Therapist-supported ICBT appears to be an efficacious treatment for anxiety in adults. The evidence comparing therapist-supported ICBT to waiting list, attention, information, or online discussion group only control was low to moderate quality, the evidence comparing therapist-supported ICBT to unguided ICBT was very low quality, and comparisons of therapist-supported ICBT to face-to-face CBT were low quality. Further research is needed to better define and measure any potential harms resulting from treatment. These findings suggest that therapist-supported ICBT is more efficacious than a waiting list, attention, information, or online discussion group only control, and that there may not be a significant difference in outcome between unguided CBT and therapist-supported ICBT; however, this latter finding must be interpreted with caution due to imprecision. The evidence suggests that therapist-supported ICBT may not be significantly different from face-to-face CBT in reducing anxiety. Future research should explore heterogeneity among studies which is reducing the quality of the evidence body, involve equivalence trials comparing ICBT and face-to-face CBT, examine the importance of the role of the therapist in ICBT, and include effectiveness trials of ICBT in real-world settings. A timely update to this review is needed given the fast pace of this area of research.
Therapist-supported ICBT appears to be an efficacious treatment for anxiety in adults. The evidence comparing therapist-supported ICBT to waiting list, attention, information, or online discussion group only control was low to moderate quality, the evidence comparing therapist-supported ICBT to unguided ICBT was low to very low quality, and comparisons of therapist-supported ICBT to face-to-face CBT was low to moderate quality. Further research is needed to better define and measure any potential harms resulting from treatment. These findings suggest that therapist-supported ICBT is more efficacious than a waiting list, attention, information, or online discussion group only control, and that there may not be a significant difference in outcome between unguided CBT and therapist-supported ICBT; however, this latter finding must be interpreted with caution due to imprecision. The evidence suggests that therapist-supported ICBT may not be significantly different from face-to-face CBT in reducing anxiety. Future research should involve equivalence trials comparing ICBT and face-to-face CBT, examine the importance of the role of the therapist in ICBT, and include effectiveness trials of ICBT in real-world settings. A timely update to this review is needed given the fast pace of this area of research.
In this article, we report the results of 3 studies evaluating the psychometric properties of scores generated using the Erikson Psychosocial Stage Inventory (EPSI; Rosenthal, Gurney, & Moore, 1981) with emerging adults. In Study 1, a hybrid bifactor solution, consisting of an overall identity factor as well as of "method effects" factors for identity synthesis and identity confusion, provided a better fit to the data than did either one or two-factor solutions. This bifactor solution was largely invariant across gender and across Whites, Blacks, and Hispanics. In Study 2, the overall identity, identity synthesis, and identity confusion scores were shown to possess convergent validity with another Eriksonian measure and with measures of identity status. In Study 3, the EPSI subscale scores were shown to possess construct validity vis-a-vis self-esteem, purpose in life, internal locus of control, ego strength, anxiety, and depression. We discuss implications for the measurement of identity.
COCHRANE CORNER † This review is an abridged version of a Cochrane Review previously published in the Cochrane Database of Systematic Reviews, 2015, Mar 5, Issue 3: CD011565 (see www.thecochranelibrary.com for information). Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the review. We thank the Cochrane Review Group for their support in publishing these reviews. See commentary on pp. 291-294, this issue.
Drinking games are a high-risk social drinking activity consisting of rules and guidelines that determine when and how much to drink (Polizzotto et al., 2007). Borsari's (2004) seminal review paper on drinking games in the college environment succinctly captured the published literature as of February 2004. However, research on college drinking games has grown exponentially during the last decade, necessitating an updated review of the literature. This review provides an in-depth summary and synthesis of current drinking games research (e.g., characteristics of drinking games, and behavioral, demographic, social, and psychological influences on participation) and suggests several promising areas for future drinking games research. This review is intended to foster a better understanding of drinking game behaviors among college students and improve efforts to reduce the negative impact of this practice on college campuses.
Heavy alcohol use and its associated negative consequences continue to be an important health issue among adolescents. Of particular concern are risky drinking practices such as playing drinking games. Although retrospective accounts indicate that drinking game participation is common among high school students, it has yet to be assessed in current high school students. Utilizing data from high school students who reported current drinking game participation (n = 178), we used latent class analysis to investigate the negative consequences resulting from gaming and examined underlying demographic and alcohol-related behavioral characteristics of students as a function of the resultant classes. Three classes of “gamers” emerged: (1) a “lower-risk” group who had a lower probability of endorsing negative consequences compared to the other groups, (2) a “higher-risk” group who reported that they experienced hangovers and difficulties limiting their drinking, got physically sick, and became rude, obnoxious, or insulting, and (3) a “sexual regret” group who reported that they experienced poor recall and unplanned sexual activity that they later regretted. Although the frequency of participating in drinking games did not differ between these three groups, results indicated that the “lower-risk” group consumed fewer drinks in a typical gaming session compared to the other two groups. The present findings suggest that drinking games are common among high school students, but that mere participation and frequency of play is not necessarily the best indicator of risk. Instead, examination of other constructs such as game-related alcohol consumption, consequences, or psychosocial variables such as impulsivity may be more useful.
Pregaming is the practice of consuming alcohol prior to going out to a social event. Although pregaming has begun to receive research attention in the college setting, very little is known about this risky drinking behavior in high school students. As pregaming has health implications for both students who are college bound and those who are not, we examined the prevalence of this behavior in a sample of high school students who reported current alcohol use and completed pregaming measures (n = 233). The present study examined the associations of gender, age, alcohol expectancies, motivations for drinking (e.g., social, enhancement, and coping), and engagement in other risky drinking practices (i.e., general hazardous use and drinking game participation) with pregaming. Results indicate that pregaming was significantly associated with being older, being a male, having high levels of hazardous alcohol use, and participating in drinking games frequently. Pregaming also occurred most often before parties and sporting events and it was associated positively with frequency of attendance at parties where alcohol is available, the tendency to use alcohol at these parties, and the amount of alcohol consumed at these parties. We discuss the findings in the context of pregaming research that has been conducted with college students, and make suggestions regarding prevention and intervention efforts focused on this risky drinking practice.
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