Assessment-only Control Condition Research Articles

Dissonance-Based Eating Disorder Prevention for Body-Dissatisfied Brazilian Cisgender Gay and BisexualMen: A Randomized Controlled Trial With a 1-Year Follow-Up.

Gay and bisexual men are at an increased risk for eating disorders (EDs) and muscle dysmorphia (MD) compared with their heterosexual counterparts. Existing dissonance-based (DB) EDs prevention programs for this population have been evaluated in the United States; however, these programs have not been evaluated in the Brazilian context. Thus, we investigated the feasibility, acceptability, and efficacy of a DB ED prevention program (i.e., the PRIDE Body Project) among Brazilian cisgender gay and bisexual men. Eligible men were randomly assigned to either a DB intervention (n = 74) condition or an assessment-only control (AOC) condition (n = 75). Participants completed measures assessing ED and MD risk and protective factors at baseline, post-intervention, 1-month, 6-month, and 1-year follow-up. Those in the intervention condition also completed acceptability measures. Feasibility and acceptability ratings were highly favorable. Regarding efficacy, post-intervention results were not significant, except for self-objectification, which showed a significantly greater decrease in the DB condition compared with the AOC condition at all time-points of follow-ups (Cohen's d = -0.31 to -0.76). At follow-up, the DB condition showed significantly greater decreases in appearance-ideal internalization, drive for muscularity, self-objectification, ED and MD symptoms at 1-month, 6-month, and 1-year follow-ups (d = -0.33 to -0.92) compared with the AOC condition. Significant increases were observed in the DB compared with the AOC condition for body appreciation at 1-month, 6-month, and 1-year follow-ups (d = 0.31-0.81). Results support the feasibility, acceptability, and efficacy of the PRIDE Body Project up to 1-year in Brazilian cisgender gay and bisexual men. Brazilian Registry of Clinical Trials (ReBEC; available at http://www.ensaiosclinicos.gov.br/) number of registration: RBR-62fctqz.

Prevention of hazardous use of alcohol among high school students: a study protocol for the randomized controlled trial ‘Our choice’

BackgroundAdolescent hazardous alcohol use is prevalent and has serious short- and long-term consequences. The trial ‘Our Choice’ examines efficacy, feasibility and acceptability of prevention interventions targeting school, parent, and student levels at Danish high schools. We hypothesize that students in a structural intervention (school and parent levels) reduce hazardous alcohol use and related health behaviors compared to students in an assessment only control group 12 months post baseline; and that adding group-based Motivational Interviewing (group MI) yields further improvements. The study examines the efficacy of interventions targeting multiple levels with the aim of providing novel insights into prevention of adolescent hazardous alcohol use and related health outcomes.MethodThe study employs a parallel group cluster randomized controlled trial design with three conditions: (1) structural condition targeting school and parent levels, (2) structural condition combined with group MI which also targets the student level, and (3) assessment-only control condition. A participatory approach is used to adapt and develop interventions. Sixteen high schools in Denmark and about N = 3100 first-year students (15–18 years) enrolled in high school in August 2023 will be recruited. Data will be collected via online questionnaires pre-interventions (baseline), 2, 6, 9 and 12 month post baseline and analyzed with generalized linear mixed models. The primary outcome is past month high intensity drinking; secondary outcomes are alcohol use, alcohol-related consequences, well-being, tobacco, and illegal substance use. Feasibility and acceptability will be assessed via surveys (students) and interviews (high school staff) to inform future implementation.Discussion‘Our Choice’ is the first trial to compare the efficacy of a structural intervention targeting school- and parent levels to an intervention targeting these levels and the student level via group MI – on hazardous drinking and related health outcomes among students. Preventing and reducing hazardous alcohol use during adolescence is crucial due to the short- and long-term negative consequences. The tested interventions can be implemented at low cost. The study has significant implications for adolescent health and well-being and has potential to inform evidence-based decisions on alcohol prevention policy, education, and health professions.Trial Registration NumberThe trial was retrospectively registered at ClinicalTrials.gov on August 24th, 2023. Trial Registration Number: ID NCT06018389.

Reducing Khat use among Somalis living in Kenya: a controlled pilot study on the modified ASSIST-linked brief intervention delivered in the community

BackgroundDuring recent decades, the consumption of the stimulant khat (catha edulis) has profoundly changed in countries around the Horn of Africa, and excessive use patterns have emerged—especially evident among displaced Somalis. This is related to the development of severe somatic and psychiatric disorders. There are currently no preventive or interventional studies targeting khat use. This study’s aim was to test screening and brief intervention (SBI) to reduce khat use among urban Somali refugees living in Kenya with limited access to public healthcare.MethodsIn this controlled study, 330 male Somali khat users from the community were either assigned to SBI (161) or an assessment-only control condition (AC; 169); due to field conditions a rigorous experimental design could not be implemented. The World Health Organization’s (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)-linked brief intervention was adapted to khat and Somali culture. Trained local counselors administered the intervention. The amount and frequency of khat use was assessed using the time-line-follow-back method. We compared the month before the intervention (t1) to the two months after it (t2, t3). Baseline differences in khat use frequency were corrected by partial matching and mixed effect models used to evaluate intervention effects.ResultsSBI was well accepted and feasible for khat users. Over the complete observation period and from t1 to t2, khat use amount and frequency decreased (p < .001) and the intervention group showed a greater reduction (group x time effects with p ≤ .030). From t2 to t3, no further reduction and no group differences emerged.ConclusionThe results provide preliminary evidence that khat use amount and frequency can be reduced in community settings by SBI, requiring little resources. Thorough assessment alone might have intervention-like effects. The non-treatment-seeking community sample and the non-professional counselors are distinct from SBI studies with other substances in other countries, but support the feasibility of this approach in khat use countries and especially in Somali populations with limited access to healthcare. Future studies that employ rigorous experimental design are needed.Trial registrationClinicalTrials.gov identifier: NCT02253589. Date of first registration 01/10/2014, retrospectively registered https://clinicaltrials.gov/ct2/show/NCT02253589. First participant 16/09/2014:

Longer-Term Efficacy of a Digital Life-Skills Training for Substance Use Prevention

The main objective of this study was to test the longer-term and differential efficacy of a mobile phone‒based life-skills training program designed to prevent substance use among adolescents. A 2-arm, parallel-group, cluster RCT with assessments at baseline and follow-up after 6 and 18 months was conducted. The efficacy of the intervention was compared with that of an assessment-only control condition. A total of 1,473 students with a mean age of 15.4 years were recruited in 2019/2020 within 89 Swiss secondary and upper secondary school classes. The automated intervention program included online feedback and individually tailored text messages provided over 22 weeks. The contents were based on social cognitive theory and addressed self-management, social, and substance use resistance skills. Primary outcomes included 30-day prevalence rates for problem drinking and tobacco use. The 18-month follow-up assessments were completed by 1,232 study (83.6%) participants. Those in the intervention group reported lower tobacco-smoking prevalence than the controls (OR=0.67; 95% CI=0.47, 0.96), but no significant difference in problem drinking (OR=0.84; 95% CI=0.61, 1.17) was observed. Among secondary outcomes, the intervention was effective at reducing cannabis-smoking prevalence (OR=0.55; 95% CI=0.39, 0.76) and cannabis use days (Cohen's d= -0.19; 95% CI= -0.29, -0.09), whereas no effects were observed for quantity of alcohol use, quantity of cigarettes smoked, well-being, or social skills. No significant moderators of the primary outcomes were observed. An automated mobile phone‒based life-skills training program produced longer-term effectiveness in preventing tobacco smoking and cannabis use, whereas no effects were observed for problem drinking. These results suggest that digitally delivered life-skills training programs are similarly effective and are an easy-to-implement alternative to training conducted within a school curriculum. This study is registered at ISRCTN41347061 (registration date: 21/07/2018).

Reducing eating disorder risk among male athletes: A randomized controlled trial investigating the male athlete body project.

No study to date has investigated an intervention program for male athletes that targets eating disorder risk factors. The purpose of this study was to measure the effects of the Male Athlete Body Project (MABP), an adaptation of the Female Athlete Body Project on body dissatisfaction, drive for muscularity, body-ideal internalization, and muscle dysmorphia. Participants were 79 male collegiate athletes who were randomized to the MABP (n=39) or an assessment-only control condition (n=40). All participants completed psychometrically validated measures at three time points: baseline, post-treatment (3 weeks after baseline for the control condition), and 1-month follow-up. Hierarchical Linear Modeling assessed differences between conditions across time. Interaction effects revealed that participation in the MABP improved satisfaction with specific body parts and reduced drive for muscularity and body-ideal internalization at post-treatment compared to a control group. Athletes in the MABP also reported increased body areas satisfaction and reductions in drive for muscularity at 1-month follow-up. Reductions in supplement use were observed at 1-month follow-up only. This study provides preliminary evidence of the efficacy of the MABP in reducing some eating disorder risk factors up to 1 month after the intervention; follow-up study considerations are discussed. NCT04077177 PUBLIC SIGNIFICANCE: This study highlights the importance of eating disorder and body image intervention efforts for male athletes. Findings suggest that male college athletes who attended a 3-session group intervention based on a well-established program for college women experienced an increase in satisfaction with specific body areas and a reduction in some eating disorder risk factors (e.g., drive for muscularity, supplement use, and body-ideal internalization) compared to a control group.

Improving body image at scale among Brazilian adolescents: study protocol for the co-creation and randomised trial evaluation of a chatbot intervention

BackgroundBody image concerns are prevalent among Brazilian adolescents and can lead to poor psychological and physical health. Yet, there is a scarcity of culturally-appropriate, evidence-based interventions that have been evaluated and made widely available. Chatbot technology (i.e., software that mimics written or spoken human speech) offers an innovative method to increase the scalability of mental health interventions for adolescents. The present protocol outlines the co-creation and evaluation of a body image chatbot for Brazilian adolescents via a partnership between academics, industry organisations and the United Nations Children’s Fund (UNICEF).MethodsA two-armed fully remote randomised controlled trial will evaluate the chatbot’s effectiveness at improving body image and well-being. Adolescent girls and boys (N = 2800) aged 13–18 years recruited online will be randomly allocated (1:1) into either: 1) a body image chatbot or 2) an assessment-only control condition. Adolescents will engage with the chatbot over a 72-hour period on Facebook Messenger. Primary outcomes will assess the immediate and short-term impact of the chatbot on state- and trait-based body image, respectively. Secondary outcomes will include state- and trait-based affect, trait self-efficacy and treatment adherence.DiscussionThis research is the first to develop an evidence-informed body image chatbot for Brazilian adolescents, with the proposed efficacy trial aiming to provide support for accessible, scalable and cost-effective interventions that address disparities in body image prevalence and readily available resources.Trial registration numberNCT04825184, registered 30th March 2021.

A social norms approach intervention to address misperceptions of anti-vaccine conspiracy beliefs amongst UK parents.

Anti-vaccine conspiracy beliefs among parents can reduce vaccination intentions. Parents’ beliefs in anti-vaccine conspiracy theories are also related to their perceptions of other parents’ conspiracy beliefs. Further, research has shown that parents hold misperceptions of anti-vaccine conspiracy belief norms: UK parents over-estimate the anti-vaccine conspiracy beliefs of other parents. The present study tested the effectiveness of a Social Norms Approach intervention, which corrects misperceptions using normative feedback, to reduce UK parents’ anti-vaccine conspiracy beliefs and increase vaccination intentions. At baseline, 202 UK parents of young children reported their personal belief in anti-vaccine conspiracy theories, future intentions to vaccinate, and their perceptions of other UK parents’ beliefs and intentions. Participants were then randomly assigned to a normative feedback condition (n = 89) or an assessment-only control condition (n = 113). The normative feedback compared participants’ personal anti-vaccine conspiracy beliefs and perceptions of other UK parents’ beliefs with actual normative belief levels. Parents receiving the normative feedback showed significantly reduced personal belief in anti-vaccine conspiracy beliefs at immediate post-test. As hypothesised, changes in normative perceptions of anti-vaccine conspiracy beliefs mediated the effect of the intervention. The intervention, did not directly increase vaccination intentions, however mediation analysis showed that the normative feedback increased perceptions of other parents’ vaccination intentions, which in turn increased personal vaccination intentions. No significant effects remained after a six-week follow-up. The current research demonstrates the potential utility of Social Norms Approach interventions for correcting misperceptions and reducing anti-vaccine conspiracy beliefs among UK parents. Further research could explore utilising a top-up intervention to maintain the efficacy.

Trajectories of reward availability moderate the impact of brief alcohol interventions on alcohol severity in heavy-drinking young adults.

Behavioral economic theory predicts that low access to environmental reward is a risk factor for alcohol use disorder (AUD). The Substance-Free Activity Session (SFAS) is a behavioral economic supplement to standard brief alcohol interventions that attempts to increase environmental reward and may therefore have beneficial effects, particularly for individuals with low levels of environmental reward. Participants were 393 college students who reported at least 2heavy-drinking episodes in the past month. Participants were randomly assigned to 1 of 3 conditions following a baseline assessment: a standard alcohol-focused brief motivational intervention plus relaxation training session (BMI+RT), BMI plus Substance-Free Activity Session (BMI+SFAS), or an assessment-only control condition (AO). In a secondary analysis of the data from this study, we used person-centered statistical techniques to describe trajectories of alcohol severity and environmental reward over a 16-month follow-up and examined whether environmental reward levels moderated the effectiveness of the interventions. Piecewise growth mixture modeling identified 2 trajectories of reward availability: low increasing (LR; n=120) and high stable (HR; n=273). Depressive symptoms, cannabis use, sensation seeking, and low life satisfaction were associated with a greater probability of classification in the LR trajectory. Alcohol severity was greater in the LR trajectory than the HR trajectory. For students in the LR trajectory, at 1, 6, and 12 months, BMI+SFAS led to greater increases in reward availability and reduced levels of alcohol severity compared with the BMI+RT and AO conditions and at 16months compared with AO. Young adults with low levels of environmental reward are at heightened risk for greater alcohol severity and may show greater benefit from brief alcohol interventions that focus on increasing substance-free reward than individuals who are not deficient in reward availability.

A Randomized Controlled Trial of the eCHECKUP to GO for High School Seniors across the Academic Year

Background Among high school students, seniors report the highest levels of alcohol use and hazardous drinking. Technology-based interventions are a promising approach for reducing alcohol use among this age group. Objectives: This randomized controlled trial investigated the efficacy of the eCHECKUP TO GO, an online personalized feedback intervention, on reducing alcohol use among high school seniors across the academic year (ClinicalTrials.gov Identifier NCT03613818). Drinker risk status, with students classified as high- or low-risk drinkers based on baseline reports binge drinking, was examined as a moderator of intervention effects. Method: Participants (N = 311) were recruited from two high schools. Class periods were randomized to the intervention condition or an assessment-only control condition. Participants completed online surveys at baseline, 30-day, and 6-month assessments. Results: Intervention effects were moderated by drinker risk status. Among high-risk drinkers, those in the intervention condition reported a significant reduction in weekly drinking quantity and estimated blood alcohol concentration (eBAC) at the 30-day follow-up relative to students in the control condition. By 6 months, reductions in alcohol outcomes among high-risk students in the intervention condition were sustained, but high-risk students in the control condition also reported reductions in weekly drinking. In contrast, for eBAC, intervention effects were significantly greater among students in the intervention condition relative to the control condition at 6 months. Conclusions: Results support the efficacy of the eCHECKUP TO GO for decreasing short-term alcohol use among seniors who are high-risk drinkers and provide preliminary evidence that reductions are sustained across the academic year.

Effectiveness of a Quit Vaping Text Message Program in Promoting Abstinence Among Young Adult E-Cigarette Users: Protocol for a Randomized Controlled Trial.

BackgroundMillions of young adults currently vape electronic cigarettes (e-cigarettes), yet little research on vaping cessation interventions exists. Text messaging is a promising, scalable intervention strategy for delivering vaping cessation treatment.ObjectiveThis study evaluates the effectiveness of a text message quit vaping program (This is Quitting) in promoting abstinence from e-cigarettes among young adults; examines changes in self-efficacy, perceived social norms, and social support for quitting as hypothesized mediators of effectiveness; and examines if treatment effectiveness is moderated by gender, race, ethnicity, or sexual minority status.MethodsOverall, 2600 young adult (aged 18-24 years) e-cigarette users in the United States will be recruited via web advertisements to participate in the study. Participants will be randomized to This is Quitting or an assessment-only control condition. The primary outcome measure is 30-day vaping abstinence at 7 months post enrollment.ResultsStudy recruitment began on December 18, 2019, and is projected to be completed by spring 2020. The final 7-month follow-up is anticipated to be completed by fall/winter 2020. Because this is the first-ever evaluation of a quit vaping program, we were unable to draw on existing literature to determine the appropriate sample size. Therefore, we examined abstinence rates among an initial pilot sample of 269 participants (This is Quitting: n=148 and control: n=121) who completed the 1-month follow-up to determine the final sample size. The 1-month response rate was 79.2% (213/269), with no difference between arms. Using intention-to-treat analyses that counted nonresponders as still vaping, 30-day abstinence rates were 16.2% (24/148) among those randomized to This is Quitting and 8.3% (10/121) among those randomized to control. A treatment difference of 16% vs 8% is detectable with 80% power at 2-sided alpha=.05 with 260/group (520 total). To detect treatment differences of this magnitude in a 20% subsample (eg, Hispanic or sexual minority young adult e-cigarette users), we will enroll 1300/group (2600 total).ConclusionsThe scientific, clinical, and public health communities are desperate for cessation resources to address vaping among young people. This study is the first-ever comparative effectiveness trial of an intervention to help young people quit vaping. It focuses on evaluating the effectiveness of a theory-grounded, empirically informed text message intervention among young adults. The study is fully powered to examine potentially important subgroup differences among young people who are more vulnerable to e-cigarette use. Although potentially more challenging from a research ethics and pragmatic standpoint, evaluating quit vaping intervention approaches in teens is an important area for future research. Data from this trial will establish a benchmark of effectiveness for other vaping cessation programs and begin to create a body of evidence focused on how best to help young people break free from e-cigarettes.Trial RegistrationClinicalTrials.gov NCT04251273; https://clinicaltrials.gov/ct2/show/NCT04251273International Registered Report Identifier (IRRID)DERR1-10.2196/18327

Efficacy and Mediators of a Web-Based Media Literacy Intervention for Indoor Tanning Prevention

Extant media literacy interventions have been delivered in person, limiting their potential for large scale reach, implementation, and dissemination. Although emerging evidence suggests the interventions can impact behavior, the theoretical mediators that can explain the efficacy remain unknown. This study investigated the efficacy and mediators of a web-based media literacy intervention for reducing indoor tanning behavior among young women. Participants were randomly assigned to one of three conditions: a media literacy intervention with counter argument production, a media literacy intervention with counter story production, or an assessment-only control condition. The outcomes of indoor tanning behavior and intention were evaluated with 3- and 6-month follow-ups. Results indicated significant effects of the web-based intervention on reducing indoor tanning behavior at the follow-ups. Changes in perceived media realism completely mediated the intervention effects on behavior. Perceived media realism, positive and negative outcome expectancies, and collective efficacy partially mediated intervention effects on intention. This study demonstrates the efficacy of a web-based media literacy intervention and the theoretical mechanisms underlying the efficacy. It indicates that by altering perceived media realism, outcome expectancies, and collective efficacy, web-based media literacy interventions could generate behavioral effects.

Reducing the Biological and Psychological Toxicity of Poverty-related Stress: Initial Efficacy of the BaSICS Intervention for Early Adolescents.

This proof-of-concept study tests the initial efficacy of the Building a Strong Identity and Coping Skills (BaSICS) intervention, a selective prevention of internalizing problems program for early adolescents exposed to high levels of poverty-related stress. Eighty-four early adolescents (Mage =11.36years) residing in very low-income neighborhoods were randomized to receive the 16-session intervention (n=44) or to an assessment-only control condition (n=40). BaSICS teaches coping skills, social identity development, and collective social action to empower youth with the ability to connect with members of their communities and cope with poverty-related stress in positive and collaborative ways. Pretest-posttest analyses showed that intervention adolescents acquired problem-solving and cognitive-restructuring skills and reduced their reliance on avoidant coping. In addition, HPA reactivity was significantly reduced in the intervention youth, but not controls. Finally, intervention youth's internalizing and somatic symptoms as reported by both youth and their parents, showed significant reductions over time, whereas control youth had no such changes. Results provide strong support for this approach to strength-building and symptom reduction in a population of early adolescents exposed to poverty-related stress.

Brief Motivational Interventions Are Associated with Reductions in Alcohol-Induced Blackouts Among Heavy Drinking College Students.

Alcohol-induced blackouts, a form of anterograde amnesia that restricts the encoding of short-term memories into long-term ones, are among the most severe alcohol-related consequences. College students are at high risk of experiencing alcohol-induced blackouts, and there is a need to determine whether alcohol interventions can effectively reduce blackouts in this population. The current study uses data from 3 randomized clinical trials to examine the effect of various intervention approaches on alcohol-induced blackouts. Four interventions were compared over 3 studies: (i) a computerized feedback intervention (electronic Check-Up To Go [e-Chug]; Study 1); (ii) a single-session brief motivational intervention (BMI; Study 1); (iii) a BMI plus behavioral economic session focused on increasing substance-free activities (BMI+Substance-Free Activity Session [SFAS]; Studies 2 and 3); and (iv) a BMI plus supplemental Relaxation Training session (BMI+Relaxation Training; Studies 2 and 3). Studies 1 and 3 also included an assessment-only control condition. For each study, participants reported whether they had experienced an alcohol-induced blackout at each time point; binary logistic regressions examined differential likelihood of experiencing an alcohol-induced blackout over time. Neither the single-session BMI nor e-Chug reduced alcohol-induced blackouts over assessment only; however, participants in the BMI+SFAS or BMI+Relaxation Training condition were significantly less likely to experience an alcohol-induced blackout compared to assessment only at 1-month (Wald=4.77, odds ratio [OR]=0.53, p=0.03) and 6-month follow-ups (Wald=5.72, OR=0.52, p=0.02). Study 2 also revealed a larger effect for the BMI+SFAS over the BMI+Relaxation Training condition at 6months (Wald=4.11 OR=0.22, p=0.043), although this was not replicated in Study 3. The effects for the 2-session BMIs lasted 6months, at which point maturation effects diminished differences between assessment-only and intervention conditions. Two sessions of BMI are a substantial enough dose to result in reductions in alcohol-induced blackouts among college student heavy drinkers.

Efficacy of a Parent-Based, Indicated Prevention for Anorexia Nervosa: Randomized Controlled Trial.

BackgroundWeb-based preventive interventions can reduce risk and incidence of bulimia and binge eating disorders among young high-risk women. However, their specific effects on core symptoms of anorexia nervosa (AN) are rather weak.ObjectiveThe primary objective of this study was to evaluate the efficacy of an indicated, parent-based, Web-based preventive program Eltern als Therapeuten (E@T) in reducing risk factors and symptoms of AN.MethodsGirls aged between 11 and 17 years were screened by selected risk factors and early symptoms of AN. At-risk families were then randomized to E@T or an assessment-only control condition. Assessments took place at pre- and postintervention (6 weeks later) and at 6- and 12-month follow-up (FU).ResultsA total of 12,377 screening questionnaires were handed out in 86 German schools, and 3941 including consent returned. Overall, 477 (447/3941, 12.10%) girls were identified as at risk for AN and 256 of those could be contacted. In all, 66 families (66/256, 25.8% of those contacted) were randomized to the E@T or a wait-list control condition, 43 (43/66, 65%) participated in postassessments, and 27 (27/66, 41%) in 12-month FUs. Due to low participation and high dropout rates of parents, recruitment was terminated prematurely. At 12-month FU, girls’ expected body weight (EBW) percentage was significantly greater for intervention participants compared with control participants (group by time interaction beta=21.0 [CI 5.81 to 36.13], P=.007; group by time squared interaction beta=−15.5 [CI −26.6 to −4.49], P=.007; estimated Cohen d=0.42]. No other significant effects were found on risk factors and attitudes of disturbed eating.ConclusionsDespite a significant increase in girls’ EBW percentage, parental participation and adherence to the intervention were low. Overall, parent-based, indicated prevention for children at risk for AN does not seem very promising, although it might be useful for parents who engage in the intervention.Trial RegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 18614564; http://www.isrctn.com/ISRCTN18614564 (Archived by WebCite at http://www.webcitation.org/74FTV1EpF).

Attentional bias modification treatment for depression: Study protocol for a randomized controlled trial

Theoretical models and empirical research point to negatively biased attention as a maintaining factor in depression. Although preliminary studies suggest experimentally modifying attentional biases (i.e., attentional bias modification; ABM) reduces depression symptoms and depression risk, relatively few rigorous studies with clinical samples have been completed. This clinical trial examines the impact of ABM on a sample of adults (N = 123) with elevated depression severity who also exhibit at least modest levels of negatively biased attention prior to treatment. Participants will be randomly assigned to either active ABM, placebo ABM, or an assessment-only control condition. Individuals assigned to ABM will complete 5 trainings per week (2 in-clinic, 3 brief trainings at-home) during a four-week period. Throughout this four-week period, participants will complete weekly assessments of symptom severity and putative treatment mediators measured across different levels of analysis (e.g., eye tracking, behavioral measures, and functional Magnetic Resonance Imaging). This article details the rationale and design of the clinical trial, including methodological issues that required more extensive consideration. Our findings may not only point to an easily-accessible, efficacious treatment for depression but may also provide a meaningful test of whether a theoretically important construct, negatively biased attention, maintains depression.

A preliminary trial of an online dissonance-based eating disorder intervention

ObjectiveWe conducted a controlled randomized preliminary trial of an expanded online version of the Body Project (n = 46) compared to an assessment-only control condition (n = 36) via a longitudinal design (baseline, postintervention, 2-month follow-up) in a community sample of women (N = 82) with clinical (n = 53) and subclinical (n = 29) eating disorder symptoms. MethodThe traditional content of the Body Project was modified to include verbal, written, and behavioral exercises designed to dissuade objectification and maladaptive social comparison and adapted to an online format. Body dissatisfaction, self-esteem, self-objectification, thin-ideal internalization, maladaptive social comparison, trait anxiety, positive affect, negative affect, and eating disorder symptomatology were evaluated in the control and the online expanded Body Project condition at baseline, postintervention, and 2-month follow-up. ResultsA 2 (condition: online expanded Body Project, control) × 3 (time: baseline, postintervention, 2-month follow-up) mixed factorial multivariate analysis of variance (MANOVA) was conducted to examine statistically significant group differences. As predicted, results indicated a statistically significant condition × time interaction. ConclusionsParticipants in the expanded online Body Project condition showed significant reductions in eating disorder symptoms and several associated psychological risk correlates from baseline to postintervention and follow-up; contrary to predictions, eating disorder symptoms and risk correlates were not significantly lower in the online expanded Body Project condition compared to the waitlist control condition at postintervention or 2-month follow-up.

Personalized Boosters After a Computerized Intervention Targeting College Drinking: A Randomized Controlled Trial.

Problematic drinking among emerging adult college students is extensive. Computer-delivered interventions (CDIs) have strong appeal because they can be quickly delivered to large numbers of students. Although they are efficacious in the short term, CDIs are not as efficacious as in-person interventions longer term. This study examined the utility of emailed boosters containing personalized feedback after a CDI to enhance and extend reductions among emerging adult college drinkers. Sex and age were explored as potential moderators. Participants were 537 college students (67.4% female) aged 18 to 24years (M age=19.65, SD=1.67) who consumed at least 1 alcoholic drink in the past 2weeks. They were randomly assigned to CDI-only, CDI+booster email, or an assessment-only control condition, and were assessed up to 9months postintervention. A booster email with personalized feedback was sent to the CDI+booster email group 2weeks after completion of the CDI. Moderation findings for age revealed that the booster may be an effective means to strengthen and extend intervention effects for emerging adults who are of legal drinking age. However, effects were negligible for underage drinkers. Although the booster effect for the overall sample demonstrated a trend in the expected direction, it failed to reach significance. Booster effects were not significantly moderated by sex. Intervention effects were not moderated by either age or sex. The present investigation contributes to a limited body of research on boosters to augment main intervention effects in college drinkers. Our study demonstrated that a brief CDI plus a simple email booster with personalized feedback resulted in significant reductions in drinking outcomes for emerging adults of legal drinking age. Efforts to further develop and refine intervention booster strategies represent a promising future direction to minimize harmful drinking among college students.

Imagery rescripting and cognitive dissonance: A randomized controlled trial of two brief online interventions for women at risk of developing an eating disorder.

This pilot study compared two brief online interventions, imagery rescripting and cognitive dissonance, to an assessment-only control condition in a sample of body-dissatisfied young women at risk of developing an eating disorder. We examined the degree to which each intervention reduced disordered eating and modified risk and protective factors for eating disorders. Female university students (N = 107, 17-28 years of age) completed a screening questionnaire, followed by random allocation to one of the three conditions, followed by a baseline assessment, body dissatisfaction induction, and brief online intervention. Participants in the active conditions then completed online daily home practice and a postintervention questionnaire. Findings provide qualified support for the imagery rescripting intervention, with participants reporting higher body image acceptance (Cohen's d = 0.49) than the cognitive dissonance condition, and higher self-compassion (d = 0.59) and lower levels of disordered eating (d = 0.59) than the control condition, at postintervention. There was no significant impact of cognitive dissonance on any factors. Change in body image acceptance and self-compassion mediated the relationship between allocated condition and change in disordered eating at postintervention. These findings provide preliminary support for the use of online-adapted imagery-based techniques (e.g., imagery rescripting) to reduce risk for the development of an eating disorder by strengthening protective factors (i.e., body image acceptance and self-compassion) and reducing disordered eating. Further exploration of the use of imagery strategies in the prevention of disordered eating is required, including prospective tests of the mechanisms of action.

A text message intervention to reduce 21st birthday alcohol consumption: Evaluation of a two-group randomized controlled trial.

Twenty-first birthdays are associated with extreme levels of heavy drinking and alcohol-related harm. Effective preventive interventions that are acceptable to young adults are needed. The current study tested the efficacy of a brief text-message intervention for reducing 21st birthday alcohol involvement designed to correct perceived 21st birthday drinking norms and provide protective behavioral strategies (PBS). We also examined potential moderators and mediators. College students (n = 200) with an upcoming 21st birthday completed a baseline assessment and were randomized to a text-message intervention or an assessment-only control condition. For participants in the intervention group, Message 1 (sent one day before the birthday celebration) focused on personalized normative feedback, and Message 2 (sent day of the birthday celebration) discussed PBS to minimize risk. Primary outcomes were assessed using responses to a follow-up assessment the day after their birthday celebration (93% completion rate). Zero-inflated negative binomial regression analyses did not reveal an overall intervention effect for estimated Blood Alcohol Content (eBAC) or alcohol problems on the 21st birthday celebration. In partial support of our hypothesis, there was an indirect effect of perceived 21st birthday norms on 21st birthday eBAC. The intervention was associated with reduced perceived norms, which was, in turn, related to a lower eBAC. There was a 3-way interaction between drinks per week, anticipated eBAC, and intervention condition for the count portion of actual eBAC such that the intervention reduced eBAC among a high-risk subset of the sample. Future research may benefit from further refining the personalized normative feedback (PNF) component of 21st birthday interventions. (PsycINFO Database Record

An Evaluation of e-CHECKUP TO GO in Canada: The Mediating Role of Changes in Social Norm Misperceptions

ABSTRACTBackground: Alcohol use and related problems are key concerns among colleges, and web-based interventions to mitigate these issues are increasingly popular across campuses. A variety of programs are commercially available and have demonstrated efficacy in reducing alcohol use and consequences; however, little is known about how these programs reduce alcohol outcomes. Objectives: The e-CHECKUP TO GO program (e-CHUG) is the briefest electronic intervention available and over 600 institutions are using it internationally. The present study evaluates the impact of the e-CHUG program on drinking outcomes and examines changes in perceived norms as a potential mediator of intervention efficacy in a sample of first-year Canadian university residence students. This is the first Canadian evaluation of e-CHUG. Methods: First year Canadian university students (N = 245) living in residence in August 2014 participated in a randomized control trial to evaluate the efficacy of e-CHUG program compared to an assessment-only control condition. Follow-up assessments were completed at 3-months and 5-months. Norm misperceptions and drinking outcomes were measured. Results: At 3-month and 5-month follow-up assessments program participants had lower norm misperceptions about peers drinking compared to control participants. Changes in norm misperceptions at 3-months mediated the effect of the program on drinking outcomes at 5-months. There were no sex differences in the associations. Conclusions/Importance: Findings suggest that e-CHECKUP TO GO may be a promising strategy for addressing norm misperceptions and subsequently drinking for Canadian students.