A Revision of Preventive Web-based Psychotherapies in Subjects at Risk of Mental Disorders

For the last years, the impulse of new technologies has overcome the traditional pathways of face-to-face clinical intervention and web-based psychological methodologies for intervention have started to gain success. This study aims to review the state-of-art about the effectiveness studies on preventive web- based interventions accomplished in samples of subjects at high risk for depressive, anxiety, eating behavior, problematic substance use symptoms and promotion of psychological well-being. Results showed that web-based psychological interventions for the prevention of mental disorders seemed to be effective for at risk individuals. Online health promotion in the general population was also effective to avoid the onset of clinical psychological circumstances. Future research should focus on personalized online intervention and on the evaluation of web-based engagement

Primary Psychosis: Risk and Protective Factors and Early Detection of the Onset

Primary psychosis, which includes schizophrenia and other psychoses not caused by other psychic or physical conditions, has a strong impact worldwide in terms of disability, suffering and costs. Consequently, improvement of strategies to reduce the incidence and to improve the prognosis of this disorder is a current need. The purpose of this work is to review the current scientific literature on the main risk and protective factors of primary psychosis and to examine the main models of prevention, especially those related to the early detection of the onset. The conditions more strongly associated with primary psychosis are socio-demographic and economic factors such as male gender, birth in winter, ethnic minority, immigrant status, and difficult socio-economic conditions while the best-established preventive factors are elevated socio-economic status and an economic well-being. Risk and protective factors may be the targets for primordial, primary, and secondary preventive strategies. Acting on modifiable factors may reduce the incidence of the disorder or postpone its onset, while an early detection of the new cases enables a prompt treatment and a consequential better prognosis. According to this evidence, the study of the determinants of primary psychosis has a pivotal role in designing and promoting preventive policies aimed at reducing the burden of disability and suffering of the disorder

For whom does it work? Moderators of outcome on the effect of a transdiagnostic internet-based maintenance treatment after inpatient psychotherapy: Randomized controlled trial

Background: Recent studies provide evidence for the effectiveness of Internet-based maintenance treatments for mental disorders. However, it is still unclear which participants might or might not profit from this particular kind of treatment delivery. Objective: The study aimed to identify moderators of treatment outcome in a transdiagnostic Internet-based maintenance treatment (TIMT) offered to patients after inpatient psychotherapy for mental disorders in routine care. Methods: Using data from a randomized controlled trial (N=400) designed to test the effectiveness of TIMT, we performed secondary analyses to identify factors moderating the effects of TIMT (intervention) when compared with those of a treatment-as-usual control condition. TIMT involved an online self-management module, asynchronous patient-therapist communication, a peer support group, and online-based progress monitoring. Participants in the control condition had unstructured access to outpatient psychotherapy, standardized outpatient face-to-face continuation treatment, and psychotropic management. Self-reports of psychopathological symptoms and potential moderators were assessed at the start of inpatient treatment (T1), at discharge from inpatient treatment/start of TIMT (T2), and at 3-month (T3) and 12-month follow-up (T4). Results: Education level, positive outcome expectations, and diagnoses significantly moderated intervention versus control differences regarding changes in outcomes between T2 and T3. Only education level moderated change differences between T2 and T4. The effectiveness of the intervention (vs control) was more pronounced among participants with a low (vs high) education level (T2-T3: B=-0.32, SE 0.16, P=.049; T2-T4: B=-0.42, SE 0.21, P=.049), participants with high (vs low) positive outcome expectations (T2-T3: B=-0.12, SE 0.05, P=.02) and participants with anxiety disorder (vs mood disorder) (T2-T3: B=-0.43, SE 0.21, P=.04). Simple slope analyses revealed that despite some subgroups benefiting less from the intervention than others, all subgroups still benefited significantly. Conclusions: This transdiagnostic Internet-based maintenance treatment might be suitable for a wide range of participants differing in various clinical, motivational, and demographic characteristics. The treatment is especially effective for participants with low education levels. These findings may generalize to other Internet-based maintenance treatments. Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN): 28632626; http://www.controlled-trials.com/isrctn/pf/ 28632626 (Archived by WebCite at http://www.webcitation.org/6IqZjTLrx). © David Daniel Ebert, Mario Gollwitzer, Heleen Riper, Pim Cuijpers, Harald Baumeister, Matthias Berking

Executive Function Impairments in Patients with Depression

Depression, the most prevalent psychiatric disorder, has a lifelong risk of 20% and is related to high rates of death among the patients. Thus, this study aims to conduct a systematic review of changes in executive functions of adult patients diagnosed with depression. We found 1381 articles; however, only 28 were selected and recovered. The inclusion criteria was the assessment of executive functions with at least one neuropsychological test, and articles that evaluated primarily adult individuals with depression, without comparison to other psychiatric disorders. Although most of the studies (25 out of 28 analyzed) have shown deficits in some executive subcomponents, these findings are not conclusive because they used different parameters of assessment. Moreover, many variables were not controlled, such as the different subtypes of the disorder, the high level of severity, comorbidity and the use of drugs. Most studies showed different deficits in executive functions in depressed patients, but further longitudinal studies are needed in order to confirm these findings

Design and methods for a randomized clinical trial treating comorbid obesity and major depressive disorder

<p>Abstract</p> <p>Background</p> <p>Obesity is often comorbid with depression and individuals with this comorbidity fare worse in behavioral weight loss treatment. Treating depression directly prior to behavioral weight loss treatment might bolster weight loss outcomes in this population, but this has not yet been tested in a randomized clinical trial.</p> <p>Methods and design</p> <p>This randomized clinical trial will examine whether behavior therapy for depression administered prior to standard weight loss treatment produces greater weight loss than standard weight loss treatment alone. Obese women with major depressive disorder (N = 174) will be recruited from primary care clinics and the community and randomly assigned to one of the two treatment conditions. Treatment will last 2 years, and will include a 6-month intensive treatment phase followed by an 18-month maintenance phase. Follow-up assessment will occur at 6-months and 1- and 2 years following randomization. The primary outcome is weight loss. The study was designed to provide 90% power for detecting a weight change difference between conditions of 3.1 kg (standard deviation of 5.5 kg) at 1-year assuming a 25% rate of loss to follow-up. Secondary outcomes include depression, physical activity, dietary intake, psychosocial variables and cardiovascular risk factors. Potential mediators (e.g., adherence, depression, physical activity and caloric intake) of the intervention effect on weight change will also be examined.</p> <p>Discussion</p> <p>Treating depression before administering intensive health behavior interventions could potentially boost the impact on both mental and physical health outcomes.</p> <p>Trial registration</p> <p>NCT00572520</p

Development of rational emotive education module for stress intervention of Malaysian Boarding School Students

This article discusses the development and validation of a Rational Emotive Education (REE) module for the stress intervention of Malaysian boarding school students. The module comprises four submodules, namely, Acceptance, Feelings, Beliefs, and Disputing Beliefs that have been developed by using the Rational Emotive Behavioral Therapy (REBT) approach. The validation stage which was evaluated by a panel of experts showed that the module’s content validity value is.92. Meanwhile, the reliability testing performed using a set of questionnaires indicated the reliability coefficient of.93 This article demonstrates how a rigorous procedure can be applied to develop and validate an effective stress intervention module before it can be administered in an actual study. The results also demonstrate how the REE module which is based on the REBT approach can be applied by school counselors for the purpose of stress intervention in an educational setting

The Use of Problem Solving Skills Training to Treat Disruptive Behavior in Schools

Disruptive behaviors in children are a class of behaviors that involve problems with impulse control, regulating emotions, compliance, aggression, and respecting the rights of others or societal norms (American Psychiatric Association, 2013; Nelson, 1996). The presence of these disruptive behaviors take a negative toll on the environment including the education setting, criminal justice system, public health services, and families (Tolan and Leventhal, 2013; Cuffel, 1997). Meta-analyses have shown several evidence-based treatments for disruptive behavior with cognitive-behavioral therapy being an effective approach (Eyeberg, Nelson, & Boggs, 2008; McCart & Sheidow, 2016). One such cognitive-behavioral therapy that is effective for decreasing disruptive behaviors in children is Problem Solving Skills Training (PSST) (Kazdin, 2017), however there is no published evaluation of PSST in a school setting. The study at hand examines the use and effectiveness of PSST in a school context comparing a delayed waitlist control group to a treatment group through a teacher-report measure of behavior and frequency of time out room referrals. Significant decreases in problem behavior were found in both teacher-report measures and time out room referrals for the active treatment group over time. These results demonstrate that PSST is an effective cognitive-behavioral based intervention to decrease disruptive behavior for children in the school setting