Adherence predictors in an Internet-based Intervention program for depression

Internet-delivered psychotherapy has been demonstrated to be effective in the treatment of depression. Nevertheless, the study of the adherence in this type of the treatment reported divergent results. The main objective of this study is to analyze predictors of adherence in a primary care Internet-based intervention for depression in Spain. A multi-center, three arm, parallel, randomized controlled trial was conducted with 194 depressive patients, who were allocated in self-guided or supported-guided intervention. Sociodemographic and clinical characteristics were gathered using a case report form. The Mini international neuropsychiatric interview diagnoses major depression. Beck Depression Inventory was used to assess depression severity. The visual analogic scale assesses the respondent’s self-rated health and Short Form Health Survey was used to measure the health-related quality of life. Age results a predictor variable for both intervention groups (with and without therapist support). Perceived health is a negative predictor of adherence for the self-guided intervention when change in depression severity was included in the model. Change in depression severity results a predictor of adherence in the support-guided intervention. Our findings demonstrate that in our sample, there are differences in sociodemographic and clinical variables between active and dropout participants and we provide adherence predictors in each intervention condition of this Internet-based program for depression (self-guided and support-guided). It is important to point that further research in this area is essential to improve tailored interventions and to know specific patients groups can benefit from these interventions.     

Linguistic Alterity and the Multiplicitous Self: Critical Phenomenologies in Latina Feminist Thought

Latina feminists like Gloria Anzaldúa and Mariana Ortega have developed anti‐essentialist accounts of selfhood that are responsive to the problem of alterity and hermeneutic alienation experienced by multiplicitous subjects, understood as those who must navigate between multiple cultural norms and often conflicting interpretive traditions (due to colonial legacies and intersectional oppressions). These accounts can be fortified by examining the sense of inarticulacy that arises from having to name conditions of existence undergirded by social and historical contradictions and ambiguities—especially under the experiential stress of gendered social violence, cultural trauma, and state terror. To address phenomenological accounts of “linguistic terrorism” and the role language plays in multiplicitous accounts of selfhood, I turn to a strategic reading of Nietzsche's existential conception of the self as a living multiplicity, and to his related account of the impoverishment of language. In doing so, I argue more generally that philosophies of agency that critique agential narratives of rupture, instability, and interpretive loss (as part of liberal emancipatory projects) often do so without sufficient attunement to the ways concepts of alterity and liminality operate in North–South contexts or Latina feminist thought. I end by highlighting the critical, decolonial impetus of these concepts as responses to cultural violence.     

Group psychotherapy as taught by the polsters and the gouldings

Psychotherapy has been viewed by many as a subtle form of interpersonal persuasion. However, persuasion, or the lack of it, in a psychotherapy relationship is not always clearly definable. Most agree that persuasion is influenced by a number of important factors, of which the personal characteristics of the therapist are generally recognized as the most significant. Experience, credibility, training, dedication, values and enthusiasm are attributes usually agreed upon as being important contributors to the therapist's power to persuade. Understandably, psychotherapy conceptualized in this manner raises significant issues of values, ethics and responsibility in treatment. While not all agree or recognize persuasive influences existing in psychotherapy, it is suggested that persuasion is a salient feature of psychotherapy, whether or not it is identified as such. It is important to remember that in all psychotherapy, trouble is apt to follow the ignorant applications of important forces. Further, it is suggested that these persuasive influences cross doctrinal differences and can be augmented by applying them with a group psychotherapy setting. In the hands of a skilled and ethical psychotherapist, these persuasive influences can be enhanced and the group can become a powerful tool in the therapeutic process. These issues are explored in this paper in relation to two different group psychotherapy training experiences with Bob and Mary Goulding and Erv and Miriam Polster.     

“I definitely feel like a scientist”: Exploring science identity trajectories among Latinx students in a critical race theory-informed undergraduate research experience

The current study investigated science identity development among Latinx university students selected for a critical race theory (CRT)-informed undergraduate research experience. Twenty students (12 female, 8 male; M_age = 22.00; SD = 2.77) enrolled in biomedical-related majors at a 4-year university responded to open-ended questions regarding their identity as scientists at 2 weeks, 6 months, and 18 months after they began the program. Results illustrated a steady increase in the number of students identifying as scientists over 18 months. At 2 weeks into the program, only 35% of Latinx students felt like a scientist. At 6 months, 45% of Latinx students identified as a scientist. At 18 months, 70% of Latinx students reported feeling like a scientist. Results also revealed variation in science identity trajectories, with four trajectories viewed in the data: (1) consistent or fast achievement, (2) gradual achievement, (3) achievement adjustment, and (4) never reach achievement. The majority of students demonstrated a trajectory in which they reached science identity achievement (the feeling that they are “a scientist”). Our results provide evidence of the positive, longitudinal impact that a CRT-informed curriculum has on the science identity development of Latinx students. Implications surrounding future research and strategies to facilitate long-term Latinx student participation in the biomedical sciences are discussed.     

Those speedos become them: the role of self-objectification in gay and heterosexual men's body image

Objectification Theory proposes that membership in sexually objectifying Western societies gradually socializes women to adopt an observer's perspective on their physical self. This leads to negative consequences, including body shame and restricted eating behavior. The authors extend this framework to investigate a subgroup of men, namely gay men, who also exist in a subculture that emphasizes and values physical appearance. Study 1 investigated trait differences in self-objectification and body image among gay and heterosexual men. Analyses indicated that gay men scored higher on self-objectification, body shame, body dissatisfaction, and drive for thinness. In Study 2, the authors experimentally manipulated state self-objectification and found that for gay men, increasing state self-objectification resulted in greater body shame and dissatisfaction and more restrained eating. Together, these results offer strong support to Objectification Theory as a useful framework from within which to view the experience of gay men.     

Evidence-based practice implementation and staff emotional exhaustion in children's services

Understanding the implementation of evidence-based practice (EBP) in community service settings is critical for the successful translation of research to practice. However, we have limited research evidence about the impact of EBP implementation on the mental health and social service workforce. In a previous study we demonstrated reduced staff turnover where an EBP was implemented with fidelity monitoring in the form of supportive ongoing supervision and consultation. Other research has shown that staff burnout and emotional exhaustion in particular is associated with poor quality of care and increased staff turnover intentions and turnover. Current research, however, has focused less on the effects that EBP implementation may have on staff emotional exhaustion. The present study investigates the association of EBP implementation and fidelity monitoring with staff emotional exhaustion in a statewide EBP implementation study. The 21 case-management teams in this study were randomized in a 2 (EBP vs. services as usual [SAU]) by 2 (monitoring vs. no monitoring) design. The EBP in this study was SafeCare^®, a home-based intervention that aims to reduce child neglect in at-risk families. SafeCare was developed from a behavior analysis approach and is based in cognitive behavioral principles. In keeping with our previous research, we hypothesized that providers implementing SafeCare with monitoring would have the lowest levels of emotional exhaustion and those receiving additional monitoring not in the context of EBP implementation would have higher emotional exhaustion relative to the other groups. Results supported our hypotheses in that we found lower emotional exhaustion for staff implementing the EBP but higher emotional exhaustion for staff receiving only fidelity monitoring and providing SAU. Together, these results suggest a potential staff and organizational benefit to EBP implementation and we discuss implications of the findings relative to EBPs and to fidelity monitoring.     

Public Attitudes about Transgender Participation in Sports: The Roles of Gender,Gender Identity Conformity,and Sports Fandom

Sex Roles - We examine the roles of gender, gender attitudes, and interest in sports on public attitudes about transgender people’s participation in athletics. Using a representative survey...