The Use of Computerized Self-Help Packages to Treat Adolescent Depression and Anxiety

Despite the efficacy of cognitive-behavioral therapy (CBT) in treating adolescent anxiety, few sufferers seek treatment. Barriers to accessing psychologists include a shortage of skilled therapists, long waiting lists, and affordability. The Internet is a medium possibly able to address issues of accessibility and affordability. This study aimed to assess the efficacy of online therapy in the treatment and prevention of adolescent anxiety and depression. Participants (N = 38) were randomly allocated to one of four conditions: online CBT, face-to-face CBT, combined face-to-face/online CBT, and control. Combined face-to-face/online CBT is more effective in treating symptoms of depression and anxiety compared to stand-alone online or face-to-face therapy. The present study suggests that for those who are unable to access face-to-face therapy, computerized therapy may be a viable option. This is an important finding, especially in light of current capacity to treat and accessibility problems faced in the treatment of adolescent depression and anxiety.     

A pilot study of CBT versus escitalopram combined with CBT in the treatment of pathological gamblers

We conducted a randomised controlled trial pilot study (N = 30) with two treatment groups: (1) Manualised cognitive behavioural therapy (CBT) (n = 15) and (2) escitalopram combined with CBT (n = 15). Treatment was administered individually and the CBT included weekly sessions for eight consecutive weeks. The treatment with escitalopram lasted for a minimum of 16 weeks (20 mg/day), with an optional continuation for a 6-month follow-up period. Repeated measures ANOVA with modified intent-to-treat analyses were conducted. Results showed significant time effects on all measures for both treatment conditions, although no significant group or time × group effects. The results indicated that both treatments were effective in the short term (effect sizes (ES) ranging from 0.45 to 0.91 for the CBT group and 0.27 to 0.72 for the escitalopram+CBT group), and that adding CBT to escitalopram had no additional statistically significant effect (between-group ES of 0.11 and 0.29 for primary outcome measures at 16-weeks post-treatment).     

Effects of Affective and Anxiety Disorders on Outcome in Problem Gamblers Attending Routine Cognitive–Behavioural Treatment in South Australia

This study evaluated the influence of 12-month affective and anxiety disorders on treatment outcomes for adult problem gamblers in routine cognitive–behavioural therapy. A cohort study at a state-wide gambling therapy service in South Australia. Primary outcome measure was rated by participants using victorian gambling screen (VGS) ‘harm to self’ sub-scale with validated cut score 21+ (score range 0–60) indicative of problem gambling behaviour. Secondary outcome measure was Work and Social Adjustment Scale (WSAS). Independent variable was severity of affective and anxiety disorders based on Kessler 10 scale. We used propensity score adjusted random-effects models to estimate treatment outcomes for sub-populations of individuals from baseline to 12 month follow-up. Between July, 2010 and December, 2012, 380 participants were eligible for inclusion in the final analysis. Mean age was 44.1 (SD = 13.6) years and 211 (56 %) were males. At baseline, 353 (92.9 %) were diagnosed with a gambling disorder using VGS. For exposure, 175 (46 %) had a very high probability of a 12-month affective or anxiety disorder, 103 (27 %) in the high range and 102 (27 %) in the low to moderate range. For the main analysis, individuals experienced similar clinically significant reductions (improvement) in gambling related outcomes across time (p < 0.001). Individuals with co-varying patterns of problem gambling and 12 month affective and anxiety disorders who present to a gambling help service for treatment in metropolitan South Australia gain similar significant reductions in gambling behaviours from routine cognitive–behavioural therapy in the mid-term.     

Internet-Based Delivery of Cognitive Behaviour Therapy Compared to Monitoring,Feedback and Support for Problem Gambling: A Randomised Controlled Trial

The aim of this study was to investigate the efficacy of an Internet-based cognitive behavioural therapy program (I-CBT) for the treatment of problem gambling, when compared to a waitlist control and an active comparison condition consisting of monitoring, feedback, and support (I-MFS). Participants (N = 174) were randomly allocated to the three conditions. Variables of interest were gambling outcome and related mental health measures. Participants in the active conditions (I-CBT and I-MFS) completed six online modules. Both I-CBT and I-MFS conditions resulted in significant treatment gains on gambling severity. However, I-CBT was also associated with reductions in a range of other gambling-related and mental health outcomes. Compared with I-MFS, I-CBT produced greater effects across seven outcomes measures, relating to gambling urges, cognitions, stress, and life satisfaction. I-CBT participants also rated the program as significantly more satisfactory. Treatment gains observed for both active conditions were found to be stable through to 12 month follow up. The results indicate that the benefits of I-CBT were more than simply the non-specific effects of engaging in online treatment or receiving motivation, feedback, and support. Online treatments for gambling may be a valuable tool in increasing help-seeking and treatment engagement in this population, and be integrated as part of stepped care approaches to treatment.     

Effectiveness of a Self Help Cognitive Behavioural Treatment Program for Problem Gamblers: A Randomised Controlled Trial

The study aimed to strengthen the scarce literature on self-help treatments for Problem Gambling (PG) by comparing the effectiveness of a Self-Help Cognitive Behavioral Treatment (SHCBT) program (n = 23) with a 6-week Waitlist condition (n = 32) in problem gamblers. Participants were community volunteers with gambling problems and were randomly allocated to the Waitlist and treatment conditions. Results showed significant improvements at post-treatment in gambling behaviors including frequency of gambling, average amount gambled per day and PG symptoms as well as a number of gambling correlates including psychological states (e.g., depression, anxiety and stress), gambling cognitions, gambling urges, gambling related self-efficacy, satisfaction with life, and quality of life among those who completed the SHCBT program, when compared with the waitlist condition. The effect size (partial η ²) ranged from .25 to .57 for all assessed outcomes that showed significant improvement from pre- to post-treatment. It was concluded that a self-help CBT program can be beneficial for treating community problem gamblers.     

Predictors of Relapse in Problem Gambling: A Prospective Cohort Study

To explore the variation of predictors of relapse in treatment and support seeking gamblers. A prospective cohort study with 158 treatment and support seeking problem gamblers in South Australia. Key measures were selected using a consensus process with international experts in problem gambling and related addictions. The outcome measures were Victorian Gambling Screen (VGS) and behaviours related to gambling. Potential predictors were gambling related cognitions and urge, emotional disturbance, social support, sensation seeking traits, and levels of work and social functioning. Mean age of participants was 44 years (SD = 12.92 years) and 85 (54 %) were male. Median time for participants enrolment in the study was 8.38 months (IQR = 2.57 months). Patterns of completed measures for points in time included 116 (73.4 %) with at least a 3 month follow-up. Using generalised mixed-effects regression models we found gambling related urge was significantly associated with relapse in problem gambling as measured by VGS (OR 1.29; 95 % CI 1.12–1.49) and gambling behaviours (OR 1.16; 95 % CI 1.06–1.27). Gambling related cognitions were also significantly associated with VGS (OR 1.06; 95 % CI 1.01–1.12). There is consistent association between urge to gamble and relapse in problem gambling but estimates for other potential predictors may have been attenuated because of methodological limitations. This study also highlighted the challenges presented from a cohort study of treatment and support seeking problem gamblers.     

Adolescents’ sensitivity in social interactions: an evaluation procedure using film clips / La sensibilidad a las interacciones sociales en adolescentes: un procedimiento de evaluación con escenas cinematográficas

This article presents a procedure designed to evaluate adolescents’ sensitivity in social interactions, an essential component of emotional intelligence, by viewing film clips. The instrument was tested on a sample of 1,536 students in the first and second cycles of secondary education. The construct validity of the measure and its relationship with other variables, by applying factor techniques, discriminant analysis and multiple regression, was evaluated. Regarding the dimensionality, the confirmatory factor analysis showed good fit of the sensitivity scores to a one-dimensional model, χ²(35) = 45.75, p = .11, RMSEA = .02, CFI = .94 and TLI = .92. The discriminant analysis allowed the classification of subjects’ responses into sensitive, ingenuous and over-interpretative responses according to their cognitive maturity (χ²(6) = 91.19, p < .001) and sex (χ²(2) = 11.23, p = .004). The multiple regression analysis showed that sensitivity is related to sex, self-expression in social situations, acceptance by the father and interpersonal intelligence (multiple validity = .46).     

Spanish version of the Dispositional Empathy with Nature scale / Versión española de la escala de Empatía Disposicional hacia la Naturaleza

The Dispositional Empathy with Nature scale (DEN) — dispositional tendency to understand and share the emotional experience of the natural world — offers a methodological tool for the study of the affective component of environmental concern. In this paper, the factor structure of the Spanish version of the DEN scale is tested (N = 394). The originally proposed one-factor structure is found using exploratory factor analysis — FACTOR program — with Unweighted Least Squares procedure and optimal implementation of parallel analysis (GFI = .99), along with high internal consistency (α = .93). The Spanish DEN scale shows moderate correlations between environmental concern measures (r = .36 – .44, p < .01) and low-to-moderate correlations with dispositional empathy with humans (r = .30 – .42, p < .05), indicating the distinctiveness of the scale. The Spanish version of the DEN scale is an adequate and reliable instrument for the measurement of empathic tendencies towards nature. Some recommendations regarding its future use are made.     

Sexual Hookups and Adverse Health Outcomes: A Longitudinal Study of First-Year College Women

“Hookups” are sexual encounters between partners who are not in a romantic relationship and do not expect commitment. We examined the associations between sexual hookup behavior and depression, sexual victimization (SV), and sexually transmitted infections (STIs) among first-year college women. In this longitudinal study, 483 women completed 13 monthly surveys assessing oral and vaginal sex with hookup and romantic partners, depression, SV, and self-reported STIs. Participants also provided biological specimens that were tested for STIs. During the study, 50% of participants reported hookup sex and 62% reported romantic sex. Covariates included previous levels of the outcome, alcohol use, impulsivity, sensation seeking, and romantic sex. Autoregressive cross-lagged models showed that, controlling for covariates, hookup behavior during college was correlated with depression, Bs = .21, ps < .05, and SV, Bs = .19, ps < .05. In addition, precollege hookup behavior predicted SV early in college, B = .62, p < .05. Hookup sex, OR 1.32, p < .05, and romantic sex, OR 1.19, p < .05, were associated with STIs. Overall, sexual hookup behavior among college women was positively correlated with experiencing depression, SV, and STIs, but the nature of these associations remains unclear, and hooking up did not predict future depression.     

Psychological Symptoms of Sexually Victimized Children and Adolescents Compared With Other Maltreatment Subtypes

The differential effects of sexual victimization and other forms of maltreatment on psychological functioning are not well understood. A sample of sexually victimized children and adolescents (N = 70; 6.3–17.9 years) and a group of youth with a history of nonsexual maltreatment (N = 108; 6.7–16.9 years) were compared using measures of mental health and psychosocial functioning. Assessments included standardized clinical interviews on individual maltreatment history and current psychopathology as well as questionnaires on behavioral and emotional symptoms, including posttraumatic stress symptoms. The results from this study suggest that the risk of experiencing any current mental disorders was independent of type of maltreatment. The risk of meeting the criteria for a current diagnosis of major depression, however, is greater among youth with a history of maltreatment that includes sexual victimization. The significant impact of sexual victimization on posttraumatic stress symptoms was found to be nonsignificant after controlling for age and gender effects. The results indicate that the outcomes of child maltreatment depend on type of maltreatment, but age and gender must be taken into account.     

Adult-Adult and Adult-Child/Adolescent Online Sexual Interactions: An Exploratory Self-Report Study on the Role of Situational Factors

Alcohol intoxication, sexual arousal, and negative emotional states have been found to precede certain sexual behaviors. Using data from an online self-report survey distributed to adults (N = 717; 423 men and 304 women), we compared adults with adult online sexual interactions (n = 640; 89.3%) to adults with interactions with a child or an adolescent (n = 77; 10.7%) on how much they reported being affected by the following factors surrounding the time of the interactions: alcohol intoxication, sexual arousal, sadness, boredom, stress, and shame. We found that those with a child or adolescent contact reported higher sexual arousal and more shame before the interaction, compared with those with an adult contact. In addition, the levels of negative emotional states varied when levels before the interactions were compared with levels after the interactions, suggesting that engaging in online sexual interactions alleviated negative emotional states, at least temporarily. The alleviatory effects, however, were accompanied by higher levels of shame after the interactions. Overall, adults that engage in online sexual interactions have remarkably similar perceptions of the situation surrounding these activities, independent of the age of their online contacts. Limitations of the study are discussed.     

Disordered gambling and co-morbidity of psychiatric disorders among college students: An examination of problem drinking,anxiety and depression

We assessed the occurrence of co-morbid psychiatric disorders (i.e., problem drinking, anxiety, and depression) among college students who met the threshold for disordered gambling. The participants included a large sample of undergraduate students (n = 1,430) who were enrolled in an introductory health course at a large, southeastern university in Spring 2011 and completed an online assessment that included scales to assess disordered gambling, problem drinking, anxiety, and depression. We calculated screening scores, computed prevalence rates for each disorder, and calculated Pearson correlations and Chi square tests to examine correlations and co-morbid relationships between the four disorders. Analyses indicated that all disorders were significantly associated (p < .01) except for disordered gambling and anxiety. Because college students who experience disordered gambling (and other psychiatric disorders) are at increased risk of experiencing co-occurring disorders, it might be useful for college health professionals to concurrently screen and intervene for co-occurring disorders.     

Feasibility and Acceptability of Smartphone Assessment in Older Adults with Cognitive and Emotional Difficulties

This feasibility study assessed perceived acceptability, adherence rates, and reasons for nonadherence to smartphone-based ecological momentary assessment (EMA). At two sites, participants (n = 103) ages 65 years or older with diagnosed anxiety or depressive disorder and cognitive concerns responded three times daily to smartphone-based EMA questions assessing clinical outcomes for two 10-day periods. Quantitative and qualitative measures followed both 10-day EMA periods. Overall, 76% of participants completed surveys on ≥ 10 of the 20 assessment days, and 70% of participants completed at least 30% of the total surveys. Reasons for nonadherence included technical, logistical, physiological, and cognitive issues. Smartphone-based EMA is feasible in older adults with cognitive and emotional difficulties. EMA tools should be responsive to the needs and preferences of participants to ensure adequate acceptability and adherence in this population. Our findings can inform the design, development, and implementation of mobile technologies in older adults in research and clinical contexts.     

The Gambling Cognitions Inventory: scale development and psychometric validation with problem and pathological gamblers

Cognitive distortions are typically identified as an important etiological factor in pathological gambling. The Gambling Cognitions Inventory (GCI) developed by Holub (2003) is examined in this study using a sample of 710 pathological gamblers collected in four Canadian studies. Confirmatory factor analysis did not support the initial 40-item scale and suggested a 33-item scale. The sample was split into two groups to conduct exploratory and confirmatory factor analyses. Scree plots and parallel analysis suggested a two-factor scale. The scale developed by exploratory factor analysis on the first sample was supported by confirmatory factor analysis on the second sample (CFI>0.95; RMSEA < 0.05). The two factors indicated a Skill and Attitude subscale and a Luck and Chance subscale. Analysis conducted within each of the four studies showed good internal reliability for the scale (range of α = 0.91–0.95) and subscales (α = 0.77–0.92). The scale and subscales correlated with gambling severity measures as well as other measures of gambling cognitions including the Gambling Attitudes and Beliefs Scale and the Gambling Beliefs Questionnaire. The results of the study indicate that the GCI is a psychometrically strong scale and may be beneficial in directing cognitive therapy to the most problematic cognitions.     

Gambling Motives: Do They Explain Cognitive Distortions in Male Poker Gamblers?

Gambling behavior is partly the result of varied motivations leading individuals to participate in gambling activities. Specific motivational profiles are found in gamblers, and gambling motives are closely linked to the development of cognitive distortions. This cross-sectional study aimed to predict cognitive distortions from gambling motives in poker players. The population was recruited in online gambling forums. Participants reported gambling at least once a week. Data included sociodemographic characteristics, the South Oaks Gambling Screen, the Gambling Motives Questionnaire-Financial and the Gambling-Related Cognition Scale. This study was conducted on 259 male poker gamblers (aged 18–69 years, 14.3% probable pathological gamblers). Univariate analyses showed that cognitive distortions were independently predicted by overall gambling motives (34.8%) and problem gambling (22.4%) (p < .05). The multivariate model, including these two variables, explained 39.7% of cognitive distortions (p < .05). The results associated with the literature data highlight that cognitive distortions are a good discriminating factor of gambling problems, showing a close inter-relationship between gambling motives, cognitive distortions and the severity of gambling. These data are consistent with the following theoretical process model: gambling motives lead individuals to practice and repeat the gambling experience, which may lead them to develop cognitive distortions, which in turn favor problem gambling. This study opens up new research perspectives to understand better the mechanisms underlying gambling practice and has clinical implications in terms of prevention and treatment. For example, a coupled motivational and cognitive intervention focused on gambling motives/cognitive distortions could be beneficial for individuals with gambling problems.     

Feasibility,Acceptability, and Initial Efficacy of an Online Sexual Health Promotion Program for LGBT Youth: The Queer Sex Ed Intervention

Lesbian, gay, bisexual, and transgender (LGBT) youth experience multiple sexual health inequities driven, in part, by deficits in parental and peer support, school-based sex education programs, and community services. Research suggests that the Internet may be an important resource in the development of sexual health among LGBT youth. We examined the feasibility of recruiting youth in same-sex relationships into an online sexual health intervention, evaluated intervention acceptability, and obtained initial estimates of intervention efficacy. LGBT youth (16 to 20 years old) completed Queer Sex Ed (QSE), an online, multimedia sexual health intervention consisting of five modules. The final sample (N = 202) completed the pretest, intervention, and posttest assessments. The primary study outcomes were sexual orientation identity and self-acceptance (e.g., coming-out self-efficacy), sexual health knowledge (e.g., sexual functioning), relationship variables (e.g., communication skills), and safer sex (e.g., sexual assertiveness). Analyses indicated that 15 of the 17 outcomes were found to be significant (p < .05). Effect sizes ranged from small for sexual orientation (e.g., internalized homophobia) and relationship variables (e.g., communication skills) to moderate for safer sex (e.g., contraceptive knowledge) outcomes. This study demonstrated the feasibility, acceptability, and initial efficacy of QSE, an innovative online comprehensive sexual health program for LGBT youth.     

Development and Validation of the Sexual Contingent Self-Worth Scale

Sexual contingent self-worth (CSW) refers to self-worth that is dependent on maintaining a sexual relationship, and has not been studied previously. This novel construct may have implications for sexual, relationship, and psychological well-being, because it could affect the cognitions, affect, and behaviors of individuals in sexual relationships. The purpose of this study was to develop the Sexual Contingent Self-Worth Scale and examine its reliability and validity in community samples. Two separate online studies (N = 329 and N = 282) included men and women who were in committed, sexually active relationships. The Sexual CSW Scale was adapted from a validated measure of relationship CSW. In Study 1, participants completed the Sexual CSW Scale, whereas in Study 2, participants also responded to standardized measures of related constructs. In addition, participants completed the Sexual CSW Scale again two weeks later in Study 2. Factor analysis yielded two subscales: (a) sexual CSW dependent on positive sexual events in the relationship and (b) sexual CSW dependent on negative sexual events. Results indicated good construct validity, incremental validity, internal consistency, and test-retest reliability for the Sexual CSW Scale. This research contributes to the fields of both CSW and sexuality by introducing a novel domain of CSW.     

The effect of three different exercise training modalities on cognitive and physical function in a healthy older population

Background

Older adults are encouraged to participate in regular physical activity to counter the age-related declines in physical and cognitive health. Literature on the effect of different exercise training modalities (aerobic vs resistance) on these health-related outcomes is not only sparse, but results are inconsistent. In general, it is believed that exercise has a positive effect on executive cognitive function, possibly because of the physiological adaptations through increases in fitness. Indications are that high-intensity interval training is a potent stimulus to improve cardiovascular fitness, even in older adults; however, its effect on cognitive function has not been studied before.Therefore, the purpose of this study was to compare the effects of resistance training, high-intensity aerobic interval training and moderate continuous aerobic training on the cognitive and physical functioning of healthy older adults.

Methods

Sixty-seven inactive individuals (55 to 75 years) were randomly assigned to a resistance training (RT) group (n = 22), high-intensity aerobic interval training (HIIT) group (n = 13), moderate continuous aerobic training (MCT) group (n = 13) and a control (CON) group (n = 19) for a period of 16 weeks. Cognitive function was assessed with a Stroop task and physical function with the Timed-Up-and-Go (TUG) and submaximal Bruce treadmill tests.

Results

No significant GROUP x TIME interaction was found for Stroop reaction time (P > .05). The HIIT group showed the greatest practical significant improvement in reaction time on the information processing task, i.e. Stroop Neutral (ES = 1.11). MCT group participants had very large practical significant improvements in reaction time on the executive cognitive tasks, i.e. Stroop Incongruent and Interference (ES = 1.28 and 1.31, respectively). The HIIT group showed the largest practically significant increase in measures of physical function, i.e. walking endurance (ES = 0.91) and functional mobility (ES = 0.36).

Conclusions

MCT and RT proved to be superior to HIIT for the enhancement of older individuals’ executive cognitive function; whereas HIIT were most beneficial for improvement in information processing speed. HIIT also induced the largest gains in physical function.

     

Does Asking Adolescents About Pornography Make Them Use It? A Test of the Question–Behavior Effect

Longitudinal survey design is the preferred method for the robust assessment of outcomes associated with socially undesirable or potentially harmful sexual behaviors. However, repeated measurement may induce the question–behavior effect (QBE)—the phenomenon where asking about a behavior changes the probability of engaging in the behavior in the future. Using an online panel sample of Croatian adolescents (M_{age at baseline} = 15.8, SD = .50), the present study explored the QBE in the context of adolescent pornography use. To this end we compared the frequency of pornography use six months after the initial survey (T2) between adolescents who participated in both baseline (T1) and T2 survey assessments (n = 1,053; 41% of males) and those who began the study at T2 (n = 130; 42% of males). In line with the findings from a recent Dutch study, we found no evidence that surveying adolescent pornography consumption increased participants’ reports of subsequent use. Implications of the findings for studying pornography use in young people are discussed.     

The role of cognitive distortion in online game addiction among Chinese adolescents

The aim of the present study was to examine the role of cognitive distortions in the development of on-line game addiction among Chinese adolescents. In Study 1, the sample comprised 495 adolescents aged 12 to 19 who recruited from two middle schools in Guangzhou, China. They were administered questionnaires relating background variables, the Internet Addiction Scale (IAS), Cognitive Distortions Scale (CDS) and Online Game Cognitive Addiction Scale (OGCAS). In Study 2, Twenty eight adolescents with excessive on-line game play recruited from a local mental hospital were randomly divided into to a CBT group (N = 14) and a clinical control group (N = 14). Measures of severity of on-line game playing, anxiety, depression, and cognitive distortions were assessed on baseline and after the 6 week intervention. Results of the present study showed that rumination and short-term thinking were the most predictors of online game addiction, and all-or-nothing thinking predict online game addiction at marginal significant levels. Males are at a greater risk of developing online game addiction than do females. CBT and basic counseling had different treatment effects on the all-or-nothing thinking scores, online comfort scores and short-term thinking scores, SDS scores and SAS scores. Interestingly, CBT and basic counseling had similar treatment effects on IAS scores and OGCAS scores. Applications of these findings to etiological research and clinical treatment programs are discussed.