Computerized versus motivational interviewing alcohol interventions: Impact on discrepancy, motivation, and drinking.

The authors conducted two randomized clinical trials with ethnically diverse samples of college student drinkers in order to determine (a) the relative efficacy of two popular computerized interventions versus a more comprehensive motivational interview approach (BASICS) and (b) the mechanisms of change associated with these interventions. In Study 1, heavy drinking participants recruited from a student health center (N = 74, 59% women, 23% African American) were randomly assigned to receive BASICS or the Alcohol 101 CD-ROM program. BASICS was associated with greater post-session motivation to change and self-ideal and normative discrepancy relative to Alcohol 101, but there were no group differences in the primary drinking outcomes at 1-month follow-up. Pre to post session increases in motivation predicted lower follow-up drinking across both conditions. In Study 2, heavy drinking freshman recruited from a core university course (N = 133, 50% women, 30% African American) were randomly assigned to BASICS, a web-based feedback program (e-CHUG), or assessment-only. BASICS was associated with greater post-session self-ideal discrepancy than e-CHUG, but there were no differences in motivation or normative discrepancy. There was a significant treatment effect on typical weekly and heavy drinking, with participants in BASICS reporting significantly lower follow-up drinking relative to assessment only participants. In Study 2, change in the motivation or discrepancy did not predict drinking outcomes. Across both studies, African American students assigned to BASICS reported medium effect size reductions in drinking whereas African American students assigned to Alcohol 101, e-CHUG, or assessment did not reduce their drinking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of group psychological interventions on distress in infertile women.

Infertile women express higher levels of distress than fertile women, with distress peaking between the 2nd and 3rd year. The purpose of this study was to determine whether group psychological interventions could prevent this surge. One hundred eighty-four women who had been trying to conceive between 1 and 2 years were randomized into either a cognitive-behavioral group, a support group, or a control group. All experimental participants attended a 10-session group program. Participants completed psychological questionnaires at intake and again at 6 and 12 months. Substantial attrition occurred, particularly in the control group. The cognitive-behavioral and support participants experienced significant psychological improvement at 6 and 12 months compared with the control participants, with the cognitive-behavioral participants experiencing the greatest positive change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral self-control program for Windows: Results of a controlled clinical trial.

Forty nonalcoholic heavy drinkers were randomly assigned to receive a computer-based version of behavioral self-control training either immediately after pretreatment assessment or after a 10-week waiting period. Results at each of 3 follow-ups strongly support the study hypotheses. Participants in the immediate treatment group significantly reduced their drinking relative to their pretreatment levels and relative to those in the delayed treatment condition at the initial follow-up, 10 weeks after the pretreatment assessment. The delayed group did not change their drinking behaviors during this period of time. However, they significantly reduced their drinking by the second follow-up conducted after they received training. At the 12-month follow-up, participants maintained the gains they had achieved during treatment. There were no interactions involving participant ethnicity or gender. Although use of other drugs was not specifically addressed, such use did not increase, and there was some evidence of a decline. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preventing binge drinking during early adolescence: One- and two- year follow-up of a school-based preventive intervention.

Examined the effectiveness of a school-based prevention program on reducing binge drinking in a sample of minority, inner-city, middle-school students. Rates of binge drinking were compared among 1,713 youths who received the program beginning in the 7th grade 9n?=?1,713) and acontrol group (n?=?1,328) that did not. The prevention program had protective effects in terms of binge drinking at the 1-year (8th grade) and 2-year (9th grade) follow-up assessments. The proportion of binge drinkers was over 50% lower in the intervention group relative to the control group at the follow-up assessments. There were also several significant program effects on proximal drinking variables, including drinking knowledge, pro-drinking attitudes, and peer drinking norms. These findings indicate that a school-based drug abuse prevention approach previously found to be effective among White youth significantly reduced binge drinking among urban minority youth. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of extended versus brief treatments for marijuana use.

Adult marijuana users (N?=?291) seeking treatment were randomly assigned to an extended 14-session Cognitive–behavioral group treatment (relapse prevention support group; RPSG), a brief 2-session individual treatment using motivational interviewing (individualized assessment and intervention; IAI), or a 4-month delayed treatment control (DTC) condition. Results indicated that marijuana use, dependence symptoms, and negative consequences were reduced significantly in relation to pretreatment levels at l-, 4-, 7-, 13-, and 16-month follow-ups. Participants in the RPSG and IAI treatments showed significantly and substantially greater improvement than DTC participants at the 4-month follow-up. There were no significant differences between RPSG and IAI outcomes at any follow-up. The relative efficacy of brief versus extended interventions for chronic marijuana-using adults is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Increasing assertiveness skills to reduce HIV risk among women living with a severe and persistent mental illness.

This study examined whether training women living with a severe mental illness to be assertive in sexual situations would decrease their risk for HIV infection. Twenty female outpatients were randomly assigned to either a 10-session assertiveness training intervention or a waiting-list control condition. All participants completed measures of HIV-related information, motivation, skills, and sexual risk behavior pre- and postintervention and at 2- and 4-month follow-ups. Compared with controls, women in the intervention group increased their assertiveness skill, HIV knowledge, and frequency of condom-protected intercourse. It is concluded that assertiveness training for women living with a severe mental illness can serve as 1 part of a comprehensive HIV-risk-reduction program for this vulnerable population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of stress inoculation training on anxiety, stress, and academic performance among adolescents.

The effectiveness of a preventive stress inoculation program for adolescents that consists of a blend of progressive muscle relaxation, cognitive restructuring, and assertiveness training was examined. Trainees were compared with an empirically derived control group on measures of anxiety, stress, and academic performance. Compared with controls, the training program participants showed significantly greater improvements on self-report measures of trait anxiety and stress-related symptoms at posttest. These improvements were maintained at a 4-wk follow-up assessment. There were no significant differences between the 2 groups in academic achievement at either posttest or follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized control trial examining the effect of acceptance and commitment training on clinician willingness to use evidence-based pharmacotherapy.

This study evaluated the effectiveness of acceptance and commitment training (ACT) for increasing drug and alcohol counselors' willingness to use evidence-based agonist and antagonist pharmacotherapy. Fifty-nine drug and alcohol counselors were randomly assigned to either a 1-day ACT workshop or a 1-day educational control workshop. Both groups then attended a 2-day workshop on empirically supported treatments for substance abuse. Measures were taken at pre- and posttraining and 3-month follow-up on reported use of pharmacotherapy, willingness to use pharmacotherapy, perceived barriers to implementing new treatments, and general acceptance. As compared with those in the education alone condition, participants in the ACT condition showed significantly higher rates of referrals to pharmacotherapy at follow-up, rated barriers to learning new treatments as less believable at posttraining and follow-up, and showed greater psychological flexibility at posttraining and follow-up. Mediational analyses indicated that reduced believability of barriers and greater psychological flexibility mediated the impact of the intervention. Results support the idea that acceptance-based interventions may be helpful in addressing the psychological factors related to poor adoption of evidence-based treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Can pretraining experiences explain individual differences in learning?

This study examined the effects of having experienced negative events related to the purpose of a training program on learning and retention. Participants were 32 private pilots who participated in an assertiveness-training study. The purpose of the training was to prevent aviation accidents caused by human error. Structured telephone interviews were conducted to determine whether participants had previously experienced 3 types of negative events related to the purpose of training. Results indicated a linear relationship between these negative events and assertive performance in a behavioral exercise 1 week after training. The same negative events, however, were not significantly related to the performance of untrained participants in the same behavioral exercise. It is suggested that previous experiences influenced posttraining performance by increasing motivation to learn. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Secondary prevention with college drinkers: Evaluation of an alcohol skills training program.

This study evaluated secondary prevention approaches for young adults (N?=?36, mean age 23 yrs) at risk for alcohol problems. Ss were randomly assigned to cognitive-behavioral alcohol skills training, a didactic alcohol information program, or assessment only. The skills program included training in blood alcohol level estimation, limit setting, and relapse prevention skills. All Ss maintained daily drinking records during the 8-wk intervention and for 1 wk at each follow-up. Repeated measures multivariate analysis of variance (MANOVA) found a significant reduction over 1-yr follow-up in self-reported alcohol consumption for the total sample. For all drinking measures, the directional findings consistently favored skills training. Despite overall reductions, most Ss continued to report occasional heavy drinking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral weight-loss intervention at the worksite: Feasibility and maintenance.

Investigated the feasibility of conducting a behavioral weight-loss program at the worksite and evaluated the effectiveness of a structured-maintenance training protocol. A total of 133 20–60 yr olds in 3 groups completed a 10-wk behavioral treatment program. The treatment program included organizational behavior modification techniques in addition to traditional small-group behavior-therapy procedures for weight control. After treatment, 2 groups received a 4-session structured-maintenance program, and 1 group served as a nonspecific (contact time) control. Follow-ups were conducted at 3 and 6 mo. Although attrition rates were high, the results indicate that the 3 groups lost a significant amount of weight during the 18 wks of treatment plus maintenance training. There were no differential effects of either weight loss or attrition among the 3 groups over the course of treatment or maintenance. Comparison of the structured- vs nonspecific-maintenance training groups at 3- and 6-mo follow-up indicates that the structured training group maintained their weight loss significantly better than the nonspecific control group. Results are interpreted to be consistent with the hypothesis that the skills required to lose weight are different from skills necessary to maintain weight loss over time. Although behavioral weight-loss programs at the worksite appear feasible, high attrition remains a significant problem. Results are discussed in terms of cost-effectiveness of worksite weight-loss intervention and directions for future research. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Virtual reality exposure therapy for the treatment of fear of flying: A controlled investigation.

Forty-five participants who refused to fly during a screening test and who also met Diagnostic and Statistical Manual of Mental Disorders criteria for specific phobia, agoraphobia, or panic disorder with agoraphobia were randomly assigned to 5 sessions of either virtual reality exposure (VRE) or attention-placebo group treatment (GT). At posttreatment, 65% of VRE participants and 57% of GT participants flew during a test flight. Both groups showed significant improvement following treatment on standardized self-report measures of flight anxiety, with a better outcome for the VRE group on 4 of 5 of these measures. At 6-month follow-up, however, most group differences had disappeared; VRE resulted in a better outcome on only 1 of 5 standardized flight anxiety measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

ModerateDrinking.Com and moderation management: Outcomes of a randomized clinical trial with non-dependent problem drinkers.

Objective: To evaluate the effectiveness of a web-based protocol, ModerateDrinking.com (MD; www.moderatedrinking.com) combined with use of the online resources of Moderation Management (MM; www.moderation.org) as opposed to the use of the online resources of MM alone. Method: We randomly assigned 80 problem drinkers to either the experimental or control group with follow-ups at 3, 6, and 12 months. Results: Seventy-five participants (94%) had outcome data at 1 or more follow-up points, and 59 participants (73%) were assessed at all 3 follow-ups. Comparing baseline measures to the average outcomes at follow-ups indicated a significant overall reduction in both groups in alcohol-related problems and consumption variables. Compared with the control group, the experimental group had better outcomes on percent days abstinent. There was an interaction between intensity of drinking at baseline and treatment in determining outcomes assessing drinking. Less heavy drinkers in the experimental group had better outcomes on log mean blood alcohol content (BAC) per drinking day compared with the control group. Heavier drinkers did not differentially benefit from the MD program on this measure. Mixed model analyses in general corroborated these outcomes. Conclusion: The outcome data provide partial evidence for the effectiveness of the MD web application combined with MM, compared with the effectiveness of the resources available online at MM by themselves. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Coping skills training: Attitude toward mental illness, depression, and quality of life 1 year later.

Presents a follow-up assessment of 18 outpatient clients who had participated in the author's (see record 1980-26239-001) coping skills curriculum of progressive relaxation, anxiety management, assertiveness, and self-reinforcement. Focusing on 3 outcomes that were not targets of training but were hypothesized as potential generalized effects of the intervention, the study revealed that coping-skills Ss held attitudes about the etiology of psychological problems (Opinions about Mental Illness Scale) consistent with those modeled during the program and reported less depression (Beck Depression Inventory) than 17 Ss in a supportive group counseling program. No differences in quality of life emerged between the 2 groups. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological effects of participation in a large group awareness training.

A study was designed to assess the psychological effects of participation in an intervention that has been classified as a large group awareness training (LGAT). One hundred and thirty-five participants in the Forum (the successor to the est training and at present the most widespread LGAT) and 73 comparable peer-nominated control Ss completed detailed questionnaires approximately 4–6 weeks pre- and 4–6 weeks posttraining. Participants and nominees also completed similar measures approximately 1? years later. Both Forum participants and nominees were men and women who were predominantly White, well educated, and of relatively high socioeconomic status. Forum outcome was assessed on a broad array of outcome dimensions (perceived control, life satisfaction, daily coping, social functioning, positive and negative affect, self-esteem, physical health, and symptomatology), using multivariate techniques. The short-term outcome analyses revealed that only perceived control was affected by Forum participation, and no long-term treatment effects were observed. Results suggest that claims about far-reaching positive or negative psychological effects of participation in LGATs such as the Forum may be exaggerated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What makes group MET work? A randomized controlled trial of college student drinkers in mandated alcohol diversion.

Nationally, college drinkers exhibit the highest rates of alcohol consumption and represent the largest percentage of problem drinkers. Group motivational enhancement therapy (GMET) has been found to catalyze problem drinking reductions among college student samples. Although research supporting the use of single-session GMET in college samples (general and mandated) is emergent, no studies have evaluated a comprehensive model of the potential active ingredients of this group intervention. College students (N = 206; 88% White; 63% men; M age = 18.6) mandated to a university alcohol diversion program were randomly assigned to 1 of 3 conditions: the standard-of-care 2-session “Focus on Alcohol Concerns” education group (FAC), a single GMET, or a single alcohol information-only control group (AI) to evaluate the role of 5 putative mediators: readiness to change, self-efficacy, perceived risk, norm estimates, and positive drinking expectancies. At 3- and 6-month follow-ups, GMET students demonstrated greater reductions in problem drinking outcomes (drinks per drinking day, hazardous drinking symptoms, and alcohol-related problems). Of the 5 mediators proposed, only self-efficacy emerged as a significant mediator. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Expression of metastasis-related genes in surgical specimens of human gastric cancer can predict disease recurrence

College undergraduates (n = 34) identified by deviant scores (at least 1.96 SD above the mean) on the Revised Social Anhedonia (SocAnh) Scale (M. Eckblad, L. J. Chapman, J. P. Chapman, & M. Mishlove, 1982) were compared with control participants (n = 139) at an initial assessment and at a 10-year follow-up evaluation. Twenty-four percent of the SocAnh group were diagnosed with schizophrenia-spectrum disorders at the follow-up compared with only 1% of the control group, despite the fact that there had been no such difference between the groups at the initial assessment 10 years earlier. The SocAnh group exceeded the control group on severity of psychotic-like experiences and had poorer overall adjustment at the follow-up but not at the initial assessment. The groups did not differ on mood symptoms or substance-use disorders. Thus, the SocAnh Scale, unlike the Perceptual Aberration and Magical Ideation Scales, appears to identify individuals at specific risk for future development of schizophrenia-spectrum disorders.     

Cigarette smuggling in Europe: who really benefits?

This study determined the effects of endurance exercise training on the resting metabolic rate (RMR). It was hypothesized that the RMR would be increased posttraining, but that this increase would reflect the influence of the last exercise bout, not a chronic adaptation to exercise training. Seventy-four subjects (40 men and 37 women) aged 17-63 y participated in a 20-wk endurance training program. RMR and maximal oxygen uptake (VO2max) were each measured on 2 separate days both pre- and posttraining; the posttraining RMR measurements were taken 24 and 72 h after the last exercise bout. There were small but significant changes posttraining in relative body fat (-1.0%), fat mass (-0.6 kg), and fat-free mass (0.7 kg) and a 17.9% increase in VO2max. The RMR remained unchanged posttraining, both 24 and 72 h after the last exercise bout, even when the data were adjusted to account for the potential confounding effects of age, sex, body composition, and VO2max. In conclusion, 20 wk of endurance exercise training had no effect on the RMR even in the presence of small changes in body composition and a large increase in VO2max.     

Ecological momentary assessment in a behavioral drinking moderation training program.

We assessed predictors of self-reported excessive drinking (>5 drinks) in a sample of heavy drinkers. Participants were randomly assigned to moderation training or a waiting-list control condition. They were trained in ecological momentary assessment (EMA) involving self-monitoring of drinking and other variables on a small hand-held computer, the electronic diary (ED). During the 8-week study, participants were compliant in their use of the ED for both random prompts and the entry of data related to specific drinking episodes. Generalized estimating equations were used to fit models involving predictors related to past history of drinking, aspects of the training program, drinking restraint, and episode-specific mood. The models indicated robust predictors of decreased and increased drinking. Our results suggest that EMA is a useful methodology for assessing drinking and related behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital discord and treatment outcome in behavioral treatment of child conduct disorders.

Research assessing the role of marital variables in the treatment of childhood conduct disorders is scarce. The aim of this study was (a) to assess the role of marital discord in the overall outcome of a program training parents in behavioral techniques (behavioral parent training) and (b) to assess the effects of an adjunctive treatment (partner support training [PST]) on outcome. The latter treatment focused on marital conflict, communication, and problem solving. Twenty-four families with a child diagnosed as oppositional or conduct disordered were assigned to either a marital-discord group (n?=?12) or a no-marital-discord group (n?=?12). Families within each group were then randomly assigned to either child management training (CMT) alone or CMT with PST. Measures of child deviance, parenting behavior, and marital satisfaction were collected at pre- and posttraining and at a 6-month follow-up. Results indicated a significant interaction between marital discord and treatment type on most measures at follow-up but not at posttraining. Although PST added little to the maintenance of change for the nondiscordant group, it produced significant gains over those who received CMT only for the discordant group. Further results highlighting the interaction of marital and treatment variables are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)