Norms clarification has been identified as an effective component of college student drinking interventions, prompting research on norms clarification as a single-component intervention known as ...Personalized Normative Feedback (PNF). Previous reviews have examined PNF in combination with other components but not as a stand-alone intervention.
To investigate the degree to which computer-delivered stand-alone personalized normative feedback interventions reduce alcohol consumption and alcohol-related harms among college students and to compare gender-neutral and gender-specific PNF.
Electronic databases were searched systematically through November 2014. Reference lists were reviewed manually and forward and backward searches were conducted.
Outcome studies that compared computer-delivered, stand-alone PNF intervention with an assessment only, attention-matched, or active treatment control and reported alcohol use and harms among college students.
Between-group effect sizes were calculated as the standardized mean difference in change scores between treatment and control groups divided by pooled standard deviation. Within-group effect sizes were calculated as the raw mean difference between baseline and follow-up divided by pooled within-groups standard deviation.
Eight studies (13 interventions) with a total of 2,050 participants were included. Compared to control participants, students who received gender-neutral (dbetween = 0.291, 95% CI 0.159, 0.423) and gender-specific PNF (dbetween = 0.284, 95% CI 0.117, 0.451) reported greater reductions in drinking from baseline to follow-up. Students who received gender-neutral PNF reported 3.027 (95% CI 2.171, 3.882) fewer drinks per week at first follow-up and gender-specific PNF reported 3.089 (95% CI 0.992, 5.186) fewer drinks. Intervention effects were small for harms (dbetween = 0.157, 95% CI 0.037, 0.278).
Computer-delivered PNF is an effective stand-alone approach for reducing college student drinking and has a small impact on alcohol-related harms. Effects are small but clinically relevant when considered from a public health perspective. Additional research is needed to examine computer-delivered, stand-alone PNF as a population-level prevention program.
Workplace coaching has experienced a dramatic rise in popularity over the past decade and is one of the fastest growing performance-enhancing interventions used by modern organizations. Yet, despite ...its popularity, workplace coaching has not been the subject of much empirical research and a true
science of coaching
has yet to be developed. The purpose of this research was to update prior meta-analyzes that investigated the impact of coaching on organizational outcomes and to provide recommendations for how the field needs to evolve. Results indicated that, consistent with prior meta-analyzes, workplace coaching is effective in achieving positive organizational outcomes. The effects of several moderators were also investigated. Finally, we discuss the results in terms of recommendations for future directions that we believe will establish and advance the
science of coaching
.
•Virtual-reality augmented exposure therapy is efficacious for combat-related PTSD.•Virtual-reality augmented exposure therapy decreases depression and anger.•Adding group therapy decreases social ...isolation in veterans.•Treatment outcome is maintained at six month follow-up.
Virtual reality exposure therapy (VRET) realistically incorporates traumatic cues into exposure therapy and holds promise in the treatment of combat-related posttraumatic stress disorder (PTSD). In a randomized controlled trial of 92 Iraq and Afghanistan veterans and active duty military personnel with combat-related PTSD, we compared the efficacy of Trauma Management Therapy (TMT; VRET plus a group treatment for anger, depression, and social isolation) to VRET plus a psychoeducation control condition. Efficacy was evaluated at mid- and post-treatment, and at 3- and 6-month follow-up. Consistent with our hypothesis, VRET resulted in significant decreases on the Clinician Administered PTSD Scale and the PTSD Checklist-Military version for both groups. Also consistent with our hypothesis, significant decreases in social isolation occurred only for those participants who received the TMT group component. There were significant decreases for depression and anger for both groups, although these occurred after VRET and before group treatment. All treatment gains were maintained six-months later. Although not part of the original hypotheses, sleep was not improved by either intervention and remained problematic. The results support the use of VRET as an efficacious treatment for combat-related PTSD, but suggest that VRET alone does not result in optimal treatment outcomes across domains associated with PTSD.
•Social skills training program (Pegasys-VR) with artificially intelligent avatars.•Pegasys VR augments Social Effectiveness Therapy for Children (SET-C).•Pegasys-VR replaced SET-C components ...difficult to disseminate in clinical settings.•Pegasys-VR was as efficacious as SET-C for children with social anxiety disorder.
Disseminating efficacious psychological treatments remains a challenge for researchers and clinicians. In the case of social anxiety disorder (SAD), Social Effectiveness Therapy for Children (SET-C) has been demonstrated as an efficacious intervention, but elements of the protocol, such as peer generalization sessions, remain challenging to conduct in typical clinical settings. To address this need, we developed an artificially intelligent, web-based application, Pegasys-VR™, designed to replace peer generalization sessions and enhance homework compliance. The feasibility of Pegasys-VR™ was tested in a randomized controlled trial in comparison to SET-C. The results indicated that both programs were equally efficacious in decreasing anxiety and improving social skill in social encounters. Sixty-three percent (63%) of children treated with SET-C and 60% treated with Pegasys-VR™ did not meet diagnostic criteria for SAD at posttreatment. Pegasys-VR™ is a feasible, efficacious, and dissemination-friendly element of a comprehensive treatment program for social anxiety disorder in children.
Substantial disagreement exists in the literature regarding which educational technology results in the highest cognitive gain for learners. In an attempt to resolve this dispute, we conducted a ...meta-analysis to decipher which teaching method, games and interactive simulations or traditional, truly dominates and under what circumstances. It was found that across people and situations, games and interactive simulations are more dominant for cognitive gain outcomes. However, consideration of specific moderator variables yielded a more complex picture. For example, males showed no preference while females showed a preference for the game and interactive simulation programs. Also, when students navigated through the programs themselves, there was a significant preference for games and interactive simulations. However, when teachers controlled the programs, no significant advantage was found. Further, when the computer dictated the sequence of the program, results favored those in the traditional teaching method over the games and interactive simulations. These findings are discussed in terms of their implications for exiting theoretical positions as well as future empirical research.
Theoretical models of posttraumatic stress disorder (PTSD) as well as exposure therapy (EXP) methodology suggest that trauma recall is crucial to altering the conditioned fear response associated ...with PTSD. However, it is unclear whether limited recall of the trauma event attenuates treatment outcomes. This study examined whether the extent of difficulty recalling aspects of a traumatic event affected fear activation, habituation, number of sessions, session length, and diagnostic outcomes in 166 Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans. Extent of trauma recall difficulty neither attenuated veterans' ability to achieve fear activation and habituation nor affected treatment outcomes. Findings suggest that even veterans who reported greater difficulty recalling their trauma event can engage successfully and benefit from EXP. This research is the first to examine trauma event recall in the context of the EXP process and contributes to the current body of literature that aims to address the question: "For whom do treatments work?"
In June 2021, a condominium in Florida collapsed, with the loss of 98 lives. Search and rescue teams spent 2 weeks, recovering the victims. This study's objective was to assess the presence of ...psychological symptoms that might emerge in the following months, using the PTSD Checklist for DSM-5 (PCL-5), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder - 7 (GAD-7), Suicide Cognitions Scale-Short (SCS-S), and the Insomnia Severity Index (ISI). A monthly survey conducted for 3 months found that overall, mean scores on these measures did not indicate significant emotional distress. We then compared the scores when the group was divided into responders who recovered human remains and those who did not. Scores were significantly higher among the subgroup that recovered human remains. Fifty-three percent (53%) of this sub-group met the cut-off score for a provisional diagnosis of PTSD, depressive disorder or generalized anxiety disorder-15% met the cut-off score criteria on the PCL-5 for probable PTSD, 36.8% for probable depressive disorder on the PHQ-9, and 26.3% for probable generalized anxiety disorder on the GAD-7. The results are consistent with other investigations examining mental health after mass disasters. Specifically, not all first responders will develop emotional distress but certain recovery activities may put some responders at higher risk, with a percentage displaying psychological distress. The results emphasize the need to assess the impact of these events on the mental health of first responders and to consider strategies to prevent or mitigate the development of impairing psychopathology.
First responders have been shown to be at risk for several negative mental health outcomes. However, it is not always clear how to intervene to prevent these outcomes. One approach has been to try to ...reduce the obstacles to care that might be imposed by the profession or the organization. In this paper, we investigate whether the nature of these obstacles varies as a function of the type of job. A group of 1,485 first responders were studied. The results indicate a number of important specialty-related differences. The results are discussed in terms of how to tailor prevention programs to confront obstacles to care.
Introduction: There is increasing recognition that first responders’ exposure to multiple traumatic events puts them at risk for the development of emotional distress, including depression, substance ...misuse, posttraumatic stress disorder (PTSD), and suicide. Despite this increased risk and higher prevalence of PTSD and other trauma-related disorders, there are few data on treatment for first responders. Method: This investigation describes the outcome of an intensive outpatient program (IOP), initially developed for military trauma, as applied to the treatment of first responders with PTSD. This treatment is unique in that it utilizes virtual reality to enhance the immersion into the exposure scene. Furthermore, we assessed the utility of both fixed-length and unbounded-length exposure sessions. Results: The results indicate that the intervention was feasible to implement and did not produce iatrogenic effects. Participants reported significantly reduced symptoms of PTSD and related emotional distress, reduced disability, and improved daily functioning. These positive outcomes were maintained at 3-month follow-up. There was no difference in outcomes between the fixed- and unbounded-length sessions. Discussion: These results suggest that an efficacious, short-term intervention incorporating virtual reality has the potential to quickly return first responders to their profession.
The prevalence of posttraumatic stress disorder (PTSD) among U.S. veterans deployed to Iraq or Afghanistan necessitates the need for comprehensive assessment and treatment strategies. This study ...investigated the utility of a combat‐related PTSD symptom provocation paradigm to elicit unique neurological responses across three groups: combat veterans with PTSD, combat veterans without PTSD, and nonmilitary participants without PTSD. Using functional near‐infrared spectroscopy (fNIRS) the results indicated that combat veterans with PTSD demonstrated significant activation to a trauma‐related sound compared with nonmilitary personnel, channel 14: d = 1.03, 95% confidence interval (CI) 0.28, 1.76; channel 15: d = 1.30, 95% CI 0.53, 2.06; and combat veterans without PTSD, channel 14: d = 0.87, 95% CI 0.14, 1.59. Specifically, this increased neural activation was approximately located in the right medial superior prefrontal cortex (Brodmann areas 9/10), an area associated with experiencing negative or threatening stimuli and emotional detachment. There were no differences across the groups for nontrauma‐related sounds. Results were less clear with respect to a combat‐related odor. These results suggest a specific neurophysiological response to trauma‐related cues and, if replicated, may offer a biomarker for combat‐related PTSD. Such a response could provide incremental validity over diagnostic assessments alone and assist in planning and monitoring of treatment outcome.
Resumen
Spanish s by the Asociación Chilena de Estrés Traumático (ACET)
UN ESTUDIO FUNCIONAL ESPECTROSCOPIA INFRARROJA CERCANA DE LAS SEÑALES AUDITIVAS Y OLFATIVAS RELACIONADAS CON TRAUMA: ¿TRASTORNO DE ESTRÉS POSTRAUMÁTICO O EXPERIENCIA DE COMBATE?
Estudio FNIRS de señales relacionadas con trauma
La prevalencia de Trastorno de Estrés Postraumático entre los veteranos de los EEUU desplegados en Irak o Afganistán requiere la necesidad de una evaluación comprensiva y de estrategias de tratamiento. Este estudio investigó la utilidad del paradigma de provocación de síntomas de TEPT relacionados con combate para obtener respuestas neurológicas únicas en tres grupos‐ veteranos de combate con TEPT, veteranos de combate sin TEPT, y participantes no militares sin TEPT. Usando la espectroscopia funcional infrarroja cercana (fNIRS) los resultados indicaron que los veteranos de combate con TEPT demostraron activación significativa al sonido relacionado con trauma comparado con personal no militar, canal 14: d= 1.03, 95% CI 0.28, 1.76; canal 15: d=1.30, 95% CI 0.53, 2.06; y veteranos de combate sin TEPT, canal 14: d=0.87, 95% CI 0.14, 1.59. Específicamente, esta activación neuronal aumentada estuvo localizada aproximadamente en la corteza prefrontal superior medial derecha (áreas 9/10 de Brodmann), un área asociada con experiencias negativas o estímulos amenazantes y desprendimiento emocional. No hubo diferencias entre los grupos para sonidos no relacionados con trauma. Los resultados fueron menos claros con respecto al olor relacionado con trauma. Estos resultados sugieren una respuesta neurofisiológica específica a señales relacionadas con trauma y si se replicasen, podría ser un biomarcador para TEPT relacionado a combate. Tal respuesta podría proporcionar validez incremental sobre las evaluaciones de diagnóstico por si solo y asistir en la planificación y el seguimiento de los resultados del tratamiento.
抽象
Traditional and Simplified Chinese s by AsianSTSS
A Functional Near‐infrared Spectroscopy Study of Traumarelated Auditory and Olfactory Cues: Posttraumatic Stress Disorder or Combat Experience?
Traditional Chinese
標題: 以功能性近紅外光譜成像技術研究創傷相關的聽覺和嗅覺提示:創傷後壓力症還是戰鬥經歷༟
撮要: 創傷後壓力症(PTSD)在往伊拉克或阿富汗服役的美國退役軍人中普遍༌需要全面的評估和治療策略。本研究探查一種戰鬥相關PTSD症狀激發範式的效用༌刺激3組樣本的神經反應:有PTSD的戰鬥退役軍人、無PTSD的戰鬥退役軍人、和無PTSD的非退役軍人。我們採用功能性近紅外光譜成像技術(fNIRS)༌發現有PTSD的戰鬥退役軍人༌跟非退役軍人相比༌對一種創傷相關的聲音有顯著的啟動༈頻道14: d = 1.03, 95% CI 0.28, 1.76; 頻道15: d = 1.30, 95% CI 0.53, 2.06༉;跟無PTSD的戰鬥退役軍人相比亦然༈頻道14: d = 0.87, 95% CI 0.14, 1.59༉。神經啟動提升的位置༌約於右邊的中上前額葉皮質༈布羅德曼分區系統第9/10區༉。該區跟感受負面或威脅刺激和情感分離有關。對於非創傷相關的聲音༌所有組別均無差異。至於創傷相關的氣味༌我們得出的結果不夠清晰。結果反映༌創傷相關的提示能產生特殊的神經生理學反應。如經重複驗證༌這種特殊反應可能是創傷相關PTSD的生理特徵。這種特殊的神經生理學反應有可能提升診斷評估的效度༌並有助計劃療程和監察療效
Simplified Chinese
标题: 以功能性近红外光谱成像技术研究创伤相关的听觉和嗅觉提示:创伤后压力症还是战斗经历༟
撮要: 创伤后压力症(PTSD)在往伊拉克或阿富汗服役的美国退役军人中普遍༌需要全面的评估和治疗策略。本研究探查一种战斗相关PTSD症状激发范式的效用༌刺激3组样本的神经反应:有PTSD的战斗退役军人、无PTSD的战斗退役军人、和无PTSD的非退役军人。我们采用功能性近红外光谱成像技术(fNIRS)༌发现有PTSD的战斗退役军人༌跟非退役军人相比༌对一种创伤相关的声音有显著的启动༈频道14: d = 1.03, 95% CI 0.28, 1.76; 频道15: d = 1.30, 95% CI 0.53, 2.06༉;跟无PTSD的战斗退役军人相比亦然༈频道14: d = 0.87, 95% CI 0.14, 1.59༉。神经启动提升的位置༌约于右边的中上前额叶皮质༈布罗德曼分区系统第9/10区༉。该区跟感受负面或威胁刺激和情感分离有关。对于非创伤相关的声音༌所有组别均无差异。至于创伤相关的气味༌我们得出的结果不够清晰。结果反映༌创伤相关的提示能产生特殊的神经生理学反应。如经重复验证༌这种特殊反应可能是创伤相关PTSD的生理特征。这种特殊的神经生理学反应有可能提升诊断评估的效度༌并有助计划疗程和监察疗效
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