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Cen YS, Xia LX. Serial Cascade Effects of Relative Deprivation and Anger Rumination on the Development of Social Aggression Over 2.5 Years in Emerging Adults. J Youth Adolesc 2024:10.1007/s10964-024-02029-z. [PMID: 38849686 DOI: 10.1007/s10964-024-02029-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 05/28/2024] [Indexed: 06/09/2024]
Abstract
Although the mechanisms of development of aggression have been focused on day by day, the complicated effects of distal and proximal factors on the development of social aggression in emerging adults have not been uncovered. A serial cascade model of aggression was proposed to address this issue. A longitudinal investigation over 2.5 years was conducted to test this model by exploring the serial cascade effects of relative deprivation (a representative of distal factors) and anger rumination (a representative of proximal factors) on the development of social aggression. A total of 1113 Chinese university students (Mage = 18.95 ± 0.96, 63.10% female) from six universities in five areas participated in this study. The results suggest that developmental trajectories and longitudinal changes in anger rumination mediate the relationship between developmental trajectories and longitudinal changes in relative deprivation and social aggression, and developmental trajectories and changes in relative deprivation mediate the longitudinal relationship between anger rumination and social aggression. These findings support the serial cascade effects of distal and proximal factors on the development of aggression and expand upon the general aggression model (GAM).
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Affiliation(s)
- Yu-Shan Cen
- Research Center of Psychology and Social Development, Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, 400715, China
| | - Ling-Xiang Xia
- Research Center of Psychology and Social Development, Faculty of Psychology, Southwest University, Chongqing, China.
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, 400715, China.
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Siegel JT, Ellis B, Riazi G, Brafford A, Guldner G, Wells JC. The paradox of the resident experiencing depression: Higher depression, less favorable help-seeking outcome expectations, and lower help-seeking intentions. Soc Sci Med 2024; 344:116593. [PMID: 38301547 DOI: 10.1016/j.socscimed.2024.116593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 12/20/2023] [Accepted: 01/10/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Medical residents experiencing depression can cause life-threatening harm to themselves and their patients. Treatment is available, but many do not seek help. METHODS The current set of three studies investigated whether depressive symptomatology in and of itself served as a help-seeking barrier-and whether expectations of help-seeking benefits provided insight into why this occurred. Nine waves of cross-sectional data were collected from medical residents across several different hospitals in the United States. RESULTS There was a large negative association between levels of depressive symptomatology and help-seeking intentions (H1) in Studies 1 and 3. In Study 2, this association was significant for one of the two help-seeking measures. For all analyses, studies, and measures, there was a large negative association between residents' levels of depressive symptomatology and agreement that seeking help will lead to positive outcomes (H2). Likewise, there was a moderately large indirect effect for all analyses, studies, and measures such that the association between levels of depressive symptomatology and help-seeking intentions occurred through less favorable expectations of help-seeking benefits (H3). Lower agreement of the benefits associated with help-seeking explained between 43 and 65% of depressive symptomatology's negative association with help-seeking intentions across studies. CONCLUSIONS The current findings indicate that depressive symptomatology itself represents a help-seeking barrier and underscore the importance of help-seeking expectations in explaining why this occurs. If future studies reveal a causal relationship between the perceived benefits of help-seeking and help-seeking intentions, then increasing such expectations could offer a potential path for increasing resident help-seeking.
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Affiliation(s)
- Jason T Siegel
- Division of Behavioral and Organizational Sciences, Claremont Graduate University, Claremont, CA, USA.
| | - Brendon Ellis
- Division of Behavioral and Organizational Sciences, Claremont Graduate University, Claremont, CA, USA.
| | - Gabrielle Riazi
- Division of Behavioral and Organizational Sciences, Claremont Graduate University, Claremont, CA, USA.
| | - Anne Brafford
- Division of Behavioral and Organizational Sciences, Claremont Graduate University, Claremont, CA, USA.
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Affengruber L, Wagner G, Dobrescu A, Toromanova A, Chapman A, Persad E, Klerings I, Gartlehner G. Values and Preferences of Patients With Depressive Disorders Regarding Pharmacologic and Nonpharmacologic Treatments : A Rapid Review. Ann Intern Med 2023; 176:217-223. [PMID: 36689749 DOI: 10.7326/m22-1900] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Developers of clinical practice guidelines need to take patient values and preferences into consideration when weighing benefits and harms of treatment options for depressive disorder. PURPOSE To assess patient values and preferences regarding pharmacologic and nonpharmacologic treatments of depressive disorder. DATA SOURCES MEDLINE (Ovid) and PsycINFO (EBSCO) were searched for eligible studies published from 1 January 2014 to 30 November 2022. STUDY SELECTION Pairs of reviewers independently screened 30% of search results. The remaining 70% of the abstracts were screened by single reviewers; excluded abstracts were checked by a second reviewer. Pairs of reviewers independently screened full texts. DATA EXTRACTION One reviewer extracted data and assessed the certainty of evidence, and a second reviewer checked for completeness and accuracy. Two reviewers independently assessed risk of bias. DATA SYNTHESIS The review included 11 studies: 4 randomized controlled trials, 5 cross-sectional studies, and 2 qualitative studies. In 1 randomized controlled trial, participants reported at the start of therapy that they expected supportive-expressive psychotherapy and antidepressants to yield similar improvements. A cross-sectional study reported that non-Hispanic White participants and men generally preferred antidepressants over talk therapy, whereas Hispanic and non-Hispanic Black participants and women generally did not have a preference. Another cross-sectional study reported that the most important nonserious adverse events for patients treated with antidepressants were insomnia, anxiety, fatigue, weight gain, agitation, and sexual dysfunction. For other comparisons and outcomes, no conclusions could be drawn because of the insufficient certainty of evidence. LIMITATIONS The main limitation of this review is the low or insufficient certainty of evidence for most outcomes. No evidence was available on second-step depression treatment or differences in values and preferences based on gender, race/ethnicity, age, and depression severity. CONCLUSION Low-certainty evidence suggests that there may be some differences in preferences for talk therapy or pharmacologic treatment of depressive disorders based on gender or race/ethnicity. In addition, low-certainty evidence suggests that insomnia, anxiety, fatigue, weight gain, agitation, and sexual dysfunction may be the most important nonserious adverse events for patients treated with antidepressants. Evidence is lacking or insufficient to draw any further conclusions about patients' weighing or valuation of the benefits and harms of depression treatments. PRIMARY FUNDING SOURCE American College of Physicians. (PROSPERO: CRD42020212442).
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Affiliation(s)
- Lisa Affengruber
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University for Continuing Education Krems, Krems, Austria, and Department of Family Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands (L.A.)
| | - Gernot Wagner
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University for Continuing Education Krems, Krems, Austria (G.W., A.D., A.T., A.C., E.P., I.K.)
| | - Andreea Dobrescu
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University for Continuing Education Krems, Krems, Austria (G.W., A.D., A.T., A.C., E.P., I.K.)
| | - Ana Toromanova
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University for Continuing Education Krems, Krems, Austria (G.W., A.D., A.T., A.C., E.P., I.K.)
| | - Andrea Chapman
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University for Continuing Education Krems, Krems, Austria (G.W., A.D., A.T., A.C., E.P., I.K.)
| | - Emma Persad
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University for Continuing Education Krems, Krems, Austria (G.W., A.D., A.T., A.C., E.P., I.K.)
| | - Irma Klerings
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University for Continuing Education Krems, Krems, Austria (G.W., A.D., A.T., A.C., E.P., I.K.)
| | - Gerald Gartlehner
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University for Continuing Education Krems, Krems, Austria, and RTI International, Research Triangle Park, North Carolina (G.G.)
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Israel P, Ruud T, Weimand B. Carer involvement in the assessment of personal recovery: A naturalistic study of assertive community treatment in Norway. Front Psychiatry 2023; 14:1135135. [PMID: 37051169 PMCID: PMC10083239 DOI: 10.3389/fpsyt.2023.1135135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 02/22/2023] [Indexed: 04/14/2023] Open
Abstract
Background The user and carer movements have come a long way in becoming embedded in mainstream mental health services for individuals with serious mental illness. However, implementing recovery-oriented practice continues to be plagued by an individualistic clinical focus. The carers do not feel integrated despite policies and best intentions. The implementation of Assertive Community Treatment (ACT) provided an opportunity to involve the carers and compare their assessment of personal recovery with the users. Aims The aims of this study were to examine (i) how family carers and users differed in their assessment of personal recovery, (ii) whether familial and personal relationships influenced how carers assess personal recovery of users, and (iii) if the experience of family carers with the ACT team was associated with personal recovery. Methods The naturalistic, explorative study recruited 69 users and 36 family carers from 12 Norwegian ACT teams. The users and carers assessed the user's personal recovery. Family carers also reported their experience and satisfaction with the ACT teams. Analyses included independent and paired sample T-tests and correlation analysis. Results Family carers were significantly more conservative than the users' assessment of the intrapsychic and interpersonal subscales of personal recovery. The pattern held true whether the family carers were matched to the users or part of the total sample. Lastly, there was a significant negative correlation between the family carer's experience of cooperation with the ACT team and their assessment of the user's intrapersonal process of recovery. Conclusions The results of our study were consistent with previous research on carer involvement in MHS. However, it is the first study that engaged carers and assessed personal recovery of the users of ACT services. Discrepancy between carers and users is the rule. Clinicians are encouraged to embrace the discrepancy and diversity carers bring and learn the methodology of multi-informant assessments. There also is a need to address, update, and integrate the personal, familial, and relational aspects of recovery. Modification of recovery measures such as QPR and their creative use with carers has the potential to generate valuable third-party information and to involve them meaningfully in mental health services.
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Affiliation(s)
- Pravin Israel
- Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
- *Correspondence: Pravin Israel
| | - Torleif Ruud
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health, Department of Special Psychiatry, Akershus University Hospital, Lørenskog, Norway
| | - Bente Weimand
- Division of Mental Health, Department of Special Psychiatry, Akershus University Hospital, Lørenskog, Norway
- Department of Health, Social, and Welfare Studies, University of South-Eastern Norway, Kongsberg, Norway
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Vîslă A, Allemand M, Flückiger C. Within- and between-patients associations between self-efficacy, outcome expectation, and symptom change in cognitive behavioral therapy for generalized anxiety disorder. J Clin Psychol 2023; 79:86-104. [PMID: 35781807 PMCID: PMC10084306 DOI: 10.1002/jclp.23407] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/05/2022] [Accepted: 06/23/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES There is limited information on how a change in patients' expectations over time results in symptom change in psychotherapy. This study aimed to investigate the changes in patients' expectations and symptoms during treatment and across follow-up as well as to determine the within- and between-patient relationships between two types of patient expectations, that is, self-efficacy and outcome expectation, and symptom change. METHODS Participants (80 participants × 6 repeated measures; 480 observations) with generalized anxiety disorder were treated using cognitive behavioral therapy and the within- and between-patient scores of self-efficacy and outcome expectation were evaluated in multilevel models as predictors of symptom change. RESULTS Patients' self-efficacy and outcome expectation increased, whereas severity of their symptoms reduced during and after treatment. At the within-patient (WP) level, an increase in self-efficacy was associated with a decrease in worry and depressive symptoms, and an increase in outcome expectation was associated with a decrease in depressive symptoms. The between-patient (BP) effect, however, was contrary to the WP effect, that is, self-efficacy was positively correlated with worry and outcome expectation was positively correlated with depressive symptoms CONCLUSION: These results highlight the importance of disaggregating the WP variability from BP variability in psychotherapy process-outcome research as they exhibit different associations at the within- and between-patient levels. Clinical Trial Registration: ClinicalTrial.gov (NCT03079336).
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Affiliation(s)
- Andreea Vîslă
- Department of Psychology, University of Zürich, Zürich, Switzerland
| | - Mathias Allemand
- Department of Psychology, University of Zürich, Zürich, Switzerland
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Heinzel S, Schwefel M, Sanchez A, Heinen D, Fehm L, Henze R, Terán C, Kallies G, Rapp MA, Fydrich T, Ströhle A, Heissel A. Physical exercise training as preceding treatment to cognitive behavioral therapy in mild to moderate major depressive disorder: A randomized controlled trial. J Affect Disord 2022; 319:90-98. [PMID: 36113693 DOI: 10.1016/j.jad.2022.09.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/28/2022] [Accepted: 09/11/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Many patients with major depressive disorder (MDD) remain untreated or do not respond to cognitive behavioral therapy (CBT). Physical exercise shows antidepressive effects and may serve as an effective augmentation treatment. However, research on combining exercise with CBT is sparse in MDD and underlying mechanisms of exercise are not well understood to date. METHODS 120 outpatients with MDD were randomized to either a high intensity exercise group (HEX), a low intensity exercise group (LEX), or a waiting list control group (WL). After 12 weeks of exercise training or waiting period, all patients received a manualized CBT. RESULTS Seventy-five patients with MDD completed both the exercise program/ waiting period and the CBT. While physical fitness improved in HEX after the exercise program, it did not change in LEX and WL. Depressive symptoms improved in all three groups from baseline to post-CBT and the group by time interaction was not significant. Regression analyses revealed that the amount of fitness improvement during exercise predicted the subsequent CBT response. LIMITATIONS The dropout rate was relatively high, preparatory CBT sessions during exercise / waiting period may have influenced depressive symptoms, and no patients with severe MDD were included. CONCLUSIONS High intense physical exercise did not lead to a general enhancement of CBT outcome, but higher increases in physical fitness seem to improve symptom change during CBT. Our results suggest that the implementation of more individually tailored exercise programs could be a promising approach for future research and clinical practice.
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Affiliation(s)
- Stephan Heinzel
- Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.
| | - Melanie Schwefel
- Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Alba Sanchez
- Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - Darlene Heinen
- Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - Lydia Fehm
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Romy Henze
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christina Terán
- Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - Gunnar Kallies
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Michael A Rapp
- Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - Thomas Fydrich
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Heissel
- Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
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Li X, Bao T, Garland SN, Li SQ, Yu J, Li Y, Mao JJ. Does expectancy affect insomnia treatment response in cancer survivors receiving acupuncture and cognitive behavioral therapy? J Cancer Surviv 2022; 17:826-835. [DOI: 10.1007/s11764-022-01272-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 10/07/2022] [Indexed: 12/05/2022]
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Qi LY, Yan SY, Yang JW, Liu CZ. The impact of expectancy on the efficacy of acupuncture treatment for postprandial distress syndrome: Secondary analysis of a randomized clinical trial. Neurogastroenterol Motil 2022; 34:e14447. [PMID: 35946062 DOI: 10.1111/nmo.14447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 05/08/2022] [Accepted: 07/12/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Expectancy is an important source of the placebo effect. However, it is unclear whether this has an effect on the efficacy of acupuncture and sham acupuncture in the treatment of postprandial distress syndrome (PDS). AIM To evaluate the effects of high expectancy (HE) and low expectancy (LE) on the efficacy of acupuncture and sham acupuncture in the treatment of PDS. METHODS This post hoc secondary analysis used data from our previous randomized controlled trial. Patients were, respectively, enrolled in the HE group and LE group according to expectancy assessments. The composite primary outcomes were the response rate and the elimination rate after 4 weeks of treatment. Expectancy was considered a factor affecting the efficacy of acupuncture treatment only if both primary outcomes achieved significance. RESULTS For the acupuncture group, the response rate was 84.5% in the HE group and 78.8% in the LE group (p = 0.458), and the elimination rate was 32.1% in the HE group and 21.2% in the LE group (p = 0.241). For the sham acupuncture group, the response rate at week 4 was 52.3% in the HE group and 53.1% in the LE group (p = 0.936), and the elimination rate at week 4 was 23.1% in the HE group and 10.6% in the LE group (p = 0.090). CONCLUSION In this study, the response rate and elimination rate were higher in the high-expectancy group, but no conclusive evidence was found for an association between expectancy and the efficacy of acupuncture and sham acupuncture.
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Affiliation(s)
- Ling-Yu Qi
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Shi-Yan Yan
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jing-Wen Yang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Cun-Zhi Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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Efficacy and mechanisms of mobile application-delivered Acceptance and Commitment Therapy for posttraumatic stress disorder in China: Study protocol for a randomized controlled trial. Internet Interv 2022; 30:100585. [PMID: 36426200 PMCID: PMC9678960 DOI: 10.1016/j.invent.2022.100585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 10/14/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND As a result of the COVID-19 pandemic and its far-reaching impact, the prevalence of posttraumatic stress disorder (PTSD) symptoms is increasing significantly in China. Yet access to reliable and effective psychological treatment is still limited during the pandemic. The widespread adoption of mobile technologies may provide a new way to address this gap. In this research we will develop an Acceptance and Commitment Therapy (ACT) based intervention delivered by mobile application and will test its usability, efficacy, and mechanism of its effects in relieving PTSD symptoms. METHODS A total of 147 Chinese participants with a diagnosis of PTSD according to the Clinician Administered PTSD Scale (CAPS-5) will be randomly assigned to an intervention group (app-delivered ACT), an active comparison group (app-delivered mindfulness), or a waitlist group. Participants in the intervention group or comparison group will use their respective apps for one month. Online self-report questionnaires will be used to assess the primary outcome of PTSD symptoms and the secondary outcomes symptoms of depression, symptoms of anxiety, and posttraumatic growth. The potential mediating variable to be tested is psychological flexibility and its components. These assessments will be conducted at baseline, at five times during treatment, at the end of treatment, and at 1- and 3-month follow-ups. DISCUSSION As far as we know, this study is the first randomized controlled trial to investigate the usability, efficacy, and mechanism of an app-delivered ACT intervention for PTSD. Furthermore, the research will assess the effect of treatment in reducing dropout rates, explore effective therapeutic components, and investigate mechanisms of symptom change, which will be valuable in improving the efficacy and usability of PTSD interventions.Trial registration: ChiCTR2200058408.
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Berking M, Eichler E, Naumann E, Svaldi J. The efficacy of a transdiagnostic emotion regulation skills training in the treatment of binge-eating disorder-Results from a randomized controlled trial. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2022; 61:998-1018. [PMID: 35567309 DOI: 10.1111/bjc.12371] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/29/2022] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Deficits in emotion regulation (ER) have been shown to be associated with binge-eating disorder (BED). To further clarify the causal nature of this association, we tested whether systematically enhancing ER skills would reduce symptoms of BED. METHODS We randomly allocated N = 101 individuals meeting the criteria for BED to a transdiagnostic ER skills training or to a waitlist control condition (WLC). Primary outcome was the reduction in binges during the treatment-vs.-waiting period as assessed with the Eating Disorder Examination (EDE) interview. RESULTS Mixed-model ANOVAs indicated that the average pre-to-post decrease in binges assessed with the EDE was significantly greater in the ER skills training condition than in the WLC (d = 0.66). These effects were stable over the 6-month follow-up period (d = 0.72). Remission rates at post/follow-up were 34.4/45.0% in the skills training and 7.5/20.0% in the WLC. Additionally, we found a greater reduction in general eating disorder psychopathology, of food consumption in a bogus taste test and of depression in the ER skills training condition. Moreover, the greater reduction in binge-eating episodes in the training condition was (partially) mediated by a greater increase in ER skills. CONCLUSIONS The findings provide further support for the assumed importance of deficits in ER as a maintaining factor and, hence, as a target in the treatment of BED. As ER skills trainings have been shown to also reduce other kinds of psychopathology, they might be considered a promising transdiagnostic add-on component to disorder-specific interventions.
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Affiliation(s)
| | - Eva Eichler
- University of Erlangen-Nuremberg, Erlangen, Germany
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Zhao C, Ren Z, Jiang G, Zhang L. Mechanisms of change in an Internet-Based ACT study for depression in China. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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12
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Wunram HL, Hamacher S, Oberste M, Neufang S, Belke L, Jänicke F, Graf C, Schönau E, Bender S, Fricke O. Influence of motivational placebo-related factors on the effects of exercise treatment in depressive adolescents. Eur Child Adolesc Psychiatry 2022; 31:1-14. [PMID: 33709258 PMCID: PMC9343287 DOI: 10.1007/s00787-021-01742-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 02/08/2021] [Indexed: 11/26/2022]
Abstract
Recent meta-analyses reveal a moderate effect of physical activity (PA) in the treatment of adolescent depression. However, not only the underlying neurobiological mechanisms, also the influences of placebo-related motivational factors (beliefs and expectancies in sporting, enjoyment and prior sports experiences), are still unclear. Based on the data of our prior study "Mood Vibes", we hypothesized that placebo-inherent factors like positive prior sports experiences and motivational factors, (positive beliefs, expectancies, and enjoyment related to PA), would increase the effects of an add-on exercise-therapy in juvenile depression. From 64 included depressed adolescents, 41 underwent an intensive add-on PA-therapy. Motivational factors were assessed using sport-specific scales. The changes in depression scores under treatment were rated by self-rating scale (German "Childhood Depression Inventory", (DIKJ)). A mixed model for repeated measures (MMRM) was used to analyze the effects of the different motivational variates on DIKJ. While prior sports experiences had no impact, motivational factors showed a significant effect on PA-induced changes in DIKJ scores (p = 0.002). The demotivated participants improved less, whereas it was sufficient to be neutral towards sporting to benefit significantly more. Motivational placebo-related factors (beliefs, expectancies and enjoyment regarding PA) affected the outcomes of an exercise treatment in depressed adolescents. Yet, a neutral mindset was sufficient to profit more from PA. Prior sporting in the sense of positive conditioning and as a protective factor did not play a role. Knowledge about these influences could in a second step help to develop tailored therapies.
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Affiliation(s)
- Heidrun Lioba Wunram
- Department of Child and Adolescent Psychiatry Psychosomatic and Psychotherapy, University Hospital of Cologne, Cologne, Germany
| | - Stefanie Hamacher
- Department of Medical Statistics, Informatics and Epidemiology (IMSIE), University of Cologne, Cologne, Germany
| | - Max Oberste
- Department of Medical Statistics, Informatics and Epidemiology (IMSIE), University of Cologne, Cologne, Germany
- Department for Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Susanne Neufang
- Department of Psychiatry and Psychotherapy, Medical Faculty Heinrich-Heine University, Düsseldorf, Germany
| | - Luisa Belke
- Children’s Hospital Amsterdam Street, Cologne, Germany
| | | | - Christine Graf
- Institute of Movement and Neuroscience, German Sport University Cologne, Cologne, Germany
| | - Eckhard Schönau
- Children’s Hospital, University Hospital of Cologne and UniReha®, University Hospital of Cologne, Cologne, Germany
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry Psychosomatic and Psychotherapy, University Hospital of Cologne, Cologne, Germany
| | - Oliver Fricke
- Department of Child and Adolescent Psychiatry, Psychotherapy and Child Neurology, Gemeinschaftskrankenhaus Herdecke and Chairs of Child and Adolescent Psychiatry, Witten/Herdecke University, Witten, Germany
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Brenes GA, Munger Clary HM, Miller ME, Divers J, Anderson A, Hargis G, Danhauer SC. Predictors of preference for cognitive-behavioral therapy (CBT) and yoga interventions among older adults. J Psychiatr Res 2021; 138:311-318. [PMID: 33892269 DOI: 10.1016/j.jpsychires.2021.03.055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/19/2021] [Accepted: 03/24/2021] [Indexed: 01/01/2023]
Abstract
The purpose of this study was to examine factors that influence a person's choice of cognitive-behavioral therapy (CBT) or yoga, the stability of these preferences, and the impact of preference on engagement and process measures. We conducted a randomized preference trial of CBT and yoga in 500 adults ≥60 years with symptoms of worry. Participants reported their intervention preference, strength of preference, and factors impacting preference. Engagement in the intervention (session completion and dropout rates) was assessed. Process measures included satisfaction with the intervention, therapeutic alliance, and intervention expectancy. Neither intervention preference (48% and 52% chose CBT and yoga, respectively) nor strength of preference differed significantly between the two preference trial groups. Intervention expectancies at baseline among those in the preference trial were approximately 4.5 units (40-point scale) higher for their preferred intervention (p < .0001 within each group). A principal component analysis of factors influencing preference identified three constructs. Using logistic regression, components focused on attitudes about CBT or yoga were predictive of ultimate preference (odds ratio = 11.5, 95% C.I.6.3-21.0 per 1SD difference in component 1 for choosing CBT; odds ratio = 7.8, 95% CI4.3-13.9 per 1SD difference in component 2 for choosing yoga). There were no significant differences between the randomized and preference trials on intervention adherence, completion of assessments, intervention satisfaction, or working alliance. Receiving a preferred treatment had no significant effects on intervention outcomes through participant engagement or process measures. When options are limited, providers may have confidence in offering the most readily available non-pharmacological treatments.
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Affiliation(s)
- Gretchen A Brenes
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, United States.
| | | | - Michael E Miller
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, United States.
| | - Jasmin Divers
- Division of Health Services Research and Winthrop Research Institute, Department of Foundations of Medicine, NYU Long Island School of Medicine, United States.
| | - Andrea Anderson
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, United States.
| | - Gena Hargis
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, United States.
| | - Suzanne C Danhauer
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, United States.
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Dietrichkeit M, Hagemann-Goebel M, Nestoriuc Y, Moritz S, Jelinek L. Side effects of the metacognitive training for depression compared to a cognitive remediation training in patients with depression. Sci Rep 2021; 11:7861. [PMID: 33846503 PMCID: PMC8041905 DOI: 10.1038/s41598-021-87198-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 03/10/2021] [Indexed: 12/27/2022] Open
Abstract
Although awareness of side effects over the course of psychotherapy is growing, side effects are still not always reported. The purpose of the present study was to examine side effects in a randomized controlled trial comparing Metacognitive Training for Depression (D-MCT) and a cognitive remediation training in patients with depression. 84 patients were randomized to receive either D-MCT or cognitive remediation training (MyBrainTraining) for 8 weeks. Side effects were assessed after the completion of each intervention (post) using the Short Inventory of the Assessment of Negative Effects (SIAN) and again 6 months later (follow-up) using the Negative Effects Questionnaire (NEQ). D-MCT and MyBrainTraining did not differ significantly in the number of side effects. At post assessment, 50% of the D-MCT group and 59% of the MyBrainTraining group reported at least one side effect in the SIAN. The most frequently reported side effect was disappointment in subjective benefit of study treatment. At follow-up, 52% reported at least one side effect related to MyBrainTraining, while 34% reported at least one side effect related to the D-MCT in the NEQ. The most frequently reported side effects fell into the categories of "symptoms" and "quality". Our NEQ version was missing one item due to a technical error. Also, allegiance effects should be considered. The sample size resulted in low statistical power. The relatively tolerable number of side effects suggests D-MCT and MyBrainTraining are safe and well-received treatment options for people with depression. Future studies should also measure negative effects to corroborate our results.
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Affiliation(s)
- Mona Dietrichkeit
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. .,Department of Psychiatry and Psychotherapy, Asklepios Clinic North, Hamburg, Germany.
| | | | - Yvonne Nestoriuc
- Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Clinical Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces Hamburg, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Wijnhoven LAMW, Engels RCME, Onghena P, Otten R, Creemers DHM. The Additive Effect of CBT Elements on the Video Game 'Mindlight' in Decreasing Anxiety Symptoms of Children with Autism Spectrum Disorder. J Autism Dev Disord 2021; 52:150-168. [PMID: 33660138 PMCID: PMC8732870 DOI: 10.1007/s10803-021-04927-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2021] [Indexed: 11/25/2022]
Abstract
The aim of the present study was to examine the additive effect of elements of cognitive behavioral therapy (CBT) on the video game Mindlight in decreasing anxiety of children with an autism spectrum disorder (ASD). A non-concurrent multiple baseline design with 8 children with ASD in the age of 8–12 was used. CBT did not have the hypothesized additive effect on Mindlight in decreasing anxiety of children with ASD. Instead, multiple participants already experienced a decrease in anxiety during the Mindlight sessions. Yet, several participants did experience a stabilization in anxiety at a low level during the CBT sessions. For now, it can be concluded that CBT does not have an additive effect on Mindlight.
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Affiliation(s)
- Lieke A. M. W. Wijnhoven
- Present Address: Mental Health Care Institute Karakter, Reinier Postlaan 12, 6525 GC Nijmegen, The Netherlands
- Present Address: Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands
- Mental Health Care Institute GGZ Oost-Brabant, P.O. Box 3, 5427 ZG Boekel, The Netherlands
| | - Rutger C. M. E. Engels
- Erasmus School of Social and Behavioral Sciences, Erasmus University, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
- Katholieke Universiteit Leuven, P.O. Box 5005, 3000 Leuven, Belgium
| | - Patrick Onghena
- Katholieke Universiteit Leuven, P.O. Box 5005, 3000 Leuven, Belgium
- Present Address: Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands
| | - Roy Otten
- Erasmus School of Social and Behavioral Sciences, Erasmus University, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
- Present Address: Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands
- Present Address: REACH Institute, Arizona State University, P.O. Box 876005, Tempe, AZ USA
- Mental Health Care Institute GGZ Oost-Brabant, P.O. Box 3, 5427 ZG Boekel, The Netherlands
- Mental Health Care Institute Pluryn, P.O. Box 53, 6500 AB Nijmegen, The Netherlands
| | - Daan H. M. Creemers
- Present Address: Mental Health Care Institute Karakter, Reinier Postlaan 12, 6525 GC Nijmegen, The Netherlands
- Erasmus School of Social and Behavioral Sciences, Erasmus University, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
- Present Address: Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands
- Mental Health Care Institute GGZ Oost-Brabant, P.O. Box 3, 5427 ZG Boekel, The Netherlands
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Perceived barriers, benefits and correlates of physical activity in outpatients with Major Depressive Disorder: A study from Brazil. Psychiatry Res 2020; 284:112751. [PMID: 31918115 DOI: 10.1016/j.psychres.2020.112751] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 12/23/2019] [Accepted: 01/01/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To evaluate the barriers, benefits and correlates of physical activity (PA) in outpatients with Major Depressive Disorder (MDD). METHODS Data were collected from outpatients under treatment for MDD at Hospital de Clínicas de Porto Alegre. Barriers and benefits were assessed with the Exercise Barriers/Benefits Scale (EBBS). Objective and self-reported PA were assessed with pedometers and the International Physical Activity Questionnaire (IPAQ), respectively. RESULTS The sample consisted of 65 outpatients (82% female; mean age = 50.9 years; SD = 10.1). Improvement in physical performance was the most reported benefit (mean = 3.00; SD = 0.3) while the most reported barrier was physical exertion (mean = 2.95; SD = 0.4). Depression symptom severity was negatively correlated with life enhancement (r = -0.337; p = 0.009), physical performance (r=-0.348; p = 0.007), psychological outlook (r=-0.364; p = 0.005), social interaction (r=-0.317; p = 0.015) and preventive health (r=-0.352; p = 0.007). CONCLUSION Physical exertion is the most perceived barrier for PA in people with MDD. Symptom severity is associated with higher barrier levels, whilst higher current PA levels are associated with more benefits and lesser barriers. Interventions targeting PA promotion should consider the identified benefits and barriers when developing PA programs for people with MDD in outpatient settings.
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