Reducing alcohol consumption among heavily drinking women: evaluating the contributions of life-skills training and booster sessions

Problem-drinking women (N = 144) without histories of severe physical dependence on alcohol received drinking-reduction training and were assigned to receive (or not receive) 2 treatment enhancements: life-skills training and booster sessions. The design resulted in 4 treatment conditions: drinking-reduction treatment (DRT) plus life-skills training, DRT plus booster sessions, DRT plus life-skills training and booster sessions, or DRT only. The interventions entailed 13 hr of DRT, 7 hr devoted to the life-skills training or to a no-life-skills training educational module, plus 8 hr of booster sessions for those receiving them. Participants evidenced significant reductions in alcohol use during the 18 months after treatment. Those with greater pretreatment drinking evidenced differential response to the experimental manipulations: The treatment enhancements (life skills and booster sessions) led to significantly improved drinking outcomes among women who were heavier drinkers at pretreatment. There were no significant effects of the treatment enhancements among lighter drinkers at pretreatment. The results provide support for use of treatment enhancements in interventions designed to moderate women problem drinkers' alcohol use.     

Sudden gains and critical sessions in cognitive-behavioral therapy for depression

In this study of cognitive-behavioral therapy for depression, many patients experienced large symptom improvements in a single between-sessions interval. These sudden gains' average magnitude was 11 Beck Depression Inventory points, accounting for 50% of these patients' total improvement. Patients who experienced sudden gains were less depressed than the other patients at posttreatment, and they remained so 18 months later. Substantial cognitive changes were observed in the therapy sessions preceding sudden gains, but few cognitive changes were observed in control sessions, suggesting that cognitive change in the pregain sessions triggered the sudden gains. Improved therapeutic alliances were also observed in the therapy sessions immediately after the sudden gains, as were additional cognitive changes, suggesting a three-stage model for these patients' recovery: preparation-->critical session/sudden gain-->upward spiral.     

Assertion training: Effectiveness in the treatment of depression

Assigned depressed outpatients (N = 32) to either group assertion training or “traditional” group psychotherapy. The results showed that over a relatively short period of time, assertion training was more effective than traditional psychotherapy in increasing self-reported assertiveness and in alleviating depression.     

Multisensory enhancement: gains in choice and in simple response times

Human observers can detect combinations of multisensory signals faster than each of the corresponding signals presented separately. In simple detection tasks, this facilitation in response times may reflect an enhancement in the perceptual processing stage or/and in the motor response stage. The current study compared the multisensory enhancements obtained in simple and choice response times (SRT and CRT, respectively) in bi- and tri-sensory (audio–visual–haptic) signal combinations using an identical experimental setup that differed only in the tasks—detecting the signals (SRT) or reporting the signals’ location (CRT). Our measurements show that RTs were faster in the multisensory combinations conditions compared to the single stimulus conditions and that the absolute multisensory gains were larger in CRT than in SRT. These results can be interpreted in two ways. According to a serial stages model, the larger multisensory gains in CRT may suggest that when combinations of multisensory signals are presented, an additional enhancement occurs in the cognitive processing stages engaged in the CRT, beyond the enhancement in the perceptual and motor stages common to both SRT and CRT. Alternatively, the results suggest that multisensory enhancement reflect task-dependent interactions within and between multiple processing levels rather than facilitated processing modules. Thus, the larger absolute multisensory gains in CRT may reflect the inverse effectiveness principle, and Bayesian statistics, in that the maximal multisensory enhancements occur in the more difficult (less precise) uni-sensory conditions, i.e., in the CRT.     

The influence of assertion training on three aspects of assertiveness in alcoholics.

This study examined three outcomes of assertion training considered relevant for alcoholics: (a) assertive behavior in negative situations; (b) discomfort in negative situations that call for assertive behavior; and (c) expectations of assertive behavior in sober vs. intoxicated states. Subjects were 38 male alcoholics in an inpatient treatment program. Although some behavioral competencies were acquired after assertion training, such training did not differentially reduce discomfort in negative situations or the discrepancy between perceptions of assertiveness in sober vs. intoxicated states at posttest or at 6-week follow-up.     

Cell numbers and in vitro responses of leucocytes and lymphocyte subpopulations following maximal exercise and interval training sessions of different intensities

Summary In vitro lymphocyte function and the mobilisation of peripheral blood leucocytes was examined in eight trained subjects who undertook an incremental exercise test to exhaustion and a series of interval training sessions. Venous blood samples were obtained before the incremental test, immediately after, and 30, 60, and 120 min after the test. Interval training sessions were undertaken on separate days and the exercise intensities for each of the different sessions were 30%, 60%, 90% and 120% of their maximal work capacity respectively, as determined from the incremental exercise test. There were 15 exercise periods of 1-min duration separated by recovery intervals of 2 min in each session. Venous blood samples were obtained immediately after each training session. Significant increases in lymphocyte subpopulations (CD3⁺, CD4⁺, CD8⁺, CD20⁺, and CD56⁺) occurred following both maximal and supramaximal exercise. This was accompanied by a significant decrease in the response of cultures of peripheral blood lymphocytes to Concanavalin A (ConA), a T-cell mitogen. The state of lymphocyte activation in vivo as measured by CD25⁺ surface antigen was not, however, affected by acute exercise. The total number of lymphocytes, distribution of lymphocyte subpopulations and in vitro lymphocyte response to ConA had returned to pre-exercise levels within half an hour of termination of exercise but serum cortisol concentrations had not begun to fall at this time. There was a significant decrease in the CD4⁺:CD8⁺ cell ratio following exercise; this was more the result of increases in CD3^–CD8⁺ cells (CD8⁺ natural killer cells) than to CD3⁺CD8⁺ cells (CD8⁺ T-lymphocytes). Decreased responsiveness of T-cells to T-cell mitogens, postexercise, may have been the result of decreases in the percentage of T-cells in postexercise mixed lymphocyte cultures rather than depressed cell function. The cause of this was an increase in the percentage of natural killer cells which did not respond to the T-cell mitogen. The results indicated that while a substantial immediate in vitro immunomodulation occurred with acute exercise, this did not reflect an immunosuppression but was rather the result of changes in the proportions of reactive cells in mononuclear cell cultures. We have also demonstrated that the degree of the change in distribution of lymphocyte subpopulation numbers and responsiveness of peripheral blood mononuclear cells in in vitro mitogen reactions increased with increasing exercise intensity. Plasma volume changes may have contributed to some of the changes seen in leucocyte population and subpopulation numbers during and following exercise.     

Specificity of training velocity and training load on gains in isokinetic knee joint strength

The present study investigated the effects of three different strength training regimes on the isokinetic strength profile of the knee extensors (quadriceps, Q) and flexors (hamstrings, H) and if increases in isokinetic strength were accompanied by an enhanced performance during a more complex leg movement, the soccer kick. Twenty-two elite soccer players performed 12 weeks of strength training (three times per week) at either high resistance (HR group: 4 sets, 8 reps, 8RM loading), low resistance (LR group: 4 sets, 24 reps, 24RM loading), loaded kicking movements (LK group: 4 sets, 16 reps, 16RM loading) while one group served as controls (CO group). Isokinetic concentric and eccentric moment of force was obtained (KinCom) as peak moment (M_peak) and moment at 50° knee flexion (M₅₀) at angular velocities of 30, 120, 240° s^-1. Isokinetic knee joint strength was unchanged in groups LR, LK, CO. However, after the HR strength training, concentric M_peak (±SD) increased (P<0.01) at 30° s^-1 (Q, 258±37 to 297±57 Nm; H, 122±22 to 140±21 Nm). Furthermore, eccentric M_peak increased at 30, 120 and 240° s^-1 (Q, 274±60 to 345±57 Nm (P<0.01), 291±56 to 309±49 Nm and 275±43 to 293±36 Nm (P<0.05), respectively; H, 143±32 to 158±25 Nm, 152±39 to 169±31 Nm and 148±27 to 163±19 Nm (P<0.05)). Corresponding increases (P<0.05) were observed for M₅₀. The H/Q ratio calculated as eccentric hamstring strength divided by concentric quadriceps strength (H_ecc/Q_con, representative for knee extension) at 240° s^-1 increased (P<0.05) from 107 to 118% (based on M_peak) and from 90 to 105% (M₅₀). Kicking performance estimated by maximal ball flight velocity was unaffected by any of the strength training regimes investigated. In conclusion, only heavy-resistance strength training induced increases in isokinetic muscle strength in the absence of learning effects. Concentric strength gains were observed at the actual velocity of training, while eccentric strength gains were found over the entire range of velocities examined. The capacity of the hamstring muscles for providing stability to the knee joint during fast extension was augmented as a result of the heavy-resistance strength training. Strength training should be integrated with other types of training involving the actual movement pattern in order to increase the performance within more complex movement patterns.     

The effects of scheduling format and booster sessions on a broad-spectrum psychosocial approach to smoking prevention

The effectiveness of a fifteen session psychosocial smoking prevention strategy was tested on 902 seventh graders from seven junior high schools in suburban New York over 2 years. The prevention program was implemented by regular classroom teachers and consisted of a cognitive component dealing with the immediate consequences of cigarette smoking, a decision-making component, a relaxation-training component, a social skills training component, and a self-improvement component. In addition to testing the overall effectiveness of this approach, the relative efficacy of two different scheduling formats was compared and the extent to which “booster” sessions conducted during the year after completion of the program helped to maintain reductions in new smoking was also examined. Results indicated that the prevention program was able to reduce new cigarette smoking by 50% at the end of the first year and by 55% at the end of the second year for the intensive format condition. New regular cigarette smoking was reduced by 87% in the second year for the students in the booster condition. Significant changes consistent with nonsmoking were also evident on several cognitive, attitudinal, and personality variables.     

Goal clarity as a component of assertive behavior and a result of assertion training

Eighty Ss were given the Rathus assertion schedule and a separate test in which their clarity of goals in various interpersonal situations was assessed. It was found that there was a direct relationship between assertion and goal clarity scores; more assertive Ss had greater goal clarity. The Rathus assertion schedule and half of the goal clarity test were administered to 24 Ss, who then were assigned randomly to 10 sessions of either an assertion training group or an insight therapy group. After treatment, the Rathus assertion schedule and the other half of the goal clarity test were administered to the 24 Ss. While there was no difference between the two groups prior to treatment, after treatment the assertion group demonstrated significantly greater goal clarity and significantly greater change on the Rathus assertion schedule than did the insight group.     

Sudden gains in the treatment of generalized anxiety disorder

The objective of this study was to investigate the prevalence and timing of sudden gains over the course of brief, psychodynamically oriented treatment for generalized anxiety disorder (GAD). Data were used from two studies of brief (i.e., 16-session) supportive-expressive psychotherapy for GAD. Anxiety symptoms were measured at every weekly treatment session. Sudden gains in anxiety symptoms were defined to parallel previous research on sudden gains in major depressive disorder (MDD). Overall, sudden gains were found for 11 of 68 participants (16.2%), with 4 (36.4%) of these patients experiencing reversals of these gains and losing over 50% of the sudden gain during subsequent treatment sessions. Applying a baseline severity cutoff and a duration criteria similar to those used in previous studies of sudden gains resulted in 10 of 29 (34.5%) patients showing sudden gains. Of these sudden gainers, 4 (40.0%) experienced a reversal and 7 (70%) experienced an upwards spike in symptoms during their psychotherapy course. When defined in a parallel fashion, rates of sudden gains in GAD are similar to those found in MDD, although anxiety symptoms are highly variable.     

Effectiveness of annual booster inoculations against various influenza serotypes and the procedure for mass vaccination

The epidemiological observation during an outbreak of A (H3N2) influenza in February-March, 1983, showed that the third annual vaccination with killed influenza vaccine did not enhance the effectiveness of vaccinations in the populations under study. It was observed that 14 months after immunization, 55.9% of the subjects examined had antibody titres of 1:40 or higher to the A/Bangkok/1/79 strain antigenically related to the vaccine strain, and 41% of the subjects of this group had antibodies to the subsequent drift variant of influenza A (H3N2) virus. These values were significantly higher than those in the group of subjects given no influenza vaccine. It is suggested that after 2 years of vaccination with killed influenza vaccines with the maximum coverage of the entire population, vaccinations be given alternately to half of previously vaccinated subjects with a 2-year interval up to the emergence of a new shift variant of influenza A virus, when again vaccination of the entire population for two successive years will be required.     

Enhanced performance in elderly subjects following bright light treatment of sleep maintenance insomnia

Sixteen older individuals with sleep maintenance insomnia were treated with night-time bright-light exposure (BL) while living at home. Twelve consecutive days of acute light treatment were followed by a 3-mo maintenance light-treatment period. Subjects completed laboratory evaluation sessions on five separate occasions (prior to and following the acute light-treatment period, and once per month during the maintenance period). During each laboratory session, performance levels, sleep, and core body temperature were measured. The performance battery consisted of four computerized tasks (Logical Reasoning, Stroop Congruency, Two Letter Visual Search, and Wilkinson Four-Choice Reaction Time) and was administered every 2 h between 10.00 and 18.00 hours. Subjects improved significantly on three of the four tasks from pre-BL to post-BL. During the maintenance period, subjects who received active BL treatment maintained significantly higher performance levels than a control BL group. Light treatment improved sleep efficiency and delayed the phase of the body temperature rhythm. Performance improvements were significantly related only to sleep and not to circadian phase. The implications for non-circadian treatments of sleep maintenance insomnia and cognitive functioning in the elderly are discussed.