Internet administered guided self-help versus individualized e-mail therapy: A randomized trial of two versions of CBT for major depression

Internet-delivered psychological treatment of major depression has been investigated in several trials, but the role of personalized treatment is less investigated. Studies suggest that guidance is important and that automated computerized programmes without therapist support are less effective. Individualized e-mail therapy for depression has not been studied in a controlled trial. Eighty-eight individuals with major depression were randomized to two different forms of Internet-delivered cognitive behaviour therapy (CBT), or to a waiting-list control group. One form of Internet treatment consisted of guided self-help, with weekly modules and homework assignments. Standard CBT components were presented and brief support was provided during the treatment. The other group received e-mail therapy, which was tailored and did not use the self-help texts i.e., all e-mails were written for the unique patient. Both treatments lasted for 8 weeks. In the guided self-help 93% completed (27/29) and in the e-mail therapy 96% (29/30) completed the posttreatment assessment. Results showed significant symptom reductions in both treatment groups with moderate to large effect sizes. At posttreatment 34.5% of the guided self-help group and 30% of the e-mail therapy group reached the criteria of high-end-state functioning (Beck Depression Inventory score below 9). At six-month follow-up the corresponding figures were 47.4% and 43.3%. Overall, the difference between guided self-help and e-mail therapy was small, but in favour of the latter. These findings indicate that both guided self-help and individualized e-mail therapy can be effective.     

Controllability and hindsight components: Understanding opposite hindsight biases for self-relevant negative event outcomes

There is an anomaly in the hindsight bias literature with respect to hindsight effects obtained after self-relevant negative event outcomes: Whereas some studies have reported reduced hindsight bias, others have shown increases. This article contrasts two explanations for the anomaly. The first points to an influence of perceived control over the event outcome: In hindsight, people decrease foreseeability (and hence, responsibility and blame) for controllable events, but they increase the perceived inevitability of uncontrollable events for coping reasons. The second explanation, derived from a reconception of hindsight bias in terms of separate components (Blank, Nestler, von Collani, & Fischer, 2008), traces the anomaly to differences in the observed hindsight components: Hindsight decreases are to be expected for foreseeability, whereas increases are restricted to the inevitability component. Our experiment (N=210) manipulated controllability and the hindsight component orthogonally and showed strong support for the component explanation, but also some influence of perceived control.     

The affective priming effect: Automatic activation of evaluative information in memory

Abstract

Fazio, Sanbonmatsu, Powell, and Kardes (1986) argued that affect may be activated automatically from memory on the mere observation of an affect-loaded stimulus. Using a variant of the standard sequential priming paradigm, it was demonstrated that the time needed to evaluate target words as positive or negative decreased if they were preceded by a similarly valenced prime word, but increased when preceded by a prime of opposite valence. Several aspects of their procedure, however, do not warrant their conclusion concerning the unconditionality of the effect. The present research investigated the generality of this affective priming effect. In Experiment 1, it was tested whether the effect can be generalised to more complex visual material. Stimulus pairs consisted of colour slides. Subjects had to evaluate the targets as quickly as possible. In Experiment 2, the standard word-word procedure was used, but target words had to be pronounced. In both experiments, significant affective priming effects were observed, supporting Bargh, Chaiken, Govender, and Pratto's (1992) assertion that the automatic activation effect is a pervasive and relative unconditional phenomenon. Implications for theories of affect and emotion are discussed.