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Henderson T, Bingham J, Hoose G, Paxton T, Thackeray M, Alldredge C, Burlingame G. Alliance and Cohesion Predicting Outcome in Group Psychotherapy: A Structural Equation Model Meta-Analysis. Int J Group Psychother 2025:1-28. [PMID: 40397017 DOI: 10.1080/00207284.2025.2499046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2025]
Abstract
Within group psychotherapy, previous meta-analyses have shown that the client-therapist relationship (alliance) and group relationships (cohesion) both predict client improvement. Accounting for the inherent connection between alliance and cohesion, we meta-analyzed studies (k = 14) that individually measured alliance, cohesion, and an outcome among group therapy participants. A random-effects, two-stage structural equation model found that alliance (b = .12) and cohesion (b = .12) uniquely predicted outcome and were statistically indistinguishable. Findings replicate past meta-analyses. Alliance and cohesion are highly related, and both uniquely predict outcome. Minimal studies and large heterogeneity limit generalizability, but we encourage clinicians to foster all therapeutic relationships and we provide researchers with suggestions for future work.
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Jin J, Xiao Q, Liu Y, Xu T, Shen Q. Test-retest reliability of decisions under risk with outcome evaluation: evidence from behavioral and event-related potentials (ERPs) measures in 2 monetary gambling tasks. Cereb Cortex 2025; 35:bhaf058. [PMID: 40099835 DOI: 10.1093/cercor/bhaf058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 01/28/2025] [Accepted: 02/17/2025] [Indexed: 03/20/2025] Open
Abstract
The balance between potential gains and losses under risk, the stability of risk propensity, the associated reward processing, and the prediction of subsequent risk behaviors over time have become increasingly important topics in recent years. In this study, we asked participants to carry out 2 risk tasks with outcome evaluation-the monetary gambling task and mixed lottery task twice, with simultaneous recording of behavioral and electroencephalography data. Regarding risk behavior, we observed both individual-specific risk attitudes and outcome-contingent risky inclination following a loss outcome, which remained stable across sessions. In terms of event-related potential (ERP) results, low outcomes, compared to high outcomes, induced a larger feedback-related negativity, which was modulated by the magnitude of the outcome. Similarly, high outcomes evoked a larger deflection of the P300 compared to low outcomes, with P300 amplitude also being sensitive to outcome magnitude. Intraclass correlation coefficient analyses indicated that both the feedback-related negativity and P300 exhibited modest to good test-retest reliability across both tasks. Regarding choice prediction, we found that neural responses-especially those following a loss outcome-predicted subsequent risk-taking behavior at the single-trial level for both tasks. Therefore, this study extends our understanding of the reliability of risky preferences in gain-loss trade-offs.
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Affiliation(s)
- Jia Jin
- Key Laboratory of Brain-Machine Intelligence for Information Behavior (Ministry of Education and Shanghai), School of Business and Management, Shanghai International Studies University, 550# Dalian West Road, Shanghai 200083, China
- Guangdong Institute of Intelligence Science and Technology Joint Lab of Finance and Business Intelligence, 2515# Huan Dao North Road, Zhuhai 519031, China
| | - Qin Xiao
- Key Laboratory of Brain-Machine Intelligence for Information Behavior (Ministry of Education and Shanghai), School of Business and Management, Shanghai International Studies University, 550# Dalian West Road, Shanghai 200083, China
| | - Yuxuan Liu
- Key Laboratory of Brain-Machine Intelligence for Information Behavior (Ministry of Education and Shanghai), School of Business and Management, Shanghai International Studies University, 550# Dalian West Road, Shanghai 200083, China
| | - Ting Xu
- Business School, Ningbo University, 818# Fenghua Road, Ningbo 315211, China
| | - Qiang Shen
- Key Laboratory of Brain-Machine Intelligence for Information Behavior (Ministry of Education and Shanghai), School of Business and Management, Shanghai International Studies University, 550# Dalian West Road, Shanghai 200083, China
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Gutierrez-Camacho JR, Avila-Carrasco L, Gamón-Madrid A, Muñoz-Torres JR, Murillo-Ruiz-Esparza A, Garza-Veloz I, Trejo-Ortiz PM, Mollinedo-Montaño FE, Araujo-Espino R, Rodriguez-Sanchez IP, Delgado-Enciso I, Martinez-Fierro ML. Evaluation of the Effect of Influenza Vaccine on the Development of Symptoms in SARS-CoV-2 Infection and Outcome in Patients Hospitalized due to COVID-19. Vaccines (Basel) 2024; 12:765. [PMID: 39066403 PMCID: PMC11281370 DOI: 10.3390/vaccines12070765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 07/01/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND COVID-19 is an infectious disease caused by SARS-CoV-2. It is unclear whether influenza vaccination reduces the severity of disease symptoms. Previous studies have suggested a beneficial effect of influenza vaccination on the severity of COVID-19. The aim of this study was to evaluate the possible protective effect of the influenza vaccine on the occurrence of SARS-CoV-2 infection symptoms and prognosis in patients hospitalized with COVID-19. METHODS This was a retrospective cohort study of patients who tested positive for SARS-CoV-2, identified by quantitative real-time polymerase chain reaction. Chi-square tests, Kaplan-Meier analysis, and multivariate analysis were performed to assess the association between influenza vaccination and the presence of symptoms in hospitalized patients with COVID-19 and their outcome. RESULTS In this study, 1712 patients received positive laboratory tests for SARS-CoV-2; influenza vaccination was a protective factor against the presence of characteristic COVID-19 symptoms such as polypnea, anosmia, dysgeusia, and fever (p < 0.001). Influenza-vaccinated patients had fewer days of hospitalization (p = 0.029). CONCLUSIONS The findings of this study support that influenza vaccination is associated with a decrease in the number of symptoms in patients hospitalized due to COVID-19, with fewer days of hospitalization, but not with the outcome of disease.
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Affiliation(s)
- Jose Roberto Gutierrez-Camacho
- Doctorado en Ciencias con Orientación en Medicina Molecular, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas, Zacatecas 98160, Mexico; (J.R.G.-C.); (A.G.-M.); (J.R.M.-T.); (I.G.-V.); (P.M.T.-O.); (F.E.M.-M.); (R.A.-E.)
| | - Lorena Avila-Carrasco
- Doctorado en Ciencias con Orientación en Medicina Molecular, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas, Zacatecas 98160, Mexico; (J.R.G.-C.); (A.G.-M.); (J.R.M.-T.); (I.G.-V.); (P.M.T.-O.); (F.E.M.-M.); (R.A.-E.)
| | - Araceli Gamón-Madrid
- Doctorado en Ciencias con Orientación en Medicina Molecular, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas, Zacatecas 98160, Mexico; (J.R.G.-C.); (A.G.-M.); (J.R.M.-T.); (I.G.-V.); (P.M.T.-O.); (F.E.M.-M.); (R.A.-E.)
| | - Jose Ramon Muñoz-Torres
- Doctorado en Ciencias con Orientación en Medicina Molecular, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas, Zacatecas 98160, Mexico; (J.R.G.-C.); (A.G.-M.); (J.R.M.-T.); (I.G.-V.); (P.M.T.-O.); (F.E.M.-M.); (R.A.-E.)
| | | | - Idalia Garza-Veloz
- Doctorado en Ciencias con Orientación en Medicina Molecular, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas, Zacatecas 98160, Mexico; (J.R.G.-C.); (A.G.-M.); (J.R.M.-T.); (I.G.-V.); (P.M.T.-O.); (F.E.M.-M.); (R.A.-E.)
| | - Perla M. Trejo-Ortiz
- Doctorado en Ciencias con Orientación en Medicina Molecular, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas, Zacatecas 98160, Mexico; (J.R.G.-C.); (A.G.-M.); (J.R.M.-T.); (I.G.-V.); (P.M.T.-O.); (F.E.M.-M.); (R.A.-E.)
| | - Fabiana E. Mollinedo-Montaño
- Doctorado en Ciencias con Orientación en Medicina Molecular, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas, Zacatecas 98160, Mexico; (J.R.G.-C.); (A.G.-M.); (J.R.M.-T.); (I.G.-V.); (P.M.T.-O.); (F.E.M.-M.); (R.A.-E.)
| | - Roxana Araujo-Espino
- Doctorado en Ciencias con Orientación en Medicina Molecular, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas, Zacatecas 98160, Mexico; (J.R.G.-C.); (A.G.-M.); (J.R.M.-T.); (I.G.-V.); (P.M.T.-O.); (F.E.M.-M.); (R.A.-E.)
| | - Iram P. Rodriguez-Sanchez
- Laboratorio de Fisiologia Molecular y Estructural, Facultad de Ciencias Biologicas, Universidad Autonoma de Nuevo Leon, San Nicolas de Los Garza 66450, Mexico;
| | - Ivan Delgado-Enciso
- Department of Molecular Medicine, School of Medicine, Cancerology State Institute, IMSS-Bienestar, University of Colima, Colima 28040, Mexico;
| | - Margarita L. Martinez-Fierro
- Doctorado en Ciencias con Orientación en Medicina Molecular, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas, Zacatecas 98160, Mexico; (J.R.G.-C.); (A.G.-M.); (J.R.M.-T.); (I.G.-V.); (P.M.T.-O.); (F.E.M.-M.); (R.A.-E.)
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Oluwoye O, Stokes BI, Burduli E, Kriegel LS, Hoagwood KE. Community-based family peer navigator programme to facilitate linkage to coordinated specialty care for early psychosis among Black families in the USA: A protocol for a hybrid type I feasibility study. BMJ Open 2023; 13:e075729. [PMID: 37407058 PMCID: PMC10335551 DOI: 10.1136/bmjopen-2023-075729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/14/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Approximately 70% of Black/African American family members report no contact with mental health providers prior to initial diagnosis and the receipt of services for early psychosis. Black families often encounter barriers and experience delays on the pathway to coordinated specialty care programmes for early psychosis. METHODS AND ANALYSIS This mixed-methods study will (1) develop and refine a family peer navigator (FPN) for Black families designed to increase access and engagement in coordinated specialty care and (2) pilot-test FPN for Black families with 40 family members with loved ones at risk for psychosis in a randomised trial to assess the acceptability and feasibility. Families will be randomised to FPN (n=20) or a low-intensive care coordination (n=20). Other outcomes include proposed treatment targets (eg, knowledge, social connectedness), preliminary impact outcomes (time to coordinated specialty care programmes, initial family engagement), and implementation outcomes (acceptability, feasibility, appropriateness). ETHICS AND DISSEMINATION Ethics approval has been obtained from Washington State University Institutional Review Board and informed consent will be obtained from all participants. This study will establish an innovative culturally responsive FPN programme and implementation strategy, and generate preliminary data to support a larger hybrid effectiveness-implementation trial. Study findings will be presented at conferences and in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT05284721.
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Affiliation(s)
- Oladunni Oluwoye
- Community and Behavioral Health, Washington State University Elson S. Floyd College of Medicine, Spokane, Washington, USA
| | - Bryony I Stokes
- Community and Behavioral Health, Washington State University Elson S. Floyd College of Medicine, Spokane, Washington, USA
- Department of Human Development, Washington State University, Pullman, Washington, USA
| | - Ekaterina Burduli
- College of Nursing, Washington State University, Spokane, Washington, USA
| | - Liat S Kriegel
- Community and Behavioral Health, Washington State University Elson S. Floyd College of Medicine, Spokane, Washington, USA
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Abstract
BACKGROUND This article identifies the most influential methods reports for group-randomized trials and related designs published through 2020. Many interventions are delivered to participants in real or virtual groups or in groups defined by a shared interventionist so that there is an expectation for positive correlation among observations taken on participants in the same group. These interventions are typically evaluated using a group- or cluster-randomized trial, an individually randomized group treatment trial, or a stepped wedge group- or cluster-randomized trial. These trials face methodological issues beyond those encountered in the more familiar individually randomized controlled trial. METHODS PubMed was searched to identify candidate methods reports; that search was supplemented by reports known to the author. Candidate reports were reviewed by the author to include only those focused on the designs of interest. Citation counts and the relative citation ratio, a new bibliometric tool developed at the National Institutes of Health, were used to identify influential reports. The relative citation ratio measures influence at the article level by comparing the citation rate of the reference article to the citation rates of the articles cited by other articles that also cite the reference article. RESULTS In total, 1043 reports were identified that were published through 2020. However, 55 were deemed to be the most influential based on their relative citation ratio or their citation count using criteria specific to each of the three designs, with 32 group-randomized trial reports, 7 individually randomized group treatment trial reports, and 16 stepped wedge group-randomized trial reports. Many of the influential reports were early publications that drew attention to the issues that distinguish these designs from the more familiar individually randomized controlled trial. Others were textbooks that covered a wide range of issues for these designs. Others were "first reports" on analytic methods appropriate for a specific type of data (e.g. binary data, ordinal data), for features commonly encountered in these studies (e.g. unequal cluster size, attrition), or for important variations in study design (e.g. repeated measures, cohort versus cross-section). Many presented methods for sample size calculations. Others described how these designs could be applied to a new area (e.g. dissemination and implementation research). Among the reports with the highest relative citation ratios were the CONSORT statements for each design. CONCLUSIONS Collectively, the influential reports address topics of great interest to investigators who might consider using one of these designs and need guidance on selecting the most appropriate design for their research question and on the best methods for design, analysis, and sample size.
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Affiliation(s)
- David M Murray
- Office of Disease Prevention, National Institutes of Health, North Bethesda, MD, USA
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Evaluation of the Potential Risk of Mortality from SARS-CoV-2 Infection in Hospitalized Patients According to the Charlson Comorbidity Index. Healthcare (Basel) 2022; 10:healthcare10020362. [PMID: 35206976 PMCID: PMC8872141 DOI: 10.3390/healthcare10020362] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/25/2022] [Accepted: 02/10/2022] [Indexed: 12/15/2022] Open
Abstract
Background: The pandemic of COVID-19 has represented a major threat to global public health in the last century and therefore to identify predictors of mortality among COVID-19 hospitalized patients is widely justified. The aim of this study was to evaluate the possible usefulness of Charlson Comorbidity Index (CCI) as mortality predictor in patients hospitalized because COVID-19. Methods: This study was carried out in Zacatecas, Mexico, and it included 705 hospitalized patients with suspected of SARS-CoV-2 infection. Clinical data were collected, and the CCI score was calculated online using the calculator from the Sociedad Andaluza de Medicina Intensiva y Unidades Coronarias; the result was evaluated as mortality predictor among the patients with COVID-19. Results: 377 patients were positive for SARS-COV-2. Obesity increased the risk of intubation among the study population (odds ratio (OR) = 2.59; 95 CI: 1.36–4.92; p = 0.003). The CCI values were higher in patients who died because of COVID-19 complications than those observed in patients who survived (p < 0.001). Considering a CCI cutoff > 31.69, the area under the ROC curve was 0.75, with a sensitivity and a specificity of 63.6% and 87.7%, respectively. Having a CCI value > 31.69 increased the odds of death by 12.5 times among the study population (95% CI: 7.3–21.4; p < 0.001). Conclusions: The CCI is a suitable tool for the prediction of mortality in patients hospitalized for COVID-19. The presence of comorbidities in hospitalized patients with COVID-19 reflected as CCI > 31.69 increased the risk of death among the study population, so it is important to take precautionary measures in patients due to their condition and their increased vulnerability to SARS-CoV-2 infection.
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Stiwi K, Rosendahl J. Efficacy of laughter-inducing interventions in patients with somatic or mental health problems: A systematic review and meta-analysis of randomized-controlled trials. Complement Ther Clin Pract 2022; 47:101552. [DOI: 10.1016/j.ctcp.2022.101552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/12/2022] [Accepted: 02/10/2022] [Indexed: 11/17/2022]
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Hogue A, Henderson CE, Ozechowski TJ, Becker SJ, Coatsworth JD. Can the group harm the individual? Reviewing potential iatrogenic effects of group treatment for adolescent substance use. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2021. [DOI: 10.1111/cpsp.12307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Janis RA, Burlingame GM, Svien H, Jensen J, Lundgreen R. Group therapy for mood disorders: A meta-analysis. Psychother Res 2021; 31:342-358. [PMID: 32930060 DOI: 10.1080/10503307.2020.1817603] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 08/21/2020] [Accepted: 08/22/2020] [Indexed: 10/23/2022] Open
Abstract
The addition of group psychotherapy as a specialty by the APA in 2018 creates a need for rigorous empirical reviews of group treatments for specific disorders. We conducted a meta-analysis of randomized controlled trials (RCTs) that tested the effect of group psychotherapy for mood disorders, including depression and bipolar disorder, at posttreatment and follow-up time-points, as well as rates of recovery and attrition. Major databases were searched for RCTs of group treatment for depression and bipolar disorder published from 1990 to 2018, which identified 42 studies across both disorders. Random effects meta-analyses indicated that group therapy for depression produced superior outcomes compared to waitlist control (WLC) and treatment as usual (TAU) and equivalent outcomes to medication. Similarly, group therapy for bipolar disorder produced superior outcomes to TAU. Analyses of recovery rates were conducted for depression, producing similar results to the main outcome analyses. Rates of attrition did not differ between group and comparison conditions for either disorder. These findings support group therapy for treating depression and bipolar disorder, although further research is needed comparing group treatment for bipolar disorder to medication.
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Affiliation(s)
- Rebecca A Janis
- Department of Psychology, Pennsylvania State University, State College, PA, USA
| | | | - Hal Svien
- Department of Psychology, Brigham Young University, Provo, UT, USA
| | - Jennifer Jensen
- Department of Psychology, Brigham Young University, Provo, UT, USA
| | - Rachel Lundgreen
- Department of Psychology, Brigham Young University, Provo, UT, USA
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Ottenstein C, Lischetzke T. Development of a Novel Method of Emotion Differentiation That Uses Open-Ended Descriptions of Momentary Affective States. Assessment 2020; 27:1928-1945. [PMID: 30947508 PMCID: PMC7545652 DOI: 10.1177/1073191119839138] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Emotion differentiation (ED) has been conceptualized as a trait that facilitates emotion regulation and increases well-being. Yet basic questions remain unanswered about how best to assess it and whether favorable outcomes can be observed only during times of stress. The goal of the present research was to develop a novel behavioral (specificity) index of ED. We conducted two daily diary studies (N = 111-190) in which we included different measures of ED, well-being, and emotion regulation. The different ED measures were largely unrelated to each other. In both studies, the specificity index of ED showed a positive association with daily well-being, but in Study 2, this association held only on days with a negative event. Results regarding ED and the use of emotion-regulation strategies were inconsistent across strategies and studies. Possible reasons for these mixed results (e.g., sample selection, context sensitivity of regulation strategies) are discussed.
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Miller RB. An Introduction to a New Generation of Clinical Statistical Approaches. JOURNAL OF MARITAL AND FAMILY THERAPY 2020; 46:577-581. [PMID: 32662548 DOI: 10.1111/jmft.12441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Anderson BT, Danforth A, Daroff PR, Stauffer C, Ekman E, Agin-Liebes G, Trope A, Boden MT, Dilley PJ, Mitchell J, Woolley J. Psilocybin-assisted group therapy for demoralized older long-term AIDS survivor men: An open-label safety and feasibility pilot study. EClinicalMedicine 2020; 27:100538. [PMID: 33150319 PMCID: PMC7599297 DOI: 10.1016/j.eclinm.2020.100538] [Citation(s) in RCA: 133] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 08/13/2020] [Accepted: 08/20/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Psilocybin therapy has shown promise as a rapid-acting treatment for depression, anxiety, and demoralization in patients with serious medical illness (e.g., cancer) when paired with individual psychotherapy. This study assessed the safety and feasibility of psilocybin-assisted group therapy for demoralization in older long-term AIDS survivor (OLTAS) men, a population with a high degree of demoralization and traumatic loss. METHODS Self-identified gay men OLTAS with moderate-to-severe demoralization (Demoralization Scale-II ≥8) were recruited from the community of a major US city for a single-site open-label study of psilocybin-assisted group therapy comprising 8-10 group therapy visits and one psilocybin administration visit (0·3-0·36 mg/kg po). Primary outcomes were rate and severity of adverse events, and participant recruitment and retention. The primary clinical outcome was change in mean demoralization from baseline to end-of-treatment and to 3-month follow-up assessed with a two-way repeated measures ANOVA. Trial registration: Clinicaltrials.gov (NCT02950467). FINDINGS From 17 July 2017 to 16 January 2019, 18 participants (mean age 59·2 years (SD 4·4)) were enrolled, administered group therapy and psilocybin, and included in intent-to-treat analyses. We detected zero serious adverse reactions and two unexpected adverse reactions to psilocybin; seven participants experienced self-limited, severe expected adverse reactions. We detected a clinically meaningful change in demoralization from baseline to 3-month follow-up (mean difference -5·78 [SD 6·01], ηp 2 = 0·47, 90% CI 0·21-0·60). INTERPRETATION We demonstrated the feasibility, relative safety, and potential efficacy of psilocybin-assisted group therapy for demoralization in OLTAS. Groups may be an effective and efficient means of delivering psychotherapy pre- and post-psilocybin to patients with complex medical and psychiatric needs. FUNDING Carey Turnbull, Heffter Research Institute, NIMH R25 MH060482, NIH UL1 TR001872, River Styx Foundation, Saisei Foundation, Sarlo Foundation, Stupski Foundation, Usona Institute, US Department of Veterans Affairs (Advanced Neurosciences Fellowship and IK2CX001495).
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Affiliation(s)
- Brian T Anderson
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
- Zuckerberg San Francisco General Hospital, 1001 Potrero Ave, Bldg 5 (PES), San Francisco, CA 94110, USA
- Corresponding author at: Zuckerberg San Francisco General Hospital, 1001 Potrero Ave, Bldg 5 (PES), San Francisco, CA 94110, USA.
| | - Alicia Danforth
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
| | - Prof Robert Daroff
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
- Mental Health Service, San Francisco VA Medical Center, 4150 Clement St, Bldg 16, San Francisco, CA 94121, USA
| | - Christopher Stauffer
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
- Mental Health Service, San Francisco VA Medical Center, 4150 Clement St, Bldg 16, San Francisco, CA 94121, USA
- Portland VA Medical Center/Oregon Health & Science University, Portland, OR, USA
| | - Eve Ekman
- Department of Psychology, Greater Good Science Center, UC Berkeley, CA, USA
| | - Gabrielle Agin-Liebes
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
- Zuckerberg San Francisco General Hospital, 1001 Potrero Ave, Bldg 5 (PES), San Francisco, CA 94110, USA
| | - Alexander Trope
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
| | - Matthew Tyler Boden
- Center for Innovation to Implementation, Veterans Affairs (VA) Palo Alto Health Care System, Menlo Park, CA, USA
| | - Prof James Dilley
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
- Zuckerberg San Francisco General Hospital, 1001 Potrero Ave, Bldg 5 (PES), San Francisco, CA 94110, USA
| | - Jennifer Mitchell
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
- Mental Health Service, San Francisco VA Medical Center, 4150 Clement St, Bldg 16, San Francisco, CA 94121, USA
- Department of Neurology, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
| | - Joshua Woolley
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
- Mental Health Service, San Francisco VA Medical Center, 4150 Clement St, Bldg 16, San Francisco, CA 94121, USA
- Corresponding author at: Mental Health Service, San Francisco VA Medical Center, 4150 Clement St, Bldg 16, San Francisco, CA 94121, USA.
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Rohde P, Brière FN, Stice E. The Potential Influence of Group Membership on Outcomes in Indicated Cognitive-Behavioral Adolescent Depression Prevention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186553. [PMID: 32916855 PMCID: PMC7559924 DOI: 10.3390/ijerph17186553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/24/2020] [Accepted: 09/02/2020] [Indexed: 11/29/2022]
Abstract
Background: Adolescent depression prevention programs are typically delivered in groups in which adolescents share a common setting and interventionist, but the influence of the group is usually ignored or statistically controlled. We tested whether the primary outcomes of reductions in depressive symptoms and future onset of major depressive disorder (MDD) varied as a function of group membership. Methods: Data were available from two randomized trials in which 220 adolescents received the Blues Program indicated prevention intervention in 36 separate groups; participants were assessed at baseline, post intervention, and at 6-, 12-, and 24-month follow-ups. Results: Ten percent of participants had developed MDD 2 years post intervention. Group-level effects for MDD onset over follow-up were nonsignificant (accounted for <1% of variance; ICC = 0.004, ns). Group-level effects for depressive symptom change across the follow-up period were also nonsignificant (ICC = 0.001, ns) but group effects accounted for 16% of depressive symptom change immediately post intervention (ICC = 0.159, p < 0.05). Group-level clustering of posttest depressive symptoms was not associated with size of group or gender composition. Conclusions: Membership in specific adolescent cognitive-behavioral depression prevention groups may have an impact in terms of immediate symptom reduction but does not appear to have significant prevention effects in terms of long-term symptom change or MDD onset.
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Affiliation(s)
- Paul Rohde
- Oregon Research Institute, Eugene, OR 97403, USA
- Correspondence: ; Tel.: +1-541-484-2123
| | - Frédéric N. Brière
- École de Psychoéducation, Université de Montréal, Montreal, QC H3T 1J4, Canada;
| | - Eric Stice
- Psychiatry and Behavioral Sciences (Public Mental Health and Population Sciences), Stanford University Medical Center, Stanford, CA 94305, USA;
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Munson MR, Jaccard JJ, Scott LD, Narendorf SC, Moore KL, Jenefsky N, Cole A, Davis M, Gilmer T, Shimizu R, Pleines K, Cooper K, Rodwin AH, Hylek L, Amaro A. Engagement intervention versus treatment as usual for young adults with serious mental illness: a randomized pilot trial. Pilot Feasibility Stud 2020; 6:107. [PMID: 32714561 PMCID: PMC7376671 DOI: 10.1186/s40814-020-00650-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 07/16/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Young adults have elevated rates of mental health disorders, yet they often do not receive consistent care. The challenge of continuing to engage young adults has been pervasive worldwide. Few engagement interventions have been designed for young adults with serious mental illness. Just Do You is a theoretically guided engagement intervention. It uses innovative modalities (i.e., technology, expressive arts activities, narrative expression, mentoring) to engage participants in conversations about services and how they work, while simultaneously orienting them to treatment. METHODS/DESIGN This pilot and feasibility study utilizes a hybrid research design, examining feasibility, acceptability, and preliminary impact, alongside implementation. The study combines qualitative methods, a small pilot randomized trial, and a small cost-benefit analysis. Respondents are clinic staff and young adults who have made initial contact with the Personalized Recovery Oriented Services (PROS) program. Quantitative survey data are collected at baseline, 2 weeks (post-intervention), 1 month, and 3 months. The assessments focus on measuring feasibility, acceptability, engagement, and mental health outcomes. Medical record extraction will be used to triangulate self-report data. We will conduct single degree of freedom contrasts to examine whether Just Do You leads to improved outcomes relative to Treatment-As-Usual using robust regression for each outcome measure. We will examine whether changes in the proposed mediating variables occur across groups using a similar contrast strategy. In addition, we will use structural equation modeling to examine the contribution of mediators to ultimate outcomes. Finally, we will use constant comparison coding techniques for qualitative analyses. DISCUSSION The aim of this study is to examine the feasibility of a young adult engagement meta-intervention through an intensive preliminary pilot trial, learning through collaboration with stakeholders. Just Do You has the potential to fill a gap in the service system for young adults with serious mental illnesses, improving the seemingly intractable problem of disengagement. The program uses culturally responsive strategies, is recovery-oriented, and builds upon the best evidence to date. Our efforts align with local and national health care reform efforts embedding people with lived experience. TRIAL REGISTRATION This trial was registered with ClinicalTrials.gov (Identifier: NCT03423212) on April 18, 2018, as Protocol Record R34 MH111861-01, New York University, as the Just Do You Program for Young Adults with Serious Mental Illness.
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Affiliation(s)
- Michelle R. Munson
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY 10003 USA
| | - James J. Jaccard
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY 10003 USA
| | - Lionel D. Scott
- School of Social Work, Georgia State University, Atlanta, Georgia 30302 USA
| | - Sarah C. Narendorf
- Graduate College of Social Work, University of Houston, 3511 Cullen Blvd, Houston, TX 77204 USA
| | - Kiara L. Moore
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY 10003 USA
| | - Nadia Jenefsky
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY 10003 USA
| | - Andrea Cole
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032 USA
| | - Maryann Davis
- Medical School, Psychiatry, University of Massachusetts, 55 Lake Avenue North, Worcester, MA 01655 USA
| | - Todd Gilmer
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA 92093 USA
| | - Rei Shimizu
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY 10003 USA
| | - Kristin Pleines
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY 10003 USA
| | - Kamilyah Cooper
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY 10003 USA
| | - Aaron H. Rodwin
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY 10003 USA
| | - Lindsay Hylek
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY 10003 USA
| | - Angel Amaro
- School of Social Work, Columbia University, 1255 Amsterdam Ave, New York, NY 10027 USA
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15
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Li X, Pan Y, Fang Z, Lei H, Zhang X, Shi H, Ma N, Raine P, Wetherill R, Kim JJ, Wan Y, Rao H. Test-retest reliability of brain responses to risk-taking during the balloon analogue risk task. Neuroimage 2020; 209:116495. [PMID: 31887425 PMCID: PMC7061333 DOI: 10.1016/j.neuroimage.2019.116495] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 12/20/2019] [Accepted: 12/23/2019] [Indexed: 12/24/2022] Open
Abstract
The Balloon Analogue Risk Task (BART) provides a reliable and ecologically valid model for the assessment of individual risk-taking propensity and is frequently used in neuroimaging and developmental research. Although the test-retest reliability of risk-taking behavior during the BART is well established, the reliability of brain activation patterns in response to risk-taking during the BART remains elusive. In this study, we used functional magnetic resonance imaging (fMRI) and evaluated the test-retest reliability of brain responses in 34 healthy adults during a modified BART by calculating the intraclass correlation coefficients (ICC) and Dice's similarity coefficients (DSC). Analyses revealed that risk-induced brain activation patterns showed good test-retest reliability (median ICC = 0.62) and moderate to high spatial consistency, while brain activation patterns associated with win or loss outcomes only had poor to fair reliability (median ICC = 0.33 for win and 0.42 for loss). These findings have important implications for future utility of the BART in fMRI to examine brain responses to risk-taking and decision-making.
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Affiliation(s)
- Xiong Li
- School of Economics and Management, Beijing University of Posts and Telecommunications, Beijing, China
| | - Yu Pan
- School of Economics and Management, Beijing University of Posts and Telecommunications, Beijing, China; Key Laboratory of Applied Brain and Cognitive Sciences, School of Business and Management, Shanghai International Studies University, Shanghai, China
| | - Zhuo Fang
- Key Laboratory of Applied Brain and Cognitive Sciences, School of Business and Management, Shanghai International Studies University, Shanghai, China; Center for Functional Neuroimaging, Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Hui Lei
- Center for Functional Neuroimaging, Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Xiaocui Zhang
- Center for Functional Neuroimaging, Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Hui Shi
- Center for Functional Neuroimaging, Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Ning Ma
- Center for Functional Neuroimaging, Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Philip Raine
- Center for Functional Neuroimaging, Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Reagan Wetherill
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Junghoon J Kim
- Department of Molecular, Cellular, and Biomedical Sciences, CUNY School of Medicine, The City College of New York, New York, NY, USA
| | - Yan Wan
- School of Economics and Management, Beijing University of Posts and Telecommunications, Beijing, China
| | - Hengyi Rao
- Key Laboratory of Applied Brain and Cognitive Sciences, School of Business and Management, Shanghai International Studies University, Shanghai, China; Center for Functional Neuroimaging, Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
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16
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Dessie ZG, Zewotir T, Mwambi H, North D. Multivariate multilevel modeling of quality of life dynamics of HIV infected patients. Health Qual Life Outcomes 2020; 18:80. [PMID: 32209095 PMCID: PMC7092601 DOI: 10.1186/s12955-020-01330-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 03/16/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Longitudinal quality of life (QoL) is an important outcome in many chronic illness studies aiming to evaluate the efficiency of care both at the patient and health system level. Although many QoL studies involve multiple correlated hierarchical outcome measures, very few of them use multivariate modeling. In this work, we modeled the long-term dynamics of QoL scores accounting for the correlation between the QoL scores in a multilevel multivariate framework and to compare the effects of covariates across the outcomes. METHODS The data is from an ongoing prospective cohort study conducted amongst adult women who were HIV-infected and on the treatment in Kwazulu-Natal, South Africa. Independent and related QoL outcome multivariate multilevel models were presented and compared. RESULTS The analysis showed that related outcome multivariate multilevel models fit better for our data used. Our analyses also revealed that higher educational levels, middle age, stable sex partners and higher weights had a significant effect on better improvements in the rate of change of QoL scores of HIV infected patients. Similarly, patients without TB co-infection, without thrombocytopenia, with lower viral load, with higher CD4 cell count levels, with higher electrolytes component score, with higher red blood cell (RBC) component score and with lower liver abnormality component score, were associated with significantly improved the rate of change of QoL, amongst HIV infected patients. CONCLUSION It is hoped that the article will help applied researchers to familiarize themselves with the models and including interpretation of results. Furthermore, three issues are highlighted: model building of multivariate multilevel outcomes, how this model can be used to assess multivariate assumptions, involving fixed effects (for example, to examine the size of the covariate effect varying across QoL domain scores) and random effects (for example, to examine the rate of change in one response variable associated to changes in the other).
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Affiliation(s)
- Zelalem G. Dessie
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, South Africa
- College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Temesgen Zewotir
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, South Africa
| | - Henry Mwambi
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, South Africa
| | - Delia North
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, South Africa
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17
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Lau BHP, Chow AYM, Ng TK, Fung YL, Lam TC, So TH, Chan JSM, Chan CHY, Zhou J, Tam MYJ, Tsang MW, Cheng NSY, Lim PFM, Chow SF, Chan CLW, Wong DFK. Comparing the efficacy of integrative body-mind-spirit intervention with cognitive behavioral therapy in patient-caregiver parallel groups for lung cancer patients using a randomized controlled trial. J Psychosoc Oncol 2020; 38:389-405. [PMID: 32146876 DOI: 10.1080/07347332.2020.1722981] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Purposes/objectives: This paper reports the comparative efficacies of integrative body-mind-spirit intervention (I-BMS) and cognitive behavioral therapy (CBT) in patient-caregiver parallel groups for Chinese patients with lung cancer.Design: Randomized controlled trial (RCT).Methods: One hundred and fifty-seven patient-caregiver dyads with no marked functional impairment were randomized into one of the two interventions with eight weekly patient-caregiver parallel groups. Assessments were conducted at baseline, within one, eight- and sixteen-weeks post-intervention. Effects of treatment group across time were analyzed by multilevel modeling.Findings: CBT led to greater reduction in emotional vulnerability than I-BMS. I-BMS resulted in greater increase in overall QoL and spiritual self-care, and more reduction in depression than CBT. Patients in both interventions experienced improvement in physical, emotional and spiritual, except social, domains of QoL.Conclusion: I-BMS was more efficacious for diverse domains of QoL, and CBT was more effective for emotional well-being, despite the relatively small between-group effect sizes.Implications for psychosocial providers/policy: (1) With the expanding repertoire of psychosocial interventions for families facing lung cancer, it has become imperative to investigate the comparative efficacies of empirically supported and culturally adapted interventions. (2) Our findings show that I-BMS was more effective for diverse domains of QoL, while CBT was more efficacious with emotional well-being, although both interventions led to significant improvements in physical, emotional and spiritual domains of patient QoL. (3) Patient-caregiver parallel groups have been shown to be effective for enhancing QoL of Chinese lung cancer patients. (4) Care professionals are encouraged to dispense interventions based on the idiosyncratic needs and preferences of the patients to maximize the treatment effects.
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Affiliation(s)
- Bobo H P Lau
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong
| | - Amy Y M Chow
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Ting-Kin Ng
- Wofoo Joseph Lee Consulting and Counselling Psychology Research Centre, Lingnan University, Hong Kong
| | - Yat-Lui Fung
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Tai-Chung Lam
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong
| | - Tsz-Him So
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong
| | - Jessie S M Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Celia H Y Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Jillian Zhou
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Michelle Y J Tam
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | | | | | | | | | - Cecilia L W Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Daniel F K Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
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18
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Moerbeek M. Optimal designs for group randomized trials and group administered treatments with outcomes at the subject and group level. Stat Methods Med Res 2020; 29:797-810. [PMID: 31041883 PMCID: PMC7082894 DOI: 10.1177/0962280219846149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
With group randomized trials complete groups of subject are randomized to treatment conditions. Such grouping also occurs in individually randomized trials where treatment is administered in groups. Outcomes may be measured at the level of the subject, but also at the level of the group. The optimal design determines the number of groups and the number of subjects per group in the intervention and control conditions. It is found by taking a budgetary constraint into account, where costs are associated with implementing the intervention and control, and with taking measurements on subject and groups. The optimal design is found such that the effect of treatment is estimated with highest efficiency, and the total costs do not exceed the budget that is available. The design that is optimal for the outcome at the subject level is not necessarily optimal for the outcome at the group level. Multiple-objective optimal designs consider both outcomes simultaneously. Their aim is to find a design that has high efficiencies for both outcome measures. An Internet application for finding the multiple-objective optimal design is demonstrated on the basis of an example from smoking prevention in primary education, and another example on consultation time in primary care.
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Affiliation(s)
- Mirjam Moerbeek
- Department of Methodology and Statistics, Utrecht University, Utrecht, the Netherlands
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19
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Barkowski S, Schwartze D, Strauss B, Burlingame GM, Rosendahl J. Efficacy of group psychotherapy for anxiety disorders: A systematic review and meta-analysis. Psychother Res 2020; 30:965-982. [DOI: 10.1080/10503307.2020.1729440] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Sarah Barkowski
- Institute of Psychosocial Medicine and Psychotherapy, Friedrich-Schiller University, Jena University Hospital, Jena, Germany
| | - Dominique Schwartze
- Institute of Psychosocial Medicine and Psychotherapy, Friedrich-Schiller University, Jena University Hospital, Jena, Germany
| | - Bernhard Strauss
- Institute of Psychosocial Medicine and Psychotherapy, Friedrich-Schiller University, Jena University Hospital, Jena, Germany
| | | | - Jenny Rosendahl
- Institute of Psychosocial Medicine and Psychotherapy, Friedrich-Schiller University, Jena University Hospital, Jena, Germany
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20
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C'de Baca J, Castillo D, DeBeer B, Qualls C. Rationale and design of an efficacy study of Group Prolonged Exposure for PTSD. Contemp Clin Trials Commun 2020; 17:100509. [PMID: 31989057 PMCID: PMC6970140 DOI: 10.1016/j.conctc.2019.100509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 11/27/2019] [Accepted: 12/12/2019] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Among health problems in the Veteran population, the most common is posttraumatic stress disorder (PTSD) and its effect on the quality of life. Prolonged Exposure therapy, based on emotional processing theory, is a first-line treatment for reducing PTSD symptom severity when delivered in an individual format, and its efficacy is well established. The primary objective of this study is to establish the efficacy of prolonged exposure delivered in a small 3-person group modality. Quality of life should improve with decreases in PTSD symptoms such as sleep disturbance, irritability, and hypervigilance. Stigma is associated with hesitation in seeking treatment and treatment dropout. A secondary objective is to measure the effect of group treatment on reducing the stigma surrounding PTSD. METHODS/DESIGN This study is a randomized controlled trial testing the efficacy of Group Prolonged Exposure (PE) for reducing PTSD symptom severity and improving quality of life in male Afghanistan and Iraq Veterans. All participants are randomly assigned to receive Group PE or Group Present-Centered Therapy (PCT) for 10-weekly, 90-min sessions. Group PE focuses on processing trauma memories, while the goal of Group PCT is improved psychosocial functioning through management of current stressors. The primary outcome is improvement in CAPS-5 PTSD symptom severity scores and quality of life measures (WHO-QOL and SF-36) from pre-treatment to post-treatment, 3-months post-treatment, and 6-months post-treatment. A secondary outcome is reductions in perceived self-stigma of mental illness based on the Stigma Scale at baseline and follow-up points. This study is designed to expand access to this first-line treatment for PTSD by delivering PE in a small group modality while conforming to the individual PE protocol, with group treatment reducing perceived stigma of mental illness.
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Affiliation(s)
- Janet C'de Baca
- New Mexico VA Health Care System VISN 22, Behavioral Health Care Line (116), 1501 San Pedro SE, Albuquerque, NM, 87108, USA
| | - Diane Castillo
- VA VISN 17 Center of Excellence for Research on Returning War Veterans, 4800 Memorial Drive, 151-C, Waco, TX, 76711, USA
| | - Bryann DeBeer
- VA VISN 17 Center of Excellence for Research on Returning War Veterans, 4800 Memorial Drive, 151-C, Waco, TX, 76711, USA.,Texas A&M University Health Science Center, Temple, TX, USA
| | - Clifford Qualls
- Mathematics and Statistics, University of New Mexico, Albuquerque, NM, USA.,Biostatistician, Biomedical Research Institute of New Mexico, Albuquerque, NM, USA
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21
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The Structure of Competence: Evaluating the Factor Structure of the Cognitive Therapy Rating Scale. Behav Ther 2020; 51:113-122. [PMID: 32005329 PMCID: PMC6997919 DOI: 10.1016/j.beth.2019.05.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 05/03/2019] [Accepted: 05/14/2019] [Indexed: 11/24/2022]
Abstract
The Cognitive Therapy Rating Scale (CTRS) is an observer-rated measure of cognitive behavioral therapy (CBT) treatment fidelity. Although widely used, the factor structure and psychometric properties of the CTRS are not well established. Evaluating the factorial validity of the CTRS may increase its utility for training and fidelity monitoring in clinical practice and research. The current study used multilevel exploratory factor analysis to examine the factor structure of the CTRS in a large sample of therapists (n = 413) and observations (n = 1,264) from community-based CBT training. Examination of model fit and factor loadings suggested that three within-therapist factors and one between-therapist factor provided adequate fit and the most parsimonious and interpretable factor structure. The three within-therapist factors included items related to (a) session structure, (b) CBT-specific skills and techniques, and (c) therapeutic relationship skills, although three items showed some evidence of cross-loading. All items showed moderate to high loadings on the single between-therapist factor. Results support continued use of the CTRS and suggest factors that may be a relevant focus for therapists, trainers, and researchers.
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22
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Murray DM, Taljaard M, Turner EL, George SM. Essential Ingredients and Innovations in the Design and Analysis of Group-Randomized Trials. Annu Rev Public Health 2019; 41:1-19. [PMID: 31869281 DOI: 10.1146/annurev-publhealth-040119-094027] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This article reviews the essential ingredients and innovations in the design and analysis of group-randomized trials. The methods literature for these trials has grown steadily since they were introduced to the biomedical research community in the late 1970s, and we summarize those developments. We review, in addition to the group-randomized trial, methods for two closely related designs, the individually randomized group treatment trial and the stepped-wedge group-randomized trial. After describing the essential ingredients for these designs, we review the most important developments in the evolution of their methods using a new bibliometric tool developed at the National Institutes of Health. We then discuss the questions to be considered when selecting from among these designs or selecting the traditional randomized controlled trial. We close with a review of current methods for the analysis of data from these designs, a case study to illustrate each design, and a brief summary.
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Affiliation(s)
- David M Murray
- Office of Disease Prevention, National Institutes of Health, North Bethesda, Maryland 20892, USA; ,
| | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Civic Campus, Ottawa, Ontario K1Y 4E9, Canada; .,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario K1Y 4E9, Canada
| | - Elizabeth L Turner
- Department of Biostatistics and Bioinformatics, and Duke Global Health Institute, Duke University, Durham, North Carolina 27710, USA;
| | - Stephanie M George
- Office of Disease Prevention, National Institutes of Health, North Bethesda, Maryland 20892, USA; ,
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23
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Biglan A. The Ultimate Goal of Prevention and the Larger Context for Translation. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2019; 19:328-336. [PMID: 26910318 DOI: 10.1007/s11121-016-0635-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Type II translational research tends to emphasize getting evidence-based programs implemented in real world settings. To fully realize the aspirations of prevention scientists, we need a broader strategy for translating knowledge about human wellbeing into population-wide improvements in wellbeing. Far-reaching changes must occur in policies and cultural practices that affect the quality of family, school, workplace, and community environments. This paper describes a broad cultural movement, not unlike the tobacco control movement, that can make nurturing environments a fundamental priority of public policy and daily life, thereby enhancing human wellbeing far beyond anything achieved thus far.
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Affiliation(s)
- Anthony Biglan
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR, 97403, USA.
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24
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Trope A, Anderson BT, Hooker AR, Glick G, Stauffer C, Woolley JD. Psychedelic-Assisted Group Therapy: A Systematic Review. J Psychoactive Drugs 2019; 51:174-188. [PMID: 30950777 DOI: 10.1080/02791072.2019.1593559] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Contemporary research with classic psychedelic drugs (e.g., lysergic acid diethylamide (LSD) and psilocybin) is indebted to the twentieth-century researchers and clinicians who generated valuable clinical knowledge of these substances through experimentation. Several recent reviews that highlight the contributions of this early literature have focused on psychedelic-assisted individual psychotherapy modalities. None have attempted to systematically identify and compile experimental studies of psychedelic-assisted group therapy. In therapeutic settings, psychedelics were often used to enhance group therapy for a variety of populations and clinical indications. We report on the results of a systematic review of the published literature in English and Spanish on psychedelic-assisted group therapies. Publications are characterized by their clinical approach, experimental method, and clinical outcomes. Given the renewed interest in the clinical use of psychedelic medicines, this review aims to stimulate hypotheses to be tested in future research on psychedelic-assisted psychotherapy, group process, and interpersonal functioning.
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Affiliation(s)
- Alexander Trope
- a Department of Psychiatry , Weill Institute for Neurosciences, UCSF , San Francisco , CA , USA
| | - Brian T Anderson
- a Department of Psychiatry , Weill Institute for Neurosciences, UCSF , San Francisco , CA , USA.,b Mental Health Service , San Francisco VA Medical Center , San Francisco , CA , USA
| | - Andrew R Hooker
- c Osher Center for Integrative Medicine , UCSF , San Francisco , CA , USA
| | - Giancarlo Glick
- d School of Medicine , Brown University , Providence , RI , USA
| | - Christopher Stauffer
- a Department of Psychiatry , Weill Institute for Neurosciences, UCSF , San Francisco , CA , USA.,b Mental Health Service , San Francisco VA Medical Center , San Francisco , CA , USA
| | - Joshua D Woolley
- a Department of Psychiatry , Weill Institute for Neurosciences, UCSF , San Francisco , CA , USA.,b Mental Health Service , San Francisco VA Medical Center , San Francisco , CA , USA
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25
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Silverman WK, Marin CE, Rey Y, Kurtines WM, Jaccard J, Pettit JW. Group- versus Parent-Involvement CBT for Childhood Anxiety Disorders: Treatment Specificity and Long-term Recovery Mediation. Clin Psychol Sci 2019; 7:840-855. [PMID: 33758679 DOI: 10.1177/2167702619830404] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective Treatment specificity and long-term recovery mediation of peer-involvement group cognitive behavioral therapy (GCBT) and parent-involvement CBT (PCBT) were investigated for youth anxiety disorders. Method 240 youths with primary anxiety diagnoses participated in a randomized controlled efficacy trial. Youth anxiety and peer variables/mediators (positive peer-youth relationships; social skills), and parent variables/mediators (psychological control; negative parent-youth relationships) were assessed. Results At posttreatment and 12-month follow up, positive peer-youth relationships were significantly higher in GCBT than PCBT (specificity). At posttreatment, not follow up, parental psychological control was significantly lower in PCBT than GCBT (specificity). Parental psychological control and positive peer-youth relationships were putative mediators. The two CBTs produced similar anxiety reductions through different mechanisms. Conclusions CBT targets show specificity and mediation, providing insight into specific mechanisms through which GCBT and PCBT bring about anxiety reduction and guidance for streamlining these CBTs in practice.
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26
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Effectiveness Trial of Brief Indicated Cognitive-Behavioral Group Depression Prevention in French-Canadian Secondary Schools. SCHOOL MENTAL HEALTH 2019. [DOI: 10.1007/s12310-019-09316-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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27
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Lo Coco G, Melchiori F, Oieni V, Infurna MR, Strauss B, Schwartze D, Rosendahl J, Gullo S. Group treatment for substance use disorder in adults: A systematic review and meta-analysis of randomized-controlled trials. J Subst Abuse Treat 2019; 99:104-116. [PMID: 30797382 DOI: 10.1016/j.jsat.2019.01.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 01/21/2019] [Accepted: 01/22/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS From residential programs to outpatient services, group therapy permeates the clinical field of substance misuse. While several group interventions for substance use disorders (SUDs) have demonstrated effectiveness, the existing evidence on group therapy has not been systematically reviewed. The current meta-analysis aims to provide estimates of the efficacy of group therapy for SUDs in adults using rigorous methods. METHODS We included studies comparing group psychotherapy to no treatment control groups, individual psychotherapy, medication, self-help groups, and other active treatments applying no specific psychotherapeutic techniques for patients with substance use disorder. The primary outcome was abstinence, and the secondary outcomes were frequency of substance use and symptoms of substance use disorder, anxiety, depression, general psychopathology, and attrition. A comprehensive search was conducted in Medline, Web of Science, CENTRAL, and PsycINFO, complemented by a manual search. Random-effects meta-analyses were run separately for different types of control groups. RESULTS Thirty-three studies were included. Significant small effects of group therapy were found on abstinence compared to no treatment, individual therapy, and other treatments. Effects on substance use frequency and SUD symptoms were not significant, but significant moderately sized effects emerged for mental state when group therapy was compared to no treatment. There were no differences in abstinence rates between group therapy and control groups. These results were robust in sensitivity analyses and there was no indication of publication bias. CONCLUSIONS The current findings represent the best available summary analysis of group therapy for SUDs in adults, however cautious interpretation is warranted given the limitations of the available data.
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Affiliation(s)
- Gianluca Lo Coco
- University of Palermo, Department of Psychology, Educational Sciences and Human Movement, Palermo, Italy.
| | | | | | | | - Bernhard Strauss
- University Hospital Jena, Friedrich Schiller University Jena, Institute of Psychosocial Medicine and Psychotherapy, Jena, Germany
| | - Dominique Schwartze
- University Hospital Jena, Friedrich Schiller University Jena, Institute of Psychosocial Medicine and Psychotherapy, Jena, Germany
| | - Jenny Rosendahl
- University Hospital Jena, Friedrich Schiller University Jena, Institute of Psychosocial Medicine and Psychotherapy, Jena, Germany
| | - Salvatore Gullo
- University of Palermo, Department of Psychology, Educational Sciences and Human Movement, Palermo, Italy
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Mahoney A, Karatzias T, Hutton P. A systematic review and meta-analysis of group treatments for adults with symptoms associated with complex post-traumatic stress disorder. J Affect Disord 2019; 243:305-321. [PMID: 30261446 DOI: 10.1016/j.jad.2018.09.059] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/23/2018] [Accepted: 09/16/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND No previous meta-analyses have specifically investigated the effectiveness of psychological group therapy for symptoms associated with complex interpersonal trauma, including whether trauma memory processing (TMP) therapies are superior to psychoeducational approaches alone. METHODS A systematic review identified 36 randomised control trials (RCTs) which were included in the meta-analysis. RESULTS Large significant effect sizes were evident for TMP interventions when compared to usual care for three outcome domains including: PTSD (k = 6, g = -0.98, 95% CI -1.53, -0.43), Depression (k = 7, g = -1.12, 95% CI -2.01, -0.23) and Psychological Distress (k = 6, g = -0.98, 95% CI 1.66, -0.40). When TMP and psychoeducation interventions were directly compared, results indicated a small non-significant effect in favour of the former for PTSD symptoms, (k = 4, g = -0.34, 95% CI -1.05, 0.36) and small non-significant effect sizes in favour of the latter for Depression (k = 3, g = 0.29, 95% CI -0.83, 1.4) and Psychological Distress (k = 6, g = 0.19, 95% CI -0.34, 0.71). LIMITATIONS Heterogeneity and a limited number of high quality RCTs, particularly in the Substance Misuse and Dissociation domains, resulted in uncertainty regarding meta-analytical estimates and subsequent conclusions. CONCLUSIONS Results suggest that TMP interventions are useful for traumatic stress whereas non-TMP interventions can be useful for symptoms of general distress (e.g. anxiety and depression). Thus, both TMP and psychoeducation can be useful for the treatment of complex interpersonal trauma symptoms and further research should unravel appropriate sequencing and dose of these interventions.
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Affiliation(s)
- Adam Mahoney
- Psychology Department, HMP & YOI Cornton Vale, Stirling, UK; School of Health & Social Science, Edinburgh Napier University, UK.
| | - Thanos Karatzias
- School of Health & Social Science, Edinburgh Napier University, UK; Rivers Centre for Traumatic Stress, NHS Lothian, UK
| | - Paul Hutton
- School of Health & Social Science, Edinburgh Napier University, UK
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Sloan DM, Unger W, Lee DJ, Beck JG. A Randomized Controlled Trial of Group Cognitive Behavioral Treatment for Veterans Diagnosed With Chronic Posttraumatic Stress Disorder. J Trauma Stress 2018; 31:886-898. [PMID: 30499227 PMCID: PMC6295345 DOI: 10.1002/jts.22338] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/03/2018] [Accepted: 07/16/2018] [Indexed: 01/18/2023]
Abstract
Relative to advances in the literature that have examined individual treatment approaches for posttraumatic stress disorder (PTSD), scientific knowledge about group treatment approaches has lagged, resulting in no currently available group treatment for PTSD despite the frequency with which this format is used. Our goal was to build upon the existing literature by examining the efficacy of a group cognitive-behavioral treatment (GCBT) for PTSD relative to group present-centered treatment (GPCT). The sample consisted of 198 male veterans with PTSD who were recruited at two Department of Veteran Affairs medical centers and randomly assigned to either GCBT (n = 98) or GPCT (n = 100); both treatments were 14 sessions. Assessments occurred at baseline, midtreatment, posttreatment, and 3-, 6-, and 12-month follow-ups. Findings indicated significant reductions in PTSD severity and PTSD diagnostic status following treatment for both GCBT, d = 0.97, and GPCT, d = 0.61. In addition, we observed significant reductions for depression symptoms, anxiety symptoms, and functional impairment for both group treatments as well as a reduction in the percentage of veteran participants who met diagnostic status for co-occurring major depression disorder and generalized anxiety disorder. Notably, these treatment gains were maintained at 12-month follow-up. Contrary to expectations, there were no significant differences between treatment conditions. Veterans diagnosed with PTSD were successfully treated using a group approach. Consistent with a growing body of evidence, the findings also suggest GPCT is as equally efficacious as group trauma-focused treatment. The trial was registered at clinicaltrials.gov (NCT01544088).
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Affiliation(s)
- Denise M. Sloan
- VA Boston Healthcare System, Boston, Massachusetts, USA,National Center for PTSD, Boston, Massachusetts, USA,Boston University School of Medicine, Department of Psychiatry, Boston, Massachusetts, USA
| | - William Unger
- VA Providence Medical Center, Providence, Rhode Island, USA
| | - Daniel J. Lee
- VA Boston Healthcare System, Boston, Massachusetts, USA,National Center for PTSD, Boston, Massachusetts, USA,Boston University School of Medicine, Department of Psychiatry, Boston, Massachusetts, USA
| | - J. Gayle Beck
- University of Memphis, Department of Psychology, Memphis, Tennessee, USA
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Osma J, Suso-Ribera C, García-Palacios A, Crespo-Delgado E, Robert-Flor C, Sánchez-Guerrero A, Ferreres-Galan V, Pérez-Ayerra L, Malea-Fernández A, Torres-Alfosea MÁ. Efficacy of the unified protocol for the treatment of emotional disorders in the Spanish public mental health system using a group format: study protocol for a multicenter, randomized, non-inferiority controlled trial. Health Qual Life Outcomes 2018. [PMID: 29530035 PMCID: PMC5848595 DOI: 10.1186/s12955-018-0866-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background Emotional disorders, which include both anxiety and depressive disorders, are the most prevalent psychological disorders according to recent epidemiological studies. Consequently, public costs associated with their treatment have become a matter of concern for public health systems, which face long waiting lists. Because of their high prevalence in the population, finding an effective treatment for emotional disorders has become a key goal of today’s clinical psychology. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders might serve the aforementioned purpose, as it can be applied to a variety of disorders simultaneously and it can be easily performed in a group format. Methods The study is a multicenter, randomized, non-inferiority controlled clinical trial. Participants will be 220 individuals with emotional disorders, who are randomized to either a treatment as usual (individual cognitive behavioral therapy) or to a Unified Protocol condition in group format. Depression, anxiety, and diagnostic criteria are the primary outcome measures. Secondary measures include the assessment of positive and negative affect, anxiety control, personality traits, overall adjustment, and quality of life. An analysis of treatment satisfaction is also conducted. Assessment points include baseline, post-treatment, and three follow-ups at 3, 6, and 12 months. To control for missing data and possible biases, intention-to-treat and per-protocol analyses will be performed. Discussion This is the first randomized, controlled clinical trial to test the effectiveness of a transdiagnostic intervention in a group format for the treatment of emotional disorders in public settings in Spain. Results obtained from this study may have important clinical, social, and economic implications for public mental health settings in Spain. Trial registration Retrospectively registered at https://clinicaltrials.gov/. Trial NCT03064477 (March 10, 2017). The trial is active and recruitment is ongoing. Recruitment is expected to finish by January 2020.
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Affiliation(s)
- Jorge Osma
- University of Zaragoza, Teruel, Spain. .,Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain. .,Facultad de Ciencias Sociales y Humanas, Universidad de Zaragoza, C/ Ciudad Escolar s/n, 44003, Teruel, Spain.
| | - Carlos Suso-Ribera
- Universitat Jaume I. Edificio de Investigación II, Av. Vicente SosBaynat s/n, 12006, Castellón, Spain
| | - Azucena García-Palacios
- CIBER of Physiopathology of Obesity and Nutrition CIBERobn, CB06/03 Instituto de Salud Carlos III, Castellón, Spain
| | - Elena Crespo-Delgado
- Universitat Jaume I. Edificio de Investigación II, Av. Vicente SosBaynat s/n, 12006, Castellón, Spain
| | - Cristina Robert-Flor
- Unidad de Salud Mental La Fuente de San Luís, C/ Arabista Ambrosio Huici, 30, 46013, Valencia, Spain
| | - Ana Sánchez-Guerrero
- Unidad de Salud Mental La Fuente de San Luís, C/ Arabista Ambrosio Huici, 30, 46013, Valencia, Spain
| | - Vanesa Ferreres-Galan
- Hospital Comarcal de Vinaròs, Avinguda Gil d'Atrosillo, s/n, 12500, Castellón, Spain
| | - Luisa Pérez-Ayerra
- Centro de Salud Mental La Milagrosa, C/ Julián Gayarre, 1A, 31005, Pamplona, Spain
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Wendt DC, Gone JP. Complexities with group therapy facilitation in substance use disorder specialty treatment settings. J Subst Abuse Treat 2018; 88:9-17. [PMID: 29606227 DOI: 10.1016/j.jsat.2018.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 02/08/2018] [Accepted: 02/10/2018] [Indexed: 11/17/2022]
Abstract
In spite of increased attention to research-based interventions for substance use disorders (SUDs), a formidable research-practice gap impedes the implementation of evidence-based treatments (EBTs). An underappreciated dimension of this gap is a mismatch in treatment modality: Whereas clinical trial and implementation research has focused primarily on individual therapy, the majority of SUD specialty treatment is in group format, with open-enrolling groups being most common. This study aims to narrow this research-practice gap by exploring clinicians' perspectives on complexities with group therapy facilitation in SUD specialty treatment settings. Semi-structured interviews were conducted with 13 group clinicians from among three outpatient SUD specialty clinics-diverse in their operational structures, treatment philosophies, clientele, and services-located in the same Midwestern U.S. metropolitan area. Interview questions addressed organizational characteristics, services provided, group therapy curricula, and use of EBTs or other structured treatments. Clinicians emphasized the importance of having flexibility in facilitating groups, through built-in group processes and clinicians' own adaptions and accommodations; this flexibility was especially emphasized for the use of EBTs or manualized interventions. Clinicians also had difficulties with group facilitation generally, as evidenced by their reported difficulty in managing complex group dynamics, their limited group therapy experience and training, and their reliance on educational groups. We discuss specific strategies for improved innovation and implementation of EBTs for SUD group therapy.
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Affiliation(s)
- Dennis C Wendt
- Department of Psychology, University of Michigan, 530 Church St., Ann Arbor, MI 48109, USA.
| | - Joseph P Gone
- Department of Psychology, University of Michigan, 530 Church St., Ann Arbor, MI 48109, USA.
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Weiskittle RE, Gramling SE. The therapeutic effectiveness of using visual art modalities with the bereaved: a systematic review. Psychol Res Behav Manag 2018; 11:9-24. [PMID: 29440940 PMCID: PMC5798551 DOI: 10.2147/prbm.s131993] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Bereaved individuals are increasingly considered at risk for negative psychological and physiological outcomes. Visual art modalities are often incorporated into grief therapy interventions, and clinical application of art therapy techniques with the bereaved has been widely documented. Although clinicians and recipients of these interventions advocate for their helpfulness in adapting to bereavement, research investigating the efficacy of visual art modalities has produced equivocal results and has not yet been synthesized to establish empirical support across settings. Accordingly, this review critically evaluates the existent literature on the effectiveness of visual art modalities with the bereaved and offers suggestions for future avenues of research. A total of 27 studies were included in the current review. Meta-analysis was not possible because of clinical heterogeneity and insufficient comparable data on outcome measures across studies. A narrative synthesis reports that therapeutic application of visual art modalities was associated with positive changes such as continuing bonds with the deceased and meaning making. Modest and conflicting preliminary evidence was found to support treatment effectiveness in alleviating negative grief symptoms such as general distress, functional impairment, and symptoms of depression and anxiety.
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Affiliation(s)
- Rachel E Weiskittle
- Department of Clinical Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Sandra E Gramling
- Department of Clinical Psychology, Virginia Commonwealth University, Richmond, VA, USA
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33
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Wendt DC, Gone JP. Group Therapy for Substance Use Disorders: A Survey of Clinician Practices. JOURNAL OF GROUPS IN ADDICTION & RECOVERY 2017; 12:243-259. [PMID: 30546274 PMCID: PMC6289265 DOI: 10.1080/1556035x.2017.1348280] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Substance use disorder (SUD) treatment is typically delivered in group format, but clinical research focuses on individual therapy. This exploratory study narrows this gap through a survey of 566 SUD group clinicians in the United States, concerning most commonly used group practices, attitudes about evidence-based treatments (EBTs), and beliefs about addiction. Clinicians reported high use of open groups, moderately high utilization of EBT practices, and moderate use of questionable practices. Clinicians' attitudes about EBTs and beliefs about addiction were correlated with the use of certain EBTs and questionable practices. Strategies for implementation of EBTs in group settings are discussed.
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34
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Schwartze D, Barkowski S, Strauss B, Knaevelsrud C, Rosendahl J. Efficacy of group psychotherapy for posttraumatic stress disorder: Systematic review and meta-analysis of randomized controlled trials. Psychother Res 2017; 29:415-431. [DOI: 10.1080/10503307.2017.1405168] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- D. Schwartze
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Friedrich-Schiller University, Jena, Germany
| | - S. Barkowski
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Friedrich-Schiller University, Jena, Germany
| | - B. Strauss
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Friedrich-Schiller University, Jena, Germany
| | - C. Knaevelsrud
- Department of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - J. Rosendahl
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Friedrich-Schiller University, Jena, Germany
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35
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Lachman JM, Cluver L, Ward CL, Hutchings J, Mlotshwa S, Wessels I, Gardner F. Randomized controlled trial of a parenting program to reduce the risk of child maltreatment in South Africa. CHILD ABUSE & NEGLECT 2017; 72:338-351. [PMID: 28881303 DOI: 10.1016/j.chiabu.2017.08.014] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 07/23/2017] [Accepted: 08/08/2017] [Indexed: 06/07/2023]
Abstract
Parenting programs in high-income countries have been shown to reduce the risk of child maltreatment. However, there is limited evidence of their effectiveness in low- and middle-income countries. The objective of this study was to examine the initial effects of a parenting program in reducing the risk of child maltreatment in highly-deprived and vulnerable communities in Cape Town, South Africa. Low-income parents (N=68) with children aged three to eight years were randomly assigned to either a group-based parenting program or a wait-list control group. Observational and parent-report assessments were taken at baseline and at immediate post-test after the intervention was delivered. Primary outcomes were parent-report and observational assessments of harsh parenting, positive parenting, and child behavior problems. Secondary outcomes were parent-report assessments of parental depression, parenting stress, and social support. Results indicated moderate treatment effects for increased frequency of parent-report of positive parenting (d=0.63) and observational assessments of parent-child play (d=0.57). Observational assessments also found moderate negative treatment effects for less frequent positive child behavior (d=-0.56). This study is the first randomized controlled trial design to rigorously test the effectiveness of a parenting program on reducing the risk of child maltreatment in sub-Saharan Africa using both observational and self-report assessments. Results provide preliminary evidence of effectiveness of reducing the risk of child maltreatment by improving positive parenting behavior. Further development is required to strengthen program components regarding child behavior management and nonviolent discipline strategies. Future research would benefit from a larger trial with sufficient power to determine program effectiveness.
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Affiliation(s)
- Jamie M Lachman
- Department of Social Policy and Intervention, Centre for Evidence Based Intervention, University of Oxford, Oxford, United Kingdom.
| | - Lucie Cluver
- Department of Social Policy and Intervention, Centre for Evidence Based Intervention, University of Oxford, Oxford, United Kingdom; Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Catherine L Ward
- Department of Psychology, University of Cape Town, South Africa; Safety and Violence Initiative, University of Cape Town, South Africa
| | - Judy Hutchings
- Centre for Evidence Based Early Intervention, School of Psychology, Bangor University, Wales
| | | | - Inge Wessels
- Department of Psychology, University of Cape Town, South Africa
| | - Frances Gardner
- Department of Social Policy and Intervention, Centre for Evidence Based Intervention, University of Oxford, Oxford, United Kingdom
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Kealy D, Sierra-Hernandez CA, Piper WE, Joyce AS, Weideman R, Ogrodniczuk JS. Psychological Mindedness and Psychotherapy Process in Short-Term Group Therapy. Psychodyn Psychiatry 2017; 45:343-361. [PMID: 28846510 DOI: 10.1521/pdps.2017.45.3.343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Psychological mindedness is regarded as an important patient characteristic that can influence the course of psychotherapy. The purpose of this study was to investigate the relationship between patients' capacity for psychological mindedness and aspects of the group psychotherapy process as experienced and rated by therapists and other group members. Participants were 110 patients who completed two forms of short-term group therapy for the treatment of complicated grief. Psychological mindedness was assessed at pretreatment by external raters using a video-interview procedure. Group therapists assessed patients' therapeutic work and therapeutic alliance following each group therapy session. Therapists and other group members rated each patient's expression of emotion and provided appraisals of their cohesion to each patient throughout the course of therapy. Psychological mindedness was found to be positively associated with several group process variables as rated by the therapist and other group members.
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Affiliation(s)
- David Kealy
- Department of Psychiatry, University of British Columbia
| | | | | | | | - Rene Weideman
- Department of Psychiatry, University of British Columbia
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Vaclavik D, Buitron V, Rey Y, Marin CE, Silverman WK, Pettit JW. Parental acculturation level moderates outcome in peer-involved and parent-involved CBT for anxiety disorders in Latino youth. ACTA ACUST UNITED AC 2017; 5:261-274. [PMID: 29226037 DOI: 10.1037/lat0000095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cognitive behavioral therapies (CBTs) are efficacious treatments for anxiety disorders in Latino youth. However, there is a gap in knowledge about moderators of CBT outcomes in Latino youth. This study addresses this gap by examining parental acculturation as a moderator of youth anxiety outcomes in a randomized controlled trial of parent-involved CBT (CBT/P) and peer-involved group CBT (GCBT) in 139 Latino youth (ages 6 to 16 years; mean age = 9.68 years). Comparable youth anxiety reduction effects were found for CBT/P and GCBT. Parental acculturation to majority US culture, but not identification with country of origin, significantly moderated youth anxiety outcomes: at low levels of parental acculturation to majority US culture, youth posttreatment anxiety scores were lower in GCBT than CBT/P; at high levels of parental acculturation to majority US culture, youth posttreatment anxiety scores were lower in CBT/P than GCBT. These findings provide further evidence for the efficacy of CBTs for anxiety disorders in Latino youth and also provide guidance for moving toward personalization of CBTs' selection depending on parental acculturation levels.
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Affiliation(s)
| | | | | | - Carla E Marin
- Yale University School of Medicine, Child Study Center
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38
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Li H, Hedeker D. Statistical methods for continuous outcomes in partially clustered designs. COMMUN STAT-THEOR M 2017. [DOI: 10.1080/03610926.2015.1076474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Hong Li
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Donald Hedeker
- Department of Health Studies, The University of Chicago Biological Sciences, Chicago, IL, USA
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Baldwin SA. Improving the rigor of psychophysiology research. Int J Psychophysiol 2017; 111:5-16. [DOI: 10.1016/j.ijpsycho.2016.04.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 04/11/2016] [Accepted: 04/20/2016] [Indexed: 12/26/2022]
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40
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Pavia L, Di Blasi M, Cinquegrana A, Scioti E, Bussola T, Pasinelli A, Cavani P. The Influence of Retention, Turnover, and Alliance on Process and Outcomes in Rolling Group Psychotherapy for Cocaine Disorder. Int J Group Psychother 2016; 66:526-550. [PMID: 38475620 DOI: 10.1080/00207284.2016.1176491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A longitudinal repeated measures design was used to investigate the influence of treatment retention, and membership turnover on individual outcomes, and the relationship between individual-level and group-level therapeutic alliance in rolling group psychotherapy for individuals with cocaine abuse disorder. Eighteen patients were studied; data were collected prior to therapy and then monthly for 24 months. Patient outcomes and process were assessed. Improvements in symptoms and psychological functioning were associated with retention in psychotherapy. Membership turnover had a negative influence on symptoms. Development of an individual alliance was affected by the development of group-level therapeutic alliance, but not by time spent in therapy.
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Giese-Davis J, Brandelli Y, Kronenwetter C, Golant M, Cordova M, Twirbutt S, Chang V, Kraemer HC, Spiegel D. Illustrating the Multi-Faceted Dimensions of Group Therapy and Support for Cancer Patients. Healthcare (Basel) 2016; 4:healthcare4030048. [PMID: 27490581 PMCID: PMC5041049 DOI: 10.3390/healthcare4030048] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/07/2016] [Accepted: 07/26/2016] [Indexed: 12/27/2022] Open
Abstract
In cancer support groups, choice of therapy model, leadership style, and format can impact patients’ experiences and outcomes. Methodologies that illustrate the complexity of patients’ group experiences might aid in choosing group style, or testing therapeutic mechanisms. We used this naturalistic study as a beginning step to explore methods for comparing cancer group contexts by first modifying a group-experience survey to be cancer-specific (Group Experience Questionnaire (GEQ)). Hypothesizing that therapist-led (TL) would differ from non-therapist-led (NTL), we explored the GEQ’s multiple dimensions. A total of 292 patients attending three types of groups completed it: 2 TL groups differing in therapy style ((1) Supportive-Expressive (SET); (2) The Wellness Community (TWC/CSC)); (3) a NTL group. Participants rated the importance of “Expressing True Feelings” and “Discussing Sexual Concerns” higher in TL than NTL groups and “Discussing Sexual Concerns” higher in SET than other groups. They rated “Developing a New Attitude” higher in TWC/CSC compared to NTL. In addition, we depict the constellation of group qualities using radar-charts to assist visualization. These charts facilitate a quick look at a therapy model’s strengths and weaknesses. Using a measure like the GEQ and this visualization technique could enable health-service decision making about choice of therapy model to offer.
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Affiliation(s)
- Janine Giese-Davis
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd., Stanford, CA 94305, USA.
- Department of Oncology, University of Calgary, 2202 2nd St. S.W., Calgary, AB T2S 3C1, Canada.
- Department of Psychosocial Resources, Tom Baker Cancer Centre, 2202 2nd St. S.W., Calgary, AB T2S 3C1, Canada.
| | - Yvonne Brandelli
- Department of Oncology, University of Calgary, 2202 2nd St. S.W., Calgary, AB T2S 3C1, Canada.
- Department of Psychosocial Resources, Tom Baker Cancer Centre, 2202 2nd St. S.W., Calgary, AB T2S 3C1, Canada.
| | - Carol Kronenwetter
- California Pacific Medical Center, Breast Health Center, 3698 California Street, San Francisco, CA 94118, USA.
| | - Mitch Golant
- The Wellness Community/Cancer Support Community, Research & Training Institute, Cancer Support Community, 4100 Chamounix Drive, Philadelphia, PA 19131, USA.
| | - Matthew Cordova
- Veterans Administration Medical Center Martinez, 150 Muir Rd., Martinez, CA 94553, USA.
- Pacific Graduate School of Psychology, Palo Alto University, 1791 Arastradero Road, Palo Alto, CA 94304-1337, USA.
| | - Suzanne Twirbutt
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd., Stanford, CA 94305, USA.
| | - Vickie Chang
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd., Stanford, CA 94305, USA.
| | - Helena C Kraemer
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd., Stanford, CA 94305, USA.
| | - David Spiegel
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd., Stanford, CA 94305, USA.
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Zum Stand der empirischen Forschung in der psychodynamischen Gruppenpsychotherapie. GRUPPENPSYCHOTHERAPIE UND GRUPPENDYNAMIK 2016. [DOI: 10.13109/grup.2016.52.2.111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
OBJECTIVE Individually-randomized psychotherapy trials are often partially nested. For instance, individuals assigned to a treatment arm may be clustered into therapy groups for purposes of treatment administration, whereas individuals assigned to a wait-list control are unclustered. The past several years have seen rapid expansion and investigation of methods for analyzing partially nested data. Yet partial nesting often remains ignored in psychotherapy trials. METHODS This review integrates and disseminates developments in the analysis of partially nested data that are particularly relevant for psychotherapy researchers. RESULTS First, we differentiate among alternative partially nested designs. Then, we present adaptations of multilevel model specifications that accommodate each design. Next, we address how moderation by treatment as well as mediation of the treatment effect can be investigated in partially nested designs. Model fitting results, annotated software syntax, and illustrative data sets are provided and key methodological issues are discussed. CONCLUSIONS We emphasize that cluster-level variability in the treatment arm need not be considered a nuisance; it can be modeled to yield insights about the treatment process.
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Affiliation(s)
- Sonya K Sterba
- a Department of Psychology and Human Development , Vanderbilt University , Nashville , TN , USA
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Kivlighan DM, Paquin JD, Hsu YKK, Wang LF. The Mutual Influence of Therapy Group Members’ Hope and Depressive Symptoms. SMALL GROUP RESEARCH 2015. [DOI: 10.1177/1046496415605638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The current study sought to further explore the theoretical model of mutual influence among therapy group members, which postulates that group members influence one another and that this influence is a key component of group treatments. However, a recent finding suggested that group members’ adjusted posttreatment outcomes were not significantly related. The current study reexamined mutual influence by testing this relationship in a markedly different sample on two outcome variables, depression and hopelessness. The data consisted of 78 HIV+ men participating in six therapy groups in a Taiwanese correctional facility. Contrary to our hypothesis, the relationship between an individual group member’s posttreatment depression and the aggregated depression scores of the other group members was not significant. As hypothesized, the relationship between an individual group member’s posttreatment hope and the aggregated sense of hope of the other group members was significant.
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Affiliation(s)
| | | | - Yu-Kuang K. Hsu
- National Hsinchu University of Education, Hsinchu City, Taiwan
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Bonsaksen T, Borge FM, Hoffart A. Group Climate as Predictor of Short- and Long-Term Outcome in Group Therapy for Social Phobia. Int J Group Psychother 2015; 63:394-417. [DOI: 10.1521/ijgp.2013.63.3.394] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Burlingame GM, Gleave R, Erekson D, Nelson PL, Olsen J, Thayer S, Beecher M. Differential effectiveness of group, individual, and conjoint treatments: An archival analysis of OQ-45 change trajectories. Psychother Res 2015; 26:556-72. [DOI: 10.1080/10503307.2015.1044583] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Calvert R, Kellett S, Hagan T. Group cognitive analytic therapy for female survivors of childhood sexual abuse. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2015; 54:391-413. [DOI: 10.1111/bjc.12085] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 04/02/2015] [Indexed: 11/30/2022]
Affiliation(s)
| | - Stephen Kellett
- Centre for Psychological Therapies Research; University of Sheffield; UK
- Sheffield Health & Social Care NHS Foundation Trust; Sheffield UK
| | - Theresa Hagan
- Sheffield Health & Social Care NHS Foundation Trust; Sheffield UK
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Probability Pyramiding Revisited: Univariate, Multivariate, and Neural Network Analyses of Complex Data. BEHAVIOR AND SOCIAL ISSUES 2015. [DOI: 10.5210/bsi.v24i0.6048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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50
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Kocovski NL, Fleming JE, Hawley LL, Ho MHR, Antony MM. Mindfulness and acceptance-based group therapy and traditional cognitive behavioral group therapy for social anxiety disorder: Mechanisms of change. Behav Res Ther 2015; 70:11-22. [PMID: 25938187 DOI: 10.1016/j.brat.2015.04.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 03/24/2015] [Accepted: 04/11/2015] [Indexed: 10/23/2022]
Abstract
The present study investigated mechanisms of change for two group treatments for social anxiety disorder (SAD): cognitive behavioral group therapy (CBGT) and mindfulness and acceptance-based group therapy (MAGT). Participants were treatment completers (n = 37 for MAGT, n = 32 for CBGT) from a randomized clinical trial. Cognitive reappraisal was the hypothesized mechanism of change for CBGT. Mindfulness and acceptance were hypothesized mechanisms of change for MAGT. Latent difference score (LDS) analysis results demonstrate that cognitive reappraisal coupling (in which cognitive reappraisal is negatively associated with the subsequent rate of change in social anxiety) had a greater impact on social anxiety for CBGT than MAGT. The LDS bidirectional mindfulness model (mindfulness predicts subsequent change in social anxiety; social anxiety predicts subsequent change in mindfulness) was supported for both treatments. Results for acceptance were less clear. Cognitive reappraisal may be a more important mechanism of change for CBGT than MAGT, whereas mindfulness may be an important mechanism of change for both treatments.
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Affiliation(s)
| | - Jan E Fleming
- Centre for Addiction and Mental Health and University of Toronto, Canada
| | - Lance L Hawley
- Centre for Addiction and Mental Health and University of Toronto, Canada
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