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Patel, Tapan A.; Cougle, Jesse R.
doi: 10.1037/ccp0000920pmid: 39446647
Objective: Appearance concerns are a core feature of multiple psychiatric disorders (i.e., body dysmorphic disorder, eating disorders, and social anxiety disorders). Individuals with these concerns commonly engage in appearance-related safety behaviors (ARSB), behaviors intended to avoid, prevent, or manage the negative evaluation of one’s physical appearance. The present study evaluated a brief ARSB reduction intervention for appearance concerns. Method: Women with elevated appearance concerns (N = 203) were recruited from across the United States and randomized to receive one of two 1-month smartphone-based interventions targeting ARSBs or unhealthy behaviors (UHBs). Both consisted of daily text messages with links to behavior checklists and reminders to avoid the respective behaviors. Results: Participants in both treatments saw substantial reductions in symptoms. Though the UHB fading condition showed significantly better treatment adherence than ARSB fading, ARSB fading led to significantly lower appearance concerns (sr2 = .028, p = .014) and eating disorder symptoms (sr2 = .024, p = .020) at posttreatment, and lower appearance concerns (sr2 = .041, p = .004), eating disorder symptoms (sr2 = .029, p = .006), social anxiety (sr2 = .048, p = .005), and appearance importance at 1-month follow-up (sr2 = .042, p = .011), relative to UHB fading. Changes in ARSBs were found to partially mediate the effect of treatment on appearance concerns. Conclusions: These preliminary findings provide novel evidence for the efficacy of targeting ARSBs and suggest that this text-based intervention may be an efficacious and accessible intervention for women with elevated appearance concerns.
Miller-Chagnon, Reagan L.; Shomaker, Lauren B.; Prince, Mark A.; Krause, Jill T.; Rzonca, Addie; Haddock, Shelley A.; Zimmerman, Toni S.; Lavender, Jason M.; Sibinga, Erica; Lucas-Thompson, Rachel G.
doi: 10.1037/ccp0000910
Read, Jennifer P.; Livingston, Jennifer A.; Shaw, Rachael J.; Wiseblatt, Aria F.; Jenzer, Tiffany; DiPaolo, Lauren R.; Mastroleo, Nadine R.; Katz, Jennifer; Testa, Maria; Colder, Craig R.
doi: 10.1037/ccp0000925
Adesogan, Olutosin; Beach, Steven R. H.; Carter, Sierra E.; Metzger, Isha W.; Lavner, Justin A.
doi: 10.1037/ccp0000926pmid: 39715425
Objective: This study examined whether a responsive parenting (RP) intervention for first-time Black mothers had secondary benefits for their mental health by reducing their postpartum depressive symptoms. Method: In total, 212 first-time Black mothers participated in the Sleep Strong African American Families randomized control trial. Mothers were randomized to the RP condition or a safety control condition at 1-week postpartum. Participants reported their depressive symptoms at 1-, 8-, and 16-week postpartum. Data were analyzed using linear regression and moderation analyses. Results: There was not a significant main effect of the intervention condition on mothers’ depressive symptoms at 8- or 16-week postpartum. However, at 8-week postpartum, the main effect of the condition was significantly moderated by mothers’ depressive symptoms at baseline: Mothers in the RP condition reported significantly lower levels of 8-week depressive symptoms than mothers in the safety control condition if they initially had clinically significant depressive symptoms but did not differ from controls if they did not initially have clinically significant depressive symptoms. This interaction effect was not significant at 16-week postpartum. Effects remained consistent, controlling for demographic variables, which did not significantly moderate condition effects at 8- or 16-week postpartum. Conclusion: Participation in the Sleep Strong African American Families responsive parenting intervention led to a more rapid reduction in depressive symptoms among first-time Black mothers with clinically significant depressive symptoms at baseline relative to the control condition. Findings suggest that family-focused responsive parenting interventions may serve as forms of “constructed resilience” that promote positive mental health early in the postpartum period.
Gómez Penedo, Juan Martín; Errázuriz, Paula; Coyne, Alice E.; Flückiger, Christoph
doi: 10.1037/ccp0000931pmid: 39715426
Objective: Machine learning has a great potential for prospectively forecasting individual patient response to mental health care (MHC), thereby enabling treatment personalization. However, previous efforts have been limited to populations living in predominantly higher income, developed countries. This study aimed to extend the reach of precision MHC systems by developing and testing a feasible and readily implementable algorithm for identifying patients at risk of nonresponse to routinely delivered psychotherapy in Chile, a developing country in Latin America. Method: Data were derived from a community-based, randomized trial that tested the effects of progress feedback on naturalistically delivered psychotherapy outcome. Patients were 547 adults who were consecutively admitted to an outpatient clinic in Santiago, Chile. Treatment response was defined using norms for reliable improvement on the Outcome Questionnaire–30. Based on 10 sociodemographic and seven clinical predictors, we trained elastic net and random forest algorithms on a randomly selected training set (70%; n = 384). The best performing algorithm was tested on a hold-out sample (30%; n = 163). Results: Reliable improvement was achieved in 42% of the cases. A random forest algorithm demonstrated moderate performance in the hold-out sample (area under the curve = .74, Brier score = .21), correctly identifying 73% of the patients who did not respond. Conclusion: This study developed a predictive algorithm that demonstrated moderate accuracy in identifying patients at risk of nonresponse to naturalistic psychotherapy in Chile, using routinely assessed and easy-to-collect sociodemographic and clinical information. Using such tools may represent one step toward reducing the multilayered outcome disparities faced by individuals receiving MHC in socioeconomically disadvantaged contexts.
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Objective: The goal of this study was to test if a mindfulness-based intervention (MBI) compared to an active control ameliorates the impacts of life stressors on momentary mindfulness and emotion regulation difficulties among adolescents exposed to chronic stressors. Method: Adolescents exposed to chronic stressors (N = 81, Mage = 13.75 years; 56% boys; 24% Hispanic/Latino, 57% White) were randomized to receive MBI within the context of a community-based mentoring program (MBI + mentoring) or mentoring-alone. Participants completed ecological momentary assessments (EMAs) three times each day for 7 days at three intervals/bursts (preintervention, midintervention, and postintervention), contributing to a total of 3,178 EMA reports. EMA assessed momentary exposure to life stressors, mindfulness (vs. mindlessness), and emotion regulation difficulties. Results: Linear mixed-effects models revealed that the interaction between intervention arm (MBI + mentoring vs. mentoring-alone) and burst was significantly associated with the random slopes of life stressor exposure predicting mindful attention (b = −.05, SE = .01, p < .001), mindful nonjudgment (b = −.03, SE = .01, p < .001), and emotion regulation difficulties (b = −.04, SE = .01, p < .001). Estimated marginal means revealed that MBI + mentoring, compared to mentoring-alone, produced small but significant attenuation in the association of life stressors with mindful attention, mindful nonjudgment, and emotion regulation difficulties at postintervention. Conclusion: Mindfulness training may buffer adolescents exposed to chronic stressors against the negative impacts of life stressors on mindfulness and emotion regulation in daily life. Going forward, it will be important to investigate these relationships in the context of mental/physical health outcomes and to include longer periods of follow-up to determine the sustainable benefits of MBI for adolescent health.
Objective: Sexual assault (SA) is unfortunately common in U.S. college campuses. Friends are central to the social context of college women, and thus to the context of SA, and thus may play a key role in SA prevention. The objective of the present study was to provide a preliminary test of a novel friend-based motivational intervention (FMI) that encourages and prepares friends to work together to reduce SA risk. Method: In a pilot trial, 51 friend dyads (N = 102) were randomized to either FMI or waitlist control (WLC) conditions and then followed over 3 months. Participant perceptions of the intervention and intervention-associated outcomes (engagement in friend-based assault protective behaviors [FAPB], readiness to change, barriers, sexual assault occurrences) were examined. Results: Those in the FMI reported greater readiness to engage in efforts to protect their friend against SA and reported higher rates of FAPB across time points relative to the WLC. Though not statistically significant, women in the FMI also reported half as many incidences of SA at the 3-month follow-up. We did not observe decreases in perceived barriers to intervening that were targeted with the FMI. Participant feedback on their experiences with the FMI was positive; women reported that FMI was empowering, personally relevant, and useful. Conclusions: Findings point to the promise of this dyad-based motivational intervention that capitalizes on the natural resource of women’s friendships to decrease risk for sexual assault.