A Feasibility Study of Behavioral Activation for Major Depressive Disorder in a Community Mental Health Setting

Behavioral activation (BA) is a well-supported treatment approach, but little research has been conducted on the effectiveness of this treatment within publicly funded community mental health settings. We examined the feasibility of conducting a randomized trial examining the effectiveness of nine sessions of BA as a treatment for major depressive disorder (MDD) in a community mental health clinic (CMHC) setting. Following adaptation of a BA manual and training of BA therapists, 80 patients seeking treatment at a CMHC were randomized, with a 3:1 randomization rate of BA to nine sessions of treatment as usual (TAU). Feasibility assessments indicated that only one eligible patient refused randomization and, of patients who attended at least one session, the median number of sessions was six for the BA group and eight for the TAU group. Of three postbaseline monthly assessments, 71.3% (171/240) were successfully obtained. On average, patients in the BA condition completed homework assignments 83.9% of the time. Treatment fidelity ratings indicated that substantially more BA techniques were delivered in the BA group compared to the TAU group (d = 2.11). Measures of BA mechanisms improved significantly over time and these changes were significantly associated with change in depressive symptoms. These results indicate that it is feasible to conduct a randomized study of BA for MDD in a CMHC setting. In addition, the study reconfirmed the potential importance of theory-relevant BA mechanism variables. Following these findings, further investigation into the effectiveness of BA in this setting is needed.     

Consequences of Repeated Critical Versus Neutral Body Checking in Women With High Shape or Weight Concern

Body checking is a repeated behavior conducted in an attempt to gain information about one’s shape, weight, size, or body composition. Body checking is associated with negative behavioral, emotional, and cognitive outcomes and may maintain body dissatisfaction and eating disorders. The precise function and consequences of body checking remain less well understood. Specifically, immediate and delayed impacts of repeated critical body checking (CBC) have not been determined. The current study randomly assigned 142 young women with high shape/weight concern to daily 10-min CBC, neutral body checking (NBC), or a non-body critical checking (NBCC) comparison condition, examining their immediate and delayed (one-week follow-up) effects on body satisfaction, self-esteem, and negative affect. Multilevel modeling and follow-up planned comparisons found that compared to NBCC, CBC participants’ body satisfaction and self-esteem immediately decreased, but negative affect improved from baseline to follow-up. Compared to CBC, NBC participants’ self-esteem and negative affect improved immediately, and their self-esteem improved over time compared to NBCC. Over time, all participants’ state body satisfaction improved, regardless of condition. Our findings suggest a 10-min CBC session may function differently than typical (harmful) in vivo body checking. However, reasons for this difference are unclear. Additional research is needed to distinguish (harmful) in vivo body checking from CBC procedures such as this and other mirror exposure interventions. Research is needed to examine the effects of varying CBC duration and instructions during body exposure to further clarify mechanisms of change during body exposures.     

Identity centrality moderates the relationship between acceptance of group‐based stressors and well‐being

Two two‐wave studies were used to examine the proposition that identity centrality enhances the effectiveness of stressor acceptance in the face of group‐based stressors. Study 1 was conducted in newly commencing psychology students (N = 154). Stressor intensity, psychology student identity centrality, and attempted stressor acceptance were measured at two‐time points over 6‐weeks. Study 2 was conducted in a group of early to late career veterinarians (N = 92) and extended Study 1 by assessing stressor frequency as an indicator of the level of demand. Veterinarian identity centrality and stressor acceptance were measured twice over 12‐months. Both studies provided support for the predicted three‐way interaction. Only when Time 1 stressors and identity centrality were both high was stressor acceptance related to a reduction in perceived stressor intensity (Study 1) or burnout symptoms (Study 2) at Time 2. These findings suggest that identity centrality enhances the effectiveness of stressor acceptance for supporting wellbeing and resilience.     

Pinyin and English Invented Spelling in Chinese-Speaking Students Who Speak English as a Second Language

This study examined pinyin (the official phonetic system that transcribes the lexical tones and pronunciation of Chinese characters) invented spelling and English invented spelling in 72 Mandarin-speaking 6th graders who learned English as their second language. The pinyin invented spelling task measured segmental-level awareness including syllable and phoneme awareness, and suprasegmental-level awareness including lexical tones and tone sandhi in Chinese Mandarin. The English invented spelling task manipulated segmental-level awareness including syllable awareness and phoneme awareness, and suprasegmental-level awareness including word stress. This pinyin task outperformed a traditional phonological awareness task that only measured segmental-level awareness and may have optimal utility to measure unique phonological and linguistic features in Chinese reading. The pinyin invented spelling uniquely explained variance in Chinese conventional spelling and word reading in both languages. The English invented spelling uniquely explained variance in conventional spelling and word reading in both languages. Our findings appear to support the role of phonological activation in Chinese reading. Our experimental linguistic manipulations altered the phonological awareness item difficulties.     

Symptom Attributions Across the Menstrual Cycle in Women with Panic Disorder

Women with panic disorder are likely to experience greater menstrual-specific symptoms (e.g., headaches, cramps) as well as more panic/anxiety-related symptoms (e.g., dizziness, faintness, chest pain, heart pounding), and may be more likely to experience these symptoms during the premenstrual phase. This study examines the attributions women make about the somatic and affective symptoms they experience during the menstrual cycle. Using a 30-day prospective design, women with and without panic disorder monitored physical and affective symptoms. Participants reported on severity of various symptoms and a primary cause for each symptom (menstrual cycle-related, panic/anxiety related, stress-related, health-related). Women with panic disorder reported more panic attacks during the premenstrual phase compared to other cycle phases. They also reported more severe affective and panic symptoms during the premenstrual phase compared to other phases, but did not significantly differ from the comparison group in menstrual symptom severity across the three cycle phases. Although women with panic disorder attributed more panic/anxiety-related causes for their symptoms across the menstrual cycle, they were able to discriminate between panic/anxiety causes and menstrual cycle-related causes. Women with panic disorder may benefit for therapy that focuses on their exacerbation of panic symptoms during the premenstrual phase.     

Reduced specificity and enhanced subjective experience of future thinking in ageing: the influence of avoidance and emotion-regulation strategies

Future thinking in older adults is characterised by a lack of specificity of imagined events and by an equal or even higher subjective experience, compared to younger adults. We considered whether this lack of specificity stemmed partly from the avoidance of a somewhat disturbing future and then examined the extent to which certain types of emotion-regulation strategies, namely positive reappraisal and positive refocusing, contributed to the subjective experience of future thinking. Middle-aged and older adults completed an adapted version of the AMT, in which temporal distance and cue word valence were manipulated, thus resulting in future conditions assumed to represent varying degrees of discomfort. Results indicate that distant future and negative cues restricted both the specificity and the subjective experience of future thinking. In addition, the use of avoidance strategies predicted the nature of future thoughts in the context of a supposed uncomfortable future (i.e., a distant future induced by negative cues), although it followed quite different age-related patterns. Together with the findings that positive reappraisal and positive refocusing (to a lesser extent) contributed to the subjective experience of future thinking, this study indicates that how individuals imagine their personal future also relies on affect- and emotion-regulation strategies.     

Collaboration and prospective memory: comparing nominal and collaborative group performance in strangers and couples

To perform prospective memory (PM) tasks in day-to-day life, we often enlist the help of others. Yet the effects of collaboration on PM are largely unknown. Adopting the methodology of the “collaborative recall paradigm”, we tested whether stranger dyads (Experiment 1) and intimate couples (Experiment 2) would perform better on a “Virtual Week” task when working together or each working separately. In Experiment 1, we found evidence of collaborative inhibition: collaborating strangers did not perform to their pooled individual potential, although the effect was modulated by PM task difficulty. We also found that the overall collaborative inhibition effect was attributable to both the retrospective and prospective components of PM. In Experiment 2 however, there was no collaborative inhibition: there was no significant difference in performance between couples working together or separately. Our findings suggest potential costs of collaboration to PM. Intimate relationships may reduce the usual costs of collaboration, with implications for intervention training programmes and for populations who most need PM support.     

Female Mexican Immigrants in the United States: Cultural Knowledge and Healing

ABSTRACT

Mexican American immigrant women have faced many adversities historically, resulting in significant injuries to their physical and psychological selves. In attempts to heal from such injuries, these women have long engaged in self-healing through maintenance of their own cultural values, identities, and beliefs and also through working with, or even becoming, traditional healers. Such healing processes can be seen as a form of adjustment to a new culture, as well as a maintenance of native culture (Espin, 1996 Espin, O. M. (1996). Latina healers: Lives of power and tradition. Encino, CA: Floricanto Press. [Google Scholar]) and may take the form of a blending of cultures representing a “new indigeneity.” This article highlights such healing practices, including the role of cultural values and beliefs for healing, as well as current efforts to blend cultural healing practices within a framework of equality and respect.     

Inference in the Wild: A Framework for Human Situation Assessment and a Case Study of Air Combat

Situation awareness is a key construct in human factors and arises from a process of situation assessment (SA). SA comprises the perception of information, its integration with existing knowledge, the search for new information, and the prediction of the future state of the world, including the consequences of planned actions. Causal models implemented as Bayesian networks (BNs) are attractive for modeling all of these processes within a single, unified framework. We elicited declarative knowledge from two Royal Australian Air Force (RAAF) fighter pilots about the information sources used in the identification (ID) of airborne entities and the causal relationships between these sources. This knowledge was represented in a BN (the declarative model) that was evaluated against the performance of 19 RAAF fighter pilots in a low‐fidelity simulation. Pilot behavior was well predicted by a simple associative model (the behavioral model) with only three attributes of ID. Search for information by pilots was largely compensatory and was near‐optimal with respect to the behavioral model. The average revision of beliefs in response to evidence was close to Bayesian, but there was substantial variability. Together, these results demonstrate the value of BNs for modeling human SA.     

The multiple-stimulus-without-replacement preference assessment tool and its predictive validity

This study demonstrates the use of two web-based programs, one to identify video preferences and the other to assess their reinforcing effects. We used the Multiple-Stimulus-Without-Replacement Preference Assessment Tool (MSWO PAT) to identify the video preference hierarchies of seven participants, ages 4–11 years old. We then used a customized reinforcer assessment program that arranged a concurrent-chains preparation with programmed conjugate schedules of reinforcement. Button presses emitted by participants modulated the quality (volume and opacity) of selected videos on a moment-to-moment basis, allowing us to identify the reinforcing effects of the videos in little time. The results showed that the preference assessment had predictive value for five of seven participants. We discuss the MSWO PAT, parameters that may affect the identification of preferences and the use of conjugate schedules to identify reinforcers.