Web-based CBT for the prevention of anxiety symptoms among medical and health science graduate students

ABSTRACT

Medical and health science graduate students report greater anxiety problems than the general population, but they are less likely to seek treatment due to cultural and logistical barriers. One preventative approach that overcomes these barriers is web-based cognitive behavioral therapy (webCBT). It is unknown whether webCBT is effective for preventing anxiety escalation within this population. A randomized controlled trial was conducted, comparing the effects of webCBT versus a control group (CG). Medical university students (n=594; Mage=27; 67% female; 80% Caucasian) completed online baseline measures and four assigned online activities. Measures were re-administered after approximately three months. There was a small interaction effect between time of assessment and treatment condition. Anxiety severity was lower in the webCBT (M[SD]=2.88[3.36]) versus CG condition (M[SD]=3.69 [3.35]) at follow-up. This effect was moderate for students with mild, versus minimal, anxiety at baseline. The proportion of students with possible anxiety disorder was lower in the webCBT (4.5%) versus CG (8.5%) condition, and the proportion of mildly anxious students with a clinically significant increase in symptoms was lower in the webCBT (10%) versus CG (20%) condition. WebCBT may aid in preventing anxiety escalation in this population, particularly for at-risk students who report mild anxiety symptoms.     

Do students with different motives for physical education respond differently to autonomy-supportive and controlling teaching?

ObjectivesThis study examined whether the effects of autonomy-supportive and controlling teaching in physical education depend on students' motivation.DesignA preliminary, cross-sectional study relied on questionnaires administered to teachers. The main study involved an experimental design with students.MethodsIn the preliminary study, 95 teachers reported on their beliefs regarding the effectiveness of autonomy supportive and controlling teaching styles for students with different motivational profiles. In the main study, 320 students completed a questionnaire on motivation and were then randomly assigned to an experimental condition in which they watched video-based vignettes of either an autonomy-supportive or a controlling style. After the experimental induction, students completed questionnaires on need satisfaction, need frustration, engagement, and oppositional defiance.ResultsTeachers tend to believe that autonomy support and control work best for students scoring high on, respectively, autonomous and controlled motivation. The main study, however, showed that the moderating role of student motivation in the effect of teaching style was limited. The few interactions obtained suggested that even students with poor quality motivation report that they would benefit from an autonomy-supportive approach and suffer from a controlling approach. Students in the autonomy-supportive, relative to the controlling, condition reported more engagement and less oppositional defiance, effects that were mediated by need satisfaction and frustration.ConclusionsAll students, independent of their motivational regulations when entering the experiment, reported that they would be more engaged and would show less oppositional defiance when they would interact with an autonomy-supportive instead of a controlling teacher during PE.     

The origins of cognitive dissonance: evidence from children and monkeys

In a study exploring the origins of cognitive dissonance, preschoolers and capuchins were given a choice between two equally preferred alternatives (two different stickers and two differently colored M&M's, respectively). On the basis of previous research with adults, this choice was thought to cause dissonance because it conflicted with subjects' belief that the two options were equally valuable. We therefore expected subjects to change their attitude toward the unchosen alternative, deeming it less valuable. We then presented subjects with a choice between the unchosen option and an option that was originally as attractive as both options in the first choice. Both groups preferred the novel over the unchosen option in this experimental condition, but not in a control condition in which they did not take part in the first decision. These results provide the first evidence of decision rationalization in children and nonhuman primates. They suggest that the mechanisms underlying cognitive-dissonance reduction in human adults may have originated both developmentally and evolutionarily earlier than previously thought.     

Perpetrators' Freedom of Choice as a Determinant of Responsibility Attribution

Abstract

In the present study, a swindler had high versus low freedom of choice while deciding to commit a crime. He actually swindled Polish university students (involved observers) out of a large versus a small amount of money (high vs. low loss). Other students (noninvolved observers) were informed about the swindler's action. All students suggested the punishment that they believed the swindler deserved (the punishments chosen were used as an index of responsibility attribution). Involved students assigned more severe punishments than noninvolved students did. In the high-loss condition, involved observers were more punitive than they were in the low-loss condition. The judgments of the swindler's victims were determined by the magnitude of their loss; they ignored information about the swindler's freedom of choice. In contrast, the responsibility attributed by the noninvolved observers was influenced by the swindler's freedom of choice, but only in the low-loss condition. Noninvolved observers informed that the swindler had high freedom of choice were insensitive to information about the magnitude of the consequences for the victim.     

Social Facilitation and Inhibition During Maximum Versus Typical Performance Situations

The distinction between maximum performance (“what people can do”) and typical performance (“what people will do”) has received considerable theoretical yet relatively little empirical attention. Findings from social facilitation and inhibition suggest that the relationship between performers' typical and maximum performance may not always be as straightforward as had originally been assumed. Ninety-four psychology students underwent a manipulation of their self-efficacy before doing an explaining task both under typical and maximum performance conditions. Results revealed a social inhibition effect in the maximum performance condition for participants of the low self-efficacy conditions. Implications and directions for future research are discussed.     

Effects of Compliance Techniques on Spontaneous and Asked-For Helping

Abstract

American college students (N = 90) were exposed to either a foot-in-the-door (small request followed by large request) or door-in-the-face (large request followed by small request) compliance manipulation, or to a control situation, prior to an opportunity to provide either spontaneous help or asked-for help. Results showed faster helping in the asked-for condition relative to the spontaneous condition. Moreover, in the spontaneous condition, the door-in-the-face technique produced faster helping than the foot-in-the-door or control manipulations. The findings support prior contentions of distinctions between the two types of helping and imply that they operate under different mechanisms.     

What matters when children play: Influence of Social Cognitive Theory and perceived environment on levels of physical activity among elementary-aged youth

ObjectivesSocial Cognitive Theory (SCT) has often been used as a guide to predict and modify physical activity (PA) behavior. We assessed the ability of commonly investigated SCT variables and perceived school environment variables to predict PA among elementary students. We also examined differences in influences between Hispanic and non-Hispanic students.DesignThis analysis used baseline data collected from eight schools who participated in a four-year study of a combined school-day curriculum and environmental intervention.MethodsData were collected from 393 students. A 3-step linear regression was used to measure associations between PA level, SCT variables (self-efficacy, social support, enjoyment), and perceived environment variables (schoolyard structures, condition, equipment/supervision). Logistic regression assessed associations between variables and whether students met PA recommendations.ResultsSchool and sex explained 6% of the moderate-to-vigorous PA models' variation. SCT variables explained an additional 15% of the models' variation, with much of the model's predictive ability coming from self-efficacy and social support. Sex was more strongly associated with PA level among Hispanic students, while self-efficacy was more strongly associated among non-Hispanic students. Perceived environment variables contributed little to the models.ConclusionsOur findings add to the literature on the influences of PA among elementary-aged students. The differences seen in the influence of sex and self-efficacy among non-Hispanic and Hispanic students suggests these are areas where PA interventions could be tailored to improve efficacy. Additional research is needed to understand if different measures of perceived environment or perceptions at different ages may better predict PA.     

The costly burden of an inauthentic self: insecure self-esteem predisposes to emotional exhaustion by increasing reactivity to negative events

Background and objectives: A long research tradition has investigated the impact of stress on university students by assuming that individuals have a limited reservoir of resources, and that negative events and circumstances progressively drain resources thereby producing exhaustion. A recent research tradition, instead, has focused on the detrimental consequences of discrepant levels of implicit (ISE) and explicit (ESE) self-esteem on the development of stress-related symptoms. The present research attempted to merge the aforementioned approaches, with the aim of explaining significant predictors of stress.

Design: Within the framework of a Longitudinal Structural Equation Model, we followed a moderated-mediated approach.

Method: A sample of university students (N?=?209; 66% females) completed a questionnaire battery including measures of ISE, ESE, perceptions of negative events, and emotional exhaustion. Participants were assessed once a week for eight consecutive weeks.

Results: ISE significantly moderated the relationship between ESE and negative events; in turn, the latter significantly predicted emotional exhaustion. Monte Carlo method for assessing mediation showed that negative events significantly mediated the relationship between incongruent self-esteem and emotional exhaustion.

Conclusions: The detrimental role of incongruent self-esteem has been corroborated. Practical implications and suggestions for future research dealing with stress in a university setting were provided.     

Self-regulatory efficacy's role in the relationship between exercise identity and perceptions of and actual exercise behaviour

Identity theory posits that when people endorse an identity they maintain or alter their behaviour in order to behave consistently with that identity. This assertion is supported in the exercise context where strength of exercise identity relates to exercise behaviour. Less is known about self-regulatory constructs that may aid individuals in behaving consistently with their exercise identity. Self-regulatory efficacy may mediate the relationship between exercise identity and exercise given the influence of this variable on exercise self-regulation; this relationship has not been examined. Exercise identity research has focused on the relationship between identity and behaviour; yet, identity theory recognizes perceptions of identity-behaviour consistency as theoretically important. Through influencing how identity-relevant information is processed, self-regulatory efficacy may also mediate the relationship between exercise identity and perceptions of identity-behaviour consistency.ObjectiveIdentity and social cognitive theories were used to examine self-regulatory efficacy as a mediator between exercise identity and i) exercise behaviour and ii) perceptions of identity-behaviour consistency.Method/designUndergraduate students (n = 311) were followed for 8 weeks. At baseline, participants completed demographic, exercise identity and exercise measures. After 4 weeks they reported their self-regulatory efficacy and after 8 weeks they reported their perceptions of identity-behaviour consistency and their exercise behaviour.ResultsConsistent with theory, self-efficacy mediated the relationship between exercise identity and both outcomes.ConclusionsFindings extend the exercise identity literature by providing empirical support for self-regulatory efficacy as a mechanism through which exercise identity strength leads to exercise behaviour and the perception of behavioural consistency with exercise identity meanings.     

The two roads of passionate goal pursuit: links with appraisal,coping, and academic achievement

Background and Objectives: In this research, we tested the role of cognitive appraisals in explaining why harmonious and obsessive passion dimensions are related to distinct forms of coping and explored if performance was impacted by these appraisal and coping processes. Design: Undergraduate students (N = 489) participated in a longitudinal study and completed three surveys throughout the course of an academic year. Methods: Participants completed assessments of both passion dimensions (Time 1), reported how they were appraising and coping with the mid-year examination period (Time 2), and provided consent to obtain their final grade in Introductory Psychology (Time 3). The hypothesized model was tested using structural equation modeling. Results: Harmonious and obsessive passion dimensions were linked with approach and avoidant coping responses, respectively. Cognitive appraisals, particularly appraisals of challenge and uncontrollability, played an indirect role in these relationships. In addition, both appraisals and coping responses had an indirect effect in the relationship between passion dimensions and final grade. Conclusions: These results identify cognitive appraisal as a reason why passion dimensions are linked with distinct coping tendencies and demonstrate the role of appraisal and coping processes in the journey to passionate goal attainment.     

Facing the risk of upward mobility: Performance-avoidance goals and social class among high-school students

ABSTRACT

Recent research has shown that lower social class students are more likely to endorse performance-avoidance goals (i.e., the fear of performing poorly) than higher-class students, particularly in situations of success. The purpose of the present research is, first, to test the upward mobility process as a moderator of the link between social class and performance-avoidance goal endorsement. The second aim is to document the further impact of this process on academic performance. Two hundred and fifteen high school students (M _age = 17.40, SD = 0.69) participated in the experiment. Half of them were randomly assigned to a “mobility salience” condition where they completed a mobility perception scale; while the other half completed a neutral scale. Then, they answered performance-avoidance goal items and solved mathematics, physics and life and earth sciences exercises. Results indicated that the salience of the mobility process increased the effect of social class on both performance-avoidance goal endorsement and mathematic performance. In addition, performance-avoidance goals appeared to be a mediator of the interaction effect between social class and the salience of the mobility process on mathematics performance. No such findings were obtained for physics and life and earth sciences. Taken together, these results support the idea that the prospect of experiencing mobility may be one of the mechanisms behind the difficulties encountered by lower-class students in an academic context.     

The role of illness perceptions in the attachment-related process of affect regulation

Abstract

Based on the predictions of the attachment theory and the Common Sense Model of illness perceptions, the current study focused on the role played by illness perceptions in explaining the path linking attachment orientations to negative affect during recovery from cardiac illness. We predicted two putative mechanisms: (1) illness perceptions would mediate the direct association between attachment-related insecurity (especially attachment anxiety) and levels of distress at follow-up and (2) illness perceptions would interact with attachment orientations (attachment avoidance in particular) in explaining patients' distress. The sample consisted of 111 male patients admitted to the Cardiac Care Unit of the Meir Medical Center, located in the central region of Israel. Patients completed a measure of attachment orientations during hospitalization (baseline). One month later, patients' illness perceptions were measured. Patients' depression and anxiety symptoms were measured at baseline and at the six-month follow-up. The associations between attachment-related anxiety and anxiety symptoms at follow-up were fully mediated by illness perceptions. Attachment-related avoidance was found to interact with illness perceptions in the prediction of depressive symptoms at follow-up. The findings shed light on the possible dynamics among personality, cognitive appraisals, and affect regulation efforts when coping with illness.     

Effects of dichotic listening on gait domains of healthy older adults during dual-tasking: An exploratory observational study

BackgroundIdentification of the cognitive mechanisms behind gait changes in aging is a prime endeavor in gerontology and geriatrics. For this reason, we have implemented a new dual-task paradigm where an auditory attentional task is performed during over-ground walking. Dichotic listening assesses spontaneous attention and voluntary attention directed to right and left-ear. The uniqueness of dichotic listening relies on its requirements that vary in difficulty and recruitment of resources from whole brain to one brain hemisphere. When used in dual-tasking, asymmetric effects on certain gait parameters have been reported.ObjectivesThe present study aims to acquire a more global understanding on how dichotic listening affects gait domains. Specifically, we aimed to understand how spontaneous vs lateralized auditory attention altered the Principal Component Analysis (PCA) structure of gait in healthy older adults.MethodsSeventy-eight healthy older adults (mean age: 71.1 years; 44 women and 34 men) underwent the Bergen dichotic listening test while walking. As this study only focuses on the effects of the cognitive task on gait, only dual-task costs for gait were calculated and entered into the PCA analyses. We explored the PCA structure for the effects on bilateral gait parameters (i.e., both limbs together) as well as on lateralized gait parameters (i.e, separate parameters by limb). We first established gait domains during single-task walking. Then, dual-task cost scores for gait were entered in a series of PCAs.ResultsResults from the PCAs for bilateral gait parameters showed limited alterations on gait structure. In contrast, PCAs for lateralized data demonstrated modifications of the gait structure during dichotic listening. The PCAs corresponding for all dichotic listening conditions showed different factor solutions ranging between 4 and 6 factors that explained between 73.8% to 80% of the total variance. As a whole, all conditions had an impact on “pace”, “pace variability” and “base of support variability” domains. In the spontaneous attention condition, a six-factor solution explaining 78.3% of the variance showed asymmetrical disruptions on the PCA structure. When attention was focused to right-ear, a five-factor solution explaining 89% of the variance and similar to baseline was found. When attention was directed to left-ear, a four-factor solution explaining 73.8% of the variance was found with symmetrical impact on all factors.ConclusionsThese findings demonstrate for the first time that specific facets of attentional control affects gait domains both symmetrically and asymmetrically in healthy older adults.     

A qualitative study of the decision to engage in tanning behaviors among female college students

IntroductionIndoor tanning is associated with increased risk of melanoma and is particularly prevalent among female college students in the U.S.ObjectivesThe present study aimed to explore why female students decide to engage, and keep engaging in indoor tanning.MethodsWe included eighteen female undergraduates who participated in group discussions. The group discussions were recorded and transcribed, then they were organized into themes.ResultsThree main themes appeared: appearance reasons for tanning, tanning-related health risks, and tanning salon-marketing strategies. Students were overall informed regarding tanning-related health risks, and suggested that they justified their tanning behaviors by rationalizations. They also revealed that the marketing strategies employed by tanning salons made them more likely to tan frequently. Finally, students spoke about how the health risks, the affects on appearance, and leaving the college setting might lead them to stop tanning.ConclusionsThese findings suggest that tanning among students could be reduced both by engaging students in programs addressing rationalizations about the risks associated with tanning, and policies targeting marketing techniques and tanning salon locations.     

Framing gratitude journaling as prayer amplifies its hedonic and eudaimonic well-being,but not health,benefits

Abstract

Gratitude is commonly practiced as prayer, but experimental studies testing the ability of gratitude journaling interventions to increase well-being have only examined secular forms of thanksgiving. We hypothesized that framing gratitude journaling as prayer would amplify its well-being effects. Undergraduate participants (N = 196) were instructed to write 10 things for which they were grateful once a week for five weeks. Participants were randomly assigned to read their thanks aloud to themselves, read their thanks to another person, or pray their thanks aloud to God. Participants in the prayer condition experienced a decrease in negative affect, and participants in the prayer condition who also exerted high effort demonstrated gains in gratitude, positive affect, and hope. Results indicate that the prayer condition may have led to increased health symptoms. Non-significant effects for the social condition suggest that the mechanisms explaining the effects of prayer are related to the theistic and sacred elements of prayer rather than its social features.     

Effects of different attention tasks on concurrent speech in adults who stutter and fluent controls

Purpose: Motor theories indicate that focusing attention on well-practiced movements interferes with skilled performance; however, specific forms of attention (alerting vs. orienting vs. executive control) associated with this effect are not well understood. The present study explored this question in relation to stuttering, and examined whether dual task conditions that engaged sustained attention or working memory (WM) affected speech fluency in different ways. We also considered whether fluency changes were associated with changes in speech rate and language.Methods: Nineteen adults who stutter (AWS) and 20 controls produced spontaneous speech under a baseline condition and two dual task conditions: one involving a sustained attention task, the other involving WM demands.Results: Both groups produced fewer stutter-like disfluencies under dual task relative to baseline conditions and this reduction did not differ between the two dual tasks (attention vs. WM). Speech rate and language variables, which were potentially influenced by attention conditions, were not affected by dual tasks in the same way as disfluencies, and appeared to be unassociated with fluency results.Conclusions: Findings indicate that atypical disfluencies decrease when attention is divided, even when secondary task demands are minimal, as they were in the sustained attention task. For simple secondary tasks, fluency changes do not appear to be a byproduct of slowed rate and are not accompanied by observable changes in language. These results demonstrate that simple manipulations of attention can induce measurable effects on aspects of speech production, and may be a useful tool for facilitating fluency in clinical intervention.     

Promoting safety belt use among state employees: the effects of prompting and a stimulus-control intervention.

This study assessed the effects of dashboard stickers and signature sheets on safety belt use among occupants of state-owned vehicles in three Florida agencies. The stickers and signature sheets contained information regarding a regulation requiring safety belt use and a consequence of a 25% reduction in benefits for noncompliance if the driver were to become involved in an accident. Safety belt use significantly increased during the intervention phase in all three agencies and maintained variable but high levels for 5 months. In Agency 1 and Agency 2 (stickers plus signature sheets) safety belt use increased from averages of 10.8% and 9.4% during baseline to 57.4% and 47.0%, respectively, during intervention. In Agency 3 (stickers only) the rates of safety belt use averaged 9.7% during baseline and 38.0% during intervention. Some increases in private vehicle use were observed. A substantial reduction in workers'' compensation claim costs was shown for the target agencies with some reductions also shown in the nontarget agencies.     

Rewarding elementary schoolchildren for their use of safety belts

This study reports on the application of reward procedures to elementary schoolchildren to increase their use of seat belts en route to two schools. Following strict rules for assessing buckle-up compliance, all passengers in a car had to be safely secured in order for the schoolchildren to receive rewards. Compliant children received paper slips as they arrived at schools, which were redeemable for stickers, bumper stickers, and coloring books. The slips were also used in weekly drawings for pizza dinners. The mean compliance rate for School 1 was 4.3% during baseline, 66.2% for the reward phase across 4 weeks, 60% for return to baseline, 17.2% for Follow-Up 1, and 8.5% for Follow-Up 2. For School 2, the mean percentage was 5.3% at baseline, 69.8% for the reward phase, 68.5% for return to baseline, 40.1% for Follow-Up 1, and 20% for Follow-Up 2. These results indicate that rewarding the schoolchildren increased their own seat-belt use as well as that of their adult drivers and other passengers. Decreases in usage were observed after the rewards were removed.     

Analyzing Components of Reading On Performance Assessments: An Expanded Simple View

This research examined the validity of the theoretical model of reading outlined by the Simple View of Reading when measuring reading ability with a performance-based reading test. Participants were 95 fourth-grade, students randomly sampled from four schools in an urban district. The test we studied employed a mixture of traditional (multiple-choice) and performance assessment approaches (constructed-response items that required written responses). Our findings indicated that writing ability emerged as an important source of individual differences in explaining overall reading ability, even when we deconstructed the test into a multiple-choice-only score.