Internet-based treatment of depression: a randomized controlled trial comparing guided with unguided self-help

Internet-delivered self-help for depression with therapist guidance has shown efficacy in several trials. Results from meta-analyses suggest that guidance is important and that self-help programs without support are less effective. However, there are no direct experimental comparisons between guided and unguided internet-based treatments for depression. The present study compared the benefits of a 10-week web-based unguided self-help treatment with the same intervention complemented with weekly therapist support via e-mail. A waiting-list control group was also included. Seventy-six individuals meeting the diagnostic criteria of major depression or dysthymia were randomly assigned to one of the three conditions. The Beck Depression Inventory (BDI-II) was used as the primary outcome measure. Secondary outcomes included general psychopathology, interpersonal problems, and quality of life. Sixty-nine participants (91%) completed the assessment at posttreatment and 59 (78%) at 6-month follow-up. Results showed significant symptom reductions in both treatment groups compared to the waiting-list control group. At posttreatment, between-group effect sizes on the BDI-II were d = .66 for unguided self-help versus waiting-list and d = 1.14 for guided self-help versus waiting-list controls. In the comparison of the two active treatments, small-to-moderate, but not statistically significant effects in favor of the guided condition were found on all measured dimensions. In both groups, treatment gains were maintained at 6-month follow-up. The findings provide evidence that internet-delivered treatments for depression can be effective whether support is added or not. However, all participants were interviewed in a structured diagnostic telephone interview before inclusion, which prohibits conclusions regarding unguided treatments that are without any human contact.     

Functions of nonsuicidal self-injury among young women in residential care: a pilot study with the Swedish version of the Inventory of Statements about Self-Injury

Nonsuicidal self-injury (NSSI) refers to the direct and deliberate destruction of one's own body tissue in the absence of lethal intent. The Inventory of Statements about Self-Injury (ISAS) is a recently developed instrument that taps both the frequency of different forms of NSSI and the self-perceived functions of the behaviour. The purpose of the present pilot study was to use the ISAS to study the functions of self-injury in a group of women with severe forms of NSSI who were treated within Swedish residential care settings and also to compare the patients' views with their therapists' views concerning these functions. Consistent with previous research, the patients reported intrapersonal functions (e.g. affect regulation and self-punishment) as more relevant than interpersonal functions (e.g. interpersonal influence and peer bonding). The therapists' ratings differed little from the patients' self-reports, although significant differences were found for some functions: The patients rated self-care and toughness as more important than the therapists did; the therapists, on the other hand, rated interpersonal influence and the marking of distress as more relevant than the patients did. Although the present study did not contain a full validation of the Swedish version of the ISAS, the results showed good internal consistency for the interpersonal and intrapersonal factors of the Swedish version.     

Einstellung defused: Interactivity and mental set

Mental set is observed when a familiar problem-solving strategy is applied to new problems that can be solved in simpler, more efficient ways. It is most famously illustrated in the water jar problems (Luchins, 1942 ). In these volume measurement problems, participants learn a rule to obtain an exact volume of liquid involving a complex combination of liquid transfer. Participants persevere in using this rule for new problems that can be solved with a much simpler rule. In two experiments presented here, participants completed the water jar task either in interactive conditions with actual water jars at a sink or in noninteractive conditions, with the problems presented on paper, as in the original Luchins procedure. Interactivity significantly reduced the degree of perseverance. In addition, participants' visuospatial skills significantly predicted the rate of perseverance (and the latencies to solution) in interactive but not in noninteractive conditions. These results underscore the importance of designing problem-solving experiments that engineer distributed cognitive systems in which participants coordinate internal and external resources in thinking.     

Is an interest in computers or individual/team sports associated with adolescent psychiatric disorders?

The Internet plays a major role in adolescents' free time activities and communication nowadays. The aim here was to investigate the possibility of an association of computers and video games or sports (team, individual) with psychiatric disorders among underage psychiatric inpatients. The series of adolescents (n?=?508) had been diagnosed using semistructured interviews (K-SADS-PL). The results showed that an interest in computers and video games did not increase the risk of any specific psychiatric disorder among these adolescent inpatients, but the likelihood of a substance-related disorder was statistically significantly lower among the boys with computers as a hobby. Team sports were related to increased likelihood of conduct disorder among the boys, whereas the likelihood of an affective disorder was reduced. No such association was found in individual sports or among the girls. We conclude that social contacts and peers play an important role in preventing adolescent depression.     

Regular and problematic leisure-time Internet use in the community: results from a German population-based survey

In our study, we attempted to identify systematically the use of Internet applications in the German population in order to derive risk factors for problematic use. In a representative survey of the German population, we queried 1,401 women and 1,111 men between the ages of 14 and 94 years by specific questions and standardized questionnaires on depression, anxiety (HADS), and depersonalization (CDS-2). The majority of the German population (55%) used the Internet in their leisure time. Users were younger and had a higher socioeconomic status (education, employment, income). Leisure-time use included e-mail and information search, as well as shopping. Chatting, online communities, games and sex were domains of young, mostly male adults. Overall, 9.3% reported at least one negative consequence of Internet use, especially neglect of recreational activities and problems with family/partner, work or education, and health. Problematic use was associated with longer average daily online times, avoidance of negative emotions, preference for certain applications (gaming, gambling, online sex) and an increased rate of depersonalization. The extent of Internet use per se is not sufficient as an addiction criterion and other negative consequences; rather, specific adverse consequences need to be identified. If the Internet is used excessively to cope with negative affect states and alternative means of coping (e.g., social support, health-promoting behavior) are diminished, a vicious cycle may ensue with increasing stress and reliance on the reinforcing properties of certain online activities that may finally lead to addictive behavior.     

Relationship specificity of aggressogenic thought-behavior processes

The purpose of this longitudinal study was to examine the relationship specificity of aggressogenic thought-behavior processes and to investigate the role of self-esteem in translating or inhibiting aggressogenic thought into aggression toward personally liked and disliked targets. Participants (186 Finnish boys and girls; 11-12 years old at Time 1) completed measures twice over a 1-year interval. We assessed children's attributions of hostility, relational goals, expectations of anger, and self-efficacy at Time 1 as well as aggression, at both time points, toward their previously identified liked and disliked peers. Our results mostly supported our hypothesis that cognitions guide behavior mainly within the relationship context. Moreover, high self-esteem potentiated cognition-behavior links toward children's own liked peer but inhibited the actualization of aggressogenic thought toward children's disliked peer. These findings highlight the importance of taking a Person × Situation approach when studying cognition-behavior processes.     

Pilot study of personality traits assessed by the Karolinska Scales of Personality (KSP) in asthma, atopy, and rhinitis

Asthma and atopy are common diseases. To study associations between personality and asthma, atopy, rhinitis, and personality traits were measured on the Karolinska Scales of Personality for 193 persons working in 19 buildings with suspected indoor air problems. In addition, information on history of atopy, asthma, and rhinitis was collected by postal questionnaire. In analyses, asthma was associated with higher impulsiveness scores, and atopy in non-asthmatics was associated with higher social desirability scores and lower irritability, guilt, and impulsiveness scores. Non-atopic rhinitis was associated with scores on several anxiety-related scales, while atopic rhinitis was not associated with scores on the Karolinska Scales of Personality. This exploration implies that asthma, atopy, and rhinitis may be associated with various but different personality trait scores. The finding of such personality trait associations in persons with non-asthmatic atopy raises the question of a potential role of an emotional conflict in atopy and the role of personality in asthma, atopy, and rhinitis.     

Reliability of informant ratings and spouse similarity based on the Temperament and Character Inventory

A cohort of 136 Swedish spouse pairs rated themselves and each other with the Temperament and Character Inventory. The data allowed assessment of the reliability of ratings by knowledgeable informants compared to self-rating for this personality test. The reliability of the informant rating was in the expected range, with an average correlation of .58. Agreement was slightly higher for the Temperament dimensions than for the Character dimensions. Additionally, the design allowed evaluation of the similarity between husbands and wives across the seven dimensions measured by the TCI. Correlations between spouses in self-reports were very low for Temperament, with only Harm Avoidance having a statistically significant correlation (.22, p < .05). On the other hand, all three Character dimensions were significantly correlated. These results support the conceptualization of Temperament and Character as separate components of personality. The results are consistent with previous reports on the personality of spouse pairs.     

Deliberate self-harm and psychological problems in young adolescents: evidence of a bidirectional relationship in girls

The purpose of this study was to test the hypotheses that there is a bidirectional prospective relationship between mental health and deliberate self-harm, in the sense that (1) psychological problems are a risk factor for the development of self-harm; (2) self-harm is a risk factor for the development of psychological problems; and (3) the relative absence of psychological problems is a protective factor against the continued use of self-harm in adolescents who have started to harm themselves. This was studied in a community sample of 879 young adolescents by means of a 2-wave longitudinal design with a one-year interval, with self-harm measured by a nine-item version of the Deliberate Self-Harm Inventory (DSHI-9r) and psychological problems by the self-report version of the Strengths and Difficulties Questionnaire (SDQ). The hypothesis of bidirectional relationship between psychological problems and self-harm was supported among girls, but not among boys - although there was evidence of psychological problems as a risk factor of self-harm in boys, the converse was not the case. The relative absence of psychological problems was found to be a protective factor against self-harm only among boys, but not among girls. The results are discussed in terms of self-harm having a different role in the development of psychopathology among girls than among boys.     

Models and the locus of their truth

If models can be true, where is their truth located? Giere (Explaining science, University of Chicago Press, Chicago, 1998) has suggested an account of theoretical models on which models themselves are not truth-valued. The paper suggests modifying Giere’s account without going all the way to purely pragmatic conceptions of truth—while giving pragmatics a prominent role in modeling and truth-acquisition. The strategy of the paper is to ask: if I want to relocate truth inside models, how do I get it, what else do I need to accept and reject? In particular, what ideas about model and truth do I need? The case used as an illustration is the world’s first economic model, that of von Thünen (1826/1842) on agricultural land use in the highly idealized Isolated State.