Acceptance and commitment therapy delivered in a dyad after a severe traumatic brain injury: a feasibility study

Objective: There is a high prevalence of complex psychological distress after a traumatic brain injury but limited evidence of effective interventions. We examined the feasibility of Acceptance and Commitment Therapy after a severe traumatic brain injury using the criteria, investigating a therapeutic effect, and reviewing the acceptability of measures, treatment protocol, and delivery method (in a dyad of two clients and a therapist). Method: Two male outpatients with severe traumatic brain injury and associated psychological distress jointly engaged in a seven session treatment program based on Acceptance and Commitment Therapy principles. Pre- and post-treatment measures of mood, psychological flexibility, and participation were taken in addition to weekly measures. Results: The intervention showed a therapeutic effect with one participant, and appeared to be acceptable for both participants with regard to program content, measures, and delivery mode by in a dyad. One participant showed both significant clinical and reliable change across several outcome measures including measures of mood and psychological flexibility. The second participant did not show a reduction in psychological inflexibility, but did show a significant drop in negative affect. Significant changes pre- to post-treatment for measures of participation were not indicated. Qualitatively, both participants engaged in committed action set in accordance with their values. Conclusions: This study suggests that Acceptance and Commitment Therapy may be feasible to be delivered in a dyad with individuals who have a severe traumatic brain injury. A further test of its potential efficacy in a phase II clinical trial is recommended

Clarifying the Relationship Between Trichotillomania and Anxiety

Although research has consistently linked unidimensional anxiety with Trichotillomania (TTM) severity, the relationships between TTM severity and anxiety dimensions (e.g., cognitive and somatic anxiety) are unknown. This knowledge gap limits current TTM conceptualization and treatment. The present study examined these relationships with data collected from ninety-one adults who participated in a randomized clinical trial for TTM treatment. Based on prior research, it was hypothesized that TTM severity would be related to the cognitive anxiety dimension and that psychological inflexibility would mediate the association. Hypotheses were not made regarding the relationship between TTM severity and somatic anxiety. Regression analyses indicated that only cognitive dimensions of anxiety predicted TTM severity and that psychological inflexibility mediated this relationship. Implications for the conceptualization and treatment of TTM are discussed

Internet addiction: a systematic review of epidemiological research for the last decade

In the last decade, Internet usage has grown tremendously on a global scale. The increasing popularity and frequency of Internet use has led to an increasing number of reports highlighting the potential negative consequences of overuse. Over the last decade, research into Internet addiction has proliferated. This paper reviews the existing 68 epidemiological studies of Internet addiction that (i) contain quantitative empirical data, (ii) have been published after 2000, (iii) include an analysis relating to Internet addiction, (iv) include a minimum of 1000 participants, and (v) provide a full-text article published in English using the database Web of Science. Assessment tools and conceptualisations, prevalence, and associated factors in adolescents and adults are scrutinised. The results reveal the following. First, no gold standard of Internet addiction classification exists as 21 different assessment instruments have been identified. They adopt official criteria for substance use disorders or pathological gambling, no or few criteria relevant for an addiction diagnosis, time spent online, or resulting problems. Second, reported prevalence rates differ as a consequence of different assessment tools and cut-offs, ranging from 0.8% in Italy to 26.7% in Hong Kong. Third, Internet addiction is associated with a number of sociodemographic, Internet use, and psychosocial factors, as well as comorbid symptoms and disorder in adolescents and adults. The results indicate that a number of core symptoms (i.e., compulsive use, negative outcomes and salience) appear relevant for diagnosis, which assimilates Internet addiction and other addictive disorders and also differentiates them, implying a conceptualisation as syndrome with similar etiology and components, but different expressions of addictions. Limitations include the exclusion of studies with smaller sample sizes and studies focusing on specific online behaviours. Conclusively, there is a need for nosological precision so that ultimately those in need can be helped by translating the scientific evidence established in the context of Internet addiction into actual clinical practice

Psychometric properties and factor structure of the computerized PTSD scale -multimedia version among adult samples reporting trauma

This study investigated the psychometric properties of the Computerized PTSD Scale-Multimedia Version (CPS-M: Richard, Mayo, Bohn, Haynes, & lll Kolman, 1997), a self-administered adaptation of the Clinician-Administered PTSD Scale (CAPS: Blake, Weathers, Nagy, Kaloupek, Klauminzer, Charney, & Keane, 1990). The sample included 161 participants from both a veteran\u27s hospital and from a large urban outpatient HMO system who reported a history of trauma. Indices of internal consistency reliability (i.e., inter-item correlations, item-scale correlations, coefficient alpha) and temporal stability fell in satisfactory ranges. To assess convergent and discriminant validity, correlations were calculated between the CPSM and the following instruments: Purdue PTSD Scale, Beck Depression Inventory II (BDI-II), Hospital Anxiety and Depression Scale (HADS), Yale-Brown Obsessive Compulsive Scale (YBOCS), and Antisocial Behavior Inventory (ASBI). As hypothesized, the CMS-M was most strongly correlated with another measure of PTSD (r = .90) followed by the BDI-II (r = .85), HADS (r = .79), YBOCS (r = .71), and ASBI (r = .25). Confirmatory factor analysis procedures were used to assess fit of a set of nested measurement models. The fit of four different measurement models was tested. An oblique four-factor, first order model composed of reexperiencing (Bl-B5), avoidance (Cl-C2), dysphoria (C3-C7 & Dl-D3), and hyperarousal (D4- D5) provided the best fit to the data

IT’S ALL THE RAGE: AN ANIMATED APPROACH TO SCREENING FOR POSTPARTUM DEPRESSION

Postpartum depression presents a complication for mothers which can, in some cases, be severe and even life-threatening. Instruments commonly used to screen for this psychological condition have been challenged by an extensive body of literature, with many mothers being unidentified and even untreated for their symptoms. The presented research introduces a newly developed screening instrument for detecting probable postpartum depression using text-free scenario-based animations, based on the lived experience of the condition as qualified by empirical research and the existing body of literature. Developed items were controlled for quality via Think Aloud Protocol and alignment studies with subject matter experts (mothers and clinicians). A consequently revised version of a scale was piloted within the United States (N=433) using an online survey platform and was tested for psychometric quality. Overall, the presented studies show promise for this newly developed tool and provide ample reason to believe that using animated scenario-based items to measure the construct of postpartum depression in a screening context is a viable option for practice and a method that deserves additional research. Additional research related to the practicality of this method of assessment and its potential to increase access and fairness in receiving care for mental health conditions is needed. The development of this assessment has the potential to innovate psychological screening practices and clinical assessment for patients at large. This approach to assessment, being patient-informed and technology-based, provides promise for lowering the rate of maternal suicide, creating a common language between patients and providers, and potentially expanding the field of psychological assessment by forming ways of reaching those who have been missed by limited screening tools (i.e., historically marginalized groups). By freeing instrument development from typical protocol and grounding the entire process in the lived experience, using animation introduces an innovative method of assessing which is not only feasible, but also favored by the users themselves

The Effectiveness of a Computer-Assisted, Cognitive-Behavior Program for Treating Anxiety Symptoms in Children with Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is a complex and multifaceted, neurodevelopmental disorder that severely impacts children and families across a variety of settings. Prevalence rates of ASD are continuing to increase rapidly, with sizeable intervention and treatment costs placed on families and society. Further complicating the matter, many individuals with ASD also evidence co-occurring anxiety symptoms or disorders and tend to be at a higher risk for developing such problems when compared to other clinical populations or typically developing children. This study investigated the effectiveness of a computer-assisted CBT program, Camp Cope-A-Lot (CCAL), in regards to reducing anxiety symptoms in four participants diagnosed with ASD. Data from quantitative measures revealed inconsistent results, yet informal, qualitative feedback from parents as well as information from the researcher’s observations and progress notes appeared more promising for use of the CCAL intervention for this population of children