Applied tension and blood donation symptoms: The importance of anxiety reduction.

Objective: Despite being a voluntary activity, many blood donors experience anxiety, and fainting (syncope) is not unusual. The muscle-tensing technique applied tension (AT) has been found to be effective in reducing vasovagal symptoms and syncope. A series of studies was developed to investigate the role of AT on anxiety and fainting. Methods: The mechanisms of AT were examined in the laboratory and the blood donor clinic. In Study 1, 70 participants were assigned randomly to either a control group or an experimental group who learned AT before watching a video depicting blood draws. In Study 2, 667 volunteer blood donors completed similar questionnaires. Results: In Study 1, a significant Condition × Sex × Needle Fear interaction, F(1, 59)=4.97, p=.03, indicated that AT reduced vasovagal symptoms in higher-fear women. Study 2 also found a significant Condition × Sex × Needle Fear effect on vasovagal symptoms, F(2, 653)=3.95, p=.02, indicating that AT reduced symptoms but primarily among women with more pronounced fear of needles. Conclusions: Analysis of the physiological data and self-reported anxiety supports the conclusion that the reduction in vasovagal symptoms was due more to decreased anxiety rather than exercise-related cardiovascular change. These results suggest that AT may provide a useful means of coping with invasive medical procedures in part by reducing anxiety. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The prevention of depressive symptoms in rural school children: A randomized controlled trial.

A controlled trial was conducted to evaluate a prevention program aimed at reducing depressive and anxious symptoms in rural school children. Seventh-grade children with elevated depression were selected. Nine primary schools (n=90) were randomly assigned to receive the program, and 9 control schools (n=99) received their usual health education classes. Children completed questionnaires on depression, anxiety, explanatory style, and social skills. Parents completed the Child Behavior Checklist (T. M. Achenbach, 1991). No intervention effects were found for depression. Intervention group children reported less anxiety than the control group after the program and at 6-month follow-up and more optimistic explanations at postintervention. Intervention group parents reported fewer child internalizing and externalizing symptoms at postintervention only. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preventing perinatal depression in low-income home visiting clients: A randomized controlled trial.

Objective: To assess the efficacy of a 6-week cognitive-behavioral intervention in preventing the onset of perinatal depression and reducing depressive symptoms among low-income women in home visitation programs. Method: Sixty-one women who were pregnant or who had a child less than 6 months of age and who were assessed as at risk for perinatal depression were randomized to a 6-week, group-based cognitive-behavioral intervention or usual home visiting services. Study participants were predominately African American, unmarried, and unemployed. Intervention sessions were led by a licensed clinical social worker or clinical psychologist. Home visitors provided 1-on-1 reinforcement of key intervention messages between group sessions. Depressive symptoms were measured with the Beck Depression Inventory–II (Beck, Steer, & Brown, 1996), and major depressive episodes were measured with the Maternal Mood Screener (MMS; Le & Mu?oz, 1998). Outcomes were assessed at baseline and at 1 week and 3 months postintervention. Results: Repeated measures analysis of variance indicated that there was a significant Time × Condition interaction, F(2, 112) = 4.1, p = .02. At 3 months postintervention, 9 of 27 (33%) women receiving usual care reported levels of depressive symptoms that met clinical cutoff for depression on the MMS compared with 3 of 32 (9%) women in the intervention condition, χ2(1, N = 59) = 5.18, p     

Asking questions changes behavior: Mere measurement effects on frequency of blood donation.

Objective: This research examined the impact of completing a questionnaire about blood donation on subsequent donation behavior among a large sample of experienced blood donors. Design: Participants (N = 4672) were randomly assigned to an experimental condition that received a postal questionnaire measuring cognitions about donation or a control condition that did not receive a questionnaire. Main Outcome Measures: Number of registrations at blood drives and number of successful blood donations were assessed using objective records both 6 months and 12 months later. Results: Findings indicated that, compared to control participants, the mean frequency of number of registrations at blood drives among participants in the experimental group was 8.6% greater at 6 months (p     

Prevention of depressive symptoms in adolescents: A randomized trial of cognitive-behavioral and interpersonal prevention programs.

This study evaluated the efficacy of 2 programs for preventing depressive symptoms in adolescents. Participants were 380 high school students randomly assigned to a cognitive-behavioral program (CB), an interpersonal psychotherapy-adolescent skills training program (IPT-AST), or a no-intervention control. The interventions involved eight 90-min weekly sessions run in small groups during wellness classes. At postintervention, students in both the CB and IPT-AST groups reported significantly lower levels of depressive symptoms than did those in the no-intervention group, controlling for baseline depression scores; the 2 intervention groups did not differ significantly from each other. The effect sizes, using Cohen's d, for the CB intervention and the IPT-AST intervention were 0.37 and 0.26, respectively. Differences between control and intervention groups were largest for adolescents with high levels of depressive symptoms at baseline. For a high-risk subgroup, defined as having scored in the top 25th percentile on the baseline depression measure, the effect sizes for the CB and the IPT-AST interventions were 0.89 and 0.84, respectively. For the whole sample, sociotropy and achievement orientation moderated the effect of the interventions. Intervention effects were short term and were not maintained at 6-month follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized clinical trial of a brief, mailed intervention for symptoms of depression.

This research evaluated the efficacy of a brief, mailed personalized feedback intervention designed to alleviate depressed mood and antecedents (ineffective coping and hopelessness). College students (N = 177) were randomly assigned to intervention or control group following a baseline assessment. A week after completing the baseline assessment, participants in the intervention condition were mailed feedback and information detailing their mood, coping strategies, as well as suggestions for enhancing mood. Results indicated that feedback was effective in reducing depressive symptoms, hopelessness, and among men, increasing willingness to use coping strategies at the 1-month follow-up. Hopelessness mediated reductions in depressive symptoms. Results support the use of personalized feedback as a low-cost, initial intervention for college students suffering from symptoms of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Testing mediators of intervention effects in randomized controlled trials: An evaluation of two eating disorder prevention programs.

The authors investigated mediators hypothesized to account for the effects of 2 eating disorder prevention programs using data from 355 adolescent girls who were randomized to a dissonance or a healthy weight intervention or an active control condition. The dissonance intervention produced significant reductions in outcomes (body dissatisfaction, dieting, negative affect, bulimic symptoms) and the mediator (thin-ideal internalization), change in the mediator correlated with change in outcomes and usually occurred before change in outcomes, and intervention effects became significantly weaker when change in the mediator was partialed, providing support for the hypothesized mediators and this new approach to testing mediation in randomized trials. Findings provide somewhat less support for the hypothesis that change in healthy eating and exercise would mediate the healthy weight intervention effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of observation and gender on psychogenic symptoms.

Objective: To assess the effects of modeling and its interaction with gender in the production of psychogenic symptoms. Design: Healthy volunteers were asked to inhale an inert substance described as a suspected environmental toxin that had been reported to provoke 4 physical symptoms. Subsequently, half of the participants observed a confederate inhale and display the 4 expected symptoms. To control for the general tendency of women to report more physical symptoms than men, participants were also asked to rate the presence of 4 unexpected symptoms. Main Outcome Measures: Symptom ratings at 10-min intervals over a 1-hr period. Results: With unexpected symptoms controlled, observation of symptom displays increased reports of expected symptoms significantly. In addition, the presence of another person of the same gender as the participant increased the production of expected symptoms, even when symptoms were not modeled by the confederate. There was also a trend for women to show more expected symptoms than men. Conclusion: Although the effect of modeling was independent of gender, the mere presence of a same-gender individual, as opposed to a person of the opposite gender, increased reports of expected symptoms, regardless of whether the second person (i.e., the confederate) displayed symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The ecological effects of universal and selective violence prevention programs for middle school students: A randomized trial.

This study reports the findings of a multisite randomized trial evaluating the separate and combined effects of 2 school-based approaches to reduce violence among early adolescents. A total of 37 schools at 4 sites were randomized to 4 conditions: (1) a universal intervention that involved implementing a student curriculum and teacher training with 6th-grade students and teachers, (2) a selective intervention in which a family intervention was implemented with a subset of 6th-grade students exhibiting high levels of aggression and social influence, (3) a combined intervention condition, and (4) a no-intervention control condition. Analyses of multiple waves of data from 2 cohorts of students at each school (N = 5,581) within the grade targeted by the interventions revealed a complex pattern. There was some evidence to suggest that the universal intervention was associated with increases in aggression and reductions in victimization; however, these effects were moderated by preintervention risk. In contrast, the selective intervention was associated with decreases in aggression but no changes in victimization. These findings have important implications for efforts to develop effective violence prevention programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized trial of skin cancer prevention in aquatics settings: The pool cool program.

Skin cancer is increasing, and prevention programs are essential. This study evaluated the impact of a skin cancer prevention program on sun-protection habits and swimming pool environments. The intervention included staff training; sun-safety lessons; interactive activities; providing sunscreen, shade, and signage; and promoting sun-safe environments. A randomized trial at 28 swimming pools in Hawaii and Massachusetts tested the efficacy of this program (Pool Cool) compared with an attention-matched injury-prevention control program. Results showed significant positive changes in children's use of sunscreen and shade, overall sun-protection habits, and number of sunburns and improvements in parents' hat use, sun-protection habits, and reported sun-protection policies and environments. Observations corroborated the positive findings. Pool Cool had significant positive effects at swimming pools in diverse audiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Worksite intervention effects on sleep quality: A randomized controlled trial.

Employees with sleep disturbance are at increased risk of disease. Exercise is believed to be effective for improving sleep quality, but few studies have been conducted. This study investigated the effects of a 24-week worksite exercise/behavioral intervention on self-rated sleep quality, via the Pittsburgh Sleep Quality Index (PSQI), in 73 employees. Greater post-test improvements in the PSQI (-2.0 ± 2.6 vs. -1.3 ± 2.7 points, p = .006, and -16 ± 61 vs. -1 ± 76%, p = .02) were found in treatment versus controls, and in women versus men (by -2.7 points [-5.0 to -0.3 points, p = .03], and by -72% [-142 to -2%, p = .04]). Similar results were found in the shift worker subgroup. Changes in sleep scores were not significantly related to baseline characteristics, changes in psychological health or quality-of-life scores, or level of exercise compliance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attention training in individuals with generalized social phobia: A randomized controlled trial.

The authors conducted a randomized, double-blind placebo-controlled trial to examine the efficacy of an attention training procedure in reducing symptoms of social anxiety in 44 individuals diagnosed with generalized social phobia (GSP). Attention training comprised a probe detection task in which pictures of faces with either a threatening or neutral emotional expression cued different locations on the computer screen. In the attention modification program (AMP), participants responded to a probe that always followed neutral faces when paired with a threatening face, thereby directing attention away from threat. In the attention control condition (ACC), the probe appeared with equal frequency in the position of the threatening and neutral faces. Results revealed that the AMP facilitated attention disengagement from threat from pre- to postassessment and reduced clinician- and self-reported symptoms of social anxiety relative to the ACC. The percentage of participants no longer meeting Diagnostic and Statistical Manual (4th ed.) criteria for GSP at postassessment was 50% in the AMP and 14% in the ACC. Symptom reduction in the AMP group was maintained during 4-month follow-up assessment. These results suggest that computerized attention training procedures may be beneficial for treating social phobia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The YouthMood Project: A cluster randomized controlled trial of an online cognitive behavioral program with adolescents.

The aim in the current study was to investigate the effectiveness of an online, self-directed cognitive–behavioral therapy program (MoodGYM) in preventing and reducing the symptoms of anxiety and depression in an adolescent school-based population. A cluster randomized controlled trial was conducted with 30 schools (N = 1,477) from across Australia, with each school randomly allocated to the intervention or wait-list control condition. At postintervention and 6-month follow-up, participants in the intervention condition had significantly lower levels of anxiety than did participants in the wait-list control condition (Cohen’s d = 0.15–0.25). The effects of the MoodGYM program on depressive symptoms were less strong, with only male participants in the intervention condition exhibiting significant reductions in depressive symptoms at postintervention and 6-month follow-up (Cohen’s d = 0.27–0.43). Although small to moderate, the effects obtained in the current study provide support for the utility of universal prevention programs in schools. The effectiveness of booster sessions should be explored in future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Efficacy of web-based personalized normative feedback: A two-year randomized controlled trial.

Objective: Web-based brief alcohol interventions have the potential to reach a large number of individuals at low cost; however, few controlled evaluations have been conducted to date. The present study was designed to evaluate the efficacy of gender-specific versus gender-nonspecific personalized normative feedback (PNF) with single versus biannual administration in a 2-year randomized controlled trial targeting a large sample of heavy-drinking college students. Method: Participants included 818 freshmen (57.6% women; 42% non-Caucasian) who reported 1 or more heavy-drinking episodes in the previous month at baseline. Participants were randomly assigned in a 2 (gender-specific vs. gender-nonspecific PNF) × 2 (single vs. biannual administration of PNF) + 1 (attention control) design. Assessments occurred every 6 months for a 2-year period. Results: Results from hierarchical generalized linear models provided modest effects on weekly drinking and alcohol-related problems but not on heavy episodic drinking. Relative to control, gender-specific biannual PNF was associated with reductions over time in weekly drinking (d = ?0.16, 95% CI [?0.02, ?0.31]), and this effect was partially mediated by changes in perceived norms. For women, but not men, gender-specific biannual PNF was associated with reductions over time in alcohol-related problems relative to control (d = ?0.29, 95% CI [?0.15, ?0.58]). Few other effects were evident. Conclusions: The present research provides modest support for the use of biannually administered web-based gender-specific PNF as an alternative to more costly indicated prevention strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of expressive writing following first myocardial infarction: A randomized controlled trial.

Objective: To assess the effects of expressive writing on health care utilization, clinical variables and subjective quality of life following first myocardial infarction (MI). Methods: One-hundred and seventy-nine first MI patients were randomized to Intervention (N = 88) or Control (N = 91) groups. The intervention group wrote about their thoughts and feelings in relation to having had an MI. Controls wrote in a neutral way about daily activities. The main outcome measures were health care utilization, physical status and subjective quality of life (QOL), assessed after one, two, and five months. Results: One-hundred and fifty-six (87%) completed the study. Five months post-intervention, the intervention group had significantly fewer recorded medical appointments compared to controls. The number of prescribed medicines decreased over time within the intervention group but increased within the control group. The intervention group attended significantly more rehabilitation sessions, reported fewer cardiac related symptoms and had lower diastolic blood pressure five months post-intervention. There was no significant group by time interaction on reported physical health. The group by time interaction on reported mental health approached significance, those in the intervention group reporting greater improvement. Conclusion: Expressive writing may be a beneficial strategy which could be incorporated into rehabilitation interventions to help individuals adjust after first MI. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Cognitive therapy versus exposure and applied relaxation in social phobia: A randomized controlled trial.

A new cognitive therapy (CT) program was compared with an established behavioral treatment. Sixty-two patients meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria for social phobia were randomly assigned to CT, exposure plus applied relaxation (EXP = AR), or wait-list (WAIT). CT and EXP = AR were superior to WAIT on all measures. On measures of social phobia, CT led to greater improvement than did EXP = AR. Percentages of patients who no longer met diagnostic criteria for social phobia at posttreatment-wait were as follows: 84% in CT, 42% in EXP = AR, and 0% in WAIT. At the 1-year follow-up, differences in outcome persisted. In addition, patients in EXP = AR were more likely to have sought additional treatment. Therapist effects were small and nonsignificant. CT appears to be superior to EXP = AR in the treatment of social phobia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief motivational interventions for heavy college drinkers: A randomized controlled trial.

In this randomized controlled trial, the authors evaluated brief motivational interventions (BMIs) for at-risk college drinkers. Heavy drinking students (N = 509; 65% women, 35% men) were randomized into 1 of 6 intervention conditions formed by crossing the baseline Timeline Followback (TLFB) interview (present versus absent) and intervention type (basic BMI, BMI enhanced with a decisional balance module, or none). Assessments completed at baseline, 1, 6, and 12 months measured typical and risky drinking as well as drinking-related problems. Relative to controls, the TLFB interview reduced consumption but not problems at 1 month. The basic BMI improved all drinking outcomes beyond the effects of the TLFB interview at 1 month, whereas the enhanced BMI did not. Risk reduction achieved by brief interventions maintained throughout the follow-up year. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interapy: A controlled randomized trial of the standardized treatment of posttraumatic stress through the internet.

Online therapy offers many advantages over face-to-face therapy. Interapy includes psychoeducation, screening, effect measures, and a protocol-driven treatment via the Internet for people suffering from posttraumatic stress. The present article reports the results of a controlled trial on the Internet-driven treatment of posttraumatic stress and grief in a group of people who manifested mild to relatively severe trauma symptoms. Participants in the treatment condition (n=69) improved significantly more than participants in the waiting-list control condition (n=32) on trauma-related symptoms and general psychopathology. The effect sizes were large. On most subscales, more than 50% of the treated participants showed reliable change and clinically significant improvement, with the highest percentages being found for depression and avoidance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peer-facilitated eating disorder prevention: A randomized effectiveness trial of cognitive dissonance and media advocacy.

The authors investigated the effectiveness of 2 interventions in reducing eating disorder risk factors under naturalistic conditions in sororities. On the basis of previous research, the campus sororities chose to implement a semimandatory, 2-session eating disorder prevention program to all new sorority members (N = 90) during sorority orientation. To facilitate evaluation, sororities agreed to random assignment of new members to either a cognitive dissonance or a media advocacy intervention. Undergraduate peer facilitators ran the groups. Although both interventions had an effect, cognitive dissonance generally was superior at 8-month follow-up. Results further support the utility of cognitive dissonance in reducing eating disorder risk factors and suggest that nondoctoral-level leaders can deliver the program. Results also indicate that a semimandatory format does not reduce effectiveness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

School-based prevention of depressive symptoms: A randomized controlled study of the effectiveness and specificity of the penn resiliency program.

The authors investigated the effectiveness and specificity of the Penn Resiliency Program (PRP; J. E. Gillham, L. H. Jaycox, K. J. Reivich, M. E. P. Seligman, & T. Silver, 1990), a cognitive-behavioral depression prevention program. Children (N = 697) from 3 middle schools were randomly assigned to PRP, Control (CON), or the Penn Enhancement Program (PEP; K. J. Reivich, 1996; A. J. Shatté, 1997), an alternate intervention that controls for nonspecific intervention ingredients. Children's depressive symptoms were assessed through 3 years of follow-up. There was no intervention effect on average levels of depressive symptoms in the full sample. Findings varied by school. In 2 schools, PRP significantly reduced depressive symptoms across the follow-up relative to both CON and PEP. In the 3rd school, PRP did not prevent depressive symptoms. The authors discuss the findings in relation to previous research on PRP and the dissemination of prevention programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)