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Trends in Psychiatry and Psychotherapy Aug 2022The effects of dialectical behavior therapy on generalized anxiety disorder have not been examined to date, whereas cognitive behavioral therapy is a well-known... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
The effects of dialectical behavior therapy on generalized anxiety disorder have not been examined to date, whereas cognitive behavioral therapy is a well-known psychotherapy for generalized anxiety disorder.
OBJECTIVES
This study investigated the effects of cognitive behavioral therapy versus dialectical behavior therapy on executive function and reduction of symptoms in generalized anxiety disorder.
METHOD
In the present study, 72 generalized anxiety disorder patients were randomly assigned to one of two groups: dialectical behavior therapy or cognitive behavioral therapy. Evaluations were performed at baseline, post-test, and three months after interventions as a follow-up. Measures included the Structured Clinical Interview for DSM-IV Axis I disorders, the Generalized Anxiety Disorder scale, the Beck Anxiety Inventory, the Beck Depression Inventory, the Tower of London Task, and the Wisconsin Card Sorting Task.Results: The results of the present study showed that both groups had reduced scores for depression and anxiety and increased scores for executive function after the psychotherapies. These changes were maintained at follow-up.
CONCLUSION
Although depression and anxiety symptoms were significantly reduced by cognitive behavioral therapy, dialectical behavior therapy was more effective for improving executive function.
Topics: Anxiety Disorders; Cognitive Behavioral Therapy; Dialectical Behavior Therapy; Executive Function; Humans; Psychotherapy
PubMed: 35559733
DOI: 10.47626/2237-6089-2020-0156 -
Health Informatics Journal Mar 2018The evolving field of persuasive and behavior change technology is increasingly targeted at influencing behavior in the area of health and wellness. This paper provides... (Review)
Review
The evolving field of persuasive and behavior change technology is increasingly targeted at influencing behavior in the area of health and wellness. This paper provides an empirical review of 16 years (85 papers) of literature on persuasive technology for health and wellness to: (1.) answer important questions regarding the effectiveness of persuasive technology for health and wellness, (2.) summarize and highlight trends in the technology design, research methods, motivational strategies, theories, and health behaviors targeted by research to date, (3.) uncover pitfalls of existing persuasive technological interventions for health and wellness, and (4.) suggest directions for future research.
Topics: Behavior Therapy; Biomedical Technology; Health Behavior; Humans; Psychological Theory
PubMed: 27245673
DOI: 10.1177/1460458216650979 -
Journal of Clinical Psychology Jun 2022Although frequently discussed within the scope of transdiagnostic psychotherapy protocols, limited data are available on their efficacy in patients with a principal... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Although frequently discussed within the scope of transdiagnostic psychotherapy protocols, limited data are available on their efficacy in patients with a principal diagnosis of major depressive disorder. The present study attempted to address that gap in the literature through a randomized clinical trial comparing transdiagnostic behavior therapy (TBT) to behavioral activation treatment for depression (BATD).
METHODS
Forty veterans with principal major depressive disorder were randomized into either 12 sessions of individual TBT or BATD, with symptom measures collected at baseline and posttreatment. Process variables for treatment engagement and completion also were recorded.
RESULTS
Participants reported similar symptom improvements in depression, stress, anhedonia, and impairment across both treatments. Clinician-rated treatment improvements favored TBT. Participants in TBT also attended more appointments, canceled or missed fewer appointments, and completed the protocol at a higher rate than participants that received BATD.
CONCLUSIONS
The present findings support TBT as an efficacious treatment for principal major depressive disorder, with potentially superior coverage of comorbid anxiety symptomatology and improved treatment adherence and completion compared to BATD. Pending replication in larger samples, TBT and other similar transdiagnostic psychotherapies should be considered for implementation across the anxiety and depressive disorders to simplify dissemination efforts for evidence-based psychotherapies and potentially improve coverage of comorbidity.
Topics: Behavior Therapy; Depression; Depressive Disorder, Major; Humans; Mood Disorders; Treatment Outcome; Veterans
PubMed: 34935138
DOI: 10.1002/jclp.23298 -
Psychiatry and Clinical Neurosciences Dec 1998This paper reviews the development of behavior therapy, its applications, and the characteristics that make this form of therapy unique and applicable to a wide range of... (Comparative Study)
Comparative Study Review
This paper reviews the development of behavior therapy, its applications, and the characteristics that make this form of therapy unique and applicable to a wide range of problems. Behavior therapy started from learning theory. It has adopted other theoretical bases and produced numerous techniques as a result of efforts to apply its principles to clinical problems. Recently, cognitive techniques of behavior therapy have been growing. The characteristics of behavior therapy are: (i) problem oriented and practical; (ii) emphasis on real life and living skills; and (iii) concrete viewpoint and techniques. These characteristics enable wide application. Today, many studies show the superior efficacy of behavior therapy for various mental and physical problems. Some well-documented techniques can be performed by non-professionals. The techniques and the viewpoint of behavior therapy would be accepted widely in Pacific Rim countries in the future.
Topics: Asia, Southeastern; Behavior Therapy; Cognitive Behavioral Therapy; Cross-Cultural Comparison; Asia, Eastern; Forecasting; Humans; Treatment Outcome
PubMed: 9895156
DOI: 10.1111/j.1440-1819.1998.tb03231.x -
International Journal of Mental Health... Aug 2022Dialectical Behaviour Therapy (DBT) programmes are often the only available treatment for people diagnosed with borderline personality disorder and were rapidly... (Review)
Review
Dialectical Behaviour Therapy (DBT) programmes are often the only available treatment for people diagnosed with borderline personality disorder and were rapidly converted to online delivery during the COVID-19 pandemic. Limited research exists surrounding how the major elements of DBT are delivered in an online environment. This scoping review considered the operationalization of online delivery of DBT and its effectiveness. EBSCO host databases were searched using free text. Of 127 papers, 11 studies from 2010 to 2021 investigating online DBT for any clinical population were included in the review. A narrative synthesis of papers selected was undertaken. Seven articles reported results from five clinical trials (n = 437). Most adaptations mirrored face-to-face programmes although there was considerable variation in how therapy was facilitated. Attendance was reported to be greater online with comparable clinical improvements to face-to-face for those who remained in therapy. Additional challenges included managing risk, therapist preparedness and technology difficulties. Online delivery of DBT programmes is feasible and may be more accessible, acceptable and as safe and effective as face-to-face delivery. However, mirroring face to face delivery in an online environment may not be the most effective and efficient way to adapt DBT to online provision. Research is needed to identify areas which require further adaptation.
Topics: Behavior Therapy; Borderline Personality Disorder; COVID-19; Dialectical Behavior Therapy; Humans; Pandemics; Treatment Outcome
PubMed: 35048482
DOI: 10.1111/inm.12976 -
Psychological Medicine Mar 2017Early weak treatment response is one of the few trans-diagnostic, treatment-agnostic predictors of poor outcome following a full treatment course. We sought to improve... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Early weak treatment response is one of the few trans-diagnostic, treatment-agnostic predictors of poor outcome following a full treatment course. We sought to improve the outcome of clients with weak initial response to guided self-help cognitive behavior therapy (GSH).
METHOD
One hundred and nine women with binge-eating disorder (BED) or bulimia nervosa (BN) (DSM-IV-TR) received 4 weeks of GSH. Based on their response, they were grouped into: (1) early strong responders who continued GSH (cGSH), and early weak responders randomized to (2) dialectical behavior therapy (DBT), or (3) individual and additional group cognitive behavior therapy (CBT+).
RESULTS
Baseline objective binge-eating-day (OBD) frequency was similar between DBT, CBT+ and cGSH. During treatment, OBD frequency reduction was significantly slower in DBT and CBT+ relative to cGSH. Relative to cGSH, OBD frequency was significantly greater at the end of DBT (d = 0.27) and CBT+ (d = 0.31) although these effects were small and within-treatment effects from baseline were large (d = 1.41, 0.95, 1.11, respectively). OBD improvements significantly diminished in all groups during 12 months follow-up but were significantly better sustained in DBT relative to cGSH (d = -0.43). At 6- and 12-month follow-up assessments, DBT, CBT and cGSH did not differ in OBD.
CONCLUSIONS
Early weak response to GSH may be overcome by additional intensive treatment. Evidence was insufficient to support superiority of either DBT or CBT+ for early weak responders relative to early strong responders in cGSH; both were helpful. Future studies using adaptive designs are needed to assess the use of early response to efficiently deliver care to large heterogeneous client groups.
Topics: Adult; Behavior Therapy; Binge-Eating Disorder; Bulimia Nervosa; Cognitive Behavioral Therapy; Female; Humans; Middle Aged; Outcome Assessment, Health Care; Young Adult
PubMed: 27852348
DOI: 10.1017/S0033291716002543 -
Journal of Consulting and Clinical... Oct 2017To examine the mediators and the potential of treatment matching to improve outcome for cognitive behavior therapy (CBT) for insomnia.
OBJECTIVE
To examine the mediators and the potential of treatment matching to improve outcome for cognitive behavior therapy (CBT) for insomnia.
METHOD
Participants were 188 adults (117 women; Mage = 47.4 years, SD = 12.6) meeting the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; text rev.; DSM-IV-TR; American Psychiatric Association [APA], 2000) diagnostic criteria for chronic insomnia (Mduration: 14.5 years, SD: 12.8). Participants were randomized to behavior therapy (BT; n = 63), cognitive therapy (CT; n = 65), or CBT (n = 60). The outcome measure was the Insomnia Severity Index (ISI). Hypothesized BT mediators were sleep-incompatible behaviors, bedtime variability (BTv), risetime variability (RTv) and time in bed (TIB). Hypothesized CT mediators were worry, unhelpful beliefs, and monitoring for sleep-related threat.
RESULTS
The behavioral processes mediated outcome for BT but not CT. The cognitive processes mediated outcome in both BT and CT. The subgroup scoring high on both behavioral and cognitive processes had a marginally significant better outcome if they received CBT relative to BT or CT. The subgroup scoring relatively high on behavioral but low on cognitive processes and received BT or CBT did not differ from those who received CT. The subgroup scoring relatively high on cognitive but low on behavioral processes and received CT or CBT did not differ from those who received BT.
CONCLUSION
The behavioral mediators were specific to BT relative to CT. The cognitive mediators were significant for both BT and CT outcomes. Patients exhibiting high levels of both behavioral and cognitive processes achieve better outcome if they receive CBT relative to BT or CT alone. (PsycINFO Database Record
Topics: Adult; Anxiety; Behavior Therapy; Cognitive Behavioral Therapy; Female; Humans; Male; Middle Aged; Sleep; Sleep Initiation and Maintenance Disorders; Treatment Outcome
PubMed: 28956950
DOI: 10.1037/ccp0000244 -
The Israel Journal of Psychiatry and... 2009Acceptance and Commitment Therapy (ACT) is one of several recently-developed acceptance-based cognitive behavioral treatments which broaden the scope of CBT. The theory... (Review)
Review
Acceptance and Commitment Therapy (ACT) is one of several recently-developed acceptance-based cognitive behavioral treatments which broaden the scope of CBT. The theory underlying ACT suggests that verbal representations generated by the human mind inevitably increase the psychological presence of pain and often lead to psychological inflexibility or the dominance of language products over other sources of information. Furthermore, the adequacy of problem-solving strategies that are used to achieve desired goals and decrease suffering is substantially decreased when applied to private experience. Therefore, humans have a greatly expanded capacity to experience aversive stimulation, but simultaneously are not well-equipped to deal effectively with such unwanted experiences. Acknowledging the inevitability of psychological pain, ACT aims at replacing experiential avoidance and similar harmful processes with more adaptive strategies, with the general goal of pursuing broad life objectives. This is achieved by encouraging mindful acceptance of unwanted experiences and by fostering committed action which is consistent with one's chosen values.
Topics: Attention; Awareness; Behavior; Behavior Therapy; Cognitive Behavioral Therapy; Defense Mechanisms; Goals; Humans; Internal-External Control; Language; Verbal Behavior
PubMed: 20635779
DOI: No ID Found -
Behavior Therapy Jun 2013A number of recent authors have compared acceptance and commitment therapy (ACT) and traditional cognitive behavior therapy (CBT). The present article describes ACT as a... (Review)
Review
A number of recent authors have compared acceptance and commitment therapy (ACT) and traditional cognitive behavior therapy (CBT). The present article describes ACT as a distinct and unified model of behavior change, linked to a specific strategy of scientific development, which we term "contextual behavioral science." We outline the empirical progress of ACT and describe its distinctive development strategy. A contextual behavioral science approach is an inductive attempt to build more adequate psychological systems based on philosophical clarity; the development of basic principles and theories; the development of applied theories linked to basic ones; techniques and components linked to these processes and principles; measurement of theoretically key processes; an emphasis on mediation and moderation in the analysis of applied impact; an interest in effectiveness, dissemination, and training; empirical testing of the research program across a broad range of areas and levels of analysis; and the creation of a more effective scientific and clinical community. We argue that this is a reasonable approach, focused on long-term progress, and that in broad terms it seems to be working. ACT is not hostile to traditional CBT, and is not directly buoyed by whatever weaknesses traditional CBT may have. ACT should be measured at least in part against its own goals as specified by its own developmental strategy.
Topics: Behavior; Behavior Therapy; Cognitive Behavioral Therapy; Humans; Object Attachment
PubMed: 23611068
DOI: 10.1016/j.beth.2009.08.002 -
JMIR MHealth and UHealth Jul 2019Smartphones have allowed for the development and use of apps. There is now a proliferation of mobile health interventions for physical activity, healthy eating, smoking...
BACKGROUND
Smartphones have allowed for the development and use of apps. There is now a proliferation of mobile health interventions for physical activity, healthy eating, smoking and alcohol cessation or reduction, and improved mental well-being. However, the strength or potential of these apps to lead to behavior change remains uncertain.
OBJECTIVE
The aim of this study was to review a large sample of healthy lifestyle apps at a single point in time (June to July 2018) to determine their potential for promoting health-related behavior change with a view to sharing this information with the public. In addition, the study sought to test a wide range of apps using a new scale, the App Behavior Change Scale (ABACUS).
METHODS
Apps focusing on 5 major modifiable lifestyle behaviors were identified using a priori key search terms across the Australian Apple iTunes and Google Play stores. Lifestyle behavior categories were selected for their impact on health and included smoking, alcohol use, physical activity, nutrition, and mental well-being. Apps were included if they had an average user rating between 3 and 5, if they were updated in the last 18 months, if the description of the app included 2 of 4 behavior change features, and if they were in English. The selected behavior change apps were rated in 2 ways using previously developed rating scales: the Mobile App Rating Scale (MARS) for functionality and the ABACUS for potential to encourage behavior change.
RESULTS
The initial search identified 212,352 apps. After applying the filtering criteria, 5018 apps remained. Of these, 344 were classified as behavior change apps and were reviewed and rated. Apps were given an average MARS score of 2.93 out of 5 (SD 0.58, range 1.42-4.16), indicating low-to-moderate functionality. Scores for the ABACUS ranged from 1 to 17, out of 21, with an average score of 7.8 (SD 2.8), indicating a low-to-moderate number of behavior change techniques included in apps. The ability of an app to encourage practice or rehearsal, in addition to daily activities, was the most commonly identified feature across all apps (310/344, 90.1%), whereas the second most common feature was the ability of the user to easily self-monitor behavior (289/344, 84.0%).
CONCLUSIONS
The wide variety of apps included in this 2018 study and the limited number of behavior change techniques found in many apps suggest an opportunity for improvement in app design that will promote sustained and significant lifestyle behavior change and, therefore, better health. The use of the 2 scales for the review and rating of the apps was successful and provided a method that could be replicated and tested in other behavior change areas.
Topics: Australia; Behavior Therapy; Humans; Mobile Applications
PubMed: 31274112
DOI: 10.2196/11926