Acceptance-enhanced behavior therapy for trichotillomania: Randomized controlled trial rationale, method, and strategies for recruiting minority participants

2019 ◽  
Vol 83 (4) ◽  
pp. 399-431
Author(s):  
Angela Neal-Barnett ◽  
Douglas W. Woods ◽  
Flint M. Espil ◽  
Martale Davis ◽  
Jennifer R. Alexander ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Behavior Therapy ◽  
Controlled Trial ◽  
Small Sample ◽  
Randomized Controlled ◽  
Promising Treatment ◽  
Current Article ◽  
Small Sample Sizes ◽  
Fidelity Measures ◽  
Minority Participants

Trichotillomania (TTM) involves the chronic pulling out of hair to the point of hair loss or thinning, which continues despite repeated attempts to stop. Behavior therapy is a promising treatment for the condition, but studies have been limited by the lack of a credible control condition, small sample sizes, follow-up periods of short duration, and low participation by underrepresented populations. In the current article, the authors describe the theoretical rationale for an acceptance-enhanced form of behavior therapy for TTM in adults and describe the methodology used to test the efficacy of this intervention against a psychoeducation and supportive control condition. In addition, the authors discuss the importance of and difficulties encountered with enrolling minority participants into TTM research, as well as strategies used to enhance minority recruitment. Finally, the authors discuss the instruments, procedures, and related outcomes of the fidelity measures used in the randomized controlled trial.

Dialectical Behavior Therapy

2010 ◽  
pp. 401-416
Author(s):  
Eunice Y. Chen ◽  
Debra Safer
Keyword(s):  
Eating Disorders ◽  
Randomized Controlled Trial ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Research Evidence ◽  
Controlled Trial ◽  
Borderline Personality ◽  
Randomized Controlled ◽  
Promising Treatment ◽  
Trial Evidence

This chapter provides a description and reviews the research evidence for the adaptation of Dialectical Behavior Therapy (DBT) for eating disorders (EDs). First, the chapter briefly describes the standard DBT program as originally developed for women with borderline personality disorder (BPD). Second, the rationale for the adaptation of DBT for EDs is reviewed. Third, the DBT model of maintenance and etiology of EDs is discussed. Fourth, the randomized controlled trial evidence for DBT for BPD is reviewed as well as that for DBT for EDs. Finally, the DBT program for EDs is outlined. It is concluded that DBT is a promising treatment for EDs, worthy of further investigation with this population.

scholarly journals Starch or Saline After Cardiac Surgery: A Double-Blinded Randomized Controlled Trial

2020 ◽  
Vol 7 ◽  
pp. 205435812094043
Author(s):  
A. Dave Nagpal ◽  
Andrea Cowan ◽  
Linna Li ◽  
Graeme Nusca ◽  
Linrui Guo ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cardiac Surgery ◽  
Weight Gain ◽  
Controlled Trial ◽  
Coronary Revascularization ◽  
Small Sample ◽  
Resource Limitations ◽  
Randomized Controlled ◽  
Surgery Patient ◽  
Double Blinded

Background: Despite decades of investigation, the balance of clinical risks and benefits of fluid supplementation with starch remain unresolved. Patient-centered outcomes have not been well explored in a “real-world” trial in cardiac surgery. Objective: We sought to compare a starch-based fluid strategy with a saline-based fluid strategy in the cardiac surgery patient. Design: A pragmatic blinded randomized controlled trial comparing starch-based with saline-based fluid strategy. Setting: A large tertiary academic center in London Ontario between September 2009 and February 2011. Participants: Patients undergoing planned, isolated coronary revascularization. Measurements: Serum creatinine and patient weight were measured daily postoperatively. Methods: Patients were randomized to receive 6% hydroxyethyl starch (Voluven) or saline for perioperative fluid requirements. Fluid administration was not protocolized. Co-primary outcomes were incidence of acute kidney injury (AKI) and maximum postoperative weight gain. Secondary outcomes included bleeding, transfusion, inotropic and ventilator support, and fluid utilization. Results: The study was prematurely terminated due to resource limitations. A total of 69 patients (19% female, mean age = 65) were randomized. Using RIFLE criteria for AKI, “risk” occurred in 12 patients in each group (risk ratio [RR] = 1.0; 95% confidence interval [CI] = 0.5-1.9; P = 1.00), whereas “injury” occurred in 7 of 35 (20%) and 3 of 34 (9%) of patients in the starch and saline groups, respectively (RR = 2.3; 95% CI = 0.6-8.1; P = .31). Maximum weight gain, bleeding and blood product usage, and overall fluid requirement were similar between groups. Limitations: The study had to be prematurely terminated due to resource limitations which led to a small sample size which was not sufficiently powered to detect a difference in the primary outcomes. Conclusions: This pragmatic double-blinded randomized controlled trial revealed a number of interesting hypothesis-generating trends and confirmed the feasibility of undertaking a logistically complex trial in a pragmatic fashion.

Efficacy of Blended Cognitive Behavior Therapy for High Fear of Recurrence in Breast, Prostate, and Colorectal Cancer Survivors: The SWORD Study, a Randomized Controlled Trial

2017 ◽  
Vol 35 (19) ◽  
pp. 2173-2183 ◽  
Author(s):  
Marieke van de Wal ◽  
Belinda Thewes ◽  
Marieke Gielissen ◽  
Anne Speckens ◽  
Judith Prins
Keyword(s):  
Colorectal Cancer ◽  
Randomized Controlled Trial ◽  
Cancer Survivors ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Controlled Trial ◽  
Cognitive Behavior ◽  
Cancer Worry ◽  
Randomized Controlled ◽  
Clinically Significant

Purpose Fear of cancer recurrence (FCR) is a common problem experienced by cancer survivors. Approximately one third of survivors report high FCR. This study aimed to evaluate whether blended cognitive behavior therapy (bCBT) can reduce the severity of FCR in cancer survivors curatively treated for breast, prostate, or colorectal cancer. Patients and Methods This randomized controlled trial included 88 cancer survivors with high FCR (Cancer Worry Scale score ≥ 14) from 6 months to 5 years after cancer treatment. Participants were randomly allocated (ratio 1:1, stratified by cancer type) to receive bCBT, including five face-to face and three online sessions (n = 45) or care as usual (CAU; n = 43). Participants completed questionnaires at baseline (T0) and 3 months later (T1). The intervention group completed bCBT between T0 and T1. The primary outcome was FCR severity assessed with the Cancer Worry Scale. Secondary outcomes included other distress-related measures. Statistical (one-way between-group analyses of covariance) and clinical effects (clinically significant improvement) were analyzed by intention to treat. Results Participants who received bCBT reported significantly less FCR than those who received CAU (mean difference, –3.48; 95% CI, –4.69 to –2.28; P < .001) with a moderate-to-large effect size ( d = 0.76). Clinically significant improvement in FCR was significantly higher in the bCBT group than in the CAU group (13 [29%] of 45 compared with 0 [0%] of 43; P < .001); self-rated improvement was also higher in the bCBT group (30 [71%] of 42 compared with 12 [32%] of 38 in the CAU group; P < .001). Conclusion bCBT has a statistically and clinically significant effect on the severity of FCR in cancer survivors and is a promising new treatment approach.

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