Randomised controlled trial of a guided self-help treatment on the Internet for binge eating disorder

Binge eating disorder (BED) is a common and under-treated condition with major health implications. Cognitive behavioural therapy (CBT) self-help manuals have proved to be efficient in BED treatment. Increasing evidence also support the use of new technology to improve treatment access and dissemination. This is the first randomised controlled study to evaluate the efficacy of an Internet guided self-help treatment programme, based on CBT, for adults with threshold and subthreshold BED. Seventy-four women were randomised into two groups. The first group received the six-month online programme with a six-month follow-up. The second group was placed in a six-month waiting list before participating in the six-month intervention. Guidance consisted of a regular e-mail contact with a coach during the whole intervention. Binge eating behaviour, drive for thinness, body dissatisfaction and interoceptive awareness significantly improved after the Internet self-help treatment intervention. The number of objective binge episodes, overall eating disorder symptoms score and perceived hunger also decreased. Improvements were maintained at six-month follow-up. Dropouts exhibited more shape concern and a higher drive for thinness. Overall, a transfer of CBT-based self-help techniques to the Internet was well accepted by patients, and showed positive results for eating disorders psychopathology.     

Cognitive behavioural treatment for chronic fatigue syndrome in a rehabilitation setting: effectiveness and predictors of outcome

Cognitive behavioural therapy (CBT) was combined with graded exercise therapy (GET) for patients with chronic fatigue syndrome (CFS) in an uncontrolled implementation study of an inpatient multidisciplinary group therapy. During the intake procedure, 160 CFS patients completed a questionnaire on fatigue related measurements, physical impairment, depression, somatic and psychological attributions, somatic focus, and sense of control over symptoms. Pre-treatment physical activity level was measured with an actometer. At baseline, post-treatment and 6-month follow-up individual strength, subjective fatigue and physical impairment, were reassessed. Large effect sizes were found on subjective fatigue (1.2 post-treatment; 1.2 follow-up) and physical impairment (−.9 post-treatment; −.9 follow-up), Clinically significant improvement was found in 33.8% of the participants at post-treatment and 30.6% at follow-up. Individual strength at post-treatment was predicted by level of physical activity before treatment, and by sense of control over symptoms and physical activity at follow-up. Clinically significant improvement in subjective fatigue was predicted by not receiving a disablement insurance benefit, shorter duration of fatigue, higher sense of control over symptoms and, at follow-up by more pre-treatment physical activity. In conclusion, the intervention was effective for CFS patients. Cognitive behavioural factors that perpetuate fatigue symptoms are also predictors of treatment outcome.     

Cognitive reappraisal and acceptance: an experimental comparison of two emotion regulation strategies

The purpose of the present study was to compare the effect of cognitive reappraisal and acceptance on subjective distress, physiological reactions and behavioral avoidance in relation to aversive emotional states elicited by film-clips. Ninety-four participants were randomized to one of three groups. The Reappraisal group was instructed to think about what they saw in a way that minimized negative emotional reactions, the Acceptance group was told to let their feelings come and go without trying to control or avoid them, while the Watch (control) group was told just to watch the film-clips. Compared to the control condition, both reappraisal and acceptance led to significant reductions of subjective distress, physiological reactions associated with aversive emotions and behavioral avoidance. On the three types of measures there were few significant differences between the Reappraisal and Acceptance groups, but when such differences existed they were to the benefit of the Reappraisal condition. In the reappraisal condition there was however a positive correlation between elicited aversive emotion and avoidance, while no such correlation existed in the acceptance condition. The results are interpreted and discussed in relation to the theories underlying reappraisal and acceptance as well as the conceptual framework for emotion regulation established by Gross (2007).     

Reduced ADHD symptoms in adults with ADHD after structured skills training group: results from a randomized controlled trial

Objective

Feasibility, acceptability, and efficacy of a Dialectical Behavioral Therapy (DBT) -based method developed in Germany were evaluated in a Swedish outpatient psychiatric context.

Method

Fifty-one adults with ADHD on stable medical treatment or on no medication were randomized to the DBT-based skills training (n = 26) or a parallel loosely structured discussion group (n = 25). Self-rating scales were administered before randomization and after the treatment.

Results

Feasibility and participant satisfaction were good in both groups while skills training was perceived as more logical and effective for ADHD-related problems. The analyses of the individuals who completed the treatment and remained stable with regard to medication (n = 19 in skills training; n = 18 in control group) showed a significant reduction in ADHD symptoms in the skills training group, but not in the control group. No reduction of comorbidity was observed in any of the groups.

Conclusions

The treatment was feasible in an outpatient psychiatric context, well tolerated, and significantly reduced ADHD symptoms in on-treatment individuals who remained stable regarding medication status.     

Evidence for an emotion-cognition interaction in the statistical prediction of suicide attempts

Suicidal behavior is a prevalent problem among adolescents and young adults. Although most theoretical models of suicide suggest that this behavior results from the interaction of different risk factors, most prior studies have tested only bivariate associations between individual risk factors and suicidal behaviors. The current study was designed to address this limitation by testing the effect of an emotion–cognition interaction on suicide attempts among youth. Specifically, we hypothesized that the interaction of emotion reactivity and problem-solving skills would statistically predict the probability of a recent suicide attempt among 87 adolescents and young adults. Results revealed a significant interaction, such that emotion reactivity was strongly associated with the probability of a suicide attempt among those with poor problem-solving skills, moderately associated among those with average problem-solving skills, and not significantly associated among those with good problem-solving skills. The next generation of studies on suicidal behavior should continue to examine how risk factors interact to predict this dangerous outcome.     

A case series of attention modification in clinically anxious youths

Research in the last fifteen years suggests that anxious individuals selectively attend towards threatening information. Attention modification interventions for internalizing adults have been developed to target cognition at this basic level; these programs have demonstrated initial efficacy in attention bias and anxiety symptom reduction. To date, there have been no published studies of attention modification in youths with clinical levels of anxiety. The current case series examined the initial efficacy of a four-week (12 sessions) attention modification program (AMP) designed to train attention away from threat in 16 children and adolescents (ages 10 to 17) diagnosed with DSM-IV anxiety disorders. Overall, youths experienced a significant decrease in anxiety and depression symptoms, and 12 of 16 youths no longer met criteria for any anxiety diagnosis at post-treatment. AMP was feasible with youths, and all youths and parents deemed the program acceptable. These findings provide support for further research on the use of cognitive bias modification interventions with clinically anxious youths.     

Relation of depression to perceived social support: results from a randomized adolescent depression prevention trial

Theorists posit that certain behaviors exhibited by depressed individuals (e.g., negative self-statements, dependency, reassurance seeking, inappropriate or premature disclosures, passivity, social withdrawal) reduce social support, yet there have been few experimental tests of this hypothesis. Using data from a randomized depression prevention trial (N = 253) involving adolescents (M age = 15.5, SD = 1.2), we tested whether a cognitive behavioral group intervention that significantly reduced depressive symptoms relative to bibliotherapy and educational brochure control conditions through 2-year follow-up produced improvements in perceived parental and friend social support and whether change in depressive symptoms mediated the effect on change in social support. Cognitive behavioral group participants showed significantly greater increases in perceived friend social support through 1-year follow-up relative to bibliotherapy and brochure controls, but there were no significant effects for perceived parental support. Further, change in depressive symptoms appeared to mediate the effects of the intervention on change in perceived friend support. Results provide experimental support for the theory that depressive symptoms are inversely related to perceived social support, but imply that this effect may be specific to friend vs. parental support for adolescents.     

The impact of cognitive behavioral therapy on post event processing among those with social anxiety disorder

Individuals with social anxiety are prone to engage in post event processing (PEP), a post mortem review of a social interaction that focuses on negative elements. The extent that PEP is impacted by cognitive behavioral therapy (CBT) and the relation between PEP and change during treatment has yet to be evaluated in a controlled study. The current study used multilevel modeling to determine if PEP decreased as a result of treatment and if PEP limits treatment response for two types of cognitive behavioral treatments, a group-based cognitive behavioral intervention and individually based virtual reality exposure. These hypotheses were evaluated using 91 participants diagnosed with social anxiety disorder. The findings suggested that PEP decreased as a result of treatment, and that social anxiety symptoms for individuals reporting greater levels of PEP improved at a slower rate than those with lower levels of PEP. Further research is needed to understand why PEP attenuates response to treatment.     

Do infants show social preferences for people differing in race?

Do infants develop meaningful social preferences among novel individuals based on their social group membership? If so, do these social preferences depend on familiarity on any dimension, or on a more specific focus on particular kinds of categorical information? The present experiments use methods that have previously demonstrated infants’ social preferences based on language and accent, and test for infants’ and young children’s social preferences based on race. In Experiment 1, 10-month-old infants took toys equally from own- and other-race individuals. In Experiment 2, 2.5-year-old children gave toys equally to own- and other-race individuals. When shown the same stimuli in Experiment 3, 5-year-old children, in contrast, expressed explicit social preferences for own-race individuals. Social preferences based on race therefore emerge between 2.5 and 5 years of age and do not affect social choices in infancy. These data will be discussed in relation to prior research finding that infants’ social preferences do, however, rely on language: a useful predictor of group or coalition membership in both modern times and humans’ evolutionary past.     

Where cognitive development and aging meet: face learning ability peaks after age 30

Research on age-related cognitive change traditionally focuses on either development or aging, where development ends with adulthood and aging begins around 55 years. This approach ignores age-related changes during the 35 years in-between, implying that this period is uninformative. Here we investigated face recognition as an ability that may mature late relative to other abilities. Using data from over 60,000 participants, we traced the ability to learn new faces from pre-adolescence through middle age. In three separate experiments, we show that face learning ability improves until just after age 30 – even though other putatively related abilities (inverted face recognition and name recognition) stop showing age-related improvements years earlier. Our data provide the first behavioral evidence for late maturation of face processing and the dissociation of face recognition from other abilities over time demonstrates that studies on adult age development can provide insight into the organization and development of cognitive systems.