Annals Of Behavioral Medicine Research Articles

Twenty years of intervention optimization.

In the classical paradigm for intervention research, the components that are to make up an intervention are identified, pilot tested, and then immediately assembled into a treatment package and subjected to an evaluation randomized controlled trial (RCT) to assess the performance of the entire package. Intervention optimization, which adapts ideas from technological fields to intervention science in order to hasten scientific progress, is an alternative to the classical paradigm. The first article introducing intervention optimization via the multiphase optimization strategy (MOST) was published in Annals of Behavioral Medicine in 2005. In this commentary, I reflect on the evolution of intervention optimization from that first publication to today, and on what the future could hold if the intervention science field continues to adopt the optimization paradigm. I propose that if intervention optimization became standard operating procedure, the field would accumulate a coherent base of knowledge about what specific intervention strategies work, for whom, under which circumstances, and why; every intervention produced would contain only components that contribute enough to justify their resource requirements; interventions would be readily implementable; and as the knowledge base grew, interventions would be improved continually.

A study on acute expectation effects on affective state and intention after a brief full-body workout in a student sample

Introduction & Purpose Research shows that even short exercise programs can have positive effects on affective state (Focht, 2009), which in turn could have a positive influence on the intention to exercise in the future (Finne et al., 2022). The state of research in recent years also indicates that such benefits can be enhanced by manipulating expectations (Helfer et al., 2015). However, most of these studies on expectation effects were conducted in laboratory settings, meaning that the results are transferable to a natural context or everyday situations only to a limited extent. The aim of this study was therefore to examine whether the manipulation of affective expectations can influence affective state after physical activity in a more naturalistic setting; in addition, it was investigated whether the expectation manipulation has an effect on the intention for future exercise. Methods In an online experiment, 121 physically active students (25.58 ± 5.11 years), 70.2% female, were randomly assigned to either a ten-minute, virtually-guided whole-body workout (PA), a ten-minute, virtually-guided whole-body workout after manipulation of affective expectations via audio file (PA + EM), or a sedentary control intervention (CG). In the audio file, a purported speaker for the research team highlighted that recent research indicates that brief workouts would have particularly positive effects on stress experience and affective state. Pre- and post-intervention data, including affective state and intention, were collected using questionnaires, such as the Mood Survey Scales by Abele-Brehm and Brehm (1986). Results After controlling for the baseline level before the intervention via analyses of covariance (ANCOVAs), PA and PA + EM showed significantly more positive scores than CG in several parameters of affective state (e.g., scale Activation, Elation, Fatigue) after the intervention, in some scales (e.g., Affective Valence, Depression) only PA + EM differed significantly from CG. The mean scores in intention after the intervention did not differ significantly between PA + EM (27.00 ± 4.57), PA (27.41 ± 6.79), and CG (27.70 ± 5.78), p = .836. Discussion Even a short, virtually-guided workout can have strong positive effects on affective state. No direct effects of the expectation manipulation on affective state or intention were found. Possible reasons for this include ceiling effects in the participants’ expectations, or that the form of expectation manipulation used was less suitable for influencing the outcomes. However, in some affective parameters, the expectation manipulation was the decisive factor for the differences to the control group, so that more latent effects of the manipulation cannot be ruled out. Conclusion Even though no significant effects of the expectation manipulation were found, the results do not appear to be entirely unaffected by it. Also, because the differences found in affect could have a long-term effect on physical activity behavior, further research is needed in this field in order to be able to make more reliable statements. From a practical perspective, when designing or implementing interventions to increase physically active behavior, practitioners should be aware of the importance of the wording used when describing physical activity to their clients. References Abele-Brehm, A., & Brehm, W. (1986). Zur Konzeptualisierung und Messung von Befindlichkeit: Die Entwicklung der „Befindlichkeitsskalen“ (BFS) [The conceptualization and measurement of mood: The development of the “Mood Survey“]. Diagnostica, 32(3), 209-228. Finne, E., Nigg, C., Weyland, S., Sauzet, O., Wienke, B., & Jekauc, D. (2022). Examining the role of affective states in relation to exercise intentions and participation in extra-curricular exercise classes at university: A repeated measurement observational study. Frontiers in Psychol, 13, Article 815466. https://doi.org/10.3389/fpsyg.2022.815466 Focht, B. C. (2009). Brief walks in outdoor and laboratory environments: Effects on affective responses, enjoyment, and intentions to walk for exercise. Research Quarterly for Exercise and Sport, 80(3), 611-620. https://doi.org/10.1080/02701367.2009.10599600 Helfer, S. G., Elhai, J. D., & Geers, A. L. (2015). Affect and exercise: Positive affective expectations can increase post-exercise mood and exercise intentions. Annals of Behavioral Medicine, 49(2), 269-279. https://doi.org/10.1007/s12160-014-9656-1

Can respondents accurately self-report posttraumatic growth when coached through the required cognitive steps?

ABSTRACT Background Coyne and Tennen [(2010). Positive psychology in cancer care: Bad science, exaggerated claims, and unproven medicine. Annals of Behavioral Medicine, 39(1), 16–26. https://doi.org/10.1007/s12160-009-9154-z] argue that completing self-reports of posttraumatic growth (PTG) requires four complicated cognitive steps. Design We conducted two experiments designed to (1) use mental chronometry (i.e., reaction times on cognitive tasks) to test whether respondents engage in multiple cognitive steps when completing self-reports of PTG, and (2) determine whether coaching participants to take these steps results in a more valid assessment. Method In Experiment 1, 310 undergraduates were randomly assigned to complete either the Posttraumatic Growth Inventory (PTGI) or Stress-Related Growth Scale (SRGS), and its corresponding current version that requires only one cognitive step. In Experiment 2, 306 undergraduates were randomly assigned to complete either a guided-steps version of the SRGS or the original SRGS. Results Experiment 1 indicated a very small difference in completion time for the PTGI, but not the SRGS, in comparison to the current versions, suggesting respondents do not engage in the four required cognitive steps. In Experiment 2, participants reported less PTG when coached to go through the four cognitive steps, but the resulting scores were generally unrelated to measures of convergent and predictive validity. Conclusion We conclude that individuals cannot accurately report PTG, even when explicitly coached.

Understanding Parental Health Literacy for Clean and Healthy Behavior in Early Childhood During the Covid-19 Pandemic

In the COVID-19 pandemic scenario, parents need to be familiar with health literacy by applying clean and healthy living habits to their family members, especially those with early childhood. This study aims to explain parents' perceptions of health literacy for a clean and healthy behavior in their children during the COVID-19 pandemic. The method used in this study is a cross-sectional study involving 22 men and 62 female respondents. Respondent requirements were used in data analysis to determine parents' perceptions of health literacy and the efforts they have made to practice clean and healthy lifestyle in their children. The research findings show that knowing the health awareness of parents has an impact on a child's balanced lifestyle. Based on six measures of clean and healthy behavior for children, three indicators were determined in the category of discipline and high discipline: using clean water, using the toilet, and doing physical activity. The act of washing children's hands with soap indicators has a high discipline score and the use of masks in children has low discipline. If the use of masks is not disciplined by parents, exposure to COVID-19 in early childhood can be disrupted.
 Keywords: Early Childhood, Parental health literacy, Clean and healthy behaviors

Journal Digest: Tic Disorders; Infrared Therapy; SGA; Weight Stigma; TBT

Journal Digest: Tic Disorders; Infrared Therapy; SGA; Weight Stigma; TBT

A Social and Behavioral Research Agenda to Facilitate COVID-19 Vaccine Uptake in the United States.

Health SecurityVol. 18, No. 4 CommentaryA Social and Behavioral Research Agenda to Facilitate COVID-19 Vaccine Uptake in the United StatesEmily K. Brunson, Monica Schoch-Spana, and on behalf of the Working Group on Readying Populations for COVID-19 VaccineEmily K. BrunsonAddress correspondence to: Emily K. Brunson, PhD, Associate Professor, Department of Anthropology, Texas State University, 601 University Dr, San Marcos, TX 78666 E-mail Address: ebrunson@txstate.eduSearch for more papers by this author, Monica Schoch-SpanaSearch for more papers by this author, and on behalf of the Working Group on Readying Populations for COVID-19 VaccinePublished Online:19 Aug 2020https://doi.org/10.1089/hs.2020.0106AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View articleFiguresReferencesRelatedDetailsCited byIn‐home healthcare worker COVID ‐19 vaccination awareness, access, and acceptability—An online focus group study15 December 2022 | Journal of the American Geriatrics SocietyCOVID-19 vaccination acceptance among community members and health workers in Ebonyi state, Nigeria: study protocol for a concurrent-independent mixed method analyses of intention to receive, timeliness of the intention to receive, uptake and hesitancy to COVID-19 vaccination and the determinants15 December 2022 | BMJ Open, Vol. 12, No. 12Effect of knowledge, social and religious factors effecting the intention of Muslims in Pakistan to receive COVID-19 vaccination: mediating role of attitude towards COVID-19 vaccination2 June 2022 | Journal of Islamic Marketing, Vol. 16Psychosocial Determinants of COVID-19 Vaccination Intention Among White, Black, and Hispanic Adults in the US1 October 2021 | Annals of Behavioral Medicine, Vol. 56, No. 4“On the last day of the last month, I will go”: A qualitative exploration of COVID-19 vaccine confidence among Ivoirian adultsVaccine, Vol. 40, No. 13COVID-19 vaccine confidence projectJournal of the American Pharmacists Association, Vol. 62, No. 1The Early-Term Adverse Effects in Healthcare Personnel after CoronaVac Vaccination1 January 2022 | Journal of Contemporary Medicine, Vol. 12, No. 2Ending the Pandemic: How Behavioural Science Can Help Optimize Global COVID-19 Vaccine Uptake22 December 2021 | Vaccines, Vol. 10, No. 1Racial/ethnic disparities in intent to obtain a COVID-19 vaccine: A nationally representative United States surveyPreventive Medicine Reports, Vol. 24Hesitancy Prevalence and Sociocognitive Barriers to Coronavirus Vaccinations in Nigeria30 December 2021 | European Review Of Applied Sociology, Vol. 14, No. 23Agent Based Model of Anti-Vaccination Movements: Simulations and Comparison with Empirical Data21 July 2021 | Vaccines, Vol. 9, No. 8Acquiring favorable attitudes based on aversive affective cues: Examining the spontaneity and efficiency of propositional evaluative conditioningJournal of Experimental Social Psychology, Vol. 95Communicating With Vaccine-Hesitant Parents: A Narrative ReviewAcademic Pediatrics, Vol. 21, No. 4Preparing for SARS-CoV-2 Vaccines in US Immigrant Communities: Strategies for Allocation, Distribution, and CommunicationAmerican Journal of Public Health, Vol. 111, No. 4Evidence-Based Strategies for Clinical Organizations to Address COVID-19 Vaccine HesitancyMayo Clinic Proceedings, Vol. 96, No. 3Factors Influencing COVID-19 Vaccination Demand and Intent in Resource-Limited Settings: Based on Health Belief Model1 June 2021 | Risk Management and Healthcare Policy, Vol. Volume 14 Volume 18Issue 4Aug 2020 InformationCopyright 2020, Mary Ann Liebert, Inc., publishersTo cite this article:Emily K. Brunson, Monica Schoch-Spana, and on behalf of the Working Group on Readying Populations for COVID-19 Vaccine.A Social and Behavioral Research Agenda to Facilitate COVID-19 Vaccine Uptake in the United States.Health Security.Aug 2020.338-344.http://doi.org/10.1089/hs.2020.0106Published in Volume: 18 Issue 4: August 19, 2020Online Ahead of Print:July 24, 2020KeywordsCOVID-19Vaccine uptakeVaccine confidenceCommunity engagementEpidemic management/responsePDF download

How Theory Can Influence Hearing Aid Use

How Theory Can Influence Hearing Aid Use

Implementing eScreening technology in four VA clinics: a mixed-method study

BackgroundTechnology-based self-assessment (TB-SA) benefits patients and providers and has shown feasibility, ease of use, efficiency, and cost savings. A promising TB-SA, the VA eScreening program, has shown promise for the efficient and effective collection of mental and physical health information. To assist adoption of eScreening by healthcare providers, we assessed technology-related as well as individual- and system-level factors that might influence the implementation of eScreening in four diverse VA clinics.MethodsThis was a mixed-method, pre-post, quasi-experimental study originally designed as a quality improvement project. The clinics were selected to represent a range of environments that could potentially benefit from TB-SA and that made use of the variety eScreening functions. Because of limited resources, the implementation strategy consisted of staff education, training, and technical support as needed. Data was collected using pre- and post-implementation interviews or focus groups of leadership and clinical staff, eScreening usage data, and post-implementation surveys. Data was gathered on: 1) usability of eScreening; 2) knowledge about and acceptability and 3) facilitators and barriers to the successful implementation of eScreening.ResultsOverall, staff feedback about eScreening was positive. Knowledge about eScreening ranged widely between the clinics. Nearly all staff felt eScreening would fit well into their clinical setting at pre-implementation; however some felt it was a poor fit with emergent cases and older adults at post-implementation. Lack of adequate personnel support and perceived leadership support were barriers to implementation. Adequate training and technical assistance were cited as important facilitators. One clinic fully implemented eScreening, two partially implemented, and one clinic did not implement eScreening as part of normal practice after 6 months as measured by usage data and self-report. Organizational engagement survey scores were higher among clinics with full or partial implementation and low in the clinic that did not implement.ConclusionsDespite some added work load for some staff and perceived lack of leadership support, eScreening was at least partially implemented in three clinics. The technology itself posed no barriers in any of the settings. An implementation strategy that accounts for increased work burden and includes accountability may help in future eScreening implementation efforts.Note. This abstract was previously published (e.g., Annals of Behavioral Medicine 53: S1–S842, 2019).

Introduction to the Special Section on Behavior Change Intervention Development: Theories, Methods, and Mechanisms.

This manuscript introduces a special section of Annals of Behavioral Medicine consisting of six independent articles examining the development of theoretically based behavior change interventions as well as consideration of the associated mechanisms of behavior change. The specific behaviors that are the focus of the papers are of lesser importance than the more general information that may be applied in many different settings with various behaviors. Each of the six articles is briefly previewed along with introductory and concluding comments. The special section serves as a foundational discussion of behavior change that will influence ongoing efforts in this important endeavor.

ZACHOWANIA ZDROWOTNE STUDENTEK PIELĘGNIARSTWA W POLSCE I NA ŁOTWIE

2. Choi Won, S., Harris, K., Okuyemik, K. (2003). Predictors of smoking initiation among college-bound high school students. Annals of Behavioral Medicine, 26, 69-74. Google Scholar

Systematic review of behaviour change techniques to promote participation in physical activity among people with dementia.

The objective of this study was to systematically review the evidence for the potential promise of behaviour change techniques (BCTs) to increase physical activity among people with dementia (PWD). PsychINFO, MEDLINE, CINAHL, and the Cochrane Central Register of Controlled Trials databases were searched 01/01/2000-01/12/2016. Randomized controlled/quasi-randomized trials were included if they recruited people diagnosed/suspected to have dementia, used at least one BCT in the intervention arm, and had at least one follow-up measure of physical activity/adherence. Studies were appraised using the Cochrane Collaboration Risk of Bias Tool, and BCTs were coded using Michie etal., 2013, Annals of Behavioral Medicine, 46, 81. taxonomy. Intervention findings were narratively synthesized as either 'very promising', 'quite promising', or 'non-promising', and BCTs were judged as having potential promise if they featured in at least twice as many very/quite promising than non-promising interventions (as per Gardner etal., 2016, Health Psychology Review, 10, 89). Nineteen articles from nine trials reported physical activity findings on behavioural outcomes (two very promising, one quite promising, and two non-promising) or intervention adherence (one quite promising and four non-promising). Thirteen BCTs were used across the interventions. While no BCT had potential promise to increase intervention adherence, three BCTs had potential promise for improving physical activity behaviour outcomes: goal setting (behaviour), social support (unspecified), and using a credible source. Three BCTs have potential promise for use in future interventions to increase physical activity among PWD. Statement of contribution What is already known on this subject? While physical activity is a key lifestyle factor to enhance and maintain health and wellbeing amongst the general population, adults rarely participate in sufficient levels to obtain these benefits. Systematic reviews suggest that specific behaviour change techniques can increase physical activity, although one review suggested that self-regulatory techniques may be counterproductive when promoting physical activity among older people. Until now, no systematic review has been conducted to assess which behaviour change techniques may be associated with greater participation in physical activity among people with dementia. What does this study add? Interventions showed mixed promise for increasing physical activity and little effect on participant adherence. Goal setting (behaviour), social support (unspecified), and using a credible source are promising approaches. No technique showed promise for increasing adherence to physical activity interventions among people with dementia.

Identifying content-based and relational techniques to change behaviour in motivational interviewing

ABSTRACT Motivational interviewing (MI) is a complex intervention comprising multiple techniques aimed at changing health-related motivation and behaviour. However, MI techniques have not been systematically isolated and classified. This study aimed to identify the techniques unique to MI, classify them as content-related or relational, and evaluate the extent to which they overlap with techniques from the behaviour change technique taxonomy version 1 [BCTTv1; Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, W., … Wood, C. E. (2013). The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: Building an international consensus for the reporting of behavior change interventions. Annals of Behavioral Medicine, 46, 81–95]. Behaviour change experts (n = 3) content-analysed MI techniques based on Miller and Rollnick’s [(2013). Motivational interviewing: Preparing people for change (3rd ed.). New York: Guildford Press] conceptualisation. Each technique was then coded for independence and uniqueness by independent experts (n = 10). The experts also compared each MI technique to those from the BCTTv1. Experts identified 38 distinct MI techniques with high agreement on clarity, uniqueness, preciseness, and distinctiveness ratings. Of the identified techniques, 16 were classified as relational techniques. The remaining 22 techniques were classified as content based. Sixteen of the MI techniques were identified as having substantial overlap with techniques from the BCTTv1. The isolation and classification of MI techniques will provide researchers with the necessary tools to clearly specify MI interventions and test the main and interactive effects of the techniques on health behaviour. The distinction between relational and content-based techniques within MI is also an important advance, recognising that changes in motivation and behaviour in MI is a function of both intervention content and the interpersonal style in which the content is delivered.

Psychosocial health coaching for chronically ill in a telehealth context: a pilot study

Psychosocial health coaching for chronically ill in a telehealth context: a pilot study

Transparency of outcome reporting and trial registration of randomized controlled trials in top psychosomatic and behavioral health journals: A 5-year follow-up

ObjectiveThe extent that randomized controlled trials (RCTs) accurately reflect intervention effectiveness depends on the completeness and accuracy of published results. A previous study found that only 40% of 63 RCTs published in top behavioral health journals in 2008–2009 clearly declared primary and secondary outcomes and only 21% were registered. The objective of this study was to conduct a five-year follow-up to assess outcome reporting clarity, proportion of registered trials, and adequacy of outcome registration in RCTs in top behavioral health journals. MethodEligible studies were RCTs published in Annals of Behavioral Medicine, Health Psychology, Journal of Psychosomatic Research, and Psychosomatic Medicine from January 2013 to October 2014. ResultsOf 76 RCT publications reviewed, only 25 (32.9%) adequately declared primary or secondary outcomes, whereas 51 (67.1%) had multiple primary outcomes or did not define outcomes. Of the 76 trials, 40 (52.6%) had been registered. Only 3 studies registered a single primary outcome and time point of assessment prior to enrolling patients, and registered and published outcomes were discrepant in 1 of the 3 studies. No studies were adequately registered as per Standard Protocol Items: Recommendation for Interventional Trials guidelines. Compared to 5years prior, the proportion of published trials with adequate outcome declaration decreased from 39.7% to 32.9% (p=0.514). The proportion of registered trials increased from 20.6% to 52.6% (p<0.001). ConclusionThe quality of published outcome declarations and trial registrations remains largely inadequate. Greater attention to trial registration and outcome definition in published reports is needed.

Active ingredients are reported more often for pharmacologic than non-pharmacologic interventions: an illustrative review of reporting practices in titles and abstracts

Key components of healthcare interventions include ‘active ingredients’ (intervention components that can be specifically linked to effects on outcomes such that, were they omitted, the intervention would be ineffective). These should be reported in titles and abstracts of published reports of randomized controlled trials (RCTs). However, reporting of non-pharmacologic interventions (NPIs), particularly behaviour change interventions (BCIs), is difficult, owing to their complexity. This illustrative review compares how pharmacologic interventions (PIs), NPIs and BCIs are specified in titles and abstracts to clarify how reporting of NPIs and BCIs can be improved. MEDLINE and Embase were searched for RCTs published in the British Medical Journal, The Journal of the American Medical Association, The New England Journal of Medicine, The Lancet and Annals of Behavioral Medicine from 2009 to March 2011. All types of intervention, participant and outcome were included. A random sample of 198 studies (sampled proportionally from included journals) stratified by intervention type (PI/NPI) was taken: 98 evaluated PIs, 96 evaluated NPIs and four evaluated both. Studies were coded for the presence or absence of key components. The frequency data were analyzed using the chi-square test. Active ingredients were named in 88% titles and 95% abstracts of PI reports, and in 51% titles and 71% abstracts of NPI reports, with a significant association between intervention type and reporting of active ingredients in titles (χ2(1) = 28.90; P < 0.001) and abstracts (χ2(1) = 16.94; P < 0.001). Active ingredients were named in BCI reports in 37% titles and 56% abstracts, and in other NPI reports in 66% titles and 86% abstracts. There was also a significant association between intervention type and reporting of active ingredients in titles (χ2(1) = 6.68; P = 0.010) and abstracts (χ2(1) = 8.66; P = 0.003). Reporting practices also differed for such components as the trial setting and intervention provider. This review highlights the need for improved reporting of NPIs (particularly BCIs) and indicates that a set of agreed labels and definitions for complex NPIs could facilitate standardized reporting. This would ensure that interventions can be faithfully replicated and that evidence for interventions can be appropriately synthesized.

Introduction to the Second Special Section on Health Disparities

Here we present the second special section on health disparities in Annals of Behavioral Medicine. Papers in the first section, published in February 2012, examined potential explanations and risk factors for disparities, resilience factors that might narrow health disparities, and interventions to improve health outcomes in populations affected by health disparities. The articles spanned a range of health conditions and risk factors across the lifespan, focusing primarily on disparities among ethnic groups. In this second special section, the focus is just as broad, addressing topics such as potential explanations for disparities (discrimination, stress) in different health conditions (obesity, diabetes), among different racial/ethnic groups (Black/African Americans, Latinos, and Native Hawaiians and Pacific People). As a collection, the papers in this special section provide interesting insights on the determinants of health disparities, utilizing both betweenand within-group comparisons. Between-group comparisons allow the examination of the possibility of distinct psychosocial processes driving observed differences between groups. For example, the paper by Tomiyama et al. [1] shows how body mass index, one of the largest health disparities between Blacks and Whites, is moderated by stress. Between-group comparisons of majority to minority groups alone, however, have limitations to advancing our knowledge about health disparities [2, 3]. One criticism of traditional comparisons of minorities to majority samples is that Whites are often implicitly viewed as a standard from which the minority group is assumed to deviate if differences are found [4]. The paper by Earnshaw and colleagues [5] takes an alternative approach, comparing Black and Latina women to examine everyday discrimination as a source of health disparities. The study did not find a difference in perceived discrimination between the groups; instead, discrimination served as a central precipitating factor for the disparities in the two different ethnic groups. Another departure from between-group research is within-group examinations of health disparities. An example of this approach is provided by Sinclair et al. [6], in which the investigators worked with Native Hawaiians and Pacific Islanders to design and test a culturally tailored intervention that was shown to be successful in improving glycemic control among individuals with diabetes. Avoiding ethnic umbrellas is critical for designing research on health disparities that can be translated into practice [7]. Consistent with this notion, in the fourth paper in this special section, Molina and colleagues [8] examine how discrimination may influence self-rated health across subgroups of Latinos in the USA and demonstrate the importance of disaggregating these groups to fully appreciate how psychosocial factors intersect with health. Taken together, these papers provide a critical lens on how individual and social factors are interwoven to produce some of the key factors that drive disparities observed in the general K. E. Whitfield Department of Psychology and Neuroscience, Duke University, Durham, NC, USA

Posttraumatic Stress Disorder and Disordered Eating: Food Addiction as Self-Medication

report important new data that confirm links between posttraumatic stress disorder (PTSD) symptoms and eating disordered behaviors. Furthermore, they extend those links with PTSD to the ingestion of sugary sodas and fast foods, a finding that persists despite race or ethnicity, marital status, education, income level, and body mass index (BMI). Although PTSD and its symptoms have previously been associated with bingeing or purging behaviors or both, as well as smoking cigarettes, this is the first study to demonstrate a connection between PTSD (and, hence, traumatic experiences) and the frequency of ingesting particular types of foods, for example, sugary sodas and fast foods. An emerging body of evidence over the last few years has characterized highly palatable foods, such as those found in fast food restaurants, as potentially addictive and acting very much like licit and illicit substances of abuse in the brain. Specifically, high concentrations of refined sugar, fat, salt, and caffeine are common components of fast food menus, and it has been posited that all these foodstuffs have addictive properties. The results of the Hirth et al. article have important and far-reaching implications. For one, their data help to elucidate the underlying mechanisms and behavioral pathways of how trauma and subsequent PTSD eventually lead to an increased chance of developing one or more of the leading causes of death in the United States. In addition to an array of medical disorders, it is well established that PTSD is associated with significantly higher rates of substance use disorders, other comorbid psychiatric disorders, and a variety of selfdestructive and impulsive behaviors, including suicide. These data also suggest that the ingestion, and especially overingestion, of fatty or sugary energy sources may be just another strategy that traumatized individuals use to numb themselves from their unpleasant feeling states and memories. In essence, certain foods can act just like other substances that alter brain chemistry and, hence, consciousness. Much work in the neurosciences has been done to establish the neurochemical mechanisms underlying these phenomena. Using food to self-medicate dysphoric states is by no means a new idea. For some time now, many people who have struggled with compulsive overeating have identified their problem as a food addiction. In 1956, Randolph first described the phenomenon of food addiction and linked it with addictive drinking. Overeaters Anonymous (OA), which was founded in 1960, defined compulsive overeating as a progressive, addictive illness and focused on refined sugar as the addicting agent, a conclusion that is no longer so far-fetched. In addition, those with overt eating disorders have described using food to self-medicate as well as being addicted to bingeing or purging behaviors. Not only do these behaviors often become habitual methods of affect regulation, but eating foods with high hedonic value can quickly, inexpensively, and legally offer a modicum of comfort and relief, however transiently, and only more problems ensue. During the last several years, mainstream science has begun to accept the notion that certain foods can act like other addicting substances in the brain, despite having other peripheral metabolic effects that substances of abuse do not necessarily have. It has been shown in both animal and human experiments that food intake and drug use both cause dopamine release in parts of the brain that mediate pleasure and emotion. Furthermore, the degree of dopamine release correlates with the sense of subjective reward or experience of pleasure from both food and drug use. Similar patterns of brain activation as seen on functional magnetic resonance imaging (MRI) in response to food and drug cues have also been found. Other studies demonstrate that food can stimulate the opiate system and that there are striking similarities in use and withdrawal patterns of sugar and of classic drugs of abuse. In addition, there often appear to be reciprocal relationships among food and other substances, in that people may gain weight when they stop smoking or drinking. Taken together, these observations support the conclusion that food and classic addictive substances compete for the same brain pathways and may serve the same purposes psychologically. This reorientation toward entertaining the concept of food addiction has been a result of the fact that at least one third of people in the United States are obese, and the mortality and morbidity associated with obesity have become a major focus throughout medicine and public health. Even though the results of the study by Hirth et al. did not find that women with PTSD symptoms had higher BMIs than those women without such symptoms, these data are relevant to an increase in the understanding of the current obesity epidemic. Other investigators have reported that obese patients have high rates of trauma and PTSD. That women with PTSD symptomatology were engaged in more strategies to lose weight, for

Reviewing Manuscripts for Peer-Review Journals: A Primer for Novice and Seasoned Reviewers

The importance of peer review in the furthering of science cannot be overstated. However, most doctoral students and early career professionals receive little formal or informal training in conducting peer reviews. In recognition of this deficit in peer reviewer training, the present article was developed to provide an overview of the peer-review process at Annals of Behavioral Medicine and describe the general and specific elements that should be included in a high-quality review for the journal. We conclude by offering exemplar reviews of a manuscript that was ultimately accepted for publication in the journal and provide commentary on specific aspects of these reviews.

Transparency of outcome reporting and trial registration of randomized controlled trials in top psychosomatic and behavioral health journals: A systematic review

Objective The most reliable evidence for evaluating healthcare interventions comes from well-designed and conducted randomized controlled trials (RCTs). The extent to which published RCTs reflect the efficacy of interventions, however, depends on the completeness and accuracy of published results. The Consolidated Standards of Reporting Trials statement, initially developed in 1996, provides guidelines intended to improve the transparency of published RCT reports. A policy of the International Committee of Medical Journal Editors, initiated in 2005, requires clinical trials published in member journals to be registered in publicly accessible registries prior to patient enrollment. The objective of this study was to assess the clarity of outcome reporting, proportion of registered trials, and adequacy of outcome registration in RCTs published in top behavioral health journals. Methods Eligible studies were primary or secondary reports of RCTs published in Annals of Behavioral Medicine, Health Psychology, Journal of Psychosomatic Research, and Psychosomatic Medicine from January 2008 to September 2009. Data were extracted for each study on adequacy of outcome reporting and registration. Results Of 63 articles reviewed, only 25 (39.7%) had adequately declared primary or secondary outcomes, whereas 38 (60.3%) had multiple primary outcomes or did not define outcomes. Only 13 studies (20.6%) were registered. Only 1 study registered sufficiently precise outcome information to compare with published outcomes, and registered and published outcomes were discrepant in that study. Conclusion Greater attention to outcome reporting and trial registration by researchers, peer reviewers, and journal editors will increase the likelihood that effective behavioral health interventions are readily identified and made available to patients.

Intention-to-Treat Analyses in Behavioral Medicine Randomized Clinical Trials

Intention-to-treat (ITT) is an analytic approach where all randomized participants are included in analyses and in their originally assigned condition, regardless of adherence or protocol deviation. The present study aimed to determine whether reporting and correct use of ITT in behavioral medicine randomized clinical trials (RCTs) published in behavioral journals has improved in recent years. ITT and related analytic conventions were examined in behavioral medicine RCTs (N = 87) published in Annals of Behavioral Medicine, Health Psychology, and the Journal of Consulting and Clinical Psychology in the years 2000-2003 and then again in 2006-2007. Logistic regression analyses tested whether ten indicators associated with ITT were being used increasingly over time. Also tested was whether reporting and correct use of ITT improved following the adoption of Consolidated Standards of Reporting Clinical Trials (CONSORT) statement. Results revealed that less than half of RCTs (42%) used ITT analyses correctly. Over time, reporting of sample size estimation and primary outcome as well as use of the term "ITT" to describe analyses improved; however, correct implementation of ITT did not. Improvement was not specifically attributable to CONSORT adoption. Investigators' claims of using ITT analyses have increased over time, but correct use of ITT has not.