A randomized controlled trial of internet-based therapy in depression

Depression is among the most prevalent disorders worldwide. In view of numerous treatment barriers, internet-based interventions are increasingly adopted to “treat the untreated”. The present trial (registered as NCT01401296) was conducted over the internet and aimed to assess the efficacy of an online self-help program for depression (Deprexis). In random order, participants with elevated depression symptoms received program access or were allocated to a wait-list control condition. After eight weeks, participants were invited to take part in an online re-assessment. To compensate for common problems of online studies, such as low completion rates and unclear diagnostic status, reminders and incentives were used, and clinical diagnoses were externally confirmed in a subgroup of 29% of participants. Relative to the wait-list group, program users experienced significant symptom decline on the Beck Depression Inventory (BDI; primary outcome), the Dysfunctional Attitudes Scale (DAS), the Quality of Life scale (WHOQOL-BREF) and the Rosenberg Self-Esteem Scale (RSE). Compared to wait-list participants, symptom decline was especially pronounced among those with moderate symptoms at baseline as well as those not currently consulting a therapist. Completion (82%) and re-test reliability of the instruments (r = .72–.87) were good. The results of this trial suggest that online treatment can be beneficial for people with depression, particularly for those with moderate symptoms.     

Young Women’s Social and Occupational Development and Mental Health in the Aftermath of Child Sexual Abuse

We examined social role functioning and depressive symptoms of young adults who were abused as children in data from a longitudinal community sample. Sexually abused women and men were more depressed during their senior year of high school, and this difference was more pronounced 2 years later. We then examined a mediational model to determine whether social functioning explained the course of depressive symptoms over this transitional period. Focusing only on young women, for whom the prevalence of abuse was much higher, results indicated that two-thirds of the effect of abuse on depressive symptoms was explained by experiences and choices in the domains of work, education and intimate relationships. Having less supportive intimate relationships and lower rates of attendance at 4-year colleges were particularly important. Findings reveal the key role played by early adult interpersonal and occupational development in perpetuating the mental health impact of childhood trauma.     

Die Vorhersage der Rückfälligkeit entlassener Sexualstraftäter mittels des Sexual Offender Risk Appraisal Guide (SORAG) und dessen Screening-Version (SORAG-SV): Darstellung der differentiellen und prädiktiven Validität

The Sex Offender Risk Appraisal Guide (SORAG) is one of the most important actuarial risk assessment instruments for sexual offenders. In the meantime, the application of actuarial instruments in recidivism risk assessment for sexual offenders is regarded as state of the art. In addition to results about interrater reliability and concurrent validity we present results about the differential and predictive validity of the SORAG and a screening version of the SORAG (SORAG-SV), which relies only on file information. In order to examine the predictive validity, we used a representative sample of 519 male sexual offenders released from a prison sentence served in one of Austrian´s prisons with a mean follow-up period of 3½ years. Furthermore, we tested the differential validity by dividing the whole sample in different subsamples regarding age, index offense type, and degree of antisociality. Both SORAG and SORAG-SV showed predominantly good predictive accuracy which, however, varied depending on offender subgroup and recidivism category.     

The adaptation dynamics of chronic functional impairment: what we can learn from older adults with vision loss

This study used vision loss due to age-related macular degeneration to learn about adaptation processes related to chronic functional impairment, focusing on Horowitz and Reinhardt's (1998) concept of Adaptation to Age-related Vision Loss (AVL) as the outcome. We hypothesized that impacts of visual acuity on AVL are mediated by perceived functional vision losses and functional abilities, and tested for "adaptive" weakening of this impact with ongoing loss. Longitudinal data covering a one-year interval from samples with age-related macular degeneration gathered in New York (N = 361) and Heidelberg (Germany, N = 90) were used. We analyzed the hypothesized causal structure by modeling latent change scores, and checked if those with low, medium, and high levels of vision loss at baseline differ in the relations between one-year change scores. Results confirmed that impacts of vision loss on AVL are mediated by decline in functional ability. However, under the most severe levels of vision loss at baseline, functional decline showed only a minor impact on AVL change not explained by a lack of further decline in vision. Findings confirm the effectiveness of adaptation in terms of reduced reactivity to functional losses across increasing level of chronic impairment. Thus, adaptation, weakening the impact of chronic functional impairment on psychological outcomes over time with disease progression, deserves consideration in the study of psychological consequences of chronic physical health conditions in old age.     

The Severe Sexual Sadism Scale: cross-validation and scale properties

The Severe Sexual Sadism Scale (SSSS) is a screening device for the file-based assessment of forensically relevant sexual sadism. The SSSS consists of 11 dichotomous (yes/no) items that code behavioral indicators of severe sexual sadism within sexual offenses. Based on an Austrian sample of 105 sexual offenders, the present study replicated the 1-dimensional scale structure of the SSSS, as evidenced by confirmatory factor analysis. More specifically, the scale was commensurate with the 1-parameter logistic test model (Rasch model). Reliability was estimated to be good. Criterion validity for the clinical diagnosis of sexual sadism was good. With a cutoff value of 7 points, sensitivity and specificity were estimated at 56% and 90%, respectively.     

Über die Treffsicherheit der standardisierten Risikoeinschätzungsverfahren Static-99 und Stable-2007 bei aus einer Sicherungsmaßnahme entlassenen Sexualstraftätern

The accuracy of the recidivism risk assessment instruments Static-99 and Stable-2007 for sexual offenders was examined in a population of released male forensic sexual offenders hospitalized under mandatory treatment in Austria (N?=?96). The Static-99 with an area under the curve (AUC) ?value of 0.86 and the Stable-2007 (AUC?=?0.71) were significantly related to sexual reoffending after nearly 7 years time at risk, thus revealing a predictive power comparable with offenders released from prison (N?=?274). Also the Stable-2007 incrementally supplemented the predictive accuracy of the Static-99. Static-99/Stable-2007 risk/need categories identified a high risk group with a 50?% chance for sexual reconviction within 5 years after release despite a favorable risk assessment as the precondition for release and post-release risk management. On the other hand, there was virtually no relapse in the three lowest risk categories suggesting a specific effect of the mandatory treatment at least in these offender categories. The data suggest that the instruments are valid not only for offenders released from prison but also for forensic sexual offenders.     

Examining the costs and benefits of inhibition in memory retrieval

Inhibitory control is thought to serve an adaptive function in controlling behavior, with individual differences predicting variation in numerous cognitive functions. However, inhibition is more properly construed as inducing both benefits and costs to performance. Benefits arise at the point when inhibition prevents expression of an unwanted or contextually inappropriate response; costs arise later, when access to the inhibited representation is required by other processes. Here we illustrate how failure to consider both the costs and benefits of inhibition has generated confusion in the literature on individual differences in cognitive control. Using retrieval-induced forgetting as a model case, we illustrate this by showing that changing the way that retrieval-induced forgetting is measured to allow greater expression of the benefits of inhibition together with the costs can reduce and even reverse the theoretically predicted correlation between motor and memory inhibition. Specifically, we show that when the final test in a retrieval-induced forgetting procedure employs item-specific cues (i.e., category-plus-stem cued recall and item-recognition) that better isolate the lingering costs of inhibition, better motor response inhibition (faster stop-signal reaction times) predicts greater retrieval-induced forgetting. In striking contrast, when the final test is less well controlled, allowing both the costs and benefits of inhibition to contribute, motor response inhibition has the opposite relationship with retrieval-induced forgetting. These findings underscore the importance of considering the correlated costs and benefits problem when studying individual differences in inhibitory control. More generally, they suggest that a shared inhibition mechanism may underlie people’s ability to control memories and actions.