Cost-effectiveness of Internet-based cognitive behavior therapy vs. cognitive behavioral group therapy for social anxiety disorder: results from a randomized controlled trial

Social anxiety disorder (SAD) is highly prevalent and associated with a substantial societal economic burden, primarily due to high costs of productivity loss. Cognitive behavior group therapy (CBGT) is an effective treatment for SAD and the most established in clinical practice. Internet-based cognitive behavior therapy (ICBT) has demonstrated efficacy in several trials in recent years. No study has however investigated the cost-effectiveness of ICBT compared to CBGT from a societal perspective, i.e. an analysis where both direct and indirect costs are included. The aim of the present study was to investigate the cost-effectiveness of ICBT compared to CBGT from a societal perspective using a prospective design. We conducted a randomized controlled trial where participants with SAD were randomized to ICBT (n = 64) or CBGT (n = 62). Economic data were assessed at pre-treatment, immediately following treatment and six months after treatment. Results showed that the gross total costs were significantly reduced at six-month follow-up, compared to pre-treatment in both treatment conditions. As both treatments were equivalent in reducing social anxiety and gross total costs, ICBT was more cost-effective due to lower intervention costs. We conclude that ICBT can be more cost-effective than CBGT in the treatment of SAD and that both treatments reduce societal costs for SAD.     

Comparison of two self-regulated and strategic instructional programs for improving writing competence

This study compared the efficacy of two versions of an instructional program aimed at developing strategic and self-regulated writing competence. In the full version, strategy instruction, students were taught strategies for producing effective text, using a combination of direct (explicit, declarative, metacognitive knowledge) instruction, teacher modeling, and collaborative and individual practice. In a modeling-only version, direct instruction was omitted. 72 Spanish 6th grade students were taught in one of three groups: Full Strategy Instruction (N=24); Modeling only (N=25), and a normal curriculum (no strategy instruction) control (N=23). Pre and posttest measures of written texts, self-efficacy and self-knowledge of writing were taken. Pre and posttest scores on writing ability tests indicated similar improvement in both intervention groups, relative to control, in both holistic measures of text quality and in counts of text features associated with mature, reader-focused composition. We found no differences between intervention groups. These findings suggest that modeling and student practice alone are sufficient to develop effective writing strategies in typically-developing 6th grade students.     

General cognitive functioning and psycholinguistic abilities in children with Smith-Magenis Syndrome

This study is a neuropsycholinguistic research of a rare genetic syndrome with microdeletion that co-occurs with intellectual disabilities and relatively good language abilities, the Smith-Magenis Syndrome (SMS). Nevertheless, there are no cognitive and psycholinguistic profile analyses performed with Spanish population. In this sense, we characterized the cognitive and psycholinguistic profile of a sample with 9 participants with SMS (7 to 11 years of age). The cognitive and psychological profile was assessed with diverse standardized tests: Wechsler Intelligence Scale for Children - IV version, Illinois Test of Psycholinguistic Abilities and Peabody Picture Vocabulary Test. Results suggest a specific cognitive and psychological profile characterized by a low IQ and relative good abilities in integrating information, whereas attention problems and hyperactive behaviors were displayed when interacting with the child during the assessment. This work is the first evidence of the cognitive and psycholinguistic profile characterization in patients with SMS in Spain, and will help to guide a more accurate diagnosis and differential intervention in rare genetic diseases with similar cognitive and psycholinguistic profiles.     

eCAT-Listening: design and psychometric properties of a computerized adaptive test on English Listening

In this study, eCAT-Listening, a new computerized adaptive test for the evaluation of English Listening, is described. Item bank development, anchor design for data collection, and the study of the psychometric properties of the item bank and the adaptive test are described. The calibration sample comprised 1.576 participants. Good psychometric guarantees: the bank is unidimensional, the items are satisfactorily fitted to the 3-parameter logistic model, and an accurate estimation of the trait level is obtained. As validity evidence, a high correlation was obtained between the estimated trait level and a latent factor made up of the diverse criteria selected. The analysis of the trait level estimation by means of a simulation led us to fix the test length at 20 items, with a maximum exposure rate of .40.     

Do adolescents who use stimulants have a different personality?

Stimulant consumption is especially important in our context because its use has greatly increased in recent years. The aim of the present study is to analyze the differences between stimulant users and nonusers (under 18 years old) in personality characteristics assessed with the MACI. The sample comprises 398 youths between 14 and 17 years old who were selected through random sampling in their homes or in recreational night spots. Results show important differences in personality features between stimulant users and nonusers. Stimulant users are characterized by having unruly, forceful, oppositional and borderline-tendency personality prototypes.     

Why are psychological treatments prolonged? Predictors of a longer duration of treatment and analysis of the differences between long- and short-term cases

The purpose of this study was to identify variables that may explain a longer psychological treatment and to analyze differences between short- and long-term cases. Data from 419 patients of the University Clinic of Psychology at the Complutense University of Madrid were analyzed. Number of intervention techniques, comorbidity, previous treatments, and a primary diagnosis of mood disorder or eating disorder were the factors that explained longer treatment duration. Significant differences were observed between short- and long-term cases in number of intervention techniques, number of therapeutic objectives, and also in some clinical variables (diagnostic group, comorbidity, previous treatment) and demographics (age and educational level). Results are discussed and some lines of intervention and/ or reflection are proposed.     

Brain dynamics associated with face-naming and the tip-of-the-tongue state

Active brain areas and their temporal sequence of activation during the successful retrieval and naming of famous faces (KNOW) and during the tip-of-the-tongue (TOT) state were studied by means of low resolution electromagnetic tomographic analysis (LORETA) applied to event-related potentials. The results provide evidence that adequate activation of a neural network during the first 500 ms following presentation of the photograph--mainly involving the posterior temporal region, the insula, lateral and medial prefrontal areas and the medial temporal lobe--is associated with successful retrieval of lexical-phonological information about the person's name. Significant differences between conditions were observed in the 538-698-ms interval; specifically there was greater activation of the anterior cingulate gyrus (ACC) towards the supplementary motor area (SMA) in the KNOW than in the TOT condition, possibly in relation to the motor response and as a consequence of the successful retrieval of lexical-phonological information about the person.     

A model of the effects of child sexual abuse on post-traumatic stress: the mediating role of attributions of blame and avoidance coping

Employing structural equation modeling, the direct and indirect effects of the severity of Child Sexual Abuse (CSA), attributions of blame for the abuse, and coping strategies on Post-traumatic Stress Disorder (PTSD) symptomatology are analyzed. The effects of other types of child maltreatment on PTSD were also controlled. The sample comprised 163 female college students who were victims of CSA. The results suggested that victims of more severe abuse showed higher levels of avoidant coping, self blame, and family blame. Having suffered other kinds of abuse or neglect was also related to higher family blame attributions. Lastly, both attributions of blame scales were indirectly related to PTSD symptomatology through avoidant coping. The strong relationships between attributions of blame, coping strategies, and PTSD suggest that it might be useful to intervene early with children who have suffered CSA in an effort to modify the attributions they make about the abuse and the way they cope with it.     

Weekend alcoholism in youth and neurocognitive aging

Numerous studies have shown that alcohol intake causes neuropsychological disorders that affect various brain structures. The ?premature ageing? hypothesis proposes that the brain areas of alcoholics undergo deterioration similar to that observed in old age. We investigated whether alcohol abuse by young people (binge drinking) causes alterations comparable to some found in elderly people. Ninety-one people were divided into four groups: a) young people who abused alcohol; b) young people who drank alcohol in moderation; c) young people who did not drink alcohol; and d) elderly adults without any significant cognitive deterioration. All of them were assessed with a neuropsychological battery. We observed some similarities in the results obtained by young drinkers and the elderly participants, which would provide some support for the hypothesis of premature aging. The tasks that young drinkers performed worse were those related to executive functions, in which the prefrontal cortex plays an essential role. We also found differences between the two groups of young drinkers (moderate and high consumption), which leads us to believe that the amount of alcohol consumed and the pattern of consumption are factors to consider in relation to cognitive impairment.     

Selective attention and distractor frequency in naming performance: comment on Dhooge and Hartsuiker (2010)

E. Dhooge and R. J. Hartsuiker (2010) reported experiments showing that picture naming takes longer with low- than high-frequency distractor words, replicating M. Miozzo and A. Caramazza (2003). In addition, they showed that this distractor-frequency effect disappears when distractors are masked or preexposed. These findings were taken to refute models like WEAVER++ (A. Roelofs, 2003) in which words are selected by competition. However, Dhooge and Hartsuiker do not take into account that according to this model, picture-word interference taps not only into word production but also into attentional processes. Here, the authors indicate that WEAVER++ contains an attentional mechanism that accounts for the distractor-frequency effect (A. Roelofs, 2005). Moreover, the authors demonstrate that the model accounts for the influence of masking and preexposure, and does so in a simpler way than the response exclusion through self-monitoring account advanced by Dhooge and Hartsuiker.