Effectiveness of Web- and Mobile-Based Treatment of Subthreshold Depression With Adherence-Focused Guidance: A Single-Blind Randomized Controlled Trial

Evidence for the impact of psychological Interventions for subthreshold depression (sD) is conflicting. Moreover, human resources to deliver such treatments are limited. This study aimed to evaluate the effectiveness of a web-based intervention with adherence-focused guidance in the treatment of sD. Participants with sD (CES-D ≥ 16, no Major Depressive Disorder according to DSM-IV criteria, N = 204) recruited via a large health insurance were randomly allocated to a web-based mobile-supported cognitive-behavioral intervention or to a waitlist control condition with unrestricted access to usual care. The primary outcome was the reduction in depressive symptom severity as measured by blind diagnostic raters using the Quick Inventory of Depressive Symptomatology (QIDS) at posttreatment. There was a statistically significant between-group difference in QIDS scores at posttreatment in favor of the intervention group, F(1, 201) = 11.31, p = .001, corresponding to a medium effect size of d = 0.37 (95% CI 0.09–0.64) and a NNT of 7 (95%–CI 3.7–41.2). Significant effects in favour of the intervention group were also found for secondary outcomes such as quality of life, anxiety, and insomnia severity. Web-based self-help interventions with adherence-focused guidance could be an acceptable and effective approach to reduce a range of negative consequences associated with subclinical depression.     

Internalism and the Origin of Rational Motivation

What makes a subject's motivationrational is its originating in her practicalreasoning. I explain the appeal of this thesisabout rational motivation, and explore itsrelation to recent discussions of internalismabout reasons for action. I do so in theservice of clarifying an important meta-ethicaldebate between Humean motivational skeptics andtheir Kantian opponents. This debate is oneover whether, as this skeptic contends andKantians deny, considerations about ourmotivational capacities, together withinternalism, restrict genuine reasons foraction to merely instrumental ones. I arguethat properly adjudicating this debate requiresidentifying one particular way in which thethesis about rational motivation has beendeveloped – namely, as a part of what I term``the traditional conception' of themotivational efficacy of practical reason. Onthis conception, rational motivation consistsin choosing some course of conduct out of one'scognitive appreciation of the way its relationto one's practicable good gives one reason todo so. And I side with Kantians against theHumean motivational skeptic in part on groundsthat Kant himself – though not all Kantians –would find congenial: namely, that we shouldaccept the traditional conception.     

Community reforestation in the Philippines: An evaluation of community contracts

Concern over massive losses of tropical forest in the Philippines has led to a reforestation program that includes contracts with local community organizations. Two projects are evaluated with respect to the objectives of the program, which were: to reverse deforestation and environmental degradation; to improve the well-being of communities by increasing income opportunities; and, to ensure a sustainable forest-based economic sector. The evaluation, first undertaken four years into the program, was based on information from a variety of sources, including the local community. The assessment highlights the importance of on-going community participation and identifies significant obstacles to meeting the program’s objectives.     

Do obsessional beliefs discriminate OCD without tic patients from OCD with tic and Tourette's syndrome patients?

There is considerable overlap in symptomatology between Tourette's syndrome (TS) and obsessive-compulsive disorder (OCD). Increased rates of tics are found in OCD and up to 60% obsessive-compulsive symptoms in TS. However, in OCD obsessive-compulsive symptoms are more often anxiety-related and, as a consequence, aimed at anxiety-reduction, whereas in TS these symptoms are more stimulus-bound. Therefore, it is of clinical interest to study whether these phenomenological differences are reflected in differences between dysfunctional cognitions accompanying OC symptoms in OCD with or without tics and TS. Current cognitive theory of OCD ascertains that specific dysfunctional beliefs are important in the etiology and maintenance of OCD. To assess these beliefs, the obsessive-compulsive beliefs questionnaire-87 (OBQ-87) has been developed. In the present study, OBQ-87 scores of OCD patients without tics, OCD with tics, and TS (without OCD) patients were compared to those of normal controls. Results: OCD without tic patients exhibited higher OBQ-87 scores than TS patients. No differences were found between OCD with or without tic patients on any of the OBQ-87 subscales. These results suggest that: (1) dysfunctional beliefs have no discriminative power with respect to OCD with or without tic patients; (2) the direct relationship between types of OC symptoms and specific dysfunctional beliefs is questionable. Therefore, one can doubt the specificity of cognitive theory of OCD to explain specific OC behavior.     

Mapping the Personality Psychopathology Five Domains Onto DSM–IV Personality Disorders in Dutch Clinical and Forensic Samples: Implications for DSM–5

The Personality Psychopathology Five (PSY–5) model represents 5 broadband dimensional personality domains that align with the originally proposed DSM–5 personality trait system, which was eventually placed in Section III for further study. The main objective of this study was to examine the associations between the PSY–5 model and personality disorder criteria. More specifically, we aimed to determine if the PSY–5 domain scales converged with the alternative DSM–5 Section III model for personality disorders, with a particular emphasis on the personality trait profiles proposed for each of the specific personality disorder types. Two samples from The Netherlands consisting of clinical patients from a personality disorder treatment program (n = 190) and forensic psychiatric hospital (n = 162) were used. All patients had been administered the MMPI–2 (from which MMPI–2–RF PSY–5 scales were scored) and structured clinical interviews to assess personality disorder criteria. Results based on Poisson or negative binomial regression models showed statistically significant and meaningful associations for the hypothesized PSY–5 domains for each of the 6 personality disorders, with a few minor exceptions that are discussed in detail. Implications for these findings are also discussed.     

Sustainable Masculinity in Ecumenical Perspective

Gender is an important topic of the WCC's Pilgrimage of Justice and Peace. It is the result of both theological anthropological concerns and the ongoing search for justice and peace. In other words, it is a typical area where traditional Faith and Order and Life and Work concerns coincide. Yet, gender is often taken to mean concerns of the role, rights, and treatment of women primarily, with some attention to the position and treatment of transgender persons and sexual minorities. This article argues that, precisely from the point of view of these ecumenical theological concerns, attention for masculinity as a gender is also required. The reason for this is that although many different forms of masculinity are supported with an appeal to the Christian tradition, not all forms of masculinity are compatible with a desire for safeguarding human dignity and a sustainable journey into the future.     

Development and Evaluation of a Telephone Communication Protocol for the Delivery of Personalized Melanoma Genomic Risk to the General Population

Communicating personalized genomic risk results for common diseases to the general population as a form of tailored prevention is novel and may require alternative genetic counseling service delivery models. We describe the development and evaluation of a communication protocol for disclosing melanoma genomic risk information to the asymptomatic general population and assess participants’ satisfaction and acceptability. Participants (n?=?117) were aged 22–69 years, living in New South Wales, Australia and unselected for family history. They provided a saliva sample and had genomic testing for melanoma for low to moderate penetrant melanoma susceptibility variants in 21 genes. Participants could choose to receive their results from a genetic counselor via telephone, followed by a mailed booklet or to receive their risk result via mailed booklet only with a follow-up call for those at high risk. A follow-up questionnaire was completed by 85% of participants 3-months later. Most participants (80%) elected to receive their result via telephone. Participants were highly satisfied with the delivery of results (mean 3.4 out of 4, standard deviation 0.5), and this did not differ by delivery mode, risk category, age or sex. On follow-up, 75% accurately recalled their risk category, 6% indicated a preference for a different delivery mode, either electronic or face-to-face. The process of disclosing genomic risk results to the general population over the telephone with accompanying written material was feasible and acceptable, and may be useful for communicating polygenic risk for common diseases in the context of increasing demands for genomic testing.     

The effectiveness of personalized e-mail newsletters and the role of personal characteristics

Personalizing communication means creating persuasive messages that refer to aspects of a person's self. Although the use of personalization is increasing, research on its effectiveness is limited and the results are mixed. This study examined the persuasiveness of personalized e-mail newsletters in terms of increased attention, cognitive activity, evaluation, attitude, intention, and behavior by means of an experiment (n=109). Participants randomly received either a personalized or a generic newsletter advertising a sports center. Personalization triggered a more positive evaluation of the message; however, it did not influence the other effect variables. The effects were moderated by consumers' need for uniqueness, trust, and privacy concerns, suggesting that personalization is a good strategy to increase message evaluation only among individuals who have a high need for uniqueness.     

Divided attention years after severe closed head injury: the effect of dependencies between the subtasks

Lesions of white matter which connects distant brain areas are characteristic for closed head injury (CHI). It was predicted that this impairs divided attention only if dependent subtasks are used which require communication between corresponding brain processes. Fourteen chronic severe CHI patients (mean age 42 years) and 14 healthy controls, matched on age, gender, and education, participated in an experiment on divided attention. A typical left hemisphere task and a typical right hemisphere task must be simultaneously performed in a condition where they are completely independent and in conditions with dependencies between the tasks. Only in the dependent conditions the CHI group showed poor divided attention performance.     

Do patients with OCD and pathological gambling have similar dysfunctional cognitions?

The obsessive-compulsive spectrum disorder (OCSD) theory postulates that a wide range of disorders is closely related to OCD. Current cognitive models ascertain that certain beliefs leading to misinterpretation of the significance of intrusions are important in the etiology and maintenance of OCD. This study examined whether pathological gambling, a disorder belonging to the OC spectrum, is characterized by similar dysfunctional cognitions as OCD. Dysfunctional beliefs of OCD patients were compared to those of patients with pathological gambling, panic disorder and normal controls. These beliefs were measured by the Obsessive-compulsive Beliefs Questionnaire-87 (OBQ-87), which was developed by a group of leading OCD researchers [Behav. Res. Ther. 35 (1997) 667]. It was hypothesized that according to the OCSD theory, pathological gamblers would exhibit similar cognitions to OCD patients, as well as increased levels of OCD symptoms. Analysis showed that OCD patients exhibited higher OBQ-87 scores than both panic patients and normal controls, but equal to pathological gambling patients. Pathological gamblers exhibited, however, no increase in OCD symptoms. These mixed results do not seem to support the OC spectrum theory for pathological gambling, moreover being contradictory to contemporary cognitive OCD models.