Treatment preference, engagement, and clinical improvement in pharmacotherapy versus psychotherapy for depression

Pharmacotherapy and psychotherapy are generally effective treatments for major depressive disorder (MDD); however, research suggests that patient preferences may influence outcomes. We examined the effects of treatment preference on attrition, therapeutic alliance, and change in depressive severity in a longitudinal randomized clinical trial comparing pharmacotherapy and psychotherapy. Prior to randomization, 106 individuals with MDD reported whether they preferred psychotherapy, antidepressant medication, or had no preference. A mismatch between preferred and actual treatment was associated with greater likelihood of attrition, fewer expected visits attended, and a less positive working alliance at session 2. There was a significant indirect effect of preference match on depression outcomes, primarily via effects of attendance. These findings highlight the importance of addressing patient preferences, particularly in regard to patient engagement, in the treatment of MDD.     

Comparing standardized coefficients in structural equation modeling: a model reparameterization approach

We propose a two-stage method for comparing standardized coefficients in structural equation modeling (SEM). At stage 1, we transform the original model of interest into the standardized model by model reparameterization, so that the model parameters appearing in the standardized model are equivalent to the standardized parameters of the original model. At stage 2, we impose appropriate linear equality constraints on the standardized model and use a likelihood ratio test to make statistical inferences about the equality of standardized coefficients. Unlike other existing methods for comparing standardized coefficients, the proposed method does not require specific modeling features (e.g., specification of nonlinear constraints), which are available only in certain SEM software programs. Moreover, this method allows researchers to compare two or more standardized coefficients simultaneously in a standard and convenient way. Three real examples are given to illustrate the proposed method, using EQS, a popular SEM software program. Results show that the proposed method performs satisfactorily for testing the equality of standardized coefficients.     

Effects of Internet use on college students' political efficacy.

This study examines the relationship between three types of Internet use (information, entertainment, and interactive contacts) and two types of political efficacy (external and internal) among U.S. college students. Information related Internet use and interactive contacts predict college students' internal political efficacy. An unexpected finding was that visiting public agency sites negatively influenced college students' external political efficacy. This implies that the quality of current public sites is below the expectation of college students and that respondents who visited those sites might develop political cynicism. This study also reveals that online news sites are becoming a primary news source for college students.     

The dynamics of success and failure: how post-behaviour evaluations relate to subsequent exercise intentions and behaviour

Objective: Exercise behaviour change involves multiple experiences with success and failure. The Model of Action Phases (MAP) offers a dynamic account of how success and failure influence both immediate evaluations and future decisions and actions. However, predictions from the MAP have not been formally tested.

Design: A longitudinal daily diary study was used to examine how post-behaviour evaluations of exercise success and failure influence subsequent exercise intentions and behaviour. Participants (N = 104) set exercise goals, and then kept a daily online exercise diary for four weeks.

Main outcome measures: Participants self-reported exercise behaviour, affective response to exercise, self-evaluations after success or failure at following through on intentions to exercise, and intentions to exercise in the next week.

Results: Multilevel modelling revealed significant within- and between-participant relationships among post-behaviour evaluations, intentions and subsequent behaviour. Findings supported MAP-derived predictions about how success and failure at exercise are associated with feelings about exercise and the self, and inform subsequent exercise intentions and behaviour.

Conclusion: Positive post-behaviour evaluations of success or failure may stabilise positive intentions and aid maintenance of exercise behaviour. Implications of these MAP-based findings for intervention design are discussed.     

Becoming a Male Client of Compensated Dating

This study explores men’s experiences in compensated dating (CD), particularly their process of becoming a client of CD in Hong Kong. By drawing on 30 individual interviews with male clients, cyber-ethnography of a major CD on-line forum, informal conversations with CD participants, off-line participant observations, and the sparse literature available on this under-examined social phenomenon, we also analyze men’s subjective understandings of being a client, of CD providers, and of CD itself, which influence men’s CD experiences and condom use behavior. Finally, this study sheds light on the contemporary issues of masculinity and sexuality in Hong Kong.     

Effect of collectivistic cultural imperatives on Asian American meta-stereotypes

The present study explored self-perceptions and meta-stereotypes along two dimensions, individuation and sociability, within a sample of Asian American and European American students. For both ethnic groups, meta-stereotypes in dimensions of individuation and sociability appear to be exaggerated forms of self-perceptions along these dimensions. Both Asian and European Americans distinguish between self-perceptions of sociability and individuation, showing that sociability and individuation are two independent constructs. Asian Americans, however, perceived that others who expect a certain level of sociability from their ethnic group would also expect the same level of individuation. Implications of these findings for the perpetuation of Asian stereotypes are discussed.     

Assessing body image in patients with systemic sclerosis (scleroderma): validation of the adapted Satisfaction with Appearance Scale

People with scleroderma often experience disfiguring appearance-related changes in socially visible and interpersonally salient areas. Although disfigurement can lead to body image dissatisfaction, this phenomenon has not been well investigated due to the lack of a disfigurement-specific measure. The Satisfaction With Appearance (SWAP) scale, previously developed in burn survivors, was adapted and administered to 254 participants with scleroderma to evaluate its psychometric integrity and its validity for use in a different medical population that experiences changes in appearance. Principal component analysis revealed two factors – Subjective Dissatisfaction and Perceived Social Impact – rather than the four found in burn victims. Excellent estimates of internal consistency and temporal stability and strong evidence for the reliability of the two-factor solution were found. The resulting factor structure in a scleroderma population suggests that differing medical conditions may create alternate constellations of BID, reflects the need for body image researchers to assess psychometrics across medical populations and may have clinical implications for BID interventions.     

Think, blink or sleep on it? The impact of modes of thought on complex decision making

This paper examines controversial claims about the merit of "unconscious thought" for making complex decisions. In four experiments, participants were presented with complex decisions and were asked to choose the best option immediately, after a period of conscious deliberation, or after a period of distraction (said to encourage "unconscious thought processes"). In all experiments the majority of participants chose the option predicted by their own subjective attribute weighting scores, regardless of the mode of thought employed. There was little evidence for the superiority of choices made "unconsciously", but some evidence that conscious deliberation can lead to better choices. The final experiment suggested that the task is best conceptualized as one involving "online judgement" rather than one in which decisions are made after periods of deliberation or distraction. The results suggest that we should be cautious in accepting the advice to "stop thinking" about complex decisions.     

Helping Yourself before Helping Others: How Sense of Control Promotes Charitable Behaviors

This research elucidates the conditions under which distress appeals can evoke the instinct to help without turning recipients away from uncomfortable situations. Five experiments demonstrated with behavioral evidence that evoking a sense of control by irrelevant causes prior to appeal exposure can increase the likelihood of registering as a volunteer (Studies 1 and 3) and the tendency to donate (Studies 2, 4, and 5) in a subsequent unrelated situation. The authors found that this effect was not evident in the absence of distress and for participants with enhanced distress tolerance. The results further showed that enhanced control increased distress tolerance, which mediated the observed effect on charitable acts but had no impact on self‐efficacy in contributing as a helper. The findings have both theoretical and managerial implications for promoting charitable behaviors.     

A Sociocultural Approach to Narcissism: The Case of Modern China

Using large Internet samples, we examined the possible influence of sociodemographic factors on the Chinese self‐concept and in particular, on the level of narcissism. We found that (i) younger persons are more narcissistic than older ones; (ii) persons from higher socioeconomic classes are more narcissistic than those from lower socioeconomic classes; (iii) persons from only‐child families are more narcissistic than those from families with multiple children; (iv) persons from urban areas are more narcissistic than those from rural areas; and (v) individualistic values are predictive of individual differences in narcissism. The findings suggest that sociocultural changes contribute to the rise of narcissism in China. Copyright © 2011 John Wiley & Sons, Ltd.