Social influence in adolescence: Behavioral and neural responses to peer and expert opinion.

Social influence plays a crucial role during the teen years, with adolescents supposedly exhibiting heightened sensitivity to their peers. In this study, we examine how social influence from different sources, particularly those with varying normative and informational significance, affect adolescents' opinion change. Furthermore, we investigated the underlying neural dynamics to determine whether these two behaviorally similar influences share their neural mechanisms. Twenty-three participants (14-17 years old) gave their opinions about facial stimuli and received feedback from either a peer group or an expert group, while brain responses were recorded using concurrent magnetoencephalography. In a second rating session, we found that participants' opinions changed in line with conflicting feedback, but only when the feedback was lower than their initial evaluation. On the neural level, conflict with peers evoked stronger neural responses than conflict with experts in the 230-400 ms time window and the right frontotemporal magnetometer channels. Nevertheless, there was no greater conformity toward peers. Moreover, conflict compared to no conflict decreased neural oscillations in the beta frequency range (20-26 Hz) at the right frontal and parietal channels. Taken together, our findings do not support the general assumption that adolescent behavior is excessively vulnerable to peer norms, although we found heightened neural sensitivity to peer feedback.

Stress of conscience in healthcare in turbulent times: A longitudinal study.

BACKGROUND: Healthcare workers frequently face ethically demanding situations in their work, potentially leading to stress of conscience. Long-term work intensification (more and more effort demanded year after year), organizational change and COVID-19 may be risk factors concerning stress of conscience. AIMS: The main aim was to investigate the relationship between long-term work intensification and stress of conscience among the personnel in a healthcare organization. Organizational change management was considered a mediator and COVID-19-related work stress a moderator in the association between work intensification and stress of conscience. RESEARCH DESIGN, PARTICIPANTS AND CONTEXT: A total of 211 healthcare district employees participated in a longitudinal survey using questionnaires collected in 2019 (major organizational change in the planning stage) and 2021 (organizational change completed). ETHICAL CONSIDERATIONS: The study was implemented according to the guidelines of the Finnish National Board on Research Integrity. The Finnish instructions were that no review by an ethics committee was necessary because participation was voluntary, informed consent was requested, participants were assured that they were free to withdraw from the longitudinal study at any time and no health data were collected. FINDINGS: Long-term work intensification was associated with more severe stress of conscience. Long-term work intensification was partially mediated through change management to stress of conscience. High COVID-19 stress strengthened the association between long-term work intensification and stress of conscience. CONCLUSIONS: Long-term work intensification must be addressed to reduce stress of conscience in healthcare, otherwise the healthcare system will be vulnerable to changes and crisis. Extra resources for personnel and management should be allocated because of work intensification during organizational change and health crises like the COVID-19 pandemic to alleviate stress of conscience.

Divergent auditory activation in relation to inhibition task performance in children and adults.

Adults and children show remarkable differences in cortical auditory activation which, in children, have shown relevance for cognitive performance, specifically inhibitory control. However, it has not been tested whether these differences translate to functional differences in response inhibition between adults and children. We recorded auditory responses of adults and school-aged children (6-14 years) using combined magneto- and electroencephalography (M/EEG) during passive listening conditions and an auditory Go/No-go task. The associations between auditory cortical responses and inhibition performance measures diverge between adults and children; while in children the brain-behavior associations are not significant, or stronger responses are beneficial, adults show negative associations between auditory cortical responses and inhibitory performance. Furthermore, we found differences in brain responses between adults and children; the late (~200 ms post stimulation) adult peak activation shifts from auditory to frontomedial areas. In contrast, children show prolonged obligatory responses in the auditory cortex. Together this likely translates to a functional difference between adults and children in the cortical resources for performance consistency in auditory-based cognitive tasks.

Profiles of early career insecurity and its outcomes in adolescence: A four-wave longitudinal study.

This study investigated the developmental profiles of perceived early career insecurity (ECI) and their outcomes among adolescents (n = 1416) during a critical educational transition from basic education to upper secondary education. We found three distinct latent profiles with varying amounts of ECI: Profile 1: Moderate and decreasing ECI before the transition (57%); Profile 2: Low-decreasing ECI before the transition but increasing ECI after the transition (31%); and Profile 3: High and stable ECI during the transition (12%). Moreover, the ECI profiles related to school and life satisfaction as well as to school stress and dropout intentions in a meaningful way consistent with the stressor hypothesis. Chronically high and increasing ECI was related to negative outcomes.

Eating behavior dimensions and 9-year weight loss maintenance: a sub-study of the Finnish Diabetes prevention study.

BACKGROUND: Behavioral processes through which lifestyle interventions influence risk factors for type 2 diabetes (T2DM), e.g., body weight, are not well-understood. We examined whether changes in psychological dimensions of eating behavior during the first year of lifestyle intervention would mediate the effects of intervention on body weight during a 9-year period. METHODS: Middle-aged participants (38 men, 60 women) with overweight and impaired glucose tolerance (IGT) were randomized to an intensive, individualized lifestyle intervention group (n = 51) or a control group (n = 47). At baseline and annually thereafter until nine years body weight was measured and the Three Factor Eating Questionnaire assessing cognitive restraint of eating with flexible and rigid components, disinhibition and susceptibility to hunger was completed. This was a sub-study of the Finnish Diabetes Prevention Study, conducted in Kuopio research center. RESULTS: During the first year of the intervention total cognitive (4.6 vs. 1.7 scores; p < 0.001), flexible (1.7 vs. 0.9; p = 0.018) and rigid (1.6 vs. 0.5; p = 0.001) restraint of eating increased, and body weight decreased (-5.2 vs. -1.2 kg; p < 0.001) more in the intervention group compared with the control group. The difference between the groups remained significant up to nine years regarding total (2.6 vs. 0.1 scores; p = 0.002) and rigid restraint (1.0 vs. 0.4; p = 0.004), and weight loss (-3.0 vs. 0.1 kg; p = 0.046). The first-year increases in total, flexible and rigid restraint statistically mediated the impact of intervention on weight loss during the 9-year study period. CONCLUSIONS: Lifestyle intervention with intensive and individually tailored, professional counselling had long-lasting effects on cognitive restraint of eating and body weight in middle-aged participants with overweight and IGT. The mediation analyses suggest that early phase increase in cognitive restraint could have a role in long-term weight loss maintenance. This is important because long-term weight loss maintenance has various health benefits, including reduced risk of T2DM.

Adolescents' stress and depressive symptoms and their associations with psychological flexibility before educational transition.

INTRODUCTION: Relatively little is known about individual differences in adolescent psychological flexibility and its associations with symptoms of stress and depression. This study examined different profiles of adolescent stress and depressive symptoms and their associations with developing psychological flexibility before the critical educational transition. METHODS: The data were derived from a general sample of 740 Finnish ninth-grade adolescents (Mage = 15.7 years, 57% female) who were assessed twice during the final grade of their basic education. The data were analyzed using growth mixture modeling. RESULTS: Four profiles of stress and depressive symptoms were identified during a school year: (1) no stress and no depressive symptoms (None; 69%); (2) mild and decreasing stress and depressive symptoms (Decreasing; 15%); (3) low but increasing stress and depressive symptoms (Increasing; 6%); and (4) high and stable levels of stress and depressive symptoms (High; 10%). The adolescents in these profiles differed from each other in their initial levels and changes of psychological flexibility. The initial level of psychological flexibility was highest in the no-symptom profile group. We observed simultaneous change trends in symptoms and psychological flexibility during a school year. When symptoms decreased, psychological flexibility increased, and when symptoms increased, psychological flexibility decreased. CONCLUSIONS: A bidirectional pattern of relationships between psychological flexibility and psychological symptoms was found. Despite initially high level of skills in psychological flexibility, some adolescents, unexpectedly, experienced increased symptoms of stress and depression during the school year. The results call for further studies to explore in-depth the developmental diversity in adolescents' well-being and its antecedents.

In the shadow of COVID-19: A randomized controlled online ACT trial promoting adolescent psychological flexibility and self-compassion.

Background: Although some adolescents managed to cope well with the challenges brought on by the COVID-19 pandemic, the well-being of many was adversely affected due to school closures, distance education, restrictions on gathering with friends, and limited access to mental health services. Many adolescents reported increased anxiety and depression as well as decreased psychological wellbeing due to the pandemic. Consequently, there is a need for psychological support that exceeds the strained resources available to schools to support young people during times of crisis and societal pressure. Objective: The present study aimed to explore the effects of an online-delivered ACT intervention to promote adolescent psychological flexibility and self-compassion and decrease psychological distress during the second wave of COVID-19 in the fall of 2020. Methods: A total of 348 adolescents aged 15-16 were randomly divided into three equal groups: 1) the iACT student coach + virtual coach group, n = 116; 2) the iACT virtual coach group, n = 116; and 3) the control group with no intervention, n = 116). Among these adolescents, 234 participated in a pre-measurement (iACT, n = 154; control, n = 80; intent-to-treat) and completed measures of psychological flexibility, self-compassion, anxiety, and depression. Results: An investigation of all the adolescents who participated in the pre-measurement (intent-to-treat analysis, n = 234) revealed no significant differences between the three groups with regard to psychological flexibility, self-compassion, and symptoms of anxiety and depression. However, upon combining the two intervention groups and examining the adolescents who completed at least 30% of the Youth Compass program (per-protocol analysis, n = 137), small but significant differences between the iACT intervention and control groups were found regarding the psychological flexibility subscale valued action, self-compassion, and anxiety in favor of the intervention group. Conclusions: Active use of an ACT-based online intervention under adverse circumstances may decrease symptoms of anxiety and increase psychological flexibility skills in adolescents.

Brain dynamics of recommendation-based social influence on preference change: A magnetoencephalography study.

People change their preferences when exposed to others' opinions. We examine the neural basis of how peer feedback influences an individual's recommendation behavior. In addition, we investigate if the personality trait of 'agreeableness' modulates behavioral change and neural responses. In our experiment, participants with low and high agreeableness indicated their degree of recommendation of commercial brands, while subjected to peer group feedback. The associated neural responses were recorded with concurrent magnetoencephalography. After a delay, the participants were asked to reevaluate the brands. Recommendations changed consistently with conflicting feedback only when peer recommendation was lower than the initial recommendation. On the neural level, feedback evoked neural responses in the medial frontal and lateral parietal cortices, which were stronger for conflicting peer opinions. Conflict also increased neural oscillations in 4-10 Hz and decreased oscillations in 13-30 Hz in medial frontal and parietal cortices§. The change in recommendation behavior was not different between the low and high agreeableness groups. However, the groups differed in neural oscillations in the alpha and beta bands, when recommendation matched with feedback. In addition to corroborating earlier findings on the role of conflict monitoring in feedback processing, our results suggest that agreeableness modulates neural processing of peer feedback.

Associations Between Sympathetic Nervous System Synchrony, Movement Synchrony, and Speech in Couple Therapy.

Background: Research on interpersonal synchrony has mostly focused on a single modality, and hence little is known about the connections between different types of social attunement. In this study, the relationship between sympathetic nervous system synchrony, movement synchrony, and the amount of speech were studied in couple therapy. Methods: Data comprised 12 couple therapy cases (24 clients and 10 therapists working in pairs as co-therapists). Synchrony in electrodermal activity, head and body movement, and the amount of speech and simultaneous speech during the sessions were analyzed in 12 sessions at the start of couple therapy (all 72 dyads) and eight sessions at the end of therapy (48 dyads). Synchrony was calculated from cross-correlations using time lags and compared to segment-shuffled pseudo synchrony. The associations between the synchrony modalities and speech were analyzed using complex modeling (Mplus). Findings: Couple therapy participants' synchrony mostly occurred in-phase (positive synchrony). Anti-phase (negative) synchrony was more common in movement than in sympathetic nervous system activity. Synchrony in sympathetic nervous system activity only correlated with movement synchrony between the client-therapist dyads (r = 0.66 body synchrony, r = 0.59 head synchrony). Movement synchrony and the amount of speech correlated negatively between spouses (r = -0.62 body synchrony, r = -0.47 head synchrony) and co-therapists (r = -0.39 body synchrony, r = -0.28 head synchrony), meaning that the more time the dyad members talked during the session, the less bodily synchrony they exhibited. Conclusion: The different roles and relationships in couple therapy were associated with the extent to which synchrony modalities were linked with each other. In the relationship between clients and therapists, synchrony in arousal levels and movement "walked hand in hand", whereas in the other relationships (spouse or colleague) they were not linked. Generally, more talk time by the therapy participants was associated with anti-phase movement synchrony. If, as suggested, emotions prepare us for motor action, an important finding of this study is that sympathetic nervous system activity can also synchronize with that of others independently of motor action.

Nonverbal Synchrony in Couple Therapy Linked to Clients' Well-Being and the Therapeutic Alliance.

Nonverbal synchrony between individuals has a robust relation to the positive aspects of relationships. In psychotherapy, where talking is the cure, nonverbal synchrony has been related to a positive outcome of therapy and to a stronger therapeutic alliance between therapist and client in dyadic settings. Only a few studies have focused on nonverbal synchrony in multi-actor therapy conversations. Here, we studied the synchrony of head and body movements in couple therapy, with four participants present (spouses and two therapists). We analyzed more than 2000min of couple therapy videos from 11 couple therapy cases using Motion Energy Analysis and a Surrogate Synchrony (SUSY), a procedure used earlier in dyadic psychotherapy settings. SUSY was calculated for all six dyads per session, leading to synchrony computations for 66 different dyads. Significant synchrony occurred in all 29 analyzed sessions and between the majority of dyads. Complex models were used to determine the relations between nonverbal synchrony and the clients' well-being and all participants' evaluations of the therapeutic alliance. The clients' well-being was related to body synchronies in the sessions. Differences were found between the clients' and therapists' alliance evaluations: the clients' alliance evaluations were related to synchrony between both dyads of opposite gender, whereas the therapists' alliance evaluations were related to synchrony between dyads of the same gender, but opposite to themselves. With four participants present, our study introduces a new aspect of nonverbal synchrony, since as a dyad synchronizes, the other two participants are observing it. Nonverbal synchrony seems to be as important in couple therapy as in individual psychotherapy, but the presence of multiple participants makes the patterns more complex.

Physical activity and aerobic fitness show different associations with brain processes underlying anticipatory selective visuospatial attention in adolescents.

Current knowledge about the underlying brain processes of exercise-related benefits on executive functions and the specific contributions of physical activity and aerobic fitness during adolescence is inconclusive. We explored whether and how physical activity and aerobic fitness are associated with the oscillatory dynamics underlying anticipatory spatial attention. We studied whether the link between physical exercise level and cognitive control in adolescents is mediated by task-related oscillatory activity. Magnetoencephalographic alpha oscillations during a modified Posner's cueing paradigm were measured in 59 adolescents (37 females and 22 males, 12-17 years). Accelerometer-measured physical activity and aerobic fitness (20-m shuttle run test) were used to divide the sample into higher- and lower-performing groups. The interhemispheric alpha asymmetry during selective attention was larger in the high than in the low physical activity group, but there was no difference between the high and low aerobic fitness groups. Exploratory mediation analysis suggested that anticipatory interhemispheric asymmetry mediates the association between physical activity status and drift rate in the selective attention task. Higher physical activity was related to increased cue-induced asymmetry, which in turn was associated with less efficient processing of information. Behaviorally, more physically active males showed stronger dependence on the cue, while more fit females showed more efficient processing of information. Our findings suggest that physical activity may be associated with a neural marker of anticipatory attention in adolescents. These findings might help to explain the varying results regarding the association of physical activity and aerobic fitness with attention and inhibition in adolescents.

Intra-individual dynamics of lesson-specific engagement: Lagged and cross-lagged effects from one lesson to the next.

BACKGROUND: Student engagement denotes active participation in academic work through commitment and involvement in learning tasks (Appleton et al., 2006, Journal of School Psychology, 44, 427). This study looks at questions such as whether engagement experiences in one lesson have an effect on the next lesson. In the present study, process-oriented analyses were conducted to examine lower secondary school students' engagement experiences and the stability of those experiences from one lesson to the next. AIMS: (1) To what extent are students' engagement experiences, in terms of behavioural and cognitive engagement, emotional engagement, and disaffection, stable from one lesson to the next (autoregressive cyclic effects)? (2) What are the cross-lagged relationships (dynamic effects) between engagement experiences from one lesson to the next? SAMPLE: The sample consisted of 56 Finnish lower secondary school students. The students provided ratings of their engagement experiences at the end of each lesson for one week (5 days, 975 ratings). Each student rated, on average, 17.4 lessons (SD = 5.67). METHODS: We specified multilevel dynamic structural equation models with random slopes. RESULTS: The models showed small significant sustainability in behavioural and cognitive engagement, emotional engagement, and disaffection from one lesson to the next, regardless of subject matter and teacher continuity. Higher behavioural and cognitive engagement in a lesson also had a self-diminishing effect on disaffection. CONCLUSIONS: The present study provides valuable information to teachers by showing that an experience in one lesson can have an effect on subsequent ones.

The Profiles of Body Image Associate With Changes in Depression Among Participants in Dance Movement Therapy Group.

This mixed-methods study analyzed the body image quality of 143 patients with depression. The participants received a 20 × 75 min dance movement therapy (DMT) group treatment, sessions twice a week. Body Image Assessment (BIA) was the data collection tool, with pre-, post-, and 3-mos follow-up assessments. Pre-intervention body image quality characteristics were low energy and activity levels, discomfort, shame and disgust toward the body, tension in social interactions. On the BIA scores, a statistical method of Latent Profile Analysis was utilized to identify participant profiles in the data. The two identified profiles were participant with initial negative body image and participant with initial neutral body image. Depression symptoms were measured with BDI, and symptoms decreased for both participant profiles following the DMT intervention. The neutral profile participants had a significantly lower depression level, better energy level, and more frequently used mindfulness factors of acting aware, non-judgmentality and non-reactivity (measured with FFMQ). Findings suggest a systemic interaction between depression symptoms, body image, attachment style, activity level, and mindfulness skills. In an interactive DMT setting it is possible to address all of these factors simultaneously.

Examining mediators of change in wellbeing, stress, and depression in a blended, Internet-based, ACT intervention for university students.

A coach-guided Acceptance and Commitment Therapy (ACT) intervention that uses a blended approach of two face-to-face and five online sessions (iACT; N = 33) has been found to be more effective than a waiting-list control condition (WLC; N = 35) at enhancing the wellbeing of university students while also reducing stress and depression. The present study explored possible mediators of change that may account for the outcomes of the study. Mediation analyses revealed that changes in the non-reactivity subscale of mindfulness mediated changes in wellbeing, depression, and stress in the iACT group. In addition, changes in the sense of coherence subscale of meaningfulness mediated changes in all outcomes. Psychological flexibility and cognitive defusion did not mediate changes in outcomes. The results suggest that the use of practices focusing on non-reactivity, meaning the ability to allow thoughts and feelings to come and go without getting carried away by them, is especially important for enhancing the wellbeing of university students. A focus on enhancing meaningfulness also plays a significant role in reducing psychological distress. These findings provide a first step toward understanding the potential mechanisms of change taking place in brief, Internet-supported, blended ACT programs.

The Effects of Dance Movement Therapy in the Treatment of Depression: A Multicenter, Randomized Controlled Trial in Finland.

This multicenter research investigates the effects of dance movement therapy (DMT) on participants diagnosed with depression. In total, 109 persons participated in the study in various locations in Finland. The participants were 39 years old, on average (range = 18-64 years), and most were female (96%). All participants received treatment as usual (TAU). They were randomized into DMT + TAU (n = 52) or TAU only (n = 57). The participants in the DMT + TAU group were offered 20 DMT sessions twice a week for 10 weeks in addition to standard care. The measurement points included pretreatment measurement at the baseline, posttreatment measurement at the end of the intervention, and a follow-up measurement 3 months afterward. The observed effects of the intervention among participants in the DMT+TAU group were a greater reduction in depression and in indicators of physical and psychological distress in comparison to the participants who received TAU-only. At the 3-month follow-up, the corrected between-group effect sizes (ESs) were medium and in favor of the DMT + TAU group (d = 0.60-0.72). These results are in line with the increasing number of research studies showing the benefits of DMT intervention among participants with depression, and these results indicate that DMT may improve the effectiveness of standard care. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT04421651.

Teacher-student interaction and lower secondary school students' situational engagement.

BACKGROUND: Prior research has shown that engagement plays a significant role in students' academic learning. AIMS: The present study sought to expand the current understanding of students' engagement by examining how situational engagement during a particular lesson is associated with the observed teacher-student classroom interactions (i.e., emotional support, instructional support, and classroom organization) in the same lesson. SAMPLE: The participants were 709 Grade 7 students (47.7% girls) from 59 classrooms in 26 lower secondary schools and 51 teachers. METHODS: The data consisted of 155 video-recorded lessons (90 language arts and 65 mathematics lessons) coded using the Classroom Assessment Scoring System - Secondary (CLASS-S) observational instrument. Students' self-ratings of their situation-specific engagement were collected using the mobile-based In Situations (InSitu) Instrument at the end of each lesson. The data were analyzed with cross-classified two-level hierarchical modelling. RESULTS AND CONCLUSIONS: The results indicated that emotional support in the classroom was positively associated with students' emotional engagement and help-seeking, whereas classroom organization was associated with students' behavioural and cognitive engagement. Overall, the findings provide novel evidence suggesting that students' engagement can be fostered by supportive teacher-student interactions.

Reducing Stress and Enhancing Academic Buoyancy among Adolescents Using a Brief Web-based Program Based on Acceptance and Commitment Therapy: A Randomized Controlled Trial.

Acceptance and commitment therapy programs have rarely been used as preventive tools for alleviating stress and enhancing coping skills among adolescents. This randomized controlled trial examined the efficacy of a novel Finnish web- and mobile-delivered five-week intervention program called Youth COMPASS among a general sample of ninth-grade adolescents (n= 249, 49% females). The intervention group showed a small but significant decrease in overall stress (between-group Cohen's d = 0.22) and an increase in academic buoyancy (d= 0.27). Academic skills did not influence the intervention gains, but the intervention gains were largest among high-stressed participants. The results suggest that the acceptance and commitment based Youth COMPASS program may be well suited for promoting adolescents' well-being in the school context.

Changes in emotions and personal goals in primiparous pregnant women during group intervention for fear of childbirth.

The changes in emotions, subjective fear of childbirth, and personal goals were examined during a group intervention to treat fear of childbirth (FOC). The objective was to gain a more detailed understanding of the changes occurring during the group intervention of FOC. The changes in emotions, subjective FOC, and personal goals were studied in primiparous pregnant women with severe FOC participating in a group intervention (n = 105). The group intervention contained six sessions during pregnancy and one after childbirth. At every session, the participants filled in a questionnaire regarding their experiences of current positive and negative emotions and the subjective FOC. The participants also set and reported their personal goals in their preparation for childbirth and parenthood. The negative emotions decreased from the beginning of the intervention. The change became significant after the fourth session. The amount of positive emotions increased but became statistically significant only after the delivery. The subjective FOC decreased significantly from the beginning of the intervention. Personal goals shifted from being mainly self-related to being mostly related to parenthood. The group intervention decreased FOC and promoted changes in emotions and personal goals that foster emotional preparedness for childbirth. It seems that the decrease in FOC was made possible through gaining a better capacity to regulate emotions, especially negative emotions. As negative emotions and fear decreased, personal goals simultaneously changed in the direction known to be adaptive for the new life situation as a parent of a newborn.

The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app: a randomized controlled trial.

BACKGROUND: Internal motivation and good psychological capabilities are important factors in successful eating-related behavior change. Thus, we investigated whether general acceptance and commitment therapy (ACT) affects reported eating behavior and diet quality and whether baseline perceived stress moderates the intervention effects. METHODS: Secondary analysis of unblinded randomized controlled trial in three Finnish cities. Working-aged adults with psychological distress and overweight or obesity in three parallel groups: (1) ACT-based Face-to-face (n = 70; six group sessions led by a psychologist), (2) ACT-based Mobile (n = 78; one group session and mobile app), and (3) Control (n = 71; only the measurements). At baseline, the participants' (n = 219, 85% females) mean body mass index was 31.3 kg/m2 (SD = 2.9), and mean age was 49.5 years (SD = 7.4). The measurements conducted before the 8-week intervention period (baseline), 10 weeks after the baseline (post-intervention), and 36 weeks after the baseline (follow-up) included clinical measurements, questionnaires of eating behavior (IES-1, TFEQ-R18, HTAS, ecSI 2.0, REBS), diet quality (IDQ), alcohol consumption (AUDIT-C), perceived stress (PSS), and 48-h dietary recall. Hierarchical linear modeling (Wald test) was used to analyze the differences in changes between groups. RESULTS: Group x time interactions showed that the subcomponent of intuitive eating (IES-1), i.e., Eating for physical rather than emotional reasons, increased in both ACT-based groups (p = .019); the subcomponent of TFEQ-R18, i.e., Uncontrolled eating, decreased in the Face-to-face group (p = .020); the subcomponent of health and taste attitudes (HTAS), i.e., Using food as a reward, decreased in the Mobile group (p = .048); and both subcomponent of eating competence (ecSI 2.0), i.e., Food acceptance (p = .048), and two subcomponents of regulation of eating behavior (REBS), i.e., Integrated and Identified regulation (p = .003, p = .023, respectively), increased in the Face-to-face group. Baseline perceived stress did not moderate effects on these particular features of eating behavior from baseline to follow-up. No statistically significant effects were found for dietary measures. CONCLUSIONS: ACT-based interventions, delivered in group sessions or by mobile app, showed beneficial effects on reported eating behavior. Beneficial effects on eating behavior were, however, not accompanied by parallel changes in diet, which suggests that ACT-based interventions should include nutritional counseling if changes in diet are targeted. TRIAL REGISTRATION: ClinicalTrials.gov ( NCT01738256 ), registered 17 August, 2012.

Cognitive behavioural therapy and mindfulness for stress and burnout: a waiting list controlled pilot study comparing treatments for parents of children with chronic conditions.

BACKGROUND: Parents of children with chronic conditions often experience a crisis with serious mental health problems for themselves as a consequence. The healthcare focus is on the children; however, the parents often worry about their children's health and future but are seldom offered any counselling or guidance. AIM: The aim of this study was to investigate the effectiveness of two group-based behavioural interventions on stress and burnout among parents of children with chronic conditions. DESIGN, PARTICIPANTS AND SETTING: After a waiting list control period (n = 28), parents were offered either a cognitive behavioural (CBT, n = 10) or a mindfulness program (MF, n = 9). RESULTS: Both interventions decreased significantly stress and burnout. The within-group effect sizes were large in both interventions (CBT, g = 1.28-1.64; MF, g = 1.25-2.20). CONCLUSIONS: Hence, the results of this pilot study show that treating a group using either CBT or mindfulness can be an efficient intervention for reducing stress levels and burnout in parents of children with chronic conditions.