Treating Procrastination Using Cognitive Behavior Therapy: A Pragmatic Randomized Controlled Trial Comparing Treatment Delivered via the Internet or in Groups

Procrastination is a common problem among university students, with at least half of the population reporting great difficulties initiating or completing tasks and assignments. Procrastination can have a negative impact on course grades and the ability to achieve a university degree, but can also lead to psychological distress. Cognitive behavior therapy (CBT) is believed to reduce procrastination, but few studies have investigated its effectiveness in a regular clinical setting. The current study explored its effects using a pragmatic randomized controlled trial comparing treatment delivered during 8 weeks as self-guided CBT via the Internet (ICBT) or as group CBT. In total, 92 university students with severe procrastination were included in the study (registered as a clinical trial on Clinicaltrials.gov: NCT02112383). Outcome measures on procrastination, depression, anxiety, and well-being were distributed at pre- and posttreatment as well as 6-month follow-up. An outcome measure of procrastination was administered weekly. Linear mixed and fixed effects models were calculated, along with improvement and deterioration rates. The results showed large within-group effect sizes on procrastination, Cohen’s d of 1.29 for ICBT, 95% Confidence Interval (CI) [0.81, 1.74], and d of 1.24 for group CBT, 95% CI [0.76, 1.70], and small to moderate benefits for depression, anxiety, and well-being. In total, 33.7% were regarded as improved at posttreatment and 46.7% at follow-up. No differences between conditions were observed after the treatment period, however, participants in group CBT continued or maintained their improvement at follow-up, while participants in self-guided ICBT showed some signs of deterioration. The findings from the current study suggest that CBT might be an effective treatment for those struggling with severe procrastination, but that a group format may be better for some to sustain their benefits over time and that the clinical significance of the results need to be investigated further.     

Comics and in-Between Kids: Immigration-Themed Graphic Novels as a Resource for Second-Generation Adolescents

This paper describes the process of acculturation for immigrant adolescents using immigration-themed graphic novels. The author’s own experience as a third-culture child is offered as a starting point. The paper explains recent developments in acculturation theory. It uses vignettes from the graphic novels to show discrimination, ethnic bullying, and cultural self-definition. The article explains adolescents’ life-and-death need to belong in tension with a need to hold onto ethnic pride. It underscores that the painful process of working through cultural identifications is an important part of identity development and faith formation for adolescents.     

The Concept of Mental Toughness: Tests of Dimensionality,Nomological Network,and Traitness

Mental toughness has received increased scholarly attention in recent years, yet conceptual issues related to its (a) dimensionality, (b) nomological network, and (c) traitness remain unresolved. The series of studies reported in this article were designed to examine these three substantive issues across several achievement contexts, including sport, education, military, and the workplace. Five studies were conducted to examine these research aims—Study 1: N = 30; Study 2: calibration sample (n = 418), tertiary students (n = 500), athletes (n = 427), and employees (n = 550); Study 3: N = 497 employees; Study 4: N = 203 tertiary students; Study 5: N = 115 army candidates. Collectively, the results of these studies revealed that mental toughness may be best conceptualized as a unidimensional rather than a multidimensional concept; plays an important role in performance, goal progress, and thriving despite stress; and can vary and have enduring properties across situations and time. This series of studies provides a foundation for further basic and applied research of mental toughness across various achievement contexts.     

An Exploration of the Relationship Between Spirituality and State and Trait Anger Among Medical Students

There is a dearth of studies exploring spiritual attitudes of medical students from developing countries and its relationship to anger. This study was conducted to assess spiritual attitudes and their relationship with anger in a set of medical students in southern India. In this cross-sectional observational study, medical students who were undergoing clinical rotations were offered participation. Selected demographic data were obtained. The participants were rated using the Spiritual Attitudes Inventory [SAI, which comprises of Duke Religiosity Index, Existential Well-Being Scale (EWBS), Negative Religious Coping and Multidimensional Health Locus of Control scale] and State and Trait Anger Expression Inventory 2. Out of 98 students approached, 82 participated (response rate 83.6 %). The mean age of sample was 20.7 years (±0.9 years) with a slight preponderance of females (54.9 %). SAI scores correlated well significantly with subscale scores. Gender had no difference on the SAI or subscale score. Differences were found between self-reported religion and EWBS scores (Kruskal–Wallis χ ² = 8.891, p = 0.012). Total SAI score had a significant negative correlation with state anger, trait anger and anger expression. High levels of spirituality may be correlated with lower levels of state anger, trait anger and anger expression in medical students.     

Caring for the Suffering: Meeting the Ebola Crisis Responsibly

The current Ebola virus epidemic in Western Africa appears to be spiraling out of control. The worst-case projections suggested that the unchecked spread could result in almost 1.4 million cases by the end of January 2015 with a case fatality rate of at least 50%. The United States and European nations have begun to respond in earnest with promises of supplies, isolation beds, and trained health care personnel in an effort to contain the epidemic and care for the sick. However, there is neither a vaccine nor specific treatment for Ebola infection, and therapy is ideally centered on supportive care. I have previously argued that the provision of palliative care is obligatory during an overwhelming health catastrophe, notably pandemic influenza. Since affected Ebola patients have best outcomes with technologically advanced intensive care—resources in scarce supply in the area—I suggest that the only acceptable approach to large numbers of very sick, dying, and suffering Ebola patients who overwhelm the resources available to successfully manage them is effective palliative care. However, this could hasten death in this vulnerable population and hence, while ethically and medically justifiable, is not without social risk.