Internet administered guided self-help versus individualized e-mail therapy: A randomized trial of two versions of CBT for major depression

Internet-delivered psychological treatment of major depression has been investigated in several trials, but the role of personalized treatment is less investigated. Studies suggest that guidance is important and that automated computerized programmes without therapist support are less effective. Individualized e-mail therapy for depression has not been studied in a controlled trial. Eighty-eight individuals with major depression were randomized to two different forms of Internet-delivered cognitive behaviour therapy (CBT), or to a waiting-list control group. One form of Internet treatment consisted of guided self-help, with weekly modules and homework assignments. Standard CBT components were presented and brief support was provided during the treatment. The other group received e-mail therapy, which was tailored and did not use the self-help texts i.e., all e-mails were written for the unique patient. Both treatments lasted for 8 weeks. In the guided self-help 93% completed (27/29) and in the e-mail therapy 96% (29/30) completed the posttreatment assessment. Results showed significant symptom reductions in both treatment groups with moderate to large effect sizes. At posttreatment 34.5% of the guided self-help group and 30% of the e-mail therapy group reached the criteria of high-end-state functioning (Beck Depression Inventory score below 9). At six-month follow-up the corresponding figures were 47.4% and 43.3%. Overall, the difference between guided self-help and e-mail therapy was small, but in favour of the latter. These findings indicate that both guided self-help and individualized e-mail therapy can be effective.     

Creativity and the subliminal manipulation of projected self‐images

Abstract:

This is a report of two experiments on the relationship between creativity and the effects of manipulations of self‐image. Creativity was estimated with the Creative Functioning Test (CFT), an assessment of the tendency to bar the use of subjective interpretations when the support for a “correct” interpretation is being gradually eroded. Self‐image was manipulated in the Identification Test (IT). This involves a backwards masking design in which an ambiguous picture of a face is presented briefly on a viewing screen, preceded by either of two subliminal verbal messages. These were I SUPERIOR and I INFERIOR in a pilot study (n = 25) and I GOOD and I BAD in the main study (n = 33). In the latter, there was also an interview which served to further cross‐validate the CFT. In both studies, creative subjects alternated between reporting young faces and adult ones significantly more often than uncreative subjects. Their identity was not, then, fixedly adult. Creative and uncreative subjects also defended their projected self‐image in different ways against the subliminal manipulations. High and stable self‐confidence was typical of both highly creative and uncreative subjects, but not of subjects in the middle range. Still, the self‐confidence in the two extreme groups was only superficially similar.     

Warm and Competent Hassan = Cold and Incompetent Eric: A Harsh Equation of Real-Life Hiring Discrimination

In a field experiment, we sent out 5,636 job applications varying how Swedish (in-group) and Arab (out-group) applicants presented themselves in terms of two fundamental dimensions of social judgment: warmth and competence. Results indicate substantial discrimination where Arab applicants receive fewer invitations to job interviews. Conveying a warmer or more competent personality increases invitations. However, appearing both warm and competent seems to be especially important for Arab applicants. Arab applicants need to appear warmer and more competent than Swedish applicants to be invited equally often. The practical importance of signaling warmth and competence in labor market contexts is discussed.     

Getting along or ahead: Effects of gender identity threat on communal and agentic self‐presentations

When faced with a threat to gender identity, people may try to restore their gender status by acting in a more gender‐typical manner. The present research investigated effects of gender identity threat on self‐presentations of agentic and communal traits in a Swedish and an Argentine sample (N = 242). Under threat (vs. affirmation), Swedish women deemphasized agentic traits (d [95% CI] = ?0.41 [?0.93, 0.11]), Argentine women increased their emphasis on communal traits (d = 0.44 [?0.08, 0.97]), and Argentine men increased their emphasis on agentic traits (d = 0.49 [?0.03, 1.01]). However, Swedish men did not appear to be affected by the threat regarding agentic (d = 0.04 [?0.47, 0.55]) or communal traits (d = 0.23 [?0.29, 0.74]). The findings are to be considered tentative. Implications for identity threat research are discussed.     

Effects of a Daytime Nap on Primed and Repeated Remote Associates Tests and Relations with Divergent Creativity

The effect of napping versus wakefulness was studied on primed and repeated Remote Associate Tests (RATs) and on divergent creativity tests. The participants were 42 students from the USA, studying international courses at a Swedish university. The hypotheses for the RATs were (1), when the correct answers were primed before the nap, the RAT should be solved better for those who entered REM sleep, compared to those with no REM sleep or a resting condition; and (2), when retested the RAT should be solved better after a nap than after rest. For the creativity tests, hypothesis (3) was that creativity should be higher after the nap than after rest. Hypothesis 1 and hypothesis 3 were not supported. Hypothesis 2 was supported in an ANOVA. The REM group improved more than the rest group on the repeated RAT. Also, the No-REM and rest groups differed, strengthening the importance of both REM and No-REM sleep for creative problem-solving.     

Validation of a Self-Concept Scale for Lynch Syndrome in Different Nationalities

Learning about hereditary cancer may influence an individual’s self-concept, which otherwise represents a complex but stable cognitive structure. Recently, a 20-statement self-concept scale, with subscales related to stigma-vulnerability and bowel symptom-related anxiety, was developed for Lynch syndrome. We compared the performance of this scale in 591 mutation carriers from Denmark, Sweden and Canada. Principal component analysis identified two sets of linked statements—the first related to feeling different, isolated and labeled, and the second to concern and worry about bowel changes. The scale performed consistently in the three countries. Minor differences were identified, with guilt about passing on a defective gene and feelings of losing one’s privacy being more pronounced among Canadians, whereas Danes more often expressed worries about cancer. Validation of the Lynch syndrome self-concept scale supports its basic structure, identifies dependence between the statements in the subscales and demonstrates its applicability in different Western populations.     

Psychosocial Factors Associated with Quality of Life Among Individuals Attending Genetic Counseling for Hereditary Cancer

The aim of this multicenter study was to explore associations between psychosocial factors (general self-efficacy, perceived availability of social support, cancer-related distress) and health-related quality of life, among individuals at risk for hereditary cancer. One-hundred and twenty one participants with a family history of breast-cancer or colorectal cancer answered a questionnaire 2-4 weeks prior to genetic counseling. The two dimensions of the health-related quality of life measure, mental and physical health were both used as outcome variables. Multiple regression (linear) analyses revealed that increasing degrees of cancer-related distress was related to decreasing degrees of mental health whereas increasing degrees of self-efficacy and social support were related to increasing degrees of this outcome variable. Self-efficacy, self-esteem support and tangible aid seemed to moderate the relationship between cancer-related distress and mental health. These results suggest that self-efficacy and certain resources of social support buffer the negative association between cancer-related distress and mental health, and might be suitable for interventional efforts. Implications for genetic counseling practice are discussed.     

A psychophysiological therapy for dental fear

A partly automated method for treating dental fear and avoidance is outlined. The method combines a desensitization procedure with EMG biofeedback and cognitive reattribution. After therapy, 21 out of 24 patients suffering from severe dental fear were able to complete dental rehabilitation. The therapy process is discussed in terms of reconditioning, cognitive reorientation and coping training.     

Risk Perception,Worry and Satisfaction Related to Genetic Counseling for Hereditary Cancer

In this multi center study, genetic counseling for hereditary cancer was evaluated by assessing patients’ worry, perceived risk of developing cancer and satisfaction with genetic counseling. An overall aim was to identify characteristics of vulnerable patients in order to customize genetic counseling. In addition, agreement between patients’ and counselors’ scores was measured. A total of 275 Norwegian patients were consecutively recruited, and 213 completed questionnaires before and after genetic counseling. Patients’ perceived risk decreased after the genetic counseling session. There was incongruence between risk perception expressed as a percentage and in words. Patients were significantly less worried after counseling. Higher levels of worry were predicted by low instrumental satisfaction with counseling, high degree of perceived risk of developing cancer and younger age. In conclusion, counselors met the patients’ psychological needs to a satisfactory degree during counseling. However, patients did not fully understand their risk of developing cancer.