Integrating Mindfulness into Positive Psychology: a Randomised Controlled Trial of an Online Positive Mindfulness Program

The purpose of the present study was to test the efficacy of an 8-week online intervention-based Positive Mindfulness Program (PMP) that integrated mindfulness with a series of positive psychology variables, with a view to improving wellbeing scores measured in these variables. The positive mindfulness cycle, based on positive intentions and savouring, provides the theoretical foundation for the PMP. The study was based on a randomised wait-list controlled trial; and 168 participants (128 females, mean age = 40.82) completed the intervention which included daily videos, meditations, and activities. The variables tested included wellbeing measures, such as gratitude, self-compassion, self-efficacy, meaning, and autonomy. Pre- and post- intervention data, including one month after the end of the intervention, were collected from both experimental and control groups. The post-test measurements of the experimental participants showed a significant improvement in all the dependent variables compared with the pre-test ones and were also significantly higher than those of the control group. One month after the intervention, the experimental group participants retained their improvement in 10 out of the 11 measurements. These positive results indicate that PMP may be effective in enhancing wellbeing and other positive variables in adult, non-clinical populations.

The feasibility, delivery and cost effectiveness of drink driving interventions : a qualitative analysis of professional stakeholders

Many intervention programs have been designed to decrease the rate of drink driving by altering the behavioural characteristics that may lead a person to drink and drive. However, most programs target high risk and repeat offenders. There is very little research on the feasibility and effectiveness of first offender programs. This project is part of a larger program of research that focuses on first time offenders, in order to reduce the rate of subsequent drink driving which may result in a repeat offence. A number of professional stakeholders were approached and interviewed with a view to capturing and reflecting current drink driving related concerns while developing an intervention in the context of Australian drink driving related legislation. The qualitative interviews involved open ended questioning which led to the themes discussed in the analysis. Included in the interviews were senior representatives from the Magistrates Court, Queensland Transport, Probation & Parole, Queensland Corrective Services, Royal Automobile Club Queensland (RACQ), Intraface Consulting (drug & alcohol EAP), Brisbane Police Prosecution Corps, Queensland Police Service and private practice psychology. Issues such as delivery of interventions, feasibility and cost-effectiveness were discussed, as were potential content and design. It was generally agreed that a tailored online intervention imposed as a sentencing option would be the most effective for first time offenders in terms of cost, ease of delivery and feasibility. The development of an online intervention program for first offenders is widely supported by professional stakeholders.

Development of the OnTrack Diabetes program

Background: Type 2 diabetes affects an estimated 347 million people worldwide and often leads to serious complications including blindness, kidney disease, and limb amputation. Comorbid dysphoria is common and is an independent risk factor for poor glycaemic control. Professional support for diabetes self-management and dysphoria has limited availability and involves high costs, especially after regular hours, and in rural and remote areas. Web-based cognitive behavior therapy offers highly accessible, acceptable, and cost-effective support for people with diabetes. This paper describes the development of OnTrack Diabetes, a self-guided, Web-based program to promote improved physical and emotional self-management in people with Type 2 diabetes. Objective: The objective of the study is to describe the development of the OnTrack Diabetes program, which is a self-guided, Web-based program aimed to promote euthymia and improved disease self-management in people with Type 2 diabetes. Methods: Semistructured interviews with 12 general practitioners and 13 patients with Type 2 diabetes identified enablers of and barriers to effective diabetes self-management, requirements for additional support, and potential program elements. Existing resources and research data informed the development of content, and consultants from relevant disciplines provided feedback on draft segments and reviewed the program before release. Using a self-guided delivery format contained costs, in addition to adapting program features and modules from an existing OnTrack program. Results: A separate paper describes the protocol for a randomized controlled trial to provide this required evaluation. Conclusions: Development of the OnTrack Diabetes program demonstrates strategies that help ensure that a program is acceptable to users. The next stages involve testing users’ experiences and examining the program’s effectiveness and cost-effectiveness in randomized controlled trials.

Reducing recidivism by first time drink driving offenders

This research provides a detailed description of first time drink driving offenders at the time of their court appearance and at follow-up to examine the factors leading to subsequent drink driving. To develop models for behavioural change a novel theoretical application of the Health Action Process Approach was used to determine what enables some offenders to avoid future drink driving. Utilising self-report and official offence records in the follow-up of offenders enabled an in depth exploration of first offender characteristics and drink driving behaviour. The research demonstrates that first offenders are not a homogenous group in terms of their characteristics or the circumstances of the offence and will be used to develop tailored countermeasures for first offenders including online intervention programs.

Study protocol for a randomised controlled trial of internet-based cognitive-behavioural therapy for obsessive-compulsive disorder.

Obsessive-Compulsive Disorder (OCD) is a common chronic psychiatric disorder that constitutes a leading cause of disability. Although Cognitive-Behaviour Therapy (CBT) has been shown to be an effective treatment for OCD, this specialised treatment is unavailable to many due to access issues and the social stigma associated with seeing a mental health specialist. Internet-based psychological treatments have shown to provide effective, accessible and affordable treatment for a range of anxiety disorders, and two Randomised Controlled Trials (RCTs) have demonstrated the efficacy and acceptability of internet-based CBT (iCBT) for OCD, as compared to waitlist or supportive therapy. Although these initial findings are promising, they do not isolate the specific effect of iCBT. This paper details the study protocol for the first randomised control trial evaluating the efficacy of therapist-assisted iCBT for OCD, as compared to a matched control intervention; internet-based therapist-assisted progressive relaxation training (iPRT). It will aim to examine whether therapist-assisted iCBT is an acceptable and efficacious treatment, and to examine how effectiveness is influenced by patient characteristics.

Screening for obstructive sleep apnea on the internet: randomized trial.

BACKGROUND: Obstructive sleep apnea is underdiagnosed. We conducted a pilot randomized controlled trial of an online intervention to promote obstructive sleep apnea screening among members of an Internet weight-loss community. METHODS: Members of an Internet weight-loss community who have never been diagnosed with obstructive sleep apnea or discussed the condition with their healthcare provider were randomized to intervention (online risk assessment+feedback) or control. The primary outcome was discussing obstructive sleep apnea with a healthcare provider at 12 weeks. RESULTS: Of 4700 members who were sent e-mail study announcements, 168 (97% were female, age 39.5 years [standard deviation 11.7], body mass index 30.3 [standard deviation 7.8]) were randomized to intervention (n=84) or control (n=84). Of 82 intervention subjects who completed the risk assessment, 50 (61%) were low risk and 32 (39%) were high risk for obstructive sleep apnea. Intervention subjects were more likely than control subjects to discuss obstructive sleep apnea with their healthcare provider within 12 weeks (11% [9/84] vs 2% [2/84]; P=.02; relative risk=4.50; 95% confidence interval, 1.002-20.21). The number needed to treat was 12. High-risk intervention subjects were more likely than control subjects to discuss obstructive sleep apnea with their healthcare provider (19% [6/32] vs 2% [2/84]; P=.004; relative risk=7.88; 95% confidence interval, 1.68-37.02). One high-risk intervention subject started treatment for obstructive sleep apnea. CONCLUSION: An online screening intervention is feasible and likely effective in encouraging members of an Internet weight-loss community to discuss obstructive sleep apnea with their healthcare provider.

Internet-based stress management for women with preterm labour: a case-based experience report

Pregnant women with preterm labour (PTL) in pregnancy often experience increased distress and anxieties regarding both the pregnancy and the child's health. The pathogenesis of PTL is, among other causes, related to the stress-associated activation of the maternal-foetal stress system. In spite of these psychobiological associations, only a few research studies have investigated the potential of psychological stress-reducing interventions. The following paper will present an online anxiety and stress management self-help program for pregnant women with PTL. Structure and content of the program will be illustrated by a case-based experience report. L.B., 32 years (G3, P1), was recruited at gestational week 27 while hospitalized for PTL for 3 weeks. She worked independently through the program for 6 weeks and had regular written contact with a therapist. Processing the program had a positive impact on L.B.'s anxiety and stress levels, as well as on her experienced depressive symptoms and bonding to the foetus. As PTL and the risk of PTB are associated with distress, psychological stress-reducing interventions might be beneficial. This study examines the applicability of an online intervention for pregnant women with PTL. The case report illustrates how adequate low-threshold psychological support could be provided to these women.

Completion strategy or emphasis manipulation? Task support for teaching information problem solving

While most students seem to solve information problems effortlessly, research shows that the cognitive skills for effective information problem solving are often underdeveloped. Students manage to find information and formulate solutions, but the quality of their process and product is questionable. It is therefore important to develop instruction for fostering these skills. In this research, a 2-h online intervention was presented to first-year university students with the goal to improve their information problem solving skills while investigating effects of different types of built-in task support. A training design containing completion tasks was compared to a design using emphasis manipulation. A third variant of the training combined both approaches. In two experiments, these conditions were compared to a control condition receiving conventional tasks without built-in task support. Results of both experiments show that students' information problem solving skills are underdeveloped, which underlines the necessity for formal training. While the intervention improved students’ skills, no differences were found between conditions. The authors hypothesize that the effective presentation of supportive information in the form of a modeling example at the start of the training caused a strong learning effect, which masked effects of task support. Limitations and directions for future research are presented.

Depresión en pacientes con epilepsia: Revisión sistemática de la literatura

Esta revisión sistemática de la literatura tuvo como objetivo investigar sobre la depresión en personas con epilepsia en la última década (2005-2015), enfocándose en identificar en el paciente con epilepsia: características sociodemográficas, prevalencia de la depresión, tipos de intervención para el manejo de la depresión, factores asociados con la aparición y el mantenimiento de la depresión y por último, identificar las tendencias en investigación en el estudio de la depresión en pacientes con epilepsia. Se revisaron 103 artículos publicados entre 2005 y 2015 en bases de datos especializadas. Los resultados revelaron que la prevalencia de depresión en pacientes con epilepsia es diversa y oscila en un rango amplio entre 3 y 70 %, por otro lado, que las principales características sociodemográficas asociadas a la depresión está el ser mujer, tener un estado civil soltero y tener una edad comprendida entre los 25 y los 45 años. A esto se añade, que los tratamientos conformados por terapia psicológica y fármacos, son la mejor opción para garantizar la eficacia en los resultados del manejo de la depresión en los pacientes con epilepsia. Con respecto a los factores asociados a la aparición de la depresión en pacientes con epilepsia, se identificaron causas tanto neurobiológicas como psicosociales, asimismo los factores principales asociados al mantenimiento fueron una percepción de baja calidad de vida y una baja auto-eficacia. Y finalmente los tipos de investigación más comunes son de tipo aplicado, de carácter descriptivo, transversales y de medición cuantitativa.

Translating training in the NYU Caregiver Intervention in Australia: Maintaining fidelity and meeting graduate standards in an online continuing professional education setting

The aim of this study was to develop an Internet-based self-directed training program for Australian healthcare workers to facilitate learning and competence in delivery of a proven intervention for caregivers of people with dementia: The New York University Caregiver Intervention (NYUCI). The NYUCI is a nonpharmacological, multicomponent intervention for spousal caregivers. It is aimed at maintaining well-being by increasing social support and decreasing family discord, thereby delaying or avoiding nursing home placement of the person with dementia. Training in the NYUCI in the United States has, until now, been conducted in person to trainee practitioners. The Internet-based intervention was developed simultaneously for trainees in the U.S. and Australia. In Australia, due to population geography, community healthcare workers, who provide support to older adult caregivers of people with dementia, live and work in many regional and rural areas. Therefore, it was especially important to have online training available to make it possible to realize the health and economic benefits of using an existing evidence-based intervention. This study aimed to transfer knowledge of training in, and delivery of, the NYUCI for an Australian context and consumers. This article details the considerations given to contextual differences and to learners’ skillset differences in translating the NYUCI for Australia.

Government intervention or entrepreneurial profit? Explaining innovation in the Korean online gaming industry

The paper examines how and why the Korean online gaming industry gained dominance in the global market despite US and Japanese competition in related gaming sectors.

A qualitative evaluation of online chat groups for women completing a psychological intervention for female sexual dysfunction

Because of the embarrassment that can surround female sexual dysfunctions, online interventions offer an anonymous and private treatment alternative. Recently, an online cognitive-behavioral treatment for female sexual dysfunctions was evaluated. Although significant improvements were observed in sexual functioning, the treatment was primarily a behavioral intervention because of difficulties with engaging participants in cognitive therapy over e-mail. To address this limitation, the use of chat groups was incorporated into a new online treatment for female sexual dysfunctions—the PursuingPleasure program. Thirty-eight women participated in the PursuingPleasure chat groups. The goals of the chat groups were to address and overcome challenges as women progressed through PursuingPleasure and to create a social support network where group therapy processes could be used. The chat groups aimed to address misunderstandings, monitor changes, and receive feedback. A qualitative analysis of the chat groups revealed that they helped to facilitate the cognitive-affective aspects of the program, as well as fulfill their other intended functions. This study demonstrates how the use of chat groups in the online treatment of female sexual dysfunctions is a useful addition to Internet-based treatment. Feedback suggests that the chat groups were one of the most helpful aspects of the program, although a small group of women reported finding the groups unhelpful.

Preliminary results of a randomised controlled trial of an online psychological intervention to reduce distress in men treated for localised prostate cancer

Prostate cancer (PCa) poses many emotional and physical challenges for men following treatment. The unmet support needs of these men are well documented, and access to psychosocial support remains problematic.

Online mindfulness-based intervention for late-stage bipolar disorder: pilot evidence for feasibility and effectiveness

OBJECTIVES: People in the late stage of bipolar disorder (BD) experience elevated relapse rates and poorer quality of life (QoL) compared with those in the early stages. Existing psychological interventions also appear less effective in this group. To address this need, we developed a new online mindfulness-based intervention targeting quality of life (QoL) in late stage BD. Here, we report on an open pilot trial of ORBIT (online, recovery-focused, bipolar individual therapy). METHODS: Inclusion criteria were: self-reported primary diagnosis of BD, six or more episodes of BD, under the care of a medical practitioner, access to the internet, proficient in English, 18-65 years of age. Primary outcome was change (baseline - post-treatment) on the Brief QoL.BD (Michalak and Murray, 2010). Secondary outcomes were depression, anxiety, and stress measured on the DASS scales (Lovibond and Lovibond, 1993). RESULTS: Twenty-six people consented to participate (Age M=46.6 years, SD=12.9, and 75% female). Ten participants were lost to follow-up (38.5% attrition). Statistically significant improvement in QoL was found for the completers, t(15)=2.88, 95% CI:.89-5.98, p=.011, (Cohen׳s dz=.72, partial η(2)=.36), and the intent-to-treat sample t(25)=2.65, 95% CI:.47-3.76, (Cohen׳s dz=.52; partial η(2)=.22). A non-significant trend towards improvement was found on the DASS anxiety scale (p=.06) in both completer and intent-to-treat samples, but change on depression and stress did not approach significance. LIMITATIONS: This was an open trial with no comparison group, so measured improvements may not be due to specific elements of the intervention. Structured diagnostic assessments were not conducted, and interpretation of effectiveness was limited by substantial attrition. CONCLUSION: Online delivery of mindfulness-based psychological therapy for late stage BD appears feasible and effective, and ORBIT warrants full development. Modifications suggested by the pilot study include increasing the 3 weeks duration of the intervention, adding cautions about the impact of extended meditations, and addition of coaching support/monitoring to optimise engagement.