Purpose and Originality: The study aims to examine and compare body image satisfaction with the level of interest in losing weight between gender, considering cognitive behaviours toward food, age, ...Body Mass Index, work, marital status, and the number of children. Method: A quantitative meta-analysis conducted randomly on a pool of Lebanese adults (n = 514) between February 2018 and June 2018. Anthropometric measures and specific demographic data assessed individually, and questions related to the level of body image satisfaction and the level of interest in losing weight were analyzed using bivariate statistical tests (t-test, χ2). Results: No relationship was found between body image satisfaction and gender at any age (p > 0.05), even though women showed a higher mean in the level of interest in losing weight (2.21 ± 0.835) than men (1.87 ± 0.835). Body image satisfaction was found inversely associated with Body Mass Index and with more significance than the level of interest in losing weight (p <0.001). Cognitive behaviours toward food and work status were only found significantly related to body image satisfaction, whereas marital status was solitary found related to the level of interest in losing weight with a small effect size (p < 0.01). Society: This study reflects the different attitude between gender toward body image satisfaction and interest in losing weight in the Lebanese adult population, in order to interpret a better understanding toward image satisfaction, while identifying determinants that might be applied for designing interventions independent of the setting. Limitations: Pregnant and lactating women were not considered in the sample. Originality/value: The impact of the study concerns the Lebanese society, and it is the first of its kind to open the subject concerning BIS between different Lebanese social groups and initiate further research in this field.
This paper looks at consensus algorithms for agent cooperation with unmanned aerial vehicles. The foundation is the consensus-based bundle algorithm, which is extended to allow multi-agent tasks ...requiring agents to cooperate in completing individual tasks. Inspiration is taken from the cognitive behaviours of eusocial animals for cooperation and improved assignments. Using the behaviours observed in bees and ants inspires decentralised algorithms for groups of agents to adapt to changing task demand. Further extensions are provided to improve task complexity handling by the agents with added equipment requirements and task dependencies. We address the problems of handling these challenges and improve the efficiency of the algorithm for these requirements, whilst decreasing the communication cost with a new data structure. The proposed algorithm converges to a conflict-free, feasible solution of which previous algorithms are unable to account for. Furthermore, the algorithm takes into account heterogeneous agents, deadlocking and a method to store assignments for a dynamical environment. Simulation results demonstrate reduced data usage and communication time to come to a consensus on multi-agent tasks.
Providing therapist‐guided cognitive behaviour therapy via the Internet (ICBT) has advantages, but a central research question is to what extent similar clinical effects can be obtained as with ...gold‐standard face‐to‐face cognitive behaviour therapy (CBT). In a previous meta‐analysis published in this journal, which was updated in 2018, we found evidence that the pooled effects for the two formats were equivalent in the treatment of psychiatric and somatic disorders, but the number of published randomized trials was relatively low (n=20). As this is a field that moves rapidly, the aim of the current study was to conduct an update of our systematic review and meta‐analysis of the clinical effects of ICBT vs. face‐to‐face CBT for psychiatric and somatic disorders in adults. We searched the PubMed database for relevant studies published from 2016 to 2022. The main inclusion criteria were that studies had to compare ICBT to face‐to‐face CBT using a randomized controlled design and targeting adult populations. Quality assessment was made using the Cochrane risk of bias criteria (Version 1), and the main outcome estimate was the pooled standardized effect size (Hedges’ g) using a random effects model. We screened 5,601 records and included 11 new randomized trials, adding them to the 20 previously identified ones (total n=31). Sixteen different clinical conditions were targeted in the included studies. Half of the trials were in the fields of depression/depressive symptoms or some form of anxiety disorder. The pooled effect size across all disorders was g=0.02 (95% CI: –0.09 to 0.14) and the quality of the included studies was acceptable. This meta‐analysis further supports the notion that therapist‐supported ICBT yields similar effects as face‐to‐face CBT.
In the past 4 decades about 500 randomized trials have examined the effects of psychological treatments of adult depression. In this article the results of a series of meta-analyses of these trials ...are summarised. Several types of psychotherapy have been examined, including cognitive behaviour therapy, behavioural activation therapy, interpersonal psychotherapy, problem-solving therapy, nondirective supportive therapy, and short-term psychodynamic psychotherapy. All therapies are effective and there are no significant differences between treatments. Psychotherapies are about equally effective as pharmacotherapy, and combined treatments are more effective than either of these alone. Therapies are also effective in specific target groups, such as older adults, college students, patients with general medical disorders, but may be somewhat less effective in chronic depression, and in patients with comorbid substance use disorders. Treatments are effective when delivered in individual, group, and guided self-help format. The effects of psychotherapies have been overestimated because of the low quality of many trials and due to publication bias. Future research should not be aimed at the development of new psychotherapies for depression, on specific treatment formats or on therapies in specific populations, because the evidence indicates that all types and formats with human involvement are effective in all specific target groups. Future research should instead focus on a further reduction of the disease burden of depression. Specifically, it should focus on the possibilities of preventing the onset of depressive disorders, treatments of chronic and treatment-resistant depression, relapse prevention, and scaling up treatments, for example by using more guided self-help interventions.
Au cours des 4 dernières décennies, environ 500 essais randomisés ont examiné les effets des traitements psychologiques de la dépression chez l'adulte. Cet article fait le sommaire des résultats d'une série de méta-analyses de ces essais. Plusieurs types de psychothérapie ont été examinés, y compris la thérapie cognitivo-comportementale, la thérapie d'activation comportementale, la psychothérapie interpersonnelle, la thérapie de résolution de problèmes, la thérapie de soutien non directive et la psychothérapie psychodynamique à court terme. Toutes les thérapies sont efficaces et il n'y a pas de différences significatives entre les traitements. Les psychothérapies sont à peu près aussi efficaces que la pharmacothérapie, et les traitements combinés sont plus efficaces que toute méthode utilisée seule. De plus, les thérapies sont efficaces parmi des groupes cibles précis, tels les aînés, les étudiants à l'université ou les patients ayant des troubles de santé, mais quelque peu moins efficaces pour traiter la dépression chronique ou des troubles concomitants de toxicomanie. Les traitements sont efficaces lorsqu'ils sont offerts sur une base individuelle, en groupe ou selon un format d'aide personnelle autoguidée. L'efficacité des psychothérapies a été surestimée en raison de la faible qualité de nombreux essais et d'un biais de publication. Les recherches futures ne devraient pas viser à élaborer de nouvelles psychothérapies pour traiter la dépression ou encore de nouvelles formules de traitement ou de thérapies destinées à des populations précises, car les preuves révèlent que tous les types et formats impliquant une participation humaine sont efficaces parmi tous les groupes ciblés. Les recherches futures devraient plutôt se consacrer à diminuer davantage le fardeau de la maladie qu'est la dépression. Plus précisément, elles devraient se pencher sur les possibilités de prévenir les troubles dépressifs, sur les traitements de la dépression chronique et de la dépression réfractaire au traitement, la prévention des rechutes, l'intensification des traitements au moyen, par exemple, des interventions d'aide personnelle autoguidée.
•Paediatric epilepsy staff were trained to deliver a mental health intervention.•Staff did not have prior formal mental health training.•Staff received six months of training and regular ...supervision.•The vast majority of staff reached competence at the end of six months.•Staff in physical healthcare settings may prefer a more flexible supervision format.
Children and young people with epilepsy are more likely to experience multiple mental health problems than those without chronic physical health conditions, yet they often do not receive evidence-based (or indeed any) psychological interventions. Integrated healthcare is recommended as a solution to address these inequalities, but remains limited in the United Kingdom. This is partly due to the lack of training and availability of ongoing supervision for clinicians to ensure the safe and effective delivery of treatments. This study aimed to train and provide supervision for health professionals to deliver a modular cognitive-behavioural intervention for common mental health problems, optimised for use in paediatric epilepsy. Specifically, this study aimed to measure therapist competence and evaluate the acceptability of training and supervision.
Fifteen health professionals working in paediatric epilepsy services were trained over a six-month period. Training included face-to-face training workshops and completing at least one training case of a young person with epilepsy and anxiety, depression and/or behavioural problems under close clinical supervision. Throughout the training, health professionals were offered weekly one-hour supervisions with an experienced Clinical Psychologist. Clinical competence was assessed using a widely used measure of therapist competence in cognitive-behavioural therapy. Rates of attendance at supervision sessions and therapist ratings of satisfaction were recorded.
At the end of the six-month training, 14 health professionals reached clinical competence in delivering the mental health intervention. One person left the service and therefore did not complete the training. Overall, health professionals were satisfied with the training and supervision. However, 14 % of supervision sessions were cancelled and a further 11 % were not attended. Supervision sessions were also often shorter than the standard hour used in mental health settings (M = 41.18 min, SD = 10.30).
Our findings suggest that health professionals working in paediatric epilepsy services can be trained to deliver a psychological intervention with proficiency. However, the supervision model typically used in mental health may need adaptation to be sustainable in physical health settings. Future research is needed to evaluate the impact of training and supervision on patient outcomes and to ensure that ethical delivery of psychological interventions by health professionals without a mental health background.
Objective: Randomized comparisons of acceptance-based treatments with traditional cognitive behavioral therapy (CBT) for anxiety disorders are lacking. To address this gap, we compared acceptance and ...commitment therapy (ACT) to CBT for heterogeneous anxiety disorders. Method: One hundred twenty-eight individuals (52% female, mean age = 38, 33% minority) with 1 or more "DSM-IV" anxiety disorders began treatment following randomization to CBT or ACT; both treatments included behavioral exposure. Assessments at pre-treatment, post-treatment, and 6- and 12-month follow-up measured anxiety-specific (principal disorder Clinical Severity Ratings CSRs, Anxiety Sensitivity Index, Penn State Worry Questionnaire, Fear Questionnaire avoidance) and non-anxiety-specific (Quality of Life Index QOLI, Acceptance and Action Questionnaire-16 AAQ) outcomes. Treatment adherence, therapist competency ratings, treatment credibility, and co-occurring mood and anxiety disorders were investigated. Results: CBT and ACT improved similarly across all outcomes from pre- to post-treatment. During follow-up, ACT showed steeper linear CSR improvements than CBT (p less than 0.05, d = 1.26), and at 12-month follow-up, ACT showed lower CSRs than CBT among completers (p less than 0.05, d = 1.10). At 12-month follow-up, ACT reported higher AAQ than CBT (p = 0.08, d = 0.42; completers: p less than 0.05, d = 0.56), whereas CBT reported higher QOLI than ACT (p less than 0.05, d = 0.42). Attrition and comorbidity improvements were similar; ACT used more non-study psychotherapy at 6-month follow-up. Therapist adherence and competency were good; treatment credibility was higher in CBT. Conclusions: Overall improvement was similar between ACT and CBT, indicating that ACT is a highly viable treatment for anxiety disorders. (Contains 2 figures, 6 tables, and 11 footnotes.)
Perfectionism is associated with symptoms of multiple psychological disorders. In this commentary, we outline our numerous concerns regarding a recent meta-analysis by Smith et al. (2023) that ...examined the efficacy of cognitive behaviour therapy for perfectionism (CBT-P). To ensure health care and policy decisions are based on high-quality evidence, evidence summaries need to be held to high standards of accountability. The study did not systematically search the literature, and omitted previous studies included in the meta-analyses they sought to reanalyze. Additionally, there was insufficient statistical power to detect intervention effects with small numbers of studies and multiple outcomes, other statistical concerns (e.g., numbers-needed-to-treat analysis), and conflation of the issue of dropout and treatment tolerance. To ensure appropriate guidance for the health care sector, evidence summaries of intervention effects must uphold high standards of quality. CBT-P has demonstrated efficacy in addressing the risk factor of perfectionism and preventing and decreasing symptoms of anxiety, depression, and eating disorders. Further systematic reviews and meta-analyses with rigorous methodology are encouraged.
Le perfectionnisme est associé aux symptômes de multiples troubles psychologiques. Dans le présent commentaire, nous exposons nos diverses préoccupations concernant une méta-analyse menée par Smith et coll. (2023) visant à examiner l'efficacité de la thérapie cognitivo-comportementale du perfectionnisme (TCC-P). Pour veiller à ce que les décisions en matière de soins de santé et de politiques soient fondées sur des données probantes solides, les résumés de ces données doivent être astreints à des normes élevées de reddition de comptes. L'étude ne prévoyait aucune recherche documentaire et omettait les études précédentes comprises dans les méta-analyses qu'elle souhaitait analyser de nouveau. De plus, la puissance statistique était insuffisante pour relever les effets des interventions, en raison du faible nombre d'études et de la multiplicité de résultats, d'autres préoccupations statistiques (p. ex., une analyse du nombre de sujets à traiter) et de l'amalgame des enjeux du taux d'abandon et de la tolérance au traitement. Pour veiller à fournir des indications pertinentes au secteur de la santé, les résumés des données probantes des effets des interventions doivent être astreints aux plus hautes normes de qualité. La TCC-P a fait la preuve de son efficacité pour agir sur les facteurs de risque du perfectionnisme et prévenir ainsi que diminuer les symptômes d'anxiété, de dépression et des troubles de l'alimentation. Des analyses systématiques et des méta-analyses plus poussées assorties d'une méthodologie rigoureuse sont encouragées.
Public Significance Statement
A recent meta-analysis by Smith et al. (2023) in Canadian Psychology made conclusions and generalizations regarding the efficacy of cognitive behaviour therapy for perfectionism (CBT-P). We provide a commentary on the article to outline numerous concerns with the research, including conflating dropout with treatment tolerance, insufficient statistical power, and too few studies for the multiple outcomes assessed. It is concluded that the findings from prior meta-analyses on the efficacy of CBT-P remain valid and that the public can have confidence in such an intervention.
Although third-wave behaviour therapies are being increasingly used for the treatment of eating disorders, their efficacy is largely unknown. This systematic review and meta-analysis aimed to examine ...the empirical status of these therapies. Twenty-seven studies met full inclusion criteria. Only 13 randomized controlled trials (RCT) were identified, most on binge eating disorder (BED). Pooled within- (pre-post change) and between-groups effect sizes were calculated for the meta-analysis. Large pre-post symptom improvements were observed for all third-wave treatments, including dialectical behaviour therapy (DBT), schema therapy (ST), acceptance and commitment therapy (ACT), mindfulness-based interventions (MBI), and compassion-focused therapy (CFT). Third-wave therapies were not superior to active comparisons generally, or to cognitive-behaviour therapy (CBT) in RCTs. Based on our qualitative synthesis, none of the third-wave therapies meet established criteria for an empirically supported treatment for particular eating disorder subgroups. Until further RCTs demonstrate the efficacy of third-wave therapies for particular eating disorder subgroups, the available data suggest that CBT should retain its status as the recommended treatment approach for bulimia nervosa (BN) and BED, and the front running treatment for anorexia nervosa (AN) in adults, with interpersonal psychotherapy (IPT) considered a strong empirically-supported alternative.
•The empirical standing of the third-wave behavior therapies for the treatment of eating disorders was evaluated.•Large improvements in symptoms were made following each third-wave therapy.•None of the third-wave therapies meet criteria for an empirically-supported treatment for eating disorders.•CBT should be provided to individuals with eating disorders, with IPT considered an alternative.
Internet interventions, and in particular Internet‐delivered cognitive behaviour therapy (ICBT), have existed for at least 20 years. Here we review the treatment approach and the evidence base, ...arguing that ICBT can be viewed as a vehicle for innovation. ICBT has been developed and tested for several psychiatric and somatic conditions, and direct comparative studies suggest that therapist‐guided ICBT is more effective than a waiting list for anxiety disorders and depression, and tends to be as effective as face‐to‐face CBT. Studies on the possible harmful effects of ICBT are also reviewed: a significant minority of people do experience negative effects, although rates of deterioration appear similar to those reported for face‐to‐face treatments and lower than for control conditions. We further review studies on change mechanisms and conclude that few, if any, consistent moderators and mediators of change have been identified. A recent trend to focus on knowledge acquisition is considered, and a discussion on the possibilities and hurdles of implementing ICBT is presented. The latter includes findings suggesting that attitudes toward ICBT may not be as positive as when using modern information technology as an adjunct to face‐to‐face therapy (i.e., blended treatment). Finally, we discuss future directions, including the role played by technology and machine learning, blended treatment, adaptation of treatment for minorities and non‐Western settings, other therapeutic approaches than ICBT (including Internet‐delivered psychodynamic and interpersonal psychotherapy as well as acceptance and commitment therapy), emerging regulations, and the importance of reporting failed trials.
Safety behaviour: A reconsideration Rachman, S.; Radomsky, Adam S.; Shafran, Roz
Behaviour research and therapy,
02/2008, Letnik:
46, Številka:
2
Journal Article
Recenzirano
Odprti dostop
There is ample evidence that the use of safety behaviour can interfere with the progress of therapy, particularly if exposure is involved. As a result, it is widely asserted that safety behaviour is ...anti-therapeutic. However, an unqualified rejection of safety behaviour should be reconsidered because we now have theoretical justification, experimental evidence and clinical observations showing that the
judicious use of safety behaviour, especially in the early stages of treatment, can be facilitative. Experiments in which escape behaviour facilitated fear reduction, and others in which the use of safety gear facilitated fear reduction, are reviewed. It also appears that safety behaviour does not necessarily prevent disconfirmatory experiences. We propose that additional investigations of the judicious use of safety behaviour will help to elucidate therapeutic uses of safety behaviour in the treatment of anxious and related types of psychopathology.
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