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Clinical researchers have recently begun to explore differences between psychotherapy outcome studies that focus on efficacy and those that focus on effectiveness. The authors provide concise descriptions of these research models, followed by more extended consideration of the most important conceptual and empirical distinctions between the two. Research on the efficacy/effectiveness distinction is then put into context: The common treatment variables that also influence treatment outcomes are reviewed. Fifty years of research on psychotherapy outcomes are next considered; contemporary research on the efficacy and effectiveness research models is emphasized. A description and evaluation of current efforts to heighten the value of technique-focused research to clinicians follow. The authors conclude by anticipating some promising future directions in this research domain.

Individuals frequently use the Internet to search for medical information. For some individuals, repeated searches for medical information on the Internet exacerbate health anxiety. Researchers have termed this phenomenon "cyberchondria" and have suggested that cyberchondria might relate to the excessive use of the Internet for other purposes as well. The present study examined associations among Internet searches for medical information, health anxiety, and problematic Internet use (PIU) using a large sample of medically healthy community adults located in the United States (N=430). As predicted, respondents who experienced increased health anxiety following Internet searches for medical information reported significantly greater PIU than respondents for whom such searches either had no impact on or decreased their health anxiety. This effect was not attributable to the frequency of health-related online searching behavior or negative affect. Conceptual and therapeutic implications are discussed.

Posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) are highly prevalent among Veterans of the conflicts in Iraq and Afghanistan. These conditions are associated with common and unique neuropsychological and neuroanatomical changes. This review synthesizes neuropsychological and neuroimaging studies for both of these disorders and studies examining their co-occurrence. Recommendations for future research, including utilizing combined neuropsychological and advanced neuroimaging techniques to study these disorders alone and in concert, are presented. It is clear from the dearth of literature that more attention in the literature should be given to examining temporal relationships between PTSD and mTBI, risk and resilience factors associated with both disorders and their co-occurrence, and mTBI-specific factors such as time since injury and severity of injury, utilizing comprehensive, yet targeted cognitive tasks.

Objective-A substantial proportion of the more than 2 million service members who have served in Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) have experienced a traumatic brain injury (TBI). Understanding the long-term impact of TBI is complicated by the non-specific nature of postconcussive symptoms (PCS) and the high rates of co-occurrence among TBI, posttraumatic stress disorder (PTSD), and depression. The goal of the present research was to examine the relations among TBI, persistent PCS, and symptoms of PTSD and depression among returning OEF/OIF Veterans.Design-Two-hundred and thirteen OEF/OIF Veterans (87% male) completed a semi-structured screening interview assessing deployment-related TBI and current, persistent PCS. Participants also completed self-report measures of combat exposure and current symptoms of PTSD and depression.Results-Nearly half (46%) of sampled Veterans screened positive for TBI, the majority of whom (85%) reported at least one persistent PCS after removing PCS that overlapped with PTSD and depression. Veterans with deployment-related TBI reported higher levels of combat exposure and symptoms of PTSD and depression. Structural equation modeling was used to assess the fit of three models of the relationships among TBI, combat exposure, persistent PCS, PTSD, and depression. Consistent with hypotheses, the best fitting model was one in which the effects of TBI on both PTSD and depression were fully mediated by non-overlapping persistent PCS.Implications-These findings highlight the importance of addressing persistent PCS in order to facilitate the functional recovery of returning war Veterans.Understanding the long-term effects of traumatic brain injury (TBI) has important public health implications. Estimates suggest that one to two million Americans sustain a TBI annually (Faul, Xu, Wald, & Coronado, 2010;Gerberding & Binder, 2003;Sosin, Sniezek, & Thurman, 1996;Thurman, Alverson, Dunn, Guerrero, & Sniezek, 1999;. Moreover, the large number of Veterans of the wars in Iraq and Afghanistan add to the global incidence of TBI. Since the inception of the current conflicts in Iraq and Afghanistan, more than two million U.S. troops have been deployed as part of (Stein & McAllister, 2009;Vanderploeg, Curtiss, Luis, & Salazar, 2007; Zaloshnja, Miller, Langlois, & Selassie, 2008). U.S. Department of Veterans AffairsIn general, following sports-related mTBI, post-injury cognitive effects (i.e., performance on neuropsychological tests) tend to resolve within 5-7 days (Guskiewicz et al., 2003), and PCS generally resolve within 2 weeks (Carroll et al., 2004). For mTBIs arising from non-sportsrelated events, post-injury cognitive effects tend to resolve within several weeks to 3 months (e.g., Belanger, Curtis, Demery, Lebowitz, & Vanderploeg, 2005;Carroll et al., 2004); however, PCS following mTBI may persist for one year post-injury or longer in adult civilian (Carroll et al., 2004) and Veteran (Stein & McAllister, 2009) samples. Despite the expectation of full recovery in most...

Executive dysfunction as a risk marker for substance abuse: The role of impulsive personality traits" (2007). Posters. Paper 24 Samuel B. Guze Symposium on Alcoholism.

Little research has been conducted on the relationship of self-efficacy at treatment entry to individual differences or to treatment outcome for patients with cocaine dependence. Those relationships were examined in 163 cocaine-dependent patients in a residential treatment program using two measures of self-efficacy administered in the first week of treatment: beliefs about success in quitting in general and confidence about not using in 11 cocaine-specific high-risk situations. The most robust correlates of self-efficacy were greater desire to stop using and lower urge to use in high-risk situations. Age, depressive symptoms, cognitive functioning, recent substance use, and past success with quitting also correlated with self-efficacy. Both measures of self-efficacy predicted quantity and frequency of cocaine use and abstinence at 3 but not 6 months after treatment after controlling pretreatment cocaine use. Results suggest that treatments should target self-efficacy in cocaine-dependent patients.