The Effectiveness of an Integrated Treatment for Functional Speech Sound Disorders—A Randomized Controlled Trial

Background: The treatment of functional speech sound disorders (SSDs) in children is often lengthy, ill-defined, and without satisfactory evidence of success; effectiveness studies on SSDs are rare. This randomized controlled trial evaluates the effectiveness of the integrated SSD treatment program PhonoSens, which focuses on integrating phonological and phonetic processing according to the Integrated Psycholinguistic Model of Speech Processing (IPMSP). Methods: Thirty-two German-speaking children aged from 3.5 to 5.5 years (median 4.6) with functional SSD were randomly assigned to a treatment or a wait-list control group with 16 children each. All children in the treatment group and, after an average waiting period of 6 months, 12 children in the control group underwent PhonoSens treatment. Results: The treatment group showed more percent correct consonants (PCC) and a greater reduction in phonological processes after 15 therapy sessions than the wait-list control group, both with large effect sizes (Cohen’s d = 0.89 and 1.04). All 28 children treated achieved normal phonological abilities: 21 before entering school and 7 during first grade. The average number of treatment sessions was 28; the average treatment duration was 11.5 months. Conclusion: IPMSP-aligned therapy is effective in the treatment of SSD and is well adaptable for languages other than German.

A Randomized Control Trial of a Brief Self-Compassion Intervention for Perfectionism, Anxiety, Depression, and Body Image

Objective: Due to a rise in perfectionistic tendencies and growing concerns about the increase in mental health conditions among students this study aimed to examine the effects of a brief intervention in self-compassion on maladaptive perfectionism, anxiety, depression, and body image.Methods: The intervention consisted of four seminars and a silent half-day retreat with short lectures and relevant experiential practices from Mindful Self-Compassion (MSC) and Mindfulness Based Stress Reduction (MBSR). This randomized wait-list control trial was pre-registered at Clinicaltrials.gov (ID: NCT03453437, Unique Protocol ID: UiBMSC2018). University students were randomly assigned to the intervention group and wait-list control group and filled out surveys weekly. A repeated measures analysis of variance (ANOVA) was used to compare the groups pre- and post-treatment. Mixed level modeling was used to analyze changes in all outcome measures over time.Results: Eighty-nine participants completed the intervention. Results of the ANOVA showed significant post-intervention reductions in maladaptive perfectionistic tendencies and symptoms of depression and anxiety, in addition to increased self-compassion and improved body image in the intervention group as compared to the wait-list group. Mixed level modeling showed statistically significant changes in self-compassion, maladaptive perfectionism, adaptive perfectionism, anxiety, and depression but not body image. Only the mixed level modeling showed small but significant changes to adaptive perfectionism, also called strivings. Implications of different changes to maladaptive perfectionism than adaptive perfectionism are discussed.

The Effectiveness of a Job Crafting, Strengths Use, and Deficit Correction Intervention on Employee Proactive Behaviors and Well-Being: A Randomized Controlled Trial

The present study evaluates the effectiveness of a mixed job crafting, strengths use, and deficit correction intervention on the proactive behaviors, work engagement, life satisfaction, and work-life balance of employees working in a home office setting. A two-armed (intervention vs. wait-list control group) randomized controlled trial with three measurement moments (pre-, post-intervention, and one-month follow-up) was designed to reach the study's goal. A sample of 80 participants part of a large multinational pharmaceutical company was randomly assigned to the intervention (n = 45) or wait-list control condition (n = 35). Mixed factorial analyses of variance showed that the combined job crafting, strengths use, and deficit correction intervention positively impacted life satisfaction (d = .47) and seeking challenging job demands (d = .44) in the short-term. There were no significant differences between the two groups regarding the other proactive behaviors, work engagement, or work-life balance. Moderator analyses revealed that autonomy and workload were moderators of the relationship between the intervention effectiveness and several outcomes (e.g., the intervention had a positive effect on the work-life balance of participants with low autonomy). Theoretical and practical implications are discussed.

A Digital Intervention to Alleviate Loneliness and Depression Among Older Persons During the COVID-19 Outbreak

Social distancing has been proven to be effective in reducing infections but may cause ill effects on the mental health of older adults. We evaluated the effects of a short-term virtual group intervention that provided tools to promote better coping, and mitigate adverse mental health effects during the outbreak of the covid-19 pandemic. A Randomized controlled trial tested the effects of a guided intervention comprised of seven online group sessions in which cognitive-behavioral techniques targeting maladaptive beliefs and appraisals were learned and practiced via ZOOM. A total of 82 community-dwelling adults from Israel, aged between 65 - 90 were randomized to either an intervention group (n=64) or a wait-list control group (n=18). Loneliness (UCLA loneliness scale) and depressive symptoms (PHQ-9) were measured pre-intervention, post-intervention, and at 1-month follow-up. The findings showed a significant decrease in loneliness and depression scores in the intervention group with results maintained at 1-month follow-up. There were no significant changes in the wait-list control group. In addition, ten participants (16%) from the intervention group demonstrated a clinically meaningful decrease in depression between baseline and post-intervention, and this was maintained among 7 participants (10%) at 1-month follow-up, compared to only 1 participant (5%) in the control group. Our intervention presents a simple and easy-to-implement tool. Its relevance extends beyond the current pandemic as the skills acquired can be applied in other forms of social crises and during routine life, in order to promote the mental health of older adults who live alone and/or reside in remote areas.

Acceptability and Preliminary Efficacy of a Web- and Telephone-Based Personalised Exercise Intervention for Individuals with Metastatic Prostate Cancer: The ExerciseGuide Pilot Randomised Controlled Trial

Preliminary research has shown the effectiveness of supervised exercise-based interventions in alleviating sequela resulting from metastatic prostate cancer. However, many individuals encounter barriers that limit the uptake of face-to-face exercise. Technology-enabled interventions offer a distance-based alternative. This pilot study aimed to explore the acceptability, safety and preliminary efficacy of a web-based exercise intervention (ExerciseGuide) in individuals with metastatic prostate cancer. Forty participants (70.2 ± 8.5 years) with metastatic prostate cancer were randomised into the 8-week intervention (N = 20) or a wait-list control (N = 20). The intervention arm had access to a computer-tailored website, personalised exercise prescription and remote supervision. ExerciseGuide was deemed acceptable with a score ≥20 on the client satisfaction questionnaire; however, the usability score was just below the pre-specified score of ≥68 on the software usability scale. There were no serious adverse events reported. Moderate-to-vigorous physical activity levels between baseline and follow-ups were significantly higher (10.0 min per day; 95% CI = (1.3–18.6); p = 0.01) in the intervention group compared to wait-list control. There were also greater improvements in step count (1332; 95% CI = (159–2505); p = 0.02) and identified motivation (0.4, 95% CI = (0.0, 0.7); p = 0.04). Our findings provide preliminary evidence that ExerciseGuide is acceptable, safe and efficacious among individuals with metastatic prostate cancer.

Teaching and Practicing Cognitive-Behavioral and Mindfulness Skills in a Web-Based Platform among Older Adults through the COVID-19 Pandemic: A Pilot Randomized Controlled Trial

The outbreak of the COVID-19 pandemic has led to an acceleration in the development of web-based interventions to alleviate related mental health impacts. The current study explored the effects of a short-term digital group intervention aimed at providing cognitive behavioral and mindfulness tools and skills to reduce loneliness and depression and to increase social support among older adults in Israel. This pilot randomized controlled trial included community-dwelling older adults (n = 82; aged between 65–90 years; 80% female) who were randomized either to an intervention group (n = 64) or a wait-list control group (n = 18). The intervention included seven online sessions, over 3.5 weeks. Depression, loneliness, and social support measures were administered at baseline, immediately post-intervention, and at 1-month follow-up. Repeated measures ANOVA revealed statistically and clinically significant reductions in depression in the intervention group, with results maintained at one-month follow-up. Loneliness levels also significantly decreased post-intervention; however, this benefit was not maintained at one-month follow-up. Social support slightly increased both post-intervention and 1-month follow-up—but these changes were not statistically significant. There were no overall changes for the wait-list control group. Our intervention provided promising evidence regarding the effectiveness of an online group intervention to alleviate mental health effects and to promote the coping of older adults during the COVID-19 pandemic. This relatively simple model can be effectively utilized by communities globally to help connect lonely and isolated older inhabitants, both during the pandemic and in more routine times.

Metta-Based Therapy for Chronic Depression: a Wait List Control Trial

Objectives Current treatments for chronic depression have focused on reducing interpersonal problems and negative affect, but paid little attention to promoting prosocial motivation and positive affect. Following this treatment focus, the objective of the present study was to examine whether the combination of metta (Loving Kindness) group meditation and subsequent tailored individual therapy focusing on kindness towards oneself and others (metta-based therapy, MBT) shows greater improvements in depressive symptoms than a wait list control group in patients with chronic depression. Methods Forty-eight patients with DSM-5 persistent depressive disorder were randomly assigned to MBT or a wait list control condition. Outcome was assessed after group meditation, after subsequent individual therapy, and at 6-month follow-up. The primary outcome measure was an independent blind rating of depressive symptoms at post-test. Secondary outcome included changes in self-reported depression, behavioral activation, rumination, social functioning, mindfulness, compassion, and clinician-rated emotion regulation. Results Mixed-design analyses showed significant differences between MBT and WLC in changes from pre- to post-test in clinician-rated and self-rated depression, behavioral activation, rumination, social functioning, mindfulness, and emotion regulation. Most of the changes occurred during group meditation and were associated with large effect sizes. Improvements were maintained at 6-month follow-up. Conclusions The results provide preliminary support for the effectiveness of MBT in treating chronic depression. Trial Registration ISRCTN, ISRCTN97264476.

Overcoming Automaticity Through Meditation

Objectives Meditation practice has recently moved into applied research to improve cognitive functions. However, it is a multifaceted practice, with focused attention meditation relying on a sharp focus, and open monitoring meditation relying on a diffuse awareness. This study aims to assess the effects of differential alterations of cognition following distinct meditative training and focuses on practitioners’ tendency to fall victim to erroneous automaticity in responding when faced with cognitive conflict. Methods Seventy-three individuals were randomly assigned to one of three intervention groups (internally focused attention meditation, externally focused attention meditation, open monitoring meditation) or a wait list control group. The meditation groups were trained over the course of 4 weeks and eight sessions. Changes in proneness to erroneous automatic responding were tested using two cognitive performance tasks that induce learned or instructed automaticity (Dot Pattern Expectancy paradigm, NEXT-paradigm). Results Overall, meditation training generally improved overcoming learned automaticity (rs = .26–.36, ps = .002–.031) but not instructed automaticity compared to the control condition. Furthermore, data suggest open monitoring outperformed focused attention in overcoming learned automaticity in one task (rs = .31–.56, ps ≤ .001–.009). Conclusions Our results provide evidence for meditative training to facilitate practitioners’ ability to select the most appropriate course of action against overlearned habits in light of the peculiarities of their current situation. Open monitoring meditation is a particularly promising avenue for reducing one’s liability to erroneous habits.

Comparison of three different exercise training modalities (aerobic, strength and mixed) in patients with schizophrenia: study protocol for a multicentre randomised wait-list controlled trial

IntroductionNumerous studies support the practice of different physical exercise modalities as an effective treatment to address the problems associated with schizophrenia, reporting that they result in improvements in patient symptoms and quality of life. Given the lack of studies comparing different types of training in controlled environments, the aim of this proposed study will be to compare the effects of three physical exercise programmes (strength, aerobic and mixed) on the symptoms, body composition, level of physical activity and health-related quality of life of patients with schizophrenia.Methods and analysisA multicentre, single-blinded (evaluator), randomised, wait-list controlled (ratio 2:2:2:1) trial will be conducted with 105 patients recruited from different psychosocial care centres. The participants will be randomised into three 16-week training groups comprising 48 sessions lasting 1 hour each, or to the wait-list control group. The training groups will complete aerobic, strength or mixed (aerobic+strength) training. The participants will be assessed before, immediately after and 6 months after the end of the intervention. The patients in the wait-list control group (n=15) will receive one of the three trainings immediately after the intervention. The study variables will include positive, negative and general symptomology (Positive and Negative Syndrome Scale) as the primary outcome; as secondary outcome: body composition (by assessing body mass index, body fat mass and waist circumference), physical activity levels (International Physical Activity Questionnaire-Short Form) and quality of life (abbreviated WHO Quality of Life questionnaire).Ethics and disseminationThis study was approved by the ethics committees for Biomedical Research at the CEU Cardenal Herrera University of Valencia, Spain (CEI18/215). Participants will be fully informed of the purpose and procedures of the study, and written informed consent will be obtained. The results from this study will be published in peer-reviewed journals and presented in scientific conferences.Trial registration numberNCT04987151.

Abstract P207: Sleep Hygiene As An Intervention To Improve Autonomic Function

Introduction: Insufficient sleep is associated with increased heart rate (HR) and blood pressure (BP). Exaggerated cardiovascular reactivity to the cold pressor test (CPT) has been linked to an increased incidence of hypertension. This project investigates the effects of improved sleep hygiene on autonomic function at rest and in response to CPT. We hypothesize a decrease in BP and HR at rest, and attenuated BP and HR response during CPT. Methods: Fifty participants (59.8 ± 1.5 years; 31 women) completed 3 overnight in-hospital stays in which they had continuous ECG and beat-to-beat BP monitoring. The first stay (S1) was a baseline control; the second stay (S2) was a 4-week wait-list control; the third stay (S3) followed an 8-week randomly assigned intervention that used sleep hygiene approaches along with scheduling to either A) stabilize sleep timing, or B) stabilize and extend the bed period. This study is still ongoing, so we are blind to the specific arm that the participants were randomized to. During each stay, autonomic testing was performed about four hours after the participant awoke, including a 5-minute resting period where breathing was controlled (BL), a 3-minute resting period where breathing was not controlled (CPT BL), and 2-minute CPT when participants then submerged their hand in 3°C water. Linear mixed models analyzing the changes in HR and systolic BP (SBP) across the three stays were used. Results: During the 5-minute BL, HR did not significantly decrease from S1 to S2 (p=.310) but did significantly decrease by 2 bpm from S2 to S3 (p=.006). SBP decreased by 7 mmHg from S1 to S2 (p=.022) but did not significantly decrease from S2 to S3 (p=.907). During CPT in all stays, HR and SBP significantly increased compared to CPT BL (p<0.05). There was a significant stay x test interaction effect in HR (interaction, p=.042), but not in SBP (interaction p=.361). Conclusion: While we are still blind to condition, both arms actively improve sleep hygiene. These preliminary data suggest that stabilization of sleep timing and possibly duration, has a positive impact on autonomic function as seen through the decreases in HR at rest and during CPT.