Interview Skills for Adults with Autism Spectrum Disorder: A Pilot Randomized Controlled Trial

The purpose of this pilot study was to evaluate the efficacy of the interview skills curriculum (ISC), a manualized 12-week group-delivered intervention for young adults with autism spectrum disorder (ASD). This intervention aims to increase social–pragmatic skills essential to a successful job interview. Twenty-eight adults (18–36 years) were randomly assigned to one of two groups: ISC or waitlist control. Results revealed that the experimental group showed larger gains in social–pragmatic skills observed during a mock job interview than the control group. Treatment effects on distal outcomes, including social adaptive behaviors and depressive symptoms were not significant, although the respective effect sizes were medium/large. Results indicate that a brief, low-intensity treatment can improve the job-interview performance of young adults with ASD.     

A Pilot Randomized Controlled Trial of a Daily Living Skills Intervention for Adolescents with Autism

Journal of Autism and Developmental Disorders - Adolescents with autism spectrum disorder (ASD) without an intellectual disability have daily living skills (DLS) impairments. An initial feasibility...     

Theory of Mind Training in Children with Autism: A Randomized Controlled Trial

Many children with Autism Spectrum Disorders (ASD) participate in social skills or Theory of Mind (ToM) treatments. However, few studies have shown evidence for their effectiveness. The current study used a randomized controlled design to test the effectiveness of a 16-week ToM treatment in 8–13 year old children with ASD and normal IQs (n = 40). The results showed that, compared to controls, the treated children with ASD improved in their conceptual ToM skills, but their elementary understanding, self reported empathic skills or parent reported social behaviour did not improve. Despite the effects on conceptual understanding, the current study does not indicate strong evidence for the effectiveness of a ToM treatment on the daily life mindreading skills.     

Mirror Illusion for Sensori-Motor Training in Stroke: A Randomized Controlled Trial

Background

Poststroke, sensory deficits are not uncommon. In spite of the close association between the sensory and motor recovery, the deficits are usually underemphasized. Mirror therapy (MT), a neural-based approach for the motor deficit has not been explored for the sensory impairment. The objective of the present study was to develop and determine the effect of a MT program for sensori-motor impairment among poststroke subjects.

Social Cognition Enhancement Training for Schizophrenia: A Preliminary Randomized Controlled Trial

The purpose of this study was to evaluate whether social cognition enhancement training (SCET) is effective in improving social context appraisal and perspective-taking abilities of patients with schizophrenia. A total of 34 patients were randomly assigned to receive SCET plus standard psychiatric rehabilitation training or standard psychiatric rehabilitation training only. SCET was conducted twice weekly on a group basis for 6 months. Some social cognitive abilities were improved rapidly after 2-month treatment whereas some improved only after 6-month treatment. These results show promise for the impact of SCET on the social cognitive functioning of individuals with chronic schizophrenia, and further investigation is merited.Kee-Hong Choi and Jung-Hye Kwon are affiliated with the Department of Psychology, Korea University, Seoul, Korea     

Barriers to Supervised Exercise Training in a Randomized Controlled Trial of Breast Cancer Patients Receiving Chemotherapy

Background Exercise adherence is a challenge for breast cancer patients receiving chemotherapy but few studies have identified the key barriers. Purpose In this paper, we report the barriers to supervised exercise in breast cancer patients participating in a randomized controlled trial. Methods Breast cancer patients initiating adjuvant chemotherapy (N = 242) were randomly assigned to usual care (n = 82) or supervised resistance (n = 82) or aerobic (n = 78) exercise. Participants randomized to the two exercise groups (n = 160) were asked to provide a reason for each missed exercise session. Results The two exercise groups attended 70.2% (5,495/7,829) of their supervised exercise sessions and provided a reason for missing 89.5% (2,090/2,334) of their unattended sessions. The 2,090 reasons represented 36 different barriers. Feeling sick (12%), fatigue (11%), loss of interest (9%), vacation (7%), and nausea/vomiting (5%) accounted for the most missed exercise sessions. Disease/treatment-related barriers (19 of the 36 barriers) accounted for 53% (1,102/2,090) of all missed exercise sessions. Demographic and medical variables did not predict the types of exercise barriers reported. Conclusions Barriers to supervised exercise in breast cancer patients receiving chemotherapy are varied but over half can be directly attributed to the disease and its treatments. Behavioral support programs need to focus on strategies to maintain exercise in the face of difficult treatment side effects. Rapid Communication Accepted by Annals of Behavioral Medicine (October 8, 2007).     

Pilot Randomized Controlled Trial of the WHO Caregiver Skills Training in Public Health Services in Italy

Journal of Autism and Developmental Disorders - Parents of children with ASD (N?=?86; mean age 44.8 months; 67 boys) were randomized to either WHO Caregiver Skills Training...     

Mindfulness Training Changes Brain Dynamics During Depressive Rumination: A Randomized Controlled Trial

BackgroundDepression is a leading cause of disability worldwide and its prevalence is on the rise. One of the most debilitating aspects of depression is the dominance and persistence of depressive rumination, a state of mind that is linked to onset and recurrence of depression. Mindfulness meditation trains adaptive attention regulation and present-moment embodied awareness, skills that may be particularly useful during depressive mind states characterized by negative ruminative thoughts.MethodsIn a randomized controlled functional magnetic resonance imaging study (N = 80), we looked at the neurocognitive mechanisms behind mindfulness-based cognitive therapy (n = 50) for recurrent depression compared with treatment as usual (n = 30) across experimentally induced states of rest, mindfulness practice and rumination, and the relationship with dispositional psychological processes.ResultsMindfulness-based cognitive therapy compared with treatment as usual led to decreased salience network connectivity to the lingual gyrus during a ruminative state, and this change in salience network connectivity mediated improvements in the ability to sustain and control attention to body sensations.ConclusionsThese findings showed that a clinically effective mindfulness intervention modulates neurocognitive functioning during depressive rumination and the ability to sustain attention to the body.     

Social Skills Training for Young Adults with High-Functioning Autism Spectrum Disorders: A Randomized Controlled Pilot Study

Despite the psychosocial difficulties common among young adults with autism spectrum disorders (ASD), little to no evidence-based social skills interventions exist for this population. Using a randomized controlled trial (RCT) design, the current study tested the effectiveness of an evidence-based, caregiver-assisted social skills intervention known as PEERS for Young Adults with high-functioning young adults with ASD (ages 18-23) using self- and caregiver-report measures. Results revealed that treated young adults reported significantly less loneliness and improved social skills knowledge, while caregivers reported significant improvements in young adults' overall social skills, social responsiveness, empathy, and frequency of get-togethers. Results support the effectiveness of using this caregiver-assisted, manualized intervention for young adults with ASD.     

Aggression Prevention Training for Individuals With Dementia and Their Caregivers: A Randomized Controlled Trial

ObjectiveInternational appeals call for interventions to prevent aggression and other behavioral problems in individuals with dementia (IWD). Aggression Prevention Training (APT), based on intervening in three contributors to development of aggression (IWD pain, IWD depression, and caregiver–IWD relationship problems) aims to reduce incidence of aggression in IWD over 1 year.DesignRandomized, controlled trial.SettingThree clinics that assess, diagnose, and treat dementia.ParticipantsTwo hundred twenty-eight caregiver–IWD dyads who screened positive for IWD pain, IWD depression, or caregiver–IWD relationship problems randomized to APT or Enhanced Usual Primary Care (EU-PC).InterventionAPT, a skills-based intervention delivered over 3 months to address pain/depression/caregiver–IWD relationship issues. EU-PC included printed material on dementia and community resources; and eight brief, weekly support calls.MeasurementsThe primary outcome was incidence of aggression over 1 year, determined by the Cohen Mansfield Agitation Inventory-Aggression Subscale. Secondary outcomes included pain, depression, caregiver–IWD relationship, caregiver burden, positive caregiving, behavior problems, and anxiety.ResultsAggression incidence and secondary outcomes did not differ between groups. However, in those screening positive for IWD depression or caregiver–IWD relationship problems, those receiving EU-PC had significant increases in depression and significant decreases in quality of the caregiver–IWD relationship, whereas those receiving APT showed no changes in these outcomes over time.ConclusionThe cost to patients, family, and society of behavioral problems in IWD, along with modest efficacy of most pharmacologic and nonpharmacologic interventions, calls for more study of novel preventive approaches.     

Alleviated Anxiety Boosts Memory Training Gain in Older Adults with Subjective Memory Complaints: A Randomized Controlled Trial

ObjectiveOlder adults with subjective memory complaints (SMC) have a higher risk of dementia and commonly demonstrate symptoms of depression and anxiety. The study aimed to examine the effect of a memory training program for individuals with SMC, and whether additional group counseling aimed at alleviating depression and anxiety would boost memory training gains.DesignA three-armed, double-blind, randomized controlled trial.Setting and ParticipantsCommunity-dwelling older adults with SMC, age ≥60.MethodsParticipants (n = 124) were randomly assigned to memory training (MT), group counseling (GC), or GC + MT intervention. The GT + MT group received 3 sessions of group counseling followed by a 4-week memory training, while the MT group attended reading and memory training, and the GC group received group counseling and health lectures. Cognitive function and symptoms of depression and anxiety were assessed at baseline, mid-, and post-intervention.ResultsAfter group counseling, the GC + MT and GC groups showed reduced symptoms of anxiety compared to the MT group. Memory training enhanced associative learning in both MT and GC + MT groups compare with the GC group, but the GC + MT group demonstrated a larger memory improvement (Cohen's d = 0.57) than the MT group (Cohen's d = 0.44).Conclusion and ImplicationsGroup counseling decreased symptoms of anxiety, memory training increased associative learning, and the combination of two intervention induced larger memory gain than memory training alone. The results suggest that it may need to integrate treatment for anxiety into memory training for older adults with SMC to achieve better intervention effect.Trial RegistrationChiCTR-IOR-15006165 in the Chinese Clinical Trial Registry.     

Lamotrigine Compared with Lithium in Mania: A Double-Blind Randomized Controlled Trial

Background: Preliminary data from case reports and small open trials suggest a role for lamotrigine in the treatment of bipolar disorder, although controlled data for the manic phase are lacking. Method: Thirty inpatients with a DSM-IV diagnosis of bipolar I disorder, currently manic, were randomly allocated to receive either lamotrigine (25 mg once daily for 1 week, 50 mg once daily for the second week, and 100 mg once daily for the last 2 weeks) or lithium (400 mg twice daily) in a 4-week randomized, double-blind, clinical trial. Results: Both treatments improved symptoms of mania, as assessed by the Mania Rating Scale, Brief Psychiatric Rating Scale, Clinical Global Impression severity and improvement scales, and the Global Assessment of Functioning scale. There were no significant differences between groups at any time point, suggesting that the dose escalation required for lamotrigine did not adversely affect its onset of action. Secondary outcome measures, including the use of lorazepam as rescue medication, did not differ between the groups. No significant adverse events were noted in either group. Conclusion: In this pilot study, lamotrigine was as effective as lithium in the treatment of patients with bipolar disorder hospitalised for acute mania.     

Online Social Cognition Training in Schizophrenia: A Double-Blind,Randomized, Controlled Multi-Site Clinical Trial

Social cognition (SC), the mental operations underlying social functioning, are impaired in schizophrenia. Their direct link to functional outcome and illness status have made them an important therapeutic target. However, no effective treatment for these deficits is currently applied as a standard of care. To address this need, we have developed SocialVille—an online, plasticity-based training program that targets SC deficits in schizophrenia. Here we report the outcomes of a double-blind, controlled, randomized, multi-site clinical trial of SocialVille. Outpatients with schizophrenia were randomized to complete 40 sessions of either SocialVille (N = 55 completers) or active control (computer games; N = 53 completers) from home. The a priori co-primary outcome measures were a social cognitive composite and a functional capacity outcome (UCSD Performance-based Skills Assessment [UPSA-2]). Secondary outcomes included a virtual functional capacity measure (VRFCAT), social functioning, quality of life, and motivation. Linear mixed models revealed a group × time interaction favoring the treatment group for the social cognitive composite (b = 2.81; P < .001) but not for the UPSA-2 measure. Analysis of secondary outcome measures showed significant group × time effects favoring the treatment group on SC and social functioning, on the virtual functional capacity measure and a motivation subscale, although these latter findings were nonsignificant with FDR correction. These results provide support for the efficacy of a remote, plasticity-based social cognitive training program in improving SC and social functioning in schizophrenia. Such treatments may serve as a cost-effective adjunct to existing psychosocial treatments. Trial Registration: {"type":"clinical-trial","attrs":{"text":"NCT02246426","term_id":"NCT02246426"}}NCT02246426.     

Aging and Engaging: A Pilot Randomized Controlled Trial of an Online Conversational Skills Coach for Older Adults

ObjectiveCommunication difficulties negatively impact relationship quality and are associated with social isolation and loneliness in later life. There is a need for accessible communication interventions offered outside specialty mental health settings.DesignPilot randomized controlled trial.SettingAssessments in the laboratory and intervention completed in-home.ParticipantsTwenty adults age 60 and older from the community and a geriatric psychiatry clinic.InterventionA web-based communication coach that provides automated feedback on eye contact, facial expressivity, speaking volume, and negative content (Aging and Engaging Program, AEP), delivered with minimal assistance in the home (eight brief sessions over 4–6 weeks) or control (education and videos on communication).MeasurementsSystem Usability Scale and Social Skills Performance Assessment, an observer-rated assessment of social communication elicited through standardized role-plays.ResultsNinety percent of participants completed all AEP sessions and the System Usability Scale score of 68 was above the cut-off for acceptable usability. Participants randomized to AEP demonstrated statistically and clinically significant improvement in eye contact and facial expressivity.ConclusionThe AEP is acceptable and feasible for older adults with communication difficulties to complete at home and may improve eye contact and facial expressivity, warranting a larger RCT to confirm efficacy and explore potential applications to other populations, including individuals with autism and social anxiety.