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Magill M, Maisto S, Borsari B, Glass JE, Hallgren K, Houck J, Kiluk B, Kuerbis A. Addictions treatment mechanisms of change science and implementation science: A critical review. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:827-839. [PMID: 36913967 PMCID: PMC10314994 DOI: 10.1111/acer.15053] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/05/2023] [Accepted: 03/03/2023] [Indexed: 03/14/2023]
Abstract
This manuscript aims to contribute to the next phase of mechanisms of behavior change (MOBC) science on alcohol or other drug use. Specifically, we encourage the transition from a basic science orientation (i.e., knowledge generation) to a translational science orientation (i.e., knowledge application or Translational MOBC Science). To inform that transition, we examine MOBC science and implementation science and consider how these two research areas can intersect to capitalize on the goals, strengths, and key methodologies of each. First, we define MOBC science and implementation science and offer a brief historical rationale for these two areas of clinical research. Second, we summarize similarities in rationale and discuss two scenarios where one draws from the other-MOBC science on implementation strategy outcomes and implementation science on MOBC. We then focus on the latter scenario, and briefly review the MOBC knowledge base to consider its readiness for knowledge translation. Finally, we provide a series of research recommendations to facilitate the translation of MOBC science. These recommendations include: (1) identifying and targeting MOBC that are well suited for implementation, (2) use of MOBC research results to inform broader health behavior change theory, and (3) triangulation of a more diverse set of research methodologies to build a translational MOBC knowledge base. Ultimately, it is important for gains borne from MOBC science to affect direct patient care, while basic MOBC research continues to be developed and refined over time. Potential implications of these developments include greater clinical significance for MOBC science, an efficient feedback loop between clinical research methodologies, a multi-level approach to understanding behavioral change, and reduced or eliminated siloes between MOBC science and implementation science.
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Affiliation(s)
- Molly Magill
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Stephan Maisto
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Brian Borsari
- Department of Psychiatry, San Francisco Veteran’s Administration, University of California – San Francisco, San Francisco, California, USA
| | - Joseph E. Glass
- Kaiser Permanente – Washington Health Research Institute, Seattle, Washington, USA
| | - Kevin Hallgren
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Jon Houck
- Mind Research Network, University of New Mexico, Albuquerque, New Mexico, USA
| | - Brian Kiluk
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Alexis Kuerbis
- Silberman School of Social Work, CUNY Hunter College, New York, New York, USA
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Hudon A, Couture J, Dellazizzo L, Beaudoin M, Phraxayavong K, Potvin S, Dumais A. Dyadic Interactions of Treatment-Resistant Schizophrenia Patients Having Followed Virtual Reality Therapy: A Content Analysis. J Clin Med 2023; 12:jcm12062299. [PMID: 36983300 PMCID: PMC10053204 DOI: 10.3390/jcm12062299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/03/2023] [Accepted: 03/15/2023] [Indexed: 03/18/2023] Open
Abstract
(1) Background: Very little is known about the inner therapeutic processes of psychotherapy interventions for patients suffering from treatment-resistant schizophrenia. Avatar therapy (AT) is one such modalities in which the patient is undergoing immersive sessions in which they interact with an Avatar representing their main persistent auditory verbal hallucination. The aim of this study is to identify the most prevalent dyadic interactions between the patient and the Avatar in AT for patient’s suffering from TRS. (2) Methods: A content analysis of 256 verbatims originating from 32 patients who completed AT between 2017 and 2022 at the Institut universitaire en santé mentale de Montréal was conducted to identify dyadic interactions between the patients and their Avatar. (3) Results: Five key dyads were identified to occur on average more than 10 times for each participant during the immersive sessions across their AT: (Avatar: Reinforcement, Patient: Self-affirmation), (Avatar: Provocation, Patient: Self-affirmation), (Avatar: Coping mechanisms, Patient: Prevention), (Patient: Self-affirmation, Avatar: Reinforcement), and (Patient: Self-appraisal, Avatar: Reinforcement). (4) Conclusion: These dyads offer a first qualitative insight to the interpersonal dynamics and patient-avatar relationships taking place during AT. Future studies on the implication of such dyadic interactions with the therapeutic outcome of AT should be conducted considering the importance of dyadic relationships in psychotherapy.
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Affiliation(s)
- Alexandre Hudon
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC H1N 3J4, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - Jonathan Couture
- Faculty of Medicine, Department of Medicine, Campus Montréal, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - Laura Dellazizzo
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC H1N 3J4, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - Mélissa Beaudoin
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC H1N 3J4, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | | | - Stéphane Potvin
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC H1N 3J4, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - Alexandre Dumais
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC H1N 3J4, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, QC H3T 1J4, Canada
- Services et Recherches Psychiatriques AD, Montréal, QC H1C 1H1, Canada
- Institut National de Psychiatrie Légale Philippe-Pinel, Montréal, QC H1C 1H1, Canada
- Correspondence:
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Maisto SA, Simons JS, Palfai TP, Moskal D, Sheinfil AZ, Tahaney KD. Effects of Alcohol Intoxication on Sexual Decision-Making among Men Who Have Sex with Men (MSM): Alcohol's Influences on Self-Control Processes. Clin Psychol Sci 2023; 11:40-58. [PMID: 36865995 PMCID: PMC9976705 DOI: 10.1177/21677026221079780] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This experiment tested mechanisms linking alcohol intoxication and analogue determinants of condomless anal intercourse (CAI) in a sample of 257 men who have sex with men (MSM). The two mechanisms tested were implicit approach biases toward CAI stimuli and executive working memory. Participants were randomized to 3 conditions (water control, placebo, or alcohol) and following beverage administration completed a working memory task, an Approach Avoidance Task of sexual vs. condom stimuli, and two video role-play vignettes of high-risk sexual scenarios. Sexual arousal and CAI intentions were assessed by self-report, and behavioral skills and risk exposure were derived from participants' role-play behavior. Estimation of four path models showed that the hypothesized mechanisms were supported for the CAI intention outcome, but the findings for the skills and risk exposure outcome were mixed. Implications for development and enhancement of HIV prevention interventions were discussed.
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Affiliation(s)
| | - Jeffrey S. Simons
- Department of Psychology, University of South Dakota, Vermillion, USA
| | - Tibor P. Palfai
- Department of Psychological and Brain Sciences, Boston University, Boston, USA
| | - Dezarie Moskal
- VA Center for Integrated Healthcare, VA Western New York Healthcare System, Buffalo, NY, USA,School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Alan Z Sheinfil
- Department of Psychology, Syracuse University, Syracuse, USA
| | - Kelli D. Tahaney
- Department of Psychological and Brain Sciences, Boston University, Boston, USA
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Atherton WL, Hudock D. Addressing the Psychosocial Needs of Individuals with Communication Disorders: The Integration of Animal-Assisted Therapy within Counseling. Semin Speech Lang 2022; 43:24-34. [PMID: 35135020 DOI: 10.1055/s-0041-1741556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Individuals with speech, language, and communication disorders often present with psychosocial concerns that span the physiological, intrapersonal, and interpersonal domains of functioning. Despite this fact, the provision of counseling service by speech-language pathologist (SLP) that directly addresses clients' psychosocial needs is sparse. Research shows the primary counseling strategy used by therapists is psychoeducation, failing to effectively address the psychosocial concerns. Integrating complementary approaches to traditional counseling in SLP can enhance both the quality of therapeutic intervention and client outcomes. The purpose of this article is to demonstrate the potential of animal-assisted therapy (AAT) as an adjunctive or complementary approach for counseling within SLP. A review of literature demonstrates a need for improved counseling service provision within SLP treatment, as well as the benefits of integrating AAT. A framework for how AAT intentions and techniques fit within SLP Scope of Practice counseling activities is presented, along with case examples to demonstrate how AAT can be integrated within SLP treatment. It is concluded that the integration of AAT as a complementary approach to traditional SLP counseling can enhance both the frequency of counseling services provided and clients' psychosocial outcomes.
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Affiliation(s)
- W Leigh Atherton
- Department of Addictions and Rehabilitation Studies, East Carolina University, Greenville, North Carolina
| | - Daniel Hudock
- Department of Communication Sciences and Disorders, Idaho State University, Pocatello, Idaho
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Palfai TP, Luehring-Jones P. How Alcohol Influences Mechanisms of Sexual Risk Behavior Change: Contributions of Alcohol Challenge Research to the Development of HIV Prevention Interventions. AIDS Behav 2021; 25:314-332. [PMID: 34148189 DOI: 10.1007/s10461-021-03346-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 10/21/2022]
Abstract
This paper examines the contributions of laboratory-based alcohol challenge research (ACR) to the development of HIV prevention interventions. Following a brief overview of HIV prevention interventions and related health behavior change models, we discuss how alcohol may influence mechanisms of behavior change. The paper highlights the value of ACR for: (1) elucidating mechanisms of action through which alcohol affects sexual risk behavior, (2) testing how alcohol may influence mechanisms thought to underlie HIV prevention interventions, (3) clarifying moderators of the causal influences of alcohol, (4) identifying novel intervention targets, and (5) developing strategies to reduce sexual risk among those who consume alcohol. We conclude with a discussion of the importance of using experimental research to identify mechanisms of behavior change that are specific to populations at high risk for HIV and outline some key implications for developing HIV prevention interventions that integrate the role of alcohol.
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Holzhauer CG, Epstein EE, Smelson DA, Mattocks K. Targeting women veteran's stress-induced drinking with cognitive reappraisal: Mechanisms and moderators of change. J Subst Abuse Treat 2021; 130:108408. [PMID: 34118700 PMCID: PMC8478824 DOI: 10.1016/j.jsat.2021.108408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 11/26/2022]
Abstract
Emotion dysregulation mediates the effects of stress on drinking among individuals with co-occurring emotional and alcohol use disorders (AUD). The current study examined the effects of cognitive reappraisal (CR), an adaptive emotion regulation strategy, on mechanisms that contribute to drinking (alcohol craving, inhibitory control) among 50 women veterans. In session one, participants were randomized to one of two 50-min "microinterventions", either to learn a CR coping strategy or receive non-therapeutic psychoeducation control. In session two, all participants underwent a personalized stress induction, after which women in the experimental condition were instructed to use CR to reduce stress, while those in the control group were instructed to sit quietly. Craving and inhibitory control were measured at post-stress induction and after using CR/sitting quietly. Moderating effects of AUD, depression, and PTSD severity were assessed. Craving and inhibitory control improved among women in both conditions (CR or sitting quietly), with no main effect of condition. Condition by AUD severity had a significant interaction effect (b = 0.018, p = .013), whereby women with more severe AUD had greater decreases in craving after sitting quietly, and women with less severe AUD had greater decreases in craving after CR. The opposite pattern was observed for inhibitory control (b = 6.45, p = .004), with women with less severe AUD having greater decreases in inhibitory control after sitting quietly, and women with more severe AUD having greater decreases in inhibitory control after CR. Results highlight CR's immediate effects on alcohol-related outcomes and the important role of symptom severity.
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Affiliation(s)
- Cathryn Glanton Holzhauer
- VA Central Western Massachusetts, Division of Research and Education, 421 North Main Street, Leeds, MA 01053, United States of America; University of Massachusetts Medical School, Department of Psychiatry, 365 Plantation Street Biotech One, Worcester, MA 01605, United States of America.
| | - Elizabeth E Epstein
- University of Massachusetts Medical School, Department of Psychiatry, 365 Plantation Street Biotech One, Worcester, MA 01605, United States of America
| | - David A Smelson
- University of Massachusetts Medical School, Department of Psychiatry, 365 Plantation Street Biotech One, Worcester, MA 01605, United States of America
| | - Kristin Mattocks
- VA Central Western Massachusetts, Division of Research and Education, 421 North Main Street, Leeds, MA 01053, United States of America; University of Massachusetts Medical School, Department of Psychiatry, 365 Plantation Street Biotech One, Worcester, MA 01605, United States of America
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Differential Effects of an Evolutionary-Based EMDR Therapy on Depression and Anxiety Symptoms: A Case Series Study. JOURNAL OF EMDR PRACTICE AND RESEARCH 2018. [DOI: 10.1891/1933-3196.12.2.46] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A novel evolutionary-based therapy, treating depression downhill (TDD), was designed as a specific therapy for depression as a syndrome (Krupnik, 2014) and later integrated with eye movement desensitization and reprocessing (EMDR) therapy into a combined TDD-EMDR treatment. The combined therapy integrates modified EMDR procedures into the theoretical context of TDD. These procedures are applied during the second (acceptance) stage of TDD-EMDR’s three-stage proltocol with the focus on acceptance of defeat/failure/loss rather than on distressing memories. Here, we report a case series of 21 military personnel diagnosed with depressive disorders, who received a course of TDD-EMDR. Eighty percent of completers (n= 15) did not meet the criteria of depressive disorder by the treatment’s end. After 12 sessions, they showed a significant reduction on the Beck’s Depression Inventory-II (BDI-II) with a large effect size (d= 2.8) and an increase in accepting disposition (d= 1.8) on the Acceptance and Action Questionnaire. Noncompleters showed similar to completers decrease of BDI-II scores at mid-treatment. We observed no statistically significant decrease of the anxiety symptoms on the Beck’s Anxiety Inventory. These results suggest that TDD-EMDR may be an effective treatment for depressive disorders. They also indicate that it may preferentially target depressive over anxiety symptoms, as was previously observed for TDD. Suggestions are made for future research.
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MacDuffie KE, Strauman TJ. Understanding Our Own Biology: The Relevance of Auto-Biological Attributions for Mental Health. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2017. [DOI: 10.1111/cpsp.12188] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Strauman TJ, Eddington KM. Treatment of Depression From a Self-Regulation Perspective: Basic Concepts and Applied Strategies in Self-System Therapy. COGNITIVE THERAPY AND RESEARCH 2016; 41:1-15. [PMID: 28216800 DOI: 10.1007/s10608-016-9801-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Self-regulation models of psychopathology provide a theory-based, empirically supported framework for developing psychotherapeutic interventions that complement and extend current cognitive-behavioral models. However, many clinicians are only minimally familiar with the psychology of self-regulation. The aim of the present manuscript is twofold. First, we provide an overview of self-regulation as a motivational process essential to well-being and introduce two related theories of self-regulation which have been applied to depression. Second, we describe how self-regulatory concepts and processes from those two theories have been translated into psychosocial interventions, focusing specifically on self-system therapy (SST), a brief structured treatment for depression that targets personal goal pursuit. Two randomized controlled trials have shown that SST is superior to cognitive therapy for depressed clients with specific self-regulatory deficits, and both studies found evidence that SST works in part by restoring adaptive self-regulation. Self-regulation-based psychotherapeutic approaches to depression hold significant promise for enhancing treatment efficacy and ultimately may provide an individualizable framework for treatment planning.
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10
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Black JJ, Chung T. Mechanisms of change in adolescent substance use treatment: how does treatment work? Subst Abus 2015; 35:344-51. [PMID: 24901750 DOI: 10.1080/08897077.2014.925029] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Adolescent substance use treatment outcome research generally shows small to moderate effects in reducing substance use, with no specific "brand" of treatment emerging as clearly superior to any other, and treatment gains that fade over time. The relatively weak and temporary effects of treatment call for improving the potency and durability of intervention effects. In response to this call, this critical narrative review summarizes research on mechanisms of change for both adults and adolescents in substance use treatment, with a particular focus on reviewing what is known regarding "how" adolescent substance use treatment works. METHODS A comprehensive review of the adolescent (aged 11-18) substance use treatment literature was conducted to identify empirical studies that examined mediators of intervention effects. Relevant databases (e.g., PsychINFO, MEDLINE) were searched using key words (e.g., "mediator"), and relevant articles from reference sections of identified studies and review papers were considered. RESULTS Studies of mechanisms of psychotherapy change are rare in the adult, and particularly adolescent, substance use treatment outcome literature. The 4 adolescent studies that examined substance use treatment mechanisms found that positive social support, motivation to abstain, and positive parenting behaviors mediated treatment effects. To date, research has not supported therapy-specific mechanisms of change, finding instead that "common" processes of change largely account for improvements in outcome across distinct "brands" of treatment. CONCLUSIONS The lack of empirical support for treatment-specific mechanisms of change may be due to the need for greater precision in defining and measuring treatment-specific causal chains. Future directions include neuroscience approaches to examining changes in brain functioning that are associated with treatment response and recovery and examining mechanisms in adaptive treatment designs, which can accommodate individual differences in targets for intervention and response to treatment.
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Affiliation(s)
- Jessica J Black
- a Western Psychiatric Institute and Clinic , University of Pittsburgh Medical Center , Pittsburgh , Pennsylvania , USA
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11
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van Der Schaaf ME, Schmits IC, Roerink M, Geurts DEM, Toni I, Roelofs K, De Lange FP, Nater UM, van der Meer JWM, Knoop H. Investigating neural mechanisms of change of cognitive behavioural therapy for chronic fatigue syndrome: a randomized controlled trial. BMC Psychiatry 2015; 15:144. [PMID: 26138726 PMCID: PMC4489043 DOI: 10.1186/s12888-015-0515-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 06/02/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic fatigue syndrome (CFS) is characterized by profound and disabling fatigue with no known somatic explanation. Cognitive behavioral therapy (CBT) has proven to be a successful intervention leading to a reduction in fatigue and disability. Based on previous neuroimaging findings, it has been suggested that central neural mechanisms may underlie CFS symptoms and play a role in the change brought on by CBT. In this randomized controlled trial we aim to further investigate the neural mechanisms that underlie fatigue in CFS and their change by CBT. METHODS/DESIGN We will conduct a randomized controlled trial in which we collect anatomical and functional magnetic resonance imaging (MRI) measures from female CFS patients before and after CBT (N = 60) or waiting list (N = 30) and compare these with measures from age and education matched healthy controls (N = 30). By including a large treatment group we will also be able to compare patients that benefit from CBT with those that do not. In addition, to further investigate the role of endocrine and immune biomarkers in CFS, we will determine cortisol and cytokine concentrations in blood, hair and/or saliva. DISCUSSION This project creates an unique opportunity to enhance our understanding of CFS symptoms and its change by CBT in terms of neuroanatomical, neurofunctional, endocrinological and immunological mechanisms and can help to further improve future treatments strategies. TRIAL REGISTRATION Dutch Trial Register #15852. Registered 9 December 2013 ( http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4311 ).
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Affiliation(s)
- Marieke E van Der Schaaf
- Radboud University Medical Center, Expert Centre for Chronic Fatigue, Nijmegen, The Netherlands. .,Donders Institute for Brain, Cognition, and Behaviour, Centre for Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands. .,Donders Institute, Centre for neuroimaging, Kapittelweg 29, P.O. Box 9101, NL-6500 HB, Nijmegen, The Netherlands.
| | - Iris C Schmits
- Radboud University Medical Center, Expert Centre for Chronic Fatigue, Nijmegen, The Netherlands.
| | - Megan Roerink
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Dirk EM Geurts
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ivan Toni
- Donders Institute for Brain, Cognition, and Behaviour, Centre for Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands.
| | - Karin Roelofs
- Behavioral Science Institute (BSI), Radboud University Nijmegen, Nijmegen, The Netherlands.
| | - Floris P De Lange
- Donders Institute for Brain, Cognition, and Behaviour, Centre for Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands.
| | - Urs M Nater
- Department of Psychology, University of Marburg, Marburg, Germany.
| | - Jos WM van der Meer
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hans Knoop
- Radboud University Medical Center, Expert Centre for Chronic Fatigue, Nijmegen, The Netherlands.
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Microinterventions targeting regulatory focus and regulatory fit selectively reduce dysphoric and anxious mood. Behav Res Ther 2015; 72:18-29. [PMID: 26163353 DOI: 10.1016/j.brat.2015.06.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 05/12/2015] [Accepted: 06/09/2015] [Indexed: 11/21/2022]
Abstract
Depression and generalized anxiety, separately and as comorbid states, continue to represent a significant public health challenge. Current cognitive-behavioral treatments are clearly beneficial but there remains a need for continued development of complementary interventions. This manuscript presents two proof-of-concept studies, in analog samples, of "microinterventions" derived from regulatory focus and regulatory fit theories and targeting dysphoric and anxious symptoms. In Study 1, participants with varying levels of dysphoric and/or anxious mood were exposed to a brief intervention either to increase or to reduce engagement in personal goal pursuit, under the hypothesis that dysphoria indicates under-engagement of the promotion system whereas anxiety indicates over-engagement of the prevention system. In Study 2, participants with varying levels of dysphoric and/or anxious mood received brief training in counterfactual thinking, under the hypothesis that inducing individuals in a state of promotion failure to generate subtractive counterfactuals for past failures (a non-fit) will lessen their dejection/depression-related symptoms, whereas inducing individuals in a state of prevention failure to generate additive counterfactuals for past failures (a non-fit) will lessen their agitation/anxiety-related symptoms. In both studies, we observed discriminant patterns of reduction in distress consistent with the hypothesized links between dysfunctional states of the two motivational systems and dysphoric versus anxious symptoms.
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Krupnik V. Integrating EMDR into an evolutionary-based therapy for depression: a case study. Clin Case Rep 2015; 3:301-7. [PMID: 25984310 PMCID: PMC4427373 DOI: 10.1002/ccr3.228] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Revised: 01/12/2015] [Accepted: 01/20/2015] [Indexed: 11/23/2022] Open
Abstract
We present an intervention in a case of major depression, where eye movement desensitization and reprocessing (EMDR) therapy was integrated into an evolutionary-based psychotherapy for depression. At the end of the treatment and at follow up assessment we observed a more accepting disposition and decreased depressive but not anxiety symptoms.
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Affiliation(s)
- Valery Krupnik
- Mental Health Department, Naval Hospital Camp Pendleton Vandergrift Blvd, Camp Pendleton, California, 92025, USA
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Toli A, Webb TL, Hardy GE. Does forming implementation intentions help people with mental health problems to achieve goals? A meta-analysis of experimental studies with clinical and analogue samples. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2015; 55:69-90. [DOI: 10.1111/bjc.12086] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 01/14/2015] [Indexed: 11/30/2022]
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Zaunmüller L, Lutz W, Strauman TJ. Affective impact and electrocortical correlates of a psychotherapeutic microintervention: an ERP study of cognitive restructuring. Psychother Res 2013; 24:550-64. [PMID: 24286245 DOI: 10.1080/10503307.2013.847986] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE Psychotherapy for depression emphasizes techniques that can help individuals regulate their moods. The present study investigated the affective impact and electrocortical correlates of cognitive restructuring, delivered as a 90-minute psychotherapeutic microintervention in a dysphoric sample. METHOD Participants (N = 92) who reported either low or high levels of dysphoric symptoms were randomly assigned to the restructuring microintervention, a control intervention or a no-intervention condition. We obtained recordings of event-related potentials (ERPs) as well as mood self-ratings during an experimental session immediately after the psychotherapeutic microintervention and the control intervention in which a set of negatively valenced pictures (IAPS) was presented with different instructions. RESULTS Whereas the restructuring intervention group and the control intervention group reported both increases in positive and decreases in negative affect from pre- to post-intervention, the three groups differed significantly on ERP measures. CONCLUSIONS Findings provide support for current models of mechanisms of action in cognitive therapies.
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Affiliation(s)
- Luisa Zaunmüller
- a Clinical Psychology and Psychotherapy, Department of Psychology , University of Trier , Trier , Germany
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Feldstein Ewing SW, Chung T. Neuroimaging mechanisms of change in psychotherapy for addictive behaviors: emerging translational approaches that bridge biology and behavior. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2013; 27:329-35. [PMID: 23815447 PMCID: PMC3864922 DOI: 10.1037/a0031491] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Research on mechanisms of behavior change provides an innovative method to improve treatment for addictive behaviors. An important extension of mechanisms of change research involves the use of translational approaches, which examine how basic biological (i.e., brain-based mechanisms) and behavioral factors interact in initiating and sustaining positive behavior change as a result of psychotherapy. Articles in this special issue include integrative conceptual reviews and innovative empirical research on brain-based mechanisms that may underlie risk for addictive behaviors and response to psychotherapy from adolescence through adulthood. Review articles discuss hypothesized mechanisms of change for cognitive and behavioral therapies, mindfulness-based interventions, and neuroeconomic approaches. Empirical articles cover a range of addictive behaviors, including use of alcohol, cigarettes, marijuana, cocaine, and pathological gambling and represent a variety of imaging approaches including fMRI, magneto-encephalography, real-time fMRI, and diffusion tensor imaging. Additionally, a few empirical studies directly examine brain-based mechanisms of change, whereas others examine brain-based indicators as predictors of treatment outcome. Finally, two commentaries discuss craving as a core feature of addiction, and the importance of a developmental approach to examining mechanisms of change. Ultimately, translational research on mechanisms of behavior change holds promise for increasing understanding of how psychotherapy may modify brain structure and functioning and facilitate the initiation and maintenance of positive treatment outcomes for addictive behaviors.
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Affiliation(s)
- Sarah W Feldstein Ewing
- University Honors College/University of New Mexico Center on Alcoholism, Substance Abuse, and Addiction, Albuquerque, NM 87131, USA.
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