Treating Procrastination Using Cognitive Behavior Therapy: A Pragmatic Randomized Controlled Trial Comparing Treatment Delivered via the Internet or in Groups

Procrastination is a common problem among university students, with at least half of the population reporting great difficulties initiating or completing tasks and assignments. Procrastination can have a negative impact on course grades and the ability to achieve a university degree, but can also lead to psychological distress. Cognitive behavior therapy (CBT) is believed to reduce procrastination, but few studies have investigated its effectiveness in a regular clinical setting. The current study explored its effects using a pragmatic randomized controlled trial comparing treatment delivered during 8 weeks as self-guided CBT via the Internet (ICBT) or as group CBT. In total, 92 university students with severe procrastination were included in the study (registered as a clinical trial on Clinicaltrials.gov: NCT02112383). Outcome measures on procrastination, depression, anxiety, and well-being were distributed at pre- and posttreatment as well as 6-month follow-up. An outcome measure of procrastination was administered weekly. Linear mixed and fixed effects models were calculated, along with improvement and deterioration rates. The results showed large within-group effect sizes on procrastination, Cohen’s d of 1.29 for ICBT, 95% Confidence Interval (CI) [0.81, 1.74], and d of 1.24 for group CBT, 95% CI [0.76, 1.70], and small to moderate benefits for depression, anxiety, and well-being. In total, 33.7% were regarded as improved at posttreatment and 46.7% at follow-up. No differences between conditions were observed after the treatment period, however, participants in group CBT continued or maintained their improvement at follow-up, while participants in self-guided ICBT showed some signs of deterioration. The findings from the current study suggest that CBT might be an effective treatment for those struggling with severe procrastination, but that a group format may be better for some to sustain their benefits over time and that the clinical significance of the results need to be investigated further.     

The Anxiety Depression Distress Inventory–27 (ADDI–27): New Evidence of Factor Structure,Item-Level Measurement Invariance,and Validity

Three studies examining the factor structure and psychometric properties of the Anxiety Depression Distress Inventory–27 (ADDI–27) extended the initial instrument development studies for this recently introduced inventory. The ADDI–27 is an empirically derived short form of the Mood and Anxiety Questionaire–90 (MASQ–90) comprising three scales: Positive Affect, Somatic Anxiety, and General Distress. The main objectives of Study 1 (N = 700) were to examine the factor structure of the ADDI–27 and its measurement invariance across gender at the item level. The objective of Study 2 (N = 538) was to examine evidence for the convergent and discriminant validity of scores on the ADDI–27. The objective of Study 3 (N = 240) was to assess further evidence for the nomological network and convergent and discriminant validity of the ADDI–27 scores. Results of exploratory structural equation modeling yielded strong support for a 3-factor model, with approximate fit indexes meeting or exceeding the conventional cutoffs. With p ≤ .001 as the criterion for detecting noninvariance, results of measurement invariance analysis suggested that all of the ADDI–27 items were invariant across gender. Results of multivariate validity analyses across 2 studies provided support for the convergent and discriminant validity of scores on the ADDI–27 scales.     

The Relationship Between Automatic Thoughts and Irrational Beliefs Predicting Anxiety and Depression

Cognitive behavioral approaches differ in their views on core cognitions and their hypothesized role in the etiology of depression and anxiety. The present study provides empirical evidence regarding the relationship between irrational beliefs and components of automatic thoughts and their role in the etiology of depression and anxiety. The present study utilized newer and improved questionnaires to assess components of irrational belief. Based on prior research by Safren et al. (Cogn Ther Res 24(3):327–344, 2000), a three-factor structure of the combined automatic thought questionnaires were utilized to measure components of automatic thoughts as they relate to depression and anxiety. Factor analytical methods were utilized to confirm the factor structure of the irrational beliefs and automatic thoughts components. Advanced path modeling was utilized to model the relationship between irrational beliefs and automatic thoughts in predicting anxiety and depression. The study used a sample of N = 542 undergraduate psychology students during stressful exam times. Results indicated that the irrational belief Demandingness represents a primary factor, followed by the secondary irrational beliefs as proposed by Rational Emotive Behavioral Theory. Selfdowning beliefs were fully mediated by depressive automatic thoughts in the case of depressive affect. Low frustration tolerance contributed unique variance to anxious and depressive affect that was not fully mediated by automatic thoughts. Results from the present study add empirical evidence that irrational beliefs indeed represent core and intermediary beliefs that lead to specific automatic thoughts, which is congruent with cognitive behavioral theory as proposed by Rational Emotive Behavioral Therapy.     

Kindergarteners' Narrative Competence Across Tasks and Time

The authors investigated children's narrative competence by analyzing the development of the reciprocal relationship between storytelling and story retelling performances over a school year through a cross-lagged panel design. The participants in this study were 170 Italian kindergarten pupils (M age = 4.98 ± 0.31 years). Children were asked to produce oral narratives in two different tasks: a storytelling and a story retelling task. Narrative competence was assessed in terms of structure and coherence. The cross-lagged panel analyses showed that both storytelling and story retelling tasks are stable constructs, but they differ in the emphasis on coherence. Data confirmed the pivotal role played by storytelling as a task, and structure as a component in fostering the development of children's narrative competence. Overall, results from this study suggest that storytelling and story retelling are tasks that involve interrelated but not overlapping processes, and trigger different aspects of narrative competence.     

Philosophical Idling and Philosophical Relativity

Peter Unger has challenged philosophical objectivism, the thesis that traditional philosophical problems have definite objective answers. He argues from semantic relativity for philosophical relativity, the thesis that for certain philosophical problems, there is no objective answer. I clarify, formulate and challenge Unger's argument. According to Unger, philosophical relativism explains philosophical idling, the fact that philosophical debates appear endless, philosophical disagreements seem irresolvable, and very little substantial progress seems made towards satisfactory and definite answers to philosophical problems. I argue, however, that the reality of philosophical idling is doubtful and, ironically, undermined by philosophical relativism. I then raise problems for several steps in Unger's argument for philosophical relativity. I conclude by arguing that philosophical relativism can avoid self‐defeat only by an ad hoc limitation of its scope. 1     

Hippocampal train stimulation modulates recall of fear extinction independently of prefrontal cortex synaptic plasticity and lesions

It has been shown that long-term potentiation (LTP) develops in the connection between the mediodorsal thalamus (MD) and the medial prefrontal cortex (mPFC) and between the hippocampus (HPC) and the mPFC following fear extinction, and correlates with extinction retention. However, recent lesion studies have shown that combined lesions of the MD and mPFC do not interfere with extinction learning and retention, while inactivation of the dorsal HPC disrupts fear extinction memory. Here we found in rats that immediate post-training HPC low-frequency stimulation (LFS) suppressed extinction-related LTP in the HPC-mPFC pathway and induced difficulties in extinction recall. HPC tetanus, applied several hours later, failed to re-establish mPFC LTP but facilitated recall of extinction. Delayed post-training HPC LFS also provoked mPFC depotentiation and difficulties with extinction recall. HPC tetanus abolished these two effects. We also found that damage to the mPFC induced fear return only in rats that received HPC LFS following extinction training. HPC tetanus also reversed this behavioral effect of HPC LFS in lesioned rats. These data suggest that the HPC interacts with the mPFC during fear extinction, but can modulate fear extinction independently of this interaction.