Efficacy of Guided iCBT for Depression and Mediation of Change by Cognitive Skill Acquisition

Guided internet CBT (iCBT) is a promising treatment for depression; however, it is less well known through what mechanisms iCBT works. Two possible mediators of change are the acquisition of cognitive skills and increases in behavioral activation. We report results of an 8-week waitlist controlled trial of guided iCBT, and test whether early change in cognitive skills or behavioral activation mediated subsequent change in depression. The sample was 89 individuals randomized to guided iCBT (n = 59) or waitlist (n = 30). Participants were 75% female, 72% Caucasian, and 33 years old on average. The PHQ9 was the primary outcome measure. Mediators were the Competencies of Cognitive Therapy Scale–Self Report and the Behavioral Activation Scale for Depression–Short Form. Treatment was Beating the Blues plus manualized coaching. Outcomes were analyzed using linear mixed models, and mediation with a bootstrap resampling approach. The iCBT group was superior to waitlist, with large effect sizes at posttreatment (Hedges’ g = 1.45). Dropout of iCBT was 29% versus 10% for waitlist. In the mediation analyses, the acquisition of cognitive skills mediated subsequent depression change (indirect effect = -.61, 95% bootstrapped biased corrected CI: -1.47, -0.09), but increases in behavioral activation did not. iCBT is an effective treatment for depression, but dropout rates remain high. Change in iCBT appears to be mediated by improvements in the use of cognitive skills, such as critically evaluating and restructuring negative thoughts.     

Books Recently Published

A test designed to measure dimensions of intrafamilial attitudes was administered to the parents of 250 children. The children were tested on the School Motivation Analysis Test. Among the many relationships obtained the most consistent predictor of the child SMAT scores was that of interspouse hostility, which was positively related to the children's assertiveness and sex scores and negatively related to childrens' narcism, protectiveness, and superego scores. In the case of the child self-sentiment scores a reversal occurred, with the fathers' interspouse hostility being positively related and the mothers' negatively related. These results must necessarily stand as tentative pending cross-validation; and they are regarded by the authors as hypothesis generating rather than as hypothesis testing. Although the linear multiple regression model used is a powerful one, it would not be unreasonable to expect interactions among some of the family attitude factors and, further, interactions of these factors with sex of the child and family demographic variables.     

Target Detection,Identification, and Marksmanship During Battlefield Noise in a Synthetic Environment

This study was conducted to determine the impact of noise on target detection, identification, and marksmanship (TDI&M) and to examine the effectiveness of a monetary reward to improve performance. Twenty active duty male soldiers participated in a non-reward and reward trial, each comprising three time blocks of two alternating 20-minute sessions, one with 87-dBA battlefield noise and the other relatively quiet. Each session involved 15 minutes of TDI&M testing followed by 5 minutes of rest. Neither noise, time on task, nor reward caused any noteworthy changes in TDI&M performance, except for foe target engagement time (ET). It appears that subjects purposely increased ET over the duration of the task to improve their hit accuracy but did not succeed in doing so. The monetary incentive to improve performance was also ineffective, because the subjects applied a similar “best” effort during the no-reward trial prior to this manipulation.     

The relation between achievement goal and expectancy-value theories in predicting achievement-related outcomes: A test of four theoretical conceptions

Although achievement goal and expectancy-value theories are both dominant in the achievement motivation literature, the relation between goals and expectancy-value variables in predicting achievement-related behaviors remains unclear. The present study evaluated the empirical validity of four contrasting theoretical conceptions which posit that (1) goals and expectancy-value variables are independent predictors of achievement-related outcomes (2) goals predict expectancy-values, (3) goals mediate the relation between expectancies and task-values, and (4) goals partially mediate the relation between expectancy-values and achievement outcomes, in predicting course performance, career intentions and academic aspirations. Path models evaluating these conceptions were tested separately in mathematics and language arts domains among 697 6th and 8th grade students. Results supported the fourth theoretical approach suggesting that expectancy-value variables predict achievement-related outcomes both directly and indirectly through achievement goals. These findings provide insight about the relation between expectancy-value and achievement goal theories and highlight their complementary role in predicting achievement behaviors.     

Issues in using interpreters in therapeutic work with refugees. What is not being expressed?

‘Interpreting’ could be thought about as a legal equal opportunities or human rights issue. Whereas interpreters are likely to focus on the linguistic issues, and will be aware of the technical complexities of their work. Clinicians may worry about the impact on the therapeutic relationship of the interpreter's presence, how this will be managed and how it may depend on the match or mismatch of such factors as the client's gender, age and first or other language. This paper considers the issue on each of these levels to reveal the complexities and dilemmas of effective clinical work with interpreters, but also what can be achieved: the multiple layers of meaning concerning the client's experience and communication which can be elicited through effective working between interpreter and clinician.     

Social Anxiety Disorder and Perceived Criticism in Intimate Relationships: Comparisons With Normal and Clinical Control Groups

Individuals with social anxiety disorder (SAD) have difficulties in their romantic relationships, including decreased satisfaction and intimacy, but the reasons for these difficulties are poorly understood. Because fear of negative evaluation is a cardinal feature of SAD, perceived criticism from a romantic partner may play a central role in socially anxious individuals’ relationships. In the present study, we compared levels of perceived, expressed, and observed criticism and reactions to criticism among individuals with SAD and their partners (n = 21), individuals with other anxiety disorders and their partners (n = 35), and couples free of psychopathology (n = 30). Participants rated both global criticism and criticism during a 10-minute problem-solving task, which was also coded for criticism by observers. Individuals with anxiety disorders showed elevated levels of interaction-specific perceived criticism, expressed criticism, and upset and stress due to criticism relative to normal controls; they also reported that the interaction was more stressful. However, there were no group differences on global measures of criticism, and the two anxious groups did not differ on any measures. Findings suggest that the high levels of criticism anxious individuals perceive and their corresponding negative reactions to criticism, though not specific to SAD, may account for some of the relationship difficulties that have been identified in SAD. Results also indicate that anxious individuals may contribute to their relationship difficulties by being highly critical themselves. Overall, our findings point to the need for a clinical focus on decreasing perceived criticism among individuals with anxiety disorders.     

Sex differences in the contexts of extreme jealousy

Research on sex differences in jealousy using continuous measures sometimes reveals that women report more intense jealousy than men in response to both sexual and emotional infidelity. Two studies tested whether these findings might have stemmed from sex differences in the interpretation of the upper anchor of the jealousy scales (e.g., “extremely jealous”). In Study 1, women and men offered different types of exemplars when describing situations in which they felt extremely jealous. A significantly greater proportion of women than men reported feeling extreme jealousy in the context of romantic relationships. Additional results demonstrated that women and men confuse the terms “jealousy” and “envy,” although this confusion cannot account for the sex differences in the contexts of extreme jealousy. Study 2 demonstrated that the sex difference in the intensity of reported jealousy disappears if the upper anchor of the scale is modified to include specific contextual information (e.g., “as jealous as you could feel in a romantic relationship”).     

Gender Differences in Impression Management in Organizations: A Qualitative Review

In this article we review the literature on impression management to determine if there are substantial gender differences in the employment of impression management tactics in organizational contexts. Based on a social roles theory perspective (Eagly, 1987), we examined use of impression management tactics in organizational settings for gender differences in behavior. We expected that men and women would generally report using impression management tactics consistent with gender role expectations and that this might not be advantageous to women in the corporate world. Our review of the literature supported our expectations. We conclude with implications of these findings for an enriched understanding of organizational behavior.