A preliminary exploration of predictors of outcome and cognitive mechanisms of change in cognitive behaviour therapy for psychosis in people not taking antipsychotic medication

BackgroundCognitive behaviour therapy (CBT) has been shown to be effective in an open trial for people with psychotic disorders who have not been taking antipsychotic medication. There is little known about predictors of outcome in CBT for psychosis and even less about hypothesised mechanisms of change.Method20 participants with schizophrenia spectrum disorders received CBT in an exploratory trial. Our primary outcome was psychiatric symptoms measured using the PANSS. Secondary outcomes were dimensions of hallucinations and delusions, self-rated recovery and social functioning, and hypothesised mechanisms of change included appraisals of psychotic experiences, dysfunctional attitudes and cognitive insight. We also measured patient characteristics that may be associated with outcome.ResultsT-tests revealed that several of the hypothesised mechanisms did significantly change over the treatment and follow-up periods. Correlational analyses showed that reductions in negative appraisals of psychotic experiences were related to improvements on outcome measures and that shorter duration of psychosis and younger age were associated with greater changes in symptoms.ConclusionsCBT based on a specific cognitive model appears to change the hypothesised cognitive mechanisms, and these changes are associated with good outcomes. CBT may be more effective for those who are younger with shorter histories of psychosis.     

Couple therapy for military veterans: overall effectiveness and predictors of response

Despite the numerous challenges facing U.S. veterans and their relationships, there have been no examinations of the effectiveness of couple therapy for relationship distress provided to veterans. In the present study, 177 couples presenting for couple therapy at two Veteran Administration Medical Centers completed assessments of relationship satisfaction prior to therapy and weekly during therapy. Results revealed that the average couple showed significant gains in relationship satisfaction during treatment (d=0.44 for men; d=0.47 for women); gains were larger for couples beginning therapy in the distressed range (d=0.61 for men; d=0.58 for women) than for couples in the nondistressed range (d=0.19 for men; d=0.22 for women). Rates of premature termination were high, with 19% of couples completing fewer than three sessions and 62% rated as not completing a "full course" of therapy. Benchmarking analyses demonstrated that the average gains were larger than would be expected from natural remission and similar to previous effectiveness trials; however, average gains were smaller than those observed in couple therapy efficacy trials. Relationship, psychological, and demographic characteristics were generally unrelated to the amount of change in therapy after controlling for initial satisfaction. However, African American couples showed significantly larger gains than Caucasian, non-Hispanic couples. Thus, though yielding smaller effects than those shown in efficacy trials, the impact of couple therapy for veterans' relationship problems appears to generalize across various demographic, psychological, and relationship characteristics.     

Not too little, but not too much: The perceived desirability of responses to personality items

Paradigms typically employed to investigate socially desirable responding in personality assessment implicitly assume linear relationships exist between trait level and desirability but recent research has called this assumption into question. In this study, participants rated the desirability of a hypothetical applicant to one of four jobs on the basis of which five-point Likert-type scale option he/she selected when responding to personality items. Results generally indicated that the most extreme option, on the desirable side of the response scale, was rated as most desirable, but perceived desirability asymptotes with the penultimate option. The middle (neutral) option, however, was consistently regarded as being much less desirable. The occupational context also significantly moderated the patterns of desirability ratings for many items.     

Psychometric properties of Yelland and Tiggemann's Drive for Muscularity Scale

The purpose of the current study was to examine the dimensionality and validity of Yelland and Tiggemann's Drive for Muscularity Scale (YT-DMS). Participants were college students (305 women, M(AGE)=20.15 years, SD=4.00; 356 men, M(AGE)=20.24 years, SD=3.85) who completed the YT-DMS, the Drive for Muscularity Attitudes Questionnaire, the Drive for Leanness Scale, the Drive for Thinness Scale, and a socio-demographic questionnaire. Results indicated the YT-DMS had a stable unidimensional factor structure in both genders, and the pattern of relationships generally supported the measure's criterion and construct validity. These results reveal the YT-DMS has promise, but helps identify possible areas for improvement, such as a greater focus on sampling the content domain associated with the drive for muscularity.     

Heterosexuality and home: Intimacies of space and spaces of touch

This paper uses the notion of touch to understand further the production of heterosexual bodies and home spaces. Specifically, it argues that the everyday geographies of heterosexual touch are an important constituent of homemaking. Considering the ordinary acts of heterosexual touch and home encourages a more nuanced reading of the mutually constitutive relationship between bodies and space. It challenges normative notions about the naturalness and normality of heterosexuality. Drawing on data from joint semi-structured interviews, solicited diaries and self-directed photography with 14 women in heterosexual relationships who live in Hamilton, Aotearoa New Zealand, I offer an in-depth, critical and nuanced analysis of sexualised touch. Building on suggestions that touch is more than simply cutaneous contact, I show that heterosexual bodies touch and feel bodies, spaces and objects in a variety of ways.     

Institutional Productivity Ratings Based on Publications in Nine Literacy Journals: 1992–2005

This study extended the work of three previous studies that compared the scholarly productivity of faculty members in universities as represented in nine literacy journals. The top 25 universities were identified and this study shows that several institutions have remained consistent through the years as those that produce the largest amount of scholarship. As in previous studies, the University of Georgia ranked first by a substantial margin. This ranking was adjusted according to faculty size, resulting in a reordering of institutions—the University of Georgia remained first. The top 22 universities publishing in two leading literacy research journals—Reading Research Quarterly and Journal of Literacy Research—were also identified. This study also indicates an increase in scholarly work by multiple authors from collaborating institutions, including those from public schools.     

The use of imagery in cognitive therapy for psychosis: A case example

There has been a long tradition of studying imagery in relation to psychotic symptoms. Recent studies have suggested that imagery may be involved in the development and maintenance of psychotic symptoms (hallucinations and delusions in particular). Following a review of this literature, including work conducted by the author and colleagues, a case study is used to illustrate the clinical applications of this work. Working with images that were associated with persecutory delusions appeared to contribute to a reduction in distress, preoccupation, and conviction in relation to these beliefs, which were assessed using a standardised measure (PSYRATS). The implications for theory, practice, and future research are considered.