The present study investigated the relative efficacy of paradoxical, behavioral, and reflection-support treatments among college students who complained about procrastination of studying. Although there is much literature describing successful use of paradoxical treatment, there has been little substantive research. Paradoxical techniques offer more complex theoretical explanations than behavioral therapy even though in practice the procedure of each are often quite similar. Subjects were selected by their response to an ad in the school newspaper that offered free treatment for students who had problems with procrastination. Further screening of participants was done through clinical interviews. Thirty-three subjects were selected for treatment of procrastination with three clients randomly assigned to each of 11 advanced psychology graduate students who served as therapists. Each therapist provided all three types of treatment, one type of treatment to each of their three assigned clients.

Despite evidence supporting a robust relation between common factors- aspects of the therapeutic setting that are common across all types of treatment- and treatment response, little is known about the mechanisms by which these common factors effect change. Two of the most well-researched common factors include the client’s expectations about the effectiveness of treatment (termed outcome expectancy), and the quality of the therapeutic relationship (termed working alliance). Using archival data, the present study tests the hypothesis that the relation between outcome expectancy and symptom reduction is mediated by the alliance following treatment for social anxiety disorder. Data were collected in a sample of 65 individuals who received cognitive behavioral therapy for social phobia with public speaking fears. Mediation analyses were conducted using Andrew Hayes’ Process Macro (Hayes, 2013). None of the mediation analyses were significant. These findings suggest that the mechanisms of common factor variables may vary by disorder.

The main aim of the study is to determine a body composition in participants of weight reduction program STOB, based on group cognitive behavioral therapy of obesity. The program lasted 12 weeks and participants underwent a cognitive behavioral therapy and followed a diet and physical activity plan. The body composition was measured by bioelectrical impedance InBody 230 at the initial and final lesson. We examined a participant's body weight, skeletal muscle, fat mass, abdominal fat mass and BMI. At the end of the weight reduction program participants lost 5% (-4,6kg) of their initial weight, achieved significant decrease in fat mass (average -4,3kg and -3%), lost 14,4cm2 of abdominal fat mass and mean BMI value decreased by 1,7. A muscle component hasn't significantly changed within the weight reduction program. The effect of 12 week weight reduction program STOB resulted in significant changes in body composition, which are associated with reduced risk of cardiovascular and metabolic complications of obesity. Using cognitive behavioral therapy as an obesity management strategy is positively evaluated especially for its effect on long term weight reduction and effective relapse prevention. Therefore a future study should be focused on a long term re-evaluation of changes in body composition in...

INTRODUCTION: Initial examination of treatment worries suggest they may represent an important construct; however, previously used measures were limited by their specificity, scale format, and lack of parent report. Therefore the present study sought to examine the initial outcomes and psychometrics of newly developed corresponding measures of treatment worries in youth (Treatment Worries Questionnaire – Child; TWQ-C) and their parents (Treatment Worries Questionnaire – Parent; TWQ-P). METHODS: Participants were 94 youth (7-17-years old) and parent dyads presenting for psychosocial treatment of an anxiety disorder. Prior to initiation of treatment, dyads completed the TWQ-C and TWQ-P along with a host of additional child and parent report measures, and three clinician-rated measures. RESULTS: Treatment worries were endorsed in the mild-moderate range by youth and the TWQ-C demonstrated good-excellent internal consistency and test-retest reliability, a strong three-factor structure, and consistent convergent and divergent relationships. Treatment worries were endorsed in the low mild range by parents and the TWQ-P demonstrated fair-good internal consistency and test-retest reliability, a less empirically, but theoretically, supported four-factor structure, and consistent divergent relationships, but variable (by factor) convergent relationships. DISCUSSION: The results of the present study provide information on the concept of treatment worries and support the use of the TWQ-C and TWQ-P as broad assessments of the concept in a variety of populations. Low endorsement of worries among parents likely relates to the nature of the present sample (treatment-seeking) and may have contributed significantly to the less ideal psychometrics of the TWQ-P in comparison to the TWQ-C. Future investigation of treatment worries using the TWQ-C and TWQ-P in a variety of samples is warranted.

Problématique : Les troubles mentaux ont une forte prévalence dans tous les pays et constituent environ un tiers des résultats de consultation en médecine générale de ville. En France, les médecins généralistes (MG) assurent la prise en charge de la plupart des psychopathologies. Selon la définition du Collège National des Généralistes Enseignants, le MG est particulièrement apte à assurer le suivi de ces patients. Différents facteurs viennent compliquer ces prises en charge- l'organisation de la formation médicale, le système de soins français, la faible fréquence des prises en charge en réseaux de soins, des difficultés de communication entre généralistes et professionnels de santé mentale - et contribuent à privilégier les traitements pharmacologiques au détriment des psychothérapies ou des traitements combinés. Objectifs : Nous souhaitions connaître les pratiques, attitudes et attentes des MG français dans le domaine de la prise en charge des troubles mentaux et dans celui des thérapies cognitivo-comportementales (T.C.C.), modalité de soins psychiques scientifiquement validée, efficace dans de nombreux troubles mentaux mais encore peu répandue en France. Méthode : Nous avons mené une étude– action auprès de MG français. Résultats : Les résultats sont indicatifs de besoins de formation. Nous présentons les concepts théoriques et thérapeutiques cognitivo-comportementaux des principaux troubles mentaux qui pourraient avoir leur place dans la formation initiale et continue ( FMI/FMC) des spécialistes en médecine générale. Discussion : celle-ci présente les limites du présent travail, et des éléments d'une FMC en T.C.C. par internet centrée sur le cadre des soins primaires. / Background: Mental health problems are prevalent in all countries and make up approximately one-third of consultations for general practitioners (GP) in large cities. In France, GPs provide service delivery to the majority of common psychopathological disorders. According to the National College of GP Educators, GPs are well suited to provide follow-up to these patients. Yet, many factors make this type of service delivery difficult: initial medical school training, the particularities of the French health system including a lack of networked service delivery, and poor communication between GPs and other health service providers, to name a few. These difficulties result in an over-usage of prescription psychotropic medications and this to the detriment of other types of therapies. Objectives: The objective of the current work is to better understand practices, attitudes and expectations of French GPs with regards to mental health treatment and the usage of CBT, an empirically validated approach to mental health problems that is still largely underutilized in France. Method: A study was implemented with the participation of French GPs. Results: The results show an overall need for better training of GPs. These results underline theoretical concepts in CBT and how they could provide a better foundation in both initial and continuing education of GPs, as well as how they could be integrated into the GP’s daily practice. Discussion: Limits of the work are presented along with a detailed inventory of CBT concepts that could be provided through an internet-based continuing education program for primary care doctors.

Many people use smoking as a weight control mechanism and do not want to quit because they fear weight gain. These weight-concerned smokers tend to be female, are significantly less likely to stop smoking, are less likely to join smoking cessation programs, and will relapse more often than smokers who are not weight-concerned. Research suggests that a woman’s confidence in her ability to control her weight after quitting relates positively with her intention to quit smoking. Likewise, success in smoking cessation has been associated with increased self-efficacy for weight control. It has been shown that success in changing one negative health behavior may trigger success in changing another, causing a synergistic effect. Recently research has focused on interventions for weight-concerned smokers who are ready to quit smoking. The present study investigated the effect of a cognitive based weight control program on self-efficacy for weight control and the effect on smoking behavior for a group of female weight concerned smokers. Two hundred and sixteen subjects who wanted to lose weight but who were not ready to quit smoking were recruited to participate in a 12-week, cognitive-behavioral weight control program consisting of twelve one-hour sessions. Subjects were randomly assigned to either 1) the weight-control program (intervention group), or 2) the control group. Results of this study demonstrated that subjects in the intervention group increased self-efficacy for weight control, which was associated with improved healthy eating index scores, weight loss, increased self-efficacy for quitting smoking, a decrease in number of cigarettes smoked and triggered positive movement in stage of change towards smoking cessation compared to the control subjects. For these subjects, positive changes in self-efficacy for one behavior (weight control) appeared to have a positive effect on their readiness to change another health behavior (smoking cessation). Further study of the psychological variables that influence weight-concerned female smokers’ decisions to initiate changes in these behaviors and their ability to maintain those changes are warranted.

Anxiety disorders; such as separation anxiety disorder, generalized anxiety disorder, social phobia and specific phobia, are widespread in children and adolescents. Cognitive behavioral therapy (CBT) has been shown to be effective in reducing excessive fears and anxieties in children and adolescents. Research has produced equivocal findings that involving parents in treatment of child anxiety enhances effects over individual CBT (ICBT). The present dissertation study examined whether parental involvement can enhance individual treatment effect if the parent conditions are streamlined by targeting specific parental variables. The first parent condition, Parent Reinforcement Skills Training (RFST), involved increasing mothers’ use of positive reinforcement and decreasing use of negative reinforcement. The second parent condition, Parent Relationship Skill Training (RLST), involved increasing maternal child acceptance and decreasing maternal control (or increasing autonomy granting). Results of the present dissertation findings support the use of all three treatment conditions (ICBT, RLST, RFST) for child anxiety; that is, significant reductions in anxiety were found in each of the three treatment conditions. No significant differences were found between treatment conditions with respect to diagnostic recovery rate, clinician rating, and parent rating of child anxiety. Significant differences between conditions were found on child self rating of anxiety, with some evidence to support the superiority of RLST and RFST to ICBT. These findings support the efficacy of individual, as well as parent involved CBT, and provide mixed evidence with respect to the superiority of parent involved CBT over ICBT. The conceptual, empirical, and clinical implications of the findings are discussed.

L’addiction aux jeux vidéo n’est pas, pour l’instant, un diagnostic pleinement reconnu. Pour aborder ce phénomène, nous questionnons le concept d’addiction sans substance. Reconnu comme une addiction comportementale dans le DSM-V, le jeu pathologique, concernant les jeux de hasard et d’argent, est le prototype des addictions sans substance. L’utilisation excessive des jeux vidéo a fait l’objet de multiples comparaisons avec le jeu pathologique. À l’avènement d’Internet, la recherche et la clinique se sont fortement focalisées sur l’utilisation excessive des jeux vidéo en ligne. Au regard de la littérature actuelle, nous avons choisi d’aborder l’addiction aux jeux vidéo selon la pluralité des jeux vidéo existants et des modes d’utilisation des jeux vidéo. Nos recherches se situent dans le champ de la psychologie cognitive et prennent leur source dans la clinique en lien avec les Thérapies Comportementales et Cognitives. La première étude permet de préciser les fonctionnements émotionnels, cognitifs et comportementaux des joueurs assidus de jeux vidéo. Nous décrivons un ensemble de phénomènes psychologiques qui sont en résonance avec la littérature actuelle sur l’addiction aux jeux vidéo. De plus, nous avons rapproché certaines cognitions des joueurs avec les croyances Anticipatoires, Soulageantes et Permissives décrites par Beck et al. (1993). Pour nous, des cognitions et des comportements spécifiques sous-tendent une attention soit orientée vers le jeu pour certains, soit orientée vers l’extérieur du jeu pour d’autres. Nous explorons différents moments de jeu : avant, pendant et après le jeu mais aussi au moment de gagner et au moment de perdre. Des comparaisons entre les moments de jeu révèlent une dynamique des émotions, cognitions et comportements en lien avec le jeu. La deuxième étude passe par l’opérationnalisation des variables psychologiques relevées dans la première étude et par la construction d’un nouvel outil de mesure de l’addiction aux jeux vidéo. Ce questionnaire nous a permis d’établir des groupes distincts de joueurs considérés comme excessifs et de joueurs non excessifs de jeux vidéo. Ainsi, nous avons comparé ces joueurs sur la base des émotions, cognitions et comportements propres à nos études. Des pistes thérapeutiques, en lien avec les TCC, sont discutées à partir de nos résultats. Une adaptation du modèle des addictions de Beck et al. (1993) est proposée. Deux études de cas permettent d’illustrer nos propos et d’aborder la clinique spécifique concernant l’addiction aux jeux vidéo. En plus des conclusions en lien avec nos travaux, nous abordons des pistes de recherche qui nous semblent présager de l’avenir des études sur cette thématique. Même s’il faut rester prudent, certaines données actuelles convergent vers le rapprochement entre l’addiction et l’utilisation excessive des jeux vidéo. Nos résultats s’ajoutent à cette argumentation. Avec la proposition du « trouble du jeu (vidéo) sur Internet » dans la section III du DMS-V, il est, d’autant plus, nécessaire de poursuivre les études. / Video game addiction is not yet a fully recognized diagnosis. To address this phenomenon, we question the concept of addiction without substance. Known as a behavioral addiction in DSM-V, pathological gambling is the prototype of addictions without substance. The excessive use of video games has been the subject of multiple comparisons with pathological gambling. With the advent of Internet, research and the clinical approach have highly focused on the excessive use of online games. In light of the current literature, we have chosen to address video game addiction according to the plurality of existing games and the different games modes. Our research lies in the scope of cognitive psychology and is rooted in the Cognitive Behavioral Therapy approach. The first study allows to specify the emotional, cognitive and behavioral functionings of assiduous video game players. We describe a set of psychological phenomena that are resonant with the current literature on video game addiction. In addition, some cognitions of players draw near to anticipatory, relief-oriented and permissive beliefs described by Beck et al. (1993). For us, specific cognitions and behaviors underlie an attention process which is directed towards the game for some and outwards of the game for others. We explore different game moments: before, during and after the game but also, at the moment of winning and losing. Comparisons between the game moments reveal a dynamic of emotions, cognitions and behaviors related to the game. The second study involves the operationalization of psychological variables identified in the first study and the construction of a new measure of video game addiction. This questionnaire allowed us to establish separate groups of players considered excessive and non-excessive video game players. Between these players, we performed statistical comparisons based on the emotions, cognitions and behaviors that are specific to our studies. From our results, therapeutic proposals related to CBT are discussed. An adaptation of addiction model of Beck et al. (1993) is proposed. Two case studies allow to illustrate these results and to address the specific clinical approach of the video game addiction. In addition to the conclusions related to our work, we discuss on new research avenues that seem to predict future studies on video game addiction. Even if we remain cautious, some current data converge towards the link between addiction and excessive use of video games. Our findings are added to this argumentation. With the proposal of "Internet gaming disorder" in Section III of the DMS-V, it is all the more necessary to continue studies.

The Secondary Prevention in Uppsala Primary Health Care Project (SUPRIM) is a randomized controlled trial evaluating the effects of cognitive behavioral therapy on coronary heart disease patients. Various outcomes of psychological and physical health are recorded every six months approximately, over the course of two years after entry to the trial. In this thesis, relationships between the psychological outcome variables, Stress, Anxiety, Depression and Exhaustion, and five physical health biomarkers, are assessed using bivariate linear mixed models. Significant associations are found between one of the biomarkers and both Depression and Exhaustion, and also between one of the other biomarkers and Exhaustion.

Orientadores: Miriam Dambros, Luis Alberto Magna / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-08T00:26:33Z (GMT). No. of bitstreams: 1 Perchon_LygiaFerreiraGomes_M.pdf: 1294691 bytes, checksum: a72c898a6ea9573ee2b6576eed28d447 (MD5) Previous issue date: 2006 / Resumo: O presente trabalho, com duração de 24 semanas, avaliou a eficácia da terapia comportamental em grupo em promover mudanças positivas no padrão de qualidade de vida (Qol) de pacientes com incontinência urinária (IU) e disfunção erétil (DE), após prostatectomia radical. Participaram da pesquisa 30 pacientes. A intervenção foi desenhada visando melhorar a QoL, através de técnicas específicas para ensinar os participantes a identificarem e a administrarem situações estressantes e teve como foco as queixas de IU e DE, pós prostatectomia radical. A diferença entre o início e o final do estudo, para cada variável, foi comparada pelo teste t de Student para dados pareados. Análise múltipla, realizada com regressão linear múltipla escalonada, foi precedida de análise de correlação simples de Pearson. Consideraram-se variáveis dependentes: percepção geral da saúde, disfunção erétil e impacto da incontinência urinária e as variáveis independentes: idade, status profissional, alcoolismo, atitude frente ao câncer e frente à cirurgia, satisfação sexual anterior à cirurgia e planos para o futuro. A média de tempo entre a data da cirurgia e o início da terapia comportamental de grupo foi de 14,8 meses (desvio padrão=6,2; mediana=16,5). Para 63,3% dos pacientes, esse intervalo foi maior que 12 meses. Não foi encontrada correlação significativa entre esse tempo e as variáveis dependentes. O escore do domínio percepção geral da saúde diminuiu ao final do estudo (p=0,000), assim como o escore referente ao impacto da incontinência urinária (p=0,023), o que significa melhora dos dois fatores. A diferença entre os escores do impacto da incontinência correlacionou-se negativamente com a idade (p=0,04) e status profissional (p=0,05). A regressão múltipla mostrou que a idade foi a variável mais importante (r2 = 26,0%); considerados simultaneamente, idade e status profissional, há um aumento de 10,3% (r2 = 36,3%). O escore de disfunção erétil aumentou no final do estudo (p=0,000), e as diferenças entre os escores dessa variável correlacionaram-se positivamente e significantemente somente com os de satisfação sexual anterior à cirurgia (p=0,029), o que demonstrou a influência da satisfação sexual anterior à cirurgia sobre a disfunção erétil (r2 = 15,8%). A terapia de grupo mostrou-se efetiva em melhorar a percepção da qualidade de vida de homens submetidos à prostatectomia radical, particularmente em relação à IU e DE / Abstract: The current study evaluated the efficacy of a 24-week, group based, behavioral therapy in improving quality of life (QoL) among men who were treated for localized prostate carcinoma (PC) with radical prostatectomy (RP), and had treatment related dysfunctions: Urinary Incontinence (UI) and Erectile Dysfunction (ED). Thirty men were assigned to a 24-week group therapy. The intervention was designed to improve QoL by helping participants to identify and effectively manage stressful experiences and was focused on treatment-related sequelae of PC. The difference of all variables was compared between the beginning and the end of the study by means of Student¿s t test for paired samples. Multiple analysis was carried out by stepwise multiple linear regression following bivariate Pearson¿s correlation analysis. This was achieved with all predictors (i.e. general health perception, ED and the impact of UI) and relevant covariates (i.e. age, work/retirement status, alcohol addiction, attitude before cancer and before surgery, sexual satisfaction, and plans for the future). The mean time from surgery to attending the behavioral group intervention was 14.8 months (sd = 6.2; median = 16.5), and for 63.3% of the patients, this time was over 12 months. There was no significant correlation between that time and the predictor variables. General health perception scores decreased at the end of the study (p = 0.000), as well as urinary incontinence impact (UI) score (p=0.023), thus denoting improvement of both factors. The difference between the scores of the latter correlated negatively and significantly with both age (p = 0.04) and work/retirement (p = 0.05). Multiple stepwise regression showed that age was the most important variable (r2 = 26.0%); considering simultaneously age and work/retirement, there is an increase of 10.3% (r2 = 36.3%). Erectile dysfunction (ED) showed an increase at the end of the study (p = 0.000), and the difference between the scores of this variable correlated positively and significantly with sexual satisfaction only (p = 0.029), which means the positive influence of previous sexual satisfaction over erectile dysfunction (r2 = 15.8%). In conclusion, a 24-week behavioral group therapy was effective in improving the perceived QoL among men treated for PC. There were changes associated with the therapy, particularly the improvement in UI and ED / Mestrado / Pesquisa Experimental / Mestre em Cirurgia