Willingness to Seek Treatment Among Black Students With Anxiety or Depression: The Synergistic Effect of Sociocultural Factors With Symptom Severity and Intolerance of Uncertainty

Anxiety and depressive disorders are among the most commonly diagnosed psychiatric disorders, yet they remain largely undertreated in the U.S. and Black adults are especially unlikely to seek or receive mental health services. Symptom severity has been found to impact treatment-seeking behaviors as have sociocultural factors. Yet no known research has tested whether these factors work synergistically to effect willingness to seek treatment. Further, emerging data point to the importance of transdiagnostic risk factors such as intolerance of uncertainty (IU). IU may be negatively related to seeking treatment given that Black adults may be uncertain whether treatment might benefit them. Thus, the current study examined the relations between symptom severity/IU and willingness to seek treatment for anxiety/depression problems and the impact of key sociocultural variables (i.e., cultural mistrust–interpersonal relations [CMI-IR], perceived discrimination [PED]) on these relations among 161 (85% female) Black undergraduates. Consistent with prediction, symptom severity was positively related to willingness, but unexpectedly, IU was positively related. There was a significant Symptom Severity × CMI-IR interaction such that severity was positively related to willingness among students with lower cultural mistrust, but not higher mistrust. There were also significant IU × PED interaction such that IU was positively related to willingness among students with lower PED, but not higher PED. Results highlight the importance of considering the interplay between symptom severity, transdiagnostic vulnerability factors, and sociocultural variables when striving to identify factors related to treatment seeking behaviors among anxious and/or depressed Black students.     

Self‐Esteem and Ethics: A Phenomenological View

This paper aims to provide an account of the relationship between self‐esteem and moral experience. In particular, drawing on feminist and phenomenological accounts of affectivity and ethics, I argue that self‐esteem has a primary role in moral epistemology and moral action. I start by providing a characterization of self‐esteem, suggesting in particular that it can be best understood through the phenomenological notion of “existential feeling.” Examining the dynamics characteristic of the so‐called “impostor phenomenon” and the experience of women who are involved in abusive relationships, I then claim that self‐esteem fundamentally shapes the way in which self and others are conceived, and the ethical demands and obligations to which they are considered to be subjected. More specifically, I argue that low self‐esteem—which in the experience of women may be rooted in particular assumptions regarding gender roles and stereotyping—can hinder autonomy, make it difficult to question other people's evaluative perspectives and behaviors, and attribute to others responsibility for their actions.     

A Systematic Scoping Review of the Choice Architecture Movement: Toward Understanding When and Why Nudges Work

In this paper, we provide a domain‐general scoping review of the nudge movement by reviewing 422 choice architecture interventions in 156 empirical studies. We report the distribution of the studies across countries, years, domains, subdomains of applicability, intervention types, and the moderators associated with each intervention category to review the current state of the nudge movement. Furthermore, we highlight certain characteristics of the studies and experimental and reporting practices that can hinder the accumulation of evidence in the field. Specifically, we found that 74% of the studies were mainly motivated to assess the effectiveness of the interventions in one specific setting, while only 24% of the studies focused on the exploration of moderators or underlying processes. We also observed that only 7% of the studies applied power analysis, 2% used guidelines aiming to improve the quality of reporting, no study in our database was preregistered, and the used intervention nomenclatures were non‐exhaustive and often have overlapping categories. Building on our current observations and proposed solutions from other fields, we provide directly applicable recommendations for future research to support the evidence accumulation on why and when nudges work. Copyright © 2017 John Wiley & Sons, Ltd.     

Trajectories of Italian Children’s Peer Rejection: Associations with Aggression,Prosocial Behavior,Physical Attractiveness,and Adolescent Adjustment

In the present study, the predictors and outcomes associated with the trajectories of peer rejection were examined in a longitudinal sample of Italian children (338 boys, 269 girls) ages 10 to 14 years. Follow-up assessments included 60% of the original sample at age 16–17. Low, medium, and high rejection trajectory groups were identified using growth mixture models. Consistent with previous studies, we found that (a) being less prosocial and more physically aggressive at age 10 was characteristic of those children with the high rejection trajectory; (b) being less attractive was related to higher peer rejection from age 10 to 14; and (c) boys with a high rejection trajectory showed high levels of delinquency and anxiety-depression and low levels of academic aspiration at age 16–17, whereas girls with a high rejection trajectory showed low levels of academic aspiration and social competence at age 16–17. Our findings indicate the detrimental consequences of peer rejection on children’s development and adjustment and shed light on the mechanisms that contribute to maintaining or worsening (e.g., being attractive, prosocial, and aggressive) a child’s negative status (e.g., being rejected) within his or her peer group over time.     

Shared Communities: A Multinational Qualitative Study of Immigrant and Receiving Community Members

Community psychology is central to understanding how immigrants and more established residents of their new settings join together to develop a shared sense of community and membership. In our present study, we explored how newer (i.e., first‐ and second‐generation immigrants) and more established community members form multiple positive psychological sense of community (PSOC) with one another. We conducted a multinational, qualitative study of PSOC through interviews with 201 first‐ and second‐generation immigrants and third generation or more “receiving community members” in three contexts (Baltimore‐Washington corridor of the U.S.; Torino, Italy; Lecce, Italy). Results indicated numerous similarities among the ways in which participants constructed PSOC in shared and nonshared communities, regardless of immigration/citizenship status, length of community residence, city, country, age, or gender. Small, proximal, and salient communities were often particularly important to building positive PSOC, which was formed around diverse membership boundaries. As intersectional beings, members converged and diverged on many characteristics, providing multiple opportunities for members to bring diversity to their communities while sharing other characteristics deemed essential to membership. Nonetheless, findings point to significant, structural challenges rooted in power and privilege that must be confronted to bridge the community‐diversity dialectic and build strong, shared sense of community.     

Emotion-Focused Cognitive-Behavioral Therapy for Youth with Anxiety Disorders: A Randomized Trial

Difficulties with emotion regulation are a core feature of anxiety disorders (ADs) in children and adults. Interventions with a specific focus on emotion regulation are gaining empirical support. Yet, no studies to date have compared the relative efficacy of such interventions to existing evidence-based treatments. Such comparisons are necessary to determine whether emotion-focused treatments might be more effective for youth exhibiting broad emotion-regulation difficulties at pretreatment. This study examined an emotion-focused cognitive-behavioral therapy (ECBT) protocol in comparison to traditional cognitive-behavioral therapy (CBT) in a sample of children with a primary anxiety disorder diagnosis. Moderation analyses examined whether children with higher levels of emotion dysregulation at pretreatment would show greater levels of improvement in ECBT than CBT. Ninety-two youth ages 7 to 12 years (58% male) with a primary diagnosis of separation anxiety disorder, generalized anxiety disorder, or social phobia were included. Participants were randomly assigned to ECBT or CBT. Results showed that youth in both conditions demonstrated similar improvements in emotion regulation and that pretreatment levels of emotion dysregulation did not moderate treatment outcomes. Additional analyses showed that ECBT and CBT were similarly effective on diagnostic, severity, and improvement measures. Future work is needed to further explore the ways that emotion regulation is related to treatment outcome for anxious youth.     

Telehealth and in‐person training outcomes for novice discrete trial training therapists

The efficacy and efficiency of telehealth and in‐person training were compared while teaching seven undergraduate students to implement components of discrete trial training. A multiple‐baseline design across skills with elements of multiple probe and delayed multiple baseline combined with an alternating‐treatments design was used to evaluate the effects of behavioral skills training (BST) on (a) implementing a multiple stimulus without replacement preference assessment, (b) setting up an instructional context, (c) delivering antecedent prompts, and (d) delivering consequences for accurate and inaccurate responding. Two skills were trained via telehealth and two skills were trained in‐person using BST procedures with a mock student. All participants provided high acceptability ratings for both training procedures. Results also showed that telehealth training was as efficacious and efficient as in‐person training for all skills across all participants. Five of six participants showed high levels of maintenance of the newly acquired skills; these five also exhibited the skills during a novel instructional task.     

Higher visuo-Attentional Demands of Multiple Object Tracking (MOT) Lead to A Lower Precision in Pointing Movements

Multiple object tracking (MOT) requires visually attending to dynamically moving targets and distractors. This cognitive ability is based on perceptual-attentional processes that are also involved in goal-directed movements. This study aimed to test the hypothesis that MOT affects the motor performance of aiming movements. Therefore, the participants performed pointing movements using their fingers or a computer mouse that controlled the movements of a cursor directed at the targets in the MOT task. The precision of the pointing movements was measured, and it was predicted that a higher number of targets and distractors in the MOT task would result in a lower pointing precision. The results confirmed this hypothesis, indicating that MOT might influence the performance of motor actions. The potential factors underlying this influence are discussed.     

Changes in schemas of patients with severe borderline personality disorder: The Oulu BPD study

Borderline personality disorder (BPD) is a relatively common and severe psychiatric disorder that can impair quality of life in many ways. The aim of this study was to determine whether a combined treatment model for BPD patients, utilising major principles from schema‐focused therapy (SFT) and dialectical behavioral therapy (DBT), could be more effective in relieving early maladaptive schemas of BPD patients, compared to treatment as usual (TAU). This study is a part of the Oulu BPD study conducted at mental health care services run by Oulu city social and health care services. The study is a multisite, randomized controlled trial conducted over a one year period, involving two groups of patients with severe BPD: (1) Community Treatment By Experts (CTBE) patients (n = 18) receiving the combined treatment model, and 2) TAU patients (n = 27). The patients' schemas were assessed using the Young Schema Questionnaire (YSQ‐L3a) before and after one year of treatment. The results reveal that CTBE patients who attended the combined treatment model showed a statistically significant reduction in eight out of 18 early maladaptive schemas, while patients receiving treatment as usual did not demonstrate any significant changes in schemas. The cognitive therapeutic treatment model can be applied for clinical use in public mental health settings using existing professionals, and appears to produce positive changes in patients with BPD.