Dynamic interpersonal therapy in an NHS tertiary level specialist psychotherapy service

We describe the introduction of dynamic interpersonal psychotherapy (DIT) into an National Health Service (NHS) tertiary psychoanalytic specialist psychotherapy service. Training in DIT began as our contribution to Improving Access to Psychological Therapies and primary care services, supporting the training and supervision of their DIT practitioners. We then discovered DIT could be a valuable treatment within our own tertiary NHS service for patients with complex presentations. Currently fighting for survival, like many NHS psychoanalytic psychotherapy services nationally, we have adopted a manual-guided, psychoanalytically based therapy to broaden our tertiary clinical psychoanalytic service and accommodate trends in mental health service provision, whilst protecting the quality and integrity of our psychotherapy. DIT helped us continue providing relevant and beneficial psychoanalytic and psychodynamic services to individual patients despite limitations of the financially challenged NHS, NICE guidelines and Payment by Results. We outline the progress and outcomes for patients with complex mental health presentations, include individual case discussion and our experience of using the DIT approach within a traditionally longer term psychoanalytic psychotherapy service.     

Psychological adjustment to cleft lip and/or palate: A narrative review of the literature

Objective: Adjustment to cleft lip and/or palate (CL/P) is multifaceted, involving several domains of psychological and social functioning. A substantial increase in research in this area has been evident in recent years, along with a preliminary shift in how adjustment to CL/P is conceptualised and measured. An updated and comprehensive review of the literature is needed in light of the rapidly expanding and changing field.

Design: A narrative review of 148 quantitative and qualitative studies published between January 2004 and July 2015.

Main outcome measures: Findings are presented according to five key domains of adjustment: Developmental Trajectory, Behaviour, Emotional Well-being, Social Experiences and Satisfaction with Appearance and Treatment. Data pertaining to General Psychological Well-being were also examined.

Results: The overall impact of CL/P on psychological adjustment appears to be low. Nonetheless, the review demonstrates the complexity of findings both within and across domains, and highlights recurring methodological challenges.

Conclusions: Research findings from the last decade are considered to be largely inconclusive, although some areas of emerging consensus and improvements in the approaches used were identified. Efforts to collect data from large, representative and longitudinal samples, which are comparable across studies and encompassing of the patient perspective, should be doubled.     

Higher body mass index is associated with episodic memory deficits in young adults

Obesity has become an international health crisis. There is accumulating evidence that excess bodyweight is associated with changes to the structure and function of the brain and with a number of cognitive deficits. In particular, research suggests that obesity is associated with hippocampal and frontal lobe dysfunction, which would be predicted to impact memory. However, evidence for such memory impairment is currently limited. We hypothesised that higher body mass index (BMI) would be associated with reduced performance on a test of episodic memory that assesses not only content, but also context and feature integration. A total of 50 participants aged 18–35 years, with BMIs ranging from 18 to 51, were tested on a novel what–where–when style episodic memory test: the “Treasure-Hunt Task”. This test requires recollection of object, location, and temporal order information within the same paradigm, as well as testing the ability to integrate these features into a single event recollection. Higher BMI was associated with significantly lower performance on the what–where–when (WWW) memory task and all individual elements: object identification, location memory, and temporal order memory. After controlling for age, sex, and years in education, the effect of BMI on the individual what, where, and when tasks remained, while the WWW dropped below significance. This finding of episodic memory deficits in obesity is of concern given the emerging evidence for a role for episodic cognition in appetite regulation.     

Implicit motives and basic psychological needs

The present article starts with discussing similarities and differences between conceptualizations of human needs in self‐determination theory (SDT; Deci & Ryan [1985], Intrinsic motivation and self‐determination in human behavior; Deci & Ryan [2000], Nebraska symposium on motivation: Perspectives on motivation) and motive disposition theory (MDT; McClelland, Human motivation, 1985). The second section focuses on the two‐process model of psychological needs (Sheldon [2011], Psychological Review, 118: 552), which aims to integrate the two approaches, whereas the third section highlights some aspects of both theories that are still decoupled or even contradictory, but nevertheless still have a high potential to be linked. These three aspects are (a) the noncorresponding concepts of implicit power motive (MDT) and basic need for autonomy (SDT); (b) the differentiation of needs into hope and fear components, which is theoretically embedded in MDT, but not in SDT; and (c) MDT researchers’ differentiation into an implicit and explicit motivational system, which is not included in SDT. Particularly, the last section highlights the potential for areas in which further integration is possible, which provides a foundation for comprehensive and exciting research on human motivation.     

Attention to faces and gaze-following in social anxiety: preliminary evidence from a naturalistic eye-tracking investigation

Social attentional biases are a core component of social anxiety disorder, but research has not yet determined their direction due to methodological limitations. Here we present preliminary findings from a novel, dynamic eye-tracking paradigm allowing spatial–temporal measurement of attention and gaze-following, a mechanism previously unexplored in social anxiety. 105 participants took part, with those high (N?=?27) and low (N?=?25) in social anxiety traits (HSA and LSA respectively) entered into the analyses. Participants watched a video of an emotionally-neutral social scene, where two actors periodically shifted their gaze towards the periphery. HSA participants looked more at the actors’ faces during the initial 2s than the LSA group but there were no group differences in proportion of first fixations to the face or latency to first fixate the face, although HSA individuals’ first fixations to the face were shorter. No further differences in eye movements were found, nor in gaze-following behaviour, although these null effects could potentially result from the relatively small sample. Findings suggest attention is biased towards faces in HSA individuals during initial scene inspection, but that overt gaze-following may be impervious to individual differences in social anxiety. Future research should seek to replicate these effects.     

The Efficacy of Interventions Aimed at Reducing Procrastination: A Meta‐Analysis of Randomized Controlled Trials

This meta‐analysis investigated the efficacy of interventions aimed at reducing procrastination in randomized controlled trials. Twelve studies, with a total of 646 participants, met inclusion criteria. The significant meta‐analytic effect size, Hedges's g = 1.18, indicates that the interventions had a large positive effect. Three variables significantly moderated effect size: Higher effects were associated with interventions delivered in person, student samples, and a no‐treatment control condition. The results lay a foundation for procrastination treatment and future research.     

The effects of ongoing task absorption on event-based prospective memory in preschoolers

The current study applied a 2 × 2 experimental design to investigate the effects of ongoing task absorption on event-based prospective memory performance of children aged 3 and 5 years. Children were required to label pictures as ongoing task but to remember to refrain from picture naming and to respond to the target cues in a different way as the prospective memory task. Two differently absorbing ongoing tasks (high absorbing scenario game task vs. low absorbing computer-based task) were administered. Results indicated that prospective memory performance of 5-year-old children was significantly better than that of 3-year-old children. Ongoing task absorption affected the ongoing task performance of preschoolers, but not overall prospective memory performance. Only the 3-year-olds were negatively affected by high ongoing task absorption, which was not the case for the 5-year-olds. The findings are discussed within the light of the multiprocess theory.     

An exploration of the benefits of animal‐assisted activities in undergraduate students in Singapore

The rise in psychological problems, attrition, and suicide rates of university students has been linked to the stressful challenges faced during university life. To buffer this, animal assisted activities (AAA) may assist in improving psychological and physiological well‐being in students, however, to date, there is little empirical evidence for their effectiveness. Consequently, this study explored the psychological and physiological benefits of AAA in a sample of undergraduate students. Sixty‐two students from two local universities participated in an hour‐long AAA session delivered by Therapy Dogs Singapore. Measures of perceived stress, anxiety, state self‐esteem, and blood pressure (BP) were taken before and after the sessions. The results indicated that students experienced significant decreases in state anxiety, systolic, and diastolic BP post AAA, and when compared to a quiet reading comparison session. State self‐esteem increased post AAA and, further, was found to moderate the change in anxiety in addition to perceived stress, whereby perceived anxiety reduced more in those with low state self‐esteem and high perceived stress. These results suggest that AAA can be an effective intervention for stress among undergraduate students, which utilizes a novel, easy to implement and enjoyable approach for Singaporean students.