An experimental therapeutics test of whether adding dissonance-induction activities improves the effectiveness of a selective obesity and eating disorder prevention program.

OBJECTIVE: Compare the Healthy Weight obesity and eating disorder prevention program, which promotes participant-driven gradual lifestyle changes to bring energy intake and expenditure into balance, to a new intervention, Project Health, which adds activities to create cognitive dissonance about unhealthy eating, a sedentary lifestyle, and excess body fat, and an obesity education video-control condition. METHOD: College students at risk for both outcomes because of weight concerns (N=364, 72% female) were randomized to condition, completing pretest, posttest, and 6, 12 and 24-month follow-up assessments. RESULTS: Project Health participants showed significantly smaller increases in measured body mass index (BMI) through 2-year follow-up than both Healthy Weight participants and controls (both d=-0.18), and significantly lower onset of overweight/obesity over 2-year follow-up than Healthy Weight participants and controls (13 vs 21% and 22%). Healthy Weight and Project Health participants showed significantly greater eating disorder symptom reductions than controls through 2-year follow-up. Healthy Weight and Project Health participants showed marginally lower eating disorder onset over follow-up than controls (3 and 3% vs 8% respectively). CONCLUSIONS: The reduced increases in BMI and future overweight/obesity onset for Project Health relative to both an active matched intervention and a minimal intervention control condition are noteworthy, especially given the short 6-h intervention duration. The reduction in eating disorder symptoms for Healthy Weight and Project Health relative to controls was also encouraging. Results suggest that adding dissonance-induction activities increased weight loss effects. Yet, effects for both were generally small and the eating disorder onset prevention effects were only marginal, potentially because intervention groups included both sexes, which reduced eating disorder incidence and sensitivity.

A computer-assisted depression intervention in primary care.

BACKGROUND: The clinical benefit for depression of an interactive computer-assisted cognitive-behavioral program on CD-ROM, the Wellness Workshop (WW), was evaluated in a randomized controlled trial. METHOD: A total of 191 individuals referred by primary-care physicians were randomly assigned to a control group, where physician-directed treatment as usual (TAU) was provided, or to a treatment group, where TAU was supplemented with the WW CD-ROM, delivered by mail (WW+TAU). Data were collected at baseline, at 6 weeks' post-intervention, and at a 6-month follow-up assessment. Participants were given a strong incentive by a reimbursement of $75 for completion of each assessment. Measures included symptom ratings obtained via structured clinical diagnostic interviews, as well as a battery of self-report questionnaires on symptoms specifically targeted by the intervention. RESULTS: Analysis of results demonstrated evidence for skill acquisition for improving dysfunctional thinking and reducing anxiety. Among those who met diagnostic criteria for depression, WW+TAU participants were three times more likely to remit at 6 weeks' post-test than TAU participants. CONCLUSIONS: The evidence supports the conclusion that the WW intervention added benefit to traditional care for depression. No placebo comparison group was included and the WW+TAU participants received slightly more attention (a supportive telephone contact, ≤ 5 min from a psychologist 2 weeks after receiving the program). Overall, the findings add support to the accumulating evidence for the potential clinical benefit of computer-assisted behavioral health interventions.

Comparative friction of orthodontic wires under dry and wet conditions.

Kinetic coefficients of friction for stainless steel, beta-titanium, nickel-titanium, and cobalt-chromium arch wires were measured on a smooth stainless steel or Teflon surface. A universal materials testing instrument was used to pull 0.017 X 0.025-inch rectangular arch wires through a pneumatically controlled binding surface. Classical friction relationships were evaluated by varying applied normal force--similar to ligature tie force--via this pneumatic control. Coefficients of friction were determined under dry and wet (artificial saliva) conditions. Frictional force values, and thus coefficients of friction, were found to increase with increasing normal force for all materials. Beta-titanium and stainless steel wires sliding against stainless steel, and stainless steel wire on Teflon consistently exhibited the lowest dry friction values. Artificial saliva increased friction for stainless steel, beta-titanium, and nickel-titanium wires sliding against stainless steel. Artificial saliva did not increase friction for cobalt chromium, stainless steel sliding against stainless steel, or stainless steel wire on Teflon compared to the dry condition. Stainless steel and beta-titanium wires sliding against stainless steel and stainless steel wire on Teflon showed the lowest friction values for the wet condition.