The cost effectiveness of Naltrexone added to cognitive-behavioral therapy in the treatment of alcohol dependence

he purpose of this study was to evaluate the comparative cost of treating alcohol dependence with either cognitive behavioral therapy (CBT) alone or CBT combined with naltrexone (CBT+naltrexone). Two hundred ninety-eight outpatients dependent on alcohol who were consecutively treated for alcohol dependence participated in this study. One hundred seven (36%) patients received adjunctive pharmacotherapy (CBT+naltrexone). The Drug Abuse Treatment Cost Analysis Program was used to estimate treatment costs. Adjunctive pharmacotherapy (CBT+naltrexone) introduced an additional treatment cost and was 54% more expensive than CBT alone. When treatment abstinence rates (36.1% CBT; 62.6% CBT+naltrexone) were applied to cost effectiveness ratios, CBT+naltrexone demonstrated an advantage over CBT alone. There were no differences between groups on a preference-based health measure (SF-6D). In this treatment center, to achieve 100 abstainers over a 12-week program, 280 patients require CBT compared with 160 CBT+naltrexone. The dominant choice was CBT+naltrexone based on modest economic advantages and significant efficiencies in the numbers needed to treat.

Assessment of Speech Dialog Systems using Multi-Modal Cognitive Load Analysis and Driving Performance Metrics

In this paper, cognitive load analysis via acoustic- and CAN-Bus-based driver performance metrics is employed to assess two different commercial speech dialog systems (SDS) during in-vehicle use. Several metrics are proposed to measure increases in stress, distraction and cognitive load and we compare these measures with statistical analysis of the speech recognition component of each SDS. It is found that care must be taken when designing an SDS as it may increase cognitive load which can be observed through increased speech response delay (SRD), changes in speech production due to negative emotion towards the SDS, and decreased driving performance on lateral control tasks. From this study, guidelines are presented for designing systems which are to be used in vehicular environments.

Cognitive behavioral interviewing for adult disorders : a practical handbook

This is a guidebook for clinicians on how to conduct assessment interviews with patients presenting with common psychological disorders. The orientation is behavioural and cognitive; so the book has wide applicability, as most clinicians explicitly or implicitly accept this combination of models as a useful basis for assessing and treating these problems. The problem areas covered are: fear and anxiety problems; depression, obesity; interpersonal problems; sexual dysfunction; insomnia; headache; and substance abuse.

Denial predicts outcome in anxiety following group cognitive behavioral therapy

This study aimed to explore whether participants' pretherapy coping strategies predicted the outcome of group cognitive behavioral therapy (CBT) for anxiety and depression. It was hypothesized that adaptive coping strategies such as the use of active planning and acceptance would be associated with higher reductions, whereas maladaptive coping strategies such as denial and disengagement would be associated with lower reductions in anxious and depressed symptoms following psychotherapy. There were 144 participants who completed group CBT for anxiety and depression. Measures of coping strategies were administered prior to therapy, whereas measures of depression and anxiety were completed both prior to and following therapy. The results showed that higher levels of denial were associated with a poorer outcome, in terms of change in anxiety but not depression, following therapy. These findings suggest the usefulness of using the Denial subscale from the revised Coping Orientation to Problems Experienced (COPE) as a predictor of outcome in group CBT for anxiety.

The treatment of recurrent abdominal pain in children : a controlled comparison of cognitive-behavioral family intervention and standard pediatric care

This study describes the results of a controlled clinical trial involving 44 7- to 14-year-old children with recurrent abdominal pain who were randomly allocated to either cognitive-behavioral family intervention (CBFI) or standard pediatric care (SPC). Both treatment conditions resulted in significant improvements on measures of pain intensity and pain behavior. However, the children receiving CBFI had a higher rate of complete elimination of pain, lower levels of relapse at 6- and 12-month follow-up, and lower levels of interference with their activities as a result of pain and parents reported a higher level of satisfaction with the treatment than children receiving SPC. After controlling for pretreatment levels of pain, children's active self-coping and mothers' caregiving strategies were significant independent predictors of pain behavior at posttreatment.

The effectiveness of psychosocial interventions for cognitive dysfunction in cancer patients who have received chemotherapy : a systematic review

Background: Chemotherapy-related cognitive dysfunction (CRCD) refers to problems with memory,attention span, or concentration, experienced by patients with cancer who have had chemotherapy. CRCD can have a significant negative effect on a patient’s quality of life. The exact cause of CRCD is unknown but is presumed to be multifactorial. Objective: To conduct a systematic review of the effectiveness of psychosocial interventions designed to treat CRCD. Methods: Participants of interest to the review were over 18 years of age, diagnosed with cancer, and receiving chemotherapy or had received chemotherapy in the past. Interventions of interest were methods to improve cognitive function. Included study designs were randomized controlled trials, quasi-experimental trials, and quantitative observational studies. The primary outcome of interest was level of cognitive function. A three-step search strategy was utilized to identify studies published from 1985 to 2011 from a wide range of databases. Joanna Briggs Institute systematic review methods were used but findings were analyzed using the Cochrane Collaboration Review Manager 5.1 program.Weightedmean differences with 95% confidence intervals were calculated from the continuous data. Results: Searching identified 3,109 potentially relevant articles and 120 full-text articles were retrieved. Two further papers were sourced from reference lists of retrieved articles. From 122 papers, six were suitable for critical appraisal and six were included in the analysis. Meta-analysis was conducted on two cognitive behavioral therapy (CBT) trials for the outcome of inability to concentrate. Significant effect was seen for one CBT intervention at 20 weeks (p = .004). Significant effect from CBT on quality of life was seen at 6-month follow-up (p < .05). Conclusions: Despite some evidence of an effect, there is insufficient evidence at this stage to strongly recommend any of the interventions to assist in decreasing the effects of CRCD, except in terms of improving quality of life.

Application of cognitive-behavioural family intervention for schizophrenia in multidisciplinary teams : what can the matter be?

Surveyed 45 therapists who had participated in a family intervention for schizophrenia training program to examine the difficulties they had encountered, their recall of the intervention strategies, and the extent that they thought the approach had become integrated in their everyday work. Between 6 mo and 3 yrs after the family training, Ss reported the number of families they had systematically treated, and the difficulties they had encountered. Allowance of time to undertake the intervention, afterhours scheduling, and illness or holidays presented particular difficulties. Only 4% reported that their knowledge of behavioral techniques was a problem, but in a written test most therapists did not display minimum recall of the material of cognitive therapy, social skills training, or behavioral strategies. The study demonstrated significant problems in disseminating cognitive-behavioral approaches to multidisciplinary settings.

The impact of users’ cognitive style on their navigational behaviors in web searching

User-Web interactions have emerged as an important area of research in the field of information science. In this study, we investigate the effects of users’ cognitive styles on their Web navigational styles and information processing strategies. We report results from the analyses of 594 minutes recorded Web search sessions of 18 participants engaged in 54 scenario-based search tasks. We use questionnaires, cognitive style test, Web session logs and think-aloud as the data collection instruments. We classify users’ cognitive styles as verbalisers and imagers based on Riding’s (1991) Cognitive Style Analysis test. Two classifications of navigational styles and three categories of information processing strategies are identified. Our study findings show that there exist relationships between users’ cognitive style, and their navigational styles and information processing strategies. Verbal users seem to display sporadic navigational styles, and adopt a scanning strategy to understand the content of the search result page, while imagery users follow a structured navigational style and reading approach. We develop a matrix and a model that depicts the relationships between users’ cognitive styles, and their navigational style and information processing strategies. We discuss how the findings from this study could help search engine designers to provide an adaptive navigation support to users.

Matching cognitive styles to computer-based instruction : an approach for enhanced learning in electrical engineering

An approach aimed at enhancing learning by matching individual students' preferred cognitive styles to computer-based instructional (CBI) material is presented. This approach was used in teaching some components of a third-year unit in an electrical engineering course at the Queensland University of Technology. Cognitive style characteristics of perceiving and processing information were considered. The bimodal nature of cognitive styles (analytic/imager, analytic/verbalizer, wholist/imager and wholist/verbalizer) was examined in order to assess the full ramification of cognitive styles on learning. In a quasi-experimental format, students' cognitive styles were analysed by cognitive style analysis (CSA) software. On the basis of the CSA results the system defaulted students to either matched or mismatched CBI material. The consistently better performance by the matched group suggests potential for further investigations where the limitations cited in this paper are eliminated. Analysing the differences between cognitive styles on individual test tasks also suggests that certain test tasks may better suit certain cognitive styles.

Cognitive behavior therapy and dialectical behavior therapy for treating obese emotional eaters

This study describes the treatment of obese individuals who rated high on emotional eating using four case studies that involved 22 sessions of either cognitive behavioral therapy (CBT) or dialectical behavioral therapy (DBT). Outcomes measures relating to weight, body mass index, emotional eating, depression, anxiety, and stress were all assessed with each participant prior to each baseline (three weekly sessions), during treatment and posttherapy. At the 8-week follow-up, the two cases that had received DBT had lost 10.1% and 7.6% of their initial body weight, whereas the two cases that had received CBT had lost 0.7% and 0.6% of their initial body weight. The two DBT cases also exhibited reductions in emotional distress, frequency of emotional eating or quantity of food eating in response to emotions, whereas the two CBT cases showed no overall reductions in these areas. Important processes from all four cases are described as are the implications to clinicians for developing more effective interventions for obese clients who engage in emotional eating.

Human–computer interaction : the impact of users’ cognitive styles on query reformulation behaviour during web searching

This paper discusses users’ query reformulation behaviour while searching information on the Web. Query reformulations have emerged as an important component of Web search behaviour and human-computer interaction (HCI) because a user’s success of information retrieval (IR) depends on how he or she formulates queries. There are various factors, such as cognitive styles, that influence users’ query reformulation behaviour. Understanding how users with different cognitive styles formulate their queries while performing Web searches can help HCI researchers and information systems (IS) developers to provide assistance to the users. This paper aims to examine the effects of users’ cognitive styles on their query reformation behaviour. To achieve the goal of the study, a user study was conducted in which a total of 3613 search terms and 872 search queries were submitted by 50 users who engaged in 150 scenario-based search tasks. Riding’s (1991) Cognitive Style Analysis (CSA) test was used to assess users’ cognitive style as wholist or analytic, and verbaliser or imager. The study findings show that users’ query reformulation behaviour is affected by their cognitive styles. The results reveal that analytic users tended to prefer Add queries while all other users preferred New queries. A significant difference was found among wholists and analytics in the manner they performed Remove query reformulations. Future HCI researchers and IS developers can utilize the study results to develop interactive and user-cantered search model, and to provide context-based query suggestions for users.

Towards an integration of the theory of planned behaviour and cognitive behavioural strategies : an example from a school-based injury prevention programme

Adolescent risk-taking behavior has potentially serious injury consequences and school-based behavior change programs provide potential for reducing such harm. A well-designed program is likely to be theory-based and ecologically valid however it is rare that the operationalisation process of theories is described. The aim of this paper is to outline how the Theory of Planned Behavior and Cognitive Behavioral Therapy informed intervention design in a school setting. Teacher interviews provided insights into strategies that might be implemented within the curriculum and provided detail used to operationalise theory constructs. Benefits and challenges in applying both theories are described with examples from an injury prevention program, Skills for Preventing Injury in Youth.

The 4C spectrum of fundamental behavioral relations for concurrent systems

The design of concurrent software systems, in particular process-aware information systems, involves behavioral modeling at various stages. Recently, approaches to behavioral analysis of such systems have been based on declarative abstractions defined as sets of behavioral relations. However, these relations are typically defined in an ad-hoc manner. In this paper, we address the lack of a systematic exploration of the fundamental relations that can be used to capture the behavior of concurrent systems, i.e., co-occurrence, conflict, causality, and concurrency. Besides the definition of the spectrum of behavioral relations, which we refer to as the 4C spectrum, we also show that our relations give rise to implication lattices. We further provide operationalizations of the proposed relations, starting by proposing techniques for computing relations in unlabeled systems, which are then lifted to become applicable in the context of labeled systems, i.e., systems in which state transitions have semantic annotations. Finally, we report on experimental results on efficiency of the proposed computations.

Towards modelling web search behaviour : integrating users’ cognitive styles

With the rapid growth of information on the Web, the study of information searching has let to an increased interest. Information behaviour (IB) researchers and information systems (IS) developers are continuously exploring user - Web search interactions to understand and to help users to provide assistance with their information searching. In attempting to develop models of IB, several studies have identified various factors that govern user's information searching and information retrieval (IR), such as age, gender, prior knowledge and task complexity. However, how users' contextual factors, such as cognitive styles, affect Web search interactions has not been clearly explained by the current models of Web Searching and IR. This study explores the influence of users' cognitive styles on their Web search behaviour. The main goal of the study is to enhance Web search models with a better understanding of how these cognitive styles affect Web searching. Modelling Web search behaviour with a greater understanding of user's cognitive styles can help information science researchers and IS designers to bridge the semantic gap between the user and the IS. To achieve the aims of the study, a user study with 50 participants was conducted. The study adopted a mixed method approach incorporating several data collection strategies to gather a range of qualitative and quantitative data. The study utilised pre-search and post-search questionnaires to collect the participants' demographic information and their level of satisfaction about the search interactions. Riding's (1991) Cognitive Style Analysis (CSA) test was used to assess the participants' cognitive styles. Participants completed three predesigned search tasks and the whole user - web search interactions, including thinkaloud, were captured using a monitoring program. Data analysis involved several qualitative and quantitative techniques: the quantitative data gave raise to detailed findings about users' Web searching and cognitive styles, the qualitative data enriched the findings with illustrative examples. The study results provide valuable insights into Web searching behaviour among different cognitive style users. The findings of the study extend our understanding of Web search behaviour and how users search information on the Web. Three key study findings emerged: • Users' Web search behaviour was demonstrated through information searching strategies, Web navigation styles, query reformulation behaviour and information processing approaches while performing Web searches. The manner in which these Web search patterns were demonstrated varied among the users with different cognitive style groups. • Users' cognitive styles influenced their information searching strategies, query reformulation behaviour, Web navigational styles and information processing approaches. Users with particular cognitive styles followed certain Web search patterns. • Fundamental relationships were evident between users' cognitive styles and their Web search behaviours; and these relationships can be illustrated through modelling Web search behaviour. Two models that depict the associations between Web search interactions, user characteristics and users' cognitive styles were developed. These models provide a greater understanding of Web search behaviour from the user perspective, particularly how users' cognitive styles influence their Web search behaviour. The significance of this research is twofold: it will provide insights for information science researchers, information system designers, academics, educators, trainers and librarians who want to better understand how users with different cognitive styles perform information searching on the Web; at the same time, it will provide assistance and support to the users. The major outcomes of this study are 1) a comprehensive analysis of how users search the Web; 2) extensive discussion on the implications of the models developed in this study for future work; and 3) a theoretical framework to bridge high-level search models and cognitive models.

Modeling users’ web search behavior and their cognitive styles

Previous studies have shown that users’ cognitive styles play an important role during Web searching. However, only limited studies have showed the relationship between cognitive styles and Web search behavior. Most importantly, it is not clear which components of Web search behavior are influenced by cognitive styles. This paper examines the relationships between users’ cognitive styles and their Web searching and develops a model that portrays the relationship. The study uses qualitative and quantitative analyses to inform the study results based on data gathered from 50 participants. A questionnaire was utilised to collect participants’ demographic information, and Riding’s (1991) Cognitive Style Analysis (CSA) test to assess their cognitive styles. Results show that users’ cognitive styles influenced their information searching strategies, query reformulation behaviour, Web navigational styles and information processing approaches. The user model developed in this study depicts the fundamental relationships between users’ Web search behavior and their cognitive styles. Modeling Web search behavior with a greater understanding of user’s cognitive styles can help information science researchers and information systems designers to bridge the semantic gap between the user and the systems. Implications of the research for theory and practice, and future work are discussed.