Increased wait-list time predicts dropout from outpatient enhanced cognitive behaviour therapy (CBT-E) for eating disorders

Between 30 and 70% of patients with eating disorders drop out from outpatient treatment. However, research has been unable to identify factors that consistently predict dropout from eating disorder treatment. Most studies have exclusively investigated the role that individual patient characteristics play in dropout and have ignored more process-based factors such as expectations about treatment, the therapeutic alliance, or time spent on a treatment waiting list. This study aimed to investigate the roles of both individual patient characteristics and process-based factors in dropout from outpatient treatment for eating disorders. The study involved data collected from consecutive eating disorder referrals to the only public specialist eating disorder service for youth and adults in Perth, Western Australia. The standard treatment provided at this service is Enhanced Cognitive Behaviour Therapy on an individual basis. The study involved 189 patients referred to the service between 2005 and 2010. Forty five percent of this sample dropped out of treatment. Results showed that, in this sample, two individual factors, lowest reported weight and the tendency to avoid affect, and one process-based factor, time spent on the wait list for treatment, were significant predictors of dropout. These findings are valuable because a process-based factor, such as wait-list time, may be easier to address and modify than a patient's weight history or the trait of mood intolerance. Increased resources for eating disorder services may reduce waiting list times which would help to reduce dropout and maximize treatment outcomes.     

Assessing the prevalence of mental health disorders and mental health needs among preschool children in care in England

Although school‐aged children living in foster care have been identified as a high‐risk group for mental health and developmental disorders, there is a paucity of data relating to preschool children in care (CIC). This study aimed to identify the prevalence of mental health and developmental disorders along with corresponding need for interventions in preschool CIC. All CIC aged 0 to 5 years in an inner city local authority underwent comprehensive, multifaceted assessments consisting of the Ages and Stages Questionnaire (J. Squires, D. Bricker, & E. Twombly, 2003), interviews with caregivers based on the Preschool Age Psychiatric Assessment (H.L. Egger & A. Angold, 2006), Mullen Scales of Early Learning (E.M. Mullen, 1995 ), and systematic clinical observation. Of 58 eligible preschoolers, 43 completed the assessment. At least one mental health disorder was found in 26 (60.5%) participants, and at least one developmental disorder was found in 11 (25.6%). When mental health and/or developmental disorders were considered together, 30 (69.8%) preschoolers fulfilled criteria for at least one diagnosis, and 18 (41.9%) had two or more comorbid conditions. Whereas 36 (83.7%) of the preschoolers needed an intervention, only 3 of these had received adequate input. In conclusion, preschool CIC constitute a high‐risk group for mental health and developmental disorders. Without age‐appropriate assessments, their needs go undetected, and opportunities for early intervention are being missed.     

Emotional signals in nonverbal interaction: dyadic facilitation and convergence in expressions, appraisals, and feelings

We examined social facilitation and emotional convergence in amusement, sadness, and fear in dynamic interactions. Dyads of friends or strangers jointly watched emotion-eliciting films while they either could or could not communicate nonverbally. We assessed three components of each emotion (expressions, appraisals, and feelings), as well as attention to and social motives toward the co-participant. In Study 1, participants interacted through a mute videoconference. In Study 2, they sat next to each other and either were or were not separated by a partition. Results revealed that facilitation and convergence are not uniform across different emotions and emotion components. Particularly strong supporting patterns emerged for the facilitation of and convergence in smiling. When direct interaction was possible (Study 2), friends showed a general tendency for strong convergence, with the exception of fear-related appraisals. This suggests that underlying processes of emotional contagion and social appraisal are differentially relevant for different emotions.     

Reasons for substance use among people with psychotic disorders: method triangulation approach

Substance use disorders (SUD) are common among people with psychotic disorders and are associated with many negative consequences. Understanding the reasons for substance use in this population may allow for the development of more effective prevention and intervention strategies. We examined reasons for tobacco, alcohol, or cannabis use among people with psychotic disorders. Sixty-four participants with a diagnosed psychotic disorder completed a self-report reasons for use questionnaire. A subset of eight participants completed semi-structured qualitative interviews. Both the qualitative and quantitative data indicated that reasons for use of tobacco, alcohol, and cannabis differed considerably. Tobacco was primarily used for coping motives, alcohol for social motives, and cannabis for pleasure enhancement motives. Prevention and intervention strategies targeting coexisting psychotic disorders and SUD may improve in effectiveness if they address the perceived beneficial effects of tobacco use, the strong social pressures influencing alcohol use and if they encourage cannabis users to seek alternative pleasurable activities.     

Child Sleep Problems and Parental Depression: Testing a Risk and Resistance Model

Although extensive studies demonstrate a link between infant sleep problems and parental depression, limited research explores this relation in parents of primary school aged children. Using cross-sectional data, we investigated direct, moderating and mediating risk and resistance factors in the relation between child sleep problems and parental depressive symptomatology in a sample of 145 Australian parents of primary school aged children. Parents completed the children’s sleep habits questionnaire, the short temperament scale for children, the perceived stress scale and the depression sub-scale of the depression, anxiety and stress–short form. Correlational analyses confirmed bivariate relations between parental stress and parental depressive symptomatology, and between child sleep problems and parental depressive symptomatology. Multiple regression analyses identified parental stress as a mediator of the relation between child sleep problems and parental depressive symptomatology, and the approach component of child temperament as a moderator of the relation between child sleep problems and parental depressive symptomatology. Findings suggest that parents of children with sleep problems experience increased stress levels and increased levels of depressive symptomatology and may be at increased risk of depression if their child has a difficult temperament characterized by low approachability. Implications for clinical intervention and future research are discussed.     

Auditory hindsight bias

People who know the outcome of an event tend to overestimate their own prior knowledge or others' na?ve knowledge of it. This hindsight bias pervades cognition, lending the world an unwarranted air of inevitability. In four experiments, we showed how knowing the identities of words causes people to overestimate others' na?ve ability to identify moderately to highly degraded spoken versions of those words. We also showed that this auditory hindsight bias occurs despite people's efforts to avoid it. We discuss our findings in the context of communication, in which speakers overestimate the clarity of their message and listeners overestimate their understanding of the message.     

Investigating the true rate of physical intimate partner violence: A review of nationally representative surveys

This review systematically investigates rates of physical intimate partner violence for both sexes in international samples. Surveys that accessed nationally representative samples, used gender inclusive methodology and neutral contexts are reviewed to determine 12-month and lifetime victimization and perpetration rates. Discrepancies between international rates, and the impact that gender equality may have upon these differences is also investigated. Electronic databases were systematically searched to identify surveys that met inclusion criteria. Eleven surveys were reviewed. Of these, Family Violence surveys had the highest methodological quality and showed equal rates for both sexes. Surveys of lesser quality typically showed higher female victimization and male perpetration rates. Countries at the extremes of gender empowerment measure scores differed in their patterns of rates. Gender equality in the US was associated with symmetry for the sexes, and inequality in Uganda associated with higher female victimization. However, as countries tended to use different methods to investigate the problem it was not possible to compare the effects of gender equality on differences in international rates of IPV. It is concluded that survey methodology needs to be consistent across nations, and specifically target family violence if true rates are to be determined and compared across the globe.     

The role of affect in attitudes toward organ donation and donor-relevant decisions

We argue that affect plays a vital role in attitudes toward organ donation and that reluctance to become an organ donor is likely to be related to the experience of affective ambivalence. Assessing the affect associated with organ donation could help to predict donor-relevant decisions. Results of a confirmatory factor analysis on 464 students showed that affective evaluations can be distinguished both from cognitive evaluations and from overall evaluations. As expected, affective evaluations revealed ambivalence (using the ‘Griffin’ measure of ambivalence) toward organ donation, whereas the two other types of evaluations did not. Results of a follow-up study using logistic regression (n?=?85), showed that affective evaluations predicted donor-relevant decisions six months later. The present findings support the proposal to include separate affective evaluations in measures of attitudes to organ donation. More general implications for the measurement and structure of attitudes in health related domains are discussed.     

Do increases in physical activity encourage positive beliefs about further change in the ProActive cohort?

Effects of behaviour change on cognitions are rarely examined within the Theory of Planned Behaviour. We tested whether increases in physical activity resulted in more positive beliefs about further change among a cohort of sedentary adults participating in a behavioural intervention trial (ProActive). At baseline, 6 and 12 months, 365 adults completed questionnaires assessing physical activity and cognitions about becoming more active over the coming year. Objective activity was assessed at baseline and 12 months. Participants reporting larger increases in activity were no more positive about making further increases than those reporting less behaviour change (p-values > 0.05). Participants with larger increases in objective activity reported weaker perceived control (β?=??0.342; p?=?0.001) and more negative instrumental attitudes (β?=??0.230; p?=?0.017) at 12 months. Participants may have felt that they had changed enough or measures of perceived success may be more sensitive to behaviour change. Alternatively, long measurement intervals may have missed immediate cognitive and affective consequences of behaviour change, or such effects may require participants to consistently self-monitor or receive feedback on performance. Future studies could test the effect of such techniques on physical activity and a wider range of cognitive, affective and physiological consequences, using more frequent measurement intervals.     

Spiritual Suffering from Medieval German Mysticism to Mother Teresa: A Psycholinguistic Analysis

Two computer programs, SSWC (Sundararajan-Schubert Word Count) and LIWC (Linguistic Inquiry and Word Count), were used in combination to analyze the texts of 3 religious writers—one true mystic (Johannes Tauler), one false mystic (Thomas Müntzer) from medieval German Christianity, and one modern “saint,” Mother Teresa (Warren, 2010 Warren , R. ( 2010 , Aug. 31 ). Introduction . In D. Van Biema & R. Lacayo (Eds.), Mother Teresa at 100/The life and works of a modern saint (pp. 6 – 7 ). New York , NY : TIME Books .[Crossref] , [Google Scholar], p. 7). Results suggest that reflections on spiritual suffering that loom large in both medieval German mysticism and Mother Teresa constitute an adaptive approach to negative emotions, so far unexplored. Implications for research on negative religious coping, and adaptive versus maladaptive reflections on negative emotions will be discussed.