Effectiveness of the Life Enhancement and Advancement Program for Weight Management in Overweight and Obese Females.

BACKGROUND: Obesity has been shown to have many deleterious physical and psychological consequences. OBJECTIVE: This study examined the effectiveness of adding the Life Enhancement and Advancement Program (LEAP) to a weight management program. DESIGN: To evaluate the different components of a weight loss program, this study included four groups: (1) dieting, exercise, and LEAP; (2) dieting, exercise, and sham training; (3) dieting and exercise; and (4) exercise only. An assessment was administered at baseline, post-intervention, and a three-month follow-up. PARTICIPANTS: Forty female participants with a body mass index (BMI) ≥ 25 were recruited from a local sports center. They provided informed consent and were randomly assigned to one of the four groups. MEASURES: Participants' heights were recorded at baseline, and their weight, waist circumference (WC), and BMI were measured at each of the three assessments. Participants completed the Personal Concerns Inventory (PCI) to assess their adaptive motivation at all three assessments. RESULTS: A MANCOVA indicated that participants who received LEAP along with dieting and exercise had a greater reduction in BMI and WC and improved more in adaptive motivation than the other groups. CONCLUSIONS: The results suggest that adding LEAP to a weight management program enhanced participants' ability to achieve and maintain weight loss. LEAP enabled participants to pursue and achieve their important goals successfully.

Scary in the eye of the beholder: Attentional bias and attentional retraining for social anxiety.

Consistent with cognitive models of social anxiety, socially anxious individuals show cognitive biases that magnify their perceived level of threat in the environment. OBJECTIVES: The first objective was to determine whether attentional bias for socially threatening stimuli occurs after concomitant depression has been controlled. The second objective was to test the effectiveness of the Attention Control Training Program for Social Anxiety (ACTP-SA) for reducing social anxiety attentional bias and improving therapeutic indices in people with social anxiety. METHOD: In the first study, socially anxious (N = 30) and non-anxious individuals (N = 30) completed the Beck Depression Inventory-II, Spielberger's State-Trait Anxiety Inventory, Conner's Social Phobia Inventory, a social-anxiety Stroop test, and a clinical interview. In the second study, individuals with social anxiety (N = 30) were randomly assigned to an experimental group that received 4 sessions of ACTP-SA, or to a sham-intervention control condition. At the post-test and a 3-month follow-up, both groups completed the same measures as in Study 1. RESULTS: In Study 1, socially anxious individuals showed higher attentional bias for threatening stimuli than the controls, after depression had been controlled for. In Study 2, participants in the experimental group, compared with the controls, showed greater reductions in attentional bias, social anxiety, and trait anxiety at post-test and follow-up. CONCLUSIONS: The results underscore the importance of information processing biases in social anxiety and the benefits of attentional bias training as a complementary intervention for modifying symptoms of social anxiety.

Do I Really Want to Change? The Effectiveness of Goal Ambivalence Feedback on Dieters' Motivation.

Becoming committed to a new health-related goal and pursuing it is difficult for many people. The present study (a) developed and tested the psychometric properties of a brief Goal Ambivalence Scale (GAS) in a sample of dieters and (b) tested the effectiveness of providing dieters with feedback on their scores on the GAS. In Study 1, dieters (n = 334, 74% females) completed the GAS and a measure of Health-Related Concerns and Actions (HRCA). The standardization of the GAS was supported by CVR and CVI, the results of a PCA, and strong reliability and validity statistics. In Study 2, the experimental group of dieters (n = 107; 67.50% female) received feedback on their GAS scores, but the control group did not (n = 111; 62.30% female). Compared with the control group, the experimental group reported a greater need for information, greater readiness to change, and higher perceived situational confidence in resisting food that was inconsistent with their dieting goals. To conclude, the GAS could be used in health settings to provide clients and providers with an objective, fast measure of commitment to achieving health-related goals. Moreover, immediate feedback on health-related goals may improve change motivation.

A Randomized Controlled Trial of Attentional Control Training for Treating Alcohol Use Disorder.

Background: There is consistent evidence that community and clinical samples of individuals with an alcohol use disorder (AUD) have attentional biases toward alcohol cues. The alcohol attentional control training program (AACTP) has shown promise for retraining these biases and decreasing alcohol consumption in community samples of excessive drinkers. However, there is a lack of evidence regarding the effectiveness of ACTP in clinical AUD samples. The main aim of the present study is to investigate whether primary pharmacological and psychological, evidence-based alcohol treatment can be enhanced by the addition of a gamified AACTP smartphone application for patients with an AUD. Design and Methods: The study will be implemented as a randomized controlled trial. A total of 317 consecutively enrolled patients with AUD will be recruited from alcohol outpatient clinics in Denmark. Patients will be randomized to one of three groups upon initiation of primary alcohol treatment: Group A: a gamified AACTP smartphone application + treatment as usual (TAU); Group B: a gamified AACTP sham-control application + TAU; or Group C: only TAU. Treatment outcomes will be assessed at baseline, post-treatment, and at 3- and 6-month follow-ups. Repeated measures MANOVA will be used to compare the trajectories of the groups over time on alcohol attentional bias, alcohol craving, and drinking reductions. It is hypothesized that Group A will achieve better treatment outcomes than either Group B or Group C. Perspectives: Because attentional bias for alcohol cues is proportional to the amount of alcohol consumed, and these biases are not addressed within current evidence-based treatment programs, this study is expected to provide new evidence regarding the effectiveness of the gamified AACTP in a clinical population. Furthermore, due to promising results found using AACTP in community samples of excessive drinkers, there is a high probability that the AACTP treatment in this study will also be effective, thereby allowing AACTP to be readily implemented in clinical settings. Finally, we expect that this study will increase the effectiveness of evidence-based AUD treatment and introduce a new, low-cost gamified treatment targeting patients with an AUD. Overall, this study is likely to have an impact at the scientific, clinical, and societal levels. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT05102942?term=NCT05102942&draw=2&rank=1, identifier: NCT05102942.

The Relationship Between Trust-in-God, Positive and Negative Affect, and Hope.

We aimed to test the relationships between Trust-in-God, positive and negative affect, and feelings of hope. A sample of university students (N = 282, 50 % female) completed the Positive and Negative Affect Schedule, the Adult Dispositional Hope Scale, and a Persian measure of Trust-in-God for Muslims. The results of a series of hierarchical regression analyses indicated that Trust-in-God was positively associated with participants' scores for hope and positive affect but was negatively associated with their scores for negative affect. The results support the relationship between Trust-in-God and indices of mental health.

Differential effects and temporal course of attentional and motivational training on excessive drinking.

Two cognitive-motivational variables that help to solidify drinkers' intentions to drink are their alcohol attentional bias and their maladaptive motivation. The Alcohol Attention Control Training Programme (AACTP) was designed to rectify the former, and the Life Enhancement and Advancement Programme (LEAP) was designed to rectify the latter. The present study used a factorial design to compare the individual and combined effects of the 2 interventions on mean weekly drinking and atypical weekly drinking of 148 harmful drinkers (49% males, mean age = 28.8 years). A variety of other cognitive-motivational and demographic measures were also taken at baseline, and the drinking measures were reassessed at posttreatment and 3 and 6 months later. In comparison with LEAP, the effects of AACTP were less enduring. Combining AACTP and LEAP had few incremental benefits. These results suggest that AACTP would be more effective for achieving short-term reductions in drinking, whereas LEAP would be more effective for alleviating problematic drinking.

Alcohol cognitive bias modification training for problem drinkers over the web.

Following successful outcomes of cognitive bias modification (CBM) programs for alcoholism in clinical and community samples, the present study investigated whether different varieties of CBM (attention control training and approach-bias re-training) could be delivered successfully in a fully automated web-based way and whether these interventions would help self-selected problem drinkers to reduce their drinking. Participants were recruited through online advertising, which resulted in 697 interested participants, of whom 615 were screened in. Of the 314 who initiated training, 136 completed a pretest, four sessions of computerized training and a posttest. Participants were randomly assigned to one of four experimental conditions (attention control or one of three varieties of approach-bias re-training) or a sham-training control condition. The general pattern of findings was that participants in all conditions (including participants in the control-training condition) reduced their drinking. It is suggested that integrating CBM with online cognitive and motivational interventions could improve results.

The motivational basis of cognitive determinants of addictive behaviors.

If a person expects that (a) drinking alcohol or using another addictive substance will enhance positive affect or reduce negative affect, and (b) there is a strong likelihood that these desirable consequences will occur if the substance is used, that person is likely to form a goal of using the substance. The theoretical framework presented here predicts that when that happens, the person will have a current concern for using the substance, with the person thereby sensitized to environmental stimuli related to procuring and using the substance. One indication of the sensitization is selective attention to substance-related stimuli, which is correlated with urges to use and actual use of the substance. Accordingly, interventions have been developed for helping substance users to overcome substance-related attentional bias. The results are promising for reducing both the attentional bias and the substance use. Finally, we discuss other cognitive-modification and motivational techniques that have been evaluated with promising results.

Attentional bias modification for addictive behaviors: clinical implications.

When a person has a goal of drinking alcohol or using another addictive substance, the person appears to be automatically distracted by stimuli related to the goal. Because the attentional bias might propel the person to use the substance, an intervention might help modify it. In this article, we discuss techniques that have been developed to help people overcome their attentional bias for alcohol, smoking-related stimuli, drugs, or unhealthy food. We also discuss how these techniques are being adapted for use on mobile devices. The latter would allow people with an addictive behavior to use the attentional training in privacy and as frequently as needed. The attentional training techniques discussed here appear to have several advantages. They are inexpensive, can be fun to use, and have flexibility in when, where, and how often they are used. The evidence so far also suggests that they are effective.

Restraint, disinhibition and food-related processing bias.

This study examined associations between restraint, disinhibition and food-related processing bias (FPB, assessed by the emotional Stroop task) in males and females in the UK, Greece and Iran. Results showed high restraint was associated with higher FPB. However, high restrained current dieters showed lower FPB that high restrained non-dieters. There was no significant difference in FPB for those showing high versus low disinhibition. Results are discussed in relation to theories of incentive salience and current concerns.

Effect of practice versus information on the visual illusion.

OBJECTIVE: The Muller-Lyer illusion is a visual illusion in which a horizontal shaft with an inward-pointing chevron (fins-out) affixed to each end is perceived longer than a shaft with outward-pointing chevrons (fins-in). The goal of this study was to compare the effects of experience and knowledge about the Muller-Lyer illusion on participants' perceptual precision. METHODS: Participants were undergraduate students (n = 108) who were not familiar with the Muller-Lyer illusion prior to the experiment. The task of participants was to adjust one movable line to make it equal to the other in Muller-Lyer figure. They received ascending and descending Muller-Lyer trials in three blocks with 20 trials each. The Experimental Group received information about the Muller-Lyer illusion prior to the third block. RESULTS: For the Experimental Group, the amount of departure in Block 3 was reduced significantly compared with previous blocks. CONCLUSION: Knowledge about the mechanisms underlying visual illusions may play an important role in helping individuals overcome them.

The search for new ways to change implicit alcohol-related cognitions in heavy drinkers.

This article summarizes a symposium on new ways to change implicit alcohol-related cognitions, presented at the 2005 Annual Meeting of the Research Society on Alcoholism in Santa Barbara, California, organized by Wiers and Cox. During the past few years, research has demonstrated that implicit cognitions predict unique variance in prospective alcohol use and preliminary results indicate that they also predict treatment outcomes. The central question in this symposium was how implicit cognitions can be changed and how the changes will influence behavior. Field presented data showing that an attentional bias for alcohol can be altered by attentional training: heavy drinkers who were trained not to attend to alcohol stimuli reported less craving and drank less beer than those trained to attend to alcohol stimuli. Schoenmakers used a similar, clinically relevant attentional retraining (AR) procedure, heavy drinkers were trained not to attend to alcohol pictures or received no training. After the training, the AR group attended less to the alcohol pictures than the control group. Fadardi described the Alcohol Attentional Control Training Program (AACTP), which makes alcohol drinkers aware of the automatic, cognitive determinants of their drinking and aims to help them to gain control over these processes. Data were presented to support the effectiveness of the AACTP. Palfai presented data showing that alcohol drinkers can be taught to use implementation intentions to gain control over their drinking, which may be used to automatically activate self-control skills in the presence of alcohol cues. In his discussion, Stacy pointed out the importance of recent cognitive theories that integrate attention and memory processes-theories that can help us better understand the mechanisms involved in AR. Together, the studies presented demonstrate that there are promising new ways in which implicit alcohol-related cognitions and their effects on drinking can be changed. After further refinement, these procedures might be used in clinical interventions that have not previously addressed implicit cognitive processes.