The acceptability and preference for the psychological treatment of PTSD

The acceptability and preference of psychological treatments is important in understanding patient treatment seeking, choice, engagement and attrition and possibly treatment response in health care. The acceptability of, and preference for, 14 different types of psychological treatment for posttraumatic stress disorder (PTSD) were investigated in a student population through invitation to participate in a web-based survey. Respondents were asked to rate each treatment on 10 scales and to rank the treatments in order of preference. Respondents were also asked whether they would seek treatment themselves, recommend treatment to friends and family, feel stigmatised by suffering from PTSD, had any prior knowledge of the treatments and if this had been positive or negative and whether they had a history of psychological problems or treatment. A total of 330 respondents completed the survey. A past or current history of psychological problems and treatment was surprisingly high. Almost all respondents indicated that they would seek or recommend treatment in spite of high levels of stigmatisation. Factor analysis of the 10 scales indicated two factors: Endorsement and Discomfort. Rank ordering on preference and Endorsement scores was highly consistent. The highly preferred and endorsed treatments involved cognitive therapy, exposure or psycho-education in spite of high levels of discomfort anticipated with exposure. Treatments involving new technologies, EMDR and psychodynamic psychotherapy received the lowest Endorsement and preference. There was a modest influence of prior knowledge of a treatment.     

Group treatment for trichotillomania: behavior therapy versus supportive therapy

In this randomized controlled trial, group behavior therapy (BT; n = 12) was compared to group supportive therapy (ST; n = 12) in the treatment of trichotillomania (TTM). Both treatments were also compared to a naturally occurring waiting period, the time period that participants waited for groups to form. Participants completing group BT experienced significantly greater decreases in self-reported hair-pulling symptoms and clinician-rated hair loss severity than did those in group ST. Decreases were significantly greater after treatment than after the naturalistic waiting period. In addition, a significantly higher percentage of those in the BT than ST condition were rated as much improved or very much improved on the Clinical Global Impression scale at posttreatment. However, despite substantial symptom improvement, TTM severity remained problematic at posttreatment. Specifically, few participants in either treatment met criteria for clinically significant change at posttreatment. In addition, relapse of symptoms occurred over the 6-month follow-up period. Results provided partial support for the short-term efficacy of group BT. However, the group format may not maximize the efficacy of BT for TTM. Thus, it is recommended that future BT research test either individual therapy or a combination of group and individual formats for TTM.     

Processing mode influences the relationship between trait rumination and emotional vulnerability

Watkins (2004) found that the mode of processing adopted during expressive writing following a failure influenced emotional recovery from the failure as a function of level of trait rumination. At higher levels of trait rumination, negative mood 12 hours after the failure was greater, but only in an abstract, evaluative writing condition and not in a concrete, process-focused condition. The current study examined whether this interaction of trait rumination with processing mode would generalize to emotional vulnerability to a subsequent negative stressor. Participants repeatedly focused on both positive and negative scenarios in either a concrete, process-focused or an abstract, evaluative mode, before a failure experience. As predicted, after the failure experience, higher levels of trait rumination were associated with lower levels of positive affect, but only for participants in the abstract, evaluative condition and not for participants in the concrete, process-focused condition. This finding is consistent with processing mode influencing the relationship between trait rumination and emotional vulnerability.     

Kinematic assessment of treadmill running using different body-weight support harnesses

10 male collegiate runners (M age = 21.4, SD = 1.5 yr.) ran on a treadmill with no body-weight support (BWS), 20% BWS, and 40% BWS conditions. In addition, they wore three different commercially available harnesses at the 20% and 40% BWS conditions. The aim was to run on the treadmill at a fast speed while maintaining an adequate step length. The purpose was to investigate how each harness changed running gait, and the differences in running gait between the harnesses with various body-weight support. Analysis of variance indicated significant restriction of upper body torso rotation between the harnesses at the 40% BWS conditions. Body-weight support resulted in a longer stride, decreased cadence, less vertical displacement of the center of mass, and diminished hip and ankle joint excursions. These changes indicated that increased body-weight support results in longer steps with the foot contacting the belt for a shorter period of time with less leg angular changes throughout the running cycling.     

Goal pursuit, goal self-concordance, and the accessibility of autobiographical knowledge

Recent theory suggests that personal goals influence the accessibility of autobiographical knowledge. We suggest that this effect is moderated by goal self-concordance: the extent to which a goal is pursued for autonomous rather than controlling reasons. Cueing paradigms were used to measure the accessibility of autobiographical knowledge relating to (i) goals that participants were and were not pursuing, and (ii) currently pursued goals that were high and low in self-concordance. As predicted, autobiographical knowledge relating to currently pursued goals was more accessible than autobiographical knowledge relating to non-pursued goals. General event knowledge relating to self-concordant goals was more accessible than general event knowledge relating to non-self-concordant goals, but a corresponding relationship did not emerge for event-specific knowledge.     

Memory specificity as a risk factor for suicidality in non-affective psychosis: The ability to recall specific autobiographical memories is related to greater suicidality

A difficulty in recalling specific autobiographical memories has been noted as a risk factor for suicidal behaviour. However, the relationship between memory specificity and suicide has not previously been investigated in those with non-affective psychosis. It was predicted that in this group, more specific memory recall would be associated with an increased risk of suicide. This is because such specific memories are likely to be associated with greater levels of distress and negative affect than less specific memories. This prediction contradicts the prevailing belief that lower memory specificity is associated with greater suicidality. Sixty participants with schizophrenia spectrum disorders were recruited, 40 of whom reported past suicide attempts. Analyses showed suicide attempters recalled a greater proportion of specific memories, whilst controlling for trait anxiety and depressive symptoms. These results supported the main hypothesis, and suggest non-specific memory may have adaptive qualities in individuals with psychosis.     

Suicide schemas in non-affective psychosis: An empirical investigation

Suicide is the leading cause of premature death among individuals experiencing psychosis. The risk of suicide is proposed to increase with a greater potential for activation of suicide related schemas. Empirical representations of suicide schemas were compared between individuals experiencing non-affective psychosis, with and without a history of suicidal behaviour. Employing a cross-sectional between-groups comparison design, 84 participants, previously diagnosed with a non-affective psychotic disorder, were recruited from community mental health services. Participants completed a demographic questionnaire and clinical measures of psychopathology. To assess participants’ suicide schemas, a series of direct and indirect cognitive tasks were designed and administered. Pathfinder analysis enabled the construction of empirically derived representations of the groups’ suicide schemas based on responses to the cognitive tasks. The suicide group achieved significantly greater scores on measures of anxiety, depression, hopelessness and suicidality than the non-suicide group, but not on measures indicative of the severity of psychosis. The suicide schema for the suicide group was more elaborate and extensive than for the non-suicide group, even when clinical measures were taken into account. Clinical and theoretical implications are discussed.     

Psychosocial correlates of depressive rumination

The study examined the relationship between brooding, the maladaptive sub-component of depressive rumination, an important cognitive mechanism implicated in the aetiology of depression, and a range of depressogenic psychosocial factors, including insecure attachment styles and maladaptive interpersonal behaviours. It was hypothesised that brooding (but not the more adaptive reflection component) is associated with an attachment pattern characterised by fear of rejection, and an interpersonal style characterised by submissiveness. Currently depressed (n = 29), previously depressed (n = 42) and never-depressed (n = 32) adults completed self-report measures assessing depressive symptoms, rumination (brooding and reflection), attachment orientation and maladaptive interpersonal behaviours. The study hypotheses were partially supported: After controlling for gender and depressive symptoms, brooding was significantly associated with one indicator of underlying rejection concerns (rejection sensitivity, p = .05), but was not associated with another indicator of underlying rejection concerns (anxious attachment style) or with avoidant attachment style. After controlling for depressive symptoms, brooding was uniquely associated with the submissive interpersonal style (p < .01). Brooding was not correlated with needy or cold interpersonal styles after controlling for depressive symptoms.