Priming of landmarks during object-location tasks: effects on self-efficacy of older adults

Computer-based training programs are a new way that many personal skills are being developed, maintained, or enhanced. However, in order for a computer-based training program to be effective, users must be highly motivated to complete the required tasks. One way to improve motivation for continuing tasks is through increasing self-efficacy, or a person’s perceived ability in an area. While older adults might greatly benefit from computer-based training programs for memory, low self-efficacy for both memory and computer use can be a barrier to motivation, limiting potential benefits. However, a person’s self-efficacy can be improved by experiencing success in a task. The current study investigated whether priming a landmark could be used to generate such success in an object-location memory task, ultimately enhancing older adults’ self-efficacy. Participants were 62 older adults and 59 younger adults who were shown a series of videos of virtual rooms and had to make memory judgments about where they had seen certain items in those rooms. Half of the participants were primed for spatial landmarks for specific objects in the virtual environment, while half were not. While many previously established effects were replicated, priming of landmarks did not significantly impact memory or self-efficacy. However, exploration of secondary analyses emphasized the importance of improving self-efficacy in older adults for these types of tasks. Specifically, self-efficacy in older adults was lower than younger adults, even after controlling for memory performance. Considerations of the importance of self-efficacy for memory performance and motivation in older adults are explored. (Published By University of Alabama Libraries

Mindfulness-based cognitive therapy for the treatment of headache pain: A pilot study

OBJECTIVE:: This pilot study reports the findings of a randomized controlled trial (RCT) investigating the feasibility, tolerability, acceptability, and initial estimates of efficacy of mindfulness-based cognitive therapy (MBCT) compared to a delayed treatment (DT) control for headache pain. It was hypothesized that MBCT would be a viable treatment approach and that compared to DT, would elicit significant improvement in primary headache pain-related outcomes and secondary cognitive-related outcomes. MATERIALS AND METHODS:: RCT methodology was employed and multivariate analysis of variance models were conducted on daily headache diary data and preassessment and postassessment data for the intent-to-treat sample (N=36), and on the completer sample (N=24). RESULTS:: Patient flow data and standardized measures found MBCT for headache pain to be feasible, tolerable, and acceptable to participants. Intent-to-treat analyses showed that compared to DT, MBCT patients reported significantly greater improvement in self-efficacy (P=0.02, d=0.82) and pain acceptance (P=0.02, d=0.82). Results of the completer analyses produced a similar pattern of findings; additionally, compared to DT, MBCT completers reported significantly improved pain interference (

The characteristics of FRILL 2 caregivers by race and gender

The FRILL 2 project, with sites in Athens, GA, Pittsburgh, PA, and Tuscaloosa, AL and funded by a grant from NIA, is a longitudinal study of the experiences of family caregivers (CGs) of older persons. The study, guided by a modified stress and coping model that includes adverse CG outcomes (i.e., abuse, exploitation), recently completed wave 1 interviews with 434 CG/care recipient (CR) dyads. This study examined characteristics of the FRILL 2 CGs and significant differences in their experiences on a gender-by-race basis for the 133 African American female (AAF), 57 African American male (AAM), 169 White female (WF), and 75 White male (WM) CGs. Differences are categorized by Demographic Characteristics (e.g. CG age, income adequacy), Predisposing Variables (e.g., religious coping, instrumental support), Caregiver Mental Health Variables (e.g., resentment, depression), and Quality of Care Variables (e.g., Physical Neglect, Exemplary Care). There were significant differences between male and female CGs as well as differences by race within each gender group. For example, WFs were more likely to isolate CR and had more caregiving resentment. AAFs suffered from anxiety and anger, yet scored high in exemplary care. WMs had lower stress scores and lower levels of perceived instrumental support. AAMs scored higher on communal behavior, yet reported more financial exploitation.Poster Presentatio

Agreement in perceptions of care by older care recipients and their caregivers

Problem. Based on Time 1 data from the Family Relationships in Late Life (FRILL 2) Project, information was collected at research sites in Pittsburgh, PA, Athens, GA, and Tuscaloosa, AL from over 400 caregiver (CG) and care recipient (CR) dyads. One objective of the study is to obtain a profile of the quality of care given to older persons by their informal CGs. Approach. Analysis of interview data from both CRs and their CGs investigated agreement on identical measures regarding the nature and quality of care given to CRs. Summary of Findings. Substantial disagreement was evident in correlational analyses. In contrast to CG responses, CRs perceived themselves to be in better overall health, able to perform more ADLs, to need less medical care, to be more socially isolated, and to experience more financial exploitation and potentially harmful behaviors. Although CGs perceived more physical neglect, CGs believed that they offered better care than did CRs. Conclusions. Explanations will be offered for the low level of agreement in information provided by CRs and their CGs.Poster Presentatio

Family members with mental health problems caring for older relatives: Implications for them and the care recipient

Little has been reported about caregiving dynamics when the identified caregiver experiences mental health problems (MHCG). This paper presents findings from a study examining the reported experience of family caregivers providing care to elders when the caregiver has a mental health problem. Funded by an RO1 grant from the National Institute on Aging, the second Family Relations in Later Life project is a five year study of long-term caregiving to older persons. A total of 444 caregiving dyads recruited from three areas of the U.S. were administered 18 standardized measures related to the caregiving experience. We found that 18% of the caregivers reported having identified psychiatric problems and in 5% of the dyads both the caregiver and care recipient experienced psychiatric problems. Care recipients of MH caregivers reported being less socially isolated and receiving more instrumental support from their caregivers than did non-MH care recipients. MH caregivers reported higher levels of resentment concerning caregiving activities and more frequent angry responses to caregiving situations than the control group. For all caregivers who reported seeking mental health treatment, 79% were MH caregivers. However, only 30% of the MH caregivers had sought mental health treatment within the past year. Persons with mental health problems providing care to family members are believed to do so at their own risk, as caregiving duties can exacerbate their MH problems and may deter them from seeking needed services. Identifying the needs of MH caregivers may avert their own decline as well as those of the care recipients.Poster Presentatio

Transfer of training and the role of mental workload in expert performance

There is a need to understand how to maximize skill development when training operators to undertake vital operational assignments (e.g., flying aircraft). At present, there is much debate in the training community over how to best train these operators and achieve maximum skill transfer, such as whether training should focus on recreating the target task or whether there are benefits to training with subcomponents of the target task. Training with subcomponents can be simpler, cheaper, and therefore more accessible than training with a complex target task, and researchers have found performance gains when training with subcomponents (Ash & Holding, 1990; Gopher, Weil, & Bareket, 1994; Whaley & Fisk, 1993). Instead of utilizing subcomponents of a complex target task, the present study investigated the mental resources required to perform a target task - termed resource training. Given that there are established inventories for breaking down the demand a target task places on different resources, such as the Multiple Resources Questionnaire (Boles & Adair, 2001a, b), this is a logical endeavor. Participants alternated back and forth between a training task and a complex video game, Everyday Shooter, four times a day over two days. The training tasks were previously shown to heavily tax a specific resource, and participants either trained a task sharing many critical resources, or few critical resources, with the video game. In addition to assessing the feasibility of resource training, the present study also assessed the effect of providing metacognitive instructions and examined the role of expertise by including video game experts. Successful transfer was noted for those training the task that shared more critical resources with the target task, providing an instance of transfer via resource training. Superior performance may have been achieved via maintained critical workload, as the group that improved over days also maintained critical workload over days while noncritical workload declined. Importantly, this improvement was only noted when standard instructions were provided. The additional instructions, which pointed out both structural and resource-based similarities between the training task and the target task, Everyday Shooter, were found to be detrimental to performance. From a methodological standpoint, this suggests that participants do not need to be explicitly instructed why certain tasks are being trained in tandem. The alternating design required participants to alternate between the training task and target task, instead of massing together consecutive training sessions before performing the target task. The alternating design is apparently a powerful means of producing transfer, as it led to better performance on the target task and likely removed the need for additional instructions regarding task similarities. Also, recent investigations in our laboratory finding evidence of transfer have employed this alternating design (e.g., Boles & Penn, 2010), while studies have struggled to find consistent evidence of transfer when massing the training sessions together. This successful implementation of resource training with an alternating design suggests that a practical way to achieve skill transfer is to select a training task that shares resources with a complex target task, and alternate training between the two. Finally, expert video game players provided higher critical workload ratings than novices. Instead of narrowing down the resources necessary to perform the video game, experts sustained higher levels of critical workload over days. This could be a major factor in superior expert performance. (Published By University of Alabama Libraries

Technology assisted intervention for improving mood: a portable computer-assisted therapy program for treating depression in older adults

The dissertation examined the effectiveness of a newly developed intervention to treat symptoms of depression among a sample of older adults. The study contained in this dissertation furthered the line of research involving self-administered treatments for depressed older adults. The intervention used in this study was developed for the purpose of creating a portable, computer-based self-administered treatment, which could later be explored as a possible intervention in overcoming barriers to mental healthcare access for older adults. This computer-based intervention was developed using a slate-PC as the platform and series of eleven sessions based on the manual Cognitive-Behavioral Therapy for Late Life Depression (Dick, Gallagher-Thompson, Coon, Powers, & Thompson (1995). Thirty-four, older adult participants were randomly assigned to either an immediate treatment group or a one-month waitlist control group. Outcome measures included both a clinician-rated measure of depression (Hamilton Rating Scale for Depression; HRSD) and a self-report measure of depression (Geriatric Depression Scale; GDS-30). Possible mediators were examined using the Dysfunctional Attitudes Scale (DAS) and the California Older Persons Pleasant Events Scale (COPPES). Treatment receipt and treatment enactment were also constructs of interest; measured by CBT knowledge tests, and the number of sessions and percentage of completed homework assignments completed by the participants. Finally, a measure of intervention benefit was administered to evaluate older adults' acceptance of the computer-based intervention used in this study. Results suggested that the older adults in the experimental condition displayed a significant decrease in depressive symptoms compared to those in the control condition. Analyses of clinical significance also suggested that older adults improved in a clinically meaningful way following the intervention. Meditational relations between condition and outcome were not found using the DAS and the COPPES. Additional, uncontrolled, analyses suggested significant relations between post-treatment depression and measures of treatment receipt and treatment enactment. Finally, feedback from the participants indicated that they considered the intervention easy to use, enjoyable, and useful for learning techniques to improve their mood. The implications of this study were discussed as they relate to the treatment of depression for older adults. New technology-based applications for the treatment of depression among older adults may follow the results found in this dissertation. (Published By University of Alabama Libraries

Evaluation of a brief behavioral activation therapy for depression (BATD) group protocol in an inpatientgeriatric psychiatry facility

The present study examined the effect of a modified Brief Behavioral Activation Therapy for Depression (BATD: Lejuez, Hopko, & Hopko) intervention added to hospital treatment as usual on depressive symptoms (measured by the Geriatric Depression Scale) and global psychopathology (measured by the Brief Symptom Inventory) at a state-run inpatient geriatric psychiatry facility. A control group received hospital treatment as usual only. The intervention was conducted in a group therapy format. Assessments were conducted at baseline, midpoint, and post-intervention. Although results revealed that the intervention did not have a significant effect on depressive symptoms or global psychopathology over and above the effects of hospital treatment as usual, this study was limited by various logistical barriers to implementing the intervention. Treatment implementation data revealed that patient attendance at groups, patient understanding of intervention materials, and patient enactment of treatment concepts in their daily lives were below expectation. Future studies should focus on increasing patient receipt and enactment of the intervention to ensure fair tests of behavioral activation interventions in this setting. (Published By University of Alabama Libraries