Healthy romantic relationships are associated with a multitude of positive physical and mental health outcomes. Conversely, low relationship quality and relationship dissolution are associated with risk for poor health outcomes. Accordingly, numerous studies investigate ways to preserve healthy relationships through the use of preventative relationship education interventions, many of which improve relationship outcomes. However, evidence for the efficacy and effectiveness of these interventions is somewhat mixed, and promising interventions often fail to reach at-risk populations due to high participant burden. There is a movement within clinical psychology to create easily accessible, targeted therapy protocols in order to increase the broad availability of these evidence-based interventions. The current study aimed to replicate and extend the Marriage Hack (MH), a brief, evidence-based preventative relationship intervention designed to stabilize the natural decline in relationship quality over time. This study addressed four specific aims designed to: 1) examine the efficacy of the MH intervention using an abbreviated protocol; 2) extend the original MH intervention by investigating theory-based mechanisms of change and assessing individual health outcomes; 3) explore how theory-based mechanisms change over time; and, 4) evaluate the relationship between within-person and between-person variance in process variables and outcome measures. Seventy-eight (N = 78) couples were randomized to the 4-week MH protocol (n = 41) or control condition (n = 37). Results demonstrated men in the intervention group exhibited 1) greater improvements in relationship satisfaction and 2) decreases in both anxiety and depression compared to men in the control group. This study did not replicate the findings of the original MH for additional outcome variables and process variables for men or women. No support was found for mediating effects of additional theory-based mechanisms of change on outcome measures. However, exploratory intensive longitudinal analyses revealed noteworthy relationships between within-person and between-person variance in process variables and treatment outcomes. Research recommendations to further improve preventative relationship interventions and clinical implications of the current findings are discussed.

Over the past 20 years, with the development and expansion of computer- and internet-based services (e.g., psychoeducational, intervention, and testing programs), the integration of technology with the treatment of mental health disorders has sparked one of the most debated topics in the mental health profession. With no clear end for this debate in sight, many believe that clinicians wish to reach a consensus and adopt a universal stance on computer-based psychological services so that discussion and research can be shifted to make meaningful contributions for the future. Although paramount, many licensed psychologists have yet to state their stance of whether they believe that internet-based therapeutic methods can be helpful; with fewer having declared whether they would be willing to utilize such techniques if given the opportunity. For this reason, the current study aimed to create a multi-focused survey to explore the attitudes of currently licensed and future clinicians (current Ph.D. or Psy.D. doctoral candidates) to explore differences in their acceptance of tele-health therapeutic interventions. An online survey was created to assess such attitudes across various domains of tele-health, as well as assess acceptance or rejection of such modalities. Clinical training directors, faculty, and students from around the United States, as well as members from the APA Division 12 (clinical psychology) were invited to participate. Binary logistic regression, percentages, and descriptive statistics were utilized to examine the data. Data indicated that no significant differences between currently licensed and future psychologists exist in their endorsement of tele-health modalities. However, it was found that cognitive-behavioral-, cognitive-, behavioral-, and systems-oriented psychologists were significantly more endorsing, and willing to utilize tele-health modes of interventions than were dynamic/analytic, or existential-oriented therapists. Data was further analyzed by gender, age, and the interaction of age * orientation. Results of this study will aid in creating a consensus as to the utilization of tele-health practices and help drive research by demonstrating which modalities (e.g., web camera, e-mail, etc.) and orientations should be the focus of research.

Infertility is a frequently occurring chronic health condition, which often persists throughout the reproductive years. Heightened anxiety symptoms often are comorbid with infertility diagnoses. Women experiencing infertility, and particularly those with anxiety symptoms, characterize an emerging population that deserves special attention. However, women experiencing infertility have identified barriers to seeking psychotherapy (e.g., fears of being dismissed from fertility treatment and/or stigmatized). Consequently, women diagnosed with infertility need a psychotherapy that not only can reduce these symptoms, but can also be private and convenient. The current study translated an empirically tested in-person mind/body protocol into an internet-based intervention to suit the needs of this population. Seventy-one women were randomly assigned to the intervention or a wait-list control. At the close of the study, only three participants had completed the intervention. At mid-assessment, relative to the wait-list group, the intervention group had a lower level of depressive symptoms and, for those with elevated anxiety symptoms at baseline, a lower level of anxiety symptoms. The findings suggest that even a partially completed internet-based intervention can reduce the anxiety and depressive symptoms of women with a diagnosis of infertility.

Purpose: An Internet-based tinnitus intervention for use in the United States could improve the provision of tinnitus-related services. Although clinical trials of such interventions were completed in Europe, the United Kingdom, and Australia, their suitability for adults with tinnitus in the United States is yet to be established. The aim of this study was to improve the cultural and linguistic suitability, and lower the readability level, of an existing program for tinnitus to ensure its suitability for U.S. English- and Spanish-speaking populations. Method: Guidelines for adaptation were followed and involved four phases: (a) cultural adaptations, as interventions targeted at specific cultures have been shown to improve outcomes; (b) creating Spanish materials to improve access of the materials to the large Spanish-speaking population in the United States; (c) professional review of the materials for acceptability as an intervention tool for a U.S. population; and (d) literacy-level adjustments to make the content accessible to those with lower levels of health literacy skills. Results: Cultural adaptations were made by using word substitutions, changing examples, and modifying the spelling of certain words. The materials were then translated into Spanish and cross-checked. Professional review ensured suitability of the chapters. Literacy-level adjustments ensured all chapters were within the guidelines for readability grade levels below the sixth-grade level. Conclusions: The previously developed tinnitus materials were revised to adhere to best practice guidelines and ensure cultural suitability for adults with tinnitus in the United States. As it is also available in Spanish, members of the large Hispanic community also have access to the intervention in their first language. Further studies should determine whether these changes improve patients' self-efficacy, engagement, and motivation to complete the intervention.

No description available.

Background: Although there is extensive evidence for the efficacy of online eating disorder (ED) prevention programs in clinical trials, these programs have rarely been adopted beyond the trial phase and offered to a wider audience. As risk factors for eating disorders are partly associated with overweight and overweight in turn is correlated to disordered eating, this study will offer a combined eating disorder prevention program which also promotes a balanced lifestyle to normal weight and overweight individuals alike. The efficacy of the program has been proven in previous trials. The study aims to evaluate the dissemination of a combined eating disorder prevention and health promotion program (everyBody) to women of all age groups and varying levels of ED risk status in the general population. Methods: A dissemination trial will be conducted in German-speaking countries, including 4160 women from the general population. Participants will be screened to exclude participants who are likely to have an ED. Eligible participants will be allocated to one of five program arms based on their BMI and respective ED symptoms. The guided program consists of 4 to 12 weeks of weekly sessions offering CBT-based exercises, psychoeducational material, self-monitoring, and group discussions. Outcomes will be assessed according to the RE-AIM model, including measures of effectiveness, reach, adoption, implementation, and maintenance of the program. Discussion/conclusions: This trial aims to disseminate a combined ED prevention and health promotion program in the general population, offering universal, selective and indicated prevention in one program. To our knowledge, it is the first trial to systematically evaluate dissemination efforts based on the RE-AIM model. This trial will be conducted as part of the EU-funded ICare (Integrating Technology into Mental Health Care Delivery in Europe) project.

PURPOSE: This study examined medication use by individuals with tinnitus who were seeking help for their tinnitus by means of a psychological intervention. METHOD: This study used a cross-sectional survey design and included individuals with tinnitus enrolled in an Internet-based cognitive behavioral therapy trial ( = 439). Study participants provided demographic details, completed various structured questionnaires and provided details about the medications used. The self-reported medications were classified using the United States Pharmacopeial Medicare Model Guidelines v7.0. RESULTS: Current medication use was reported by 67% ( = 293) of the study participants. Those currently using medication were older; had consulted their primary care physician, had greater tinnitus severity, depression, anxiety, and insomnia when compared with those not reporting any current medication use. The top 10 medication used included cardiovascular agents ( = 162; 55.3%), antidepressants ( = 80; 27.3%), electrolytes/minerals/metals/vitamins ( = 70; 23.9%), respiratory tract/pulmonary agents ( = 62; 21.2%), anxiolytics ( = 59; 20.1%), hormonal agents/stimulant/replacement/modifying (thyroid; = 45; 15.4%), gastrointestinal agents ( = 43; 14.7%), analgesics ( = 33; 11.3%), blood glucose regulators ( = 32; 10.9%), and anticonvulsants ( = 26; 8.87%). Some associations between type of medication used and demographic or tinnitus-related variables were noted especially for the cardiovascular agents, electrolytes/minerals/metals/vitamins, and anxiolytics. CONCLUSIONS: This exploratory study indicated a large percentage of patients using medication and a range of medications. Further studies are required to assess the effects of such medications on the tinnitus percept and concurrent medication moderate treatment effects.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-06-01T13:11:29Z No. of bitstreams: 1 nathaliamunckmachado.pdf: 2472600 bytes, checksum: 5e57568c0b9bd251def1f74cfdf9b386 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-06-02T15:13:27Z (GMT) No. of bitstreams: 1 nathaliamunckmachado.pdf: 2472600 bytes, checksum: 5e57568c0b9bd251def1f74cfdf9b386 (MD5) / Made available in DSpace on 2017-06-02T15:13:27Z (GMT). No. of bitstreams: 1 nathaliamunckmachado.pdf: 2472600 bytes, checksum: 5e57568c0b9bd251def1f74cfdf9b386 (MD5) Previous issue date: 2017-02-20 / Os fatores relacionados aos problemas causados pelo tabagismo justificam diversos esforços voltados para a busca de intervenções. Estratégias de comunicação para transmitir mensagens que expressam tanto as perdas associadas ao hábito de fumar quanto os ganhos obtidos ao parar de fumar têm sido usadas para reduzir o consumo de tabaco. Entretanto, poucos estudos têm avaliado o efeito de tais mensagens elaboradas para a cessação tabágica e ainda não existem conclusões claras sobre qual tipo de mensagem é mais eficaz para motivar as pessoas a parar de fumar. Objetivo: O estudo avaliou qual tipo de mensagem relacionada ao tabagismo (positiva ou negativa) foi mais eficaz para o recrutamento online de fumantes através do Facebook Advertising. Métodos: Anúncios contendo aspectos negativos do tabagismo e aspectos positivos da cessação foram criados e divulgados pelo Facebook Ads. Ao clicar nos anúncios, os usuários eram automaticamente direcionados para a intervenção “Viva sem Tabaco” (www.vivasemtabaco.com.br). O valor gasto na divulgação foi de 647,64 reais. Os dados foram extraídos da plataforma de anúncios do Facebook e dos logs de acesso do servidor. Os dados de logs foram tratados e analisados usando a linguagem de programação R. Resultados: O anúncio positivo atingiu 174.029 pessoas e o negativo atingiu 180.527 pessoas, que foram convertidos em 2.688 e 3.662 cliques, respectivamente. O custo do clique foi de R$0,12 para o anúncio positivo e de R$0,09 para o anúncio negativo. Conclusões: O anúncio negativo alcançou maior número de usuários, gerou mais cliques para o site e teve maior conversão em número de contas e plano de parada criados. Anúncios contendo aspectos negativos do tabagismo parecem ser mais custo efetivo para o recrutamento e engajamento de fumantes à intervenção. Além disso, o Facebook mostrou ser uma boa ferramenta de divulgação e recrutamento e pode ser uma solução para a dificuldade de alcançar fumantes para intervenções de cessação. / Introduction: Gain and loss-framed messages about smoking have been used to promote cessation. However, there are still no clear conclusions about what kind of message is more effective to motivate smokers to quit. This study compared the effectiveness of loss and gainframed messages on smokers’ online recruitment through Facebook Advertising. Methods: Loss and gain-framed messages about smoking were created and released by Facebook Ads. The users who clicked on the ads were automatically redirected to the "Live Without Tobacco" intervention (www.vivasemtabaco.com.br). The amount spent on disclosure was 647.64 Brazilian reals. Data were collected from Facebook Ads platform and from a relational database. Analyses were performed on the 6.350 users who clicked on one of the ads and on 1.731 that were redirected to the intervention. Results: Gain-framed ads reached 174,029 people and loss-framed ads reached 180,527, which were converted into 2.688 and 3,662 clicks, respectively. The cost of the click was R$0.12 for gain-famed ads and R$0.09 for the loss-framed. Conclusion: Loss-framed ads reached more users, got more clicks on the website, and had a greater conversion to the number of accounts and quit plans created. Loss-framed messages about smoking appear to be more cost effective for both recruitment and engagement of smokers to the intervention. Facebook has proven to be a good outreach and recruitment tool and can be a solution to the difficulty of reaching smokers for cessation interventions.

Les violences sexuelles ont de fortes répercussions sur la santé mentale des victimes. Aussi bien en temps de paix qu’en temps de guerre, les femmes payent un lourd tribut à la suite de ces violences. L’accès au traitement troubles anxiodépressifs liés à ces actes de violence est souvent limité dans les pays à faible revenu à cause de plusieurs facteurs. Le présent mémoire se propose de réfléchir sur les possibilités de traitement des troubles mentaux liés aux violences sexuelles chez les femmes en contexte de soins de santé primaires. Objectifs Cette étude a pour objectifs d’identifier les outils pour le dépistage et la prise en charge des troubles anxiodépressifs chez les femmes victimes de violences sexuelles au Congo Kinshasa et de proposer un modèle de psychothérapie à distance pour la prise en charge de ces victimes de violences sexuelles. Résultats Il existe des plateformes digitales de traitement des troubles anxiodépressifs utilisant la thérapie cognitivocomportementale ayant fait leurs preuves. Nous avons proposé un modèle de psychothérapie à distance s’intégrant dans le système de santé congolais en contexte de soins de santé primaires. Conclusions Malgré les obstacles à l’implantation des technologies digitales en Afrique, l’usage des plateformes à distance de thérapie web est une option envisageable dans la prise en charge des troubles anxiodépressifs chez les femmes victimes de violence sexuelle en RDC. L’intégration des plateformes de thérapie à distance dans les soins de santé primaires pourrait contribuer à diminuer efficacement la prévalence des troubles anxiodépressifs consécutifs aux violences sexuelles. Mots-clés : violences sexuelles, troubles anxiodépressifs, thérapies à distance, soins de santé primaires. / Sexual violence has a strong impact on the mental health of victims. In both peacetime and wartime, women pay a heavy price as a result of such violence. Access to treatment for mental disorders related to the consequences of such acts is often limited in low-income countries due to several factors. This paper aims to reflect on the possibilities of treating mental disorders linked to sexual violence in women in the context of primary health care. Objective Identify tools for the screening and management of anxiety-depressive disorders among women victims of sexual violence in Congo Kinshasa and propose a remote psychotherapy model for the care of these victims of sexual violence. The presentation of two articles, one of which is a narrative review providing an inventory of digital technologies for the treatment of anxiety-depressive disorders in Africa and the other a protocol on the acceptability of treatments for anxio-depressive disorders by digital technologies in the context of care primary health care was carried out. Results We have demonstrated the existence of digital platforms for the treatment of anxiety-depressive disorders using cognitive-behavioral therapy in the West. We have proposed a remote psychotherapy model that fits into the Congolese health system in the context of primary health care. Conclusions Despite the obstacles to a good establishment as well as the problems related to mental health in Africa, the use of remote web therapy platforms appears beneficial in the management of anxiety-depressive disorders. The integration of these platforms into primary health care could effectively help reduce the prevalence of anxiety-depressive disorders resulting from sexual violence. Keywords: Internet Based Intervention, Online, anxiety disorders, post-traumatic stress, depression, third countries, gender-based violence.