Comparing web-based mindfulness with loving-kindness and compassion training for promoting well-being in pregnancy: Protocol for a three-arm pilot randomized controlled trial

© Amy Louise Finlay-Jones, Jacqueline Ann Davis, Amanda O\u27Donovan, Keerthi Kottampally, Rebecca Anne Ashley, Desiree Silva, Jeneva Lee Ohan, Susan L Prescott, Jenny Downs. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 14.10.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included. Background: Promoting psychological well-being and preventing distress among pregnant women is an important public health goal. In addition to adversely impacting the mother’s health and well-being, psychological distress in pregnancy increases the risk of poor pregnancy outcomes, compromises infant socioemotional development and bonding, and heightens maternal and child vulnerability in the postpartum period. Mindfulness and compassion-based interventions show potential for prevention and early intervention for perinatal distress. As there is an established need for accessible, scalable, flexible, and low-cost interventions, there is increased interest in the delivery of these programs on the web. This project aims to pilot a three-arm randomized controlled trial (RCT) to determine the feasibility of a full-scale RCT comparing 2 web-based interventions (mindfulness vs loving-kindness and compassion) with a web-based active control condition (progressive muscle relaxation). Objective: The primary objective of this study is to assess the feasibility of an RCT protocol comparing the 3 conditions delivered on the web as a series of instructional materials and brief daily practices over a course of 8 weeks. The second objective is to explore the experiences of women in the different intervention conditions. The third objective is to estimate SD values for the outcome measures to inform the design of an adequately powered trial to determine the comparative efficacy of the different conditions. Methods: Pregnant women (n=75) participating in a longitudinal birth cohort study (the ORIGINS project) will be recruited to this study from 18 weeks of gestational age. We will assess the acceptability and feasibility of recruitment and retention strategies and the participants’ engagement and adherence to the interventions. We will also assess the experiences of women in each of the 3 intervention conditions by measuring weekly changes in their well-being and engagement with the program and by conducting a qualitative analysis of postprogram interviews. Results: This project was funded in September 2019 and received ethics approval on July 8, 2020. Enrollment to the study will commence in September 2020. Feasibility of a full-scale RCT will be assessed using ADePT (a process for decision making after pilot and feasibility trials) criteria. Conclusions: If the study is shown to be feasible, results will be used to inform future full-scale RCTs. Evidence for flexible, scalable, and low-cost interventions could inform population health strategies to promote well-being and reduce psychological distress among pregnant women

Types of aggression used by girls with and without attention-deficit/hyperactivity disorder

This thesis was designed to investigate differences in aggression between girls with and without attention-deficit/hyperactivity disorder (ADHD). Forty girls with ADHD and 43 girls without ADHD aged 9- to 12- years and their mothers and teachers participated. A multiassessment methodology was used to investigate these differences, employing mothers' reports, teachers' reports, and a laboratory aggression analogue task (a computer game involving simulated girls in other rooms). The results indicated that mothers and teachers saw girls with ADHD as having much higher levels of all types of aggression assessed, including overt, relational, proactive, and reactive aggression, than girls in the control group. On the lab task, girls with ADHD used a strategy that involved more threatening and bragging comments, and social exclusions of their co-players. Expected differences on some of the lab task measures did not emerge. Also, according to mothers, teachers, and the results from the lab task, girls with ADHD were significantly less prosocial than girls in the control group. Where significant group differences had been found, follow-up tests generally indicated that girls with ADHD and comorbid oppositional-defiant disorder (ODD) were more aggressive than girls in the control group, with girls with ADHD but not ODD falling in between. In sum, these results indicate substantial cause for concern for the concurrent and future psychosocial well-being of girls with ADHD.Arts, Faculty ofPsychology, Department ofGraduat

Adherence among adolescents prescribed medication for symptoms of attention deficit hyperactivity disorder

Attention Deficit Hyperactivity Disorder (ADHD) is a relatively common psychiatric disorder that is characterized by inappropriate levels of inattention and/or hyperactive-impulsive behaviours. Although stimulant medication is known to be an effective way to manage ADHD symptoms for adolescents with the disorder, there has been a lack of research into behaviours that may compromise the effectiveness, of this treatment, such as nonadherence to the medication. This study was designed to investigate the association between parent and adolescent reported rates of adherence and rationally derived factors that were hypothesized to relate to adherence amongst adolescents with ADHD. In this study, none of the rationally derived factors that showed adequate evidence for internal reliability (i.e., perceived barriers to medication taking, perceived benefits to medication taking, individual characteristics, and social influences) correlated With or predicted adherence reports for 29 adolescents prescribed medication for ADHD symptoms. Exploratory analyses revealed that two items from the interview used were correlated with adherence reports; these indicated that adolescents who perceived their medication as addictable were less adherent, and adolescents who perceive their disorder as heritable were more adherent. Adherence reports also correlated with parent reported symptoms of anxiety and depression. The two items identified by the exploratory analyses, in addition to the parent reported anxious/depressed symptoms, accounted for 23% of the variance in adherence reports. Another interesting result was the high rates of reported adherence, in contrast to low rates that were expected. Possible explanations for these results, in addition to directions for future research in this area, are discussed.Arts, Faculty ofPsychology, Department ofGraduat

Positive illusions in ADHD girls

We compared social self-competence ratings in 9 to 12 year old girls with (n=42) versus without (n=40) ADHD, relative to ratings of the girls’ social competence made by mothers, teachers, and blind raters duringa social laboratory task. Relative to scores from mothers, teachers, and the lab-task, girls with ADHD over-estimated their competence significantly more than control girls. Over-estimates were greater for girls with ADHD who also had heightened oppositional-defiant symptoms, or lower depressive symptoms. Over-estimates were positively related to a socially desirable reporting bias for girls with ADHD, but not for control girls, suggesting that girls with ADHD attempt to present themselves in an unduly positive, self-protective light. For girls with ADHD, over-estimates also were positively related to maladjustment and negatively related to adjustment. However, for girls without ADHD, over-estimates were positively related to adjustment. Overall, over-estimates of competence function differently in girls with and without ADHD.Arts, Faculty ofPsychology, Department ofReviewedFacult