Single-Session Transcranial Direct Current Stimulation Temporarily Improves Symptoms, Mood, and Self-Regulatory Control in Bulimia Nervosa: A Randomised Controlled Trial

BACKGROUND: Evidence suggests that pathological eating behaviours in bulimia nervosa (BN) are underpinned by alterations in reward processing and self-regulatory control, and by functional changes in neurocircuitry encompassing the dorsolateral prefrontal cortex (DLPFC). Manipulation of this region with transcranial direct current stimulation (tDCS) may therefore alleviate symptoms of the disorder. OBJECTIVE: This double-blind sham-controlled proof-of-principle trial investigated the effects of bilateral tDCS over the DLPFC in adults with BN. METHODS: Thirty-nine participants (two males) received three sessions of tDCS in a randomised and counterbalanced order: anode right/cathode left (AR/CL), anode left/cathode right (AL/CR), and sham. A battery of psychological/neurocognitive measures was completed before and after each session and the frequency of bulimic behaviours during the following 24-hours was recorded. RESULTS: AR/CL tDCS reduced eating disorder cognitions (indexed by the Mizes Eating Disorder Cognitions Questionnaire-Revised) when compared to AL/CR and sham tDCS. Both active conditions suppressed the self-reported urge to binge-eat and increased self-regulatory control during a temporal discounting task. Compared to sham stimulation, mood (assessed with the Profile of Mood States) improved after AR/CL but not AL/CR tDCS. Lastly, the three tDCS sessions had comparable effects on the wanting/liking of food and on bulimic behaviours during the 24 hours post-stimulation. CONCLUSIONS: These data suggest that single-session tDCS transiently improves symptoms of BN. They also help to elucidate possible mechanisms of action and highlight the importance of selecting the optimal electrode montage. Multi-session trials are needed to determine whether tDCS has potential for development as a treatment for adult BN

Targeted prevention of common mental health disorders in university students: randomised controlled trial of a transdiagnostic trait-focused web-based intervention

Background: A large proportion of university students show symptoms of common mental disorders, such as depression, anxiety, substance use disorders and eating disorders. Novel interventions are required that target underlying factors of multiple disorders.<p></p> Aims: To evaluate the efficacy of a transdiagnostic trait-focused web-based intervention aimed at reducing symptoms of common mental disorders in university students.<p></p> Method: Students were recruited online (n = 1047, age: M = 21.8, SD = 4.2) and categorised into being at high or low risk for mental disorders based on their personality traits. Participants were allocated to a cognitive-behavioural trait-focused (n = 519) or a control intervention (n = 528) using computerised simple randomisation. Both interventions were fully automated and delivered online (trial registration: ISRCTN14342225). Participants were blinded and outcomes were self-assessed at baseline, at 6 weeks and at 12 weeks after registration. Primary outcomes were current depression and anxiety, assessed on the Patient Health Questionnaire (PHQ9) and Generalised Anxiety Disorder Scale (GAD7). Secondary outcome measures focused on alcohol use, disordered eating, and other outcomes.<p></p> Results: Students at high risk were successfully identified using personality indicators and reported poorer mental health. A total of 520 students completed the 6-week follow-up and 401 students completed the 12-week follow-up. Attrition was high across intervention groups, but comparable to other web-based interventions. Mixed effects analyses revealed that at 12-week follow up the trait-focused intervention reduced depression scores by 3.58 (p<.001, 95%CI [5.19, 1.98]) and anxiety scores by 2.87 (p = .018, 95%CI [1.31, 4.43]) in students at high risk. In high-risk students, between group effect sizes were 0.58 (depression) and 0.42 (anxiety). In addition, self-esteem was improved. No changes were observed regarding the use of alcohol or disordered eating.<p></p> Conclusions This study suggests that a transdiagnostic web-based intervention for university students targeting underlying personality risk factors may be a promising way of preventing common mental disorders with a low-intensity intervention

Perceived acceptability of wearable devices for the treatment of mental health problems

OBJECTIVE: This study examined the potential acceptability of wearable devices (e.g., smart headbands, wristbands, and watches) aimed at treating mental health disorders, relative to conventional approaches. METHODS: A questionnaire assessed perceptions of wearable and nonwearable treatments, along with demographic and psychological information. Respondents (N = 427) were adults from a community sample (Mage  = 44.6, SDage  = 15.3) which included current (30.2%) and former (53.9%) mental health help-seekers. RESULTS: Perceived effectiveness of wearables was a strong predictor of interest in using them as adjuncts to talk therapies, or as an alternative to self-help options (e.g., smartphone applications). Devices were more appealing to those with negative evaluations of psychological therapy and less experience in help-seeking. CONCLUSIONS: Interest in using wearable devices was strong, particularly when devices were seen as effective. Clients with negative attitudes to conventional therapies may be more responsive to using wearable devices as a less directive treatment approach.Hugh Hunkin, Daniel L. King, Ian T. Zaja

A review of web-based support systems for students in higher education

Abstract Background Recent evidence suggests that there is an increasing need for accessible and anonymous services to support higher education (HE) students suffering from psychological and/or academic difficulties. Such difficulties can lead to several negative outcomes, including poor academic performance, sub-optimal mental health, reduced study satisfaction, and dropout from study. Currently, universities in the UK lack financial resources and the on-campus mental health services traditionally offered to students are increasingly economically unsustainable. Compounded by the perceived stigma of using such services, mental health providers have been driven to address the escalating needs of students through online services. Methods In this paper, we review online support systems identified through a literature search and a manual search of references in the identified papers. Further systems were identified through web searches, and systems still in development were identified by consultation with researchers in the field. We accessed systems online to extract relevant information, regarding the main difficulties addressed by the systems, the psychological techniques used and any relevant research evidence to support their effectiveness. Conclusion A large number of web-based support systems have been developed to support mental health and wellbeing, although few specifically target HE students. Further research is necessary to establish the effectiveness of such interventions in providing a cost-effective alternative to face-to-face therapy, particularly in certain settings such as HE institutions

eHealth cognitieve gedragstherapie voor patiënten met chronische somatische aandoeningen

-based cognitive behavioral therapy for patients with chronic somatic conditions Many patients with chronic somatic conditions regularly experience impairments in physical and psychological functioning in their daily life. A way to support these patients is to offer online programs based on cognitive behavioral therapy (Internet-based cognitive behavioral therapy; ICBT). Although a substantial evidence base already exists regarding the effectiveness of ICBT in treating, for example, depressive symptoms, research on ICBT for chronic somatic conditions is still upcoming. In recent years, a growing number of randomized controlled trials were published that examined the effectiveness of ICBT in various chronic somatic conditions. To systematically and quantitatively evaluate the results of these studies, a metaanalysis was conducted, the results of which are discussed in this article. Results indicated that ICBT is also overall effective for chronic somatic conditions, with small to moderate effect sizes. Larger effects were occasionally found for disease-specific outcomes such as disease symptoms and disease-specific quality of life. A longer treatment duration was found to be marginally related to a larger decrease in depressive symptoms. In addition to the results of the meta-analysis, this article provides an overview of the recent literature regarding several clinically relevant ICBT topics: cost-effectiveness, guided ICBT interventions versus self-help, the role of treatment duration, and optimal design and implementation of eHealth interventions.FSW - Self-regulation models for health behavior and psychopathology - ou

Collateral outcomes in e-mental health:A systematic review of the evidence for added benefits of computerized cognitive behavior therapy interventions for mental health

Background.E-mental health is a growing research field and an increasing number of computerized cognitive behavior therapy (cCBT) interventions are available for numerous mental health issues. Such interventions are often claimed to have added benefits, or collateral outcomes, when compared with traditional delivery platforms. Our aim was to systematically review the evidence of the cost-effectiveness, geographic flexibility, time flexibility, waiting time for treatment, stigma, therapist time, effects on help-seeking and treatment satisfaction of cCBT interventions for mental health.Method.The electronic databases Medline and Web of Science were searched for peer-reviewed controlled trials investigating collateral outcomes in computerized and internet-based CBT.Results.The literature search identified 101 published papers (95 studies), which were included in this review. The results suggest that cCBT interventions are cost-effective and often cheaper than usual care. Limited evidence was found with regard to geographic flexibility, time flexibility, waiting time for treatment, stigma and the effects on help-seeking. Personal support in cCBT was found to take many forms, was not limited only to therapists, and seemed to increase treatment adherence and reduce attrition. Treatment satisfaction with cCBT was found to be high, but more research on attrition due to dissatisfaction is required.Conclusions.Although the results of this systematic review on the collateral outcomes provide support for the potential of cCBT, these outcomes need to be better assessed within individual e-mental health studies.</jats:sec