Development and Pilot Evaluation of Smartphone-Delivered Cognitive Behavior Therapy Strategies for Mood- and Anxiety-Related Problems: MoodMission

Given the ubiquity and interactive power of smartphones, there are opportunities to develop smartphone applications (apps) that provide novel, highly accessible mental health supports. This paper details the development of a smartphone app, “MoodMission,” that aims to provide evidence-based Cognitive Behavior Therapy (CBT) strategies for mood- and anxiety-related problems, contributing to the prevention of clinically significant depression and anxiety disorders and serving as an adjunct to therapeutic interventions delivered by trained health professionals. MoodMission was designed to deliver strategies in the form of real-time, momentary responses to user-reported low moods and anxiety. The development process involved: (a) construction of a battery of strategies, (b) empirical evaluation, (c) a software and behavioral plan design and testing process, (d) user feedback, and (e) a public launch. A pilot study of 44 participants completed the Mobile Application Rating Scale (MARS; Hides et al., 2014) for usability testing and feedback. MoodMission was rated significantly higher than standardized health app norms on the majority of the domains, including Entertainment, Interest, Customization, Target Group, Graphics, Visual Appeal, Quality of Information, Quantity of Information, Visual Information, Credibility of Source, Recommendation to Use, Estimated Frequency of Use, and Overall Rating (Hedges’s g range 0.57–1.97, p < .006). Case examples illustrate the practical uses of the app. In addition to clinical applications, MoodMission holds promise as a research tool either as an augmentation to clinician-delivered therapy, or as a vehicle for standardizing client access to specific CBT strategies (e.g., in studies intending to study different change processes).     

Resilience,Life Events,and Well-Being During Midlife: Examining Resilience Subgroups

Developmental midlife processes involve resilience, changing challenges, and perceptions of getting older. In Study I and II, the Managing Life Survey resulted in growth, managing uncertainty, objectivity, adversity, and strategy use subscales. In Study II, resilience subgroups were identified. High and non-religious resilience groups had significantly higher averages for MLS subscales, time orientations, grit, life satisfaction; and significantly lower averages for adversity and negative event scores, compared to other groups. Noteworthy findings herein consist of (1) differences across resilience groups, with spiritual strategies emerging as an important discriminator; (2) the role of future perspectives on well-being characterizing early midlife; (3) the influence of growth and purpose on well-being characterizing late midlife; and (4) the cumulative effect of education on life satisfaction in late midlife. The results herein are consistent with the psychological benefits of moderate levels of challenge; with developmental differences across early and late midlife, and with Socioemotional Selectivity Theory.     

Attachment styles and clinical correlates in people at ultra high risk for psychosis

Evidence suggests that attachment styles may influence subclinical psychosis phenotypes (schizotypy) and affective disorders and may play a part in the association between psychosis and childhood adversity. However, the role of attachment in the initial stages of psychosis remains poorly understood. Our main aim was to describe and compare attachment styles in 60 individuals at ultra high risk for psychosis (UHR) and a matched sample of 60 healthy volunteers (HV). The HV had lower anxious and avoidant attachment scores than the UHR individuals (p < .001). Sixty-nine percentage of the UHR group had more than one DSM-IV diagnosis, mainly affective and anxiety disorders. The UHR group experienced more trauma (p < .001) and more mood and anxiety symptoms (p < .001). Interestingly, in our UHR group, only schizotypy paranoia was correlated with insecure attachment. In the HV group, depression, anxiety, schizotypy paranoia, and social anxiety were correlated with insecure attachment. This difference and some discrepancies with previous studies involving UHR suggest that individuals at UHR may compose a heterogeneous group; some experience significant mood and/or anxiety symptoms that may not be explained by specific attachment styles. Nonetheless, measuring attachment in UHR individuals could help maximize therapeutic relationships to enhance recovery.     

American Psychiatric Association: Position Statement on Firearm Access,Acts of Violence and the Relationship to Mental Illness and Mental Health Services

The American Psychiatric Association, (“APA”), with more than 36,000 members at present, is the Nation's leading organization of physicians who specialize in psychiatry. APA provides for education and advocacy and develops policy through Position Statements. It promotes enhanced knowledge of particular topics relevant to psychiatric practice and patient care through Resource Documents. Since 1993, the APA has developed various positions and resource materials related to firearms and mental illness, incorporating evolving themes as new issues emerge. This paper reflects the APA's 2014 Position Statement on Firearm Access, Acts of Violence and the Relationship to Mental Illness and Mental Health Services.     

Adjustments to the correction for attenuation

With respect to the often-present covariance between error terms of correlated variables, D. W. Zimmerman and R. H. Williams's (1977) adjusted correction for attenuation estimates the strength of the pairwise correlation between true scores without assuming independence of error scores. This article focuses on the derivation and analysis of formulas that perform the same function for partial and part correlation coefficients. Values produced by these formulas lie closer to the actual true-score coefficient than do the observed-score coefficients or those obtained by using C. Spearman's (1904) correction for attenuation. The new versions of the formulas thus allow analysts to use hypothetical values for error-score correlations to estimate values for the partial and part correlations between true scores while disregarding the independence-of-errors assumption.     

Two languages, one developing brain: event-related potentials to words in bilingual toddlers

Infant bilingualism offers a unique opportunity to study the relative effects of language experience and maturation on brain development, with each child serving as his or her own control. Event-related potentials (ERPs) to words were examined in 19- to 22-month-old English-Spanish bilingual toddlers. The children's dominant vs. nondominant languages elicited different patterns of neural activity in the lateral asymmetry of an early positive component (P100), and the latencies and distributions of ERP differences to known vs. unknown words from 200-400 and 400-600 ms. ERP effects also differed for 'high' and 'low' vocabulary groups based on total conceptual vocabulary scores. The results indicate that the organization of language-relevant brain activity is linked to experience with language rather than brain maturation.     

Role function and job satisfaction of school psychologists practicing in an expanded role model

School psychologists are typically itinerant among multiple schools and often spend up to two-thirds of their time on assessment activities related to students with disabilities and special education programs. School psychologists in delivery of an expanded role service model are assigned to a single school and provide more consultation and intervention services. 97 school psychologists assigned to an expanded role in a single southeastern urban school district were surveyed on their job roles and job satisfaction. The majority were satisfied or very satisfied with their jobs, particularly with engaging in activities that were of service to others and staying involved in a variety of job activities. School psychologists wanted to spend less time in assessment, multidisciplinary team meetings, and administrative duties. The discrepancy between the desired and actual amount of time spent in multidisciplinary meetings was negatively related to job satisfaction. Psychologists wanted to spend more time in direct and indirect intervention, professional development, and networking.     

Adult age, gender, and race group differences in images of aging

Younger and older African American and Caucasian American adults, who were matched by age (M age = 40.63 years), completed a survey on perceptions of aging and subjective age. The 2 groups did not differ in the age they considered someone to be old (M age = 74.5 years). However, when asked which age was the happiest age, African Americans chose a significantly younger age (M age = 18.26 years) than did Caucasian Americans (M age = 31.32 years), and this racial group difference interacted with age differences such that older Caucasian Americans named an older age than did younger Caucasian Americans. The authors found no such age difference for African Americans. When asked if old age was a happy time, 60% of Caucasian Americans answered yes, whereas only 2% of African Americans answered yes. These and other differences in images and concerns of old age and subjective age suggest a far more negative view of aging for African Americans and a need for changes in the provision of positive information about aging for this group.     

Outcome From a Randomized Controlled Trial of Group Therapy for Binge Eating Disorder: Comparing Dialectical Behavior Therapy Adapted for Binge Eating to an Active Comparison Group Therapy

Dialectical Behavior Therapy for Binge Eating Disorder (DBT-BED) aims to reduce binge eating by improving adaptive emotion-regulation skills. Preliminary findings have been promising but have only compared DBT-BED to a wait-list. To control for the hypothesized specific effects of DBT-BED, the present study compared DBT-BED to an active comparison group therapy (ACGT). Men and women (n = 101) meeting DSM-IV BED research criteria were randomly assigned to 20 group sessions of DBT-BED (n = 50) or ACGT (n = 51). DBT-BED had a significantly lower dropout rate (4%) than ACGT (33.3%). Linear Mixed Models revealed that posttreatment binge abstinence and reductions in binge frequency were achieved more quickly for DBT-BED than for ACGT (posttreatment abstinence rate = 64% for DBT-BED vs. 36% for ACGT) though differences did not persist over the 3-, 6-, and 12-month follow-up assessments (e.g., 12-month follow-up abstinence rate = 64% for DBT-BED vs. 56% for ACGT). Secondary outcome measures revealed no sustained impact on emotion regulation. Although both DBT-BED and ACGT reduced binge eating, DBT-BED showed significantly fewer dropouts and greater initial efficacy (e.g., at posttreatment) than ACGT. The lack of differential findings over follow-up suggests that the hypothesized specific effects of DBT-BED do not show long-term impact beyond those attributable to nonspecific common therapeutic factors.