Cognitive-Behavioral Versus Supportive Psychotherapy for Intermittent Explosive Disorder: A Randomized Controlled Trial

Few clinical trials have evaluated the efficacy of psychotherapy for Intermittent Explosive Disorder (IED). The present study tested the efficacy of a cognitive behavioral intervention (versus supportive psychotherapy) among adults with IED. In this randomized clinical trial, 44 participants with IED (22 men and 22 women) aged 20–55 years completed twelve 50-minute individual sessions of either a multi-component cognitive behavioral intervention for IED (n = 19) or a time equated supportive psychotherapy (n = 25). At baseline, posttreatment, and 3-month follow-up, all participants received the Overt Aggression Scale–Modified, which was conducted by an interviewer who was blind to the participant’s study condition. During these visits, participants also completed self-report measures of relational aggression (Self-Report of Relational Aggression and Social Behavior), anger (State-Trait Anger Expression Inventory-2), cognitive biases (e.g., Social Information Processing Questionnaire Attribution and Emotional Response Questionnaire), and associated symptoms (e.g., Beck Depression Inventory). Primary study outcomes were aggressive behavior and anger. Though participants in both treatments tended to improve over time, the cognitive behavioral intervention was superior to supportive psychotherapy in decreasing aggressive behavior and relational aggression. These findings support the efficacy of a multicomponent cognitive behavioral intervention in treating aggression in IED.     

Cognitive therapy for social phobia: individual versus group treatment

Cognitive-behavioural group treatment is the treatment of choice for social phobia. However, as not all patients benefit, an additional empirically validated psychological treatment would be of value. In addition, few studies have examined whether a group treatment format is more effective than an individual treatment format. A randomized controlled trial addressed these issues by comparing individual cognitive therapy, along the lines advocated by Clark and Wells (Clark, D.M. and Wells, A., 1995. A cognitive model of social phobia. In: R. G. Heimberg, M. Liebowitz, D. Hope and F. Schneier (Eds.), Social Phobia: Diagnosis, assessment, and treatment (pp. 69-93). New York: Guilford.), with a group version of the treatment and a wait-list control condition. 71 patients meeting DSM-IV criteria for social phobia participated in the trial, 65 completed the posttreatment assessment and 59 completed a six-month follow-up. Social phobia measures indicated significant pretreatment to posttreatment improvement in both individual and group cognitive therapy. Individual cognitive therapy was superior to group cognitive therapy on several measures at both posttreatment and follow-up. The effects of treatment on general measures of mood and psychopathology were less substantial than the effects on social phobia. The results suggest that individual cognitive therapy is a specific treatment for social phobia and that it's effectiveness may be diminished by delivery in a group format.     

How WEIRD are positive psychology interventions? A bibliometric analysis of randomized controlled trials on the science of well-being

ABSTRACT

The past two decades have witnessed a rapid rise in well-being research, and a profusion of empirical studies on positive psychology interventions (PPIs). This bibliometric analysis quantifies the extent to which rigorous research on PPIs that employ randomized controlled trials (RCTs) reaches beyond Western Educated Industrialized Rich Democratic (WEIRD) populations. A search was conducted through databases including PubMed, PsycINFO, and Scopus for studies from 1998 to 2017. In total, we found 187 full-text articles that included 188 RCTs from 24 countries. We found that RCTs on the efficacy of PPIs are still predominately conducted in western countries, which accounted for 78.2% of the studies. All these countries are highly industrialized and democratic, and study populations are often highly educated and have a high income. However, there has been a strong and steady increase in publications from non-Western countries since 2012, indicating a trend towards globalization of positive psychology research.     

Guided self-help for disordered eating: A randomised control trial

Treatment guidelines recommend evidence-based guided self-help (GSH) as the first stage of treatment for bulimia nervosa and binge eating disorder. The current randomised control trial evaluated a cognitive behavioural therapy-based GSH pack, ‘Working to Overcome Eating Difficulties,’ delivered by trained mental health professionals in 6 sessions over 3 months. It was congruent with the transdiagnostic approach and so was intended as suitable for all disordered eating, except severe anorexia nervosa. Eighty one clients were randomly allocated to either a GSH or waiting list condition. Eating disorder psychopathology (EDE-Q), key behavioural features and global distress (CORE) were measured at pre- and post-intervention, and 3- and 6-month follow-up. Results showed significant improvements in eating disorder psychopathology, laxative abuse, exercise behaviours, and global distress, with the GSH condition being superior to the waiting list on all outcomes. Treatment gains were maintained at 3 and 6 months. This study adds to the evidence supporting GSH for disordered eating, including EDNOS. However, further work is needed to establish the factors that contribute to observed therapeutic improvements and determine for whom GSH is most suitable.     

Resurgence of temporal patterns of responding

The resurgence of temporal patterns of key pecking by pigeons was investigated in two experiments. In Experiment 1, positively accelerated and linear patterns of responding were established on one key under a discrete-trial multiple fixed-interval variable-interval schedule. Subsequently, only responses on a second key produced reinforcers according to a variable-interval schedule. When reinforcement on the second key was discontinued, positively accelerated and linear response patterns resurged on the first key, in the presence of the stimuli previously correlated with the fixed- and variable-interval schedules, respectively. In Experiment 2, resurgence was assessed after temporal patterns were directly reinforced. Initially, responding was reinforced if it approximated an algorithm-defined temporal pattern during trials. Subsequently, reinforcement depended on pausing during trials and, when it was discontinued, resurgence of previously reinforced patterns occurred for each pigeon and for 2 of 3 pigeons during a replication. The results of both experiments demonstrate the resurgence of temporally organized responding and replicate and extend previous findings on resurgence of discrete responses and spatial response sequences.     

Effects of a Center-Based Parent Training Package on Parents’ Accuracy of Generalized Program Implementations at Home

Abstract

The purpose of this study was to evaluate the effects of a parent training package on parents’ accuracy of program implementations and their children’s goal achievements on parent-implemented programs at home. Parents also completed a quiz with questions about three-contingencies before and after the training. Three mother-child dyads participated in this study. All three children were 4-year-old boys with developmental delays. We employed a multiple baseline across three parent-child dyads as the primary design combined with a pretest and posttest. The individual parent training sessions consisted of office meetings and in-vivo classroom coaching sessions on program implementations. Each parent was trained individually to mastery criteria on program implementations using the Teacher Performance Rate Accuracy Scale (TPRA). After completing the parent training package, all parents acquired program implementations skills, and their program implementation skills were generalized to teach new behaviors at home with a high level of fidelity. Their quiz scores on three-term contingencies also increased to a relatively high level.     

An evaluation of positive psychology intervention effectiveness trials using the re-aim framework: A practice-friendly review

Meta-analyses indicate the efficacy of positive psychology interventions in promoting well-being. But, despite accumulating empirical and anecdotal evidence of these interventions’ implementation in real-world settings, no review of effectiveness research exists. Accordingly, we identified 40 positive psychology intervention effectiveness trials targeting adults, and scored their reporting using the practice-friendly RE-AIM tool which assesses five dimensions of intervention utility: Reach, Efficacy, Adoption, Implementation and Maintenance. Reporting levels varied substantially: reporting on Reach scored 64%; Efficacy scored 73%; Adoption scored 84%; Implementation scored 58%; and Maintenance scored 16%. Within these five dimensions, reporting on participation rates, methods to select delivery agents, differences between participants and non-participants, programme maintenance and costs, was particularly sparse. The studies involved 10,664 participants, approximately half required specialist delivery, and 12 were researcher delivered. To maximize the potential of PPIs for population health promotion, expanded reporting on effectiveness trials is required. Recommendations to assist this process are offered.     

A Pilot Randomized Trial of an Online Parenting Skills Program for Pediatric Traumatic Brain Injury: Improvements in Parenting and Child Behavior

This pilot study examined changes in parenting skills and child behavior following participation in an online positive parenting skills program designed for young children with traumatic brain injury (TBI). Thirty-seven families with a child between 3 and 9 years of age who sustained a moderate to severe TBI were randomly assigned to one of two interventions: online parenting skills training (n = 20) or access to Internet resources on managing brain injury (n = 17). Parent–child interaction observations and parent ratings of child behavior were collected pre- and post-treatment. Generalized estimating equations and mixed models were used to examine changes in parenting skills and child behavior problems as well as the moderating role of family income on treatment response. Participants in the parenting skills group displayed significant improvements in observed positive parenting skills relative to participants in the Internet resource group. Income moderated improvements in parent ratings of child behavior, with participants in the low-income parenting skills group and high-income Internet resource group reporting the greatest improvements in behavior. This is the first randomized controlled trial examining online parenting skills training for families of young children with TBI. Improvements in positive parenting skills and child behavior support the utility of this intervention, particularly for families from lower socioeconomic backgrounds.