ABSTRACT
BACKGROUND: Effective emotion regulation (ER) is important to long-term healthy functioning, but little is known about what constitutes effective ER in the moment or how social anxiety symptoms and different strategies influence short-term effectiveness outcomes. METHODS: Intensive ecological momentary data from N = 124 college students illustrate how different ways of operationalizing ER effectiveness leads to different conclusions about the short-term effectiveness of different strategies in daily life. RESULTS: When effectiveness is operationalized as the degree to which participants judged that their ER attempts made them feel better, social anxiety severity was negatively associated with effectiveness, and avoidance-oriented strategies were judged to be less effective than engagement-oriented strategies. In contrast, when effectiveness is operationalized as the degree of change in self-reported affect following ER attempts, social anxiety severity was not related to effectiveness, and avoidance-oriented strategies were more effective than engagement-oriented strategies. Social anxiety and ER strategy type did not interact in either model, regardless of how effectiveness was measured. CONCLUSIONS: The study highlights discrepancies when examining two common but distinct ways of measuring the same overarching effectiveness construct, and raises intriguing questions about how forms of psychopathology that are intimately tied to emotion dysregulation, like social anxiety, moderate different ways of measuring the effectiveness of ER attempts.
Subject(s)
Anxiety/psychology , Emotional Regulation , Phobia, Social/psychology , Emotions , Female , Humans , Male , Psychopathology , Self Report , Students/psychology , Young AdultABSTRACT
OBJECTIVE: Web-based cognitive bias modification for interpretation (CBM-I) can improve interpretation biases and anxiety symptoms but faces high rates of dropout. This study tested the effectiveness of web-based CBM-I relative to an active psychoeducation condition and the addition of low-intensity telecoaching for a subset of CBM-I participants. METHOD: 1,234 anxious community adults (Mage = 35.09 years, 81.2% female, 72.1% white, 82.6% not Hispanic) were randomly assigned at Stage 1 of a sequential, multiple-assignment randomized trial to complete five weekly sessions of CBM-I or psychoeducation on our team's public research website. After the first session, for Stage 2, an algorithm attempted to classify CBM-I participants as higher (vs. lower) risk for dropping out; those classified as higher risk were then randomly assigned to complete four brief weekly telecoaching check-ins (vs. no coaching). RESULTS: As hypothesized (https://doi.org/j2xr; Daniel, Eberle, & Teachman, 2020), CBM-I significantly outperformed psychoeducation at improving positive and negative interpretation biases (Recognition Ratings, Brief Body Sensations Interpretation Questionnaire) and anxiety symptoms (Overall Anxiety Severity and Impairment Scale, Anxiety Scale from Depression Anxiety Stress Scales-Short Form), with smaller treatment gains remaining significant at 2-month follow-up. Unexpectedly, CBM-I had significantly worse treatment dropout outcomes than psychoeducation, and adding coaching (vs. no coaching) did not significantly improve efficacy or dropout outcomes (notably, many participants chose not to interact with their coach). CONCLUSIONS: Web-based CBM-I appears effective, but supplemental coaching may not mitigate the challenge of dropout. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Subject(s)
Anxiety , Cognitive Behavioral Therapy , Humans , Female , Male , Adult , Cognitive Behavioral Therapy/methods , Anxiety/therapy , Internet-Based Intervention , Middle Aged , Internet , Anxiety Disorders/therapy , Patient Dropouts/psychologyABSTRACT
Background: People with HIV in the United States are aging, with risk for negative health outcomes from social isolation. PositiveLinks is a mobile health (mHealth) intervention that includes an anonymous Community Message Board (CMB) for peer-to-peer conversations. We investigated differences in CMB usage and social support between younger (<50 years) and older (≥50) members. Methods: We assessed the relationship between age groups and app use using chi-square tests. CMB posts were analyzed qualitatively to categorize forms of social support. To have a visual understanding of this relationship, we created a network diagram to display interactions among PL members. Results: Among 87 participants, 31 (42.5%) were in the older age group. Older members launched the app more often at 6 months (445.5 vs. 240.5 mean launches per participant, p ≤ 0.001) and 12 months (712.3 vs. 292.6 launches, p ≤ 0.001) compared with younger members. Older members also demonstrated more CMB posts at 6 months (47.4 vs. 7.6 mean posts per participant, p = 0.02) and 12 months (77.5 vs. 10.6 posts, p = 0.04). Of 1861 CMB posts, 7% sought support and 72% provided support. In addition, the network visualization showed that four participants, who were in the older age group, had more post generation than others and most of their posts provided support. Conclusions: Older PL members demonstrated significantly more app use than younger members, including CMB posts for social support. This durable app engagement indicates that mHealth can enable social connection among people living with chronic disease across the lifespan.
ABSTRACT
The present study assessed target engagement, preliminary efficacy, and feasibility as primary outcomes of a free multi-session online cognitive bias modification of interpretation (CBM-I) intervention for anxiety in a large community sample. High trait anxious participants (N = 807) were randomly assigned to a CBM-I condition: 1) Positive training (90% positive-10% negative); 2) 50% positive-50% negative training; or 3) no-training control. Further, half of each CBM-I condition was randomized to either an anxious imagery prime or a neutral imagery prime. Due to attrition, results from six out of eight sessions were analyzed using structural equation modeling of latent growth curves. Results for the intent-to-treat sample indicate that for target engagement, consistent with predictions, decreases in negative interpretations over time were significantly greater among those receiving positive CBM-I training compared to no-training or 50-50 training, and vice-versa for increases in positive interpretations. For intervention efficacy, the decrease in anxiety symptoms over time was significantly greater among those receiving positive CBM-I training compared to no-training. Interaction effects with imagery prime were more variable with a general pattern of stronger results for those completing the anxious imagery prime. Findings indicate that online CBM-I positive training is feasible and shows some promising results, although attrition rates were very high for later training sessions.
Subject(s)
Cognitive Behavioral Therapy , Anxiety/therapy , Anxiety Disorders/therapy , Bias , Humans , Treatment OutcomeABSTRACT
Poor adherence to long-term therapies for chronic diseases, such as cancer, compromises effectiveness of treatment and increases the likelihood of disease progression, making medication adherence a critical issue in population health. While the field has documented many eers to adherence to medication, it has also come up with few efficacious solutions to medication adherence, indicating that new and innovative approaches are needed. In this paper, we evaluate medication-taking behaviors based on social cognitive theory (SCT), presenting patterns of adherence stratified across SCT constructs in 33 breast cancer survivors over an 8-month period. Findings indicate that medication adherence is a very personal experience influenced by many simultaneously interacting factors, and a deeper contextual understanding is needed to understand and develop interventions targeting non-adherence.