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Preview: Journal of Consulting and Clinical Psychology - Vol 77, Iss 6

Journal of Consulting and Clinical Psychology - Vol 85, Iss 11

The Journal of Consulting and Clinical Psychology publishes original contributions on the following topics: (a) the development, validity, and use of techniques of diagnosis, treatment, and prevention of disordered behavior; (b) studies of populations of

Last Build Date: Fri, 24 Nov 2017 05:00:18 GMT


Smokers who are unmotivated to quit and have a child with asthma are more likely to quit with intensive motivational interviewing and repeated biomarker feedback.

Mon, 30 Oct 2017 04:00:00 GMT

Objective: Smokers who are not motivated to quit are an important group for intervention, particularly if they have children with asthma. Research indicates that unmotivated smokers are less responsive to intensive interventions, although motivation-by-treatment interactions have not been tested. This study examines whether motivation to quit moderates the effect of a cessation induction intervention. Method: Parents had an asthmatic child requiring urgent care, and did not have to want to quit smoking to be eligible for the study. Two home visits included asthma education, motivational interviewing (MI) for cessation, and feedback on child’s secondhand smoke exposure (SHSe). Participants were then randomized (n = 339, 79.6% female) to receive Enhanced-PAM (Precaution Adoption Model; 6 MI calls including SHSe feedback) or PAM (6 contact control calls). Motivation to quit was assessed at baseline and point-prevalence abstinence (ppa) and SHSe outcomes were objectively measured. Results: At baseline, 38.9% were not motivated to quit. Those who were not motivated to quit were 3 to 4 times more likely to be abstinent at 6 months in Enhanced-PAM versus PAM (7-day ppa: OR = 3.71, 95% CI = [1.06, 12.99]; 30-day: OR = 4.15, 95% CI [1.20, 14.35]); those receiving Enhanced-PAM achieved quit rates comparable to motivated smokers. Those who were not motivated to quit were more than 4 times as likely to have very low/undetectable SHSe at follow-up in Enhanced-PAM versus PAM (OR = 4.46, 95% CI [1.31, 15.15]). Among motivated smokers, neither outcome significantly differed by treatment arm. Conclusion: It cannot be assumed that smokers who are unmotivated to quit will not be responsive to intensive interventions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

Mechanisms underlying mindfulness-based addiction treatment versus cognitive behavioral therapy and usual care for smoking cessation.

Mon, 26 Jun 2017 04:00:00 GMT

Objective: To examine cognitive and affective mechanisms underlying mindfulness-based addiction treatment (MBAT) versus cognitive-behavioral therapy (CBT) and usual care (UC) for smoking cessation. Method: Participants in the parent study from which data were drawn (N = 412; 54.9% female; 48.2% African American, 41.5% non-Latino White, 5.4% Latino, 4.9% other; 57.6% annual income <$30,000) were randomized to MBAT (n = 154), CBT (n = 155), or UC (n = 103). From quit date through 26 weeks postquit, participants completed measures of emotions, craving, dependence, withdrawal, self-efficacy, and attentional bias. Biochemically confirmed 7-day smoking abstinence was assessed at 4 and 26 weeks postquit. Although the parent study did not find a significant treatment effect on abstinence, mixed-effects regression models were conducted to examine treatment effects on hypothesized mechanisms, and indirect effects of treatments on abstinence were tested. Results: Participants receiving MBAT perceived greater volitional control over smoking and evidenced lower volatility of anger than participants in both other treatments. However, there were no other significant differences between MBAT and CBT. Compared with those receiving UC, MBAT participants reported lower anxiety, concentration difficulties, craving, and dependence, as well as higher self-efficacy for managing negative affect without smoking. Indirect effects of MBAT versus UC on abstinence occurred through each of these mechanisms. Conclusions: Whereas several differences emerged between MBAT and UC, MBAT and CBT had similar effects on several of the psychosocial mechanisms implicated in tobacco dependence. Results help to shed light on similarities and differences between mindfulness-based and other active smoking cessation treatments. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

Baseline patterns of substance use disorder severity and depression and anxiety symptoms moderate the efficacy of mindfulness-based relapse prevention.

Mon, 30 Oct 2017 04:00:00 GMT

Objective: Few studies have evaluated moderators of mindfulness-based relapse prevention (MBRP) for substance use disorders (SUDs). We tested whether baseline patterns of scores for SUD symptom severity and depression and anxiety symptoms moderated the efficacy of MBRP. Method: We used a latent class moderation approach with data from a randomized trial of MBRP compared to cognitive–behavioral relapse prevention and treatment as usual (TAU; Bowen et al., 2014; N = 286, 71.8% male, 48.4% non-White, mean age = 38.44 years, SD = 10.92) and a randomized trial comparing MBRP to TAU (Bowen et al., 2009; N = 168, 63.7% male, 44.6% non-White, mean age = 40.45, SD = .28). Indicators for the latent class models were measures of SUD severity (Severity of Dependence Scale and Short Inventory of Problems), depression symptoms (Beck Depression Inventory), and anxiety symptoms (Beck Anxiety Inventory). Results: In both trials, 3 latent classes provided the best fit: a high–high class characterized by high SUD severity and depression and anxiety symptoms, a high–low class characterized by high SUD severity and low depression and anxiety symptoms, and a low–low class characterized by low SUD severity and depression and anxiety symptoms. In both trials, we found significant latent Class × Treatment interaction effects: There were significant and large effects of MBRP on substance use outcomes in the high–high and high–low classes, but no MBRP effect in the low–low class. Conclusion: MBRP may be an optimal treatment for preventing relapse among clients with severe levels of SUD symptoms and depression and anxiety symptoms, as well as clients with only severe SUD symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

Testing positive for a genetic predisposition to depression magnifies retrospective memory for depressive symptoms.

Mon, 30 Oct 2017 04:00:00 GMT

Objective: Depression, like other mental disorders and health conditions generally, is increasingly construed as genetically based. This research sought to determine whether merely telling people that they have a genetic predisposition to depression can cause them to retroactively remember having experienced it. Method: U.S. adults (men and women) were recruited online to participate (Experiment 1: N = 288; Experiment 2: N = 599). After conducting a test disguised as genetic screening, we randomly assigned some participants to be told that they carried elevated genetic susceptibility to depression, whereas others were told that they did not carry this genetic liability or were told that they carried elevated susceptibility to a different disorder. Participants then rated their experience of depressive symptoms over the prior 2 weeks on a modified version of the Beck Depression Inventory-II. Results: Participants who were told that their genes predisposed them to depression generally reported higher levels of depressive symptomatology over the previous 2 weeks, compared to those who did not receive this feedback. Conclusions: Given the central role of self-report in psychiatric diagnosis, these findings highlight potentially harmful consequences of personalized genetic testing in mental health. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

The effects of the growing pro-social program on cognitive distortions and early maladaptive schemas over time in male prison inmates: A randomized controlled trial.

Mon, 30 Oct 2017 04:00:00 GMT

Objective: This randomized controlled trial aimed to assess the efficacy of a structured cognitive–behavioral group program, Growing Pro-Social (GPS), in reducing cognitive distortions and early maladaptive schemas over time in male prison inmates. Method: A total of 254 participants were recruited from nine Portuguese prisons and allocated to receive GPS (n = 121) or treatment as usual (n = 133). Participants were assessed with self-report measures on cognitive distortions and early maladaptive schemas at baseline, during intervention, at post-treatment and at 12 months’ follow-up. Assessors were blind to group allocation. Treatment effects were tested with latent growth curve models. Results: At baseline, no significant differences between conditions were found. Results from latent growth curve models showed that condition was a significant predictor of change observed in all outcome measures over time. When compared with the control group, the treatment group showed a significant increase on adaptive thinking, and a significant decrease of cognitive distortions and early maladaptive schemas over time. Results also showed that treatment effects were maintained over time (12 months after GPS completion). Additionally, participants who completed the program presented higher improvements on cognitive distortions and early maladaptive schemas over time than noncompleters. Conclusion: This study showed that a structured cognitive–behavioral group program can have positive effects on the cognitive functioning of male prison inmates, by reducing cognitive distortions and the prominence of early maladaptive schemas. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

The efficacy of cognitive-behavioral therapy for eating disorders: A systematic review and meta-analysis.

Mon, 30 Oct 2017 04:00:00 GMT

Objective: This meta-analysis examined the efficacy of cognitive–behavioral therapy (CBT) for eating disorders. Method: Randomized controlled trials of CBT were searched. Seventy-nine trials were included. Results: Therapist-led CBT was more efficacious than inactive (wait-lists) and active (any psychotherapy) comparisons in individuals with bulimia nervosa and binge eating disorder. Therapist-led CBT was most efficacious when manualized CBT-BN or its enhanced version was delivered. No significant differences were observed between therapist-led CBT for bulimia nervosa and binge eating disorder and antidepressants at posttreatment. CBT was also directly compared to other specific psychological interventions, and therapist-led CBT resulted in greater reductions in behavioral and cognitive symptoms than interpersonal psychotherapy at posttreatment. At follow-up, CBT outperformed interpersonal psychotherapy only on cognitive symptoms. CBT for binge eating disorder also resulted in greater reductions in behavioral symptoms than behavioral weight loss interventions. There was no evidence that CBT was more efficacious than behavior therapy or nonspecific supportive therapies. Conclusions: CBT is efficacious for eating disorders. Although CBT was equally efficacious to certain psychological treatments, the fact that CBT outperformed all active psychological comparisons and interpersonal psychotherapy specifically, offers some support for the specificity of psychological treatments for eating disorders. Conclusions from this study are hampered by the fact that many trials were of poor quality. Higher quality RCTs are essential. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

Form and formulation: Examining the distinctiveness of body image constructs in treatment-seeking patients with binge-eating disorder.

Mon, 30 Oct 2017 04:00:00 GMT

Objective: Body-image disturbance is a core aspect of eating disorders, yet the clinical manifestations of individuals’ weight and shape concerns are complex, vary considerably, and are poorly understood by clinicians and researchers. This study aimed to distinguish different aspects of body-image disturbance—including weight/shape dissatisfaction, weight/shape overvaluation, weight/shape preoccupation, and fear of weight gain—in patients with binge-eating disorder (BED). Examining how each specific body image construct relates to biopsychosocial features of BED could contribute to the refinement of conceptualization and treatment planning. Method: The current study assessed body-image disturbance and eating-disorder psychopathology in 748 treatment-seeking patients with BED using established investigator-based interviews reliably administered by doctoral clinicians. Results: The 4 body image constructs, although related to one another, showed some important similarities in associations with biopsychosocial clinical features, as well as some important distinctions. The relation between overvaluation and self-esteem was, as conceptualized, more strongly negative than for other body image variables, and preoccupation was more associated than other body image variables with eating concerns. Biopsychosocial features of BED were associated with different forms of body-image disturbance, but associations of body image variables with body mass index (BMI) were not significant and associations with binge-eating frequency did not differ across body image variables. Conclusion: Manifestations of body-image disturbance in BED are complex and understanding the distinctions between different body image constructs can contribute to treatment formulation. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

An app-based blended intervention to reduce body dissatisfaction: A randomized controlled pilot study.

Thu, 31 Aug 2017 04:00:00 GMT

Objective: As a common experience in the general population, dissatisfaction with one’s body is associated with a variety of psychological problems and unhealthy behaviors, including the development of eating disorders. Therefore, the purpose of the present study was to develop and evaluate an app-based intervention to reduce body dissatisfaction. Method: Participants reporting elevated levels of body dissatisfaction were randomly allocated to an app-based intervention (n = 26) or to a wait list group (n = 27). The app-based intervention included a brief counseling session and 14 days of training with the Mindtastic Body Dissatisfaction app (MT-BD). The MT-BD app uses gamification strategies to systematically foster approach of functional and avoidance of dysfunctional stimuli. The primary outcome was body dissatisfaction as assessed with the Body Dissatisfaction scale of the Eating Disorder Inventory-2 (Garner, 1991). Secondary outcome measures included severity of eating disorder symptoms and depressive symptoms. Results: Participants in the intervention group showed significantly greater reductions in body dissatisfaction compared to the wait list group (d = −0.62). The intervention group also showed greater reductions in eating disorder symptoms compared to the wait list group (d = −0.46). Reductions in body dissatisfaction and eating disorder symptoms were sustained at a 1-month follow-up. Conclusion: We found preliminary evidence that an app-based intervention may significantly reduce body dissatisfaction. Further research using larger samples and targeting clinical populations is necessary to evaluate the potential of interventions such as MT-BD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)