Protocol and Outcome Evaluation of Comprehensive Outpatient Treatment of Adolescent Rumination Syndrome.

OBJECTIVES: Rumination syndrome (RS) is an increasingly recognized functional gastrointestinal condition with limited treatment research. Current treatment recommendations emphasize diaphragmatic breathing (DB), despite limited outcomes, and the most robust results have originated from inpatient treatment models. This paper described the protocol for Comprehensive Behavioral Treatment for Rumination Syndrome (CBT-R) utilized in an outpatient setting and evaluation of preliminary outcomes. METHODS: The CBT-R protocol is described in detail, grounded in behavioral theory and phased treatment approach to symptom elimination. The treatment is evaluated via a retrospective case series design of pediatric patients (aged 8-18) with a primary diagnosis of RS treated in an outpatient setting by a pediatric psychologist. RESULTS: Twenty-eight patients met inclusion criteria and are included in intent-to-treat analysis, with 23 patients evaluated for outcomes (47.8% female, M age = 14.3; SD = 2.8). Sample included 17.4% with comorbid psychiatric diagnosis and 43.5% with comorbid medical diagnoses. Outcome results demonstrate improvement for a majority of patients (87.0%), with most demonstrating complete resolution of symptoms (73.9%). Treatment length varied significantly, ranging from 1 to 22 visits (M = 4.8, SD = 5.4) and was complicated by necessary admission or supplemental nutrition in 21.7% of patients. Psychological factors were related to poor treatment outcomes and longer treatment duration. CONCLUSIONS: CBT-R results in positive treatment outcomes for majority of patients, with most patients demonstrating complete resolution of symptoms, providing a superior outpatient treatment option for some pediatric patients. Sample characteristics challenge previous understanding of RS as female dominated and with high levels of psychiatric comorbidity.

Children and adolescents attempting to participate in a worldwide online depression screener.

Depression rates are increasing among minors. Internet is central to the lives of many minors, and many of them look online for depression information. This report describes minors who attempted to screen themselves for depression in a worldwide online study. Google Ads were used to recruit individuals to a multilingual depression screening study that was meant to target and recruit adults. Of 158,170 individuals accessing the site, 30,396 (19.22%) were minors from 190 countries. Proportions of minors varied considerably between different cultures. Given youth's interest in depression information, online services to ethically and effectively address youth depression are needed.

Publication Trends in Psychotherapy: Bibliometric Analysis of the Past 5 Decades.

OBJECTIVE: Bibliometric analyses are commonly used to document publication trends over time; however, this methodology has not been used to investigate possible trends concerning publishing about psychotherapy brands. In this study, the authors sought to identify the publication trends of peer-reviewed articles about 30 psychotherapy brands. METHODS: Analyses were focused on the past 50 years and on each decade from 1970 to 2019. All searches were performed between October 2018 and January 2019 on the EbscoHost platform. Two databases were selected for the searches: PsycINFO and PubMed. RESULTS: In the 28,594 articles reviewed, most published articles concerned cognitive-behavioral therapy (CBT), and five brands accounted for almost 78% of all publications: CBT, psychoanalysis, family systems therapy, behavioral therapy, and cognitive therapy. Three trends were identified across decades: five therapies consistently yielded the largest number of publications, the number of publications focused on therapies with less research support declined from the 1970s to the 1990s, and publications about therapies with more of a research basis increased in the 1990s through the 2010s. Publications on meditation and mindfulness presented the most salient growth area for all psychotherapies across the 5 decades. A few psychotherapy brands have dominated the publishing realm during the past 50 years and across each decade. CONCLUSIONS: Possible explanations for these publication trends were considered, including the emergence of the evidence-based therapy movement and various sociohistorical changes. Potential psychotherapy publications trends in the future are discussed.

Effect of Three Types of Activities on Improving Mood and Enjoyment in a Brief Online Depression Study.

The goal of this study is to determine whether different types of activities have a differential effect on mood and enjoyment. Methods. A secondary analysis of the data of 754 participants (M age = 35.8 years, SD age = 12.6; M PHQ-9 = 7.6, SD PHQ-9 = 7.0) who were recruited via Amazon Mechanical Turk (AMT) to participate in a brief online study. Participants completed an activity log and reported retrospectively about three types of activities (Pleasant, Meaningful, and Mastery) at baseline and one week follow-up. A mixed effects ANOVA was used to analyze the effect of weekly activities on mood, and a temporal analysis model was used to test for the effect of daily activities on enjoyment. Results. Participants who reported higher number of Mastery activities for the week had higher mood ratings at follow-up (F (1, 39) = 4.89, p < .05), regardless of depression status at baseline. Pleasant and Meaningful activities did not have a significant effect on mood. Daily engagement in any of the three activity types increased enjoyment of that day (Pleasant: b = 0.312, t (1811) = 46.73, p < .001; Meaningful: b = 0.254, t (1814) = 11.65, p < .001; Mastery: b = 0.290, t (1816) = 13.07, p < .001]. Conclusions. These findings contribute to the understanding on how brief behavioral activation interventions delivered online may influence participants' mood and enjoyment, and can inform clinicians' recommendations about types of activities.

Feasibility of pediatric obesity and prediabetes treatment support through Tess, the AI behavioral coaching chatbot.

Behavioral intervention technologies (BITs) are unique ways to incorporate the benefits of technology and psychology to address differing health needs through various media, including Internet interventions, mobile apps, and video games. BITs present several possible benefits, including increased dissemination and accessibility, cost-effectiveness, increased engagement, and decreased stigma, especially among youth. A behavioral coaching chatbot, Tess, addresses different facets of behavioral health, such as depression and anxiety. Available 24/7, Tess delivers customized integrative support, psychoeducation, and interventions through brief conversations via existing communication channels (i.e., SMS text messaging and Facebook Messenger). This study assessed the feasibility of integrating Tess in behavioral counseling of adolescent patients (n = 23; Mage = 15.20 years; Rangeage = 9.78-18.54 years; 57% female) coping with weight management and prediabetes symptoms. Tess engaged patients via a preferred method of communication (SMS text messaging) in individualized conversations to promote treatment adherence, behavior change, and overall wellness. Adolescent patients reported experiencing positive progress toward their goals 81% of the time. The 4,123 messages exchanged and patients' reported usefulness ratings (96% of the time) illustrate that adolescents engaged with and viewed this chatbot as helpful. These results highlight the feasibility and benefit of support through artificial intelligence, specifically in a pediatric setting, which could be scaled to serve larger groups of patients. As a partner to clinicians, Tess can continue the therapeutic interaction outside office hours while maintaining patient satisfaction. Due to Tess's capacity for continuous learning, future iterations may have additional features to increase the user experience.

Facebook for recruiting Spanish- and English-speaking smokers.

BACKGROUND: Recruitment for research is usually expensive and time consuming. Facebook (FB) recruitment has become widely utilized in recent years. The main aim of this study was to assess FB as a recruitment tool in a study for Spanish- and English-speaking smokers. Additionally, the study set out to compare performance of ads by language (Spanish vs. English), location (U.S. vs. San Francisco) and content (self-efficacy ad vs. fear appeal ad). METHODS: Participants of a one-condition smoking cessation webapp study were recruited utilizing FB ads and posts through two phases: a recruitment-focused phase and an experimental phase comparing language, location and content. RESULTS: During the recruitment phase 581 participants in total (U.S. = 540, San Francisco = 41) provided consent. Of the U.S. participants 275 were Spanish-speakers and 265 English-speakers. The cost-per-consent was $25.81 for Spanish-speakers, and $15.49 for English-speakers. During the experimental phase U.S. users performed better (i.e. more clicks, engagement and social reach) than San Francisco users, Spanish-speakers engaged more than English-speakers, and the self-efficacy ad performed better than the fear appeal ad. CONCLUSIONS: This study showed that although there were differences in cost-per-consent for Spanish- and English-speakers, recruitment of Spanish-speakers through Facebook is feasible. Furthermore, comparing performance of ads by location, language, and ad content may contribute to developing more efficient campaigns.