A cognitive stress-reduction intervention program for adolescents.

Abstract

VioLit summary: OBJECTIVE: The purpose of this study by Hains and Szyjakowski was to examine the effectiveness of a program of cognitive intervention to help train adolescents to cope with feelings of stress and other negative emotional arousal states. METHODOLOGY: The study used an experimental cross-sectional design, with a non-probability sample of 21 adolescent males, 16 to 17 years, attending a college preparatory high school in a midwestern city. Participation was voluntary, with consent of parents. Subjects were randomly assigned to either the experimental group which was to receive the training (n=9), or to a waiting list control group (n=12). All subjects were assessed before and after the experimental period in one-hour group sessions, with a follow-up assessment of the treatment group being conducted ten weeks later. Data collection revolved around measures of anxiety, anger, self-esteem, depression and self-reports of cognitions in an imaginary stressful situation. Anxiety was measured via use of the 40-item State-Trait Anxiety Inventory, which had high internal consistency, and which measured current as well as general long-term anxiety. The 90-item Anger Inventory measured the amount of anger a person would feel if a certain event occurred, and had high split-half reliability. Self-esteem was measured with the 25-item Coopersmith Self-Esteem Inventory, using approval or disapproval of items relating to the individual's self-perception as competent, successful or worthwhile. The instrument has been found to have good reliability and validity. A 20-item modified version of the Beck Depression Inventory was employed, which was found to have high reliability and validity coefficients. Self-reports of cognitions were measured with a thought-listing task, whereby subjects reported their thought patterns after two specific tasks had been completed. The first involved imagining waiting for a difficult exam to begin, and the other required subjects to imagine calling a girl to ask her out on a date. Responses were scored according to three dimensions - positive thoughts that would enhance behavior, negative thoughts that would interfere with behavior and neutral thoughts that were unclassifiable. Treatment procedures involved three stages - the conceptualization phase, the skill acquisition and rehearsal phase and the application phase. The first stage of the training centered upon the ability to identify and monitor self-defeating thoughts, with subjects completing a record sheet that described various events and emotions they had experienced, as well as any self-defeating cognitions that they might have felt. The second part of the training showed the subjects how to challenge, evaluate the evidence for, and restructure their negative cognitions, by teaching them rational responses or self-instructions to substitute in place of the cognitions. The application phase of the treatment involved further practice of skills in preparation for stressful events. Analyses in the study included MANCOVA and ANCOVA. FINDINGS/DISCUSSION: The authors found significant group differences on trait anxiety, anger and self-esteem, with the subjects in the experimental group reporting lower anxiety and anger and higher self-esteem than did those subjects in the control group after the training. No significant differences between the two groups were found on state-anxiety or depression, which might be due, in part, to the low initial scores on depression. The treatment group also exhibited more positive cognitions after training, with no difference in negative thoughts. Assessment of the treatment group's post-training and follow-up scores showed no significant within-group differences on anger, self-esteem, depression and self-reported cognitions, although significant decreases were found for the two anxiety measures, suggesting that the subjects felt less anxious at follow-up and maintained treatment gains in the other measures. The researchers concluded that a cognitive stress reduction intervention program would be a viable method for adolescent intervention. AUTHORS' RECOMMENDATIONS: The authors recommended that further research be conducted to assess the effectiveness of cognitive stress reduction intervention with other populations of adolescents, such as clinical samples or those subjects exhibiting specific forms of problem behavior related to stress. EVALUATION: The authors present a well-written and concise study of the effectiveness of a cognitive stress reduction intervention program. The small sample size, and restriction to 16 and 17 year old males in a competitive college-oriented school, however, preclude good generalizability of results. Other factors and their role in the stress process would have been interesting to examine, as would have a follow-up of the control group. A more thorough discussion of the findings, and of their implications for policy and treatment, would also have been valuable. Despite these limitations, the study employs well-established measures of its dependent variables, as well as a well-defined treatment program, and uses sophisticated and appropriate analyses, to provide an excellent basis for further research into the area of stress reduction for adolescents. (CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado) KW - Juvenile Male KW - Training Program KW - Cognitive Behavioral KW - Intervention Program KW - Stress Management KW - Juvenile Stress KW - Juvenile Anger KW - Anger Management KW - Juvenile Self-Esteem KW - Program Evaluation KW - Prosocial Attitudes and Behavior KW - Social Skills KW - Anger Treatment KW - Treatment Program

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