Overcoming procrastination: one-year follow-up and predictors of change in a randomized controlled trial of Internet-based cognitive behavior therapy

Procrastination is a common self-regulatory failure that can have a negative impact on well-being and performance. However, few clinical trials have been conducted, and no follow-up has ever been performed. The current study therefore aimed to provide evidence for the long-term benefits and investigate predictors of a positive treatment outcome among patients receiving Internet-based cognitive behavior therapy (ICBT). A total of 150 self-recruited participants were randomized to guided or unguided ICBT. Self-report measures of procrastination, depression, anxiety, and quality of life were distributed at pre-treatment assessment, post-treatment assessment, and one-year follow-up. Mixed effects models were used to investigate the long-term gains, and multiple linear regression for predictors of a positive treatment outcome, using the change score on the Irrational Procrastination Scale as the dependent variable. Intention-to-treat was implemented for all statistical analyses. Large within-group effect sizes for guided and unguided ICBT, Cohen’s d = .97–1.64, were found for self-report measures of procrastination, together with d = .56–.66 for depression and anxiety. Gains were maintained, and, in some cases, improved at follow-up. Guided and unguided ICBT did not differ from each other, mean differences ?.31–1.17, 95% CIs [?2.59–3.22], and none of the predictors were associated with a better result, bs ?1.45–1.61, 95% CIs [?3.14–4.26]. In sum, ICBT could be useful and beneficial in relation to managing procrastination, yielding great benefits up to one year after the treatment period has ended, with comparable results between guided and unguided ICBT.     

Creating state of the art,next-generation Virtual Reality exposure therapies for anxiety disorders using consumer hardware platforms: design considerations and future directions

Decades of research and more than 20 randomized controlled trials show that Virtual Reality exposure therapy (VRET) is effective in reducing fear and anxiety. Unfortunately, few providers or patients have had access to the costly and technical equipment previously required. Recent technological advances in the form of consumer Virtual Reality (VR) systems (e.g. Oculus Rift and Samsung Gear), however, now make widespread use of VRET in clinical settings and as self-help applications possible. In this literature review, we detail the current state of VR technology and discuss important therapeutic considerations in designing self-help and clinician-led VRETs, such as platform choice, exposure progression design, inhibitory learning strategies, stimuli tailoring, gamification, virtual social learning and more. We illustrate how these therapeutic components can be incorporated and utilized in VRET applications, taking full advantage of the unique capabilities of virtual environments, and showcase some of these features by describing the development of a consumer-ready, gamified self-help VRET application for low-cost commercially available VR hardware. We also raise and discuss challenges in the planning, development, evaluation, and dissemination of VRET applications, including the need for more high-quality research. We conclude by discussing how new technology (e.g. eye-tracking) can be incorporated into future VRETs and how widespread use of VRET self-help applications will enable collection of naturalistic “Big Data” that promises to inform learning theory and behavioral therapy in general.     

Positive Loss and Tragic Memory: On the Preservation of Community

Theologies of disaster have to recognize exceptional disasters in the framework of a general human exposure to vulnerability, while engaging in the formation of human and religious resilience. Resilience is about “bouncing back and forward” in and through precautionary and self‐adaptive responses to disasters. Drawing up a distinction between personal tragedies and socially shared disasters, the basic argument is that the reconnection of disrupted communities lies at the center of both tragedy and disaster. This article describes a post‐secular theology of tragedy and disaster that mainly stays in a vernacular language, referring to basic assumptions of the gospel while refraining from using the heavier repertoires of Christian doctrine.     

Fried and Freud on the Acropolis; on duality in the base of psychoanalytic thinking

Freud was conflicted in relation to his religious background. On the one hand, he was very clear on his adherence to a scientific Weltanschauung. On the other, he was fascinated by the Moses figure and one may see a Judaist structure in his way of thinking. The aim of this paper is to reflect on this conflict and the question of faith in psychoanalysis. After looking at object and method in religion and psychoanalysis, the authors go into the concept of ‘psychic reality’ and its change in the history of psychoanalysis. Through an analysis of Freud’s A Disturbance of Memory on the Acropolis and the function of literature, it is claimed that faith may be seen as a condition for the sense of experiential reality.     

Acceptance and commitment therapy versus tinnitus retraining therapy in the treatment of tinnitus: a randomised controlled trial

The study compared the effects of Acceptance and Commitment Therapy (ACT) with Tinnitus Retraining Therapy (TRT) on tinnitus impact in a randomised controlled trial. Sixty-four normal hearing subjects with tinnitus were randomised to one of the active treatments or a wait-list control (WLC). The ACT treatment consisted of 10 weekly 60 min sessions. The TRT treatment consisted of one 150 min session, one 30 min follow-up and continued daily use of wearable sound generators for a recommended period of at least 8 h/day for 18 months. Assessments were made at baseline, 10 weeks, 6 months and 18 months. At 10 weeks, results showed a superior effect of ACT in comparison with the WLC regarding tinnitus impact (Cohen’s d = 1.04), problems with sleep and anxiety. The results were mediated by tinnitus acceptance. A comparison between the active treatments, including all assessment points, revealed significant differences in favour of ACT regarding tinnitus impact (Cohen’s d = 0.75) and problems with sleep. At 6 months, reliable improvement on the main outcome measure was found for 54.5% in the ACT condition and 20% in the TRT condition. The results suggest that ACT can reduce tinnitus distress and impact in a group of normal hearing tinnitus patients.     

The role of task persistence in young adolescence for successful educational and occupational attainment in middle adulthood

The main purpose of the present study was to investigate the importance of task persistence in young adolescence for successful educational and occupational attainment in middle adulthood. Data from age 13 (N = 1,092) and adult age (age 43 for women, N = 569 and age 47 for men, N = 393) were taken from the Swedish longitudinal research program entitled "Individual Development and Adaptation." In line with previous research, task persistence was found to be related to changes in grades between age 13 and age 16, over and above other childhood factors. Task persistence at age 13 was also a significant predictor of both income and occupational level in middle adulthood for the men, controlling for a number of childhood factors (including intelligence), and even when educational attainment in adulthood was taken into account. Finally, task persistence was related to educational attainment in adulthood. The authors suggest that task persistence is a second fundamental factor besides general mental ability, influencing attainment within the area of working life and education. The influence of task persistence is discussed in form of personality-environment selection mechanisms.     

Relationships Between Parental Negativity and Childhood Antisocial Behavior over Time: A Bidirectional Effects Model in a Longitudinal Genetically Informative Design

This study examined the direction and etiology underlying the relationships between parental negativity and early childhood antisocial behavior using a bidirectional effects model in a longitudinal genetically informative design. We analyzed parent reports of parental negativity and early childhood antisocial behavior in 6,230 pairs of twins at 4 and 7 years of age. Results from a cross-lagged twin model contribute to the understanding of the mechanisms underlying the bidirectional processes involved in parental negativity and childhood antisocial behavior. Specifically, the findings of this study suggest that the association between parenting and child antisocial behavior is best explained by both parent-driven and child-driven effects. We found support for the notion that parent's negative feelings towards their children environmentally mediate the risk for child antisocial behavior. We also found evidence of genetically mediated child effects; in which genetically influenced antisocial behavior evoke parental negativity towards the child.     

Internet Versus Group Cognitive-Behavioral Treatment of Distress Associated With Tinnitus: A Randomized Controlled Trial

Tinnitus distress can be reduced by means of cognitive-behavior therapy (CBT), and the treatment can be delivered in different ways. The most recent format is Internet-based self-help. The aim of this study was to compare this treatment (n = 26) with standard group-based CBT (n = 25) in a randomized controlled trial. Outcomes on self-report inventories measuring tinnitus distress were evaluated immediately after and 1 year after treatment. Results showed that both groups had improved, and there were few differences between them. The effect size for the Internet treatment was d = 0.73 (95% CI = 0.16–1.30) and for the group treatment was d = 0.64 (95% CI = 0.07–1.21). The Internet treatment consumed less therapist time and was 1.7 times as cost-effective as the group treatment. At pretreatment patients rated the Internet treatment as less credible than the group treatment. In conclusion, Internet treatment for tinnitus distress merits further investigation, as the outcomes achieved are promising.     

Is it the sound or your relationship to it? The role of acceptance in predicting tinnitus impact

Tinnitus is an experience of sound in the absence of an appropriate external source. A symptom that can accompany most central or peripheral dysfunctions of the auditory system, tinnitus can lead to significant distress, depression, anxiety, and decreases in life quality. This paper investigated the construct of psychological acceptance in a population of tinnitus patients. First, a cross-sectional study (N = 77) was conducted in which a tinnitus specific acceptance questionnaire was developed. Results showed that a Tinnitus Acceptance Questionnaire (TAQ) generated good internal consistency. A factor solution was derived with two factors: activity engagement and tinnitus supression. Second, a longitudinal study (N = 47) investigated the mediating role of acceptance on the relationship between tinnitus distress at baseline and tinnitus distress, anxiety, life quality, and depression at a 7-month follow-up. The results showed full mediation of activity engagement for depression and life quality at follow-up, partial mediation for tinnitus distress, and no mediation for anxiety. The role of acceptance in the negative impact of tinnitus distress merits further investigation.     

Chronic Pain and Praying to a Higher Power: Useful or Useless?

In the present study a Swedish sample of 118 persons with chronic pain completed online tests on two occasions in association with treatment trials. A three item subscale measuring praying as a coping strategy was derived from the Coping Strategies Questionnaire (CSQ), but adapted to refer to “a higher power” instead of “God”. Measures of pain and anxiety/depression were also included. Results revealed significant associations between praying and pain interference and impairment. Praying was also associated with anxiety and depression scores. Results also showed that prayer predicted depression scores at follow-up, and that follow-up prayer was predicted by pain interference at first measurement occasion. Overall, if prayer had any relation with the other variables it was in the negative direction of more distress being associated with more praying both concurrently and prospectively.