The effect of pre-treatment psychoeducation on eating disorder pathology among patients with anorexia nervosa and bulimia nervosa

Pre-treatment psychoeducation can be effective for bulimic groups, but little is known about its effect on patients with anorexia nervosa. This study investigated the impact of a pre-treatment psychoeducational intervention on outpatients with diagnoses of full or atypical anorexia nervosa (N = 54) or bulimia nervosa/atypical eating disorder at a normal weight (N = 43). Each attended a four-session psychoeducational group whilst awaiting outpatient treatment. They completed measures of eating and personality disorder pathology pre-intervention, repeating the measures of eating pathology post-intervention. Effectiveness was tested for each diagnostic group using intention-to-treat analyses. Results confirm that such psychoeducational groups reduce unhealthy eating attitudes among bulimic patients, regardless of initial levels of eating and personality pathology. In contrast, the groups were not effective for anorexia nervosa sufferers. Such groups should be considered routinely during waiting periods for bulimia nervosa treatment, but further research is needed to determine how to help anorexia nervosa patients at this stage

Redefining smoking relapse as recovered social identity – secondary qualitative analysis of relapse narratives

Although many people in the general population manage to quit smoking, relapse is common. Theory underpinning the determinants of smoking relapse is under-developed. This article aims to specify theoretical insight into the process of relapse to smoking, to underpin effective intervention development. Secondary qualitative analysis of extended narratives of smoking relapse (n=23) were inductively coded within our conceptual framework of a socially situated narrative theoretical approach to identity. Smoking relapse is conceptualised as a situated rational response to a ‘disruption’ in individual narrative identity formation, and an attempt to recover a lost social identity. Emotional reactions to relapse, such as pleasure, but also guilt and shame, support this assertion by demonstrating the ambivalence of re-engaging in a behaviour that is situated and rational in terms of individual identity formation, yet ostracised and stigmatised by wider culture

Alcohol and remembering a hypothetical sexual assault: Can people who were under the influence of alcohol during the event provide accurate testimony?

We examined the influence of alcohol on remembering an interactive hypothetical sexual assault scenario in the laboratory using a balanced placebo design. Female participants completed a memory test 24 hours and 4 months later. Participants reported less information (i.e., responded ‘don’t know’ more often to questions) if they were under the influence of alcohol during scenario encoding. The accuracy of the information intoxicated participants reported did not differ compared to sober participants, however, suggesting intoxicated participants were effectively monitoring the accuracy of their memory at test. Additionally, peripheral details were remembered less accurately than central details, regardless of intoxication level; and memory accuracy for peripheral details decreased by a larger amount compared to central details across the retention interval. Finally, participants were more accurate if they were told they were drinking alcohol rather than a placebo. We discuss theoretical implications for alcohol myopia and memory regulation, together with applied implications for interviewing intoxicated witnesses

Bostonia: The Boston University Alumni Magazine. Volume 12

Founded in 1900, Bostonia magazine is Boston University’s main alumni publication

Mental contrasting for health behaviour change: a systematic review and meta-analysis of effects and moderator variables

Mental contrasting is a self-regulation imagery strategy that involves imagining a desired future and mentally contrasting it with the present reality, which is assumed to prompt the individual to realise that action is required to achieve the desired future. Research has combined mental contrasting with implementation intentions (MCII) (‘if-then’ plans), which is hypothesised to strengthen the effects. A systematic review was conducted to evaluate the effectiveness of mental contrasting for improving health-related behaviours. A meta-analysis (N = 1528) using random effects modelling found a main effect of mental contrasting on health outcomes, adjusted Hedges’ g = 0.28 (SE = .07), 95% CI [0.13–0.43], p < .001 at up to four weeks, and an increased effect at up to three months (k = 5), g = 0.38 (SE = 0.6), CI [0.20–0.55], p < .001. The combination of mental contrasting with implementation intentions (MCII; k = 7) showed a similar effect, g = 0.28, CI [0.14–0.42], p < .001. Mental contrasting shows promise as a brief behaviour change strategy with a significant small to moderate-sized effect on changing health behaviour in the short-term. Analysis on a small subset of studies suggested that the addition of implementation intentions (MCII) did not further strengthen the effects of mental contrasting on health behaviours, although additional studies are needed.N/

Considering the case for an antidepressant drug trial involving temporary deception: a qualitative enquiry of potential participants

<p>Abstract</p> <p>Background</p> <p>Systematic reviews of randomised placebo controlled trials of antidepressant medication show small and decreasing differences between pharmacological and placebo arms. In part this finding may relate to methodological problems with conventional trial designs, including their assumption of additivity between drug and placebo trial arms. Balanced placebo designs, which include elements of deception, may address the additivity question, but pose substantial ethical and pragmatic problems. This study aimed to ascertain views of potential study participants of the ethics and pragmatics of various balanced placebo designs, in order to inform the design of future antidepressant drug trials.</p> <p>Methods</p> <p>A qualitative approach was employed to explore the perspectives of general practitioners, psychiatrists, and patients with experience of depression. The doctors were chosen via purposive sampling, while patients were recruited through participating general practitioners. Three focus groups and 12 in-depth interviews were conducted. A vignette-based topic guide invited views on three deceptive strategies: post hoc, authorised and minimised deception. The focus groups and interviews were tape-recorded and transcribed. Transcripts were analysed thematically using Framework.</p> <p>Results</p> <p>Deception in non-research situations was typically perceived as acceptable within specific parameters. All participants could see the potential utility of introducing deception into trial designs, however views on the acceptability of deception within antidepressant drug trials varied substantially. Authorized deception was the most commonly accepted strategy, though some thought this would reduce the effectiveness of the design because participants would correctly guess the deceptive element. The major issues that affected views about the acceptability of deception studies were the welfare and capacity of patients, practicalities of trial design, and the question of trust.</p> <p>Conclusion</p> <p>There is a trade-off between pragmatic and ethical responses to the question of whether, and under what circumstances, elements of deception could be introduced into antidepressant drug trials. Ensuring adequate ethical safeguards within balanced placebo designs is likely to diminish their ability to address the crucial issue of additivity. The balanced placebo designs considered in this study are unlikely to be feasible in future trials of antidepressant medication. However there remains an urgent need to improve the quality of antidepressant drug trials.</p

Impact of spouse caregiving on health behaviors and physical and mental health status

The impact of caring for a spouse with a progressive dementia on caregiver's health behaviors and health status was examined. Data collected from 44 spouse caregivers indicates that: • Providing full-time care interferes with preventive health behaviors (eating nutritiously, exercising) and contributes to high risk behaviors (overeating, alcohol and substance use); • Health behaviors are frequently used as coping strategies; • Caregivers rated their own health as poorer than their spouse's health; and • Disabling (arthritis, cardiac and back problems) and stress-related health problems (migraines, colitis) are a consequence of and interfere with care provision.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68204/2/10.1177_153331759400900105.pd