Internet-Based Cognitive Behavioural Treatments for Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis.

Obsessive-compulsive disorder (OCD) is a common mental health condition characterized by distressing, intrusive thoughts (obsessions) and repetitive behaviours (compulsions) aimed at reducing anxiety. Internet-based cognitive behavioural therapy (ICBT) has emerged as an effective treatment modality for various mental health disorders. This meta-analysis evaluates the efficacy of guided self-help ICBT (GSH ICBT) and unguided self-help ICBT (SH ICBT) against active and passive control conditions in adults with OCD. A comprehensive systematic literature search yielded 12 randomized controlled trials (RCTs) comprising 15 comparison arms (N = 1416) that met the inclusion criteria. Results indicate that GSH ICBT significantly reduced OCD symptomatology posttreatment compared to active controls (g = 0.378, k = 9), with no significant effects maintained at follow-up (g = 0.153, k = 4). GSH ICBT was also found to be as effective as active CBT interventions in reducing comorbid anxiety and depression symptoms posttreatment (g = 0.278, k = 6) and at follow-up (g = 0.124, k = 4). However, improvements in quality of life were not significant posttreatment (g = 0.115, k = 4) nor at follow-up (g = 0.179, k = 3). Combined GSH and SH ICBT demonstrated large effects on reducing OCD symptoms (g = 0.754, k = 6), medium effects on comorbid symptoms (g = 0.547, k = 6) and small effects on quality of life (g = 0.227, k = 2) when compared to inactive controls. No significant differences were found between GSH and SH ICBT in all measured outcomes posttreatment (OCD: g = 0.098, k = 3; AD: g = 0.070, k = 3; QoL: g = -0.030, k = 1) and at follow-up (OCD: g = 0.265, k = 2; AD: g = 0.084, k = 2; QoL: g = 0.00, k = 1). Sample size was identified as a significant moderator of treatment effects. This paper further explores clinical significance, treatment adherence, therapist time investment and moderator influences of the ICBT. The limitations of the study and recommendations for future research are thoroughly discussed.

The development of visual attention in early infancy: Insights from a free-viewing paradigm.

Theories of visual attention suggest a cascading development of subfunctions such as alertness, spatial orientation, attention to object features, and endogenous control. Here, we aimed to track infants' visual developmental steps from a primarily exogenously to more endogenously controlled processing style during their first months of life. In this repeated measures study, 51 infants participated in seven fortnightly assessments at postterm ages of 4-16 weeks. Infants were presented with the same set of static and dynamic paired comparison stimuli in each assessment. Visual behavior was evaluated by a newly introduced scoring scheme. Our results confirmed the suggested visual developmental hierarchy and clearly demonstrated the suitability of our scoring scheme for documenting developmental changes in visual attention during early infancy. Besides the general ontogenetic course of development, we also discuss intra- and interindividual differences which may affect single assessments, and highlight the importance of repeated measurements for reliable evaluation of developmental changes.

PROTOCOL: Effects of virtual reality exposure therapy versus in vivo exposure in treating social anxiety disorder in adults: A systematic review and meta-analysis.

This is the protocol for a Campbell systematic review. The objectives are as follows: (a) to quantify the effect sizes for virtual reality exposure therapy (VRET) in the treatment of social anxiety disorder (SAD), targeting primary social anxiety symptoms, comorbid anxiety and depression symptoms and improvements in quality of life, when compared to WL, information control, care-as-usual and placebo; (b) to compare VRET to in vivo cognitive and cognitive-behavioral interventions in treating SAD, at posttest and follow-up, using between-group design; (c) to identify the key features which are linked to beneficial outcomes in the two formats in treating SAD and (d) to collect and interpret information on differences in treatment uptake, adherence and attrition, as well as clinical significance and therapist-time in both treatment formats.

Disorder-specific internet-based cognitive-behavioral therapy in treating panic disorder, comorbid symptoms and improving quality of life: A meta-analytic evaluation of randomized controlled trials.

Compared to conventional face-to-face psychological treatments, internet-based cognitive-behavioral therapy (iCBT) presents an innovative alternative that has been found to be effective in the treatment of anxiety disorders. The current study provides a meta-analysis investigating the efficacy of disorder-specific guided self-help (Gsh) iCBT compared to various active and inactive control conditions, with focus on adult panic disorder sufferers with or without agoraphobia (PD/A). Systematic literature search yielded 13 randomized controlled trials (RCTs) (N = 1214) that met the eligibility criteria for this study. We found no statistically significant differences between Gsh iCBT and various active CBT interventions in reducing PD/A symptoms at both post-test (g = 0.015, k = 10) and follow-up (g = 0.113, k = 6) levels. Also, comorbid anxiety and depression were reduced equivalently at post-test (g = 0.004, k = 6) and follow-up (g = 0.004, k = 6). Quality of life was equally improved at post-test (g = -0.100, k = 5) and follow-up (g = 0.074, k = 2). When compared to inactive controls, we found large effect sizes in PD/A (g = -0.892, k = 9) and comorbid anxiety and depression (g = -0.723, k = 9) symptoms, and moderate change in quality of life (g = -0.484, k = 3) at post-test. There was no difference between Guided self-help iCBT and Self-help iCBT in PD/A (g = -0.025, k = 3) and comorbid anxiety and depression (g = -0.025, k = 3) at post-test. Baseline severity, country of original research and adherence to the treatment in form of initial uptake were identified as statistically significant moderators of the iCBT treatment.

Key Elements of mHealth Interventions to Successfully Increase Physical Activity: Meta-Regression.

BACKGROUND: Mobile technology gives researchers unimagined opportunities to design new interventions to increase physical activity. Unfortunately, it is still unclear which elements are useful to initiate and maintain behavior change. OBJECTIVE: In this meta-analysis, we investigated randomized controlled trials of physical activity interventions that were delivered via mobile phone. We analyzed which elements contributed to intervention success. METHODS: After searching four databases and science networks for eligible studies, we entered 50 studies with N=5997 participants into a random-effects meta-analysis, controlling for baseline group differences. We also calculated meta-regressions with the most frequently used behavior change techniques (behavioral goals, general information, self-monitoring, information on where and when, and instructions on how to) as moderators. RESULTS: We found a small overall effect of the Hedges g=0.29, (95% CI 0.20 to 0.37) which reduced to g=0.22 after correcting for publication bias. In the moderator analyses, behavioral goals and self-monitoring each led to more intervention success. Interventions that used neither behavioral goals nor self-monitoring had a negligible effect of g=0.01, whereas utilizing either technique increased effectiveness by Δg=0.31, but combining them did not provide additional benefits (Δg=0.36). CONCLUSIONS: Overall, mHealth interventions to increase physical activity have a small to moderate effect. However, including behavioral goals or self-monitoring can lead to greater intervention success. More research is needed to look at more behavior change techniques and their interactions. Reporting interventions in trial registrations and articles need to be structured and thorough to gain accurate insights. This can be achieved by basing the design or reporting of interventions on taxonomies of behavior change.

The Efficient Measurement of Job Satisfaction: Facet-Items versus Facet Scales.

The measurement of job satisfaction as a central dimension for workplace health and well-being is crucial to set suitable health- and performance-enhancing management decisions. Measuring different facets of job satisfaction leads to a more precise understanding about job satisfaction in research as well as to more specific interventions in companies. This study examines the measurement of job satisfaction with facet scales (multiple-items for one facet) and facet-items (one item for one facet). Facet-items are a cost-effective and fast way to measure job satisfaction in facets, whereas facet scales are more detailed and provide further information. Results from 788 bank employees showed that facet-items of job satisfaction were significantly correlated with the corresponding facet scales and had high factor loadings within the appropriate factor. Furthermore, the same correlational pattern between facet scales and external criteria was found for facet-items and external criteria (identification with the company, work engagement, stress, resources). The findings support the usage of facet-items in companies and in research where cost- and time-effectiveness is imperative and the usage of facet scales where an even deeper understanding of job satisfaction is needed. In practice, the usage of efficient measurements is evident, especially in the upcoming field of eHealth tools.

[School well-being of students with and without special educational needs--a comparison of students in inclusive and regular classes]. / Schulisches Wohlbefinden von SchülerInnen mit und ohne sonderpädagogischen Förderbedarf--Integrations- und Regelklassen im Vergleich.

OBJECTIVE: The present study examines the academic well-being of students with and without special educational needs (SEN) in inclusive classes compared to students from regular classes in which no child with SEN is taught. In addition, the relationships between the school well-being and emotional problems, conduct problems, hyperactivity/inattention, peer relationship problems and prosocial behavior are analyzed. METHOD: A total of 1115 students from the 4th and 7th grade (37 % 4th graders, 63 % 7th graders) participated in the survey, 126 of whom had been diagnosed as having SEN. The subscale Well-Being at School taken from the FEESS 3­4 (Rauer & Schuck, 2004) and the SDQ (Goodman, 1997) were used for measurement. RESULTS: Results indicate high reliabilities for the subscale Well-Being in School for students both with and without SEN for both grades 4 and 7. Furthermore, it could be shown that the variance explained for school well-being can be connected to elements on the students' individual level as well as on the class-specific level. Significant predictors of school well-being were sex, behavioral difficulties and strengths as well as the school grade. The SEN status (no SEN vs. SEN) and the class setting (regular vs. inclusive class) did not influence the school well-being significantly.