How do psychological treatments work? Investigating mediators of change

Little is known about how psychological treatments work. Research on treatment-induced mediators of change may be of help in identifying potential causal mechanisms through which they operate. Outcome-focused randomised controlled trials provide an excellent opportunity for such work. However, certain conceptual and practical difficulties arise when studying psychological treatments, most especially deciding how best to conceptualise the treatment concerned and how to accommodate the fact that most psychological treatments are implemented flexibly. In this paper, these difficulties are discussed, and strategies and procedures for overcoming them are described.     

How does a vacation from work affect employee health and well-being?

Health and well-being (H&W) improve during vacation. However, it is unclear whether this general development applies to all employees, while also little is known about the underlying processes causing such an improvement. Our research questions were: (1) Does every worker experience a positive effect of vacation on H&W? and (2) Can vacation activities and experiences explain changes in H&W during vacation? In a 7-week longitudinal field study, 96 workers reported their H&W 2 weeks before, during, 1 week, 2 and 4 weeks after a winter sports vacation on 6 indicators (health status, mood, fatigue, tension, energy level and satisfaction). Sixty percent of the sample experienced substantial improvement of H&W during and after vacation. Yet, a small group experienced no (23%) or a negative effect of vacation (17%). Spending limited time on passive activities, pleasure derived from vacation activities, and the absence of negative incidents during vacation explained 38% of the variance in the vacation effect. Although vacation has a positive, longer lasting effect for many, it is not invariably positive for all employees. Choosing especially pleasant vacation activities and avoiding negative incidents as well as passive activities during active vacations apparently contributes to the positive effect of vacation on H&W.     

How does a vacation from work affect employee health and well-being?

Health and well-being (H&W) improve during vacation. However, it is unclear whether this general development applies to all employees, while also little is known about the underlying processes causing such an improvement. Our research questions were: (1) Does every worker experience a positive effect of vacation on H&W? and (2) Can vacation activities and experiences explain changes in H&W during vacation? In a 7-week longitudinal field study, 96 workers reported their H&W 2 weeks before, during, 1 week, 2 and 4 weeks after a winter sports vacation on 6 indicators (health status, mood, fatigue, tension, energy level and satisfaction). Sixty percent of the sample experienced substantial improvement of H&W during and after vacation. Yet, a small group experienced no (23%) or a negative effect of vacation (17%). Spending limited time on passive activities, pleasure derived from vacation activities, and the absence of negative incidents during vacation explained 38% of the variance in the vacation effect. Although vacation has a positive, longer lasting effect for many, it is not invariably positive for all employees. Choosing especially pleasant vacation activities and avoiding negative incidents as well as passive activities during active vacations apparently contributes to the positive effect of vacation on H&W.     

Coping with work and family: How do dual‐earners interact?

Juggling the demands of both work and family has become increasingly difficult, especially for dual‐earner households; nevertheless, families have developed strategies to deal with work‐family challenges. This paper uses couple level analyses (APIM models) with 100 dual‐earner couples to provide insight about partners' mutual influence on the use of work‐family coping strategies. The results show that women's use of coping strategies is more associated with work‐family conflict and work‐family enrichment than men's coping. In addition, using partner coping, having a positive attitude towards multiple roles, using planning and management skills and avoiding having to cut back on professional responsibilities is associated with better outcomes (more enrichment and less conflict). Surprisingly, the use of childcare facilities is associated with women's conflict and partner effects were only found concerning the use of management and planning skills. These skills, however, have distinct effects for men and women's outcomes: their use by men reduces their own conflict but increases their wives', while their use by women decreases their own conflict and increases their own and their partner's enrichment. These results point to the fact that gender roles continue to be a hallmark of work‐family issues. Our design and results point out the need for new interventions that take couple interdependences into account.     

How do women experience myocardial infarction? A qualitative exploration of illness perceptions, adjustment and coping

While UK Department of Health policy recognizes the importance of secondary prevention and rehabilitation following a cardiac event, there still appears a dearth of research addressing women's needs. This study aimed to explore adjustment in terms of women's perception of their cardiac event, impact on relationships and coping strategies employed. Five women suffering first time MI were interviewed, using a semi-structured format and were telephoned 2 months later. Data were analysed using Interpretative Phenomenological Analysis. Perceptions included: Making Sense of the Event, Cognitive and Emotional Responses and Self-beliefs. Relationships issues were: Others' Reactions and Change in Relationships and Roles. Cognitive and Behavioural strategies and Support from others (including cardiac rehabilitation) formed coping strategies. For most participants, the event was unexpected evoking uncertainty and later, emotions extending beyond the more widely accepted depression and anxiety. Women tended to minimize severity of symptoms and impact of event (perhaps as a way of coping and protecting others), displaying a strong sense of optimism and hope that life would soon return to "normal". However, it appeared this was difficult to maintain and the experience seemed to challenge relationships and roles. The findings suggest recommendations for further research with possible implications for clinical practice.     

How and when do students use flashcards?

Previous survey research has documented students' use of self-regulated study strategies, with a particular interest in self-testing. These surveys indicate that students frequently use flashcards to self-test and that self-testing is primarily used as a way to monitor learning. Whereas previous surveys provide information about whether and why students self-test, they provide minimal information about how and when students choose to self-test. Accordingly, the primary purpose of the current survey was to explore how and when students engage in self-testing. We surveyed 374 undergraduates about the amount of practice and the timing of practice, two factors that strongly affect the efficacy of self-testing. Results indicate that students understand the benefits of practising to higher criterion levels (amount of practice) but do not typically implement or understand the benefits of practising with longer lags (timing of practice). We discuss practical implications for supporting more successful student learning.     

How and when do students use flashcards?

Previous survey research has documented students' use of self-regulated study strategies, with a particular interest in self-testing. These surveys indicate that students frequently use flashcards to self-test and that self-testing is primarily used as a way to monitor learning. Whereas previous surveys provide information about whether and why students self-test, they provide minimal information about how and when students choose to self-test. Accordingly, the primary purpose of the current survey was to explore how and when students engage in self-testing. We surveyed 374 undergraduates about the amount of practice and the timing of practice, two factors that strongly affect the efficacy of self-testing. Results indicate that students understand the benefits of practising to higher criterion levels (amount of practice) but do not typically implement or understand the benefits of practising with longer lags (timing of practice). We discuss practical implications for supporting more successful student learning.     

Dirty work,dirty worker? Stigmatisation and coping strategies among domestic workers

Domestic work can be perceived to be ‘dirty work’ in several ways: it is associated with dirt handling, low occupational prestige, and domestic workers have a servile relationship to their clients/employers. This stigma may negatively affect domestic workers' sense of self, and thus coping strategies appear to be critical. In this article, we explore the coping strategies that moderate the relation between the stigma of dirty work and domestic workers' sense of self, based on the analyses of 43 interviews with domestic workers in Belgium. By using a social stress approach in which stigma is considered a stressor, our results reveal a range of maladaptive and adaptive coping strategies that contribute to a negative or a more positive sense of self. Four main categories of coping strategies are discussed: confronting or countering perceptions and behaviours, occupational ideologies, social weighting and defensive tactics. The first two categories are adaptive coping strategies; the last two can be adaptive or maladaptive. We also reveal that workers used adaptive and maladaptive coping strategies simultaneously, leading to mixed implications for their sense of self.     

Why do people need self-esteem? A theoretical and empirical review

Terror management theory (TMT; J. Greenberg, T. Pyszczynski, & S. Solomon, 1986) posits that people are motivated to pursue positive self-evaluations because self-esteem provides a buffer against the omnipresent potential for anxiety engendered by the uniquely human awareness of mortality. Empirical evidence relevant to the theory is reviewed showing that high levels of self-esteem reduce anxiety and anxiety-related defensive behavior, reminders of one's mortality increase self-esteem striving and defense of self-esteem against threats in a variety of domains, high levels of self-esteem eliminate the effect of reminders of mortality on both self-esteem striving and the accessibility of death-related thoughts, and convincing people of the existence of an afterlife eliminates the effect of mortality salience on self-esteem striving. TMT is compared with other explanations for why people need self-esteem, and a critique of the most prominent of these, sociometer theory, is provided.     

How do group meetings make a community Therapeutic?

Summary Following an abrupt shift from a therapeutic community with emphasis on group meetings to a hierarchical medical model on a mental hospital floor, disturbed patients required extensive individual nursing care. This increased work load for the nursing staff resulted in admissions having to be limited to the rare cases who needed little or no nursing care. As patients were discharged, the vacancy rate went up to approximately 20% for a week and remained high for another two weeks. Nursing staff-patient relations deteriorated.Subsequently, it was possible to resume the emphasis on the groups of a therapeutic community and to observe the contrast. The experience showed how groups can effect and support a therapeutic community. It clarified some of the mechanisms by which groups positively affected disturbed patients. Some mechanisms by which the staff, community, and group meetings favorably influenced the nursing staff-patient relationship and intrastaff communications became clear also.     

How do we convert a number into a finger trajectory?

How do we understand two-digit numbers such as 42? Models of multi-digit number comprehension differ widely. Some postulate that the decades and units digits are processed separately and possibly serially. Others hypothesize a holistic process which maps the entire 2-digit string onto a magnitude, represented as a position on a number line. In educated adults, the number line is thought to be linear, but the “number sense” hypothesis proposes that a logarithmic scale underlies our intuitions of number size, and that this compressive representation may still be dormant in the adult brain. We investigated these issues by asking adults to point to the location of two-digit numbers on a number line while their finger location was continuously monitored. Finger trajectories revealed a linear scale, yet with a transient logarithmic effect suggesting the activation of a compressive and holistic quantity representation. Units and decades digits were processed in parallel, without any difference in left-to-right vs. right-to-left readers. The late part of the trajectory was influenced by spatial reference points placed at the left end, middle, and right end of the line. Altogether, finger trajectory analysis provides a precise cognitive decomposition of the sequence of stages used in converting a number to a quantity and then a position.     

Performance expectations,personal resources,and job resources: How do they predict work engagement?

Research on work engagement has mainly focused on the role of job and personal resources and has ignored the possible impact of personal demands workers develop with regard to their work. The aim of our study was to test the reciprocal relationships that job resources, personal resources, and personal demands, operationalized as performance expectations, share with work engagement. Three-wave longitudinal data were collected in a Belgian public institution (N?=?473). Results confirm the causal effects of job resources, personal resources, and performance expectations on work engagement. Reciprocal relationships are not significant. Results are discussed with regard to the impact of changes in job and personal resources and performance expectations on work engagement. Practical implications including reinforcement of Human Resources practices such as appraisal interviewing and career management are also discussed.     

How (and where) does moral judgment work?

Moral psychology has long focused on reasoning, but recent evidence suggests that moral judgment is more a matter of emotion and affective intuition than deliberate reasoning. Here we discuss recent findings in psychology and cognitive neuroscience, including several studies that specifically investigate moral judgment. These findings indicate the importance of affect, although they allow that reasoning can play a restricted but significant role in moral judgment. They also point towards a preliminary account of the functional neuroanatomy of moral judgment, according to which many brain areas make important contributions to moral judgment although none is devoted specifically to it.     

How do people evaluate social sexual conduct at work? A psycholegal model

The authors tested a psycholegal model of how people evaluate social sexual conduct at work with videotaped reenactments of interviews with alleged complainants, perpetrators, and other workers. Participants (200 full-time male and female workers) were randomly assigned to evaluate the complaints with either the reasonable person or reasonable woman legal standard. Participants answered questions about sexual harassment law and completed the Ambivalent Sexism Inventory. Participants who took the reasonable woman perspective, as compared with those who took the reasonable person perspective, were more likely to find the conduct harassing; this was especially the case among participants high in hostile sexism. Medium-sized gender effects were found in the severe case but were absent in the weaker, more ambiguous case. The implications of these findings for hostile work environment law are discussed.     

Theoretical note: When is a coping strategy not a coping strategy?

Abstract

This paper discusses the issue of differentiating between cognitive coping behaviors and appraisal processes. Although these can be separated in theory, and experimental procedures can manipulate appraisals independantly of coping, it is difficult to separate these constructs in naturalistic studies on appraisal and coping responses to real life stressors. The ability to separate these constructs requires knowledge of an individual's precise motivation, an age-old stumbling block in psychological research. It is proposed that, at least in naturalistic studies on stress, appraisal and coping, perhaps the best that can be achieved is to record a particular behavior and report it as such, without attempting to guess at the motivation underlying it.     

How do world-class cricket batsmen anticipate a bowler's intention?

Four experiments are reported that examine the ability of cricket batsmen of different skill levels to pick up advance information to anticipate the type and length of balls bowled by swing and spin bowlers. The information available upon which to make the predictive judgements was manipulated through a combination of temporal occlusion of the display and selective occlusion or presentation of putative anticipatory cues. In addition to a capability to pick up advance information from the same cues used by intermediate and low-skilled players, highly skilled players demonstrated the additional, unique capability to pick up advance information from some specific early cues (especially bowling hand and arm cues) to which the less skilled players were not attuned. The acquisition of expert perceptual-motor skill appears to involve not only refinement of information extraction but also progression to the use of earlier, kinematically relevant sources of information.     

How do people know?

To fully understand processes of knowing and knowledge acquisition, it is necessary to examine people's understanding of their own knowing. Individual and developmental differences in what it means to know something, and hence in the criteria for justifying knowledge claims, have potentially wide-ranging implications. In providing support for a claim, young children have difficulty differentiating explanation of why a claim makes sense and evidence that the claim is true. Epistemic understanding progresses developmentally, but substantial variation remains among adults, with few adults achieving understanding of the complementary strengths and weaknesses of evidence and explanation in argument. Epistemic understanding shapes intellectual values and hence the disposition (as opposed to competence) to exercise intellectual skills. Only its most advanced levels support a disposition to engage in the intellectual effort that reasoned argument entails. The sample case of juror reasoning illustrates how epistemic understanding underlies and shapes intellectual performance.