A comparison of three treatments for the outpatient alcoholic

The abuse of alcohol is a complex behavior pattern exhibited by approximately nine million people in this country (Tarter & Sugarman, 1976) and has become a field of interest to science, industry, and the helping professions. Estimates of spontaneous recovery among alcoholics vary drastically. In 1971 the National Institute on Alcohol Abuse and Alcoholism began sponsorship of a comprehensive alcoholism treatment program located in 45 community centers throughout the nation. Using a multiple criterion measure of improvement, their report (Rand Corporation, 1976) estimated the rate of spontaneous improvement for alcoholics to be as high as 53%. In reviewing the rates of spontaneous improvement from a number of studies, Baekland (1977) states, It thus appears that depending on the patient\u27s personal and social assets, there is a 2-15% spontaneous improvement rate in alcoholics who do not receive formal treatment (P 390). Unlike the Rand Report, Baekland used total abstinence ·as the measure of spontaneous improvement. The present study sought to compare the relative effectiveness of group administered covert sensitization with traditional insight-oriented group therapy in treating alcoholism. To control for the effects of relaxation training, therapist contact, favorable outcome expectancy, and the act of imaging (variables inherent in the covert sensitization procedure but not controlled for in the previously cited outcome studies), a relaxation placebo control group was employed which was empirically evaluated for its credibility. It was hypothesized that subjects in all three groups would show significant improvement over time on each of the dependent measures, and that subjects receiving covert sensitization would show significantly greater improvements than subjects receiving traditional group therapy or the relaxation placebo treatment. No differences were expected between group therapy and the relaxation placebo treatment

Mechanisms of Change in Exposure Therapy for Anxiety and Related Disorders: A Research Agenda

Anxiety and related disorders are a significant public-health burden with rising prevalence in the wake of the COVID-19 pandemic. As demand for effective anxiety treatment increases, so too does the need for strategies to bolster treatment outcomes. Research on the mechanisms of exposure therapy, the frontline behavioral treatment, will be critically important for optimizing clinical outcomes. We outline an initial agenda for future research on the mechanisms of change of exposure therapy, developed in collaboration with a large international team of researchers through the Exposure Therapy Consortium. Key questions and recommendations for future research focus on four priority areas: conceptualization, measurement, study design/analysis, and individual/contextual differences. Rising to the challenge of addressing these questions will require coordinated action and availability of centralized tools that can be used across trials, settings, and research groups

Children’s coping with in vivo peer rejection: An experimental investigation

We examined children's behavioral coping in response to an in vivo peer rejection manipulation. Participants (N=186) ranging between 10 and 13 years of age, played a computer game based on the television show Survivor and were randomized to either peer rejection (i.e., being voted out of the game) or non-rejection control. During a five-min. post-feedback waiting period children's use of several behavioral coping strategies was assessed. Rejection elicited a marked shift toward more negative affect, but higher levels of perceived social competence attenuated the negative mood shift. Children higher in depressive symptoms were more likely to engage in passive and avoidant coping behavior. Types of coping were largely unaffected by gender and perceived social competence. Implications are discussed. © 2006 Springer Science+Business Media, LLC

Children’s Feedback Preferences in Response to an Experimentally Manipulated Peer Evaluation Outcome: The Role of Depressive Symptoms

The present study examined the linkage between pre-adolescent children’s depressive symptoms and their preferences for receiving positive vs. negative feedback subsequent to being faced with an experimentally manipulated peer evaluation outcome in real time. Participants (n = 142) ages 10 to 13, played a computer contest based on the television show Survivor and were randomized to either a peer rejection (i.e., receiving the lowest total ‘likeability’ score from a group of peer-judges), a peer success (i.e., receiving the highest score), or a control peer evaluation condition. Children’s self-reported feedback preferences were then assessed. Results revealed that participants assigned to the negative evaluation outcome, relative to either the success or the control outcome, showed a significantly higher subsequent preference for negatively tuned feedback. Contrary to previous work and predictions derived from self-verification theory, children higher in depressive symptoms were only more likely to prefer negative feedback in response to the negative peer evaluation outcome. These effects for depression were not accounted for by either state mood at baseline or mood change in response to the feedback manipulation

A comparison of three treatments for the outpatient alcoholic

The abuse of alcohol is a complex behavior pattern exhibited by approximately nine million people in this country (Tarter & Sugarman, 1976) and has become a field of interest to science, industry, and the helping professions. Estimates of spontaneous recovery among alcoholics vary drastically. In 1971 the National Institute on Alcohol Abuse and Alcoholism began sponsorship of a comprehensive alcoholism treatment program located in 45 community centers throughout the nation. Using a multiple criterion measure of improvement, their report (Rand Corporation, 1976) estimated the rate of spontaneous improvement for alcoholics to be as high as 53%. In reviewing the rates of spontaneous improvement from a number of studies, Baekland (1977) states, It thus appears that depending on the patient\u27s personal and social assets, there is a 2-15% spontaneous improvement rate in alcoholics who do not receive formal treatment (P 390). Unlike the Rand Report, Baekland used total abstinence ·as the measure of spontaneous improvement. The present study sought to compare the relative effectiveness of group administered covert sensitization with traditional insight-oriented group therapy in treating alcoholism. To control for the effects of relaxation training, therapist contact, favorable outcome expectancy, and the act of imaging (variables inherent in the covert sensitization procedure but not controlled for in the previously cited outcome studies), a relaxation placebo control group was employed which was empirically evaluated for its credibility. It was hypothesized that subjects in all three groups would show significant improvement over time on each of the dependent measures, and that subjects receiving covert sensitization would show significantly greater improvements than subjects receiving traditional group therapy or the relaxation placebo treatment. No differences were expected between group therapy and the relaxation placebo treatment

The Impact of Criteria-based and Data-driven Sampling Approaches on the Heterogeneity and Interpretability of Posttraumatic Stress Symptom Networks

Background. The application of psychopathological symptom networks requires reconciliation of the observed cross-sample heterogeneity. We leveraged the largest sample to be used in a PTSD network analysis (N = 28,594) to examine the impact of criteria-based and data-driven sampling approaches on the heterogeneity and interpretability of networks. Methods. Severity and diagnostic criteria identified four overlapping subsamples and cluster analysis identified three distinct data-derived profiles. Networks estimated on each subsample were compared to a respective benchmark network at the symptom-relation level by calculating sensitivity, specificity, correlation, and density of the edges. Negative edges were assessed for Berkson’s bias, a source of error that can be induced by threshold samples on severity. Results. Criteria-based networks showed reduced sensitivity, specificity, and density but edges remained highly correlated and a meaningfully higher proportion of negative edges was not observed relative to the benchmark network of all cases. Among the data-derived profile networks, the Low Severity network had the highest proportion of negative edges not present in the benchmark network of symptomatic cases. The High Severity profile also showed a higher proportion of negative edges, whereas the Medium Severity profile did not. Conclusion. Although networks showed differences, Berkson’s bias did not appear to be a meaningful source of systematic error. These results can guide expectations about the generalizability of symptom networks across samples that vary in their ranges of severity. Future work should continue to explore whether network heterogeneity is reflective of meaningful and interpretable differences in the symptom relations from which they are composed