Therapeutic alliance in guided internet-delivered cognitive behavioural treatment of depression, generalized anxiety disorder and social anxiety disorder

Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in several controlled trials, but the mechanisms of change are largely unknown. Therapeutic alliance is a factor that has been studied in many psychotherapy trials, but the role of therapeutic alliance in ICBT is less well known. The present study investigated early alliance ratings in three separate samples. Participants from one sample of depressed individuals (N = 49), one sample of individuals with generalized anxiety disorder (N = 35), and one sample with social anxiety disorder (N = 90) completed the Working Alliance Inventory (WAI) modified for ICBT early in the treatment (weeks 3-4) when they took part in guided ICBT for their conditions. Results showed that alliance ratings were high in all three samples and that the WAI including the subscales of Task, Goal and Bond had high internal consistencies. Overall, correlations between the WAI and residualized change scores on the primary outcome measures were small and not statistically significant. We conclude that even if alliance ratings are in line with face-to-face studies, therapeutic alliance as measured by the WAI is probably less important in ICBT than in regular face-to-face psychotherapy.     

Executive function tests in early‐onset psychosis: which one to choose?

People with schizophrenia exhibit executive functioning deficits, an area well investigated in the adult onset schizophrenia (AOS) group, but far less so in early-onset schizophrenia (EOS). Since EOS in general seems to exhibit poorer cognitive functions and is clinically more compromised than AOS, choice of efficient and sensitive assessment measures is not necessarily the same within the two groups. The MATRICS Consensus Cognitive Battery was developed for adults when studying treatment effects and uses Mazes (Neuropsychological Assessment Battery [NAB]) to assess executive functioning. We tested 31 adolescents with schizophrenia spectrum disorders and 66 healthy controls in order to examine how Mazes compares to two other commonly used tests to measure executive functioning, D-KEFS Color Word Interference Test (Stroop) and the Wisconsin Card Sorting Test (WCST). Significant discriminating power was found for all three measures. Patients performed 0.8-1.5 SD below controls with Stroop as the most sensitive measure, followed by Mazes and WCST. Mazes was selected by the MATRICS to assess treatment effects in AOS and is shown to be able. We find the instrument also able to separate adolescent patients from controls and thus, it appears a sensible choice in clinical settings. If a more elaborated neuropsychological evaluation of the executive functioning domain is needed, Stroop should be considered a complementary test.     

Music therapy with hospitalized infants—the art and science of communicative musicality

Infants seek contingent, companionable interactions with others. Infants in a Neonatal Intensive Care Unit (NICU), while receiving care that optimizes their chances of survival, often do not have the kind of interactions that are optimal for their social development. Live music therapy (MT) with infants is an intervention that aims for contingent, social interaction between therapist and infant. This study, with a limited numbers of infants, examined the effectiveness of an MT intervention in the NICU at The Royal Children's Hospital Melbourne. Two groups of late pre‐term and full‐term infants were recruited to the study; one was given MT and the other was not. A healthy group of infants not given MT served as an additional control. The effect of MT was indexed using two measures reflecting infant social engagement: the Neurobehavioral Assessment of the Preterm Infant (NAPI) and the Alarm Distress Baby Scale (ADBB). Results suggest that the MT intervention used at The Royal Children's Hospital Melbourne supports infants' neurobehavioral development. In particular, hospitalized infants who received MT were better able to maintain self‐regulation during social interaction with an adult, were less irritable and cried less, and were more positive in their response to adult handling, when compared with infants who did not receive the intervention. These are important prerequisites for social interaction and development. Further and larger scale research using MT with this population is indicated.     

Do new ways of working foster work engagement?

Although New Ways of Working (NWW) are increasingly implemented in organizational practice, few studies have addressed its pros and cons for employee outcomes. NWW enable employees to choose when and where to work, while being supported by electronic communication. We examined the effects of NWW on work engagement and exhaustion, and investigated whether communication quality mediated these relationships. The results of a five-day diary study (n= 550) showed that daily use of NWW was positively related to daily engagement and negatively to daily exhaustion due to increased effective and efficient communication. In addition, NWW enhanced connectivity among co-workers, resulting in enhanced daily engagement and reduced exhaustion. However, we also found a positive relationship between NWW and exhaustion, because NWW increased interruptions during the work process. Although some caution is needed, we conclude that NWW have the potential to foster work engagement.     

Values of Children among Sub-Saharan African Women: The Case of Ghanaian Women

This paper examines whether previously suggested reasons for having children: economic, social and psychological values of child can be identified among a group of sub-Sahara women, and the extent to which a spiritual value of child can be identified on the basis of African's belief in ancestors and its influence on their daily lives. Two groups of Ghanaian mothers—270 women (mean age = 42.14 years) with adolescent-aged child and 264 mothers (mean age =31.41 years) with a young child—participated in the study. Exploratory factor analyses found mixed support for the existence of social and psychological values of child. Economic values of child could not be identified. However, spiritual values of child came out as a clear factor, and accounted for about 10% of the explained variance, albeit the explained valiance was less than that from social and psychological values of child. The implications of these for family planning in sub-Sahara Africa and for fighting HIV/AIDS are discussed.     

The impact of sample non‐normality on ANOVA and alternative methods

In this journal, Zimmerman (2004, 2011) has discussed preliminary tests that researchers often use to choose an appropriate method for comparing locations when the assumption of normality is doubtful. The conceptual problem with this approach is that such a two‐stage process makes both the power and the significance of the entire procedure uncertain, as type I and type II errors are possible at both stages. A type I error at the first stage, for example, will obviously increase the probability of a type II error at the second stage. Based on the idea of Schmider et al. (2010) , which proposes that simulated sets of sample data be ranked with respect to their degree of normality, this paper investigates the relationship between population non‐normality and sample non‐normality with respect to the performance of the ANOVA, Brown–Forsythe test, Welch test, and Kruskal–Wallis test when used with different distributions, sample sizes, and effect sizes. The overall conclusion is that the Kruskal–Wallis test is considerably less sensitive to the degree of sample normality when populations are distinctly non‐normal and should therefore be the primary tool used to compare locations when it is known that populations are not at least approximately normal.