Acceptability,Feasibility, and Effectiveness of Internet-Based Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder in New York

Cognitive-behavioral therapy (CBT), consisting of exposure and response prevention (EX/RP), is both efficacious and preferred by patients with obsessive–compulsive disorder (OCD), yet few receive this treatment in practice. This study describes the implementation of an Internet-based CBT program (ICBT) developed in Sweden in individuals seeking OCD treatment in New York. After translating and adapting the Swedish ICBT for OCD, we conducted an open trial with 40 adults with OCD. Using the RE-AIM implementation science framework, we assessed the acceptability, feasibility, and effectiveness of ICBT. The Yale–Brown Obsessive Compulsive Scale (Y-BOCS) was the primary outcome measure. Of 40 enrolled, 28 participants completed the 10-week ICBT. In the intent-to-treat sample (N = 40), Y-BOCS scores decreased significantly over time (F = 28.12, df = 2, 49, p < . 001). Depressive severity (F = 5.87, df = 2, 48, p < . 001), and quality of life (F = 12.34, df = 2, 48, p < . 001) also improved. Sensitivity analyses among treatment completers (N = 28) confirmed the intent-to-treat results, with a large effect size for Y-BOCS change (Cohen’s d = 1.38). ICBT took less time to implement than face-to face EX/RP and participants were very to mostly satisfied with ICBT. On a par with results in Sweden, the adapted ICBT program reduced OCD and depressive symptoms and improved quality of life among individuals with moderate to severe OCD. Given its acceptability and feasibility, ICBT deserves further study as a way to increase access to CBT for OCD in the United States.     

Improved Parent Cognitions Relate to Immediate and Follow-Up Treatment Outcomes for Children With ADHD-Predominantly Inattentive Presentation

We investigated treatment effects on parenting self-efficacy and parent cognitive errors, and whether these parent cognitions are related to short- and long-term outcomes in parenting behaviors in psychosocial treatment for youth with attention-deficit/hyperactivity disorder, predominantly inattentive presentation (ADHD-I). In a randomized controlled trial across two sites (University of California, San Francisco, and University of California, Berkeley), 199 children between the ages of 7 and 11 were randomized to the Child Life and Attention Skills (CLAS; n = 74) program, parent-focused treatment (PFT; n = 74), or treatment as usual (TAU; n = 51). Parents reported on self-efficacy, cognitive errors, positive parenting, and negative parenting prior to treatment, immediately after treatment, and in the next school year at follow-up. Compared to TAU, CLAS and PFT had higher posttreatment parenting self-efficacy, and CLAS alone had lower posttreatment parent cognitive errors. At follow-up, only CLAS had improved parent cognitive errors compared to TAU. No other between-group differences were found in parenting self-efficacy or cognitive errors. Improved parenting self-efficacy was associated with improved posttreatment negative parenting outcomes for PFT and CLAS, and improved parent cognitive errors were also related to improvements in positive and negative posttreatment parenting outcomes for CLAS. Posttreatment parenting self-efficacy mediated follow-up negative parenting outcomes for CLAS and posttreatment parent cognitive errors mediated improved follow-up positive and negative parenting outcomes for CLAS. PFT and CLAS led to enhanced parenting self-efficacy, and CLAS appears especially robust in improving parent cognitive errors both in the short and long term. Pathways provide support for the possibility of parent cognitions as mediators of treatment effects on parenting; clinical focus on such cognitions may be useful.     

Facial expressions as performances in mime

That facial expressions are universal emotion signals has been supported by observers agreeing on the emotion mimed by actors. We show that actors can mime a diverse range of states: emotions, cognitions, physical states, and actions. English, Hindi, and Malayalam speakers (N?=?1200) viewed 25 video clips and indicated the state conveyed. Within each language, at least 23 of the 25 clips were recognised above chance and base rate. Facial expressions of emotions are not special in their recognisability, and it is miming that may be the universal human ability.     

The everyday dynamics of rumination and worry: precipitant events and affective consequences

ABSTRACT

Rumination and worry are two perseverative, negatively valenced thought processes that characterise depressive and anxiety disorders. Despite significant research interest, little is known about the everyday precipitants and consequences of rumination and worry. Using an experience sampling methodology, we examined and compared rumination and worry with respect to their relations to daily events and affective experience. Participants diagnosed with Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), co-occurring MDD–GAD, or no diagnosis carried an electronic device for one week and reported on rumination, worry, significant events, positive affect (PA), and negative affect (NA). Across the clinical groups, occurrences of everyday events predicted subsequent increases in rumination, but not worry. Further, higher momentary levels of rumination, but not worry, predicted subsequent decreases in PA and increases in NA. Thus, in these clinical groups, rumination was more susceptible to daily events and produced stronger affective changes over time. We discuss implications for theory and clinical intervention.     

The relations between cognitive ability and personality: Convergent results across measures

Several studies have investigated the relations between cognitive ability and Big Five personality constructs. The present study extended previous research by (a) examining these relationships in large samples (total N = 120,014), (b) including several measures of cognitive ability and personality, (c) examining both domain and facet-level personality scores, (d) expanding the personality domains studied to include Machiavellianism, and (e) correcting the observed correlations for range restriction and reliability to provide a better statistical estimate of the relations between the cognitive and personality scores and constructs. Results were consistent with prior research showing a positive relationship between cognitive ability and Openness and negative relationships between cognitive ability and Neuroticism and Conscientiousness. Negative relations between cognitive ability and Extraversion and Agreeableness also were observed. Machiavellianism, not part of the Big Five was found to have a positive correlation with cognitive ability. Of particular interest was the finding that the relations between cognitive ability and personality were affected by the specific content of the cognitive and personality measures. Cognitive measures with verbal content were more strongly correlated with personality than were cognitive measures with math or nonverbal content for all of the samples. Also, there was considerable variability in the cognitive-personality correlations for the facets underlying each personality domain. The variability in correlations at the facet-level implies that cognitive-personality relationships at the domain-level will vary as a function of the specific content of the cognitive and personality measures. Overall, the results provide support for cognitive-personality association at the measurement level.     

Reducing behavioural risk factors for cancer: An affect regulation perspective

Nearly half of all cancer deaths are attributable to preventable causes, primarily unhealthy behaviours such as tobacco use, alcohol use and overeating. In this review, we argue that people engage in these behaviours, at least in part, as a means of regulating their affective states. To better understand why people engage in these behaviours and how researchers might design interventions to promote the selection of healthier methods for regulating affect, we propose a conceptual model of affect regulation. We synthesise research from both the stress and coping tradition as well as the emotion and emotion regulation tradition, two literatures that are not typically integrated. In so doing, we indicate where researchers have made headway in understanding these behaviours as affect regulation and note how our model could be used to structure future work in a way that would be particularly advantageous to cancer control efforts.     

Reactionary Deconversion from Mormonism: Polarization of Ideological and Behavioral Religiosity Among Active and Former Mormons

In contrast to a growing body of literature examining the experiences and trends of those who leave their faith tradition—particularly among Christian denominations—relatively little is known about those who specifically disaffiliate from Mormonism, although some evidence suggests that former Mormons may be especially likely to embrace secularity or irreligion rather than other religious beliefs and practices. Pursuant to empirically investigating this reactionary dynamic, the current study compared the relative religiosity and secularity of an online sample of active Mormons (n?=?194) and former Mormons (n?=?109) using the Abbreviated Religiousness Measure (ARM), an updated questionnaire of multidimensional religiosity. Results supported the ARM’s improved psychometrics and its hypothesized three-factor structure with both subsamples. Additionally, multivariate and univariate results indicated that active and former Mormon participants from our sample, significantly polarized in their self-reported level of religious beliefs, rituals, and influence on daily behaviors, with active Mormon reporting high religiosity and former Mormons reporting low religiosity or high secularity. Although these results comport with reactionary deconversion dynamics found in other high cost religions, limits to generalizability are discussed. Reasons for and implications of this reactionary phenomenon are also posited.     

On an Observer’s Reaction to Hearing of Someone Harming Him or Herself

Anthropological studies in India inspired the idea of a distinct domain of moral purity, but a precise characterization of that domain has been elusive. One proposal based on current theorizing in psychology is that prototypical purity violations are self-harming actions, which are perceived as disgusting and immoral whether done accidentally or intentionally. In three studies (Ns?=?400, 80, 132), we examined judgments of self-harming actions in two cultural groups—American and Indian. There was little support for the proposed characterization of the purity domain: Self-harms were slightly to modestly immoral for Indians and Americans. Both Indians and Americans found self-harms to be sad, not disgusting. And intentionality influenced how immoral and how sad the action was judged. Instead, the findings supported a view that all immorality, including those concerning self-harm, depends on perceived harm.