Is cognitive behavioural therapy effective in reducing suicidal ideation and behaviour when delivered face-to-face or via e-health? A systematic review and meta-analysis

Cognitive Behavioural Therapy (CBT) is a widely used psychotherapeutic intervention for suicide prevention despite its efficacy for suicide prevention in adults remaining ambiguous. Reluctance or inability to access face-to-face help suggests that e-health delivery may be a valuable resource for suicidal people. The aim of this study was to systematically review and conduct meta-analysis on research assessing the efficacy of CBT delivered via face-to-face and e-health for suicidal ideation and behaviour. A comprehensive literature search of MEDLINE, PsycINFO, Scopus, PubMed and The Cochrane Central Register of Controlled Trials was conducted. From 764 identified articles, 26 met the inclusion criteria for investigating CBT for suicidal ideation and behaviours in adult populations. Data were extracted on study characteristics and meta-analysis was performed where possible. There was a statistically significant, small to medium effect for face-to-face delivered CBT in reducing suicidal ideation and behaviour although there was significant heterogeneity between the included studies. CBT delivered via e-health was not found to be efficacious for reducing suicidal ideation and behaviour in adults though the number of studies reviewed was small.     

Relapse prevention for alcohol and drug problems: that was Zen, this is Tao

Relapse prevention, based on the cognitive-behavioral model of relapse, has become an adjunct to the treatment of numerous psychological problems, including (but not limited to) substance abuse, depression, sexual offending, and schizophrenia. This article provides an overview of the efficacy and effectiveness of relapse prevention in the treatment of addictive disorders, an update on recent empirical support for the elements of the cognitive-behavioral model of relapse, and a review of the criticisms of relapse prevention. In response to the criticisms, a reconceptualized cognitive-behavioral model of relapse that focuses on the dynamic interactions between multiple risk factors and situational determinants is proposed. Empirical support for this reconceptualization of relapse, the future of relapse prevention, and the limitations of the new model are discussed.     

Perceptions of the social and personal characteristics of hypermuscular women and of the men who love them

A predominately European American sample of middle class college students rated hypermuscular female bodybuilders and the men who were romantically involved with them on measures of perceived gender traits, personality traits, social behaviors, and heterosexual behaviors. Participants perceived hypermuscular women, as compared to the average woman, as having more masculine and fewer feminine interests, less likely to be good mothers, and less intelligent, socially popular, and attractive. However, participants also perceived them as being less likely to engage in socially deviant behaviors or to be sexually manipulative and more likely to be extraverted, conscientious, and open to new experiences than the average woman. Participants perceived men who are romantically involved with hypermuscular women as having stronger masculine traits, interests, and identities than the average man. The authors found no relationships between the perceiver's gender type and his or her perceptions of hypermuscular women or the men who were romantically involved with them.     

Detecting state and trait anxiety from auditory and visual cues: a meta-analysis

Observers' ability to detect state anxiety and trait anxiety in others was evaluated in a meta-analysis that also included a critical moderator variable, communication channel. The overall effect size (r) for accuracy was .39 for the 46 state anxiety studies and .26 for the 34 trait anxiety studies. However, the effect of communication channel was very substantial in magnitude and highly significant; it also interacted with the type of anxiety. State anxiety was correctly identified more often from audio-only stimuli (M r = .49) compared with video-only cues (r = .24), whereas the opposite was true for trait anxiety, where video-only cues resulted in greater accuracy (r = .31) compared with audio-only stimuli (r = .05). Results indicated that the moment-to-moment change in emotion (state anxiety) may be better communicated with vocal/verbal stimuli, whereas more stable features of personality (trait anxiety) may be more apparent from body and facial cues.     

Multicultural competency in research: examining the relationships among multicultural competencies, research training and self-efficacy, and the multicultural environment

Research on multicultural competencies has mainly focused on the practice dimension of psychology training and practice. Little theoretical or empirical research has examined multicultural research training and self-efficacy. In this study, 119 psychology graduate students filled out a Web survey focusing on the research training environment, research self-efficacy, multicultural competency, the multicultural environment, and social desirability. Results showed that multicultural competency, research training, and the multicultural environment were related to multicultural research self-efficacy. Hierarchical regressions showed that multicultural competency predicted students' research anxiety; social desirability predicted multicultural research utility, multicultural competency, and the research training environment; and multicultural competency predicted students' confidence in research and perceptions that their graduate training programs were multicultural. Implications are discussed.     

Continuity and change in the life story: a longitudinal study of autobiographical memories in emerging adulthood

If a person's internalized and evolving life story (narrative identity) is to be considered an integral feature of personality itself, then aspects of that story should manifest some continuity over time while also providing evidence regarding important personality change. Accordingly, college freshmen and seniors provided detailed written accounts of 10 key scenes in their life stories, and they repeated the same procedure 3 months and then 3 years later. The accounts were content analyzed for reliable narrative indices employed in previous studies of life stories: emotional tone, motivational themes (agency, communion, personal growth), and narrative complexity. The results showed substantial continuity over time for narrative complexity and positive (vs. negative) emotional tone and moderate but still significant continuity for themes of agency and growth. In addition, emerging adults (1) constructed more emotionally positive stories and showed (2) greater levels of emotional nuance and self-differentiation and (3) greater understanding of their own personal development in the 4th year of the study compared to the 1st year. The study is the first to demonstrate both temporal continuity and developmental change in narrative identity over time in a broad sampling of personally meaningful life-story scenes.     

Tempting today, troubling tomorrow: the roots of the precarious couple effect

The precarious couple effect occurs when men pair with women who are both critical and more verbally disinhibited than them. Evidence that dissatisfaction runs high in such relationships makes one ask why people enter them in the first place. In Study 1, respondents recalled that past partners who were verbally disinhibited were relatively active in initiating the relationship. In Study 2, verbally inhibited men evidenced ambivalence in that they disliked disinhibited women more than inhibited ones but these feelings of disliking did not translate into expectations of feeling tense during the interaction. Study 3 revealed that initial interactions between inhibited men and disinhibited women go smoothly unless (a) the women are critical and (b) the pair discusses a stressful topic. The authors suggest that members of precarious couples are drawn to one another because, in initial encounters, their communication styles are relatively symbiotic. Alas, this initial chemistry does not always endure.     

Interpersonal precipitants and suicide attempts in borderline personality disorder

Borderline personality disorder (BPD) is often characterized by multiple low lethality suicide attempts triggered by seemingly minor incidents, and less commonly by high lethality attempts that are attributed to impulsiveness or comorbid major depression. The relationships among life events, impulsiveness, and type of suicidal behavior has hardly been studied in BPD and mood disorders. This study compared depressed attempters with and without BPD to identify specific suicide precipitants and risk factors in BPD and their relationship to severity of suicidal behavior. Attempters with comorbid BPD and major depressive disorder (MDD) had a higher number of lifetime suicide attempts; made their first attempt at a younger age; reported more interpersonal triggers; and had higher levels of lifetime aggression, hostility, and impulsivity, compared with attempters with major depression only. Environmental triggers of attempts in BPD are more likely to be interpersonal stressors. Lethality of attempts in BPD plus MDD is equal to that in MDD only, indicating that the seriousness of precipitants is unrelated to the lethality of the suicidal behavior. The differences between groups suggest that risk assessment and treatment should target both depression and personality disorder in those with combined illness.     

The warpy thoughts scale: a new 20-item instrument to measure dysfunctional attitudes

Cognitive theories of psychopathology propose that specific negative cognitive schema held by individuals can increase their likelihood of experiencing depressive episodes. While it has been argued that such dysfunctional attitudes are state measures that occur primarily during periods of depression, a range of research has supported the view that holding dysfunctional attitudes is ongoing, persisting prior to and following depressive episodes. To date, the need for a parsimonious measure of dysfunctional attitudes has not been well addressed. Using data provided by 4545 participants in a free on-line cognitive behavioural therapy program, MoodGYM, we have developed the Warpy Thoughts Scale (WTS), a 20-item instrument measuring dysfunctional attitudes. This scale provides 3 first order factors (Relationships, Achievements and Entitlements) and a higher order factor, Warpy Thoughts, from which a Warpy Thoughts score can be obtained. Confirmatory factor analyses on this model indicated that it provides robust results for men and women and for individuals in a wide range of ages. WTS scores were moderately correlated with levels of depressive and anxiety symptoms (0.39 and 0.40, respectively) and explained up to one-fifth of the variance of these mental health measures. Further validation of the WTS against other measures of dysfunctional thoughts is required.     

Construct validity of the misrepresentation scales of the psychological screening inventory

This study provides construct validity evidence and reliabilities (consistency and stability) for 5 misrepresentation (response distortion) scales of the Psychological Screening Inventory (PSI; Lanyon, 1970, 1973, 1978) in assessing 3 constructs: exaggeration of psychopathology, exaggeration of personal virtue, and exaggeration of health problems. Using data from forensic cases, the existence and independence of these 3 constructs were confirmed in data from the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and the Balanced Inventory of Desirable Responding (Paulhus, 1986, 1991). The PSI scales were then shown to load highly on these constructs. The PSI scales also showed the expected patterns when their mean scores were examined for 15 sets of responses from participant groups with varied motivations to misrepresent. We present receiver operating characteristic data to show the success of the scales in distinguishing between simulators and appropriate comparison groups. Using the same data, we also present classification accuracy in terms of positive predictive power and negative predictive power based on a sensitivity level of 90% and misrepresentation base rates of .20 and .10.