Behaviour research and therapy
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Randomized Controlled Trial
Attentional bias modification and pain: The role of sensory and affective stimuli.
There is growing evidence to support attentional bias modification (ABM) techniques such as the modified dot-probe task within the pain literature. Such techniques can help to inform theoretical models of pain by identifying the causal role of attentional bias constructs. The aim of this research was to explore the effects of dot-probe ABM that trains individuals towards (+) or away from (-) sensory (S) and affective (A) pain words, on attentional biases, interpretation biases, and pain outcomes. ⋯ Those trained towards affective pain words were found to have a greater pain threshold but also greater distress at tolerance. However, mechanisms of change could not be established, as ABM did not affect attentional or interpretation bias, even though changes in attentional bias were associated with pain outcomes. These findings provide partial support for the threat interpretation model and highlight the utility of affective pain ABM, although further investigation of causal mechanisms is warranted.
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Randomized Controlled Trial
An online guided ACT intervention for enhancing the psychological wellbeing of university students: A randomized controlled clinical trial.
Stress, anxiety and depression are relatively common problems among university students. This study examined whether an online psychological intervention aiming at enhancing the wellbeing of university students could be an effective and practical alternative for meeting the needs of a university population. University students (N = 68; 85% female; 19-32 years old) were randomly assigned to either a guided seven-week online Acceptance and Commitment Therapy (iACT) intervention or a waiting list control condition (WLC). ⋯ In addition, iACT participants' self-reported stress (d = 0.54) and symptoms of depression (d = 0.69) were significantly reduced compared to the participants in the control group. These benefits were maintained over a 12-month follow-up period (within iACT group, d = 0.65-0.69, for primary measures). The results suggest that an online-based, coach-guided ACT program with blended face-to-face and online sessions could be an effective and well-accepted alternative for enhancing the wellbeing of university students.
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Randomized Controlled Trial
Psychological flexibility and catastrophizing as associated change mechanisms during online Acceptance & Commitment Therapy for chronic pain.
The underlying mechanisms of the effectiveness of cognitive behavioural interventions for chronic pain need further clarification. The role of, and associations between, pain-related psychological flexibility (PF) and pain catastrophizing (PC) were examined during a randomized controlled trial on internet-based Acceptance & Commitment Therapy (ACT) for chronic pain. We assessed (1) the unique and combined indirect effects of PF and PC on outcomes, and (2) the causality of relations between PF, PC and the primary outcome pain interference in daily life (MPI) during ACT. ⋯ Further assessment of changes during ACT showed, however, that only PF, and not PC, predicted subsequent changes in MPI, while early and late changes in both PF and PC predicted later changes in each other. In conclusion, only PF functioned as a direct, causal working mechanism during ACT, with larger indirect effects that occurred earlier than changes in PC. Additionally, PC may function as an indirect mechanism of change during ACT for chronic pain via its direct influence on PF.
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Randomized Controlled Trial
The effect of positive mood induction on reducing reinstatement fear: Relevance for long term outcomes of exposure therapy.
While exposure therapy is effective in treating anxiety, fear can return after exposure. Return of fear can be understood through mechanisms of extinction learning. One form of return of fear is reinstatement, or, the fear that results from an unsignaled unconditional stimulus (US) presentation after extinction. ⋯ The current study evaluated the degree to which positive mood induction (positive imagery training; PIT) compared to control (positive verbal training; PVT) before extinction a) decreased CS+ negative valence during extinction and b) reduced reinstatement fear. Compared to PVT, PIT a) increased positive affect, b) decreased post-extinction CS+ negative valence, and c) reduced reinstatement responding as measured by eye blink startle reflex (when shock was used at reinstatement) and self-report fear (regardless of reinstatement US type). Results suggest that increasing positive affect prior to exposure therapy could reduce relapse through reinstatement.
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Randomized Controlled Trial
Stepped care versus face-to-face cognitive behavior therapy for panic disorder and social anxiety disorder: Predictors and moderators of outcome.
To investigate predictors and moderators of treatment outcome by comparing immediate face-to-face cognitive behavioral therapy (FtF-CBT) to a Stepped Care treatment model comprising three steps: Psychoeducation, Internet-delivered CBT, and FtF-CBT for panic disorder (PD) and social anxiety disorder (SAD). ⋯ In general, the same patient characteristics appear to be associated with the treatment outcome for CBT provided in low- and high-intensity formats when treated in public mental health care clinics. The findings suggest that patients with lower social functioning and higher impairment from their anxiety disorder benefit less from these treatments and may require more adapted and extensive treatment. CLINICALTRIALS.GOV: Identifier: NCT00619138.