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.     

Ensemble coding of facial identity is not refined by experience: Evidence from other-race and inverted faces

The ability to recognize identity despite within-person variability in appearance is likely a face-specific skill and shaped by experience. Ensemble coding – the automatic extraction of the average of a stimulus array – has been proposed as a mechanism underlying face learning (allowing one to recognize novel instances of a newly learned face). We investigated whether ensemble encoding, like face learning and recognition, is refined by experience by testing participants with upright own-race faces and two categories of faces with which they lacked experience: other-race faces (Experiment 1) and inverted faces (Experiment 2). Participants viewed four images of an unfamiliar identity and then were asked whether a test image of that same identity had been in the study array. Each test image was a matching exemplar (from the array), matching average (the average of the images in the array), non-matching exemplar (a novel image of the same identity), or non-matching average (an average of four different images of the same identity). Adults showed comparable ensemble coding for all three categories (i.e., reported that matching averages had been present more than non-matching averages), providing evidence that this early stage of face learning is not shaped by face-specific experience.     

“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.     

Cerebral blood flow in 5‐ to 8‐month‐olds: Regional tissue maturity is associated with infant affect

Infancy is marked by rapid neural and emotional development. The relation between brain function and emotion in infancy, however, is not well understood. Methods for measuring brain function predominantly rely on the BOLD signal; however, interpretation of the BOLD signal in infancy is challenging because the neuronal‐hemodynamic relation is immature. Regional cerebral blood flow (rCBF) provides a context for the infant BOLD signal and can yield insight into the developmental maturity of brain regions that may support affective behaviors. This study aims to elucidate the relations among rCBF, age, and emotion in infancy. One hundred and seven mothers reported their infants' (infant age M ± SD = 6.14 ± 0.51 months) temperament. A subsample of infants completed MRI scans, 38 of whom produced usable perfusion MRI during natural sleep to quantify rCBF. Mother‐infant dyads completed the repeated Still‐Face Paradigm, from which infant affect reactivity and recovery to stress were quantified. We tested associations of infant age at scan, temperament factor scores, and observed affect reactivity and recovery with voxel‐wise rCBF. Infant age was positively associated with CBF in nearly all voxels, with peaks located in sensory cortices and the ventral prefrontal cortex, supporting the formulation that rCBF is an indicator of tissue maturity. Temperamental Negative Affect and recovery of positive affect following a stressor were positively associated with rCBF in several cortical and subcortical limbic regions, including the orbitofrontal cortex and inferior frontal gyrus. This finding yields insight into the nature of affective neurodevelopment during infancy. Specifically, infants with relatively increased prefrontal cortex maturity may evidence a disposition toward greater negative affect and negative reactivity in their daily lives yet show better recovery of positive affect following a social stressor.     

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...     

Partner Violence, Social Support, and Distress Among Inner-City African American Women

This study examined the role of social support in the partner violence–psychological distress relation in a sample of African American women seeking medical care at a large, urban hospital (n = 138). Results from bivariate correlational analyses revealed that partner violence was related to lower perceived social support and greater psychological distress, and lower social support was related to more distress. Furthermore, findings based on path analysis indicated that low levels of social support helped account for battered women's increased distress. Findings point to the need for service providers to screen for partner violence in nontraditional sites, such as hospital emergency rooms, and to address the role of social support resources in preventive interventions with African American battered women.     

Socioeconomic status, resources, psychological experiences, and emotional responses: a test of the reserve capacity model

The current study used ecological momentary assessment to test several tenets of the reserve capacity model (L.C. Gallo & K. A. Matthews, 2003). Women (N = 108) with varying socioeconomic status (SES) monitored positive and negative psychosocial experiences and emotions across 2 days. Measures of intrapsychic and social resources were aggregated to represent the reserve capacity available to manage stress. Lower SES was associated with less perceived control and positive affect and more social strain. Control and strain contributed to the association between SES and positive affect. Lower SES elicited greater positive but not negative emotional reactivity to psychosocial experiences. Women with low SES had fewer resources relative to those with higher SES, and resources contributed to the association between SES and daily experiences.     

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.