Using Cognitive Behavior Therapy in Clinical Work With African American Children and Adolescents: A Review of the Literature

A comprehensive review of the literature on clinical work with African American youth with cognitive behavior therapy (CBT) is presented. The strengths and limitations of CBT in relation to this population are outlined. Although CBT shows promise in helping, research on the efficacy and effectiveness of CBT in this group is lacking. Se presenta una reseña exhaustiva de la literatura sobre trabajo clínico con jóvenes Afroamericanos usando terapia cognitiva conductual (TCC). Se perfilan los puntos fuertes y las limitaciones de la TCC en relación a esta población. A pesar de que la TCC muestra signos prometedores para servir de ayuda, no hay suficiente investigación sobre la eficacia y efectividad de la TCC en este grupo.     

The influence of question framing on symptom report and perceived health status

Abstract

Self-reports of symptom experience and subjective ratings of health were obtained from 157 undergraduates. The format of the symptom-report question was varied so that half the participants underlined any symptoms (in a list of 30) they had experienced (endorse condition), whereas the remaining participants crossed out any they had not experienced (exclude condition). Within each of these conditions, half were asked to record symptoms over the last month, and half over the last year. Participants in the exclude condition reported, on average, 70% more symptoms than those in the endorse condition. More symptoms were reported over the last year than the last month. Adjusting for the number of symptoms reported and the perceived seriousness of the symptom set as a whole, participants rated their own state of health more negatively in the endorse than exclude condition. This is consistent with research on the “feature-positive” effect, suggesting that active responses have greater influence on self-perceptions. It is argued that self-report measures of health status must be interpreted in relative, rather than absolute terms, and that attention should be paid to the underlying cognitive processes.     

Change and processes of change within interventions to promote adjustment to multiple sclerosis: Learning from patient experiences

This qualitative study was nested within a trial of cognitive behaviour therapy (CBT) and supportive listening for patients with multiple sclerosis (MS). It aimed to enrich understanding of the changes made during therapy and to explore processes of change. In-depth interviews with 30 participants from the treatment trial were analysed inductively and five main themes were developed. The benefits that participants described experiencing as a result of the interventions were highly variable, idiosyncratic and often departed from outcomes measured within the trial. Tuning into and sharing one’s thoughts and feelings and learning specific strategies for living with MS appeared to be important processes for change, and participants identified the latter as particularly important for sustaining long-term benefits from therapy. Whether participants fully engaged with the interventions appeared to be related to their perceptions of being the right sort of candidate for the intervention, their expectations and motivations, the therapeutic relationship, adequate tailoring of the intervention, and practical issues. This study builds on previous research on factors and processes involved in adjustment to MS, the benefits of CBT for this population and highlights important issues to consider when developing psychosocial interventions for people with MS.     

Two alternative models of health behaviour and recovery from activity limitations due to acute injury: A prospective study

Cognitions influence recovery from activity limitations. In this study we aimed to independently test, compare and combine the common sense self-regulation model (CS-SRM) and social cognitive theory (SCT) in predicting recovery from activity limitations due to acute injury. Measures were gathered at two time points 5–6 weeks apart. The sample consisted of 146 university students (Mean age: 21.86, SD: 4.83, 62% female) with a heterogeneous range of injuries that limited their participation in physical activity. The dependent variable was recovery from activity limitations (Physical Functioning?–?Short Form-36). The predictor variables were measured using the Brief Illness Perception Questionnaire and SCT items designed according to theoretical recommendations. Time-line (TL) and self-efficacy (SE) were significant predictors of recovery in a multivariate analysis, controlling for reported pain at Time 1. A combined model including the best predictors from both models, TL (β = ?0.25, p < 0.05, R ² change = 0.17, p < 0.01) and SE (β =0.31, p < 0.05, R ² change = 0.05, p < 0.05), accounted for a significant amount of the variance in recovery from activity limitations. A combination of key variables from both models may be particularly useful for understanding the cognitive factors that influence recovery from activity limitations.     

Development and exploratory cluster-randomised opportunistic trial of a theory-based intervention to enhance physical activity among adolescents

This article reports the development and exploratory testing of a school-based intervention programme designed to enhance levels of physical activity in adolescents. The intervention is based on social cognitive theory (SCT), self-regulation theory (SRT) and planning as evidence-based mediators of physical activity changes. Two classes, paired on socio-economic variables, were selected from each of eight Portuguese schools and randomly assigned to an intervention or control group (N = 291). Primary outcome was ‘moderate to vigorous physical activity’ (International Physical Activity Questionnaire) measured pre and post intervention and at three and nine months follow-up. SCT, SRT and planning variables were secondary outcomes measured pre and post intervention. At post test, participants in the intervention group reported 18 min per week more physical activity (PA), adjusted for pre-intervention, age and sex, than those in the control group (95% confidence interval ?10 to 46; p = 0.249). This difference increased to 33 min (95% CI–4 to 71; p = 0.082) at three months and to 57 min (95% CI 13 to 101, p = 0.008) at nine month follow-up. Moreover, the intervention resulted in changes of some of the theoretical target variables, including outcome expectancies and coping planning. However, no evidence was found for the changes in theoretical moderators to mediate the intervention effects on behaviour. Implications for theory and for future research are discussed.     

What do pre-adolescents and adolescents understand about HIV/AIDS?

Abstract

Pre-adolescents and adolescents (N= 80, aged 10, 12, 15, and 18 years) were tested on their knowledge of HIV/AIDS. Knowledge was assessed using a self-report questionnaire (examining levels of factual knowledge) and a semi-structured interview (examining cognitive developmental levels of understanding). Examination of the developmental shifts in understanding of HIV/AIDS revealed an increase in conceptual complexity on causal and prevention dimensions. The main conceptual changes included a shift from single cause to multiple cause solutions and a shift from identifying surface or immediate features to implicating less salient features. Additionally, with age, concepts about HIV/AIDS were increasingly organised around internal, physiological principles. Questionnaire responses yielded significant age-related increases in knowledge. Level of knowledge, as measured by the questionnaire, was higher than that assessed by the interview for the three youngest age groups. Thus, factual information acquired about HIV/AIDS is not automatically accompanied by understanding. In light of these findings the past conclusion that adolescents have high levels of knowledge of HIV/AIDS is questioned.     

The effect of a delayed weekend sleep pattern on sleep and morning functioning

Abstract

It is a common practice for young adults to delay their weekend sleep schedule. The present study was designed to assess the effect of this sleep pattern on the sleep of Sunday night and the functioning of Monday morning. The sleep schedules of 30 young adults were manipulated for 2 consecutive weeks. In the Habitual-Sleep (HS) week, subjects followed their habitual sleep schedule throughout the week; in the Delayed-Sleep (DS) week, subjects' sleep schedule on Friday and Saturday nights were delayed by two hours. Compared to the HS week, subjects showed significantly lower subjective sleepiness near bedtime and trends of longer sleep onset latency on Sunday night in the DS week. In addition, there was both lowered cognitive performance and overall mood rating on Monday morning in the DS week. The delayed weekend sleep pattern contributes to Sunday night insomnia and the Monday morning “blues”.     

3D Multiple Object Tracking Boosts Working Memory Span: Implications for Cognitive Training in Military Populations

Recently, there has been much theoretical and applied interest in the prospects of cognitive training for improving cognition. NeuroTracker is a relatively recent training device for improving dynamic attention in athletes by training 3D multiple-object tracking skills. We examined its effectiveness for improving working memory (WM) span in members of the Canadian Armed Forces (CAF) by randomly assigning participants to the experimental (NeuroTracker), active control (adaptive dual n-back task), or passive control (no contact) conditions. NeuroTracker training resulted in significant gains in verbal, visual, and matrix span. No gain was observed in the active or passive control group. These results suggest that NeuroTracker could be a useful training tool for increasing WM span in military samples. Future studies could examine the effects of NeuroTracker training on militarily relevant performance measures that draw on WM span.     

Deficit in Response Inhibition in Children with Attention Deficit/Hyperactivity Disorder (ADHD): Impact of Motivation?

To date, neuropsychological and psycho-physiological studies have revealed inconsistent results regarding an executive or motivational deficit explaining the response inhibition deficit in children with attention deficit/hyperactivity disorder (ADHD). Research on differentiating neuropsychological processes in ADHD subtypes is still scarce. Therefore, the motivational impact on response inhibition among boys with ADHD was examined in this study. In the first study, 19 boys with ADHD-combined type (ADHD-C) and 19 age-matched healthy control subjects performed a modified Go/No-Go task with the following experimental conditions: neutral, auditory feedback, reward, response cost, and reward/response cost. Performance and physiological data (heart rate and skin conductance responses) were recorded. In a second study with the modified Go/No-Go task, data for six children with ADHD-C, six with ADHD-inattentive subtype (ADHD-I), and six healthy control subjects were compared. Neither of the two studies revealed group by condition interactions. In study 1, boys with ADHD-C generally made more commissions and omissions compared to the control group. However, feedback significantly improved the response inhibition in all children. The heart rate of all children was increased in the two conditions of reward and reward/response cost. Study 2 revealed that children with ADHD-I responded more slowly and showed increased reaction time variability compared to both other groups. The present study supports an executive rather than a motivational deficit in the response inhibition among children with ADHD-C, though further results also indicate the role of auditory feedback on response inhibition. Additionally, the findings support the differentiation of ADHD-C and ADHD-I, suggesting that ADHD-I children are characterized by a sluggish cognitive tempo.     

Executive Cognitive Function as a Correlate and Predictor of Child Food Intake and Physical Activity

Investigated were relations among executive cognitive function (ECF), food intake, and physical activity in 184, fourth grade children. It was hypothesized that self-reported ECF proficiency would predict greater self-reported fruit/vegetable intake and physical activity, but less “snack food” intake. Structural models demonstrated that ECF was significantly correlated with less concurrent snack food intake and greater concurrent fruit/vegetable intake, but not physical activity. Baseline ECF also significantly predicted greater fruit/vegetable intake and physical activity four months later, but not snack food intake. One implication is to promote ECF as a correlate and predictor of food intake and physical activity in children by providing opportunities for youth to practice newly developing ECF capacities.