The Role of Dysfunctional Beliefs and Attitudes about Sleep (DBAS), Rumination, Psychological Inflexibility, and Insomnia Among College Students

The purpose of the study was to understand additional variables that play a role between insomnia and the inability to stay present with internal feelings/emotions (i.e., psychological inflexibility) among college students. These variables that were predicted to help explain this relationship include dysfunctional sleep-related cognitions and insomnia rumination. To do this, college students were surveyed online at the start of the study and one month later. In addition, to be included in the study they must have been enrolled in a 2- or 4-year university, have access to the internet, and not diagnosed with another sleep disorder. Participants (n = 490) were from the mountain west and Midwest region of the U.S. A majority of participants were composed of college students who are full-time (94.7%), undergraduate (99.8%), female (75.1%), or White (83.7%). Results showed psychological inflexibility, dysfunctional sleep-related cognitions, insomnia rumination, and insomnia were significantly correlated with each other. The main analysis (i.e., serial mediation), showed that dysfunctional sleep-related cognitions, insomnia rumination helped explain the relationship between psychological inflexibility and insomnia. These results suggest there is potential to assisting future interventions by understanding and targeting these negative repetitive thoughts (i.e., dysfunctional sleep-related cognitions and insomnia rumination). Future studies should aim to uncover treatment outcomes for these variables

Increasing Pediatric Hearing Aid Use: Considerations for Clinical Practice

Purpose: Hearing aid use can be variable for young children, and inconsistent wear time can undermine spoken language development. This study explored the effectiveness of hearing aid data logging (DL) awareness and coaching sessions on increasing hours of hearing aid use. We also collected qualitative data on challenges participants experienced managing hearing aid use. Method: We used a single-subject design that included three conditions, during a 6-week period, in the same order for each participant. Condition A was baseline, Condition B was DL monitoring alone, and Condition C was remote coaching calls plus DL monitoring. Results: Hours of hearing aid use increased for each child from baseline to the end of the study, ranging from 1.19 to 4.4 hr. Mothers reported that the coaching calls were beneficial and helped them identify and problem-solve issues. Conclusions: Parents were able to increase hours of hearing aid use with DL awareness and coaching support. Tele-audiology offers an opportunity to provide parents with more frequent support that can be individualized based on their situation, challenges, and family needs

eHealth Education and Support for Pediatric Hearing Aid Management: Parent Goals, Questions and Challenges

Purpose: To investigate parent goals, questions, and challenges that emerged during coaching phone calls in an eHealth program designed to provide education and support for hearing aid management. Methods: Coaching phone calls were audio-recorded, transcribed and qualitatively analyzed for emergent themes within the categories of goals, questions, and challenges. Results: Emergent themes revealed parent goals were focused on self-efficacy, routines, device care and child development. Emergent themes for questions revealed parents asked questions related to the device care, audiology appointments, confirmation of learning, and child development. For challenges emergent themes revealed parents’ own struggles (e.g., with emotions), issues related to working with their audiologist, child factors and anticipated challenges. Conclusion: The eHealth intervention allowed parents to raise questions and discuss their challenges in a supportive environment. Supportive accountability helped participants identify and address barriers to hearing aid management based on their priorities and current challenges. Providing supplemental learning support, in addition to routine audiology visits, can help parents develop more effective hearing aid management routines

Moderators and Predictors in a Parent Hearing Aid Management eHealth Program

Objective: Consistent hearing-aid use is essential for spoken language development of children who are hard of hearing. A recent randomized controlled trial of an eHealth hearing aid management education program found the intervention increased knowledge, perceptions, confidence, and device monitoring among parents of young children. Yet, it is not known which variables can be a point of emphasis to improve treatment outcomes. The purpose of this study was to investigate potential moderators and predictors in the eHealth program. Design: Randomized controlled trial Study Sample: Parents (N=78) of children (42 months or younger) were randomized to the intervention or treatment-as-usual (TAU) group. Results: Results revealed that high psychological inflexibility, low parent activation, and low hours of hearing aid use may moderate device monitoring frequency and knowledge; parents in the intervention improved over time compared to the TAU group. Psychological inflexibility and parent activation also predicted treatment outcomes. Conclusion: The findings suggest the need to address parent psychological inflexibility related to hearing loss management, parents’ role in their child’s hearing aid management, and reported hours of hearing aid use as part of hearing aid service delivery. Identification of barriers to hearing aid management can assist audiologists in adjusting support to improve outcomes

A Systematic Review and Meta-Analysis of Self-Guided Online Acceptance and Commitment Therapy as a Transdiagnostic Self-Help Intervention

Online Acceptance and Commitment Therapy (ACT) interventions use websites and smartphone apps to deliver ACT exercises and skills. The present meta-analysis provides a comprehensive review of online ACT self-help interventions, characterizing the programs that have been studied (e.g. platform, length, content) and analyzing their efficacy. A transdiagnostic approach was taken, including studies that addressed a range of targeted problems and populations. Multi-level meta-analyses were used to nest multiple measures of a single construct within their respective studies. A total of 53 randomized controlled trials were included (n = 10,730). Online ACT produced significantly greater outcomes than waitlist controls at post-treatment for anxiety, depression, quality of life, psychological flexibility, and all assessed outcomes (i.e. omnibus effect), which were generally maintained at follow-up. However, only psychological flexibility and all assessed outcomes at post-treatment were found to be significantly greater for online ACT when compared to active controls, with no significant follow-up effects. Overall, these results further clarify that ACT can be effectively delivered in an online format to target a wide range of mental health concerns, although it is less clear if and when online ACT is more efficacious than other online interventions

eHealth Parent Education for Hearing Aid Management: A Pilot Randomized Controlled Trial

Objective: Parents frequently experience challenges implementing daily routines important for consistent hearing aid management. Education that supports parents in learning new information and gaining confidence is essential for intervention success. We conducted a pilot study to test an eHealth program to determine if we could implement the program with adherence and affect important behavioral outcomes compared to treatment as usual. Design: Randomized controlled trial Study sample: Parents of children birth to 42 months who use hearing aids. Eighty-two parents were randomly assigned to the intervention or treatment-as-usual group. Four parents assigned to the intervention group did not continue after baseline testing. Results: The intervention was delivered successfully with low drop out (10%), high session completion (97%), and high program adherence. The intervention conditions showed significantly greater gains over time for knowledge, confidence, perceptions, and monitoring related to hearing aid management. Significant differences between groups were not observed for hearing aid use time. Conclusion: We found that we could successfully implement this eHealth program and that it benefitted the participants in terms of knowledge and confidence with skills important for hearing aid management.Future research is needed to determine how to roll programs like this out on a larger scale

Baseline cocaine demand predicts contingency management treatment outcomes for cocaine-use disorder.

Cocaine use disorder (CUD) is a significant public health issue. Behavioral interventions such as contingency management (CM) have been demonstrated to be highly effective in promoting cocaine abstinence. However, identifying individual characteristics associated with cocaine relapse may help improve treatment outcomes. Cocaine demand is a behavioral economic measure that shares a scientific foundation with CM. In the current study, we assessed baseline cocaine demand using a hypothetical cocaine purchasing task. Participants ( = 58) consisted of treatment-seeking individuals with CUD. All participants received 1 month of CM treatment for cocaine abstinence, and treatment responders were defined as presenting 6 consecutive cocaine negative urine samples from thrice weekly clinic visits. Demand data were well described by the exponentiated demand model. Indices of demand (intensity of demand [₀], elasticity [α]) were significantly associated with recent (last 30 days) cocaine use. Importantly, linear regression revealed that CM treatment nonresponders presented significantly higher ₀ (p = .025). Subsequent quantile regression analyses examining the relationship between CM treatment response and ₀ revealed statistically reliable effects of being a nonresponder across 3 of the lower percentiles (i.e., 15, 25, and 30). Overall, these findings provide further support for the utility of exponentiated demand model. To our knowledge, this is the first study to demonstrate an association between baseline demand and contingency management response and systematically extend the findings of prior demand research to a novel drug class, cocaine