A comparison of weight control and weight control plus body image therapy for obese men and women.

Participants were 65 obese men and women who were randomly assigned to either weight control or weight control plus cognitive–behavioral body image therapy. Both conditions showed clinically significant improvements in body image at posttreatment and 1-year follow-up. Adding body image therapy to weight control did not result in greater psychological improvements and did not result in better maintenance of body image change when participants regained weight after treatment. Weight loss and maintenance were equivalent between groups. Adding body image therapy did not improve or detract from weight loss. Although body image therapy has been shown to be effective in obese persons, it appears that a well-rounded cognitive–behavioral weight control program is effective as well. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral body image therapy for body dysmorphic disorder.

Body dysmorphic disorder (BDD) is a distressing body image disorder that involves excessive preoccupation with physical appearance in a normal appearing person. Prior case reports of behavior therapy were encouraging, but no controlled evaluation of behavior therapy or any other type of treatment had been conducted. In the present study, 54 BDD subjects were randomly assigned to cognitive behavior therapy or no treatment. Patients were treated in small groups for eight 2-hour sessions. Therapy involved modification of intrusive thoughts of body dissatisfaction and overvalued beliefs about physical appearance, exposure to avoided body image situations, and elimination of body checking. Body dysmorphic disorder symptoms were significantly decreased in therapy subjects and the disorder was eliminated in 82% of cases at posttreatment and 77% at follow-up. Overall psychological symptoms and self-esteem also improved in therapy subjects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Unlinking Negative Cognition and Symptoms of Depression: Evidence of a Specific Treatment Effect for Cognitive Therapy.

In this study, the authors examined whether cognitive therapy alters the association between negative cognition and symptoms of depression. Participants were recruited during psychiatric hospitalization for depression. Following discharge, they were randomly assigned to 6 months of outpatient treatment. Treatment consisted of pharmacotherapy either alone or in combination with cognitive therapy and/or family therapy. Following this 6-month treatment period, negative cognition and symptoms of depression were assessed monthly for 1 year. Hierarchical linear modeling indicated that the association between negative cognition and depression during follow-up was weaker for patients randomized to cognitive therapy than for patients who did not receive cognitive therapy. Cognitive therapy appeared to unlink negative cognition and symptoms of depression to a greater extent than other forms of treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Problem-solving strategies in reflective and impulsive children.

87 reflective and 86 impulsive 7-, 9-, and 11-yr-old children (determined by Matching Familiar Figures Test scores) were given a series of 5 problem-solving tasks in which they were required to determine the correct solution from a number of equiprobable solutions by gathering information that eliminated incorrect alternatives. Results indicate that the relative impact of cognitive style on problem solving varied with developmental level and the type of problem that was solved. Cognitive style had the greatest impact on the performance and strategy behavior of 7- and 11-yr-olds. No significant differences were found between reflective and impulsive 9-yr-olds on any measure. Nevertheless, when cognitive style was a significant contributor to performance, reflective children processed task information more efficiently than impulsive children and used more systematic and/or developmentally mature strategies. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Cognitive-behavioral body image therapy for body dysmorphic disorder": Correction.

Reports 2 errors in the original article by J. C. Rosen et al (Journal of Consulting and Counseling Psychology, 1995[Apr], 63[2], 263–269). On page 263, the correct prevalence of body dysmorphic disorder is 1.5% among women. On page 265, NHANES II stands for National Health and Nutrition Examination Surveys, Study 2. (The following abstract of this article originally appeared in record 1995-26170-001). Body dysmorphic disorder (BDD) is a distressing body image disorder that involves excessive preoccupation with physical appearance in a normal appearing person. Prior case reports of behavior therapy were encouraging, but no controlled evaluation of behavior therapy or any other type of treatment had been conducted. In the present study, 54 BDD subjects were randomly assigned to cognitive behavior therapy or no treatment. Patients were treated in small groups for eight 2-hour sessions. Therapy involved modification of intrusive thoughts of body dissatisfaction and overvalued beliefs about physical appearance, exposure to avoided body image situations, and elimination of body checking. Body dysmorphic disorder symptoms were significantly decreased in therapy subjects and the disorder was eliminated in 82% of cases at posttreatment and 77% at follow-up. … (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction to the special section on measuring cognitive products in research and practice.

This article introduces a special section of the Journal of Consulting and Clinical Psychology titled "Measuring Cognitive Products in Research and Practice." The practice of cognitive behavior therapies—and research on their effectiveness and the validity of the models of psychopathology and therapy associated with these treatments—requires valid assessment of cognition. Cognitive variables can be considered at several levels; the main focus of the articles in this special section is on techniques suited to measurement of cognitive products, thoughts, and images of which people are conscious. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of "training the trainers" course for helping tsunami-survivor children on Sri Lankan disaster volunteer workers.

The authors evaluated the impact of a "training the trainers" course for helping Sri Lankan tsunami-survivor children on education and mental health disaster volunteers. Sixty-two disaster volunteers were randomly assigned to either a school-based (ERASE Stress) "training the trainers" course or to an alternative "befriending" program that served as a control group. Participants in the ERASE Stress course significantly improved their perception of self-efficacy as tsunami survivors' helpers (Disaster-Helper Self-Efficacy Scale), self-mastery (Mastery scale), and optimism about their personal future (item from the Children's Future Orientation Scale). In addition, the perceived ability to use cognitive coping strategies (Cognitive Emotion Regulation Questionnaire) such as refocusing on planning, positive reappraisal, and putting the trauma into perspective was enhanced. The ERASE Stress course may be an effective method for strengthening local community capacity to deal with trauma survivors in developing countries. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Feasibility of a Cognitive Restructuring Intervention for Treatment of Chronic Pain in Persons With Disabilities.

Objective: To determine the feasibility of a cognitive restructuring intervention relative to an education intervention for treatment of pain in persons with chronic pain secondary to disability. Study Design: Quasi-experimental. Participants: 18 adults with chronic pain and disability. Interventions: Cognitive restructuring (n = 13) or education (n = 5) group intervention. Main Outcome Measure: Average pain intensity. Results: Participants in the cognitive group reported greater pre- to posttreatment decreases in pain than those in the education group. Participants rated both interventions positively and expressed enthusiasm for psychosocial interventions for pain. Conclusions: Preliminary findings suggest that decreases in pain can occur as a result of a cognitive restructuring intervention and support the feasibility of conducting intervention trials in persons with disability-related chronic pain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Cognitive therapy of anxiety disorders: Science and practice.

Reviews the book, Cognitive therapy of anxiety disorders: Science and practice edited by David A. Clark and Aaron T. Beck (2009). Drs. Clark and Beck’s book Cognitive therapy of anxiety disorders: Science and practise is a comprehensive review of cognitive therapy for anxiety from its empirical theoretical foundation to its clinical application to disorders. Although the focus of the text is ultimately on the cognitive treatment of anxiety, the rich theoretical background that is interwoven throughout makes this book of interest to academics and graduate students as well as clinicians. The book is divided into three parts, each with several chapters: 1) cognitive theory and research on anxiety; 2) assessment and intervention techniques used in cognitive therapy for anxiety; and 3) the application of cognitive therapy to specific anxiety disorders (e.g., panic disorder, obsessive– compulsive disorder [OCD]). Overall, this book is an excellent resource for researchers and clinicians working in the field of anxiety disorders. The reference section alone makes it a valuable addition to one’s bookshelf, and the authors have done an excellent job of organising a vast, and at time disparate, body of research into a cohesive review of cognitive theory as it applies to anxiety. Although the treatment chapters may be a bit overly ambitious in attempting to review both the research and the application of the cognitive model to the treatment of specific disorders, the book in its entirety is clearly an essential text for those interested in obtaining a comprehensive understanding of cognitive therapy and anxiety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Body dysmorphic disorder: a cognitive behavioural model and pilot randomised controlled trial

A cognitive behavioural model of body image is presented with specific reference to body dysmorphic disorder (BDD). We make specific hypotheses from the model for testing BDD patients in comparison with: (i) patients with "real" disfigurements who seek cosmetic surgery; (ii) subjects with "real" disfigurements who are emotionally well adjusted; and (iii) healthy controls without any defect. There have been no randomised controlled trials of treatment for BDD and therefore the model has clear implications for the development of cognitive behavioural therapy. This was evaluated in a pilot controlled trial. Nineteen patients were randomly allocated to either cognitive behaviour therapy or a waiting list control group over 12 weeks. There were no significant pre-post differences on any of the measures in the waiting list group. There were significant changes in the treated group on specific measures of BDD and depressed mood. Cognitive behaviour therapy should be further evaluated in a larger controlled trial in comparison with another psychological treatment such as interpersonal therapy and pharmacotherapy.     

A randomized controlled trial of fluoxetine and cognitive behavioral therapy for bulimia nervosa: short-term outcome

This study compared and combined fluoxetine and individual cognitive behavioral therapy in the treatment of bulimia nervosa. Participants were 76 women who sought treatment at the Eating Disorders Program of the Toronto Hospital and who met DSM-III-R criteria for bulimia nervosa. Subjects were randomly assigned to receive fluoxetine alone, cognitive behavior therapy alone, or the two in combination and were treated over 16 weeks. Short-term outcome revealed that all three treatment conditions were associated with clinical improvement across a wide range of parameters. The combination of pharmacotherapy and psychotherapy was superior to pharmacotherapy alone on specific parameters and there was no statistically significant advantage to the combination over psychotherapy alone. Limitations to the study include the absence of a placebo pill group and a waiting list control group as well as a substantial dropout rate across all three treatment conditions.     

Cognitive behavior modification: A step in the wrong direction?

Documents a recent cognitive trend in behavior therapy and reviews the highlights of the behavioristic–cognitive debates that have appeared in the journals over the years. Three types of data bearing on the relative effectiveness of cognitive and behavior therapy are presented: (a) controlled studies comparing the effectiveness of the new cognitive behavior modification techniques with traditional behavior therapy procedures, (b) studies comparing the effectiveness of 2 traditional behavior therapy techniques in which one of the procedures relies less on cognitive operations than does the other, and (c) data from other areas of psychology (attitude change, perception) that bear on the relationship between cognition and behavior change. Although the latter 2 data sources favor traditional behavior therapy, the controlled comparisons show the 2 types of techniques to be equally effective. Since the controlled cognitive behavior modification/behavior therapy comparisons have so far, however, not involved clinical populations, the question remains unresolved pending comparisons involving clinically relevant targets. (131 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Internet therapy versus internet self-help versus no treatment for problematic alcohol use: A randomized controlled trial.

Objective: Problematic alcohol use is the third leading contributor to the global burden of disease, partly because the majority of problem drinkers are not receiving treatment. Internet-based alcohol interventions attract an otherwise untreated population, but their effectiveness has not yet been established. The current study examined the effectiveness of Internet-based therapy (therapy alcohol online; TAO) and Internet-based self-help (self-help alcohol online; SAO) for problematic alcohol users. Method: Adult problem drinkers (n = 205; 51% female; mean age = 42 years; mean Alcohol Use Disorders Identification Test score = 20) were randomly assigned to TAO, SAO, or an untreated waiting-list control group (WL). Participants in the TAO arm received 7 individual text-based chat-therapy sessions. The TAO and SAO interventions were based on cognitive–behavioral therapy and motivational interviewing techniques. Assessments were given at baseline and 3 and 6 months after randomization. Primary outcome measures were alcohol consumption and treatment response. Secondary outcome measures included measures of quality-of-life. Results: Using generalized estimating equation regression models, intention-to-treat analyses demonstrated significant effects for TAO versus WL (p = .002) and for SAO versus WL (p = .03) on alcohol consumption at 3 months postrandomization. Differences between TAO and SAO were not significant at 3 months postrandomization (p = .11) but were significant at 6 months postrandomization (p = .03), with larger effects obtained for TAO. There was a similar pattern of results for treatment response and quality-of-life outcome measures. Conclusions: Results support the effectiveness of cognitive–behavioral therapy/motivational interviewing Internet-based therapy and Internet-based self-help for problematic alcohol users. At 6 months postrandomization, Internet-based therapy led to better results than Internet-based self-help. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The accelerate study: The longitudinal effect of speed of processing training on cognitive performance of older adults.

Objective: Examine the short-term and long-term impact of speed of processing training on cognitive performance in older adults. Study Design: Randomly assigned, 2-group experimental design with assessment periods at baseline, immediately after training, and at 2 subsequent annual points. Setting: Laboratory. Participants: Older adults (N=159) with speed of processing impairments. Interventions: Speed of processing training group or a social contact Internet control group. Participants in both groups received approximately ten 1-hr training sessions. Main Outcome Measures: Cognitive measures. Results: Speed of processing training resulted in improved performance on two measures of information processing (Useful Field of View and the Starry Night tests). Conclusions: Speed of processing training produced significant processing speed improvement that was robust over a 2-year period. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

You're changed if you do and changed if you don't: Mechanisms underlying paradoxical interventions.

We examined 2 mechanisms of change under paradoxical interventions: reactance and increased sense of self-efficacy. Procrastinating college students were randomly assigned to either paradoxical or self-control interventions. Effective study time and perceived self-efficacy were measured before and after treatment. In Study 1 nonverbal measure of initial reactance was employed. In Study 2 reactance was experimentally manipulated. Under paradoxical interventions, Ss higher on initial reactance benefited more from therapy than did Ss with low reactance; nonreactant Ss did not increase their effective study time, but they did improve in perceived efficacy to control their procrastination; increased study time was negatively correlated with increased self-efficacy. In self-control treatment, increased study time was accompanied by increased self-efficacy. Paradoxical interventions seem to reduce procrastination through the mechanism of reactance in some clients, whereas in others they lead to a cognitive change, possibly mediating a subsequent behavior change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy of cognitive behavior therapies: A quantitative review of the research evidence.

Assessed the effectiveness of cognitive behavior therapies in a review of 48 studies of adolescents and adults that compared cognitive behavioral therapy with some form of control group. Analyses indicated that cognitive behavior therapies were superior to no treatment; however, there was no firm evidence that these therapies were superior to other psychotherapies. Analyses failed to find cognitive behavior therapies emphasizing behavioral techniques to be more effective than primarily cognitive approaches. Also, the efficacy of cognitive behavior therapies appeared relatively uniform across diagnostic categories and equally effective when administered in a group or individual format. There was no evidence that sex or age of patient, experience of therapist or even duration of therapy were related to treatment effects. (54 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of experimental socialization paradigms upon two moral responses to transgression.

In an initial experiment on the antecedents of self-criticism and reparation, 57 5th-grade girls were equally assigned to 2 treatments: High Cognitive Structure High Control and Low Cognitive Structure-Low Control. Each S was repeatedly punished for an aggressive act on 10 training trials. On the test trial, a more destructive act was contrived to elicit internalized moral responses. In a 2nd experiment, using the same techniques but designed to distinguish independent antecedents, 68 5th-grade boys were equally assigned to each of 4 treatments: High Cognitive Structure-High Control, High Cognitive Structure-Low Control, Low Cognitive Structure-High Control, and Low Cognitive Structure-Low Control. Induction of self-criticism was significantly related to E's cognitive structuring during training. Reparative responses were a function of whether S or E controlled punishment. The 2 moral responses were concluded to be the consequences of distinct patterns of social reinforcement and not attributable to a unitary entity such as "conscience" or "superego." (33 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Computerized behavior therapy for opioid-dependent outpatients: A randomized controlled trial.

The authors evaluated the efficacy of an interactive, computer-based behavioral therapy intervention, grounded in the community reinforcement approach (CRA) plus voucher-based contingency management model of behavior therapy. Our randomized, controlled trial was conducted at a university-based research clinic. Participants comprised 135 volunteer adult outpatients who met DSM-IV criteria for opioid dependence. All participants received maintenance treatment with buprenorphine and were randomly assigned to one of three treatments: (a) therapist-delivered CRA treatment with vouchers, (b) computer-assisted CRA treatment with vouchers, or (c) standard treatment. The therapist-delivered and computer-assisted CRA plus vouchers interventions produced comparable weeks of continuous opioid and cocaine abstinence (M = 7.98 and 7.78, respectively) and significantly greater weeks of abstinence than the standard intervention (M = 4.69; p     

Effectiveness of cognitive/relaxation therapy and study-skills training in reducing self-reported anxiety and improving the academic performance of test-anxious students.

Determined whether study-skills training contributed to a treatment program that included relaxation training and cognitive therapy. 45 test-anxious undergraduates were randomly assigned to 1 of 4 treatment conditions: (a) relaxation/cognitive therapy, (b) study-skills training, (c) a combination of relaxation/cognitive therapy and study-skills training, or (d) no treatment. Pre- and posttreatment measures were collected on self-reported state anxiety and classroom examination performance. Findings show that relaxation/cognitive therapy was effective in reducing anxiety but failed to improve classroom test scores. Study-skills training had no significant effect on either measure. The combined therapy both reduced anxiety and improved performance relative to the no-treatment control condition and was significantly more effective than was either treatment alone. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relapse prevention training and problem-solving therapy in the long-term management of obesity.

This study compared 2 extended therapy programs for weight management with standard behavioral treatment (BT) without additional therapy contacts. Participants were 80 obese women who completed 20 weekly group sessions of BT and achieved a mean initial weight loss of 8.74 kg. Participants were randomly assigned to a no-further-contact condition (BT only) or to one of two extended interventions consisting of relapse prevention training (RPT) or problem-solving therapy (PST). No significant overall weight-change differences were observed between RPT and BT or between RPT and PST. However, participants who completed the PST intervention had significantly greater long-term weight reductions than BT participants, and a significantly larger percentage of PST participants achieved clinically significant losses of 10% or more in body weight than did BT participants (35% vs 6%). (PsycINFO Database Record (c) 2010 APA, all rights reserved)