Kleinke, Kristian
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Publication Access status: Metadata only , Effect of Life Review Therapy for Holocaust Survivors: A randomized controlled trialDespite the therapeutic needs of aging Holocaust survivors, no randomized controlled trial (RCT) of psychotherapy exists for this population, with very few on older adults in general. This RCT aimed to compare the efficacy of Life Review Therapy for Holocaust survivors (LRT‐HS) relative to a supportive control group. Holocaust survivors with a probable diagnosis of full or subsyndromal posttraumatic stress disorder (PTSD) or depressive disorder were included. Exclusion criteria were probable dementia, acute psychotic disorder, and acute suicidality. The predefined primary endpoint was the course of PTSD symptom scores. In total, 49 of 79 consecutive individuals assessed for eligibility were randomized and included in the intent‐to‐treat analyses (LRT‐HS: n = 24, control: n = 25; M age = 81.5 years, SD = 4.81, 77.6% female). Linear mixed models revealed no statistically significant superiority of LRT‐HS for PTSD symptoms at posttreatment, with moderate effect sizes, Time x Condition interaction: t (75) = 1.46, p = .148, d within = 0.70, d between = 0.41, but analyses were significant at follow‐up, with large effect sizes, t (79) = 2.89, p = .005, d within = 1.20, d between = 1.00. LRT‐HS superiority for depression was observed at posttreatment, t (73) = 2.58, p = .012, but not follow‐up, t (76) = 1.08, p = .282, with moderate effect sizes, d within = 0.46–0.60, d between = 0.53–0.70. The findings show that even in older age, PTSD and depression following exposure to multiple traumatic childhood events can be treated efficaciously using an age‐appropriate treatment that includes structured life review and narrative exposure.Source Type:Article4 - Some of the metrics are blocked by yourconsent settings
Publication Access status: Metadata only , Mobile phone-based approach bias retraining for smokers seeking abstinence: a randomized-controlled studyApproach bias modification (ApBM) has shown promise in addiction treatment, but effects are small and ecological validity suffers from completing trainings in the laboratory. Providing app-based trainings via mobile phones could increase training efficacy. One-hundred-and-thirty-one smokers seeking abstinence attended a smoking cessation intervention and were thereafter randomized to one of three conditions: (a) app-based ApBM-training; (b) app-based sham training; (c) no training. App trainings were performed on 14 consecutive days at home. Behavioral and self-report data was assessed at pretest, posttest, and a 6-week follow-up. App-based ApBM led to stronger reductions in cigarette smoking as compared to no training. However, both training variants led to stronger declines in nicotine dependence and the sham training was superior in reducing alcohol consumption. Although approach biases for positive cues increased following ApBM training, this effect did not mediate treatment outcome. Other smoking-related cognitive biases did not change after training. Our results can inform future research in the optimization and advancement of ApBM treatment for addiction. Trial registration Registered with Current Controlled Trials: study ID ISRCTN15690771. Registered on 20 November 2018; http://www.isrctn.com/ISRCTN15690771 .Source Type:Article - Some of the metrics are blocked by yourconsent settings
Publication Access status: Open Access , Repressive and vigilant coping styles in stress and relaxation: evidence for physiological and subjective differences at baseline, but not for differential stress or relaxation responsesIntroduction: Previous research suggested differential stress reactivity depending on individuals’ coping style, e.g., as classified by the model of coping modes. Specifically, stronger physiological reactivity and weaker subjective stress ratings were found for repressors than for sensitizers. However, it remains to be investigated (i) whether these findings, which are largely based on social stress induction protocols, also generalize to other stressors, (ii) whether repressors vs. sensitizers also exhibit differential stress recovery following the application of a relaxation method, and (iii) which stress reactivity and recovery patterns are seen for the two remaining coping styles, i.e., fluctuating, and non-defensive copers. The current study thus examines stress reactivity in physiology and subjective ratings to a non-social stressor and the subsequent ability to relax for the four coping groups of repressors, sensitizers, fluctuating, and non-defensive copers. Methods: A total of 96 healthy participants took part in a stress induction (Mannheim Multicomponent Stress Test) and a subsequent relaxation intervention. Subjective ratings of stress and relaxation, heart rate (HR), heart rate variability (HRV), and blood pressure were assessed during the experiment. HR and blood pressure are markers of the sympathetic stress response that can be regulated by relaxation, while HRV should increase with relaxation. To investigate long-term relaxation effects, subjective ratings were also assessed on the evening of testing. Results: Despite successful stress induction, no differential responses (baseline to stress, stress to relaxation) were observed between the different coping groups on any of the measures. In contrast, a strong baseline effect was observed that persisted throughout the experiment: In general, fluctuating copers showed lower HR and higher HRV than non-defensive copers, whereas repressors reported lower subjective stress levels and higher levels of relaxation during all study phases. No differences in subjective ratings were observed in the evening of testing. Conclusion: Contrary to previous research, no differential stress reactivity pattern was observed between coping groups, which could be due to the non-social type of stressor employed in this study. The novel finding of physiological baseline differences between fluctuating and non-defensive individuals is of interest and should be further investigated in other stressor types in future research.Source Type:Article324 140 - Some of the metrics are blocked by yourconsent settings
Publication Access status: Open Access , Retraining automatic action tendencies for smoking using mobile phone-based approach-avoidance bias training: a study protocol for a randomized controlled studyBackground Automatic tendencies to approach drug-related cues have been linked to the development and maintainance of harmful drug-taking behavior. Recent studies have demonstrated that these automatic approach tendencies can be targeted directly by means of cognitive bias modification (CBM). Moreover, changing those approach tendencies may enhance treatment outcomes. However, training and therapy effects tend to be rather small and adherence to the training might be impaired by time-consuming multiple laboratory training sessions. Here, we present a protocol for a randomized controlled design to improve CBM training efficiency and facilitate access to the training by providing mobile-phone-based training sessions at home to current smokers motivated to quit smoking. Methods Participants (n = 100) are current smokers who smoke at least six cigarettes per day for at least 6 months and are willing to quit smoking. All participants attend a brief behavioral smoking cessation intervention (TAU) and are randomly assigned either to an experimental (TAU + training) or a control group. Participants in the experimental condition are given access to a training application (app) aimed at retraining automatic approach biases for smoking cues. Participants are instructed to perform the app training outside the laboratory context on a daily basis for 14 consecutive days. Participants in the control group do not receive the training. Primary outcome measures are changes in smoking-related approach biases and reductions in daily nicotine consumption as assessed at baseline, post-training and at 6-week follow up. Secondary outcome measures include approach biases for alternative stimuli or smoking stimuli to which participants were not exposed during training, attentional and association biases, biochemical outcomes, and self-reported smoking behavior, also measured at three different time points (baseline, post-training, and follow up). After completion of the study, smokers in the control condition will receive access to the training app. Discussion This randomized controlled trial is the first to test the effectiveness of an app-based CBM intervention as an adjunct to a brief smoking cessation intervention in smokers motivated to quit smoking. The results of this study can inform future research in the optimization and advancement of CBM treatment for addiction.Source Type:Article465 115