Choosing Across Cultures: The Effect of Choice Complexity on Treatment Outcomes

Prior research has revealed that having choice over treatments can improve their efficacy. However, it is currently unknown if the benefits of treatment choice hold for complex decisions and different cultures. The effects of differing numbers of treatment options were explored across two cultural contexts: United States and Japan. Participants were exposed to an uncomfortable stimulus and provided with up to 15 placebo treatment options they believed would reduce discomfort. There was a significant interaction such that participants from Japan benefited most from fewer treatment options (2 and 5) compared with more treatment options (10 and 15). Participants from the United States, however, showed either no change in discomfort or less discomfort as the number of choices increased. Additionally, participants from Japan reported less satisfaction with the decision process when they had more treatment options to choose from whereas U.S. participants reported similar, if not slightly higher, satisfaction with more treatment options. Further, a second study indicated that a positive experience with the decision process mediated the relationship between choice complexity and treatment efficacy for Japanese participants. These data demonstrate the importance of culture and choice complexity when discussing treatment choice and resulting outcomes in the medical context. Copyright © 2015 John Wiley & Sons, Ltd.     

A THERAPEUTIC PLAYGROUP FOR DEPRESSED MOTHERS AND THEIR INFANTS: FEASIBILITY STUDY AND PILOT RANDOMIZED TRIAL OF COMMUNITY HUGS

Symptoms of depression negatively impact on mother?infant relationships and child outcomes. We evaluated a novel, 10‐session mother?infant therapeutic playgroup—Community HUGS (CHUGS)—which combines cognitive and experiential components through psychoeducation, play, music, and movement. Participants were mothers experiencing a range of postnatal mental health difficulties, including depression, with infants ≤12 months of age. However, the aim was not to treat maternal depression but to ameliorate associated problems in the mother?infant interaction. In the feasibility study, all participants received CHUGS. In the pilot randomized controlled trial (RCT), participants were randomized between intervention and a wait‐list. Outcomes were the Parenting Stress Index (PSI; R.R. Abidin, 1995), Parenting Sense of Competency Scale (Self‐Efficacy subscale; J. Gibaud‐Wallston & L.P. Wandersman, 1978), and the Depression, Anxiety, Stress Scales (P.F. Lovibond & S.H. Lovibond, 1995). In the feasibility study (n = 74), PSI scores dropped on all subscales, all ps < .01. Depression, p < .001, anxiety, p = .01, stress, p = .01, and self‐efficacy, p < .001, all showed improvements, as did observer‐rated mother?infant interactions, p < .001. In the RCT, depression, p < .001, anxiety, p = .005, and stress, p < .001, symptoms were significantly reduced for intervention participants (n = 16), as compared to wait‐list participants (n = 15). The CHUGS program had high participant satisfaction and produced improvements in self‐efficacy, depression, anxiety, stress, and mother?infant interactions that supported the program's acceptability and the utility of further rollout.     

The Explanatory Challenge: Moral Realism Is No Better Than Theism

Many of the arguments for and against robust moral realism parallel arguments for and against theism. In this article, I consider one of the shared challenges: the explanatory challenge. The article begins with a presentation of Harman's formulation of the explanatory challenge as applied to moral realism and theism. I then examine two responses offered by robust moral realists to the explanatory challenge, one by Russ Shafer‐Landau and another by David Enoch. Shafer‐Landau argues that the moral realist can plausibly respond to the challenge in a way unavailable to theists. I argue that Shafer‐Landau's response is implausible as it stands and that once revised, it will apply to theism just as well. I then argue that Enoch's response, to the extent that it is plausible, can be used to defend theism as well.     

Children’s Maternal Representations Moderate the Efficacy of Parent–Child Interaction Therapy—Emotion Development (PCIT-ED) Treatment For Preschool Depression

Research on Child and Adolescent Psychopathology - A randomized controlled trial (RCT) demonstrated that a novel psychotherapy, Parent–Child Interaction Therapy—Emotion Development...