scholarly journals The effectiveness and acceptability of empirically supported treatments in gender minority youth across four randomized controlled trials.

2020 ◽  
Vol 88 (12) ◽  
pp. 1053-1064
Author(s):  
Nathan L. Hollinsaid ◽  
John R. Weisz ◽  
Bruce F. Chorpita ◽  
Hilary E. Skov ◽  
the Research Network on Youth Mental Health ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Minority Youth ◽  
Controlled Trials ◽  
Empirically Supported Treatments ◽  
Gender Minority ◽  
Randomized Controlled ◽  
Empirically Supported

scholarly journals The Effectiveness and Acceptability of Empirically-Supported Treatments in Gender Minority Youth Across Four Randomized Controlled Trials

2020 ◽  
Author(s):  
Nathan Louis Hollinsaid ◽  
John R. Weisz ◽  
Bruce F. Chorpita ◽  
Hilary E. Skov ◽  
Maggi Price
Keyword(s):  
Mental Health ◽  
Gender Identity ◽  
Randomized Controlled Trials ◽  
Externalizing Problems ◽  
Minority Youth ◽  
Controlled Trials ◽  
Empirically Supported Treatments ◽  
Gender Minority ◽  
Randomized Controlled ◽  
Empirically Supported

Objective: Gender minority youth (i.e., children/adolescents whose gender identity and/or expression is inconsistent with their birth-assigned sex) experience elevated rates of emotional and behavioral problems relative to cisgender youth (who identify with their birth-assigned sex), which are not intrinsic to gender identity but attributable to unique minority stressors. Although empirically-supported treatments have proven effective in treating these mental health concerns generally, randomized controlled trials have not examined effects for gender minority youth.Method: To address this gap, we pooled data from clinically-referred youth (N = 432; M(SD)age = 10.6(2.2); 55.1% White) assigned to empirically-supported treatment conditions across four previous randomized controlled trials of modular psychotherapy. A proxy indicator of gender identity (i.e., youth’s wish to be the opposite sex) was used to classify gender minority (n = 64) and cisgender (n = 368) youth. Youth- and caregiver-reported pretreatment internalizing and externalizing problems, treatment effectiveness on these domains, and treatment acceptability were compared across groups.Results: Gender minority youth reported more severe pretreatment internalizing and externalizing problems compared to cisgender youth; in contrast, their caregivers reported less severe problems. Though treatment was equally effective for both groups on most outcomes, gender minority youth’s caregiver-reported externalizing problems improved more slowly and less reliably, and their self-reported internalizing problems were more likely to remain clinically elevated. Further, gender minority youth reported lower treatment satisfaction.Conclusions: While findings suggest that empirically-supported treatments may effectively address many mental health problems for gender minority youth, they also underscore the need for treatment enhancements that improve acceptability and outcomes.Public Significance Statement: This study examined the effectiveness and acceptability of empirically-supported mental health treatments for gender minority youth (who endorsed a wish to be the opposite sex) and cisgender youth. Gender minority youth reported more severe problems before treatment, demonstrated slower improvement in caregiver-reported behavior problems, and endorsed lower treatment satisfaction. Findings support the potential need for provider-focused trainings relevant to gender minority youth.

Treatment of Eating Disorders

2017 ◽  
pp. 315-334
Author(s):  
Evelyn Attia ◽  
Anne E. Becker ◽  
Cynthia M. Bulik ◽  
Alison E. Field ◽  
Neville H. Golden ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Randomized Controlled Trials ◽  
Behavioral Therapy ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Empirically Supported ◽  
Duration Of Illness ◽  
Evidence Based Treatments ◽  
Family Based Treatment ◽  
Family Based

This chapter focuses on treatments for adolescents with eating disorders, using information derived from randomized controlled trials and evidence-based treatments for eating disorders in adults. Available data provide some guidance in selecting treatments, but there are significant limitations in research on psychological and pharmacological interventions. Family-based treatment is effective for adolescents with anorexia nervosa, especially for those with a short duration of illness. For adolescents with bulimia nervosa, both family-based treatment and guided self-help based on cognitive-behavioral therapy are empirically supported interventions. At this time, there are no randomized controlled trials on the treatment of adolescents with binge-eating disorder, and, despite the widespread use of psychotropic medications, there is little empirical information about the utility and safety of such interventions for adolescents. Additional large well-controlled systematic studies with adolescents are needed to inform best care practices.

Empirically supported psychological interventions for social phobia in adults: a qualitative review of randomized controlled trials

2007 ◽  
Vol 38 (1) ◽  
pp. 3-14 ◽  
Author(s):  
K. Ponniah ◽  
S. D. Hollon
Keyword(s):  
Social Phobia ◽  
Randomized Controlled Trials ◽  
Exposure Therapy ◽  
Psychological Intervention ◽  
Skills Training ◽  
Psychological Interventions ◽  
Controlled Trials ◽  
Qualitative Review ◽  
Randomized Controlled ◽  
Empirically Supported

BackgroundSocial phobia is a chronic disorder that results in substantial impairment. We conducted a qualitative review of randomized controlled trials (RCTs) of psychological interventions for social phobia.MethodArticles were identified through searches of electronic databases and manual searches of reference lists. They were classified by psychological interventions evaluated. Data regarding treatment, participants and results were then extracted and tabulated. We identified which psychological interventions are empirically supported, using the scheme proposed by Chambless & Hollon (Journal of Consulting and Clinical Psychology 1998, 66, 7–18).ResultsThirty studies evaluating the efficacy of social skills training (SST), exposure therapy and/or cognitive treatments were identified. Cognitive behavior therapy (CBT), involving cognitive restructuring and exposure to feared and avoided social situations or behavioral experiments, was found to be an efficacious and specific treatment for social phobia. Exposure therapy was found to be an efficacious treatment since most of the evidence of its efficacy was from comparisons with no treatment. There were mixed findings regarding the relative efficacy of CBT and in vivo exposure. Some studies reported that the interventions were equivalent, while others found that patients treated with CBT had a better outcome. There was little evidence to support the use of SST.ConclusionsCBT is the psychological intervention of choice for social phobia. The findings of this review are compared to those of other major reviews and limitations are discussed.

The Effect of Partly Missing Covariates on Statistical Power in Randomized Controlled Trials With Discrete-Time Survival Endpoints

Methodology ◽  
2017 ◽  
Vol 13 (2) ◽  
pp. 41-60
Author(s):  
Shahab Jolani ◽  
Maryam Safarkhani
Keyword(s):  
Randomized Controlled Trials ◽  
Discrete Time ◽  
Treatment Effect ◽  
Survival Data ◽  
Controlled Trials ◽  
Missing Covariates ◽  
Indicator Method ◽  
Imputation Methods ◽  
Randomized Controlled ◽  
Baseline Covariates

Abstract. In randomized controlled trials (RCTs), a common strategy to increase power to detect a treatment effect is adjustment for baseline covariates. However, adjustment with partly missing covariates, where complete cases are only used, is inefficient. We consider different alternatives in trials with discrete-time survival data, where subjects are measured in discrete-time intervals while they may experience an event at any point in time. The results of a Monte Carlo simulation study, as well as a case study of randomized trials in smokers with attention deficit hyperactivity disorder (ADHD), indicated that single and multiple imputation methods outperform the other methods and increase precision in estimating the treatment effect. Missing indicator method, which uses a dummy variable in the statistical model to indicate whether the value for that variable is missing and sets the same value to all missing values, is comparable to imputation methods. Nevertheless, the power level to detect the treatment effect based on missing indicator method is marginally lower than the imputation methods, particularly when the missingness depends on the outcome. In conclusion, it appears that imputation of partly missing (baseline) covariates should be preferred in the analysis of discrete-time survival data.

Interventions for suicide and self-injury: A meta-analysis of randomized controlled trials across nearly 50 years of research.

2020 ◽  
Vol 146 (12) ◽  
pp. 1117-1145
Author(s):  
Kathryn R. Fox ◽  
Xieyining Huang ◽  
Eleonora M. Guzmán ◽  
Kensie M. Funsch ◽  
Christine B. Cha ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Self Injury
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