Multimedia Field Test: Digitalizing Better Sleep Using the Sleepio Program

The promise of online cognitive behavioral therapy for insomnia (CBT-I) and other sleep-related problems as an alternative to traditional face-to-face treatment rests upon the accessibility, ease-of-use, and effectiveness of these approaches. Here we provide a review of Sleepio, a digitalized, state-of-the-art CBT-I program for adults, informed by our personal experience with the program, available research, and information provided at the Sleepio website. The 6-week treatment program can be completed flexibly via web-based or mobile platform. Initial assessment of individual goals and baseline sleep patterns is used to build a personalized account comprised of four sections: Sleep Diary, Case File, Library, and Community. Sleepio uses evidence-based principles and practices, engaging content, and an easy-to-follow format. Unique features of the program including synchronization with compatible sleep tracking devices, multiple built-in user supports, and a 14-day money-back guarantee. Both statistical and clinically meaningful sleep improvements have been found in a large randomized controlled trial. Overall, Sleepio represents a model program for online CBT-I delivery.     

Qualitative insights into the relationship between socioeconomic status and students’ academic achievement goals

Recent research using quantitative methodologies and an emerging social psychological theory of socioeconomic status (SES) has found an association between students’ SES and their academic achievement goals. As a new area of research in the achievement goal tradition, there has been little investigation of the contextual influences upon particular goal orientations in divergent SES contexts. To explore these influences, focus groups were conducted with 24 secondary school students aged 16–17 years attending a high and a low SES school in New South Wales, Australia. These teenagers were approaching a ‘developmental deadline’ which required immediate decisions about future work and education pathways. As such, they could be experiencing a period of heightened contextual influences. Directed content analysis of the focus groups observed the broad distinctions in achievement goals seen in previous quantitative studies. However, the analysis elucidated some of the ways in which norms and values in different SES contexts influenced the adoption of particular goal orientations. In some cases, the same orientation had markedly different contextual influences stemming from students’ SES backgrounds. From these exploratory findings, we argue for further research into the factors which influence the adoption of different achievement goals by students from different SES backgrounds.     

If you want to know, consider asking: how likely is it that patients will hurt themselves in the future?

Although self-harming behavior is a common and costly problem for psychiatric inpatients released from the hospital, standardized tools that assess patients' risk for self-harm are rarely used in clinical settings. In this study of dually diagnosed psychiatric inpatients (N = 147), we assessed the utility of patients' self-perceptions of risk in predicting self-harm in the community. Patients' self-perceptions of risk predicted self-harm 8 weeks after discharge from the hospital (Lag 1; area under the curve [AUC] = 0.75). Self-perceptions of risk at the 8-week interview also predicted self-harm 2 months later (Lag 2; AUC = 0.72). Self-perceived risk added predictive utility above and beyond scores on a measure of depression and seemed to capture changes in risk state over time. The results suggest that inpatients can accurately perceive their own risk and therefore may be important collaborators in the risk management process.     

Mothers and Fathers in Family Cognitive-Behavioral Therapy for Anxious Youth

Cognitive-behavioral therapy (CBT) for anxiety disorders in youth has been evaluated in randomized clinical trials and found to be an efficacious treatment. Studies have investigated the effects of increased parental/family involvement in treatment. In the majority of these studies, however, parental involvement is synonymous with maternal involvement leaving the role of fathers unknown. Studies including parents in treatment have yet to examine the independent contribution of mothers and fathers to child outcome. We examined the relationship between both mother (n = 45) and father (n = 45) attendance and engagement in therapy sessions, maternal and paternal psychopathology, and child (n = 45) treatment outcome when parents were included in a Family CBT program for anxiety-disordered youth. Some indications were found for the notion that greater rates of mother and father attendance in session, as well as higher ratings of mother and father engagement in session, are associated with improved child outcome. Parental psychopathology was not associated with attendance, engagement, or child outcome. Recommendations for future research are offered.     

Feasibility of telephone-based cognitive behavioral therapy targeting major depression among urban dwelling African-American people with co-occurring HIV

Given the burden of depression among those with HIV, and the impact of HIV on urban minority communities there is an urgent need to assess innovative treatment interventions that not only treat depression but do so in a way that allows for increased access to mental health care. This single site, uncontrolled, pilot study sought to determine the feasibility and depression outcomes of an 11-session telephone-based cognitive behavioral therapy intervention delivered over 14 weeks targeting low-income, urban-dwelling, HIV-infected African-American people with major depression. The diagnosis of major depression was made using the Mini International Neuropsychiatric Interview. The primary outcome was the Hamilton Depression Rating Scale (HAM-D) and the secondary outcome was the Quick Inventory of Depression Symptomatology-Self Report (QIDS-SR). Feasibility and satisfaction were also assessed. Assessments occurred at baseline, midpoint and at study conclusion (14 weeks). Fifteen people were screened for the study. Six HIV-infected, low-income, African-American people individuals (five females and one male) were eligible and participated in the study. All patients finished the study. On average, participants completed nine sessions. The sessions lasted for an average of 48 min (SD = 11.5). Compared to mean HAM-D score at baseline (HAM-D = 22.8 (SD = 3.1), the mean HAM-D score was significantly reduced at study conclusion (HAM-D = 9.8 (SD = 7.4); (t (5) = 4.6, p = 0.006); (Cohen d = 1.9)). Compared to the mean QIDS-SR score at baseline (QIDS-SR = 15.5 (SD = 4.2) the mean QIDS score was significantly reduced at study conclusion (QIDS = 7.0 (SD = 5.4);(t (5) = 3.2, p = 0.02); (Cohen d = 1.3)).The mean satisfaction scores across all participants at post-treatment was 5.7 (SD = 0.3) with of a maximum score of 6. Telephone-based CBT can be delivered to low-income, urban-dwelling ethnic minority HIV-infected people resulting in significant reductions in depression symptoms with high satisfaction. The efficacy of this intervention will be assessed in a planned randomized control trial.     

Cognitive and metacognitive activity in mathematical problem solving: prefrontal and parietal patterns

Students were taught an algorithm for solving a new class of mathematical problems. Occasionally in the sequence of problems, they encountered exception problems that required that they extend the algorithm. Regular and exception problems were associated with different patterns of brain activation. Some regions showed a Cognitive pattern of being active only until the problem was solved and no difference between regular or exception problems. Other regions showed a Metacognitive pattern of greater activity for exception problems and activity that extended into the post-solution period, particularly when an error was made. The Cognitive regions included some of parietal and prefrontal regions associated with the triple-code theory of (Dehaene, S., Piazza, M., Pinel, P., & Cohen, L. (2003). Three parietal circuits for number processing. Cognitive Neuropsychology, 20, 487–506) and associated with algebra equation solving in the ACT-R theory (Anderson, J. R. (2005). Human symbol manipulation within an 911 integrated cognitive architecture. Cognitive science, 29, 313–342. Metacognitive regions included the superior prefrontal gyrus, the angular gyrus of the triple-code theory, and frontopolar regions.     

Leveraging Motivational Mindsets to Foster Positive Interracial Interactions

As the United States becomes increasingly diverse, interracial contact will become considerably less rare. Much research has suggested that interracial interactions are often stressful and uncomfortable for both Whites and racial minorities. Bringing together several bodies of research, the present article outlines a motivational perspective on the dynamics of intergroup contact. To this end, we consider the roles of three motivational mindsets that have the potential to shape interactions to be less cognitively depleting and more enjoyable for both interactants. In particular, we consider the effects of (i) approach and avoidance motivation (Handbook of Motivation and Cognition: Foundation of Social Behavior, 1990, New York: Guilford Press), (ii) promotion and prevention regulatory focus (American Psychologist, 52 , 1997, 1280), and (iii) learning and performance goals (Psychological Review, 95 , 1988, 256) in shaping the dynamics of interracial contact. We suggest that investigations into these motivational mindsets will offer further insight into how and why interracial interactions go awry and will assist in the development of strategies and interventions that facilitate more smooth and enjoyable contact experiences.