Goodlife (Netherlands)

This study examined the impact of clinical severity on treatment outcome in two programs that differ markedly in treatment intensity: day hospital mentalization-based treatment (MBT-DH) and intensive outpatient mentalization-based treatment (MBT-IOP) for borderline personality disorder (BPD). A multicenter randomized controlled trial was conducted. Participants include the full intention-to-treat sample of the original trial of N= 114 randomized BPD patients (MBT-DH n= 70, MBT-IOP n= 44), who were assessed at baseline and subsequently every 6 up to 36 months after start of treatment. Outcomes were general symptom severity, borderline features, and interpersonal functioning. Clinical severity was examined in terms of severity of BPD, general symptom severity, comorbid symptom disorders, comorbid personality disorders, and cluster C personality features. None of the severity measures was related to treatment outcome or differentially predicted treatment outcome in MBT-DH and MBT-IOP, with the exception of a single moderating effect of co morbid symptom disorders on outcome in terms of BPD features, indicating less improvement in MBT-DH for patients with more symptom disorders. Overall, patients with varying levels of clinical severity benefited equally from MBT-DH and MBT-IOP, indicating that clinical severity may not be a useful criterion to differentiate in treatment intensity.

Although health promotion efforts to increase exercise behavior often emphasise long-term outcomes, sustained action in service of a distal reward is challenging. These studies examined how focusing on the proximal benefits of exercise, compared to distal outcomes or more general outcomes, may strengthen individuals' self-regulatory self-efficacy and support physical activity or exercise behavior. Participants in Study 1 (N=1057 community members) completed an online survey. Participants in Study 2 (N=69 students) and Study 3 (N=107 students) experienced experimental manipulations related to proximal or distal outcomes of exercise, and then completed survey measures. In Study 4, new members at a commercial gym (N=210) completed a survey and had check-ins recorded over 17weeks. In Study 1, participants who ranked proximal outcomes of exercise as relatively more important than distal outcomes reported more frequent physical activity. In Studies 2 and 3, participants induced to focus on proximal outcomes reported increased self-regulatory self-efficacy. In Study 4, valuing proximal benefits predicted sustained exercise behavior (i.e. check-ins), particularly when fitness goal adherence felt difficult. Those holding increased proximal outcome beliefs reported more activity and greater efficacy to overcome the barriers that derail exercise.