Cognitive reactivity, dysfunctional attitudes, and depressive relapse and recurrence in cognitive therapy responders

Dysfunctional attitudes can foreshadow depressive relapse/recurrence. Priming mood, through induction paradigms, is hypothesized to activate dysfunctional attitudes. Cognitive reactivity (CR) refers to mood-linked increases in dysfunctional attitudes after priming. Here we explored the extent to which CR as well as residual, unprimed, dysfunctional attitudes predicted depressive relapse/recurrence among depressed patients who responded to acute phase cognitive therapy (CT). Consenting adults, aged 18–70, with recurrent major depressive disorder (n = 523) participated in a two-site randomized controlled trial examining the durability of continuation phase treatments. Patients received 16–20 sessions of CT. Among the 245 incompletely remitted responders, 213 agreed to undergo a mood induction paradigm. After 8 months of continuation phase treatments, participants were followed an additional 24 months. Although the mood induction significantly lowered mood in 80% of responders, the expected CR was not evident. By contrast, higher unprimed dysfunctional attitudes following CT did predict relapse/recurrence over 20 and 32 months post-randomization. The findings of this large longitudinal study of incompletely remitted CT responders challenge the notion that it is necessary to prime mood in order to maximize dysfunctional attitudes’ prediction of relapse and/or recurrence. While findings cannot be generalized beyond CT responders, they emphasize the clinical importance of reducing dysfunctional attitudes in preventing depression.     

Trajectories of Response to Treatment for Posttraumatic Stress Disorder

Research on the predictors of response to cognitive-behavioral treatments for PTSD has often produced inconsistent or ambiguous results. We argue this is in part due to the use of statistical techniques that explore relationships among the entire sample of participants rather than homogeneous subgroups. Using 2 large randomized controlled trials of Cognitive Processing Therapy (CPT), CPT components, and Prolonged Exposure, we employed growth mixture modeling to identify distinct trajectories of treatment response and to determine the predictors of those trajectories. We determined that the participants’ trajectories could be best represented by 2 latent classes, which we subsequently labeled responders (87% of the sample) and nonresponders (13% of the sample). Notably, there was not a separate class for partial responders. Assignment to the nonresponder class was associated with receiving the written accounts (WA) component of CPT, a pretreatment diagnosis of major depression (MDD), and more pretreatment hyperarousal symptoms. Thus, it appears that some individuals do not benefit from merely writing about their trauma and processing it with the therapist; they may also need to engage in cognitive restructuring to successfully ameliorate their symptoms. Additionally, those who meet criteria for MDD or have high levels of hyperarousal at the onset of treatment might require additional treatment or support.     

Me and my 400 friends: the anatomy of college students' Facebook networks, their communication patterns, and well-being

Is there a trade-off between having large networks of social connections on social networking sites such as Facebook and the development of intimacy and social support among today's generation of emerging adults? To understand the socialization context of Facebook during the transition to adulthood, an online survey was distributed to college students at a large urban university; participants answered questions about their relationships by systematically sampling their Facebook contacts while viewing their Facebook profiles online. Results confirmed that Facebook facilitates expansive social networks that grow disproportionately through distant kinds of relationship (acquaintances and activity connections), while also expanding the number of close relationships and stranger relationships, albeit at slower rates. Those with larger networks estimated that larger numbers of contacts in their networks were observing their status updates, a form of public communication to one's entire contact list. The major function of status updates was emotional disclosure, the key feature of intimacy. This finding indicates the transformation of the nature of intimacy in the environment of a social network site. In addition, larger networks and larger estimated audiences predicted higher levels of life satisfaction and perceived social support on Facebook. These findings emphasize the psychological importance of audience in the Facebook environment. Findings also suggest that social networking sites help youth to satisfy enduring human psychosocial needs for permanent relations in a geographically mobile world--college students with higher proportions of maintained contacts from the past (primarily high school friends) perceived Facebook as a more useful tool for procuring social support.     

Expanding stress generation theory: test of a transdiagnostic model

Originally formulated to understand the recurrence of depressive disorders, the stress generation hypothesis has recently been applied in research on anxiety and externalizing disorders. Results from these investigations, in combination with findings of extensive comorbidity between depression and other mental disorders, suggest the need for an expansion of stress generation models to include the stress generating effects of transdiagnostic pathology as well as those of specific syndromes. Employing latent variable modeling techniques to parse the general and specific elements of commonly co-occurring Axis I syndromes, the current study examined the associations of transdiagnostic internalizing and externalizing dimensions with stressful life events over time. Analyses revealed that, after adjusting for the covariation between the dimensions, internalizing was a significant predictor of interpersonal dependent stress, whereas externalizing was a significant predictor of noninterpersonal dependent stress. Neither latent dimension was associated with the occurrence of independent, or fateful, stressful life events. At the syndrome level, once variance due to the internalizing factor was partialed out, unipolar depression contributed incrementally to the generation of interpersonal dependent stress. In contrast, the presence of panic disorder produced a "stress inhibition" effect, predicting reduced exposure to interpersonal dependent stress. Additionally, dysthymia was associated with an excess of noninterpersonal dependent stress. The latent variable modeling framework used here is discussed in terms of its potential as an integrative model for stress generation research.     

characters and clues: factors affecting children's extension of knowledge through integration of separate episodes

Children build up knowledge about the world and also remember individual episodes. How individual episodes during which children learn new things become integrated with one another to form general knowledge is only beginning to be explored. Integration between separate episodes is called on in educational contexts and in everyday life as a major means of extending knowledge and organizing information. Bauer and San Souci (2010) provided an initial demonstration that 6-year-olds extend their knowledge by integrating between separate but related episodes; the episodes shared a high level of surface similarity. Experiments 1A and 1B of the current research were tests of integration under low and high levels of surface similarity, respectively. In Experiment 1A, when surface similarity of the episodes was low, 6-year-olds integrated between passages of text, yet their performance was not as robust as observed previously. In Experiment 1B, when surface similarity of the episodes was high, a replication of Bauer and San Souci's results was observed. In Experiment 2, we tested whether a "hint" to consult the information learned in the passages improved performance even when surface level similarity was low. The hint had a strong facilitating effect. Possible mechanisms of integration between separate yet related episodes are discussed.     

Establishing and Evaluating the Key Functions of an Interactive Systems Framework Using an Assets-Getting to Outcomes Intervention

Community practitioners can face difficulty in achieving outcomes demonstrated by prevention science. Building a community practitioner's prevention capacity—the knowledge and skills needed to conduct critical prevention practices—could improve the quality of prevention and its outcomes. The purpose of this article is to: (1) describe how an intervention called Assets‐Getting To Outcomes (AGTO) was used to establish the key functions of the ISF and present early lessons learned from that intervention's first 6 months and (2) examine whether there is an empirical relationship between practitioner capacity at the individual level and the performance of prevention at the program level—a relationship predicted by the ISF but untested. The article describes an operationalization of the ISF in the context of a five‐year randomized controlled efficacy trial that combines two complementary models designed to build capacity: Getting To Outcomes (GTO) and Developmental Assets. The trial compares programs and individual practitioners from six community‐based coalitions using AGTO with programs and practitioners from six similar coalitions that are not. In this article, we primarily focus on what the ISF calls innovation specific capacity and discuss how the combined AGTO innovation structures and uses feedback about its capacity‐building activities, which can serve as a model for implementing the ISF. Focus group discussions used to gather lessons learned from the first 6 months of the AGTO intervention suggest that while the ISF may have been conceptualized as three distinct systems, in practice they are less distinct. Findings from the baseline wave of data collection of individual capacity and program performance suggest that practitioner capacity predicts, in part, performance of prevention programs. Empirically linking practitioner capacity and performance of prevention provides empirical support for both the ISF and AGTO. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

Elevated Appraisals of the Negative Impact of Naturally Occurring Life Events: A Risk Factor for Depressive and Anxiety Disorders

The tendency to appraise naturally occurring life events (LEs) as having high negative impact may be a predisposing factor for the development of depression and anxiety disorders. In the current study, appraisals of the negative impact of recent LEs were examined in relationship to depressive and anxiety disorders in a sample of 653 adolescents who were administered diagnostic and life stress interviews at ages 15 and 20. Participants’ appraisals of the negative impact of LEs reported at age 15 were statistically adjusted using investigator-based ratings to control for objective differences across LEs. Higher appraisals of the negative impact of LEs were associated with both past and current depressive and anxiety disorders at age 15 and predicted subsequent first onsets of depressive and anxiety disorders occurring between ages 15 and 20. In addition, appraisals of the negative impact of LEs were particularly elevated among those experiencing both a depressive and anxiety disorder over the course of the study. The findings suggest that systematically elevated appraisals of the negative impact of LEs are a predisposing factor for depression and anxiety disorders and may represent a specific risk factor for co-morbid depression and anxiety in mid-adolescence and early adulthood.     

Psychological Dating Violence Perpetration and Victimization: Trajectories From Middle to High School

Despite evidence documenting the negative consequences, psychological dating violence occurs frequently in adolescent dating relationships. No information exists on the trajectories that adolescents follow and their association to nonphysical peer violence. The sample comprised 624 randomly selected 6th graders. In yearly surveys from 6th through 12th grade, 550 of the 624 students reported dating at least twice during the 3 months prior to completing the survey. These students responded to questions about frequency of engagement in psychological dating violence perpetration and victimization. We used Proc TRAJ to identify developmental trajectories of behavior over time and generalized estimating equation models to examine the associations of the trajectories and peer aggression. Adolescents followed three distinct developmental trajectories related to psychological dating violence victimization and perpetration: low, increasing, and high. Based on the joint probabilities of victimization and perpetration, we identified four predominant groups: low victimization/low perpetration (LVLP; 36%), increasing victimization/increasing perpetration (40%), high victimization/high perpetration (HVHP; 15%), and increasing victimization/low perpetration (IVLP; 7%). The LVLP had significantly more boys and White students; the HVHP group had an even gender distribution and more African‐American students. For all groups, peer aggression decreased from Grade 6 to 12; students in the HVHP group reported the highest peer aggression, and students in the LVLP reported the lowest peer aggression. Findings suggest a strong, reciprocal relationship in the developmental trajectories of adolescents who experience and perpetrate psychological dating violence. Those highly engaged in these behaviors were also more likely to be violent toward peers. Aggr. Behav. 38:510‐520, 2012. © 2012 Wiley Periodicals, Inc.     

The Emotional City: Refugee Settlement and Neoliberal Urbanism in Calgary

Based on a case study in Calgary, we frame refugee (re)settlement through literature in emotional geography and argue that the logistics of settlements are emotional as well as pragmatic. Social agencies play a crucial role in the settlement of refugees, especially the government-sponsored class. Personal connections with a settlement worker make the negotiation of the city emotional from the outset. In addition, accessible public spaces and institutions help create positive emotional attachments. Other aspects, such as limited mobility and dispersed settlement, construct obstacles and intensify a sense of isolation. Neoliberal urban policy has made the settlement process in Canada more difficult.