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  Subjects -> PSYCHOLOGY (Total: 934 journals)
Showing 1 - 174 of 174 Journals sorted alphabetically
Acción Psicológica     Open Access   (Followers: 3)
Acta Colombiana de Psicología     Open Access   (Followers: 5)
Acta Comportamentalia     Open Access   (Followers: 3)
Acta de Investigación Psicológica     Open Access   (Followers: 3)
Acta Psychologica     Hybrid Journal   (Followers: 25)
Activités     Open Access   (Followers: 1)
Actualidades en Psicologia     Open Access   (Followers: 2)
Ad verba Liberorum : Journal of Linguistics & Pedagogy & Psychology     Open Access   (Followers: 9)
Addictive Behaviors Reports     Open Access   (Followers: 7)
ADHD Attention Deficit and Hyperactivity Disorders     Hybrid Journal   (Followers: 22)
ADHD Report The     Full-text available via subscription   (Followers: 9)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 43)
Advances in Mental Health     Hybrid Journal   (Followers: 73)
Advances in Methods and Practices in Psychological Science     Full-text available via subscription   (Followers: 3)
Advances in Physiotherapy     Hybrid Journal   (Followers: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 59)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 29)
African Journal of Cross-Cultural Psychology and Sport Facilitation     Full-text available via subscription   (Followers: 5)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 431)
Aggressive Behavior     Hybrid Journal   (Followers: 17)
Aging, Neuropsychology, and Cognition     Hybrid Journal   (Followers: 39)
Ágora - studies in psychoanalytic theory     Open Access   (Followers: 3)
Aletheia     Open Access   (Followers: 1)
American Behavioral Scientist     Hybrid Journal   (Followers: 18)
American Imago     Full-text available via subscription   (Followers: 3)
American Journal of Applied Psychology     Open Access   (Followers: 43)
American Journal of Community Psychology     Hybrid Journal   (Followers: 27)
American Journal of Health Behavior     Full-text available via subscription   (Followers: 23)
American Journal of Orthopsychiatry     Hybrid Journal   (Followers: 5)
American Journal of Psychoanalysis     Hybrid Journal   (Followers: 20)
American Journal of Psychology     Full-text available via subscription   (Followers: 32)
American Psychologist     Full-text available via subscription   (Followers: 193)
Anales de Psicología     Open Access   (Followers: 2)
Análise Psicológica     Open Access   (Followers: 1)
Análisis y Modificación de Conducta     Open Access   (Followers: 2)
Analitika : Jurnal Magister Psikologi Uma     Open Access  
Analysis     Full-text available via subscription   (Followers: 3)
Annual Review of Clinical Psychology     Full-text available via subscription   (Followers: 72)
Annual Review of Organizational Psychology and Organizational Behavior     Full-text available via subscription   (Followers: 33)
Annual Review of Psychology     Full-text available via subscription   (Followers: 239)
Anuario de investigaciones (Facultad de Psicología. Universidad de Buenos Aires)     Open Access   (Followers: 1)
Anuario de Psicología / The UB Journal of Psychology     Open Access   (Followers: 1)
Anuario de Psicología Jurídica     Open Access   (Followers: 1)
Anxiety, Stress & Coping: An International Journal     Hybrid Journal   (Followers: 21)
Applied and Preventive Psychology     Hybrid Journal   (Followers: 16)
Applied Cognitive Psychology     Hybrid Journal   (Followers: 74)
Applied Neuropsychology : Adult     Hybrid Journal   (Followers: 40)
Applied Neuropsychology : Child     Hybrid Journal   (Followers: 21)
Applied Psycholinguistics     Hybrid Journal   (Followers: 19)
Applied Psychological Measurement     Hybrid Journal   (Followers: 20)
Applied Psychology     Hybrid Journal   (Followers: 162)
Applied Psychology: Health and Well-Being     Hybrid Journal   (Followers: 50)
Applied Psychophysiology and Biofeedback     Hybrid Journal   (Followers: 8)
Archive for the Psychology of Religion / Archiv für Religionspychologie     Hybrid Journal   (Followers: 23)
Archives of Clinical Neuropsychology     Hybrid Journal   (Followers: 30)
Archives of Scientific Psychology     Open Access   (Followers: 4)
Arquivos Brasileiros de Psicologia     Open Access   (Followers: 1)
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 9)
Asia-Pacific Psychiatry     Hybrid Journal   (Followers: 3)
Asian American Journal of Psychology     Full-text available via subscription   (Followers: 5)
Asian Journal of Behavioural Studies     Open Access  
Asian Journal of Business Ethics     Hybrid Journal   (Followers: 9)
Assessment     Hybrid Journal   (Followers: 12)
Attachment: New Directions in Psychotherapy and Relational Psychoanalysis     Full-text available via subscription   (Followers: 14)
Attention, Perception & Psychophysics     Full-text available via subscription   (Followers: 12)
Australasian Journal of Organisational Psychology     Hybrid Journal   (Followers: 8)
Australian and Aotearoa New Zealand Psychodrama Association Journal     Full-text available via subscription  
Australian Educational and Developmental Psychologist, The     Full-text available via subscription   (Followers: 8)
Australian Journal of Psychology     Hybrid Journal   (Followers: 19)
Australian Journal of Rehabilitation Counseling     Full-text available via subscription   (Followers: 4)
Australian Psychologist     Hybrid Journal   (Followers: 11)
Autism Research     Hybrid Journal   (Followers: 37)
Autism Research and Treatment     Open Access   (Followers: 25)
Autism's Own     Open Access   (Followers: 2)
Autism-Open Access     Open Access   (Followers: 6)
Avaliação Psicológica     Open Access  
Avances en Psicologia Latinoamericana     Open Access   (Followers: 1)
Aviation Psychology and Applied Human Factors     Hybrid Journal   (Followers: 20)
Balint Journal     Hybrid Journal   (Followers: 2)
Barbaroi     Open Access  
Basic and Applied Social Psychology     Hybrid Journal   (Followers: 41)
Behavior Analysis in Practice     Full-text available via subscription   (Followers: 9)
Behavior Analysis: Research and Practice     Full-text available via subscription   (Followers: 3)
Behavior Analyst     Hybrid Journal   (Followers: 3)
Behavior Modification     Hybrid Journal   (Followers: 10)
Behavior Research Methods     Hybrid Journal   (Followers: 19)
Behavior Therapy     Hybrid Journal   (Followers: 50)
Behavioral Development Bulletin     Full-text available via subscription  
Behavioral Interventions     Hybrid Journal   (Followers: 11)
Behavioral Neuroscience     Full-text available via subscription   (Followers: 54)
Behavioral Sciences & the Law     Hybrid Journal   (Followers: 24)
Behavioral Sleep Medicine     Hybrid Journal   (Followers: 7)
Behaviormetrika     Hybrid Journal  
Behaviour     Hybrid Journal   (Followers: 12)
Behaviour Change     Full-text available via subscription   (Followers: 13)
Behaviour Research and Therapy     Hybrid Journal   (Followers: 19)
Behavioural and Cognitive Psychotherapy     Hybrid Journal   (Followers: 138)
Behavioural Processes     Hybrid Journal   (Followers: 8)
Biofeedback     Hybrid Journal   (Followers: 4)
BioPsychoSocial Medicine     Open Access   (Followers: 7)
BMC Psychology     Open Access   (Followers: 17)
Body, Movement and Dance in Psychotherapy: An International Journal for Theory, Research and Practice     Hybrid Journal   (Followers: 10)
Boletim Academia Paulista de Psicologia     Open Access  
Boletim de Psicologia     Open Access  
Brain Informatics     Open Access  
British Journal of Clinical Psychology     Full-text available via subscription   (Followers: 149)
British Journal of Developmental Psychology     Full-text available via subscription   (Followers: 37)
British Journal of Educational Psychology     Hybrid Journal   (Followers: 35)
British Journal of Health Psychology     Full-text available via subscription   (Followers: 46)
British Journal of Mathematical and Statistical Psychology     Full-text available via subscription   (Followers: 21)
British Journal of Psychology     Full-text available via subscription   (Followers: 61)
British Journal of Psychotherapy     Hybrid Journal   (Followers: 69)
British Journal of Social Psychology     Full-text available via subscription   (Followers: 34)
Buletin Psikologi     Open Access  
Burnout Research     Open Access   (Followers: 8)
Cadernos de psicanálise (Rio de Janeiro)     Open Access  
Cadernos de Psicologia Social do Trabalho     Open Access  
Canadian Art Therapy Association     Hybrid Journal  
Canadian Journal of Behavioural Science     Full-text available via subscription   (Followers: 5)
Canadian Journal of Experimental Psychology     Full-text available via subscription   (Followers: 15)
Canadian Psychology / Psychologie canadienne     Full-text available via subscription   (Followers: 13)
Case Studies in Sport and Exercise Psychology     Hybrid Journal   (Followers: 1)
Castalia : Revista de Psicología de la Academia     Open Access  
Cendekia : Jurnal Kependidikan dan Kemasyarakatan     Open Access  
Child Development Perspectives     Hybrid Journal   (Followers: 29)
Child Development Research     Open Access   (Followers: 16)
Ciencia Cognitiva     Open Access   (Followers: 2)
Ciencia e Interculturalidad     Open Access   (Followers: 3)
Ciências & Cognição     Open Access  
Ciencias Psicológicas     Open Access  
Clínica y Salud     Open Access  
Clinical Medicine Insights : Psychiatry     Open Access   (Followers: 9)
Clinical Practice in Pediatric Psychology     Full-text available via subscription   (Followers: 11)
Clinical Psychological Science     Hybrid Journal   (Followers: 11)
Clinical Psychologist     Hybrid Journal   (Followers: 17)
Clinical Psychology & Psychotherapy     Hybrid Journal   (Followers: 71)
Clinical Psychology and Special Education     Open Access   (Followers: 3)
Clinical Psychology Review     Hybrid Journal   (Followers: 41)
Clinical Psychology: Science and Practice     Hybrid Journal   (Followers: 22)
Clinical Schizophrenia & Related Psychoses     Full-text available via subscription   (Followers: 8)
Coaching : Theorie & Praxis     Open Access   (Followers: 1)
Coaching Psykologi - The Danish Journal of Coaching Psychology     Open Access   (Followers: 2)
Cogent Psychology     Open Access  
Cógito     Open Access  
Cognition & Emotion     Hybrid Journal   (Followers: 43)
Cognitive Behaviour Therapist     Hybrid Journal   (Followers: 13)
Cognitive Behaviour Therapy     Hybrid Journal   (Followers: 17)
Cognitive Neuropsychology     Hybrid Journal   (Followers: 35)
Cognitive Psychology     Hybrid Journal   (Followers: 72)
Cognitive Research : Principles and Implications     Open Access   (Followers: 3)
Consciousness and Cognition     Hybrid Journal   (Followers: 32)
Construção Psicopedagógica     Open Access  
Consulting Psychology Journal : Practice and Research     Full-text available via subscription   (Followers: 4)
Contagion : Journal of Violence, Mimesis, and Culture     Full-text available via subscription   (Followers: 5)
Contemporary Educational Psychology     Hybrid Journal   (Followers: 28)
Contemporary School Psychology     Hybrid Journal   (Followers: 4)
Contextos Clínicos     Open Access  
Counseling et spiritualité / Counselling and Spirituality     Full-text available via subscription   (Followers: 1)
Counseling Outcome Research and Evaluation     Hybrid Journal   (Followers: 12)
Counseling Psychologist     Hybrid Journal   (Followers: 17)
Counseling Psychology and Psychotherapy     Open Access   (Followers: 12)
Counselling and Psychotherapy Research : Linking research with practice     Hybrid Journal   (Followers: 27)
Counselling and Values     Hybrid Journal   (Followers: 5)
Counselling Psychology Quarterly     Hybrid Journal   (Followers: 13)
Couple and Family Psychoanalysis     Full-text available via subscription   (Followers: 1)
Couple and Family Psychology : Research and Practice     Full-text available via subscription   (Followers: 6)
Creativity Research Journal     Hybrid Journal   (Followers: 24)
Creativity. Theories - Research - Applications     Open Access   (Followers: 5)
Criminal Justice Ethics     Hybrid Journal   (Followers: 10)
Cuadernos de Neuropsicología     Open Access   (Followers: 1)
Cuadernos de Psicologia del Deporte     Open Access  
Cuadernos de Psicopedagogía     Open Access  
Cultural Diversity and Ethnic Minority Psychology     Full-text available via subscription   (Followers: 16)
Cultural-Historical Psychology     Open Access   (Followers: 2)
Culturas Psi     Open Access  
Culture and Brain     Hybrid Journal   (Followers: 4)
Current Addiction Reports     Hybrid Journal   (Followers: 12)
Current Behavioral Neuroscience Reports     Hybrid Journal   (Followers: 2)
Current Directions In Psychological Science     Hybrid Journal   (Followers: 57)
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 4)
Current Opinion in Psychology     Hybrid Journal   (Followers: 8)
Current Psychological Research     Hybrid Journal   (Followers: 14)
Current Psychology     Hybrid Journal   (Followers: 14)
Current psychology letters     Open Access   (Followers: 2)
Current Research in Psychology     Open Access   (Followers: 17)
Cyberpsychology, Behavior, and Social Networking     Hybrid Journal   (Followers: 16)
Decision     Full-text available via subscription   (Followers: 5)
Depression and Anxiety     Hybrid Journal   (Followers: 23)
Depression Research and Treatment     Open Access   (Followers: 13)
Development and Psychopathology     Hybrid Journal   (Followers: 8)
Developmental Cognitive Neuroscience     Open Access   (Followers: 18)
Developmental Neuropsychology     Hybrid Journal   (Followers: 20)
Developmental Psychobiology     Hybrid Journal   (Followers: 9)
Developmental Psychology     Full-text available via subscription   (Followers: 44)
Diagnostica     Hybrid Journal   (Followers: 2)
Dialectica     Hybrid Journal   (Followers: 1)
Discourse     Full-text available via subscription   (Followers: 10)
Diversitas : Perspectivas en Psicologia     Open Access  
Drama Therapy Review     Hybrid Journal   (Followers: 2)
Dreaming     Full-text available via subscription   (Followers: 11)

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Journal Cover Behavior Therapy
  [SJR: 1.929]   [H-I: 80]   [50 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0005-7894
   Published by Elsevier Homepage  [3177 journals]
  • Honoring the Past, Envisioning the Future: ABCT’s 50th Anniversary
           Presidential Address
    • Authors: Michelle G. Craske
      Pages: 151 - 164
      Abstract: Publication date: March 2018
      Source:Behavior Therapy, Volume 49, Issue 2
      Author(s): Michelle G. Craske
      The theme of the Association for Behavioral and Cognitive Therapies (ABCT) 50th Anniversary was to honor the past and envision the future. From the wisdom, foresight, and determination of the pioneers of our organization, and the continuous upholding of the scientific method over the last 50 years, cognitive behavioral therapy (CBT) has become the most empirically supported psychological treatment for a wide array of mental health problems. Yet, we still have a long way to go. This address outlines a vision for the future of CBT, which involves greater collaborative science, with all minds working together on the same problem, and greater attention to the risk factors and critical processes that underlie psychopathology and explain treatment change. Such knowledge generation can inform the development of new, more efficient and more effective therapies that are tailored with more precision to the needs of each person. Latest technologies provide tools for a precision focus while at the same time increasing the reach of our treatments to the many for whom traditional therapies are unavailable. Our impact will be greatly enhanced by large samples with common methods and measures that inform a precision approach. We have come a long way since ABCT was founded in 1966, and we are poised to make even larger strides in our mission to enhance health and well-being by harnessing science, our major guiding principle.

      PubDate: 2018-03-19T04:54:44Z
      DOI: 10.1016/j.beth.2017.05.003
  • Treating Procrastination Using Cognitive Behavior Therapy: A Pragmatic
           Randomized Controlled Trial Comparing Treatment Delivered via the Internet
           or in Groups
    • Authors: Alexander Rozental; David Forsström; Philip Lindner; Simon Nilsson; Lina Mårtensson; Angela Rizzo; Gerhard Andersson; Per Carlbring
      Pages: 180 - 197
      Abstract: Publication date: March 2018
      Source:Behavior Therapy, Volume 49, Issue 2
      Author(s): Alexander Rozental, David Forsström, Philip Lindner, Simon Nilsson, Lina Mårtensson, Angela Rizzo, Gerhard Andersson, Per Carlbring
      Procrastination is a common problem among university students, with at least half of the population reporting great difficulties initiating or completing tasks and assignments. Procrastination can have a negative impact on course grades and the ability to achieve a university degree, but can also lead to psychological distress. Cognitive behavior therapy (CBT) is believed to reduce procrastination, but few studies have investigated its effectiveness in a regular clinical setting. The current study explored its effects using a pragmatic randomized controlled trial comparing treatment delivered during 8 weeks as self-guided CBT via the Internet (ICBT) or as group CBT. In total, 92 university students with severe procrastination were included in the study (registered as a clinical trial on NCT02112383). Outcome measures on procrastination, depression, anxiety, and well-being were distributed at pre- and posttreatment as well as 6-month follow-up. An outcome measure of procrastination was administered weekly. Linear mixed and fixed effects models were calculated, along with improvement and deterioration rates. The results showed large within-group effect sizes on procrastination, Cohen’s d of 1.29 for ICBT, 95% Confidence Interval (CI) [0.81, 1.74], and d of 1.24 for group CBT, 95% CI [0.76, 1.70], and small to moderate benefits for depression, anxiety, and well-being. In total, 33.7% were regarded as improved at posttreatment and 46.7% at follow-up. No differences between conditions were observed after the treatment period, however, participants in group CBT continued or maintained their improvement at follow-up, while participants in self-guided ICBT showed some signs of deterioration. The findings from the current study suggest that CBT might be an effective treatment for those struggling with severe procrastination, but that a group format may be better for some to sustain their benefits over time and that the clinical significance of the results need to be investigated further.

      PubDate: 2018-03-19T04:54:44Z
      DOI: 10.1016/j.beth.2017.08.002
  • Modification of Hostile Interpretation Bias in Depression: A Randomized
           Controlled Trial
    • Authors: Hillary L. Smith; Kirsten H. Dillon; Jesse R. Cougle
      Pages: 198 - 211
      Abstract: Publication date: March 2018
      Source:Behavior Therapy, Volume 49, Issue 2
      Author(s): Hillary L. Smith, Kirsten H. Dillon, Jesse R. Cougle
      Interpretation Bias Modification (IBM) is gaining attention in the literature as an intervention that alters cognitive biases and reduces associated symptoms. Forty, primarily college-aged, non-treatment-seeking adults with major depressive disorder (MDD) were randomly assigned to receive either IBM targeting hostile interpretation bias (IBM-H) or a healthy video control (HVC) condition. Compared to those in HVC, participants in IBM-H reported more benign interpretations and fewer hostile interpretations at posttreatment. No difference in depressive interpretation bias was found between groups at posttreatment. IBM-H led to improved anger control at posttreatment and follow-up compared to HVC, though no effects of condition were found on trait anger or depressive symptoms. The IBM-H group perceived their treatment as less credible than the HVC group. For individuals with high expectancy of treatment success, IBM-H led to lower posttreatment depressive symptoms compared to HVC, while findings trended in the opposite direction for those with low expectancy of success. Overall, these preliminary findings point to boundary conditions for the efficacy of IBM protocols for anger and depression and potential improvements to be made to future IBM protocols.

      PubDate: 2018-03-19T04:54:44Z
      DOI: 10.1016/j.beth.2017.08.001
  • Prospective Associations of Coping Styles With Depression and Suicide Risk
           Among Psychiatric Emergency Patients
    • Authors: Adam G. Horwitz; Ewa K. Czyz; Johnny Berona; Cheryl A. King
      Pages: 225 - 236
      Abstract: Publication date: March 2018
      Source:Behavior Therapy, Volume 49, Issue 2
      Author(s): Adam G. Horwitz, Ewa K. Czyz, Johnny Berona, Cheryl A. King
      Suicide is the second leading cause of death for those ages 13–25 in the United States. Coping is a mediator between stressful life events and adverse outcomes, and coping skills have been incorporated into interventions (e.g., cognitive-behavioral therapy, dialectical behavior therapy, safety-planning interventions) for suicidal populations. However, longitudinal research has not directly examined the prospective associations between multiple coping styles and suicide-related outcomes in high-risk samples. This study identified cross-sectional and 4-month longitudinal associations of coping styles with suicide risk factors (i.e., depression, suicidal ideation, suicidal behavior) in a sample of 286 adolescent and young adult psychiatric emergency patients. Positive reframing was the coping style most consistently associated with positive outcomes, whereas self-blame and disengagement were consistently associated with negative outcomes. Active coping protected against suicidal behavior for males, but not for females. This was the first study to examine longitudinal relationships between coping and suicide-related outcomes in a high-risk clinical sample. Findings suggest that clinical interventions with suicidal adolescents and young adults may benefit from a specific focus on increasing positive reframing and reducing self-blame.

      PubDate: 2018-03-19T04:54:44Z
      DOI: 10.1016/j.beth.2017.07.010
  • Predicting Response to an Internet-Delivered Parenting Program for Anxiety
           in Early Childhood
    • Authors: Amy J. Morgan; Ronald M. Rapee; Agus Salim; Jordana K. Bayer
      Pages: 237 - 248
      Abstract: Publication date: March 2018
      Source:Behavior Therapy, Volume 49, Issue 2
      Author(s): Amy J. Morgan, Ronald M. Rapee, Agus Salim, Jordana K. Bayer
      Previous research has identified factors related to outcome in child anxiety treatment and parent training programs for child behavior problems. However, it is unclear what factors predict outcomes in interventions delivered online to parents of young children at risk of anxiety. This study investigated predictors of child anxiety outcomes among 433 families with young children (3–6 years) who participated in a randomized controlled trial of Cool Little Kids Online, an eight-module early intervention program for child anxiety based on cognitive-behavioral therapy (CBT). Potential predictors included baseline demographic factors, child and parent mental health factors, and indicators of program use, including number of online modules completed and frequency of homework practice. Results showed that only access to a printer moderated intervention effectiveness. Printer access predicted lower child anxiety in the Cool Little Kids Online group, but had no effect on outcomes in the wait-list group. In both groups, higher levels of child anxiety symptoms, child-inhibited temperament, and poorer parent mental health at baseline predicted higher levels of child anxiety symptoms at 6-month follow-up. The amount of online program use was not related to improvements in child anxiety symptoms. However, parents who reported practicing the program skills more frequently showed greater reductions in child anxiety, and access to a printer was related to frequency of program skills practice. These findings provide empirical support for the important role of skills practice in online CBT interventions, and suggest that practicing program skills may be more important than completing the online modules.

      PubDate: 2018-03-19T04:54:44Z
      DOI: 10.1016/j.beth.2017.07.009
  • Consumer Smartphone Apps Marketed for Child and Adolescent Anxiety: A
           Systematic Review and Content Analysis
    • Authors: Laura Jane Bry; Tommy Chou; Elizabeth Miguel; Jonathan S. Comer
      Pages: 249 - 261
      Abstract: Publication date: March 2018
      Source:Behavior Therapy, Volume 49, Issue 2
      Author(s): Laura Jane Bry, Tommy Chou, Elizabeth Miguel, Jonathan S. Comer
      Anxiety disorders are collectively the most prevalent mental health problems affecting youth. To increase the reach of mental health care, recent years have seen increasing enthusiasm surrounding mobile platforms for expanding treatment delivery options. Apps developed in academia and supported in clinical trials are slow to reach the consumer marketplace. Meanwhile, proliferation of industry-developed apps on consumer marketplaces has been high. The present study analyzed content within mobile products prominently marketed toward consumers for anxiety in youth. Systematic inventory of the Google Play Store and Apple Store using keyword searches for child and adolescent anxiety yielded 121 apps, which were evaluated on the basis of their descriptive characteristics, mobile functionalities, and adherence to evidence-based treatment principles. Findings revealed that evidence-based treatment content within the sample is scant and few comprehensive anxiety self-management apps were identified. Advanced features that leverage the broader functionalities of smartphone capabilities (e.g., sensors, ecological momentary assessments) were rarely present. Findings underscore the need to increase the prominence and accessibility of quality child anxiety intervention products for consumers. Strategies for improving marketing of supported apps to better penetrate consumer markets are discussed.

      PubDate: 2018-03-19T04:54:44Z
      DOI: 10.1016/j.beth.2017.07.008
  • Visual Attention to Pictorial Food Stimuli in Individuals With Night
           Eating Syndrome: An Eye-Tracking Study
    • Authors: Sabrina Baldofski; Patrick Lüthold; Ingmar Sperling; Anja Hilbert
      Pages: 262 - 272
      Abstract: Publication date: March 2018
      Source:Behavior Therapy, Volume 49, Issue 2
      Author(s): Sabrina Baldofski, Patrick Lüthold, Ingmar Sperling, Anja Hilbert
      Night eating syndrome (NES) is characterized by excessive evening and/or nocturnal eating episodes. Studies indicate an attentional bias towards food in other eating disorders. For NES, however, evidence of attentional food processing is lacking. Attention towards food and non-food stimuli was compared using eye-tracking in 19 participants with NES and 19 matched controls without eating disorders during a free exploration paradigm and a visual search task. In the free exploration paradigm, groups did not differ in initial fixation position or gaze duration. However, a significant orienting bias to food compared to non-food was found within the NES group, but not in controls. A significant attentional maintenance bias to non-food compared to food was found in both groups. Detection times did not differ between groups in the search task. Only in NES, attention to and faster detection of non-food stimuli were related to higher BMI and more evening eating episodes. The results might indicate an attentional approach-avoidance pattern towards food in NES. However, further studies should clarify the implications of attentional mechanisms for the etiology and maintenance of NES.

      PubDate: 2018-03-19T04:54:44Z
      DOI: 10.1016/j.beth.2017.07.005
  • Racial Differences in Attributions, Perceived Criticism, and Upset: A
           Study With Black and White Community Participants
    • Authors: Kelly M. Allred; Dianne L. Chambless
      Pages: 273 - 285
      Abstract: Publication date: March 2018
      Source:Behavior Therapy, Volume 49, Issue 2
      Author(s): Kelly M. Allred, Dianne L. Chambless
      The primary aims of the current investigation were (a) to examine the relationships among attributions, perceived constructive and destructive criticism, and upset due to criticism and (b) to explore racial differences in mean levels of attributions, perceived criticism, upset due to criticism, and warmth in a community sample of Blacks and Whites (N = 272). The Attributions of Criticism Scale (ACS) was used to measure participants’ attributions regarding criticism from their relatives. No racial differences were found in mean levels of attributions or type of perceived criticism. However, Blacks were significantly less upset by perceived criticism from their relatives than Whites. When the relationships between attributions, perceived criticism, and upset were explored, results showed that positive attributions were associated with greater perceived constructive criticism and less upset due to criticism, whereas negative attributions were associated with greater perceived destructive criticism and more upset. Perceptions of relatives’ warmth were also associated with greater perceived constructive criticism and less perceived destructive criticism, but warmth was only related to less upset for Blacks and not Whites. Findings suggest that attributions and warmth play an important role in the perception of criticism and the extent to which individuals become upset in response to criticism from loved ones. Results also point to potential racial differences in mean levels of these variables and the associations among them.

      PubDate: 2018-03-19T04:54:44Z
      DOI: 10.1016/j.beth.2017.07.004
  • Profile Analysis of Psychological Symptoms Associated With Misophonia: A
           Community Sample
    • Authors: Dean McKay; Se-Kang Kim; Lauren Mancusi; Eric A. Storch; Christopher Spankovich
      Pages: 286 - 294
      Abstract: Publication date: March 2018
      Source:Behavior Therapy, Volume 49, Issue 2
      Author(s): Dean McKay, Se-Kang Kim, Lauren Mancusi, Eric A. Storch, Christopher Spankovich
      Misophonia is characterized by extreme aversive reactions to certain classes of sounds. It has recently been recognized as a condition associated with significant disability. Research has begun to evaluate psychopathological correlates of misophonia. This study sought to identify profiles of psychopathology that characterize misophonia in a large community sample. A total of N = 628 adult participants completed a battery of measures assessing anxiety and anxiety sensitivity, depression, stress responses, anger, dissociative experiences, obsessive-compulsive symptoms and beliefs, distress tolerance, bodily perceptions, as well as misophonia severity. Profile Analysis via Multidimensional Scaling (PAMS) was employed to evaluate profiles associated with elevated misophonia and those without symptoms. Three profiles were extracted. The first two accounted for 70% total variance and did not show distinctions between groups. The third profile accounted for 11% total variance, and showed that misophonia is associated with lower obsessive-compulsive symptoms for neutralizing, obsessions generally, and washing compared to those not endorsing misophonia, and higher levels of obsessive-compulsive symptoms associated with ordering and harm avoidance. This third profile extracted also showed significant differences between those with and without misophonia on the scale assessing physical concerns (that is, sensitivity to interoceptive sensations) as assessed with the ASI-3. Further research is called for involving diagnostic interviewing and experimental methods to clarify these putative mechanisms associated with misophonia.

      PubDate: 2018-03-19T04:54:44Z
      DOI: 10.1016/j.beth.2017.07.002
  • Efficacy of Guided iCBT for Depression and Mediation of Change by
           Cognitive Skill Acquisition
    • Authors: Nicholas R. Forand; Jeffrey G. Barnett; Daniel R. Strunk; Mohammed U. Hindiyeh; Jason E. Feinberg; John R. Keefe
      Pages: 295 - 307
      Abstract: Publication date: March 2018
      Source:Behavior Therapy, Volume 49, Issue 2
      Author(s): Nicholas R. Forand, Jeffrey G. Barnett, Daniel R. Strunk, Mohammed U. Hindiyeh, Jason E. Feinberg, John R. Keefe
      Guided internet CBT (iCBT) is a promising treatment for depression; however, it is less well known through what mechanisms iCBT works. Two possible mediators of change are the acquisition of cognitive skills and increases in behavioral activation. We report results of an 8-week waitlist controlled trial of guided iCBT, and test whether early change in cognitive skills or behavioral activation mediated subsequent change in depression. The sample was 89 individuals randomized to guided iCBT (n = 59) or waitlist (n = 30). Participants were 75% female, 72% Caucasian, and 33 years old on average. The PHQ9 was the primary outcome measure. Mediators were the Competencies of Cognitive Therapy Scale–Self Report and the Behavioral Activation Scale for Depression–Short Form. Treatment was Beating the Blues plus manualized coaching. Outcomes were analyzed using linear mixed models, and mediation with a bootstrap resampling approach. The iCBT group was superior to waitlist, with large effect sizes at posttreatment (Hedges’ g = 1.45). Dropout of iCBT was 29% versus 10% for waitlist. In the mediation analyses, the acquisition of cognitive skills mediated subsequent depression change (indirect effect = -.61, 95% bootstrapped biased corrected CI: -1.47, -0.09), but increases in behavioral activation did not. iCBT is an effective treatment for depression, but dropout rates remain high. Change in iCBT appears to be mediated by improvements in the use of cognitive skills, such as critically evaluating and restructuring negative thoughts.

      PubDate: 2018-03-19T04:54:44Z
      DOI: 10.1016/j.beth.2017.04.004
  • Corrigendum to “Intervention Effectiveness of The Incredible Years: New
           Insights Into Sociodemographic and Intervention-Based Moderators”
           [Behavior Therapy 48 (2017) 1–18]
    • Authors: Joyce Weeland; Rabia R. Chhangur; Danielle van der Giessen; Walter Matthys; Bram Orobio de Castro; Geertjan Overbeek
      Pages: 308 - 309
      Abstract: Publication date: March 2018
      Source:Behavior Therapy, Volume 49, Issue 2
      Author(s): Joyce Weeland, Rabia R. Chhangur, Danielle van der Giessen, Walter Matthys, Bram Orobio de Castro, Geertjan Overbeek

      PubDate: 2018-03-19T04:54:44Z
      DOI: 10.1016/j.beth.2017.09.007
  • Presidential Address: Are the Obsessive-Compulsive Related Disorders
           Related to Obsessive-Compulsive Disorder' A Critical Look at DSM-5’s
           New Category
    • Authors: Jonathan S. Abramowitz
      Pages: 1 - 11
      Abstract: Publication date: January 2018
      Source:Behavior Therapy, Volume 49, Issue 1
      Author(s): Jonathan S. Abramowitz
      The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) includes a new class of obsessive-compulsive and related disorders (OCRDs) that includes obsessive-compulsive disorder (OCD) and a handful of other putatively related conditions. Although this new category promises to raise awareness of underrecognized and understudied problems, the empirical validity and practical utility of this new DSM category is questionable. This article critically examines the arguments underlying the new OCRD class, illuminates a number of problems with this class, and then discusses implications for clinicians and researchers.

      PubDate: 2018-02-05T03:02:53Z
      DOI: 10.1016/j.beth.2017.06.002
  • Prospective Associations Between Sleep Disturbance and Repetitive Negative
           Thinking: The Mediating Roles of Focusing and Shifting Attentional Control
    • Authors: Rebecca C. Cox; David A. Cole; Eliza L. Kramer; Bunmi O. Olatunji
      Pages: 21 - 31
      Abstract: Publication date: January 2018
      Source:Behavior Therapy, Volume 49, Issue 1
      Author(s): Rebecca C. Cox, David A. Cole, Eliza L. Kramer, Bunmi O. Olatunji
      Although considerable evidence has linked sleep disturbance to symptoms of psychopathology, including repetitive negative thinking, few studies have examined how sleep disturbance may predict repetitive negative thinking over time. Further, no study to date has examined specific mechanisms that may account for this relationship. The present study sought to address these gaps in the literature by testing focusing and shifting attentional control as two potential mediators of the relationship between sleep disturbance and repetitive negative thinking over a 6-month period. A final sample of 445 unselected community participants completed measures of sleep disturbance and repetitive negative thinking at Time 1, measures of focusing and shifting attentional control 3 months later, and measures of repetitive negative thinking again 6 months later. Results revealed that focusing, but not shifting, attentional control mediated the relationship between sleep disturbance and repetitive negative thinking, specifically, worry, rumination, and obsessions. These findings provide preliminary evidence for focusing attentional control as a candidate mechanism that may explain the causal role of sleep disturbance in the development of repetitive negative thinking observed in various disorders.

      PubDate: 2018-02-05T03:02:53Z
      DOI: 10.1016/j.beth.2017.08.007
  • Comparing Children’s Memories for Negative Versus Positive Events in the
           Context of Posttraumatic Stress Symptoms
    • Authors: Jemma Bray; Neil Brewer; Kate Cameron; Reginald D.V. Nixon
      Pages: 32 - 45
      Abstract: Publication date: January 2018
      Source:Behavior Therapy, Volume 49, Issue 1
      Author(s): Jemma Bray, Neil Brewer, Kate Cameron, Reginald D.V. Nixon
      How well children remember negative events is not fully understood. Previous research has failed to simultaneously test memory and perceptions of memory for both negative and positive events. Children (n = 38, 7–17 years) recruited from a hospital following accidental injury were tested for their memory of an injury-producing accident (negative event) and a positive event (unexpectedly receiving a $50 gift voucher). Objective accuracy of memory, memory quality characteristics (e.g., how coherently the event was recalled), children’s judgments of their memory (meta-cognitive), and posttraumatic stress (PTS) symptoms were assessed 2 months post-injury. Children’s memories for their experiences were verified using witness/parent reports. Memory quality characteristics of children’s free recollection were coded with a previously used standardized system. Overall, children showed high levels of accuracy for both events, with little degradation over time. High PTS children showed little evidence of deficits in coherence or organization in their narratives relative to low PTS children. Although in some instances high PTS children judged their memory quality to be poor compared to low PTS children, this depended on how this was assessed (e.g., self-report questionnaire vs. coded narratives). In terms of limitations, it is unclear whether the findings will generalize for memories of repeated events. Witness verification of the accident details itself could be prone to error. In conclusion, the findings are broadly supportive of the proposal made by theorists who argue that trauma memories are recalled no less accurately than other distinctive memories. The role of meta-cognitive elements of children’s memory and reporting in PTS is less clear.

      PubDate: 2018-02-05T03:02:53Z
      DOI: 10.1016/j.beth.2017.03.006
  • Benchmarking Treatment Response in Tourette’s Disorder: A Psychometric
           Evaluation and Signal Detection Analysis of the Parent Tic Questionnaire
    • Authors: Emily J. Ricketts; Joseph F. McGuire; Susanna Chang; Deepika Bose; Madeline M. Rasch; Douglas W. Woods; Matthew W. Specht; John T. Walkup; Lawrence Scahill; Sabine Wilhelm; Alan L. Peterson; John Piacentini
      Pages: 46 - 56
      Abstract: Publication date: January 2018
      Source:Behavior Therapy, Volume 49, Issue 1
      Author(s): Emily J. Ricketts, Joseph F. McGuire, Susanna Chang, Deepika Bose, Madeline M. Rasch, Douglas W. Woods, Matthew W. Specht, John T. Walkup, Lawrence Scahill, Sabine Wilhelm, Alan L. Peterson, John Piacentini
      This study assessed the psychometric properties of a parent-reported tic severity measure, the Parent Tic Questionnaire (PTQ), and used the scale to establish guidelines for delineating clinically significant tic treatment response. Participants were 126 children ages 9 to 17 who participated in a randomized controlled trial of Comprehensive Behavioral Intervention for Tics (CBIT). Tic severity was assessed using the Yale Global Tic Severity Scale (YGTSS), Hopkins Motor/Vocal Tic Scale (HMVTS) and PTQ; positive treatment response was defined by a score of 1 (very much improved) or 2 (much improved) on the Clinical Global Impressions – Improvement (CGI-I) scale. Cronbach’s alpha and intraclass correlations (ICC) assessed internal consistency and test-retest reliability, with correlations evaluating validity. Receiver- and Quality-Receiver Operating Characteristic analyses assessed the efficiency of percent and raw-reduction cutoffs associated with positive treatment response. The PTQ demonstrated good internal consistency (α = 0.80 to 0.86), excellent test-retest reliability (ICC = .84 to .89), good convergent validity with the YGTSS and HM/VTS, and good discriminant validity from hyperactive, obsessive-compulsive, and externalizing (i.e., aggression and rule-breaking) symptoms. A 55% reduction and 10-point decrease in PTQ Total score were optimal for defining positive treatment response. Findings help standardize tic assessment and provide clinicians with greater clarity in determining clinically meaningful tic symptom change during treatment.

      PubDate: 2018-02-05T03:02:53Z
      DOI: 10.1016/j.beth.2017.05.006
  • PTSD Symptom Severity and Emotion Regulation Strategy Use During Trauma
           Cue Exposure Among Patients With Substance Use Disorders: Associations
           With Negative Affect, Craving, and Cortisol Reactivity
    • Authors: Matthew T. Tull; Christopher R. Berghoff; Linnie E. Wheeless; Rivka T. Cohen; Kim L. Gratz
      Pages: 57 - 70
      Abstract: Publication date: January 2018
      Source:Behavior Therapy, Volume 49, Issue 1
      Author(s): Matthew T. Tull, Christopher R. Berghoff, Linnie E. Wheeless, Rivka T. Cohen, Kim L. Gratz
      The co-occurrence of posttraumatic stress disorder (PTSD) pathology with a substance use disorder (SUD) is associated with emotion regulation deficits. However, studies in this area generally rely on trait-based emotion regulation measures, and there is limited information on the relation of PTSD pathology to the use of specific emotion regulation strategies in response to trauma-related distress among SUD patients or the consequences of these strategies for trauma cue reactivity. This study examined the relation of PTSD symptom severity to the use of specific emotion regulation strategies during trauma cue exposure among trauma-exposed SUD patients, as well as the indirect relations of PTSD symptom severity to changes in negative affect, cravings, and cortisol levels pre- to posttrauma cue exposure through different emotion regulation strategies. Participants were 133 trauma-exposed SUD patients. Participants listened to a personalized trauma script and reported on emotion regulation strategies used during the script. Data on negative affect, cravings, and cortisol were collected pre- and postscript. PTSD symptom severity related positively to the use of more adaptive (e.g., distraction) and maladaptive (e.g., suppression) regulation strategies. Moreover, evidence for the indirect effects of PTSD symptom severity on negative affect and cortisol reactivity through both adaptive and maladaptive emotion regulation strategies was found. Implications of findings are discussed.

      PubDate: 2018-02-05T03:02:53Z
      DOI: 10.1016/j.beth.2017.05.005
  • Effectiveness of Web- and Mobile-Based Treatment of Subthreshold
           Depression With Adherence-Focused Guidance: A Single-Blind Randomized
           Controlled Trial
    • Authors: David Daniel Ebert; Claudia Buntrock; Dirk Lehr; Filip Smit; Heleen Riper; Harald Baumeister; Pim Cuijpers; Matthias Berking
      Pages: 71 - 83
      Abstract: Publication date: January 2018
      Source:Behavior Therapy, Volume 49, Issue 1
      Author(s): David Daniel Ebert, Claudia Buntrock, Dirk Lehr, Filip Smit, Heleen Riper, Harald Baumeister, Pim Cuijpers, Matthias Berking
      Evidence for the impact of psychological Interventions for subthreshold depression (sD) is conflicting. Moreover, human resources to deliver such treatments are limited. This study aimed to evaluate the effectiveness of a web-based intervention with adherence-focused guidance in the treatment of sD. Participants with sD (CES-D≥ 16, no Major Depressive Disorder according to DSM-IV criteria, N = 204) recruited via a large health insurance were randomly allocated to a web-based mobile-supported cognitive-behavioral intervention or to a waitlist control condition with unrestricted access to usual care. The primary outcome was the reduction in depressive symptom severity as measured by blind diagnostic raters using the Quick Inventory of Depressive Symptomatology (QIDS) at posttreatment. There was a statistically significant between-group difference in QIDS scores at posttreatment in favor of the intervention group, F(1, 201) = 11.31, p = .001, corresponding to a medium effect size of d = 0.37 (95% CI 0.09–0.64) and a NNT of 7 (95%–CI 3.7–41.2). Significant effects in favour of the intervention group were also found for secondary outcomes such as quality of life, anxiety, and insomnia severity. Web-based self-help interventions with adherence-focused guidance could be an acceptable and effective approach to reduce a range of negative consequences associated with subclinical depression.

      PubDate: 2018-02-05T03:02:53Z
      DOI: 10.1016/j.beth.2017.05.004
  • Multi-Informant Assessments of Adolescent Social Anxiety: Adding Clarity
           by Leveraging Reports from Unfamiliar Peer Confederates
    • Authors: Danielle E. Deros; Sarah J. Racz; Melanie F. Lipton; Tara M. Augenstein; Jeremy N. Karp; Lauren M. Keeley; Noor Qasmieh; Brigitte I. Grewe; Amelia Aldao; Andres De Los Reyes
      Pages: 84 - 98
      Abstract: Publication date: January 2018
      Source:Behavior Therapy, Volume 49, Issue 1
      Author(s): Danielle E. Deros, Sarah J. Racz, Melanie F. Lipton, Tara M. Augenstein, Jeremy N. Karp, Lauren M. Keeley, Noor Qasmieh, Brigitte I. Grewe, Amelia Aldao, Andres De Los Reyes
      Adolescent social anxiety (SA) assessments often include adolescent and parent reports, and low reporting correspondence results in uncertainties in clinical decision-making. Adolescents display SA within non-home contexts such as peer interactions. Yet, current methods for collecting peer reports raise confidentiality concerns, though adolescent SA assessments nonetheless would benefit from context-specific reports relevant to adolescent SA (i.e., interactions with unfamiliar peers). In a sample of 89 adolescents (30 Evaluation-Seeking; 59 Community Control), we collected SA reports from adolescents and their parents, and SA reports from unfamiliar peer confederates who interacted with adolescents during 20-minute mock social interactions. Adolescents and parents completed reports on trait measures of adolescent SA and related concerns (e.g., depressive symptoms), and adolescents completed self-reports of state arousal within mock social interactions. Adolescents’ SA reports correlated with reports on parallel measures from parents in the .30s and with peer confederates in the .40s to .50s, whereas reports from parent-confederate dyads correlated in the .07 to .22 range. Adolescent, parent, and peer confederate SA reports related to reports on trait measures of adolescent SA and depressive symptoms, and distinguished Evaluation-Seeking from Community Control Adolescents. Confederates’ SA reports incrementally predicted adolescents’ self-reported SA over and above parent reports, and vice versa, with combined Rs ranging from .51 to .60. These combined Rs approximate typical correspondence levels between informants who observe adolescents in the same context (e.g., mother-father). Adolescent and peer confederate (but not parent) SA reports predicted adolescents’ state arousal in social interactions. These findings have implications for clarifying patterns of reporting correspondence in clinical assessments of adolescent SA.

      PubDate: 2018-02-05T03:02:53Z
      DOI: 10.1016/j.beth.2017.05.001
  • Predictors and Trajectories of Response to the Homework, Organization, and
           Planning Skills (HOPS) Intervention for Adolescents with ADHD
    • Authors: Rosanna P. Breaux; Joshua M. Langberg; Stephen Molitor; Melissa R. Dvorsky; Elizaveta Bourchtein; Zoe Smith; Cathrin D. Green
      Abstract: Publication date: Available online 10 April 2018
      Source:Behavior Therapy
      Author(s): Rosanna P. Breaux, Joshua M. Langberg, Stephen Molitor, Melissa R. Dvorsky, Elizaveta Bourchtein, Zoe Smith, Cathrin D. Green
      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; M age =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 organization, and time management skills. Parents provided information on whether they monitored and used contingencies to reinforce skills use at home. Outcome measures included parent and teacher ratings of homework problems and organizational/time management skills post-intervention. Grade point average and assignment completion were also evaluated as objective outcomes. Regressions found accurate homework recording and time management to be unique predictors of parent-reported homework and organizational skills outcomes. Growth mixture models examining organizational skills trajectories throughout the intervention significantly predicted parent- and teacher-reported outcomes, GPA, and assignment completion; homework recording trajectories predicted parent-reported outcomes and GPA. Sixty-eight percent of participants displayed high acquisition of organization and homework recording skills. Parent-reported use of monitoring and contingencies to support adolescent skills implementation was not associated with outcomes. Results highlight the importance of examining individual differences in school-based intervention studies targeting organization, time management, and planning. Importantly, for a school-based adolescent-focused intervention, improvement in outcomes does not appear to be dependent upon parent skills implementation. Unlabelled Table ADHD attention-deficit/hyperactivity disorder GPA grade point average OTMP organization, time-management, and planning HOPS Homework, Organization, and Planning Skills SMH school mental health

      PubDate: 2018-04-15T11:21:35Z
      DOI: 10.1016/j.beth.2018.04.001
  • What drives OCD symptom change during CBT treatment' Temporal
           relationships among obsessions and compulsions
    • Authors: Judith M. Laposa; Lance L. Hawley; Kevin J. Grimm; Danielle Katz; Neil A. Rector
      Abstract: Publication date: Available online 6 April 2018
      Source:Behavior Therapy
      Author(s): Judith M. Laposa, Lance L. Hawley, Kevin J. Grimm, Danielle Katz, Neil A. Rector
      Cognitive behavior therapy (CBT) is an effective treatment for obsessive compulsive disorder (OCD). However, less is known about how obsessions and compulsions change during treatment, either in tandem, sequentially, or independently. The current study used latent difference score analysis to show path-analytic dynamic modelling of OCD symptom change during CBT. Four competing models of the temporal relationship between obsessions and compulsions were examined: no coupling (obsessions and compulsions are unrelated), goal directed (obsessions leads change in compulsions), habit driven (compulsions leads changes in obsessions), and reciprocal. Treatment seeking participants (N=84) with a principal diagnosis of OCD completed 12weeks of CBT group therapy and completed measures assessing obsession and compulsion severity at pre-treatment, sessions 4, 8, and end of treatment. Bivariate results supported the goal directed traditional CBT model, where obsession scores are temporally associated with subsequent changes in compulsion scores. These results have implications for theoretical and treatment modelling of obsessions and compulsions in OCD treatment.

      PubDate: 2018-04-15T11:21:35Z
      DOI: 10.1016/j.beth.2018.03.012
  • “Teaching Moments” in Psychotherapy: Addressing Emergent Life Events
           using Strategies from a Modular Evidence-Based Treatment
    • Authors: Karen Guan; Maya M. Boustani; Bruce F. Chorpita
      Abstract: Publication date: Available online 5 April 2018
      Source:Behavior Therapy
      Author(s): Karen Guan, Maya M. Boustani, Bruce F. Chorpita
      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% male, 85% Latino) seen by 18 therapy providers in the modular EBT condition (MATCH) of a community effectiveness trial. MATCH experts rated descriptions of 75 ELEs from therapy sessions on how well they might be addressed clinically by any of MATCH's 33 strategies for youth anxiety, depression, trauma, or conduct problems (i.e., “addressability”). MATCH-expert ratings were compared with observationally coded provider responses to ELEs. Results revealed that when assuming the presence of youth and caregiver in session, two-thirds of ELEs were identified as fully addressable and nearly all ELEs (96%) were partially addressable. ELEs related to family issues were most common but least likely to be addressable. Problem Solving and Relaxation skills could address the greatest percentage (87%) of ELEs. The most common supplemental content not explicitly prescribed in MATCH, but identified as necessary to fully address ELEs, was “assessing and empathic listening.” Provider responses often were incongruent with MATCH-expert raters regarding which strategies to use for which ELEs. In summary, most ELEs reported in a diverse community sample could be theoretically harnessed as “teaching moments” for skills within an existing, multi-problem EBT. However, providers may benefit from development of a structured resource to guide them in choosing the most effective response when these unexpected events arise.

      PubDate: 2018-04-15T11:21:35Z
      DOI: 10.1016/j.beth.2018.03.014
  • Early Change Trajectories in Cognitive-Behavioral Therapy for Binge-Eating
    • Authors: Anja Hilbert; Stephan Herpertz; Stephan Zipfel; Brunna Tuschen-Caffier; Hans-Christoph Friederich; Andreas Mayr; Ross D. Crosby; Martina de Zwaan
      Abstract: Publication date: Available online 5 April 2018
      Source:Behavior Therapy
      Author(s): Anja Hilbert, Stephan Herpertz, Stephan Zipfel, Brunna Tuschen-Caffier, Hans-Christoph Friederich, Andreas Mayr, Ross D. Crosby, Martina de Zwaan
      Rapid response is considered the most well-established outcome predictor across treatments of binge-eating disorder (BED), including cognitive-behavioral therapy (CBT). 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 four 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-month follow-up. Other classifications of rapid response based on Receiver Operating Characteristics curve analyses or on the literature (≥ 10% reduction in binge eating at week 1, ≥ 70% reduction in binge eating at week 4) only predicted posttreatment remission or overall depression, respectively. Latent change trajectories, but not other rapid response classifications, predicted binge-eating frequency over time. A fine-grained analysis of change over the first four weeks of CBT for BED revealed different trajectories of early change in binge eating that led to an improved prediction of binge-eating outcome, compared to that of common rapid response classifications. Thorough monitoring of early change trajectories during treatment may have clinical utility.

      PubDate: 2018-04-15T11:21:35Z
      DOI: 10.1016/j.beth.2018.03.013
  • Maintenance of Gains in Relationship and Individual Functioning Following
           the Online OurRelationship Program
    • Authors: Brian D. Doss; McKenzie K. Roddy; Kathryn M. Nowlan; Karen Rothman; Andrew Christensen
      Abstract: Publication date: Available online 28 March 2018
      Source:Behavior Therapy
      Author(s): Brian D. Doss, McKenzie K. Roddy, Kathryn M. Nowlan, Karen Rothman, Andrew Christensen
      In the United States, more than 40% of marriages end in divorce and more than one third of intact marriages are distressed. Unfortunately, only a minority of couples seek couple therapy to improve their relationships. Online interventions, with their increased reach and reduced costs, offer the potential to improve relationships nationwide. The online OurRelationship program has been shown in previous nationwide studies to improve relationship and individual functioning. The present study examined whether initial gains in the OurRelationship program were maintained in the following year and whether the extent of maintenance varied across important demographic and individual factors. In this study, 151 distressed heterosexual couples (302 individuals) who were randomized to the OurRelationship program were assessed 3 and 12months following the intervention. Initial gains in relationship satisfaction, relationship confidence, and negative relationship quality were maintained through 12months; positive relationship quality significantly improved over follow-up. Furthermore, couples maintained their initial gains in depressive symptoms, perceived health, work functioning, and quality of life; anxious symptoms continued to significantly decrease over follow-up. Finally, there was no evidence that historically underserved groups – racial/ethnic minorities, lower income couples, or rural couples – experienced greater deterioration. In fact, Hispanic couples reported continued improvement in relationship confidence and negative relationship quality in the 12months following the program. The ability of the OurRelationship program – an eight-hour, primarily self-help program – to create long-lasting improvements in distressed relationships. indicates it may have the potential to improve the lives of distressed couples on a broad scale.

      PubDate: 2018-04-15T11:21:35Z
      DOI: 10.1016/j.beth.2018.03.011
  • The links between social anxiety disorder, insomnia symptoms, and alcohol
           use disorders: Findings from a large sample of adolescents in the United
    • Authors: Heidemarie Blumenthal; Daniel J. Taylor; Renee M. Cloutier; Catherine Baxley; Heather Lasslett
      Abstract: Publication date: Available online 26 March 2018
      Source:Behavior Therapy
      Author(s): Heidemarie Blumenthal, Daniel J. Taylor, Renee M. Cloutier, Catherine Baxley, Heather Lasslett
      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 =10,140) completed interviews to assess past 12-month SAD and AUD diagnostic status as well as insomnia symptoms. Analyses tested whether insomnia symptoms accounted for a significant proportion of the SAD-AUD relation. Results indicated that insomnia symptoms were positively related to both SAD and AUD status, and the relation between SAD and AUD status was significantly reduced when insomnia symptoms were included in the model. Findings remained significant after controlling for the effects of age, gender, posttraumatic stress disorder, major depressive disorder, and other drug dependence status. Experimental examination and intensive longitudinal assessment of these relationships are needed before strong conclusions can be inferred about causality and temporal relationships. The current findings do indicate insomnia may be an important indirect and stigma free treatment target to address in prevention and treatment efforts for SAD, AUDs, and their co-occurrence.

      PubDate: 2018-04-15T11:21:35Z
      DOI: 10.1016/j.beth.2018.03.010
  • Dialectical Behavior Therapy is effective for the treatment of suicidal
           behavior: A meta-analysis
    • Authors: Christopher R. DeCou; Katherine Anne Comtois; Sara J. Landes
      Abstract: Publication date: Available online 22 March 2018
      Source:Behavior Therapy
      Author(s): Christopher R. DeCou, Katherine Anne Comtois, Sara J. Landes
      Dialectical Behavior Therapy (DBT) prioritizes suicidal behavior and other self-directed violence as the primary treatment targets, and has been demonstrated to reduce self-directed violence in clinical trials. This paper synthesizes findings from controlled trials that assessed self-directed violence and suicidality, including suicide attempts, non-suicidal self-injury (NSSI), suicidal ideation, and accessing psychiatric crisis services. Eighteen controlled trials of DBT were identified. Random effects meta-analyses demonstrated that DBT reduced self-directed violence (d =−.324, 95% CI=−.471 to −.176), and reduced frequency of psychiatric crisis services (d =−.379, 95% CI=−.581 to −.176). There was not a significant pooled effect of DBT with regard to suicidal ideation (d =−.229, 95% CI=−.473 to .016). Our findings may reflect the prioritization of behavior over thoughts within DBT, and offer implications for clinical practice and future research concerning the implementation of DBT for acute suicidality.

      PubDate: 2018-04-15T11:21:35Z
      DOI: 10.1016/j.beth.2018.03.009
  • Alcohol-Induced Amnesia and Personalized Drinking Feedback: Blackouts
           Predict Intervention Response
    • Authors: Mary Beth Miller; Angelo M. DiBello; Ellen Meier; Eleanor L.S. Leavens; Jennifer E. Merrill; Kate B. Carey; Thad R. Leffingwell
      Abstract: Publication date: Available online 21 March 2018
      Source:Behavior Therapy
      Author(s): Mary Beth Miller, Angelo M. DiBello, Ellen Meier, Eleanor L.S. Leavens, Jennifer E. Merrill, Kate B. Carey, Thad R. Leffingwell
      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 Disorders Identification Test (AUDIT) was also evaluated as a moderator to rule out the possibility that amnesia is simply an indicator of more general alcohol risk. College students (N =198) reporting alcohol use in a typical week completed assessments at baseline and one-month follow-up as part of a larger intervention trial. Participants were randomized to assessment only (AO; n =58) or personalized feedback intervention (PFI; n =140). Hierarchical regression was used to examine direct and indirect intervention effects. A significant group by amnesia interaction revealed that only PFI participants who had experienced alcohol-induced amnesia in the past month reported decreases in alcohol consequences at one-month follow-up. The PFI reduced alcohol-related consequences indirectly through changes in peak BAC, but only among those who had experienced amnesia at baseline. In contrast, baseline alcohol risk (AUDIT) did not moderate intervention effects, and use of protective behavioral strategies did not statistically mediate intervention effects. Findings suggest that loss of memory for drinking events is a unique determinant of young adult response to brief alcohol intervention. Normative feedback interventions may be particularly effective for individuals who have experienced alcohol-induced amnesia in the past 30days.

      PubDate: 2018-04-15T11:21:35Z
      DOI: 10.1016/j.beth.2018.03.008
  • Using a Learning Collaborative Model to Disseminate Cognitive Processing
           Therapy to Community-Based Agencies
    • Authors: Stefanie T. LoSavio; Kirsten H. Dillon; Robert A. Murphy; Karen Goetz; Falesha Houston; Patricia A. Resick
      Abstract: Publication date: Available online 20 March 2018
      Source:Behavior Therapy
      Author(s): Stefanie T. LoSavio, Kirsten H. Dillon, Robert A. Murphy, Karen Goetz, Falesha Houston, Patricia A. Resick
      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, received weekly consultation, and submitted audio-recorded sessions to be rated for fidelity. Clinicians were rostered as approved treatment providers if they completed all training requirements. Additionally, we engaged leadership from each agency to build a sustainable practice. Clinicians trained through the Learning Collaborative demonstrated a high degree of fidelity to the treatment (average competence ratings “satisfactory” to “good”), and most (68%) were rostered as approved treatment providers. Patients treated by clinician trainees exhibited significant symptom reductions (d =1.68 and 1.28 for post-traumatic stress and depression symptoms, respectively, among treatment completers). At a 6-month follow-up, 95% of rostered clinicians and 100% of agencies with rostered clinicians were still providing the treatment. These results suggest that the Learning Collaborative model is a promising approach for the dissemination and implementation of evidence-based treatments for adult posttraumatic stress disorder.

      PubDate: 2018-04-15T11:21:35Z
      DOI: 10.1016/j.beth.2018.03.007
  • Assessing Social Affiliative Behavior: A Comparison of In Vivo and Video
    • Authors: Cristina P. Garcia; Lauren T. Catalano; Kristen R. Dwyer; Julie M. McCarthy; Melanie E. Bennett; Jack J. Blanchard
      Abstract: Publication date: Available online 19 March 2018
      Source:Behavior Therapy
      Author(s): Cristina P. Garcia, Lauren T. Catalano, Kristen R. Dwyer, Julie M. McCarthy, Melanie E. Bennett, Jack J. Blanchard
      Social affiliation, or engagement in positive social interactions, is often profoundly impaired in individuals with schizophrenia. Valid measures of social affiliation are needed to understand these impairments and their symptom and functional correlates; however, such measures are limited and have not been validated. This pilot study evaluated one such measure—the video-based Social Affiliation Interaction Task (SAIT)—and a novel in vivo behavioral measure, the Affiliative Conversation Task (ACT). Twenty participants with schizophrenia or schizoaffective disorder (SZ) and 35 non-psychiatric controls (CT) completed both tasks and measures of negative symptoms and functioning. We explored group differences in social affiliation skills; convergent validity between social affiliation skill ratings from the two tasks; and concurrent validity with social affiliation skill ratings, negative symptoms, and functioning. SZ evidenced lower affiliation skill ratings than CT on the video SAIT, but not on the ACT, and the tasks displayed moderate convergent validity for affiliation skill ratings. Less affiliation skill in the SAIT was correlated with more negative symptoms and less functioning in the SZ group with medium effects, though the results were not significant. Findings suggest that the SAIT may be more sensitive to individual differences in skill level. Future research should continue to examine the SAIT for use in measuring affiliation skills.

      PubDate: 2018-04-15T11:21:35Z
      DOI: 10.1016/j.beth.2018.03.006
  • The Intersection of Implementation Science and Behavioral Health: An
           Introduction to the Special Issue
    • Authors: Courtney Benjamin Wolk; Rinad S. Beidas
      Abstract: Publication date: Available online 16 March 2018
      Source:Behavior Therapy
      Author(s): Courtney Benjamin Wolk, Rinad S. Beidas

      PubDate: 2018-03-19T04:54:44Z
      DOI: 10.1016/j.beth.2018.03.004
  • Mental contamination in obsessive–compulsive disorder: Associations with
           contamination symptoms and treatment response
    • Authors: Brittany M. Mathes; Katherine A. McDermott; Sarah A. Okey; Ana Vazquez; Ashleigh M. Harvey; Jesse R. Cougle
      Abstract: Publication date: Available online 16 March 2018
      Source:Behavior Therapy
      Author(s): Brittany M. Mathes, Katherine A. McDermott, Sarah A. Okey, Ana Vazquez, Ashleigh M. Harvey, Jesse R. Cougle
      The most common symptom of obsessive compulsive disorder is contamination fear. Feelings of contamination can be provoked through contact with a physical contaminant, referred to as contact contamination (CC), as well as in the absence of one, referred to as mental contamination (MC). Prior research indicates that CC and MC are distinct, and MC may interfere with treatment for CC. However, no study to date has examined how MC may be associated with responses to physical contaminants and treatment response for CC. 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 ERP for CC and completed self-report measures and behavioral tasks assessing CC and MC at pre-treatment, post-treatment, and follow-up. As hypothesized, at pre-treatment, 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 measures, and greater pre-treatment MC predicted greater post-treatment CC, though this effect was only evident in one of two CC measures. Additionally, specificity analyses indicated changes in MC were independent of changes in disgust propensity, a related construct. Pre-treatment disgust propensity also predicted treatment outcome, though the addition of pre-treatment disgust propensity as a covariate reduced the relationship between pre-treatment MC and post-treatment CC to non-significance. Results suggest MC plays an important role in the manifestation and treatment of CC symptoms and may represent a manifestation of disgust proneness. Theoretical and clinical implications are discussed.

      PubDate: 2018-03-19T04:54:44Z
      DOI: 10.1016/j.beth.2018.03.005
  • Do parents benefit from help when completing a self-guided parenting
           program online' A randomized controlled trial comparing Triple P
           Online with and without telephone support
    • Authors: Jamin J. Day; Matthew R. Sanders
      Abstract: Publication date: Available online 9 March 2018
      Source:Behavior Therapy
      Author(s): Jamin J. Day, Matthew R. Sanders
      In response to recent increases in the dissemination of web-based parenting supports, an important consideration is whether the core benefits of self-directed participation in online parenting interventions are counterbalanced by issues such as high dropout and non-completion rates commonly reported within the Internet intervention literature. This study outlines a randomized controlled trial of Triple P Online, a web-based variant of the Triple P—Positive Parenting Program, delivered with varied levels of support scaffolding. Participants were 183 parents of children aged between 1 and 8 with concerns about their child’s behavior and at least one area of disadvantage or family difficulty. Participants were randomized to self-directed Triple P Online, telephone-supported Triple P Online, or a wait-list control (WL). Primary outcomes measured at baseline, post-intervention, and five-month follow-up were negative parenting styles and child behavior problems. Secondary outcomes included: parent confidence, anger, and adjustment; relationship quality; program engagement; and parent satisfaction. Self-directed participants showed short-term treatment effects including reductions in overall negative parenting and frequency of child behavior problems, while practitioner-support led to greater improvements in negative parenting and intensity of difficult child behaviors. Participants in the supported condition were also more likely to complete modules and reported greater program satisfaction. At follow-up, 50% of outcomes for the self-directed condition were significantly better than control, while 94% of outcomes were significantly better than control in the practitioner-supported condition. Although self-directed online approaches to parenting intervention are promising, this research highlights how minimal support can improve effective engagement and enhance outcomes for families.

      PubDate: 2018-03-19T04:54:44Z
      DOI: 10.1016/j.beth.2018.03.002
  • Pre-extinction stress prevents context-related renewal of fear
    • Authors: Shira Meir Drexler; Christian J. Merz; Oliver T. Wolf
      Abstract: Publication date: Available online 8 March 2018
      Source:Behavior Therapy
      Author(s): Shira Meir Drexler, Christian J. Merz, Oliver T. Wolf
      Extinction learning, which creates new safety associations, is thought to be the mechanism underlying exposure therapy, commonly used for the treatment of anxiety disorders and post-traumatic stress disorder. The relative strength and availability for retrieval of both the fear and safety memories determine the response in a given situation. While the fear memory is often context-independent and may easily generalize, extinction memory is highly context-specific. ‘Renewal’ of the extinguished fear memory might thus occur following a shift in context. The aim of the current work was to create an enhanced and generalized extinction memory to a discrete stimulus using stress exposure before extinction learning, thereby preventing renewal. In our contextual fear conditioning paradigm, 40 healthy men acquired (Day 1), retrieved and extinguished (Day 2) the fear memories, with no differences between the stress and the control group. A significant difference between the groups emerged in the renewal test (Day 3). A renewal effect was seen in the control group (N =20), confirming the context-dependency of the extinction memory. In contrast, the stress group (N =20) showed no renewal effect. Fear reduction was generalized to the acquisition context as well, suggesting that stress rendered the extinction memory more context-independent. These results are in line with previous studies that showed contextualization disruption as a result of pre-learning stress, mediated by the rapid effects of glucocorticoids on the hippocampus. Our findings support research investigating the use of glucocorticoids or stress induction in exposure therapy and suggest the right timing of administration in order to optimize their effects.

      PubDate: 2018-03-19T04:54:44Z
      DOI: 10.1016/j.beth.2018.03.001
  • Effects of Intensive Behavioral Treatment for Children with Varying Levels
           of Conduct Problems and Callous-Unemotional Traits
    • Authors: Pevitr S. Bansal; Daniel A. Waschbusch; Sarah M. Haas; Dara E. Babinski; Sara King; Brendan F. Andrade; Michael T. Willoughby
      Abstract: Publication date: Available online 8 March 2018
      Source:Behavior Therapy
      Author(s): Pevitr S. Bansal, Daniel A. Waschbusch, Sarah M. Haas, Dara E. Babinski, Sara King, Brendan F. Andrade, Michael T. Willoughby
      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 post-treatment) and treatment outcomes (likelihood of normalization from treatment) were examined. Participants were 67 children (n =49 boys; M age =9.6years) with varying levels of CP and CU who participated in an intensive eight-week summer treatment program (STP) in which behavior therapy was delivered to children in recreational and classroom settings and to parents via weekly parent training sessions. Effects of treatment were measured using parent and teacher ratings of oppositional defiant disorder (ODD), conduct disorder (CD), callous behavior, and impairment. Results showed that CU moderated treatment effects for CD and callous-behavior but not ODD or impairment. The moderating effects showed some evidence that participants with high CP and high CU before treatment had better treatment responses (larger change between pre- and post-treatment) but worse treatment outcomes (lower likelihood of normalization after treatment). These results suggest that intensive treatment, such as the STP, may be necessary but not sufficient for children with CP and CU traits.

      PubDate: 2018-03-19T04:54:44Z
      DOI: 10.1016/j.beth.2018.03.003
  • Relapse/Recurrence Prevention in Major Depressive Disorder: 26-Month
    • Authors: Amanda J. Shallcross; Emily C. Willroth; Aaron Fisher; Sona Dimidjian; James J. Gross; Pallavi D. Visvanathan; Iris B. Mauss
      Abstract: Publication date: Available online 8 February 2018
      Source:Behavior Therapy
      Author(s): Amanda J. Shallcross, Emily C. Willroth, Aaron Fisher, Sona Dimidjian, James J. Gross, Pallavi D. Visvanathan, Iris B. Mauss
      We conducted a 26-month follow-up of a previously reported 12-month study that compared mindfulness-based cognitive therapy (MBCT) to a rigorous active control condition (ACC) for depressive relapse/recurrence prevention and improvements in depressive symptoms and life satisfaction. Participants in remission from major depression were randomized to an 8-week MBCT group (n = 46) or the ACC (n = 46). Outcomes were assessed at baseline; postintervention; and 6, 12, and 26 months. Intention-to-treat analyses indicated no differences between groups for any outcome over the 26-month follow-up. Time to relapse results (MBCT vs. ACC) indicated a hazard ratio = .82, 95% CI [.34, 1.99]. Relapse rates were 47.8% for MBCT and 50.0% for ACC. Piecewise analyses indicated that steeper declines in depressive symptoms in the MBCT vs. the ACC group from postintervention to 12 months were not maintained after 12 months. Both groups experienced a marginally significant rebound of depressive symptoms after 12 months but were still improved at 26 months compared to baseline (b = –4.12, p <= .008). Results for life satisfaction were similar. In sum, over a 26-month follow-up, MBCT was no more effective for preventing depression relapse/recurrence, reducing depressive symptoms, or improving life satisfaction than a rigorous ACC. Based on epidemiological data and evidence from prior depression prevention trials, we discuss the possibility that both MBCT and ACC confer equal therapeutic benefit. Future studies that include treatment as usual (TAU) control conditions are needed to confirm this possibility and to rule out the potential role of time-related effects. Overall findings underscore the importance of comparing MBCT to TAU as well as to ACCs.

      PubDate: 2018-03-19T04:54:44Z
      DOI: 10.1016/j.beth.2018.02.001
  • Working from home: An initial pilot examination of videoconferencing-based
           cognitive behavioral therapy for anxious youth delivered to the home
    • Authors: Aubrey L. Carpenter; Donna B. Pincus; Jami M. Furr; Jonathan S. Comer
      Abstract: Publication date: Available online 5 March 2018
      Source:Behavior Therapy
      Author(s): Aubrey L. Carpenter, Donna B. Pincus, Jami M. Furr, Jonathan S. Comer
      Progress in evidence-based treatments for child anxiety has been hampered by limited accessibility of quality care. This study utilized a multiple baseline design to evaluate the pilot feasibility, acceptability, and preliminary efficacy of real-time, Internet-delivered, family-based cognitive-behavioral therapy for child anxiety delivered to the home setting via videoconferencing. Participants included 13 anxious youth (Mean age=9.85) with a primary/co-primary anxiety disorder diagnosis. Eleven participants (84.6%) completed treatment and all study procedures. Consistent with hypotheses, the intervention was feasible and acceptable to families (i.e., high treatment retention, high client satisfaction, strong therapeutic alliance, and low barriers to participation). Moreover, the novel videoconferencing treatment format showed preliminary efficacy: 76.9% of the intention-to-treat (ITT) sample and 90.9% of treatment completers were treatment responders (i.e., Clinical Global Impressions-Improvement Scale=1 or 2 at posttreatment), and 69.2% of the ITT sample and 81.8% of treatment completers were diagnostic responders (as per the Anxiety Disorders Interview for Children). Gains were largely maintained at 3-month follow-up evaluation. Outcome patterns within and across subjects are discussed, as well as limitations and the need for further controlled evaluations. With continued support, videoconferencing treatment formats may serve to meaningfully broaden the reach of quality care for youth anxiety disorders.

      PubDate: 2018-03-08T04:21:43Z
      DOI: 10.1016/j.beth.2018.01.007
  • Development of a Distance-Based Effect Size Metric for Single-Case
           Research: Ratio of Distances
    • Authors: Michael T. Carlin; Mack S. Costello
      Abstract: Publication date: Available online 21 February 2018
      Source:Behavior Therapy
      Author(s): Michael T. Carlin, Mack S. Costello
      This article describes the development of an effect size measure called Ratio of Distances (RD). The goal was to develop a measure of level change for single case experimental research that met several practical requirements: (a) the measure is adaptable to designs with varying numbers of observations per, and across, phases. (b) the measure is adaptable to situations in which slope does and does not exist, (c) the measure has no ceiling, as is the limitation with commonly used overlap-based measures of effect size, and (d) the measure is computationally transparent and easily computed using widely available analysis tools (e.g., Microsoft Excel). The measure is applicable to single cases and meta-analyses.

      PubDate: 2018-02-26T04:02:17Z
      DOI: 10.1016/j.beth.2018.02.005
  • Enhancing the Efficacy of Cognitive Bias Modification for Social Anxiety
    • Authors: Elizabeth S. Stevens; Evelyn Behar; Alexander A. Jendrusina
      Abstract: Publication date: Available online 18 February 2018
      Source:Behavior Therapy
      Author(s): Elizabeth S. Stevens, Evelyn Behar, Alexander A. Jendrusina
      Cognitive bias modification for interpretation (CBM-I) is a promising treatment modality for social anxiety disorder, but effect sizes are relatively small across investigations (Hallion & Ruscio, 2011). Additionally, the extent to which CBM-I impacts other cognitive, emotional, and behavioral outcomes is unclear. This study investigated whether two empirically supported treatment components for anxiety disorders, imaginal exposure (IE) and relaxation, augment the effects of CBM-I and increase the extent to which the effects of CBM-I generalize to behavioral and affective outcomes. We randomly assigned 111 undergraduate students with social anxiety to undergo IE, relaxation, or neutral thinking prior to CBM-I, then measured their interpretation biases, as well as their speaking time, anxiety, and subjective evaluations of performance during a speech task. Results indicated that individuals who received IE prior to CBM-I evidenced more adaptive interpretation biases and less behavioral avoidance during the speech task than did individuals who engaged in relaxation or neutral thinking. However, they did not report differential anxiety, habituation, or evaluations of their performance on the speech task. These findings suggest that the combination of CBM-I with adjunct components that target behavioral, rather than cognitive, mechanisms can facilitate transfer of the effects of CBM-I to reducing behavioral avoidance.

      PubDate: 2018-02-26T04:02:17Z
      DOI: 10.1016/j.beth.2018.02.004
  • A Two-Session Hierarchy for Shaping Successive Approximations of Speech in
           Selective Mutism: Pilot Study of Mobile Apps and Mechanisms of Behavior
    • Authors: Brian E. Bunnell; Franklin Mesa; Deborah C. Beidel
      Abstract: Publication date: Available online 16 February 2018
      Source:Behavior Therapy
      Author(s): Brian E. Bunnell, Franklin Mesa, Deborah C. Beidel
      Selective mutism (SM) is an anxiety disorder marked by withdrawal of speech in particular social situations. Treatment is often difficult, requiring attention to several characteristics particular to the disorder. Therapeutic tools and activities such as games and mobile applications (apps) may be particularly advantageous to behavioral therapy for SM. A two-session hierarchy for shaping successive approximations of speech in SM was piloted with 15 children, 5 to 17years old, who were randomly assigned to shaping while using mobile apps, other therapeutic tools/activities, and reinforcement alone. Very strong treatment gains were observed – 13 of 15 (88.7%) children completed the hierarchy during the first session and 14 (93.3%) did so during the second session, with the final child completing all but the final step (i.e., to ask and respond to at least five open-ended questions). Moreover, all 15 children spoke to the clinician within 59minutes of treatment (M =17minutes), and 14 (93.3%) children held five, five-minute conversations with additional unknown adults during the second session. This occurred regardless of the inclusion of therapeutic tools/activities, although preliminary patterns of responding were observed such that children shaped while using mobile apps tended to show less self-reported and physiologically measured anxious distress. The utility of therapeutic activities and mobile apps when treating SM is discussed as well as areas for future research.

      PubDate: 2018-02-26T04:02:17Z
      DOI: 10.1016/j.beth.2018.02.003
  • Behavioral versus Nonbehavioral Guided Self-Help for Parents of Children
           with Externalizing Disorders in a Randomized Controlled Trial
    • Authors: Christopher Hautmann; Christina Dose; Karin Duda-Kirchhof; Lisa Greimel; Martin Hellmich; Stephanie Imort; Josepha Katzmann; Julia Pinior; Kristin Scholz; Stephanie Schürmann; Tanja Wolff Metternich-Kaizman; Manfred Döpfner
      Abstract: Publication date: Available online 13 February 2018
      Source:Behavior Therapy
      Author(s): Christopher Hautmann, Christina Dose, Karin Duda-Kirchhof, Lisa Greimel, Martin Hellmich, Stephanie Imort, Josepha Katzmann, Julia Pinior, Kristin Scholz, Stephanie Schürmann, Tanja Wolff Metternich-Kaizman, Manfred Döpfner
      Self-help interventions for parents, which have a behavioral basis, are considered to be an effective treatment option for children with externalizing disorders. Nonbehavioral approaches are widely used but have little empirical evidence. The main objective of this trial was to compare the efficacy of a behavioral and a nonbehavioral guided self-help program for parents. Families of children (aged 4–11years) diagnosed with attention-deficit/hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD) were randomized to either a behavioral or a nonbehavioral guided self-help program including eight parenting booklets and ten counseling telephone calls. The analyses considered the ratings of five informants: blinded clinician, therapist, participant, (her or his) partner, and teacher. Of the 149 families randomized to treatment (intention-to-treat sample [ITT]), 110 parents completed the intervention (per-protocol sample [PP]). For the four primary outcome measures (blinded clinician- and participant-rated ADHD and ODD) at post-assessment, the analysis revealed a treatment advantage for the behavioral group in blinded clinician-rated ODD symptoms (ITT: d =0.37; PP: d =0.35). Further treatment differences, all in favor of the behavioral group (ITT and PP), were detected in therapist ratings (i.e., ODD) and participant ratings (e.g., parental self-efficacy [only PP], negative parenting behavior, parental stress). In both samples, no differences were found at post-assessment for ratings of the partner and the teacher, or at the 12-month follow-up (only participant ratings available). Behavioral guided self-help shows some treatment advantage in the short term. No superiority over nonbehavioral therapy was detected 12months after treatment termination.

      PubDate: 2018-02-15T03:39:12Z
      DOI: 10.1016/j.beth.2018.02.002
  • Predictors and Outcomes of Sudden Gains and Sudden Regressions in
           Cognitive Behavioral Therapy for Youth Anxiety
    • Authors: Phoebe H. Durland; Christopher M. Wyszynski; Brian C. Chu
      Abstract: Publication date: Available online 2 February 2018
      Source:Behavior Therapy
      Author(s): Phoebe H. Durland, Christopher M. Wyszynski, Brian C. Chu
      Sudden gains (SGs), referring to large, stable symptom improvement occurring between consecutive treatment sessions, have been associated with improved outcomes among adults with various psychological disorders. Little research exists on SGs or sudden symptom worsening (i.e., sudden regressions [SRs]) during treatment for youth disorders. The current study examined predictors and outcomes of SGs/SRs via multiple informants in youth anxiety treatment. Participants were 118 youth (age M =11.6, SD =2.5; 53.8% female) and their caregivers receiving a CBT protocol for a principal anxiety disorder. Anxiety symptom severity was assessed weekly via the State–Trait Anxiety Inventory for Children–Trait–Child/Parent versions. SGs and SRs occurred in 45.8% and 31.3% of youth, respectively. SRs were more common among youth with comorbid mood or externalizing disorders, while SGs occurred more often among youth with greater pre-treatment anxiety symptom severity. SGs were not associated with post-treatment outcomes, but SRs predicted significantly higher post-treatment internalizing symptoms based on child report (β =.23, p =.03) and externalizing symptoms based on child (β =.15, p =.04) and parent report (β =.16, p =.03), controlling for overall magnitude of symptom change. SRs among youth receiving CBT for anxiety are associated with pre-treatment clinical complexity and poorer post-treatment outcomes and may serve as a warning sign to clinicians of possible treatment failure.

      PubDate: 2018-02-05T03:02:53Z
      DOI: 10.1016/j.beth.2018.01.006
  • Changes in Decentering across Cognitive Behavioral Group Therapy for
           Social Anxiety Disorder
    • Authors: Sarah A. Hayes-Skelton; Carol S. Lee
      Abstract: Publication date: Available online 31 January 2018
      Source:Behavior Therapy
      Author(s): Sarah A. Hayes-Skelton, Carol S. Lee
      To further improve treatments, we need to better understand potential common treatment mechanisms, such as decentering, or the ability to observe thoughts and feelings as objective events in the mind rather than personally identifying with them (Safran & Segal, 1990). Therefore, this study examined whether 12-sessions of Cognitive Behavioral Group Therapy for 81 clients (57.6% female, 50.8% White) diagnosed with social anxiety disorder led to increases in decentering and whether increased decentering was associated with improved outcome. Furthermore, this study examined whether decentering was associated with outcome over and above a competing mechanism - cognitive reappraisal. Overall, results indicated that CBGT in this study led to similar outcomes compared to previous studies and decentering increased over CBGT (d’s from 0.81 to 2.23). Change in decentering predicted improvement on most, but not all measures of outcome and those who no longer met criteria for social anxiety disorder at post-treatment had significantly greater change in decentering across therapy and significantly higher decentering scores at post-treatment compared to those who retained a social anxiety disorder diagnosis at post-treatment. Finally, changes in decentering predicted outcome over and above change reappraisal on all outcome measures. These results largely support the role of decentering in CBGT for social anxiety; however, the implications of the inconsistencies in results based on which outcome measure was used are discussed.

      PubDate: 2018-02-05T03:02:53Z
      DOI: 10.1016/j.beth.2018.01.005
  • Comparing Alliance in Two Cognitive-Behavioural Therapies for Adolescents
           with ADHD using a Randomized Controlled Trial
    • Authors: Bianca Boyer; Kelsey J. MacKay; Bryce D. McLeod; Saskia van der Oord
      Abstract: Publication date: Available online 31 January 2018
      Source:Behavior Therapy
      Author(s): B. Boyer, K.J. MacKay, B.D. McLeod, S. Van Der Oord
      Alliance is defined as the client-therapist bond and their ability to collaborate on therapeutic activities. Treatment for adolescents with ADHD is rarely studied in terms of alliance. In this study, two cognitive-behavioral treatments (CBT; one structured treatment aimed at planning skills and one less-structured solution focused treatment both delivered in the style of Motivational Interviewing) were compared with regard to alliance and alliance-outcome association. The influence of therapist competence on this alliance-outcome association was also evaluated. The alliance between 69 adolescents diagnosed with ADHD and their therapists was measured early in treatment, using the Therapy Process Observational Coding System for Child Psychotherapy - Alliance scale. Observer-rated therapist competence was measured using the Motivational Interviewing Treatment Integrity scale (version 3.1.1.). Outcome variables were the adolescents’ reduction in Planning problems and ADHD symptoms. The alliance, and more specifically collaboration on therapeutic activities, was significantly higher for the more structured CBT (p =.04; moderate effect size). Alliance was not related to outcome in the more structured CBT, whilst the alliance was positively related to the reduction in planning problems in the less structured CBT. Finally, alliance was a significant mediator between therapist competence and treatment outcome for the less-structured CBT. The clarity and structure of CBT may help facilitate alliance formation for adolescents with ADHD who often have difficulty implementing structure themselves. Therapists may need to invest more in alliance formation in less structured CBT as the alliance affects outcome. Moreover, enhancing therapist competence in less structured CBT may help improve outcomes in less structured CBT, as therapist competence may impact outcome through alliance.

      PubDate: 2018-02-05T03:02:53Z
      DOI: 10.1016/j.beth.2018.01.003
  • A Cross-Lagged Panel Approach to Understanding Social Support and Chronic
           Posttraumatic Stress Disorder Symptoms in Veterans: Assessment Modality
    • Authors: Matthew J. Woodward; Sandra B. Morissette; Nathan A. Kimbrel; Eric C. Meyer; Bryann B. DeBeer; Suzy B. Gulliver; J. Gayle Beck
      Abstract: Publication date: Available online 31 January 2018
      Source:Behavior Therapy
      Author(s): Matthew J. Woodward, Sandra B. Morissette, Nathan A. Kimbrel, Eric C. Meyer, Bryann B. DeBeer, Suzy B. Gulliver, J. Gayle Beck
      Although there is a strong and consistent association between social support and posttraumatic stress disorder (PTSD), the directionality of this association has been debated, with some research indicating that social support protects against PTSD symptoms, whereas other research suggests that PTSD symptoms erode social support. The majority of studies in the literature have been cross-sectional, rendering directionality impossible to determine. Cross-lagged panel models overcome many previous limitations; however, findings from the few studies employing these designs have been mixed, possibly due to methodological differences including self-report versus clinician-administered assessment. The current study used a cross-lagged panel structural equation model to explore the relationship between social support and chronic PTSD symptoms over a one-year period in a sample of 264 Iraq and Afghanistan Veterans assessed several years after trauma exposure. Approximately a third of the sample met criteria for PTSD at the baseline assessment, with veterans’ trauma occurring an average of six years prior to baseline. Two separate models were run, with one using PTSD symptoms assessed via self-report and the other using clinician-assessed PTSD symptoms. Excellent model fit was found for both models. Results indicated that the relationship between social support and PTSD symptoms was affected by assessment modality. Whereas the self-report model indicated a bidirectional relationship between social support and PTSD symptoms over time, the clinician assessed model indicated only that baseline PTSD symptoms predicted social support one year later. Results highlight that assessment modality is one factor that likely impacts disparate findings across previous studies. Theoretical and clinical implications of these findings are discussed, with suggestions for the growing body of literature utilizing these designs to dismantle this complex association.

      PubDate: 2018-02-05T03:02:53Z
      DOI: 10.1016/j.beth.2018.01.004
  • Group CBT for externalizing disorders in urban schools: Effect of training
           strategy on treatment fidelity and child outcomes
    • Authors: Ricardo Eiraldi; Jennifer A. Mautone; Muniya S. Khanna; Thomas J. Power; Andrew Orapallo; Jaclyn Cacia; Billie S. Schwartz; Barry McCurdy; Jacqueline Keiffer; Cynthia Paidipati; Rebecca Kanine; Manju Abraham; Shelby Tulio; Lauren Swift; Shannon N. Bressler; Beatriz Cabello; Abbas F. Jawad
      Abstract: Publication date: Available online 6 January 2018
      Source:Behavior Therapy
      Author(s): Ricardo Eiraldi, Jennifer A. Mautone, Muniya S. Khanna, Thomas J. Power, Andrew Orapallo, Jaclyn Cacia, Billie S. Schwartz, Barry McCurdy, Jacqueline Keiffer, Cynthia Paidipati, Rebecca Kanine, Manju Abraham, Shelby Tulio, Lauren Swift, Shannon N. Bressler, Beatriz Cabello, Abbas F. Jawad
      Public schools are an ideal setting for the delivery of mental health services to children. Unfortunately, services provided in schools, and more so in urban schools, have been found to lead to little or no significant clinical improvements. Studies with urban school children seldom report on the effects of clinician training on treatment fidelity and child outcomes. This study examines the differential effects of two levels of school-based counselor training: Training workshop with basic consultation (C) vs. Training workshop plus enhanced consultation (C+) on treatment fidelity and child outcomes. Fourteen school staff members (counselors) were randomly assigned to C or C+. Counselors implemented a group cognitive behavioral therapy protocol (Coping Power Program, CPP) for children with or at risk for externalizing behavior disorders. Independent coders coded each CPP session for content and process fidelity. Changes in outcomes from pre- to post- were assessed via a parent psychiatric interview and interviewer-rated severity of illness and global impairment. Counselors in C+ delivered CPP with significantly higher levels of content and process fidelity compared to counselors in C. Both C and C+ resulted in significant improvement in interviewer-rated impairment; the conditions did not differ from each other with regard to impairment. Groups did not differ with regard to pre- to- post-treatment changes in diagnostic severity level. School-based behavioral health staff in urban schools are able to implement interventions with fidelity and clinical effectiveness when provided with ongoing consultation. Enhanced consultation resulted in higher fidelity. Enhanced consultation did not result in better student outcomes compared to basic consultation. Implications for resource allocation decisions with staff training in EBP are discussed.

      PubDate: 2018-01-16T02:38:03Z
      DOI: 10.1016/j.beth.2018.01.001
  • Combined Audience and Video Feedback with Cognitive Review Improves State
           Anxiety and Self-perceptions during Speech Tasks in Socially Anxious
    • Authors: Junwen Chen; Jordan E. McLean; Eva Kemps
      Abstract: Publication date: Available online 5 December 2017
      Source:Behavior Therapy
      Author(s): Junwen Chen, Jordan E. McLean, Eva Kemps
      This study investigated the effects of combined audience feedback with video feedback plus cognitive preparation, and cognitive review (enabling deeper processing of feedback) on state anxiety and self-perceptions including perception of performance and perceived probability of negative evaluation in socially anxious individuals during a speech performance. One hundred and forty socially anxious students were randomly assigned to four conditions, namely Cognitive Preparation + Video Feedback + Audience Feedback + Cognitive Review (CP+VF+AF+CR), Cognitive Preparation + Video Feedback + Cognitive Review (CP+VF+CR), Cognitive Preparation + Video Feedback only (CP+VF), and Control. They were asked to deliver two impromptu speeches that were evaluated by confederates. Participants’ levels of anxiety and self-perceptions pertaining to the speech task were assessed before and after feedback, and after the second speech. Compared to participants in the other conditions, participants in the CP+VF+AF+CR condition reported a significant decrease in their state anxiety and perceived probability of negative evaluation scores, and a significant increase in their positive perception of speech performance from before to after the feedback. These effects generalised to the second speech. Our results suggest that adding audience feedback to video feedback plus cognitive preparation and cognitive review may improve the effects of existing video feedback procedures in reducing anxiety symptoms and distorted self-representations in socially anxious individuals.

      PubDate: 2017-12-12T11:04:59Z
      DOI: 10.1016/j.beth.2017.11.006
  • Can a mediator moderate' Considering the role of time and change in
           the mediator-moderator distinction
    • Authors: Bryan T. Karazsia; Kristoffer S. Berlin
      Abstract: Publication date: Available online 12 October 2017
      Source:Behavior Therapy
      Author(s): Bryan T. Karazsia, Kristoffer S. Berlin
      The concepts of mediation and moderation are important for specifying ways in which psychological treatments work and for whom they are most beneficial. Historically, the terms were confused and used interchangeably, so a rich body of scholarly literature makes clear their distinction. Researchers are also becoming increasingly aware that mediation and moderation can be integrated and that such integration can advance theory development and testing. One question that has not received sufficient attention is whether a mediator can simultaneously moderate. We tackle this question in this paper, and in doing so we expand on the MacArthur conceptualizations of mediation and moderation. The result is a presentation of a meta-theoretical model that illustrates how a construct that is initially a mediator can, not simultaneously but over time, evolve into a construct that moderates. When this occurs, a construct that changed for the better as a result of an intervention can later promote more positive change during a later intervention. Various implications of this novel paradigm for future research are discussed, including the importance of this model in the emerging context of managed healthcare.

      PubDate: 2017-10-14T13:35:06Z
      DOI: 10.1016/j.beth.2017.10.001
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