J Consult Clin Psychol [JOURNAL]
Sun
200 papers
Web-based interpretation bias training to reduce anxiety: A sequential, multiple-assignment randomized trial.
Eberle JW, Daniel KE, Baee S … +13 more , Silverman AL, Lewis E, Baglione AN, Werntz A, French NJ, Ji JL, Hohensee N, Tong X, Huband JM, Boukhechba M, Funk DH, Barnes LE, Teachman BA
J Consult Clin Psychol · 2024 Jun · PMID 39023984 · Full text
OBJECTIVE: Web-based cognitive bias modification for interpretation (CBM-I) can improve interpretation biases and anxiety symptoms but faces high rates of dropout. This study tested the effectiveness of web-based CBM-I r...
OBJECTIVE: Web-based cognitive bias modification for interpretation (CBM-I) can improve interpretation biases and anxiety symptoms but faces high rates of dropout. This study tested the effectiveness of web-based CBM-I relative to an active psychoeducation condition and the addition of low-intensity telecoaching for a subset of CBM-I participants. METHOD: 1,234 anxious community adults (Mage = 35.09 years, 81.2% female, 72.1% white, 82.6% not Hispanic) were randomly assigned at Stage 1 of a sequential, multiple-assignment randomized trial to complete five weekly sessions of CBM-I or psychoeducation on our team's public research website. After the first session, for Stage 2, an algorithm attempted to classify CBM-I participants as higher (vs. lower) risk for dropping out; those classified as higher risk were then randomly assigned to complete four brief weekly telecoaching check-ins (vs. no coaching). RESULTS: As hypothesized (https://doi.org/j2xr; Daniel, Eberle, & Teachman, 2020), CBM-I significantly outperformed psychoeducation at improving positive and negative interpretation biases (Recognition Ratings, Brief Body Sensations Interpretation Questionnaire) and anxiety symptoms (Overall Anxiety Severity and Impairment Scale, Anxiety Scale from Depression Anxiety Stress Scales-Short Form), with smaller treatment gains remaining significant at 2-month follow-up. Unexpectedly, CBM-I had significantly worse treatment dropout outcomes than psychoeducation, and adding coaching (vs. no coaching) did not significantly improve efficacy or dropout outcomes (notably, many participants chose not to interact with their coach). CONCLUSIONS: Web-based CBM-I appears effective, but supplemental coaching may not mitigate the challenge of dropout. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Different trajectories of relationship satisfaction among rural Black couples following preventive relationship intervention.
Weber DM, Lavner JA, Beach SRH
J Consult Clin Psychol · 2024 Jun · PMID 39023983 · Full text
OBJECTIVE: This study examined variability in response to a couple and relationship education program for Black coparenting couples using group-based trajectory modeling. We identified groups of couples with different re...
OBJECTIVE: This study examined variability in response to a couple and relationship education program for Black coparenting couples using group-based trajectory modeling. We identified groups of couples with different relationship satisfaction trajectories across a 2-year period following preintervention assessment. METHOD: Black couples with a preadolescent child were randomized to the Protecting Strong African American Families intervention (N = 170) or a control condition (N = 174) and reported on their relationship satisfaction preintervention and approximately 9, 17, and 25 months later. RESULTS: Results indicated two trajectory groups among men and women receiving the intervention, comprising a large group consistently high in relationship satisfaction over time and a smaller group with moderate, stable satisfaction over time. In the control condition, there was also a large group of men and women who remained consistently high in satisfaction, but the smaller group with initially moderate satisfaction experienced decreased satisfaction over time. Trajectories among men and women in the moderate groups differed by treatment condition, reflecting nonsignificant change (i.e., stable satisfaction) for those receiving intervention and significant decline for controls. Trajectories among women in the high group also differed by treatment condition, reflecting better functioning among women receiving intervention. CONCLUSIONS: Results indicated many benefits of intervention, most notably the stabilization of satisfaction among couples beginning with moderate satisfaction (who experienced declining satisfaction in the control condition). Similar examination of within-sample variability in response to other couple and relationship education programs may enhance understanding of specific treatment effects and guide identification of those most likely to benefit from relationship intervention. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Acceptance and commitment therapy versus cognitive behavioral therapy for insomnia: A randomized controlled trial.
El Rafihi-Ferreira R, Hasan R, Toscanini AC … +6 more , Linares IMP, Suzuki Borges D, Brasil IP, Carmo M, Lotufo Neto F, Morin C
J Consult Clin Psychol · 2024 Jun · PMID 39023982 · Publisher ↗
OBJECTIVE: To compare the effectiveness of an acceptance and commitment therapy (ACT)-based protocol and cognitive behavior therapy (CBT) for insomnia in adults. METHOD: The participants comprised 227 adults with insomni...
OBJECTIVE: To compare the effectiveness of an acceptance and commitment therapy (ACT)-based protocol and cognitive behavior therapy (CBT) for insomnia in adults. METHOD: The participants comprised 227 adults with insomnia. They were randomized to six weekly group sessions consisting of acceptance and commitment therapy for insomnia (n = 76), cognitive behavioral therapy for insomnia (n = 76), or waitlist (WL; n = 75). RESULTS: Both treatment modalities significantly reduced insomnia severity with large effect sizes in the posttreatment phase. These results were maintained during the follow-up period with large effect sizes. CBT was superior to ACT in reducing the Insomnia Severity Index at posttreatment and follow-up, with a small effect size. ACT was superior to WL at posttreatment and at follow-up, with a moderate effect size. The treatment response and remission ratios were higher with CBT at posttreatment and similar at 6-month follow-up for both therapies, as ACT made further gains in response and remission. ACT had a significantly higher proportion of response and remission than WL in both periods (posttreatment and follow-up). Both therapies improved daytime functioning at both posttreatment and follow-up, with few differential changes across the groups. CONCLUSIONS: Both cognitive behavior therapy and acceptance and commitment therapy are effective, with CBT showing superiority and ACT showing delayed improvement. ACT has proven to be an effective therapy, especially in the long term, even in the absence of behavioral techniques such as stimulus control and sleep restriction, and it is a viable option for those who have difficulties adhering to behavioral techniques. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Measurement-based matching of patients to psychotherapists' strengths.
Constantino MJ
J Consult Clin Psychol · 2024 Jun · PMID 39023981 · Publisher ↗
Treatment personalization has evolved into an important zeitgeist in psychotherapy research. To date, such efforts have principally embodied a unidirectional focus on personalizing interventions to the patient. For examp...
Treatment personalization has evolved into an important zeitgeist in psychotherapy research. To date, such efforts have principally embodied a unidirectional focus on personalizing interventions to the patient. For example, earlier work in this area attempted to determine whether, on average, certain patients with certain characteristics or needs would respond better to one treatment package versus others. To the extent such "Aptitude × Treatment interactions" emerged, they could help guide overarching treatment selection. More recently, and drawing on technological and statistical advancements (e.g., machine learning, dynamic modeling), predictive algorithms can help determine for which individual patients certain treatment packages (DeRubeis et al., 2014) or specific during-session interventions within them (Fisher & Boswell, 2016) confer the most advantage for clinical improvement. Again, such work can help guide treatment decisions, though now at multiple care points. Although the aforementioned innovations in personalized psychotherapy have been leading-edge, precision care need not remain unidirectional. Rather, it can be complemented by efforts to personalize treatment decisions . Namely, we can harness therapist effectiveness data to help ensure that therapists treat the patients they are empirically most equipped to help and use the interventions with which they have had the most empirical success. Such threads have been the focus of our team's novel, evolving, and multimethod work on improving psychotherapy by leveraging therapists' own practice-based evidence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Advancing a mission of translational intervention science: Comment on premature implementation.
Beidas RS, Saldana L, Shelton RC
J Consult Clin Psychol · 2024 May · PMID 38829331 · Publisher ↗
Replies to comments made by Kenneth E. Freedland et al. (see record 2024-89430-002) on Rinad S. Beida, Lisa Saldana, and Rachel C. Shelton's original article (see record 2023-46817-001). In reading Freedland et al.'s (20...
Replies to comments made by Kenneth E. Freedland et al. (see record 2024-89430-002) on Rinad S. Beida, Lisa Saldana, and Rachel C. Shelton's original article (see record 2023-46817-001). In reading Freedland et al.'s (2024) commentary, it appears that their lens prioritizes internal validity and more explanatory and mechanistic work. While we also value these scientific goals and concur that the approaches they identify are clearly methodologically rigorous, we do not think the approaches will substantially reduce the unacceptable translation gap or address the fundamental issues of context. Our approach recognizes that there is tremendous value in cocreating solutions and interventions with patients, clinicians, and community members in the settings where we are seeking to promote health and address health inequities, and questions traditional assumptions and paradigms that scientists "know best" have effective solutions or should hold all of the power and knowledge (Brownson et al., 2022; Sanchez et al., 2023; Shelton, Adsul, & Oh, 2021; Shelton, Adsul, Oh, et al., 2021). We believe it is critical that we expand the pathways through which we advance intervention science in a meaningful and impactful way, and with more explicit attention to issues of context, equity, engagement, and external validity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Testing psychosocial interventions in context: Commentary on Beidas et al. (2023).
Freedland KE, Powell LH, Czajkowski SM … +1 more , Epstein LH
J Consult Clin Psychol · 2024 May · PMID 38829330 · Publisher ↗
In their recent Viewpoint article, Beidas et al. (2023) argue that researchers should test psychosocial interventions in the contexts in which they are meant to be delivered and that they can accelerate the deployment of...
In their recent Viewpoint article, Beidas et al. (2023) argue that researchers should test psychosocial interventions in the contexts in which they are meant to be delivered and that they can accelerate the deployment of these interventions by advancing directly from pilot trials to effectiveness and implementation studies without conducting efficacy trials. In this commentary, we argue that this is a well-intended but problematic approach and that there is a more productive strategy for translational behavioral intervention research. The commentary discusses issues concerning intervention development, refinement, and optimization; pilot and efficacy testing of interventions; the contexts in which interventions are delivered; clinical practice guidelines; and quick versus programmatic answers to significant clinical research questions. Testing psychosocial interventions in the contexts in which they are meant to be delivered is a complex task for interventions that are designed to be used in a wide variety of contexts. Nevertheless, interventions can be tested in the contexts in which they are meant to be delivered without sacrificing programmatic intervention development or safety and efficacy testing. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Dose-response relationship in cognitive behavioral therapy for depression: A nonlinear metaregression analysis.
Klein T, Breilmann J, Schneider C … +8 more , Girlanda F, Fiedler I, Dawson S, Crippa A, Priebe S, Barbui C, Becker T, Kösters M
J Consult Clin Psychol · 2024 May · PMID 38829329 · Publisher ↗
OBJECTIVE: Evidence on the optimal "dose" of cognitive behavioral therapy (CBT) for treating major depressive disorder is sparse. This analysis aimed to evaluate the dose-response curve in CBT using a nonlinear approach,...
OBJECTIVE: Evidence on the optimal "dose" of cognitive behavioral therapy (CBT) for treating major depressive disorder is sparse. This analysis aimed to evaluate the dose-response curve in CBT using a nonlinear approach, whereby "dose" was defined as number of treatment sessions. The dose-response curve of CBT was compared to other psychotherapies and pharmacological treatments for depression. METHOD: A systematic review and metaregression analysis of randomized controlled trials (RCTs) examining the efficacy of CBT in adults with acute depression was conducted. Treatment arms examining other psychosocial or pharmacological interventions were also analyzed. Cubic spline metaregression techniques were used to model nonlinear dose-response curves. RESULTS: Seventy-two studies and 7,377 participants were included. Modeling the dose-response curve between change of depression symptom severity and the number of CBT sessions resulted in a nonlinear curve characterized by a strong improvement in symptom severity from baseline within the first eight sessions. Symptom reduction continues in the further course of the treatment, but at a slower pace. A similar pattern of symptom development was found for other therapies as well, although the prominence of early improvement and overall effect sizes vary across treatment arms. CONCLUSION: Results imply a general tendency for the strongest alleviation of depressive symptom severity in early stages of CBT treatment, thus, if aiming at symptom alleviation, speak for short CBT interventions. However, these findings have to be discussed in the light of the limited data regarding the sustainability of treatment effects in short-term therapies and effects beyond symptomatic changes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
The temporal order of emotional, cognitive, and behavioral gains in daily life during treatment of depression.
Snippe E, Elmer T, Ceulemans E … +3 more , Smit AC, Lutz W, Helmich MA
J Consult Clin Psychol · 2024 Aug · PMID 38780574 · Publisher ↗
OBJECTIVE: Despite the importance for understanding mechanisms of change, little is known about the order of change in daily life emotions, cognitions, and behaviors during treatment of depression. This study examined th...
OBJECTIVE: Despite the importance for understanding mechanisms of change, little is known about the order of change in daily life emotions, cognitions, and behaviors during treatment of depression. This study examined the within-person temporal order of emotional, cognitive, and behavioral improvements using ecological momentary assessment data. METHOD: Thirty-two individuals with diagnosed depression completed ecological momentary assessment questions on emotions (sad mood, happy mood), behaviors (social interaction, number of activities), and cognitive variables (worrying, negative self-thoughts) 5 times a day during a 4-month period in which they underwent psychotherapy for depression. Nonparametric change-point analyses were used to determine the timing of gains (i.e., improvements in the mean of each variable) for each individual. We then established whether the first (i.e., earliest) gains in emotions preceded, followed, or occurred in the same week as cognitive and behavioral gains for each individual. RESULTS: Contrary to our hypotheses, first gains in behaviors did not precede first emotional gains (3 times, 8%) more often than they followed them (26 times, 70%). Cognitive gains often occurred in the same week as first emotional gains (43 times, 58%) and less often preceded (13 times, 18%) or followed emotional gains (18 times, 24%). CONCLUSION: The first improvements in behaviors did not tend to precede the first improvements in emotions likely because fewer behavioral gains were found. The finding that cognitive variables tend to improve around the same time as sad mood may explain why many studies failed to find that cognitive change predicts later change in depressive symptoms. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Disruptive child behavior severity and parenting program session attendance: Individual participant data meta-analysis.
Melendez-Torres GJ, Leijten P, Scott S … +6 more , Gardner F, Axford N, Seabra Santos MJ, Menting A, Hutchings J, Berry V
J Consult Clin Psychol · 2024 Oct · PMID 38780573 · Publisher ↗
OBJECTIVE: We tested if baseline disruptive child behavior problem severity predicts parental attendance at sessions of a parenting group program. METHOD: We used a database of randomized trials of the Incredible Years p...
OBJECTIVE: We tested if baseline disruptive child behavior problem severity predicts parental attendance at sessions of a parenting group program. METHOD: We used a database of randomized trials of the Incredible Years parenting program in Europe and restricted the sample to participants randomized to the intervention arm. Using baseline Eyberg Child Behavior Inventory scores, we distinguished between trial-level problem severity and child-level problem severity, compared linear and quadratic functional forms at both levels, and considered cross-level interactions, all in a multilevel Poisson regression framework. RESULTS: Drawing on 918 participants in 12 trials, we found that within trials, parents of children with the least and most severe problems attended fewer sessions. Between trials, each additional 10-point increase in the Eyberg Child Behavior Inventory trial mean predicted an 11% increase in attendance. Models including child sex, age, or family low-income did not change coefficients or their interpretation. CONCLUSIONS: Our findings suggest that although generally attendance is higher in parents of children with more challenging behavior, it seems difficult for group programs to keep families with the least or most severe problems engaged. Our findings call for the need to better understand the conditions under which lower attendance translates into equivalent or lesser program benefits. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Location-scale modeling as an integrative approach to symptom dynamics during psychotherapy: An illustration with depressive symptoms.
Brose A, Koval P, Heinrich M … +3 more , Zagorscak P, Bohn J, Knaevelsrud C
J Consult Clin Psychol · 2024 Sep · PMID 38780572 · Publisher ↗
OBJECTIVE: Depressive symptom dynamics, including change trajectories and symptom variability, have been related to therapy outcomes. However, such dynamics have often been examined separately and related to outcomes of...
OBJECTIVE: Depressive symptom dynamics, including change trajectories and symptom variability, have been related to therapy outcomes. However, such dynamics have often been examined separately and related to outcomes of interest using two-step analyses, which are characterized by several limitations. Here, we show how to overcome these limitations using location-scale models in a dynamic structural equation modeling framework. METHOD: We introduce location-scale modeling in an accessible manner to pave the way for its use in research integrating within-person dynamics and intervention-related change in psychopathology, and we illustrate this modeling approach in a large-scale internet-based intervention for depression ( = 1,656). Using eight data points sampled across about 8 weeks, we predicted improvement across the intervention (50% symptom reduction) as a function of early change and symptom variability. RESULTS: Early symptom change was associated with a more likely improvement across therapy. Variability of symptoms beyond change trajectories during the intervention was associated with less likely improvement. CONCLUSIONS: Location-scale models, and dynamic structural equation modeling more generally, are well suited to modeling how patterns of symptom change during psychotherapy are related to important (e.g., therapy) outcomes. Our illustrative application of location-scale modeling showed that symptom variability was associated with less overall improvement in depressive symptoms. However, this finding requires replication with more intensive sampling of symptoms before final conclusions can be drawn on when and how to distinguish maladaptive from adaptive variability during psychotherapy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Cognitive and interpersonal moderators of two evidence-based depression prevention programs.
Jones JD, Schwartz KTG, Davis M … +3 more , Gallop R, Hankin BL, Young JF
J Consult Clin Psychol · 2024 Jul · PMID 38635190 · Full text
OBJECTIVE: To test potential cognitive and interpersonal moderators of two evidence-based youth depression prevention programs. METHOD: Two hundred four adolescents ( = 14.62 years, = 1.65; 56% female; 71% White, 11% Bl...
OBJECTIVE: To test potential cognitive and interpersonal moderators of two evidence-based youth depression prevention programs. METHOD: Two hundred four adolescents ( = 14.62 years, = 1.65; 56% female; 71% White, 11% Black, 11% multiracial, 5% Asian, 2% other races, 18% Hispanic/Latinx) were randomized to either a cognitive-behavioral (Coping With Stress [CWS]) or interpersonal (Interpersonal Psychotherapy-Adolescent Skills Training [IPT-AST]) prevention program. Potential moderators, selected based on theory and research, included rumination, negative cognitive style, dysfunctional attitudes, hopelessness, parent-adolescent conflict, negative interactions with parents and friends, and social support from parents and friends. Depression symptoms were assessed repeatedly through 18 months postintervention. RESULTS: After adjusting for multiple comparisons, rumination ( = -2.02, = .61, = .001, = .47), hopelessness ( = -2.03, = .72, = .005, = .41), and conflict with father ( = 1.68, = .74, = .02, = .32) moderated intervention effects on change in depression symptoms from postintervention through 18-month follow-up. For example, at high levels of conflict with father, youth in IPT-AST reported a significant decrease in symptoms during follow-up, whereas youth in CWS reported a nonsignificant change in symptoms. At low levels of conflict with father, youth in IPT-AST reported a significant increase in symptoms during follow-up, whereas youth in CWS reported a nonsignificant change in symptoms. CONCLUSIONS: These exploratory secondary analyses of Personalized Depression Prevention study data highlight specific cognitive and interpersonal risk factors that could be considered when determining which prevention program may be most effective for a given adolescent. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Family engagement in a behavioral parenting intervention: A randomized comparison of telehealth versus office-based treatment formats.
Sanchez AL, Javadi N, Comer JS
J Consult Clin Psychol · 2024 Jun · PMID 38619454 · Full text
OBJECTIVE: Despite effective treatment options, many families-especially those from marginalized backgrounds-lack access to quality care for their children's behavioral difficulties. Since the COVID-19 pandemic, teleheal...
OBJECTIVE: Despite effective treatment options, many families-especially those from marginalized backgrounds-lack access to quality care for their children's behavioral difficulties. Since the COVID-19 pandemic, telehealth has become a prominent format for the delivery of outpatient services, with potential to increase access to quality care. Although telehealth-delivered parenting interventions are associated with positive clinical , limited research has examined whether telehealth formats improve treatment relative to office-based care. The present study is the first controlled comparison of engagement across office-based parent-child interaction therapy (PCIT) and internet-delivered PCIT (iPCIT). METHOD: Children ages 3-5 years, and their caregiver(s) ( = 40) participated in a randomized trial comparing iPCIT to office-based PCIT in the treatment of behavioral problems. Analyses examined the effects of treatment format on engagement (i.e., missed sessions, premature treatment discontinuation, homework completion, therapeutic alliance, and treatment satisfaction). Logistic and linear regressions further explored whether treatment format moderated the effects of common predictors of treatment engagement (i.e., family economic means, racial/ethnic background, caregiver stress). RESULTS: iPCIT improved attendance rates relative to office-based PCIT, especially for families from minoritized racial/ethnic backgrounds. At the same time, among families with relatively higher levels of caregiver stress, office-based PCIT was associated with lower dropout rates and improved treatment alliance and satisfaction, relative to iPCIT. CONCLUSIONS: This study provides the first experimental support that telehealth formats can improve treatment attendance in behavioral parenting interventions. Findings highlight nuances in treatment engagement across treatment formats that reveal limits to the extent telehealth transcends engagement concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Grief-focused cognitive behavioral therapies for prolonged grief symptoms: A systematic review and meta-analysis.
Komischke-Konnerup KB, Zachariae R, Boelen PA … +2 more , Marello MM, O'Connor M
J Consult Clin Psychol · 2024 Apr · PMID 38573714 · Publisher ↗
BACKGROUND: Studies suggest that cognitive behavioral therapies (CBTs) may be efficacious in reducing symptoms of prolonged grief disorder (PGD), but no comprehensive overview and pooled estimate of CBTs' effect on PGD i...
BACKGROUND: Studies suggest that cognitive behavioral therapies (CBTs) may be efficacious in reducing symptoms of prolonged grief disorder (PGD), but no comprehensive overview and pooled estimate of CBTs' effect on PGD in adulthood exist. We conducted a systematic review and meta-analysis of randomized controlled trials. METHOD: Studies were selected independently by two researchers based on a systematic literature search in Pubmed, APA PsycInfo, Web of Science, and Embase. Meta-analyses provided pooled effect sizes for the effects of CBTs on PGD symptoms and secondary outcomes. We explored potential moderators of effect, risk of bias of included studies, and evaluated the quality of the meta-analytical evidence through the Grading of Recommendations, Assessment, Development, and Evaluation system. RESULTS: The meta-analysis included 22 studies of 2,602 bereaved adults (averaged study M = 49 years). CBTs had a statistically significant medium effect on PGD symptoms at postintervention ( = 22, g = 0.65, 95% CI [0.49, 0.81]), and a large effect at follow-up ( = 7, g = 0.90, 95% CI [0.37, 1.43]). Statistically significant small-to-medium effects were found at postintervention on posttraumatic stress symptoms ( = 10, g = 0.74, 95% CI [0.49, 0.98]), depression ( = 19, g = 0.53, 95% CI [0.36, 0.71]), and anxiety (K = 9, g = 0.35, 95% CI [0.22, 0.49]). The effects on PGD remained unchanged when adjusted for possible outliers. None of the moderator analyses reached statistical significance. CONCLUSION: This review suggests that CBTs are efficacious in reducing PGD symptoms in adulthood. Generalization of findings should be done with caution due to considerable inconsistency and indirectness of meta-analytic evidence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Peak experiences during insight mindfulness meditation retreats and their salutary and adverse impact: A prospective matched-controlled intervention study.
Hadash Y, Veksler T, Dar O … +2 more , Oren-Schwartz R, Bernstein A
J Consult Clin Psychol · 2024 Apr · PMID 38573713 · Publisher ↗
OBJECTIVE: We sought to address a growing debate regarding the adverse and salutary impact of unusual, extraordinary or intense subjective experiences during meditation-based interventions. To do so, we empirically chara...
OBJECTIVE: We sought to address a growing debate regarding the adverse and salutary impact of unusual, extraordinary or intense subjective experiences during meditation-based interventions. To do so, we empirically characterized such peak experiences during an intensive meditation intervention and their impact postintervention. METHOD: We conducted a preregistered prospective intervention study among 96 adults who registered for 6-day insight (Vipassana) mindfulness meditation retreats and 47 matched controls. Controls were selected from a pool of 543 people recruited from the same community of meditators as retreat participants and systematically matched to retreat participants on age and lifetime meditation experience. Measures included the novel Peak Meditative Experience Scale and the Impact of PMES. RESULTS: Seventeen peak experiences that were primarily pleasant (e.g., deep and unusual peace, aha! Moment) occurred more frequently among retreat participants than among matched controls in daily living (ps < .05; mean ϕ = .33). In contrast, 14 peak experiences that were mostly unpleasant (e.g., flashbacks, overwhelming sadness) occurred at similar rates in both groups (ps > .05). At 2-week follow-up, the perceived impact of all pleasant and most unpleasant peak experiences was more salutary than adverse (ps ≤ .015; M Cohen's = 1.61). CONCLUSIONS: Peak experiences that resulted from meditation retreats were primarily pleasant and had a large salutary impact postretreat. Inconsistent with conclusions from uncontrolled retrospective studies, findings document that intensive insight mindfulness meditation training in retreats may not contribute to unpleasant peak experiences and even when they occurred their impact was typically more salutary than adverse. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Multiculturalism: A paradigmatic force in psychology.
Comas-Diaz L
J Consult Clin Psychol · 2024 Apr · PMID 38573712 · Publisher ↗
Prior to the advent of multiculturalism, mainstream psychology mirrored the Euro-American culture. In contrast, multiculturalism acts as a prism that reveals the diversity in the human condition. Since most empirical res...
Prior to the advent of multiculturalism, mainstream psychology mirrored the Euro-American culture. In contrast, multiculturalism acts as a prism that reveals the diversity in the human condition. Since most empirical research is still conducted on Western, educated, industrialized, rich, and democratic populations, we need to construct a representative map of the human psychological and behavioral phenome. To work toward this goal, multicultural psychologists go beyond personal transformation and openness to the other. They question power relations, oppose oppressive systems, address psychology's fallacy of neutrality, and engage in social justice action. Specifically, multicultural psychologists work to restore the humanity of both the oppressed and the oppressor. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Session-level effects of cognitive processing therapy and prolonged exposure on individual symptoms of posttraumatic stress disorder among U.S. veterans.
Moshier SJ, Mahoney CT, Bovin MJ … +2 more , Marx BP, Schnurr PP
J Consult Clin Psychol · 2024 Jul · PMID 38546622 · Full text
OBJECTIVE: To compare the course of change in individual posttraumatic stress disorder (PTSD) symptoms during prolonged exposure therapy (PE) and cognitive processing therapy (CPT). METHOD: We analyzed data from a previo...
OBJECTIVE: To compare the course of change in individual posttraumatic stress disorder (PTSD) symptoms during prolonged exposure therapy (PE) and cognitive processing therapy (CPT). METHOD: We analyzed data from a previously published randomized clinical trial comparing PE and CPT among male and female U.S. military veterans with PTSD (Schnurr et al., 2022). Using data from a self-rated PTSD symptom measure administered before each therapy session, we evaluated individual symptom change from pretreatment to final therapy session ( = 802). Then, using network intervention analysis, we modeled session-by-session PTSD symptom networks that included treatment allocation (CPT vs. PE) as a node in the networks, allowing us to compare individual symptom change following each session in each treatment. RESULTS: Relative to CPT, PE was associated with greater reduction in 10 PTSD symptoms from first to final session of therapy. Numerous treatment-specific effects on individual symptoms emerged during the treatment period; these session-level effects occurred only in symptoms relatively specific to the diagnosis of PTSD (e.g., avoidance, hypervigilance). PE was associated with greater reduction in avoidance following the introduction and early weeks of imaginal exposure. The treatments yielded comparable effects on trauma-related blame and negative beliefs from pretreatment to final therapy session. However, there were differences in session-level change in these symptoms that may reflect differential timing of interventions that reduce distorted cognitions within each treatment. CONCLUSIONS: Findings may facilitate the shared decision-making process for patients choosing between CPT and PE. Session-level results provide direction for future research on the specific intervention components of CPT and PE. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
What works better? 1-year outcomes of an effectiveness trial comparing online, telehealth, and group-based formats of a military parenting program.
Gewirtz AH, DeGarmo DS, Lee S
J Consult Clin Psychol · 2024 May · PMID 38546621 · Publisher ↗
OBJECTIVE: The present study, conducted with a population of military families, examined the comparative effectiveness of three program formats of Adaptive Parenting Tools (ADAPT), a parenting program for families of sch...
OBJECTIVE: The present study, conducted with a population of military families, examined the comparative effectiveness of three program formats of Adaptive Parenting Tools (ADAPT), a parenting program for families of school-aged children in which a National Guard or Reserve (NG/R) parent had returned from deployment to the post-9/11 conflicts. Despite well-documented need, parenting programs for NG/R families are scarce and often inaccessible. We predicted that both facilitator-delivered conditions (i.e., in-person group; individual telehealth) would result in stronger improvements in observed parenting than assignment to the online self-directed condition. We further proposed a noninferiority hypothesis wherein no significant difference would be detected between telehealth and group conditions. METHOD: Families ( = 244; 87% Caucasian) were recruited from NG/R units in two midwestern states. Families (with a 5-12-year-old child) were randomized to one of three conditions: in-person multifamily group, individual telehealth, or an online, self-directed condition. The intervention was delivered using the same content across conditions, over 14 weeks (group, telehealth conditions) or 12 modules (online condition); either or both parents could participate. RESULTS: Intent-to-treat analyses supported both hypotheses: families in both in-person group and telehealth conditions showed significant improvements to observed parenting at 1-year postbaseline compared with those assigned to the self-directed online condition. CONCLUSIONS: This is the first study to demonstrate that in-person group and telehealth parenting programs are equally effective and that both are superior to a self-directed online program. Limitations include differences between the session lengths in each format, as well as greater attrition in the in-person format. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Parent-child emotion dynamics in families presenting for behavioral parent training: Is there a link with child behavior, parenting, and treatment outcome?
Fischer MS, Loiselle R, Weber DM … +5 more , Highlander A, McCall MP, Cain GH, Forehand R, Jones DJ
J Consult Clin Psychol · 2024 Sep · PMID 38512173 · Full text
OBJECTIVE: Behavioral parent training (BPT) is the standard of care for early onset behavior disorders (BDs), however, not all families benefit. Emotion regulation (ER) is one potential mechanism underlying BPT outcomes,...
OBJECTIVE: Behavioral parent training (BPT) is the standard of care for early onset behavior disorders (BDs), however, not all families benefit. Emotion regulation (ER) is one potential mechanism underlying BPT outcomes, yet there are challenges in capturing intra- and interpersonal aspects of emotion regulation within parent-child interactions that are central to BPT. This study examined how vocally encoded emotional arousal unfolds during parent-child interactions and how parents and children influence each other's arousal (Aim 1), the links between these emotion dynamics, child behavior, and parenting at baseline (Aim 2), and BPT outcome (Aim 3). METHOD: Families of children with BDs ( = 45) completed two interaction tasks and measures of parenting and child behavior. Parent-child dynamics of vocal fundamental frequency (₀) were modeled using actor-partner interdependence models (APIMs) and coupled linear oscillators (CLOs). RESULTS: When considering relative levels of ₀ from one talk turn to the next (APIMs), parents and children showed intrapersonal regulation and synchronizing reactivity to each other's ₀. When considering the shape of oscillations (CLOs), parents and children showed intrapersonal regulation but no reactivity. Intrapersonal regulation of ₀ during the interaction was slowed for parents with more maladaptive parenting and children with more behavior problems at baseline. CONCLUSIONS: This preliminary characterization of f0 in families presenting for BPT provides insights into the emotion dynamics potentially underlying parenting behavior and child behavior. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Monitoring emotional intensity and variability to forecast depression recurrence in real time in remitted adults.
Schreuder MJ, Schat E, Smit AC … +2 more , Snippe E, Ceulemans E
J Consult Clin Psychol · 2024 Aug · PMID 38512172 · Publisher ↗
OBJECTIVE: Recurrent depressive episodes are preceded by changing mean levels of repeatedly assessed emotions (e.g., feeling restless), which can be detected in real time using statistical process control (SPC). This stu...
OBJECTIVE: Recurrent depressive episodes are preceded by changing mean levels of repeatedly assessed emotions (e.g., feeling restless), which can be detected in real time using statistical process control (SPC). This study investigated whether monitoring changes in the standard deviation (SD) of emotions and negative thinking improves the early detection of recurrent depression. METHOD: Formerly depressed adults (N = 41) monitored their emotions five times a day for 4 consecutive months. During the study, 22 individuals experienced recurrent depression. We used SPC to detect warning signs (i.e., changing means and SDs) of four emotions (positive and negative affect with high or low arousal) and negative thinking. RESULTS: -based warning signs only preceded 23%-36% of recurrences, but almost never reflected a false alarm (0%-16%). Correspondingly, -based warnings had a high specificity (at the cost of sensitivity), while mean-based warnings had a higher sensitivity (but lower specificity). There was little overlap in mean- and -based warning signs. For the majority of emotions, monitoring for high alongside monitoring changes in mean levels improved the detection of depression ( < .015) compared to when only monitoring for changing mean levels. CONCLUSIONS: Warning signs for depression manifest not only in changing mean levels of emotions and cognitions but also in increasing SDs. These warnings could eventually be used to detect not just who is at increased risk for depression but also when risk is rising. Further research is needed to evaluate the clinical utility of depression SPC. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
A controlled trial of adaptive disclosure-enhanced to improve functioning and treat posttraumatic stress disorder.
Litz BT, Yeterian J, Berke D … +7 more , Lang AJ, Gray MJ, Nienow T, Frankfurt S, Harris JI, Maguen S, Rusowicz-Orazem L
J Consult Clin Psychol · 2024 Mar · PMID 38358703 · Full text
OBJECTIVE: This is a randomized controlled trial (NCT03056157) of an enhanced adaptive disclosure (AD) psychotherapy compared to present-centered therapy (PCT; each 12 sessions) in 174 veterans with posttraumatic stress...
OBJECTIVE: This is a randomized controlled trial (NCT03056157) of an enhanced adaptive disclosure (AD) psychotherapy compared to present-centered therapy (PCT; each 12 sessions) in 174 veterans with posttraumatic stress disorder (PTSD) related to traumatic loss (TL) and moral injury (MI). AD employs different strategies for different trauma types. AD-Enhanced (AD-E) uses letter writing (e.g., to the deceased), loving-kindness meditation, and bolstered homework to facilitate improved functioning to repair TL and MI-related trauma. METHOD: The primary outcomes were the Sheehan Disability Scale (SDS), evaluated at baseline, throughout treatment, and at 3- and 6-month follow-ups (Brief Inventory of Psychosocial Functioning was also administered), the Clinician-Administered PTSD Scale (CAPS-5), the Dimensions of Anger Reactions, the Revised Conflict Tactics Scale, and the Quick Drinking Screen. RESULTS: There were statistically significant between-group differences on two outcomes: The intent-to-treat (ITT) mixed-model analysis of SDS scores indicated greater improvement from baseline to posttreatment in the AD-E group (d = 2.97) compared to the PCT group, d = 1.86; -2.36, 95% CI [-3.92, -0.77], t(1,510) = -2.92, p < .001, d = 0.15. Twenty-one percent more AD-E cases made clinically significant changes on the SDS than PCT cases. From baseline to posttreatment, AD-E was also more efficacious on the CAPS-5 (d = 0.39). These differential effects did not persist at follow-up intervals. CONCLUSION: This was the first psychotherapy of veterans with TL/MI-related PTSD to show superiority relative to PCT with respect to functioning and PTSD, although the differential effect sizes were small to medium and not maintained at follow-up. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe