Development and evaluation of a scale assessing therapist fidelity to guidelines for delivering therapist-assisted Internet-delivered cognitive behaviour therapy

Internet-delivered cognitive behaviour therapy (ICBT) is often accompanied by therapist emails, but there is limited research on the quality of this therapist-assistance. In this study, an ICBT Therapist Rating Scale (ICBT-TRS) was developed and evaluated to assess whether therapist emails showed fidelity to specific therapist behaviours. Using data from a previous ICBT trial for depression and anxiety, the ICBT-TRS was used to rate 706 emails sent by 39 therapists to 91 randomly selected patients. Emails were rated for adherence (absent/present) and quality (inadequate/competent) on the following behaviours: Builds Rapport, Seeks Feedback, Provides Symptom Feedback, Provides Psychoeducation, Facilitates Understanding, Praises Effort, Encourages Practice, Clarifies Administrative Procedures, and Communicates Effectively. Inter-rater reliability was high. Most behaviours were identified as present in 72–100% of emails, with the exception of Provides Symptom Feedback and Facilitating Understanding which were only present in 54 and 61% of emails. The majority of emails were rated as high quality (88–98% of messages). While not related to symptom improvement, ICBT-TRS ratings were higher when patients were more engaged in ICBT (e.g. log-ins) and among therapists who specialized in ICBT or had a background in Psychology. The ICBT-TRS has potential to facilitate ICBT research and clinical training.     

The relationship between therapeutic engagement,cognitive errors,and coping action patterns: An exploratory study

Aim: This exploratory study examined the relationship between clients’ involvement in therapy and their cognitive errors (CE) and coping action patterns (CAP). Method: Therapy sessions from N = 26 clients were rated for CE and CP using the CE and CAP methods. Client involvement was measured with the Positive and Negative Affect Schedule, as well as the . Results: The CEs’ ‘magnification of the negative or minimisation of the positive’ and ‘labelling’ were associated with measures of affective therapeutic engagement. The coping styles ‘negotiation’, ‘opposition’, ‘submission’, ‘isolation’, ‘support seeking’, ‘information seeking’, ‘delegation’, and ‘escape’ were found to be associated with affective and behavioural dimensions of therapeutic involvement. Conclusions: These findings provide preliminary supporting evidence that CE and CP are related to the extent to which clients engage in the work of therapy. Implications for researchers and therapists are discussed.     

The effects of perceived social support on quality of life in patients awaiting coronary artery bypass grafting and their partners: testing dyadic dynamics using the Actor-Partner Interdependence Model

Patients awaiting coronary artery bypass grafting (CABG) need support from their partners or family caregivers to manage their self care successfully and to maximise quality of life. Partners need social support to help overcome the stressful tasks of an unexpected caregiving role. It is not known whether the individual's perceived social support contributes to their own, as well as their partner's quality of life. The aims of this study were to assess differences in social support and quality of life in patients and partners awaiting CABG, and to examine whether patients' and partners' perceived social support predicted their own, as well as their partner's quality of life before CABG. This cross-sectional study recruited 84 dyads (patients 84% males, aged 64.5 years and partners 94% females, aged 61.05 years). Perceived social support was assessed using the Medical Outcomes Study Social Support survey, with sub-scales for informational/emotional support, affectionate support, tangible support and positive social interaction. Quality of life was assessed using the Short-Form 12 Health Survey. Dyadic data were analysed using the Actor-Partner Interdependence Model, with distinguishable dyad regression. Results revealed the patients' informational/emotional support exhibited an actor effect on their own mental health (? = 0.19, p = 0.001); indicating those with low informational/emotional support had poorer mental health. There was a partner effect of the patients' informational/emotional support on their partner's mental health (? = 0.14, p = 0.024), indicating the patients' informational/emotional support was associated with the partner's mental health. None of the other types of social support exhibited an actor effect or a partner effect on the patient's or the partner's mental or physical health. More research into the relationship between social support and mental health is needed to help inform the design of interventions that target the dyad.     

Self-forgiveness and forgiveness-seeking in response to rumination: Cardiac and emotional responses of transgressors

Self-forgiveness and forgiveness-seeking are important and understudied aspects of forgiveness. We examined the cardiac and emotional patterns of healthy young adults (40 women, 40 men) who recalled an unresolved offense they had caused another person. Participants engaged in four imagery conditions: ruminating about the offense, being humbly repentant and engaging in self-forgiveness, seeking forgiveness from the victim and receiving forgiveness, and seeking forgiveness from the victim and being begrudged. Being repentant and begrudged forgiveness by one’s victim was associated with the same level of guilt as when ruminating, but significantly more negative emotion, less control, and less empathy than when ruminating, self-forgiving, and receiving forgiveness from the victim. Compared to ruminating about one’s wrongdoing, self-forgiving alleviated guilt and negative emotion, increased perceived control, decreased heart rate, and increased parasympathetic activation. Imagery of receiving forgiveness from the victim resulted in these same patterns and was equivalent to self-forgiveness across variables.     

On utrocular discrimination

Observers with good stereoacuity judged which eye received sine-wave grating patterns in a two-category forced-choice procedure. Large individual differences were found, but for most observers reliable discrimination was achieved at low spatial frequencies. No observer could perform the task above chance levels at high spatial frequencies. Discrimination was unaffected by retinal location, grating orientation, grating contrast, stimulus duration, or practice with feedback. Among observers who could perform the task, the following results were obtained: (1) Introduction of high spatial frequency components did not interfere with performance so long as a low spatial frequency component was present. (2) When gratings of low equal spatial frequency were presented to both eyes simultaneously at different contrast levels, observers could identify which eye received the higher contrast. (3) At low spatial frequencies, observers could distinguish monocular from binocular presentation. (4) Temporal frequency variations (counterphase flicker) influenced performance for some observers. Binocular summation and interocular transfer were unaffected by the spatial frequency variations which modulate utrocular discrimination. A new procedure for measuring stereopsis was developed which made possible comparison of utrocular discrimination with stereopsis at specific spatial frequencies. Stereopsis appeared mildly affected by spatial frequency.     

Individual and Organizational Predictors of the Ethicality of Graduate Students’ Responses to Research Integrity Issues

The development of effective means to enhance research integrity by universities requires baseline measures of individual, programmatic, and institutional factors known to contribute to ethical decision making and behavior. In the present study, master’s thesis and Ph.D. students in the fields of biological, health and social sciences at a research extensive university completed a field appropriate measure of research ethical decision making and rated the seriousness of the research issue and importance for implementing the selection response. In addition they were asked to rate their perceptions of the institutional and departmental research climate and to complete a measure of utilitarian and formalistic predisposition. Female students were found to be more ethical in their decision making compared to male students. The research ethical decision measure was found to be related to participants’ ethical predisposition and overall perception of organizational and departmental research climate; however, formalism was the only individual predictor to reach statistical significance and none of the individual subscales of the research climate measure were significantly correlated to ethicality. Participants’ ratings of the seriousness of the issue were correlated with their ratings of the importance of carrying out their selected response but neither was significantly predictive of the ethicality of their responses. The implications of these findings for the development of more effective training programs and environments for graduate students in research ethics and integrity are discussed.     

Perceptual Priming by Invisible Motion

When observers see motion that is not really there, they can nonetheless show evidence of motion priming. And when observers do not see motion that is really there, they also show evidence for motion priming. Evidently, the process responsible for establishing motion correspondence is sensitive to contextual information, and this sensitivity is modulated at preconscious levels of visual analysis.     

Pattern and flicker detection examined in terms of the nasal-temporal division of the retina

Contrast thresholds for the detection of flicker and the detection of pattern were measured for nasal and temporal retinae of each eye separately. While confirming that these two types of threholds can differ, depending on the spatial frequency, the results provide no support for hemiretinal or hemispheric asymmetries in the distribution of the putative pattern and movement channels.     

On assessing individual differences in rumination on sadness

The Rumination on Sadness Scale (RSS), an individual-difference measure of rumination on sadness, was developed as an alternative to the Ruminative Responses scale of the Response Styles Questionnaire (RRRSQ; Nolen-Hoeksema & Morrow, 1991). Research has shown the RRRSQ to consist of multiple, not highly intercorrelated factors; only I factor explicitly addresses rumination. In Study 1, a 1-factor solution to a principal components analysis was shown to hold for responses to the RSS. The RSS was also shown to be reliable. In Study 2, convergent and discriminant validity of the RSS were assessed. In Study 3, individuals with high RSS scores exhibited more distress regarding current concerns with the introduction of a delay period (to allow them to ruminate) after a sad mood induction.     

Late adolescent perceptions of parent religiosity and parenting processes

The current investigation examined the relations between adolescent reports of parent religiosity and parenting processes, using both a dimensional and a typological conceptualization of parenting. Self-report data were collected from 357 late adolescents. Partial correlations indicated that parent religiosity was associated with both parenting dimensions and parenting styles in conceptually expected directions. Regression analyses provided evidence that the dimensional conceptualization of parenting explained additional variability in perceived parental religiosity above and beyond parenting style effects. Findings suggest that a dimensional conceptualization of parenting processes extends the literature on parent religiosity because it yields more nuanced information about how parental religiosity may be related to differentiated parenting behaviors. Potential therapeutic implications of the findings are discussed.