term effects seen in previous live treatment CBT trials can occur in Internet-delivered treatment as well.