Comparison of outcomes across low-intensity psychological interventions for depression and anxiety within a stepped-care setting: A naturalistic cohort study using propensity score modelling

Low-intensity interventions for common mental disorders (CMD) address issues such as clinician shortages and barriers to accessing care. However, there is a lack of research into their comparative effectiveness in routine care. We aimed to compare treatment effects of three such interventions, utilizing four years' worth of routine clinical data. Users completing a course of guided self-help bibliotherapy (GSH), internet-delivered cognitive behavioural therapy (iCBT) or psychoeducational group therapy (PGT) from a stepped-care service within the NHS in England were included. Propensity score models (stratification and weighting) were used to control for allocation bias and determine average treatment effect (ATE) between the interventions. 21,215 users comprised the study sample (GSH = 12,896, iCBT = 6862, PGT = 1457). Adherence-to-treatment rates were higher in iCBT. All interventions showed significant improvements in depression (PHQ-9), anxiety (GAD-7) and functioning (WSAS) scores, with largest effect sizes for iCBT. Both propensity score models showed a significant ATE in favour of iCBT versus GSH and PGT, and in favour of GSH versus PGT. Discernible differences in effectiveness were seen for iCBT in comparison with GSH and PGT. Given variance in delivery mode and human resources between different low-intensity interventions, building on these findings would be valuable for future service provision and policy decision making.     

Deliberators Must Be Imperfect

This paper argues that, with certain provisos, predicting one's future actions is incompatible with rationally deliberating about whether to perform those actions. It follows that fully rational omniscient agents are impossible, since an omniscient being could never rationally deliberate about what to do (omniscient beings, the paper argues, will always meet the relevant provisos). Consequently, theories that explain practical reasons in terms of the choices of a perfectly rational omniscient agent must fail. The paper considers several ways of defending the possibility of an omniscient agent, and concludes that while some of these may work, they are inconsistent with the aim of explaining practical normativity by appeal to such an agent.     

A qualitative exploration of alcohol use among student sportspeople: A social identity perspective

Research indicates that university student sportspeople are a high‐risk subgroup for hazardous alcohol consumption. Adopting a social identity perspective, we explored the social and psychological processes linking sports participation and alcohol use. Twenty‐two individual semi‐structured interviews were conducted with UK student sportspeople (male: 12; female: 10). A deductive thematic analysis identified three core themes: social identification and sports group membership, identity processes in (alcohol) behaviours and sport context‐specific significance of alcohol. Results suggest that the consumptive practices among student sportspeople were strategic activities underpinned by social identity processes, and which served to provide a positive sports experience at the group level. Our findings highlight the interactions between the sport environment, the social structure of sport participation and the multipurpose function of alcohol in this context. We discuss the implications of these results in support of a social identity approach to sport‐related drinking.     

Effects of Anxiety on Novice Genetic Counseling Students’ Experience of Supervised Clinical Rotations

Supervised clinical experiences with patients comprise a critical component of genetic counseling student education. Previous research has found genetic counseling students tend to be more anxiety prone than the general population, and anxiety related to supervision has been found in genetic counseling and related fields. The present study investigated how anxiety affects the experience of supervision for genetic counseling students. Second year genetic counseling students were invited to participate through email invitations distributed via training directors of the 33 programs accredited at the time of the study by the American Board of Genetic Counseling. An initial online survey contained the trait scale of the State-Trait Anxiety Inventory to estimate anxiety proneness in this population and an invitation to participate in a 45-minute semi-structured phone interview focusing on students’ experiences of supervision during their clinical rotations. High and low trait anxiety groups were created using STAI scores, and the groups’ interview responses were compared using consensual qualitative research methodology (CQR; Hill 2012). The high anxiety group was more likely to describe problematic supervisory relationships, appreciate the supervisor’s ability to help them when they get stuck in sessions, and feel their anxiety had a negative effect on their performance in general and in supervision. Common themes included supervisors’ balancing support and guidance, the importance of feedback, ego-centric responses, and supervisors as focal points. The results of the present study are largely consistent with current literature. Further research findings and research, practice, and training recommendations are provided.     

Consumer conviction and commitment: An appraisal‐based framework for attitude certainty

This paper explores consumers' commitment to and conviction about their beliefs in the form of attitude certainty. Based on a review of past research, we present a new framework for understanding attitude certainty and how consumers' attitude certainty is shaped by their resisting or yielding to persuasive messages, or even by their reflections on the evidence supporting their attitudes. We propose that attitude certainty is formed and changed largely through an attribution-based reasoning process linked to a finite set of distinct appraisals. Our framework is used to both organize past research and offer guidance for future research endeavors. In addition, we distinguish our framework of appraisal-based attitude certainty from past models in attitudes and persuasion research that have referenced or taken note of the attitude certainty construct. Implications and future directions for the study of consumer behavior are discussed.     

Emotion Regulation Mediates the Association Between ADHD and Depressive Symptoms in a Community Sample of Youth

The purpose of this study was to examine the longitudinal relationship between attention-deficit/hyperactivity disorder (ADHD) symptoms, emotion regulation (ER) ability, and depressive symptoms within a diverse community sample of 277 youth, ages 9–12 (56 % male). Participants were drawn from a larger study examining adolescent risk behaviors, and completed annual assessments over 3 years. Youth ADHD symptoms were assessed at Time 1 (T1) using the parent-reported Disruptive Behavior Disorders Rating Scale, ER was assessed with the parent-reported Emotion Regulation Checklist at Time 2 (T2), and youth depressive symptoms were assessed using the self-reported Revised Child Anxiety and Depression Scales at Time 3 (T3). Analyses examined T2 ER as a mediator between T1 ADHD symptoms (including the unique contributions of inattentive [IA] versus hyperactive/impulsive [HI] symptoms) and T3 depressive symptoms. Structural equation modeling (SEM) indicated the path model specified provided an excellent fit to the data. Tests of indirect effects suggested that T2 ER appears to be a significant mechanism that underlies the relationship between T1 ADHD and T3 depression, even when accounting for T1 oppositional defiant and depressive symptoms. Furthermore, while both T1 IA and HI symptoms had significant indirect effects on T3 depression through the mechanism T2 ER, HI proved a more robust predictor of T2 ER than IA. Results of this prospective study support cross-sectional findings pointing to ER as a potential mechanism linking ADHD and depressive symptoms in youth. Clinical implications and future directions are discussed.     

Cognitive style and religiosity: The role of conflict detection

Recent research has indicated a negative relation between the propensity for analytic reasoning and religious beliefs and practices. Here, we propose conflict detection as a mechanism underlying this relation, on the basis of the hypothesis that more-analytic people are less religious, in part, because they are more sensitive to conflicts between immaterial religious beliefs and beliefs about the material world. To examine cognitive conflict sensitivity, we presented problems containing stereotypes that conflicted with base-rate probabilities in a task with no religious content. In three studies, we found evidence that religiosity is negatively related to conflict detection during reasoning. Independent measures of analytic cognitive style also positively predicted conflict detection. The present findings provide evidence for a mechanism potentially contributing to the negative association between analytic thinking and religiosity, and more generally, they illustrate the insights to be gained from integrating individual-difference factors and contextual factors to investigate analytic reasoning.     

When psychology undermines beliefs

This paper attempts to specify the conditions under which a psychological explanation can undermine or debunk a set of beliefs. The focus will be on moral and religious beliefs, where a growing debate has emerged about the epistemic implications of cognitive science. Recent proposals by Joshua Greene and Paul Bloom will be taken as paradigmatic attempts to undermine beliefs with psychology. I will argue that a belief p may be undermined whenever: (i) p is evidentially based on an intuition which (ii) can be explained by a psychological mechanism that is (iii) unreliable for the task of believing p; and (iv) any other evidence for belief p is based on rationalization. I will also consider and defend two equally valid arguments for establishing unreliability: the redundancy argument and the argument from irrelevant factors. With this more specific understanding of debunking arguments, it is possible to develop new replies to some objections to psychological debunking arguments from both ethics and philosophy of religion.