Amie R. Newins

Contingency Management Versus Psychotherapy for Prenatal Smoking Cessation: A Meta-Analysis of Randomized, Controlled Trials

OBJECTIVES Prenatal smoking is the leading preventable cause of poor obstetric outcomes, yet treatment options are limited. Past reviews of prenatal smoking cessation have often grouped all counseling into a single category, which ignores the fact that psychotherapy is distinct from brief counseling. The objective of this study was to compare the effect sizes of two intensive interventions for prenatal smoking cessation: contingency management (i.e., financial incentives for abstinence) and psychotherapy. METHODS A systematic search for randomized controlled trials testing the efficacy of contingency management or psychotherapy was completed using PubMed, PsycINFO, Web of Science, the Cochrane Library, and EMBASE. Independent raters extracted data and assessed trials for risk of bias. Treatment effects were analyzed for three times points: late pregnancy, early postpartum, and late postpartum. RESULTS The search yielded 22 studies, and meta-analytic results indicated that interventions (compared with control groups) generally increased the odds of abstinence. Moderator analyses indicated that intervention type (contingency management vs. psychotherapy) accounted for variability in effect sizes. When comparing treatment type, effects of contingency management interventions were significantly greater than those of psychotherapeutic interventions. Although psychotherapy did not affect smoking abstinence, contingency management interventions had significant treatment effects at all three time points. CONCLUSIONS Contingency management seems to be a safe and efficacious prenatal smoking cessation treatment. Although psychotherapy alone did not show an effect on prenatal smoking abstinence, future research may seek to combine this approach with contingency management to promote prenatal smoking cessation.

Rape acknowledgment and sexual minority identity: The indirect effect of rape myth acceptance.

Despite preliminary literature suggesting that individuals who identify as sexual minorities evidence lower rates of unacknowledged rape than those who identify as heterosexual (Anderson, Wandrey, Klossner, Cahill, & Delahanty, 2017), little research has been dedicated to elucidating this finding. The present study examined the rates of unacknowledged rape based on sexual minority status. Rape myth acceptance was examined as a potential mechanism that may account for any observed differences. Students at a large public university in the Southeastern United States completed an online survey of unwanted sexual experiences, rape acknowledgment, and rape myth acceptance; the 298 individuals who experienced a rape since Age 14 were included. Individuals who identified as sexual minorities were significantly more likely to be acknowledged survivors (i.e., conceptualized their experience as rape) than those who identified as heterosexual. The indirect effect of sexual minority status on rape acknowledgment via rape myth acceptance was significant such that individuals who identified as sexual minorities were more likely to reject rape myths, which, in turn, was associated with greater odds of being an acknowledged rape survivor. Clinicians who treat survivors of sexual trauma should be prepared to work with individuals who identify as sexual minorities, given that they are more likely to experience sexual trauma and conceptualize their victimization as rape.

A Brief Computer-Based Sexual Assault Risk Reduction Program: A Feasibility, Acceptability, and Preliminary Efficacy Pilot Study:

Sexual victimization among college women is a common problem, necessitating the development of risk reduction programs that are both effective and acceptable to this population. Computer-based programs may be a cost- and time-effective option. This pilot study sought to examine the feasibility, acceptability, and preliminary efficacy of a computer-based risk reduction program. A total of 136 collegiate women were randomly assigned to receive either a computer-based risk reduction program or an educational program about campus resources (active control condition). Measures included predicted use of resistance techniques, risk detection, and acceptability of the program. No participants dropped out of the study, and acceptability ratings were generally high. Women reported learning new material from the program, preferring the computer-based program to large-group programs, and believing that other undergraduate women would benefit from the program. Furthermore, women reported they did not experience significant emotional disturbance due to the material. In addition, postintervention, the risk reduction program group had significantly better risk detection compared with the control group. The control group evidenced a reduction in predicted use of assertive resistance between pre- and postintervention assessments, while the risk reduction program group did not. Given preliminary support for the feasibility, acceptability, and preliminary efficacy of a brief, computerized risk reduction program, further research on computerized, online risk reduction programs, such as the one in this study, appears warranted.

The Indirect Effect of Child Maltreatment Severity on Adult PTSD Symptoms through Anxiety Sensitivity

ABSTRACT Although the rate of posttraumatic stress disorder (PTSD) among survivors of child maltreatment is high, individuals differ in symptom severity and many do not experience clinically significant levels of psychopathology. The present study tested the indirect effects of child maltreatment severity on adult PTSD, suicidal ideations, and alcohol dependence via anxiety sensitivity. A sample of 336 participants (mean age of 22.81 years, SD = 8.93; 70.2% female) completed an online survey of child abuse and neglect, anxiety sensitivity, PTSD symptom severity, suicidal ideation severity, and alcohol dependence severity. The results revealed significant indirect effects of child maltreatment on PTSD symptom severity through cognitive and social concerns, but not physical concerns. No direct or indirect effects were demonstrated for suicidal ideations or alcohol dependence severity. These findings elucidate mechanisms in the robust relationship between child maltreatment and adult PTSD symptoms and can potentially inform future research on mechanisms of change in psychotherapy.

Psychometric validation of the Anticipated Effects of Alcohol Mixed with Energy Drinks Scale.

Young people are increasingly consuming alcohol mixed with energy drinks (AmEDs). As coingestion of these beverages results in greater adverse consequences than from drinking alcohol alone, we need to understand what factors contribute to and deter coingestion. Existing studies in this area have not utilized a theoretically based or empirically validated measure of outcome expectancies for drinking AmEDs. Our study modified Morean, Corbin, and Treat’s (2012) Anticipated Effects of Alcohol Scale to assess the expected effects of drinking AmEDs. We evaluated the factor structure and concurrent validity of the Anticipated Effects of Alcohol Mixed with Energy Drinks (AEAMEDS) among 549 university students, aged 18–25, who had a lifetime history of consuming alcohol (231 had consumed AmEDs in the past 90 days). Exploratory and confirmatory factor analysis supported a 4-factor structure. Consistent with hypotheses, stronger high arousal/positive expectancies and weaker low arousal/negative expectancies were associated with greater AmED use. At the bivariate level, stronger low arousal/positive expectancies were associated with greater quantities of AmED use, but this relationship disappeared when taking into account other outcome expectancies. Moreover, students expected low arousal/positive expectancies to be less intense when consuming AmEDs than alcohol alone, but ratings for all other AmED expectancies were equivalent to consuming alcohol alone. These findings contribute to our knowledge of risk and protective factors for AmED use.