Behav Ther [JOURNAL]
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200 papers
Using a Randomized Clinical Trial to Test the Efficacy of a Culturally Responsive Mobile Health Application in African Americans.
Watson-Singleton NN, Pennefather J
Behav Ther · 2024 Jul · PMID 38937052 · Publisher ↗
Mindfulness is a promising health promotion strategy for African Americans, and it is imperative that culturally responsive mindfulness approaches be accessible to this population. One way to address this need is to deve...
Mindfulness is a promising health promotion strategy for African Americans, and it is imperative that culturally responsive mindfulness approaches be accessible to this population. One way to address this need is to develop and test if culturally responsive mobile health (mhealth) applications are efficacious in reducing stress-related outcomes in this population. With this goal in mind, we employed a repeated-measures randomized control trial (RCT) across a 12-week intervention period to evaluate if participants in the intervention group outperformed a wait-list control group in reductions in stress, depressive symptoms, anxiety, emotional regulation difficulties as well as in increases in self-compassion, resilience, and mindfulness attitudes and behaviors. Our sample included 170 Black/African American participants who were randomly assigned to either the intervention condition (n = 84) or the wait-list control group (n = 86). Participants in the intervention condition reported more self-compassion, used more mindfulness, and had greater self-efficacy using mindfulness; yet, no other differences were evident. Participants expressed high levels of satisfaction with the app and gave it a positive rating for its relevance to their lives. These findings support the efficacy of a culturally responsive mindfulness mHealth app to enhance self-compassion and increase the use of health-promoting behaviors, like mindfulness, among African Americans. Implications for future research are discussed.
Dysfunctional Attitudes Versus Metacognitive Beliefs as Within-Person Predictors of Depressive Symptoms Over Time.
Strand ER, Anyan F, Hjemdal O … +2 more , Nordahl HM, Nordahl H
Behav Ther · 2024 Jul · PMID 38937051 · Publisher ↗
Understanding within-person variation between theorized mechanisms of disorder and depressive symptoms can help identify targets for interventions. Cognitive models of depression hypothesize dysfunctional attitudes as un...
Understanding within-person variation between theorized mechanisms of disorder and depressive symptoms can help identify targets for interventions. Cognitive models of depression hypothesize dysfunctional attitudes as underlying vulnerability factors, while the metacognitive model places emphasis on dysfunctional metacognitive beliefs. However, no previous study has tested the relative importance of change in dysfunctional attitudes and metacognitive beliefs as predictors of change in depressive symptoms within individuals. In a sample of 1,418 individuals measured at four time-points separated by 5-week intervals, a multilevel model approach was used to test the relative importance of change in dysfunctional attitudes and metacognitive beliefs as predictors of change in depressive symptoms. Change in dysfunctional attitudes and metacognitive beliefs predicted change in depressive symptoms over time. However, change in metacognitive beliefs and in particular negative metacognitive beliefs and judgements of cognitive confidence were significantly stronger predictors of change in depressive symptoms compared to dysfunctional attitudes. Furthermore, change in metacognitive beliefs predicted change in dysfunctional attitudes beyond change in depressive symptoms. These results suggest that metacognitive beliefs rather than dysfunctional attitudes might be more important for depressive symptoms over time within persons and that metacognitive change may also influence dysfunctional attitudes over time. Metacognitive beliefs are therefore a promising target for treatment and prevention aiming to reduce depressive symptoms, but replication of our results in clinical samples is warranted before more clear conclusions can be drawn.
Rethinking Unacceptable Thoughts: Validation of an Expanded Version of the Dimensional Obsessive-Compulsive Scale.
Lee EB, Wetterneck CT, McIngvale E … +2 more , Williams MT, Björgvinsson T
Behav Ther · 2024 Jul · PMID 38937050 · Publisher ↗
The Dimensional Obsessive-Compulsive Scale (DOCS) is widely used to measure obsessive-compulsive disorder (OCD) severity across four broad symptom dimensions (i.e., contamination, responsibility for harm, unacceptable th...
The Dimensional Obsessive-Compulsive Scale (DOCS) is widely used to measure obsessive-compulsive disorder (OCD) severity across four broad symptom dimensions (i.e., contamination, responsibility for harm, unacceptable thoughts, symmetry). Despite its proven utility, there is reason to suspect that the unacceptable thoughts subscale conflates different types of unacceptable thoughts that are meaningfully distinct from one another. In the current study, we first evaluated the psychometric properties of a newly developed DOCS violent and/or aggressive thoughts subscale. We then examined the factor structure, psychometric properties, and diagnostic sensitivity of a seven-factor version of the DOCS that includes the four original DOCS subscales and three more-specific versions of the unacceptable thoughts scale (i.e., sexually intrusive thoughts, violent and/or aggressive thoughts, and scrupulous or religious thoughts). The sample included 329 residential and intensive outpatients, the majority of which had a diagnosis of OCD (75.2%). The new unacceptable thoughts subscales demonstrated convergent and discriminant validity with unique associations between the subscales and depression, suicide, and perceived threat from emotions that were not present in the broader unacceptable thoughts subscale. The seven-factor version of the DOCS demonstrated slightly lower levels of diagnostic sensitivity than the original DOCS. Thus, the four-factor version of the DOCS is recommended for screening purposes. A score of 40 or higher on the seven-factor version of the DOCS best predicted a diagnosis of OCD. Overall, the three additional unacceptable thoughts subscales appear to be distinct factors that have potential value in research and clinical settings.
For Whom and for How Long Does the "Be a Mom" Intervention Work? A Secondary Analysis of Data From a Randomized Controlled Trial Exploring the Mid-Term Efficacy and Moderators of Treatment Response.
Carona C, Pereira M, Araújo-Pedrosa A … +3 more , Monteiro F, Cristina Canavarro M, Fonseca A
Behav Ther · 2024 Jul · PMID 38937049 · Publisher ↗
This study explored clinical and sociodemographic moderators of treatment response to "Be a Mom", an internet-based cognitive behavioral therapy (iCBT) intervention, from baseline to postintervention, in women at high ri...
This study explored clinical and sociodemographic moderators of treatment response to "Be a Mom", an internet-based cognitive behavioral therapy (iCBT) intervention, from baseline to postintervention, in women at high risk for postpartum depression (PPD). The study also assessed the stability of women's treatment gains from baseline to 4-months postintervention (follow-up). This open-label randomized controlled trial (RCT) involved a sample of 1,053 postpartum Portuguese women identified as being at high risk for PPD (i.e., having a score of 5.5 or higher on the Postpartum Depression Predictors Inventory-Revised); participants were allocated to "Be a Mom" intervention group or a waiting-list control group, and completed self-report measures at baseline, postintervention, and a 4-month follow-up (554 women completed follow-up assessments). Depressive and anxiety symptoms were measured using the Edinburgh Postnatal Depression Scale and the anxiety subscale of the Hospital Anxiety and Depression Scale, and flourishing/positive mental health was assessed with the Mental Health Continuum. Regression models and linear mixed models were used to examine moderators of treatment and the mid-term efficacy of the "Be a Mom" intervention, respectively. The results revealed that treatment completion, higher depression scores at baseline, and higher income levels were linked to greater symptom reduction and positive mental health enhancement. Moreover, the efficacy of the "Be a Mom" intervention was supported at the 4-month follow-up. The "Be a Mom" intervention appears to be an effective iCBT tool for reducing psychological distress and enhancing positive mental health in women at risk for PPD, with therapeutic improvements maintained over a 4-month period.
Pilot Effectiveness and Acceptability of Partial Hospitalization Treatment Incorporating Transdiagnostic, Cognitive-Behavioral Intervention.
Kennedy SM, Henderson-Davis V, Henry L … +9 more , Hawks JL, Diaz KI, Crabbs T, Khindria N, Moe-Hartman J, Nook L, President KF, Stovall S, Anthony LG
Behav Ther · 2024 Jul · PMID 38937048 · Publisher ↗
Acute mental health treatment (e.g., partial hospitalization or PHP) is a critical component of the mental health services landscape for youth whose symptoms are too acute for a typical outpatient setting, but for whom i...
Acute mental health treatment (e.g., partial hospitalization or PHP) is a critical component of the mental health services landscape for youth whose symptoms are too acute for a typical outpatient setting, but for whom inpatient psychiatric hospitalization is not recommended or desired. Very few interventions have been developed, adapted for, or evaluated in these fundamentally different delivery contexts. Transdiagnostic treatments may be ideal for addressing the comorbidity, complexity, and heterogeneity typical of acute mental health settings. Our aim was to examine initial acceptability and effectiveness of an adaptation of the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A; Ehrenreich-May, Kennedy, et al., 2017), delivered as part of comprehensive therapeutic programming in a general psychiatric PHP. We recruited 152 youths (M age = 13.1 years, 62.5% female) and caregivers, who participated in an average of 11 days of intensive UP-C/A intervention. Participants rated symptoms and functioning at baseline, weekly, posttreatment, and 1-month follow-up. Latent growth curve modeling was used to examine patterns of change and evaluate the impact of potential demographic and treatment-related covariates. For all outcomes, a quadratic model best fit the data, with symptoms and emotional reactivity decreasing significantly during treatment and then leveling off during follow-up. There was a medium-sized change in functional impairment from baseline to the 1-month follow-up, and ≥90% of participants reported treatment as acceptable and helpful. Results provide initial support for use of a transdiagnostic, cognitive-behavioral intervention in acute mental health settings and suggest important future directions, including controlled trials and investigation of implementation supports.
Explaining How Psychotherapy Affects the Brain Can Increase the Perceived Effectiveness of Psychotherapy: A Randomized Controlled Trial.
Perricone A, Bitran A, Ahn WK
Behav Ther · 2024 Jul · PMID 38937047 · Publisher ↗
Past studies repeatedly found that biological explanations of mental disorders cause laypeople and clinicians to doubt the effectiveness of psychotherapy. This could be clinically detrimental, as combined pharmacotherapy...
Past studies repeatedly found that biological explanations of mental disorders cause laypeople and clinicians to doubt the effectiveness of psychotherapy. This could be clinically detrimental, as combined pharmacotherapy and psychotherapy is often optimal. The distrust of psychotherapy is theorized to stem from dualistic reasoning that psychotherapy, perceived as occurring in the mind, does not necessarily affect the brain. The current study aims to mitigate this belief in a randomized controlled trial. Participants (individuals with symptoms of depression (n = 262), the general public (n = 374), and mental health clinicians (n = 607)) rated the efficacy of psychotherapy for a depression case before and after learning that the case was biologically caused. Participants also received either an intervention passage describing how psychotherapy results in brain-level changes, an active control passage emphasizing the effectiveness of psychotherapy without explaining the underlying biological mechanisms, or no intervention. Unlike the active control and no-intervention control conditions, the intervention caused participants to judge psychotherapy as significantly more effective than at baseline even though they learned that depression was biologically caused. An intervention counteracting dualism can mitigate the belief that psychotherapy is less effective for biologically caused depression. Future research should examine the durability of this intervention in clinical settings.
Increased Generalization, Stronger Acquisition, or Reduced Extinction? Investigation of the Mechanisms Underlying the Acquisition-in-Multiple-Contexts Effect.
Chao WJM, McConnell BL
Behav Ther · 2024 Jul · PMID 38937046 · Publisher ↗
Prior research has demonstrated that conducting acquisition in multiple contexts results in more responding to the point that it can even nullify the benefit of subsequent extinction in multiple contexts on reducing rene...
Prior research has demonstrated that conducting acquisition in multiple contexts results in more responding to the point that it can even nullify the benefit of subsequent extinction in multiple contexts on reducing renewal of excitatory responding. The underlying mechanism to explain why this happens has not been systematically examined. Using self-reported expectancy of the outcome, the current study investigates three mechanisms that potentially explain why acquisition in multiple contexts results in more responding-greater generalization, stronger acquisition learning, or slower extinction learning. Participants (N = 180) received discriminative training with a conditioned stimulus (CS+) and outcome pairing and a CS- → noOutcome pairing in either one or three contexts. This was followed by either extinction treatment in a novel context or no extinction. Finally, testing occurred in the acquisition context, the extinction context, or a novel context. Stronger renewal of extinguished conditioned expectation was observed for participants who received CS+ → Outcome pairings in three contexts relative to one context. There was no effect of the number of contexts on the strength of the excitatory CS+ → Outcome association or degree of inhibitory learning that occurred during extinction. This suggests that generalization is the mechanism responsible for the adverse impact to extinction learning when acquisition is conducted in multiple contexts.
Risk Factors That Predict Future Onset of Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, and Purging Disorder in Adolescent Girls.
Yamamiya Y, Stice E
Behav Ther · 2024 Jul · PMID 38937045 · Full text
Because very few prospective studies have identified risk factors that predicted future onset of threshold/subthreshold anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD),...
Because very few prospective studies have identified risk factors that predicted future onset of threshold/subthreshold anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD), we analyzed prospective data collected from a large cohort of adolescent girls followed over an 8-year period to advance knowledge about risk factor specificity. Adolescent girls recruited from middle schools in Texas (N = 492; M age = 13.02 [SD = 0.73], age range = 11-15) completed questionnaires assessing risk factors at baseline and diagnostic interviews assessing eating disorders annually over 8 years. Only low BMI predicted future AN onset. Pressure to be thin, thin-ideal internalization, body dissatisfaction, negative emotionality, low parent support, and modeling of eating pathology predicted future BN onset. Pressure to be thin, thin-ideal internalization, negative emotionality, low parent support, and modeling of eating pathology predicted future BED onset. Pressure to be thin, body dissatisfaction, dietary restraint, low parent support, modeling of eating pathology, and high BMI predicted future PD onset. Predictive effects were medium-to-large. Results support etiological theories of eating disorders that postulate the pursuit of the thin ideal, body dissatisfaction, negative affect, dietary restraint, and interpersonal issues increase risk for most eating disorders. The evidence that girls with low body weight are at risk for AN, whereas girls with high body weight are at risk for PD are novel. Although several risk factors predicted future onset of BN, BED, and PD, results suggest that risk factors for AN are qualitatively distinct and should be investigated further.
Social Motivation Differentiates Social Anxiety and Depression: A Daily Diary Study.
Rum R, Birg JA, Silva G … +3 more , Rottenberg J, Clayson PE, Goodman FR
Behav Ther · 2024 Jul · PMID 38937044 · Publisher ↗
Because social anxiety and depression commonly co-occur, it can be challenging to disentangle the emotional and motivational features of these conditions in everyday life contexts. In this daily diary study, we sought to...
Because social anxiety and depression commonly co-occur, it can be challenging to disentangle the emotional and motivational features of these conditions in everyday life contexts. In this daily diary study, we sought to understand the interplay between daily social anxiety and depression symptoms and emotion and motivation, determining whether daily symptoms are independently linked with positive affect, negative affect, and social motivation (desire to approach or to withdraw from others). Community-dwelling adults (N = 269) with a wide range of social anxiety and depression symptoms completed daily assessments for 14 consecutive days (a total of 2,986 daily surveys). Within-person analyses found that increases in social anxiety and depression symptoms were uniquely associated with elevated negative affect; only increases in depression symptoms were associated with diminished positive affect. Increases in social anxiety symptoms were associated with an elevated desire to approach others but not a desire to withdraw from others. By contrast, increases in depression symptoms were associated with a diminished desire to approach others and an elevated desire to withdraw from others. Desire for social connection may distinguish social anxiety from depression. Examining patterns of daily social motivation may enhance clinicians' ability to differentiate the difficulties that arise from social anxiety from those that arise from depression.
School-Based Intervention for Adolescents With ADHD: Predictors of Effects on Academic, Behavioral, and Social Functioning.
DuPaul GJ, Evans SW, Cleminshaw-Mahan CL … +1 more , Fu Q
Behav Ther · 2024 Jul · PMID 38937043 · Publisher ↗
Adolescents with attention-deficit/hyperactivity disorder (ADHD) experience significant academic, behavioral, and social skill difficulties including underachievement, risk for school dropout, poor peer relations, and em...
Adolescents with attention-deficit/hyperactivity disorder (ADHD) experience significant academic, behavioral, and social skill difficulties including underachievement, risk for school dropout, poor peer relations, and emotion dysregulation. Although stimulant medication reduces ADHD symptoms, psychosocial and educational interventions are necessary to address functional impairments. We examined the nature and predictors of academic, behavioral, and social skills trajectories in response to multicomponent organizational and interpersonal skills training in 92 high school students with ADHD. Latent trajectory class analyses revealed positive treatment response ranging from 61.5% (report card grades) to 100% (inattention symptoms, organizational skills, social skills). Organizational skill and academic grade treatment response trajectories were predicted by assigned sex, pretreatment anxiety, and treatment dosage, while improvement in behavioral and social functioning was associated with better emotion regulation and family relations prior to treatment along with stronger working alliance with treatment coach at midtreatment. Multicomponent organizational and interpersonal skills training appears effective for most high school students with ADHD and the degree treatment-induced change is associated with multiple malleable factors can be leveraged to enhance intervention response.
Reckoning With Our Past and Righting Our Future: Report From the Behavior Therapy Task Force on Sexual Orientation and Gender Identity/Expression Change Efforts (SOGIECEs).
Comer JS, Georgiadis C, Schmarder K … +11 more , Chen D, Coyne CA, Gudiño OG, Kazantzis N, Langer DA, LeBeau RT, Liu RT, McLean C, Sloan DM, Williams MT, Pachankis JE
Behav Ther · 2024 Jul · PMID 38937042 · Publisher ↗
Sexual orientation and gender identity/expression change efforts (SOGIECEs) are discredited practices that are associated with serious negative effects and incompatible with modern standards for clinical practice. Despit...
Sexual orientation and gender identity/expression change efforts (SOGIECEs) are discredited practices that are associated with serious negative effects and incompatible with modern standards for clinical practice. Despite evidence linking SOGIECEs with serious iatrogenic effects, and despite support for LGBTQ+-affirmative care alternatives, SOGIECE practices persist. In the 1970s and 1980s, Behavior Therapy published articles testing and/or endorsing SOGIECEs, thereby contributing to their overall development, acceptance, and use. The Behavior Therapy Task Force on SOGIECEs was assembled to conduct a rigorous review of the SOGIECE articles published in Behavior Therapy and to decide whether, and what, formal action(s) should be taken on these articles. This report provides a detailed review of the historic SOGIECE literature published in Behavior Therapy and outlines the Task Force's deliberative and democratic processes resulting in actions to: (1) add prominent advisory information to k = 24 SOGIECE papers in the form of digital "black box" disclaimers that caution readers that the SOGIECE practices tested or described in these papers are inconsistent with modern standards, (2) offset organizational financial benefits from the publication of these papers, and (3) promote LGBTQ+-affirmative practices. SOGIECEs are not the only concerning practices across the field's history, and the pages of today's scientific journals include practices that will be at odds with tomorrow's moral standards and ethical guidelines. This report calls for precautionary measures and editorial safeguards to minimize the future likelihood and impact of problematic published scholarship, including the need to fully include those with relevant lived experiences in all aspects of clinical science and peer review.
The Role of Aversive Appearance-Related Comparisons and Self-Discrepancy in Depression and Well-Being From a Longitudinal General Comparative-Processing Perspective.
Schlechter P, Morina N
Behav Ther · 2024 May · PMID 38670674 · Publisher ↗
Research indicates that aversive appearance-related comparisons (i.e., perceived as threatening one's own motives) are associated with depressive symptoms. However, central elements underlying the comparison process are...
Research indicates that aversive appearance-related comparisons (i.e., perceived as threatening one's own motives) are associated with depressive symptoms. However, central elements underlying the comparison process are poorly understood. Drawing on central propositions of comparison theory, we hypothesized that an increased aversive comparison frequency instigates high levels of perceived comparison discrepancy to the standard, resulting in an intensified negative affective impact. Consequently, this heightened affective impact is expected to elicit more depressive symptoms and lower psychological well-being. We additionally expected that these pathways are moderated by dispositional self-discrepancies. In a two-wave longitudinal study, participants with elevated depressive symptoms (N = 500) responded to measures of self-discrepancy, depressive symptoms, psychological well-being, and the Comparison Standards Scale for Appearance. The latter assesses aversive social, temporal, counterfactual, and criteria-based comparisons regarding their frequency, perceived discrepancy to the standard, and engendered affective impact. The affective impact after engaging in aversive appearance-related comparisons (partially) accounted for the relation between comparison discrepancy and subsequent depressive symptoms and psychological well-being. Perceived discrepancy to the aversive comparison standards was not a key variable in this process. Dispositional self-discrepancy emerged as moderator on different pathways. Clinical implications are discussed in light of central theoretical accounts from a general comparative-processing perspective.
Supporting Families Affected by Adversity: An Open Feasibility Trial of Family Life Skills Triple P.
Sanders MR, Turner KMT, Baker S … +6 more , Ma T, Chainey C, Horstead SK, Wimalaweera S, Gardner S, Eastwood J
Behav Ther · 2024 May · PMID 38670673 · Publisher ↗
This pilot feasibility study examined the effects of a new trauma-informed parenting program, Family Life Skills Triple P (FLSTP), in an open uncontrolled trial conducted in a regular service delivery context via video c...
This pilot feasibility study examined the effects of a new trauma-informed parenting program, Family Life Skills Triple P (FLSTP), in an open uncontrolled trial conducted in a regular service delivery context via video conferencing. FLSTP was trialed as a group-delivered 10-session intervention. Program modules target positive parenting skills (4 sessions) and adult life skills including coping with emotions, taking care of relationships, self-care, dealing with the past, healthy living, and planning for the future. Participants were 50 parents with multiple vulnerabilities, due to social disadvantage or adverse childhood experiences, who had children aged 3-9 with early onset behavior problems. Outcomes were assessed across four data collection points: baseline, mid-intervention (after Session 4), post-intervention, and 3-month follow up. Findings show moderate to large intra-group effect sizes for changes in child behavior problems, parenting practices and risk of child maltreatment, and medium effect sizes for parental distress, emotion regulation and self-compassion. Parents and practitioners reported high levels of consumer satisfaction with the program. Parents with lower levels of parental self-efficacy, lower personal agency and higher baseline scores on a measure of child abuse potential were at greater risk of not completing the program. The strength of these preliminary findings indicates that a more rigorous evaluation using a randomized clinical trial is warranted.
Using Adherence and Competence Measures Based on Practice Elements to Evaluate Treatment Fidelity for Two CBT Programs for Youth Anxiety.
Violante S, McLeod BD, Southam-Gerow MA … +2 more , Chorpita BF, Weisz JR
Behav Ther · 2024 May · PMID 38670672 · Full text
Measures designed to assess the quantity and quality of practices found across treatment programs for specific youth emotional or behavioral problems may be a good fit for evaluating treatment fidelity in effectiveness a...
Measures designed to assess the quantity and quality of practices found across treatment programs for specific youth emotional or behavioral problems may be a good fit for evaluating treatment fidelity in effectiveness and implementation research. Treatment fidelity measures must demonstrate certain reliability and validity characteristics to realize this potential. This study examines the extent to which two observational measures, the Cognitive-Behavioral Treatment for Anxiety in Youth Adherence Scale (CBAY-A) and the CBAY Competence Scale (CBAY-C), can assess the quantity (the degree to which prescribed therapeutic techniques are delivered as intended) or quality (the competence with which prescribed techniques are delivered) of practices found in two distinct treatment programs for youth anxiety. Treatment sessions (N = 796) from 55 youth participants (M age = 9.89 years, SD = 1.71; 46% female; 55% White) with primary anxiety problems who participated in an effectiveness study were independently coded by raters who coded quantity, quality, and the youth-clinician alliance. Youth received one of three treatments: (a) standard (i.e., cognitive-behavioral therapy program), (b) modular (i.e., a cognitive-behavioral and parent-training program), and (c) usual clinical care. Interrater reliability for the CBAY-A items was good across the standard and modular conditions but mixed for the CBAY-C items. Across the standard and modular conditions, the CBAY-A Model subscale scores demonstrated evidence of construct validity, but the CBAY-C Model subscale scores showed mixed evidence. The results provide preliminary evidence that the CBAY-A can be used across different treatment programs but raise concerns about the generalizability of the CBAY-C.
Family Accommodation in Children and Adolescents With Misophonia.
Storch EA, Guzick AG, D'Souza J … +12 more , Clinger J, Ayton D, Kook M, Rork C, Smith EE, Draper IA, Khalfe N, Rast CE, Murphy N, Lijfijjt M, Goodman WK, Cervin M
Behav Ther · 2024 May · PMID 38670671 · Full text
Family accommodation (e.g., reassurance, modifying routines, assisting avoidance) has not been explored among youth with misophonia but may have important clinical and intervention implications. We examined family accomm...
Family accommodation (e.g., reassurance, modifying routines, assisting avoidance) has not been explored among youth with misophonia but may have important clinical and intervention implications. We examined family accommodation in 102 children and adolescents with interview-confirmed misophonia and compared its frequency and content to family accommodation in 95 children and adolescents with anxiety disorders. Findings showed that family accommodation was ubiquitous in pediatric misophonia and may be even more frequent than in youth with anxiety disorders. Assisting the child, participating in misophonia-related behaviors, and modifying family routines were endorsed by more than 70% of parents of children with misophonia. Further, compared to parents of children with anxiety disorders, parents of children with misophonia more frequently reported child distress and anger when they did not accommodate. Family accommodation was moderately to strongly associated with misophonia severity even when accounting for co-occurring internalizing and externalizing symptoms and sociodemographic factors. This first study of family accommodation in pediatric misophonia suggests accommodation may be an important clinical feature. A notable study limitation is that the measure of misophonia did not delineate between adaptive versus maladaptive accommodations. Excessive and maladaptive accommodation may be one potential candidate to target in interventions when considered within a broader treatment plan. Importantly, adaptive accommodations should also be considered in day-to-day management if they improve functioning and quality of life.
Effect of Reliable Recovery on Health Care Costs and Productivity Losses in Emotional Disorders.
Barrio-Martínez S, Ruiz-Rodríguez P, Medrano LA … +7 more , Priede A, Muñoz-Navarro R, Moriana JA, Carpallo-González M, Prieto-Vila M, Cano-Vindel A, González-Blanch C
Behav Ther · 2024 May · PMID 38670670 · Publisher ↗
Despite the high economic costs associated with emotional disorders, relatively few studies have examined the variation in costs according to whether the patient has achieved a reliable recovery. The aim of this study wa...
Despite the high economic costs associated with emotional disorders, relatively few studies have examined the variation in costs according to whether the patient has achieved a reliable recovery. The aim of this study was to explore differences in health care costs and productivity losses between primary care patients from a previous randomized controlled trial (RCT)-PsicAP-with emotional symptoms who achieved a reliable recovery and those who did not after transdiagnostic cognitive-behavioral therapy (TD-CBT) plus treatment as usual (TAU) or TAU alone. Sociodemographic and cost data were obtained for 134 participants treated at five primary care centers in Madrid for the 12-month posttreatment period. Reliable recovery rates were higher in the patients who received TD-CBT + TAU versus TAU alone (66% vs. 34%, respectively; chi-square = 13.78, df = 1, p < .001). Patients who did not achieve reliable recovery incurred more costs, especially associated with general practitioner consultations (t = 3.01, df = 132, p = .003), use of emergency departments (t = 2.20, df = 132, p = .030), total health care costs (t = 2.01, df = 132, p = .040), and sick leaves (t = 1.97, df = 132, p = .048). These findings underscore the societal importance of achieving a reliable recovery in patients with emotional disorders, and further support the value of adding TD-CBT to TAU in the primary care setting.
A Randomized Controlled Pilot Trial of Primary Care Treatment Integrating Motivation and Exposure Treatment (PC-TIME) in Veterans With PTSD and Harmful Alcohol Use.
Possemato K, Mastroleo NR, Balderrama-Durbin C … +4 more , King P, Davis A, Borsari B, Rauch SAM
Behav Ther · 2024 May · PMID 38670669 · Full text
Individuals with posttraumatic stress disorder (PTSD) often engage in harmful alcohol use. These co-occurring conditions are associated with negative health consequences and disability. PTSD and harmful drinking are typi...
Individuals with posttraumatic stress disorder (PTSD) often engage in harmful alcohol use. These co-occurring conditions are associated with negative health consequences and disability. PTSD and harmful drinking are typically experienced as closely related-thus treatments that target both simultaneously are preferred by patients. Many individuals with PTSD and harmful alcohol use receive primary care services but encounter treatment barriers in engaging in specialty mental health and substance use services. A pilot randomized controlled trial of a brief integrated treatment for PTSD and harmful drinking versus primary care treatment as usual (PC-TAU) took place in three U.S. Department of Veterans Affairs (VA) primary care clinics. The intervention (primary care treatment integrating motivation and exposure [PC-TIME]) combines motivational interviewing to reduce alcohol use and brief prolonged exposure for PTSD delivered over five brief sessions. Participants (N = 63) were veterans with PTSD and harmful drinking. Multilevel growth curve modeling examined changes in drinking (average number of drinks per drinking day and percentage of heavy drinking days) and self-reported PTSD severity at baseline, 8, 14, and 20 weeks. Participants reported high satisfaction with PC-TIME and 70% (n = 23) completed treatment. As hypothesized, a significantly steeper decrease in self-reported PTSD severity and heavy drinking was evident for participants randomized to PC-TIME compared with PC-TAU. Contrary to expectations, no significant posttreatment differences in PTSD diagnoses were observed. PC-TIME participants were less likely to exceed National Institute for Alcoholism and Alcohol Abuse (NIAAA) guidelines for harmful alcohol use posttreatment compared with PC-TAU participants. PC-TIME is a promising brief, primary care-based treatment for individuals with co-occurring PTSD and harmful alcohol use. A full-scale randomized clinical trial is needed to fully test its effectiveness.
Validation of a Novel Perceptual Body Image Assessment Method Using Mobile Digital Imaging Analysis: A Cross-Sectional Multicenter Evaluation in a Multiethnic Sample.
Braun-Trocchio R, Ray A, Graham R … +4 more , Brandner CF, Warfield E, Renteria J, Graybeal AJ
Behav Ther · 2024 May · PMID 38670668 · Full text
Given that mobile digital imaging analyses (DIA) are equipped to automate body composition and subsequently alter one's appearance at a given objective body fat percent (BF%), the purpose of this study was to validate th...
Given that mobile digital imaging analyses (DIA) are equipped to automate body composition and subsequently alter one's appearance at a given objective body fat percent (BF%), the purpose of this study was to validate the use of this tool for assessments of body image. Participants (f = 134, m = 89) from two separate centers underwent body composition scans using a mobile DIA and completed the Multidimensional Body Self-Relations Questionnaire-Appearance Scale (MBSRQ-AS). Using a DIA-generated avatar, participants altered their figure so that it represented their perceived body, ideal body, and what a partner would find attractive. Distortion was calculated as perceived minus actual BF% and dissatisfaction was calculated as either ideal or partner minus perceived BF%. The total sample and females (p < 0.050), but not males, had significantly lower perceived BF% compared to their actual. Ideal and partner BF% was significantly lower than the perceived BF% for all groups (all p < 0.050). Ideal and partner BF% mean differences (MD) from perceived were positively associated with appearance evaluation (AE) and body area satisfaction (BAS) and negatively associated with overweight preoccupation and self-classified weight for the total sample (all p < 0.050). Perceived demonstrated negative associations with AE and BAS (p < 0.050), but only for females when separated by sex. Perceptual body image measured by DIA is significantly associated with attitudinal body image and may allow practitioners to better quantify this growing issue.
Implementation and Preliminary Outcomes of an Exposure-Based Summer Camp for Pediatric OCD and Anxiety.
McCarty RJ, Downing ST, Guastello AD … +7 more , Lazaroe LM, Ordway AR, MirHosseini T, Barthle-Herrera MA, Cooke DL, Mathews CA, McNamara JPH
Behav Ther · 2024 May · PMID 38670667 · Publisher ↗
Despite the high prevalence of anxiety disorders in children and adolescents and the existence of effective evidence-based treatments for them, access to psychological care remains a major public health concern. Summer c...
Despite the high prevalence of anxiety disorders in children and adolescents and the existence of effective evidence-based treatments for them, access to psychological care remains a major public health concern. Summer camps may provide an effective treatment avenue for youth who might not otherwise have access to care. This study describes the design and implementation of Fear Facers, a semistructured, 5-day, daytime exposure-therapy-based summer camp designed for youth with a primary diagnosis of obsessive-compulsive disorder (OCD), social anxiety, separation anxiety, or a specific phobia. Preliminary data regarding feasibility and patient outcomes is also reported. Among 52 children and adolescents aged 7 to 16 who attended one of six camp sessions between 2018 and 2021, significant reductions in anxiety (d = 0.54) and OCD symptoms (d = 0.57) were observed from pre-camp to immediately post-camp. A subset of campers who were followed for an additional 3 months post-camp (n = 22) showed maintenance of treatment gains. Retention rates for the intervention were high. Our investigation provides further support for the use of a camp-based design for cognitive-behavioral approaches, and may provide a unique setting to maximize elements of inhibitory learning in exposures. We also discuss a number of elements regarding feasibility that need consideration for those hoping to develop similar interventions.
Internet-Based Versus Face-to-Face Cognitive-Behavioral Therapy for Social Anxiety Disorder: A Randomized Control Trial.
Soleimani Rad H, Goodarzi H, Bahrami L … +1 more , Abolghasemi A
Behav Ther · 2024 May · PMID 38670666 · Publisher ↗
During the COVID-19 epidemic, face-to-face mental health services faced obstacles. Using Internet-based interventions was a good solution and had the potential to overcome these treatment barriers. However, there is no s...
During the COVID-19 epidemic, face-to-face mental health services faced obstacles. Using Internet-based interventions was a good solution and had the potential to overcome these treatment barriers. However, there is no strong research evidence about the effectiveness of these methods for social anxiety disorder in different cultures and developing countries. Therefore, the present study aimed to investigate the effectiveness and application of Internet-based cognitive-behavioral therapy for social anxiety disorder in Iran. The current study was a pretest-posttest follow-up experimental design. Fifty-four adolescents with social anxiety disorder were selected from Lorestan province (Iran) by cluster sampling method and randomly assigned to three groups: face-to-face, internet-based, and wait-list control. At the beginning and end of the study and 3-month follow-up, three groups were interviewed and answered questionnaires related to the primary and secondary symptoms of social anxiety disorder. Two experimental groups were treated with the same therapeutic intervention during 10 weekly sessions. ANCOVA analysis showed that both forms of intervention effectively reduced social phobia, fear of negative evaluation and social interaction anxiety and increased emotion regulation. Also, a significant decrease in secondary outcomes, including physical symptoms, insomnia, social dysfunction, and depression symptoms, was observed in both groups. The treatment effects were stable during a 3-month follow-up. Our findings showed that although Internet-based cognitive-behavioral therapy for adolescents with social anxiety disorder can be effective, several clinical, cultural, and implementation weaknesses should be considered.
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