All at once or one at a time? A randomized controlled trial comparing two ways to deliver bibliotherapy for panic disorder

Bibliotherapy is potentially effective in the treatment of panic disorder (PD). A still unanswered question is whether pacing is important. This study was designed to test whether there is a difference between being assigned a full book as therapy and receiving one individual chapter every week (i.e. pacing). A total of 28 participants were randomized to either 10 paced chapters or one book with 10 chapters. To maximize compliance, short weekly telephone calls were added in both conditions (M = 17.8 min, SD = 4.2). Both treatments showed promising results, with effects maintained up to 2 years and with within-group effect sizes (Cohen's d) between 0.95 and 1.11. Pretreatment ratings of credibility were positively correlated with the change scores at both posttest and 2-year follow-up for three panic measures. Pacing of text material in bibliotherapy for PD is not needed, and all material can be provided at once when the treatment is guided by a therapist.     

Individually-tailored, Internet-based treatment for anxiety disorders: A randomized controlled trial

Previous studies on Internet-based treatment with minimal to moderate therapist guidance have shown promising results for a number of specific diagnoses. The aim of this study was to test a new approach to Internet treatment that involves tailoring the treatment according to the patient’s unique characteristics and comorbidities.A total of 54 participants, regardless of specific anxiety diagnosis, were included after an in-person, semi-structured diagnostic interview and randomized to a 10 week treatment program or to a control group. Treatment consisted of a number of individually-prescribed modules in conjunction with online therapist guidance. Significant results were found for all dependent measures both immediately following treatment and at 1 and 2 year intervals. Mean between-group effect size including measures of anxiety, depression and quality of life was Cohen’s d = 0.69 at post-treatment, while the mean within-group effect size was d = 1.15 at post-treatment and d = 1.13 and d = 1.04 at 1 and 2 year follow-up respectively.The tentative conclusion drawn from these results is that tailoring the Internet-based therapy can be a feasible approach in the treatment of anxiety in a homogeneous population.     

The Rumsfeld effect: the unknown unknown

A set of studies tested whether people can use awareness of ignorance to provide enhanced test consistency over time if they are allowed to place uncertain items into a "don't know" category. For factual knowledge this did occur, but for a range of other forms of knowledge relating to conceptual knowledge and personal identity, no such effect was seen. Known unknowns would appear to be largely restricted to factual kinds of knowledge.     

Therapeutic alliance in guided internet-delivered cognitive behavioural treatment of depression, generalized anxiety disorder and social anxiety disorder

Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in several controlled trials, but the mechanisms of change are largely unknown. Therapeutic alliance is a factor that has been studied in many psychotherapy trials, but the role of therapeutic alliance in ICBT is less well known. The present study investigated early alliance ratings in three separate samples. Participants from one sample of depressed individuals (N = 49), one sample of individuals with generalized anxiety disorder (N = 35), and one sample with social anxiety disorder (N = 90) completed the Working Alliance Inventory (WAI) modified for ICBT early in the treatment (weeks 3-4) when they took part in guided ICBT for their conditions. Results showed that alliance ratings were high in all three samples and that the WAI including the subscales of Task, Goal and Bond had high internal consistencies. Overall, correlations between the WAI and residualized change scores on the primary outcome measures were small and not statistically significant. We conclude that even if alliance ratings are in line with face-to-face studies, therapeutic alliance as measured by the WAI is probably less important in ICBT than in regular face-to-face psychotherapy.     

Self-control as predictor of school grades,life balance,and flow in adolescents

Background. Recently, several studies have shown that strength of self-control is a crucial factor in determining positive outcomes in individuals’ lives. Most attention has been directed to the relationships that self-control has with learning and academic achievement. Aims. This article analyses the effects of self-control not only on school grades but also on the experience of life balance and flow. It is theorized that students with a higher level of self-control are better able to distribute their time in a satisfying way over academic and leisure matters, and are better able to shield their studying against distractions. Samples. A total of 697 eighth graders with a mean age of 13.4 years participated in the longitudinal study. Method. Students completed a questionnaire containing measures of self-control, school grades, subjective life balance, and flow while studying at the beginning and at the end of the school year. Structural equation modelling was used to analyse the relationships between the constructs. Results and conclusions. Results of cross-lagged analyses show that self-control predicted school grades, life balance, and flow. The findings suggest that self-control may assist adolescents to be better prepared, not only for school, but also for coordinating their investments in different areas of their lives.     

Outcome predictors in guided and unguided self-help for social anxiety disorder

Internet-based self-help with therapist guidance has shown promise as an effective treatment and may increase access to evidence-based psychological treatment for social anxiety disorder (SAD). Although unguided self-help has been suggested primarily as a population-based preventive intervention, some studies indicate that patients with SAD may profit from unguided self-help. Gaining knowledge about predictors of outcome in guided and unguided self-help for SAD is important to ensure that these interventions can be offered to those who are most likely to respond. Utilizing a sample of 245 patients who received either guided or unguided self-help for SAD, the present study examined pre-treatment symptoms and program factors as predictors of treatment adherence and outcome. The results were in line with previous findings from the face-to-face treatment literature: namely, the intensity of baseline SAD symptoms, but not depressive symptoms, predicted treatment outcomes in both unguided and guided self-help groups. Outcomes were unrelated to whether a participant has generalized versus specific SAD. Furthermore, for the unguided self-help group, higher credibility ratings of the treatment program were associated with increased treatment adherence. The findings suggest that guided and unguided self-help may increase access to SAD treatment in a population that is more heterogeneous than previously assumed.     

Visuospatial attention in schizophrenia: deficits in broad monitoring

Although selective attention is thought to be impaired in people with schizophrenia (PSZ), prior research has found no deficit in the ability to select one location and withdraw attention from another. PSZ and healthy control subjects (HCS) performed a stimulus detection task in which one, two, or all four peripheral target locations were cued. When one or two locations were cued, both PSZ and HCS responded faster when the target appeared at a cued than uncued location. However, increases in the number of validly cued locations had much more deleterious effects on performance for PSZ than HCS, especially for targets of low contrast whose detection was more dependent on attention. PSZ also responded more slowly in trials with four cued locations relative to trials with one or two invalidly cued locations. Thus, visuospatial attention deficits in schizophrenia arise when broad monitoring is required rather than when attention must be focused narrowly.     

Contagious bodies. An investigation of affective and discursive strategies in contemporary online activism

The paper presents an analysis of Climate Justice Fast, a campaign consisting of an international hunger strike against political in action on climate change. Within the theoretical framework of political online activism and theories of affect, we investigate the encoding and decoding of the starving activist bodies in relation to CJF. Our material consists of texts from the CJF website, activist blogs, and two online debates on a large Danish media platform. The methodological approach is discourse analytical and esthetic-affective. In our analysis we outline the different semantic significations of the starving bodies as central signifiers and we investigate the different affective responses to the hunger strike. We furthermore argue that the starved body seems to be relationally powerful, because of both its contagious ability to attune other bodies and its semantic ‘wildness’.     

Erscheinungsformen und Ursachen von Amoktaten aus kriminologischer,forensisch-psychiatrischer und forensisch-psychologischer Sicht

Cases of running amok are intentional, accomplished and attempted multiple homicides by which mass murder is generally carried out by a single offender, motivated by anger, hate and revenge, attacking defined or randomly selected victims. The offender intends to become famous and in many cases commits suicide after the attack. Young offenders up to the age of 24 years old differ from the heterogeneous group of adults. Within a core group of young offenders personality disorders and behavioral problems are the main cause of the attacks. A quiet, reclusive and always somewhat strange loner has a deep feeling of alienation, feels offended and disregarded, identifies with perpetrators and stages the crime as revenge for subjectively experienced insults. Schizotypal, paranoid and narcissistic aspects dominate. The offenders are not characterized by patterns of impulsive, aggressive or dissocial behavior.