Examining the initial usability,acceptability and feasibility of a digital mental health intervention for college students in India

Generalised anxiety disorder (GAD) is prevalent among college students in India; however, barriers like stigma, treatment accessibility and cost prevent engagement in treatment. Web- and mobile-based, or digital, mental health interventions have been proposed as a potential solution to increasing treatment access. With the ultimate goal of developing an engaging digital mental health intervention for university students in India, the current study sought to understand students' reactions to a culturally and digitally adapted evidence-based cognitive behavioural therapy (CBT) for GAD intervention. Specifically, through theatre testing and focus groups with a non-clinical sample of 15 college students in India, the present study examined initial usability, acceptability and feasibility of the “Mana Maali Digital Anxiety Program.” Secondary objectives comprised identifying students' perceived barriers to using the program and eliciting recommendations. Results indicated high usability, with the average usability rating ranking in the top 10% of general usability scores. Participants offered actionable changes to improve usability and perceived acceptability among peers struggling with mental health issues. Findings highlight the benefits of offering digital resources that circumvent barriers associated with accessing traditional services. Results build on existing evidence that digital interventions can be a viable means of delivering mental healthcare to large, defined populations.     

The use of safety behaviours to manage intrusive memories in depression

Cognitive models of clinical disorders conceptualise cognitive and behavioural safety-seeking behaviours as central to symptom persistence because they prevent disconfirmation of key maintaining beliefs. Despite growing evidence of the role of negative beliefs about intrusive memories in depression, it remains unclear why such beliefs persist. Accordingly, we examined whether safety behaviours in response to unhelpful beliefs about intrusive memories might play a role in their maintenance. Eighteen high dysphoric (i.e., BDI-II12) individuals who reported an intrusive negative autobiographical memory in the past week completed a battery of measures about their memory, associated negative beliefs and safety behaviours adopted in response to their beliefs. The most commonly endorsed beliefs reflected themes of wanting to control memories (e.g., ‘I should be able to rid my mind of this memory’) and self-deprecation about experiencing them (e.g., ‘Because I can’t control this memory, I am a weak person’). The beliefs prompted a range of safety behaviours, with cognitive distraction being the most common. The findings demonstrate that safety behaviours are common in response to maladaptive beliefs about intrusive memories. Treatment developments in this area are needed, and should incorporate strategies to challenge beliefs about memories, reduce the use of safety behaviours, and promote processing of intrusive memories.     

Cognitive predictors of symptom return following depression treatment

This study tested whether poor cognitive change during depression treatment predicted time to return of depressive symptoms. Depressed participants (N = 121) completed assessments of dysfunctional attitudes and extreme thinking (i.e., number of totally agree and totally disagree responses) during hospitalization and again after 6 months of outpatient treatment. Participants then completed monthly depression assessments for 1 year. Survival analyses for time to symptom recurrence during follow-up were conducted among participants who reported 50% improvement in their depressive symptoms and were at least partially asymptomatic at the end of treatment (n = 53). Poor change in dysfunctional attitudes and poor change in extreme thinking both predicted shorter time to return of depressive symptoms.     

Retention of high tactile acuity throughout the life span in blindness

Previous studies of tactile acuity on the fingertip, using passive touch, have demonstrated an age-related decline in spatial resolution for both sighted and blind subjects. We have reexamined this age dependence with two newly designed tactile-acuity charts that require active exploration of the test symbols. One chart used dot patterns similar to braille, and the other used embossed Landolt rings. Groups of blind braille readers and sighted subjects ranging from 12 to 85 years old were tested in two experiments. We replicated previous findings for sighted subjects by showing an age-related decrease in tactile acuity by nearly 1% per year. Surprisingly, the blind subjects retained high acuity into old age, showing no age-related decline. For the blind subjects, tactile acuity did not correlate with braille reading speed, the amount of daily reading, or the age at which braille was learned. We conclude that when measured with active touch, blind subjects retain high tactile acuity into old age, unlike their aging sighted peers. We propose that blind people's use of active touch in daily activities, not specifically braille reading, results in preservation of tactile acuity across the life span.     

Age differences in collaborative memory: the role of retrieval manipulations

In two experiments, we examined age differences in collaborative inhibition (reduced recall in pairs of people, relative to pooled individuals) across repeated retrieval attempts. Younger and older adults studied categorized word lists and were then given two consecutive recall tests and a recognition test. On the first recall test, the subjects were given free-report cued recall or forced-report cued recall instructions (Experiment 1) or free recall instructions (Experiment 2) and recalled the lists either alone or in collaboration with another subject of the same age group. Free-report cued recall and free recall instructions warned the subjects not to guess, whereas forcedreport cued recall instructions required them to guess. Collaborative inhibition was obtained for both younger and older adults on initial tests of free-report cued recall, forced-report cued recall, and free recall, showing that the effect generalizes across several tests for both younger and older adults. Collaborative inhibition did not persist on subsequent individual recall or recognition tests for list items. Older adults consistently falsely recalled and recognized items more than did younger adults, as had been found in previous studies. In addition, prior collaboration may exaggerate older adults’ tendency toward higher false alarms on a subsequent recognition test, but only after a free recall test. The results provide generality to the phenomenon of collaborative inhibition and can be explained by invoking concepts of strategy disruption and source monitoring.     

Overshadowing of subsequent events and recovery thereafter

Four experiments using a conditioned lick suppression preparation with rats were conducted to examine whether overshadowing of subsequent events could be obtained in Pavlovian backward conditioning (i.e. unconditioned stimulus [US] before conditioned stimulus [CS]), and to determine whether such overshadowing could be reversed without further training with the overshadowed CS, as has been reported in overshadowing of antecedent events. In Experiment 1, a backward-conditioned CS overshadowed a second backward-conditioned CS. Two posttraining manipulations, extinction of the overshadowing CS (Experiment 2) and shifting of the temporal relationship of the overshadowing CS to the US (Experiment 3), increased responding to the overshadowed CS. These results constitute the first unambiguous demonstration of stimulus competition between subsequent events using first-order conditioning, and they show that, like overshadowing with forward conditioning, such overshadowing is due, at least in part if not completely, to a failure to express information that had been acquired.     

Temporal Coding in Pavlovian Conditioning: Hall-Pearce Negative Transfer

The Hall-Pearce (1979) negative transfer effect in rats was used to examine whether temporal relationships are coded as part of the informational content of associations that result from CS-US pairings. The transfer effect consists of adeficit in conditioned responding following CS-US pairings in Phase 2 that results from prior CS-US pairings in Phase 1. strong weak Using conditioned bar-press suppression, we found that gaps of different duration between CS termination and US onset in the two training phases resulted in less of a Hall-Pearce negative transfer effect than did an equivalent gap in the twotraining phases. The results are discussed with respect tothe temporal coding hypothesis (Matzel, Held, &Miller, 1988), the Pearce and Hall (1980) model, and Bouton's (1993) interference model.