Mediators of Change in Cognitive Behavior Therapy for Clinical Burnout.
n-Lagerlöf E Abstract Evidence supporting the effectiveness of cognitive behavior therapy (CBT) for stress-related illness is growing, but little is known about its mechanisms of change. The aim of this study was to investigate potential mediators of CBT for severe stress in form of clinical burnout, using an active psychological treatment as comparator. We used linear mixed models to analyze data from patients (N = 82) with clinical burnout who received either CBT or another psychological treatment in a randomized controlled trial. Potential mediators (i.e., sleep quality, behavioral activation, perceived co...
Source: Behavior Therapy - May 1, 2019 Category: Psychiatry & Psychology Authors: Santoft F, Salomonsson S, Hesser H, Lindsäter E, Ljótsson B, Lekander M, Kecklund G, Öst LG, Hedman-Lagerlöf E Tags: Behav Ther Source Type: research

Individuals Intolerant of Uncertainty: The Maintenance of Worry and Distress Despite Reduced Uncertainty.
Abstract The intolerance of uncertainty model of worry posits that individuals worry as a means to cope with the discomfort they feel when outcomes are uncertain, but few experimental studies have investigated the causal relationships between intolerance of uncertainty, situational uncertainty, and state worry. Furthermore, existing studies have failed to control for the likelihood of future negative events occurring, introducing an important rival hypothesis to explain past findings. In the present study, we examined how individuals with high and low trait intolerance of uncertainty differ in their behavioral, co...
Source: Behavior Therapy - May 1, 2019 Category: Psychiatry & Psychology Authors: Ranney RM, Behar E, Bartoszek G Tags: Behav Ther Source Type: research

Trajectories of Change in a Group Behavioral Activation Treatment for Severe, Recurrent Depression.
This study examined trajectories of change across 10-session group BA for individuals with severe, chronic, or recurrent forms of depression. We also tested whether individuals who had associated sudden gains or depression spikes had better outcomes than those who did not have these change patterns. We examined psychological and sociodemographic predictors of the patterns of change. Participants were 104 individuals who met diagnostic criteria for major depressive disorder and participated in one of 10 BA groups, provided over a 2-year period. A linear, but not quadratic or cubic, rate of change fit the data and the effect...
Source: Behavior Therapy - May 1, 2019 Category: Psychiatry & Psychology Authors: O'Mahen HA, Moberly NJ, Wright KA Tags: Behav Ther Source Type: research

Translating CBM-I Into Real-World Settings: Augmenting a CBT-Based Psychiatric Hospital Program.
n T Abstract Cognitive bias modification for interpretation (CBM-I) is an appealing augmentation to cognitive-behavioral therapy (CBT) because it targets cognitive bias efficiently via computerized training. Few studies have tested the combination of CBM-I and CBT, and none have translated lab-based CBM-I protocols to an acute psychiatric setting. The present study describes the development and implementation of CBM-I as an augmentation to a CBT-based partial hospital. We developed a transdiagnostic CBM-I based on the word-sentence association paradigm (WSAP), which reinforces individuals for endorsing benign inte...
Source: Behavior Therapy - May 1, 2019 Category: Psychiatry & Psychology Authors: Beard C, Rifkin LS, Silverman AL, Björgvinsson T Tags: Behav Ther Source Type: research

Impulsivity and Behavior-Dependent Life Events Mediate the Relationship of Reward Sensitivity and Depression, but Not Hypomania, Among at-Risk Adolescents.
Abstract Both reward sensitivity and impulsivity are related to the development and course of bipolar spectrum disorders (BSDs) and have been implicated in other disorders and negative functional outcomes such as substance abuse, obesity, suicidal behaviors, and risk-taking. Furthermore, according to the transactional component of the Behavioral Approach System (BAS)/reward hypersensitivity theory of BSDs, people with reward hypersensitivity should experience more BAS-relevant events, and thus, are more vulnerable to mood symptoms and episodes via stress generation. Impulsivity may exacerbate stress generation in ...
Source: Behavior Therapy - May 1, 2019 Category: Psychiatry & Psychology Authors: Bart CP, Abramson LY, Alloy LB Tags: Behav Ther Source Type: research

Infant Language Production and Parenting Skills: A Randomized Controlled Trial.
Abstract The current study examined the indirect effect of the use of behavioral parenting skills following the Infant Behavior Program, a brief, home-based adaptation of the child-directed interaction phase of parent-child interaction therapy, on infant language production. Participants were 60 infants (55% male, mean age 13.47 ± 1.31 months) and their caregivers, who were recruited at a large urban pediatric primary care clinic and were included if their scores exceeded the 75th percentile on a brief screener of early behavior problems. Families were randomly assigned to receive the infant behavior progra...
Source: Behavior Therapy - May 1, 2019 Category: Psychiatry & Psychology Authors: Garcia D, Rodriquez GM, Hill RM, Lorenzo NE, Bagner DM Tags: Behav Ther Source Type: research

Effects of Rumination and Worry on Sleep.
Abstract Recent research suggests that the stress-sleep relationship is mediated by pre-sleep arousal (PSA) and that cognitive arousal has a stronger mediating effect than somatic arousal; however, this has not been directly tested. Using multilevel moderated mediation, we compared the effects of cognitive arousal and somatic arousal within the stress-sleep relationship. We also assessed whether two forms of repetitive negative thought-rumination and worry-are similarly involved in the stress-sleep relationship. Data was collected from 178 participants across the United States via an online platform. Participants ...
Source: Behavior Therapy - May 1, 2019 Category: Psychiatry & Psychology Authors: Tousignant OH, Taylor ND, Suvak MK, Fireman GD Tags: Behav Ther Source Type: research

Repetitive Thinking in Social Anxiety Disorder: Are Anticipatory Processing and Post-Event Processing Facets of an Underlying Unidimensional Construct?
Abstract Existing literature suggests that anticipatory processing and post-event processing-two repetitive thinking processes linked to social anxiety disorder (SAD)-might be better conceptualized as facets of an underlying unidimensional repetitive thinking construct. The current study tested this by examining potential factor structures underlying anticipatory processing and post-event processing. Baseline data from two randomized controlled trials, consisting of 306 participants with SAD who completed anticipatory processing and post-event processing measures in relation to a speech task, were subjected to con...
Source: Behavior Therapy - May 1, 2019 Category: Psychiatry & Psychology Authors: Wong QJJ, McEvoy PM, Rapee RM Tags: Behav Ther Source Type: research

Examining the Effects of Exercise on Pattern Separation and the Moderating Effects of Mood Symptoms.
Abstract Aerobic exercise has broad cognitive benefits. One target of interest is enhanced memory. The present study explored pattern separation as a specific memory process that could be sensitive to acute and regular exercise and clinically significant for disorders (e.g., depression) characterized by cognitive-affective deficits and hippocampal impairment. In a within-subjects design, participants (N = 69) attended two visits during which they repeated a behavioral pattern separation task at rest and after an activity (cycling, stretching). Regular exercise habits, demographics, mood and anxiety symptoms, and r...
Source: Behavior Therapy - May 1, 2019 Category: Psychiatry & Psychology Authors: Bernstein EE, McNally RJ Tags: Behav Ther Source Type: research

Cognitive and Behavioral Differences Between Subtypes in Refractory Irritable Bowel Syndrome.
Abstract Irritable bowel syndrome (IBS) is a functional gastrointestinal syndrome consisting of different bowel pattern subtypes: diarrhea predominant (IBS-D), constipation predominant (IBS-C), and alternating (IBS-A). This paper aimed to identify whether (a) psychological factors implicated in the cognitive behavioral model of IBS were differentially associated with bowel pattern subtypes, (b) whether there were differences in symptom severity and work and social adjustment across the IBS-subtypes. Analysis was conducted on baseline data of 557 individuals with refractory IBS recruited into the Assessing Cognitiv...
Source: Behavior Therapy - May 1, 2019 Category: Psychiatry & Psychology Authors: Windgassen S, Moss-Morris R, Everitt H, Sibelli A, Goldsmith K, Chalder T Tags: Behav Ther Source Type: research

Sleep-Related Problems in Pediatric Obsessive-Compulsive Disorder and Intensive Exposure Therapy.
Abstract Limited research has examined sleep-related problems (SRPs) among children and adolescents with obsessive-compulsive disorder (OCD). The present study addresses this gap by investigating preliminary associations between SRPs, demographic factors (gender and age), family variables (family accommodation and parental stress), and clinical factors (medication status, internalizing and externalizing symptoms, OCD severity, OCD-related impairment), and treatment outcomes in a sample of 103 youth (aged 7 to 17 years; 53% female) with a primary diagnosis of OCD. Clinician, parent, and child measures were used to ...
Source: Behavior Therapy - May 1, 2019 Category: Psychiatry & Psychology Authors: Nabinger de Diaz NA, Farrell LJ, Waters AM, Donovan C, McConnell HW Tags: Behav Ther Source Type: research

Is Heightened Disgust Propensity Truly a Risk Factor for Contamination-Related Obsessive-Compulsive Disorder?
Abstract Disgust propensity (DP) has been conceptualized as a stable personality trait that confers risk for contamination-related OCD (C-OCD). However, the extent to which DP leads to the subsequent development of C-OCD is unclear. In fact, the presence of C-OCD might lead to an increase in DP rather than the inverse. The present study was aimed to test this hypothesis in a large clinical sample of OCD patients (≥ 21 years of age) with (C-OCD; n = 56) and without (NC-OCD; n = 103) contamination-related symptoms that completed measures of OCD symptoms, depression, anxiety, and DP. DP was assessed twice, in refe...
Source: Behavior Therapy - May 1, 2019 Category: Psychiatry & Psychology Authors: Melli G, Poli A, Chiorri C, Olatunji BO Tags: Behav Ther Source Type: research

The Effect of a Brief Mindfulness Training on Distress Tolerance and Stress Reactivity.
Abstract Poor distress tolerance (DT) is considered an underlying facet of anxiety, depression, and a number of other psychological disorders. Mindfulness may help to increase DT by fostering an attitude of acceptance or nonjudgment toward distressing experiences. Accordingly, the present study examined the effects of a brief mindfulness training on tolerance of different types of distress, and tested whether trait mindfulness moderates the effect of such training. Undergraduates (n = 107) naïve to mindfulness completed a measure of trait mindfulness and underwent a series of stress tasks (cold pressor, hyper...
Source: Behavior Therapy - May 1, 2019 Category: Psychiatry & Psychology Authors: Carpenter JK, Sanford J, Hofmann SG Tags: Behav Ther Source Type: research

Predictors of Symptom Outcome in Interpretation Bias Modification for Dysphoria.
Abstract Interpretation Bias Modification (IBM) interventions have been effective in reducing negative interpretation biases theorized to underlie depressive psychopathology. Although these programs have been highlighted as potential short-term interventions for depression, mixed evidence has been found for their effects on depressive symptoms. There is a need to examine attitudes towards training as well as individual difference factors that may impact symptom outcomes for IBM depression interventions. Seventy-two dysphoric young adults were randomly assigned to receive either an IBM targeting negative interpreta...
Source: Behavior Therapy - May 1, 2019 Category: Psychiatry & Psychology Authors: Smith HL, McDermott KA, Carlton CN, Cougle JR Tags: Behav Ther Source Type: research

Emotion Regulation Strategies in Cognitive Behavioral Therapy for Panic Disorder.
In this study, a preliminary model of ER in CBT for PD/A is proposed based on existing theories, and several propositions of the model are tested. We hypothesized that increases in cognitive reappraisal would precede decreases in biased cognitions, decreases in expressive suppression would follow decreases in biased cognitions, and a reduction in symptom severity would follow decreases in expressive suppression. Twenty-nine patients who received CBT for PD/A completed weekly self-report measures of symptom severity, anxiety sensitivity, reappraisal and expressive suppression. In addition, patients were compared to a matche...
Source: Behavior Therapy - May 1, 2019 Category: Psychiatry & Psychology Authors: Strauss AY, Kivity Y, Huppert JD Tags: Behav Ther Source Type: research

Sudden Gains: How Important Are They During Exposure and Response Prevention for Obsessive-Compulsive Disorder?
Abstract Symptom reduction over the course of cognitive-behavioral therapy is not always distributed evenly across sessions. Some individuals experience a sudden gain, defined as a large, rapid, and stable decrease in symptoms during treatment. Although research documents a link between sudden gains and treatment for depression and anxiety, findings in the context of obsessive-compulsive disorder (OCD) treatment are mixed. The present study investigated the relationship between sudden gains and treatment outcome in 44 adults with OCD and addressed limitations of previous studies by measuring OCD symptoms dimension...
Source: Behavior Therapy - May 1, 2019 Category: Psychiatry & Psychology Authors: Buchholz JL, Abramowitz JS, Blakey SM, Reuman L, Twohig MP Tags: Behav Ther Source Type: research

Corrigendum to "Causal role for inverse reasoning on obsessive-compulsive symptoms: Preliminary evidence from a cognitive bias modification for interpretation bias study" [J. Behav. Ther. Exp. Psychiatry 57 (2017) 143-155].
Corrigendum to "Causal role for inverse reasoning on obsessive-compulsive symptoms: Preliminary evidence from a cognitive bias modification for interpretation bias study" [J. Behav. Ther. Exp. Psychiatry 57 (2017) 143-155]. J Behav Ther Exp Psychiatry. 2019 Mar 29;: Authors: Wong SF, Grisham JR PMID: 30935591 [PubMed - as supplied by publisher] (Source: Behavior Therapy)
Source: Behavior Therapy - March 29, 2019 Category: Psychiatry & Psychology Authors: Wong SF, Grisham JR Tags: J Behav Ther Exp Psychiatry Source Type: research

Recent Developments in the Treatment of Depression.
Abstract The cognitive and behavioral interventions can be as efficacious as antidepressant medications and more enduring, but some patients will be more likely to respond to one than the other. Recent work has focused on developing sophisticated selection algorithms using machine-learning approaches that answer the question, "What works best for whom?" Moreover, the vast majority of people suffering from depression reside in low- and middle-income countries where access to either psychotherapy or medications is virtually nonexistent. Great strides have been made in training nonspecialist providers (know...
Source: Behavior Therapy - March 1, 2019 Category: Psychiatry & Psychology Authors: Hollon SD, Cohen ZD, Singla DR, Andrews PW Tags: Behav Ther Source Type: research

The "Brightening" Effect: Reactions to Positive Events in the Daily Lives of Individuals With Major Depressive Disorder and Generalized Anxiety Disorder.
The "Brightening" Effect: Reactions to Positive Events in the Daily Lives of Individuals With Major Depressive Disorder and Generalized Anxiety Disorder. Behav Ther. 2019 Mar;50(2):270-284 Authors: Khazanov GK, Ruscio AM, Swendsen J Abstract Depressed individuals are less reactive than healthy individuals to positive stimuli in the laboratory, but accumulating evidence suggests that they are more emotionally reactive to positive events in their daily lives. The present study probed the boundaries of this curious "mood brightening" effect and investigated its specificity to major de...
Source: Behavior Therapy - March 1, 2019 Category: Psychiatry & Psychology Authors: Khazanov GK, Ruscio AM, Swendsen J Tags: Behav Ther Source Type: research

A Propensity Score Analysis of Homework Adherence-Outcome Relations in Cognitive Behavioral Therapy for Depression.
Abstract Little is known about whether or not a consistently high level of homework adherence over the course of therapy benefits patients. This question was examined in two samples of patients who were receiving individual Cognitive Behavioral Therapy (CBT) for depression (Ns = 128 [Sequenced Treatment Alternatives to Relieve Depression: STAR-D] and 183 [Continuation Phase Cognitive Therapy Relapse Prevention: C-CT-RP]). Logistic and linear regression and propensity score models were used to identify whether or not clinician assessments of homework adherence differentiated symptom reduction and remission, as asse...
Source: Behavior Therapy - March 1, 2019 Category: Psychiatry & Psychology Authors: Callan JA, Kazantzis N, Park SY, Moore CG, Thase ME, Minhajuddin A, Kornblith S, Siegle GJ Tags: Behav Ther Source Type: research

Does Motivation Impact OCD Symptom Severity? An Exploration of Longitudinal Effects.
This study is novel in its use of RI-CLPM in an OCD sample and represents an important addition to the literature on the longitudinal impacts of dynamic constructs of motivation. Our findings may provide future researchers with strategies to supplement ERP with CA-driven motivational interviewing. PMID: 30824247 [PubMed - in process] (Source: Behavior Therapy)
Source: Behavior Therapy - March 1, 2019 Category: Psychiatry & Psychology Authors: Ponzini G, Van Kirk N, Schreck M, Nota JA, Schofield CA, Gironda C, Elias J Tags: Behav Ther Source Type: research

Defining Treatment Outcomes in Pediatric Obsessive-Compulsive Disorder Using a Self-Report Scale.
This study examined benchmarks of treatment response and clinical remission on the Obsessive Compulsive Inventory-Child Version (OCI-CV) for youth with obsessive-compulsive disorder (OCD). Participants were 91 youth who enrolled in a randomized controlled trial that examined the benefit of augmenting cognitive behavior therapy (CBT) with either d-cycloserine or placebo. Youth completed the OCI-CV at baseline, Week 4 (prior to initiating exposure therapy), and posttreatment. Receiver operator curve (ROC) analyses examined optimal benchmarks for treatment response and clinical remission as identified by independent evaluator...
Source: Behavior Therapy - March 1, 2019 Category: Psychiatry & Psychology Authors: McGuire JF, Geller DA, Murphy TK, Small BJ, Unger A, Wilhelm S, Storch EA Tags: Behav Ther Source Type: research

The Relative Effects of Abstract Versus Concrete Processing on Proactivity in Depression.
Abstract Low levels of proactivity are characteristic of individuals with depression. Two studies were conducted to compare the relative effects of abstract versus concrete processing on proactivity in high dysphoric individuals. In Study 1, participants read information about an upcoming research study and were then randomly allocated to a writing task that induced them to think about participating in that study in either an abstract (e.g., Why you would participate in the study?; n = 25) or concrete (e.g., How you will participate in the study?; n = 25) way. Participants were then asked to indicate whether they ...
Source: Behavior Therapy - March 1, 2019 Category: Psychiatry & Psychology Authors: Dey S, Newell BR, Moulds ML Tags: Behav Ther Source Type: research

Improved Perceptions of Emotion Regulation and Reflective Functioning in Parents: Two Additional Positive Outcomes of Parent-Child Interaction Therapy.
Abstract The purpose of this study was to test whether Parent-Child Interaction Therapy (PCIT), a widely used effective therapy for children's externalizing behaviors and parenting problems, was associated with improvements in parents' emotion regulation and reflective functioning. We also investigated whether these improvements had unique associations with children's improvements in externalizing and internalizing symptoms. Participants were 139 Australian children aged 29 to 83 months and their caregivers; all were referred for child externalizing behavior problems coupled with parenting skill deficits or high p...
Source: Behavior Therapy - March 1, 2019 Category: Psychiatry & Psychology Authors: Zimmer-Gembeck MJ, Kerin JL, Webb HJ, Gardner AA, Campbell SM, Swan K, Timmer SG Tags: Behav Ther Source Type: research

The Struggle of Behavioral Therapists With Exposure: Self-Reported Practicability, Negative Beliefs, and Therapist Distress About Exposure-Based Interventions.
Abstract Exposure-based interventions are a core ingredient of evidence-based cognitive-behavioral treatment (CBT) for anxiety disorders, posttraumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). However, previous research has documented that exposure is rarely utilized in routine care, highlighting an ongoing lack of dissemination. The present study examined barriers for the dissemination of exposure from the perspective of behavioral psychotherapists working in outpatient routine care (N = 684). A postal survey assessed three categories of barriers: (a) practicability of exposure-based inter...
Source: Behavior Therapy - March 1, 2019 Category: Psychiatry & Psychology Authors: Pittig A, Kotter R, Hoyer J Tags: Behav Ther Source Type: research

Pilot Evaluation of a Tablet-Based Application to Improve Quality of Care in Child Mental Health Treatment.
Abstract Mental health systems need scalable solutions that can reduce the efficacy-effectiveness gap and improve mental health outcomes in community mental health service settings. Two major challenges to delivery of high-quality care are providers' fidelity to evidence-based treatment models and children's and caregivers' engagement in the treatment process. We developed a novel, tablet-based application designed to enhance via technology the quality of delivery of trauma-focused cognitive-behavioral therapy (TF-CBT). We piloted its use in four community mental health service organizations using a blocked random...
Source: Behavior Therapy - March 1, 2019 Category: Psychiatry & Psychology Authors: Davidson TM, Bunnell BE, Saunders BE, Hanson RF, Danielson CK, Cook D, Chu BC, Dorsey S, Adams ZW, Andrews AR, Walker JH, Soltis KE, Cohen JA, Deblinger E, Ruggiero KJ Tags: Behav Ther Source Type: research

Different Disgust Domains Specifically Relate to Mental and Contact Contamination Fear in Obsessive-Compulsive Disorder: Evidence From a Path Analytic Model in an Italian Clinical Sample.
Abstract Both contact contamination (CC) and mental contamination (MC) fears-which combined represent the most common manifestation of obsessive-compulsive disorder (OCD)-have been widely associated with disgust propensity. However, extant research explored this relationship using measures assessing only pathogen-related disgust, not taking into account the potential role played by sexual and moral disgust, despite literature about MC suggesting that this might be particularly relevant. In Study 1, the psychometric properties of the Italian version of the Three Domains of Disgust Scale (TDDS) were assessed in a la...
Source: Behavior Therapy - March 1, 2019 Category: Psychiatry & Psychology Authors: Poli A, Melli G, Radomsky AS Tags: Behav Ther Source Type: research

Patient-Informed Treatment Development of Behavioral Smoking Cessation for People With Schizophrenia.
The objective of this study was to use qualitative methodology to tailor and refine an existing smoking cessation intervention for the population of people who use cigarettes and are diagnosed with schizophrenia, schizoaffective, or psychotic disorder. Successive cohort design methodology was used to iteratively modify the treatment in response to qualitative participant, therapist, and consultant feedback on the intervention. Qualitative methodology for participant feedback included analysis of semistructured interviews with participants, visualization of app utilization data, and stakeholder feedback from study therapist...
Source: Behavior Therapy - March 1, 2019 Category: Psychiatry & Psychology Authors: Wilson SM, Thompson AC, Currence ED, Thomas SP, Dedert EA, Kirby AC, Elbogen EB, Moore SD, Calhoun PS, Beckham JC Tags: Behav Ther Source Type: research

Self-Criticism Impacts Emotional Responses to Pain.
Abstract Nonsuicidal self-injury (NSSI) is associated with numerous negative outcomes (e.g., suicide attempts), making it a focus of great clinical concern. Yet, mechanisms reinforcing NSSI remain unclear. The benefits and barriers model proposes that NSSI engagement is determined by both benefits of and barriers to NSSI. Benefits include mood improvement, a function reported by most who engage in NSSI; barriers include a desire to avoid pain and bodily harm. Self-criticism is generally understood as a trait lowering desire to avoid pain and bodily harm, thus decreasing that specific barrier. However, recent resea...
Source: Behavior Therapy - March 1, 2019 Category: Psychiatry & Psychology Authors: Fox KR, O'Sullivan IM, Wang SB, Hooley JM Tags: Behav Ther Source Type: research

Testing an App-Assisted Treatment for Suicide Prevention in a Randomized Controlled Trial: Effects on Suicide Risk and Depression.
The objective of the present study was to evaluate the effect of an app-assisted suicide prevention treatment on suicide risk and depression. One hundred twenty-nine participants were randomized to treatment as usual (TAU), consisting of psychotherapy adhering to the framework of Collaborative Assessment and Management of Suicidality (CAMS), with (TAU+APP, N = 60) or without (TAU, N = 69) access to a mobile application (i.e., LifeApp'tite). Suicide risk and symptoms of depression were assessed pre- and posttherapy, and at 4-month follow-up. The TAU+APP group showed a smaller decrease on self-reported suicide risk at the en...
Source: Behavior Therapy - March 1, 2019 Category: Psychiatry & Psychology Authors: O'Toole MS, Arendt MB, Pedersen CM Tags: Behav Ther Source Type: research

An Internet-Based Compassion-Focused Intervention for Increased Self-Criticism: A Randomized Controlled Trial.
Abstract Increased levels of self-criticism and a lack of self-compassion have been associated with the development and maintenance of a range of psychological disorders. In the current study, we tested the efficacy of an online version of a compassion-focused intervention, mindfulness-based compassionate living (MBCL), with guidance on request. A total of 122 self-referred participants with increased levels of self-criticism were randomly assigned to care as usual (CAU) or the intervention group (CAU + online intervention). Primary endpoints were self-reported depressive, anxiety and distress symptoms (DASS-21) a...
Source: Behavior Therapy - March 1, 2019 Category: Psychiatry & Psychology Authors: Krieger T, Reber F, von Glutz B, Urech A, Moser CT, Schulz A, Berger T Tags: Behav Ther Source Type: research

Dissemination and Implementation of Cognitive Behavioral Therapy for Depression in the Kaiser Permanente Health Care System: Evaluation of Initial Training and Clinical Outcomes.
Abstract Notwithstanding its empirical status and strong recommendation in clinical practice guidelines, cognitive behavioral therapy (CBT) continues to be delivered infrequently and with low fidelity on the clinical front lines. Recently, organized efforts and policies within the public sector to disseminate and implement CBT and other evidence-based psychotherapies have yielded encouraging results and provided optimism for bridging the research-to-practice-gap. Following from these efforts, the current article examines the initial impact and experience of the implementation of an individualized approach to CBT t...
Source: Behavior Therapy - March 1, 2019 Category: Psychiatry & Psychology Authors: Karlin BE, Brown GK, Jager-Hyman S, Green KL, Wong M, Lee DS, Bertagnolli A, Ross TB Tags: Behav Ther Source Type: research

A Direct Observational Measure of Family Functioning for a Low-Resource Setting: Adaptation and Feasibility in a Kenyan Sample.
This study aimed to adapt a direct observational tool for assessing family interaction patterns in Kenya, to outline a replicable adaptation process, and to explore tool feasibility and acceptability. We reviewed existing tools to assess their adaptability based on compatibility with context-specific data. After initial modifications, the measure was iteratively adapted through pilot testing and collaborative discussions between U.S. and Kenyan collaborators that drove changes and further piloting. The measure was administered to 26 families. The Family Problem Solving Code was chosen for adaptation. The tool's activity st...
Source: Behavior Therapy - March 1, 2019 Category: Psychiatry & Psychology Authors: Giusto A, Kaiser BN, Ayuku D, Puffer ES Tags: Behav Ther Source Type: research

Effects of Intensive Behavioral Treatment for Children With Varying Levels of Conduct Problems and Callous-Unemotional Traits.
Abstract The purpose of this study was to examine whether callous-unemotional (CU) traits moderated the effects of intensive behavior therapy in elementary school-age children with varying levels of conduct problems (CP). Both treatment response (magnitude of change between pre- and posttreatment) and treatment outcomes (likelihood of normalization from treatment) were examined. Participants were 67 children (n = 49 boys, Mage = 9.6 years) with varying levels of CP and CU who participated in an intensive 8-week summer treatment program (STP) in which behavior therapy was delivered to children in recreational and c...
Source: Behavior Therapy - January 1, 2019 Category: Psychiatry & Psychology Authors: Bansal PS, Waschbusch DA, Haas SM, Babinski DE, King S, Andrade BF, Willoughby MT Tags: Behav Ther Source Type: research

"Teaching Moments" in Psychotherapy: Addressing Emergent Life Events Using Strategies From a Modular Evidence-Based Treatment.
"Teaching Moments" in Psychotherapy: Addressing Emergent Life Events Using Strategies From a Modular Evidence-Based Treatment. Behav Ther. 2019 Jan;50(1):101-114 Authors: Guan K, Boustani MM, Chorpita BF Abstract Emergent life events (ELEs) are unexpected, acute client stressors reported in psychotherapy sessions that are associated with reduced evidence-based treatment (EBT) integrity and client progress. As a potential solution, this study examined the extent to which ELEs could be appropriately addressed using existing EBT strategies. Participants were 34 low-income youth (ages 5-15, 50% ...
Source: Behavior Therapy - January 1, 2019 Category: Psychiatry & Psychology Authors: Guan K, Boustani MM, Chorpita BF Tags: Behav Ther Source Type: research

Early Change Trajectories in Cognitive-Behavioral Therapy for Binge-Eating Disorder.
This study sought to identify latent trajectories of early change in CBT and compare them to common rapid response classifications. In a multicenter randomized trial, 86 adults with BED (DSM-IV) or subsyndromal BED provided weekly self-reports of binge eating over the first 4 weeks of CBT, which were analyzed to predict binge eating, depression, and body mass index at posttreatment, 6-, and 18-month follow-up. Using latent growth mixture modeling, three patterns of early change-including moderate and low decreasing-as well as low stable binge eating were identified, which significantly predicted binge-eating remission at 6...
Source: Behavior Therapy - January 1, 2019 Category: Psychiatry & Psychology Authors: Hilbert A, Herpertz S, Zipfel S, Tuschen-Caffier B, Friederich HC, Mayr A, Crosby RD, de Zwaan M Tags: Behav Ther Source Type: research

Attention Bias Modification Treatment for Adolescents With Social Anxiety Disorder.
Abstract Social anxiety disorder (SAD) tends to emerge during the early teenage years and is particularly refractory to change even when standard evidence-based CBT treatments are delivered. Efforts have been made to develop novel, mechanistic-driven interventions for this disorder. In the present study, we examined Attention Bias Modification Treatment (ABMT) for youth with SAD. Participants were 58 adolescents (mean age = 14.29 years) who met diagnostic criteria for SAD and who were randomized to ABMT or a placebo control condition, Attention Control Training (ACT). We predicted that ABMT would result in greater...
Source: Behavior Therapy - January 1, 2019 Category: Psychiatry & Psychology Authors: Ollendick TH, White SW, Richey J, Kim-Spoon J, Ryan SM, Wieckowski AT, Coffman MC, Elias R, Strege MV, Capriola-Hall NN, Smith M Tags: Behav Ther Source Type: research

Predictors and Trajectories of Response to the Homework, Organization, and Planning Skills (HOPS) Intervention for Adolescents With ADHD.
Abstract The goal of the present study was to evaluate the relative importance of adolescent and parent skills acquired during participation in the Homework, Organization, and Planning Skills (HOPS) intervention in predicting intervention response. A sample of 111 middle school students with attention-deficit/hyperactivity disorder (66% male; Mage = 11.99, SD = 1.05) received the HOPS intervention, which includes 16 brief sessions with the adolescent and two parent meetings. Each session, school mental health providers completed checklists measuring students' acquisition of homework recording, materials organizati...
Source: Behavior Therapy - January 1, 2019 Category: Psychiatry & Psychology Authors: Breaux RP, Langberg JM, Molitor SJ, Dvorsky MR, Bourchtein E, Smith ZR, Green CD Tags: Behav Ther Source Type: research

Mental Contamination in Obsessive-Compulsive Disorder: Associations With Contamination Symptoms and Treatment Response.
This study examined the relationships between CC and MC in a sample of individuals with elevated contamination symptoms (N = 88), half of whom met diagnostic criteria for OCD. Participants engaged in three sessions of exposure and response prevention (ERP) for CC and completed self-report measures and behavioral tasks assessing CC and MC at pretreatment, posttreatment, and follow-up. As hypothesized, at pretreatment, MC was positively associated with reactivity to physical contaminants, even after participants washed their hands. ERP for CC was associated with unique changes in CC and MC across self-report and behavioral m...
Source: Behavior Therapy - January 1, 2019 Category: Psychiatry & Psychology Authors: Mathes BM, McDermott KA, Okey SA, Vazquez A, Harvey AM, Cougle JR Tags: Behav Ther Source Type: research

Using Explicit Case Formulation to Improve Cognitive Processing Therapy for PTSD.
Abstract We investigated the utility of explicit case formulation (CF) within Cognitive Processing Therapy (CPT) for individuals with posttraumatic stress disorder (PTSD). An uncontrolled pre-posttreatment design was used. Participants attended 12-16 weekly sessions of CPT with explicit CF, where CF guided treatment length and treatment components. Treatment was completed by 19 of the 23 participants who started therapy. Results revealed significant reductions in PTSD and depression severity as well as unhelpful PTSD-related beliefs from pre- to posttreatment (ds between 1.10 - 1.92) and treatment gains were maint...
Source: Behavior Therapy - January 1, 2019 Category: Psychiatry & Psychology Authors: Nixon RDV, Bralo D Tags: Behav Ther Source Type: research

Predictors and Moderators of Cognitive and Behavioral Therapy Outcomes for OCD: A Patient-Level Mega-Analysis of Eight Sites.
Abstract Cognitive (CT) and behavioral treatments (BT) for OCD are efficacious separately and in combination. Tailoring treatment to patient-level predictors and moderators of outcome has the potential to improve outcomes. The present study combined data from eight treatment clinics to examine the benefits of BT (n = 125), CT (n = 108), and CBT (n = 126), and study predictors across all treatments and moderators of outcome by treatment type. All three methods led to large benefits for OCD and depression symptoms. Residual gain scores for OCD symptoms were marginally smaller for BT compared to treatments containing...
Source: Behavior Therapy - January 1, 2019 Category: Psychiatry & Psychology Authors: Steketee G, Siev J, Yovel I, Lit K, Wilhelm S Tags: Behav Ther Source Type: research

Internet-Delivered Exposure-Based Cognitive-Behavioral Therapy for Adolescents With Functional Abdominal Pain or Functional Dyspepsia: A Feasibility Study.
, Ljótsson B Abstract Functional abdominal pain (FAP) and functional dyspepsia (FD) are common in adolescents and associated with low quality of life. Exposure-based cognitive-behavioral therapy (CBT) is efficient for adult and adolescent irritable bowel syndrome (IBS), but has never been evaluated for adolescent FAP/FD. The aim of this study was to evaluate the feasibility and potential efficacy of a novel disorder-specific Internet-delivered CBT (Internet-CBT) for adolescents with FAP or FD, using an uncontrolled open pilot including 31 adolescents. The Internet-CBT consisted of 10 weekly online modules, ...
Source: Behavior Therapy - January 1, 2019 Category: Psychiatry & Psychology Authors: Bonnert M, Olén O, Lalouni M, Hedman-Lagerlöf E, Särnholm J, Serlachius E, Ljótsson B Tags: Behav Ther Source Type: research

The Relationship Between Dropout and Outcome in Naturalistic Cognitive Behavior Therapy.
This study analyzed data from a large sample of adults (N = 1,092) receiving naturalistic cognitive behavioral therapy (CBT) to test the hypotheses that dropouts, as compared to completers, had (1) higher symptom severity at treatment termination, (2) a slower rate of symptom change during treatment, and (3) a higher odds that the therapist rated treatment as ending for reasons related to poor outcome. Results showed that although dropouts ended treatment with higher symptom severity than completers, dropouts and completers did not differ in their rate of symptom change during treatment, suggesting that dropouts had higher...
Source: Behavior Therapy - January 1, 2019 Category: Psychiatry & Psychology Authors: Zieve GG, Persons JB, Yu LAD Tags: Behav Ther Source Type: research

Long-Term Outcome of a Cluster-Randomized Universal Prevention Trial Targeting Anxiety and Depression in School Children.
Abstract The present study concerns a 3-year follow-up of a universal prevention trial targeting anxiety and depressive symptoms in school children. In addition to evaluating the long-term effect of the prevention program, we also examined attrition and its effect on the outcome. High rates of attrition have commonly been observed in studies in the field. However, the role of attrition is not sufficiently understood regarding internal and external validity biases. The current study comprised 695 children (aged 8-11 at baseline) from 17 schools in Sweden. Schools were cluster-randomized to either the intervention o...
Source: Behavior Therapy - January 1, 2019 Category: Psychiatry & Psychology Authors: Ahlen J, Lenhard F, Ghaderi A Tags: Behav Ther Source Type: research

Does Exposure and Response Prevention Behaviorally Activate Patients With Obsessive-Compulsive Disorder? A Preliminary Test.
Abstract Exposure and response prevention (ERP) and behavioral activation (BA) are effective treatments for obsessive-compulsive disorder (OCD) and depression, respectively. Patients with OCD often exhibit depression; furthermore, ERP for OCD is associated with reduced depressive symptoms. To our knowledge, no study has examined whether ERP itself functions to behaviorally activate patients with concurrent OCD and depressive symptoms. This prospective study was designed to test the hypotheses that (a) OCD exposure hierarchy completion, increased BA, and depressive symptom reduction would all be related, and (b) pr...
Source: Behavior Therapy - January 1, 2019 Category: Psychiatry & Psychology Authors: Blakey SM, Abramowitz JS, Leonard RC, Riemann BC Tags: Behav Ther Source Type: research

Durability of Cognitive Behavioral Therapy Effects for Youth and Adolescents With Anxiety, Depression, or Traumatic Stress:A Meta-Analysis on Long-Term Follow-Ups.
Abstract Cognitive behavioral therapies (CBT) for youth with anxiety, traumatic stress, and depression have demonstrated strong effects in individual studies and meta-analyses. Relatively more attention has been given to posttreatment effects, though, and assessment of follow-up effects has been limited at the meta-analytic level. The current meta-analysis aimed to (a) examine the effects of youth CBT at posttreatment, 1-month, 3-month, 6-month, 1-year, and long-term (2+ years) follow-up as well as (b) identify research-related variables (e.g., measure respondent type) that relate to effects. Using a random effect...
Source: Behavior Therapy - January 1, 2019 Category: Psychiatry & Psychology Authors: Rith-Najarian LR, Mesri B, Park AL, Sun M, Chavira DA, Chorpita BF Tags: Behav Ther Source Type: research

Social Anxiety Disorder and Perceived Criticism in Intimate Relationships: Comparisons With Normal and Clinical Control Groups.
Abstract Individuals with social anxiety disorder (SAD) have difficulties in their romantic relationships, including decreased satisfaction and intimacy, but the reasons for these difficulties are poorly understood. Because fear of negative evaluation is a cardinal feature of SAD, perceived criticism from a romantic partner may play a central role in socially anxious individuals' relationships. In the present study, we compared levels of perceived, expressed, and observed criticism and reactions to criticism among individuals with SAD and their partners (n = 21), individuals with other anxiety disorders and their ...
Source: Behavior Therapy - January 1, 2019 Category: Psychiatry & Psychology Authors: Porter E, Chambless DL, Keefe JR, Allred KM, Brier MJ Tags: Behav Ther Source Type: research

Alcohol-Induced Amnesia and Personalized Drinking Feedback: Blackouts Predict Intervention Response.
Abstract Alcohol-induced amnesia ("blackout") is a reliable predictor of alcohol-related harm. Given its association with other negative consequences, experience of alcohol-induced amnesia may serve as a teachable moment, after which individuals are more likely to respond to intervention. To test this hypothesis, alcohol-induced amnesia was evaluated as a moderator of brief intervention effect on (a) alcohol-related consequences and (b) the proposed intervention mediators, protective behavioral strategies and peak blood alcohol concentration (BAC). Baseline alcohol risk measured using the Alcohol Use Dis...
Source: Behavior Therapy - January 1, 2019 Category: Psychiatry & Psychology Authors: Miller MB, DiBello AM, Meier E, Leavens ELS, Merrill JE, Carey KB, Leffingwell TR Tags: Behav Ther Source Type: research

Using a Learning Collaborative Model to Disseminate Cognitive Processing Therapy to Community-Based Agencies.
Abstract Although effective treatments for posttraumatic stress disorder exist, their use in community settings is disappointingly low. Training alone does not necessarily lead to adoption. To address this problem, we trained community clinicians in cognitive processing therapy, an evidence-based treatment for posttraumatic stress disorder, using a Learning Collaborative, an intensive training methodology focused on both clinical training and developing sustainability. Sixty clinicians within 18 agencies began the year-long, team-based Learning Collaborative. Clinicians attended three in-person Learning Sessions, ...
Source: Behavior Therapy - January 1, 2019 Category: Psychiatry & Psychology Authors: LoSavio ST, Dillon KH, Murphy RA, Goetz K, Houston F, Resick PA Tags: Behav Ther Source Type: research

The Links Between Social Anxiety Disorder, Insomnia Symptoms, and Alcohol Use Disorders: Findings From a Large Sample of Adolescents in the United States.
Abstract Social anxiety disorder (SAD) is associated with increased risk of developing an alcohol use disorder (AUD). Most of the current literature has focused on the role of acute stress responding in this relation; however, both SAD and AUDs also are linked to insomnia symptoms (i.e., difficulty falling or staying asleep). As adolescence is a sensitive period for the onset of these disorders, the present study examined if insomnia symptoms might partially account for the SAD-AUD link in a large sample of adolescents. Data from the National Comorbidity Survey-Adolescent Supplement were examined. Participants (N ...
Source: Behavior Therapy - January 1, 2019 Category: Psychiatry & Psychology Authors: Blumenthal H, Taylor DJ, Cloutier RM, Baxley C, Lasslett H Tags: Behav Ther Source Type: research