Practice-based evidence: patients who did not respond to group analysis

Evidence-based psychotherapy is typically based on treatment outcome for the "average" patient in aggregate designs; reports on individual non-responders are rarely published. In this observational study, we explored factors that might have contributed to non-response in long-term dynamic group psychotherapy. Eight patients (14%) who did not change were compared with 48 treatment responders on clinical variables, and their case stories were retrospectively scrutinized for explanatory factors. The non-responders had less initial distress, stayed for shorter durations in therapy, and were more dissatisfied with their group and therapists. Based on detailed case stories, attempts are made to tease out idiographic hypotheses why each patient did not change during group analysis.     

Therapeutic alliance in guided internet-delivered cognitive behavioural treatment of depression, generalized anxiety disorder and social anxiety disorder

Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in several controlled trials, but the mechanisms of change are largely unknown. Therapeutic alliance is a factor that has been studied in many psychotherapy trials, but the role of therapeutic alliance in ICBT is less well known. The present study investigated early alliance ratings in three separate samples. Participants from one sample of depressed individuals (N = 49), one sample of individuals with generalized anxiety disorder (N = 35), and one sample with social anxiety disorder (N = 90) completed the Working Alliance Inventory (WAI) modified for ICBT early in the treatment (weeks 3-4) when they took part in guided ICBT for their conditions. Results showed that alliance ratings were high in all three samples and that the WAI including the subscales of Task, Goal and Bond had high internal consistencies. Overall, correlations between the WAI and residualized change scores on the primary outcome measures were small and not statistically significant. We conclude that even if alliance ratings are in line with face-to-face studies, therapeutic alliance as measured by the WAI is probably less important in ICBT than in regular face-to-face psychotherapy.     

Memory factors in Rey AVLT: Implications for early staging of cognitive decline

Supraspan verbal list learning is widely used to assess dementia and related cognitive disorders where declarative memory deficits are a major clinical sign. While the overall learning rate is important for diagnosis, serial position patterns may give insight into more specific memory processes in patients with cognitive impairment. This study explored these patterns in a memory clinic clientele. One hundred eighty three participants took the Rey Auditory‐Verbal Learning Test (RAVLT). The major groups were patients with Alzheimer's disease (AD), Vascular Dementia (VD), Mild Cognitive Impairment (MCI), and Subjective Cognitive Impairment (SCI) as well as healthy controls (HC). Raw scores for the five trials and five serial partitions were factor analysed. Three memory factors were found and interpreted as Primacy, Recency, and Resistance to Interference. AD and MCI patients had impaired scores in all factors. SCI patients were significantly impaired in the Resistance to Interference factor, and in the Recency factor at the first trial. The main conclusion is that serial position data from word list testing reflect specific memory capacities which vary with levels of cognitive impairment.     

A Review of Published Self-help Books for Panic Disorder

This brief review of 14 self-help books on panic disorder compares: target group, treatment time, included components, existence of structured exercises, and whether or not daily record-keeping is encouraged. Six of the books cover all components deemed necessary for a multimodal cognitive-behavioral treatment package, and five of these are recommended. The reviews are followed by a brief summary of published bibliotherapy studies in which a selection of the books has been used. The results of these studies suggest that bibliotherapy is effective, with an effect size ranging from d = 0.5 to d = 1.5.     

The Five Factor Mindfulness Questionnaire in Norway

The aim of this study was to adapt the Five Factor Mindfulness Questionnaire (FFMQ) for use in Norway. Three studies involving three different samples of university students (mean age 22 years, total N = 792) were conducted. Confirmatory factor analyses showed that a five factor structure provided an acceptable fit to the data. All five factors loaded significantly on the overall mindfulness factor. As expected, correlations between the FFMQ total scores and subscales were positive and significant, ranging from 0.45 to 0.65. Correlations between FFMQ total/subscales and Mindful Attention Awareness Scale (MAAS) were significant and negative (since low scores on the MAAS indicate high mindfulness), ranging from r = ?0.17 to ?0.69. The Norwegian FFMQ total score was inversely correlated with all indicators of psychological health: neuroticism (r = ?0.61), ruminative tendencies (r = ?0.41), self‐related negative thinking (r = ?0.40), emotion regulation difficulties (r = ?0.66) and depression (r = ?0.46 to r = ?0.65). In contrast to the other FFMQ subscales, the FFMQ Observe subscale did not have a positive relation to psychological health in our mostly non‐meditating sample. However, being able to non‐judgmentally observe one's inner life and environment is a part of the mindfulness construct that might emerge more clearly with more mindfulness training. We conclude that the Norwegian FFMQ has acceptable psychometric properties and can be recommended for use in Norway, especially in studies seeking to differentiate between different aspects of mindfulness and how these may change over time.     

Personality characteristics associated with romantic attachment: a comparison of interview and self-report methodologies

This study compared the personality attributes associated with self-report versus interview assessment of romantic attachment. Twenty-three-year-olds (N = 83) completed the Romantic Attachment Interview, the Experiences in Close Relationship Inventory, and measures of response bias, self-enhancement, and self-insight. Five psychologists evaluated the participants' personality. Although both self-report and interview assessment were related to attachment-relevant personality attributes, interview assessment was slightly more likely to explain unique variance in personality, especially regarding intrapsychic attributes. Self-enhancement was negatively related to secure attachment and positively related to dismissing attachment. The opposite pattern emerged for self-insight. A subgroup of 12 vulnerable individuals who described themselves as securely attached on self-report was judged as dismissing according to interview assessment. These individuals scored low on self-insight and high on self-enhancement and psychological vulnerability. The results are discussed with reference to the relative strengths of different measures of romantic attachment and relations among dismissing attachment, self-enhancement, and narcissism.     

Interactive decision-making: effects of consultation before personal decisions on postdecision consolidation

Pre- and postdecision processes were studied in triads of participants, dyads of participants, and for individual decision-makers in two experiment (N = 57 and 50). Participants were students volunteering to take part in the study (21 men and 36 women with a mean age of 24 yr. and 25 men and 25 women with a mean age of 27 yr.). The purpose was to examine how much interactive versus individual social interaction (consultation with others before making a personal decision) affects postdecision consolidation. Predecision differentiation and postdecision consolidation have been defined as attractiveness changes over time in favour of the chosen alternative. Participants were coded into three categories (noncompensatory, compensatory, and nonclassified) according to their different decision strategies. For Exp. 1, postdecision consolidation effects were significant for participants who used a noncompensatory (no comparisons across attributes) decision strategy. For Exp. 2, postdecision consolidation effects were significant for participants who made a personal decision but not those who made an interactive decision. The differing results in these two experiments were discussed.     

Joint attention in term and preterm infants at 12 months corrected age: the significance of gender and intervention based on a randomized controlled trial

This study tested the effects of optimized neonatal mother–infant transactions on joint attention performance at 12 months. Surviving infants <2000 g from a geographically defined area were randomly assigned to a preterm intervention (n = 71) or preterm control group (n = 69). Comparisons were made between preterm groups, secondary with a term group (n = 75). Joint attention was measured using the Early Social Communication Scales. Preterm intervention infants scored significantly higher than preterm control infants on elements Initiating Joint Attention (p < 0.05), Initiating Object Requests (p < 0.05), and Responding to Social Interaction (p < 0.0005). Intervention was not associated with performance on elements Responding to Joint Attention, or on Responding to Requests. ELBW infants scored significantly lower than VLBW and LBW infants on imperative functions. Girls outperformed boys on all communication elements. An intervention implemented during the neonatal period can be of advantage for certain aspects of joint attention performance in preterm infants.