scholarly journals Relapse prevention for eating disorders: a randomized controlled trial targeting weight-related self-esteem

2021 ◽  
Author(s):  
Sarah M Royal
Keyword(s):  
Randomized Controlled Trial ◽  
Eating Disorder ◽  
Controlled Trial ◽  
Treatment Protocol ◽  
Self Esteem ◽  
Treatment Manual ◽  
Future Research ◽  
Behavioural Intervention ◽  
Randomized Controlled

A high level of weight-related self-esteem (WRSE) at the end of eating disorder treatment is predictive of relapse. The first goal of this project was to develop a cognitive-behavioural intervention to target WRSE in partially remitted eating disorder clients to prevent relapse (WRSE protocol). The second goal (Study 1) was to conduct a pilot study to assess whether receiving the WRSE protocol leads to improvements in WRSE and related variables. The final goal of this project (Study 2) was to conduct a randomized controlled trial to determine whether the individual-based treatment added to treatment as usual (TAU) provided additional benefits to eating disorder clients, with respect to WRSE, eating disorder symptoms, and relapse. After the treatment manual was developed, 16 clients were recruited and administered the treatment protocol in Study 1. The results indicated that participants had significant improvements in levels of WRSE and related variables following treatment. For Study 2, 47 participants who had achieved behavioural symptom interruption were randomly assigned to either 1) TAU + WRSE protocol or 2) TAU. Results were mainly consistent across Complete Case and Last Observation Carried Forward procedures where participants who received the additional WRSE protocol had greater improvements in WRSE, body checking behaviour, and self-esteem. Groups did not differ with respect to body avoidance, general avoidance, fat talk, and other variables compared to participants who received TAU only. Multiple imputation procedures, which accounted for missing data, indicated no significant differences for all measured variables. Participants who completed the WRSE protocol had significantly greater adherence to their meal plan (i.e., less dietary restriction) compared to participants who only received TAU. Groups did not differ regarding level of binge eating and/or vomiting after the intervention period, and there were no differences in relapse between groups at 3-month follow-up. Overall, the newly developed treatment provided some benefit to eating disorder clients above and beyond TAU. However, the data appear to have been sensitive to attrition. Future research should include further refinement of the treatment protocol and evaluation across a longer follow-up period to assess its impact on relapse rates.

scholarly journals Relapse prevention for eating disorders: a randomized controlled trial targeting weight-related self-esteem

2021 ◽  
Author(s):  
Sarah M Royal
Keyword(s):  
Randomized Controlled Trial ◽  
Eating Disorder ◽  
Controlled Trial ◽  
Treatment Protocol ◽  
Self Esteem ◽  
Treatment Manual ◽  
Future Research ◽  
Behavioural Intervention ◽  
Randomized Controlled

A high level of weight-related self-esteem (WRSE) at the end of eating disorder treatment is predictive of relapse. The first goal of this project was to develop a cognitive-behavioural intervention to target WRSE in partially remitted eating disorder clients to prevent relapse (WRSE protocol). The second goal (Study 1) was to conduct a pilot study to assess whether receiving the WRSE protocol leads to improvements in WRSE and related variables. The final goal of this project (Study 2) was to conduct a randomized controlled trial to determine whether the individual-based treatment added to treatment as usual (TAU) provided additional benefits to eating disorder clients, with respect to WRSE, eating disorder symptoms, and relapse. After the treatment manual was developed, 16 clients were recruited and administered the treatment protocol in Study 1. The results indicated that participants had significant improvements in levels of WRSE and related variables following treatment. For Study 2, 47 participants who had achieved behavioural symptom interruption were randomly assigned to either 1) TAU + WRSE protocol or 2) TAU. Results were mainly consistent across Complete Case and Last Observation Carried Forward procedures where participants who received the additional WRSE protocol had greater improvements in WRSE, body checking behaviour, and self-esteem. Groups did not differ with respect to body avoidance, general avoidance, fat talk, and other variables compared to participants who received TAU only. Multiple imputation procedures, which accounted for missing data, indicated no significant differences for all measured variables. Participants who completed the WRSE protocol had significantly greater adherence to their meal plan (i.e., less dietary restriction) compared to participants who only received TAU. Groups did not differ regarding level of binge eating and/or vomiting after the intervention period, and there were no differences in relapse between groups at 3-month follow-up. Overall, the newly developed treatment provided some benefit to eating disorder clients above and beyond TAU. However, the data appear to have been sensitive to attrition. Future research should include further refinement of the treatment protocol and evaluation across a longer follow-up period to assess its impact on relapse rates.

Treating severe and enduring anorexia nervosa: a randomized controlled trial

2013 ◽  
Vol 43 (12) ◽  
pp. 2501-2511 ◽  
Author(s):  
S. Touyz ◽  
D. Le Grange ◽  
H. Lacey ◽  
P. Hay ◽  
R. Smith ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Social Adjustment ◽  
Retention Rate ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Retention Rates ◽  
Randomized Controlled

BackgroundThere are no evidence-based treatments for severe and enduring anorexia nervosa (SE-AN). This study evaluated the relative efficacy of cognitive behavioral therapy (CBT-AN) and specialist supportive clinical management (SSCM) for adults with SE-AN.MethodSixty-three participants with a diagnosis of AN, who had at least a 7-year illness history, were treated in a multi-site randomized controlled trial (RCT). During 30 out-patient visits spread over 8 months, they received either CBT-AN or SSCM, both modified for SE-AN. Participants were assessed at baseline, end of treatment (EOT), and at 6- and 12-month post-treatment follow-ups. The main outcome measures were quality of life, mood disorder symptoms and social adjustment. Weight, eating disorder (ED) psychopathology, motivation for change and health-care burden were secondary outcomes.ResultsThirty-one participants were randomized to CBT-AN and 32 to SSCM with a retention rate of 85% achieved at the end of the study. At EOT and follow-up, both groups showed significant improvement. There were no differences between treatment groups at EOT. At the 6-month follow-up, CBT-AN participants had higher scores on the Weissman Social Adjustment Scale (WSAS; p = 0.038) and at 12 months they had lower Eating Disorder Examination (EDE) global scores (p = 0.004) and higher readiness for recovery (p = 0.013) compared to SSCM.ConclusionsPatients with SE-AN can make meaningful improvements with both therapies. Both treatments were acceptable and high retention rates at follow-up were achieved. Between-group differences at follow-up were consistent with the nature of the treatments given.

scholarly journals Can a Lifestyle Genomics Intervention Motivate Patients to Engage in Greater Physical Activity than a Population-Based Intervention? Results from the NOW Randomized Controlled Trial

2020 ◽  
Vol 13 (6) ◽  
pp. 180-186
Author(s):  
Justine R. Horne ◽  
Jason Gilliland ◽  
Tara Leckie ◽  
Colleen O’Connor ◽  
Jamie A. Seabrook ◽  
...  
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Energy Expenditure ◽  
Leisure Time ◽  
Controlled Trial ◽  
Population Based ◽  
Future Research ◽  
Randomized Controlled ◽  
Metabolic Equivalents

<b><i>Background:</i></b> Lifestyle genomics (LGx) is a science that explores interactions between genetic variation, lifestyle components such as physical activity (PA), and subsequent health- and performance-related outcomes. The objective of this study was to determine whether an LGx intervention could motivate enhanced engagement in PA to a greater extent than a population-based intervention. <b><i>Methods:</i></b> In this pragmatic randomized controlled trial, participants received either the standard, population-based Group Lifestyle Balance<sup>TM</sup> (GLB) program intervention or the GLB program in addition to the provision of LGx information and advice (GLB + LGx). Participants (<i>n</i> = 140) completed a 7-day PA recall at baseline, 3, 6, and 12 months. Data from the PA recalls were used to calculate metabolic equivalents (METs), a measure of energy expenditure. Statistical analyses included split plot analyses of covariance and binary logistic regression (generalized linear models). Differences in leisure time PA weekly METs, weekly minutes of moderate + high-intensity PA, and adherence to PA guidelines were compared between groups (GLB and GLB + LGx) across the 4 time points. <b><i>Results:</i></b> Weekly METs were significantly higher in the GLB + LGx group (1,114.7 ± 141.9; 95% CI 831.5–1,397.8) compared to the standard GLB group (621.6 ± 141.9 MET/week; 95% CI 338.4–904.8) at the 6-month follow-up (<i>p</i> = 0.01). All other results were non-significant. <b><i>Conclusions:</i></b> The provision of an LGx intervention resulted in a greater weekly leisure time PA energy expenditure after the 6-month follow-up. Future research should determine how this could be sustained over the long-term. <b><i>Clinical Trial Registration:</i></b> NCT03015012.

scholarly journals Depression prevention via digital cognitive behavioral therapy for insomnia: a randomized controlled trial

SLEEP ◽  
2019 ◽  
Vol 42 (10) ◽  
Author(s):  
Philip Cheng ◽  
David A Kalmbach ◽  
Gabriel Tallent ◽  
Christine Lm Joseph ◽  
Colin A Espie ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Relative Rate ◽  
Cognitive Behavioral ◽  
Future Research ◽  
Depression Prevention ◽  
Randomized Controlled

Abstract Study Objectives Insomnia is a common precursor to depression; yet, the potential for insomnia treatment to prevent depression has not been demonstrated. Cognitive behavioral therapy for insomnia (CBT-I) effectively reduces concurrent symptoms of insomnia and depression and can be delivered digitally (dCBT-I); however, it remains unclear whether treating insomnia leads to sustained reduction and prevention of depression. This randomized controlled trial examined the efficacy of dCBT-I in reducing and preventing depression over a 1-year follow-up period. Methods Patients with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) insomnia disorder were randomly assigned to receive dCBT-I or an attentional control. The follow-up sample included 358 patients in the dCBT-I condition and 300 patients in the online sleep education condition. The primary outcome measure was relative rate ratios for depression at 1-year follow-up. Insomnia responses to treatment were also tested as predictors of incident depression at the 1-year follow-up. Results At 1-year follow-up, depression severity continued to be significantly lower in the dCBT-I condition relative to control. In addition, the number of individuals who reported no depression at 1-year follow-up was 51% higher in the dCBT-I condition relative to control. In those with minimal to no depression at baseline, the incident rate of moderate-to-severe depression at 1-year follow-up was reduced by half in the dCBT-I condition relative to the control condition. Conclusion dCBT-I showed robust effects as an intervention that prevents depression. Future research should examine dose–response requirements and further characterize mechanisms of action of dCBT-I for depression prevention. Clinical Trial Sleep to Prevent Evolving Affective Disorders; NCT02988375.

scholarly journals Changing Stress Mindsets with a Novel Imagery Intervention: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Jacob J Keech ◽  
Martin S Hagger ◽  
Kyra Hamilton
Keyword(s):  
Randomized Controlled Trial ◽  
Academic Performance ◽  
Mixed Model ◽  
Controlled Trial ◽  
Intervention Group ◽  
Future Research ◽  
Ecological Stress ◽  
Beneficial Effects ◽  
Randomized Controlled

Objective: Changing individuals’ stress mindset has emerged as a technique that may be effective in aiding stress management, but there is limited data on the effects of this technique in managing stress in ‘real world’ contexts beyond a few days. This study aimed to (1) evaluate the efficacy of a novel imagery-based intervention in changing stress mindset; and, (2) evaluate the effect of the intervention on stress-related outcomes, compared to a control, after two weeks. Methods: The study adopted a pre-registered randomized controlled trial design. University students (N = 150) attended a research laboratory twice over two weeks, receiving the intervention or control condition stimuli in Session 1, and completing measures in both sessions. Academic performance data was collected from university records. Results: Mixed model ANOVAs revealed a large-sized difference in stress mindset among intervention group participants immediately following the intervention and at the follow-up relative to controls. There were also robust effects of the intervention on perceived distress, positive and negative affect, proactive behavior, and academic performance at the follow-up in individuals with high baseline perceived distress. Conclusions: Findings indicate that the intervention is a promising approach for changing individuals’ stress mindset and that changing stress mindset can have beneficial effects on coping with ecological stressors. Future research should use intensive longitudinal designs to examine momentary activation of stress mindset and responses to ecological stress.

scholarly journals Effectiveness and sustainability of a motor-cognitive stepping exergame training on stepping performance in older adults: a randomized controlled trial

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Klaus Hauer ◽  
Elena Litz ◽  
Michaela Günther-Lange ◽  
Caroline Ball ◽  
Eling D. de Bruin ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Intervention Group ◽  
Exercise Program ◽  
Future Research ◽  
Control Group ◽  
Randomized Controlled ◽  
Balance Exercises

Abstract Background Training effects reported for stepping exergames on stepping performances in older adults often based on not comprehensively validated outcomes measures, and follow-up data on their sustainability are lacking. The aim of this study is to evaluate the effectiveness and sustainability of a motor-cognitive stepping exergame training on the stepping performance in older adults. Methods Fifty-eight older adults (78.3 ± 6.5 years) participated in the randomized controlled trial with a 10-week intervention and 10-week follow-up period. The intervention group (IG: n = 29) took part in a once-weekly exercise program including strength and balance exercises supplemented with an additional stepping exergame training. The control group (CG: n = 29) only performed the strength and balance exercises. Outcome measures included stepping reaction times (SRTs) and games scores for individual stepping exergame levels and for the overall exergame performance, as measured by an assessment strategy previously validated in older adults. Results SRTs and/or games scores for 7 out of 10 levels and the overall exergame performance significantly improved in the IG compared to the CG during the intervention (p ≤ 0.001–0.039, ηp2 = 0.090–0.445). Training gains were sustained for 2 levels and for the overall exergame performance (p = 0.017–0.033, ηp2 = 0.127–0.193). Conclusion The study demonstrates that the additional stepping exergame training effectively and sustainably improves the performance in complex motor-cognitive stepping exergame tasks in older adults, which can be relevant for preventing falls. Future research is needed to evaluate the effectiveness of such training on reducing the number of falls. Trial registration ISRCTN registry, ISRCTN14855620, 06/06/2019 (retrospectively registered).

scholarly journals A Randomized Controlled Trial to Evaluate Interventions Designed to Improve University Students' Subjective Financial Wellness in the United Kingdom

2020 ◽  
Vol 31 (2) ◽  
pp. 296-312
Author(s):  
Kelly Ann Schmidtke ◽  
Antony Elliott ◽  
Krishane Patel ◽  
Derek King ◽  
Ivo Vlaev
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Future Research ◽  
Control Group ◽  
Financial Behaviors ◽  
Randomized Controlled ◽  
Financial Wellness ◽  
Subjective Perceptions ◽  
The United Kingdom

This article describes a randomized controlled trial to evaluate the effectiveness of intervention tools designed to help people save more or spend less money by enhancing their capabilities, motivations, and opportunities. The participants included 177 students from an English University who were randomly allocated to either the Control, Savings-Tool, or Savings+Habit-Tools group. Participants provided with the intervention tool(s) for 4 weeks were more likely to experience improvements in both their financial satisfaction and subjective perceptions than those in the Control group not asked to use either tool. The tools did not significantly affect financial behaviors or objective financial wellness. The discussion examines limitations of the study and discusses avenues for future research such as including a longer follow-up period.

Treatment Fidelity Procedures for an Aphasia Intervention Within a Randomized Controlled Trial: Design, Feasibility, and Results

2020 ◽  
Vol 29 (1S) ◽  
pp. 412-424
Author(s):  
Elissa L. Conlon ◽  
Emily J. Braun ◽  
Edna M. Babbitt ◽  
Leora R. Cherney
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Treatment Protocol ◽  
Treatment Fidelity ◽  
Protocol Adherence ◽  
Study Condition ◽  
Randomized Controlled ◽  
Aphasia Therapy ◽  
Percent Accuracy ◽  
Over Time

Purpose This study reports on the treatment fidelity procedures implemented during a 5-year randomized controlled trial comparing intensive and distributed comprehensive aphasia therapy. Specifically, the results of 1 treatment, verb network strengthening treatment (VNeST), are examined. Method Eight participants were recruited for each of 7 consecutive cohorts for a total of 56 participants. Participants completed 60 hr of aphasia therapy, including 15 hr of VNeST. Two experienced speech-language pathologists delivered the treatment. To promote treatment fidelity, the study team developed a detailed manual of procedures and fidelity checklists, completed role plays to standardize treatment administration, and video-recorded all treatment sessions for review. To assess protocol adherence during treatment delivery, trained research assistants not involved in the treatment reviewed video recordings of a subset of randomly selected VNeST treatment sessions and completed the fidelity checklists. This process was completed for 32 participants representing 2 early cohorts and 2 later cohorts, which allowed for measurement of protocol adherence over time. Percent accuracy of protocol adherence was calculated across clinicians, cohorts, and study condition (intensive vs. distributed therapy). Results The fidelity procedures were sufficient to promote and verify a high level of adherence to the treatment protocol across clinicians, cohorts, and study condition. Conclusion Treatment fidelity strategies and monitoring are feasible when incorporated into the study design. Treatment fidelity monitoring should be completed at regular intervals during the course of a study to ensure that high levels of protocol adherence are maintained over time and across conditions.

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