Metacognitive therapy in recurrent depression: A case replication series in Denmark

Metacognitive therapy (MCT) for depression is derived from the Wells and Matthews (1994) self‐regulatory model, in which a Cognitive‐Attentional Syndrome (CAS) is the cause of psychological disorders. MCT for depression focuses on identifying patients' CAS and helps them to stop it. The CAS consists of worry, rumination and dysfunctional coping strategies. The focus in MCT is on removing the CAS by challenging positive and negative metacognitive beliefs and eliminating dysfunctional behaviors. In this case series, MCT was delivered to four depressed Danes and treatment was evaluated in 5–11 sessions of up to one hour each. An A‐B design with follow‐up at 3 and 6 months was conducted and the primary outcome was Beck's Depression Inventory II (BDI‐II). We measured CAS processes with the Major depressive Disorder Scale (MDD‐S). The results of the case series showed clinically significant improvements in depressive symptoms, rumination and metacognitive beliefs and the effects were still present at follow‐up for all patients. The small number of patients and decreasing baselines observed in some cases limits the conclusions. However, the results suggest that this treatment is feasible and was associated with large improvements in symptoms when delivered away from its point of origin and in a Danish help‐seeking sample.     

Cognitive functioning and cortisol profiles in first episode major depression

Major Depressive Disorder (MDD) is often associated with high levels of stress and disturbances in the Hypothalamic Pituitary Adrenal (HPA) system, yielding high levels of cortisol, in addition to cognitive dysfunction. Previous studies have shown a relationship between cortisol profile and cognitive functioning in recurrent MDD in general. More specifically, the association between hypercortisolism and cognitive functioning, such as memory and Executive Functioning (EF), and also more recently cortisol suppression has been explored. However, no studies have investigated these relationships in patients diagnosed with first episode MDD. The aim of the present study was to examine the relationship between cortisol levels before and after the Dexamethasone suppression test (DST) and cognitive function in first episode MDD patients. Twenty‐one patients meeting the DSM‐IV criteria for a first episode of MDD diagnosis were included in the study. The control group was matched for age, gender and education level. Cortisol was measured in saliva collected with Salivette sampling devices. Saliva samples were collected 4 times during a 24 hours period over two consecutive days: at awakening, after 45 minutes, after 7 hours and at 11 pm. Dexamethasone (1.0 mg) was given orally on Day 1 at 11 pm. The neuropsychological test battery consisted of standardized tests measuring executive functioning (EF) and memory functioning. Cortisol levels did not differ significantly between patients and controls on Day 1, except for the last sample before Dexamethasone administration, where the control group showed higher levels. Both groups showed suppression after Dexamethasone. On Day 2 there was a significant difference between groups at the third sample, showing a significantly lower level in the control group, suggesting that the controls have a more effective suppression profile than the patients. There were no significant correlations between cortisol levels before or after Dexamethasone and cognitive measures. The results indicate impairment on HPA‐axis functioning in first episode MDD patients, with less suppression functioning compared to healthy controls, but no relationship between cortisol profile and cognitive functioning in EF or Memory.     

Illness Perception and Well-Being Among Persons with Multiple Sclerosis and Their Caregivers

This study jointly examined illness beliefs held by persons with multiple sclerosis (PwMS) and caregivers in relation to well-being. A group of 68 PwMS and their caregivers completed the Revised Illness Perception Questionnaire, Psychological Well-being Scales, Satisfaction with Life Scale and Positive Affect and Negative Affect Schedule. Findings revealed that PwMS’ well-being was primarily predicted by their own illness beliefs, and that also caregivers’ well-being was primarily predicted by their own beliefs. Across the two groups, well-being was positively associated with their belief that they understood the disease, and inversely associated with their representations of negative emotions. In addition, among PwMS, well-being was inversely associated with the number of symptoms they specifically attributed to their illness, while among caregivers, well-being was positively associated with beliefs that treatment could control the disease. Based on the study findings, psychoeducational and cognitive-behavioral strategies are suggested to promote well-being among PwMS and caregivers.     

Socialisation Influences on Gender Ideologies of Immigrant and Native Youth in Germany,England, Sweden and the Netherlands

Adolescence is a crucial life course phase for identity formation, and youths’ gender ideologies significantly predict gendered behaviours and longer-term transitions. With Western post-industrial societies becoming more culturally diverse, the present study provides novel cross-nationally comparative evidence on gender socialisation processes among native and immigrant youth in Sweden, Germany, England, and the Netherlands, which vary in gender and migration policies and cultures. In addition to parents’ gender ideologies, the study also considers classmates’ gender ideologies as factors shaping 14-year-old adolescents’ gender ideologies. The analysis draws on 5917 adolescent-parent dyads from the Children of Immigrants Longitudinal Study which we link with country-level gender empowerment measures from the United Nations. Remarkably, with the exception of native female adolescents in England and Germany, parents tend to report slightly more egalitarian beliefs than adolescents across the four countries. OLS regressions show that parents’ and classmates’ gender ideologies correlate significantly with adolescents’ ideologies, with little variation across gender and immigrant groups in all four countries. From a policy and practical point of view, the great similarity in the intergenerational transmission of gender beliefs across diverse family backgrounds as well as cultural and policy contexts seem remarkable.

     

Investigating the Links Between Cultural Values and Belief in Conspiracy Theories: The Key Roles of Collectivism and Masculinity

Research suggests that belief in conspiracy theories (CT) stems from basic psychological mechanisms and is linked to other belief systems (e.g., religious beliefs). While previous research has extensively examined individual and contextual variables associated with CT beliefs, it has not yet investigated the role of culture. In the current research, we tested, based on a situated cultural cognition perspective, the extent to which culture predicts CT beliefs. Using Hofstede's model of cultural values, three nation-level analyses of data from 25, 19, and 18 countries using different measures of CT beliefs (Study 1, N = 5323; Study 2a, N = 12,255; Study 2b, N = 30,994) revealed positive associations between masculinity, collectivism, and CT beliefs. A cross-sectional study among U.S. citizens (Study 3, N = 350), using individual-level measures of Hofstede's values, replicated these findings. A meta-analysis of correlations across studies corroborated the presence of positive links between CT beliefs, collectivism, r = .31, 95% CI = [.15; .47], and masculinity, r = .39, 95% CI = [.18; .59]. Our results suggest that in addition to individual differences and contextual variables, cultural factors also play an important role in shaping CT beliefs.     

Attention and semantic processing during speech: an fMRI study

This fMRI study was conducted to investigate whether language semantics is processed even when attention is not explicitly directed to word meanings. In the “unattended” condition, the subjects performed a visual detection task while hearing semantically related and unrelated word pairs. In the “phoneme” condition, the subjects made phoneme judgements between prime and target words, and in the “word” condition, they indicated whether the words in each word pair were semantically related or unrelated. In the word condition, stronger activity was obtained for unrelated than related words in the superior temporal gyrus/sulcus (STG/STS), lingual/fusiform gyri and cuneus, whereas in the phoneme condition no such effect was observed. However, during the unattended condition, stronger activity was found in the right STG. Our results suggest that both semantic judgement of word pairs and their passive hearing activate the same neural networks but this activation is more restricted in the passive hearing.     

General self-efficacy and health-related quality of life after myocardial infarction

Fatigue after myocardial infarction (MI) has been found to be distressing. A person's self-efficacy will influence his/her health behavior and plays an active role in tackling illness consequences. This study investigated associations between fatigue, disturbed sleep, general self-efficacy, and health-related quality of life (HRQoL) in a sample of 145 respondents admitted to hospital for MI two years earlier. The aim was to identify the predictive value of general self-efficacy and to elucidate mediating factors between self-efficacy and HRQoL. General self-efficacy measured four months after MI was positively related to HRQoL after two years. In tests of indirect effects, fatigue meditated the effects between self-efficacy and the physical and the mental dimension of HRQoL, respectively. The indirect effect of disturbed sleep went through that of fatigue. To conclude, patients who suffer from post-MI fatigue may need support aimed at helping them increase their self-efficacy as well as helping them adapt to sleep hygiene principles and cope with fatigue, both of which will have positive influences on HRQoL.     

Causal attributions of obese men and women in genetic testing: Implications of genetic/biological attributions1

The present study sought to investigate genetic/biological attributions of obesity, their associations with a predisposition to obesity and their crossectional and longitudinal implications for weight regulation in obese individuals presenting for genetic testing and counselling. A total of 421 obese men and women underwent psychological and anthropometric assessment and a mutation screen of the melanocortin-4 receptor gene. At study entry, women revealed more genetic/biological attributions than men on the Revised Illness Perception Questionnaire adapted to obesity (86.2% versus 59.7%). Genetic/biological attributions of obesity were associated in both sexes with a family history of obesity, assessed through Stunkard's Figure Rating Scale. In both sexes, genetic/biological attributions were unrelated to weight regulation beliefs and behaviour (i.e. self-efficacy, controllability beliefs, restrained eating and physical activity), assessed through standardised questionnaires or interview at baseline and at six-month follow-up. In addition, causal attributions and weight regulation beliefs and behaviour were not predictive of body mass index at six-month follow-up. Overall, the results indicate that causal attributions of obesity to genetic/biological factors in obese individuals presenting for genetic screening and counselling are crossectionally and longitudinally unrelated to weight regulation and longer-term weight outcome. Those who attribute their obesity to genetic/biological factors likely have a familial obesity risk.     

Psychodynamic psychotherapy for children with disruptive disorders

Findings from a clinical project aiming to make psychodynamic psychotherapy more effective for children with disruptive disorders are summarised and discussed. In this project a supportive expressive model was used and the therapists worked with both children and parents. Nine boys aged 6 – 10 years were treated; all were reported to function better socially after therapy, but improvements were less marked in those boys who in addition to the initial diagnoses of ODD or CD had ADHD. Collaborative meetings with school teachers were associated with more positive effects.