Browsing by Subject "Behavior Therapy"
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Item Behavioral Intervention for Smoking Cessation in Adolescents and Young Adults(2006-08-11) Schepis, Ty Stephen; Rao, UmaSmoking is the leading preventable cause of morbidity and mortality in the United States. The vast majority of adult smokers initiate smoking before the age of 18, and the cumulative risk for initiation does not decline until the middle 20's. Thus, early intervention programs could be of great benefit to public health. Here, we have tested such a program: a smoking cessation treatment named the Modified Brief Office Intervention (M-BOI). The M-BOI is a 10-session cognitivebehaviorally based intervention. Sixty-three participants were consented for treatment, and 38 received M-BOI treatment, in conjunction with randomized double-blind, placebo-controlled bupropion. Of treated participants, 60.5% reduced their baseline level of smoking by half at the end of treatment; overall, treated participants reduced their smoking by 49.8%. Using intent-to-treat analyses, 7.3% of participants achieved biochemically verified cessation, and treatment was associated with a significant decrease in smoking. Treatment did not seem to significantly reduce exhaled carbon monoxide (CO) levels but did reduce urine cotinine. Depression history and baseline level of depressive symptoms had no effect on change in smoking during treatment, but this may have been due to low power to detect differences. Exploratory analyses demonstrated that treatment was associated with an increase in smoking-related self-efficacy, and decreases in maladaptive cognitions related to unpleasant events, nicotine withdrawal symptoms, smoking urges and nicotine dependence symptoms. Finally, there were preliminary indications that treatment ameliorated depressive symptoms in individuals with a history of a depressive disorder. Participants rated treatment as helpful with their cessation efforts and the majority would recommend M-BOI treatment to others. One major limitation of this study is the lack of data on M-BOI treatment without pharmacotherapy. Taken together, this study provides preliminary evidence for the efficacy and acceptability of the M-BOI. Further evaluation is needed to more firmly establish its effects.Item Change in Psychosocial Functioning During Cognitive Therapy for Depression(2009-01-09) Dunn, Todd Wilson; Jarrett, Robin B.Major Depressive Disorder (MDD) is a highly prevalent and recurrent disorder that impairs peoples' work, relationships, and leisure activities. Cognitive Therapy (CT) improves this impairment in psychosocial functioning in adults with MDD, but questions remain as to how improvements occur both independently and in relation to depressive symptoms. To address this issue, the current study developed a theoretical framework based on social cognitive theory to conceptualize change in psychosocial functioning during CT and tested it with structural equation modeling. Using data from 470 patients undergoing acute-phase CT (A-CT) for MDD, results showed that: a) change in psychosocial functioning and depressive symptom severity occurred independently of each other, b) change in psychosocial functioning during the first month of A-CT partially mediated change in depressive symptom severity from treatment baseline to week seven of A-CT, and c) psychosocial functioning at week seven of A-CT significantly predicted subsequent depressive symptom severity. In terms of the theoretical framework, results suggested that when people with MDD were exposed to an environmental stimuli (i.e., acute-phase CT), change in their behavior (i.e., psychosocial functioning) partially mediated change in personal factors (i.e., depressive symptom severity) and not vice versa. By disentangling the sequence of change in psychosocial functioning and depressive symptom severity, this study pushed the field one step closer to understanding how A-CT treats the impairment in psychosocial functioning associated with MDD.Item Cognitive Interviewing to Assess a New Measure of Attitudes and Beliefs Held by Candidates for Bariatric Surgery(2010-11-02) Sharma, Rachita; Brandon, Anna RachelIncreases in the obese population of the United States have subsequently led to increases in the numbers of bariatric surgeries pursued. However, despite increases in the number of surgeries performed, the success rate of the surgeries still remains acutely tied in with adherence to lifestyle modifications post-surgery, which are products of individuated attitudes and beliefs. Identification of these variables pre-surgery may enable health-care professionals to brainstorm preemptive intervention techniques aimed at providing support to bariatric patients post-surgery. However, no measures to identify such attitudes and beliefs exist. This qualitative study utilized Cognitive Interviewing to assess sources of response error in two new measures designed to identify attitudes and beliefs of candidates for bariatric surgery. Our hypothesis was that the newly created measures would be easy to understand and answer. METHODS: Twenty patients attending a bariatric clinic were offered $20 gift cards to answer questions on The Eating Behaviors Self-Efficacy Measure and The Perceived Barriers to Exercise Measure. A standardized instruction script asking participants to “thinkaloud” while answering questions was read before each interview. Interviews were audio recorded and transcribed to assess similarities in sources of response error. RESULTS: The majority of participants (90%) struggled with understanding/executing instructions of the measures. In addition, several specific items were identified as sources of confusion. Recommendations to reduce sources of response error were made to the test-makers. CONCLUSION: Although the hypothesis was not supported, future adaptation of recommendations could decrease most sources of response error. Additional Cognitive Interviewing after instrument refinement was recommended. After revision, The Eating Behavior Efficacy Measure and The Perceived Barriers to Exercise Measure should receive pilot testing in a longitudinal investigation of the scales’ validity and reliability for clinical use.Item Exploratory Study of Manualized Parent Training with Parental Support for Children with Autism Spectrum Disorder(2018-07-02) Cartwright, Julia Elizabeth; Bellone, Katherine; White, Stormi P.; Travis, Rebekah; Jarrett, Robin B.; Elliott, StephenParents of children with Autism Spectrum Disorder (ASD) present for therapeutic services with two essential needs: training on behavioral strategies specific to children with ASD and support for parental stress. Training parents as agents of behavior change increases intervention exposure naturally. Parents of children with ASD experience high parental stress, which negatively impacts parenting and treatment engagement. The current study assessed outcomes of adding a parent-support component to RUBI Autism Network's Parent Training for Disruptive Behaviors (RUBI Manual). A single-subject alternating treatments design was implemented within a community-based sample of parent-child dyads (10 participants). Each dyad received two treatment packages in a rapid alternating fashion. PT-Alone sessions included a manualized parent-training module, while PT-Plus sessions included a manualized parent-training module and 15-minute pre-session parent-support component. Five dyads with a child (average age=32 months) with ASD and disruptive behavior participated in three baseline and 11 RUBI Manual sessions, six included the parent-support component. Hypotheses included that parental stress and child disruptive behavior would decrease with intervention, while parent positive praise would increase. While the intervention effectively reduced child disruptive behaviors and increased parent praise, the primary finding was that the addition of the parent-support component further increased parent treatment integrity and parent praise. Results support a model of change for parenting behavior. Specifically, meaningfully programming for parent support within child behavioral treatment improved parent engagement, reflected in increased parent treatment integrity, which resulted in increased parenting skills, reflected in increased parent praise. Increased parenting skills likely contributed to decreased child disruptive behavior and parental stress. Inclusion of a parent-support component is supported as an effective practice for parent training within this specialized population.