Mid-life stress is associated with both up- and down-regulation of markers of humoral and cellular immunity

Perception of stress with consequent activation of a neuroendocrine cascade causes changes in immune function that may be bi-directional, with alterations in basal levels of biological parameters outside the optimal range. In this cross-sectional study of 302 healthy persons (males 56.3%, females 43.7%) aged 41-46 years, higher stress levels, as assessed by questionnaire measures of recurrent and recent perceived stress, were associated with a 4-fold greater risk of having a high compared to mid-range serum neopterin concentration, indicating activation of cellular immune mechanisms [adjusted odds ratio, OR; (95% confidence intervals, CI): Low stress=1.00 (reference group); Medium stress=4.13 (1.51, 11.29); High stress=4.63, (1.35, 15.83), p for trend=0.01]. Higher stress levels were associated with a 3-fold greater risk of having signs of humoral immune activation, as indicated by salivary IgA concentration [high compared to mid-range salivary IgA: Low stress=1.00 (reference group); Medium stress=1.06 (0.48, 2.34); High stress=3.62 (1.26, 10.39), p for trend=0.02], but also a 4-fold greater risk of humoral immune depression [low compared to mid-range IgA: Low stress=1.00 (reference group); Medium stress=1.72 (0.74, 3.99); High stress=4.38 (1.47, 13.00), p for trend=0.02]. In conclusion, in this cross-sectional study, higher stress levels were associated with higher serum neopterin and both elevated and depressed salivary IgA levels. These findings emphasise the importance of considering that stress may have bi-directional effects on immune mechanisms, and are consistent with an activational effect of chronic, perceived stress on cellular immunity, and a bi-directional effect on IgA levels, one aspect of humoral immunity.     

The frequency of actions and thoughts scale: development and psychometric validation of a measure of adaptive behaviours and cognitions

This paper describes the development and preliminary psychometric evaluation of an instrument that measures the frequency of adaptive behaviours and cognitions related to therapeutic change during cognitive behavioural therapy (CBT), for symptoms of anxiety and depression. Two studies were conducted. In study one, 661 participants completed an online survey with 28 items targeting adaptive behaviours and cognitions. Exploratory factor analysis performed on part of the sample (n = 451) revealed that a four-factor solution ‘characterised’ the data. This led to the development of a 12-item instrument, the Frequency of Actions and Thoughts Scale (FATS). Confirmatory factor analysis was used to confirm the factor structure of the FATS using the remaining sample (n = 210), which revealed an acceptable model fit. In study two, 125 participants with clinically significant symptoms of anxiety, depression, or both were recruited to an Internet-delivered CBT (iCBT) treatment course. Participants completed the FATS and other measures throughout treatment, after treatment, and at three-month follow-up. Correlations and residual change scores of the FATS and its subscales with measures of anxiety, depression, behavioural activation, and CBT-related skills usage supported the construct validity of the FATS. A significant increase in FATS scores over treatment was also observed. The findings provide preliminary support for the psychometric properties of the FATS, which appears to have utility in research investigating mechanisms of change in CBT.     

Faking Good on the MCMI–III: Implications for Child Custody Evaluations

Jean Piaget, Paul Fraisse and Maurice Reuchlin. Paul Fraisse and Jean Piaget (Eds.). Experimental Psychology: Its Scope and Methods. Vol. 1. History and Method. New York: Basic Books, 1968, 245 pages, $5.95. Reviewed by Steven G. Vandenberg.

Joseph Nuttin, Paul Fraisse, and Richard Meili. Paul Fraisse and Jean Piaget (Eds.). Experimental Psychology: Its Scope and Methods. Vol. 5. Motivation, Emotion and Personality. New York: Basic Books, 1968. 289 pages, $5.95. Reviewed by Steven G. Vandenberg.

Magda B. Arnold (Ed.) The Nature of Emotion: Selected Readings. Baltimore: Penguin Books, 1968. 398 pages. $1.95 Reviewed by David C. Murray.

Gilbert Kliman, Psychological Emergencies of Childhood. New York and London: Grune &; Stratton, 1968, 145 pages. Reviewed by Michael L. Peck.

Warren D. Gribbons and Paul R. Lohnes. Emerging Careers. New York: Teachers College Press, 1968 Reviewed by Steven G. Vandenberg.

Pascal, Gerald R., Behind the Screen. Boston, Christopher Publishing House, 1969, 243 pages, $6.50. Reviewed by Dell Lebo.

A. A. Roback and Thomas Kiernan. Pictorial History of Psychology and Psychiatry, New York: Philosophical Library, 1969, 294 pages, $12.50. Reviewed by Irving R. Stone.

Patricia Minuchin, Barbara Biber, Edna Shapiro, and Herbert Zimiles. The Psychological Impact of School Experience. New York: Basic Books, 1969, xxii + 514 pages, $12.50. Reviewed by Lita Linzer Schwartz.

William H. Grier &; Price M. Cobbs. Black Rage. New York: Basic Books. Pp. 213, $5.95. Reviewed by Dell Lebo.

Ruth M. Beard. An Outline of Piaget's Developmental Psychology for Students and Teachers. New York: Basic Books, Inc. Publishers, 1969. Pp. xvi + 139. $4.95 Reviewed by Louise Bates Ames.

Arthur Wellon. Five Years in Mental Hospitals. New York: Exposition Press, 1967. Pp. 155, $5.50. Reviewed by Irving R. Stone.     

Be yourself,believe in yourself,and be happy: Self‐efficacy as a mediator between personality factors and subjective well‐being

Strobel, M., Tumasjan, A. & Spörrle, M. (2011). Be yourself, believe in yourself, and be happy: Self‐efficacy as a mediator between personality factors and subjective well‐being. Scandinavian Journal of Psychology 52, 43–48. Research has shown close connections between personality and subjective well‐being (SWB), suggesting that personality traits predispose individuals to experience different levels of SWB. Moreover, numerous studies have shown that self‐efficacy is related to both personality factors and SWB. Extending previous research, we show that general self‐efficacy functionally connects personality factors and two components of SWB (life satisfaction and subjective happiness). Our results demonstrate the mediating role of self‐efficacy in linking personality factors and SWB. Consistent with our expectations, the influence of neuroticism, extraversion, openness, and conscientiousness on life satisfaction was mediated by self‐efficacy. Furthermore, self‐efficacy mediated the influence of openness and conscientiousness, but not that of neuroticism and extraversion, on subjective happiness. Results highlight the importance of cognitive beliefs in functionally linking personality traits and SWB.     

Transdiagnostic internet treatment for anxiety and depression: a randomised controlled trial

Disorder-specific cognitive behavioural therapy programs delivered over the internet (iCBT) with clinician guidance are effective at treating specific anxiety disorders and depression. The present study examined the efficacy of a transdiagnostic iCBT protocol to treat three anxiety disorders and/or depression within the same program (the Wellbeing Program). Seventy-seven individuals with a principal diagnosis of major depression, generalised anxiety disorder, panic disorder, and/or social phobia were randomly assigned to a Treatment or Waitlist Control group. Treatment consisted of CBT-based online educational lessons and homework assignments, weekly email or telephone contact from a clinical psychologist, access to a moderated online discussion forum, and automated emails. Eighty one percent of Treatment group participants completed all 8 lessons within the 10 week program. Post-treatment data were collected from 34/37 Treatment group and 35/37 Control group participants, and 3-month follow-up data were collected from 32/37 Treatment group participants. Relative to Controls, Treatment group participants reported significantly reduced symptoms of anxiety and depression as measured by the Depression Anxiety and Stress Scales-21 item, Patient Health Questionnaire-9 item, and Generalised Anxiety Disorder-7 item scales, with corresponding between-groups effect sizes (Cohen’s d) at post treatment of.56,.58, and.52, respectively. The clinician spent a mean time of 84.76 min (SD = 50.37) per person over the program. Participants rated the procedure as highly acceptable, and gains were sustained at follow-up. These results provide preliminary support for the efficacy of transdiagnostic iCBT in the treatment of anxiety and depressive disorders.     

The Relationships Between Codependency and Femininity and Masculinity

Feminist writers critical of the codependency model have argued that codependency refers to an overly strong conformity to the traditional feminine role. Canonical correlation analysis using data from 192 first-year university students found a moderate association between codependency and gender-role identification. The specific nature of this association varied with different aspects of codependency. External focus (approval seeking) was associated with high scores on the negative aspects of femininity and low scores on positive aspects of masculinity. Self-sacrificing was associated with high positive femininity and low negative masculinity. Women scored higher than men on one aspect of codependency: external focus. Although the data are broadly consistent with a feminist critique of codependency, the relationship between codependency and gender-role identification appears to be more complex than previously suggested.     

Factor structure of the Spielberger Anger Expression scales when used with Australian prisoners

The State-Trait Anger Expression Inventory administered to prison inmates has supported the factor structure of the three anger expression scales although this structure has not been verified with Australian participants. Data collected from 397 Western Australian male prisoners produced a factor structure consistent with the scale structure outlined in the 1991 manual. Scale means and standard deviations were similar to those reported for U.S. and Canadian prisoners. It is therefore appropriate to use the standard scoring procedures with Australian male prisoners.     

Increased skills usage statistically mediates symptom reduction in self-guided internet-delivered cognitive–behavioural therapy for depression and anxiety: a randomised controlled trial

Cognitive–behavioural therapy (CBT) is an effective treatment for clinical and subclinical symptoms of depression and general anxiety, and increases life satisfaction. Patients’ usage of CBT skills is a core aspect of treatment but there is insufficient empirical evidence suggesting that skills usage behaviours are a mechanism of clinical change. This study investigated if an internet-delivered CBT (iCBT) intervention increased the frequency of CBT skills usage behaviours and if this statistically mediated reductions in symptoms and increased life satisfaction. A two-group randomised controlled trial was conducted comparing internet-delivered CBT (n = 65) with a waitlist control group (n = 75). Participants were individuals experiencing clinically significant symptoms of depression or general anxiety. Mixed-linear models analyses revealed that the treatment group reported a significantly higher frequency of skills usage, lower symptoms, and higher life satisfaction by the end of treatment compared with the control group. Results from bootstrapping mediation analyses revealed that the increased skills usage behaviours statistically mediated symptom reductions and increased life satisfaction. Although skills usage and symptom outcomes were assessed concurrently, these findings support the notion that iCBT increases the frequency of skills usage behaviours and suggest that this may be an important mechanism of change.     

An open trial of a brief transdiagnostic internet treatment for anxiety and depression

The present study evaluated the efficacy of a brief version of an internet-administered transdiagnostic CBT protocol, the Wellbeing Program (Titov et al., 2011), designed to treat three anxiety disorders and major depression within the same program. This brief version included the same core CBT skills as the original, but condensed the materials from 8 to 5 online lessons, reduced the duration of treatment from 10 to 8 weeks and did not include an online forum. Thirty-two individuals with a principal diagnosis of major depression, generalised anxiety disorder, panic disorder or social phobia received CBT-based online educational lessons, homework assignments, weekly contact from a clinical psychologist and automated emails. Eighty-one percent of participants completed the lessons within the 8 week program. Post-treatment and 3-month follow-up data were collected from 28/32 and 31/32 participants respectively. Participants improved significantly on the Depression Anxiety and Stress Scales – 21 Item, Patient Health Questionnaire – 9 Item, and Generalised Anxiety Disorder – 7 Item scales, with corresponding within-group effect sizes (Cohen’s d) at follow-up of 1.05, .73, and .95, respectively. Participants rated the procedure as highly acceptable with gains of a similar magnitude as those found for the original program, but less time was spent per participant by the clinician in the present trial (mean = 44.61 min, SD = 34.45) compared to the original program (mean = 84.76 min, SD = 50.37). These results provide additional support for the efficacy of transdiagnostic iCBT in the treatment of anxiety and depressive disorders and indicate that a brief version may be of benefit.     

Meta-analysis of the efficacy and acceptability of cognitive-behavioural therapy for Arab adult populations experiencing anxiety,depression or post-traumatic stress disorder

A meta-analysis of the literature of cognitive behaviour therapy (CBT) with Arab adult populations experiencing anxiety, depression or post-traumatic stress disorder (PTSD) was conducted. Nine studies (n = 536) met the eligibility criteria. Three of the nine studies (33%) were randomised control trials using waitlist control groups. All studies (100%) reported a statistically significant reduction in psychological symptoms at post-treatment with large effect sizes for anxiety (effect size, 95% confidence interval) (1.44 [1.29, 1.59]), depression (1.26 [1.16, 1.35]) and PTSD (2.08 [1.94, 2.23]). Six out of the nine studies (67%) collated follow-up data and reported that reductions of psychological symptoms were maintained at follow-up. An average dropout rate of 26% indicated good overall acceptability. Five out of nine (55%) of the trials reported diagnostic remission rates and of those trials the mean remission rate was 31%). Five of the nine eligible studies (55%) delivered remotely via Internet or telephone were found to have similar effect sizes as face-to-face CBT. The current meta-analysis indicates the potential of CBT, delivered either face-to-face or via internet, as efficacious and acceptable interventions for the treatment of anxiety, depression and PTSD for Arab adult populations.