Psychological interventions decrease unintended pregnancies: A meta-analysis of randomized controlled trials.

OBJECTIVE: Despite innovations in contraceptive methods, unintended pregnancies remain common. Researchers have examined psychological approaches to decrease unintended pregnancies through contraceptive use. These interventions have involved applying aspects of social cognitive theory, the health belief model and self-determination theory. Research findings on the effects of these psychological approaches show conflicting evidence. The aim of this meta-analysis was to clarify the impact of these psychological interventions on unintended pregnancies DESIGN: Meta-analysis of randomized controlled trials (RCTs) of psychological interventions intended to prevent unwanted pregnancies through an increase in the use of contraceptive methods METHODS: A systematic search of databases and article reference lists led to 26 relevant RCTs with a total of 31,222 participants RESULTS: The odds ratio for pregnancy in the psychological intervention condition = .83, 95% CI [.75, .93]. The results also showed that the longer an intervention's follow-up period was, the less the prevention effect. Quality assessment of included studies indicated that all used a treatment manual and reported attrition. It also showed that most studies reported the reasons for drop-out and assessed the facilitators' adherence to the intervention protocol. The proportion of variability due to chance amongst studies was I2  = 22%. Duval and Tweedie's Trim and Fill showed a difference between the observed and the adjusted values. The adjusted value, representing a conservative estimate of effect size, was OR = .891, 95% CI [.777, .999] CONCLUSIONS: Altogether, these results support the efficacy of psychological interventions aimed at preventing unintended pregnancy through contraception.

The Association between the Five-factor Model of Personality and Problem Gambling: a Meta-analysis.

This meta-analysis examined the associations between five-factor personality model traits and problem gambling. To be eligible for inclusion in the meta-analysis, studies had to provide effect size data that quantified the magnitude of the association between all five personality traits and problem gambling. Studies also had to use psychometrically sound measures. The meta-analysis included 20 separate samples from 19 studies and 32,222 total participants. The results showed that problem gambling was significantly correlated with the five-factor model of personality. The strongest personality correlate of problem gambling was neuroticism r = .31, p = < 0.001, 95% CI [0.17, 0.44], followed by conscientiousness r = - .28, p = < 0.001, 95% CI [-0.38,-0.17] ), agreeableness r = - .22, p = < 0.001, 95% CI [-0.34, - 0.10], openness r = - .17, p = < 0.001, 95% CI [-0.22,-0.12], and extraversion r = - .11, p = .024, 95% CI [-0.20,-0.01]. These results suggest problem gamblers tend to share a common personality profile - one that could provide clues as to the most effective ways to prevent and to treat problem gambling.

Efficacy of psychological interventions for selective mutism in children: A meta-analysis of randomized controlled trials.

BACKGROUND: Selective mutism is a rare childhood anxiety disorder characterized by a consistent failure to speak in certain social situations where speech is expected, despite fluent speech in other situations. The purpose of this meta-analysis was to investigate the efficacy of psychological interventions for selective mutism in randomized controlled trials (RCTs). METHODS: Five RCTs with a total of 233 participants were analysed using a random-effects model. A quality assessment of the included studies revealed that psychometrically sound measures and treatment manuals were used across all studies. RESULTS: The results of the analyses showed psychological interventions to be more effective than no treatment, with the overall weighted effect size of g = 0.87, indicating a large mean treatment effect. This effect did not significantly differ with whether only selective mutism specific or nonselective mutism specific measures were included in the analysis. CONCLUSIONS: These findings provide support for the efficacy of psychological treatment for selective mutism. Future research could examine the effects of the successful treatments identified in this meta-analysis when compared with a psychological placebo or another bona fide treatment.

Trait perspective taking and romantic relationship satisfaction: A meta-analysis.

This meta-analysis evaluated the association between trait perspective taking and romantic relationship satisfaction. The study synthesized the association in 20 separate samples in a total of 18 published and unpublished studies, involving a total of 4,678 participants. The studies were completed by many different research teams, using different samples, different measures, and various correlational research designs. The results showed a significant association between trait perspective taking and romantic relationship satisfaction (r = .21, 95% confidence intervals [.17, .25]). The results did not vary significantly with whether the respondents were men or women, whether they rated their own perspective taking or that of their partner, or whether the perspective taking assessed was general or specific to the partner. The findings provide a basis for future intervention studies that test whether increasing perspective taking has a positive effect on relationship satisfaction. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Meditation and telomere length: a meta-analysis.

Objective: Telomeres are the caps at the end of chromosomes. Short telomeres are a biomarker for worsening health and early death.Design: The present study consolidated research on meditation and telomere length through a meta-analysis of results of studies examining the effect of meditation on telomere length by comparing the telomere length of meditating participants with participants in control conditions.Results: A search of the literature identified 11 studies reporting 12 comparisons of meditating individuals with individuals in control conditions. An overall significant weighted effect size of g =.40 indicated that the individuals in meditation conditions had longer telomeres. When an outlier effect size was trimmed from the analysis, the effect size was smaller, g =.16. Across studies, a greater number of hours of meditation among participants in meditation conditions was associated with larger effect sizes.Conclusion: These findings provide tentative support for the hypothesis that participants in meditation conditions have longer telomeres than participants in comparison conditions, and that a greater number of hours of meditation is associated with a greater impact on telomere biology. The results of the meta-analysis have potential clinical significance in that they suggest that meditation-based interventions may prevent telomere attrition or increase telomere length.

Government-mandated warnings on cannabis legally sold for recreational use.

BACKGROUND: Frequent cannabis use can pose risks to health and safety. Multiple governments have legalized the sale of cannabis for recreational use and mandated health and safety warnings for recreational cannabis packages or signs at sales locations. The purposes of this study were to identify common themes across warnings and to compare the actual warnings with those previously recommended by cannabis experts and cannabis users. METHODS: We searched Google and Google Scholar for online lists of governments that allow or will soon allow the sale of cannabis for recreational use. Using the online lists we found, we searched for laws mandating the warnings, using the search terms "mandated warnings for recreational use marijuana" in addition to the name of the jurisdiction under review. We evaluated the content of the warnings and compared them with warnings recommended by cannabis experts and by users of recreational cannabis. RESULTS: Each search led to millions of results. Within the top results of each of the searches there were website links to official legislative websites, databases and documents of the jurisdiction under review. We used these official documents. The search revealed that 11 U.S. states and two countries allow the recreational use of cannabis and that 10 U.S. states and Canada mandate warnings on legally sold recreational cannabis. The mandated warnings can be categorized as focusing on one of nine risks: (1) negative health effects on the user, (2) harm to children or fetuses, (3) risks related to driving or operating machinery, (4) risks of habit formation leading to over-use, (5) risks relating to over-use on a single occasion, especially with regard to edible cannabis, (6) developmental risks for young people, (7) harm caused by secondary smoke, (8) risks of effects lasting several hours, and (9) risks specific to using cannabis topicals. The warnings include no graphic images and no phone number to call for help quitting. CONCLUSIONS: The warnings, as a group, parallel most warnings recommended by cannabis experts and a sample of recreational users of cannabis. The effects of the warnings are unknown, but prior research findings on warnings for cannabis and for other substances suggest potential for positive effects in raising awareness of risks and decreasing the risks. The warnings could be used in public health campaigns. Public health professionals may find it possible through research to help improve the warnings, either in presentation or in content. Cannabis researchers can use the list to identify additional risks suitable for inclusion in mandated warnings.

The Relationship Between Childhood Psychosocial Stressor Level and Telomere Length: A Meta-Analysis.

This meta-analysis examined the association between the level of childhood psychosocial stressors and telomere length, an important health biomarker. The meta-analysis, including 27 samples and 16,238 participants, found a significant association of -0.08 between a higher level of childhood stressors and shorter telomere length at a mean age of 42 across studies. Moderator analyses showed a trend in the direction of effect sizes being significantly larger with shorter times between the stressors and telomere measurement. Moderator analyses showed significantly higher effect sizes for studies that used a categorical method for assessing child stressor level and for assays completed with qPCR rather than with the Southern blot method. There was no significant moderation of effect size by whether study assayed leukocytes or buccal cells, whether the study assessed child stressor level by memory-based recall versus archival records, and whether the study controlled for age, sex, or additional variables. The results, focused on childhood events, add to prior findings that perceived stress and negative emotions are associated with telomere length.

A meta-analysis of the relationship between anxiety and telomere length.

BACKGROUND AND OBJECTIVES: Telomeres are protective caps at the ends of chromosomes, and shorter telomeres are associated with poor physical health. The present study set out to consolidate the varying effect sizes found so far in studies of anxiety and telomere length. DESIGN AND METHODS: A meta-analytic investigation of the relationship between anxiety and telomere length used information from 17 different samples comprising a total of 19,424 participants. RESULTS: The results showed a small but significant association, r = -.06, between higher anxiety and shorter telomeres. Studies comparing individuals diagnosed with an anxiety disorder with other individuals had a significant effect size, and studies that did not use this comparison threshold did not have a significant effect size. CONCLUSIONS: Anxiety is associated with an important biomarker related to health. Future experimental studies that examine the impact of interventions intended to reduce anxiety in conjunction with measurement of telomere length can further clarify the impact of anxiety on telomere length.

Cannabis Users' Recommended Warnings for Packages of Legally Sold Cannabis: An Australia-Centered Study.

Introduction: Although cannabis use creates health risks, governments have recently been legalizing either medical use or leisure use. These governments can mandate health warnings on cannabis packages. Prior research examined recommended warnings of cannabis experts. The aim of this study was to obtain suggested cannabis health and safety warnings from cannabis users. Methods: We used a media release, Facebook postings, and announcements in university classes to seek individuals who had used cannabis at least once according to their own report. Using online data collection software that keeps participants anonymous, we asked the individuals to suggest a warning that governments could mandate on cannabis packages. Results: In total, 288 users suggested warnings. Categorizing the warnings into content categories led to six warning topics: (1) risk of harm to mental health and psychological functioning; (2) risk of operating machinery while under the influence; (3) short-term physical side effects; (4) responsible use; (5) long-term negative physical effects; and (6) dependence, addiction, or abuse. The user-suggested warnings overlapped with six expert-recommended warnings identified in prior survey research and included two content areas that did not feature in expert-recommended warnings: short-term physical side effects and the importance of responsible use. Conclusions: The results are consistent with prior findings that some youths perceive cannabis use as potentially harmful. The current findings provide possible new content for warnings on cannabis packages.

The efficacy of empathy training: A meta-analysis of randomized controlled trials.

[Correction Notice: An Erratum for this article was reported in Vol 63(1) of Journal of Counseling Psychology (see record 2015-58774-003). In the article, the last name of author Emily Teding van Berkhout was incorrectly set in the running head as van Berkhout. It should be Teding van Berkhout. All versions of this article have been corrected.] High levels of empathy are associated with healthy relationships and prosocial behavior; in health professionals, high levels of empathy are associated with better therapeutic outcomes. To determine whether empathy can be taught, researchers have evaluated empathy training programs. After excluding 1 outlier study that showed a very large effect with few participants, the meta-analysis included 18 randomized controlled trials of empathy training with a total of 1,018 participants. The findings suggest that empathy training programs are effective overall, with a medium effect (g = 0.63), adjusted to 0.51 after trim-and-fill evaluation for estimated publication bias. Moderator analyses indicated that 4 factors were statistically significantly associated with higher effect sizes: (a) training health professionals and university students rather than other types of individuals, (b) compensating trainees for their participation, (c) using empathy measures that focus exclusively on assessing understanding the emotions of others, feeling those emotions, or commenting accurately on the emotions, and (d) using objective measures rather than self-report measures. Number of hours of training and time between preintervention assessment and postintervention assessment were not statistically significantly associated with effect size, with 6 months the longest time period for assessment. The findings indicate that (a) empathy training tends to be effective and (b) experimental research is warranted on the impact of different types of trainees, training conditions, and types of assessment. (PsycINFO Database Record

The Relationship Between Perceived Stress and Telomere Length: A Meta-analysis.

Telomeres protect the ends of chromosomes, and short telomere length is associated with poor health and mortality. This study reports a meta-analytic investigation of the relationship between perceived stress and telomere length, including results from eight studies with a total of 1143 participants. A meta-analytic effect size of r = -0.25, p < 0.001, indicated that higher levels of perceived stress were associated with shorter telomere length. Examination of the studies for moderators of effect size identified some significant moderators, such as a difference in effect sizes between samples comprised of only women and mixed-sex samples. These results are only suggestive as they are based on a small set of studies, and funnel plot analyses indicated a publication bias. A significant relationship between more perceived stress and shorter telomere length is consistent with theoretical frameworks positing that stress induces physiological changes that result in shortened telomeres. Copyright © 2014 John Wiley & Sons, Ltd.

Assessing Police Classifications of Sexual Assault Reports: A Meta-Analysis of False Reporting Rates.

The objective of the study was to determine, through meta-analysis, the rate of confirmed false reports of sexual assault to police. The meta-analysis initially involved a search for relevant articles. The search identified seven studies where researchers or their trained helpers evaluated reported sexual assault cases to determine the rate of confirmed false reports. The meta-analysis calculated an overall rate and tested for possible moderators of effect size. The meta-analytic rate of false reports of sexual assault was .052 (95 % CI .030, .089). The rates for the individual studies were heterogeneous, suggesting the possibility of moderators of rate. However, the four possible moderators examined-year of publication, whether the data set used had information in addition to police reports, whether the study was completed in the U.S. or elsewhere, and whether inter-rater reliabilities were reported-were all not significant. The meta-analysis of seven relevant studies shows that confirmed false allegations of sexual assault made to police occur at a significant rate. The total false reporting rate, including both confirmed and equivocal cases, would be greater than the 5 % rate found here.

The association between depression and leukocyte telomere length: a meta-analysis.

BACKGROUND: Telomeres protect the ends of chromosomes, and shorter leukocyte telomeres are associated with poor health. Depression may be associated with the shortening of leukocyte telomeres. The present study set out to consolidate the varying effect sizes found so far in studies of depression and telomere length and to identify moderators of the relationship between depression and telomere length. METHODS: A meta-analytic investigation of the relationship between depression and leukocyte telomere length used information from 21,040 participants. RESULTS: A significant effect size, r = -.12, P < .001, indicated that depression was associated with shorter telomere length. Several variables significantly moderated effect size. Concurrent associations (k = 25) between depression and telomere length were significantly stronger than longitudinal associations (k = 5). Studies that used the Southern blot (k = 3) and fluorescent in situ hybridization (FISH; k = 2) assays to measure telomere length showed larger effect sizes than studies that used quantitative polymerase chain reaction (qPCR; k = 25). Finally, study reports that indicated that the telomere assays were conducted blind to depression level of participants (k = 11) had significantly lower effect sizes than those of other studies (k = 19). CONCLUSIONS: The significant relationship between depression and shorter telomere length is consistent with a theoretical model positing that distress, such as experienced in depression, results in physiological changes leading to shortened telomeres.

Effects of online cognitive treatment for problematic anger: a randomized controlled trial.

Problematic anger, which is common, has been associated with a wide range of negative interpersonal and intrapersonal consequences, including violent behaviour, relationship damage, health problems and low self-esteem. This article reports the results of the first randomized controlled trial of brief online cognitive treatment for anger. The sample included 75 adults who were randomly assigned to cognitive treatment or a waiting list control. The analyses with the 59 participants who completed the post-intervention assessment at four weeks after the beginning of the intervention showed that individuals who received the intervention reported significantly lower anger levels than the control group at post-assessment. The treatment group showed a substantial decrease in anger from pre to post. The results suggest that brief online cognitive treatment can be effective for reducing problematic anger in adults. These findings provide an initial support for the development of internet-based cognitive treatment for problematic anger.

Experiences of marijuana-vaporizer users.

BACKGROUND: Using a marijuana vaporizer may have potential harm-reduction advantages on smoking marijuana, in that the user does not inhale smoke. Little research has been published on use of vaporizers. METHODS: In the first study of individuals using a vaporizer on their own initiative, 96 adults anonymously answered questions about their experiences with a vaporizer and their use of marijuana with tobacco. RESULTS: Users identified 4 advantages to using a vaporizer over smoking marijuana: perceived health benefits, better taste, no smoke smell, and more effect from the same amount of marijuana. Users identified 2 disadvantages: inconvenience of setup and cleaning and the time it takes to get the device operating for each use. Only 2 individuals combined tobacco in the vaporizer mix, whereas 15 combined tobacco with marijuana when they smoked marijuana. Almost all participants intended to continue using a vaporizer. CONCLUSIONS: Vaporizers seem to have appeal to marijuana users, who perceive them as having harm-reduction and other benefits. Vaporizers are worthy of experimental research evaluating health-related effects of using them.

A meta-analytic review of the effects of mindfulness meditation on telomerase activity.

The enzyme telomerase, through its influence on telomere length, is associated with health and mortality. Four pioneering randomized control trials, including a total of 190 participants, provided information on the effect of mindfulness meditation on telomerase. A meta-analytic effect size of d=0.46 indicated that mindfulness meditation leads to increased telomerase activity in peripheral blood mononuclear cells. These results suggest the need for further large-scale trials investigating optimal implementation of mindfulness meditation to facilitate telomerase functioning.

Self-arranged exposure for overcoming blood-injection-injury Phobia: a case study.

Blood-injection-injury (BII) phobia is both common and dangerous, because it can lead to avoidance of medical procedures for diagnosis and treatment. It also tends to prevent individuals from donating blood for use in the healthcare of others. BII phobia often has an unusual characteristic for a type of phobia - fainting. The typical treatment for BII phobia involves teaching the client how to avoid fainting and staging multiple gradual-exposure trials for the client. In this case report, an adult with the phobia obtained initial, mostly written, guidance from a psychologist, arranged her own applied muscle-tension practice sessions to learn how to keep from fainting, created her own fear hierarchy, and staged exposure trials herself, ending years of avoidance of blood withdrawal. By the end of the trials, she was able to give blood for a medical test and to donate blood for the first time in her life and to work as a volunteer at a blood-donation center. The results provide the first evidence that adults with BII phobia can end the phobia by arranging their own sessions of applied-tension practice and gradual self-exposure. The results suggest a new option for treating specific phobias in general with some adults: initial professional guidance followed by self-arranged gradual-exposure trials.

Changes in smoking level after viewing graphic cigarette warnings: preliminary findings.

BACKGROUND AND OBJECTIVES: Some countries require graphic warnings on cigarette packages, and other countries, including the United States, may follow that lead. A few studies have produced findings suggesting that graphic warnings may have effects on smoking-related attitudes and behaviors. The objective of the present study was to gather evidence on the effects of graphic warnings on smoking level and related behavior. METHODS: This study was conducted with 89 adult smokers in the United States to examine the effects of warnings that included graphic images of cosmetically important physical harm caused by smoking. Participants completed measures of smoking level and cessation-related behavior before and after viewing 4 weekly health warnings about smoking, each with a graphic image showing cosmetically important health harm caused by smoking. RESULTS: The study results showed significant improvement on all measures, providing pre-post evidence of a significant decrease in smoking level after viewing graphic and written warnings. The more participants perceived the warnings as distressing and useful, the more their smoking decreased. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: The study findings provide preliminary evidence that graphic warnings can lead to increases in cessation-related behavior and decreases in level of smoking.

Expert-recommended warnings for medical marijuana.

Medical marijuana is legal in some countries, including in many US states. At present, there are no government-mandated warnings on packages of marijuana, even though the substance has dangers similar to those of alcohol, tobacco, and various prescribed drugs. This article reports the results of an effort to collect marijuana warnings recommended by scientific experts on marijuana. The recommended warnings, the first ever from marijuana experts, come from 13 experts. The expert-recommended warnings pertain to risks relating to (1) safety, (2) physical health, (3) fetal harm, (4) mental health, (5) withdrawal and dependence, and (6) adolescent development. The results provide initial expert recommendations for warnings to be required on packages of medical marijuana.

The nature of well-being: the roles of hedonic and eudaimonic processes and trait emotional intelligence.

The present study reconceptualized the role of hedonic (pleasure) and eudaimonic (engagement) functions as well-being processes and distinguished them from well-being outcomes. Well-being outcomes encompass life satisfaction, positive affect, psychological well-being, social well-being, subjective physical health, and absence of depression, anxiety, and stress. It was hypothesized that trait emotional intelligence (EI) would mediate the relationship between well-being processes and well-being outcomes. Participants (N = 370, mean age = 27.35 years, SD = 10.01) completed measures of hedonic and eudaimonic well-being processes, trait EI, and well-being outcome indices. Path analysis using structural equation modeling showed that trait EI fully mediated the relationship between hedonic and eudaimonic processes and well-being outcomes. Results demonstrated that engagement in meaningful activities as captured by hedonic and eudaimonic well-being processes may promote well-being outcomes.