Experiences and engagement with the design features and strategies of an internet-delivered treatment programme for generalised anxiety disorder: a service-based evaluation

Background: Outcome research has highlighted the efficacy of internet-based cognitive behavioural therapy (iCBT). Some process research has examined users experiences of iCBT. Understanding the user experience provides valuable feedback to developers of internet-delivered interventions.

Aim: The present study aimed to evaluate user's experiences and engagement with the design features of an internet-delivered treatment programme for anxiety.

Methods: Semi-structured interviews were conducted with 7 participant users of the Space from Anxiety programme. A thematic analysis framework was employed to analyse the data collected.

Results: Identified themes related to participants engagement and adherence with the programme material, participant's experience of personal development through interaction with the programme content and participants experience of the social features employed in the programme. Another theme investigated the various attributes or conditions necessary for internet-delivered therapy to be helpful to an individual.

Conclusion: Considering the experiences of users of online interventions provides insight into what works for whom both in terms of technological features and the various skills and strategies that may compose the treatment intervention. Knowing more about what design features and strategies/components of the intervention are attractive and keep users involved can only enhance the delivery of effective internet-delivered interventions for anxiety disorders.     

In the beginning: role of autonomy support on the motivation, mental health and intentions of participants entering an exercise referral scheme

Self-determination theory (Deci & Ryan, 2000, Intrinsic motivation and self-determination in human behaviour. New York: Plenum Publishing) highlights the impact autonomy supportive environments can have on exercise motivation and positive health outcomes. Yet little is known about whether differential effects occur as a function of which significant other is providing this support. Further, no research has examined the relationship between motivation and the social environment with participants' mental health and intentions to be physically active before entering an exercise intervention. Study participants were 347 British adults who were about to start an exercise referral scheme. Regression analyses revealed that the effects of autonomy support on mental health and physical activity intentions differed as a function of who provided the support (offspring, partner or physician), with the offspring having the weakest effects. A structural model was supported, indicating that autonomy support and more autonomous regulations led to more positive mental health outcomes and stronger intentions to be physically active. Knowledge of the social environmental and personal motivation of those about to commence an exercise programme can provide important insights for professionals supporting such efforts.     

Maternal Control of Girls Versus Boys: Relations to Empathy and Persuasive Style with Peers

We investigated relations between maternal control and girls’and boys’ concern for others. Fifty-six pairs of children were separately interviewed, using a newly developed measure of empathy. While mothers completed a parenting inventory, we videotaped children as one child attempted to convince a friend to make greeting cards for hospitalized children. High maternal control was associated with lower empathy and less interpersonally sensitive verbal persuasion, but only in girls.     

Treatment Effects for Common Outcomes of Child Sexual Abuse: A Current Meta-Analysis

The present meta-analysis examined the effects of psychosocial treatments at reducing deleterious outcomes of sexual abuse. The meta-analysis included a total of 35 published and unpublished studies written in English, focusing on youth under the age of 18, and evaluating the effectiveness of treatments for the most common negative outcomes of sexual abuse: PTSD symptoms, externalizing problems, and internalizing problems. Results revealed medium effect sizes for PTSD symptoms, externalizing problems, and internalizing problems following treatment for sexual abuse. This study also examined the potential moderating effects of treatment (e.g., modality, duration, inclusion of caregiver) and participant (e.g., age, gender, ethnicity) characteristics. Results indicated that longer interventions were associated with greater treatment gains while group and individual treatments were equally effective. These findings shed new light on treatment effectiveness and provide useful information regarding the conditions under which treatment may be most effective. Future directions for research in this area are discussed.     

The effect of fixation transitions on quiet eye duration and performance in the soccer penalty kick: instep versus inside kicks

Male goalkeepers of intermediate skill level attempted to stop penalty kicks executed with the instep and inside foot, in situ. A mobile eye tracker and an external camera were used to collect the gaze and motor behaviors of the goalkeepers, as well as the penalty takers’ motor behaviors and flight of the ball. Percent saves was greater during instep (28%) than inside foot kicks (12%), but we detected few differences in fixation frequency, location, duration, or transitions that could be attributed to the type of kick used. Fixation transitions (or the frequency of gaze shifts between locations) were significantly higher on goals than on saves. During the final phase of the kicking action, the quiet eye was located on the visual pivot and was longer during saves than goals. Furthermore, when the final fixation on the ball exceeded approximately 1,100 ms, then the likelihood of goals increased. The results are discussed in light of past studies in goaltending and the dual demands of motor tasks that require information be fixated both early and late at spatial locations that exceed the limits of focal vision.     

Facebook tells me so: applying the theory of planned behavior to understand partner-monitoring behavior on Facebook

The social networking site (SNS) Facebook is becoming increasingly recognized as a medium through which individuals can investigate and monitor others' activities. However, little is known about whether Facebook monitoring behavior occurs within romantic relationships and, accordingly, the psychological predictors of this behavior. The present study employed an extended theory of planned behavior (TPB) framework including self-esteem, partner trust, and demographic characteristics, to predict frequent Facebook partner-monitoring. Facebook users (N=244) in romantic relationships completed measures assessing the standard TPB constructs (attitude, subjective norm, and perceived behavioral control), additional predictor variables (self-esteem and partner trust), and demographic characteristics (age, gender, relationship length, daily Facebook logins, and time spent per login). One week later, participants reported their level of Facebook partner-monitoring during the previous week. Regression analyses supported the standard TPB constructs of attitude and subjective norm in predicting intentions to engage in frequent Facebook partner-monitoring, with intention, in turn, predicting behavior. Partner trust, but not self-esteem, significantly predicted frequent Facebook partner-monitoring intentions. Of the demographic characteristics, daily Facebook logins significantly predicted both intention and behavior and, unexpectedly, relationship length directly affected behavior. Overall, the current study revealed that frequent Facebook partner-monitoring is influenced by attitudinal, normative, and relational factors and, potentially, increased visits to Facebook. These findings provide a new understanding of an individual's use of the world's leading SNS to monitor their partner's activities and provide a foundation for future studies to investigate the potential negative implications this activity may have for those in romantic relationships.     

Preschool Depression: The Importance of Identification of Depression Early in Development

The empirical finding that school-aged children could suffer clinical depression refuted the widely held assumption that this age group would be too developmentally immature to experience depressive symptoms. Currently childhood depression is a well-recognized and widely treated clinical disorder. Following more recent developmental findings emphasizing the emotional sophistication of very young children, scientific studies have demonstrated that depression can arise early in life, during the preschool period of development. Preschool depression is characterized by typical symptoms of depression such as anhedonia; changes in sleep, appetite, and activity level; and excessive guilt. Further, longitudinal continuity of preschool depression into school age has been established, suggesting that preschool depression is an early manifestation of the later childhood disorder. Based on the known efficacy of early developmental intervention in a number of domains and disorders related to the greater neuroplasticity of the brain earlier rather than later in childhood, it is important to identify depression at the earliest possible point. Early intervention strategies for preschool depression that focus on enhancing emotional development are currently being tested.     

Subjective discriminability of invisibility: A framework for distinguishing perceptual and attentional failures of awareness

Conscious visual perception can fail in many circumstances. However, little is known about the causes and processes leading to failures of visual awareness. In this study, we introduce a new signal detection measure termed subjective discriminability of invisibility (SDI) that allows one to distinguish between subjective blindness due to reduction of sensory signals or to lack of attentional access to sensory signals. The SDI is computed based upon subjective confidence in reporting the absence of a target (i.e., miss and correct rejection trials). Using this new measure, we found that target misses were subjectively indistinguishable from physical absence when contrast reduction, backward masking and flash suppression were used, whereas confidence was appropriately modulated when dual task, attentional blink and spatial uncertainty methods were employed. These results show that failure of visual perception can be identified as either a result of perceptual or attentional blindness depending on the circumstances under which visual awareness was impaired.     

LGB-Affirmative Cognitive Behavioral Treatment for Social Anxiety: A Case Study Applying Evidence-Based Practice Principles

Guided by the American Psychological Association's principles of evidence-based practice, this article reviews a single-case treatment outcome study whereby a client characteristic, sexual identity, was integrated into the assessment and treatment of social anxiety symptoms. The case involved a young adult European-American male who presented to a training clinic with a primary diagnosis of social anxiety disorder as well as secondary symptoms of excessive worry and concerns of sexual identity confusion. Recent evidence suggests that gay men report more symptoms of social anxiety when compared to heterosexual men, and those who make more efforts to conceal their sexual identity experience increased anxiety and have greater difficulty committing to a personal identity. Further, it has been hypothesized that fear of rejection from heterosexual individuals underlies this anxiety. The client attended 50 sessions over the course of 18 months. Treatment progress was assessed via self-report questionnaires assessing social anxiety and worry. Consistent with principles of evidence-based practice, a cognitive behavioral treatment protocol was employed at the outset of therapy and resulted in a decline in the client's social anxiety scores. However, once the case conceptualization and treatment focus shifted to focus on sexual identity, his scores continued to decline at an even steeper rate. He ultimately came to identify himself as having a same-sex sexual orientation, began living his life in a manner consistent with that identification, and reported a number of positive outcomes at termination of therapy. Implications for treatment of social anxiety in sexual minorities are discussed.