Experiences and engagement with the design features and strategies of an internet-delivered treatment programme for generalised anxiety disorder: a service-based evaluation

Background: Outcome research has highlighted the efficacy of internet-based cognitive behavioural therapy (iCBT). Some process research has examined users experiences of iCBT. Understanding the user experience provides valuable feedback to developers of internet-delivered interventions.

Aim: The present study aimed to evaluate user's experiences and engagement with the design features of an internet-delivered treatment programme for anxiety.

Methods: Semi-structured interviews were conducted with 7 participant users of the Space from Anxiety programme. A thematic analysis framework was employed to analyse the data collected.

Results: Identified themes related to participants engagement and adherence with the programme material, participant's experience of personal development through interaction with the programme content and participants experience of the social features employed in the programme. Another theme investigated the various attributes or conditions necessary for internet-delivered therapy to be helpful to an individual.

Conclusion: Considering the experiences of users of online interventions provides insight into what works for whom both in terms of technological features and the various skills and strategies that may compose the treatment intervention. Knowing more about what design features and strategies/components of the intervention are attractive and keep users involved can only enhance the delivery of effective internet-delivered interventions for anxiety disorders.     

Treatment Effects for Common Outcomes of Child Sexual Abuse: A Current Meta-Analysis

The present meta-analysis examined the effects of psychosocial treatments at reducing deleterious outcomes of sexual abuse. The meta-analysis included a total of 35 published and unpublished studies written in English, focusing on youth under the age of 18, and evaluating the effectiveness of treatments for the most common negative outcomes of sexual abuse: PTSD symptoms, externalizing problems, and internalizing problems. Results revealed medium effect sizes for PTSD symptoms, externalizing problems, and internalizing problems following treatment for sexual abuse. This study also examined the potential moderating effects of treatment (e.g., modality, duration, inclusion of caregiver) and participant (e.g., age, gender, ethnicity) characteristics. Results indicated that longer interventions were associated with greater treatment gains while group and individual treatments were equally effective. These findings shed new light on treatment effectiveness and provide useful information regarding the conditions under which treatment may be most effective. Future directions for research in this area are discussed.     

Subjective discriminability of invisibility: A framework for distinguishing perceptual and attentional failures of awareness

Conscious visual perception can fail in many circumstances. However, little is known about the causes and processes leading to failures of visual awareness. In this study, we introduce a new signal detection measure termed subjective discriminability of invisibility (SDI) that allows one to distinguish between subjective blindness due to reduction of sensory signals or to lack of attentional access to sensory signals. The SDI is computed based upon subjective confidence in reporting the absence of a target (i.e., miss and correct rejection trials). Using this new measure, we found that target misses were subjectively indistinguishable from physical absence when contrast reduction, backward masking and flash suppression were used, whereas confidence was appropriately modulated when dual task, attentional blink and spatial uncertainty methods were employed. These results show that failure of visual perception can be identified as either a result of perceptual or attentional blindness depending on the circumstances under which visual awareness was impaired.     

LGB-Affirmative Cognitive Behavioral Treatment for Social Anxiety: A Case Study Applying Evidence-Based Practice Principles

Guided by the American Psychological Association's principles of evidence-based practice, this article reviews a single-case treatment outcome study whereby a client characteristic, sexual identity, was integrated into the assessment and treatment of social anxiety symptoms. The case involved a young adult European-American male who presented to a training clinic with a primary diagnosis of social anxiety disorder as well as secondary symptoms of excessive worry and concerns of sexual identity confusion. Recent evidence suggests that gay men report more symptoms of social anxiety when compared to heterosexual men, and those who make more efforts to conceal their sexual identity experience increased anxiety and have greater difficulty committing to a personal identity. Further, it has been hypothesized that fear of rejection from heterosexual individuals underlies this anxiety. The client attended 50 sessions over the course of 18 months. Treatment progress was assessed via self-report questionnaires assessing social anxiety and worry. Consistent with principles of evidence-based practice, a cognitive behavioral treatment protocol was employed at the outset of therapy and resulted in a decline in the client's social anxiety scores. However, once the case conceptualization and treatment focus shifted to focus on sexual identity, his scores continued to decline at an even steeper rate. He ultimately came to identify himself as having a same-sex sexual orientation, began living his life in a manner consistent with that identification, and reported a number of positive outcomes at termination of therapy. Implications for treatment of social anxiety in sexual minorities are discussed.     

Invariance and convergent and discriminant validity between mothers' and fathers' ratings of oppositional defiant disorder toward adults, ADHD-HI, ADHD-IN, and academic competence factors within Brazilian, Thai, and American children

Confirmatory factor analysis was used to test the invariance of an oppositional defiant disorder toward adults, attention-deficit/hyperactivity disorder-hyperactivity/impulsivity, attention-deficit/hyperactivity disorder-inattention, and an Academic Competence factor model between mothers' and fathers' ratings within Brazilian (n = 894), Thai (n = 2,075), and American (n = 817) children with the Child and Adolescent Disruptive Behavior Inventory (G. L. Burns, T. Taylor, & J. Rusby, 2001a, 2001b). The results showed invariance of item loadings, intercepts, and residuals, as well as factor variances, covariances, and means between mothers' and fathers' ratings within each sample. Convergent and discriminant validity was also observed for the between-parent factor correlations, thus providing additional support for the construct validity of the Child and Adolescent Disruptive Behavior Inventory. The confirmatory factor analysis invariance procedure provides a much better way to examine between-source ratings of behavior problems in children than do the simple correlation and raw discrepancy score procedures.     

Human Capabilities and the Ethics of Debt

The Journal of Value Inquiry -     

Inferior Frontal Regions Underlie the Perception of Phonetic Category Invariance

ABSTRACT— The problem of mapping differing sensory stimuli onto a common category is fundamental to human cognition. Listeners perceive stable phonetic categories despite many sources of acoustic variability. What are the neural mechanisms that underlie this perceptual stability? In this functional magnetic resonance imaging study, a short-interval habituation paradigm was used to investigate neural sensitivity to acoustic changes within and between phonetic categories. A region in the left inferior frontal sulcus showed a pattern of activation consistent with phonetic invariance: insensitivity to acoustic changes within a phonetic category and sensitivity to changes between phonetic categories. Left superior temporal regions, in contrast, showed graded sensitivity to both within- and between-category changes. These results suggest that perceptual insensitivity to changes within a phonetic category may arise from decision-related mechanisms in the left prefrontal cortex and add to a growing body of literature suggesting that the inferior prefrontal cortex plays a domain-general role in computing category representations.     

Synaesthesia: learned or lost?

The question why synaesthesia, an atypical binding within or between modalities, occurs is both enduring and important. Two explanations have been provided: (1) a congenital explanation: we are all born as synaesthetes but most of us subsequently lose the experience due to brain development; (2) a learning explanation: synaesthesia is related to some learning process during childhood. Three recent studies provide conflicting support for these explanations. Two studies supported the idea that synaesthesia is learned by showing that the frequency of everyday language implicitly modulates the synaesthetic experience. Another study argued that synaesthesia reflects basic, innate magnitude representations. In this paper we reassess these points of view, and show that it is possible for both to be valid. These findings are integrated into an interactive specialization account of development in order to explain the neuronal mechanism underlying synaesthesia.     

INCREASING AUTISTIC CHILDREN'S SPONTANEOUS VERBALIZATIONS OF AFFECTION: AN ASSESSMENT OF TIME DELAY AND PEER MODELING PROCEDURES

We assessed the efficacy of time delay and peer modeling procedures in increasing autistic children's spontaneous verbalizations of affection. Four autistic children were taught to spontaneously say “I like (love) you” in response to a hug from a familiar person and their mother. Generalization from a free play training setting to free play outdoors and at home was assessed. Ancillary social and affection behaviors were also observed. Results indicated that the time delay was a quick and effective procedure for all the children. Peer modeling was unsuccessful in teaching the target behavior.