1
|
Kroemeke A, Dudek J, Kijowska M, Owen R, Sobczyk-Kruszelnicka M. The effect of an online acceptance and commitment intervention on the meaning-making process in cancer patients following hematopoietic cell transplantation: study protocol for a randomized controlled trial enhanced with single-case experimental design. Trials 2024; 25:392. [PMID: 38890709 PMCID: PMC11186126 DOI: 10.1186/s13063-024-08235-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Hematopoietic cell transplantation (HCT) is a highly invasive and life-threatening treatment for hematological neoplasms and some types of cancer that can challenge the patient's meaning structures. Restoring meaning (i.e., building more flexible and significant explanations of the disease and treatment burden) can be aided by strengthening psychological flexibility by means of an Acceptance and Commitment Therapy (ACT) intervention. Thus, this trial aims to examine the effect of the ACT intervention on the meaning-making process and the underlying mechanisms of change in patients following HCT compared to a minimally enhanced usual care (mEUC) control group. The trial will be enhanced with a single-case experimental design (SCED), where ACT interventions will be compared between individuals with various pre-intervention intervals. METHODS In total, 192 patients who qualify for the first autologous or allogeneic HCT will be recruited for a two-armed parallel randomized controlled trial comparing an online self-help 14-day ACT training to education sessions (recommendations following HCT). In both conditions, participants will receive once a day a short survey and intervention proposal (about 5-10 min a day) in the outpatient period. Double-blinded assessment will be conducted at baseline, during the intervention, immediately, 1 month, and 3 months after the intervention. In addition, 6-9 participants will be invited to SCED and randomly assigned to pre-intervention measurement length (1-3 weeks) before completing ACT intervention, followed by 7-day observations at the 2nd and 3rd post-intervention measure. The primary outcome is meaning-related distress. Secondary outcomes include psychological flexibility, meaning-making coping, meanings made, and well-being as well as global and situational meaning. DISCUSSION This trial represents the first study that integrates the ACT and meaning-making frameworks to reduce meaning-related distress, stimulate the meaning-making process, and enhance the well-being of HCT recipients. Testing of an intervention to address existential concerns unique to patients undergoing HCT will be reinforced by a statistically rigorous idiographic approach to see what works for whom and when. Since access to interventions in the HCT population is limited, the web-based ACT self-help program could potentially fill this gap. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT06266182. Registered on February 20, 2024.
Collapse
Affiliation(s)
- Aleksandra Kroemeke
- Institute of Psychology, Health & Coping Research Group, SWPS University, Warsaw, Poland.
| | - Joanna Dudek
- Faculty of Psychology, SWPS University, Warsaw, Poland
| | - Marta Kijowska
- Institute of Psychology, Health & Coping Research Group, SWPS University, Warsaw, Poland
| | | | - Małgorzata Sobczyk-Kruszelnicka
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| |
Collapse
|
2
|
Almgren Bäck G, Mossige M, Bundgaard Svendsen H, Rønneberg V, Selenius H, Berg Gøttsche N, Dolmer G, Fälth L, Nilsson S, Svensson I. Speech-to-text intervention to support text production among students with writing difficulties: a single-case study in nordic countries. Disabil Rehabil Assist Technol 2024:1-20. [PMID: 38776244 DOI: 10.1080/17483107.2024.2351488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 04/30/2024] [Indexed: 05/24/2024]
Abstract
Studies report that speech-to-text applications (STT) may support students with writing difficulties in text production. However, existing research is sparse, shows mixed results, and lacks information on STT interventions and their applicability in schools. Therefore, this study aimed to investigate whether a systematic and intensive assistive technology intervention focusing on STT can improve text production. A modified multiple-baseline across-subject design was used involving eight middle school students, four Norwegian and four Swedish. Their STT-produced narrative texts were collected during and after the intervention and the productivity, accuracy, and text quality were analysed. Keyboarding was the baseline control condition. The results demonstrated that seven of the eight students increased text productivity and that the proportion of word-level accuracy was maintained or improved. The use of punctuation progressed in participants with poor baseline skills. Most students' STT-produced texts had at least a similar ratio of meaningfulness and text quality as keyboarding. However, the magnitude of the changes and development patterns varied, with three students showing the most notable impacts. In conclusion, this study's intervention seemed beneficial in initially instructing STT, and the progress monitoring guided individually adapted future interventions such as balancing productivity and formal language aspects. Removing the spelling barrier with STT provided an opportunity for students to improve their higher-order skills, such as vocabulary diversity and overall text quality. Furthermore, visible progress, such as the ability to produce longer texts, might motivate continued STT usage. However, such development may not always be immediate.
Collapse
Affiliation(s)
| | - Margunn Mossige
- National Centre for Reading Education and Research, University of Stavanger, Norway
| | | | - Vibeke Rønneberg
- National Centre for Reading Education and Research, University of Stavanger, Norway
| | - Heidi Selenius
- Department of Special Education, Stockholm University, Sweden
| | | | - Grete Dolmer
- VIA Research Center for Pedagogy and Education, Denmark
| | - Linda Fälth
- Department of Pedagogy and Learning, Linnaeus University, Sweden
| | - Staffan Nilsson
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, Gothenburg University
| | - Idor Svensson
- Department of Psychology, Linnaeus University, Sweden
| |
Collapse
|
3
|
Manolov R, Tanious R. Type I error rates and power of two randomization test procedures for the changing criterion design. Behav Res Methods 2024; 56:3637-3657. [PMID: 38082114 PMCID: PMC11133045 DOI: 10.3758/s13428-023-02303-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 05/30/2024]
Abstract
Single-case experimental design (SCED) data can be analyzed following different approaches. One of the first historically proposed options is randomizations tests, benefiting from the inclusion of randomization in the design: a desirable methodological feature. Randomization tests have become more feasible with the availability of computational resources, and such tests have been proposed for all major types of SCEDs: multiple-baseline, reversal/withdrawal, alternating treatments, and changing criterion designs. The focus of the current text is on the last of these, given that they have not been the subject of any previous simulation study. Specifically, we estimate type I error rates and statistical power for two different randomization procedures applicable to changing criterion designs: the phase change moment randomization and the blocked alternating criterion randomization. We include different series lengths, number of phases, levels of autocorrelation, and random variability. The results suggest that type I error rates are generally controlled and that sufficient power can be achieved with as few as 28-30 measurements for independent data, although more measurements are needed in case of positive autocorrelation. The presence of a reversal to a previous criterion level is beneficial. R code is provided for carrying out randomization tests following the two randomization procedures.
Collapse
Affiliation(s)
- Rumen Manolov
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, University of Barcelona, Passeig de la Vall d'Hebron 171, 08035, Barcelona, Spain.
| | - René Tanious
- Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
| |
Collapse
|
4
|
Manolov R, Onghena P. Testing delayed, gradual, and temporary treatment effects in randomized single-case experiments: A general response function framework. Behav Res Methods 2024; 56:3915-3936. [PMID: 37749426 PMCID: PMC11133040 DOI: 10.3758/s13428-023-02230-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2023] [Indexed: 09/27/2023]
Abstract
Randomization tests represent a class of significance tests to assess the statistical significance of treatment effects in randomized single-case experiments. Most applications of single-case randomization tests concern simple treatment effects: immediate, abrupt, and permanent changes in the level of the outcome variable. However, researchers are confronted with delayed, gradual, and temporary treatment effects; in general, with "response functions" that are markedly different from single-step functions. We here introduce a general framework that allows specifying a test statistic for a randomization test based on predicted response functions that is sensitive to a wide variety of data patterns beyond immediate and sustained changes in level: different latencies (degrees of delay) of effect, abrupt versus gradual effects, and different durations of the effect (permanent or temporary). There may be reasonable expectations regarding the kind of effect (abrupt or gradual), entailing a different focal data feature (e.g., level or slope). However, the exact amount of latency and the exact duration of a temporary effect may not be known a priori, justifying an exploratory approach studying the effect of specifying different latencies or delayed effects and different durations for temporary effects. We provide illustrations of the proposal with real data, and we present a user-friendly freely available web application implementing it.
Collapse
Affiliation(s)
- Rumen Manolov
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, University of Barcelona, Passeig de la Vall d'Hebron 171, 08035, Barcelona, Spain.
| | - Patrick Onghena
- Faculty of Psychology and Educational Sciences, Methodology of Educational Sciences Research Group, KU Leuven, Tiensestraat 102, 3000, Leuven, Belgium
| |
Collapse
|
5
|
van Houten J, Bouwmeester S, Bachrach N. Effectiveness of Day Treatment Group Schema Therapy for Personality Disorders: A Multiple Baseline Single-Case Study. Clin Psychol Psychother 2024; 31:e2964. [PMID: 38528762 DOI: 10.1002/cpp.2964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Schema therapy is effective for most outpatients with personality disorders (PDs). However, a subgroup does not sufficiently benefit from outpatient programmes. Despite its common clinical use, a thorough evaluation of day treatment group schema therapy (GST) is lacking. AIMS This study aimed to investigate the effectiveness of day treatment GST for patients with PDs. METHODS AND PROCEDURES Negative core beliefs were the primary outcome in a multiple baseline single-case design, measured weekly before and during 30 weeks of day treatment GST. Secondary outcomes included severity of primary PD, early maladaptive schemas (EMS), schema modes and general psychopathology measured before and after day treatment GST. Intervention effects were evaluated through visual inspection and randomization test analysis, with a reliable change index calculated for the secondary outcome measures. OUTCOMES AND RESULTS A total of 79% of treatment completers showed a significant positive effect of day treatment GST with large effect sizes (Cohen's d: 0.96-10.04). Secondary outcomes supported these findings: 56% had a significant decrease in the severity of primary PD and 53% in general psychopathology. In addition, 63% of EMS and 72% of schema modes (87.5% for functional schema modes) showed significant positive reliable changes. CONCLUSIONS AND IMPLICATIONS This is the first empirical study that demonstrated the effectiveness of day treatment GST in patients with severe PDs. Day treatment GST can serve as a stepped care treatment option for nonresponsive patients in outpatient programmes. Further randomized controlled (cost-)effectiveness research is necessary to substantiate these findings and investigate the specific patient populations for which day treatment is essential.
Collapse
Affiliation(s)
- Joska van Houten
- Department of Trauma Related and Personality Disorders, GGZ Oost Brabant, Helmond, The Netherlands
| | - Samantha Bouwmeester
- Department of Developmental Psychology, Tilburg University, Tilburg, The Netherlands
| | - Nathan Bachrach
- Department of Trauma Related and Personality Disorders, GGZ Oost Brabant, Helmond, The Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Department of Mental Health Care Psychology, RINO Zuid, Eindhoven, The Netherlands
| |
Collapse
|
6
|
Batley P, Thamaran M, Hedges LV. ABkPowerCalculator: An App to Compute Power for Balanced (AB) k Single Case Experimental Designs. MULTIVARIATE BEHAVIORAL RESEARCH 2024; 59:406-410. [PMID: 37847706 DOI: 10.1080/00273171.2023.2261229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Single case experimental designs are an important research design in behavioral and medical research. Although there are design standards prescribed by the What Works Clearinghouse for single case experimental designs, these standards do not include statistically derived power computations. Recently we derived the equations for computing power for (AB)k designs. However, these computations and the software code in R may not be accessible to applied researchers who are most likely to want to compute power for their studies. Therefore, we have developed an (AB)k power calculator Shiny App (https://abkpowercalculator.shinyapps.io/ABkpowercalculator/) that researchers can use with no software training. These power computations assume that the researcher would be interested in fitting multilevel models with autocorrelations or conduct similar analyses. The purpose of this software contribution is to briefly explain how power is derived for balanced (AB)k designs and to elaborate on how to use the Shiny App. The app works well on not just computers but mobile phones without installing the R program. We believe this can be a valuable tool for practitioners and applied researchers who want to plan their single case studies with sufficient power to detect appropriate effect sizes.
Collapse
|
7
|
Heijman J, Wouters H, Schouten KA, Haeyen S. Effectiveness of trauma-focused art therapy (TFAT) for psychological trauma: study protocol of a multiple-baseline single-case experimental design. BMJ Open 2024; 14:e081917. [PMID: 38286685 PMCID: PMC10826536 DOI: 10.1136/bmjopen-2023-081917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/15/2024] [Indexed: 01/31/2024] Open
Abstract
INTRODUCTION Treatments such as eye movement desensitisation and reprocessing and (narrative) exposure therapies are commonly used in psychological trauma. In everyday practice, art therapy is also often used, although rigorous research on its efficacy is lacking. Patients seem to benefit from the indirect, non-verbal experiential approach of art therapy. This protocol paper describes a study to examine the effectiveness of a 10-week individual trauma-focused art therapy (TFAT) intervention. METHODS AND ANALYSIS A mixed-methods multiple-baseline single-case experimental design will be conducted with 25-30 participants with psychological trauma. Participants will be randomly assigned to a baseline period lasting 3-5 weeks, followed by the TFAT intervention (10 weeks) and follow-up (3 weeks). Quantitative measures will be completed weekly: the Beck Depression Inventory-II, the Mental Health Continuum Short Form, the Resilience Scale, the Rosenberg Self-Esteem Scale and the Self-expression and Emotion Regulation in Art Therapy Scale. The Post-Traumatic Stress Disorder Checklist-5 will be completed at week 1 and week 10. Qualitative instruments comprise a semistructured interview with each individual patient and therapist, and a short evaluation for the referrer. Artwork will be used to illustrate the narrative findings. Quantitative outcomes will be analysed with linear mixed models using the MultiSCED web application. Qualitative analyses will be performed using thematic analysis with ATLAS.ti. ETHICS AND DISSEMINATION This study has been approved by the ethics committee of the HAN University of Applied Sciences (ECO 394.0922). All participants will sign an informed consent form and data will be treated confidentially. Findings will be published open access in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT05593302.
Collapse
Affiliation(s)
- Jackie Heijman
- Research Group Arts & Psychomotor Therapies in Health Care, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Hans Wouters
- Research Group Arts & Psychomotor Therapies in Health Care, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Bartimeus, Zeist, The Netherlands
| | - Karin Alice Schouten
- Research Centre of the Arts Therapies, KenVaK, Heerlen, The Netherlands
- ARQ Centre '45, Diemen, The Netherlands
| | - Suzanne Haeyen
- Research Group Arts & Psychomotor Therapies in Health Care, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Scelta Expert Centre for Personality Disorders, GGNet Centre for Mental Health, Apeldoorn, The Netherlands
| |
Collapse
|
8
|
Wan-Vermeer R, Bouwmeester S, Starrenburg A. Brief individual experiential schema therapy in adult outpatients with cluster C personality disorders: Does it work? Clin Psychol Psychother 2024; 31:e2948. [PMID: 38343344 DOI: 10.1002/cpp.2948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 10/30/2023] [Accepted: 12/11/2023] [Indexed: 02/15/2024]
Abstract
This study investigated the effectiveness of brief individual experiential schema therapy (ST) in 12 adult outpatients with cluster C personality disorders (PD) using randomised multiple baseline design. Waitlist period was followed by five explorative sessions, 18 experiential ST sessions, two treatment follow-up (FU) booster sessions and a 6-month FU assessment. Overall well-being (ORS), behavioural treatment goals and negative core beliefs were assessed 60-91 times, global symptomatic distress (BSI) six times. PD severity (SCID-5-PD) was pre-post-analysed. Randomisation and non-parametric tests showed large significant effects (d = 1.08-2.38, r = .53-.66) on all outcomes at treatment-FU and 6-month FU assessment. This is the first study providing preliminary evidence of effectiveness of brief individual experiential ST for patients with cluster C PD, tentatively challenging the common tenet that long treatment duration is required. Due to limitations, replication is recommended.
Collapse
|
9
|
Manolov R. Does the choice of a linear trend-assessment technique matter in the context of single-case data? Behav Res Methods 2023; 55:4200-4221. [PMID: 36622560 DOI: 10.3758/s13428-022-02013-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2022] [Indexed: 01/10/2023]
Abstract
Trend is one of the data aspects that is an object of assessment in the context of single-case experimental designs. This assessment can be performed both visually and quantitatively. Given that trend, just like other relevant data features such as level, immediacy, or overlap does not have a single operative definition, a comparison among the existing alternatives is necessary. Previous studies have included illustrations of differences between trend-line fitting techniques using real data. In the current study, I carry out a simulation to study the degree to which different trend-line fitting techniques lead to different degrees of bias, mean square error, and statistical power for a variety of quantifications that entail trend lines. The simulation involves generating both continuous and count data, for several phase lengths, degrees of autocorrelation, and effect sizes (change in level and change in slope). The results suggest that, in general, ordinary least squares estimation performs well in terms of relative bias and mean square error. Especially, a quantification of slope change is associated with better statistical results than quantifying an average difference between conditions on the basis of a projected baseline trend. In contrast, the performance of the split-middle (bisplit) technique is less than optimal.
Collapse
Affiliation(s)
- Rumen Manolov
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, University of Barcelona, Passeig de la Vall d'Hebron 171, 08035, Barcelona, Spain.
| |
Collapse
|
10
|
Khasho DA, van Alphen SPJ, Ouwens MA, Arntz A, Heijnen-Kohl SMJ, Videler AC. The effectiveness of individual schema therapy in older adults with borderline personality disorder: A multiple-baseline case series design. Clin Psychol Psychother 2023; 30:1313-1323. [PMID: 37641578 DOI: 10.1002/cpp.2900] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/30/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE The aim of this study was to explore the effectiveness of schema therapy (ST) in older adults with borderline personality disorder (BPD). METHODS Multiple baseline case series design with five BPD patients, with a mean age of 66. After a baseline phase with random length, patients received weekly ST sessions for a year, followed by follow-up sessions during 6 months. Participants rated the credibility of negative core beliefs weekly; various secondary outcome measures were assessed every 6 months (severity of BPD, early maladaptive schemas, schema modes, personality functioning, maladaptive personality traits, psychological distress and quality of life), and BPD diagnosis was assessed before baseline and after follow-up. Data were analysed with mixed regression analyses and paired t-tests. RESULTS Results revealed that ST led to a significant decrease in credibility of negative core beliefs, with high effect sizes. All participants remitted from their BPD diagnosis. CONCLUSION This is the first study exploring the effectiveness of ST for BPD in older adults, and it suggests that ST can be a powerful intervention for this group of patients.
Collapse
Affiliation(s)
- David A Khasho
- GGz Breburg, PersonaCura, Clinical Centre of Excellence for Personality Disorders and Autism in Older Adults, Tilburg, The Netherlands
| | - Sebastiaan P J van Alphen
- GGz Breburg, PersonaCura, Clinical Centre of Excellence for Personality Disorders and Autism in Older Adults, Tilburg, The Netherlands
- Department of Clinical and Life Span Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Mondriaan, Clinical Centre of Excellence for Older Adults with Personality Disorders, Heerlen-Maastricht, The Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Machteld A Ouwens
- GGz Breburg, PersonaCura, Clinical Centre of Excellence for Personality Disorders and Autism in Older Adults, Tilburg, The Netherlands
- Tranzo Department, Tilburg University, Tilburg, The Netherlands
| | - Arnoud Arntz
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Sylvia M J Heijnen-Kohl
- Mondriaan, Clinical Centre of Excellence for Older Adults with Personality Disorders, Heerlen-Maastricht, The Netherlands
| | - Arjan C Videler
- GGz Breburg, PersonaCura, Clinical Centre of Excellence for Personality Disorders and Autism in Older Adults, Tilburg, The Netherlands
- Tranzo Department, Tilburg University, Tilburg, The Netherlands
| |
Collapse
|
11
|
MacIntyre E, Sigerseth M, Larsen TF, Fersum KV, Meulders M, Meulders A, Michiels B, Braithwaite FA, Stanton TR. Get Your Head in the Game: A Replicated Single-Case Experimental Design Evaluating the Effect of a Novel Virtual Reality Intervention in People With Chronic Low Back Pain. THE JOURNAL OF PAIN 2023; 24:1449-1464. [PMID: 37030584 DOI: 10.1016/j.jpain.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 03/16/2023] [Accepted: 03/28/2023] [Indexed: 04/08/2023]
Abstract
Chronic low back pain (CLBP) is a leading cause of disability worldwide. Contemporary treatment of CLBP is suboptimal, with small-moderate effect sizes and high relapse rates. Virtual reality (VR) is an increasingly accessible technology that can improve adherence to exercise programs through gamification. Using VR to facilitate exercise adherence and enjoyment may improve the clinical outcomes. This study aimed to evaluate the effects of a gamified VR graded activity intervention in people with CLBP, using commercially available and bespoke VR programs. A sequentially replicated, multiple-baseline, randomized AB single-case experimental design was undertaken in 10 people with CLBP. Outcomes were assessed daily and included pain intensity (primary) and pain catastrophizing, pain-related fear, and anxiety/worry (secondary). The effect of the intervention on the primary outcome was evaluated using a multilevel-model, nonparametric randomization test. The VR graded activity intervention resulted in a significant reduction in pain intensity (effect estimate = -1.0, standard error = .27, P < .0011) with 4 participants achieving ≥30% pain reduction (minimum important change). There was a significant effect of the intervention on pain catastrophizing but not pain-related fear or anxiety/worry measures. These findings provide preliminary support for a VR graded activity program to reduce pain in people with CLBP. PERSPECTIVE: This novel, VR graded activity intervention reduced pain intensity and catastrophizing in people with CLBP. The intervention also had high adherence and enjoyment. Given that this intervention involved 2 freely available VR programs, it can be easily translated into clinical practice.
Collapse
Affiliation(s)
- Erin MacIntyre
- IIMPACT in Health, University of South Australia, Adelaide, Australia
| | - Maja Sigerseth
- Institute of Global Health and Primary Care, University of Bergen, Bergen, Norway
| | - Thomas Fiskeseth Larsen
- Department of Computer science, Electrical engineering and Mathematical sciences, Faculty of Engineering and Science, Western Norway University of Applied Sciences, Bergen, Norway; Department of Informatics, University of Bergen, Bergen, Norway
| | - Kjartan Vibe Fersum
- Institute of Global Health and Primary Care, University of Bergen, Bergen, Norway
| | - Michel Meulders
- Operations Research and Statistics Research Group, KU Leuven, Brussels, Belgium
| | - Ann Meulders
- Experimental Health Psychology, Maastricht University, Maastricht, The Netherlands; Health Psychology, KU Leuven, Leuven, Belgium
| | | | | | - Tasha R Stanton
- IIMPACT in Health, University of South Australia, Adelaide, Australia
| |
Collapse
|
12
|
Perreault T, Arendt-Nielson L, Fernández-de-las-Peñas C, Dommerholt J, Herrero P, Hubbard R. Intramuscular Electrical Stimulation for the Treatment of Trigger Points in Patients with Chronic Migraine: A Protocol for a Pilot Study Using a Single-Case Experimental Design. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1380. [PMID: 37629671 PMCID: PMC10456716 DOI: 10.3390/medicina59081380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 07/25/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023]
Abstract
Background and Objectives: Trigger points (TrPs) are prevalent in patients with migraine headaches. Needling interventions targeting TrPs in migraine patients may reduce the intensity and frequency of headaches, yet systematic reviews reveal a lack of robust evidence. Intramuscular electrical stimulation (IMES) is a modality that delivers electrical current into muscles and TrPs, with recent studies suggesting it may amplify the therapeutic effects of dry needling peripherally and centrally. This could be advantageous for patients with migraine and symptomatic TrPs. Materials and Methods: This study will implement a multiple baseline single-case experimental design (SCED). In a clinical setting, a SCED study lends itself to conducting research with only a few patients that each serve as their own controls. In this SCED study, four participants with chronic migraine will be enrolled in a non-concurrent manner and randomized to one of four baseline measurement periods (4, 5, 6 or 7 weeks), leading to four potentially different start dates for each participant in the intervention phase. During the intervention phase, patients will receive five sessions of dry needling with IMES, one session per week for five weeks. The primary outcome measure will be headache frequency, i.e., the reduction in the number of headache days over a one-month period using electronic headache diary data from the Migraine Buddy smartphone application. Secondary outcome measures will be changes in mean migraine pain intensity using a numeric pain rating scale (NPRS), migraine disability using the Migraine Disability Assessment Test (MIDAS), the Headache Impact Test (HIT-6), and changes in selected cervical musculoskeletal impairments including pressure pain thresholds (PPTs) over TrPs, the craniocervical flexion test (CCFT), and cervical active range of motion (AROM). Primary and secondary outcome measures will be analyzed separately using both visual and statistical analyses. Results: Actively recruiting participants. This project was approved by the Mass General Brigham Institutional Review Board (protocol #2023P000931) and is registered with ClinicalTrials.gov (NCT05893914). Conclusions: This study will seek to determine the effects of a five-week intervention period of IMES to TrPs in the posterior cervical muscles of subjects with chronic migraine.
Collapse
Affiliation(s)
- Thomas Perreault
- Department of Physical Therapy, Wentworth Douglass Hospital, Dover, NH 03820, USA;
| | - Lars Arendt-Nielson
- Center for Neuroplasticity and Pain, SMI, School of Medicine, Aalborg University, DK-9220 Aalborg, Denmark; (L.A.-N.); (C.F.-d.-l.-P.)
- Department of Gastroenterology & Hepatology, Mech-Sense, Clinical Institute, Aalborg University Hospital, DK-9000 Aalborg, Denmark
- Steno Diabetes Center North Denmark, Clinical Institute, Aalborg University Hospital, DK-9000 Aalborg, Denmark
| | - César Fernández-de-las-Peñas
- Center for Neuroplasticity and Pain, SMI, School of Medicine, Aalborg University, DK-9220 Aalborg, Denmark; (L.A.-N.); (C.F.-d.-l.-P.)
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Madrid, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia-Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Madrid, Spain
| | - Jan Dommerholt
- Myopain Seminars, Bethesda, MD 20814, USA;
- Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of Maryland, Baltimore, MD 21201, USA
| | - Pablo Herrero
- IIS Aragon, Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain;
| | - Ryan Hubbard
- Department of Physical Therapy, Wentworth Douglass Hospital, Dover, NH 03820, USA;
| |
Collapse
|
13
|
De TK, Onghena P. The randomized marker method for single-case randomization tests: Handling data missing at random and data missing not at random. Behav Res Methods 2022; 54:2905-2938. [PMID: 35132582 DOI: 10.3758/s13428-021-01781-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2021] [Indexed: 12/16/2022]
Abstract
Single-case experiments are frequently plagued by missing data problems. In a recent study, the randomized marker method was found to be valid and powerful for single-case randomization tests when the missing data were missing completely at random. However, in real-life experiments, it is difficult for researchers to ascertain the missing data mechanism. For analyzing such experiments, it is essential that the missing data handling method is valid and powerful for various missing data mechanisms. Hence, we examined the performance of the randomized marker method for data that are missing at random and data that are missing not at random. In addition, we compared the randomized marker method with multiple imputation, because the latter is often considered the gold standard among imputation techniques. To compare and evaluate these two methods under various simulation conditions, we calculated the type I error rate and statistical power in single-case randomization tests using these two methods of handling missing data and compared them to the type I error rate and statistical power using complete datasets. The results indicate that while multiple imputation presents an advantage in the presence of strongly correlated covariate data, the randomized marker method remains valid and results in sufficient statistical power for most of the missing data conditions simulated in this study.
Collapse
Affiliation(s)
- Tamal Kumar De
- Methodology of Educational Sciences Research Group, Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102 Box 3762, 3000, Leuven, Belgium.
| | - Patrick Onghena
- Methodology of Educational Sciences Research Group, Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102 Box 3762, 3000, Leuven, Belgium
| |
Collapse
|
14
|
Baillot A, St-Pierre M, Lapointe J, Bernard P, Bond D, Romain AJ, Garneau PY, Biertho L, Tchernof A, Blackburn P, Langlois MF, Brunet J. Acceptability and feasibility of the TELEhealth BARIatric behavioural intervention to increase physical ACTIVity (TELE-BariACTIV): A single-case experimental study protocol (Preprint). JMIR Res Protoc 2022; 11:e39633. [PMID: 36173668 PMCID: PMC9562082 DOI: 10.2196/39633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/23/2022] [Accepted: 08/29/2022] [Indexed: 12/04/2022] Open
Abstract
Background Regular physical activity (PA) is recommended to optimize weight and health outcomes in patients who have undergone metabolic and bariatric surgery (MBS). However, >70% of patients have low PA levels before MBS that persist after MBS. Although behavioral interventions delivered face-to-face have shown promise for increasing PA among patients who have undergone MBS, many may experience barriers, preventing enrollment into and adherence to such interventions. Delivering PA behavior change interventions via telehealth to patients who have undergone MBS may be an effective strategy to increase accessibility and reach, as well as adherence. Objective This paper reports the protocol for a study that aims to assess the feasibility and acceptability of the protocol or methods and the Telehealth Bariatric Behavioral Intervention (TELE-BariACTIV). The intervention is designed to increase moderate-to-vigorous intensity PA (MVPA) in patients awaiting bariatric surgery and is guided by a multitheory approach and a patient perspective. Another objective is to estimate the effect of the TELE-BariACTIV intervention on presurgical MVPA to determine the appropriate sample size for a multicenter trial. Methods This study is a multicenter trial using a repeated (ABAB’A) single-case experimental design. The A phases are observational phases without intervention (A1=pre-MBS phase; A2=length personalized according to the MBS date; A3=7 months post-MBS phase). The B phases are interventional phases with PA counseling (B1=6 weekly pre-MBS sessions; B2=3 monthly sessions starting 3 months after MBS). The target sample size is set to 12. Participants are inactive adults awaiting sleeve gastrectomy who have access to a computer with internet and an interface with a camera. The participants are randomly allocated to a 1- or 2-week baseline period (A1). Protocol and intervention feasibility and acceptability (primary outcomes) will be assessed by recording missing data, refusal, recruitment, retention, attendance, and attrition rates, as well as via web-based acceptability questionnaires and semistructured interviews. Data collected via accelerometry (7-14 days) on 8 occasions and via questionnaires on 10 occasions will be analyzed to estimate the effect of the intervention on MVPA. Generalization measures assessing the quality of life, anxiety and depressive symptoms, and theory-based constructs (ie, motivational regulations for PA, self-efficacy to overcome barriers to PA, basic psychological needs satisfaction and frustration, PA enjoyment, and social support for PA; secondary outcomes for a future large-scale trial) will be completed via web-based questionnaires on 6-10 occasions. The institutional review board provided ethics approval for the study in June 2021. Results Recruitment began in September 2021, and all the participants were enrolled (n=12). Data collection is expected to end in fall 2023, depending on the MBS date of the recruited participants. Conclusions The TELE-BariACTIV intervention has the potential for implementation across multiple settings owing to its collaborative construction that can be offered remotely. International Registered Report Identifier (IRRID) DERR1-10.2196/39633
Collapse
Affiliation(s)
- Aurélie Baillot
- Nursing Department, Université du Québec en Outaouais, Gatineau, QC, Canada
- Institut du savoir de l'hôpital Montfort-recherche, Ottawa, ON, Canada
- Centre de Recherche en Médecine Psychosociale, Centre Intégré de Santé et Services Sociaux de l'Outaouais, Gatineau, QC, Canada
| | - Maxime St-Pierre
- Basic Science Department, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Josyanne Lapointe
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, QC, Canada
- Montreal Mental Health University Institute Research Centre, Montreal, QC, Canada
| | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, QC, Canada
- Montreal Mental Health University Institute Research Centre, Montreal, QC, Canada
| | - Dale Bond
- Department of Surgery, Hartford Hospital/HealthCare, Hartford, CT, United States
| | - Ahmed Jérôme Romain
- Montreal Mental Health University Institute Research Centre, Montreal, QC, Canada
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Pierre Y Garneau
- Department of Surgery, Université de Montréal, Montréal, QC, Canada
| | - Laurent Biertho
- Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC, Canada
| | - André Tchernof
- Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC, Canada
| | - Patricia Blackburn
- Division of Kinesiology, Department of Health Sciences, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Marie-France Langlois
- CHUS Research Center and Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jennifer Brunet
- Institut du savoir de l'hôpital Montfort-recherche, Ottawa, ON, Canada
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Cancer Therapeutic Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| |
Collapse
|
15
|
Norman-Nott N, Wilks CR, Hesam-Shariati N, Schroeder J, Suh J, Czerwinski M, Briggs NE, Quidé Y, McAuley J, Gustin SM. The No Worries Trial: Efficacy of Online Dialectical Behaviour Therapy Skills Training for Chronic Pain (iDBT-Pain) Using A Single Case Experimental Design. THE JOURNAL OF PAIN 2021; 23:558-576. [PMID: 34678466 DOI: 10.1016/j.jpain.2021.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/29/2021] [Accepted: 10/05/2021] [Indexed: 12/25/2022]
Abstract
Emotion dysregulation frequently co-occurs with chronic pain, which in turn leads to heightened emotional and physical suffering. This cycle of association has prompted a recommendation for psychological treatment of chronic pain to target mechanisms for emotion regulation. The current trial addressed this need by investigating a new internet-delivered treatment incorporating emotional skills training from dialectical behavioural therapy (DBT). Using a single-case experimental design that is suited to heterogeneous populations and can demonstrate efficacy with a small sample, three participants with chronic pain were recruited. Participants received four weeks of online DBT skills training (iDBT-Pain intervention) which incorporated one-on-one sessions over Zoom and a web app. Results revealed compelling evidence for the intervention on the primary outcome of emotion dysregulation and were promising for the secondary outcome of pain intensity. Improvement was also identified on pre-and post-measures of depression, coping behaviours, sleep problems, wellbeing, and harm avoidance, indicating that the intervention may positively influence other factors related to chronic pain. Overall, the trial provides preliminary efficacy for the intervention to improve chronic pain. However, we recommend further investigation of the iDBT-Pain intervention, either in single case trials, which when conducted with scientific rigour may be aggregated to derive nomothetic conclusions, or in a group-comparison trial to compare with usual modes of treatment. Perspective: This trial advances understanding of emotion-focused treatment for chronic pain and provides evidence for a viable new technological treatment. Importantly, as an internet-delivered approach, the iDBT-Pain intervention is accessible to those with restricted mobility and remote communities where there are often limited psychological services for people with chronic pain. Trial registration: The trial was registered on the Australian and New Zealand Clinical Trials Registry (ACTRN12620000604909).
Collapse
Affiliation(s)
- Nell Norman-Nott
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia; School of Psychology, University of New South Wales, Sydney, Australia
| | - Chelsey R Wilks
- Department of Psychological Science, University of Missouri-St Louis, United States
| | - Negin Hesam-Shariati
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia; School of Psychology, University of New South Wales, Sydney, Australia
| | - Jessica Schroeder
- School of Computer Science and Engineering, University of Washington, United States
| | - Jina Suh
- School of Computer Science and Engineering, University of Washington, United States; Microsoft Research, Redmond, United States
| | | | - Nancy E Briggs
- Stats Central, Mark Wainwright Analytical Centre, University of New South Wales, Sydney, Australia
| | - Yann Quidé
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia; School of Psychology, University of New South Wales, Sydney, Australia
| | - James McAuley
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia; School of Health Sciences, University of New South Wales, Sydney, Australia
| | - Sylvia M Gustin
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia; School of Psychology, University of New South Wales, Sydney, Australia.
| |
Collapse
|
16
|
Penninx Quevedo R, de Jongh A, Bouwmeester S, Didden R. EMDR therapy for PTSD symptoms in patients with mild intellectual disability or borderline intellectual functioning and comorbid psychotic disorder: A case series. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 117:104044. [PMID: 34438220 DOI: 10.1016/j.ridd.2021.104044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 07/13/2021] [Accepted: 07/20/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Little is known about the effectiveness of EMDR therapy for PTSD symptoms in persons with mild intellectual disability or borderline intellectual functioning (MID-BIF, IQ 50-85) and psychosis. AIMS To examine effectiveness, feasibility, and safety of eye movement desensitization and reprocessing (EMDR) therapy in six patients with MID-BIF, PTSD and psychotic disorder. METHODS AND PROCEDURES Data were collected in a multiple baseline across-subjects design. Before, during and after treatment, weekly assessments on PTSD symptoms and adverse events were carried out. PTSD classification was assessed, and severity of hallucinations, delusions, and general psychopathology were measured at pretreatment, posttreatment and three-month follow-up. OUTCOMES AND RESULTS There were no dropouts and five of the six participants completed treatment early. They showed a decrease in PTSD symptom severity and did no longer meet DSM-5 PTSD criteria at posttreatment. Results were maintained at follow-up. Symptoms did not exacerbate as indicated by a significant decrease in general psychopathology (in five participants) and an improvement in general functioning. In five participants severity of psychotic symptoms decreased. CONCLUSIONS AND IMPLICATIONS EMDR therapy is safe and feasible and the results suggest that it can be an effective treatment for PTSD in patients with triple mental health problems in a tertiary mental health treatment setting.
Collapse
Affiliation(s)
| | - Ad de Jongh
- Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, the Netherlands; Research Department PSYTREC, Bilthoven, the Netherlands; School of Health Sciences, Salford University, Manchester, United Kingdom; Institute of Health and Society, University of Worcester, United Kingdom; School of Psychology, Queen's University, Belfast, Northern Ireland, United Kingdom
| | | | - Robert Didden
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands; Trajectum, Zwolle, the Netherlands; GGZ Oost-Brabant, Centre for Mild Intellectual Disability and Psychiatry, Boekel, The Netherlands
| |
Collapse
|
17
|
Silva FLD, Galindo Neto NM, Sá GGDM, França MSD, Oliveira PMPD, Grimaldi MRM. Technologies for health education about foreign-body airway obstruction: an integrative review. Rev Esc Enferm USP 2021; 55:e03778. [PMID: 34259757 DOI: 10.1590/s1980-220x2020035103778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 02/19/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To analyze technologies developed for health education about airway obstruction. METHOD Integrative review through search in the databases Medical Literature Analysis and Retrieval System Online, Latin American and Caribbean Health Sciences Literature, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and Scopus. Original studies, with no time and language restrictions, were selected. The data were extracted by two independent researchers and organized into synoptic tables. Result integration was based on the data reduction method. RESULTS The eight included articles were published in Brazilian and international journals and were predominantly methodological. The identified technologies were applications, online courses, 3D animations, booklet, and website. The theme was approached among the contents of Basic Life Support. An absence of technologies approaching the theme with accessibility was observed. CONCLUSION The identified technologies were digital and printed, presenting content validity and effectivity for use in education and health. Even so, there is gap in studies highlighting specific educational technologies on airway obstruction.
Collapse
Affiliation(s)
| | - Nelson Miguel Galindo Neto
- Instituto Federal de Educação, Ciência e Tecnologia de Pernambuco, Departamento de Enfermagem, Campus Pesqueira, Pesqueira, PE, Brasil
| | - Guilherme Guarino de Moura Sá
- Instituto Federal de Educação, Ciência e Tecnologia de Pernambuco, Departamento de Enfermagem, Campus Belo Jardim, Belo Jardim, PE, Brasil
| | - Michelline Santos de França
- Instituto Federal de Educação, Ciência e Tecnologia de Pernambuco, Departamento de Enfermagem, Campus Abreu e Lima, Abreu e Lima, PE, Brasil
| | | | | |
Collapse
|
18
|
Klein IL, van de Loo KFE, Hoogeboom TJ, Janssen MCH, Smeitink JAM, van der Veer E, Verhaak CM, Custers JAE. Blended cognitive behaviour therapy for children and adolescents with mitochondrial disease targeting fatigue (PowerMe): study protocol for a multiple baseline single case experiment. Trials 2021; 22:177. [PMID: 33648576 PMCID: PMC7923335 DOI: 10.1186/s13063-021-05126-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 02/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background Mitochondrial disease is a rare, hereditary disease with a heterogeneous clinical presentation. However, fatigue is a common and burdensome complaint in children and adolescents with mitochondrial disease. No psychological intervention targeting fatigue exists for paediatric patients with a mitochondrial disease. We designed the PowerMe intervention, a blended cognitive behaviour therapy targeting fatigue in children and adolescents with mitochondrial disease. The aim of the intervention is to reduce perceived fatigue by targeting fatigue-related cognitions and behaviours. Methods A multiple baseline single case experiment will be conducted in five children (8–12 years old) and 5 adolescents (12–18 years old) with mitochondrial disease and severe fatigue. Patients will be included in the study for 33 weeks, answering weekly questions about the fatigue. Patients will be randomly assigned a baseline period of 5 to 9 weeks before starting the PowerMe intervention. The intervention consists of face-to-face and online sessions with a therapist and a website with information and assignments. The treatment will be tailored to the individual. Each patient will work on their personalized treatment plan focusing on personally relevant goals. The primary outcome is perceived fatigue. Secondary outcomes are quality of life, school presence and physical functioning. Discussion The results of the PowerMe study will provide information on the efficacy of a blended cognitive behaviour therapy on reducing perceived fatigue and its impact on daily life in children and adolescents with mitochondrial disease. Strengths and limitations of the study design are discussed. Trial registration Dutch Trial Register NTR 7675. Registered on 17 December 2018. Identifier https://www.trialregister.nl/trial/7433
Collapse
Affiliation(s)
- I L Klein
- Radboud university medical center, Radboud Institute for Health Sciences, Radboud Center for Mitochondrial Medicine, Department of Medical Psychology, PO Box 9101, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, The Netherlands.
| | - K F E van de Loo
- Radboud university medical center, Radboud Institute for Health Sciences, Radboud Center for Mitochondrial Medicine, Department of Medical Psychology, PO Box 9101, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, The Netherlands
| | - T J Hoogeboom
- Radboud university medical center, Radboud Institute for Health Sciences, IQ Healthcare, PO Box 9101, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, The Netherlands
| | - M C H Janssen
- Radboud university medical center, Radboud Institute for Molecular Life Sciences, Radboud Center for Mitochondrial Medicine, Department of Internal Medicine, PO Box 9101, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, The Netherlands
| | - J A M Smeitink
- Radboud university medical center, Radboud Institute for Molecular Life Sciences, Radboud Center for Mitochondrial Medicine, Department of Pediatrics, PO Box 9101, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, The Netherlands
| | - E van der Veer
- International Mito Patients Association, Bergambacht, The Netherlands
| | - C M Verhaak
- Radboud university medical center, Radboud Institute for Health Sciences, Radboud Center for Mitochondrial Medicine, Department of Medical Psychology, PO Box 9101, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, The Netherlands
| | - J A E Custers
- Radboud university medical center, Radboud Institute for Health Sciences, Radboud Center for Mitochondrial Medicine, Department of Medical Psychology, PO Box 9101, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, The Netherlands
| |
Collapse
|
19
|
van Donzel L, Ouwens M, van Alphen S, Bouwmeester S, Videler A. The effectiveness of adapted schema therapy for cluster C personality disorders in older adults - integrating positive schemas. Contemp Clin Trials Commun 2021; 21:100715. [PMID: 33604483 PMCID: PMC7873345 DOI: 10.1016/j.conctc.2021.100715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 10/13/2020] [Accepted: 01/11/2021] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Schema therapy (ST) is an efficacious psychotherapy for personality disorders (PDs) in adults. The first empirical support for the effectiveness of ST in older adults with cluster C PDs was provided recently. ST partly focusses on the positive, but there is an increasing awareness of imbalance in the ST community because of the emphasis on negative schemas versus attention to positive schemas. Positive schemas may be important vehicles of therapeutic change in psychotherapy with older people, as it may help strengthen the healthy adult mode, and it might also help change a negative life review. Suggestions were made to increase the efficacy and feasibility of ST in older adults, including adjusting the case conceptualisation, modifying the experiential techniques, making use of the patient's wisdom and reactivating positive schemas. The aim of the current study is to investigate the feasibility and effectiveness of adapted individual ST for older adults. METHODS/DESIGN A multiple baseline design is used with positive and negative core beliefs as primary outcome measures. Ten older adults (age > 60 years) with cluster C PDs are treated with schema therapy, with weekly sessions during one year. This treatment phase is preceded by a baseline phase varying randomly from 4 to 8 weeks. After treatment, there is a 6-month follow-up phase with monthly booster sessions. Symptomatic distress, schema modes, early maladaptive schemas (EMS) and early adaptive schemas (EAS) are secondary outcome measures. PD will be diagnosed before baseline and after treatment phase. EAS are assessed with the Dutch version of the Young Positive Schema Questionnaire (YPSQ). DISCUSSION To the best of our knowledge, this is the first empirical study in which positive schemas are integrated in ST treatment to examine the efficacy of an adapted form of ST for older adults. This is in line with wider developments supporting the integration of positive schema's into ST. It offers the possibility to improve the effectiveness of ST in older adults. TRIAL REGISTRATION The Netherlands National Trial Register NL8346, registered 1 February 2020.
Collapse
Affiliation(s)
| | - M.A. Ouwens
- PersonaCura, Clinical Centre of Excellence for Personality Disorders and Autism in Older Adults, GGz Breburg, Tilburg, the Netherlands
- Tranzo Department, Tilburg University, Tilburg, the Netherlands
| | - S.P.J. van Alphen
- PersonaCura, Clinical Centre of Excellence for Personality Disorders and Autism in Older Adults, GGz Breburg, Tilburg, the Netherlands
- Department of Clinical and Lifespan Psychology, Vrije Universiteit Brussel, Brussels, Belgium
- Clinical Centre of Excellence for Personality Disorders in Older Adults, Mondriaan, Heerlen, the Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, the Netherlands
| | - S. Bouwmeester
- Department of Psychology, Education & Child Studies, Erasmus University, Rotterdam, the Netherlands
| | - A.C. Videler
- PersonaCura, Clinical Centre of Excellence for Personality Disorders and Autism in Older Adults, GGz Breburg, Tilburg, the Netherlands
- Tranzo Department, Tilburg University, Tilburg, the Netherlands
| |
Collapse
|
20
|
Jim HL, Range F, Marshall-Pescini S, Dale R, Plotnik JM. Investigating Indirect and Direct Reputation Formation in Asian Elephants ( Elephas maximus). Front Psychol 2021; 11:604372. [PMID: 33519611 PMCID: PMC7841644 DOI: 10.3389/fpsyg.2020.604372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/17/2020] [Indexed: 11/17/2022] Open
Abstract
Reputation is a key component in social interactions of group-living animals and appears to play a role in the establishment of cooperation. Animals can form a reputation of an individual by directly interacting with them or by observing them interact with a third party, i.e., eavesdropping. Elephants are an interesting taxon in which to investigate eavesdropping as they are highly cooperative, large-brained, long-lived terrestrial mammals with a complex social organisation. The aim of this study was to investigate whether captive Asian elephants (Elephas maximus) could form reputations of humans through indirect and/or direct experience in two different paradigms: (1) a cooperative string-pulling task and (2) a scenario requiring begging. Fourteen captive Asian elephants in Thailand participated in an experimental procedure that consisted of three parts: baseline, observation, and testing. In the observation phase, the subject saw a conspecific interact with two people-one cooperative/generous and one non-cooperative/selfish. The observer could then choose which person to approach in the test phase. The elephants were tested in a second session 2-5 days later. We found no support for the hypothesis that elephants can form reputations of humans through indirect or direct experience, but these results may be due to challenges with experimental design rather than a lack of capacity. We discuss how the results may be due to a potential lack of ecological validity in this study and the difficulty of assessing motivation and attentiveness in elephants. Furthermore, we highlight the importance of designing future experiments that account for the elephants' use of multimodal sensory information in their decision-making.
Collapse
Affiliation(s)
- Hoi-Lam Jim
- Domestication Lab, Department of Interdisciplinary Life Sciences, Konrad Lorenz Institute of Ethology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Friederike Range
- Domestication Lab, Department of Interdisciplinary Life Sciences, Konrad Lorenz Institute of Ethology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Sarah Marshall-Pescini
- Domestication Lab, Department of Interdisciplinary Life Sciences, Konrad Lorenz Institute of Ethology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Rachel Dale
- Domestication Lab, Department of Interdisciplinary Life Sciences, Konrad Lorenz Institute of Ethology, University of Veterinary Medicine Vienna, Vienna, Austria
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems, Austria
| | - Joshua M. Plotnik
- Department of Psychology, Hunter College, City University of New York, New York, NY, United States
- Department of Psychology, The Graduate Center, City University of New York, New York, NY, United States
| |
Collapse
|
21
|
Estudos experimentais sobre COVID-19: panorama da produção científica mundial. ACTA PAUL ENFERM 2020. [DOI: 10.37689/acta-ape/2020ao01215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
22
|
Investigation of Single-Case Multiple-Baseline Randomization Tests of Trend and Variability. EDUCATIONAL PSYCHOLOGY REVIEW 2020. [DOI: 10.1007/s10648-020-09549-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
23
|
Lanovaz MJ, Turgeon S. How Many Tiers Do We Need? Type I Errors and Power in Multiple Baseline Designs. Perspect Behav Sci 2020; 43:605-616. [PMID: 33024931 PMCID: PMC7490309 DOI: 10.1007/s40614-020-00263-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Design quality guidelines typically recommend that multiple baseline designs include at least three demonstrations of effects. Despite its widespread adoption, this recommendation does not appear grounded in empirical evidence. The main purpose of our study was to address this issue by assessing Type I error rate and power in multiple baseline designs. First, we generated 10,000 multiple baseline graphs, applied the dual-criteria method to each tier, and computed Type I error rate and power for different number of tiers showing a clear change. Second, two raters categorized the tiers for 300 multiple baseline graphs to replicate our analyses using visual inspection. When multiple baseline designs had at least three tiers and two or more of these tiers showed a clear change, the Type I error rate remained adequate (< .05) while power also reached acceptable levels (> .80). In contrast, requiring all tiers to show a clear change resulted in overly stringent conclusions (i.e., unacceptably low power). Therefore, our results suggest that researchers and practitioners should carefully consider limitations in power when requiring all tiers of a multiple baseline design to show a clear change in their analyses.
Collapse
Affiliation(s)
- Marc J Lanovaz
- École de psychoéducation, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montreal, QC H3C 3J7 Canada.,Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, QC Canada
| | - Stéphanie Turgeon
- École de psychoéducation, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montreal, QC H3C 3J7 Canada
| |
Collapse
|
24
|
Gladwin TE. An implementation of N-way repeated measures ANOVA: Effect coding, automated unpacking of interactions, and randomization testing. MethodsX 2020; 7:100947. [PMID: 32612937 PMCID: PMC7315100 DOI: 10.1016/j.mex.2020.100947] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 05/27/2020] [Indexed: 11/27/2022] Open
Abstract
The paper presents the details of an implementation of repeated measures ANOVA, consisting of a set of functions to organize data and represent contrasts to be tested and run statistical tests. The implementation is focused on uses common in experimental psychology. An arbitrary number of within-subject factors, each with an arbitrary number of levels, can be used. A non-parametric, randomization- and permutation-based formulation of repeated measures ANOVA was defined and implemented. Methods for testing interactions with categorical and continuous between-subject variables are implemented. Post-hoc tests for exploring interactions are automated. Simulations indicate correct control of false positive rate for all types of test. The software provides output with statistics including p-values and partial eta squared.An open source implementation of repeated measures ANOVA based on effect coding. Generates p-values and automatized unpacking of interactions for N-factor designs. A non-parametric test is defined based on permutation tests.
Collapse
Affiliation(s)
- Thomas Edward Gladwin
- Department of Psychology and Counseling, University of Chichester, Chichester, United Kingdom.,Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, the Netherlands.,Institute for Lifecourse Development, University of Greenwich, London, United Kingdom
| |
Collapse
|