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Psychiatry Research Mar 2018This paper examined neurocognitive functioning and its relationship to behavior treatment response among youth with Tourette's Disorder (TD) in a large randomized... (Randomized Controlled Trial)
Randomized Controlled Trial
This paper examined neurocognitive functioning and its relationship to behavior treatment response among youth with Tourette's Disorder (TD) in a large randomized controlled trial. Participants diagnosed with TD completed a brief neurocognitive battery assessing inhibitory functions, working memory, and habit learning pre- and post-treatment with behavior therapy (CBIT, Comprehensive Behavioral Intervention for Tics) or psychoeducation plus supportive therapy (PST). At baseline, youth with tics and Attention Deficit Hyperactivity Disorder (ADHD) exhibited some evidence of impaired working memory and simple motor inhibition relative to youth with tics without ADHD. Additionally, a small negative association was found between antipsychotic medications and youth's performance speed. Across treatment groups, greater baseline working memory and aspects of inhibitory functioning were associated with a positive treatment response; no between-group differences in neurocognitive functioning at post-treatment were identified. Within the behavior therapy group, pre-treatment neurocognitive status did not predict outcome, nor was behavior therapy associated significant change in neurocognitive functioning post-treatment. Findings suggest that co-occurring ADHD is associated with some impairments in neurocognitive functioning in youth with Tourette's Disorder. While neurocognitive predictors of behavior therapy were not found, participants who received behavior therapy exhibited significantly reduced tic severity without diminished cognitive functioning.
Topics: Adolescent; Antipsychotic Agents; Attention Deficit Disorder with Hyperactivity; Behavior Therapy; Child; Female; Humans; Inhibition, Psychological; Learning; Male; Memory, Short-Term; Mental Status and Dementia Tests; Tourette Syndrome; Treatment Outcome
PubMed: 29407718
DOI: 10.1016/j.psychres.2017.12.066 -
Annals of Behavioral Medicine : a... Dec 2020Artificial Intelligence (AI) is transforming the process of scientific research. AI, coupled with availability of large datasets and increasing computational power, is... (Review)
Review
BACKGROUND
Artificial Intelligence (AI) is transforming the process of scientific research. AI, coupled with availability of large datasets and increasing computational power, is accelerating progress in areas such as genetics, climate change and astronomy [NeurIPS 2019 Workshop Tackling Climate Change with Machine Learning, Vancouver, Canada; Hausen R, Robertson BE. Morpheus: A deep learning framework for the pixel-level analysis of astronomical image data. Astrophys J Suppl Ser. 2020;248:20; Dias R, Torkamani A. AI in clinical and genomic diagnostics. Genome Med. 2019;11:70.]. The application of AI in behavioral science is still in its infancy and realizing the promise of AI requires adapting current practices.
PURPOSES
By using AI to synthesize and interpret behavior change intervention evaluation report findings at a scale beyond human capability, the HBCP seeks to improve the efficiency and effectiveness of research activities. We explore challenges facing AI adoption in behavioral science through the lens of lessons learned during the Human Behaviour-Change Project (HBCP).
METHODS
The project used an iterative cycle of development and testing of AI algorithms. Using a corpus of published research reports of randomized controlled trials of behavioral interventions, behavioral science experts annotated occurrences of interventions and outcomes. AI algorithms were trained to recognize natural language patterns associated with interventions and outcomes from the expert human annotations. Once trained, the AI algorithms were used to predict outcomes for interventions that were checked by behavioral scientists.
RESULTS
Intervention reports contain many items of information needing to be extracted and these are expressed in hugely variable and idiosyncratic language used in research reports to convey information makes developing algorithms to extract all the information with near perfect accuracy impractical. However, statistical matching algorithms combined with advanced machine learning approaches created reasonably accurate outcome predictions from incomplete data.
CONCLUSIONS
AI holds promise for achieving the goal of predicting outcomes of behavior change interventions, based on information that is automatically extracted from intervention evaluation reports. This information can be used to train knowledge systems using machine learning and reasoning algorithms.
Topics: Artificial Intelligence; Behavior Therapy; Behavioral Sciences; Health Behavior; Humans; Outcome and Process Assessment, Health Care
PubMed: 33416835
DOI: 10.1093/abm/kaaa095 -
Annals of Behavioral Medicine : a... Dec 2014There is little guidance about to how select dose parameter values when designing behavioral interventions. (Review)
Review
BACKGROUND
There is little guidance about to how select dose parameter values when designing behavioral interventions.
PURPOSE
The purpose of this study is to present approaches to inform intervention duration, frequency, and amount when (1) the investigator has no a priori expectation and is seeking a descriptive approach for identifying and narrowing the universe of dose values or (2) the investigator has an a priori expectation and is seeking validation of this expectation using an inferential approach.
METHODS
Strengths and weaknesses of various approaches are described and illustrated with examples.
RESULTS
Descriptive approaches include retrospective analysis of data from randomized trials, assessment of perceived optimal dose via prospective surveys or interviews of key stakeholders, and assessment of target patient behavior via prospective, longitudinal, observational studies. Inferential approaches include nonrandomized, early-phase trials and randomized designs.
CONCLUSIONS
By utilizing these approaches, researchers may more efficiently apply resources to identify the optimal values of dose parameters for behavioral interventions.
Topics: Behavior Therapy; Humans; Research Design
PubMed: 24722964
DOI: 10.1007/s12160-014-9618-7 -
JMIR MHealth and UHealth Feb 2019Increasing physical activity (PA) levels in adolescents aged 12 to 18 years is associated with prevention of unhealthy weight gain and improvement in cardiovascular... (Review)
Review
BACKGROUND
Increasing physical activity (PA) levels in adolescents aged 12 to 18 years is associated with prevention of unhealthy weight gain and improvement in cardiovascular fitness. The widespread availability of mobile health (mHealth) and wearable devices offers self-monitoring and motivational features for increasing PA levels and improving adherence to exercise programs.
OBJECTIVE
The aim of this scoping review was to identify the efficacy or effectiveness of mHealth intervention strategies for facilitating PA among adolescents aged 12 to 18 years.
METHODS
We conducted a systematic search for peer-reviewed studies published between 2008 and 2018 in the following electronic databases: PubMed, Google Scholar, PsychINFO, or SportDiscus. The search terms used included mHealth or "mobile health" or apps, "physical activity" or exercise, children or adolescents or teens or "young adults" or kids, and efficacy or effectiveness. Articles published outside of the date range (July 2008 to October 2018) and non-English articles were removed before abstract review. Three reviewers assessed all abstracts against the inclusion and exclusion criteria. Any uncertainties or differences in opinion were discussed as a group. The inclusion criteria were that the studies should (1) have an mHealth component, (2) target participants aged between 12 and 18 years, (3) have results on efficacy or effectiveness, and (4) assess PA-related outcomes. Reviews, abstracts only, protocols without results, and short message service text messaging-only interventions were excluded. We also extracted potentially relevant papers from reviews. At least 2 reviewers examined all full articles for fit with the criteria and extracted data for analysis. Data extracted from selected studies included study population, study type, components of PA intervention, and PA outcome results.
RESULTS
Overall, 126 articles were initially identified. Reviewers pulled 18 additional articles from excluded review papers. Only 18 articles were passed onto full review, and 16 were kept for analysis. The included studies differed in the sizes of the study populations (11-607 participants), locations of the study sites (7 countries), study setting, and study design. Overall, 5 mHealth intervention categories were identified: website, website+wearable, app, wearable+app, and website+wearable+app. The most common measures reported were subjective weekly PA (4/13) and objective daily moderate-to-vigorous PA (5/13) of the 19 different PA outcomes assessed. Furthermore, 5 of 13 studies with a control or comparison group showed a significant improvement in PA outcomes between the intervention group and the control or comparison group. Of those 5 studies, 3 permitted isolation of mHealth intervention components in the analysis.
CONCLUSIONS
PA outcomes for adolescents improved over time through mHealth intervention use; however, the lack of consistency in chosen PA outcome measures, paucity of significant outcomes via between-group analyses, and the various study designs that prevent separating the effects of intervention components calls into question their true effect.
Topics: Adolescent; Adolescent Behavior; Behavior Therapy; Child; Exercise; Female; Humans; Male; Telemedicine; Text Messaging
PubMed: 30747716
DOI: 10.2196/11847 -
Alcohol Research & Health : the Journal... 2011Numerous effective behavioral therapies have been developed that can bring the treatment to the patient rather than bringing the patient to treatment. These behavioral... (Review)
Review
Numerous effective behavioral therapies have been developed that can bring the treatment to the patient rather than bringing the patient to treatment. These behavioral therapy techniques, which can provide effective treatment across the spectrum of severity of alcohol abuse disorders, include facilitated self-change, individual therapies, couples and family approaches, and contingency management. New methods of delivery and successful adjuncts to existing behavioral treatments also have been introduced, including computerized cognitive-behavioral treatments, Web-based guided self-change, and mindfulness-based approaches. Although a wide variety of behavioral approaches have been shown to have good efficacy, choosing the treatment most appropriate for a given patient remains a challenge.
Topics: Adaptation, Psychological; Alcoholism; Animals; Behavior Therapy; Humans; Mindfulness
PubMed: 23580016
DOI: No ID Found -
The Cochrane Database of Systematic... Oct 2006While behavioural or cognitive-behavioural therapy (BT/CBT) is recommended as the psychotherapeutic treatment of choice for children and adolescents with... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
While behavioural or cognitive-behavioural therapy (BT/CBT) is recommended as the psychotherapeutic treatment of choice for children and adolescents with obsessive-compulsive disorder (OCD), the application of BT/CBT to paediatric OCD may not be straightforward.
OBJECTIVES
This review examines the overall efficacy of BT/CBT for paediatric OCD, its relative efficacy against psychopharmacology and whether there are benefits in using BT/CBT combined with medication.
SEARCH STRATEGY
We searched CCDANCTR-Studies and CCDANCTR-References (searched on 5/8/2005), MEDLINE, EMBASE, PsycINFO, the reference lists of all selected studies and handsearched journals specifically related to behavioural treatment of OCD.
SELECTION CRITERIA
Included studies were randomised controlled trials or quasi-randomised trials with participants who were 18 years of age or younger and had a diagnosis of OCD, established by clinical assessment or standardised diagnostic interview. Reviewed studies included the standard behavioural or cognitive-behavioural techniques, either alone or in combination, compared with wait-list or pill placebo.
DATA COLLECTION AND ANALYSIS
The quality of selected studies was assessed by two independent reviewers. The primary outcomes comprised of endpoint scores on the gold standard clinical outcome measure of OCD symptoms, distress and interference (CY-BOCS) and endpoint OCD status.
MAIN RESULTS
Four studies with 222 participants were considered eligible for inclusion and for data extraction. Two studies showed significantly better post-treatment functioning and reduced risk of continuing with OCD at post-treatment for the BT/CBT group compared to placebo or wait-list comparisons. We suggested that the POTS 2004 result, equal to a difference of about eight points on the CY-BOCS, represented the best available estimate for the efficacy of BT/CBT relative to no treatment. (WMD -7.50; 95% CI -11.55, -3.45). Pooled evidence from two trials indicated that the efficacy of BT/CBT and medication did not differ significantly (WMD -3.87; 95% CI -8.15, 0.41). There was evidence of the benefit of combined BT/CBT and medication compared to medication alone (WMD -4.55; 95% CI -7.40, -1.70), but not relative to BT/CBT alone (WMD -2.80; 95% CI -7.55, 1.95). The rates of drop out suggested BT/CBT is an acceptable treatment to child and adolescent patients and their families.
AUTHORS' CONCLUSIONS
Although only based on a small number of studies, behavioural or cognitive-behaviour therapy appears to be a promising treatment for OCD in children and adolescents. It can lead to better outcomes when combined with medication compared to medication alone. Additional trials are needed to confirm these findings. In the interim, consideration should be given to the ways in which BT/CBT might be made more widely available as a treatment for OCD in children and adolescents.
Topics: Adolescent; Behavior Therapy; Child; Cognitive Behavioral Therapy; Humans; Obsessive-Compulsive Disorder; Randomized Controlled Trials as Topic
PubMed: 17054218
DOI: 10.1002/14651858.CD004856.pub2 -
Administration and Policy in Mental... Sep 2023This paper presents two studies conducted to develop and evaluate a new pragmatic measure of therapist adherence to Dialectical Behavior Therapy (DBT): the DBT Adherence...
This paper presents two studies conducted to develop and evaluate a new pragmatic measure of therapist adherence to Dialectical Behavior Therapy (DBT): the DBT Adherence Checklist for Individual Therapy (DBT AC-I). Study 1 used item response analysis to select items from the gold standard DBT Adherence Coding Scale (DBT ACS) using archival data from 1271 DBT sessions. Items were then iteratively refined based on feedback from 33 target end-users to ensure relevance, usability, and understandability. Study 2 examined the psychometric properties of the DBT AC-I as a therapist self-report and observer-rated measure in 100 sessions from 50 therapist-client dyads, while also evaluating predictors of therapist accuracy in self-rated adherence. When used as a therapist self-report measure, concordance between therapist and observer ratings was at least moderate (AC ≥ 0.41) for all DBT AC-I items but overall concordance (ICC = 0.09) as well as convergent (r = 0.05) and criterion validity (AUC = 0.54) with the DBT ACS were poor. Higher therapist accuracy was predicted by greater DBT knowledge and adherence as well as more severe client suicidal ideation. When used by trained observers, the DBT AC-I had excellent interrater reliability (ICC = 0.93), convergent validity (r = 0.90), and criterion validity (AUC = 0.94). While therapists' self-rated adherence on the DBT AC-I should not be assumed to reflect their actual adherence, some therapists may self-rate accurately. The DBT AC-I offers an effective and relatively efficient method of evaluating adherence to DBT when used by trained observers.
Topics: Humans; Dialectical Behavior Therapy; Behavior Therapy; Checklist; Reproducibility of Results; Psychotherapy
PubMed: 37284966
DOI: 10.1007/s10488-023-01274-x -
Journal of Experimental Psychology.... Jul 2019This review article discusses various cognitive and behavioral interventions that have been developed with the goal of promoting self-controlled responding. Self-control... (Review)
Review
This review article discusses various cognitive and behavioral interventions that have been developed with the goal of promoting self-controlled responding. Self-control can exert a significant impact on human health and impulsive behaviors are associated with a wide range of diseases and disorders, leading to the suggestion that impulsivity is a trans-disease process. The self-control interventions include effort exposure, reward discrimination, reward bundling, interval schedules of reinforcement, impulse control training, and mindfulness training. Most of the interventions have been consistently shown to increase self-control, except for mindfulness training. Some of the successful interventions are long-lasting, whereas others may be transient. Most interventions are domain-specific, targeting specific cognitive and behavioral processes that relate to self-control rather than targeting overall self-control. For example, effort exposure appears to primarily increase effort tolerance, which in turn can improve self-control. Similarly, interval schedules primarily target interval timing, which promotes self-controlled responses. A diagram outlining a proposed set of intervention effects on self-control is introduced to motivate further research in this area. The diagram suggests that the individual target processes of the interventions may potentially summate to produce general self-control, or perhaps even produce synergistic effects. In addition, it is suggested that developing a self-control profile may be advantageous for aligning specific interventions to mitigate specific deficits. Overall, the results indicate that interventions are a promising avenue for promoting self-control and may help to contribute to changing health outcomes associated with a wide variety of diseases and disorders. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Topics: Behavior Therapy; Cognition; Humans; Impulsive Behavior; Reinforcement, Psychology; Self-Control
PubMed: 31070430
DOI: 10.1037/xan0000208 -
Journal of the American College of... Jul 2014Growing epidemiological evidence identifies key domains relevant to behavioral cardiology, including health behaviors, emotions, mental mindsets, stress management,... (Review)
Review
Growing epidemiological evidence identifies key domains relevant to behavioral cardiology, including health behaviors, emotions, mental mindsets, stress management, social connectedness, and a sense of purpose. Each of these domains exists along a continuum, ranging from positive factors that promote health, to negative factors, which are pathophysiological. To date, there has been relatively little translation of this growing knowledge base into cardiology practice. Four initiatives are proposed to meet this challenge: 1) promulgating greater awareness of the potency of psychosocial risks factors; 2) overcoming a current "artificial divide" between conventional and psychosocial risk factors; 3) developing novel cost-effective interventions using Internet and mobile health applications, group-based counseling, and development of tiered-care behavioral management; and 4) in recognition that "one size does not fit all" with respect to behavioral interventions, developing specialists who can counsel patients in multidisciplinary fashion and use evidence-based approaches for promoting patient motivation and execution of health goals.
Topics: Animals; Behavior Therapy; Cardiology; Cardiovascular Diseases; Forecasting; Health Behavior; Humans; Observational Studies as Topic; Risk Factors; Stress, Psychological
PubMed: 24998134
DOI: 10.1016/j.jacc.2014.03.047 -
The Cochrane Database of Systematic... Oct 2007Cognitive-behavioral therapy (CBT) appears to be effective in the treatment of antisocial behavior both in adolescents and adults. Treatment of antisocial behavior in... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Cognitive-behavioral therapy (CBT) appears to be effective in the treatment of antisocial behavior both in adolescents and adults. Treatment of antisocial behavior in youth in residential settings is a challenge since it usually involves more serious behavioral problems and takes place in a closed setting. The motivation for change is usually low and there is little possibility to address the maintenance of any behavioral changes following release.
OBJECTIVES
To investigate the effectiveness of CBT in reducing recidivism of adolescents placed in secure or non-secure residential settings. A secondary objective was to see if interventions that focus particularly on criminogenic needs are more effective than those with a more general focus on cognitions and behavior.
SEARCH STRATEGY
We searched a number of databases including: CENTRAL 2005 (Issue 2), MEDLINE 1966 to May 2005, Sociological Abstracts 1963 to May 2005, ERIC 1966 to November 2004, Dissertation Abstracts International 1960s to 2005. We contacted experts in the field concerning current research.
SELECTION CRITERIA
Both randomised controlled trials and studies with non-randomized comparison groups were included. Participants had to be young people aged 12-22 and placed in a residential setting for reasons of antisocial behavior.
DATA COLLECTION AND ANALYSIS
Two reviewers independently reviewed 93 titles and abstracts; 35 full-text reports were retrieved and data from 12 trials eligible for inclusion were extracted and entered into RevMan. Results were synthesized using a random effects model, due to the significant heterogeneity across included studies. Results are reported at 6, 12 and 24 months post-treatment, and presented in graphical (forest plots) form. Odds ratios are used throughout and intention-to-treat analyses were made with drop-outs imputed proportionally. Pooled estimates were weighted with inverse variance methods and 95% confidence intervals were used.
MAIN RESULTS
The results for 12 months follow-up show that although single studies generally show no significant effects, the results for pooled data are clearly significant in favor of CBT compared to standard treatment with an odds ratio of 0,69. The reduction in recidivism is about 10% on the average. There is no evidence of effects after 6 or 24 months or when CBT is compared to alternative treatments.
AUTHORS' CONCLUSIONS
CBT seems to be a little more effective than standard treatment for youth in residential settings. The effects appear about one year after release, but there is no evidence of more long-term effects or that CBT is any better than alternative treatments.
Topics: Adolescent; Adult; Antisocial Personality Disorder; Behavior Therapy; Cognitive Behavioral Therapy; Female; Humans; Male; Residential Treatment; Secondary Prevention
PubMed: 17943869
DOI: 10.1002/14651858.CD005650.pub2