Cognitive-behavioral treatment for adolescent pathological gamblers

This study evaluated the effectiveness of a cognitive-behavioral treatment for adolescent pathological gamblers. Perception of control and severity of the problem served as dependent variables. Four adolescent pathological gamblers meeting DSM-III-R criteria were treated in a multiple baseline design across individuals. Results showed clinically significant changes for all subjects; they remained abstinent at 1-, 4-, and 6-month follow-ups. The clinical implications of these results are discussed.     

More on adolescent pregnancy.

Responds to L. Silka's (see record 1982-30189-001) and P. Williams's (see record 1982-30129-001) comments on D. Baumrind's (see record 1982-01029-001) article concerning teenage sexual activity, pregnancy, and birthrate. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

School-based adolescent pregnancy classes

School-based adolescent pregnancy classes provide the childbirth educator with a unique opportunity to be visible to students. Attitudes about sexuality and pregnancy can be changed within the mainstream population by the presence of prepared childbirth classes at schools. The problems of absenteeism and denial of pregnancy that result in late reporting to health care providers can be minimized. The expectant teen-ager can be encouraged to attend school and given self-confidence in assuming the role of a parent after birth. Support can be engendered from faculty, students, and the teen-ager's support person.     

Commitment and the prevention of adolescent cigarette smoking.

Tested the effects of commitment (CM) to nonsmoking on resistance to arguments favoring cigarette smoking. In Exp I, 37 7th graders were assigned to a public CM condition, in which they were audiotaped as they explained why they would not become smokers, or to information control or no-treatment conditions. In Exp II, 51 7th graders participated in conditions of (1) high CM, in which they were given high choice to write and publicly audiotape a speech about why smoking is bad; (2) low CM, in which they were given low choice to write an anonymous essay about why smoking is bad; or to (3) a no-treatment condition. Ss then listened to arguments favoring smoking. CM failed to enhance resistance to persuasion in either experiment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Endocrine problems of adolescent pregnancy

A number of changes in renal and endocrine physiology occur during pregnancy that alter hormone levels and affect a number of disease processes. Increased glomerular filtration causes an increase in hormone and substrate clearance. Increased placental steroid production causes an increase in hormone-binding globulin production, insulin resistance, and prolactinoma growth. Production of peptide hormones may cause changes in normal physiology and alter dynamic hormone testing. Placental vasopressinase increases vasopressin clearance. A number of diseases of hormone overproduction and underproduction affect pregnancy outcome and must be treated promptly by therapeutic modalities that also may affect the fetus.     

Cognitive-behavioral treatment of panic disorder.

Cognitive-behavioral therapy can be effective for many clients with panic disorder. Therapy can be conceptualized in terms of four central components. First, the initial preparation for therapy involves establishing a working alliance, educating the client about panic symptoms and treatments, and conducting a diagnostic assessment. Second, skills training is used to cultivate active coping skills that the client can use to tolerate symptoms of emotional distress. Third, exposure is used to encourage clients to test and refine their newly developed coping skills. Fourth, relapse prevention is used to help clients discontinue psychological and biological treatments without suffering lasting setbacks. Through the use of cognitive-behavioral therapy, most clients can learn to control their symptoms of panic and reduce their anticipatory anxiety. Treatment gains can be maintained after therapy is discontinued. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of comorbidity in prevention of adolescent depressive symptoms.

Despite the well-known relevance of comorbidity, few studies have examined the impact of comorbid anxiety or externalizing symptoms on the prevention of depressive symptoms in adolescents. To replicate earlier positive effects of a cognitive-behavioral prevention program of depressive symptoms and to test the hypothesis that the prevention program would be less effective in adolescents with comorbid anxiety and externalizing symptoms, the authors conducted a study involving 301 8th-grade students randomly divided into an intervention group and a nonintervention control group. The randomized design included baseline, postintervention, and 6-month follow-up. The prevention program included 10 sessions held in a regular school setting. The prevention program showed positive effects on depressive symptoms independent of comorbid symptoms. These effects were found mainly with girls independent of their depressive symptoms at baseline, and in part with boys with less severe depressive symptoms at baseline. It is surprising that negative effects of the prevention program on depressive symptoms were found on the depression of boys with more severe depressive symptoms at baseline. The prevention program's low rate of attrition and high recruitment rate support the generalizability of the results. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is adolescent pregnancy hazardous?

A study of the pregnancy outcome in 3320 teenagers revealed a low incidence of pre-eclampsia and anaemia and high rates of eclampsia, prematurity and low birthweight. The perinatal loss was 2.2 per cent and there was one maternal death. A comprehensive programme designed to improve antenatal surveillance is recommended for adolescents.     

Cognitive-behavioral treatment of women's body-image dissatisfaction.

Body-image dissatisfaction is a problem that affects a substantial minority of women and cuts across various diagnostic groups. College women with a significant level of body-image dissatisfaction were randomly assigned to either a cognitive–behavioral treatment (CBT) program (n?=?15) or to a waiting-list control group (n?=?16). The CBT program consisted of six structured, individual sessions that applied cognitive–behavioral procedures to the problem of negative body image. At pretest, posttest, and 7-week follow-up, multiple aspects of body image and other areas of psychosocial functioning were assessed. Relative to the control condition, the CBT program successfully improved affective body image, weakened maladaptive body-image cognitions, and enhanced social self-esteem and feelings about physical fitness and sexuality. Treatment effects were largely maintained at follow-up. After posttest, the control group received a 3-week treatment with immediate effects that generally replicated those obtained in the 6-week program. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral therapy for pathological gamblers.

Few studies have evaluated efficacy of psychotherapies for pathological gambling. Pathological gamblers (N = 231) were randomly assigned to (a) referral to Gamblers Anonymous (GA), (b) GA referral plus a cognitive- behavioral (CB) workbook, or (c) GA referral plus 8 sessions of individual CB therapy. Gambling and related problems were assessed at baseline, 1 month later, posttreatment, and at 6- and 12-month follow-ups. CB treatment reduced gambling relative to GA referral alone during the treatment period and resulted in clinically significant improvements, with some effects maintained throughout follow-up ( ps = .05). Individual CB therapy improved some outcomes compared with the CB workbook. Attendance at GA and number of CB therapy sessions or workbook exercises completed were associated with gambling abstinence. These data suggest the efficacy of this CB therapy approach. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural considerations in adolescent suicide prevention and psychosocial treatment.

Ethnic groups differ in rates of suicidal behaviors among youths, the context within which suicidal behavior occurs (e.g., different precipitants, vulnerability and protective factors, and reactions to suicidal behaviors), and patterns of help-seeking. In this article, the authors discuss the cultural context of suicidal behavior among African American, American Indian and Alaska Native, Asian American and Pacific Islander, and Latino adolescents, and the implications of these contexts for suicide prevention and treatment. Several cross-cutting issues are discussed, including acculturative stress and protective factors within cultures; the roles of religion and spirituality and the family in culturally sensitive interventions; different manifestations and interpretations of distress in different cultures; and the impact of stigma and cultural distrust on help-seeking. The needs for culturally sensitive and community- based interventions are discussed, along with future opportunities for research in intervention development and evaluation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral factors in seasonal affective disorder.

To longitudinally examine cognitive-behavioral correlates of seasonal affective disorder (SAD), the authors assessed women with a history of SAD and nondepressed, matched controls across fall, winter, and summer. SAD history participants reported more automatic negative thoughts throughout the year than controls and demonstrated a progression from decreased activity enjoyment during fall to reduced activity frequency during winter. Ruminative response style, measured in fall, predicted symptom severity during the winter. Across assessments, SAD history women endorsed greater depressive affect in response to low light intensity stimuli than to bright or ambiguous intensity stimuli, but less depressed mood to bright light stimuli than controls. These results suggest that the cognitive-behavioral factors related to nonseasonal depression may play a role in SAD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex roles and unwanted pregnancy in adolescent and adult women.

Discusses the stresses of unwanted pregnancy for women, their partners and families, and health professionals. Psychologists are considered capable of reducing the likelihood of unwanted pregnancy as well as contributing to a constructive resolution of the crisis. Factors that are often associated with contraceptive use and nonuse are highlighted. It is also shown that socialization in traditional sex roles contributes to ineffective contraceptive protection. Problems associated with the resolution of unwanted pregnancy are presented, such as resentment toward the child, the sense of loss for the adopted child or the aborted fetus, and depression. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral treatment of late-life generalized anxiety disorder.

This study addressed the efficacy of cognitive-behavioral therapy (CBT), relative to minimal contact control (MCC), in a sample of 85 older adults (age 60 years and over) with generalized anxiety disorder (GAD). All participants completed measures of primary outcome (worry and anxiety), coexistent symptoms (depressive symptoms and specific fears), and quality of life. Results of both completer and intent-to-treat analyses revealed significant improvement in worry, anxiety, depression, and quality of life following CBT relative to MCC. Forty-five percent of patients in CBT were classified as responders, relative to 8% in MCC. Most gains for patients in CBT were maintained or enhanced over 1-year follow-up. However, posttreatment scores for patients in CBT failed to indicate return to normative functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A meta-analysis of adolescent smoking prevention programs

OBJECTIVES: A large number of studies evaluating adolescent smoking prevention programs have been published. Systematic quantitative reviews of this literature are needed to learn what does and does not work. The present meta-analysis focuses on the efficacy of school-based programs. METHODS: Evaluations of 94 separate interventions were included in the meta-analysis. Studies were screened for methodological rigor and those with weaker methodology were segregated from those with more defensible methodology; major analyses focused on the latter. RESULTS: Behavioral effect sizes were found to be largest for interventions with a social reinforcement orientation, moderate for interventions with either a developmental or a social norms orientation, and small for interventions with the traditional rational orientation. Attitude effect sizes followed the same pattern, but knowledge effect sizes were similar across all four orientation categories. CONCLUSIONS: Because behavioral effect represents the fundamental objective of programs for prevention of adolescent tobacco use, the present results indicate that school-based programs should consider adopting interventions with a social reinforcement, social norms, or developmental orientation.     

Cognitive-behavioral and response-prevention treatments for bulimia nervosa.

This study was designed to assess the additive effects of major components of cognitive-behavioral treatment for bulimia nervosa. Seventy-seven female patients with bulimia nervosa were allocated at random to one of four conditions: wait-list control, self-monitoring of caloric intake and purging behaviors, cognitive-behavioral treatment, and cognitive-behavioral treatment combined with response prevention of vomiting. In the treatment conditions, participants were seen individually for fourteen 1-hr sessions over a 4-month period. All the treatment groups showed significant improvement, whereas the wait-list control group did not. Cognitive-behavioral treatment was, however, the most successful in reducing purging and in promoting positive psychological changes. Fifty-six percent of participants in this condition ceased binge eating and purging by the end of treatment, and the frequency of purging declined by 77.2% during the same period. Of the three treatment conditions, only cognitive-behavioral treatment was superior to the wait-list control. At the 6-month follow-up, 59% of the cognitive-behavioral group were abstinent, and purging had declined by 80%. Cognitive-behavioral treatment was significantly superior to the other treatment groups at this time. Thus, the addition of response prevention of vomiting did not enhance the efficacy of cognitive-behavioral treatment, and the evidence suggests that it may have had a deleterious effect. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral treatment of panic complicated by medical illness.

Notes that cognitive-behavior therapy combined with medication can be an effective treatment combination for individuals suffering from panic attacks. Certain cases may prove difficult however, particularly when an individual is recovering from a serious medical illness in which many of the symptoms of the medical illness overlap with the symptoms of panic. This article reviews some of the complicating factors that may occur with such cases as well as techniques for helping individuals differentiate between symptoms that denote a recurrence of the medical illness and those that involve panic disorder and anxiety. Two case vignettes, one of a 54-yr-old steel worker and one of a 19 yr-old gymnast, are included that portray how cognitive-behavioral techniques can be used to help individuals reduce their anxiety and panic and also effectively differentiate symptoms of a recurring medical illness. (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)     

Cognitive-behavioral intervention increases abstinence rates for depressive-history smokers.

Describes the test of the hypothesis that a cognitive-behavioral mood management intervention would be effective for smokers with a history of major depressive disorder (MDD). The method was randomized trial; the assessments occurred at Weeks 0, 8, 12, 26, and 52. Ss were 149 smokers (aged 18–65 yrs); 31% had a history of MDD. All received 2 mg of nicotine gum. Mood management was provided in 10 group sessions over 8 wks. Standard treatment was provided in 5 group sessions over 8 wks. Outcome was continuous abstinence. History-positive Ss were more likely to be abstinent when treated with mood management. Treatment condition differences were not significant for history-negative Ss. For history-positive Ss, less anger at baseline predicted abstinence. For history-negative Ss, more years smoked and higher baseline carbon monoxide predicted abstinence. Cognitive-behavioral therapy did not affect mood after quitting. Abstinence predictors differed as a function of baseline diagnosis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent pregnancy prevention in managed care

Efforts by the US government, employers, and insurance industry to address women's health issues have neglected the problem of adolescent pregnancy. 30 million of the 37.4 million US adolescents have health insurance coverage and 20-40% of them are enrolled in managed care plans, either through private insurance or Medicaid. Each year, managed care insurance plans pay for 150,000-300,000 adolescent pregnancies, half of which end in a live birth. There are many gaps in current approaches to adolescent health care that can be filled by physicians and managed care organizations. Prevention of adolescent pregnancy would have immediate, cost-effective results. Managed care insurance, with its organizational structure, has the potential to address the traditional obstacles to adolescent reproductive health of lack of confidentiality and difficulties with access. An adolescent health care coordinator could be hired to track teen care within the insurance plan, educate staff, and arrange and enforce protocols. It would be instructive to see whether such case management could achieve reductions in repeat adolescent pregnancies by targeting follow-up activities to this risk group. Finally, managed care organizations should analyze teen pregnancy prevention programs in their own setting and select the most effective interventions on the basis of cost and medical outcome rather than political expediency.