Leonidas Castro-Camacho , Margarita María Díaz , Sergio Barbosa
{"title":"Effect of a group prevention program based on the unified protocol for college students in Colombia: A quasi-experimental study","authors":"Leonidas Castro-Camacho , Margarita María Díaz , Sergio Barbosa","doi":"10.1016/j.jbct.2021.04.001","DOIUrl":"https://doi.org/10.1016/j.jbct.2021.04.001","url":null,"abstract":"<div><p><span>Given the high prevalence of emotional disorders among college students, its high social, emotional and economic costs, and a large treatment gap, we designed and evaluated a preventive group intervention based on the Unified Protocol for the transdiagnostic treatment of emotional disorders (UP; Barlow et al., 2011). A total sample of 128 college students in a state university in Bogotá (Colombia) was recruited for this quasi-experimental study with three assessment points: pre-treatment, post-treatment, and three-month follow-up. Participants were included in the control or intervention conditions based on non-random assignement. At the end of the intervention, group analysis suggested significant declines in transdiagnostic risk factors and neurotic temperament and gains in </span>mindfulness<span>, perceived control, and emotional dysregulation<span>. Significant declines were found also for emotional variables such as stress, anxiety, and depression. These results suggest that a preventive intervention based on the Unified Protocol may have a significant impact on several transdiagnostic risk factors and emotional variables making it a promising prevention and mental health promotion program for college students. Since this is the first Colombian study on the matter, its replication and the use of larger and more diverse samples are recommended for future research.</span></span></p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"32 2","pages":"Pages 111-123"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92109385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matthew T. Luciano , Meghan E. McDevitt-Murphy , James G. Murphy , Rebecca J. Zakarian , Cecilia Olin
{"title":"Open trial of a personalized feedback intervention and substance-free activity supplement for veterans with PTSD and hazardous drinking","authors":"Matthew T. Luciano , Meghan E. McDevitt-Murphy , James G. Murphy , Rebecca J. Zakarian , Cecilia Olin","doi":"10.1016/j.jbct.2022.02.004","DOIUrl":"10.1016/j.jbct.2022.02.004","url":null,"abstract":"<div><p>This study reports findings from an open trial of a two-session intervention for veterans with symptoms of PTSD and hazardous drinking. Rooted behavioral economic theory, this intervention aimed to decrease alcohol use and increase alcohol-free activities through personalized and normative feedback. This trial assessed the feasibility and acceptability of the intervention in a sample of 15 veterans. Participants completed assessments at baseline and post-intervention (1-month and 3-months). Thirteen participants (86.6%) were retained between the baseline assessment and second intervention session. Acceptability data indicated that veterans overwhelmingly viewed the intervention positively with little dropout between the two sessions. Further, participants in our study reduced alcohol consumption from 37.30 (SD<!--> <!-->=<!--> <!-->17.30) drinks per week at baseline to 22.50 (<em>SD</em> <!-->=<!--> <!-->27.75) drinks per week at the 1-month assessment and then to 14.60 (<em>SD</em> <!-->=<!--> <!-->18.64) at the 3-months assessment, representing medium to large effects. PTSD severity also decreased from 57.20 (<em>SD</em> <!-->=<!--> <!-->16.72) at baseline to 48.90 (<em>SD</em> <!-->=<!--> <!-->18.99) at the 1-month assessment, representing a small effect. Though effect sizes from pilot trials should be interpreted with caution, findings suggest that this intervention was well-received, feasible to deliver, and may have resulted in improvements in intervention targets.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"32 2","pages":"Pages 136-144"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0b/8f/nihms-1791266.PMC9307063.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9912747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jean M. Quintero , Elena W. Mayville , Richard G. Heimberg , David M. Fresco , Douglas S. Mennin
{"title":"Implicit approach and avoidance motivational changes in GAD patients treated with emotion regulation therapy","authors":"Jean M. Quintero , Elena W. Mayville , Richard G. Heimberg , David M. Fresco , Douglas S. Mennin","doi":"10.1016/j.jbct.2021.05.005","DOIUrl":"https://doi.org/10.1016/j.jbct.2021.05.005","url":null,"abstract":"<div><p><span>Approach and avoidance motivational changes over the course of Emotion Regulation<span> Therapy (ERT) were assessed at pre-, mid-, and post-treatment using an Approach-Avoidance variant of the Implicit Association Test (AAIAT) that specifically targeted implicitly-held action tendencies about approach/avoidance in the context of positively and negatively valenced word stimuli. We expected implicit associations would be demonstrated by reduced AAIAT Total scores from mid- to post-treatment potentially reflecting increased approaching of contexts regardless of valence. We hypothesized that: (1) AAIAT performance would be responsive to ERT during the second half of treatment when the intervention is specifically focused on exposure to approach-avoidance conflict; (2) changes in AAIAT performance during this period would be associated with changes in clinical outcomes; (3) changes in clinical outcomes during the first half of treatment would not be associated with changes in AAIAT performance occurring in the second half. As expected, AAIAT performance significantly changed from mid- to post-treatment, reflecting an increased likelihood of approaching contexts regardless of valence. These changes were related to improvements in </span></span>quality of life, functional impairment, and negative emotional intensity. ERT shows promise in changing maladaptive approach/avoidance motivational tendencies for individuals with distress disorders, particularly during the second half, when treatment is focused on approach-avoidance content. This study underscores the value of implementing behavioral tasks as complementary tools to self-report measures in furthering our understanding of core mechanisms (e.g., motivation) implicated in the psychopathology and treatment of distress disorders.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"32 2","pages":"Pages 151-156"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92020905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alissa J. Ellis , Alexandra Sturm , Michelle Rozenman , Emma Smith , Ibukun Olabinjo
{"title":"thinkSMART®: A pilot study of a transdiagnostic cognitive-behavioral treatment for adolescents with executive functioning weaknesses","authors":"Alissa J. Ellis , Alexandra Sturm , Michelle Rozenman , Emma Smith , Ibukun Olabinjo","doi":"10.1016/j.jbct.2022.01.002","DOIUrl":"https://doi.org/10.1016/j.jbct.2022.01.002","url":null,"abstract":"<div><p>Executive functions are a broad term used to describe the cognitive functions necessary to help individuals complete tasks and achieve goals. Executive functioning weaknesses are a hallmark feature of psychopathology, particularly in youth. These weaknesses are associated with chronic impairment across academic, social and family domains and do not typically improve into adulthood. Despite these negative outcomes, few behavioral interventions have been successfully developed to target executive functioning outside of ADHD, particularly in adolescents with various types of psychopathology. The thinkSMART® program was created to target the broad heterogeneity of adolescents with executive function weakness. We discuss the rationale for the development of the program, as well as outline the primary skill areas addressed. We also present an open-trial pilot study using the program in adolescents ages 12–17 who identify as having executive functioning weaknesses. Preliminary findings highlight the acceptability and feasibility of the program, as well as the initial efficacy in improving adolescents’ day-to-day executive functioning. We discuss the limitations and benefits of providing broad skills and compensatory strategies to improve adolescent executive functioning.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"32 2","pages":"Pages 124-135"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92145212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Treatment focus diffusion predicts poorer clinical progress in children's public mental health care","authors":"Kalyn L. Holmes, Charles W. Mueller","doi":"10.1016/j.jbct.2021.09.002","DOIUrl":"https://doi.org/10.1016/j.jbct.2021.09.002","url":null,"abstract":"<div><p><span><span><span>Recent evidence from well-controlled efficacy studies suggests that diffusing </span>treatment focus across multiple concerns is associated with poorer clinical outcomes. However, research regarding treatment focus diffusion (TFD) in public </span>mental health<span> care (PMHC) settings, broadly or in implemented evidence-based treatments (EBT), is scarce, despite therapists<span> in such settings often reporting more complex cases. Using multilevel modeling, this study examined TFD differences between two in-home PMHC services: (a) Multisystemic Therapy (MST; </span></span></span><em>n</em> <!-->=<!--> <!-->911 youths, 109 therapists), an implemented EBT, and (b) a less structured service more characteristic of treatment as usual (<em>n</em> <!-->=<!--> <!-->2362 youth, 457 therapists). The relationship between TFD and monthly therapeutic progress within and across these two service formats was also examined. Treatment focus diffusion occurred less in the implemented EBT. Overall, receiving services through the less structured service format and more diffused treatment focus predicted less and slower progress over the course of treatment. The relationship between TFD and less clinical progress was stronger in the MST format. These findings held when accounting for indicators of case complexity including initial level of impairment and number of diagnoses. EBTs appear to maintain a narrower treatment focus even when implemented in a public mental health system. However, even in EBTs, TFD predicts poorer clinical progress. Maintaining a narrow treatment focus, even in complex cases typical of PMHC, might improve clinical outcomes.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"32 2","pages":"Pages 99-110"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92085787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David Lafortune , Valerie A. Lapointe , Cloé Canivet , Natacha Godbout , Marie-Aude Boislard
{"title":"Validation of a virtual environment for sexual aversion","authors":"David Lafortune , Valerie A. Lapointe , Cloé Canivet , Natacha Godbout , Marie-Aude Boislard","doi":"10.1016/j.jbct.2021.11.001","DOIUrl":"https://doi.org/10.1016/j.jbct.2021.11.001","url":null,"abstract":"<div><p>This study focused on sexual aversion<span> (SA) – namely the experience of fear, disgust, and avoidance when exposed to sexual contexts or cues – and aimed to validate a virtual environment's ability to progressively trigger the typical emotional responses of SA. Thirty-nine participants (16 low-SA and 23 high-SA individuals) were immersed in a virtual room and then successively exposed to six scenarios in which a synthetic character showed erotic behaviors of increasing sexual intensity. Throughout immersion, subjective measures of anxiety and disgust (Subjective Units of Discomfort Scale; SUDS), skin conductance, heart rate, cardiac output, and eye movements were recorded. The changes in SUDS and physiological variables were examined through repeated measures analyses of variance. SUDS scores significantly increased as the levels of exposure progressed among the high-SA participants, who also reported significantly more anxiety and disgust than the low-SA group. Significant large time effects were found for cardiac output and eye fixation<span> (on face, chest, and genitals), but no significant group*time interactions were found for physiological variables. Results show that this virtual environment may be a promising tool for research and practice, and its efficacy as part of a virtual reality exposure-based treatment for SA should be tested.</span></span></p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"32 2","pages":"Pages 85-98"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92145213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Guest editorial: Progress in CBT for anxiety disorders","authors":"Jasper Smits Ph.D. (Professor of psychology)","doi":"10.1016/j.jbct.2022.02.001","DOIUrl":"10.1016/j.jbct.2022.02.001","url":null,"abstract":"","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"32 1","pages":"Pages 1-2"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114413096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer L. Buchholz , Shannon M. Blakey , Samantha N. Hellberg , Maya Massing-Schaffer , Lillian Reuman , Heidi Ojalehto , Joe Friedman , Jonathan S. Abramowitz
{"title":"Expectancy violation during exposure therapy: A pilot randomized controlled trial","authors":"Jennifer L. Buchholz , Shannon M. Blakey , Samantha N. Hellberg , Maya Massing-Schaffer , Lillian Reuman , Heidi Ojalehto , Joe Friedman , Jonathan S. Abramowitz","doi":"10.1016/j.jbct.2021.12.004","DOIUrl":"10.1016/j.jbct.2021.12.004","url":null,"abstract":"<div><p><span><span>Despite empirical support for the efficacy of exposure-based therapy for anxiety-related disorders, many individuals do not respond to this intervention or else experience a return of fear after treatment. Inhibitory learning theory has informed novel approaches to exposure therapy delivery that aim to improve both short- and long-term outcomes. One exposure optimization strategy is to maximize expectancy violation (i.e., the difference between expected and actual outcomes), which is thought to strengthen inhibitory (i.e., non-threat) associations and enhance long-term fear extinction. In practice, exposure therapy is traditionally preceded by cognitive restructuring to lessen the magnitude of harm expectancies. Yet this technique may restrict the discrepancy between expected and actual outcomes, thus reducing the potency of exposure and limiting the durability of treatment gains. The present study examined the effects of manipulating the timing of cognitive techniques during exposure-based therapy by randomly assigning 45 participants with </span>spider phobia to one of three conditions: (a) cognitive restructuring before exposure (CR-EXP; </span><em>n</em> <!-->=<!--> <!-->15), (b) exposure before cognitive restructuring (EXP-CR; <em>n</em> <!-->=<!--> <span>15), and (c) stress management control (SM; </span><em>n</em> <!-->=<!--> <!-->15). Although both CR-EXP and EXP-CR were more effective than SM, there were no significant differences between CR-EXP and EXP-CR on measures of fear, avoidance, spider-related cognitions, or change in harm expectancy. Clinical implications, study limitations, and future directions are discussed.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"32 1","pages":"Pages 13-24"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117309091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah Farraway , Viviana M. Wuthrich , Heidi Lyneham , Jennifer Hudson , Maria Kangas , Mary-Lou Chatterton , Catherine Mihalopoulos , Ronald M. Rapee
{"title":"Barriers to remission from child and adolescent anxiety disorders following extensive treatment: An exploratory study","authors":"Sarah Farraway , Viviana M. Wuthrich , Heidi Lyneham , Jennifer Hudson , Maria Kangas , Mary-Lou Chatterton , Catherine Mihalopoulos , Ronald M. Rapee","doi":"10.1016/j.jbct.2021.12.002","DOIUrl":"10.1016/j.jbct.2021.12.002","url":null,"abstract":"<div><p><span>Although treatments for child and adolescent (hereafter, children) anxiety show good efficacy, a significant proportion of children do not remit, even 12</span> <span><span>months after receiving treatment. Barriers to treatment responsiveness among chronically anxious children is not well studied. The current study evaluated barriers and predictors of poor treatment response among a small sample of children who reached the third step in a three-stage stepped-care intervention. Stepped-care involved low-intensity CBT, followed by standard CBT if required, and subsequently high intensity CBT if still warranted. Children moved to the next step of stepped-care if requested by their caregiver following feedback of clinical status and symptom change by their </span>therapist. From the initial sample of 139 children entering step 1, 26 (18.7%) children provided data in the third step and were assessed approximately 12</span> <!-->months following their baseline assessment. Several baseline constructs and treatment engagement measures were completed both quantitatively and qualitatively. At the end of Step 3, 14 of 26 (54%) participants had not remitted from their primary disorder and 19 (77%) were not remitted from all anxiety disorders. Non-remission was associated with baseline measures of higher primary disorder severity, fewer anxiety disorders, higher child self-reported social anxiety and total difficulties, and poorer mood. Therapy factors associated with non-remission included greater avoidance, less engagement with exposure tasks, and poorer homework completion. Identifying factors that predict poor response to treatment can help to tailor intervention and improve outcomes for this very complex group of young people.</p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"32 1","pages":"Pages 3-11"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121537082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lily A. Brown , Kevin Narine , Anu Asnaani , Keith Bredemeier , Wenting Mu
{"title":"Changes in affect, physical activity, physical health, and sleep in cognitive behavioral therapy for anxiety: A pilot study","authors":"Lily A. Brown , Kevin Narine , Anu Asnaani , Keith Bredemeier , Wenting Mu","doi":"10.1016/j.jbct.2021.12.006","DOIUrl":"10.1016/j.jbct.2021.12.006","url":null,"abstract":"<div><p><span>Anxiety disorders are associated with poorer physical activity and sleep. While associated with significant reductions in anxiety, it is not clear whether CBT for anxiety also improves physical health, sleep and physical activity. We evaluated changes in psychological and physical health outcomes using technology-based assessments in a naturalistic sample of adult patients receiving CBT for anxiety disorders (</span><em>N<!--> <!-->=<!--> </em><span><span>40). Participants were provided with a wearable device (Fitbit) and </span>ecological momentary assessments (EMA) throughout the duration of their CBT, or up to 20 weeks. We observed significant improvements in anxiety, depression, social isolation, and self-efficacy in emotion management. Self-reported sleep disorder symptoms, global physical health, or physical functioning and objectively measured sleep efficiency or physical activity (steps) did not significantly change. Steeper reductions in EMA-assessed anxiety were associated with steeper improvements in depression, social isolation, self-efficacy in emotion management, and physical function. These findings highlight the utility of EMA assessments during CBT in a naturalistic clinic. Whereas CBT for anxiety-related disorders is associated with significant improvements in affect, it may not be associated with improvements in sleep or physical activity. CBT for anxiety may require augmentation for patients who have goals of improving sleep, physical health, or physical activity.</span></p></div>","PeriodicalId":36022,"journal":{"name":"Journal of Behavioral and Cognitive Therapy","volume":"32 1","pages":"Pages 45-56"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123183937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}