Ruminative subtypes and coping responses: Active and passive pathways to depressive symptoms

Individuals draw on a variety of cognitive strategies—some active, some passive—as a way of coping with stress and dysphoria. Previous research suggests that the impact of rumination—one such strategy—on depression depends on whether rumination takes the passive form of brooding versus the more active form of reflection. This study tests whether brooding and reflection explain the effects of passive versus active coping responses, respectively, on depressive symptoms. In an undergraduate sample (n=284), brooding partially mediated the relationship between passive coping and depressive symptoms, whereas reflection did not. Reflection moderated the relationship between active coping and symptoms, such that low active copers who were high in reflection endorsed more symptoms than those low in reflection. Brooding and reflection may operate within cognitive–behavioural response pathways characterised by an active/passive distinction. Whether reflection is maladaptive likely depends on the active nature of the surrounding coping response.     

Randomized,placebo-controlled trial of cognitive-behavioral therapy alone or combined with sertraline in the treatment of pediatric obsessive–compulsive disorder

Background

To examine the efficacy of sequential sertraline and cognitive-behavioral therapy (CBT) treatment relative to CBT with pill placebo over 18 weeks in children and adolescents with obsessive–compulsive disorder (OCD).

Methods

Forty-seven children and adolescents with OCD (Range = 7–17 years) were randomized to 18-weeks of treatment in one of three arms: 1) sertraline at standard dosing + CBT (RegSert + CBT); 2) sertraline titrated slowly but achieving at least 8 weeks on the maximally tolerated daily dose + CBT (SloSert + CBT); or 3) pill placebo + CBT (PBO + CBT). Assessments were conducted at screening, baseline, weeks 1–9, 13, and 17, and post-treatment. Raters and clinicians were blinded to sertraline (but not CBT) randomization status. Primary outcomes included the Children's Yale-Brown Obsessive–Compulsive Scale, and response and remission status. Secondary outcomes included the Child Obsessive Compulsive Impact Scale–Parent/Child, Children's Depression Rating Scale-Revised, Multidimensional Anxiety Scale for Children, and Clinical-Global Impressions-Severity.

Results

All groups exhibited large within-group effects across outcomes. There was no group by time interaction across all outcomes suggesting that group changes over time were comparable.

Conclusions

Among youth with OCD, there was no evidence that sequentially provided sertraline with CBT differed from those receiving placebo with CBT.

ClinicalTrials.gov Identifier

NCT00382291.     

Talkativeness in Cognitively Normal Women at Genetic Risk for Alzheimer’s Disease

Previous research has suggested a correlation between some linguistic patterns and the risk for Alzheimer’s disease (AD). There is increasing clinical need to identify factors that can be used alone or in combination to predict the onset of AD. The purpose of the present study was to explore the association of language skills and genetic risk for Alzheimer’s disease. Oral and written language samples of cognitively normal women with a susceptibility gene for AD (ApoE e4) were compared to those of noncarriers on measures of grammatical complexity, topic relevance, and talkativeness by observers unaware of participant genotypes. Participants included 29 ApoE e4 carriers 49-73 years of age, and 29 e4 noncarriers 48-76 years of age, most of whom had a first-degree relative with AD. Carriers and noncarriers were group matched for age, educational level, and estimated IQ. Participant groups did not differ significantly in language complexity or topic relevance. However, the ApoE e4 group was significantly more talkative than the noncarrier group (p < .05).     

“Leaving it to God” Religion and Spirituality among Filipina Immigrant Breast Cancer Survivors

Many Filipinos have a powerful adherence to Catholicism. However, little is known about spirituality and religious involvement of Filipina Americans who have been diagnosed with breast cancer. Ten (n = 10) in-depth qualitative interviews with Filipina immigrant breast cancer survivors identified prayer to be the most common religious practice, followed by prayers by others and spiritual support from the Catholic Church. These findings can help clinicians and researchers understand the role of spirituality and religion in providing comfort and support for Filipina immigrant breast cancer patient as they face the stress of diagnosis and treatment.     

“A Community with Diversity of Culture,Wealth, Resources,and Living Experiences”: Defining Neighborhood in an Unincorporated Community

To obtain a better understanding of how people living in an unincorporated region define their neighborhood, a long-term photovoice project was conducted. Thirty-one photovoice sessions and eight structured interviews were coded and analyzed to assess participants’ neighborhood definitions. Participant’s difficulties in identifying the geographic, physical and demographic characteristics of their neighborhood led them to use social interactions, place-mediated values, and civic engagement to define neighborhood.     

Self-Regulation and Other Executive Functions Relationship to Pediatric OCD Severity and Treatment Outcome

The intersection of obsessive-compulsive disorder (OCD) and executive functioning (EF) in children and adolescents is an emerging topic in the current literature. Spurred by the consistent association between increased EF deficits and higher adult obsessive-compulsive severity, a few initial studies have replicated this relationship in pediatric OCD samples and also have found preliminary evidence that EF deficits are associated with worse response to first-line psychotherapeutic or psychopharmacological treatments for pediatric OCD. This study aimed to extend the literature by providing the first comprehensive investigation of how multiple EF domains, measured repeatedly over the course of treatment, impact pediatric obsessive-compulsive severity and response to multimodal treatment. Multi-level modeling results found that deficits in shifting, inhibition, emotional control, planning/organizing, monitoring and initiating all predicted higher average obsessive compulsive severity across treatment. Interestingly, out of the eight domains of EF investigated, only emotional control moderated treatment outcome such that those with worse emotional control experienced less of a reduction in obsessive-compulsive severity during treatment. The findings generally align with previous theories for the link between EF and OCD and indicate that emotional control has important implications in the treatment of pediatric OCD. In fact, emotional control may provide one explanation for why factors such as disgust sensitivity, oppositional behavior, and third-wave behavioral treatment techniques have all been linked to pediatric OCD treatment outcome. Future research should investigate augmentation strategies that target emotional control in children and adolescents.     

How farsighted are behavioral tendencies of approach and avoidance? The effect of stimulus valence on immediate vs. ultimate distance change

Research suggests that affective stimuli facilitate behavior that causes a compatible change in distance (i.e., approach positive and avoid negative stimuli). In natural settings, however, behavior often causes different consequences at different points in time. It is unclear whether affective stimuli interact with immediate or ultimate action-consequences (i.e., consequences that are more removed in time). To shed light on this, we tested whether stimulus valence facilitates behavior that ultimately causes a compatible change in distance, even when this behavior immediately causes an incompatible distance change. Participants moved a manikin on a computer screen toward or away from a positive or negative word. On half of the trials, moving the manikin ultimately in one direction required an initial movement in the opposite direction. Results from two studies showed that stimulus valence facilitated ultimate-compatible distance change regardless of the initial direction. This suggests that affective stimuli facilitate behavior that is relatively farsighted.