Mindfulness‐based cognitive therapy is effective as relapse prevention for patients with recurrent depression in Scandinavian primary health care

This study examined the effectiveness of mindfulness‐based cognitive therapy (MBCT) in primary care for patients with recurrent depression (major depressive disorder: MDD). According to the World Health Organization (WHO), MDD is now the leading cause of disease burden in middle‐ and high‐income countries. Patients (N = 45) with three or more previous depressive episodes were recruited to participate in MBCT as a preventative intervention. Using a benchmarking approach, outcome data was compared with data from a recent efficacy study. The methodology is a rigorous approach to assessing effectiveness when evidence‐based UK protocols are transferred into the existing Scandinavian service delivery. Additionally, a person‐centred methodological approach was used to assess clinical significance on the Reliable Change Index (RCI). The analysis revealed comparable or larger effects from pre‐test to post‐test in reduced psychiatric symptoms, increased quality of life and level of mindfulness, and the effects were maintained over 14 months. Analysis of the relapse rate in the current study (16%) compared to the TAU in the efficacy study (68%) yielded an h value of 0.78, a moderate effect size. Only 13% dropped out of the treatment. According to the RCI findings, 65% to 67% of participants in the clinical group improved, no individual worsened, and women showed a significantly greater improvement of depression and anxiety than men. Therapeutic alliance and motivation had no impact on the outcome. The overall result suggests that MBCT can be implemented successfully in Scandinavian primary health care as a preventive intervention for patients with recurrent depression.     

Modeling within-subject dependencies in ordinal paired comparison data

This paper presents two probabilistic models based on the logistic and the normal distribution for the analysis of dependencies in individual paired comparison judgments. It is argued that a core assumption of latent class choice models, independence of individual decisions, may not be well-suited for the analysis of paired comparison data. Instead, the analysis and interpretation of paired comparison data may be much simplified by allowing for within-person dependencies that result from repeated evaluations of the same options in different pairs. Moreover, by relating dependencies among the individual-level responses to (in)consistencies in the judgmental process, we show that the proposed graded paired comparison models reduce to ranking models under certain conditions. Three applications are presented to illustrate the approach.This research was partially supported by NSF grant SBR-9409531. The authors are grateful to the reviewers, Alan Agresti and Herbert Hoijtink for their helpful comments on this research.     

Facial reactions to different emotionally relevant stimuli

Facial EMG activity was measured from the Corrugator supercilii and the Zygomatic major muscle regions while 48 subjects were exposed to pictures of angry and happy facial expressions, snakes and flowers as well as low and high preference nature scenes. The valency perspective predicted that facial reactions should be related to the intensity of the positive and the negative valency of stimuli. The mimicking behavior approach predicted that facial reactions should only be reflected as a mimicking response to the facial stimuli, whereas the evolutionary:biological perspective predicted that the most clearcut positive and negative facial reactions should be evoked by facial stimuli and by snakes. In support of the latter perspective, the present results showed that angry faces and snakes evoked the most distinct Corrugator supercilii muscle response, whereas happy faces evoked the largest Zygomatic major muscle response.     

The influence of cognitive set on performance and arousal under different noise loads

Three groups of 12 subjects each performed a mental arithmetic task while exposed to continuous white noise in two experimental sessions. In Session I, each group was exposed to a different noise level [56, 72.5, or 85dB(A)], whereas in Session II all had the medium [72.5 dB(A)] intensity. Arithmetic performance deteriorated with increasing noise intensity in Session I, and in Session II each group retained its position relative to the other two groups. Thus, the higher the noise intensity in the first session, the poorer the performance in the second session. These results suggest that the motivation and energy mobilized in Session II were determined by the cognitive set adopted to meet the demands of Session I. Arousal level, as measured by adrenaline excretion and heart rate, was higher during both experimental sessions than in a control session. The rise in adrenaline output was of the same magnitude regardless of the intensity of the noise, which indicates that the subjects adjusted to the increase in total load by slowing down their performance rather than by raising their energy mobilization. Heart rate rose in response to changes in noise level in Session II relative to Session I, regardless of the direction of the change.     

DURATION OF SCOTOPIC CONTRAST HUES

STABELL, U. & STABELL, B. Duration of scotopic contrast hues. Scand. J. Psychol. , 1971, 12, 106–112.–It is generally accepted that following intense and prolonged bleaching, regeneration of cone pigments in man takes a few minutes to reach completion. The results show that the scotopic hue may remain visible for more than one hour. Hence, it is suggested that light signals and not bleaching signals produce the scotopic contrast hues.     

Electro-aversion therapy of chronic alcoholism

Twenty-six male patients with severe chronic alcoholism were treated with electro-aversion therapy according to two different designs. At follow-up after 12 months, 24 per cent had not had any relapse requiring admissions to hospital, 12 per cent were lost during the follow-up period, and 64 per cent had relapses. Before treatment all the patients had been admitted to hospital several times a year.

Aversion therapy without supplementary treatment is indicated mainly for patients who have intact social relationships and regular work. Treatment of advanced states of alcoholism requires supplementary treatment in the form of anxiety-relieving methods, psychosocial support and teaching the patient new and alternative habits.     

Constrained latent class analysis: Simultaneous classification and scaling of discrete choice data

A reparameterization of a latent class model is presented to simultaneously classify and scale nominal and ordered categorical choice data. Latent class-specific probabilities are constrained to be equal to the preference probabilities from a probabilistic ideal-point or vector model that yields a graphical, multidimensional representation of the classification results. In addition, background variables can be incorporated as an aid to interpreting the latent class-specific response probabilities. The analyses of synthetic and real data sets illustrate the proposed method.The authors thank Yosiho Takane, the editor and referees for their valuable suggestions. Authors are listed in reverse alphabetical order.     

Maximum likelihood estimation of the polychoric correlation coefficient

The polychoric correlation is discussed as a generalization of the tetrachoric correlation coefficient to more than two classes. Two estimation methods are discussed: Maximum likelihood estimation, and what may be called two-step maximum likelihood estimation. For the latter method, the thresholds are estimated in the first step. For both methods, asymptotic covariance matrices for estimates are derived, and the methods are illustrated and compared with artificial and real data.This paper was read at the 1978 European Meeting on Psychometrics and Mathematical Psychology in Uppsala, Sweden, June 1978.Research reported in this paper has been supported by the Bank of Sweden Tercentenary Foundation under project Structural Equation Models in the Social Sciences, project director Karl G. Jöreskog.