Determinants of Depression Severity and Duration in Canadian Adults: The Moderating Effects of Gender and Social Support

This study examined the effects of 4 subtypes of social support (tangible, affective, positive social interaction, and emotional/informational) and gender on the severity and duration of depressive symptoms within the general adult Canadian population. Data were collected from the Canadian Community Health Survey (CCHS; Statistics Canada, 2002 ). Upon meeting predetermined criteria, 6,316 participants were included in the study. The findings suggest that, overall, positive social interaction was significantly associated with decreases in depression severity; while emotional/informational support was significantly associated with increases in depression severity. Positive social interaction and emotional/informational support appeared to significantly decrease the duration of depression. Interesting gender differences also emerged among the 4 subtypes of social support. Implications of the findings are discussed.     

Predicting Response to Intensive Multimodal Inpatient Treatment: A Comparison of Single- and Multiple-Class Growth Modeling Approaches

In a modest body of research, personality functioning assessed via performance-based instruments has been found to validly predict treatment outcome and, to some extent, differential response to treatment. However, state-of-the-science longitudinal and mixture modeling techniques, which are common in many areas of clinical psychology, have rarely been used. In this article, we compare multilevel growth curve modeling (MLM) and latent class growth modeling (LCGM) approaches with the same data set to illustrate the different research questions that can be addressed by each method. Global Assessment of Functioning (GAF) scores collected at 6 points during the course of a long-term multimodal inpatient treatment of 58 severely and persistently mentally ill adults were used to model the trajectory of treatment outcome. Pretreatment Rorschach-based markers of personality functioning and other markers of psychiatric severity were examined as covariates in each modeling approach. The results of both modeling approaches generally indicated that more psychologically impaired clients responded less favorably to treatment. The LCGM approach revealed 2 unique trajectories of improvement (a persistently low group and a higher starting, improving group). Personality functioning and baseline psychiatric variables significantly predicted group membership and the rate of change within the groups. A side-by-side examination of these 2 methods was found to be useful in predicting differential treatment response with personality functioning variables.     

Convergent Validity of the Early Memory Index in Two Primary Care Samples

Karliner, Westrich, Shedler, and Mayman (1996) developed the Early Memory Index (EMI) to assess mental health, narrative coherence, and traumatic experiences in reports of early memories. We assessed the convergent validity of EMI scales with data from 103 women from an urban primary care clinic (Study 1) and data from 48 women and 24 men from a suburban primary care clinic (Study 2). Patients provided early memory narratives and completed self-report measures of psychopathology, trauma, and health care utilization. In both studies, lower scores on the Mental Health scale and higher scores on the Traumatic Experiences scale were related to higher scores on measures of psychopathology and childhood trauma. Less consistent associations were found between the Mental Health and Traumatic Experiences scores and measures of health care utilization. The Narrative Coherence scale showed inconsistent relationships across measures in both samples. In analyses assessing the overall fit between hypothesized and actual correlations between EMI scores and measures of psychopathology, severity of trauma symptoms, and health care utilization, the Mental Health scale of the EMI demonstrated stronger convergent validity than the EMI Traumatic Experiences scale. The results provide support for the convergent validity of the Mental Health scale of the EMI.     

A connectionist modeling study of the neural mechanisms underlying pain’s ability to reorient attention

Connectionist modeling was used to investigate the brain mechanisms responsible for pain’s ability to shift attention away from another stimulus modality and toward itself. Different connectionist model architectures were used to simulate the different possible brain mechanisms underlying this attentional bias, where nodes in the model simulated the brain areas thought to mediate the attentional bias, and the connections between the nodes simulated the interactions between the brain areas. Mathematical optimization techniques were used to find the model parameters, such as connection strengths, that produced the best quantitative fits of reaction time and event-related potential data obtained in our previous work. Of the several architectures tested, two produced excellent quantitative fits of the experimental data. One involved an unexpected pain stimulus activating somatic threat detectors in the dorsal posterior insula. This threat detector activity was monitored by the medial prefrontal cortex, which in turn evoked a phasic response in the locus coeruleus. The locus coeruleus phasic response resulted in a facilitation of the cortical areas involved in decision and response processes time-locked to the painful stimulus. The second architecture involved the presence of pain causing an increase in general arousal. The increase in arousal was mediated by locus coeruleus tonic activity, which facilitated responses in the cortical areas mediating the sensory, decision, and response processes involved in the task. These two neural network architectures generated competing predictions that can be tested in future studies.     

Jumping to conclusions, a lack of belief flexibility and delusional conviction in psychosis: a longitudinal investigation of the structure, frequency, and relatedness of reasoning biases

Two reasoning biases, jumping to conclusions (JTC) and belief inflexibility, have been found to be associated with delusions. We examined these biases and their relationship with delusional conviction in a longitudinal cohort of people with schizophrenia-spectrum psychosis. We hypothesized that JTC, lack of belief flexibility, and delusional conviction would form distinct factors, and that JTC and lack of belief flexibility would predict less change in delusional conviction over time. Two hundred seventy-three patients with delusions were assessed over twelve months of a treatment trial (Garety et al., 2008). Forty-one percent of the sample had 100% conviction in their delusions, 50% showed a JTC bias, and 50%-75% showed a lack of belief flexibility. Delusional conviction, JTC, and belief flexibility formed distinct factors although conviction was negatively correlated with belief flexibility. Conviction declined slightly over the year in this established psychosis group, whereas the reasoning biases were stable. There was little evidence that reasoning predicted the slight decline in conviction. The degree to which people believe their delusions, their ability to think that they may be mistaken and to consider alternative explanations, and their hastiness in decision making are three distinct processes although belief flexibility and conviction are related. In this established psychosis sample, reasoning biases changed little in response to medication or psychological therapy. Required now is examination of these processes in psychosis groups where there is greater change in delusion conviction, as well as tests of the effects on delusions when these reasoning biases are specifically targeted.     

Memory as discrimination: a challenge to the encoding-retrieval match principle

Four experiments contrasted the predictions of a general encoding-retrieval match hypothesis with those of a view claiming that the distinctiveness of the cue-target relationship is the causal factor in retrieval. In Experiments 1, 2, and 4 participants learned the relationships between 4 targets and trios of cues; in Experiment 3 there were 3 targets, each associated with a pair of cues. A learning phase was followed by a cued-recognition task where the correct target had to be identified based on 1 or more of the cues. The main performance measurement was response time. Learning was designed to lead to high accuracy so effects could be attributed to retrieval efficiency rather than to variations in encoding. The nature of the cues and targets was varied across experiments. The critical factor was whether each cue was uniquely associated with the to-be-recalled target. All experiments orthogonally manipulated (a) how discriminative-or uniquely associated with a target-each cue was and (b) the degree of overlap between the cues present during learning and those present at retrieval. The novel finding reported here is that increasing the encoding-retrieval match can hinder performance if the increase simultaneously reduces how well cues predict a target-that is, a cue's diagnostic value. Encoding-retrieval match was not the factor that determined the effectiveness of retrieval. Our findings suggest that increasing the encoding-retrieval match can lead to no change, an increase, or a decrease in retrieval performance.     

CUE: The continuous unified electronic diary method

In the present article, we introduce the continuous unified electronic (CUE) diary method, a longitudinal, event-based, electronic parent report method that allows real-time recording of infant and child behavior in natural contexts. Thirty-nine expectant mothers were trained to identify and record target behaviors into programmed handheld computers. From birth to 18?months, maternal reporters recorded the initial, second, and third occurrences of seven target motor behaviors: palmar grasp, rolls from side to back, reaching when sitting, pincer grip, crawling, walking, and climbing stairs. Compliance was assessed as two valid entries per behavior: 97?% of maternal reporters met compliance criteria. Reliability was assessed by comparing diary entries with researcher assessments for three of the motor behaviors: palmar grasp, pincer grip and walking. A total of 81?% of maternal reporters met reliability criteria. For those three target behaviors, age of emergence was compared across data from the CUE diary method and researcher assessments. The CUE diary method was found to detect behaviors earlier and with greater sensitivity to individual differences. The CUE diary method is shown to be a reliable methodological tool for studying processes of change in human development.     

The Emotional Experience Associated with Worrying in Adolescents

Among adults, both normal and pathological worrying has been found to be associated with a unique emotional syndrome involving irritability, restlessness, low frustration tolerance and difficulty relaxing. This emotional state is empirically distinguishable from anxiety and depression, and is reliably assessed by the Stress scale of the Depression Anxiety Stress Scales (DASS). The association between worry and ‘stress’ may have important implications for a better theoretical understanding of worrying in adults. Among youth, however, the emotional experience associated with worrying has not yet been clearly described. The present study aimed to explore whether a distinct, adult-like ‘stress’ syndrome can be assessed in adolescents via self-report, and whether, as in adults, stress has a specific association with worrying. A simplified version of the DASS was created to maximize its comprehension by adolescents. A group of 340 12–18-year-olds completed the simplified DASS and a self-report measure of worry. Factor analyses revealed a three-factor structure underlying the simplified DASS, similar to the original adult version. Further analyses showed that worry had a unique association with Stress, over and above its association with Depression and Anxiety. Adolescents who worry more excessively and uncontrollably also reported higher levels of irritability, restlessness and difficulty relaxing, while the autonomic arousal symptoms of anxiety had consistently low associations with worrying, especially in older adolescents. Results indicate that the proposed cognitive avoidance function of worrying may be present by adolescence.     

Family,public and private religiousness and psychological well-being over time in at-risk adolescents

Positive effects of different dimensions of religiousness (including private, public and familial) on well-being as well as the stress buffering effects of religiousness have been documented. However, relatively little research has explored how these different facets of religiousness are related to psychological well-being in at-risk adolescents. This study examined family, public and private religiousness and their protective influence on psychological adjustment in adolescents at risk for poor psychological and behavioural outcomes. Participants include 186 urban teens divided between African Americans and European Americans. Structured interviews assessed religiousness, stress, as well as change in emotional distress and substance abuse problems over a one-year period. Greater private religiousness protects adolescents exposed to higher levels of stress from emotional and behavioural problems. In contrast, higher levels of family religiousness exacerbate emotional problems over time in adolescents exposed to greater stress. Findings demonstrate the complex influence of religiousness on psychological well-being in adolescence.     

Therapeutic Assessment With Children: A Pilot Study of Treatment Acceptability and Outcome

Therapeutic Assessment (TA) with children is a hybrid of psychological assessment and short-term intervention. It uses the ongoing process and results of psychological assessment to enhance parents' understanding of their child and to facilitate change. Clinical reports and single case studies suggest that TA with children is an acceptable and effective brief intervention. However, no aggregate data have been published to support this claim. This pilot study investigated the acceptability and preoutcome–postoutcome of TA with 14 clinically referred children with emotional and behavior problems and their parents. Results indicated high treatment acceptability as well as significantly decreased child symptomatology and enhanced family functioning as reported by children and mothers. In addition, mothers demonstrated a significant increase in positive emotion and a significant decrease in negative emotion pertaining to their children's challenges and future. The findings, although limited due to the design and small sample size, support assertions from published single case studies that TA is possibly an efficacious child and family intervention for children with emotional and behavioral problems and should be studied in a larger, comparison design.