Psychological intervention

About: Psychological intervention is a research topic. Over the lifetime, 82654 publications have been published within this topic receiving 2608356 citations.

Weighing the Costs of Disaster: Consequences, Risks, and Resilience in Individuals, Families, and Communities

Abstract: Disasters typically strike quickly and cause great harm. Unfortunately, because of the spontaneous and chaotic nature of disasters, the psychological consequences have proved exceedingly difficult to assess. Published reports have often overestimated a disaster's psychological cost to survivors, suggesting, for example, that many if not most survivors will develop posttraumatic stress disorder (PTSD); at the same time, these reports have underestimated the scope of the disaster's broader impact in other domains. We argue that such ambiguities can be attributed to methodological limitations. When we focus on only the most scientifically sound research--studies that use prospective designs or include multivariate analyses of predictor and outcome measures--relatively clear conclusions about the psychological parameters of disasters emerge. We summarize the major aspects of these conclusions in five key points and close with a brief review of possible implications these points suggest for disaster intervention. 1. Disasters cause serious psychological harm in a minority of exposed individuals. People exposed to disaster show myriad psychological problems, including PTSD, grief, depression, anxiety, stress-related health costs, substance abuse, and suicidal ideation. However, severe levels of these problems are typically observed only in a relatively small minority of exposed individuals. In adults, the proportion rarely exceeds 30% of most samples, and in the vast majority of methodologically sound studies, the level is usually considerably lower. Among youth, elevated symptoms are common in the first few months following a high-impact disaster, but again, chronic symptom elevations rarely exceed 30% of the youth sampled. 2. Disasters produce multiple patterns of outcome, including psychological resilience. In addition to chronic dysfunction, other patterns of disaster outcome are typically observed. Some survivors recover their psychological equilibrium within a period ranging from several months to 1 or 2 years. A sizeable proportion, often more than half of those exposed, experience only transient distress and maintain a stable trajectory of healthy functioning or resilience. Resilient outcomes have been evidenced across different methodologies, including recent studies that identified patterns of outcome using relatively sophisticated data analytic approaches, such as latent growth mixture modeling. 3. Disaster outcome depends on a combination of risk and resilience factors. As is true for most highly aversive events, individual differences in disaster outcomes are informed by a number of unique risk and resilience factors, including variables related to the context in which the disaster occurs, variables related to proximal exposure during the disaster, and variables related to distal exposure in the disaster's aftermath. Multivariate studies indicate that there is no one single dominant predictor of disaster outcomes. Rather, as with traumatic life events more generally, most predictor variables exert small to moderate effects, and it is the combination or additive total of risk and resilience factors that informs disaster outcomes. 4. Disasters put families, neighborhoods, and communities at risk. Although methodologically complex research on this facet of disasters' impact is limited, the available literature suggests that disasters meaningfully influence relationships within and across broad social units. Survivors often receive immediate support from their families, relatives, and friends, and for this reason many survivors subsequently claim that the experience brought them closer together. On the whole, however, the empirical evidence suggests a mixed pattern of findings. There is evidence that social relationships can improve after disasters, especially within the immediate family. However, the bulk of evidence indicates that the stress of disasters can erode both interpersonal relationships and sense of community. Regardless of how they are affected, postdisaster social relations are important predictors of coping success and resilience. 5. The remote effects of a disaster in unexposed populations are generally limited and transient. Increased incidence of extreme distress and pathology are often reported in remote regions hundreds if not thousands of miles from a disaster's geographic locale. Careful review of these studies indicates, however, that people in regions remote to a disaster may experience transient distress, but increased incidence of psychopathology is likely only among populations with preexisting vulnerabilities (e.g., prior trauma or psychiatric illness) or actual remote exposure (e.g., loss of a loved one in the disaster). Finally, we review the implications for intervention. There is considerable interest in prophylactic psychological interventions, such as critical incident stress debriefing (CISD), that can be applied globally to all exposed survivors in the immediate aftermath of disaster. Multiple studies have shown, however, that CISD is not only ineffective but in some cases can actually be psychologically harmful. Other less invasive and more practical forms of immediate intervention have been developed for use with both children and adults. Although promising, controlled evaluations of these less invasive interventions are not yet available. The available research suggests that psychological interventions are more likely to be effective during the short- and long-term recovery periods (1 month to several years postdisaster), especially when used in combination with some form of screening for at-risk individuals. Such interventions should also target the maintenance and enhancement of tangible, informational, and social-emotional support resources throughout the affected community. Language: en

Effectiveness of interventions to promote physical activity in children and adolescents: systematic review of controlled trials.

Abstract: Objective To review the published literature on the effectiveness of interventions to promote physical activity in children and adolescents. Design Systematic review. Data sources Literature search using PubMed, SCOPUS, Psychlit, Ovid Medline, Sportdiscus, and Embase up to December 2006. Review methods Two independent reviewers assessed studies against the following inclusion criteria: controlled trial, comparison of intervention to promote physical activity with no intervention control condition, participants younger than 18 years, and reported statistical analyses of a physical activity outcome measure. Levels of evidence, accounting for methodological quality, were assessed for three types of intervention, five settings, and three target populations. Results The literature search identified 57 studies: 33 aimed at children and 24 at adolescents. Twenty four studies were of high methodological quality, including 13 studies in children. Interventions that were found to be effective achieved increases ranging from an additional 2.6 minutes of physical education related physical activity to 283 minutes per week of overall physical activity. Among children, limited evidence for an effect was found for interventions targeting children from low socioeconomic populations, and environmental interventions. Strong evidence was found that school based interventions with involvement of the family or community and multicomponent interventions can increase physical activity in adolescents. Conclusion Some evidence was found for potentially effective strategies to increase children9s levels of physical activity. For adolescents, multicomponent interventions and interventions that included both school and family or community involvement have the potential to make important differences to levels of physical activity and should be promoted. A lack of high quality evaluations hampers conclusions concerning effectiveness, especially among children.

Healthcare via Cell Phones: A Systematic Review

Abstract: Regular care and informational support are helpful in improving disease-related health outcomes. Communication technologies can help in providing such care and support. The purpose of this study was to evaluate the empirical evidence related to the role of cell phones and text messaging interventions in improving health outcomes and processes of care. Scientific literature was searched to identify controlled studies evaluating cell phone voice and text message interventions to provide care and disease management support. Searches identified 25 studies that evaluated cell phone voice and text messaging interventions, with 20 randomized controlled trials and 5 controlled studies. Nineteen studies assessed outcomes of care and six assessed processes of care. Selected studies included 38,060 participants with 10,374 adults and 27,686 children. They covered 12 clinical areas and took place in 13 countries. Frequency of message delivery ranged from 5 times per day for diabetes and smoking cessation support to once a week for advice on how to overcome barriers and maintain regular physical activity. Significant improvements were noted in compliance with medicine taking, asthma symptoms, HbA1C, stress levels, smoking quit rates, and self-efficacy. Process improvements were reported in lower failed appointments, quicker diagnosis and treatment, and improved teaching and training. Cost per text message was provided by two studies. The findings that enhancing standard care with reminders, disease monitoring and management, and education through cell phone voice and short message service can help improve health outcomes and care processes have implications for both patients and providers.