The role of client choice and target selection in self-management therapy for depression in older adults.

In a study designed to maximize the effectiveness of treatment by allowing participants to select the target of treatment, 40 depressed older adults were randomly assigned to a waiting-list control condition or to conditions in which the target of treatment was either chosen or assigned. All participants received self-management therapy and the choice was between changing behavior or changing cognition. It was found that individually administered self-management therapy was effective in treating depression for older adults. There were no differences in outcome between versions of self-management therapy that targeted behavioral or cognitive change. Among those who completed treatment, there were no differences in outcome between those who received a choice and those who did not. Individuals who were given a choice of treatment options, however, were less likely to drop out of treatment prematurely. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Readiness to adopt a self-management approach to cardiac health: Predicting outcomes from cardiac rehabilitation.

Purpose/Objective: To examine whether initial attitudes toward a self-management approach to cardiac health and early-treatment changes in those attitudes predict outcomes in cardiac rehabilitation. Research Method/Design: One hundred eighteen participants took part in a 12-week Phase II cardiac rehabilitation program. Questionnaires to assess readiness to engage in a self-management approach, mood, activity level, and diet were completed at pretreatment and at Weeks 3, 6, 9, and 12. Results: Repeated-measures regressions showed that participants with higher pretreatment levels of readiness to engage in a self-management approach showed more pronounced improvements in mood, activity level, and diet than did those with lower levels of readiness. Those who reported significant shifts in self-management attitudes during the first 3 weeks of the program finished treatment with greater improvements on measures of mood, cardiorespiratory fitness, activity level, and weight than did participants who reported smaller shifts. Conclusions/Implications: Results suggest that pretreatment acceptance of a self-management orientation, as well as early shifts toward such a stance, predicted treatment gains. This information may be used to improve outcomes from cardiac rehabilitation by intervening to enhance readiness in those that start at low levels or fail to engage in the initial stages of treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Computer-Supported Collaborative Negotiation Methodology

The development of large-scale civil engineering projects requires the collaboration of experts from different specialties. However, conflicts and disputes occur regularly during the entire life cycle of large-scale projects due to the complex structure of organization and the different types of expertise involved. If these disputes or conflicts cannot be resolved or addressed quickly and effectively, the collaborative mode of the participants can be affected, creating a hostile environment in which progress of the project will slow to a halt. Therefore, better methodologies are needed to improve the collaborative process and to create more effective, efficient, and sustainable solutions to conflicts. This paper presents a methodology for facilitating the negotiation of conflicts during the development of large-scale civil engineering projects. Two fundamental theories are used in this methodology: (1) game theory, which is the study of players' actions based on the premise that the decision of any player can affect the payoff of all players; and (2) negotiation theory, which is the study of the interactions between parties, designed to reconcile their differences and produce a settlement. The strong support given by these two theories to negotiators is highlighted in the following observations. First, people need to negotiate because of their conflicting interests. From the negotiator's point of view, expressing the interests of all participants is very important in conflict resolution and can be accomplished by following the principles outlined in negotiation theory. Once the interests have been expressed correctly, the influence of positions or of conflicting interests on the overall negotiation outcome is evaluated using game theory. Based on these two fundamental theories, this paper presents a collaborative negotiation methodology and a computer agent named CONVINCER, which incorporates that methodology to facilitate or mediate the negotiation of conflicts in large-scale civil engineering projects. Hypothetical case studies and resolution processes demonstrate the effectiveness of the CONVINCER agent in conflict resolution. Results of applying the methodology to different scenarios also show that the CONVINCER agent provides efficient, effective, and sustainable solutions, thus improving the conflict resolution paradigm in the A∕E∕C industry.     

The role of processing strategies in the acquisition and transfer of a cognitive skill.

How the difficulty of initial training influences the acquisition and transfer of strategic processing skills and memory for processed stimuli was examined in 3 experiments. Participants were asked to discriminate between similar or dissimilar random polygon stimuli. Participants were asked to discriminate between novel transfer polygons; this was followed by a recognition memory task. Results suggest that the difficulty of initial training influences strategic skill acquisition. Strategies acquired during training are applied at transfer regardless of their effectiveness for processing transfer stimuli. This is true even when participants are given feedback indicating that their processing strategy is ineffective. It is argued that skill acquisition is influenced by the acquisition of both stimulus-specific knowledge and strategic skills, and that the strategic skills acquired serve to optimize processing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hot or cold: Is communicating anger or threats more effective in negotiation?

Is communicating anger or threats more effective in eliciting concessions in negotiation? Recent research has emphasized the effectiveness of anger communication, an emotional strategy. In this article, we argue that anger communication conveys an implied threat, and we document that issuing threats is a more effective negotiation strategy than communicating anger. In 3 computer-mediated negotiation experiments, participants received either angry or threatening messages from a simulated counterpart. Experiment 1 showed that perceptions of threat mediated the effect of anger (vs. a control) on concessions. Experiment 2 showed that (a) threat communication elicited greater concessions than anger communication and (b) poise (being confident and in control of one's own feelings and decisions) ascribed to the counterpart mediated the positive effect of threat compared to anger on concessions. Experiment 3 replicated this positive effect of threat over anger when recipients had an attractive alternative to a negotiated agreement. These findings qualify previous research on anger communication in negotiation. Implications for the understanding of emotion and negotiation are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Toward application of the Therapeutic Workplace: Reply to Higgins (2001), Marlatt (2001), McLellan (2001), and Petry (2001).

Responds to comments by N. M. Petry, S. T. Higgins, A. T. McLellan, and G. A. Marlatt (see records 2001-14365-003, 2001-14365-004, 2001-14365-005, 2001-14365-006 respectively) on the article by K. Silverman et al. (see record 2001-14365-002). The Therapeutic Workplace appears effective at initiating abstinence from heroin and cocaine in pregnant and postpartum women. However, the cost and complexity of the intervention must be reduced before it is ready for widespread application. This treatment is designed to train and employ drug abuse patients, and to use the salary that they earn for working to reinforce abstinence. Limiting teaching to only critical skills can reduce the costs of training. Computerizing the intervention also can reduce its cost and complexity. Major cost efficiencies should be realized when participants become employed in Therapeutic Workplace businesses; these businesses could provide a self-sustaining means of arranging long-term employment and salary-based abstinence reinforcement. Studies are required that simultaneously demonstrate the effectiveness and cost efficiencies of using salary for real work to reinforce drug abstinence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of Practice Conditions and Supplemental Training Method on Cognitive Learning and Interpersonal Skill Generalization

Organizational expenditures for interpersonal-skills training have been rising. However, little is known about the translation of cognitive learning into skilled interpersonal-task performance, or about the mechanisms through which interpersonal skills in one domain generalize to other interpersonal tasks. This study used a 2 x 2 experimental design to examine the effectiveness of neutral versus stressful practice conditions and mastery-versus performance-oriented supplemental training for improving cognitive learning and interpersonal-skill transfer to a novel task. Participants who experienced stressful salary-negotiation practice conditions, followed by mastery-oriented supplemental training, showed greater skill transfer when performing a novel task (i.e., contract negotiations). Results showed that superior cognitive learning (i.e., recall, comprehension, and synthesis) and greater time on task were the mechanisms that supported interpersonal-skill transfer for trainees in the stressful practice/ mastery-oriented training condition when compared with the other experimental groups. Copyright 1998 Academic Press.     

"Self-management of diabetes mellitus: A critical review": Erratum.

Reports an error in the original article by T. A. Goodall and W. K. Halford (Health Psychology, 1991, Vol 10[1], 1–8). On Page 2, the citation to Johnson et al (1986) should be deleted from the following statement: "However, most studies (e.g., Carney, Schechter, & Davis 1983; Christenson et al., 1983; Johnson, Silverstein, Rosenbloom, Carter, & Cunningham, 1986) have operationalized self-management as a single global index of compliance to treatment.' The Johnson et al study used a series of summary measures. (The following abstract of this article originally appeared in record 1991-25029-001.) Reviews the determinants of effective self-management and the methods of promoting better self-management. Demographic variables have been thought to affect self-management, but evidence suggests they have little impact. The important determinants of self-management are transient situational factors such as psychological stress and social support. Interventions to promote better self-management have reported initial improvements in blood glucose control, but the long-term effects are unclear. Self-management has been inadequately assessed and attempts to improve self-management have relied excessively on providing information… (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized trial of a lay person-led self-management group intervention for back pain patients in primary care

STUDY DESIGN: Randomized, controlled trial. OBJECTIVE: To evaluate a four-session self-management group intervention for patients with pain in primary care, led by trained lay persons with back pain. The intervention was designed to reduce patient worries, encourage self-care, and reduce activity limitations. BACKGROUND DATA: Randomized trials of educational interventions suggest that activating interventions may improve back pain outcomes. Expert opinion increasingly regards effective self-management of back pain as important in achieving good outcomes. In this study, an educational intervention designed to activate patients and support effective self-management was evaluated. METHODS: Six to 8 weeks after a primary care visit for back pain, patients were invited to participate in an educational program to improve back pain self-management. Those showing interest by returning a brief questionnaire became eligible for the study. Participants (n = 255) randomly were assigned to either a self-management group intervention or to a usual care control group. The effect of the intervention, relative to usual care, was assessed 3, 6, and 12 months after randomization, controlling for baseline values. The intervention consisted of a four-session group applying problem-solving techniques to back pain self-management, supplemented by educational materials (book and videos) supporting active management of back pain. The groups were led by lay persons trained to implement a fully structured group protocol. The control group received usual care, supplemented by a book on back pain care. RESULTS: Participants randomly assigned to the self-management groups reported significantly less worry about back pain and expressed more confidence in self-care. Roland Disability Questionnaire Scores were significantly lower among participants in the self-management groups relative to the usual care controls at 6 months (P = 0.007), and this difference was sustained at 12 months at borderline significance levels (P = 0.09). Among self-management group participants, 48% showed a 50% or greater reduction in Roland Disability Questionnaire Score at 6 months, compared with 33% among the usual care controls. CONCLUSIONS: Self-management groups led by trained lay persons following a structured protocol were more effective than usual care in reducing worries, producing positive attitudes toward self-care, and reducing activity limitations among patients with back pain in primary care.     

Measuring effects of a skills training intervention for drug abusers.

Examined the effectiveness of a supplemental skills training and social-network-development aftercare program with 130 drug abusers (aged 15–55 yrs) from 4 residential therapeutic communities. The program included training in assertiveness, problem-solving, stress management, and giving and receiving praise; training techniques included group discussion, modeling, role playing and feedback. Pre- and posttesting with a problem situation inventory showed that the intervention produced positive effects on Ss' performance at the conclusion of treatment. Performance improved in situations involving avoidance of drug use, coping with drug relapse, social interaction, interpersonal problem solving, and coping with stress. It is concluded that as a reentry strategy, the supplemental intervention is an effective adjunct to residential treatment. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of Delivery Systems on Collaborative Negotiations for Large-Scale Infrastructure Projects

In large-scale projects, collaboration is an essential key for the success of projects. Since different participants from different organizations try to work together in projects, competitive stresses exist in their relationships and as a result, disputes or conflicts may inevitably occur. This paper builds on Pea-Mora and Wang's collaborative negotiation methodology for facilitating∕mediating the negotiation process of conflicts. In order for that collaborative negotiation methodology to be more detailed for its implementation, it needs to account for the effect of project structures and delivery methods on the negotiation processes in large-scale projects. Because contracts define the temporary formal and informal relationships among the different parties in a project and subsequently, they define the framework of the negotiations of conflicts within that project, different delivery systems may be more or less effective in terms of conflict resolution. In this research, to study the effect of delivery system on negotiation of conflicts, first, several different project structures and delivery systems are studied in order to identify participants' roles, responsibilities, and relationships. Second, potential conflicts in relationships among project participants are examined to show that each delivery system has typical or pattern behavior that may affect the interrelationship among groups on negotiations. These patterns or characteristics of the groups and their relationship make possible to evaluate quantitatively and qualitatively the advantage or disadvantage of each delivery system in terms of conflict avoidance or dispute resolution. Then, indexes of negotiation effectiveness for each delivery system are developed in order to quantify the advantage of implementing the collaborative negotiation methodology in a large-scale project within a particular delivery system.     

Correction to Lehman, Taylor, Kiefe, and Seeman (2009).

Reports an error in "Relationship of early life stress and psychological functioning to blood pressure in the CARDIA study" by Barbara J. Lehman, Shelley E. Taylor, Catarina I. Kiefe and Teresa E. Seeman (Health Psychology, 2009[May], Vol 28[3], 338-346). A URL for supplemental materials was included due to a production error. There are no supplemental materials for this article. (The following abstract of the original article appeared in record 2009-06704-010.) Objective: Low childhood socioeconomic status (CSES) and a harsh early family environment have been linked with health disorders in adulthood. In this study, the authors present a model to help explain these links and relate the model to blood pressure change over a 10-year period in the Coronary Artery Risk Development in Young Adults sample. Design: Participants (N = 2,738) completed measures of childhood family environment, parental education, health behavior, and adult negative emotionality. Main Outcome Measures: These variables were used to predict initial systolic and diastolic blood pressure (SBP and DBP, respectively) and the rate of blood pressure change over 10 years. Results: Structural equation modeling indicated that family environment was related to negative emotions, which in turn predicted baseline DBP and SBP and change in SBP. Parental education directly predicted change in SBP. Although African American participants had higher SBP and DBP and steeper increases over time, multiple group comparisons indicated that the strength of most pathways was similar across race and gender. Conclusion: Low CSES and harsh family environments help to explain variability in cardiovascular risk. Low CSES predicted increased blood pressure over time directly and also indirectly through associations with childhood family environment, negative emotionality, and health behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral intervention to reduce African American adolescents' risk for HIV infection.

Two hundred forty-six African American adolescents were randomly assigned to an educational program or an 8-week intervention that combined education with behavior skills training including correct condom use, sexual assertion, refusal, information provision, self-management, problem solving, and risk recognition. Skill-trained participants (a) reduced unprotected intercourse, (b) increased condom-protected intercourse, and (c) displayed increased behavioral skills to a greater extent than participants who received information alone. The patterns of change differed by gender. Risk reduction was maintained 1 year later for skill-trained youths. It was found that 31.1% of youths in the education program who were abstinent at baseline had initiated sexual activity 1 year later, whereas only 11.5% of skills training participants were sexually active. The results indicate that youths who were equipped with information and specific skills lowered their risk to a greater degree, maintained risk reduction changes better, and deferred the onset of sexual activity to a greater extent than youths who received information alone. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intragroup decision making in intergroup negotiation: Majority/minority effects and hawkishness of member preferences.

Participants took part in an intergroup negotiation. In the first stage participants recorded their individual preferences (i.e., which of several possible options they should strive to achieve during the negotiation) for each negotiation issue. In the second stage they repeated this process as part of a 3-person cooperative group in preparation for the negotiation task. Our results show that the decision aggregation of negotiation teams is driven by 2 factors: The majority/minority status of the members advocating a given option and the extent to which the option advocated by a member was more hawkish (i.e., advantageous to the ingroup) than that of fellow members. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Teaching secondary students with learning disabilities to self-manage classroom survival skills

This multiple baseline study investigated the effectiveness of a cognitive-behavioral self-management training package on the consistent use of specific classroom survival skills. Participants were three adolescent males with learning disabilities in Grades 7 and 8. The training package involved a multicomponent strategy focused on the improvement, maintenance, and cross-classroom generalization of targeted classroom preparedness skills. Following intervention, the training procedures were systematically faded. Results demonstrated more consistent use of targeted classroom survival skills by all three students in both learning support and mainstream generalization settings. Long-term maintenance of the intervention effects was observed for two students in both settings. Three social validity measures revealed positive results. Implications for self-management in secondary education settings are discussed.     

The effect of stress inoculation training on anxiety and performance.

Conducted a meta-analysis to determine the overall effectiveness of of stress inoculation training and to identify conditions that may moderate the effectiveness of this approach. The analysis was based on a total of 37 studies with 70 separate hypothesis tests, representing the behavior of 1,837 participants. Results indicate that stress inoculation training was an effective means for reducing performance anxiety, reducing state anxiety, and enhancing performance under stress. The examination of moderators such as the experience of the trainer, the type of setting in which training was implemented, and the type of trainee population revealed no significant limitations on the application of stress inoculation training to applied training environments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of social modeling, cognitive structuring, and self-management strategies on affective self-disclosure.

Assessed immediate and delayed effects of social modeling, cognitive structuring, and 2 self-management strategies for increasing affective self-disclosure in 48 undergraduate males. Ss were randomly assigned to (a) social modeling, (b) cognitive structuring, (c) attention placebo, or (d) no-training control groups. Following training, Ss took a performance test and 2 pencil-and-paper measures. With this treatment used as a blocking variable, Ss were then randomly assigned to (a) goal-directed behavior, (b) self-reinforcement, or (c) no-training control groups. A delayed posttest was administered 3 wks later. Results indicate that social modeling and cognitive structuring had immediate effects on affective self-disclosure. Also, a combination of social learning and self-management strategies was more effective over time than any single treatment or no treatment at all. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral intervention to reduce AIDS risk activities.

Behavior change can curtail the spread of acquired immune deficiency syndrome (AIDS). In this study, 104 gay men with a history of frequent AIDS high-risk behavior completed self-report, self-monitoring, and behavioral measures related to AIDS risk. The sample was randomly divided into experimental and waiting-list control groups. The experimental intervention provided AIDS risk education, cognitive-behavioral self-management training, sexual assertion training, and attention to the development of steady and self-affirming social supports. Experimental group participants greatly reduced their frequency of high-risk sexual practices and increased behavioral skills for refusing sexual coercions, AIDS risk knowledge, and adoption of "safer sex" practices. Change was maintained at the 8-month follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The treatment of insomnia through mass media, the results of a televised behavioral training programme

An important trend in behavioral medicine is a psycho-educational approach to health problems. A training course aimed at the treatment of sleep disorders has been developed using the following basic principles: (1) a symptomatic approach, (2) emphasis on information on sleep and sleep disorders, (3) self-management, and (4) interventions based on behaviour therapeutic principles that are further developed for the treatment of sleep disorders. Because the results of courses used in primary health care were encouraging, a similar training course of eight programmes was broadcasted by the Dutch educational radio and television station Teleac. About 200,000 people viewed the course, 23,000 of whom ordered the course material. The results of the training course were assessed from a sample (N = 325) by means of a sleep diary in a pre-test, post-test and a follow-up condition. In addition, several questionnaires were used to collect information on personality factors and on physical and psychological complaints. The training produced an estimated decrease in sleep latency of 25 minutes. The duration of sleep increased by nearly 40 minutes. Of the people using hypnotic drugs 40% ceased their use after the course. The training course broadcasted by Teleac is found to be an effective means of improving sleeping behaviour. The results of the course are comparable with interventions that use direct therapist-client contact, suggesting that the presence of a therapist in this approach may not be of crucial importance. The decrease in the use of hypnotics makes the approach cost-effective.     

Spontaneous immunoglobulin-producing capacity of cultures from lupus patients and normal donors following depletion of cells expressing CD19 or CD38

The adult "credit card" asthma self-management plan has been shown to be an effective and acceptable system for reducing asthma morbidity when introduced as part of a 6 month community-based asthma programme. The aim of the present study was to assess the effectiveness of the credit card plan 2 yrs after the end of the programme. Markers of asthma morbidity and use of medical services were compared during the 12 months before enrolment, and 2 yrs after completing the 6 month asthma programme. Of the 69 participants who originally enroled in the 6 month asthma programme, 58 were surveyed 2 yrs after completion of the programme. These participants showed a significant improvement in all but one of the asthma morbidity measures. The proportion waking most nights with asthma in the previous 12 months decreased from 29 to 9% (p=0.02), emergency visits to a general practitioner decreased from 43 to 16% (p=0.001), hospital emergency department visits with asthma decreased from 19 to 5% (p=0.02) and hospital admissions decreased from 17 to 5% (p=0.04). Only 24% of patients reported that they usually monitored their peak flow rate daily, but this increased to 73% during a "bad" attack of asthma. A long-term reduction in asthma morbidity and requirement for acute medical services can result following the introduction of the adult credit card asthma self-management plan. Adult patients with asthma are most likely to undertake peak flow monitoring preferentially during periods of unstable asthma, rather than routinely during periods of good control.