Internet-Based Acceptance and Commitment Therapy: A Transdiagnostic Systematic Review and Meta-Analysis for Mental Health Outcomes

Internet-based acceptance and commitment therapy (iACT) primarily targets the process of psychological flexibility. Its accessibility and low-intensity delivery are applicable across different treatment and prevention scenarios. This transdiagnostic meta-analysis reviews the effectiveness of iACT on anxiety, depression, quality of life, and psychological flexibility across individuals with different psychological and somatic conditions/complaints, or undiagnosed complaints. Seven databases were searched for randomized controlled trials that reported on anxiety, depression, quality of life, and psychological flexibility outcomes from iACT in any adult population. Engagement with iACT was summarized and methodological and population-related variables were investigated as potential moderators of effectiveness. Across 25 studies, small pooled effects were found for all outcomes at post-assessment and maintained at follow-up time-points. Interventions with therapist guidance demonstrated greater effectiveness in improving depression and psychological flexibility outcomes compared to nonguided iACT, and populations defined by a psychological condition or symptoms (e.g., depressed samples) demonstrated greater improvements in anxiety compared to nonclinical or somatic populations (e.g., chronic pain samples or students). Participants completed on average 75.77% of iACT treatments. While we found iACT to be effective in improving and maintaining mental health outcomes across diverse populations, there was limited evidence of reliable, clinically significant effects. PROSPERO registration number: CRD42020140086.     

Defining the Assessment and Treatment Competencies to Deliver Low-Intensity Cognitive Behavior Therapy: A Multi-Center Validation Study

Despite the vastly increased dissemination of the low-intensity (LI) version of cognitive behavior therapy (CBT) for the treatment of anxiety and depression, no valid and reliable indices of the LI-CBT clinical competencies currently exist. This research therefore sought to develop and evaluate two measures: the low-intensity assessment competency scale (LIAC) and the low-intensity treatment competency scale (LITC). Inductive and deductive methods were used to construct the competency scales and detailed rating manuals were prepared. Two studies were then completed. The first study used a quantitative, fully-crossed design and the second a multi-center, quantitative longitudinal design. In study one, novice, qualified, and expert LI-CBT practitioners rated an LI-CBT assessment session (using the LIAC) and an LI-CBT treatment session (using the LITC). Study two used the LIAC and LITC across four training sites to analyze the competencies of LI-CBT practitioners over time, across raters, and in relation to the actor/patients’ feedback concerning helpfulness, the alliance, and willingness to return. Both the LIAC and LITC were found to be single factor scales with good internal, test-retest reliability and reasonable inter-rater reliability. Both measures were sensitive to measuring change in clinical competence. The LIAC had good concurrent, criterion, discriminant, and predictive validity, while the LITC had good concurrent, criterion, and predictive validity, but limited discriminant validity. A score of 18 accurately delineated a minimum level of competence in LI-CBT assessment and treatment practice, with incompetent practice associated with patient disengagement. These observational ratings scales can contribute to the clinical governance of the burgeoning use of LI-CBT interventions for anxiety and depression in routine services and also in the methods of controlled studies.     

“Doing Good” versus “Being Good”: The interplay between pride appeals and regulatory-focused messages in green advertising

Many consumers feel proud of making green choices, which is of crucial relevance to explaining environmentally responsible behaviors. However, compared to other self-conscious emotions, such as guilt and shame, little research attention has been paid to the role of pride in green consumerism. Through conducting two online experimental surveys, this research examined what features of a message induce the two facets of the emotion pride—authentic and hubristic—and how pride appeals interact with message frames having different regulatory foci. In Study 1, participants revealed more favorable eco-friendly attitudes and intentions when hubristic pride appeals were combined with promotion-focused messages (detailing the positive benefits of using the green product), and when authentic pride appeals were matched with prevention-focused messages (emphasizing the negative consequences averted by using the green product). Study 2 replicated and supported the proposed matching hypotheses while including a control condition. Findings of this research will add to a growing body of literature on pride as a discrete emotion and its carryover effects on persuasion while providing guidelines to help practitioners design green advertising campaigns.     

Readers and service commissioners require clear financial disclosures: Comment on innovation,research integrity,and change: A conflict of interest management framework for program developers (Sanders et al., 2019)

Sanders et al.'s proposal for a management framework for conflicting interests among program developers is very welcome. The underlying principles of such a framework must nevertheless prioritise the need for researchers and commissioners of services to make objective assessments of the impact of interventions reported in journal articles. This is particularly important in the field of randomised trials which may influence public sector expenditure. Using a strict definition derived from known financial conflict of interest, we have demonstrated that child-based effect sizes are much lower for independent studies than for studies with developer involvement. On this basis, we propose that journals publishing evaluations of psychosocial interventions should agree a standardised format for declarations of conflicts of interest based on that recommended by the International Committee of Medical Journal Editors.     

Feeling togetherness online: a phenomenological sketch of online communal experiences

Phenomenology and the Cognitive Sciences - The internet provides us with a multitude of ways of interacting with one another. In discussions about how technological innovations impact and shape our...     

Suicide compared to other causes of mortality in physicians

Physicians frequently are early adopters of healthy behaviors based on their knowledge and economic resources. The mortality patterns of physicians in the United States, particularly suicide, have not been rigorously described for over a decade. Previous studies have shown lower all-cause mortality among physicians yet reported conflicting results about cause-specific mortality such as suicide. In this study, we compared all-cause and cause-specific mortality in a sample of physicians to the age-gender matched general U.S. population from 1948 through 1998. We also compared the mortality experience across medical specialties. The risk of all-cause mortality was 56% lower than expected in men, and 26% lower in women, compared to the general population. Standardized mortality ratios (SMRs) were markedly lower for diseases strongly linked to smoking, e.g., cardiovascular diseases, respiratory diseases, and lung cancer. Suicide was the only cause of death where risk was greater than the general population. Overall, we found that physicians are at substantially lower risk of dying compared to the general population for all causes of death except suicide. The findings for suicide are strikingly different than other causes of death and should provide impetus for new research on the mental health of physicians.     

The imaginer and the imagined

A transference of the imaginer and the imagined, arising from largely unconscious fantasies of the way parent and child interact to construct a view of reality, is present in all analyses. For narcissistic patients, primitive fantasies of the imaginer and imagined form an enduring organization, and the enactment of these fantasies in transference and countertransference distorts the way analyst and patient construct meaning. Clinical material demonstrates the deepening that occurs when these fantasies are interpreted.     

Is a common grouping mechanism involved in the phenomena of illusory continuity and stream segregation?

Two auditory phenomena--stream segregation and illusory continuity through a wide-band noise interruption--were studied to determine whether the same principles of perceptual organization applied to both. A cycle was formed of a repeating alternation of two short bursts of narrow-band noise (NBN), one centered at a high frequency (H) and the other at a low frequency (L), with shorter bursts of wide-band noise (WBN) inserted between successive NBNs (H WBN L WBN H WBN...). In some conditions, listeners could hear a single NBN moving up and down behind the WBN bursts, although there was no NBN present with the WBN. Listeners rated the strength of this illusory continuity. Center frequency separation, rate of onsets, and bandwidth of the NBNs were varied. Increases in values of all three variables decreased illusory continuity. Other listeners rated the stream segregation of the H and L bands when successive NBNs were separated either by WBN bursts (as above) or by silences. The same three acoustic variables were manipulated. Increases in all three variables decreased the perception of a single stream. The similar disruptive effects on illusory continuity and on the one-stream percept in the stream segregation task support the idea that both phenomena depend on a common preliminary process of linking together the parts of a sequence that have similar frequencies.     

Teenage Offenders' Ability to Detect Deception in Their Peers

This study investigated the deception detection abilities of teenage offenders and teenage non‐offenders who made veracity judgments about 12 videotaped interviewees and also explored the behavioural characteristics of teenage liars and truth tellers. The findings revealed that teenage offenders were significantly more accurate in their credibility judgments than teenage non‐offenders. However, the offenders' impressive accuracy rates were not as a consequence of using valid cues to deceit. The feedback hypothesis helps to explain why the offenders were more accurate in their decisions: Operating within a criminal environment may mean that teenage offenders frequently lie and are lied to. Consequently, they receive more feedback than non‐offenders regarding the effectiveness of their lies as well as how successful they are at detecting lies. As a result, their lie detection ability improves. The current study suggests moving away from individual deceptive cues as predictors of deceit towards a more intuitive and holistic approach to lie detection, such as the Brunswikian Lens Model.Copyright © 2016 John Wiley & Sons, Ltd.