Effects of Rational Emotive Cognitive Behavioral Coaching on Depression Among Type 2 Diabetic Inpatients

Depression is a human illness that may prevent sustainable goal attainment. People with Type 2 diabetes mellitus have a much higher risk of being depressed than the nonclinical population, which may be due to associations between the neurobiological mechanisms that play a role in the two diseases. The objective of the present study was to investigate the effects of rational emotive cognitive behavioral coaching (RE-CBC) on depressive thinking in a group of inpatients with Type 2 diabetes in Nigeria. A pretest–posttest control group design was used. Eighty participants were randomly allocated to the treatment and control groups. Outcomes were evaluated using Nigerian language (Igbo) versions of the Beck Depression Inventory-II and the Hamilton Rating Scale for Depression, and the intervention was delivered in Igbo. An Igbo version of the Rational Emotive Behavior Therapy Manual for Depression was used as the intervention package. Data were analyzed using mean rank, repeated measures ANOVA, and the Mann–Whitney U test. At the end of the intervention, a significant decline in depression was observed among the participants in the group that received RE-CBC, but not in those that received standard counseling (control group). The effects of RE-CBC were maintained at follow-up. The present results suggest that RE-CBC is an effective and time-efficient intervention for managing depression in inpatients living with Type 2 diabetes. Further evaluations are warranted in other countries.     

The Early Presentation of Dementia in People with Down Syndrome: a Systematic Review of Longitudinal Studies

Adults with Down syndrome (DS) are at a very high risk of developing early onset Alzheimer’s disease (AD) due to trisomy of chromosome 21. AD is preceded by a prolonged prodromal “pre-clinical” phase presenting with clinical features that do not fulfil the diagnostic criteria for AD. It is important to clinically characterise this prodromal stage to help early detection of the disease as neuropathology of AD is almost universal by the fifth decade in DS. There is a lack of knowledge of the trajectory of decline associated with the onset of dementia in this population and early signs may be overlooked or misdiagnosed, negatively affecting the quality of life of those affected and the use of early pharmacological or psychosocial interventions. The objective of this systematic review is to evaluate the published literature on longitudinal data in order to identify the cognitive and behavioural changes occurring during the prodromal and early stages of AD in this population. Fifteen peer-reviewed articles met the inclusion criteria, including a total number of 831 participants, with the duration between baseline and follow up varying from 1 year to 47 years. Results suggest that, compared to the general population for which short-term (episodic) memory loss is the most common indicator associated with the onset of AD, in people with DS, executive dysfunction and Behavioural and Psychological Symptoms of Dementia (BPSD) are commonly observed during pre-clinical and early stages and may precede memory loss. The review highlights the importance of using a broad spectrum of assessments in the context of heterogeneity of symptoms. Theoretical and practical implications are discussed, as well as the need for further research.     

Evaluating Treatments for Functionally Equivalent Problem Behavior Maintained by Adult Compliance with Mands During Interactive Play

A primary goal of behavioral interventions is to reduce dangerous or inappropriate behavior and to generalize treatment effects across various settings. However, there is a lack of research evaluating generalization of treatment effects while individuals with functionally equivalent problem behavior interact with each other. For the current study, the severe problem behavior of two participants with developmental disabilities was targeted for assessment and treatment. Results of a functional analysis indicated that for both participants, problem behaviors occurred when destructive behavior produced reinforcement of participant mands . The use of a multiple schedule that alternated between differential reinforcement of other behaviors and differential reinforcement of alternative behavior (mands) was sufficient to produce a significant reduction in problem behavior for one participant; the addition of differential reinforcement of alternative behaviors via compliance was necessary for the second participant. Extended treatment sessions, which focused on interaction between the two participants, involved one therapist concurrently implementing each participant’s treatment while they were directed to play with one another (a situation that previously evoked problem behavior). Results show that each participant’s treatment produced low to zero rates of problem behavior even during extended interactions.     

Cognitive and neural consequences of memory suppression in major depressive disorder

Negative biases in cognition have been documented consistently in major depressive disorder (MDD), including difficulties in the ability to control the processing of negative material. Although negative information-processing biases have been studied using both behavioral and neuroimaging paradigms, relatively little research has been conducted examining the difficulties of depressed persons with inhibiting the retrieval of negative information from long-term memory. In this study, we used the think/no-think paradigm and functional magnetic resonance imaging to assess the cognitive and neural consequences of memory suppression in individuals diagnosed with depression and in healthy controls. The participants showed typical behavioral forgetting effects, but contrary to our hypotheses, there were no differences between the depressed and nondepressed participants or between neutral and negative memories. Relative to controls, depressed individuals exhibited greater activity in right middle frontal gyrus during memory suppression, regardless of the valence of the suppressed stimuli, and differential activity in the amygdala and hippocampus during memory suppression involving negatively valenced stimuli. These findings indicate that depressed individuals are characterized by neural anomalies during the suppression of long-term memories, increasing our understanding of the brain bases of negative cognitive biases in MDD.     

Measuring Competence and Dysfunction in Preschool Children: Source Agreement and Component Structure

Agreement between parents and teachers on ratings of three domains of behaviors exhibited by preschool children and the structural relations between these domains were measured. Parents and teachers rated the behaviors of a socioeconomically diverse sample of 610 children; ratings were obtained from parents at three time points and from teachers at two time points. The results indicated little agreement between sources on the ratings of individual child behaviors; however, ratings within a source were stable over time. Principal components analyses of source ratings combined and separately indicated virtually identical and independent three-component solutions comprised of a coping competence, externalizing behavior, and internalizing behavior component. These data suggest that competence and dysfunction develop in response to different contextual demands and underscore the importance of measuring each domain of behavior in clinical and research settings.     

Psychosocial resources, threat, and the perception of distance and height: support for the resources and perception model

Threatening things are often perceptually exaggerated, such that they appear higher, closer, of greater duration, or more intense than they actually are. According to the Resources and Perception Model (RPM) psychosocial resources can prevent this exaggeration, leading to more accurate perception. Two studies tested RPM. Study 1 showed that the perceived closeness of a threatening object (a live tarantula) but not an innocuous object (a cat toy) was moderated by induced self-worth. Further, the more self-worth that participants experienced, the less close the tarantula appeared to them. Study 2 showed that greater levels of self-esteem reduced perceived height, but only among participants prevented from holding a protective handrail while looking down. Together, these studies confirm that resources moderate the physical perception of both distance and height, that resources moderate perception of threats but not nonthreats, that different resources have similar moderating effects, and that psychosocial resources can supplant physical resources.     

Enhanced response inhibition during intensive meditation training predicts improvements in self-reported adaptive socioemotional functioning

We examined the impact of training-induced improvements in self-regulation, operationalized in terms of response inhibition, on longitudinal changes in self-reported adaptive socioemotional functioning. Data were collected from participants undergoing 3 months of intensive meditation training in an isolated retreat setting (Retreat 1) and a wait-list control group that later underwent identical training (Retreat 2). A 32-min response inhibition task (RIT) was designed to assess sustained self-regulatory control. Adaptive functioning (AF) was operationalized as a single latent factor underlying self-report measures of anxious and avoidant attachment, mindfulness, ego resilience, empathy, the five major personality traits (extroversion, agreeableness, conscientiousness, neuroticism, and openness to experience), difficulties in emotion regulation, depression, anxiety, and psychological well-being. Participants in Retreat 1 improved in RIT performance and AF over time whereas the controls did not. The control participants later also improved on both dimensions during their own retreat (Retreat 2). These improved levels of RIT performance and AF were sustained in follow-up assessments conducted approximately 5 months after the training. Longitudinal dynamic models with combined data from both retreats showed that improvement in RIT performance during training influenced the change in AF over time, which is consistent with a key claim in the Buddhist literature that enhanced capacity for self-regulation is an important precursor of changes in emotional well-being.