Evaluation of Psychology Clinicians’ Attitudes Towards Computerized Cognitive Behavior Therapy, for Use in Their Future Clinical Practice, with Regard to Treating Those Suffering from Anxiety and Depression

Computerized Cognitive Behavioural Therapy (CCBT) is an empirically supported therapeutic modality used in the treatment of anxiety and depression. It is an important area of research considering there is much research lacking in this area, especially regarding trainee and qualified psychology clinicians\u27 attitudes which are informative in terms of uptake and adherence. This study examined trainee and qualified psychology clinicians\u27 attitudes towards CCBT for use in their future clinical practice, with regard treating those suffering from anxiety and depression. Overall, 31 participants took part in the research, which resulted in 31 completed informed consent forms and questionnaires being returned to the researcher. This data was gathered using an email-based survey and a convenience, voluntary sample, which was comprised of 31 participants with varying employment statuses, who had achieved a minimum of a Masters degree in the counseling/ psychology fields. The survey consisted of quantitative questions such as Credibility and Expectancy Scales (Borkovec & Mathews, 1988) to measure participant\u27s perceptions of CCBT and how likely they were to recommend CCBT to a client, and qualitative questions were used to gather more details regarding their perceptions of the advantages and disadvantages of CCBT. All participation was voluntary. This mixed-methods survey found results that suggested that participant\u27s attitudes towards CCBT were less than favorable; specifically, results showed low ratings of the logical nature of CCBT, its potential to facilitate successful client outcomes and low rates of probable referral of a client to CCBT. Participants also indicated a lack of knowledge surrounding such programs and their implementation. Qualitative results found that attitudes towards CCBT were less than favorable, and that clinicians\u27 had a lack of information and knowledge about such programs. Further research should examine if these results would be maintained amongst a larger sample size. The electronic version of this dissertation is available free at Ohiolink ETD Center, www.ohiolink.edu/et

Alter ego, state of the art on user profiling: an overview of the most relevant organisational and behavioural aspects regarding User Profiling.

This report gives an overview of the most relevant organisational and\ud behavioural aspects regarding user profiling. It discusses not only the\ud most important aims of user profiling from both an organisation’s as\ud well as a user’s perspective, it will also discuss organisational motives\ud and barriers for user profiling and the most important conditions for\ud the success of user profiling. Finally recommendations are made and\ud suggestions for further research are given

Exploring the use of information and communication technology by people with mood disorder:a systematic review and metasynthesis

BACKGROUND: There is a growing body of evidence relating to how information and communication technology (ICT) can be used to support people with physical health conditions. Less is known regarding mental health, and in particular, mood disorder. OBJECTIVE: To conduct a metasynthesis of all qualitative studies exploring the use of ICTs by people with mood disorder. METHODS: Searches were run in eight electronic databases using a systematic search strategy. Qualitative and mixed-method studies published in English between 2007 and 2014 were included. Thematic synthesis was used to interpret and synthesis the results of the included studies. RESULTS: Thirty-four studies were included in the synthesis. The methodological design of the studies was qualitative or mixed-methods. A global assessment of study quality identified 22 studies as strong and 12 weak with most having a typology of findings either at topical or thematic survey levels of data transformation. A typology of ICT use by people with mood disorder was created as a result of synthesis. CONCLUSIONS: The systematic review and metasynthesis clearly identified a gap in the research literature as no studies were identified, which specifically researched how people with mood disorder use mobile ICT. Further qualitative research is recommended to understand the meaning this type of technology holds for people. Such research might provide valuable information on how people use mobile technology in their lives in general and also, more specifically, how they are being used to help with their mood disorders

Automation bias and prescribing decision support – rates, mediators and mitigators

Purpose: Computerised clinical decision support systems (CDSS) are implemented within healthcare settings as a method to improve clinical decision quality, safety and effectiveness, and ultimately patient outcomes. Though CDSSs tend to improve practitioner performance and clinical outcomes, relatively little is known about specific impact of inaccurate CDSS output on clinicians. Although there is high heterogeneity between CDSS types and studies, reviews of the ability of CDSS to prevent medication errors through incorrect decisions have generally been consistently positive, working by improving clinical judgement and decision making. However, it is known that the occasional incorrect advice given may tempt users to reverse a correct decision, and thus introduce new errors. These systematic errors can stem from Automation Bias (AB), an effect which has had little investigation within the healthcare field, where users have a tendency to use automated advice heuristically. Research is required to assess the rate of AB, identify factors and situations involved in overreliance and propose says to mitigate risk and refine the appropriate usage of CDSS; this can provide information to promote awareness of the effect, and ensure the maximisation of the impact of benefits gained from the implementation of CDSS. Background: A broader literature review was carried out coupled with a systematic review of studies investigating the impact of automated decision support on user decisions over various clinical and non-clinical domains. This aimed to identify gaps in the literature and build an evidence-based model of reliance on Decision Support Systems (DSS), particularly a bias towards over-using automation. The literature review and systematic review revealed a number of postulates - that CDSS are socio-technical systems, and that factors involved in CDSS misuse can vary from overarching social or cultural factors, individual cognitive variables to more specific technology design issues. However, the systematic review revealed there is a paucity of deliberate empirical evidence for this effect. The reviews identified the variables involved in automation bias to develop a conceptual model of overreliance, the initial development of an ontology for AB, and ultimately inform an empirical study to investigate persuasive potential factors involved: task difficulty, time pressure, CDSS trust, decision confidence, CDSS experience and clinical experience. The domain of primary care prescribing was chosen within which to carry out an empirical study, due to the evidence supporting CDSS usefulness in prescribing, and the high rate of prescribing error. Empirical Study Methodology: Twenty simulated prescribing scenarios with associated correct and incorrect answers were developed and validated by prescribing experts. An online Clinical Decision Support Simulator was used to display scenarios to users. NHS General Practitioners (GPs) were contacted via emails through associates of the Centre for Health Informatics, and through a healthcare mailing list company. Twenty-six GPs participated in the empirical study. The study was designed so each participant viewed and gave prescriptions for 20 prescribing scenarios, 10 coded as “hard” and 10 coded as “medium” prescribing scenarios (N = 520 prescribing cases were answered overall). Scenarios were accompanied by correct advice 70% of the time, and incorrect advice 30% of the time (in equal proportions in either task difficulty condition). Both the order of scenario presentation and the correct/incorrect nature of advice were randomised to prevent order effects. The planned time pressure condition was dropped due to low response rate. Results: To compare with previous literature which took overall decisions into account, taking individual cases into account (N=520), the pre advice accuracy rate of the clinicians was 50.4%, which improved to 58.3% post advice. The CDSS improved the decision accuracy in 13.1% of prescribing cases. The rate of AB, as measured by decision switches from correct pre advice, to incorrect post advice was 5.2% of all cases at a CDSS accuracy rate of 70% - leading to a net improvement of 8%. However, the above by-case type of analysis may not enable generalisation of results (but illustrates rates in this specific situation); individual participant differences must be taken into account. By participant (N = 26) when advice was correct, decisions were more likely to be switched to a correct prescription, when advice was incorrect decisions were more likely to be switched to an incorrect prescription. There was a significant correlation between decision switching and AB error. By participant, more immediate factors such as trust in the specific CDSS, decision confidence, and task difficulty influenced rate of decision switching. Lower clinical experience was associated with more decision switching (but not higher AB rate). The rate of AB was somewhat problematic to analyse due to low number of instances – the effect could potentially have been greater. The between subjects effect of time pressure could not be investigated due to low response rate. Age, DSS experience and trust in CDSS generally were not significantly associated with decision switching. Conclusion: There is a gap in the current literature investigating inappropriate CDSS use, but the general literature supports an interactive multi-factorial aetiology for automation misuse. Automation bias is a consistent effect with various potential direct and indirect causal factors. It may be mitigated by altering advice characteristics to aid clinicians’ awareness of advice correctness and support their own informed judgement – this needs further empirical investigation. Users’ own clinical judgement must always be maintained, and systems should not be followed unquestioningly

Understanding the role of social norms in a web-based personalised, feedback intervention for alochol use

Excessive alcohol consumption in university students in the UK has been identified by Government agencies and health care providers as significant problem. Social norms research suggests students evaluate and regulate their own alcohol consumption through social comparison with peers. However, students are prone to misperceptions, inaccurately estimating others’ alcohol consumption to be higher than their own. The over estimation of normative peer alcohol consumption has been associated with higher personal alcohol consumption. Unitcheck is an online alcohol resource available to university students in the UK (www.unitcheck.co.uk). Using a social norms approach this online alcohol intervention provides instant personalised normative feedback to students, directly comparing reported individual alcohol consumption with normative peer alcohol consumption. This comparison is designed to correct students’ overestimation of normative peer drinking and encourage moderate alcohol consumption. Currently, Unitcheck feedback is labelled as comparing personal alcohol consumption to normative alcohol consumption of the typical University of Leeds student. There is a paucity of research exploring student responses to personalised normative feedback on an individual level. The aim of this study was to evaluate how students reporting alcohol consumption above recommended weekly limits at the University of Leeds, respond to instant, online personalised normative feedback presented as part of a study version of Unitcheck. A between subjects experimental design employing qualitative think-aloud methodology, plus a semi-structured interview was used. Participants were 21 Undergraduate students in their first or second year of study at the University of Leeds, 67% female, mean age 19.3 years (range 18-21), meanalcohol consumption over the previous week 38.4 units (range 10-150). Participants were randomised to one of two study groups and asked to work through the Unitcheck resource whilst thinking their thoughts aloud. Group A (n=11) used a same-sex referent group in the personalised normative feedback for University of Leeds students. Group B (n=10) used typical University of Leeds student as the normative referent group. All participants then completed a semi-structured interview assessing how believable and personally relevant they found the feedback. Findings from thematic analysis of the transcripts suggest that personalised feedback prompts participants to actively consider their personal value judgements regarding acceptable drinking behaviour. Students responded directly to the normative feedback component. Justifications of ratings of believability of normative feedback were based on personal observations of student drinking behaviour and perceived credibility of the normative data. The current manipulation focussed on gender as a salient comparison group, participants suggested year of study and age as alternative salient normative comparison groups

The effectiveness and acceptability of a computerised guided self-help programme for vaginismus: a mixed methods design

Overview This volume is separated into three parts: • Part 1: Literature review. A systematic review and meta-analysis of twelve randomised controlled trials that examined the efficacy of psychological treatment for vaginal pain. The aim was to understand whether efficacy of treatment differed for vaginal pain defined as medical or psychiatric in aetiology. Differences and similarities in efficacy were examined on outcomes of pain and sexual function. Effectiveness of psychological treatment was found to be comparable regardless of aetiology, indicating that this distinction may not be helpful for informing treatment decisions. • Part 2: Empirical paper. A mixed methods study evaluated a new computerised programme for six women with vaginismus. Change in pain-related fear, penetration behaviour and pain intensity was quantitatively assessed. Interviews were used to qualitatively explore acceptability and change. Pain-related fear and pain intensity reduced over the course of the programme; successful penetration increased. The programme was experienced as convenient, gradual, and supportive, with moments of frustration at progress. The programme also had a positive influence on self-awareness, confidence, normalisation, and approach behaviours, with exposure attributed as the most difficult but important aspect of change. • Part 3: Critical appraisal. An appraisal of methodology used in the empirical study, discussing the potential biases encountered with research allegiance

Groupthink 2.0: An empirical analysis of customers' conformity-seeking in online communities

Online communities have witnessed an ongoing interest from both digital practitioners and scholars alike. Whilst the motives for and outcomes of customers' participation have been convincingly evidenced, there is a lack of conceptual and empirical understanding on the decision-making processes within virtual groups. This study employs Janis' (1972) Groupthink theory to investigate customers' tendency to conform when making decisions in a financial online community. Based on a sample of 343 respondents and multiple regression analysis, it is shown that perceived stress and group insulation have a positive influence upon Groupthink, whilst group cohesion has a negative effect. The findings support the applicability of Groupthink theory in an online context and emphasise defective social decision-making processes in online communities as a key priority for future research. Digital marketers gain insight on strategies to manage their customers' conformity-seeking tendencies and to prevent dysfunctional decision-making processes

COMPUTER ASSISTED ASSESSMENT IN OMAN: FACTORS AFFECTING STUDENT PERFORMANCE

This thesis investigates the social and psychological factors that might affect Omani higher education students if computerised assessment was to be implemented. A review of the literature and the historical and cultural development in Oman suggested that a number of different variables might affect students‘ performance when taking computerised assessment. These factors which include gender, college of study and geographical region of residence may cause unwanted and selective differences in student performance which are not related to the content of the assessment. In addition, the potential effects of such variables as computer experience and computer self-efficacy on student performance were investigated. The study also explored student and academic staff attitudes towards computerised assessment. Both quantitative and qualitative methods are used in this study through a selection of instruments such as a test that was delivered in different modes, questionnaires, focus groups and semi-structured interviews. Quantitative approaches are used to provide answers to the main study questions about student performance, and qualitative approaches are used to get deeper insights into the students‘ and staff members‘ perceptions, attitudes and values in relation to the research subject of the study. All these instruments were developed based upon the literature and also validated through a separate initial study. The main study took place after the instruments had been validated and involved over 400 students and 100 staff at three Omani Applied Sciences Colleges. Statistical analysis showed a small but significant difference between the two assessment modes in favour of the paper-and-pencil test. There was a significant difference in performance between both genders, with females out-performing males. However, the most striking finding was a differential effect of assessment mode between males and females. Males performed better in the computerized test than in the paper-based one, in contrast to females whose performance in the paper test was better. This suggests that the introduction of computerised testing may affect males and females in different ways. One 4 possible explanation for this is that Omani males have more opportunities to use computers inside and outside homes. The questionnaire results and the qualitative information from focus groups both showed that females were more nervous and found it more difficult to read from the computer screen than males did. Also, it was obvious in the focus group discussions that females had more negative feelings towards computerised testing compared to males, both before and after experiencing computerised assessment. The study found that students‘ performance in the English language test had showed significant variation across colleges, and among students from different regions. This variation seemed to be associated with variation in computer experience among students at the different colleges and from different regions. This may be due to regional differences or specificities, especially in terms of computer use, among the nine administrative regions in Oman. Staff attitudes and perceptions towards CAA, in general, were positive and not affected by either the gender or nationality/language factor. Most of the academic staff members revealed their willingness to implement CAA but also stressed that CAA should be gradually implemented. Both students and staff members identified a number of important points such as the need for a reliable system, qualified technicians and sufficient computers if Computer Assisted Assessment was to achieve wide acceptability.Ministry of Higher Educatio

Learning designs incorporating animated pedagogical agents: Their potential for improving academic writing competence, writing self-efficacy, and reducing writing anxiety

Academic writing can be extremely challenging, especially for new university students. This is compounded by the mass-migration of courses to online delivery, which further increases the complexity of acquiring writing skills. Animated pedagogical agents (APAs) have shown promise in addressing these problems, because they simulate authentic face-to-face social interactions thereby potentially increasing student engagement, motivation, and favourable emotions conducive to learning. This study’s first aim was to examine the impact of learning designs employing APAs on novice learners’ academic writing, writing anxiety, and writing self-efficacy. Its second aim was to examine the influence of various delivery options (didactic delivery or scaffolded questioning) with support messages (emotional, motivational or neither) on writing competence, writing anxiety and writing self-efficacy. These aims were achieved in a mixed-method study that included six experimental conditions tested using two multimedia academic writing lessons provided to 106 participants who were new to Australian tertiary studies. Quantitative data were collected immediately before and after the lessons (Phase 1), while qualitative data were obtained by interviews with a subset of participants after Lesson 2 (Phase 2). The impact of the independent variable combinations on the dependent variables were examined quantitatively (General Linear Modelling, t-tests) and qualitatively (thematic analysis). The results demonstrate that completing two academic writing lessons with APAs can increase writing competence and self-efficacy, and reduce writing anxiety. However, no significant differences were found between the support and delivery groups. Despite the lack of significant inter-group differences, more participants from the emotional group reported that their negative emotions were reduced because of the lesson. Also, all the participants in the motivational group reported perceptions of writing improvement as a result of attending the lessons. The overall positive result suggests promising possibilities for writing support delivered online to counter student under preparedness for academic writing