Self-help Cognitive Behavioral Therapy Improves Health-Related Quality of Life for Inflammatory Bowel Disease Patients: A Randomized Controlled Effectiveness Trial.

Patients with inflammatory bowel disease (IBD) often have poor health-related quality of life (HRQL) and are at risk for anxiety and depression. Cognitive behavioral therapy (CBT) can help patients with IBD cope with their disease. Unfortunately, barriers to care include expense and availability of qualified therapists. Stand-alone, self-help CBT could improve access to care. This study examined the effectiveness of a self-help CBT workbook for patients with IBD. A randomized controlled trial compared the CBT workbook to an active psychoeducational control workbook. A total of 140 participants enrolled. In both groups, scores improved on a range of measures, including catastrophizing, visceral sensitivity, and HRQL, although pre-post effect sizes were generally larger in the CBT group. Only participants in the CBT group experienced significant improvements in anxiety and depression. Improvements were generally maintained or consolidated at 3-month follow-up. Self-help CBT can be an effective and inexpensive way to improve HRQL for patients with IBD.

Interactive associations between abstinence plans and romantic partner conflict and support with cigarette smoking.

BACKGROUND: While most individuals who smoke cigarettes desire to quit, quit motivation can change daily and sustained abstinence is rarely achieved in quit attempts. Assessment of psychosocial factors that moderate associations between daily abstinence intentions and smoking behavior is necessary to inform effective cessation efforts. METHODS: A secondary analysis was conducted using data from a 28-day ecological momentary assessment study among individuals who smoke and who were not actively planning a long-term quit attempt (N = 81 individuals; N = 1585 days). We examined main effect and interaction associations between primary predictors (daily abstinence plans and within- and between-person estimates of perceived romantic relationship conflict and support) and daily number of cigarettes smoked, as well as baseline emotion regulation difficulties as a moderator of these associations. RESULTS: Smoking was reduced on days with an abstinence plan (ß=-0.57,p<.001), especially among individuals with lower average levels of conflict (plan × between-person conflict interaction: ß=0.98, p < .001), and higher average levels of support (plan × between-person support interaction: ß=0.26, p < .001). Additionally, smoking was increased on days when participants had higher levels of conflict than usual (ß=0.07, p < .01), but only on days when participants did not have a plan (plan × within-person conflict interaction:ß=-0.10, p < .05). Emotion regulation difficulties did not moderate any associations. CONCLUSION: This study adds to the literature on the influence of negative aspects of social experience on smoking behavior. Further, the present study underlines the importance of assessing the influence of both positive and negative aspects of - and within- and between-person differences in - social experiences.

A Novel Measure of Real-Time Perseverative Thought.

Perseverative thinking (PT), or repetitive negative thinking, has historically been measured using global self-report scales. New methods of assessment are needed to advance understanding of this inherently temporal process. We developed an intensive longitudinal method for assessing PT. A mixed sample of 77 individuals ranging widely in trait PT, including persons with PT-related disorders (generalized anxiety disorder, major depression) and persons without psychopathology, used a joystick to provide continuous ratings of thought valence and intensity following exposure to scenarios of differing valence. Joystick responses were robustly predicted by trait PT, clinical status, and stimulus valence. Higher trait perseverators exhibited more extreme joystick values overall, greater stability in values following threatening and ambiguous stimuli, weaker stability in values following positive stimuli, and greater inertia in values following ambiguous stimuli. The joystick method is a promising measure with the potential to shed new light on the dynamics and precipitants of perseverative thinking.

Interactions between daily abstinence plans and approach/avoidance motivation on cigarette smoking in pre-quit smokers.

Enhancing motivation to quit among smokers who are not ready for cessation is a key component of several interventions. However, there is a dearth of empirical data about motivational factors and smoking behavior among pre-quit smokers. Here, we examined interactions between approach/avoidance goal motivations and daily abstinence plan (i.e., plans to either continue or abstain from smoking) on daily cigarette use. Current smokers (n = 82; M = 11.4 cigs/day; 46% Female) completed a baseline assessment, including a measure of approach/avoidance motivation [Behavioral Inhibition and Behavioral Activation Scales (BIS/BAS)], followed by 28-days of Ecological Momentary Assessment (EMA). EMA included a morning assessment of abstinence plan, and evening assessment of cigarettes smoked. Multilevel linear models tested interactions between BIS/BAS and abstinence plan on cigarette smoking (defined as percent change from within-subject mean). There was a significant abstinence plan × BIS interaction, F(1, 637) = 6.567, p = .011, and abstinence plan × BAS interaction, F(1, 637) = 6.553, p = .011, on cigarette smoking. High BIS and low BAS were each associated with reduced smoking on abstinence days and increased smoking on non-abstinence days. Modest rates of smoking cessation may be due to the unassisted, spontaneous nature of most quit attempts. Among pre-quit smokers, high behavioral inhibition and low behavioral activation may underlie the ability to intentionally vary smoking levels according to individuals' daily abstinence plans. Future studies should examine how motivational factors during the pre-quit stage may predict long-term smoking cessation in the future. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Impact of self-efficacy on daily intention to not smoke.

BACKGROUND: To improve cessation interventions, it is necessary to understand the factors associated with daily motivation to not smoke. One hypothesized factor is self-efficacy; however, there has been a lack of evidence investigating self-efficacy as a dynamic construct. METHODS: This study examined the influence of baseline and daily self-efficacy on setting daily abstinence plans in pre-quit smokers and successful plans. Participants (N = 76) completed measures of self-efficacy at baseline, and each evening during 28 days of ecological momentary assessment. RESULTS: Baseline self-efficacy was not correlated with mean daily rating of self-efficacy or variance in ratings. GLMM found that participants who had higher baseline self-efficacy than others were more likely to set an abstinence plan while participants who had a higher rating of self-efficacy on the previous night than others were more likely to set a plan on any given morning. Participants were less likely to set an abstinence plan if they had smoked on the previous day but were more likely if they had set an abstinence plan on the previous day. Participants were less likely to have a successful plan not to smoke if they smoked on the previous day. CONCLUSIONS: The current data indicates that both baseline rating and day-to-day fluctuations in SE influence daily abstinence plan in pre-quit smokers. Future intervention research could examine the use of methods designed to increase and maintain a person's daily self-efficacy and how this can be leveraged to encourage these smokers to attempt long-term cessation.