Facilitating and inhibiting effects of priming and selection criteria in a sequence of dichotic listening trials

Competing models of attention make different predictions of how priming from recent stimulus processing could interact with intended selection. The present experiment examined the interaction between exogenous attention and endogenous priming across trial sequences. A sound cue directed attention to left, right or both sides before a dichotic syllable pair was presented. Participants were asked to report one syllable from each trial. Results showed that responses were slower on trials where one of the presented syllables had also been presented on the previous trial. Within these trials, the repeated syllable was selected less frequently, and the responses doing so were slower. Examined according to response choice on the preceding trial, syllables that had been ignored on the preceding trial tended to be ignored on the current trial (negative priming), while syllables that had been selected on the preceding trial tended to be selected on the current trial (positive priming). Responses that followed these selection biases were faster than responses that did not. Response selection was also influenced by the attention direction cue for the current trial, but not by the cue presented on the preceding trial. The results support an attentional model where traces from the preceding processing are retained, and current selection is biased to minimize cognitive conflict between recent and current processing. Negative priming appears to be due to after-effects of preceding processing, independently of the intentions behind that processing. The study accounts for positive and negative priming of dichotic listening sequences within an established, computationally viable biased competition framework.     

Group critical incident stress debriefing with emergency services personnel: a randomized controlled trial

Although single-session individual debriefing is contraindicated, the efficacy of group psychological debriefing remains unresolved. We conducted the first randomized controlled trial of critical incident stress debriefing (CISD) with emergency workers (67 volunteer fire-fighters) following shared exposure to an occupational potentially traumatic event (PTE). The goals of group CISD are to prevent post-traumatic stress and promote return to normal functioning following a PTE. To assess both goals we measured four outcomes, before and after the intervention: post-traumatic stress, psychological distress, quality of life, and alcohol use. Fire brigades were randomly assigned to one of three treatment conditions: (1) CISD, (2) Screening (i.e., no-treatment), or (3) stress management Education. Controlling for pre-intervention scores, CISD was associated with significantly less alcohol use post-intervention relative to Screening, and significantly greater post-intervention quality of life relative to Education. There were no significant effects on post-traumatic stress or psychological distress. Overall, CISD may benefit broader functioning following exposure to work-related PTEs. Future research should focus on individual, group, and organizational factors and processes that can promote recovery from operational stressors. Ultimately, an occupational health (rather than victim-based) approach will provide the best framework for understanding and combating potential threats to the health and well-being of workers at high risk for PTE exposure.     

An online hazard perception training course reduces heavy braking,speeding, and over-revving rates during everyday driving

In essence, driver training involves learning the skills required to drive safely and avoid dangerous events. However, in traditional on-road driver instruction, drivers virtually never accrue experience of the most significant types of events that they are learning to avoid: crashes. One means of providing this experience safely is to present novice drivers with video clips of real crashes, as part of structured learning exercises. A six-week automated online hazard perception training course for drivers, incorporating evidence-based training methods and over a hundred crash clips, was previously found to improve novice drivers’ hazard perception skill, which is known to be an important attribute for avoiding crashes. However, since hazard perception was measured using computer-based methods, the possibility remained that the training effect might not transfer to actual driving. We report a randomized control trial in which novice drivers were recruited to assess everyday driving behaviour objectively, using g-force triggered dashcams and GPS trackers installed in their vehicles. On-road data were collected for a one-month baseline period, and for a further two months after half of the sample completed the hazard perception training course. Drivers who completed the course significantly reduced their rate of heavy-braking events, their speeding behaviour, and their rate of over-revving events. These findings support the proposal that a relatively inexpensive and highly scalable hazard perception training intervention can improve on-road driving behaviour, with the clear potential to impact real-world driver safety.     

Telehealth and in‐person training outcomes for novice discrete trial training therapists

The efficacy and efficiency of telehealth and in‐person training were compared while teaching seven undergraduate students to implement components of discrete trial training. A multiple‐baseline design across skills with elements of multiple probe and delayed multiple baseline combined with an alternating‐treatments design was used to evaluate the effects of behavioral skills training (BST) on (a) implementing a multiple stimulus without replacement preference assessment, (b) setting up an instructional context, (c) delivering antecedent prompts, and (d) delivering consequences for accurate and inaccurate responding. Two skills were trained via telehealth and two skills were trained in‐person using BST procedures with a mock student. All participants provided high acceptability ratings for both training procedures. Results also showed that telehealth training was as efficacious and efficient as in‐person training for all skills across all participants. Five of six participants showed high levels of maintenance of the newly acquired skills; these five also exhibited the skills during a novel instructional task.     

Longitudinal Impact of a Family Critical Time Intervention on Children in High-Risk Families Experiencing Homelessness: A Randomized Trial

A randomized trial compared effects of a Family Critical Time Intervention (FCTI) to usual care for children in 200 newly homeless families in which mothers had diagnosable mental illness or substance problems. Adapted from an evidence‐based practice to prevent chronic homelessness for adults with mental illnesses, FCTI combines housing and structured, time‐limited case management to connect families leaving shelter with community services. Families were followed at five time points over 24 months. Data on 311 children—99 ages 1.5–5 years, 113 ages 6–10 years, and 99 ages 11–16 years—included mother‐, teacher‐, and child‐reports of mental health, school experiences, and psychosocial well‐being. Analyses used hierarchical linear modeling to investigate intervention effects and changes in child functioning over time. Referral to FCTI reduced internalizing and externalizing problems in preschool‐aged children and externalizing for adolescents 11–16. The intervention led to declines in self‐reported school troubles for children 6–10 and 11–16. Both experimental and control children in all age groups showed reductions in symptoms over time. Although experimental results were scattered, they suggest that FCTI has the potential to improve mental health and school outcomes for children experiencing homelessness.     

Reducing the risk of bias in health behaviour change trials: Improving trial design,reporting or bias assessment criteria? A review and case study

Objective: It has been suggested that randomised controlled trials (RCTs) of health behaviour change (HBC) interventions are less rigorously designed than – for example– drug trials. This study presents an approach to clarifying whether this is due to poor trial design, incomplete trial reporting and/or the inappropriateness of commonly applied risk of bias assessment criteria.

Design: First, a framework of key sources of bias and common strategies for reducing bias risk is developed based on a literature review. Second, we describe the design of a multi-site RCT evaluating the cost-effectiveness of an HIV-treatment adherence intervention (case study). The choices made by the multidisciplinary team trying to minimise the risk of bias are compared against the risk of bias framework.

Main outcome measures: Implementation of common strategies for reducing the risk of bias in the case study; alternative or additional strategies applied; a justification for each deviation from the risk of bias framework.

Results: Most of the common strategies for reducing the risk of bias could be implemented. Alternative strategies were developed for minimising the risk of performance bias and contamination. Several additional, domain-specific risk of bias strategies were implemented.

Conclusions: The literature provides useful guidance for reducing the risk of bias in HBC trials. Yet, the case study suggests that HBC trial designers may face specific challenges that require alternative/additional measures for reducing the risk of bias. Using the risk of bias justification table (RATIONALE) could lead to better-designed HBC trials, more comprehensive trial reports and the data necessary for evaluating the appropriateness of commonly applied risk of bias assessment criteria to HBC trials.     

Transdiagnostic Internet treatment for anxiety disorders: A randomized controlled trial

Clinician-guided Internet-based cognitive behavioural therapy (iCBT) programs are clinically effective at treating specific anxiety disorders. The present study examined the efficacy of a transdiagnostic Internet-based cognitive behavioural treatment (iCBT) program to treat more than one anxiety disorder within the same program (the Anxiety Program). Eighty six individuals meeting diagnostic criteria for generalized anxiety disorder (GAD), panic disorder, and/or social phobia were randomly assigned to a treatment group, or to a waitlist control group. Treatment consisted of CBT based online educational lessons and homework assignments, weekly email or telephone contact from a clinical psychologist, access to a moderated online discussion forum, and automated emails. An intention-to-treat model using the baseline-observation-carried-forward principle was employed for data analyses. Seventy-five percent of treatment group participants completed all 6 lessons within the 8 week program. Post-treatment data was collected from 38/40 treatment group and 38/38 control group participants, and 3-month follow-up data was collected from 32/40 treatment group participants. Relative to controls, treatment group participants reported significantly reduced symptoms of anxiety as measured by the Generalized Anxiety Disorder - 7 Item, Social Phobia Screening Questionnaire, and the Panic Disorder Severity Rating Scale - Self Report Scale, but not on the Penn State Worry Questionnaire, with corresponding between-groups effect sizes (Cohen’s d) at post-treatment of 0.78, 0.43, 0.43, and 0.20, respectively. The clinician spent a total mean time of 46 min per person over the program, participants rated the procedure as moderately acceptable, and gains were sustained at follow-up. Modifications to the Anxiety program, based on post-treatment feedback from treatment group participants, were associated with improved outcomes in the control group. These results indicate that transdiagnostic programs for anxiety disorders may be successfully administered via the Internet.